Cancer cachexia reduces the efficacy of immune checkpoint inhibitors in cancer patients.

OBJECTIVE: Cachexia, a multifactorial syndrome, is frequently noticed in cancer patients. A recent study has shown inconsistent findings about the relationship between cachexia and the efficiency of immune checkpoint inhibitors (ICIs). To analyze this disparity, we did a meta-analysis. METHODS: From the beginning of each database to July 2023, literature describing the association between cachexia and prognosis of ICI-treated patients with solid malignancies was systematically searched in three online databases. Estimates were pooled, and 95% confidence intervals (CIs) were generated. RESULTS: We analyzed a total of 12 articles, which included data from 1407 patients. The combined results of our analysis showed that cancer patients with cachexia had significantly worse overall survival (HR = 1.88, 95% CI: 1.59-2.22, p < 0.001), progression-free survival (HR = 1.84, 95% CI: 1.59-2.12, p < 0.001), and time to treatment failure (HR = 2.15, 95% CI: 1.32-3.50, p = 0.002). These findings were consistent in both univariate and multivariate analyses. Additionally, while not statistically significant, we observed a trend towards a lower objective response rate in cancer patients with cachexia compared to those without cachexia (OR = 0.59, 95% CI: 0.32-1.09, p = 0.093). CONCLUSION: Poor survival in cachexia patients suggests a negative relationship between cachexia and ICI efficacy. In clinical practice, the existence of cachexia should be estimated to choose individuals who may benefit from ICIs.

Mapping Topsoil Total Nitrogen Using Random Forest and Modified Regression Kriging in Agricultural Areas of Central China.

Accurate understanding of spatial distribution and variability of soil total nitrogen (TN) is critical for the site-specific nitrogen management. Based on 4337 newly obtained soil observations and 33 covariates, this study applied the random forest (RF) algorithm and modified regression kriging (RF combined with residual kriging: RFK, hereafter) model to spatially predict and map topsoil TN content in agricultural areas of Henan Province, central China. According to the RFK prediction, topsoil TN content ranged from 0.52 to 1.81 g kg-1, and the farmland with the topsoil TN contents of 1.00-1.23 g kg-1 and 0.80-1.23 g kg-1 accounted for 48.2% and 81.2% of the total farmland area, respectively. Spatially, the topsoil TN in the study area was generally higher in the west and lower in the east. By using the Boruta variable selection algorithm, soil organic matter (SOM) and available potassium contents in topsoil, nitrogen deposition, average annual precipitation, livestock discharges, and topsoil pH were identified as the main factors driving the spatial distribution and variation of soil TN in the study area. The RF and RFK models used showed the expected performance and achieved acceptable TN prediction accuracy. In comparison, RFK performed slightly better than the RF model. The R2 and RMSE achieved by the RFK model were improved by 4.5% and 4.5%, respectively, compared with that by the RF model. However, the results suggest that RFK was inferior to the RF model in quantifying prediction uncertainty and thus may have a slight disadvantage in model reliability.

[Clinical, familial and hereditary analysis of myotonic dystrophy].

OBJECTIVE: To analyze the clinical, familial and hereditary features of myotonic dystrophy to improve the knowledge and provide molecule evidence for gene diagnosis and prenatal diagnosis of myotonic dystrophy or dystrophia myotonia (DM) families. METHODS: Clinical data of 2 DM families were collected based on the probands. The number of trinucleotide CTG repeat in the 3' untranslated region of myotonic dystrophy protein kinase (DMPK) gene on chromosome 19 was determined by DNA sequence and repeat fragment. RESULTS: Except for 1 subclinical patient, another 5 patients progressed slowly with the features of myotonic muscular weakness and atrophy. One patient had hatchet face, 1 had cataract and diabetes mellitus, and the other 3 were bald. Electromyologram showed 3 patients had myotonic discharge and myopathic abnormalities. The number of trinucleotide CTG repeat in the 3' untranslated region of DMPK gene of 5 patients exceeded 50. CONCLUSION: DM can be anticipated. Gene analysis can verify the disease and identify subclinical patients. It helps to prevent the DM births by hereditary consultation performing prenatal diagnosis.