Perception of Patients, Physicians, and Chaperones Regarding the Use of Chaperones During Patient Examinations for Plastic Surgery: A Systematic Review.

In this systematic review, we searched electronic databases for literature addressing physician use of chaperones during examinations of patients undergoing plastic surgery from the perspective of the patient, physician, and chaperone from inception of the database until April 2023. After screening 939 articles, we included seven studies in a systematic review. We conducted an inductive thematic analysis of four domains (physician perspective, patient perspective, chaperone perspective, and chaperone documentation). The results of the analysis showed that surgeons who are experienced, are men, or have received education related to using chaperones are more likely to provide chaperones during patient examinations for medicolegal protection and patient comfort. A small percentage of surgeons have faced accusations from patients of inappropriate behavior. Most of these incidents have occurred without a chaperone present. Patients who have long associations with a particular plastic surgery practice are less likely to want a chaperone. When physicians examine nonsensitive areas, most patients prefer having no chaperone. However, young patients and patients undergoing reconstructive procedures are more likely to request chaperones. Patients prefer having family members or friends serve as chaperones. Notably, despite the presence of a chaperone, we found that documentation of the presence of a chaperone was inadequate. Using a chaperone helps establish trust and ensure patient comfort. Further research, including qualitative studies and multinational approaches, is warranted to gain deeper insights and develop comprehensive guidelines for chaperone use that empowers both patients and health care providers.

Physical fitness levels and trends of kindergarteners in Hong Kong during the COVID-19 pandemic.

Background/objectives: The study aimed to examine the physical fitness and activity levels of kindergarteners in Hong Kong during the coronavirus disease 2019 pandemic. Methods: A total of 2052 kindergarteners (48% girls; 32.9% Grade 1, 34% Grade 2, and 33.1% Grade 3) were recruited from July 2020 to November 2021. Participants completed the physical fitness tests, including body composition, flexibility, lower-limb muscle strength, upper-limb muscle strength, lower-limb muscle endurance, and agility. Children's physical activity and overall well-being were examined using parental proxy reports. Parents also reported their physical activity and parental support to children's physical activity engagement, as well as their perception of children's kindergarten physical activity environment. Fitness differences by age and gender were analyzed using one-way ANOVA and ANCOVA measuring effect size with partial eta-squared. Additionally, correlations assessed the relationship between children's fitness and parents' proxy reports. Results: The results of the physical fitness tests were higher than those in previous studies conducted by the Physical Fitness Association of Hong Kong in 2015-2018. Gender-based differences were observed in most tests for children aged 4 years and older, with boys showing higher scores in the standing long jump, shot put, and balance tests, while girls had higher scores in the sit-and-reach test. Parents' proxy questionnaire answers indicated that children's continuous jump test performances were significantly related to their frequency of physical activity per week (r = 0.19, p < 0.001), and that children's health was significantly and positively correlated with their fitness level (r = 0.179, p < 0.009). Inadequate school physical activity was associated with poor upper-limb strength (r = 0.078, p < 0.005). Moreover, a high level of parental support for their children's participation in physical activity was correlated with a high level of parental participation in vigorous-intensity physical activities (r = 0.167, p < 0.005). Conclusion: The physical fitness of children in Hong Kong was less affected by the epidemic. Parents' healthy behaviors and support were related to children's participation in PA. Efforts to improve children's physical fitness and motor development should include parent education and physical activity involvement.

Construction of an immune-related gene signature for overall survival prediction and immune infiltration in gastric cancer.

BACKGROUND: Treatment options for patients with gastric cancer (GC) continue to improve, but the overall prognosis is poor. The use of PD-1 inhibitors has also brought benefits to patients with advanced GC and has gradually become the new standard treatment option at present, and there is an urgent need to identify valuable biomarkers to classify patients with different characteristics into subgroups. AIM: To determined the effects of differentially expressed immune-related genes (DEIRGs) on the development, prognosis, tumor microenvironment (TME), and treatment response among GC patients with the expectation of providing new biomarkers for personalized treatment of GC populations. METHODS: Gene expression data and clinical pathologic information were downloaded from The Cancer Genome Atlas (TCGA), and immune-related genes (IRGs) were searched from ImmPort. DEIRGs were extracted from the intersection of the differentially-expressed genes (DEGs) and IRGs lists. The enrichment pathways of key genes were obtained by analyzing the Kyoto Encyclopedia of Genes and Genomes (KEGGs) and Gene Ontology (GO) databases. To identify genes associated with prognosis, a tumor risk score model based on DEIRGs was constructed using Least Absolute Shrinkage and Selection Operator and multivariate Cox regression. The tumor risk score was divided into high- and low-risk groups. The entire cohort was randomly divided into a 2:1 training cohort and a test cohort for internal validation to assess the feasibility of the risk model. The infiltration of immune cells was obtained using 'CIBERSORT,' and the infiltration of immune subgroups in high- and low-risk groups was analyzed. The GC immune score data were obtained and the difference in immune scores between the two groups was analyzed. RESULTS: We collected 412 GC and 36 adjacent tissue samples, and identified 3627 DEGs and 1311 IRGs. A total of 482 DEIRGs were obtained. GO analysis showed that DEIRGs were mainly distributed in immunoglobulin complexes, receptor ligand activity, and signaling receptor activators. KEGG pathway analysis showed that the top three DEIRGs enrichment types were cytokine-cytokine receptors, neuroactive ligand receptor interactions, and viral protein interactions. We ultimately obtained an immune-related signature based on 10 genes, including 9 risk genes (LCN1, LEAP2, TMSB15A mRNA, DEFB126, PI15, IGHD3-16, IGLV3-22, CGB5, and GLP2R) and 1 protective gene (LGR6). Kaplan-Meier survival analysis, receiver operating characteristic curve analysis, and risk curves confirmed that the risk model had good predictive ability. Multivariate COX analysis showed that age, stage, and risk score were independent prognostic factors for patients with GC. Meanwhile, patients in the low-risk group had higher tumor mutation burden and immunophenotype, which can be used to predict the immune checkpoint inhibitor response. Both cytotoxic T lymphocyte antigen4+ and programmed death 1+ patients with lower risk scores were more sensitive to immunotherapy. CONCLUSION: In this study a new prognostic model consisting of 10 DEIRGs was constructed based on the TME. By providing risk factor analysis and prognostic information, our risk model can provide new directions for immunotherapy in GC patients.

Significant effect of posterior line treatment of HER2 positive advanced gastric cancer: A case report.

At present, there are few options for third line and above treatment of advanced gastric cancer and the single drug effect is poor. HER2 positive gastric cancer is an important subtype of gastric cancer and has certain immune characteristics. The combination of HER2 inhibitor and PD-1 inhibitor has a synergistic effect, and anti-tumor drugs targeting HER2 can play an anti-angiogenesis role by downregulating VEGF. We report a patient with HER2-positive gastric cancer who developed post-operative tumor recurrence and metastasis after adjuvant chemotherapy and radiotherapy. Trastuzumab combined with albumin paclitaxel was used as second-line treatment with progression-free survival for 9 months. In third line treatment, we retained trastuzumab and combined it with camrelizumab and apatinib. During the treatment period, although the patient stopped taking the drugs due to the side effects of camrelizumab and apatinib, he achieved a PFS of 10.4 months. Considering the good effect of the third line treatment, we added another PD-1 inhibitor and continued to combine trastuzumab treatment. We found that the patient still benefited from the treatment and continued to survive for another 4 months. At present, the patient is treated with DisitamabVedotin (HER2-ADC) combined with PD-1 inhibitor, and no overall survival outcome has been observed.

TiO2nanorod arrays/Ti3C2TxMXene nanosheet composites with efficient photocatalytic activity.

Semiconductor photocatalysis holds significant promise in addressing both environmental and energy challenges. However, a major hurdle in photocatalytic processes remains the efficient separation of photoinduced charge carriers. In this study, TiO2nanorod arrays were employed by glancing angle deposition technique, onto which Ti3C2TxMXene was deposited through a spin-coating process. This hybrid approach aims to amplify the photocatalytic efficacy of TiO2nanorod arrays. Through photocurrent efficiency characterization testing, an optimal loading of TiO2/Ti3C2Txcomposites is identified. Remarkably, this composite exhibits a 40% increase in photocurrent density in comparison to pristine TiO2. This enhancement is attributed to the exceptional electrical conductivity and expansive specific surface area inherent to Ti3C2TxMXene. These attributes facilitate swift transport of photoinduced electrons, consequently refining the separation and migration of electron-hole pairs. The synergistic TiO2/Ti3C2Txcomposite showcases its potential across various domains including photoelectrochemical water splitting and diverse photocatalytic devices. As such, this composite material stands as a novel and promising entity for advancing photocatalytic applications. This study can offer an innovative approach for designing simple and efficient photocatalytic materials composed of MXene co-catalysts and TiO2for efficient water electrolysis on semiconductors.

Proton Pump Inhibitors Increases Longitudinal Risk of Mortality, Decompensation, and Infection in Cirrhosis: A Meta-Analysis.

BACKGROUND/AIMS: Proton pump inhibitors (PPIs) are frequently prescribed to cirrhotic patients, but there is limited longitudinal evidence regarding their effects. This study aimed to assess the impact of PPIs on adverse events in cirrhotic patients. METHODS: A comprehensive search was conducted using the Medline and Embase databases to identify relevant articles. Pooled hazard ratios (HRs) using DerSimonian and Laird random-effects model were calculated to evaluate the risk of adverse events such as long-term mortality, hepatic decompensation, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), and overall infection in cirrhotic patients with PPI use. RESULTS: The analysis included 28 studies with 260,854 cirrhotic patients. The prevalence of PPI use among cirrhotic patients was 55.93%. The use of PPIs was not significantly associated with short-term mortality in cirrhotic patients. However, long-term mortality (HR 1.321, 95% CI 1.103-1.581, P = 0.002), decompensation (HR 1.646, 95% CI 1.477-1.835, P < 0.001), HE (HR 1.968, 95% CI 1.372-2.822, P < 0.001), SBP (HR 1.751, 95% CI 1.649-1.859, P < 0.001), and infection (HR 1.370, 95% CI 1.148-1.634, P < 0.001) were significantly associated with PPI use. Sensitivity analysis with prospective studies yielded similar results. CONCLUSION: PPIs should be reserved for appropriate indications at lowest effective dose for cirrhotic patients due to the potential harm.

Highly Sensitive H2S Gas Sensor Based on a Lead-Free CsCu2I3 Perovskite Film at Room Temperature.

Recently, there have been reports of lead halide perovskite-based sensors demonstrating their potential for gas sensing applications. However, the toxicity of lead and the instability of lead-based perovskites have limited their applications. This study addressed this issue by developing a H2S gas sensor based on a lead-free CsCu2I3 film prepared using a one-step CVD method. The sensor demonstrated excellent sensing properties, including a high response and selectivity toward H2S, even at low concentrations (0.2 ppm) at room temperature. Furthermore, a reasonable sensing mechanism was proposed. It is suggested that the sensing mechanism sheds light on the role of defects in perovskite materials, the impact of H2S as an electron donor, and the occurrence of reversible chemical reactions. These findings suggest that lead-free CsCu2I3 has great potential in the field of H2S gas sensing.

Investigating and promoting health behaviors reactivity among Hong Kong older adults in the post-COVID-19 Era: An exploratory network analysis.

BACKGROUND: Physical distance has increased the risk of developing a variety of health problems, especially among older people. During the COVID-19 lockdown period, physical activity decreased, screen time increased, food consumption increased, as well as exposure to unhealthy behaviour, leading to poorer sleep quality and more negative emotions, which ultimately led to poorer physical health, mental health, and subjective vitality among older adults. Although there were numerous research studies on changes in health behaviours during COVID-19, only a few were targeted at older adults, and none were conducted in Asian countries. METHOD: The current study is aiming to identify the changes in health behaviours, as well as their associations with older adults' mental health as a result of the COVID-19 pandemic among Hong Kong older adults, using exploratory network analysis. In this study, a random tele-survey was conducted among older adults. RESULTS: A total of 664 participants have been involved in the telephone survey, with 213 males and 451 females, of which mean age was 74.37. The explored network showed strong centrality and edge stability, thus enabling to reveal an overview of the associations between health behaviours and mental well-being of older adults. The lavaan model has also demonstrated the casual paths within the explored network, which indicated the significant impact of sleeping quality, eating habits and social networking on resilience. CONCLUSION: The outcomes of the study were able to identify the lifestyle changes of Hong Kong older adults due to COVID-19. Although the present study is not regarded as novel internationally, it may be representative of the Hong Kong community. In order to facilitate active aging during the pandemic, a user-friendly electronic platform for healthy living should include older adults in the future.

The effects of walking on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia: a study protocol of randomized control trial by comparing supervised group-based intervention and non-supervised individual-based intervention.

BACKGROUND: Kingdom of Saudi Arabia (KSA) demographics are also changing with the increase in life expectancy in the country and the rise in the number of older Saudi Arabians. Saudi Arabia has a higher rate of physically inactive people, and most of them are between the ages of 55-64. Walking is one of the most prevalent forms of physical activity in Saudi Arabia and the study showed that most people prefer walking for recreational and health benefits. Therefore, the purpose of the proposed study is to compare the effects of supervised group-based walking and non-supervised individual-based walking interventions on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia. METHOD: This study will apply a three-group (2 intervention groups and 1 control group), double-blinded, randomized controlled trial (RCT) to examine the effect of different forms of walking interventions on Saudi Arabia older adults' frailty, cognitive function and quality of life immediately after a 16-week intervention, as well as the residual effects 12 weeks after completion of the interventions. DISCUSSION: This study aims to determine whether supervised group walking and non-supervised individual walking lead to different effects. Given the limited evidence in the literature regarding Saudi Arabia older adults' physical fitness and health, it is worthwhile to explore the effect of walking, as well as the forms of walking on improving the overall physical fitness and psychological status of older adults in Saudi Arabia. The findings of the current study could also create awareness of the government and the general public in Saudi Arabia of the ageing problems and the effective ways of achieving better intervention results. TRIAL REGISTRATION: The trial is registered at the ClinicalTrials.gov PRS (Trial ID: NCT05151575; Date of first posted: 12/07/2021).

Betainization of Polydopamine/Polyethylenimine Coating for Universal Zwitterionization.

Biofoulants can adhere to multiple surfaces, degrading the performance of medical devices and industrial facilities and/or causing nosocomial infection. The surface immobilization of zwitterionic materials can prevent the initial attachment of the foulants but lacks extensive implementation. Herein, we propose a facile, universal, two-step surface modification strategy to improve fouling resistance. In the first step, the substrates were immersed in a codeposition solution containing dopamine and branched polyethylenimine (PEI) to form a "primer" layer (PDA/PEI). In the second step, the primer layers were treated with 1,3-propane sultone to betainize primary/secondary/tertiary amine moieties of PEI, generating zwitterions on substrates. After betainization, PS-grafted PDA/PEI (PDA/PEI/S) via a ring-opening alkylation reaction manifested changes in wettability. X-ray photoelectron spectroscopy revealed the presence of zwitterionic moieties on the PDA/PEI/S surfaces. Further investigations using ellipsometry and atomic force microscopy were conducted to scrutinize the relation among the PEI content, film thickness, primer stability, and betainization. As a result, zwitterion-decorated substrates prepared under optimal conditions can exhibit high resistance against bacterial fouling, achieving a 98.5% reduction in bacterial attachment. In addition, the method shows a substrate-independent property, capable of successfully applying it on organic and inorganic substrates. Finally, the newly developed approach shows excellent biocompatibility, displaying no significant difference compared with blank control samples. Overall, we envision that the facile surface modification strategy can further promote the preparation of zwitterion-decorated materials in the future.

Weekly cumulative extracurricular core training time predicts cadet physical performance: A descriptive epidemiological study.

Background: Core training can enhance athletic performance by enhancing core strength and stability. To achieve this outcome, however, a tailored training program is required; the normal military training curriculum is inadequate. The connection between cumulative weekly extracurricular training time, cumulative weekly extracurricular core training time and cadet performance is unknown. Methods: The association between cumulative weekly extracurricular training time, cumulative weekly extracurricular core training time and performance has been discovered using a descriptive epidemiological study methodology. Questionnaires were used to collect information on personal characteristics and weekly cumulative extracurricular (core) training time, as well as the results of the Chinese Army Physical Fitness Test (C-APFT), which included 100-m dash, 5000-m run, 3000-m armed training run, 400-m steeplechase, 800 m breaststroke, horizontal bar pull-ups, 2-min sit-ups, 2-min push-ups, and hand grenade throwing. This study recruited two hundred and twenty male cadets (aged 18 to 23 years, 19.68 ± 0.91) from a military medical university. Results: (a) The correlation between cumulative weekly extracurricular training time and C-APFT score is significant. The 100-m dash, 5000-m run, 3000-m armed training run, 400-m steeplechase, and 2-min push-ups performed the best when participants exercised for 5 to 10 h per week. (b) The number of cadets scoring good or excellent on the C-APFT improves with cumulative weekly extracurricular core training time. The recommended amount of core training for cadets per week is 120 min. (c) The average cumulative weekly extracurricular core training time was a effective predictor of performance on the 400-m steeplechase (R2 = 0.470, F = 10.641, P＜0.01), horizontal bar pull-ups (R2 = 0.238, F = 68.191, P＜0.01), 2-min sit-ups (R2 = 0.280, F = 84.710, P＜0.01), 100-m run (R2 = 0.031, F = 6.920, P＜0.01), 3000-m armed training run (R2 = 0.025, F = 5.603, P＜0.05), 2-min push-ups (R2 = 0.019, F = 4.295, P＜0.05), and hand grenade tossing (R2 = 0.025, F = 5.603, P＜0.05). Conclusions: Active participation in extracurricular core training can improve cadets' C-APFT scores. An average cumulative weekly extracurricular training duration of 5-10 h showed the most progress, and more than 120 min per week was ideal for extracurricular core training. The amount of extracurricular time spent on core training exercises each week can be used as a predictor of the C-APFT.

Advanced pancreatic cancer with KRAS wild-type and EGFR-sensitive mutation respond favorably to furmonertinib: A case report.

Pancreatic cancer is the leading cause of cancer death, and treatment options are limited and mostly ineffective. The patient we report had an EGFR exon 19 deletion and had disease progression in the short term after receiving three front-line treatment regimens. We administered furmonertinib and observed tumor shrinkage, decreased CA19-9. The progression-free survival (PFS) of furmonertinib was 4.7 months, and no adverse effects were observed. However, the patient did not benefit from subsequent nimotuzumab-based therapy. Targeted therapy driven by the detection of genetic signatures in this patient shows potential clinical benefit in refractory advanced pancreatic cancer.

Advances in Meta-Optics and Metasurfaces: Fundamentals and Applications.

Meta-optics based on metasurfaces that interact strongly with light has been an active area of research in recent years. The development of meta-optics has always been driven by human's pursuits of the ultimate miniaturization of optical elements, on-demand design and control of light beams, and processing hidden modalities of light. Underpinned by meta-optical physics, meta-optical devices have produced potentially disruptive applications in light manipulation and ultra-light optics. Among them, optical metalens are most fundamental and prominent meta-devices, owing to their powerful abilities in advanced imaging and image processing, and their novel functionalities in light manipulation. This review focuses on recent advances in the fundamentals and applications of the field defined by excavating new optical physics and breaking the limitations of light manipulation. In addition, we have deeply explored the metalenses and metalens-based devices with novel functionalities, and their applications in computational imaging and image processing. We also provide an outlook on this active field in the end.

Real-World Results of Raltitrexed Combined with S-1 and Bevacizumab in Heavily Pretreated Metastatic Colorectal Cancer.

Purpose: Treatment options for refractory metastatic colorectal cancer (CRC) are scarce. This retrospective study aimed to evaluate the efficacy and safety of raltitrexed combined with S-1 and bevacizumab in patients with heavily pretreated metastatic CRC in a clinical real-world setting. Patients and Methods: Records of patients with metastatic CRC refractory to standard therapies who initiated raltitrexed plus S-1 and bevacizumab from October 2017 to December 2021 were retrospectively reviewed at our institution. The study endpoints included median overall survival (OS), overall response rate (ORR), progression-free survival (PFS), disease control rate (DCR), and adverse events (AEs). Results: Forty-four patients with metastatic CRC, who had previously undergone standard chemotherapy received the regimen comprising raltitrexed plus S-1 and bevacizumab. As of March 2022, the median follow-up was 23.2 months (95% confidence interval 15.8-30.6). The median OS and median PFS were 13.5 (95% CI 9.9-17.1) and 4.7 months (95% CI 3.6-5.8), respectively, with a 16-week PFS rate of 60.9%. Among 43 patients with measurable lesions, the ORR and DCR were 7.0% (3/43) and 65.1% (28/43), respectively. Patients without peritoneal metastases (P = 0.003, hazard ratio 0.160, 95% CI 0.048-0.531), lower carcinoembryonic antigen level (≤42.8 ng/mL) (P = 0.039, HR 0.382, 95% CI 0.153-0.952), and no previous treatment with both vascular endothelial growth factor inhibitors (VEGF) and S-1 (P = 0.020, HR 0.215, 95% CI 0.059-0.785) had better OS. The incidence of any grade of treatment-related AEs was 88.6%, most of which were mild to moderate, and no treatment-related deaths occurred. Conclusion: Raltitrexed combined with S-1 and bevacizumab shows promising antitumor activity and safety and could be an alternative for patients with metastatic CRC who are refractory or intolerant to standard therapy.

Angular momentum holography via a minimalist metasurface for optical nested encryption.

Metasurfaces can perform high-performance multi-functional integration by manipulating the abundant physical dimensions of light, demonstrating great potential in high-capacity information technologies. The orbital angular momentum (OAM) and spin angular momentum (SAM) dimensions have been respectively explored as the independent carrier for information multiplexing. However, fully managing these two intrinsic properties in information multiplexing remains elusive. Here, we propose the concept of angular momentum (AM) holography which can fully synergize these two fundamental dimensions to act as the information carrier, via a single-layer, non-interleaved metasurface. The underlying mechanism relies on independently controlling the two spin eigenstates and arbitrary overlaying them in each operation channel, thereby spatially modulating the resulting waveform at will. As a proof of concept, we demonstrate an AM meta-hologram allowing the reconstruction of two sets of holographic images, i.e., the spin-orbital locked and the spin-superimposed ones. Remarkably, leveraging the designed dual-functional AM meta-hologram, we demonstrate a novel optical nested encryption scheme, which is able to achieve parallel information transmission with ultra-high capacity and security. Our work opens a new avenue for optionally manipulating the AM, holding promising applications in the fields of optical communication, information security and quantum science.

Healthy Lifestyle Behavior, Goal Setting, and Personality among Older Adults: A Synthesis of Literature Reviews and Interviews.

BACKGROUND: Despite the well-known health benefits of adopting a healthy lifestyle, older adults' self-determination, goals, and motivation, as well as other personality factors, are known to influence their healthy lifestyle behaviors, yet these interactions have rarely been discussed. METHOD: The literature that investigated and discussed the interaction of personality, goals, and healthy lifestyle behaviors among older adults was reviewed. In addition, interview responses from older adults regarding their experiences in participating in a real-life physical activity intervention and its relationship with their personality traits and goal setting were synthesized using content analysis. RESULTS: The current review highlights the relationship between healthy living practices, goal setting, and personalities, and it is backed up and expanded upon by interviews with participants. People with different personality types are likely to have diverse views on HLBs. Individuals who are more conscientiousness or extraverted are more likely to adopt HLBs than those who are not. DISCUSSION: It is suggested that a meta-analysis should be conducted on the relationship between personality, goal setting, and physical exercise or other specific HLBs. In addition, future research should focus on various types of HLB therapies that take into account personality and goal setting.

Clinical practice guidelines for the management of hyperemesis gravidarum: A systematic review and quality appraisal with AGREE II.

BACKGROUND AND OBJECTIVES: Nausea, vomiting and hyperemesis in early pregnancy are common in primary care, and hospital care is required in severe cases. The aim of this review is to appraise relevant clinical practice guidelines (CPGs) to manage hyperemesis gravidarum (HG) by using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) checklist. METHOD: A systematic search was conducted employing PubMed, Cochrane and ScienceDirect from inception until May 2021. The quality of four CPGs were evaluated by two appraisers independently using the AGREE II checklist. RESULTS: Four international CPGs that fulfilled the criteria were included in this review; all scored over 50% according to the AGREE II tool. Applying a modified categorisation standard, CPGs were considered as either 'recommended' or 'recommended with modifications'. DISCUSSION: The synthesis of all four CPGs suggested similar management strategies for HG, with minor differences. Medical practitioners could use the guiding principles of management on the basis of the needs of individual patients.

Application progress of liquid biopsy in gastric cancer.

Gastric cancer (GC) is one of the most common malignant tumors globally. Guiding the individualized treatment of GC is the focus of research. Obtaining representative biological samples to study the biological characteristics of GC is the focus of diagnosis and treatment of GC. Liquid biopsy technology can use high-throughput sequencing technology to detect biological genetic information in blood. Compared with traditional tissue biopsy, liquid biopsy can determine the dynamic changes of tumor. As a noninvasive auxiliary diagnostic method, liquid biopsy can provide diagnostic and prognostic information concerning the progression of the disease. Liquid biopsy includes circulating tumor cells, circulating tumor DNA, circulating tumor RNA, tumor educated platelets, exosomes, and cytokines. This article describes the classification of liquid biopsy and its application value in the occurrence, development, and therapeutic efficacy of GC.

POLE/POLD1 mutation and tumor immunotherapy.

POLE and POLD1 encode the catalytic and proofreading subunits of DNA polymerase ε and polymerase δ, and play important roles in DNA replication and proofreading. POLE/POLD1 exonuclease domain mutations lead to loss of proofreading function, which causes the accumulation of mutant genes in cells. POLE/POLD1 mutations are not only closely related to tumor formation, but are also a potential molecular marker for predicting the efficacy of immunotherapy in pan-carcinomatous species. The association of POLE/POLD1 mutation, ultra-high mutation load, and good prognosis have recently become the focus of clinical research. This article reviews the function of POLE/POLD1, its relationship with deficient mismatch repair/high microsatellite instability, and the role of POLE/POLD1 mutation in the occurrence and development of various tumors.

Safety and efficacy of irinotecan, oxaliplatin, and capecitabine (XELOXIRI) regimen with or without targeted drugs in patients with metastatic colorectal cancer: a retrospective cohort study.

BACKGROUND: Five-fluorouracil, folinic acid, oxaliplatin and irinotecan (FOLFOXIRI) regimen is used as the first-line treatment for metastatic colorectal cancer (mCRC). The use of capecitabine, an oral fluoropyrimidine pro-drug, is feasible and safe; hence, it provides an interesting alternative to 5-fluorouracil in the abovementioned regimen. This study aimed to evaluate the efficacy and safety of capecitabine, oxaliplatin, and irinotecan (XELOXIRI) regimen use with or without targeted drugs in Chinese patients with mCRC. METHODS: We conducted a retrospective, longitudinal cohort study of patients with mCRC who received XELOXIRI regimen with or without targeted drugs (bevacizumab or cetuximab) every 2 weeks between January 2017 and November 2019 at the National Cancer Center/Cancer Hospital, the Chinese Academy of Medical Sciences, and Peking Union Medical College. Treatment efficacy was assessed by investigators by evaluating the objective response rate (ORR) and disease control rate (DCR). Overall survival (OS) was assessed using Cox proportional hazards models. The adverse events were also analyzed. RESULTS: Sixty-one consecutive patients were examined and followed up for survival. As of November 8, 2021, the median follow-up time was 35.4 months. Disease progression and death occurred in 50 (82%) and 38 (62%) patients, respectively. The median treatment duration of XELOXIRI with or without bevacizumab or cetuximab was 10 cycles (range, 1-12 cycles). The median OS and PFS were 32.2 months (95%CI [24.8-39.6]) and 9.3 months (95% CI [8.1-10.5]), respectively. The ORR of 48 patients with measurable lesions was 70.8%, and the DCR was 89.6%. RAS/BRAF wild-type (HR 0.39; 95% CI [0.16-0.96], p = 0.04) and metastatic organs > 2 (HR 3.25; 95% CI [1.34-7.87], p = 0.009) were independent prognostic factors for OS. The incidence of any grade of adverse events (AEs) was 96.7% (59/61). Grade ≥ 3 AEs included neutropenia (19.7%), leukopenia (9.8%), diarrhea (3.3%), vomiting (3.3%), febrile neutropenia (1.6%), and thrombocytopenia (1.6%). No treatment-related death occurred. CONCLUSION: The use of the XELOXIRI regimen with or without a targeted drug was effective, with a manageable toxicity profile in Chinese patients with mCRC.