Purpose:To evaluate the results of combination chemotherapy with MxFL[mitoxantrone(MIT),Fluaroracil (5 FU),Leucovorin (CF)]in the treatment of metastatic breast cancer.Methods:From 1993 through 1998,41 patients with metastatic breast cancer were enrolled in this study, Twenty six patients had no prior chemotherapy and 15 were had prior chemotherapy in nineteen patients estrogen receptor (ER) was positive. MIT 12 mg/m 2 by was given intravenous titrate the first day; continuous 5 FU 320 mg/m 2 by intravenous titrate the first day;continuous 5 FU 320 mg/m 2 by intravenous titrate was given for one hundred and twenty hours during the first day to the fifth day; at the same time, CF 50 mg/m 2 by intravenous titrate, once every twelve hours for five days. Repeated every three weeks. Results:Complete response was observed in 11 patients and partial response was observed in 19 patients with an overall response rate of 73.2%. The median response duration was 17 months and the median survival period was 23 months. The dose limiting toxicity was neutropenia which was seen in 85.4% of the treated cases (19.5% in grades Ⅲ and Ⅳ). Stomatitis was observed in 9.8% of the patients and local venous toxicity was observed in 12.2% of the patients. Conclusions:A high response rate is obtained in metastatic breast cancer treated by MxFL. Such treatment may be used as first line chemotherapy for metastatic breast cancer.

Objective:To investigate the clinical value ofplatelet distribution width ratio (RDW) and neutrophil lymphocyte ratio (NLR) in the prediction of coronary no reflow in patients treated with acute percutaneous coronary intervention (PCI).Methods:66 patients underwent emergency PCI treatment in our hospital from January 2016 December 2016 were selected as the research object,RDW and NLR of the patients before treatment were detected,and coronary no reflow phenomenon after emergency PCI rate were statistically calculated.RDW and NLR of patients with no reflow and normal blood flow were compared,the relationship between RDW and NLR with no reflow and the value of them predicting coronary no reflow were analyzed.Results:The incidence of coronary no reflow after emergency PCI was 30.30％ (20/66).Compared with patients with normal blood flow,the RDW and NLR of patients with coronary no reflow were elevate (P＜0.05).Spearman correlation analysis results showed that RDW and NLR were positively correlated with coronary no reflow (r=0.826,0.878,P＜0.05).Further ROC curve analysis showed that AUC of preoperative RDW combined with NLR predicting the postoperative coronary no reflow in patients treated with emergency PCI were higher than RDW and NLR alone.Conclusion:RDW and NLR in patients treated with emergency PCI were closely related to the postoperative coronary no reflow,which might be used as reference index for evaluation of coronary no reflow after emergency PCI.

Objective:To evaluate the efficacy of quantitative fecal immunochemical test (fecal immunochemical test, FIT) in the screening of colorectal cancer and precancerous lesions.Methods:47 243 patients who underwent quantitative FIT screening for colorectal cancer in the Health Management Department of Shenzhen People′s Hospital from January 2019 to October 2020 were enrolled as subjects. Colonoscopy was recommended for patients with positive quantitative FIT. A follow-up was done after one year to compare the results of the quantitative FIT positive group and the negative group after colonoscopy. Data were adjusted by propensity score matching method and a receiver operating characteristic curve ( ROC) was established to evaluate the diagnostic effect of quantitative FIT combined with colonoscopy on colorectal cancer and precancerous lesions. Results:A hemoglobin concentration>100 μg/L was set as a positive threshold. There were 2 472 positive cases of quantitative FIT, and the positive rate was 5.23%. After one-year follow-up, 284 patients had completed colonoscopy; the colonoscopy compliance was 11.49%. Of the negative population, 1 493 patients selected colonoscopy within one year. Compared with the results of gold standard colonoscopy, the sensitivity and specificity of quantitative FIT for screening for advanced adenoma and cancer were 26.53% and 86.54%, respectively. The sensitivity for colorectal cancer screening was 94.44% and screening for advanced adenoma was 22.77%. After propensity score matching, there were 256 FIT positive patients and 705 FIT negative patients. Colorectal cancer was the outcome variable, while FIT combined with colonoscopy, age combined with colonoscopy, and FIT combined with age combined with colonoscopy were the diagnostic indicators. The areas under the curve were 0.841(95% CI:0.778-0.904), 0.677(95% CI: 0.535-0.820), and 0.882(95% CI:0.807-0.958), respectively. Conclusion:Quantitative FIT has a high susceptibility to opportunistic screening for colorectal cancer, and a low sensitivity to advanced adenoma. At the same time, quantitative FIT combined with colonoscopy has a good diagnostic accuracy for colorectal cancer, which is better than the effect of using age as a cut-off point for colonoscopy. Quantitative FIT combined with age and colonoscopy has the best effect on screening for colorectal cancer. Quantitative FIT has a high sensitivity to colorectal cancer and a low sensitivity to advanced adenoma.

Objective? To investigate the prevalence, characteristics and influencing factors of violent behaviors in patients with schizophrenia during the onset stage of the disease in the community, and to provide targeted guidance for community and family when delivering care and rehabilitation for the patients. Methods? From March to July in 2018, a total of 235 newly admitted schizophrenic patients in two specialized hospitals and one general hospital in Zhanjiang city were selected by convenience sampling. By the use of the self-designed questionnaire, the main caregivers were investigated directly about the patients＇ general information, patients factors,family factors and violent behaviors. The influences of the patients factors and family factors on the violent behaviors were analyzed. A total of 226 properly filled questionnaires were retrieved. Results? Among the 226 patients, a total of 161 cases (71.24%) committed violence one week before admission in which 129 cases(57.08%) were general attack, and 32 cases (14.16%) were dangerous violence, 65 patients (28.76%) did not committed any violent behaviors. Ordinal Logistic regression analysis showed that the risk factors of the violence were the presence of conduct disorder before illness, previous verbal attacks, destruction of property, or personal attacks against others, as well as emotional vulnerability , verbal stimulation or behavior/action stimulation from surrounding environments(P＜0.05). Harmonious family relations and the main Guardians' good execution of doctors' advice were the protective factors (P＜ 0.05). Conclusions? Patients who have previously had verbal attacks,property damage, physical attacks against others, and who have behavioral disorders before illness should be the focus of community and family care. Creating a harmonious family and rehabilitation environment in community should be an important part of family and community care for schizophrenic patients. Health education of mental illness for patients, primary caregivers and community should be strengthened.