[Characteristics of the tumor microenvironment and therapeutic progress in malignant pleural effusion].

Malignant pleural effusion (MPE) can be secondary to various advanced malignant tumors. Although systemic anti tumor therapy may be effective in primary tumors, it cannot reduce the accumulation of MPE in proportion of the patients. The interaction of tumor cells, immune cells, and mesenchymal cells, as well as the abnormal proliferation of tumor-associated blood vessels, together create an immunosuppressive microenvironment for MPE, which promotes the abnormal proliferation of tumor cells and the accumulation of MPE. With the in-depth study of the tumor microenvironment, the application of local systemic anti-tumor therapy with local intrathoracic application of immune checkpoint inhibitors, immune cells, cytokines, and gene-mediated cytotoxic immunotherapy are able to alleviate the immunosuppressive tumor microenvironment and inhibit the accumulation of MPE. This article aimed to describe the tumor microenvironment in MPE and provide clues for identifying novel therapeutic targets.

Different risk factors of recurrent pulmonary tuberculosis between Tibetan and Han populations in Southwest China.

OBJECTIVE: The geographical environment and living habits are different between Tibetan and Han populations. The present study aimed to investigate the risk factors of recurrent pulmonary tuberculosis (TB), and analyze the differences between the two populations. PATIENTS AND METHODS: A total of 480 TB patients, including 80 Tibetan and 80 Han patients with recurrent pulmonary TB, and 320 patients without recurrent pulmonary TB, were included in present study. All patients with pulmonary TB were diagnosed between 2000 and 2001 and followed until December 2012. Multivariate logistic regression was used for the statistical analysis. RESULTS: Among all patients, the independent risk factors associated with recurrent pulmonary TB were no use of directly observed therapy, short course (DOTS) (HR 5.867, 95% CI 2.557-13.461), diabetes (HR 3.288, 95% CI 1.301-8.312), smoking (HR 2.387, 95% CI 1.328-4.291) and malnutrition (HR 1.910, 95% CI 1.110-3.285). The independent risk factors of recurrent pulmonary TB for the Tibetan patients included no use of DOTS and malnutrition, while the independent risk factors for the Han patients were diabetes and smoking. CONCLUSIONS: The risk factors of pulmonary TB recurrence were different between Tibetan and Han patients. To reduce the recurrent rate of pulmonary TB, especially for Tibetan populations, pursuing high-quality DOTS is essential.