Background and objective About 80% lung cancer is non-small cell lung cancer (NSCLC) and more than 7096 are in advanced stage. "lhe aim of this study is to evaluate the clinical efficacy and the side effects of erlotinib in the treat-ment of elderly patients with advanced non-small cell lung cancer. Methods Twenty-nine patients with advanced non-small cell lung cancer were treated with erlotinib 150 mg/d, then the adverse reaction and clinical efficacy were recorded during 3 months. Results Total 29 patients were evaluated for efficacy. The total rate of effect was 20.69%, including I case CR, 5 cases PR, 9 cases SD and 14 cases PD. We compared the effective rate of stage Ⅲwith Ⅳ. There were no significant difference between the effec-tive rate of stageⅢand IV (P=0.337). The main side effects were rash (37.93%), diarrhea (17.24%) and vomiting (6.9%) and most side effects were grade Ⅰ and Ⅱ. Conclusion Erlotinib for elderly patients with advanced non-small cell lung cancer have better effective and less toxic effects and the further clinical study should be warranted.

Objective To determine the role of serum procalcitonin(PCT)and C-reactive protein (CRP)in predicting spontaneous bacterial peritonitis(SBP)in patients with liver cirrhosis combined with ascites. Methods Ninety-eight patients with liver cirrhosis combined with ascites were enrolled, including 48 cases with SBP(SBP group)and 50 cases without SBP(non-SBP group).The levels of serum PCT and CRP were compared between 2 groups.The receiver operating characteristic(ROC)curves were used to evaluate the diagnostic SBP value of PCT and CRP levels in patients with liver cirrhosis combined with ascites.Results The serum PCT and CRP levels in SBP group were significantly higher than those in non-SBP group:3.90(6.95)μg/L vs.0.50(0.43)μg/L and 20.80(11.27)mg/L vs.10.87(6.22)mg/L, and there were statistical differences(P<0.01).The ROC cures results showed that the areas under the curve of serum PCT and CRP levels were 0.924(95% CI 0.860-0.987)and 0.852(95% CI 0.777-0.926), and the optimal cut-off of predicting SBP in patients with liver cirrhosis combined with ascites were 0.81 μg/L and 13.89 mg/L. The sensitivity was 91.7% and 85.4%, and the specificity was 80.0%and 70.0% respectively.The mortality in SBP group was significant higher than that in non-SBP group:20.83%(10/48)vs.6.00%(3/50),and there was statistical difference(P<0.05).In SBP group,the serum PCT and CRP levels in death patients were significant higher than those in survival patients: 13.00 (10.90) μg/L vs. 2.50 (5.30) μg/L and 35.40 (31.22) mg/L vs. 18.05(10.15) mg/L, and there were statistical differences(P<0.01 or<0.05).Conclusions The increase of serum PCT and CRP levels can be used as an important diagnostic index for SBP in patients with liver cirrhosis combined with ascites, and has predictive value for prognosis.

Objective:To evaluate the efficacy of remimazolam combined with alfentanil for gastroscopy in frail elderly patients.Methods:Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ elderly patients, aged 65-85 yr, with body mass index of 18-30 kg/m 2, of Clinical Frailty Scale score≥5, scheduled for elective painless gastroscopy, were divided into 2 groups ( n=30 each) using a random number table method: remimazolam combined with alfentanil group (group R) and propofol combined with remifentanil group (group P). A combination of alfentanil 10 μg/kg and remimazolam 0.2 mg/kg was intravenously injected until loss of consciousness in group R. Remifentanil 0.5 μg/kg combined with propofol 1.0-2.0 mg/kg was intravenously injected until loss of consciousness in group P. According to the intraoperative conditions, 1/4 of the initial dose of remimazolam was intravenously injected in group R, and 1/4 of the initial dose of propofol was intravenously injected in group P. The time for gastroscopy, requirement for additional remimazolam or propofol, onset time of anesthesia, emergence time and time of post-anesthesia care unit stay were recorded.Physician′s satisfaction scores, patient′s satisfaction scores and Verbal Pain Scale scores were recorded.The occurrence of injection pain, respiratory depression, bradycardia, hypotension and nausea and vomit was recorded. Results:There was no significant difference in the requirement for additional remimazolam or propofol, onset time of anesthesia, time for gastroscopy, physician′s satisfaction scores, and patient′s satisfaction scores, Verbal Pain Scale scores and incidence of nausea and vomit between two groups ( P>0.05). Compared with P group, the emergence time and time of post-anesthesia care unit stay were significantly shortened, and the incidence of injection pain (0 vs.33%), respiratory depression (0 vs.20%), hypotension (3% vs.23%) and bradycardia (3% vs.23%) was decreased in R group ( P<0.05). Conclusions:Remimazolam combined with alfentanil is safe and effective, with rapid recovery from anesthesia, and provides better efficacy than the combination of propofol and remifentanil when used for gastroscopy in frail elderly patients.

Objective:To compare the clinical efficacy and pharmacoeconomic evaluation of bevacizumab or cetuximab combined with chemotherapy in the treatment of advanced colorectal cancer.Methods:The clinical data of 68 patients with advanced colorectal cancer from January 2018 to December 2020 in Baotou Tumor Hospital were retrospectively analyzed. Among them, 40 patients with treated with bevacizumab combined with chemotherapy (bevacizumab group), 28 patients were treated with cetuximab combined with chemotherapy (cetuximab group), and the chemotherapy of two group was FOLFOX/FOLFIRI program. The short-term clinical efficacy, adverse reactions and pharmacoeconomic evaluation result were compared between two groups.Results:There were no statistical differences in effective rate and disease control rate between bevacizumab group and cetuximab group: 30.00% (12/40) vs. 28.57% (8/28) and 67.5% (27/40) vs. 60.71% (17/28), P>0.05. The incidence of Ⅲ to Ⅳ grade erythra in bevacizumab group was significantly lower than that in cetuximab group: 2.50% (1/40) vs. 71.43% (20/28), and there was statistical difference ( P<0.01); there were no statistical differences in the incidences of Ⅲ to Ⅳ grade bone marrow suppression, nausea vomiting, hepatic functional lesion and diarrhea between two groups ( P>0.05). The pharmacoeconomic evaluation result showed that the cost of monoclonal antibody and total cost in bevacizumab group were significantly lower than those in cetuximab group: (9 009 ± 1 500) yuan vs. (27 840 ± 2 202) yuan and (11 242 ± 1 731) yuan vs. (29 867 ± 3 002) yuan, and there were statistical differences ( P<0.01); the cost-effectiveness ratio in bevacizumab group was 37 473.3, and it in cetuximab group was 104 430.1, the incremental cost-effectiveness ratio of two programs was 11 640.6. Conclusions:In the treatment of advanced colorectal cancer, the efficacy of bevacizumab combined with chemotherapy is similar to that of cetuximab combined with chemotherapy, but bevacizumab combined with chemotherapy has lower costs and fewer adverse reactions, so bevacizumab is more economical and applicable.

Objective To investigate the cognition of colorectal cancer-related knowledge and influencing factors of patients with middle- and advanced-stage colorectal cancer in ethnic minority areas of Inner Mongolia. Methods According to the national population and the prevalence of colorectal cancer, 277 patients with colorectal cancer were selected by stratified and random sampling in Inner Mongolia. The patients were surveyed in Baotou, Chifeng, Bayannaoer, and other hospitals. The questionnaire included patients' basic information, cognition of colorectal cancer risk factors and screening knowledge, screening information, etc. Results Before suffering from the disease, the patients' knowledge of colorectal cancer (risk factors, early screening knowledge, treatment methods) was low. About 54.9% of patients were unaware of high risk factors for colorectal cancer, 75.8% of patients did not understand the knowledge of early screening of colorectal cancer, and 37.5% of patients did not underst and the treatment of colorectal cancer. The main influencing factors of colorectal cancer cognition were education level and occupation. Patients who work in institutions and enterprises and with higher education level had better cognition. Conclusion Patients with middle- and advanced-stage colorectal cancer in Inner Mongolia have poor knowledge and awareness of risk factors and screening of colorectal cancer before diagnosis. Education level and occupation are factors influencing colorectal cancer cognition, therefore, people with low knowledge rate of colorectal cancer and low education level as well as unemployed laid-off people should be given priority intervention.

Objective:To analyze the efficacy and safety of tislelizumab in the treatment of advanced gastric cancer.Methods:The clinical data of 54 patients with advanced gastric cancer in Baotou Cancer Hospital from July 2022 to December 2023 were retrospectively analyzed. Among them, 27 patients were treated with chemotherapy (control group), and 27 patients were treated with tislelizumab combined with chemotherapy (combination group). The efficacy was evaluated after 2 cycles. The patients were followed up until March 2024, and the survival status was evaluated by progression-free survival (PFS) and duration of remission (DOR). The adverse reactions were recorded. Kaplan-Meier survival curve was drawn, and the compared used log rank test. Binary Logistic regression was used to analyze the independent risk factors of efficacy in patients with advanced gastric cancer.Results:The effective rate and disease control rate in combined group were significantly higher than those in control group: 29.6% (8/27) vs. 7.4% (2/27) and 85.2% (23/27) vs. 59.3% (16/27), and there were statistical differences ( χ2 = 4.42 and 4.52, P<0.05). Kaplan-Meier survival curve analysis result showed that the median PFS and DOR in combination group were significantly longer than those in control group (9.9 months vs. 7.2 months and 8.7 months vs. 6.4 months), and there were statistical differences (log-rank χ2 = 6.58 and 8.47, P<0.05). Among the 54 patients, 10 cases (18.5%) were effective, and 44 cases (81.5%) were ineffective. The efficacy was related to the number of organ metastase, prealbumin and Helicobacter pylori infection rate, and there were statistical differences ( P<0.05). Binary Logistic regression analysis result showed that the number of organ metastase >1, prealbumin <160 mg/L and Helicobacter pylori infection were independent risk factors of efficacy in patients with advanced gastric cancer ( OR = 0.089, 8.418 and 0.153; 95% CI 0.012 to 0.661, 1.255 to 56.449 and 0.025 to 0.944; P<0.05). There was no statistical difference in the incidence of adverse reactions between two groups ( P>0.05). Conclusions:The tislelizumab combined with chemotherapy in patients with advanced gastric cancer can improve the efficacy and prolong the survival without increasing the incidence of adverse reactions.