PRaG 3.0 therapy for human epidermal growth factor receptor 2-positive metastatic pancreatic ductal adenocarcinoma:A case report

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly fatal disease with limited effective treatment especially after first-line chemotherapy.The human epidermal growth factor receptor 2(HER-2)immunohistochemistry(IHC)positive is associated with more aggressive clinical behavior and shorter overall survival in PDAC.CASE SUMMARY We present a case of multiple metastatic PDAC with IHC mismatch repair proficient but HER-2 IHC weakly positive at diagnosis that didn’t have tumor regression after first-line nab-paclitaxel plus gemcitabine and PD-1 inhibitor treatment.A novel combination therapy PRaG 3.0 of RC48(HER2-antibody-drug conjugate),radio-therapy,PD-1 inhibitor,granulocyte-macrophage colony-stimulating factor and interleukin-2 was then applied as second-line therapy and the patient had confirmed good partial response with progress-free-survival of 6.5 months and overall survival of 14.2 month.She had not developed any grade 2 or above treatment-related adverse events at any point.Percentage of peripheral CD8^(+) Temra and CD4^(+) Temra were increased during first two activation cycles of PRaG 3.0 treatment containing radiotherapy but deceased to the baseline during the maintenance cycles containing no radiotherapy.CONCLUSION PRaG 3.0 might be a novel strategy for HER2-positive metastatic PDAC patients who failed from previous first-line approach and even PD-1 immunotherapy but needs more data in prospective trials.

New hope for esophageal stricture prevention:A prospective singlecentertrial on acellular dermal matrix

BACKGROUNDGiven the high incidence of esophageal cancer in China,an increasing number ofpatients there are undergoing endoscopic mucosal dissection(ESD).Although the5-year survival rate after ESD can exceed 95%,esophageal stricture,the mostcommon and serious postoperative complication,affects the long-term prognosisof patients and the quality of life.Autologous mucosal grafts have proven to besuccessful in preventing stricture after ESD for early esophageal cancer.AIMTo examine the viability of acellular dermal matrix(ADM)as an alternative to autologous mucosa for the prevention of stricture after ESD.METHODSThis is a prospective,single-center,controlled study.Consecutive patients who underwent ESD surgery and werewilling to undergo autologous mucosal transplantation were recruited between January 1 and December 31,2017.Consecutive patients who underwent ESD surgery and were willing to undergo ADM transplantation wererecruited between January 1 to December 31,2019.A final three-year follow-up of patients who receivedtransplants was conducted.RESULTSBased on the current incidence of esophageal stricture,the sample size required for both the autologous mucosalgraft group and the ADM group was calculated to be 160 cases.Due to various factors,a total of 20 patients withautologous mucosal grafts and 25 with ADM grafts were recruited.Based on the inclusion exclusion andwithdrawal criteria,9 patients ultimately received autologous mucosal grafts and completed the follow-up,while11 patients received ADM grafts and completed the follow-up.Finally,there were 2 cases of stenosis in theautologous mucosal transplantation group with a stenosis rate of 22.22%and 2 cases of stenosis in the ADMtransplantation group with a stenosis rate of 18.18%,with no significant difference noted between the groups(P=0.94).CONCLUSIONIn this prospective,single-center,controlled trial,we compared the effectiveness of autologous mucosatransplantation and ADM for the prevention of esophageal stricture.Due to certain condition limitations,we wereunable to recruit sufficient subjects meeting our target requirements.However,we implemented strict inclusion,exclusion,and withdrawal criteria and successfully completed three years of follow-up,resulting in valuableclinical insights.Based on our findings,we hypothesize that ADM may be similarly effective to autologousmucosal transplantation in the prevention of esophageal stricture,offering a comparable and alternative approach.This study provides a new therapeutic idea and direction for the prevention of esophageal stricture.

基于肠道微生态对中医外感寒湿伤脾理论的初步探讨

外感寒湿邪气最易伤脾阳,影响脾主运化与脾的散精功能.人体肠道菌群广泛参与肠道及胃肠消化生理机能的调节.因此,本文通过现代研究对肠道微生态与“脾”的相关性的普遍认识,探讨机体胃肠消化功能紊乱发生的过程中肠道菌群应对寒湿环境随机暴露的响应机制,认为肠道微生态失调可能是中医外感寒湿伤脾的形成机制之一.

Coordination configurations of cupric tartrate in electronic industry wastewater

The coordination structure of cupric tartrate(Cu−TA)complex was investigated by ultraviolet−visible(UV-Vis)and liquid chromatography/mass spectrometer(LC-MS)firstly;furthermore,effective coordination configurations and electronic properties of Cu−TA in aqueous solution were systematically revealed by density functional theory(DFT)calculations.Consistently,Job plots show the possible existence of[Cu(TA)]and[Cu(TA)_(2)]^(2-)at 230 and 255 nm based on UV-Vis results.LC-MS results confirm the existence of the single and high coordination complexes[Cu_(2)(TA)_(2)]^(+),[Cu(TA)_(2)]^(+)and[Cu_(2)(TA)_(3)(H_(2)O)_(2)(OH)_(2)]^(2+).DFT calculation results show that carboxylic oxygen and hydroxyl oxygen of tartaric acid(TA)are preferred sites for Cu(Ⅱ)coordination.[Cu(TA)](1H,3H sites O of TA coordinated with Cu(Ⅱ)),[Cu(TA)_(2)]^(2-)(two 1^(C),2^(H) sites O of TA coordinated with Cu(Ⅱ)),and[Cu(TA)_(3)]^(4-)(three 2H,3H sites O of TA coordinated with Cu(Ⅱ))should be dominant coordination configurations of Cu−TA.The corresponding Gibbs reaction energies are-170.1,-136.2,and-90.2 kJ/mol,respectively.

Quasi-Z Source Inverter Control of PV Grid-Connected Based on Fuzzy PCI

The photovoltaic grid-connected inverter is an important interface between the photovoltaic power generation system and power grid.Its high-quality operation is directly related to the output power quality of the power grid.In order to further optimize the control effect of the quasi-Z source grid-connected photovoltaic inverter,a fuzzy proportional complex integral control(PCI)method is proposed for the current internal loop control.This method can eliminate the steady-state error,and has the characteristic of zero steady-state error adjustment for the AC disturbance signal of a specific frequency.The inductance-capacitance-inductance(LCL)filter is adopted in the grid-connected circuit,and the feedback capacitive current is taken as the control variable of the inner loop to form the active damping control method,which can not only effectively suppress the resonance of the LCL circuit,but also significantly inhibit the high-order harmonics in the grid-connected current.Finally,a system simulation model is built in MATLAB/Simulink to verify the superiority and effectiveness of the proposed method.

A meta-analysis of Duhuo Jisheng decoction combined with non-operative therapy on lumbar disc herniation

Objective:To systematically evaluate the cllinical efficacy of Duhuo Jisheng decoction(DHJSD)combined with non-surgical therapy on lumbar disc herniation(LDH).Methods:China Science and Technology Journal Database(VIP),Chinese National Knowledge Infrastructure(CNKI),WanFang Data,PubMed were searched and eligible randomized controlled clinical trials(RCTs)were included.Two reviewers evaluated the quality of the included RCTs and extracted data independently.Then,data analysis was performed with RevMetn 4.2 software.Results:A total of 18 RCTs were enrolled,including 1682 patients.Meta-analysis results showed that the overall response rate of DHJSD combined with non-operative therapy group(treatment group)in the treatment of LDH was better than that of the non-operative therapy group(control group)[OR=4.29,95%CI(3.19,5.76),P<0.001].JOA score of the treatment group was significantly higher than that of control group[OR=3.96,95%CI(3.4,4.52),P<0.001].VAS score was dramatically lower in the treatment group than the control group[OR=-1.58,95%CI(-1.97,-1.18),P<0.001].Conclusion:The clinical efficacy of DHJSD combined with non-surgical therapy is better than that of non-surgical therapy alone.However,due to the low quality of the included literatures,large-scale and high-quality RCTs are still needed for further confirmation.

ZnGa_(2)S_(4):an infrared nonlinear optical material with large second-harmonic generation response and wide band gap

High-performance nonlinear optical(NLO)crystals are crucial devices to convert wavelength of solid-state lasers.Chalcogenides play an indispensable role in the research of infrared NLO materials.In this work,ternary chalcogenide ZnGa_(2)S_(4) with defect diamond-like structure was screened out and synthesized by chemical vapor transport method.

Supramolecular Polymerization Driven by the Dimerization of Single-stranded Helix to Double-stranded Helix

We reported a type of strong and highly directional non-covalent interactions based on the dimerization of single-stranded helix to double-stranded helix that can achieve supramolecular polymerization, giving rise to the formation of linear supramolecular polymers.

Shenkang Injection protects against diabetic nephropathy in streptozotocin(STZ)-induced mice through enhancement of anti-oxidant and anti-inflammatory activities

Objective:To investigate the protective effects and possible mechanisms of Shenkang Injection(SKI)on the diabetic nephropathy in streptozotocin-induced mice.Methods:STZ with the feeding of high fat diet(HFD)was used to induce diabetic mice.The balb/c mice and diabetic mice were then randomly divided into five groups:(1)control group,(2)model group,(3)alprostadil(Alp,1.5μg/kg)group,(4)SKI(30 ml/kg)group,(5)Alp(1.5μg/kg)+SKI(15 ml/kg)group.After six weeks'treatment,blood,urine and kidney tissues were collected for biochemical assay,EUSA assay,and pathological analysis.Results:Diabetic mice exhibited evident manifestations of diabetic nephropathy(DN),as indicated by increased 24-h urine volume,urinary albumin and kidney weight index(P<0.01),which could be attenuated by SKI treatment(P<0.01).SKI was further found to improve abnormal morphology in glomerulus with increased glomerular volume and to decrease urinary N-acetyl-b-D-glucpsaminidase(NAG),β2-microglobulin(β2-MG),and kidney injury molecules-1(KIM-1)levels(P<0.05,P<0.01).Plasma levels of anti-oxidant enzymes significantly reduced in the diabetic mice,and those decreases could be reversed by SKI and Alp treatments.Additionally,SKI obviously suppressed the diabetes-induced increases of proinflammatory cytokines(IL-6,IL-1βand TNF-α)(P<0.01).Meanwhile,SKI was found to effectively attenuate the diabetes-induced coagulation dysfunction,as evidenced by lengthening prothrombin and thrombin time,and decreasing plasma levels of fibrinogen(FIB),6-K-PGF1αand thromboxane B2(TXB2)(P<0.05,P<0.01).With SKI and Alp combined treatment,the anti-oxidant activities and improvements of coagulation dysfunction were enhanced.Conclusion:SKI possesses a remarkable property to prevent diabetic nephropathy.The improvements of kidney function and hypercoagulability by SKI were enhanced with Alp combined treatment.The molecular mechanisms underlying the protection of SKI against DN may be related to enhancing the antioxidant and anti-inflammatory activities,and improving the coagulation dysfunction.