Invasive mucinous adenocarcinoma (IMA) is a rare subtype of pulmonary adenocarcinoma, accounting for approximately 2%-10% of all pulmonary adenocarcinoma cases. IMA is characterized by a high frequency of intrapulmonary metastasis and a generally poor prognosis. Clinically, IMA often presents with nonspecific pneumonia-like symptoms. Radiologically, it manifests as multilobar and multifocal consolidations and ground-glass opacities, which significantly overlap with the radiologic features of pneumonia and other benign or malignant tumors. Consequently, IMA is frequently misdiagnosed in clinical practice, and a definitive diagnosis is nearly impossible upon initial presentation, leading to delayed treatment and a poor prognosis. Currently, there is a lack of systematic reviews correlating the clinical manifestations, pathological characteristics, and radiologic features of IMA. This review aims to systematically elucidate the clinical, pathological, and radiologic features of IMA, and thoroughly analyze its diagnostic challenges and key points for differential diagnosis, in order to provide a theoretical basis and practical guidance for the early diagnosis of this disease.

Invasive mucinous adenocarcinoma (IMA) is a rare subtype of pulmonary adenocarcinoma, accounting for approximately 2%-10% of all pulmonary adenocarcinoma cases. IMA is characterized by a high frequency of intrapulmonary metastasis and a generally poor prognosis. Clinically, IMA often presents with nonspecific pneumonia-like symptoms. Radiologically, it manifests as multilobar and multifocal consolidations and ground-glass opacities, which significantly overlap with the radiologic features of pneumonia and other benign or malignant tumors. Consequently, IMA is frequently misdiagnosed in clinical practice, and a definitive diagnosis is nearly impossible upon initial presentation, leading to delayed treatment and a poor prognosis. Currently, there is a lack of systematic reviews correlating the clinical manifestations, pathological characteristics, and radiologic features of IMA. This review aims to systematically elucidate the clinical, pathological, and radiologic features of IMA, and thoroughly analyze its diagnostic challenges and key points for differential diagnosis, in order to provide a theoretical basis and practical guidance for the early diagnosis of this disease.

Invasive mucinous adenocarcinoma (IMA) is a rare subtype of pulmonary adenocarcinoma, accounting for approximately 2%-10% of all pulmonary adenocarcinoma cases. IMA is characterized by a high frequency of intrapulmonary metastasis and a generally poor prognosis. Clinically, IMA often presents with nonspecific pneumonia-like symptoms. Radiologically, it manifests as multilobar and multifocal consolidations and ground-glass opacities, which significantly overlap with the radiologic features of pneumonia and other benign or malignant tumors. Consequently, IMA is frequently misdiagnosed in clinical practice, and a definitive diagnosis is nearly impossible upon initial presentation, leading to delayed treatment and a poor prognosis. Currently, there is a lack of systematic reviews correlating the clinical manifestations, pathological characteristics, and radiologic features of IMA. This review aims to systematically elucidate the clinical, pathological, and radiologic features of IMA, and thoroughly analyze its diagnostic challenges and key points for differential diagnosis, in order to provide a theoretical basis and practical guidance for the early diagnosis of this disease.

At the 2024 Annual Meeting of the American Society of Clinical Oncology (ASCO), multiple research achievements in the field of colorectal cancer were announced. This article summarizes and interprets the research results related to colorectal cancer from the perspectives of local treatment progress, immunotherapy progress, targeted therapy, neoadjuvant therapy and surgery, and explores the hot spots, problems, and future directions of colorectal cancer treatment.

Objective To investigate the efficacy and safety of intravenous thrombolysis with low-dose and standard-dose recombinant tissue plasminogen activator(rt-PA)in the elderly patients(aged over 80 years)with acute ischemic stroke(AIS).Methods A total of 201 elderly patients with AIS treated at Tianjin Fourth Central Hospital from February 2019 to February 2023 were prospectively included and randomly assigned to the rt-PA low-dose group(n=93,0.6 mg/kg)and rt-PA standard-dose group(n=108,0.9 mg/kg).The incidence of intra-cranial hemorrhage,symptomatic intracranial hemorrhage,fatal intracranial hemorrhage,neurologic deterioration within 7 days and mortality within 90 days were observed to evaluate the safety.The neurologic improvement rate and good prognosis rate at 90 days were used to evaluate the effectiveness.A stratified analysis of 90-day outcomes was performed based on stroke severity and age.Results The incidence of intracranial hemorrhage,symptomatic intracranial hemorrhage and fatal intracranial hemorrhage within 7 days in rt-PA low-dose group was lower than that in rt-PA standard-dose group(P＜0.05).There were no statistically significant differences between the two groups concerning the residual safety index and the effectiveness index.The 90-day good prognosis rate of moderate stroke sub-group and of≥90 years of age sub-group in rt-PA low-dose group were both higher than that of rt-PA standard-dose group(P＜0.05).Conclusions For AIS patients with moderate stroke and aged over 90 years,intravenous thrombolytic therapy with rt-PA 0.6 mg/kg is recommended.

Endosomal TLRs (TLR3/7/8/9) are highly analogous innate immunity sensors for various viral or bacterial RNA/DNA molecular patterns. Among them, TLR7, in particular, has been suggested to be a target for various inflammatory disorders and autoimmune diseases including systemic lupus erythematosus (SLE); but few small-molecule inhibitors with elaborated mechanism have been reported in literature. Here, we reported a well-characterized human TLR7-specific small-molecule inhibitor, TH-407b, with promising potency and negligible cytotoxicity through a novel binding mechanism. Notably, TH-407b not only effectively inhibited TLR7-mediated pro-inflammatory signaling in a variety of cultured cell lines but also demonstrated potent inflammation suppressing activities in primary peripheral blood mononuclear cells (PBMCs) derived from SLE patients. Furthermore, TH-407b showed prominent efficacy in vivo, improved survival rate and ameliorated symptoms of SLE model mice. To obtain molecular insights into the TH-407b derivatives' inhibition mechanism, we performed the structural analysis of TLR7/TH-407b complex using cryogenic electron microscopy (cryo-EM) method. As an atomistic resolution cryo-EM structure of the TLR family, it not only of value to facilitate structure-based drug design, but also shed light to methodology development of small proteins using EM. Significantly, TH-407b has unveiled an inhibition strategy for TLR7 via stabilizing its resting/inactivated state. Such a resting state could be generally applicable to all TLRs, rendering a useful method for targeting this group of important immunological receptors.

Abstract Astragalus polysaccharides(APS), as one of the main active components of Astragali Radix, a traditional famous tonic drug in China, has good pharmacological effects in regulating immunity and anti-oxidation. In recent years, with the success of PD-1/PD-L1 inhibitors and anti-CTLA-4 drugs in cancer treatment, immunotherapy has truly become one of the main clinical anti-tumor treatment methods. Aiming at the characteristics of tumor immune escape and tumor microenvironment change, this paper explores the clinical potential of APS as an anti-tumor adjuvant drug, and summarizes the role and mechanism of APS in inhibiting tumor immune escape, regulating tumor microenvironment, and improving immune function. To summarize and analyze the immune regulation of APS on various tumors in order to provide an objective basis for APS as a clinical anti-tumor adjuvant drug.

Objective:To study the combined use of neoadjuvant chemotherapy and immunotherapy in patients with borderline resectable pancreatic cancer.Methods:The clinical data of patients with pancreatic cancer who were planned to undergo perioperative treatment before surgical treatment at the Fifth Medical Center of PLA General Hospital from January 2019 to June 2021 were retrospectively studied. Of 22 patients with pancreatic cancer, there were 10 males and 12 females, aged (56.0±10.2) years old. Preoperative treatment with chemotherapy (nab-paclitaxel and S-1, AS) and immunotherapy regimen before surgery were given. The baseline characteristics, treatment efficacy, surgical pathology and prognosis were analyzed.Results:Of 22 patients who were treated with neoadjuvant chemotherapy combined with programmed death-1 (PD-1) monoclonal antibody, 11 patients (50%) had tumors in the head, neck and uncinated process of pancreas. On radiographic assessment, one patient achieved CR (4.5%, 1/22), 9 patients PR (40.9%, 9/22), and 11 patients SD (50.0%, 11/22). All patients subsequently underwent R 0 resection. The postoperative pTNM staging showed 91% (20/22) of patients were in stage IA-IIB, 31.8% (7/22) of patients had pT2, 63.6% (14/22) had N0, and 1 patient had pCR. Thirteen patients (54.2%, 13/22) received postoperative adjuvant therapy. The median recurrence-free survival (RFS) was 6.4 months and the median time to progression (TTP) was 12.8 months. The median overall survival of patients was not reached. Postoperative pathology TNM staging IIA to III ( HR=3.63, 95% CI: 1.18-11.20, P=0.025) and postoperative pathology T2-3 stage ( HR=2.02, 95% CI: 1.01-5.05, P=0.049) were significantly associated with RFS. Postoperative pathology TNM stages IIA to III ( HR=2.39, 95% CI: 1.04-5.50, P=0.041) and postoperative pathology T2-3 stage ( HR=2.53, 95% CI: 1.26-5.09, P=0.009) were significantly associated with TTP. Conclusion:AS combined with PD-1 monoclonal antibody showed good efficacy as a neoadjuvant therapy for patients with borderline-resectable pancreatic cancer.

Objective:To evaluate the efficacy and safety of radiofrequency introduction of L-vitamin C in patients with melasma.Methods:From March to June 2019, 20 patients with melasma were admitted to the Department of Dermatology, the Seventh Medical Center of PLA General Hospital, including 19 females and 1 male, aged 30-60 years, with an average age of 43.5 years. All patients were treated with 22 percent of L-vitamin C once a week, a total of 8 times of treatment and followed up for 12 weeks. Each subject was assessed with standardized clinical photo, skin tests (VISIA skin image analyzer and CK multifunctional skin tester) and patient self-assessment. In addition, the adverse reactions were recorded.Results:Physician evaluation and patient self-evaluation showed that skin symptoms were improved obviously after treatment. 90% of the subjects thought that all of the skin moisture, pores, fine lines, glossiness, and color spots were improved after 12 weeks. The skin texture, ultraviolet stain and the brown spots which were detected with VISIA skin image analyzer were all improved after one week and one month. Difference was statistically significant ( P<0.05). Skin glossiness was significantly improved, skin moisture content increased and melanin decreased, which were detected with CK multifunctional skin tester. The differences were statistically significant ( P<0.05). But there was no significant change in transdermal water loss and red pigment index ( P>0.05). Conclusions:22% L-vitamin C can be used to treat melasma and improve photoaging safely without affecting skin barrier function.

Objective To investigate the effect and mechanism of miR-885-3p on the radiosensitivity of colorectal cancer cell HT-29. Methods The expression of miR-885-3p in HT-29 cells irradiated with different doses (0, 2, 4, 6, 8 Gy) of X-rays was detected by qPCR. The effect of miR-885-3p in modulating cell radiosensitivity was assessed in HT-29 cells with miR-885-3p overexpression. Bioinformatics prediction and dual luciferase reporter gene assay were employed to identify the direct target gene of miR-885-3p. Relationship between miR-885-3p and target gene tyrosine kinase 1 (AKT1) was investigated via regulation of miR-885-3p expression. The effect of AKT1 on radiosensitivity in HT-29 cells was evaluated through knockdown AKT1. The effect of AKT1 on miR-885-3p-induced radiosensitivity was detected by co-transferring miR-885-3p and AKT1 gene into HT-29 cells. Results miR-885-3p expression was up-regulated in radiation-induced HT-29 cells (F=46. 64, P<0. 05). Over-expression of miR-885-3p and knockdown of AKT1 enhanced cell radiosensitization by inhibiting survival and promoting apoptosis (t=12. 33, 12. 95, P <0. 05) with SER of 1. 602 and 1. 946, respectively. Inhibition of miR-885-3p promoted radioresistance by increasing cell survival and inhibiting apoptosis (t=11. 94, P<0. 05) with a SER of 0. 839. AKT1 is a target gene downstream of miR-885-3p, overexpression of AKT1 reversed the effect of miR-885-3p on cell radiosensitivity with a SER of 0. 680. Conclusions miR-885-3p can enhance the radiosensitivity of colorectal cancer HT-29 cells by directly targeting AKT1, which provides a target for improving the radiosensitivity of clinical colorectal cancer.