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High-flow nasal cannulas (HFNCs) have become common devices for patients with respiratory failure who are treated in general wards. Few reports have been published on in-hospital mortality associated with the ratio of oxygen saturation (ROX) index, measured by pulse oximetry/fraction of inspired oxygen to respiratory rate, in patients treated with HFNCs. We aimed to examine in-hospital mortality and associated factors in patients who initiated HFNC use in a general ward. Sixty patients who initiated HFNC use in general wards at Kobe University Hospital between December 2016 and October 2020 were retrospectively enrolled. We assessed in-hospital mortality, comorbidities, and ROX index. The in-hospital mortality was 48.3%, and ROX index values were significantly lower in patients who died than in those who did not (at HFNC oxygen therapy initiation; 6.93 [2.73–18.5] vs. 9.01 [4.62–18.1], p = 0.00861). Although the difference was not statistically significant, the change in ROX index values between HFNC initiation and 12 hours after initiation tended to be greater in the patients who died in the hospital (0.732 [−2.84–3.5] vs. −0.35[−4.3–2.6], p = 0.0536). Lower ROX index values may be associated with the in-hospital death of patients who are treated with HFNCs in general wards.

Ratoe Suraya, Motoko Tachihara, Tatsuya Nagano, Yoshihiro Nishimura, Kazuyuki Kobayashi Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, JapanCorrespondence: Motoko Tachihara, Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan, Tel +81-78-382-5660, Fax +81-78-382-5661, Email mt0318@med.kobe-u.ac.jpAbstract: Non-small-cell lung cancer (NSCLC) is a major health burden, and novel therapeutic options are needed to help solve this problem. One such option is immunotherapy, which targets immune checkpoint molecules that inhibit cancer cells, decreasing immune system activation, for example, immunotherapies target PD-1, its ligand PD-L1, and CTLA-4. There have been major advances in the development of agents that inhibit these molecules, called immune checkpoint inhibitors, and several of them are already approved for usage in NSCLC patients, especially in advanced stages. In this review, the reasons why immune checkpoint inhibitors could be beneficial and the clinical results of studies using these drugs for advanced or recurrent NSCLC patients are discussed, as is the safety profile of the drugs.Keywords: non-small cell lung cancer, immune checkpoint inhibitors, PD-1, PD-L1, CTLA-4

Nanako Miwa,1 Tatsuya Nagano,1 Naoe Jimbo,2 Ryota Dokuni,1 Tatsunori Kiriu,1 Chihiro Mimura,1 Yuichiro Yasuda,1 Masahiro Katsurada,1 Masatsugu Yamamoto,1 Motoko Tachihara,1 Yugo Tanaka,3 Kazuyuki Kobayashi,1 Tomoo Itoh,2 Yoshimasa Maniwa,3 Yoshihiro Nishimura1 1Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan; 2Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan; 3Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanCorrespondence: Tatsuya Nagano Tel +81 78 382 5660Fax +81 78 382 5661Email tnagano@med.kobe-u.ac.jpPurpose: Caspase recruitment domain-containing protein 9 (CARD9) is expressed at high levels in bone marrow cells and has a crucial role in innate immunity. Current studies indicate that CARD9 also plays a key role in tumor progression, but there are few reports on the role of CARD9 in lung cancer. The aim of this study was to clarify the role of CARD9 in lung adenocarcinoma.Patients and Methods: Lung adenocarcinoma tumor samples from 74 patients who underwent complete resection at Kobe University Hospital from January 2014 to December 2014 were analyzed by immunohistochemistry. The role of CARD9 in cancer cells was analyzed using lung cancer cell lines treated with CARD9 siRNA.Results: High expression of CARD9 was observed in 32.4% of tumors, and compared to low expression of CARD9, high expression was associated with poorer overall survival (P = 0.0365). Univariate and multivariate analyses showed that high expression of CARD9 was an independent prognostic factor. Knockdown of CARD9 in lung adenocarcinoma cells inhibited proliferation but did not increase apoptosis. In addition, CARD9 activated the NF-κB pathway in a lung adenocarcinoma cell line.Conclusion: CARD9 was shown to be an independent prognostic factor of poor outcome for lung cancer and may represent a molecular target for treatment.Keywords: CARD9, lung adenocarcinoma, spiral array, immunohistochemistry

Additional file 3. Uncut blotting images for Budesonide/Glycopyrronium /Formoterol Fumarate Triple Therapy Prevents Pulmonary Hypertension in a COPD Mouse Model via NFκB Inactivation.

Additional file 1: Table S1. List of primers used for qPCR analysis.

Additional file 1. Questionnaire.

Additional file 2: Figure S1. Lymphocyte counts in the BAL fluid of mice from all experimental groups 1 day post-elastase treatment. Figure S2. Immunostaining VEGF-A (A), eNOS (B), and Ki 67 (C) in the lung vasculature of mouse lung of all experimental groups at Pulmonary Hypertension phase. Scale bar:50 uM. Black arrows indicate vessel.