Recommendations from Experts in the Management of Adverse Reactions to ALK Inhibitors (2021 Version) / 中国肺癌杂志

Anaplastic lymphoma kinase (ALK) fusion gene, as a tumor driver gene, was crucial for the occurrence and development of non-small cell lung cancer (NSCLC). Recently, targeted ALK fusion gene has become the main treatment method for ALK-positive NSCLC. The first and second generation ALK inhibitors (ALKi), such as crizotinib, ceritinib, alectinib and ensartinib have been approved in China. However, there was no guidance for the management of ALKi adverse reactions. Therefore, this "Recommendations from experts in the management of adverse reactions to ALK inhibitors (2021 version)" has been summarized, led by Lung Cancer Professional Committee of Sichuan Cancer Society and Sichuan Medical Quality Control Center for Tumor Diseases, to provide practical and feasible strategies for clinical ALKi management specification of adverse reactions.
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Hospitalization Due to Asthma Exacerbation: A China Asthma Research Network (CARN) Retrospective Study in 29 Provinces Across Mainland China

PURPOSE: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.METHODS: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.RESULTS: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.

Seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China / 中华流行病学杂志

Objective To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China.Methods This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast,north,central,east,south,northwest and southwest).The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded.The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared.Results During the study period,6 480 patients were admitted for asthma exacerbation,accounting for 3.14％ of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals.The ratio of asthmatic patients to total inpatients in the northeast area (5.61％) was highest,and the ratio in east area was lowest (1.97％).Statistical analysis showed that the difference among different areas was significant (P＜0.000 1).In most areas,both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October).In the northeast area,east area and south area,the peaks in spring were more obvious,while in the north area and southwest area,the peaks in autumn were more obvious.In the northwest area the peaks occurred in winter (December-January) and summer (June-August),respectively.The differences in hospitalization due to asthma among different months were significant in the northeast,north,and southwest areas (P＜0.005).Conclusion The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China.In most areas,more asthmatic patients were admitted to hospitals in spring and autumn.

Seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China / 中华流行病学杂志

Objective To understand the seasonal distribution of patient hospitalization due to asthma exacerbation in 7 geographic areas in China.Methods This was a retrospective study which involved patients hospitalized for asthma exacerbation in 29 hospitals throughout 7 geographic areas in the mainland of China (northeast,north,central,east,south,northwest and southwest).The numbers of asthmatic patients and total inpatients of the respiratory department of each hospital were recorded.The monthly ratio of asthmatic patients to the total inpatients in every area was calculated and compared.Results During the study period,6 480 patients were admitted for asthma exacerbation,accounting for 3.14％ of all the 206 135 patients admitted to the respiratory departments in the 29 hospitals.The ratio of asthmatic patients to total inpatients in the northeast area (5.61％) was highest,and the ratio in east area was lowest (1.97％).Statistical analysis showed that the difference among different areas was significant (P＜0.000 1).In most areas,both the number and proportion of hospitalized asthmatic patients peaked in spring (February-April) and autumn (September-October).In the northeast area,east area and south area,the peaks in spring were more obvious,while in the north area and southwest area,the peaks in autumn were more obvious.In the northwest area the peaks occurred in winter (December-January) and summer (June-August),respectively.The differences in hospitalization due to asthma among different months were significant in the northeast,north,and southwest areas (P＜0.005).Conclusion The number of patients hospitalized for asthma exacerbation fluctuated with season in different areas in China.In most areas,more asthmatic patients were admitted to hospitals in spring and autumn.

Effects of anti-endothelial cell antibody(AECA)and intervention of methylprednisolone in emphysema rats / 中国生化药物杂志

Objective To explore the effects and mechanisms of anti-endothelial cell antibody (AECA )in the alveolar cell apoptosis of the emphysema rats induced by smoking,and to discuss the intervention effects of methylprednisolone.Methods 39 male Sprague-Dawley rats were randomly divided into normal control group,model group,and intervention group,with 13 rats in each group.Emphysema models were established in the latter two groups.After exposing to cigarette smoking for one month,methylprednisolone injected intraperitoneally in the intervention group(10 mg/kg,1 time/d),6d/week.On the 90th day,inferiora vena cave blood samples were collected and all rats were sacrificed.The levels of AECA were detected in bronchial alveolar lavage fluid (BALF )and serum,respectively.Pathological changes were observed in lung tissues stained by hematoxylin eosin, quantitative determination of lung average mean linear intercept(MLI)and mean alveolar number(MAN)were preformed. Results Compared with normal group and intervention group,the levels of AECA in BALF and serum,MLI in the model group were higher(P<0.05 ),but the levels of MAN was lower (P<0.05);There is a positive correlation between AECA in BALF and MLI of rats(r=0.821,P<0.05),a negative correlation between AECA in BALF and MAN(r=-0.894,P<0.05.Conclusions ACEA may enroll the pathogenesis of emphysema in rats induced by smoking and related with the severity.Methylprednisolone may inhibit the formation of emphysema by reducing the expression level of AECA in airway.

Study on relationship between serum total IgE and β《,2》-adrenoreceptor polymorphism in asthmatic patients / 中国医师杂志

Objective To study the association between serum total IgE level and β2-adrenoreceptor polymorphism (β2-AR) in asthmatic patients. Methods ELISA was used to determine serum total IgE and AS-PCR was used to determine β2-adrenoreceptor polymor- phism in 44 asthmatic patients. Results In β2-AR 16 locus genotype, the distribution frequencies of Arg/Arg, Gly/Gly showed increasing tendency, whereas Arg/Gly showed decreasing tendency, in normal serum total IgE group and increased serum total IgE group. But there was no significant difference between this two groups. In β2- AR 27 locus genotype, the distribution frequency of Gln/Gln genotype accounts for 76.2% and Gln/Glu genotype for 19.0% in increased serum total IgE group, while Gln/Gln genotype accounts for 9.0% and Gln/Glu geno- type for 73.9% in normal serum total IgE group. There was significant difference between two groups ( P<0.01 ). Conclusions Serum total IgE was correlated with β2-AR 27 locus genetic polymorphism, which may contribute to understand the mechanism of asthma in the peo- ple of the Han nationality in GuiZhou.

Changes in blood hemorheology and early morning blood pressure in patients with obstructive sleep apnea-hypoventilation syndrome / 中华全科医师杂志

Objective To investigate changes in morning blood pressure surge (MBPS) and blood hemorheology in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS) of various severity. Methods Total 118 patients with OSHAS diagnosed at the Department of Respiratory Diseases, People's Hospital of Guizhou Province were divided into three groups, i.e. , 31 mild, 40 moderate and 47 severe cases, based on their apnea-hypoventilation index (AHI), and 25 healthy persons were selected as controls. Blood hemorheology, oxygen saturation, morning blood pressure surge of the patients, as well as percentage of the time with oxygen saturation more than 90 percent of the total monitoring time (TS90%) were recorded. Results Early morning blood pressure surge was found in 21 cases (43%) with severe, eight (20%) with moderate and one (3%) with mild OSAHS. All indicators of blood hemarheology and TS90% were significantly higher in the patients with OSAHS than those in controls (P<0.05 ), those in moderate and severe OSAHS were significantly higher than those in controls (P<0.05 ) and those in severe OSAHS was significantly higher than those in moderate and mild OSAHS (P<0.05). All indicators of blood hemorheology were significantly higher in those with early morning blood pressure surge than those without it (P<0.05). Conclusions Blood viscosity, percentage of early morning blood pressure surge and TS90% in the patients with OSAHS are increased with severity of apnea-hypoventilation, and changes in blood hemorheology correlated with early morning blood pressure surge.

The study between serum uric acid and early morning blood pressure of Obstructive sleep apnea syndrome patients / 中国实用内科杂志

Objective To study between serum uric acid and early morning blood pressure of the different degrees of Obstructive sleep apnea syndrome(OSAHS)patients.Methods134 cases of OSAHS were divided into mild,midrange and severe groups according to apnea-hypopnea index(AHI),and 23 healthy people as normal control group.serum uric acid and early morning blood pressure were measured among four groups.ResultsSerum uric acid levels in mild,midrange,severe OSAHS groups and the control group were(392.10?88.22)?mol/L,(460.14?118.86)?mol/L,(537.63?134.11)?mol/L,(304.36?80.12)?mol/L,there were significant differences among four groups.there were significant differences between severe OSAHS and the others in blood pressure,as well as between OSAHS midrange group and the control group.ConclusionSerum uric acid in OSAHS patients increased with increasing degree of AHI,the disorder of serum uric acid possiblly contribute to abnormal blood pressure in OSAHS patients.