Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis

BACKGROUND Gastric cancer(GC)is the fifth most common type of cancer and has the fourth highest death rate among all cancers.There is a lack of studies examining the impact of liver metastases on the effectiveness of immunotherapy in individuals diagnosed with GC.AIM To investigate the influence of liver metastases on the effectiveness and safety of immunotherapy in patients with advanced GC.METHODS This retrospective investigation collected clinical data of patients with advanced stomach cancer who had immunotherapy at our hospital from February 2021 to January 2023.The baseline attributes were compared using either the Chi-square test or the Fisher exact probability method.The chi-square test and Kaplan-Meier survival analysis were employed to assess the therapeutic efficacy and survival duration in GC patients with and without liver metastases.RESULTS The analysis comprised 48 patients diagnosed with advanced GC,who were categorized into two groups:A liver metastasis cohort(n=20)and a non-liver metastatic cohort(n=28).Patients with liver metastasis exhibited a more deteriorated physical condition compared to those without liver metastasis.The objective response rates in the cohort with metastasis and the cohort without metastasis were 15.0%and 35.7%(P>0.05),respectively.Similarly,the disease control rates in these two cohorts were 65.0%and 82.1%(P>0.05),respectively.The median progression-free survival was 5.0 months in one group and 11.2 months in the other group,with a hazard ratio of 0.40 and a significance level(P)less than 0.05.The median overall survival was 12.0 months in one group and 19.0 months in the other group,with a significance level(P)greater than 0.05.CONCLUSION Immunotherapy is less effective in GC patients with liver metastases compared to those without liver metastasis.

Ion-Velocity Imaging Study of Dissociative Charge Exchange Reactions between Ar^(+)and trans-/cis-Dichloroethylene

Dissociative charge exchange re-actions between Ar^(+)ion and trans-/cis-dichloroethylene(trans-/cis-C_(2)H_(2)Cl_(2))are investi-gated with the ion-velocity imag-ing technique.The dechlorinated product C_(2)H_(2)Cl^(+)is the predomi-nant,and most of this product show the spatial distribution around the target,implying that the dissociation occurs in the large impact-parameter collision and via the energy resonant charge transfer.Meanwhile,a few C_(2)H_(2)Cl^(+)locate around the center-of-mass,which is at-tributed to the fragmentation of intimate association between C_(2)H_(2)Cl_(2)and Ar^(+)or in the small impact-parameter collision.The product C_(2)HCl_(+)exhibits the velocity distribution fea-tures similar to those of C_(2)H_(2)Cl_(+).The rarest product C_(2)HCl_(2)+shows the distributions around the molecular target,due to the quick dehydrogenation after the energy-resonant charge transfer in the large impact-parameter collision.

Prediction model of stress ulcer after laparoscopic surgery for colorectal cancer established by machine learning algorithm

BACKGROUND Patients with colorectal cancer(CRC)are prone to stress ulcer after laparoscopic surgery.The analysis of risk factors for stress ulcer(SU)in patients with CRC is important to reduce mortality and improve patient prognosis.AIM To identify risk factors for SU after laparoscopic surgery for CRC,and develop a nomogram model to predict the risk of SU in these patients.METHODS The clinical data of 135 patients with CRC who underwent laparoscopic surgery between November 2021 and June 2022 were reviewed retrospectively.They were divided into two categories depending on the presence of SUs:The SU group(n=23)and the non-SU group(n=112).Univariate analysis and multivariate logistic regression analysis were used to screen for factors associated with postoperative SU in patients undergoing laparoscopic surgery,and a risk factor-based nomogram model was built based on these risk factors.By plotting the model's receiver operating characteristic(ROC)curve and calibration curve,a Hosmer-Lemeshow goodness of fit test was performed.RESULTS Among the 135 patients with CRC,23 patients had postoperative SU,with an incidence of 17.04%.The SU group had higher levels of heat shock protein(HSP)70,HSP90,and gastrin(GAS)than the non-SU group.Age,lymph node metastasis,HSP70,HSP90,and GAS levels were statistically different between the two groups,but other indicators were not statistically different.Logistic regression analysis showed that age≥65 years,lymph node metastasis,and increased levels of HSP70,HSP90 and GAS were all risk factors for postoperative SU in patients with CRC(P<0.05).According to these five risk factors,the area under the ROC curve for the nomogram model was 0.988(95%CI:0.971-1.0);the calibration curve demonstrated excellent agreement between predicted and actual probabilities,and the Hosmer-Lemeshow goodness of fit test revealed that the difference was not statistically significant(χ2=0.753,P=0.999),suggesting that the nomogram model had good discrimination,calibration,and stability.CONCLUSION Patients with CRC aged≥65 years,with lymph node metastasis and elevated HSP70,HSP90,GAS levels,are prone to post-laparoscopic surgery SU.Our nomogram model shows good predictive value.

Electroacupuncture reduces apoptotic index and inhibits p38 mitogen-activated protein kinase signaling pathway in the hippocampus of rats with cerebral ischemia/reperfusion injury

Electroacupuncture attenuates cerebral hypoxia and neuronal apoptosis induced by cerebral ischemia/reperfusion injury.To further identify the involved mechanisms,we assumed that electroacupuncture used to treat cerebral ischemia/reperfusion injury was associated with the p38 mitogen-activated protein kinase（MAPK） signaling pathway.We established rat models of cerebral ischemia/reperfusion injury using the modified Zea-Longa＇s method.At 30 minutes before model establishment,p38 MAPK blocker SB20358 was injected into the left lateral ventricles.At 1.5 hours after model establishment,electroacupuncture was administered at acupoints of Chize（LU5）,Hegu（LI4）,Zusanli（ST36）,and Sanyinjiao（SP6） for 20 minutes in the affected side.Results showed that the combination of EA and SB20358 injection significantly decreased neurologic impairment scores,but no significant differences were determined among different interventional groups.Hematoxylin-eosin staining also showed reduced brain tissue injuries.Compared with the SB20358 group,the cells were regularly arranged,the structures were complete,and the number of viable neurons was higher in the SB20358 ＋ electroacupuncture group.Terminal deoxynucleotidyl transferase（Td T）-mediated d UTP nick-end labeling assay showed a decreased apoptotic index in each group,with a significant decrease in the SB20358 ＋ electroacupuncture group.Immunohistochemistry revealed reduced phosphorylated p38 expression at 3 days in the electroacupuncture group and SB20358 ＋ electroacupuncture group compared with the ischemia/reperfusion group.There was no significant difference in phosphorylated p38 expression between the ischemia/reperfusion group and SB20358 group.These findings confirmed that the electroacupuncture effects on mitigating cerebral ischemia/reperfusion injury are possibly associated with the p38 MAPK signaling pathway.A time period of 3 days could promote the repair of ischemic cerebral nerves.

Brain activation and inhibition after acupuncture at Taichong and Taixi: resting-state functional magnetic resonance imaging

Acupuncture can induce changes in the brain. However, the majority of studies to date have focused on a single acupoint at a time. In the present study, we observed activity changes in the brains of healthy volunteers before and after acupuncture atTaichong （LR3） andTaixi （KI3） using resting-state functional magnetic resonance imaging. Fifteen healthy volunteers underwent resting-state functional magnetic resonance imaging of the brain 15 minutes before acupuncture, then received acupuncture atTaichong andTaixi using the nail-pressing needle insertion method, after which the needle was retained in place for 30 minutes. Fifteen minutes after withdrawal of the needle, the volunteers underwent a further session of resting-state functional magnetic res-onance imaging, which revealed that the amplitude of low-frequency lfuctuation, a measure of spontaneous neuronal activity, increased mainly in the cerebral occipital lobe and middle occipital gyrus （Brodmann area 18/19）, inferior occipital gyrus （Brodmann area 18） and cuneus （Brodmann area 18）, but decreased mainly in the gyrus rectus of the frontal lobe （Brodmann area 11）, inferi-or frontal gyrus （Brodmann area 44） and the center of the posterior lobe of the cerebellum. The present ifndings indicate that acupuncture atTaichong andTaixi speciifcally promote blood lfow and activation in the brain areas related to vision, emotion and cognition, and inhibit brain areas related to emotion, attention, phonological and semantic processing, and memory.

Electroacupuncture exerts neuroprotective effects on ischemia/reperfusion injury in JNK knockout mice：the underlying mechanism

Simple regulation of c-Jun N-terminal kinase（JNK） or p38 mitogen-activated protein kinase（MAPK） pathways is not enough to trigger cell apoptosis.However,activation of the stress activated pathway（JNK/p38 MAPK） together with inhibition of the growth factor activated extracellular signal-regulated kinase（ERK） pathway can promote cell apoptosis.We hypothesized that inhibition of the JNK or p38 pro-apoptotic pathway and activating the ERK pathway could be the mechanism of anti-apoptosis following cerebral ischemia/reperfusion injury.To investigate the mechanism of the protective effect of electroacupuncture on cerebral ischemia/reperfusion injury in JNK knockout mice,mouse models of cerebral ischemia/reperfusion injury were established by Longa’s method.Electroacupuncture was conducted at acupoints Chize（LU5）,Hegu（LI4）,Sanyinjiao（SP6） and Zusanli（ST36） 1.5 hours after ischemia/reperfusion injury for 20 minutes,once a day.The neurological function was evaluated using neurological deficit scores.The expression of phospho-extracellular signal-regulated kinase（p-ERK） and phospho-p38（p-p38） in JNK knockout mice was detected using double-labeling immunofluorescence and western blot assay.The m RNA expression of ERK and p38 was measured by quantitative real-time polymerase chain reaction.Electroacupuncture improved neurological function,increased the immunoreactivity and relative expression of p-ERK and reduced that of p-p38 in the cerebral cortex and hippocampus on the injured side.Electroacupuncture increased m RNA expression of ERK,but decreased that of p38 in the cerebral cortex and hippocampus on the injured side.In conclusion,electroacupuncture upregulated the protective ERK pathway and inhibited the pro-apoptotic p38 pathway,thereby exerting a neuroprotective effect and improving the neurological function in JNK knockout mice.

Progress in research of single-flavor Chinese medicine extracts in treatment of non-small cell lung cancer

Lung cancer is one of the diseases with high morbidity and mortality,and non-small cell lung cancer accounts for a large proportion of it.Traditional Chinese medicine has a long history in treating tumors.More and more researchers have paid more attention to it.At present,many studies have proved that traditional Chinese medicine extracts such as astragalus,turmeric,ginseng,coix seed,and gallbladder can inhibit tumor cell proliferation,and have synergistic effects when used in combination with radiotherapy and chemotherapy Its mechanism of action is mostly related to regulating the cell cycle,inhibiting the expression of cancer-related genes,and inducing apoptosis.It is believed that with the development of purification technology,Chinese medicine extracts will play a greater role.