PD-1 inhibitor-augmented HAIC-TKI therapy in hepatocellular carcinoma with portal vein tumor thrombosis: real-world survival benefits, safety, and subgroup-specific efficacy

BackgroundPD-1/PD-L1 inhibitors have shown efficacy in improving the prognosis of patients with hepatocellular carcinoma (HCC) accompanied by portal vein tumor thrombosis (PVTT) in pivotal clinical trials including the landmark IMbrave150 study. However, not all the patients benefit from the PD-1/PD-L1 blockade immunotherapy. This study aimed to improve the identification of PVTT-associated HCC patients who may benefit from the combination of PD-1 inhibitor and hepatic arterial infusion chemotherapy (HAIC) and tyrosine kinase inhibitor (TKI) treatment under real-world conditions.MethodsFrom 377 HCC-PVTT patients receiving HAIC-TKI ± PD-1 inhibitors (2016-2023), we compared 76 dual-therapy (HT) and 175 triple-therapy (HTP) cases. Median follow-up period was 34.8 months in the HT group and 33.4 months in the HTP group (P=0.175). Propensity score matching (1:1 caliper=0.2) was used to balance baseline characteristics. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and safety were evaluated in both groups. Specific subgroups including Vp4 type PVTT, extrahepatic metastases, and patients over 60 years old, were analyzed.ResultsTriple therapy significantly improved median OS (24.6 vs. 13.5 months; HR=0.58, 95%CI:0.42–0.80; P=0.001) and PFS (11.1 vs. 6.4 months; HR=0.56, P<0.001), with a 15% absolute ORR increase (66.3% vs. 51.3%, P=0.034). In subgroup analysis, for patients with Vp4 type PVTT, the addition of PD-1 inhibitor prolonged overall survival by 6.0 months (P=0.04). For patients aged 60 years and above, the addition of PD-1 inhibitor prolonged overall survival by 1.9 months (P=0.363). For patients with extrahepatic metastasis, the addition of PD-1 inhibitor prolonged overall survival by 3.0 months (P=0.913). Grade 3–4 adverse events were comparable (30.9% vs. 19.7%, P=0.09), but two patients experienced immune treatment-related fatalities in the HTP group.ConclusionThe triple therapy (HAIC-TKI-PD-1) demonstrated superior efficacy over HAIC-TKI dual therapy in HCC patients with PVTT, achieving significant improvements in ORR, mOS, and mPFS, with an acceptable safety profile. However, PD-1 inhibitors showed minimal survival benefits in patients aged >60 or with extrahepatic metastases

A Rapid Synchronous Determination Method for Soil Inorganic Carbon Content and its Carbon Isotope Ratio

The accumulation and leaching of soil inorganic carbon (SIC) play crucial roles in the global carbon balance and represent a key research focus in carbon cycling studies. Accurate quantification of SIC content and its stable isotope ratio is critical for identifying the current "missing" carbon sink in terrestrial ecosystems. This study developed a rapid，high-throughput method for synchronous measurement of soil inorganic carbon (IC) content and its carbon isotope ratios using cavity ring-down spectroscopy(CRDS) combined with an automated small-volume gas sampler. A synchronous analysis method for inorganic carbon content and isotope ratios in different types of soils was established by analyzing certified reference materials. Results demonstrated that this method has a measurement range of 0.050−0.500 mg (as carbonate)，with a correlation coefficient ≥0.999. The accuracy of SIC analysis was better than 1 g/kg，and the accuracy of carbon isotope analysis was better than 0.5 ‰，with no observed isotope fractionation. The newly developed method was applied to determine inorganic carbon content and isotope ratios in soils with different types and SIC contents. The results showed that all samples achieved good repeatability，and the results were consistent with those measured using the original method. Moreover，the accuracy of SIC content and isotope ratios in soils of 100 mesh is better than that in soils of 60 mesh. The optimized method is simple to operate，offers a low detection limit，requires minimal processing time，and exhibits excellent repeatability，making it highly suitable for rapid and batch analysis of SIC content and its stable carbon isotope ratio

Clinical symptom improvement and lipidomic signatures in overweight/obese PCOS treated by lifestyle and acupuncture intervention

BackgroundPolycystic ovary syndrome (PCOS) is interrelated with obesity. Lifestyle intervention, mainly focusing on weight loss, has emerged as promising strategies to improve fertility outcomes in women with obesity. Acupuncture can aid in weight loss through metabolic regulation. However, evaluating the effectiveness of lifestyle and acupuncture in improving symptoms of polycystic ovary syndrome is still lacking.ResultsThis study aims to evaluate the efficacy of long-term lifestyle and acupuncture treatment on PCOS and elucidate the lipidomic features of these interventions in patients with overweight/obese PCOS, and identify potential therapeutic targets. Thirty-one women with PCOS and twenty-eight age and BMI matched controls were recruited. The participants with PCOS were randomly assigned to either lifestyle and acupuncture intervention group (A&L) or Lifestyle and sham acupuncture group (SA&L) for 4 months. The patients were followed up for an additional 4 months. Clinical indices indicating hyperandrogenism, homeostasis and quality of life was collected to evaluate the effectiveness of treatments. Comprehensive lipidomic analyses by utilizing mass spectrometry were conducted to profile the lipidomic signatures of participants with PCOS before and after treatment. After the A&L intervention, the BMI of participants with PCOS was significantly reduced. Assessments of insulin resistance (HbA1c, HOMA-IR, ISI), hyperandrogenism (SHBG, FAI), physical activity, and β-endorphin showed significant improvement. Lipidomic analysis revealed a panel of lipid species that effectively distinguished participants with PCOS from those without PCOS (AUC = 0.9747). Serum 18:0 Lyso PI, involved in intracellular insulin signaling pathways, was specifically associated with the A&L regimen. The co-regulation of 18:0 Lyso PI and 16:0 SM (d18:1/16:0) were associated with the A&L regimen.Conclusion18:0 Lyso PI may be a potential biomarker for A&L therapy in PCOS patients

Effects of culture and social cynicism on anxious attachment transference from mother to partner

We examined the role of culture and social cynicism beliefs in the transference of an anxious attachment style from mother to romantic partner among a group of undergraduates from the US (n = 200) and Hong Kong (n = 147). The results showed that anxious attachment to mother and to partner was moderately correlated among both cultural groups. However, social cynicism beliefs were found to moderate the relationship between anxious attachment to mother and attachment to partner among U.S. but not Hong Kong Chinese participants. This observed differential effect of social cynicism beliefs could be explained by differences in self-direction values across the 2 cultural groups. The findings in the study are of theoretical significance as they provide insights for further research on the influences of cultural variables and personal beliefs on attachment transference.</jats:p

Minimally invasive removal of a foreign body in the pancreas using digital intelligent technology: a case report

Pancreatitis caused by a fish bone penetrating the posterior wall of the stomach and entering the pancreas is rare. We herein report a case involving a woman in her late 30s with an approximately 1-month history of recurrent upper abdominal pain. Initial evaluation at another hospital failed to identify the cause but raised suspicion of pancreatic cancer. Computed tomography, magnetic resonance imaging, and a detailed consultation led us to suspect that the patient’s pain had been caused by inadvertent ingestion of a fish bone. We used three-dimensional visualization technology to determine the location of the fish bone and informed the patient of the lesion and surgical plan through a simulated surgical demonstration. During surgery, we applied augmented reality navigation technology to remove the fish bone by a minimally invasive approach. The patient was discharged on postoperative day 3. She was followed up by telephone 24 hours after discharge. Outpatient follow-up was performed 1 week after discharge and on day 30. The patient recovered well and developed no complications. This case shows that digital medical technology can be applied in patients undergoing surgical removal of a pancreatic foreign body. Such technology assists with preoperative evaluation, patient education, and intraoperative trauma reduction

The NiCo Bimetal Catalyst Loaded on Polyvinylidene Fluoride Coated on the Self-Supporting Silk Electrode as an Advanced Electrocatalyst for the Hydrogen Evolution Reaction

In this work, a NixCox/Silk-PVDF bimetallic catalyst electrode was prepared for the hydrogen evolution reaction (HER) in hydropower. This cheap, durable, and efficient electrode has good practical application prospects. Green natural silk, which will pollute the environment. The electrodes (obtained by varying the Ni:Co ratio and hydrothermal times) were prepared hydrothermally. Ni and Co elements were revealed by X-ray diffraction, X-ray photoelectron spectroscopy, and transmission electron microscopy. Ni2Co2/silk-PVDF was identified as an effective catalyst in 1 M KOH alkaline electrolyte with an overpotential of 89.4 mV at 20 mA cm&minus;2 and a Tafel slope of 47.46 mv dec&minus;1. It showed low resistance and a high specific surface area in EIS and CV tests, respectively, proving its superior HER performance. Finally, the stability and durability of the electrode coated with PVDF were demonstrated via testing at a voltage of &minus;0.1 V over 24 h. This work provides an environmentally friendly and simple method to load metal on a self-supporting electrode to be used in the hydrogen evolution reaction

Mediastinal Hepatoid Adenocarcinoma Treated With Arterial Interventional Therapy: A Case Report and Review of Literature

Hepatoid adenocarcinoma (HAC) is an extremely rare extrahepatic carcinoma, which is pathologically featured by hepatocellular carcinoma (HCC) and marked by producing alpha-fetoprotein (AFP). HAC of mediastinum is extremely rare. For inoperable patients, the curative treatment options have not been established, and the outcome of HAC is usually poor. Here, we present a case of mediastinal HAC with normal serum AFP level who achieved well-controlled and good response after local–regional interventional approach combined with systemic PD-1 inhibitor. A 53-year-old male who complained of chest pain was admitted to our hospital in February 2021. A chest CT scan revealed several tumors in his mediastinum. The laboratory data showed normal serum AFP level. HAC was diagnosed through pathological assessment of biopsy. Surgery was not available due to the infiltration of sternum. Local regional FOLFOX chemotherapy was given by transarterial infusion, followed by transcatheter arterial chemoembolization, and thereafter combined with systemic anti-PD-1 treatment. The patient achieved favorable disease control and apparent symptom relief. So transarterial interventional therapy combined immunotherapy may be a possible and promising treatment for mediastinal HAC.</jats:p