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BACKGROUND: Transbronchial lung biopsy (TBLB) was a useful method for the diagnosis of peripheral pulmonary nodules (PPNs), but the smaller tissue samples obtained often could not meet the subsequent molecular pathological diagnosis. The purposes of this study were to assess the diagnostic yield of virtual bronchoscope navigation (VBN) combined with radial endobronchial ultrasound (rEBUS) guided transbronchial cryo-biopsy (TBCB) and to compare it with TBLB. METHODS: Patients with PPNs, who planned to undergo bronchoscopy and were admitted to Henan Provincial People’s Hospital and Zhoukou Central Hospital from January 1, 2020 to December 31, 2020, were divided into the TBCB group (experimental group) and TBLB group (control group) using the block randomization method. TBCB and TBLB were performed with the guidance of VBN-rEBUS. The diagnostic yields, complications, specimen surface areas, and operation times were observed. The differences between the two groups were measured by the independent sample t-test or Chi-square test. RESULTS: A total of 152 patients were enrolled, of whom 138 completed the study, and 102 received a definite diagnosis by bronchoscopy. The diagnostic yield showed no statistically significant difference between TBCB group and TBLB group (79.1% vs. 69.0%, P=0.124). For PPNs with the diameter

Background: Lung adenocarcinoma (LUAD) remains the most common type of lung cancer and is associated with distant metastasis and poor prognosis. Epithelial-mesenchymal transition (EMT) plays crucial roles in carcinogenesis, embryogenesis, and wound healing. EMT-related molecules may be adopted for early diagnosis and prognosis of cancer and targeting them may constitute an attractive strategy for treatment. This study aims to identify the EMT-related long non-coding RNAs (lncRNAs) and develop a risk signature to accurately predict the prognosis of LUAD patients. Methods: The RNA-seq data and corresponding clinical profiles were obtained from LUAD cohort of The Cancer Genome Atlas (TCGA) database. EMT-related lncRNAs significantly associated with prognosis were identified by Pearson correlation analysis and univariate regression analysis. Subsequently, an EMT-related prognostic risk signature was developed through LASSO and multivariate regression analyses. Kaplan Meier and receiver operating characteristic curve analysis were implemented to assess the predictive performance of the signature. The nomogram was constructed to predict the 1-year, 3-year, and 5-year overall survival of LUAD patients. Additionally, enrichment analyses were carried out to identify probable biologic processes and cellular pathways involved in the signature. The correlation of immune cell infiltration and risk score was also evaluated by CIBERSORT algorithm. Finally, we constructed a ceRNA network to further study possible downstream targets and molecular mechanisms of EMT-related lncRNAs in LUAD. Results: Eight EMT-related lncRNAs were identified to develop a prognostic risk signature in LUAD. Patients with high-risk scores had worse survival outcomes than those with low-risk scores. The signature showed robust predictive potential, and was verified to be an independent prognostic factor. Moreover, the risk score based on the signature was significantly correlated with immune cell infiltration in LUAD. Conclusions: We established and validated a prognostic signature that reflects the tumor microenvironment characteristics and predicts the outcomes for LUAD.

Objective To evaluate the efficacy of the Archimedes Navigation System (Broncus Medical, San Jose, CA, USA) for guidance during transbronchial cryobiopsy and the incidence of complications in patients with diffuse lung disease. Methods High-resolution computed tomography and transbronchial cryobiopsy were used to evaluate eight patients with diffuse lung disease. The Archimedes Navigation System was used before cryobiopsy to obtain the best path with which to avoid large vessels. Three to five cryobiopsy specimens were taken from each sampled segment. Results Preoperative planning using the Archimedes Navigation System was successfully performed on all eight patients. The probe-to-pleura distance was approximately 10 mm. No cases of pneumothorax occurred, one patient developed moderate bleeding, two developed minor bleeding, and five developed minimal bleeding that stopped spontaneously. A final diagnosis was obtained for seven patients, and ongoing follow-up was being conducted for the last patient at the time of this writing. Conclusions This is the first report of combining navigation technology with cryobiopsy to diagnose diffuse lung disease. The Archimedes Navigation System, which provides real-time guidance, is helpful in pre-cryobiopsy planning and diagnosis of diffuse lung disease. Moreover, this system can reduce the pneumothorax rate and bleeding risk by avoiding large vessels.

Background: The initial outbreak of coronavirus disease 2019 (COVID-19) pandemic has rapidly extended globally, which brought huge detrimental to the whole society. While some countries and regions are currently experiencing another outbreak of COVID-19. Methods: In this study, by using the epidemic data from January 2 to February 11, 2021 in city Shijiazhuang, an extended SEIR model was established to evaluate the effectiveness of emergency response, nucleic acid testing (NAT) and stay-at-home order for all individuals, and to simulate the impact of delayed interventions. Findings: We estimated an initial effective reproduction number (Rt) was 4·70, and the Rt value gradually decreased with the implementation of government interventions. Meanwhile, the final cumulative number of confirmed cases decreased by 99·99% (898 cases), and peak of current confirmed cases decreased by 99·99% (763 cases) compared with that without intervention. With fewer interventions, the number of infected individuals will continue to increase. Delayed interventions were simulated which would show at least 80% (1614 cases), 218% (2854 cases), 464% (5061 cases), and 879% (8787 cases) more infections can be attained for Shijiazhuang city, if the intervention was delayed by 2, 4, 6, and 8 days, respectively. Interpretation: The Shijiazhuang government has effectively controlled the spread of the epidemic by adopting a series of comprehensive non-pharmacological interventions in time. Funding Information: The study was supported by grants from the National Social Science Foundation of China (20BRK041). Declaration of Interests: The authors declare that they have no competing interests.

Understanding disease-associated stem cell abnormality has major clinical implications for prevention and treatment of human disorders, as well as for regenerative medicine. Here we report a multifaceted study on airway epithelial stem cells in Tracheobronchopathia Osteochondroplastica (TO), an under-detected tracheobronchial disorder of unknown etiology and lack of specific treatment. Epithelial squamous metaplasia and heterotopic bone formation with abnormal cartilage proliferation and calcium deposits are key pathological hallmarks of this disorder, but it is unknown whether they are coincident or share certain pathogenic mechanisms in common. By functional evaluation and genome-wide profiling at both transcriptional and epigenetic levels, we reveal a role of airway basal cells in TO progression by acting as a repository of inflammatory and TGFβ-BMP signals, which contributes to both epithelial metaplasia and mesenchymal osteo-chondrogenesis via extracellular signaling and matrix remodeling. Restoration of microenvironment by cell correction or local pathway intervention may provide therapeutic benefits.

An outbreak of COVID-19 has spread worldwide, and it is urgent to evaluate risk factors associated with severe cases. We aimed to identify risk factors for severe patients with COVID-19. A total of 52 patients with COVID-19 admitted to Henan Provincial People’s Hospital were enrolled in this study, and patients’ information was extracted from electronic medical records. The severity of symptoms of COVID-19 was divided into “mild” and “severe.” Univariate analysis was used to select potential risk factors. A risk model was constructed using multivariable logistic regression analysis. Advanced age (OR = 1.098, 95% CI = 1.020-1.183) and number of comorbidities (OR = 6.067, 95% CI = 1.078-34.143) were significant risk factors for severe patients with COVID-19. The comorbidities included hypertension, diabetes, cardiovascular disease, respiratory disease, and past surgical history. A risk score was developed based on this model, and the developed risk prediction model had good discriminative power and was well-calibrated. This study indicates that advanced age and comorbidities are risk factors for severe patients with COVID-19. More attention should be paid to high-risk patients during hospitalization.

Background: SARS-CoV-2 is causing a worldwide health crisis We aimed to present clinical and CT features for a cohort of patients in Henan, China with more foc

Background/aim Multidrug resistance (MDR) is often associated with overexpression of P-glycoprotein (ABCB1) in cancer cells. Apatinib is a novel Vascular endothelial growth factor receptor-TKI (VEGFR-TKI) which inhibits the function of ABCB1 in certain cancers. This study aimed to investigate the effect of apatinib on the reversal of paclitaxel (PTX) resistance in A549 lung cancer cells (A549/PTX) and related mechanisms. Materials and methods A549/PTX cells were treated with apatinib alone, PTX alone, or PTX and apatinib. Cell viability was measured by the CCK8 assay. Apoptosis rate, cell-cycle arrest, Rhodamine efflux and reactive oxygen species (ROS) generation were determined by flow cytometry. The intracellular paclitaxel concentration was measured by ultra performance liquid chromatography (UPLC). Protein levels were analyzed by western blotting. Results A549/PTX cells had significant resistance to PTX and higher expression of ABCB1 compared to A549 cells. Apatinib increased the cytotoxicity of PTX, enhanced PTX-induced apoptosis and cycle arrest, and triggered intracellular ROS generation in A549/PTX cells. In addition, apatinib treatment increased the concentration of intracellular PTX in A549/PTX cells. Apatinib-PTX combination inhibited AKT and ERK pathways. Conclusion Apatinib reverses the drug resistance to PTX in A549 PTX-resistant cells through inhibiting the function of ABCB1 and resumes anti-cancer effects.

Long noncoding RNAs (lncRNAs) have been demonstrated to play significant roles in non-small cell lung cancer (NSCLC) progression. Recently, a newly identified lncRNA, LncRNA LINC00668 (LINC00668), was reported to be involved in the regulation of progression of several tumors. However, the expression pattern and biological function of LINC00668 in NSCLC remains largely unclear. In this study, we found that LINC00668 expression was significantly up-regulated in both NSCLC tissues and cell lines. we also showed that LINC00668 upregulation was induced by transcription factor STAT3. Clinical investigation demonstrated that high expression level of LINC00668 was associated with advanced TNM stage, histological grade and lymph node metastasis. Moreover, multivariate analysis confirmed LINC00668 expression level to be an independent prognostic indicator for overall survival of NSCLC patients. Functional assays indicated that knockdown of LINC00668 suppressed NSCLC cells proliferation, migration and invasion, and promoted apoptosis. Mechanistic studies indicated that LINC00668 is a direct target of miR-193a, leading to down-regulation in the expression of its target gene KLF7. Our findings suggested that STAT3-induced LINC00668 contributed to NSCLC progression through upregulating KLF7 expression by sponging miR-193a, and may serve as a prognostic biomarker and a potential target for NSCLC.