RESUMEN
Conventional laparoscopic-assisted right hemicolectomy requires a small abdominal incision to extract the specimen, which becomes an important source of postoperative complications and impairs perioperative experience. Transvaginal natural orifice specimen extraction surgery (NOSES VIIIA) avoids this small incision by extracting the specimen through the vagina. Here we describe the design of a multicenter, open-label, parallel, noninferior, phase III randomized controlled trial (NCT05495048). The aim of this study is to confirm that the NOSES VIIIA procedure is not inferior to small-incision assisted right hemicolectomy in long-term oncological efficacy. A total of 352 female patients with right colon adenocarcinoma/high-grade intraepithelial neoplasia will be randomly assigned to the NOSES VIIIA arm and the small-incision arm in a 1:1 ratio. The primary end point of this trial is 3 year disease-free survival. Clinical Trial Registration: NCT05495048 (ClinicalTrials.gov).
Asunto(s)
Adenocarcinoma , Neoplasias del Colon , Laparoscopía , Cirugía Endoscópica por Orificios Naturales , Femenino , Humanos , Adenocarcinoma/cirugía , Ensayos Clínicos Fase III como Asunto , Colectomía/efectos adversos , Neoplasias del Colon/cirugía , Laparoscopía/efectos adversos , Laparoscopía/métodos , Estudios Multicéntricos como Asunto , Cirugía Endoscópica por Orificios Naturales/efectos adversos , Cirugía Endoscópica por Orificios Naturales/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Estudios de Equivalencia como AsuntoRESUMEN
Immune checkpoint proteins have become recent research hotspots for their vital role in maintaining peripheral immune tolerance and suppressing immune response function in a wide range of tumors. Therefore, investigating the immunomodulatory functions of immune checkpoints and their therapeutic potential for clinical use is of paramount importance. The immune checkpoint blockade (ICB) is an important component of cancer immunotherapy, as it targets inhibitory immune signaling transduction with antagonistic antibodies to restore the host immune response. Anti-programmed cell death-1 (PD-1) and anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) monoclonal antibodies are two main types of widely used ICBs that drastically improve the survival and prognosis of many patients with cancer. Nevertheless, the response rate of most cancer types remains relatively low due to the drug resistance of ICBs, which calls for an in-depth exploration to improve their efficacy. Accumulating evidence suggests that immune checkpoint proteins are glycosylated in forms of N-glycosylation, core fucosylation, or sialylation, which affect multiple biological functions of proteins such as protein biosynthesis, stability, and interaction. In this review, we give a brief introduction to several immune checkpoints and summarize primary molecular mechanisms that modulate protein stability and immunosuppressive function. In addition, newly developed methods targeting glycosylation on immune checkpoints for detection used to stratify patients, as well as small-molecule agents disrupting receptor-ligand interactions to circumvent drug resistance of traditional ICBs, in order to increase the clinical efficacy of immunotherapy strategies of patients with cancer, are also included to provide new insights into scientific research and clinical treatments.
RESUMEN
The ecological restoration of rare earth mines and the management of rare earth tailings have consistently posed global challenges, constraining the development of the rare earth industry. In this study, Zeolite A is efficiently prepared from the tailings of an ion-type rare earth mine in the southern Jiangxi Province of China. The resulting Zeolite A boasts exceptional qualities, including high crystallinity, a substantial specific surface area, and robust thermal stability. The optimum conditions for Zeolite synthesis are experimental determination and the adsorption properties of Zeolite A for typical pollutants (Cd2+, Cu2+, NH4+, PO43- and F-) in rare earth mines. The synthesised Zeolite A material is found to have strong adsorption properties. The adsorption mechanism is mainly cation exchange, and the priority of adsorption of pollutants is Cu2+> Cd2+ > NH4+ > PO43- > F-. Notably, the sodium Zeolite A material synthesized at room temperature can be effectively recycled multiple times. In summary, we propose a method to synthesise low cost and high adsorption zeolites using rare earth tailings. This will facilitate the reduction of rare earth tailings and the rehabilitation of rare earth mines. Our method has great potential as a rehabilitation technology for rare earth mines.