What enlightenment has the development of lung cancer bone metastasis brought in the last 22 years

BACKGROUND Lung cancer bone metastasis(LCBM)is a disease with a poor prognosis,high risk and large patient population.Although considerable scientific output has accumulated on LCBM,problems have emerged,such as confusing research structures.AIM To organize the research frontiers and body of knowledge of the studies on LCBM from the last 22 years according to their basic research and translation,clinical treatment,and clinical diagnosis to provide a reference for the development of new LCBM clinical and basic research.METHODS We used tools,including R,VOSviewer and CiteSpace software,to measure and visualize the keywords and other metrics of 1903 articles from the Web of Science Core Collection.We also performed enrichment and proteinprotein interaction analyses of gene expression datasets from LCBM cases worldwide.RESULTS Research on LCBM has received extensive attention from scholars worldwide over the last 20 years.Targeted therapies and immunotherapies have evolved into the mainstream basic and clinical research directions.The basic aspects of drug resistance mechanisms and parathyroid hormone-related protein may provide new ideas for mechanistic study and improvements in LCBM prognosis.The produced molecular map showed that ribosomes and focal adhesion are possible pathways that promote LCBM occurrence.CONCLUSION Novel therapies for LCBM face animal testing and drug resistance issues.Future focus should centre on advancing clinical therapies and researching drug resistance mechanisms and ribosome-related pathways.

Veno-venous-extracorporeal membrane oxygenation treatment for severe capillary leakage syndrome: A case report

BACKGROUND Capillary leak syndrome(CLS)is characterized by the leakage of large amounts of fluid and plasma proteins into the interstitial space,resulting in hypoalbuminemia,hypovolemic shock,elevated blood concentration,systemic progressive edema,and multiple serosal cavity effusion.Clinical syndromes such as cavity effusion pose a grave threat to the life and health of the patient.CASE SUMMARY A 58-year-old female patient was admitted to the hospital after being in a coma for 6 h following accidental ingestion of a pesticide.She was treated with phencyclidine hydrochloride and pralidoxime iodide for detoxification,mechanical ventilation to maintain oxygen supply,continuous renal replacement therapy to maintain the internal environment,and hemoperfusion to promote the excretion of toxins.She also received a transfusion of red blood cells and massive fluid resuscitation.However,her blood pressure was not maintained.The patient was diagnosed with CLS due to pesticide poisoning.Oxygenation was difficult to maintain under full ventilator support;therefore,veno-venous-extracorporeal membrane oxygenation(VV-ECMO)treatment was given 13 h after admission.Her oxygenation level improved,but a large amount of ascites and pleural effusion soon became apparent.We continued drainage with an indwelling drainage tube,and the ECMO flow stabilized.The leakage gradually decreased,and ECMO was discontinued 3 d later.On the 6th day,the patient recovered from unconsciousness,but on gastroscopic evaluation,severe erosions were found in her entire stomach.With the family’s consent,treatment was stopped,and the patient was discharged from the hospital on the 7th day.CONCLUSION ECMO,liquid resuscitation and management,and improvement in plasma colloidal osmotic pressure,circulation,and tissue oxygen supply are crucial in treating CLS.

Characterization of <i>Staphylococcus aureus</i>infections among children in an outpatient clinic, China

Objective: We aimed to investigate the epidemiology and identify antibiotic resistance patterns of isolates from children with skin and soft tissue infections attending an outpatient clinic in Southern China. Method: An observational study of outpatient pediatric patients was conducted in a rural area of Guangxi. Infections were characterized in 230 patients and staphylococcal isolates tested for susceptibility to a range of antibiotics. Results: Among the 307 patients, 38.5% were infants. Culture yielded Staphylococcus aureus (S. aureus) in 230 patients, of which 24 (10.4%) were methicillin-resistant S. aureus (MRSA). Staphylococcal strains were most isolated from hand, foot and umbilicus. The 1-12 mon group had the highest staphylococcal infection rate (86%), followed by the 6-12 year group, but MRSA was more common in the older children (19.5% of S. aureus). MRSA had significantly more resistance than MSSA to chloromycin (46% vs 11%), clindamycin (67% vs 19%), gentamicin (33% vs 2%), rifampicin (25% vs 2.9%), and sulphamthoxazole-trimethoprim (17% vs 3%). Conclusion: S. aureus remains a leading cause of pediatric skin and soft tissue infections. Over 10% of isolates were methicillin-resistant with high rates of resistance to non-beta lactam antibiotics, reducing options for therapy and limiting choices for empirical treatment.

Hepatitis B Virus Infection in B-Cell Non-Hodgkin’s Lymphoma, and Effect of Entecavir in Prophylactic Antiviral Therapy

Background: specialized studies on hepatitis B virus (HBV) infection and B-NHL (B-cell Non-Hodgkin’s Lymphoma) are limited, as well as prophylactic antiviral therapy for B-NHL patients with HBV infection who are receiving anticancer chemotherapy. This study aims to investigate the association between HBV infection and B-NHL, and to evaluate the effect of prophylactic antiviral therapy for HBV-infected B-NHL patients. Study design: A retrospective, case-control study was performed. The study group included 420 patients with B-NHL who were consecutively diagnosed from May 2003 to October 2013 (age range, 14 - 71 years), and the control group included 1280 Chinese residents in Guangxi who participated in the Health Survey (age range, 18 - 74 years). We compared the prevalence rate of HBV infection and clinic-pathologic characteristics between the two groups. The prevalence rate of HBV infection in our study was 34.7% (146/420), higher than the prevalence rate of 13.9% (178/1280) in the general population (P < 0.001). Among 146 B-NHL patients who received anticancer chemotherapy, 104 patients (71.2%) received prophylactic antiviral therapy. Conclusion: This study provides evidence that HBV may play an important role in development of B-NHL. Entecavir maybe the better antiviral drugs than Lamivudine, and antiviral therapy is maintained more than 6 months that maybe the optimal duration of prophylactic antiviral therapy. But further investigation should be conducted for determination of optimal duration and monitoring of antiviral therapy.

Evaluation of humoral immunity and peripheral blood T lymphocyte subset levels after Mycoplasma pneumoniae infection

Objective:To evaluate humoral immunity and peripheral blood T lymphocyte subset levels after Mycoplasma pneumoniae infection. Methods:118 cases of children with Mycoplasma pneumoniae infection were selected as observation group, and 98 cases of healthy children receiving medical examination in our hospital during the same period were selected as control group. The differences in humoral immunity, T lymphocyte subsets, anti-inflammatory and pro-inflammatory factors, Th1/Th2 balance state, etc were compared between two groups of children. Results:Serum IgA level of observation group was lower than that of control group (P<0.05), and IgM level was higher than that of control group (P<0.05). Peripheral blood CD3+and CD4+T lymphocyte levels as well as CD4+/CD8+ratio were lower than those of control group (P<0.05), while CD8+T lymphocyte level was higher than that of control group (P<0.05). Serum pro-inflammatory factors IL-8 and TNF-αlevels were higher than those of control group (P<0.05), while anti-inflammatory factors IL-10 and IL-13 levels were lower than those of control group (P<0.05). Serum IL-4, IFN-γand IL-4/IFN-γlevels were higher than those of control group (P<0.05). Conclusions:Humoral immune and cellular immune suppression, high inflammatory state and so on after Mycoplasma pneumoniae infection are the important mechanisms leading to disease progression.

Safety and efficacy of thalidomide in patients with transfusiondependentβ-thalassemia:a randomized clinical trial

Thalidomide inducesγ-globin expression in erythroid progenitor cells,but its efficacy on patients with transfusion-dependentβ-thalassemia(TDT)remains unclear.In this phase 2,multi-center,randomized,double-blind clinical trial,we aimed to determine the safety and efficacy of thalidomide in TDT patients.A hundred patients of 14 years or older were randomly assigned to receive placebo or thalidomide for 12 weeks,followed by an extension phase of at least 36 weeks.The primary endpoint was the change of hemoglobin(Hb)level in the patients.The secondary endpoints included the red blood cell(RBC)units transfused and adverse effects.In the placebo-controlled period,Hb concentrations in patients treated with thalidomide achieved a median elevation of 14.0(range,2.5 to 37.5)g/L,whereas Hb in patients treated with placebo did not significantly change.Within the 12 weeks,the mean RBC transfusion volume for patients treated with thalidomide and placebo was 5.4±5.0 U and 10.3±6.4 U,respectively(P<0.001).Adverse events of drowsiness,dizziness,fatigue,pyrexia,sore throat,and rash were more common with thalidomide than placebo.In the extension phase,treatment with thalidomide for 24 weeks resulted in a sustainable increase in Hb concentrations which reached 104.9±19.0 g/L,without blood transfusion.Significant increase in Hb concentration and reduction in RBC transfusions were associated with nonβ0/β0 and HBS1L-MYB(rs9399137 C/T,C/C;rs4895441 A/G,G/G)genotypes.These results demonstrated that thalidomide is effective in patients with TDT.