BACKGROUND: This study aimed to investigate programmed death-ligand 1 tumor proportion score in predicting the safety and efficacy of PD-1/PD-L1 antibody-based therapy in treating patients with advanced non-small cell lung cancer (NSCLC) in a real-world setting. METHODS: This retrospective, multicenter, observational study enrolled adult patients who received PD-1/PD-L1 antibody-based therapy in China and met the following criteria: (1) had pathologically confirmed, unresectable stage III-IV NSCLC; (2) had a baseline PD-L1 tumor proportion score (TPS); and (3) had confirmed efficacy evaluation results after PD-1/PD-L1 treatment. Logistic regression, Kaplan-Meier analysis, and Cox regression were used to assess the progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAEs) as appropriate. RESULTS: A total of 409 patients, 65.0% ( n = 266) with a positive PD-L1 TPS (≥1%) and 32.8% ( n = 134) with PD-L1 TPS ≥50%, were included in this study. Cox regression confirmed that patients with a PD-L1 TPS ≥1% had significantly improved PFS (hazard ratio [HR] 0.747, 95% confidence interval [CI] 0.573-0.975, P = 0.032). A total of 160 (39.1%) patients experienced 206 irAEs, and 27 (6.6%) patients experienced 31 grade 3-5 irAEs. The organs most frequently associated with irAEs were the skin (52/409, 12.7%), thyroid (40/409, 9.8%), and lung (34/409, 8.3%). Multivariate logistic regression revealed that a PD-L1 TPS ≥1% (odds ratio [OR] 1.713, 95% CI 1.054-2.784, P = 0.030) was an independent risk factor for irAEs. Other risk factors for irAEs included pretreatment absolute lymphocyte count >2.5 × 10 9 /L (OR 3.772, 95% CI 1.377-10.329, P = 0.010) and pretreatment absolute eosinophil count >0.2 × 10 9 /L (OR 2.006, 95% CI 1.219-3.302, P = 0.006). Moreover, patients who developed irAEs demonstrated improved PFS (13.7 months vs. 8.4 months, P <0.001) and OS (28.0 months vs. 18.0 months, P = 0.007) compared with patients without irAEs. CONCLUSIONS A positive PD-L1 TPS (≥1%) was associated with improved PFS and an increased risk of irAEs in a real-world setting. The onset of irAEs was associated with improved PFS and OS in patients with advanced NSCLC receiving PD-1/PD-L1-based therapy.
Humans ; Carcinoma, Non-Small-Cell Lung/metabolism* ; Male ; Female ; Retrospective Studies ; Middle Aged ; Lung Neoplasms/metabolism* ; Aged ; B7-H1 Antigen/metabolism* ; Programmed Cell Death 1 Receptor/metabolism* ; Adult ; Aged, 80 and over ; Immune Checkpoint Inhibitors/therapeutic use*

This study aims to investigate the therapeutic efficacy of 50 Hz-0.6 mT low-frequency pulsed electromagnetic field (PEMF) on postmenopausal osteoporosis in ovariectomized rats. Thirty 3-month-old female SD rats were selected and divided into a sham operation group (Sham), an ovariectomized model group (OVX), and a low-frequency pulsed electromagnetic field (PEMF) treatment group, with 10 rats in each group. After 8 weeks, the whole-body bone mineral density (BMD) of each group of rats was measured. The treatment group began to receive PEMF stimulation for 90 minutes daily, while the OVX group only received a simulated placement without electricity. After 6 weeks of intervention, all rats were sacrificed and tested for in vitro BMD, micro-CT, biomechanics, serum biochemical indicators, and bone tissue-related proteins. The results showed that the BMD of the OVX group was significantly lower than that of the Sham group 8 weeks after surgery, indicating successful modeling. After 6 weeks of treatment, compared with the OVX group, the PEMF group exhibited significantly increased BMD in the whole body, femur, and vertebral bodies. Micro-CT analysis results showed improved bone microstructure, significantly increased maximum load and bending strength of the femur, elevated levels of serum bone formation markers, and increased expression of osteogenic-related proteins. In conclusion, this study demonstrates that daily 90-minute exposure to 50 Hz-0.6 mT PEMF effectively enhances BMD, improves bone biomechanical properties, optimizes bone microstructure, stimulates bone formation, and inhibits bone resorption in ovariectomized rats, highlighting its therapeutic potential for postmenopausal osteoporosis.
Female ; Animals ; Rats, Sprague-Dawley ; Osteoporosis, Postmenopausal/therapy* ; Rats ; Bone Density ; Ovariectomy ; Magnetic Field Therapy/methods* ; Electromagnetic Fields

OBJECTIVE To design and synthesize mono-carbonyl curcumin analogues(MCACs)and investigate the activities of them against breast cancer.METHODS The analogues F1,F2,and F3 were obtained by aldol condensation reaction,and their antitumor activities(including the activities of human breast cancer cell MCF-7 and human lung cancer cell A549)were detected by MTT assay[evaluated with half inhibitory concentration(IC50)].The results of MTT assay were compared with those of curcumin.Bioinformatics methods were used to collect the core targets of analogues F1,F2 and F3 acting on breast cancer,and then molecular docking verification was carried out.The cell experiments were conducted to investigate the effects of high,medium and low concentrations(16,8,4 μmol/L)of F1,F2 and F3 on the expression of the first core target protein as well as the effects of medium concentration of F1,F2 and F3 on the expression of cleaved-caspase-3.RESULTS Compared with curcumin,IC50 of analogues F1,F2 and F3 to A549 and MCF-7 cells(except for IC50 of analogue F2 to A549 cells)were decreased significantly(P＜0.05 or P＜0.01);among them,IC50of analogue F2 to MCF-7 cell was the lowest,being(9.67±1.27)μmol/L.Bioinformatics analysis showed that index of affinity of analogues F1,F2 and F3 with the first core target epidermal growth factor receptor(EGFR),protein kinase B(AKT)and AKT were 5.909 2,8.402 5 and 6.486 6,respectively;high concentration of F1 could significantly reduce the phosphorylation level of EGFR protein in MCF-7 cells(P＜0.01),while low,medium,and high concentrations of F2 and high concentration of F3 could significantly reduce the phosphorylation level of AKT protein in MCF-7 cells(P＜0.05 or P＜0.01).Medium concentration of F1,F2,and F3 could significantly increase the expression level of cleaved-caspase-3 protein in MCF-7 cells(P＜0.01).CONCLUSIONS Designed and synthesized MCACs F1,F2 and F3 all have good anti-breast cancer activity,and F2 has better anti-breast cancer activity.

Objective To construct a quality evaluation index system for non-medical technical services in public hospitals,aiming to provide a more scientific and feasible basis for evaluating patient service quality.Methods Based on literature research,the SERVQUAL theory was used to preliminarily formulate a comprehensive and full-cycle evaluation index for patient service quality.The final evaluation index system was determined through expert consultation,and the Analytic Hierarchy Process was used to determine the weights of the evaluation indices.Results The questionnaire response rates for the two rounds of expert consultation were both 100％.The authority coefficients of the experts were 0.82 and 0.80,respectively,indicating a high level of expert authority.The Kendall's W coefficient increased from 0.088 to 0.107 between the two rounds,and the difference was statistically significant (P<0.001),indicating good consistency of expert opinions.The consistency results of each judgment matrix were less than 0.1,passing the consistency test.The final evaluation index system consisted of six primary indicators (tangibility,reliability,responsiveness,assurance,empathy,and continuity) and 33 secondary indicators.Conclusion The selection of evaluation indicators revolves around the core service processes of outpatient,inpatient,and other hospital services,focusing on key elements at various critical junctures that influence patient experience.The evaluation indicators aim to guide hospitals to improve not only essential needs but also desired improvements in service quality,thus promoting the continuous enhancement of hospital services.

Objective To explore the value of the albumin-to-alkaline phosphatase ratio(AAPR)with modified Glasgow prognostic score(mGPS)in assessing the response to and prognosis of intravesical Bacillus Calmette-Guérin(BCG)therapy in patients with non-muscle invasive bladder cancer(NMIBC).Methods A total of 153 high-risk NMIBC patients treated with intravesical BCG in our hospital during Jan.2018 and Oct.2021 were enrolled.Patients were divided into response and non-response groups based on the treatment efficacy,and into good and poor prognosis groups based on the clinical outcomes.AAPR and mGPS were calculated.The relationship between AAPR,mGPS and BCG treatment non-response was analyzed with multivariate logistic regression.Clinical data and scores were compared between prognosis groups.The associations between AAPR,mGPS,and poor prognosis after BCG treatment were assessed with a Cox proportional hazards model.Patients were stratified into high-and low-A APR groups,and into mGPS 0,1,and 2 groups.Kaplan-Meier survival curves were plotted for progression-free survival(PFS)across different AAPR and mGPS strata.The diagnostic performance of AAPR combined with mGPS in predicting treatment non-response and poor prognosis was evaluated using receiver operating characteristic(ROC)curves.Results Among the 153 patients,the response rate to BCG treatment was 71.90％(110/153),the 3-year poor prognosis rate was 45.75％(70/153),and the 3-year PFS rate was 54.25％(83/153).Increased AAPR was identified as an independent protective factor for both treatment response and good prognosis,while higher mGPS was an independent risk factor(P＜0.05).The 3-year PFS rate was significantly higher in the high-AAPR group than in the low-A APR group(P＜0.001).Among the mGPS groups,the 3-year PFS rate was lowest in the mGPS 2 group,followed by mGPS 1 and mGPS 0 groups(P＜0.001).The area under the ROC curve(AUC)for AAPR with mGPS in predicting BCG treatment non-response and poor prognosis was 0.864 and 0.901,respectively,significantly higher than using AAPR(0.774,0.781)or mGPS alone(0.798,0.809)(P＜0.05).Conclusion Lower AAPR and higher mGPS are associated with non-response and poor prognosis in NMIBC patients undergoing intravesical BCG therapy.The combination of AAPR and mGPS has high predictive value.

Objective To compare the efficacy of artificial intelligence(AI)diagnostic group and artificial reading group in the diagnosis for osteoporotic vertebral compression fractures.Methods From January 2023 to December 2023,80 patients with osteoporotic vertebral compression fractures and 20 patients without fractures but with nonspecific low back pain were included in the study.According to the patient's computed tomography(CT)image,the AI software diagnosis and physicians of different seniority(one senior physician,one intermediate physician and one junior physician)diagnosis were performed.The diagnostic efficacy of different detection methods was compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and area under the receiver operating characteristic(ROC)curve(AUC)and Kappa value of each group were as follows:AI image interpretation:0.975,0.900,0.975,0.900,0.938,0.875;senior physician:0.950,0.900,0.974,0.818,0.925,0.819;intermediate physician:0.825,0.850,0.957,0.548,0.837,0.560;and junior physician:0.750,0.750,0.923,0.429,0.751,0.390.Conclusion The diagnostic performance of AI was comparable to that of senior physician,and significantly higher than that of intermediate and primary physicians.

Malignant tumors (commonly referred to as cancer) represent a major global public health challenge and contribute significantly to the worldwide disease burden. Early screening plays a critical role in improving detection rates, enabling timely intervention, and enhancing patient survival rates. However, current cancer screening guidelines primarily focus on site-specific screening, which may not fully address the need for comprehensive early detection. A scientifically rational, multi-cancer screening approach offers several advantages: it optimizes the use of biological samples, reduces time costs for participants, enhances the efficiency and comprehensiveness of screening, and minimizes overall expenses. Such an approach also facilitates the rational allocation of healthcare resources, ultimately helping to reduce the societal burden of cancer. To address this need, the Cancer Epidemiology Committee of the Chinese Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers in China. This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and international researches on cancer screening, early detection, and treatment for prevalent malignancies. Drawing upon China's unique demographic and healthcare context, as well as practical screening experiences, the consensus provides evidence-based recommendations on target populations, screening technologies, and procedural workflows for multi-cancer screening. These guidelines align with the principles and methodologies established by the World Health Organization (WHO), aiming to enhance the effectiveness of combined cancer screening in China, improve early detection rates, and provide a scientific foundation for national cancer prevention and control strategies.

Cancer stands as a significant global public health challenge, and cancer screening serves as a pivotal strategy for reducing its mortality. Presently, only a limited number of cancer types have appropriate screening methods available. Traditional single-cancer screening approaches are fraught with limitations, including invasiveness, low accuracy, and poor patient compliance. Multi-cancer early detection (MCED) leveraging liquid biopsy technology enables non-invasive and efficient early detection of multiple cancers by analyzing biomarkers such as cell-free DNA, cell-free RNA, proteins, and metabolites in blood and other bodily fluids. This innovative approach substantially broadens the spectrum of detectable cancers and enhances population coverage, showcasing immense potential for improving existing cancer screening strategies. This expert consensus comprehensively reviews the progress of liquid biopsy-based MCED, biomarker selection and detection technologies, the criteria for cancer type selection, research design and clinical utility evaluation, as well as implementation pathways. The overarching goal of this consensus is to offer scientific guidance for further research and the widespread adoption of MCED, thereby facilitating the continuous optimization of cancer screening strategies.

Objective To detect the expression of N-acetyltransferase 10(NAT10)and polyadenylate bind-ing protein cytoplasmic 1(PABPC1)in non muscle invasive bladder cancer(NMIBC),and analyze the correla-tion between them and epithelial mesenchymal transition(EMT)and prognosis.Methods A total of 122 pa-tients with NMIBC treated in the hospital from May 2019 to May 2021 were selected.Immunohistochemistry was used to detect the expression of NAT10 and PABPC1 proteins in NMIBC tissues.Real time fluorescence quantitative polymerase chain reaction(qPCR)was used to detect the expression of NAT10,PABPC1 mRNA,and EMT markers in NMIBC tissues.Pearson correlation analysis was conducted on the correlation between EMT indicators[Snail,N-cadherin(N-cad),vimentin(Vim)mRNA].Cox regression analysis was conducted on the relationship between NAT10,PABPC1 and prognosis of NMIBC.Results Compared with adjacent tis-sues,the expression of NAT10 mRNA,PABPC1 mRNA,Snail mRNA,N-cad mRNA,and Vim mRNA in NMIBC cancer tissues was higher,and the difference was statistically significant(P＜0.001).The expression of NAT10 mRNA,PABPC1 mRNA in NMIBC cancer tissues was positively correlated with Snail mRNA,N-cad mRNA,and Vim mRNA(r=0.678,0.702,0.711,0.754,0.788,0.663,P＜0.001).The positive rates of NAT10 and PABPC1 in NMIBC cancer tissues were 59.02％(72/122)and 60.66％(74/122),respectively,while those in adjacent tissues were 6.56％(8/122)and 4.92％(6/122),respectively(x2=76.176,85.995,P＜0.001).The positive rates of NAT10 and PABPC1 in NMIBC cancer tissues were higher than those in ad-jacent tissues,and the difference was statistically significant(x2=76.176,85.995,P＜0.001).The positivity rates of NAT10 and PABPC1 in cancer tissues of stage T1,high-grade NMIBC patients were higher than those in cancer tissues of Ta/Ti,low-grade patients,and the differences were statistically significant(P＜0.05).The 3-year overall progression free survival rates of NMIBC patients in the NAT10 positive and negative groups were 48.61％(35/72)and 80.00％(40/50),respectively,with a statistically significant difference(Log rank x2=13.780,P=0.000).The 3-year overall progression free survival rates of PABPC1 positive and negative patients were 47.30％(35/74)and 83.33％(40/48),respectively,with a statistically significant difference(Log rank x2=11.830,P=0.001).T1 stage,high-grade,NAT10 positive,and PABPC1 positive were risk fac-tors affecting the prognosis of NMIBC.Conclusion The expression of NAT10 and PABPC1 in NMIBC cancer tissue is significantly upregulated and positively correlated with EMT markers,which is correlated with poor prognosis of NMIBC.