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Background: This study compared a co‐ablation (CA) system, which is a novel ablation device, with an argon‐helium cryoablation (AHC) system. We aimed to compare the efficacy and safety of CA and AHC for the treatment of stage III–IV non‐small cell lung cancer (NSCLC). Methods: We conducted a multicenter randomized controlled trial (RCT) to determine whether CA was noninferior to AHC. The primary efficacy endpoints were the iceball coverage rate (ICR) and the disease control rate (DCR) one month after treatment. Noninferiority was declared if the lower limit of two‐sided 95% confidence interval (CI) was less than 10%. The ICR and DCR were identified by logistic regression. Treatment safety was assessed. Results: A total of 81 patients underwent randomization (41 assigned to the CA and 40 assigned to the AHC groups)and transthoracic ablation. The ICRs in the CA and AHC groups were 99.24% ± 2.18% and 98.66% ± 3.79%, respectively. Central lesions were associated with an increased risk of an incomplete ICR. The DCRs in the CA and AHC groups were 97.6% and 95%, respectively. A smaller lesion area in the CA group was significantly correlated with a better DCR. The rate of complications was 29.26% in the CA group and 30% in the AHC group. (P = 0.943). There was less probe usage per patient in the CA group. Conclusions: We determined that CA is noninferior to AHC in terms of efficacy and safety for the treatment of stage III–IV NSCLC. A smaller lesion area in the CA group was significantly correlated with a better DCR. Key points: CA was noninferior to AHC for stage III–IV NSCLC. [ABSTRACT FROM AUTHOR]

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common and potentially lethal clinical syndromes characterized by acute respiratory failure resulting from excessive pulmonary inflammation, noncardiogenic pulmonary edema, and alveolar–capillary barrier disruption. At present, there is no effective and specific therapy for ALI/ARDS. Mesenchymal stem cells (MSCs) have well‐known therapeutic potential in patients with ALI/ARDS. Heme oxygenase‐1 (HO‐1), a cytoprotective enzyme, possesses antioxidative, anti‐inflammatory, and antiapoptotic effects. Thus, a combination of MSC transplantation with HO‐1 delivery may have an additional protective effect against ALI/ARDS. This study investigated the effect of HO‐1‐modified bone‐marrow–derived MSCs (MSCs‐HO‐1) on lipopolysaccharide (LPS)‐induced ALI and its underlying mechanisms. We established MSCs‐HO‐1 through lentiviral transduction. The ALI rat model was established by successive LPS inhalations following injection with MSCs‐HO‐1. The survival rate, histological changes in the lungs, total protein concentration and neutrophil counts in bronchoalveolar lavage fluid, lung wet/dry weight ratio, cytokine levels in serum and lungs, nuclear transcription factor‐κB activity, and protein expression of Toll‐like receptor 4 signaling adaptors were examined. Furthermore, the cell viability, apoptosis, and paracrine activity of MSCs‐HO‐1 were examined under inflammatory stimuli in vitro. MSCs‐HO‐1 injection improved these parameters compared with primary unmodified MSCs. Moreover, MSCs‐HO‐1 had superior prosurvival and antiapoptotic properties and enhanced paracrine functions in vitro. Therefore, MSCs‐HO‐1 exert an enhanced protective effect to alleviate LPS‐induced ALI in rats, and the mechanisms may be partially associated with superior prosurvival, antiapoptosis, and enhanced paracrine functions of MSCs‐HO‐1. These findings provide a novel insight into MSC‐based therapeutic strategies for treating ALI/ARDS. Modification with the heme oxygenase‐1 (HO‐1) gene provided prosurvival, antiapoptosis and enhanced paracrine functions of mesenchymal stem cells (MSCs), leading to improvement of acute lung injury (ALI). [ABSTRACT FROM AUTHOR]

Objective: To explore the value of ¹⁸F-FDG PET-CT in evaluating bronchial mucosa involvement in patients with saroidosis., Methods: A retrospective analysis was conducted among 6 sarcoidosis patients with and 14 patients without bronchial mucosa involvement to collect the data including the standard uptake value (SUVMax/Mean) of ¹⁸F-FDG, serum angiotensin converting enzyme (sACE), and proportion of lymphocytes and CD4⁺/CD8 ⁺ T lymphocyte ratio in bronchoalveolar lavage fluid (BALF)., Results: The lung focal SUV(Max/Mean) was higher in patients with bronchial mucosa involvement than those without (7.04 ± 5.83/5.00 ± 4.69 vs 5.68 ± 3.66/3.82 ± 2.39), but such differences were not statistically significant (P=0.565/0.495). The SUV(Max/Mean) of the hilum of the lung and the mediastina lymph nodes were significantly higher in patients with bronchial mucosa involvement (13.28 ± 5.57/10.48 ± 4.43 vs 6.20 ± 1.77/4.52 ± 1.43, P=0.0003/0.0002; 13.84 ± 4.35/9.69 ± 2.74 vs 7.16 ± 2.52/5.28 ± 1.77, P=0.0004/0.0004). The level of sACE and CD4⁺/CD8 ⁺ T lymphocyte ratio in BALF were also significantly higher in patients with bronchial mucosa involvement (60.58 ± 16.3 vs 49.16 ± 13.3 IU/L, P=0.045; 7.30 ± 5.0 vs 2.90 ± 3.1, P=0.026). The proportion of lymphocytes in BALF was comparable between the patients with and without bronchial mucosa involvement (44.10 ± 10.3% vs 35.30 ± 12.5%, P=0.148)., Conclusions: For patients with saroidosis, ¹⁸F-FDG PET-CT is useful in evaluating bronchial mucosa involvement, which is one of the key features of active sarcoidosis.

Background: It is unclear that patients with advanced non-small cell lung cancer (NSCLC) should receive prolonged chemotherapy or the best support, after achieving a maximum tumor response with 4 to 6 initial chemotherapy cycles. The aim of this study is to compare maintenance paclitaxel therapy with observation in advanced NSCLC patients., Methods: A total of 166 patients with stage IIIB or IV NSCLC were treated with four monthly paclitaxel-carboplatin as following: paclitaxel 100 mg/m(2) weekly for 3 of 4 weeks with carboplatin (area under the curve[AUC]=6) on day 1. Patients who responded at week 16 were assigned to either weekly paclitaxel therapy(70 mg/m(2), 3 of 4 weeks) or observation. Maintenance therapy continued until disease progression, development of intercurrent illness, intolerable toxicity, or investigator decision to terminate treatment., Results: There was a longer median time to progression in maintenance therapy compared with observation (P< 0.05). One- and two-year survival rates were 65% and 24% in the paclitaxel arm and 59% and 20% in the observation arm, respectively (P> 0.05). The performance status and the stage were the independent prognostic factors by Cox regression., Conclusions: Maintenance paclitaxel could benefit median time to progression but not survival time in patients who responded to induction chemotherapy. Nevertheless, further evaluation of maintenance therapy should be done before the concept is abandoned.