Neoadjuvant short-course radiotherapy followed by camrelizumab and chemotherapy in locally advanced rectal cancer (UNION): early outcomes of a multicenter randomized phase III trial.

BACKGROUND: Neoadjuvant short-course radiotherapy (SCRT) followed by CAPOX and camrelizumab (a programmed cell death protein 1 monoclonal antibody) has shown potential clinical activity for locally advanced rectal cancer (LARC) in a phase II trial. This study aimed to further confirm the efficacy and safety of SCRT followed by CAPOX and camrelizumab compared to long-course chemoradiotherapy (LCRT) followed by CAPOX alone as neoadjuvant treatment for LARC. PATIENTS AND METHODS: In this randomized, phase III trial, patients with T3-4/N+ rectal adenocarcinoma were randomly assigned (1 : 1) to receive SCRT or long-course chemoradiotherapy (LCRT), followed by two cycles of camrelizumab and CAPOX or CAPOX alone, respectively. After surgery, each arm underwent either six cycles of camrelizumab and CAPOX, followed by up to 17 doses of camrelizumab, or six cycles of CAPOX. The primary endpoint was pathological complete response (pCR) rate (ypT0N0) assessed by a blinded independent review committee. Key secondary endpoints tested hierarchically were 3-year event-free survival (EFS) rate and overall survival (OS). RESULTS: Between July 2021 and March 2023, the intention-to-treat population comprised 113 patients in the experimental arm and 118 patients in the control arm, with surgery carried out in 92% and 83.9%, respectively. At data cut-off (11 July 2023), the pCR rates were 39.8% [95% confidence interval (CI) 30.7% to 49.5%] in the experimental arm compared to 15.3% (95% CI 9.3% to 23.0%) in the control arm (difference, 24.6%; odds ratio, 3.7; 95% CI 2.0-6.9; P < 0.001). In each arm, surgical complication rates were 40.0% and 40.8%, and grade ≥3 treatment-related adverse events were 29.2% and 27.2%. Three-year EFS rate and OS continue to mature. CONCLUSIONS: In LARC patients, neoadjuvant SCRT followed by camrelizumab plus CAPOX demonstrated a significantly higher pCR rate than LCRT followed by CAPOX, with a well-tolerated safety profile. SCRT followed by camrelizumab and chemotherapy can be recommended as a neoadjuvant treatment modality for these patients.

[Efficacy of oblique lumbar interbody fusion combined with different internal fixation methods in the treatment of degenerative lumbar diseases].

Objective: To compare the efficacy among stand-alone oblique lateral lumbar interbody fusion (OLIF-SA), OLIF combined with lateral screw internal fixation (OLIF-AF) and OLIF combined with posterior percutaneous pedicle screw internal fixation (OLIF-PF) in the treatment of degenerative lumbar diseases. Methods: The clinical data of patients with degenerative lumbar diseases who underwent OLIF-SA, OLIF-AF and OLIF-PF in the Department of Neurosurgery, Xuanwu Hospital, Capital Medical University from January 2017 to January 2021 were retrospectively analyzed. Patients' visual analogue score (VAS) and Oswestry disability index (ODI) at 1 week and 12 months postoperatively were recorded, and efficacy of OLIF surgery with different internal fixation methods was evaluated by comparing clinical scores and imaging examinations at preoperative, postoperative and follow-up, and bony fusion and postoperative complications were recorded. Results: A total of 71 patients were included in the study, with 23 males and 48 females, aged (65±11) (34-88) years. There were 25 patients in the OLIF-SA group, 19 patients in the OLIF-AF group, and 27 patients in the OLIF-PF group. Compared with those of OLIF-PF group [(196±46) min and 50 (50, 60) ml], OLIF-SA and OLIF-AF groups had shorter operative time [(97±38) min and (118±48) min] and less intraoperative blood loss [20 (10, 50) ml and 40 (20, 50) ml] (both P<0.001). There was no statistically significant difference in the fusion rate among three groups (P>0.05). No statistically significant differences of VAS and ODI scores were observed among OLIF-SA, OLIF-AF and OLIF-PF groups during preoperative period [VAS: 5.0 (4.0, 6.0), 5.0 (4.0, 6.0) and 5.0 (4.0, 5.3); ODI: 44.0% (35.0%, 47.0%), 46.5% (43.3%, 46.5%) and 43.5% (35.8%, 46.0%)], and at one week postoperatively [VAS: 2.0 (2.0, 3.0), 3.0 (2.0, 3.0) and 2.0 (2.0, 3.0); ODI: 13.0% (12.0%, 18.0%), 21.0% (13.5%, 21.8%) and 16.5%(14.0%, 21.0%)] and final follow-up [VAS: 1.0 (0, 1.0), 1.0 (1.0, 2.0) and 1.0 (1.0, 2.0); ODI: 7.0% (5.0%, 11.0%), 10.0% (7.0%, 14.8%) and 8.0% (6.0%, 12.0%)], respectively (all P>0.05). Conclusion: Compared with OLIF-AF and OLIF-PF, OLIF-SA is a safe and effective surgical method with similar efficacy and fusion rates, decreases the cost of internal fixation, and reduces intraoperative time blood loss.

[Analysis on influencing factors on HIV testing behaviors in some foreigners in Guangzhou].

Objective: To analyze the influencing factors of HIV testing behavior among foreigners in Guangzhou, and provide a reference for promoting HIV testing and intervention services in foreigners. Methods: A cross-sectional survey was conducted from November 2019 to January 2020 among 230 eligible foreigners selected in Guangzhou through convenient sampling method in the form of one-to-one questionnaire interview, HIV testing behaviors and related influencing factors were described and analyzed with χ(2) test and multivariate logistic regression model. Results: A total of 230 foreigners were included in the study, in whom 156 were males (67.8%), 217 were from Africa (94.3%), 138 (60.0%) were with education level of university and above, 169 (73.5%) were in business, 47 (20.4%) were students, 132 (57.4%) had cumulative residence >12 months in Guangzhou and 113 (49.1%) had health examination in China in the past 6 months. In these foreigners, the rate of AIDS-related knowledge awareness was 76.0%, the proportion of condom use in the last sex was 39.6%(89/225) and 47.8%(110/230) received HIV tests in the past 3 months. Multivariate logistic regression analysis showed, the influencing factors of HIV testing behavior in the past 3 months included cumulative residence ≤12 months (compared with cumulative residence >12 months, OR=3.12, 95%CI: 1.49-6.56), health examination in China in the past 6 months (compared to those who had not, OR=2.53, 95%CI: 1.17-5.48), awareness of HIV testing and consulting service in Guangzhou (compared with those who had no awareness, OR=3.65, 95%CI: 1.71-7.78). Conclusions: Some foreigners in Guangzhou had relatively low rates of HIV testing and condom use. Those who pay attention to their own health status and know well about HIV testing and consulting services are more likely to receive HIV testing, foreigners in Guangzhou should be encouraged to receive HIV testing. Their self-testing awareness should be improved.

[Clinical application of intraoperative CT in management of maxillofacial fracture].

Nine patients with maxillofacial fracture that received intraoperative CT examination in Lanzhou General Hospital of Lanzhou Military Command from January 2017 to March 2017 were retrospectively studied. The procedure of intraoperative CT was introduced. The value of this technique was preliminarily discussed in order to provide a new method for the accurate implementation of maxillofacial fracture surgery.