BACKGROUND Cholangiocarcinoma(CCA)poses a significant clinical challenge due to its low radical resection rate and a propensity for high postoperative recurrence,resulting in a poor dismal.Although the combination of ...BACKGROUND Cholangiocarcinoma(CCA)poses a significant clinical challenge due to its low radical resection rate and a propensity for high postoperative recurrence,resulting in a poor dismal.Although the combination of targeted therapy and immunotherapy has demonstrated notable efficacy in several solid tumors recently,however,its application in CCA remains underexplored and poorly documented.CASE SUMMARY This case report describes a patient diagnosed with stage IV CCA,accompanied by liver and abdominal wall metastases,who underwent palliative surgery.Subsequently,the patient received two cycles of treatment combining lenvatinib with sintilimab,which resulted in a reduction in abdominal wall metastasis,while intrahepatic metastasis displayed progression.This unexpected observation illustrates different responses of intrahepatic and extrahepatic metastases to the same therapy.CONCLUSION Lenvatinib combined with sintilimab shows promise as a potential treatment strategy for advanced CCA.Genetic testing for related driver and/or passenger mutations,as well as an analysis of tumor immune microenvironment analysis,is crucial for optimizing drug combinations and eventually addressing the issue of non-response in specific metastatic sites.展开更多
To improve the complexity of chaotic signals,in this paper we first put forward a new three-dimensional quadratic fractional-order multi-scroll hidden chaotic system,then we use the Adomian decomposition algorithm to ...To improve the complexity of chaotic signals,in this paper we first put forward a new three-dimensional quadratic fractional-order multi-scroll hidden chaotic system,then we use the Adomian decomposition algorithm to solve the proposed fractional-order chaotic system and obtain the chaotic phase diagrams of different orders,as well as the Lyaponov exponent spectrum,bifurcation diagram,and SE complexity of the 0.99-order system.In the process of analyzing the system,we find that the system possesses the dynamic behaviors of hidden attractors and hidden bifurcations.Next,we also propose a method of using the Lyapunov exponents to describe the basins of attraction of the chaotic system in the matlab environment for the first time,and obtain the basins of attraction under different order conditions.Finally,we construct an analog circuit system of the fractional-order chaotic system by using an equivalent circuit module of the fractional-order integral operators,thus realizing the 0.9-order multi-scroll hidden chaotic attractors.展开更多
文摘BACKGROUND Cholangiocarcinoma(CCA)poses a significant clinical challenge due to its low radical resection rate and a propensity for high postoperative recurrence,resulting in a poor dismal.Although the combination of targeted therapy and immunotherapy has demonstrated notable efficacy in several solid tumors recently,however,its application in CCA remains underexplored and poorly documented.CASE SUMMARY This case report describes a patient diagnosed with stage IV CCA,accompanied by liver and abdominal wall metastases,who underwent palliative surgery.Subsequently,the patient received two cycles of treatment combining lenvatinib with sintilimab,which resulted in a reduction in abdominal wall metastasis,while intrahepatic metastasis displayed progression.This unexpected observation illustrates different responses of intrahepatic and extrahepatic metastases to the same therapy.CONCLUSION Lenvatinib combined with sintilimab shows promise as a potential treatment strategy for advanced CCA.Genetic testing for related driver and/or passenger mutations,as well as an analysis of tumor immune microenvironment analysis,is crucial for optimizing drug combinations and eventually addressing the issue of non-response in specific metastatic sites.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.61561022 and 61672226)。
文摘To improve the complexity of chaotic signals,in this paper we first put forward a new three-dimensional quadratic fractional-order multi-scroll hidden chaotic system,then we use the Adomian decomposition algorithm to solve the proposed fractional-order chaotic system and obtain the chaotic phase diagrams of different orders,as well as the Lyaponov exponent spectrum,bifurcation diagram,and SE complexity of the 0.99-order system.In the process of analyzing the system,we find that the system possesses the dynamic behaviors of hidden attractors and hidden bifurcations.Next,we also propose a method of using the Lyapunov exponents to describe the basins of attraction of the chaotic system in the matlab environment for the first time,and obtain the basins of attraction under different order conditions.Finally,we construct an analog circuit system of the fractional-order chaotic system by using an equivalent circuit module of the fractional-order integral operators,thus realizing the 0.9-order multi-scroll hidden chaotic attractors.
