Progress in the study of association between hematological indicators and retinopathy of prematurity (Review).

Retinopathy of prematurity (ROP) is a retinopathy caused by abnormal proliferation of blood vessels in premature infants. It can lead to retinal detachment and, in severe cases, blindness, rendering ROP a critical condition. Advances in neonatal medicine have improved survival rates of low birth weight and low gestational age infants. However, this progress has also led to a rise in incidence of ROP. Currently, premature birth, low birth weight and high postpartum oxygen levels are independent risk factors for ROP. Other factors include mode of delivery, multiple births, anemia, blood transfusion, maternal pregnancy factors, neonatal bronchopulmonary dysplasia, use of surfactants, arterial ductus arteriosus and necrotizing enterocolitis. Laboratory indicators in premature infants such as platelet count, levels of blood glucose, inflammatory cells, lipid and hemoglobin and blood transfusion may also be associated with ROP. However, the etiology and pathogenesis of ROP are not fully understood. A number of factors may influence the onset and progression of ROP, including decreased platelet counts, decreased hemoglobin levels, increased white blood cell counts, increased blood glucose levels, and disorders of lipid metabolism. The present study reviewed the effects of platelet count, hemoglobin, blood glucose, inflammatory cells and factors, blood lipids, and plasma metabolic pathways on ROP.

A potential role for inflammatory cytokines in a rare late-onset capsular block syndrome: a case report.

BACKGROUND: Late-onset capsule block syndrome (CBS) is a rare complication of cataract phacoemulsification and the implantation of a posterior chamber intraocular lens (PCIOL), which manifests six months to years after surgery. The hallmark of CBS is the formation of an opaque liquid substance between the implanted intraocular lens (IOL) and the posterior capsule. However, its pathogenesis remains unclear. CASE PRESENTATION: A 64-year-old female patient with chronic angle-closure glaucoma (axis length < 21 mm) underwent trabeculectomy surgery combined with phacoemulsification and PCIOL. After a 4-year follow-up, a decline in visual acuity occurred in her right eye due to the location of opaque fluid in the visual axis and distension of the capsular bag. The initial course of action was to release the trapped fluid. Neodymium: yttrium-aluminum-garnet (Nd: YAG) laser capsulotomy could not be employed due to her non-dilating pupil and high extension of the posterior capsule. Subsequently, anterior capsule peeling and anterior segment vitrectomy surgery were performed. The depth of the anterior chamber (ACD), the distance between the face of the retro-IOL and the posterior capsule, the best-corrected visual acuity (BCVA), and the visual quality (VQ) were measured both before and after surgery. Inflammatory cytokine levels in the opaque substances (OS) trapped between the PCIOL and the posterior capsule were assessed using a flow cytometer and compared to normal statistical data in aqueous humor. After surgery, the patient experienced a significant improvement in BCVA and VQ. The distance between the face of the retro-IOL and the posterior capsule was on the verge of disappearing. However, ACD did not differ between pre- and post-operatively. Interleukin-8 (IL-8) and basic fibroblast growth factor (BFGF) concentrations were higher in the OS than in aqueous humor, especially in the former. However, the concentration of vascular cell adhesion molecule (VCAM) in the OS was lower than in aqueous humor. CONCLUSIONS: Anterior segment vitrectomy surgery proved to be a successful treatment for late-onset CBS, presenting a challenging case. In the human lens, inflammatory cytokines originating from the opaque substances may contribute to abnormal metabolism in the sealed area, a consequence of late-onset CBS.

Association between dietary calcium, potassium, and magnesium consumption and glaucoma.

BACKGROUND: Calcium (Ca), potassium (K) and magnesium (Mg) may be involved in the occurrence and development of glaucoma by influencing the retinal oxidative stress and regulate blood pressure. However, epidemiological opinions on dietary intake of macroelement related to glaucoma are inconsistent. Herein, this study aims to explore the association between dietary Ca, K, and Mg consumption and glaucoma. METHODS: Data of 7,042 adults aged ≥40 years old who received the glaucoma examinations were extracted from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2008 in this cross-sectional study. Univariate and multivariate logistic regression were used to explore the association between dietary Ca, K, and Mg intake and glaucoma with the odd ratios (ORs) and 95% confidence intervals (CIs). We also investigated this relationship in individuals of different age, with/without hypertension and visual field defect (VFD). RESULTS: There were 502 (8.11%) participants had glaucoma. After adjusted for covariables, we found that enough dietary Ca consumption was related to a decreased risk of glaucoma [OR = 0.59, 95%CI: (0.42-0.81)], whether in persons with/without hypertension (all P<0.05). In particular, dietary K intake may be a potential protect factor for glaucoma in non-hypertension populations [OR = 0.47, 95%CI: (0.22-0.99), P = 0.049]. Additionally, hypertension/non-hypertension persons who aged <65 years old or with/without VFD should all pay attention to the enough dietary supplement of Ca, K, and Mg according to their own circumstances. CONCLUSION: Enough dietary Ca, K, and Mg consumption may be potential protect factors of glaucoma that could provide some dietary reference for developing targeted glaucoma prevention and control measures.

China Glaucoma Treatment Pattern Study I-Primary Angle-Closure Glaucoma: protocol for a multicentre, retrospective, observational study.

INTRODUCTION: Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness globally, and the number of patients with PACG rises every year. Yet, there is a lack of knowledge about the clinical characteristics, therapeutic options and profile of patients with PACG in China. Hence, we design the China Glaucoma Treatment Pattern Study Ⅰ-Primary Angle-Closure Glaucoma (Ch-GTPⅠ). The objective of this paper is to describe the design and methodology of Ch-GTP. The aim of this study is to characterise the profile and trend associated with initial PACG treatment for the last 10 years in China. METHODS: Ch-GTPⅠ is a national multicentre retrospective observational study that will randomly sample from 50 hospitals throughout China. Over 7000 patient records hospitalised for initial PACG treatment from 2011 to 2020 will be selected randomly. The data from electronic medical records will be uploaded to an encrypted online platform that will receive and collate data from all collaborating hospitals. Data abstraction and monitoring will be performed in a standardised manner by trained statisticians to ensure consistency. Systematic data cleaning will also be conducted by statisticians to ensure data integrity before final data storage. The outcomes will include four broad categories: (1) demographics, (2) clinical characteristics, (3) therapeutic strategies and procedures and (4) early outcomes at discharge. The demographic characteristics and early outcomes will be summarised using descriptive statistics. Comparative analyses of characteristics and treatment pattern changing trends for different regions and years will be used to test for significant differences (t-test or Mann-Whitney U test). ETHICS AND DISSEMINATION: The collaborating hospitals obtained local approval based on a standard ethics application from internal ethics committees or acknowledged an existent ethics approval of the leading institution with approval from internal ethics committees. Due to the retrospective nature, written informed consent from patients was waived by the ethics committee. The results will be published in academic journals and presented at national and international academic conferences. TRIAL REGISTRATION NUMBER: ChiCTR2100054643.

Retinal thickness changes in different subfields reflect the volume change of cerebral white matter hyperintensity.

Purpose: To investigate the relationship between the retinal thickness in different subfields and the volume of white matter hyperintensity (WMH), with the hope to provide new evidence for the potential association between the retina and the brain. Methods: A total of 185 participants aged over 40 years were included in our study. Magnetic resonance imaging (MRI) was used to image the WMH, and WMH volume was quantitatively measured by a specific toolbox. The thickness of the total retina, the retinal nerve fiber layer (RNFL), and the ganglion cell and inner plexiform layer (GCIP) was measured by optical coherence tomography (OCT) in nine subfields. The association between retinal thickness and WMH volume was demonstrated using binary logistic regression and Pearson correlation analysis. Results: Participants were divided into two groups by the WMH volume (‰, standardized WMH volume) median. In the quartile-stratified binary logistic regression analysis, we found that the risk of higher WMH volume showed a positive linear trend correlation with the thickness of total retina (95% CI: 0.848 to 7.034; P for trend = 0.044)/ GCIP (95% CI: 1.263 to 10.549; P for trend = 0.038) at the central fovea, and a negative linear trend correlation with the thickness of nasal inner RNFL (95% CI: 0.086 to 0.787; P for trend = 0.012), nasal outer RNFL (95% CI: 0.058 to 0.561; P for trend = 0.004), and inferior outer RNFL (95% CI: 0.081 to 0.667; P for trend = 0.004), after adjusting for possible confounders. Correlation analysis results showed that WMH volume had a significant negative correlation with superior outer RNFL thickness (r = -0.171, P = 0.02) and nasal outer RNFL thickness (r = -0.208, P = 0.004). Conclusion: It is suggested that central fovea and outer retina thickness are respectively associated with WMH volume. OCT may be a biological marker for early detection and longitudinal monitoring of WMH.

Clinical Observation of Macular Vessel Density in Type 2 Diabetics with High Myopia.

INTRODUCTION: To compare the macular retinal vessel density(VD) of diabetics with high myopia, diabetics without high myopia and healthy controls. METHODS: This cross-sectional study recruited type 2 diabetic (T2D) people with no history of ocular treatment in our hospital. Thirty T2D people with high myopia (30 eyes) were included in group A, while 30 T2D people (30 eyes) without myopia were included in group B. Another healthy volunteers (30 eyes) were included in group C. The superficial and deep capillary plexuses VD of macular were measured in all subjects by optical coherence tomography angiography (OCTA). In T2D people with high myopia, the correlation between VD in macular regions and baseline data was investigated. RESULTS: ① Overall comparison of the 3 groups: No statistically significant differences in macular central superficial vessel density (SVD) were found in the three groups（P > 0.05). There were significant differences in the temporal, superior, nasal, inferior SVD between the 3 groups (P < 0.05). There were significant differences in macular central, temporal, superior, nasal, and inferior deep vessel density (DVD) between the three groups (P < 0.05). ② Comparison of B (no myopia, T2D group) and C (healthy control group): Inferior SVD in group B was lower than that in group C (P < 0.05). Temporal, superior, nasal, and inferior DVD in group B were lower than those in group C (P < 0.05). ③ A (high myopia group, T2D) compared with B (no myopia, T2D group), A group compared with C (healthy control group): Temporal, superior, nasal, inferior SVD and DVD in group A were all lower than those in group B and C (P < 0.05), DVD in group B were lower than those in group C (P < 0.05). ④ The mean SVD and DVD were not correlated with age, IOP , anterior chamber depth, corneal curvature but they were negatively correlated with axial length and duration of diabetes in the T2D people with high myopia. CONCLUSION: Myopia and diabetes are two important factors affecting macular retinal vessel density. Comparing with the eyes of T2D people without high myopia, the VD in macular regions shows a higher decline in the eyes of T2D people with high myopia.

Identifying Quantitative Trait Loci for Thousand Grain Weight in Eggplant by Genome Re-Sequencing Analysis.

Eggplant (Solanum melongena L.; 2n = 24) is one of the most important Solanaceae vegetables and is primarily cultivated in China (approximately 42% of world production) and India (approximately 39%). Thousand-grain weight (TGW) is an important trait that affects eggplant breeding cost and variety promotion. This trait is controlled by quantitative trait loci (QTLs); however, no quantitative trait loci (QTL) has been reported for TGW in eggplant so far, and its potential genetic basis remain unclear. In this study, two eggplant lines, 17C01 (P1, wild resource, small seed) and 17C02 (P2, cultivar, large seed), were crossed to develop F1, F2 (308 lines), BC1P1 (44 lines), and BC1P2 (44 lines) populations for quantitative trait association analysis. The TGWs of P1, P2 and F1 were determined as 3.00, 3.98 and 3.77 g, respectively. The PG-ADI (polygene-controlled additive-dominance-epistasis) genetic model was identified as the optimal model for TGW and the polygene heritability value in the F2 generation was as high as 80.87%. A high-quality genetic linkage bin map was constructed with resequencing analysis. The map contained 3,918 recombination bins on 12 chromosomes, and the total length was 1,384.62 cM. A major QTL (named as TGW9.1) located on chromosome 9 was identified to be strongly associated with eggplant TGW, with a phenotypic variance explanation of 20.51%. A total of 45 annotated genes were identified in the genetic region of TGW9.1. Based on the annotation of Eggplant genome V3 and orthologous genes in Arabidopsis thaliana, one candidate gene SMEL_009g329850 (SmGTS1, encoding a putative ubiquitin ligase) contains 4 SNPs and 2 Indels consecutive intron mutations in the flank of the same exon in P1. SmGTS1 displayed significantly higher expression in P1 and was selected as a potential candidate gene controlling TGW in eggplant. The present results contribute to shed light on the genetic basis of the traits exploitable in future eggplant marker-assisted selection (MAS) breeding.

Observation on the Curative Effect of Microsurgery in 154 Children with Strabismus and Analysis of Its Influencing Factors.

Strabismus is a common ophthalmic disease in the process of child body development, in which the two eyes cannot gaze at the target at the same time, and the incidence of this disease of children is higher. In children with esotropia, exotropia, and up and down strabismus and other typical symptoms, the cause is genetic, innerve, and refractive and regulated, and not receiving timely treatment may lead to stereo vision and diplopia and other phenomena, affecting their learning and life. Surgical treatment is the main treatment for strabismus at present. Traditional orthodontic surgery is performed by doctors under the naked eye, often due to improper operation or suture error and other factors, resulting in more postoperative complications, such as more tissue damage, conjunctival congestion, and muscle suture reaction, which seriously affect the clinical effect of surgical treatment. In recent years, with the continuous development of microsurgical technology, the correction of strabismus under a microscope has been widely carried out in clinic. The operation under the microscope makes the operation more delicate and accurate, overcomes the defects of traditional surgery, and highlights the advantages of minimally invasive surgery. The purpose of this study was to investigate the effect of microsurgical techniques in the treatment of strabismus in children and to analyze the factors influencing the outcome. The results showed that microsurgical strabismus correction in the treatment of strabismus children has short operation time, less intraoperative blood loss, short hospital stay, high efficiency, and less complications, which is worthy of popularization. Age, preoperative strabismus angle, refractive error, distance stereopsis injury, near stereoscopic injury, and duration of disease were all independent influencing factors of postoperative efficacy.

To Find Out the Relationship Between Levels of Glycosylated Hemoglobin with Meibomian Gland Dysfunction in Patients with Type 2 Diabetes.

AIM: The aim of this study was to investigate the relationship between levels of glycosylated hemoglobin (HbA1c) with meibomian gland dysfunction (MGD) in patients with type 2 diabetes mellitus (T2DM) and to further explore the related influencing factors. METHODS: Totally, 167 patients with T2DM and 68 non-diabetic subjects were selected. Further, T2DM patients were divided into 2 groups based on 7% HbA1c. Standard patient evaluation of eye dryness (SPEED), lipid layer thickness (LLT), partial blink (PB) ratio, percentage of partial glands (MGP), meibomian gland yielding liquid secretion (MGYLS), meibomian gland yielding secretion score (MGYSS), line of marx (LOM), tear break up time (TBUT), tear meniscus height (TMH) and Schirmer I test (SIT) were applied to evaluate meibomian gland function. Finally, the correlation between HbA1c and various indicators was also analyzed. RESULTS: Between HbA1c≥7% group and HbA1c<7% group, the differences in LLT (P=0.003), MGP (P<0.001), MGYLS (P=0.014) and TBUT (P=0.015) were all statistically significant. Compared with the non-diabetic group, LLT (P=0.020), MBP (P<0.001), MGYS (P< 0.001), TBUT (P<0.001), SIT (P=0.001), TMH (P=0.017) and LOM (P<0.001) were significantly different in HbA1c≥7% group, while the differences of MBP (P=0.031), MGYSS (P<0.001), SIT (P=0.001) and LOM (P<0.001) in HbA1c≤7% group were statistically significant. Besides, the prevalence of MGD in HbA1c≥7% group was evidently higher than that in non-diabetic group (P=0.002). Correlation analysis showed that HbA1c was significantly associated with the LTT and MGP. CONCLUSION: HbA1c≥7% is likely to result in meibomian gland function dysfunctions in T2DM patients, especially related to LLT and MGP.

Who and how many can work from home? Evidence from task descriptions.

The Covid-19 crisis has forced great societal changes, including forcing many to work from home (WFH) in an effort to limit the spread of the disease. The ability to work from home has long been considered a perk, but we have few estimates of how many jobs are actually possible to be performed from home. This paper proposes a method to estimate the share of these jobs. For each occupation, we obtain a WFH friendly measure by asking respondents from Amazon Mechanical Turk (MTurk) to evaluate whether the corresponding tasks can be performed from home based on the descriptions from the International Standard Classification of Occupations 2008 (ISCO-08) standard. The share of WFH friendly jobs in an economy can then be estimated by combining these measures with the labor statistics on occupational employments. Using Norway as an illustrating example, we find that approximately 38% of Norwegian jobs can be performed from home. The Norwegian results also suggest that the pandemic and the government's attempts to mitigate this crisis may have a quite uneven impact on the working population. Those who are already disadvantaged are often less likely to have jobs that can be performed from home.

Reduction of Ocular Surface Damage and Bacterial Survival Using 0.05% Povidone-Iodine Ocular Surface Irrigation before Cataract Surgery.

BACKGROUND: To investigate the effects of 0.05% povidone-iodine (PI) irrigation on the ocular surface structure and bacterial survival rate in patients with cataract. METHODS: Ninety eyes of 90 patients with cataract were included. Before surgery, the operative field was irrigated with 0.05% PI and divided into 30-s, 1-, and 2-min groups. Anterior chamber fluid was cultured bacteriologically. Tear film breakup time (BUT), corneal fluorescein staining (CFS), lacrimal river height (LRH), and Schirmer test I (STI) were conducted to assess ocular surface. RESULTS: In all groups, the patients had significantly shorter postoperative BUT at 1 day, 3 days, and 1 week postoperatively than preoperatively. In addition, there was still lower BUT at 1 month postoperatively in the 1- and 2-min groups. STI and LRH were all decreased postoperatively at different time points (1 day, 3 days, 1 week), while CFS was increased. With the extension of time preoperatively (1 and 3 months), the ocular surface indicators returned to the preoperative level. The bacterial cultures after eye irrigating were negative in all groups. CONCLUSION: 0.05% PI irrigating the conjunctival sac for 30 s can achieve a low bacterial contamination rate. Importantly, it reduced the damage of ocular surface, which is beneficial to the recovery of ocular surface function.

Combined phacoemulsification, 23-gauge pars plana vitrectomy with internal limiting membrane peeling and gas tamponade for patients with coexisting idiopathic macular hole and age-associated cataract.

The aim of the present study was to assess the curative effect of combined phacoemulsification, 23-gauge pars plana vitrectomy with Brilliant blue G-assisted limiting membrane peeling and gas tamponade in patients with coexisting idiopathic macular hole (IMH) and age-associated cataract. A total of 21 consecutive patients (21 eyes) with coexisting IMH and age-associated cataract were enrolled in the study. All patients were treated by 23-gauge microincision vitrectomy with internal limiting membrane peeling, gas tamponade and combined phacoemulsification. The pre-operative MH diameter, MH index and best-corrected visual acuity (BCVA), as well as events of post-operative MH closure and complications were recorded and analyzed. Anatomic closure of the MH was achieved in 19 eyes (90.4%) with a single surgery. The LogMAR BCVA value at 1 month after surgery and the final follow-up visit was significantly lower than the baseline value (P=0.0036 and P=0.0015, respectively). A significant correlation was identified between the MH index and the post-operative LogMAR BCVA (r=0.869; P<0.001). The combined technique applied in the present study produced favorable anatomic and functional results for patients with coexisting IMH and age-associated cataracts. The pre-operative MH size measured by optical coherence tomography may serve as a predictive factor for the LogMAR BCVA value following MH surgery.

Cataract surgery combined with micro-incision vitrectomy in patients with behcet's disease uveitis.

BACKGROUND: This study sought to report the outcomes of a combined cataract extraction, intraocular lens (IOL) insertion and micro-incision vitrectomy (MIVS) procedure for the treatment of Behcet uveitis. METHODS: This investigation involved the retrospective evaluation of a case series of patients with Behcet uveitis who underwent cataract extraction, IOL insertion and MIVS in a single surgical session at the same institution between January 2013 and November 2016. Outcome measures included visual acuity, inflammatory reaction, systemic anti-inflammatory medications, intraocular pressure (IOP) and complications. RESULTS: Seven eyes of seven patients with a mean age of 39.00 ± 5.54 years (range, 32 to 48 years) and a mean follow-up duration of 13.57 ± 5.83 months (range, 6 to 24 months) were studied; five patients with a history of well-controlled uveitis were included. All patients underwent cataract extraction and IOL implantation combined with MIVS. All patients received postoperative steroids, which were slowly tapered during the weeks after surgery. There were no significant complications related to the surgery. Overall, best-corrected visual acuity (BCVA) was improved from log MAR (logarithm of the minimum angle of resolution) 1.67 ± 0.67 preoperatively to log MAR 0.74 ± 0.35 postoperatively; this improvement was statistically significant (p < 0.05). All eyes were deemed quiet at follow-up, and no patients required the escalation of therapy for long-term uveitis control. CONCLUSIONS: This retrospective series indicates that a procedure that combines phacoemulsification, IOL implantation and MIVS is a feasible technique for the removal of cataracts and pathologic vitreous in eyes with Behcet uveitis. This approach can restore vision without obvious complications.

Thymosin α1 plus routine treatment inhibit inflammatory reaction and improve the quality of life in AECOPD patients.

CONTEXT: Thymosin α1 (Tα1) is considered to be a promising immunomodulatory drug and could balance immunity and tolerance in immune tolerance and autoimmunity. OBJECTIVE: To explore the efficacy of Tα1 plus routine complex treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Eighty-four AECOPD patients were enrolled and randomized into an experimental group and a control group. All patients received the routine treatment. Additionally, the experimental group received subcutaneous injections of Tα1 while the control group received placebo. Four weeks later, the curative effect of treatment and immune function of both groups were analyzed. RESULTS: Partial pressures of oxygen (PaO2), PaCO2, and pulmonary function of the experimental group improved after treatment compared to that recorded prior to treatment and that observed for the control group (p < 0.01, both). The CD4(+) T cell count, serum interferon (IFN)-γ levels, and the ratios of CD4(+)/CD8(+) and IFN-γ/interleukin (IL)-4 increased in both groups (p < 0.01), while the CD8(+) T cell count and levels of IL-4, IL-8, and leukotrienes B4 (LTB4) decreased as expected (p < 0.01). Meanwhile, the above-mentioned indices of the experimental group improved significantly compared to the indices of the control group (p < 0.05 or 0.01). CONCLUSIONS: Tα1 plus routine treatment could improve the immune function of AECOPD patients and inhibit the inflammatory reaction, thus reducing the recurrence of chronic obstructive pulmonary disease (COPD).

Role of integrin-linked kinase in drug resistance of lung cancer.

OBJECTIVE: The objective of the present investigation was to investigate the role of integrin-linked kinase (ILK) in the gemcitabine-resistant lung cancer cell line A549 and explore the underlying mechanism. MATERIALS AND METHODS: Gemcitabine-resistant A549 (A549/GemR) cell line was established by pulse-exposed to moderate concentration of gemcitabine (Gem), and the drug resistant index was measured by MTT assay. Expression of ILK in A549/GemR cell line was detected by Western blot and real-time PCR. An ILK gene-silencing cell line was constructed using lentivirus-coated ILK shRNA. MTT assay was used to detect the drug sensitivity of the A549/GemR cell line to Gem after the ILK gene silencing. Western blot was used to measure the expression of E-cadherin, fibronectin, and MRP1 (multidrug resistance-associated protein 1) after silencing the ILK gene. RESULT: The drug resistance index of A549/GemR was 13.5, and the messenger RNA and protein level of ILK was increased in A549/GemR. IC50 (half maximal inhibitory concentration) decreased from 14.69 to 4.13 mg/L when ILK was knocked down in A549/GemR. The expression of fibronectin and MRP1 was upregulated and E-cadherin expression was downregulated in A549/GemR, and these changes were reversed after ILK was knocked down. CONCLUSION: ILK was involved in drug resistance to Gem in lung cancer, and this function may be mediated by epithelial-mesenchymal transition and the MRP1 pathway.

Comparison of pemetrexed and docetaxel as salvage chemotherapy for the treatment for nonsmall-cell lung cancer after the failure of epidermal growth factor receptor-tyrosine kinase inhibitors.

OBJECTIVE: To compare the therapeutic effects and adverse reactions of pemetrexed and docetaxel as salvage chemotherapy in patients with nonsmall-cell lung cancer (NSCLC) after the failure of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI). METHODS: In this randomized Phase 2 trial, patients with NSCLC who had previously failed EGFR-TKI therapy were randomized to receive intravenous pemetrexed (500 mg/m(2) for 21 days [one cycle]) or docetaxel (75 mg/m(2) for 21 days [one cycle]). Therapeutic effects were evaluated according to Response Evaluation Criteria in Solid Tumours standards and adverse effects were evaluated according to the US National Cancer Institute Common Terminology Criteria for Adverse Events. RESULTS: There was no statistically significant difference in disease control rate, response rate, median survival and 1-year survival between treatment groups. Rates of nausea, myelosuppression, renal damage and hair loss were significantly higher in the docetaxel group than the pemetrexed group. CONCLUSION: Pemetrexed is effective and well tolerated as salvage chemotherapy in patients with NSCLC after EGFR-TKI failure and may be a suitable therapeutic option in these patients.