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Objective:To investigate the efficacy of camrelizumab combined with second-line therapy in patients with recurrent or metastatic esophageal squamous cell carcinoma (ESCC) in the real-world settings.Methods:Clinical data of 48 patients with esophageal cancer who met the inclusion criteria were retrospectively analyzed. The types of failure after first-line treatment, clinical efficacy, side effects and prognostic factors of second-line treatment were analyzed. SPSS 25.0 software was used for statistical analysis. Count data were expressed by composition ratio and analyzed by Chi-square test or Fisher's exact test. Survival analysis was conducted by Kaplan-Meier curve and log-rank test. Non-normally distributed data were recorded with the median, range and quartile. Results:There were 26, 14, and 4 cases of combined chemoradiotherapy, chemotherapy and radiotherapy in the treatment of second-line camrelizumab, and 4 cases received immunotherapy alone. The median duration of immunotherapy was 6 cycles (range, 2-39 cycles). After second-line treatment, the short-term efficacy of 17, 27 and 4 cases was partial remission (PR), stable disease (SD) and progressive disease (PD), respectively. The overall response rate (ORR) was 35.4% and disease control rate (DCR) was 91.7%. The 1- and 2-year OS rates were 42.9% and 22.5%, and 1- and 2-year PFS rates were 29.0% and 5.8%. The median OS and PFS were 9.0 months (95% CI=6.4-11.7) and 8.5 months (95% CI=1.5-5.6), respectively. Multivariate analysis showed that combined immunotherapy mode, number of cycles of immunotherapy and short-term efficacy were the independent prognostic indicators affecting OS in this group of patients ( HR=2.598, 0.222, 8.330, P=0.044, <0.001, <0.001). Lymphocyte count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), combined immunotherapy mode and short-term efficacy were the independent prognostic indicators affecting PFS in this group ( HR=3.704, 3.598, 6.855, 2.159, 2.747, P=0.009, 0.008, <0.001, 0.049, 0.012). Conclusions:Camrelizumab combined with second-line therapy can bring survival benefit to patients with recurrent or metastatic ESCC after first-line therapy, especially immunotherapy combined with chemoradiotherapy can significantly provide survival benefit. Peripheral blood inflammatory biomarkers are independent indicators affecting clinical prognosis of patients. Patients with better short-term efficacy also achieve better prognosis. The final conclusion remains to be validated by a large number of randomized controlled studies.
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Objective:To analyze whether involved-field irradiation (IFI) was associated with improved survival and reduced treatment-related adverse events compared with elective nodal irradiation (ENI) in Chinese patients with esophageal squamous cell carcinoma receiving radiotherapy.Methods:Literature review was conducted from CNKI, Wanfang Data, PubMed, Embase, Web of Science and Cochrane Central databases (until July 31, 2022). Relevant data were collected according to the inclusion and exclusion criteria. Primary outcomes included overall survival (OS) rate and treatment-related adverse events. Secondary outcomes included progression-free survival (PFS) rate and local control rate (LCR). Risk of bias was assessed using the Cochrane Risk of Bias tool. The quality of the results was assessed by using the meta analysis of Evidence Evaluation and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methods.Results:A total of 7 articles with 918 patients were included of which 465 received IFI and 453 received ENI. The 1-, 2-, 3-and 5-year OS rates in the IFI group were not significantly different from those in the ENI group (1-year OS rate: RR=1.00, 95% CI=0.94-1.07, P=0.97, high certainty; 2-year OS rate: RR=1.01, 95% CI=0.90-1.13, P=0.90, high certainty; 3-year OS rate: RR=0.86, 95% CI=0.71-1.05, P=0.14, high certainty; 5-year OS rate: RR=0.76, 95% CI=0.42-1.37, P=0.36, low certainty). In the IFI group, patients with ≥grade 2 acute radiation esophagitis ( RR=0.71, 95% CI=0.58-0.87, P=0.001, high certainty), ≥grade 3 acute radiation esophagitis ( RR=0.39, 95% CI=0.24-0.64, P<0.001, high certainty) and ≥grade 2 acute radiation pneumonitis ( RR=0.72, 95% CI=0.52-0.99, P=0.04, high certainty) were significantly lower compared with those in the ENI group. However, no significant differences were observed in the incidence of ≥grade 3 late radiation esophagitis, ≥grade 3 acute radiation pneumonitis and ≥grade 3 late radiation pneumonitis between two groups. No significant differences were noted in the 1-, 2-, 3-PFS rates and LCR between two groups. Conclusions:For Chinese patients with esophageal squamous cell carcinoma, IFI and ENI yield similar efficacy in terms of OS, PFS and LCR. However, IFI has a lower incidence of ≥grade 2 acute radiation esophagitis, ≥grade 3 acute radiation esophagitis and ≥grade 2 acute radiation pneumonitis than ENI.
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Non-crosslinked polyolefin blends have become a favorable alternative material to crosslinked polyethylene (XLPE) cable insulation owing to their low power consumption in the production process and good recyclability at the end of service life. Although studies on non-crosslinked materials have achieved significant results, the electrical and thermal aging properties of these materials undeniably need extensive research attention and systematic exploration. Aging performance is directly related to the lifetime and reliability of cables. In this study, the electrical treeing and thermal aging phenomena of 70 wt.% linear low-density polyethylene (LLDPE) and 30 wt.% high-density polyethylene (HDPE) blends (abbreviated as 70L-30H) were studied and compared with those of XLPE by investigating the microstructural feature, electrical treeing behavior, and mechanical performance during thermal aging. Electrical treeing tests show that 70L-30H blends exhibited smaller treeing dimensions and lower electrical tree growth rates than those of XLPE. Thermal aging tests exhibit that the mechanical property degradation of 70L-30H blends is less than that of XLPE under the same aging time. Through differential scanning calorimetry analysis and microstructure observation, the 70L-30H blend shows higher melting temperature, thicker lamellae, and higher crystallinity with a uniform and fine spherulite structure, which are responsible for good anti-aging performance. This study indicates that the blends exhibit better electrical and thermal aging resistance than XLPE, which provides a performance guarantee for its further application in the non-crosslinked cable system.
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Coronavirus replication is associated with the remodeling of cellular membranes resulting in the formation of double-membrane vesicles (DMVs). Recently, a pore spanning DMV was identified as a putative portal for viral RNA transcription and replication products providing a novel target for antiviral intervention. However, the exact components and the structure of the SARS-CoV-2 pore remain to be determined. Here, we investigate the structure of DMV pores by in situ cryo-electron tomography combined with subtomogram averaging. We reveal non-structural proteins (nsp) 3 and 4 as minimal components forming a DMV spanning pore and show that nsp3 Ubl1-Ubl2 domains are critical for inducing membrane curvature and DMV formation. Altogether, SARS-CoV-2 nsp3-4 has a dual role by driving the biogenesis of replication organelles and forming DMV-spanning replicopores. One-Sentence SummaryBiogenesis of SARS-CoV-2 replication organelles is driven by nsp3-4 constituting the double-membrane vesicle spanning pore.
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Six degree-of-freedom (DoF) haptic rendering of multi-region contacts between a moving hand avatar and varied-shaped components of a music instrument is fundamental to realizing interactive simulation of music playing. There are two aspects of computational challenges: first, some components have significantly small sizes in some dimensions, such as the strings on a seven-string plucked instrument (e.g., Guqin), which makes it challenging to avoid pop-through during multi-region contact scenarios. Second, deformable strings may produce high-frequency vibration, which requires simulating diversified and subtle force sensations when a hand interacts with strings in different ways. In this paper, we propose a constraint-based approach to haptic interaction and simulation between a moving hand avatar and various parts of a string instrument, using a cylinder model for the string that has a large length-radius ratio and a sphere-tree model for the other parts that have complex shapes. Collision response algorithms based on configuration-based optimization is adapted to solve for the contact configuration of the hand avatar interacting with thin strings without penetration. To simulate the deformation and vibration of a string, a cylindrical volume with variable diameters is defined with response to the interaction force applied by the operator. Experimental results have validated the stability and efficiency of the proposed approach. Subtle force feelings can be simulated to reflect varied interaction patterns, to differentiate collisions between the hand avatar with a static or vibrating string and the effects of various colliding forces and touch locations on the strings.