Safety of Combined Yttrium-90 Radioembolization and Immune Checkpoint Inhibitor Immunotherapy for Hepatocellular Carcinoma

PurposeTo investigate the safety of yttrium-90 radioembolization in combination with checkpoint inhibitor immunotherapy for the treatment of hepatocellular carcinoma (HCC).Materials and MethodsThis single-center retrospective study included 26 consecutive patients with HCC who received checkpoint inhibitor immunotherapy within 90 days of radioembolization from April 2015 to May 2018. Patients had preserved liver function (Child-Pugh scores A–B7) and either advanced HCC due to macrovascular invasion or limited extrahepatic disease (21 patients) or aggressive intermediate stage HCC that resulted in earlier incorporation of systemic immunotherapy (5 patients). Clinical documentation, laboratory results, and imaging results at 1- and 3-month follow-up intervals were reviewed to assess treatment-related adverse events and treatment responses.ResultsThe median follow-up period after radioembolization was 7.8 months (95% confidence interval [CI], 5.6–11.8). There were no early (30-day) mortality or grades 3/4 hepatobiliary or immunotherapy-related toxicities. Delayed grades 3/4 hepatobiliary toxicities (1–3 months) occurred in 2 patients in the setting of HCC disease progression. One patient developed pneumonitis. The median overall survival from first immunotherapy was 17.2 months (95% CI, 10.9–23.4). The median overall survival from first radioembolization was 16.5 months (95% CI, 6.6–26.4). From first radioembolization, time to tumor progression was 5.7 months (95% CI, 4.2–7.2), and progression-free survival was 5.7 months (95% CI, 4.3–7.1).ConclusionsRadioembolization combined with checkpoint inhibitor immunotherapy in cases of HCC appears to be safe and causes limited treatment-related toxicity. Future prospective studies are needed to identify the optimal combination treatment protocols and evaluate the efficacy of combination therapy.     

Oncogene Mdm2 takes part in hepatocarcinogenesis

1　ＩＮＴＲＯＤＵＣＴＩＯＮＭｕｔａｔｉｏｎｓｉｎｔｈｅｐ53ｇｅｎｅａｒｅｔｈｅｍｏｓｔｃｏｍｍｏｎａｌｔｅｒａｔｉｏｎｆｏｕｎｄｉｎｈｕｍａｎｍａｌｉｇｎａｎｔｔｕｍｏｒｓ[1,2 ] .ＢｕｔｔｈｅｒｅｈａｖｅｂｅｅｎｆｅｗｒｅｐｏｒｔｓａｂｏｕｔｔｈｅｅｆｆｅｃｔｏｆＭｄｍ 2-ｉｎｄｕｃｅｄＰ53ｉｎａｃｔｉｖａｔｉｏｎｉｎｈｕｍａｎＨＣＣ .Ｗｅａｎａ ｌｙｚｅｄｔｈｅｐ53ｇｅｎｅｍｕｔａｔｉｏｎｓｉｎｅｘｏｎｓ 5～ 8ｂｙｐｏｌｙ ｍｅｒａｓｅｃｈａｉｎｒｅａｃｔｉｏｎ -ｓｉｎｇｌｅｓｔｒａｎｄｃｏｎｆ…     

The third inactivated vaccine booster dramatically enhanced SARS-CoV-2 antibody responses and did not influence the profile of prothrombotic antibody

The purpose of this study is to investigate the production of both severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-specific antibodies and autoantibodies in serum following the third booster vaccination of the inactivated COVID-19 vaccine, and to study the effect of B cell subsets with CD27 and CD38 phenotypes in peripheral blood on antibody production. Routine blood indexes, SARS-CoV-2 antibodies, platelet factor 4 and seven antiphospholipid antibodies were detected both before and 2 months after vaccination in the medical staff of the Zhongnan Hospital of Wuhan University. Peripheral blood B cell subtypes were detected before vaccination. Following immunization, the positive rate of anti-N-S1 immunoglobulin (IgG) had increased from 24.8% to 91.3% and the average antibody concentration had increased by 11 times. The positive rate of neutralizing antibody had increased from 24.8% to 91.3%, the average antibody concentration had increased by 12 times, and the primary increased anti-S1 IgG subtype was that of IgG1. Peripheral blood CD27 + CD38+ B cells were positively correlated with antibody levels after vaccination and were a predictor of the antibody response. In addition, although some indicators showed slight absolute changes, the blood parameters and antiphospholipid antibodies of most volunteers were normal both before and after COVID-19 inactivated vaccine inoculation, and there was no statistical difference in abnormal rates either before or after inoculation. Antibodies in vivo were increased after vaccination with the inactivated vaccine, and IgG1 was the main subtype involved in response to the vaccine. Vaccination with the inactivated COVID-19 vaccine did not appear to affect thrombus-related autoantibodies.     

分隔膜无针输液接头预防导管相关血流感染的Meta分析

目的 系统性评价分隔膜无针输液接头与肝素帽预防导管相关血流感染发生率的差异。方法 检索万方数据库、中国知网(CNKI)、维普数据库(VIP)、PubMed、CINAHL Complete、Cochrane Library建库至2018年1月1日以来国内外有关分隔膜无针输液接头与肝素帽的所有随机对照试验;对符合纳入标准的文献进行质量评估后使用ReVMan5.3进行Meta分析。结果导管相关血流感染发生率:OR=0.13,5%CI(0.06,0.27),P＜0.000 01;静脉炎发生率:OR=0.10,5%CI(0.03,0.34),P=0.000 20;堵管发生率:OR=0.12,5%CI(0.07,0.19),P＜0.000 01。结论 分隔膜无针输液接头与肝素帽相比较,分隔膜无针输液接头可明显减少导管相关血流感染、静脉炎、堵管发生率。     

气相色谱法测定磷酸二甲啡烷中有机溶剂残留

目的：采用气相色谱法测定磷酸二甲啡烷原料药中的乙酸乙酯、三氯甲烷和N,N-二甲基甲酰胺（DMF）3种有机溶剂的残留量。方法：采用毛细管气相色谱法,PEG-20M柱,程序升温,以水为溶剂,FID检测器,对乙酸乙酯、三氯甲烷和DMF的残留量进行检测。结果：3种有机溶剂基本实现基线分离且线性关系良好（r均在0.9990以上）,上述3种溶剂残留的检出限范围分别为0.63,0.60和8.92μg·ml-1。3批样品中3种有机溶剂的残留量均符合ICH的规定。结论：该检测方法灵敏、准确、可靠,可用于磷酸二甲啡烷原料的质量控制。     

Meta-analysis of the relationship between lymphovascular invasion and prognosis of patients with stage I gastric cancer

Lymphovascular invasion is considered to be a high-risk pathological feature after radical resection of gastric cancer, but the relationship between lymphovascular invasion and the prognosis of stage I gastric cancer is still controversial. Therefore, we used meta-analysis to systematically evaluate the relationship between lymphovascular invasion and the prognosis of stage I gastric cancer. Up to September 2, 2021, the databases of PubMed, EMBASE, Cochrane Library, CNKI, and Wanfang were searched. According to the inclusion and exclusion criteria, 2 researchers independently completed the screening of literature, extraction of data, and quality evaluation. Meta-analysis was performed using RevMan 5.4 software merged with HR and 95%CI. A total of 7508 patients with stage I gastric cancer were included in 9 studies, and the positive rate of lymphovascular invasion was 17%. Lymphovascular invasion was significantly associated with shorter overall survival (OS) (univariate: HR = 4.05, 95%CI: 1.91–8.58; multivariate: HR = 2.10, 95%CI: 1.37–3.22) and relapse-free survival (RFS) (univariate: HR = 4.79, 95%CI: 2.30–9.99; multiple: HR = 2.17, 95%CI: 1.56–3.00). This study indicates that lymphovascular invasion is an independent risk factor affecting the prognosis of patients with stage I gastric cancer, and can be used as a reference index for postoperative adjuvant therapy.     

Anterior epitympanic recess volume and Cog process length in temporal bones with Körner's septum: A radio- anatomical investigation

ObjectiveKörner's septum is a dense bony lamina dividing the mastoid cavity into superficial squamous and deeper petrosal portions at the level of antrum. In this study, we aimed at investigating the association of the Körner's septum with the length of the Cog process and the volume of anterior epitympanic recess (AER), using the 3-dimensional reconstruction models based on high resolution computed tomography sections of the temporal bone.MethodsUsing OsiriX software for MacOS (version 3.8.1, Pixmeo), we measured the volumes from three- dimensional models of anterior epitympanic recess. Anterior epitympanic recess volumes and Cog process lengths of the temporal bones with and without Körner's septum were compared.ResultsCog process length was significantly higher, and AER volume was significantly lower in patients with Körner's septum compared to the patients without. (p < 0.001). Additionally, Cog process length was significantly (p = 0.008), negatively, but weakly (rho= ?0.24) correlated with AER volume.ConclusionTemporal bones with Körner's septum had a longer Cog process and a smaller AER.