The diagnosis value of endobronchial ultrasound transbronchial lung biopsy combined with rapid on-site evaluation in peripheral lung cancer.

INTRODUCTION: Rapid on-site evaluation (ROSE) has the potential to increase endobronchial ultrasound transbronchial lung biopsy with guide sheath (EBUS-GS-TBLB) accuracy in the diagnosis of peripheral lung cancer. However, studies have reported controversial results. OBJECTIVES: The aim of the study was to evaluate the diagnosis value of EBUS-GS-TBLB combination with ROSE in peripheral lung cancer. METHODS: A total of 138 patients undergoing EBUS-GS-TBLB and ultimately diagnosed with lung cancer were allocated into the ROSE group and non-ROSE group. The result of the diagnostic yields, number of biopsy sites, the complication, cytopathological diagnostic cost and procedure times of EBUS-GS-TBLB with ROSE and without ROSE were compared. RESULTS: The diagnostic yields of TBLB were 87.8% and 78.1% in ROSE group and non-ROSE group, respectively (P < .05). The number of biopsy, procedure times and the percentage of the complication in ROSE group was significantly lower than in non-ROSE group (P < .05, respectively). The cytopathological diagnostic cost of ROSE group was lower compared with non-ROSE group (P < .05). CONCLUSIONS: EBUS-GS-TBLB combined with ROSE could be helpful to diagnose peripheral lung cancer, and could reduce the number of biopsy, procedure times, cytopathological diagnostic cost and complication.

Long noncoding RNA AK089579 inhibits epithelial-to-mesenchymal transition of peritoneal mesothelial cells by competitively binding to microRNA-296-3p via DOK2 in peritoneal fibrosis.

Peritoneal fibrosis (PF) represents a well-recognized complication associated with continuous ambulatory peritoneal dialysis therapy, characterized by a reversible epithelial-to-mesenchymal transition (EMT) at the early stage. The aim of the current study was to investigate the effects linked with the long noncoding RNA (lncRNA) AK089579 on the EMT of peritoneal mesothelial cells (PMCs) as well as the associated regulatory mechanisms of AK089579 downstream of tyrosine kinase 2 (DOK2) and microRNA-296-3p (miR-296-3p). Enrichment analysis, gene intersection association analysis, and a gene-gene intersection network were initially constructed to ascertain whether AK089579 regulated the expression of DOK2 through the mediation of miR-296-3p via the Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway in PF. After the PF mouse model had been constructed, the expression of the proteins associated with the JAK2/STAT3 signaling pathway and EMT and PMC migration and invasion were all determined accordingly. Based on the obtained results, AK089579 was determined to function as a competing endogenous RNA for miR-296-3p while acting to up-regulate the expression of DOK2, which is a target gene of miR-296-3p. AK089579 was detected to confer an inhibitory effect on the activation of the JAK2/STAT3 signaling pathway, whereby the migration and invasion of PMCs among the mice models were suppressed. Meanwhile, up-regulated miR-296-3p and down-regulated DOK2 produced contrasting effects when compared with the aforementioned findings. Treatment with wp10066, a JAK2/STAS3 signaling pathway inhibitor, was shown to reverse the effects exerted by up-regulated miR-296-3p. Taken together, the central findings of the current study present evidence highlighting the capability of the lncRNA AK089579 to bind competitively to miR-296-3p and indirectly enhance the expression of DOK2, which in turn suppresses the activation of the JAK2/STAT3 signaling pathway, whereby the EMT, migration, and invasion of PMCs was inhibited in PF.-Zhang, X. W., Wang, L., Ding, H. Long noncoding RNA AK089579 inhibits epithelial-to-mesenchymal transition of peritoneal mesothelial cells by competitively binding to microRNA-296-3p via DOK2 in peritoneal fibrosis.

Diagnostic value of serum dihydrodiol dehydrogenase 2 levels in patients with non-small-cell lung cancer.

OBJECTIVES: Dihydrodiol dehydrogenase 2 (DDH2) plays an important role in pathogenesis of non-small-cell lung cancer (NSCLC). This study aimed to evaluate the value of serum DDH2 levels in NSCLC patients. METHODS: Serum samples were obtained from 863 NSCLC patients and 439 healthy controls. The samples were randomly divided into a training set and a test set. Serum DDH2 levels were assayed by enzyme-linked immunosorbent assay (ELISA). RESULTS: The levels of DDH2 in NSCLC patients were significantly higher than those in healthy controls ( P < 0.001). The diagnostic use of DDH2 in lung adenocarcinoma was significantly greater than that of carcinoembryonic antigen, cytokeratin 19 fragment (CYFRA21-1), and carbohydrate antigen 125 ( P < 0.001). Combining DDH2 with carcinoembryonic antigen, CYFRA21-1, and carbohydrate antigen 125 was more effective for lung adenocarcinoma diagnosis than DDH2 alone. In addition, the levels of DDH2 could contribute to the diagnosis of lung squamous cell carcinoma. CONCLUSIONS: The measurement of serum DDH2 is a valuable diagnostic marker for NSCLC patients.

Topotecan alleviates ventilator-induced lung injury via NF-κB pathway inhibition.

OBJECTIVE: We investigated the effect of topotecan on injury and inflammation in a model of ventilator-inducedlunginjury (VILI). METHODS: Acute lung injury (ALI) was induced in mice by high-tidal volume ventilation, and the mice were then treated with topotecan or PBS. Lung tissue and bronchoalveolar lavage fluid were collected to assess pulmonary vascular leaks, inflammation, and cell apoptosis. RESULTS: Compared to PBS treatment, topotecan significantly decreased the ALI score, myeloperoxidase (MPO) content, total protein concentration, and presence of inflammatory cells and inflammatory cytokines in bronchoalveolar lavage fluid. Topotecan also reduced caspase-3 activation and type Ⅱ alveolar epithelial cell apoptosis. Moreover, topotecan inhibited NF-κB expression and activation in the VILI model. CONCLUSION: Topotecan alleviates acute lung injury in the model of VILI through the inhibition of the NF-κB pathway.

Diagnostic and prognostic value of serum Cripto-1 in patients with non-small cell lung cancer.

INTRODUCTION: Cripto-1 (CR-1) is a member of the epidermal growth factor (EGF)-CFC protein family, which is involved in tumor pathogenesis. OBJECTIVES: This study aimed to explore the diagnostic and prognostic value of serum CR-1 level in patients with non-small cell lung cancer (NSCLC). METHODS: Serum specimens from 312 NSCLC patients and 120 healthy controls were collected. Serum CR-1 level was measured using enzyme-linked immunosorbent assay. RESULTS: The serum CR-1 level was significantly elevated in NSCLC patients compared with healthy controls (P < .001). Higher serum CR-1 level was associated with advanced TNM stage, lymph node metastasis and distant metastasis. With a cutoff value of 1.67 ng/mL, CR-1 showed a good diagnostic performance for NSCLC. Kaplan-Meier log rank analysis revealed that the low serum CR-1 patients had a better overall survival (OS) and progression-free survival (PFS) compared with high CR-1 patients (P = .004 and .001, respectively). Further univariate and multivariate Cox regression analyses showed that serum CR-1 level was an independent risk factor of prognosis of NSCLC patients. CONCLUSIONS: Our study suggests that serum CR-1 level is a useful diagnostic and prognostic marker for NSCLC patients.

Diagnosis value of serum soluble B7-H4 expression in non-small cell lung cancer.

INTRODUCTION: B7-H4, a member of the inhibitory B7 family, can restrain T cell proliferation, activation, cytokine secretion, and may be involved in immune evasion in cancer patients. OBJECTIVES: This aim of the study was to determine the expression level of soluble B7-H4 (sB7-H4) in circulation and to subsequently evaluate the clinical significance of circulating sB7-H4 in patients with non-small cell lung cancer (NSCLC). METHODS: Serum specimens from 128 patients with NSCLC, 100 healthy volunteers (HV), and 80 patients with benign lung diseases (BLD) were collected. The concentrations of sB7-H4 were measured by sandwich enzyme-linked immunosorbent assay. RESULTS: Serum sB7-H4 levels in patients with NSCLC were significantly higher than those in patients with BLD (P < 0.05), or those in HV (P < 0.05). Using a cutoff of 27.8 ng/mL, the sensitivity and specificity of sB7-H4 in differentiating between patients with NSCLC and patients with BLD, and between patients with NSCLC and HV was, 46.9% and 92.5%, and 54.7% and 95.0%, respectively. An area under the curve (AUC) for NSCLC resulting from sB7-H4 (0.863), which was significantly better than any other tumour markers tested including CA125 (0.763), and CEA (0.775). CONCLUSION: In conclusion, assessment of serum sB7-H4 levels could be considered as a diagnostic biomarker for NSCLC.

The value of macrophage inhibitory cytokine-1 level in differentiating benign from malignant solitary pulmonary nodules.

INTRODUCTION: Macrophage inhibitory cytokine-1 (MIC-1), a transforming growth factor-ß superfamily cytokine, is involved in tumor pathogenesis, and its measurement can be used as a clinical tool for the diagnosis of a wide range of cancers. OBJECTIVES: The aim of this study was to explore the diagnostic value of serum MIC-1 in patients with solitary pulmonary nodules (SPNs). METHODS: Serum specimens from 158 malignant SPN patients, 110 benign SPN patients, along with 120 healthy volunteers. The levels of serum MIC-1 were measured by sandwich enzyme-linked immunosorbent assay. RESULTS: Serum levels of MIC-1 in malignant SPN patients were significantly higher than those in benign SPN patients (P < .01), or those in healthy volunteers (P < .01). With a cutoff of 685.8 pg/ml, the sensitivity and specificity of MIC-1 in differentiating between malignant SPN patients and benign SPN patients, and between malignant SPN patients and healthy volunteers was, 56.3% and 92.7%, and 65.8% and 96.7%, respectively. An area under the curve (AUC) for malignant SPN resulting from MIC-1, which was significantly better than any other tumor markers tested including carbohydrate antigens 12-5 (CA125), and carcinoembryonic antigen (CEA). CONCLUSIONS: In conclusion, measurement of serum MIC-1 levels could be considered as a diagnostic biomarker for malignant SPN patients.

Gemcitabine in Combination with a Second Cytotoxic Agent in the First-Line Treatment of Locally Advanced or Metastatic Pancreatic Cancer: a Systematic Review and Meta-Analysis.

BACKGROUND: It remains controversial whether the addition of a second cytotoxic agent can further improve the therapeutic effect of gemcitabine monotherapy in advanced or metastatic pancreatic cancer (LA/MPC). OBJECTIVE: The objective of the present systematic review and meta-analysis was to investigate the efficacy and safety of gemcitabine-based doublet chemotherapy regimens compared to single-agent gemcitabine in the first-line treatment of unresectable LA/MPC. METHODS: We searched for randomized controlled trials (RCTs) of gemcitabine monotherapy versus gemcitabine in combination with a second cytotoxic agent in patients with LA/MPC. The last search date was December 31, 2016. RESULTS: Twenty-seven RCTs were identified and included in the present systematic review and meta-analysis, involving a total of 7343 patients. The meta-analysis showed that gemcitabine-based combination therapy significantly improved overall survival (OS) (HR: 0.89; 95% confidence interval (CI): 0.85-0.94; P < 0.0001), progression-free survival (PFS) (HR: 0.80; 95% CI: 0.73-0.88; P < 0.0001), and overall response rate (ORR) (RR: 1.83; 95% CI: 1.62-2.07; P < 0.0001) in comparison to single-agent gemcitabine. Subgroup analysis suggested that the antitumor activity differed between gemcitabine-based combination regimens: doublet regimens of gemcitabine plus a taxoid, and gemcitabine plus a fluoropyrimidine, in particular an oral fluoropyrimidine, resulted in a significant OS benefit for the patients. However, the combination of gemcitabine with other cytotoxic agents, such as platinum compounds or topoisomerase inhibitors failed to reduce the mortality risk. Combination therapy caused more grade 3/4 toxicities, including neutropenia, thrombocytopenia, vomiting, diarrhea, and fatigue. CONCLUSIONS: Gemcitabine-based doublet regimens demonstrated superiority over gemcitabine monotherapy in overall efficacy, but were associated with increased toxicity. Different gemcitabine-based combinations showed different antitumor activity, and doublet regimens of gemcitabine in combination with a taxoid or a fluoropyrimidine, in particular an oral fluoropyrimidine provided significant survival benefits in the first-line treatment of unresectable LA/MPC.

Serum Cripto-1 is a novel biomarker for non-small cell lung cancer diagnosis and prognosis.

INTRODUCTION: Cripto-1 (CR-1) is highly expressed in several different types of human tumors. However, the clinical significance of CR-1 expression in serum specimens from non-small cell lung cancer (NSCLC) patients has not yet been determined. OBJECTIVES: The aim of this study was to explore the diagnostic and prognostic value of serum CR-1 levels in patients with NSCLC. METHODS: Serum specimens from 592 NSCLC patients, 180 benign lung disease patients and 240 healthy controls were collected. The concentrations of CR-1 were measured by sandwich enzyme-linked immunosorbent assay. RESULTS: Patients with NSCLC had higher serum CR-1 levels than the controls (P < 0.01) and patients with benign lung diseases (P < 0.01). When a cutoff point of 1.8 ng/mL was selected (diagnostic specificity 95%), the diagnostic sensitivity for NSCLC is 56.8%. About 37.5% of carcinoembryonic antigen (CEA)-negative lung cancer patients were CR-1 positive at 95% specificity. In patients with stage I/II lung cancer, use of these two markers in combination results in almost 21% increase in sensitivity, at 95% specificity, compared with CEA alone. Uni-variate analysis revealed that NSCLC patients with positive CR-1 had a shorter overall survival (OS) and progression-free survival (PFS) than those with negative CR-1 [hazard ratio (HR) of 2.93, P = 0.005; HR of 2.12, P = 0.005]. Cox multi-variate analysis indicated that CR-1 was an independent prognostic indicator of PFS and OS (HR of 1.91, P = 0.006; HR of 1.82, P = 0.007). Kaplan-Meier survival curves further confirmed that patients with negative CR-1 had longer PFS and OS (P = 0.026 and P = 0.011, respectively). CONCLUSIONS: In conclusion, measurement of serum CR-1 is a useful diagnostic and prognostic marker for NSCLC patients.

Diagnostic and prognostic value of serum periostin in patients with non-small cell lung cancer.

The periostin protein is expressed in a variety of human malignancies. The aim of this study was to explore the diagnostic and prognostic value of serum periostin levels in patients with non-small cell lung cancer (NSCLC). We measured serum periostin levels by ELISA in 296 NSCLC patients, 120 benign lung diseases (BLD) patients and 160 healthy controls. The levels of serum periostin in NSCLC patients were significantly elevated compared with those in healthy controls (P < 0.001) and BLD patients (P < 0.001). Using a cutoff value of 30.87 ng/ml, the sensitivity and specificity of periostin in differentiating between NSCLC patients and BLD patients, and between NSCLC patients and healthy controls was, 48.6 and 91.7%, and 51.4 and 97.5%, respectively. Kaplan-Meier log rank analysis revealed that the higher serum periostin levels group had a poorer progression-free survival (PFS) and overall survival (OS) compared with lower periostin group (P = 0.024, P = 0.015, respectively). Further univariate and multivariate Cox regression analysis showed that serum periostin was an independent risk factor of prognosis of NSCLC patients. In conclusion, our study suggests that serum periostin could be considered as a diagnostic and prognostic marker for NSCLC patients.

Prognostic value of soluble H7-B4 in pleural effusion associated with lung cancer.

B7-H4, a member of the inhibitory B7 family, can restrain T cell proliferation, activation, and cytokine secretion and may be involved in immune evasion in cancer patients. This study aimed to evaluate the diagnostic and prognostic value of pleural effusion levels of soluble B7-H4 (sB7-H4) in lung cancer patients with malignant pleural effusion (MPE). Pleural effusion samples were collected from 98 lung cancer patients with malignant effusion and from 60 patients with nonmalignant pleural effusion. Pleural effusion concentrations of sB7-H4 were measured using sandwich enzyme-linked immunosorbent assay. Malignant effusion exhibited higher sB7-H4 levels than those in nonmalignant effusion (P < 0.01). Lung cancer patients with pleural effusion sB7-H4 levels below 35.8 ng/ml had a longer overall survival than those with higher levels (P < 0.05). By multivariate analysis, pleural effusion sB7-H4 was an independent prognostic factor in patients with MPE. In conclusion, measurement of sB7-H4 might be a useful diagnostic and prognostic value for MPE patients.

Relationship between serum irisin levels and urinary albumin excretion in patients with type 2 diabetes.

AIM: Irisin is first discovered as a potential mediator of obesity related energy homeostasis. Recent studies indicate that irisin is associated with endothelial dysfunction and atherosclerosis in patients with type 2 diabetes. Our objective was to examine the relationship between irisin and urinary albumin excretion in patients with type 2 diabetes. METHODS: 100 newly diagnosed patients with type 2 diabetes and 100 healthy subjects were selected. Serum irisin levels were measured by ELISA, and urine albumin was measured by radioimmunoassay. High resolution ultrasound was used to measure brachial artery diameter at rest, after reactive hyperemia (flow-mediated arterial dilation, FMD) and after sublingual glyceryltrinitrate. RESULTS: Patients with type 2 diabetes presented decreased irisin levels when compared to controls (14.12±3.93 versus 28.98±2.56ng/ml, P=0.015).Serum irisin levels in the microalbuminuric and macroalbuminuria subgroup were 9.89±1.56ng/ml and 5.67±1.89ng/ml, respectively, which were significantly lower than those in the normoalbuminuria (15.97±3.12ng/ml). In comparison to microalbuminuric subgroup, macroalbuminuria subgroup had lower levels of irisin. By dividing the distribution of serum irisin levels into quartiles, FMD was increased gradually with the increase of serum irisin levels (P<0.001). Multiple stepwise linear regression analysis showed that FMD (ß=0.75, P=0.002), 2-hBG (ß=-0.25, P=0.038) and UAE (ß=-0.87, P=0.008) were significantly associated with irisin. Pearson's correlation analyses showed a negative correlation between irisin and logUAE (r=-0.57) and between FMD and logUAE (r=-0.47), and positive correlations between irisin and FMD (r=0.51). CONCLUSIONS: Decreased plasma levels of irisin seem to be associated with UAE and FMD in patients with type 2 diabetes.

Diagnostic value of soluble receptor-binding cancer antigen expressed on SiSo cells and carcinoembryonic antigen in malignant pleural effusion in patients with lung cancer.

AIM: The aim of this study was to evaluate the diagnostic value of soluble receptor-binding cancer antigen expressed on SiSo cells (sRCAS1) and carcinoembryonic antigen (CEA) in lung cancer patients with malignant pleural effusion (MPE) and benign pleural effusion (BPE). METHODS: Pleural effusion samples from 118 patients were classified on the basis of diagnosis as MPE (n=60) and BPE (n=58). The concentration of sRCAS1 was determined by enzyme-linked immunosorbent assay. The CEA levels were also determined in all patients. RESULTS: Of 60 MPE patients, 50 had sRCAS1>9.7 U/mL and 54 had CEA>5.5 ng/mL. The concentration of both sRCAS1 and CEA in MPE was significantly higher compared with that in BPE (P<0.01 in both cases). With a cutoff point of 9.7 U/mL, sRCAS1 had a sensitivity of 83.3% and a specificity of 91.4% for differential diagnosis. The combined detection of sRCAS1 and CEA had a sensitivity of 98.3% and a specificity of 96.6% to distinguish MPE from BPE. CONCLUSION: The combined detection of sRCAS1 and CEA may be more valuable in the differential diagnosis between MPE and BPE.

Expression of Nemo-like kinase was increased and negatively correlated with the expression of TCF4 in lung cancers.

Nemo-like kinase (NLK), as a mitogen activated protein kinase (MAPK)-like kinase, is involved in the development of several human cancers. In this study, we explored the expression of NLK in lung squamous cell carcinoma (SCC) and adenocarcinoma tissues, and investigated the associations among NLK, ß-catenin, T-cell factor 4 (TCF4), and the clinicopathological factors of lung cancers. The expressions of NLK, ß-catenin, TCF4 were examined in 109 cases of lung cancers using immunohistochemistry method. The expression of NLK was observed in the nuclei of lung cancer tissues, and was significantly higher in lung cancer tissues than that in corresponding normal lung tissues (t = 21.636, n = 109, P < 0.001). The high expression of NLK was found in 45 cases of lung SCCs (45/49, 91.84%), which was much more than that in adenocarcinomas (38/60, 63.33%) (P = 0.001). Furthermore, the high expression of NLK was negatively correlated with TCF4 expression and positively correlated with the membranous expression of ß-catenin. In conclusion, the present study demonstrated that the expression of NLK was localized in nucleus and significantly increased in lung cancers. The expression of NLK was negatively correlated with TCF4 expression and positively correlated with ß-catenin membranous expression in lung cancers.

WITHDRAWN: Clinical significance and prognostic value of serum RCAS1 in patients with non-small cell lung cancer.

Ahead of Print article withdrawn by publisher. Receptor-binding cancer antigen expressed on SiSo cells (RCAS1) is a human tumor-associated antigen that induces cell-cycle arrest and apoptosis in cells. The aim of this study was to explore the clinical significance and prognostic value of serum RCAS1 levels in patients with non-small cell lung cancer (NSCLC). Serum specimens from 97 patients with NSCLC, 30 healthy volunteers (HVs) and 60 patients with benign lung diseases (BLD) were collected. The concentrations of RCAS1 were measured by enzyme-linked immunosorbent assay (ELISA). Serum RCAS1 levels were higher in the NSCLC group in comparison with the HV and BLD groups (p<0.001). With a cutoff point of 19.8 U/mL, RCAS1 showed a good diagnostic performance for NSCLC. Univariate analysis revealed that NSCLC patients with elevated RCAS1 levels had significantly shorter overall survival times (p=0.013). By multivariate analysis, serum RCAS1 was identified as an independent prognostic factor (p=0.003). Measurement of RCAS1 might be a useful diagnostic and prognostic marker in NSCLC.

Diagnostic value of pleural interleukin 17 and carcinoembryonic antigen in lung cancer patients with malignant pleural effusions.

Interleukin 17 (IL-17) has been found to be increased in some human cancers; however, the possible implication of IL-17 in regulating antitumor responses in lung cancer patients with malignant pleural effusions (MPE) remains to be elucidated. This study aimed to investigate the diagnostic value of pleural IL-17 and carcinoembryonic antigen (CEA) in MPE and benign pleural effusions (BPE). Pleural effusion samples from 108 patients were classified on the basis of diagnosis as MPE (n = 56) and BPE (n = 52). The concentration of IL-17 was determined by enzyme-linked immunosorbent assay (ELISA). The CEA levels were also determined in all patients. A significant difference was observed in the levels of CEA (P < 0.01) between MPE and BPE. The concentration of IL-17 in MPE was significantly higher compared to that in BPE (P < 0.01). With a cutoff point of 15.7 pg/ml, IL-17 had a sensitivity of 76.8 % and a specificity of 80.8 % for differential diagnosis. The combined detection of IL-17 and CEA had a sensitivity of 96.4 % and a specificity of 92.3 % to distinguish MPE from BPE. The combined detection of IL-17 and CEA may be more valuable in the differential diagnosis between MPE and BPE.

Efficacy and safety of Abraxane in treatment of progressive and recurrent non-small cell lung cancer patients: A retrospective clinical study.

BACKGROUND: Abraxane is a novel Cremophor-free nanoparticle paclitaxel that has been demonstrated to improve efficacy in the treatment of solid tumors. We undertook this retrospective study to evaluate the efficacy and safety of Abraxane in the progressive or recurrent non-small cell lung cancer (NSCLC) patients. METHODS: From August 2009 to April 2011, 33 patients who were diagnosed with progressive or recurrent NSCLC and treated with one or more prior platinum-based chemotherapies, were enrolled. The patients were injected with Abraxane, 260 mg/m2 , d1, and were evaluated for efficacy and safety. The treatment was repeated every three weeks unless progressive lesions or unacceptable toxicities were found. RESULTS: There were no complete response and 11 partial responses (33.3%). Patients with squamous cell carcinoma showed better responses than those with adenocarcinoma (41.7% and 21.1%, respectively). Fourteen patients had stable disease, and the disease control rate was 75.8%. The median progression-free survival was five months (95% confidence interval [CI]: 3.5-6.5). Four patients (12.1%) experienced grade 3-4 hematologic toxicities; one anemia (3.0%), two leucopenia (6.1%) and one thrombocytopenia (3.0%). Six patients (18.2%) experienced grade 3-4 non-hematologic toxicities; two abnormal hepatic functions (6.1%), one fatigue (3.0%), one peripheral neuropathy (3.0%), and two alopecia (6.1%). CONCLUSION: Recurrent and progressive NSCLC patients pretreated with platinum-based chemotherapy might benefit from Abraxane with tolerable adverse events.

[Effect of Bi-level positive airway pressure ventilator on the heart function and vascular endothelial function of patients with the overlap syndrome].

OBJECTIVE: To study the mechanism of Bi-level positive airway pressure (BIPAP) on the heart function and the vascular endothelial function of the overlap syndrome (OS). METHODS: There were 87 males and 33 females (mean age 48 ± 4, range 40 - 53 years) admitted to the Affiliated Jiangning Hospital respiratory department of Nanjing Medical University. Subjects tested with PSG were allocated to normal, OSAHS, COPD and OS groups by the result of pulmonary function testing. All persons were tested with pulmonary function (FEV(1)% of predicted, FEV(1)/FVC%, PEF%), heart function (Tei index, BNP), vascular endothelial function (ET-1, NO, AT-III) and PSG (AHI, LSaO2, the time of SaO2 < 90%). The measurements were repeated in patients with OS after BiPAP treatment and 1 month after follow-up. One-way ANOVA was used for comparison between 2 groups. Post-hoc multiple comparisons of means were performed by using LSD. Paired-samples t Test was used for comparison of data between baseline and post-treatment. RESULTS: The FEV(1)% of predicted, FEV(1)/FVC%, and PEF% in the OS group were significantly lower than the those in the other groups (F = 215.47 - 681.65, P < 0.05). The vascular endothelial function was impaired more severely than the other groups (F = 46.60 - 259.12, P < 0.05). The heart function, pulmonary function, and vascular endothelial function were significantly improved after BiPAP treatment (t = -17.13 - 42.06, P < 0.05). CONCLUSION: The vascular endothelial dysfunction is associated with OS. Treatment by BiPAP can improve hypoxia and vascular endothelial function, and therefore may be useful in prevention of cardiovascular disease in OS.

[Cross-sectional study of current situation of glycemic control with type 1 diabetes in Guangdong Province].

OBJECTIVE: To investigate the glycemic control and the related factors of type 1 diabetic patients in Guangdong Province. METHODS: Medical records and blood samples of type 1 diabetic patients were collected in 89 tertiary and secondary hospitals from all of the 21 cities in Guangdong Province. The clinical data were analyzed to explore the correlates of glycemic control. HbA1c levels, measured in Guangdong Diabetes Center, were used to assess glycemic control. RESULTS: 851 patients were enrolled from August 6, 2010 to May 25, 2011. There were 408 males and 443 females. The median (interquartile range) age was 29.6 years (20.3 - 41.3 years). The onset age of diabetes was 25.3 years (15.7 - 35.5 years). The disease duration was 3.3 years (1.0 - 7.3 years). The BMI was 19.9 kg/m(2) (17.9 - 21.8 kg/m(2)). HbA1c levels were 8.6% (6.9% - 11.0%) and only 234 (27.50%) patients reached the age-specific target levels. Correlates with poorer glycemic control were 13 - 19 years old (vs 7 - 12 and ≥ 20 years old), lower household income, not on dietary intervention, never accepting diabetic education and shorter diabetic duration. CONCLUSION: The majority of Guangdong type 1 diabetic patients did not achieve target values for glycemic control, indicating an urgent need for comprehensive management to improve glycemic control.

[Clinical trial on standard treatment of acute organophosphorus poisoning].

OBJECTIVE: To explore the norms of treatment of acute organophosphorus pesticide poisoning (AOPP), and observe the curative effect. METHODS: On basis of the pre-research, the norms of treatment of AOPP were summarized, and a multi-center clinical trial was performed in 6 hospitals selected from high incidence of AOPP in Shandong Province. RESULTS: 422 patients of AOPP in 6 hospitals in observation period were treated and observed by the norms of treatment. Among them, the proportion of oral poisoning was 97.16%, middle and severe degree were 87.44%. Compared with themselves 2 years ago before standard treatment, the curative effect of the norms of treatment for AOPP was much better than before. The mortality rate of AOPP declined from 9.87% to 1.66% (Chi2 = 27.92, P < 0.01), that was much better than the average therapeutic effect level of all our province in the same period (the mortality rate: 8.92%) (Chi2 = 26.05, P < 0.01). The average amount of atropine [(37.54 +/- 17.76) mg], dropped greatly [(1280.70 +/- 69.22) mg] (U = 439.22, P < 0.01).The usage of atropine by continuous intravenous injection with venous pump was better than ordinary intravenous injection. The mean dosage of pralidoxime chloride increased twice than the previous (U = 19.48, P < 0.01). There was no drug poisoning. CONCLUSION: The standard treatment of AOPP is urgently needed in our country, especially in rural area. By this trial, the satisfactory effect of the norms of treatment for AOPP summarized is observed and it reduces the fatality rate remarkably.