Effects of Tanreqing Injection on ICU Mortality among ICU Patients Receiving Mechanical Ventilation: Time-Dependent Cox Regression Analysis of A Large Registry / 中国结合医学杂志

OBJECTIVE@#To assess whether the use of Tanreqing (TRQ) Injection could show improvements in time to extubation, intensive care unit (ICU) mortality, ventilator-associated events (VAEs) and infection-related ventilator associated complication (IVAC) among patients receiving mechanical ventilation (MV).@*METHODS@#A time-dependent cox-regression analysis was conducted using data from a well-established registry of healthcare-associated infections at ICUs in China. Patients receiving continuous MV for 3 days or more were included. A time-varying exposure definition was used for TRQ Injection, which were recorded on daily basis. The outcomes included time to extubation, ICU mortality, VAEs and IVAC. Time-dependent Cox models were used to compare the clinical outcomes between TRQ Injection and non-use, after controlling for the influence of comorbidities/conditions and other medications with both fixed and time-varying covariates. For the analyses of time to extubation and ICU mortality, Fine-Gray competing risk models were also used to measure competing risks and outcomes of interest.@*RESULTS@#Overall, 7,685 patients were included for the analyses of MV duration, and 7,273 patients for the analysis of ICU mortality. Compared to non-use, patients with TRQ Injection had a lower risk of ICU mortality (Hazards ratios (HR) 0.761, 95% CI, 0.581-0.997), and was associated with a higher hazard for time to extubation (HR 1.105, 95% CI, 1.005-1.216), suggesting a beneficial effect on shortened time to extubation. No significant differences were observed between TRQ Injection and non-use regarding VAEs (HR 1.057, 95% CI, 0.912-1.225) and IVAC (HR 1.177, 95% CI, 0.929-1.491). The effect estimates were robust when using alternative statistic models, applying alternative inclusion and exclusion criteria, and handling missing data by alternative approaches.@*CONCLUSION@#Our findings suggested that the use of TRQ Injection might lower mortality and improve time to extubation among patients receiving MV, even after controlling for the factor that the use of TRQ changed over time.

Lung cancer chemotherapy in the context of precision medicine:New perspectives and new thoughts / 医学研究生学报

Withthe findings of the differential efficacy of pemetrexedon squamous and non-squamous cell carcinoma as a start-ing point begins the exploration into precise chemotherapy .In order to further improve the accuracy of chemotherapy , the primary resist-ance mechanism of the targeted therapyhas to be investigated to find those who benefit more from chemotherapy than from the targeted therapy and, on the other hand , the mechanism the prognosis of chemotherapyneeds to be exploredfor the precise useof chemotherapy . Future studies on the prediction of the effect of chemotherapy may focus oncirculating tumor cells and patient -derived tumor xenografts . The development of a new generation of antibody drugs conjugated with chemotherapy can improve the target of chemotherapeutic drugs and reduce their adverse effects .With the characteristic of "wide coverage"and as the cornerstone of anti-cancer treatment , chemother-apy combined with target therapy ( as with the tyrosine kinase inhibitor or anti-angiogenesis drugs ) or immunotherapy can significantly improve the curative effect .In the era of precision medicine , chemotherapy will findapproval for its new roles .