Radiogenomic analysis of prediction HER2 status in breast cancer by linking ultrasound radiomic feature module with biological functions.

BACKGROUND: Human epidermal growth factor receptor 2 (HER2) overexpressed associated with poor prognosis in breast cancer and HER2 has been defined as a therapeutic target for breast cancer treatment. We aimed to explore the molecular biological information in ultrasound radiomic features (URFs) of HER2-positive breast cancer using radiogenomic analysis. Moreover, a radiomics model was developed to predict the status of HER2 in breast cancer. METHODS: This retrospective study included 489 patients who were diagnosed with breast cancer. URFs were extracted from a radiomics analysis set using PyRadiomics. The correlations between differential URFs and HER2-related genes were calculated using Pearson correlation analysis. Functional enrichment of the identified URFs-correlated HER2 positive-specific genes was performed. Lastly, the radiomics model was developed based on the URF-module mined from auxiliary differential URFs to assess the HER2 status of breast cancer. RESULTS: Eight differential URFs (p < 0.05) were identified among the 86 URFs extracted by Pyradiomics. 25 genes that were found to be the most closely associated with URFs. Then, the relevant biological functions of each differential URF were obtained through functional enrichment analysis. Among them, Zone Entropy is related to immune cell activity, which regulate the generation of calcification in breast cancer. The radiomics model based on the Logistic classifier and URF-module showed good discriminative ability (AUC = 0.80, 95% CI). CONCLUSION: We searched for the URFs of HER2-positive breast cancer, and explored the underlying genes and biological functions of these URFs. Furthermore, the radiomics model based on the Logistic classifier and URF-module relatively accurately predicted the HER2 status in breast cancer.

Methylomics and cancer: the current state of methylation profiling and marker development for clinical care.

Epigenetic modifications have long been recognized as an essential level in transcriptional regulation linking behavior and environmental conditions or stimuli with biological processes and disease development. Among them, methylation is the most abundant of these reversible epigenetic marks, predominantly occurring on DNA, RNA, and histones. Methylation modification is intimately involved in regulating gene transcription and cell differentiation, while aberrant methylation status has been linked with cancer development in several malignancies. Early detection and precise restoration of dysregulated methylation form the basis for several epigenetics-based therapeutic strategies. In this review, we summarize the current basic understanding of the regulation and mechanisms responsible for methylation modification and cover several cutting-edge research techniques for detecting methylation across the genome and transcriptome. We then explore recent advances in clinical diagnostic applications of methylation markers of various cancers and address the current state and future prospects of methylation modifications in therapies for different diseases, especially comparing pharmacological methylase/demethylase inhibitors with the CRISPRoff/on methylation editing systems. This review thus provides a resource for understanding the emerging role of epigenetic methylation in cancer, the use of methylation-based biomarkers in cancer detection, and novel methylation-targeted drugs.

HYAL1 deficiency attenuates lipopolysaccharide-triggered renal injury and endothelial glycocalyx breakdown in septic AKI in mice.

BACKGROUND: Renal dysfunction and disruption of renal endothelial glycocalyx are two important events during septic acute kidney injury (AKI). Here, the role and mechanism of hyaluronidase 1 (HYAL1) in regulating renal injury and renal endothelial glycocalyx breakdown in septic AKI were explored for the first time. METHODS: BALB/c mice were injected with lipopolysaccharide (LPS, 10 mg/kg) to induce AKI. HYAL1 was blocked in vivo using lentivirus-mediated short hairpin RNA targeting HYAL1 (LV-sh-HYAL1). Biochemical assays were performed to measure the levels and concentrations of biochemical parameters associated with AKI as well as levels of inflammatory cytokines. Renal pathological lesions were determined by hematoxylin-eosin (HE) staining. Cell apoptosis in the kidney was detected using terminal-deoxynucleoitidyl transferase-mediated nick end labeling (TUNEL) assay. Immunofluorescence and immunohistochemical (IHC) staining assays were used to examine the levels of hyaluronic acid in the kidney. The protein levels of adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) signaling, endothelial glycocalyx, and autophagy-associated indicators were assessed by western blotting. RESULTS: The knockdown of HYAL1 in LPS-subjected mice by LV-sh-HYAL1 significantly reduced renal inflammation, oxidative stress, apoptosis and kidney dysfunction in AKI, as well as alleviated renal endothelial glycocalyx disruption by preventing the release of hyaluronic acid to the bloodstream. Additionally, autophagy-related protein analysis indicated that knockdown of HYAL1 significantly enhanced autophagy in LPS mice. Furthermore, the beneficial actions of HYAL1 blockade were closely associated with the AMPK/mTOR signaling. CONCLUSION: HYAL1 deficiency attenuates LPS-triggered renal injury and endothelial glycocalyx breakdown in septic AKI in mice.

Research on the Visualization of Railway Signal Operation and Maintenance Based on BIM + GIS.

To adapt to the "fine" and "extensive" management characteristics of railway signal equipment operation and maintenance, achieving real-time and interactive monitoring of signal equipment operation status, and developing an integrated approach to equipment operation and maintenance, this paper takes a comprehensive management perspective. To create a lightweight BIM model, the Garland folding algorithm is utilized to simplify the IFC file format. Building on this approach, the data are divided based on building component division standards to obtain separate files containing geometric information and semantic attributes. The geometric information files are converted to a 3D Tiles format, combining BIM semantic attributes with semantic attribute files through an intermediate format. Dynamic data management is achieved by setting the octree space index structure in combination with a view-frustum culling algorithm. Then, the 3D Tiles target file is imported into the Cesium platform, and Node.js is used to achieve three-dimensional visualization of railway signal operation and maintenance. The proposed method is verified using an inbound signal as an example to assess its feasibility. The results demonstrate the potential of the proposed method to achieve stable integration between BIM equipment full lifecycle maintenance and GIS geographical space display. Railway signal equipment is endowed with comprehensive one-click information query functions for equipment positioning and spatial analysis, improving the efficiency and scientific decision-making level of equipment operation and maintenance.

Feasibility of soil and sludge standards for freshwater sediment pollutant determination and quality judgment.

The environmental standards of soil and sludge have been typically referenced for freshwater sediment determination and quality assessment, especially in some areas without sediment standards. The feasibility of determination method and quality standard of soils and sludge for freshwater sediment was investigated in this study. Fractions of heavy metals, nitrogen, phosphorus, and reduced inorganic sulfur (RIS) in different type of samples were determined, including freshwater sediments, dryland and paddy soils, and sludge with air-drying (AD) and freeze-drying (FD) treatment, respectively. Results showed fraction distributions of heavy metals, nitrogen, phosphorus, and RIS in sediments markedly differed from those of soils and sludge. Fraction redistributions of heavy metals, nitrogen, phosphorus, and RIS in sediments were observed with AD compared to those treated by FD. The proportions of heavy metals, nitrogen, and phosphorus associated with organic matter (or sulfide) in FD sediments decreased by 4.8-74.2%, 9.5-37.5%, and 16.1-76.3%, respectively, compared to those in AD sediments, while those associated with Fe/Mn oxides increased by 6.3-39.1%, 50.9-226.9%, and 6.1-31.0%, respectively. The fraction proportions of RIS in sediments with AD also sharply decreased. Determination of standard methods for sludge and soil caused the distortion of pollutant fraction analysis in sediment. Similarly, the quality standard of sludge and soil was inappropriate for sediment quality assessment due to the differences in pollutant fraction pattern between sediment and soils/sludge. Totally, soil and sludge standards are inapplicable for freshwater sediment pollutant determination and quality judgment. This study would greatly advance the establishment of freshwater sediment determination methods and quality standards.

bta-miR-2904 inhibits bovine viral diarrhea virus replication by targeting viral-infection-induced autophagy via ATG13.

MicroRNAs (miRNAs) are endogenous small and noncoding RNA molecules (18-25 nt) that can regulate expression of their target genes post-transcriptionally. Previously, using high-throughput sequencing data obtained on a Solexa platform, we found that Bos taurus bta-miR-2904 (miR-2904) was significantly upregulated in Madin-Darby bovine kidney (MDBK) cells infected with bovine viral diarrhea virus (BVDV) strain NADL at 2, 6, and 18 h postinfection (hpi) compared to uninfected MDBK cells. Moreover, miR-2904 overexpression significantly reduced BVDV replication. However, the mechanism by which miR-2904 inhibits viral replication remains unclear. In this study, we used electron microscopy, laser confocal microscopy, dual-luciferase reporter analysis, real-time PCR, and Western blot assays to investigate the effect of the miR-2904 expression on BVDV NADL replication and virus-infection-induced autophagy. The results indicate that miR-2904 inhibits autophagy of MDBK cells by targeting autophagy-related gene 13 (ATG13), and overexpression of miR-2904 inhibited the replication of BVDV NADL.

The performance of detecting Mycobacterium tuberculosis complex in lung biopsy tissue by metagenomic next-generation sequencing.

BACKGROUND: Tuberculosis (TB) is a chronic infectious disease caused by the Mycobacterium tuberculosis complex (MTBC), which is the leading cause of death from infectious diseases. The rapid and accurate microbiological detection of the MTBC is crucial for the diagnosis and treatment of TB. Metagenomic next-generation sequencing (mNGS) has been shown to be a promising and satisfying application of detection in infectious diseases. However, relevant research about the difference in MTBC detection by mNGS between bronchoalveolar lavage fluid (BALF) and lung biopsy tissue specimens remains scarce. METHODS: We used mNGS to detect pathogens in BALF and lung biopsy tissue obtained by CT-guide percutaneous lung puncture (CPLP) or radial endobronchial ultrasound transbronchial lung biopsy (R-EBUS-TBLB) from 443 hospitalized patients in mainland China suspected of pulmonary infections between May 1, 2019 and October 31, 2021. Aim to evaluate the diagnostic performance of mNGS for detecting MTBC and explore differences in the microbial composition in the 2 specimen types. RESULTS: Among the 443 patients, 46 patients finally were diagnosed with TB, of which 36 patients were detected as MTBC positive by mNGS (8.93%). Striking differences were noticed in the higher detection efficiency of lung biopsy tissue compared with BALF (P = 0.004). There were no significant differences between the 2 specimen types in the relative abundance among the 27 pathogens detected by mNGS from the 36 patients. CONCLUSIONS: This study demonstrates that mNGS could offer an effective detection method of MTBC in BALF or lung tissue biopsy samples in patients suspected of TB infections. When it comes to the situations that BALF samples have limited value to catch pathogens for special lesion sites or the patients have contraindications to bronchoalveolar lavage (BAL) procedures, lung biopsy tissue is an optional specimen for MTBC detection by mNGS. However, whether lung tissue-mNGS is superior to BALF-mNGS in patients with MTBC infection requires further prospective multicenter randomized controlled studies with more cases.

Genetic alteration of Chinese patients with rectal mucosal melanoma.

BACKGROUND: Rectal mucosal melanoma (RMM) is a rare and highly aggressive disease with a poor prognosis. Due to the rarity of RMM, there are few studies focusing on its genetic mechanism. This retrospective study aimed to analyze the genetic spectrum and prognosis of RMM in China and lay a foundation for targeted therapy. METHODS: 36 patients with primary RMM from Peking University Cancer Hospital were enrolled in this study. The Next-generation sequencing (NGS) data of the tumor samples were fitted into the TruSight™ Oncology 500 (TSO500) Docker pipeline to detect genomic variants. Then, the univariate and multivariate Cox hazard analysis were performed to evaluate the correlations of the variants with the overall survival (OS), along with Kaplan-Meier and log-rank test to determine their significance. RESULTS: BRAF mutations, NRG1 deletions and mitotic index were significant prognostic factors in the univariate analysis. In multivariable analysis of the OS-related prognostic factors in primary RMM patients, it revealed 2 significant alterations: BRAF mutations [HR 7.732 (95%CI: 1.735-34.456), P = 0.007] and NRG1 deletions [HR 14.976 (95%CI: 2.305-97.300), P = 0.005]. CONCLUSIONS: This is the first study to show genetic alterations exclusively to Chinese patients with RMM. We confirmed genetic alterations of RMM differ from cutaneous melanoma (CM). Our study indicates that BRAF and NRG1 were correlated with a poor prognostic of RMM and may be potential therapeutic targets for RMM treatment.

[Identification of soft rot pathogens on Chinese cabbage [Brassica campestris L. ssp. chinensis (L.) Makino var. communis Tsen et Lee] in Beijing].

OBJECTIVE: This study aimed to identify soft rot pathogens of Chinese cabbage [Brassica campestris L. ssp. chinensis (L.) Makino var. communis Tsen et Lee] in Beijing. METHODS: The 40 strains isolated from Tongzhou and Daxing districts in Beijing were characterized by morphological, biological, biochemical and physiological methods, 16S rRNA sequence as well as 16S-23S rRNA intergenic spacer (IGS) region analysis. RESULTS: The strains belonged to two different Pectobacterium carotovorum subspecies: 13 strains of them belonged to Pectobacterium carotovorum subsp. carotovorum (Pcc) and the other 27 strains belonged to Pectobacterium carotovorum subsp. brasiliensis (Pcb). The results of Chinese cabbage (Brassica campestris L. ssp. pekinensis) pathogenicity test showed that the strains in the same subspecies, origins and 16S rRNA gene sequences had significant differences in pathogenicity. CONCLUSION: Pectobacterium carotovorum subsp. carotovorum and Pectobacterium carotovorum subsp. brasiliensis were the soft rot pathogens on Chinese cabbage [ Brassica campestris L. ssp. chinensis(L.) Makino var. communis Tsen et Lee] in Beijing. It was the first report that Pectobacterium carotovorum subsp. brasiliensis (Pcb) caused soft rot disease on cabbage in China.

Noninvasive Abiotic Stress Phenotyping of Vascular Plant in Each Vegetative Organ View.

The last decades have witnessed a rapid development of noninvasive plant phenotyping, capable of detecting plant stress scale levels from the subcellular to the whole population scale. However, even with such a broad range, most phenotyping objects are often just concerned with leaves. This review offers a unique perspective of noninvasive plant stress phenotyping from a multi-organ view. First, plant sensing and responding to abiotic stress from the diverse vegetative organs (leaves, stems, and roots) and the interplays between these vital components are analyzed. Then, the corresponding noninvasive optical phenotyping techniques are also provided, which can prompt the practical implementation of appropriate noninvasive phenotyping techniques for each organ. Furthermore, we explore methods for analyzing compound stress situations, as field conditions frequently encompass multiple abiotic stressors. Thus, our work goes beyond the conventional approach of focusing solely on individual plant organs. The novel insights of the multi-organ, noninvasive phenotyping study provide a reference for testing hypotheses concerning the intricate dynamics of plant stress responses, as well as the potential interactive effects among various stressors.

A 3D porous polymer monolith-based platform integrated in poly(dimethylsiloxane) microchips for immunoassay.

In this work, we demonstrate the immunocapture and on-line fluorescence immunoassay of protein and virus based on porous polymer monoliths (PPM) in microfluidic devices. Poly(glycidyl methacrylate-co-ethylene glycol dimethacrylate) [poly(GMA-co-EGDMA)] monoliths were successfully synthesized in the polydimethylsiloxane (PDMS) microfluidic channels by in situ UV-initiated free radical polymerization. After surface modification, PPM provides a high-surface area and specific affinity 3D substrate for immunoassays. Combining with well controlled microfluidic devices, the direct immunoassay of IgG and sandwich immunoassay of inactivated H1N1 influenza virus using 5 µL sample has been accomplished, with detection limits of 4 ng mL(-1) and less than 10 pg mL(-1), respectively. The enhanced detection sensitivity is due to both high surface area of PPM and flow-through design. The detection time was obviously decreased mainly due to the shortened diffusion distance and improved convective mass transfer inside the monolith, which accelerates the reaction kinetics between antigen and antibody. This work provides a novel microfluidic immunoassay platform with high efficiency thereby enabling fast and sensitive immunoassay.

Survival benefit of anlotinib in T790M-positive non-small-cell lung cancer patients with acquired osimertinib resistance: A multicenter retrospective study and exploratory in vitro study.

OBJECTIVES: Acquired resistance represents a bottleneck to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment in lung cancer. Our study aimed to explore the efficacy of antiangiogenic-based therapy in osimertinib-resistant NSCLC patients and assess the efficacy of anlotinib in vitro study. METHODS: Our multicenter study retrospectively collected 268 osimertinib-resistant NSCLC patients with EGFR T790M mutation and explored the efficacy of anlotinib in patients and in vitro. RESULTS: PFS was significantly longer in the antiangiogenic-based therapy group than in the immunotherapy group (HR: 0.71, p = 0.050) and the chemotherapy group (HR: 0.28, p = 0.001). Both the ORR and DCR of the antiangiogenic-based group were higher than the immunotherapy group and the chemotherapy group. Subgroup analysis showed a trend of more benefits from the anlotinib-based therapy than the bevacizumab-based therapy in terms of PFS (HR: 0.63, p = 0.087) and OS (HR: 0.52, p = 0.063). In vitro assays verified that anlotinib alone or combined with osimertinib exerted potent cytotoxicity to T790M-mutant H1975 cell line with acquired osimertinib resistance. CONCLUSIONS: Our study suggested that antiangiogenic-based therapy might improve PFS and OS in EGFR-mutant NSCLC patients with acquired resistance to osimertinib. Moreover, anlotinib-based therapy could be a promising effective treatment for this group of patients.

Correlation of androgen receptor with ultrasound, clinicopathological features and clinical outcomes in breast cancer.

BACKGROUND: This study aimed to explore whether there is an association between androgen receptor (AR) expression and ultrasound, clinicopathological features and prognosis of breast cancer. METHODS: A total of 141 breast cancer patients were included in this retrospective study. AR expression was analyzed by immunohistochemistry. The images of B-mode, color Doppler and strain elastography from 104 patients were collected continuously, and the corresponding ultrasound characteristics were obtained. The differences in ultrasound and clinicopathological features in different AR status were analyzed. Progression-free survival (PFS) of patients was obtained through up to 90 months of follow-up; then, the effect of AR on PFS was analyzed. Subsequently, a nomogram was constructed to predict the AR status. The predictive accuracy was calculated using C-index. RESULTS: The positive expression of AR (AR +) was associated with lower histological grade (p = 0.034) and lower Ki-67 level (p = 0.029). Triple-negative breast cancer (TNBC) had the lowest probability of AR + (p < 0.001). The AR + group mostly showed unsmooth margin (p < 0.001), posterior acoustic shadowing (p = 0.002) and higher elasticity score (p = 0.022) on ultrasound. The echo pattern of most tumors with AR + was heterogeneous (p = 0.024) in Luminal A subtype. AR + could be a sign of a better prognosis in overall breast cancer (p < 0.001), as well as in human epidermal growth factor receptor 2 (HER2) overexpression and Luminal B subtypes (p = 0.001 and 0.025). The nomogram showed relatively reliable performance with a C-index of 0.799. CONCLUSION: Our research demonstrated that AR expression was closely related to ultrasound, clinicopathological features and prognosis of breast cancer.

Effect of salinity on the determination of dissolved non-reactive phosphorus and total dissolved phosphorus in coastal waters.

The salinity may affect the phosphorus (P) determination accuracy in coastal waters, especially for the dissolved non-reactive P (DNRP) and total dissolved P (TDP). In this work, the competition mechanism between NaCl and DNRP for oxidants (K2 S2 O8 , the most commonly used and recognized oxidant) was identified in different DNRP determinations. Furthermore, salinity influences on determinations of tetrasodium pyrophosphate decahydrate, glyphosate, phytic acid sodium salt hydrate, adenosine-5'-nomophosphate disodium, and TDP were investigated. The results indicated that approximately 10% IHP6 and AMP would be transferred to dissolved reactive P (DRP) during digestion without K2 S2 O8 . When NaCl increased from 0% to 3.5% with fresh water method, the determination of Gly + K2 HPO4 and IHP6 + K2 HPO4 decreased by 8.0% ± 0.00% and 24% ± 0.01%, respectively. In addition, the determinations of DNRPs and TDP with different salinities in natural coastal waters by fresh water method and seawater method were performed. It showed that when the salinity >5.0 PSU, the DNRPs and TDP determination results presented deviations. At a salinity of 35.0 PSU, the TDP (KH2 PO4 + Gly + IHP6 + AMP) reduction measured by two methods was more than 12.3% ± 0.46%. Furthermore, oxidants with higher digestion efficiency than K2 S2 O8 should be developed. PRACTITIONER POINTS: ~10% IHP6 and AMP could be transferred to DRP during digestion without K2 S2 O8 addition. Salinity affects the DNRPs determination results mainly due to competition for oxidants and complexation with metal ions. More than 12.3% TDP in coastal waters could not be measured when the salinity was 35.0 PSU.

Overexpression of FAM83A Is Associated with Poor Prognosis of Lung Adenocarcinoma.

Family with sequence similarity 83, member A (FAM83A) plays an essential and fundamental role in the proliferation, progression, and apoptosis of many malignant tumors, including lung cancer. This study aimed to determine the expression pattern of FAM83A in lung adenocarcinoma (LUAD) and its correlation with the prognosis of cancer and the survival of the patients. Bioinformatics analysis, immunohistochemistry, and Western blotting were used to explore and detect the expression of FAM83A in LUAD cells. The mechanism of FAM83A in proliferation and migration was examined. The correlation between FAM83A expression and survival rate was assessed by the Kaplan-Meier and Cox regression. FAM83A expression was elevated in LUAD tissues and was related to shorter overall survival (P < 0.05). A significant increase in FAM83A protein was observed in the LUAD tissue (P < 0.05). Compared with patients with early-stage tumors (stage I-II), those with advanced stage tumors (stage III-IV) had significantly higher FAM83A expression levels (P < 0.05). Downregulation of FAM83A led to a reduction in cell proliferation, a decrease in migration ability, and diminished epithelial-mesenchymal transition (EMT) in the lung cancer cell lines. Overexpression of FAM83A was associated with early lymph node metastasis and poor overall survival among LUAD patients. The findings indicated that FAM83A may play a critical role in promoting the LUAD progression and thus might serve as a novel prognostic marker in LUAD.

Acute Respiratory Distress Syndrome Caused by Occupational Exposure to Waterproofing Spray: A Case Report and Literature Review.

Background: Acute respiratory distress syndrome (ARDS) is a serious respiratory disease, caused by severe infection, trauma, shock, inhalation of harmful gases and poisons and presented with acute-onset and high mortality. Timely and accurate identification will be helpful to the treatment and prognosis of ARDS cases. Herein, we report a case of ARDS caused by occupational exposure to waterproofing spray. To our knowledge, inhalation of waterproofing spray is an uncommon cause of ARDS, and what makes our case special is that we ruled out concurrent infections with some pathogens by using metagenomic next-generation sequencing (mNGS) as an auxiliary diagnosis, which presents the most comprehensive etiological examination of similar reports. Case Presentation: A previously healthy 25 years old delivery man developed hyperpyrexia, chest tightness, cough and expectoration. The symptoms occurred and gradually exacerbated after exposure to a waterproofing spray. The chest computed tomography (CT) finding showed diffuse ground glass and infiltrative shadows in both lungs. The diagnosis of ARDS related to waterproofing spray was established on the basis of comprehensive differential diagnosis and etiological examination. The patient achieved good curative effect after proper systemic glucocorticoid therapy. Conclusions: The diagnosis and differential diagnosis of acute respiratory failure for outdoor workers, such as delivery drivers or hikers, should be considered whether toxic aerosol exposure exists from daily contacts. The case can educate the public that more attention should be paid to avoid exposure to these chemicals by aerosols/ingestion mode and some preventive strategies should be taken in occupational environment. The treatment effect of glucocorticoids is significant in ARDS patients with general chemical damage caused by inhaling toxic gases and substances.

Neoadjuvant Savolitinib targeted therapy stage IIIA-N2 primary lung adenocarcinoma harboring MET Exon 14 skipping mutation: A case report.

MET exon 14 skipping mutation (METex14m) is rare and occurs in approximately 1-4% of all non-small cell lung cancer (NSCLC) patients and approximately 2.8% of resected stage I-III NSCLC patients. Savolitinib is an oral, potent and highly selective type Ib MET inhibitor, which has been shown to be promising activity and acceptable safety profile in patients with advanced NSCLC harboring METex14m. Most recently, many studies have been probing into the feasibility and efficacy of target therapy for perioperative application in NSCLC. Interestingly, there are very few recorded cases of such treatments. Here, we presented that systemic treatment with the MET inhibitor savolitinib before surgery could provide the potential to prolong overall survival (OS) of patients with locally advanced potentially resectable NSCLC. A 49-year-old woman was diagnosed with stage IIIA (T2bN2M0) primary lung adenocarcinoma exhibiting a METex14m by real-time quantitative polymerase chain reaction (RT-qPCR). Given that the tumor load and the size of lymph nodes experienced a significant downstaging after the neoadjuvant treatment of savolitinib with 600mg once a day for 5 weeks, left lower lobectomy and systemic lymphadenectomy were successfully performed. The pathological response was 50% and the final postoperative pathological staging was pT1cN0M0, IA3 (AJCC, 8th edition). The case provides empirical basis for the neoadjuvant treatment with savolitinib in METex14m-positive locally advanced primary lung adenocarcinoma, which will offer some innovative insights and clinical evidence for more effective clinical treatment of neoadjuvant targeted therapy for METex14m-positive NSCLC.

Nomograms predicting recurrence in patients with triple negative breast cancer based on ultrasound and clinicopathological features.

OBJECTIVES: The clinicopathological and ultrasound features associated with recurrence in patients with triple negative breast cancer (TNBC) were used to develop a nomogram to predict the prognosis of TNBC. METHODS: Clinicopathological data of 300 patients with TNBC treated between July 2012 and September 2014 were retrospectively reviewed. The endpoint was progression-free survival (PFS). Prognostic factors were screened by multivariate COX regression to develop nomograms. The C-index and calibration curves were used to evaluate the predictive accuracy and discriminatory ability of nomograms. RESULTS: Of 300 patients with TNBC followed-up for 5 years, 80 (26.7%) had PFS events. Five informative prognostic factors (large size, vertical orientation, posterior acoustic enhancement, lymph node involvement, and high pathological stage) were screened and used to construct a nomogram for PFS. The C-index of the PFS nomogram was 0.88 (p < 0.01, 95% confidence interval, 0.85-0.90), indicating good predictive accuracy. CONCLUSIONS: We developed and validated a nomogram for predicting PFS in TNBC. Vertical orientation and posterior acoustic enhancement in ultrasound images of TNBC were associated with worse outcomes. ADVANCES IN KNOWLEDGE: Patients with TNBC have a very poor prognosis and patients have a high risk of recurrence, and our study developed a nomogram based on ultrasound and clinicopathological features for TNBC patients to improve the accuracy of individualized prediction of recurrence and provide help for clinical treatment.

Immune Thrombocytopenia Induced by Immune Checkpoint Inhibitrs in Lung Cancer: Case Report and Literature Review.

Immune checkpoint inhibitors (ICIs), including antibodies targeting programmed cell death protein-1 (PD-1) and programmed cell death ligand-1 (PD-L1), are being extensively used on advanced human malignancies therapy. The treatment with ICIs have acquired durable tumor inhibition and changed the treatment landscape in lung cancer. Immune-related adverse events including pneumonitis and thyroiditis have been well described, but less frequent events, such as ICIs-induced thrombocytopenia, are now emerging and may sometimes be severe or fatal. Since early detection and prompt intervention are crucial to prevent fatal consequences, it is of outmost importance that medical staff is aware of these potential toxicities and learn to recognize and treat them adequately. This review focuses on the epidemiology, clinical presentation, mechanisms, and clinical management of ICIs-induced thrombocytopenia in patients with lung cancer. We also present a patient with advanced lung adenocarcinoma who received the PD-L1 inhibitor atezolizumab and eventually developed severe thrombocytopenia. The case indirectly suggests that cytokine changes might contribute to immune dysregulation in ICIs-induced thrombocytopenia.

Right atrial papillary fibroelastoma arising from the Chiari network detected by echocardiography: a case report and literature review.

PURPOSE: To improve our understanding of cardiac papillary fibroelastomaand provide evidence for its treatment and prognosis. MATERIALS AND METHODS: We report a 54-year-old Chinese male who was hospitalized for a 14-day headache with a previous vertebral aneurysm history. A right atrial mass arising from the Chiari network was detected by echocardiography and complete tumor resection was performed finally. Pathologic findings confirmed the diagnosis of cardiac papillary fibroelastoma. The recovery of the patient was uneventful and follow-up echocardiographic examination revealed no recurrence of the tumor. RESULTS: Transthoracic echocardiography revealed a mobile, sessile mass in the right atrium without obstructing the orifice of the tricuspid valve. The subsequent transesophageal echocardiography confirmed the presence of a 1.56cm × 1.24cm mobile, sessile, irregular mass arising from the Chiari network (Fig. 1) and showed no evidence of patent foramen ovale. CONCLUSIONS: Early recognition and surgical excision is essential for patients with cardiac papillary fibroelastoma.