Pectin-assisted one-pot synthesis of MoS2 nanocomposites for resistive switching memory application

Developing simple, large-scale, and environmentally-friendly ways to prepare two-dimensional (2D) semiconductive hexagonal phase MoS₂ (2H-MoS₂) nanocomposites remains a significant challenge. Herein, we propose a facile and green method for preparing few-layer MoS₂ nanosheets via a pectin-assisted one-pot synthesis (PAOS), where pectin serves as the surfactant and stabilizer to assist the direct exfoliation of bulk MoS₂ into few-layered semiconductive 2H-MoS₂ nanosheets in water, as well as a second functional part to produce the 2H-MoS₂/pectin nanocomposites simultaneously. Based on the facilely prepared 2H-MoS₂/pectin nanocomposites, extraordinary flash memory devices with a typical bistable electrical switching and nonvolatile rewritable memory effect were realized, achieving a low threshold voltage below 2.0 V, a high ON/OFF ratio as high as 5 × 10², and a retention time longer than 10⁴ s. Systematic investigations reveal that the electrical transition is due to the charge trapping and detrapping behaviors of the 2D 2H-MoS₂/pectin nanocomposites. These findings through PAOS not only offer a general route for efficiently preparing 2H-MoS₂ nanosheets and nanocomposites, but also reveal the great potential of 2D MoS₂-based materials in rectifying the electronic properties for high-performance memory devices.

First-principles study of CO2 hydrogenation to formic acid on single-atom catalysts supported on SiO2

The hydrogenation of CO₂ into valuable chemical fuels reduces the atmospheric CO₂ content and also has broad economic prospects. Support is essential for catalysts, but many of the reported support materials cannot meet the requirements of accessibility and durability. Herein, we theoretically designed a series of single-atom noble metals anchored on a SiO₂ surface for CO₂ hydrogenation using density functional theory (DFT) calculations. Through theoretical evaluation of the formation energy, hydrogen dissociation capacity, and activity of CO₂ hydrogenation, we found that Ru@SiO₂ is a promising candidate for CO₂ hydrogenation to formic acid. The energy barrier of the rate-determining step of the entire conversion process is 23.9 kcal mol^-1; thus, the reaction can occur under mild conditions. In addition, active and stable origins were revealed through electronic structure analysis. The charge of the metal atom is a good descriptor of the catalytic activity. The Pearson correlation coefficient (PCC) between metal charge and its CO₂ hydrogenation barrier is 0.99. Two solvent models were also used to investigate hydrogen spillover processes and the reaction path was searched by the climbing image nudged-elastic-band (CI-NEB) method. The results indicated that the explicit solvent model could not be simplified into a few solvent molecules, leading to a large difference in the reaction paths. This work will serve as a reference for the future design of more efficient catalysts for CO₂ hydrogenation.

Current Sample Preparation Methods and Analytical Techniques for the Determination of Synthetic Antioxidants in Edible Oils

Synthetic antioxidants play a critical role in the storage and process of edible oil due to that they can retard lipid oxidation, maintain the quality of oils, and prolong the shelf life. However, a series of studies have proved the potential risks of synthetic antioxidants for human health when consumed in excess, and many countries have established the permitted amounts of synthetic antioxidants in oils. Thus, the accurate quantification of synthetic antioxidants in edible oils is necessary, and there have developed various analytical methods involved in chromatographical, electrochemical, and spectroscopic methods. Owing to the complex matrix and the incompatibility between the oil sample and the detection instrument, sample preparation is usually adopted prior to the instrument detection to improve the detection effectiveness. The current review aims to provide a comprehensive overview of the recently developed sample preparation methods and analytical techniques applied to determine synthetic antioxidants in edible oils from 2010 to present, with emphasis on the sample preparation methods combined with separation-based analytical techniques such CE and LC with various detectors. The advantages and limitations of some typical analytical methods are discussed and some insights in the future perspectives are also provided in this review. This article is protected by copyright. All rights reserved.

[Clinical validation of the 2020 diagnostic approach for pediatric autoimmune encephalitis in a single center]

Objective: To evaluate the value of the 2020 diagnostic criteria (Cellucci criteria) for pediatric autoimmune encephalitis (AE) in children with suspected AE in a single center. Methods: The clinical data of 121 children hospitalized at the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2021, with a diagnosis of suspected AE, were retrospectively collected and analyzed. The children were divided into definite antibody-positive AE (dAPAE), probable antibody-negative AE (prANAE), possible AE (pAE) and non-AE groups according to the Chinese expert consensus and the Graus criteria. A new diagnosis was made according to the Cellucci criteria which was compared with the clinical diagnosis to evaluate the diagnostic value of the Cellucci criteria. The Mann-Whitney U test, Kruskal-Wallis test, and χ² test were used to compare the differences among groups. The sensitivity and specificity were used to evaluate efficacy of the Cellucci criteria. Results: Among the 121 children, 72 were males and 49 were females, with an age of 10.3 (6.5, 14.0) years at disease onset. There were 99 cases diagnosed as AE according the clinical diagnosis (58 males and 41 females), of which 43 cases were diagnosed as dAPAE, 14 cases as prANAE and 42 cases as pAE, and the other 22 cases were not AE (14 males and 8 females). The top 2 initial symptoms in the 99 children with AE were seizures (53 cases, 53.5%) and abnormal mental behaviors (35 cases, 35.4%). And the most common symptoms during the course of the disease were abnormal mental behaviors (77 cases, 77.8%) and seizures (64 cases, 64.6%). There were statistically differences in the incidence of consciousness disorders, autonomic dysfunctions during the course of the disease and the length of hospitalization among the 4 groups (χ²=21.63, 13.74, H=22.60, all P<0.05). Ninety-six of the 121 children were tested for AE-related antibodies, of which 45 cases (46.9%) were antibody-positive. According to the Cellucci criteria, 42 cases were diagnosed as dAPAE, 34 cases as prANAE and 14 cases as pAE. Compared with the clinical diagnosis, the sensitivity of the Cellucci criteria for the diagnosis of the 3 types of AE were 93.02%, 92.86% and 87.88%, and the specificity were 96.23%, 74.39% and 86.36%, respectively. Conclusions: The Cellucci criteria has a high sensitivity and specificity for the diagnosis of pAE and dAPAE in the clinical management of children with suspected AE, while a high sensitivity but low specificity for the diagnosis of prANAE. Therefore, it is recommended to apply the Cellucci criteria selectively in clinical practice according to the actual situation, especially in the diagnosis of prANAE.

Atmospheric transport drives regional interactions of ozone pollution in China

In recent years, ozone pollution becomes a serious environmental issue in China. A good understanding of source-receptor relationships of ozone transport from aboard and inside China is beneficial to mitigating ozone pollution there. To date, these issues have not been comprehensively assessed, especially for highly polluted regions in the central and eastern China (CEC), including the North China Plain (NCP), Twain-Hu region (THR), Yangtze River Delta (YRD), Pearl River Delta (PRD), and Sichuan Basin (SCB). Here, based on simulations over 2013-2020 from a well-validated chemical transport model, GEOS-Chem, we show that foreign ozone accounts for a large portion of surface ozone over CEC, ranging from 25.0% in THR to 39.4% in NCP. Focusing on transport of domestic ozone between the five regions in CEC, we find that atmospheric transport can largely modulate regional interactions of ozone pollution in China. At the surface, THR receives the largest amount of ozone from the other four regions (54.2% of domestic ozone in the receptor region, the same in below), followed by PRD (32.3%), SCB (26.7%), YRD (21.1%), and NCP (18.0%). Meanwhile, YRD exports largest amount of ozone to the other regions, ranging from 8.9% in SCB to 28.4% in THR. Although SCB is relatively isolated and thus impacts NCP, YRD, and PRD weakly (< 2.2%), export of SCB ozone to THR reaches 9.3%. The regional ozone transport over CEC, occurring mostly in the lower troposphere, is mainly modulated by the East Asian monsoon circulations, proximity between source and receptor regions, seasonal changes of ozone production, and topography.

Early detection of rumors based on source tweet-word graph attention networks

The massively and rapidly spreading disinformation on social network platforms poses a serious threat to public safety and social governance. Therefore, early and accurate detection of rumors in social networks is of vital importance before they spread on a large scale. Considering the small-world property of social networks, the source tweet-word graph is decomposed from the global graph of rumors, and a rumor detection method based on graph attention network of source tweet-word graph is proposed to fully learn the structure of rumor propagation and the deep representation of text contents. Specifically, the proposed model can adequately capture the contextual semantic association representation of source tweets during the propagation and extract semantic features. For the data sparseness of the early stage of information dissemination, text attention mechanism based on opinion similarity can aggregate and capture more tweet propagation structure features to help improve the efficiency of early detection of rumors. Through the analysis of the experimental results on real public datasets, the rumor detection performance of the proposed method is better than that of other baseline methods. Especially in the early rumor detection tasks, the proposed method can detect rumors with an accuracy of nearly 90% in the early stage of information dissemination. And it still has good robustness with noise interference.

Pharmacokinetics and bioequivalence of two imidocarb formulations in cattle after subcutaneous injection

Imidocarb (IMD) is commonly used for treatment of eperythrozoon, babesia, piroplasma and trypanosoma in animals, but there are few studies on its pharmacokinetics in cattle. The purpose of this study was to obtain pharmacokinetic parameters and assess the bioequivalence of subcutaneous injections of two IMD formulations in cattle. Forty-eight healthy cattle, 24 males and 24 females, were randomLy divided into two groups (test group and reference group) with 12 males and 12 females per group. The generic IMD was injected subcutaneously with a single dose of 3.0 mg/kg in the test group. Reference group animals were given one injection of the marketed IMD at the same dosage. The limit of detection (LOD) and limit of quantification (LOQ) for IMD in cattle plasma were 0.05 ng/mL and 0.1 ng/mL, respectively. The recoveries ranged from 88.50% to 92.42%, and the equation of this calibration curve was Y = 13672.1X+187.43. The pharmacokinetics parameters of the test group showed that the maximum concentration of 2257.5±273.62 ng/mL was obtained at 2.14±0.67 h, AUC0-t 14553.95±1946.85 ng·h/mL, AUC∞ 15077.88±1952.19 ng·h/mL, T1/2 31.77±25.75 h, CL/F 0.14±0.02 mL/h/g, and Vz/F 6.53±5.34 mL/g. There was no significant difference in AUC0-t, AUC∞ and Cmax between the test group and the reference group (P>0.05). The 90% confidence interval of AUC0-t, AUC0-∞ and Cmax in the test group was included in 80%-125% AUC0-t, AUC0-∞ and 70%-143% Cmax in the reference group, respectively. Based on these results, the two preparations were found to be bioequivalent.

[Weight status related early changes in blood pressure, cardiac structure and function in 4-year-old children]

Objective: To explore the association between weight status and early changes in blood pressure, cardiac structure and function in children at 4 years of age. Methods: A cross-sectional study of the relationship between weight status and cardiovascular parameters was performed on the platform of "Shanghai Birth Cohort" in Shanghai Xinhua Hospital between 2017 and 2020. Height, weight, blood pressure and echocardiography were measured in 1 477 children at 4 years of age. According to body mass index (BMI), participants were classified into five groups: underweight, lean, normal weight, overweight and obese. Blood pressure, cardiac structure and function indexes were compared among different groups using one-way ANOVA. The associations between blood pressure, cardiac structure and function and weight status in children were analyzed by linear regression models. Multivariate logistic regression models were used to analyze whether weight status was an independent risk factor for elevated blood pressure or left ventricular hypertrophy (LVH) in children. Results: A total of 1 477 children including 772 boys and 705 girls were included in this study. There were 115 overweight and obese boys (14.9%) and 68 overweight and obese girls (9.6%). The majority of children had normal weight (916 cases, 62.0%), followed by underweight (303 cases, 20.5%), overweight (130 cases, 8.8%), lean (75 cases, 5.1%), and obese (53 cases, 3.6%). With the increase of BMI, systolic blood pressure, diastolic blood pressure, left ventricular mass index (LVMI), left ventricular posterior wall thickness in systole, left ventricular posterior wall thickness in diastole, left ventricular diameter in end-systole, left ventricular diameter in end-diastole, interventricular septum thickness in systole and left ventricular ejection fraction showed significantly positive trend, and the differences among the groups were significant (F=31.73, 6.59, 14.22, 4.96, 3.01, 31.50, 39.79, 5.91, 3.09, all P<0.05). Multiple linear regression showed that overweight and obese were all positively associated with systolic blood pressure (β=5.2, 95%CI 3.6-6.8), LVMI (β=1.9, 95%CI 0.8-3.1), left ventricular diameter in end-systole (β=1.3, 95%CI 0.9-1.8), and left ventricular diameter in end-diastole (β=1.6, 95%CI 1.0-2.2). In the Logistic regression model, compared with normal weight children, overweight (OR=2.37, 95%CI 1.37-4.41) and obese children (OR=10.90, 95%CI 4.47-26.60) both had significantly increased risk of elevated blood pressure. However, the risk of LVH did not significantly increased. Conclusions: Overweight and obesity in 4-year-old children are associated with increased blood pressure, increased left ventricle diameter and LVMI. Overweight and obesity are independent risk factors for elevated blood pressure in children at 4 years of age.

Black Silver: Three-Dimensional Ag Hybrid Plasmonic Nanostructures with Strong Photon Coupling for Scalable Photothermoelectric Power Generation

The conversion of solar energy into electric power has been extensively studied, for example, by photovoltaics. However, photo-thermoelectric (P-TE) conversion as an effective solar-to-electricity conversion process is less studied. Here, we present an efficient full-solar-spectrum plasmonic absorber for scalable P-TE conversion based on a simple integration of light absorber and commercial thermoelectric modules. Our developed light absorber of silica-silver hybrid structures achieves an average absorption of 99.4% in the wavelength range from 200 to 2500 nm, which covers over 98% solar energy in this range. It thus appears fully matte black and is named black silver. The light absorber includes a hierarchical structure with Ag nanoparticles attached on three-dimensional SiO₂ nanostructures, resulting in ultrahigh absorption. Strong localized surface plasmon resonance hybridization together with multiple scattering causes the perfect light absorption. Using the black silver as a light absorber for P-TE power generation, it can achieve a peak voltage density as high as 82.5 V m^-2 under a solar intensity of 100 mW cm^-2, which is large enough to power numerous electronic devices. By assembling 20 thermoelectric modules in series, we test their possibility of practical application, and they can also achieve an average voltage density of 70.66 V m^-2. Our work opens up a promising technology that facilitates high-efficiency and scalable solar energy conversion via the P-TE effect.

In situ photodeposition of platinum clusters on a covalent organic framework for photocatalytic hydrogen production

Photocatalytic hydrogen production has been considered a promising approach to obtain green hydrogen energy. Crystalline porous materials have arisen as key photocatalysts for efficient hydrogen production. Here, we report a strategy to in situ photodeposit platinum clusters as cocatalyst on a covalent organic framework, which makes it an efficient photocatalyst for light-driven hydrogen evolution. Periodically dispersed adsorption sites of platinum species are constructed by introducing adjacent hydroxyl group and imine-N in the region of the covalent organic framework structural unit where photogenerated electrons converge, leading to the in situ reduction of the adsorbed platinum species into metal clusters by photogenerated electrons. The widespread platinum clusters on the covalent organic framework expose large active surface and greatly facilitate the electron transfer, finally contributing to a high photocatalytic hydrogen evolution rate of 42432 μmol g⁻¹ h⁻¹ at 1 wt% platinum loading. This work provides a direction for structural design on covalent organic frameworks to precisely manipulate cocatalyst morphologies and positions at the atomic level for developing efficient photocatalysts.

Porous covalent organic frameworks have arisen as tunable photocatalysts for H₂ production. Here, authors report frameworks engineered with co-catalyst binding sites to improve photocatalytic H₂ evolution performances.

Cellobiose phosphorylase from Caldicellulosiruptor bescii catalyzes reversible phosphorolysis via different kinetic mechanisms

In the process of yielding biofuels from cellulose degradation, traditional enzymatic hydrolysis, such as β-glucosidase catalyzing cellobiose, can barely resolve the contradiction between cellulose degradation and bioenergy conservation. However, it has been shown that cellobiose phosphorylase provides energetic advantages for cellobiose degradation through a phosphorolytic pathway, which has attracted wide attention. Here, the cellobiose phosphorylase gene from Caldicellulosiruptor bescii (CbCBP) was cloned, expressed, and purified. Analysis of the enzymatic properties and kinetic mechanisms indicated that CbCBP catalyzed reversible phosphorolysis and had good thermal stability and broad substrate selectivity. In addition, the phosphorolytic reaction of cellobiose by CbCBP proceeded via an ordered Bi Bi mechanism, while the synthetic reaction proceeded via a ping pong Bi Bi mechanism. The present study lays the foundation for optimizing the degradation of cellulose and the synthesis of functional oligosaccharides.

Oriented Growth of Thin Films of Covalent Organic Frameworks with Large Single-Crystalline Domains on the Water Surface

It has been a longstanding challenge to rationally synthesize thin films of organic two-dimensional (2D) crystals with large single-crystalline domains. Here, we present a general strategy for the creation of 2D crystals of covalent organic frameworks (COFs) on the water surface, assisted by a charged polymer. The morphology of the preorganized monomers underneath the charged polymer on the water surface and their diffusion were crucial for the formation of the organic 2D crystals. Thin films of 2D COFs with an average single-crystalline domain size of around 3.57 ± 2.57 μm² have been achieved, and their lattice structure, molecular structure, and grain boundaries were identified with a resolution down to 3 Å. The swing of chain segments and lattice distortion were revealed as key factors in compensating for the misorientation between adjacent grains and facilitating error corrections at the grain boundaries, giving rise to larger single-crystalline domains. The generality of the synthesis method was further proved with three additional 2D COFs. The oriented single-crystalline domains and clear grain boundaries render the films as model materials to study the dependence of the vertical conductivity of organic 2D crystals on domain sizes and chemical structures, and significant grain boundary effects were illustrated. This study presents a breakthrough in the controlled synthesis of organic 2D crystals with structural control at the molecular level. We envisage that this work will inspire further investigation into the microstructure-intrinsic property correlation of 2D COFs and boost their application in electronics.

Clinical observation of low-dose combination chemotherapy in refractory/recurrent paroxysmal nocturnal hemoglobinuria patients: A single-center retrospective analysis

BACKGROUND

We performed a retrospective analysis to investigate the clinical characteristics and therapeutic strategies of 20 refractory/recurrent PNH patients, including the clinical efficacy of chemotherapy treatment, safety, and survival.

METHODS

The clinical data of 20 classic PNH patients who were refractory/recurrent or had glucocorticoid dependence in our hospital were analyzed, including clinical manifestations, laboratory examinations, treatment efficacy, and survival.

RESULTS

Seventeen patients had a marked improvement in anemia after chemotherapy, 14 patients acquired blood transfusion independence, and the Hb of 3 patients increased to normal levels. Although 6 patients still needed blood transfusion, the transfusion interval was significantly prolonged. The percentages of LDH, TBIL, and RET, which are indicators of hemolysis, were significantly lower than those before chemotherapy. The dosage of adrenal glucocorticoids was reduced by more than half compared with that before chemotherapy.

CONCLUSIONS

Chemotherapy can reduce PNH clones, promote normal hematopoiesis, and control hemolytic attack. It is a promising and widely used therapeutic method.

Avenir® vs. AxiumTM Coils for the Treatment of Intracranial Aneurysms: Results of a Multicenter Randomized Controlled Trial With Short-Term Follow-Up

Purpose

Endovascular coil occlusion is a successful and rapidly evolving strategy used to treat patients who present with intracranial aneurysms. This study aimed to compare the safety and efficacy of the Avenir® and Axium^TM passive mechanically detachable coil systems.

Methods

A prospective, multicenter, randomized controlled study was carried out at ten medical centers from March 2018 to December 2019. A series of consecutive patients diagnosed with intracranial aneurysms were randomly assigned to undergo endovascular treatment with either the Avenir® or the Axium^TM mechanically detachable coil systems. The short-term outcomes from the two groups were compared with a focus on treatment efficacy and safety.

Results

A total of 162 and 161 patients were enrolled in the Avenir and Axium groups, respectively. The rate of successful coil detachment was 100% for the Avenir group and 99.38% for the Axium group. At the six-month follow-up visit, the overall aneurysm occlusion rate was 94.66% for the Avenir group and 96.95% for the Axium group (p > 0.05). We observed no statistically significant differences in clinical condition (as per the modified Rankin Scale) or the degree of aneurysm occlusion (as determined by digital subtraction angiography [DSA] and Raymond-Roy Occlusion Classification). Surgical complications were reported in 27 subjects in the Avenir group and 22 in the Axium group (p > 0.05). DSA performed at 6 months revealed complete aneurysm occlusion in 84 and 86% of patients in the Avenir and Axium groups, respectively.

Conclusion

We observed no significant short-term differences with respect to efficacy or safety when using either Avenir® or Axium^TM coils for the treatment of intracranial aneurysms.

Access to Photostability-Enhanced Unnatural Base Pairs via Local Structural Modifications

Completing the storage and retrieval of increased genetic information in vivo and producing therapeutic proteins have been achieved by the unnatural base pair dNaM-dTPT3. Up to now, some biological and chemical approaches are implemented to improve the semi-synthetic organism (SSO). However, the photosensitivity of this pair, suggested as a potential threat to the healthy growth of cells, is still a problem to solve. Hence, we designed and synthesized a panel of TPT3 analogues with the basic structural skeletons of TPT3 but modified thiophene rings at variant sites to improve the photostability of unnatural base pairs. A comprehensive screening strategy, including photosensitivity tests, kinetic experiments, and replication in vitro by PCR and in vivo by amplification, was implemented. A new pair, dNaM-dTAT1, which had almost equally high efficiency and fidelity with the dNaM-dTPT3 pair itself both in vivo and in vitro, was proven to be more photostable and thermostable and less toxic to E. coli cells. The discovery of dNaM-dTAT1 represents our first progress for the optimization of this type of bases toward more photostable properties; our data also suggest that less photosensitive unnatural base pairs will be beneficial to build a healthier cellular replication system.

Key genes associated with prognosis and metastasis of clear cell renal cell carcinoma

BACKGROUND

Clear cell renal cell carcinoma (ccRCC) is a tumor that frequently shows the hematogenous pathway and tends to be resistant to radiotherapy and chemotherapy. However, the exact mechanism of ccRCC metastasis remains unknown.

METHODS

Differentially expressed genes (DEGs) of three gene expression profiles (GSE85258, GSE105288 and GSE22541) downloaded from the Gene Expression Omnibus (GEO) database were analyzed by GEO2R analysis, and co-expressed DEGs among the datasets were identified using a Venn drawing tool. The co-expressed DEGs were investigated using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, and hub genes were determined based on the protein-protein interaction network established by STRING. After survival analysis performed on UALCAN website, possible key genes were selected and verified in ccRCC cell lines and ccRCC tissues (n = 44). Statistical analysis was conducted using GraphPad Prism (Version 8.1.1).

RESULTS

A total of 104 co-expressed DEGs were identified in the three datasets. Pathway analysis revealed that these genes were enriched in the extracellular matrix (ECM)-receptor interaction, protein digestion and absorption and focal adhesion. Survival analysis on 17 hub genes revealed that four key genes with a significant impact on survival: procollagen C-endopeptidase enhancer (PCOLCE), prolyl 4-hydroxylase subunit beta (P4HB), collagen type VI alpha 2 (COL6A2) and collagen type VI alpha 3 (COL6A3). Patients with higher expression of these key genes had worse survival than those with lower expression. In vitro experiments revealed that the mRNA expression levels of PCOLCE, P4HB and COL6A2 were three times higher and that of COL6A3 mRNA was 16 times higher in the metastatic ccRCC cell line Caki-1 than the corresponding primary cell line Caki-2. Immunohistochemistry revealed higher expression of the proteins encoded by these four genes in metastatic ccRCC compared with tumors from the corresponding primary sites, with statistical significance.

CONCLUSION

PCOLCE, P4HB, COL6A2 and COL6A3 are upregulated in metastatic ccRCC and might be related to poor prognosis and distant metastases.

Site-specified Unnatural Base Excision via Visible Light

Base excision (BE) is an important yet hard-to-control biological event. Unnatural base pairs are powerful tools to revolutionize biological study in various areas. In this paper, we report a visible-light-induced...

GlmU inhibitor from the roots of Euphorbia ebracteolata as an anti-tuberculosis agent

Ebractenoid F was identified to be a GlmU inhibitor from Euphorbia ebracteolata, which could inhibit the cell wall biosynthesis of M. tb H37Ra, along with the biofilm formation.

Neoadjuvant programmed cell death 1 blockade combined with chemotherapy for resectable esophageal squamous cell carcinoma

BACKGROUND

Programmed cell death 1 (PD-1) blockade induces tumor regression in patients with advanced esophageal squamous cell carcinoma (ESCC); however, little is known about the efficacy of PD-1 blockade as neoadjuvant therapy in resectable ESCC. We aim to assess the safety and feasibility of using the combination of neoadjuvant PD-1 blockade with chemotherapy in patients with ESCC.

METHODS

Patients with previously untreated, resectable (stage II or III) ESCC were enrolled. Each patient received two 21-day cycles of neoadjuvant treatment with camrelizumab, nab-paclitaxel, and carboplatin before undergoing surgical resection approximately 6-9 weeks after the first cycle.

RESULTS

Between January 2020 and September 2020, 37 patients were screened, of whom 23 were enrolled. The neoadjuvant therapeutic regimen had an acceptable side effect profile, and no delays in surgery were observed. Severe (grade 3-4) treatment-related adverse events included neutropenia (9 of 23, 39.1%) and leukopenia (2 of 23, 8.7%). The objective response and disease control rates were 90.5% and 100%, respectively. Twenty patients received surgery, and R0 resection was achieved in all cases. Five (25%) patients had a pathological complete response (PCR) and 10 (50%) patients had a major pathological response. The proportion of patients with a high tumor mutation burden and a high expression of programmed death-ligand 1 (PD-L1) in primary tumor was significantly higher in the PCR group than in the non-PCR group (p=0.044). The number of infiltrating PD-L1+ CD163+ cells was significantly lower in the PCR group than in the non-PCR group after treatment (p=0.017).

CONCLUSIONS

Neoadjuvant camrelizumab plus carboplatin and nab-paclitaxel had manageable treatment-related adverse effects and induced an objective response in 90.5% of patients, demonstrating its antitumor efficacy in resectable ESCC.

TRIAL REGISTRATION NUMBER

ChiCTR2000028900.