Adjuvant chemotherapy improves the survival outlook for patients undergoing operations for lung metastases caused by colorectal cancer(CRC).However,a multidisciplinary approach that evaluates several factors related to patient and tumor characteristics is necessary for managing chemotherapy treatment in metastatic CRC patients with lung disease,as such factors dictate the timing and drug regimen,which may affect treatment response and prognosis.In this study,we explore the potential of spatial metabolomics for evaluating metabolic phenotypes and therapy outcomes during the local de-livery of the anticancer drug,oxaliplatin,to the lung.12 male Yorkshire pigs underwent a 3 h left lung in vivo lung perfusion(IVLP)with various doses of oxaliplatin(7.5,10,20,40,and 80 mg/L),which were administered to the perfusion circuit reservoir as a bolus.Biocompatible solid-phase microextraction(SPME)microprobes were combined with global metabolite profiling to obtain spatiotemporal infor-mation about the activity of the drug,determine toxic doses that exceed therapeutic efficacy,and conduct a mechanistic exploration of associated lung injury.Mild and subclinical lung injury was observed at 40 mg/L of oxaliplatin,and significant compromise of the hemodynamic lung function was found at 80 mg/L.This result was associated with massive alterations in metabolic patterns of lung tissue and perfusate,resulting in a total of 139 discriminant compounds.Uncontrolled inflammatory response,abnormalities in energy metabolism,and mitochondrial dysfunction next to accelerated kynurenine and aldosterone production were recognized as distinct features of dysregulated metabolipidome.Spatial pharmacometabolomics may be a promising tool for identifying pathological responses to chemotherapy.

Objective:To compare the efficacy and safety of triamcinolone acetonide (TA) alone and in combination with 5-fluorouracil (5-FU) for treating keloids using meta-analysis.Methods:Databases including PubMed, Embase, and Cochrane Library were retrieved with the search terms of " triamcinolone acetonide, 5-fluorouracil, glucocorticoid, fluorouracil, keloid, scar, TAC, 5-FU, hypertrophic scar " and databases including Chinese Journal Full- Text Database, Chinese Biomedical Database, and Wanfang Data were retrieved with the search terms of "曲安奈德,瘢痕疙瘩, 5-氟尿嘧啶,糖皮质激素,增生性瘢痕" in Chinese to obtain the publicly published randomized controlled trials about the effects of TA alone and in combination with 5-fluorouracil for treating keloids from the establishment of each database to august 2019. The outcome indexes included effective proportion of treatment, incidence proportion of adverse reactions, and recurrence proportion of keloids. RevMan 5.3 and Stata 14.0 statistical software were used to conduct a meta-analysis of eligible studies. Results:A total of 1 326 patients with keloids were included in 14 studies, including 668 patients in TA+ 5-fluorouracil group whose keloids were injected with TA and 5-fluorouracil and 658 patients in TA alone group whose keloids were injected with TA alone. A total of 7 articles achieved 1 to 3 points in modified Jadad score, while 7 articles achieved 4 to 7 points in modified Jadad score. Patients in TA+ 5-fluorouracil group had a higher effective proportion of treatment than that of TA alone group (relative risk=1.28, 95% confidence interval=1.16-1.41, P<0.01). Subgroup analysis showed that the quality of the included literature and ethnic factors might be the source of heterogeneity in effective proportion of treatment. Patients in TA+ 5-fluorouracil group had a lower incidence proportion of adverse reactions than that of TA alone group (relative risk=0.44, 95% confidence interval=0.25-0.75, P<0.01). Patients in TA+ 5-fluorouracil group had a lower recurrence proportion of keloids than that of TA alone group (relative risk=0.25, 95% confidence interval=0.14-0.44, P<0.01). There was no publication bias in incidence proportion of adverse reactions ( P>0.05), while the effective proportion of treatment and recurrence proportion of keloids had publication bias ( P<0.05). Conclusions:TA combined with 5-fluorouracil is more effective than TA alone for treating keloids, with less incidence of adverse reactions and recurrence.