Winter Wheat Yield Estimation Based on Sparrow Search Algorithm Combined with Random Forest:A Case Study in Henan Province,China

Precise and timely prediction of crop yields is crucial for food security and the development of agricultural policies.However,crop yield is influenced by multiple factors within complex growth environments.Previous research has paid relatively little attention to the interference of environmental factors and drought on the growth of winter wheat.Therefore,there is an urgent need for more effective methods to explore the inherent relationship between these factors and crop yield,making precise yield prediction increasingly important.This study was based on four type of indicators including meteorological,crop growth status,environmental,and drought index,from October 2003 to June 2019 in Henan Province as the basic data for predicting winter wheat yield.Using the sparrow search al-gorithm combined with random forest(SSA-RF)under different input indicators,accuracy of winter wheat yield estimation was calcu-lated.The estimation accuracy of SSA-RF was compared with partial least squares regression(PLSR),extreme gradient boosting(XG-Boost),and random forest(RF)models.Finally,the determined optimal yield estimation method was used to predict winter wheat yield in three typical years.Following are the findings:1)the SSA-RF demonstrates superior performance in estimating winter wheat yield compared to other algorithms.The best yield estimation method is achieved by four types indicators’composition with SSA-RF)(R^(2)=0.805,RRMSE=9.9%.2)Crops growth status and environmental indicators play significant roles in wheat yield estimation,accounting for 46%and 22%of the yield importance among all indicators,respectively.3)Selecting indicators from October to April of the follow-ing year yielded the highest accuracy in winter wheat yield estimation,with an R^(2)of 0.826 and an RMSE of 9.0%.Yield estimates can be completed two months before the winter wheat harvest in June.4)The predicted performance will be slightly affected by severe drought.Compared with severe drought year(2011)(R^(2)=0.680)and normal year(2017)(R^(2)=0.790),the SSA-RF model has higher prediction accuracy for wet year(2018)(R^(2)=0.820).This study could provide an innovative approach for remote sensing estimation of winter wheat yield.yield.

Left atrial appendage occluder detachment treated with transthoracic ultrasound combined with digital subtraction angiography guided catcher:A case report

BACKGROUND There are very few cases of cardiac occluder detachment,and it is rare to completely remove the occluder using interventional methods without undergoing thoracotomy surgery after detachment.This case innovatively used ultrasound guidance combined with digital subtraction angiography(DSA)to completely remove the occluder,accumulating some experience.CASE SUMMARY The patient underwent left atrial appendage occlusion surgery in our hospital due to atrial fibrillation.After the surgery,the occluder fell off and became free in the left ventricle,which is very dangerous.We innovatively used ultrasound guidance,combined with DSA,and interventional surgery to successfully capture the free occluder using a catcher,completely remove it,and then re implant a new left atrial appendage occluder.After the surgery,the patient recovered very well.CONCLUSION The size selection of the occluder is slightly conservative,and the shape of the left atrial appendage opening is irregular.

Influence of static cartoons combined with dynamic virtual environments on preoperative anxiety of preschool-aged children undergoing surgery

BACKGROUND Preschoolers become anxious when they are about to undergo anesthesia and surgery,warranting the development of more appropriate and effective interventions.AIM To explore the effect of static cartoons combined with dynamic virtual environments on preoperative anxiety and anesthesia induction compliance in preschool-aged children undergoing surgery.METHODS One hundred and sixteen preschool-aged children were selected and assigned to the drug(n=37),intervention(n=40),and control(n=39)groups.All the children received routine preoperative checkups and nursing before being transferred to the preoperative preparation room on the day of the operation.The drug group received 0.5 mg/kg midazolam and the intervention group treatment consisting of static cartoons combined with dynamic virtual environments.The control group received no intervention.The modified Yale Preoperative Anxiety Scale was used to evaluate the children’s anxiety level on the day before surgery(T0),before leaving the preoperative preparation room(T1),when entering the operating room(T2),and at anesthesia induction(T3).Compliance during anesthesia induction(T3)was evaluated using the Induction Compliance Checklist(ICC).Changes in mean arterial pressure(MAP),heart rate(HR),and respiratory rate(RR)were also recorded at each time point.RESULTS The anxiety scores of the three groups increased variously at T1 and T2.At T3,both the drug and intervention groups had similar anxiety scores,both of which were lower than those in the control group.At T1 and T2,MAP,HR,and RR of the three groups increased.The drug and control groups had significantly higher MAP and RR than the intervention group at T2.At T3,the MAP,HR,and RR of the drug group decreased and were significantly lower than those in the control group but were comparable to those in the intervention group.Both the drug and intervention groups had similar ICC scores and duration of anesthesia induction(T3),both of which were higher than those of the control group.CONCLUSION Combining static cartoons with dynamic virtual environments as effective as medication,specifically midazolam,in reducing preoperative anxiety and fear in preschool-aged children.This approach also improve their compliance during anesthesia induction and helped maintain their stable vital signs.

Anti-OX40 Antibody Combined with HBc VLPs Delays Tumor Growth in a Mouse Colon Cancer Model

Objective Combination immunotherapy strategies targeting OX40,a co-stimulatory molecule that can enhance antitumor immunity by modulating the proliferation,differentiation,and effector function of tumor-infiltrating T cells,have attracted much attention for their excellent therapeutic effects.In this study,we aimed to evaluate the antitumor efficacy of combined anti-OX40 and hepatitis B core viruslike particles(HBc VLPs)therapy using a mouse colon cancer model.Methods Humanized B-h OX40 mice were injected subcutaneously with MC38 colon tumor cells and treated with HBc VLPs+anti-h OX40 antibody.Tumor growth was monitored.Flow cytometric analysis was performed to evaluate the populations of T cell subsets in the tumors.Results The combination of anti-OX40 with HBc VLPs resulted in a significant delay in tumor growth,suggesting that a potent antitumor immunity was induced by the combination therapy.Further studies revealed that HBc VLPs+anti-OX40 treatment induced a significant increase in effector T cells(Teffs)and a significant decrease in regulatory T cells(Tregs)in the tumor microenvironment(TME),which accounted for the synergistic antitumor effect of anti-OX40 in combination with HBc VLPs.Conclusion Combination therapy of anti-h OX40 and HBc VLPs provides synergistic antitumor activity in colon cancer-bearing mice,which may represent a potential design strategy for cancer immunotherapy.

Targeted anti-tumor synergistic effects of Myc decoy oligodeoxynucleotides-loaded selenium nanostructure combined with chemoradiotherapy on LNCaP prostate cancer cells

In the present study,we investigated the synergistic effects of targeted methotrexate-selenium nanostructure containing Myc decoy oligodeoxynucleotides along with X-irradiation exposure as a combination therapy on LNCaP prostate cancer cells.Myc decoy ODNs were designed based on the promoter of Bcl-2 gene and analyzed by molecular docking and molecular dynamics assays.ODNs were loaded on the synthesized Se@BSA@Chi-MTX nanostructure.The physicochemical characteristics of nanostructures were determined by FTIR,DLS,UV-vis,TEM,EDX,in vitro release,and hemolysis tests.Subsequently,the cytotoxicity properties of them with and without X-irradiation were investigated by uptake,MTT,cell cycle,apoptosis,and scratch assays on the LNCaP cell line.The results of DLS and TEM showed negative charge(−9 mV)and nanometer size(40 nm)for Se@BSA@Chi-DEC-MTX NPs,respectively.The results of FTIR,UV-vis,and EDX showed the proper interaction of different parts and the correct synthesis of nanoparticles.The results of hemolysis showed the hemocompatibility of this nanoparticle in concentrations less than 6 mg/mL.The ODNs release from the nanostructures showed a pH-dependent manner,and the release rate was 15%higher in acidic pH.The targeted Se@BSA@Chi-labeled ODN-MTX NPs were efficiently taken up by LNCaP cells by targeting the prostate-specific membrane antigen(PSMA).The significant synergistic effects of nanostructure(containing MTX drug)treatment along with X-irradiation showed cell growth inhibition,apoptosis induction(~57%),cell cycle arrest(G2/M phase),and migration inhibition(up to 90%)compared to the control.The results suggested that the Se@BSA@Chi-DEC-MTX NPs can potentially suppress the cell growth of LNCaP cells.This nanostructure system can be a promising approach for targeted drug delivery and chemoradiotherapy in prostate cancer treatment.

Lenvatinib combined with sintilimab plus transarterial chemoembolization as first-line treatment for advanced hepatocellular carcinoma

BACKGROUND Recently,combination therapy has shown a better trend towards improved tumour response and survival outcomes than monotherapy in patients with hepatocellular carcinoma(HCC).However,research on triple therapy[lenvatinib+sintilimab+transarterial chemoembolization(TACE)]as a first-line treatment for advanced HCC is limited.AIM To evaluate the safety and efficacy of triple therapy as a first-line treatment for advanced HCC.METHODS HCC patients with Barcelona Clinic Liver Cancer stage C treated with triple therapy were enrolled.All patients were treated with lenvatinib every day and sintilimab once every 3 wk.Moreover,TACE was performed every 4-6 wk if necessary.The primary outcome of the study was overall survival(OS).The secondary outcomes were the objective response rate(ORR),disease control rate(DCR),and incidence of adverse events.RESULTS Forty HCC patients who underwent triple therapy were retrospectively analysed from January 2019 to January 2022.With a median follow-up of 8.5 months,the 3-,6-,and 12-mo OS rates were 100%,88.5%,and 22.5%,respectively.The ORR and DCR were 45%and 90%,respectively.The median progressive free survival and median OS were not reached.Common complications were observed in 76%of the patients(grade 3,15%;grade 4,2.5%).CONCLUSION Combination therapy comprising lenvatinib,sintilimab and TACE achieved promising outcomes in advanced HCC patients and had manageable effects.

Effect of Dendrobium nobile powder combined with conventional therapy on mild to moderate fatty liver

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)encompasses a variety of liver conditions impacting individuals who consume minimal or no alcohol.Recently,traditional Chinese medicine has been gradually used to treat mild to moderate fatty liver,among which Dendrobium nobile Lindl.powder has been affirmed by many doctors and patients to be effective.However,there is limited research on combining this treatment with standard therapies for mild to moderate NAFLD.AIM To survey the effect of combining Dendrobium nobile Lindl.powder with standard treatment on liver function and lipid metabolism disorder in patients with mild to moderate NAFLD.METHODS Eighty patients with mild to moderate NAFLD participated in this retrospective study,classified into two groups:The observation group(n=40)and the control group(n=40).In November 2020 and November 2022,the study was conducted at People’s Hospital of Chongqing Liang Jiang New Area.The control group received standard treatment,while the observation group received Dendrobium nobile Lindl.powder based on the control group.The study compared differences in traditional Chinese medicine clinical syndrome scores,liver fibrosis treatment,liver function indicators,lipid levels,and serum inflammatory factor levels before and after treatment,and we calculated the incidence of adverse reactions for both groups.RESULTS The total effective rate was 97.50%in the observation group and 72.5%in the control group.After 8 weeks of treatment,the main and secondary symptom scores remarkably decreased,especially in the observation group(P<0.05),and there was a significant reduction in the serum levels of hyaluronic acid(HA),laminin(LN),human rocollagen III(PC III),and collagen type IV(CIV).The levels of HA,LN,PC III,and CIV were significantly lower in the observation group(P<0.05).After 8 weeks,both groups indicated remarkable improvements in liver function and blood lipid levels,with the observation group having even lower levels(P<0.05).Serum levels of interleukin-1β,tumor necrosis factor-α,and interleukin-8 also dropped significantly.The observation group had a lower rate of adverse reactions(5.00%)compared to the control group(22.50%).CONCLUSION Adding Dendrobium nobile Lindl.powder to standard treatment has been found to remarkably improve symptoms and reduce inflammation in patients with mild to moderate fatty liver disease.It also enhances hepatic function and lipid profile,ameliorates liver fibrosis indices,and lowers the risk of side effects.Consequently,this therapeutic protocol shows promise for clinical implementation and dissemination.

Therapeutic effect of San Bi Tang combined with glucosamine sulfate capsules in cold-dampness-type knee osteoarthritis

BACKGROUND Cold-dampness-type knee osteoarthritis is a common middle-aged and elderly disease,but its pathogenesis is not fully understood,and its clinical treatment has limitations.Glucosamine sulfate capsules are commonly used for treating arthritis,and San Bi Tang is a classic formula of traditional Chinese medicine(TCM)that has the effects of warming yang,dispelling dampness,relaxing muscles,and activating collaterals.This research hypothesized that the combination of modified San Bi Tang and glucosamine sulfate capsules could enhance the clinical efficacy of treating cold-dampness-type knee osteoarthritis through complementary effects.AIM To analyze the clinical efficacy of San Bi Tang combined with glucosamine sulfate capsules when treating cold-dampness-type knee osteoarthritis.METHODS A total of 110 patients with cold-dampness-type knee osteoarthritis were selected as research subjects and randomly divided into a control group and an experimental group of 55 cases each.The control group received only treatment with glucosamine sulfate capsules,while the experimental group received additional treatment with modified San Bi Tang for a duration of 5 wk.The patients’knee joint functions,liver and kidney function indicators,adverse reactions,and vital signs were evaluated and analyzed using SPSS 26.0 software.RESULTS Before treatment,the two groups’genders,ages,and scores were not significantly different,indicating comparability.Both groups’scores improved after treatment,which could indicate pain and knee joint function improvement,but the test group had better scores.The TCM-specific symptoms and the clinical efficacy of the treatment in the test group were higher.Before and after treatment,there were no abnormalities in the patients’liver and kidney function indicators.CONCLUSION The combination of modified San Bi Tang and glucosamine sulfate capsules is superior to treatment with sulfated glucosamine alone and has high safety.

Early Application Study of Intravenous Pain Pump Combined with Parecoxib Injection in Relieving Pain in Patients after Thoracoscopy

Objective: To explore the clinical effectiveness of combined use of intravenous pain pump with Parecoxib injection in alleviating pain in patients during the early postoperative period after thoracoscopic surgery. Methods: Eighty patients who underwent thoracoscopic surgery in a tertiary hospital were selected as the study subjects and randomly divided into two groups, with 40 patients in each group. The control group received routine postoperative treatment with intravenous pain pump, while the experimental group received Parecoxib in addition to the standard postoperative pain pump treatment. Visual Analog Scale (VAS) pain scores were used to evaluate postoperative pain relief in both groups, along with adverse reactions, postoperative complications, and patient satisfaction with pain relief. Results: Patients who received Parecoxib injection in addition to the routine use of intravenous pain pump had VAS pain scores lower than 3 points at 6 h, 12 h, 24 h, and 36 h postoperatively compared to those in the control group. The incidence of postoperative lung collapse, pleural effusion, and pulmonary infections was also significantly lower in the experimental group. The differences between the two groups were statistically significant (P Conclusion: Early combined use of Parecoxib injection in the early postoperative period after thoracoscopic surgery has shown good clinical efficacy. It can reduce the level of pain in patients, promote effective coughing and expectoration, facilitate early mobilization of patients, improve patient compliance, reduce complications, shorten hospital stay, and expedite patient recovery. Therefore, it is worth promoting the widespread clinical application of Parecoxib injection in this setting.

Disitamab vedotin combined with apatinib in gastric cancer: A case report and review of literature

BACKGROUND In patients with human epidermal growth factor receptor 2(HER2)-overex-pressing gastric cancer(GC),the combination of HER2 targeting and a standard first-line chemotherapy regimen has been demonstrated to significantly improve their prognosis.However,in a proportion of patients,cancer progresses within a short period of time,and there is currently no standard treatment after disease progression.CASE SUMMARY This study presents a case of a 51-year-old male with advanced GC who un-derwent radical resection(Billroth type II subtotal gastrectomy and gastrojejun-ostomy)and resection of liver metastases.Immunohistochemical staining revealed a HER2 score of 2+,a dMMR status,and a Ki67 proliferation index of 30%to 40%.The gene test results indicated the presence of ERBB2 amplification and a PD-L1 expression level of less than 5%.Since December 2021,the patient has experienced disease progression during both first-line(two cycles of KN026 combined with KN046)and second-line(five cycles of nivolumab combined with trastuzumab and SOX chemotherapy)treatment regimens.The patient's prognosis following the first and second lines of treatment was unfavorable,with pro-gression occurring in a relatively short time.For third-line therapy,disitamab vedotin(RC48)plus apatinib was used.At the time of this report,the patient had achieved a progression-free survival(PFS)of 25.8 months,which exceeded the median survival time for patients with advanced GC.CONCLUSION Despite the unfavorable prognosis associated with advanced GC,the imple-mentation of personalized treatment approaches may still prove beneficial for select patients.In patients with HER2-positive GC with extensive metastatic involvement,the use of the HER2-targeted combination with apatinib has demonstrated the potential to prolong both PFS and overall survival.

Observation on the Clinical Effect of Applying Venetoclax Combined with Demethylation Drug Therapy in Patients with Acute Myeloid Leukemia

Objective: To investigate the therapeutic effect of applying venetoclax combined with demethylating drugs in treating patients with acute myeloid leukemia (AML). Methods: Eighty cases of AML patients treated with venetoclax combined with demethylating drugs in our hospital were selected from March 2021 to March 2024, including 40 cases of primary treatment patients and 40 cases of relapsed and refractory patients. The efficacy and safety of the combined drug therapy was analyzed. Results: The primary treatment group was presented with a complete remission (CR) rate of 40.5%, partial remission (PR) rate of 47.50%, no response (NR) rate of 12.50%, and a remission rate of 87.50%. The relapsed- refractory group was presented with a CR rate of 37.50%, PR rate of 42.50%, NR rate of 17.50%, and a remission rate of 87.50%. There was no statistical significance between the groups (P > 0.05). The hematological adverse reactions of the combined treatment for AML were leukopenia and the non-hematological adverse reactions were mainly infections, with an incidence rate of 87.50%. Conclusion: The efficacy of venetoclax combined with demethylating drugs in AML was remarkable and the treatment regimen can be adjusted according to the treatment-resistant response.

Mechanism of intervention of medicine combined with mild moxibustion on hypothyroidism rat model

Objective:To explore the intervention effect of medicine combined with mild moxibustion on immune factor and Na/I symporter(NIS)in hypothyroidism rat model.Methods:The model was successfully made by intragastric administration of propylthiouracil(PTU)solution medicine and medicine combined with mild moxibustion groups were given levothyroxine sodium suspension 60μg/kg body weight by gavage,once a day.In the medicine combined with mild moxibustion group,mild moxibustion was applied in“Dazhui”,“Mingmen”,“Pishu”,“Shenshu”,and 10 minutes per point,once a day,and one day off every six days;four weeks in a row.The model group and medicine was fixed in the same way as the medicine combined with mild moxibustion group.The blank group received no treatment.The contents of thyrotropin-releasing hormone(TSH),tatalthyroxine(TT4),thyroid peroxidase antibody(TPOAb),thyroglobulin antibodies(TGAb),Interleukin-4(IL-4)and Interleukin-23(IL-23)in serum were determined by Enzyme Linked Immunosorbent Assay(ELISA).The content of NIS and the expression level of NISmRNA in thyroid tissues of each group were detected by immunohistochemistry and real-time polymerase chain reaction(R-T PCR).Results:Compared with the blank group,the contents of TSH,TPOAb,TGAb and IL-23 in the serum of rats in the model group were increased,the contents of IL-4 and TT4 were decreased,and the contents of NIS and NISmRNA in thyroid tissue were decreased,with statistical significance(P<0.01).Compared with model group,the contents of TSH,TPOAb,TGAb and IL-23 in serum of medicine group and medicine combined with mild moxibustion group were decreased,while the contents of IL-4 and TT4 were increased;the NIS content and NISmRNA expression in thyroid tissues were increased,and the differences were statistically significant(P<0.01).Compared with the medicine group,NISmRNA expression in thyroid tissues of medicine combined with mild moxibustion groups was increased,and the difference was statistically significant(P<0.05).Conclusion:Medicine combined with mild moxibustion can decrease the contents of TPOAb,TGAb and IL-23,and increase the content of IL-4,increasing the content and expression of NIS to interfere with the hypothyroidism rat model.

Evaluation of the Application Effect of Short Video Combined with BOPPPS Teaching Mode in Clinical Anesthesia Teaching

Objective:To study the application effect of short video combined with BOPPPS teaching mode in clinical anesthesia practice.Method:48 students assigned to clinical anesthesia in digestive endoscopy of Shanxi Bethune Hospital from July 1,2022 to April 1,2023 were selected as research objects.They were randomly divided into the control group(PowerPoint presentation teaching group)and the observation group(short video combined with BOPPPS teaching group),with 24 students in each group.After the internship,the students’theoretical and technical scores were tested,the effects of the two teaching modes were compared,and the students’satisfaction was investigated.Results:The test scores of students in the observation group were significantly better than those in the control group(P<0.05).The short video combined with BOPPPS teaching mode can significantly improve students’learning interest,operation skills,and memory(P<0.05).The students’satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:In clinical practice,the application of short video combined with BOPPPS teaching mode has achieved great effect,which is worth further promotion and research.

Envafolimab combined with chemotherapy in the treatment of combined small cell lung cancer: A case report

BACKGROUND Combined small cell lung cancer(C-SCLC) is a special subtype of small cell lung cancer that is relatively rare, aggressive, and prone to early metastasis and has a poor prognosis. Currently, there are limited studies on C-SCLC, and there is no uniform standard treatment, especially for extensive C-SCLC, which still faces great challenges. In recent years, the development and progress of immunotherapy have provided more possibilities for the treatment of C-SCLC. We used immunotherapy combined with first-line chemotherapy to treat extensive-stage C-SCLC to explore its antitumor activity and safety.CASE SUMMARY We report a case of C-SCLC that presented early with adrenal, rib, and mediastinal lymph node metastases. The patient received carboplatin and etoposide with concurrent initiation of envafolimab. After 6 cycles of chemotherapy, the lung lesion was significantly reduced, and the comprehensive efficacy evaluation showed a partial response. No serious drug-related adverse events occurred during the treatment, and the drug regimen was well tolerated.CONCLUSION Envafolimab combined with carboplatin and etoposide in the treatment of extensive-stage C-SCLC has preliminary antitumor activity and good safety and tolerability.

Theanine combined with cisplatin inhibits the proliferation and metastasis of TNBC cells through Akt signaling pathway

Background:Theanine,was natural compounds,has been employed in antibacterial,antineoplastic,promotion of hair growth,therapy of poliosis,and removing pattogenic heat from the blood and toxic material from the body for centuries.However,few reports focused on the treatment by theanine combined with chemotherapy in triple negative breast cancer.Methods:Our study aimed to evaluate and compare the molecular and cellular effects of theanine in combination with cisplatin in triple negative breast cancer lines MDA-MB-231.The 50%inhibitory concentration and cell viability were determined by the cell counting kit-8 assay.Meanwhile,wound healing and transwell assays were used to evaluate the effect of theanine combination with cisplatin on triple negative breast cancer(TNBC)cell metastasis.Moreover,the label-free proteomic method was available to explore the molecular mechanism of theanine combination with cisplatin on TNBC cells.What’s more,reverse transcription-polymerase chain reaction and western blotting were carried out to evaluate the related protein and mRNA alteration in the Akt signaling pathway.Results:With theanine added,the inhibitory effect of cisplatin on cell proliferation and metastasis was significantly improved.Meanwhile,with the increase of theanine concentration,the anti-tumor effect of the combination group was also significantly improved.Afterward,label-free proteomics analysis showed that theanine combined with cisplatin could significantly activate the Akt signaling pathway,thus improving the anti-tumor effect of cisplatin.Finally,reverse transcription-polymerase chain reaction and western blotting experiment showed that the combination of cisplatin with theanine induced the greatest down-regulation of phosphorylated Akt expression.Conclusion:All in all,combining theanine with appears to be a promising strategy for the effective treatment of TNBC in the prospective application which merits further clinical investigation.

Wind-speed forecasting model based on DBN-Elman combined with improved PSO-HHT

Random and fluctuating wind speeds make it difficult to stabilize the wind-power output,which complicates the execution of wind-farm control systems and increases the response frequency.In this study,a novel prediction model for ultrashort-term wind-speed prediction in wind farms is developed by combining a deep belief network,the Elman neural network,and the Hilbert-Huang transform modified using an improved particle swarm optimization algorithm.The experimental results show that the prediction results of the proposed deep neural network is better than that of shallow neural networks.Although the complexity of the model is high,the accuracy of wind-speed prediction and stability are also high.The proposed model effectively improves the accuracy of ultrashort-term wind-speed forecasting in wind farms.

Discussion on gemcitabine combined with targeted drugs in the treatment of pancreatic cancer

Pancreatic cancer is a malignant tumor with poor prognosis.The treatment of pancreatic cancer depends on the tumor stage and type,and includes local treatment(surgery,radiotherapy and ablation intervention)and systemic therapy(chemotherapy,targeted therapy and immunotherapy).We read with great interest the review“Effective combinations of anti-cancer and targeted drugs for pancreatic cancer treatment”published on World J Gastroenterol and intended to share some of our perspectives in pancreatic cancer treatment.This review presents the therapeutic effects of the combination of gemcitabine and targeted drugs,which gives us a deeper insight into the combination treatments for pancreatic cancer.

Difficult-to-treat rheumatoid arthritis treated with Abatacept combined with Baricitinib:A case report

BACKGROUND Sporadic cases of rheumatoid arthritis(RA)due to unsatisfactory responses to Abatacept(ABT)have been reported;however,the rescue therapy has not been finalized.Here,we present a case with difficult-to-treat RA(D2T RA)that was resistant to either a single ABT or a Janus kinase(JAK)inhibitor(Tofacitinib),but improved with a combination of ABT and JAK inhibitor(Baricitinib,BAT).CASE SUMMARY A 46-year-old Chinese woman who had RA for ten years that was resistant to Tocilizumab,Etanercept,Adalimumab,and ABT.According to the European League Against Rheumatism definition,the patient was diagnosed with D2T RA.It was then improved with a combination of ABT and a JAK inhibitor BAT.CONCLUSION ABT combined with BAT may be an acceptable strategy for treating D2T RA.

Successful treatment of eyebrow intradermal nevi by shearing combined with electrocautery and curettage:Two case reports

BACKGROUND An intradermal nevus is a common skin tumour,and the classical method of removal has a risk of recurrence and scarring.It is a challenge for dermatologists to treat eyebrow intradermal nevi quickly and efficiently.This study focused on investigating the efficacy and safety of shearing combined with electrocautery and curettage in the treatment of eyebrow intradermal nevi.CASE SUMMARY We describe two adult patients with eyebrow intradermal nevi treated by shearing combined with electrocautery and curettage.Both patients were followed up regularly after surgery.At follow-up,no recurrence of eyebrow intradermal nevus and no obvious scars or hypopigmentation were found in either patient.The results indicated that shearing combined with electrocautery and curettage could remove eyebrow intradermal nevus without side effects and confirmed the efficacy and safety of this modality for treating these skin lesions.CONCLUSION Shearing combined with electrocautery and curettage has superior merits,including simple operation,good cosmetic effects,and high patient satisfaction,presenting great application potential for treating intracutaneous nevus.

Study on the Effect of Shuanghuanglian Powder Needle Combined with Cefoperazone and Sulbactam Sodium on Pseudomonas aeruginosa in Vitro

Objective: To explore the antibacterial activity of combined use of Shuanghuanglian and cefoperazone sulbactam sodium on resistant strains of Pseudomonas aeruginosa. Methods: The Pseudomonas aeruginosa strains which were sensitive and resistant to cefoperazone sulbactam sodium were selected to prepare different test bacterial solutions respectively;The experimental liquid of Shuanghuanglian and Cefoperazone Sulbactam Sodium were prepared separately and set as different test groups and control groups;The Drug Sensitivity Tests of Shuanghuanglian and cefoperazone sulbactam sodium at different concentration gradients which were used alone or used in combination were carried out for different strains with sensitivity and resistance, And use standard entry as a reference control. Result: The results of drug sensitivity test of Shuanghuanglian combined with Cefoperazone-Sulbactam sodium against the resistant strains of Pseudomonas aeruginosa were compared with the results of drug sensitivity test of the two separately used, and the difference was statistically significant (P 〈 0.05) [The drug sensitivity test results of Shuanghuanglian and cefoperazone sulbactam sodium to Pseudomonas aeruginosa resistant strains were statistically significant compared with the drug sensitivity test results of Shuanghuanglian and Cefoperazone Sulbactam Sodium used separately (P 〈 0.05)];There was a dependence between strains and concentration in the effect of the combination of the two drugs. Conclusion: The combination of Shuanghuanglian and cefoperazone sulbactam sodium has synergistic antibacterial or bactericidal effect on Pseudomonas aeruginosa resistant strains. .