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This study retrospectively analyzed the laboratory data and chest images of patients with amyopathic dermatomyositis associated with ILD (ADM-ILD) and patients with other connective tissue disease-related ILDs (CTD-ILDs) to find a characteristic index for the early recognition of ADM-ILD and help clinicians consider the possibility of ADM-ILD as soon as possible.In our cohort study, the records of 128 Chinese patients with CTD-ILD, including 33 ADM-ILD patients, 37 rheumatoid arthritis (RA)-ILD patients, 33 primary Sjogren's syndrome (pSS)-ILD patients, 14 systemic sclerosis (SSc)-ILD patients and 11 systemic lupus erythematosus (SLE)-ILD patients. The patients' clinical features, laboratory parameters, and chest HRCT findings were analyzed.ADM-ILD patients generally had significantly higher LDH (333.52±160.21 U/L), AST (66.21±83.66 U/L), and CK-MB (18.23±8.28 U/L) levels than other CTD-ILD patients. A total of 90.91% (30/33) of ADM-ILD patients had elevated LDH. Patients with ADM-ILD were more prone to organizing pneumonia radiologic patterns on chest HRCT scans than patients with other CTD-ILDs (χADM-ILD patients have higher serum LDH, AST and CK-MB levels, especially serum LDH levels, and are more prone to organizing pneumonia radiologic patterns on chest HRCT scans than other CTD-ILD patients. A high level of serum LDH with ILD may be a useful characteristic index for recognizing ADM-ILD.

Background Lactate dehydrogenase (LDH) is an easily obtained biological marker and a promising index for determining the severity of amyopathic dermatomyositis with interstitial lung disease (ADM-ILD). In this study, we retrospectively analysed the clinical signs and laboratory data from ADM-ILD patients displaying nonspecific interstitial pneumonia (NSIP) or organizing pneumonia (OP) ILD radiological patterns, and we identified the serum LDH level as a useful biomarker for early ADM-ILD detection. Methods In our cohort study, 158 Chinese patients were divided into four groups according to whether NSIP or OP patterns were present on high-resolution computed tomography (HRCT). The 4 groups included 25 ADM-NSIP and 92 control-NSIP patients, 15 ADM-OP patients, and 29 control-OP patients. Patient’s demographic features, clinical presentation, laboratory parameters, duration of ILD, and follow-up data were recorded and analysed. Results ADM-ILD patients generally had higher AST (45.96 ± 42.45 in NSIP, 64.53 ± 75.75 in OP, U/L) and LDH (317.20 ± 104.29 in NSIP, 356.60 ± 214.84 in OP, U/L) levels than the corresponding control groups. A total of 40.53% (15/37) and 86.49% (32/37) of ADM-ILD patients had high serum levels of AST and LDH above the normal range, respectively. At a cut-off level of 235.5 U/L, identified by the ROC curve, serum LDH yielded a sensitivity of 78.38% and specificity of 82.64% for ADM with NSIP or OP radiological patterns. The 5-year overall survival rate of ADM-OP patients (73.33%) was significantly worse than that of control-OP patients (94.12%) (p=0.007). No difference was evident in the survival rate between the NSIP groups. The presence of skin ulcers (p=0.028) and OIp=0.029) were significant risk factors for poor outcomes in ADM-ILD patients. A lower serum level of ferritin (< 500 ng/ml) indicated a better patient prognosis (p=0.023). The presence of coexistent myositis-associated autoantibodies with anti-melanoma differentiation-associated gene 5 (anti-MDA5) seems to protect ADM-ILD patients. Conclusions The LDH level can be used as a screening biomarker for patients with NSIP or OP ILD radiological patterns. It is important to recognize ADM-ILD early, especially in patients with the OP radiological pattern, which appears to impact patient treatment and outcomes.

Introduction Nicotine dependence (ND) is a maladaptive pattern of tobacco smoking with withdrawal symptoms similar to other drug addictive disorders. It is very common in clinical practice that smokers always have different degrees of nicotine dependence with the same amount of tobacco consumption. Behaviors may influence daily cigarette consumption or smoking status. Hence it is critical to ascertain the association between concurrent behaviors and high nicotine dependence among smokers. Methods A total of 343 patients who attended a clinic for smoking cessation were recruited, and the information on concurrent behaviors were recorded. Factors associated and not associated with nicotine dependence were recorded. Nicotine dependence was determined by Fagerström test for nicotine dependence (FTND). Results High ND patients (FTND >5) showed significant behaviors distribution compared with mild and moderate ND patients (FTND ≤5). There is no single behavior that was significantly different between high ND and mild and moderate ND smokers. However, the combined effects of nicotine dependence influencing behaviors of caffeine drinking and mental activities after dinner have an association with high ND (OR=1.939; 95% CI: 1.154–3.258, p=0.012). In addition, the combined effects of inadequate sleep time (

Pulmonary MALT lymphoma is a rare disease that is easily misdiagnosed. The objective of this study was to improve the understanding of pulmonary MALT lymphoma for clinicians.The computed tomography (CT) scans of 18 patients (13 males and 5 females), aged 41-70 years (mean=55.6 years), with histologically proven pulmonary MALT lymphoma were retrospectively reviewed by two radiologists, and pulmonary imaging findings were described. Correlations between the pulmonary abnormalities and histopathological findings in 13 patients were retrospectively reviewed.Elementary lesions were characterized by masses or mass-like areas of consolidation (15/18), nodules (5/18), air bronchograms (16/18), airway dilatation (7/18), cavitation (5/18), airways passing through the lesion (8/18), CT angiogram signs (12/14) and vessels passing through the lesion (12/14). Additional findings included multiple cysts (n = 1), pleural effusion (n = 1) and atelectasis (n = 1). Pulmonary abnormalities were correlated with pathological appearance. Pathological examination confirmed lymphomatous infiltration with a bronchovascular distribution but no vessel or airway destruction, which appeared on CT as the vessels/airways passed through lesions naturally.We herein demonstrated the imaging findings for 18 cases of pulmonary MALT lymphomas by analyzing the corresponding pathologies. We also discovered that vessels/airways could pass through pulmonary MALT lymphoma lesions, which may be helpful for diagnosis. This disease should be considered when chest CT imaging shows multiple/single masses or nodules or mass-like areas of consolidation together with vessels/airways passing through lesions.

Exacerbation of chronic obstructive pulmonary disease (ECOPD) is an important event during the course of the disease. It causes a more rapid decline in lung function, which is associated with hospitalization and the risk of death. Therefore, it is essential to discover approaches to early detection and prevention of ECOPD. Peak expiratory flow (PEF) can be safely used instead of spirometry which can assess the severity of COPD as a standard tool. We hypothesized that monitoring PEF could possibly be used to predict the ECOPD.To verify this hypothesis, daily morning PEF was monitored for 6 months in 53 patients with moderate to severe COPD (mean FEV1 31.53%predicted) who were enrolled in Ningbo, China.A total of 69 exacerbations of COPD (63 of gradual onset, six of sudden onset) were recorded in this study. Thirty cases (43.5%) of gradual onset exacerbations needed to be hospitalized, and the mean PEF significantly decreased (vs baseline) during the 5 days that preceded those exacerbations (from 161.9 ± 39.4 L/min to 137.9 ± 36.1 L/min, P 0.05, statistical power = 0.92). However, this was not the case with non-hospitalized exacerbations (from 175.4 ± 42.5 L/min to 161.5 ± 39.3 L/min, P = 0.172, statistical power = 0.63). The ROC analysis demonstrated that 24 h before hospitalized exacerbation, the optimal cutoff value of ΔPEF for its prediction was 28 L/min (17% from baseline), with a sensitivity and specificity of 76.7% and 72.7%, respectively (area under the curve [AUC] = 0.84, P 0.05, statistical power = 0.78). While 48 h before hospitalized exacerbation, the optimal cutoff value of ΔPEF for its prediction was 14 L/min (9% from baseline), with a sensitivity and specificity of 86.7% and 66.7%, respectively (AUC = 0.863, P 0.05, statistical power = 0.87).As a rapid, inexpensive method, PEF could be used for the prediction and early detection of hospitalized exacerbation of COPD. This may provide opportunity for early intervention of ECOPD.

Background: Nicotine dependence (ND) is a maladaptive pattern of tobacco smoking with withdrawal symptoms like other drug addictive disorders. It is very common in clinic that smokers always have different degree of nicotine dependence with same amount of tobacco consumption. Lifestyle may influence cigarettes daily consumption or smoke state. So it is critical to prove the influence of healthy or unhealthy lifestyles in high nicotine dependence smokers. This study aimed to identify behavioral correlates to high ND.Methods: 343 patients who went to clinic for smoking cessation were recruited. Participants completed a demographic questionnaire. The extent of Nicotine dependence was determined by Fagerstrom Test for Nicotine Dependence (FTND).Results: High ND patients (FTND>5) showed significant life style compared with mild and moderate ND patients (FTNDχ2=36.98, P value=0.002). There is no single lifestyle index can significantly distinguish high ND from mild and moderate ND. However, combined behaviors of caffeine drink and mental activities after dinner contribute to the risk of high ND (OR:1.939, 95%CI:1.154-3.258, P value=0.012). In addition, combined index of(sleep time < 8 hours, caffeine drink and mental activities after dinner) each significantly distinguished patients of high ND from patients of mild and moderate ND. with high nicotine dependence(OR:2.208, 95%CI:1.032-4.737, P value=0.042）.Conclusion: Interact effects of mental activities after dinner and caffeine drink will increase the risk of high nicotine dependence. Sleep less than 8 hours with behaviors of mental activities after dinner and caffeine drink also have the same effect.

In recent years, various biomarkers have been gradually applied on bronchoalveolar lavage (BAL) fluid for the diagnosis of invasive pulmonary aspergillosis (IPA). The objective of this study is to assess the value of the liquid-based cytopathology test (LCT) for improving the identification of IPA in BAL fluid from possible IPA patients, following special staining with periodic acid-Schiff staining (PAS) or Grocott's methenamine silver (GMS). A total of 47 consecutive possible IPA patients who underwent bronchoscopy with BAL fluid from January 2017 to December 2018 were included. 45 people had a pair of BAL fluid specimens and 2 patients had two BAL fluid specimens. The 49 pairs of BAL fluid specimens were processed for culture, tuberculosis acid fast staining smear, direct microbial smear, and LCT with special staining (PAS and GMS), respectively. Then, we compared the sensitivity and specificity of PAS and GMS in BAL fluid in high-risk patients. Among 47 possible IPA patients, 25 patients had proven/probable IPA, and 11 patients had other invasive fungal diseases. The sensitivity of GMS was higher than that of PAS (92.11% versus 81.58%; P = 0.175). The specificity of GMS was 81.82%, which was higher than that of PAS (81.82% versus 72.73%; P = 0.611). The negative predictive value (NPV) for PAS and GMS were 53.33% and 75.00%, respectively. The positive predictive value (PPV) for PAS and GMS were 91.18% and 94.59%, respectively. This study showed that special staining of LCT in BAL fluid may be a novel method for the diagnosis of IPA, and the GMS of LCT had higher sensitivity and specificity, which was superior to PAS.

Thyroid carcinoma (THCA) is the most common thyroid malignancy and accounts for 1% of overall malignant tumors. Long intergenic non-protein coding RNA 342 (LINC00342) has been validated to be a regulator in non-small cell lung cancer (NSCLC). However, the biological role of LINC00342 in THCA has not been reported or discussed yet. Therefore, the present study focused on the role of LINC00342 and its mechanism in THCA. Firstly, real-time quantitative polymerase chain reaction (RT-qPCR) was conducted for detecting LINC00342 expression in THCA and the outcomes disclosed that LINC00342 had a high expression in THCA tissues and cells. Besides, functional assays reflected that LINC00342 silence inhibited THCA progression by anti-proliferation, anti-migration/invasion and pro-apoptosis as well as blocking epithelial-mesenchymal transition (EMT). Next, through RNA immunoprecipitation (RIP), RNA pull down and luciferase reporter assays, we confirmed that LINC00342 and charged multivesicular body protein 5 (CHMP5) could bind to miR-384. Further, the expression of CHMP5 was declined with miR-384 up-regulation or LINC00342 down-regulation. Finally, rescue experiments revealed that CHMP5 upregulation reversed LINC00342 knockdown-mediated effects on THCA cells. All data showed that LINC00342 promoted THCA progression by absorbing miR-384 to upregulate CHMP5 expression. These findings proved that LINC00342 might be a promising target for THCA treatment.

BACKGROUND Previous studies have found that vascular endothelial growth factor (VEGF) is associated with lung cancer, yet little is known about vascular endothelial growth factor-D (VEGF-D) in bronchoalveolar lavage fluid (BALF) of lung cancer patients. In this study, we aim to investigate the expression and evaluation of VEGF-D in BALF for lung cancer diagnosis. METHODS BALF samples were acquired from 81 patients: 40 with benign diseases and 41 with lung cancer. The expression of VEGF-D in BALF was measured using sandwich enzyme-linked immune sorbent assays (ELISA), and the evaluation of VEGF-D in BALF for lung cancer diagnosis was also investigated. RESULTS In the BALF samples, the levels of VEGF-D in the lung cancer group were higher than in the benign disease group; however, there was no statistical significance between the two groups (p > 0.05). In the pathological classification of lung cancer, the levels of VEGF-D in the BALF differed significantly between the lung squamous carcinoma group and the benign disease group (p < 0.05). The diagnostic accuracies of VEGF-D in BALF for discrimination between patients with squamous cell carcinoma and benign disease were reasonable based on receiver operating characteristic (ROC curve) analysis, with a corresponding sensitivity of 64.7% and specificity of 60%, respectively. CONCLUSIONS This study demonstrated that the detection of VEGF-D levels in BALF is a valuable diagnostic tool for lung squamous carcinoma.

Objective. This epidemiological investigation aimed at determining the current situation regarding the diagnosis and treatment of chronic obstructive pulmonary disease (COPD), especially missed diagnosis and missed treatment, in a group of individuals residing in an island area of Ningbo. Methods. Adults ≥60 years of age were selected from an island area of Ningbo. All participants completed a COPD-Screening Questionnaire and underwent a post-bronchodilator pulmonary function test. COPD-positive individuals then completed a questionnaire surveying the status of diagnosis and treatment of COPD and the reasons for missed diagnosis and treatment. The data were collated and analyzed using SPSS version 22.0 (IBM Corporation, Armonk, NY, USA). Findings. (1) A total of 1526 individuals were screened, of whom 1371 (89.8%) were eventually included in data analysis. From these, 254 were diagnosed with spirometry-defined COPD, corresponding to an overall prevalence of 18.5%. Prevalence was higher in men (28.9%) than in women (8.3%) among the sample. (2) According to chi-squared test results, risk factors for COPD included sex, age, smoking history (pack-years), cough, and dyspnea. Body mass index, family history of respiratory diseases, and exposure to biomass smoke from cooking were not risk factors for COPD. (3) Multivariate logistic regression analysis revealed that age and smoking were independent risk factors for COPD. (4) Receiver operating curve analysis revealed that, at a cutoff of 19.5, the highest sum of sensitivity and specificity was 69.7% and 75.5%, respectively. The COPD-Screening Questionnaire could be used as a preselection method to screen for COPD in primary care settings. (5) Of 254 individuals diagnosed with COPD, only 10 had a history of COPD and only 35 had a previous diagnosis of pneumonia or bronchitis. These data revealed that the rate of missed diagnosis of COPD in the Ningbo island area was 96.1%. Conclusion. The prevalence of COPD among elderly individuals in the Ningbo island area was significantly higher than in other parts of China. Moreover, the rate of missed diagnosis of COPD in the Ningbo island area was extremely high. Smoking and age were independent factors for the occurrence of COPD.

Oxidative stress induced by tobacco smoking is one of the main causes of DNA damage and is known to be involved in various cancers. Smoking is the leading cause of lung cancer, while the role of cigarette smoke-induced oxidative DNA damage response during lung carcinogenesis is largely unknown. In this study, we investigated oxidative DNA damage response levels in smoking and nonsmoking patients with lung cancer, and evaluated the potential diagnostic value of 8-OHdG for lung cancer. We observed a higher level of 8-OHdG expression and secretion in airways of lung cancer patients than that of noncancer controls. 8-OHdG expression was associated with the TNM stages. Additionally, cigarette smoke-induced oxidative DNA damage response was observed in bronchial epithelial cells in vitro and in vivo. A statistical significance correlation was found between the levels of 8-OHdG and smoking index. With a cut-off value of 2.86 ng/ml, 8-OHdG showed a sensitivity and specificity of 70.0% and 73.7%, respectively, to identify a patient with lung cancer. These findings not only underscore the importance of smoking in oxidative DNA damage response of lung cancer patients, but also suggest 8-OHdG as a potential diagnostic biomarker for lung cancer.

As novel non-invasive tumor diagnostic biomarkers, exosomal bioactive miRNAs have received increasing attention. Herein, the aim of this study is to explore the clinical values and roles of exosomal miR106b in lung cancer. The exosomal miR-106b level was much higher in the serum of patients with lung cancer than that in healthy volunteers. Also, the exosomal miR-106b level in the lung cancer patient serum was associated with TNM stages and lymph node metastasis. Furthermore, exosomal miR-106b enhanced the migrated and invasive ability of lung cancer cells and increased the MMP-2 and MMP-9 expression. Mechanistically, exosomal miR-106b could target PTEN, and promote lung cancer cell migration and invasion. More importantly, PTEN overexpression reversed the effect of exosomal miR-106b on lung cancer cell migration and invasion. Taken together, these findings indicate that exosomal miR-106b may be a promising diagnostic biomarker and drug target for patients with lung cancer.

Rationale: Dieulafoy disease of the bronchus is a rare vascular deformity. To the best of our knowledge, reports of these involving both lung vascular are hitherto absent. Patient concerns: A 67-year-old male was admitted to our department due to agnogenic hemoptysis. Diagnoses: Bronchoscopy was performed and some smooth, pulsatile nodular lesions were found in the middle and lower lobes, Computed tomography angiography of the bronchial artery confirmed a left bronchial artery arising from the aortic arch at T4 level, and both bronchial arteries were dilated and tortuous. Interventions: Bronchial artery embolization was performed successfully. Outcomes: The patient was discharged with no hemoptysis. In addition, patient is under follow-up until today without any further incidents. Lessons: This case reminds us that Dieulafoy disease of the bronchus could be a potential etiology for unexplained hemoptysis. The clinician should be aware of this disease when bronchoscopy revealed multiple some smooth, pulsatile nodular lesions, thereafter, bronchoscope biopsy should be avoided, as it could lead to fatal hemoptysis.

Spontaneous hemothorax due to anticoagulant use is extremely rare in clinical practice. Dabigatran is a novel anticoagulant to prevent stroke or thromboembolic episodes in patients with nonvalvular atrial fibrillation. We report on an 83-year-old man who received dabigatran therapy (110 mg twice daily) for 7 months and developed massive spontaneous hemothorax and acute renal failure. The patient was admitted to the hospital with complaint of a dull ache in the chest and dyspnea. Chest computed tomography scan revealed massive pleural effusion in the left hemithorax with atelectasis. Acute renal failure was observed 4 days later after admission. Almost 2500 mL of blood was repeatedly drained by ultrasound-guided thoracocentesis, followed by a dramatic decrease in serum red blood cell count, hemoglobin and hematocrit. After excluding other possible causes, diagnostic withdrawal was performed for dabigatran, and plasma transfusion was conducted to supply the lost blood volume. A causal relationship was established, because the patient’s renal function gradually improved and no further pleural effusion developed after dabigatran was discontinued. This is a rare case report of massive spontaneous hemothorax caused by dabigatran. Therefore, practitioners should be aware of hemothorax as a potential complication of dabigatran therapy.

Spontaneous hemothorax due to anticoagulant use is extremely rare in clinical practice. Dabigatran is a novel anticoagulant to prevent stroke or thromboembolic episodes in patients with nonvalvular atrial fibrillation. We report on an 83-year-old man who received dabigatran therapy (110 mg twice daily) for 7 months and developed massive spontaneous hemothorax and acute renal failure. The patient was admitted to the hospital with complaint of a dull ache in the chest and dyspnea. Chest computed tomography scan revealed massive pleural effusion in the left hemithorax with atelectasis. Acute renal failure was observed 4 days later after admission. Almost 2500 mL of blood was repeatedly drained by ultrasound-guided thoracocentesis, followed by a dramatic decrease in serum red blood cell count, hemoglobin and hematocrit. After excluding other possible causes, diagnostic withdrawal was performed for dabigatran, and plasma transfusion was conducted to supply the lost blood volume. A causal relationship was established, because the patient's renal function gradually improved and no further pleural effusion developed after dabigatran was discontinued. This is a rare case report of massive spontaneous hemothorax caused by dabigatran. Therefore, practitioners should be aware of hemothorax as a potential complication of dabigatran therapy.

In the present study, we assessed the diagnostic value of epidermal growth factor (egf) and cancer antigens 125 (ca125) and 15-3 (ca15-3) in bronchoalveolar lavage fluid (balf) of lung cancer from 79 enrolled patients with suspected lung cancer. All patients underwent fibrescopic examination, during which balf samples were collected. Levels of egf, ca125, and ca15-3 were determined in balf using commercially available test kits. The results showed that levels of egf in balf were significantly higher in patients with lung cancer than in patients with benign diseases (p < 0.01), no significant differences for ca125 (p = 0.67) or ca15-3 (p = 0.43) in balf were observed between the lung cancer patients and the non-cancer control subjects. With a cut-off value of 27.22 pg/mL, egf showed a sensitivity of 63.6% and a specificity of 65.7% in predicting the malignant nature of pulmonary disease. The study findings suggest that levels of egf are significantly increased in balf from patients with lung cancer than in balf from patients with benign disease. Detection of the level of egf in balf is proposed as a noninvasive test to identify patients at high risk for lung cancer.

Background. We evaluated the utility of galactomannan (GM) in bronchoalveolar lavage fluid (BALF) for the diagnosis of invasive pulmonary aspergillosis (IPA) in nonneutropenic patients. Methods. A total of 183 patients were included in the final analysis. Bronchoscopies and the detection of GM in BALF were all performed on them. Results. Ten cases of IPA were diagnosed. ROC data demonstrated that, for diagnosing IPA, an optimal cutoff value for GM in BALF of 0.76 yielded a sensitivity of 100.0% and a specificity of 76.2%. Symptoms and radiological findings had no significant difference between proven or probable IPA group and non-IPA group. In our case-control analysis, although nine patients with false-positive results received treatment with Piperacillin/tazobactam, there was no significant difference between case and control group. Conclusions. BALF GM detection is a valuable adjunctive diagnostic tool. Our retrospective study suggests that the optimal value of GM detection in BALF is 0.76 in nonneutropenic patients.

Genetic susceptibility to asthma has been a research focus in the scientific community. Several studies have been conducted in recent years to evaluate the risk of asthma and insertion/deletion (I/D) polymorphism of angiotensin-converting enzyme (ACE). However, the results remain conflicting rather than conclusive.We carried out a search in Medline, EMBASE, and Chinese National Knowledge Infrastructure (CNKI) database for relevant studies. Data were extracted using a standardized form and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the strength of the association.Our meta-analysis on 11,897 subjects from all available studies showed that the DD genotype was associated with increased asthma risk than those with the II (OR = 1.59, 95% CI = 1.20-2.12) or ID/II (OR = 1.62, 95% CI = 1.24-2.10) genotype. Stratified analyses by ethnicity (Europeans and Asians) and age (adults and children) obtained statistically similar results in the two genetic models. In the subgroup analysis by source of controls, the DD genotype was associated with a significantly elevated risk of asthma among population-based controls (DD vs. II: OR = 2.27, 95% CI = 1.45-3.56) but not hospital-based controls (DD vs. II: OR = 1.18, 95% CI = 0.93-1.49).This meta-analysis provides strong evidence that the I/D polymorphism of ACE is associated with asthma risk. Additional well-designed large studies were required for the validation of our results, especially in African populations.

case of schwannoma with hemorrhagic cystic degeneration in the right upper mediastinum was admitted to the Affiliated Hospital of Ningbo University in July 2010. The patient shows symptoms of cough and shortness of breath. He received video-assisted thoracoscopic resection of right upper mediastinal mass. This disease displayed different symptoms depending on tumor size and location.2011年6月宁波大学附属医院收治右侧上纵隔并伴出血囊性变的神经鞘瘤患者1例，临床表现为气促、咳嗽，采取经胸腔镜右上纵隔肿块切除术，病理证实为神经鞘瘤并伴出血囊性变。本病临床表现不一，主要视肿瘤大小和部位而异。一旦发现，应尽早手术。.

Rationale Eosinophilic pleural effusion (EPE) is an eosinophil count ≥10% in pleural effusion, which is a rare condition in drug therapy. Patient concerns We describe the case of a 70-year-old Alzheimer patient who was taking olanzapine for 2 months for the treatment of depression, and developed peripheral eosinophilia and bilateral EPE. Diagnoses Olanzapine-induced peripheral eosinophilia and eosinophilic pleural effusion was diagnosed. Interventions Olanzapine was discontinued, and repeated drainage of fluid from the pleural cavity was performed. Outcomes All symptoms-as well as the EPE-were resolved 6 months later. Lessons This case is a reminder that olanzapine may be a potential agent for EPE, and that this should be considered in clinical practice.

Objective To explore the expression of HER4 in gastric carcinoma and elucidate the relationship between its overexpression and clinical pathology.

There has been significant interest in the association between asthma and the polymorphisms of IL-17A and IL-17F for a period of time. This work aims to present a clearer relationship between asthma and the polymorphisms of IL-17A and IL-17F.Searches were performed in Medline, EMBASE, and the Chinese National Knowledge Infrastructure (CNKI) databases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the relationship between polymorphisms of IL-17A and IL-17F and asthma.Nine studies comprising 3650 asthmatics and 3370 controls were included in this meta-analysis for all single nucleotide polymorphisms (SNPs) (2-6 per SNP). Our study examined the polymorphisms of IL-17F rs1889570 (C/T) (CC versus TT: OR = 0.55, 95%CI = 0.41-0.75; CT versus TT: OR = 0.54, 95%CI = 0.40-0.72; CC/CT versus TT: OR = 0.55, 95%CI = 0.42-0.72; CC versus CT/TT, OR = 1.83, 95%CI = 1.39-2.41), IL-17A rs4711998(A/G) (AA/AG versus GG: OR = 0.67, 95%CI = 0.46-0.98), and IL-17A rs3819024(A/G) (AA versus GG: OR = 1.77, 95%CI = 1.39-2.25) and found they were significantly related to the risk of asthma.Our systematic review showed that IL-17F rs1889570(C/T), IL-17A rs4711998(A/G) and IL-17A rs3819024(A/G) may be potential risk factors for asthma susceptibility.

Genetic susceptibility to obstructive sleep apnea (OSA) has been a research focus in the scientific community in the past few years. In this study, we recruited 375 subjects to investigate whether functional polymorphisms in the promoter region of matrix metalloproteinase (MMP)-2 (-1306C/T) and MMP-9 (-1562C/T) increased susceptibility to OSA. Our study showed no significant association between MMP-2 -1306C/T polymorphism and risk of OSA (T vs. C: OR = 1.01, 95% CI = 0.67–1.52; P = 0.97). Compared with the MMP-9 -1562C allele, the -1562T allele was associated with increased risk of OSA (T vs. C: OR = 1.56, 95% CI = 1.02–2.39; P = 0.04). However, neither MMP-2 -1306C/T nor MMP-9 -1562C/T polymorphism was found to be associated with severity of the disease. Our study suggested that the MMP-2 -1306C/T polymorphism was not associated with OSA susceptibility, whereas the MMP-9 -1562T allele was associated with increased risk of OSA.

Aberrant DNA methylation can be a potential genetic mechanism in non-small cell lung cancer (NSCLC). However, inconsistent findings existed among the recent association studies between cigarette smoking and gene methylation in lung cancer. The purpose of our meta-analysis was to evaluate the role of gene methylation in the smoking behavior of NSCLC patients. A total of 116 genes were obtained from 97 eligible publications in the current meta-analyses. Our results showed that 7 hypermethylated genes (including CDKN2A, RASSF1, MGMT, RARB, DAPK, WIF1 and FHIT) were significantly associated with the smoking behavior in NSCLC patients. The further population-based subgroup meta-analyses showed that the CDKN2A hypermethylation was significantly associated with cigarette smoking in Japanese, Chinese and Americans. In contrast, a significant association of RARB hypermethylation and smoking behavior was only detected in Chinese but not in Japanese. The genes with altered DNA methylation were likely to be potentially useful biomarkers in the early diagnosis of NSCLC.

Several epidemiological studies have been conducted to examine the association between leptin and leptin receptor (LEPR) gene polymorphisms and risk of obstructive sleep apnea (OSA). However, the results remain conflicting rather than conclusive. The aim of this study was to investigate associations of leptin and LEPR polymorphisms and risk of OSA. We carried out a search in MEDLINE, EMBASE, and Chinese National Knowledge Infrastructure (CNKI) databases for relevant studies. Data were extracted using a standardized form and pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated to assess the strength of the association. Overall, no statistically significant association of OSA risk and polymorphisms of Gln233Arg, Lys109Arg, Lys656Asn, 19A/G, Pro1019Arg, and 2548G/A was found. However, in the stratified analysis by ethnicity, Gln233Arg polymorphism was associated with a significantly decreased risk of OSA in European (homozygote comparison: OR = 0.35, 95 % CI = 0.14–0.85, P = 0.02), but not for Asian population. Our study suggested that leptin and LEPR polymorphisms had no association with OSA risk in all examined patients, whereas there was an association between Gln233Arg polymorphism and OSA risk in Europeans.

Changes of cytokines in bronchoalveolar lavage fluid (BALF) reflect immunologic reactions of the lung in pulmonary malignancies. Detection of biomarkers in BALF might serve as an important method for differential diagnosis of lung cancer. A total of 78 patients admitted into hospital with suspected lung cancer were included in our study. BALF samples were obtained from all patients, and were analyzed for TGF-β1, IL-6, and TNF-α using commercially available sandwich ELISA kits. The levels of TGF-β1 in BALF were significantly higher in patients with lung cancer compared with patients with benign diseases (P = 0.003). However, no significant difference of IL-6 (P = 0.61) or TNF-α (P = 0.72) in BALF was observed between malignant and nonmalignant groups. With a cut-off value of 10.85 pg/ml, TGF-β1 showed a sensitivity of 62.2%, and a specificity of 60.6%, in predicting the malignant nature of pulmonary disease. Our data suggest that TGF-β1 in BALF might be a valuable biomarker for lung cancer. However, measurement of IL-6 or TNF-α in BALF has poor diagnostic value in lung cancer.

To assess the diagnostic value of narrow-band imaging(NBI) in the diagnosis of central lung cancer.Patients (n = 153) suspected of having lung cancer underwent white light bronchoscopy(WLB), NBI and autofluorescence bronchoscopy(AFB) in turn. At least 3 biopsies in each case were taken from sites visualized as lesions. The sensitivity and specificity of NBI, AFB and combination of NBI and AFB were compared.There were 106 male (69.3%) and 47 female patients (30.7%). By NBI, 91 and 62 cases were positive and negative respectively. The sensitivity and specificity of NBI were 63.5% (87/137) and 75.0% (12/16) respectively. By AFB, 140 and 13 cases were positive and negative respectively. The sensitivity and specificity of AFB were 94.2% (129/137) and 87.5% (5/16) respectively. By NBI combined with AFB, 133 and 20 cases were positive and negative respectively, the sensitivity and specificity being 95.6% (131/137) and 87.5% (14/16) respectively. The difference of specificity between NBI plus AFB and AFB alone was significant (P0.01), but the difference of sensitivity between NBI plus AFB and AFB alone(P0.05) was not. The difference of specificity between NBI plus AFB and NBI alone was significant (P0.01), but the P value of specificity between NBI plus AFB and NBI was 0.03.Combination of NBI and AFB could increase the specificity of lung cancer diagnosis compared to AFB alone.

Involvement of epidermal growth factor (EGF) is reported in diseases caused by hypoxia. Its functional polymorphism may alter its transcription, affecting EGF expression, contributing to obstructive sleep apnea (OSA). The aim of this study was to investigate associations of EGF+61 polymorphism and risk of OSA. Two hundred two participants were enrolled in this case–control study. DNA was extracted from peripheral blood, and EGF 61A/G polymorphism was determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. No significant association between EGF 61 A/G polymorphism and risk of OSA was observed in any of the gene models tested (AA vs. GG: OR = 0.97, 95 % CI = 0.37–2.55; P = 0.95). However, compared with GG genotype, AG genotype associated with decreased risk of severe OSA (AG vs. GG: OR = 0.32, 95 % CI = 0.11–0.94). Our study showed that AG genotype has a protective effect on OSA patients against severe disease, although EGF 61A/G polymorphisms have no role on the risk of the disease. Additional large studies should further validate our findings.

A total of 87 patients were enrolled and bronchoalveolar lavage fluid (BALF) samples were obtained from all subjects. A significant difference was found in BALF VEGF-C level between patients with squamous cell carcinoma and benign diseases (P = 0.043). In addition, the concentration of NSE in BALF form the malignant group was significantly higher compared with that of the benign groups (P = 0.018). However, no statistical difference was observed in BALF CEA (P = 0.375) or CYFRA21-1 (P = 0.838) between lung cancer patients and nonmalignant controls. With a cut-off value of 2.06 ng/ml, NSE had a sensitivity of 72.9%, a specificity of 69.2%, respectively, in predicting the malignant nature of pulmonary mass. Our study observed that the level of VEGF-C was increased in BALF of patients with squamous cell carcinoma. Moreover, we found that NSE was significantly higher in BALF of lung cancer patients than in benign diseases.

To detect the expression of human epidermal-growth-factor receptor 4 (HER4) and elucidate the relationship between its overexpression and the clinicopathological characteristics in non-small cell lung cancer (NSCLC).The expression of HER4 was detected in 70 cases of paraffin-embedded NSCLC tissues by immunohistochemical assay.HER4 were overexpressed in 91.4% of NSCLC. The overexpression of HER4 was significantly related to lymph node metastasis (P=0.007), TNM stages (P=0.011) and postoperative survival rate (P= 0.0258).erbB4 is one of the genes to regulate the growth of advanced NSCLC. The artificial interference with HER4 overexpression may be a good way in the treatment of advanced NSCLC.