Objective:To compare the clinical efficacy of oxycodone hydrochloride controlled-release tablets (OHCT) and pa-tient-controlled intravenous analgesia (PCIA) in the treatment of intractable cancer pain. Methods:Retrospective analysis was conduct-ed to evaluate the intractable cancer pain of 89 elderly patients who were admitted to the medical oncology departments of The Second Affiliated Hospital of Fujian Medical University and the Fuzhou General Hospital of Nanjing Military Command between September 2012 and March 2014. Among the 89 patients, 47 were treated with OHCT, and 42 received PCIA. The total dosage ranged from 60 mg/d to 400 mg/d PO q12h for patients in the OHCT group, whereas abackground dose+patient-controlled dosemode was adopted for patients in the PCIA group. The therapeutic efficacy, presence of adverse reactions, cost of treatment, and degree of patient satisfaction were compared between the two groups. Results:The average dosages of analgesics in the two groups were almost the same (P>0.05). Visual analogue scale (VAS) values and daily average VAS values were both lower in the PCIA group than in the OHCT group at 24 h after analgesia (P<0.05). The incidence of adverse reactions, such as nausea and vomiting, was also lower in the PCIA group than in the OHCT group (P<0.05). The cost of treatment and degree of patient satisfaction were the same in both groups (P>0.05). Conclusion:Pa-tients who received PCIA attained better analgesia and exhibited less adverse reactions than those who received OHCT whereas the treatment cost and patient satisfaction did not differ in both groups.

Objective:To understand the clinical features and risk factors of the first seizures in children with febrile seizures, to guide clinicians to take appropriate intervention measures for children with risk factors, and to reduce the incidence of febrile seizures.Methods:A total of 616 children with first-onset febrile seizures admitted in our hospital from August 2016 to August 2018 were enrolled in this study.The clinical characteristics and risk factors of first-onset seizures were retrospectively analyzed.And 601 children with fever but no seizures were randomly selected as the control group.Results:There were 616 children with febrile seizures, including 344 males and 272 females, 584 Hans and 32 Mongolian.A total of 126 cases (20.5%) were under 1 year old, 405 cases (65.8%) were 1-3 years old, and 85 cases(13.7%) were over 3 years old.The upper third of the episodes were acute upper respiratory tract infections[53.6%(330/616)], herpetic angina[25.9% (160/616)], and infant acute rash[10.5%(65/616)]. There were 570 cases(92.5%) with seizures at 38.0 ℃ and above, 16 cases(2.6%)had fever after seizures.A total of 534 cases(86.7%) had seizures within 24 hours of fever, and 608 cases(98.7%) presented with a generalized seizures.The duration of seizures was less than 5 min in 548 cases (89.0%), 5-14 min in 48 cases (7.8%), 15-29 min in 16 cases (2.6%) and more than 30 min in 4 cases (0.4%). Of the 572 patients (92.9%), only one seizure occurred in a single heat stroke.In the clinical type, simple febrile seizures accounted for 88.3%(544/616), complex febrile seizures accounted for 11.0%(68/616), and seizures persisted in 0.7%(4/616). Risk factors analysis showed that age, low sodium, low iron and low zinc, cesarean section, abnormal birth history, vaccine exposure history one week before convulsion, and family history of febrile seizures were statistically different between the febrile seizure group and the control group( P<0.05). Logistic regression analysis found that the age of first febrile seizures, low iron, cesarean section, low sodium and family history of febrile seizures were the independent risk factors for the first episode of febrile seizures ( P<0.05). Conclusion:The first episode of febrile seizures are more common in infants and young children under 3 years old.It is mainly caused by simple febrile seizures.The temperature of seizures is high and it is easy to occur within 24 hours after fever.Viral infection is the most common cause.The risk factors for the first episode of febrile seizures are episode age, low iron, cesarean section, low sodium and family history of febrile seizures.Taking appropriate interventions for risk factors can reduce the incidence of febrile seizures.

Objective:To evaluate the clinical efficacy,toxicity,and prognostic factors of nab-paclitaxel as first-line treatment for elderly patients with advanced lung squamous carcinoma.Methods:This was a prospective study.Forty patients enrolled in the Second Affili-ated Hospital of Fujian Medical University were treated with nab-paclitaxel(260 mg/m2,ivggt d1),and a period of three weeks was considered as one session.The effects were evaluated after two cycles.Results:All 40 patients were followed up and appraised.Two patients achieved complete remission,13 achieved partial remission,13 achieved stable disease,and 12 achieved progressive disease. The objective response rate was 37.5% and the disease control rate was 70.0%.The progression-free survival(PFS),median overall sur-vival,and 1-year survival rate was 6.3 months,12.6 months,and 62.5%,respectively.The main hematologic toxicities were neutrope-nia and anemia,and the main non-hematologic adverse events were fatigue,constipation,nausea,vomiting,muscle aches,and hear-ing loss.Most patients could tolerate these toxic reactions.Moreover,Cox multivariate regression analysis showed that the neoplasm stage,Eastern Cooperative Oncology Group performance status,response rate,and PFS were independent factors for the survival rate (P<0.05),while age was not related to patient prognosis(P>0.05).Conclusions:Nab-paclitaxel as single drug and first-line therapy for elderly patients with advanced lung squamous carcinoma is effective and safe.

[摘 要] 目的：探讨卵巢癌组织中PD-L1与唾液酸结合性免疫球蛋白样凝集素15（Siglec-15）的关系及其临床意义以及两者对卵巢癌SKOV3细胞增殖、迁移及侵袭的影响。方法：收集2017年1月至2019年12月福建医科大学附属第二医院妇科50例手术切除的卵巢癌组织和配对输卵管组织的石蜡包埋标本，采用免疫组化染色Envision法检测癌组织和输卵管组织中PD-L1和Siglec-15的表达水平，Kaplan-Meier生存曲线和Logistic回归分析PD-L1和Siglec-15表达与患者预后的关系。利用瞬时转染技术在卵巢癌细胞SKOV3中分别转染si-PD-L1和si-NC，用qPCR和WB法检测SKOV3细胞中PD-L1的表达对Siglec-15的影响，用CCK-8及Transwell法验证PD-L1及Siglec-15表达对SKOV3细胞增殖、迁移及侵袭的影响。结果：50例卵巢癌组织中，PD-L1与Siglec-15均呈高表达（50.00%与42.00%）。PD-L1表达与肿瘤病理类型、有无腹水、淋巴结转移、FIGO分期及卵巢癌复发与否具有关联（均P<0.05）；Siglec-15表达与卵巢癌患者淋巴结转移及FIGO分期具有关联（均P<0.05）。成功构建PD-L1低表达SKOV3细胞株，降低PD-L1表达可使Siglec-15表达升高。结论：PD-L1和Siglec-15在卵巢癌组织中均有较高的阳性表达率，PD-L1是卵巢癌复发的独立风险因素。PD-L1和Siglec-15两者的表达呈负相关，降低PD-L1表达可使Siglec-15表达水平升高而抑制SKOV3细胞增殖、迁移和侵袭的能力。

[摘 要] 目的： 探讨程序性死亡蛋白-配体1（programmed death ligand-1，PD-L1）和肿瘤浸润淋巴细胞（tumor-infiltrating lymphocyte, TIL）在三阴性乳腺癌（triple-negative breast cancer，TNBC）组织中的水平及其临床意义。方法：收集2015年1月至2019年1月福建医科大学附属第二医院手术切除的61例TNBC患者的癌及癌旁组织石蜡标本，用免疫组化法检测癌组织中PD-L1表达和CD8+ TIL的水平，用卡方检测方法分析TNBC组织中PD-L1和CD8+ TIL水平与患者临床病理特征及预后的关系。结果： PD-L1和CD8+ TIL在TNBC组织中的阳性率分别为63.9%（39/61）和32.8%（20/61）。PD-L1表达与TNBC患者的肿瘤大小、淋巴结转移、病理分期、复发与否有明显关联（均P<0.05），与患者的年龄、肿瘤分化程度、脉管侵犯以及Ki67表达水平无明显关联（均P>0.05）；CD8+ TIL水平与TNBC患者的肿瘤大小、肿瘤分化程度、淋巴结转移、病理分期、复发与否有明显关联（均P<0.05），与患者的年龄、脉管侵犯以及Ki67表达水平无明显关联（均P>0.05）。PD-L1和CD8+ TIL水平与患者的无进展生存期（PFS）及总生存期（OS）具有显著相关性（均P<0.05），PD-L1+或者缺乏CD8+ TIL与患者更差的PFS及OS相关（均P<0.05）。结论：TNBC组织中存在较高水平的PD-L1和CD8+ TIL，PD-L1阳性表达或缺乏CD8+ TIL与肿瘤侵袭性增加相关，也与患者更差的PFS及OS相关。