To analyze the treatment strategy for a 78-year-old female patient with mismatch repair deficient (dMMR) gastric cancer who achieved long-term survival. After third-line chemotherapy failed, gene testing showed ARID1A p.Gln748fs, c.2733-1G＞T variation, with PD-L1 TPS 30%, CPS 60%. The nivolumab was employed, and two weeks later, the best response was partial response (PR). During the fourth-line immunotherapy maintenance treatment, progression of left adrenal metastasis was observed. The expression of human epidermal growth factor receptor-2 (HER-2) was positive, and the antibody drug conjugate disitamab vedotin (RC48) was chosen for treatment. After 10 months of treatment with nivolumab combined with RC48, the best efficacy was assessed as stable disease (SD), with a progression free survival (PFS) of up to 12 months. Radiotherapy was employed, and immunotherapy was maintained, allowing the patient to achieve a PFS of 18 months again. During immunotherapy, a clinical pharmacist developed a personalized pharmaceutical care plan for this patient. At the last follow-up, this patient achieved 78 months of long-term survival.

Sophorae Flavescentis Radix is one of the commonly used traditional Chinese medicine in China, and a large amount of pharmaceutical residue generated during its processing and production is discarded as waste, which not only wastes resources but also pollutes the environment. Therefore, elucidating the chemical composition of the residue of Sophorae Flavescentis Radix and the differences between the residue and Sophorae Flavescentis Radix itself is of great significance for the comprehensive utilization of the residue. This study, based on ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) technology combined with multivariate statistical methods, provides a thorough characterization, identification, and differential analysis of the overall components of Sophorae Flavescentis Radix and its residue. Firstly, 61 compounds in Sophorae Flavescentis Radix were rapidly identified based on their precise molecular weight, fragment ions, and compound abundance, using a self-constructed compound database. Among them, 41 compounds were found in the residue, mainly alkaloids and flavonoids. Secondly, through principal component analysis(PCA) and orthogonal partial least squares discriminant analysis(OPLS-DA), 15 key compounds differentiating Sophorae Flavescentis Radix from its residue were identified. These included highly polar alkaloids, such as oxymatrine and oxysophocarpine, which showed significantly reduced content in the residue, and less polar flavonoids, such as kurarinone and kuraridin, which were more abundant in the residue. In summary, this paper clarifies the overall composition, structure, and content differences between Sophorae Flavescentis Radix and its residue, suggesting that the residue of Sophorae Flavescentis Radix can be used as a raw material for the extraction of its high-activity components, with promising potential for development and application in cosmetics and daily care. This research provides a scientific basis for the future comprehensive utilization of Sophorae Flavescentis Radix and its residue.
Drugs, Chinese Herbal/chemistry* ; Chromatography, High Pressure Liquid/methods* ; Mass Spectrometry/methods* ; Sophora/chemistry* ; Flavonoids/chemistry* ; Alkaloids/chemistry*

Objective： The aim of this study is to explore the predictive value of biparametric magnetic resonance imaging(bpMRI)for pelvic lymph node metastasis in prostate cancer patients with PSA≤20 μg/L and establish a nomogram. Methods： The imaging data and clinical data of 363 patients undergoing radical prostatectomy and pelvic lymph node dissection in the First Affiliated Hospital of Nanjing Medical University from July 2018 to December 2023 were retrospectively analyzed. Univariate analysis and multivariate logistic regression were used to screen independent risk factors for pelvic lymph node metastasis in prostate cancer, and a nomogram of the clinical prediction model was established. Calibration curves were drawn to evaluate the accuracy of the model. Results： Multivariate logistic regression analysis showed extrocapusular extension (OR=8.08,95%CI=2.62－24.97, P<0.01), enlargement of pelvic lymph nodes (OR=4.45,95%CI=1.16－17.11,P=0.030), and biopsy ISUP grade(OR=1.97,95%CI=1.12－3.46, P=0.018)were independent risk factors for pelvic lymph node metastasis. The C-index of the prediction model was 0.834, which indicated that the model had a good prediction ability. The actual value of the model calibration curve and the prediction probability of the model fitted well, indicating that the model had a good accuracy. Further analysis of DCA curve showed that the model had good clinical application value when the risk threshold ranged from 0.05 to 0.70.Conclusion： For prostate cancer patients with PSA≤20 μg/L, bpMRI has a good predictive value for the pelvic lymph node metastasis of prostate cancer with extrocapusular extension, enlargement of pelvic lymph nodes and ISUP grade≥4.
Humans ; Male ; Prostatic Neoplasms/diagnostic imaging* ; Lymphatic Metastasis ; Retrospective Studies ; Nomograms ; Prostate-Specific Antigen/blood* ; Lymph Nodes/pathology* ; Pelvis ; Predictive Value of Tests ; Prostatectomy ; Lymph Node Excision ; Risk Factors ; Magnetic Resonance Imaging ; Logistic Models ; Middle Aged ; Aged

Targeting drug delivery systems mediated by nanoparticles has shown great potential in the diagnosis and treatment of cancer. However, influences of different tumor progressions on the accumulation of nanoparticles, especially the ligand-modified active targeting nanoparticles are seldom exploited. In this work, the accumulation and penetration of RGD-modified gold nanoparticles (active AuNPs) with different sizes were investigated in orthotopic breast cancer with different tumor progressions. The results showed that the smallest active AuNPs had better accumulation and permeation effects in early tumor tissues with the relatively looser extracellular matrix, larger gaps, lower interstitial fluid pressure, and less receptor expression, which was due to size effects. However, the larger active AuNPs had better accumulation and penetration effects in late tumor tissues with highly expressed target receptors integrin α _v β ₃ because of the multivalent interactions between larger active nanoparticles and integrin α _v β ₃. In the midterm, tumor accumulation of active AuNPs was equally influenced by size effects and multivalent interactions. Therefore, RGD-modified nanoparticles with sizes of 7 and 90 nm accumulated more in tumors. This study will guide a rational design of active targeting nanoparticles for enhancing the diagnosis and treatment of tumors based on their progressions.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.

Airway mucus hypersecretion is one of the important pathophysiological and clinical manifestations of chronic obstructive pulmonary disease.It has been reported in the literature that COPD patients with chronic airway mucus hyperse-cretion have more frequent acute exacerbations,more severe lung function decline,and higher hos-pitalizations and mortality.Therefore,it is particu-larly critical to understand the pathogenesis of hy-persecretion of mucus in chronic obstructive pul-monary disease and find out effective treatment.This article focuses on the structure,significance of airway mucus and the mechanism of hypersecre-tion of mucus in chronic obstructive pulmonary dis-ease(COPD).In addition,we also summarized drug and non-drug therapy for chronic airway mucus hy-persecretion in this article.Drug therapy includes traditional drug therapy,some new targeted drug therapy for pathogenesis and traditional Chinese medicine therapy,and non-drug therapy includes smoking cessation,physical therapy and bronchos-copy therapy.We hope that it will provide new ideas and directions for the treatment of mucus hy-persecretion in COPD patients.