Objective:To explore effects of family medical information management platform on medication discrepancy, medication compliance and nutritional management of patients with colorectal cancer undergoing chemotherapy.Methods:Using the convenient sampling method, a total of 64 patients with colorectal cancer who received chemotherapy in Henan Provincial People's Hospital from March 2018 to June 2019 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 32 cases in each group. The control group adopted conventional management, while the observation group adopted family medical information management platform. After intervention, Medication Discrepancy Tool (MDT) and the Chinese Version of Morisky Medication Compliance Scale were used to compare the incidence of medication discrepancy and medication compliance of patients of the two groups. The nutritional status of patients in the two groups was compared using BMI, hemoglobin, total protein, albumin and modified Subjective Global Assessment (SGA) scores.Results:After the intervention, the incidence of medication discrepancy in the observation group was 21.88% (7/32) , lower than 62.50% (20/32) in the control group, and the difference was statistically significant (χ 2=10.827, P<0.01) . After the intervention, there was a statistically significant difference in medication compliance between the two groups ( Z=2.207, P<0.05) . After intervention, BMI, hemoglobin, total protein and albumin of the observation group were higher than those of the control group, and the modified SGA score was lower than that of the control group, and the differences were statistically significant ( t=-2.340, -3.007, -2.137, -3.334, 3.107; P<0.05) . After intervention, the number of normal nutritional cases in the observation group was higher than that in the control group, and the number of severe malnutrition cases was lower than that in the control group, and the differences were statistically significant (χ 2=4.267, 5.379; P<0.05) . Conclusions:The application of family medical information management platform can reduce medication discrepancy of patients with colorectal cancer undergoing chemotherapy, improve their medication compliance and reduce the occurrence of malnutrition.

PURPOSE: Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND METHODS: Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities. RESULTS: Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21. CONCLUSION: R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
Asian Continental Ancestry Group ; B-Lymphocytes ; Cyclophosphamide ; Disease-Free Survival ; Doxorubicin ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell ; Prednisone ; Prognosis ; Rituximab ; Vincristine

AIM:To investigate the expression and potential role of complement 5a receptor (C5aR) in chro-nic graft-versus-host disease (cGVHD).METHODS:The expression of C5aR on lymphocytes and the frequency of CD4+CD25+ Foxp3+ regulatory T cells (Tregs) in 20 cGVHD patients and 9 healthy donors was detected by flow cytometry.The correlation between the expression of C5aR and the percentage of Tregs in the cGVHD patients was analyzed.In addition, the splenocytes from the mice were cultured in vitro, and stimulated these splenocytes with recombinant mouse C5a protein (rmC5a).The peripheral blood mononuclear cells (PBMCs) from cGVHD patients were cultured in vitro, which was inhibited by C5aR antagonist (C5aRA).The frequency of Tregs in these splenocytes and the PBMCs were evaluated by flow cytometry.RESULTS:The expression of C5aR on the lymphocytes was significantly increased in the cGVHD patients compared with the healthy donors, while the percentage of Tregs was markedly lower in the cGVHD patients.The expression of C5aR was negatively correlated with the percentage of Tregs.Furthermore, the development of Tregs was suppressed by rmC5a stimulation, but was promoted by C5aRA in vitro.CONCLUSION:C5aR elevation is associated with Treg reduction in cGVHD, indicating that C5aR may play a potential role in suppressing Tregs, resulting in the incidence of cGVHD.

Objective: To understand the potential viral pathogens other than enteroviruses existing in samples of hand foot and mouth disease (HFMD) patient and study their molecular feature and genotype. Methods: The deep sequencing analysis of a fecal specimen collected from HFMD patient was conducted by metagenomics and bioinformatics. Results: Enterovirus A71 and sapovirus mixed infection was found in this case. The nucleic acid of sapovirus was confirmed positive by RT-PCR and the 7 429 bp complete genome sequence of sapovirus was obtained by assembling sequencing reads which consisted of 3 open reading frames. Phylogenetic analysis revealed that this strain of virus should belong to the genotype 1 of sapovirus having a homology of 99.4% with sapovirus Hu/G1/Zhejiang1/China/2014 strain, which is a currently predominant genotype circulating in China. Conclusions The sapovirus, which is a predominant strain circulating in China, was a mixed infected causative agent existing in HFMD sample identified by deep sequencing. This study will serve as a reference for pathogen detection of HFMD and diarrheal related diseases, as well as provide a sequence reference for molecular feature study of sapovirus in China in the future.

OBJECTIVE To investigate the effect of amifostine(Amf)on the differentiation of human megakaryocyte cell line-Dami. METHODS Dami cells were treated with Amf 0.01-5.0 mmol · L-1 for 12 d. Dami cells were counted every day for the growth curve:only cells with a diameter>20μm. The platelet demarcation membrane system was observed by transmission electron microscopy. The expression of CD33,CD34,CD41a and DNA ploidy was detected by flow cytometry. RESULTS Amf 0.1-1.0 mmol · L-1 promoted the differentiation of Dami cells ,but inhibited their proliferation at a concentration>1.0 mmol · L-1. When these cells were treated with Amf 1.0 mmol · L-1 for 12 d,the platelet demarcation membrane system was observed,the percentage of cells with a diameter >20 μm was increased by 24.6%(P<0.01),the expression of CD41a was increased by 11.9%,while the expression of CD33 was decreased by 13.6%(P<0.05). Polyploidy cells(16N)were observed,and 4N,8N and 16N cells were increased to 31.56%,8.83% and 3.43%,respectively(P<0.05). CONCLUSION Amf 0.1-1.0 mmol · L-1 can promote the differentiation of Dami cells,but inhibit their proliferation at a high concentration(>1.0 mmol·L-1).

Objective To explore the application effects of solution focused approach in psychological intervention to the anxiety and depression before operation in lung cancer patients. Methods A total of 92 lung cancer patients were divided into control group and observation group, with each group 46 cases. The patients of control group was given routine psychological nursing, while the patients of observation group received a 5 -steps psychological intervention of solution focused approach on the basis of routine psychological nursing. The patients were elevated for the level of anxiety and depression by the self-rating anxiety scale ( SAS) and the self-rating depression scale ( SDS) on the day of admission and the day before operation, and results were compared between two groups. Results The differences of SAS and SDS scores between two groups were not statistically significant before intervention (P >0. 05). After psychological intervention, the scores of SAS and SDS of observation group were ( 45. 85 ± 7. 49 ) and ( 49. 03 ± 7. 46 ) points respectively, which were lower than (50.62±8.01)and(54.36±6.72)inthecontrolgroup(t=2.950,3.600;P<0.05).Conclusions The application of solution focused approach in preoperative psychological intervention can effectively relieve the anxiety and depression before operation in patients with lung cancer.

Background and purpose:Rectal small cell carcinoma is high malignant tumor and prone to early metastasis. It is rare in the clinical and its prognosis is poor. The aim of this article was to analyze clinical characteristics and summarize the diagnosis,treatment and prognosis of rectal small cell carcinoma.Methods:Clinical data of 16 cases with rectal small cell carcinoma conifrmed by pathology from Jan. 2001 to Jan. 2013 in the Tumor Hospital Affiliated to Zhengzhou University Hospital were analyzed retrospectively.Results:Among the 16 rectal small cell carcinoma patients (mean age is 58.5 years), 9 were male, 7 were female; 4 cases in stageⅡ, 7 cases in stageⅢ and 5 cases in stageⅣ. Ten cases underwent surgical treatment, of which 6 cases underwent radical surgery, 4 cases underwent palliative surgery;6 cases received chemotherapy alone, 2 cases received chemoradiotherapy, 2 cases did not receive any treatment postoperatively. Five cases were lost opportunity for operation, of which 3 cases underwent chemotherapy alone and 2 cases underwent chemoradiotherapy. One case did not receive any treatment. Among 10 cases of resection of the lesions, 5 cases had vascular invasion and 7 cases had local lymph node metastasis. All patients received 7-65 months of follow-up. The median survival was 15.4 months. The 6 months, 1 year, 2 years, 3 years and 5 years survival rates were 58.4%, 46.2%, 26.6%, 13.1% and 6.2% respectively. The prognosis of patients was associated with tumor staging, presence of vascular invasion and lymph node metastasis, and type of operation (P<0.05); but not related to age, gender and tumor size (P>0.05).Conclusion:The biologic behavior of rectal small cell carcinoma which is a rare disease and similar to small cell lung cancer, and its prognosis is poor. Treatment methods include surgery, radiotherapy and chemotherapy. The overall result is poor.

OBJECTIVETo investigate the prognostic impact of different chemotherapy strategies on small cell esophageal carcinoma (SCEC).

METHODSThe clinical data of 62 patients with histologically confirmed SCEC treated in our department between January 2006 and April 2011 were retrospectively analyzed. There were 39 patients with limited stage (LS) and 23 patients with extensive stage (ES) SCEC according to the Veterans Administration Lung Study Group staging system. Cox's hazard regression model was used to determine the prognostic factors, and Chi-square test was used to detect the difference of frequencies among different groups. Kaplan-Meier and log-rank analyses were used to estimate and compare the survival rates.

RESULTSThe chemotherapy combined with local therapy group was significantly better than chemotherapy alone group in median survival time (MST) (20.8 vs. 7.6 months, P<0.05). The MST was 18.0 months and the 1-, 2-, and 3-year overall survival rates (OS) were 68.8%, 38.6%, and 20.9%, respectively, for all the 62 patients. Etoposide plus cisplatin or carboplatin (EP/CP) did not result in significantly longer MST, compared with that of the cases treated by other combination chemotherapy (P>0.05, for either LS or ES cases). Multivariate analysis showed that the VALSG stage, the number of chemotherapy cycles (≥ 4), and treatment modality are independent prognostic factors (P<0.05).

CONCLUSIONSSCEC is a tumor characterized by high malignancy and poor prognosis. Chemotherapy combined with local therapy is an effective treatment for SCEC, and appropriate chemotherapy cycles (≥ 4) may improve the survival time. EP/CP, as commonly used multidrug chemotherapy regimen, is not superior to other combination chemotherapy.

Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Carboplatin ; administration & dosage ; Carcinoma, Small Cell ; drug therapy ; mortality ; pathology ; Chi-Square Distribution ; Cisplatin ; administration & dosage ; Esophageal Neoplasms ; drug therapy ; mortality ; pathology ; Etoposide ; administration & dosage ; Humans ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVETo revalidate the conversion factor（CF）for the conversion of BCR-ABL （P210）transcript levels to the international scale（BCR- ABLIS）in chronic myeloid leukemia（CML） which validated before.

METHODSPeking University People's Hospital（PKUPH）prepared the exchange samples for revalidation of CFs of 15 laboratories which validated nine or eighteen months ago. The fresh BCR-ABL（P210）（+）bone morrow or peripheral blood nucleated cells were diluted with BCR-ABL （P210）（-）cells to achieve different BCR- ABL levels, totally 16 sets and 24 samples per set were prepared. TRIzol reagent was added in each tube. Each laboratory tested BCR-ABL transcript levels of one set of samples. Agreement between BCR-ABLIS of each laboratory and PKUPH was assessed by the Bland- Altman method. For laboratories which did not meet the criteria of revalidation, linear regression equation was derived after the samples with maximum BCR-ABL deviation were removed until R²>0.98, then new CF was calculated.

RESULTS10 laboratories met the revalidation criteria with both bias within ±1.4 fold and 95% limits of agreement within ±6 folds, and their CFs still could be used for accurately conversion of BCR-ABLIS. New CFs were recalculated as of 1.8-6.3 folds of their previous CFs in 5 laboratories not met the criteria.

CONCLUSIONRevalidation of CF by sample exchange among laboratories was necessary for accurate and continuous application of BCR-ABLIS, which not only tested the validity of CF acquired before but also calculated new available CFs for those with invalid CFs.

Bone Marrow Cells ; Fusion Proteins, bcr-abl ; genetics ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; genetics

Objective To investigate the prognostic impact of different chemotherapy strategies on small cell esophageal carcinoma ( SCEC ) . Methods The clinical data of 62 patients with histologically confirmed SCEC treated in our department between January 2006 and April 2011 were retrospectively analyzed. There were 39 patients with limited stage ( LS) and 23 patients with extensive stage ( ES) SCEC according to the Veterans Administration Lung Study Group staging system. Cox′s hazard regression model was used to determine the prognostic factors, and Chi?square test was used to detect the difference of frequencies among different groups. Kaplan?Meier and log?rank analyses were used to estimate and compare the survival rates. Results The chemotherapy combined with local therapy group was significantly better than chemotherapy alone group in median survival time (MST) (20.8 vs. 7.6 months, P<0.05). The MST was 18.0 months and the 1?, 2?, and 3?year overall survival rates ( OS) were 68.8%, 38.6%, and 20.9%, respectively, for all the 62 patients. Etoposide plus cisplatin or carboplatin ( EP/CP ) did not result in significantly longer MST, compared with that of the cases treated by other combination chemotherapy ( P>0.05, for either LS or ES cases ) . Multivariate analysis showed that the VALSG stage, the number of chemotherapy cycles (≥4 ) , and treatment modality are independent prognostic factors ( P<0. 05 ) . Conclusions SCEC is a tumor characterized by high malignancy and poor prognosis. Chemotherapy combined with local therapy is an effective treatment for SCEC, and appropriate chemotherapy cycles (≥4) may improve the survival time. EP/CP, as commonly used multidrug chemotherapy regimen, is not superior to other combination chemotherapy.