Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.
Humans ; Antibodies, Monoclonal/therapeutic use* ; Apoptosis ; China ; Disease-Free Survival ; East Asian People ; Immunotherapy ; Interferon-alpha/therapeutic use* ; Lymphatic Metastasis ; Melanoma/pathology* ; Programmed Cell Death 1 Receptor/therapeutic use* ; Skin Neoplasms/pathology* ; Melanoma, Cutaneous Malignant

Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.
Humans ; Antibodies, Monoclonal/therapeutic use* ; Apoptosis ; China ; Disease-Free Survival ; East Asian People ; Immunotherapy ; Interferon-alpha/therapeutic use* ; Lymphatic Metastasis ; Melanoma/pathology* ; Programmed Cell Death 1 Receptor/therapeutic use* ; Skin Neoplasms/pathology* ; Melanoma, Cutaneous Malignant

Objective:To summarize the research progress on tissue damage, poisoning mechanism and treatment measures for the injury caused by liquid rocket propellant nitrogen tetroxide (N 2O 4) in China and foreign copuntries. Literature resource and selection The literatures published in the related fields at home and abroad. Literature quotation Fifty-one references were cited. Literature synthesis N 2O 4 is currently a commonly used liquid rocket propellant, which is a colorless gas or liquid and easy decomposition into nitrogen dioxide. It has the characteristics of flammability, explosive, strong oxidation and toxicity. In the process of propellant transportation and usage, poisoning and explosion accidents caused by N 2O 4 leakage occurred from time to time, which seriously threatened the physical and mental health of employees. Early inhalation of N 2O 4 may cause eye and respiratory tract irritation, and severe ones included pulmonary edema and acute respiratory distress syndrome. Long-term exposure may lead to idiopathic pulmonary fibrosis, and the difficulty of treatment N 2O 4 for poisoning patients was increasedwheninjured by the blast of the explosion at the same time. A large number of experimental studies have shown that vitamins E and radix salviaemiltiorrhizae (RSM) can reduce oxidative stress and inflammatory responses induced by N 2O 4. However, due to the lack of specific antidotes in actual treatment, symptomatic treatments such as oxygen administration and correction of pulmonary edema were often used. Conclusions:N 2O 4 poisoning can cause acute respiratory system damage, such as respiratory tract inflammation and pulmonary edema and also lead to chronic diseases, such as fibrosis or other organ damages. Symptomatic and supported treatment is often used in the process of treatment. It indicated that further study of N 2O 4is needed to clarify the molecular mechanism of its action, so as to provide help for clinical treatment.

Objective:To summarize the research progress on tissue damage, poisoning mechanism and treatment measures for the injury caused by liquid rocket propellant nitrogen tetroxide (N 2O 4) in China and foreign copuntries. Literature resource and selection The literatures published in the related fields at home and abroad. Literature quotation Fifty-one references were cited. Literature synthesis N 2O 4 is currently a commonly used liquid rocket propellant, which is a colorless gas or liquid and easy decomposition into nitrogen dioxide. It has the characteristics of flammability, explosive, strong oxidation and toxicity. In the process of propellant transportation and usage, poisoning and explosion accidents caused by N 2O 4 leakage occurred from time to time, which seriously threatened the physical and mental health of employees. Early inhalation of N 2O 4 may cause eye and respiratory tract irritation, and severe ones included pulmonary edema and acute respiratory distress syndrome. Long-term exposure may lead to idiopathic pulmonary fibrosis, and the difficulty of treatment N 2O 4 for poisoning patients was increasedwheninjured by the blast of the explosion at the same time. A large number of experimental studies have shown that vitamins E and radix salviaemiltiorrhizae (RSM) can reduce oxidative stress and inflammatory responses induced by N 2O 4. However, due to the lack of specific antidotes in actual treatment, symptomatic treatments such as oxygen administration and correction of pulmonary edema were often used. Conclusions:N 2O 4 poisoning can cause acute respiratory system damage, such as respiratory tract inflammation and pulmonary edema and also lead to chronic diseases, such as fibrosis or other organ damages. Symptomatic and supported treatment is often used in the process of treatment. It indicated that further study of N 2O 4is needed to clarify the molecular mechanism of its action, so as to provide help for clinical treatment.

Objective To summarize and analyze the efficacy of microvascular decompression (MVD) for cerebral neurovascular compression syndrome and its postoperative complications. Methods MVD was performed in 39 patients with cerebral neurovascular compression syndrome, including 19 with trigeminal neuralgia, 18 with facial spasm and 2 with glossopharyngeal neuralgia. The surgical techniques and prevention of postoperative complications were analyzed. Results The immediate relief of pain was succeed in 17 with trigeminal neuralgia and 2 with glossopharyngeal neuralgia and the spasm was eliminated in 16 with facial spasm right after the operation. No hematoma, infection, cerebrospinal fluid leakage or death appeared and the total effectiveness rate was 94.87%. Follow-up was performed in 34 with an average of 1.58 years and 32 were recorded with good results. Conclusion MVD for cerebral neurovascular compression syndrome is safe, minimally invasive and effective. It is by far the first choice in the treatment of cerebral neurovascular compression syndrome.