Value of exhaled hydrogen sulfide in early diagnosis of esophagogastric junction adenocarcinoma.

Esophagogastric junction adenocarcinoma (EJA) has increased in recent years, and it exhibits a poor prognosis and a short survival period for patients. Hydrogen sulfide (H2S) plays an important role in the pathogenesis of cancer and has been studied as a diagnostic factor in some tumor diseases. However, few studies have explored the diagnostic value of H2S for EJA. In the present study, a total of 56 patients with early-stage EJA were enrolled while 57 healthy individuals were selected as the healthy control group. Clinical features were recorded, and exhaled H2S and blood samples were collected from both groups. Exhaled H2S and serum interleukin-8 (IL-8) expression levels were detected in both groups. The correlation between exhaled H2S and serum IL-8 levels was analyzed using Pearson's correlation method. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of exhaled H2S combined with IL-8 detection in EJA. The results showed that patients with EJA exhaled more H2S than healthy individuals. In addition, exhaled H2S was positively correlated with increased IL-8 expression. The ROC curve revealed that the exhaled H2S test had an acceptable diagnostic effect and could be used to diagnose EJA. The increase in H2S exhaled by patients with EJA indicated that H2S may be related to the occurrence and development of EJA; however, the in vivo mechanism needs to be further explored. Collectively, it was determined in the present study that exhaled H2S was significantly higher in patients with early-stage EJA than in healthy controls and combined diagnosis with patient serum IL-8 could improve diagnostic accuracy, which has potential diagnostic value for early diagnosis and screening of EJA.

Anterior segment features in neovascular glaucoma: An ultrasound biomicroscopy study.

PURPOSES: To investigate the features of the anterior segment structures in neovascular glaucoma (NVG) and analyze its differences from primary angle-closure glaucoma (PACG). METHODS: This study included patients who were first diagnosed with monocular NVG and PACG at the Affiliated Eye Hospital of Nanchang University during August 2019 to June 2022. Ultrasound biomicroscopy (UBM) was used to measure the anterior segment parameters of those eyes, including anterior chamber depth (ACD), anterior chamber width (ACW), anterior chamber area (ACA), iris area (IA), maximum iris thickness (ITMAX), middle iris thickness (ITMID), iris curvature (IC), lens vault (LV), angle opening distance (AOD500), trabecular iris angle (TIA500), trabecular-iris space area (TISA500) and peripheral anterior synechia (PAS) length. RESULTS: In this study, paired samples t-test showed that IA [1.170(0.324) mm2], ITMAX [0.368(0.079) mm], ITMID [0.280(0.062) mm] and IC [0.147(0.037) mm] of NVG were smaller than F-NVG [2.058(0.195) mm2, 0.611(0.045) mm, 0.415(0.049) mm and 0.272(0.077) mm], the AOD500, TIA500, and TISA500 of NVG were also smaller than F-NVG. Independent samples t-test showed that ACD [2.349(0.350) mm] and ACA [16.326(3.547) mm2] of NVG were larger than PACG [1.971(0.240) mm, 12.030(1.860) mm2], but the IA [1.170(0.324) mm2], ITMAX [0.368(0.079) mm], ITMID [0.280(0.062) mm], IC [0.147(0.037) mm] and LV [0.436(0.172 mm)] were smaller than PACG [1.740(0.294) mm2, 0.548(0.084) mm, 0.404(0.065) mm, 0.283(0.060) mm and 0.737(0.196) mm]. Among the 16 patients with 360° angle-closure NVG, the PAS length was 0.834 (0.326) mm, which exceeded the Schwalbe line. CONCLUSION: In NVG, the iris is atrophied, thinned, and straight, while the ACD is normal or slightly shallow. In 360° angle-closure NVG, the PAS length exceeds the Schwalbe line, presenting a pseudo angle phenomenon and a hockey stick sign. Notably, the anterior segment structure morphology of NVG exhibit differences from those of PACG.

Simultaneous Interface Engineering and Phase Tuning of CeO2-Decorated Catalysts for Boosted Oxygen Evolution Reaction.

Heterogeneous catalysts have attracted extensive attention among various emerging catalysts for their exceptional oxygen evolution reaction (OER) capabilities, outperforming their single-component counterparts. Nonetheless, the synthesis of heterogeneous materials with predictable, precise, and facile control remains a formidable challenge. Herein, a novel strategy involving the decoration of catalysts with CeO2 is introduced to concurrently engineer heterogeneous interfaces and adjust phase composition, thereby enhancing OER performance. Theoretical calculations suggest that the presence of ceria reduces the free energy barrier for the conversion of nitrides into metals. Supporting this, the experimental findings reveal that the incorporation of rare earth oxides enables the controlled phase transition from nitride into metal, with the proportion adjustable by varying the amount of added rare earth. Thanks to the role of CeO2 decoration in promoting the reaction kinetics and fostering the formation of the genuine active phase, the optimized Ni3FeN/Ni3Fe/CeO2-5% nanoparticles heterostructure catalyst exhibits outstanding OER activity, achieving an overpotential of just 249 mV at 10 mA cm-2. This approach offers fresh perspectives for the conception of highly efficient heterogeneous OER catalysts, contributing a strategic avenue for advanced catalytic design in the field of energy conversion.

[Automatic detection method of intracranial aneurysms on maximum intensity projection images based on SE-CaraNet].

Conventional maximum intensity projection (MIP) images tend to ignore some morphological features in the detection of intracranial aneurysms, resulting in missed detection and misdetection. To solve this problem, a new method for intracranial aneurysm detection based on omni-directional MIP image is proposed in this paper. Firstly, the three-dimensional magnetic resonance angiography (MRA) images were projected with the maximum density in all directions to obtain the MIP images. Then, the region of intracranial aneurysm was prepositioned by matching filter. Finally, the Squeeze and Excitation (SE) module was used to improve the CaraNet model. Excitation and the improved model were used to detect the predetermined location in the omni-directional MIP image to determine whether there was intracranial aneurysm. In this paper, 245 cases of images were collected to test the proposed method. The results showed that the accuracy and specificity of the proposed method could reach 93.75% and 93.86%, respectively, significantly improved the detection performance of intracranial aneurysms in MIP images.

Coordination-induced and tunable layered rare-earth hydroxide-complex intercalated nanohybrid phosphorescent photosensitizer and therapy.

Hydrotalcite intercalated nanohybrid has served as a vital phosphorescent photosensitizer owing to remarkable 1O2 quantum yield and high cell mortality performance. However, it is rather difficult for potential large or complex guest phosphors to directly intercalate into the hydrotalcite gallery. Hence, it is necessary to regulate the interlayer microenvironment of hydrotalcites firstly for outstanding photosensitive properties. Herein, two isomers, 5,5'BDA and 4,4'BDA, with distinctive dual coordinative features were selected to modify the layer microenvironment of the LGdH gallery and induce the introduction of prospective Gd(HPhN)3 phosphorescent complexes into hydrotalcite through two different coordination effects successively. A LGdH-BDA-Gd(HPhN)3 intercalated nanohybrid phosphorescent photosensitizer was successfully obtained. The results indicated that the more efficient improvement was observed from 5,5'BDA due to offering a more spacious and stable space. Specifically, LGdH-5,5'BDA-Gd(HPhN)3 showed significantly better room temperature phosphorescence properties than LGdH-4,4'BDA-Gd(HPhN)3, whose lifetime was nearly 15 times longer than the latter. Additionally, the LGdH-5,5'BDA-Gd(HPhN)3 system displayed superior singlet oxygen generation in vitro under 460 nm irradiation (the quantum yield Φ = 0.48) and outstanding photodynamic therapy performance in tumor cells. LGdH presented more remarkable enhancement performance on the RTP properties of the luminescent molecules. This work provides a novel platform for designing a high-performance hydrotalcite intercalated nanohybrid phosphorescent photosensitizer through coordination induction to regulate the layer microenvironment.

Exosomes as Powerful Biomarkers in Cancer: Recent Advances in Isolation and Detection Techniques.

Exosomes, small extracellular vesicles derived from cells, are known to carry important bioactive molecules such as proteins, nucleic acids, and lipids. These bioactive components play crucial roles in cell signaling, immune response, and tumor metastasis, making exosomes potential diagnostic biomarkers for various diseases. However, current methods for detecting tumor exosomes face scientific challenges including low sensitivity, poor specificity, complicated procedures, and high costs. It is essential to surmount these obstacles to enhance the precision and dependability of diagnostics that rely on exosomes. Merging DNA signal amplification techniques with the signal boosting capabilities of nanomaterials presents an encouraging strategy to overcome these constraints and improve exosome detection. This article highlights the use of DNA signal amplification technology and nanomaterials' signal enhancement effect to improve the detection of exosomes. This review seeks to offer valuable perspectives for the enhancement of amplification methods applied in practical cancer diagnosis and prognosis by providing an overview of how these novel technologies are utilized in exosome-based diagnostic procedures.

Quantifying uncertainty: Air quality forecasting based on dynamic spatial-temporal denoising diffusion probabilistic model.

Air pollution constitutes a substantial peril to human health, thereby catalyzing the evolution of an array of air quality prediction models. These models span from mechanistic and statistical strategies to machine learning methodologies. The burgeoning field of deep learning has given rise to a plethora of advanced models, which have demonstrated commendable performance. However, previous investigations have overlooked the salience of quantifying prediction uncertainties and potential future interconnections among air monitoring stations. Moreover, prior research typically utilized static predetermined spatial relationships, neglecting dynamic dependencies. To address these limitations, we propose a model named Dynamic Spatial-Temporal Denoising Diffusion Probabilistic Model (DST-DDPM) for air quality prediction. Our model is underpinned by the renowned denoising diffusion model, aiding us in discerning indeterminacy. In order to encapsulate dynamic patterns, we design a dynamic context encoder to generate dynamic adjacency matrices, whilst maintaining static spatial information. Furthermore, we incorporate a spatial-temporal denoising model to concurrently learn both spatial and temporal dependencies. Authenticating our model's performance using a real-world dataset collected in Beijing, the outcomes indicate that our model eclipses other baseline models in terms of both short-term and long-term predictions by 1.36% and 11.62% respectively. Finally, we conduct a case study to exhibit our model's capacity to quantify uncertainties.

A microbial ecosystem enhanced by regulating soil carbon and nitrogen balance using biochar and nitrogen fertiliser five years after application.

The indiscriminate use of nitrogen fertiliser (NF) is a obstruction to improve soil quality and crop yields. However, the effect of biochar and NF on soil microbial ecosystem (SME) and crop yields is unknown. A five-year field experiment in China aimed to evaluate the effects of biochar and nitrogen fertiliser (NF) combination on soil structure, C-to-N ratio (CNR), microbial biomass, and spring maize yield. Biochar and NF were applied at different rates, and the combined application resulted in a soil solid-liquid-gas ratio closer to the ideal value. The use of biochar alone and in combination with NF significantly increased soil's C, N, and CNR. A moderate application of biochar and NF resulted in favourable biological and chemical properties of the soil. The application of biochar and NF at moderate levels led to an increase in SME, with the B8N150 producing the highest yield. The highest yield of B8N150 represents a 24.25% increase compared to the unfertilized control and a 9.04% increase compared to B0N150. Moderate use of biochar and NF could be beneficial in areas with similar climatic conditions.

Collagen 1-mediated CXCL1 secretion in tumor cells activates fibroblasts to promote radioresistance of esophageal cancer.

Esophageal squamous-cell carcinoma (ESCC) is commonly treated with radiotherapy; however, radioresistance hinders its clinical effectiveness, and the underlying mechanism remains elusive. Here, we develop patient-derived xenografts (PDXs) from 19 patients with ESCC to investigate the mechanisms driving radioresistance. Using RNA sequencing, cytokine arrays, and single-cell RNA sequencing, we reveal an enrichment of cancer-associated fibroblast (CAF)-derived collagen type 1 (Col1) and tumor-cell-derived CXCL1 in non-responsive PDXs. Col1 not only promotes radioresistance by augmenting DNA repair capacity but also induces CXCL1 secretion in tumor cells. Additionally, CXCL1 further activates CAFs via the CXCR2-STAT3 pathway, establishing a positive feedback loop. Directly interfering with tumor-cell-derived CXCL1 or inhibiting the CXCL1-CXCR2 pathway effectively restores the radiosensitivity of radioresistant xenografts in vivo. Collectively, our study provides a comprehensive understanding of the molecular mechanisms underlying radioresistance and identifies potential targets to improve the efficacy of radiotherapy for ESCC.

Investigation and Improvement of Pushing Dislocation in Ceramsite Sand Three-Dimensional Printing.

Three-dimensional printing (3DP) is considered to be one of the important technologies for a new manufacturing mode. When ceramsite sand is used as a 3DP material to produce a mold (core), the printed layer is prone to deviation from the original location. In this study, the continuous stacking of the printed part deviation was termed as pushing dislocation, and a physical model was designed to investigate the pushing dislocation mechanism. When the gravity of the printing layer and the pressure of the sand scraper decreased, or when the supporting force increased, the angle of the sand scraper and the maximum friction of the prelaying layer on the printed part will reduce the pushing dislocation. To optimize the quality of the ceramsite sand mold, experiments on the pushing dislocation were conducted by altering the recoater speed, layer thickness, and bottom support condition (with or without bottom supporting plate). The sample dimensions were obtained by a 3D imaging scanner, and the gas evolution and ignition loss were measured. The results revealed that the dimensional difference of samples continuously decreased and the pushing dislocation was gradually reduced as the recoater speed and layer thickness increased. The pushing dislocation of the X-direction sample was more severe compared with that of the Y-direction sample. Increasing the layer thickness is an effective way of reducing the pushing dislocation. The bottom supporting plate can reduce the pushing dislocation, but the effect was insignificant.

A General Preparation of Solid Solution-Oxide Heterojunction Photocatalysts through Metal-Organic Framework Transformation Induced Pre-nucleation.

Solid solution-oxide heterostructures combine the advantages of solid solution and heterojunction materials to improve electronic structure and optical properties by metal doping, and enhance charge separation and transfer in semiconductor photocatalysts by creating a built-in electric field. Nevertheless, the effective design and synthesis of these materials remains a significant challenge. Here, we develop a generally applicable strategy that leverages the transformable properties of metal-organic frameworks (MOFs) to prepare solid solution-oxide heterojunctions with controllable structural and chemical compositions. The process consists of three main steps. First, MOFs with different topological structures and metal centers are transformed, accompanied by pre-nucleation of a metal oxide. Second, solid solution is prepared through calcination of the transformed MOFs. Finally, a heterojunction is formed by combining solid solution with another metal oxide group through endogenous overflow. DFT calculations and study on carrier dynamics show that the structure of the material effectively prevents electrons from returning to the bulk phase, exhibiting superior photocatalytic reduction performance of CO2 . This study is expected to promote the controllable synthesis and research of MOF-derived heterojunctions.

Pulmonary Arterial Hypertension Induced by Immune Checkpoint Inhibitor Combined Therapy in a Patient with Intrahepatic Cholangiocarcinoma: A Case Report.

Case: Immune Checkpoint Inhibitors (ICIs) have dramatically revolutionized the therapeutic approaches by which we treat a series of cancers accompanied by immune-related adverse events (irAEs). Herein, we reported an intrahepatic cholangiocarcinoma male patient with a history of ankylosing spondylitis developing pulmonary arterial hypertension (PAH) under ICI combined therapy with pembrolizumab and lenvatinib. The indirect measurement of cardiac ultrasound showed a pulmonary artery pressure (PAP) of 72mmHg after 21 three-week cycles of ICI combined therapy. The patient partially responded to the treatment of glucocorticoid and mycophenolate mofetil. The PAP decreased to 55mmHg 3 months after the ICI combined therapy was discontinued, but increased to 90mmHg after the ICI combined therapy was rechallenged. We treated him with adalimumab -an antitumor necrosis factor-alpha (ani-TNF-α) antibody- combined with glucocorticoid and immunosuppressants under lenvatinib monotherapy. The patient responded again with PAP decreasing to 67mmHg after 2 two-week cycles of adalimumab. Accordingly, we diagnosed him to have irAE-related PAH. Our findings supported the use of glucocorticoid disease-modifying antirheumatic drugs (DMARDs) as a treatment option in refractory PAH.

Fabrication of Ce-doped Hollow NiCo2 O4 Nanoprisms with Heterointerface from MOF-Engaged Strategy for Oxygen Evolution Reaction.

The reasonable design and controlled synthesis of efficient and hollow nanocatalysts with plentiful heterointerface and fully exposed active sites to accelerate the electron transfer and mass transfer process for oxygen evolution reaction (OER) is highly desirable for water splitting by electrolysis. Herein, a metal-organic framework (MOF)-engaged strategy is developed to prepare Ce-doped hollow mesoporous NiCo2 O4 nanoprisms (NiCo2 O4 /CeO2 HNPs) for enhanced OER. Due to the advanced synthesis strategy generating a large number of interfaces between NiCo2 O4 and CeO2 , as well as modulated electrons of the active center by the synergistic action of multi-metals, the obtained catalyst exhibits excellent OER performance with a small overpotential of 290 mV at current density (J) of 10 mA cm-2 . Spinel/Perovskite hollow nanoprisms synthesized by a similar way demonstrates the versatility of our strategy. This work may provide new insights into the development of rare earth-doped hollow polymetallic spinel oxide catalysts.

Investigation of the correlation between brain functional connectivity and ESRD based on low-order and high-order feature analysis of rs-fMRI.

BACKGROUND: The lack of analysis of brain networks in individuals with end-stage renal disease (ESRD) is an obstacle to detecting and preventing neurological complications of ESRD. PURPOSE: This study aims to explore the correlation between brain activity and ESRD based on a quantitative analysis of the dynamic functional connectivity (dFC) of brain networks. It provides insights into differences in brain functional connectivity between healthy individuals and ESRD patients and aims to identify the brain activities and regions most relevant to ESRD. METHODS: Differences in brain functional connectivity between healthy individuals and ESRD patients were analyzed and quantitatively evaluated in this study. Blood oxygen level-dependent (BOLD) signals obtained through resting-state functional magnetic resonance imaging (rs-fMRI) were used as information carriers. First, a connectivity matrix of dFC was constructed for each subject using Pearson correlation. Then a high-order connectivity matrix was built by applying the "correlation's correlation" method. Second, sparsification of the high-order connectivity matrix was performed using the graphical least absolute shrinkage and selection operator (gLASSO) model. The discriminative features of the sparse connectivity matrix were extracted and sifted using central moments and t-tests, respectively. Finally, feature classification was conducted using a support vector machine (SVM). RESULTS: The experiment showed that functional connectivity was reduced to some degree in certain brain regions of ESRD patients. The sensorimotor, visual, and cerebellum subnetworks had the highest numbers of abnormal functional connectivities. It is inferred that these three subnetworks most likely have a direct relationship to ESRD. CONCLUSIONS: The low-order and high-order dFC features can identify the positions where brain damage occurs in ESRD patients. In contrast to healthy individuals, the damaged brain regions and the disruption of functional connectivity in ESRD patients were not limited to specific regions. This indicates that ESRD has a severe impact on brain function. Abnormal functional connectivity was mainly associated with the three functional brain regions responsible for visual processing, emotional, and motor control. The findings presented here have the potential for use in the detection, prevention, and prognostic evaluation of ESRD.

Role of skip N2 lymph node metastasis for patients with the stage III-N2 lung adenocarcinoma: a propensity score matching analysis.

PURPOSE: Recent studies have indicated some differences in the prognosis of patients with stage III-N2 lung adenocarcinoma, and the prognosis of patients with skip N2 lymph node metastasis (SKN2) is good. This study grouped patients with stage III-N2 lung adenocarcinoma by propensity score matching (PSM) to evaluate the impact of SKN2 on the prognosis of these patients. METHODS: The clinical data for patients who underwent radical lobectomy and had a postoperative pathological diagnosis of stage III-N2 lung adenocarcinoma at our centre from 2016 to 2018 were collected, and PSM was performed at a ratio of 1:1. RESULTS: A total of 456 patients were enrolled in this study. After PSM, 112 patients were included in the SKN2 group, and 112 patients were included in the non-SKN2 group. When comparing the SKN2 group with the non-SKN2 group, the 3-year OS rate was (71.4% vs. 12.5%, p < 0.001), and the 3-year DFS rate was (35.7% vs. 5.4%, p < 0.001). It is further divided into four groups:single-station SKN2 (N2a1),Multi-station SKN2 (N2a2),single-station non-SKN2 (N2b1) and Multi-station non-SKN2 (N2b2).The 3-year OS and DFS rates of skip lymph node metastasis were better than those of non-skip lymph node metastasis(OS:N2a1 vs. N2b1 68.4% vs. 23.5%,p < 0.001;N2a2 vs. N2b2 73.0% vs. 7.7%,p < 0.001)(DFS:N2a1 vs. N2b1 68.4% vs. 5.9%,p < 0.001;N2a2 vs. N2b2 62.2% vs. 5.1%,p < 0.001), regardless of the number of N2 station(OS:N2a1 vs. N2a2 68.4% vs. 73.0%,p = 0.584;N2b1 vs. N2b2 23.5% vs. 7.7%,p = 0.051). On multivariate analysis, sex (p = 0.008) ,Vascular tumour thrombus(p = 0.047),size(p = 0.002)and SKN2 (p < 0.001) were independent predictors of OS. CONCLUSION: For patients with stage III-N2 lung adenocarcinoma, the prognosis of SKN2 patients is better than non-SKN2 patients', and SKN2 may be used as an important factor in the N2 subgroup classification in future TNM staging.

Postoperative survival of pulmonary invasive mucinous adenocarcinoma versus non-mucinous invasive adenocarcinoma.

PURPOSE: In 2015, the World Health Organization renamed mucinous bronchioloalveolar adenocarcinoma as pulmonary invasive mucinous adenocarcinoma (IMA). Due to its low incidence and unclear prognosis with surgical treatment, previous studies have presented opposing survival outcomes. We aimed to investigate the differences in surgical prognosis and prognosis-related risk factors by comparing IMA with non-mucinous invasive adenocarcinoma (NMA). METHODS: A total of 20,914 patients diagnosed with IMA or NMA from 2000 to 2014 were screened from the Surveillance, Epidemiology, and End Results database. The screened patients were subjected to propensity score matching (PSM) in a 1:4 ratio to explore the survival differences between patients with IMA and NMA and the factors influencing prognosis. RESULTS: For all patients, IMA was prevalent in the lower lobes of the lungs (p < 0.0001), well-differentiated histologically (p < 0.0001), less likely to have lymph node metastases (94.4% vs. 72.0%, p < 0.0001) and at an earlier pathological stage (p = 0.0001). After PSM, the IMA cohort consisted of 303 patients, and the NMA cohort consisted of 1212 patients. Kaplan‒Meier survival analysis showed no difference in overall survival (OS) between patients in the IMA cohort and those in the NMA cohort (p = 0.7). Cox proportional hazards analysis showed that differences in tumor pathological type did not influence OS between the two cohorts (p = 0.65). Age (HR: 1.98, 95% CI 1.7-2.31, p < 0.0001), gender (HR: 0.64, 95% CI 0.55-0.75, p < 0.0001), and radiation treatment (HR: 2.49, 95% CI 1.84-3.37, p < 0.0001) were independent predictors of patient OS. CONCLUSION: There was no significant difference in OS between patients with IMA and those with NMA after surgical treatment. Age, sex, and radiation treatment can independently predict OS.

Phase Change Thermal Energy Storage Enabled by an In Situ Formed Porous TiO2.

Uneven and insufficient encapsulation caused by surface tension between supporting and phase change materials (PCMs) can be theoretically avoided if the encapsulation process co-occurs with the formation of supporting materials in the same environment. Herein, for the first time, a one-pot one-step (OPOS) protocol is developed for synthesizing TiO2 -supported PCM composite, in which porous TiO2 is formed in situ in the solvent of melted PCMs and directly produces the desired thermal energy storage materials with the completion of the reaction. The preparation features straightforward operation and high environmental metrics with no emission, requires only stirring and heating without the addition of organic solvent or catalyst. Moreover, the preparation process can be easily scaled-up at the laboratory. Because of the OPOS protocol and porous TiO2 inside, the as-obtained PCM composite possesses a 66.5% encapsulation ratio and 166.8% thermal conductivity enhancement compared to pristine unsupported PCMs, with 94.7% light-to-thermal conversion efficiency and promising bacterial inhibition activity without any leakage.

Case report: Different mechanisms of drug resistance in a synchronous multiple primary lung cancer patient after EGFR-TKI treatment.

Non-small-cell lung cancer (NSCLC) is the most common cancer in the world. In recent years, the incidence of synchronous multiple primary lung cancer (SMPLC) has gradually increased. Surgery is the preferred method to treat these patients. The management of SMPLC patients who cannot tolerate surgical treatment is controversial. We report a rare case in which a 70-year-old Chinese woman with no history of smoking had three primary lung adenocarcinoma lesions. Two lesions had epidermal growth factor receptor (EGFR) exon 19 deletion mutations, and one lesion had the L858R mutation. After first-generation EGFR-tyrosine kinase inhibitor (TKI) treatment, the three lesions all showed a good response until disease progression. After the corresponding drug treatments were given based on the different drug resistance mechanisms, good responsiveness was shown in each lessions. This case suggests that in the treatment of SMPLC, it is necessary to learn the molecular-biological information of each lesion due to the differences thereof, and a targeted treatment regimen should be developed on this basis.

Comparison of neoadjuvant immunotherapy plus chemotherapy versus chemotherapy alone for patients with locally advanced esophageal squamous cell carcinoma: A propensity score matching.

Objectives: Clinical studies on immune checkpoint inhibitors (ICIs) combined with neoadjuvant chemotherapy (nCT) have been carried out for the resectable esophageal squamous cell carcinoma (ESCC). So far, few studies have compared the survival outcomes of nCT plus ICIs and nCT alone. This study aimed to compare the efficacy and safety of neoadjuvant ICIs combined with nCT versus nCT followed by esophagectomy for patients with resectable locally advanced ESCC. Methods: A retrospective analysis of ESCC patients underwent nCT or nCT combined with ICIs followed by esophagectomy (from March 2013 to April 2021) was performed. A 1:1 propensity score matching (PSM) with a caliper 0.01 was conducted to balance potential bias. Results: A total of 47 comparable pairs of ESCC patients receiving nCT and nCT combined with ICIs were selected for the final analysis. The tumor regression grade (TRG) 0 and pathologic complete response (pCR) rates in the nCT+ICIs group were significantly higher than those of the nCT group (21.7% vs. 4.5%, P=0.016; and 17.0% vs. 2.1%, P=0.035, respectively). The rate of nerve invasion was 4.3% in the nCT+ICIs group, significantly lower than 23.4% of the nCT group (P=0.007). The incidences of adverse events in the nCT+ICIs group were similar compared with the nCT group and there was no grade 5 toxicity in either group. The 1-, 2-year disease-free survival rates (DFS) were 95.7%, 80.7% and 76.1%, 63.8% in the two groups (P=0.001, and P=0.046, respectively). The 1-year OS was improved in the nCT+ICIs group, which was close to a statistical difference (95.7% vs. 84.8%, P=0.074). Local recurrence rate in the nCT+ICIs group was 6.4%, significantly lower than 21.3% of the nCT group (P=0.036), while there was no significant difference in the distant metastasis. Conclusions: Compared with nCT alone, neoadjuvant immunotherapy plus nCT for patients with locally advanced ESCC has an advantage in pathological response, and could improve DFS with a good safety and feasibility, while long term survival validation is still needed further.