Parotid metastasis of rare lung adenocarcinoma:A case report

BACKGROUND Lung cancer(LC)is the leading cause of malignancy-related deaths worldwide.The most common sites of metastasis include the nervous system,bone,liver,respiratory system,and adrenal glands.LC metastasis in the parotid gland is very rare,and its diagnosis presents a challenge.Here,we report a case of parotid metastasis in primary LC.CASE SUMMARY The patient was a 74-year-old male who was discovered to have bilateral facial asymmetry inadvertently two years ago.The right earlobe was slightly swollen and without pain or numbness.Computed tomography(CT)examination showed bilateral lung space-occupying lesions.Pulmonary biopsy was performed and revealed adenocarcinoma(right-upper-lung nodule tissue).Positron emission tomography-CT examination showed:(1)Two hypermetabolic nodules in the right upper lobe of the lung,enlarged hy-permetabolic lymph nodes in the right hilar and mediastinum,and malignant space-occupying lesion in the right upper lobe of the lung and possible metastasis to the right hilar and mediastinal lymph nodes;and(2)multiple hypermetabolic nodules in bilateral parotid glands.Parotid puncture biopsy was performed considering lung adenocarcinoma metastasis.Gene detection of lung biopsy specimens revealed an EGFR gene 21 exon L858R mutation.CONCLUSION This case report highlights the challenging diagnosis of parotid metastasis in LC given its rare nature.Such lesions should be differentiated from primary tumors of the parotid gland.Simple radiological imaging is unreliable,and puncture biopsy is needed for final diagnosis of this condition.

Dietary fiber intake and its association with diabetic kidney disease in American adults with diabetes:A cross-sectional study

BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with T2D.METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and 2018.DF intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of both.Logistic regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were performed.RESULTS Among the 6032 participants,38.4%had DKD.With lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),respectively.The subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In United States adults with T2D,increased DF intake may be related to reduced DKD incidence.Further research is required to confirm these findings.

Assessing the Clinical Efficacy and Effectiveness of Sentinel Lymph Node Biopsy Combined with Breast-Conserving Surgery for Early-Stage Breast Cancer

Objective:To analyze the impact of sentinel lymph node biopsy(SLNB)combined with breast-conserving surgery in the clinical treatment of early-stage breast cancer.Methods:80 patients with early-stage breast cancer admitted to the Second Department of Breast Surgery at Dezhou Second People’s Hospital from September 2020 to September 2022 were selected and randomly divided into a control group and an observation group using the random number table method,with 40 cases in each group.The control group underwent a modified radical mastectomy,while the observation group underwent SLNB combined with breast-conserving surgery.The surgical efficacy and prognosis between the two groups were compared.Results:The observation group exhibited shorter operation,hospitalization,and extubation times,as well as less intraoperative blood loss and drainage volume,all of which were significantly better than those in the control group(P<0.05).Additionally,the observation group demonstrated a higher rate of excellent breast cosmetology and quality of life,with lower complication incidence,significantly outperforming the control group(P<0.05).There was no statistical difference in the metastasis rate and recurrence rate between the two groups(P>0.05).Conclusion:The combination of SLNB and breast-conserving surgery proves highly effective for patients with early-stage breast cancer,presenting fewer complications and enhancing both breast cosmetic outcomes and quality of life.

Changes in intestinal microflora in rats with acute respiratory distress syndrome

AIM:To implement high-throughput 16S rDNA sequencing to study microbial diversity in the fecal matter of rats with acute lung injury/acute respiratory distress syndrome(ALI/ARDS).METHODS:Intratracheal instillation of lipopolysaccharide was used to induce ALI,and the pathological changes in the lungs and intestines were observed.D-lactate levels and diamine oxidase(DAO)activities were determined by enzymatic spectrophotometry.The fragments encompassing V4 16S rDNA hypervariable regions were PCR amplified from fecal samples,and the PCR products of V4 were sequenced by Illumina MiSeq.RESULTS:Increased D-lactate levels and DAO activities were observed in the model group(P<0.01).Sequencing results revealed the presence of 3780 and4142 species in the control and model groups,respectively.The percentage of shared species was 18.8419%.Compared with the control group,the model group had a higher diversity index and a lower number of species of Fusobacteria(at the phylum level),Helicobacter and Roseburia(at the genus level)(P<0.01).Differences in species diversity,structure,distribution and composition were found between the control group and early ARDS group.CONCLUSION:The detection of specific bacteria allows early detection and diagnosis of ALI/ARDS.

Endoscopic resection of benign esophageal schwannoma:Three case reports and review of literature

BACKGROUND Esophageal schwannomas are uncommon esophageal submucosal benign tumors and are usually treated with surgery.CASE SUMMARY Here,we report three cases of middle/lower thoracic esophageal schwannoma treated successfully with endoscopic resection.These lesions were misdiagnosed as leiomyoma on preoperative imaging.During the endoscopic resection of such tumors,there is a risk of esophageal perforation due to their deep location.If possible,submucosal tunneling endoscopic resection should be used.CONCLUSION For larger schwannomas,endoscopy combined with thoracoscopy can be considered for en bloc resection.We performed a mini literature review in order to present the current status of diagnosis and treatment for esophageal schwannoma.

Prognostic Value of Th-22 Cells and Related Functional Cytokines in Patients with Vitiligo

Objective:To investigate the prognostic value of Th-22 cells and related functional cytokines in patients with vitiligo.Methods:Thirty-five patients with vitiligo who admitted to the outpatient clinic from June 2016 to November 2018 in the hospital were selected as the study group.Thirty healthy controls were selected as the control group.Th-22 cells and their related cytokines were analyzed in both groups.Resylts:The levels of cytokines in Th-22 and Th-17 cells in the study group were significantly higher than those in the control group(P<0.05).The expression of Treg lymphocyte-related factors in the study group was lower than that in the control group(P<0.05).The changes in cell and factor levels in patients with vitiligo before and after treatment were significantly different(P<0.05).Conclusion:It is shown that three cells,including Th-22,Th-17 and Treg are related to each other,and they can inhibit and promote the pathogenesis of vitiligo which provides a reference for prognosis and treatment.

Observation on the Risk of Falling and Self-efficacy in Elderly Patients with Hip Fracture

Objectives:To study the risk of falling and self-efficacy in elderly patients with hip fracture.Methodology:Forty elderly patients with hip fractures that were caused by falling were admitted into our hospital from April 2018 to April 2019,and were enrolled into this study.All patients were assessed by using the Morse Fall Scale(MFS)and Falls Efficacy Scale(FES).The basic situation of the patients with hip fractures caused by falling and the scores of MFS and FES before and after falling were evaluated.Results:Results showed that the number of patients with femoral neck fractures accounted for 70%out of all patients,and the number of patients with intertrochanteric fractures accounted for the remaining 30%of the patients.The number of patients with academic qualification below primary school is 16,the number of patients with middle high school education is 11 and the number of patients with high school education and above is 13.Slipping is the cause of hip fracture that accounted for the most in patients,followed by outing activities,whereas least patients with hip fractures was caused by falling in nursing home.There were 29 patients’who used crutches or walking aids and this number was more than that of those who required the devices.After the MFS and FES analyses,the results(scores of MFS and FES)showed that the risk before the fall was lower.In contrast,the risk of fracture and post-surgery after the fall was greatly increased.Conclusion:The elderly patients with hip fractures were found to have increased risk of falling and thus,these patients require good care.

Application of Quality of Life Scale in Hematological Disease Research

Quality of life research is an emerging and rapidly developing health measurement technology.Quality of life assessment is performed using scales.Accurate quality of life assessment provides comprehensive information of patient which allows clinicians to put emphasis on overall quality of life(Total QOL)of patient.Quality of life scales have been applied for analysis of diseases such as leukemia and immune thrombocytopenia.This article reviews the use of commonly used quality of life scales for hematological diseases.

The Change of Quantitative of HBeAg Can Predict the Efficacy of Peg-IFN-α 2a in HBeAgpositive CHB Patients

Objective To investigate the quantitation of hepatitis B e antigen (HBeAg) at week 24 in predicting the efifcacy of pegylated-interferon alfa-2a (Peg-IFN-α2a) in HBeAg-positive chronic hepatitis B (CHB) patients at week 48 and to find a useful predictor for treatment efficacy and investigate individualized treatment of antiviral therapy. Methods Ninety-six HBeAg-positive CHB patients with detectable HBeAg who were treated with Peg-IFN-α2a were enrolled in this trial. They were categorized into 3 groups according to the changes of HBeAg in week 24:HBeAg decline>2 log10 group (group A), HBeAg decline between 1 1og10-2 log10 (group B), HBeAg decline<1 log10 group (group C), and group C was randomly distributed into C1 and C2. The patients in group A, group B, and group C1 continued the original therapy and the patients in group C2 were given lamivudine plus Peg-IFN-α2a for 24 weeks. At week 48, the treatment efifcacy and hepatitis B virus covalently closed circular DNA (HBV cccDNA) in liver biopsies were analyzed. Results At week 48, mean reduction of serum HBV DNA:group A:5.8 log10 copies/ml, group B:3.8 log10 copies/ml, group C1:2.8 log10 copies/ml, group C2:5.7 log10 copies/ml, the reduction of HBV DNA in group A was greater than groups B and C1 (P<0.01), that in group C1 was greater than group C2 (P<0.01), the difference between groups B and C1 had no statistical signiifcance (P=0.19). Mean reduction of HBeAg:group A:2.7 log10S/CO, group B:1.9 log10S/CO, group C1:0.9 log10S/CO, group C2:1.5 log10S/CO, the difference among groups A, B and C1 and between groups C1 and C2 were statistically signiifcant (P<0.01). At week 48, HBV DNA undetectable rate in group A, group B, group C1 and group C2 were 87.5%, 34.5%, 17.4%and 81.9%, respectively, the rate in group A was greater than groups B and C1 (P<0.01),that in group C1 was greater than group C2 (P<0.01). HBeAg seroconversion rate were 75.0%, 24.1%, 13.0%and 22.7%, respectively, that in group A was greater than groups B and C1 (P<0.01). Group A had lower cccDNA in liver tissue than group B and group C1 (P<0.01). The difference of HBV cccDNA between groups B and C1 and that between groups C1 and C2 had no statistical signiifcance. Conclusions HBeAg decline > 2 log10 at week 24 in Peg-IFN-α 2a-treated hepatitis B patients suggested a better efficacy at week 48; HBeAg decline < 2 log10 at week 24 suggests a worse efficacy at week 48, the combined therapy of Peg-IFN-α and lamivudine could improve the clinical responses. The change of quantitative of HBeAg at week 24 may be used as a predictor of treatment effects at week 48.

Psychological Cognition of Women of Childbearing Age on the Use of Cosmetics During Pregnancy

Objective:To investigate the psychological cognition of women of childbearing age on the use of cosmetics during pregnancy,so as to provide guidance for women of childbearing age to correctly use cosmetics during pregnancy.Methods:A total of 180 women of childbearing age who underwent gynecological examination in Dezhou People’s Hospital from October 2020 to October 2021 were selected as the research subjects.Questionnaires were used to investigate the psychological cognition of women of childbearing age on the use of cosmetics during pregnancy.Results:Among the 180 women of childbearing age,48(26.67%)felt that cosmetics cannot be used during pregnancy,60(33.33%)felt that it did not matter,and 72(40.00%)agreed that cosmetics can be used during pregnancy.In addition,urban women,highly educated women,unmarried women,and enterprise employees agreed with the use of special cosmetics for pregnant women or the selective use of cosmetics during pregnancy.Conclusion:Most women of child-bearing age felt that cosmetics can be used during pregnancy;this cognition is related to their education level,occupation,and registered residence.

Effects of coronavirus disease 2019 vaccination on seizures in patients with epilepsy

Background:Given that seizures may be triggered by vaccination,this study aimed to evaluate the risk and correlative factors of seizures in patients with epilepsy(PWE)after being vaccinated against coronavirus disease 2019(COVID-19).Methods:This study retrospectively enrolled PWE who were vaccinated against COVID-19 in the epilepsy centers of 11 hospitals in China.We divided the PWE into two groups as follows:(1)patients who developed seizures within 14 days of vaccination were assigned to the SAV(with seizures after vaccination)group;(2)patients who were seizure-free within 14 days of vaccination were assigned to the SFAV(seizure-free after vaccination)group.To identify potential risk factors for seizure reccurence,the binary logistic regression analysis was performed.Besides,67 PWE who had not been vaccinated were also included for elucidating the effects of vaccination on seizures recurrence,and binary logistic regression analysis was performed to determine whether vaccination would affect the recurrence rate of PWE who had drug reduction or withdrawal.Results:The study included a total of 407 patients;of which,48(11.8%)developed seizures within 14 days after vaccination(SAV group),whereas 359(88.2%)remained seizure-free(SFAV group).The binary logistic regression analysis revealed that duration of seizure freedom(P<0.001)and withdrawal from anti-seizure medications(ASMs)or reduction in their dosage during the peri-vaccination period were significantly associated with the recurrence of seizures(odds ratio=7.384,95%confidence interval=1.732–31.488,P=0.007).In addition,32 of 33 patients(97.0%)who were seizure-free for more than three months before vaccination and had a normal electroencephalogram before vaccination did not have any seizures within 14 days of vaccination.A total of 92(22.6%)patients experienced non-epileptic adverse reactions after vaccination.Binary logistic regression analysis results showed that vaccine did not significantly affect the recurrence rate of PWE who had the behavior of ASMs dose reduction or withdrawal(P=0.143).Conclusions:PWE need protection from the COVID-19 vaccine.PWE who are seizure-free for>3 months before vaccination should be vaccinated.Whether the remaining PWE should be vaccinated depends on the local prevalence of COVID-19.Finally,PWE should avoid discontinuing ASMs or reducing their dosage during the peri-vaccination period.

Severity of early allograft dysfunction following donation after circulatory death liver transplantation:a multicentre study

Background:Early allograft dysfunction(EAD)is associated with decreased graft and patient survival rates.This study aimed to identify the severity of EAD and develop a predictive model for EAD after donation after circulatory death(DCD)liver transplantation(LT).Furthermore,the influence of operative time on EAD incidence was also evaluated.Methods:In this retrospective,multicentre cohort study,nomograms were established based on a single-centre training cohort(n=321)and validated in a 3-center validation cohort(n=501).Results:The incidence rate of EAD was 46.4%(149/321)in the training cohort and 40.5%(203/501)in the validation cohort.Of the 149 EAD patients in the training cohort,77 patients with either elevated alanine aminotransferase(ALT)or aspartate aminotransferase(AST)were classified as having EAD type A,and the rest of the EAD patients were classified as having EAD type B.Recipients with EAD type B had lower graft and patient survival rates than recipients with EAD type A(P=0.043 and 0.044,respectively).We further developed a nomogram to predict EAD(graft weight,cold ischemia time,donor age,model for end-stage liver disease(MELD)score)and another nomogram to predict EAD type B(graft weight,cold ischemia time,MELD score).The nomograms for the prediction of EAD and EAD type B had good discrimination[concordance index(C-index)=0.712(0.666-0.758),0.707(0.641-0.773)]and calibration[Hosmer-Lemeshow(HL)P=0.384,P=0.425]in the validation cohort.An increased operative time(>6 h)was associated with increased EAD and EAD type B incidence in the high-risk group(P=0.005,P=0.020,respectively).Conclusions:EAD type B was associated with decreased graft and patient survival rates.The novel nomograms effectively predicted the incidence of EAD and EAD type B in DCD LT patients.

Treatment of single-segment lumbar tuberculosis with minimally invasive posterior internal fixation combined with anterior small incision debridement

To review the clinical efficacy of minimally invasive pedicle fixation combined with anterior small incision focus debridement for single-segment lumbar spine tuberculosis,a total of 31 patients with single-segment marginal lumbar tuberculosis were enrolled in the study.All the patients received quadruple anti-tuberculosis chemotherapy for 2 weeks before surgery and treatment with minimally invasive posterior internal fixation,anterior small incision focus debridement,and bone graft fusion.Those patients with preoperative kyphosis deformity were initially treated with appropriate posterior distraction correction.Except for 1 patient who healed 2 weeks after medical dressing change,the remaining30 patients healed as expected.All the patients had no screwrelated surgical complications,neurological dysfunction,vascular injury,and other complications.The average visual analog scale scores at 3 months postoperatively were significantly decreased to1.4±1.5(P<0.05).In conclusion,under the premise of treatment using appropriate,effective anti-tuberculosis agents,this surgical procedure for managing patients with lumbar vertebral tuberculosis achieved satisfactory results,effectively reducing the exposure range and fusion segments in simple anterior focus debridement and internal fixation.Using minimally invasive posterior pedicle screw fixation can effectively increase spine stability,reduce fusion segment,and decrease anterior surgical trauma and complications.