Wavelength-polarization-multiplexed multichannel perfect vortex array generator based on dielectric metasurface.

The multi-channel perfect vortex (PV) array based on metasurface has important applications in optical communication, particle manipulation, quantum optics, and other fields due to its ultra-thin structure and excellent wavefront control ability. However, it is very challenging to utilize a single metasurface to simultaneously achieve independent channel PV arrays at different wavelengths with low crosstalk and low structural complexity. Here, we propose and design a single rectangular structured metasurface based on TiO2, achieving a multi-channel PV beam array with dual-wavelength and dual-polarization multiplexing. Simulation and experimental results show that when two orthogonal linearly polarized beams with wavelengths of 532 nm and 633 nm are incident on the metasurface, clear PV arrays with corresponding topological charge arrangements can be obtained in different diffraction regions of the same observation plane. The metasurface proposed in this article can enhance the channel capacity of a PV beam array through wavelength-polarization-multiplexing, thus having important application potential in spatial information transmission, high-dimensional information storage, and secure information encryption.

Systematic review of the efficacy and safety of lenvatinib in various solid tumors.

OBJECTIVE: The purpose of this study was to investigate the efficacy and safety of lenvatinib in various types of solid tumors. METHOD: By searching PubMed, Web of Science, Cochrane, CNKI, Wanfang and other databases, all the literatures about the comparison of clinical efficacy of lenvatinib in the treatment of various solid tumors. According to the criteria of inclusion and exclusion of literature, two participants screened the literature, collated the data and evaluated the literature. RevMan 5.4 software was used for meta-analysis of the included literatures. RESULTS: A total of 12 studies were included, including 5213 patients. Meta-analysis showed that, in terms of efficacy, the risk (HR) of prolonging PFS in the treatment of various solid tumors in the lenvatinib group was 1.91 times that in the control group (HR = 1.91, 95% CI: 1.58-2.31, p < 0.00001), and the risk (HR) of prolonging OS was 1.27 times that in the single targeted drug group (HR = 1.27, 95% CI: 1.15-1.40, p < 0.00001). In terms of safety, the risk of adverse events in the treatment of various solid tumors in the lenvatinib group was higher than that in the control group, especially in Endocrine Toxicities, Renal/Urinary Toxicities, Vascular Toxicities, Musculoskeletal/a Connective Tissue Toxicities and Metabolism/Nutrition Toxicities. CONCLUSIONS: Lenvatinib in various solid tumors can prolong OS and disease PFS of patients, improve the clinical benefit rate and improve the quality of life of patients. At the same time, there is a certain incidence of adverse events, and symptomatic intervention should be given in clinical medication.

Intuitionistic fuzzy-based entropy weight method-TOPSIS for multi-attribute group decision-making in drilling fluid waste treatment technology selection.

Drilling fluid waste is produced by oil and gas industry operations and can potentially cause serious environmental pollution and energy consumption if not properly treated. Currently, there are several treatment methods available for drilling fluid waste such as bioremediation, thermal treatment, solidification/stabilization treatment, electrochemical remediation, physiochemical treatment, and supercritical fluid treatment. However, selecting an adequate method to treat drilling fluid waste is a critical consideration. The objective of this work is to analyze the problem of drilling fluid waste pollution and treatment methods, establish a drilling fluid waste treatment decision index system that takes into account various factors, and apply the intuitionistic fuzzy-based entropy weight method (EWM)-technique for order of preference by similarity to ideal solution (TOPSIS) method to make a multi-attribute group decision on drilling fluid waste treatment methods. The method is then applied to the WBQ004-1-H1 drilling project as an example for comprehensive analysis. The final decision results show that A3 (0.566) > A1 (0.537) > A6 (0.526) > A5 (0.485) > A4 (0.478) > A2 (0.447), so the solidification/stabilization treatment is the most suitable method for this project, providing new insights into selecting drilling fluid waste treatment methods in actual projects.

Evaluation of HER-2 positive breast cancer treated with dual-targeted treatment of trastuzumab plus pertuzumab.

Objective: Clinical studies have shown that trastuzumab combined with pertuzumab (dual-targeted drug therapy) can significantly improve the treatment status and prognosis of HER-2 positive breast cancer patients through double targeting of HER-2. This study systematically evaluated the efficacy and safety of trastuzumab combined with pertuzumab in the treatment of HER-2 positive breast cancer.Method: We search relevant databases and collect RCTs on the treatment of HER-2 positive breast cancer with dual-targeted treatment. Meta-analysis was performed using Revman5.4 software.Results: A total of 10 studies for 8553 patients were included. Meta-analysis showed that, in terms of efficacy, overall survival (OS) (HR = 1.40, 95%CI = 1.29-1.53, p < 0.00001) and progression-free survival (PFS) (HR = 1.36, 95%CI = 1.28-1.46, p < 0.00001) in dual-targeted drug therapy were better than which in the single-targeted drug group. In terms of safety, the highest incidence (Relative risk, RR) of Adverse reactions was Infections and infestations (RR = 1.48, 95%CI = 1.24-1.77, p < 0.0001) follow by Nervous system disorders (RR = 1.29, 95%CI = 1.12-1.50, p = 0.0006), Gastrointestinal disorders (RR = 1.25, 95%CI = 1.18-1.32, p < 0.0001), Respiratory, thoracic, and mediastinal disorders (RR = 1.21, 95%CI = 1.01-1.46, p = 0.04), Skin and subcutaneous tissue disorders (RR = 1.14, 95%CI = 1.06-1.22, p = 0.0002) and General disorders (RR = 1.14, 95%CI = 1.04-1.25, p = 0.004) in dual-targeted drug therapy group. The incidence of Blood system disorder (RR = 0.94, 95%CI = 0.84-1.06, p = 0.32) and Liver dysfunction (RR = 0.80, 95%CI = 0.66-0.98, p = 0.03) was lower than that of the single targeted drug group.Conclusion: Dual-targeted treatment for HER-2-positive breast cancer can prolong the OS, PFS and improve the quality of patients' life. Meanwhile, it also brings a higher medication risk, which requires a rational selection of drug symptomatic interventions.

Biomarkers of related driver genes predict anti-tumor efficacy of immune checkpoint inhibitors.

Cancer is a disease with high morbidity and mortality in the world. In the past, the main treatment methods for cancer patients were surgery, radiotherapy and chemotherapy. However, with early treatment, the recurrence rate of cancer is higher, and the drug resistance of cancer cells is faster. In recent years, with the discovery of immune escape mechanism of cancer cells, Immunotherapy, especially Immune Checkpoint Inhibitors (ICIs), has made a breakthrough in the treatment of solid tumors, significantly prolonging the overall survival time and disease-free progression in some solid tumors, and its clinical benefits are more prominent than those of traditional anti-tumor drugs, which has become the hope of cancer patients after the failure of multi-line therapy. More and more studies have shown that there is a correlation between cancer driving genes and the clinical benefits of ICIs treatment, and the therapeutic effects and adverse reactions of ICIs can be predicted by the status of driving genes. Therefore, screening potential biomarkers of people who may benefit from immunotherapy in order to maximize the therapeutic benefits is a top priority. This review systematically summarizes the cancer driving genes that may affect the clinical benefits of immune checkpoint inhibitors, and provides accurate scientific basis for clinical practice.

Survival Prediction of Patients Treated With Immune Checkpoint Inhibitors via KRAS/TP53/EGFR-Single Gene Mutation.

Background: Immune checkpoint inhibitors (ICIs) have become an effective treatment option for cancer. KRAS, EGFR and TP53 are common mutated oncogenes in cancer whose single gene status may predict the therapeutic effect of clinical ICIs. In this efficacy evaluation, we aimed to clarify whether the single gene mutation status of KRAS, EGFR or TP53 affects the survival benefits of ICIs in cancer patients. Methods: We used PubMed, Cochrane Library, web of science, and clinical trials Gov database to retrieve qualified documents, the time was up to January 2022. Hazard ratios (HRS) and 95% confidence intervals (CIs) were used to determine the single gene mutation status and no progression of KRAS, EGFR or TP53. Results: A total of 19 studies included 7029 cancer patients treated with ICIs. The results showed that KRAS, EGFR or TP53 single gene mutation could significantly improve PFS and OS in patients receiving ICIs, but the degree of improvement was different. The risk of prolongation of PFS (HR = 1.48, 95% CI = 1.19-1.85, p = 0.0004) and OS (HR = 1.68, 95% CI = 1.36-2.07, p < 0.00001) caused by TP53 single gene mutation was relatively high, the risk ratio of prolongation of PFS (HR = 1.38, 95% CI = 1.21-1.57, p < 0.00001) and OS (HR = 1.56, 95% CI = 1.20-2.04, p = 0.001) caused by EGFR single gene mutation was the second, the risk ratio of prolongation of PFS (HR = 1.33, 95% CI = 1.12-1.57, p = 0.001) and OS (HR = 1.39, 95% CI = 1.18-1.63, p < 0.00001) caused by KRAS single gene mutation was relatively low, and the results were significantly different. Conclusion: In cancer patients, KRAS, EGFR or TP53 single gene status is correlated with the benefits of immunotherapy PFS and OS, which suggests that gene sequencing should be carried out in time in the process of clinical treatment to determine the gene mutation of patients and better predict the clinical treatment effect of ICIs.

Effects of Concomitant Antibiotics Use on Immune Checkpoint Inhibitor Efficacy in Cancer Patients.

OBJECTIVE: Immune checkpoint inhibitors (ICIs) have changed the outcomes of a variety of cancers in an unprecedented manner. Gut microbiome plays a crucial regulatory role in the antineoplastic therapy of ICIs, which can be influenced by antibiotic (ABX) administration. In this efficacy evaluation, we aimed to clarify the correlations of ABX administration with the survival of cancer patients receiving ICIs treatment. METHOD: The eligible literatures were searched using PubMed, Cochrane Library, Web of Science, and Clinical trials.gov databases before Nov 2021. The correlations of ABX administration with progression-free survival (PFS) and overall survival (OS) were determined using Hazard ratios (HRs) coupled with 95% confidence intervals (CIs). RESULTS: A total of 12 studies enrolling 6010 cancer patients receiving ICIs treatment were included in this efficacy evaluation. ABX administration was significantly correlated worse PFS (HR=1.60, 95%CI=1.33-1.92, P<0.00001) and OS (HR=1.46, 95%CI=1.32-1.61, P<0.00001). Similar results were found in the subgroup analysis of non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC) and melanoma. CONCLUSIONS: ABX use during ICIs treatment of cancer may significantly shorten PFS and OS. ABX should be used cautiously in cancer patients receiving ICIs. However, further validations are still essential due to existing publication bias.

Application of interval-valued Pythagorean fuzzy VIKOR approach for petroleum sludge treatment technology evaluation and selection.

Petroleum sludge is produced during oilfield development and production and can negatively impact the production area and surrounding environment. With increasing attention to the environmental protection of oilfields, finding an energy-efficient, environmentally sound, cost-effective and socially acceptable sludge treatment method is crucial to the sustainable development of oil companies. However, there are several problems in the selection process: ① there is no effective index system for the evaluation of treatment technologies; ② there is data uncertainty and loss of information; ③ experts in the field often make one-sided decisions; and ④ the common decision models fail to balance the general effect and local dominance of a treatment technology. This study is innovative in the following aspects: ① a decision index system of petroleum sludge treatment technology is established; ② the interval-valued Pythagorean fuzzy set effectively managed data uncertainty and loss of information; ③ the redundancy-based expert weighting method is used to avoid one-sided decisions; and ④ using the basic ideas of the VIKOR model to balance the general effect and local dominance of a technology. Example verification proved the effectiveness of this method and a sensitivity analysis showed the results were reliable. Finally, this study compared the results obtained by three other similar methods, and comparative analysis demonstrated that this approach effectively evaluated and selected petroleum sludge treatment technologies. This study improves the rationality of petroleum sludge treatment technology selection and provides a necessary reference for the selection of treatment technology for other petroleum pollutants.

Sufentanil versus fentanyl for pain relief in labor involving combined spinal-epidural analgesia: a systematic review and meta-analysis of randomized controlled trials.

PURPOSE: To systematically compare the efficacy and safety of sufentanil versus fentanyl for pain relief in labor involving combined spinal-epidural analgesia (CSEA), a systematic review and meta-analysis of randomized controlled trials targeting parturients requesting labor analgesia was conducted. METHODS: The primary outcome measure was visual analog scale scores assessed at 10, 15, 30, and 60 min after intrathecal injection. Secondary outcomes included duration of spinal analgesia, incidence of side effects in parturients, and neonatal Apgar scores. RESULTS: Twelve randomized controlled trials, including data from 881 patients fulfilled the inclusion criteria. No clinically meaningful differences in pain reduction after intrathecal injection were found between the two analgesics. Sufentanil extended the duration of spinal analgesia by 25.40 min (95% CI 21.82 to 28.98 min; p < 0.00001) compared with fentanyl. The risk for pruritus, nausea, and vomiting among parturients was 82% for those using sufentanil (relative risk 0.82 [95% CI 0.67-0.99]; p = 0.04) and 48% for those using fentanyl (relative risk 0.48 [95% CI 0.29-0.80]; p = 0.005). Both the synthesis results and sensitivity analysis demonstrated no differences in the risk for respiratory depression between parturients using sufentanil versus fentanyl. The neonates in sufentanil group exhibited higher Apgar scores than the fentanyl group 5 min after delivery (weighted mean difference 0.10 [95% CI 0.05-0.16]; p = 0.0002). CONCLUSION: Existing evidence suggests that compared with fentanyl, sufentanil used for analgesia in combined spinal-epidural during labor is more effective in extending the duration of spinal analgesia, and may be safer for the infant. There was overall low clinical and statistical heterogeneity among the included studies. For all outcomes, variations caused by heterogeneity across trials were acceptable. Thus the findings of this meta-analysis may provide additional evidence for future clinical practices of pain relief in labor involving CSEA. Stronger evidence supporting this conclusion will require data from more high-quality and multicenter randomized controlled trials.

Clinical Consumption of Opioid Analgesics in China: A Retrospective Analysis of the National and Regional Data 2006-2016.

CONTEXT: The annual consumption of opioid analgesics in the U.S. was more than 10 times the world average, whereas that in China was at a moderate level within Asia but much lower than the worldwide average. The opposite situations of opioid use in the U.S. and China revealed totally different problems in the developed versus developing world, that is, overuse versus underuse of opioids. OBJECTIVES: This study analyzed the clinical consumption, estimated the needs of pain treatment, and evaluated the adequacy of opioid analgesic consumption in mainland China and its seven regions. METHODS: A retrospective analysis of the national and regional consumption of opioid analgesics in mainland China during 2006-2016 was conducted. The adequacy of consumption measure was used to gauge the overall adequacy of opioid analgesic consumption in morphine equivalents (MEs) for the treatment of moderate-to-severe pain in mainland China and compared with international data. Annual per capita consumption was adopted to measure the clinical consumption of opioid analgesics in MEs at a national level and across seven regions of mainland China. Needs of morphine for cancer pain treatment in mainland China and in its seven regions were estimated and compared with the clinical consumption of opioid analgesics in MEs. RESULTS: The adequacy of consumption measure of mainland China ranged from 0.0041 to 0.0088 during 2006-2016, which was less than 1% of that in the reference countries. The poor North East region had only 10.85% of the cancer pain morphine needs fulfilled. The highest fulfillment rate was 36.02% in rich Southern China, which was 25.9% at the national level. CONCLUSION: The clinical consumption of opioid analgesics for the treatment of moderate-to-severe pain in mainland China was far below the international level. The annual per capita of clinical consumption was lower, and the adequacy of cancer pain treatment was poorer in less developed areas. All these findings call for actions to strengthen pain management.