OBJECTIVE:To observe the effect of the Traditional Chinese Medicine,modified Taohongsiwu decoction,versus pyridoxine on patients with hand-foot syndrome(HFS)from capecitabine,sorafenib,and gefitinib chemotherapy for g...OBJECTIVE:To observe the effect of the Traditional Chinese Medicine,modified Taohongsiwu decoction,versus pyridoxine on patients with hand-foot syndrome(HFS)from capecitabine,sorafenib,and gefitinib chemotherapy for gastric,lung,breast,colon,or rectal cancer.Also,to compare quality of life of patients in each group.METHODS:Patients were assigned randomly to group A or B.Group A was given modifiedTaohongsiwu decoction to soak hands and feet for 30 min,once daily.Group B was given 100 mg pyridoxine orally,twice daily.After a 2-week treatment,thetherapeutic effect was assessed by observing three major symptoms,including pain,ulceration,and muscular atrophy.This was assessed with the HFS-14 questionnaire.RESULTS:Significant differences were observed between the two groups in pain relief,and improvement of daily life,walking,and interpersonal communication(P<0.01).No significant differences in driving ability or interpersonal relationships were found.After 2 weeks,the effective rate was 88.3%in group A,which was significantly higher than the50%in group B(P=0.00).CONCLUSION:Modified Taohongsiwu decoction is effective in the treatment of patients with HFS.It improves patients'quality of life according to the HFS-14.展开更多
Objective:To investigate clinical and neuroimaging features of enterovirus71(EV71) related acute flaccid paralysis in patients with hand-fool-mouth disease.Methods:Nine patients with acute flaccid paralysis met the cr...Objective:To investigate clinical and neuroimaging features of enterovirus71(EV71) related acute flaccid paralysis in patients with hand-fool-mouth disease.Methods:Nine patients with acute flaccid paralysis met the criterion of EV71 induced hand-foot-mouth disease underwent spinal and brain MR imaging from May 2008 to Sep 2012.Results:One extremity flaccid was found in four cases(3 with lower limb,1 with upper limb),two limbs flaccid in three cases(2 with lower limbs,1 with upper limbs),and four limbs flaccid in two cases.Spinal MRI studies showed lesion with high signal in T2-weighted images(T2WI) and low signal T1-weighted images(T1WI) in the spinal cord of all nine cases,and the lesions were mainly in bilateral and unilateral anterior hom of cervical spinal cord and spinal cord below thoracic 9(T9) level.In addition,the midbrain,pons, and medulla,which were involved in 3 cases with brainstem encephalitis,demonstrated abnormal signal.Moreover,spinal cord contrast MRI studies showed mild enhancement in corresponding anterior hom of the involved side,and strong enhancement in its ventral root.Conclusions: EV71 related acute flaccid paralysis in patients with hand-foot-mouth disease mainly affected the anterior hom regions and ventral root of cervical spinal cord and spinal cord below T9 level. MR imaging could efficiendy show the characteristic pattern and extent of the lesions which correlated well with the clinical features.展开更多
Objective： To observe the clinical therapeutic effects of acupuncture on chemotherapy-induced hand-foot syndrome（HFS）.Methods： A total of 60 patients treated with chemotherapy of capecitabine and suffering from th...Objective： To observe the clinical therapeutic effects of acupuncture on chemotherapy-induced hand-foot syndrome（HFS）.Methods： A total of 60 patients treated with chemotherapy of capecitabine and suffering from the chemotherapy-induced HFS were divided into an acupuncture group and a Vitamin B6 group according to the random number table, 30 cases in each one. In the acupuncture group, after chemotherapy,acupuncture was given at Bǎihui（百会 GV 20）, Hégǔ（合谷 LI 4）, Wàiguān（外关 TE 5）, Zúsānlǐ（足三里ST 36） and Ashi points. The needles were retained for 30 min in each treatment, once a day, totally for 2 weeks. In the Vitamin B6 group, after chemotherapy, Vitamin B6 was taken orally, 300 mg a day, totally for 2 weeks. Separately, on the day of enrollment and after 2 weeks of treatment, the scores of Karnofsky performance scale（KPS） and the quality of life（QLQ-C30） were evaluated in the acupuncture group and the Vitamin B6 group. After 2 weeks of treatment, the therapeutic effects were evaluated.Results： The effective rate of chemotherapy-induced HFS was 70.0% in the acupuncture group and was36.7% in the Vitamin B6 group. The result in the acupuncture group was higher than the Vitamin B6 group, indicating the significant difference（P0.05）. After treatment, the KPS scores（84.23 ± 10.49） in the acupuncture group were higher obviously than the Vitamin B6 group（77.84 ± 10.33）, indicating the significant difference（P0.05）. Regarding QLQ-C30 evaluation, after 2-week treatment, the scores in the items of physical function, role function, emotional function, cognitive function and social function were all reduced remarkably as compared with those before treatment in the two groups, indicating the significant differences（all P〈0.05）. After treatment, the scores of physical function（7.13 ± 1.56 vs 16.72 ± 4.29）,emotional function（4.89 ± 0.87 vs 11.76 ± 1.29） and cognitive function（6.32 ± 1.23 vs 18.17 ± 4.1） in the acupuncture group were all lower obviously than those in the Vitamin B6 group, indicating the significant differences（all P0.05）; and the scores of role function and social function were not different significantly as compared with the VB6 group（all P〈0.05）.Conclusion： Acupuncture is effective for HFS induced by the chemotherapy with capecitabine and its effects are better than the oral administration of Vitamin B 6 in terms of physical function, emotional function and cognitive function.展开更多
BACKGROUND Pegylated liposomal doxorubicin(PLD)uses the hydrophilic layer of liposomes to reach the sweat on the skin surface or accumulate in the sweat glands,producing toxic free radicals and oxidative damage,result...BACKGROUND Pegylated liposomal doxorubicin(PLD)uses the hydrophilic layer of liposomes to reach the sweat on the skin surface or accumulate in the sweat glands,producing toxic free radicals and oxidative damage,resulting in hand-foot syndrome(HFS).Regional cooling can induce vasoconstriction to reduce the release of drugs in the limbs and reduce the accumulation of drugs in sweat glands;thus,decreasing the incidence and severity of HFS.AIM To study the efficacy of cooling patches to prevent HFS caused by PLD in the short-term.METHODS This is a retrospective cohort study.Female breast cancer patients(n=101)who were treated with PLD in two breast wards at our department from February 2020 to February 2021 were enrolled in the study and were randomly divided into the cooling group(51 patients)and the control group(50 patients).Patients in the control group only received routine care,while the patients in the cooling group applied cooling patches,based on routine care,to the palm and back of the hands 15 min before chemotherapy infusion for 10 h.All patients took a corresponding dose of dexamethasone orally one day before chemotherapy,on the day of chemotherapy,and one day after chemotherapy.SPSS23.0 version was used to analyze the data in this study.The occurrence and severity of HFS was analyzed by the Mann-Whitney U test,and scores were analyzed by the Student’s t test or Wilcoxon rank-sum test.A P value<0.05 was regarded as statistically significant.RESULTS In this study,neither group of patients developed Grade 3 HFS.In the control group,the incidence of Grade 1 HFS and Grade 2 HFS was 38%and 2%,respectively.However,in the cooling group,only one person developed Grade 1 HFS(2%),and none of the patients developed Grade 2 HFS.These findings showed that cooling patches can effectively reduce the frequency and severity of HFS(P<0.0001)in the short-term.Before the fourth chemotherapy cycle,although general self-efficacy scale scores in the cooling group were low,they were still significantly higher than those in the control group(17.22±5.16 vs 19.63±6.42,P=0.041).Compared with the control group,the mean Hand-Foot Skin Reaction and Quality of Life Questionnaire score in the cooling group was significantly lower(18.08±7.01 vs 14.20±7.39,P=0.008).CONCLUSION Cooling patches can effectively reduce the frequency and severity of HFS caused by PLD in the short-term.In addition,it may help delay the decline in patients’self-efficacy.展开更多
AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS...AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions. We examined the relationship between MKI-associated HFSR and overall survival(OS) after the initiation of treatment.RESULTS The median OS was 10.9 mo in the MKI-associated HFSR group and 3.4 mo in the no HFSR group, showing a significant difference in multivariate analysis. A multivariate analysis of the time to treatment failure indicated that the intervention by pharmacists and MKI-associated HFSR were significant factors. The median cumulative dose and the mean medication possession ratio were significantly higher in the intervention group than in the non-intervention group. A borderline significant difference was observed in terms of OS in this group.CONCLUSION Intervention by pharmacists increased drug adherence. Under increased adherence, MKI-associated HFSR was an advantageous surrogate marker. Intervention by healthcare providers needs to be performed for adequate sorafenib treatment.展开更多
Outbreaks of hand-foot-mouth disease（HFMD） have occurred many times and caused serious health burden in China since 2008. Application of modern information technology to prediction and early response can be helpful ...Outbreaks of hand-foot-mouth disease（HFMD） have occurred many times and caused serious health burden in China since 2008. Application of modern information technology to prediction and early response can be helpful for efficient HFMD prevention and control. A seasonal auto-regressive integrated moving average（ARIMA） model for time series analysis was designed in this study. Eighty-four-month（from January 2009 to December 2015） retrospective data obtained from the Chinese Information System for Disease Prevention and Control were subjected to ARIMA modeling. The coefficient of determination（R^2）, normalized Bayesian Information Criterion（BIC） and Q-test P value were used to evaluate the goodness-of-fit of constructed models. Subsequently, the best-fitted ARIMA model was applied to predict the expected incidence of HFMD from January 2016 to December 2016. The best-fitted seasonal ARIMA model was identified as（1,0,1）（0,1,1）12, with the largest coefficient of determination（R^2=0.743） and lowest normalized BIC（BIC=3.645） value. The residuals of the model also showed non-significant autocorrelations（P_（Box-Ljung（Q））=0.299）. The predictions by the optimum ARIMA model adequately captured the pattern in the data and exhibited two peaks of activity over the forecast interval, including a major peak during April to June, and again a light peak for September to November. The ARIMA model proposed in this study can forecast HFMD incidence trend effectively, which could provide useful support for future HFMD prevention and control in the study area. Besides, further observations should be added continually into the modeling data set, and parameters of the models should be adjusted accordingly.展开更多
Hand-foot syndrome (HFS), also known as palmar-plantar erythrodysesthesia, is a skin toxicity that could be observed during target therapies such as with tyrosine-kinase inhibitors (TKI). It usually develops within th...Hand-foot syndrome (HFS), also known as palmar-plantar erythrodysesthesia, is a skin toxicity that could be observed during target therapies such as with tyrosine-kinase inhibitors (TKI). It usually develops within the first 2 - 4 weeks of drug administration. We present a case of HFS induced by Pazopanib after 2 months of treatment, in patients previously treated with Sunitinib, suggesting a possible cumulative toxicity of two drugs. The clinical and therapeutic management of skin adverse reactions during TKI therapy usually requires 25% dose reduction and adequate local treatment. It is important for the clinicians to recognize clinical signs and symptoms of such skin toxicities. Attention should be paid especially when two or more drugs from the same class are used in combined treatment.展开更多
Objective: To investigate the effect of surgical nursing on grade III Hand-Foot Syndrome (HFS) induced by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery. Method: From January 2019 to Decem...Objective: To investigate the effect of surgical nursing on grade III Hand-Foot Syndrome (HFS) induced by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery. Method: From January 2019 to December 2019, 10 patients with HFS grade III caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery in the Breast Department of Cancer Prevention and Treatment Center of Sun Yat-sen University were selected, and surgical nursing methods were used to intervene and observe the therapeutic effects of the patients. Results: One patient was cured within 7 days, the cure rate was 10% in 7 days, 8 patients were cured within 10 days, the cure rate was 80% in 10 days, 10 patients were cured within 15 days, the cure rate was 100% in 15 days. Conclusion: The surgical nursing method is effective for patients with grade III HFS caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery, shortening the treatment time of HFS, and is worthy of clinical promotion.展开更多
In this article, the transmission dynamics of a Hand-Foot-Mouth disease model with treatment and vaccination interventions are studied. We calculated the basic reproduction number and proved the global stability of di...In this article, the transmission dynamics of a Hand-Foot-Mouth disease model with treatment and vaccination interventions are studied. We calculated the basic reproduction number and proved the global stability of disease-free equilibrium when R0 R0 > 1. Meanwhile, we obtained the optimal control strategies minimizing the cost of intervention and minimizing the infected person. We also give some numerical simulations to verify our theoretical results.展开更多
Some viruses, including certain members of the enterovirus genus, have been reported to cause pancreatitis, especially Coxsackie virus. However, no case of human enterovirus 71(EV71) associated with pancreatitis has b...Some viruses, including certain members of the enterovirus genus, have been reported to cause pancreatitis, especially Coxsackie virus. However, no case of human enterovirus 71(EV71) associated with pancreatitis has been reported so far. We here report a case of EV71-induced hand-foot-and-mouth disease(HFMD) presenting with pancreatitis in a 2-year-old girl. This is the first report of a patient with acute pancreatitis in HFMD caused by EV71. We treated the patient conservatively with nasogastric suction, intravenous fluid and antivirals. The patient's symptoms improved after 8 d, and recovered without complications. We conclude that EV71 can cause acute pancreatitis in HFMD, which should be considered in differential diagnosis, especially in cases of idiopathic pancreatitis.展开更多
Background:Breast cancer is a global problem,and a large number of new cases are diagnosed every year.Capecit-abine is effective in patients with metastatic breast cancer(MBC).Hand-foot syndrome(HFS)is a common advers...Background:Breast cancer is a global problem,and a large number of new cases are diagnosed every year.Capecit-abine is effective in patients with metastatic breast cancer(MBC).Hand-foot syndrome(HFS)is a common adverse effect of capecitabine.In this study,we investigated the association between single nucleotide polymorphisms(SNPs)in genes involved in capecitabine metabolism pathways and capecitabine-induced HFS in Chinese patients with MBC to identify some predictive genetic biomarkers.Methods:We selected 3 genes involved in capecitabine metabolism and screened genetic variants in these target genes.We genotyped a total of 22 SNPs in the thymidylate synthase gene(TYMS),the methylene tetrahydrofolate reductase gene(MTHFR),and the ribonucleotide reductase M1 gene(RRM1)in 342 MBC patients treated with capecit-abine-based chemotherapy.The genotype distributions of each SNP in patients with and without HFS were assessed using Pearson’sχ^(2)test,and the relationship between HFS and genotypes of SNPs was determined using logistic regression analysis.The association between SNPs and their corresponding gene expression was analyzed using the Blood expression quantitative trait loci(eQTL)browser online tools.Results:We found 4 positive sites for HFS in the TYMS and MTHFR genes:TYMS rs2606241(P=0.022),TYMS rs2853741(P=0.019),MTHFR rs3737964(P=0.029),and MTHFR rs4846048(P=0.030).Logistic regression analyses showed that the genotype AG of MTHFR rs3737964[odds ratio(OR)=0.54,95%confidence interval(CI)0.31-0.97,P=0.038]and MTHFR rs4846048(OR=0.54,95%CI 0.30-0.98,P=0.042)were protective factors of HFS,whereas the genotype CT of TYMS rs2853741(OR=2.25,95%CI 1.31-3.87,P=0.012)increased the risk of HFS.The association between the genotype GT of TYMS rs2606241(OR=1.27,95%CI 0.73-2.23,P=0.012)and HFS was uncertain.Further eQTL analyses confirmed that the alleles of rs3737964 and rs4846048 affected the gene expression levels of MTHFR in cis.Conclusions:We have identified four potentially useful pharmacogenetic markers,TYMS rs2606241,TYMS rs2853741,MTHFR rs3737964,and MTHFR rs4846048 to predict capecitabine-induced HFS in MBC patients.展开更多
Hand-foot syndrome(HFS)is a widely recognized dose-limiting cutaneous toxicity effect of fluoropyrimidine chemotherapy agents that impairs clinical benefits and treatment outcomes.Even though the cause and pathophysio...Hand-foot syndrome(HFS)is a widely recognized dose-limiting cutaneous toxicity effect of fluoropyrimidine chemotherapy agents that impairs clinical benefits and treatment outcomes.Even though the cause and pathophysiology of HFS are relatively widely reported,how the toxicity of fluoropyrimidine translates into persistent inflammation has not been studied.Additionally,prevention and treatment strategies for HFS based on its mechanistic occurrence and development are scarce.In our study,we demonstrated that cGAS-STING signaling pathway-mediated cellular senescence played a critical role in the inflammatory reaction and provided a therapeutic solution for HFS.Mechanistically,DNA damage,as the primary cytotoxic cause,in keratinocytes induces cell cycle arrest,activates the cGAS-STING signaling pathway,and subsequently mediates cellular senescence,ultimately fueling a robust secondary inflammatory response that results in HFS.More importantly,the thymidine prodrug thymidine diacetate was proven to be effective in preventing HFS by compensating for thymidylate deficiency to facilitate the replication and repair of DNA and thus causing the escape from cellular senescence.These data highlight the importance of DNA damage-mediated cellular senescence in the etiology of HFS and provide a potential therapeutic anchor point for fluoropyrimidine-induced HFS.展开更多
基金Supported by Doctoral Fund of the Ministry of Education 2010(No.20104401110003)National Natural Science Foundation of China(No.81273616 and 30973693)Guangdong Natural Science Foundation(No.S2013010013434)
文摘OBJECTIVE:To observe the effect of the Traditional Chinese Medicine,modified Taohongsiwu decoction,versus pyridoxine on patients with hand-foot syndrome(HFS)from capecitabine,sorafenib,and gefitinib chemotherapy for gastric,lung,breast,colon,or rectal cancer.Also,to compare quality of life of patients in each group.METHODS:Patients were assigned randomly to group A or B.Group A was given modifiedTaohongsiwu decoction to soak hands and feet for 30 min,once daily.Group B was given 100 mg pyridoxine orally,twice daily.After a 2-week treatment,thetherapeutic effect was assessed by observing three major symptoms,including pain,ulceration,and muscular atrophy.This was assessed with the HFS-14 questionnaire.RESULTS:Significant differences were observed between the two groups in pain relief,and improvement of daily life,walking,and interpersonal communication(P<0.01).No significant differences in driving ability or interpersonal relationships were found.After 2 weeks,the effective rate was 88.3%in group A,which was significantly higher than the50%in group B(P=0.00).CONCLUSION:Modified Taohongsiwu decoction is effective in the treatment of patients with HFS.It improves patients'quality of life according to the HFS-14.
基金funded by the Hainan Natural Science Foundation 310119Haiman Health Institution Project(No 2011-22)
文摘Objective:To investigate clinical and neuroimaging features of enterovirus71(EV71) related acute flaccid paralysis in patients with hand-fool-mouth disease.Methods:Nine patients with acute flaccid paralysis met the criterion of EV71 induced hand-foot-mouth disease underwent spinal and brain MR imaging from May 2008 to Sep 2012.Results:One extremity flaccid was found in four cases(3 with lower limb,1 with upper limb),two limbs flaccid in three cases(2 with lower limbs,1 with upper limbs),and four limbs flaccid in two cases.Spinal MRI studies showed lesion with high signal in T2-weighted images(T2WI) and low signal T1-weighted images(T1WI) in the spinal cord of all nine cases,and the lesions were mainly in bilateral and unilateral anterior hom of cervical spinal cord and spinal cord below thoracic 9(T9) level.In addition,the midbrain,pons, and medulla,which were involved in 3 cases with brainstem encephalitis,demonstrated abnormal signal.Moreover,spinal cord contrast MRI studies showed mild enhancement in corresponding anterior hom of the involved side,and strong enhancement in its ventral root.Conclusions: EV71 related acute flaccid paralysis in patients with hand-foot-mouth disease mainly affected the anterior hom regions and ventral root of cervical spinal cord and spinal cord below T9 level. MR imaging could efficiendy show the characteristic pattern and extent of the lesions which correlated well with the clinical features.
文摘Objective： To observe the clinical therapeutic effects of acupuncture on chemotherapy-induced hand-foot syndrome（HFS）.Methods： A total of 60 patients treated with chemotherapy of capecitabine and suffering from the chemotherapy-induced HFS were divided into an acupuncture group and a Vitamin B6 group according to the random number table, 30 cases in each one. In the acupuncture group, after chemotherapy,acupuncture was given at Bǎihui（百会 GV 20）, Hégǔ（合谷 LI 4）, Wàiguān（外关 TE 5）, Zúsānlǐ（足三里ST 36） and Ashi points. The needles were retained for 30 min in each treatment, once a day, totally for 2 weeks. In the Vitamin B6 group, after chemotherapy, Vitamin B6 was taken orally, 300 mg a day, totally for 2 weeks. Separately, on the day of enrollment and after 2 weeks of treatment, the scores of Karnofsky performance scale（KPS） and the quality of life（QLQ-C30） were evaluated in the acupuncture group and the Vitamin B6 group. After 2 weeks of treatment, the therapeutic effects were evaluated.Results： The effective rate of chemotherapy-induced HFS was 70.0% in the acupuncture group and was36.7% in the Vitamin B6 group. The result in the acupuncture group was higher than the Vitamin B6 group, indicating the significant difference（P0.05）. After treatment, the KPS scores（84.23 ± 10.49） in the acupuncture group were higher obviously than the Vitamin B6 group（77.84 ± 10.33）, indicating the significant difference（P0.05）. Regarding QLQ-C30 evaluation, after 2-week treatment, the scores in the items of physical function, role function, emotional function, cognitive function and social function were all reduced remarkably as compared with those before treatment in the two groups, indicating the significant differences（all P〈0.05）. After treatment, the scores of physical function（7.13 ± 1.56 vs 16.72 ± 4.29）,emotional function（4.89 ± 0.87 vs 11.76 ± 1.29） and cognitive function（6.32 ± 1.23 vs 18.17 ± 4.1） in the acupuncture group were all lower obviously than those in the Vitamin B6 group, indicating the significant differences（all P0.05）; and the scores of role function and social function were not different significantly as compared with the VB6 group（all P〈0.05）.Conclusion： Acupuncture is effective for HFS induced by the chemotherapy with capecitabine and its effects are better than the oral administration of Vitamin B 6 in terms of physical function, emotional function and cognitive function.
文摘BACKGROUND Pegylated liposomal doxorubicin(PLD)uses the hydrophilic layer of liposomes to reach the sweat on the skin surface or accumulate in the sweat glands,producing toxic free radicals and oxidative damage,resulting in hand-foot syndrome(HFS).Regional cooling can induce vasoconstriction to reduce the release of drugs in the limbs and reduce the accumulation of drugs in sweat glands;thus,decreasing the incidence and severity of HFS.AIM To study the efficacy of cooling patches to prevent HFS caused by PLD in the short-term.METHODS This is a retrospective cohort study.Female breast cancer patients(n=101)who were treated with PLD in two breast wards at our department from February 2020 to February 2021 were enrolled in the study and were randomly divided into the cooling group(51 patients)and the control group(50 patients).Patients in the control group only received routine care,while the patients in the cooling group applied cooling patches,based on routine care,to the palm and back of the hands 15 min before chemotherapy infusion for 10 h.All patients took a corresponding dose of dexamethasone orally one day before chemotherapy,on the day of chemotherapy,and one day after chemotherapy.SPSS23.0 version was used to analyze the data in this study.The occurrence and severity of HFS was analyzed by the Mann-Whitney U test,and scores were analyzed by the Student’s t test or Wilcoxon rank-sum test.A P value<0.05 was regarded as statistically significant.RESULTS In this study,neither group of patients developed Grade 3 HFS.In the control group,the incidence of Grade 1 HFS and Grade 2 HFS was 38%and 2%,respectively.However,in the cooling group,only one person developed Grade 1 HFS(2%),and none of the patients developed Grade 2 HFS.These findings showed that cooling patches can effectively reduce the frequency and severity of HFS(P<0.0001)in the short-term.Before the fourth chemotherapy cycle,although general self-efficacy scale scores in the cooling group were low,they were still significantly higher than those in the control group(17.22±5.16 vs 19.63±6.42,P=0.041).Compared with the control group,the mean Hand-Foot Skin Reaction and Quality of Life Questionnaire score in the cooling group was significantly lower(18.08±7.01 vs 14.20±7.39,P=0.008).CONCLUSION Cooling patches can effectively reduce the frequency and severity of HFS caused by PLD in the short-term.In addition,it may help delay the decline in patients’self-efficacy.
文摘AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions. We examined the relationship between MKI-associated HFSR and overall survival(OS) after the initiation of treatment.RESULTS The median OS was 10.9 mo in the MKI-associated HFSR group and 3.4 mo in the no HFSR group, showing a significant difference in multivariate analysis. A multivariate analysis of the time to treatment failure indicated that the intervention by pharmacists and MKI-associated HFSR were significant factors. The median cumulative dose and the mean medication possession ratio were significantly higher in the intervention group than in the non-intervention group. A borderline significant difference was observed in terms of OS in this group.CONCLUSION Intervention by pharmacists increased drug adherence. Under increased adherence, MKI-associated HFSR was an advantageous surrogate marker. Intervention by healthcare providers needs to be performed for adequate sorafenib treatment.
基金financially supported by the Health and Family Planning Commission of Hubei Province(No.WJ2017F047)the Health and Family Planning Commission of Wuhan(No.WG17D05)
文摘Outbreaks of hand-foot-mouth disease（HFMD） have occurred many times and caused serious health burden in China since 2008. Application of modern information technology to prediction and early response can be helpful for efficient HFMD prevention and control. A seasonal auto-regressive integrated moving average（ARIMA） model for time series analysis was designed in this study. Eighty-four-month（from January 2009 to December 2015） retrospective data obtained from the Chinese Information System for Disease Prevention and Control were subjected to ARIMA modeling. The coefficient of determination（R^2）, normalized Bayesian Information Criterion（BIC） and Q-test P value were used to evaluate the goodness-of-fit of constructed models. Subsequently, the best-fitted ARIMA model was applied to predict the expected incidence of HFMD from January 2016 to December 2016. The best-fitted seasonal ARIMA model was identified as（1,0,1）（0,1,1）12, with the largest coefficient of determination（R^2=0.743） and lowest normalized BIC（BIC=3.645） value. The residuals of the model also showed non-significant autocorrelations（P_（Box-Ljung（Q））=0.299）. The predictions by the optimum ARIMA model adequately captured the pattern in the data and exhibited two peaks of activity over the forecast interval, including a major peak during April to June, and again a light peak for September to November. The ARIMA model proposed in this study can forecast HFMD incidence trend effectively, which could provide useful support for future HFMD prevention and control in the study area. Besides, further observations should be added continually into the modeling data set, and parameters of the models should be adjusted accordingly.
文摘Hand-foot syndrome (HFS), also known as palmar-plantar erythrodysesthesia, is a skin toxicity that could be observed during target therapies such as with tyrosine-kinase inhibitors (TKI). It usually develops within the first 2 - 4 weeks of drug administration. We present a case of HFS induced by Pazopanib after 2 months of treatment, in patients previously treated with Sunitinib, suggesting a possible cumulative toxicity of two drugs. The clinical and therapeutic management of skin adverse reactions during TKI therapy usually requires 25% dose reduction and adequate local treatment. It is important for the clinicians to recognize clinical signs and symptoms of such skin toxicities. Attention should be paid especially when two or more drugs from the same class are used in combined treatment.
文摘Objective: To investigate the effect of surgical nursing on grade III Hand-Foot Syndrome (HFS) induced by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery. Method: From January 2019 to December 2019, 10 patients with HFS grade III caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery in the Breast Department of Cancer Prevention and Treatment Center of Sun Yat-sen University were selected, and surgical nursing methods were used to intervene and observe the therapeutic effects of the patients. Results: One patient was cured within 7 days, the cure rate was 10% in 7 days, 8 patients were cured within 10 days, the cure rate was 80% in 10 days, 10 patients were cured within 15 days, the cure rate was 100% in 15 days. Conclusion: The surgical nursing method is effective for patients with grade III HFS caused by Doxorubicin hydrochloride liposome chemotherapy after breast cancer surgery, shortening the treatment time of HFS, and is worthy of clinical promotion.
文摘In this article, the transmission dynamics of a Hand-Foot-Mouth disease model with treatment and vaccination interventions are studied. We calculated the basic reproduction number and proved the global stability of disease-free equilibrium when R0 R0 > 1. Meanwhile, we obtained the optimal control strategies minimizing the cost of intervention and minimizing the infected person. We also give some numerical simulations to verify our theoretical results.
文摘Some viruses, including certain members of the enterovirus genus, have been reported to cause pancreatitis, especially Coxsackie virus. However, no case of human enterovirus 71(EV71) associated with pancreatitis has been reported so far. We here report a case of EV71-induced hand-foot-and-mouth disease(HFMD) presenting with pancreatitis in a 2-year-old girl. This is the first report of a patient with acute pancreatitis in HFMD caused by EV71. We treated the patient conservatively with nasogastric suction, intravenous fluid and antivirals. The patient's symptoms improved after 8 d, and recovered without complications. We conclude that EV71 can cause acute pancreatitis in HFMD, which should be considered in differential diagnosis, especially in cases of idiopathic pancreatitis.
基金This work was supported by the Chinese Academic of Medical Sciences Initiative for Innovative Medicine(CAMS-12M-1-010)Beijing Municipal Science&Technology Commission(Z151100004015024)
文摘Background:Breast cancer is a global problem,and a large number of new cases are diagnosed every year.Capecit-abine is effective in patients with metastatic breast cancer(MBC).Hand-foot syndrome(HFS)is a common adverse effect of capecitabine.In this study,we investigated the association between single nucleotide polymorphisms(SNPs)in genes involved in capecitabine metabolism pathways and capecitabine-induced HFS in Chinese patients with MBC to identify some predictive genetic biomarkers.Methods:We selected 3 genes involved in capecitabine metabolism and screened genetic variants in these target genes.We genotyped a total of 22 SNPs in the thymidylate synthase gene(TYMS),the methylene tetrahydrofolate reductase gene(MTHFR),and the ribonucleotide reductase M1 gene(RRM1)in 342 MBC patients treated with capecit-abine-based chemotherapy.The genotype distributions of each SNP in patients with and without HFS were assessed using Pearson’sχ^(2)test,and the relationship between HFS and genotypes of SNPs was determined using logistic regression analysis.The association between SNPs and their corresponding gene expression was analyzed using the Blood expression quantitative trait loci(eQTL)browser online tools.Results:We found 4 positive sites for HFS in the TYMS and MTHFR genes:TYMS rs2606241(P=0.022),TYMS rs2853741(P=0.019),MTHFR rs3737964(P=0.029),and MTHFR rs4846048(P=0.030).Logistic regression analyses showed that the genotype AG of MTHFR rs3737964[odds ratio(OR)=0.54,95%confidence interval(CI)0.31-0.97,P=0.038]and MTHFR rs4846048(OR=0.54,95%CI 0.30-0.98,P=0.042)were protective factors of HFS,whereas the genotype CT of TYMS rs2853741(OR=2.25,95%CI 1.31-3.87,P=0.012)increased the risk of HFS.The association between the genotype GT of TYMS rs2606241(OR=1.27,95%CI 0.73-2.23,P=0.012)and HFS was uncertain.Further eQTL analyses confirmed that the alleles of rs3737964 and rs4846048 affected the gene expression levels of MTHFR in cis.Conclusions:We have identified four potentially useful pharmacogenetic markers,TYMS rs2606241,TYMS rs2853741,MTHFR rs3737964,and MTHFR rs4846048 to predict capecitabine-induced HFS in MBC patients.
基金supported by the Youth Thousand Talents Program of China,start-up grants from the Shanghai Jiao Tong University(No.WF220408211)supported by grants from the State Key Laboratory of Oncogenes and Related Genes(No.90-17-02)at Shanghai Jiao Tong Universityfrom the Interdisciplinary Program of Shanghai Jiao Tong University(China)(No.YG2017MS18).
文摘Hand-foot syndrome(HFS)is a widely recognized dose-limiting cutaneous toxicity effect of fluoropyrimidine chemotherapy agents that impairs clinical benefits and treatment outcomes.Even though the cause and pathophysiology of HFS are relatively widely reported,how the toxicity of fluoropyrimidine translates into persistent inflammation has not been studied.Additionally,prevention and treatment strategies for HFS based on its mechanistic occurrence and development are scarce.In our study,we demonstrated that cGAS-STING signaling pathway-mediated cellular senescence played a critical role in the inflammatory reaction and provided a therapeutic solution for HFS.Mechanistically,DNA damage,as the primary cytotoxic cause,in keratinocytes induces cell cycle arrest,activates the cGAS-STING signaling pathway,and subsequently mediates cellular senescence,ultimately fueling a robust secondary inflammatory response that results in HFS.More importantly,the thymidine prodrug thymidine diacetate was proven to be effective in preventing HFS by compensating for thymidylate deficiency to facilitate the replication and repair of DNA and thus causing the escape from cellular senescence.These data highlight the importance of DNA damage-mediated cellular senescence in the etiology of HFS and provide a potential therapeutic anchor point for fluoropyrimidine-induced HFS.
