Successful treatment of new-onset diabetes mellitus and IgA nephropathy after COVID-19 vaccination: a case report.

De novo glomerular injuries or relapse of nephropathy following COVID-19 vaccine has been reported. Here we present the first case of successful treatment of new-onset diabetes mellitus and biopsy-proven IgA nephropathy after COVID-19 vaccination. A 56-year-old man with no known medical history of renal dysfunction or diabetes mellitus developed both within 3 months after receiving a third dose of inactivated COVID-19 vaccine (Vero cells). His symptoms were characterized by brown urine, severe dry mouth, and excessive thirst. Randomly acquired blood glucose levels exceeded 33.3 mmol/L. A kidney biopsy showed IgA nephropathy. He was started on insulin for glycemic control. After glucocorticoid and cyclophosphamide treatment, oral tablets of repaglinide, combined with acarbose, controlled blood glucose and stabilized kidney function. This case is unique because the kidneys and pancreas were simultaneously affected by the vaccine. Successful treatment of the disease proved that cyclophosphamide combined with glucocorticoids were effective and that blood glucose was successfully controlled. This treatment option could be useful in similar cases in the future.

RHAMM regulates the growth and migration of lung adenocarcinoma A549 cell line by regulating Cdc2/CyclinB1 and MMP9 genes Running title: RHAMM regulates the growth of lung adenocarcinoma cells.

Objective: The study aims to explore the effects of receptor of hyaluronan mediated motility (RHAMM) on the proliferation, invasion and migration of the lung adenocarcinoma (LUAD) cell line A549 and its targeted regulatory pathway. Methods: Bioinformatics was used to analyze the differentially expressed genes in LUAD chips. The mRNA and protein expression level of Cdc2, CyclinB1, MMPs and epithelial-mesenchymal transition (EMT) related markers E-cadherin and Vimentin were tested by qRT-PCR and western blot in A549 cell line after silencing RHAMM. Cell proliferation, cell division cycle, migration and invasion abilities were tested in RHAMM knockdown A549 cells by flow cytometry and in vitro assays. Results: Silencing RHAMM inhibited EMT, proliferation, migration and invasion of A549 cell line and induced cells to cluster at G2/M phase. In addition, after silencing RHAMM, the mRNA and protein expressions of Cdc2 and CyclinB1 were decreased while those of MMP9 were increased. Conclusion: The findings suggest that RHAMM regulates cell division cycle by regulating Cdc2 and CyclinB1, and regulates extracellular matrix degradation by regulating MMP9. These targeted modulations regulate the occurrence and development of LUAD cells.

Third-line chemotherapy in advanced gastric cancer: A systematic review and meta-analysis.

BACKGOUND: Little information regarding to the survival advantage of third-line chemotherapy in advanced gastric cancer patients is available. The current study is designed to systematically review and perform meta-analysis on the effect of third-line chemotherapy on progressive or recurrent gastric cancer treatment. METHODS: After thorough searching of online databases, total 20 articles were included into qualitative systematic review and 6 of them were used to conduct qualitative meta-analysis. RESULTS: It was found that the third-line chemotherapy was superior to placebo or best supportive care in terms of prolonging median oval survival (OS) length and progress free survival (PFS) length (Hedges's g for OS = -0.315 ±â€Š0.077, P < .001; and for PFS = -0.382 ±â€Š0.098, P < .001). In addition, the third-line chemotherapy was favored (Hedges's g = 0.848, P < .001) in terms of overall survival rate (Hazard ratio = 0.679, 95% confidence interval: 0.565-0.816, P < .001) or tumor free survival rate (Hazard ratio = 0.561, 95% confidence interval: 0.444-0.709, P < .001). CONCLUSION: The third-line chemotherapy is superior to the best supportive care in advanced gastric cancer patients who had been pretreated with first-line and second-line chemotherapy.

Comparison between CT and MRI in the assessment of pulmonary embolism: A meta-analysis.

OBJECTIVE: Besides pulmonary arteriography, a number of imaging techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT), were adopted in the detection of identifying pulmonary embolism (PE). However, the contrast of sensitivity and specificity in these methods was studied little in a statistical way. To compare the effects of MRI and CT, this study used a series of methods to analyze data in included researches. METHODS: A comprehensive computer search was conducted through internet up to July 2016. The quality assessment was performed by the Quality Assessment Tool for Diagnostic Accuracy Studies, version 2 tool. The diagnostic value of comparison between MRI and CT was evaluated by using the pooled estimate of sensitivity, specificity, and summary receiver operating characteristic (SROC) curve. In addition, sensitivity analysis and bias analysis were applied to ensure the accuracy of the results. RESULTS: Ten studies with 590 cases were involved in the study. Only 2 trials had high risk regarding bias while other trials were supposed to be at low risk of applicability. Heterogeneity existed in analysis of both CT and MRI. The pooled sensitivity of CT was 0.90 (95% CI: 0.85-0.93), pooled specificity was 0.88 (95% CI: 0.77 to 0.95), the pooled sensitivity of MRI was 0.92 (95% CI: 0.89-0.94), and pooled specificity was 0.91 (95% CI: 0.77-0.97). The Q index of sensitivity and specificity for CT and MRI were 71.38, 19.67, 47.14, and 12.35, respectively. The SROC curve area under the curve of CT and MRI were 0.94 (95% CI: 0.91-0.96) and 0.93 (95% CI: 0.91-0.95), respectively. CONCLUSION: This meta-analysis demonstrates that MRI has better sensitivity and specificity in detecting subsegmental artery PE. MRI is a relatively better detection technique for PE. This conclusion is consistent with many published researches.