Objective To explore the narcotic effect of three inhalation induced methods of sevoflurane.Methods According to the different inhalation methods of sevoflurane,60 patients with elective upper abdominal surgery under intubation general anesthesia were divided into group A (vital capacity breathing),group B (tidal volume breathing),and group C (gradually increasing the concentration of sevoflurane),each group 20 cases.The sevoflurane concentration of A group and B group was 9％,which of group C was 4％,and oxygen pipeline was prefilled by oxygen flow(3L/min).The heart rate(HR),mean blood pressure(MAP),diastolic blood pressure(DBP) and systolic blood pressure(SBP) values and the effect of muscle relaxants were observed and recorded at T1 (basic indicators),T2 (eyelash reflex),T3 (before intubation),T4 (intubation time 2 min),T5 (intubation time 4 min),T6 (intubation time 6 min).Results The SBP,DBP,and MAP of group A,B and C at different time points were all inhibited(all P ＜0.05),and the significant inhibitory effect was at time point T3 (all P ＜0.01).There was no close correlation between HR changes and the muscle relaxant effect of group A,B and C at different point(all P ＞ 0.05).Conclusion Three kinds of sevoflurane inhalation induction can lower blood pressure,and they are safe,reliable,and able to be accepted by the patients.

Purpose: This study aims to evaluate the efficacy and safety of a new combination treatment of vinorelbine and pyrotinib in human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer (MBC) and provide higher level evidence for clinical practice. Materials and Methods: This was a prospective, single-arm, phase 2 trial conducted at three institutions in China. Patients with HER2-positive MBC, who had previously been treated with trastuzumab plus a taxane or trastuzumab plus pertuzumab combined with a chemotherapeutic agent, were enrolled between March 2020 and December 2021. All patients received pyrotinib 400 mg orally once daily plus vinorelbine 25 mg/m2 intravenously or 60-80 mg/m2 orally on day 1 and day 8 of 21-day cycle. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included the objective response rate (ORR), disease control rate (DCR), overall survival, and safety. Results: A total of 39 patients were enrolled. All patients had been pretreated with trastuzumab and 23.1% (n=9) of them had accepted trastuzumab plus pertuzumab. The median follow-up time was 16.3 months (95% confidence interval [CI], 5.3 to 27.2), and the median PFS was 6.4 months (95% CI, 4.0 to 8.8). The ORR was 43.6% (95% CI, 27.8% to 60.4%) and the DCR was 84.6% (95% CI, 69.5% to 94.1%). The median PFS of patients with versus without prior pertuzumab treatment was 4.6 and 8.3 months (p=0.017). The most common grade 3/4 adverse events were diarrhea (28.2%), neutrophil count decreased (15.4%), white blood cell count decreased (7.7%), vomiting (5.1%), and anemia (2.6%). Conclusion Pyrotinib plus vinorelbine showed promising efficacy and tolerable toxicity as second-line treatment in patients with HER2-positive MBC.

OBJECTIVETo compare the effect of first-line treatment with platinum-based chemotherapy and non-platinum-based chemotherapy in patients with lung metastases from triple negative breast cancer (TNBC).

METHODSSixty-five eligible patients were divided into platinum-treated group and non-platinum-treated group according to the first-line therapy. Factors predicting the chemotherapeutic efficacy included overall survival (OS), progression-free survival (PFS) and objective response (OR).

RESULTSIn the platinum-treated group of 32 patients, 2 cases (6.3%) achieved CR, 16 cases (50.0%) achieved PR, 11 (34.4%) cases achieved SD, and 3 patients (9.4%) achieved PD. In the non-platinum-treated group of 33 patients, 2 cases (6.1%) achieved CR, 6 cases (18.2%) achieved PR, 16 cases (48.5%) achieved SD, and 9 cases (27.3%) achieved PD. Median PFS was significantly longer in the platinum-treated group than in the non-platinum-treated group (10 months vs. 6.0 months, P = 0.012), and OS was also improved (32 months vs. 22 months, P = 0.006). Multivariate analysis of several factors including local-regional lymph node involvement, lung metastasis-related symptoms, first-line platinum-based chemotherapy, disease-free interval, size and number of lung lesions, showed that first-line platinum-based chemotherapy was an independent prognostic factor for TNBC patients with lung metastases.

CONCLUSIONSCompared with non-platinum-based chemotherapy, the first-line platinum-based chemotherapy can improve PFS and OS in TNBC patients with metastases confined to the lungs.

Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Disease-Free Survival ; Humans ; Lung Neoplasms ; drug therapy ; Neoplasms, Second Primary ; Platinum ; therapeutic use ; Triple Negative Breast Neoplasms ; drug therapy