Objective : To explore the factors influencing the efficacy of first-generation EGFR tyrosine kinase inhibitors(EGFR-TKIs) in patients with EGFR-mutated advanced lung adenocarcinoma and to construct and validate a corresponding nomogram prediction model. Methods : A total of 220 patients with EGFR-mutated advanced lung adenocarcinoma treated with icotinib were enrolled and randomly divided into a training group(154 cases) and a validation group(66 cases) in a 7 ∶3 ratio. Cox regression analysis was performed to identify factors affecting the efficacy of first-generation EGFR-TKIs in the training group. A prediction model was constructed, and calibration curves and receiver operating characteristic(ROC) curves were plotted to validate the model′s performance. Results: In the training group, the objective response rate was 35.71%, the disease control rate was 77.27%, the median progression-free survival(PFS) was 12.5 months, the median overall survival was 18 months, the 2-year OS rate was 66.23%, and the PFS rate was 42.21%. Univariate analysis showed that brain metastasis, bone metastasis, TNM stage, differentiation degree, neutrophil-to-lymphocyte ratio(NLR), post-treatment p53 levels, p53 difference(Δp53), post-treatment cancer antigen gene(CAGE) levels, and CAGE difference(ΔCAGE) were associated with PFS(P2=4.429, P=0.351). ROC curve analysis in the training group showed that the nomogram model had a sensitivity of 80.00%, specificity of 77.53%, and AUC of 0.864 for predicting therapeutic efficacy, while the validation group showed a sensitivity of 74.08%, specificity of 71.43%, and AUC of 0.835. Conclusion Changes in lung cancer autoantibodies(Δp53 and ΔCAGE), TNM stage, and NLR are key factors influencing the efficacy of first-generation EGFR-TKIs in EGFR-mutated advanced lung adenocarcinoma. The nomogram prediction model based on p53 and CAGE demonstrates good predictive performance.

Objective To observe the inhibitory effect of the antibodies against midgut-protein-ingredient of Anopheles stephensi on the oocysts of Plasmodium yoelii.Methods Female An.stephensi mosquitoes raised in laboratory were dissected and the midguts were collected.Eight BALB/c mice were immunized using midgut-protein(100 ?g/mouse,4 times with an interval of 7～10day).Ten days after the last immunization,blood was taken from mice armpit artery and serum separated.The immune active antigen of the midgut protein was analyzed by Western blotting.Protein with Mr 38 000～50 000 was separated by sephadex filtering and used to immunize 12 BALB/c mice(100 ?g/mouse,4 times with interval of 7～10 days).PBS control group was established.Seven days after the last immunization,serum antibody was detected by ELISA.When the antibody titer in immunized mice reached ≥1:2 560,mice in both groups were infected by P.yoelii(about 2?107 plasmodium-infected RBC) by abdominal injection.The mosquitoes were fed on the infected mice when the number of female gametes was higher than 2 per 10 microscopical fields 3 days later.After 9 days,the mosquitoes were dissected and the amount of oocysts in midgut was counted.Results Eight protein bands were shown in midgut-protein of An.stephensi by Western blotting and the band of Mr 38 000～50 000-midgut-protein appeared clearer.The infection rate of oocysts in the experiment and control groups were 28.70%(62/216) and 51.09%(47/92) respectively(P