Platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios are associated with the efficacy of immunotherapy in stage III/IV non-small cell lung cancer.

Peripheral serological indicators are novel markers associated with prognosis in multiple malignant tumors. In the present study, platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were selected to construct a model that predicts long-term survival of patients with stage IIIB-IV non-small cell lung cancer (NSCLC) who received treatment with an anti-programmed cell death protein-1 (PD-1) monoclonal antibody. A total of 133 patients were eligible for the present retrospective study (January 2019-February 2021). The area under the receiver operating characteristic curve was used to compare the diagnostic value of PLR and NLR, and combined PLR and NLR. The objective response rate and disease control rate of each group were obtained and the differences were compared using the χ2 test. The prognostic value of these indicators was assessed using the Kaplan-Meier method. Cox regression analysis was used to evaluate risk factors associated with long-term survival. Statistically significant parameters were included in the nomogram. Based on the median PLR and NLR values, the patients were divided into high PLR (H-PLR) (PLR >200.00, 67 patients) and low PLR (L-PLR) (PLR ≤200.00, 66 patients), and high NLR (H-NLR) (NLR >3.56, 65 patients) and low NLR (L-NLR) (NLR ≤3.56, 68 patients) groups. Immune-related adverse events (irAEs) occurred in 22 patients (16.5%) during the observation period, including 18 grade 2-3 irAEs and 4 grade 4 cases. H-NLR and H-PLR were associated with poor progression-free (PFS) and overall survival (OS) in the present study. NLR was an independent prognostic factor for PFS [hazard ratio (HR): 0.201, 95% confidence interval (CI): 0.060-0.670; P=0.009) and OS (HR: 0.413, 95% CI: 0.226-0.754; P=0.004) in this patient group. Therefore, NLR may be used in the prognostication of patients with stage IIIB-IV NSCLC treated with PD-1 inhibitors. These serological markers may be used in combination with established immunomarkers to help predict outcomes.

Zinc chloride aqueous solution as a solvent for starch.

It is important to obtain starch-based homogeneous systems for starch modification. Regarding this, an important key point is to find cheap, low-cost and low-toxicity solvents to allow complete dissolution of starch and its easy regeneration. This study reveals that a ZnCl2 aqueous solution is a good non-derivatizing solvent for starch at 50 °C, and can completely dissolve starch granules. The possible formation of a "zinc-starch complex" might account for the dissolution; and the degradation of starch, which was caused by the H(+) inZnCl2 aqueous solution, could not contribute to full dissolution. From polarized light microscopic observation combined with the solution turbidity results, it was found that the lowest ZnCl2 concentration for full dissolution was 29.6 wt.% at 50 °C, with the dissolving time being 4h. Using Fourier-transform infrared (FTIR), solid state (13)C nuclear magnetic resonance (NMR), and X-ray diffraction (XRD), it was revealed that ZnCl2 solution had no chemical reaction with starch glucosides, but only weakened starch hydrogen bonding and converted the crystalline regions to amorphous regions. In addition, as shown by intrinsic viscosity and thermogravimetric analysis (TGA), ZnCl2 solution caused degradation of starch macromolecules, which was more serious with a higher concentration of ZnCl2 solution.