Nephrotic syndrome associated with solid malignancies: a systematic review.

BACKGROUND: Nephrotic syndrome (NS) can occur as a paraneoplastic disorder in association with various types of carcinoma. However, paraneoplastic nephrotic syndrome (PNS) is often misdiagnosed as idiopathic nephrotic syndrome or as an adverse effect of oncology treatment, leading to delayed diagnosis and suboptimal treatment. The characteristics of NS associated with solid malignancies are not yet elucidated. We systematically summarized the clinical data for 128 cases of NS combined with solid malignancies with the aim of informing the clinical management of PNS. METHODS: We searched the PubMed database for articles published from the date of inception through to October 2023 using the following keywords: "cancer" or "malignant neoplasms" or "neoplasia" or "tumors" and "nephrotic syndrome", "nephrotic" or "syndrome, nephrotic". All data were extracted from case reports and case series, and the extraction included a method for identifying individual-level patient data. RESULTS: A literature search yielded 105 cases of PNS and 23 of NS induced by cancer therapy. The median age at diagnosis was 60 years, with a male to female ratio of 1.8:1. In patients with PNS, manifestations of NS occurred before, concomitantly with, or after diagnosis of the tumor (in 36%, 30%, and 34% of cases, respectively). Membranous nephropathy (49%) was the most prevalent renal pathology and found particularly in patients with lung, colorectal, or breast carcinoma. Regardless of whether treatment was for cancer alone or in combination with NS, the likelihood of remission was high. CONCLUSION: The pathological type of NS may be associated with specific malignancies in patients with PNS. Prompt identification of PNS coupled with suitable therapeutic intervention has a significant impact on the outcome for patients.

Vascular plant communities and biocrusts act as controlling factors in mitigating soil erosion on the Great Wall in a semi-humid area of Northwestern China.

The Great Wall, a World Heritage Site and a vertical wall habitat, is under threat of soil erosion. The role of vascular plants and biocrust in controlling soil erosion has attracted attention, yet our knowledge of the underlying mechanism is limited, and there is a lack of systematic strategies for erosion prevention and control. In this study, we quantified the vascular plant community functional composition (including species diversity, functional diversity, and community-weighted mean), biocrust coverage, and soil erosion levels associated with seven different zones (lower, middle, and upper zones on East and West faces, plus wall crest) of the Great Wall. We then employed a combination of linear regression analysis, random forest model, and structural equation model to evaluate the individual and combined effects, as well as the direction and relative importance of these factors in reducing soil erosion. The results indicated that the vascular plant species richness, species diversity, functional richness, community-weighted mean, and moss crust coverage decreased significantly from the crest to the lower zone of the Great Wall (P < 0.05), and were negatively correlated with the soil erosion area and depth on both sides of the Great Wall (P < 0.05). This suggests that higher zones on the wall favored the colonization and growth of biocrusts and vascular plants and that biocrusts and vascular plants reduced soil erosion on the wall. Based on these findings, we propose a "restoration framework" for managing soil erosion on walls, based on biocrust and vascular plant communities (namely target species selection, plant community construction, biocrust inoculation, and maintenance of community stability), which aims to address the urgent need for more effective soil erosion prevention and control strategies on the Great Wall and provide practical methods that practitioners can utilize.

Treatment of Multiple Primary Malignancies With PD-1 Inhibitor Camrelizumab: A Case Report and Brief Literature Review.

Background: With significant advances in the diagnostic tools and treatment modalities of cancer, the incidence of multiple primary malignancies (MPMs) has increased in the last decades. The therapeutic option changed with the arising of immune checkpoint inhibitors (ICIs), which have improved the survival of a broad spectrum of tumors. However, little information is available when it comes to the efficacy, resistance, and underlying mechanisms of ICIs. Case Presentation: A 67-year-old woman was diagnosed with pulmonary sarcomatoid carcinoma (PSC) with a history of hepatocellular carcinoma (HCC) and viral hepatitis B. Following the lack of response to systemic chemotherapy, she was treated with camrelizumab, an anti-programmed cell death protein 1 monoclonal antibody, in combination with chemotherapy, and a partial response was obtained both in PSC and HCC. After a course of 9-month treatment, the PSC lesion shrank still, while HCC was evaluated as a progressive disease with an increase in the diameter of liver neoplasm, elevated alpha-fetoprotein, and enlarged abdominal lymph nodes. Then, with the addition of radiotherapy for abdominal metastasis, the lung lesion was continuously shrinking. In the meantime, the liver neoplasm and abdominal lymph nodes showed no significant enlargement. Conclusion: Camrelizumab combination therapy could consistently benefit the MPM patients with PSC and HCC, which may be a promising option for patients with MPMs.

A Soft Evaporation and Ionization Technique for Mass Spectrometric Analysis and Bio-Imaging of Metal Ions in Plants Based on Metal-Iodide Cluster Ionization.

Protonation/deprotonation is the well-recognized mass spectrometric mechanism in matrix-assisted laser desorption ionization of organic molecules but not for metal ions with different oxidation states. We describe herein a soft evaporation and ionization technique for metal ions based on iodination/de-iodination in metal-iodide cluster ionization (MICI). It is not only able to determine identities and oxidation states of metal ions but also reveal spatial distributions and isotope ratios in response to physiological or environmental changes. A long chain alcohol 1-tetradecanol with no functional groups that can absorb laser irradiation was used to cover and prevent samples from direct laser ablation. Upon the irradiation of the third harmonic Nd3+:YAG (355 nm, 3 ns), iohexol containing three covalently bonded iodine atoms instantly generates negative iodide ions that can quantitatively form clusters with at least 14 essential metal ions present in plants. The detection limits vary with different metal ions down to low fmol. MICI eliminates the atomization process that obscures metal charges in inductively coupled plasma mass spectrometry. Because only metal ions can be iodinated with iohexol, interferences from the abundant organic molecules of plants that are confronted by secondary ion mass spectrometry (SIMS) are also greatly decreased.

Clustered repetitive transcranial magnetic stimulation for the prevention of depressive relapse/recurrence: a randomized controlled trial.

Repetitive transcranial magnetic stimulation (rTMS) may have the potential to prevent depressive relapse. This assessor-blinded, randomized controlled study was designed to evaluate the efficacy and safety of rTMS as a mono- and combination therapy in the prevention of depressive relapse/recurrence. A total of 281 depressed patients who had achieved stable full or partial remission on a 6-month antidepressant (ADP) run-in treatment were randomly assigned to an rTMS (n = 91), ADP (n = 108), or combined (rTMS + ADP, n = 82) treatment group for 12 months. Monthly clustered rTMS was conducted in 5-10 sessions over a 3-5-day period. Maintenance outcomes were assessed using time to relapse/recurrence and relapse/recurrence rate. Overall, 71.2% (200/281) of the participants completed the treatment per the protocol. rTMS + ADP and rTMS significantly reduced the risk of relapse/recurrence compared with ADP (P = 0.000), with hazard ratios of 0.297 and 0.466, respectively. Both rTMS-containing regimens produced significantly lower relapse/recurrence rates than ADP (15.9% and 24.2% vs. 44.4%, P < 0.001). In the relapsed/recurrent subgroup, first-episode depressed, rTMS-treated patients had a markedly lower relapse/recurrence rate than ADP-treated patients. Five patients on the ADP-containing regimens, but none on rTMS alone, developed acute mania. The rTMS-containing regimens had considerably more certain side effects than did the ADP group. We concluded that TMS, whether as a mono- or additional therapy, is superior to antidepressants in preventing depressive relapse/recurrence, particularly in first-episode depressed patients. The treatment does not increase the risk of manic switch, but may increase the risk of certain side effects.