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1.
Chinese Medical Journal ; (24): 2551-2561, 2023.
Article in English | WPRIM | ID: wpr-1007566

ABSTRACT

BACKGROUND@#The brain is a common metastatic site in patients with non-small cell lung cancer (NSCLC), resulting in a relatively poor prognosis. Systemic therapy with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) is recommended as the first-line treatment for EGFR -mutated, advanced NSCLC patients. However, intracranial activity varies in different drugs. Thus, brain metastasis (BM) should be considered when choosing the treatment regimens. We conducted this network meta-analysis to explore the optimal first-line therapeutic schedule for advanced EGFR -mutated NSCLC patients with different BM statuses.@*METHODS@#Randomized controlled trials focusing on EGFR-TKIs (alone or in combination) in advanced and EGFR -mutant NSCLC patients, who have not received systematic treatment, were systematically searched up to December 2021. We extracted and analyzed progression-free survival (PFS) and overall survival (OS). A network meta-analysis was performed with the Bayesian statistical model to determine the survival outcomes of all included therapy regimens using the R software. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used to compare intervention measures, and overall rankings of therapies were estimated under the Bayesian framework.@*RESULTS@#This analysis included 17 RCTs with 5077 patients and 12 therapies, including osimertinib + bevacizumab, aumolertinib, osimertinib, afatinib, dacomitinib, standards of care (SoC, including gefitinib, erlotinib, or icotinib), SoC + apatinib, SoC + bevacizumab, SoC + ramucirumab, SoC + pemetrexed based chemotherapy (PbCT), PbCT, and pemetrexed free chemotherapy (PfCT). For patients with BM, SoC + PbCT improved PFS compared with SoC (HR = 0.40, 95% CI: 0.17-0.95), and osimertinib + bevacizumab was most likely to rank first in PFS, with a cumulative probability of 34.5%, followed by aumolertinib, with a cumulative probability of 28.3%. For patients without BM, osimertinib + bevacizumab, osimertinib, aumolertinib, SoC + PbCT, dacomitinib, SoC + ramucirumab, SoC + bevacizumab, and afatinib showed superior efficacy compared with SoC (HR = 0.43, 95% CI: 0.20-0.90; HR = 0.46, 95% CI: 0.31-0.68; HR = 0.51, 95% CI: 0.34-0.77; HR = 0.50, 95% CI: 0.38-0.66; HR = 0.62, 95% CI: 0.43-0.89; HR = 0.64, 95% CI: 0.44-0.94; HR = 0.61, 95% CI: 0.48-0.76; HR = 0.71, 95% CI: 0.50-1.00), PbCT (HR = 0.29, 95% CI: 0.11-0.74; HR = 0.31, 95% CI: 0.15-0.62; HR = 0.34, 95% CI: 0.17-0.69; HR = 0.34, 95% CI: 0.18-0.64; HR = 0.42, 95% CI: 0.21-0.82; HR = 0.43, 95% CI: 0.22-0.87; HR = 0.41, 95% CI: 0.22-0.74; HR = 0.48, 95% CI: 0.31-0.75), and PfCT (HR = 0.14, 95% CI: 0.06-0.32; HR = 0.15, 95% CI: 0.09-0.26; HR = 0.17, 95% CI: 0.09-0.29; HR = 0.16, 95% CI: 0.10-0.26; HR = 0.20, 95% CI: 0.12-0.35; HR = 0.21, 95% CI: 0.12-0.39; HR = 0.20, 95% CI: 0.12-0.31; HR = 0.23, 95% CI: 0.16-0.34) in terms of PFS. And, SoC + apatinib showed relatively superior PFS when compared with PbCT (HR = 0.44, 95% CI: 0.22-0.92) and PfCT (HR = 0.21, 95% CI: 0.12-0.39), but similar PFS to SoC (HR = 0.65, 95% CI: 0.42-1.03). No statistical differences were observed for PFS in patients without BM between PbCT and SoC (HR = 1.49, 95% CI: 0.84-2.64), but both showed favorable PFS when compared with PfCT (PfCT vs. SoC, HR = 3.09, 95% CI: 2.06-4.55; PbCT vs. PfCT, HR = 0.14, 95% CI: 0.06-0.32). For patients without BM, osimertinib + bevacizumab was most likely to rank the first, with cumulative probabilities of 47.1%. For OS, SoC + PbCT was most likely to rank first in patients with and without BM, with cumulative probabilities of 46.8%, and 37.3%, respectively.@*CONCLUSION@#Osimertinib + bevacizumab is most likely to rank first in PFS in advanced EGFR -mutated NSCLC patients with or without BM, and SoC + PbCT is most likely to rank first in OS.


Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/metabolism , Afatinib/therapeutic use , Lung Neoplasms/metabolism , Bevacizumab/therapeutic use , Bayes Theorem , Network Meta-Analysis , Protein Kinase Inhibitors/therapeutic use , Pemetrexed/therapeutic use , ErbB Receptors/genetics , Brain Neoplasms/genetics , Mutation/genetics
2.
Chinese Journal of Geriatrics ; (12): 116-119, 2021.
Article in Chinese | WPRIM | ID: wpr-884853

ABSTRACT

Objective:To examine whether Butorphanol administered before Sufentanil can reduce hemodynamic fluctuations during the induction period in elderly patients.Methods:Sixty elderly patients with the American Society of Anesthesiologists(ASA)Ⅱ-Ⅲ scheduled for elective surgery under general anesthesia were randomly divided into two groups, with 30 patients in each group.Before anesthesia induction, patients in Group B were pretreated with Butorphanol(0.4 mg)and those in Group C were pretreated with the same volume of normal saline.Changes in blood pressure(MAP)and heart rate in the 15 min from the induction to the end of intubation were compared between the two groups.The incidences of adverse cardiovascular events requiring drug intervention and of cough during the induction period were recorded.The heart rate and blood pressure were standardized based on the mean value at 5 minutes after arterial puncture.Results:After pretreatment with Butorphanol, blood pressure experienced a less reduction in Group B than in Group C( P<0.05), and maintained at a higher level in the later period of induction( P<0.05); the decrease in heart rate was lower in Group B than in Group C( P<0.05), but the difference between the two groups was not significant in the later period of induction, while heart rate variability induced by intubation was higher in Group B than in Group C; the incidence of severe hypotension was lower in Group B than in Group C(3.3% vs.56.7%, χ2=20.23, P<0.0001); during the induction period, the incidence of cough was lower in Group B than in Group C(6.7% vs.43.4%, χ2=12.27, P=0.0005). Conclusions:Butorphanol pretreatment can reduce the incidence and severity of hypotension and the incidence of cough during the induction period in elderly patients.

3.
Chinese Journal of Lung Cancer ; (12): 357-364, 2021.
Article in Chinese | WPRIM | ID: wpr-880281

ABSTRACT

Treatments for advanced non-small cell lung cancer (NSCLC) include chemotherapy, targeted therapy, and immunotherapy represented by immune checkpoint inhibitors. However, the efficacy of monotherapy is still limited. Nowdays, combination strategy has drawn great attention. Anti-angiogenic agents are widely used in treating advanced NSCLC, which can not only suppress the growth and metastasis of tumor by suppressing tumor vessels, and also have synergic effect with other anti-tumor agents because they can normalize vessels and regulate immune micro-environment. This article summarizes the underlying mechanism of combining anti-angiogenic agents and other anti-tumor agents, reviews the clinical trials on the combination strategy including monoclonal antibodies and tyrosine kinase inhibitor, so as to provide a potential strategy for treating advanced NSCLC.
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4.
Chinese Journal of Lung Cancer ; (12): 19-24, 2021.
Article in Chinese | WPRIM | ID: wpr-880234

ABSTRACT

Over the past several decades, advances in driven targeted therapy has revolutionized the management of oncogene-driven non-small cell lung cancer (NSCLC). However, there are only a few targeted drugs available for patients with rare mutations, such as BRAF, HER2, MET, RET, etc. In recent years, immune checkpoint inhibitors (ICIs) have demonstrated promising benefit in NSCLC. Till now, efficacy of ICIs for NSCLC with rare mutation is largely unknown. It is fairly difficult to conduct a large formal prospective controlled trials because of the rarity of these mutation. In this article, currently available real world studies based on convincing clinical evidence will be reviewed, which will ultimately facilitate our rational use of ICIs for NSCLC with rare mutation.
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5.
Chinese Journal of General Practitioners ; (6): 839-841, 2020.
Article in Chinese | WPRIM | ID: wpr-870713

ABSTRACT

Sixty ASA Ⅰ-Ⅱ male patients aged 45-65 yrs undergoing general anesthesia in Chenzhou First People′s Hospital from May to September 2019 were randomly divided into two groups with 30 cases in each. Before the recover from anesthesia, patients in group L were irrigated with 100 mg lidocaine and 20 ml normal saline through the urinary catheter, while those in group C were irrigated with 20 ml normal saline in the same way. After irrigation, the catheter was clamped for 5 min and then released. The of urination intention when patient is conscious was observed and urethral irritation score was assessed. The cases of unconscious catheter grasping behavior, catheter-related restlessness and the need for rescued medication were compared between two groups. Compared to group C, group L had lower urinary intention rate (3.3%), lower urethral irritation score (1.94±0.15), lower rate of unconscious catheter grasping (6%), lower incidence of catheter agitation (0) and remedial medication (0). It is suggested that bladder irrigation with lidocaine before anesthesia recovery can reduce the symptoms of catheter-related irritation.

6.
Chinese Journal of Geriatrics ; (12): 430-434, 2020.
Article in Chinese | WPRIM | ID: wpr-869391

ABSTRACT

Objective:To explore the predictive value of the COMPASS-cancer associated thrombosis(COMPASS-CAT)risk assessment model and the modified Khorana risk assessment model for the risk of venous thromboembolism(VTE)in elderly patients with lung cancer.Methods:A retrospective analysis was conducted on clinical data of 276 hospitalized lung cancer patients aged 60 years and over in the Cancer Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College from March 2013 to March 2017.Patients were divided into the VTE group(n=39)and the non-VTE group(n=237). The COMPASS-CAT model and the modified Khorana model were used to evaluate the risk of venous thromboembolism in the two groups.The sensitivity, specificity and Youden index of the two models were calculated.The receiver-operating characteristics(ROC)curves of the two evaluation models were drawn.The predictive effect and influence of two evaluation models on VTE risk in elderly lung cancer patients were compared by using Medcalc software analysis and multivariate Logistic regression analysis.Results:The incidence of VTE was 14.13%(39/276). The sensitivity, specificity, Youden index and the AUC under ROC curves of the COMPASS-CAT model and the modified Khorana model were 0.718 and 0.795, 0.861 and 0.527, 0.524 and 0.348, and 0.789 and 0.661, respectively.Using the Medcalc software to compare the two models, the area under the curve of the COMPASS-CAT risk assessment model was increased by 0.128, compared with the modified Khorana model( Z=2.676, P=0.0075). Multivariate Logistic regression analysis showed that COMPASS-CAT≥7 points and Khorana≥2 points were independent risk factors for VTE in elderly patients with lung cancer( P<0.05). Conclusions:The modified Khorana model can predict the risk of VTE in elderly patients with lung cancer, but the accuracy of prediction is low.The COMPASS-CAT model has a higher predictive value for VTE risk assessment than the modified Khorana model and is more suitable for elderly patients with lung cancer.

7.
Chinese Journal of Radiation Oncology ; (6): 744-750, 2020.
Article in Chinese | WPRIM | ID: wpr-868684

ABSTRACT

Objective:To evaluate the efficacy and safety of comprehensive treatment based on radiotherapy for patients with leptomeningeal metastases (LM) in this prospective study.Methods:A total of 93 patients diagnosed with LM admitted to our hospital undergoing whole brain radiotherapy (WBRT) or craniospinal irradiation (CSI) with or without simultaneous boost from 2014 to 2017 were enrolled. The dynamic changes of clinical signs and symptoms, enhanced magnetic resonance imaging (MRI), cerebrospinal fluid cytology and liquid biopsy detection were recorded. The primary endpoint was overall survival (OS), the secondary endpoints were local control (LC), intracranial progress-free survival (IPFS), brain metastasis specific survival (BMSS) and toxicity.Results:The major primary disease was non-small cell lung cancer. The whole cohort received WBRT with boost (40 Gy in 20 fractions (f) for WBRT and 60 Gy in 20 f for boost), focal radiation to LM, WBRT and CSI (40 Gy in 20 f or 50 Gy in 25 f for WBRT and 36 Gy in 20 f for CSI). For 20 patients, tumor cells were identified and intrathecal chemotherapy was performed. Sixty-three patients received target therapy. The median follow-up time was 33.8 months. The 1-year OS, LC and IPFS was 62.4%, 77.2% and 52.6%, respectively. The median survival time was 15.9 months, and the median BMSS was 42.2 months. Treatment-related grade 3-4 adverse events were rare and only 8 cases was observed to have grade 3 hematological toxicity.Conclusion:Reasonable comprehensive treatment including precise radiotherapy, intrathecal chemotherapy and targeted therapy can be well tolerated and prolong the survival time of LM patients.

8.
Chinese Journal of Oncology ; (12): 50-54, 2020.
Article in Chinese | WPRIM | ID: wpr-799034

ABSTRACT

Objective@#To explore the clinical features and risk factors of hepatic injury due to immune checkpoint inhibitors (CPI) therapy in malignant tumor.@*Methods@#Data of 112 patients (64 men and 48 women) who received CPI between January 2016 and March 2019 in Chinese Academy of Medical Sciences and Peking Union Medical College Shenzhen Hospital, and Huazhong University of Science and Techology Union Shenzhen Hospital were retrospectively collected. The median age of these patients was 60 years.@*Results@#Hepatic adverse events were observed in 30 patients out of 112 patients (26.8%). Among them, the incidence of grade 3-5 hepatic adverse events were 7.14% (8/112). The median time of hepatic adverse event occurrence was 3 weeks (2-30) after undergoing therapy. The results of univariate and multivariate analyses showed that liver cancer was attributed to the CPI induced hepatitis (P<0.05). Patients with severe hepatic injury got almost complete resolution after receiving methlprednisolone for 4 to 6 weeks.@*Conclusion@#Live cancer is the risk factor of CPI-related hepatic adverse events.

9.
Chinese Journal of Lung Cancer ; (12): 983-988, 2020.
Article in Chinese | WPRIM | ID: wpr-880217

ABSTRACT

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a pathological subtype of lung neuroendocrine cancer, which accounts for 2.4%-3.1% in surgical specimens of lung cancer. It is characterized by high invasiveness and poor prognosis, and highly correlated with smoking. There are few relevant studies due to the low incidence and small sample size. Therefore, it is relatively difficult to diagnosis and treatment in clinical practice. In this review, we described molecular subtype, diagnostic and prognostic-related markers about large cell neuroendocrine carcinoma of lung based on the recent progress in genomic sequencing and molecular markers, to find the direction for the next research.
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10.
Journal of Chinese Physician ; (12): 1825-1828, 2019.
Article in Chinese | WPRIM | ID: wpr-800566

ABSTRACT

Objective@#To investigate the effect of inflammatory stimulation on the biological function of human umbilical cord mesenchymal stem cells (MSCs) and its mechanism.@*Methods@#Under sterile condition, 40-60 ml cord blood of normal full-term caesarean section was taken, and the cells were separated by Ficoll Hypaque gradient centrifugation. After 24 hours of conventional culture, the cells were divided into 4 groups: C group (control group), LPSL group, LPSM group and LPSH group. Group C was added with complete culture medium. Group LPSL, group LPSM and group LPSH were added with equal amount of culture medium containing 12.5, 25, 50 μg/ml lipopolysaccharides (LPS) respectively. The effects of different concentrations of LPS on the proliferation and osteogenic differentiation of mesenchymal stem cells were observed.@*Results@#After incubation for 24 and 48 hours, the proliferation activity of MSCs in LPSL, LPSM and LPSH groups was higher than that in group C (P<0.05), and the proliferation ability of MSCs induced by low dose LPS for 48 h was the strongest (P<0.05). With the increase of culture time, the expression of nuclear factor kappa B (NF-κB) and Toll-like receptor 4 (TLR4) protein in the four groups increased gradually. The expression of NF-κB and TLR4 protein in the LPSL, LPSM and LPSH groups were higher than that in the control group (P<0.05). With the increase of LPS concentration, the expression of NF-κB and TLR4 protein increased gradually, with statistically significant difference (P<0.05). Alkaline phosphatase (ALP) activity and calcium nodule number in LPSL, LPSM and LPSH group were higher than those in group C; ALP activity and calcium nodule number in LPSM group were higher than those in LPSH group; ALP activity and calcium nodule number in LPSL group were higher than those in LPSM and LPSH, group with statistically significant difference (P<0.05).@*Conclusions@#Inflammatory response can stimulate the proliferation and osteogenic differentiation of human umbilical cord mesenchymal stem cells. Low concentration of LPS may be an ideal factor for the osteogenic differentiation of umbilical cord mesenchymal stem cells. It has certain significance and application prospect in the actual clinical disease treatment, but the detailed mechanism of action and whether the effect of lower dose is better still to be further studied.

11.
Chinese Journal of Lung Cancer ; (12): 111-117, 2019.
Article in Chinese | WPRIM | ID: wpr-775656

ABSTRACT

Standard treatment for resectable IIIa/N2 non-small-cell lung cancer (NSCLC) is still under debate. Optional treatments include chemotherapy, radiotherapy and surgery, other options include target therapy and immunotherapy. Multidisciplinary treatment has therefore been emphasized by various clinical trials, including bimodality strategy which has been defined as chemotherapy plus surgery or chemotherapy plus radiotherapy, and trimodality treatment which refers to chemotherapy plus surgery and radiotherapy. However, there is still no consensus on the optimal strategy on treating resectable IIIa/N2 NSCLC. Therefore, we reviewed a series of phase II and III clinical trials as well as some meta-analyses and case reports to compare the efficacy of different strategies on survival of cN2 NSCLC, and concluded that for resectable IIIa/N2 NSCLC surgery is recommended, and that strategy of chemotherapy plus surgery may not achieve better survival than that of chemotherapy plus radiotherapy. Size of tumor as well as lymph nodes should be taken into account when choosing optimal therapy, so that promising individualized strategy could be given to patients with resectable stage IIIa/N2 NSCLC.
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Subject(s)
Humans , Clinical Trials as Topic , Combined Modality Therapy , Lung Neoplasms , Drug Therapy , Radiotherapy , General Surgery , Therapeutics , Meta-Analysis as Topic , Neoplasm Staging , Treatment Outcome
12.
Journal of Chinese Physician ; (12): 1825-1828, 2019.
Article in Chinese | WPRIM | ID: wpr-824310

ABSTRACT

Objective To investigate the effect of inflammatory stimulation on the biological function of human umbilical cord mesenchymal stem cells (MSCs) and its mechanism.Methods Under sterile condition,40-60 ml cord blood of normal full-term caesarean section was taken,and the cells were separated by Ficoll Hypaque gradient centrifugation.Mter 24 hours of conventional culture,the cells were divided into 4 groups:C group (control group),LPSL group,LPSM group and LPSH group.Group C was added with complete culture medium.Group LPSL,group LPSM and group LPSH were added with equal amount of culture medium containing 12.5,25,50 μg/ml lipopolysaccharides (LPS) respectively.The effects of different concentrations of LPS on the proliferation and osteogenic differentiation of mesenchymal stem cells were observed.Results After incubation for 24 and 48 hours,the proliferation activity of MSCs in LPSL,LPSM and LPSH groups was higher than that in group C (P < 0.05),and the proliferation ability of MSCs induced by low dose LPS for 48 h was the strongest (P < 0.05).With the increase of culture time,the expression of nuclear factor kappa B (NF-κB) and Toll-like receptor 4 (TLR4) protein in the four groups increased gradually.The expression of NF-κB and TLR4 protein in the LPSL,LPSM and LPSH groups were higher than that in the control group (P < 0.05).With the increase of LPS concentration,the expression of NF-κB and TLR4 protein increased gradually,with statistically significant difference (P < 0.05).Alkaline phosphatase (ALP) activity and calcium nodule number in LPSL,LPSM and LPSH group were higher than those in group C;ALP activity and calcium nodule number in LPSM group were higher than those in LPSH group;ALP activity and calcium nodule number in LPSL group were higher than those in LPSM and LPSH,group with statistically significant difference (P < 0.05).Conclusions Inflammatory response can stimulate the proliferation and osteogenic differentiation of human umbilical cord mesenchymal stem cells.Low concentration of LPS may be an ideal factor for the osteogenic differentiation of umbilical cord mesenchymal stem cells.It has certain significance and application prospect in the actual clinical disease treatment,but the detailed mechanism of action and whether the effect of lower dose is better still to be further studied.

13.
Chinese Journal of Lung Cancer ; (12): 408-412, 2018.
Article in Chinese | WPRIM | ID: wpr-772426

ABSTRACT

BACKGROUND@#As the morbidity and mortality in lung cancer keep raising, we are here to discuss the effect of clinical features especially the initial symptomon on diagnosis and follow-up treatment of newly diagnosed lung cancer patients.@*METHODS@#The clinical features of the 500 patients with lung cancer in our hospital from March, 2017 to May, 2017 were analyzed retrospectively, including the initial symptom, stage, biomarkers, pathology, etc. RESULTS: There were 266 famle (53.3%), 372 adenocarcinoma (74.4%), 285 smokers (58%), status score of most patients (98.2%) was 0-1. 58.2% (n=291) of all the patients got biomarkers test, of which epidermal growth factor receptor (EGFR) mutations was 61.2%(178/291), anaplasticlymphoma kinase (ALK) fusion gene positive was 4.1% (12/291). Smoking status, initial symptom, pathological typing, TNM staging and EGFR mutation were the main factors affecting follow-up treatment.@*CONCLUSIONS@#Patients with typical symptoms have shorter diagnosis time. Smoking status, lung cancer-related symptoms, pathology, TNM staging and EGFR mutation status are the main factors that affect the follow-up treatment.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anaplastic Lymphoma Kinase , China , ErbB Receptors , Genetics , Metabolism , Lung Neoplasms , Diagnosis , Genetics , Metabolism , Pathology , Mutation , Receptor Protein-Tyrosine Kinases , Genetics , Metabolism , Retrospective Studies , Smokers
14.
Chinese Journal of Oncology ; (12): 776-781, 2018.
Article in Chinese | WPRIM | ID: wpr-807554

ABSTRACT

Objective@#To investigate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) on patients with lung adenosquamous carcinoma, and to analyze relative factors.@*Methods@#From August 2007 to July 2017, 40 patients who were pathologically diagnosed as lung adenosquamous carcinoma in our hospital and received EGFR TKIs treatment were retrospectively analyzed. All patients underwent EGFR mutation detection, resulted in 11 wild type, 13 19Del, 13 21L858R mutations, and 3 uncommon EGFR mutations in 20 exon and 19/21 complex mutation. A higher frequency of EGFR mutation was found in non-smokers and patients with adenocarcinoma components over 50.0%.@*Results@#Twenty-six (65.0%) patients had disease progression after EGFR TKIs treatment, with a median progression-free survival (PFS) of 5.5 months (95% CI 0.52-10.49 months). A total of 20 (50.0%) patients died with an median overall survival (OS) of 15 months (95% CI 11.03-18.97 months). Multivariate analysis showed that gender, age, smoking, histopathological subtypes, EGFR mutations, and brain metastasis had no influence on PFS (all P>0.05). Gender, age, smoking, histopathological subtypes, and the presence of brain metastasis during TKI treatment had no influence on OS (P>0.05), while EGFR mutation is the only influencing factor of OS (P<0.05) in the current study.@*Conclusions@#EGFR TKIs had modest efficacy in lung adenosquamous carcinoma, especially in patients with EGFR mutation. Based on the pathological features, EGFR mutation and EGFR TKIs treatment should be introduced into the routine clinical practice to improve the survival of patients with lung adenosquamous carcinoma.

15.
Chinese Journal of Radiology ; (12): 339-344, 2017.
Article in Chinese | WPRIM | ID: wpr-512957

ABSTRACT

Objective To evaluate whether an early change in 18F-fluorodeoxyglucose (18F-FDG) uptake can predict tumor response to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) and prognosis in patients with non-small cell lung cancer (NSCLC). Methods From August 2009 to April 2015, 22 patients with NSCLC who were eligible to EGFR-TKI treatment were enrolled. PET-CT scan was performed before (baseline) and 1 month after EGFR-TKI administration. Up to 5 hottest single tumor lesions (no more than 2 per organ) were considered to be target lesions. Maximum standardized uptake values (SUVmax) were measured, and post-treatment percentage changes in SUVmax (ΔSUV%) were calculated. PET responses were classified using PET response criteria in solid tumors (PERCIST). Then conventional CT scan was performed every 2 months for follow-up. Kappa statistic was used to compare agreement between the RERCIST recommendations-based therapeutic response evaluation and those based on RECIST1.1 criteria. Fisher exact test was used to compare the probability of disease progression in the early metabolic response and non-response groups. Predictive accuracy of ΔSUV% with respect to response or non-progression at CT scan was evaluated by ROC analysis. Progression-free survival (PFS) was determined by Kaplan-Meier survival analysis, and between-group comparison was performed by log-rank test. Results After 1 month of EGFR-TKI treatment, 12 patients (55%) showed partial metabolic response (PMR), 6 (27%) had stable metabolic disease (SMD), and 4 (18%) had progressive metabolic disease (PMD). There was a moderate agreement(Kappa=0.506,P<0.05) between PET response at 1 month based on PERCIST recommendations and CT response at 3 months according to RECIST 1.1. Non-progression was significantly more frequent in patients with an early PMR (χ2=11.941, P=0.005). Progression had been confirmed later during therapy in all patients with PMD . By using ROC analysis, the area under the curve for prediction of response was 0.906 (95% CI, 0.766—1.000; P=0.002), corresponding to a sensitivity of 88.9% and specificity of 84.6% at a cut-off of 40.36% in ΔSUV%. Using a cut-off value of 25.84% in ΔSUV%, highΔSUV% group (ΔSUV% ≥ 25.84%) had significantly longer PFS than low ΔSUV% group (ΔSUV%<25.84%). Conclusion Early assessment of PET-CT at 1 month of EGFR-TKI treatment could be useful to predict tumor response and clinical outcome in patients with NSCLC.

16.
The Journal of Practical Medicine ; (24): 2536-2538, 2017.
Article in Chinese | WPRIM | ID: wpr-611896

ABSTRACT

Objective To evaluate the condition of oxidative stress and immunosuppression in early stage of severe sepsis,and investigate the correlation between them. Methods A prospective random control study in-cluded patients group(n=51)and control group(n=31). The concentration of serum superoxide dismutase was measured by enzyme linked immunosorbent assay(ELISA),CD4+CD25+Treg% was measured by flow cytometry , respectively. The difference between two groups was compared and the correlation between parameters in patients group was evaluated. Results The concentration of serum SOD was lower than control group (P < 0.01). CD4+CD25+Treg% significantly high,compared to the control group(P < 0.01). There was no strong correlation be-tween parameters in patients group. Conclusion Oxidative stress and immunosuppression are exist in the early stage of severe sepsis.

17.
Chinese Journal of Clinical Oncology ; (24): 935-941, 2015.
Article in Chinese | WPRIM | ID: wpr-481911

ABSTRACT

Lung cancer is the leading cause of cancer death worldwide. Significant advancements have been observed in the thera-py for non-small celllung cancer (NSCLC). With constant extension of new awareness regarding the histopathology of lung cancer, ho-mologous chemotherapeutic regimens have been developed on the basis of histopathological sub-typing methods. With developments in molecular biology, driving gene mutations during tumorigenesis and progression have been discovered. A series of targeted drugs for various molecular subtypes has also been investigated and developed on the basis of these mutations. This review summarizes recently published clinical outcomes on the management of advanced NSCLC and strategies to apply drugs in clinical treatments.

18.
Chinese Journal of Experimental Ophthalmology ; (12): 118-122, 2015.
Article in Chinese | WPRIM | ID: wpr-637456

ABSTRACT

Background Rabbits are commonly used as animal models for the evaluation of drugs and surgery to lower intraocular pressure (IOP).The accuracy of IOP measurement is therefore critical in the analysis of data and subsequent extrapolation to humans.An accurate method to measure rabbit IOP is intracameral manometry,but it is an invasive way.Schi(o)tz,Perkins and Rebound were often used in clinic.However,their accuracy in measuring rabbit IOP in experimental study is unclear.Objective The purpose of this study was to investigate the accuracy of IOP measured by Schi(o)tz tonometer,Perkins tonometer and Rebound tonometer relative to intracameral manometry in New Zealand white rabbits.Methods The central corneal thickness (CCT),corneal curvature (CC),axial length (AL),anterior chamber depth (ACD),lens thickness (LT) and scleral thickness (ST) were respectively measured in 8 eyes of 8 healthy New Zealand white rabbits with lenstar900 and ultrasound biomicroscopy (UBM).The actual IOP was measured with a 24G needle inserted the anterior chamber and connected to a pressure transducer under the general anesthesia,the IOP gradient was set with a 24G needle inserting the vitreous cavity and connecting to a container with balanced salt solution(BSS).Then,comparative measurements at the same pressures were performed with three types of tonometers.The IOP values from Schi(o)tz tonometer,Perkins tonometer and Rebound tonometer were calibrated based on actual IOP from intracameral manometry and eyeball physiological parameters by multiple regression equation.Results The mean of CCT,CC,AL,ACD,LT and ST was (338.96 ±21.52) μm,(51.68±1.66) D,(14.63±0.19) mm,(2.22±0.04) mm,(6.15±0.10) mm and (339.80±47.41) μm.Compared with the intracameral manometry value (IMV),the error range was (17.08± 11.22) mmHg in the Schi(o)tz tonometer value (STV),(25.81±12.43) mmHg in the Perkins tonometer value (PTV) and (22.50±11.47) mmHg in the Rebound tonometer value (RTV),with significant differences between them (t =10.54,14.39,13.59,all at P< 0.05).Compared with IMV,the 95% limits of agreement of three portable tonometer values is larger,and three portable tonometer values had the greater measurement error with elevated IOP gradient.The regression equations was IOP =141.015 + 1.570 × STV + 0.122 × CCT-3.480 × CC between actual IOP and STV (R =0.92,P =0.00),IOP =-33.323+1.914×PTV+0.133×CCT between actual IOP and PTV(R =0.88,P=0.00),IOP=160.395+1.866×RTV+ 0.201×CCT+34.554×LT-2.649×CC+0.063×ST between actual IOP and RTV (R=0.95,P=0.00).Conclusions The physiological parameters of rabbit eyeball are obviously different from human.The STV,PTV and RTV have a great measuring error in comparson with actual IOP,and therefore it is necessary to correct STV,PTV and RTV based on the ocular physiology parameters in experimental study.

19.
International Journal of Laboratory Medicine ; (12): 1086-1087, 2015.
Article in Chinese | WPRIM | ID: wpr-464930

ABSTRACT

Objective To evaluate the comparability of erythrocyte sedimentation rate (ESR) between the Monitor‐20 automated ESR analyzer and manual Westergren method .Methods ESR of 50 clinic samples were detected by Monitor‐20 automated ESR an‐alyzer and Westergren method respectively ,and the results of ESR were compared analyzed .Results There there was no significant differences between ESR results detected by by Monitor‐20 automated ESR analyzer and Westergren method (t= 0 .4673 ,P> 0 . 05) .The satisfactory correlation was founded between the two method (r=0 .9890 ,P<0 .01) .Conclusion There may be a satisfac‐tory correlation between Monitor‐20 automated ESR analyzer and manual Westergren method in the determination of ESR .Monitor‐20 automated ESR analyzer could be a rapid ,precise ,accurate method in measuring ESR ,and could be worthy to extend the applica‐tion in clinic .

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Chinese Journal of Practical Nursing ; (36): 1126-1129, 2015.
Article in Chinese | WPRIM | ID: wpr-470080

ABSTRACT

Objective To evaluate the effect of PRECEDE-PROCEED model in elder patents with diabetes.Methods 70 elder patients with diabetes were divided into the control group (34 cases)and the intervention group(36 cases) randomly.Routine nursing care was used in the control group,while the PRECEDE-PROCEED model was used in the intervention group in addition.Compared the level of FBG and the 2hPG betweenthe two groups.Results Before and after the intervention,the difference of FBG and 2hPG was not significant between the two groups,P> 0.05.Two weeks after the intervention,the incidence rate of hypoglycemia in the intervention group was 8.3%(3/36),which was significant lower than that of in the control group (29.4%,10/34),thex2=5.137,P<0.05.Conclusion PRECEDE-PROCEED model can be well-applied to decrease hypoglycemia in elder patients with diabetes.

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