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BACKGROUND@#Immune checkpoint inhibitor associated pneumonia (CIP) is a serious side effect of immune checkpoint inhibitors. There is a consensus on the treatment of acute phase of CIP, but the treatment of pulmonary interstitial fibrosis after the acute phase is still a clinical problem to be solved.@*METHODS@#The diagnosis and treatment of a non-small cell lung cancer (NSCLC) patient with immune checkpoint inhibitor associated pneumonia in the Stereotactic Radiotherapy Department of Qingdao Central Hospital were retrospectively analyzed, and literatures were reviewed.@*RESULTS@#A 70-year-old male patient was diagnosed with Poorly differentiated squamous cell carcinoma of left lung with mediastinal lymph node metastasis T3N3M0 stage IIIc, EGFR/ALK/ROS1/RAF negative, PD-L1 (22c3) immunohistochemistry negative. After the progression of first-line chemotherapy, the patient was diagnosed as immune checkpoint inhibitor associated pneumonia grade 3 during second-line monotherapy with Nivolumab. After initial high-dose glucocorticoid pulse therapy, the lung computed tomography (CT) imaging and clinical symptoms of the patients were partially relieved, and then pirfenidone (300 mg tid) was given orally for more than 11 months. During the treatment of pirfenidone, the CT imaging and clinical symptoms of the patients were significantly improved, and there were no other adverse reactions except grade 1 nausea. During this period, chemotherapy and Anlotinib was given concurrently with pirfenidone and showed good safety profile.@*CONCLUSIONS@#This case report is the first report of pirfenidone in the treatment of CIP, which provides a new idea for the clinical practice and research of CIP treatment.
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Objective:To investigate the effect of adenosine deaminase acting on RNA 1 (ADAR1) on 5-serotonin-2c receptor in alleviating aggression in socially isolated mice.Methods:Sixty healthy male BALB / c mice aged 21 days were randomly divided into six groups: social isolation group, social control group, ADAR1 inducer social isolation group, ADAR1 inhibitor social isolation group, ADAR1 inducer social control group and ADAR1 inhibitor control group.The mice fed in single cage for 4 weeks were used as social isolation model while the mice fed in group were used as control group.ADAR1 inducer (5.0×10 4 U/kg) and inhibitor (10 mg/kg) were given intraperitoneally to mice in the ADAR1 inducer social isolation group and the ADAR1 inhibitor social isolation group respectively.The aggressive behavior of mice was evaluated by resident-intruder test.The expression of ADAR1 and 5-serotonin-2c receptors in the brain of mice was detected by immunohistochemistry and Western blot. Results:The attack latency of social isolation group was significantly lower than that of social control group ((43.15±6.99) s, (542.40±30.50) s; t=15.906, P<0.01), and the latency of attack ((256.70±29.49) s) in the ADAR1 inducer social isolation group was significantly higher than that in the social isolation group ( t=7.046, P<0.01). The latency of attack ((15.25±2.18)s) in the ADAR1 inhibitor social isolation group was significantly lower than that in the social isolation group ( t=3.809, P<0.01). The optical density of ADAR1 immunoreactive cells in the amygdala of the social isolation group mice was significantly lower than that in the corresponding brain area of the social control group (BLA: (0.038±0.002), (0.074±0.004); LaDL: (0.033±0.002), (0.060±0.002); LaVM: (0.045±0.003), (0.073±0.004); Lavl area: (0.044±0.003), (0.070±0.003); t=8.428, 9.037, 6.462, 5.698, all P<0.01). The optical density of ADAR1 immunoreactive positive cells in the amygdala (BLA: (0.060±0.003), LaDL: (0.042±0.002), LaVM: (0.056±0.004), Lavl: (0.054±0.003) in the ADAR1 inducer social isolation group was significantly higher than those in the corresponding brain area of the social isolation group mice ( t=6.055, 2.876, 2.312, 2.492; all P<0.05). The expression of ADAR1 protein and 5-serotonin-2c receptor protein in amygdala of social isolation group were significantly lower than those of social isolation group ( t=11.37, 12.65; P<0.01). The expression of ADAR1 protein and 5-serotonin-2c receptor protein in the amygdala of the ADAR1 inducer social isolation group were significantly higher than those of the social isolation group ( t=3.02, 4.401; P<0.05). Conclusion:ADAR1 inducer alleviates the aggressive behavior of social isolated BALB / c mice by enhancing the protein expression of 5-serotonin-2c receptor in the amygdala of social isolated BALB/c mice.
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HBeAg seroconversion is an important process during antiviral therapy for patients with HBeAg-positive chronic hepatitis B (CHB), while the first-line antiviral drugs, such as entecavir and tenofovir disoproxil fumarate, tend to have low HBeAg clearance rate and/or seroconversion rate, and at present, there is still a lack of effective radical treatment regimens. Latest studies have shown that fecal microbial transplantation (FMT) can induce HBeAg clearance in HBeAg-positive CHB patients receiving long-term antiviral therapy. This article reviews the research advances in the role of FMT in inducing HBeAg clearance in HBeAg-positive CHB patients and points out that FMT may become a new treatment regimen for HBeAg-positive CHB patients.
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OBJECTIVE：To investi gate the potential mechanism of couplet medicine of Cuscutae Semen-Lycii Fructus in the treatment of premature ovarian failure. METHODS ：Main active components and related targets of couplet medicine of Cuscutae Semen-Lycii Fructus in the treatment of premature ovarian failure were obtained from TCMSP ，GeneCards and OMIM database. The intersection genes between them were screened using Venn online tool. Cytoscape 3.7.0 software was adopted to establish the active ingredients-target network and the PPI network. GO and KEGG pathway enrichment analysis on intersection genes were carried out by DAVID database. Finally ，an active component-target-key pathway network was constructed. RESULTS ：Totally 42 active components ，231 and 1 913 targets for active components and disease were obtained from couplet medicine of Cuscutae Semen-Lycii Fructus. The components with high node degree included quercetin ，kaempferol，β-sitosterol，isorhamnetin，glycitein， stigmasterol and sesamin ，etc. There were 149 intersection genes between the active component targets and premature ovarian failure targets. PPI network contained 149 nodes and 2 970 edges，with an average node degree of 39.9 and an average medium of 0.005 4. The results of GO analysis showed that molecule function of the above-mentioned genes mainly involved protein binding ， enzyme binding ，etc. Biological process mainly included that positive regulatio n of transcription from RNA polymerase Ⅱ promoter，positive regulation of transcription DNA-templated ， Cell components mainly included nucleus ，cytoplasm，etc. Signaling pathway mainly involved cancer signaling pathway ， hepatitis B signling pathway ，PI3K/AKT signaling pathway ， MAPK signaling pathway ， etc. The results of active 617693370@qq.com component-target-key pathway network showed that active components of Cuscutae Semen and Lycii Fructus were flavonoids and alcohols ；key target included AKT 1，TP53， VEGFA，IL6，TNF，etc. Signaling pathway mainly involved cancer signaling pathway ，hepatitis B signaling pathway ，PI3K/AKT signaling pathway ，MAPK signaling pathway ，etc. CONCLUSIONS ：Through PI 3K/AKT signaling pathway and MAPK signaling pathway，the active components of couplet medicine of Cuscutae Semen-Lycii Fructus may act on AKT 1，TP53 and other targets ， and then play a therapeutic role on premature ovarian failure. The Potential active components stigmasterol ，sesamin and potential targets IL 6，TNF were found.
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Objective To explore the continuity nursing effect of WeChat platform on PICC patients with intermittent chemotherapy. Methods 150 patients with primary PICC intubation tumor were selected as the study object, and were divided into three groups according to the order of treatment, each group of 50 cases. The control group adopted the traditional health education mode; the observation group 1 pushed PICC catheter maintenance related content three times a week based on WeChat platform on the basis of routine health education, and the observation group 2 on the basis of routine health education pushed PICC catheter maintenance related content, collected questions three times and answered questions for everyone in the Weixin group. The PICC self-management ability and incidence of catheter-related complications of the three groups were compared after 3 months. Results The scores of PICC self-management ability in the three groups were (133.84±5.67), (142.36±8.62) and (148.76±6.52). There was significant difference in the scores of PICC self-management ability between the three groups (F=56.384, P<0.05). The incidence of catheter-related complications in the three groups were 14% (7/50), 4% (2/50) and 2% (1/50), respectively, and the difference was statistically significant (χ2=6.643, P<0.05) between the three groups. The incidence of catheter-related complications was statistically significant only in the control group compared with the observation group 2 (χ2=4.891, P<0.05). Conclusions Continuous nursing based on Weixin platform can improve the self-management ability of PICC catheterization patients during the intermittent period of chemotherapy. Continuous nursing based on Weixin group chat can reduce the incidence of catheter-related complications, which is worthy of wide clinical recommendation.
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Objective To investigate the clinical effect of comfortable nursing intervention on postoperative patients with liver cancer. Methods A total of 66 postoperative patients with liver cancer who were treated in our hospital from November 2015 to August 2017 were selected as experimental subjects. Patients were divided into observation group and control group by digital odd-even method. The patients in the control group(n=33)were given the routine nursing method, and the observation group(n=33) were given the comfortable nursing method. The postoperative pain degree, the scores of self-rating anxiety scale(SAS)and self-rating depression scale (SDS) between the two groups were compared. Results Compared with the control group, postoperative pain degree of patients with liver cancer was significantly relieved in the observation group (P＜0. 05). Compared with the control group, SAS score of postoperative patients with liver cancer reduced significantly in the observation group (P＜0. 05). Compared with the control group, SDS score of post-operative patients with liver cancer reduced significantly in the observation group(P＜0. 05). Conclusion Appropriate comfortable nursing interventions for postoperative patients with liver can relieve postoperative pain, reduce postoperative SAS score and SDS score adequately, so that can improve for rapid recover and prognosis for postoperative patients with liver cancer.
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Clinical studies have confirmed the FOLFIRINOX regimen (oxaliplatin + irinotecan + fluorouracil + leucovorin) is an effective regimen for advanced pancreatic cancer patients with good performance status.Current clinical studies on FOLFIRINOX regimen mainly include neoadjuvant therapy for unresectable and borderline resectable pancreatic cancer and first-line therapy for locally advanced pancreatic cancer and metastatic pancreatic cancer,which improved patient's surgical resection opportunities and survival.In addition,the toxicity,safety of FOLFIRINOX regimen and effective population selection for FOLFIRINOX regimen are also the problems concerned by researchers.
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Objective To investigate the related risk factors of complicated parapneumonic effusion (CPPE) in children. Method The clinical data of 88 children with parapneumonic effusion (PPE) were retrospectively analyzed from January 2013 to April 2015. According to the treatment effect of antibiotics, CPPE group and uncomplicated parapneumonic effusion (UPPE) group were divided. The univariate analysis of clinical and laboratory parameters was performed between two groups. Then the multifactor logistic regression was performed further. The receiver operator characteristic (ROC) curve was draw. Results The univariate analysis indicated that the risk factors were the formation of loculation and serum CD3+ and CD19+ levels (Z=2.030~7.457, P30%and the formation of loculation.
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Objective To explore the clinical characteristics of pleural effusion caused byMycoplasma pneumoniae in children.MethodsThe clinical data from children with pleural effusion caused byMycoplasma pneumoniae were retrospectively analyzed. Differences of clinical characteristics in children with pleural effusion caused byMycoplasma pneumoniae infection and non-Mycoplasma pneumoniae infection were compared. Moreover, multiple logistic regression analysis was performed on the factors that were identified to have statistical differences in single factor analysis. Receiver operating characteristic (ROC) curve was performed and the diagnostic boundary value of each factor and the diagnostic accuracy of the regression model were calculated.ResultsThere were statistical differences between children with pleural effusion caused byMycoplasma pneumoniae infection and by non-Mycoplasma pneumoniae infection in age, white blood cell count, lactic dehydrogenase (LDH), levels of IgA and IgM, and the proportion of multiple nuclei, glucose and lactic acid (LAC) in pleural effusion, pleural thickening, and formation of ifbrous separation (allP??3.92 years, serum IgM?>?1.29 g/L, LDH?>?367 U/L and pleural effusion LAC?
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Objective To describe the burden of caregivers of children with asthma,and to provide reference for the development of family care support program.Methods Qualitative research was used to carry out semi-structured interviews with 13 caregivers of children with asthma in the pediatric outpatient of the First Affiliated Hospital of Guangzhou Medical University.The data collected were analyzed with Colaizzi 7-step analysis method.Results The carcgiver burden was classified into 4 themes,including time and energy exhaustion,heavy economic burden,insufficient knowledge of care and negative emotions.Conclusions The burden of caregivers of children with asthma has a relatively great impact on the daily work and life,even the physical and mental health.Care workers should be concerned about the status of caregiver burden and provide targeted interventions,which could help caregiver adapt to their roles,maintain and promote the health of children patients and their families.