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The use of immune checkpoint inhibitors (ICIs) has changed the clinical outcome of non-small cell lung cancer (NSCLC), with the widespread application of ICIs, immune-related adverse events (irAEs) have also appeared. Immune checkpoint inhibitor pneumonitis (CIP) is a serious adverse event of ICIs treatment that needs attention. Therefore, early identification of high-risk groups of CIPs and early intervention can reduce the occurrence of permanent drug withdrawal and severe CIPs, thereby improving patients′ prognosis.
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Objective: Four ultrasound elastography parameters were used to compare the color distribution of mediastinal and hilar lymph nodes (LNs) in endobronchial ultrasound real-time elastography (EBUS-RTE), and the clinical value in differentiating benign from malignant mediastinal and hilar lymph nodes were explored. Methods: We selected patients who received EBUS-TBNA in the Second Hospital of Lanzhou University from January 2016 to December 2018 and simultaneously conducted EBUS-RTE. Elastography of lymph nodes were analyzed by elastography image type, elasticity score, strain ratio (SR), and blue color proportion (BCP), respectively. A re-ceiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic value of the four ultrasound elastography pa-rameters. The area under the curve (AUC) and the critical value of the best diagnosis were calculated, and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the four parameters were compared. Results: A total of 80 pa-tients were enrolled, including 152 lymph nodes with 102 malignant lymph nodes and 50 benign ones. Elastography image type, elas-ticity score, SR, and BCP had statistical significance in the differential diagnosis of benign and malignant lymph nodes (P<0.01). The ac-curacy of BCP in the diagnosis of benign and malignant lymph nodes was the highest (88.3%), and the sensitivity, specificity, positive predictive value, and negative predictive value were 90.0%, 94.1%, 85.4%, and 88.6%, respectively. The optimal definition value of BCP was 85.7%; all the 65 LNs with a BCP≥85.7% were diagnosed as malignant. Conclusions: Elastography image type, elasticity score, SR, and BCP of ultrasound elastography are important in the differential diagnosis of mediastinal and hilar lymph nodes, and BCP showed the highest diagnostic valuation.
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Idiopathic pulmonary fibrosis (IPF) is one of the most common idiopathic interstitial pneumonia.The main symptoms for IPF are dry cough and exertional shortness of breath,which is worsen gradually with the development of pulmonary fibrosis.Patients with IPF often suffer from sleep disordered breathing (SDB).Sleep architecture for these patients including the sleep efficiency,deep sleep,rapid eye movement sleep and arousal index,are changed,which seriously affects the quality of life.In the absence of effective therapies,optimizing the quality of life may become a major therapeutic target for IPF.The diagnosis and treatment of SDB can significantly improve the quality of life for patients with IPF.
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High mobility group N (HMGN),one member of the high mobility group superfamily,is expressed ubiquitously in living cells.HMGN can bind directly to nucleosomes and modulate the structure of the chromatin fiber,which affect the cellular transcription profile and cellular differentiation and the ability to repair damaged DNA.The occurence of tumor is closely related to the abnormal transcription caused by accumulation of mutations.Abnormal transcription can prompt the tumor cells to escape from the tight regulation of cell cycle progression.Studies show that HMGN plays an important role in cancer progression by involving in the regulation of tumor cell cycle and affecting the biological behavior of tumor cells.
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Objective To study the relationship between adiponectin and pulmonary function, age and gender in pa-tients with chronic obstructive pulmonary disease (COPD). Methods A total of 120 COPD patients with normal body mass index (BMI＜24 kg/m2 ) were selected and divided into acute exacerbation group (n=60) and stable group (n=60). And 60 healthy people were included as controls. There were equal numbers of male and female in each group. The serum level of ad-iponectin was sdetected by ELISA in there groups. The pulmonary function was collected,and values of FEV1/FVC, FEV1%predicted and RV/TLC were calculated in three groups. Results The serum level of adiponectin was significantly higher in acute exacerbation group than that of stable group and control group (P＜0.05). And the serum level of adiponectin was significantly higher in stable group than that of control group (P＜0.05). The serum levels of adiponectin were signifi-cantly higher in female patients than those of male patients (P＜0.05). The values of FEV1%, FEV1/FVC and FEV1%pre-dicted were significantly lower in acute exacerbation group and stable group than those of control group. The value of RV/TLC was significantly higher in acute exacerbation group and stable group than that of control group (P＜0.05). There was a negative correlation in serum levels of adiponectin, FEV1%predicted and FEV1/FVC between acute exacerbation group and stable group. But there was a negative correlation in serum levels of adiponectin and RV/TLC between these two groups ( P＜0.01). There was a positive correlation between serum level of adiponectin and age in male patients (r=0.943,P＜0.01). Con-clusion The serum level of adiponectin was significantly increased in patients with COPD, which suggested that adiponec-tin played an important part in proinflammatory and might be closely related with airway resistance. The serum level of adipo-nectin might exist gender differences and may be related with age.
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Objective To study the relationships between airway inflammation,reticular basement membrane (RBM) thickness and bronchial hyperresponsiveness (BHR) before and after treatment with inhaled corticosteroids (ICS) in patients with asthma.Methods Twenty-eight patients with asthma (asthma group) were treated with inhaled budesonide (200 μg,twice a day for 12 months).Lung function,bronchoalveolar lavage (BAL) fluid and airway biopsy pathology were carried out before and after treatment.And 10 patients without asthma were acted as control group.Results BAL fluid eosinophils,epithelial cell and mast cell proportions before treatment in asthma group were significantly higher than those in control group [asthma group:(1.60 ±0.11)％,(2.50 ±0.29)％,(0.1100 ±0.0100)％ ;control group:(0.50 ±0.02)％,(1.20 ±0.08)％,(0.0200 ±0.0001)％,P ＜0.01].RBM and smooth muscle thickness were increased in asthma group than those in control group [ asthma group:( 14.25 ± 2.15 ),(0.36 ± 0.01 ) μ m;control group:(4.45 ± 1.22),(0.20 ± 0.01 ) μ m,P ＜ 0.01 ].BAL fluid eosinophils,epithelial cell and mast cell proportions,RBM and smooth muscle thickness decreased after treatment in asthma group [ (0.80 ±0.04)％,(1.60 ±0.07)％,(0.0500 ±0.0020)％,(6.18 ± 1.30) μm,(0.26 ±0.02) μm,P ＜0.01].RBM thickness was negative correlation with methacholine provoking dose which made forced expired volume in one second reduce by 20％ (r =-0.672,P ＜ 0.01 ).Conclusions Airway inflammation,RBM thickness and BHR in patients with asthma are interrelated and improved with ICS.The results of this study support the need for early and long treatment with ICS.
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<p><b>BACKGROUND</b>To study the effect of selective bronchial artery infusion (BAI) and chemotherapy in the treatment of patients with intermediate and advanced lung cancer.</p><p><b>METHODS</b>Forty-five cases of advanced lung cancer were treated by BAI, which were compared with 40 cases of advanced lung cancer treated by systemic chemotherapy.</p><p><b>RESULTS</b>The response rate of BAI (33/44, 75.0%) was better than that of systemic chemotherapy (20/40, 50.0%)( P < 0.05). The side-effect of BAI was lower than that of systemic chemotherapy ( P < 0.05), but one case occured paraplegia after BAI. The response rate of small cell undifferentiated lung cancer, squamous cell carcinoma and adenocarcinoma was 94.5% (17/18), 66.6% (14/21) and 40.0% (2/5) respectively in the BAI group. Significant difference of the response rate was found in squamous cell carcinoma and adenocarcinoma between the two groups ( P < 0.05).</p><p><b>CONCLUSIONS</b>BAI has better response rate and less toxicity than systemic chemotherapy in intermediate and advanced lung cancer, especially in patients with squamous cell carcinoma. Small cell undifferentiated lung carcinoma should be treated by systemic chemotherapy firstly and then BAI. Adenocarcinoma should be treated by BAI firstly and then other therapy.</p>
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AIM: To investigate the effect of apoptosis and the change of mitochondial tansmembrane potential in A549 cells induced by thermochemotherapy of ADM. METHODS: ADM of different concentrations was directly applied to A549 cells cultivated in vitro. Cells maintained at 42.5 ℃ for 30 min. RESULTS: The inhibition of A549 cells was increased by thermochemotherapy of ADM significantly,and the cytoplasmic concentration of thermochemotherapy of ADM was significantly higher than that of chemotherapy (P