It remains controversial whether tumor necrosis factor (TNF)-α antagonism is effective for asthma. This meta-analysis was performed to evaluate efficacy of TNF-α antagonism in treatment of patients with asthma. MEDLINE, EMBASE, LILACS, and CINAHL databases were searched for English-language studies published through January 3, 2010. Randomized-controlled trials comparing TNF-α antagonism with control therapy were selected. For each report, data were extracted in relation to the outcomes analyzed: asthma exacerbation, asthma quality of life questionnaire scores, and forced expiratory volume in 1 second. Four assessable trials were identified including 641 patients with asthma. TNF-α antagonism therapy was superior to control therapy in preventing exacerbations in asthmatics [pooled odds ratio 0.52 (95% confidence interval 0.29-0.88), P=0.02]; however, there was a nonsignificant reduction in asthma quality of life questionnaire scores [0.23 (0 to 0.47), P=0.05], forced expiratory volume in 1 second [0.03, (-0.14 to 0.10), P=0.74] when analyzed using standardized mean differences. TNF-α antagonism was superior to control chemotherapy in terms of asthma exacerbation, but not asthma quality of life questionnaire scores or forced expiratory volume in 1 second.

Objective To evaluate the effect of clinical pathway in pulmonary thrombus embolism (PTE) .Methods 60 cases of PTE were admitted department of respiratory from 2011 to 2012 and divided into the experimental group and the control group ,30 cases for each group .The control group was implemented with normal process of hospital management while experimental group de-veloped clinical pathways .The efficacy ,department of respiratory drug costs ,complications and patient satisfaction were recorded and computed .Results The average department of respiratory and drug costs in experimental group respectively was (17 .13 ± 2 .22)days ,(16 545 .04 ± 1 557 .44) RMB and (7 050 .83 ± 372 .74) RMB ;less than (19 .77 ± 3 .41)day ,(17 709 .45 ± 1 902 .05) RMB and (7 345 .75 ± 450 .82) RMB in control group ,there were significant difference between the two groups (P<0 .05) .The satisfaction scores of experimental group and the control group respectively were (93 .47 ± 3 .88)sores and (90 .90 ± 5 .30)scores , there was significant difference between the two groups (P<0 .05) .The therapeutic effect and complication rates between experi-mental group and control group were no significant difference (P>0 .05) .Conclusion The effect of clinical pathway in PTE have a positive role in reducing hospitalization time ,total costs ,drug costs and increasing satisfaction ,it is worth to develop in primary hos-pital .

Objective To evaluate the role of interleukin-5 (IL-5) in the pathogenesis of allergic asthma, we observed the effects of recombinant human (rh) IL-5 inhalation on changes of activity and number of circulating eosinophils in allergic asthmatics, as well as concentrations of serum IgE.Methods A randomized double-blind, placebo-controlled study design was employed in each subject which acted as his or her own control. Eight nonsmoking asthmatics were enrolled in this study. All paients had mild atopic asthma, with baseline forced expiratory volume in 1 second (FEV1) greater than 70% of predicted value, requiring only intermittent use inhaled β2-agonists. Each paitent had one or more documented positive skin prick test responses to aeroallergens. None had received inhaled or oral corticoseroids in the previous 3 months. Each subject inhaled 10 μg of rhIL-5 (Genzyme Co., Boston, MA) in vehicle (0.1% bovine serum albumin in 0.9% saline) or vehicle only as a 0.5 ml nebulized solution. At least 4 weeks were allowed to elapse between the two inhalation, and the order of inhalation of rhIL-5 or vehicle was randomized. Measurements of total nuclear blood cell counts and cell differntial counts, and concentrations of eosinophil cationic protein (ECP) were performed before, and at 2, 24, and 48 h after the inhalation of rhIL-5 or vehicle. Levels of ECP in serum were determined with commercially available ECP Fluoroimmunoassay kits (Pharmacia AB, Uppsals, Sweden) according to the procedures recommended by the manufactures. All data were presented as mean±standard error of mean. Statistical analysis was done by repeated measures analysis of variance (ANOVA) for data conforming to a normal distribution, and by Friedman's test for those data with a nonparametric distribution.Results Eosinophil numbers and ECP levels within the control group did not appear to change from baseline at any time throughout the study. Eosinophil numbers from baseline (3.6±1.1×105/ml) to 6.3±1.2×105/ml (P<0.01) at 24 h, and to 5.7±0.9×105/ml (P<0.01) at 48 h after IL-5 inhalation. Accompanying this significant blood eosinophilia was a significant elevation of serum ECP levels. Compared with baseline value (6.3±1.1 pg/ml), inhalation of IL-5 lead to ECP levels in crease with time, reaching a significant hight extent at 24 h (17.6±2.8 pg/ml, P<0.01); And this elevated ECP levels lasted at least 48 h (18.1±2.9 pg/ml, P<0.01). However, IL-5 inhalation had no significant effect of levels of serum total IgE.Conclusions The findings in the present study provided direct evidence the IL-5 not only induced a significant blood eosinophilia, but also resulted in the activation of circulating eosinophils. Our data further support the importance of IL-5 in the pathogenesis of brochial asthma in human.

It remains controversial whether tumor necrosis factor (TNF)-α antagonism is effective for asthma.This meta-analysis was performed to evaluate efficacy of TNF-α antagonism in treatment of patients with asthma.MEDLINE,EMBASE,LILACS,and CINAHL databases were searched for English-language studies published through January 3,2010.Randomized-controlled trials comparing TNF-α antagonism with control therapy were selected.For each report,data were extracted in relation to the outcomes analyzed:asthma exacerbation,asthma quality of life questionnaire scores,and forced expiratory volume in 1 second.Four assessable trials were identified including 641 patients with asthma.TNF-α antagonism therapy was superior to control therapy in preventing exacerbations in asthmatics [pooled odds ratio 0.52 (95％ confidence interval 0.29-0.88),P=0.02]; however,there was a nonsignificant reduction in asthma quality of life questionnaire scores [0.23 (0 to 0.47),P=0.05],forced expiratory volume in 1 second [0.03,(-0.14 to 0.10),P=0.74] when analyzed using standardized mean differences.TNF-α antagonism was superior to control chemotherapy in terms of asthma exacerbation,but not asthma quality of life questionnaire scores or forced expiratory volume in 1 second.

BACKGROUND: Lung cancer is the second most common cancer worldwide, with non-small-cell lung cancer (NSCLC) accounting for the majority of cases. Patients with NSCLC have achieved great survival benefits from immunotherapies targeting immune checkpoints. Glucocorticoids (GCs) are frequently used for palliation of cancer-associated symptoms, as supportive care for non-cancer-associated symptoms, and for management of immune-related adverse events (irAEs). The aim of this study was to clarify the safety and prognostic significance of glucocorticoid use in advanced patients with NSCLC treated with immune checkpoint inhibitors (ICIs). METHODS: The study searched publications from PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, Chinese National Knowledge Infrastructure, Wanfang Data, and Chinese Science and Technology Journal Database up to March 1st, 2022, and conducted a meta-analysis to assess the effects of glucocorticoid use on overall survival (OS) and progression-free survival (PFS) in NSCLC patients treated with ICIs through the available data. The study calculated the pooled hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: This study included data from 25 literatures that were mainly retrospective, with 8713 patients included. Patients taking GCs had a higher risk for tumor progression and death compared with those not taking GCs (PFS: HR = 1.57, 95% CI: 1.33-1.86, P <0.001; OS: HR = 1.63, 95% CI: 1.41-1.88, P <0.001). GCs used for cancer-associated symptoms caused an obviously negative effect on both PFS and OS (PFS: HR = 1.74, 95% CI: 1.32-2.29, P <0.001; OS: HR = 1.76, 95% CI: 1.52-2.04, P <0.001). However, GCs used for irAEs management did not negatively affect prognosis (PFS: HR = 0.68, 95% CI: 0.46-1.00, P = 0.050; OS: HR = 0.53, 95% CI: 0.34-0.83, P = 0.005), and GCs used for non-cancer-associated indications had no effect on prognosis (PFS: HR = 0.92, 95%CI: 0.63-1.32, P = 0.640; OS: HR = 0.91, 95% CI: 0.59-1.41, P = 0.680). CONCLUSIONS In advanced NSCLC patients treated with ICIs, the use of GCs for palliation of cancer-associated symptoms may result in a worse PFS and OS, indicating that they increase the risk of tumor progression and death. But, in NSCLC patients treated with ICIs, the use of GCs for the management of irAEs may be safe, and the use of GCs for the treatment of non-cancer-associated symptoms may not affect the ICIs' survival benefits. Therefore, it is necessary to be careful and evaluate indications rationally before administering GCs in individualized clinical management.
Humans ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Glucocorticoids/therapeutic use* ; Immune Checkpoint Inhibitors/therapeutic use* ; Lung Neoplasms/drug therapy* ; Retrospective Studies