Jun She

Purpose To assess the benefits of the traditional Chinese medicine (TCM) Qufenghuoxue formula, on the treatment of chemotherapy-induced peripheral neuropathy (CIPN) in patients with lung cancer receiving paclitaxel (PTX). Methods Patients with CIPN grading 2–3 were randomly assigned to three groups of TCM, vitamin B1, or warm water. The intervention duration consisted of four cycles, 3 weeks each, coinciding with the follow-up period. Primary efficacy endpoint was the proportion of patients achieving CIPN relief, defined by reduction in CIPN severity grade, while secondary endpoint evaluated completion of the recommended PTX dosing. Results TCM significantly reduced grade 2–3 CIPN incidence and increased symptom relief (48.6% vs 12.0% vs 7.5%; P < 0.001) with a shorter median time to recovery compared with vitamin B1 and warm water, respectively. Additionally, it improved scores of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity subscale (11.5 vs 20.4 vs 22.4), neuropathy pain scale (16.8 vs 27.7 vs 29.2) and quality of life (42.6 vs 36.0 vs 33.6; all P < 0.001) and also showed greater potential of completing the recommended dose level of PTX (83.8% vs 74.6% vs 59.7%; P = 0.0034) compared with vitamin B1 and warm water. With warm water as reference, the hazard ratio of PTX dose reductions/cessation due to CIPN was 0.34 (95% confidence interval [CI]: 0.168–0.67, P = 0.002) for TCM and 0.56 (95% CI: 0.314–1.008; P = 0.053) for vitamin B1. Conclusion Qufenghuoxue formula may be a promising strategy for the treatment of CIPN in patients receiving PTX. Trial Registration Chinese Clinical Trial Registry; No.: ChiCTR2300069949. Registered 30 March 30, 2023, URL: www.chictr.org/cn/.

Metastatic pulmonary angiosarcoma exhibits highly heterogeneous clinical, imaging and pathological features, with an extremely poor prognosis. This case report describes a 30‐year‐old woman who presented with recurrent hemoptysis and multiple pulmonary nodules with exudative changes in the lung, pathologically resembling granulomatous lesions and eventually confirmed as primary cardiac angiosarcoma with pulmonary metastasis. Twenty‐two cases of metastatic pulmonary angiosarcoma from the literature were reviewed. For cases with recurrent hemoptysis, multiple pulmonary nodules or thin‐walled cysts and ‘halo sign’ or ground‐glass opacities, metastatic pulmonary angiosarcoma should be highly suspected. Histopathology remains the gold standard for diagnosis. Early biopsies or small biopsy specimens carry a risk of false negativity; adequate tissue samplings are essential to improve diagnostic accuracy.

Background: Little attention has been paid to the pathophysiological changes in the natural history of chronic obstructive pulmonary disease (COPD). The destructions of the small airways were visualized on thoracic micro-computed tomography scan. We investigated whether small airway inflammation (SAI) was the risk for the development of COPD. Methods: A total of 1062 patients were enrolled and analyzed in the study. The partitioned airway inflammation was determined by exhaled nitric oxide (NO) of FnNO, FeNO₅₀, FeNO₂₀₀, and calculated CaNO_dual. Both FeNO₂₀₀ and CaNO_dual were compared to detect the promising predictor for peripheral airway/alveolar inflammation in COPD. The correlation between exhaled NO and white cell classification was evaluated to determine the inflammation type during the development of COPD. Results: Exhaled NO levels (FnNO, FeNO₅₀, FeNO₂₀₀, and CaNO_dual) were the highest in the COPD group compared with all other groups. Furthermore, compared with controls, exhaled NO levels (FeNO₅₀, FeNO₂₀₀, and CaNO_dual) were also significantly higher in the emphysema, chronic bronchitis, and smoking groups. FeNO₂₀₀ was found to be a promising predictor for peripheral airway/alveolar inflammation (area under the curve [AUC] of the receiver operating characteristic [ROC] curve, area under the curve [AUC] = 0.841) compared with CaNO_dual (AUC ROC = 0.707) in COPD. FeNO₂₀₀ was the main risk factor (adjusted odds ratio, 2.191; 95% CI, 1.797–2.671; p = 0.002) for the development of COPD. The blood eosinophil and basophil levels were correlated with FeNO₅₀ and FeNO₂₀₀. Conclusion: The complete airway inflammations were shown in COPD, whereas SAI was the main risk factor for the development of COPD, which might relate to eosinophil and basophil levels.

Background: Acute respiratory distress syndrome (ARDS) is a disease with high mortality and morbidity. Regulator of G protein signaling protein 6 (RGS6), identified as a tumor suppressor gene, has received increasing attention owing to its close relationship with oxidative stress and inflammation. However, the association between ARDS and RGS6 has not been reported. Methods: Congruously regulated G protein-coupled receptor (GPCR)-related genes and differentially expressed genes (DEGs) in an acute lung injury (ALI) model were identified, and functional enrichment analysis was conducted. In an in vivo study, the effects of RGS6 knockout were studied in a mouse model of ALI induced by lipopolysaccharide (LPS). HE staining, ELISA, and immunohistochemistry were used to evaluate pathological changes and the degree of inflammation. In vitro, qRT‒PCR, immunofluorescence staining, and western blotting were used to determine the dynamic changes in RGS6 expression in cells. The RGS6 overexpression plasmid was constructed for transfection. qRT‒PCR was used to assess proinflammatory factors transcription. Western blotting and flow cytometry were used to evaluate apoptosis and reactive oxygen species (ROS) production. Organoid culture was used to assess the stemness and self-renewal capacity of alveolar epithelial type II cells (AEC2s). Results: A total of 110 congruously regulated genes (61 congruously upregulated and 49 congruously downregulated genes) were identified among GPCR-related genes and DEGs in the ALI model. RGS6 was downregulated in vivo and in vitro in the ALI model. RGS6 was expressed in the cytoplasm and accumulated in the nucleus after LPS stimulation. Compared with the control group, we found higher mortality, more pronounced body weight changes, more serious pulmonary edema and pathological damage, and more neutrophil infiltration in the RGS6 knockout group upon LPS stimulation in vivo. Moreover, AEC2s loss was significantly increased upon RGS6 knockout. Organoid culture assays showed slower alveolar organoid formation, fewer alveolar organoids, and impaired development of new structures after passaging upon RGS6 knockout. In addition, RGS6 overexpression decreased ROS production as well as proinflammatory factor transcription in macrophages and decreased apoptosis in epithelial cells. Conclusions: RGS6 plays a protective role in ALI not only in early inflammatory responses but also in endogenous lung stem cell regeneration. Graphical

Background: Data that guide selection of differing anticoagulant regimens for specific cancer-associated venous thromboembolism (VTE) are lacking. We aimed to compare the efficacy and safety of rivaroxaban and low-molecular-weight heparin (LMWH) against nonhigh-risk pulmonary embolism (PE) in Chinese lung cancer patients. Methods: Four hundred forty-six Chinese lung cancer patients with nonhigh-risk PE who initiated treatment with rivaroxaban or LMWH were identified from Zhongshan Hospital database from 2016 to 2020. The primary outcomes were the composite event of VTE recurrence or major bleeding, and all-cause mortality. The secondary outcomes were VTE recurrence, major bleeding and clinically relevant non-major bleeding (CRNMB). Propensity score matching was used to balance baseline covariates. We conducted sensitivity analysis by stabilized inverse probability of treatment weighting and competing risk analysis by a Fine and Gray subdistribution hazard model. Results: In propensity score-matched cohorts, rivaroxaban was similar to LMWH in the risks of the composite outcome (hazard ratio (HR), 0.73; 95% confidence interval (CI), 0.45–1.21; P = 0.22), VTE recurrence (HR, 0.69; 95% CI, 0.36–1.34; P = 0.28), major bleeding (HR, 0.79; 95% CI, 0.37–1.68; P = 0.54) and CRNMB (HR, 1.13; 95% CI, 0.62–2.09; P = 0.69). All-cause mortality was significantly lower in rivaroxaban group than LMWH group (HR, 0.52; 95% CI, 0.36–0.75; P < 0.001). The primary and secondary outcomes favored rivaroxaban over LMWH in all the subgroups expect for central PE and intermediate-risk PE. The sensitivity analysis yielded similar results, and competing risk analysis was in accordance with the primary findings. Conclusions: Rivaroxaban might be a promising alternative to LMWH as initial treatment for nonhigh-risk PE in lung cancer patients.

Coronavirus disease 2019 (COVID‐19), the highly contagious viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has spread worldwide with millions of cases and more than 5 million deaths to date. SARS‐CoV‐2 has caused serious damage all over the world with many countries experiencing the third or the fourth wave of the viral disease outbreaks, mainly due to the emergence of mutant variants. Those who unvaccinated remain most vulnerable to COVID‐19 and its variants. COVID‐19 vaccination, along with prevention strategies, is a critical measure to defense against the disease. COVID‐19 vaccination can reduce the spread of virus and help protect susceptible population. Although herd immunity might not be realized solely by vaccination, COVID‐19 vaccines have been proved to be effective in reducing the risk of severe disease, hospitalization, and even death. It is recommended that people get vaccinated as soon as they are eligible. This review summarizes the recent SARS‐CoV‐2 variants that brought challenges for vaccination and herd immunity and discusses promising management strategies.

Background Data that guide selection of differing anticoagulant regimens for specific cancer-associated venous thromboembolism (VTE) are lacking. We aimed to compare the efficacy and safety of rivaroxaban and low-molecular-weight heparin (LMWH) against nonhigh-risk pulmonary embolism (PE) in Chinese lung cancer patients. Methods 446 Chinese lung cancer patients with nonhigh-risk PE who initiated treatment with rivaroxaban or LMWH were identified from Zhongshan Hospital database from 2016 to 2020. The primary outcomes were the composite event of VTE recurrence or major bleeding, and all-cause mortality. The secondary outcomes were VTE recurrence, major bleeding and clinically relevant non-major bleeding (CRNMB). Propensity score matching was used to balance baseline covariates. We conducted sensitivity analysis by stabilized inverse probability of treatment weighting and competing risk analysis by a Fine and Gray subdistribution hazard model. Results In propensity score-matched cohorts, a trend for lower rate of the composite outcome was found in rivaroxaban group compared to LMWH group (hazard ratio (HR), 0.73; 95% confidence interval (CI), 0.45–1.21; P = 0.22). All-cause mortality was significantly lower in rivaroxaban group than LMWH group (HR, 0.52; 95% CI, 0.36–0.75; P < 0.001), while rivaroxaban was similar to LMWH in the risks of VTE recurrence (HR, 0.69; 95% CI, 0.36–1.34; P = 0.28), major bleeding (HR, 0.79; 95% CI, 0.37–1.68; P = 0.54) and CRNMB (HR, 1.13; 95% CI, 0.62–2.09; P = 0.69). The primary and secondary outcomes favored rivaroxaban over LMWH in all the subgroups expect for central PE and intermediate-risk PE. The sensitivity analysis yielded similar results, and competing risk analysis was in accordance with the primary findings. Conclusions Rivaroxaban might be a promising alternative to LMWH as initial treatment for nonhigh-risk PE in lung cancer patients.

Inflammatory responses are considered to be the critical mechanism underlying particulate matter (PM)-induced development and exacerbation of chronic respiratory diseases. MiR-29b-3p has been found to participate in various biological processes, but its role in PM-induced inflammatory responses was previously unknown. Here, we constructed a miRNA PCR array to find that miR-29b-3p was the most highly expressed in human bronchial epithelial cells (HBECs) exposed to PM. MiR-29b-3p promoted PM-induced pro-inflammatory cytokines (IL-1β, IL-6, and IL-8) expression via inhibiting the AMPK signaling pathway in HBECs. RNA sequencing and luciferase reporter assay identified that miR-29b-3p targeted complement C1q tumor necrosis factor-related protein 6 (C1QTNF6), a protein that protected from PM-induced inflammatory responses via activating the AMPK signaling pathway. In vivo, miR-29b-3p antagomirs delivered via the tail vein prior to PM exposure significantly counteracted PM-induced miR-29b-3p upregulation and C1QTNF6 downregulation in lung tissues. Furthermore, miR-29b-3p inhibition alleviated inflammatory cells infiltration and pro-inflammatory cytokines secretion in the lung of PM-exposed mice. These findings firstly revealed that miR-29b-3p acted as a novel modulator of PM-induced inflammatory responses by targeting the C1QTNF6/AMPK signaling pathway, which contributes to a better understanding of the biological mechanisms underlying adverse PM-induced respiratory health effects.

An ongoing outbreak of 2019‐nCoV pneumonia was first identified in Wuhan, Hubei province, China at the end of 2019. With the spread of the new coronavirus accelerating, person‐to‐person transmission in family homes or hospitals, and intercity spread of 2019‐nCoV occurred. At least 40,261 cases confirmed, 23,589 cases suspected, 909 cases death and 3444 cases cured in China and worldwide 24 countries confirmed 383 cases being diagnosed, 1 case death in February 10th, 2020. At present, the mortality of 2019‐nCoV in China is 2.3%, compared with 9.6% of SARS and 34.4% of MERS reported by WHO. It seems the new virus is not as fatal as many people thought. Chinese authorities improved surveillance network, made the laboratory be able to recognize the outbreak within a few weeks and announced the virus genome that provide efficient epidemiological control. More comprehensive information is required to understand 2019‐nCoV feature, the epidemiology of origin and spreading, and the clinical phenomina. According to the current status, blocking transmission, isolation, protection, and alternative medication are the urgent management strategies against 2019‐nCoV.