Objective To evaluate the efficacy and untoward effects of brucea javanica oil emulsion combined with radiotherapy in the treatment of patients with esophageal cancer. Methods 50 initial treatment patients with esophageal squamous cell carcinoma were randomly assigned to observation group (25 cases) and control group (25 cases). All patients were treated with three dimensional conformal intensity modulated radiation therapy (3D-IMRT) and the radiation dose was 64 Gy/32 times (95 % PTV). The patients in observation group received the treatment of brucea javanica oil emulsion during radiotherapy. The differences between the two groups were compared in respect of the efficacy, the adverse reactions and the quality of life (QOL). Results The effective rate in observation group was 92%(23/25) and it was 68%(17/25) in control group, there was significant difference between the two groups (χ2 = 4.500, P= 0.034). The incidence of radiation esophagitis at the level of RTOG2 and above in observation group was 20%(5/25) and it was 60%(15/25) in the control group, there was significant difference between the two groups (χ2= 8.333, P=0.004). The improvement rate of QOL in observation group was 68 % (17/25) and it was 40 % (10/25) in control group, there was significant difference between the two groups (χ2 = 3.945, P= 0.047). Conclusion Brucea javanica oil emulsion combined with radiotherapy for the treatment of patients with esophageal cancer can improve the therapeutic effect and QOL,it can also reduce radiation reactions.

Objective To explore the related factors of tumor regression speed during radiotherapy for esophageal cancer and analyze the relationship between recent clinical curative effect and tumor regression speed.Methods 68 previously untreated esophageal cancer patients were treated with three dimensional conformal intensity modulated radiation therapy (3D-IMRT).The radiation dose was 64 Gy/32 times (95 ％ PTV).All the patients were divided into 3 groups according to the size of primary lesions during the entire course of radiotherapy.Fast regression was defined as a complete response before dose 32 Gy,slow regression with dose in the range of 64 Gy and other cases as residual disease.The correlations of tumor regression speed with age,gender,classification,length of lesion and the lesion location were analyzed.And the relationship between recent clinical curative effect and tumor regression speed was discussed.Results The age,gender,classification and the lesion location were not associated with tumor regression (P ＞ 0.05).There was a negative correlation between tumor regression speed and the length of lesion [88.9 ％ (16/18),69.2 ％ (18/26) and 12.5 ％ (3/24) in fast,slow and residual group,respectively,x2 =27.923,P ＜ 0.05].There was a positive correlation between recent clinical curative effect and tumor regression speed (r =0.415,P ＜ 0.05).Conclusion The length of primary lesion is an independent risk factor for recent clinical curative effect and tumor regression speed of esophageal cancer patients treated with 3D-IMRT.

Objective To study the clinical efficacy of sodium cantharidinate and vitamin B6 injection combined with concurrent chemoradiotherapy in treatment of locally advanced nasopharyngeal carcinoma (LA-NPC).Methods 115 patients with LA-NPC in Shanxi Cancer Hospital were randomly assigned to observation group (61 cases) and control group (54 cases) from February 2014 to April 2016.The patients in the observation group were treated with sodium cantharidate and vitamin B6 injection combined with concurrent chemoradiotherapy.The patients in the control group were treated with concurrent chemoradiotherapy.The differences between the two groups were compared in respect of recent curative effect,the quality of life (QOL) and the adverse reactions.Results The recent effective rate was 93.44 ％ (57/61) in the observation group and 79.63 ％ (43/54) in the control group,and there was significant difference between the two groups (x2 =4.818,P =0.049).The improvement rate of QOL was 73.77 ％ (45/61) in the observation group and 53.70 ％ (29/54) in the control group,and there was significant difference between the two groups (x2 =5.028,P =0.032).The incidence rates of oral cavity mucous membrane inflammation,hematology toxicity,pharynx and esophagus adverse reactions,the gastrointestinal tract adverse reactions and skin fibrosis in the observation group were lower than those in the control group,and there were significant differences between the two groups (all P ＜ 0.05).Conclusion The recent effect of sodium cantharidinate and vitamin B6 injection combined with concurrent chemoradiotherapy on the patients with LA-NPC is obvious.The comprehensive treatment can also reduce adverse reactions and improve the QOL.

Objective:To explore the clinical value of the geriatric potentially inappropriate medication(PIM)evaluation system in elderly inpatients.Methods:As a prospective cohort study, 203 elderly inpatients with polypharmacy were randomly divided into the control group and experimental group.Geriatric PIM evaluation system(based on the criteria for judging potential inappropriate drug use in Chinese elderly 2017 edition)on wechat platform was applied to patients of experimental group.During the 6 months, the number of elderly syndromes, types of drugs, the days in hospitalization, readmission rates and all-cause mortality were compared between two groups.Results:The age of 203 elderly inpatients ranged from 60 to 94(77.30±10.34)years, including 121 males and 82 females.The morbidity proportion of top five diseases were 69.95%(142/203)in cerebral infarction(non-acute phase), 62.07%(126/203)in hypertension, 24.14%(49/203)in coronary heart disease, 9.85%(20/203)in atrial fibrillation, and 6.40%(13/203)in cardiac insufficiency.The 97.53%(198/203)of elderly hospitalized patients had at least one senile syndrome, the average was 4.3±2.0.Insomnia, fall and frailty accounted for 32.87%(15/198), 28.45%(56/198)and 13.66%(27/198)respectively.Compared with the control group, the average length of stay in hospital in the experimental group significantly decreased[(16.38±4.29) vs.(21.32±6.10)d, t=2.438、 P=0.025], the number of senile syndrome, the score of fall, weakness and the re-admission rate were also decreased significantly(3.11±2.14 vs.4.32±1.50, t=0.854、 P=0.032; 6.19±1.35 vs.8.61±3.22, t=4.078、 P=0.044; 3.94±1.92 vs.5.65±1.34, t=2.843、 P=0.038; 9.81%(10/102) vs.1.98%(2/101), χ2=4.772、 P=0.029), and the frequency of PIM was significantly different between two groups(417.36±49.21 vs.210.25±38.23, t=2.136、 P=0.034). Conclusions:After making the drug adjustment on the elderly inpatients with multiple drugs, PIM evaluation system for the elderly are able to reduce the incidence of geriatric syndrome, shorten the length of stay in hospital, improve the rational use of drugs, and enhance the quality of life of the elderly patients.

OBJECTIVE To assess the efficacy， safety and cost-effectiveness of tenecteplase in the treatment of acute ischemic stroke， and to provide a basis for clinical rational drug use and related decision-making. METHODS The related literature in the PubMed， the Cochrane Library， CNKI， Wanfang data and health technology assessment （HTA） databases were searched from the establishment of the database to June 30th， 2024. Systematic reviews/meta-analyses， pharmacoeconomic studies and HTA reports on tenecteplase in the treatment of acute ischemic stroke were collected. After data extraction and quality assessment， descriptive analysis of the included studies was carried out. RESULTS A total of 31 articles were included， involving 28 systematic reviews/ meta-analysis and 3 pharmacoeconomic studies. In terms of effectiveness， compared with alteplase， tenecteplase （0.25 mg/kg） could significantly increase the early neurological improvement； the 90 d excellent neurological recovery rate， 90 d good neurological recovery rate， and recanalization were not inferior to alteplase. For safety， compared with alteplase， tenecteplase did not increase the incidence of hemorrhage， symptomatic intracranial hemorrhage， 3-month mortality， or intracranial hemorrhage. In terms of cost-effectiveness， foreign research results showed that tenecteplase had economic advantages over alteplase. CONCLUSIONS Compared with alteplase， tenecteplase is effective and safe in the treatment of acute ischemic stroke， and it is cost-effective.