Symptomatic bradycardia in tuberculosis-related giant bullae(vanishing lung syndrome):A case report

Rationale:Vanishing lung syndrome is rare and can be associated with a history of smoking and marijuana use.The occurrence of giant bullae can also be linked to infections,particularly tuberculosis in tropical countries.Patient concerns:A 26-year-old male complained of weakness,severe vomiting,and reduced breathlessness when lying on the left side.He had a history of pulmonary tuberculosis two years ago.Diagnosis:Symptomatic bradycardia in tuberculosis-related giant bullae.Interventions:The patient was recommended to undergo an elective bullectomy,but he decided not to proceed with the procedure.Atropine sulfate was administered to alleviate symptoms of bradycardia,while a standardized anti-tuberculosis regimen were started for the next six months.Outcomes:Following 7 days of intensive care treatment involving antituberculosis medications and atropine sulfate,the patient achieved hemodynamic stability,opting against bullectomy despite residual symptoms of dyspnea.Subsequent six months of antituberculosis therapy notably alleviated symptoms without requiring bullectomy.Lessons:Increasing intrathoracic pressure can also be caused mechanically by giant bullae.Cardiac symptoms in vanishing lung syndrome are reversible and can be alleviated once the underlying cause is addressed.In this case,symptomatic bradycardia was reduced only with tuberculosis treatment without bullectomy intervention。

The Value of γδ T Cells in Lung Infections and Advances in Diagnosis and Treatment

Lung infections are usually caused by pathogenic microorganisms and are a disease with high morbidity and mortality. In clinical practice, the use of broad-spectrum antibiotics has become increasingly common, but this has also led to the problem of antibiotic abuse and irrational use, which in turn has spawned the emergence of multidrug-resistant bacteria, making the treatment of lung infections more complex and difficult. In the human immune system, γδ T cells play a crucial role in defense against foreign pathogens and regulation of autoimmune responses. These cells act as a bridge between innate and adaptive immunity and can be rapidly activated in the early stages of infection to produce inflammatory factors and chemokines that attract other immune cells to the site of infection. Recent advances have shown that γδ T cells not only play a direct role in the innate immunity of pathogen infection, but are also involved in regulating the subsequent adaptive immune response. The aim of this review is to explore the mechanism of γδ T cells in lung infections and to summarize the current progress of clinical research, with the aim of providing new scientific basis and therapeutic strategies for the treatment of lung infections.

A Case of Lautropia mirabilis Infection in a Lung Transplant Patient and a Review of the Literature

Lautropia mirabilis is an opportunistic pathogen that typically causes intestinal and oral infections when the body’s immune system is compromised or the microbial flora is imbalanced.Respiratory infections caused by Lautropia mirabilis are extremely rare.The symptoms and severity of Lautropia mirabilis infection may vary depending on individual differences and the site of infection.Through a review of relevant literature and this case study,it has been observed that Lautropia mirabilis may also cause pulmonary infectious diseases,and in immunocompromised patients,it can lead to severe infections,potentially resulting in death.

H pylori seroprevalence in patients with lung cancer

AIM: To assess H pylori seroprevalence in lung cancer and determine whether there is a potential association between lung cancer and H pylori infection. METHODS: The study was conducted on forty consecutive patients with lung cancer, confirmed by pathology (32 men, 8 women; mean age 55.50 ± 11.91 years, range 16-77 years). Forty healthy subjects (25 men, 15 women; mean age 43.08 ± 12.60 years, range 20-79 years) from the patients’ family members were matched to each case subject on the basis of age and socioeconomic status. H pylori infection was detected with a commercially available immunoglobulin G (IgG) enzyme-linked immunosorbent assay (Trinity kit, Biotech co., USA), previously validated in adults (86% sensitivity, 96% specificity) against a gold standard of culture and histology. RESULTS: H pylori seropositivity was present in 52.5% of patients with lung cancer in comparison to 45.0% of healthy control subjects. Although H pylori seropositivity was more frequent in lung cancer patients than in controls, the difference did not reach statistical significance (OR = 1.35, 95% CI = 0.56-3.25; P = 0.65). In addition, there was no significant difference between cases and controls in terms of gastrointestinal symptoms. CONCLUSION: The earlier described association between H pylori infection and lung cancer was not supported in this study. Further studies with larger sample sizes should be undertaken to assess the frequency of H pylori infection in patients with lung cancer and their potential association.

Simultaneous Paragonimus infection involving the breast and lung:A case report

BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain,abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.CASE SUMMARY Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication.CONCLUSION Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.Thus, thorough history-taking and clinical suspicion of parasitic infection are important.

Role of neutrophil chemoattractant CXCL5 in SARS-CoV-2 infection-induced lung inflammatory innate immune response in an in vivo hACE2 transfection mouse model

Understanding the pathogenesis of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and clarifying antiviral immunity in hosts are critical aspects for the development of vaccines and antivirals.Mice are frequently used to generate animal models of infectious diseases due to their convenience and ability to undergo genetic manipulation.However,normal adult mice are not susceptible to SARS-CoV-2.Here,we developed a viral receptor(human angiotensin-converting enzyme 2,hACE2)pulmonary transfection mouse model to establish SARS-CoV-2 infection rapidly in the mouse lung.Based on the model,the virus successfully infected the mouse lung 2 days after transfection.Viral RNA/protein,innate immune cell infiltration,inflammatory cytokine expression,and pathological changes in the infected lungs were observed after infection.Further studies indicated that neutrophils were the first and most abundant leukocytes to infiltrate the infected lungs after viral infection.In addition,using infected CXCL5-knockout mice,chemokine CXCL5 was responsible for neutrophil recruitment.CXCL5 knockout decreased lung inflammation without diminishing viral clearance,suggesting a potential target for controlling pneumonia.

Helicobacter pyloriseroprevalence in patients with lung cancer

AIM:To assess Helicobacter pylori(Hpylon)seroprevalence in a cohort of Greek patients with lung cancer. METHODS:Seventy-two lung cancer patients(55 males and 17 females,aged 58.2±11.7 years)and 68,age and gender-matched,control subjects were enrolled.All subjects underwent an enzyme-linked immunosorbent assay IgG serologic test for Hpylori diagnosis. RESULTS:A correlation between age and HpyloriIgG level was detected for both lung cancer patients(r=0.42, P=0.004)and controls(r=0.44,P=0.004).Seropositivity for Hpyloridid not differ significantly between patients with lung cancer and controls(61.1% vs 55.9%,P>0.05). Concerning the mean serum concentration of IgG antibodies against Hpylori,no significant difference between the two groups was detected(32.6±19.1 vs 27.4±18.3 U/mL, P>0.05). CONCLUSION:No significant association between Hpylori infection and lung cancer was found.

Treatment of Severe Post-kidney-transplant Lung Infection by Integrative Chinese and Western Medicine

Objective： To explore treatments of severe post-kidney-transplant lung infection by integrative Chinese and Western medicine （ICWM）, in order to elevate the curing rate as well as to lower the death rate. Methods： Based on conventional ways of Western medical treatments of 18 cases of severe post-kidney-transplant lung infection, such as putting the patients in single individual ward, antibiotics to prevent infection, respiratory machines, blood filtration, nutritional support, steroids, and maintaining electrolytes balance, we applied integrated Chinese medicinal treatments, like altering conventional prescription ＂pneumonia Ⅲ ＂, and conducted clinical observation of effectiveness, and indexes including white blood cell （WBC）, neutrophilic granulocyte, blood urea nitrogen （BUN）, blood creatinine （Or）, etc. Results： Of the 18 cases studied, 7 were already cured, 8 proved the treatment effective, 3 died. All clinical indexes had statistically significant changes compared with those of before treatment （P〈0. 01 ）. Cenclusien. ICWM can increase curing rate and lower death rate.

Intravenous infusion of mesenteric lymph from severe intraperitoneal infection rats causes lung injury in healthy rats

AIM: To investigate whether mesenteric lymph from rats with severe intraperitoneal infection (SII) induces lung injury in healthy rats.

Rapidly progressing primary pulmonary lymphoma masquerading as lung infectious disease:A case report and review of the literature

BACKGROUND Primary anaplastic large cell lymphoma of the lung represents a diagnostic challenge due to diverse manifestations and non-specific radiological findings,particularly in cases that lack extra-pulmonary manifestations and lung biopsy.CASE SUMMARY A 40-year-old woman presented with a 6-d history of fever,dry coughing,and dyspnea.Her white blood cell count was 20100/mm3 with 90%neutrophils.PaO2 was 60 mmHg and SaO2 was 90%when breathing ambient air.Chest computed tomography(CT)identified a solid nodule,15 mm in diameter,with a poorly defined boundary in the upper right lung,and several smaller solid nodules throughout both lungs.Pulmonary artery CT and subsequent bedside X-ray showed diffuse patchy shadows throughout both lungs.Repeated cultures of blood samples and alveolar lavage failed to identify any pathogen.Due to the mismatch between clinical and imaging features,we conducted a bone marrow biopsy,and the results showed proliferation along all three lineages but no atypical or malignant cells.The patient received empirical antibacterial,antiviral,and antifungal treatments,as well as corticosteroids.The patient’s condition deteriorated rapidly despite treatment.The patient died 6 d after hospitalization due to respiratory failure.Post-mortem lung biopsy failed to show inflammation but identified widespread infiltration of alveolar septum by anaplastic lymphoma kinase(ALK)-positive anaplastic cells.CONCLUSION ALK-positive anaplastic large cell lymphoma could present as a primary pulmonary disease without extra-pulmonary manifestations.

Carbon ion radiotherapy for synchronous choroidal melanoma and lung cancer: A case report

BACKGROUND Despite being the most common intraocular malignancy among adults,choroidal melanoma is a rare cancer type,even more so when accompanied by lung cancer.We report a patient with synchronous choroid melanoma and lung cancer treated with carbon ion radiotherapy(CIRT).CASE SUMMARY A 41-year-old woman was transferred to our center with a diagnosis of choroidal melanoma in her right eye.During the examination,we found a right lung tumor that was histologically diagnosed as lung cancer.The patient was treated with CIRT for both malignant neoplasms.The CIRT dose was 70 photon equivalent doses(GyE)in five fractions for the right eye choroidal melanoma and 72 GyE in 16 fractions for the right lung cancer.At 3 mo after CIRT,the choroidal melanoma completely disappeared,as did the right lung cancer 7 mo after;the patient was in complete remission.CONCLUSION CIRT may be an effective treatment for double primary lung cancer and choroid melanoma.

Improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection

Objective:To study the improving effect of sputum aspiration combined with bronchoalveolar lavage by fiber bronchoscope on the condition and inflammation in lung cancer patients with postoperative pulmonary infection.Methods:A total of 78 patients with lung cancer who received surgical treatment in our hospital between August 2013 and January 2015 and were with postoperative infection were selected as the research subjects and randomly divided into two groups, control group received mechanical ventilation therapy, observation group received bronchoalveolar lavage by bronchoscope combined with mechanical ventilation, and the inflammatory factor levels, RAAS system activity and respiratory mechanics indexes of two groups were determined after treatment.Results:3 d after treatment, serum hs-CRP, TNF-α, IL-8, PCT, renin, angiotensin II and aldosterone levels of observation group were lower than those of control group, and PIP, Raw and WOB values were lower than those of control group while Cdyn value was higher than that of control group.Conclusion:For lung cancer patients with postoperative pulmonary infection, bronchoalveolar lavage by bronchoscope combined with mechanical ventilation can optimize patients' condition, relieve systemic inflammatory response and improve respiratory function, and it has positive clinical significance.

Evaluation of sex specificity on oxidative stress induced in lungs of mice irradiated by ^(12)C^(6+) ions

The aim of this work is to identify if there is sex specificity on 12C6+ ion-induced oxidative damage in mouse lung at different time points. Kun-Ming mice were divided into two groups, each composed of six males and six females: control group and irradiation group with a single acute dose of 4 Gy. Animals were sacrificed at 2, 4 and 12 h respectively, there lungs were removed immediately, and the oxidative stress-related biomarkers were measured by Diagnostic Reagent Kits. The results showed that the relative activities of superoxide dismutase (4 h), catalase (2 h) and Se-dependent glutathione peroxidase (12 h) have significant changes (P<0.05) between male groups and female groups, suggesting that the lungs of male mice are more sensitive to counteracting the oxidative challenge. Moreover, higher levels of malondiadehyde and lower contents of glutathione were also found in males, indicating that oxidative stress induced by 12C6+ ion is pronounced in the lungs of males. We thought that these sex-responded differences may be attributed to the influence of sex hormones.

Assessing the Effectiveness of Montelukast Sodium in Managing Pulmonary Infections in Lung Cancer Patients

Objective:To investigate the efficacy of montelukast sodium in the treatment of lung cancer patients with pulmonary infections.Methods:A total of 330 patients diagnosed with lung cancer and pulmonary infection,who were admitted to the First Affiliated Hospital of Xi’an Medical University from 2020 to 2022,were selected as research subjects.They were randomly divided into two groups:a control group receiving conventional treatment and an observation group receiving conventional treatment combined with montelukast sodium.Each group consisted of 165 cases.The time required for clinical symptom improvement,the resolution of lung infection signs,and the levels of serum inflammatory factors before and after treatment were compared between the two groups.Results:The observation group exhibited significantly faster improvement in clinical symptoms compared to the control group(P<0.001).ELISA assays were conducted to detect the expression levels of IL-1β,IL-6,IL-8,and TNF-αin the serum of both groups at 1 week and 2 weeks into the treatment.The results indicated that,as the treatment progressed,the observation group displayed significantly lower levels of the four serum inflammatory factors compared to the control group(P<0.001).Conclusion:Montelukast sodium demonstrates efficacy in the treatment of patients with lung cancer complicated by pulmonary infections.These findings suggest its potential for further verification and clinical application.

A CASE OF TRICUSPID ENDOCARDITIS WITH SUBSEQUENT LUNG ABSCESS

THE incidence of isolated right heart infective endocarditis （IE） is far less common than that of left heart. Clinical presentation is often associated with pulmonary manifestations. The main symptoms include high fever, chest pain, and dyspnea due to septic pulmonary emboli. Degenerative valvular disease, congenital heart diseases, prosthetic valves, long-term hemodialysis, diabetes mellitus predispose patients at increased risk of IE.1 In young persons, IE may be associated with intravenous drug abuse.2 This report dealt with a young patient who had none of the risk factors mentioned above. He was diagnosed and treated for lung abscess and septemia for one and a half months. Further investigation unveiled infective vegetation on tricuspid valve. Following surgical resection of the vegetation, fever and respiratory symptoms completely remitted. The mechanism of the IE occurred on the normal native tricuspid valve is proposed.

Proteome-wide screening for the analysis of protein targeting of Chlamydia pneumoniae in endoplasmic reticulum of host cells and their possible implication in lung cancer development

Available reports have confirmed a link between bacterial infection and the progression of different types of cancers,including colon,lungs,and prostate cancer.Here we report the Chlamydia pneumonia proteins targeting in endoplasmic reticulum(ER)using in-silico approaches and their possible role in lung cancer etiology.We predicted 48 proteins that target human ER,which may be associated with protein folding and protein-protein interactions during infection.The results showed C.pneumoniae proteins targeting human ER and their implications in lung cancer growth.These targeted proteins may be involved in competitive interactions between host and bacterial proteins,which may change the usual pathway functions and trigger the development of lung cancer.Moreover,C.pneumoniae unfolded protein accumulation in the human ER possibly induces ER stress,consequently activating the unfolded protein response(UPR),and providing a favorable microenvironment for cancer growth.The current study showed the C.pneumoniae protein targeting in ER of host cell and their implication in lung cancer growth.These results may help researchers better manage lung cancer and establish a molecular mechanism for C.pneumoniae lung cancer association.

Role of Partial Thoracoplasty in Lung Lesions —A Single Institute Experience

Thoracoplasty has been a useful procedure to control and cure recalcitrant lung lesions often as a last measure to treat pulmonary infections like post-?tubercular chronic empyema with fibrocavitary lesions and residual pleural space infections after pulmonary resections. Long-standing empyemas with persistent discharge on drainage often respond poorly after decortication and?debridement alone due to non-expanding underlying lung tissue due to fibrotic changes. These cases often develop recurrent empyemas with sepsis with high morbidity and mortality. Similarly chronic space-occupying lung lesions with adjacent pulmonary damage and fibrosis leave a considerable residual space after surgery of these lesions and these persistent residual space leads to pleural space infections and empyema. In the presence of a large apical abscess and destruction of the apical pulmonary tissue forming a potential space confined by the bony thoracic cage and limited inferiorly by the rigid lining of the abscess, the cure and management of the chronic empyema especially the post-tubercular ones are particularly difficult. We address these cases in our series by performing partial thoracoplasty tailored to the site of the lesions in addition to other procedures. Partial thoracoplasty was found beneficial for selective cases of chronic empyema, obliteration of residual cavity after resectional surgery and management of the apical abscess.

Deep Learning ResNet101 Deep Features of Portable Chest X-Ray Accurately Classify COVID-19 Lung Infection

This study is designed to develop Artificial Intelligence(AI)based analysis tool that could accurately detect COVID-19 lung infections based on portable chest x-rays(CXRs).The frontline physicians and radiologists suffer from grand challenges for COVID-19 pandemic due to the suboptimal image quality and the large volume of CXRs.In this study,AI-based analysis tools were developed that can precisely classify COVID-19 lung infection.Publicly available datasets of COVID-19(N=1525),non-COVID-19 normal(N=1525),viral pneumonia(N=1342)and bacterial pneumonia(N=2521)from the Italian Society of Medical and Interventional Radiology(SIRM),Radiopaedia,The Cancer Imaging Archive(TCIA)and Kaggle repositories were taken.A multi-approach utilizing deep learning ResNet101 with and without hyperparameters optimization was employed.Additionally,the fea-tures extracted from the average pooling layer of ResNet101 were used as input to machine learning(ML)algorithms,which twice trained the learning algorithms.The ResNet101 with optimized parameters yielded improved performance to default parameters.The extracted features from ResNet101 are fed to the k-nearest neighbor(KNN)and support vector machine(SVM)yielded the highest 3-class classification performance of 99.86%and 99.46%,respectively.The results indicate that the proposed approach can be bet-ter utilized for improving the accuracy and diagnostic efficiency of CXRs.The proposed deep learning model has the potential to improve further the efficiency of the healthcare systems for proper diagnosis and prognosis of COVID-19 lung infection.

Changes in tumor-antigen expression profile as human small-cell lung cancers progress

Objective： Our group has previously observed that in patients with small-cell lung cancers （SCLCs）, the expression of a tumor antigen, glioma big potassium （gBK） ion channel, is higher at the time of death than when the cancer is first treated by surgical resection. This study aimed to determine whether this dichotomy was common in other potential lung tumor antigens by examining the same patient samples using our more extensive profile analysis of tumor-antigen precursor protein （TAPP）. We then tested the hypothesis that therapeutic intervention may inadvertently cause this increased gBK production. Methods： SCLC samples （eight surgical resections and three autopsy samples） and three control lungs were examined by quantitative real-time polymerase chain reaction for 42 potential TAPPs that represent potential T-cell-mediated immunological targets. Results： Twenty-two TAPP mRNAs displayed the same profile as gBK, i.e., more mRNAs were expressed at autopsy than in their surgical counterparts. B-cyclin and mouse double minute 2, human homolog of PS3-binding protein were elevated in both autopsy and surgical specimens above the normal-lung controls. When HTB119 cells were incubated with doxorubicin, gBK was strongly induced, as confirmed by intracellular flow cytometry with a gBK-specific antibody. Conclusion： Our findings suggested that more immunological targets became available as the tumor responded to chemotherapy and proceeded toward its terminal stages.

Network pharmacology and molecular docking to explore Polygoni Cuspidati Rhizoma et Radix treatment for acute lung injury

BACKGROUND Polygoni Cuspidati Rhizoma et Radix(PCRR),a well-known traditional Chinese medicine(TCM),inhibits inflammation associated with various human diseases.However,the anti-inflammatory effects of PCRR in acute lung injury(ALI)and the underlying mechanisms of action remain unclear.AIM To determine the ingredients related to PCRR for treatment of ALI using multiple databases to obtain potential targets for fishing.METHODS Recognized and candidate active compounds for PCRR were obtained from Traditional Chinese Medicine Systems Pharmacology,STITCH,and PubMed databases.Target ALI databases were built using the Therapeutic Target,DrugBank,DisGeNET,Online Mendelian Inheritance in Man,and Genetic Association databases.Network pharmacology includes network construction,target prediction,topological feature analysis,and enrichment analysis.Bioinformatics resources from the Database for Annotation,Visualization and Integrated Discovery were utilized for gene ontology biological process and Kyoto Encyclopedia of Genes and Genomes network pathway enrichment analysis,and molecular docking techniques were adopted to verify the combination of major active ingredients and core targets.RESULTS Thirteen bioactive compounds corresponding to the 433 PCRR targets were identified.In addition,128 genes were closely associated with ALI,60 of which overlapped with PCRR targets and were considered therapeutically relevant.Functional enrichment analysis suggested that PCRR exerted its pharmacological effects in ALI by modulating multiple pathways,including the cell cycle,cell apoptosis,drug metabolism,inflammation,and immune modulation.Molecular docking results revealed a strong associative relationship between the active ingredient and core target.CONCLUSION PCRR alleviates ALI symptoms via molecular mechanisms predicted by network pharmacology.This study proposes a strategy to elucidate the mechanisms of TCM at the network pharmacology level.