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OBJECTIVE: To improve the understanding of pleural sparganosis by analyzing a clinical case and literature review. METHODS: The clinical data of a patient with pleural sparganosis diagnosed by immunoserology and pathology was analyzed. The data of 6 cases from literature reports regarding pleural sparganosis were reviewed through database including PubMed, VIP, Wanfang and China Knowledge Resource Integrated Database. The clinical characteristics, diagnosis and treatment of the 7 cases were summarized and analyzed. RESULTS: A 38-year-old man was admitted to our hospital with right pleural effusion, and received the final diagnosis of pleural sparganosis according to increase of eosinophils in blood and plural effusion, positive sparganum-mansoni antibody in serum, and parasite bodies in pleural tissues biopsied with medical thoracoscopy. The patient was treated successfully with consecutive three-day doses of praziquantel (75 mg × kg⻹ × d⻹). The documents reported 6 cases of pleural sparganosis on the database of PubMed, Wafang,VIP and China Knowledge Resource Integrated Database. Pleural effusion was found in 5 cases by chest radiograph or CT.Serum sparganum-mansoni antibody assays were strongly positive in 5 cases, and sparganosis bodies were confirmed by pleural histological findings in 3 cases. Two patients received video-assisted thoracic surgery examinations. Six patients recovered with the treatment of praziquantel. CONCLUSIONS: Pleural sparganosis is a rare disease. Patients with increase of eosinophils in blood and pleural effusion should receive serum sparganum-mansoni antibody test to avoid misdiagnosis of pleural sparganosis. Medical thoracoscopy plays an important role in the diagnosis of pleural sparganosis.
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Doenças Pleurais/diagnóstico , Esparganose/diagnóstico , Adulto , Biópsia , Eosinófilos , Humanos , Masculino , Doenças Pleurais/etiologia , Derrame Pleural , Esparganose/etiologia , Cirurgia Torácica VídeoassistidaRESUMO
Radial endobronchial ultrasonography (R-EBUS) has been a surge in the development of new ultrasonography for the diagnosis of pulmonary diseases beyond the central airway. However, it faces challenges in accurately pinpointing the location of abnormal lesions. Therefore, this study proposes an improved machine learning model aimed at distinguishing between malignant lung disease (MLD) from benign lung disease (BLD) through R-EBUS features. An enhanced manta ray foraging optimization based on elite perturbation search and cyclic mutation strategy (ECMRFO) is introduced at first. Experimental validation on 29 test functions from CEC 2017 demonstrates that ECMRFO exhibits superior optimization capabilities and robustness compared to other competing algorithms. Subsequently, it was combined with fuzzy k-nearest neighbor for the classification prediction of BLD and MLD. Experimental results indicate that the proposed modal achieves a remarkable prediction accuracy of up to 99.38%. Additionally, parameters such as R-EBUS1 Circle-dense sign, R-EBUS2 Hemi-dense sign, R-EBUS5 Onionskin sign and CCT5 mediastinum lymph node are identified as having significant clinical diagnostic value.
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Pneumopatias , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Mediastino/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Ultrassonografia/métodos , Pneumopatias/patologiaRESUMO
Lung cancer is categorized into two main types: non-small cell lung cancer (NSCLC) and small cell lung cancer. Of these, NSCLC accounts for approximately 85% of all cases and encompasses varieties such as squamous cell carcinoma and adenocarcinoma. For patients with advanced NSCLC that do not have oncogene addiction, the preferred treatment approach is a combination of immunotherapy and chemotherapy. However, the progression-free survival (PFS) typically ranges only from about 6 to 8 months, accompanied by certain adverse events. In order to carry out individualized treatment more effectively, it is urgent to accurately screen patients with PFS for more than 12 months under this treatment regimen. Therefore, this study undertook a retrospective collection of pulmonary CT images from 60 patients diagnosed with NSCLC treated at the First Affiliated Hospital of Wenzhou Medical University. It developed a machine learning model, designated as bSGSRIME-SVM, which integrates the rime optimization algorithm with self-adaptive Gaussian kernel probability search (SGSRIME) and support vector machine (SVM) classifier. Specifically, the model initiates its process by employing the SGSRIME algorithm to identify pivotal image features. Subsequently, it utilizes an SVM classifier to assess these features, aiming to enhance the model's predictive accuracy. Initially, the superior optimization capability and robustness of SGSRIME in IEEE CEC 2017 benchmark functions were validated. Subsequently, employing color moments and gray-level co-occurrence matrix methods, image features were extracted from images of 60 NSCLC patients undergoing immunotherapy combined with chemotherapy. The developed model was then utilized for analysis. The results indicate a significant advantage of the model in predicting the efficacy of immunotherapy combined with chemotherapy for NSCLC, with an accuracy of 92.381% and a specificity of 96.667%. This lays the foundation for more accurate PFS predictions and personalized treatment plans.
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Carcinoma Pulmonar de Células não Pequenas , Imunoterapia , Neoplasias Pulmonares , Aprendizado de Máquina , Tomografia Computadorizada por Raios X , Humanos , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/terapia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/terapia , Feminino , Masculino , Tomografia Computadorizada por Raios X/métodos , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Máquina de Vetores de Suporte , RadiômicaRESUMO
This paper focuses on the study of multilevel COVID-19 X-ray image segmentation based on swarm intelligence optimization to improve the diagnostic level of COVID-19. We present a new ant colony optimization with the Cauchy mutation and the greedy Levy mutation, termed CLACO, for continuous domains. Specifically, the Cauchy mutation is applied to the end phase of ant foraging in CLACO to enhance its searchability and to boost its convergence rate. The greedy Levy mutation is applied to the optimal ant individuals to confer an improved ability to jump out of the local optimum. Furthermore, this paper develops a novel CLACO-based multilevel image segmentation method, termed CLACO-MIS. Using 2D Kapur's entropy as the CLACO fitness function based on 2D histograms consisting of non-local mean filtered images and grayscale images, CLACO-MIS was successfully applied to the segmentation of COVID-19 X-ray images. A comparison of CLACO with some relevant variants and other excellent peers on 30 benchmark functions from IEEE CEC2014 demonstrates the superior performance of CLACO in terms of search capability, and convergence speed as well as ability to jump out of the local optimum. Moreover, CLACO-MIS was shown to have a better segmentation effect and a stronger adaptability at different threshold levels than other methods in performing segmentation experiments of COVID-19 X-ray images. Therefore, CLACO-MIS has great potential to be used for improving the diagnostic level of COVID-19. This research will host a webservice for any question at https://aliasgharheidari.com.
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COVID-19 , Processamento de Imagem Assistida por Computador , Algoritmos , COVID-19/diagnóstico por imagem , Humanos , Mutação , SARS-CoV-2 , Raios XRESUMO
Previous studies have indicated that, in lung cancers, the gene rearrangement of ALK is mutually exclusive with mutations in the epidermal growth factor receptor (EGFR) gene. However, the coexistence of EML4-ALK fusions and EGFR mutations (double positive) has been occasionally reported, with frequencies ranging from 0-8%. Currently, no consensus standard therapy exists for tumors with double positive mutations. In the present case report, the case is described of a 53-year-old woman with stage IV lung adenocarcinoma, harboring a concomitant EGFR mutation and ALK gene rearrangement, who was refractory to gefitinib administration but demonstrated a good response to crizotinib and pemetrexed chemotherapy. A review of the literature revealed a total of 65 cases, including our case, harboring double positive mutations, and of these cases, 39 (60.0%) patients had received an EGFR tyrosine kinase inhibitor (EHGR-TKI), and 15 (23%) patients had received crizotinib treatment, the majority of whom had crizotinib selected for them as a second-line or third-line therapy. The disease control rate (DCR) of EGFR-TKI was 72.2%, with the progression-free survival (PFS) being 11.9 months, whereas the DCR of crizotinib was 93.3%, with the PFS being 10 months.
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Multiple myeloma (MM) is characterized by abnormal proliferation of neoplastic plasma cells. Pleural effusion as an initial presentation of this disease is rare, as is true pleural myeloma. We herein present a case of solitary pleural myelomatous lesion in a 70-year-old male patient diagnosed by pleural biopsy via semi-rigid thoracoscopy followed by histopathological examination. Furthermore, a review of the related English literature identified 22 cases of pleural myeloma, only 3 of which were diagnosed by video-assisted thoracoscopy. To the best of our knowledge, this is the first reported case of a solitary pleural myelomatous lesion diagnosed by pleural biopsy via semi-rigid thoracoscopy. Patients with MM with pleural involvement, including the present case, appear to have a short survival despite aggressive treatment. Our patient received chemotherapy with bortezomib, epiadriamycin and dexamethasone; however, he deteriorated rapidly after one cycle of chemotherapy and succumbed to the disease 8 weeks after the initial presentation. According to our experience, semi-rigid thoracoscopy is an effective and safe method for obtaining a pleural specimen for histopathological evaluation.
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A 36-year-old female presented with an eosinophilic pleural effusion. The eosinophilic pleural effusion was considered to have been caused by a parasitic infection. Spirometra mansoni spargana was confirmed by semi-rigid thoracoscopy. About 2 months after treatment with praziquantel for 3 days, the pleural effusion had disappeared on the chest roentgenogram.
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Derrame Pleural/diagnóstico , Esparganose/diagnóstico , Plerocercoide/isolamento & purificação , Spirometra/isolamento & purificação , Adulto , Animais , Anti-Helmínticos/uso terapêutico , Feminino , Humanos , Derrame Pleural/tratamento farmacológico , Derrame Pleural/parasitologia , Praziquantel/uso terapêutico , Esparganose/complicações , Esparganose/tratamento farmacológico , Resultado do TratamentoRESUMO
BACKGROUND: It has been reported that hepatitis B virus (HBV) replication can be suppressed by microRNA-210 (miR-210). However, whether serum miR-210 levels can serve as disease parameters in patients with chronic hepatitis B (CHB) remains unclear. METHODS: Serum miR-210 levels were quantified in 115 CHB patients and 20 healthy controls by real-time PCR. RESULTS: We found that serum miR-210 levels can discriminate the different groups of CHB patients from healthy control (P<0.05), as well as patients with HBe antigen positive from those with HBe antigen negative (P<0.05). Serum miR-210 levels correlated with HBV DNA and HBs antigen (r=0.525, P<0.001 and r=0.348, P<0.001). Notably, inactive carrier patients with high (>3500 IU/mL) or low (<3500 IU/mL) levels of HBs antigen were differentiated by serum miR-210 levels (P<0.05). Moreover, serum miR-210 levels correlated with liver inflammatory activity markers including alanine aminotransferase (ALT) and HAI score. However, there was no correlation of serum miR-210 levels with parameters of liver function including serum albumin, international normalized ratio and bilirubin, as well as the stages of liver fibrosis. CONCLUSIONS: Serum miR-210 can be used as an indicator of HBV replication and translation, and a potential marker of necroinflammation in patients with CHB.
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Hepatite B Crônica/sangue , MicroRNAs/sangue , Adulto , Antígenos Virais/sangue , Biomarcadores/sangue , DNA Viral/sangue , Progressão da Doença , Feminino , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Vírus da Hepatite B/fisiologia , Hepatite B Crônica/virologia , Humanos , Fígado/lesões , Fígado/fisiopatologia , Fígado/virologia , Masculino , Pessoa de Meia-Idade , Risco , Replicação ViralRESUMO
Small interfering RNA (siRNA) provides a promising therapeutic approach in the silencing of disease-causing genes. In the present study, the use of 2'-O-methyl-modified siRNA-cluster of differentiation 31 (siRNACD31), with cationic liposome RNA interference (RNAi)-mate as a carrier, effectively silenced the platelet endothelial cell molecule 1 (PECAM-1) gene of murine hemangioendothelioma cells in vitro. In vivo, 2'-O-methyl-modified siRNACD31 carried by RNAi-mate was successfully delivered, targeting the PECAM-1 gene in the vasculature of nude mouse lung carcinoma xenografts. The growth of the lung carcinoma xenografts was inhibited by the 2'-O-methyl-modified siRNACD31 and RNAi-mate complexes, and the expression of the PECAM-1 protein was downregulated, with a simultaneous decrease in vascular endothelial growth factor (VEGF) protein in the lung carcinoma xenografts. 2'-O-methyl-modified siRNACD31-RNAi-mate complexes may provide a potential therapeutic strategy in lung carcinoma treatment. The effect of PECAM-1 on VEGF expression may possibly be attributed to the function of PECAM-1 signal transduction.
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The objective was to investigate the molecular mechanism of mitochondrial reactive oxygen species (ROS) signaling regulation of pulmonary artery endothelial cell (HPAEC) secretion in the condition of oxidative stress. Acrolein (40 µM) induced HPAEC mitochondrial generation of ROS, rotenone (2 µmol/L) blocked mitochondrial respiratory chain complex I, cesium chloride (CsCl, 40 mmol/L)blocked K(+)channels, and saline (0.9 g/dl) were used as control. The generations of NOS, ET-1 and VEGF were determined with ELISA in the condition of different treatment reagents namely acrolein, acrolein plus rotenone, acrolein plus CsCl and saline. In the different reagent treatment of HPAECs, acrolein increased mitochondrial ROS, membrane potential, Kv1.5 mRNA and protein expression, intracellular calcium and the generation of NOS (determining NO production), ET-1 and VEGF, and those were reduced by rotenone. CsCl decreased the increment of membrane potential, the elevation of intracellular calcium and the upregulation of NOS, E-1 and VEGF expressions, which were induced by acrolein. The present study demonstrated that mitochondrial ROS-K(+)channel regulated HPAEC secretion of NO, ET-1 and VEGF in the condition of oxidative stress. Kv1.5 channel may be an important component of ROS-K+ channel signaling pathway, and intracellular calcium contributed to mitochondrial ROS-K(+) channel signaling modulation of HPAEC secretion.