Progress of research on aroma absorption mechanism and aroma fixation pathway of jasmine green tea.

This overview summarizes the latest research progress on the aroma absorption mechanism and aroma fixation pathway of jasmine green tea, and discusses in depth the aroma absorption mechanism of green tea, the aroma release mechanism of jasmine flowers, as well as the absorption and fixation mechanism of the aroma components of jasmine green tea in the process of scenting, to provide a theoretical basis for the improvement of the quality of jasmine green tea and the innovation of processing technology. It was found that the aroma absorption mechanism of jasmine green tea is mainly associated with both physical and chemical adsorption, aroma release in jasmine involves the phenylpropanoid/benzoin biosynthetic pathway, ß-glycosidase enzymes interpreting putative glycosidic groups, and heat shock proteins (HSPs) as molecular chaperones to prevent stress damage in postharvest flowers due to high temperatures and to promote the release of aroma components, and so forth. The preparation of aroma-protein nano-complexes, heat stress microcapsules, and the spraying of polymeric substances - ß-cyclodextrin are three examples of aroma-fixing pathways. This overview also summarizes the problems and future development trends of the current research and proposes the method of loading benzyl acetate, the main aroma component of jasmine, through konjac glucomannan (KGM)-based gel to solve the problem of volatile aroma and difficult-to-fix aroma, which provides a reference for the sustainable development of the jasmine green tea industry. © 2024 Society of Chemical Industry.

BMI is associated with FEV1 decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials.

BACKGROUND: There is considerable heterogeneity in the rate of lung function decline in chronic obstructive pulmonary disease (COPD), the determinants of which are largely unknown. Observational studies in COPD indicate that low body mass index (BMI) is associated with worse outcomes, and overweight/obesity has a protective effect - the so-called "obesity paradox". We aimed to determine the relationship between BMI and the rate of FEV1 decline in data from published clinical trials in COPD. METHODS: We performed a systematic review of the literature, and identified 5 randomized controlled trials reporting the association between BMI and FEV1 decline. Four of these were included in the meta-analyses. We analyzed BMI in 4 categories: BMI-I (< 18.5 or <  20 kg/m2), BMI-II (18.5 or 20 to < 25 kg/m2), BMI-III (25 to < 29 or < 30 kg/m2) and BMI-IV (≥29 or ≥ 30 kg/m2). We then performed a meta-regression of all the estimates against the BMI category. RESULTS: The estimated rate of FEV1 decline decreased with increasing BMI. Meta-regression of the estimates showed that BMI was significantly associated with the rate of FEV1 decline (linear trend p = 1.21 × 10- 5). CONCLUSIONS: These novel findings support the obesity paradox in COPD: compared to normal BMI, low BMI is a risk factor for accelerated lung function decline, whilst high BMI has a protective effect. The relationship may be due to common but as-of-yet unknown causative factors; further investigation into which may reveal novel endotypes or targets for therapeutic intervention.

CCD and RSM optimization approach for antioxidative activity and immune regulation in head kidney of yellow catfish (Pelteobagrus fulvidraco) based on different lipid levels and temperatures.

Yellow catfish (Pelteobagrus fulvidraco) is an important economic cultured fish in China. Here we report antioxidative activity and immune regulation in head kidney using a central composite design based on water temperature (20-34 °C) and dietary lipid (2-17%). Response values were optimized using response surface methodology to maximize the immune response and relieve oxidative stress. The experiment was conducted under laboratory conditions and lasted for seven weeks. The results showed that the linear effects of lipid level on superoxide dismutase (SOD, and lysozyme (LYZ) activity, and malondialdehyde (MDA) content in head kidney, respiratory burst activity (RBA) of head kidney macrophages, and cumulative mortality of fish infected by Streptococcus iniae (S. iniae) were significant (P < 0.05). Similarly, the linear effects of water temperature on SOD activity, MDA content, and cumulative mortality were significant (P < 0.05). In addition, the quadratic effects of water temperature and lipid level on all experimental response values were significant (P < 0.05), and no interactive effect was found between water temperature and lipid level (P > 0.05). High water temperature and high lipid diet significantly reduced the antioxidative activity and immune response in head kidney, and increased MDA content, which caused increased mortality of the S. iniae-infected fish. The adjusted R2 values for SOD activity, MDA content, LYZ activity, RBA, phagocytic activity, and cumulative mortality regression models were 0.76, 0.85, 0.87, 0.79, 0.64, and 0.87, respectively. The optimal combination of water temperature and lipid level was 26.9 °C and 7.7%, at which good antioxidative activity and immune regulation were achieved, with reliability of 0.878. This combination was close to the optimal combination of water temperature and lipid level for growth performance (27.5 °C and 9.2%) reported previously. Thus, the optimal combination may not only promote growth, but also enhance antioxidant and immune levels.

Inhibition of miR-92d-3p enhances inflammation responses in genetically improved farmed tilapia (GIFT, Oreochromis niloticus) with Streptococcus iniae infection by modulating complement C3.

MicroRNAs (miRNAs) are small, non-coding RNAs that regulate target gene expression by binding to the 3'-untranslated regions (3'-UTRs) of their target mRNAs. The miR-92 family is an important miRNA family, which was discovered to be related to regulation of tumor proliferation, apoptosis, invasion, and metastasis. Inhibition of miR-92d-3p was found previously in head kidney of genetically improved farmed tilapia (GIFT, Oreochromis niloticus) exposed to Streptococcus iniae infection. In this study, we found that miR-92d-3p regulated complement C3 mRNA levels by binding to its 3'-UTR by 3'-UTR luciferase reporter assay, and reduced miR-92d-3p expression resulted in increased C3 mRNA levels. We detected a negative relationship between the expression levels of miR-92d-3p and C3 in GIFT injected with miRNA antagomir. We performed in vivo functional analysis by miR-92d-3p silencing. Inhibition of miR-92d-3p levels in GIFT head kidney caused a significant increase in C3 expression, which consequently increased the white blood cell counts and interleukin-1ß, tumor necrosis factor-α, and interferon-γ mRNA levels, all of which may help to activate the inflammatory response in GIFT post-infection with S. iniae. Our findings indicate that miR-92d-3p regulated C3 levels by binding with the C3 mRNA 3'-UTR, and this interaction affected S. iniae infection induction and the immune response in GIFT. We concluded that miR-92d-3p plays an important role in modulating the inflammatory response in GIFT head kidney. Our findings may contribute to understanding the mechanisms of miRNA-mediated gene regulation in tilapia in response to S. iniae infection.

Influences of dietary lipid and temperature on growth, fat deposition and lipoprotein lipase expression in darkbarbel catfish (Pelteobagrus vachellii).

Darkbarbel catfish (Pelteobagrus vachellii) is an important freshwater fish in China. Water temperature greatly influences the absorption and utilization of dietary lipid by fish. Response values (including growth, hepatic fat deposition, and gene expression) for darkbarbel catfish mediated by two factors (water temperature 20-34°C; dietary lipid level 2-17%) were the focus of this study. The relationship between the two factors and the response values was evaluated by the response surface method using the central composite design. The experiment was conducted under laboratory conditions and lasted for seven weeks. A total of 975 experimental fish (average weight 11.75 ± 0.17g) were selected and placed in 39 plastic tanks. The results showed that the linear effects of lipid level on feed conversion rate (FCR), hepatopancreas somatic index (HSI), hepatic triglycerides (TG), cholesterol (TC), and lipoprotein lipase (LPL) gene expression were significant (P < 0.05). The linear effects of water temperature on specific growth rate (SGR), HSI, TC level, and LPL mRNA expression were significant (P < 0.05). The quadratic effects of water temperature and lipid level on SGR and FCR were significant (P < 0.05). Low water temperature and low lipid diets significantly inhibited growth, increased HSI, and reduced hepatic TG and TC levels, and LPL mRNA expression. The adjusted R2 values for the SGR, FCR, HSI, TC, TG, and LPL mRNA regression models were 0.77, 0.85, 0.62, 0.73, 0.85, and 0.91, respectively. The optimal combination of water temperature and dietary lipid level was 27.5°C and 9.2%, at which the greatest growth and FCR were 2.13%.d-1 and 1.31 respectively, with desirability of 0.904. These results indicated that water temperature may mediate the requirement and utilization of dietary lipid, and intervene in hepatic fat deposition. The results of this study can be used to help optimize the culture conditions of darkbarbel catfish.

Pulmonary nocardiosis following COVID-19 in a patient with idiopathic pulmonary fibrosis and lung transplantation: a case report.

Background: Nocardiosis is an opportunistic infection that primarily affects immunocompromised patients. Pulmonary nocardiosis is the most prevalent form, but can also spread to other organs. Potential causes contributing to opportunistic infection may include immunosuppression and disruption of tight junctions, both of which can result from COVID-19. Case presentation: We reported a case of a 68-year-old male patient who presented with a 10-day history of fever, cough, and productive sputum. Upon physical examination, velcro rales were detected in the right lung, while breath sounds in the left lung were clear. The patient had previously undergone left lung transplantation due to idiopathic pulmonary fibrosis four years ago. He was initially hospitalized and treated for COVID-19 but was readmitted due to worsening symptoms. Subsequently, pulmonary nocardiosis was diagnosed utilizing metagenomic next-generation sequencing of bronchoalveolar lavage fluid. The above-mentioned condition was improved following treatment with cancidas and linezolid. Now, he is under regular follow-up. Conclusion: This case highlights the complexity of COVID-19 and the occurrence of secondary opportunistic infections, which require further investigation.

Furazolidone-induced pulmonary toxicity in Helicobacter pylori infection: Two case reports.

BACKGROUND: Helicobacter pylori (H. pylori) infection is a global problem, causing significant morbidity and mortality. Furazolidone is recommended to eradicate H. pylori infections in China owing to the highly associated antibiotic resistance. CASE SUMMARY: This article presents two cases of lung injury caused by furazolidone treatment of H. pylori infection and the relevant literature review. Two patients developed symptoms, including fever, cough, and fatigue after receiving a course of furazolidone for H. pylori infection. Chest computed tomography showed bilateral interstitial infiltrates. Laboratory studies revealed elevated blood eosinophil count. After discontinuing furazolidone with or without the use of corticosteroids, the symptoms improved rapidly. A PubMed database literature search revealed three reported cases of lung injury suggestive of furazolidone-induced pulmonary toxicity. CONCLUSION: Clinicians should be aware of the side effects associated with the administration of furazolidone to eradicate H. pylori infection.

A pyroptosis-related lncRNA signature in bladder cancer.

PURPOSE: Pyroptosis, a type of programmed cell death, is implicated in the tumorigenesis, development and migration of cancer, which can be regulated by long non-coding RNAs (lncRNAs). Our research aimed to investigate the prognostic role of pyroptosis-related lncRNAs and the relationship to the tumor immune microenvironment through bioinformatics analysis. METHODS: The clinical and RNA-sequencing data of bladder cancer patients were downloaded from The Cancer Genome Atlas (TCGA). And 412 bladder cancer subjects with clinical information were divided into training and testing cohort. And 52 reported pyroptosis-related genes were used to screen pyroptosis-related lncRNAs. A pyroptosis-related lncRNA signature was constructed based on Cox regression analyses. RESULTS: A 9-pyroptosis-related-lncRNA signature was identified to separate patients with bladder cancer into two groups. The prognosis of bladder cancer patients in the high-risk group was significantly inferior compared with those in the low-risk group. Risk scores were validated to develop an independent prognostic indicator based on multivariate Cox regression analysis. Receiver operating characteristic curve (ROC) analysis examined the signature on overall survival. The area under time-dependent ROC curve (AUC) at 1-, 3, and 5-years measured 0.747, 0.783, and 0.768, respectively. Analysis of the immune landscape and PD-L1 expression showed that PD-L1 is upregulated in the high-risk group. The immunocyte subtypes of the two groups were different. CONCLUSION: A novel pyroptosis-related lncRNA signature was identified with prognostic value for bladder cancer patients. Pyroptosis-related lncRNAs have a potential role in cancer immunology and may serve as prognostic or therapeutic targets.

Structure, Merits, Gel Formation, Gel Preparation and Functions of Konjac Glucomannan and Its Application in Aquatic Food Preservation.

Konjac glucomannan (KGM) is a natural polysaccharide extracted from konjac tubers that has a topological structure composed of glucose and mannose. KGM can be used as a gel carrier to load active molecules in food preservation. The three-dimensional gel network structure based on KGM provides good protection for the loaded active molecules and allows for sustained release, thus enhancing the antioxidant and antimicrobial activities of these molecules. KGM loaded with various active molecules has been used in aquatic foods preservation, with great potential for different food preservation applications. This review summarizes recent advances in KGM, including: (i) structural characterization, (ii) the formation mechanism, (iii) preparation methods, (iv) functional properties and (v) the preservation of aquatic food.

Review of Konjac Glucomannan Structure, Properties, Gelation Mechanism, and Application in Medical Biology.

Konjac glucomannan (KGM) is a naturally occurring macromolecular polysaccharide that exhibits remarkable film-forming and gel-forming properties, and a high degree of biocompatibility and biodegradability. The helical structure of KGM is maintained by the acetyl group, which plays a crucial role in preserving its structural integrity. Various degradation methods, including the topological structure, can enhance the stability of KGM and improve its biological activity. Recent research has focused on modifying KGM to enhance its properties, utilizing multi-scale simulation, mechanical experiments, and biosensor research. This review presents a comprehensive overview of the structure and properties of KGM, recent advancements in non-alkali thermally irreversible gel research, and its applications in biomedical materials and related areas of research. Additionally, this review outlines prospects for future KGM research, providing valuable research ideas for follow-up experiments.

Targeting ALK Rearrangements in NSCLC: Current State of the Art.

Anaplastic lymphoma kinase (ALK) alterations in non-small cell lung cancer (NSCLC) can be effectively treated with a variety of ALK-targeted drugs. After the approval of the first-generation ALK inhibitor crizotinib which achieved better results in prolonging the progression-free survival (PFS) compared with chemotherapy, a number of next-generation ALK inhibitors have been developed including ceritinib, alectinib, brigatinib, and ensartinib. Recently, a potent, third-generation ALK inhibitor, lorlatinib, has been approved by the Food and Drug Administration (FDA) for the first-line treatment of ALK-positive (ALK+) NSCLC. These drugs have manageable toxicity profiles. Responses to ALK inhibitors are however often not durable, and acquired resistance can occur as on-target or off-target alterations. Studies are underway to explore the mechanisms of resistance and optimal treatment options beyond progression. Efforts have also been undertaken to develop further generations of ALK inhibitors. This review will summarize the current situation of targeting the ALK signaling pathway.

Alternative splicing events in tumor immune infiltration in renal clear cell carcinomas.

Alternative splicing (AS) is a gene regulatory mechanism that drives protein diversity and dysregulation of AS plays a significant role in tumorigenesis. This study aimed to develop a prognostic signature based on AS and elucidate the role in tumor immune microenvironment (TIME) in clear cell renal cell carcinoma (ccRCC). The prognosis-related AS events were analyzed by univariate Cox regression analysis. Gene set enrichment analyses (GSEA) were performed for functional annotation. Prognostic signatures were identified and validated using univariate and multivariate Cox regression, LASSO regression, Kaplan-Meier survival analysis, and proportional hazards model. The context of TIME in ccRCC was also analyzed. Gene and protein expression data of C4orf19 were obtained from ONCOMINE website and Human Protein Altas. Splicing factors (SFs) regulatory networks were visualized. 4431 survival-related AS events in ccRCC were screened. Based on splicing subtypes, eight AS prognostic signatures were constructed. A nomogram with good prognostic prediction was generated. Furthermore, the prognostic signatures were significantly correlated with TIME diversity and immune checkpoint inhibitor (ICI)-related genes. C4orf19 was the only gene whose expression levels were downregulated among the prognostic AS-related genes, which is considered as a promising prognostic factor in ccRCC. Potential functions of SFs were determined by splicing regulatory networks. In our study, AS patterns of novel indicators for prognostic prediction of ccRCC were explored. The AS-SF networks provide information of regulatory mechanisms. Players of AS events related to TIME were investigated, which contribute to prognosis monitoring of ccRCC.

Insight into derivative Weibull mixture model in describing simulated distributed activation energy model and distillers dried grains with solubles pyrolysis processes.

The kinetics of biomass pyrolysis is fundamental for exploring its mechanisms and optimizing its processes, which is helpful for designing its systems. The derivative Weibull mixture model was proposed for kinetic description of the simulated distribution energy model (DAEM) processes and distillers dried grains with solubles (DDGS) pyrolysis processes. The conversion rate data of these processes at different heating rates could be accurately described by the derivative Weibull mixture model. Moreover, the proposed model could effectively smooth the noises contained in the experimental conversion rate data of DDGS pyrolysis. The derivative Weibull mixture model separated DDGS pyrolysis reactions into several individual processes, and provided some data required for further isoconversional kinetic analysis. The predicted curves from the derivative Weibull mixture model allowed us to obtain the effective activation energies of DDGS pyrolysis, which varied significantly from 170 to 330 kJ mol-1 in the conversion range between 0.1 and 0.9.

Exploring the application and mechanism of sodium hyaluronate in cryopreservation of red blood cells.

The cryopreservation of red blood cells (RBCs) is essential for transfusion therapy and maintaining the inventory of RBCs units. The existing cryoprotectants (CPAs) have many defects, and the search for novel CPAs is becoming a research hotspot. Sodium hyaluronate (SH) is polymerized from sodium glucuronate and N-acetylglucosamine, which has good water binding capacity and biocompatibility. Herein, we reported for the first time that under the action of medium molecular weight sodium hyaluronate (MSH), the thawed RBCs recovery increased from 33.1 â€‹± â€‹5.8% to 63.2 â€‹± â€‹3.5%. In addition, RBCs functions and properties were maintained normally, and the residual MSH could be removed by direct washing. When MSH was used with a very low concentration (5% v/v) of glycerol (Gly), the thawed RBCs recovery could be increased to 92.3 â€‹± â€‹4.6%. In general, 40% v/v Gly was required to achieve similar efficiency. A mathematical model was used to compare the performance of MSH, PVA and trehalose in cryopreservation, and MSH showed the best efficiency. It was found that MSH could periodically regulate the content of intracellular water through the "reservoir effect" to reduce the damages during freezing and thawing. Moreover, MSH could inhibit ice recrystallization when combined with RBCs. The high viscosity and strong water binding capacity of MSH was also conducive to reducing the content of ice. This works points out a new direction for cryopreservation of RBCs and may promote transfusion therapy in clinic.

A Prediction Model Using Alternative Splicing Events and the Immune Microenvironment Signature in Lung Adenocarcinoma.

BACKGROUND: Alternative splicing (AS) is a gene regulatory mechanism that drives protein diversity. Dysregulation of AS is thought to play an essential role in cancer initiation and development. This study aimed to construct a prognostic signature based on AS and explore the role in the tumor immune microenvironment (TIME) in lung adenocarcinoma. METHODS: We analyzed transcriptome profiling and clinical lung adenocarcinoma data from The Cancer Genome Atlas (TCGA) database and lists of AS-related and immune-related signatures from the SpliceSeq. Prognosis-related AS events were analyzed by univariate Cox regression analysis. Gene set enrichment analyses (GSEA) were performed for functional annotation. Prognostic signatures were identified and validated using univariate and multivariate Cox regression, LASSO regression, Kaplan-Meier survival analyses, and proportional hazards model. The context of TIME in lung adenocarcinoma was also analyzed. Gene and protein expression data of Cyclin-Dependent Kinase Inhibitor 2A (CDKN2A) were obtained from ONCOMINE and Human Protein Atlas. Splicing factor (SF) regulatory networks were visualized. RESULTS: A total of 19,054 survival-related AS events in lung adenocarcinoma were screened in 1,323 genes. Exon skip (ES) and mutually exclusive exons (ME) exhibited the most and fewest AS events, respectively. Based on AS subtypes, eight AS prognostic signatures were constructed. Patients with high-risk scores were associated with poor overall survival. A nomogram with good validity in prognostic prediction was generated. AUCs of risk scores at 1, 2, and 3 years were 0.775, 0.736, and 0.759, respectively. Furthermore, the prognostic signatures were significantly correlated with TIME diversity and immune checkpoint inhibitor (ICI)-related genes. Low-risk patients had a higher StromalScore, ImmuneScore, and ESTIMATEScore. AS-based risk score signature was positively associated with CD8+ T cells. CDKN2A was also found to be a prognostic factor in lung adenocarcinoma. Finally, potential functions of SFs were determined by regulatory networks. CONCLUSION: Taken together, our findings show a clear association between AS and immune cell infiltration events and patient outcome, which could provide a basis for the identification of novel markers and therapeutic targets for lung adenocarcinoma. SF networks provide information of regulatory mechanisms.

Different Risks of Mortality and Longitudinal Transition Trajectories in New Potential Subtypes of the Preserved Ratio Impaired Spirometry: Evidence From the English Longitudinal Study of Aging.

Background: Preserved ratio impaired spirometry (PRISm), characterized by the decreased forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) with a preserved FEV1/FVC ratio, is highly prevalent and heterogeneous. We aimed to identify the subtypes of PRISm and examine their differences in clinical characteristics, long-term mortality risks, and longitudinal transition trajectories. Methods: A total of 6,616 eligible subjects were included from the English longitudinal study of aging. Two subtypes of the PRISm were identified as mild PRISm (either of FEV1 and FVC <80% predicted value, FEV1/FVC ≥0.7) and severe PRISm (both FEV1 and FVC <80% predicted values, FEV1/FVC ≥0.7). Normal spirometry was defined as both FEV1 and FVC ≥80% predicted values and FEV1/FVC ≥0.7. Hazard ratios (HRs) and 95% CIs were calculated by the multiple Cox regression models. Longitudinal transition trajectories were described with repeated spirometry data. Results: At baseline, severe PRISm had increased respiratory symptoms, including higher percentages of phlegm, wheezing, dyspnea, chronic bronchitis, and emphysema than mild PRISm. After an average of 7.7 years of follow-up, severe PRISm significantly increased the risks of all-cause mortality (HR=1.91, 95%CI = 1.58-2.31), respiratory mortality (HR = 6.02, 95%CI = 2.83-12.84), and CVD mortality (HR = 2.11, 95%CI = 1.42-3.13) compared with the normal spirometry, but no significantly increased risks were found for mild PRISm. In the two longitudinal transitions, mild PRISm tended to transition toward normal spirometry (40.2 and 54.7%), but severe PRISm tended to maintain the status (42.4 and 30.4%) or transition toward Global Initiative for Chronic Obstructive Lung Disease (GOLD)2-4 (28.3 and 33.9%). Conclusion: Two subtypes of PRISm were identified. Severe PRISm had increased respiratory symptoms, higher mortality risks, and a higher probability of progressing to GOLD2-4 than mild PRISm. These findings provided new evidence for the stratified management of PRISm.

Complete System to Generate Clean Water from a Contaminated Water Body by a Handmade Flower-like Light Absorber.

The utilization of solar energy to make human lives better has been one of the primary and green approaches adopted by ordinary people and researchers for decades. This approach has recently gained a lot of attention as a way to tackle clean water scarcity in remote areas. Costly components, complex manufacturing procedures with rarely available equipment, and a surface to condense water vapors are challenges in the way of its application in the required areas. Here, we propose a complete system to solve this problem with a handmade light absorber and a superhydrophilic surface (antifogging) to get vapors back to collect clean water. Our handmade flower-like light absorber stitched by crochet work, the single stitch method, was able to get a decent evaporation rate of 1.75 kg/m2·h in pure water and slightly lower rates of 1.62 and 1.65 kg/m2·h with brine and pond water, respectively. Still, our proposed superhydrophilic coated surface can collect ∼37% more water than the pristine surface. This system has a huge potential for use in rural areas because of multiple key advantages, such as simple technology, readily available low-cost raw materials, and easy fabrication.

Efficacy and Safety of First-Line Treatment Strategies for Anaplastic Lymphoma Kinase-Positive Non-Small Cell Lung Cancer: A Bayesian Network Meta-Analysis.

BACKGROUND: Targeted therapies have led to significant improvement in the management and prognosis of anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC). We performed a network meta-analysis of frontline treatment options of ALK-positive NSCLC to provide clinical guidance. METHODS: PubMed, Embase, ClinicalTrials.gov, and international conference databases were searched to identify relevant trials from inception to June 30, 2021. Phase III randomized controlled trials (RCTs) comparing treatments for patients with ALK-positive advanced NSCLC in the first-line setting were included in a Bayesian network meta-analysis. Eligible studies reported at least one of the following clinical outcomes: progression-free survival (PFS), overall survival (OS), risk of the central nervous system (CNS) progression, adverse events (AEs) of grade (G) 3 or higher (G3 AEs), or serious AEs (SAEs). Hazard ratios (HRs) and CI for primary outcome of PFS and secondary outcome of OS and risk of CNS progression were obtained. A multivariate, consistency model, fixed-effects analysis was used in the network meta-analysis. Data on G3 AEs and SAEs were abstracted and meta-analyzed. Risk of bias (RoB) was assessed using the Cochrane Collaboration's tool. RESULTS: Nine RCTs comprising 2,484 patients were included with seven treatments: alectinib, brigatinib, ceritinib, crizotinib, ensartinib, lorlatinib, and chemotherapy. Compared with chemotherapy, ALK-tyrosine kinase inhibitors (TKIs) significantly prolong PFS and reduced risk of CNS progression except for ceritinib. Lorlatinib appears superior at reducing risk of CNS progression. None of the ALK-TKIs have a significantly prolonged OS as compared with chemotherapy. Lorlatinib increases the risk of G3 AEs as compared with alectinib (odds ratio 4.26 [95% CrI 1.22 to 15.53]), while alectinib caused the fewest G3 AEs. CONCLUSIONS: Lorlatinib is associated with the highest PFS benefit and lowest risk of CNS progression benefits for patients with advanced ALK-positive NSCLC, compared with other first-line treatments, but with higher toxicity. The implementation of a newer generation of ALK-TKIs in the first-line treatment of ALK-positive NSCLC into current clinical practice is evolving rapidly.

Safety and efficacy of anti-PD-1 inhibitors in Chinese patients with advanced lung cancer and hepatitis B virus infection: a retrospective single-center study.

BACKGROUND: Programmed death protein (ligand) 1 [PD-(L)1] inhibitors have provided new therapeutic options for advanced lung cancer. However, patients with hepatitis B virus (HBV) infection have been traditionally excluded from most registered trials of this form of treatment. METHODS: We performed a retrospective analysis of patients with HBV and advanced lung cancer who received anti-PD-1 immunotherapy from September 2018 to May 2020 in our department. Treatment-related hepatotoxicity was evaluated and recorded. Overall response rate and progression free survival were also assessed in the patients using iRECIST. RESULTS: Seventeen patients were evaluated in this analysis. Of these, six (35.3%) experienced hepatic transaminase elevation during immunotherapy. Three of these patients developed Grade 3 hepatic immune-related adverse events and received systemic corticosteroids, following which aminotransferase levels recovered to normal in all patients and no adverse events were observed in subsequent treatment. No patient experienced HBV reactivation or flare. One patient developed active pulmonary tuberculosis (TB). Other adverse events were mild, well tolerated and short term. The objective response rate (ORR) of the cohort was 62.5%, and the median progression-free survival (PFS) was 3 months. CONCLUSIONS: Lung cancer patients can be treated safely with anti-PD-1 inhibitors in the context of HBV infection. Close monitoring for hepatotoxicity and prophylactic antiviral therapy is advised. Further studies on the use of anti-PD-1 inhibitors in HBV-infected patients are needed.

New insights into early intervention of chronic obstructive pulmonary disease with mild airflow limitation.

Chronic obstructive pulmonary disease (COPD) has become one of the major public health problems worldwide due to its high morbidity and mortality. Up until now, COPD is still under-diagnosed and under-treated, especially for mild or moderate patients. It is widely accepted that the majority of patients with COPD are in the early stages, yet this subpopulation is underestimated. In recent years, growing evidence indicates that substantial physiological and clinical abnormalities exist in patients with mild COPD compared with healthy controls. Furthermore, recent studies suggest that pharmacologic intervention in early COPD has the potential to alter clinical outcomes. The main objective of this review is to summarize recent research regarding the heterogeneous pathophysiology, clinical features, and treatment of mild and moderate COPD. We also discuss promising markers of disease progression, which may contribute to the development of precision medicine in early COPD.