Objective:To investigate the safety of early antiplatelet therapy for non-cardioembolic mild stroke patients with thrombocytopenia.Methods:Data of acute ischemic stroke patients with baseline National Institutes of Health Stroke Scale(NIHSS)score≤3 and a platelet count<100×109/L were obtained from a multicenter register.Those who required anticoagulation or had other contraindications to antiplatelet therapy were excluded.Short-term safety outcomes were in-hospital bleeding events,while the long-term safety outcome was a 1-year all-cause death.The short-term neurological outcomes were evaluated by modified Rankin scale(mRS)score at discharge.Results:A total of 1868 non-cardioembolic mild stroke patients with thrombocytopenia were enrolled.Multivariate regression analyses showed that mono-antiplatelet therapy significantly increased the proportion of mRS score of 0-1 at discharge(OR=1.657,95%CI:1.253-2.192,P<0.01)and did not increase the risk of intracranial hemorrhage(OR=2.359,95%CI:0.301-18.503,P>0.05),compared with those without antiplatelet therapy.However,dual-antiplatelet therapy did not bring more neurological benefits(OR=0.923,95%CI:0.690-1.234,P>0.05),but increased the risk of gastrointestinal bleeding(OR= 2.837,95%CI:1.311-6.136,P<0.01)compared with those with mono-antiplatelet therapy.For patients with platelet counts≤75×109/L and>90×109/L,antiplatelet therapy significantly improved neurological functional outcomes(both P<0.05).For those with platelet counts(>75-90)×109/L,antiplatelet therapy resulted in a significant improvement of 1-year survival(P<0.05).For patients even with concurrent coagulation abnormalities,mono-antiplatelet therapy did not increase the risk of various types of bleeding(all P>0.05)but improved neurological functional outcomes(all P<0.01).There was no significant difference in the occurrence of bleeding events,1-year all-cause mortality risk,and neurological functional outcomes between aspirin and clopidogrel(all P>0.05).Conclusions:For non-cardioembolic mild stroke patients with thrombocytopenia,antiplatelet therapy remains a reasonable choice.Mono-antiplatelet therapy has the same efficiency as dual-antiplatelet therapy in neurological outcome improvement with lower risk of gastrointestinal bleeding.

BACKGROUND: Preliminary researches conformed that neoadjuvant immunotherapy combined with chemotherapy had a significant short-term effect in resectable non-small cell lung cancer (NSCLC), but there were few clinical trials about neoadjuvant chemoimmunotherapy in China. We aimed to assess retrospectively the antitumour activity and safety of neoadjuvant chemoimmunotherapy for resectable stage Ib-IIIb NSCLC. METHODS: Twenty patients who had been diagnosed as stage Ib-IIIb NSCLC and received chemoimmunotherapy as neoadjuvant treatment between November 2019 and December 2020, in Beijing Chest Hospital, Capital Medical University were recruited. These patients received neoadjuvant treatment for 21 days as a cycle and antitumour activity and safety were evaluated every two cycles. RESULTS: Of 20 patients received neoadjuvant chemoimmunotherapy, 17 patients underwent surgical resection. 16 patients had R0 resection (no residual tumor resection) and 1 patient had R1 resection (microscopic residual tumor resection). Radiographic objective response rate (ORR) was 85.0% (4 complete response, 13 partial response). 5.0% (1/20) of patients had stable disease, and 10.0% (2/20) of patients had progression disease. The major pathologic response (MPR) was 47.1% (8/17), and complete pathologic response (CPR) was 29.4% (5/17). 1 case developed grade IV immune-related pneumonia (IRP) and 9 (45.0%) cases had grade III hematologic toxicity. CONCLUSIONS Immunotherapy combined with chemotherapy as neoadjuvant therapy has a better efficiency and tolerable adverse effects for patients with resectable NSCLC in stage Ib-IIIb.

Background and objective Small cell lung cancer (SCLC) accounts for nearly 15% of all cases of can-cer. As a type of highly invasive tumors, SCLC has high degree of malignancy, early and extensive metastasis, and is sensitive to chemotherapy and radiotherapy. The early treatment response rate of SCLC is high but it can also relapse rapidly without any treatment. Its median survival time is merely four to six months. Although many studies on SCLC have been conducted in re-cent years, its clinical treatment strategies have remained unchanged. The treatment of SCLC is still confined to chemotherapy regimens of etoposide plus cisplatin (EP) and other classic treatments because the surgical treatment of SCLC, particularly for Ⅲa treatment, has yet to reach a consensus. This study investigated the prognostic factors and clinical therapy effect in the comprehensive treatment of Ⅲa SCLC after surgical treatment.Methods This study was conducted through the retrospective analysis of the clinical data of 78 patients with SCLC who underwent surgical treatment in Beijing Chest Hospital affiliated to Capital Medical University between January 1995 and December 1995. Through follow-up, we performed statistical analysis of each patient's gender, age, tumor size, lymph node metastasis, tumor-node-metastasis (TNM) staging, surgical methods, and adjuvant radiation and chemotherapy.Results The median survival in this clinical trial team was 13.93 months. Among the participants, 47 patients accepted neoadjuvant chemotherapy and their median survival were 14.25 months. By contrast, 31 patients accepted postoperative adjuvant chemotherapy and their median survival were 13.83 months. No statistical difference was observed between the two groups. Moreover, 28 patients were of single Lymph node metastasis and their median survival was 17.1 months. By contrast, 50 patients were of multiple lymph node metastasis and their median survival was 11.9 months. Significant statistical difference was observed between the two groups (P<0.01).Conclusion In performing further evalua-tion of the status and value of surgical treatment in the comprehensive treatment of SCLC, several patients benefitted from Ⅲa SCLC surgery with comprehensive treatment.

As one of the important liquid biopsies, circulating tumor cells (CTCs) shows more and more clinical values in the treatment of lung cancer such as diagnostic screening, treatment evaluation, postoperative monitoring, and prog-nosis predicting etc.A large number of small pulmonary nodules patients are detected when screening the high risk population of lung cancer. However, small lung nodules are not equal to lung cancer, and 90%-95% of them are benign lesion, therefore, to accurately and correctly differentiate whether it is benign or malignant when patients firstly detected and treat a small pulmo-nary nodule is become a new opportunity and challenge for clinician. With the improvement of CTCs detection technology, whether it will play an important role in early differential diagnosis of lung cancer. And whether it will have clinical significance to early lung cancer surgery operations. These require further researches and explorations so as to achieve clinical transforma-tion in the future.

OBJECTIVETo investigate the current status of social support for HIV/AIDS patients under antiretroviral treatment (ART) and related factors in Wuhan.

METHODSSocial Support Rating Scale (SSRS) was used to analyze the current status of social support for HIV/AIDS patients under ART in Wuhan. Student's t test, analysis of variance (ANOVA) and multiple linear regression model were used to identify the related factors.

RESULTSThe scores of subjective support, objective support, utilization of social support, and overall social support for 330 HIV/AIDS patients were significant lower than the national norm (P < 0.05). Multiple linear regression analysis showed that the subjective support (β' = -0.260), objective support (β' = -0.196) and overall social support (β' = -0.141) for the patients who were unmarried, divorced or widowed were worse than those for the patients who were married (P < 0.05). The patients with higher educational level had more objective support (β' = 0.250) and utilization of social support (β' = 0.232) than those with lower educational level (P < 0.05). The subjective support for patients without HIV related symptoms in the past two weeks was better than those with HIV related symptoms (β' = 0.232, P < 0.05).

CONCLUSIONThe current status of social support for HIV/AIDS patients under ART in Wuhan was worse than that for healthy people. More attention should be paid to HIV/AIDS patients with worse social support.

Acquired Immunodeficiency Syndrome ; drug therapy ; Anti-Retroviral Agents ; therapeutic use ; China ; Educational Status ; HIV Infections ; drug therapy ; Humans ; Linear Models ; Marital Status ; statistics & numerical data ; Regression Analysis ; Social Support

Objective To evaluate the clinical significance of dissection of pulmonary ligament was operated on videoassisted thoracic surgery(VATS) with bullectomy for spontaneous pneumothorax.Methods From Jan 2012 to Dec 2013, 232 patients (188 males, 44 females) underwent VATS with bullectomy for spontaneous pneumothorax or hemopeumothorax, whose age were between 14 and 45 years and mean age was(26.4 ± 10.1) years.202 patients resulted from upper lobe spontaneous pneumothorax, 23 patients for lower lobe spontaneous pneumothorax, 7 patients for hemopeumothorax, and 18 cases because of recurrence after bullectomy (7.7 ％, 18/232).all the patients were accepted bullectomy with or without dissection of pulmonary ligament.Results Between 112 patients who underwent upper lobe bullectomy with dissection of pulmonary ligament, at 1 st postoperative day, it was found 92 patients whose pleural effusion were less than 300 ml (82.1％ ,92/112);20 patients whose pleural effusion were greater than or equal to 300 ml(17.9％, 20/112), and the mean drainage from thoracic cavity was(147.0 ± 61.0)ml.At 3 rd day, the mean drainage was(33.4 ± 20.0) ml.Within 23 cases who underwent lower lobe bullectomy with dissection of pulmonary ligament, the mean drainage from thoracic cavity, at 1 st postoperative day, was (155.2 ±41.1)ml,and the mean drainage, at the 3rd day, was(52.1 ± 21.3)ml.Also,within 90 patients who underwent bullectomywithout dissection of pulmonary ligament, 9 patients whose pleural effusion, at 1 st postoperative day, were less than 300ml(10％ ,9/90);81 patients whose pleural effusion were greater than or equal to 300ml (90％, 81/90);the mean drainage for 90 patients was(65.1 ± 28.0)ml.At the 3rd day, 40 patients' pleural effusion were greater than or equal to 300ml (44.4％,40/90) , and the mean drainage was(40.2 ± 25.5) ml.2 of 7 hemopeumothorax patients bled for the vessels injury during pulmonary ligament avulsion.Conclusion There was significant difference in clinical outcomes between two groups, and the dissection of pulmonary ligament was able to reduce the pooling of pleural effusion, facilitate the drainage of pleural effusion, and prevent pneumothorax recurrence, but there is no convincing evidence that dissection of pulmonary ligament can lead to bronchial deformation, stenosis, and reduce the free thoracic space.

Objective To investigate the current status of social support for HIV/AIDS patients under antiretroviral treatment(ART)and related factors in Wuhan. Methods Social Support Rating Scale(SSRS)was used to analyze the current status of social support for HIV/AIDS patients under ART in Wuhan. Student’s t test,analysis of variance(ANOVA)and multiple linear regression model were used to identify the related factors. Results The scores of subjective support,objective support,utilization of social support,and overall social support for 330 HIV/AIDS patients were significant lower than the national norm(P<0.05). Multiple linear regression analysis showed that the subjective support(β′=-0.260),objective support(β′=-0.196)and overall social support(β′=-0.141) for the patients who were unmarried,divorced or widowed were worse than those for the patients who were married(P<0.05). The patients with higher educational level had more objective support(β′=0.250)and utilization of social support(β′=0.232)than those with lower educational level (P<0.05). The subjective support for patients without HIV related symptoms in the past two weeks was better than those with HIV related symptoms(β′=0.232,P<0.05). Conclusion The current status of social support for HIV/AIDS patients under ART in Wuhan was worse than that for healthy people. More attention should be paid to HIV/AIDS patients with worse social support.

CD98 is a transmembrane heterodimer of cell surface.It regulates cell signaling pathway by activating some correlated proteins,and controls cell polarization,proliferation,adhesion and migration.CD98 plays an important role in the development of cancer and may be a novel tumor marker for diagnosis and prognosis in lung cancer.

Objective To study the relationship between monoeyte chemoattractant protein 1 (MCP-1)-2518A/G polymorphism and lung cancer in Han nationality of North China. Methods One hun-dred and thirty-four unrelated consecutive patients with lung cancer(112 with NSCLC, 22 with SCLC)and 82 healthy individuals were studied. The polymorphisms of MCP-1-2518A/G were detected with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Results The distribution of AA, AG and GG genotypes of MCP-1-2518 was significantly different in lung cancer patients compared with controls (X~2=8. 486,P=0. 014). There was a significant increase in the frequency of the AA genotype (OR=2. 645, X~2=6. 532, P=0.011) and a significant decrease in the frequency of the GG genotype (OR=0.519, X~2=4.929, P=0. 026)in the lung cancer patients, compared with controls. In the NSCLC patients the fre-quency of the AA genotype was higher than controls(OR=3. 138, X~2=8. 905, P=0.003) and the frequency of the GG genotype was lower than controls(OR=0. 516 ,X~2=4. 613, P=0. 032). The frequencies of AA, AG and GG genotypes in SCLC patients and controls had no difference. Conclusion This preliminary study showed that MCP-1-2518A/G polymorphism was associated with NSCLC but not SCLC.

BACKGROUND AND OBJECTIVEAdenoid cystic carcinoma is primary bronchopulmonary carcinoma with low malignancy, and 43 patients treated in the past 50 years in our hospital were retrospectively studied. The aim of this study is to discuss the clinical symptoms, pathologic characteristic and therapeutic method of primary tracheal or bronchuotracheal adenoid cystic carcinoma.

METHODSThis study summarized total 43 patients of primary tracheal or bronchus adenoid cystic carcinoma treated in our hospital from Jan. 1958 to Dec. 2007. Among them, 40 patients were treated by surgical resection, and 3 patients were treated by fiberoptic bronchoscope's interventional treatment.

RESULTSThe 1-yr, 3-yr, 5-yr survival rates of the 43 patients above were 100% (41/41), 89.5% (34/38), 87.1% (27/31), respectively.

CONCLUSIONPrimary tracheal or bronchus adenoid cystic carcinoma are rare and low malignancy carcinoma. The clinical symptoms of them are not typical. The best treatment is early detection and taking measures of operation plus radiotherapy. The other palliative treatment is fiberoptic bronchoscope's interventional treatment.

Adult ; Aged ; Bronchial Neoplasms ; diagnosis ; mortality ; surgery ; Carcinoma, Adenoid Cystic ; diagnosis ; mortality ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Tomography, X-Ray Computed ; Tracheal Neoplasms ; diagnosis ; mortality ; surgery