BACKGROUND Multiple primary carcinomas(MPCs)are defined as two or more independent primary cancers that occur simultaneously or sequentially in the same individual.Synchronous MPCs are rarer than solitary cancers or m...BACKGROUND Multiple primary carcinomas(MPCs)are defined as two or more independent primary cancers that occur simultaneously or sequentially in the same individual.Synchronous MPCs are rarer than solitary cancers or metachronous MPCs.Accurate diagnoses of synchronous MPCs and the choice of treatment are critical for successful outcomes in these cases.CASE SUMMARY A 64-year-old patient presented with dysphagia,without obvious cause.A diagnosis of synchronous esophageal squamous cell carcinoma and colon adenocarcinoma with liver metastasis was confirmed based on examination and laboratory results.After multi-disciplinary consultations,combination chemotherapy(a 3-wk cycle with oxaliplatin 212 mg administered on day 1 and capecitabine 1.5 g twice daily on days 1-14)and esophageal cancer radiotherapy were initiated.Based on the results of genetic testing,we switched to a regimen of leucovorin+fluorouracil+oxaliplatin and cetuximab regimen for 8 cycles.Subsequently,capecitabine and bevacizumab were administered until the most recent follow-up,at which the tumor remained stable.CONCLUSION Successful cetuximab chemotherapy treatment provides a reference for the nonoperative and homogeneous treatment of different pathological types of synchronous MCPs.展开更多
BACKGROUND Immune checkpoint inhibitors,including programmed death-ligand 1(PD-L1)and programmed death-1(PD-1)have recently been approved to treat locally advanced and metastatic urothelial carcinoma(UC).However,some ...BACKGROUND Immune checkpoint inhibitors,including programmed death-ligand 1(PD-L1)and programmed death-1(PD-1)have recently been approved to treat locally advanced and metastatic urothelial carcinoma(UC).However,some patients experience rapid tumor progression rather than any clinical benefit from anti-PDL1/PD-1 therapy.CASE SUMMARY A 73-year-old woman with bladder UC showed the progression of multiple metastases after surgery and chemotherapy for over 12 mo.The patient could not tolerate further chemotherapy.Next-generation sequencing was performed,and the results indicated that the tumor mutational burden was 6.4 mutations/Mb.The patient received the anti-PD-L1 agent toripalimab combined with albuminbound paclitaxel.Compared with the baseline staging before immunotherapy,the patient had a treatment failure time of<2 mo,an increase in tumor burden of>50%,and a>2-fold increase in progression,indicating hyperprogression.CONCLUSION Selecting patients most likely to respond to treatment with immunotherapeutic agents remains challenging.For older patients with advanced UC who have already exhausted multi-line chemotherapy options,immunotherapy should be used prudently if no effective biomarker is available.Further studies are required to clarify the causes and mechanisms of hyperprogression.展开更多
Objective:To explore the medication rule of Traditional Chinese Medicine(TCM)in the treatment of sleep disorder after stroke by using data mining technology.Methods:A computer search was used to search the electronic ...Objective:To explore the medication rule of Traditional Chinese Medicine(TCM)in the treatment of sleep disorder after stroke by using data mining technology.Methods:A computer search was used to search the electronic database of clinical literature on the treatment of sleep disorders after stroke by TCM from January 2000 to January 2021.Excel was used to establish the database,and the prescription information was described and analyzed statistically.Using IBM SPSS Modeler 18.0 software,Apriori algorithm was used for TCM association analysis,and IBM SPSS 22.0 software was used for systematic cluster analysis of high-frequency TCM.Results:A total of 67 literatures were included,covering 131 traditional Chinese medicines.The medecines with a higher frequency of sodium use include Ziziphi Spinosae Semen(Suanzaoren),Angelicae Sinensis Radix(Danggui),Ligusticum(Chuanxiong),liquorice(Gancao),Poria cocos(Fuling),and so on.From the effect point of view,deficiency-tonifying medicine,sedative medicine and blood-activating and stasis-removing medicine are commonly used.The medicinal properties are mainly cold,mild and warm.The main medicine flavor are sweet and bitter.The medicines mostly belong to the liver,heart and spleen Meridian.Thirty-three association rules were obtained for medicine pairs and medicine groups from the correlation analysis,and the core combinations were"Ziziphi Spinosae Semen(Suanzaoren)-Tuber fleeceflower stem(Yejiaoteng)","Ziziphi Spinosae Semen(Suanzaoren)-Polygala(Yuanzhi)","Ziziphi Spinosae Semen(Suanzaoren)-Cortex albiziae(Hehuanpi)"and"Angelicae Sinensis Radix(Danggui)-Radix bupleuri(Chaihu)-Radix Paeoniae Alba(Baishao)"and so on.Seven medicine aggregation groups were obtained by medicine cluster analysis.Conclusion:In the treatment of sleep disorder after stroke by TCM,the main method is to calm the heart and mind.Meanwhile,according to different syndrome types,the treatment methods of tonifying the heart and spleen,nourishing the liver and kidney,soothing the liver and softening the liver,clearing heat and resolving phlegm,nourishing the blood and promoting blood circulation are selected,which provide certain reference for clinical treatment.展开更多
The activation and deactivation of the chain-transfer agent were achieved by oxygen initiation and regulation with triethylborane under ambient temperature and atmosphere.The autoxidation of triethylborane overcame th...The activation and deactivation of the chain-transfer agent were achieved by oxygen initiation and regulation with triethylborane under ambient temperature and atmosphere.The autoxidation of triethylborane overcame the oxygen inhilbition and produced initiating radicals that selectively activate the chain-transfer agent for the chain growth or deactivate the active chain-end of polymer in controlled radical polymerization.Both activation and deactivation were highly efficient with broad scope for various polymers with different chain-transfer agents in both organic and aqueous systems.Oxygen molecule was particularly used as an external regulator to initiate and achieve the temporal control of both activation and deactivation by simply feeding the air.展开更多
文摘BACKGROUND Multiple primary carcinomas(MPCs)are defined as two or more independent primary cancers that occur simultaneously or sequentially in the same individual.Synchronous MPCs are rarer than solitary cancers or metachronous MPCs.Accurate diagnoses of synchronous MPCs and the choice of treatment are critical for successful outcomes in these cases.CASE SUMMARY A 64-year-old patient presented with dysphagia,without obvious cause.A diagnosis of synchronous esophageal squamous cell carcinoma and colon adenocarcinoma with liver metastasis was confirmed based on examination and laboratory results.After multi-disciplinary consultations,combination chemotherapy(a 3-wk cycle with oxaliplatin 212 mg administered on day 1 and capecitabine 1.5 g twice daily on days 1-14)and esophageal cancer radiotherapy were initiated.Based on the results of genetic testing,we switched to a regimen of leucovorin+fluorouracil+oxaliplatin and cetuximab regimen for 8 cycles.Subsequently,capecitabine and bevacizumab were administered until the most recent follow-up,at which the tumor remained stable.CONCLUSION Successful cetuximab chemotherapy treatment provides a reference for the nonoperative and homogeneous treatment of different pathological types of synchronous MCPs.
基金Supported by the National Natural Science Foundation,No.81973640.
文摘BACKGROUND Immune checkpoint inhibitors,including programmed death-ligand 1(PD-L1)and programmed death-1(PD-1)have recently been approved to treat locally advanced and metastatic urothelial carcinoma(UC).However,some patients experience rapid tumor progression rather than any clinical benefit from anti-PDL1/PD-1 therapy.CASE SUMMARY A 73-year-old woman with bladder UC showed the progression of multiple metastases after surgery and chemotherapy for over 12 mo.The patient could not tolerate further chemotherapy.Next-generation sequencing was performed,and the results indicated that the tumor mutational burden was 6.4 mutations/Mb.The patient received the anti-PD-L1 agent toripalimab combined with albuminbound paclitaxel.Compared with the baseline staging before immunotherapy,the patient had a treatment failure time of<2 mo,an increase in tumor burden of>50%,and a>2-fold increase in progression,indicating hyperprogression.CONCLUSION Selecting patients most likely to respond to treatment with immunotherapeutic agents remains challenging.For older patients with advanced UC who have already exhausted multi-line chemotherapy options,immunotherapy should be used prudently if no effective biomarker is available.Further studies are required to clarify the causes and mechanisms of hyperprogression.
基金financial support from Pre-research Project of Equipment Development Department of China(No.41422010505)the Technology Innovation Leading Program of Shanxi Province,China(No.2019CGHJ-21)。
基金Beijing Science and Technology Program(No.Z191100006619065)National Key R&D Program(No.2017YFC1700101)。
文摘Objective:To explore the medication rule of Traditional Chinese Medicine(TCM)in the treatment of sleep disorder after stroke by using data mining technology.Methods:A computer search was used to search the electronic database of clinical literature on the treatment of sleep disorders after stroke by TCM from January 2000 to January 2021.Excel was used to establish the database,and the prescription information was described and analyzed statistically.Using IBM SPSS Modeler 18.0 software,Apriori algorithm was used for TCM association analysis,and IBM SPSS 22.0 software was used for systematic cluster analysis of high-frequency TCM.Results:A total of 67 literatures were included,covering 131 traditional Chinese medicines.The medecines with a higher frequency of sodium use include Ziziphi Spinosae Semen(Suanzaoren),Angelicae Sinensis Radix(Danggui),Ligusticum(Chuanxiong),liquorice(Gancao),Poria cocos(Fuling),and so on.From the effect point of view,deficiency-tonifying medicine,sedative medicine and blood-activating and stasis-removing medicine are commonly used.The medicinal properties are mainly cold,mild and warm.The main medicine flavor are sweet and bitter.The medicines mostly belong to the liver,heart and spleen Meridian.Thirty-three association rules were obtained for medicine pairs and medicine groups from the correlation analysis,and the core combinations were"Ziziphi Spinosae Semen(Suanzaoren)-Tuber fleeceflower stem(Yejiaoteng)","Ziziphi Spinosae Semen(Suanzaoren)-Polygala(Yuanzhi)","Ziziphi Spinosae Semen(Suanzaoren)-Cortex albiziae(Hehuanpi)"and"Angelicae Sinensis Radix(Danggui)-Radix bupleuri(Chaihu)-Radix Paeoniae Alba(Baishao)"and so on.Seven medicine aggregation groups were obtained by medicine cluster analysis.Conclusion:In the treatment of sleep disorder after stroke by TCM,the main method is to calm the heart and mind.Meanwhile,according to different syndrome types,the treatment methods of tonifying the heart and spleen,nourishing the liver and kidney,soothing the liver and softening the liver,clearing heat and resolving phlegm,nourishing the blood and promoting blood circulation are selected,which provide certain reference for clinical treatment.
基金the National Natural Science Foundation of China(Nos.21704017,21871056,and 91956122).
文摘The activation and deactivation of the chain-transfer agent were achieved by oxygen initiation and regulation with triethylborane under ambient temperature and atmosphere.The autoxidation of triethylborane overcame the oxygen inhilbition and produced initiating radicals that selectively activate the chain-transfer agent for the chain growth or deactivate the active chain-end of polymer in controlled radical polymerization.Both activation and deactivation were highly efficient with broad scope for various polymers with different chain-transfer agents in both organic and aqueous systems.Oxygen molecule was particularly used as an external regulator to initiate and achieve the temporal control of both activation and deactivation by simply feeding the air.