Efficacy and safety of neoadjuvant immunotherapy in resectable esophageal or gastroesophageal junction carcinoma: A pooled analysis of prospective clinical trials

Neoadjuvant chemoradiotherapy (NCRT) plus radical esophagectomy is currently the standard treatment for resectable esophageal or gastroesophageal junction (GEJ) carcinoma. The aim of this study is to evaluate the efficacy and safety of neoadjuvant immunotherapy in resectable esophageal or GEJ carcinoma. Prospective clinical trials investigating efficacy and/or safety of neoadjuvant immunotherapy with immune checkpoint inhibitors (ICIs) followed by radical esophagectomy in patients with newly diagnosed resectable esophageal or GEJ carcinoma were identified through literature search. Quality assessment was performed by using the Newcastle–Ottawa scale. Preliminary treatment outcomes of pathologically complete response (pCR, ypT0N0) and grade 3-4 adverse effects (AEs) were pooled together and then compared with standard NCRT of the historical control CROSS study by Chi-square (χ2) test. A two-sided P value < 0.05 was considered statistically significant. A total of 17 eligible non-randomized trials with 455 participants were included into analysis. The most common primary endpoint was pCR (n = 7, 41%), and the median sample size and follow-up period was 23 patients and 7.9 months, respectively. For patients receiving neoadjuvant immunotherapy, the overall pCR, R0 resection, and grade 3-4 AE rates were 33.2%, 95.5%, and 35.1%, respectively. For esophageal squamous cell carcinoma (ESCC) and adenocarcinoma (EAC), neoadjuvant immunochemoradiotherapy showed no significant improvement in pCR rate than NCRT (ESCC, 50% vs 48.7%, P = 0.9; EAC, 32.6% vs 23.1%, P = 0.22). Grade 3-4 AEs were the most common in patients with neoadjuvant immunochemoradiotherapy, significantly higher than immunochemotherapy (46.7% vs 32.8%, P = 0.04) and NCRT (46.7% vs 18.1%, P < 0.0001). In conclusion, for patients with resectable esophageal or GEJ carcinoma, the addition of ICIs to standard NCRT could not improve pCR rate in both ESCC and EAC, but significantly increased the risk of severe AEs. Large-scale phase 3 randomized trials were urgently needed to further confirm the survival benefit and safety profile of neoadjuvant immunotherapy

Collaborative multidisciplinary management and expertise of cT2-3 locally advanced operable esophageal squamous cell carcinoma:two case reports

Background: The accurate clinical staging of esophageal squamous cell carcinoma (ESCC) is pivotal for guiding treatment strategies. However, the current precision in staging for clinical T (cT)2 and cT3 stages remains unsatisfactory. This article discusses the role of multidisciplinary teams (MDTs) in the clinical staging and formulation of neoadjuvant treatment strategies for locally advanced operable ESCC. These challenges underscore the importance of precise staging in the decision-making process for appropriate therapeutic interventions.Case Description: Through the lens of two patient case studies with locally advanced resectable ESCC, the article showcases the intricate process of treatment planning undertaken by MDTs. It captures a range of expert perspectives from Japan, China, Hong Kong (China), Korea, the USA, and Europe, focusing on the challenges of differentiating between cT2 and cT3 stages of the disease, which is a critical determinant in the management and therapeutic approach for patients.Conclusions: The article concludes that the accurate staging of ESCC is a cornerstone in determining the most suitable treatment strategies. It underscores the vital role that MDTs play in both clinical staging and the decision-making process for treatment. Highlighting the limitations in current diagnostic methods, the article emphasizes the urgent need for advanced research and the refinement of diagnostic tools to improve the precision of staging, particularly between the cT2 and cT3 stages. It suggests that future research should consider whether a reclassification of these stages could be warranted to enhance treatment planning and outcomes for patients with ESCC.<br/

Robot-assisted transmediastinal esophagectomy: The path of concept and practice

The technique and concept of surgical treatment of esophageal cancer are constantly progressing. Using a combination of transcervical mediastinoscopy and robotic systems, this approach facilitates upper mediastinal operations without the need for thoracic manipulation. Its potential advantages comprise shorter operation times, reduced postoperative pain, shorter hospital stays, and fewer pulmonary complications. Additionally, patients unfit for traditional thoracic surgery might benefit from this approach. This article aims to introduce and share the surgical techniques and prospects of robot-assisted transmediastinal esophagectomy

Tunable Luminescent A-SiN_xO_y Films with High Internal Quantum Efficiency and Fast Radiative Recombination Rates

In this work, we systematically investigated the Nx bonding defects that induced high photoluminescence internal quantum efficiencies (PL IQEs) and very fast radiative recombination processes in amorphous silicon oxynitride (a-SiNxOy) systems. The luminescent N‒Si‒O bonding-related defect states were checked for the XPS, EPR, and temperature-dependent steady-state PL (TD-SSPL) properties. The PL IQEs were calculated from PL quantum yields through the principle of planar geometry optics, and then confirmed by the TD-SSPL properties. The radiative recombination rates [kr(R)] were determined by combining the PL IQE values and ns-PL lifetimes obtained from time-resolved PL measurements. Both the PL IQE, exceeding 72%, and the fast kr(R) (~108 s&#8722;1) are proportional to the concentration of Nx defects, which can be explained by N‒Si‒O bonding states related to the quasi-three-level model, suggesting the possible realization of stimulated light emission in a-SiNxOy systems

Mechanistic Study of the Synergistic Interaction of Furfuryl Alcohol and Caprolactam in the Modification of <i>Pinus massoniana</i> Earlywood and Latewood

Furfurylated wood has many advantages, such as decay resistance, dimensional stability, hardness, etc. However, furfurylation increases the brittleness and decreases the flexural resistance of wood, which greatly limits its application. Therefore, caprolactam (CPL) is incorporated with furfuryl alcohol (FA) to improve the performance of furfurylated wood. In this study, an FA and CPL combinational modifier was used to treat masson pine (Pinus massoniana Lamb.) earlywood and latewood. The synergistic interaction of both components with the wood cell walls was systematically evaluated via microstructural, chemical, and thermal analysis using scanning electron microscopy (SEM), infrared spectroscopy (ATR-FTIR), X-ray photoelectron spectrometry (XPS), and differential scanning calorimetry (DSC). The SEM images showed that polymerized modifiers were distributed in tracheids, ray cells, and pits, with a higher degree of distribution in latewood tissues. The FA-CPL co-treatment led to the highest degree of distribution in cell cavities as well as of cell wall swelling. The results of the weight percentage gain (WPG) of modified wood agreed with the SEM findings that the FA-CPL co-treatment could more effectively increase the WPG than individual modification. The results of FTIR and XPS revealed that FA and CPL might chemically bind with each other as well as react with lignin and hemicellulose in the cell walls during the curing process. In addition, the interactions between modifiers and cell walls were slightly different for earlywood and latewood. DSC analysis indicated that the wood hygroscopicity decreased and the thermal stability improved after modification

A Generalized 9-Intersection Model for Topological Relations between Regions with Holes

Current models cannot distinguish detailed topological relations between regions with holes. In order to solve this problem, a new detailed representation model for topological relations is proposed in this study. In this model, the key is to describe topological relations caused by multi-holes. Definitions of regions with holes and real objects expressed by elements of regions with holes are comprehensively analyzed, and then a practical definition of regions with holes is presented. Based on the 9-intersection model, a generalized 9-intersection model is proposed, which can completely describe detailed topological relations between regions with holes. For showing the description ability, the model is applied to describe detailed topological relations between regions with holes and detailed topological relations between objects of different complexities with the same major categories of topological relations, and a case study is designed to show the practicality of the model. The results show that the model is valid

A Generalized 9-Intersection Model for Topological Relations between Regions with Holes

Current models cannot distinguish detailed topological relations between regions with holes. In order to solve this problem, a new detailed representation model for topological relations is proposed in this study. In this model, the key is to describe topological relations caused by multi-holes. Definitions of regions with holes and real objects expressed by elements of regions with holes are comprehensively analyzed, and then a practical definition of regions with holes is presented. Based on the 9-intersection model, a generalized 9-intersection model is proposed, which can completely describe detailed topological relations between regions with holes. For showing the description ability, the model is applied to describe detailed topological relations between regions with holes and detailed topological relations between objects of different complexities with the same major categories of topological relations, and a case study is designed to show the practicality of the model. The results show that the model is valid

Red blood cells: a potential delivery system

Abstract Red blood cells (RBCs) are the most abundant cells in the body, possessing unique biological and physical properties. RBCs have demonstrated outstanding potential as delivery vehicles due to their low immunogenicity, long-circulating cycle, and immune characteristics, exhibiting delivery abilities. There have been several developments in understanding the delivery system of RBCs and their derivatives, and they have been applied in various aspects of biomedicine. This article compared the various physiological and physical characteristics of RBCs, analyzed their potential advantages in delivery systems, and summarized their existing practices in biomedicine. Graphical Abstrac

Carbon Nanostructure of Kraft Lignin Thermally Treated at 500 to 1000 °C

Kraft lignin (KL) was thermally treated at 500 to 1000 °C in an inert atmosphere. Carbon nanostructure parameters of thermally treated KL in terms of amorphous carbon fraction, aromaticity, and carbon nanocrystallites lateral size (La), thickness (Lc), and interlayer space (d002) were analyzed quantitatively using X-ray diffraction, Raman spectroscopy, and high-resolution transmission electron microscopy. Experimental results indicated that increasing temperature reduced amorphous carbon but increased aromaticity in thermally treated KL materials. The Lc value of thermally treated KL materials averaged 0.85 nm and did not change with temperature. The d002 value decreased from 3.56 Å at 500 °C to 3.49 Å at 1000 °C. The La value increased from 0.7 to 1.4 nm as temperature increased from 500 to 1000 °C. A nanostructure model was proposed to describe thermally treated KL under 1000 °C. The thermal stability of heat treated KL increased with temperature rising from 500 to 800 °C