ABSTRACT
Objective@#To investigate the adrenocortical function changes of patients with advanced solid tumors who received the anti- programmed cell death protein-1 (PD-1) antibody, SHR-1210 therapy.@*Methods@#The clinical data of 98 patients with advanced solid tumors who were enrolled in a prospective phase I trial of SHR-1210 therapy at our institution between April 27, 2016 and June 8, 2017 were collected. The levels of plasma adrenocorticotropic hormone (ACTH) and cortisol were evaluated in 96 patients. The clinical manifestations, laboratory tests and radiologic data were collected to define the immune-related adrenal insufficiency.@*Results@#Until December 14th, 2018, no SHR-1210 related primary adrenal insufficiency occurred, and the incidence of immune-related secondary adrenal insufficiency was 1.0% among the 96 patients, which was identified as grade 2. No patient developed grade 3-4 adrenal insufficiency. The main clinical manifestations of the patient who was diagnosed as secondary adrenal insufficiency were grade 2 fatigue, anorexia and headache.The patient developed fatigue and anorexia at the 267th day after receiving the first dose of SHR-1210, the hypocortisolism occurred on the 279th day, and the headache emerged on the 291th day. The anorexia of patient who treated by physiological replacement doses of glucocorticoid since the 457th day was attenuated.The patient whose cortisol level was still below the normal limit continued to accept the hormone replacement therapy up to 776 days after the initial administration of SHR-1210.@*Conclusions@#The incidence of SHR-1210 related adrenal insufficiency of patients with advanced solid tumors is low, and the symptoms can be effectively ameliorated by hormone replacement therapy. The potential adverse outcome of adrenal insufficiency following immunotherapy should be noticed by clinicians to avoid the occurrence of adrenal crisis.
ABSTRACT
Objective To understand the indoor air pollution caused by smoking and the influencing factors.Methods On the different time after and before smoking,the concentrations of carbon monoxide(CO),inhalabe particle(IP),formaldehyde,total volatile organic compounds(TVOC) in the air in an office were determined,the influence factors such as ventilated conditions and the number of smokers were investigated.Results When the windows and doors were closed,the concentrations of indoor air pollutants at the different time after smoking in the office were obviously higher than those without smoking,and formaldehyde and TVOC still exceeded the standard limit after 3 hours.When the windows and doors were opened,the concentrations of indoor air pollutants after smoking increased obviously,but decreased to the level of no smoking about 30 minutes later.When the windows and doors were opened,the peak values of the indoor air pollutants resulted by smoking were obviously lower than those when the windows and doors were closed.The peak values of the pollutants were positively related to the number of smokers. Conclusion Indoor air pollution caused by smoking is serious.Ventilation can reduce the indoor air pollution effectively.