Notes

Heart disappointment like a critical side-effect associated with iodinated contrast-induced hyperthyroidism: case-report.
Conclusions SIBO usually occurs in elderly patients who receive continuous PPI rather than on-demand use. If elderly require long-term PPI therapy, on demand administration is suggested as long as primary diseases are properly treated.Objective To discuss the effects of transjugular intrahepatic portosystemic shunt (TIPS) procedure on hemodynamics in cirrhotic patients. Methods A total of 23 cirrhotic patients for TIPS insertion were enrolled from January 2018 to October 2018. Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), transthoracic echocardiography and non-invasive cardiac output measurement based on impedance cardiogram were carried out before and 24h, 1 month, 6 months after TIPS in order to observe cardiac function and hemodynamic changes after TIPS. Results Significant increases in right atrial area [(17.2±4.0) cm(2) vs. #link# (15.0±3.4) cm(2), P0.05). Conclusion Cirrhotic patients who had no cardiovascular pathologies had adequate adaptation and good compensation ability to reach a new hemodynamic homeostasis for the increased volume load after TIPS insertion.Objectives To study the feasibility of using ultrasound to evaluate diaphragm function in patients with invasive mechanical ventilation. Methods From March to December 2017, 40 adult patients with acute respiratory distress syndrome who were admitted to the Department of Critical Care Medicine, Xiangya Hospital, Central South University for more than 48 hours were included. Diaphragmatic excursion and thickness of bilateral anterior, middle and posterior parts were measured by ultrasound for 5 consecutive days. Results (1) Compared with the diaphragmatic excursion of the right [anterior (11.05±3.04) mm; middle (12.08±2.71) mm; posterior (11.51±3.33) mm] and left [anterior (13.63±7.52) mm; middle (15.44±7.52) mm; posterior (14.76±6.93) mm] sides on day 1, the diaphragmatic excursion of the right [anterior (8.90±3.65) mm; middle (10.02±4.24) mm; posterior (10.25±4.38) mm] and left [anterior (9.82±1.96) mm; middle (11.60±1.13) mm; posterior (11.52±1.98) mm] sides decreased significantly on day 3 (P less then 0.0 withdrawing from mechanical ventilation.Objective To analyze the effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) on coronavirus disease 2019 (COVID-19) patients with hypertension, and to provide an evidence for selecting antihypertensive drugs in those patients. Methods Clinical data were retrospectively analyzed in 58 COVID-19 patients with hypertension admitted to Shanghai Public Health Clinical Center from January 20 to February 22, 2020, including epidemiological history, clinical manifestations, laboratory findings, chest CT and outcome. Patients were divided into ACEI/ARB group and non-ACEI/ARB group. link2 Results Twenty-six patients were in ACEI/ARB group and the other 32 patients in non-ACEI/ARB group, with median age 64.0 (49.5, 72.0) years and 64.0 (57.0, 68.8) years respectively. The median time to onset was 5(3, 8) days in ACEI/ARB group and 4 (3, 7) days in non-ACEI/ARB group, the proportion of patients with severe or critical illness was 19.2% and 15.6% respectively. The main clinical symptoms in two groups were fever (80.8% vs. 84.4%) and cough (23.1% vs. 31.3%). The following parameters were comparable including lymphocyte counts, C-reactive protein, lactate dehydrogenase, D-dimer, bilateral involvement in chest CT (76.9% vs. 71.9%), worsening of COVID-19 (15.4% vs. 9.4%), favorable outcome (92.3% vs. 96.9%) between ACEI/ARB group and non-ACEI/ARB group respectively (all P>0.05). However, compared with non-ACEI/ARB group, serum creatinine [80.49 (68.72, 95.30) μmol/L vs. 71.29 (50.98, 76.98) μmol/L, P=0.007] was higher significantly in ACEI/ARB group. Conclusions ACEI/ARB drugs have no significant effects on baseline clinical parameters (serum creatine and myoglobin excluded) , outcome, and prognosis of COVID-19 patients with hypertension. Antihypertensive drugs are not suggested to adjust in those patients, but the potential impairment of renal function as elevation of serum creatinine should be paid attention in patients administrating ACEI/ARB drugs.Lung resection following pneumonectomy for recurrent lung cancer is a challenging scenario. link3 Peri-operative airway management and choice of surgical procedure are issues to be addressed by both the anesthesiologists and thoracic surgeons. We hereby report a case of anterior segmentectomy of the right upper for recurrent lung cancer, in a patient who had previously underwent pneumonectomy for primary lung cancer one year earlier. A modified conventional tracheal intubation and unique surgical techniques were applied for video-assisted thoracoscopic surgery (VATS) anterior segmentectomy of the right upper lobe in a patient with a notable mediastinal shift (following contralateral pneumonectomy), resulting in a good recovery and clinical outcome. The clinical experience is summarized in detail in this article.Lung cancer is one of the most common malignancies with the highest incidence rate and mortality rate worldwide, and non-small cell lung cancer (NSCLC) accounts for about 85%. Only 5% NSCLC patients are anaplastic lymphoma kinase (ALK) rearrangement positive NSCLC, but the prognosis of these patients is poor, and treatment is urgent. selleckchem (X-396), a next-generation ALK tyrosine kinase inhibitor (ALK-TKI), has shown greater potency on inhibiting ALK activity and controlling brain metastases than crizotinib, which is indicated for the treatment of crizotinib-resistant, ALK-positive NSCLC patients. Several phase I to III clinical trials included both healthy volunteers and NSCLC patients have been conducted both in China and abroad. In this review, we briefly summarized the results of these trials, and preliminary efficacy, safety, pharmacology and pharmacokinetics/pharmacodynamics of ensartinib were discussed.Idiopathic pulmonary fibrosis (IPF) is characterized by diffuse alveolitis and disorder of alveolar structure and eventually leads to pulmonary interstitial fibrosis. The cause of IPF is unknown and there is no effective treatment for IPF. There is no effective treatment for IPF, mainly to delay disease progression and improve patient's quality of life. At present, the incidence of IPF with lung cancer (IPF-LC) has increased significantly, which resulted in higher mortality and reduced quality of life. IPF-LC is more common in men, elderly, and smokers. It is a fatal disease and its clinical manifestations lack specificity. IPF-LC has no clear treatment plan, meanwhile, the median survival time is short, and the prognosis is poor. At present, the pathogenesis and treatment plan of IPF-LC are not clear. This article provides a brief review of the current research on the risk factors, pathogenesis, clinical characteristics and treatment of IPF-LC."Liquid biopsy" have been intensively studied in recent decades. The exosomes carry their maternal partial functional proteins and genes. As a form of intercellular vesicular transport, exosome-mediated intercellular communication participates in a variety of physiological and pathological processes. The information transmission mediated by exosomes is associated with pathophysiological status and plays an important role in the pathogenesis of cancer. Their detection may be beneficial for the diagnosis and treatment of tumor. This article reviews advances in knowledge on the exosome properties, the effect of exosomes on malignant tumorigenesis, and their clinical application. The data will provide a reference for clinical practitioners.
Pneumonectomy and sleeve resection are routine operations for the treatment of central non-small cell lung cancer (NSCLC), but some patients suffered of central NSCLC, whose pulmonary function is too poor to tolerate pneumonectomy, or the tumor involves the bronchus and pulmonary artery extensively,it is hard to perform bronchovascular sleeve lobectomy. The aim of this study is to assess the feasibility of lung autotransplantation in the treatment of central NSCLC.

The clinical data of 3 cases with central NSCLC treated by lung autotransplantation was reviewed from December 2016 to December 2018. One patient underwent double sleeve resection of left upper lobe with end-to-end anastomosis of the bronchus. Because the resection of the pulmonary artery was too long to perfrom a tension-free anastomosis, the inferior pulmonary vein was cut off, then the left lower lobe was moved up for an anastomosis of the inferior pulmonary vein and the stump of the superior pulmonary vein. In the other 2 cases, left pneumoesection and improve postoperative quality of life.
For patients with central NSCLC with extensive tumor invasion, thus inability to tolerate sleeve resection or pneumonectomy, autologous lung transplantation can preserve lung function to the greatest extent with a complete tumor resection and improve postoperative quality of life.
Anaplastic lymphoma kinase (ALK) rearrangement is a common driver gene of non-small cell lung cancer (NSCLC). Ceritinib is a second-generation ALK inhibitor, which can bring survival benefits to ALK-positive metastatic NSCLC. However, few studies focus on the safety and efficacy of ceritinib in China. Therefore, this study intends to investigate the safety and preliminary efficacy of ceritinib 450 mg with meals in Chinese patients with ALK-positive NSCLC through a real world study.

From October 2018 to December 2019, patients with ALK-positive NSCLC from 8 medical centers in Sichuan province were recruited in this study. All of these participants received ceritinib 450 mg/d with food. The basic characteristics, adverse effects (AEs) and responses were collected and analyzed in order to evaluate the safety and efficacy of ceritinib.

A total of 109 patients were included in this study. Data cutoff was January 23, 2020. The median duration of treatment exposure was 5.87 mon (range 0.4 mon-15.7 mon). Total AEs were reported in 98 (89.9%) of 109 patients and grade 3 or 4 AEs were reported in 22.9% of patients. Most common AEs (mainly grade 1 or 2) were diarrhea (60.6%), elevated alanine aminotransferase (ALT)(38.5%) and aspartate aminotransferase (AST)(37.6%). As of data cutoff, 45 patients discontinued ceritinib. The overall response rate (ORR) was 37.6% (95%CI 28.5%-47.4%) and disease control rate (DCR) was 86.2% (95%CI 78.3%-92.1%).

The treatment of ceritinib 450 mg with food for Chinese ALK-positive NSCLC patients had a good safety profile and favorable DCR in real-world setting. However, this conclusion needs to be further verified by large sample, prospective trials.
The treatment of ceritinib 450 mg with food for Chinese ALK-positive NSCLC patients had a good safety profile and favorable DCR in real-world setting. However, this conclusion needs to be further verified by large sample, prospective trials.
Leptomeningeal metastasis (LM) are a severe complication of non-small cell lung cancer (NSCLC), and normally accompanied by poor prognosis. For the patients with targetable mutations, epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are the preferred treatment, but the acquired TKI resistance is inextricable. The aim of this study is to analyze the different gene mutation spectrum and mutation frequency of the cerebrospinal fluid (CSF) and plasma in NSCLC patients with LM, and screen out the drug-resistant mutations so as to guide the choice of treatment accurately.

The paired CSF and plasma samples were collected from the NSCLC-LM patients with acquired TKI resistance. Next generation sequencing (NGS) was used to detect the gene variations of circulating tumor DNA (ctDNA).

A total of 18 NSCLC patients with LM were collected. Of the basic mutations, 11 cases (61.11%) were EGFR, 6 cases (33.33%) were anaplastic lymphoma kinase (ALK), and 1 case (5.56%) was ROS proto-oncogene 1, receptor tyrosine kinase (ROS1).
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