Small cell lung cancer (SCLC) is a highly malignant tumor with a very poor prognosis; therefore, more effective treatments are urgently needed for patients afflicted with the disease. In recent years, emerging molecular classifications based on key transcription factors of SCLC have provided more information on the tumor pathophysiology, metastasis, immune microenvironment, and acquired therapeutic resistance and reflected the intertumoral heterogeneity of the various SCLC phenotypes. Additionally, advances in genomics and single-cell sequencing analysis have further revealed the high intratumoral heterogeneity and plasticity of the disease. Herein, we review and summarize these recent lines of evidence and discuss the possible pathogenesis of SCLC.

As a type of experiential psychotherapy,Satir communication model can help the individual system and the family system achieve a state from dysfunction to healthy function,which can enrich the intervention connotation of family support and provide a new direction for the realization of full-life circle care.This paper aims to introduce the concept,core elements,common treatment techniques,application and effects,current challenges and relevant suggestions of Satir communication model in the nursing field from the perspective of family support,in order to provide references for the localization development and clinical integration of Satir communication model in the field of nursing in China.

Epidermal growth factor receptor ( EGFR ) mutations are common oncogenic driver mutations in patients with non-small cell lung cancer (NSCLC). The application of EGFR-tyrosine kinase inhibitors (TKIs) is beneficial for patients with advanced and early-stage NSCLC. With the development of next-generation sequencing technology, numerous patients have been found to have more than one genetic mutation in addition to a single EGFR mutation; however, the efficacy of conventional EGFR-TKIs and the optimal treatments for such patients remain largely unknown. Thus, we review the incidence, prognosis, and current treatment regimens of EGFR compound mutations and EGFR concomitant mutations to provide treatment recommendations and guidance for patients with these mutations.
Humans ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Protein Kinase Inhibitors/pharmacology* ; Mutation/genetics* ; ErbB Receptors

Objective:To evaluate the safety and efficacy of carotid artery stenting (CAS) in the treatment of non-circumferential severe calcification using the distal embolic protection device.Methods:Clinical data of patients with severe calcification lesions in cervical carotid artery treated by CAS from Jan 2018 to Dec 2020 at our center was analyzed retrospectively.Results:226 consecutively admitted patients of cervical carotid artery stenosis and non-circumferential severe calcification (CR>270°) underwent CAS using the distal embolic protection device. The technical success rate was 90.26%. No death or myocardial infarction occurred during the perioperative period. Two patients had ipsilateral hemiparesis ischemic stroke during post-dilatation. The incidence of perioperative bradycardia/hypotension was 25.34%. Patients were followed up for 6-36 months, with median follow-up period of 17.3 months. The incidence of mild or moderate in-stent restenosis (<70%) was 16.59%, and the incidence of severe in-stent restenosis or occlusion (>70%) was 3.22%.Conclusions:For carotid artery stenosis with non-circumferential severe calcification in high risk for CEA patients, carotid artery stenting is safe and effective with the aggressive pre-dilation strategies, strict stent selections and implantation standards. The incidence of perioperative death, myocardial infarction or ipsilateral hemiparesis ischemic stroke was low. The patency rate of the carotid stent in the calcification lesion is satisfactory during the mid-term follow-up.

Immune checkpoint inhibitor (ICI) has become one of the important therapeutic strategies for the patients with advanced non-small cell lung cancer (NSCLC). The latest clinical studies have shown that immunotherapy can bring more survival benefits to patients with early lung cancer and operable patients with locally advanced lung cancer. However, the strategies of neoadjuvant immunotherapy, the timing of operation, the evaluation system of curative effect, predictive markers and other problems still need to be explored in the clinical practice of large samples. This paper reviews the progress of neoadjuvant immunotherapy in NSCLC.

Objective:To analyze the effect and mechanism of gadolinium chloride on hepatic ischemia-reperfusion injury (HIRI) in Sprague Dawley (SD) rats.Methods:Thirty six eight weeks special pathogen free SD rats, were included in the project. The body weight ranged from 200 to 250 g. Thirty six rats were randomly divided into sham operation group, model group and gadolinium chloride group with 12 rats/group. Model of ischemia-reperfusion injury was generated in the rats of model group; In the gadolinium chloride group, preoperative intraperitoneal injection of gadolinium chloride was performed before the model of HIRI was established; In the sham operation group, only the abdomen was opened and closed and the hilum was dissected. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected in the three groups. The relative expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1 β (IL-1β) mRNA were detected by Q-PCR. Western blot was used to detect the expression of markers involved in the Toll like receptor 2/myeloid differentiation factor 88 (MyD88) signaling pathway. Immunohistochemistry staining was used to detect the expression of Fas and Fas ligands in hilar bile duct epithelial cells.Results:ALT and AST were (55±8) U/L, (92±22) U/L in sham operation group, lower than those in model group (1 247±62) U/L, (1 117±60) U/L, respectively, and ALT and AST in gadolinium chloride group were (622±50) U/L and (552±41) U/L, lower than those in model group (all P<0.05). Compared with the sham operation group, the relative expression of TNF-α, IL-1 β, IL-6 mRNA in the model group was significantly higher (all P<0.05), but the expression of those markers were higher than gadolinium chloride group (all P<0.05). Gadolinium chloride down-regulated the expression of Toll like receptor 2/MyD88 signaling pathway in rat with liver ischemia-reperfusion. The percentage of Fas protein positive cells in model group was (40.2±3.8)%, and the percentage of Fas ligand positive cells was (36.9±2.9)%, which was higher than those in gadolinium chloride group (29.7±2.3)% and (23.6±2.1)% with statistically significant differences (all P<0.05). Conclusion:Gadolinium chloride can reduce the injury of liver function and inhibit the expression of inflammatory factors in liver tissue of SD rats with hepatic ischemia-reperfusion, which may play a protective role by down regulating the expression of relative protein in Toll like receptor 2/MyD88 signaling pathway.

Immune checkpoint inhibitors (ICIs) therapy is the most commonly used immunotherapy regimen at present. It has been approved for clinical treatment of melanoma, kidney cancer, head and neck cancer, bladder cancer and other tumors. It has made a breakthrough in the treatment of lung cancer and become a new pillar of comprehensive treatment of lung cancer. However, ICIs alone is less effective in non-selective patients, and combination therapy has become a hot topic of exploration. This article focuses on the development of combined immune checkpoint inhibitors and describes how immunotherapy can be used to treat early stage cancer.

[Abstract] In recent years, investigation on immune checkpoint inhibitors has made exciting progress in anti-tumor therapy. Through continuous exploration, there is a deeper understanding of intermolecular interaction patterns among PD-L1, PD-1, CD80, CTLA-4, etc. In addition to classically acting as a T cell inhibitory receptor, PD-L1 was found to be co-expressed with PD-1 or CD80 on the same cell and play a positive immunoregulatory function through cis-interaction, significantly affecting the interaction network between tumor cells and immune cells and the efficacy of immunotherapy, and bringing new changes to the understanding of the mechanisms of cancer immunotherapy. This review provides an in-depth analysis of the cis-PD-L1/PD-1 and cis-PD-L1/CD80 pathways and their interactions with a complex network of CTLA-4 and CD28 molecules, finally outlines the effects of blocking this cis-interaction pathway on T cell signaling, cytotoxic function, and the efficacy of anti-tumor immunotherapy.

Precision detection techniques have promoted the development of individualized diagnosis and treatment of tumors in the era of precision medicine. At the same time, clinical demands of precision treatments have further driven the development and application of precision detection techniques. In recent years, precision medical detection techniques realized rapid transformations from low-throughput to high-throughput genomic sequencing, from tissue biopsies to liquid biopsies, and from multicell promiscuous detection to single cell precision sequencing. All these changes have promoted the emergence and development of new technologies, new targets, and new drugs in the era of precision oncology medicine. In the future, multi-dimensional combined detection could help to improve the accuracy of precision medicine; ctDNA methylation detection analysis could broaden the research field of precision medicine; and the transformation of clinical trial design could also contribute to promote the in-depth development of precision medicine.

[Abstract] The research on immune checkpoint has made breakthrough progress in recent years. The PD-1/PD-L1 signaling pathway is closely related to the immune escape mechanism, and their inhibitors have also made great success in lung cancer. From Checkmate017, Checkmate-057 to KEYNOTE-010 and OAK studies, PD-1/PD-L1 inhibitors have gradually established their position as standard treatment for the advanced NSCLC patients after chemotherapy failed. PD-1/PD-L1 inhibitors can be combined with other cancer treatment methods, including radiotherapy, chemotherapy, targeted therapy and other immunotherapies, whichhave synergistic effects in the treatment of lung cancer, thus improving the efficacy. Immune checkpoint inhibitors bring changes in the treatment patterns of lung cancer, but also to the traditional efficacy evaluation model,as wellas reaction to the treatment-related adverse. In addition, the development of immune check point inhibitors has effectively promoted the progress of precision medicine.