Antibody-drug conjugates （ADCs） are a novel class of anti-tumor agents composed of a targeted monoclonal antibody， a cytotoxic drug， and a linker connecting the two. They combine the high specificity of antibodies with the potent cytotoxicity of chemotherapeutic agents. Triple-negative breast cancer （TNBC） is characterized by high aggressiveness， elevated risks of recurrence and metastasis， and poor prognosis， largely due to the lack of effective therapeutic targets. This review summarizes the research progress of ADCs in the treatment of TNBC. It has been found that ADCs targeting human epidermal growth factor receptor 2 （such as trastuzumab deruxtecan）， trophoblast cell surface antigen 2 （such as sacituzumab govitecan and datopotamab deruxtecan）， zinc transporter LIV-1 （such as ladiratuzumab vedotin）， HER-3 （such as patritumab deruxtecan）， epidermal growth factor receptor （such as AVID100）， and glycoprotein non-metastatic melanoma protein B （such as glembatumumab vedotin） have all demonstrated promising therapeutic effects against TNBC. Despite challenges including acquired resistance and treatment-related toxicities， ADCs are undoubtedly reshaping the therapeutic landscape for TNBC and are expected to occupy a more central position in TNBC treatment in the future.

Objective To observe the value of T1 mapping combining diffusion weighted imaging(DWI)for noninvasive preoperative predicting tumor-infiltrating lymphocyte(TIL)level in invasive breast cancer.Methods Totally 143 patients with invasive breast cancer were retrospectively collected and divided into high group(TIL≥10％,n=73)and low group(TIL＜10％,n=70)according to TIL level by postoperation pathology.Clinicopathological information were collected,MRI features of breast cancer lesions were documented,mean T1 values(T1mean)and mean ADC values(ADCmean)were measured,and then were compared between groups.Multivariate logistic regression analysis was used to identify independent predictive factors of TIL levels,and a nomogram was constructed based on regression model.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the predictive value for TIL levels.Results Compared with low group,high group had higher proportion of human epidermal growth factor receptor 2(HER2)positivity(P＜0.05),and showed more circular/oval shapes and more smooth margins but less peritumoral edema(all P＜0.05).Significant differences of lesions enhancement pattern was found between groups(P＜0.05).T1mean and ADCmean were both higher in high group than those in low group(both P＜0.05).Lesions enhancement pattern,T1mean and ADCmean were all independent predictors of TIL levels in breast cancer.The AUC of nomogram combining the above 3 factors for predicting TIL level was 0.848,significantly higher than that of lesions enhancement pattern(AUC=0.569,Z=5.384,P＜0.05)and T1mean(AUC=0.662,Z=3.876,P＜0.05),but not statistically different with that of ADCmean(AUC=0.814,Z=1.578,P=0.115).Decision curve analysis showed that this nomogram had good clinical application value.Conclusion Combining T1 mapping and DWI could effectively predict level of TIL level in breast cancer before surgery.

Objective To observe the value of T1 mapping combining diffusion weighted imaging(DWI)for noninvasive preoperative predicting tumor-infiltrating lymphocyte(TIL)level in invasive breast cancer.Methods Totally 143 patients with invasive breast cancer were retrospectively collected and divided into high group(TIL≥10％,n=73)and low group(TIL＜10％,n=70)according to TIL level by postoperation pathology.Clinicopathological information were collected,MRI features of breast cancer lesions were documented,mean T1 values(T1mean)and mean ADC values(ADCmean)were measured,and then were compared between groups.Multivariate logistic regression analysis was used to identify independent predictive factors of TIL levels,and a nomogram was constructed based on regression model.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the predictive value for TIL levels.Results Compared with low group,high group had higher proportion of human epidermal growth factor receptor 2(HER2)positivity(P＜0.05),and showed more circular/oval shapes and more smooth margins but less peritumoral edema(all P＜0.05).Significant differences of lesions enhancement pattern was found between groups(P＜0.05).T1mean and ADCmean were both higher in high group than those in low group(both P＜0.05).Lesions enhancement pattern,T1mean and ADCmean were all independent predictors of TIL levels in breast cancer.The AUC of nomogram combining the above 3 factors for predicting TIL level was 0.848,significantly higher than that of lesions enhancement pattern(AUC=0.569,Z=5.384,P＜0.05)and T1mean(AUC=0.662,Z=3.876,P＜0.05),but not statistically different with that of ADCmean(AUC=0.814,Z=1.578,P=0.115).Decision curve analysis showed that this nomogram had good clinical application value.Conclusion Combining T1 mapping and DWI could effectively predict level of TIL level in breast cancer before surgery.

Objective To observe the clinical efficacy and safety of external application of Piyan Formula in treating epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKIs)-related rashes.Methods Sixty cases of EGFR-TKIs-related rash patients were randomly allocated into either a treatment group or a control group.The treatment group received external application of Piyan Formula to the rash area twice daily for 14 days.The control group received external application of fucidic acid cream to the rash area twice daily for 14 days.Changes in rash grading,itching grading,quality of life scores and adverse event were observed and recorded in both groups.At the same time,levels of hypersensitive C-reactive protein,interleukin(IL)-6,and IL-1β were measured before treatment and 24 hours after treatment.Results After treatment,the rash severity,itching severity,and quality of life scores were notably lower in the treatment group compared to the control group(P<0.05).The levels of hypersensitive C-reactive protein,IL-6,and IL-1β exhibited a significant decrease compared to their pre-treatment values.(P<0.05).Compared with the control group,the levels of hypersensitive C-reactive protein,IL-6,and IL-1β decreased in the treatment group,with statistically significant differences(P<0.05).No adverse events related to Piyan Formula or fucidic acid cream occurred during the treatment process.Conclusion External application of Piyan Formula in treating EGFR-TKIs-related rashes shows significant clinical efficacy,can effectively reduce the levels of inflammatory factors,and has high safety,thus warranting clinical promotion.

Background::Although significant advances have been made in the treatment of multiple myeloma (MM), leading to unprecedented response and survival rates among patients, the majority eventually relapse, and a cure remains elusive. This situation is closely related to an incomplete understanding of the immune microenvironment, especially monocytes/macrophages in patients with treatment-na?ve MM. The aim of this study was to provide insight into the immune microenvironment, especially monocytes/macrophages, in patients with treatment-na?ve MM.Methods::This study used the single-cell RNA sequencing (scRNA-seq) data of both patients with MM and heathy donors to identify immune cells, including natural killer (NK) cells, T cells, dendritic cells (DCs), and monocytes/macrophages. Transcriptomic data and flow cytometry analysis of monocytes/macrophages were used to further examine the effect of monocytes/macrophages in treatment-na?ve MM patients.Results::A significant difference was observed between the bone marrow (BM) immune cells of the healthy controls and treatment-na?ve MM patients through scRNA-seq. It is noteworthy that, through an scRNA-seq data analysis, this study found that interferon (IFN)-induced NK/T cells, terminally differentiated effector memory (TEMRA) cells, T-helper cells characterized by expression of IFN-stimulated genes (ISG +Th cells), IFN-responding exhausted T cells, mannose receptor C-type 1 (MRC1) + DCs, IFN-responding DCs, MHCII + DCs, and immunosuppressive monocytes/macrophages were enriched in patients with treatment-na?ve MM. Significantly, transcriptomic data of monocytes/macrophages demonstrated that "don’t eat me" -related genes and IFN-induced genes increase in treatment-na?ve MM patients. Furthermore, scRNA-seq, transcriptomic data, and flow cytometry also showed an increased proportion of CD16 + monocytes/macrophages and expression level of CD16. Cell-cell communication analysis indicated that monocytes/macrophages, whose related important signaling pathways include migration inhibitory factor (MIF) and interleukin 16 (IL-16) signaling pathway, are key players in treatment-na?ve MM patients. Conclusions::Our findings provide a comprehensive and in-depth molecular characterization of BM immune cell census in MM patients, especially for monocytes/macrophages. Targeting macrophages may be a novel treatment strategy for patients with MM.

OBJECTIVE：To explore t he risk factors that may lead to the ineff ectiveness of using palonosetron combined with dexamethasone to prevent chemotherapy-induced nausea and vomiting （CINV），and to provide a reference for the rational choice and use of antiemetic drugs. METHODS ：In a retrospective case-control study ，871 patients who used palonosetron combined with dexamethasone to prevent CINV in a tertiary cancer hospital from 2016 to 2020 were selected as the object. Totally 32 related data such as demographic data ，living habits ，medical history ，examination information and treatment information were counted as variables. Combined with single factor regression ，multi-factor regression， likelihood ratio forward or backward stepwise 163.com regression were used to comprehensively screen the factors for many times. The standard target factors screened by stepwise E-mail：kongtiandong@126.com regression were included in the multivariate Logistic regression analysis，and the regression model was evaluated by the ROC c urve. RESULTS ：The multivariate Logistic regression model fitted well（AUC in ROC was 0.83，but 0.82 after screening ）. The results showed that there were 15 statistically significant independent influential factors ，including 12 independent risk factors ，ie. poor nutritional status （OR＝2.11，95％CI（1.05，4.22），P＝0.036）， history of gastrointestinal disease （OR＝2.76，95％CI（1.87，4.07），P＜0.001），abnormal electrolyte level （OR＝2.54，95％CI （1.74，3.69），P＜0.001），nausea and vomiting 24 h before chemotherapy （OR＝8.47，95％CI（3.28，21.91），P＜0.001），history of chemotherapy-induced vomiting （OR＝3.20，95％ CI （2.18，4.71），P＜0.001），high risk level of vomiting caused by chemotherapy（OR＝3.16，95％CI（2.38，4.20），P＜0.001），application of opioid combined with non-steroidal analgesics （OR＝ 4.18，95％CI（2.06，8.49），P＜0.001），the use of other drugs that stimulate the intestine and stomach （OR＝2.49，95％CI（1.28， 4.83），P＝0.007），history of surgery （OR＝1.88，95％CI（1.34，2.63），P＜0.001），high level of albumin （OR＝1.05，95％CI （1.01，1.08），P＝0.015），multiple days of single chemotherapy （OR＝1.69，95％CI（1.11，2.56），P＝0.014），and opioid analgesia medicine （OR＝1.71，95％CI（1.15，2.53），P＝0.007）；and the following 3 independent protective factors included long time of diagnosis （OR＝0.65，95％CI（0.46，0.93），P＝0.019），non-first chemotherapy （OR＝0.52，95％CI（0.33，0.83），P＝ 0.006），and drugs combined chemotherapy （OR＝0.55，95％CI（0.34，0.90），P＝0.018）. CONCLUSIONS ：Patients with the following conditions are more likely to experience CINV prevention ineffectiveness ，ie. single long-term chemotherapy ，application of chemotherapy plan with a higher risk of emesis ，history of chemotherapy-induced vomiting ，history of gastrointestinal diseases ， nausea and vomiting 24 hours prior to chemotherapy ，history of surgery ，within 1 year of diagnosis ，chemotherapy for the first time，use of opioids ，use of 5-HT3 reuptake inhibitors ，malnutrition and electrolyte disorders.

Objective To investigate the relation between the characteristics of CD8+T lymphocyte infiltration and the prognosis of triple-negative breast cancer patients. Methods We retrospectively analyzed the clinicopathological data of 126 patients with triple-negative breast cancer undergoing preoperative neoadjuvant chemotherapy. Immunohistochemical staining was used to analyze the relation between CD8+T lymphocyte infiltration and clinicopathological characteristics. Kaplan-Meier method was used to draw the survival curve, and Cox risk ratio regression model was used to analyze the prognostic factors affecting disease-free survival time (DFS). Results High-density CD8+Tils was associated with age < 60 years old, high pathological grade and high clinical stage (P < 0.05). The pCR rate of high-density CD8+Tils group was higher than that of the low-density group (66.7% vs. 19.8%, P=0.000). The median DFS of the high-density group was significantly longer than that of the low-density group (49 vs. 25 months, P < 0.05). Multivariate analysis showed that high pathological grade, tumor diameter > 2 cm, lymph node metastasis, vascular invasion and CD8+Tils low-density infiltration were factors for poor prognosis (P < 0.05), and CD8+Tils was an independent prognostic factor. Conclusion CD8+Tils may be an independent prognostic indicator for triple-negative breast cancer. The patients with high-density infiltration have high postoperative pCR rate, long DFS and better long-term efficacy.

Objective To investigate the prognostic factors of patients with upper urinary tract urothelial carcinoma (UTUC) treated with gemcitabine plus cisplatin (GC).Methods The clinical and follow-up data of 80 patients with UTUC admitted to Beijing Friendship Hospital,Capital Medical University from January 2013 to July 2018 were retrospectively analyzed.All patients underwent UTUC radical surgery.All patients were treated with GC regimen:1,8,and 15 days,Gemcitabine 800 mg/m2,intravenous infusion over 30 min;day 2 Cisplatin 70 mg/m2,protected from light 2 h intravenous drip;28 d for 1 cycle.Adjuvant treatments such as acid suppression,hydration,and antiemetic were given before and after chemotherapy.Patients completed 1 to 5 cycles with an average of 2 cycles.The patient's age,gender,presence or absence of water,primary tumor site,tumor stage and grade,lymphatic vascular infiltration,tumor recurrence,lymph node metastasis,organ metastasis,chemotherapy cycle,total Survival,etc.are used as indicators ofobservation.Univariate analysis of the patient's overall survival,screening for clinical variables associated with prognosis,and then using the COX proportional hazards model for multivariate prognostic analysis to determine independent influencing factors.Results Eighty patients with UTUC were followed up for 2 to 72 months with a median follow-up of 27 months.Sixteen patients (20％) died of UTUC recurrence or metastasis,and 64 (80％) patients survived.The 1-year cumulative survival rate was 78.26％ (18/23),and the 2-year cumulative survival rate was 54.18％ (9/13 ×78.26％),the 3-year cumulative survival rate was 39.41％ (8/1 1 × 54.18％),the 4-year cumulative survival rate was 31.53％ (12/15 × 39.41％),and the 5-year cumulative survival rate was 28.66％ (10/11 × 31.53％).Univariate analysis showed combined hydronephrosis (P =0.023),lymphatic vessel infiltration (LVI) (P =0.001),tumor TNM stage (P =0.002),tumor recurrence (P =0.008),simple lymph node metastasis (P =0.005),organ metastasis (P ＜ 0.001) was related to survival rate.COX model multivariate analysis showed that the independent risk factors associated with survival of patients with UTUC receiving chemotherapy with GC regimen were hydronephrosis (HR =4.355,95％CI:1.232-15.390,P=0.022),LVI (HR =0.133,95％ CI:0.035-0.509,P=0.003),TNM stage (HR=0.099,95％CI:0.010-0.929,P=0.043).Conclusion The presence or absence of hydronephrosis,LVI,and tumor TNM staging are independent factors influencing the prognosis of patients with UTUC who have adjuvant chemotherapy.

OBJECTIVE:To observe the effects of epidural anesthesia analgesia on childbearing. METHODS:197 delivery woman were randomly divided into observation group (95 cases) and control group (102 cases). Control group was given natural childbirth,and observation group was additionally given epidural anesthesia analgesia. Neonatal Apgar score (5 min),behavioral neurological score and VAS,mother-infant situation,the incidence of ADR were compared between 2 groups. RESULTS:There was no statistical significance in neonatal Apgar score and behavioral neurological score between 2 groups (P>0.05);VAS score and the rate of cesarean section in observation group was significantly lower than in control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of postpartum hemorrhage,vaginal midwifery and asphyxia neonatorum (P>0.05). ADR as itchy skin,nausea and vomiting,headache,limb numbness of observation group were improved after symptomat-ic treatment. CONCLUSIONS:The epidural anesthesia analgesia have no effect on childbearing and can relieve labor pain with good safety.

There are two kinds of treatments on Alzheimer's disease (AD) rat by transplanting neural stem cells (NSCs),i.e.the replacing cell curing and the gene therapy.By replacing method,the AD rats showed signs of recovering to some extent on both histomorphology and behavior after transplanting NSCs into their brains.Transplanting NSCs along with the nerve nutrition factor (NTFs) showed better curative effects than NSCs transplantation alone.However,little is known about the molecular mechanism involving in the development of NSCs in vivo conditions.And the blindness of the treatment hindered the comparison of various affecting factors.The NSCs gene therapy is still in initial studying,with the effects of both cell replacement and gene therapy.This treatment genetically modified NSCs mainly by unitary nutrition fators such as nerve growth factor (NGF),brain-derived neurotrophic factor (BDNF),and glial cell line-derived neurotrophic factor (GDNF).And it was almost known nothing about the exogenous gene expression efficiency,the induce differentiation,the restore of function and security after genetically-modified NSCs transplanted into the AD rat brain.The detecting technology of NSCs transplanting curative effects of the AD rat is unitary at present.And the combined method is the developing trend,such as combining the immunohistochemical method with in vivo-tracking,and combining morphology index with the function index.