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BACKGROUND@#Nivolumab is an checkpoint inhibitor combining with programmed death-1 (PD-1) receptor on T cells, which can block the interactions between PD-1 and programmed death ligands (PD-L), including PD-L1 and PD-L2. And then block the immunosuppression mediated by the PD-1 pathway. The aim of the study is to investigate the clinical manifestations, diagnosis, treatment and prognosis of treatment-related skin toxicity caused by PD-1 inhibitor Nivolumab.@*METHODS@#The clinical data of treatment-related skin toxicity caused by PD-1 inhibitor Nivolumab in a patient with advanced lung adenocarcinoma admitted to the Shanghai Chest Hospital was retrospectively analyzed. The diagnosis, treatment and prognosis of the patient were discussed.@*RESULTS@#The patient was a 60-year-old male presented with relapse after surgery and adjuvant postoperative chemotherapy for his lung carcinoma. The patient's condition still progressed after multiple chemotherapy, targeted therapy and local radiotherapy of bone metastasis. Then Nivolumab, a kind of PD-1 inhibitors, was given intravenously every 3 weeks with the average dosage 3 mg/kg. After one cycle of Nivolumab, the patient began to have skin rashes, which aggravated gradually. The patient's skin toxicity was alleviated after enough steroids and was controlled with tapering steroids slowly. Now the patient was still given oral steroids treatment. And the lung disease remained stable.@*CONCLUSIONS@#Immune-related skin toxicity associated with PD-1 inhibitor should be aware of; early detection, early treatment and the prognosis could be better. It is necessary to improve the understanding of Immune-related skin toxicity associated with PD-1 inhibitor, to diagnose and treat it early, and the prognosis could be better.
Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma of Lung , Drug Therapy , Nivolumab , Pharmacology , Therapeutic Uses , Prognosis , Programmed Cell Death 1 Receptor , SkinABSTRACT
More and more studies have indicated that the relationship between vitamin D pathway and asthma,and the mechanisms include multiple abnormal aspects of vitamin D pathway leading to abnormal em-bryonic development and immune system disorders and so on. This review summarizes the relationship between vitamin D,vitamin D binding protein,vitamin D receptors,related gene polymorphisms and the immune system to describe the pathogenesis of asthma.
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Background and purpose:The involvement of estrogen signaling in lung cancer is controversial. But the findings showed that ERβ might play an important role in neoplastic lung biology. Several studies have evaluated expression of ERβin both normal and neoplastic human lung tissues with variable conclusions. We aimed to evaluate the expressive of estrogen receptors (ER)α,βin non-smoking non-small cell lung cancer (NSCLC) and investigate the relationships between the survival and expressions of ERα,β. Methods:Immunohistochemical assay was used to detect the expression ERαand ERβin 144 NSCLC patients, and analyzed the expressions status of ERα,βand survival. Results:The positive rate of ERαwas 7.6%, only in adenocarcinoma cancer. The positive rate of ERβwas 52.1%, and the expressions of stageⅠandⅡwas signiifcantly higher than that of stageⅢandⅣ(P=0.020). The median survival time (MST) of ERβpositive expression was better than that of negative expression (43 months vs 38 months, P=0.028). The MST of ERβpositive expression of female patients was better than that of negative expression (45 months vs 37 months, P=0.033). The MST of ERβpositive expression of adenocarcinoma were 46 months and better than negative 38 months (P=0.021). Conclusion:The expression of ERβwas signiifcantly higher in early-stage non-smoking NSCLC. It indicated that the positive expression of ERβwas related to the better MST, especially in female adenocarcinoma patients.
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Objective To observe the short-term efficacy and safety of sequential administration of erlotinib and chemotherapy in unselected, chemonaive patients with advanced non-small-cell lung cancer (NSCLC). Methods Previously-untreated patients (n=23) with stage Ⅲ_B/Ⅳ NSCLC and ECOG PS of 0/1 received erlotinib (150 mg/d) on days 15-28 of a 4-week cycle that included gemcitabine (1250 mg/m~2, days 1 and 8), and either cisplatin (75 mg/m~2, day 1) or carboplatin (AUC=5, day 1). The primary end points were tumor response rate and safety. Results 23 patients received a total of 95 cycles of treatment, and all were evaluable for efficacy and toxicity. The overall response rate was 30.4%, 0 case achieved complete responses (CR), 7 cases (30.4%) achieved partial responses (PR), 14 cases (60.9 %) achieved stable disease (SD), 2 cases (8.7 %) achieved progression disease (PD). The disease control rate was 91.3 %. The sequential administration of erlotinib following gemcitabine/platinum chemotherapy was well tolerated. The major grade 3 treatment-related adverse events were eutropenia (13.4%), rash (8.7%), nausea (8.7%) and thrombocytopenia (8.7%). No treatment-related interstitial lung disease. Conclusion equential administration of erlotinib following gemcitabine/platinum chemotherapy was effective, and the toxicity was tolerable. This treatment strategy warrants further investigation.
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Objective To probe into the medical cost and economic losses of childhood asthma. Methods Total 200 of asthmatic children aged 2~16 yrs were diagnosed according to asthma OPD and enrolled in this study from the Affiliated Hospital of Medical College of Qingdao University during 2005—2006. All of them were taken the epidemiologic and economic survey. Results Among them, 184 were from kindergartens, primary or middle schools. There were totally 7 629 days for the asthmatic children absent from class per year because of illness. The overall direct economic loss was RMB 798 467.00 and indirect loss was RMB 210 997.80 yearly. Conclusion Asthma not only brings about great impact on children physical and mental health, but also exerts massive economic loss on the society and families. The whole society and medical workers should pay more attention to it and try to reduce its harm to a relatively low level.