Post­recovery symptoms of infected cases after Omicron pandemic: a quick online cross-sectional study based on C19-YRSm in China.

BACKGROUND: The post COVID-19 health condition of Chinese residents infected with Omicron is not clear after the change of epidemic prevention policies. This study aimed to clarify the epidemiology and associated factors about health status of rehabilitation patients. METHODS: A quick questionnaire study based on C19-YRSm was conducted in mainland China through internet from May 1, 2023, to May 7, 2023. Chinese native speakers infected with Omicron variant agreed to participate were included. Persisting symptom and living habits were simultaneously inquired. Logistic regression analysis was used to identify the associated factors. RESULTS: In this study 753 individuals were included. Of whom 57.90% were males, 89.38% did not seek medical service, 99.47% recovered within less than 120 days. Breathlessness (47.68%), cognitive impairment (44.89%), Anxiety/mood changes (33.20%), pain/discomfort (32.94%), fatigue or tiredness not improved by rest (32.27%) and post-exertional malaise (30.01%) were the top reported key symptoms. Less than 10% respondents reported functional limitations. The prevalence of fever was reported greater than that of other symptoms, with dry eyes at 14.87%, appetite change at 14.34%, and hair loss at 12.22%. Middle age (OR: 2.353, 95%CI: 1.171 ~ 4.729), underlying diseases (OR: 2.293, 95%CI: 1.216 ~ 4.324), severe key symptom (OR: 6.168, 95%CI: 1.376 ~ 27.642) and at least one other symptom (OR: 1.847, 95%CI: 1.225 ~ 2.718)during the recovery were the risk factors of poor overall health after infection (current overall health score <8; 74.10%), while daily exercise in recovery period (OR: 0.457, 95%CI: 0.229 ~ 0.913), a low-fat diet (OR: 0.600, 95%CI: 0.401 ~ 0.898) and the recovery time from 2 to 4 months (OR: 0.639, 95%CI: 0.445 ~ 0.918) were the protective factors. CONCLUSION: This is the first time to use the C19-YRSm scale to evaluate the health status in China. The study revealed prevalence of persistent symptoms within 120 days after Omicron onset.

Analysis of the Imaging Features and Prognosis of Pulmonary Tuberculosis Complicated with Pulmonary Embolism

OBJECTIVE: This study aimed to explore the imaging characteristics of patients with pulmonary tuberculosis complicated with pulmonary embolism and analyze the prognosis of the condition, thereby reducing the mortality and misdiagnosis rate of complications in this type of pulmonary tuberculosis. METHODS: In this retrospective study, a total of 70 patients diagnosed with pulmonary embolism by computed tomography pulmonary angiography (CTPA) from January 2016 to May 2021 in Anhui Chest Hospital were included. Among them, 35 patients with pulmonary embolism combined with pulmonary tuberculosis were set as the study group, and the other 35 patients with pulmonary embolism only were set as the control group. The imaging findings of chest CT examination, the incidence of pulmonary hypertension, the level of N-terminal proto-B-type brain natriuretic peptide (NT-proBNP), and the prognosis of patients were compared between the two groups. The incidence of deep venous embolism was evaluated by ultrasonography of the lower extremity. RESULTS: In the study group, the median age of patients was 71 years, and the ratio of males to females was 2.5 to 1. In the control group, the median age was 66 years old, and the male-to-female ratio was 2.2 to 1. There were 16 cases (16/35, 45.71%) in the study group and 10 cases (10/35, 28.57%) in the control group with an increased level of NT-proBNP. Pulmonary hypertension occurred in 10 patients (10/35, 28.57%) in the study group and 7 patients (7/35, 20.00%) in the control group. Patients who lost follow-up included 5 in the study group (5/35, 14.29%) and 3 in the control group (3/35, 8.57%). There were 17 cases (17/35, 48.57%) in the study group and 3 cases (3/35, 8.57%) in the control group with pulmonary artery widening, and the difference was significant (P < 0.001). There were 13 deaths in the study group (13/35, 37.14%) and 1 death in the control group (1/35, 2.86%), and the difference was significant (P <0.001). CONCLUSION: Special signs of pulmonary artery widening, pulmonary hypertension of varying degrees, and increased levels of NT-proBNP of varying degrees can be found in patients with pulmonary tuberculosis complicated with pulmonary embolism, and the three signs are positively correlated. The mortality of patients with pulmonary tuberculosis complicated with pulmonary embolism is significantly higher than that of patients with pulmonary embolism alone. Pulmonary tuberculosis and pulmonary embolism both occur in the ipsilateral lung, causing clinical symptoms to cover each other, thereby making diagnosis difficult.

Transformation of Lung Squamous Cell Carcinoma to Small Cell Lung Cancer After Immunotherapy Resistance: A Case Report.

The transformation of lung adenocarcinoma to small cell lung cancer (SCLC) following treatment with epidermal growth factor (EGFR) receptor tyrosine kinase inhibitors (TKIs) is a relatively common phenomenon. However, transformation of non-small cell lung cancer (NSCLC) to SCLC following treatment with immunotherapy is very rare. Here, we report a case of a 56-year-old patient diagnosed with driver gene mutation-negative lung squamous cell carcinoma (SCC). He received four cycles of immunotherapy with sugemalimab and chemotherapy with albumin paclitaxel in combination with carboplatin, and a partial response was achieved. Subsequently, the patient received 5 cycles of immunotherapy with sugemalimab. However, he developed rapid progression of mediastinal lymph nodes, and biopsy results showed transformation to SCLC. His tumor did not respond to the next line of carboplatin combined with etoposide, and he died six months after the discovery of SCLC transformation. In conclusion, SCLC transformation is also an important resistance mechanism for lung SCC patients treated with immunotherapy and predicts a very poor outcome. Repeat biopsy is needed for advanced lung SCC that has progressed with immunotherapy.

Antibacterial, injectable, and adhesive hydrogel promotes skin healing.

With the development of material science, hydrogels with antibacterial and wound healing properties are becoming common. However, injectable hydrogels with simple synthetic methods, low cost, inherent antibacterial properties, and inherent promoting fibroblast growth are rare. In this paper, a novel injectable hydrogel wound dressing based on carboxymethyl chitosan (CMCS) and polyethylenimine (PEI) was discovered and constructed. Since CMCS is rich in -OH and -COOH and PEI is rich in -NH2, the two can interact through strong hydrogen bonds, and it is theoretically feasible to form a gel. By changing their ratio, a series of hydrogels can be obtained by stirring and mixing with 5 wt% CMCS aqueous solution and 5 wt% PEI aqueous solution at volume ratios of 7:3, 5:5, and 3:7. Characterized by morphology, swelling rate, adhesion, rheological properties, antibacterial properties, in vitro biocompatibility, and in vivo animal experiments, the hydrogel has good injectability, biocompatibility, antibacterial (Staphylococcus aureus: 56.7 × 107 CFU/mL in the blank group and 2.5 × 107 CFU/mL in the 5/5 CPH group; Escherichia coli: 66.0 × 107 CFU/mL in the blank group and 8.5 × 107 CFU/mL in the 5/5 CPH group), and certain adhesion (0.71 kPa in the 5/5 CPH group) properties which can promote wound healing (wound healing reached 98.02% within 14 days in the 5/5 CPH group) and repair of cells with broad application prospects.

Molecular determinants of clinical outcomes for anaplastic lymphoma kinase-positive non-small cell lung cancer in Chinese patients: A retrospective study.

Gene complexity affects the clinical outcomes of anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC). Here, we reviewed the medical records of patients with NSCLC between September 2015 and December 2020 in a single institution. We examined the clinical and genomic predictors of these outcomes using multivariate Cox proportional hazards analysis. Overall, 105 patients with ALK-rearranged NSCLC were included. Echinoderm microtubule-associated protein-like 4 (EML4) was the predominant fusion partner (96.2%). Five patients (4.8%) had non-EML4 fusion partners; three had novel partners. EML4::ALK variant 3 (36.5%) was predominant. One patient had the following three subtypes: E13::A20, E6ins33::A20, and E20::A20. Median progression-free survival (PFS), but not overall survival (OS), was significantly different between patients with variants 3 and 1. TP53 was the most common concomitant mutation (21.4%). The presence of TP53 mutations was associated with shorter PFS among patients who received ALK-TKI. Patients with concomitant oncogene mutations presented significantly shorter OS and PFS than those with only ALK rearrangement. In a multivariate Cox regression model, concomitant oncogene mutations and variant 3 carrier status were prognostic factors for PFS, whereas baseline brain metastasis was a prognostic factor for OS.

Extracranial metastasis of glioblastoma with genomic analysis: a case report and review of the literature.

Background: Glioblastoma (GBM) is the first most frequent type of primary malignant brain tumors in adults. It is basically confined to the brain, and extracranial metastases (ECM) are rare. The genomic features of GBM with ECM are not fully elucidated. Case Description: Here, we present a case of a male patient with headache and left eye vision loss for 2 months who had a left occipital lobe tumor. GBM of grade IV [isocitrate dehydrogenase 1 (IDH-1) wild type] was diagnosed based on the histological profiles of intracranial tumor according to the World Health Organization standard. ECM of GBM located in the mediastinal lymph node occurred 6 months after resection of the intracranial tumor. High throughput gene sequencing was performed using ECM lesions. Mutated genes included tumor protein 53 (TP53), CUB and Sushi multiple domains 3 (CSMD3), poly(ADP-ribose) polymerase family member 4 (PARP4), and PTEN. The patient underwent surgery, radiotherapy, chemotherapy, and anti-angiogenic drug treatment. Unfortunately, the patient died 8 months after surgery. Conclusions: ECM of GBM is rare, and its prognosis is very poor. Mutated genes in ECM included TP53, CSMD3, PARP4, and PTEN in our case. Genomic analysis provides important insights into GBM and its ECM.

Screening and analysis of immune-related genes of Aedes aegypti infected with DENV2.

Dengue virus type Ⅱ (DENV2) is a primary serotype responsible for the dengue fever epidemic, and Aedes aegypti is the main DENV2 vector. Understanding the Aedes aegypti immune mechanism against DENV2 is the basis for research on immune blockade in mosquitoes. Some preliminary studies lack validation in the literature, so this study was performed to further study and validate the potential target genes to provide a further basis for screening key target genes. We screened 51 genes possibly related to Aedes aegypti infection and immunity from the literature for further verification. First, bioinformatic methods such as GO, KEGG and PPI analysis were used, and then RT-qPCR was used to detect the changes in mRNA expression in the midguts and salivary glands of Aedes aegypti infected with DENV2.Bioinformatic analysis showed that mostly genes of the glucose metabolism pathway and myoprotein were influenced. In salivary glands, the Gst (xa) and Toll (xb) expression levels were significantly correlated with DENV2 load (y, lg[DENV2 RNA copies]), y = -3436xa+0.2287xb+3.8194 (adjusted R2 = 0.5563, F = 9.148, PF = 0.0045). In midguts, DENV2 load was significantly correlated with the relative Fba(R2 = 0.4381, t = 2.497, p < 0.05, df = 8), UcCr(R2 = 0.4072, t = 2.344, p < 0.05, df = 8) and Gbps1(R2 = 0.4678, t = 2.652, p < 0.05, df = 8) expression levels, but multiple regression did not yield significant results. This study shows that genes related to glucose metabolism and muscle proteins contribute to the interaction between Aedes aegypti and dengue virus. It was confirmed that SAAG-4, histone H4, endoplasmin, catalase and other genes are involved in the regulation of DENV2 infection in Aedes aegypti. It was revealed that GST and Toll in salivary glands may have antagonistic effects on the regulation of DENV2 load. Fba, UcCr and Gbps1 in the midgut may increase DENV2 load. These study results further condensed the potential target gene range of the Aedes aegypti immune mechanism against DENV2 infection and provided basic information for research on the Aedes aegypti in vivo blockade strategy against DENV2.

Tracheobronchopathia Osteochondroplastica: A Case Report.

BACKGROUND: Tracheobronchopathia osteochondroplastica (TO) is a rare idiopathic disease with a stable course that involves the mucous membrane of the tracheobronchial tree. Most cases present no specific symptoms, and there are currently no established guidelines for diagnosis and treatment. In this report, we discuss a single case of a patient with TO who was diagnosed based on clinical imaging and histopathology. CASE SUMMARY: A patient with a history of smoking and alcohol consumption, but no specific clinical symptoms, was diagnosed with TO after undergoing fiber-optic bronchoscopy. Nodular processes with smooth surface mucosa and detached bronchial mucosa were observed. The presence of TO was confirmed by pathological examination. CONCLUSION: The diagnosis of TO is difficult, and early fiber-optic bronchoscopy and pathological examination should be performed to facilitate the diagnosis.

Prognostic Value of Ki-67 Expression in Advanced Lung Squamous Cell Carcinoma Patients Treated with Chemotherapy.

BACKGROUND: The relationship between the Ki-67 expression level and chemotherapy response and survival prognosis in advanced lung squamous cell carcinoma (SCC) remains unclear. METHODS: A total of 101 patients were included in the study. All patients received systemic first-line platinum-based chemotherapy. The Ki-67 expression level was determined by immunohistochemistry analysis. RESULTS: The Ki-67 expression level was positively correlated with an increase in tumor T stage (P = 0.0140), N stage (P < 0.0001), and M stage (P < 0.0001) in advanced lung SCC. High Ki-67 expression could predict chemotherapy response (area under the curve = 0.7524, P < 0.0001). Patients with tumors that expressed high levels of Ki-67 had shorter overall survival (OS) (18.8 months vs 25.5 months, P = 0.0002) and progression-free survival (PFS) (4.8 months vs 6.7 months, P < 0.0001). Cox analysis found Ki-67 expression to be an independent prognostic biomarker of shortened OS (P = 0.009) and PFS (P = 0.008). CONCLUSION: Ki-67 expression may affect chemotherapy response and thus has prognostic value. Ki-67 expression may be a promising prognostic biomarker for advanced lung SCC.

Inhibition of miR-22 promotes differentiation of osteoblasts and improves bone formation via the YWHAZ pathway in experimental mice.

INTRODUCTION: In senile osteoporosis countering the age-mediated bone loss, promotion of osteoblastogenesis and identification of responsible micro-RNA (miR) would be a successful strategy. MATERIAL AND METHODS: miR microarray screening was carried out to identify the suppressed miRs after real time polymerase chain reaction (RT-PCR) analysis in mesenchymal stem cells (MSCs) derived from adult bone marrow during the proliferation to the mineralization stage. The primary calvarial pre-osteoblasts (human) were harvested and received transfection of miR-22's antagomir or agomir in vitro. Bioinformatics study suggested YWHAZ as the favorable target gene. Next, YWHAZ knockdown was studied for its effect on differentiation of osteoblasts. For in vivo studies, ovariectomized or sham mice were injected with miR-22's antagomir for a period of 6 weeks. The stromal cells were isolated in the 6th week for ex vivo experiments. RESULTS: miR-22 was found to be down-regulated in bone marrow derived mesenchymal stem cells. miR-22's antagomir converted the pre-osteoblasts to a more differentiated and mineralized phenotype showing upregulated protein expression of COL1A1, ALP and CBFA1. The miR-22's antagomir suppressed YWHAZ, enhanced stability of CBFA1 and promoted the differentiation of osteoblasts. In vivo, miR-22's antagomir promoted mineralization and osteoblastogenesis, elevated bone strength and reversed the ovariectomy mediated bone loss in sham mice. CONCLUSIONS: Inhibition of miR-22 may be a potential target for treating osteoporosis clinically. The findings hence suggest that inhibition of miR-22 may be an effective anabolic therapeutic approach in treating osteoporosis clinically.

The effect of anti-cancer and anti-tuberculosis treatments in lung cancer patients with active tuberculosis: a retrospective analysis.

BACKGROUND: Lung tuberculosis (TB) and lung cancer have a complex relationship. Data concerning TB treatment in lung cancer patients are still incomplete. The aim of this study was to investigate the effects of anti-cancer and anti-tuberculosis treatments in lung cancer patients with active lung TB. METHODS: In a retrospective cohort study, lung cancer patients with active lung TB were identified between January 2013 and December 2016. Age- and sex-matched lung cancer patients without tuberculosis were selected as control subjects. Anti-cancer and anti-tuberculosis treatments were administered according to the national guidelines. The clinical courses and responses of lung cancer patients with and without active lung TB were examined and compared. RESULTS: A total of 31 consecutive lung cancer patients were diagnosed with active lung TB. Fifty-one lung cancer patients without TB were enrolled as control subjects. Most patients in the two groups were elderly, had advanced non-small cell lung cancer and had tumor burdens. The anti-cancer treatment completion rate and response rate were not different between two group (87.1% in TB treatment patients vs. 92.2% in lung cancer patients, 77.4% in TB treatment patients vs. 88.2% in lung cancer patients, respectively). The anti-tuberculosis treatment completion rate and success rate was 87.1 and 80.7%. The median survival times were not different between two groups (52 weeks in TB treatment patients vs. 57 weeks in lung cancer patients). The change in Karnofsky performance score was also not different between two groups. The most common side effect in TB treatment patients was liver injury (61.3%). The most serious side effect in TB treatment patients was leukocyte deficiency (9.7% in Grade 3). Both of side effects mentioned above were not different between two groups. CONCLUSION: Both anti-cancer and anti-tuberculosis treatments can be safely and effectively administered in lung cancer patients with active lung TB. Attention should be paid to the risk of tuberculosis in lung cancer patients in TB high-burden countries.

Anserine and glucosamine supplementation attenuates the levels of inflammatory markers in rats with rheumatoid arthritis.

Rheumatoid arthritis (RA) is an autoimmune disorder that affects the joint synovium. Anserine is a functional dipeptide containing methylhistidine and ß-alanine, and is present in the brain and skeletal muscle of birds and mammals. Glucosamine is an amino sugar used in the synthesis of glycosylated proteins and lipids. We evaluated the effects of anserine and glucosamine on RA. Rats were assigned into the control group, RA group, anserine group (1 mg/kg), glucosamine group (200 mg/kg), or anserine plus glucosamine group (anserine, 1 mg/kg + glucosamine, 200 mg/kg). Treatment was continued for 45 consecutive days and was administered orally. The serum levels of catalase, glutathione peroxidase (Gpx), superoxide dismutase (SOD), reduced glutathione (GSH), lipid peroxidation, uric acid, nitric oxide, ceruloplasmin, zinc, copper, prostaglandin E2 (PGE2), matrix metalloproteinase (MMP)-3, tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-6 were assayed. The mRNA and protein levels of nuclear factor (NF)-κB and inducible nitric oxide synthase (iNOS) in synovial tissue were also determined. Anserine plus glucosamine significantly increased the catalase, SOD, Gpx, GSH, and zinc levels compared to the control, anserine, and glucosamine groups. Also, anserine plus glucosamine significantly reduced the PGE2, MMP-3, TNF-α, IL-1ß, and IL-6 levels compared to the control, anserine, and glucosamine groups. Furthermore, anserine plus glucosamine significantly reduced the mRNA and protein levels of NF-κB and iNOS compared to the control, anserine, and glucosamine groups. Therefore, supplementation of anserine plus glucosamine shows therapeutic potential for RA.

High level of RNF187 contributes to the progression and drug resistance of osteosarcoma.

Objectives: Ring finger protein 187 (RNF187) was recently demonstrated to be up-regulation and function as a promoter in multiple cancers. However, the roles of RNF187 in osteosarcoma (OS) are unclear. Here, we tried to reveal the clinicopathological and biological roles of RNF187 in OS. Materials and Methods: We employed the quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) to determine the expression of RNF187 in OS tissues and cells. Migration and invasion capacities were analyzed by wound healing and transwell assays, and colony formation and CCK8 assays were performed to investigate proliferative ability. The functional effects of RNF187 on OS drugs resistance were further determined by CCK8 and western blot assays. Then, the relationship between RNF187 expression and clinical implications was analyzed by tissue microarrays (TMAs) including 51 OS cases. Moreover, the prognostic value was also determined by Kaplan-Meier analysis. Results: We reported that RNF187 mRNA was significantly increased in OS tissues compared to matched nontumorous tissues (3.83 ±0.79 vs. 1.70 ± 0.63), which was in line with the IHC assay in TMAs. By RNA interference and cDNA transfection, we showed high level of RNF187 increased the migration, invasion and proliferation of OS cells. Moreover, we demonstrated that elevated RNF187 expression induced OS cell drugs resistance, activated the ERK1/2 molecular and markedly enhanced the BCL-2 expression. Clinically, OS patients with high level of RNF187 was associated with Histologic differentiation (p=0.001), an advanced Enneking stage (p=0.001), response to chemotherapy (p=0.004), and metastasis (p= 0.001). Clinically, our data displayed that the RNF187 overexpression in OS samples associated with shorten overall survival (p=0.001) and high tumor recurrence (p=0.001) in postoperative OS patients. Conclusions: Our results indicate that Elevated RNF187 expression is a new adverse outcomes marker for OS patients and may be used as a new therapeutic target of OS.

RNA interference of odorant receptor CquiOR114/117 affects blood-feeding behavior in Culex quinquefasciatus.

The odorant receptors (ORs) play a critical role for mosquitoes in the identification of blood-feeding hosts and other physiological processes. The OR8 subfamily in mosquitoes has been shown to be strongly involved in the detection the mammalian host associated odor, 1-octen-3-ol. CquiOR114/117 has been shown to be an orthologous OR8 in Culex quinquefasciatus Say. In this study, the expression of CquiOR114/117 in the different developmental stages of Cx. quinquefasciatus was detected by the amplification of CquiOR114/117 with real-time fluorescence quantitative polymerase chain reaction (PCR). RNA interference (RNAi) technology was used to interfere with the expression of CquiOR114/117 in females to observe the blood-feeding behavior change. The results showed that the expression level of CquiOR114/117 in the egg-to-pupa stage was significantly lower than that in the adult stage and that the expression level of the female mosquitoes peaked on the third day after emergence. The expression of CquiOR114/117 was significantly decreased in the 2-6 days after the injection of dsRNA compared with the control groups. The analysis of the blood-feeding behavior showed a significant positive correlation between CquiOR114/117 expression and the engorgement rate of the mosquitoes. CquiOR114/117 is speculated to have an effect on the blood-feeding behavior of Cx. quinquefasciatus.

Analysis of the relationship between Ki-67 expression and chemotherapy and prognosis in advanced non-small cell lung cancer.

BACKGROUND: To analyse the relationship between the Ki-67 index of advanced non-small cell lung cancer (NSCLC) and the objective response rate (ORR) and progression-free survival (PFS) of patients who received chemotherapy. METHODS: The Ki-67 index of advanced NSCLC pathology was established by immunohistochemistry; using univariate and multivariate analyses, we retrospectively analysed the relationship between the Ki-67 index of 112 advanced NSCLC patients in our hospital and chemotherapy response and PFS. Both epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) were found to be wild type in adenocarcinoma patients, and no gene testing was performed for those with squamous cell carcinoma. All selected patients received four cycles of platinum-based chemotherapy, and according to the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1), the curative effect was evaluated after every two cycles. RESULTS: In the univariate and multivariate analyses, the Ki-67 index was significantly associated with the objective response to chemotherapy (B =-0.069, P=0.000). Ki-67 expression could also accurately predict the ORR of chemotherapy [P<0.0001, area under the curve (AUC) =0.7467, 95% confidence interval (CI): 0.6578-0.8356]: squamous cell carcinoma group [P=0.0003, AUC =0.8065 (95% CI: 0.6922-0.9208)], adenocarcinoma group [P=0.0193, AUC =0.6810 (95% CI: 0.5360-0.8262)]. The overexpression of Ki-67 was a negative prognostic factor for PFS in advanced NSCLC (P<0.0001): squamous cell carcinoma (P=0.0055), adenocarcinoma (P<0.0001). According to the multivariate Cox analysis, Ki-67 index (P=0.000) and stage (P=0.001) were negative factors of PFS. CONCLUSIONS: The Ki-67 index might be a clinically significant biomarker in advanced NSCLC and may be able to predict the efficacy of chemotherapy. High expression of Ki-67 might also be an indicator of shortened PFS time.

Survival analysis of patients with advanced non-small cell lung cancer receiving tyrosine kinase inhibitor (TKI) treatment: A multi-center retrospective study.

BACKGROUND: The study was conducted to assess differences in overall survival (OS) in patients with non-small cell lung cancer (NSCLC) receiving different treatment modalities of tyrosine kinase inhibitors (TKIs). METHODS: A total of 463 NSCLC patients receiving TKI treatment were included. OS was compared according to treatment timing in all patients, the elderly, and patients positive for EGFR mutations. RESULTS: One hundred and seventy two patients received TKIs as first-line treatment, 220 as second-line, and 67 as third-line. The results between the three groups were not statistically significant: the one, two, and three-year OS rates were: 55.3%, 22.3%, and 11.3% (first-line); 59.6%, 27.8%, and 14.9% (second-line); and 53.8%, 41.3%, and 29.5% (third-line), respectively (P = 0.095). Results between the three groups of elderly patients were also not statistically significant (P = 0.469). The one and two-year OS rates in EGFR mutation-positive patients receiving first-line treatment were 48% and 17.5%, respectively. The one, two, and three-year OS rates of patients receiving second-line treatment were: 54.2%, 30.3%, and 20.2%, respectively. There were no statistically significant differences between the groups with EGFR mutations receiving first-line or second-line treatment. Thirteen EGFR mutation-positive patients received third-line TKI treatment for a median duration of 7 months. Their one and two-year OS rates were 69.8% and 58.2%, respectively, which were higher than in the other two groups (P = 0.015). CONCLUSION: Three lines of TKI therapy can prolong survival in NSCLC patients. Elderly patients can benefit from TKI therapy. EGFR mutation-positive patients can benefit from second-line or third-line TKI therapy.

The genetic diversity and population structure of domestic Aedes aegypti (Diptera: Culicidae) in Yunnan Province, southwestern China.

BACKGROUND: There was no record of Aedes aegypti in Yunnan Province, China, until 2002, but this species is now continuously found in nine cities (or counties). Until now, little was known about the genetic diversity and population structure of this invasive species. Thus, a detailed understanding of the invasion strategies, colonisation and dispersal of this mosquito from a population genetics perspective is urgently needed for controlling and eliminating this disease vector. METHODS: The genetic diversity and population structure of Ae. aegypti communities were analysed by screening nine microsatellite loci from 833 Ae. aegypti mosquitoes sampled from 28 locations in Yunnan Province. RESULTS: In total, 114 alleles were obtained, and the average polymorphic information content (PIC) value was 0.672. The value of the alleles per locus ranged from 2.90 to 5.18, with an average of 4.04. The value of He ranged from 0.353 to 0.681, and the value of Ho within populations ranged from 0.401 to 0.689. Of the 28 locations, two showed significant departures from the Hardy-Weinberg equilibrium (HWE) with P-values less than 0.05, and a bottleneck effect was detected among locations from Ruili and the border areas with the degree of 60% and 50%, respectively. Combined with the F-statistics (FIT = 0.222; FCT = 0.145), the analysis of molecular variance (AMOVA) revealed that there was substantial molecular variation among individuals, accounting for 77.76% of the sample, with a significant P-value (<0.0001). The results suggest that genetic differences in Ae. aegypti originated primarily among individuals rather than among populations. Furthermore, the STRUCTURE and UPGMA cluster analyses showed that Ae. aegypti from the border areas were genetically isolated compared to those from the cities Ruili and Jinghong, consistent with the results of the Mantel test (R 2 = 0.245, P < 0.0001). CONCLUSIONS: Continuous invasion contributes to the maintenance of Ae. aegypti populations' genetic diversity and different invasion accidents result in the genetic difference among Ae. aegypti populations of Yunnan Province.

Identification of Differentially Expressed Genes In Deltamethrin-Resistant Culex pipiens quinquefasciatus.

Culex quinquefasciatus is one of China's major house-dwelling mosquito species and an important vector of filariasis and encephalitis. Chemical treatments represent one of the most successful approaches for comprehensive mosquito prevention and control. However, the widespread use of chemical pesticides has led to the occurrence and development of insecticide resistance. Therefore, in-depth studies of resistance to insecticides are of vital importance. In this study, we performed a gene expression analysis to investigate genes from Cx. quinquefasciatus that may confer pyrethroid resistance. We aimed to understand the mechanisms of Cx. quinquefasciatus resistance to pyrethroid insecticides and provide insights into insect resistance management. Using a resistance bioassay, we determined the deltamethrin LC50 values (lethal concentration required to kill 50% of the population) for Cx. quinquefasciatus larvae in the F21, F23, F24, F26, F27, and F30 generations. The 7 tested strains exhibited pesticide resistance that was 25.25 to 87.83 times higher than that of the SanYa strain. Moreover, the expression of the OBPjj7a (odorant-binding protein OBPjj7a), OBP28 (odorant-binding protein OBP28), and E2 (ubiquitin-conjugating enzyme) genes was positively correlated with deltamethrin resistance ( R2 = 0.836, P = 0.011; R2 = 0.788, P = 0.018; and R2 = 0.850, P = 0.009, respectively) in Cx. quinquefasciatus. The expression of 4 additional genes, H/ACA, S19, SAR2, and PGRP, was not correlated with deltamethrin resistance. In summary, this study identified 3 Cx. quinquefasciatus genes with potential involvement in deltamethrin resistance, and these results may provide a theoretical basis for the control of mosquito resistance and insights into resistance detection.

Recurrent myoepithelial carcinoma of the submandibular gland treated by rAd-p53 combined with radiotherapy: A case report.

The aim of the present study was to report the case of a patient with recurrent myoepithelial carcinoma of the submandibular gland without progression for five years following treatment. A 71-year-old male patient presented to hospital with a painless swelling in the region of the right submandibular gland, and received a radical neck dissection on January 29, 2008. A nodule of ~7×4×2 cm was identified at the site of the right submandibular gland, and the pathological results revealed a diagnosis of myoepithelial carcinoma of the right submandibular gland with no lymph node metastasis. However, this case developed local recurrence with wide-spread metastasis in the lungs. Between April and October 2008, the patient underwent several treatment regimens and demonstrated no improvement following 6 cycles of chemotherapy. From then on, the patient was treated with recombinant adenoviral-p53 (rAd-p53) combined with radiotherapy using a 6 millivolt medical linear accelerator. The foci were relieved and the cancer demonstrated no signs of progression during the 5-year follow-up. rAd-p53 combined with radiotherapy was useful for treating myoepithelial carcinoma of the submandibular gland.