ABSTRACT
BACKGROUND@#Studies have shown that the incidence and severity of corona virus disease 2019 (COVID-19) in patients with lung cancer are higher than those in healthy people. At present, the main anti-tumor treatments for lung cancer include surgery, immunotherapy, chemotherapy, radiotherapy, targeted therapy and anti-angiogenesis therapy. While the effects of different anti-tumor treatments on the occurrence and severity of COVID-19 pneumonia are not uniform. Therefore, we aimed to describe clinical characteristics and antitumor therapy of patients with lung cancer and COVID-19 pneumonia, and examined risk factors for severity in this population.@*METHODS@#From December 1, 2022 to February 15, 2023, a retrospective study was conducted in 217 patients diagnosed with COVID-19 and pathologically confirmed lung cancer in the Jinling Hospital. We collected data about patients' clinical features, antitumor treatment regimen within 6 months, and the diagnosis and treatment of COVID-19. Risk factors for occurrence and severity of COVID-19 pneumonia were identified by univariable and multivariable Logistic regression models.@*RESULTS@#(1) Among the 217 patients included, 51 (23.5%) developed COVID-19 pneumonia, of which 42 (82.4%) were classified as medium and 9 (17.6%) were classified as severe; (2) Univariate and multivariate analysis revealed overweight (OR=2.405, 95%CI: 1.095-5.286) and intrapulmonary focal radiotherapy (OR=2.977, 95%CI: 1.071-8.274) are risk factors for increasing occurrence of COVID-19 pneumonia, while other therapies are not; (3) Chronic obstructive pulmonary disease (COPD) history (OR=7.600, 95%CI: 1.430-40.387) was more likely to develop severe pneumonia and anti-tumor therapies such as intrapulmonary focal radiotherapy, chemotherapy, targeted therapy and immunotherapy did not increase severity.@*CONCLUSIONS@#Intrapulmonary focal radiation therapy within 6 months increased the incidence of COVID-19 pneumonia, but did not increase the severity. However, there was no safety concern for chemotherapy, targeted therapy, surgery and immunotherapy.
Subject(s)
Humans , COVID-19 , Retrospective Studies , Lung Neoplasms/drug therapy , Incidence , Pneumonia/etiologyABSTRACT
Objective:To explore a new method of ultrasound-guided positioning of the tip of neonatal peri-pherally inserted central catheter (PICC).Methods:Clinical data of 174 newborn infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Beijing Chaoyang District Maternal and Child Healthcare Hospital from January 2019 to April 2021 receiving PICC catheter intubated under the guidance of ultrasound for positioning the tip were retrospectively analyzed to explore the accuracy, reliability and feasibility of the improved ultrasound-guided positioning technique.Before lower extremity catheterization, ultrasound was performed to monitor the vascular pattern and catheterization of PICC was conducted under the guidance of ultrasound.Results:(1) Among 174 infants intubated with ultrasound-guided positioning of the PICC tip, 172(98.9%) of them had the ideal position, and 2(1.1%) did not achieve the ideal position, but achieved the ideal position after ultrasound-guided correction.(2) Lower extremity venous catheterization was successfully performed at 100.0% after ultrasound-guided monitoring of blood vessels.The time-consuming of lower extremity venous catheterization was significantly shorter than that of the previous method [(31.50±2.58) min vs.(56.10 ±5.30 min)]( t=46.84, P<0.001). The total success rate of catheterization and catheterization of lower limb vein increased by 7.0% and 17.5%, respectively.(3) Only 1 (0.57%) case reported the complication of catheter tip thrombosis, the complication rate of which decreased from the previous 79.00% to 2.70%(2/112 cases). Conclusions:The improved ultrasound-guided positioning of the PICC tip is convenient, simple, faster and accurate, which enhances the success rate and is worthy to be applied in clinical practice.
ABSTRACT
Objective:To provide a retrospective analysis of the levels of occupational external exposure of radiation workers in Hubei province from 2009 to 2018 in a way to prevent and control its risks.Methods:The external individual doses were surveyed for 50 070 radiation workers between 2009 and 2018 by the effort of the Hubei Provincial Center for Disease Control and Prevention. Under the relevant national standards, the external radiation doses to radiation workers were conducted by using TLDs.Results:The average annual collective effective dose to radiation workers in a 10 years period was 1.93 man·Sv, the median of average annual effective dose of 0.14 mSv ( P25- P75: 0.06-0.30 mSv), and the average annual effective dose of 0.40 mSv. The annual effective doses received by 46 562 workers were less than 1 mSv, accounting for 92.99% of the total monitored workers. The annual effective dose varied dependent on occupational categories, showing a year-by-year decline trend and staying at a low level after 2012. The relative high radiation doses were seen in nuclear medicine and interventional radiology in medical applications, non-destructive testing and well logging in industrial applications, and other types of radiation applications. Conclusions:The average annual effective dose decreased year in a by year manner and kept at a low level. This indicated that the radiological protection measures taken during the 10 years ensure the health of workers. The continuous monitoring result suggest that much more attention should be paid to such categories workers as nuclear medicine, interventional radiology, non-destructive testing, well logging and others through improving radiation protection measures.
ABSTRACT
Objective@#To investigate the clinical effect of early holistic treatment in elderly patients with intertrochanteric fracture.@*Methods@#From January 2017 to December 2017, 84 elderly patients with intertrochanteric fracture received by orthopaedics department of Shaoxing Central Hospital were divided into two groups.The observation group (46 patients) received early holistic therapy, and the control group (38 patients) received traditional orthopaedic trauma treatment.Two groups of patients were treated with proximal femoral anti-rotation intramedullary nail fixation, and the therapeutic effect was compared between the two groups.@*Results@#After 12 months of follow-up, the scores of Harris(evaluation standard of total hip joint curative effect) pain, mobility, deformity, function and total scores in the observation group were (39.13±2.66)points, (3.40±0.44)points, (3.30±0.38)points, (37.73±2.44)points, (83.56±2.51)points, respectively, which were higher than those in the control group[(37.05±2.95)points, (3.17±0.59)points, (3.09±0.52)points, (35.67±3.19)points, (78.98 ±3.37)points], there were statistically significant differences between the two groups (pain: t=3.395, P=0.001; activity: t=2.044, P=0.044; deformity: t=2.135, P=0.035; function: t=3.352, P=0.001; total score: t=7.131, P=0.000). After 12 months of follow-up, the excellent and good rate of operation in the observation group was 84.78%, which was higher than 71.05% in the control group, there difference was statistically significant between the two groups (χ2=5.477, P=0.019). The clinical statistics showed that the time from injury to operation, the time of ambulation and hospitalization in the observation group were (2.31±0.53) d, (3.53±0.69)d, (15.86±2.60)d, respectively, which were shorter than those in the control group[(3.45±1.02)d, (5.02±1.13)d, (19.73±3.12)d], the differences were statistically significant between the two groups (the time from injury to operation: t=6.585, P=0.000; the time of ambulation after operation: 7.128, P=0.000; hospitalization time: t=6.202, P=0.000). The incidence of complication was 6.52% in the observation group and 23.68% in the control group, the difference was statistically significant between the two groups (χ2=11.484, P=0.000). There was no death in the observation group at 12 months after operation, and the mortality rate in the control group was 2.63%, the difference was no statistically significant between the two groups (χ2=2.665, P=0.102).@*Conclusion@#The application of early holistic treatment concept in the treatment of elderly patients with intertrochanteric fracture can improve the therapeutic effect and shorten the rehabilitation process of the patients.
ABSTRACT
Objective To investigate the clinical effect of early holistic treatment in elderly patients with intertrochanteric fracture.Methods From January 2017 to December 2017,84 elderly patients with intertrochanteric fracture received by orthopaedics department of Shaoxing Central Hospital were divided into two groups .The observation group (46 patients) received early holistic therapy ,and the control group (38 patients) received traditional orthopaedic trauma treatment .Two groups of patients were treated with proximal femoral anti -rotation intramedullary nail fixation , and the therapeutic effect was compared between the two groups .Results After12 months of follow -up,the scores of Harris(evaluation standard of total hip joint curative effect ) pain,mobility,deformity,function and total scores in the observation group were (39.13 ±2.66) points,(3.40 ±0.44) points,(3.30 ±0.38) points,(37.73 ± 2.44)points,(83.56 ±2.51) points,respectively,which were higher than those in the control group [(37.05 ± 2.95)points,(3.17 ±0.59)points,(3.09 ±0.52) points,(35.67 ±3.19) points,(78.98 ±3.37) points],there were statistically significant differences between the two groups ( pain:t=3.395,P=0.001;activity:t=2.044,P=0.044;deformity:t=2.135,P=0.035;function:t=3.352,P=0.001;total score:t=7.131,P=0.000).After 12 months of follow-up,the excellent and good rate of operation in the observation group was 84.78％,which was higher than 71.05％in the control group ,there difference was statistically significant between the two groups (χ2 =5.477,P=0.019).The clinical statistics showed that the time from injury to operation ,the time of ambulation and hospitalization in the observation group were (2.31 ±0.53) d,(3.53 ±0.69) d,(15.86 ±2.60) d,respectively, which were shorter than those in the control group [(3.45 ±1.02) d,(5.02 ±1.13) d,(19.73 ±3.12) d],the differences were statistically significant between the two groups (the time from injury to operation:t=6.585,P=0.000;the time of ambulation after operation:7.128,P=0.000;hospitalization time:t =6.202,P=0.000).The incidence of complication was 6.52％in the observation group and 23.68％ in the control group,the difference was statistically significant between the two groups (χ2 =11.484,P=0.000).There was no death in the observation group at 12 months after operation,and the mortality rate in the control group was 2.63％,the difference was no statistically significant between the two groups (χ2 =2.665,P =0.102).Conclusion The application of early holistic treatment concept in the treatment of elderly patients with intertrochanteric fracture can improve the therapeutic effect and shorten the rehabilitation process of the patients .
ABSTRACT
Objective@#To investigate the value of ultrasound in the localization of peripherally inserted central catheter (PICC) in neonates.@*Methods@#A retrospective analysis of the PICC catheterization was conducted at Department of Neonatology, Beijing Chaoyang District Maternal and Child Healthcare Hospital from June 2017 to December 2018.The ultrasound monitoring was performed immediately after PICC catheterization.The probe was placed into the midline position of the lower xiphoid or the subclavian parasternal line for scanning, and it would be the PICC if a high-echo " equal sign" was observed by ultrasound.It was believed that the PICC was successfully placed when ultrasound detected that the PICC tip was located in the junction of inferior vena cava or superior vena cava in the right atrium.@*Results@#(1)Among 112 infants with PICC catheterization, 103 cases (92.0%) were accurately placed, 9 cases (8.0%) were not placed in the ideal site, among them, 2 cases were too deep, 4 cases were too shallow and 3 cases were catheter heterotopia.The tip position was accurate after the readjustment under ultrasound monitoring in those patients whose the first ultrasound showed the tip position was not ideal.(2)The PICC indwelling time was as short as 2 days (removed due to severe arrhythmia) and as long as 56 days with an average of (15.1±10.7) days.(3)The catheter-related complications occurred in 3 cases with an incidence of 2.7%.@*Conclusions@#Using ultrasound to determine the PICC tips position is accurate and reliable, which is worthy of extensive application in the neonatal wards.
ABSTRACT
Objective: To discuss the pathogenesis,clinical manifestations,diagnosis,differential diagnosis, treatment,and prognosis of the patient with rituximab (RTX)-induced interstitial lung disease (ILD) (RTX-ILD).Methods:A male patient aged 19 years old was confirmed as classical Hodgkin's lymphoma more than 2 years ago,and received autologous hemopoietic stem cell transplantation (HSCT)when the disease recurred 1 year ago.Two months after HSCT,the maintenance chemotherapy was given every month with 375 mg· m-2 RTX,but the mediastinal recurrence appeared during the period,then the mediastinal residual lesion radiotherapy was done for 10 times.However,8 d after the third RTX chemotherapy,the patient experienced post-exercising tachypnea,fever,cough,chest congestion,and limb weakness.The chest CT scanning results suggested ground gloss opacity on both lungs,and blood gas analysis suggested a hypoxemia.Neither antibacterial nor antifungal treatment worked well.Afterwards,the sequential etiological examination showed the negative results,and the bronchoscope examination showed the normal results as well.Considering about the possibility of RTX-ILD,RTX was stopped immediately and turned to intravenous infusion of methylprednisolone 40 mg per day.Results:Five d later,the symptoms of the patients were improved,and the follow-up methylprednisolone was changed to oral and gradually reduced to discontinuation.Conclusion:RTX-ILD is relatively rare,and its clinical manifestations lack specificity. Hormonotherapy is the main method in treatment of RTX-ILD. The patients sensitive to hormonotherapy have better prognosis than those insensitive to hormonotherapy.
ABSTRACT
Objective:To investigate the effect of PLTP gene on CSE-induced IL-8 production in human bronchial epithelial cell line (HBECs). Methods:Wistar rats were exposed to air or cigarette smoke for 6 hours/day on 3 consecutive days,then the lungs were sectioned and examined. The number of total white blood cell and differential white blood cells in BALF were counted. The different concentrations of CSE co-cultured with HBECs for 24 hours. Cells growth was detected by MTT assay. Expression levels of PLTP mRNA and IL-8 mRNA were examined by RT-PCR,protein of PLTP was investigated by Western blot,and production of IL-8 ex-amined by ELISA. Results:The number of white blood cells in BALF was significantly increased compared with controls. Enhanced ex-pression level of PLTP and IL-8 were observed in CS-exposure group. Proliferation of HBECs tends to decrease at high concentrations of CSE(2. 0% CSE and 4. 0% CSE). The results suggested that the production of IL-8 induced by CSE in a time- and concentration-dependent manner,while the expression of PLTP induced by CSE in a dose-dependent manner. Furthermore,expression levels of IL-8 significantly increased after silence PLTP gene. Conclusion:PLTP siRNA could increase CSE-induced IL-8 production in HBECs.
ABSTRACT
Objective:To investigate the effect of PLTP gene on CSE-induced IL-8 production in human alveolar Type Ⅱcells ( Adenocarcinomic human alveolar epithelial cells , A549 ) .Methods: The different concentrations of CSE co-cultured with human alveolar epithelial cell line ( A549 ) for 24 hours.MTT assay was performed to study the effect of CSE on human alveolar epithelial cell line(A549) growth.Expression levels of PLTP mRNA and IL-8 mRNA were examined by RT-PCR,protein of PLTP were examined by Western blot ,and protein of IL-8 was examined by ELISA .Results: MTT assay showed that the proliferation of A 549 cell line were stimulated by the 0.125%CSE,while the proliferation of A549 cell tends to decrease at high concentrations of CSE (2.0% CSE and 4.0%CSE),and in this middle concentrations of CSE (0.25%CSE ,0.5%CSE and 1.0%CSE),the proliferation of A549 cell was not significantly affected .Our studys suggested that PLTP and IL-8 release were induced by CSE in a concentration-dependent and time-dependent manner ,and expression levels of IL-8 obviously increased after silence PLTP gene .Conclusion:PLTP siRNA can increased CSE-induced IL-8 production in human alveolar epithelial cells (A549).
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the role of phospholipid transfer protein (PLTP) in cigarette smoke extract (CSE)-induced apoptosis of rat alveolar type II cells (RLE-6TN) in vitro.</p><p><b>METHODS</b>Rat alveolar epithelial cell line RLE-6TN were transfected with a small interfering RNA (siRNA) targeting PLTP prior to exposure to different concentrations of CSE for 24 or 48 h. The morphological changes of the apoptotic cells were observed by fluorescence microscopy with Hochest staining, and the cell apoptosis rate was measured with flow cytometry. The expression level of PLTP and caspase-3 activity in the cells were examined with Western blotting.</p><p><b>RESULTS</b>Exposure to CSE significantly increased the cell apoptosis rate from (1.68∓0.098)% to (18.663∓0.964)% (P<0.001). Hoechst staining revealed distinct apoptotic changes in CSE-treated cells, which showed increased PLTP expression and caspase-3 activity. PLTP knockdown with the specific siRNA partly suppressed the SCE-induced enhancement of caspase-3 activity in the cells.</p><p><b>CONCLUSION</b>PLTP may play a role in CSE-induced apoptosis of rat alveolar cells in vitro.</p>
Subject(s)
Animals , Rats , Apoptosis , Caspase 3 , Metabolism , Cell Line , Epithelial Cells , Cell Biology , Phospholipid Transfer Proteins , Metabolism , RNA, Small Interfering , Smoke , TobaccoABSTRACT
Objective To investigate the influence of intravenous infusion by double-lumen peripherally inserted central catheter (PICC)on continuous dynamic central venous pressure(CVP)monitoring.Methods In the patient undergoing the double-lemon PICC,continuous dynamic CVP monitoring was performed by a lumen and the intravenous infusion was conducted by another lu-men.Whether the simultaneous venous infusion affecting the values of continuous dynamic CVP monitoring was observed.Results Intravenous infusion through double-lumen PICC had no influence on simultaneously continuous dynamic CVP monitoring (P>0.05),which could influence the values of CVP monitoring when simultaneously using the intravenous infusion pump(P0.05).The CVP values could recovered to the status before infusion when continuously infusing after stopping using the infusion pump.Compared with before in-fusion,the CVP values after stopping intravenous infusion had no obvious change(P>0.05).Conclusion Intravenous infusion by double-lumen PICC has no influence on continuous dynamic CVP monitoring.But simultaneously adding infusion pump has certain influence on the CVP monitoring values.
ABSTRACT
Objective To investigate the cognition of basic doctors on essential drugs in Luo County. Methods The random sampling was used to investigate the basic doctors in Luoping County, and 200 copies questionnaire were distributed. Results The questionnaire response rate was 98%. The survey results indicated that the cognition on essential drugs among basic doctors was poor, but most basic doctors have positive attitudes and behaviors in essential drugs. Conclusion It is necessary to improve the awareness of essential drugs among basic doctors in Luo County.
ABSTRACT
Objective To investigate the effect of meridian exercises on blood glucose and clinical symptoms of community elderly type 2 diabetic patients.Methods Sixty elderly patients with type 2diabetes mellitus (T2DM) were selected from two communities from February to September in 2012.Thirty participants from one community received meridian excise-based group sport management (experiment group),the other 30 subjects from another community got meridian excise-based individual sport management (control group).Before and after the intervention,blood glucose and self-report symptoms were assessed.Results At baseline and after the intervention,there was statistically significant difference of postprandial blood glucose and self-symptom score between the two groups (t values were-5.954,-2.900,-4.214 and-3.798,respectively; all P＜0.05).After the intervention,experiment group showed statistically significant difference in self-assessment of symptom score from the control group (t=-5.484,P＜0.05).Conclusion Meridian exercises can efficiently improve diabetic patients' postprandial blood glucose and clinical symptons.
ABSTRACT
Objective To investigate the relationship between 24-hour ambulatory blood pressure and urine microalbumin(UMA)level in the elderly with non-diabetic essential hypertension.Methods One hundred elderly cases with essential hypertension were selected from the Department of Geriatrics,the Sixth People's Hospital,Shanghai and divided into two groups,one with UMA less than 30 mg/24h,and the other with UMA equal to or greater than 30 mg/24h.Ambulatory blood pmssure,serum level of creatinine (sCr),UMA and other characteristics were measured for all the subjects studied and compared to find possible relationship between blood pressure and UMA.Results Level of sCr,diastolic blood pressure at night (nDBP),24-hour average blood pressure,average blood pressure at night were all significantly higher in the group with UMA equal to or greater than 30 mg/24h than that with UMA less than 30 mg/24h(P<0.05 or P<0.01). Multivariate logistic regression analysis indieated that both sCr and nDBP were indispensable predictors for high microalbuminuria in patients with essential hypertension.Conclusions Ambulatory blood pressure monitoring,especially blood pressure variation at night,has more important predictive value for severity of renal damage caused by hypertension in the elderly with non-diIlbetic essential hypertension.