Objective To evaluate the efficacy and toxicity of the protocol of FOLFOX4 for advanced colorectal cancer. Methods 27 patients received FOLFOX4oxaliplatin 85 mg/m2 as a 2-hour infusion on day 1 and a 2-hour infusion of LV (200 mg?m-2?d-1) followed by a 5-Fu bolus (400 mg?m-2?d-1) and 22-hour infusion (600 mg?m-2?d-1) for 2 consecutive days every 2 weeks. Four courses were carried out with an interval of one month. Results The total effective rate was 44.44 %, CR(3.70 %), PR(40.74 %). Median survival of all patients was 10.0 months. Mean Survival was 11.5 months. One year survival rate was 30.02 %. Median duration of 12 effective patients were 5.3 months. Median survival of effective patients and non-effective was 11.8 and 8.5 months respectively(P

Objective To analyze the pathogenesis and prevention and treatment of limb deep venous thrombosis complicated by postoperative gynaecological malignant tumours.Methods A retrospective analysis of 22 cases with limb deep venous thrombosis complicated by postoperative gynaecological malignant tumours in our hospital were analyzed.According to the situation of patients,surgery or conservative treatment was conducted.The clinical efficacy after treatment was observed.Results In 22 cases,6 cases underwent surgical treatment,16 cases underwent conservative treatment.After treatment,18 cases were cured,3 cases were effective,1 case ineffective.After treatment,the TT,Pt,APTT and FBG levels were (24.17 ±2.13)s,(18.25 ±2.13)s,(31.68 ± 10.30)s and (2.26 ±0.52) g/L,which were all better than before treatment,the differences were statistically significant (t =10.362,9.774,12.281,8.462,P =0.028,0.032,0.012,0.029).Followed up for 3 months,no recurrence of LDVT was observed.Conclusion The cases of gynecological malignant tumor have higher risk of limb deep vein thrombosis,we should taken prevention actively,once diagnosed should take effective intervention measures to improve the prognosis.

Objective To investigate the clinical pathological characteristics, diagnosis and treatment of breast rhabdomyosarcoma, and to enhance the awareness of malignancy infiltration to bone marrow (BM). Methods The data of one case of Rhabdomyosarcoma of breast were analyzed retrospectively. BM aspirate and biopsy, morphology, immunology, cytogenetics, molecular biology (MICM) in different parts of BM, peripheral blood smear, fine puncture of breast mass, final biopsy of breast mass by Mammotome System and whole body PET-CT were performed. The immunochemistry stain of specimen of breast mass was used. Results The peripheral blood smear of this patient showed immature erythrocytes, leucocytes and classification of unknown cells which were consistent with BM morphology. The results of BM aspirate and biopsy depicted a hypercellular specimen with disseminated unknown cells infiltration. Unknown cells were positive for CD56 and negative for any hematopoietic markers by flow cytometry. The whole body PET-CT showed that uptake of 18F-FDG of bilateral breast and whole BM was increased, whereas the mass of breast was not presented by CT. PET-CT suggested a probable malignant hematologic disease. The enough specimen of breast mass got from Mammotome System showed embryonal rhabdomyosarcoma, and the tumor cells were positive for MyoD1, Vimentin and Desmin. Conclusions It is a challenge for early diagnosis of solid sarcoma with unknown origin which diffusely infiltrating into BM. Negative expression of hematopoietic markers by flow cytometry plays a role on differential diagnosis in this setting, whereas PET-CT only provides a valuable reference. Enough specimen and immunohistochemical staining could provide solid evidences of diagnosis.

Objective To explore the clinical features and causes of misdiagnosis of the patients with acquired deficiency of vitamin K-dependent coagulation factors (ADVKDCF). Methods Retrospective analysis was performed with the data from 62 patients with ADVKDCF for etiological factors, clinical manifestations,laboratory examinations, diagnosis and treatments. Results Among the 62 patients, 51 patients were with unknown causes( subgroup A) and 11 were with clear histories of anticoagulant rodenticide poisoning( subgroup B). The presentations of hemorrhage of the patients varied with hematuria as the most common first symptom,followed by skin, mucosa, muscle, internal organs bleeding (28/62). The most common hemorrhage symptom is hematuria. 35 of the 62 patients had hemoglobin(Hb) levels less than 100 g/L due to blood loss( the lowest level was 32 g/L). Thirty-eight patients were misdiagnosed at the first visit and the median time from hemorrhage manifestation to definite diagnosis was 8 days (range,2 to 192 days). ADVKDCF was mostly misdiagnosed as the urinary system diseases (23/38), followed by hemophilia (8/38). Laboratory examinations showed normal platelet count , throm bin time (TT) and normal fibrinogen(Fg) concentration, but prolonged plasma prothrombin time (PT), activated partial prothrombin time (APTT) and international normalized ration (INR). All of patients received high dose vitamin K ( intravenous vitamin K1 with a initial dose of 20 to 240 mg/d and then oral vitamin K4 maintenance) . The bleeding symptoms disappeared 1 day after treatment and the Hb levels increased dramatically. There were significant differences in PT, APTT and INR of the patients before and after treatment( P ＜0. 01 ). Followed by a median follow - up of 8 months , no patient had severe adverse effects or recurrence. Conclusion The hemorrhage presentations of the patients with ADVKDCF are various. The most common hemorrhage symptom is hematuria. The misdiagnosis rate of ADVKDCF is high with urinary systems disorders as the most common misdiagnosis. Sequential treatment with vitamin K is an effective and safe method to prevent recurrence. Early detection of coagulation function is helpful to reduce misdiagnosis possibility.

The study is aim to explore the value of surgical approach and related treatment in thyroid nodule.We searched Pubmed and CNKI by setting keywords "thyroid operation" from January 2006 to date,a total of 90 literatures were retrieved.Inclusion criteria were as follows:variety surgical treatment of thyroid nodule;methods and effects of integrative medicine of thyroid disease.39 studies met the inclusion criteria.Different surgical treatments of thyroid nodule had advantages and disadvantages and should be selected according to the specific condition of the patients.Priority should be given more effective,less invasive,less painful,more beautiful and low-cost surgery.The depth study of features of surgical treatment of thyroid nodule will help provide a better reference for clinical treatment.

Objective:To explore the effect of follow-up management of the use of insulin pumps outside hospital led by diabetes specialist nurses in type 2 diabetic patients.Methods:From April 2018 to March 2020, convenience sampling was used to select patients with type 2 diabetes who used insulin pumps in the First Affiliated Hospital of Xinxiang Medical University as the object. The patients ( n=104) enrolled from April 2018 to March 2019 were set as control group receiving conventional out-of-hospital follow-up management of insulin pump use, and patients ( n=152) enrolled from April 2019 to March 2020 were set as observation group adopted out-of-hospital follow-up management of insulin pump use led by diabetes specialist nurses, and the observation lasted for three months. The differences in fasting blood glucose, glycosylated hemoglobin, Scale of the Diabetes Self-Care Activities (SDSCA) score and the Exercise of Self-Care Agency Scale (ESCA) score, and insulin pump-related negative events were compared between the two groups of patients. Results:Before intervention, there was no significant difference in fasting blood glucose, glycosylated hemoglobin, SDSCA score, and ESCA score between the two groups ( P>0.05) . After intervention, the fasting blood glucose and glycosylated hemoglobin of observation group were lower than those of control group, and the scores of SDSCA and ESCA were higher than those of control group, and the differences were statistically significant ( P<0.05) . The fasting blood glucose and glycosylated hemoglobin of observation group after intervention were lower than those before intervention, and the scores of SDSCA and ESCA were higher than those before intervention, and the differences were statistically significant ( P<0.05) . In control group, there were 17, 23, and 14 cases of pipeline obstruction, hypoglycemia, injection site infection or induration respectively, and observation group had 8, 7, and 5 cases of pipeline obstruction, hypoglycemia, injection site infection or induration respectively; incidences of insulin pump-related negative events of control group and observation group were 51.92% and 13.16% respectively, and the difference was statistically significant ( P<0.05) . Conclusions:Follow-up management of out-of-hospital insulin pump use led by diabetes specialist nurses can increase the insulin adjustment self-efficacy of type 2 diabetic patients, effectively control blood glucose and glycosylated hemoglobin, improve self-behavior management and nursing ability, and reduce the occurrence of insulin pump-related negative events.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.