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1.
J Thorac Dis ; 16(1): 773-797, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38410605

RESUMO

Background: The epidemiology and severity of asthma vary by sex and age. The diagnosis, treatment, and management of asthma in female patients are quite challenging. However, there is hitherto no comprehensive and standardized guidance for female patients with asthma. Methods: Corresponding search strategies were determined based on clinical concerns regarding female asthma. Search terms included "sex hormones and lung development", "sex hormone changes and asthma", "hormones and asthma immune response", "women, asthma", "children, asthma", "puberty, asthma", "menstruation, asthma", "pregnancy, asthma", "lactation, asthma", "menopause, asthma", "obesity, asthma", and "women, refractory, severe asthma". Literature was retrieved from PubMed/Medline, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data with the search date of July 30, 2022 as the last day. This consensus used the Grading of Recommendations Assessment, Development, and Evaluation to evaluate the strength of recommendation and quality of evidence. Results: We collected basic research results and clinical evidence-based medical data and reviewed the effects of sex hormones, classical genetics, and epigenetics on the clinical presentation and treatment response of female patients with asthma under different environmental effects. Based on that, we formulated this expert consensus on the management of female asthma throughout the life cycle. Conclusions: This expert consensus on the management of asthma in women throughout the life cycle provides diagnosis, treatment, and research reference for clinical and basic medical practitioners.

2.
JMIR Public Health Surveill ; 10: e47453, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38315527

RESUMO

BACKGROUND: Cough is a common symptom during and after COVID-19 infection; however, few studies have described the cough profiles of COVID-19. OBJECTIVE: The aim of this study was to investigate the prevalence, severity, and associated risk factors of severe and persistent cough in individuals with COVID-19 during the latest wave of the Omicron variant in China. METHODS: In this nationwide cross-sectional study, we collected information of the characteristics of cough from individuals with infection of the SARS-CoV-2 Omicron variant using an online questionnaire sent between December 31, 2022, and January 11, 2023. RESULTS: There were 11,718 (n=7978, 68.1% female) nonhospitalized responders, with a median age of 37 (IQR 30-47) years who responded at a median of 16 (IQR 12-20) days from infection onset to the time of the survey. Cough was the most common symptom, occurring in 91.7% of participants, followed by fever, fatigue, and nasal congestion (68.8%-87.4%). The median cough visual analog scale (VAS) score was 70 (IQR 50-80) mm. Being female (odds ratio [OR] 1.31, 95% CI 1.20-1.43), having a COVID-19 vaccination history (OR 1.71, 95% CI 1.37-2.12), current smoking (OR 0.48, 95% CI 0.41-0.58), chronic cough (OR 2.04, 95% CI 1.69-2.45), coronary heart disease (OR 1.71, 95% CI 1.17-2.52), asthma (OR 1.22, 95% CI 1.02-1.46), and gastroesophageal reflux disease (GERD) (OR 1.21, 95% CI 1.01-1.45) were independent factors for severe cough (VAS>70, 37.4%). Among all respondents, 35.0% indicated having a productive cough, which was associated with risk factors of being female (OR 1.44, 95% CI 1.31-1.57), having asthma (OR 1.84, 95% CI 1.52-2.22), chronic cough (OR 1.44, 95% CI 1.19-1.74), and GERD (OR 1.22, 95% CI 1.01-1.47). Persistent cough (>3 weeks) occurred in 13.0% of individuals, which was associated with the risk factors of having diabetes (OR 2.24, 95% CI 1.30-3.85), asthma (OR 1.70, 95% CI 1.11-2.62), and chronic cough (OR 1.97, 95% CI 1.32-2.94). CONCLUSIONS: Cough is the most common symptom in nonhospitalized individuals with Omicron SARS-CoV-2 variant infection. Being female, having asthma, chronic cough, GERD, coronary heart disease, diabetes, and a COVID-19 vaccination history emerged as independent factors associated with severe cough, productive cough, and persistent cough.


Assuntos
Asma , COVID-19 , Doença das Coronárias , Diabetes Mellitus , Refluxo Gastroesofágico , Feminino , Humanos , Lactente , Masculino , SARS-CoV-2 , Estudos Transversais , Vacinas contra COVID-19 , COVID-19/complicações , COVID-19/epidemiologia , Tosse/epidemiologia , Fatores de Risco , China/epidemiologia , Asma/complicações , Asma/epidemiologia
3.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38310083

RESUMO

Chest tightness variant asthma (CTVA) is an atypical form of asthma with chest tightness as the sole or predominant symptom. The underlying receptors for chest tightness may be bronchial C-fibers or rapidly adapting receptors. The nerve impulses are transmitted via the vagus nerve and processed in different regions of the cerebral cortex. Chest tightness is associated with sensory perception, and CTVA patients may have a heightened ability to detect subtle changes in lung function, which may be unrelated to respiratory muscle activity, lung hyperinflation, or mechanical loading of the respiratory system. The airway inflammation, pulmonary ventilation dysfunction (especially involving small airways), and airway hyperresponsiveness may underlie the sensation of chest tightness. CTVA patients are prone to comorbid anxiety and depression, which share similar central nervous system processing pathways with dyspnea, suggesting a possible neurological basis for the development of CTVA. This article examines the recognition and mechanisms of chest tightness symptoms, and explores the pathogenesis of CTVA, focusing on its association with the airway inflammation, ventilation dysfunction, airway hyperresponsiveness, and psychosocial factors.

4.
BMC Pulm Med ; 23(1): 119, 2023 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-37060029

RESUMO

BACKGROUND: Immune checkpoint inhibitors (ICIs) have been widely used in the treatment of cancer. Moreover, immune-related adverse events (irAEs) have become a new clinical challenge. ICI-associated myocarditis is a rare but fatal condition among diverse organ injuries, and early recognition and effective interventions are critical for patients. CASE PRESENTATION: In this report, we present the case of a healthy 60-year-old male who was diagnosed with lung squamous cell carcinomas following chemotherapy and received ICIs. The patient presented with asymptomatic cardiac biomarker elevation followed by immune-related myocarditis. Fortunately, the patient achieved a good clinical result after receiving high-dose steroids. The treatment with ICIs was discontinued because of recurrent increases in troponin T. CONCLUSION: ICI-mediated associated myocarditis is an uncommon but potentially life-threatening adverse event. The current data suggest that clinicians need to be cautious about reinitiation in low-grade patients; however, further study of the diagnosis and treatment is necessary.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Miocardite , Masculino , Humanos , Pessoa de Meia-Idade , Carcinoma Pulmonar de Células não Pequenas/patologia , Inibidores de Checkpoint Imunológico/efeitos adversos , Neoplasias Pulmonares/patologia , Miocardite/induzido quimicamente , Miocardite/diagnóstico , Miocardite/tratamento farmacológico , Imunoterapia/efeitos adversos
5.
J Med Virol ; 94(10): 4850-4859, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35739613

RESUMO

Mumps is an acute infectious disease that spreads widely around the world. The aim of this study was to investigate the epidemiological features and sociodemographic factors associated with mumps in mainland China from 2004 to 2018. Incidence data for mumps during the period 2004-2018 were collected from the Public Health Sciences Data Center of China. Joinpoint regression analysis was performed to explore the trends of mumps. Space-time clustering analysis was conducted to spatial and temporal aggregation areas of mumps. A generalized linear model was used to explore sociodemographic factors associated with the incidence of mumps. The average annual incidence of mumps was 21.44/100 000 in mainland China. It was increased dramatically during 2004-2012 (annual percentage change​ [​​​​​​APC] = 7.51, 95% confidence interval [CI]: 2.28-13.00). After 2012, it remained stable, however, significantly increased in intermediately developed regions from 2015 to 2018 (APC = 25.84, 95% CI: 3.59-52.86). The first-level spatial and temporal aggregation areas were distributed in Xinjiang, Gansu, Qinghai, Ningxia and Shaanxi, Tibet, Sichuan, Yunnan, Chongqing, Guizhou, and Guangxi, with gathering times from January 1, 2006 to December 31, 2012 (relative risk [RR] = 1.87, p < 0.001). The percentage of the population aged 0-14 years, number of health workers per capital, and number of passengers were found to be positively associated with the incidence of mumps. Overall, after 2012, the incidence of mumps in mainland China remained stable. High-risk periods, clusters of regions, and sociodemographic factors for mumps were identified, which will help the government develop the disease- and location-specific interventive measures.


Assuntos
Caxumba , China/epidemiologia , Humanos , Incidência , Caxumba/epidemiologia , Fatores Sociodemográficos , Tibet
6.
Respir Res ; 23(1): 27, 2022 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-35151329

RESUMO

BACKGROUND: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is the main factor that leads to the deterioration of the disease. Currently, the diagnosis of AECOPD mainly relies on clinical manifestations, good predictors or biomarkers are lacking. We aim to reveal specific biomarkers and potential pathogenesis of AECOPD and provide a research basis for the diagnosis and treatment. METHODS: Four patients with AECOPD, four patients with stable COPD, and five control subjects were enrolled for RNA sequencing and KEGG analysis. The mRNA level of target genes was verified by quantitative real-time PCR (qPCR) with an expanded sample size (30 patients with AECOPD, 27 patients with stable COPD, and 35 control subjects). ELISA and immunofluorescence were used to identify the target proteins. Furthermore, the expression and function of WNT/ß-catenin signaling pathway were assessed in animal models of COPD. RESULTS: RNA sequencing showed that 54 genes were up-regulated and 111 genes were down-regulated in the AECOPD. Differentially expressed genes were mainly enriched in WNT signaling pathway, et al. QPCR revealed that multi-genes of the WNT/ß-catenin signaling were significantly down-regulated in AECOPD (P < 0.05), and ß-catenin protein was significantly decreased in plasma of AECOPD and stable COPD (P < 0.01), while phosphorylated ß-catenin was significantly up-regulated in peripheral blood mononuclear cells of AECOPD (P < 0.05). Similarly, WNT ligands, WNT receptors, and downstream signaling molecules were down-regulated, with an increased phosphorylated ß-catenin protein in animal models of COPD. Activation of WNT/ß-catenin signaling pathway by lithium chloride reduced the expression of phosphorylated ß-catenin and ameliorated the COPD-like airway inflammation in mice. CONCLUSION: WNT/ß-catenin signaling pathway is down-regulated in AECOPD patients and in animal models of COPD. Increased expression of phosphorylated ß-catenin in the blood might be a potential biomarker of AECOPD. Activation of WNT/ß-catenin pathway may also represent a therapeutic target for AECOPD.


Assuntos
Regulação para Baixo , Perfilação da Expressão Gênica/métodos , Regulação da Expressão Gênica , Doença Pulmonar Obstrutiva Crônica/genética , Transcriptoma/genética , Proteínas Wnt/genética , beta Catenina/genética , Idoso , Animais , Biomarcadores/sangue , Modelos Animais de Doenças , Progressão da Doença , Humanos , Leucócitos Mononucleares/metabolismo , Leucócitos Mononucleares/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/metabolismo , RNA Mensageiro/genética , Proteínas Wnt/biossíntese , Via de Sinalização Wnt , beta Catenina/biossíntese
7.
Inflammation ; 45(1): 6-13, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34480251

RESUMO

Asthma is a common chronic respiratory disease that affects millions of people worldwide. The incidence of asthma has continued to increase every year. Bronchial asthma involves a variety of cells, including airway inflammatory cells, structural cells, and neutrophils, which have gained more attention because they secrete substances that play an important role in the occurrence and development of asthma. Neutrophil extracellular traps (NETs) are mesh-like structures composed of DNA, histones, and non-histone molecules that can be secreted from neutrophils. NETs can enrich anti-bacterial substances and limit pathogen migration, thus having a protective effect in case of inflammation. However, despite of their anti-inflammatory properties, NETs have been shown to trigger allergic asthma and worsen asthma progression. Here, we provide a systematic review of the roles of NETs in asthma.


Assuntos
Asma/imunologia , Armadilhas Extracelulares/imunologia , Neutrófilos/imunologia , Progressão da Doença , Humanos , Gravidade do Paciente
8.
Front Med (Lausanne) ; 8: 727381, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34778289

RESUMO

Background and objective: To evaluate the awareness/knowledge and clinical practice for the treatment of atypical asthma among respiratory specialists and primary care practitioners (PCPs) in China. Methods: A total number of 1,997 physicians participated in the survey via WeChat. The questionnaire included six main items: physician demographic characteristics, awareness, diagnosis, medical prescription, assessment/education, and proposal. Results: Cough variant asthma (CVA) was recognized by 97.51% of physicians (1,166 respiratory specialists and 799 PCPs), followed by chest tightness variant asthma (CTVA, 83.72%) and occult asthma (73.54%). Specialists were more likely to follow diagnostic recommendations than PCPs (P < 0.01); however, 34.15% of physicians reported the utility of bronchodilation tests, airway provocation tests, and peak expiratory flow monitoring. A total of 91.70% and 92.01% of physicians prescribed inhaled corticosteroids (ICS) or ICS plus long-acting beta-agonists (LABA) for CVA and CTVA, respectively. Physicians prescribed an ICS or ICS/LABA for 4 (2-8) or 8 (4-12) weeks for CVA and 4 (2-8) or 5 (4-12) weeks for CTVA, and the prescription durations were significantly shorter for PCPs than for specialists (P < 0.01). Further, 52.42% and 35.78% reported good control of CVA and CTVA, respectively, with significantly lower control rates for PCPs than for specialists (P < 0.01). Additionally, specialists exhibited better assessment and educational habits than PCPs. Conclusion: While atypical asthma was identified by most specialists and PCPs, there remains a gap between management in real clinical practice and guideline recommendations, especially for PCPs. Further training of PCPs and clinical studies of atypical asthma are required to improve practice.

10.
BMC Pulm Med ; 21(1): 290, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507583

RESUMO

BACKGROUND: Chronic cough is characterized by cough as the only or main symptom, with a duration of more than 8 weeks and no obvious abnormality in chest X-ray examination. Its etiology is complex, including respiratory disease, digestive system disease, circulation system disease, and psychological disease. Although a set of etiological diagnosis procedures for chronic cough have been established, it is still difficult to diagnose chronic cough and there are still some patients with misdiagnosis. CASE PRESENTATION: We present a case of a 54-year-old female patient who had chronic cough for 28 years. Physical examination had no positive signs and she denied any illness causing cough like tuberculosis, rhinitis. Recurrent clinic visits and symptomatic treatment didn't improve the condition. Finally, gastroscopy identified the possible etiology of choledochoduodenal fistula that was proved by surgery. And after surgery, the patient's cough symptoms were significantly improved. CONCLUSION: We report a rare case of chronic cough caused by choledochoduodenal fistula which demonstrates our as yet inadequate recognition of the etiology and pathogenesis. Written informed consent was obtained from the patient.


Assuntos
Fístula Biliar/diagnóstico , Doenças do Ducto Colédoco/diagnóstico , Tosse/etiologia , Duodenopatias/diagnóstico , Fístula Intestinal/diagnóstico , Fístula Biliar/cirurgia , Colangiopancreatografia por Ressonância Magnética , Doença Crônica , Doenças do Ducto Colédoco/cirurgia , Duodenopatias/cirurgia , Feminino , Gastroscopia , Humanos , Fístula Intestinal/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento
11.
PLoS One ; 16(9): e0256480, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34473738

RESUMO

BACKGROUND: The prevalence of pulmonary embolism (PE) in the acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) is highly controversial. We conducted a systematic review and meta-analysis to summarize the epidemiology and characteristics of PE with AE-COPD for current studies. METHODS: We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies published prior to October 21, 2020. Pooled proportions with 95% confidence intervals (95% CIs) were calculated using a random effects model. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals were used as effect measures for dichotomous and continuous variables, respectively. RESULTS: A total of 17 studies involving 3170 patients were included. The prevalence of PE and deep vein thrombosis (DVT) in AE-COPD patients was 17.2% (95% CI: 13.4%-21.3%) and 7.1% (95% CI: 3.7%-11.4%%), respectively. Dyspnea (OR = 6.77, 95% CI: 1.97-23.22), pleuritic chest pain (OR = 3.25, 95% CI: 2.06-5.12), lower limb asymmetry or edema (OR = 2.46, 95% CI:1.51-4.00), higher heart rates (MD = 20.51, 95% CI: 4.95-36.08), longer hospital stays (MD = 3.66, 95% CI: 3.01-4.31) were associated with the PE in the AE-COPD patients. Levels of D-dimer (MD = 1.51, 95% CI: 0.80-2.23), WBC counts (MD = 1.42, 95% CI: 0.14-2.70) were significantly higher and levels of PaO2 was lower (MD = -17.20, 95% CI: -33.94- -0.45, P<0.05) in the AE-COPD with PE group. The AE-COPD with PE group had increased risk of fatal outcome than the AE-COPD group (OR = 2.23, 95% CI: 1.43-3.50). CONCLUSIONS: The prevalence of PE during AE-COPD varies considerably among the studies. AE-COPD patients with PE experienced an increased risk of death, especially among the ICU patients. Understanding the potential risk factors for PE may help clinicians identify AE-COPD patients at increased risk of PE. PROSPERO REGISTRATION NUMBER: CRD42021226568.


Assuntos
Dor no Peito/epidemiologia , Dispneia/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Edema Pulmonar/epidemiologia , Embolia Pulmonar/epidemiologia , Trombose Venosa/epidemiologia , Doença Aguda , Biomarcadores/sangue , Dor no Peito/patologia , Dispneia/patologia , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Tempo de Internação/estatística & dados numéricos , Razão de Chances , Prevalência , Doença Pulmonar Obstrutiva Crônica/patologia , Edema Pulmonar/patologia , Embolia Pulmonar/patologia , Fatores de Risco , Trombose Venosa/patologia
12.
Front Med (Lausanne) ; 8: 704358, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34336903

RESUMO

Background: The prognostic value of the national early warning score (NEWS) in patients with infections remains controversial. We aimed to evaluate the prognostic accuracy of NEWS for prediction of in-hospital mortality in patients with infections outside the intensive care unit (ICU). Methods: We searched PubMed, Embase, and Scopus for related articles from January 2012 to April 2021. Sensitivity, specificity, and likelihood ratios were pooled by using the bivariate random-effects model. Overall prognostic performance was summarized by using the area under the curve (AUC). We performed subgroup analyses to assess the prognostic accuracy of NEWS in selected populations. Results: A total of 21 studies with 107,008 participants were included. The pooled sensitivity and specificity of NEWS were 0.71 and 0.60. The pooled AUC of NEWS was 0.70, which was similar to quick sequential organ failure assessment (qSOFA, AUC: 0.70) and better than systemic inflammatory response syndrome (SIRS, AUC: 0.60). However, the sensitivity (0.55) and AUC (0.63) of NEWS were poor in elder patients. The NEWS of 5 was more sensitive, which was a better threshold for activating urgent assessment and treatment. Conclusions: The NEWS had good diagnostic accuracy for early prediction of mortality in patients with infections outside the ICU, and the sensitivity and specificity were more moderate when compared with qSOFA and SIRS. Insufficient sensitivity and poor performance in the elder population may have limitations as an early warning score for adverse outcomes. NEWS should be used for continuous monitoring rather than a single time point predictive tool.

13.
Front Med (Lausanne) ; 8: 699880, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34307426

RESUMO

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the National Early Warning Score 2 (NEWS2) is recommended for the risk stratification of COVID-19 patients, but little is known about its ability to detect severe cases. Therefore, our purpose is to assess the prognostic accuracy of NEWS2 on predicting clinical deterioration for patients with COVID-19. Methods: We searched PubMed, Embase, Scopus, and the Cochrane Library from December 2019 to March 2021. Clinical deterioration was defined as the need for intensive respiratory support, admission to the intensive care unit, or in-hospital death. Sensitivity, specificity, and likelihood ratios were pooled by using the bivariate random-effects model. Overall prognostic performance was summarized by using the area under the curve (AUC). We performed subgroup analyses to assess the prognostic accuracy of NEWS2 in different conditions. Results: Eighteen studies with 6,922 participants were included. The NEWS2 of five or more was commonly used for predicting clinical deterioration. The pooled sensitivity, specificity, and AUC were 0.82, 0.67, and 0.82, respectively. Benefitting from adding a new SpO2 scoring scale for patients with hypercapnic respiratory failure, the NEWS2 showed better sensitivity (0.82 vs. 0.75) and discrimination (0.82 vs. 0.76) than the original NEWS. In addition, the NEWS2 was a sensitive method (sensitivity: 0.88) for predicting short-term deterioration within 72 h. Conclusions: The NEWS2 had moderate sensitivity and specificity in predicting the deterioration of patients with COVID-19. Our results support the use of NEWS2 monitoring as a sensitive method to initially assess COVID-19 patients at hospital admission, although it has a relatively high false-trigger rate. Our findings indicated that the development of enhanced or modified NEWS may be necessary.

15.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 50(1): 123-130, 2021 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-34117844

RESUMO

Bronchial asthma is a chronic respiratory disease,characterized by airway inflammation,airway hyperresponsiveness,reversible airway obstruction and airway remodeling,in which a variety of cells including airway inflammatory cells and structural cells are involved. Previous studies have shown that asthma is mainly driven by Th2 cytokines IL-4,IL-5,and IL-13,leading to airway eosinophil inflammation. With further research,however,it has been found that neutrophils are also closely related to asthma. Numbers of neutrophils are elevated in airway through increased chemotaxis and decreased apoptosis,which is earlier than eosinophils,leading to airway neutrophilic inflammation. Neutrophils can produce elastase,myeloperoxidase,neutrophil extra- cellular traps,chemokines and cytokines,participating in the occurrence and development of asthma. The antagonists against these molecules,such as anti-IL-8 receptor antibody,anti-IL-17 antibody,and DNase,have shown positive effects on neutrophilic asthma,but further studies are needed to support their clinical application. This article mainly reviews the role of neutrophils in asthma and related mechanisms.


Assuntos
Asma , Neutrófilos , Asma/imunologia , Citocinas , Eosinófilos , Humanos , Inflamação , Neutrófilos/imunologia
16.
Ann Palliat Med ; 10(7): 8479-8483, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34118833

RESUMO

Lung cancer can be divided into small cell lung cancer and non-small cell lung cancer (NSCLC). NSCLC can be further divided into squamous cell carcinoma, adenocarcinoma, and large-cell neuroendocrine carcinoma (LCNEC). At present, our understanding of LCNEC is limited. LCNEC is a rare condition but is highly malignant with a poor prognosis. The mean age of onset was about 65 years old, and was highly correlated with smoking. Although many treatment methods, including surgery, radiotherapy, and chemotherapy, are available, the therapeutic effect was limited and there is still a lack of clear guidelines and recommendations for its therapy. At present, immunotherapy is rapidly developing, and its application in lung cancer is increasing. However, there is limited literature about immunotherapy in LCNEC. Here, we present a case of LCNEC at stage IIIA, which involved a 64-year-old man with a 30-year history of smoking. Enhanced chest radiography indicated a malignant tumor in the upper lobe of the left lung. We treated this patient with neoadjuvant chemo-immunotherapy with albumin paclitaxel, carboplatin, and sintilimab. We also performed postoperative chemo-immunotherapy the same as before surgery. The patient has well tolerated this treatment and remains under postoperative observation for 6 months at the time of writing.


Assuntos
Carcinoma Neuroendócrino , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Idoso , Carcinoma Neuroendócrino/terapia , Humanos , Imunoterapia , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante
17.
BMC Pulm Med ; 21(1): 142, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33941132

RESUMO

BACKGROUND: In nonneutropenic patients with underlying respiratory diseases (URD), invasive pulmonary aspergillosis (IPA) is a life-threatening disease. Yet establishing early diagnosis in those patients remains quite a challenge. METHODS: A retrospective series of nonneutropenic patients with probable or proven IPA were reviewed from January 2014 to May 2018 in Department of Respiratory Medicine of two Chinese hospitals. Those patients were suspected of IPA and underwent lung computed tomography (CT) scans twice within 5-21 days. The items required for IPA diagnosis were assessed by their host factors, mycological findings and CT scans according to the European Organization for Research and Treatment of Cancer (EORTC) and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (MSG) criteria (EORTC/MSG criteria). RESULTS: Together with the risk factors, mycological findings and nonspecific radiological signs on first CT, ten patients were suspected of IPA. With the appearance of cavities on second CT scan in the following days, all patients met the criteria of probable or possible IPA. Except one patient who refused antifungal treatment, nine patients received timely antifungal treatment and recovered well. One of the nine treated IPA cases was further confirmed by pathology, one was confirmed by biopsy. CONCLUSIONS: Dynamic monitor of CT scan provided specific image evidences for IPA diagnosis. This novel finding might provide a noninvasive and efficient strategy in IPA diagnosis with URD.


Assuntos
Aspergilose Pulmonar Invasiva/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , China , Feminino , Humanos , Aspergilose Pulmonar Invasiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Estudos Retrospectivos
18.
Front Immunol ; 12: 594330, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33828547

RESUMO

Cigarette smoke (CS)-induced macrophage activation and airway epithelial injury are both critical for the development of chronic obstructive pulmonary disease (COPD), while the eventual functions of autophagy in these processes remain controversial. We have recently developed a novel COPD mouse model which is based on the autoimmune response sensitized by CS and facilitated by elastin. In the current study, we therefore utilized this model to investigate the roles of autophagy in different stages of the development of bronchitis-like airway inflammation. Autophagic markers were increased in airway epithelium and lung tissues, and Becn+/- or Lc3b-/- mice exhibited reduced neutrophilic airway inflammation and mucus hyperproduction in this COPD mouse model. Moreover, treatment of an autophagic inhibitor 3-methyladenine (3-MA) either during CS-initiated sensitization or during elastin provocation significantly inhibited the bronchitis-like phenotypes in mice. Short CS exposure rapidly induced expression of matrix metallopeptidase 12 (MMP12) in alveolar macrophages, and treatment of doxycycline, a pan metalloproteinase inhibitor, during CS exposure effectively attenuated the ensuing elastin-induced airway inflammation in mice. CS extract triggered MMP12 expression in cultured macrophages, which was attenuated by autophagy impairment (Becn+/- or Lc3b-/-) or inhibition (3-MA or Spautin-1). These data, taken together, demonstrate that autophagy mediates both the CS-initiated MMP12 activation in macrophages and subsequent airway epithelial injury, eventually contributing to development COPD-like airway inflammation. This study reemphasizes that inhibition of autophagy as a novel therapeutic strategy for CS-induced COPD.


Assuntos
Autofagia , Bronquite/etiologia , Bronquite/metabolismo , Elastina/metabolismo , Poluição por Fumaça de Tabaco/efeitos adversos , Animais , Biomarcadores , Bronquite/patologia , Linhagem Celular , Células Cultivadas , Modelos Animais de Doenças , Suscetibilidade a Doenças , Elastina/genética , Expressão Gênica , Humanos , Imuno-Histoquímica , Pulmão/metabolismo , Pulmão/patologia , Macrófagos Alveolares/imunologia , Macrófagos Alveolares/metabolismo , Macrófagos Alveolares/patologia , Masculino , Metaloproteinase 12 da Matriz/genética , Metaloproteinase 12 da Matriz/metabolismo , Camundongos
19.
Front Med (Lausanne) ; 8: 641948, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33777982

RESUMO

Background: Chronic cough is a common complaint that in rare cases can be caused by premature ventricular beats (PVCs). Materials and Methods: In this report, we present the case of a healthy 44-year-old female who presented persistent cough and cough syncope that was attributed to PVCs. Results: The cough disappeared after radiofrequency ablation, and no recurrence of arrhythmia or cough was observed. Conclusion: PVCs should be considered a probable cause of chronic cough and cough syncope in differential diagnosis.

20.
Signal Transduct Target Ther ; 6(1): 91, 2021 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-33640900

RESUMO

Eosinophils are terminally differentiated cells derived from hematopoietic stem cells (HSCs) in the bone marrow. Several studies have confirmed the effective roles of eosinophils in asthmatic airway pathogenesis. However, their regulatory functions have not been well elucidated. Here, increased C-C chemokine ligand 6 (CCL6) in asthmatic mice and the human orthologs CCL15 and CCL23 that are highly expressed in asthma patients are described, which are mainly derived from eosinophils. Using Ccl6 knockout mice, further studies revealed CCL6-dependent allergic airway inflammation and committed eosinophilia in the bone marrow following ovalbumin (OVA) challenge and identified a CCL6-CCR1 regulatory axis in hematopoietic stem cells (HSCs). Eosinophil differentiation and airway inflammation were remarkably decreased by the specific CCR1 antagonist BX471. Thus, the study identifies that the CCL6-CCR1 axis is involved in the crosstalk between eosinophils and HSCs during the development of allergic airway inflammation, which also reveals a potential therapeutic strategy for targeting G protein-coupled receptors (GPCRs) for future clinical treatment of asthma.


Assuntos
Asma/genética , Quimiocinas CC/genética , Eosinófilos/metabolismo , Proteínas Inflamatórias de Macrófagos/genética , Receptores CCR1/genética , Adolescente , Adulto , Idoso , Animais , Asma/patologia , Medula Óssea/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Eosinófilos/patologia , Feminino , Voluntários Saudáveis , Células-Tronco Hematopoéticas/metabolismo , Humanos , Hipersensibilidade/genética , Hipersensibilidade/patologia , Inflamação/genética , Inflamação/patologia , Pulmão/metabolismo , Pulmão/patologia , Masculino , Camundongos , Camundongos Knockout , Pessoa de Meia-Idade , Ovalbumina/farmacologia , Compostos de Fenilureia/farmacologia , Piperidinas/farmacologia , Transdução de Sinais/efeitos dos fármacos , Adulto Jovem
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