Construction of a 12-gene prognostic model for colorectal cancer based on heat shock protein-related genes.

Some heat shock proteins (HSPs) have been shown to influence tumor prognosis, but their prognostic significance in colorectal cancer (CRC) remains unclear. This study explored the prognostic significance of HSP-related genes in CRC. Transcriptional data and clinical information of CRC patients were obtained from The Cancer Genome Atlas (TCGA) database, and a literature search was conducted to identify HSP-related genes. Using Least Absolute Selection and Shrinkage Operator (LASSO) regression and univariate/multivariate Cox regression analyses, 12 HSP-related genes demonstrating significant associations with CRC survival were successfully identified and employed to formulate a predictive risk score model. The efficacy and precision of this model were validated utilizing TCGA and Gene Expression Omnibus (GEO) datasets, demonstrating its reliability in CRC prognosis prediction. gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses revealed significant disparities between high- and low-risk groups in chromatin remodeling biological functions and neutrophil extracellular trap formation pathways. Single sample gene set enrichment analysis (ssGSEA) further revealed differences in immune cell types and immune functional status between the two risk groups. Differential analysis showed higher expression of immune checkpoints within the low-risk group, while the high-risk group exhibited notably higher Tumor Immune Dysfunction and Exclusion (TIDE) scores. Additionally, we predicted the sensitivity of different prognosis risk patients to various drugs, providing potential drug choices for tailored treatment. Combined, our study successfully crafted a novel CRC prognostic model that can effectively predict patient survival, immune landscape, and treatment response, providing important support and guidance for CRC patient prognosis.

Evaluation of the Effectiveness of Remote Monitoring to Establish a Community Health Intervention During COVID-19: A Community Intervention Trial.

Background: The widespread use of telemedicine systems and medical information networks has made telemedicine one of the current trends in health care. The purpose of this article is to propose a community health intervention with remote monitoring and teleconsultation during COVID-19 for the prevention and control of COVID-19 at the rural level. Methods: In this intervention study, a randomized group of 1,500 community residents was selected. A questionnaire with acceptable validity and reliability was used to collect data. The study was conducted with the test group itself as a control, and the questionnaire was completed again 6 months after the health intervention through remote monitoring. The extent of the effect of the remote monitoring intervention on community health during COVID-19 was measured. The data were entered into SPSS 26, and the data were analyzed using the K-S normality test, t-test, and chi-square test. Results: After 6 months of the intervention, the differences in mean scores of the test group were statistically significant (p < 0.05) in cognition, perceived benefits, self-efficacy, and behavioral outcomes, with a substantial increase in mean scores for all variables. Conclusions: The application of remote monitoring during COVID-19 in rural communities can influence the health perception, benefit perception, self-efficacy, and behavior of community residents, thus effectively preventing and controlling the spread of COVID-19 in rural communities. It reduces medical barriers for rural areas while meeting.

Mid-Infrared Serial Microring Resonator Array for Real-Time Detection of Vapor-Phase Volatile Organic Compounds.

Chip-scale infrared spectrometers consisting of a microring resonator array (MRA) were developed for volatile organic compound (VOC) detection. The MRA is serially positioned to serve as a wavelength sorting element that enables wavelength demultiplexing. Unlike conventional devices operated by a single microring, our MRA can perform multiwavelength mid-infrared (mid-IR) sensing by routing the resonant wavelength light from a broadband mid-IR source into different sensing channels. Miniaturized spectrometer devices were fabricated on mid-IR transparent silicon-rich silicon nitride (SiNx) thin films through complementary metal-oxide-semiconductor (CMOS) processes, thus enabling wafer-level manufacturing and packaging. The spectral distribution of the resonance lines and the optimization of the microring structures were designed using finite-difference time-domain (FDTD) modeling and then verified by laser spectrum scanning. Using small microring structures, the spectrum showed a large free spectral range (FSR) of 100 nm and held four spectral channels without crosstalk. Unlike near-infrared microrings using refractive index sensing, our MRA can detect hexane and ethanol vapor pulses by monitoring the intensity variation at their characteristic mid-IR absorption bands, thus providing high specificity. Applying multiwavelength detection, the sensor module can discriminate among various VOC vapors. Hence, our mid-IR MRA could be an essential component to achieve a compact spectroscopic sensing module that has the potential for applications such as remote environmental monitoring and portable health care devices.

Efficient vortex beam generation using gradient refractive-index microphase plates.

Vortex beams were theoretically demonstrated by patterning a fiber facet with $N$-segment microphase plates. By changing the aluminum oxynitride material composition of each segment, gradient refractive-index phase plates (GRPs) were designed and introduced a ${{2}}\pi l$ azimuthal optical phase difference. The gradient index profile was able to convert a fiber Gaussian mode to a Laguerre-Gaussian mode with varieties of topological charge $l$. A three-dimensional finite-difference time-domain method was applied to calculate the near-field optical phase maps and the far-field beam profiles projected from the micro-GRPs. A uniform vortex beam with a symmetrical doughnut shape was obtained by optimizing the GRPs' radii and the number of segments. The micro-GRPs enabled flat optical components for efficient vortex beam generation.

Mid-infrared frequency doubling using strip-loaded silicon nitride on epitaxial barium titanate thin film waveguides.

Broadband mid-infrared (mid-IR) frequency doubling was demonstrated using nonlinear barium titanate (BTO) thin films. The device has a strip-loaded waveguide structure consisting of top silicon nitride (SiN) strips and an underneath BTO guiding layer. The epitaxial BTO was deposited on a strontium titanate (STO) substrate by pulsed-laser deposition. Through a SiN grating coupler, the pumping mid-IR light at wavelength λ=3.30-3.45µm was coupled into the nonlinear BTO layer, where the spectrum of the near-infrared (NIR) second-harmonic generation was characterized. The developed BTO waveguides provide a platform for mid-IR nonlinear integrated photonics and on-chip quantum optics.

Real-time isotopic methane detection using mid-infrared spectroscopy.

A real-time, nondestructive mid-infrared (mid-IR) platform was proposed for isotopic methane detection. The measurement system consisted of a tunable mid-IR laser, a miniaturized gas chamber, and a mid-IR signal receiver. The isotope ratio of the 12CH4/13CH4 was identified by measuring the mid-IR spectrum at λ=3.2-3.5µm.In-situ12CH4/13CH4 monitoring was then achieved by tracing the characteristic mid-IR absorption peaks assigned to the 12CH4 at λ=3.328µm and 13CH4 at λ=3.340µm. The real-time methane isotope analysis can be applied to environmental monitoring and petroleum industries.

Mid-Infrared Chalcogenide Waveguides for Real-Time and Nondestructive Volatile Organic Compound Detection.

A mid-infrared (mid-IR) sensor chip was demonstrated for volatile organic compound (VOC) detection. The sensor consisted of As2Se3 optical waveguides built by microelectronic fabrication processes. The VOC sensing performance was characterized by measuring acetone and ethanol vapors at their characteristic C-H absorption from λ = 3.40 to 3.50 µm. Continuous VOC detection with <5 s response time was achieved by measuring the intensity attenuation of the waveguide mode. The miniaturized noninvasive VOC sensor can be applied to breath analysis and environmental toxin monitoring.

Real-Time Gas Mixture Analysis Using Mid-Infrared Membrane Microcavities.

Real-time gas analysis on-a-chip was demonstrated using a mid-infrared (mid-IR) microcavity. Optical apertures for the microcavity were made of ultrathin silicate membranes embedded in a silicon chip using the complementary metal-oxide-semiconductor (CMOS) process. Fourier transform infrared spectroscopy (FTIR) shows that the silicate membrane is transparent in the range of 2.5-6.0 µm, a region that overlaps with multiple characteristic gas absorption lines and therefore enables gas detection applications. A test station integrating a mid-IR tunable laser, a microgas delivery system, and a mid-IR camera was assembled to evaluate the gas detection performance. CH4, CO2, and N2O were selected as analytes due to their strong absorption bands at λ = 3.25-3.50, 4.20-4.35, and 4.40-4.65 µm, which correspond to C-H, C-O, and O-N stretching, respectively. A short subsecond response time and high gas identification accuracy were achieved. Therefore, our chip-scale mid-IR sensor provides a new platform for an in situ, remote, and embedded gas monitoring system.

Analysis of risk factors of suicidal ideation in adolescent patients with depression and construction of prediction model.

BACKGROUND: Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group. Most adolescent patients with depression have suicidal ideation (SI); however, few studies have focused on the factors related to SI, and effective predictive models are lacking. AIM: To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention. METHODS: The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed. Based on whether or not they had SI, they were divided into a SI group (n = 91) and a non-SI group (n = 59). The general data and laboratory indices of the two groups were compared. Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression, a nomogram prediction model was constructed based on the analysis results, and internal evaluation was performed. Receiver operating characteristic and calibration curves were used to evaluate the model's efficacy, and the clinical application value was evaluated using decision curve analysis (DCA). RESULTS: There were differences in trauma history, triggers, serum ferritin levels (SF), high-sensitivity C-reactive protein levels (hs-CRP), and high-density lipoprotein (HDL-C) levels between the two groups (P < 0.05). Logistic regression analysis showed that trauma history, predisposing factors, SF, hs-CRP, and HDL-C were factors influencing SI in adolescent patients with depression. The area under the curve of the nomogram prediction model was 0.831 (95%CI: 0.763-0.899), sensitivity was 0.912, and specificity was 0.678. The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043, indicating that the model had a good fit. CONCLUSION: The nomogram prediction model based on trauma history, triggers, ferritin, serum hs-CRP, and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.

Identification of the biosynthetic gene cluster and regulatory cascade for the synergistic antibacterial antibiotics griseoviridin and viridogrisein in Streptomyces griseoviridis.

Griseoviridin (GV) and viridogrisein (VG, also referred to as etamycin), produced by Streptomyces griseoviridis, are two chemically unrelated compounds belonging to the streptogramin family. Both of these natural products demonstrate broad-spectrum antibacterial activity and constitute excellent candidates for future drug development. To elucidate the biosynthetic machinery associated with production of these two unique antibiotics, the gene cluster responsible for both GV and VG production was identified within the Streptomyces griseoviridis genome and characterized, and its function in GV and VG biosynthesis was confirmed by inactivation of 30 genes and complementation experiments. This sgv gene cluster is localized to a 105 kb DNA region that consists of 36 open reading frames (ORFs), including four nonribosomal peptide synthetases (NRPSs) for VG biosynthesis and a set of hybrid polyketide synthases (PKS)-NRPSs with a discrete acyltransferase (AT), SgvQ, to assemble the GV backbone. The enzyme encoding genes for VG versus GV biosynthesis are separated into distinct "halves" of the cluster. A series of four genes: sgvA, sgvB, sgvC, and sgvK, were found downstream of the PKS-NRPS; these likely code for construction of a γ-butyrolactone (GBL)-like molecule. GBLs and the corresponding GBL receptor systems are the highest ranked regulators that are able to coordinate the two streptomyces antibiotic regulatory protein (SARP) family positive regulators SgvR2 and SgvR3; both are key biosynthetic activators. Models of GV, VG, and GBL biosynthesis were proposed by using functional gene assignments, determined on the basis of bioinformatics analysis and further supported by in vivo gene inactivation experiments. Overall, this work provides new insights into the biosyntheses of the GV and VG streptogramins that are potentially applicable to a host of combinatorial biosynthetic scenarios.

Detection of volatile organic compounds using mid-infrared silicon nitride waveguide sensors.

Mid-infrared (mid-IR) sensors consisting of silicon nitride (SiN) waveguides were designed and tested to detect volatile organic compounds (VOCs). SiN thin films, prepared by low-pressure chemical vapor deposition (LPCVD), have a broad mid-IR transparent region and a lower refractive index (nSiN = 2.0) than conventional materials such as Si (nSi = 3.4), which leads to a stronger evanescent wave and therefore higher sensitivity, as confirmed by a finite-difference eigenmode (FDE) calculation. Further, in-situ monitoring of three VOCs (acetone, ethanol, and isoprene) was experimentally demonstrated through characteristic absorption measurements at wavelengths λ = 3.0-3.6 µm. The SiN waveguide showed a five-fold sensitivity improvement over the Si waveguide due to its stronger evanescent field. To our knowledge, this is the first time SiN waveguides are used to perform on-chip mid-IR spectral measurements for VOC detection. Thus, the developed waveguide sensor has the potential to be used as a compact device module capable of monitoring multiple gaseous analytes for health, agricultural and environmental applications.

Primary ascending colon cancer accompanying skip metastases in left shoulder skin and left neck lymph node: A case report.

BACKGROUND: Lymph node skip metastases are common in lung, breast, and thyroid cancer patients, but are rare in colon cancer patients. Specifically, lymph node skip metastases occur in 1%-3% of colon cancer patients. Previous reports have demonstrated colon cancer skip metastases involving the retropancreatic and portocaval lymph nodes and Virchow's node; however, reports involving skip metastases into the left neck lymph nodes and left shoulder skin are extremely rare, as are related reports of clinical treatment and prognosis. CASE SUMMARY: A 44-year-old Chinese man was admitted to the hospital for evaluation of persistent shoulder pain for 3 d and a cutaneous mass (3.0 cm × 2.0 cm) on the left shoulder. The left shoulder cutaneous mass was excised and bisected, revealing tissues with a fish-like appearance. The pathologic diagnosis of the cutaneous mass suggested a signature [CDX-2 (++), CK20 (++), Ki-67 (+) > 50%] of infiltrating or metastatic colorectal adenocarcinoma. An enhanced computed tomography scan of the abdomen revealed chronic appendicitis with fecal stone formation, cecal edema, and a pelvic effusion. A colonoscopy revealed a cauliflower-like mass within the ascending colon area that involved the lumen. The surface of the ascending colon mass was eroded and bleeding; a biopsy was performed. The pathologic diagnosis of the colonoscopy biopsy was an ascending colon mucinous adenocarcinoma. The patient underwent a laparoscopic radical resection of the right colon based on the pathological diagnosis. The tumor was 5.0 cm × 4.5 cm × 1.8 cm in size and infiltrated the entire thickness of the intestinal wall with vascular tumor thrombi. No nerve tissue involvement was noted. The ileum and colon resection margins were negative. The postoperative pathologic analysis revealed non-metastatic involvement of ileocecal, pericolic, or peri-ileal lymph nodes. The postoperative medical examination revealed palpably enlarged lymph nodes in the left neck, and the following color Doppler ultrasound examination of the neck confirmed enlarged lymph nodes in the left neck. After surgical resection and pathologic diagnosis, a common pathologic signature consistent with resected cutaneous mass and right colon was identified, suggesting skip metastasis of left cervical lymph nodes. The patient was then treated with eight courses of chemotherapy and under follow-up evaluations for 4 years; currently, no tumor recurrences or metastases have been noted. CONCLUSION: We report an abnormal skip metastasis involving the left shoulder skin and left neck lymph node in a patient with ascending colon adenocarcinoma. Specifically, we observed non-metastatic involvement of the lymph nodes around the tumor site but with metastases to the cervical lymph nodes. The standard surgical operations were performed to resect the cutaneous mass, tumor tissue, and cervical lymph nodes, followed by chemotherapy for eight courses. The patient is healthy with no tumor recurrences or metastases for 4 years. This clinical case will contribute to future research about the abnormal skip metastasis in colon cancers and a better clinical treatment design.

Real-time and non-destructive hydrocarbon gas sensing using mid-infrared integrated photonic circuits.

A chip-scale mid-infrared (mid-IR) sensor was developed for hydrocarbon gas detection. The sensor consisted of amorphous Si (a-Si) optical ridge waveguides that were fabricated by complementary metal-oxide-semiconductor (CMOS) processes. The waveguide exhibited a sharp fundamental mode through λ = 2.70 to 3.50 µm. Its sensing performance was characterized by measuring methane and acetylene. From the spectral mode attenuation, the characteristic C-H absorption bands associated with methane and acetylene were found at λ = 3.29-3.33 µm and λ = 3.00-3.06 µm, respectively. In addition, real-time methane and acetylene concentration monitoring was demonstrated at λ = 3.02 and 3.32 µm. Hence, the mid-IR waveguide sensor enabled an accurate and instantaneous analysis of hydrocarbon gas mixtures.

Clinical outcomes of laparoscopic versus open right hepatectomy for liver tumors: A meta-analysis.

BACKGROUND: Laparoscopic right hepatectomy (LRH) is one of the most challenging procedures. Right liver resections have been always performed in open procedure and open right hepatectomy (ORH) was initially considered as routine way. Moreover, it is unclear how beneficial the minimally invasive technique is to patients; thus, we conducted a meta-analysis to acquire a more reliable conclusion about the feasibility and safety of LRH compared with ORH. METHODS: We comprehensively searched the electronic databases of PubMed, Embase, and the Cochrane Library using the key words. Meta-analysis was performed using the Review Manager, with results expressed as odds ratio and weighted mean difference with 95% confidence intervals. The fixed-effect model was selected initially if high heterogeneity was not present between the studies; otherwise, the randomized-effect model was used. Subgroup analysis was performed based on different surgical methods of pure laparoscopic operation or hand-assisted operation. RESULTS: Seven studies with 467 patients were included. In the overall analysis, less intraoperative blood loss (MD = -155.17; 95% CI, -238.89, -71.45; P = .0003) and a shorter length of stay (MD = -4.45; 95% CI, -5.84, -3.07; P < .00001) were observed in the LRH group compared to the ORH group. There were fewer overall complications (OR = 0.30; 95% CI, 0.10, 0.90; P = 0.03) and severe complications (OR = 0.24; 95% CI, 0.10, 0.58; P = .002;) in the LRH group than in the ORH group. The disadvantage of LRH was the longer operative time (MD = 49.39; 95% CI, 5.33, 93.45; P = .03). No significant difference was observed between the 2 groups in portal occlusion, rate of R0 resection, transfusion rate, mild complications, and postoperative mortality. In the subgroup analysis, intraoperative blood loss was significantly lower in the pure LRH group and hand-assist LRH group compared with ORH group. Length of stay was shorter by use of pure LRH and hand-assisted LRH manners than ORH. The incidence rate of complications was lower in the pure LRH group than in the ORH group. In contrast, there was no significant difference between hand-assisted LRH group and ORH group. CONCLUSION: Compared to ORH, LRH has short-term surgical advantages and leads to a shorter recovery time in selected patients. We speculate that the operative time of LRH is closer with ORH. Overall, LRH can be considered a feasible choice in routine clinical practice with experienced surgeons, although more evidence is needed to make a definitive conclusion.

All-nanoparticle layer-by-layer coatings for Mid-IR on-chip gas sensing.

Functionalization of optical waveguides with submicron coatings of zinc peroxide (ZnO2) and silica (SiO2) nanoparticles (NPs) is reported that enabled selective concentration of acetone vapors in the vicinity of the waveguide, boosting the sensitivity of a mid infrared (MIR) on-chip detector. Controlled thickness was achieved by introducing precise control of the substrate withdrawal speed to the layer-by-layer (LbL) deposition technique.

Mid-Infrared Electro-Optical Modulation Using Monolithically Integrated Titanium Dioxide on Lithium Niobate Optical Waveguides.

Tunable photonic circuits were demonstrated in the mid-Infrared (mid-IR) regime using integrated TiO2-on-LiNbO3 (ToL) waveguides. The upper waveguide ridge was made by a sputtered TiO2 thin film with broad transparency at λ = 0.4-8 µm and an optimized refractive index n = 2.39. The waveguide substrate is a z-cut single crystalline LiNbO3 (LN) wafer that has strong Pockels effect, thus enabling the tunability of the device through electro-optical (E-O) modulation. A sharp waveguide mode was obtained at λ = 2.5 µm without scattering or mode distortion found. The measured E-O coefficient γeff was 5.9 pm/V approaching γ31 of 8.6 pm/V of LN. The ToL waveguide showed a hybrid mode profile where its optical field can be modified by adjusting the TiO2 ridge height. Our monolithically integrated ToL modulator is an efficient and small footprint optical switch critical for the development of reconfigurable photonic chips.

Midinfrared Multispectral Detection for Real-Time and Noninvasive Analysis of the Structure and Composition of Materials.

In situ material identification and object tracking have been demonstrated using a mid-infrared (mid-IR) robotic scanning system. This detection method is capable of inspecting materials noninvasively because the mid-IR spectrum overlaps with numerous characteristic absorption bands corresponding to various chemical function groups. The scanning system consisted of a fiber probe connected to a mid-IR tunable laser with a wavelength tuning range of λ = 2.45-3.75 µm. For the high-speed performance of the scanning system to be evaluated, a testing platform was constructed with an object plate rapidly rotating at ω = 231 rpm. The objects on the plate were SU-8 epoxy-based resin and polydimethylsiloxane, which were mid-IR absorptive while visibly transparent. Applying mid-IR multispectral scanning, the system was able to simultaneously track the object position and identify the composition by interpreting the spectral and spatial intensity variation. The mid-IR robotic scanning method thus provides a visualization system critical for process inspection in automatic manufacturing and high-throughput biomedical screening.

Schisandrin B shows neuroprotective effect in 6-OHDA-induced Parkinson's disease via inhibiting the negative modulation of miR-34a on Nrf2 pathway.

BACKGROUND: MiR-34 family members have been previously shown to play potential functional role in Parkinson's disease (PD) pathogenesis. However, the regulatory role of miR-34a has not been demonstrated in PD yet. This study aims to clarify the potential neuroprotective effect of Schisandrin B (Sch B) involving miR-34a function in 6-OHDA-induced PD model. METHODS: The expression changes of miR-34a and Nrf2 pathway related genes were detected in 6-OHDA-treated SH-SY5Y cells under Sch B pretreatment. Cell viability and PD feathers of 6-OHDA-induced PD mice were measured for neuroprotection assessment. The regulation of miR-34a on Nrf2 activity and expression was demonstrated through gain-of-function and loss-of-function studies, while the regulatory role of miR-34a in the neuroprotection of Sch B was investigated both in vitro and in vivo. RESULTS: Sch B pretreatment ameliorated 6-OHDA-induced changes in vitro, like upregulated miR-34a expression, inhibited Nrf2 pathways and decreased cell survival, and PD feathers in vivo. Moreover, Nrf2 was negatively regulated by miR-34a, while miR-34a overexpression inhibited the neuroprotection of Sch B in both dopaminergic SH-SY5Y cells and PD mice. CONCLUSION: Sch B showed neuroprotective effect in 6-OHDA-induced PD pathogenesis, which could be inhibited by miR-34a, involving the negative regulatory mechanism of miR-34a on Nrf2 pathways.

Effects of Fe oxide on N transformations in subtropical acid soils.

Subtropical ecosystems are often characterized by high N cycling rates, but net nitrification rates are often low in subtropical acid soils. NO3(-)-N immobilization into organic N may be a contributing factor to understand the observed low net nitrification rates in these acid soils. The effects of Fe oxide and organic matter on soil N transformations were evaluated using a (15)N tracing study. Soil net nitrification was low for highly acidic yellow soil (Ferralsols), but gross ammonia oxidation was 7 times higher than net nitrification. In weakly acidic purple soil (Cambisols), net nitrification was 8 times higher than in Ferralsols. The addition of 5% Fe oxide to Cambisols, reduced the net nitrification rate to a negative rate, while NO3(-)-N immobilization rate increased 8 fold. NO3(-)-N immobilization was also observed in Ferralsols which contained high Fe oxides levels. A possible mechanism for these reactions could be stimulation of NO3(-)-N immobilization by Fe oxide which promoted the abiotic formation of nitrogenous polymers, suggesting that the absence of net nitrification in some highly acid soils may be due to high rates of NO3(-)-N immobilization caused by high Fe oxide content rather than a low pH.

A phase I clinical and pharmacokinetic study of paclitaxel liposome infused in non-small cell lung cancer patients with malignant pleural effusions.

PURPOSE: To investigate the feasibility, pharmacokinetics, efficacy and toxicity of intrapleural paclitaxel liposome injection in non-small cell lung cancer (NSCLC) patients with malignant pleural effusions. PATIENTS AND METHODS: Twelve of 15 NSCLC patients with malignant pleural effusions were treated with paclitaxel liposome and three were treated with free paclitaxel. Adequate pleural fluid, blood and urine were collected for pharmacokinetic study. The clinical efficacy and toxicity were synthetically evaluated according to the correlative criteria. RESULTS: The overall toxicity of paclitaxel liposome was lower than that of free paclitaxel. In the patients treated with paclitaxel liposome, there were minimal local chest pain, anaphylaxis, anaemia, neutropaenia and hepatotoxicity. The complete response rates of pleural effusion at the first, second, third and sixth month were, respectively, 27.3%, 18.2%, 9.1% and 9.1%, and overall response rates were 90.9%, 72.7%, 63.6% and 54.5%, respectively. Pharmacokinetic study showed that mean C(max,IP), T(1/2) and AUC(0-->96,IP) in pleural fluid were, respectively, about 2-fold, 2-fold and 2.5-fold than those of free paclitaxel, and AUC(0-->96,Pla) in plasma was also much higher than that of free paclitaxel, however, excretory rate in 24h from urine was lower than that of free paclitaxel. CONCLUSIONS: This study demonstrated that paclitaxel liposome was a more useful agent than free paclitaxel for the treatment of malignant pleural effusions because of its relatively low toxicity and distinct pharmacokinetic characteristics. The phase II study of a large number of patients was recommended to confirm this finding.