硝苯吡啶对慢性肺源性心脏病血液动力学的影响

本文研究硝苯吡啶对慢性肺源性心脏病血液动力学的影响,对21例临床急性发作期慢性肺源性心脏病患者作心肺阻抗微分图检查,其中治疗组9例,对照组13例。结果表明口服常规剂量硝苯吡啶1周与2周末时,患者的肺动脉压、肺血管阻力、平均动脉压及外周血管阻力与治疗前相比,明显下降,氧输送量及心指数于治疗2周末时也明显增加。本文认为常规剂量硝苯吡啶治疗缺氧性肺动脉高压有效,能降低肺动脉压、肺血管阻力,改善心脏功能,一般不会导致体循环低血压及加重低氧血症。     

血管抑素联合顺铂治疗Lewis肺癌

目的探讨血管抑素联合顺铂对内皮细胞增殖和Lewis肺癌生长抑制作用.方法将内皮细胞接种到96孔板中,加入不同试药72 h后,作MTT检测每孔中的细胞数.将Lewis肺癌细胞接种到C57小鼠右腋下,随机分为4组,分别用不同试药处理.每2日测量瘤体积,20天后处死动物,称取瘤重,常规病理和免疫组织化学染色检查,观察微血管密度和血管内皮细胞生长因子表达情况.结果顺铂与血管抑素在抑制血管内皮细胞增殖方面具有协同作用.顺铂组和顺铂 血管抑素组瘤体积、瘤重和血管密度均明显＜对照组.其中以顺铂与血管抑素在同时应用时瘤体积与瘤重又明显低于顺铂组.结论血管抑素与顺铂同时使用对lewis肺癌生长的抑制作用优于先后使用.     

The cutting-edge progress of immune-checkpoint blockade in lung cancer

Great advances in immune checkpoint blockade have resulted in a paradigm shift in patients with lung cancer. Immune-checkpoint inhibitor (ICI) treatment, either as monotherapy or combination therapy, has been established as the standard of care for patients with locally advanced/metastatic non-small cell lung cancer without EGFR/ALK alterations or extensive-stage small cell lung cancer. An increasing number of clinical trials are also ongoing to further investigate the role of ICIs in patients with early-stage lung cancer as neoadjuvant or adjuvant therapy. Although PD-L1 expression and tumor mutational burden have been widely studied for patient selection, both of these biomarkers are imperfect. Due to the complex cancer-immune interactions among tumor cells, the tumor microenvironment and host immunity, collaborative efforts are needed to establish a multidimensional immunogram to integrate complementary predictive biomarkers for personalized immunotherapy. Furthermore, as a result of the wide use of ICIs, managing acquired resistance to ICI treatment remains an inevitable challenge. A deeper understanding of the underlying biological mechanisms of acquired resistance to ICIs is helpful to overcome these obstacles. In this review, we describe the cutting-edge progress made in patients with lung cancer, the optimal duration of ICI treatment, ICIs in some special populations, the unique response patterns during ICI treatment, the emerging predictive biomarkers, and our understanding of primary and acquired resistance mechanisms to ICI treatment.     

Aprepitant triple therapy for the prevention of chemotherapy-induced nausea and vomiting following high-dose cisplatin in Chinese patients: a randomized,double-blind,placebo-controlled phase III trial

Purpose

Aprepitant, an oral neurokinin-1 receptor antagonist, has demonstrated improved control of chemotherapy-induced nausea and vomiting (CINV) in previous studies. This is the first phase III study to evaluate the efficacy and tolerability of aprepitant in patients receiving highly emetogenic chemotherapy (HEC) in Asian countries.

Methods

This multicenter, double-blind, placebo-controlled trial assessed the prevention of CINV during the acute phase (AP), delayed phase (DP), and overall phase (OP). Patients receiving HEC were randomized to either an aprepitant group (day 1, aprepitant 125 mg; days 2–3, aprepitant 80 mg) or a standard therapy group (days 1–3, placebo). Both groups received intravenous granisetron and oral dexamethasone. The primary end point was complete response (CR; no emesis and no use of rescue therapy) during the OP.

Results

Of the 421 randomized patients, 411 (98 %) were assessable for efficacy; 69.6 % (142/204) and 57.0 % (118/207) of patients reported CR during the OP in the aprepitant and standard therapy groups, respectively (P?=?0.007). CR rates in the aprepitant group were higher during the DP (74.0 % vs. 59.4 %, P?=?0.001) but were similar during the AP (79.4 % vs. 79.3 %, P?=?0.942). Toxicity and adverse events were comparable in both groups.

Conclusions

The addition of aprepitant to standard antiemetic treatment regimens for Chinese patients undergoing HEC provided superior CINV prevention and was well tolerated.     

BIM induction of apoptosis triggered by EGFR-sensitive and resistance cell lines of non-small-cell lung cancer

We sought to improve the understanding of oncogene-dependent and independent non-small-cell lung cancer (NSCLC), which could provide insight into mechanism of sensitivity and/or resistance to tyrosine kinase inhibitors or chemotherapeutics. NSCLC cell lines with different EGFR genotypes were used in this study; MTT assay and flow cytometry were applied to study the sensitivities of these cell lines to gefitinib and cisplatin. Western blot was performed to determine the expression levels of BIM and other Bcl-2 family proteins pre- and pro-treatment. Gefitinib provoked apoptosis of caspase activation via the intrinsic pathways and significantly up-regulated expression of BIM protein in drug-sensitive PC-9 cell line, but not resistant PC-9/BB4 cell line. The knockdown of BIM expression by RNA interference virtually eliminated gefitinib-induced cell killing in PC-9 cells in vitro. Cisplatin could induce apoptosis of the cell lines, including H1299, A549, PC-9, and PC-9/BB4 cells, but which was not associated with overexpression of BIM. BIM is involved in TKI-induced apoptosis in sensitive EGFR-mutant cell line. Down-regulation of BIM and resistance to gefitinib were both seen in the acquired resistant PC-9/BB4 cell line. The induction of BIM may have a role in the treatment of TKI-resistant tumors.     

Serum cytokine levels in patients with advanced non-small cell lung cancer: correlation with treatment response and survival

To investigate whether expression of several cytokines affected clinical outcome in non-small cell lung cancer patients. A total of 86 stage IIIB/IV non-small cell lung cancer patients, treated with platinum-based doublets, were examined expression levels of IL-1, IL-2R, IL-5, IL-6, IFN-γ, TNF-α pre- and post-chemotherapy. Enzyme-linked immunosorbent assay technique was performed. Kaplan–Meier analysis and Cox regression analyses were used to adjust for possible confounding variables. IL-6 expression levels were significantly decreased due to chemotherapy in patients with stable disease (P = 0.041). IL-2R expression levels were significantly increased due to chemotherapy in patients with progression disease (P = 0.010). Patients with high concentrations of TNF post-chemotherapy had a significantly longer survival (P = 0.009, 17 months versus 11 months) than low levels. Multivariate analysis showed that sex, response rate, IL-1 and TNF-α were significantly predictive of the survival. Serum IL-6 and IL-2R levels correlated with chemoresponse in advanced non-small cell lung cancer, serum IL-1 and TNF-α can be predictive factors in advanced non-small cell lung cancer.     

支气管哮喘动脉血气改变

本文研究了３１例哮喘的动脉血气及酸碱紊乱情况.结果表明：平均ＰａＣＯ＿２为４．９７±０．８５ｋＰａ，平均ＰａＯ＿２为９．１５±ｌ．８３ｋＰａ，２５例发生不同程度的低氧血症.约４１．９％（１３／３１）发生呼碱，３２．３％发生代酸，１６．１％发生代碱及９．７％发生呼酸；这些酸碱紊乱多混合存在，以呼碱十代酸出现率最高（８／３１）.代酸者紫绀发生率明显高于非代酸者，ＰａＯ＿２也较低（Ｐ＜０．０５）．我们认为代酸在哮喘中并不罕见.     

慢性阻塞性肺病患者的营养支持

探讨营养不良慢性阻塞性肺病患者营养支持的方案、方法及对呼吸肌张力的影响。方法ＭＮＣＯＰＤ患者３０例，按营养支持的方法分为２组。Ａ组１５例，Ｂ组１５例。每天总热量供应为静息能量消耗＊１．５，Ａ组４０％由静脉补给。