Association Between RET Fusions and Efficacy of Pemetrexed-based Chemotherapy for Patients With Advanced NSCLC in China: A Multicenter Retrospective Study

BackgroundRearranged during transfection (RET) proto-oncogene gene fusions are rare in non–small-cell lung cancer (NSCLC). We compared the efficacy of pemetrexed-based chemotherapy with other chemotherapy regimens in patients with NSCLC with different RET fusion subtypes.Patients and MethodsA retrospective, multicenter study of patients with pathologically confirmed stage IIIB/IV lung adenocarcinomas was conducted. RET rearrangements were detected using next generation sequencing. We analyzed the clinical characteristics of patients with RET-rearranged NSCLC and the efficacy of chemotherapy regimens. We also evaluated the efficacy between groups of patients with and without KIF5B-RET–rearranged lung cancer.ResultsWe evaluated 62 patients with NSCLC and RET rearrangements, including 41 with KIF5B-RET, 15 with CCDC6-RET, and 6 with other rare fusion subtypes. Of these 62 patients, 50 had stage IIIB/IV. We also evaluated 40 patients with first-line chemotherapy information available. The median progression-free survival was significantly different between those receiving pemetrexed-based chemotherapy and those receiving other chemotherapy regimens (9.2 vs. 5.2 months; P = .007). The median progression-free survival for patients with KIF5B-RET fusion and non–KIF5B-RET fusion was not significantly different statistically (7.8 vs. 11.2 months; P = .847). For second-line chemotherapy, a statistically significant difference was found between the chemotherapy regimens (4.9 vs. 2.8 months; P = .049). Survival follow-up data were available for 38 patients with advanced NSCLC. The median overall survival was 26.4 months. The overall survival of the patients with RET-rearranged NSCLC who had received pemetrexed-based chemotherapy versus no pemetrexed-based chemotherapy was 35.2 versus 22.6 months (P = .052). No difference in survival was observed between the patients with KIF5B-RET and non–KIF5B-RET rearrangements.ConclusionsPemetrexed-based treatment should be considered first when selecting the chemotherapy regimen for patients with NSCLC and RET rearrangements.     

川芎嗪防治膝关节软骨退变的实验研究

目的 :应用膝关节制动的动物模型 ,探讨中药川芎嗪对膝关节OA软骨退变的保护作用。方法 :2 4只健康成年家兔 ,随机分为两组 ,每组 12只 ,动物的右后肢采用膝关节伸直位管形石膏制动的方法建立骨性关节炎模型。实验组膝关节注射川芎嗪 0 3ml,每周 1次 ,对照组注射 0 3ml生理盐水 ,每周 1次 ,在模型建立 6、9周时 ,每组分别取 6只动物 ,进行超氧化物歧化酶 (SOD)、丙二醛 (MDA)、糖胺多糖 (GAG)含量测定 ,并观察滑膜、软骨的病理改变。结果 :实验组MDA的浓度低于对照组的浓度 ,两者差异有显著性 (6周 ,P <0 0 5 ;9周 ,P <0 0 1) ,6周时 ,对照组的GAG含量明显上升 ,与正常组及实验组相比 ,均有显著性差异 (P <0 0 1)。实验组SOD浓度在不同时期均高于对照组 (6周 ,P <0 0 5 ;9周 ,P <0 0 1)。光镜观察可见 ,实验组滑膜和软骨病理改变较对照组轻。结论 :川芎嗪对早期膝关节OA的软骨退变具有保护作用     

幽门螺杆菌感染与肝硬化并发症相关性临床分析

目的：研究肝硬化患者Hp感染的临床特点。方法：对明确诊断为肝硬化的108例患者的上消化道出血、肝性脑病、肝源性糖尿病等状况与Hp感染情况的关系进行分析。结果：Hp感染与上消化道出血无相关性。Hp感染所致的血氨升高是肝性脑病的重要原因。Hp感染使肝硬化患者血糖升高明显，易于并发糖尿病。结论：根除Hp可预防肝性脑病和肝源性糖尿病的发生，但上消化道出血的肝硬化患者不必进行积极的Hp根除治疗，而应注重肝脏本身。     

The cost of Alzheimer's disease in China and re-estimation of costs worldwide

Introduction

The socioeconomic costs of Alzheimer's disease (AD) in China and its impact on global economic burden remain uncertain.

超声监测腹腔镜套扎切除子宫肌瘤术创面36例分析

目的通过超声定期监测子宫创面愈合情况评价腹腔镜下线圈套扎法切除子宫肌瘤的临床应用。方法腹腔镜下应用线圈套扎法切除子宫肌瘤浆膜下或壁间肌瘤外突型36例,术后超声定期监测子宫创面疤痕愈合恢复情况。结果线圈套扎法切除浆膜下子宫肌瘤18例创面恢复佳;子宫壁间肌瘤外突>50%者11例,创面4、5周后消失;子宫壁间肌瘤外凸<50%者7例创面恢复慢,并发症多。结论据超声监测腹腔镜下套扎法切除子宫肌瘤是一种可行的手术方法,但需结合临床分型适当采用。     

Dietary intake and risk of rheumatoid arthritis—a cross section multicenter study

Environmental factors play an important role in the development of rheumatoid arthritis (RA). Among these factors, smoking is generally considered to be an established risk factor for RA. Data regarding the impact of diet on risk of RA development is limited. This study assessed the impact of dietary patterns on RA susceptibility in Chinese populations. This was a large scale, case-control study composed of 968 patients with RA and 1037 matched healthy controls. Subjects were recruited from 18 teaching hospitals. Socio-demographic characteristics and dietary intakes 5 years prior to the onset of RA were reported by a self-administered questionnaire. Differences in quantity of consumption between cases and controls were analyzed by Student’s t test. Multiple logistic regression analysis was applied to identify independent dietary risk factor(s) responsible for RA susceptibility. Compared to healthy individuals, RA patients had decreased consumption of mushrooms (P = 0.000), beans (P = 0.006), citrus (P = 0.000), poultry (P = 0.000), fish (P = 0.000), edible viscera (P = 0.018), and dairy products (P = 0.005). Multivariate analyses revealed that several dietary items may have protective effects on RA development, such as mushrooms (aOR = 0.669; 95%CI = 0.518–0.864, P = 0.002), citrus fruits (aOR = 0.990; 95%CI = 0.981–0.999, P = 0.04), and dairy products (aOR = 0.921; 95%CI 0.867–0.977, P = 0.006). Several dietary factors had independent effects on RA susceptibility. Dietary interventions may reduce the risk of RA.     

Résistance au vécuronium chez le brûlé. Influence de la surface brûlée sur la dose efficace 95

ObjectiveTo assess the neuromuscular blocking effect of vecuronium in adult bum patients, to draw dose-response curves, to determine the ED 95 according to burn surface area, to analyze the time course of this pattern in order to recognize the development of a resistance according to the length of postinjury period.Study designProspective open study, extending over a 12 month period.PatientsSixty-three consecutive adult burn patients in an acute phase and 13 control patients who had been thermally injured at least 500 days before their inclusion in the study.MethodsAnaesthesia was achieved with thiopentone, fentanyl and vecuronium in patients undergoing excision and autograft surgery. Neuromuscular blockade was assessed by thumb adduction, measured by electromyography using evoked train of four responses to ulnar nerve stimulation. Dose-response curves were determined using the single dose method from only one predetermined dose of vecuronium per patient on each day of the study. Dose-response curves were compared using linear regression and ED 95 were calculated from log-probit data.ResultsIn the control group, ED 95 was 53 mg·kg⁻¹. Before the 7th postinjury day, patients did not differ from controls. Between the 7th and the 70th postinjury day the ED 95 increased significantly. Patients with a burn surface area (BSA) of less than 20% had a ED 95 of 69 mg·kg⁻¹, between 20% and 40% of BSA the ED 95 was 103 mg·kg⁻¹, between 40% and 60% BSA the ED 95 was 134 mg·kg⁻¹ and patients with a BSA over 60% had a ED 95 at 154 mg·kg⁻¹. The onset of action increased in all groups and was significantly different from control group.ConclusionAcutely burn patients become resistant to the neuromuscular blocking effect of vecuronium. This resistance is related to the magnitude of burn injury. The mechanism of resistance is related to an increase in nicotonic acetylcholine receptors.In these patients, the dose of vecuronium must be titrated to achieve effective muscular paralysis: The correcting factor is 1.3 for a BSA under 20%, 1.9 for a BSA between 20 and 40%, 2.5 for a BSA between 40 and 60%, and 2.9 for a BSA between 60%.     

眼轮匝肌岛状皮瓣在面瘫性下睑外翻修复中的应用

目的：探索应用下睑眼轮匝肌瓣结合颞部眼轮匝肌肌皮瓣治疗面瘫性下睑外翻的一种新方法。方法：用下睑眼轮匝肌瓣复合颞侧眼轮匝肌肌皮瓣加强下睑修复面瘫性睑外翻，同时利用现有切口提升患侧面部。结果：7例患者术后皮瓣全部成活，随访4月至1年，下睑外翻的症状都得到了矫正，面部松弛的症状也有不同程度的改善，供瓣区瘢痕不明显。结论：应用颞部眼轮匝肌肌皮瓣加强下睑，眼轮匝肌瓣供血好成活率高，同时应用下睑眼轮匝肌瓣外侧悬吊能有效地纠正下睑外翻，改善患侧面部不对称。