Objective To explore the clinical efficacy of furmonertinib in the treatment of brain metastasis from non-small cell lung cancer(NSCLC)and its impact on survival and prognosis.Methods The medical records of 76 patients with NSCLC brain metastasis who were admitted to Anqing Hospital of Navy from March to December 2021 were retrospectively analyzed.According to the treatment plan,they were divided into study group(33 cases)and control group(43 cases).The control group was treated with whole brain radiotherapy,and the study group was given oral furmonertinib on the basis of the control group.After 3 months of treatment,disease control rate,objective remission rate,serum tumor marker levels and adverse drug reactions were compared between the two groups.All the patients were followed up for 12 months,and the overall survival(OS)and progression free survival(PFS)were recorded.Results The objective remission rate and disease control rate in the study group were higher than those in the control group(P<0.05).After 3 months of treatment,serum carcinoma embryonic antigen(CEA)and cytokeratin 19 fragment(CYFRA21-1)were decreased in both groups,and the two indexes in the study group were lower than those in the control group(P<0.05).The PFS of the study group and control group were 7.5 months and 5.0 months,respectively.The one-year OS of the study group and control group was 75.00%and 52.50%,respectively.There were statistically significant differences in the survival curves of PFS and one-year OS between the two groups(P<0.05).No significant difference was found in the incidences of myelosuppression,diarrhea,rash,cough,upper respiratory tract or oral mucosal infection between the two groups(P>0.05).The proportion of patients with increased transaminase in the study group was higher than that in the control group(P<0.05).Conclusion Furmonertinib can not only improve the objective remission rate and disease control rate of patients with NSCLC brain metastasis,but also effectively prolong the PFS and OS,with good safety.However,it may increase the risk of transaminase elevation.

Objective:To investigate the predicting value of high sensitivity C-reactive protein (hs-CRP) and albumin (Alb) ratio on prognosis of patients with in-hospital cardiac arrest (IHCA).Methods:A total of 107 patients with IHCA and spontaneous circulation recovery (ROSC) after cardiopulmonary resuscitation (CPR) in the Affiliated Hospital of Xuzhou Medical University during January 1, 2017 and September 30, 2020 were selected as the subjects and divided into the survival group and death group according to the survival condition on day 14 after IHCA. The correlation between ratio of high sensitivity C-reactive protein/albumin (hs-CRP/Alb) and the prognosis of patients was analyzed.Results:No statistical significant differences were found between the survival and death groups in sex, age, medical history, ECG monitoring, recovery ventilation mode, percentage of first monitoring of heart rate and pre-resuscitation Alb (all P > 0.05). However, there were significant differences in the percentage of non-cardiogenic CA and adrenaline dose > 5 mg, time of CPR, concentrations of blood lactic acid, Alb, hs-CRP, and ratio of hs-CRP/Alb (all P < 0.05). Logistic regression analysis showed that percentage of adrenaline dose > 5 mg, concentration of blood lactic acid, time of CPR, and ratio of hs-CRP/Alb were independent risk factors for predicting death. ROC curve analysis showed that hs-CRP/Alb ratio, and concentration of hs-CRP and Alb had predictive value on the death of patients with IHCA; the areas under the curves of hs-CRP/Alb ratio, hs-CRP and Alb concentration were 0.876, 0.864 and 0.745, respectively. The predictive efficiency of hs-CRP/Alb ratio was better than that of hs-CRP concentration or Alb concentration. Conclusions:hs-CRP/Alb ratio has predictive value for the prognosis of patients with IHCA and the predictive value is superior to that of hs-CRP and Alb concentration.

Objective To observe the effect of HIF-1a/iNOS signaling pathway on myocardial ischemia-reperfusion injury in rat heart transplantation and the protective mechanism of N-acetylcysteine (NAC) on donor heart after cardiac transplantation in rats.Methods Eighty healthy male Lewis rats were randomly divided into 3 groups,the control group (0.3 ml saline was infused via inferior vena cava 30 min before donor harvest or implantation),NAC donor pretreatment group [NAC (30 mg/kg.w) was injected into the vena cava of donor rat 30 min defore donor harvest],and the NAC receptor pretreatment group (NAC 300 mg/kg.w was injected into the vena cava of the recipient rats 30 min before transplantation.The 30 min was injected into the vena cava of the recipient rats).A transplant model was established and the graft was obtained after 24 h transplantation.The expression of iNOS,HIF-1a and mRNA in cardiac muscle tissue was detected by immunohistochemistry and Real time-PCR.Results HIF-1a protein expression in graft myocardial tissue was significantly lower in NAC donor pretreatment and recipient pretreatment group compared with control group (P ＜0.05),the differences were statistically significant (2.72±0.17 vs.2.24±0.23 vs.3.14.±0.16,F=56.26,P =0.000).The iNOS protein expression in NAC donor pretreatment group,and NAC recipient pretreatment group were lower than that in the control group (1.52±0.18 vs.1.61±0.19 vs.3.30±0.18,F=232.345,P =0.000),the differences were statistically significant (P ＜ 0.05).24 h after transplantation,the differences in graft myocardial tissue HIF-1a and iNOS mRNA among the three groups were statistically significant (F=7.467,16.490,P=0.003,0.000).The expression of iNOS mRNA in the NAC receptor pretreatment group was significantly lower than that in the control group (P＜0.05).Conclusion HIF-1a/iNOS signaling pathway can regulate ischemia reperfusion injury in rat heart transplantation,and the protective effect of NAC on donor heart maybe mediated via this pathway.

ObjectiveTo explore the effect of Yinaotongluo Capsule on diffuse weighting image and enenery metabolism of ischemia-reperfuing rat.MethodsMagnetic resonance diffusion-weighted imaging(DWI) and 1H and magnetic resonance spectroscopy(MRS) were performed in different brain regions in focal cerebral ischemic-reperfusion injury model rats. ResultsYinaotongluo Capsule could significantly reduce the area and the intensity of infarction of rats by DWI 3 h and 5 d after treatment compared with the model group.The result of 1H MRS examination demonstrated Lac peak was lower and NAA peak higher than that of the model group. ConclusionYinaotongluo Capsule can effectually improve enenery metabolism during cerebral ischemia and reperfuing, so that to reduce the neuronal dysfunction and death in infarcts at the late stage.