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Objective:To explore the markers predicting the efficacy of anti-programmed death receptor-1 (PD-1)/PD-1 ligand (PD-L1) immunotherapy for non-small cell lung cancer (NSCLC) and analyze their relationships with the tumor immune microenvironment.Methods:(1) Gene expression profile data and relevant clinical data of 55 NSCLC patients receiving anti-PD-1/PD-L1 monotherapy from two independent clinical cohorts were downloaded from the GEO database. Genes associated with progression-free survival (PFS) were screened using univariate Cox regression analysis. (2) Twenty-six pathological tissue specimens of NSCLC patients who received anti-PD-1/PD-L1 monotherapy in the Cancer Hospital of Chinese Academy of Medical Sciences (CICAMS) from April 2016 to August 2019 prior to the screening of genes were selected to verify the predictive value of the screened genes using immunohistochemistry. (3) The relationship between efficacy predictive markers and PD-L1 and infiltrating immune cells in the tumor immune microenvironment was analyzed using NSCLC gene expression profile downloaded from the TCGA database.Results:Univariate Cox regression analysis revealed that only T-Cell Surface Glycoprotein CD3 Gamma Chain (CD3G) was a risk predictive gene for PFS in NSCLC patients in both clinical cohorts of the GEO database (GSE93157: P = 0.049; GSE136961: P = 0.034). Further Kaplan-Meier survival curves showed that PFS was significantly prolonged in the high CD3G expression group ( P = 0.012). The results of survival analysis in the CICAMS clinical cohort also demonstrated that NSCLC patients with high CD3G expression had a better prognosis after receiving anti-PD-1/PD-L1 monotherapy ( P = 0.001) compared with those with low CD3G expression. Univariate and multivariate Cox regression analyses also showed that CD3G was an independent predictor of PFS (univariate: P = 0.002; multivariate: P = 0.001). The tumor immune microenvironment analysis showed that CD3G was positively correlated with PD-L1 expression (lung adenocarcinoma: r = 0.44, P < 0.001; lung squamous cell carcinoma: r = 0.37, P < 0.001) and the infiltration level of CD8 + T cells (lung adenocarcinoma: r = 0.13, P = 0.002; lung squamous cell carcinoma: r = 0.70, P < 0.001). CD3G was also positively correlated with the expression of CD8 + T cell chemokines CCL5, CXCL9, CXCL10 and CXCL11. Conclusion:Patients with NSCLC with high CD3G expression have greater clinical benefits after anti-PD-1/PD-L1 monotherapy compared with those with low CD3G expression. CD3G can be used as a potential marker to predict the efficacy of immunotherapy for NSCLC.
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Objective To evaluate the effect of acupuncture on the quality of recovery during the early period after gynecological laparoscopic surgery using the Quality of Recovery?40 questionnaire ( QoR?40). Methods Sixty patients, aged 20-60 yr, with body mass index of 18.5-28.0 kg∕m2, of American Society of Anesthesiologists physical status ⅠorⅡ, scheduled for elective gynecological laparoscopic surgery, were equally and randomly divided into either control group ( group C ) or acupuncture group (group Acu) using a random number table. Bilateral Neiguan (PC6) and Hegu (L14) acupoints were stimulated for 30 min starting from the time point before skin incision and immediately after the end of surgery. The quality of recovery was assessed using the QoR?40 on 1 day before surgery, and at 24 and 48 h after surgery. The patient′s cognitive function was assessed using Mini?Mental State Examination. The requirement for rescue analgesics was recorded. The occurrence of nausea and vomiting was also recorded. Results Compared with group C, the global QoR?40 and Mini?Mental State Examination scores were significantly increased, and the incidence of nausea and vomiting and requirement for rescue analgesics were decreased at 24 and 48 h after surgery in group Acu ( P<0. 05 ) . Conclusion Acupuncture can improve the quality of recovery during the early period after gynecological laparoscopic surgery using the QoR?40.
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Objective To evaluate the role of mitochondrial ATP-sensitive potassium (mitoKATP) channel in mitigation of cerebral ischemia-reperfusion (I/R) injury by isoflurane preconditioning in rats and the relationship with c-Jun N-terminal kinase (JNK) signaling pathway.Methods Thirty-two male Sprague-Dawley rats,weighing 280-320 g,were randomly divided into 4 groups (n =8 each) using a random number table:sham operation group (group S),group I/R,isoflurane preconditioning group (group Ⅰ-pre),and 5-hydroxydecanoate (5-HD,a selective mitoKATP channel antagonist) group.Cerebral I/R was produced by modified 4-vessel technique described by Pulsinelli in anesthetized rats.In group Ⅰ-pre,the rats were exposed to 1.5％ isoflurane for 1 h everyday for 5 consecutive days before ischemia.In group 5-HD,5-HD 15 mg/kg was injected intraperitoneally at 30 min before ischemia and the other procedures were similar to those previously described in group Ⅰ-pre.Neurological behavior was evaluated at 24 h of reperfusion.The rats in each group were sacrificed at 72 h of reperfusion,and the brains were removed for determination of neuronal apoptosis (by TUNEL) and expression of caspase-3 and phosphor-JNK (p-JNK) protein (using Western blot) in hippocampal tissues.Apoptotic rate was calculated.Results Compared with group S,the number of grid cross was significantly decreased,hanging time was shortened,apoptotic rate was increased,and caspase-3 expression was up-regulated in I/R,Ⅰ-pre and 5-HD groups,the expression of p-JNK protein was up-regulated in IR and 5-HD groups,and no significant change was found in the expression of p-JNK protein in group Ⅰ-pre.Compare with group I/R,the number of grid cross was significantly increased,hanging time was prolonged,apoptotic rate was decreased,and the expression of caspase-3 and p-JNK protein was downregulated in group Ⅰ-pre,and no significant change was found in the parameters mentioned above in group 5-HD.Compared with group Ⅰ-pre,the number of grid cross was significantly decreased,hanging time was shortened,apoptotic rate was increased,and the expression of caspase-3 and p-JNK protein was up-regulated in group 5-HD.Conclusion The mitoKATP channel is involved in mitigation of cerebral I/R injury by isoflurane preconditioning through blocking the JNK signaling pathway in rats.