Spontaneous hemothorax, defined as bleeding into the pleural cavity without trauma or coagulopathy, is rare. Especially, it is uncommon in patients with primary epithelial lung cancer. We report a rare autopsy case of lung adenocarcinoma harboring both an anaplastic lymphoma kinase (ALK) rearrangement and a tumor protein p53 (TP53) mutation, in which hemothorax led to the formation of a giant pleural hematoma.A 75-year-old man with stage IVB lung adenocarcinoma presented with mediastinal and cervical lymph node metastases and right pleural effusion at diagnosis. Molecular testing revealed an ALK rearrangement and a TP53 mutation. He was treated sequentially with alectinib, lorlatinib, and brigatinib. After disease progression and treatment-related complications, he presented to the emergency department with acute dyspnea and a rapid decrease in hemoglobin level. Contrast-enhanced computed tomography showed encapsulated fluid retention with faint high attenuation in the right pleural cavity, and magnetic resonance imaging findings were consistent with a hematoma. Given his poor performance status and the absence of active bleeding on imaging, invasive intervention was not performed. Despite supportive management, he died one week after admission from respiratory failure and hemodynamic deterioration.Autopsy revealed a giant pleural hematoma above the diaphragm, surrounded by pleural metastases. Although no definite source vessel was identified, active bleeding from a metastatic pleural lesion was observed, suggesting persistent tumor-related hemorrhage as the cause of the hemothorax.This case represents an extremely rare presentation of ALK-rearranged lung adenocarcinoma complicated by spontaneous hemothorax. Neither ALK rearrangement nor TP53 mutation has been directly linked to hemothorax, but the aggressive biological behavior associated with this molecular profile may have contributed to the catastrophic pleural bleeding. In lung cancer patients, rapid pleural fluid accumulation with hyperdense imaging findings should raise suspicion for hemothorax.

The high-altitude and unique climatic conditions of Tibet can have a significant impact on the growth and development of local children and adolescents. We aimed to apply an artificial neural network model to evaluate the physical health status of primary and secondary school students aged 7 to 18 years in Shigatse, Tibet, China. A cross-sectional study was conducted among eligible primary and secondary school students from 7 randomly selected schools in Shigatse, Tibet, China, between April and October 2024. Health-related data, including height, weight, lung vital capacity, visual acuity, and dental caries, were recorded. By applying a comprehensive evaluation index system, an artificial neural network model was constructed to evaluate the health status of these students. A total of 4106 students (2047 boys and 2059 girls) were included. The body shape score (based on body mass index), body mass index of vital capacity, and health disorder score were 72.83 ± 12.29, 70.97 ± 8.45, and 69.26 ± 9.52, respectively. The corresponding measurements for boys and girls were 72.58 ± 12.22 and 73.07 ± 12.37, 69.02 ± 8.33 and 72.91 ± 8.11, and 69.22 ± 9.69 and 69.30 ± 9.36, respectively. The prevalence of myopia, dental caries, severe underweight, underweight, overweight, obesity, and growth retardation was 59.24%, 70.21%, 8.04%, 7.84%, 3.97%, 1.14%, and 7.67%, respectively. The mean and variance of health comprehensive scores were 70.42 ± 5.88, with 70.06 ± 5.75 and 70.77 ± 5.99 for boys and girls, respectively. The overall health status of Tibetan primary and secondary school students was moderate. Underweight, dental caries, and myopia were important health problems in these students. Public health departments, schools, and parents should work together to provide more comprehensive health education, supply necessary resources, and guide these students in adopting a healthy lifestyle to promote normal growth and development.

Background: Cetuximab-based therapies continue to play an important role in the management of recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) despite the increasing use of immunotherapy. However, data regarding treatment outcomes and prognostic factors remain limited. This study aimed to evaluate treatment outcomes and prognostic factors associated with survival in patients with R/M HNSCC treated with cetuximab-based regimens. Methods: This retrospective single-center cohort study included patients with recurrent/metastatic HNSCC who received cetuximab-based systemic therapy at the Department of Medical Oncology, Manisa Celal Bayar University Faculty of Medicine, between May 2012 and September 2025. Demographic, clinical, laboratory, and PET/CT data were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors associated with survival were evaluated using univariable and multivariable Cox proportional hazards regression analyses. Results: A total of 57 patients were included in the study. The median age was 65 years, and 91.2% of patients were male. Most patients had ECOG performance status 0-1 (94.7%) and stage IV disease (71.9%). The larynx was the most common primary tumor site (50.9%), while distant lymph node metastasis (63.2%) and lung metastasis (61.4%) were the predominant metastatic sites. Median PFS and OS were 4.6 months and 13.8 months, respectively. Kaplan-Meier analysis demonstrated that patients with a body mass index (BMI) > 25 had longer OS, whereas chronic kidney disease (CKD), primary tumor localization, and best response to first-line treatment were significantly associated with survival. In multivariable Cox regression analysis, chronic kidney disease (CKD) (HR: 5.15, p = 0.004), oral cavity primary tumor localization (HR: 2.55, p = 0.013), progressive disease as the best response to first-line treatment (HR: 4.44, p < 0.001) and the absence of grade 1-2 cetuximab-related dermatologic toxicity (HR: 3.20, p = 0.027) remained independent adverse prognostic factors. BMI was not independently associated with survival in multivariable analysis. Conclusions: Cetuximab-based therapy demonstrated clinically meaningful activity in patients with R/M HNSCC. Comorbidities, primary tumor localization, the absence of grade 1-2 cetuximab-related dermatologic toxicity and treatment response appear to substantially influence survival outcomes. Larger prospective studies are warranted to validate these findings.

Thoracic malignancies, including lung adenocarcinoma and malignant pleural mesothelioma, remain associated with poor prognosis and limited durable responses in advanced stages. Although targeted therapies and immunotherapy have improved outcomes in selected patients, chemotherapy remains central for those without actionable mutations. Their treatment response is heterogeneous, presents limited benefit, and reliable predictive biomarkers of chemotherapy sensitivity are still lacking, representing a setting with a high clinical need and an opportunity for novel research strategies. These tumors frequently involve the pleural cavity and are commonly associated with malignant pleural effusion, contributing to respiratory symptoms and often requiring therapeutic drainage. Notably, malignant pleural effusion represents a clinically accessible source of viable tumor cells accessible through minimally invasive procedures. In this proof-of-concept study, we explored the feasibility of generating patient-derived organoids from malignant pleural effusion for functional drug testing in thoracic tumors. Organoids were established from five patients with advanced lung adenocarcinoma lacking targetable mutations and, as an illustrative case, from a patient with malignant pleural mesothelioma. The organoids recapitulated the tumor-specific phenotypic features as characterized by mutational profiling and immunohistochemistry, and were subjected to systematic chemotherapy drug screening with FDA-approved antitumor compounds to explore for alternative therapies. Candidate hits like Idarubicin, Tazemetostat or Vemurafenib were further examined through dose-response assays. These findings demonstrate the feasibility of generating patient-derived organoids from malignant pleural effusions and support their use as exploratory platforms for functional drug testing in thoracic malignancies. Further studies with larger cohorts and integrated molecular analyses are required to validate their potential clinical utility.

Mature microRNAs (miRNAs) and their precursors (pre-miRNAs) are closely related to various physiological and pathological processes. The simultaneous monitoring of miRNA and its precursor can discriminate tumor cells from DNA-damaged cells and increase the diagnosis reliability. Herein, we design a size-selective tetrahedral DNA nanocage for high-fidelity imaging of miRNA and its precursor in living cells. In this research, the DNA nanocage framework is self-assembled from six ssDNAs, and hairpin probes (H1 and H2) can bind to two edges of the DNA nanocage for the recognition of pre-miRNA, and entropy-driven reaction substrates are docked inside the DNA nanocage framework for the recognition of miRNA. Due to the size-selectivity of the DNA nanocage, longer pre-miRNAs (60-70 nt) are excluded from the cavity, but shorter miRNAs (19-23 nt) can enter the cavity. Once the DNA nanocage framework is internalized into cells, pre-miRNA-155 initiates catalytic hairpin assembly between H1 and H2 to recover AF647 fluorescence, and miRNA-155 triggers entropy-driven strand displacement to restore AF568 fluorescence. In the presence of intracellular ATP, the fuel strand is released from fuel strand/ATP aptamer duplex to displace miRNA-155 that can initiate new entropy-driven strand displacement to enhance AF568 fluorescence. This nanosensor enables high-fidelity imaging of miRNA-155 and its precursor in living cells. Moreover, it can quantify both miRNA-155 and pre-miRNA-155 at the single-cell level, and distinguish their levels between lung cancer tissues and normal counterparts. Furthermore, this nanosensor enables the differentiation of tumor cells from DNA-damaged cells, offering a powerful tool for precise diagnosis.

Light therapies, such as photobiomodulation and photodynamic therapy, have demonstrated effective therapeutical response. However, external irradiation and targeting internal organs is challenging due to high light attenuation and the interindividual anatomical variability, strongly affecting light dosimetry. When considering lung diseases, such as pneumonia and inflammatory conditions, light dosimetry using transcutaneous delivery must consider the total light path from skin coupling through thoracic tissues to the fluence rate reaching the lungs. We here present a computational model based on Monte Carlo simulation developed in house to determine the light dosimetry in the lungs for different wavelengths in normal and diseased lungs. The simulation uses the actual anatomical models derived from human CT scans to generate 3D representations of the thoracic cavity, including 12 distinct tissue types. The lungs were segmented into normal, collapsed regions, infiltrate, and blood vessels. Wavelength-dependent absorption and scattering coefficients for each tissue type were estimated by the reported data in the literature. Our analysis focused on normalized energy deposition profiles defined as µa*fluence rate and fluence rate distributions within each lobe from normal, focal, and diffuse pneumonia, and COVID-19 conditions, under different irradiation positions. The results reveal significant variations in energy deposition and fluence rate distribution across different lung conditions and irradiation parameters, highlighting the need for individualized light dosimetry planning.

The morphogenesis of the diaphragm requires a coordinated development of different components with potential of malformation. Diaphragmatic herniation has rarely been reported in large animals and has not been described in a rhinoceros. An 8-day-old- female southern white rhinoceros calf was diagnosed with congenital diaphragmatic hernia with large parts of the intestine translocated in the thoracic cavity. Gross necropsy revealed bilateral Bochdalek hernia, severe damage of the intestinal tract and congestion of both lungs. Histologic findings demonstrated lung hypoplasia and severe pneumonia due to regurgitation and aspiration of nutritional components.