和胃解毒汤治疗食道癌患者的疗效和安全性

目的探讨和胃解毒汤治疗食道癌患者的疗效以及安全性,为临床治疗食道癌提供新思路。方法选取2019年1月至2020年5月梅州市人民医院收治的食道癌患者62例作为研究对象,按照不同的治疗方案分为对照组(30例)和试验组(32例)。对照组给予调强适形放射治疗加紫杉醇(TXL)联合洛铂(LBP)化疗,即TP化疗方案;试验组在对照组基础上加用和胃解毒汤。比较分析两组患者的治疗效果,并评价两组患者的胃肠道不良反应发生情况。结果试验组治疗有效率及疾病控制率分别为78.13%和87.50%,显著高于对照组的53.33%和66.67%,差异有统计学意义(P<0.05);主要不良反应为胃肠道反应,以恶心呕吐、食欲下降为主,可耐受,其中试验组胃肠道不良反应发生率9.38%,显著低于对照组的30.00%(P<0.05)。结论和胃解毒汤在食道癌患者综合治疗中具有良好的疗效,减轻了不良反应,对治疗食道癌有积极的意义。     

Evolutionary dynamics of supervision-compliance game on optimal pre-positioning strategies in relief supply chain management

Emergency supply reserves are indispensable material bases in relief supply chain management. However, limited in-kind relief resources stockpiled in government-managed depositories may fail to meet the surging demand following the disaster. This paper develops an optimal pre-positioning strategy for emergency supplies with pre-purchasing contracts between local governments (LGs) and emergency supply manufacturers (ESMs) to properly address demand uncertainty in different disaster scenarios. Physical materials and production capacity are integrated into a holistic and hybrid reserve model to mitigate overstock or stock-out risks. Applying an evolutionary game-theoretic framework, contract enforcement has been extensively analyzed to avoid LGs dereliction of duty and ESMs’ breach of contract. A novel dynamic penalty mechanism is proposed to control the fluctuations in strategy choices and effectively improve ESMs’ compliance without LGs’ excessive inputs on supervision. The numerical simulation results, along with sensitivity analyses on major cost-accounting, demand characteristics, and environmental parameters, show that safety stock is the primary guarantee in most cases, while reactive stock acts as an important supplement for disasters with long-term consequences. The joint reserve policy (except for no action strategy) outperforms the price-only contract on the total reserved quantity of emergency supplies at a lower long-term average cost. The initial state and cost-benefit structures dominate the complex interplay and periodical fluctuations in the supervision-compliance game. The doomed cycle of order, disorder, and reorder in contract performance management can be well managed under the proposed dynamic penalty mechanism, which appears much more efficient and incentive-compatible in promoting both parties to fulfill their obligations.