Objective We built a prediction model of mortality risk in patients the with Acinetobacter baumannii (AB)-caused hospital-acquired (HAP) and ventilator-associated pneumonia (VAP). Methods In this retrospective study, 164 patients with AB lower respiratory tract infection were admitted to the respiratory intensive care unit (RICU) from January 2019 to August 2021 (29 with HAP, 135 with VAP) and grouped randomly into a training cohort (n = 115) and a validation cohort (n = 49). Least absolute shrinkage and selection operator regression and multivariate Cox regression were used to identify risk factors of 90-day mortality. We built a nomogram prediction model and evaluated model discrimination and calibration using the area under the receiver operating characteristic curve (AUC) and calibration curves, respectively. Results Four predictors (days in intensive care unit, infection with carbapenem-resistant AB, days of carbapenem use within 90 days of isolating AB, and septic shock) were used to build the nomogram. The AUC of the two groups was 0.922 and 0.823, respectively. The predictive model was well-calibrated; decision curve analysis showed the proposed nomogram would obtain a net benefit with threshold probability between 1% and 100%. Conclusions The nomogram model showed good performance, making it useful in managing patients with AB-caused HAP and VAP.
Introduction and importance:Lung cancer is extremely difficult to treat due to its high incidence and mortality rate. Immune checkpoint inhibitor therapy is a major breakthrough in the field of oncology and is an emerging anti-tumor treatment modality after chemotherapy, targeted therapy and anti-angiogenic therapy. However, patients with complete response were also noticed as an anecdote especially in the aged. Here we presented a non-small cell lung cancer case who benefited from treatment of anti-PD-1 antibody.Case presentation: An 80-year-old male was admitted, presenting with a intermittent cough and a small amount of blood in the sputum for 2 months, computed tomography showed a lesion in the right lung. Lung puncture biopsy results suggested lung squamous cell carcinoma. Wild-type epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) were showed in the tumor tissue specimen. Antiprogrammed death 1 (PD-1) antibody monotherapy was initiated for 13 cycles. After the first anti-PD-1 antibody treatment, cryotherapy was performed under tracheoscopy on the mucosal bulge of the right principal bronchus and the root of the right upper lobe bronchial neoplasm. Complete remission (CR) was confirmed via imaging before the 3rd cycle. Subsequent CT suggested stable disease conditions. The presence of CR was further confirmed through a Positron Emission Computed Tomography (PET)/CT test in the 13th cycle. The patient now experienced a long-term complete response of more than 4 years till now.Clinical Discussion: Lung cancer has the highest morbidity and mortality in China. Immune monotherapy has become the standard first-line treatment for patients with upregulated expression of programmed death-ligand 1 (PD-L1). The effect of immunotherapy is similar and equally safe in older and younger patients with lung cancer. Monotherapy has the potential to achieve rapid lesion regression in elderly lung cancer patients, and the presence of immunological memory in T lymphocytes may be responsible for long-term response of the tumor lesions. Conclusion:We reported a long-term complete response of advanced lung squamous cell carcinoma in aged treated with first-line anti-PD-1 antibody monotherapy. More studies are needed to evaluate the efficacy and safety of immune checkpoint inhibitors in the aged.
Background. Colorectal cancer (CRC), one of the main causes of death, remains a leading cause of mortality in gastrointestinal cancer and tends to affect the younger generation. However, the pathological process of colorectal cancer is unclear. Exploring potential pathogenesis and therapeutic targets of CRC is significant as its high prevalence and high mortality. Nowadays, the rapid development of bioinformatics provides us an opportunity to explore potential molecular markers of CRC. Materials and Methods. First, three CRC gene chips with paracancerous controls were downloaded from the Gene Expression Omnibus (GEO) database. Second, after combining and batch correcting the three chips using the R language and Perl language, the differentially expressed genes (DEGs) were selected to investigate how they affect the CRC occurrence and development by GO and KEGG enrichment analysis. Third, based on the STRING website and the Cytoscape software, the protein-protein interaction (PPI) network was constructed and the core genes were screened out. Finally, through polymerase chain reaction (PCR) and immunohistochemistry (IHC), the expression and function of the core gene CXCL8 in CRC were explored. Results. GSE10950, GSE44076, and GSE75970, including 126 intestinal cancer samples and 126 paracancer samples, were screened as the datasets. 192 DEGs were screened, including 43 upregulated genes and 149 downregulated genes. Through the DEGs screened out, GO enrichment analysis, KEGG enrichment analysis, and the construction of PPI interaction network were carried out. Finally, according to the nodes and edges in the PPI network, the DEGs were sorted and the core genes were selected. Through basic experiments, the first ranked CXCL8 was further studied, and the results suggest that the expression of CXCL8 is related to the proliferation, migration, invasion, and even distant metastasis of CRC. Conclusion. The present study showed that DEGs of CRC are associated with multiple tumor-related biological processes and signaling pathways. The core gene CXCL8 has the potential to be a new therapeutic target for CRC.
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