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Lung cancer has the highest risk of brain metastasis (BM) among all solid carcinomas. The emergence of BM has a significant impact on the selection of oncologic treatment for patients. Immune checkpoint inhibitors (ICIs) are the most promising treatment option for patients without druggable mutations and have been shown to improve survival in patients with non-small cell lung cancer (NSCLC) BM in clinical trials with good safety. Moreover, ICI has shown certain effects in NSCLC BM, and the overall intracranial efficacy is comparable to extracranial efficacy. However, a proportion of patients showed discordant responses in primary and metastatic lesions, suggesting that multiple mechanisms may exist underlying ICI activity in BM. According to studies pertaining to tumor immune microenvironments, ICIs may be capable of provoking immunity in situ . Meanwhile, systematic immune cells activated by ICIs can migrate into the central nervous system and exert antitumor effects. This review summarizes the present evidence for ICI treatment efficacy in NSCLC BM and proposes the possible mechanisms of ICI treatment for NSCLC BMs based on existing evidence.
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Humanos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Inibidores de Checkpoint Imunológico/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Carcinoma , Microambiente TumoralRESUMO
Purpose@#Platelet-related indices, including mean platelet volume (MPV) and plateletocrit (PCT), have been reported as new prognostic factors of overall survival (OS) in many cancers, but not yet in biliary tract cancer (BTC). We intended to assess these indices in predicting OS in BTC patients with the aim to build a new prognostic model for patients with BTC after surgical resection. @*Materials and Methods@#Survival analysis and time receiver operating characteristic analysis were applied to screen the platelet indices. Univariate and multivariate Cox analyses were used to identify independent prognostic factors and develop a new prognostic model. Harrell’s C-statistics, calibration curves, and decisive curve analysis were used to assess the model. @*Results@#MPV and platelet distribution width (PDW)/PCT showed the best prognostic accuracy among the platelet indices. In multivariable analysis, factors predictive of poor OS were presence of nodal involvement, Non-radical surgery, poor tumor differentiation, carbohydrate antigen 19-9 > 100 U/mL, MPV > 8.1 fl, and PDW/PCT > 190. The new model was found to be superior to the TNM staging system and our new staging system showed higher discriminative power. @*Conclusion@#MPV and PDW/PCT have high prognostic value in BTC patients, and the novel staging system based on these two indices showed good discrimination and accuracy compared with the American Joint Committee on Cancer 7th TNM staging system.
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Purpose@#Platelet-related indices, including mean platelet volume (MPV) and plateletocrit (PCT), have been reported as new prognostic factors of overall survival (OS) in many cancers, but not yet in biliary tract cancer (BTC). We intended to assess these indices in predicting OS in BTC patients with the aim to build a new prognostic model for patients with BTC after surgical resection. @*Materials and Methods@#Survival analysis and time receiver operating characteristic analysis were applied to screen the platelet indices. Univariate and multivariate Cox analyses were used to identify independent prognostic factors and develop a new prognostic model. Harrell’s C-statistics, calibration curves, and decisive curve analysis were used to assess the model. @*Results@#MPV and platelet distribution width (PDW)/PCT showed the best prognostic accuracy among the platelet indices. In multivariable analysis, factors predictive of poor OS were presence of nodal involvement, Non-radical surgery, poor tumor differentiation, carbohydrate antigen 19-9 > 100 U/mL, MPV > 8.1 fl, and PDW/PCT > 190. The new model was found to be superior to the TNM staging system and our new staging system showed higher discriminative power. @*Conclusion@#MPV and PDW/PCT have high prognostic value in BTC patients, and the novel staging system based on these two indices showed good discrimination and accuracy compared with the American Joint Committee on Cancer 7th TNM staging system.
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Objective To investigate short term effect of brachypodium total hip arthroplasty for young patients with osteonecrosis, and to provide a reference for clinical treatment. Methods From January 2008 to January 2012, 44 cases of femoral head necrosis patients (46 hips) were selected, with age from 28 to 52, and average age (39.94 ± 5.25) years old; according to prosthesis type they were divided into control group and observation group, control group( 22 cases of 24 hips, using metal-on-polyethylene Duraloc total hip prosthesis replacement treatment), and in the observation group (22 cases of 22 hips, with use of ceramic-on-ceramic Metha Brachypodium total hip prosthesis replacement therapy). Patients were followed up for 12 to 36 months, Harris score, range of motion and other indicators were compared in two groups of patients. Results In observation group and control group, the level of WOMAC score, total Harris score and function, motion range, pain, abnormalities score were significantly improved compared with those before operation:in observation group:(27.46 ± 4.19) scores vs.(66.38 ± 5.84) scores, (92.73 ± 7.68) scores vs.(42.67 ± 7.28) scores, (45.28 ± 5.34) scores vs. (22.19 ± 4.19) scores, (4.46 ± 0.63) scores vs. (3.25 ± 0.66) scores, (39.54 ± 1.54) scores vs. (15.39 ± 2.86) scores, (3.45 ± 0.65) scores vs. (1.84 ± 0.32) scores;in control group:(28.16 ± 4.07) scores vs. (65.67 ± 6.22) scores, (93.03 ± 7.54) scores vs.(43.74 ± 7.57) scores, (44.65 ± 5.26) scores vs. (22.45 ± 4.37) scores, (4.74 ± 0.71) scores vs. (3.17 ± 0.59) scores, (39.87 ± 1.26) scores vs. (16.19 ± 2.55) scores, (3.77 ± 0.73) scores vs. (1.93 ± 0.43) scores, and there were significantly differences (P0.05). All patients were follower up for 12-36(23.19 ± 3.66) months. One case in observation group had leg swelling and healed after symptomatic treatment, 1 case in the control group had limb swelling, and 1 case had extensive subcutaneous bleeding .And they were cured after symptomatic treatment 1 case had femoral dislocation, and no secondary dislocation happened after the implementation of manual reduction. Conclusions Brachypodium ceramic ceramic total hip replacement therapy has same effect for young osteonecrosis patients compared to polyethylene and metal prosthesis in improving hip function, but the ceramic-on-ceramic prosthesis brachypodium has better performance in wear resistance with smaller friction coefficient is smaller, and is suitable for young patients.
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Objective Polysaccharide from Sargassum thunbergii Kuntze(PST) was purified and degraded to study its anticoagulation activity.Diatomite was used for decolourization and NaCIO for degration of the polysaccharide to get three degraded products.Methods PST and the degraded products were applied in mice anticoagulation experiment by methods of cutting tail and capillary.Results All samples showed significant activities to extend bleeding time and blood coagulation time in mice,as well as to increase the amount of bleeding in mice.Conclusion Polysaccharide from Sargassum thunbergii Kuntze has significant anticoagulative activity and its anticoagulative activity is closely related with its molecular-weight.
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Object To evaluate the antioxidative activity of the high molecular weight polyphenols from Sargassum thunbeergii Kuntze and Sargassum kjellmanianum Yendo. Methods Three kinds of evaluation systems for antioxidative activity were adopted to test their efficiency to scavenge radicals (including hydroxyl free radical ?OH, superoxide redical O? 2 and DPPH? free radical). Results The high molecular weight polyphenols from the two kinds of brown algae had strong activity to scavenge the radicals above. Furthermore, they acted almost as the same level. Conclusion The high molecular weight polyphenols from the two kinds of brown algae had strong antioxidative activity, thus they are the potential, natural and marine antioxidants.
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Objective To report a method for preparation of saturated oligosaccharides from al- ginate. Methods The alginate was degraded by acid hydrolysis, followed by fractionation at pH 2.85 resulting in the homopolyguluronic acids (PG) and homopolymannuronic acids (PM). The alginate-derived homopolymers were further degraded by acid hydrolysis at pH 3.8, 120 ℃ for 3 h, and at pH 4, 120 ℃ for 4 h, respectively. The resulted acidic hydrolysates were separated by gel permeation chromatography to get oligosaccharide fractions, and the oligosaccharides were obtaind by repeated purification on gel chromatography. The structures of the oligosaccharides were characterized by analyses of infra-red spectroscopy (IR), nuclear magnetic resonance spectrometry (NMR), and mass spectrometry (MS). Results It was showed that the derived oligosaccharides were in saturated structures with the same structure characteristics as the original alginate macromolecule. Conclusion The method des cribed in this paper is a effective and convenient approach for the preparation of low-molecular-weight oligosaccharides from alginate.
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Objective To investigate the anticoagulant activities of phlorotannins STP-1 and STP-2 from Sargassum thunbeergii Kuntze.Methods Coagulation time(CT)and bleeding time(BT)of mice were determined by in-vivo experiment to test the effect of phlorotannins by capillary method and cutting tail method respectively.Furthermore,activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)were measured to evaluate the in-vitro anticoagulant activity of phlorotannins on New Zealand rabbits.Results Phlorotannins STP-1 had a significant effect on the prolongation of CT,BT,APTT,PT and TT,especially at the dosage of 1.0 mg/mL.Conclusion Phlorotannins STP-1 has both in-vivo and in-vitro anticoagulant activity.