Sensitivity analysis for radiation-induced lung injury caused by radiotherapy for lung cancer patients in Tibetan Plateau, China / 中华放射肿瘤学杂志

Objective To investigate the factors associated with radiation-induced lung injury (RILI) caused by radiation therapy for lung cancer patients in Tibetan Plateau,China.Methods A total of 262 patients with non-small cell lung cancer (NSCLC) confirmed by pathology or cytology from April 2012 to February 2016,consisting of 138 native Tibetans living at an elevation over 3 000 meters and 124 non-native Tibetans or non-Tibetan people,were analysed.All patients received intensity-modulated radiotherapy ± chemotherapy and underwent CT follow-up for over 6 months.For patients with grade ≥ 2 RILI,the associations of ethnicity,age,sex,Kamofsky Performance Scale (KPS) score,clinical stage,chemotherapy,and smoking history with RILI were analyzed.For two groups of patients,native Tibetan population and non-native Tibetan population,the associations of sex,smoking history,chemotherapy,and radiation dose with RILI were analyzed.Radiation dose-volume parameters were compared using the chisquare test or's's exact test,and their correlations were analyzed using the Person correlation test;a multivariate analysis was performed using the logistic regression model.Results For the 262 NSCLC patients,ethnicity (P=0.040),sex (P=0.001),KPS score (P=0.026),presence or absence of smoking history (P =0.014),minimum lethal dose (P =0.037),V5 (P =0.000),and V20 (P=0.025)were found to be associated with the development of RILI.Further analysis showed that only the smoking history (P=0.013) was significantly correlated with demographic composition.And there was no significant relationship between radiation dose for different groups and the incidence of RILI (all P=＞ 0.05).Conclusions Native Tibetan patients with NSCLC are more susceptible to RILI.

An extensive DeBakey type IIIb aortic dissection with massive right pleural effusion presenting as abdominal pain and acute anemia:particular case report / 老年心脏病学杂志（英文版）

We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an-giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start-ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.