Mutation characteristics and molecular evolution of ovarian metastasis from gastric cancer and potential biomarkers for paclitaxel treatment.

Ovarian metastasis is one of the major causes of treatment failure in patients with gastric cancer (GC). However, the genomic characteristics of ovarian metastasis in GC remain poorly understood. In this study, we enroll 74 GC patients with ovarian metastasis, with 64 having matched primary and metastatic samples. Here, we show a characterization of the mutation landscape of this disease, alongside an investigation into the molecular heterogeneity and pathway mutation enrichments between synchronous and metachronous metastasis. We classify patients into distinct clonal evolution patterns based on the distribution of mutations in paired samples. Notably, the parallel evolution group exhibits the most favorable prognosis. Additionally, by analyzing the differential response to chemotherapy, we identify potential biomarkers, including SALL4, CCDC105, and CLDN18, for predicting the efficacy of paclitaxel treatment. Furthermore, we validate that CLDN18 fusion mutations improve tumor response to paclitaxel treatment in GC with ovarian metastasis in vitro and vivo.

The FGF6 amplification mutation plays an important role in the progression and treatment of malignant meningioma.

Meningioma is a benign tumor with slow growth and long course. However, patients with recurrent malignant meningioma still face a lack of effective treatment. Here, we report a rare case of primary mediastinal malignant meningioma with lung and bone metastases, who benefited from the treatment of apatinib (≥33 months) and anlotinib (until the publication date). Retrospective molecular analysis revealed the frequent amplification of FGF6 in primary and metastatic lesions. Then we constructed the FGF6 over-expressed IOMM-LEE and CH157MN malignant meningioma cell lines, and in vitro and vivo experiments showed that overexpression of FGF6 can promote the proliferation, migration and invasion of malignant meningioma cells. Based on the Western analysis, we revealed that FGF6 can promote the phosphorylation of FGFR, AKT, and ERK1/2, which can be inhibited by anlotinib. Together, we were the first to verify that overexpression of FGF6 promotes the progression of malignant meningiomas by activating FGFR/AKT/ERK1/2 pathway and pointed out that anlotinib may effectively inhibit the disease progression of patients with FGF6 amplification.

Prognostic and metabolic characteristics of a novel cuproptosis-related signature in patients with hepatocellular carcinoma.

Cuproptosis is a novel discovered mode of programmed cell death. To identify the molecular regulatory patterns related to cuproptosis, this study was designed for exploring the correlation between cuproptosis-related genes (CRGs) and the prognosis, metabolism, and treatment of hepatocellular carcinoma (HCC). Cancer Genome Atlas (TCGA) database was used to screen 363 HCC samples, which were categorized into 2 clusters based on the expression of CRGs. Survival analysis demonstrated that overall survival (OS) was better in Cluster 1 than Cluster 2 which might to be relevant to differences in metabolic based on functional analysis. With LASSO regression analysis and univariate COX regression, 8 prognosis-related genes were screened, a differently expressed genes (DEGs) were then constructed (HCC patients' DEGs)-based signature. The signature's stability was also validated in the 2 independent cohorts and test cohorts (GSE14520, HCC dataset in PCAWG). The 1-year, 3-year, and 5-year area under the curve (AUC) were 0.756, 0.706, and 0.722, respectively. The signature could also well predict the response to chemotherapy, targeted and transcatheter arterial chemoembolization (TACE) by providing a risk score. Moreover, the correlation was uncovered by the research between the metabolism and risk score. In conclusion, a unique cuproptosis-related signature that be capable of predicting patients' prognosis with HCC, and offered valuable insights into chemotherapy, TACE and targeted therapies for these patients has been developed.

Integrated vegetation cover of typical steppe in China based on mixed decomposing derived from high resolution remote sensing data.

Grasslands represent the largest ecosystem in China, accurate and efficient extraction of its integrated vegetation cover (IVC) plays a crucial role in supporting policy decisions. This study presented a method for grassland monitoring via IVC derived from high-resolution satellite data. Taking the multispectral data of Gaofen-1 (GF-1) and Gaofen-6 (GF-6) with 16 m resolution as the main data source, vegetation cover of six representative regions was assessed based on mixed-pixel decomposition model. Using grassland vegetation cover and ratio of grassland area, the IVC in each site was calculated and verified against ground-measured sample data. The results showed that the IVC of grassland was closely related to vegetation habitat driven by regional hydrothermal regime. Yichang grassland, dominated with warm-temperate shrub tussock type, had the highest IVC (80.06 %) due to its favorable hydrothermal conditions. For the main grassland types in Hulunbuir and Gansu Province (temperate meadow steppe and temperate typical steppe), the IVC was 79.38 % and 58.46 %, respectively. In both Xilin-Gol and Nagqu, vegetation cover decreased gradually from east to west, and the IVC was merely 42.83 % and 42.61 %, respectively. Both regions are endowed with less hydrothermal resources to different degrees. Alxa, with a predominately temperate desert landscape, had the lowest IVC of 15.58 % where precipitation is extremely scarce. Based on the grass species of measured samples, the dominant species and biodiversity of different grassland types in Gansu Province and Hulunbuir Municipality of Inner Mongolia Autonomous Region were analyzed. The results showed that the meadow grassland has the richest biodiversity. The temperate mountain meadows in Gansu Province have a high species diversity, with a total of 90 grass species, and the lowland meadows in Hulunbuir have a total of 49 grass species. This study utilizes high-resolution data to conduct large-scale vegetation monitoring, which is a viable alternative for efficient assessment of steppe ecology.

Prevalence and clinico-genomic characteristics of patients with TRK fusion cancer in China.

Neurotrophic tyrosine kinase (NTRK) fusions involving NTRK1, NTRK2, and NTRK3 were found in a broad range of solid tumors as driver gene variants. However, the prevalence of NTRK fusions in Chinese solid tumor patients is rarely reported. Based on the next-generation sequencing data from 10,194 Chinese solid tumor patients, we identified approximately 0.4% (40/10,194) of Chinese solid tumor patients with NTRK fusion. NTRK fusions were most frequently detected in soft tissue sarcoma (3.0%), especially in the fibrosarcoma subtype (12.7%). A total of 29 NTRK fusion patterns were identified, of which 11 were rarely reported. NTRK fusion mostly co-occurred with TP53 (38%), CDKN2A (23%), and ACVR2A (18%) and rarely with NTRK amplification (5.0%) and single nucleotide variants (2.5%). DNA-based NTRK fusion sequencing exhibited a higher detection rate than pan-TRK immunohistochemistry (100% vs. 87.5%). Two patients with NTRK fusions showed clinical responses to larotrectinib, supporting the effective response of NTRK fusion patients to TRK inhibitors.

Familial and genetic association with neurodevelopmental disorders caused by a heterozygous variant in the SRRM2 gene.

Background: Neurodevelopmental disorders (NDDs) are a class of disorders affecting brain development and function, characterized by an inability to reach cognitive, emotional, and motor developmental milestones. The pathology of NDDs is complex. A recent study found that variants in the SRRM2 gene cause NDDs. However, genetic conditions play the most important role in the etiology of NDD. The genetic causes of NDD are extremely heterogeneous, leading to certain challenges in clinical diagnosis. Methods: A pregnant woman with congenital intelligence disorder came to our hospital for genetic diagnosis to predict the status of her fetus. Her mother and a brother also suffer from congenital intelligence disorder. She has a daughter with speech delay. Whole exome sequencing was used to identify a mutation (c.1415C>G) in the SRRM2 gene of this family that resulted in a change in the 472nd amino acid residue of the SRRM2 protein from serine to terminated. Conclusion: We report a family with an autosomal dominant genetic disorder caused by variants in the SRRM2 gene causing NDDs. Prenatal diagnosis can help patients with this genetic disorder to have healthy offspring.

Next generation sequencing predicting clinical effect of immunotherapy on adult rhabdomyosarcoma patient: A case report.

RATIONALE: Rhabdomyosarcoma (RMS) is a rare sarcoma that rarely occurs in adults and accounts for only 1% of all adult tumors. The standard treatment for RMS is surgical resection, radiotherapy, and chemotherapy. PATIENT CONCERNS: Adult patients often present with an aggressive course and poor prognosis. DIAGNOSES: The patient was diagnosed with RMS in September 2019 and was confirmed by hematoxylin-eosin staining and immunohistochemistry after surgical resection. INTERVENTIONS: The patient received surgical resection in September 2019. He was admitted to another hospital after the first recurrence in November 2019. After the second routine surgical resection, the patient underwent chemotherapy, radiotherapy, and anlotinib maintenance treatment. He relapsed again in October 2020 and was admitted to our hospital. Next-generation sequencing was performed on the punctured tissue of the patient's lung metastatic lesion, and high tumor mutational burden (TMB-H), high microsatellite instability (MSI-H), and positive programmed death-ligand 1 (PD-L1) were observed. The patient then received toripalimab and anlotinib combined therapy and was evaluated for a partial response after 2 months. OUTCOMES: This benefit has persisted for more than 17 months. LESSONS: This is the longest progression-free survival for PD-1 inhibitors in RMS, and there is a trend of continued extension of progression-free survival in this patient. This case supports the hypothesis that positive PD-L1, TMB-H, and MSI-H could be beneficial biomarkers for immunotherapy in adult RMS.

Current status and frontier tracking of the China HACCP system.

In today's booming society and in the age of science and technology, the diversification of food processing methods, the continuous extension of the food trade chain, and the potential hazard factors in the food production process all make people pay more and more attention to the establishment, development, and improvement of the hazard analysis and critical control points (HACCP) system. Only terminal control and post-processing supervision of food can guarantee the absolute safety of food. In the process of processing, it is particularly important to strictly identify and evaluate the food safety hazards. To better assist food production enterprises in establishing and implementing HACCP systems, to implement the primary responsibility of food safety, and to improve the theoretical level and practical application of HACCP system in China, an investigation of the current situation and development frontier of HACCP system in China was conducted. Based on the core journal database of China Knowledge Network, the Chinese Social Science Citation Index database, and the Chinese Science Citation Database as the literature search database platform, the study used the CiteSpace visual metrics software system to analyze 1,084 pieces of literature in the field of HACCP research, in order to track the dynamics and impact of research in this field by Chinese research institutions and major authors, and analyze the research hotspots in the field. It is important for further research on HACCP. The results of the study showed that (1) the number of publications in the field of HACCP in China increased steadily from 1992 to 2004 and then began to decrease; (2) the indexes of journals with more publications were more concentrated, and the journal Food Science published the most; (3) the indexes of major research institutions showed that the cultivation bases of the State Key Laboratory of Chinese Medicinal Materials in the Center of Chinese Medicine Resources of the Chinese Academy of Traditional Medicine, the Guangdong Institute of Occupational Diseases, the Nanchang University of Life Sciences, and the Guangdong Institute of Occupational Diseases were more concentrated. Prevention and Treatment Institute, School of Life Sciences of Nanchang University, China Aquatic Products Quality Certification Center, School of Food Science and Nutrition Engineering of China Agricultural University, and other research structures have the most publications and strong scientific research strength; (4) from the main author indicators, the research in the field of HACCP has formed a total of four more active research teams, involving Chinese herbal medicine, ecological planting, ecological agriculture, occupational disease prevention and treatment, light industry handicrafts, computer software and computer application, agricultural economy, and other research directions. The cooperation between the authors of each team is closer. It is suggested that in terms of food safety requirements, China should not only integrate the traditional supervision measures for food terminals and after the event but also reflect the role of food hazard analysis and assessment in the production process and comprehensively integrate the pre-production, production, and post-production management of food so that food can really be safe.

EGFR-TKI Combined with Pemetrexed versus EGFR-TKI Monotherapy in Advanced EGFR-mutated NSCLC: A Prospective, Randomized, Exploratory Study.

PURPOSE: We aimed to evaluate whether the addition of pemetrexed is effective in improving progression-free survival (PFS) in epidermal growth factor receptor (EGFR)-mutated patients with or without concomitant alterations. Materials and Methods: This multicenter clinical trial was conducted in China from June 15, 2018, to May 31, 2019. A total of 92 non-small cell lung cancer (NSCLC) patients harboring EGFR-sensitive mutations were included and divided into concomitant and non-concomitant groups. Patients in each group were randomly treated with EGFR-tyrosine kinase inhibitor (TKI) monotherapy or EGFR-TKI combined with pemetrexed in a ratio of 1:1. PFS was recorded as the primary endpoint. RESULTS: The overall median PFS of this cohort was 10.1 months. There were no significant differences in PFS between patients with and without concomitant and between patients received TKI monotherapy and TKI combined with pemetrexed (p=0.210 and p=0.085, respectively). Stratification analysis indicated that patients received TKI monotherapy had a significantly longer PFS in non-concomitant group than that in concomitant group (p=0.002). In concomitant group, patients received TKI combined with pemetrexed had a significantly longer PFS than patients received TKI monotherapy (p=0.013). Molecular dynamic analysis showed rapidly emerging EGFR T790M in patients received TKI monotherapy. EGFR mutation abundance decreased in patients received TKI combined chemotherapy, which supports better efficacy for a TKI combined chemotherapy as compared to TKI monotherapy. A good correlation between therapeutic efficacy and a change in circulating tumor DNA (ctDNA) status was found in 66% of patients, supporting the guiding role of ctDNA minimal residual disease (MRD) in NSCLC treatment. CONCLUSION: EGFR-TKI monotherapy is applicable to EGFR-sensitive patients without concomitant alterations, while a TKI combined chemotherapy is applicable to EGFR-sensitive patients with concomitant alterations. CtDNA MRD may be a potential biomarker for predicting therapeutic efficacy.

Construction and application of Optimized Comprehensive Drought Index based on lag time: A case study in the middle reaches of Yellow River Basin, China.

Drought is a complex and dynamic natural phenomenon. A single drought index can hardly reflect the multi-type characteristics of drought, and comprehensive drought indices that incorporate data from multiple sources have been proposed recently. In this study, an Optimized Comprehensive Drought Index (OCDI) was constructed by taking into account the lag time of meteorological drought, agricultural drought and hydrological drought. The Standardized Precipitation Evapotranspiration Index (SPEI), Vegetation Condition Index (VCI), and Water Storage Deficit Index (WSDI) represented the three types of droughts, respectively. Specifically, we used the Solar-induced Chlorophyll Fluorescence (SIF) to characterize the vegetation condition instead of the Normalized Difference Vegetation Index (NDVI). The application results of the proposed drought index in the middle reaches of Yellow River basin (MRYRB) showed that the lag time of different types of drought indices had seasonal differences, with a shorter lag time in summer (0-4 months) and a longer lag time in winter and spring (> 4 months). For typical drought events, the drought intensity and duration identified by OCDI were compatible with the drought evolution characteristics and consistent with the historical records, therefore, OCDI is more suitable for drought monitoring in the study area. Based on the monitoring results of the OCDI, the average number of droughts in the MRYRB was 16 times, with a duration of 2.8 months and an average drought intensity of 0.28 (at moderate drought grade). Drought times and intensity were higher in the northwestern part of the study area, and spring was a high-frequency period for drought occurrences.

Effects of climate change and human activities on gross primary productivity in the Heihe River Basin, China.

As the primary source of carbon dioxide fixation, vegetation is critical to the carbon sink process. In this paper, the Net Primary Productivity (NPP) and the Gross Primary Productivity (GPP) were simulated using the Carnegie-Ames-Stanford Approach (CASA) model and the Vegetation Photosynthesis Model (VPM), respectively, and then the Potential Gross Primary Productivity (PGPP) and the GPP affected by human activities (AGPP) were simulated by combining Potential Net Primary Productivity (PNPP), and then the impact of climate change and human activities on GPP was assessed in the Heihe River Basin (HRB). The results showed that the GPP of grassland and Bare or Sparse Vegetation (BSV) exhibited a fluctuation rise, with increases of 0.709 gCm-2 a-1 and 0.115 gCm-2 a-1, respectively, whereas the GPP of cropland showed a fluctuation reduction, with a decline rate of -0.465 gCm-2 a-1. Climate change and human activity are both positive for vegetation growth, and human activity being the primary factor influencing GPP change. Human-dominated vegetation restoration accounted for 56.1% of the overall restoration area, with grassland GPP being the most visible response to human activities. The GPP changes in crop and grassland had a positive correlation with precipitation but a negative correlation with temperature among climate change factors, whereas the GPP changes in BSV had a negative correlation with both precipitation and temperature. Quantitative analyses of climate change and human activities' dynamic contributions to vegetation can give scientific and theoretical insight for dealing with global climate change.

A novel PHKA2 variant in a Chinese boy with glycogen storage diseases type IXa.

Background: Glycogen storage diseases (GSDs) are a group of heterogeneous inherited metabolic disorders with an incidence of 4%-5%. There are 19 types of GSDs, making diagnosis one of the greatest challenges. Methods: The proband and his parents were referred to our hospital for genetic diagnosis. Ultrasound screening suggested hepatomegaly. A novel insertion variant NM_000292 c.1155_1156insT (p. 386N>*) in PHKA2 gene was identified using trio whole exome sequencing (Trio-WES), which resulted in the codon of amino acid 386 from asparagine to termination (p. 386N>*). The 3D mutant protein structure was predicted using AlphaFold, and the results showed that the truncated PHKA2 protein contained 385 of the 1,235 amino acids of the mature protein. Conclusion: We describe a previously unreported case of a GSDs IXa type Chinese boy caused by a novel PHKA2 variant. This clinical case contributes to the understanding of the characteristics of GSDs type IXa and expands the variants spectrum of genes related to GSDs type IXa. Our findings demonstrated the significance of genetic testing in the diagnosis of GSDs.

Proteomics and bioinformatics analysis of cardiovascular related proteins in offspring exposed to gestational diabetes mellitus.

Introduction: Previous studies have demonstrated that exposed to the initial suboptimal intrauterine environment of gestational diabetes mellitus (GDM) may increase risk of cardiovascular disease in adulthood. Methods: In order to investigate the underlying mechanisms involved in the increased risk of cardiovascular diseases (CVDs) in the offspring of GDM, we applied a high-throughput proteomics approach to compare the proteomic expression profile of human umbilical vessels of normal and GDM offspring. Results: A total of significantly different 100 proteins were identified in umbilical vessels from GDM group compared with normal controls, among which 31 proteins were up-regulated, while 69 proteins were down-regulated. Differentially expressed proteins (DEPs) are validated using Western blotting analysis. The analysis of these differently expressed proteins (DEPs) related diseases and functions results, performed by Ingenuity Pathway Analysis (IPA) software. Based on "Diseases and Disorders" analysis, 17 proteins (ACTA2, ADAR, CBFB, DDAH1, FBN1, FGA, FGB, FGG, GLS, GSTM1, HBB, PGM3, PPP1R13L, S100A8, SLC12A4, TPP2, VCAN) were described to be associated with CVD, especially in Anemia, Thrombus and Myocardial infarction. Functional analysis indicated that DEPs involved in many cardiovascular functions, especially in "vasoconstriction of blood vessel" (related DEPs: ACTA2, DDAH1, FBN1, FGA, FGB, and FGG). Upstream regulator analyses of DEPs identifies STAT3 as inhibitor of ACTA2, FGA, FGB, and FGG. Conclusion: The results of this study indicate that intrauterine hyperglycemia is associated with an elevated risk of cardiovascular risk in the offspring.

The m6A methyltransferase METTL3 promotes trophoblast cell invasion by regulating MYLK expression.

INTRODUCTION: The progression of placental diseases such as preeclampsia is closely related to trophoblast dysfunction. Recent studies indicated the dysregulation of N6-methyladenosine (m6A) RNA modification in trophoblast disorders, while the function of METTL3, a methyltransferase of m6A, in trophoblasts remains to be studied. METHODS: The expression of METTL3 was determined by real-time PCR and immunoblotting. METTL3 expression in trophoblast cell lines HTR-8/SVneo and JEG-3 was knocked down using shRNA. The invasion of trophoblast cells in Matrigel was determined using xCELLigence. The m6A-containing transcripts was determined by m6A-sequencing in HTR-8/SVneo cells. The myosin light chain kinase (MYLK) gene was transfected into HTR-8/SVneo cells. RESULTS: The expression of METTL3 was downregulated in preeclamptic placentae compared to normal placentae. Knockdown of METTL3 repressed the invasion of extravillous trophoblast cells. Mechanistically, METTL3 promoted the stability of MYLK mRNA through m6A modification. Overexpression of MYLK rescued retarded cell invasion by METTL3 depletion. DISCUSSION: Collectively, our results highlight an essential role of METTL3-MYLK axis in trophoblast invasion.

A comprehensive drought monitoring method integrating multi-source data.

Droughts are the most expensive natural disasters on the planet. As a result of climate change and human activities, the incidence and impact of drought have grown in China. Timely and effective monitoring of drought is crucial for water resource management, drought mitigation, and national food security. In this study, we constructed a comprehensive drought index (YCDI) suitable for the Yellow River Basin using principal component analysis and the entropy weight-AHP method, which integrated a standardized precipitation evapotranspiration index (SPEI), self-calibrating Palmer drought severity index (scPDSI), vegetation condition index (VCI), and standardized water storage index (SWSI). SWSI is calculated by the terrestrial water storage anomaly (TWSA), which can more comprehensively reflect the impact of surface water resources on drought (as compared with soil moisture-based indexes). The study results showed that: (1) compared with single drought index, YCDI has stronger ability to monitor drought process. In terms of time scale and drought degree, the monitoring results based on YCDI were similar with data presented in the China Flood and Drought Bulletin and Meteorological Drought Yearbook, reaching ~87% and ~69%, respectively. The correlation between drought intensity and crop harvest area was 0.56. (2) By the combined analysis of the Mann-Kendall test and Moving T test, it was found that the abrupt change of YCDI index at the time of 2009, mainly due to the precipitation in 2009 reached the lowest value in the past 30 years in northern China and extreme high temperature weather. (3) The YCDI of Henan and Shandong provinces in the middle and lower reaches of the basin decreased more significantly, with the maximum value reaching 0.097/yr, while the index in the upper reaches showed an increasing trend with the maximum rate of 0.096/yr. (4) The frequency of mild drought, moderate drought, severe drought and extreme drought in the Yellow River basin during the study period was 15.84%, 12.52%, 4.03% and 0.97%, respectively. Among them, the highest frequency of droughts occurred in Ningxia, Inner Mongolia and central Shaanxi provinces. Drought causation in the Yellow River basin is more influenced by human activities than climate change in the middle and lower reaches, while climate change is the main factor in the upper reaches. Overall, YCDI is a reliable indicator for monitoring the spatial and temporal evolution of drought in the Yellow River basin, and it can be used for monitoring soil moisture changes and vegetation dynamics, which can provide scientific guidance for regional drought governance.

A Comprehensive Understanding of the Genomic Bone Tumor Landscape: A Multicenter Prospective Study.

Complexity and heterogeneity increases the difficulty of diagnosis and treatment of bone tumors. We aimed to identify the mutational characterization and potential biomarkers of bone tumors. In this study, a total of 357 bone tumor patients were recruited and the next generation sequencing (NGS)-based YuanSu450 panel, that includes both DNA and RNA sequencing, was performed for genomic alteration identification. The most common mutated genes in bone tumors included TP53, NCOR1, VEGFA, RB1, CCND3, CDKN2A, GID4, CCNE1, TERT, and MAP2K4. The amplification of genes such as NCOR1, VEGFA, and CCND3 mainly occurred in osteosarcoma. Germline mutation analysis reveal a high frequency of HRD related mutations (46.4%, 13/28) in this cohort. With the assistance of RNA sequencing, 16.8% (19/113) gene fusions were independently detected in 20% (16/79) of patients. Nearly 34.2% of patients harbored actionable targeted mutations, of which the most common mutation is CDKN2A deletion. The different mutational characterizations between juvenile patients and adult patients indicated the potential effect of age in bone tumor treatment. According to the genomic alterations, the diagnosis of 26 (7.28%) bone tumors were corrected. The most easily misdiagnosed bone tumor included malignant giant cell tumors of bone (2.8%, 10/357) and fibrous dysplasia of bone (1.7%, 6/357). Meanwhile, we found that the mutations of MUC16 may be a potential biomarker for the diagnosis of mesenchymal chondrosarcomas. Our results indicated that RNA sequencing effectively complements DNA sequencing and increased the detection rate of gene fusions, supporting that NGS technology can effectively assist the diagnosis of bone tumors.

The advanced development of molecular targeted therapy for hepatocellular carcinoma.

Hepatocellular carcinoma (HCC), one of the most common malignant tumors in China, severely threatens the life and health of patients. In recent years, precision medicine, clinical diagnoses, treatments, and innovative research have led to important breakthroughs in HCC care. The discovery of new biomarkers and the promotion of liquid biopsy technologies have greatly facilitated the early diagnosis and treatment of HCC. Progress in targeted therapy and immunotherapy has provided more choices for precise HCC treatment. Multiomics technologies, such as genomics, transcriptomics, and metabolomics, have enabled deeper understanding of the occurrence and development mechanisms, heterogeneity, and genetic mutation characteristics of HCC. The continued promotion and accurate typing of HCC, accurate guidance of treatment, and accurate prognostication have provided more treatment opportunities and prolonged survival timelines for patients with HCC. Innovative HCC research providing an in-depth understanding of the biological characteristics of HCC will be translated into accurate clinical practices for the diagnosis and treatment of HCC.

The Role of PD-L1 Expression in Prediction and Stratification of Recurrent or Refractory Extranodal Natural Killer/T-Cell Lymphoma.

Background and Aims: The clinical outcome of relapsed and refractory (RR) extranodal natural killer/T-cell lymphoma (ENKTL) is poor. It is necessary to identify RR patients in ENKTL and find novel therapeutic targets to improve the prognosis of patients with RR ENKTL. Methods: A total of 189 ENKTL patients with effective clinical characteristics were enrolled. Paraffin specimens were collected for PD-L1 expression identification. Kaplan-Meier curve analysis was performed for survival analysis. Whole exome sequencing (WES) was performed for identifying the mutational characterization of RR and effective treatment (ET) patients. Results: Univariate and multivariate Cox proportional hazards regression analysis showed that negative PD-L1 expression (HR = 1.132, 95% CI = 0.739-1.734, P = 0.036) was an independent predictor of poor prognosis in patients with ENKTL. The overall survival (OS) of PD-L1 positive patients was significantly higher than that of PD-L1 negative patients (P = 0.009). Then, we added PD-L1 expression as a risk factor to the model of Prognostic Index of Natural Killer Lymphoma (PINK), and named as PINK+PD-L1. The PINK+PD-L1 model can significantly distinguish RR patients, ET patients, and the whole cohort. Moreover, our data showed that PD-L1 expression was lower than 25% in most RR patients, suggesting that RR subtypes may be associated with low expression of PD-L1 (P = 0.019). According to the whole exome sequencing (WES), we found that the mutation frequencies of JAK-STAT (P = 0.001), PI3K-AKT (P = 0.02) and NF-kappa B (P < 0.001) pathways in RR patients were significantly higher than those in ET patients. Conclusion: Patients tend to show RR when PD-L1 expression is lower than 25%. The model of PINK+PD-L1 can stratify the risk of different groups and predict OS in ENKTL patients. The mutational profile of ENKTL patients with RR is different from that of patients with ET.

An advanced non-small cell lung cancer patient with EGFR and KRAS mutations, and PD-L1 positive, benefited from immunotherapy: a case report.

Background: Patients with epidermal growth factor receptor (EGFR)-sensitive mutations have great opportunity to benefit from EGFR-tyrosine kinase inhibitors (TKI) in non-small cell lung cancer (NSCLC). Although the presence of Kirsten rat sarcoma virus (KRAS) mutations is predictive of lack of benefit from EGFR-tyrosine kinase inhibitor (TKI) therapy for NSCLC, patients with KRAS mutations could be more sensitive to programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors. However, the application of immunotherapy in EGFR mutated NSCLC patients is still controversial. Case Description: In this study, we reported the case of a 56-year-old NSCLC patient who harbored the mutations of EGFR L858R and KRAS G12D, with a high tumor mutational burden value and positive PD-L1 expression. Considering the EGFR sensitive mutation, gefitinib combined pemetrexed was administered; however, the disease progressed soon after. The patient then underwent combined treatment of bevacizumab (400 mg), camrelizumab (200 mg), and pemetrexed (0.8 mg), and partial response was observed after 4 months. When chemotherapy was removed from the combined treatment, liver metastasis was detected. Interestingly, the disease was well controlled when the combined treatment of bevacizumab, camrelizumab, and pemetrexed was resumed. Overall, the patient benefits lasted more than 17 months. Conclusions: Our results indicated that immunotherapy may be a potential choice in NSCLC with EGFR and KRAS mutations, and combined chemotherapy may effectively increase therapeutic efficiency during combined immunotherapy.

Assessing Vegetation Ecosystem Resistance to Drought in the Middle Reaches of the Yellow River Basin, China.

The frequency and intensity of droughts are increasing in many parts of the world as a result of global climate change and human activity, posing a serious threat to regional ecological security. The climate in the middle reaches of the Yellow River Basin (MRYRB) has been warm and dry in recent years, with frequent droughts. In order to investigate the temporal trend of drought, and reveal the resistance of vegetation to drought in the MRYRB, this study used remotely-sensed vegetation index products (MODIS-NDVI and SPOT-NDVI) and the standardized precipitation evapotranspiration index (SPEI). The results indicated that: (1) drought intensity showed a weak upward trend in the study area from 2000 to 2018, with linear growth rates of SPEI at temporal scales of 1, 3, 6, 9 and 12 months of -0.002, 0.0034, 0.0198, 0.0234, and 0.0249, respectively; (2) drought was positively correlated with vegetation in most areas (97.6%), and vegetation was most affected by drought on long-term time scales (9 and 12 months); (3) with the extension of drought, vegetation resistance index decreased, then gradually recovered after the end of the drought. Forest had the longest resistance duration of 260 days, while grassland and cultivated land had resistance durations of only 170 days. This study adds to the understanding of vegetation's ability to withstand drought, and these findings provide evidence to support drought response in the MRYRB.