Objective To detect the expression and clinical significance of POLD1 gene in non-small cell lung cancer (NSCLC) via bioinformatics method. Methods The expression difference of POLD1 in NSCLC tissue and normal lung tissue was investigated by TIMER database. UALCAN database was used to further verify different expression of POLD1 as well as the relationship between POLD1 expression and clinicopathological characteristics of NSCLC. The correlation between POLD1 gene and prognosis of NSCLC patients was detected by GEPIA and TIMER database. cBioPortal database was used to analyze frequencies of POLD1 gene mutation. POLD1-related protein-protein interaction network was constructed by STRING database. The relationship between POLD1 and immune infiltration was based on TISIDB database. Results The expression of POLD1 gene in lung adenocarcinoma and lung squamous cell carcinoma was significantly higher than that in normal lung tissue. In lung adenocarcinoma, patients with lower POLD1 level showed better prognosis. 1.2% of lung adenocarcinoma patients and 1.8% of lung squamous cell carcinoma patients carried mutated POLD1 gene, mainly missense mutations. POLD1 may interact with POLD2, POLD3, POLD4, POLE, RPA1, PCNA, MSH6, MSH2 and FEN1. The biological processes include DNA replication, mismatch repair, etc. Besides, the expression of POLD1 in NSCLC was correlated with the number of different immune cells. Conclusions The POLD1 gene is highly expressed in NSCLC patients, and negatively related with survival prognosis in patients of lung adenocarcinoma. POLD1 gene may be a potential diagnostic target and prognostic marker in NSCLC.
Objective To explore the clinical characteristics of Chlamydia psittaci pneumonia. Methods From January 2020 to March 2023, 21 cases of Psittacosis from the First Affiliated Hospital of Nanjing Medical University were diagnosed via metagenomic next-generation sequencing (mNGS). They were divided into a severe group (n=10) and a non-severe group (n=11) based on diagnostic criteria for severe pneumonia, and the clinical presentation, secondary examination, treatment, and prognosis of the two groups were analyzed retrospectively. Results Among the 21 patients, there were 11 males and 10 females, with a mean age of (51.7±11.6) years. All patients had an acute onset and 12 had a confirmed history of exposure to poultry. The onset of the disease occurred in the autumn and winter seasons in 18 patients. All the patients were suffering from high fevers. Other symptoms included coughing, phlegm, tightness in the chest and fatigue. Laboratory examinations showed that the levels of leukocytes, neutrophil counts, C-reactive protein, procalcitonin, aminotransferase, creatine kinase, lactic dehydrogenase, brain natriuretic peptide precursors and D-dimer were significantly higher in the severe group than those in the non-severe group. Chest CT scans revealed varying levels of consolidation and spot shadowing with peripheral exudate in all patients. The patients in the severe group were more likely to have bilateral lung involvement, bilateral pleural effusion, cavity and mediastinal lymph node enlargement. Eleven patients received tetracycline alone, three received laudanum alone, two received respiratory quinolones alone, and five received a combination of two drugs including tetracycline. Chest CT at clinical follow-up showed absorption of lung lesions. Conclusions Chlamydia psittaci pneumonia usually occurs in the fall and winter, and most patients have a history of contact with poultry. Clinical presentation and imaging are not specified. The technology of mNGS enables early diagnosis of the disease, and neutrophil lymphocyte ratio, neutrophil-lymphocyte ratio and lactic dehydrogenase levels help assess the risk of severe disease.
ObjectiveTo explore the clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor.MethodsThe clinical data, pathological features, treatment and prognosis from 10 patients with thoracic inflammatory myofibroblastic tumor confirmed by pathology were analysed retrospectively from April 2012 to April 2019 at Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University).ResultsTen participants including six males and four females with a mean age of 37.9 years old. Lesions were detected by physical examination in five patients, cough, chest pain and hemoptysis were the common symptoms. A total of 10 lesions including six in the right lung, three in the left lung and one in the mediastinum. Nine patients were treated with surgery, and one patient received high-frequency electrocautery though rigid bronchoscopy under general anesthesia. All the patients were confirmed by immunohistochemistry, positive rate of smooth muscle actin was 70%, positive rate of anaplastic lymphoma kinase was 70%. The mean follow-up time was 35.9 months, and one patient relapsed the other nine patients were cured.ConclusionsInflammatory myofibroblastic tumor is potentially malignant or low malignant, the clinical manifestations and imaging findings are not specific, once confirmed by pathology, radical surgery is the first choice. For the lesion limited to the airway, interventional therapy could be the choice, but close follow up is needed.