Brain metastasis is the most common intracranial tumor in adults. Radiotherapy is one of the most important treatments, in addition to drugs, surgery, and other treatments. In recent years, rapid development of targeted therapy and radiosurgical technology has transformed the treatment mode of brain metastases, with increasing emphasis on individualized treatment. However, the mode of radiotherapy in patients with driver gene-positive remains controversial. In this article, the advances in the timing of radiotherapy for brain metastases were reviewed.

Objective To analyze the clinical features and surgical treatment strategies of T4a thyroid cancer.Methods We retrospectively analyzed patients with thyroid cancer treated in the Department of Head and Neck Surgery of Sichuan Cancer Hospital from January 2004 to May 2021.A total of 303 cases were included and statistically analyzed for pathological type,invaded organs,surgical approach,survival time,and overall survival rate.The postoperative survival curves of the patients were analyzed using the Kaplan Meier method.Results Of the 303 patients enrolled,53 patients were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 98.4％(246/250),97.0％(224/231)and 90.2％(92/102),respectively.Of the 94 patients with recurrent laryngeal nerve invasion only,13 were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 100％(81/81),98.7％(77/78)and 97.4％(38/39),respectively.There were 151 patients with invasion of recurrent laryngeal nerve and tracheal/laryngeal/esophageal nerve,31 of them were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 96.7％(116/120),95.3％(101/106)and 82.2％(37/45),respectively.According to the survival curve analysis,the group with recurrent laryngeal nerve invasion only had an advantage in overall survival time over the group with recurrent laryngeal nerve and tracheal/laryngeal/esophageal invasion.Conclusion Surgical resection is supposed to be preferred for T4a thyroid cancer if there is a chance of surgery.A reasonable surgical strategy,radical surgery while preserving the vital tissues and organs,and one-stage repair and reconstruction can bring patients a better quality of life and prognosis.

Objective To mine and analyze the adverse event data of polatuzumab vedotin(Pola)and fam-trastuzumab deruxtecan-nxki(T-Dxd),so as to provide reference for clinical medication safety.Methods The adverse events reported from January 1,2004 to June 7,2023 were extracted based on openFDA database.The suspicious risk signals were screened by the Open Vigil 2.1 data platform and ranked by signal strength and frequency of occurrence;then ADEs were classified by reference to the MedDRA 26.0.Results A total of 7 164 and 22 870 ADE reports related to Pola and T-Dxd were obtained,and 104 and 95 suspicious ADE signals were detected,respectively.According to the signal intensity,cytomegalovirus enterocolitis(ROR=416.94)for Pola and interstitial lung disease[reporting odds ratio(ROR)=82.55]for T-Dxd ranked first,both of which were recorded in the drug instructions.According to the frequency of occurrence,the two drugs were most frequently associated with death(n=111)and nausea(n=285),respectively.The risk of Pola was associated with 12 systems/organs,of which 26 risk signals were not documented in the drug instruction,and the risk of T-Dxd was associated with 13 systems/organs,of which 18 risk signals were not documented in the drug instruction.Conclusion By tapping the ADE after real-world administration of Pola and T-Dxd,physicians are prompted to pay attention to the risk of adverse reactions in clinical use and actively take preventive and therapeutic measures to ensure the safety of patients'medication.

Objective To investigate whether curcumin is a potential drug for the treatment of gastrointestinal stromal tumors(GIST).Methods The differential genes of imatinib-resistant cells and non-resistant cells were analyzed by cell transcriptology.The antitumor activity of curcumin was verified by cell counting kit-8(CCK-8)method,and the concentration of Curcumin ranged from 5 to 80 μg·mL-1for GIST-T1 and GIST-T1/IMR cells.20 μg·mL-1 Curcumin as the experimental group,phosphate buffered solution as the control group.The contents of interleukin-6(IL-6),reactive oxygen species(ROS)and nitric oxide(NO)were measured by enzyme linked immunosorbent assay.The cell cycle changes were analyzed by flow cytometry.Results Using non-resistant cells as a contrast,the results showed that there were 1 300 up-regulated genes and 1 609 down-regulated genes in imatinib-resistant cells.The 50％inhibiting concentration values of Curcumin on GIST-T1 and GIST-T1/IMR cells were(15.33±1.36)and(10.49±2.12)μg·mL-1,respectively.In GIST-T1 cells,the IL-6 levels in experimental group and control group were(3.45±0.01)and(5.64±0.42)pg·mL-1;the ROS levels were(2 841.42±81.83)and(4 174.32±439.12)pg·mL-1;the iNOS levels were(7.02±0.08)and(8.08±0.03)μmol·L-1,respectively.In GIST-T1/IMR cells,the IL-6 levels in experimental group and control group were(2.47±0.30)and(6.30±0.01)pg·mL-1;the ROS levels were(4 706.40±146.71)and(8 254.34±342.35)pg·mL-1;the iNOS levels were(6.42±0.09)and(7.29±0.04)μmol·L-1,respectively.Among the 2 cells,the differences of above indicators were statistically significant between the experimental group and the control group(P＜0.05,P＜0.01).Curcumin blocked the cell cycle of GIST-T1 and GIST-T1/IMR in G1 phase,further shortens S phase and G2 phase.Conclusion Curcumin can inhibit the secretion of inflammation and regulate the proliferation of GIST.

There is a complex symbiotic relationship between gut microbiota and the host,and a bidirectional communication pathway exists between gut microbiota and the brain,known as the"microbiota-gut-brain axis".Research has found that general anesthetics and the brain can engage in complex two-way communication through the microbiota-gut-brain axis.General anesthetics can alter the composition and metabolism of gut microbiota.This article reviews the effects of common general anesthetics on the microbio-ta-gut-brain axis and their mechanisms,with the aim of providing reference for the related research on anesthesia and the microbiota-gut-brain axis.

Anastomotic leakage is one of the most severe complications following esophagectomy.Research on predictive factors is crucial for its prevention.Blood markers such as C-reactive protein,white blood cell count,procalcitonin,and albumin levels are widely used due to their accessibility,but they have limitations in distinguishing anastomotic leakage from other postoperative infections.The assessment of blood supply to the anastomotic site,including factors like vessel length and diameter,is also readily obtainable and valuable in predictive models,though there is limited research in this area.The use of indocyanine green offers a more direct evaluation of blood supply,but its application is not widespread,and data acquisition is challenging.Preoperative comorbidities such as diabetes have been shown to delay wound healing and increase the risk of leakage;thus,it is recommended to include these factors in comprehensive studies.Although surgical techniques and the location of the anastomosis have been extensively studied,further exploration of these details is necessary.Researchers should integrate these factors to develop multifactorial predictive models,enabling the identification of high-risk patients preoperatively and the implementation of effective preventive measures to reduce the incidence of anastomotic leakage.

Pyroptosis is a kind of inflammatory cell death mediated by the Gasdermin family,which has made great progress in tumor therapy in recent years.Basing on that cell pyroptosis can activate the anti-tumor immune response,and tumor immunotherapy is a new field of tumor therapy,the regulation of cell pyroptosis exhibits great potential for tumor therapy.Meanwhile,nanotechnology is the key means of tumor precision treatment with the advantages of precise targeting and continuous release.Based on these current situations,this paper summarizes the drugs that activate pyroptosis and the nanocarriers that use nanotechnology to promote pyroptosis to participate in tumor therapy,and summarizes the mechanism and application of their action on pyroptosis.This paper is aimed to provide certain references for anti-tumor therapy based on pyroptosis.

As an emerging drug delivery technology,microneedles can puncture the skin's stratum corneum to create micron-sized conduits,painlessly,minimally invasive,and efficiently deliver drugs into viable epidermis or dermis for local or systemic therapeutic effects.This paper reviews the current clinical trials of microneedles used in the treatment of various diseases,elaborates on the characteristics of various types of microneedles,and summarizes the latest research progress of microneedles used to treat skin tumors,including chemotherapy,photothermal and photodynamic therapy,immunotherapy,gene therapy,and combination therapy.This review provides ideas and directions for further research on microneedles in treating skin tumors.

Bridging therapy serves as an adjunctive treatment during chimeric antigen receptor T cell therapy(CAR-T)and is specifically im-plemented after the collection of mononuclear cells but before the subsequent infusion of CAR-T cells.This approach can mitigate the pro-gression of large B-cell lymphoma(LBCL)to a certain extent,reduce tumor burden,and facilitate the infusion of CAR-T cells.Bridging therapy includes chemotherapy,radiation therapy,and targeted therapies and ensures effective reinfusion of CAR-T cells and enhances the thera-peutic efficacy of CAR-T cells.This study systematically reviews the significance,methodologies,and characteristics of CAR-T-cell-related bridging therapy for large B-cell lymphoma to provide valuable references for its clinical application.

Objective To acquire,evaluate and integrate the best evidence of perioperative exercise interventions in patients with liver cancer and provide evidence-based references for clinical medical staff.Methods Following the"6S"Evidence Resource Pyramid model,literatures in perioperative exercise interventions published between January 2010 and June 2022 were retrieved from various databases,including BMJ Best Practice,UpToDate,Guidelines International Network,National Guideline Clearinghouse,National Institute for Health and Clinical Excellence,Scottish Intercollegiate Guidelines Network,Medlive,Cochrane Library,JBI,Web of Science,PubMed,Embase,CINAHL,CNKI,SinoMed,Wanfang Data,American Cancer Society,American College of Sports Medicine and International Liver Cancer Association from January 2010 to June 2022.Two researchers evaluated the quality of the retrieved literatures and extracted evidences that met the inclusion criteria.Results A total of 22 articles were included,yielding 26 pieces of evidence across seven themes:the necessity of exercise,evaluation before exercise,preoperative exercise program,postoperative exercise program,exercise monitoring,health education and effect evaluation.Conclusions This study provides a summary of the best evidence regarding perioperative exercise interventions in the patients with liver cancer.The findings offer valuable references for clinical healthcare providers to deliver evidence-based care for the patients with liver cancer.