Exploration of Personalized Treatment for Advanced Hepatocellular Carcinoma: Combination Therapy of Selinexor, Palbociclib, and Pembrolizumab with Umbilical Cord Blood NK Cells.

Objective: To report the efficacy and safety of combination therapy with selinexor, palbociclib, pembrolizumab, and umbilical cord blood NK cells for advanced hepatocellular carcinoma (HCC).Advanced HCC has a poor prognosis and limited effective treatment options. Exploring personalized combination treatment strategies is critically important for improving outcomes in patients with advanced HCC. This study aims to provide preliminary evaluation of the clinical effectiveness and safety of this combination regimen in this high-risk population, and lay the groundwork for larger studies to bring more treatment choices to patients with advanced HCC. Methods: A 67-year-old male patient with advanced HCC and multiple metastases was treated with palbociclib 75mg on days 1-14 of a 28-day cycle, pembrolizumab 200mg intravenous infusion, selinexor 40mg weekly, and umbilical cord blood NK cell (12×109 cells) infusion on days 1, 14, 28 and 42. Imaging examinations and tumor marker detection were performed before and after two cycles of treatment to evaluate response. Results: After two cycles of combination treatment, follow-up PET-CT showed partial response with the liver tumors reduced in size by approximately 60%, lung metastases reduced by approximately 90%, and FDG uptake decreased more than 90% in lymph nodes and bone metastases. The AFP level decreased compared to baseline. Liver function tests including albumin, bilirubin and prothrombin time improved. The patient's performance status also improved from ECOG 2 to ECOG 1. Conclusions: This case report describes preliminary signals that the combination of selinexor, palbociclib, pembrolizumab, and umbilical cord blood NK cells may warrant further investigation for the treatment of advanced HCC. Objective response was observed based on standardized response criteria. However, due to the limitations of a single-arm case study design, definitive conclusions cannot be drawn regarding the efficacy or safety profile of this personalized combination approach. Larger and more robust clinical trials are needed to fully validate if this treatment strategy can achieve clinical benefit for advanced HCC. Future studies should aim to elucidate potential biomarkers that may help identify patients most likely to respond to this combination regimen. Exploring optimal patient selection criteria could also help maximize clinical benefit. Further research is warranted to continue exploring precision medicine combinations involving immunotherapy, targeted agents and cellular therapies for advanced HCC.

[Effect of acupoint-catgut implantation on the physical agility of professional athletes].

OBJECTIVES: To observe the impact of acupoint-catgut implantation on physical agility of athletes and to probe into its underlying mechanism. METHODS: A total of 68 volunteer athletes were recruited in the present study. Sixteen rowers of China National Women's Racing Boat Team (CNWRBT) underwent comparative observation between pre- and post-treatment with acupoint-catgut implantation. Fifty-two athletes from Zhejiang Heavy Athletics Events Team (HAET) and Sand-beach Volleyball Team (SBVT) were randomized into control (n = 26) and treatment (n = 26) groups which were treated with massage (20 mm, once daily for 1 year), and catgut implantation at Guanyuan (CV 4), Mingmen (GV 4), etc. (once every two weeks), respectively. In the later group, after 6 times of treatment, the catgut implantation was given once a month, continuously for 1 year. Serum testosterone and plasma hemoglobin (Hb) levels were detected before, 1.5 mon, 3 mon, 6 mon and 12 mon after the treatment, respectively. RESULTS: 1) Compared with pre-treatment, the 2 000 m ergometer time was shortened significantly (P < 0.01), and serum testosterone and plasma hemoglobin (Hb) levels were increased evidently in 16 volunteer rowers of CNWRBT after 3 months' acupoint-catgut implantation treatment (P < 0.05, P < 0.01). 2) In comparison with control group and pre-treatment, the midium- and long-distance running scores of the athletes of Zhejiang HAET and SBVT were elevated considerably (P < 0.01), serum testosterone and plasma Hb levels increased significantly (P < 0.05). CONCLUSION: Acupoint-catgut implantation can significantly improve the athletes' anti-fatigue exercise capacity, enhance their physical agility to elevate their athletics events score, which may be closely related to its effects in raising blood testosterone and hemoglobin levels.

[Observation on therapeutic effect of catgut implantation at acupoints on exercise fatigue and study on the mechanism].

OBJECTIVE: To probe into the therapeutic effect of catgut implantation at acupoint on exercise fatigue and to study on the mechanism. METHODS: Catgut implantation was given at main points Guanyuan (CV 4), Shen shu (BL 23), Mingmen (GV 4), Zusanli (ST 36), Sanyinjiao (SP 6) in 41 players during training for 2 courses. Training-related condition and changes of blood testosterone (T) and hemoglobin (Hb) before and after training were observed. RESULTS: After treatment, sleeping quality, the mental state at the time of getting out of bed in the morning, appetite, training wish, training stamina, training quality, training attention, etc. in the player significantly improved, and blood T and Hb levels significantly increased. CONCLUSION: Catgut implantation at acupoints can significantly improve exercise fatigue in the player and the mechanism is possibly related with increase of testosterone and hemoglobin levels.