Assessment of systemic immune-inflammation index in predicting postoperative pulmonary complications in patients undergoing lung cancer resection.

BACKGROUND: Hematological inflammatory parameters, including neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, are good predictors of postoperative pulmonary complications after lung cancer resection. However, the clinical value of the systemic immune-inflammation index has not been extensively studied. METHODS: We retrospectively analyzed a cohort of patients that underwent lung cancer resection in our center, and we analyzed the hematological inflammatory parameters (including systemic immune-inflammation index) and postoperative pulmonary complications after lung cancer resection. The receiver operating characteristic curve was applied to determine the best cut-off value. Multivariable analysis was applied to assess which of the factors was the most important. RESULTS: Two hundred and four patients were enrolled in this study. Of these, 47 postoperative pulmonary complications events were observed in 40 patients in this cohort. Surgery method, white blood cell count, albumin, forced expiratory volume in 1 second, carbon monoxide diffusing capacity, intensive care unit stay, and systemic immune-inflammation index were found to be significantly different between the postoperative pulmonary complications and non-postoperative pulmonary complications groups. We then used the receiver operating characteristic curves and the Youden index to determine the best cutoff value. Multivariable analysis revealed that systemic immune-inflammation index and forced expiratory volume in 1 second were the most important predictive factors of postoperative pulmonary complications after lung cancer resection. CONCLUSION: Hematological inflammatory parameters of systemic immune-inflammation index and forced expiratory volume in 1 second could be a favorable index to predict postoperative pulmonary complications after lung cancer resection.

Randomized controlled trial of chemotherapy plus geiftinib as ifrst-line treatment for patients with advancedEGFR mutation-positive lung adenocarcinoma / 中国癌症杂志

Background and purpose:For patients with advanced lung adenocarcinoma harboring an activating EGFR gene mutation, the current standard of care is EGFR-TKI alone. This study aimed to compare efficacy and safety of gefitinib plus chemotherapy with gefitinib or chemotherapy alone for treating advanced lung adenocarcinoma with an activatingEGFR gene mutation.Methods:This study included 61 patients with lung adenocarcinoma harboring an acti-vatingEGFR gene mutation (19 exons deletion and exon 21 L858R mutations) whose ECOG performance status was 0 or 1. Patients were randomly divided into 3 groups. Group A (n=20) were given carboplatin/pemetrexed of a 4-week cycle, six cycles at most, plus gefitinib (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1; gefitinib 250 mg/d, d 5-21), and then re-ceived pemetrexed of a 4-week cycle plus gefitinib as maintenance therapy; Group B (n=20) were given carboplatin/peme-trexed of a 4-week cycle, six cycles at most (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1), then received pemetrexed as maintenance therapy; Group C (n=21) were given gefitinib (gefitinib 250 mg/d). Patients continued to receive therapy until disease progression or unacceptable toxicity or death. The primary end point was middle PFS and 12 months PFS rate. The secondary end points included objective response rate and adverse events.Results:Groups A and C both lost 1 case during follow-up. Median PFS for patients was 20.1 months (95%CI:18.0-22.2) in group A, 5.5 months (95%CI:3.9-7.2) in group B, and 9.8 months (95%CI:6.8-12.8) in group C. PFS rates of 12 months for groups A, B and C were 78.9%, 15.0% and 40.0%, respectively. The overall objective response rates for groups A, B and C were 84.2%, 35.0% and 65.0%, respectively. Serious adverse events were reported by 36.8% for group A, 30.0% for group B, and 5.0% for group C. The most common grade 3/4 adverse events were neutropenia (3 cases in group A, 4 cases in group B), fatigue (2 cases in group A, 2 cases in group B) and liver function impairment (2 cases in group A, 1 case in group C).Conclusion:Among patients withEGFR mutant lung adenocarcinoma, combination of chemotherapy with gefitinib as first-line treatment demonstrates an improvement in PFS. Long-term survival results will be further followed up.

The Application of Multimedia to Molecular Biology Teaching / 中华医学教育探索杂志

Molecular biology,one of the major branches of biochemistry,is quite abstract and abstruse for students.Fortunately with the help of multimedia,an effective teaching assistant method which enjoys great advantages,teachers can fully convey teaching ideas in a vivid picture.As a result,it will be much easier for students to follow teachers in class.