The Efficacy of Pyrotinib as a Third- or Higher-Line Treatment in HER2-Positive Metastatic Breast Cancer Patients Exposed to Lapatinib Compared to Lapatinib-Naive Patients: A Real-World Study.

Background: Pyrotinib is a novel irreversible pan-ErbB receptor tyrosine kinase inhibitor. Evidence of the efficacy of pyrotinib-based treatments for HER2-positive metastatic breast cancer (MBC) in patients exposed to lapatinib is limited. Methods: Ninety-four patients who received pyrotinib as a third- or higher-line treatment for HER2-positive MBC were included in this retrospective study. The primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis were implemented to balance important patient characteristics between groups. Results: Thirty (31.9%) patients were pretreated with lapatinib and subsequently received pyrotinib as an anti-HER2 treatment, and 64 (68.1%) patients did not receive this treatment. The OS and PFS indicated a beneficial trend in lapatinib-naive group compared to lapatinib-treated group in either the original cohort (PFS: 9.02 vs 6.36 months, p = 0.05; OS: 20.73 vs 14.35 months, p = 0.08) or the PSM (PFS: 9.02 vs 6.08 months, p = 0.07; OS: 19.07 vs 18.00 months, p = 0.61) or IPTW (PFS: 9.90 vs 6.17 months, p = 0.05; OS: 19.53 vs 15.10 months, p = 0.08) cohorts. Subgroup analyses demonstrated lapatinib treatment-related differences in PFS in the premenopausal subgroup and the no prior trastuzumab treatment subgroup, but no significant differences were observed in OS. Conclusion: Pyrotinib-based therapy demonstrated promising effects in HER2-positive MBC patients in a real-world study, especially in lapatinib-naive patients, and also some activity in lapatinib-treated patients.

[The biochemical properties of L-arginine/nitric oxide pathway in rat brain mitochondria].

Biochemical property of L-arginine (L-Arg)/nitric oxide synthase (NOS)/nitric oxide (NO) system was observed in rat brain mitochondria. The results showed that there existed L-Arg transporters of high-affinity, low-transport and saturability in mitochondria membrane of normal rat brain. The maximum transport velocity (V(max)) and Michaelis constant (Km) were 5.87+/ -0.46 nmol/mg pro x min(-1) and 7.8+/- 0.56 micromol/L respectively. In normal condition, endothelium-type NOS was expressed in the mitochondria of rat brain, with its V(max) and Km being 2.7+/-0.3 nmol/mg pro x min(- 1) and 20.85+/-3.27 micromol/L, respectively. NO production was increased in a time-dependent manner and reached a maximum value at 60 min. These results suggest that the L-Arg transporters in MT membrane of normal rat brain were similar with Y(+) type amino acid transporters in cellullar membrane. Furthermore the NOS of mitochondria belongs to eNOS, whereas the L-Arg/NOS/NO system may be a source of NO.

[Study of EEG approximate entrophy in different brain functional states].

AIM: The approximate entrophy was applied to study EEG in different brain functional states. METHODS: EEG were recorded in 40 cases healthy volunteers, who are in five functions states (1. resting conscious with eye-close. 2. resting conscious with eye-opened. 3. closed eyes and listening pure tone. 4. staring at picture. 5. closed eyes and counting numbers). ApEn were calculated in these EEG. RESULTS: The ApEn of frontal was the highest and ApEn of occipital was the lowest in resting conscious with eye-closed. ApEn in every brain area were higher than that in resting conscious with eye-opened. ApEn were changed in different physiological functions. Variation of frontal EEG ApEn value were highest. CONCLUSIONS: The ApEn may reflect characteristic of EEG non-linear dynamical. It is a stable parameter. The dates of its requirement were fewer. It may be a useful parameter in studying EEG time series.

Guillain-Barre syndrome and Campylobacter jejuni infection. A study on the etiological characteristics of Guillain-Barre syndrome in China.

Fecal culture for Campylobacter jejuni with the method of Skirrow and serum class specific antibodies (IgG, IgM, IgA) against Campylobacter jejuni using a solid phase enzyme linked immunosorbent assay were performed in 17 cases of Guillain-Barre Syndrome, 17 other neurological disease controls, and 33 normal controls. The results revealed: 1. the incidence of Campylobacter jejuni infection, especially the recent one in Guillain-Barre Syndrome was much higher than in the other two groups; 2. the recent incidence of infection in those below 30 years old and those within the period of summer and autumn was higher than that above 30 years old and that in the other seasons. The results suggested that Campylobacter jejuni infection might be one of the important precipitating factors of Guillain-Barre syndrome and might play an important role in the epidemiological pattern of Guillain-Barre Syndrome in China.

[The diagnostic value of magnetic resonance imaging on neuromuscular diseases].

The article concentrated on the study of skeletal muscles of four extremities in 12 cases of different kinds of neuromuscular diseases and 4 volunteers with MRI. The results revealed: MRI could clearly display individual muscle, muscle groups or abnormal muscles morphologically. It could also demonstrate the difference between the neurogenic and myogenic changes. In patients with progressive muscular dystrophy (PMD), the gracilis m. and sartorius m. were relatively intact. In patients with primary myopathies, the severity of MRI changes was consistent with the severity of the illness and the EMG changes. The results indicated that MRI examination was helpful in the diagnosis of neuromuscular disorders. It can define the distribution and the severity of impaired muscles. In addition, MRI could be used to select the appropriate muscles for EMG examinations or muscle biopsies. Selective muscular impairments might be the characteristics of patients with PMD.

Cepholosporium acremonium. A new strain of fungus causing white piedra.

A strain of fungus (CZ408) was isolated from white piedra of a female child. Mycological identification showed that it is the first case in the world. Asymptomatic white nodules were noted on the hair of the scalp, and they were distributed irregularly along the shaft 4-10 cm from the scalp. The nodules, hard, not easily broken or removed, consist of hyphae, spores and metabolic materials around the hair. Oral antimycotic drugs are effective in treating this disease.

[A 3 to 6-year follow-up study of 414 cases of cerebral infarction and cerebral hemorrhage].

To study the long-term prognosis, we performed annual follow-up examinations on 414 patients who had survived cerebrovascular accidents, including 334 cases of cerebral infarction and 80 cases of cerebral hemorrhage. All patients had been admitted to the Neurological Service of our hospital from January 1, 1976 to December 31, 1980, and were followed up for 3-6 years. The life-table method, the log rank test, and the rank sum test were used to determine the cumulative marked improvement rate, the cumulative recovery rate of pathological reflexes, the cumulative survival rate, and the cumulative recurrence rate. The results revealed the marked improvement rate in cerebral infarction was 81.98%, while in cerebral hemorrhage 89.87% at the end of 3 years after discharge. The recovery rate of pathological reflexes was 52.59% in cerebral infarction, 54.75% in cerebral hemorrhage at the end of 4 years. The cumulative survival rate was 58.67% in cerebral infarction, 53.36% in cerebral hemorrhage at the end of 6 years. The cumulative recurrence rate was 49.39% in cerebral infarction, 49.81% in cerebral hemorrhage at the end of 6 years.

[Uremic neuropathy].

Two autopsy cases of uremic neuropathy were reported. The chief clinical features were progressive peripheral sensory impairment, especially of the deep sensation, and the distal weakness of the four extremities. Histopathological findings revealed not only marked segmental demyelination and axonal degeneration of the peripheral nerves, but also severe damage of the skeletal muscles, including the necrosis of the myofibers, streaming of the Z-band, aggregation of glycogen, and the presence of membranous bodies under the electron microscope. It indicated that both the peripheral nerves and the skeletal muscles were involved in some metabolic diseases.

A 1-4 year follow-up study of 306 cases of stroke.

To study the long-term prognosis of stroke, we performed annual follow-up examinations on 306 patients who had survived cerebrovascular accidents. All patients had been admitted to the Neurology Service, First Teaching Hospital, Beijing Medical College from January 1, 1976, to December 31, 1978, and were followed up for 1 to 4 years. The series included 217 cases of cerebral thrombosis, 54 of cerebral hemorrhage, and 35 of TIA. The life-table method was used to determine the cumulative survival rate (CSR), cumulative marked improvement rate (CMIR), and cumulative recurrence rate (CRR), for each of these three types of stroke. The main results were the following: 1. The prognosis was not significantly influenced by sex, BP level on admission, or type of cerebrovascular accident. 2. Age was an important prognostic factor. The survival rate decreased significantly in each successive age group. However, age was not a risk factor for recurrence or poor improvement. 3. The cumulative survival rate, cumulative marked improvement rate, and cumulative recurrence rate did not differ significantly among cerebral thrombosis, cerebral hemorrhage, and TIA.