Improved brain metastases segmentation using generative adversarial network and conditional random field optimization mask R-CNN.

BACKGROUND: In radiotherapy, the delineation of the gross tumor volume (GTV) in brain metastases using computed tomography (CT) simulation localization is very important. However, despite the criticality of this process, a pronounced gap exists in the availability of tools tailored for the automatic segmentation of the GTV based on CT simulation localization images. PURPOSE: This study aims to fill this gap by devising an effective tool specifically for the automatic segmentation of the GTV using CT simulation localization images. METHODS: A dual-network generative adversarial network (GAN) architecture was developed, wherein the generator focused on refining CT images for more precise delineation, and the discriminator differentiated between real and augmented images. This architecture was coupled with the Mask R-CNN model to achieve meticulous GTV segmentation. An end-to-end training process facilitated the integration between the GAN and Mask R-CNN functionalities. Furthermore, a conditional random field (CRF) was incorporated to refine the initial masks generated by the Mask R-CNN model to ensure optimal segmentation accuracy. The performance was assessed using key metrics, namely, the Dice coefficient (DSC), intersection over union (IoU), accuracy, specificity, and sensitivity. RESULTS: The GAN+Mask R-CNN+CRF integration method in this study performs well in GTV segmentation. In particular, the model has an overall average DSC of 0.819 ± 0.102 and an IoU of 0.712 ± 0.111 in the internal validation. The overall average DSC in the external validation data is 0.726 ± 0.128 and the IoU is 0.640 ± 0.136. It demonstrates favorable generalization ability. CONCLUSION: The integration of the GAN, Mask R-CNN, and CRF optimization provides a pioneering tool for the sophisticated segmentation of the GTV in brain metastases using CT simulation localization images. The method proposed in this study can provide a robust automatic segmentation approach for brain metastases in the absence of MRI.

A couple-based dyadic coping intervention for colorectal cancer patient-spousal caregiver dyads: A randomized controlled study.

PURPOSE: To evaluate the clinical effects of a couple-focused dyadic coping intervention in colorectal cancer (CRC) couples. METHODS: The study was a single-blinded randomized controlled study which 226 CRC couples were recruited and randomized to either the intervention (N = 113) or the control (N = 113) group. All couples received usual care while the six-week dyadic coping intervention was provided to the intervened couples in psycho-education and skill training methods through face-to-face combined with telephone formats. Measurement data, including dyadic coping, marital satisfaction, quality of life and psychological well-being were collected at pre- and post-intervention periods. And multilevel model (MLM) was applied to analyze the effects of the intervention and the role tendency. RESULTS: A total of 173 couples completed the program and post-intervention evaluation. The retention rate was 76.5%. Results from MLM showed that the dyadic coping intervention is effective in promoting levels of dyadic coping (P < 0.001), marital satisfaction (P = 0.042), mental health (P = 0.006), and positive psychological well-being (P < 0.001), and alleviating depression (P = 0.015) in CRC couples. For role tendency, the intervention found to be more effective in CRC spousal caregivers' positive psychological well-being compared to the patients (P = 0.037). CONCLUSION: The couple-based dyadic coping intervention is effective in promoting dyadic coping and improving psychological adjustment in CRC couples. More studies were needed to further evaluate the program and its long-term efficacy in the future. In addition, given the positive effects of the intervention, clinical nursing stuffs may consider implementing such intervention in their routine work while caring for CRC couples.

Bone metastasis in non-small-cell lung cancer: genomic characterization and exploration of potential targets.

Background: Bone metastasis (BM) seriously affects the quality of life and reduces the survival time of patients with non-small-cell lung cancer (NSCLC). The genomic characteristics and potential targets of BMs are yet to be fully explored. Objective: To explore the genetic characteristics and potential targets of BM in NSCLC. Design: In all, 83 patients with NSCLC were retrospectively selected in this study. Genomic characterization of BMs was explored with the analysis of NGS results from primary tumors and BMs in 6 patients, then combined with NGS results of lung tumors in 16 patients with initial recurrence in bone to analyze mutations potentially associated with BMs, and finally, the correlation was further validated in 61 postoperative patients. Methods: The next generation sequencing (NGS) was performed to identify genomic differences between pulmonary primary tumors and BM. Fluorescence in situ hybridization and immunohistochemistry were performed in postoperative tumor tissues from patients who had undergone radical surgery to validate the predictive role of molecular targets for BM. The correlation between cyclin-dependent kinase 4 (CDK4) and BM was evaluated by Pearson's chi-square test. The university of alabama at birminghan cancer data analysis portal (UALCAN) was carried out for the detection of CDK4 expression in lung cancer and the relationship between CDK4 and clinicopathological parameters. The relationship between prognosis and CDK4 expression was analyzed by the Kaplan-Meier plotter. Results: The rate of gene amplification was increased (24% versus 36%) while gene substitution/indel was decreased (64% versus 52%) in BMs. The BM-specific mutations were analyzed in 16 recurrent patients which revealed the highest incidence of CDK4 amplification (18.8%). According to the Kaplan-Meier plotter database, the NSCLC patients with high CDK4 gene expression showed poor overall survival (OS) and recurrence-free survival (RFS) (p < 0.05). The incidence of CDK4 amplification tended to be higher in recurrent patients compared to the patients without BM (18.8% versus 4.7%, p = 0.118). Conclusion: Compared to the primary tumors of NSCLC, the genome of BMs showed an increased proportion of amplification and a decreased proportion of gene substitution/indel. Furthermore, the CDK4 amplification ratio seemed to be elevated in NSCLC patients with BM which may be associated with poor OS and RFS.

Genomic characterization and potential targets of bone metastasis in non-small cell lung cancer NGS was performed on the matched primary tumors and bone metastases to explore the differences in the genomes of bone metastases, and it was found that gene amplification increased in bone metastases. Combined with the results of NGS in NSCLC patients with the first postoperative recurrence site in the bone, it was found that CDK4 amplification expression increased in bone metastases. Finally, the correlation between bone metastasis and CDK4 amplification was verified by expanding the sample.

An integrated intervention programme for couples facing colorectal cancer: A randomized controlled trial.

BACKGROUND: Under the guidance of a preliminary Live with Love Conceptual Framework, a Caring for Couples Coping with Colorectal Cancer (4Cs: CRC) programme was designed specifically for colorectal cancer couples. The objectives of this study included examining the efficacy of the programme for couples adapting to colorectal cancer and comparing the effects of different intervention delivery modes (online, face-to-face and blended) on couple outcomes. METHODS: A four-arm randomized controlled trial was conducted among Chinese colorectal cancer couples. Couples were randomly assigned to an online intervention, a face-to-face intervention, a blended intervention or a control group. Self-efficacy, dyadic coping, communication and dyadic outcomes (physical and mental health, negative and positive emotions and marital satisfaction) were evaluated at baseline and 6 weeks later. Analysis of variance (ANOVA) and repeated measures ANOVA were employed to assess between-group differences and within-group effects in the four groups, respectively. RESULTS: A total of 179 couples completed the 6-week study and post-study assessments. The intervention showed generally medium-to-large effects across multiple measured outcomes, including self-efficacy, dyadic coping, communication, mental health, negative emotions and positive emotions for both patients and spouse caregivers. Additionally, interventions delivered through different modes produced equally significant effects on couple outcomes. CONCLUSIONS: The integrated intervention programme is effective in improving cancer adaptation in colorectal cancer couples. Long-term follow-up and a mix of quantitative and qualitative assessments are crucial for further evaluation of the programme. TRIAL REGISTRATION: Retroactive registration is under review.

131I-Labeled Anti-HER2 Nanobody for Targeted Radionuclide Therapy of HER2-Positive Breast Cancer.

Purpose: The unique structure of nanobodies is advantageous for the development of radiopharmaceuticals for nuclear medicine. Nanobodies targeted to human epidermal growth factor receptor 2 (HER2) can be used as tools for the imaging and therapy of HER2-overexpressing tumors. In this study, we aimed to describe the generation of a 131I-labeled anti-HER2 nanobody as a targeted radionuclide therapy (TRNT) agent for HER2-positive breast cancer. Methods: The anti-HER2 nanobody NM-02 was labeled with 131I using the iodogen method, and its radiochemical purity and stability in vitro were assessed. The pharmacokinetic profile of 131I-NM-02 was investigated in normal mice. Tumor accumulation, biodistribution, and therapeutic potential of 131I-NM-02 were evaluated in HER2-positive SKBR3 xenografts; HER2-negative MB-MDA-231 xenografts were used as the control group. Results: 131I-NM-02 could be readily prepared with satisfactory radiochemical purity and stability in vitro. Apparent tumor uptake was observed in HER2-positive tumor-bearing mice with rapid blood clearance and favorable biodistribution. 131I-NM-02 could significantly inhibit tumor growth and extend the life of these mice with good organ compatibility. Negligible tumor accumulation and inhibitory effects of 131I-NM-02 were observed in the negative control group. Conclusion: 131I-NM-02 has the potential to be explored as a novel tool for TRNT of HER2-positive breast cancer.

Thoracic SMARCA4-deficient undifferentiated tumor.

Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a recently described smoking-related malignancy. The pathogenesis of SMARCA4-UT is the mutational inactivation and loss of expression of a subunit encoding the mammalian switch/sucrose nonfermenting ATPase-dependent chromatin remodeling complex (which can be mobilized using adenosine triphosphate hydrolysis nucleosomes and regulate other cellular processes including development, differentiation, proliferation, and apoptosis), in particular SMARCA4 and SMARCA2. The dynamic activity of this complex plays an important role in regulating the activation and repression of gene expression programs. SMARCA4-UT exhibits morphological features similar to the malignant rhabdoid tumor (MRT), small cell carcinoma of the ovary of the hypercalcemic type (SCCOHT), and INI1-deficient tumor, but SMARCA4-UT differs from SCCOHT and MRT from a genomic perspective. SMARCA4-UT mainly involves the mediastinum and lung parenchyma, and appears as a large infiltrative mass that easily compresses surrounding tissues. At present, chemotherapy is a common treatment, but its efficacy is not clear. Moreover, the inhibitor of the enhancer of zeste homolog 2 showed promising efficacy in some patients with SMARCA4-UT. This study aimed to review the clinical characteristics, diagnosis, treatment, and prognosis of SMARCA4-UT.

A couple-based dyadic coping intervention for couples coping with colorectal cancer: A pilot feasibility study.

PURPOSE: Compared to individual coping, dyadic coping has significant impact on cancer adaptation in cancer couples. Few intervention studies have focused on dyadic coping in colorectal cancer couples. The purpose of this study was to test the feasibility, acceptability, and preliminary efficacy of a Systemic Transactional Model-guided, couples-based dyadic coping intervention program for colorectal cancer couples. METHODS: A pre-/post-test single-group pilot study was conducted among Chinese colorectal cancer couples. Couples received six intervention sessions delivered by researchers via face-to-face or telephone. Recruitment and retention rates were calculated to assess program feasibility. Quantitative and qualitative post-intervention program evaluation were evaluated to assess acceptability. Additionally, effect sizes were calculated using Dyadic Coping Inventory, Dyadic Adjustments Scale, Medical Outcomes Study 12-item Short-Form, Benefit-Finding Scale, and Hospital Anxiety and Depression Scale to assess preliminary program efficacy. RESULTS: Of the 31 eligible couples approached, 21 dyads completed the baseline questionnaire, with 16 dyads completing the intervention and post-intervention assessments. Recruitment (67.7%) and retention (76.2%) rates supported the feasibility of the intervention program. Program acceptability was supported by participant satisfaction with the program. The intervention had small-to-medium effect sizes (Cohen's d = 0.19-0.48) in improving dyadic coping and most cancer adaptation outcomes for both patients and their spousal caregivers, validating the preliminary efficacy of the program. CONCLUSIONS: The couples-based dyadic coping intervention is feasible, acceptable, and effective for improving dyadic coping levels and cancer adaptation in colorectal cancer couples. Further examination of this intervention program in a large-scale randomized controlled trial is required.

A qualitative study about colorectal cancer patients and spousal caregivers' experience and needs during COVID-19: implications for self-efficacy intervention.

Objective: This study aims to understand the experiences of colorectal cancer (CRC) patients and their spousal caregivers during the COVID-19 pandemic and to refine a self-efficacy (SE) intervention for these couples. Methods: A descriptive phenomenological approach was used in this study. Data were collected from 11 CRC couples. All interviews were recorded, transcribed, and analyzed using the Colaizzi strategy. Results: Three themes and eight subthemes emerged: (1) Get and contribute support, (2) Life's challenges, and (3) Journey of reconstruction. The CRC couples encountered escalating challenges in coping with cancer during COVID-19. At the same time, they have received considerable support and developed confidence in rebuilding themselves in the process. Healthcare providers are advised to focus on giving appropriate support to CRC couples, so they can go further. Conclusions: This study gave insights into healthcare providers on the experiences of CRC couples and the development of SE intervention program to support these couples: (1) initially providing caregiving training for spousal caregivers and psychological support for patients, (2) encouraging self-care for CRC couples in the middle stage, (3) guiding them to view life positively in the later stage, and (4) assessing their situation in time to identify their needs and to provide support. Healthcare providers are recommended to increase flexibility in the SE intervention program delivery format to reduce the impact of COVID-19 on CRC couples.

Pulmonary Salivary Gland Tumor, Mucoepidermoid Carcinoma: A Literature Review.

Pulmonary mucoepidermoid carcinoma (PMEC) is the most common malignant salivary gland tumor in the lungs and accounts for 0.1-0.2% of all lung malignancies in adults. It has no specific epidemiological or clinical characteristics. Correct diagnosis requires the combined examinations of images, laboratories, pathology, and immunohistochemistry (IHC) as well as molecular characteristics. PMEC tumors are characterized by squamous, intermediate, and mucus-secreting cells. Currently, histological appearance, mitotic frequency, cellular atypia, and necrocytosis allow the classification of PMEC into low grade or high grade. Molecular changes are crucial to pathological diagnosis. The driver of PMEC seems to be the fusion protein MECT1-MAML2 that is generated from a genetic mutation in t (11; 19) (q21; p13), while other gene mutations are also reported. However, no treatment of PMEC exists so far; surgical excision is still the primary treatment, while the efficacies of chemotherapy or radiotherapy are undefined. Tyrosine kinase inhibitor (TKI) therapy and immunotherapy showed to have significant therapeutic effects but require more investigation and better understanding. This review focuses on the clinical characteristics, imaging and pathologic features, immunohistochemical examination, mutation analysis, differential diagnosis, prognosis, and treatment of PMEC.

The application of eHealth in cancer survivorship care: A review of web-based dyadic interventions for post-treatment cancer survivors and caregivers.

Objective: Both cancer survivors and caregivers often experience a range of problems and unmet needs during the post-treatment survivorship. Web-based dyadic interventions may be critical for cancer survivors and their caregivers. This article aims to systematically explore existing web-based dyadic interventions for post-treatment cancer survivors and caregivers in terms of intervention focus, content, delivery, and outcomes and to provide valuable recommendations for future research. Methods: A comprehensive literature search was conducted to identify articles published in English or Chinese in the English databases PubMed, EMBASE, MEDLINE, PsycINFO, and Cochrane Library, and the Chinese databases CNKI and Wanfang Data, from database inception to March 2022. The literature references were also manually searched for additional eligible articles. Results: Thirteen studies were included for analysis in this review. Cancer couple dyads were the main target of the interventions that were included. Information support, psychotherapy, self-management skills training, dyadic coping, and social support were the main intervention treatment elements. The combined results in this review support the feasibility, usability, and acceptability of eHealth interventions and showed trends in positive intervention effects for cancer survivors and caregivers in terms of self-efficacy, quality of life, physical health, mental health, and dyadic relationship. Conclusions: This review identifies the positive outcomes of web-based dyadic interventions for post-treatment cancer survivors and caregivers. Further development and refinement of post-treatment cancer survivor-caregiver dyadic web-based interventions, with personalized online platforms and multiple components for supportive care needs, should be promoted.

[99mTc]Tc-Labeled Plectin-Targeting Peptide as a Novel SPECT Probe for Tumor Imaging.

Certain receptors are often overexpressed during tumor occurrence and development and closely correlate with carcinogenesis. Owing to its overexpression on the cell membrane and cytoplasm of various tumors, plectin, which is involved in tumor proliferation, migration, and invasion, has been viewed as a promising target for cancer imaging. Hence, plectin-targeting agents have great potential as imaging probes for tumor diagnosis. In this study, we developed a [99mTc]Tc-labeled plectin-targeted peptide (PTP) as a novel single-photon emission computed tomography (SPECT) probe for tumor imaging and investigated its pharmacokinetics, biodistribution, and targeting ability in several types of tumor-bearing mouse models. The PTP had good biocompatibility and targeting ability to tumor cells in vitro and could be readily labeled with [99mTc]Tc after modification with the bifunctional chelator 6-hydrazino nicotinamide (HYNIC). Furthermore, the prepared [99mTc]Tc-labeled PTP ([99mTc]Tc-HYNIC-PTP) showed high radiochemical purity and excellent stability in vitro. In addition, favorable biodistribution, fast blood clearance, and clear accumulation of [99mTc]Tc-HYNIC-PTP in several types of tumors were observed, with a good correlation between tumor uptake and plectin expression levels. These results indicate the potential of [99mTc]Tc-HYNIC-PTP as a novel SPECT probe for tumor imaging.

The development and evaluation of a web-based complex intervention: The caring for couples coping with colorectal cancer "4Cs: CRC" program.

Objective: This article aims to systematically present the completed process of developing and evaluating a web-based complex intervention called 'Caring for Couples Coping with Colorectal Cancer "4Cs: CRC" program'; summarize the findings of this integrated supportive program; and provide valuable experience and suggestions for future interventions. Methods: The integrated 4Cs: CRC program was guided by the Medical Research Council (MRC) framework, which has widely been used to develop and evaluate complex interventions. Three stages were completed for the program development, namely: (1) developing a complex intervention; (2) assessing feasibility; and (3) evaluating the complex intervention. Results: Based on a series of interactive studies and a dyadic theoretical framework, the 4Cs: CRC program was developed into an integrated supportive six-week program that includes five weekly web-based interventions, as well as three biweekly face-to-face sessions. In particular, an online platform was designed to provide web-based interventions for couples facing colorectal cancer (CRC). Both the pilot study and qualitative process evaluation showed the program's preliminary feasibility, acceptability, and effectiveness. Conclusions: Under the guidance of the MRC framework, the 4Cs: CRC program was developed based on multiple interacting components. The program was initially proven to be feasible, acceptable, and effective at supporting CRC couples in mainland China, but requires further improvements according to the qualitative process evaluation results. More importantly, a full-scale randomized controlled trial is required to further explore the program's effectiveness in a wider population.

O-GlcNAcylation and stablization of SIRT7 promote pancreatic cancer progression by blocking the SIRT7-REGγ interaction.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers and its dismal prognosis indicates the urgent need to elucidate the potential oncogenic mechanisms. SIRT7 is a classic NAD+-dependent deacetylase that stabilizes the transformed state of cancer cells. However, its functional roles in PDAC are still unclear. Here, we found that SIRT7 expression is upregulated and predicts poor prognosis in PDAC. Then we screened the new interacting proteins of SIRT7 by mass spectrometry and the results showed that SIRT7 can interact with O-GlcNAc transferase (OGT). O-GlcNAcylation stabilizes the SIRT7 protein by inhibiting its interaction with REGγ to prevent degradation, and hyper-O-GlcNAcylation in pancreatic cancer cells leads to hypoacetylation of H3K18 via SIRT7, which promotes transcriptional repression of several tumour suppressor genes. In addition, SIRT7 O-GlcNAcylation at the serine 136 residue (S136) is required to maintain its protein stability and deacetylation ability. In vivo and in vitro experiments showed that blocking SIRT7 O-GlcNAcylation at S136 attenuates tumour progression. Collectively, we demonstrate that O-GlcNAcylation is an important post-translational modification of SIRT7 in pancreatic cancer cells, and elucidating this mechanism of SIRT7 is expected to pave the way for the development of novel therapeutic methods in the future.

The Dyadic Effects of Self-Efficacy on Quality of Life in Advanced Cancer Patient and Family Caregiver Dyads: The Mediating Role of Benefit Finding, Anxiety, and Depression.

Objectives: To explore the dyadic interdependence of self-efficacy, benefit finding, anxiety, depression, and QOL in cancer patient (CP) and family caregiver (FC) dyads, and to ascertain the dyadic effects of self-efficacy on quality of life (QOL) in CP-FC dyads. Methods: Conducted from November 2014 to December 2015, participants comprised 772 CP-FC dyads. The study surveyed participant characteristics, self-efficacy, benefit finding, anxiety, depression, and QOL. Data were analyzed using Pearson's correlation, T-test, and actor-partner interdependence mediation model (APIMeM). Results: CPs' self-efficacy was positively correlated with both their own and FCs' benefit finding and mental component summary (MCS), and negatively associated with anxiety and depression (all Ps < 0.01, |r| = 0.144∼0.432). However, CPs' self-efficacy was only positively correlated with their own physical component summary (PCS) (r = 0.193), but not FCs' PCS. The same profile was identified in FCs' self-efficacy (all Ps < 0.01, |r| = 0.100∼0.468). FCs reported higher levels of self-efficacy and PCS compared to CPs (both Ps < 0.001). Significant positive correlations (r = 0.168-0.437) were identified among all paired variables in CP-FC dyads (all Ps < 0.001). To some extent, dyads' self-efficacy influences dyads' MCS and PCS through improving positive emotions (benefit finding) and relieving negative emotions (anxiety and depression). Conclusions: Study findings not only support the dyadic interdependence of self-efficacy, benefit finding, anxiety, depression, and QOL in CP-FC dyads but confirm the hypothesis that dyads' self-efficacy may impact their MCS/PCS via an indirect approach to improve benefit finding and relieve anxiety and/or depression in CP-FC dyads.

131I-Labeled gold nanoframeworks for radiotherapy-combined second near-infrared photothermal therapy of cancer.

Photothermal therapy (PTT) has shown great promise for cancer treatment via light-triggered heat generation, while the anticancer efficacy of sole PTT is often limited. In this study, we report the use of radionuclide 131I-labeled gold nanoframeworks (131I-AuNFs) for radiotherapy-combined second near-infrared (NIR-II) PTT of breast cancer. AuNFs synthesized via a simple reduction approach are surface functionalized with polydopamine and poly(ethylene glycol), followed by labeling with 131I. The formed 131I-AuNFs with a high photothermal conversion efficacy and stable radioactivity can effectively accumulate into subcutaneous 4T1 mouse models as confirmed by in vivo single photon emission computed tomography (SPECT) imaging. Upon 1064 nm laser irradiation of tumors, local heat is generated for NIR-II PTT, which combines with radiotherapy to achieve a much higher therapeutic efficacy relative to sole treatment. As such, 131I-AuNFs-mediated radiotherapy-combined NIR-II PTT results in the effective inhibition of the growth of subcutaneous tumors. This study thus provides a facile nanoplatform for effective combination cancer therapy.

Molecular and Clinical Characteristics of Primary Pulmonary Lymphoepithelioma-Like Carcinoma.

Objectives: Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is an extremely rare subtype of non-small cell lung cancer (NSCLC). Currently, there are no established treatment protocols due to rarity of the cancer. Thus, this study aimed to explore the molecular and clinical characteristics of PPLELC. Study design and setting: Data from patients with PPLELC who were admitted to Zhejiang Cancer Hospital from August 2009 to September 2020 were retrospectively collected. Next-generation sequencing was performed to obtain a genomic profile and tumor mutation burden (TMB) value of patients with adequate tissue and divided them into two groups according to the expression level of PD-L1. The correlation of PD-L1 expression and the clinicopathological characteristics was evaluated by Pearson Chi-square test. Kaplan-Meier curves was applied to present the probability of survival between PD-L1 expression level and overall survival (OS). Moreover, the literature on the immunotherapy of advanced PPLELC published in PubMed between 2016 and 2020 were reviewed and the efficacy of immunotherapy were analyzed. Results: A total of 18 patients pathologically diagnosed as PPLELC were included. After a follow-up period of 8.8-138 months, 14 patients survived, three patients died and one patient lost, the median OS was 45.3 months Seven samples (tissue-available) tested by NGS and the median TMB was 2.5 mutations/Mb. 19 somatic mutated genes were recognized and TP53 (43%) and CYLD (43%) were the two most commonly mutated genes. Only seven patients who underwent NGS were tested for PD-L1. Three patients with high PD-L1 expression (PD-L1≥ 50%) and four patients with low PD-L1 expression (PD-L1 <50%) were included. No significant correlation was observed between PD-L1 expression and clinical characteristics (age, gender, smoking status, tumor stage, lymph node metastasis) (p > 0.05) and OS (p = 1). What's more, 10 PPLELC patients involved in previous studies and one patient received nivolumab in the current study were collected retrospectively. 4/11 (36.4%) patients achieved PR, 6/11 (54.5%) patients achieved SD, and 1/11 (9.1%) patients achieved PD and the disease control rate (DCR) was 90.9%. Conclusions: The prognosis of PPLELC is better than that of other NSCLC, and immunotherapy may be a promising treatment to prolong the survival of advanced PPLELC patients. Whether the immunotherapy efficacy of PPLELC can be predicted by PD-L1 and TMB needs further clinical investigation. CYLD genetic alterations may participate in Epstein-Barr virus-mediated tumorigenesis in PPLELC, providing a novel therapeutic target.

Interventions to Improve Self-Efficacy in Colorectal Cancer Patients and/or Caregivers: A Systematic Review and Meta-Analysis.

OBJECTIVE: High levels of self-efficacy (SE) in colorectal cancer (CRC) patients and/or caregivers enable patients to cope with cancer, reduce caregiver burden, and promote quality of life (QOL) in patients and caregivers alike. This review aims to (a) identify the SE theory sources covered by SE interventions or interventions, including targeting improved SE for CRC patients and/or caregivers, to guide future development of SE interventions; and (b) explore intervention effects based on SE theory through meta-analysis. METHODS: Using five electronic databases-CINAHL, Cochrane Library, Embase, PsycINFO, and PubMed-a systematic search was performed in April 2021 to identify English or Chinese literature that studied improving SE interventions for CRC patients and/or caregivers. Manual screening of the articles' references list was also performed. RESULTS: A total of 18 studies were found to be suitable and included in this review. Of the 18 studies that were included, 10 randomized controlled trials (RCTs) studies with 917 participants were eligible for meta-analysis. Interventions provide support for SE drawing on different sources of information. Performance accomplishment (PA) is the key source, with vicarious experience (VE) and verbal persuasion (VP) assisting in improving PA. Reducing negative emotional arousal (NEA) and improving positive emotional arousal (PEA) are also indispensable factors in improving SE. The meta-analysis results show that interventions based on the SE theory can bring about positive effects for CRC patients and/or caregivers. CONCLUSIONS: Different sources of information aimed at improving SE, covered by the interventions, including PA, VE, VP, NEA, and PEA, have been explored. Positive intervention outcomes that focused on improving SE for CRC patients and/or caregivers were identified and highlighted. For future SE interventions, we advocate choosing combination sources of SE information to design interventions. It is recommended that future SE improvement interventions should focus on improving PA, supplemented by increasing VE, while reducing NEA and providing useful VP.

A literature review of the relationship between dyadic coping and dyadic outcomes in cancer couples.

PURPOSE: Couples are usually affected by cancer as patient-partner dyads, and they may react as a unit rather than as individuals, i.e., dyadic coping. This paper aims to comprehensively summarise the relationship between dyadic coping and dyadic outcomes (relationship satisfaction, quality of life, and psychological adjustment) in cancer couples, and provide valuable evidence to guide future research. METHOD: A systematic search of five online databases, e.g., Cochrane Library, Embase, Medline, PubMed, and PsycINFO, was conducted to identify cancer couple-based studies published in English or Chinese from January 1990 to March 2021. A manual search was also performed on the article reference lists. RESULTS: Twenty-eight studies met the inclusion criteria. We found that communication, supportive dyadic coping, delegated dyadic coping and common dyadic coping might strengthen marital bonds, alleviate couples' stress, and facilitate mental health, but on the other hand, they possibly increase patients' and/or partners' physical or psychological burden. Negative dyadic coping and protective buffering were related to lower relationship satisfaction, worse quality of life, and more depressive symptoms. Patients reported more self-emotional disclosure, common dyadic coping, and negative dyadic coping than partners, while partners showed more holding back, supportive dyadic coping, delegated dyadic coping, and protective buffering. Moreover, patients were more susceptible to dyadic coping strategies. CONCLUSIONS: This review provides a comprehensive overview of the relationship between dyadic coping and dyadic outcomes. Based on the available evidence, the development of personalised interventions for improving dyadic coping is required to help couples live better with cancer.

Neddylation Alleviates Methicillin-Resistant Staphylococcus aureus Infection by Inducing Macrophage Reactive Oxygen Species Production.

Neddylation, a posttranslational modification in which NEDD8 is covalently attached to target proteins, has emerged as an endogenous regulator of innate immunity. However, the role of neddylation in methicillin-resistant Staphylococcus aureus (MRSA) infection remains unknown. In this study, we found that neddylation was activated after MRSA infection in vivo and in vitro. Inhibition of neddylation with MLN4924 promoted injury of liver and kidneys in C57BL/6 mice with MRSA bloodstream infection and increased mortality. Blockade of neddylation, either pharmacologically (MLN4924, DI591) or through the use of Uba3 small interfering RNA, inhibited Cullin3 neddylation and promoted Nrf2 accumulation, thus reducing reactive oxygen species (ROS) induction and bacterial killing ability in mouse peritoneal macrophages. In summary, our findings suggest that activation of neddylation in macrophages plays a critical protective role against MRSA infection by increasing ROS production, partially by signaling through the NEDD8-Cullin3-Nrf2-ROS axis. Furthermore, our results may provide a new non-antibiotic treatment strategy for MRSA infection through targeting of neddylation.

Pulmonary enteric adenocarcinoma.

Pulmonary enteric adenocarcinoma (PEAC) is an exceptionally rare subtype of non-small cell lung cancer (NSCLC). It is characterized by pathological features similar to those of colorectal adenocarcinoma. Most patients with PEAC have almost no special clinical manifestations, and it is often difficult to differentiate from metastatic colorectal adenocarcinoma (MCRC). As a special type of lung adenocarcinoma, PEAC has unique mutation expression and immune characteristics; its mutation profile shows higher Kirsten rat sarcoma viral oncogene (KRAS), human epidermal growth factor receptor-2 (HER2) , DNA mismatch repair(MMR) mutation rates, and much lower epidermal growth factor receptor (EGFR) rate. So in the future, targeted therapy may tend to be a new light in the treatment of PEAC. As for immunohistochemistry (IHC), CDX-2, villin, and CK7 are significantly positive in PEAC. This review focuses on the pathologic features, immunohistochemical examination, mutation analysis, diagnosis, treatment, and prognosis of PEAC.