Efficacy and safety of PD-1/PD-L1 inhibitors-based immunocombination therapy versus sunitinib in the treatment of advanced renal cell carcinoma: a Meta-analysis / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：系统评价基于PD-1/PD-L1抑制剂的免疫联合治疗（以下称“免疫联合治疗”）对比舒尼替尼治疗晚期肾细胞癌（RCC）的安全性和有效性。方法：检索PubMed、Embase、Cochrane Library及中国知网（CNKI）数据库，收集国内外公开发表的免疫联合治疗对比舒尼替尼应用于晚期RCC的随机对照试验（RCT），检索时间均为自建库时间至2022年10月。由两名研究者独立评价纳入研究的质量、提取资料并交叉核对，采用StataMP16.0软件进行Meta分析。结果：共纳入6项RCT，Meta分析结果显示，（1）有效性：与舒尼替尼相比，免疫联合治疗显著提高了晚期RCC患者的总生存期[OS，HR=0.74，95% CI （0.67，0.80），P<0.01]和无进展生存期[PFS，HR=0.66，95% CI （0.51，0.81），P<0.01]；（2）安全性：两治疗组均有较高的不良反应（AE）发生率，差异无统计学意义。但免疫联合治疗组发生皮肤及内分泌系统AE显著高于舒尼替尼治疗组，而血液系统相关AE则明显低于舒尼替尼治疗组；（3）以1%为临界点，免疫联合治疗组的RCC患者，无论是PD-L1阳性或阴性的，其OS和PFS均高于舒尼替尼组。结论：免疫联合治疗可显著延长晚期RCC患者的OS和PFS，但不同系统发生AE有差异，且RCC患者PD-L1表达状态（1%为临界点）并不影响免疫联合治疗的获益。

Characteristics and clinical significance of the changes in PD-1/PD-L1 and related immune cells in peripheral blood and tumor tissues of patients with cervical squamous cell cancer / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨PD-1/PD-L1通路及相关免疫细胞在宫颈鳞癌（cervical squamous cell cancer，CSCC）发生、发展中的变化特点及其临床意义。方法：收集2018年12月至2020年9月在福州市第一医院接受手术的CSCC患者和健康体检人员的癌组织/宫颈组织和外周血样本，分为健康对照组、宫颈上皮内癌变（cervical intraepithelial neoplasia，CIN）Ⅱ级组、CIN Ⅲ级组和CSCC组，代表CSCC发生、发展进程各阶段，每组50例。ELISA法检测各组人员的外周血血浆中PD-1、PD-L1、叉头状转录因子P3（FOXP3）的表达水平，FCM法检测各组人员外周血PD-1+CD4+CD25+CD127-/low细胞的数量，应用多色荧光组织染色法检测肿瘤浸润性淋巴细胞（TIL）在CSCC组织中的分布特点。结果：随着模拟的CSCC发生和发展，外周血中PD-1、PD-L1和FOXP3 的表达呈上升趋势，术后则呈下降趋势。在CSCC患者抗凝全血中，CD4+、CD4+CD25+CD127-/low以及PD-1+CD4+CD25+CD127-/low细胞占淋巴细胞的比例增加。在CSCC组织中可见大量CD4+、CD8+和FOXP3+细胞浸润，其中CD4+和FOXP3+细胞主要围绕肿瘤细胞聚集区分布、CD8+和PD-L1+细胞则呈广泛弥漫性分布。结论：PD-1、PD-L1、FOXP3和适应性调节性T细胞是促进CSCC发生发展的重要因素，其可作为ESCC免疫治疗的靶点和临床预后的潜在标志物。

Efficacy and safety of nivolumab plus ipilimumab versus nivolumab monotherapy in the treatment of malignant tumors: A Meta-analysis / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To systematically evaluate the efficacy and safety of nivolumab plus ipilimumab versus nivolumab monotherapy in the treatment of malignant tumors, so as to provide evidence-based medical proof for clinical administration. Methods: Databases, such as PubMed, CNKI, VIP, and Wanfang Data, were searched from January 2000 to January 2022 to collect the clinical trial data in terms of nivolumab plus ipilimumab versus nivolumab monotherapy for malignant tumors were published in both domestic and abroad. Two reviewers independently evaluated the quality of included RCTs, and extracted and cross-checked the data. RevMan 5. 4 was used for the Meta-analysis. Results: A total of 7 RCTs studies including 10 articles were included. Compared with the nivolumab monotherapy group, the OS of patients in the combined treatment group was significantly improved (HR=0.86, 95% CI:0. 75-0.99, P=0. 03), and the PFS was significantly prolonged (HR=0.69, 95% CI: 0.55-0.85, P=0.000 6). However, as for safety, treatment-related adverse events (OR=3.18, 95% CI: 1.55-6.55, P=0.002) and adverse events leading to drug discontinuation (OR=7.11, 95% CI: 4.85-10.42, P<0.000 01) in the combination therapy group were significantly higher than those in the monotherapy group. Conclusion: Compared with nivolumab monotherapy, nivolumab plus ipilimumab can significantly improve the OS and PFS of tumor patients, but is also associated with more treatment-related adverse events and adverse events leading to drug discontinuation. Therefore, it is necessary to pay attention to follow-up and regular monitoring to prevent the occurrence of serious adverse reactions.

Underreporting deaths in public health surveillance areas of Zhejiang Province / 预防医学

Objective@#To understand the underreporting rate of death among residents in Zhejiang Province from 2016 to 2018, so as to provide a basis for improvement of death surveillance measures. @*Methods@#Multi-stage random cluster sampling was used to select residents in 30 public health surveillance areas of Zhejiang Province and all the residents were investigated the general information and death conditions that occurred during the period 2016-2018 by door to door visit. The underreporting rate of death was calculated and descriptive methods were used to analyze the causes of underreporting deaths.@*Results@#A total of 358 992 residents were investigated in 30 public health surveillance areas of Zhejiang Province. There were 63 underreporting deaths among 5 896 deaths, with an underreporting rate of 1.07%. The underreporting rate in men was 1.30%, which was higher than 0.75% in women ( P<0.05 ). The underreporting rate of residents aged 20 to <40 years was 6.74%, the highest among all the age groups ( P<0.05 ). The underreporting rate was 4.46% on the way to the hospital, the highest among all the places of death ( P<0.05 ). The underreporting rate in Wuxing District of Huzhou was 5.80%, the highest among all the surveillance areas. There were 25 cases of "late report or untimely review", accounting for 39.68%; 38 cases of "not report", accounting for 60.32%, of which 14 cases were caused by doctors forgetting to report, accounting for 22.22%. @*Conclusion@#The underreporting rate of death in Zhejiang Province from 2016 to 2018 is generally low. In response to underreporting deaths, multi-departmental collaboration should be promoted to effectively strengthen the reporting and management of routine death surveillance.

Prevalence and influencing factors of dyslipidemia among patients with type 2 diabetes mellitus in rural communities of Zhejiang Province / 预防医学

Objective@#To learn the prevalence of dyslipidemia and its influencing factors among patients with type 2 diabetes mellitus (T2DM) in rural areas of Zhejiang Province, and to provide evidence for dyslipidemia control.@* Methods@#A sample of 10 343 patients with T2DM managed by communities from three counties (Jiashan,Suichang and Yongkang) were recruited. Through the residents’ health record system and specific investigation, demographic features,physical examination results of blood pressure,height, weight, waist circumstance (WC), glycated hemoglobin (HbA1c),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were collected to analyze the spectrum of dyslipidemia. A logistic regression model was established to explore the associated factors of dyslipidemia. @*Results @#The prevalence rate of dyslipidemia among the patients with T2DM in rural communities was 66.91%. The prevalence rates of higher level of TC, TG, LDL-C were 41.76%, 41.28%, 15.89%, respectively, while the prevalence rateof lower level of HDL-C was 16.92%. The prevalence rates of purely high TC,high TC with TG and purely high TG were 11.84%,11.75% and 11.47%,respectively. Higher level of TG with lower level of HDL-C was common in males (11.32%) and higher level of TC with TG was common in females (14.60%). The results from multivariate logistic regression analysis indicated that females(OR=1.499,95%CI:1.352-1.663),age(OR=0.992,95%CI:0.988-0.996),poor control of HbA1c(OR=1.241,95%CI:1.141-1.351), abdominal obesity(OR=1.169,95%CI:1.064-1.285),overweight(OR=1.384,95%CI:1.257-1.524)and obesity(OR=1.582,95%CI:1.352-1.852)were associated with dyslipidemia. @*Conclusions@#The prevalence of dyslipidemia is relatively higher among the patients with T2DM in rural communities of Zhejiang Province. Higher level of TC and TG contributed to most dyslipidemia. The patients with T2DM who are females,have poor control of plasma glucose and suffer from obesity should be under surveillance.