Risk-based,response-adapted therapy for early-stage extranodal nasal-type NK/T-cell lymphoma in the modern chemotherapy era: A China Lymphoma Collaborative Group study

We aimed to determine the survival benefits of chemotherapy (CT) added to radiotherapy (RT) in different risk groups of patients with early-stage extranodal nasal-type NK/T-cell lymphoma (ENKTCL), and to investigate the risk of postponing RT based on induction CT responses. A total of 1360 patients who received RT with or without new-regimen CT from 20 institutions were retrospectively reviewed. The patients had received RT alone, RT followed by CT (RT + CT), or CT followed by RT (CT + RT). The patients were stratified into different risk groups using the nomogram-revised risk index (NRI). A comparative study was performed using propensity score-matched (PSM) analysis. Adding new-regimen CT to RT (vs RT alone) significantly improved overall survival (OS, 73.2% vs 60.9%, P < .001) and progression-free survival (PFS, 63.5% vs 54.2%, P < .001) for intermediate-risk/high-risk patients, but not for low-risk patients. For intermediate-risk/high-risk patients, RT + CT and CT + RT resulted in non-significantly different OS (77.7% vs 72.4%; P = .290) and PFS (67.1% vs 63.1%; P = .592). For patients with complete response (CR) after induction CT, initiation of RT within or beyond three cycles of CT resulted in similar OS (78.2% vs 81.7%, P = .915) and PFS (68.2% vs 69.9%, P = .519). For patients without CR, early RT resulted in better PFS (63.4% vs 47.6%, P = .019) than late RT. Risk-based, response-adapted therapy involving early RT combined with CT is a viable, effective strategy for intermediate-risk/high-risk early-stage patients with ENKTCL in the modern treatment era.     

Bibliometric analysis of toll-like receptor agonists associated with cancer therapy

Background:Toll-like receptors (TLRs), a family of innate pattern-recognition receptors, have been exploited as a target for antitumor strategy. An increasing number of TLR agonists, serving as immunotherapeutics or vaccine adjuvants, were developed. This study aimed at exploring the status and trend of current researches on TLR agonists through bibliometric analysis.Methods:Original publications on TLR agonists were collected from the Web of Science Core Collection. Data were analyzed in terms of publication outputs, journals, countries, institutions, authors, co-authorship, co-citation, research hotspots, and evolution trends through VOSviewer and CiteSpace.Results:A total of 1914 TLR agonists-related articles, published in 612 academic journals between 2000 and 2019, were enrolled in the study. The Journal of Immunology published the most publications, followed by PLoS One and Blood. The USA that is in possession of the largest number of articles and the most extensive cooperators was the most leading country in this field. University of Minnesota ranked the first in terms of paper totality, but its average citations ranking was lower than University of Pennsylvania. Gudkov AV was the most productive author, whose team reported a TLR5 agonist that had radioprotective activity in mouse and primate models in 2008. The paper of Akira Shizuo, professor of Osaka University, was widely cited by international peers. The research trend of TLR agonists has undergone 3 periods: mechanisms of TLR signalings in immunotherapy (2000–2010), discovery of TLR agonists (2011–2014), application, therapeutic evaluation, and drug design of TLR agonists (2015–2019).Conclusion:This study provides investigators a landscape of TLR agonists research from the perspective of bibliometrics.     

免疫评分系统在结直肠癌中应用的研究进展

结直肠癌是常见的消化系统恶性肿瘤,发病率和死亡率呈逐年上升趋势。TNM分期系统是目前国际上最为通用的肿瘤分期系统,但其分期标准仅基于肿瘤细胞本身特征,未能纳入患者整体免疫情况,在对患者预后的指导中逐渐显露不足。因此,在量化分析肿瘤微环境中免疫细胞的基础上,提出了免疫评分系统。近年多项研究证实,免疫评分系统能够更精准地评估结直肠癌患者的临床预后,且效果优于TNM分期。此外,免疫评分系统在辅助放化疗、评估免疫治疗疗效等方面也发挥重要作用,可进一步优化TNM分期系统及风险分层,有利于制定肿瘤患者的个体化治疗方案。本文就免疫评分系统在结直肠癌患者预后及疗效评估方面的研究进展进行综述。     

肝素结合蛋白对脓毒症患者急性肾损伤的预测价值

目的 探讨肝素结合蛋白(HBP)对脓毒症患者急性肾损伤(AKI)的预测价值。方法 回顾性分析山西医科大学第三医院急诊科于2020年5月至2021年5月收治的70例脓毒症患者的临床资料,根据入院时是否并发AKI分为AKI组(n=41)和非AKI组(n=29),比较2组患者HBP及其他临床资料。采用SPSS 19.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、秩和检验及χ²检验。采用Spearman相关法分析HBP与其他临床资料的相关性;logistic回归分析脓毒症并发AKI的危险因素,绘制受试者工作特征(ROC)曲线,分析脓毒症患者AKI危险因素的预测价值。结果 AKI组与非AKI组间HBP[176.24(100.77,255.92)和44.02(23.15,100.92) ng/ml]、SCR[204.50(137.10,363.35)和92.30(70.70,109.25) μmol/L]、APACHE Ⅱ[(25.22±8.17)和(17.45±5.05)分]、SOFA[(14.63±3.75)和(7.48±3.80)分]、PCT[26.00(14.39,71.03)和3.73(0.63,11.99) ng/L]比较,差异均有统计学意义(均P＜0.05)。HBP与SCR、APACHE Ⅱ、SOFA、PCT(r=0.538、0.341、0.566、0.444,均P＜0.05)呈正相关,与eGFR呈负相关(r=-0.546,P＜0.001);logistic回归分析显示HBP(OR=1.024,95%CI 1.012~1.036)、SOFA评分(OR=1.581,95%CI 1.294~1.932)均为脓毒症并发AKI的危险因素(P＜0.05);ROC曲线分析HBP对脓毒症AKI的发生有预测价值,最佳截断点为79.895,其灵敏度和特异度分别为92.7%和72.4%。结论 HBP可作为脓毒症患者发生AKI的有效预测指标。     

68Ga-DOTA-生长抑素受体PET/CT神经内分泌肿瘤显像操作指南

本指南针对神经内分泌肿瘤患者提出⁶⁸Ga-DOTA-生长抑素受体PET/CT检查的临床适应证、核医学医务人员岗位要求、检查操作规范、报告处理、质量控制及显像过程中的辐射安全问题,为临床进行⁶⁸Ga-DOTA-生长抑素受体PET/CT检查提供相应操作规范,为各种影像学表现提供合理解释和标准的诊断报告。     

Experimental study of acute lung injury induced by different tidal volume ventilation in rats

Mechanical ventilation (MV) is a dual blade sward which if misused could lead to lung injury, called ventilator induced lung injury (VILI). Pathogenesis of VILI is very complex with various manifestations, which is the focus in MV field in recent years.^1 In our research, the rats were ventilated with different tidal volume,