目的探讨替罗非班联合双联抗血小板治疗进展性卒中的有效性和安全性,得出静脉泵入的有效时间及速度。方法收集山东第一医科大学附属聊城二院2018年6—12月进展性卒中患者,分为双抗组28例,替罗非班组22例,记录其人口学特征、脑梗死的危...目的探讨替罗非班联合双联抗血小板治疗进展性卒中的有效性和安全性,得出静脉泵入的有效时间及速度。方法收集山东第一医科大学附属聊城二院2018年6—12月进展性卒中患者,分为双抗组28例,替罗非班组22例,记录其人口学特征、脑梗死的危险因素、新发梗死部位及可能发病机制,替罗非班开始应用时机,不同时间点的美国国立卫生研究院卒中量表(NIHSS)评分以及并发症,静脉泵入的持续时间、维持剂量及泵入速度。记录加重后继续治疗14 d NIHSS评分,出院后90 d改良Rankin量表(mRS)评分。结果双抗组加重后继续治疗14 d,NIHSS评分下降(2.92±1.13)分,1例发生消化道出血,无颅内出血并发症。替罗非班组加重后继续治疗14 d NIHSS评分下降(3.46±1.71)分,1例发生皮肤黏膜出血,无颅内出血并发症,替罗非班静脉泵入的时间为42.2~135.7(86.6±42.3)h,泵入速度为0.15~0.45(0.31±0.12)mg/h。与双抗组比较,替罗非班组NIHSS评分及90 d mRS评分下降明显[(3.36±1.71)分比(4.75±2.30)分和(2.93±1.04)分比(3.52±1.83)分],两组比较差异有统计学意义(P<0.05)。结论静脉应用替罗非班联合双联抗血小板治疗是一种相对安全有效的治疗进展性卒中的方法。展开更多
目的探讨新辅助放化疗(nCRT)联合根治性手术治疗局部进展期直肠癌的安全性和疗效。方法回顾性分析首都医科大学附属北京朝阳医院普通外科2013年3月至2018年12月收治的208例局部进展期直肠癌病人的临床资料。分为nCRT组(97例)和直接手术...目的探讨新辅助放化疗(nCRT)联合根治性手术治疗局部进展期直肠癌的安全性和疗效。方法回顾性分析首都医科大学附属北京朝阳医院普通外科2013年3月至2018年12月收治的208例局部进展期直肠癌病人的临床资料。分为nCRT组(97例)和直接手术组(111例)。比较两组手术资料、围手术期并发症和局部复发率以及生存情况。结果nCRT组肿瘤下缘与肛缘距离显著低于直接手术组[(5.8±2.2)cm vs.(6.9±2.9)cm,P=0.003]。nCRT组的病理完全缓解率(pCR)为19.6%,淋巴结清扫数量[(12.0±4.7)枚vs.(16.6±6.7)枚,P<0.001]、脉管浸润率(16.5%vs.30.6%,P=0.017)和癌结节检出率(4.1%vs.11.7%,P=0.046)均显著低于直接手术组。与直接手术组相比,nCRT组手术时间明显延长[(251.9±70.6)min vs.(227.4±85.0)min,P=0.015]、术中失血量显著增加(165 mL vs.125 m L,P=0.041)、保护性造口率明显增加(85.1%vs.28.0%,P<0.001)。两组的保肛率、围手术期并发症总发生率、术后平均住院时间、造口还纳率等差异无统计学意义。随访时间34(6~83)个月,随访率91.4%。nCRT组的局部复发率明显降低(5.5%vs.15.2%,P=0.03),5年总体生存率(OS)(77.4%vs.59.5%,P=0.047)和无病生存率(DFS)(75.1%vs.61.6%,P=0.015)显著升高。nCRT组中pCR病人的5年OS显著高于非pCR病人(100.0%vs.69.3%,P=0.033)。结论虽然nCRT显著增加了直肠癌病人的保护性造口率、延长手术时间和增加术中出血量,但能够明显降低肿瘤的局部复发率,增加病人5年OS和DFS。展开更多
Objective： To observe the efficacy and safety of trastuzumab combined with chemotherapy in patients with human epidermal growth factor receptor 2 （HER2）-overexpressing advanced breast cancer. Methods： A total of 9...Objective： To observe the efficacy and safety of trastuzumab combined with chemotherapy in patients with human epidermal growth factor receptor 2 （HER2）-overexpressing advanced breast cancer. Methods： A total of 90 patients with HER2-overexpressing advanced breast cancer were enrolled in this study. All patients were diagnosed with ductal invasive breast cancer by pathological analysis, and were aged between 31-73 years with a median of 51 years. HER2-positivity was defined as 3（＋） staining in immunochemistry or amplification of fluorescence in situ hybridization （FISH, ratio ≥2.0）. Trastuzumab was administered in combination with chemotherapy as first-line treatment and beyond progression as a second- line, third-line, and above treatment in 90, 34, 14, and 6 patients, respectively. The chemotherapy regimen was given according to normal clinical practice. The response rate was evaluated every two cycles, and the primary endpoints were progression-free survival （PFS） and overall survival （OS）. Survival curves were estimated by using Kaplan-Meier graphs and were compared by using log-rank test statistics. Multivariate analysis was done using Cox＇s proportional hazards regression model, and the level of significance was P〈0.05. Results： All 90 patients received at least one dose of trastuzumab, and efficacy could be evaluated in 85 patients. The median follow-up was 50 months. In total, 72 （80.00%） patients had visceral metastasis, and 43 （47.78%） patients had progressed after one or more extensive chemotherapy regimens for metastatic diseases. The median PFS for first-line trastuzumab was 10 months （range, 2-59 months）, and the median OS after metastasis or initially local advanced disease was 22 months （range, 2-1 16 months）. Conclusions： Trastuzumab combined with chemotherapy was active and well-tolerated as a first-line treatment and even beyond progression in HER2-overexpressing advanced breast cancer as a second-line or third-line treatment. However, its eff展开更多
文摘目的探讨替罗非班联合双联抗血小板治疗进展性卒中的有效性和安全性,得出静脉泵入的有效时间及速度。方法收集山东第一医科大学附属聊城二院2018年6—12月进展性卒中患者,分为双抗组28例,替罗非班组22例,记录其人口学特征、脑梗死的危险因素、新发梗死部位及可能发病机制,替罗非班开始应用时机,不同时间点的美国国立卫生研究院卒中量表(NIHSS)评分以及并发症,静脉泵入的持续时间、维持剂量及泵入速度。记录加重后继续治疗14 d NIHSS评分,出院后90 d改良Rankin量表(mRS)评分。结果双抗组加重后继续治疗14 d,NIHSS评分下降(2.92±1.13)分,1例发生消化道出血,无颅内出血并发症。替罗非班组加重后继续治疗14 d NIHSS评分下降(3.46±1.71)分,1例发生皮肤黏膜出血,无颅内出血并发症,替罗非班静脉泵入的时间为42.2~135.7(86.6±42.3)h,泵入速度为0.15~0.45(0.31±0.12)mg/h。与双抗组比较,替罗非班组NIHSS评分及90 d mRS评分下降明显[(3.36±1.71)分比(4.75±2.30)分和(2.93±1.04)分比(3.52±1.83)分],两组比较差异有统计学意义(P<0.05)。结论静脉应用替罗非班联合双联抗血小板治疗是一种相对安全有效的治疗进展性卒中的方法。
文摘目的探讨新辅助放化疗(nCRT)联合根治性手术治疗局部进展期直肠癌的安全性和疗效。方法回顾性分析首都医科大学附属北京朝阳医院普通外科2013年3月至2018年12月收治的208例局部进展期直肠癌病人的临床资料。分为nCRT组(97例)和直接手术组(111例)。比较两组手术资料、围手术期并发症和局部复发率以及生存情况。结果nCRT组肿瘤下缘与肛缘距离显著低于直接手术组[(5.8±2.2)cm vs.(6.9±2.9)cm,P=0.003]。nCRT组的病理完全缓解率(pCR)为19.6%,淋巴结清扫数量[(12.0±4.7)枚vs.(16.6±6.7)枚,P<0.001]、脉管浸润率(16.5%vs.30.6%,P=0.017)和癌结节检出率(4.1%vs.11.7%,P=0.046)均显著低于直接手术组。与直接手术组相比,nCRT组手术时间明显延长[(251.9±70.6)min vs.(227.4±85.0)min,P=0.015]、术中失血量显著增加(165 mL vs.125 m L,P=0.041)、保护性造口率明显增加(85.1%vs.28.0%,P<0.001)。两组的保肛率、围手术期并发症总发生率、术后平均住院时间、造口还纳率等差异无统计学意义。随访时间34(6~83)个月,随访率91.4%。nCRT组的局部复发率明显降低(5.5%vs.15.2%,P=0.03),5年总体生存率(OS)(77.4%vs.59.5%,P=0.047)和无病生存率(DFS)(75.1%vs.61.6%,P=0.015)显著升高。nCRT组中pCR病人的5年OS显著高于非pCR病人(100.0%vs.69.3%,P=0.033)。结论虽然nCRT显著增加了直肠癌病人的保护性造口率、延长手术时间和增加术中出血量,但能够明显降低肿瘤的局部复发率,增加病人5年OS和DFS。
文摘Objective： To observe the efficacy and safety of trastuzumab combined with chemotherapy in patients with human epidermal growth factor receptor 2 （HER2）-overexpressing advanced breast cancer. Methods： A total of 90 patients with HER2-overexpressing advanced breast cancer were enrolled in this study. All patients were diagnosed with ductal invasive breast cancer by pathological analysis, and were aged between 31-73 years with a median of 51 years. HER2-positivity was defined as 3（＋） staining in immunochemistry or amplification of fluorescence in situ hybridization （FISH, ratio ≥2.0）. Trastuzumab was administered in combination with chemotherapy as first-line treatment and beyond progression as a second- line, third-line, and above treatment in 90, 34, 14, and 6 patients, respectively. The chemotherapy regimen was given according to normal clinical practice. The response rate was evaluated every two cycles, and the primary endpoints were progression-free survival （PFS） and overall survival （OS）. Survival curves were estimated by using Kaplan-Meier graphs and were compared by using log-rank test statistics. Multivariate analysis was done using Cox＇s proportional hazards regression model, and the level of significance was P〈0.05. Results： All 90 patients received at least one dose of trastuzumab, and efficacy could be evaluated in 85 patients. The median follow-up was 50 months. In total, 72 （80.00%） patients had visceral metastasis, and 43 （47.78%） patients had progressed after one or more extensive chemotherapy regimens for metastatic diseases. The median PFS for first-line trastuzumab was 10 months （range, 2-59 months）, and the median OS after metastasis or initially local advanced disease was 22 months （range, 2-1 16 months）. Conclusions： Trastuzumab combined with chemotherapy was active and well-tolerated as a first-line treatment and even beyond progression in HER2-overexpressing advanced breast cancer as a second-line or third-line treatment. However, its eff
