BACKGROUND Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma(HCC)since 2008.While radiological complete responses are extremely rare,improved supportive care and multidisciplinary app...BACKGROUND Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma(HCC)since 2008.While radiological complete responses are extremely rare,improved supportive care and multidisciplinary approaches in clinical practice may explain the recent increase in case reports and retrospective series documenting such responses.CASE SUMMARY This case series describes 3 patients with advanced HCC who achieved durable complete responses using first-line sorafenib therapy,even in the presence of portal vein thrombosis or extrahepatic spread,and highlights the potential for sustained remission in selected patients.Dermatologic toxicity and non-viral etiology may correlate with favorable outcomes;however,reliable predictive biomarkers for sorafenib response are lacking.CONCLUSION Future research into the etiology and molecular differences in HCC is necessary to develop more personalized therapy options.展开更多
Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these...Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface electromyography.In this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury.Eleven patients with chronic complete thoracic spinal cord injury were recruited.Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol.The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation.Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically significant.These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.展开更多
BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particu...BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particularly in the vertical direction.Endoscopic full-thickness resection(EFTR)has proven to be an effective method for the treatment of submucosal tumors but is seldom utilized in the eradication of R-NENs.AIM To review cases of R-NENs removed using EFTR and to evaluate the safety and efficacy of this technique.METHODS This retrospective cohort study enrolled 160 patients with pathologically confirmed R-NENs,including 132 who underwent endoscopic submucosal dissection(ESD)and 28 who underwent EFTR.Lesions were categorized as<1 cm,1-2 cm,and>2 cm in size.CR rate,en bloc resection rate,operation time,and complications were evaluated.Subgroup analyses and follow-up were also performed.RESULTS EFTR achieved 100%CR rates for lesions<1 cm and 1-2 cm,compared with 67.0%and 50.0%,respectively,in the ESD group.En bloc resection and successful removal of the R-NENs were achieved in all patients.Meanwhile,EFTR showed performance comparable to ESD in terms of operation time,hospitalization cost,and postoperative adverse events,except for a one-day longer hospital stay.We also analyzed the invasion depth of R-NENs based on full-thickness specimens.The data showed that 80%of lesions(<1 cm)and 85.7%of lesions(1-2 cm)had invaded the SM3 level or deeper at the time of resection.For ESD specimens,46.6%(<1 cm)and 89.3%(1-2 cm)of lesions had infiltrated more than 2000μm beneath the muscularis mucosae.CONCLUSION EFTR has shown superior performance in the resection of small R-NENs compared with that of ESD.展开更多
The undrained mechanical behavior of unsaturated completely weathered granite(CWG)is highly susceptible to alterations in the hydraulic environment,particularly under uniaxial loading conditions,due to the unique natu...The undrained mechanical behavior of unsaturated completely weathered granite(CWG)is highly susceptible to alterations in the hydraulic environment,particularly under uniaxial loading conditions,due to the unique nature of this soil type.In this study,a series of unconfined compression tests were carried out on unsaturated CWG soil in an underground engineering site,and the effects of varying the environmental variables on the main undrained mechanical properties were analyzed.Based on the experimental results,a novel constitutive model was then established using the damage mechanics theory and the undetermined coefficient method.The results demonstrate that the curves of remolded CWG specimens with different moisture contents and dry densities exhibited diverse characteristics,including brittleness,significant softening,and ductility.As a typical indicator,the unconfined compression strength of soil specimens initially increased with an increase in moisture content and then decreased.Meanwhile,an optimal moisture content of approximately 10.5%could be observed,while a critical moisture content value of 13.0%was identified,beyond which the strength of the specimen decreases sharply.Moreover,the deformation and fracture of CWG specimens were predominantly caused by shear failure,and the ultimate failure modes were primarily influenced by moisture content rather than dry density.Furthermore,by comparing several similar models and the experimental data,the proposed model could accurately replicate the undrained mechanical characteristics of unsaturated CWG soil,and quantitatively describe the key mechanical indexes.These findings offer a valuable reference point for understanding the underlying mechanisms,anticipating potential risks,and implementing effective control measures in similar underground engineering projects.展开更多
BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the ...BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.展开更多
The complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space is studied.By moment inequality and truncation methods,we establish the...The complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space is studied.By moment inequality and truncation methods,we establish the equivalent conditions of complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space.The results complement the corresponding results in probability space to those for sequences of independent,identically distributed random variables under sublinear expectation space.展开更多
In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergen...In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergence of NSD random variables.We establish and improve a general result on the complete f-moment convergence for Sung’s type randomly weighted sums of NSD random variables under some general assumptions.As an application,we show the complete consistency for the randomly weighted estimator in a nonparametric regression model based on NSD errors.展开更多
In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise c...In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise completely positive(RPCP)decomposition.We study the properties of RPCP matrices and give some necessary and sufficient conditions for a matrix pair to be RPCP.First,we give an equivalent decomposition for the RPCP matrices,which is different from the RPCP-decomposition and show that the matrix pair(X,X)is RPCP if and only if X is completely positive.Besides,we also prove that the RPCP matrices checking problem is equivalent to the separable completion problem.A semidefinite algorithm is also proposed for detecting whether or not a matrix pair is RPCP.The asymptotic and finite convergence of the algorithm are also discussed.If it is RPCP,we can further give a RPCP-decomposition for it;if it is not,we can obtain a certificate for this.展开更多
BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who unde...BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who underwent hepatectomy followed by a combination of sorafenib and camrelizumab,resulting in complete remission(CR)for 5 years.CASE SUMMARY A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC,Barcelona Clinic Liver Cancer stage C.Enhanced computed tomography imaging revealed a 152 mm×171 mm tumor in the right liver,invading the portal vein and hepatic vein.Liver function was normal.The patient successfully underwent hepatectomy on July 18,2019.However,by December 2019,HCC recurrence with lung metastases and portal vein invasion were detected.He started treatment with sorafenib(200 mg twice daily)and camrelizumab(200 mg every 3 weeks).By May 12,2020,the patient was confirmed to have CR.Camrelizumab was adjusted to 200 mg every 12 weeks from June 16,2021,with the last infusion on March 29,2024.Although no further tumor recurrence was observed,he experienced two episodes of gastrointestinal bleeding due to esophagogastric varices,which were managed with endoscopic therapy.To date,the patient has remained in CR for 5 years.CONCLUSION The combination of hepatectomy with sorafenib and camrelizumab can achieve durable CR in patients with supergiant HCC and portal vein invasion.Further research is necessary to address these challenges and improve patient outcomes.展开更多
BACKGROUND Gallbladder cancer is a highly malignant and aggressive tumor,often diagnosed at an advanced stage.The prognosis for advanced gallbladder cancer remains poor,with limited options for effective treatment.CAS...BACKGROUND Gallbladder cancer is a highly malignant and aggressive tumor,often diagnosed at an advanced stage.The prognosis for advanced gallbladder cancer remains poor,with limited options for effective treatment.CASE SUMMARY A 65-year-old male patient presented with a soft tissue mass in the gallbladder.Following laparoscopic exploration,he underwent radical surgery for gallbladder cancer,with the tumor staged as pT2N1M0(stage III).Post-surgery,the patient received four cycles of adjuvant chemotherapy.However,one month later,over 60 metastatic lesions were detected in the liver,lungs,and lymph nodes.In response to the widespread metastasis,he underwent six cycles of combination therapy consisting of sintilimab,albumin-bound paclitaxel,and cisplatin.After two cycles,a partial response was achieved.Maintenance therapy was initiated with a combination of sintilimab and albumin-bound paclitaxel for four cycles.Monotherapy with sintilimab was continued thereafter until October 2023.Complete remission was confirmed in September 2021.The patient sustained this complete response for more than three years,including an eleven-month period without disease progression following the discontinuation of sintilimab.Genetic analysis revealed a tumor mutational burden of 15.4 mutations/megabase,which indicates a potentially favorable response to immunotherapy.CONCLUSION This case demonstrates the potential of combining immunotherapy(sintilimab)with chemotherapy to achieve durable remission in metastatic gallbladder cancer,even in a patient with extensive metastasis.In addition,it indicated the importance of tumor mutational burden as a predictive biomarker of immunotherapy.展开更多
BACKGROUND Transarterial chemoembolization(TACE)is a widely accepted palliative therapy modality for unresectable hepatocellular carcinoma(HCC).Although it is rarely curative,complete radiological response can be achi...BACKGROUND Transarterial chemoembolization(TACE)is a widely accepted palliative therapy modality for unresectable hepatocellular carcinoma(HCC).Although it is rarely curative,complete radiological response can be achieved in selected patients,leading to prolonged survival.Post-treatment tumoral calcification is an uncom-mon imaging finding in HCC and is rarely reported after drug-eluting beads TACE(DEB-TACE).CASE SUMMARY Two patients with large,solitary HCCs(>5 cm)were treated with DEB-TACE,and both achieved complete radiological response after two treatment sessions.Approximately 1 year after DEB-TACE,imaging demonstrated progressive peripheral tumoral calcification.Over 6 years of follow-up,both patients remained in remission with preserved liver function.CONCLUSION These two cases highlight the potential for complete remission and long-term survival in selected patients with large HCC following DEB-TACE.The appearance of peripheral calcification may represent a late imaging marker of effective tumor necrosis and durable treatment response although prospective studies are warranted to clarify its prognostic value.展开更多
1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Part...1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Partial hepatectomy is recommended for patients with early stage HCC.[2]A large proportion of patients with HCC inChina are diagnosed in the intermediate to advanced HCC stages,rendering them ineligible for hepatectomy due to aspects such as liver dysfunction,insufficient residual liver volume,or surgical technique.展开更多
Objective Current autosomal short tandem repeat(STR)assays can analyze the zygotic composition by comparing the allelic genes at each locus of complete hydatidiform moles(CHM),with a maternal genotype serving as an es...Objective Current autosomal short tandem repeat(STR)assays can analyze the zygotic composition by comparing the allelic genes at each locus of complete hydatidiform moles(CHM),with a maternal genotype serving as an essential reference for comparative analysis.However,their application in pathology represents a challenge because of deficiency or contamination of maternal-origin tissues.This study aimed to develop a novel STR genotyping method for identifying CHM genotypes without a maternal component.Methods Samples with the pathologic description of molar pregnancy were collected.Routine hematoxylin–eosin(HE)staining and p57 immunohistochemistry staining were conducted in accordance with standard guidelines.A novel 26-plex system was explored to classify CHM and diploid pregnancies.The system combined 22 STRs on chromosomes 21/18/13/X,3 sex loci,and 1 quality control marker(TAF9L),enabling molecular diagnosis in the absence of maternal tissue.At last,traditional DNA typing based on villi and decidua(maternal component)of each case was used for result consistency analysis.Results CHM and nonmolar abortus could not be distinguished by the basic HE staining with no fetal evidence or other prominent features.DNA typing was successfully processed for all cases according to the novel 26-plex and traditional system.CHM(46XX)diagnosis required single A-STR/X-STR peaks and absent Y-chromosome markers,excluding chromosomal abnormalities via TAF9L analysis.When the villous tissue analysis revealed single peaks at X-STR/SRY loci,a 1:1 amelogenin ratio,and a 2:1 TAF9L peak ratio,these results overlapped with those of 46XY hydropic abortus or CHM.Notably,p57 immunohistochemical staining resolved the ambiguity.Consistency with traditional DNA genotyping confirmed system accuracy.This multiplex assay enhanced reliability in mole diagnosis,supporting clinical differentiation and genetic counseling.Conclusion This study presents a rapid and cost-effective assay for the genotypic identification of CHM without the need for a maternal component.The method combined the characteristics of STR loci distributed across different chromosomes and developed the clinic application of forensic biomarkers.展开更多
BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated b...BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated by appendiceal mucinous tumor,supplemented by a review of 10 previously reported cases to distill diagnostic and therapeutic insights.CASE SUMMARY A 74-year-old male patient presented with abdominal pain.Abdominal contrastenhanced computed tomography(CECT)initially suggested a colonic tumor with intussusception.Colonoscopy identified a mass in the colon 60 cm from the anus.Intraoperative exploration confirmed CAI secondary to an appendiceal neoplasm.The patient underwent laparoscopic right hemicolectomy with regional lymphadenectomy under general anesthesia.Postoperative recovery was uneventful,and the patient was discharged 9 days post-surgery.Twelve-month follow-up revealed no evidence of recurrence or metastasis.CONCLUSION Plain abdominal computed tomography may underestimate the presence of CAI and appendiceal mucinous tumor,whereas CECT significantly improves diagnostic accuracy.Preoperative suspicion of appendiceal malignancy should be entertained in cases of CAI.In the absence of definitive biopsy results,intraoperative frozen section analysis is recommended to guide radical resection.展开更多
Transition metal-based nanomaterials have emerged as promising electrocatalysts for oxygen evolution reaction(OER).Considerable research efforts have shown that self-reconstruction occurs on these nanomaterials under ...Transition metal-based nanomaterials have emerged as promising electrocatalysts for oxygen evolution reaction(OER).Considerable research efforts have shown that self-reconstruction occurs on these nanomaterials under operating conditions of OER process.However,most of them undergo incomplete reconstruction with limited thickness of reconstruction layer,leading to low component utilization and arduous exploration of real catalytic mechanism.Herein,we identify the dynamic behaviors in complete reconstruction of Co-based complexes during OER.The hollow phytic acid(PA)cross-linked CoFe-based complex nanoboxes with porous nanowalls are designed because of their good electrolyte penetration and mass transport ability,in favor of the fast and complete reconstruction.A series of experiment characterizations demonstrate that the reconstruction process includes the fast substitution of PA by OH-to form Co(Fe)(OH)xand subsequent potential-driven oxidation to Co(Fe)OOH.The obtained CoFeOOH delivers a low overpotential of 290 mV at a current density of 10 mA cm^(-2)and a long-term stability.The experiment results together with theory calculations reveal that the Fe incorporation can result in the electron rearrangement of reconstructed CoFeOOH and optimization of their electronic structure,accounting for the enhanced OER activity.The work provides new insights into complete reconstruction of metal-based complexes during OER and offers guidelines for rational design of high-performance electrocatalysts.展开更多
Palladium-based catalysts have long been considered the benchmark for methane combustion;however,the authentic phase of catalytic active sites remains a subject of ongoing debate.Additionally,challenges like water-poi...Palladium-based catalysts have long been considered the benchmark for methane combustion;however,the authentic phase of catalytic active sites remains a subject of ongoing debate.Additionally,challenges like water-poisoning and long-term stability need to be addressed to advance catalyst performance.Herein,we investigate Pd on Co_(3)O_(4) nanorods as a highly effective catalyst for catalytic oxidation of methane,demonstrating long-term stability and water tolerance during a 100-h continuous operation at 350℃.Comprehensive characterizations reveal the presence of an active Pd-oxygen vacancy(Ov)-cobalt interface in Pd/Co_(3)O_(4),which effectively adsorbs molecular O_(2).The absorbed oxygen species on this interface are activated and directly participate in methane combustion.Moreover,near-ambient pressure X-ray photoelectron spectroscopy demonstrates that Pd nanoparticles undergo a rapid phase transition and predominantly remain in the metallic state during the reaction.This behavior is attributed to the electronic metal-support interaction between Pd and Co_(3)O_(4).Furthermore,in situ Fourier transformed infrared spectrum reveals that under reaction conditions,HCO3*species are formed initially and subsequently transformed into formate species,indicating that the formate pathway is the dominant mechanism for CH_(4) oxidation.展开更多
BACKGROUND Gastric cancer is a malignant tumor with high morbidity and mortality worldwide.Neoadjuvant chemotherapy(NAC),defined as chemotherapy administered before the primary treatment(usually surgery)to reduce tumo...BACKGROUND Gastric cancer is a malignant tumor with high morbidity and mortality worldwide.Neoadjuvant chemotherapy(NAC),defined as chemotherapy administered before the primary treatment(usually surgery)to reduce tumor size and control micrometastases,has emerged as a crucial therapeutic strategy for locally advanced gastric cancer.Pathological complete response(pCR),characterized by the absence of viable tumor cells in the resected specimen after neoadjuvant treatment,is recognized as a strong predictor of favorable prognosis.However,the factors influencing the achievement of pCR remain incompletely understood.AIM To identify and analyze the predictive factors associated with achieving pCR after NAC in gastric cancer patients,thereby providing evidence-based guidance for clinical decision-making.METHODS A retrospective analysis was performed on 215 patients from Shandong Cancer Hospital and Tai’an Central Hospital with locally advanced gastric cancer who underwent NAC followed by radical surgery at our hospital between January 2015 and December 2023.Comprehensive clinical and pathological data were collected,including age,gender,tumor location,Lauren classification,clinical staging,chemotherapy regimens,number of chemotherapy cycles,and baseline hematological indicators.The baseline hematological indicators included neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio,albumin level,carcinoembryonic antigen(CEA),and carbohydrate antigen 19-9.Univariate and multivariate logistic regression analyses were employed to determine the independent predictive factors for pCR.RESULTS Among 215 gastric cancer patients,41(19.1%)achieved pCR after NAC.Multivariate analysis identified five independent predictive factors for pCR:Lauren intestinal type[odds ratio(OR)=3.28],lower clinical T stage(OR=2.75),CEA decrease≥70%after NAC(OR=3.42),pre-treatment NLR<2.5(OR=2.13),and≥4 chemotherapy cycles(OR=2.87).The fluorouracil,leucovorin,oxaliplatin,docetaxel regimen achieved the highest pCR rate(27.5%),and oxaliplatin-containing regimens were superior to cisplatin-containing regimens(22.3%vs 12.7%,P=0.034).Patients with both low NLR and platelet-to-lymphocyte ratio had the highest pCR rate(33.8%),while those with both high inflammatory markers had the lowest rate(10.7%).Earlier clinical stage disease(cT3N+vs cT4N+:28.6%vs 13.0%)and lower lymph node burden were associated with higher pCR rates.CONCLUSION The achievement of pCR after NAC in gastric cancer patients is closely associated with Lauren intestinal type,lower clinical T stage,a significant decrease in CEA after chemotherapy,low pre-treatment NLR,and an adequate number of chemotherapy cycles.展开更多
Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc...Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc-tion with the domain-based local pair natural orbital(DLPNO)method,has been applied to assess the average binding energies(ABEs)of large benzene clus-ters,specifically(C6H6)13,at the coupled cluster singles and doubles with perturbative triples correction[CCSD(T)]level and the complete basis set(CBS)limit.Utilizing GEBF-DLPNO-CCSD(T)/CBS ABEs as benchmarks,various DFT functionals were evaluated.It was found that several functionals with empirical dispersion correction,including M06-2X-D3,B3LYP-D3(BJ),and PBE-D3(BJ),provide accurate descriptions of the ABEs for(C6H6)13 clusters.Additionally,the M06-2X-D3 functional was used to calculate the ABEs and relative stabili-ties of(C6H6)n clusters for n=11,12,13,14,and 15 revealing that the(C6H6)13 cluster ex-hibits the highest relative stability.These findings align with experimental evidence suggest-ing that n=13 is one of the magic numbers for benzene clusters(C6H6)n,with n≤30.展开更多
BACKGROUND Descending duodenal adenocarcinoma(DDA)is a rare malignancy of the digestive system,typically characterized by microsatellite instability-high(MSIH).Pembrolizumab is a monoclonal antibody that has been appr...BACKGROUND Descending duodenal adenocarcinoma(DDA)is a rare malignancy of the digestive system,typically characterized by microsatellite instability-high(MSIH).Pembrolizumab is a monoclonal antibody that has been approved for the treatment of MSI-H solid tumors in China.CASE SUMMARY We present the case of a 55-year-old female patient diagnosed with DDA.Biopsy findings indicated MSI-H status with high expression of programmed cell deathligand 1(PD-L1).The patient was unable to undergo immediate surgery due to multiple metastatic lymph nodes in the retroperitoneum.After one cycle of the SOX(S-1+oxaliplatin)chemotherapy regimen,the patient’s performance status significantly declined,and she experienced active gastrointestinal bleeding.Following active communication with the patient's family,pembrolizumab treatment was initiated.After two cycles of treatment,the disease was assessed as a partial response.A positron emission tomography/computed tomography scan performed after two years of treatment indicated a clinical complete response(CCR).The patient maintained this CCR for four years.She has now discontinued pembrolizumab for over one year,and no disease recurrence has been observed during re-examination.CONCLUSION Patients with MSI-H DDA exhibiting high PD-L1 expression who are treated with pembrolizumab can achieve sustained CCR.展开更多
BACKGROUND Gastric ulcer(GU),a common gastrointestinal condition,is influenced by multiple factors,particularly inflammatory and immune responses.Complete blood count(CBC)-derived inflammatory biomarkers represent a n...BACKGROUND Gastric ulcer(GU),a common gastrointestinal condition,is influenced by multiple factors,particularly inflammatory and immune responses.Complete blood count(CBC)-derived inflammatory biomarkers represent a novel indicator of systemic inflammation and immune status;however,their association with GU remains unclear.AIM To investigate the association between CBC-derived inflammatory markers and GU.METHODS The study sample included individuals admitted to the Gastroenterology Unit of the Second Affiliated Hospital of Nanchang University from 2023 to 2024.We explored how each CBC-based inflammation indicator correlated with GU occurrence through logistic models,and assessed their predictive ability using receiver operating characteristic curve analysis.Additionally,we applied the least absolute shrinkage and selection operator method along with stepwise regression techniques to determine which inflammatory indicators were most significantly linked to GU.RESULTS Higher levels of log2 neutrophil-to-lymphocyte ratio,log2 monocyte-to-lymphocyte ratio,log2 systemic immuneinflammation index,log2 systemic inflammatory response index(SIRI),and log2 aggregate index of systemic inflammation were significantly associated with increased GU prevalence across all models,while log2 platelet-tolymphocyte ratio was significant only in the fully adjusted model.SIRI demonstrated the highest discriminative ability,with an area under the curve of 0.868.CONCLUSION Hematological indicators derived from CBC tests show a significant correlation with the prevalence of GU.Among them,SIRI demonstrated the most prominent association.These markers could act as practical tools in recognizing individuals more likely to develop GU.展开更多
文摘BACKGROUND Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma(HCC)since 2008.While radiological complete responses are extremely rare,improved supportive care and multidisciplinary approaches in clinical practice may explain the recent increase in case reports and retrospective series documenting such responses.CASE SUMMARY This case series describes 3 patients with advanced HCC who achieved durable complete responses using first-line sorafenib therapy,even in the presence of portal vein thrombosis or extrahepatic spread,and highlights the potential for sustained remission in selected patients.Dermatologic toxicity and non-viral etiology may correlate with favorable outcomes;however,reliable predictive biomarkers for sorafenib response are lacking.CONCLUSION Future research into the etiology and molecular differences in HCC is necessary to develop more personalized therapy options.
基金supported by the Fundamental Research Funds for Central Public Welfare Research Institute,No.2020CZ-5(to WS and GS)the National Natural Science Foundation of China,No.31970970(to JSR)Fundamental Research Funds for the Central Universities,No.YWF-23-YG-QB-010(to JSR)。
文摘Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface electromyography.In this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury.Eleven patients with chronic complete thoracic spinal cord injury were recruited.Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol.The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation.Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically significant.These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.
基金Supported by National Natural Science Foundation of China,No.82004298Jiangsu Graduate Research and Practice Innovation Program,China,No.KYCX23_2090.
文摘BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particularly in the vertical direction.Endoscopic full-thickness resection(EFTR)has proven to be an effective method for the treatment of submucosal tumors but is seldom utilized in the eradication of R-NENs.AIM To review cases of R-NENs removed using EFTR and to evaluate the safety and efficacy of this technique.METHODS This retrospective cohort study enrolled 160 patients with pathologically confirmed R-NENs,including 132 who underwent endoscopic submucosal dissection(ESD)and 28 who underwent EFTR.Lesions were categorized as<1 cm,1-2 cm,and>2 cm in size.CR rate,en bloc resection rate,operation time,and complications were evaluated.Subgroup analyses and follow-up were also performed.RESULTS EFTR achieved 100%CR rates for lesions<1 cm and 1-2 cm,compared with 67.0%and 50.0%,respectively,in the ESD group.En bloc resection and successful removal of the R-NENs were achieved in all patients.Meanwhile,EFTR showed performance comparable to ESD in terms of operation time,hospitalization cost,and postoperative adverse events,except for a one-day longer hospital stay.We also analyzed the invasion depth of R-NENs based on full-thickness specimens.The data showed that 80%of lesions(<1 cm)and 85.7%of lesions(1-2 cm)had invaded the SM3 level or deeper at the time of resection.For ESD specimens,46.6%(<1 cm)and 89.3%(1-2 cm)of lesions had infiltrated more than 2000μm beneath the muscularis mucosae.CONCLUSION EFTR has shown superior performance in the resection of small R-NENs compared with that of ESD.
基金Project(42202318)supported by the National Natural Science Foundation of ChinaProject(252300421199)supported by the Natural Science Foundation of Henan Province,ChinaProject(2024JJ6219)supported by the Hunan Provincial Natural Science Foundation of China。
文摘The undrained mechanical behavior of unsaturated completely weathered granite(CWG)is highly susceptible to alterations in the hydraulic environment,particularly under uniaxial loading conditions,due to the unique nature of this soil type.In this study,a series of unconfined compression tests were carried out on unsaturated CWG soil in an underground engineering site,and the effects of varying the environmental variables on the main undrained mechanical properties were analyzed.Based on the experimental results,a novel constitutive model was then established using the damage mechanics theory and the undetermined coefficient method.The results demonstrate that the curves of remolded CWG specimens with different moisture contents and dry densities exhibited diverse characteristics,including brittleness,significant softening,and ductility.As a typical indicator,the unconfined compression strength of soil specimens initially increased with an increase in moisture content and then decreased.Meanwhile,an optimal moisture content of approximately 10.5%could be observed,while a critical moisture content value of 13.0%was identified,beyond which the strength of the specimen decreases sharply.Moreover,the deformation and fracture of CWG specimens were predominantly caused by shear failure,and the ultimate failure modes were primarily influenced by moisture content rather than dry density.Furthermore,by comparing several similar models and the experimental data,the proposed model could accurately replicate the undrained mechanical characteristics of unsaturated CWG soil,and quantitatively describe the key mechanical indexes.These findings offer a valuable reference point for understanding the underlying mechanisms,anticipating potential risks,and implementing effective control measures in similar underground engineering projects.
基金Supported by General Project of Natural Science Foundation of Chongqing,China,No.cstc2021jcyj-msxmX0604Chongqing Doctoral"Through Train"Research Program,China,No.CSTB2022BSXM-JCX0045.
文摘BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.
基金supported by Doctoral Scientific Research Starting Foundation of Jingdezhen Ceramic University(Grant No.102/01003002031)Re-accompanying Funding Project of Academic Achievements of Jingdezhen Ceramic University(Grant Nos.215/20506277,215/20506341)。
文摘The complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space is studied.By moment inequality and truncation methods,we establish the equivalent conditions of complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space.The results complement the corresponding results in probability space to those for sequences of independent,identically distributed random variables under sublinear expectation space.
基金supported by the National Social Science Fundation(Grant No.21BTJ040)the Project of Outstanding Young People in University of Anhui Province(Grant Nos.2023AH020037,SLXY2024A001).
文摘In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergence of NSD random variables.We establish and improve a general result on the complete f-moment convergence for Sung’s type randomly weighted sums of NSD random variables under some general assumptions.As an application,we show the complete consistency for the randomly weighted estimator in a nonparametric regression model based on NSD errors.
文摘In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise completely positive(RPCP)decomposition.We study the properties of RPCP matrices and give some necessary and sufficient conditions for a matrix pair to be RPCP.First,we give an equivalent decomposition for the RPCP matrices,which is different from the RPCP-decomposition and show that the matrix pair(X,X)is RPCP if and only if X is completely positive.Besides,we also prove that the RPCP matrices checking problem is equivalent to the separable completion problem.A semidefinite algorithm is also proposed for detecting whether or not a matrix pair is RPCP.The asymptotic and finite convergence of the algorithm are also discussed.If it is RPCP,we can further give a RPCP-decomposition for it;if it is not,we can obtain a certificate for this.
文摘BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who underwent hepatectomy followed by a combination of sorafenib and camrelizumab,resulting in complete remission(CR)for 5 years.CASE SUMMARY A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC,Barcelona Clinic Liver Cancer stage C.Enhanced computed tomography imaging revealed a 152 mm×171 mm tumor in the right liver,invading the portal vein and hepatic vein.Liver function was normal.The patient successfully underwent hepatectomy on July 18,2019.However,by December 2019,HCC recurrence with lung metastases and portal vein invasion were detected.He started treatment with sorafenib(200 mg twice daily)and camrelizumab(200 mg every 3 weeks).By May 12,2020,the patient was confirmed to have CR.Camrelizumab was adjusted to 200 mg every 12 weeks from June 16,2021,with the last infusion on March 29,2024.Although no further tumor recurrence was observed,he experienced two episodes of gastrointestinal bleeding due to esophagogastric varices,which were managed with endoscopic therapy.To date,the patient has remained in CR for 5 years.CONCLUSION The combination of hepatectomy with sorafenib and camrelizumab can achieve durable CR in patients with supergiant HCC and portal vein invasion.Further research is necessary to address these challenges and improve patient outcomes.
文摘BACKGROUND Gallbladder cancer is a highly malignant and aggressive tumor,often diagnosed at an advanced stage.The prognosis for advanced gallbladder cancer remains poor,with limited options for effective treatment.CASE SUMMARY A 65-year-old male patient presented with a soft tissue mass in the gallbladder.Following laparoscopic exploration,he underwent radical surgery for gallbladder cancer,with the tumor staged as pT2N1M0(stage III).Post-surgery,the patient received four cycles of adjuvant chemotherapy.However,one month later,over 60 metastatic lesions were detected in the liver,lungs,and lymph nodes.In response to the widespread metastasis,he underwent six cycles of combination therapy consisting of sintilimab,albumin-bound paclitaxel,and cisplatin.After two cycles,a partial response was achieved.Maintenance therapy was initiated with a combination of sintilimab and albumin-bound paclitaxel for four cycles.Monotherapy with sintilimab was continued thereafter until October 2023.Complete remission was confirmed in September 2021.The patient sustained this complete response for more than three years,including an eleven-month period without disease progression following the discontinuation of sintilimab.Genetic analysis revealed a tumor mutational burden of 15.4 mutations/megabase,which indicates a potentially favorable response to immunotherapy.CONCLUSION This case demonstrates the potential of combining immunotherapy(sintilimab)with chemotherapy to achieve durable remission in metastatic gallbladder cancer,even in a patient with extensive metastasis.In addition,it indicated the importance of tumor mutational burden as a predictive biomarker of immunotherapy.
文摘BACKGROUND Transarterial chemoembolization(TACE)is a widely accepted palliative therapy modality for unresectable hepatocellular carcinoma(HCC).Although it is rarely curative,complete radiological response can be achieved in selected patients,leading to prolonged survival.Post-treatment tumoral calcification is an uncom-mon imaging finding in HCC and is rarely reported after drug-eluting beads TACE(DEB-TACE).CASE SUMMARY Two patients with large,solitary HCCs(>5 cm)were treated with DEB-TACE,and both achieved complete radiological response after two treatment sessions.Approximately 1 year after DEB-TACE,imaging demonstrated progressive peripheral tumoral calcification.Over 6 years of follow-up,both patients remained in remission with preserved liver function.CONCLUSION These two cases highlight the potential for complete remission and long-term survival in selected patients with large HCC following DEB-TACE.The appearance of peripheral calcification may represent a late imaging marker of effective tumor necrosis and durable treatment response although prospective studies are warranted to clarify its prognostic value.
文摘1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Partial hepatectomy is recommended for patients with early stage HCC.[2]A large proportion of patients with HCC inChina are diagnosed in the intermediate to advanced HCC stages,rendering them ineligible for hepatectomy due to aspects such as liver dysfunction,insufficient residual liver volume,or surgical technique.
基金supported by the Key Research and Development Program of Shaanxi(No.S2024-YF-YB-SF-1359).
文摘Objective Current autosomal short tandem repeat(STR)assays can analyze the zygotic composition by comparing the allelic genes at each locus of complete hydatidiform moles(CHM),with a maternal genotype serving as an essential reference for comparative analysis.However,their application in pathology represents a challenge because of deficiency or contamination of maternal-origin tissues.This study aimed to develop a novel STR genotyping method for identifying CHM genotypes without a maternal component.Methods Samples with the pathologic description of molar pregnancy were collected.Routine hematoxylin–eosin(HE)staining and p57 immunohistochemistry staining were conducted in accordance with standard guidelines.A novel 26-plex system was explored to classify CHM and diploid pregnancies.The system combined 22 STRs on chromosomes 21/18/13/X,3 sex loci,and 1 quality control marker(TAF9L),enabling molecular diagnosis in the absence of maternal tissue.At last,traditional DNA typing based on villi and decidua(maternal component)of each case was used for result consistency analysis.Results CHM and nonmolar abortus could not be distinguished by the basic HE staining with no fetal evidence or other prominent features.DNA typing was successfully processed for all cases according to the novel 26-plex and traditional system.CHM(46XX)diagnosis required single A-STR/X-STR peaks and absent Y-chromosome markers,excluding chromosomal abnormalities via TAF9L analysis.When the villous tissue analysis revealed single peaks at X-STR/SRY loci,a 1:1 amelogenin ratio,and a 2:1 TAF9L peak ratio,these results overlapped with those of 46XY hydropic abortus or CHM.Notably,p57 immunohistochemical staining resolved the ambiguity.Consistency with traditional DNA genotyping confirmed system accuracy.This multiplex assay enhanced reliability in mole diagnosis,supporting clinical differentiation and genetic counseling.Conclusion This study presents a rapid and cost-effective assay for the genotypic identification of CHM without the need for a maternal component.The method combined the characteristics of STR loci distributed across different chromosomes and developed the clinic application of forensic biomarkers.
文摘BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated by appendiceal mucinous tumor,supplemented by a review of 10 previously reported cases to distill diagnostic and therapeutic insights.CASE SUMMARY A 74-year-old male patient presented with abdominal pain.Abdominal contrastenhanced computed tomography(CECT)initially suggested a colonic tumor with intussusception.Colonoscopy identified a mass in the colon 60 cm from the anus.Intraoperative exploration confirmed CAI secondary to an appendiceal neoplasm.The patient underwent laparoscopic right hemicolectomy with regional lymphadenectomy under general anesthesia.Postoperative recovery was uneventful,and the patient was discharged 9 days post-surgery.Twelve-month follow-up revealed no evidence of recurrence or metastasis.CONCLUSION Plain abdominal computed tomography may underestimate the presence of CAI and appendiceal mucinous tumor,whereas CECT significantly improves diagnostic accuracy.Preoperative suspicion of appendiceal malignancy should be entertained in cases of CAI.In the absence of definitive biopsy results,intraoperative frozen section analysis is recommended to guide radical resection.
基金National Natural Science Foundation of China(22478310,U21A20286 and 22206054)。
文摘Transition metal-based nanomaterials have emerged as promising electrocatalysts for oxygen evolution reaction(OER).Considerable research efforts have shown that self-reconstruction occurs on these nanomaterials under operating conditions of OER process.However,most of them undergo incomplete reconstruction with limited thickness of reconstruction layer,leading to low component utilization and arduous exploration of real catalytic mechanism.Herein,we identify the dynamic behaviors in complete reconstruction of Co-based complexes during OER.The hollow phytic acid(PA)cross-linked CoFe-based complex nanoboxes with porous nanowalls are designed because of their good electrolyte penetration and mass transport ability,in favor of the fast and complete reconstruction.A series of experiment characterizations demonstrate that the reconstruction process includes the fast substitution of PA by OH-to form Co(Fe)(OH)xand subsequent potential-driven oxidation to Co(Fe)OOH.The obtained CoFeOOH delivers a low overpotential of 290 mV at a current density of 10 mA cm^(-2)and a long-term stability.The experiment results together with theory calculations reveal that the Fe incorporation can result in the electron rearrangement of reconstructed CoFeOOH and optimization of their electronic structure,accounting for the enhanced OER activity.The work provides new insights into complete reconstruction of metal-based complexes during OER and offers guidelines for rational design of high-performance electrocatalysts.
文摘Palladium-based catalysts have long been considered the benchmark for methane combustion;however,the authentic phase of catalytic active sites remains a subject of ongoing debate.Additionally,challenges like water-poisoning and long-term stability need to be addressed to advance catalyst performance.Herein,we investigate Pd on Co_(3)O_(4) nanorods as a highly effective catalyst for catalytic oxidation of methane,demonstrating long-term stability and water tolerance during a 100-h continuous operation at 350℃.Comprehensive characterizations reveal the presence of an active Pd-oxygen vacancy(Ov)-cobalt interface in Pd/Co_(3)O_(4),which effectively adsorbs molecular O_(2).The absorbed oxygen species on this interface are activated and directly participate in methane combustion.Moreover,near-ambient pressure X-ray photoelectron spectroscopy demonstrates that Pd nanoparticles undergo a rapid phase transition and predominantly remain in the metallic state during the reaction.This behavior is attributed to the electronic metal-support interaction between Pd and Co_(3)O_(4).Furthermore,in situ Fourier transformed infrared spectrum reveals that under reaction conditions,HCO3*species are formed initially and subsequently transformed into formate species,indicating that the formate pathway is the dominant mechanism for CH_(4) oxidation.
文摘BACKGROUND Gastric cancer is a malignant tumor with high morbidity and mortality worldwide.Neoadjuvant chemotherapy(NAC),defined as chemotherapy administered before the primary treatment(usually surgery)to reduce tumor size and control micrometastases,has emerged as a crucial therapeutic strategy for locally advanced gastric cancer.Pathological complete response(pCR),characterized by the absence of viable tumor cells in the resected specimen after neoadjuvant treatment,is recognized as a strong predictor of favorable prognosis.However,the factors influencing the achievement of pCR remain incompletely understood.AIM To identify and analyze the predictive factors associated with achieving pCR after NAC in gastric cancer patients,thereby providing evidence-based guidance for clinical decision-making.METHODS A retrospective analysis was performed on 215 patients from Shandong Cancer Hospital and Tai’an Central Hospital with locally advanced gastric cancer who underwent NAC followed by radical surgery at our hospital between January 2015 and December 2023.Comprehensive clinical and pathological data were collected,including age,gender,tumor location,Lauren classification,clinical staging,chemotherapy regimens,number of chemotherapy cycles,and baseline hematological indicators.The baseline hematological indicators included neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio,albumin level,carcinoembryonic antigen(CEA),and carbohydrate antigen 19-9.Univariate and multivariate logistic regression analyses were employed to determine the independent predictive factors for pCR.RESULTS Among 215 gastric cancer patients,41(19.1%)achieved pCR after NAC.Multivariate analysis identified five independent predictive factors for pCR:Lauren intestinal type[odds ratio(OR)=3.28],lower clinical T stage(OR=2.75),CEA decrease≥70%after NAC(OR=3.42),pre-treatment NLR<2.5(OR=2.13),and≥4 chemotherapy cycles(OR=2.87).The fluorouracil,leucovorin,oxaliplatin,docetaxel regimen achieved the highest pCR rate(27.5%),and oxaliplatin-containing regimens were superior to cisplatin-containing regimens(22.3%vs 12.7%,P=0.034).Patients with both low NLR and platelet-to-lymphocyte ratio had the highest pCR rate(33.8%),while those with both high inflammatory markers had the lowest rate(10.7%).Earlier clinical stage disease(cT3N+vs cT4N+:28.6%vs 13.0%)and lower lymph node burden were associated with higher pCR rates.CONCLUSION The achievement of pCR after NAC in gastric cancer patients is closely associated with Lauren intestinal type,lower clinical T stage,a significant decrease in CEA after chemotherapy,low pre-treatment NLR,and an adequate number of chemotherapy cycles.
基金supported by the National Key R&D Program of China(No.2023YFB3712504)the National Natural Science Foundation of China(Nos.22273038,22073043,and 22033004)。
文摘Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc-tion with the domain-based local pair natural orbital(DLPNO)method,has been applied to assess the average binding energies(ABEs)of large benzene clus-ters,specifically(C6H6)13,at the coupled cluster singles and doubles with perturbative triples correction[CCSD(T)]level and the complete basis set(CBS)limit.Utilizing GEBF-DLPNO-CCSD(T)/CBS ABEs as benchmarks,various DFT functionals were evaluated.It was found that several functionals with empirical dispersion correction,including M06-2X-D3,B3LYP-D3(BJ),and PBE-D3(BJ),provide accurate descriptions of the ABEs for(C6H6)13 clusters.Additionally,the M06-2X-D3 functional was used to calculate the ABEs and relative stabili-ties of(C6H6)n clusters for n=11,12,13,14,and 15 revealing that the(C6H6)13 cluster ex-hibits the highest relative stability.These findings align with experimental evidence suggest-ing that n=13 is one of the magic numbers for benzene clusters(C6H6)n,with n≤30.
基金Supported by Medical Science Research Project of Hebei Province in 2023,Key Laboratory of Research on Molecular Mechanism of Gastrointestinal Tumors in Qinhuangdao,No.20231891.
文摘BACKGROUND Descending duodenal adenocarcinoma(DDA)is a rare malignancy of the digestive system,typically characterized by microsatellite instability-high(MSIH).Pembrolizumab is a monoclonal antibody that has been approved for the treatment of MSI-H solid tumors in China.CASE SUMMARY We present the case of a 55-year-old female patient diagnosed with DDA.Biopsy findings indicated MSI-H status with high expression of programmed cell deathligand 1(PD-L1).The patient was unable to undergo immediate surgery due to multiple metastatic lymph nodes in the retroperitoneum.After one cycle of the SOX(S-1+oxaliplatin)chemotherapy regimen,the patient’s performance status significantly declined,and she experienced active gastrointestinal bleeding.Following active communication with the patient's family,pembrolizumab treatment was initiated.After two cycles of treatment,the disease was assessed as a partial response.A positron emission tomography/computed tomography scan performed after two years of treatment indicated a clinical complete response(CCR).The patient maintained this CCR for four years.She has now discontinued pembrolizumab for over one year,and no disease recurrence has been observed during re-examination.CONCLUSION Patients with MSI-H DDA exhibiting high PD-L1 expression who are treated with pembrolizumab can achieve sustained CCR.
文摘BACKGROUND Gastric ulcer(GU),a common gastrointestinal condition,is influenced by multiple factors,particularly inflammatory and immune responses.Complete blood count(CBC)-derived inflammatory biomarkers represent a novel indicator of systemic inflammation and immune status;however,their association with GU remains unclear.AIM To investigate the association between CBC-derived inflammatory markers and GU.METHODS The study sample included individuals admitted to the Gastroenterology Unit of the Second Affiliated Hospital of Nanchang University from 2023 to 2024.We explored how each CBC-based inflammation indicator correlated with GU occurrence through logistic models,and assessed their predictive ability using receiver operating characteristic curve analysis.Additionally,we applied the least absolute shrinkage and selection operator method along with stepwise regression techniques to determine which inflammatory indicators were most significantly linked to GU.RESULTS Higher levels of log2 neutrophil-to-lymphocyte ratio,log2 monocyte-to-lymphocyte ratio,log2 systemic immuneinflammation index,log2 systemic inflammatory response index(SIRI),and log2 aggregate index of systemic inflammation were significantly associated with increased GU prevalence across all models,while log2 platelet-tolymphocyte ratio was significant only in the fully adjusted model.SIRI demonstrated the highest discriminative ability,with an area under the curve of 0.868.CONCLUSION Hematological indicators derived from CBC tests show a significant correlation with the prevalence of GU.Among them,SIRI demonstrated the most prominent association.These markers could act as practical tools in recognizing individuals more likely to develop GU.
