Effect of Different Antitumor Regimens on Incidence and Severity of Corona Virus Disease 2019 Pneumonia in Lung Cancer Patients: A Single-center Retrospective Study / 中国肺癌杂志

BACKGROUND@#Studies have shown that the incidence and severity of corona virus disease 2019 (COVID-19) in patients with lung cancer are higher than those in healthy people. At present, the main anti-tumor treatments for lung cancer include surgery, immunotherapy, chemotherapy, radiotherapy, targeted therapy and anti-angiogenesis therapy. While the effects of different anti-tumor treatments on the occurrence and severity of COVID-19 pneumonia are not uniform. Therefore, we aimed to describe clinical characteristics and antitumor therapy of patients with lung cancer and COVID-19 pneumonia, and examined risk factors for severity in this population.@*METHODS@#From December 1, 2022 to February 15, 2023, a retrospective study was conducted in 217 patients diagnosed with COVID-19 and pathologically confirmed lung cancer in the Jinling Hospital. We collected data about patients' clinical features, antitumor treatment regimen within 6 months, and the diagnosis and treatment of COVID-19. Risk factors for occurrence and severity of COVID-19 pneumonia were identified by univariable and multivariable Logistic regression models.@*RESULTS@#(1) Among the 217 patients included, 51 (23.5%) developed COVID-19 pneumonia, of which 42 (82.4%) were classified as medium and 9 (17.6%) were classified as severe; (2) Univariate and multivariate analysis revealed overweight (OR=2.405, 95%CI: 1.095-5.286) and intrapulmonary focal radiotherapy (OR=2.977, 95%CI: 1.071-8.274) are risk factors for increasing occurrence of COVID-19 pneumonia, while other therapies are not; (3) Chronic obstructive pulmonary disease (COPD) history (OR=7.600, 95%CI: 1.430-40.387) was more likely to develop severe pneumonia and anti-tumor therapies such as intrapulmonary focal radiotherapy, chemotherapy, targeted therapy and immunotherapy did not increase severity.@*CONCLUSIONS@#Intrapulmonary focal radiation therapy within 6 months increased the incidence of COVID-19 pneumonia, but did not increase the severity. However, there was no safety concern for chemotherapy, targeted therapy, surgery and immunotherapy.

Clinical significance of FLAIR vascular hyperintensities in patients with chronic atherosclerotic middle cerebral artery occlusion / 国际脑血管病杂志

Objective:To investigate the clinical significance of fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVHs) in patients with chronic atherosclerotic middle cerebral artery occlusion.Methods:From July 2016 to November 2020, patients admitted to the Department of Neurology, Jiangdu People's Hospital of Yangzhou and first found chronic atherosclerotic middle cerebral artery occlusion were enrolled. The demographic, clinical and MRI imaging data were collected. According to the presence or absence of acute cerebral infarction, they were divided into the non-acute cerebral infarction group and the acute cerebral infarction group. According to the modified Rankin Scale score at 3 months after the onset, patients with acute cerebral infarction were further divided into the good outcome group (≤2) and the poor outcome group (>2). A multivariate logistic regression model was used to analyze the independent correlation between FVHs and the risk of cerebral infarction in patients with chronic atherosclerotic middle cerebral artery occlusion and the outcome in patients with cerebral infarction. Results:A total of 94 patients with chronic atherosclerotic middle cerebral artery occlusion were enrolled, including 38 with non-acute cerebral infarction (40.4%) and 56 with acute cerebral infarction (59.6%). In patients with acute cerebral infarction, 13 (23.2%) had a poor outcome, and 43 (76.8%) had a good outcome. The fibrinogen level, the proportion of patients with FVHs and the FVHs score in the cerebral infarction group were significantly higher than those in the non-cerebral infarction group (all P<0.05). Multivariate logistic regression analysis showed that the FVHs score was significantly, independently, and positively correlated with the risk of acute cerebral infarction (odds ratio 2.524, 95% confidence interval 1.400-4.552; P=0.002). The National Institutes of Health Stroke Scale score at admission, the modified Rankin Scale score at admission, and FVHs score in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that there was a significant independent negative correlation between the FVHs score and the outcome of patients with cerebral infarction (odds ratio 0.144, 95% confidence interval 0.045-0.459; P=0.001). Conclusions:FVHs suggest that the blood supply is in a state of decompensation. When FVHs are present, the risk of cerebral infarction in patients with chronic middle cerebral artery occlusion is significantly increased; the wider the range of FVHs, the higher the risk of poor outcome after cerebral infarction.

Carotid artery calcification and ischemic stroke: a retrospective case series study / 国际脑血管病杂志

Objective To investigate the relationship between carotid artery calcification and ischemic stroke.Methods The demographic data,vascular risk factors and clinical features of patients with acute ischemic stroke and non-acute stroke patients admitted in the same period were collected retrospectively.All the patients received 64-slice spiral CT examination,and the scan data were transmitted to a GE workstation.A smart score software was used to evaluate carotid artery calcification.Multivariate logistic regression analysis was used to identify the independent risk factors for ischemic stroke.Receiver operator characteristic (ROC) curve was used to analyze and determine the predictive value of carotid artery calcification in acute ischemic stroke.Results A total of 86 patients with acute ischemic stroke and 89 with non-acute stroke (control group) were enrolled.In addition to the previous stroke history,there were no significant differences in age,gender,and vascular risk factors between the ischemic stroke group and the control group.The calcium score (338.57 ± 77.35 vs.147.79 ± 64.52; t =4.065,P =0.045),total calcified volume (372.22 ± 78.73 mm3 vs.197.27 ±61.12 mm3; t =4.740,P =0.031),and calcification quality (70.33 ± 13.83 mg vs.32.44 ± 12.27 mg; t =6.673,P =0.011) of the ischemic stroke group were significantly higher than those of the control group.In patients with ischemic stroke,there were no significant differences in the carotid artery calcification score (335.50 ± 85.95 vs.312.73 ± 90.61; t =0.052,P =0.820),total calcified volume (357.91 ± 88.93 mm3 vs.311.71 ± 81.43 mm3; t=0.071,P=0.791),and calcium quality (59.68± 17.36 mg vs.51.29 ± 18.69 mg; t =0.071,P =0.791) between the symptomatic sides and non-symptomatic sides.Multivariate logistic regression analysis showed that the carotid artery calcification score (odds ratio [OR] 4.963,95％ confidence interval [CI] 5.932-18.994; P=0.019),total calcified volume (OR 5.967,95％ CI 3.940-14.993; P =0.015),and calcium quality (OR 6.815,95％ CI 4.703-21.946; P =0.007) were the independent risk factors for ischemic stroke.The ROC curve analysis of carotid artery calcification score showed that when it was 231.25,it had a predictive value for acute ischemic stroke.The sensitivity was 85.4％,specificity was 89.9％,positive predictive value was 87.1％,and negative predictive value was 89.1％.The area under the ROC curve was 0.891 (95％ CI 0.808-0.913; P =0.027).Conclusions Carotid artery calcification is one of the independent risk factors for ischemic stroke.Carotid artery calcification score has some predictive value for acute ischemic stroke.

CT microvascular permeability surface imaging evaluation of acute cerebral infarction / 中国医学影像技术

Objective To investigate the application of CT microvascular permeability surface (PS) in acute ischemic stroke. Methods Thirty patients suffering from acute or sub-acute cerebral infarction underwent CT perfusion (CTP) combining with CTA. Cerebral hemodynamic parameters (cerebral blood flow [CBF], cerebral blood volume [CBV], time to peak [TTP], PS) between lesions and contralateral side were compared. The manifestation of microvascular hyper permeability were analyzed. Results Significant differences were found in cerebral hemodynamic parameters between the core of cerebral infarction and the contralateral hemisphere (P＜0.05). There was no significant difference in CBF and CBV between the surrounding of cerebral infarction and the contralateral hemisphere, but PS and TTP showed delaying and heightening, the difference was significant (P＜0.05). High-density extravasation of contrast media in infarction zone was observed 30 min after CTP in 3 patients, the value of PS reached (9.20±1.43) ml/100 (ml·min). Conclusion CT microvascular PS may monitor hemorrhagic transformation in acute ischemic stroke, and guide thrombolytic therapy.

Application of Voxel-Based Morphometry Technique in Patients with Mild Cognitive Impairment / 国际脑血管病杂志

Mild cognitive impairment(MCI)refers to cognitive regression which goes beyond one'S age and education level,but does not influence the activities of daily living.More than half patients with MCI will develop dementia within five years.Therefore,MCI is considered as a risk status of dementia.Early diagnosis of MCI prevents against patients developing dementia. Voxel-based morphometry(VBM)technique quantitatively calculates the size of global and local gray matter voxel and signal intensity.It is a full automatic analysis technique of objective brain morphology.This article reviews the application of VBM technique in patient with MCI.