ObjectiveTo review the definition, incidence, risk factors, potential pathogenesis, biomarkers, and choice of follow-up treatment strategies of hyperprogressive disease (HPD).MethodDomestic and international literatures were collected to summarize the research progress of HPD in patients with malignant tumors who treated with immune checkpoint inhibitors (ICIs).ResultsThe research types of HPD were scattered, the sample size was limited, the definition standard was different, and there was lack of prospective validation studies. Therefore, the early warning assessment and molecular mechanism of HPD would become the next focus of the study of immunotherapy.ConclusionICIs can greatly improve the survival time of some patients with advanced malignant tumor, although some patients have HPD during treatment, but the incidence is relatively low.
ObjectiveTo explore the changes of intraoperative temperature and influencing factors of the short-term prognosis of patients undergoing clipping of posterior communicating artery aneurysms.MethodsThe basic clinic data and intraoperative temperature of patients undergoing elective clipping of posterior communicating artery aneurysms between October 2018 and July 2019 were collected, and the minimum intraoperative temperature was categorized into ≥36.0 and <37.5℃, ≥35.0 and <36.0℃, and <35.0℃. According to the Glasgow outcome scale (GOS) at discharge, the patients were divided into good prognosis group (GOS 4-5) and bad prognosis group (GOS 1-3). Multiple logistic regression analysis was used to obtain the risk factors of short-term prognosis.ResultsA total of 127 cases were involved, and intraoperative hypothermia (<36.0℃) occurred in 64 cases (50.4%). The intraoperative temperature presented classical three-phrase changes, i.e. it dropped rapidly at 1 hour after anesthesia introduction, decreased slowly during 2-3 hours after anesthesia introduction, and then entered the plateau. In the 127 cases, 93 (73.2%) had good prognosis, with an intraoperative hypothermia proportion of 44.1% (41/93); and 34 (26.8%) had bad prognosis, with an intraoperative hypothermia proportion of 67.6% (23/34). Univariate analysis showed that Hunt-Hess grade (χ2=18.999, P<0.001), intraoperative bleeding (χ2=7.074, P=0.008), minimum intraoperative temperature (Z=−3.473, P=0.001), and postoperative complications (χ2=43.060, P<0.001) were related to the short-term prognosis of patients undergoing clipping of posterior communicating artery aneurysms. Multiple logistic regression analysis presented that high Hunt-Hess grade (Ⅳ, Ⅴ) [odds ratio (OR)=6.456, 95% confidence interval (CI) (1.141, 36.532), P=0.035], the minimum intraoperative temperature <35.0℃ [OR=7.552, 95%CI (1.450, 39.345), P=0.016], and postoperative complications [OR=22.866, 95%CI (6.778, 77.142), P<0.001] were independent risk factors of the short-term prognosis. The difference in short-term prognosis between patients with the minimum intraoperative temperature ≥35.0 and <36.0℃ and the ones with the minimum intraoperative temperature ≥36.0 and <37.5℃ was not statistically significant (P>0.05).ConclusionsThe minimum intraoperative temperature<35.0℃ and postoperative complications were changeable factors to effect progonosis of patients undergoing elective clipping of posterior communicating artery aneurysms. Clinical staff should set medical intervention measures based on the individual conditions of patients to improve patients’ quality of life.
Objective To detect the difference of periostin expression in small cell lung cancer (SCLC) cell, and explore its effect on chemoresistance of SCLC patients. Methods The expression of periostin in mRNA and protein was detected by RT-PCR and Western blot analysis in SCLC H69 and multidrug resistant strain H69AR. The expression of periostin was up-regulated by recombinant plasmid-periostin in H69 cell. The survival rate in the transfected group was different from that of the negative control group and uninterrupted group. Results The expression of periostin mRNA and protein in the sensitive strain H69 was lower than that of the multidrug resistant strain H69AR (P<0.05). The recombinant periostin-plasmid was transfected into H69 cells and at the same concentration of chemotherapeutic drugs (cisplatin, etoposide) the survival rate increased significantly (P<0.05). The positive expression rate of periostin in SCLC tissues was 67.44%, and the sensitivity of the chemotherapy group was lower than that of the drug resistant group (P<0.05). Conclusion The expression of periostin in SCLC cell H69 is significantly lower than that of the multidrug resistant strain H69AR and overexpression of periostin increases resistance of the sensitive strain H69 and hence periostin may be involved in SCLC chemoresistance.