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BACKGROUND: Laryngeal and hypopharyngeal cancers often require surgical treatment, which can lead to the development of pharyngocutaneous fistula (PCF). Our research aimed to assess the predictive value of skeletal muscle mass (SMM) and systemic inflammation indices for PCF and construct a clinically effective nomogram. METHODS: A nested case-control study of 244 patients matched from 1171 patients with laryngeal or hypopharyngeal cancer was conducted. SMM was measured at the third cervical level based on CT scans. A PCF nomogram was developed based on the univariate and multivariate analyses. RESULTS: Glucose, white blood cell count, platelet-to-lymphocyte ratio, and skeletal muscle index were independent risk factors for PCF. The area under the curve for the PCF nomogram was 0.841 (95% CI 0.786-0.897). The calibration and decision curves indicated that the nomogram was well-calibrated with good clinical utility. CONCLUSIONS: The nomogram we constructed may help clinicians predict PCF risk early in the postoperative period, pending external validation.
Assuntos
Fístula Cutânea , Neoplasias Hipofaríngeas , Neoplasias Laríngeas , Doenças Faríngeas , Humanos , Nomogramas , Estudos de Casos e Controles , Estudos Retrospectivos , Neoplasias Laríngeas/complicações , Laringectomia/efeitos adversos , Fístula Cutânea/etiologia , Fístula Cutânea/cirurgia , Doenças Faríngeas/etiologia , Inflamação , Músculo Esquelético , Neoplasias Hipofaríngeas/cirurgiaRESUMO
Background: Patients with sinonasal and skull base malignancies experience many types of complications after surgery. The intensive care unit (ICU) provides a high level of care for these patients; however, the effect of ICU care on complication rates remains unclear. Methods: Between November 2014 and November 2022, we retrospectively analyzed 151 patients with sinonasal and skull base malignancies. Fifty-six of these patients were admitted to the ICU and 95 were admitted to the non-ICU after surgery. Propensity score matching (PSM) was performed to balance baseline characteristics. The complication rates of the ICU and non-ICU groups were compared. Results: Before PSM, the complication rate was 28.5%. Patients admitted to the ICU had a higher incidence of medical complications (P = .032). Orbital injury (n = 9) and diplopia or visual changes (n = 9) were the most common surgical complications, whereas respiratory tract infections (n = 7) were the most common medical complications. After PSM, the incidences of surgical, medical, and all complications in the ICU and non-ICU groups were 23.8% and 19.0% (P = .791), 16.7% and 9.5% (P = .520), and 38.1% and 26.2% (P = .350), respectively. Conclusions: This preliminary study revealed that ICU admission did not reduce the complication rate of patients with sinonasal and skull base malignancies. Further studies are required to validate these findings and clarify the potential role of the ICU.
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The rapid development of bioengineering technology has introduced Fc-fusion proteins, representing a novel kind of recombinant protein, as promising biopharmaceutical products in tumor therapy. Numerous related anti-tumor Fc-fusion proteins have been investigated and are in different stages of development. Fc-fusion proteins are constructed by fusing the Fc-region of the antibody with functional proteins or peptides. They retain the bioactivity of the latter and partial properties of the former. This structural and functional advantage makes Fc-fusion proteins an effective tool in tumor immunotherapy, especially for the recruitment and activation of natural killer (NK) cells, which play a critical role in tumor immunotherapy. Even though tumor cells have developed mechanisms to circumvent the cytotoxic effect of NK cells or induce defective NK cells, Fc-fusion proteins have been proven to effectively activate NK cells to kill tumor cells in different ways, such as antibody-dependent cell-mediated cytotoxicity (ADCC), activate NK cells in different ways in order to promote killing of tumor cells. In this review, we focus on NK cell-based immunity for cancers and current research progress of the Fc-fusion proteins for anti-tumor therapy by activating NK cells.
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Fragmentos Fc das Imunoglobulinas , Células Matadoras Naturais , Citotoxicidade Celular Dependente de Anticorpos , Fragmentos Fc das Imunoglobulinas/genética , Imunoterapia , Proteínas Recombinantes de Fusão/genéticaRESUMO
Controlling the spatial and temporal behavior of peptide segments is essential in the fabrication of functional peptide-based materials and nanostructures. To achieve a desired structure, complex sequence design is often required, coupled with the inclusion of unnatural amino acids or synthetic modifications. Herein, we investigate the structural properties of 1:1 inclusion complexes between specific oligopeptides and cucurbit[8]uril (CB[8]), inducing the formation of turns, and by alteration of the peptide sequence, tunable structural chirality. We also explore extended peptide sequence binding with CB[8], demonstrating a simple approach to construct a peptide hairpin.
Assuntos
Hidrocarbonetos Aromáticos com Pontes/química , Peptídeos/química , Sequência de Aminoácidos , Dicroísmo Circular , Transferência Ressonante de Energia de Fluorescência , Modelos Moleculares , Dobramento de Proteína , EstereoisomerismoRESUMO
Most high-grade serous ovarian cancer (HGSOC) patients develop resistance to platinum-based chemotherapy and recur. Many biomarkers related to the survival and prognosis of drug-resistant patients have been delved by mining databases; however, the prediction effect of single-gene biomarker is not specific and sensitive enough. The present study aimed to develop a novel prognostic gene signature of platinum-based resistance for patients with HGSOC. The gene expression profiles were obtained from Gene Expression Omnibus and The Cancer Genome Atlas database. A total of 269 differentially expressed genes (DEGs) associated with platinum resistance were identified (P < .05, fold change >1.5). Functional analysis revealed that these DEGs were mainly involved in apoptosis process, PI3K-Akt pathway. Furthermore, we established a set of seven-gene signature that was significantly associated with overall survival (OS) in the test series. Compared with the low-risk score group, patients with a high-risk score suffered poorer OS (P < .001). The area under the curve (AUC) was found to be 0.710, which means the risk score had a certain accuracy on predicting OS in HGSOC (AUC > 0.7). Surprisingly, the risk score was identified as an independent prognostic indicator for HGSOC (P < .001). Subgroup analyses suggested that the risk score had a greater prognostic value for patients with grade 3-4, stage III-IV, venous invasion and objective response. In conclusion, we developed a seven-gene signature relating to platinum resistance, which can predict survival for HGSOC and provide novel insights into understanding of platinum resistance mechanisms and identification of HGSOC patients with poor prognosis.