Objective To further improve the awareness of the clinical feature of acute fibrinous and organizing pneumonia (AFOP).Methods One case of AFOP treated in our department was described in details.The relevant cases were searched in Wanfang database using key words acute fibrinous and organizing pneumonia [in Chinese].Results Four reports containing 9 cases were identified from published literature.A total of 10 cases (including this one) were analyzed.The patients included 7 males and 3 females (43 to 78 years of age).Eight patients presented with cough.Chest tightness and dyspnea were reported in 8 cases,and fever in 9 cases.Velcro crackles were heard in 4 patients.Laboratory tests showed WBC increased in 2 cases,increased neutrophil count in 6 cases,elevated C-reactive protein in 9 cases,and faster erythrocyte sedimentation rate in 8 cases.The partial oxygen pressure (PO2) ranged from 54 mmHg to 69 mmHg.Chest CT scan showed unilateral lesions in 3 cases and bilateral lesions in 7 cases initially.The main CT findings were patchy,consolidation and ground-glass opacities,sometimes associated with air bronchogram.The diagnosis was confirmed by lung biopsy in all the 10 cases.Bronchoscopy biopsy was conducted in 6 cases,and percutaneous lung biopsy in 3 cases.One patient received both bronchoscopy biopsy and percutaneous lung biopsy.Methylprednisolone was used in all cases.No patient received mechanical ventilation.One patient died.Conclusions AFOP is a new type of interstitial lung disease,the etiology of which is unknown.AFOP often occurs in middle-and old-aged patients.AFOP is easily misdiagnosed due to its unspecific clinical manifestations,which are similar to common pneumonia.The confirmation of AFOP diagnosis depends on pathological biopsy.Corticosteroids treatment is appropriate,but the dosage,duration,and long term effect of corticosteroids are not established.

Objective:To evaluate the efficacy and adverse reaction caused by Capecitabine compared with S-1 as maintenance treat-ments for patients with advanced gastric cancer (AGC) after first-line induction chemotherapy. Methods:A total of 130 AGC patients who did not suffer disease progression after first-line chemotherapies, including XELOX (four to six cycles), SOX (four to six cycles), and mFOLFOX6 regimen (six to eight cycles), were randomized into three groups. The Capecitabine group (Cap) received maintenance che-motherapy with Capecitabine (1 000 mg/m2 twice daily for 14 days, 21 days/cycle), while the S-1 group (S1) received S-1 (40, 50, or 60 mg according to the body surface area and orally administered twice a day for 14 days, 21 days/cycle). The control group was consid-ered as the observation group. Patients with maintenance treatments received drugs until disease progression or observation of intol-erant toxicity. Results:A total of 44, 33, and 53 patients received XELOX, SOX, and mFOLFOX6 regimens, respectively. The overall DCR was 63.1%. Among the 82 patients, 35, 28, and 19 belonged to the Cap, S1, and observation groups, respectively. The comparison be-tween the efficacy of treatments in the Cap and S1 groups did not show statistically significant differences (P=0.678). The median time of progression was 8.5 months in the Cap group and 9.0 months in the S1 group (P>0.05). Both groups showed better responses than the observation group, which demonstrated a median progression of 6.0 months (P<0.001). The median overall survivals were 14.5, 15.0, and 14.0 months in the Cap, S-1, and observation groups, respectively (P=0.188). The most common adverse effects observed among the patients with maintenance treatments included myelo-suppression, gastrointestinal reaction, fatigue, hand-foot syndrome, and stomatitis. No death occurred in relation to the therapy. Conclusion:The effectiveness of Capecitabine and S-1 as maintenance chemotherapies in AGC patients after the first-line induction chemotherapy are similar, and both can prolong the time of disease pro-gression with low toxicity.

OBJECTIVE To investigate the preventive effect and mechanism of simvastatin on cerebral ischemia-reperfusion injury(CIRI)in hyperlipidemic mice.METHODS Sixty C57BL/6J mice were randomly divided into Sham group,CIRI group(CIRI model was prepared by middle cerebral artery occlusion and reperfusion(MCAO/R)),hyperlipemia group(i.p poloxamer 407),hyperlipemia+CIRI group(i.p poloxamer 407,followed by MCAO/R operation after 24 h),and hyperlipemia+CIRI+simvastatin 5 and 10 mg·kg-1 groups(i.g simvastatin for 7 d,and then treated as the hyperlipemia+CIRI group).After reperfusion for 24 h,the neurological deficit score(NDS)was evaluated;the Rotarod experiment was used to determine the first drop latency;autonomous activity was used to test the hori-zontal and vertical movement frequency of mice;TTC staining was used to measure the volume of cerebral infarction;laser speckle flow imaging was used to detect cerebral blood flow in mice;the kits were used to detect total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),malondialdehyde(MDA)levels,and glutathione peroxidase(GSH-PX)levels in serum;qPCR and Western blotting were used to detect the mRNA and protein expression levels of clock genes Rev-erbα and Bmal1 in the right cerebral cortex of mice,respectively.RESULTS Compared with the Sham group,the NDS of the CIRI group was significantly increased(P<0.01),the latency period was shortened(P<0.01),and the number of activities was reduced(P<0.01);Compared with the CIRI group,the hyperlipemia+CIRI group showed aggravated neurological damage(P<0.01);the volume of cerebral infarction was significantly increased(P<0.01);the cerebral blood flow was significantly decreased(P<0.01);the levels of TC,TG,LDL-C,and MDA in serum were significantly increased(P<0.01),while the level of GSH-PX was significantly decreased(P<0.01);the mRNA and protein expression levels of Rev-erbα in the cere-bral cortex were significantly downregulated(P<0.01);the mRNA and protein expression levels of Bmal1 were significantly upregulated(P<0.01).Compared with the hyperlipemia+CIRI group,the hyper-lipemia+CIRI+simvastatin 5 and 10 mg·kg-1 groups showed reduced neurological damage(P<0.01);the volume of cerebral infarction was significantly decreased(P<0.01);the cerebral blood flow was significantly increased(P<0.01);the levels of TC,TG,LDL-C,and MDA in serum were significantly reduced(P<0.01),while the level of GSH-PX was significantly increased(P<0.01);the mRNA and protein expression levels of Rev-erbα in the cerebral cortex were significantly upregulated(P<0.01);the mRNA and protein expression levels Bmal1 were significantly downregulated(P<0.01).CONCLU-SION Prophylactic administration of simvastatin can effectively alleviate hyperlipidemia combined with cerebral ischemic injury in mice,and the mechanism is related to the regulation of blood lipid and clock gene expression.

AIM: To investigate the relationship between genotypes of rs628031, rs650284, rs683369 of SLC22A1 gene and the toxicities and clinical response of oxaliplatin in patients with colorectal cancer. METHODS: A total of 72 patients diagnosed as colorectal cancer during January 2018 to June 2018 were selected and all patients received oxaliplatin treatment. Their peripheral venous blood was collected and genotyping was conducted by using SNaPshot. The toxicities including gastrointestinal toxicity, hematological toxicity and peripheral neurotoxicity were evaluated according to the Common Terminology Criteria Adverse Events (CTCAE) Version 5.0. Clinical response was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST Version 1.1). RESULTS: The results of Chi-test showed that different genotypes of SLC22A1 SNP sites rs628031 and rs683369 may be related to the toxicities and clinical response of oxaliplatin significantly. Specifically, when compared with the patients with GG type of rs628031, the patients with the GA or AA type had a lower incidence of grade 3 nausea and vomiting (P=0.017) and may also be less responsive to efficacy (P=0.008). When compared with the patients with CC type of rs683369, the patients with the GC or GG type had a lower incidence of grade 3 nausea and vomiting (P=0.002) and may also be less responsive to efficacy (P=0.014).CONCLUSION: The polymorphisms of SLC22A1 gene are closely related to the toxicities and clinical response of oxaliplatin in patients with colorectal cancer, which may be helpful for improving clinical treatment.