ABSTRACT
BACKGROUND: The significant expression of PD-L1 in thymic epithelial tumors (TETs) has been confirmed, and immunotherapy and its combination therapy have been effective in TETs. However, there is no present evidence that the expression levels of PD-L1 affects the efficacy of combination therapy. Our study aimed to shed light on this relationship. METHODS: Patients with thymic epithelial tumors (TETs) from multicenter hospitals were retrospectively identified. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAEs) in 22 patients were included. We divided the patients the 22 patients with PD-L1 test into three levels (high expression, low expression and no expression) and analyzed the relationship between the levels of PD-L1 expression and the efficacy of combination therapy. RESULTS: Combination therapy showed an effective benefit in 22 patients with TETs, the median PFS (mPFS) was 16 months (95% CI: 8.5-23.5) and the median OS (mOS) was 38 months (95% CI: 21.5-54.5). Cox-regressive analysis found whether PD-L1 expression affected the PFS of patients (p = 0.017). Among the patients with PD-L1 expression, the levels of expression were correlated with curative effect (Kruskal-Wallis test, PFS: P = 0.012; OS: P = 0.01), and high expression group was along with better efficacy than low expression (Wilcoxon test, P = 0.01). Moreover, in 17 patients treated with immunotherapy combined with chemotherapy, the expression of PD-L1 was also associated with efficacy (Kruskal-Wallis test, p = 0.021). CONCLUSIONS: PD-L1 expression affects the PFS of patients. High expression of PD-L1 patients with TETs responded better to combination therapy, which could provide a therapeutic option in clinic. Besides, other targeted treatments should be considered.
ABSTRACT
Geothermal energy is increasingly employed across diverse applications, with bridge deck snow melting emerging as a notable utilization scenario. In Jinan city, China, a project is underway to utilize ground source heat pumps (GSHPS) for heating bridges. However, essential operational parameters, including fluid medium, temperature, and heat exchange details, are currently lacking. This study addresses the thermal design challenges associated with ground heat exchangers (GHE) for bridge heating through a combination of numerical modeling and field experiments. Utilizing software Fluent, a refined three-dimensional multi-condition heat transfer numerical analysis was carried out. Field tests based on actual operating conditions were also conducted and the design parameters were verified. The results indicate that an inlet temperature of 5°C and an aqueous solution of ethylene glycol with a mass concentration of 35% as the heat exchange medium are suitable for the GSHPS in Jinan; Moreover, the influence of backfill material and operation time on the heat transfer efficiency was revealed and the suitable material with 10% bentonite and 90% SiO2 was suggested; Finally, based on the influence of the pipe spacing on the heating characteristics of bridge deck, the transition spacing of 0.2 m is given for the temperature response of the bridge deck. This comprehensive study contributes valuable insights through simulation and experimental analysis of the thermal environment variation, aiming to advance the development of GSHPS for bridge deck heating in Jinan, China.