Objective To assess the risk factors of pulmonary infection in patients with cerebral hemorrhage,and then to provide references for policy-making.Methods Relative literature of crosssectional or case-control studies about risk factors of pulmonary infection in patients with cerebral hemorrhage was searched by computer in data bases such as CNKI,VIP,CBM,WanFang Data and PubMed from January of 1994 to October 2014.Resluts A total of 22 studies (2 case-control studies and 20 crosssectional studies) were brought into the study.The risk factors' OR and its 95％CI was 2.64(2.10-3.33) for over 60 years of age,2.05(1.56-2.69) for smoking history,3.07(2.24-4.19)for those who have diabetes,3.36 (2.40-4.70) for those who have chronic pulmonary diseases,1.54 (1.16-2.05) for those who have heart diseases,2.38 (1.83-3.08) for those who have a history of stroke,5.07 (3.15-8.16) for disorder of consciousness,2.78(2.36-3.27) for amount of bleeding over 30ml,2.85(2.22-3.66) for deviated from midline,2.58 (1.60-4.17) for breaking into ventricle,2.05(1.67-2.51) for high level of fasting blood sugar respectively,and so on.Conclusions Prophylactic measures can be carried out according to the risk factors of pulmonary infection in patients with cerebral hemorrhage,and then to reduce the incidence rate of pulmonary infection.

Comparing the definition,classification,quantity,core capacity construction and the supervision mode of Chinese and the United States specialist nurses,there was a gap between them.The training for the specialist nurses in China was at the initial stage.The advanced experience should be learned from America to provide the reference for building the core capacity and supervision mode of the specialist nurses.

Objective To evaluate the effect of combination treatment by psychological intervention and a new atypical antipsychotic Paliperidone extended-release tablets(paliperidone ER)on first-episode schizophrenic out-patients.Methods All 62 patients diagnosed as first-episode schizophrenia by DSM-Ⅳ were randomly allocated into,combination treatment group and control group,for a 12-month treatment study.The combination treatment group was treated by paliperidone ER once a day and psychological counseling once a month,while the control group was treated only by paliperidone ER.The efficacy and social function were assessed by Positive and Negative Syndrome Scale(PANSS)and Personal and Social Performance Scale(PSP)individually at baseline,and following 1,3,6,9,12 months.The remission rate was calculated at the end of the 3rd,6th,9th month.The safety and tolerability were assessed using Barnes Akathisia Scale(BARS),extrapyramidal side effects scale(SAS)and involuntary movement scale(AIMS).Results Twenty-seven patients of combination treatment group and seventeen patients of the control group completed the trial with the discontinuation rate 12.9% and 45.2%,respectively.The difference between the above two groups was statistically significant(P＜0.05).The mean total score of PANSS and the PSP of the both groups were significantly improved(P＜0.05)after treatment.PANSS total score reduced more than 30% compared with baseline,and PSP total score increased more than 7.The remission rate of combination treatment group was 74.2%,51.6% and 67.7% at the end of 3rd,6th,and 9th month,which was better than the control group(45.2%,38.7% and 38.7%)(P＜0.05).Both incidence and types of adverse events were almost same between the two groups.The major adverse events were extrapyramidal symptoms,tachycardia,gastrointestinal discomfort and akathisia.Conclusion Paliperidone ER treatment combined with psychological intervention on first-episode schizophrenia out-patients can improve their treatment compliance by reducing the discontinuation rate.And this combination treatment can increase the remission rate and improve social functioning of the patients.

Objective To investigate the expression fragile histidinetriad (FHIT) protein in cervical carcinoma and its relationship with clinicopathological feature of the disease. Methods Immunohistochemistry SP was used to detect the expression of FHIT protein in 20 cases with chronic cervsis and 95 cases with Ⅰ aⅢ b stage cervical carcinoma before and after treatment. The association of the expression of FHIT with clinicopathological feature was analyzed by the statistical method. Results There were significant differences between FHIT expression and histological grades and types of tissue, lymph node metastasis and invade depth (P ＜0.05). FHIT expression was not correlated with age and clinical stage (P ＞0.05). There were significant differences in FHIT protein expression levels in the patients with cervial cancer between before-after radiotherapy and the levels before radiotherapy was lower then those after radiotherapy (P ＜0.05). There was positively correlated in FHIT protein expression rates before and after radiotherapy (P ＜0.05). There were significant correlation between FHIT expression and 3-year survival rate, the positive rates of the expression FHIT protein higher then negative ones (P ＜0.05). Conclusion FHIT protein has great reference value that could be as a parameter for evaluating biological action and predicting the prognosis of cervical cancer.

OBJECTIVEThe efficacies of the selective 5-hydroxytryptamine3 (5-HT3) antagonists--ramosetron (0.3 mg) and granisetron (3 mg) in treating acute chemotherapy-induced digestive system dysunction were compared.

METHODSA total of 111 patients were enrolled in a single-blind, randomised crossover study; with data from 98 were used to assess efficacy and data from 110 to assess the safety profile. Ramosetron or granisetron was given intraveneously 15 min befire chemotherpy.

RESULTSThe ability of ramosetron to prevent emesis, nausea and anorexia was similar to granisetron during the first 6 h following the administration of chemotherapy, ciplatin or doxorubicin. However, during the first 24 h after chemotherapy, significant differences between ramosetron and granisetron appeared: emetic episode (P = 0.068), nausea (P = 0.006), and anorexia (P = 0.048) remained lower in ramosetron-treated patients. The safety profile of ramosetron was similar to that of granisetron and adverse events in both groups were generally mild and transient.

CONCLUSIONRamosetron is more potent and longer-lasting than granisetron in preventing chemotherapy-induced digestive disturbances.

Adolescent ; Adult ; Aged ; Anorexia ; chemically induced ; drug therapy ; Antiemetics ; therapeutic use ; Antineoplastic Agents ; adverse effects ; Benzimidazoles ; therapeutic use ; Cisplatin ; adverse effects ; Cross-Over Studies ; Doxorubicin ; adverse effects ; Female ; Granisetron ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Nausea ; chemically induced ; prevention & control ; Serotonin Antagonists ; therapeutic use ; Single-Blind Method ; Vomiting, Anticipatory ; etiology ; prevention & control

Objective: To investigate the feasibility of multiplex real-time RT-PCR with fluorescent probes in early screening of Ph-like acute lymphoblastic leukemia (ALL) and analyze the clinical feature and prognos. Method: A total of 118 adult B-ALL patients diagnosed between October 2010 and March 2016 were enrolled in this study. Multiplex RT-PCR was used to detect the Ph-like ALL related fusion gene and CRLF2 expression in 58 BCR-ABL and MLL rearrangement negative patients. The clinical features, treatment response and prognosis were analyzed in Ph-like fusion gene positive and/or CRLF2 over-expression patients. Result: Among 58 patients, 9 patients (9/58, 15.5%) showed Ph-like ALL related fusion genes positive and 10 patients (10/58, 17.2%) showed CRLF2 over-expression. There were statistical differences in age, WBC count, immunophenotypes, cytogenetics and risk stratification among Ph-like fusion gene positive or CRLF2 over-expression patients, Ph⁺ patients, MLL⁺ patients and B-other patients. The 2-year overall survival rates were 65%, 47%, 64% and 74% respectively among these four groups (P=0.043) . The 2-year relapse free survival rates were 51%, 39%, 62% and 70% respectively among these four groups (P=0.010) . Conclusion Routine screening of Ph-like ALL by multiplex RTPCR is feasible.

OBJECTIVETo evaluate the efficacy and safety of nausea oral, disintegrating buccal tablet (DBT) in the prevention of gastrointestinal reaction induced by anticancer drugs (cisplatin DDP 30 - 50 mg/m(2) or adramycin ADM >/= 40 mg/m(2)), as compared with those of kytril tablets.

METHODSA multicenter, open and randomized self-crossover control trial was carried out with all the eligible patients randomized into AB or BA group. Patients in AB group were given nausea 0.1 mg as buccal tablet one hour before chemotherapy in the first cycle and kytril tablet 2 mg in the second cycle, those in BA group were given these drugs in the reverse order.

RESULTSSeventy-three patients were allotted to this study, including 44 patients in DDP-arm and 29 in ADM-arm. Sixty-two patients were evaluable for response and 70 patients for safety. Nausea DBT was as effective as kytril tablet in the control of anorexia, nausea and vomiting during the first 24 hours after chemotherapy, with response rates of 74.2%, 77.4%, 83.9% in nausea DBT and 74.2%, 71.0%, 88.7% DBT in kytril tablets. A high efficacy in the control of vommitting induced by cisplatin was observed in both nausea DBT and kytril tablets. The complete control rates and overall control rates were 83.3%, 91.7% in nausea DBT and 86.1%, 97.2% in kytril tablets, respectively. The side effects of nausea DBT were head heaviness, dry mouth and somnolence, which were mild and comparable with kytril in their frequencies.

CONCLUSIONNausea disintegrating buccal tablet is able to effectively prevent gastrointestinal reaction induced by anticancer drugs, with efficacy and side effects similar to kytril tablets. Nausea DB tablet, an intraoral disintegrator, is very convenient for patients who can not swallow tablets for various reasons.

Adolescent ; Adult ; Aged ; Antiemetics ; therapeutic use ; Antineoplastic Agents ; adverse effects ; Cisplatin ; adverse effects ; Digestive System ; drug effects ; Doxorubicin ; adverse effects ; Female ; Granisetron ; therapeutic use ; Humans ; Male ; Middle Aged ; Nausea ; chemically induced ; drug therapy ; Ondansetron ; Tablets ; Treatment Outcome ; Vomiting ; chemically induced ; drug therapy

Objective: To investigate the clinical characteristics, diagnosis, treatment and prognosis of therapy-related myeloid neoplasms (t-MNs) after successful treatment for acute promyelocytic leukemia (APL) . Methods: Clinical data of 4 patients, diagnosed as t-MNs secondary to APL at Hematology Hospital of Chinese Academy of Medical Sciences from October 2012 to January 2019, were collected retrospectively. T-MNs related literature was reviewed. Results: The 4 cases were all females, with the median age 42 (range 40-53) years old at the diagnosis of APL. Regarding the induction and consolidation regimens, 3 patients received all-trans retinoid acid (ATRA) and arsenic trioxide (ATO) combined with anthracycline/anthraquinone and/or cytosine. One patient only received ATRA and other auxiliary drugs. Alkylating agents were not administrated. The 4 patients developed t-MNs 40 to 43 months after complete remission (CR) of APL, including 1 case of therapy-related myelodysplastic syndrome (t-MDS) and 3 cases of acute myeloid leukemia (t-AML) . The PML-RARα fusion genes were all negative when t-MNs developed. The three patients with t-AML were treated with 3 to 4 re-induction regimens, one of whom underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after complete remission (CR) . One patient with t-MDS received hypomethylating agents. After a median follow-up of 54.5 (48-62) months, 2 patients with t-AML died, the median overall survival after t-MN was 12 (5-18) months. From 1989 to 2018, a total of 63 t-MN cases were reported in the literature. Therefore, 67 cases were analyzed when four patients in our center were added, including 27 males and 40 females with median age 52.5 (15-76) years. The median latency was 39 (12-126) months and the median overall survival after diagnosis of t-MN was 10 (1-39) months. Conclusions Although rare, t-MNs may occur after successful control of APL. There are no existing guidelines for prevention and treatment of t-MNs, which have very poor prognosis. If cytopenia or other abnormalities of peripheral blood cells develop after 3 years of APL, t-MNs should be considered as a differential diagnosis.