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Objective To determine whether relative abundance of epidermal growth factor receptor (EGFR) mutations in plasma predicts clinical response to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in patients with advanced lung adenocarcinoma. Methods In this prospective study, adult patients with advanced lung adenocarcinoma were enrolled in our hospital from 1 April 2016 to 1 January 2017. EGFR mutations in tumor tissues were detected by ADx-amplification refractory mutation system (ADx-ARMS). EGFR mutations of plasma free tumor DNA were detected by ADx-ARMS and ADx-super amplification refractory mutation system (ADx-SuperARMS) at the same time. Patients with EGFR-mutant in tumor tissues and receiving EGFR-TKIs were finally enrolled. Plasma mutation-positive patients with both methods were high abundance group.Patients with positive mutations by ADx-SuperARMS but negative by ADx-ARMS were medium abundance group. Mutation-negative patients with both methods were recognized as low abundance group. The correlation between EGFR mutation abundance and clinical response to EGFR-TKIs were analyzed. Results Among 71 patients enrolled, 42 harbored EGFR mutations in plasma were detected by ADx-ARMS, while 53 were found by ADx-SuperARMS.There were 42 patients in high abundance group, 11 in medium group while the other 18 in low group. The objective response rates (ORRs) were 69.0%,7/11 and 10/18 in high, medium and low groups, respectively. The difference was significant between high and low abundances groups (P=0.006). Median progression-free survival (PFS) in high,medium and low groups were 11.0, 8.5 and 9.0 monthes, respectively (P<0.001). In patients with tumor 19-Del, the ORRs were 70.4%,5/7 and 6/11 in high,medium and low abundance groups, respectively. The median PFS of high abundance group was significantly longer than the other two groups (12.0 monthes vs 9.0, 9.0 monthes). As to subjects with L858R mutation, the ORRs were 10/15,2/4 and 3/6,respectively, with median PFS 9.6, 5.5 and 9.5 monthes. Conclusions The relative abundance of EGFR mutations in plasma predicts clinical response to EGFR-TKIs in patients with advanced lung adenocarcinoma. The higher the mutation abundance is, the better the efficacy of EGFR-TKIs is.
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Objective To investigate the effectiveness of Varenicline combined with MEDCHART application software for health education and follow-up in patients at smoking cessation clinic.Methods A total of 104 cases who had smoking cessation counseling and intervention at smoking cessation clinic from February 2014 to January 2015 were divided randomly into MEDCHART APP group (n=51) and conventional group (n=53).Both groups were intervened by brief admonishment and given Varenicline.The 9-12 weeks and 26th week protracted continuous abstinence rates were observed.Results There were no significant difference in 9-12 week protracted withdrawal rate between 26th week APP and conventional groups (56.9％ vs.45.3％),the 26th week abstinence rates in group MEDCHART APP (41.2％) were significantly higher than the conventional group (20.8％)(x2=5.088,P＜0.05).There was significant difference in full course completion rates between the two groups;15 cases (29.4％) completed the course in group MEDCHART APP,whereas 5 cases (9.4％) did so in conventional group (x2=4.405,P＜0.05).Conclusion MEDCHART APP can strengthen health education and follow-up,which helps extend the time for Varenicline,increase 26th week smoking cessation withdrawal rate.It is a useful tool for smoking cessation education and follow-up.
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ObjectiveTo investigate the feasibility and clinical effect of bispectral index (BIS) monitoring target controlled infusion of midazolam and propofol for sedation of mechanically ventilated patients.MethodsEighty cases with severe respiratory failure,sane,the need for endotracheal intubation mechanical ventilation for at least 24 h were divided into 4 groups by random digits table with 20 cases each.Group A and group C patients routinely received propofol and midazolam,group B and group D patients used BIS monitoring target controlled infusion of propofol and midazolam.The correlation of BIS and Ramsay score was analyzed,and the changes of mean arterial pressure (MAP) and heart rate (HR) were compared among 4 groups.ResultsBIS was negatively correlated with Ramsay score in group B and group D (P ＜ 0.05).MAP after 24 h intubation was lower than that at intubation immediately among 4 groups [group A:(63.89 ±4.68) mm Hg (1 mm Hg =0.133 kPa) vs.(92.33 ±3.57) mm Hg,group B:(62.66 ±3.97) mm Hg vs.(93.76 ± 4.02) mm Hg,group C:(64.59 ± 3.29) mm Hg vs. (93.78 ± 4.61 ) mm Hg,group D:(63.18 ±2.51 )mm Hg vs. (93.61 ± 5.36) mm Hg],and there were significant differences (P＜ 0.05).Group A and group B reached the standard after 1 h intubation.HR after 24 h intubation decreased in 4 groups,but there was no significant difference (P ＞ 0.05).ConclusionsBIS monitoring target conmolled infusion of midazolam and propofol for sedation of mechanically ventilated patients can achieve similar sedative effects,in addition,the need for rapid sedation of mechanically ventilated patients with suitable choice of propofol.At the same time,BIS is negatively correlated with Ramsay score.
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Objective To compare the mandibular advancement appliance(MAA) with mandibular advancement and left-leaning appliance (MALA) in the treatment of mild or moderate obstructive sleep ap-nea-hypopnea syndrome (OSAHS). Methods Twenty-two cases of mild or moderate OSAHS were treated with MAA, and 19 cases with MALA. After 1-3 months, they were examined again with Epworth score and polysonmography (PSG). Results After 1-3 months of the MAA or MALA treatment, the Epworth score was improved evidently. The apnea -hypopnea index, max apnea time, mean apnea time, oxygen desaturatian index, and the longest time of oxygen desaturation were all lowered after the treatment, and the lowest SaO2 and the mean SaO2 were higher after the treatment. The differences were all distinctive (P<0.05 or<0.01). When patients treated with MAA were compared with those treated with MALA,only the max apnea time [(35.5±6.9),(31.3±6.0) s, respectively] and the longest time of oxygen desaturation [ (41.0±18.9), (29.9±9.3) s, respectively] had significant difference. Conclusion MALA may be helpful for shortening max apnea time and the longest time of oxygen desaturation, thus MAA is an effective alternative to patients of OSAHS. Further research should be done.
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<p><b>BACKGROUND</b>The prethrombotic state can be observed in advanced lung cancer patients. The aim of this study is to determine the dynamic changes and significance of antithrombin and fibrinolytic function in advanced lung cancer patients during chemotherapy.</p><p><b>METHODS</b>Antithrombin activity (AT:A), fibrinogen (FIB), D-dimer (D-D), plasminogen activity (PLG), tissue plasminogen activator antigen (t-PA:Ag) and plasminogen activator inhibitor-1 antigen (PAI-1:Ag) were measured in 33 advanced lung can-cer patients before and after chemotherapy, and 30 healthy people as controls.</p><p><b>RESULTS</b>Before chemotherapy, lung cancer patients had significantly lower AT:A (P < 0.01) and higher D-D, PLG:A, PAI-1:Ag and FIB (P < 0.01) than those of controls. There was no significant difference in t-PA:Ag between lung cancer patients and controls (P > 0.05). During the chemotherapy, AT:A, D-D and t-PA:Ag of lung can-cer patients remarkably decreased (P < 0.01), and PLG:A, PAI-1:Ag and FIB remarkably increased (P < 0.01) compared to those before chemotherapy.</p><p><b>CONCLUSIONS</b>Chemotherapy may enhance the prethrombotic state in advanced lung cancer patients. Dynamic observation of antithrombin and fibrinolytic function during chemotherapy might be useful for preventing pulmonary hemorrhage and pulmonary infarct and estimating prognosis of those patients.</p>
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OBJECTIVE:To optimize the forming technology for Zuojin dropping pill.METHODS:The base material and cooling agent were optimized by orthogonal experiment with the type of base material,the ratio of drug to base material,the temperature of physic liquor,the type of the cooling agent as factors taking the mixing state,forming condition and dissolution time as indexes; the dripping condition was optimized with the temperature of the cooling agent,the caliber of the dripping mouth,the dripping distance and dripping speed as factors taking the variation coefficient of the pill weight difference as index. RESULTS:The optimal forming technology was as follows:with polyglycol 4000 as base and paraffin oil as cooling agent; the cooling temperature was 12 ℃;the caliber of the dripping mouth was 3.5/4.9 mm;the dripping distance was 10 cm and the dripping speed was 25 drop?min-1.CONCLUSION:The forming technology is stable,reproducible and the preparation was well-shaped,and the forming technology serves as a reference for the production of Zuojin dropping pill.
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OBJECTIVE:To establish the optimal technical condition for the extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription with supercritical CO2 fluid(SFE-CO2).METHODS:The technical condition for the extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription were optimized using L9(34)orthogonal design table with extraction pressure,the extraction temperature,the pressure and temperature of separator Ⅰ as factors and with the yield of the volatile oil as index.RESULTS:A highest extraction yield of volatile oil from the volatile herbs of Huoxiang zhengqi prescription was achieved(2.057%)under an optimal technical condition as follows:with extraction pressure at 25 MPa,the extraction temperature at 30 ℃,the pressure for separator Ⅰ at 9 MPa and the temperature of separator Ⅰ at 45 ℃.CONCLUSION:Extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription by SFE-CO2 is characterized by high extraction yield,stable,pure operation,safe,and by which the biological activity of the volatile oil can be maintained,thus it is a potential extraction and separation method.
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OBJECTIVE: To study the preventive effect of Breviscapus Injection on the chronic hypoxic myocardium injury in rats and its mechanism. METHODS: Transmission electron microscope and biochemical analysis were used to assay the therapeutic effect of Breviscapus Injection in rat model induced by 4 week's hypoxia. RESULTS: The contents of malondialdehyde (MDA) and Ca(2+) in the homogenate of myocardial tissue of the hypoxic rats were significantly higher than those of the control rats. The activities of superoxide dismutase (SOD), nitric oxide synthase (NOS) in the homogenate of myocardial tissue and the plasmic NO levels of the hypoxic rats were significantly lower than those of the control rats. Breviscapus Injection reduced the contents of MDA and Ca(2+), and increased the levels of SOD, NOS and NO. Ultrastructural examination revealed that the injuries of the ultrastructure of heart in hypoxic rats were improved by treatment with Breviscapus Injection. CONCLUSION: Breviscapus Injection can effectively prevent and treat the hypoxia-induced myocardial damage. One of its mechanisms may relate to its adjusting NO level, anti-damaging of free radicals and inhibiting calcium overload.
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Aim To study the effect of puerarin on reperfusion injury after thrombolytic therapy in acute pulmonary thromboembolism and its mechanism. Methods Thirty-two Japanese rabbits were randomly divided into sham operation group (group S),Thrombolysis-only group(group T), and Puerarin group(group Pur). Acute pulmonary thromboembolism models of rabbits were established with injection of autologous blood clots through the right heart catheters,haemodynamic monitoring was performed by introducing heart catheter through right jugular vein.The activity of plasma superoxide dismutase (SOD) and content of plasma malondialdehyde (MDA) were detected before embolization,2 h after embolization,2 h and 4 h after thrombolysis. At the end,the rabbits were sacrificed and their lung,removed for histopathologic and electron microscopic investigations. Results ①Pulmonary arterial mean pressure (PAMP) were decreased at 1 hour after thrombolysis both in group T and group Pur(P
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Objective To investigate the serum levels of vascular endothelial growth factor(VEGF)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS),and make a primary relative study on the relationship between VEGF and pH.Methods Thirty-nine patients with mild to moderate OSAHS,36 patients with severe OSAHS and 18 healthy snorers who had been admitted to the First Hospital Affiliated to Wenzhou Medical College from Feb.2003 to Sep.2004 were enrolled in this study.The serum levels of VEGF were detected in all patients at 7:00 AM the next day after the detection of polysomnography(PSG).Additionally 31 patients with OSAHS were detected by doppler echocardiography to get the values of pulmonary artery pression.Results There was nocturnal hypoxia in patients with OSAHS compared with healthy snorers,and the degree of nocturnal hypoxia was depended with the grade of OSAHS(both achieved statistical difference)by the detection of PSG.The levels of VEGF was significantly higher in patients with severe OSAHS than in healthy snorers(P
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Aim To investigate the effect of ligustrazine on pulmonary arterial pressure,thromboxane A2(TXA2) and prostacyclin(PGI2) in chronic hypoxic hypercapnic rats.Methods Thirty rats were randomly divided into control group(A), hypoxic hypercapnic group(B) and hypoxic hypercapnia+ ligustrazine (lig) group (C) .Results The mPAP in group B was significantly higher than that in group A(P0.05) ; The specific value of WA/TA(vessel wall area/total area) and SMC (the density of medial smooth muscle cells) were significantly higher in group B than that in group A(P0.05).Conclusion Ligustrazine can inhibit pulmonary hypertension and structural remodeling of pulmonary artery in chronic hypoxic hypercapnic rats by inhibiting synthesis of TXA2.
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AIM: To investigate the effect of diltiazem on mean pulmonary arterial pressure(mPAP) and nitric oxide synthase(NOS) in arterioles in chronic hypoxic hypercapnic rats. METHODS: Twenty-four rats were randomly divided into three groups: control group(A),hypoxic hypercapnic group(B), hypoxic hypercapnia+ diltiazem group (C), constitutive endothelial NOS(ceNOS) were observed in arterioles of rats using the technique of immunohistochemistry,ceNOS mRNA were observed by the technique of in situ hybridization . RESULTS: (1)mPAP was significantly higher in rats of B group than that of A and C group( P 0 05),but mCAP was lower in rats of C group than that in B group.(2)Light microscopy showed WA/TA (vessel wall area/total area) was significantly lower in rats of C group than that of B group ( P
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AIM: To study the effect of ligustrazine on pulmonary hypertensive rats induced by hypoxic hy- percapnia. METHODS: Thirty rats were randomly divided into three groups: control group(A), hypoxic hypercapnic group (B), hypoxic hypercapnia+ligustrazine (lig. ) group(C). RESULTS: (1) Mean pulmonary axterial pressure (mPAP)of group B was significantly higher than that of group A and mPAP of group C was significantly lower than that of group B(P0.05); (2)Electron microscopy and immunohistochemistry showed ligustrazing could inhibit the diposition of col- lagenous fiber(collagen type Ⅰ )in pulmonary arterioles induced by hypoxic hypercapnia; (3) Plasma endothelin level of group C was significantly lower than that of group B (P
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AIM: To study the effect of safflower injection on expression of COX-2 mRNA in chronic hypoxic hypercapnic rat pulmonary arterioles.METHODS: Sprague-Dawley rats were randomly divided into normal control group,hypoxic hypercapnic group(B),hypoxic hypercapnia+ safflower injection group(C).The concentration of TXB2 and 6-Keto-PGF1? in plasma and in lung were detected by the technique of radioimmunoassay.COX-2 mRNA was observed in arterioles from rats by the technique of in situ hybridization.RESULTS: ① Mean pulmonary arterial pressure(mPAP),weight ratio of right ventricle(RV) to left ventricle plus septum(LV+S) were much higher in B group than those in control group.No significant difference of mean carotid arterial pressure(mCAP) was observed in three groups.② The concentration of TXB2 and the ratio of TXB2/6-keto-PGF1? were significantly higher in B group than those in control group.③ Light microscopy showed that vessel wall area/total area,the density of medial smooth muscle cells and the thickness of medial smooth cell layer were significantly higher in B group than those in control group.Electron microscopy showed proliferation of medial smooth muscle cells and collagenous fibers in pulmonary arterioles in B group.Safflower injection reversed the changes mentioned above.④ Expression of COX-2 mRNA in pulmonary arterioles was much higher in C group than those in B group.Differences of COX-1 mRNA in pulmonary arterioles were not significant between these two groups.CONCLUSION: Safflower injection increases the expression of COX-2 mRNA in chronic hypoxic hypercapnic rat pulmonary arterioles,indicating an important mechanism that safflower injection inhibits the formation of hypoxic hypercapnia pulmonary hypertension and pulmonary vessel remodeling.