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Osimertinib, as a representative of the third generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), has significant curative effect for EGFR T790M mutation type non-small cell lung cancer (NSCLC). But with the development of clinical research Osimertinib's resistance gradually appear. How to deal with the resistance is a problem that the clinical workers must focus on. This article will review the latest research progress of the mechanisms and the solutions of osimertinib acquired resistance.
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Objective:To explore the correlation between TCM Syndromes of small pulmonary nodules (SPN) and the features of CT imaging and tumor markers in the chest.Methods:With retrospective study, the clinical data of 420 patients with small pulmonary nodules who were included from June 2016 to May 2018 from the East China Hospital Affiliated to Fudan University and Shanghai TCM Integrated Hospital were analized. The correlation between TCM syndromes and clinical high-risk indicators was analyzed by frequency analysis and Pearson correlation analysis.Results:The TCM syndromes were mainly lung qi and spleen qi deficiency syndrome (28.8%), followed by qi and yin deficiency syndrome (27.6%), lung yin deficiency syndrome (22.9%), qi deficiency and blood stasis syndrome (12.4%) and liver depression and spleen deficiency syndrome (8.3%). Compared with the patients with qi deficiency and blood stasis, the patients with liver depression and spleen deficiency had carcino embryonic antigen (CEA) level decreased significantly ( P<0.01); compared with the patients with qi and yin deficiency, CYFRA21-1 level in the patients with lung yin deficiency increased significantly ( P<0.001) and CYFRA21-1 level decreased in the patients with qi deficiency and blood stasis ( P=0.014); compared with the patients with lung yin deficiency, the level of neuron-specific- enolase (NSE) in the patients with lung qi and spleen qi deficiency. The level of NSE decreased ( P=0.044), and the level of NSE increased significantly in patients with liver depression and spleen deficiency ( P=0.005); there was no significant difference in the level of SCC between different syndromes ( F=0.825, P=0.551). The syndrome of deficiency of lung yin was moderately correlated with chronic bronchitis, smooth margin and burr ( r=0.613, -0.628, 0.755). The syndrome of qi and yin deficiency was lowly correlation to the solidity ( r=-0.421). The syndrome of lung qi and spleen qi deficiency was moderately correlation with the solidity ( r=0.540), and were low correlation with the chronic bronchitis history, ground glass, round, quasi round, and smooth edge ( r value was 0.303, -0.495, 0.376, -0.337, 0.319 respectively); liver depression and spleen deficiency syndrome were correlated with smoking history, chronic bronchitis history, left lower lobe of lung, isolated focus, multiple focus, quasi circle, NSE ( r value was -0.099, -0.150, 0.120, 0.113, -0.113, -0.107, 0.133 respectively); qi deficiency and blood stasis syndrome was moderately correlated with lobular shape ( r=0.682), and slightly correlated with irregular edge ( r=0.470). Conclusions:There is a certain correlation between TCM syndrome differentiation and clinical indexes in patients with pulmonary nodules. The level of tumor markers was different in different syndrome types. Among them, the lung yin deficiency syndrome and qi deficiency and blood stasis syndrome are at high risk of developing malignant tumors, but the lung qi and spleen qi deficiency syndrome, qi and yin deficiency syndrome and liver depression and spleen deficiency syndrome are at low risk of developing malignant tumors.
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Peripheral T-cell lymphomas (PTCL) are a heterogeneous group of malignancies derived from mature postthymic T cells or natural killer (NK) cells. The patients with PTCL were more aggressive with poorer prognosis than those with the corresponding B-cell lymphomas. The advances of diagnosis and treatment for PTCL are reviewed in this article.
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Objective: To observe the effect of strengthening qi and nourishing yin recipe (SQNY recipe) on the expressions of estrogen receptor ? (ER?) and CyclinD1 of Lewis lung cancer in C57BL/6 mice with immunohistochemistry, and discuss the mechanism of its anti-proliferation and anti-metastasis effects, and analyse the correlation between ER? and CyclinD1. Methods: Twenty-four C57BL/6 mice were randomly divided into three groups. They were all transplanted with Lewis lung cancer cells, and received the interventions the next day as follows: tumor-bearing control group was fed with 0.9% NaCl, and TCM group was treated with SQNY recipe, and DDP group was given intraperitoneal DDP injection. All of mice were killed on the 20th day, weighed the tumor and counted lung metastases to calculate the inhibition rates of tumor growth and metastasis. The expressions of ER?, CyclinD1 in tumor tissues were detected by immunohistochemistry. Results: The inhibition rates of tumor growth and metastasis were 35.02% and 54.20% in TCM group, and were 41.18% and 39.02% in DDP group, respectively (all P
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<p><b>BACKGROUND</b>To investigate the effect and complication of three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with stage I-III non-small cell lung cancer.</p><p><b>METHODS</b>Thirty elderly patients with stage I-III NSCLC who were treated with 3D-CRT from January, 1998 to January, 2002 were retrospectively analyzed. In the 30 patients, 46 targets were treated with 3-5 Gy per fraction to a total dose of 42-66 Gy. The effect and complication were analysed.</p><p><b>RESULTS</b>The overall 1-, 2-, 3-year survival rates and the median survival time were 65.8%, 41.2%, 20.6%, and 23 months respectively. The overall 1-, 2-, 3-year local control rates were 59.8%, 31.1%, and 28.3%. The overall incidence of radiation pneumonitis was 16.7% (15/30) with grade≥3 of 6.7%, and one case was died from rediation pneumonitis. The incidence of radiation pulmonary fibrosis was 10.0% (3/30), and the incidence of radiation esophagistis was 43.3% (13/30), but both two side effects were slight.</p><p><b>CONCLUSIONS</b>3D-CRT can improved the survival in elderly patients with stage I-III non-small cell lung cancer by escalating radiotherapy doses.</p>
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Based on the characteristics of voluntary service,the article is intended to analyze the types, contents and functions of voluntary service carried out in medical institutions and discuss several problems on its organization and management,in order to provide some practical ideas for medical institutions to make the best use of this social resource.