Efficacy and safety of different PD-1 inhibitors in combination with lenvatinib in the treatment of unresectable primary liver cancer: a multicentre retrospective study.

Immune checkpoint inhibitors (ICIs) are safe and efficacious treatments for advanced primary liver cancer (PLC). The efficacy of different ICIs in the treatment of liver cancer remains unclear. The purpose of this study was to explore whether there is a difference in the efficacy and safety of various programmed cell death protein 1 (PD-1) inhibitors in combination with lenvatinib in the treatment of unresectable PLC. Patients with PLC treated with lenvatinib in combination with PD-1 inhibitors (camrelizumab, tislelizumab, sintilimab, or pembrolizumab) between January 2018 and December 2021 were retrospectively enrolled. Tumor response, adverse events, and grades were evaluated. Kaplan-Meier analysis and log-rank test were used to compare the overall survival and progression-free survival of patients treated with different PD-1 inhibitors. Cox regression analysis was used for univariate and multivariate analyses to identify clinical variables related to treatment efficacy. This study included a total of 176 patients who received a combination of lenvatinib and PD-1 inhibitors. Of these, 103 patients received camrelizumab, 44 received tislelizumab, 20 received sintilimab, and 9 received pembrolizumab. There was no significant difference in the pairwise comparison of camrelizumab, tislelizumab, sintilimab, and pembrolizumab using Kaplan-Meier survival analysis. Adverse events occurred in 40 (22.7%) patients (grade ≥ 3, 2.3%). The incidence of grade 3 adverse events among the four PD-1 inhibitor groups was below 5%. Camrelizumab, tislelizumab, sintilimab, and pembrolizumab are viable options for patients with unresectable PLC. These PD-1 inhibitors in combination with lenvatinib showed good safety profiles. The results guide selecting treatment for patients with unresectable PLC.

[Evaluation of the Nurses' Utilization of the Pain Management Information System Based on the Information System Success Model].

BACKGROUND: Pain records provide important data to medical teams to guide their provision of pain management interventions. Incomplete records and records that do not integrate pain data will affect patient safety. Use of information technology helps facilitate communication within the medical team and improve quality of care. PURPOSE: This study was designed to evaluate the effectiveness of a pain management information system. METHODS: The questionnaire survey method was employed in this study. The system-evaluation questionnaire was designed based on the six dimensions of the information system success model (ISSM), including system quality, information quality, service quality, intention to use, user satisfaction, and net benefits. Three months after the pain management system was implemented, the opinions of 282 nurses from a medical center in central Taiwan were collected. Research data were analyzed using descriptive and inferential statistical methods. RESULTS: Of the six dimensions, "information quality" received the highest average score (4.71). The two dimensions of "intention to use" and "user satisfaction" had the highest correlation with "net benefits". "User satisfaction" was found to have the highest predictive power for the "net benefits" of the system, with an explanatory power of about 81.2%. CONCLUSIONS: The pain management system considered in this study was shown to provide complete and accurate pain management information, which is an important factor affecting nurses' intention to use and satisfaction. The evaluation results based on the ISSM show the pain management system to be a good information system that generates accurate information and has a high intention-to-use rate and high rate of user satisfaction.

A Pan-Cancer Analysis of SLC12A5 Reveals Its Correlations with Tumor Immunity.

BACKGROUND: Solute carrier family 12 member 5 (SLC12A5) has been reported to play an oncogenic role in certain malignancies. Its prognostic roles and immune mechanisms of action in human cancers, however, remain largely unknown. METHODS: Data derived from TCGA, GEPIA, and TIMER databases were utilized to delve into the expressing patterns, prognostic values, clinical significances, and tumor immunity of SLC12A5 in tumors. Additionally, the association of SLC12A5 expressions with tumor mutation burden (TMB), methyltransferases, and mismatch repairs (MMRs) was also analyzed. RESULTS: Herein, we observed that SLC12A5 was significantly overexpressed in various malignancies, and SLC12A5 levels correlated with overall survival, disease-specific survival, and tumor stage of certain cancers. Furthermore, we noticed that SLC12A5 was distinctly associated with methyltransferases, mismatch repair proteins, TMB, and MSI in human cancers. CONCLUSIONS: SLC12A5 may act as a potential prognostic and immunological biomarker and therapeutic target for human cancers.

Development and validation of the HNC-LL score for predicting the severity of coronavirus disease 2019.

BACKGROUND: Information regarding risk factors associated with severe coronavirus disease (COVID-19) is limited. This study aimed to develop a model for predicting COVID-19 severity. METHODS: Overall, 690 patients with confirmed COVID-19 were recruited between 1 January and 18 March 2020 from hospitals in Honghu and Nanchang; finally, 442 patients were assessed. Data were categorised into the training and test sets to develop and validate the model, respectively. FINDINGS: A predictive HNC-LL (Hypertension, Neutrophil count, C-reactive protein, Lymphocyte count, Lactate dehydrogenase) score was established using multivariate logistic regression analysis. The HNC-LL score accurately predicted disease severity in the Honghu training cohort (area under the curve [AUC]=0.861, 95% confidence interval [CI]: 0.800-0.922; P<0.001); Honghu internal validation cohort (AUC=0.871, 95% CI: 0.769-0.972; P<0.001); and Nanchang external validation cohort (AUC=0.826, 95% CI: 0.746-0.907; P<0.001) and outperformed other models, including CURB-65 (confusion, uraemia, respiratory rate, BP, age ≥65 years) score model, MuLBSTA (multilobular infiltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hypertension, and age) score model, and neutrophil-to-lymphocyte ratio model. The clinical significance of HNC-LL in accurately predicting the risk of future development of severe COVID-19 was confirmed. INTERPRETATION: We developed an accurate tool for predicting disease severity among COVID-19 patients. This model can potentially be used to identify patients at risks of developing severe disease in the early stage and therefore guide treatment decisions. FUNDING: This work was supported by the National Nature Science Foundation of China (grant no. 81972897) and Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2015).

New Constituents from the Low Polar Fraction of the Fruits of Crataegus dahurica and Their Anti-Inflammatory Activity in RAW264.7 Cells.

The fruit of Crataegus dahurica Koehne was used to treat the disease of infantile indigestion and dyspepsia as an ethnic medicine and food. As a continuous work on finding the active constituents from the edible herbs, four new biphenyl derivatives (1-4), together with two known compounds (5 and 6), were obtained from the petroleum ether fraction of the fruits of C. dahurica. Their structures were determined by the extensive 1D and 2D NMR spectra and HR-MS spectrometry. Furthermore, the anti-inflammatory activities of all the isolated compounds were investigated, in which compound 4 showed moderately inhibitory effects on NO production in RAW264.7 cells without inducing cytotoxicity.

Relevant Factors Affecting Nurse Use of a Pain Management System.

This study aimed to explore influencing factors and predictive capability for nursing staff use of a pain management system based on the information system success model. There were three key results: (a) Information quality is the most important influencing factor; (b) The correlations between these factors were all positively correlated; (c)Information quality and user satisfaction are the affect factors in predicting net benefits. These results elucidate the relevant factors affecting use of a pain management system by nurses, and can also predict system benefits.

Expression and clinical significance of periostin in oral lichen planus.

Oral lichen planus (OLP) is a chronic inflammatory lesion involving the oral mucosa, which has a high likelihood of progressing to cancer. The present study investigated the periostin expression in the mucosa and serum of patients with OLP and its correlation with serum cytokines. A total of 117 patients with OLP and 110 healthy controls were included in the study. The protein expression of periostin were measured in the OLP and normal oral mucosa by immunohistochemistry. ELISA was performed to measure the serum levels of periostin, tumour necrosis factor-α (TNF-α), interleukin (IL)-6, interferon-γ (IFN-γ), IL-4 and thymic stromal lymphopoietin (TSLP). Compared with the control group the OLP group had a significantly increased number of cases with high periostin expression in the oral mucosa and a significantly increased serum periostin level (P<0.05). Among all 117 OLP subjects, high periostin expression was associated with higher serum IL-6, TNF-α, TSLP and tissue mast cell density. High periostin expression was also significantly associated with a lower IFN-γ/IL-4 ratio (P<0.05). The present study concluded that periostin expression was increased in the oral mucosa and serum of patients with OLP and was associated with inflammatory response, T helper 2 cytokine-predominant immune imbalance, increased mast cell count and TSLP. The modulation of periostin may represent an attractive novel therapeutic target.

[Analysis on content of Ni-Cr in gingival and blood of hares after wearing non-noble porcelain-fused-to-metal crown].

OBJECTIVE: Purpose of the study was to investigate the content of Nickel (Ni) and Chromium (Cr) ion in gingival tissue and blood, and to discuss the reason of gray line in gingival after wearing non-noble Porcelain-Fused-to-Metal crown. METHODS: 38 rabbits were selected as experimental animals which were divided into three groups: control group, group 1 (3 months) and group 2 (6 months). The content of Ni and Cr ion in gingival tissue and blood was detected by atomic absorption spectrometer. RESULTS: The amount of Ni and Cr in group 2 was significantly higher than that in other groups (P < 0.05) . There was no difference between group 1 and control group (P > 0.05) . CONCLUSION: The reason of gingival colouration might be the electrochemical corrosion. The metal ion was released in gingival tissue and blood.