Plasma Heat Shock Protein 90 Alpha: A Valuable Predictor of Early Chemotherapy Effectiveness in Advanced Non-Small-Cell Lung Cancer.

BACKGROUND Heat shock protein-90 alpha (HSP90a) is more abundant in non-small-cell lung cancer (NSCLC) patients than in control individuals. However, whether it can reflect chemotherapy efficacy remains unknown. This study aimed to investigate the association of HSP90a with chemotherapy in advanced NSCLC. MATERIAL AND METHODS We retrospectively evaluated data from patients admitted to the Department of Respiratory Medicine, Shaoxing People's Hospital, from September 2016 to September 2018 with stage IIIB or IV NSCLC and administered 4 cycles of third-generation platinum-based combination chemotherapy (2 drugs simultaneously). Based on the RECIST1.1 criteria, complete remission (CR), partial response (PR), and stable disease (SD) in 60 cases were determined before and after chemotherapy. Before chemotherapy and after 1, 2, and 4 cycles of chemotherapy, plasma HSP90alpha levels were quantitated by ELISA. Chest CT was performed before and after 2 and 4 cycles of chemotherapy. RESULTS After 1-4 cycles of chemotherapy, plasma HSP90alpha levels were significantly lower than pre-chemotherapy levels (P<0.05). The sums of the longest tumor diameters after 2 and 4 cycles of chemotherapy were decreased compared with pre-chemotherapy values (P<0.05). Plasma HSP90alpha levels and tumor size showed no significant correlation before and after chemotherapy (r=0.244, P=0.06). CONCLUSIONS Plasma HSP90alpha can be considered a valuable predictor of early chemotherapy effectiveness in advanced NSCLC, and is positively correlated with tumor remission after chemotherapy. However, plasma HSP90alpha level is not correlated with tumor diameter and pathological type.

Long-Chain Non-Coding RNA Metastasis-Related Lung Adenocarcinoma Transcript 1 (MALAT1) Promotes the Proliferation and Migration of Human Pulmonary Artery Smooth Muscle Cells (hPASMCs) by Regulating the MicroRNA-503 (miR-503)/Toll-Like Receptor 4 (TLR4) Signal Axis.

BACKGROUND To study the role of the long-chain noncoding RNA (lncRNA) metastasis-related lung adenocarcinoma transcript 1 (MALAT1), microRNA-503 (miR-503), Toll-like receptor 4 (TLR4) signal axis in the pathogenesis of pulmonary arterial hypertension (PAH). MATERIAL AND METHODS Total RNA was extracted from the plasma of 45 PAH patients and 45 healthy subjects, and the expression of lncRNA MALAT1 and miR-503 was measured by quantitative real-time polymerase chain reaction (qRT-PCR). The effects of lncRNA MALAT1 and miR-503 on Toll-like receptor 4 (TLR4) and the proliferation, migration, and apoptosis of human pulmonary artery smooth muscle cells (hPASMCs) were tested following in vitro transfection of hPASMCs. RESULTS lncRNA MALAT1 was highly expressed in the plasma of PAH patients and in hypoxia-induced hPASMCs. Silencing lncRNA MALAT1 inhibited the proliferation and migration of hPASMC cells while promoting their apoptosis. MiR-503 is underexpressed in plasma and hPASMCs of patients with PAH. TLR4 was a target gene of miR-503 and was highly expressed in peripheral blood mononuclear cells (PBMCs) of PAH patients. lncRNA MALAT1 was a "molecular sponge" of miR-503, regulating the expression of TLR4 and the proliferation, migration, and apoptosis of hPASMCs through miR-503. CONCLUSIONS lncRNA MALAT1 promotes the proliferation and migration of hPASMCs and inhibits their apoptosis by inhibiting the miR-503/TLR4 signal axis.

[Peutz-Jeghers syndrome complicated with pulmonary mucinous adenocarcinoma: a case report and review of the literature].

OBJECTIVE: To explore the clinical characteristics, complications and prognosis of Peutz-Jeghers syndrome. METHODS: The clinical manifestations, imaging characteristics and pathological data of one patient with Peutz-Jeghers syndrome treated in Shaoxing People's Hospital were presented, and 3 cases of Peutz-Jeghers syndrome complicated with lung cancer reported in the literature were reviewed. The literature review was carried out by searching the Pubmed and CBMdisc database with Peutz-Jeghers syndrome and lung cancer as the key words. RESULTS: The patient treated in our hospital was a 30-year-old female. The primary manifestations were cough, sputum production and hemoptysis. Multiple gastrointestinal hamartomatous polyps were found, and associated with melanin pigmentation of the buccal mucosa, the lips, the hands and the feet. Therefore the diagnosis of Peutz-Jeghers syndrome was made. Chest CT scan showed a peripheral nodule at the right lower lobe, which was confirmed to be lung mucinous adenocarcinoma by surgery and pathology. The 3 cases reported in the literature were males aging from 22 to 43 years old. Cough, expectoration and hemoptysis were defined as the manifestations for 2 patients, and another case was found by physical check-up. They all died within a short period. Pathological study revealed adenocarcinoma of the lung in all the cases. CONCLUSION: Peutz-Jeghers syndrome complicated with lung cancer is rare and has a poor prognosis.

Minocycline Induces Autophagy and Inhibits Cell Proliferation in LPS-Stimulated THP-1 Cells.

Excessive activation and proliferation of inflammatory cell and uncontrolled release of cytokines and chemokines, also known as cytokine storm, is considered to be the main cause of sepsis. Accumulating evidence has indicated that autophagy may play an important role in regulating immune response and controlling excessive inflammation. Recent studies have showed that minocycline has immunomodulatory effects on cytokine and chemokine production. It has also been reported that minocycline can induce autophagy, suggesting that autophagy may be involved in the process of minocycline regulating inflammation and immune response. However, the precise mechanism is unclear. In the present study, we used enzyme-linked immunosorbent assays (ELISA) to measure the production of cytokines following minocycline treatment of lipopolysaccharide- (LPS-) stimulated THP-1 cells. Western blotting analysis was performed to confirm autophagy and the mTOR signal pathway. Cell proliferation was measured by WST-1 cell proliferation assay. We demonstrated that LPS induced autophagy in a tumor necrosis factor- (TNF-) α-mediated manner, and simultaneously, LPS induced the release of TNF-α to trigger inflammation and activated mammalian target of rapamycin (mTOR) to potentiate cell proliferation. Minocycline, which induces autophagy by inhibiting mTOR, suppresses cytokine production and cell proliferation and protects THP-1 cells from LPS toxicity. Further study demonstrated that there might be an intimate crosstalk between the inhibitor kappa B kinase (IKK)/nuclear factor-kappa B (NF-κB) signaling pathway and autophagy flux in modification of inflammatory responses. In addition, rapamycin, the mTOR inhibitor, has cooperative effect with minocycline on suppression of TNF-α release and induction of autophagy by repressing mTOR. Our data brought a novel clue to evaluate minocycline using as a potential therapeutic medicine for sepsis.

Dynamic Chest CT Evaluation in Three Cases of 2019 Novel Coronavirus Pneumonia.

A recent outbreak of pneumonia in Wuhan, China, was caused by the 2019 novel coronavirus (2019-nCoV). There have been some reports of imaging findings regarding the disease's characteristic features. Here, we report three cases of coronavirus disease 2019 (COVID-19) with dynamic pulmonary CT evaluation. The CT scan showed multiple regions of ground-glass opacities and patchy consolidation in COVID-19 patients and the CT scan was useful in tracking the progression or regression of COVID-19.

Helicobacter pylori is associated with weakened pulmonary function and reduced incidence of allergic conditions in patients with chronic cough.

The present study aimed to investigate the potential association between Helicobacter pylori (a H. pylori) positive state and chronic cough. A clinical observational study with systematic analysis was performed, including 278 patients with complaints of chronic cough and 148 healthy controls. a H. pylori positive state was present in 61.2% of the patients in the chronic cough group and 68.9% in the chronic refractory cough group, as opposed to 43.9% in the control group. There was a significant improvement in 65.5% of the patients with chronic refractory cough following successful a H. pylori eradication therapy. In addition, patients with chronic cough exposed to a H. pylori exhibited decreased pulmonary function with a decrease in forced expiratory volume in 1 sec by 84 ml, a decrease in the forced vital capacity by 53 ml and a decrease in maximal vital capacity by 46 ml. The difference was even more obvious in the chronic refractory cough group. The allergy status differed significantly according to age between a H. pylori-positive and -negative cases in the cough variant asthma and allergic cough groups. Among patients aged <40 years, a H. pylori-positive cases had a lower prevalence of atopy and lower total serum immunoglobin E levels compared with a H. pylori-negative cases. However, there was no significant association between a H. pylori status and C-reactive protein levels, erythrocyte sedimentation rate or eosinophil count in the peripheral blood. In conclusion, the present study demonstrated that a H. pylori infection may be a factor associated with chronic cough and it may be associated with a decline in pulmonary function and reduced incidence of allergic conditions. Thus, a H. pylori may represent a target for the treatment of chronic cough.

Endobronchial Ultrasound Elastography Differentiates Intrathoracic Lymph Nodes: A Meta-Analysis.

BACKGROUND: In this study, we investigated the clinical significance of endobronchial ultrasound elastography for differentiating malignant and benign intrathoracic lymph nodes. METHODS: A meta-analysis was performed to evaluate the sensitivity and specificity of endobronchial ultrasound elastography in diagnosing intrathoracic lymph nodes. Publications before October 1, 2017, were included for analysis. Sensitivity, specificity, and other variables were pooled using the bivariate mixed-effects regression model. RESULTS: Seven studies met the inclusion criteria and were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio was 0.93 (95% confidence interval [CI], 0.85 to 0.97), 0.85 (95% CI, 0.78 to 0.90), 6.3 (95% CI, 4.2 to 9.2), 0.08 (95% CI, 0.04 to 0.18), and 74 (95% CI, 33 to 168), respectively. The summary receiver operating characteristic curve was 0.93 (95% CI, 0.91 to 0.95). CONCLUSIONS: The results revealed endobronchial ultrasound elastography is a new technique with high sensitivity and specificity. It has a fine performance in diagnosing intrathoracic lymph nodes.

[Effect of eletroacupuncture for Z syndrome without organic lesion and serum leptin].

OBJECTIVE: To explore the effect and mechanism of electroacupuncture (EA) for Z syndrome without organic lesion (metabolic syndrome combined with obstructive sleep apnea hypopnea syndrome). METHODS: Fifty-eight patients with Z syndrome were divided into three groups according to mild,moderate and severe degree. Acupuncture and EA were used at Daimai (GB 26), Zhongwan (CV 12), Xiawan (CV 10), Zusanli ST 36), Qihai (CV 6) and Huaroumen (ST 24), etc., once a day and five times a week. The treatment of ten times was a course, and two courses were acquired continuously. Sleep respiration monitoring (PSG) was done before EA and in one week after treatment respectively. Triacylglycerol (TG) fasting blood glucose (FBG) fasting insulin (INS) and serum leptin (Lep) were tested before and after treatment in the three groups. RESULTS: After treatment apnea hypopnea index (AHI) and the percentage of the time of arterial oxygen saturation (SaO2) less than 90% taken in the total sleep time (SLT 90%) were improved apparently than those before treatment in the three groups (all P < 0.05). The levels of TG, FPG, INS and Lep were decreased after treatment in all groups (all P < 0.05). CONCLUSION: EA can improve AHI and nocturnal hypoxia of Z syndrome, and the mechanism may be related to decreasing the indices of metabolism syndrome and leptin.