Sequential occurrence of T790M mutation and small cell lung cancer transformation in EGFR-positive lung adenocarcinoma:A case report

BACKGROUND The emergence of secondary drug resistance when treating epidermal growth factor receptor(EGFR)mutated non-small cell lung cancer(NSCLC)using EGFRtyrosine kinase inhibitors(EGFR-TKIs),seriously affects the therapeutic efficacy and survival of patients.Here,we report a case of advanced NSCLC focusing on the application of multiple biopsy modalities to reveal the development of multiple resistance mechanisms during targeted therapies.CASE SUMMARY A 54-year-old male patient presented with EGFR 19Del-mutated advanced lung adenocarcinoma,and exhibited the development of a T790M mutation during initial TKI treatment.Following 3 mo of Osimertinib treatment,a mixed response was observed.Tissue biopsy of the progressive lesion showed transformation to small cell lung cancer(SCLC)harboring RB1 and TP53 mutations,with loss of the original T790M mutation.A standard chemotherapy regimen with Anlotinib for SCLC was administered.Repeat biopsy revealed adenocarcinoma combined with SCLC after tumor progression.The patient’s overall survival was 24 mo.CONCLUSION Multiple biopsy modalities can reveal the development of multiple resistance mechanisms which help with treatment decision-making.Comprehensive treatment regimens according to the drug resistance mechanism significantly improved the prognosis of such patients.

Research progress on the relationship between exercise and tumor

Tumor is a major threat of the health of Chinese people at present.Exercise has a certain relationship with tumor and is one of the hot topics in the research of tumor.In this paper,it made a review of the researches on the occurrence and development of tumor,therapeutic effect and prognosis,rehabilitation of tumor patients,and the effect of tumor on exercise in recent years.It indicates that the interaction between exercise and tumor is one of the best prevention methods for tumor and has a positive impact on the prognosis and rehabilitation of tumor patients.

Discussing tuina for atlantoaxial subluxation in adults based on the theory of‘tendon-bone balance’

According to Chinese medicine,the atlantoaxial joint is a composite joint composed of tendons and bones,and the stability of the joint depends on the‘tendon-bone balance’involving tendons,ligaments,atlas and axis.Multiple causes of‘tendon off-position,joint subluxation’will lead to joint‘tendon-bone imbalance’,which will evolve into atlantoaxial subluxation(AAS),endangering human health.Chinese therapeutic massage(tuina)is a very effective treatment for AAS in adults,but conventional manipulations are prone to ineffectiveness or accidents due to neglect of the causal relationship of the‘tendon-bone imbalance’and inappropriate manipulations.Compared with conventional manipulations,the rational choice of modified manipulations under the guidance of‘tendon-bone balance’theory is more effective and less risky,and more worthy of clinical promotion.From the‘tendon-bone balance’theory,we considered the shortcomings of conventional manipulations,and introduced several modified manipulations that have their own strengths in‘tendon smoothing’and‘bone setting’,in order to provide new ideas for treatment of AAS in adults.

Clinical observation of moving cupping on the back for patients with chronic fatigue syndrome-related sleep disorders

Objective: To observe the clinical efficacy of moving cupping on the back for patients with chronic fatigue syndrome (CFS)-related sleep disorders. Methods: A total of 60 patients with CFS-related sleep disorders were randomized into a control group and an observation group, with 30 cases in each group. The control group was treated with oral administration of fluoxetine hydrochloride capsule. The observation group was treated with moving cupping on the back, once every other day. The efficacy was observed after 4 weeks of treatment. The fatigue scale-14 (FS-14) and Pittsburgh sleep quality index (PSQI) were assessed before and after the treatment to evaluate the clinical efficacy. Results: The total effective rate was 93.3% in the observation group, and 73.3% in the control group. The difference between the two groups was statistically significant (P<0.05). After treatment, the improvement of physical fatigue value, mental fatigue value, and the total score of FS-14 in the observation group were statistically different from those in the control group (all P<0.05). The scores of subjective sleep quality, sleep latency, habitual sleep efficiency, use of sleeping medication, daytime dysfunction of PSQI and the total score in the observation group were improved more significantly than those in the control group (all P<0.05). Conclusion: Moving cupping on the back can significantly improve sleep disorders in CFS patients, and it has a better curative effect than oral fluoxetine hydrochloride capsules.