OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-perf...OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS)was utilized to identify the chemical composition and authenticate the active constituents of XHPWS,ensuring rigorous quality control across batches.A dextran sulfate sodium(DSS)-induced UC model was established in C57BL/6 mice,which were treated with XHPWS in vivo.The efficacy against UC was assessed by measuring parameters such as body weight,disease activity index(DAI)scores,and colon length.Levels of inflammatory cytokines,including interleukin-6(IL-6),interleukin-1β(IL-1β),and tumor necrosis factor-alpha(TNF-α),in colonic tissue were evaluated using enzymelinked immunosorbent assay(ELISA).Histological analysis of colon sections was conducted using hematoxylin and eosin staining.A network pharmacology approach was employed to explore the mechanisms of XHPWS and to predict its potential targets in UC treatment.Predicted protein expressions in colonic tissue were validated using immune-ohistochemistry(IHC)and Western blotting techniques.RESULTS:XHPWS effectively alle via ted DSS-induced UC symptoms in mice,as evidenced by restored body weight,reduced colon shortening,and decreased DAI scores.Histopathological examination revealed that XHPWS significantly reduced intestinal inflammatory infiltration,restored intestinal epithelial permeability,and increased goblet cell count.Network pharmacology analysis identified 63 active compounds in XHPWS and suggested that it might target 35 potential proteins associated with UC treatment.Functional enrichment analysis indicated that the protective mechanism of XHPWS could be related to the advanced glycation end products-receptor for advanced glycation end products(AGE-RAGE)signaling pathway.Notably,quercetin,kaempferol,wogonin,and nobiletin,the main components of XHPWS,showed strong correlations with the core targets.Additionally,experimental validation demonstrated that XHPWS significantly decreased levels of inflammatory cytokines interleukin 6(IL-6),interleukin 1 beta(IL-1β),and tumor necrosis factor alpha(TNF-α)in UC mice,while downregulating the expression of proteins related to the AGE-RAGE pathway.CONCLUSION:Our study demonstrated that XHPWS effectively alle via tes colitis symptoms and inflammation in UC mice,potentially through the regulation of the AGE-RAGE pathway.These findings provide strong evidence for the therapeutic potential of XHPWS in UC treatment,thereby broadening its clinical applications.展开更多
Low-valent sulfur oxy-acid salts(LVSOs)represent a category of oxygen-containing salts characterized by their potent reducing capabilities.Notably,sulfite,dithionite,and thiosulfate are prevalent reducing agents that ...Low-valent sulfur oxy-acid salts(LVSOs)represent a category of oxygen-containing salts characterized by their potent reducing capabilities.Notably,sulfite,dithionite,and thiosulfate are prevalent reducing agents that are readily available,cost-effective,and exhibit minimal ecological toxicity.These LVSOs have the ability to generate or promote the generation of strong oxidants or reductants,which makes them widely used in advanced oxidation processes(AOPs)and advanced reduction processes(ARPs).This article provides a comprehensive review of the recent advancements in AOPs and ARPs involving LVSOs,alongside an examination of the fundamental principles governing the generation of active species within these processes.LVSOs fulfill three primary functions in AOPs:Serving as sources of reactive oxygen species(ROS),auxiliary agents,and activators.Particular attention is devoted to elucidating the reaction mechanisms through which LVSOs,in conjunction with metal ions,metal oxides,ultraviolet light(UV),and ozone,produce potent oxidizing agents in both homogeneous and heterogeneous systems.Regarding ARPs,this review delineates the mechanisms by which LVSOs generate strong reducing agents,including hydrated electrons,hydrogen radicals,and sulfite radicals,under UV irradiation,while also exploring the interactions between these reductants and pollutants.The review identifies existing gaps within the current framework and proposes future research avenues to address these challenges.展开更多
Current research on heterogeneous advanced oxidation processes(HAOPs)predominantly emphasizes catalyst iteration and innovation.Significant efforts have been made to regulate the electron structure and optimize the el...Current research on heterogeneous advanced oxidation processes(HAOPs)predominantly emphasizes catalyst iteration and innovation.Significant efforts have been made to regulate the electron structure and optimize the electron distribution,thereby increasing the catalytic activity.However,this focus often overshadows an equally essential aspect of HAOPs:the adsorption effect.Adsorption is a critical initiator for triggering the interaction of oxidants and contaminants with heterogeneous catalysts.The efficacy of these interactions is influenced by a variety of physicochemical properties,including surface chemistry and pore sizes,which determine the affinities between contaminants and material surfaces.This dispar ity in affinity is pivotal because it underpins the selective removal of contaminants,especially in complex waste streams containing diverse contaminants and competing matrices.Consequently,understanding and mastering these interfacial interactions is fundamentally indispensable not only for improving pro cess efficiency but also for enhancing the selectivity of contaminant removal.Herein,we highlight the importance of adsorption-driven interfacial interactions for fundamentally elucidating the catalytic mechanisms of HAOPs.Such interactions dictate the overall performance of the treatment processes by balancing the adsorption,reaction,and desorption rates on the catalyst surfaces.Elucidating the adsorption effect not only shifts the paradigm in understanding HAOPs but also improves their practical ity in water treatment and wastewater decontamination.Overall,we propose that revisiting adsorption driven interfacial interactions holds great promise for optimizing catalytic processes to develop effective HAOP strategies.展开更多
This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinom...This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.展开更多
BACKGROUND Owing to the absence of specific symptoms in early-stage gastric cancer,most patients are diagnosed at intermediate or advanced stages.As a result,treatment often shifts from surgery to other therapies,with...BACKGROUND Owing to the absence of specific symptoms in early-stage gastric cancer,most patients are diagnosed at intermediate or advanced stages.As a result,treatment often shifts from surgery to other therapies,with chemotherapy and targeted therapies being the primary options for advanced gastric cancer treatment.A total of 116 patients with advanced gastric cancer,admitted from January 2021 to December 2023,were selected and divided into two groups of 58 each using the random number table method.The control group received FOLFOX4 chemothe-rapy(oxaliplatin+calcium+folinate+5-fluorouracil)combined with intravenous sindilizumab.The observation group received the same treatment as the control group,supplemented by oral administration of Senqi Shiyiwei granules.Both groups underwent treatment cycles of 3 weeks,with a minimum of two cycles.The therapeutic efficacy,immune mechanisms,and treatment-related toxicity and side effects were compared between the groups.The objective remission rate in the observation group(55.17%)was higher than that of the control group(36.21%)(P<0.05).After two treatment cycle,CD3+,CD4+,and CD4+/CD8+levels were higher in the observation group compared to the control group,while CD8+,regulatory T cells,and natural killer cells were lower(P<0.05).Additionally,the incidence of leukopenia,nausea,and vomiting was lower in observed group(P<0.05).No significant differences were observed in the incidence of other adverse reactions(P>0.05).CONCLUSION Adjuvant therapy with Shenqixian granules may enhance the efficacy of simudizumab combined with FOLFOX4 chemotherapy in advanced gastric cancer and the immune function by increasing immune cell counts,making it a valuable option in clinical treatment.展开更多
BACKGROUND The 5-year survival rate for patients with pancreatic cancer(PC)is 4%-12%.Surgery is the only treatment that offers curative potential,but only 15%-20%of patients are eligible for surgery.PC is prone to rec...BACKGROUND The 5-year survival rate for patients with pancreatic cancer(PC)is 4%-12%.Surgery is the only treatment that offers curative potential,but only 15%-20%of patients are eligible for surgery.PC is prone to recurrence and metastasis,and the antitumor effect of chemotherapy is notably limited.CASE SUMMARY Histopathological analysis of a 53-year-old female PC patient who underwent Whipple surgery revealed poorly differentiated tumor cells infiltrating nerves,lymphatics,and blood vessels.The patient received two different first-line chemotherapy regimens consecutively;however,both regimens struggled to control disease progression.During this period,the patient underwent liver metastasis ablation surgery,Candida albicans liver abscess,and stereotactic body radiotherapy.With the addition of camrelizumab to the modified FOLFIRINOX regimen,tumor control was achieved.The patient subsequently refused to continue chemotherapy,and the antitumor regimen was changed to a combination of camrelizumab and apatinib.After patients received a combination of immunotherapy and targeted therapy,the length of hospital stay was significantly reduced.Furthermore,all side effects were within acceptable limits,leading to an improved quality of life and prolonged progression-free survival.Unfortunately,the pain associated with cancer,coupled with the side effects of opioid analgesics,has led the patient to reject all available anticancer treatment options.Approximately one month after camrelizumab and apatinib were discontinued without medical authorization,the PC recurred and rapidly progressed to widespread metastasis,ultimately leading to the patient's death approximately one month later.The overall survival was 2 years.CONCLUSION Immunotherapy and targeted therapy have the potential to increase both the quality of life and survival time of PC patients,particularly those whose tumor progression is not effectively controlled by chemotherapy alone.Nevertheless,further clinical trials are necessary to validate these findings.展开更多
People with advanced chronic liver disease(ACLD)have an enhanced risk of malnutrition,which has multifactorial etiology and is mainly linked to a reduced energy and protein intake;malnutrition is critical for patients...People with advanced chronic liver disease(ACLD)have an enhanced risk of malnutrition,which has multifactorial etiology and is mainly linked to a reduced energy and protein intake;malnutrition is critical for patients with cirrhosis since it is often associated with sarcopenia,a skeletal muscle depletion with a loss of muscle mass and function.Late-evening snacks have been extensively studied,and guidelines are recommended to counteract the effects of prolonged fasting at night in patients with ACLD.However,it has not been fully explored whether late evening snacking is clarified as a milestone to address the nutritional needs of people with ACLD or whether it has a potential role in improving body compo-sition.In this randomised control trial,Yu et al demonstrated that long-term nocturnal snacks have the potential to significantly improve body composition by body fat mass,visceral fat area and body cell mass in patients with ACLD.While the improvement in skeletal muscle mass was minor,the promising results in other compositions provide hope for future research and patient care.展开更多
Carbon fibers(CFs)with notable comprehensive properties,such as light weight,high specific strength,and stiffness,have garnered considerable interest in both academic and industrial fields due to their diverse and adv...Carbon fibers(CFs)with notable comprehensive properties,such as light weight,high specific strength,and stiffness,have garnered considerable interest in both academic and industrial fields due to their diverse and advanced applications.However,the commonly utilized precursors,such as polyacrylonitrile and pitch,exhibit a lack of environmental sustainability,and their costs are heavily reliant on fluctuating petroleum prices.To meet the substantial market demand for CFs,significant efforts have been made to develop cost-effective and sustainable CFs derived from biomass.Lignin,the most abundant polyphenolic compound in nature,is emerging as a promising precursor which is well-suited for the production of CFs due to its renewable nature,low cost,high carbon content,and aromatic structures.Nevertheless,the majority of lignin raw materials are currently derived from pulping and biorefining industrial by-products,which are diverse and heterogeneous in nature,restricting the industrialization of lignin-derived CFs.This review classifies fossil-derived and biomass-derived CFs,starting from the sources and chemical structures of raw lignin,and outlines the preparation methods linked to the performance of lignin-derived CFs.A comprehensive discussion is presented on the relationship between the structural characteristics of lignin,spinning preparation,and structure-morphology-property of ligninderived CFs.Additionally,the potential applications of these materials in various domains,including energy,catalysis,composites,and other advanced products,are also described with the objective of spotlighting the unique merits of lignin.Finally,the current challenges faced and future prospects for the advancement of lignin-derived CFs are proposed.展开更多
Enhancing the corrosion resistance of carriers within Fenton-like systems and inhibiting the migration and aggregation of single atoms in reaction environments are essential for maintaining both high activity and stab...Enhancing the corrosion resistance of carriers within Fenton-like systems and inhibiting the migration and aggregation of single atoms in reaction environments are essential for maintaining both high activity and stability at catalytic sites,thus meeting fundamental requirements for practical application.The Fenton-like process of activating various strong oxidants by silicon-based single atom catalysts(SACs)prepared based on silicon-based materials(mesoporous silica,silicon-based minerals,and organosilicon materials)has unique advantages such as structural stability(especially important under strong oxidation conditions)and environmental protection.In this paper,the preparation strategies for the silicon-based SACs were assessed first,and the structural characteristics of various silicon-based SACs are systematically discussed,their application process and mechanism in Fenton-like process to achieve water purification are investigated,and the progress of Fenton-like process in density functional theory(DFT)of siliconbased derived single atom catalysts is summarized.In this paper,the preparation strategies and applications of silicon-based derived SACs are analyzed in depth,and their oxidation activities and pathways to different pollutants in water are reviewed.In addition,this paper also summarizes the device design and application of silicon-based derived SACs,and prospects the future development of silicon-based SACs in Fenton-like applications.展开更多
The global concern surrounding the advancement of methods for treating wastewater and polluted soil has markedly increased over time.While electrochemical advanced oxidation processes(EAOPs)and biotreatments are commo...The global concern surrounding the advancement of methods for treating wastewater and polluted soil has markedly increased over time.While electrochemical advanced oxidation processes(EAOPs)and biotreatments are commonly employed technologies for remediating wastewater and polluted soil,their widespread adoption is hindered by their limitations,which include high costs associated with EAOPs and prolonged remediation time of biotreatments.In the review,we provided an overviewof EAOP technology and biotreatment,emphasizing the critical aspects involved in building a combined system.This review systematically evaluates recent research that combines EAOPswith bioremediation for treating wastewater or contaminated soil as pretreatment or post-treatment process.Research findings suggest that the combined treatment method represents a promising and competitive technology that can overcome some of the limitations of individual treatments.Additionally,we discussed the potential applications of this technology in varying levels of wastewater and soil pollution,as well as the underlying combination mechanisms.展开更多
Efficient and innovative nano-catalytic oxidation technologies offer a breakthrough in removing emerging contaminants(ECs)from water,surpassing the limitations of traditional methods.Environmental functional materials...Efficient and innovative nano-catalytic oxidation technologies offer a breakthrough in removing emerging contaminants(ECs)from water,surpassing the limitations of traditional methods.Environmental functional materials(EFMs),particularly high-end oxidation systems using eco-friendly nanomaterials,show promise for absorbing and degrading ECs.This literature review presents a comprehensive analysis of diverse traditional restoration techniques-biological,physical,and chemical-assessing their respective applications and limitations in pesticide-contaminated water purification.Through meticulous comparison,we unequivocally advocate for the imperative integration of environmentally benign nanomaterials,notably titanium-based variants,in forthcoming methodologies.Our in-depth exploration scrutinizes the catalytic efficacy,underlying mechanisms,and adaptability of pioneering titanium-based nanomaterials across a spectrum of environmental contexts.Additionally,strategic recommendations are furnished to surmount challenges and propel the frontiers of implementing eco-friendly nanomaterials in practical water treatment scenarios.展开更多
BACKGROUND Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer(AGC);however,the regimen needs optimization.AIM To evaluate the efficacy of a...BACKGROUND Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer(AGC);however,the regimen needs optimization.AIM To evaluate the efficacy of albumin-bound paclitaxel(nab-ptx)combined with the small molecule vascular endothelial growth factor inhibitor anlotinib in secondline and beyond treatment of AGC.METHODS We collected data from AGC patients at our hospital who experienced disease progression after first-line chemotherapy and received anlotinib combined with nab-ptx.The primary endpoints included overall survival(OS)and progressionfree survival(PFS),while the secondary endpoints were objective response rate(ORR),disease control rate(DCR),and adverse events(AEs).RESULTS Preliminary results indicated that anlotinib combined with nab-ptx can provide significant efficacy in second-line or above treatment for AGC(median PFS=6.0 months,median OS=12.0 months),with an ORR of 42%and a DCR of 78%.Further analysis revealed that patients who experienced hypertension,proteinuria,and hand-foot syndrome during treatment had better efficacy compared to those who did not experience these AEs.Mechanistic studies suggest that this regimen likely exerts synergistic anti-tumor effects by activating the immune response through the reduction of regulatory T-cell proportions.Common adverse reactions included bone marrow suppression,peripheral neuropathy,hypertension,proteinuria,and hand-foot syndrome,which were manageable and resolved with appropriate interventions,indicating the promising application of this regimen in second-line or above treatment for AGC.CONCLUSION The combination of anlotinib and nab-ptx shows promising efficacy with fewer toxicities in AGC treatment.The regimen holds promise as a second-line treatment of AGC;however,its specific clinical value requires further research.展开更多
Over the past decade,the therapeutic armamentarium for inflammatory bowel disease(IBD)has substantially expanded with the incorporation of multiple classes of advanced therapies.Currently,in addition to tumor necrosis...Over the past decade,the therapeutic armamentarium for inflammatory bowel disease(IBD)has substantially expanded with the incorporation of multiple classes of advanced therapies.Currently,in addition to tumor necrosis factor-α inhibitors,the therapeutic arsenal for IBD includes anti-integrin agents,interleukin(IL)-12/23p40 and IL-23p19 antibodies,Janus kinase inhibitors,and sphingosine 1-phosphate receptor modulators.Although advances in IBD pharmacotherapy have enabled disease remission and improved control of intestinal inflammation in many individuals previously considered clinically'intractable',they have also increased the complexity of decision-making related to the initial positioning and sequencing of therapies in the heterogeneous clinical presentations of IBD.Until molecular and genetic markers capable of predicting therapeutic responses become available in practice,the choice of initial and subsequent therapy in individuals with IBD is based on factors including disease severity,phenotype,risk of complications,comorbidities,extraintestinal manifestations,and the balance between efficacy,safety,convenience,and access.This review explores the factors that influence treatment decisions regarding initial therapy selection and sequencing across IBD scenarios,offering practical tips for personalizing therapy based on the safety and efficacy of advanced treatments and the individual's risk of disease-or therapy-related adverse outcomes.展开更多
Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the trig...Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the triglyceride-glucose(TyG)index as a potential surrogate marker for insulin resistance,which may significantly influence the prognosis of patients undergoing immunotherapy combined with chemotherapy.In this context,the study by Yao et al demonstrates that a high TyG index correlates with improved overall survival and progressionfree survival in advanced GC patients receiving sintilimab and chemotherapy.Specifically,patients in the high TyG group had a significantly longer median progression-free survival of 9.8 months[95%confidence interval(CI):9.2-10.9]compared to 8.0 months(95%CI:7.5-8.5)in the low TyG group(hazard ratio=0.58,95%CI:0.43-0.79,P<0.001).Similarly,the median overall survival was significantly longer in the high TyG group at 23.1 months(95%CI:21.2-NA)vs 16.5 months(95%CI:13.9-18.3)in the low TyG group(hazard ratio=0.30,95%CI:0.21-0.42,P<0.001).These findings underscore the strong prognostic potential of the TyG index in guiding treatment strategies for advanced GC.These findings underscore the need for further investigation into the TyG index’s role as a prognostic tool and its underlying mechanisms in influencing treatment efficacy.We advocate for additional multicenter studies to validate these results and explore the TyG index’s applicability across diverse patient populations,ultimately aiming to refine treatment strategies and improve patient outcomes in advanced GC.展开更多
BACKGROUND The global prevalence of non-alcoholic steatohepatitis(NASH)and its associated risk of adverse outcomes,particularly in patients with advanced liver fibrosis,underscores the importance of early and accurate...BACKGROUND The global prevalence of non-alcoholic steatohepatitis(NASH)and its associated risk of adverse outcomes,particularly in patients with advanced liver fibrosis,underscores the importance of early and accurate diagnosis.AIM To develop a machine learning-based diagnostic model for advanced liver fibrosis in NASH patients.METHODS A total of 749 patients who underwent liver biopsy at Beijing Ditan Hospital,Capital Medical University,between January 2010 and January 2020 were included.Patients were randomly divided into training(n=522)and validation(n=224)cohorts.Five machine learning models were applied to predict advanced liver fibrosis,with feature selection based on Shapley Additive Explanations(SHAP).The diagnostic performance of these models was compared to traditional scores such as the aspartate aminotransferase to platelet ratio index(APRI)and fibrosis index based on the 4 factors(FIB-4),using metrics including the area under the receiver operating characteristic curve(AUROC),decision curve analysis(DCA),and calibration curves.RESULTS The Extreme Gradient Boosting(XGBoost)model outperformed all other machine learning models,achieving an AUROC of 0.934(95%CI:0.914-0.955)in the training cohort and 0.917(95%CI:0.880-0.953)in the validation cohort(P<0.001).Incorporating liver stiffness measurement into the model further improved its performance,with an AUROC of 0.977(95%CI:0.966-0.980)in the training cohort and 0.970(95%CI:0.950-0.990)in the validation cohort,significantly surpassing APRI and FIB-4 scores(P<0.001).The XGBoost model also demonstrated superior clinical utility,as evidenced by DCA and calibration curve analysis in both cohorts.CONCLUSION The XGBoost model provides a highly accurate,non-invasive diagnosis of advanced liver fibrosis in NASH patients,outperforming traditional methods.An online tool based on this model has been developed to assist clinicians in evaluating the risk of advanced liver fibrosis.展开更多
BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression sta...BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression status of patients with middle and advanced HCC,the influencing factors,and the correlation between these psychological factors and quality of life.METHODS We collected baseline data from 100 patients with HCC,assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire.Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression,while Pearson correlation assessed relationships among HAMA,HAMD,and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.RESULTS Results indicated that 64%of patients exhibited anxiety and 65%showed depression symptoms.Key influencing factors included Barcelona Clinic Liver Cancer C stage,multiple tumors,social support,prior treatments(such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy),as well as HAMA and HAMD scores.Anxiety and depression correlated negatively with quality of life,with coefficients of-0.671 and-0.575 for HAMA and HAMD,respectively.CONCLUSION Anxiety and depression are prevalent among patients with middle and advanced HCC,impacting quality of life.This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.展开更多
BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally adva...BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.展开更多
Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor...Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor,underscoring the need for reliable prognostic tools to refine treatment strategies.A study by Yao et al explores the role of the triglyceride-glucose(TyG)index as a prognostic marker for advanced GC patients receiving immunotherapy combined with chemotherapy.The results of the study demonstrate that the TyG index correlates with improved survival outcomes,including better progression-free survival and overall survival.This editorial critically evaluates the significance of these findings,discusses their implications for future research,and highlights innovative directions that could drive further breakthroughs in the application of the TyG index to cancer therapy.This editorial also highlights the potential of TyG in advancing precision oncology and advocates for global validation and mechanistic investigations to further solidify its clinical utility.Future research should focus on validating the TyG index across various malignancies,exploring its potential to influence immunotherapy through metabolic interventions,and developing multi-biomarker models that integrate TyG with immune and genomic profiles.展开更多
Background: Cancer-related fatigue(CRF) is a significant burden for patients with advanced lung cancer. While exercise is recommended for managing CRF during pre-and active treatment phases, evidence supporting its ef...Background: Cancer-related fatigue(CRF) is a significant burden for patients with advanced lung cancer. While exercise is recommended for managing CRF during pre-and active treatment phases, evidence supporting its efficacy in advanced stage remains limited. This systematic review and meta-analysis aimed to quantify the effects of exercise on CRF and its common complications in patients with advanced lung cancer.Methods: A systematic search of 4 databases(Pub Med, Embase, Cochrane, and Web of Science) was conducted up to July 10, 2024 to identify relevant randomized controlled trials(RCTs). Studies were selected based on predefined eligibility criteria, including adult patients with advanced lung cancer reporting fatigue as an outcome. Study selection followed Preferred Reporting Items for Systematic Reviews and MetaAnalyses(PRISMA) 2020 guidelines, and the risk of bias was assessed using the Cochrane Risk of Bias tool(Ro B 2.0). The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation(GRADE) system. Random-or fixed-effects models were used for meta-analyses based on heterogeneity levels.Results: Eight RCTs involving 749 patients were included. Meta-analysis revealed that exercise significantly improved CRF in patients with advanced lung cancer(standardized mean difference(SMD) =-0.33;95% confidence interval(95%CI):-0.54 to-0.12);p = 0.00;I2= 0.00%).Subgroup analysis showed greater efficacy in patients aged ≤60 years(p = 0.028), those engaging in traditional Chinese exercise(p = 0.003),and interventions lasting fewer than 12 weeks(p = 0.017). Exercise also significantly improved quality of life(SMD = 0.29;95%CI: 0.02-0.55;p = 0.04;I2= 0.00%) and reduced dyspnea(SMD =-0.43;95%CI:-0.71 to-0.16;p = 0.00;I2= 0.00%). No significant effects were observed on sleep quality, anxiety, or depression. The risk of bias across studies was moderate, and the quality of evidence, as evaluated by GRADE, was rated as low due to study limitations. Adverse events were minimal, with only one mild, exercise-related event reported.Conclusion: Exercise significantly alleviates CRF in patients with advanced lung cancer, improves certain complications, and enhances quality of life. The intervention's effectiveness varies by age, type of exercise, and duration. Further high-quality studies are needed to validate these findings.展开更多
BACKGROUND Aneurysmal bone cysts(ABCs)are usually treated with curettage or various minimally invasive percutaneous procedures.Patient refractory to these treatments,as well as those with locally advanced or unresecta...BACKGROUND Aneurysmal bone cysts(ABCs)are usually treated with curettage or various minimally invasive percutaneous procedures.Patient refractory to these treatments,as well as those with locally advanced or unresectable tumors,present a challenge for orthopedic surgeons and require new treatment approaches.Antiresorptive drugs inhibit osteoclastic resorption and increase intralesional osteogenesis.Denosumab induces tumor ossification,but this effect may disappear after drug withdrawal due to limited impact on neoplastic cells.Bisphosphonates(BPs)may induce apoptosis of tumor cells and allow for long-term local control.We hypothesized that after denosumab treatment,BPs would better accumulate in the tumor and exert an irreversible antitumor effect.AIM To test the hypothesis that the sequential use of BPs after denosumab induction improves treatment outcomes in surgically unsalvageable ABCs.METHODS Using data from five electronic databases(Scopus,MEDLINE,EMBASE,PubMed,Web of Science),we aimed to identify all patients who received denosumab therapy(DT)for unresectable ABCs.Among published case reports and case series,we identified patients who discontinued denosumab for various reasons and divided them into two groups:Group 1 included 31 patients without further anti-resorptive therapy and Group 2 included 12 patients who received BPs in the context of rebound hypercalcemia.Local control rates in both groups were analyzed.RESULTS As of December 2024,43 patients have been reported in the literature who received DT for locally advanced/unresectable ABCs.There were 27 males and 16 females with a mean age of 15.8 years.At a median follow-up time of 15.5 months,there were 10 confirmed and two pathologically unconfirmed relapses after denosumab discontinuation.All 10 relapses occurred in patients in Group 1 at a median time of 13.5 months.Among patients in Group 2,with a median follow-up time of 12.5 months after completion of therapy,no local relapses were observed.The difference between local recurrence rates(32%vs 0%)is statistically significant(P value=0.02).Kaplan-Meier estimates show the same trend with marginal statistical significance(P value=0.085).Here we put forward a novel treatment algorithm.CONCLUSION BPs used in post-denosumab ossifying ABCs appear to improve treatment outcomes,presumably by targeting residual tumor cells.Prospective clinical studies are warranted to validate this promising two-stage conceptual strategy in difficult-to-treat ABC.展开更多
基金the Guangdong Provincial Basic and Applied Basic Research Project:Mechanistic Study on the Regulation of Inflammatory Microenvironment and Improvement of Ulcerative Colitis by Lingnan Traditional Medicine Ficus Pandurata Hance through Wilms'Tumor 1-associating Protein-Mediated RNA Methyltransferase Promoting Toll Like Receptor 4 m6A Modification(2023A1515011699)the Zhongshan Medical Research Project:Mechanistic Study on the Action of Xiahuo Pingwei San in the Treatment of Ulcerative Colitis(2022A020446)。
文摘OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS)was utilized to identify the chemical composition and authenticate the active constituents of XHPWS,ensuring rigorous quality control across batches.A dextran sulfate sodium(DSS)-induced UC model was established in C57BL/6 mice,which were treated with XHPWS in vivo.The efficacy against UC was assessed by measuring parameters such as body weight,disease activity index(DAI)scores,and colon length.Levels of inflammatory cytokines,including interleukin-6(IL-6),interleukin-1β(IL-1β),and tumor necrosis factor-alpha(TNF-α),in colonic tissue were evaluated using enzymelinked immunosorbent assay(ELISA).Histological analysis of colon sections was conducted using hematoxylin and eosin staining.A network pharmacology approach was employed to explore the mechanisms of XHPWS and to predict its potential targets in UC treatment.Predicted protein expressions in colonic tissue were validated using immune-ohistochemistry(IHC)and Western blotting techniques.RESULTS:XHPWS effectively alle via ted DSS-induced UC symptoms in mice,as evidenced by restored body weight,reduced colon shortening,and decreased DAI scores.Histopathological examination revealed that XHPWS significantly reduced intestinal inflammatory infiltration,restored intestinal epithelial permeability,and increased goblet cell count.Network pharmacology analysis identified 63 active compounds in XHPWS and suggested that it might target 35 potential proteins associated with UC treatment.Functional enrichment analysis indicated that the protective mechanism of XHPWS could be related to the advanced glycation end products-receptor for advanced glycation end products(AGE-RAGE)signaling pathway.Notably,quercetin,kaempferol,wogonin,and nobiletin,the main components of XHPWS,showed strong correlations with the core targets.Additionally,experimental validation demonstrated that XHPWS significantly decreased levels of inflammatory cytokines interleukin 6(IL-6),interleukin 1 beta(IL-1β),and tumor necrosis factor alpha(TNF-α)in UC mice,while downregulating the expression of proteins related to the AGE-RAGE pathway.CONCLUSION:Our study demonstrated that XHPWS effectively alle via tes colitis symptoms and inflammation in UC mice,potentially through the regulation of the AGE-RAGE pathway.These findings provide strong evidence for the therapeutic potential of XHPWS in UC treatment,thereby broadening its clinical applications.
基金supported by Natural Science Foundation of China(Nos.52070133,42107073,42477075)Natural Science Foundation of Sichuan Province(No.2024NSFSC0130)+2 种基金the Sichuan Science and Technology Program(No.2024NSFTD0014)Key Laboratory of Jiangxi Province for Persistent Pollutants Prevention Control and Resource Reuse(No.2023SSY02061)Key R&D Program of Heilongjiang Province(No.2023ZX02C01)。
文摘Low-valent sulfur oxy-acid salts(LVSOs)represent a category of oxygen-containing salts characterized by their potent reducing capabilities.Notably,sulfite,dithionite,and thiosulfate are prevalent reducing agents that are readily available,cost-effective,and exhibit minimal ecological toxicity.These LVSOs have the ability to generate or promote the generation of strong oxidants or reductants,which makes them widely used in advanced oxidation processes(AOPs)and advanced reduction processes(ARPs).This article provides a comprehensive review of the recent advancements in AOPs and ARPs involving LVSOs,alongside an examination of the fundamental principles governing the generation of active species within these processes.LVSOs fulfill three primary functions in AOPs:Serving as sources of reactive oxygen species(ROS),auxiliary agents,and activators.Particular attention is devoted to elucidating the reaction mechanisms through which LVSOs,in conjunction with metal ions,metal oxides,ultraviolet light(UV),and ozone,produce potent oxidizing agents in both homogeneous and heterogeneous systems.Regarding ARPs,this review delineates the mechanisms by which LVSOs generate strong reducing agents,including hydrated electrons,hydrogen radicals,and sulfite radicals,under UV irradiation,while also exploring the interactions between these reductants and pollutants.The review identifies existing gaps within the current framework and proposes future research avenues to address these challenges.
基金supported by the National Key Research and Development Program of China(2022YFC3205300)the National Natural Science Foundation of China(22176124).
文摘Current research on heterogeneous advanced oxidation processes(HAOPs)predominantly emphasizes catalyst iteration and innovation.Significant efforts have been made to regulate the electron structure and optimize the electron distribution,thereby increasing the catalytic activity.However,this focus often overshadows an equally essential aspect of HAOPs:the adsorption effect.Adsorption is a critical initiator for triggering the interaction of oxidants and contaminants with heterogeneous catalysts.The efficacy of these interactions is influenced by a variety of physicochemical properties,including surface chemistry and pore sizes,which determine the affinities between contaminants and material surfaces.This dispar ity in affinity is pivotal because it underpins the selective removal of contaminants,especially in complex waste streams containing diverse contaminants and competing matrices.Consequently,understanding and mastering these interfacial interactions is fundamentally indispensable not only for improving pro cess efficiency but also for enhancing the selectivity of contaminant removal.Herein,we highlight the importance of adsorption-driven interfacial interactions for fundamentally elucidating the catalytic mechanisms of HAOPs.Such interactions dictate the overall performance of the treatment processes by balancing the adsorption,reaction,and desorption rates on the catalyst surfaces.Elucidating the adsorption effect not only shifts the paradigm in understanding HAOPs but also improves their practical ity in water treatment and wastewater decontamination.Overall,we propose that revisiting adsorption driven interfacial interactions holds great promise for optimizing catalytic processes to develop effective HAOP strategies.
文摘This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.
文摘BACKGROUND Owing to the absence of specific symptoms in early-stage gastric cancer,most patients are diagnosed at intermediate or advanced stages.As a result,treatment often shifts from surgery to other therapies,with chemotherapy and targeted therapies being the primary options for advanced gastric cancer treatment.A total of 116 patients with advanced gastric cancer,admitted from January 2021 to December 2023,were selected and divided into two groups of 58 each using the random number table method.The control group received FOLFOX4 chemothe-rapy(oxaliplatin+calcium+folinate+5-fluorouracil)combined with intravenous sindilizumab.The observation group received the same treatment as the control group,supplemented by oral administration of Senqi Shiyiwei granules.Both groups underwent treatment cycles of 3 weeks,with a minimum of two cycles.The therapeutic efficacy,immune mechanisms,and treatment-related toxicity and side effects were compared between the groups.The objective remission rate in the observation group(55.17%)was higher than that of the control group(36.21%)(P<0.05).After two treatment cycle,CD3+,CD4+,and CD4+/CD8+levels were higher in the observation group compared to the control group,while CD8+,regulatory T cells,and natural killer cells were lower(P<0.05).Additionally,the incidence of leukopenia,nausea,and vomiting was lower in observed group(P<0.05).No significant differences were observed in the incidence of other adverse reactions(P>0.05).CONCLUSION Adjuvant therapy with Shenqixian granules may enhance the efficacy of simudizumab combined with FOLFOX4 chemotherapy in advanced gastric cancer and the immune function by increasing immune cell counts,making it a valuable option in clinical treatment.
文摘BACKGROUND The 5-year survival rate for patients with pancreatic cancer(PC)is 4%-12%.Surgery is the only treatment that offers curative potential,but only 15%-20%of patients are eligible for surgery.PC is prone to recurrence and metastasis,and the antitumor effect of chemotherapy is notably limited.CASE SUMMARY Histopathological analysis of a 53-year-old female PC patient who underwent Whipple surgery revealed poorly differentiated tumor cells infiltrating nerves,lymphatics,and blood vessels.The patient received two different first-line chemotherapy regimens consecutively;however,both regimens struggled to control disease progression.During this period,the patient underwent liver metastasis ablation surgery,Candida albicans liver abscess,and stereotactic body radiotherapy.With the addition of camrelizumab to the modified FOLFIRINOX regimen,tumor control was achieved.The patient subsequently refused to continue chemotherapy,and the antitumor regimen was changed to a combination of camrelizumab and apatinib.After patients received a combination of immunotherapy and targeted therapy,the length of hospital stay was significantly reduced.Furthermore,all side effects were within acceptable limits,leading to an improved quality of life and prolonged progression-free survival.Unfortunately,the pain associated with cancer,coupled with the side effects of opioid analgesics,has led the patient to reject all available anticancer treatment options.Approximately one month after camrelizumab and apatinib were discontinued without medical authorization,the PC recurred and rapidly progressed to widespread metastasis,ultimately leading to the patient's death approximately one month later.The overall survival was 2 years.CONCLUSION Immunotherapy and targeted therapy have the potential to increase both the quality of life and survival time of PC patients,particularly those whose tumor progression is not effectively controlled by chemotherapy alone.Nevertheless,further clinical trials are necessary to validate these findings.
文摘People with advanced chronic liver disease(ACLD)have an enhanced risk of malnutrition,which has multifactorial etiology and is mainly linked to a reduced energy and protein intake;malnutrition is critical for patients with cirrhosis since it is often associated with sarcopenia,a skeletal muscle depletion with a loss of muscle mass and function.Late-evening snacks have been extensively studied,and guidelines are recommended to counteract the effects of prolonged fasting at night in patients with ACLD.However,it has not been fully explored whether late evening snacking is clarified as a milestone to address the nutritional needs of people with ACLD or whether it has a potential role in improving body compo-sition.In this randomised control trial,Yu et al demonstrated that long-term nocturnal snacks have the potential to significantly improve body composition by body fat mass,visceral fat area and body cell mass in patients with ACLD.While the improvement in skeletal muscle mass was minor,the promising results in other compositions provide hope for future research and patient care.
基金National Natural Science Foundation of China,Grant/Award Numbers:32171717,32271814Natural Science Foundation of Tianjin Municipality,Grant/Award Numbers:24JCJQJC00030,22JCYBJC01560,23JCZDJC00630China Postdoctoral Science Foundation,Grant/Award Number:2023M740562。
文摘Carbon fibers(CFs)with notable comprehensive properties,such as light weight,high specific strength,and stiffness,have garnered considerable interest in both academic and industrial fields due to their diverse and advanced applications.However,the commonly utilized precursors,such as polyacrylonitrile and pitch,exhibit a lack of environmental sustainability,and their costs are heavily reliant on fluctuating petroleum prices.To meet the substantial market demand for CFs,significant efforts have been made to develop cost-effective and sustainable CFs derived from biomass.Lignin,the most abundant polyphenolic compound in nature,is emerging as a promising precursor which is well-suited for the production of CFs due to its renewable nature,low cost,high carbon content,and aromatic structures.Nevertheless,the majority of lignin raw materials are currently derived from pulping and biorefining industrial by-products,which are diverse and heterogeneous in nature,restricting the industrialization of lignin-derived CFs.This review classifies fossil-derived and biomass-derived CFs,starting from the sources and chemical structures of raw lignin,and outlines the preparation methods linked to the performance of lignin-derived CFs.A comprehensive discussion is presented on the relationship between the structural characteristics of lignin,spinning preparation,and structure-morphology-property of ligninderived CFs.Additionally,the potential applications of these materials in various domains,including energy,catalysis,composites,and other advanced products,are also described with the objective of spotlighting the unique merits of lignin.Finally,the current challenges faced and future prospects for the advancement of lignin-derived CFs are proposed.
基金supported by National Natural Science Foundation of China(No.52170086)Natural Science Foundation of Shandong Province(No.ZR2021ME013)+1 种基金Natural science Foundation of Shaanxi province(No.2024JC-YBQN-0252)Special Scientific Research Project of Hanzhong City-Shaanxi University of Technology Co-construction State Key Laboratory(No.SXJ2106)。
文摘Enhancing the corrosion resistance of carriers within Fenton-like systems and inhibiting the migration and aggregation of single atoms in reaction environments are essential for maintaining both high activity and stability at catalytic sites,thus meeting fundamental requirements for practical application.The Fenton-like process of activating various strong oxidants by silicon-based single atom catalysts(SACs)prepared based on silicon-based materials(mesoporous silica,silicon-based minerals,and organosilicon materials)has unique advantages such as structural stability(especially important under strong oxidation conditions)and environmental protection.In this paper,the preparation strategies for the silicon-based SACs were assessed first,and the structural characteristics of various silicon-based SACs are systematically discussed,their application process and mechanism in Fenton-like process to achieve water purification are investigated,and the progress of Fenton-like process in density functional theory(DFT)of siliconbased derived single atom catalysts is summarized.In this paper,the preparation strategies and applications of silicon-based derived SACs are analyzed in depth,and their oxidation activities and pathways to different pollutants in water are reviewed.In addition,this paper also summarizes the device design and application of silicon-based derived SACs,and prospects the future development of silicon-based SACs in Fenton-like applications.
基金supported by the National Natural Science Foundation of China(No.51709103)the Natural Science Foundation of Hunan Province,China(Nos.2018JJ3242 and 2021JJ30362)the Science and Technology Innovation Leading Plan of High Tech Industry in Hunan Province(No.2021GK4055).
文摘The global concern surrounding the advancement of methods for treating wastewater and polluted soil has markedly increased over time.While electrochemical advanced oxidation processes(EAOPs)and biotreatments are commonly employed technologies for remediating wastewater and polluted soil,their widespread adoption is hindered by their limitations,which include high costs associated with EAOPs and prolonged remediation time of biotreatments.In the review,we provided an overviewof EAOP technology and biotreatment,emphasizing the critical aspects involved in building a combined system.This review systematically evaluates recent research that combines EAOPswith bioremediation for treating wastewater or contaminated soil as pretreatment or post-treatment process.Research findings suggest that the combined treatment method represents a promising and competitive technology that can overcome some of the limitations of individual treatments.Additionally,we discussed the potential applications of this technology in varying levels of wastewater and soil pollution,as well as the underlying combination mechanisms.
基金supported by the Research Platform Open Fund Project of Zhejiang Industry and Trade Vocation College(No.Kf202203)the Scientific Research Project of CCCC First Harbor Engineering Company Ltd.(No.2022-7-2)+3 种基金the National Natural Science Foundation of China(No.22406142)the Fellowship of China National Postdoctoral Program for Innovative Talents(No.BX20230262)the Fellowship of China Postdoctoral Science Foundation(No.2023M732636)the Shanghai Post-doctoral Excellence Program(No.2023755).
文摘Efficient and innovative nano-catalytic oxidation technologies offer a breakthrough in removing emerging contaminants(ECs)from water,surpassing the limitations of traditional methods.Environmental functional materials(EFMs),particularly high-end oxidation systems using eco-friendly nanomaterials,show promise for absorbing and degrading ECs.This literature review presents a comprehensive analysis of diverse traditional restoration techniques-biological,physical,and chemical-assessing their respective applications and limitations in pesticide-contaminated water purification.Through meticulous comparison,we unequivocally advocate for the imperative integration of environmentally benign nanomaterials,notably titanium-based variants,in forthcoming methodologies.Our in-depth exploration scrutinizes the catalytic efficacy,underlying mechanisms,and adaptability of pioneering titanium-based nanomaterials across a spectrum of environmental contexts.Additionally,strategic recommendations are furnished to surmount challenges and propel the frontiers of implementing eco-friendly nanomaterials in practical water treatment scenarios.
基金Supported by Natural Science Foundation of Hubei Province,No.2019CFC929.
文摘BACKGROUND Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer(AGC);however,the regimen needs optimization.AIM To evaluate the efficacy of albumin-bound paclitaxel(nab-ptx)combined with the small molecule vascular endothelial growth factor inhibitor anlotinib in secondline and beyond treatment of AGC.METHODS We collected data from AGC patients at our hospital who experienced disease progression after first-line chemotherapy and received anlotinib combined with nab-ptx.The primary endpoints included overall survival(OS)and progressionfree survival(PFS),while the secondary endpoints were objective response rate(ORR),disease control rate(DCR),and adverse events(AEs).RESULTS Preliminary results indicated that anlotinib combined with nab-ptx can provide significant efficacy in second-line or above treatment for AGC(median PFS=6.0 months,median OS=12.0 months),with an ORR of 42%and a DCR of 78%.Further analysis revealed that patients who experienced hypertension,proteinuria,and hand-foot syndrome during treatment had better efficacy compared to those who did not experience these AEs.Mechanistic studies suggest that this regimen likely exerts synergistic anti-tumor effects by activating the immune response through the reduction of regulatory T-cell proportions.Common adverse reactions included bone marrow suppression,peripheral neuropathy,hypertension,proteinuria,and hand-foot syndrome,which were manageable and resolved with appropriate interventions,indicating the promising application of this regimen in second-line or above treatment for AGC.CONCLUSION The combination of anlotinib and nab-ptx shows promising efficacy with fewer toxicities in AGC treatment.The regimen holds promise as a second-line treatment of AGC;however,its specific clinical value requires further research.
文摘Over the past decade,the therapeutic armamentarium for inflammatory bowel disease(IBD)has substantially expanded with the incorporation of multiple classes of advanced therapies.Currently,in addition to tumor necrosis factor-α inhibitors,the therapeutic arsenal for IBD includes anti-integrin agents,interleukin(IL)-12/23p40 and IL-23p19 antibodies,Janus kinase inhibitors,and sphingosine 1-phosphate receptor modulators.Although advances in IBD pharmacotherapy have enabled disease remission and improved control of intestinal inflammation in many individuals previously considered clinically'intractable',they have also increased the complexity of decision-making related to the initial positioning and sequencing of therapies in the heterogeneous clinical presentations of IBD.Until molecular and genetic markers capable of predicting therapeutic responses become available in practice,the choice of initial and subsequent therapy in individuals with IBD is based on factors including disease severity,phenotype,risk of complications,comorbidities,extraintestinal manifestations,and the balance between efficacy,safety,convenience,and access.This review explores the factors that influence treatment decisions regarding initial therapy selection and sequencing across IBD scenarios,offering practical tips for personalizing therapy based on the safety and efficacy of advanced treatments and the individual's risk of disease-or therapy-related adverse outcomes.
文摘Gastric cancer(GC)remains a leading cause of cancer-related mortality worldwide,necessitating the identification of reliable prognostic indicators to enhance treatment outcomes.Recent research has highlighted the triglyceride-glucose(TyG)index as a potential surrogate marker for insulin resistance,which may significantly influence the prognosis of patients undergoing immunotherapy combined with chemotherapy.In this context,the study by Yao et al demonstrates that a high TyG index correlates with improved overall survival and progressionfree survival in advanced GC patients receiving sintilimab and chemotherapy.Specifically,patients in the high TyG group had a significantly longer median progression-free survival of 9.8 months[95%confidence interval(CI):9.2-10.9]compared to 8.0 months(95%CI:7.5-8.5)in the low TyG group(hazard ratio=0.58,95%CI:0.43-0.79,P<0.001).Similarly,the median overall survival was significantly longer in the high TyG group at 23.1 months(95%CI:21.2-NA)vs 16.5 months(95%CI:13.9-18.3)in the low TyG group(hazard ratio=0.30,95%CI:0.21-0.42,P<0.001).These findings underscore the strong prognostic potential of the TyG index in guiding treatment strategies for advanced GC.These findings underscore the need for further investigation into the TyG index’s role as a prognostic tool and its underlying mechanisms in influencing treatment efficacy.We advocate for additional multicenter studies to validate these results and explore the TyG index’s applicability across diverse patient populations,ultimately aiming to refine treatment strategies and improve patient outcomes in advanced GC.
基金Supported by the Natural Science Foundation of China,No.81970512the Beijing Hospitals Authority Youth Programme,No.QMl220201802+1 种基金the Beijing Traditional Chinese Medicine Science and Technology Development Fund Project,No.Qn-2020-25High-Level Public Health Technical Personnel Construction Project.
文摘BACKGROUND The global prevalence of non-alcoholic steatohepatitis(NASH)and its associated risk of adverse outcomes,particularly in patients with advanced liver fibrosis,underscores the importance of early and accurate diagnosis.AIM To develop a machine learning-based diagnostic model for advanced liver fibrosis in NASH patients.METHODS A total of 749 patients who underwent liver biopsy at Beijing Ditan Hospital,Capital Medical University,between January 2010 and January 2020 were included.Patients were randomly divided into training(n=522)and validation(n=224)cohorts.Five machine learning models were applied to predict advanced liver fibrosis,with feature selection based on Shapley Additive Explanations(SHAP).The diagnostic performance of these models was compared to traditional scores such as the aspartate aminotransferase to platelet ratio index(APRI)and fibrosis index based on the 4 factors(FIB-4),using metrics including the area under the receiver operating characteristic curve(AUROC),decision curve analysis(DCA),and calibration curves.RESULTS The Extreme Gradient Boosting(XGBoost)model outperformed all other machine learning models,achieving an AUROC of 0.934(95%CI:0.914-0.955)in the training cohort and 0.917(95%CI:0.880-0.953)in the validation cohort(P<0.001).Incorporating liver stiffness measurement into the model further improved its performance,with an AUROC of 0.977(95%CI:0.966-0.980)in the training cohort and 0.970(95%CI:0.950-0.990)in the validation cohort,significantly surpassing APRI and FIB-4 scores(P<0.001).The XGBoost model also demonstrated superior clinical utility,as evidenced by DCA and calibration curve analysis in both cohorts.CONCLUSION The XGBoost model provides a highly accurate,non-invasive diagnosis of advanced liver fibrosis in NASH patients,outperforming traditional methods.An online tool based on this model has been developed to assist clinicians in evaluating the risk of advanced liver fibrosis.
文摘BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression status of patients with middle and advanced HCC,the influencing factors,and the correlation between these psychological factors and quality of life.METHODS We collected baseline data from 100 patients with HCC,assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire.Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression,while Pearson correlation assessed relationships among HAMA,HAMD,and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.RESULTS Results indicated that 64%of patients exhibited anxiety and 65%showed depression symptoms.Key influencing factors included Barcelona Clinic Liver Cancer C stage,multiple tumors,social support,prior treatments(such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy),as well as HAMA and HAMD scores.Anxiety and depression correlated negatively with quality of life,with coefficients of-0.671 and-0.575 for HAMA and HAMD,respectively.CONCLUSION Anxiety and depression are prevalent among patients with middle and advanced HCC,impacting quality of life.This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.
基金Natural Science Foundation of Hubei Province of China,No.2024AFB655Key Research and Development Program of Hubei Province of China,No.2021BCA116National Natural Science Foundation of China,No.82072736,No.82003205,No.
文摘BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.
基金Supported by the Natural Science Foundation of Fujian Province,No.2023J01160Scientific Research Project of Putian University,No.2022059Special Project for Outstanding Young Talents of Putian University,No.2024072.
文摘Gastric cancer(GC),the fifth most common malignancy worldwide,poses a substantial challenge in clinical oncology,particularly in its advanced stages.Despite advancements in immunotherapy,patient prognosis remains poor,underscoring the need for reliable prognostic tools to refine treatment strategies.A study by Yao et al explores the role of the triglyceride-glucose(TyG)index as a prognostic marker for advanced GC patients receiving immunotherapy combined with chemotherapy.The results of the study demonstrate that the TyG index correlates with improved survival outcomes,including better progression-free survival and overall survival.This editorial critically evaluates the significance of these findings,discusses their implications for future research,and highlights innovative directions that could drive further breakthroughs in the application of the TyG index to cancer therapy.This editorial also highlights the potential of TyG in advancing precision oncology and advocates for global validation and mechanistic investigations to further solidify its clinical utility.Future research should focus on validating the TyG index across various malignancies,exploring its potential to influence immunotherapy through metabolic interventions,and developing multi-biomarker models that integrate TyG with immune and genomic profiles.
基金supported by funding from the National Key Research and Development Program of China(Research Project of Modernization on TCM,Grant number:2018YFC1707406)。
文摘Background: Cancer-related fatigue(CRF) is a significant burden for patients with advanced lung cancer. While exercise is recommended for managing CRF during pre-and active treatment phases, evidence supporting its efficacy in advanced stage remains limited. This systematic review and meta-analysis aimed to quantify the effects of exercise on CRF and its common complications in patients with advanced lung cancer.Methods: A systematic search of 4 databases(Pub Med, Embase, Cochrane, and Web of Science) was conducted up to July 10, 2024 to identify relevant randomized controlled trials(RCTs). Studies were selected based on predefined eligibility criteria, including adult patients with advanced lung cancer reporting fatigue as an outcome. Study selection followed Preferred Reporting Items for Systematic Reviews and MetaAnalyses(PRISMA) 2020 guidelines, and the risk of bias was assessed using the Cochrane Risk of Bias tool(Ro B 2.0). The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation(GRADE) system. Random-or fixed-effects models were used for meta-analyses based on heterogeneity levels.Results: Eight RCTs involving 749 patients were included. Meta-analysis revealed that exercise significantly improved CRF in patients with advanced lung cancer(standardized mean difference(SMD) =-0.33;95% confidence interval(95%CI):-0.54 to-0.12);p = 0.00;I2= 0.00%).Subgroup analysis showed greater efficacy in patients aged ≤60 years(p = 0.028), those engaging in traditional Chinese exercise(p = 0.003),and interventions lasting fewer than 12 weeks(p = 0.017). Exercise also significantly improved quality of life(SMD = 0.29;95%CI: 0.02-0.55;p = 0.04;I2= 0.00%) and reduced dyspnea(SMD =-0.43;95%CI:-0.71 to-0.16;p = 0.00;I2= 0.00%). No significant effects were observed on sleep quality, anxiety, or depression. The risk of bias across studies was moderate, and the quality of evidence, as evaluated by GRADE, was rated as low due to study limitations. Adverse events were minimal, with only one mild, exercise-related event reported.Conclusion: Exercise significantly alleviates CRF in patients with advanced lung cancer, improves certain complications, and enhances quality of life. The intervention's effectiveness varies by age, type of exercise, and duration. Further high-quality studies are needed to validate these findings.
文摘BACKGROUND Aneurysmal bone cysts(ABCs)are usually treated with curettage or various minimally invasive percutaneous procedures.Patient refractory to these treatments,as well as those with locally advanced or unresectable tumors,present a challenge for orthopedic surgeons and require new treatment approaches.Antiresorptive drugs inhibit osteoclastic resorption and increase intralesional osteogenesis.Denosumab induces tumor ossification,but this effect may disappear after drug withdrawal due to limited impact on neoplastic cells.Bisphosphonates(BPs)may induce apoptosis of tumor cells and allow for long-term local control.We hypothesized that after denosumab treatment,BPs would better accumulate in the tumor and exert an irreversible antitumor effect.AIM To test the hypothesis that the sequential use of BPs after denosumab induction improves treatment outcomes in surgically unsalvageable ABCs.METHODS Using data from five electronic databases(Scopus,MEDLINE,EMBASE,PubMed,Web of Science),we aimed to identify all patients who received denosumab therapy(DT)for unresectable ABCs.Among published case reports and case series,we identified patients who discontinued denosumab for various reasons and divided them into two groups:Group 1 included 31 patients without further anti-resorptive therapy and Group 2 included 12 patients who received BPs in the context of rebound hypercalcemia.Local control rates in both groups were analyzed.RESULTS As of December 2024,43 patients have been reported in the literature who received DT for locally advanced/unresectable ABCs.There were 27 males and 16 females with a mean age of 15.8 years.At a median follow-up time of 15.5 months,there were 10 confirmed and two pathologically unconfirmed relapses after denosumab discontinuation.All 10 relapses occurred in patients in Group 1 at a median time of 13.5 months.Among patients in Group 2,with a median follow-up time of 12.5 months after completion of therapy,no local relapses were observed.The difference between local recurrence rates(32%vs 0%)is statistically significant(P value=0.02).Kaplan-Meier estimates show the same trend with marginal statistical significance(P value=0.085).Here we put forward a novel treatment algorithm.CONCLUSION BPs used in post-denosumab ossifying ABCs appear to improve treatment outcomes,presumably by targeting residual tumor cells.Prospective clinical studies are warranted to validate this promising two-stage conceptual strategy in difficult-to-treat ABC.
