肺癌患者生活质量调查及化疗期间发生抑郁的影响因素分析

目的:探讨肺癌患者化疗前后生活质量的变化及化疗期间发生抑郁的影响因素。方法:将2015年1月～2019年12月我院收治的80例肺癌患者纳入研究。所有患者均接受化疗干预,采用健康状况调查简表(SF-36)评分评估患者化疗前后生活质量,以抑郁自评量表(SDS)评估患者抑郁发生情况。对肺癌患者化疗期间发生抑郁的影响因素进行单因素以及多因素Logistic回归分析。结果:化疗后患者的各项生活质量评分均低于化疗前(P0.05)。80例肺癌患者化疗期间出现46例抑郁症,抑郁症发生率为57.50%。经单因素分析发现:性别、受教育程度、家庭月收入、疼痛程度、知晓病情均与肺癌患者化疗期间发生抑郁有关(P0.05)。经多因素Logistic回归分析可得:女性、家庭月收入2500元、Ⅰ度及以上疼痛、知晓病情均是肺癌患者化疗期间发生抑郁的独立危险因素(OR=7.295、1.692、3.952、4.015,P0.05)。结论:化疗会在一定程度上降低肺癌患者的生活质量,同时会增加患者抑郁症发生风险,女性、家庭月收入2500元、Ⅰ度及以上疼痛、知晓病情均是肺癌患者化疗期间发生抑郁的独立危险因素。     

布地奈德联合特布他林雾化吸入治疗对毛细支气管炎患儿潮气呼吸肺功能、T细胞亚群及血清炎性因子的影响

摘要 目的：探讨布地奈德联合特布他林雾化吸入治疗对毛细支气管炎患儿潮气呼吸肺功能、T细胞亚群及血清炎性因子的影响。方法：选取2019年1月~2019年12月期间我院收治的毛细支气管炎患儿98例,采用随机数字表法分为对照组（常规方案治疗）和观察组（对照组基础上加用布地奈德联合特布他林雾化吸入治疗）,各49例。记录两组治疗1周后总有效率。对比两组治疗前、治疗1周后的潮气呼吸肺功能指标[吸气/呼气时间比（Ti/Te）、达峰时间比（TPTEF/TE）、达峰容积比（VPEF/VE）、每千克潮气量（Vt/kg）]、T细胞亚群[CD3⁺、CD4⁺、CD8⁺及CD4⁺/CD8⁺]、血清炎性因子[降钙素原（PCT）、C反应蛋白（CRP）]。比较两组不良反应发生率。结果：+、CD4⁺、CD4⁺/CD8⁺均高于治疗前,且观察组高于对照组（P<0.05）,PCT、CRP、CD8+均低于治疗前,且观察组低于对照组（P<0.05）。两组患儿不良反应发生率对比无统计学差异（P>0.05）。结论：雾化吸入特布他林联合布地奈德治疗毛细支气管炎患儿疗效显著,可有效改善患儿T细胞亚群、潮气呼吸肺功能,减轻患儿炎性反应,且安全性好。     

不同病理分期肺腺癌患者血清代谢组学研究

肺癌是当今世界最常见的恶性肿瘤之一,其新发率和死亡率多年来都居于各类癌症之首,其中85%的肺癌都是非小细胞癌,而腺癌又是最常见的非小细胞癌。肺癌的高隐匿性是造成其高死亡率的最主要原因,因此为肺癌的早期诊断和病理分期寻求高效可靠的方法是十分必要的。代谢组学揭示了小分子代谢物的一系列变化,反映了生命活动的最终状态,因此也能直接反映疾病不同发展阶段的病理生理变化。本研究利用核磁共振氢谱(1H-NMR),对在我院就诊的27例不同病理分期的肺腺癌患者和13例健康志愿者进行了血清代谢物分析,运用正交偏最小二乘判别分析(OPLS-DA)对1H-NMR数据进行建模,单变量统计分析对模型进行评价。结果表明肺腺癌患者组的血清中有14种代谢物出现明显差异,其中丙酮酸、丙氨酸、NAC1、乳酸、GPC和甘氨酸比起对照组来有显著上升,而葡萄糖、谷氨酰胺、亮氨酸、异亮氨酸、缬氨酸、丙酮、乙酰乙酸和苏氨酸则显著下降。而在不同分期肺腺癌患者间进行比较后发现,异亮氨酸、乙酰乙酸、NAC1和乳酸的变化与肺腺癌的发展有相关性,可能是肺腺癌早期诊断和分期的潜在生物标志物。     

Software simulation of tumour motion dose effects during flattened and unflattened ITV-based VMAT lung SBRT

PurposeRestricted studies comparing different dose rate parameters are available while ITV-based VMAT lung SBRT planning leads to perform the analysis of the most suitable parameters of the external beams used. The special emphasis was placed on the impact of dose rate on dose distribution variations in target volumes due to interplay effects.MethodsFour VMAT plans were calculated for 15 lung tumours using 6 MV photon beam quality (flattening filter FF vs. flattening filter free FFF beams) and maximum dose rate of 600 MU/min, 1000 MU/min and 1400 MU/min. Three kinds of motion simulations were performed finally giving 180 plans with perturbed dose distributions.Results6FFF-1400 MUs/min plans were characterized by the shortest beam on time (1.8 ± 0.2 min). Analysing the performed motion simulation results, the mean dose (Dmean) is not a sensitive parameter to related interplay effects. Looking for local maximum and local minimum doses, some discrepancies were found, but their significance was presented for individual patients, not for the whole cohort. The same was observed for other verified dose metrics.ConclusionsGenerally, the evaluation of VMAT robustness between FF and FFF concepts against interplay effect showed a negligible effect of simulated motion influence on tumour coverage among different photon beam quality parameters. Due to the lack of FFF beams, smaller radiotherapy centres are able to perform ITV-based VMAT lung SBRT treatment in a safe way. Radiotherapy department having FFF beams could perform safe, fast and efficient ITV-based VMAT lung SBRT without a concern about significance of interplay effects.     

Impact of lung density on isolated lung tumor dose in VMAT using inline MR-Linac

PurposeThis study investigated the impact of lung density on the isolated lung tumor dose for volumetric modulated arc therapy (VMAT) in an inline magnetic resonance linear accelerator (MR-Linac) using the Monte Carlo (MC) simulation.MethodsCT images of the thorax phantoms with lung tumors of 1, 2, and 3 cm diameters were converted into voxel-base phantoms with lung densities of 0.1, 0.2, and 0.3 g/cm³, respectively. The dose distributions were calculated for partial-arc VMAT. The dose distributions were compared using dose differences, dose volume histograms, and dose volume indices.ResultsIn all cases, the inline magnetic field significantly enhanced the lung tumor dose compared to that at 0 T. For the 1 cm lung tumor, the inline magnetic field of 1 T increased the minimum dose of 95% of the Planning target volume (PTV D₉₅) by 14.0% in 0.1 g/cm³ lung density as compared to that in 0.3 g/cm³ at 0 T. In contrast, at 0 and 0.5 T, the PTV D₉₅ in 0.3 g/cm³ lung density was larger than that in lung density of 0.1 g/cm³. For the 2 cm lung tumor, a similar tendency to 1 cm was observed, whereas the dose impact of lung density was smaller than that for 1 cm. For the 3 cm lung tumor, the lung tumor dose was independent of lung density at 0.5 T and 1.0 T.ConclusionThe inline MR-Linac with the magnetic field over 1 T can enhance the PTV D₉₅ for VMAT regardless of the lung density.     

Comparison of methods for the demarcation between earlywood and latewood in tree rings of Norway spruce

The precise demarcation between earlywood and latewood is important for the detailed analysis of intra-annual tree ring features. Different techniques based on visual assessment, wood anatomy analysis and X-ray densitometry have been developed and are currently used for this purpose. Depending on the chosen method, tree species and environmental conditions, the results can significantly vary. Thus, it is important to determine the technique optimal for a particular research. Here, we investigated Norway spruce (Picea abies) tree rings to examine the agreement among the following demarcation methods: (1) direct visual assessment, (2) Mork’s index (anatomical definition of the transition from earlywood to latewood based on cell wall-lumen ratio) and (3) fixed and floating density thresholds applied to intra-ring density profiles. The aim was to modify both the Mork’s criterion and density thresholds on the basis of reference values given by visual identification of earlywood/latewood transition. A total of 231 tree rings were analysed by all methods. Our results showed that the usage of floating threshold (defined for each ring separately based on density profiles) is more reliable in comparison with fixed threshold (the same threshold value used for all tree rings and samples). Statistical analysis revealed the best correspondence between visual identification of earlywood/latewood transition and demarcation based on the standard Mork’s index and the floating density threshold derived as 80 % of maximum latewood density. In terms of Mork’s index calibration, the results showed that to determine latewood cells in Norway spruce trees growing in temperate conditions, it is sufficient to use an index value equal to 0.83. The results are applicable for the studied spruce population growing in a temperate climate. The methodology itself, however, is universal and can help to calibrate criteria for earlywood-latewood demarcation under specific conditions.     

Silencing LINC00504 inhibits cell proliferation,invasion as well as migration and promotes cell apoptosis in lung cancer cells via upregulating miR-876-3p

LINC00504 acts as an oncogene and associates with unfavorable prognosis in patients with lung cancer. Silencing LINC00504 may be a promising strategy for treatment of lung cancer and its effects were firstly investigated in lung cancer cells this study. The gene expression level of miR-876-3p as well as LINC00504 were measured via PCR assay. The cell proliferation was investigated through Cell Counting Kit-8 (CCK-8) assay and colony formation assay. Flow cytometry was applied for detection of cell apoptosis. Wound healing and transwell assay were performed for measurement of cell migration and invasion respectively. The apoptosis related protein expressions were measured by western blot. Luciferase report assay was conducted for verification the target gene. LINC00504 was higher expressed in five types of lung cancer cells studied herein when compared with the control normal cells. LINC00504 knockdown exerted inhibitory effects on cell apoptosis, cell migration as well as cell invasion and promoted cell apoptosis. All the effects mentioned above were counteracted by miR-876-3p inhibitor. Silencing LINC00504 possessed anti-proliferation, repression of cell invasion as well as migration and pro-apoptosis effects via targeting up-regulation of miR-876-3p in lung cancer cells, proving the new therapeutic targets and highlighting the potential application in future diagnosis and treatment in lung cancer.     

T-UCRs with digestive and respiratory diseases

From the perspective of histoembryology, the lung, gaster, and intestines that derived from the endoderm of the gastrula are structurally homologous. The interplay of intestines and lung in many pathologic changes is called the gut-lung axis. RNAs transcribed from ultraconserved regions (T-UCRs) are highly evolutionarily conserved in many mammalian genomes and have been found to be important in the pathogenesis and diagnosis of many diseases. More and more studies in recent years have shown that T-UCRs play important roles both in digestive and respiratory diseases. Taking the gut-lung axis as the entry point, this review summarizes the T-UCRs related to digestive and respiratory diseases in recent years. Meanwhile, these T-UCRs and their targets can lay a foundation for future drug research.     

肺癌住院患者营养不良风险调查及其影响因素分析

摘要 目的：肺癌住院患者营养不良风险调查及其影响因素分析。方法：选择2015年2月至2020年1月期间我院诊治的125例肺癌住院患者的临床资料进行回顾性分析。根据患者的营养状态评估结果将其分为81例营养不良组和44例营养良好组。比较两组患者的人口学资料和临床资料,采用多因素Logistic回归分析营养不良发生的影响因素。结果：营养不良患者占比64.80%（81/125）。与营养良好组相比,营养不良组年收入≥50000元患者比例明显下降（P<0.05）,营养不良组体质量指数（BMI）≤22 kg/m²患者比例、肿瘤分期III~Ⅳ期+广泛期患者比例以及肿瘤低分化患者比例明显升高,血清白蛋白水平和淋巴细胞绝对值（LYM）明显下降（P<0.05）。经多因素Logistic回归分析显示肿瘤分期III~Ⅳ期+广泛期以及肿瘤低分化是肺癌住院患者营养不良的危险因素（OR=1.743、1.812,P<0.05）,年收入≥50000元、BMI>22kg/m²、白蛋白水平≥29.55 g/L和LYM≥2.47×10⁹/L是肺癌住院患者营养不良的保护因素（OR=0.487、0.502、0.453、0.731,P<0.05）。结论：肺癌住院患者营养不良风险较高,年收入情况、BMI、肿瘤分期、分化程度、白蛋白水平以及LYM均是肺癌住院患者营养不良风险的影响因素,对上述指标进行监测有利于提前预测营养不良的发生,从而为预防肺癌住院患者营养不良的发生提供指导。