1.Research on constructing talent training objectives and courses of undergraduate education of tropical medicine by Delphi method
Jie WU ; Yan LI ; Qunfang CAI ; Sufang DONG ; Li YIN ; Yajun LU ; Qianfeng XIA
Chinese Journal of Medical Education Research 2024;23(3):343-346
Objective:To construct talent training objectives and courses for undergraduate education of tropical medicine.Methods:Two rounds of questionnaire consultation were conducted among 15 experts by Delphi method. SPSS 26.0 software was used for statistical analysis, and the recovery rate, expert authority coefficient, mean of importance score, full score ratio, coefficient of variation and Kendall coordination coefficient were calculated respectively. Kendall's rank correlation test was used to analyze the degree of expert coordination, and the "boundary value method" was used to screen the indicators.Results:The effective recovery rates of the two rounds of consultation were all 100.00% and the expert authority coefficient was 0.815. The coordination coefficient was 0.25, 0.32, and 0.27, 0.36 respectively, and the significance test showed P<0.001. Finally, 11 talent training objectives and 7 courses for undergraduate education of tropical medicine were formed. Conclusions:The talent training objectives and courses for undergraduate education of tropical medicine are reasonable and reliable, which can provide theoretical support for tropical medicine talent training and have certain guiding value.
2.Transarterial chemoembolization combined with lenvatinib plus programmed death 1 inhibitor for the treatment of unresectable intermediate-advanced hepatocellular carcinoma
Jingzheng HUANG ; Mingyue CAI ; Wensou HUANG ; Yongjian GUO ; Jingjun HUANG ; Qunfang ZHOU ; Liteng LIN ; Bihui CAO ; Licong LIANG ; Juan ZHOU ; Kangshun ZHU
Chinese Journal of Radiology 2022;56(8):879-885
Objective:To investigate the clinical efficacy and safety of transarterial chemoembolization (TACE) combined with lenvatinib plus PD-1 inhibitor (TACE+Len+PD-1) versus TACE combined with lenvatinib (TACE+Len) for patients with unresectable intermediate-advanced hepatocellular carcinoma (HCC).Methods:The data of 94 patients with intermediate-advanced HCC who received TACE+Len+PD-1 (One week after TACE, the patient were treated with lenvatinib and PD-1 inhibitor. lenvatinib, 8 or 12 mg/d, orally; PD-1 inhibitor, 200 mg/3 weeks, iv) or TACE+Len (One week after TACE, the patient were treated with lenvatinib.lenvatinib, 8 or 12 mg/d, orally) in the Second Affiliated Hospital of Guangzhou Medical University from June 2019 to February 2021 were collected and retrospectively analyzed. Among these patients, 44 were in the TACE+Len+PD-1 group and 50 were in the TACE+Len group. Tumor responses were evaluated according to modified response evaluation criteria in solid tumors. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were compared between the two groups. The potential prognostic factors for PFS and OS were determined.Results:The ORR of TACE+Len+PD-1 group and TACE+Len group was 72.8% (32/44) and 52.0% (26/50) (χ2=4.25, P=0.039), respectively. The DCR of TACE+Len+PD-1 group and TACE+Len group was 86.4% (38/44) and 62.0% (31/50) (χ2=7.12, P=0.008), respectively. The median PFS and median OS in TACE+Len+PD-1 group were significantly longer than those in TACE+Len group (PFS, 7.9 vs. 5.6 months, χ2=7.91, P=0.005; OS, 18.5 vs. 13.6 months, χ2=4.40, P=0.036). Multivariate Cox regression analyses showed that TACE+Len (HR=2.184,95%CI 1.366-3.493), incomplete tumor capsule (HR=2.002,95%CI 1.294-3.209) and extrahepatic metastasis (HR=1.765,95%CI 1.095-2.844) were the independent risk factors for PFS, while TACE+Len (HR=2.081,95%CI 1.097-3.948) and BCLC stage C (HR=7.325,95%CI 2.260-23.746) were the independent risk factors for OS. The incidence of ≥grade 3 AEs in TACE+Len+PD-1 group was similar to that in TACE+Len group (χ2=0.45, P=0.501). Conclusion:Compared with TACE+Len, TACE+Len+PD-1 resulted in a better tumor response and a longer PFS and OS in patients with intermediate-advanced HCC.