China special issue on gastrointestinal tumors-Radiological features of pathological complete response in mismatch repair deficient colorectal cancer after neoadjuvant PD-1 blockade: A post hoc analysis of the PICC phase II trial

Neoadjuvant programmed cell death protein 1 (PD-1) blockade exhibits promising efficacy in patients with mismatch repair deficient (dMMR) colorectal cancer (CRC). However, discrepancies between radiological and histological findings have been reported in the PICC phase II trial (NCT 03926338). Therefore, we strived to discern radiological features associated with pathological complete response (pCR) based on computed tomography (CT) images. Data were obtained from the PICC trial that included 36 tumors from 34 locally advanced dMMR CRC patients, who received neoadjuvant PD-1 blockade for 3 months. Among the 36 tumors, 28 (77.8%) tumors achieved pCR. There were no statistically significant differences in tumor longitudinal diameter, the percentage change in tumor longitudinal diameter from baseline, primary tumor sidedness, clinical stage, extramural venous invasion status, intratumoral calcification, peritumoral fat infiltration, intestinal fistula and tumor necrosis between the pCR and non-pCR tumors. Otherwise, tumors with pCR had smaller posttreatment tumor maximum thickness (median: 10 mm vs 13 mm, P = .004) and higher percentage decrease in tumor maximum thickness from baseline (52.9% vs 21.6%, P = .005) compared to non-pCR tumors. Additionally, a higher proportion of the absence of vascular sign (P = .003, odds ratio [OR] = 25.870 [95% CI, 1.357-493.110]), nodular sign (P < .001, OR = 189.000 [95% CI, 10.464-3413.803]) and extramural enhancement sign (P = .003, OR = 21.667 [2.848-164.830]) was observed in tumors with pCR. In conclusion, these CT-defined radiological features may have the potential to serve as valuable tools for clinicians in identifying patients who have achieved pCR after neoadjuvant PD-1 blockade, particularly in individuals who are willing to adopt a watch-and-wait strategy.     

Molecular profiling of Chinese R-CHOP treated DLBCL patients: Identifying a high-risk subgroup

Diffuse large B-cell lymphoma (DLBCL) is a clinically aggressive and heterogenous disease. Although most patients can be cured by immunochemotherapy, 30% to 40% patient will ultimately develop relapsed or refractory disease. Here, we investigated the molecular landscapes of patients with diverse responses to R-CHOP. We performed capture-based targeted sequencing on baseline samples of 105 DLBCL patients using a panel consisting of 112 lymphoma-related genes. Subsequently, 81 treatment-naïve patients with measurable disease and followed for over 1 year were included for survival analysis. Collectively, the most commonly seen mutations included IGH fusion (69%), PIM1(33%), MYD88 (29%), BCL2 (29%), TP53 (29%), CD79B (25%) and KMT2D (24%). Patients with TP53 mutations were more likely to have primary refractory disease (87.0% vs 50.0%, P = .009). For those with TP53 disruptive mutations, 91.7% patients were in the primary refractory group. Interestingly, BCL-2 somatic hypermutation was only seen in patients without primary refractory disease (P = .014). In multivariate analysis, BCL-2 amplification (hazard ratio [HR] = 2.94, P = .022), B2M mutation (HR = 2.99, P = .017) and TP53 mutation (HR = 3.19, P < .001) were independently associated with shorter time to progression (TTP). Furthermore, TP53 mutations was correlated with worse overall survival (P = .049). Next, we investigated mutation landscape in patients with wild-type (WT) TP53 (n = 58) and found that patients harboring MYD88 L265P had significantly inferior TTP than those with WT or non-265P (P = .046). Our study reveals the mutation spectrum of treatment-naive Chinese DLBCL patients. It also confirms the clinical significance of TP53 mutations and indicates the prognostic value of MYD88 L265P in TP53 WT patients.     

肿瘤合并感染新冠肺炎患者临床分析及疫情期间肿瘤患者的管理建议

目的:探讨分析肿瘤合并新冠病毒感染患者情况并提出自己的思考与建议。方法:通过统计2020年1月至2020年3月期间纳入的313名本院肿瘤科在新冠疫情期间肿瘤合并感染新冠肺炎患者情况，汇总临床资料，分析患者肺部影像学特点，总结肿瘤合并新冠肺炎病毒感染患者临床特征、预后及转归等，并提出自己建议。结果:科室总共313名患者住院，5名新冠感染患者，新冠病毒肺炎发生率为1.6%，这比之前所报道的武汉市新冠病毒普通人群发生率0.37%要高接近3倍，肿瘤合并新冠患者死亡率接近20%。结论:对于疫情结束初期病房应尽量减少患者非必要往返医院次数，实行肿瘤患者分层管理，加强轻症患者随访，线上管理等；而对于住院患者，则采取缓冲分诊模式，做好病房消毒隔离以及管理，避免感染，减少肿瘤病房新型冠状病毒爆发概率。     

阿尔茨海默病患者的执行功能障碍

目的了解阿尔茨海默病(A lzhe im er d isease,AD)患者执行功能损害状况及对于生活能力的影响,探讨执行功能障碍与记忆等AD常见认知功能损害的相关性。方法运用神经心理学测验的方法对40例AD患者及30例轻度认知功能损害(m ild cogn itive impairm ent,MC I)患者进行执行功能、记忆及其他认知功能检查,同时进行生活能力评定。另外选择40名健康老人作对照。结果AD组的执行功能测验成绩均显著低于健康对照组(P<0.01),其中额叶功能评定量表(FAB)(5.29±2.47)分,执行性画钟作业(CLOX1)(4.63±3.56)分,Stroop测验错误次数(Stroop1)(14.17±8.99)分,词语流畅性测验(RVR)(17.56±10.51)分。除Stroop测验反应时间(Stroop2)外,MC I组的其他执行功能测验成绩显著低于健康对照组(P<0.05),其中FAB为(7.67±2.44)分,CLOX1为(7.86±3.78)分,Stroop1为(7.21±8.07)分,RVR为(30.86±8.38)分。用多元逐步回归方法分析不同认知功能对生活能力的影响,结果为反映执行功能的FAB测验成绩处于第一位,独立与操作性日常生活能力(IADL)相关(β=-0.778,t=-7.079,P<0.01)。各项执行功能测验与年龄相关性不明显(r=0.026~0.250,P>0.05),与简易精神状态量表(MMSE)、记忆测验成绩相关性好(r=0.438~0.786,P<0.01)。结论AD患者具有明显的执行功能障碍;在尚未到达痴呆水平的MC I阶段也可发现执行功能损害。执行功能和整体认知功能及记忆等认知域功能具有良好的相关性。AD患者的执行功能障碍是导致生活能力下降的重要因素。     

食蟹猴年龄相关的运动功能减退及其与纹状体多巴胺转运体的关系

目的研究食蟹猴老化过程中运动行为和脑内纹状体多巴胺系统功能变化及两者之间的相关关系。方法选取4岁、10岁和15岁3个年龄组的健康食蟹猴共29只,利用计算机化的网络摄像头视频检测系统和行为分析软件连续采集和分析每个动物8h随意运动活动总量,各年龄组分别选取4只动物用多巴胺转运体(DAT)配体99mTc-TRODAT-1结合单光子发射体层摄影术(SPECT)显像观察脑内纹状体多巴胺转运体放射性摄取率的变化。结果在4岁、10岁和15岁年龄组,8h随意运动活动总量(×106)分别为5·00±1·93,3·28±1·02,2·79±0·67,在10岁和15岁较之4随年龄组分别降低了34·50%和55·71%(P<0·05,P<0·01),但此两个年龄组运动活动总量无显著差异(P>0·05);纹状体99mTc-TRODAT-1放射性摄取率分别为2·98±0·08,2·56±0·12和2·27±0·35,10岁和15岁较之4随年龄组分别降低了14·00%和25·60%,但仅4岁与15岁年龄组存在显著相关关系(P<0·01)。二者均随着年龄的增长呈逐渐减低的趋势,直线回归分析显示两者分别与年龄呈负相关关系(r=-0·57,P=0·001;r=-0·86,P<0·01)。8h随意运动活动总量与纹状体99mTc-TRODAT-1放射性摄取率呈显著的正相关关系(r=0·70,P<0·05)。结论正常食蟹猴老化过程中,脑内多巴胺神经系统功能的减退伴随着运动行为的减少,两者之间的相关关系进一步佐证了运动功能的减退可能是由于纹状体内多巴胺神经元功能减退所致。     

有机相脂肪酶催化合成技术在食品及相关领域的应用

对有机相脂肪酶催化合成技术的研究及其在食品、化妆品、医药、精细化工领域的应用进行了综述，表明有机相脂肪酶催化合成技术具有直接利用底物、反应条件温和、反应选择性高、产品容易分离纯化、产品具有绿色环保概念等优点。     

饮用水电化学法杀菌副产物三氯甲烷生成因素的研究

目的　了解电化学杀菌过程中副产物三氯甲烷的生成因素。方法　取滤后水 (三层滤料快滤池后、投放液氯前 )分别以石墨、Ti(基 ) - Ti为电极 ,配制不同 SO42 - 和 Cl- 浓度的实验水样 ,调节不同槽电流密度 ,电解不同时间后 ,取样分析 ,考察在不同条件下 CHCl3 的产生情况。结果　采用 Ti(基 ) - Ti电极的间歇电解过程中产生的 CHCl3 比采用石墨电极时多 ,且电流密度越大 ,产生的 CHCl3 越多。加入微量电解质 Na2 SO4对 CHCl3 的产生量无显著影响 ;加入微量电解质 Na Cl,〔CHCl3 〕随〔Cl- 〕的增大而增大。结论　在饮用水电解杀菌时应采用石墨电极 ,电解时间不宜超过 10分钟 ,电流密度宜 1m A/ cm2 ,以使 CHCl3 的生成量最小