Objective: To study the relationship between plasma level of N-terminal B-type natriuretic peptide (NT-proBNP) and ventricular diastolic dysfunction in elder hypertensive patients without target organ damage.
Methods: A total of 66 relevant patients treated in our hospital from 2012-03 to 2014-03 were studied. According to the standard of ventricular diastolic dysfunction, the patients were divided into 2 groups: Study group, n=27 patients with diastolic dysfunction and Control group, n=39 patients without diastolic dysfunction. The patients in Study group were further divided into 3 sub-groups based on Doppler classification of diastolic dysfunction:Grade 1, the patients with E/A<1.0, DT≥240 ms, IVRT>90 ms, n=8. Grade 2, the patients with E/A>1.5, DT (150-220) ms, IVRT<90 ms, n=13. Grade 3-4, the patients with E/A>1.5, DT≤150 ms, IVRT<70 ms, n=6. Plasma levels of NT-proBNP and Doppler ultrasound findings were compared to study the relationship between
NT-proBNP and ventricular diastolic dysfunction.
Results: Plasma level of NT-proBNP was higher in Study group than that in Control group. NT-proBNP level in Grade 3-4 sub-group was obviously higher than those in Grade 1 and Grade 2 sub-groups, NT-proBNP level in Grade 2 sub-group was higher than that in Grade 1 sub-group. Pearson correlation analysis indicated that NT-proBNP level was positively related to systolic blood pressure, diastolic function and E/E’ (r=0.211, P=0.037, r=0.442, P=0.004 and r=0.556, P=0.000), while negatively related to E’/A’ (r=-0.372, P=0.000).
Conclusion: The increased plasma level of NT-proBNP are highly support for ventricular diastolic dysfunction in elder hypertensive patients without target organ damage, NT-proBNP level is related to ventricular diastolic function.

Objective:To establish an individualized nomogram model to predict the risk of sarcopenia by analyzing the related factors of myopenia in elderly inpatients.Methods:Inpatients in the department of Affiliated Hospital of Qinghai University from January 2017 to December 2018, aged ≥ 60 years old, were included by the diagnostic criteria of Asian sarcopenia working group, and the independent risk factors were screened by logistic regression for the occurrence of sarcopenia. According to the independent risk factors, a nomogram model was established to predict the risk of sarcopenia. Bootstrap method was used to verify the model. C-index and calibration curve were used to evaluate the differentiation and calibration of the prediction model.Results:Totally 83 of 268 elderly patients had sarcopenia, the incidence was 30.9%. Age ( OR = 1.726, 95% CI 1.244-2.432), body mass index ( OR = 0.753, 95% CI 0.621-0.969), current smoking ( OR = 1.081, 95% CI 1.048-3.297), osteoporosis ( OR = 2.031, 95% CI 1.201-4.193) were all independent risk factors of myopenia in elderly patients. The concordance index for predicting the risk of myopenia was 0.775 (95% CI 0.722-0.827). Conclusion:Age, body mass index, osteoporosis, smoking are the independent risk factors of myopenia in elderly patients. The nomogram model can more directly evaluate the risk of sarcopenia in elderly patients.

Rearranged during transfection (RET) fusions are found in 0.7% to 2% of non-small cell lung cancer (NSCLC). Fusions between RET gene and other domains represent the distinct biological and clinicopathological subtypes of NSCLC. Recent years have witnessed the remarkable advancement of RET fusion-positive advanced NSCLC therapy. Conventional chemotherapy produced moderate clinical benefits. Prior to the introduction of targeted therapy or in the context of unavailability, platinum-based systemic regimens are initial therapy options. Immunotherapy predicted minimal response in the presence of RET fusions while currently available data have been scarce, and the single-agent immunotherapy or in combination with chemotherapy regimens are not recommended as initial systemic therapy in this population. The repurpose of multi-target kinase inhibitors in patients with RET fusion-positive NSCLC showed encouraging therapeutic activity, with only cabozantinib and vandetanib being recommended as initial or subsequent options under certain circumstances. However, there are still unmet clinical needs. Pralsetinib and selpercatinib have been developed as tyrosine kinase inhibitors (TKI) selectively targeting RET variation of fusions or mutations, and both agents significantly improved the prognosis of patients with RET fusion-positive NSCLC. Pralsetinib and selpercatinib have been established as preferred first-line therapy or subsequent therapy options. As observed with other TKIs treatment, resistance has also been associated with RET targeted inhibition, and the acquired resistance eventually affect the long-term therapeutic effectiveness, leading to limited subsequent treatment options. Therefore, it is essential to identify resistance mechanisms to TKI in RET fusion-positive advanced NSCLC to help reveal and establish new strategies to overcome resistance. Here, we review the advances in the treatment of RET fusion-positive advanced NSCLC.
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Carcinoma, Non-Small-Cell Lung/genetics* ; Humans ; Lung Neoplasms/genetics* ; Mutation ; Protein Kinase Inhibitors/therapeutic use* ; Proto-Oncogene Proteins c-ret/genetics*