目的 对EGFR-TKI治疗进展后不同治疗策略的生存期和疗效进行探讨.方法 以该院2016年1—12月接诊的67例EGFR-TKI治疗后出现进展且接受后续治疗的晚期肺腺癌患者为对象,对其实施放疗治疗的同时,给予不同的进展后首次治疗策略,8例为EGFR-TKI联合化疗组,8例为继续EGFR-TKI治疗组,51例为单纯化疗组,分析各组生存期与疗效.结果 67例患者在EGFR-TKI进展后未得到完全缓解,总客观缓解率(ORR)为2.99％,总疾病控制率(DCR)为50.75％;继续EGFR-TKI组DCR为75.00％,EGFR-TKI联合化疗组DCR为62.50％,单纯化疗组为45.10％差异有统计学意义(P<0.05);EGFR-TKI联合化疗组平均无进展生存期(PFS)为3.3个月,继续EGFR-TKI治疗组平均PFS为3.0个月,单纯化疗组平均PFS为2.0个月差异无统计学意义(P>0.05);EGFR-TKI联合化疗组平均总生存期(OS)为11.5个月,继续EGFR-TKI治疗组平均OS为6.9个月,单纯化疗组平均OS为8.8个月,BSC组平均OS为0.9个月差异有统计学意义(P<0.001).结论 初次EGFR-TKI治疗后,部分晚期肺腺癌患者耐药后仍然可在EGFR-TKI治疗中受益.
OBJECTIVE To observe and analysis of prophylactic use of antibiotics in gynecologic patients before operation ,so as to provide recommendations and reference for reasonable use of antibiotics .METHODS A total of 1167 cases of gynecologic patients records from Jan .2009 to Dec .2010 in our hospital were selected and the clinical data were studied restrospectively .Statistics the preoperative duration of the timing of prophylactic use of antibiotics ,and drug selection data were collected and the use of antimicrobial agents was discussed .RESULTS According to the rules of not use or use antibiotics within 2 h before operation ,there were 898 cases ,accounting for 76 .95% .More than 2 h using antibiotics before operation were 269 cases ,accounting for 23 .05% .A total of 1039 patients used antibiotics for less than 3 days ,accounting for 89 .03% .There were 10 .97% of patients using longer .The top utilization rate of several antibiotics were anaerobic bacteria drug resistance ,the second generation cephalosporins ,and the third generation of cephalosporins .CONCLUSION There are problems in prophylactic antibioterial useage for prevention ,including improper time using and using to long time ,which should pay enough attention .
Objective: To improve the diagnosis rate of occult breast cancer. Methods: Mammographies of 10 cases of breast cancer confirmed by surgery and pathology were retrospective analyzed. Results: In 10 cases,there were 2 cases with lobular carcinoma in situ,five cases with ductal carcinoma in situ and three cases with infiltrating ductal carcinoma. Conclusion: CR mammography has an important value in diagnosis of clinical hidden breast cancer.
