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Small cell lung cancer (SCLC), characterized by early metastasis, relapse, relapse and resistance and poor prognosis, still faces difficulties in treatment. Recently, Immunotherapy is a novel treatment for SCLC, researchers are also eager to achieve a breakthrough in targeted treatment of SCLC. Genomic instability of SCLC and sensitivity to cytotoxic chemotherapy, therefore, poly ADP-ribose polymerase (PARP) inhibitors targeting DNA repair related pathways have become a hotspot in the research of SCLC targeted therapy. Studies on PARP inhibitors in SCLC have been conducted in combination with other therapeutic strategies, including the treatment of recurrent SCLC and first-line treatment,as well as maintenance treatment after induction. These studies also explored the predictive markers of PARP inhibitors in SCLC. Although the current results of PARP inhibitors in SCLC are limited, and the predictive markers are also inconsistent, we also see that PARP inhibitors could be a breakthroughfor precision medicine of SCLC. .
الملخص
Small cell lung cancer (SCLC), characterized by early metastasis, relapse, relapse and resistance and poor prognosis, still faces difficulties in treatment. Recently, Immunotherapy is a novel treatment for SCLC, researchers are also eager to achieve a breakthrough in targeted treatment of SCLC. Genomic instability of SCLC and sensitivity to cytotoxic chemotherapy, therefore, poly ADP-ribose polymerase (PARP) inhibitors targeting DNA repair related pathways have become a hotspot in the research of SCLC targeted therapy. Studies on PARP inhibitors in SCLC have been conducted in combination with other therapeutic strategies, including the treatment of recurrent SCLC and first-line treatment,as well as maintenance treatment after induction. These studies also explored the predictive markers of PARP inhibitors in SCLC. Although the current results of PARP inhibitors in SCLC are limited, and the predictive markers are also inconsistent, we also see that PARP inhibitors could be a breakthroughfor precision medicine of SCLC. .
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Brain metastasis was a common metastasis site and leading cause of death in non-small cell lung cancer (NSCLC). Tyrosine kinase inhibitors had improved survival of NSCLC patients with positive drive gene. It also brings good news to NSCLC patients with positive drive gene and brain metastases. However, there is still no effective treatment for NSCLC patients with drive gene-negative and brain metastases. In recent years, immunotherapy has made breakthrough progress and become important first and second line treatment options of NSCLC especially in patients with drive gene-negative. The role of immunotherapy in specific populations of NSCLC-brain metastasis patients, especially drive gene-negative patients has become the focus of attention. In this report, we review the research progress of immunotherapy in NSCLC with brain metastases, especially in driver-negative patients, analyze the limitations of existing research and future challenge. .
الموضوعات
Humans , Brain Neoplasms , Allergy and Immunology , Therapeutics , Carcinoma, Non-Small-Cell Lung , Genetics , Pathology , Immunotherapy , Methods , Lung Neoplasms , Genetics , Pathology , Patient Selectionالملخص
<p><b>OBJECTIVE</b>To explore the correlation between UGT1A1 (*28, *60 and * 93) polymorphism and the adverse reactions in small cell lung cancer patients after irinotecan chemotherapy.</p><p><b>METHODS</b>Clinical data of 58 small cell lung cancer patients in extensive stage treated in our hospital were retrospectively analyzed. Polymerase chain reaction was used to amplify the UTG, and direct sequencing was performed to determine the UGT polymorphism. The adverse reactions ≥ grade 3 after irinotecan chemotherapy in patients with different UGT genotype were analyzed.</p><p><b>RESULTS</b>Amongthe 58 patients with extensive stage small cell lung cancer, there were 45 (77.6%) cases of wild type UGT1A1*28, 40 (69.0%) cases of wild type UGT1A1* 93, 38 (65.5%) cases of wild type UGT1A1*60, 18 cases of mutation in UGT1A1* 93 and 20 cases of mutation in UGT1A1*60. In UGT1A1 promoter position 28, there were 8 (13.8%) cases of TA5 mutation and 5 (8.6%) cases of TA7 mutation. Among the patients with TA5 mutation, 5 cases had ≥ grade 3 diarrhea, 3 cases had ≥ grade 3 leucopenia and 3 cases had ≥ grade 3 neutropenia, while among the patients with UGT1A1 * 93 mutation, 7 cases had ≥ grade 3 diarrhea, 6 cases had ≥ grade 3 leucopenia and 4 cases had ≥ grade 3 neutropenia.</p><p><b>CONCLUSIONS</b>TA5 and UGT1A1* 93 mutation increase the risk of diarrhea and ≥ grade 3 leukopenia and neutropenia, however, wild type UGT1A1 (*28, * 93, *60) and mutant UGT1A1*60 do not increase those risks. Further prospective study in a larger number of patients is needed to clarify the association between UGT1A1*28, UGT1A1* 93 and UGT1A1*60 polymorphism and adverse reactions of irinotecan, and to help clinicians in choosing a better therapeutic modality for personalized chemotherapy to improve curative effect and reduce adverse reactions.</p>
الموضوعات
Humans , Antineoplastic Agents, Phytogenic , Camptothecin , Diarrhea , Genotype , Glucuronosyltransferase , Genetics , Metabolism , Neutropenia , Polymorphism, Genetic , Promoter Regions, Genetic , Prospective Studies , Retrospective Studies , Small Cell Lung Carcinoma , Drug Therapy , Geneticsالملخص
Objective To analyze the correlation between subjective symptoms and function of nasal ventila-tion in nonallergic rhinitis with eosinophilia syndrome ( NARES) ,in order to provide the basis for the clinical diagno-sis.Methods 44 patients with NARES were selected as the NARES group ,and 50 healthy people were selected as the control group at the same time .The total nasal resistance ( TNR ) , MCA of the two groups were compared , and Pearson or Spearman correlation was used to analyze the subjective symptoms and objective test indexes in patients with NARES.Results Before contraction,the TNR values of NARES group in 75Pa and 150Pa were higher than those of the control group (Mann-Whiteny Z=7.365,8.125,all P0.05).Conclusion The correlation between subjective symptoms and function of nasal ventilation in NARES patients is not obvious .Clinical diagnosis should be comprehensive ,in case of missed diagnosis and misdiagnosis .
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Objective:To invetigate the value of a novel puncture and drainage of intracranial hematoma for the treatment of hypertensive intracerebral hemorrhage.Methods:In the group there were 27 patients with hypertensive intracerebral hemorrhage,with mean age of 61 years. Their hematomas located in thalamus(1 patient),basal ganglia(22 patients),and lobe(4 patients).The mean(SD)hematoma volume was 40(3.2)mL,the mean Glasgow Coma Scale (GCS)score was 10.15,and the mean National Institutes of Health Stroke Scale(NIHSS)score was 30.65 at admission.CT scan provided hematoma location.and the percutaneous puncture. grind and drainage were performed under the local anesthesia by using a novel puncture and drainage of intracranial hematoma.Results:No adverse events occurred during the punctures and after the procedures.One patiems died 20 days after procedure.Other patients were followed up for more than 6 months.Eight patients had a good outcome as assessed by Glasgow Outcome Scale(GOS)scores,15 had mild disability,2 had serious disability,and 1 was in a permanent vegetative state.Conclusions:This novel puncture and drainage of intracranial hematoma can be used in the treatment of hypertensive intracerebral hemorrhage,and it is simple and safe.
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OBJECTIVE@#To study the relationship between arousal and nocturnal apnea-hypopnea syndrome (OSAHS).@*METHOD@#Fifty four patients with OSAHS underwent overnight polysomnography (PSG) were enrolled, An hour continuous PSG monitoring in non-rapid eye movement (NREM) was recorded for all patients. The mean heart rate (HR) in 10 s before each arousal and the peak HR IN 10 s after arousal were compared, and the breathing disorder related arousal index (B-ArL) and pulse rate rise index (PRRI) were calculated at this time, and then a correlation analysis were performed and then Delta HR at apnea termination between these events were compared.@*RESULT@#the peak HR in 10 s after arousal onset was significantly higher than the mean HR in 10 s before arousal onset, and B-Arl was positively correlated to PRRI. the Delta HR of events with EEG arousal at apnea termination was higher than those without EEG arousal.@*CONCLUSION@#The results indicate that arousal can influence the function of cardiovascular regulation; Frequent arousal is one of the main causes of the cardiovascular consequences in OSAHS patients. Operation can reduce these influences.
الموضوعات
Adult , Female , Humans , Male , Middle Aged , Arousal , Heart Rate , Polysomnography , Sleep Apnea, Obstructive , General Surgeryالملخص
Objective To explore the value of microarousal in the diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods 120 snorers were monitored by standard polysomnography(PSG). The overnight PSG recordings were also performed 1 year after operation in 24 patients, who had filled in the Epworth Sleep Score(ESS) before and after treatment, to evaluate the improvement of daytime sleepiness. Results After operation, obstructive sleep apnea of the 24 patients disappeared, their ODI 4 decreased from (52?26)/h to (10?8)/h, microarousal decreased from (28?16)/h to (14?6)/h, and the subjective and objective daytime sleepiness was improved. Conclusion The EEG changes of microarousal with at least 3 seconds in OSAHS patients can be recorded by computerized EEG analysis. Microarousal can serve as an index for daytime sleepiness, and be complementary to AHI in the diagnosis and treatment of OSAHS.