Acute cardiac tamponade after Endostar treatment of non-small cell lung cancer: A case report.

RATIONALE: Recombinant human endostatin (Endostar) is extensively utilized in China for the clinical management of patients with driver gene-negative non-small cell lung cancer (NSCLC) at stage TNM IV. This report describes the case of a lung cancer patient treated exclusively with Endostar maintenance therapy, who experienced a rapid deterioration in respiratory function. PATIENT CONCERNS: The case involved a patient with a pathologically confirmed squamous cell carcinoma of the left lung, treated in our department. Following 1 month of albumin-bound paclitaxel chemotherapy and localized radiotherapy for the left lung lesion, the patient initiated treatment with a single agent, Endostar 30mg, on October 19, 2021. The medication was administered via intravenous infusion over a 7 days. DIAGNOSIS: On October 23, 2021, the patient exhibited symptoms of chest constriction, discomfort, coughing, and sputum production. By October 28, the patient presented with pronounced dyspnea and respiratory distress. An emergency CT scan detected pericardial tamponade and significant deviations in several blood parameters from pretreatment values. INTERVENTIONS: Percardial puncture and catheter drainage were recommended as therapeutic intervention. OUTCOMES: Considering the patient advanced age, the patient and their family opted to refuse this medical procedure, leading to the patient unfortunate demise on November 2, 2021. LESSONS: Medical professionals should remain vigilant for the potential, albeit rare, risk of Endostar inducing acute pericardial tamponade, a severe and potentially fatal complication.

Dignity-preserving care of people with dementia in different nursing environments: a qualitative systematic review.

AIMS: To systematically identify, evaluate and synthesize qualitative evidence about the dignity-related nursing experiences of people with dementia in families and nursing homes, summarize the similarities and differences and analyse the causes and influencing factors. METHODS: A synthesis of qualitative studies retrieved from eight databases that were published before September 2022. Two reviewers independently screened and selected studies. Inclusion criteria were established according to the PICOS principle. Quality assessment was guided by Joanna Briggs Institute's Qualitative Assessment and Review Instrument and the structured topic synthesis method was used to summarise studies eligible for inclusion. RESULTS: Three key themes were extracted from 14 included studies; the living environment, relationship needs and self-awareness, which focused on improving the dementia-centred nursing environment, meeting the needs of the relationship-centred nursing network, and finally, improving the self-awareness of people with dementia to promote dignity. CONCLUSION: This systematic review shows people with dementia need to integrate into society and maintain their dignity in a dementia-friendly environment that is respectful, inclusive environment that promotes freedom.

Sudden aortic dissection: A cautionary tale for the unexplained back pain during bevacizumab treatment.

Bevacizumab is widely used in the treatment of colorectal cancer, liver cancer, and other advanced solid tumors because of its multiple targets, no genetic testing and better safety. Globally, the use of bevacizumab in the clinic has been climbing year by year based on several large-scale, multicenter prospective studies. While bevacizumab undeniably has a good clinical safety profile, it has also been associated with adverse effects such as drug-related hypertension and anaphylaxis. In our recent clinical work, we met a female patient with acute aortic coarctation previously treated with multiple cycles of bevacizumab, who was admitted with sudden onset of back pain. Because the patient had just had an enhanced CT of the chest and abdomen a month earlier, no abnormal lesions apparently associated with low back pain were found. So when the patient was seen on this occasion, our clinical diagnosis was first considered to be neuropathic pain, but a further multiphase enhancement CT was done again for further exclusion and the final diagnosis was acute aortic dissection. The patient later died within 1 hour after the chest pain had worsened again while waiting for a surgical blood supply within 72 hours of presentation. The risk of fatal acute aortic dissection is not sufficiently emphasized in the revised instructions for bevacizumab, although the adverse effects associated with aortic dissection and aneurysm are mentioned. Our report is of high practical value in raising clinicians' vigilance and safe management of patients using bevacizumab worldwide.

Construction of a miRNA-mRNA Network Related to Exosomes in Colon Cancer.

Background: The competing endogenous RNA (CeRNA) network plays important roles in the occurrence and development of colon cancer. This research is aimed at constructing a miRNA-mRNA network associated with exosomes in colon cancer. Methods: We explored the GEO database and then analyzed the RNAs of 722 samples to obtain differentially expressed miRNAs (DEMs) and mRNAs (DEGs) alongside the progress of colon cancer. Next, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of DEM target genes and DEGs were performed. In addition, a miRNA-mRNA network related to exosomes in colon cancer was constructed based on DEMs and DEGs. Finally, the expression of miRNA and mRNA in the network was verified by GEPIA2 on the base of TCGA database. Results: Through our analysis, 19 DEMs (17 up and 2 down) and 1672 DEGs (954 up and 718 down) were screened. The GO and KEGG results show that these DEGs were mainly enriched in ribonucleoprotein complex biogenesis, noncoding RNA metabolic process, cell-substrate junction, cadherin binding, transcription coregulator activity, and regulation of the human T-cell leukemia virus 1 infection-related pathway. Besides, a miRNA-mRNA network, including 4 miRNAs (hsa-miR-623, hsa-miR-320c, hsa-miR-486-5p, and hsa-miR-1290) and 7 mRNAs (GNAI1, CADM1, PGRMC2, etc.), was constructed. Three of these seven mRNAs were downregulated in colon cancer. Ultimately, the GNAI1, CADM1, and PGRMC2 expression levels were verified by TCGA database. Conclusions: This study reveals the network relationship between colon cancer exosome-derived miRNA and targeted mRNA. It deepens our understanding of new molecular mechanisms and pathways that may play a role in the occurrence and metastasis of colon cancer.

Modifiable factors associated with behavioural and psychological symptoms of dementia among patients residing at home: The impacts of patient, caregiver and environmental variables.

The present study aimed to explore the modifiable factors of behavioural and psychological symptoms of dementia (BPSD) among patients residing at home in terms of patient, caregiver and environmental factors. A cross-sectional survey of 193 patients with dementia residing at home and their caregivers who visited the memory clinic of the Department of Neurology in a tertiary (the highest level) hospital in China from November 2018 to May 2019 was performed. Exacerbated BPSD were associated with patient (old age, high education level, increased dementia severity, and the use of psychotropic drugs), caregiver (low positive aspects and high expressed emotion) and environmental (poor home environment) factors. The use of psychotropic drugs by the patient, positive aspects and expressed emotions of the caregiver, and home environment were modifiable factors that provided evidence for the direction of intervention for BPSD among patients residing at home.