1.Effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome.
Kuiwu LI ; Haoran CHU ; Ling ZOU ; Jingru RUAN ; Lumin LIAO ; Xiaoyu HAN ; Wenli MA ; Ming FANG ; Jingwei ZHU ; Yucheng FANG ; Ziye WANG ; Tingting TONG
Chinese Acupuncture & Moxibustion 2025;45(7):935-944
OBJECTIVE:
To observe the effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome (IBS-D) and explore its underlying mechanisms.
METHODS:
Of 38 newborn rats from 4 healthy SPF pregnant rats, 12 neonatal rats were randomly selected in a normal group. IBS-D model was prepared by the combined measures for the rest rats, including neonatal maternal separation, acetic acid enema and chronic restraint stress. Twenty-four successfully-modeled rats were randomized into a model group and a moxibustion group, 12 rats in each one. In the moxibustion group, suspending moxibustion was delivered at bilateral "Tianshu" (ST25) and "Shangjuxu" (ST37), 20 min each time, once daily and for 7 consecutive days. Separately, before acetic acid enema (aged 35 days), after modeling (aged 45 days) and after intervention (aged 53 days), the body mass, loose stool rate (LSR) and and the minimum volume threshold when abdominal withdrawal reflex (AWR) scored 3 were observed in the rats of each group. After intervention (aged 53 days), using HE and PAS staining, the morphology of duodenum was observed, the length of villus and the depth of crypt were measured, the ratio of the length of villus to the depth of crypt was calculated; and the numbers of mucosal intraepithelial lymphocytes (IELs) and goblet cells were counted. With ELISA adopted, the contents of γ-interferon (IFN-γ), interleukin-4 (IL-4) and secretory immunoglobulin A (sIgA) in duodenal mucosa of rats were detected. The proportion of T cell subsets in duodenal mucosa was detected using flow cytometry. The microvilli and tight junctions of duodenal mucosal epithelial cells were observed by transmission electron microscopy, and the integrity of duodenal mucosa observed by scanning electron microscopy.
RESULTS:
Compared with the normal group, for the rats in the model group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the the ratio of the length of villus to the depth of crypt, as well as the proportion of CD8+ T subset were all reduced (P<0.01, P<0.05), the counts of goblet cells in duodenal mucosa decreased (P<0.01); LRS, the proportion of CD4+ T subset and CD4+/CD8+, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were all elevated (P<0.01); and the numbers of IELs rose (P<0.01). The morphology of duodenal mucosa was irregular, the villi got shorter, sparse and scattered, with uneven density. The morphology of epithelial cells was destroyed and the tight junctions damaged, with larger spaces. When compared with the model group, in the moxibustion group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the ratio of the length of villus to the depth of crypt, as well as the counts of goblet cells in duodenal mucosa increased (P<0.01); LRS, the proportion of CD4+ T subset, and CD4+/CD8+, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were reduced (P<0.01); and the numbers of IELs was dropped (P<0.01). The morphology of duodenal mucosa was more regular, the villi were grew, got longer and arranged regularly, with even density. The morphology of epithelial cells was slightly destroyed, and the tight junctions partially damaged.
CONCLUSION
Moxibustion at "Tianshu" (ST25) and "Shangjuxu" (ST37) can reduce visceral hypersensitivity in IBS-D rats and relieve abdominal pain, diarrhea and other symptoms. Its effect mechanism may be related to the repair of small intestinal mucosal immune barrier and the improvement in the immune function in IBS-D.
Animals
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Irritable Bowel Syndrome/immunology*
;
Rats
;
Moxibustion
;
Intestinal Mucosa/immunology*
;
Female
;
Diarrhea/therapy*
;
Intestine, Small/immunology*
;
Male
;
Humans
;
Rats, Sprague-Dawley
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Disease Models, Animal
2.Advances in Radiotherapy for Extensive-stage Small Cell Lung Cancer in the Era of Immunotherapy.
Tingting CHEN ; Yanling YANG ; Haonan HAN ; Dongmin LIU ; Yajing YUAN ; Liming XU
Chinese Journal of Lung Cancer 2025;28(5):353-362
Small cell lung cancer (SCLC) is the thoracic malignant tumor and accounts for about 15% of lung malignancies and transfer often occurs by the time of diagnosis. Extensive stage-small cell lung cancer (ES-SCLC) accounts for about 2/3 of all SCLC. For many years, radiotherapy has occupied an important position in the treatment of SCLC, especially in the treatment of ES-SCLC, because SCLC is more sensitive to radiotherapy. However, in recent years, immune checkpoint inhibitor has shown more excellent antitumor activity in the treatment of ES-SCLC and become the mainstream argument for the treatment of ES-SCLC. However, will radiotherapy be buried by the times among the therapeutic approaches for ES-SCLC? In this article, we will review the clinical progress of radiotherapy, immunotherapy and combination therapy for ES-SCLC.
.
Humans
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Small Cell Lung Carcinoma/therapy*
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Lung Neoplasms/therapy*
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Immunotherapy
;
Neoplasm Staging
;
Radiotherapy/methods*
;
Combined Modality Therapy
3.New insights into translational research in Alzheimer's disease guided by artificial intelligence, computational and systems biology.
Shulan JIANG ; Zixi TIAN ; Yuchen YANG ; Xiang LI ; Feiyan ZHOU ; Jianhua CHENG ; Jihui LYU ; Tingting GAO ; Ping ZHANG ; Hongbin HAN ; Zhiqian TONG
Acta Pharmaceutica Sinica B 2025;15(10):5099-5126
Alzheimer's disease (AD) is characterized by cognitive and functional deterioration, with pathological features such as amyloid-beta (Aβ) aggregates in the extracellular spaces of parenchymal neurons and intracellular neurofibrillary tangles formed by the hyperphosphorylation of tau protein. Despite a thorough investigation, current treatments targeting the reduction of Aβ production, promotion of its clearance, and inhibition of tau protein phosphorylation and aggregation have not met clinical expectations, posing a substantial obstacle in the development of drugs for AD. Recently, artificial intelligence (AI), computational biology (CB), and systems biology (SB) have emerged as promising methodologies in AD research. Their capacity to analyze extensive and varied datasets facilitates the identification of intricate patterns, thereby enriching our comprehension of AD pathology. This paper provides a comprehensive examination of the utilization of AI, CB, and SB in the diagnosis of AD, including the use of imaging omics for early detection, drug discovery methods such as lecanemab, and complementary therapies like phototherapy. This review offers novel perspectives and potential avenues for further research in the realm of translational AD studies.
4.Fibrinogen-tau Aggregates Exacerbate Tau Pathology and Memory Deficits in Alzheimer's Disease Model Mice.
Tingting WEN ; Lanxia MENG ; Han LIU ; Qian ZHANG ; Lijun DAI ; Liqin HUANG ; Liang DAN ; Kedong ZHU ; Jiaying LUO ; Zhaohui ZHANG
Neuroscience Bulletin 2025;41(7):1246-1260
Vascular damage plays a significant role in the onset and progression of Alzheimer's disease (AD). However, the precise molecular mechanisms underlying the induction of neuronal injury by vascular damage remain unclear. The present study aimed to examine the impact of fibrinogen (Fg) on tau pathology. The results showed that Fg deposits in the brains of tau P301S transgenic mice interact with tau, enhancing the cytotoxicity of pathological tau aggregates and promoting tau phosphorylation and aggregation. Notably, Fg-modified tau fibrils caused enhanced neuronal apoptosis and synaptic damage compared to unmodified fibrils. Furthermore, intrahippocampal injection of Fg-modified tau fibrils worsened the tau pathology, neuroinflammation, synaptic damage, neuronal apoptosis, and cognitive dysfunction in tau P301S mice compared to controls. The present study provides compelling evidence linking Fg and tau, thereby connecting cerebrovascular damage to tau pathology in AD. Consequently, inhibiting Fg-mediated tau pathology could potentially impede the progression of AD.
Animals
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tau Proteins/metabolism*
;
Alzheimer Disease/metabolism*
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Fibrinogen/metabolism*
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Mice, Transgenic
;
Mice
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Disease Models, Animal
;
Memory Disorders/metabolism*
;
Male
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Mice, Inbred C57BL
;
Brain/metabolism*
;
Hippocampus/metabolism*
;
Protein Aggregation, Pathological/metabolism*
;
Apoptosis
;
Phosphorylation
5.The Bed Nucleus of the Stria Terminalis-Paraventricular Nucleus of the Hypothalamus Neural Circuit Regulates Neuropathic Pain Through the Brain-Spleen Axis.
Shoumeng HAN ; Xin CHEN ; Li MA ; Xin ZENG ; Ying WANG ; Tingting XIE ; Fancan WU ; Kun SONG ; Kenji HASHIMOTO ; Hanbing WANG ; Long WANG
Neuroscience Bulletin 2025;41(12):2148-2166
Neuropathic pain is a chronic condition caused by damage or dysfunction in the nervous system. While the spleen may influence neuropathic pain, its role has been poorly understood. This study demonstrates that the spleen plays a crucial role in regulating neuropathic pain through the bed nucleus of the stria terminalis (BNST) - paraventricular nucleus of the hypothalamus (PVN) neural circuit in a chronic constriction injury (CCI) mouse model. Splenectomy, splenic denervation, or splenic sympathectomy significantly increased the mechanical withdrawal threshold (MWT) and reduced macrophage infiltration in the dorsal root ganglia (DRG) of CCI mice. Pseudorabies virus injections into the spleen revealed connections to the BNST and PVN in the brain. Chemogenetic inhibition of the BNST-PVN circuit increased macrophage infiltration in the DRG and decreased the MWT; these effects were reversed by splenectomy, splenic denervation, or sympathectomy. These findings underscore the critical role of the spleen, regulated by the BNST-PVN circuit, in neuropathic pain.
Animals
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Neuralgia/pathology*
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Septal Nuclei/physiopathology*
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Male
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Spleen/physiopathology*
;
Paraventricular Hypothalamic Nucleus/physiopathology*
;
Mice, Inbred C57BL
;
Splenectomy
;
Mice
;
Neural Pathways/physiopathology*
;
Disease Models, Animal
;
Ganglia, Spinal/physiopathology*
;
Sympathectomy
;
Macrophages
6.Research advancements in molecular glues derived from natural product scaffolds: Chemistry, targets, and molecular mechanisms.
Lina YIN ; Tingting NIU ; Ling LI ; Wei YU ; Bo HAN ; Asma REHMAN ; Kewu ZENG
Chinese Herbal Medicines 2025;17(2):235-245
The mechanism of action of traditional Chinese medicine (TCM) remains unclear. Historically, research on TCM has mainly focused on exploring the mechanisms of active components acting on single targets. However, it is insufficient to explain the complex mechanisms by which these active components in TCM treat diseases. In recent years, the emergence of molecular glues (MGs) theory has provided new strategies to address this issue. MGs are small molecules that can promote interactions between proteins at their interface. The characteristic of MGs is to establish connections between diverse protein structures, thereby enabling a chemically-mediated proximity effect that triggers a wide spectrum of biological functions. Natural products are the result of billions of years of evolutionary processes in the natural environment. Thus, the extensive structural diversity of natural products renders them a rich source of MGs, including polyketides, terpenoids, steroids, lignans, organic acids, alkaloids and other classes. Currently, several well-known natural MGs, including the immunosuppressants cyclosporin A (CsA) and tacrolimus (FK506), as well as the anticancer agent taxol, have been incorporated into clinical practice. Meanwhile, the advancement of new technologies is propelling the discovery of novel MGs from natural products. Thus, we primarily summarize a growing variety of MGs from natural origins reported in recent years and categorize them based on the chemical structural types. Moreover, the main sources of TCM are natural products. The discovery of natural MGs promises to provide a new perspective for the elucidation of the molecular mechanism behind the efficiency of TCM. In summary, this review aims to provide insights from the perspective of natural products that could potentially influence TCM and modern drug development.
7.Gandou Bushen Decoction Ameliorates Cognitive Impairment in Wilson Disease Model TX Mice by Regulating Melatonin Synthesis via the SIRT3/FOXO3α Pathway
Luyao WANG ; Limin WU ; Tingting WANG ; Xinru FANG ; Zhenzhen JIANG ; Yike YUE ; Dan ZHAO ; Qianzhuo LIU ; Hui HAN
Journal of Sichuan University (Medical Sciences) 2025;56(1):102-111
Objective Melatonin has been shown to have neuroprotective effects.This study is aimed at observing the effects of copper deposition on cognitive function in a toxic milk(TX)mouse model of Wilson disease(WD),and investigating the effects and mechanisms of action of Gandou Bushen Decoction(GDBSD)on melatonin synthesis and pineal function in the WD model mice.Methods A total of 30 homozygous TX mice were randomly assigned to 3 groups(n=10 in each group),including a WD group,a GDBSD group,and a dimercaptosuccinic acid(DMSA)group.A total of 10 DL mice were included in the normal control(NC)group.The structure and copper content of pineal gland tissues,oxidative stress and apoptosis-related markers,and serum melatonin levels were evaluated using hematoxylin-eosin(HE)staining,enzyme-linked immunosorbent assay(ELISA),flow cytometry,and Western blot.Results Compared with the NC group,the WD group exhibited decreased learning and cognitive abilities(P<0.05),damaged pineal gland structure,increased copper content,reactive oxygen species(ROS)levels,and mitochondrial damage rate in the pineal gland(P<0.01),altered levels of melatonin and oxidative stress-related markers(P<0.05),upregulated expression levels of pro-apoptotic proteins Bax and Caspase-3,and decreased expression of the anti-apoptotic protein Bcl-2(P<0.01).After treatment with GDBSD and DMSA,the SIRT3/FOXO3α signaling pathway was activated,the copper content in the pineal gland was reduced,and oxidative stress and apoptosis-related damages were improved,leading to an improvement in learning and memory abilities(P<0.05).Conclusion GDBSD can alleviate cognitive impairments in WD mice caused by pineal gland copper deposition by inhibiting oxidative stress and apoptosis in the pineal gland.The underlying molecular mechanism is associated with the regulation of the SIRT3/FOXO3α signaling pathway.
8.Diagnostic value of serum cysteine protease inhibitor S in patients with gastric cancer
Dongmei XIA ; Guangshun SHI ; Tingting HAN ; Shui JIN
Journal of Clinical Medicine in Practice 2025;29(2):48-51
Objective To investigate the expression level and diagnostic value of serum cysteine protease inhibitor S(CST4)in patients with gastric cancer.Methods Clinical data of 115 patients with suspected gastric cancer who complained of gastric discomfort were retrospectively analyzed,and they were divided into benign disease group(n=50),precancerous disease group(n=26)and gas-tric cancer group(n=39).The levels of serum CST4,carcinoembryonic antigen(CEA),carbohy-drate antigen 19-9(CA19-9)and carbohydrate antigen 72-4(CA72-4)were analyzed in the three groups.The positive rates of CST4 among the three groups were compared.Binary Logistic regression analysis was used to screen for independent risk factors for gastric cancer occurrence.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of CST4 in gastric cancer.Results The positive rate of CST4 was 6.00%(3/50)in the benign gastric disease group,30.77%(8/26)in the gastric precancerous lesion group,and 66.67%(26/39)in the gastric canc-er group.The positive rate of CST4 in the gastric cancer group was higher than that in the gastric pre-cancerous lesion group and the benign gastric disease group(P<0.05).The results of binary Logistic regression analysis showed that advanced age,high levels of serum CST4 and high levels of CEA were independent risk factors for gastric cancer occurrence(P<0.05).The area under the curve(AUC)for CST4 alone in diagnosing gastric cancer was 0.847(95%CI,0.760 to 0.934),with an optimal cut-off value of 94.6 U/mL,the Youden index of 0.638,sensitivity of 71.8%,and specificity of 92.0%.The AUC for the combined diagnosis of gastric cancer using CST4,age and CEA was 0.959(95%CI,0.919 to 0.992),with sensitivity of 94.9%and specificity of 86.0%.Conclusion As a novel se-rum marker,CST4 has high predictive value in the auxiliary diagnosis of gastric cancer.
9.The impact of mandibular retrognathism on memory and cognitive function in rats
Qingchun Li ; Quancheng Han ; Xiaoyu Liu ; Tingting Wu
Acta Universitatis Medicinalis Anhui 2025;60(9):1661-1669
Objective:
To investigate the impact of mandibular retrognathism on brain function in rats and its potential mechanisms.
Methods :
Male SD rats aged 3 to 4 weeks ( w) were randomly divided into control group ( n = 10) and mandible retrusion ( MR) group ( n = 30) ,with the MR group further divided into three subgroups: 1,2, or 4 weeks,with 10 rats in each subgroup.The MR group used modified metal tubes,which were bonded to the lingual side of the maxillary incisors in rats,forcing the mandible to retract by 2-2. 5 mm,thereby achieving the goal of constructing a mandibular retrognathism model; the control group received no interventions.The effects of mandibular retraction on the spatial learning ability and memory ability of rats were explored by behavioral experi- ments such as Morris water maze,Y maze and new object recognition 1,2,and 4 weeks after modeling,respective- ly.Hematoxylin-eosin ( HE) and Nissl staining were employed to observe the histomorphological changes in CA1, CA3,and DG regions of hippocampal tissues.Immunohistochemistry was employed to detect the protein expression levels of tropomyosin receptor kinase B ( TrkB) in the CA1,CA3,and dentate gyrus ( DG) regions of the hippo- campus.Western blot was used to assess the expression changes in the TrkB / phosphoinositide 3-kinase ( PI3K) / protein kinase B ( AKT) pathway in hippocampal tissue.Quantitative analysis of apoptosis-related proteins in the hippocampus,including Bcl-2-associated X protein ( Bax) ,B-cell lymphoma-2 protein ( Bcl-2) ,and Caspase-3, was conducted using qRT-PCR and Western blot.
Results:
Behavioral experiments showed that rats in the MR group,especially the MR 4 w group,were significantly weaker in learning and spatial memory than the control group,MR 1 w,and MR 2 w( P<0. 05) .HE staining showed that pyramidal cells in the control group were ar- ranged orderly with regular morphology.In contrast,the MR group exhibited a reduction in the number of cells in the hippocampal CA1,CA3,and dentate gyrus ( DG) regions.The cells were sparsely and irregularly arranged, with nuclear condensation and enlarged cellular spaces. Nissl staining further demonstrated damage to the Nissl bodies in the MR group.Meanwhile,the TrkB / PI3K / AKT signaling pathway was activated in the MR group,and the expression of p-TrkB,PI3K,and p-AKT proteins was up-regulated ( P <0. 05) .Western blot and qRT-PCR indicated that MR up-regulated the expression of pro-apoptotic protein Bax,apoptotic effector protein Caspase-3 ( P<0. 05) ,and inhibited the expression of anti-apoptotic protein Bcl-2 ( P <0. 05) .
Conclusion
Mandibular retraction impairs brain function and affects cognition and learning memory in rats.This may be achieved by regula- ting the TrkB / PI3K / AKT signaling pathway to induce apoptosis in hippocampal neurons.
10.Prognosis and influencing factors analysis of patients with initially resectable gastric cancer liver metastasis who were treated by different modalities: a nationwide, multicenter clinical study
Li LI ; Yunhe GAO ; Liang SHANG ; Zhaoqing TANG ; Kan XUE ; Jiang YU ; Yanrui LIANG ; Zirui HE ; Bin KE ; Hualong ZHENG ; Hua HUANG ; Jianping XIONG ; Zhongyuan HE ; Jiyang LI ; Tingting LU ; Qiying SONG ; Shihe LIU ; Hongqing XI ; Yun TANG ; Zhi QIAO ; Han LIANG ; Jiafu JI ; Lin CHEN
Chinese Journal of Digestive Surgery 2024;23(1):114-124
Objective:To investigate the prognosis of patients with initially resectable gastric cancer liver metastasis (GCLM) who were treated by different modalities, and analyze the influencing factors for prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 327 patients with initially resectable GCLM who were included in the database of a nationwide multicenter retrospective cohort study on GCLM based on real-world data from January 2010 to December 2019 were collected. There were 267 males and 60 females, aged 61(54,68)years. According to the specific situations of patients, treatment modalities included radical surgery combined with systemic treatment, palliative surgery combined with systemic treatment, and systemic treatment alone. Observation indicators: (1) clinical characteristics of patients who were treated by different modalities; (2) prognostic outcomes of patients who were treated by different modalities; (3) analysis of influencing factors for prognosis of patients with initially resectable GCLM; (4) screening of potential beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard regression model. The propensity score matching was employed by the 1:1 nearest neighbor matching method with a caliper value of 0.1. The forest plots were utilized to evaluate potential benefits of diverse surgical combined with systemic treatments within the population. Results:(1) Clinical characteristics of patients who were treated by different modalities. Of 327 patients, there were 118 cases undergoing radical surgery plus systemic treatment, 164 cases undergoing palliative surgery plus systemic treatment, and 45 cases undergoing systemic treatment alone. There were significant differences in smoking, drinking, site of primary gastric tumor, diameter of primary gastric tumor, site of liver metastasis, and metastatic interval among the three groups of patients ( P<0.05). (2) Prognostic outcomes of patients who were treated by different modalities. The median overall survival time of the 327 pati-ents was 19.9 months (95% confidence interval as 14.9-24.9 months), with 1-, 3-year overall survival rate of 61.3%, 32.7%, respectively. The 1-year overall survival rates of patients undergoing radical surgery plus systemic treatment, palliative surgery plus systemic treatment and systemic treatment alone were 68.3%, 63.1%, 30.6%, and the 3-year overall survival rates were 41.1%, 29.9%, 11.9%, showing a significant difference in overall survival rate among the three groups of patients ( χ2=19.46, P<0.05). Results of further analysis showed that there was a significant difference in overall survival rate between patients undergoing radical surgery plus systemic treatment and patients undergoing systemic treatment alone ( hazard ratio=0.40, 95% confidence interval as 0.26-0.61, P<0.05), between patients undergoing palliative surgery plus systemic treatment and patients under-going systemic treatment alone ( hazard ratio=0.47, 95% confidence interval as 0.32-0.71, P<0.05). (3) Analysis of influencing factors for prognosis of patients with initially resectable GCLM. Results of multivariate analysis showed that the larger primary gastric tumor, poorly differentiated tumor, larger liver metastasis, multiple hepatic metastases were independent risk factors for prognosis of patients with initially resectable GCLM ( hazard ratio=1.20, 1.70, 1.20, 2.06, 95% confidence interval as 1.14-1.27, 1.25-2.31, 1.04-1.42, 1.45-2.92, P<0.05) and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy were independent protective factors for prognosis of patients with initially resectable GCLM ( hazard ratio=0.60, 0.39, 0.46, 95% confidence interval as 0.42-0.87, 0.25-0.60, 0.30-0.70, P<0.05). (4) Screening of potentinal beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Results of forest plots analysis showed that for patients with high-moderate differentiated GCLM and patients with liver metastasis located in the left liver, the overall survival rate of patients undergoing radical surgery plus systemic treatment was better than patients undergoing palliative surgery plus systemic treatment ( hazard ratio=0.21, 0.42, 95% confidence interval as 0.09-0.48, 0.23-0.78, P<0.05). Conclusions:Compared to systemic therapy alone, both radical and palliative surgery plus systemic therapy can improve the pro-gnosis of patients with initially resectable GCLM. The larger primary gastric tumor, poorly differen-tiated tumor, larger liver metastasis, multiple hepatic metastases are independent risk factors for prognosis of patients with initial resectable GCLM and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy are independent protective factors for prognosis of patients with initially resectable GCLM.


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