Objective To compare the efficacy and safety of osimertinib and aumolertinib in the treatment of advanced non-small cell lung carcinoma(NSCLC)with epidermal growth factor receptor(EGFR)mutation.Methods A total of 139 patients with EGFR-mutated advanced NSCLC treated in the First People's Hospital of Yunnan Province from January,2019 to December,2022 were retrospectively collected.After screening by that row of criteria,104 patients were included in this study.According to the treatment drugs,they were divided into osimertinib group and aumolertinib group,with 52 cases in each group.The osimertinib group received osimertinib mesylate tablets 80 mg once daily,and the aumolertinib group received aumolertinib mesylate tablets 110 mg once daily.The disease control rate(DCR),objective remission rate(ORR)and progression-free survival(PFS)of the two groups were observed.PFS and overall survival(OS)were evaluated.The Cox regression model was used to analyze the key factors affecting patient survival.Results The ORR of aumolertinib group was significantly higher than that of osimertinib group.The median progression-free survival(mPFS)of aumolertinib group was significantly longer than that of osimertinib group(P=0.045).Cox regression model showed that clinical stage Ⅲ(HR=2.25,95%Cl 1.28～3.95,P=0.005),no brain metastasis(HR=0.59,95%Cl 0.35～0.98,P=0.040),third generation TKI type aumolertinib(HR=1.82,95%CI 1.15～2.87,P=0.011).Conclusion Aumolertinib and osimertinib have similar clinical efficacy in the treatment of advanced NSCLC patients with EGFR mutation.However,in terms of long-term efficacy,aumolertinib has significantly better median PFS and overall OS,and higher safety than osimertinib.

OBJECTIVETo compare the effects of electroacupuncture (EA) at "Dachangshu" (BL 25) or "Tianshu" (ST 25) for visceral sensitivity, gene expression product c-kit of colonic Cajal interstitial cells (ICC) and capsaicin receptor 1 (TRPV1) of irritable bowel syndrome (IBS) rats, so as to investigate the effect and mechanism differences of EA at the back point and the front point of large intestine for IBS rats.

METHODSForty-two Wistar neonatal rats were randomly divided into a blank group (9 rats) and a model group (33 rats). IBS model was established with mother and child separation, acetic acid enema in young rats and colorectal dilatation method. Twenty-seven IBS rats in life were randomly divided into a model control group, a Dachangshu group and a Tianshu group, 9 rats in each group. EA (disperse-dense wave, 2 Hz/100 Hz, 0.1-0.3 mA) for 20 min was used at "Dachangshu" (BL 25) and "Tianshu" (ST 25) respectively in the Dachangshu and Tianshu groups, once every other day, totally 5 times. The rats in the model control group were fixed with soft cloth sleeve for 20 min, without acupuncture. No intervention was used in the blank group. The stool property Bristol grading score was recorded before and after intervention in each group. The visceral sensitivity was evaluated by abdominal withdrawal reflex. The latency until the first systolic wave occurred and the number of systolic wave within 90 s were observed. Immunohistochemical was used to detect the positive expressions of c-kit and TRPV1, the ICC colon specific marker.

RESULTSCompared with the blank group, the Bristol score increased，latency period shortened, systolic wave number increased, c-kit and TRPV1 positive expressions increased in the model control group (all <0.01). Compared with the model control group, the Bristol score decreased, latency period increased, systolic wave number decreased, c-kit and TRPV1 positive expressions decreased after intervention in the Dachangshu and Tianshu groups (<0.05, <0.01). Compared with the Dachangshu group, the TRPV1 positive expression decreased after intervention in the Tianshu group (<0.05).

CONCLUSIONEA at "Dachangshu" (BL 25) or "Tianshu"(ST 25) can improve the diarrhea in IBS model rats, reduce the visceral sensitivity, and its mechanism may be related to regulating the expressions of colon c-kit and TRPV1. EA at "Tianshu" (ST 25) is more apparent for TRPV1 than at "Dachangshu" (BL 25).

Acupuncture Therapy ; Female ; Humans ; Leukocytosis ; complications ; therapy ; Middle Aged ; Thrombocytosis ; complications ; therapy