Publications by authors named "Li-Chung Chiu"

Article Synopsis
  • A study tested the effectiveness of inhaled colistin in treating ventilator-associated pneumonia caused by resistant bacteria, using two types of nebulizers: a vibrating mesh nebulizer (VMN) and a jet nebulizer (JN).
  • Patients receiving intravenous (IV) colistin inhalation were randomly assigned to either nebulizer type and compared to a control group receiving IV only over a period of 7 to 10 days, with a focus on clinical improvement.
  • While VMN delivered a higher dose of colistin in lab tests, both nebulizers showed similar clinical outcomes in patients, showing significant benefits over the IV-only group.
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  • The study investigates the role of anti-SAE1 antibodies in patients with idiopathic inflammatory myopathies (IIMs) and how these antibodies relate to interstitial lung disease (ILD), particularly among Taiwanese individuals.
  • A cohort of 6,496 patients was analyzed, with 70 found to be SAE1 positive; clinical characteristics, diagnoses, and the presence of ILD were evaluated over time.
  • Results showed that strong SAE1 positivity correlated more strongly with IIM and ILD compared to weak positivity, indicating its potential clinical utility in diagnosis.
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Background And Objectives: Genomic alterations after resistance to osimertinib therapy in advanced T790M-mutated non-small cell lung cancer (NSCLC) are complex and poorly understood. In this study, we aimed to detect these genomic alternations via comprehensive next-generation sequencing (NGS) of tissue and liquid biopsies.

Patients And Methods: From September 2020 to June 2021, 31 stage IIIB/IV T790M-mutated NSCLC patients who exhibited progressive disease after osimertinib therapy and provided written informed consent were recruited.

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Real-world clinical experience of using anti-programmed death-ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) combined with chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer (SCLC) patients has rarely been reported. In this study, we aimed to perform a retrospective multicenter clinical analysis of extensive-stage SCLC patients receiving first-line therapy with anti-PD-L1 ICIs combined with chemotherapy. Between November 2018 and March 2022, 72 extensive-stage SCLC patients receiving first-line atezolizumab or durvalumab in combination with chemotherapy, according to the cancer center databases of Linkou, Chiayi, and Kaohsiung Chang Gung Memorial Hospitals, were retrospectively included in the analysis.

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Background: Cadmium and nickel exposure can cause oxidative stress, induce inflammation, inhibit immune function, and therefore has significant impacts on the pathogenesis and severity of many diseases. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can also provoke oxidative stress and the dysregulation of inflammatory and immune responses. This study aimed to assess the potential associations of cadmium and nickel exposure with the severity and clinical outcomes of patients with coronavirus disease 2019 (COVID-19).

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Introduction: The clinical outcomes of sequential treatment of advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) patients with first-line bevacizumab combined with 1st/2nd-generation EGFR-TKIs are unclear. Thus, we aimed to analyze the outcomes of these patients.

Methods: Between January 2015 and December 2020, data for 102 advanced EGFR-mutated lung adenocarcinoma patients receiving first-line bevacizumab combined with erlotinib or afatinib followed by treatments at multiple institutions were retrospectively analyzed.

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Autoimmune encephalitis is a rare but critical complication of COVID-19. The management of COVID-19-associated autoimmune encephalitis includes the use of steroids, intravenous immunoglobulin (IVIG), plasmapheresis, and monoclonal antibody therapy. This study presented a patient with critical COVID-19 autoimmune encephalitis who rapidly recovered after the initiation of corticosteroids and IVIG therapy.

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Article Synopsis
  • Brain metastasis often occurs in patients with non-small cell lung cancer (NSCLC), and some need neurosurgery for treatment, followed by systemic therapy.
  • A study analyzed 93 NSCLC patients between 2017 and 2021, revealing a median postresection survival of 34.36 months, with better outcomes for those with adenocarcinoma compared to non-adenocarcinoma types.
  • Factors like poor performance status (ECOG PS ≥2) and liver metastasis were linked to lower survival rates, highlighting the importance of these factors in treatment decisions.
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The lung dose of nebulized drugs for spontaneous breathing is influenced by breathing patterns and nebulizer performance. This study aimed to develop a system for measuring breath patterns and a formula for estimating inhaled drugs, and then to validate the hypothesized prediction formula. An model was first used to determine correlations among the delivered dose, breath patterns, and doses deposited on the accessories and reservoirs testing with a breathing simulator to generate 12 adult breathing patterns ( = 5).

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Background: Real-world clinical experience with afatinib as a treatment for advanced lung adenocarcinoma harboring uncommon epidermal growth factor receptor (EGFR) mutations (G719X, L861Q and S768I) has rarely been reported.

Objective: We aimed to perform a retrospective multicenter study to analyze afatinib therapy in untreated advanced lung adenocarcinoma harboring uncommon EGFR mutations.

Patients And Methods: Between May 2014 and June 2021, the data of 90 stage IIIB/IV lung adenocarcinoma patients with uncommon EGFR mutations (G719X/L861Q/S768I) treated with first-line afatinib from the cancer center database of Linkou, Tucheng, and Kaohsiung Chang Gung Memorial Hospitals were retrospectively retrieved and analyzed.

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  • ARDS is a serious condition characterized by an imbalanced immune response, leading to severe oxidative stress and high mortality rates; a study found that over half (52.2%) of patients died in the hospital.
  • Researchers assessed amino acid and biogenic amine metabolites in 69 ARDS patients, discovering that higher levels of kynurenine and its ratio to tryptophan in the blood were linked to death rates.
  • The study suggests that monitoring the kynurenine pathway could help predict outcomes for ARDS patients and may provide targets for treatments aimed at reducing oxidative stress and improving survival.
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Tuberculous pleurisy is a common extrapulmonary TB that poses a health threat. However, diagnosis of TB pleurisy is challenging because of the low positivity rate of pleural effusion mycobacterial culture and difficulty in retrieval of optimal pleural tissue. This study aimed to investigate the efficacy of mycobacterial culture from pleural tissue, obtained by forceps biopsy through medical pleuroscopy, in the diagnosis of TB pleurisy.

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Background: Although bevacizumab in combination with afatinib or erlotinib is an effective and safe first-line therapy for advanced epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), there are very few clinical data comparing afatinib and erlotinib combined with bevacizumab. We performed a retrospective multicenter analysis for the comparison of two combination therapies.

Methods: Between May 2015 and October 2020, data of 135 stage IIIB/IV EGFR-mutated NSCLC patients receiving first-line afatinib or erlotinib combined with bevacizumab combination therapy in Linkou, Keelung, Chiayi, and Kaohsiung Chang Gung Memorial Hospitals were retrieved and retrospectively analyzed.

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Background: Mechanical ventilation brings the risk of ventilator-induced lung injury, which can lead to pulmonary fibrosis and prolonged mechanical ventilation.

Methods: A retrospective analysis of patients with acute respiratory distress syndrome (ARDS) who received open lung biopsy between March 2006 and December 2019.

Results: A total of 68 ARDS patients receiving open lung biopsy with diffuse alveolar damage (DAD; the hallmark pathology of ARDS) were analyzed and stratified into non-fibrosis ( = 56) and fibrosis groups ( = 12).

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chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and a history of exposure to noxious stimuli. Cigarette smoking is the most important causal factor for developing COPD. Cadmium, a minor metallic element, is one of the main inorganic components in tobacco smoke.

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Article Synopsis
  • * Using monocytic THP-1 cells and blood samples from 31 OSA patients, researchers found that intermittent hypoxia boosts IL-8 expression at protein and mRNA levels, leading to enhanced monocyte migration towards IL-8.
  • * The study identified that specific cellular pathways (ERK, PI3K, PKC) are involved in this IL-8 activation, and noted that OSA patients have higher IL-8 expression
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  • Acute respiratory distress syndrome (ARDS) leads to severe respiratory failure, often requiring mechanical ventilation, which can risk further lung injury.
  • Extracorporeal membrane oxygenation (ECMO) is used as a rescue therapy for severe ARDS, enabling lower lung pressures and allowing the lungs to heal.
  • Recent research suggests a need for personalized mechanical ventilation settings during ECMO, but optimal settings and their impact on patient outcomes remain unclear.
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  • This study compares the effectiveness of prone positioning versus ECMO as rescue therapies for severe ARDS related to influenza pneumonia.
  • It analyzed 263 patients from eight hospitals in Taiwan, finding that those who received prone positioning had a significantly lower 60-day mortality rate (28% vs. 60%).
  • The results suggest that prone positioning may be a better initial treatment option for these patients, although the exact relationship between prone positioning and improved outcomes remains unclear.
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  • Apoptosis contributes to immune depression in sepsis, with both apoptosis and pyroptosis being involved in this condition and TLR4 and RAGE playing key roles.
  • The study explored the effects of TLR4 inhibition on cell death in sepsis by analyzing PBMCs stimulated with LPS and HMGB1 from 20 sepsis patients.
  • TLR4 inhibition increased the Bcl2 to Bax ratio, but did not reduce apoptosis; instead, it led to increased cell death in certain immune cells, suggesting a complex mechanism at play.
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Background: The experience of using consolidation durvalumab in post-concurrent chemoradiation (CCRT) unresectable stage III non-small cell lung cancer (NSCLC) is rare in real-world clinical practice, and the factors associated with its efficacy are also unclear. We sought to analyze the efficacy of consolidation durvalumab and the factors associated with its efficacy using a multicenter observational study.

Methods: The data for 61 patients with post-CCR unresectable stage III NSCLC receiving consolidation durvalumab at the Chang Gung Memorial Hospitals in Linkou, Keelung, Chiayi, and Kaohsiung from November 2017 to March 2020 were analyzed.

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  • * The analysis involved 313 patients with severe pneumonia, revealing that those with ARDS had distinct clinical characteristics such as higher MP and increased mortality, compared to non-ARDS patients.
  • * Regression analysis showed that MP significantly predicts 28-day mortality, with persistently high MP in non-survivors, suggesting it may be a more reliable indicator of risk compared to driving pressure.
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  • Acute Respiratory Distress Syndrome (ARDS) can be caused by local lung damage or systemic inflammatory responses, and its complexity impacts patient outcomes.
  • A study of 152 severe ARDS patients on ECMO found an overall hospital mortality rate of 53.3%, with indirect ARDS patients experiencing significantly higher mortality rates compared to those with direct ARDS.
  • The study identified different clinical characteristics and mortality predictors between the two groups, with factors like diabetes and SOFA scores playing key roles in outcomes for both direct and indirect ARDS patients.
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  • * Positive fluid balance can increase mortality risk in critically ill patients, and a conservative fluid management approach has been shown to benefit ARDS patients by reducing the time on mechanical ventilation and in intensive care.
  • * In a study of 152 severe ARDS patients on ECMO, a higher cumulative fluid balance (CFB) was linked to increased hospital mortality, suggesting that careful fluid management during the early ECMO phase is crucial for improving patient outcomes.
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Early-stage NSCLC (stages I and II, and some IIIA diseases) accounts for approximately 30% of non-small cell lung cancer (NSCLC) cases, with surgery being its main treatment modality. The risk of disease recurrence and cancer-related death, however, remains high among NSCLC patients after complete surgical resection. In previous studies on the long-term follow-up of post-operative NSCLC, the results showed that the five-year survival rate was about 65% for stage IB and about 35% for stage IIIA diseases.

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