Neoadjuvant Immunotherapy in Oncogene-Positive Non-Small Cell Lung Cancer: A Multicenter Study.

BACKGROUND: Preoperative immunotherapy has shed light on the management of resectable non-small cell lung cancer (NSCLC). However, whether neoadjuvant immunotherapy benefits patients with oncogene-positive NSCLC remains unknown. METHODS: Data were retrieved from 4 institutions in the period from August 2018 to May 2021. Eligible patients were aged ≥18 years with histologically confirmed stage IIA to stage IIIB (T1-2 N1-2 or T3-4 N0-2) NSCLC that was deemed to be surgically resectable. The neoadjuvant regimen included immune checkpoint inhibitors alone or in combination with platinum-based doublets. Surgical resection was performed 4 to 6 weeks after the first day of the last cycle of treatment. The primary end point was major pathologic response (MPR; ≤10% viable tumor cells). Analyses were categorized according to the patients' oncogene (EGFR, ALK, KRAS, MET, BRAF, ROS1, RET) status. RESULTS: Overall, 137 patients were identified; 46 (33%) patients had nonsquamous cell cancer, and 114 (83%) had stage IIIA/B disease. Oncogene alterations were identified in 22 (16%) patients, of whom only 2 patients (2/22 [9%]) had an MPR compared with 65 (65/115 [56.5%]) in the oncogene-negative population (P < .001). Similar results were retained after propensity score matching for age, sex, smoking status, histologic type, stage, and cycles of neoadjuvant treatment. Squamous cell carcinoma (odds ratio, 2.54; 95% CI, 1.08-5.99) and positive oncogene status (odds ratio, 0.13; 95% CI, 0.03-0.64) were found to be indicators for MPR by logistic regression. The 1-year event-free survival rate was 75.4% in the oncogene-positive group, which was not significantly different from 85.5% in the oncogene-negative population (P = .23). CONCLUSIONS: Patients with stage II-III oncogene-positive NSCLCs respond less than patients with oncogene-negative NSCLCs after neoadjuvant immunotherapy.

The association of glutamate level in pregenual anterior cingulate, anhedonia, and emotion-behavior decoupling in patients with major depressive disorder.

Impairments of translating emotional salience into effortful behavior are core features of anhedonia in cohorts with major depressive disorder. Glutamate metabolism is considered to be involved in this process, but the empirical study is relatively few. Therefore, the present study aimed to examine the correlations between glutamate level in pregenual anterior cingulate, anhedonia, and emotion-behavior decoupling in patients with major depressive disorder. Fifteen individuals diagnosed with major depressive disorder and ten healthy individuals were recruited. All participants were asked to complete self-report instruments for anhedonia and the computerized anticipatory and consummatory pleasure task, and the in vivo glutamate levels were measured by proton magnetic resonance spectroscopy. Thus, a potential lower glutamate levels in pregenual anterior cingulate in individuals with major depressive disorder were founded to be positively correlated with the ability of pleasure experiencing. The mechanism of glutamate in pregenual anterior cingulate in anhedonia in patients with major depressive disorder may be reflected in the early pleasurable experience stage, rather than in the transformation of emotional experience to motivation or reward-seeking behavior, which may be different from that in schizophrenia.

Impairment of response inhibition to emotional face stimuli in individuals with subclinical depression.

Response inhibition, a crucial component of executive function, is closely related to personal impulse control, social adaption, and mental health. Previous studies have found response inhibition deficit in patients with major depressive disorder, but whether it also exists in individuals with subclinical depression (SD) remains unclear. This study aimed to identify the ability of response inhibition to emotional face stimuli both under explicit and implicit conditions in individuals with SD. Thirty-six subclinical depressed college students and 39 healthy individuals were recruited and administered the non-emotional, explicit, and implicit emotional stop-signal tasks (SSTs). Mixed-model analyses of variance were used to analyze the differences between and within groups. In implicit emotional SST, the results showed a significant longer stop-signal response time, a shorter stop-signal delay time, a shorter go reaction time, and a similar proportion of stop success in the SD group compared to healthy controls. However, the above indices showed no significant difference between the two groups in the non-emotional SST and explicit emotional SST. These findings suggest a possible defect of response inhibition in implicit emotional processing in individuals with SD, which may potentially serve as a marker of susceptibility to depression and thus be applied to early screening and intervention for major depressive disorder.

Association between depressive symptoms and suicidal risk: Based on self-reported and clinical-interview measurements from a network perspective.

Suicide is commonly found in patients with major depressive disorder (MDD), while the associations among depressive symptoms and their relationships with suicidal risk remain unclear. This study identified the symptoms associated with suicidal risk and the most central symptoms in the MDD networks based on both self-reported and clinical-interview scales. A total of 446 outpatients with MDD were recruited. The Mini International Neuropsychiatric Interview (MINI) was used to assess the suicidal risk. The 13-item Beck Depression Inventory (BDI-13) and 17-item Hamilton Depression Rating Scale (HAMD-17) were used to measure the depressive symptoms. Network analysis was used to estimate the network models. Ten symptoms in the BDI-13 network were related to suicidal risk, among which sadness had the strongest association. Among the six symptoms in the HAMD-17 network that were associated with suicidal risk, guilty feeling was the strongest. Sense of failure was the most central symptom in the BDI-13 network, while depressed mood had the highest centrality in the HAMD-17 network. The depressive symptoms related to suicide risk and the clinical features of MDD showed different characteristics based on different assessment types. Combining self-reported and clinician-rated assessments in future studies and clinical practice might lead to some new findings.

Analysis of the variation pattern in left upper division veins and establishment of simplified vein models for anatomical segmentectomy.

BACKGROUND: Three-dimensional computed tomography bronchography and angiography (3D-CTBA) is a powerful tool to analyze pulmonary anatomy. We used 3D-CTBA to analyze variations of the pulmonary veins of the left upper division (LUD) and created a simplified LUD vein model. METHODS: Between January 2019 and October 2019, 124 patients with left-sided pulmonary lesions were admitted and underwent 3D-CTBA prior to surgery. We reviewed the anatomical variations of the LUD veins in these patients using 3D-CTBA images and classified them according to their position in relation to the bronchus. To facilitate this process, the same nomenclature as that used to describe the veins of the right upper lobe (RUL) is used for the LUD. RESULTS: The pattern of LUD veins could be classified into three forms: an anterior + central form, an anterior form and a central form. For the central form, V 1+2 a, V 1+2 b, V 1+2 c and V 1+2 d drained into V. cent. For the anterior form, V 1+2 d drained into V. ant. The anterior + central form could be further classified into three subtypes (V abc, V ab and V a). CONCLUSIONS: This is the first report to categorize the pattern of veins in the LUD. This may facilitate the creation of simplified models for use in pre-operative planning for segmentectomy.

Effects of dietary yeast culture on shrimp growth, immune response, intestinal health and disease resistance against Vibrio harveyi.

The current study was conducted to evaluate the effects of different levels of yeast culture (YC) supplementation at 0% (YC 0%), 1% (YC 1%), and 2% (YC 2%) on growth, feed conversion ratio, body composition, intestinal morphology, microflora, immune response, and resistance to Vibrio harveyi infection in Litopenaeus vannamei. After 8-weeks feeding trial, the results showed significant improvement (p < .05) in the final weight, weight gain rate, specific growth rate, survival rate and low feed conversion ratio in YC groups than the control. Serum total protein, superoxide dismutase, catalase, alkaline phosphatase, acid phosphatase, lysozyme, and phenol oxidase in shrimps fed diet YC (2%) were significantly higher (p < .05), whereas significantly decreased trend in serum cholesterol, triglyceride, aspartate aminotransferase, and alanine aminotransferase (p < .05) were observed in YC (2%) diet. Proteobacteria, Bacteroidetes, Actinobacteria, and Firmicutes were the core phylum bacteria found in the shrimp intestines. At the genus level, opportunistic pathogenic bacteria, Vibrio was significantly decreased (p < .05) while beneficial bacteria Pseudoalteromonas was increased in YC (2%) group. Intestinal villus height and width in shrimps fed YC diets were significantly improved than the control diet (p < .05). YC groups challenged test significantly showed (p < .05) improved shrimps immune response against V. harveyi infections with YC (2%) recording the highest percentage survival rate (70%). The present study demonstrated that supplementing YC (2%) can improve growth, intestinal microbiota, intestinal morphology, and immune response against V. harveyi infections in L. vannamei.

Incidence, prognostic factors, and a nomogram of lung cancer with bone metastasis at initial diagnosis: a population-based study.

BACKGROUND: Bone is one of the common metastatic sites of lung cancer, and its prognosis is not optimistic. We performed a study to evaluate the incidence, survival, and prognostic factors of lung cancer with bone metastasis (LCBM) at initial diagnosis, and to develop a nomogram to predict its outcomes. METHODS: We conducted a retrospective study choosing 13,541 patients with LCBM from the Surveillance, Epidemiology, and End Results (SEER) 18 registry database. An X-tile analysis provided the optimal age cutoff point. The incidence, overall survival, and prognosis of bone metastasis were evaluated according to the patient information, characteristics of the tumor, and therapy. We also used multivariable Cox regression to estimate mortality hazard ratios (HRs) among patients with LCBM, while a visual nomogram was established to judge the prognosis. RESULTS: The incidence of disease increased with age, but survival rates show the opposite trend. The median survival time was about 4 months. In addition, although the differences for patient race is not significant (P=0.445), White patients are prone to have bone metastases from lung cancer according to the incidence analysis. The difference for laterality is also not significant (P=0.534), while the factors of age, gender, the total number of sites, histological types, grade, tumor size, and treatment are significantly related to the outcome of patients with LCBM. Furthermore, our nomogram could predict the probability of surviving to the median survival time of the population with a c-index of 0.72. CONCLUSIONS: Age, characteristics of the tumor, and therapy should be considered for prediction of prognosis for patients with lung cancer bone metastasis. Putatively, the younger patients and the patients with chemotherapy and surgery may indicate improved survival.

Complete video-assisted thoracoscopic surgery for pulmonary sequestration.

OBJECTIVE: To analyze the characteristics and technical difficulties of complete video-assisted thoracoscopic surgery (c-VATS) for treatment of pulmonary sequestration operation. METHODS: 25 cases of c-VATS lobectomy for intrapulmonary sequestration performed between January 2009 and May 2012 were reviewed. The 25 patients included 13 (52%) males and 12 (48%) females, with a mean age of 34.7 years (range, 16-62 years). Preoperative imaging by CT scan and three-dimensional reconstruction of abnormal blood vessels diagnosed 19 cases as pulmonary sequestration, misdiagnosed 1 case as pulmonary cyst syndrome, 4 cases as bronchiectasis and 1 case as benign tumor. RESULTS: All the patients underwent c-VATS excision, 16 in the left lower lobe, 7 in the right lower lobe, 1 in right middle lobe and 1 extralobar pulmonary sequestration. Vascular abnormality was observed intraoperative including the thoracic aorta in 20 cases, abdominal aorta in 2 cases, phrenic arteries and intercostal artery in 1 cases and thoracic aorta combined with abdominal aorta in 1 case. No conversion to open was achieved in all cases. The mean operating time was 114.2 mins (range, 78-156 mins), the mean blood loss was 228 mL (range, 50-3,000 mL), the mean duration of chest drainage was 3.2 days (range, 2-7 days) and the mean length of post-operative hospital stay was 6.6 days (range, 3-13 days). There was no mortality, without significant postoperative complications, were cured and discharged. Patients were followed up for 2-32 months, mean 21.4 months, with no recurrence. CONCLUSIONS: c-VATS is feasible, effective, and safe in treatment of pulmonary sequestration. It is worthy of clinical application.