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Neoadjuvant camrelizumab(an anti-PD-1 antibody)plus chemotherapy or apatinib(a VEGFR-2 inhibitor)for initially unresectable stage II–III non-small-cell lung cancer:a multicentre,two-arm,phase 2 exploratory study

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Signal Transduction and Targeted Therapy 2024年第7期9卷 3015-3023页

作者： Haoran Xia Han Zhang Zheng Ruan Huibiao Zhang Liangdong Sun Hezhong Chen Yongxin Zhou Lele Zhang Dongliang Bian Xinsheng Zhu Jing Zhang Fenghuan Sun Huansha Yu Nan Song Xiaogang Liu Yuming Zhu Haiping Zhang Wenxin He Jian Chen Jie Yang Guohan Chen Shiliang Xie Dongfang Tang Xiaomiao Zhang Liang Duan Deping Zhao Qinchuan Li Peng Zhang Gening Jiang Department of Thoracic Surgery Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina Department of Thoracic Surgery Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Thoracic Surgery Huadong Hospital Affiliated to Fudan UniversityShanghaiChina Department of Thoracic Surgery Changhai HospitalNaval Medical UniversityShanghaiChina Department of Thoracic-Cardiovascular Surgery Tongji HospitalTongji University School of MedicineShanghaiChina Central Laboratory Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina Experimental Animal Center Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina Department of Oncology Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina Department of Thoracic Surgery Shanghai East HospitalTongji University School of MedicineShanghaiChina

This multicentre,two-arm,phase 2 study aimed to explore the efficacy and safety of neoadjuvant camrelizumab plus chemotherapy or apatinib in patients with initially unresectable stage II–III non-small-cell lung cancer(NSCLC).Eligible patients regardless of PD-L1 expression received neoadjuvant camrelizumab 200 mg and platinum-doublet chemotherapy every 3 weeks(arm A)or those with PD-L1-positive tumors received neoadjuvant camrelizumab and apatinib 250 mg once daily(arm B),for 2–4 cycles,followed by *** primary endpoint was major pathological response(MPR)*** patients in arm A and 21 in arm B were *** rates were 50.0%(15/30)in arm A and 42.9%(9/21)in arm B,with all patients achieving R0 *** these patients,the MPR and pathological complete response rates were both 20.0%(95%CI 4.3–48.1)in arm A and were 55.6%(95%CI 21.2–86.3)and 11.1%(95%CI 0.3–48.2)in arm B,*** corresponding objective response rates were 33.3%(95%CI 11.8–61.6)and 55.6%(95%CI 21.2–86.3).With a median follow-up of 22.4 months(95%CI 19.0–26.0),the median event-free survival was not reached(NR;95%CI 13.6-NR)in arm A and 16.8 months(95%CI 8.6-NR)in arm *** 3 or above treatment-related adverse events occurred in eight(26.7%)patients in arm A and three(14.3%)in arm *** analysis showed baseline TYROBP expression was predictive of treatment response in arm *** camrelizumab plus chemotherapy or apatinib exhibits preliminary efficacy and manageable toxicity in patients with initially unresectable stage II–III NSCLC.

关键词： Surgery chemotherapy treatment

Clinical efficacy and mechanism study of mid-frequency anti-snoring device in treating moderate obstructive sleep apnea-hypopnea syndrome

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World Journal of Clinical Cases 2024年第5期12卷 942-950页

作者： Bao Qian Zhan-Jun Chen Yong-Sheng Wang Xiao-Yan Hu Xiao-Biao Hu Yong-Hua Zheng pulmonary medicine Shanghai Jinshan Tinglin HospitalShanghai 201505China Radiology medicine Shanghai Jinshan Tinglin HospitalShanghai 201505China

BACKGROUND Obstructive sleep apnea-hypopnea syndrome(OSAHS)is primarily caused by airway obstruction due to narrowing and blockage in the nasal and nasopha-ryngeal,oropharyngeal,soft palate,and tongue base *** mid-frequency anti-snoring device is a new technology based on sublingual nerve *** principle is to improve the degree of oropharyngeal airway stenosis in OSAHS patients under mid-frequency wave ***,there is a lack of clinical application and imaging *** We selected 50 patients diagnosed with moderate OSAHS in our hospital between July 2022 and August *** underwent a 4-wk treatment regimen involving the mid-frequency anti-snoring device during nighttime *** the treatment,we monitored and assessed the sleep apnea quality of life index and Epworth Sleepiness Scale ***,we performed computed tomo-graphy scans of the oropharynx in the awake state,during snoring,and while using the mid-frequency anti-snoring ***-sectional area measurements in different states were taken at the narrowest airway point in the soft palate posterior and retrolingual *** Compared to pretreatment measurements,patients exhibited a significant reduction in the apnea-hypopnea index,the percentage of time with oxygen saturation below 90%,snoring frequency,and the duration of the most prolonged apnea *** lowest oxygen saturation showed a notable increase,and both sleep apnea quality of life index and Epworth Sleepiness Scale scores *** computed tomography scans revealed that in OSAHS patients cross-sectional areas of the oropharyngeal airway in the soft palate posterior area and retrolingual area decreased during snoring compared to the awake ***,during mid-frequency anti-snoring device treatment,these areas increased compared to *** The mid-frequency anti-snoring device demonstrates the potential to enhance various sleep parameters in pat

关键词： Mid-frequency anti-snoring device Obstructive sleep apnea-hypopnea syndrome Sleep monitoring Oropharyngeal computed tomography Curative effect

DNA of neutrophil extracellular traps promote NF-κBdependent autoimmunity via cGAS/TLR9 in chronic obstructive pulmonary disease

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Signal Transduction and Targeted Therapy 2024年第7期9卷 3040-3055页

作者： Jun Chen Tao Wang Xiaoou Li Lijuan Gao Ke Wang Mengxin Cheng Zijian Zeng Lei Chen Yongchun Shen Fuqiang Wen Department of Respiratory and Critical Care medicine West China HospitalWest China School of Medicineand Division of Pulmonary DiseasesState Key Laboratory of BiotherapySichuan UniversityChengduSichuan 610041China

Chronic obstructive pulmonary disease(COPD)is characterised by persistent airway inflammation even after cigarette smoking *** extracellular traps(NETs)have been implicated in COPD severity and acute airway inflammation induced by short-term cigarette smoke(CS).However,whether and how NETs contribute to sustained airway inflammation in COPD remain *** study aimed to elucidate the immunoregulatory mechanism of NETs in COPD,employing human neutrophils,airway epithelial cells(AECs),dendritic cells(DCs),and a long-term CS-induced COPD mouse model,alongside cyclic guanosine monophosphate-adenosine monophosphate synthase and toll-like receptor 9 knockout mice(cGAS-^(−/−)TLR9^(−/−));Additionally,bronchoalveolar lavage fluid(BALF)of COPD patients was *** from COPD patients released greater cigarette smoke extract(CSE)-induced NETs(CSE-NETs)due to mitochondrial respiratory chain *** CSE-NETs,containing oxidatively-damaged DNA(NETs-DNA),promoted AECs proliferation,nuclear factor kappa B(NF-κB)activation,NF-κB-dependent cytokines and type-I interferons production,and DC maturation,which were ameliorated/reversed by silencing/inhibition of cGAS/*** the COPD mouse model,blocking NETs-DNA-sensing via cGAS^(−/−)and TLR9^(−/−)mice,inhibiting NETosis using mitoTEMPO,and degrading NETs-DNA with DNase-I,respectively,reduced NETs infiltrations,airway inflammation,NF-κB activation and NF-κBdependent cytokines,but not type-I interferons due to IFN-α/βreceptor *** NETs components(myeloperoxidase and neutrophil elastase activity)in BALF of COPD smokers correlated with disease severity and NF-κB-dependent cytokine levels,but not type-I interferon *** conclusion,NETs-DNA promotes NF-κB-dependent autoimmunity via cGAS/TLR9 in long-term CS exposure-induced ***,targeting NETs-DNA and cGAS/TLR9 emerges as a potential strategy to alleviate persistent airway inflammation in COPD.

关键词： inflammation TLR9 neutrophil

Severe aspiration pneumonia in the elderly

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Journal of Intensive medicine 2024年第3期4卷 307-317页

作者： Sebastian Ocrospoma Marcos I.Restrepo Division of pulmonary Diseases&Critical Care medicine University of Texas Health San AntonioSan AntonioTXUSA Section of pulmonary&Critical Care medicine South Texas Veterans Health Care SystemSan AntonioTXUSA

The global population is aging at an unprecedented rate,resulting in a growing and vulnerable elderly population in need of efficient comprehensive healthcare services that include long-term care and skilled nursing *** this context,severe aspiration pneumonia,a condition that carries substantial morbidity,mortality,and financial burden,especially among elderly patients requiring admission to the intensive care unit,has attracted greater *** pneumonia is defined as a pulmonary infection related to aspiration or dysphagia in *** episodes of coughing on food or liquid intake,a history of relevant underlying conditions,abnormalities on videofluoroscopy or water swallowing,and gravity-dependent shadow distribution on chest imaging are among the clues that suggest *** with aspiration pneumonia tend to be elderly,frail,and suffering from more comorbidities than those without this ***,we comprehensively address the epidemiology,clinical characteristics,diagnosis,treatment,prevention,and prognosis of severe aspiration community-acquired pneumonia in the elderly to optimize care of this high-risk demographic,enhance outcomes,and minimize the healthcare costs associated with this *** preventive measures and effective management strategies is vital in ensuring the well-being of our aging population.

关键词： Aspiration pneumonia Aged Critical illness Swallowing disorders Frailty Antibacterial agents

CircPMS1 promotes proliferation of pulmonary artery smooth muscle cells,pulmonary microvascular endothelial cells,and pericytes under hypoxia

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Animal Models and Experimental medicine 2024年第3期7卷 310-323页

作者： Xiaoyi Hu Shang Wang Hui Zhao Yaqin Wei Ruowang Duan Rong Jiang Wenhui Wu Qinhua Zhao Sugang Gong Lan Wang Jinming Liu Ping Yuan Department of Cardio-pulmonary Circulation Shanghai Pulmonary HospitalSchool of MedicineTongji UniversityShanghaiChina Institute of Bismuth Science University of Shanghai for Science and TechnologyShanghaiChina Department of Geriatrics Shanghai Institute of GeriatricsHuadong HospitalFudan UniversityShanghaiChina Department of Anesthesiology Shanghai Pulmonary HospitalSchool of MedicineTongji UniversityShanghaiChina

Background:Circular RNAs(circRNAs)have been recognized as significant regulators of pulmonary hypertension(PH);however,the differential expression and function of circRNAs in different vascular cells under hypoxia remain ***,we identified co-differentially expressed circRNAs and determined their putative roles in the proliferation of pulmonary artery smooth muscle cells(PASMCs),pulmonary microvascular endothelial cells(PMECs),and pericytes(PCs)under ***:Whole transcriptome sequencing was performed to analyze the differential expression of circRNAs in three different vascular cell *** analysis was used to predict their putative biological *** real-time polymerase chain reaction,Cell Counting Kit-8,and EdU Cell Proliferation assays were carried out to determine the role of circular postmeiotic segregation 1(circPMS1)as well as its potential sponge mechanism in PASMCs,PMECs,and ***:PASMCs,PMECs,and PCs exhibited 16,99,and 31 differentially expressed circRNAs under hypoxia,***1 was upregulated in PASMCs,PMECs,and PCs under hypoxia and enhanced the proliferation of vascular ***1may upregulate DEP domain containing 1(DEPDC1)and RNA polymerase II subunit D expression by targeting microRNA-432-5p(miR-432-5p)in PASMCs,upregulate MAX interactor 1(MXI1)expression by targeting miR-433-3p in PMECs,and upregulate zinc finger AN1-type containing 5(ZFAND5)expression by targeting miR-3613-5p in ***:Our results suggest that circPMS1 promotes cell proliferation through the miR-432-5p/DEPDC1 or miR-432-5p/POL2D axis in PASMCs,through the miR-433-3p/MXI1 axis in PMECs,and through the miR-3613-5p/ZFAND5 axis in PCs,which provides putative targets for the early diagnosis and treatment of PH.

关键词： circular postmeiotic segregation 1 circular RNAs hypoxia pulmonary hypertension vascular cells

Research progress of viral sepsis:etiology,pathophysiology,diagnosis,and treatment

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Emergency and Critical Care medicine 2024年第2期4卷 74-81页

作者： Jianping Li Yiqi Luo Hao Li Yunhong Yin Yi Zhang Department of pulmonary and Critical Care medicine Qilu Hospital of Shandong UniversityJinanShandongChina

Sepsis is a common systemic disease characterized by various physiological and pathological *** can result from infection by various pathogens,such as bacteria,viruses,and *** rate of culture-negative sepsis is almost 42%,indicating that most patients may have nonbacterial *** the outbreak of coronavirus disease 2019,viral sepsis has attracted growing attention because many critically ill patients develop *** sepsis can be caused by viral infections and combined with,or secondary to,bacterial *** the common types of viral sepsis and the main characteristics of its pathogenesis will be helpful for effective diagnosis and treatment,thereby reducing *** identification of the causative agent of viral sepsis can help reduce the overuse of broad-spectrum *** this article,we reviewed the common viruses of sepsis,their potential pathophysiology,targets of diagnosis,and remedies for viral sepsis.

关键词： Acute gastrointestinal injury Acute kidney injury Acute lung injury Cytokine storm Diagnosis Treatment of viral sepsis Viral sepsis

Formulation of international standards of Chinese medicine technology:clinical practice guide of Chinese medicine for cough

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Journal of Traditional Chinese medicine 2024年第2期44卷 396-402页

作者： FANG Hanyu HONG Zheng LI Deming ZHANG Hongchun SHI Yihang LI Xiaojuan SUN Zengtao CHEN Wei ZHANG Chuchu ZU Yaqi Beijing University of Chinese medicine Beijing 100029China Department of Traditional Chinese medicine for pulmonary Diseases Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029 National Center for Respiratory medicine Beijing 100029China Department of Traditional Chinese medicine for pulmonary Diseases Center of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China Tianjin University of Traditional Chinese medicine Tianjin 301617China Second Teaching Hospital of Tianjin University of Traditional Chinese medicine Tianjin 300250China Center for Evidence-based medicine Beijing University of Chinese MedicineBeijing 100029China Institute of Information on Traditional Chinese medicine China Academy of Chinese Medical SciencesBeijing 100700China

OBJECTIVE:To formulate the first clinical practice guideline for the treatment of cough using Chinese medicine based on the grading of recommendations assessment,development,and evaluation(GRADE)systematic approach,including clinical evidence,evaluation of ancient literature,and expert ***:In the process of development,the regulation of"evidence-based,consensus-assisted,and empirical"was followed,and a comprehensive systematic approach of recommendation assessment,GRADE,evidence-based evaluation,expert consensus,and the Delphi method was *** the process of guideline development,evidence-based evaluation of ancient literature was included for the first time,and clinical evidence was fully integrated with clinical expert ***:The clinical practice guidelines for the treatment of cough with Chinese herbal medicine were developed after a comprehensive consideration of evidence-based evaluation and expert *** guideline recommendations focused on recommending herbal compound decoctions and Chinese patent medicines for cough in different *** on the GRADE systematic approach,we conducted an evidence-based evaluation of the recommended Chinese patent medicines one by one;meanwhile,the expert consensus method was used to unify the recommendations of ***:Based on clinical evidence,ancient literature evaluation,and expert consensus,a clinical practice guideline for Traditional Chinese medicine(TCM)in the treatment of cough was developed,providing the first current clinical practice guideline for domestic and foreign TCM and Western medicine practitioners,especially respiratory professionals at home and abroad.

关键词： medicine Chinese Traditional clinical practice cough practice guide international standard

lmpact of non-canonical ALK fusion on the efficacy of targeted therapy in non-small cell lung cancer

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Chinese Medical Journal 2024年第12期137卷 1468-1470页

作者： Hao Zeng Qi Wei Yuan Tang Yuanyuan Zhang Sihan Tan Qin Huang Xin Pu Yalun Li Panwen Tian Department of pulmonary and Critical Care medicine West China HospitalSichuan UniversityChengduSichuan 610041China Department of Pathology West China HospitalSichuan UniversityChengduSichuan 610041China Department of pulmonary and Critical Care medicine Lung Cancer CenterWest China HospitalSichuan UniversityChengduSichuan 610041China Department of pulmonary and Critical Care medicine State Key Laboratory of Respiratory Health and MultimorbidityPrecision Medicine Key Laboratory of Sichuan ProvinceWest China HospitalSichuan UniversityChengduSichuan 610041China

To the Editor:With the wide application of next-generation sequencing(NGS),a number of EML4-ALK fusion partners or coexisting(non)-EML4-ALK and non-EML4-ALK have been detected in non-small cell lung cancer(NSCLC).Although targeted therapies for patients with metastatic NSCLC and actionable mutations dramatically change how these patients are treated,studies have demonstrated differences in progression-free survival(PFS)among patients based on different ALK fusion partners.

关键词： targeted lung NSCLC

Bronchoalveolar lavage fluid metagenomic next-generation sequencing assay for identifying pathogens in lung cancer patients

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BIOCELL 2024年第4期48卷 623-637页

作者： JIYU WANG HUIXIA LI DEYUAN ZHOU LIHONG BAI KEJING TANG Division of pulmonary and Critical Care medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Institute of pulmonary Diseases Sun Yat-sen UniversityGuangzhouChina Department of Pharmacy The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina

Background:For patients with lung cancer,timely identiﬁcation of new lung lesions as infectious or non-infectious,and accurate identiﬁcation of pathogens is very important in improving OS of *** a new auxiliary examination,metagenomic next-generation sequencing(mNGS)is believed to be more accurate in diagnosing infectious diseases in patients without underlying diseases,compared with conventional microbial tests(CMTs).We designed this study toﬁnd out whether mNGS has better performance in distinguishing infectious and non-infectious diseases in lung cancer patients using bronchoalveolar lavageﬂuid(BALF).Materials and Methods:This study was a real-world retrospective review based on electronic medical records of lung cancer patients with bronchoalveolar lavage(BAL)and BALF commercial mNGS testing as part of clinical care from 1 April 2019 through 30 April 2022 at The First Afﬁliated Hospital of Sun Yat-sen University.164 patients were included in this *** were categorized into the pulmonary non-infectious disease(PNID)group(n=64)and the pulmonary infectious disease(PID)group(n=100)groups based onﬁnal ***:BALF mNGS increased the sensitivity rate by 60%compared to CMTs(81%vs.21%,p0.1).Among the patients with PID,bacteria were the most common cause of *** infections occurred in 32%of patients,and Pneumocystis Yersini was most *** with Tyrosine kinase inhibitors(TKIs)therapy possess longer overall survival(OS)than other anti-cancer agents,the difference between TKIs and immuno-checkpoint inhibitors(ICIs)was insigniﬁcant(median OS TKIs *** ***-angiogenic *** ***=76 vs.84 vs.61 vs.58 vs.60).Conclusions:our study indicates that BALF mNGS can add value by improving overall sensitivity in lung cancer patients with potential pulmonary infection,and was outstanding in identifying Pneumocystis *** could be able

关键词： Lung cancer Bronchoalveolar lavage fluid Metagenomic next-generation sequencing Infectious diseases