Background:The efficacy of combining immune checkpoint inhibitors(ICIs)with chemotherapy in neoadjuvant therapy for locally advanced gastric cancer has been explored.However,limited research exists on its effectivenes...Background:The efficacy of combining immune checkpoint inhibitors(ICIs)with chemotherapy in neoadjuvant therapy for locally advanced gastric cancer has been explored.However,limited research exists on its effectiveness in conversion therapy,and its superiority over standalone chemotherapy remains to be elucidated.This study aims to investigate the efficacy and survival outcomes of patients treated with ICIs in combination with conversion therapy for locally advanced gastric cancer.Methods:Retrospective data from patients with locally advanced gastric cancer treated with either oxaliplatin+S-1(SOX)alone or in combination with ICIs in conversion therapywere collected.Clinical andpathological characteristics,disease-free survival,andefficacy assessments in nonoperable patients were compared between the 2 treatment groups.Efficacy was further evaluated through dynamic changes in serum markers,and patients’quality of life was assessed using the QLQ-STO22(Gastric Cancer–Specific Quality of Life Questionnaire)quality-of-life measurement scale.Results:A total of 140 patients underwent conversion therapy:80 in the SOX alone group and 60 in the SOX combined with the ICIs group.There were no significant differences in baseline characteristics between the 2 groups.Compared with the SOX alone group,the SOX combined with ICIs group exhibited a higher conversion rate(83.3%vs 75%,P=0.23),R0 resection rate(90.0%vs 83.3%,P=0.31),pathological complete response(pCR)rate(18%vs 5%,P=0.02),median disease-free survival(21.4 vs 16.9 months,P=0.007),the objective response rate in nonoperable patients(60%vs 40%,P=0.301),and median progression-free survival time(7.9 vs 5.7 months,P=0.009).The QLQ-STO22 quality-of-life assessment revealed statistically significant improvements in pain,swallowing difficulties,and dietary restrictions in the combination therapy group compared with those in the monotherapy group.The enhanced efficacy of immune combination with SOX is evident,as demonstrated by the significantly prolonged surgical duration in operated patients(206.6±26.6 min vs 197.8±19.8 min,P=0.35)and intraoperative blood loss(158.9±21.2 mL vs 148.9±25.1 mL,P=0.59).No significant differences were observed in postoperative complications.Conclusions:Compared with the SOX conversion therapy regimen,SOX combined with ICIs demonstrated higher conversion rates,R0 resection rates,pathological response rates,and disease-free survival without increasing surgical difficulty or complications.Nonoperable patients also experienced longer progression-free survival and objective response rates.展开更多
Background: Self-efficacy has been identified as an important determinant of youth's behavior change including physical activity(PA) participation. However, the dimensionality check of a PA self-efficacy scale has...Background: Self-efficacy has been identified as an important determinant of youth's behavior change including physical activity(PA) participation. However, the dimensionality check of a PA self-efficacy scale has rarely been conducted in China. The current study aims to examine(1) the unidimensionality of a shortened Chinese version of PA self-efficacy scale(S-PASESC);(2) the measurement invariance of S-PASESC across gender and levels of education;(3) the latent factor mean difference between gender and levels of education;(4) the direct effects of self-efficacy on PA by different gender and education levels; and(5) the comparisons of the direct effects of self-efficacy on PA across gender and education levels.Methods: The participants were 5 th through 11 th grade public school students recruited from 7 cities located in different geographic regions of China. The final data include a total of 3003 participants(49.7% boys) who have completed the scales.Results: Confirmatory factor analysis(CFA) test supported the unidimensionality of S-PASESC. The S-PASESC is invariant across gender and 3 levels of education at both configural, full metric, and full scalar levels. Findings from latent mean comparisons showed that boys reported higher PA self-efficacy than girls. Students' perceived PA self-efficacy tend to decrease from elementary to high school. Finally, self-efficacy positively related to PA by groups of different gender and education levels and the relationship between self-efficacy and PA is stronger among middle school boys than girls.Conclusion: Findings suggest S-PASESC is a valid scale for measuring Chinese students' PA self-efficacy.展开更多
基金funded by the Science and Technology Plan of Inner Mongolia Autonomous Region(no.2022YFSH0097)the Medical Research Advancement Fund Project(no.TB212014).
文摘Background:The efficacy of combining immune checkpoint inhibitors(ICIs)with chemotherapy in neoadjuvant therapy for locally advanced gastric cancer has been explored.However,limited research exists on its effectiveness in conversion therapy,and its superiority over standalone chemotherapy remains to be elucidated.This study aims to investigate the efficacy and survival outcomes of patients treated with ICIs in combination with conversion therapy for locally advanced gastric cancer.Methods:Retrospective data from patients with locally advanced gastric cancer treated with either oxaliplatin+S-1(SOX)alone or in combination with ICIs in conversion therapywere collected.Clinical andpathological characteristics,disease-free survival,andefficacy assessments in nonoperable patients were compared between the 2 treatment groups.Efficacy was further evaluated through dynamic changes in serum markers,and patients’quality of life was assessed using the QLQ-STO22(Gastric Cancer–Specific Quality of Life Questionnaire)quality-of-life measurement scale.Results:A total of 140 patients underwent conversion therapy:80 in the SOX alone group and 60 in the SOX combined with the ICIs group.There were no significant differences in baseline characteristics between the 2 groups.Compared with the SOX alone group,the SOX combined with ICIs group exhibited a higher conversion rate(83.3%vs 75%,P=0.23),R0 resection rate(90.0%vs 83.3%,P=0.31),pathological complete response(pCR)rate(18%vs 5%,P=0.02),median disease-free survival(21.4 vs 16.9 months,P=0.007),the objective response rate in nonoperable patients(60%vs 40%,P=0.301),and median progression-free survival time(7.9 vs 5.7 months,P=0.009).The QLQ-STO22 quality-of-life assessment revealed statistically significant improvements in pain,swallowing difficulties,and dietary restrictions in the combination therapy group compared with those in the monotherapy group.The enhanced efficacy of immune combination with SOX is evident,as demonstrated by the significantly prolonged surgical duration in operated patients(206.6±26.6 min vs 197.8±19.8 min,P=0.35)and intraoperative blood loss(158.9±21.2 mL vs 148.9±25.1 mL,P=0.59).No significant differences were observed in postoperative complications.Conclusions:Compared with the SOX conversion therapy regimen,SOX combined with ICIs demonstrated higher conversion rates,R0 resection rates,pathological response rates,and disease-free survival without increasing surgical difficulty or complications.Nonoperable patients also experienced longer progression-free survival and objective response rates.
基金supported by a grant from the National Social Science Foundation of China (No. 13CTY031)
文摘Background: Self-efficacy has been identified as an important determinant of youth's behavior change including physical activity(PA) participation. However, the dimensionality check of a PA self-efficacy scale has rarely been conducted in China. The current study aims to examine(1) the unidimensionality of a shortened Chinese version of PA self-efficacy scale(S-PASESC);(2) the measurement invariance of S-PASESC across gender and levels of education;(3) the latent factor mean difference between gender and levels of education;(4) the direct effects of self-efficacy on PA by different gender and education levels; and(5) the comparisons of the direct effects of self-efficacy on PA across gender and education levels.Methods: The participants were 5 th through 11 th grade public school students recruited from 7 cities located in different geographic regions of China. The final data include a total of 3003 participants(49.7% boys) who have completed the scales.Results: Confirmatory factor analysis(CFA) test supported the unidimensionality of S-PASESC. The S-PASESC is invariant across gender and 3 levels of education at both configural, full metric, and full scalar levels. Findings from latent mean comparisons showed that boys reported higher PA self-efficacy than girls. Students' perceived PA self-efficacy tend to decrease from elementary to high school. Finally, self-efficacy positively related to PA by groups of different gender and education levels and the relationship between self-efficacy and PA is stronger among middle school boys than girls.Conclusion: Findings suggest S-PASESC is a valid scale for measuring Chinese students' PA self-efficacy.
