With the widespread useof immune checkpoint inhibitors(ICIs)in the treatment of various solid tumors,immune-related adverse events have attracted increasing clinical attention.Although ICI-associated myocarditis is rare,it typically has an insidious onset,progresses rapidly,and carries a high mortality rate,making it one of the most severe complications of ICI therapy.Early recognition and management remain challenging due to the absence of standardized diagnostic and therapeutic guidelines.ICI-associated myocarditis is characterized by the following features,with symptom onset commonly occurring within weeks of initiating ICI therapy.Its clinical manifestations are often non-specific and can be misdiagnosed as coronary artery disease or viral myocarditis.Prompt administration of high-dose corticosteroids combined with immunosuppressants,cardiac rhythm and functional support,is crucial for effective management.Although numerous stud-ies highlight the importance of early detection and multidisciplinary collaboration,there is still no consensus on standardized treatment pro-tocols.This report describes a case of acute ICI-associated myocarditis with ovarian cancer who developed symptoms after receiving com-bined apalutamide and toripalimab therapy.The patient responded well to corticosteroid pulse therapy,second-line immunosuppressants,and intensive care support.Due to recurrent ventricular arrhythmias,an implantable cardioverter defibrillator was placed,and cardiac func-tion remained stable during follow-up.Through this case and a review of the relevant literature,we discuss the clinical features,compre-hensive treatment strategies,and long-term management approaches for ICI-associated myocarditis,aiming to raise clinical awareness,pro-mote standardized multidisciplinary team collaboration,and ultimately improve patient outcomes.

With the widespread useof immune checkpoint inhibitors(ICIs)in the treatment of various solid tumors,immune-related adverse events have attracted increasing clinical attention.Although ICI-associated myocarditis is rare,it typically has an insidious onset,progresses rapidly,and carries a high mortality rate,making it one of the most severe complications of ICI therapy.Early recognition and management remain challenging due to the absence of standardized diagnostic and therapeutic guidelines.ICI-associated myocarditis is characterized by the following features,with symptom onset commonly occurring within weeks of initiating ICI therapy.Its clinical manifestations are often non-specific and can be misdiagnosed as coronary artery disease or viral myocarditis.Prompt administration of high-dose corticosteroids combined with immunosuppressants,cardiac rhythm and functional support,is crucial for effective management.Although numerous stud-ies highlight the importance of early detection and multidisciplinary collaboration,there is still no consensus on standardized treatment pro-tocols.This report describes a case of acute ICI-associated myocarditis with ovarian cancer who developed symptoms after receiving com-bined apalutamide and toripalimab therapy.The patient responded well to corticosteroid pulse therapy,second-line immunosuppressants,and intensive care support.Due to recurrent ventricular arrhythmias,an implantable cardioverter defibrillator was placed,and cardiac func-tion remained stable during follow-up.Through this case and a review of the relevant literature,we discuss the clinical features,compre-hensive treatment strategies,and long-term management approaches for ICI-associated myocarditis,aiming to raise clinical awareness,pro-mote standardized multidisciplinary team collaboration,and ultimately improve patient outcomes.

OBJECTIVEFindings from the previous studies have suggested a relationship between ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP-1) or plasma cell membrane glycoprotein 1 (PC-1) gene single nucleotide polymorphism (K121Q, rs1044498) and genetic susceptibility to obesity. However, such relationship is not reproduced by some currently available studies. In this context, the present study is aimed to quantitatively analyze the association of K121Q variant with obesity in all published case-control studies in European adult populations.

METHODSPublished literature from PubMed, EMBASE, and ISI web of science databases were retrieved. The studies evaluating the association of ENPP1/PC1 gene K121Q polymorphism with obesity were included, in which sufficient data were presented to calculate the odds ratio (OR) with 95% confidence intervals (CIs).

RESULTSTen case-control studies meeting the inclusion criteria identified a total of 24,324 subjects including 11,372 obese and 12,952 control subjects. The meta-analysis results showed a statistically significant association of K121Q with obesity [OR (95%CI): 1.25 (1.04-1.52) P=0.021] under a recessive model of inheritance (QQ vs. KK+KQ) without heterogeneity or publication bias.

CONCLUSIONSThe results from the present study have indicated that ENPP1/PC1 Q121 variant may increase the risk of obesity and that more well-designed studies based on a larger population will be required to further evaluate the role of ENPP1/PC1 gene K121Q polymorphism in obesity and other related metabolic syndromes.

Europe ; epidemiology ; Genetic Predisposition to Disease ; Humans ; Obesity ; epidemiology ; genetics ; Odds Ratio ; Phosphoric Diester Hydrolases ; genetics ; Polymorphism, Genetic ; Pyrophosphatases ; genetics ; Risk Factors

Objective To assess the value of 64-slice computer tomography used in the preoperative evaluation of rectal cancer to predict the operative procedures. Methods There were 51 pathologically proven rectal cancer patients recruited, undergoing multi-slice computer tomagraphy (MSCT) assessment preoperatively. Preoperative MSCT stage and predictive operative procedures were recorded to compare with postoperative pathological stage and practical operative procedures. Kappa Coefficient for Diagnosis Coherence and Spearman correlation analysis were performed. Results The overall accuracy of CT-TNM stages were 74.5% which led to high coherence to pathological TNM stage ( Kappa value = 0.658,P=0.000). The univariate analysis showed that distance from tumor to dentate line (F = 3.386, P =0.042 ) and tumor thickness (F = 4.542, P = 0.016) was a statistically risk factor for operative procedures. Moreover, the significant correlation between tumor thickness (cc =0.319, P =0.023 ), as well as CT-M stage (cc = 0.369, P = 0.008) and CT-TNM stage ( cc = 0.365, P = 0. 008), and operative procedures was observed, by means of conducting Spearman correlation. The possibility of developing palliative stoma was 75%, when sufficing both CT-MI stage and tumor thickness ≥20 mm; The possibility of performing sphincter sparing radical operation reached 86% when both CT-T stage < 4 and distance from tumor to dentate line were referred by MSCT. Conclusion The objective parameters influencing development of operative procedures, involving tumor thickness, CT-M stage and CT-T stage, can be rendered by MSCT preoperative assessment, which served as valuable reference for clinical decision of operative procedures in retal cancer.

The interaction between immune response and metabolic regulation can be viewed as a central homeostatic mechanism,dysfunction of which will lead to many diseases.This nonlinear interaction,which has the characteristic of super-complexity,can’t be controlled unless it is studied as a holism and the change of condition is researched.To study this homeostasis,bottom-up method used in system biology is limited.Ying-wei theory of TCM uses another method to describe di erent states of metabolic and immune systems e ectively.The unique approaches and rich experiences applied in TCM are of great value.