Preliminary Efficacy Evaluation of Neoadjuvant Immunotherapy Combined with Chemotherapy in Resectable Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#Preliminary researches conformed that neoadjuvant immunotherapy combined with chemotherapy had a significant short-term effect in resectable non-small cell lung cancer (NSCLC), but there were few clinical trials about neoadjuvant chemoimmunotherapy in China. We aimed to assess retrospectively the antitumour activity and safety of neoadjuvant chemoimmunotherapy for resectable stage Ib-IIIb NSCLC.@*METHODS@#Twenty patients who had been diagnosed as stage Ib-IIIb NSCLC and received chemoimmunotherapy as neoadjuvant treatment between November 2019 and December 2020, in Beijing Chest Hospital, Capital Medical University were recruited. These patients received neoadjuvant treatment for 21 days as a cycle and antitumour activity and safety were evaluated every two cycles.@*RESULTS@#Of 20 patients received neoadjuvant chemoimmunotherapy, 17 patients underwent surgical resection. 16 patients had R0 resection (no residual tumor resection) and 1 patient had R1 resection (microscopic residual tumor resection). Radiographic objective response rate (ORR) was 85.0% (4 complete response, 13 partial response). 5.0% (1/20) of patients had stable disease, and 10.0% (2/20) of patients had progression disease. The major pathologic response (MPR) was 47.1% (8/17), and complete pathologic response (CPR) was 29.4% (5/17). 1 case developed grade IV immune-related pneumonia (IRP) and 9 (45.0%) cases had grade III hematologic toxicity.@*CONCLUSIONS@#Immunotherapy combined with chemotherapy as neoadjuvant therapy has a better efficiency and tolerable adverse effects for patients with resectable NSCLC in stage Ib-IIIb.

The intervention mechanism of Fufang-Zhongjiefeng aerosol in the treatment of chronic pharyngitis based on TLR-4/MyD88/NF-κB pathway / 国际中医中药杂志

Objective:To study the function and possible mechanism of Fufang-Zhongjiefeng aerosol in the treatment of chronic pharyngitis. Method:Sixty SD rats were randomly divided into normal group, model group, low-, medium-, and high-dose Fufang-Zhongjiefeng aerosol group, and positive drug group, with 10 rats in each group. Except the normal group, the pharynx of other groups were injected with group A beta-hemolytic streptococcus (GAS) to establish chronic pharyngitis rat model. After the modeling, the low-, medium-, and high-dose Fufang-Zhongjiefeng aerosol groups were sonicated with 20 ml of 0.9% normal saline to dissolve the Fufang-Zhongjiefeng aerosol 2.33, 4.66, 9.32 g/kg, respectively. The normal group and the model group were given the same volume of normal saline, and the positive drug group was intraperitoneally injected with ampicillin sodium 0.93 g/kg once a day for 14 days. The pathological changes of pharyngeal mucosa were detected by hematoxylin and eosin (HE) staining. The levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and nterleukin-6 (IL-6) in serum were detected by Enzyme-linked Immunosorbent Assay (ELISA). The expression levels of toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor kappa B (NF-κB) p65 protein in pharyngeal mucosa were detected by immunohistochemistry. The expression levels of TLR4, MyD88 and NF-κB p65 mRNA in pharyngeal mucosa were detected by quantitative real-time reverse transcription-polymerase chain reaction (RT-qPCR). Results:Compared with the model group, the serum TNF-α, IL-1β and IL-6 levels of rats in the Fufang-Zhongjiefeng aerosol low-, medium-, high-dose group and the positive drug group were significantly reduced ( P<0.05). The expression of TLR-4, MyD88 and NF-κB p65 protein in the pharyngeal mucosal tissue of rats in the low-, medium-, high-dose Fufang-Zhongjiefeng aerosol group and the positive drug group were significantly reduced ( P<0.05). The expressions of TLR-4 mRNA (1.17 ± 0.41, 2.44 ± 1.06, 1.25 ± 0.34 vs. 3.87 ± 1.43), MyD88 mRNA (1.15 ± 0.53, 1.75 ± 0.36, 1.09 ± 0.14 vs. 2.44 ± 0.19), and NF-κB p65 mRNA (1.97 ± 0.51, 2.64 ± 0.26, 2.31 ± 0.44 vs. 5.08 ± 0.34) in the pharyngeal mucosa tissue of rats in the medium-, high-dose group and the positive drug group were significantly reduced ( P<0.05). Conclusion:Fufang-Zhongjiefeng aerosol can effectively treat chronic pharyngitis, which could inhibit the expression of TLR-4, MyD88, and NF-κB to reduce the expression of inflammatory factors so as to play the rold of anti-inflammatory effect.

AngioJet in patients treated for acute deep venous thrombosis by mechanical aspiration thrombectomy combined with catheter-directed thrombolysis / 中华普通外科杂志

Objective To evaluate AngioJet in patients treated for acute deep venous thrombosis (DVT) by mechanical aspiration thrombectomy combined with catheter-directed thrombolysis (CDT).Methods A retrospective analysis of 83 acute DVT patients treated by mechanical aspiration thrombectomy combined with CDT from Dec 2014 to Oct 2018 in the Third Hospital of Hebei Medical University was conducted.Results 43 cases (routine group) were treated by mechanical aspiration thrombectomy using a large-caliber catheter combined with CDT,and 40 cases (AngioJet group) were treated by AngioJet aspiration thrombectomy combined with CDT(P ＞ 0.05).Thrombosis was completely dissolved in 28 cases in AngioJet group while in 10 cases in large-caliber catheter group.Venous damage rate was higher (38 cases vs.13 cases) in routine group.Conclusion AngioJet combined with CDT can effectively and safety remove thrombus in the lower extremity deep venous system.

Effect analysis of atorvastatin to prevent the arterial restenosis after intracavitary therapy of the lower atherosclerotic occlusive / 中国综合临床

Objective To discuss the effect of atorvastatin to prevent the arterial restenosis after intracavitary therapy of patients with lower atherosclerotic occlusive (LASO).Methods One hundred and ten patients with LASO were randomly divided into the control group (n =55) and research group (n =55).All patients were given intraeavitary therapy (including balloon dilation, stent implantation and endarterectomy, stentimplantation and thromboetomy).The patients of the control group were given conventional anticoagulant therapy while the observation group were given atorvastatin 20 mg/d based same treatment of the control group for 6 months.The blood lipid, C-reactive protein (CRP), intima-media thickness (IMT) and the patency rate of lower limb artery of two group were observed and recorded before treatment and at 1 day,1 month,3 months and 6 months after treatment.Results The total cholesterol (preoperation, 1 month, 3 months and 6 months after operation were (4.90± 1.02) mmol/L, (4.07 ± 0.76) mmol/L, (3.82 ± 0.53) mmol/L and (3.64 ± 0.35) mmol/L respectively), CRP (preoperation, 1 month, 3 months and 6 months after operation were (31.60 ± 13.32) mg/L, (19.24±9.45) mg/L, (9.84 ± 6.43) mg/L and (6.34 ± 3.82) mg/L respectively) and IMT (preoperation, 1 month, 3 months and 6 months after operation were (1.08±0.25) mm, (1.02±0.27) mm, (0.92±0.22) mm and (0.81±0.16) mm respectively) of research group showed a downward trend,while the control group had no significant change, there were statistically significant differences among the research group (P＜0.05).Total cholesterol, IMT and CRP were significantly different among the patients of the research group at different time points (P ＜ 0.05), while there was no statistically significant difference in different times of patient(P＞0.05).There were no statistical significant about the patency rate at 1 day, 1 month,and 3 months after treatment between the two groups(P＞0.05),while the patency rate of research group at 6 months after treatment was obviously higher than that of control group (94.5％ (52/55) vs.74.5％ (41/55);x2 =7.637, P ＜0.05).Conclusion Atorvastatin can effectively reduce the blood lipid and CRP of patients with lower atherosclerotic occlusive and increase the patency rate,it is worth popularization and application.

Gene expression profiles of ERCC1, TYMS, RRM1, TUBB3 and EGFR in tumor tissue from non-small cell lung cancer patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Personalized medicine becomes essential in lung cancer treatment, however lung-cancer-related gene expression profiles in Chinese patients remain unknown. In this study, the correlation of gene expression profiles and clinical characteristics in non-small-cell lung cancer (NSCLC) was investigated.</p><p><b>METHODS</b>Seventy-six Chinese patients with NSCLC were enrolled in the study to investigate mRNA expression profiles of excision repair cross complement group 1 (ERCC1), thymidylate synthetase (TYMS), ribonucleotide reductase (RRM1), class III β-tubulin (TUBB3), and epidermal growth factor receptor (EGFR) genes and their correlation with patient clinical characteristics. A novel liquidchip technology was used to detect mRNA expression levels in formalin fixed paraffin embedded tumor pathology samples. The relationships between gene expression and clinical characteristics were assessed using the Mann-Whitney test.</p><p><b>RESULTS</b>ERCC1 mRNA levels were higher in tumors from patients with metastatic disease than patients with non-metastatic disease (P = 0.021), and higher in adenocarcinomas than squamous cell carcinomas (P = 0.006). Increased TUBB3 mRNA expression levels were found in patients with performance status (PS) 1 in comparison with PS 0 (P = 0.049), with poorly differentiated tumors in comparison with tumors that were moderately and well differentiated (P ≤ 0.000 1), and with advanced stage in comparison with early stage disease (P ≤ 0.000 1).</p><p><b>CONCLUSIONS</b>ERCC1 mRNA levels were higher in metastatic adenocarcinoma NSCLC; TUBB3 mRNA levels were significantly higher in poorly differentiated tumors and in advanced stage NSCLC, which indicates the poor prognosis.</p>

Approach to the patient with subacute thyroiditis during pregnancy / 中华内分泌代谢杂志

Pregnant women with subacute thyroiditis (SAT) are rare.One case was reported and the clinical features and management principles of SAT during pregnancy were reviewed.In pregnant women with SAT,the illness is usually not serious.If subclinical or clinical hypothyroidism develops,L-T4 must be given and thyroid function be monitored routinely,and the medication be adjusted carefully to ensure the maternal-fetal safety.

Clinical features and treatment of cryptogenic hemoptysis / 中国介入影像与治疗学

ObjectiveTo discuss the incidence,treatment and effect of cryptogenic hemoptysis (CH).MethodsPatients with CH were selected from 231 patients with hemoptysis according to clinical evaluation,chest radiography,fiberoptic bronchoscopy and CT scan,and the clinical data and treatment methods were retrospectively analyzed.ResultsFifty-three of 231 patients referred for CH,the incidence of CH was 22.94 ％ (53/231),of which 45 (45/53,84.91％ ) received internal conservative treatment and 8 (8/53,15.09％) received bronchial artery embolization (BAE).High resolution CT (HRCT) showed ground-glass opacities in 20 CH patients after hemoptysis.Bronchial arteriography showed abnormalities,including arterial enlargement and localized hypervascularity in 8 patients and systemic to pulmonary shunting in 3 patients.No recurrence of hemoptysis was observed during 1 to 8-year follow-up.ConclusionBleeding can be controlled in most of CH patients by internal conservative treatment,only a few patients with massive hemoptysis need BAE,and both treatments have good short and long term results.

Extended-spectrum ?-Lactamases and Resistance in Escherichia coli Isolated from Biliary Tract and Abdominal Cavity / 中华医院感染学杂志

OBJECTIVE To investigate the prevalence of extended-spectrum ?-lactamases(ESBLs) and the resistance in Escherichia coli isolates from biliary tract and abdominal cavity.METHODS ESBLs-producers were detected by CLSI Phenotypic Confirmatory Test and susceptibilities were tested by agar dilution method.RESULTS 50.1% Of isolates were ESBLs producers in those isolates.ESBLs producers were highly resistant to ampicillin,cefazolin,cefuroxime,fluoroquinolones,and cefotaxime.The resistant rate to ceftazidime,cefepime,cefoperazone-sulbactam,amikacin,and cefmetazole was less than 40%.None was resistant to meropenem in ESBLs producers.In non-ESBLs producers the resistant rate to ampicillin,cefazolin,cefuroxime,fluoroquinolones was more than 40% and most were susceptible to other antimicrobial agents.The resistant rate to ampicillin,cefazolin,cefuroxime,and ciprofloxacin was significantly higher in ESBLs producers than non-ESBLs producers.CONCLUSIONS With resistance to most of antimicrobial agents,ESBLs-producers were highly prevalent in E.coli isolates from biliary tract and abdominal cavity,so more attention should be paid to survey and detect those strains.