1. Perioperative airway management in patients undergoing bronchoscopic treatment of tracheal stenosis
Yu SUN ; Hongwei WANG ; Taidi ZHONG ; Enguo CHEN
Chinese Journal of Anesthesiology 2019;39(9):1114-1116
Data of patients underwent bronchoscopic treatment of tracheal stenosis from May 2011 to April 2016 were collected.Patients were questioned about the medical history before operation, and the airway was fully evaluated.The laryngeal mask was used for the patients with upper 1/3 tracheal stenosis and subglottic stenosis, and endotracheal intubation was applied for the other patients.Patients with severe tracheal stenosis received extracorporeal membrane oxygenation (ECMO)-assisted ventilation.The tracheal tube or laryngeal mask was removed immediately when patients were awake and spontaneous breathing and swallowing reflex recovered after operation, and oxygen was inhaled by mask.A total of 189 patients were included in this study, 93 patients received endotracheal intubation, and 91 patients were ventilated via the laryngeal mask, and 5 patients underwent ECMO-assisted ventilation.Forty-four patients adopted the method of preserving spontaneous breathing, and the other 145 patients did not.There were 165 patients in whom the endotracheal tube or laryngeal mask was removed immediately after they were awake, and the remaining 24 cases were sent to the intensive care unit with the endotracheal tube.For the patients with tracheal stenosis, preoperative interview and airway assessment are especially important, and appropriate airway management strategies should be developed; vital signs should be closely observed during operation, and the proper ventilation mode is selected, and ECMO-assisted ventilation could be considered for the patients with severe tracheal stenosis; the timing of removal of the endotracheal tube or laryngeal mask should be seized after operation.
2.Emerging vaccine nanotechnology: From defense against infection to sniping cancer.
Chan FENG ; Yongjiang LI ; Bijan Emiliano FERDOWS ; Dylan Neal PATEL ; Jiang OUYANG ; Zhongmin TANG ; Na KONG ; Enguo CHEN ; Wei TAO
Acta Pharmaceutica Sinica B 2022;12(5):2206-2223
Looking retrospectively at the development of humanity, vaccination is an unprecedented medical landmark that saves lives by harnessing the human immune system. During the ongoing coronavirus disease 2019 (COVID-19) pandemic, vaccination is still the most effective defense modality. The successful clinical application of the lipid nanoparticle-based Pfizer/BioNTech and Moderna mRNA COVID-19 vaccines highlights promising future of nanotechnology in vaccine development. Compared with conventional vaccines, nanovaccines are supposed to have advantages in lymph node accumulation, antigen assembly, and antigen presentation; they also have, unique pathogen biomimicry properties because of well-organized combination of multiple immune factors. Beyond infectious diseases, vaccine nanotechnology also exhibits considerable potential for cancer treatment. The ultimate goal of cancer vaccines is to fully mobilize the potency of the immune system as a living therapeutic to recognize tumor antigens and eliminate tumor cells, and nanotechnologies have the requisite properties to realize this goal. In this review, we summarize the recent advances in vaccine nanotechnology from infectious disease prevention to cancer immunotherapy and highlight the different types of materials, mechanisms, administration methods, as well as future perspectives.
3. Repair effect of adipose-derived mesenchymal stem cells on lung injury in rats exposed to silica
Shangya CHEN ; Ru HAN ; Enguo ZHANG ; Ye YANG ; Qiang JIA ; Linlin SAI ; Cunxiang BO ; Yu ZHANG ; Zhongjun DU ; Hua SHAO
Chinese Journal of Industrial Hygiene and Occupational Diseases 2019;37(1):20-25
Objective:
To observe the repairing effect of adipose mesenchymal stem cells (ADSCs) on lung injury induced by silica in rats.
Methods:
Primary ADSCs-GFP was obtained from rats. ADSCs-GFP was injected into tail vein of silicosis model rats. The expression of green fluorescence in lungs was observed regularly to determine the homing ability of ADSCs. Primary ADSCs of rats were obtained and randomly divided into control group, exposure group, vehicle group and ADSCs group. Silicosis rat model was established by non-exposed tracheal drip method. 24 hours after silica exposure, rats in ADSCs group were injected with ADSCs of 1×106/kg body weight through tail vein, and the pathological changes of lung tissue were observed and evaluated 28 days after intervention. To explore the early intervention mechanism of ADSCs on pulmonary fibrosis in silicosis model rats, apoptosis-related proteins were detected by immunohistochemistry.
Results:
28 days after exposure to silica, rats in the exposure group showed obvious pulmonary fibrosis. Compared with exposure group and vehicle group, ADSCs group showed less pulmonary inflammation, less silica nodules and less collagen deposition area. Immunohistochemical results showed that the expression of Caspase-3 and cytochrome C protein decreased and Bcl-2 protein increased after ADSCs transplantation.
Conclusion
ADSCs infusion has an obvious intervention effect on postponing early silicosis fibrosis in rats exposed to silica, and its mechanism is related to the regulation of apoptotic process.
4.Development and validation of a risk-prediction model for immune-related adverse events in patients with non-small-cell lung cancer receiving PD-1/PD-L1 inhibitors.
Qing QIU ; Chenghao WU ; Wenxiao TANG ; Longfei JI ; Guangwei DAI ; Yuzhen GAO ; Enguo CHEN ; Hanliang JIANG ; Xinyou XIE ; Jun ZHANG
Journal of Zhejiang University. Science. B 2023;24(10):935-942
Lung cancer remains the leading cause of cancer deaths worldwide and is the most common cancer in males. Immune-checkpoint inhibitors (ICIs) that target programmed cell death protein-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) have achieved impressive efficacy in the treatment of non-small-cell lung cancer (NSCLC) (Pardoll, 2012; Champiat et al., 2016; Gao et al., 2022). Although ICIs are usually well tolerated, they are often accompanied by immune-related adverse events (irAEs) (Doroshow et al., 2019). Non-specific activation of the immune system produces off-target immune and inflammatory responses that can affect virtually any organ or system (O'Kane et al., 2017; Puzanov et al., 2017). Compared with adverse events caused by chemotherapy, irAEs are often characterized by delayed onset and prolonged duration and can occur in any organ at any stage of treatment, including after cessation of treatment (Puzanov et al., 2017; von Itzstein et al., 2020). They range from rash, pneumonitis, hypothyroidism, enterocolitis, and autoimmune hepatitis to cardiovascular, hematological, renal, neurological, and ophthalmic irAEs (Nishino et al., 2016; Kumar et al., 2017; Song et al., 2020). Hence, we conducted a retrospective study to identify validated factors that could predict the magnitude of the risk of irAEs in patients receiving PD-1/PD-L1 inhibitors; our approach was to analyze the correlation between the clinical characteristics of patients at the start of treatment and relevant indicators such as hematological indices and the risk of developing irAEs. Then, we developed an economical, practical, rapid, and simple model to assess the risk of irAEs in patients receiving ICI treatment, as early as possible.
Male
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Humans
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Carcinoma, Non-Small-Cell Lung/drug therapy*
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Lung Neoplasms/drug therapy*
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Immune Checkpoint Inhibitors/adverse effects*
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Programmed Cell Death 1 Receptor
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Retrospective Studies
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Apoptosis