A novel biologically active xylaphenoside from the endophytic fungus Xylaria CGMCC No.5410

A novel 3,4-dihydroisocoumarin glycoside (1) was obtained from the culture of endophytic fungal Xylaria CGMCC No.5410 from the leaves of Selaginella moellendorffii Hieron, together with five known compounds (2-6). Their structures elucidations were conducted by HRESIMS, NMR and IR spectroscopic analysis. All the isolated compounds were evaluated for their antimicrobial, anti-tumor, and anti-HIV-1 activities. Compound 1 only displayed weak antimicrobial activity against micrococcus luteus. The other known compounds showed different antimicrobial, anti-tumor, or anti-HIV-1 activities.

Effects of motor imagery based brain-computer interface on upper limb function and attention in stroke patients with hemiplegia: a randomized controlled trial

BACKGROUND

Seeking positive and comprehensive rehabilitation methods after stroke is an urgent problem to be solved, which is very important to improve the dysfunction of stroke. The aim of this study was to investigate the effects of motor imagery-based brain-computer interface training (MI-BCI) on upper limb function and attention in stroke patients with hemiplegia.

METHODS

Sixty stroke patients with impairment of upper extremity function and decreased attention were randomly assigned to the control group (CR group) or the experimental group (BCI group) in a 1:1 ratio. Patients in the CR group received conventional rehabilitation. Patients in the BCI group received 20 min of MI-BCI training five times a week for 3 weeks (15 sessions) in addition to conventional rehabilitation. The primary outcome measures were the changes in Fugl-Meyer Motor Function Assessment of Upper Extremities (FMA-UE) and Attention Network Test (ANT) from baseline to 3 weeks.

RESULTS

About 93% of the patients completed the allocated training. Compared with the CR group, among those in the BCI group, FMA-UE was increased by 8.0 points (95%CI, 5.0 to 10.0; P < 0.001). Alert network response time (32.4ms; 95%CI, 58.4 to 85.6; P < 0.001), orienting network response (5.6ms; 95%CI, 29.8 to 55.8; P = 0.010), and corrects number (8.0; 95%CI, 17.0 to 28.0; P < 0.001) also increased in the BCI group compared with the CR group. Additionally, the executive control network response time (- 105.9ms; 95%CI, - 68.3 to - 23.6; P = 0.002), the total average response time (- 244.8ms; 95%CI, - 155.8 to - 66.2; P = 0.002), and total time (- 122.0ms; 95%CI, - 80.0 to - 35.0; P = 0.001) were reduced in the BCI group compared with the CR group.

CONCLUSION

MI-BCI combined with conventional rehabilitation training could better enhance upper limb motor function and attention in stroke patients. This training method may be feasible and suitable for individuals with stroke.

TRIAL REGISTRATION

This study was registered in the Chinese Clinical Trial Registry with Portal Number ChiCTR2100050430(27/08/2021).

The therapeutic effect of transcranial direct current stimulation combined with cognitive training on patients with unilateral neglect after stroke

BACKGROUND: Unilateral neglect (UN) is a frequent cognitive disability following a stroke. Additional research is needed to determine the most effective cognitive rehabilitation techniques. OBJECTIVE: Based on the unilateral neglect neural network, we aim to explore the effect of a new model of transcranial direct current stimulation (tDCS) combined with cognitive training on stroke patients with unilateral neglect. METHODS: Thirty stroke patients with UN after stroke were randomly divided into three groups. All patients received cognitive training for UN and transcranial direct current stimulation with an anode placed on the corresponding part of the right hemisphere for 2 weeks. Treatment group A received multi-site tDCS from the inferior parietal lobule, middle temporal gyrus to prefrontal lobe. Group B received single-site tDCS of the inferior parietal lobule. The improvement of UN symptoms was evaluated by the scores of the Deviation index and Behavioral Inattention Test conventional tests. RESULTS: All groups showed improvements in all tests, and the scores of the treatment groups were statistically significant compared with the control group. CONCLUSION: Both single-site tDCS and multi-site tDCS have therapeutic effects on UN after stroke, and the difference in the therapeutic effects of the two modes still needs to be further explored.

Highly sensitive liquid chromatographic method combined with online ion suppression to remove interfering anions and mass spectrometry for impurity profiling of paromomycin sulfate

A previously developed high-performance liquid chromatography method combined with pulsed amperometric detection allowed to separate many impurities of paromomycin. However, due to the presence of ion pairing agents and sodium hydroxide in the mobile phase, direct coupling to mass spectrometry for the identification of the chemical structures of the impurities was not an option. Indeed, ion suppression was encountered by trifluoroacetic acid and pentafluoroproponic acid in the mobile phase. A cation self-regenerating suppressor, which was originally designed for increasing analyte conductivity of ammonia and amines analysis in ion chromatography, was coupled between the liquid chromatography and ion trap-time of flight-mass spectrometry and almost all trifluoroacetic acid and pentafluoroproponic acid in the mobile phase was removed. The limit of detection of paromomycin in this integrated system improved significantly to 20 ng/ml (0.4 ng). The chemical structures of 19 impurities were elucidated and seven impurities were reported for the first time.

Analysis of the Safety and Pregnancy Outcomes of Fertility-sparing Surgery in Ovarian Malignant Sex Cord-stromal Tumours: A Multicentre Retrospective Study

AIMS

To assess the difference in survival between fertility-sparing surgery (FSS) and radical surgery and explore pregnancy outcomes after FSS in stage I malignant sex cord-stromal tumours (MSCSTs).

MATERIALS AND METHODS

We carried out a multicentre retrospective cohort study on patients who were diagnosed with MSCSTs and the tumour was confined to one ovary. The patients were divided into FSS and radical surgery groups. Inverse probability of treatment weighting (IPTW) was used to balance variables between the two groups. Kaplan-Meier analysis was used to compare the difference in disease-free survival (DFS). Univariate and multivariate Cox regression analysis was used to find risk factors of DFS. Univariate logistic regression analysis was used to assess risk factors of pregnancy.

RESULTS

In total, 107 patients were included, of whom 54 (50.5%) women underwent FSS and 53 (49.5%) received radical surgery. After IPTW, a pseudo-population of 208 was determined and all of the covariates were well balanced. After a median follow-up time of 50 months (range 7-156 months), 10 patients experienced recurrence and two died. There was no significant difference in DFS between the two groups, both in unweighted (P = 0.969) or weighted cohorts (P = 0.792). In the weighted cohort, stage IC (P = 0.014), tumour diameter >8 cm (P = 0.003), incomplete staging surgery (P = 0.003) and no adjuvant chemotherapy (P < 0.001) were the four high-risk factors associated with a shorter DFS. Among 14 patients who had pregnancy desire, 11 (78.6%) women conceived successfully; the live birth rate was 76.9%. In univariate analysis, only adjuvant chemotherapy (P = 0.009) was associated with infertility.

CONCLUSIONS

On the premise of complete staging surgery, FSS is safe and feasible in early stage MSCSTs with satisfactory reproductive outcomes.

Modified quantitative and volumetric response evaluation criteria for patients with hepatocellular carcinoma after transarterial chemoembolization

Objective

This study aimed to investigate the cutoff value of quantitative and volumetric response evaluation criteria for patients with hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) and compare the performance of the modified criteria to one-dimensional criteria in survival prediction.

Methods

A retrospective single-center study was performed for treatment-naive patients with HCC who underwent initial TACE between June 2015 and June 2019. Treatment response assessment was performed after the first observation by contrast CT or MRI, with the measurement of diameters by modified Response Evaluation Criteria in Solid Tumors (mRECIST) and volumes by quantitative European Association for Study of the Liver (qEASL). Overall survival (OS) was the primary endpoint of this study. The new cutoff value for volumetric response evaluation criteria was created using restricted cubic splines. The performance of modified qEASL (mqEASL, with the new cutoff value) and mRECIST on survival prediction was compared by Cox regression models in internal and external validation.

Results

A total of 129 patients (mean age, 60 years ± 11 [standard deviation]; 111 men) were included and divided into training (n=90) and validation (n=39) cohorts. The cutoff value for the viable volume reduction was set at 57.0%. The mqEASL enabled separation of non-responders and responders in terms of median OS (p<0.001), 11.2 months (95% CI, 8.5-17.2 months) vs. 31.5 months (95% CI, 25.5-44.0 months). Two multivariate models were developed with independent prognostic factors (tumor response, metastasis, portal vein tumor thrombus, and subsequent treatment) to predict OS. Model 2 (for mqEASL) had a greater Harrel's C index, higher time-dependent area under the receiving operator characteristic curve (AUROC), and more precise calibration on 6-month survival rates than Model 1 (for mRECIST).

Conclusions

With the modified cutoff value, the quantitative and volumetric response of HCC patients to TACE becomes a precise predictor of overall survival. Further studies are needed to verify this modification before application in clinical practice.

Mushroom Poisoning Outbreaks - China, 2022

What is already known about this topic?

Mushroom poisoning is one of the most serious food safety issues in China. By the end of 2021, over 520 poisonous mushrooms had been discovered in China. The Southwest region of China was the most severely affected. Mushroom poisonings mainly concentrated in the summer and autumn months.

What is added by this report?

In 2022, China CDC conducted an investigation of 482 incidents of mushroom poisoning across 21 provincial-level administrative divisions (PLADs). This resulted in 1,332 patients and 28 deaths, with a total case fatality rate of 2.1%. A total of 98 mushrooms were identified, causing 7 different clinical types of diseases. Three provisional new species (Collybia humida nom. prov., Spodocybe venenata nom. prov., and Omphalotus yunnanensis nom. prov.) were newly recorded as poisonous mushrooms in China, in addition to 10 other species.

What are the implications for public health practice?

In view of the extensive impact and harm of poisonous mushrooms on public health, it is necessary to promote prevention and improve the ability of professionals to identify, diagnose, and treat mushroom poisoning.

Quinoxaline-fused octaphyrin(2.0.0.0.2.0.0.0). A rudimentary chemosensor

A quinoxaline-fused octaphyrin(2.0.0.0.2.0.0.0) was synthesized by the FeCl₃-induced oxidative coupling of an α-free quinoxaline-fused tetrapyrrole. This macrocycle adopts a figure-of-eight conformation in the solid state and acts as a rudimentary chemosensor in solution. The Lewis basic anions fluoride and hydroxide induce a colour change via a deprotonation mechanism.

Snap29 Is Dispensable for Self-Renewal Maintenance but Required for Proper Differentiation of Mouse Embryonic Stem Cells

Pluripotent embryonic stem cells (ESCs) can self-renew indefinitely and are able to differentiate into all three embryonic germ layers. Synaptosomal-associated protein 29 (Snap29) is implicated in numerous intracellular membrane trafficking pathways, including autophagy, which is involved in the maintenance of ESC pluripotency. However, the function of Snap29 in the self-renewal and differentiation of ESCs remains elusive. Here, we show that Snap29 depletion via CRISPR/Cas does not impair the self-renewal and expression of pluripotency-associated factors in mouse ESCs. However, Snap29 deficiency enhances the differentiation of ESCs into cardiomyocytes, as indicated by heart-like beating cells. Furthermore, transcriptome analysis reveals that Snap29 depletion significantly decreased the expression of numerous genes required for germ layer differentiation. Interestingly, Snap29 deficiency does not cause autophagy blockage in ESCs, which might be rescued by the SNAP family member Snap47. Our data show that Snap29 is dispensable for self-renewal maintenance, but required for the proper differentiation of mouse ESCs.

Exosomal HBV-DNA for diagnosis and treatment monitoring of chronic hepatitis B

This study examined exosomal hepatitis B virus (HBV)-DNA levels in chronic HBV infection (CHB). Patients were grouped according to the European Association for the Study of the Liver classification (1: HBV-DNA-positive CHB, normal alanine aminotransferase [ALT]; 2: HBV-DNA-positive CHB, elevated ALT; 3: HBV-DNA-negative HBeAb-positive CHB, normal ALT; 4: HBV-DNA-positive HBeAg-negative HBeAb-positive CHB, elevated ALT; 5: HBV-DNA-negative, HBcAb-positive; 6: HBV-negative, normal ALT). Exosomes were isolated, comparative analysis of exosomes and serum HBV-DNA. The HBV-DNA content was lower in exosomes than in serum for groups 1, 2, and 4 (all P < 0.05). In the groups negative for serum HBV-DNA (groups 3 and 5), the exosomal HBV-DNA levels were higher than the serum HBV-DNA levels (all P < 0.05). The exosomal and serum HBV-DNA levels were correlated in groups 2 (R ² = 0.84) and 4 (R ² = 0.98). The exosomal HBV-DNA levels were correlated with total bilirubin (R ² = 0.94), direct bilirubin (R ² = 0.82), and indirect bilirubin (R ² = 0.81) in group 5 (all P < 0.05). In patients with CHB and negative for serum HBV-DNA, exosomal HBV-DNA was detectable and could be used to monitor the treatment effects. Exosomal HBV-DNA could be used in patients with a high suspicion of HBV infection but negative for serum HBV-DNA.

Human Motion Segmentation via Velocity-Sensitive Dual-Side Auto-Encoder

Human motion segmentation (HMS) aims to segment a long human action video into a bunch of short and meaningful action clips. Existing supervised learning approaches need a large amount of training data which may be costly in real-world scenario, while most unsupervised clustering methods cannot fully explore the temporal correlations among human motions and hard to achieve promising performances. In our paper, we design a novel unsupervised framework, called Velocity-Sensitive Dual-Side Auto-Encoder (VSDA), for HMS task. Specifically, a multi-neighbor auto-encoder (MNA) is proposed to extract informative temporal features, which fully explores the local temporal patterns of human motions. In addition, a long-short distance encoding (LSE) strategy is designed. It constrains the encoded representations of close (short-distance) frames becoming similar while the representations of far-away (long-distance) frames becoming distinctive. Similarly, this strategy is also deployed on the decoded outputs as the long-short distance decoding (LSD) module. The LSE/LSD guides the learning process explicitly and implicitly to achieve the dual-side structure. Moreover, we consider the energy variations during the human motion to propose the velocity-sensitive (VS) guidance mechanism for further model improvement. VSDA leverages the temporal characteristics of human motion and derives promising HMS performance. Comprehensive experiments on six real-world human motion datasets illustrate the effectiveness of our proposed model.

Transcutaneous electrical acupoint stimulation for the prevention of perioperative neurocognitive disorders in geriatric patients: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

To evaluate whether transcutaneous electrical acupoint stimulation (TEAS) decreases rates of perioperative neurocognitive disorders (PND) when used as an adjuvant method during perioperative period in geriatric patients since the new definition was released in 2018.

METHODS

Six databases [Chinese National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, WanFang Database, PubMed, EMBASE, and Cochrane Library] were systematically searched. Data analysis was performed using RevMan 5.4.1 software (Copenhagen: The Nordic Cochrane Centre, the Cochrane Collaboration, 2020). Risk ratios (RR) with 95% confidence interval were calculated using a random effects model. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

RESULTS

13 randomized clinical trials (999 patients) in total were included. TEAS had positive effects on preventing the incidence of PND (RR: 0.43; 0.31, 0.61; P < .001; low certainty) [postoperative delirium within 7 days (RR: 0.39; 0.26, 0.59; P < .001), delayed neurocognitive recovery within 3 months (RR: 0.51; 0.33, 0.78; P = .002)]. TEAS could also improve the scores of the confusion assessment method (CAM) (Mean difference: -1.30; -2.14, -0.46; P = .003; low certainty). Limited evidence suggested that TEAS could reduce the serum levels of biochemical indicator (S100β) (SMD = -1.08, -1.67, -0.49, P < .001; I2  = 83%; very low certainty) as well as anesthetic requirements (remifentanil) (SMD: -1.58; -2.54, -0.63; P = .001; I2  = 87%; very low certainty). Subgroup analysis indicated that different protocols of TEAS had significant pooled benefits (TEAS used only in surgery and in combination with postoperative intervention) (RR: 0.45; 0.31, 0.63; P < .001). Acupoint combination (LI4 and PC6) in the TEAS group had more significantly advantages (RR: 0.34; 0.17, 0.67; P = .002). TEAS group had a lower incidence of PND in different surgery type (orthopedic surgery and abdominal surgery) (RR: 0.43; 0.30, 0.60; P < .001), as well as with different anesthetic modality (intravenous anesthesia and intravenous and inhalational combined anesthesia) (RR: 0.38; 0.23, 0.61; P < .001).

CONCLUSION

In terms of clinical effectiveness, TEAS appeared to be beneficial for prophylaxis of PND during a relatively recent period, noting the limitations of the current evidence.

Aging-induced down-regulation of Pka/Bkca pathway in rat cerebral arteries

The incidence of cerebrovascular diseases increases significantly with aging. This study aimed to test the hypothesis that aging may influence the protein kinase A (PKA)-dependent vasodilation via RyR/BKCa pathway in the middle cerebral arteries (MCA). Male Sprague-Dawley rats were randomly divided into control (4-6 month-old) and aged (24-month-old) groups. The functions of MCA and ion channel activities in smooth muscle cells were examined using myograph system and patch-clamp. Aging decreased the isoproterenol/forskolin-induced relaxation in the MCA. Large-conductance Ca2+-activated-K+ (BKCa) channel inhibitor, iberiotoxin, significantly attenuated the forskolin-induced vasodilatation and hyperpolarization in the young group, but not in the aged group. The amplitude and frequency of spontaneous transient outward currents (STOCs) were significantly decreased in the aged group. Single channel recording revealed that the mean open time of BKCa channels were decreased, while an increased mean closed time of BKCa channels were found in the aged group. The Ca2+/voltage sensitivity of the channels was decreased accompanied by reduced BKCa α and β1-subunit, the expression of RyR2, PKA-Cα and PKA-Cβ subunits were also declined in the aged group. Aging induced down-regulation of PKA/BKCa pathway in cerebral artery in rats. The results provides new information on further understanding in cerebrovascular diseases resulted from age-related cerebral vascular dysfunction.

Natural Polyphenols for Treatment of Colorectal Cancer

Colorectal cancer (CRC) is a prevalent and serious gastrointestinal malignancy with high mortality and morbidity. Chemoprevention refers to a newly emerged strategy that uses drugs with chemopreventive properties to promote antioxidation, regulate cancer cell cycle, suppress proliferation, and induce cellular apoptosis, so as to improve cancer treatment outcomes. Natural polyphenols are currently recognized as a class of chemopreventive agents that have shown remarkable anticarcinogenic properties. Numerous in vitro and in vivo studies have elucidated the anti-CRC mechanisms of natural polyphenols, such as regulation of various molecular and signaling pathways. Natural polyphenols are also reportedly capable of modulating the gut microbiota and cancer stem cells (CSCs) to suppress tumor formation and progression. Combined use of different natural polyphenols is recommended due to their low bioavailability and instability, and combination treatment can exert synergistical effects, reduce side effects, and avoid drug resistance in CRC treatment. In summary, the application of polyphenols in the chemoprevention and treatment of CRC is promising. Further clinical evaluation of their effectiveness is warranted and anticipated.

Positive response of a recurrent clear cell sarcoma to anlotinib combined with chemotherapy: A case report

RATIONALE

Renal clear cell sarcoma is a rare and highly invasive malignant renal tumor that easily relapses after treatment. Recurrent recurrent clear cell carcinoma (CCSK) responds poorly to chemotherapy and has no established standardized treatment, and need to be explored potentially useful treatments.

PATIENT CONCERNS

A 18-years-old patient with renal clear cell sarcoma recurrence after open radical nephrectomy.

DIAGNOSIS

Recurrent clear cell sarcoma.

INTERVENTIONS

After chemotherapy alone failed, the patient received 6 courses of anlotinib combined with chemotherapy. The tumor had significantly reduced in size and the recurrent tumor and part of the liver were resected.

OUTCOMES

No tumor recurrence or metastasis was detected during the follow-up 8 months after the operation.

LESSONS

This is the first report describing the use of anlotinib in treating CCSK. We believe that anlotinib combined with chemotherapy may be a useful treatment option for patients with recurrent CCSK.

Strain modulated luminescence in green InGaN/GaN multiple quantum wells with microwire array by piezo-phototronic effect

We have demonstrated piezo-phototronic enhanced modulation in green InGaN/GaN multiple quantum well (MQW) light-emitting diodes (LEDs) with a microwire array (MWA) structure. It is found that an a-axis oriented MWA structure induces more c-axis compressive strain than a flat structure when a convex bending strain is applied. Moreover, the photoluminescence (PL) intensity exhibits a tendency to increase first and then decrease under the enhanced compressive strain. Specifically, light intensity reaches a maximum of about 123% accompanied by 1.1-nm blueshift, and the carrier lifetime comes to the minimum simultaneously. The enhanced luminescence characteristics are attributed to strain-induced interface polarized charges, which modulate the built-in field in InGaN/GaN MQWs and could promote the radiative recombination of carriers. This work opens a pathway to drastically improve InGaN-based long-wavelength micro-LEDs with highly efficient piezo-phototronic modulation.

Dietary habits, nutrition and esophageal cancer: A case-control study on Kazakhs in Xinjiang

OBJECTIVE

To explore associations between dietary habits and esophageal epithelial cell carcinoma (ESCC) and provide a potential direction for exploring how different dietary habits and nutrient intake might affect ESCC development.

METHODS

198 ESCC cases and 200 controls on Kazakhs were recruited in Xinjiang from 2010 to 2019 for a group-matched case-control study. The case group were recruited from the First Affiliated Hospital of Xinjiang Medical University and Affiliated Cancer Hospital of Xinjiang Medical University. The control population were recruited from two parts: hospital-based control and population-based control. The diagnosis was confirmed by histological examination. The food frequency questionnaire was used to investigate the dietary nutrients intake. Folic acid, vitamin B12, and DNA-methyltransferase 1(DNMT1) levels were measured in serum samples obtained from cases and controls.

RESULTS

The cholesterol intake of ESCC group was significantly higher than that of the control group while the intakes of protein, thiamin, riboflavin, folic acid, vitamin A, B6, C and E were significantly lower than the control group. Factors including lacking fresh vegetables and fruits, low educational level, low income, alcohol drinking, eating solid and dry food and smoked meat, dieting irregularly, salty taste preference, low serum folic acid level and high serum DNMT1 level were associated with increased risk of ESCC in Kazakhs.

CONCLUSION

Dietary habits and nutrient intake were associated with increased risk of ESCC in Kazakhs that may provide a potential direction for further studies.

Towards Exploring Large Molecular Space: An Efficient Chemical Genetic Algorithm

Generating molecules with desired properties is an important task in chemistry and pharmacy. An efficient method may have a positive impact on finding drugs to treat diseases like COVID-19. Data mining and artificial intelligence may be good ways to find an efficient method. Recently, both the generative models based on deep learning and the work based on genetic algorithms have made some progress in generating molecules and optimizing the molecule's properties. However, existing methods need to be improved in efficiency and performance. To solve these problems, we propose a method named the Chemical Genetic Algorithm for Large Molecular Space (CALM). Specifically, CALM employs a scalable and efficient molecular representation called molecular matrix. Then, we design corresponding crossover, mutation, and mask operators inspired by domain knowledge and previous studies. We apply our genetic algorithm to several tasks related to molecular property optimization and constraint molecular optimization. The results of these tasks show that our approach outperforms the other state-of-the-art deep learning and genetic algorithm methods, where the z tests performed on the results of several experiments show that our method is more than 99% likely to be significant. At the same time, based on the experimental results, we point out the insufficiency in the experimental evaluation standard which affects the fair evaluation of previous work.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11390-021-0970-3.

Transarterial Chemoembolization Combined with Immune Checkpoint Inhibitors Plus Tyrosine Kinase Inhibitors versus Immune Checkpoint Inhibitors Plus Tyrosine Kinase Inhibitors for Advanced Hepatocellular Carcinoma

OBJECTIVE

This study aimed to evaluate the effectiveness and safety of transarterial chemoembolization (TACE) in combination with immune checkpoint inhibitors (ICIs) plus tyrosine kinase inhibitors (TKIs) (TACE+IT) versus ICIs plus TKIs (IT) for advanced hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

Data of consecutive advanced HCC patients receiving TACE+IT or IT between January 2019 and December 2021 were included and were retrospectively analyzed. Propensity score matching (PSM) was performed to reduce bias due to confounding variables. The primary outcome of the study was overall survival (OS). The secondary outcomes were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs), respectively.

RESULTS

Sixty-four patients were enrolled in the study, among which 24 and 40 received TACE+IT and IT, respectively. The PSM cohort included 24 patients receiving TACE+IT (TACE+IT group) and 24 patients receiving IT (IT group) alone. During a median follow-up of 23 months, patients in TACE+IT group had significantly longer OS (median, 17.3 vs 11.8 months, P = 0.023), better ORR (41.7% vs 12.5%, P = 0.023) and DCR (79.2% vs 50.0%, P = 0.035) than those in the IT group, whereas a non-significant trend in PFS (median, 7.4 vs 6.7 months, P = 0.23) was observed. According to multivariable cox regression analysis, it was found that treatment modality was the only independent risk factor for OS (HR = 0.404, 95% CI = 0.179-0.911, P < 0.05). There were no remarkable differences in AEs associated with ICIs and TKIs between the two groups, with the exception of gastrointestinal reaction.

CONCLUSION

TACE combined with ICIs plus TKIs significantly improved OS, ORR, and DCR and showed a relatively longer PFS trend over ICIs combined with TKIs for advanced HCC.

Semi-Supervised Domain Adaptive Structure Learning

Semi-supervised domain adaptation (SSDA) is quite a challenging problem requiring methods to overcome both 1) overfitting towards poorly annotated data and 2) distribution shift across domains. Unfortunately, a simple combination of domain adaptation (DA) and semi-supervised learning (SSL) methods often fail to address such two objects because of training data bias towards labeled samples. In this paper, we introduce an adaptive structure learning method to regularize the cooperation of SSL and DA. Inspired by the multi-views learning, our proposed framework is composed of a shared feature encoder network and two classifier networks, trained for contradictory purposes. Among them, one of the classifiers is applied to group target features to improve intra-class density, enlarging the gap of categorical clusters for robust representation learning. Meanwhile, the other classifier, serviced as a regularizer, attempts to scatter the source features to enhance the smoothness of the decision boundary. The iterations of target clustering and source expansion make the target features being well-enclosed inside the dilated boundary of the corresponding source points. For the joint address of cross-domain features alignment and partially labeled data learning, we apply the maximum mean discrepancy (MMD) distance minimization and self-training (ST) to project the contradictory structures into a shared view to make the reliable final decision. The experimental results over the standard SSDA benchmarks, including DomainNet and Office-home, demonstrate both the accuracy and robustness of our method over the state-of-the-art approaches.

GOLM1 is related to the inflammatory/immune nature of uveal melanoma and acts as a promising indicator for prognosis and immunotherapy response

Purpose: Inflammatory/immune-related features are associated with the immunotherapy and prognosis of uveal melanoma (UVM). In this study, we systematically analyzed the correlation between GOLM1 and the inflammatory/immune nature of UVM and explored its potential value in predicting prognosis and guiding immunotherapy for UVM patients.

Methods: A total of 143 UVM patients were enrolled in the current study. The differentially expressed genes between the GOLM1-low expression (LEXP) and GOLM1-high expression (HEXP) subgroups were calculated by the “limma” package and further annotated to reveal the key pathways by the “ClusterProfiler” package. Immunocyte infiltration was evaluated by single-sample gene set enrichment analysis, while the potential response to immunotherapy was realized by subclass mapping analysis. Moreover, tumor tissue sections from 23 UVM patients were collected and stained for GOLM1 (1:300; cat# DF8100, Affinity Biosciences), PD-L1 (1:250; cat# ab213524, Abcam), PD-1 (1:100; cat# ab52587, Abcam), CTLA-4 (1:300; cat# DF6793, Affinity Biosciences), and IFN-γ (1:300; cat# DF6045, Affinity Biosciences).

Results: We found that higher expression of GOLM1 correlated with an unfavorable prognosis in UVM patients. Multivariate Cox regression analysis suggested that GOLM1 served as a prognostic factor independent of clinicopathological parameters. Notably, we found that the expression of PD-1, PD-L1, IFN-γ, and CTLA4 was higher in the GOLM1-high subgroup than in the GOLM1-low expression subgroup at the mRNA level and was subsequently validated at the protein level by immunohistochemistry. Gene pattern and SubMap analyses confirmed the indicator role of GOLM1 in predicting immunotherapy response in UVM.

Conclusion: Taken together, GOLM1 is a novel prognostic marker, and it can be employed to predict the overall survival outcomes and treatment responses of anti-PD-1/PD-L1 and anti-CTLA4 therapies for UVM patients.