Identification of novel prognostic factors focusing on clinical outcomes in patients with non-small cell lung cancer after stereotactic body radiotherapy

Stereotactic body radiotherapy (SBRT) has attracted extensive attention as an effective treatment for patients with early-stage non-small cell lung cancer. However, the factors affecting prognosis after SBRT have not been fully elucidated. The aim of the present study was to investigate the prognostic factors associated with overall survival (OS) and local control (LC) after SBRT. Between March 2003 and March 2020, 497 patients with primary or oligo-metastatic lung cancer who underwent SBRT treatment were retrospectively reviewed. Univariate analysis was performed against various factors related to patient and tumor characteristics using Kaplan-Meier method. Furthermore, the factors with statistically significant differences identified via univariate analysis underwent a stratified Cox proportional hazard regression analysis. The median follow-up period for all patients was 26.17 months (range, 0.36-194.37), and the 5-year OS and LC rates were 66.3 and 86.0%, respectively. Multivariate analysis showed that surfactant protein-D (SP-D), tumor CT values (TCTV) and iodine density values (IDV) were independent prognostic factors for OS, and histology, TCTV and IDV were for LC. Although histology was not selected as a prognostic factor related to OS, it was indicated that patients with squamous cell carcinoma were associated with the SP-D high group compared with the SP-D normal group. In addition, TCTV was correlated to water density values, which tended to decrease with increasing IDV. From these findings, SP-D and TCTV were identified as potential new candidate prognostic factors after SBRT, and it is possible that combining SP-D and histology, and TCTV and IDV may improve the accuracy of prognostic prediction.     

Nucleation of Surfactant–Alkane Mixed Solid Monolayer and Bilayer Domains at the Air–Water Interface

We investigated the wetting transitions of tetradecane and hexadecane droplets in dodecyltrimethylammonium bromide (C12TAB), tetradecyltrimethylammonium bromide (C14TAB), and hexadecyltrimethylammonium bromide (C16TAB) aqueous solutions. By varying the surfactant concentration, the formation of mixed monolayers of a surfactant and an alkane was observed at the air–water interface. Depending on the combination of surfactant and alkane, these wetting monolayers underwent another thermal phase transition upon cooling either to a frozen mixed monolayer (S1) or a bilayer structure composed of a solid monolayer of a pure alkane rested on a liquid-like mixed monolayer (S2). Based on the phase diagrams determined by phase modulation ellipsometry, the difference in the morphology of the nucleated S1 and S2 phase domains was also investigated using Brewster angle microscopy. Domains of the S1 phase were relatively small and highly branched, whereas those of the S2 phase were large and circular. The difference in domain morphology was explained by the competition of the domain line tension and electrostatic dipole interactions between surfactant molecules in the domains.     

Treatment of respiratory failure due to respiratory syncytial virus pneumonia with natural surfactant

We describe two infants suffering from severe pneumonia caused by respiratory syncytial virus (RSV) infection and needing mechanical ventilation with both high ventilator settings and a high fraction of inspired oxygen. The severity of the respiratory failure and the possibility of decreased and/or altered surfactant production led us to treat these infants with intratracheal instillation of natural surfactant. This resulted in an improvement of lung compliance and a decrease in the amount of oxygen required to maintain acceptable oxygen saturations. Intratracheal surfactant instillation might, therefore, be useful in the treatment of severe RSV pneumonia. Pediatr Pulmonol 1996; 22:412–415. © 1996 Wiley-Liss, Inc.     

肺表面活性物质对哮喘小鼠模型树突细胞功能的调节机制

目的: 研究外源性肺表面活性物质对小鼠哮喘模型的免疫调节作用及其对树突细胞(DC)功能的影响.方法:BALB/c小鼠50只,分为3组:哮喘组15只[采用卵蛋白(OVA)致敏和激发]、对照组15只(以生理盐水代替OVA致敏和激发)、治疗组20只[每次OVA激发后10 min以肺表面活性物质(PS) 20 g/L雾化吸入,时间为2,5,10,15和20 min].用HE染色方法评定哮喘模型.分离培养脾脏DC,用流式细胞仪(FACS)检测DC表面共刺激分子CD80的表达变化.取DC培养液3 mL,加入OVA,调整OVA浓度至10 mg/L.分别在2,4,6,12,24 h取DC培养液,1300 r/min离心5 min,取上清液,ELISA法检测IL-12 P70.结果: 哮喘组小鼠的肺组织表现为嗜酸细胞及淋巴细胞浸润为主的炎症变化,治疗组和对照组无此变化.哮喘组DC阳性表达率明显高于治疗组(P<0.01);吸入PS对DC表面共刺激分子的抑制作用在2 min时最强.哮喘组DC上清液IL-12低于治疗组(P<0.01);治疗组DC上清液IL-12可以在高水平维持较长时间,而哮喘组的DC上清液IL-12含量降低,且维持时间较短.结论:小鼠哮喘模型中存在明显的DC功能缺陷;外源性吸入PS,能明显改善DC功能,从而保护哮喘发作时小鼠的肺功能.     

Impact of Surfactant and Calcium Sulfate Type on Air-Entraining Effectiveness in Concrete

The paper presents the evaluation of the influence of calcium sulfate on the air void microstructure in concrete and its action mechanism depending on the character of the air-entraining agent. Gypsum dehydration has been previously proven to negatively influence the air void structure of air-entrained concrete. Ettringite, nucleating from tricalcium aluminate and calcium sulfate, influences the adsorption and mode of action of anionic-based polycarboxylate ether admixtures. The authors suspected the admixture’s air-entraining mechanism was also affected by these characteristics. Gypsum dehydration was confirmed to influence the air void structure. In the case of the anionic surfactant, the content of air bubbles smaller than 300 µm was lower compared to cement with gypsum and hemihydrate. On the other hand, the content of air voids with a diameter up to 60 µm, which are the most favorable, was higher. The results obtained led to the conclusion that the mechanism of air entrainment was twofold, and in most cases occurred through the lowering of surface tension and/or through the adsorption of surfactant on cement grains. The adsorptive mechanism was proved to be more effective in terms of the total air content and the structure of the air void system. The results and conclusions of the study provide guidelines to determine the proper surfactant type to reduce the risk of improper air entrainment of concrete, and emphasize the importance of gypsum dehydration of cement in the process of air entrainment.     

Less-invasive surfactant administration (LISA)

Less-invasive surfactant administration (LISA) is a technique whereby surfactant is given via a thin catheter inserted in the trachea. Although some current guidance has been to administer LISA in preterm infants with respiratory distress syndrome (RDS) without endotracheal intubation, the use of LISA differs across the world. The LISA technique allows the infant to remain on non-invasive ventilation support and avoids intubation and therefore mechanical ventilation. Practicalities around the procedure such as the use of premedication or the administration on delivery suite as prophylaxis are yet to be fully studied. Through recent meta-analyses, LISA has been shown to reduce the combined outcome of bronchopulmonary dysplasia (BPD) and mortality in preterm infants. This article summarises the evidence and discusses the practicalities of LISA in a clinical setting.     

Pulmonary delivery of siRNA against acute lung injury/acute respiratory distress syndrome

The use of small interfering RNAs (siRNAs) has been under investigation for the treatment of several unmet medical needs, including acute lung injury/acute respiratory distress syndrome (ALI/ARDS) wherein siRNA may be implemented to modify the expression of pro-inflammatory cytokines and chemokines at the mRNA level. The properties such as clear anatomy, accessibility, and relatively low enzyme activity make the lung a good target for local siRNA therapy. However, the translation of siRNA is restricted by the inefficient delivery of siRNA therapeutics to the target cells due to the properties of naked siRNA. Thus, this review will focus on the various delivery systems that can be used and the different barriers that need to be surmounted for the development of stable inhalable siRNA formulations for human use before siRNA therapeutics for ALI/ARDS become available in the clinic.     

超临界二氧化碳萃取丹酚酸B的提取工艺研究

目的 研究超临界CO2中加入非离子表面活性剂的多元醇混合体系萃取丹酚酸B的新工艺.方法 以丹酚酸B的提取率为指标,采用正交实验法进行丹参提取工艺的优选,采用HPLC法测定其含量.结果 超临界CO2萃取中加入非离子表面活性剂的多元醇混合体系可大大提高丹酚酸B的提取率.在本实验条件下,丹参的超临界萃取最佳工艺为:夹带剂选择10%乙醇+5%吐温-80,用量与药材相等,萃取温度55℃,压力30 MPa,萃取时间1.5 h.结论 加入非离子表面活性剂的多元醇混合体系比只用乙醇作夹带剂进行超临界CO2提取丹酚酸B的效率高约6倍.     

经鼻持续气道正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征

目的 探讨经鼻持续气道正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的效果.方法 <32周的早产儿合并新生儿呼吸窘迫综合征早产儿33例随机分入2组进行对照研究:应用肺表面活性物质后立即拔管继以经鼻持续气道正压通气(S-N组)16例和应用肺表面活性物质后接受机械通气治疗(S-M组)17例.比较2组主要终点和次要终点是否需要机械通气及通气时间,以及其他相关临床特征.结果 生后7 d时,S-N组有1例(6.25%)接受机械通气,S-M组有8例(47.00%)仍不能脱离呼吸机.S-M组与S-N组相比较,用氧时间[(11.4±4.6)d与(7.0±1.9)d]、经鼻持续气道正压通气时间[(6.5±2.9)d与(3.5±2.3)d)]、机械通气时间[(5.9±3.3)d与(2.2±1.2)d]、重症监护室住院时间[(29.9±8.0)d与(21.7±10.1)d]、再次使用肺表面活性物质的概率[(12.5%,2/16)与(53.0%,9/17)],S-M组均显著高于S-N组,差异有统计学意义(P均<0.05).结论 应用肺表面活性物质后立即继以经鼻持续气道正压通气有利于新生儿呼吸窘迫综合征的治疗.