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1.
Int J Mol Sci ; 23(2)2022 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-35055000

RESUMO

The cellulose of the plant cell wall indirectly affects the cell shape and straw stiffness of the plant. Here, the novel brittleness mutant brittle stalk-5 (bk-5) of the maize inbred line RP125 was characterized. We found that the mutant displayed brittleness of the stalk and even the whole plant, and that the brittleness phenotype existed during the whole growth period from germination to senescence. The compressive strength was reduced, the cell wall was thinner, and the cellulose content was decreased compared to that of the wild type. Genetic analysis and map-based cloning indicated that bk-5 was controlled by a single recessive nuclear gene and that it was located in a 90.2-Kb region on chromosome 3 that covers three open reading frames (ORFs). Sequence analysis revealed a single non-synonymous missense mutation, T-to-A, in the last exon of Zm00001d043477 (B73: version 4, named BK-5) that caused the 951th amino acid to go from leucine to histidine. BK-5 encodes a cellulose synthase catalytic subunit (CesA), which is involved with cellulose synthesis. We found that BK-5 was constitutively expressed in all tissues of the germinating stage and silking stage, and highly expressed in the leaf, auricula, and root of the silking stage and the 2-cm root and bud of the germinating stage. We found that BK-5 mainly localized to the Golgi apparatus, suggesting that the protein might move to the plasma membrane with the aid of Golgi in maize. According to RNA-seq data, bk-5 had more downregulated genes than upregulated genes, and many of the downregulated genes were enzymes and transcription factors related to cellulose, hemicellulose, and lignin biosynthesis of the secondary cell wall. The other differentially expressed genes were related to metabolic and cellular processes, and were significantly enriched in hormone signal transduction, starch and sucrose metabolism, and the plant-pathogen interaction pathway. Taken together, we propose that the mutation of gene BK-5 causes the brittle stalk phenotype and provides important insights into the regulatory mechanism of cellulose biosynthesis and cell wall development in maize.

2.
ACS Appl Mater Interfaces ; 14(1): 1452-1459, 2022 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-34958544

RESUMO

Generating hydrogen by water electrolysis is a promising and sustainable approach to the production of a green energy carrier, but the sluggish kinetics of the oxygen evolution reaction (OER) at anode leads to a high working potential. Replacing OER with electro-oxidation of organics driven at a low potential offers an effective way to accelerate the sluggish anode reaction, and thus increase hydrogen evolution in water-splitting. Herein, we have prepared a Ru nanoparticles on N-doped carbon nanotubes (Ru-NPs@NCNTs) to implement electro-oxidation of benzyl alcohol toward reducing the anodic potential in watersplitting. The potential of the anode reaction is remarkably decreased from 1.76 to 1.19 V vs RHE at a current density of 10 mA cm-2 with the assistance of a Ru-NPs catalyst. Furthermore, 100% selectivity and 95% yield of valuable benzaldehyde were achieved simultaneously. The Ru-NPs also exhibits good durability and wide applicability to other alcohols. The high performance of Ru-NPs is mainly attributed to the unique horizontal adsorption configuration of benzyl alcohol with surface atoms of the catalyst, shortening the distance between the •OH group and Ru atoms, and increasing the activation rate of the •OH group. This work presents a feasible strategy to boost water-splitting performance and concurrently produce value-added organics under mild conditions.

3.
Bioresour Technol ; 344(Pt B): 126223, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34756980

RESUMO

Per- and polyfluoroalkyl substances (PFAS) are a group of chemicals widely manufactured for industrial and commercial applications in the past decades due to their remarkable stability as well as hydrophobic and lipophobic nature. PFAS species have been recognized as emerging environmental contaminants of concern due to their toxicity and environmental persistence, thereby attracting intensive research seeking effective technologies for their removal from the environment. The objective of this review is to provide a thorough analysis of the biodegradation of PFAS in multiple environmental matrices and offer a future outlook. By discussing targeted PFAS species, degradation intermediates, degradation efficiencies, and microbial species, a comprehensive summary of the known microbial species and their degradation pathways are presented. The biodegradation pathways for different types of PFAS species are summarized in two major categories, biodegradation with and without the cleavage of C-F bond. Existing uncertainties and future research directions for PFAS biodegradation are provided.


Assuntos
Fluorcarbonetos , Poluentes Químicos da Água , Biodegradação Ambiental , Fluorcarbonetos/análise , Poluentes Químicos da Água/análise
4.
Chemosphere ; 288(Pt 1): 132509, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34627811

RESUMO

Herein, polypyrrole/titanium oxide/reduced graphene oxide (PTi/r-GO) electrodes were prepared and successfully applied for the photoelectrocatalytic (PEC) degradation of methyl orange (MO) under visible light. Polypyrrole-TiO2 composites rich in p-n heterojunctions were first prepared, then modified with r-GO to improve the electrical conductivity and facilitate charge separation under visible light irradiation. The obtained PTi/r-GO composites were then deposited onto a titanium mesh, which served as the working electrode in PEC experiments. A MO removal efficiency of 93% was achieved in 50 min using PTi/r-GO electrode under PEC conditions (Xe lamp, λ > 420 nm, bias of 0.6 V, 0.1 M Na2SO4 electrolyte), which was far higher than MO removal efficiencies under electrocatalytic oxidation (22%) or photocatalytic oxidation (47%) conditions. This confirmed that excellent activity of the PTi/r-GO electrode under PEC conditions was due to a combination of electrochemical and photocatalytic oxidation processes (involving •OH and •O2- generation). Further, PTi/r-GO was very stable under the applied PEC conditions, with the MO removal efficiency remaining >90% after five cycles. PEC degradation pathways for MO on PTi/r-GO were explored, with a number of key intermediates in the MO mineralization process identified. Results demonstrate that PEC electrodes combining p-type polypyrrole, n-type TiO2 and rGO are very effective in the treatment of hazardous organic compounds in wastewater.


Assuntos
Polímeros , Titânio , Catálise , Corantes , Eletrodos , Grafite , Luz , Pirróis
5.
J Environ Manage ; 304: 114303, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-34933269

RESUMO

Chinese state authorities have successfully accelerated afforestation over large areas through the Returning Farmland to Forest Program (RFFP). However, variation in the implementation of the RFFP among villages may lead to uncertainty in forest transitions at multiple spatial levels. Here, we combined remote sensing analysis with field quadrats and questionnaire surveys to assess the RFFP's effectiveness in increasing vegetation cover at the Lancang watershed, township and natural village levels in Weixi County, a biodiversity hotspot in northwest Yunnan. From 2000 to 2010 and 2010 to 2014, forest coverage increased, and areas of shrubland and agricultural land decreased at both watershed and township levels, which reflected a positive impact of the RFFP. However, the new forests established under the RFFP in the study area mostly consisted of monocultures of walnut and pine trees, a situation that could threaten local biodiversity. Changes in forest and shrub coverage varied among natural villages-gain and loss trends both occurred, indicating a limited impact of the RFFP. Nonparticipating RFFP households also abandoned cropland, and agricultural land area in these villages declined over the study period. At the watershed and township levels, RFFP greatly promoted increases in forest coverage. Elevation, the behavior of village officials and household livelihoods were often the most relevant factors at the natural village level. Interactions among these multiple drivers resulted in cross-scale heterogeneity of vegetation cover changes in northwest Yunnan. Future forest policies need to be tailored to specific regions and be based on assessments of local natural and socioeconomic conditions.


Assuntos
Agricultura , Florestas , Biodiversidade , China , Conservação dos Recursos Naturais , Fazendas
6.
J Am Chem Soc ; 2021 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-34865490

RESUMO

Solar-driven carbonylation with CO2 replacing toxic CO as a C1 source is of considerable interest; however it remains a great challenge due to the inert CO2 molecule. Herein, we integrate cobalt single-site and ultrafine CuPd nanocluster catalysts into a porphyrin-based metal-organic framework to construct composite photocatalysts (Cu1Pd2)z@PCN-222(Co) (z = 1.3, 2.0, and 3.0 nm). Upon visible light irradiation, excited porphyrin can concurrently transfer electrons to Co single sites and CuPd nanoclusters, providing the possibility for coupling CO2 photoreduction and Suzuki/Sonogashira reactions. This multicomponent synergy in (Cu1Pd2)1.3@PCN-222(Co) can not only replace dangerous CO gas but also dramatically promote the photosynthesis of benzophenone in CO2 with over 90% yield and 97% selectivity under mild condition. Systematic investigations clearly decipher the function and collaboration among different components in these composite catalysts, highlighting a new insight into developing a sustainable protocol for carbonylation reactions by employing greenhouse gas CO2 as a C1 source.

8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 269-272, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34891288

RESUMO

Ballistocardiagram (BCG) is a non-contact and non-invasive technique to obtain physiological information with the potential to monitor Cardio Vascular Disease (CVD) at home. Accurate detection of J-peak is the key to get critical indicators from BCG signals. With the development of deep learning methods, many researches have applied convolution neural network (CNN) and recurrent neural network (RNN) based models in J-peak detection. However, these deep learning methods have limitations in inference speed and model complexity. To improve the computational efficiency and memory utilization, we propose a robust lightweight neural network model, called JwaveNet. Moreover, in the preprocessing stage, J-peaks are re-modeled by a new transformation method based on their physiological meaning, which has been proven to increase performance. In our experiment, BCG signals, including four different sleeping positions, were collected from 24 subjects with synchronous electrocardiogram (ECG) signals. The experiment results have shown that our lightweight model greatly reduces latency and model size compared to other baseline models with high detecting accuracy.

9.
Comput Biol Med ; 141: 105167, 2021 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-34959111

RESUMO

OBJECTIVE: To explore whether 1 Hz repetitive transcranial magnetic stimulation (rTMS) has positive effects on brain activity and behavior of autistic children with intellectual disability. METHODS: 32 autistic children with intellectual disability (26 boys and 6 girls) were recruited to participate in this feasibility study. The autistic children were divided randomly and equally into an experimental group and a control group. 16 children (three girls and 13 boys; mean ± SD age: 7.8 ± 2.1 years) who received rTMS treatment twice a week were served as the experimental group, while 16 children (three girls and 13 boys; mean ± SD age: 7.2 ± 1.6 years) with sham stimulation were considered as the control group. Recurrence quantification analysis (RQA) was employed to quantify the nonlinear features of electroencephalogram (EEG) signals recorded during the resting state. Three RQA measures, including recursive rate (RR), deterministic (DET) and mean diagonal length (L) were extracted from the EEG signals to characterize the deterministic features of cortical activity. RESULTS: Significant differences in RR and DET were observed between the experimental group and the control group. We also found discernible discrepancies in the Autism Behavior Checklist (ABC) score pre- and post-rTMS for the experimental group. CONCLUSIONS: 1 Hz repetitive transcranial magnetic stimulation (rTMS) could positively influence brain activity and behavior of autistic children with intellectual disability.

10.
Waste Manag ; 139: 25-38, 2021 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-34929416

RESUMO

A study was conducted to evaluate the hydraulic conductivity (k) of six bentonite-polymer composite (BPC) geosynthetic clay liners (GCLs) using five synthetic municipal solid waste incineration ash (IA) leachates with ionic strength (I) ranging from 174 to1978 mM. The BPC GCLs contained a dry blend of bentonite and proprietary polymers and had polymer loading ranging from 0.5 to 5.5%. The polymers used in the BPC GCLs were classified as linear polymer (LP) or crosslinked polymer (CP) based on the swelling characteristics of specimens extracted from the GCLs. Comparable hydraulic conductivity tests were also performed on two conventional bentonite (CB) GCLs as controls. The BPC GCLs had k of 2.6 - 6.7 × 10-11 m/s when permeated with IA leachate with I = 174 mM, whereas the CB GCLs had k > 5.0 × 10-8 m/s when permeated with the same leachate. However, k of the BPC GCLs ranged from the order of 10-10 to 10-7 m/s when permeated with IA leachates with I > 600 mM. BPC GCLs with high polymer loading generally had lower k compared to those with lower polymer loading when permeated with the same IA leachate, regardless of the polymer type. Polymer eluted from the BPC GCLs containing LP during permeation with DI water or IA leachate. Unlike CPs, LPs are water-soluble, therefore, they seem to easily migrate during permeation. There was no correlation between the percentage of polymer retained and the final hydraulic conductivity of the LPB GCLs used in this study.

11.
Front Genet ; 12: 752485, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34970297

RESUMO

RHD variants in D¯ Chinese pregnant women arose difficulties in management during pregnancy. Therefore, this study aims to precisely manage D¯ pregnant women by evaluating the spectrum of RHD mutations in D¯ pregnant women and getting insight into the possible rare alleles of RHD. A total of 76 D¯ pregnant women were analyzed by performing polymerase chain reactions with sequence-specific primers (PCR-SSP), the 10 RHD exons Sanger sequencing, RHD zygosity detection, and mRNA sequencing (mRNA-seq). About 40% of alleles are variations of RHD, including RHD 1227A homozygous, RHD-CE(2-9)-D, et al. Therefore, we developed a molecular diagnostic strategy for Chinese women, and most D¯ pregnant women can be diagnosed with this simple decision tree. After RHD genotyping for D¯ pregnancy women, we eliminated at least 15% unnecessary ante- and postpartum injections of Rh immunoglobulin (RhIG). As the first pedigree study and the first functional analysis under physiological conditions, mRNA-seq revealed that c.336-1G>A mutation mainly led to the inclusion of the intron 2, which indirectly explained the D¯ phenotype in this family. We also developed a robust protocol for determining fetal RhD status from maternal plasma. All 31 fetuses were predicted as RhD positive and confirmed the RhD status after birth.

12.
Front Bioeng Biotechnol ; 9: 781614, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34926426

RESUMO

This paper proposes an optimization paradigm for structure design of curved-tube nozzle based on genetic algorithm. First, the mathematical model is established to reveal the functional relationship between outlet power and the nozzle structure parameters. Second, genetic algorithms transform the optimization process of curved-tube nozzle into natural evolution and selection. It is found that curved-tube nozzle with bending angle of 10.8°, nozzle diameter of 0.5 mm, and curvature radius of 8 mm yields maximum outlet power. Finally, we compare the optimal result with simulations and experiments of the rotating spinning. It is found that optimized curved-tube nozzle can improve flow field distribution and reduce the jet instability, which is critical to obtain high-quality nanofibers.

13.
J Clin Transl Hepatol ; 9(5): 661-671, 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34722181

RESUMO

Background and Aims: Protein phosphatase 2A (PP2A) is associated with many cancers. This study aimed to clarify whether PPP2CA, which encodes the alpha isoform of the catalytic subunit of PP2A, plays a role in hepatocellular carcinoma (HCC) and to identify the potential underlying molecular pathways. Methods: Based on bioinformatics, public databases and our in-house RNA-Seq database, we analyzed the clinical value and molecular mechanism of PPP2CA in HCC. Results: Data were analyzed from 2,545 patients with HCC and 1,993 controls without HCC indexed in The Cancer Genome Atlas database, the Gene Expression Omnibus database and our in-house RNA-Seq database. PPP2CA expression was significantly higher in HCC tissue than in non-cancerous tissues (standardized mean difference: 0.69, 95% confidence interval [CI]: 0.50-0.89). PPP2CA expression was able to differentiate HCC from non-HCC, with an area under the summary receiver operator characteristic curve of 0.79 (95% CI: 0.75-0.83). Immunohistochemistry of tissue sections confirmed that PPP2CA protein was up-regulated in HCC tissues. High PPP2CA expression in HCC patients was associated with shorter overall, progression-free and disease-free survival. Potential molecular pathways through which PPP2CA may be involved in HCC were determined using miRWalk 2.0 as well as analysis of Gene Ontology categories, Kyoto Encyclopedia of Genes and Genomes pathways, and protein-protein interaction networks. Conclusions: PPP2CA is up-regulated in HCC and higher expression correlates with worse prognosis. PPP2CA shows potential as a diagnostic marker for HCC. Future studies should examine whether PPP2CA contributes to HCC through the candidate microRNAs, pathways and hub genes identified in this study.

14.
Water Sci Technol ; 84(9): 2180-2193, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34810304

RESUMO

In order to make the sponge city construction model more consistent with the inherent characteristics of the city, this paper constructs classification of the sponge city construction index system. We carry out multivariate statistical and cluster analysis based on geographic information system (GIS) and classify the different regions of mainland China, putting forward key points of construction for different types of regions. The results show that climatic factor, hydrological factor and soil factor are the main factors affecting sponge city construction, followed by city scale and level of urban economic development; the third is underlying surface type and geomorphological type. The cities are classified into ten clusters, and they present a continuously zonal or flaky distribution from northeast to southwest on the whole; more than 80% of cities obviously present a continuously zonal or flaky distribution. Each of the nine clusters has at least one pilot city, which can be used as a reference for construction.


Assuntos
Hidrologia , Reforma Urbana , China , Cidades
15.
Mikrochim Acta ; 188(11): 393, 2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34698939

RESUMO

Solid contact-based ion-selective electrodes (SC-ISEs) based on silver nanoparticles/polyaniline (Ag@PANI) as the solid contact (SC) were successfully prepared. The Ag@PANI SC showed high capacitance and excellent electron transport performance. Owing to the synergetic effects of the Ag nanoparticles and PANI, a GC/Ag@PANI-II/Pb2+-ISE (where II refers to a Ag content of 0.01 wt% in the SC layer) showed a low Pb2+ detection limit (6.31 × 10-10 M) with a slope of 29.1 ± 0.3 mV/dec, a fast response (< 5 s), and high stability. GC/Ag@PANI-II/Pb2+-ISE exhibited a Nernstian response for Pb2+ ions over a wide concentration range (10-3 to 10-9 M). After a 3-week operation, GC/Ag@PANI-II/Pb2+-ISE responded linearly to Pb2+ over the range of 10-7-10-3 M, demonstrating good long-term potential stability. Furthermore, the electrode showed excellent reproducibility and repeatability of the potential values and was successfully applied to detect the Pb2+ concentration in real samples with a recovery of 97 - 109%. Results suggest that Ag@PANI composites offer good transducer performance in trace ion detection sensors.

16.
J Evid Based Med ; 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34632732

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) has turned into a pandemic and resulted in huge death tolls and burdens. Integrating Chinese and western medicine has played an important role in the fight against the COVID-19 pandemic. PURPOSE: We aimed to develop a living evidence-based guideline of integrating Chinese and western medicine for COVID-19. STUDY DESIGN: Living evidence-based guideline. METHODS: This living guideline was developed using internationally recognized and accepted guideline standards, dynamically monitoring the release of new clinical evidence, and quickly updating the linked living systematic review, evidence summary tables, and recommendations. Modified Delphi method was used to reach consensus for all recommendations. The certainty of the evidence, resources, and other factors were fully considered, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence and the strength of recommendations. RESULTS: The first version of this living guidance focuses on patients who are mild or moderate COVID-19. A multidisciplinary guideline development panel was established. Ten clinical questions were identified based on the status of evidence and a face-to-face experts' consensus. Finally, nine recommendations were reached consensus, and were formulated from systematic reviews of the benefits and harms, certainty of evidence, public accessibility, policy supports, feedback on proposed recommendations from multidisciplinary experts, and consensus meetings. CONCLUSION: This guideline panel made nine recommendations, which covered five traditional Chinese medicine (TCM) prescription granules/decoction (MXXFJD, QFPD, XFBD, TJQW, and JWDY), three Chinese patent medicines (LHQW granules/capsule, JHQG granules, and LHQK granules), and one Chinese herbal injection (XBJ injection). Of them, two were strongly recommended (LHQW granules/capsule and QFPD decoction), and five were weakly recommended (MXXFJD decoction, XFBD decoction, JHQG granules, TJQW granules, and JWDY decoction) for the treatment of mild and moderate COVID-19; two were weakly recommended against (XBJ injection and LHQK granules) the treatment of mild and moderate COVID-19. The users of this living guideline are most likely to be clinicians, patients, governments, ministries, and health administrators.

17.
Small ; 17(44): e2103558, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34605183

RESUMO

Solar-driven CO2 reaction with water oxidation into alcohols represents a promising approach to achieve real artificial photosynthesis. However, rapid recombination of photogenerated carriers seriously restricts the development of artificial photosynthesis. Herein, a facile method is explored to construct low-cost Z-Scheme heterostructure Cu2 O/polymeric carbon nitride (PCN) by in situ growth of Cu2 O hollow nanocrystal on PCN. The protective PCN layer and Z-schematic charge flow can make robust Cu2 O/PCN photocatalysts, and the spatial separation of electrons and holes with high redox potentials of ECB (-1.15 eV) and EVB (1.65 eV) versus NHE can efficiently drive CO2 photoreduction to methanol in pure water, which is further confirmed by DFT calculation. The Z-scheme heterostructure Cu2 O/PCN exhibits a high methanol yield of 276 µmol g-1 in 8 h with ca. 100% selectivity, much superior to that of isolated Cu2 O and PCN, and all the reported Cu2 O-based heterostructures. This work provides a unique strategy to efficiently and selectively promote the conversion of CO2 and H2 O into high-value chemicals by constructing a low-cost Z-scheme heterostructure.

18.
Nanotechnology ; 33(3)2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34614489

RESUMO

This study reported a novel method to obtain rutile TiO2with excellent photocatalytic activity for degradation of organic dyes. In this study, the concentrated HCl was selected as the inhibitor to make TiO2precursor hardly hydrolyzed at room temperature. And a certain amount of urea was added, which results in TiO2precursor hydrolyzed to produce rutile TiO2due to urea thermally decomposed into alkaline substances to neutralize the concentrated HCl. To further explore the mechanism of excellent photocatalytic performance of rutile TiO2, a series of experiments, characterizations, and DFT computations were carried out. Based on DFT computations and experimental results, it could be concluded that the introduction of surface oxygen vacancies was the main reason for the excellent photocatalytic performance of the samples, and the concentration of surface oxygen vacancies would affect the physical and chemical properties of rutile TiO2. Meaningfully, this unique and innovative work broke the traditional preconception of rutile TiO2and provided a theoretical possibility for rutile TiO2to be applied in other research fields.

19.
J Hazard Mater ; 416: 126081, 2021 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-34492899

RESUMO

An anaerobic biofilm reactor was used to pretreat a typical municipal solid waste landfill leachate. It was challenging to remove Fe, Pb, and Ni to meet the discharge-to-sewer standards at a hydraulic retention time (HRT) typically used in previous studies. This work further systematically studied the factors that limited the metal removal. The HRT limited metal removal because the required metal sulfides precipitation time was more than 3.5 times of the HRT. Sulfide availability only slightly limited the metal removal since adding sulfate above the stoichiometric requirement improved the metal removal by only 5-11%. Via experiments combined with modeling, it was found that metal bisulfide was the dominant complex that limited Fe removal, but humic acids-metal complex was the dominant complex that limited the removal of Pb and Ni. When the total dissolved sulfide concentration is <18 mg/L, humic substances are more limiting the removal of the three metals than bisulfide. On the other hand, when the total dissolved sulfide concentration is >250 mg/L, bisulfide is more limiting than humic substances.


Assuntos
Metais Pesados , Poluentes Químicos da Água , Anaerobiose , Substâncias Húmicas , Metais Pesados/análise , Resíduos Sólidos , Poluentes Químicos da Água/análise
20.
Artigo em Inglês | MEDLINE | ID: mdl-34559308

RESUMO

BACKGROUND: Lenvatinib is regarded as the first-line therapy for patients with unresectable hepatocellular carcinoma (HCC). This study assessed the efficacy and safety of lenvatinib with or without immune checkpoint inhibitors (ICIs) in patients with unresectable HCC. METHODS: In this multicentric retrospective study, patients with unresectable HCC who treated with lenvatinib with or without ICIs would be enrolled. Overall survival, progression-free survival, objective response rate, and disease control rate were calculated to assess the antitumor response. RESULTS: Between January 2019 and August 2020, 65 patients received lenvatinib plus ICIs while other 45 patients received lenvatinib. The baseline characteristics were comparable between the two groups. Lenvatinib plus ICIs provided significantly higher overall survival (hazard ratio = 0.47, 95% CI 0.26-0.85; p = 0.013) and progression-free survival (hazard ratio = 0.35, 95% CI 0.20-0.63; p < 0.001) than lenvatinib monotherapy. Moreover, patients with lenvatinib plus ICIs had significantly higher objective response rate (41.5% vs 20.0%, p = 0.023) and disease control rate (72.3% vs 46.7%, p = 0.009) per RECIST v1.1 than those with lenvatinib. No treatment-related deaths were observed. Grade 3 or greater adverse events occurring in 10% or more of patients in either treatment group were hypertension [13 (20.0%) of 65 patients treated with lenvatinib plus ICIs vs 8 (17.8%) of 45 patients treated with lenvatinib], and palmar-plantar erythrodysesthesia [seven (10.8%) vs two (4.4%)]. CONCLUSIONS: In this real-world study, lenvatinib combined with ICIs showed significantly promising efficacy and manageable safety than lenvatinib alone in patients with unresectable HCC.

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