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新辅助免疫治疗在局部晚期直肠癌中应用循证证据
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作者 蒲文吉 苏晓晔 +3 位作者 冯玲玲 陈文琦 徐志渊 金晶 《中国肿瘤临床》 CAS CSCD 北大核心 2024年第9期472-479,共8页
错配修复功能缺陷(deficient mismatch repair,dMMR)是目前公认的预测免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)疗效的生物标志物,国内外指南已推荐dMMR实体瘤患者一线治疗选择免疫治疗。在直肠癌中,仅5%患者为dMMR/高度微... 错配修复功能缺陷(deficient mismatch repair,dMMR)是目前公认的预测免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)疗效的生物标志物,国内外指南已推荐dMMR实体瘤患者一线治疗选择免疫治疗。在直肠癌中,仅5%患者为dMMR/高度微卫星不稳定(microsatellite instability-high,MSI-H),绝大多数为“免疫沙漠型”或错配修复功能完整(mismatch repair proficient,pMMR)/微卫星稳定(microsatellite stabilization,MSS),即对ICIs反应欠佳。因此免疫药物与新辅助放化疗的协同作用是近些年基础和临床研究的热点,并且有较多Ⅱ/Ⅲ期免疫全新辅助治疗(immuno-total neoadjuvant therapy,iTNT)相关临床试验涌现,局部进展期直肠癌(locally advanced rectal cancer,LARC)管理模式也开始进入非手术治疗时代。dMMR/MSI-H型LARC患者新辅助免疫疗法效果显著,有望让患者在后续治疗中豁免手术和放化疗从而选择观察等待策略;对于pMMR/MSS型LARC,目前初步认定ICIs从初始作为后线姑息方案前移到一线选择策略以及继续开展大型临床试验。但iTNT在LARC中应用最佳模式尚无定论,但短程放疗序贯新辅助化疗联合免疫药物可能获得良好短期疗效。寻找其它新的生物标志物,可能会鉴定出部分对iTNT敏感的pMMR/MSS型患者(尤其是低位直肠癌)。未来LARC治疗策略需结合患者临床复发危险度分层和器官保留意愿两方面考虑,实现分层精准治疗。本文将对LARC中iTNT的相关研究背景、基础和临床研究进展以及存在问题等进行综述。 展开更多
关键词 局部晚期直肠癌 新辅助免疫治疗 循证医学 证据总结
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High-efficiency crystalline carbon nitride photocatalysts:Status and perspectives
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作者 wenji pu Yunqiao Zhou +4 位作者 Lingfeng Yang Haifeng Gong Yuhan Li Qingyu Yang Dieqing Zhang 《Nano Research》 SCIE EI CSCD 2024年第9期7840-7863,共24页
Crystallinity and crystal structure greatly influence the photocatalytic behavior of photocatalysts.Pristine g-C3N4 produced by traditional thermal-induced polycondensation reaction bears low crystallinity and thus po... Crystallinity and crystal structure greatly influence the photocatalytic behavior of photocatalysts.Pristine g-C3N4 produced by traditional thermal-induced polycondensation reaction bears low crystallinity and thus poor photoactivity,which originates from the incomplete polymerization of the precursor containing amine groups,abundant hydrogen bonds,and unreacted amino,as well as cyanide functional groups in the skeleton.During photocatalytic process,these residual functional groups often work as electron trap sites,which may hinder the transfer of electrons on the plane,resulting in low photoactivity.Fortunately,crystalline carbon nitride(CCN)was reported as a promising photocatalyst because its increased crystallinity not only reduces the number of carriers recombination centers,but also increases charge conductivity and improves light utilization due to extendedπ-conjugated systems and delocalizedπ-electrons.As such,we summarize the recent studies on CCN-based photocatalysts for the photoactivity enhancement.Firstly,the unique structure and properties of CCN materials are presented.Next,the preparation methods and modification strategies are well outlined.We also sum up the applications of CCN-based materials in the environmental purification and energy fields.Finally,this review concerning CNN materials ends with prospects and challenges in the obtainment of high crystallinity by effective techniques,and the deep understanding of photocatalytic mechanism. 展开更多
关键词 crystalline carbon nitride preparation method modification strategy photocatalytic application
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