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Objective: To evaluate the effectiveness and safety of hyperthermia combined with chemotherapy for non-small cell lung cancer (NSCLC). Methods: All of randomized controlled trials (RCT) about hyperthermia in combination with chemotherapy (versus chemotherapy alone) were collected through Cochrane library, PubMed, EMbase, CBM, CNKI, VIP, Wanfang Database from database inception to October 2019, no limit on language. Two researchers extracted data and assess literature quality separately, and made a metaanalysis by RevMan 5.3 software. 32 trials with 2361 patients, 1154 in treatment group and 1152 in control group, wereincluded in the review. Results: The results of the Meta-analysis exhibited that compared with chemotherapy alone, hyperthermia combined with chemotherapy could can enhance tumor response rate [RR=1.48, 95% CI (1.34, 1.63), p

Background: Coronavirus disease 2019 (COVID-19) is an emerging and rapidly evolving disease with no effective drug treatment. Traditional Chinese medicines have been widely used to treat COVID-19 in China. Chansu and its major active constituent, bufalin, exert broad-spectrum antiviral effects. Although the clinical efficacy of Chansu injection for COVID-19 treatment has been confirmed, its mechanism of action remains unclear. Objectives: In this study, we used network pharmacology and molecular docking technology to explore the potential material basis and mechanism of action of Chansu injection for COVID-19 treatment. Methods: The main components of Chansu injection were determined using high-performance liquid chromatography (HPLC). The PharmMapper, SwissTargetPrediction, SEA, and TCMID databases were used to screen for the active ingredients and therapeutic targets of Chansu injection while the OMIM and GeneCards Suite databases were used to search for COVID-19-related targets. The STRING database was used for protein–protein interaction (PPI) network construction and topological analysis while DAVID was used for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of the core targets. Molecular docking of the three Chansu injection components (i.e., cinobufagin, resibufogenin, and bufalin) to angiotensin-converting enzyme II, spike (S) protein, 3CL protease, and RNA-dependent RNA polymerase was also carried out. Results: The three Chansu injection compounds were identified using HPLC. A total of 236 drug-related targets and 16,611 disease-related targets were identified, and 77 common targets were determined through mapping. The PPI mapping results revealed 16 core targets obtained through topological analysis and screening. Further, GO and KEGG pathway enrichment analyses revealed that the PI3K and JAK–STAT signaling pathways are the major pathways regulated by Chansu injection in COVID-19 treatment. The molecular docking results suggest that the three Chansu injection components have high binding energies to the S protein. Conclusions: This study revealed that the potential mechanism of Chansu injection for COVID-19 treatment involves multiple targets and pathways, thereby providing a scientific basis for its clinical application and further research.

To systemically evaluate the efficacy and safety of Banmao Capsules in the adjuvant treatment for non-small cell lung cancer(NSCLC). All of randomized controlled trials(RCT) about Banmao Capsules in adjuvant treatment for non-small cell lung cancer were retrieved in PubMed, EMbase, Cochrane Library, CNKI, VIP, CBM, WanFang database from database inception to August 2019. Two researchers extracted data and assessed literature quality separately, and made a Meta-analysis by RevMan 5.3 software. Thirteen trials involving 1 148 patients, including 595 in treatment group and 553 in control group, were enrolled in the review. The Meta-analysis showed that compared with conventional treatment, adjuvant treatment of NSCLC with Banmao Capsules can enhance the objective tumor response rate(RR=1.43,95%CI[1.30,1.58],Plt;0.01), and the disease control rate(RR=1.16,95%CI[1.11,1.22],Plt;0.01); improve the quality of life(RR=1.56,95%CI[1.27,1.92],Plt;0.01); reduce the incidence of myelosuppression(RR=0.41,95%CI[0.26,0.66],Plt;0.01), gastrointestinal reactions(RR=0.46,95%CI[0.33,0.65],Plt;0.01), liver and kidney dysfunction(RR=0.44,95%CI[0.29,0.66],Plt;0.01). The results showed that in the treatment of NSCLC, Banmao Capsules can increase the short-term efficacy, improve the quality of life of patients, and reduce the side effects of platinum-based chemotherapy drugs. More high-quality and large-scale randomized controlled trials are required in the future.

To systemically evaluate the efficacy and safety of Cinobufacini Injection in combination with platinum-contained first-line chemotherapy for treatment of non-small cell lung cancer(NSCLC). The randomized controlled trials(RCT) about the Cinobufacini in combination with platinum-contained first-line chemotherapy(versus chemotherapy alone) were collected through PubMed,Cochrane library,CNKI,VIP,CBM,and Wan Fang Database from database inception to December 2018. Two researchers extracted data and assessed the literature quality separately,and made a Meta-analysis by using Rev Man 5. 3 software. Twenty-seven RCTs were included in the present review,involving 2 125 patients,1 082 in treatment group and 1 043 in control group. The Meta-analysis results showed that as compared with chemotherapy alone,the combination of Cinobufacini and platinum-contained first-line chemotherapy could enhance one year survival rate(RR = 1. 34,95%CI[1. 17,1. 55],P0. 01),two year survival rate(RR = 1. 84,95% CI[1. 31,2. 59],P0. 01),objective tumor response rate(RR = 1. 47,95%CI[1. 33,1. 63],P0. 01); improve the quality of life for patients(RR =1. 54,95%CI[1. 37,1. 72],P0. 01); and reduce the incidences of WBC toxicity(RR = 0. 63,95% CI[0. 49,0. 80],P0. 01),platelet toxicity(RR = 0. 54,95%CI[0. 35,0. 84],P0. 01),gastrointestinal reactions(RR = 0. 60,95%CI[0. 45,0. 80],P0. 05),pain(RR = 1. 68,95% CI[1. 38,2. 03],P0. 01),and hair loss reaction(RR = 0. 76,95% CI[0. 59,0. 98],P0. 05). The results showed that for the treatment of NSCLC,the addition of cinofacini to conventional platinum-contained chemotherapy can increase the long-term and short-term efficacy of chemotherapy,improve the quality of life for patients,and reduce the side effects of platinumbased chemotherapy drugs. However,more high quality and large-scale randomized controlled trials are required to verify this conclusion in the future.

Objective To determine the impact of adjuvant corticosteroids administered to patients hospitalized with influenza A (H7N9) viral pneumonia. Design The effects of adjuvant corticosteroids on mortality were assessed using multivariate Cox regression and a propensity score-matched case-control study. Nosocomial infections and viral shedding were also compared. Setting Hospitals with influenza A (H7N9) viral pneumonia patient admission in 84 cities and 16 provinces of Mainland China. Patients Adolescent and Adult patients aged >14 yr with severe laboratory-confirmed influenza A (H7N9) virus infections were screened from April 2013 to March 2015. Interventions None. Measurements and main results The study population comprised 288 cases who were hospitalized with influenza A (H7N9) viral pneumonia. The median age of the study population was 58 years, 69.8% of the cohort comprised male patients, and 51.4% had at least one type of underlying diseases. The in-hospital mortality was 31.9%. Two hundred and four patients (70.8%) received adjuvant corticosteroids; among them, 193 had hypoxemia and lung infiltrates, 11 had chronic obstructive pulmonary disease, and 11 had pneumonia only. Corticosteroids were initiated within 7 days (interquartile range, 5.0-9.4 d) of the onset of illness and the maximum dose administered was equivalent to 80-mg methylprednisolone (interquartile range, 40-120 mg). The patients were treated with corticosteroids for a median duration of 7 days (interquartile range, 4.0-11.3 d). Cox regression analysis showed that compared with the patients who did not receive corticosteroid, those who received corticosteroid had a significantly higher 60-day mortality (adjusted hazards ratio, 1.98; 95% CI, 1.03-3.79; p = 0.04). Subgroup analysis showed that high-dose corticosteroid therapy (> 150 mg/d methylprednisolone or equivalent) significantly increased both 30-day and 60-day mortality, whereas no significant impact was observed for low-to-moderate doses of corticosteroids (25-150 mg/d methylprednisolone or equivalent). The propensity score-matched case-control analysis showed that the median viral shedding time was much longer in the group that received high-dose corticosteroids (15 d), compared with patients who did not receive corticosteroids (13 d; p = 0.039). Conclusions High-dose corticosteroids were associated with increased mortality and longer viral shedding in patients with influenza A (H7N9) viral pneumonia.

MicroRNA (miR)‑27b has been reported to partici-pate in regulating the activity of non‑small cell lung carcinoma (NSCLC) cells. Additionally, when downregulated in NSCLC it promotes resistance to docetaxel; however, the underlying molecular mechanism remains largely unknown. Using reverse transcription‑quantitative polymerase chain reaction, the present study determined that the expression of miR‑27b was significantly reduced in NSCLC cells that were resistant to docetaxel. In addition, epidermal growth factor receptor (EGFR) was identified as a possible target of miR‑27b by searching the online miRNA database, TargetScan. A luciferase assay further validated EGFR as an effective target gene of miR‑27b. In addition, it was determined that in tumor tissue samples resistant to docetaxel miR‑27b was significantly downregulated, whilst EGFR was significantly upregulated. miR‑27b negatively regulated the expression of EGFR. This was evident as the transfection of miR‑27b mimics led to downregulation of the expression levels of EGFR, whilst miR‑27b inhibitors upregulated the expression levels of EGFR. Furthermore, it was demonstrated that the transfection of miR‑27b mimics significantly suppressed the apoptosis and promote the viability of A549 human lung carcinoma cells. In line with this, the introduction of miR‑27b inhibitors significantly induced apoptosis and inhibited the proliferation of A549 cells. These results indicate that miR‑27b may promote NSCLC cell viability and enhance resistance to docetaxel treatment through direct inhibition of EGFR expression. Additionally, miR‑27b may become a promising molecular target for improving the effectiveness of chemotherapy with docetaxel.

Background Despite advances in asthma management, exacerbations constitute a significant health economic burden. Objective To observe the efficacy and safety of Chinese herbal medicine formula entitled PingchuanYiqi (PCYQ) granule, on acute asthma and to explore its possible mechanism. Materials and methods This proof-of-concept study consisted of a randomized, double-blind, placebo-controlled trial in patients with acute asthma (n = 300). Participants with acute mild-to-moderate asthma recruited from seven centers in China were randomly assigned to receive PCYQ or placebo. The primary outcomes were PEF (L/min) and total asthma symptom scores. Furthermore, a panel of cytokines including serum IL-4, IL-5, IL-6, IL-8, IL-1β, IL-17A, IFN-α, IFN-β, IFN-γ, CRP, CCL-5, IP-10, and PGD2 levels was detected using ELISA. Results The PCYQ (n = 139) significantly improved the morning PEF on day 4 (349.73 ± 93.92 vs. 313.56 ± 92.91 L/min, P = 0.004) and day 7 (360.42 ± 94.39 vs. 329.52 ± 95.97 L/min, P = 0.023), and the evening PEF on day 4 (352.65 ± 95.47 vs. 320.58 ± 95.30 L/min, P = 0.012) and day 7 (360.42 ± 94.39 vs. 336.86 ± 95.59 L/min, P = 0.029) in comparison with the placebo (n = 143). The PCYQ also improved the clinical symptoms scores and reduced the puffs of short-acting β2-agonist (all P Conclusion The PCYQ as the Chinese herbal medicine formula significantly improves lung function and symptoms of acute asthma, and reduces SABA dosage possibly via decrease of inflammatory biomarkers such as IL-5, IL-8, IL-1β and PGD2. Trial registration ISRCTN61674768 ( http://www.isrctn.com/ ).

Lymphangiogenesis plays an important role in the cancer metastasis. Bone marrow-derived mesenchymal stem cells (BM-MSCs) migrate to the site of tumorigenesis and in turn promote the metastasis. In order to investigate the involvement of BM-MSCs in lymphangiogenesis of lung cancer, we prepared a Lewis lung tumor model in chimeric mice that established by transplanting BM from green fluorescent protein (GFP) transgenic mice (C57BL/6-EGFP) into irradiated C57BL/6 mice. GFP-positive cells existed in bone marrow of acceptor mice revealed the success of the transplantation. Observation of GFP-positive cells in tumor slice demonstrated that BM-MSCs transformed into the lung tumor. Immunohistochemical analyses of lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) demonstrated a part of lymphatic endothelial cells (LECs) in lung cancer were derived from BM-MSCs, and those LECs contributed to the lung tumor lymphangiogenesis (Figure 1). Furthermore, we found an oral liquid formulation of Chinese herbal drugs, Jinfukang inhibited the lymphangiogenesis. Our findings suggest that BM-MSCs transform to tumor, differentiate into LECs, and involve in the lymphangiogenesis in lung cancer of mice. The results might provide a potential for the lung cancer therapies.

Xiao-Min Lu,* Ji-Ping Zhu,* Xian-Mei Zhou Department of Respiratory Medicine, Affiliated Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing University of Traditional Chinese Medicine, Nanjing, People’s Republic of China *These authors contributed equally tothis work Background: Insomnia is a common comorbidity associated with COPD. Although benzodiazepines (BZDs) can have adverse effects on respiratory response in COPD patients, these are the most common hypnotics. The aim of this study was to examine by meta-analysis the efficacy and safety of BZD to treat insomnia in COPD patients. Materials and methods: Electronic databases (PubMed, China National Knowledge Infrastructure, Cochrane clinical trials database) were searched. Studies were eligible if they compared the effects of BZD versus placebo on insomnia in COPD patients. Two reviewers extracted data independently. Disagreements were resolved by discussion with another reviewer until a consensus was achieved. Data that included objective and subjective sleep evaluation and respiratory function variables were extracted. Data were analyzed by the methods recommended by Review Manager 5.3 software. Results: A total of 233 records were identified through the initial search; of these, five studies were included in the meta-analysis. When BZD was compared with placebo, objective sleep quality was significantly improved, including total sleep time (95% confidence interval [CI] 0.54–1.14, P

Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal lung disease for which, thus far, there are no effective treatments. The pericarp of Citrus reticulata, as a traditional herbal drug, has been used for the clinical treatment of lung-related diseases in China for many years. In the present study, the amines from the pericarp of Citrus reticulata were isolated, and their hydrochlorides were prepared. The results of screening using cultured human embryonic lung fibroblasts (hELFs) revealed that, of the amines, 4-methoxyphenethylamine hydrochloride (designated as amine hydrochloride 1) possessed the most potent inhibitory effect. Further in vivo experiments using a rat model of bleomycin-induced pulmonary fibrosis demonstrated that the oral administration of amine hydrochloride 1 significantly lowered the hydroxyproline content in both serum and lung tissue, and alleviated pulmonary alveolitis and fibrosis. Immunohistochemical analysis revealed that amine hydrochloride 1 exerted its inhibitory effect against IPF through the downregulation of lung transforming growth factor (TGF)-β1 protein expression. Our results demonstrated that amine hydrochloride 1 prevented the development of bleomycin‑induced lung fibrosis in rats. Thus, our data suggest that the amines from the pericarp of Citrus reticulata have therapeutic potential for use in the treatment of IPF.

During the spring of 2013, a novel avian-origin influenza A (H7N9) virus emerged and spread among humans in China. Data were lacking on the clinical characteristics of the infections caused by this virus.Using medical charts, we collected data on 111 patients with laboratory-confirmed avian-origin influenza A (H7N9) infection through May 10, 2013.Of the 111 patients we studied, 76.6% were admitted to an intensive care unit (ICU), and 27.0% died. The median age was 61 years, and 42.3% were 65 years of age or older; 31.5% were female. A total of 61.3% of the patients had at least one underlying medical condition. Fever and cough were the most common presenting symptoms. On admission, 108 patients (97.3%) had findings consistent with pneumonia. Bilateral ground-glass opacities and consolidation were the typical radiologic findings. Lymphocytopenia was observed in 88.3% of patients, and thrombocytopenia in 73.0%. Treatment with antiviral drugs was initiated in 108 patients (97.3%) at a median of 7 days after the onset of illness. The median times from the onset of illness and from the initiation of antiviral therapy to a negative viral test result on real-time reverse-transcriptase-polymerase-chain-reaction assay were 11 days (interquartile range, 9 to 16) and 6 days (interquartile range, 4 to 7), respectively. Multivariate analysis revealed that the presence of a coexisting medical condition was the only independent risk factor for the acute respiratory distress syndrome (ARDS) (odds ratio, 3.42; 95% confidence interval, 1.21 to 9.70; P=0.02).During the evaluation period, the novel H7N9 virus caused severe illness, including pneumonia and ARDS, with high rates of ICU admission and death. (Funded by the National Natural Science Foundation of China and others.).

The currently accepted approaches to treatment of pulmonary fibrosis are based on the treatment of alveolitis and pulmonary fibrosis, however clinically available anti-inflammatory and antifibrotic agents are not often beneficial. Hu-qi-yin, one of the traditional Chinese herbal formulas, has been used for clinical therapy of pulmonary fibrosis in China. The aim of the present study is to evaluate the preventive effects of Hu-qi-yin on the bleomycin (BLM)-induced pulmonary fibrosis in rats. The degree of fibrosis was evaluated with hydroxyproline contents in serum and lung tissue 28 days post-BLM instillation. The semi-quantitative analyses of lung sections were conducted to evaluate the intensity of alveolitis and fibrosis. Furthermore, the expression of transforming growth factor-β 1 (TGF-β 1 ) was quantitatively studied at the protein and mRNA levels by immunohistochemistry and in situ hybridization, respectively. Oral treatment with Hu-qi-yin improved the body weight loss of rats in doses of 3.8, 7.6 g/kg compared with BLM-treated control group, and significantly inhibited the alveolitis and pulmonary fibrosis in a dose-dependent manner as reflected by decreases of the hydroxyproline contents of serum and lung, and amelioration of alveolitis and pulmonary fibrosis fraction 28 days after BLM administration. The one of the possible mechanisms of the protective effect of Hu-qi-yin was via reduction of the overexpression of TGF-β 1 protein and mRNA. These results suggested a great potential that Hu-qi-yin might be effective in the treatment of pulmonary fibrosis.

To investigate the expression of granulocyte-macrophage colony-stimulating factor (GM-CSF), GM-CSF/IL-3/IL-5 receptor common beta chain (GM-CSFbetacR), surfactant protein (SP)-A and SP-D in adult patients with idiopathic pulmonary alveolar proteinosis (PAP), so as to demonstrate the possible association of GM-CSF, GM-CSFbetacR, SP-A and SP-D with human PAP.The protein expression of GM-CSF, GM-CSFbetacR, SP-A and SP-D in the alveolar macrophages and alveolar type II epithelial cells was detected by immunohistochemical staining.The age was 51.8 +/- 9.5 years old for patients with idiopathic PAP (6; males 4, females 2) and 48.8 +/- 12.6 years old for the control adult individuals (6; males 4, females 2). There was no difference in the expression of GM-CSF (P = 0.818) and SP-D (P = 0.24) in alveolar macrophages between patients with idiopathic PAP and the controls. The expression of GM-CSFbetacR (P = 0.002) and SP-A (P = 0.004) in alveolar macrophages of patients with idiopathic PAP was less than that in the controls. There was no expression of GM-CSF in alveolar type II epithelial cells of patients with idiopathic PAP and the controls. There was a little expression of GM-CSFbetacR in alveolar type II epithelial cells of the controls. There was no expression of GM-CSFbetacR in alveolar type II epithelial cells of patients with idiopathic PAP. There was no difference in the expression of SP-A (P = 0.818) and SP-D (P = 0.485) in alveolar type II epithelial cells between patients with idiopathic PAP and the controls.The decreased protein expression of GM-CSFbetacR in alveolar macrophages may be one of the mechanisms causing dysfunction of the macrophages in adult patients with idiopathic PAP.

To improve the treatment of severe hypoxaemia in patients with pulmonary alveolar proteinosis (PAP).The clinical data of a patient with pathologically proven PAP treated with whole-lung lavage utilizing extracorporeal membrane oxygenation (ECMO) were described and the literature was reviewed.This 57-year-old man was admitted because of cough and progressive dyspnea for 12 months. His PaO(2) was 46 mm Hg (1 mm Hg = 0.133 kPa) and saturation of pulse oximeter (SpO(2)) was from 85% to 88% with oxygen 5 L/min by nasal cannula. His chest CT, bronchoscopy with bronchoalveolar lavage and transbronchial biopsies were consistent with PAP. Whole-lung lavage was performed in the operation room under general anesthesia. A double-lumen tube was intubated in order to selectively ventilate and lavage a single lung independently. During mechanical ventilation for both lungs, the SpO(2) was from 80% to 90%, but when a single right lung ventilation was tried, the SpO(2) (from 68% to 80%) dropped significantly. To ensure adequate oxygen supply during lavage, a veno-arterial ECMO was set up by inserting catheters percutaneously into the right femoral artery and right femoral vein respectively. Then the SpO(2) improved, from 89% to 97% during single right lung ventilation. The left lung was lavaged with a total of 20.8 L of normal saline. The SpO(2) ranged from 80% to 94% during the lavage. After the lavage, the patient no longer experienced shortness of breath. Then 28 days later the right lung was lavaged without the aid of ECMO. A month after the second lavage, his chest CT showed marked improvement in infiltrates of both lungs.When a patient with PAP has refractory hypoxemia prior to the lavage procedure, ECMO should be considered in order to avoid severe hypoxaemia with fatal consequences during lavage.

The main treatment strategy of cancer patients with brain metastases was irradiation; while so far there were few researches concerning chemotherapy combined with radiotherapy for these patients. This study was designed to observe the therapeutic effect, toxicity, and survival of concurrent whole-brain radiotherapy (WBRT) combined chemotherapy with COAPC regimen in non-small cell lung cancer (NSCLC) patients with brain metastases.A total of 45 NSCLC patients with brain metastasis received a course of COAPC regimen [cyclophosphamide 0.3 mg/m(2) i.v. d(1), vincristine 1.4 mg/m(2) i.v. d(1), doxorubicin 50 mg/m(2) i.v. d(1), cisplatin 20 mg/m(2) i.v. d(1-5), semustine 80 mg/m(2) PO d(1)] every 3-4 weeks. Whole-brain radiotherapy was administered on day 6 of the first course of chemotherapy using (60)Co at a dose of 2 Gy given in 5 fractions per week. Patients with brain lesions of 1-3 received WBRT at a dose of 40 Gy and then small field to a total dose of 60 Gy. Patients with brain lesions of more than 3 received WBRT at a total dose of 40 Gy.The treatment improved neurological symptoms in 80% of the patients. The response rates to brain lesions and primary lesions were 64.4% and 40.0%, respectively. The median survival time (MST) was 10 months. The 1-year and 5-year survival rates were 44.1% and 6.7%, respectively. The MST in the patients with brain metastasis was only 14 months,which was longer than the MST of 9 months in the patients with other metastasis sites(P=0.012).Concurrent WBRT and chemotherapy can be safely preformed for the patients with brain metastasis from NSCLC with a remarkable response rate and encouraging survival duration.

Adriamycin, dacarbazine and ifosfamide are three effective chemotherapy drugs in treating progressive soft tissue sarcoma. However, few regimen is effective for the patients who failed in treatment with prior Adriamycin and ifosfamide at standard dose. This study was designed to observe and evaluate the efficacy and toxicity of high dose ifosfamide(HDI) regimen on pre-treated soft tissue sarcoma.Ten patients with advanced soft tissue sarcoma and 5 patients after surgical resection were treated with HDI administered by continuous infusion at a dose of 14 g/m2 per cycle over 6 days. All patients were pretreated with anthracycline +/- standard dose ifosfamide.An overall response rate of 40% was observed with 2 complete and 2 partial remission. In the follow up at 4-48 month, the overall median survival time was 21 +/- 3.29 months and the median response duration was 6 +/- 1.45 months. The major toxicity was myelosuppression. 45.9% patients experienced grade 3-4 neutropenia.HDI is an active salvage regimen in anthracycline +/- standard dose ifosfamide pretreated soft tissue sarcoma.