Objective According to the changes of microcirculation in the pulmonary cancers, the treatment effect was evaluated after the vascular interventional therapy.Methods Angiography of 138 primary pulmonary carcinomas, and the feeding arteries were performed. Areas of mass blush were measured for 81 cases before and after therapy. The tumour blush was considered to be the imaging appearance of the microcirculation of the lung carcinoma. The angiographic images were collected by digital image system (DSA and movie). Results (1) The rate of the tumour blush appearance was 88.8% in this group. (2) The areas of the lung carcinoma blush in 81 cases before and after therapy were (941.4?73.2)mm 2 and (427.9? 93.8 )mm 2( P

Objective To study the effect of vasopressin (VS) on the small bowel circulation and the safety of emboliotherapy for the small intestinal hemorrhage by DSA. Methods Ten dogs were divided into three groups. Vasa recta were ligated 30min after VS infusion ended in group A( n =4), and 2h after VS infusion ended in group B( n =4), they were ligated without VS infusion in control group ( n =2). DSA were performed before and after VS infusion, before and after the ligation. The tested parts of intestine were resected to make the pathologic examination a week late. Results All branches of mesenteric arteries contracted and the contrast developed light in the intestinal wall after VS infusion. Branches contraction recovered but the contrast developed still slight in the intestinal wall about 30min after infusion ended. All manifestation of DSA recovered to normal 2h after infusion ended. In all groups, the blood vessel net can be seen but is fewer and scattered in the area of ligation. The collorate presented soon after the ligation. The pathologic examination proved that there was only mind mucosal ischemia in all groups. Conclusion The repressive effect of VS to the circulation of intestine weakened and then disappeared rapidly after the infusion ended. VS infusion had no significant effect on the safety of emboliotherapy for small intestinal bleeding when the infusion has been finished for more than 2hr. DSA can demonstrated the circulation state of the intestine before and after embolization.

BACKGROUND: In recent years, immune checkpoint inhibitors (ICIs) have become a hot spot in cancer because of their remarkable survival benefits on non-small cell lung cancer (NSCLC) patients. However, the immune-related adverse events (ir-AEs) induced by ICIs have been frequently reported due to its specificity and severity. This article is to summarize and evaluate ir-AEs induced by ICIs. Hopefully it can provide guidance for advanced NSCLC patients treatment options, early recognition and management of ir-AEs. METHODS: Randomized controlled trials (RCT) which involved ICIs in the treatment of advanced NSCLC were retrieved in the Cochrane Libraby, PubMed, EMBASE and other databases. The primary outcome includes the incidence, grade and organ specificity of ir-AEs. Relative risk (RR) was used as the effect size, which was expressed as 95% confidence interval (CI). The Stata 15.0 and RevMan 5.3 software are used to conduct the meta analysis. RESULTS: A total of 17 RCTs were included. The ir-AEs were generally more than those in the traditional chemotherapy group. The risk and severity of ir-AEs induced by ICIs combined group were generally higher than that of ICI monotherapy, while the incidence of severe ir-AEs induced by ICIs combination therapy was similar to that of anti-cytotoxic T-lymphocyte-asscociated antigen 4 (CTLA-4) group. CONCLUSIONS ICIs have different toxicity profile compared with chemotherapy, and their immune-related toxicity is stronger than that of traditional chemotherapy. ICIs induced ir-AEs is organ-specific, and different ICI has specific immune-related toxicity profiles. As ICIs represent a new and distinct class of treatment for NSCLC, this article has systematically illustrated the efficacy and ir-AEs induced by ICIs, hopefully it can be useful for clinicians and patients to get a further understanding of ICIs, and facilitate early prediction, comprehensive diagnosis, and prompt management of ir-AEs by providing status reference and management suggestions, so that ICI can bring more benefit for advanced NSCLC patients.

OBJECTIVE To establish a physiologically-based pharmacokinetic （PBPK） model of amikacin in elderly patients with renal insufficiency. METHODS PK-SIM® software was adopted for model building， optimization and simulation. The physical and chemical properties and pharmacokinetic parameters related to amikacin were collected by literature review. The PBPK model on adults was established and extrapolated to the elderly population based on the built-in human model. Data from clinical PK studies were used to optimize and validate the model. The goodness of fit， relative residual， and mean folding error （MFE） were used to evaluate the performance of forecasting. The final model was employed to simulate the exposure of amikacin in the elderly population with renal insufficiency， and the efficacy and safety of commonly used clinical dosing regimens were evaluated， and the recommended regimens were proposed. RESULTS The established PBPK model of amikacin had good prediction performance in both adult and elderly populations， with the absolute mean of relative residual value of 25%； the MFE of peak concentration （cmax） and area under the plasma concentration curve （AUC0－∞） in all simulation occasions ranged ＞0.5-＜2. The simulation results showed that， compared with healthy adults， no significant clinical difference in cmax was observed in the elderly with renal insufficiency at the same dosing regimen， but the trough concentration increased significantly due to accumulation. Prolonging the administration interval of amikacin rather than reducing the dosage was more helpful to ensure the efficacy and to reduce the occurrence of nephrotoxicity. CONCLUSIONS The PBPK model for amikacin is successfully established in the elderly patient with renal insufficiency， and shows good predictive performance.