Assessing the corrosion protection property of coatings loaded with corrosion inhibitors using the real-time atmospheric corrosion monitoring technique

The atmospheric corrosion monitoring(ACM)technique has been widely employed to track the real-time corrosion behavior of metal materials.However,limited studies have applied ACM to the corrosion protection properties of organic coatings.This study compared a bare epoxy coating with one containing zinc phosphate corrosion inhibitors,both applied on ACM sensors,to observe their corrosion protection properties over time.Coatings with artificial damage via scratches were exposed to immersion and alternating dry and wet environments,which allowed for monitoring galvanic corrosion currents in real-time.Throughout the corrosion tests,the ACM currents of the zinc phosphate/epoxy coating were considerably lower than those of the blank epoxy coating.The trend in ACM current variations closely matched the results obtained from regular electrochemical tests and surface analysis.This alignment highlights the potential of the ACM technique in evaluating the corrosion protection capabilities of organic coatings.Compared with the blank epoxy coating,the zinc phosphate/epoxy coating showed much-decreased ACM current values that confirmed the effective inhibition of zinc phosphate against steel corrosion beneath the damaged coating.

Programmed cell death 1 inhibitor sintilimab plus S-1 and gemcitabine for liver metastatic pancreatic ductal adenocarcinoma

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly aggressive cancer with poor prognosis.When it metastasizes to the liver,treatment options become particularly limited and challenging.Current treatment options for liver metastatic PDAC are limited,and chemotherapy alone often proves insufficient.Immunotherapy,particularly programmed cell death 1(PD-1)inhibitors like sintilimab,shows potential efficacy for various cancers but has limited reports on PDAC.This study compares the efficacy and safety of sintilimab plus S-1 and gemcitabine vs S-1 and gemcitabine alone in liver metastatic PDAC.AIM To explore the feasibility and effectiveness of combined PD-1 inhibitor sintilimab and S-1 and gemcitabine(combination group)vs S-1 and gemcitabine used alone(chemotherapy group)for treating liver metastatic pancreatic adenocarcinoma.METHODS Eligible patients were those with only liver metastatic PDAC,an Eastern Cooperative Oncology Group performance status of 0-1,adequate organ and marrow functions,and no prior anticancer therapy.Participants in the combination group received intravenous sintilimab 200 mg every 3 weeks,oral S-140 mg/m²twice daily on days 1-14 of a 21-day cycle,and intravenous gemcitabine 1000 mg/m²on days 1 and 8 of the same cycle for up to eight cycles or until disease progression,death,or unacceptable toxicity.Participants in the chemotherapy group received oral S-140 mg/m²twice daily on days 1-14 of a 21-day cycle and intravenous gemcitabine 1000 mg/m²on days 1 and 8 of the same cycle for up to eight cycles.Between June 2020 and December 2021,66 participants were enrolled,with 32 receiving the combination treatment and 34 receiving chemotherapy alone.RESULTS The group receiving the combined therapy exhibited a markedly prolonged median overall survival(18.8 months compared to 10.3 months,P<0.05)and progression-free survival(9.6 months vs 5.4 months,P<0.05).compared to the chemotherapy group.The incidence of severe adverse events did not differ significantly between the two groups(P>0.05).CONCLUSION The combination of PD-1 inhibitor sintilimab with S-1 and gemcitabine demonstrated effectiveness and safety for treating liver metastatic PDAC,meriting further investigation.

Proton pump inhibitors and all-cause mortality risk among cancer patients

BACKGROUND Proton pump inhibitors(PPIs)are widely used,including among cancer patients,to manage gastroesophageal reflux and other gastric acid-related disorders.Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes,including greater mortality.AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.METHODS This retrospective cohort study used data from the TriNetX research network,with electronic health records from multiple healthcare organizations.The study employed a new-user,active comparator design,which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists(H2RA)users among adult cancer patients.Newly prescribed PPIs(esomeprazole,lansoprazole,omeprazole,pantoprazole,or rabeprazole)users were compared to non-users or newly prescribed H2RAs(cimetidine,famotidine,nizatidine,or ranitidine)users.The primary outcome was all-cause mortality.Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects.Multivariable Cox regression models were used to estimate hazard ratios(HRs)and 95% confidence interval(CI).RESULTS During the follow-up period(median 5.4±1.8 years for PPI users and 6.5±1.0 years for non-users),PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year,2 years,and at the end of follow up(HRs:2.34-2.72).Compared with H2RA users,PPI users demonstrated a higher rate of all-cause mortality HR:1.51(95%CI:1.41-1.69).Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure,confirming the robustness of these findings.In a sensitivity analysis,we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs,providing insights into the long-term effects of past PPI use.In addition,at 1-year follow-up,the analysis revealed a significant difference in mortality rates between former PPI users and non-users(HR:1.84;95%CI:1.82-1.96).CONCLUSION PPI use among cancer patients was associated with a higher risk of all-cause mortality compared to non-users or H2RA users.These findings emphasize the need for cautious use of PPIs in cancer patients and suggest that alternative treatments should be considered when clinically feasible.However,further studies are needed to corroborate our findings,given the significant adverse outcomes in cancer patients.

基于PKC/ERK通路探讨益肾达络饮对脂多糖诱导的星形胶质细胞活化的作用机制

目的 基于PKC/ERK通路探讨益肾达络饮对脂多糖诱导的星形胶质细胞的作用机制。方法 将60只C57BL/6 J雌性小鼠随机分为分为空白组,激素组和益肾达络饮高、中、低剂量组,其中正常组20只(其中空白组10只,模型组10只),其余每组10只,空白组给予生理盐水,其余各组给予相应药物处理,连续灌胃7 d,最后一次灌胃2 h后眼球取血,制备空白血清和含药血清。提取新生48 h C57BL/6 J乳鼠原代星形胶质细胞,以脂多糖(LPS)诱导星形胶质细胞活化,胶质纤维酸性蛋白(GFAP)作为星形胶质细胞鉴定和活化的标志,实验分为空白组、模型组、益肾达络饮高、中、低剂量组、激素组,给予相应血清预处理24 h,除空白组外其余各组加入1μg/mL LPS作用24 h诱导星形胶质细胞活化,CCK-8检测各组细胞活性,免疫荧光法检测细胞GFAP表达变化,蛋白免疫印迹法检测细胞蛋白激酶C(PKC)、细胞外信号调节蛋白激酶(ERK)、p-ERK和GFAP的蛋白表达。结果 与空白组比较,模型组细胞活性、GFAP、PKC和p-ERK/ERK蛋白表达量显著升高(P<0.01),且细胞体明显变大;与模型组比较,益肾达络饮高、中、低剂量组和激素组细胞活性和PKC蛋白表达量显著降低(P<0.01),益肾达络饮高剂量组和低剂量组GFAP和p-ERK/ERK蛋白表达量显著降低(P<0.01或P<0.05),益肾达络饮中剂量组p-ERK/ERK蛋白表达量显著降低(P<0.01),激素组GFAP蛋白表达量显著降低(P<0.01)。结论 益肾达络饮可以改善由LPS所引起的星形胶质细胞的活化,降低GFAP的表达,抑制炎症反应,其作用机制可能与抑制PKC/ERK通路的激活有关。

补阳还五汤对脑缺血再灌注大鼠线粒体氧化损伤和PKCε-Nampt通路的影响

目的探讨补阳还五汤对脑缺血再灌注(I/R)大鼠线粒体氧化损伤及PKCε-Nampt通路的影响。方法大鼠随机分为假手术组、模型组、补阳还五汤组(14.3 g/kg)和依达拉奉组(3 mg/kg),除假手术组外均采用MCAO法建立脑I/R损伤模型,术后24 h各组给予相应剂量药物,给药7 d后通过神经功能评分评估神经功能缺损情况,免疫荧光检测神经元标志物MAP-2表达,观察神经元损伤情况,检测ROS、MDA水平和SOD活性评价氧化损伤情况,荧光探针JC-1检测线粒体膜电位变化,修饰酶循环法检测NAD^(+)/NADH比值,Western blot法检测PKCε、p-PKCε、Nampt蛋白表达,免疫组化法检测p-PKCε、Nampt蛋白阳性表达。结果与模型组比较,补阳还五汤组脑梗死体积、神经功能评分降低(P<0.05),脑组织MAP-2荧光强度增强(P<0.05),神经元损伤减轻,脑组织ROS、MDA水平降低(P<0.05),SOD活性、线粒体膜电位、NAD^(+)/NADH比值升高(P<0.05),p-PKCε、Nampt蛋白表达升高(P<0.05)。结论补阳还五汤可通过激活PKCε-Nampt信号通路、提高线粒体功能来减轻大鼠脑I/R损伤。

PKC/TRPV1通路在大鼠三叉神经痛中的病理作用

目的探究蛋白激酶C(PKC)/瞬时感受器电位香草酸亚型1(TRPV1)通路在大鼠三叉神经疼痛(TN)中的病理作用。方法采用眶下神经慢性收缩术(ION-CCI)来创建大鼠TN的模型。将大鼠随机分为假手术组(Sham组)、CCI组、CCI+DMSO组、CCI+GF109203X(双吲哚马来酰亚胺,一种PKC抑制剂)组。使用Von Frey毛刷检测大鼠的机械痛阈。采用qRT-PCR及Western blot分别检测三叉神经节(TG)内PKC和TRPV1表达量的变化。HE染色观察TG的病理变化。结果CCI组大鼠机械痛阈降低(P<0.05),大鼠TG内的磷酸化的PKC(p-PKC)和TRPV1表达显著增加(P<0.05)。组织病理学结果显示,与Sham组相比,CCI组观察到TG出现明显的炎性细胞浸润增多、神经细胞肿胀等变化。注射GF109203X后降低了大鼠TG内PKC的磷酸化和TRPV1的表达,大鼠机械痛阈升高(P<0.05),光学显微镜下可见TG内细胞肿胀和炎症细胞有所减少。结论PKC/TRPV1通路可能参与了大鼠的三叉神经痛。

Risk of hepatitis B virus reactivation in oncological patients treated with tyrosine kinase inhibitors:A case report and literature analysis

Hepatitis B virus(HBV)reactivation(HBVr)represents a severe and potentially life-threatening condition,and preventive measures are available through blood test screening or prophylactic therapy administration.The assessment of HBVr traditionally considers factors such as HBV profile,including hepatitis B surface antigen(HBsAg)and antibody to hepatitis B core antigen,along with type of medication(chemotherapy;immunomodulants).Nevertheless,consideration of possible patient’s underlying tumor and the specific malignancy type(solid or hematologic)plays a crucial role and needs to be assessed for decision-making process.

Sodium-dependent glucose transporter 2 inhibitors effects on myocardial function in patients with type 2 diabetes and asymptomatic heart failure

BACKGROUND Sodium-dependent glucose transporter 2 inhibitors(SGLT2i)have shown efficacy in reducing heart failure(HF)burden in a very heterogeneous groups of patients,raising doubts about some contemporary assumptions of their mechanism of action.We previously published a prospective observational study that evaluated mechanisms of action of SGLT2i in patients with type 2 diabetes who were in HF stages A and B on dual hypoglycemic therapy.Two groups of patients were included in the study:the ones receiving SGLT2i as an add-on agent to metformin and the others on dipeptidyl peptidase-4 inhibitors as an add-on to metformin due to suboptimal glycemic control.AIM To evaluate the outcomes regarding natriuretic peptide,oxidative stress,inflammation,blood pressure,heart rate,cardiac function,and body weight.METHODS The study outcomes were examined by dividing each treatment arm into two subgroups according to baseline parameters of global longitudinal strain(GLS),N-terminal pro-brain natriuretic peptide,myeloperoxidase(MPO),high-sensitivity C-reactive protein(hsCRP),and systolic and diastolic blood pressure.To evaluate the possible predictors of observed changes in the SGLT2i arm during follow-up,a rise in stroke volume index,body mass index(BMI)decrease,and lack of heart rate increase,linear regression analysis was performed.RESULTS There was a greater reduction of MPO,hsCRP,GLS,and blood pressure in the groups with higher baseline values of mentioned parameters irrespective of the therapeutic arm after 6 months of follow-up.Significant independent predictors of heart rate decrease were a reduction in early mitral inflow velocity to early diastolic mitral annular velocity at the interventricular septal annulus ratio and BMI,while the predictor of stroke volume index increase was SGLT2i therapy itself.CONCLUSION SGLT2i affect body composition,reduce cardiac load,improve diastolic/systolic function,and attenuate the sympathetic response.Glycemic control contributes to the improvement of heart function,blood pressure control,oxidative stress,and reduction in inflammation.

Immune checkpoint inhibitor-associated gastritis:Patterns and management

Immune checkpoint inhibitors(ICIs)are widely used due to their effectiveness in treating various tumors.Immune-related adverse events(irAEs)are defined as adverse effects resulting from ICI treatment.Gastrointestinal irAEs are a common type of irAEs characterized by intestinal side effects,such as diarrhea and colitis,which may lead to the cessation of ICIs.Although irAE gastritis is rarely reported,it may lead to serious complications such as gastrorrhagia.Furthermore,irAE gastritis is often difficult to identify early due to its diverse symptoms.Although steroid hormones and immunosuppressants are commonly used to reverse irAEs,the best regimen and dosage for irAE gastritis remains uncertain.In addition,the risk of recurrence of irAE gastritis after the reuse of ICIs should be considered.In this editorial,strategies such as early identification,pathological diagnosis,mana-gement interventions,and immunotherapy rechallenge are discussed to enable clinicians to better manage irAE gastritis and improve the prognosis of these patients.

Present and prospect of transarterial chemoembolization combined with tyrosine kinase inhibitor and PD-1 inhibitor for unresectable hepatocellular carcinoma

In this editorial,we comment on the article(World J Gastrointest Oncol 2024;16:1236-1247),which is a retrospective study of transarterial chemoembolization(TACE)combined with multi-targeted tyrosine kinase inhibitor(TKI)and programmed cell death protein-1(PD-1)inhibitor for the treatment of unresectable hepatocellular carcinoma(HCC).Herein,we focus specifically on the mechanisms of this triple therapy,administration sequence and selection of each medication,and implications for future clinical trials.Based on the interaction mechanisms between medications,the triple therapy of TACE+TKI+PD-1 is proposed to complement the deficiency of each monotherapy,and achieve synergistic antitumor effects.Although this triple therapy has been evaluated by several retrospective trials,it is still controversial whether the triple therapy achieves better clinical benefits,due to the flawed study design and heterogeneity in medications.In addition,the administration sequence,which may greatly affect the clinical benefit,needs to be fully considered at clinical decision-making for obtaining better prognosis.We hope that this editorial could contribute to the design and optimization of future trials.

基于PKCβ/Erk1/2/NF-κB信号通路探讨补中益气汤对自身免疫性甲状腺炎小鼠的影响

目的观察补中益气汤对自身免疫性甲状腺炎(AIT)小鼠PKCβ/Erk1/2/NF-κB信号通路的影响,探讨其治疗AIT的作用机制。方法80只8周龄NOD.H-2^(h4)小鼠随机分为对照组、模型组、中药组和硒酵母片组,每组20只。对照组饮用蒸馏水,其余各组予0.05%碘化钠溶液自由饮用8周建立AIT小鼠模型。各给药组灌胃给予相应药物给药8周。HE染色观察甲状腺组织形态,ELISA测定血清甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)含量,RT-qPCR检测甲状腺组织蛋白激酶Cβ(PKCβ)、细胞外信号调节蛋白激酶1/2(Erk1/2)、核因子(NF)-κBp65、维甲酸相关孤儿受体γt(RORγt)和白细胞介素(IL)-17 mRNA表达,Western blot检测甲状腺组织PKCβ、Erk1/2、NF-κBp65、RORγt、IL-17蛋白表达。结果与对照组比较,模型组小鼠甲状腺组织出现大量淋巴细胞浸润,血清TGAb、TPOAb含量明显升高(P<0.001),甲状腺组织PKCβ、Erk1/2、NF-κBp65、RORγt、IL-17 mRNA和蛋白表达明显升高(P<0.001);与模型组比较,中药组和硒酵母片组小鼠甲状腺组织淋巴细胞浸润减轻,血清TGAb、TPOAb含量明显降低(P<0.001),甲状腺组织PKCβ、Erk1/2、NF-κBp65、RORγt、IL-17 mRNA和蛋白表达明显降低(P<0.001),中药组与硒酵母片组各指标差异无统计学意义(P>0.05)。结论补中益气汤可能通过调控PKCβ/Erk1/2/NF-κB信号通路减轻AIT小鼠炎症反应,改善甲状腺组织淋巴细胞浸润状态。

Hepatic arterial infusion chemotherapy with anti-angiogenesis agents and immune checkpoint inhibitors for unresectable hepatocellular carcinoma and meta-analysis

BACKGROUND Hepatic arterial infusion chemotherapy(HAIC)has been proven to be an ideal choice for treating unresectable hepatocellular carcinoma(uHCC).HAIC-based treatment showed great potential for treating uHCC.However,large-scale studies on HAIC-based treatments and meta-analyses of first-line treatments for uHCC are lacking.AIM To investigate better first-line treatment options for uHCC and to assess the safety and efficacy of HAIC combined with angiogenesis inhibitors,programmed cell death of protein 1(PD-1)and its ligand(PD-L1)blockers(triple therapy)under real-world conditions.METHODS Several electronic databases were searched to identify eligible randomized controlled trials for this meta-analysis.Study-level pooled analyses of hazard ratios(HRs)and odds ratios(ORs)were performed.This was a retrospective single-center study involving 442 patients with uHCC who received triple therapy or angiogenesis inhibitors plus PD-1/PD-L1 blockades(AIPB)at Sun Yat-sen University Cancer Center from January 2018 to April 2023.Propensity score matching(PSM)was performed to balance the bias between the groups.The Kaplan-Meier method and cox regression were used to analyse the survival data,and the log-rank test was used to compare the suvival time between the groups.RESULTS A total of 13 randomized controlled trials were included.HAIC alone and in combination with sorafenib were found to be effective treatments(P values for ORs:HAIC,0.95;for HRs:HAIC+sorafenib,0.04).After PSM,176 HCC patients were included in the analysis.The triple therapy group(n=88)had a longer median overall survival than the AIPB group(n=88)(31.6 months vs 14.6 months,P<0.001)and a greater incidence of adverse events(94.3%vs 75.4%,P<0.001).CONCLUSION This meta-analysis suggests that HAIC-based treatments are likely to be the best choice for uHCC.Our findings confirm that triple therapy is more effective for uHCC patients than AIPB.

Molecular insights into clinical trials for immune checkpoint inhibitors in colorectal cancer:Unravelling challenges and future directions

Colorectal cancer(CRC)is a complex disease with diverse etiologies and clinical outcomes.Despite considerable progress in development of CRC therapeutics,challenges remain regarding the diagnosis and management of advanced stage metastatic CRC(mCRC).In particular,the five-year survival rate is very low since mCRC is currently rarely curable.Over the past decade,cancer treatment has significantly improved with the introduction of cancer immunotherapies,specifically immune checkpoint inhibitors.Therapies aimed at blocking immune checkpoints such as PD-1,PD-L1,and CTLA-4 target inhibitory pathways of the immune system,and thereby enhance anti-tumor immunity.These therapies thus have shown promising results in many clinical trials alone or in combination.The efficacy and safety of immunotherapy,either alone or in combination with CRC,have been investigated in several clinical trials.Clinical trials,including KEYNOTE-164 and CheckMate 142,have led to Food and Drug Administration approval of the PD-1 inhibitors pembrolizumab and nivolumab,respectively,for the treatment of patients with unresectable or metastatic microsatellite instability-high or deficient mismatch repair CRC.Unfortunately,these drugs benefit only a small percentage of patients,with the benefits of immunotherapy remaining elusive for the vast majority of CRC patients.To this end,primary and secondary resistance to immunotherapy remains a significant issue,and further research is necessary to optimize the use of immunotherapy in CRC and identify biomarkers to predict the response.This review provides a comprehensive overview of the clinical trials involving immune checkpoint inhibitors in CRC.The underlying rationale,challenges faced,and potential future steps to improve the prognosis and enhance the likelihood of successful trials in this field are discussed.

Effects of proton pump inhibitors on inflammatory bowel disease:An updated review

Inflammatory bowel disease(IBD)is believed to be caused by various factors,including abnormalities in disease susceptibility genes,environmental factors,immune factors,and intestinal bacteria.Proton pump inhibitors(PPIs)are the primary drugs used to treat acid-related diseases.They are also commonly prescribed to patients with IBD.Recent studies have suggested a potential association between the use of certain medications,such as PPIs,and the occurrence and progression of IBD.In this review,we summarize the potential impact of PPIs on IBD and analyze the underlying mechanisms.Our findings may provide insights for conducting further investigations into the effects of PPIs on IBD and serve as an important reminder for physicians to exercise caution when prescribing PPIs to patients with IBD.

Hepatocellular carcinoma immune microenvironment and check point inhibitors-current status

Hepatocellular carcinoma(HCC)is the most common primary tumor of the liver and has a high mortality rate.The Barcelona Clinic Liver Cancer staging system in addition to tumor staging also links the modality of treatment available to a particular stage.The recent description of the tumor microenvironment(TME)in HCC has provided a new concept of immunogenicity within the HCC.Virusrelated HCC has been shown to be more immunogenic with higher expression of cytotoxic T lymphocytes and decreased elements for immunosuppression such as regulatory T cells.This immunogenic milieu provides a better response to immunotherapy especially immune checkpoint inhibitors(ICIs).In addition,the recent data on combining locoregional therapies and other strategies may convert the less immunogenic state of the TME towards higher immunogenicity.Therefore,data are emerging on the use of combinations of locoregional therapy and ICIs in unresectable or advanced HCC and has shown better survival outcomes in this difficult population.

2-APB通过PKCα/HIF-1α信号通路抑制H_(2)O_(2)诱导的软骨细胞凋亡

目的探讨2-氨基乙氧基苯硼酸(2-APB)对H_(2)O_(2)诱导的软骨细胞凋亡的作用及其机制。方法实验分为Control组、H_(2)O_(2)组、2-APB组和H_(2)O_(2)+2-APB组。CCK-8法检测各组细胞活力;显微镜下观察2-APB对H_(2)O_(2)诱导的软骨细胞形态变化的影响;TUNEL法和流式细胞术检测软骨细胞凋亡情况;流式细胞术检测脂质活性氧(ROS)水平;Western blot法检测2-APB对H_(2)O_(2)诱导的各组细胞中Cleaved-PARP、p-PKCα和HIF-1α蛋白的表达情况;免疫荧光法检测PKCα抑制剂BIM-Ⅰ对H_(2)O_(2)诱导的各组细胞中HIF-1α的荧光表达情况。结果2-APB对H_(2)O_(2)诱导的软骨细胞凋亡具有抑制作用,且当2-APB浓度为100μmol/L时抑制效果最为显著(F=235.80,P<0.01);2-APB能够抑制H_(2)O_(2)所致软骨细胞凋亡阳性率(F=114.80,P<0.01)以及ROS的水平(F=52.99,P<0.01),并且抑制Cleaved-PARP(F=10.10,P<0.05)、p-PKCα(F=24.56,P<0.05)和HIF-1α(F=6.85,P<0.05)蛋白的表达;PKCα抑制剂BIM-Ⅰ能够抑制H_(2)O_(2)所致HIF-1α荧光强度的增加。结论2-APB可以通过抑制PKCα/HIF-1α通路减少H_(2)O_(2)诱导的软骨细胞凋亡,进而保护软骨细胞。

Transcatheter arterial chemoembolization combined with PD-1 inhibitors and Lenvatinib for hepatocellular carcinoma with portal vein tumor thrombus

BACKGROUND Hepatocellular carcinoma(HCC)patients complicated with portal vein tumor thrombus(PVTT)exhibit poor prognoses and treatment responses.AIM To investigate efficacies and safety of the combination of PD-1 inhibitor,transcatheter arterial chemoembolization(TACE)and Lenvatinib in HCC subjects comorbid with PVTT.METHODS From January 2019 to December 2020,HCC patients with PVTT types Ⅰ-Ⅳ were retrospectively enrolled at Beijing Ditan Hospital.They were distributed to either the PTL or TACE/Lenvatinib(TL)group.The median progression-free survival(mPFS)was set as the primary endpoint,while parameters like median overall survival,objective response rate,disease control rate(DCR),and toxicity level served as secondary endpoints.RESULTS Forty-one eligible patients were finally recruited for this study and divided into the PTL(n=18)and TL(n=23)groups.For a median follow-up of 21.8 months,the DCRs were 88.9%and 60.9%in the PTL and TL groups(P=0.046),res-pectively.Moreover,mPFS indicated significant improvement(HR=0.25;P<0.001)in PTL-treated patients(5.4 months)compared to TL-treated(2.7 months)patients.There were no treatment-related deaths or differences in adverse events in either group.CONCLUSION A triplet regimen of PTL was safe and well-tolerated as well as exhibited favorable efficacy over the TL regimen for advanced-stage HCC patients with PVTT types Ⅰ-Ⅳ.

Evaluating the influence of sarcopenia and myosteatosis on clinical outcomes in gastric cancer patients undergoing immune checkpoint inhibitor

BACKGROUND The development and progression of gastric cancer(GC)are closely linked to the nutritional status of patients.Although immunotherapy has been demonstrated to be clinically effective,the relationships of sarcopenia and myosteatosis with the use of immune checkpoint inhibitors(ICIs)in patients with gastric cancer remain to be characterized.METHODS We performed a retrospective study of patients who were undergoing immuno-therapy for GC.For the evaluation of sarcopenia,the optimal cut-off value for the skeletal muscle index was established using receiver operating characteristic analysis of data obtained from pre-treatment computed tomography images at the L3 vertebral level.Myosteatosis was defined using the mean skeletal muscle density(SMD),with a threshold value of<41 Hounsfield units(HU)for patients with a body mass index(BMI)<25 kg/m^(2)and<33 HU for those with a BMI≥25 kg/m^(2).The log-rank test was used to compare progression-free survival(PFS)and overall survival(OS),and a Cox proportional hazard model was used to identify prognostic factors.Nomograms were developed to predict the PFS and OS of patients on the basis of the results of multivariate analyses.RESULTS We studied 115 patients who were undergoing ICI therapy for GC,of whom 27.4%had sarcopenia and 29.8%had myosteatosis.Patients with sarcopenia or myosteatosis had significantly shorter PFS and OS than those without these conditions.Furthermore,both sarcopenia and myosteatosis were found to be independent predictors of PFS and OS in patients with GC administering an ICI.The prediction models created for PFS and OS were associated with C-indexes of 0.758 and 0.781,respectively.CONCLUSION The presence of sarcopenia or myosteatosis is a reliable predictor of the clinical outcomes of patients with GC who are undergoing treatment with an ICI.

Metastatic stomach lymphoepithelioma-like carcinoma and immune checkpoint inhibitor therapy:A case report

BACKGROUND Pulmonary lymphoepithelioma-like carcinoma(PLELC)is a rare type of nonsmall-cell lung cancer.Stomach lymphoepithelioma-like carcinoma(LELC)metastasis secondary to PLELC has not been reported recently.CASE SUMMARY A 64-year-old female was admitted to our hospital for a regular gastroscopy examination with a 6-year history of surgical resection for left PLELC.Positron emission tomography/computed tomography suggested high accumulation of 18F-fludeoxyglucose in the gastric cardia region.Upper gastrointestinal endoscopy confirmed a large mass at the stomach fundus.Immunohistochemistry(IHC)of the biopsy suggested metastatic stomach LELC.Proximal gastrectomy showed that this 6.5 cm×5.0 cm mass was located in the stomach fundus near the cardia.Histopathological examination showed a poorly differentiated carcinoma with prominent lymphoplasmacytic infiltration.IHC demonstrated that the tumor was positive for CK(AE1/AE3),p63,p40,p53,Ki-67(70%),and EGFR(3+)and negative for CK7,CK20,Her2,and CD10.In situ hybridization analysis showed positive staining Epstein-Barr virus-encoded RNA.Tumor programmed cell death ligand 1(PD-L1)expression score was 98%,and the combined positive score was 100,with no evidence of microsatellite instability.Thus,the patient was unequivocally diagnosed with metastatic stomach LELC secondary to pulmonary LELC.After discharge,this patient underwent PD-1 inhibitor treatment(toripalimab,240 mg)every 3 wk for ten cycles,and she has had no tumor recurrence.CONCLUSION For gastric LELC metastasis,PD-1 inhibitor therapy could become a new therapeutic approach,though there is still no evidence from large data sets to support this.

基于PKA/PKC信号通路蛋白磷酸化探讨补肾强精颗粒对弱精症模型大鼠精子动力学调控机制

目的 基于PKA/PKC信号通路探讨补肾强精颗粒对弱精子症模型大鼠精子动力学调控机制方法 40只SPF级雄性SD大鼠分为正常组、模型组、复方玄驹组、补肾强精颗粒低剂量组和补肾强精颗粒高剂量组,每组8只。采用雷公藤甲素复制少弱精子症模型,造模期间治疗组予以药物治疗。造模持续2周,药物治疗持续4周。实验完成时,收获大鼠的附睾、睾丸组织和血清样本。附睾组织用于精液分析,ELISA检测大鼠血清睾酮含量;qRT-PCR、Western blot检测睾丸组织中PKA、PKC的表达量。结果 与正常组相比,模型组的PR和PR+NP显著降低(P<0.01),血清睾酮含量和PKA、PKC的mRNA及蛋白表达水平显著下降(P<0.01),而复方玄驹组及高剂量补肾强精颗粒组的上述指标则显著提高(P<0.01),低剂量补肾强精颗粒组在PR、PR+NP的提升上与模型组相比无明显差异(P>0.05),其血清睾酮含量和PKA的mRNA表达水平有所增加(P<0.05)。低剂量补肾强精颗粒组在PR和PKA、PKC的mRNA及蛋白表达上均显著低于高剂量组(P<0.01),而PR+NP和PKC蛋白表达无显著差异(P>0.05)。结论 补肾强精颗粒能激活PKA/PKC信号通路,提高大鼠血清睾酮含量,改善雷公藤甲素导致的大鼠精子活力下降,且该治疗作用在一定范围内与药物剂量成正相关。