Objective : To explore the factors influencing the efficacy of first-generation EGFR tyrosine kinase inhibitors(EGFR-TKIs) in patients with EGFR-mutated advanced lung adenocarcinoma and to construct and validate a corresponding nomogram prediction model. Methods : A total of 220 patients with EGFR-mutated advanced lung adenocarcinoma treated with icotinib were enrolled and randomly divided into a training group(154 cases) and a validation group(66 cases) in a 7 ∶3 ratio. Cox regression analysis was performed to identify factors affecting the efficacy of first-generation EGFR-TKIs in the training group. A prediction model was constructed, and calibration curves and receiver operating characteristic(ROC) curves were plotted to validate the model′s performance. Results: In the training group, the objective response rate was 35.71%, the disease control rate was 77.27%, the median progression-free survival(PFS) was 12.5 months, the median overall survival was 18 months, the 2-year OS rate was 66.23%, and the PFS rate was 42.21%. Univariate analysis showed that brain metastasis, bone metastasis, TNM stage, differentiation degree, neutrophil-to-lymphocyte ratio(NLR), post-treatment p53 levels, p53 difference(Δp53), post-treatment cancer antigen gene(CAGE) levels, and CAGE difference(ΔCAGE) were associated with PFS(P2=4.429, P=0.351). ROC curve analysis in the training group showed that the nomogram model had a sensitivity of 80.00%, specificity of 77.53%, and AUC of 0.864 for predicting therapeutic efficacy, while the validation group showed a sensitivity of 74.08%, specificity of 71.43%, and AUC of 0.835. Conclusion Changes in lung cancer autoantibodies(Δp53 and ΔCAGE), TNM stage, and NLR are key factors influencing the efficacy of first-generation EGFR-TKIs in EGFR-mutated advanced lung adenocarcinoma. The nomogram prediction model based on p53 and CAGE demonstrates good predictive performance.

Objective:To explore the effect of paradoxical intention training on the sleep quality, negative emotion and quality of life of elderly patients with obstructive sleep apnea syndrome (OSAS) .Methods:From March 2018 to February 2020, convenience sampling was used to enroll 130 elderly OSAS patients admitted to the First Affiliated Hospital of Zhengzhou University. Patients were randomly divided into control group and observation group, with 65 cases in each group. Control group implemented routine nursing, while observation group conducted paradoxical intention training based on routine nursing. Pittsburgh Sleep Quality Index (PSQI) , Hospital Anxiety and Depression Scale (HADS) , Calgary Sleep Apnea Quality of Life Index (SAQLI) were used before and after the intervention to compare the sleep quality, psychological status and quality of life between two groups.Results:After one week of intervention, the score of PSQI, anxiety subscale (HADS-A) , depression subscale (HADS-D) of observation group were (7.08±2.70) , (6.25±1.20) and (6.34±1.24) respectively, lower than those of control group, the differences were statistically significant ( t=4.871, 9.439, 8.754; P<0.01) . After the intervention, the total score of SAQLI in observation group was (4.87±0.35) and that in control group was (4.22±0.25) , the difference was statistically significant ( t=12.184, P<0.01) . Conclusions:Paradoxical intention training can help improve the sleep quality, psychological conditions and quality of life of elderly OSAS patients.

Objective To investigate the correlation and significance of S100A12 with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Fifty-three patients with OSAHS were chosen as OSAHS group and 46 healthy volunteers were chosen as control group.The levels of S100A12 and hs-CRP in the two groups were compared,and its relationship with those of epworth (ESS),apnea hypopnea index (AHI),and minimum blood oxygen saturation (L-SpO2) were analysised.Results The scores of ESS,BMI,A HI,L-SpO2,hs-CRP and S100A12 in two groups were statistically significant (P＜0.05).The severity of hs-CRP in severe OSAHS group was significantly higher than that of mild OSAHS group (P＜0.05).There was no significant difference in hs-CRP between moderate OSAHS group and mild OSAHS group and severe group (P＞0.05).The level of S100A12 in severe OSAHS group was significantly higher than that of moderate OSAHS group and OSAHS mild group(P＜0.05).The level of S100A12 in moderate moderate group was significantly higher than that of mild group(P＜0.01).hs-CRP was negatively correlated with ESS and AHI (r=0.822,0.787,P＜0.01),was positively correlated with L-SpO2 (r=-0.740,P＜0.01),S100A12 was positively correlated with ESS and AHI (r =0.707,P ＜ 0.01),and negatively correlated with ESS and AHI (r =0.707,0.807,P＜0.01),and negatively correlated with with L-SpO2 (r=-0.670,P＜0.01).Conclusion S100A12 is associated with OSAHS.The higher the severity of OSAHS,the higher the S100A12 value,which can be used as a new predictor of cardiovascular disease risk in OSAHS patients.

Castleman Disease ; Heart Neoplasms ; Humans ; Myxoma ; Retroperitoneal Space

Objective To observe the changes in fibrinolytic factors in rats with pulmonary thromboembolism (PTE) after recombinant prourokinase ( rPro-UK) treatment and its significance .Methods PTE was induced in male Sprague-Dawley (SD) rats by injecting heated 125iodine-labeled fibrinogen(Fib) autologous thromboemboli into external jugular veins.Twenty-eight rats were randomly assigned into following groups (7 rats each):①healthy control group;②PTE 5 d group,the rats in which were sacrificed at 5 d after the PTE model was made; ③ PTE3d receiving rPro-UK thrombolytic treament groups including multibolus treatment sub group ( rPro-UK was given in 1 mg/kg on the post-PTE third day followed by 2 consecutive days of a lower dose 0.25 mg/kg and rats were sacrificed 2 h after the last injection at the same time as PTE5d group) and single bolus treatment sub group ( rPro-UK was given in 1 mg/kg on the post-PTE third day followed by 2 consecutive days of 0.5 ml saline and rats were sacrificad at the same time as the former group ).The rats were quickly sacrificad at the fixed time through carotid bleeding and plasma samples were reserved for analysis of uroki -nase-type plasminogen activator (u-PA), urokinase-type plasminogen activator receptor (u-PAR), fibrinogen (Fib) andα2-antiplasmin (α2-AP) .Results ①Plasma concentrations of u-PA and u-PAR were increased were significantly in rPro-UK multibolus treatment sub group than in PTE 5 d group(Pu-PA <0.05,Pu-PAR <0.01)and rPro-UK single bolus treatment sub group(Pu-PA <0.01,Pu-PAR <0.05),correlated with the thrombolysis rate in rPro-UK multibolus treatment sub group (ru-PA =0.766,P<0.05;ru-PAR=0.785,P<0.05).② No difference of plasma Fib and α2-AP was seen between Pro-UK treatment groups and PTE 5 d group(P >0.05).Conclusion ① Plasma levels of endogenous u-PA and u-PAR are increased at different time points after PTE and are further enhanced after Pro-UK treatment, which promotes endogenous fibrinolysis and thrombus lysis .This is probably related to increased synthesis and secretion of endothelial cells which may be a key thrombolytic mechanism of Pro-UK.②Absence of systemic activation of the fibrinolytic system in Pro-UK multibo-lus treatment sub group means that the regimen is feasible and Pro-UK is fibrin specific .

Objective To evaluate the efficacy of continuous positive airway pressure (CPAP)-based standard treatment on obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with type 2 diabetes and insulin resistance (IR) in the elderly.Methods 63 elderly type 2 diabetes patients diagnosed as OSAHS were randomly divided into control group (n =31) and CPAP group (n =32).Patients in control group were treated with conventional therapy including diet control,exercise and antidiabetic drugs,and patients in CPAP group were treated with CPAP treatment combined with conventional therapy.Fasting glucose (FBG),oral glucose tolerance test (OGTT),homeostasis model assessment of IR index (HOMA-IR),body mass index (BMI),apnea-hypopnea index (AHI),lowest oxygen saturation (L-SaO2) and the dosage of insulin application were observed after 7 days,1 month,3 months of the treatment.Glycosylated hemoglobin (HbA1c) was determined before and after 3 months of the treatment.Results In CPAP group,levels of FBG and 2 h OGTT glucose,HOMA-IR,AHI,daily insulin dosage were significantly reduced and L-SaO2 was significantly increased after 7 days of the treatment; BMI was significantly reduced after 1 month of the treatment;HbA1c level was significantly reduced after 3 months of the treatment.In control group,L-SaO2 was significantly reduced along with the multiple time points; daily insulin dosage was significantly increased after 3 months of the treatment.There were no significant differences in all observed indicators between groups before treatment.There were significant differences in the observed indicators between groups after treatment except for BMI after 7 days of the treatment.Conclusions Compared with conventional therapy,CPAP-based standard treatment has more efficacy on increasing insulin sensitivity and improving insulin resistance in elderly patients with OSAHS and type 2 diabetes.

Objective To study the clinical significance of plasma adrenomedullin (ADM) and brain natriuretic peptide (BNP) levels in the elderly patients with chronic cor pulmonale. Methods The levels of ADM and BNP in plasma of the elderly patients with chronic cor pulmonale (39 cases in the acute stage and 30 cases in remission stage) were detected by radioimmunoassay. Their correlations with PaO 2,ET-1 and the ratio of right ventricular pre-ejection period to the pulmonary flow acceleration time (RVPEP /AT), which reflected the degree of pulmonary hypertension, were investigated. 27 elderly healthy subjects served as a normal control group. Results The levels of ADM and BNP in the acute and remission stages of cor pulmonale groups were both significantly higher 〔(27.31?6.27)ng/L,(17.22?4.15)ng/L and (66.21?12.79)ng/L,(52.74?8.85)ng/L, respectively〕 than those in the normal control group〔(11.18?3.95)ng/L, (34.52?3.34)ng/L, respectively〕. The levels of ADM and BNP in the acute stage were both significantly higher than those in the remission stage (all P0.05). Conclusions The study suggests that ADM and BNP involve in the pathophysiological process of chronic cor pulmonale in the elderly patients and may play a compensatory role in the disease.

Objectives To investigate the clinical significance of plasma adrenomedullin (ADM) concentrations in patients with asthma.Methods The plasma ADM concentrations in 23 asthmatic patients with an acute attack and 18 asthmatic patients in remission stage were measured by radioimmunoassay.Linear regression analysis was used to evaluate the correlations between two variables.Twenty healthy subjects served as a normal control group.Results The plasma ADM concentrations in asthmatic patients with an acute attack [(28.73?7.12)ng/L]were significantly higher than those of stable asthmatic patients [(13.85?4.48)ng/L,P0.05).Conclusion The results suggest that ADM is involved in the pathophysiological process of acute asthma attack and may play an important role in the inflammation of asthmatic airways.