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Background: Definitive concurrent chemoradiotherapy (CCRT) followed by maintenance therapy with immune checkpoint inhibitors offers the best chance of cure for patients with stage III non-small cell lung cancer (NSCLC). A significant challenge in this regimen is the occurrence of acute severe lymphopenia (ASL), which can compromise treatment efficacy. Currently, there are no effective strategies for preventing and treating ASL. Shenglin decoction (SLD), a traditional Chinese herbal medicine formulation, has demonstrated preliminary efficacy in mitigating ASL. However, robust evidence from clinical trials and a clear understanding of its mechanism of action are still needed. This study aims to comprehensively assess the efficacy, safety, and underlying mechanisms of SLD in the prevention of ASL. Methods: This prospective, dual-center, open-label, randomized controlled trial will enroll 140 stage III NSCLC patients. Participants will be randomly allocated in a 1:1 ratio to a control group or an experimental group. Both groups will undergo definitive CCRT. Alongside the commencement of CCRT, the experimental group will receive an additional oral SLD intervention for a duration of three months. The primary outcome is the incidence rate of ASL, defined as the proportion of patients who experience at least one instance of a total lymphocyte count falling below 0.5 × 10^9 cells/L within 3 months of initiating CCRT treatment. Additionally, 16S rRNA gene sequencing analysis of fecal samples to assess gut microbiota, as well as metabolomic analysis of fecal/blood samples, will be conducted to explore potential mechanisms. Discussion: This study protocol aims to rigorously evaluate the efficacy and safety of SLD, as well as elucidate its mechanism of action in preventing ASL. Successful outcomes could establish SLD as an evidence-based intervention for ASL prevention in NSCLC patients undergoing CCRT. Trial Registration: The trial was registered at the Chinese Clinical Trials Registry (ChiCTR2300071788, https://www.chictr.org.cn/).
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We propose an electro-optic tunable optical filter based on sidewall long period waveguide grating (LPWG) in lithium niobate on insolator (LNOI). The operation of our proposed filter is based on the mode coupling, filtering, and absorption achieved, respectively, with two corrugated sidewall LPWGs, a tapered waveguide, and two metal ribbons. Our typical fabricated devices achieved a 16.32-dB rejection band and an EO tuning efficiency of â¼0.344â nm/V. Our proposed LPWG and filter are compact and could be integrated with other LNOI waveguide devices to realize more sophisticated functions for on-chip optical signal processing.
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By using a population of 123 F12 lines (recombinant inbred lines, RILs) derived from a cross between India variety Dular and Japanica variety Lemont, an analysis of quantitative trait loci (QTL) was conducted for the flag leaf chlorophyll content of rice. The chlorophyll content was determined by SPAD-502 in 2005 and 2006, respectively, and software QTLMapper 1.6 was applied to analyze the QTL, including the additive and epistatic effects and the QTL interactions with environment for chlorophyll content. A total of ten QTL showing additive effects on chlorophyll content (Chl) were detected, which accounted for 73.51% of the phenotypic variation. The percentage of phenotypic variation explained by single QTL was 2.08%-20.14%, and the interactions of 6 QTLs with environment (AE) were significant. Epistasis analysis indicated that there existed 13 significant additive x additive interactions on chlorophyll content, 6 pairs of which were significant in additive x additive interactions with environment (AAE).