Chronic Diseases and Translational Medicine最新文献

The most prevalent age-related movement condition, Parkinson's disease (PD), is characterized by bradykinesia, resting tremor, unbalanced gait, muscular rigidity, postural instability, as well as some nonmotor symptoms like autonomic and cognitive dysfunctions.

PD is caused by a loss of nerve cells in a part of the brain, the substantia nigra. These cells are responsible for producing dopamine, which acts as a messenger between the brain and nervous system that helps control and coordinate body movements. If the nerve cells in the substantia nigra die or become damaged, the amount of dopamine in the brain is reduced. Motor control is impaired, causing movements to become slow and abnormal. The loss of nerve cells is a slow process. The symptoms of PD usually only start to develop when around 80% of the nerve cells in the substantia nigra have been lost.¹

Lewy bodies and Lewy neurites collect alpha-synuclein in PD. Select peripheral autonomic nervous system neurons and central nervous system neurons are affected. The incidence of PD rises with age, and the lifetime frequency is 1%–5%. Multiple twin studies support the idea that environmental factors play a larger role in disease pathogenesis than do genetic factors, even though evidence for a few rare genetic mutations in a small subset of young people with PD cases offers some insights into the pathogenesis.²

Although the precise cause of PD is uncertain, mounting evidence points to viral infection as a potential factor. For instance, the varicella-zoster virus (VZV) may remain dormant in the ganglia and reawaken because of weakened immunity or aging. Herpes zoster (shingles) is a VZV infection that causes a painful skin rash and blisters on the dermatome infected. Herpes zoster may be related to PD, according to recent research.^{3, 4}

Herpes zoster vaccination protects against Alzheimer's disease (AD), which is related to herpes virus infection.^5-9 In the current analysis we attempted to determine if herpes zoster vaccination might reduce the risk of PD.

Data on PD prevalence by US state is from Mantri et al.¹⁰ They identified 27,538,023 Medicare beneficiaries that met inclusion criteria, of whom 392,214 had a PD diagnosis in 2014.

Data on Shingles vaccination among adults aged 60 and over in the US in 2018 is from Terlizzi and Black.¹¹ The National Health Interview Survey (NHIS) data from 2008 to 2018 were used for this investigation. The NHIS is a household survey of the civilian, noninstitutionalized US population that is conducted nationally. It is continually carried out by the National Center for Health Statistics (NCHS) during the entire year. Although follow-ups to completed interviews may be made over the phone, interviews are conducted in respondents’ homes.

Statistical analysis was performed with SPSS

To the Editor,

Lung cancer associated with cystic airspaces is a group of uncommon lung malignant lesions that are easy to misdiagnose even though the use of computed tomography (CT) has been more common for lung cancer screening in the clinic. The incidence of this lesion has been reported at 0.5%–3.7% in different studies.^1-3 Up to 80% of patients was of pulmonary adenocarcinomas and most patients had a history of smoking.²

Here, we reported a case of lung adenocarcinoma associated with cystic airspace developed at least 7 years progression from one purely thin-walled lung cavity closing to the pleura on CT images in a 53-year-old man without a smoking history. Histopathology revealed the thickened wall of the cystic airspace was lung adenocarcinoma with extensive papillary and micropapillary patterns and psammoma bodies.

A 53-year-old asymptomatic male without a smoking history has had a physical examination every 1–2 years since 2013. The patient has no history of asbestos and dust exposure. In December 2013, a local thin-wall air cavity in the right lower lobe close to the pleura (Figure 1A) and nodular thickening of the bilateral pleura with partial calcification (data not shown) were found for the first time on his CT scan. Five months later, this patient underwent a chest CT examination again and there was no obvious change compared to the CT scan in 2013 (Figure 1B). After that, he did a chest CT examination every 1–2 years. No obvious radiological change was found (Figure 1C,D). However, in Oct 2018, a nonsolid nodule was found extruding from the local wall of the cystic airspace (Figure 1E), but these changes did not attract the attention of radiologists and physicians. Two years later, this nodule increased in size, and the wall of the cystic airspace thickened, which was considered the manifestation of lung cancer (Figure 1F). From 2013 to 2020, this patient had no discomfort.

In December 2020, he was administrated to our hospital for further diagnosis and treatment. A physical examination of this case showed no obvious abnormality. Axial CT images in a lung window setting showed a thicken-walled cystic space with exophytic solid nodules along the cyst wall (Figure 1G). A soft tissue nodule was seen in the mediastinal window (Figure 1H). An irregular thick-walled cavity with local solid nodule formation after three-dimensional reconstruction can be easily detected (Figure 1I). Bilateral pleurae showed irregular thickening and multiple small nodules and calcifications (Figure 1J).

After exclusion of extrathoracic malignancies by examination of brain CT scan and single-photon emission computed tomography (SPECT) whole bone scan, resection of the cyst with nodules was performed and the malignant tumor was reported via intraoperative frozen tissue pathology. So, a right lower lobectomy with lymph node dissection was subsequently performed. Postoperative path