Search

Objectives: Tracheobronchial foreign body aspiration (TFBA) is a major cause of accidental death in children. Lower respiratory tract infection (LRTI) may be caused by TFBA, but there are few reports about LRTI associated with TFBA. This study collected TFBA cases in our hospital to analyze LRTI and determine its risk factors. Methods: A total of 194 children who underwent tracheobronchial foreign body (TFB) extraction in The Children's Hospital of Zhejiang University School of Medicine from June 2019 to April 2020 were enrolled. CT chest is routinely used in the workup of suspected airway FB at our institution to evaluate for patients, a FB was already highly suspected. The retention time was defined as from the time of TFB inhalation or presentation (if there was no history of TFBA) to the time of TFB removal. General characteristics including weight, clinical symptoms, operative records, cervicothoracic CT, retention time, type of TFB and postoperative hospitalization time were collected. Chi-square tests, rank sum tests and multivariate logistic regression analyses were performed. Results: The incidence of LRTI was 46.6%, 68.6%, and 68.6% when the retention time was within 24 hours, between 24 hours and up to 1 week and more than 1 week, respectively. Postoperative hospitalization time of LRTI group was significantly longer than that of non-LRTI group. Findings for cervicothoracic CT as pneumonia, emphysema, atelectasis meant more serious clinical manifestations and the retention time was longer in the LRTI group than in the non-LRTI group. There was a positive correlation between the retention time of a TFB and LRTI in multivariate logistic regression analysis. Conclusions: The incidence of LRTI caused by TFBA is high. LRTI is association with longer postoperative hospitalization time. The TFB retention time is an independent risk factor for LRTI. If a patient presents with significant LRTI symptoms, a course of steroids and antibiotics maybe a safer approach rather than proceeding immediately with bronchoscopic removal. [ABSTRACT FROM AUTHOR]

In recent years, single-cell RNA sequencing analyses have identified multiple subpopulations of these cells in brains harboring Alzheimer's disease (AD) pathology. Consequently, ablation of IFN-I receptor gene selectively from neural cells reduces A plaques in a mouse AD model [[6]], affirming a feedforward loop whereby plaque-induced inflammation further exacerbates AD pathology. Nevertheless, the IFN-II receptor gene dose is similarly elevated as that of IFNARs in DS [[10]], and IFN-II was shown to counteract the pathogenic effect of IFN-I in aging brain [[15]]. Reactive microglia accompany many neurodegenerative conditions and their contribution to disease progression is increasingly appreciated. [Extracted from the article]

There is an increasing number of studies on the transradial approach (TRA) for carotid artery stenting. We aimed to summarize the published data on TRA vs the transfemoral approach (TFA). We searched Science Direct, Embase, PubMed, and Web of Science databases for the relevant literature. Primary outcomes included surgical success and cardiovascular and cerebrovascular complication rates; secondary outcomes included the rates of vascular access-related and other complications. We also compared the crossover rate, success rate, and complications between TRA and TFA carotid stenting. This is the first such meta-analysis regarding TRA and TFA. Twenty studies on TRA carotid stenting were included (n = 1300). Among 19 studies, the success rate of TRA carotid stenting was.951 (95% confidence interval [CI]:.926–.975); death rate was.022 (.011–.032); stroke rate was.005 (.001–.008); radial artery occlusion rate was.008 (.003–.013); and forearm hematoma rate was.003 (−.000 to.006). Among 4 studies comparing TRA and TFA, the success rate was lower (odds ratio:.02; 95% CI:.00–.23) and crossover rate was higher (odds ratio: 40.16; 95% CI: 4.41–365.73) with TRA. Thus, transradial neuro-interventional surgery has a lower success rate than TFA. [ABSTRACT FROM AUTHOR]

Background: Screening with low‐dose computed tomography (LDCT) is an efficient way to detect lung cancer at an earlier stage, but has a high false‐positive rate. Several pulmonary nodules risk prediction models were developed to solve the problem. This systematic review aimed to compare the quality and accuracy of these models. Methods: The keywords "lung cancer," "lung neoplasms," "lung tumor," "risk," "lung carcinoma" "risk," "predict," "assessment," and "nodule" were used to identify relevant articles published before February 2021. All studies with multivariate risk models developed and validated on human LDCT data were included. Informal publications or studies with incomplete procedures were excluded. Information was extracted from each publication and assessed. Results: A total of 41 articles and 43 models were included. External validation was performed for 23.2% (10/43) models. Deep learning algorithms were applied in 62.8% (27/43) models; 60.0% (15/25) deep learning based researches compared their algorithms with traditional methods, and received better discrimination. Models based on Asian and Chinese populations were usually built on single‐center or small sample retrospective studies, and the majority of the Asian models (12/15, 80.0%) were not validated using external datasets. Conclusion: The existing models showed good discrimination for identifying high‐risk pulmonary nodules, but lacked external validation. Deep learning algorithms are increasingly being used with good performance. More researches are required to improve the quality of deep learning models, particularly for the Asian population. [ABSTRACT FROM AUTHOR]

Objective: Unicystic ameloblastomas are a variant of ameloblastoma with a definite recurrence rate because of the biological behaviours of the tumour. The risk factors associated with disease recurrence were analysed in this retrospective study. Methods: A total of 132 patients with primary unicystic ameloblastoma reported in a tertiary hospital from 2005 to 2015 were analysed to identify the clinic‐pathological and radiological factors associated with recurrence using univariate and multivariate Cox regression analyses. Results: The mean volume was 30.54cm3 ± 12.55 cm3, and this value differed significantly according to recurrence (p < 0.001). Root resorption and bone cortex/soft tissue invasion were also significantly associated with recurrence among unicystic ameloblastoma patients (p = 0.017 vs. p < 0.001, respectively). A new stage classification system was developed to predict disease recurrence of patients. The multivariate Cox regression analysis revealed that the new stage classification system was the only predictor of disease recurrence in unicystic ameloblastoma patients (p < 0.001), regardless of root resorption, position and site characteristics. Conclusions: Volume, root resorption and bone cortex/soft tissue invasion were risk factors for disease recurrence among unicystic ameloblastoma patients. The new stage classification was an independent predictor of disease recurrence in patients with unicystic ameloblastoma. [ABSTRACT FROM AUTHOR]

Background: Comorbidity of Myasthenia gravis (MG) and Graves' disease (GD) in treated HIV‐infected individuals has rarely been described and little study has been done on the link between HIV‐related immune reconstitution and autoimmune diseases occurring post antiretroviral therapy. Case Presentation: Here we report on a 33‐year‐old Chinese man with HIV infection who had been virologically suppressed since 2018. The patient was diagnosed with GD and was treated in 2020. Early in 2022, he developed fluctuating weakness and fatigue involving the bilateral extraocular muscles and limbs. With a positive neostigmine test, he was considered to have MG, but showed a poor response to oral medication. After multiple failed medication attempts, a thymectomy was finally performed to resolve his symptoms. The consecutive onset of immunological events may have partially resulted from immune reconstitution after viral control. Conclusions: This is a rare case of HIV‐related immune reconstitution‐associated autoimmune disease (IRAD) with comorbidity of MG and GD which was reported initially. Cooperation with multidisciplinary teams is essential to avoid misdiagnosis and to promote the overall health of HIV‐infected patients. [ABSTRACT FROM AUTHOR]

Background. Esophageal squamous cell carcinoma (ESCC) is a common second primary neoplasia in patients with a history of head and neck squamous cell carcinoma (HNSCC). The aim of this study was to provide further information and novel insights into the risk factors for ESCC in patients with HNSCC. Methods. We retrospectively analyzed 98 HNSCC patients diagnosed from 2007 to 2017, 30 HNSCC patients suffering from ESCC, who had undergone endoscopic examination because of positive imaging examinations or symptoms, and 68 HNSCC patients who had no ESCC occurrence for at least six years post-HNSCC diagnosis. Associated clinicopathological data and lifestyle information of the ESCC group and the without ESCC group were collected, and a case-control study of risk factors was analyzed between the two groups. Results. The majority (83.4%) of the cases with HNSCC esophageal cancers were male patients over 50 years. We established that 93.75% (30/32) of the ESCC occurred within six years after HNSCC diagnosis. HNSCC location, stage, and radiotherapy history had no significant association with the development of ESCC. High Ki67 labeling index (Ki67 LI) (>46) patients tended to be 3.1 times (95% CI = 1.3–7.6) more likely to develop ESCC compared to low Ki67 LI (≤45) patients (P < 0.05). Drinkers with alcohol flushing response were at a 3.3 times higher risk to have ESCC (95% CI = 1.0–10.4) than drinkers without flush response (P < 0.05). Conclusions. HNSCC patients, especially drinkers with an alcohol flushing response, as well as those with high Ki67 LI of HNSCC tissue, were more likely to develop ESCC. [ABSTRACT FROM AUTHOR]

Background: To investigate the association between the risk of lung cancer and short‐term body mass index (BMI) changes in male never‐smokers of a large population‐based prospective study. Methods: A total of 37,085 male never‐smokers from Kailuan cohort with at least ≥2 BMI measurements were recruited in the present study. The BMI change in the follow‐up was calculated as the annual percent change between BMI at last examination and that at baseline, and categorized into five groups: stable (−0.1 to <0.1 kg/m2/year), minor loss (−1.0 to <0.1 kg/m2/year) or gain (0.1 to <1.0 kg/m2/year), and major loss (<−1.0 kg/m2/year) or gain (≥1.0 kg/m2/year). The hazards ratios (HRs) and its 95% confidence intervals (CI) were estimated using Cox regression models. Results: During a median follow‐up of 5.16 years, 224 lung cancer cases were identified. We found a U‐shaped association between BMI changes and lung cancer risk. Compared to men with stable BMI, those with major loss had a nearly twofold higher risk of lung cancer (HR = 1.97, 95% CI: 1.12–3.45), as well as those with major gain had more than twofold higher risk of lung cancer (HR = 2.15, 95% CI: 1.15–4.02). The associations existed when the analysis was stratified by BMI, waist circumference and blood lipids, and lipoproteins concentration at baseline examination. Conclusions: The dramatic changes in BMI, both gain and loss, might increase lung cancer risk. The control of body weight would be a potential way for lung cancer prevention especially for the nonsmokers. [ABSTRACT FROM AUTHOR]

Diabetes is directly related to the risk of breast cancer (BC) occurrence and worsened BC prognosis. Currently, there are no specific treatments for diabetes‐associated BC. This paper aims to understand the fundamental mechanisms of diabetes‐induced BC progression and to develop personalized treatments. It reports a metabolic reprogramming strategy (MRS) that pharmaceutical induction of glucose import and glycolysis with metformin and NF‐κB inhibitor (NF‐κBi) while blocking the export of excessive lactate via inhibiting monocarboxylate transporter 4 (MCT4) leads to a metabolic crisis within the cancer cells. It demonstrates that the MRS shifts the metabolism of BC cells toward higher production of lactate, blocks lactate secretion, prompts intracellular acidification and induces significant cytotoxicity. Moreover, a novel MCT4 inhibitor CB‐2 has been identified by structure‐based virtual screening. A triple combination of metformin, CB‐2, and trabectedin, a drug that impedes NF‐κB signaling, strongly inhibits BC cells. Compared to normal glucose condition, MRS elicits more potent cancer cell‐killing effects under high glucose condition. Animal model studies show that diabetic conditions promote the proliferation and progression of BC xenografts in nude mice and that MRS treatment significantly inhibits HG‐induced BC progression. Therefore, inhibition of MCT4 combined with metformin/NF‐κBi is a promising cancer therapy, especially for diabetes‐associated BC. [ABSTRACT FROM AUTHOR]