1.Skin adverse reactions to afatinib and their correlation with anti-lung cancer efficacy
Meihong DA ; Meiqi SHI ; Qiao YAN ; Haijing YANG ; Zhengbang DONG ; Fei WANG
Chinese Journal of Dermatology 2021;54(1):64-67
Objective:To investigate the type and severity of skin adverse reactions induced by afatinib in the treatment of lung cancer, and to analyze their correlation with anti-lung cancer efficacy.Methods:A case-case-control study was conducted on lung cancer patients treated with afatinib in ZhongDa Hospital, Southeast University from December 2016 to January 2018. The type and severity of skin adverse reactions were evaluated in 76 patients with lung cancer based on the National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 4.0, and these patients were divided into 3 groups according to the severity of skin lesions, including grade-0, -1, and -2/3 groups. The patients underwent chest computed tomography (CT) examination every 3 months, and the tumor response to afatinib was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) . Anti-lung cancer efficacy of afatinib was compared among the patients with different grades of skin lesions by using the Kruskal-wallis H rank sum test. Results:After treatment with afatinib, 44 of the 76 patients with lung cancer achieved stable condition or partial remission, and 32 experienced disease progression. Skin adverse reactions occurred in 69 patients, and manifested as acneiform lesions in 42 (55.3%) patients, paronychia in 35 (46.1%) , mucosal erosions in 30 (39%) , hair changes in 8 (10.5%) , and hand-foot syndrome in 6 (7.9%) . Improvement was achieved in 3, 7 and 34 cases in the grade-0, -1, and -2/3 groups ( n = 7, 19 and 50 respectively) , respectively. There was a significant difference in the response rate among the 3 groups ( χ2 = 6.117, P = 0.047) , and the response rate was significantly higher in the grade-1 and -2/3 groups than in the grade-0 group (both P < 0.001) , and higher in the grade-2/3 group than in the grade-1 group ( P < 0.001) . Conclusion:The treatment of lung cancer with afatinib can cause various types of skin lesions, such as acneiform lesions, paronychia, mucosal erosions, hair changes and hand-foot syndrome, and the higher the severity of the skin lesions, the more marked the anti-lung cancer efficacy of afatinib.
2.Application of the Peabody developmental motor scale in the assessment of neurodevelopmental disorders in premature infants
Meiqi WANG ; Hua MEI ; Chunzhi LIU ; Yayu ZHANG ; Huixian LI ; Fei YAN
Chinese Pediatric Emergency Medicine 2017;24(10):760-763
With the progress and development of perinatal medicine,the survival rate of preterm infant has been increased significantly. Early complications of premature infants could be effectively con-trolled,but some surviving premature infants left cerebral palsy,motor development retardation,visual impair-ment and other neurodevelopmental disorders,which seriously affected the quality of life.As a part of the neonatal physical examination,Peabody developmental motor scale plays an increasingly important role in understanding the early intelligence development,behavioral capacity,and neurological development of newborns.This paper reviewed the application of the Peabody developmental motor scale in the assessment of neurodevelopmental disorders in premature infants.
3.Influence of dietary factors on radius speed of sound in female college students
ZHOU Meiqi, WANG Yan, SUN Lei, ZHANG Shu, YOU Ting, TIAN Su
Chinese Journal of School Health 2021;42(1):61-64
Objective:
To understand the level of radius speed of sound (SOS) in female college students and explore the effect of dietary on their bone health,so as to provide a reference for effective prevention fracture and osteoporosis among college students.
Methods:
A total of 363 female college students were selected by multistage stratified random sampling method. Dietary intake was assessed with a self-administered food frequency questionnaire, principal component analysis was used to derive dietary patterns. Speed of sound was measured by ultrasonic bone densitometer.
Results:
In all, the mean SOS of female college students was(4 138.0±114.3)m/s, 26.7% of female college students had low bone mass. Three dietary patterns were identified by factor analysis, explaining 55.4% of the diet variation: "snack" "plant" "high protein and high fat" patterns, respectively. Multiple linear regression analysis showed that with the increase of age, the level of SOS in radius increased significantly; and snacks consumption was negatively associated with the level of SOS(β=13.23, -0.47, P<0.05).
Conclusion
University stage is still the critical period of bone mass accumulation for female, snacks consumption may have a negative impact on bone health, so it is necessary to carry out nutrition education to help improve health awareness, promote health eating, and lead health lives to prevent osteoporosis.
4.Investigation and analysis of digestive endoscopy nurses′acquisition of specialist knowledge
Xiaofan YU ; Xiu WANG ; Yue WANG ; Meiqi WANG ; Yan ZHOU
Chinese Journal of Modern Nursing 2016;22(12):1711-1713,1714
Objective To understand the digestive endoscopy nurses acquisition of specialized knowledge for providing reasonable training measures for digestive endoscopy nurses .Methods Using self-designed digestive endoscopy nurse specialist knowledge questionnaire , digestive endoscopy nurses professional training questionnaire survey was conducted among 95 nurses in Jilin province in July 2015.Results Specialized knowledge score of the 95 nurses was (19.97 ±3.37), with the correct rate 73.96%, in which self-protection dimension was 85.60%as the highest one, and digestive endoscopic surgery nursing cooperation dimension was 58.50%as the lowest. Different level hospitals , different ways of employment and whether the digestive endoscopy nurses ever participated in the digestive endoscopy training influenced the specialist knowledge score ( P <0.05 ). Conclusions Acquisition of specialist knowledge of digestive endoscopy nurses in the survey is in the medium level, thus it is imperative to strengthen the digestive endoscopy nurse specialist knowledge training .Various forms to carry out the specialized knowledge and skills training which can meet the needs of digestive endoscopy nurse training and improve their specialized knowledge and skill levels should be adopted .
5.The diagnostic evaluation value of multidetector CT,CT cholangiography and CT angiography pre-postreatment for advanced hilar cholangiocarcinoma
Ping LIANG ; Jinhua CAI ; Gengrui CHEN ; Lin DENG ; Xiaoyun YAN ; Guangren HUANG ; Meiqi LIANG ; Yan ZHANG ; Zhongkui HUANG
Journal of Practical Radiology 2024;40(9):1459-1462
Objective To explore the application value of multidetector computed tomography(MDCT),computed tomography cholangiography(CTC)and computed tomography angiography(CTA)reconstruction technology in the diagnosis and classification and the evaluation of the efficacy of biliary drainage in advanced hilar cholangiocarcinoma(HCCA).Methods A total of 44 patients of inoperable advanced HCCA were collected.Conventional CT plain scan and enhanced multi-phase scan were performed before treat-ment.Minimum intensity projection(MinIP)combined with curve planar reformation(CPR)was used to perform CTC.CTA of the portal vein,hepatic artery and hepatic vein were performed by maximum intensity projection(MIP),volume rendering(VR)or CPR,respectively.CT was reexamined after biliary drainage treatment.The study included the comparison between reconstruction technology of CTC and CTA and conventional CT scanning technology,CTC in the classification and diagnosis of HCCA,CTA in the evaluation of vascular invasion,and the evaluation of the effect of jaundice drainage by biliary imaging before and after biliary drain-age treatment.Results All HCCA cases obtained clear location diagnosis,including 39 cases of Bismuth-Corlette type Ⅳ and 5 cases of type Ⅲ.There were 40 cases of hepatic vascular involvement,including 15 cases of bilateral portal vein invasion by tumor,12 cases of portal vein constriction,8 cases of portal vein tumor thrombosis,4 cases of bilateral hepatic arteries involvement,and 1 case of hepatic vein involvement.CTC and CTA could better display a full view of the bile duct and blood vessel than conventional CT scanning ima-ges,and provided more accurate analysis of tumor classification and degree of vascular invasion.Before treatment,CT showed severe dila-tion of bile duct in 21 cases and moderate dilation in 20 cases,severe dilation of the intrahepatic bile duct in the left lobe but mild dilation of the intrahepatic bile duct in the right lobe in 3 cases.After drainage treatment,the contraction rate of intrahepatic bile duct dilation was<25%in 4 cases,25%to 49%in 13 cases,50%to 74%in 18 cases,and ≥75%in 9 cases.The bile duct contraction rate was positively correlated with the decrease in total bilirubin(TBIL).Conclusion MDCT,CTC and CT A reconstruction technology can well complete the diagnosis of advanced HCCA,Bismuth-Corlette typing,and vascular evaluation.Observing the contraction rate of the intrahepatic bile duct after biliary drainage treatment can evaluate the efficacy of jaundice drainage.
6.A randomized, prospective, multi-centre clinical trial of NP regimen (vinorelbine+cisplatin) plus Gensing Rg3 in the treatment of advanced non-small cell lung cancer patients.
Yan SUN ; Hongsheng LIN ; Yunzhong ZHU ; Jifeng FENG ; Zhengtang CHEN ; Gongshu LI ; Xiangru ZHANG ; Zongqi ZHANG ; Junfang TANG ; Meiqi SHI ; Xuezhi HAO ; Hui HAN
Chinese Journal of Lung Cancer 2006;9(3):254-258
BACKGROUNDGensing Rg3 is an active component from ginseng. The aim of this study is to observe the clinical anticancer effect of Rg3 in combination with chemotherapy regimen NP (vinorelbine+cisplatin) in advanced non-small cell lung cancer (NSCLC).
METHODSStage III-IV NSCLC patients confirmed by pathology or cytology all received vinorelbine plus cisplatin for at least two cycles, and were randomized into two groups: patients in arm A also received placebo twice a day, while patients in arm B received two tablets of Rg3 twice a day for at least two months. The endpoints of the study were the efficacy, survival and tolerance of patients.
RESULTSFrom July 2000 to May 2002, 115 patients were enrolled into the trial. The patients' characteristics were well balanced in the two groups. Sex of patients: male, 79; female 36. Types of pathology: adenocarcinoma, 71; squamous cell carcinoma, 29; adenosquamous carcinoma, 8; others, 7. TNM stage: stage III, 45; stage IV, 70. Prior chemotherapy: with, 17; without, 98. Prior radiotherapy: with, 15; without, 100. Prior surgical treatment: with, 23; without, 92. Nine patients discontinued from the trial due to severe adverse effects (5) and other reasons (4), so there were 106 patients evaluable for clinical efficacy. The response rate was 14.5% (8/55) in arm A, and 33.3% (17/51) in arm B (P=0.011). The survival time in arm A was 9.7 months (mean) and 8.0 months (median), and 15.3 months (mean) and 10.0 months (median) in arm B (P=0.0088).
CONCLUSIONSPreliminary results show improvements in response rate and survival time (median and mean) in Rg3 arm compared with placebo arm. It is worthy to confirm the results in further clinical trials.
7.Diagnostic Stability in Psychiatric Patients From Hospital Admission to Discharge: A 10-Year Retrospective Study
Furu LIU ; Menghui GAO ; Qiongqiong WU ; Meiqi YAN ; Renrong WU ; Ping SHAO ; Jing HUANG
Psychiatry Investigation 2023;20(5):461-470
Objective:
This study aimed to evaluate the consistency or stability of mental disorders diagnosed in the psychiatry ward setting, investigate factors associated with consistency, and observe the disease distribution over the decade.
Methods:
A total of 20,359 psychiatric inpatients were included in this retrospective study from June 2011 to December 2020. Diagnoses from the first admission to discharge were evaluated to determine the diagnostic consistency during hospitalization. Readmissions were selected as the subgroup, whose first and last discharge diagnoses were compared to analyze the relatively long-term diagnostic stability. Demographic and clinical characteristics were collected to identify predictors of diagnostic discrepancy.
Results:
From 2011–2020, the hospitalization rate decreased from 42.7% to 20.7% for schizophrenia and grew from 13.3% to 23.8% for depression. Diagnoses were retained by 92.6% of patients at their first discharge diagnosis, ranging from 100% for disorders of psychological development to 16.3% for unspecified mental disorders. About 33.9% of diagnostic conversions were to bipolar disorder in patients having inconsistent diagnoses. However, among rehospitalizations, the diagnostic stability notably dropped to 71.3%. For rehospitalizations, mood disorders and schizophrenia spectrum disorders were relatively stable diagnoses categories, with 72.6% to 76.7% of patients receiving the same diagnosis, although results of specified diagnoses within these categories ranged from 5.9% to 91.0%. Except for mood disorders and schizophrenia spectrum disorders, the diagnoses of all other categories were below 70%. Long lengths of hospitalization and old age were associated with short-term diagnosis alterations.
Conclusion
Longitudinal follow-up and integration of multiple aspects of information are essential for accurate diagnosis.
8.Relationship between serum iron metabolism and glucose and lipid metabolism in patients with type 2 diabetes mellitus
Junxin YAN ; Meiqi GUO ; Tongjuan GUAN ; Zhicong ZHOU ; Ying HUANG ; Xiaolan YANG ; Ying WANG ; Xiaoyu LV ; Jingfang LIU
Chinese Journal of Diabetes 2023;31(12):903-908
Objective To explore the relationship between serum iron(SI)metabolism and glucose and lipid metabolism in patients with type 2 diabetes mellitus(T2DM).Methods A total of 170 T2DM patients hospitalized in the Department of Endocrinology,Lanzhou University First Hospital from 2019 to 2021 were included.During the same period,30 healthy individuals from physical examination center were selected as the normal control(NC)group.Based on HbA1c control,T2DM patients were divided into subgroups with good blood glucose control(H1,HbA1c<7%,n=39),poor glucose control(H2,7%<HbA1c<9%,n=63)and very poor glucose control(H3,HbA1c>9%,n=68).According to the level of blood lipids,T2DM patients were divided into subgroups with normal blood lipids(L1,n=36)and high blood lipids(L2,n=134).Results Compared with NC group,age,SBP,DBP,BMI,serum ferritin(SF),FPG,FIns,HOMA-IR,TyG,TG,LDL-C and SUA increased inT2DM group(P<0.05),while SI,TF,total iron binding capacity(TIBC),DI,HDL-C and eGFR decreased(P<0.05).The levels of TF and TIBC in H3 subgroup were lower than those in H1 subgroup(P<0.05).LDL-C of L2 subgroup was higher than that of L1 subgroup(P<0.05),while HDL-C was lower than that of L1 subgroup(P<0.05).Pearson correlation analysis showed that SF was positively correlated with HbA1c,TyG,TG and SUA(P<0.05),and negatively correlated with HDL-C and eGFR(P<0.05).TF was positively correlated with HDL-C and eGFR(P<0.05),but negatively correlated with age,SBP,DBP,TyG and SUA(P<0.05).Multiple linear regression analysis showed that SF and FPG were influencing factors for HbA1c in T2DM patients.Conclusion SI metabolism is closely related to glucose and lipid metabolism in T2DM patients.
9.Study on the effect of differentiated management in a multi-campus hospital for improving patient experience
Tingting WANG ; Meijuan LAN ; Yuping ZHANG ; Meiqi YAO ; Chenling ZHU ; Jianping SONG ; Yan YANG ; Xiuqin FENG
Chinese Journal of Nursing 2024;59(15):1797-1803
Objective To explore and implement a differentiated management strategy for multi-campus hospitals to improve patient experience and satisfaction,and achieve the goal of homogenized management.Methods In December 2021,the Picker Patient Experience Questionnaire was used to survey the patient experience at 3 campuses of a tertiary A hospital in Hangzhou,and the reasons for the differences were analyzed.Based on policy document reviews,special group discussions,and expert meetings,differentiated management strategy for multi-campus hospitals was formulated.The patient experience and satisfaction before(December 2021)and after(December 2023)the implementation were compared.Results After the application of the one-hospital multi-campus difference management strategy,the overall medical experience score of the patients in the 3 campus was(58.54±2.36)points,which was higher than(58.13±3.24)points before the application(t=-3.223,P=0.001),and there was no statistically significant differences among the patients in the 3 campuses(F=0.781,P=0.458).After the application of the management strategy,the overall satisfaction score of the patients in the 3 campus was(98.44±6.22)points,which was higher than(97.98±6.87)points before the application of the management strategy(t=-2.490,P=0.013),and there was no statistical significance among the patients in the 3 campus(F=1.128,P=0.324).The number of banners and letters of commendation received by the 3 campuses increased from 1 661 before the application to 2 190 after the application,with a growth rate of 31.85%.Conclusion Differentiated management in a multi-campus hospital,aiming at homogenized quality through differentiated strategies,is practicable and can significantly improve the patient experience and satisfaction across different campuses.