Thyroid dysfunction during PD-1 inhibitor treatment in patients with cancer: Incidence and association with progression-free survival

The use of programmed cell death-1 (PD-1) inhibitors has recently been approved in China. As a consequence, the identification of relevant prognostic markers that can assess the efficacy of these compounds is required. Therefore, the present study aimed to explore the incidence of thyroid dysfunction and its ability to predict progression-free survival (PFS) in Chinese patients with cancer who received PD-1 inhibitor treatment. Data from 72 patients with cancer who received treatment with PD-1 inhibitors alone or in combination with chemotherapy or targeted drugs were analyzed. Moreover, the expression levels of free triiodothyronine, thyroxine, and thyrotropin during treatment were assessed to evaluate thyroid dysfunction. A total of 26 (36.1%) patients who had received PD-1 inhibitors developed thyroid dysfunction. Specifically, the incidence of thyroid dysfunction was 35.6% in patients with lung cancer, 25.0% in patients with malignant melanoma, and 46.7% in patients with other types of cancer. In addition, the median PFS was 7.0 (95% confidence interval, 4.9-9.1) months, whereas the 1- and 2-year PFS rates were 35.1 and 26.2%, respectively. Generally, patients with thyroid dysfunction exhibited longer PFS compared with those without thyroid dysfunction (P=0.001). Subgroup analyses were subsequently performed, which demonstrated that thyroid dysfunction was associated with longer PFS in patients with malignant melanoma (P=0.039) and other types of cancer (P=0.002), but not in those with lung cancer (P=0.083). These findings were noted in patients who received PD-1 inhibitor monotherapy (P=0.003), but not PD-1 inhibitor plus chemotherapy (P=0.172) or PD-1 inhibitor plus targeted therapy (P=0.582). Finally, thyroid dysfunction [P=0.001; hazard ratio (HR)=0.260] and PD-1 inhibitor monotherapy (P=0.015; HR=2.231) were identified as independent factors that could predict PFS. In conclusion, the present study demonstrated that thyroid dysfunction during PD-1 inhibitor treatment could be used as a potential marker for the prognosis of favorable PFS in patients with cancer.     

Two important factors affecting the prognosis of patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma

ObjectiveTo investigate the effects of hand–foot syndrome (HFS) and fatigue on disease progression and survival in patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma.MethodsA retrospective analysis of patients with advanced hepatocellular carcinoma treated with sorafenib in our hospital from 1 October 2018 to 31 October 2021 was performed, and clinical and pathological data and follow-up results were obtained. Patients were divided into groups according to the severity of HFS and fatigue. Survival analysis among the groups was performed using the Kaplan–Meier method, continuous variables were analyzed using the t-test, and factors associated with survival were evaluated using multivariate Cox regression analysis.ResultsThe study included 150 men and 23 women with a mean age of 60.77 years (range: 40–85 years). The median overall survival (OS), progression-free survival (PFS), and time to tumor progression (TTP) increased with increasing severity of HFS. Conversely, the median OS, PFS, and TTP decreased with increasing severity of fatigueConclusionHFS and fatigue were independent risk factors affecting TTP, PFS, and OS among patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma.     

吉非替尼治疗晚期非小细胞肺癌疗效分析

目的观察吉非替尼对晚期非小细胞肺癌患者的疗效。方法对吉非替尼治疗的非小细胞肺癌22例进行分析。结果22例中可评估的14例中(5例疾病稳定,2例完全缓解,1例部分缓解)有效率21.4%,临床获益率8/14(57.2%)。结论吉非替尼对晚期非小细胞肺癌疗效较好,其副反应相对小,耐受性好。     

微波炮制苦杏仁的研究

应用微波技术炮制苦杏仁,苦杏仁酶灭活完全,苦杏仁甙含量不受损失。并对微波炮制时间和温度进行了研究。     

旋覆代赭汤对反流性食管炎大鼠血清FT4、TSH的影响

目的:观察旋覆代赭汤对反流性食管炎的疗效并探讨其作用机制方法:采用"食管-十二指肠端侧吻合术",造成大鼠反流性食管炎动物模型。64只大鼠随机分为4组,予以不同治疗后,观察大鼠食管黏膜病理变化及血清游离甲状腺激素(free thyroxine,FT4)、促甲状腺激素(thyrotropic hormone,TSH)浓度。结果:①中药组、西药组体质量增加值分别与模型组比较显著增加(P<0.05)。②中药组、西药组病理形态学光镜检查积分与模型组比较有显著性差异(P<0.05)。③中药组、西药组血清浓度与模型组比较显著升高(P<0.05)。结论:旋覆代赭汤能改善模型大鼠松弛的食管下括约肌,其作用机制可能是提高血清FT4、TSH浓度,促进大鼠食管肌条的收缩幅度、收缩频率,增强消化道蠕动功能。     

普贝生与催产素用于足月妊娠引产的临床疗效比较

目的：探讨普贝生用于足月妊娠引产的临床效果和安全性。方法1选取2007年10月至2009年12月我院有引产指征的产妇128例,随机分为两组,即普贝生组和催产素组各64例。普贝生组阴道放置普贝生引产,催产素组常规静滴催产素引产,比较两组产妇的宫颈Bishop评分和分娩情况、剖宫产率、新生儿结局等。结果：观察组总有效率为93．75％,与对照组差异有统计学意义（P〈0．05）,两组给药后不同时间Bishop评分差异具有显著性。观察组的剖宫产率明显低于催产素组（P〈0．05）;两组子宫过度刺激、宫颈裂伤、急产及产后出血的发生率均无显著性差异（P〉0．05）。两组新生儿体重及出生后lmin、5minA。pgar评分无统计学差异（P〉0．05）。结论：在足月妊娠产妇中选择性使用普贝生引产不仅能缩短引产时间、减少住院日,而且能降低剖宫产率,值得临床上推广和应用。     

正骨接骨药丸治疗尺桡骨骨折临床观察

目的：观察正骨接骨药丸治疗骨折的临床疗效。方法：将符合要求的142例尺桡骨骨折患者随机分为两组,治疗组71例,对照组71例。治疗组采用口服正骨接骨药丸治疗,对照组口服麝香接骨胶囊,治疗40d后对两组进行疗效评定。结果：治疗组疗效优于对照组（t=2．640,P=0.010）。结论：正骨接骨药丸能促进骨折的活血化瘀、消肿,缩短患者主观疼痛期、促进伤骨骨痂生长,显著促进尺桡骨骨折愈合指标的改善,其疗效优于麝香接骨胶囊。     

儿外科监护室血流感染的病原菌分布及耐药性分析

目的 了解儿外科重症监护病房血流感染的病原菌分布及药物敏感情况,以利于临床合理选用抗生素.方法 收集2011年1月至2015年12月我院儿外科重症监护病房确诊为血流感染的138例患儿的临床资料,对病原菌分布及耐药情况进行分析.结果 5年中血流感染的发生率为3.88‰(138/35524),且以1岁以下婴儿发生最多,最终死亡19例(13.77%).138例血流感染患儿共获得179株病原菌,革兰阳性菌、革兰阴性菌和真菌感染分别占60.89%(109/179)、22.91%(41/179)和16.20%(29/179).革兰阳性菌中凝固酶阴性葡萄球菌检出率最高(84/179,46.93%);革兰阴性菌中前3位的是鲍曼不动杆菌(15/179,8.38%)、肺炎克雷白杆菌(12/179,6.70%)和大肠埃希菌(6/179,3.35%),其中耐碳青霉烯类鲍曼不动杆菌的检出呈逐年上升趋势;真菌中以非白色念珠菌为主(14/179,7.82%).检出的多重耐药菌株对碳青霉烯类的耐药率明显上升.结论 儿外科重症监护病房患儿的血流感染率逐年增高,且低龄儿童的病死率亦高,需要临床上注重病原学检测,以指导合理使用抗菌药物,减少耐药菌株的产生.     

胸腺肽对小鼠免疫性肝损伤保护研究

目的 研究胸腺肽对小鼠免疫性肝损伤的保护作用.方法 采用卡介苗联合脂多糖诱导法,建立免疫性肝损伤的小鼠模型,观察胸腺肽对小鼠免疫性肝损伤的保护作用.结果 胸腺肽能明显降低免疫性肝炎模型小鼠血清丙氨酸氨基转移酶(ALT)的活性,并能显著减轻肝炎小鼠的肝指数和脾指数(P＜0.05).结论 胸腺肽对小鼠免疫性肝损伤有保护作用.