Drug resistance related genes in lung adenocarcinoma predict patient prognosis and influence the tumor microenvironment.

Lung adenocarcinoma (LUAD) is the predominant type of non-small lung cancer (NSCLC) with strong invasive ability and poor prognosis. The drug resistance related genes are potentially associated with prognosis of LUAD. Our research aimed to identify the drug resistance related genes and explore their potential prognostic value in LUAD patients. The data used in this study were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Firstly, we screened drug resistance related genes in LUAD by differential gene analysis, univariate Cox regression and drug sensitivity analyses. Subsequently, we constructed a risk score model using LASSO Cox regression analysis, and verified whether the risk score can predict the survival of LUAD patients independent of other factors. Moreover, we explored the immune infiltration of 22 immune cells between high-risk and low-risk patients. Totally 10 drug-resistance positively related genes (PLEK2, TFAP2A, KIF20A, S100P, GDF15, HSPB8, SASH1, WASF3, LAMA3 and TCN1) were identified in LUAD. The risk score model of LUAD constructed with these 10 genes could reliably predict the prognosis of LUAD patients. 18 pathways were significantly activated in high-risk group compared with low-risk group. In addition, the infiltration proportion of multiple immune cells was significantly different between high-risk and low-risk groups, and the proportion of M1 phagocytes was significantly higher in the high-risk group compared with the low-risk group. The drug resistance related genes (PLEK2, TFAP2A, KIF20A, S100P, GDF15, HSPB8, SASH1, WASF3, LAMA3 and TCN1) could predict the prognosis of LUAD patients. Clarifying the roles and mechanisms of these 10 genes in regulating drug resistance in LUAD will help to improve individualized clinical treatment protocols and predict patient sensitivity to treatment.

The relationship between lifestyle factors and clinical symptoms of bipolar disorder patients in a Chinese population.

There is evidence that bipolar disorder (BD) patients with an unhealthy lifestyle have a worse course of illness. This study was designed to examine the extent to which lifestyle could influence the severity of clinical symptoms associated with BD. A total of 113 BD patients were recruited in this study. The lifestyle information including data on dietary patterns, physical activity, and sleep quality were collected using a self-rated questionnaire. The results showed that the consumption of whole grain, seafood, and dairy products were significantly negatively correlated with the 17-item Hamilton Rating Scale for Depression (HAMD-17) total score. The consumption of sugar, soft drinks, and alcohol as well as being a current smoker were positively correlated with the severity of clinical symptoms. Multiple linear regression and binary logistic regression analyses demonstrated an independent negative correlation between both whole grain and dairy product consumption with the HAMD-17 score. The results from the current study suggested that lifestyle factors, especially dietary patterns, might be associated with clinical symptoms of BD. The association between the consumption of specific foods and severity of depressive symptoms may offer some useful information and further understanding of the role of lifestyle factors in the development of BD.

Radiotherapeutic treatment of a fighter pilot with nasopharyngeal carcinoma.

BACKGROUND: Radiotherapy is the standard and most effective treatment for nasopharyngeal carcinoma (NPC) in its early stages. However, its application in fighter pilots returning to flying duties with NPC has not been previously reported, presumably due to post-radiotherapeutic complications. CASE REPORT: A 36-yr-old male fighter pilot had a painless mass in the left neck for 5 mo. Pathological diagnosis demonstrated nonkeratinizing squamous cell carcinoma in the left nasopharynx which had metastasized to lymph nodes in the left side of the neck. He was diagnosed and staged with NPC (T1N2M0) before treatment with radiotherapy and adjuvant chemotherapy. The patient suffered from catarrhal otitis media and xerostomia after 3 mo of radiotherapy, but these symptoms resolved. After a total of 8 mo of radiotherapy, he was in remission with no evidence of tumor recurrence or metastasis. He had normal Eustachian tube, hearing, and vestibular function before and after hypobaric chamber testing and passed all flight-related physical examinations. Consequently, he was granted a medical waiver and returned to flying status in two-seat fighter aircraft, flying for 53 h in a 12-mo period. After passing all flight-related tests again, he was then allowed to fly in single-seat aircraft. At the time of submission of this article, he has flown for 147 h and remained on flying status for 26 mo. He will be monitored annually for long-term effects of radiotherapy and/or disease recurrence. CONCLUSIONS: Fighter pilots with NPC may be safely considered for medical waiver with appropriate monitoring after successful treatment.

Synchronous rectal and gastric cancer in a fighter pilot: aeromedical concerns.

Synchronous cancer of the stomach and rectum is very rare. In a special population of pilots, especially fighter pilots, synchronous rectal and gastric cancer is much more uncommon. We herein report a case of synchronous carcinoma of the rectum and stomach. The patient was a 44-year-old male fighter pilot who complained with bloody stool and altered bowel habits. He was diagnosed with hereditary nonpolyposis colorectal cancer with a definite family history, and subsequently he underwent simultaneous low anterior resection and distal gastrectomy with D2 lymphadenectomy. Postoperative pathologic assessment showed a poorly differentiated gastric adenocarcinoma with signet ring cell components (pT2N1M0; stage IIb) and a moderately differentiated rectal adenocarcinoma with myxoid components (pT3N0M0; stage IIa). Both tumors showed positive expression of p53, Ki-67, VEGF, carcinoembryonic antigen, MRP, TS, P-gp, and TopoII, and negative expression of c-erbB2, CD34, CD31, D2-40, S-100, FVIII, MLH1, MSH2, and MSH6 oncoproteins. Six cycles of XELOX chemotherapy and 50 Gy/25 f radiotherapy were delivered postoperatively. Now, he has returned to his work under medical observation for about 6 months. From this patient's diagnosis and treatment, we think that the gene screening should be used in pilot selection. According to the result of gene screening, we can give pertinence examinations to the target organ of genes. It is very necessary for pilots to keep keen vigilance at gastrointestinal tumors because they have to face many high-risk factors in working. As to pilots, the selection of operation should be individualized.

A fighter pilot case of pulmonary sequestration.

BACKGROUND: Pulmonary sequestration is a rare congenital malformation. The diagnosis of pulmonary sequestration is based on the identification of an abnormal arterial supply. Conventional treatment for pulmonary sequestration is surgical removal of the tissue, which may induce serious trauma and requires a long recovery time. Recently, endovascular treatment has become feasible as a safer and less invasive method to treat pulmonary sequestration. CASE REPORT: To the best of our knowledge, pulmonary sequestration has not been reported in pilots. In this study, we report a fighter pilot case of intralobar pulmonary sequestration detected with the assistance of spiral computed tomography (CT) and digital subtraction angiography. The young fighter pilot had experienced recurrent hemoptysis and pulmonary infections for approximately 10 yr before the pulmonary sequestration was diagnosed. We performed a transcatheter arterial embolization and a subsequent CT angiography confirmed complete infarction of the sequestration. After the treatment, no clinical complications were observed and the patient, with normal lung function restored, was qualified to serve as a fighter pilot again. DISCUSSION: Compared with conventional removal surgery, endovascular treatment is a superior treatment for pulmonary sequestration in a fighter pilot in maintenance of pilot qualification.

[Study on the relationship between estrogen receptor beta and etiology of human endometrial polyps].

OBJECTIVE: To investigate the relationships between the expression of estrogen receptor beta (ERbeta) and etiology of human endometrial polyps (EP). METHODS: Thirty-six females with infertility and 36 females with intrauterine contraceptive device (IUD, aged from 23 years to 33 years, average 28 years) were enrolled in the study. Blood samples were taken before hysteroscopy for analysis of the level of estradiol in serum. All the tissue samples of benign EP and endometrium in the same cycle were obtained through hysteroscopy on the 5th to 9th days of menstruation cycle (all the women selected had the same menstrual period). Part of the samples of EP were made into homogenates to assay the level of estradiol, and the rest of EP and endometrium were both fixed with 10% formalin. If one of the samples was confirmed by histopathologic analysis, the correspondence was eligible. Otherwise, they were abnegated. Seventy-two samples were collected and 60 were eligible as a result. The expression of ERbeta and ERalpha in these samples was detected by immunohistochemical staining, while the levels of estradiol in both serum and homogenate of EP were detected by radioimmunoassay. RESULTS: The expression of stromal ERbeta of EP in infertility and IUD groups (2.1 +/- 0.9, 1.9 +/- 0.5) was significantly higher than those of endometrium in the same cycle (1.7 +/- 0.3, 1.3 +/- 1.1) (P < 0.05), while the expression of stromal ERalpha of EP was significantly decreased than those of endometrium (P > 0.05). The expression of ERbeta in glands had no difference in both EP and endometrium. The expression of ERbeta was significantly positively related to the levels of estradiol in both serum and homogenate (P < 0.01), while the expression of ERalpha had no correlation with estradiol. CONCLUSIONS: Overexpression of ERbeta in stroma might play an important role in the pathogenesis of EP.