Tracheobronchial ruptures caused by blunt chest trauma are rarely encountered but may be life-threatening. It is even rarer when the rupture is in the right middle lobe bronchus. Here we present a case of incomplete laceration of the right middle lobe bronchus after blunt trauma, which could easily be overlooked because of the absence of obvious symptoms. A 58-year-old man suffered multiple traumas after being attacked by cattle, closed chest drainage was promptly performed in the local hospital for bilateral hemopneumothorax. Three days later, the patient was transferred to our center for urgent exploratory thoracic surgery due to persistent hemothorax. We did not diagnose bronchial injury even after a bedside emergency bronchoscopy due to the adherence of bloody secretions and sputum crusts. It was not until a repeat chest CT 4 days after the initial surgery that we suspected an incomplete right middle lobe bronchial laceration, which was confirmed by postoperative bronchoscopy. The patient eventually underwent right middle lobe lung resection for a deep and wide bronchial laceration and recovered well. Clinicians should be fully aware of the possibility of this condition after blunt chest trauma and make good use of CT and bronchoscopy to help with diagnosis and treatment.

Background The prognosis and survival of lung adenocarcinoma (LUAD) patients are still not promising despite recent breakthroughs in treatment. Endoplasmic reticulum stress (ERS) is a self-protective mechanism resulting from an imbalance in quality control of unfolded proteins when cells are stressed, which plays an active role in lung cancer development, but the relationship between ERS and the pathological characteristics and clinical prognosis of LUAD patients remains unclear. Methods LASSO and Cox regression were applied based on sequencing information to construct the model, which was validated to be robust. The risk scores of the patients were calculated using the formula provided by the model, and the patients were divided into high and low-risk groups according to the median cut-off of risk scores. Cox regression analysis identifies independent prognostic factors for these patients, and enrichment analysis of prognosis-related genes was also performed. The relationship between risk scores and tumor mutation burden (TMB), cancer stem cell index, and drug sensitivity was explored. Results We constructed a 13-gene prognostic model for LUAD patients. Patients in the high-risk group had worse overall survival, lower immune score and ESTIMATE score, higher TMB, higher cancer stem cell index, and higher sensitivity to conventional chemotherapeutic agents. In addition, we constructed a nomogram that predicts 5-year survival in LUAD patients, which helps clinicians to foresee the prognosis from a new perspective. Conclusions Our results highlight the association of ERS with LUAD and the potential use of ERS in guiding treatment.