Study design: Review of two randomized controlled trials and two prospective single-arm studies performed at 147 sites in 28 countries. Key findings: Data from 1837 patients treated with paclitaxel drug-coated balloon (P-DCB) and 143 patients treated with uncoated percutaneous transluminal angioplasty showed that there was no significant difference in all-cause mortality between the two treatment groups through 5 years. Conclusion: This independent patient-level meta-analysis demonstrates that P-DCB is safe. There was no correlation between level of paclitaxel exposure and mortality. Commentary: Paclitaxel is a cytotoxic agent that blocks mitosis and thereby inhibits intimal hyperplasia after endovascular intervention. A previous study by Katsano et al 1 suggested a higher incidence of late mortality with use of P-DCB and drug-eluting stent therapies compared with uncoated balloon angioplasty or bare-metal stents to treat femoropopliteal artery occlusive disease in a meta-analysis of summary-level data. Katsano postulated that late paclitaxel toxicity may be the cause of the increased death rate because paclitaxel crystals loaded on DCBs or drugeluting stents have a half-life of weeks or months. Dr Schneider and his coauthors note that the previous review was disadvantaged by "its derivation from published or presented results of heterogeneous trials and devices." Schneider points out that their study represents an independent assessment of adjudicated, individual patient-level data and therefore their results are more reliable than those of the previous study. I summarized the study by Katsano et al 1 in the April 2019 issue of JVS Vantage Point by saying, "I would emphasize that although demographics were generally well balanced, there was a greater incidence of atherosclerotic risk factors (diabetes, hypertension, hyperlipidemia, smoking) in the paclitaxel arms in some of the studies reviewed in this paper. I don't believe we need to inform our patients yet that there may be an increased chance of long-term death because future analysis may show that higher risk patients (those with more atherosclerotic risk factors) were treated with these devices and their mortality would be expected to be higher." Since I wrote that review, I cringed whenever I heard subsequent opinions voiced by various societies and respected clinicians who concluded that we should inform our patients of this potential increased risk of death before intervening. I was seriously thinking of asking my bosses (the JVS Editors) to withdraw my review before it was published to avoid looking foolish when my opinion came out in press. Based on the results of the current analysis, maybe I'm smarter than I thinkdwell, at least until the next analysis on this controversial subject is published.

Chronic inflammation is one of the critical causes to promote the initiation and metastasis of solid malignancies including lung cancer (LC). Here, we aimed to investigate the prognostic roles of albumin (Alb)‐to‐fibrinogen (Fib) ratio (AFR), Fib and Alb in LC and to establish a novel effective nomogram combined with AFR. Four hundred twelve LC patients diagnosed between February 2005 and December 2014 were recruited in this prospective study. The prognostic roles of AFR, Fib, Alb, neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR) and monocyte‐to‐lymphocyte ratio (MLR) were identified by X‐tile software, Kaplan–Meier curve, Cox regression model, and time‐dependent ROC. Pretreatment high circulating Fib, low AFR, and Alb were significantly associated with increased risk of death for LC patients, especially for non‐small cell lung cancer (NSCLC) patients in all stages. The area under curves (AUCs) of AFR, Fib, and NLR were higher than them within Alb and PLR for predicting the survival of NSCLC patients. Moreover, we found that clinical outcome of high AFR patient with chemo‐radiotherapy was superior to low AFR patient; overall survival rate of stage II‐III NSCLC patients undergoing chemo‐radiotherapy was significantly lower than the surgical patients with treatment of adjuvant chemo‐radiotherapy(P = 0.001) in low AFR subgroup. On the contrary, clinical outcome of the patients receiving chemo‐radiotherapy was the same to the patients undergoing surgery and adjuvant chemo‐radiotherapy (P = 0.405) in high AFR subgroup. In addition, c‐index of predicted nomogram including AFR (0.717) for NSCLC patients with treatment of chemo‐radiotherapy was higher than that without AFR (0.707). Our findings demonstrated that circulating pretreatment AFR might be a potential biomarker to predict clinical efficacy of surgical resection and adjuvant chemo‐radiotherapy and be a prognostic biomarker for NSCLC individuals.

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MicroRNAs (miRNAs) have been found to play important regulatory roles in various physiological and pathological processes. MiRNAs also exhibit high stability and are present at high concentrations in human bodily fluids. Consequently, miRNAs may represent attractive and novel diagnostic biomarkers for certain clinical conditions. Recently, the capacity for extracellular vesicles, including microvesicles and exosomes, to carry miRNAs that participate in cell-to-cell communication has been described. In the present study, the miRNA expression patterns for three kinds of pleural effusions that were obtained from patients with pneumonia (group A), pulmonary tuberculosis (group B), and lung cancer (group C) were detected with high-throughput sequencing. When the expression levels of these miRNAs were compared among the three groups, three differentially expressed miRNAs were detected between groups A and B, while 27 differentially expressed miRNAs were detected between groups A and C. Notably, miR-378i was significantly elevated only in group B, while miR-205-5p and miR-200b were markedly increased only in group C (p < 0.01). Further studies are needed to confirm whether these differentially expressed miRNAs may serve as prospective diagnostic markers for pulmonary diseases.