Objective To investigate the relationship between serum tumor markers and the severity of silicosis.Methods Retrospective study.Total of 160 patients with silicosis were included in the study, and 160 healthy volunteers were recruited as the control group.Tumor marker levels in both bronchoalveolar lavage fluid(BALF)and serum were detected by the immunochemiluminecence methods.The pulmonary function parameters, blood gas analysis and lactate dehydrogenase(LDH)were also analyzed.Lung tissue obtained by a patient with silicosis was stained by neuron specific enolase(NSE), carbohydrate antigen125(CA125) and carbohydrate antigen19-9(CA19-9).Results Serum NSE, CA125 and CA19-9 levels were significantly higher in cases than those in controls[(34.47±13.30)μg/L vs(10.24±7.20)μg/L,t=20.27, P<0.000 1;(33.96±17.80)kU/L vs(12.23±15.30)kU/L, t=11.71, P<0.000 1;(4.68±5.67)kU/L vs(2.78±3.45)kU/L,t=3.67,P<0.002].Significant negative correlations were found between values of tumor markers(CA125 and CA19-9) and spirometric parameters,such as forced expiratory volume in one second %(FVE1%), forced expiratory volume in one second/forced vital capacity(FVE1/FVC), carbon monoxide diffusion capacity (Dlco) and total lung capacity(TLC) (r=-0.423,P=0.001;r=-0.323,P=0.011;r=-0.479,P=0.001;r=-0.285,P=0.043) and (r=-0.324,P=0.022;r=-0.256,P=0.023;r=-0.354,P=0.013;r=-0.356,P=0.012).Significant positive correlations were also observed between values of these tumor markers and LDH(r=0.378,P=0.001 and r=0.347,P=0.21).Significant negative correlations were found between NSE and Dlco and TLC(r=-0.374,P=0.004 and r=-0.368,P=0.002).Significant positive correlations were also observed between NSE and LDH(r=0.404,P=0.001).The NSE and CA19-9 levels in BALF were significantly higher than those in serum[(39.32±29.30)μg/L vs(25.7±12.12)μg/L,t=2.15,P=0.036;(21.36±12.11)kU/L vs(11.28±10.78)kU/L, t=2.64,P=0.012].Patients experienced a decrease in NSE and CA19-9 concentrations following whole lung lavage[(39.20±10.24)μg/L vs(15.32±8.35)μg/L,t=8.02,P<0.05;(26.24±12.23)kU/L vs(18.84±5.64)kU/L,t=2.46,P<0.05].Immunohistochemical studies showed positive NSE and CA19-9 staining in lung biopsy specimen.Conclusion Elevated serum tumor markers including NSE, CA125 and CA19-9 would provide valuable clinical information to assess disease severity in silicosis.

Objective To explore the symptoms and clusters of patients with advanced non-small cell lung cancer (NSCLC), and to discuss the correlation between their symptom clusters and quality of life. Methods A total of 150 patients who were diagnosed of advanced NSCLC in Nanjing Chest Hospital between January 2015 and December 2016 were selected by convenience sampling. The patients' basic information was collected, and their symptoms and quality of life were evaluated with M. D. Anderson symptom inventory (MDASI) and functional assessment of cancer therapy-lung (FACT-L). The symptom clusters were extracted by principal component analysis, and the correlation between symptom clusters and the quality of life were then explored through correlation analysis and multivariate regression analysis.Results The top 3 symptoms in terms of severity in the 150 advanced NSCLC patients were fatigue, poor appetite and shortness of breath, while the top 3 symptoms in terms of frequency were fatigue, poor appetite and distress. Totally 4 symptom clusters were extracted by principal component analysis, including the emotional symptom cluster, the fatigue cluster, the illness perception cluster and the gastrointestinal tract cluster. The 4 symptom clusters were negatively correlated with the quality of life (r=-0.359--0.721,P<0.05). According to the multivariate regression analysis, the gastrointestinal tract and fatigue clusters were the main factors contributing to the life quality in advanced NSCLC patients (R2=0.522,P<0.05).Conclusions Advanced NSCLC patients were plagued with multiple symptom clusters. Therefore, nursing staff should build an efficient symptom management pattern to improve their quality of life.

Objective:To investigate the efficacy and safety of recombinant human endostatin(Endostar)combined with platium-contained chemotherapeutic agents in advanced non-small cell lung cancer(NSCLC)patients over 60 years old.Methods:93 advanced NSCLC patients from January 2019 to June 2021 were selected as the research objects.The patients received three days of continuous intravenous infusion of Endostar(210 mg for 72 hours)combined with platinum-containing chemotherapy.The efficacy and toxicities were evaluated according to Response Evaluation Criteria in Solid Tumors(RECIST)version1.1 and National Cancer Institute Common Terminology Criteria for Adverse Events(NCI-CTCAE version 4.0), respectively.Follow-up data were obtained to perform the Kaplan-Meier survival analysis.Results:In our study, the objective remission rate(ORR)and disease control rate(DCR)were 38.7% and 78.5%, respectively.The median progression-free survival(PFS)and overall survival(OS)were 6.8 months and 16.5 months, respectively.A Multivariate analysis showed that tumor staging and TP53 mutation were independent prognostic factors related to PFS and OS in advanced NSCLC patients.Adverse reactions related to Endostar during treatment included arrhythmia in 2 cases(2.2%), myocardial ischemia in 1 case(1.07%)and bloody sputum in 1 case(1.07%), all of which were Grade 1 or Grade 2.Conclusions:The application of three days continuous intravenous infusion of Endostar combined with platium-contained chemotherapeutic agents is worthy to be recommended for clinical application in elderly patients with advanced NSCLC due to its high effective rate and survival advantage, as well as good safety.