Effects of glucocorticoid use on survival of advanced non-small-cell lung cancer patients treated with immune checkpoint inhibitors / 中华医学杂志(英文版)

BACKGROUND@#Lung cancer is the second most common cancer worldwide, with non-small-cell lung cancer (NSCLC) accounting for the majority of cases. Patients with NSCLC have achieved great survival benefits from immunotherapies targeting immune checkpoints. Glucocorticoids (GCs) are frequently used for palliation of cancer-associated symptoms, as supportive care for non-cancer-associated symptoms, and for management of immune-related adverse events (irAEs). The aim of this study was to clarify the safety and prognostic significance of glucocorticoid use in advanced patients with NSCLC treated with immune checkpoint inhibitors (ICIs).@*METHODS@#The study searched publications from PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, Chinese National Knowledge Infrastructure, Wanfang Data, and Chinese Science and Technology Journal Database up to March 1st, 2022, and conducted a meta-analysis to assess the effects of glucocorticoid use on overall survival (OS) and progression-free survival (PFS) in NSCLC patients treated with ICIs through the available data. The study calculated the pooled hazard ratios (HRs) and 95% confidence intervals (CIs).@*RESULTS@#This study included data from 25 literatures that were mainly retrospective, with 8713 patients included. Patients taking GCs had a higher risk for tumor progression and death compared with those not taking GCs (PFS: HR = 1.57, 95% CI: 1.33-1.86, P <0.001; OS: HR = 1.63, 95% CI: 1.41-1.88, P <0.001). GCs used for cancer-associated symptoms caused an obviously negative effect on both PFS and OS (PFS: HR = 1.74, 95% CI: 1.32-2.29, P <0.001; OS: HR = 1.76, 95% CI: 1.52-2.04, P <0.001). However, GCs used for irAEs management did not negatively affect prognosis (PFS: HR = 0.68, 95% CI: 0.46-1.00, P = 0.050; OS: HR = 0.53, 95% CI: 0.34-0.83, P = 0.005), and GCs used for non-cancer-associated indications had no effect on prognosis (PFS: HR = 0.92, 95%CI: 0.63-1.32, P = 0.640; OS: HR = 0.91, 95% CI: 0.59-1.41, P = 0.680).@*CONCLUSIONS@#In advanced NSCLC patients treated with ICIs, the use of GCs for palliation of cancer-associated symptoms may result in a worse PFS and OS, indicating that they increase the risk of tumor progression and death. But, in NSCLC patients treated with ICIs, the use of GCs for the management of irAEs may be safe, and the use of GCs for the treatment of non-cancer-associated symptoms may not affect the ICIs' survival benefits. Therefore, it is necessary to be careful and evaluate indications rationally before administering GCs in individualized clinical management.

needling technique for diabetic fundus hemorrhage / 中国针灸

OBJECTIVE@#To observe the clinical effect of ' -- needling technique for diabetic fundus hemorrhage.@*METHODS@#With before-after study design, 34 patients with diabetic eyeground hemorrhage were treated with basic treatment (oral administration of antidiabetic medication or insulin injections to ensure blood glucose in the normal range); in addition, acupuncture was given at bilateral Fengchi (GB 20), Taiyang (EX-HN 5), Jingming (BL 1), Cuanzhu (BL 2), Sanyinjiao (SP 6) and Hegu (LI 4). The ' -- needling technique was applied at Fengchi (GB 20); the heat reinforcing needling technique was applied at Taiyang (EX-HN 5); the slow needle insertion technique was applied at Jingming (BL 1); and the - needling technique was applied at Cuanzhu (BL 2); the neutral supplementation and draining method was applied at remaining acupoints. The acupuncture was given once a day, 6 times as one course, and totally 4 courses were given with an interval of 1 day between courses. The follow-up visit was 6 months after treatment. The TCM symptom scores, fundus examination results and vision improvement were observed before and after treatment, and the effect was observed.@*RESULTS@#Compared before treatment, the visual acuity, TCM symptom scores, fundus microaneurysm and hemorrhage points in 34 patients (68 eyes) were significantly improved after treatment (0.05).@*CONCLUSION@#' -- needling technique could improve symptoms, promote the absorption of fundus hemorrhage, and improve vision in patients with diabetic fundus hemorrhage.

Effect of modified huopo xialing decoction in treating pi-wei dampness-heat syndrome and its impact on the tongue epithelial cell apoptosis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the effects of modified Huopo Xialing Decoction (HXD) in treating patients of Pi-Wei dampness-heat syndrome (PWDHS) and its impact on epithelial cell apoptosis of tongue.</p><p><b>METHODS</b>Fifty patients with PWDHD were randomized depending on their visiting sequence into two groups, the 30 patients in the treatment group treated with HXD and the 20 in the control group treated with Domperidone. The therapeutic course for both groups was 2 weeks. Besides, a normal control group consisting of 30 healthy volunteers was set up. The changes of tongue fur, grade of major syndromes in different groups were observed and scored before and after treatment to evaluate the therapeutic effectiveness, and the apoptotic index (AI) was estimated using TUNEL technique.</p><p><b>RESULTS</b>AI in the two patient groups before treatment was obviously lower than that in the normal group (P < 0.01 or P < 0.05); after treatment, AI in the treatment group increased significantly (P < 0.01), with no difference from that in the normal group (P > 0.05), while in the control group, it only showed a slight trend of increasing. Similar outcome of tongue fur grades was seen in the two groups, it was improved significantly (P < 0.01) in the treatment group but insignificantly in the control group (P > 0.05). After treatment, syndrome scores were both lower in the two groups (P < 0.01), but the decrement in the treatment group was more significant than that in the control group (P < 0.01). Comparison between groups showed that the total effective rate in the treatment group was significantly superior to that in the control group (90% vs 65%, P < 0.01).</p><p><b>CONCLUSION</b>HXD has good clinical efficacy in treating PWDHS, and has good effect in alleviating the greasy yellow tongue fur in patients with PWDHS by accelerating the tongue epithelial cell apoptosis.</p>

Cloning and secretory expression of islet neogenesis-associated protein in Pichia pastoris / 南方医科大学学报

<p><b>OBJECTIVE</b>To clone the recombinant human islet neogenesis-associated protein (rhINGAP) gene for its secretory expression in Pichia pastoris.</p><p><b>METHODS</b>INGAP gene was amplified with PCR and inserted between Xho I and EcoR I downstream sites of the alpha factor of the recombinant plasmid alpha/pUC18. The fusion gene of alpha factor and INGAP was subsequently inserted between BamH I and EcoR I sites of the plasmid pPIC9K of P. pastoris. After confirmation with restriction enzyme digestion and sequencing, the positive recombinant plasmid that integrated INGAP gene was linearized with Sal I digestion and transformed into the yeast host strain GS115 through electroporation. The yeast transformants that harbored the INGAP gene with high copies were selected with the auxotroph medium and G418, followed then by PCR verification of the positive transformants, from which the expression of recombinant human INGAP was induced with methanol as the only carbone source. The antigenic activity of the desired protein was then detected using Western blotting and enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS AND CONCLUSION</b>The recombinant expression plasmid INGAP/pPIC9K was successfully constructed, and 3 positive transformants were obtained. The expressed protein showed good antigenic activity as confirmed by Western blotting and ELISA.</p>