Immune checkpoint inhibitor-associated gastritis: Patterns and management.

Immune checkpoint inhibitors (ICIs) are widely used due to their effectiveness in treating various tumors. Immune-related adverse events (irAEs) are defined as adverse effects resulting from ICI treatment. Gastrointestinal irAEs are a common type of irAEs characterized by intestinal side effects, such as diarrhea and colitis, which may lead to the cessation of ICIs. Although irAE gastritis is rarely reported, it may lead to serious complications such as gastrorrhagia. Furthermore, irAE gastritis is often difficult to identify early due to its diverse symptoms. Although steroid hormones and immunosuppressants are commonly used to reverse irAEs, the best regimen and dosage for irAE gastritis remains uncertain. In addition, the risk of recurrence of irAE gastritis after the reuse of ICIs should be considered. In this editorial, strategies such as early identification, pathological diagnosis, management interventions, and immunotherapy rechallenge are discussed to enable clinicians to better manage irAE gastritis and improve the prognosis of these patients.

Clinical features and prognosis of cardiac metastatic tumors.

BACKGROUND: This study aimed to explore the clinical features and prognosis of cardiac metastatic tumors. In addition, whether continuing antitumor therapy after the development of cardiac metastases can benefit patients and the response of cardiac metastases were investigated. METHODS: A retrospective analysis was conducted on patients with malignancies who were admitted to Fujian Cancer Hospital and Fujian Provincial Hospital from January 2007 to September 2022, and the follow-up period ended in March 2023. Clinical data were gathered, treatment efficacy was evaluated, and survival analysis was performed. RESULTS: After the patients developed cardiac metastasis, the overall 30-day, 3-month, 6-month, and 12-month survival rates were 85.00%, 59.00%, 51.00% and 38.00%, respectively. With continued treatment, the average survival time was 27.33 months (95% confidence interval [CI]: 16.88-37.79), which exceeded the 6.6 months (95% confidence interval [CI]: 0.03-13.69) observed for patients who withdrew from treatment (P < 0.001). The responses of cardiac metastases corresponded to the responses of the primary tumors. Patients with a cardiac response had a median survival time of 55.60 months, which exceeded the 13.40 months observed for those without a cardiac response. However, there was no significant difference (P = 0.375). CONCLUSIONS: In conclusion, continuing antitumor therapy after the development of cardiac metastases can significantly prolong patient survival. Cardiac metastases and primary tumors respond consistently to antitumor treatment. The risk of death due to heart failure in cancer patients with cardiac metastases needs to be further investigated.

Effect of eplerenone on cognitive impairment in spontaneously hypertensive rats.

OBJECTIVE: The present study aimed to determine the effect of blocking brain mineralocorticoid receptor on cognitive impairment in spontaneously hypertensive rats and its intracellular changes. METHODS: 12-week-old male spontaneous hypertensive rats (SHR) and Wistar Kyoto (WKY) rats were given eplerenone (EPL, 30 mg/Kg/d or 100 mg/Kg/d) or pure water via oral gavage daily for 8 weeks. Effects of blocking brain mineralocorticoid receptor (MR) on cognitive function were examined through cognitive behavioral experiments. The morphology of hippocampal neurons was observed. Synaptic proteins and autophagy levels were detected by western blot. RESULTS: The results showed decreases in both short-term working memory and long-term spatial learning and memory ability, hippocampal neuron damage, and reduced expression of synaptic proteins in the SHR-Veh group. Impaired autophagy was found in the SHR-Veh group as evidenced by decreased expression levels of Beclin-1 protein and a defect in P62 degradation. These abnormalities were reversed by eplerenone, either the high dosage or low dosage. Reduced cognitive dysfunction and enhanced autophagy in hippocampal neurons in both SHR-EPL30 group and SHR-EPL100 group were independent of lowering blood pressure. CONCLUSION: Eplerenone improves cognitive deficits observed in SHRs, and increases autophagy in hippocampal neurons of SHRs, which suggests a new site of MR antagonists in treatment of hypertension-related cognitive impairment.

Monkey plays Pac-Man with compositional strategies and hierarchical decision-making.

Humans can often handle daunting tasks with ease by developing a set of strategies to reduce decision-making into simpler problems. The ability to use heuristic strategies demands an advanced level of intelligence and has not been demonstrated in animals. Here, we trained macaque monkeys to play the classic video game Pac-Man. The monkeys' decision-making may be described with a strategy-based hierarchical decision-making model with over 90% accuracy. The model reveals that the monkeys adopted the take-the-best heuristic by using one dominating strategy for their decision-making at a time and formed compound strategies by assembling the basis strategies to handle particular game situations. With the model, the computationally complex but fully quantifiable Pac-Man behavior paradigm provides a new approach to understanding animals' advanced cognition.

Evidence accumulation for value computation in the prefrontal cortex during decision making.

A key step of decision making is to determine the value associated with each option. The evaluation process often depends on the accumulation of evidence from multiple sources, which may arrive at different times. How evidence is accumulated for value computation in the brain during decision making has not been well studied. To address this problem, we trained rhesus monkeys to perform a decision-making task in which they had to make eye movement choices between two targets, whose reward probabilities had to be determined with the combined evidence from four sequentially presented visual stimuli. We studied the encoding of the reward probabilities associated with the stimuli and the eye movements in the orbitofrontal (OFC) and the dorsolateral prefrontal (DLPFC) cortices during the decision process. We found that the OFC neurons encoded the reward probability associated with individual pieces of evidence in the stimulus domain. Importantly, the representation of the reward probability in the OFC was transient, and the OFC did not encode the reward probability associated with the combined evidence from multiple stimuli. The computation of the combined reward probabilities was observed only in the DLPFC and only in the action domain. Furthermore, the reward probability encoding in the DLPFC exhibited an asymmetric pattern of mixed selectivity that supported the computation of the stimulus-to-action transition of reward information. Our results reveal that the OFC and the DLPFC play distinct roles in the value computation during evidence accumulation.

A neural network model for the orbitofrontal cortex and task space acquisition during reinforcement learning.

Reinforcement learning has been widely used in explaining animal behavior. In reinforcement learning, the agent learns the value of the states in the task, collectively constituting the task state space, and uses the knowledge to choose actions and acquire desired outcomes. It has been proposed that the orbitofrontal cortex (OFC) encodes the task state space during reinforcement learning. However, it is not well understood how the OFC acquires and stores task state information. Here, we propose a neural network model based on reservoir computing. Reservoir networks exhibit heterogeneous and dynamic activity patterns that are suitable to encode task states. The information can be extracted by a linear readout trained with reinforcement learning. We demonstrate how the network acquires and stores task structures. The network exhibits reinforcement learning behavior and its aspects resemble experimental findings of the OFC. Our study provides a theoretical explanation of how the OFC may contribute to reinforcement learning and a new approach to understanding the neural mechanism underlying reinforcement learning.

Aneuploid progenies of triploid hybrids between diploid and tetraploid loach Misgurnus anguillicaudatus in China.

Triploid Chinese loach, Misgurnus anguillicaudatus, hybrids between tetraploids from Hubei Province and diploids from Liaoning Province were mated with either diploid wild-type or triploid hybrids to analyze viability and ploidy of the resultant progenies. Both triploid males and females generated fertile gametes, but progenies from the crosses using gametes of triploid hybrids did not survive beyond the larval stages. In crosses between wild-type diploid females and triploid hybrid males, embryos ranging from 2.2n to 2.6n were predominant with a mode of either 2.4n (chromosome numbers 59, 60, 61) or 2.5n (chromosome numbers 62, 63). Those from the crosses between triploid hybrid females and diploid males gave a modal ploidy level at approximately 2.5n in one case, but a shift to a higher ploidy level was observed in other embryos. In the progenies between triploid hybrid females and males, the ploidy level at approximately 3.0n (chromosome numbers 74, 75, 76) was most frequent. The cytogenetic results of the progenies suggest the production of aneuploid gametes with a modal ploidy level at approximately 1.5n in triploid hybrids. However, a shift to higher chromosome numbers in gametes was observed in certain cases, suggesting the involvement of mortality selection of gametes and/or zygotes with lower chromosome numbers.