Family Environmental Risk and Perceived Stress in Adolescent Depressive Symptoms: A Network Analysis.

This study, grounded in the Process-Person-Context-Time framework, investigates the complex interplay of family environmental factors and their influence on adolescent depressive symptoms, focusing on the role of 'perceived stress'. Using network analysis, we examined data from 735 junior high students (52.1% female adolescents) from three provinces in China (Jiangsu, Shandong, and Henan), with an average age of 13.81 ± 0.92 years, ranging from 12 to 16 years, exploring the relationships between depressive symptoms, perceived stress, and seven family risk factors. The analysis identified three distinct communities. The incorporation of perceived stress led to its integration into a community that included depressive symptoms, parental restrictive monitoring, and family economic strain. Perceived stress emerged as the strongest predictor of depressive symptoms, surpassing parental restrictive monitoring. Furthermore, it overtook depressive symptoms as the node with the strongest bridging connection within its community. These findings underscore the importance of interventions targeting both family conditions and the internal processing of these stressors by adolescents, especially in challenging family environments, to mitigate the risk of depression and promote resilience.

Moderating Role of Sexual Attitudes in the Association between Online Sexual Activity and Problematic Pornography Use: Evidence from the Chinese Community and Help-Seeking Men.

Objectives: This study aimed to investigate the moderating role of sexual attitudes in the association between online sexual activity (OSA) and problematic pornography use (PPU) in the Chinese context. Specifically, we examined whether incongruence stemming from attitudes (i.e., disapproval of nonmarital and casual sex but engaging in OSA) amplifies the perception of PPU. Methods: We recruited two samples of Chinese men, one from the community (N1 = 525) and the other comprising help-seeking individuals (N2 = 578). Results: Sexual attitudes moderate the relationship between OSA and PPU in both samples, with the predictive influence of OSA on PPU weakening among individuals with a relatively permissive attitude (scored one SD above the mean of sexual attitudes), and strengthened among individuals with a relatively conservative attitude (scored one SD below the mean of sexual attitudes). Conclusions: In the conservative sexual cultural context of China, a relatively conservative sexual attitude might strengthen the association between OSA and PPU.

The prevalence and genetic disorders spectrum of thalassemia among breast cancer patients in Jiangxi province, China.

Background: Thalassemia is a common inherited hematological disease with genetic disorders characterized by imbalanced synthesis of the globin chains. Due to the improvement of treatment methods, patients with thalassemia can survive for a long time. Therefore, it is not uncommon for patients with thalassemia suffering from malignant tumors. However, there are quite few reports on thalassemia patients complicated with breast cancer. Herein, we try to investigate the prevalence and genetic disorders spectrum of thalassemia in patients with breast cancer. Methods: Blood routing tests and serum ferritin analysis were conducted in 1887 breast cancer patients treated in the department of radiation oncology during 1 April 2020 and 30 March 2022. The suspected thalassemia carriers with small mean corpuscular volume (MCV), mean corpuscular hemoglobin content (MCH) or mean corpuscular hemoglobin concentration (MCHC) but the concentration of serum ferritin within normal limits were further investigated by polymerase chain reaction (PCR) and flow through hybridization gene chip to detect common mutations of α-globin and ß-globin genes using Thalassemia Geno Array Diagnostic Kit. The prevalence and genetic mutation spectrum of thalassemia among breast cancer patients were analyzed. Results: Four hundred and eighty-nine suspected thalassemia carriers were detected by complete blood cell counts and serum ferritin analysis among 1887 breast cancer patients. One hundred and seven cases (5.7%) were identified as carriers of thalassemia, of which 55 cases (51.4%) were α-thalassemia, 50 cases (46.7%) were ß-thalassemia, and 2 cases (1.9%) were co-inheritance of α-thalassemia and ß-thalassemia simultaneously. In α-thalassemia, the most prevalent genotype is -SEA/αα; as for ß-thalassemia, ßIVS-II-654/ß is the most common genotype. The degree of anemia is more severe in ß-thalassemia than in α-thalassemia. Conclusion: This is the first comprehensive molecular epidemiological investigation on thalassemia among breast cancer patients. Our data indicated that thalassemia was not uncommon in breast cancer patients. The physicians should have the knowledge to avoid misdiagnosis as iron deficiency anemia.

Investigating the Associations of ADHD Symptoms, Impulsivity, Physical Exercise, and Problematic Pornography Use in a Chinese Sample.

Investigating the relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms and impulsivity will benefit our understanding of the concept of problematic pornography use (PPU), and revealing predisposing and malleable moderators of PPU will be beneficial for its prevention and intervention. The current study not only aimed to observe these relationships, but also explored the potential moderating role of physical exercise in the general population. A total of 600 Chinese adults (Mage = 32.31, SDage = 12.40, 39.8% women) were recruited and completed an online survey. The results showed that participants with regular exercise scored lower than those without exercise on ADHD, impulsivity, and PPU (all ps < 0.001). Using latent moderated structural equations (LMS), the findings revealed that the relationship between ADHD symptoms and PPU was mediated by impulsivity, and physical exercise moderated this relationship (B = -0.14, p = 0.048). Specifically, when individuals' physical exercise was higher than 0.84 standard deviations above the mean, the positive predictive effect of impulsivity on PPU was not significant. These findings indicate the important role of impulsivity in the relationship between ADHD and PPU, and physical exercise could be a meaningful component of interventions among individuals experiencing PPU.

Symptoms of problematic pornography use among help-seeking male adolescents: Latent profile and network analysis.

Background and aims: Little data exist on exploring the subgroups and characteristics of problematic pornography use (PPU) in help-seeking adolescents. The aims of the study were to classify the subgroups among help-seeking male adolescents, explore their similarities and differences, and uncover their core symptoms. Methods: A total of 3,468 Chinese male adolescents (Mage = 16.64 years, SD = 1.24) who were distressed about their pornography use were recruited. The Problematic Pornography Consumption Scale, the Brief Pornography Screen Scale, and Moral Disapproval of Pornography Use were used to classify them. The General Health Questionnaire, the Pornography Craving Questionnaire, and the Sexual Compulsivity Scale were used to investigate participants' negative consequence related to their pornography use; and the Online Sexual Activity Questionnaire (OSAs) and time spent on pornography use every week were considered as quantitative indicators. Results: Help-seeking male adolescents could be divided into 3 profiles, namely, self-perceived problematic (SP, n = 755), impaired control (IC, n = 1,656), and problematic use groups (PPU, n = 1,057). Frequency of OSAs was important for the identification of SP individuals, while negative consequences were more effective in identifying individuals with objective dysregulated behavior. Salience and mood modification were shared by all groups; however, in addition to this, the SP and PPU groups also showed withdrawal symptoms. Discussion and conclusion: This study's results provide support for the presence of different profiles of help-seeking individuals and information on potential intervention targets among adolescents which is lacking in the literature.

A Network Comparison of Motives behind Online Sexual Activities and Problematic Pornography Use during the COVID-19 Outbreak and the Post-Pandemic Period.

Many researchers have considered whether online sexual activities (OSAs) increased over the course of the COVID-19 pandemic and whether these have led to an increase in problematic pornography use (PPU). This study investigated the impact of COVID-19 on PPU through pornography use motivations (PUMs) and OSAs to develop a better understanding of the mechanism and changes affecting PPU. Two groups of Chinese adults were recruited during the initial months of the pandemic (April 2020, n1 = 496) and the post-pandemic period (October 2021, n2 = 504). A network analysis was conducted to compare the structures of PPU symptoms among the two groups. The results showed that PUMs and OSAs were stronger predictors of PPU during the pandemic than post-pandemic (R2pandemic = 57.6% vs. R2post-pandemic = 28.7%). The motives of fantasy, sexual pleasure, stress reduction, and self-exploration were the prominent motivations during these two periods, but we found distinct PPU-related communities. PPU, sexual pleasure, and viewing sexually explicit materials (a type of OSAs) constituted a community during the pandemic but not in the post-pandemic's network. The present study indicated that the pandemic may not have been the only factor impacting the higher rate of PPU. Instead, the higher frequency of OSAs during the pandemic may have been a strategy to cope with stress and to safely satisfy sexual desire.

The Association between the Quantity and Severity of Pornography Use: A Meta-analysis.

Although the quantity of pornography use (QPU, i.e., frequency/time spent on pornography use) has been positively associated with the severity of pornography use (i.e., problematic pornography use, PPU), the magnitudes of relationships have varied across studies. This meta-analysis aimed to assess the overall relationships and identify potential moderating variables to explain the variation in these associations between QPU and PPU. We performed a literature search for all published and unpublished studies from 1995 to 2020 in major online scientific databases up until December 2020. Sixty-one studies were identified with 82 independent samples involving 74,880 participants. Results indicated that there was a positive, moderate relationship between QPU and PPU (r = 0.34, p < .001). The strength of relationship significantly varied across measures of PPU based on different theoretical frameworks, indicators of QPU, and sexual cultural contexts (conservative vs. permissive sexual values). Frequency was a more robust quantitative indicator of PPU than time spent on pornography use. In conservative countries, QPU showed more robust association with self-perceived PPU. Future studies are encouraged to select the measurement of PPU according to research aims and use multi-item measures with demonstrated content validity to assess pornography use. Cross-cultural (conservative/permissive) comparisons also warrant further research.

The role of impaired control in screening problematic pornography use: Evidence from cross-sectional and longitudinal studies in a large help-seeking male sample.

In help- or treatment-seeking people, there may be a portion of individuals with self-perceived addiction; however, how to distinguish these individuals from help-seeking patients with dysregulated pornography use remains unclear. The present study sought to examine the specific role of impaired control in identifying individuals with self-perceived problems when screening problematic pornography use (PPU) in a large help-seeking male sample (N = 8,845; Mage = 25.82 years, SD = 7.83). Based on the results of latent profile analysis, three groups were identified in the help-seeking sample: Self-perceived PPU group (n = 2,089; 23.6%), impaired control group (n = 4,180; 47.3%), and PPU group (n = 2,576; 29.1%). The self-perceived PPU group was characterized by the highest moral incongruence, but not objectively dysregulated in pornography use. The other two groups met the criteria of impaired control, suggesting that, impaired control may distinguish between self-perceived PPU and dysregulated use in help-seeking men. Six months later, self-reported data were collected again from 972 of these help-seeking men. The longitudinal cross-lagged analysis showed that impaired control at baseline positively predicted PPU at the 6-month follow-up; simultaneously, the reverse association was also significant and positive. In sum, impaired control functioned as a criterion to differentiate between self-perceived PPU and dysregulated pornography use. Impaired control might be used as a robust and reliable predictor of PPU, but it may not be a sufficient criterion of PPU in itself. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Properties of the Problematic Pornography Consumption Scale (PPCS-18) in community and subclinical samples in China and Hungary.

Several scales assessing problematic pornography use (PPU) are available. However, in most previous studies, primarily nonclinical and Western samples were used to validate these scales. Thus, further research is needed to validate scales to assess problematic pornography use across diverse samples, including subclinical populations. The aim of the present study was to examine and compare the psychometric properties of the PPCS-18 in Hungarian and Chinese community samples and in subclinical men. A sample of Chinese community men (N1 = 695), a sample of subclinical men who were screened for PPU using the Brief Pornography Screen (N2 = 4651), and a sample of Hungarian community men (N3 = 9395) were recruited to investigate the reliability and validity of the PPCS-18. Item-total score correlation, confirmatory factor analyses, reliability, and measurement invariance tests showed that the PPCS-18 yielded strong psychometric properties among Hungarian and Chinese community men and indicated potential utility in the subclinical men. The network analytic approach also corroborates that the six factors of the PPCS-18 can reflect the characteristic of the participants from different cultural contexts, and participants from community and subclinical populations. In sum, the PPCS-18 demonstrated high generalizability across cultures and community and subclinical men.

Polysaccharides Derived from Saposhnikovia divaricata May Suppress Breast Cancer Through Activating Macrophages.

BACKGROUND: Saposhnikovia divaricata (SD) has been used in traditional Chinese medicine to treat pain, inflammation, and arthritis. Recently, it has been reported that SD extract may inhibit tumor growth, but the mechanism involved is elusive. The aim of this study was to investigate the anti-tumor activity of polysaccharides derived from SD in breast cancer and the underlying mechanisms. MATERIALS AND METHODS: Polysaccharides isolated from SD were analyzed using Fourier transform infrared (FT-IR) spectroscopy and gas chromatography-mass spectroscopy (GC-MS). Their effects on cell growth of U937, MCF-7, and MDA-MB-231, and tumor growth in a mouse MDA-MB 231 xenograft model were examined. Their role in U937 activation, MCF-7, and MDA-MB 231 cytokine release profiles were also tested. RESULTS: In vitro studies showed that SD polysaccharides (SDPs) promoted U937 cell growth dose-dependently, with no obvious effect on growth of breast cancer cell lines MCF-7 and MDA-MB-231. SDP also showed an antagonistic effect against the growth inhibition of U937 by the culture supernatants of MCF-7 and MDA-MB-231, and reversed the polarization status of U937. Treatment of SCID mice bearing MDA-MB-231-derived xenograft tumors with SDP significantly reduced tumor growth. At all tested concentrations, no obvious toxic side-effects were recorded. DISCUSSION: We tentatively concluded that SDPs potently promote the growth of U937 and activate it to inhibit the tumor growth of SCID mice bearing MDA-MB-231-derived xenograft tumors indirectly, with no obvious growth inhibition effects on MCF-7 and MDA-MB-231 in vitro. Our finding indicated that SDP could be a potential anticancer agent for breast cancer.

Genetic profiling of primary and secondary tumors from patients with lung adenocarcinoma and bone metastases reveals targeted therapy options.

BACKGROUND: Patients newly diagnosed with lung adenocarcinoma with bone metastases (LABM) have poor survival rates after treatment with conventional therapies. To improve outcomes, we retrospectively investigated whether the application of a more comprehensive genetic test of tumor biopsies samples from LABM patients could provide the basis for treatment with more effective tyrosine kinase inhibitors (TKIs) regimens. METHODS: Fine needle biopsies were taken from the primary tumor (PT) and a secondary bone metastasis (BM) of 17 LABM patients before treatment. Simple genetic profiles for selecting therapies were initially obtained using an ARMS-PCR test for EGFR and ALK fusion mutations. More detailed genetic profiles of somatic exon SNVs and CNVs in 457 cancer-related genes were retrospectively derived using capture single molecule amplification and resequencing technology (capSMART). RESULTS: ARMS-PCR identified 14 EGFR positive, 3 EGFR negative and 1 ALK fusion positive patient. A therapy regimen incorporating TKIs Gefitinib and Crizotinib was offered to the EGFR and ALK fusion positive patients, respectively. With the exception of two patients, molecular profiling of matching PT and BM biopsies identified a highly shared somatic variant fingerprint, although the BMs exhibited additional genomic instability. In six of 13 EGFR positive patients and in all three EGFR negative patients, examination of the genetic profiles identified additional clinically significant mutations that are known or experimental drug targets for treatment of lung cancer. CONCLUSION: Our findings firstly suggest that treatment regimens based on comprehensive genetic assessment of newly diagnosed LABM patients should target both the PT and secondary BMs, including rogue clones with potential to form new BMs. Second, the additional information gained should allow clinicians to design and implement more personalized treatment regimens and potentially improve outcomes for LABM patients.

Concomitant fulvestrant with reirradiation for unresectable locoregional recurrent estrogen receptor positive (ER+) breast cancer: A case report and narrative review.

RATIONALE: Locoregional recurrence of breast cancer is a challenging issue for clinicians. Treatment options for unresectable recurrent estrogen receptor positive (ER+) breast cancer in previously irradiated area are limited. Some studies showed concomitant fulvestrant with radiation therapy might increase radiosensitivity compared with radiation alone in vitro, no in vivo reports yet. PATIENT CONCERN: Here, we present a case report and make a narrative review of concomitant fulvestrant with radiation therapy for unresectable locoregional recurrent ER+ breast cancer. The patient was treated with modified radical mastectomy in 2015, adjuvant chemotherapy, radiotherapy, followed by exemestane until November 2018, relapsed in internal mammary lymph nodes with sternum involved. DIAGNOSIS: The final diagnosis was breast cancer internal mammary lymph nodes metastasis with sternum involved. INTERVENTIONS: After diagnosis was made, concurrent fulvestrant with reirradiation as a palliative treatment were proposed under multiple disciplinary team. OUTCOMES: There was a good clinical response, enabling curative chance with radiation therapy to a total dose of 60 Gy. Computed tomography scan revealed no evidence of residual tumor. LESSONS: As far as we know, this is the first report concerning concomitant fulvestrant with reirradiation for unresectable locoregional recurrent ER+ breast cancer. Since no severe adverse events were observed, this strategy could be a suitable "loco-regional rescue therapy" to further reduce tumor progression or even reach a curative effect. Studies of this treatment strategy in randomized clinical trials are warranted to further assess its safety and effectiveness.

Positive association between heart dosimetry parameters and a novel cardiac biomarker, solubleST-2, in thoracic cancer chest radiation.

BACKGROUND: Early screening and diagnosis of radiation-induced heart disease (RIHD) is difficult in patients with chest radiation exposure. sST-2 is involved in myocardial stress or injury. We evaluated the relationship between heart dose parameters and sST-2 changes in chest malignant tumor patients who received chest radiation. METHODS: We prospectively collected thoracic malignancy cancer patients who had received chest radiotherapy. Heart dosimetry parameters were extracted from the treatment planning system. sST-2 was measured at baseline, the middle stage, and after radiotherapy (recorded as pre-ST-2, mid-ST-2, and post-ST-2). sST-2 change rate was calculated. Scatter plots showed the relationship between cardiac dose parameters and ST-2 change rate. Multiple regression was used to analyze the relationship between cardiac dose parameters and ST-2 change rate. RESULTS: Totally, 60 patients were enrolled. The mean V5 , V10 , V20 , V30 , V40 , and MHD was 60.93 ± 27.79%, 51.43 ± 25.44%, 39.17 ± 21.75%, 28.07 ± 17.15%,18.66 ± 12.18%, and 18.60 ± 8.63 Gy, respectively. The median M-LAD was 11.31 (IQR 3.33-18.76) Gy. The mean pre-ST-2, mid-ST-2, and post-ST-2 was 5.1 ± 3.8, 6.4 ± 3.9, and 7.6 ± 4.4, respectively. sST-2 was elevated with thoracic irradiation (P < .001). Multivariate linear regression analyses showed that V5 , V10 , V20 , and MHD were independently and positively associated with ST-2 change rate (ß = .04, .04, .04, and .10, respectively, all P < .05). CONCLUSION: Serum sST-2 levels were elevated over time during radiotherapy. V5 , V10 , V20 and MHD were independently and positively associated with the elevated ST-2 change rate.

The Assessment of Problematic Internet Pornography Use: A Comparison of Three Scales with Mixed Methods.

The primary aim of this study was to compare different screening tools for problematic internet pornography use (IPU) and identify the most accurate measure. The reliability and validity of three scales, namely, the Problematic Pornography Consumption Scale (PPCS), Problematic Pornography Use Scale (PPUS), and Short Internet Addiction Test Adapted to Online Sexual Activities(s-IAT-sex), were examined using three homogeneous groups, respectively. A total of 972 adults (mean age = 24.8) from 28 provinces/regions in China participated in the quantitative part (QUAN). The Brief Pornography Screener served as the reference standard. The PPCS demonstrated stronger reliability and validity, including criterion validity, as well as greater sensitivity and acceptable specificity; therefore, it was considered to be the more accurate screening instrument. In the qualitative part (QUAL), we interviewed 22 volunteers and 11 therapists (who had worked with individuals with problematic IPU) to examine their perspectives on the core features of problematic IPU and dimensions of the PPCS. Almost all the interviewees endorsed the structure of the PPCS. These findings encourage the use of the PPCS in future research studies and underscore its screening applications because of its ability to classify IPU as problematic or nonproblematic.

RNF6 facilitates metastasis and radioresistance in hepatocellular carcinoma through ubiquitination of FoxA1.

Ring finger protein 6 (RNF6), a RING-domain E3 ubiquitin Ligase, functions as a potential tumor promoter in several caners. However, the function and clinical significance of RNF6 in hepatocellular carcinoma (HCC) remains unclear. Here, we found that high RNF6 expression was detected frequently in primary HCC tissues, and was closely associated with malignant phenotype and shorter survival among the HCC patients. Multivariate analyses also revealed that RNF6 overexpression was independent prognostic factors for poor outcome of patients with HCC. Further, RNF6 knockdown notably inhibited the metastasis abilities of HCC in vivo and in vitro. RNF6 silence also suppressed the epithelial-mesenchymal transition (EMT) and radioresistance in HCC. Mechanistically, our results demonstrated that RNF6 directly bound and ubiquitylated Forkhead box protein A1 (FoxA1), an important transcriptional repressor of EMT process. Additionally, our data shown that the oncogenic effect of RNF6 in HCC is partially dependent on FoxA1 degradation. Collectively, our data suggest that RNF6 plays a crucial oncogenic role in HCC tumorigenesis, and we provide a novel evidence that RNF6 may be serve as a prognostic and therapeutic target for HCC progression.

The Relationship Between Observers' Self-Attractiveness and Preference for Physical Dimorphism: A Meta-Analysis.

Background: Many studies have reported an association between observers' self-attractiveness and their preference for sexual dimorphism across different physical domains, including the face, voice, and body. However, the results of these studies are inconsistent. Here, a meta-analysis was conducted to estimate the association between observers' own attractiveness and their dimorphic preference. Methods: Major electronic databases including PsycINFO, Web of Science, PubMed, ProQuest, and Google Scholar were searched during April 2017 (the first time) and April 2018 (the second time). The effect size computation and moderating effect analyses were conducted separately for masculine and feminine preferences. Results: We identified 5,359 references, of which we included 25 studies (x = 55, x = number of the effect size) with 6,853 participants in the meta-analysis. Across these studies, the correlation between observers' own attractiveness and their sexual dimorphic preference was 0.095 (x = 55) and that for preference for masculinity (x = 39) and femininity (x = 16) were 0.102 and 0.076, respectively. The results of the funnel plot, Egger's regression method, and fail-safe number suggested that there was no obvious publication bias. The relationship depended on the relationship context (short or long-term), opposite or same sex (the gender of the observer and host), measures of observers' self-attractiveness (subject or objective), and preference task (e.g., attractiveness rating, forced-choice, and face sequence test). Furthermore, for female participants, using a hormonal contraceptive also influenced their masculinity preference. The effect size for the preference for a masculine body and voice was larger than that for facial masculinity. Conclusion: We found a small but significant correlation between self-attractiveness and physical dimorphic preference, the relationship was moderated by the relationship context, same/opposite-sex, and contraceptive using. These three moderating effects represented the observer's trade-off on good genes, good provider and good father (3Gs) consistent with the life history strategies. Besides, measurement of observers' attractiveness, type of preference task and stimuli may also involve the relationship.

Downregulation of USP18 inhibits growth and induces apoptosis in hepatitis B virus-related hepatocellular carcinoma cells by suppressing BCL2L1.

Ubiquitin-specific peptidase 18 (USP18) is closely related with hepatitis B virus (HBV), which has been involved in tumourigenesis. However, there has been little research into the role of USP18 on the progression of hepatocellular carcinoma (HCC), especially in HBV-related HCC. In present study, we found that USP18 expression was aberrantly elevated in HCC tissues than adjacent non-tumour tissues. Importantly, USP18 expression was higher in HBV-related HCC cell lines (HepG2.2.15 and Hep3B) than HBV-unrelated HCC cell lines. Furthermore, knockdown of USP18 significantly suppressed tumour cell proliferation in vitro and tumour growth in vivo, whereas overexpression of USP18 promoted HCC cells growth. Moreover, our experimental data revealed that USP18 silencing obviously blocked cell cycle at G1 phase and increased cell apoptosis. Finally, BCL2L1, a member of BCL2 family protein, was identified as a downstream gene of USP18. Mechanistically, we found that USP18 directly bind to BCL2L1 and positively regulated its expression in HCC cells. Overall, our results suggested that USP18 has a crucial role in regulating diverse aspects of the pathogenesis of HCC, indicating that it might be a potential therapeutic target.

Successful treatment with anti-programmed-death-1 antibody in a relapsed natural killer/T-cell lymphoma patient with multi-line resistance: a case report.

BACKGROUND: Extranodal natural killer/T-cell lymphoma (NKTCL), nasal type, is an aggressive malignancy with poor prognosis. Currently, there is no recommended standard therapy for relapsed NKTCL. CASE PRESENTATION: A 37-year-old woman with lymphadenopathy was diagnosed with NKTCL by biopsy of an enlarged lymph node on the right side of her neck. Enhanced computed tomography revealed no metastasis. For this patient, we performed continuous chemotherapy followed by radiotherapy; however, nodule biopsy showed metastases in her lower limbs 3 months after radiotherapy, which confirmed disease progression. Unfortunately, the patient' s temperature was persistently high and her skin ulcers could not be controlled well using multi-line treatment. Therefore, we attempted treatment with the anti-programmed-death-1 (PD-1) antibody, pembrolizumab. Surprisingly, the patient achieved clinical complete remission (CR) after four cycles of pembrolizumab treatment, despite having persistent detectable Epstein-Barr virus (EBV) DNA. Other molecular monitoring techniques were unavailable for this patient owing to the retrospective nature of the study. The only adverse event was soreness of the upper limb joints and muscles. CONCLUSION: This relapsed NKTCL case treated with pembrolizumab showed that multimodal therapy including pembrolizumab would be partially or totally effective for relapsed NKTCL.