Shandong Cancer Hospital (Shandong Provincial Institute of Cancer Prevention and Treatment)

Background Kinematic alignment (KA) unicompartmental knee arthroplasty (UKA), which has not been widely adopted in clinical practice, aims to implant a more personalized and physiologically compatible mobile-bearing UKA prosthesis for the treatment of advanced single compartment knee osteoarthritis. KA UKA is anticipated to enhance patient satisfaction and decrease the revision rate following UKA. However, its quantified biomechanical indicators remain unclear. The purpose of this study is to reveal the biomechanical characteristics of the tibiofemoral joint in normal and KA UKA knees, and to evaluate the biomechanical effect. Methods In this study, six cadaveric knee joint specimens were utilized for biomechanical testing before (normal cadaveric knee joint specimen ) and after KA UKA. The knee joint specimens were subjected to an axial load of 1000 N, and the biomechanical parameters were assessed at flexion angles ranging from 0° to 120° in 10° increments. Results The root mean square (RMS) values of the tibiofemoral contact area, mean contact pressure, and peak contact pressure during knee flexion were 529 mm², 1.8 MPa, and 4.5 MPa in normal knees, respectively. After KA UKA, these values changed to 449 mm², 2.0 MPa, and 9.8 MPa, respectively. Additionally, the RMS value of the external rotation of the femur relative to the tibia in the tibiofemoral joint was 9.9° in normal knees, while the posterior translations of the center of the femoral condyle, the medial femoral condyle, and the lateral femoral condyle were 18.4 mm, 11.5 mm, and 25.4 mm respectively. After KA UKA, these values changed to 8.6°, 19.3 mm, 12.9 mm, and 25.9 mm respectively. Conclusion At the same flexion angle, the increase in peak contact pressure in the medial compartment after KA UKA is the most significant compared with the normal knees. However, the kinematic characteristics do not change significantly after KA UKA. These findings are beneficial for understanding the possible postoperative complications and good functional effects of KA UKA.

Background Many meta-analyses have reported the associations between red and processed meat consumption and cancer outcomes, but few have assessed the credibility of the evidence. In addition, the results of dose-effect analyses of the association between red and processed meat consumption and cancer outcomes were inconsistently reported in different articles. Here we propose a protocol for an umbrella review (UR) that be designed to assess these associations and explore the potential dose-response relationships. Methods We will independently search five electronic databases and two registers from inception to July 2024 for systematic reviews with meta-analysis concerning the associations of red and processed meat consumption with cancer incidence and mortality. We will conduct the statistical analysis between August 2024 and December 2024. Also, an up-to-date search for additional primary studies of cancer outcomes that were not included in previously published meta-analyses will be conducted. The main outcomes will include the incidence and mortality of any cancer related to red and processed meat exposure. A series of unique associations will be created based on the cancer outcome, exposure, and clinical or population setting. For each association, we will update the meta-analysis by combining studies included in prior meta-analyses and new studies that were not included in prior meta-analyses, and re-perform the meta-analysis using the random-effects models. According to the credibility of the evidence assessment, all associations with a P value of ≤ 0.05 will be categorized as convincing, highly suggestive, suggestive, or weak evidence. All analyses will be performed in R (version 4.2.3). Results The results of this UR are planned to be submitted to a peer-reviewed journal. Conclusion The main aim of protocol publication is to get feed back from the reviewers to develop a standard protocol before its publication and after publication, it should guide this protocol to take up similar research by any researcher(s) by following meticulously this standard protocol. Registration PROSPERO CRD42023414550.

Antibody–drug conjugates (ADCs) have emerged as a transformative modality in the treatment of solid tumors. YL201, a novel B7H3-targeting ADC, leverages a tumor microenvironment activable linker-payload platform, coupled with a novel topoisomerase 1 inhibitor via a protease-cleavable linker. Here we report the findings from a large-scale, global, multicenter, phase 1 trial evaluating the safety, pharmacokinetics and preliminary efficacy of YL201 in patients with advanced solid tumors refractory to standard therapies. The trial included a dose-escalation part (phase 1) and a dose-expansion part (phase 1b). A total of 312 patients were enrolled across multiple tumor types, including extensive-stage small cell lung cancer (ES-SCLC), nasopharyngeal carcinoma (NPC), non-small cell lung cancer, esophageal squamous cell carcinoma and other solid tumors. The maximum tolerated dose was determined to be 2.8 mg kg⁻¹, and the recommended expansion dose was selected as 2.0 mg kg⁻¹ and 2.4 mg kg⁻¹ every 3 weeks. The most common grade 3 or higher treatment-related adverse events included neutropenia (31.7%), leukopenia (29.5%) and anemia (25.0%). Only 4 cases of interstitial lung disease (1.3%) and 1 case of infusion reactions (0.3%) were observed. Encouraging anti-tumor activity was observed, particularly in patients with ES-SCLC (objective response rate (ORR), 63.9%), NPC (ORR, 48.6%), lung adenocarcinoma (ORR, 28.6%) and lymphoepithelioma-like carcinoma (ORR, 54.2%). No significant correlation between B7H3 membrane expression and the ORR was found. YL201 demonstrated an acceptable safety profile and a promising efficacy in heavily pretreated patients with advanced solid tumors, particularly in those with ES-SCLC, NPC or lymphoepithelioma-like carcinoma. Phase 3 clinical trials for patients with SCLC and NPC have already been initiated. ClinicalTrials.gov identifiers: NCT05434234 and NCT06057922.

Optical biosensors, valued for their exceptional sensitivity, specificity and versatility, are gaining popularity in the field of biosensing. Such devices detect and quantify a variety of analytes encompassing interactions of light with biological elements employing either labeled or label-free methodologies, and make them requisite tools in environmental studies, agriculture, biotechnology, food inspection, disease diagnosis, safety and medicine. Given the rapid pace of innovation, there is a pressing need to consolidate and critically evaluate the current state of optical biosensors to expedite future research and development efforts. This review aims to present a comprehensive overview of recent advances and emerging trends in optical biosensing technology in terms of both labeled and label-free strategies over the last decade. This study will explore the latest innovation in sensor design and fabrication, including nanotechnology integration with microfluidics, their significant miniaturization and performance enrichment. Moreover, various challenges and prospects for unique optical biosensors are also conferred herein. This study is unparalleled as it enables to have a broader insight into the optical biosensor, presenting specific, quantitative, highly accurate and sensitive detection of the target analytes. It anticipates leading to the next generation biosensors with broader spectrum of the required applications.

Background Early and accurate identification of epidermal growth factor receptor (EGFR) mutation status in non-small cell lung cancer (NSCLC) patients with brain metastases is critical for guiding targeted therapy. This study aimed to develop a deep learning radiomics model utilizing multi-sequence magnetic resonance imaging (MRI) to differentiate between EGFR mutant type (MT) and wild type (WT). Methods In this retrospective study, 288 NSCLC patients with confirmed brain metastases were enrolled, including 106 with EGFR MT and 182 with EGFR WT. All patients were randomly divided into a training dataset (75%) and a validation dataset (25%). Radiomics and deep learning features were extracted from the brain metastatic lesions using contrast-enhanced T1-weighted (T1CE) and T2-weighted (T2W) MRI images. Features extraction and selection were performed using the least absolute shrinkage and selection operator (LASSO) and ResNet34. The predictive performance of the signatures for EGFR mutation status was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses. Results No significant differences were found between the training and validation datasets. A four-feature radiomics signature (RS) demonstrated excellent predictive accuracy for EGFR MT, with α-binormal-based and empirical AUCs of 0.931 (95% CI: 0.880–0.940) and 0.926 (95% CI: 0.877–0.933), respectively. Incorporating deep learning signature (DLS) further enhanced the model’s performance, achieving α-binormal-based and empirical AUCs of 0.943 (95% CI: 0.921–0.965) and 0.938 (95% CI: 0.914–0.962) in the training dataset. These findings were confirmed in the validation dataset, with AUCs of 0.936 (95% CI: 0.917–0.955) and 0.921 (95% CI: 0.901–0.941), demonstrating robust and consistent predictive performance. Conclusions The multi-sequence MRI-based deep learning radiomics model exhibited high efficacy in predicting EGFR mutation status in NSCLC patients with brain metastases. This approach, which integrates advanced radiological features with deep learning techniques, offers a non-invasive and accurate method for determining EGFR mutation status, potentially guiding personalized treatment decisions in clinical practice.

This study aims to explore the effects of problem-based learning (PBL) and prescription-based preoperative talk (PPT) teaching methods in the teaching of tumors in cerebellopontine angle (CPA) of clinical neurosurgery residents.One hundred-thirty neurosurgery residents working in Qilu Hospital of Shandong University from September 2021 to June 2024 were randomly divided into two groups. The experimental group adopted the combination of PBL and PPT, referred to as PPP. In contrast, the control group simply learned the material on their own. The effectiveness of the teaching methods was then assessed using theory test scores and customized questionnaires. Compared with the control group, the test scores of the experimental group were significantly improved (P = 0.005). In addition, the test score of the experimental group was still higher than that of the control group 1 month after the course (P = 0.033). The satisfaction questionnaire of PPP teaching method showed that the experimental group had higher satisfaction in 6 aspects of stimulating an interest, enhancing students’ self-learning abilities, mastery of basic and anatomical knowledge, analytical and problem-solving skills, help for clinical thinking, and doctor-patient communication skills. In the teaching of cerebellopontine angle tumors, the PPP teaching method can provide a unique experiential learning opportunity for neurosurgery residents, improve theoretical test scores, and promote self-evaluation and satisfaction. In addition, this method can enhance neurosurgical residents’ understanding of tumor diseases in the CPA region. Therefore, it helps to improve the overall teaching effectiveness.

The challenges faced by rural family caregivers of infants have a profound impact on their early development. To exploring the challenges and support needs of infant caregivers in rural areas of China, this qualitative study conducted in-depth interviews with 11 caregivers (including 7 grandmothers, 1 grandfather, and 3 mothers) of infants from five rural areas in Jiyuan City, Henan Province, between July 2022 and January 2023. Data was collected using a semi-structured interview guide (comprising 12 questions) prepared by the researchers. The data was analyzed using a directed content analysis approach based on the Social Ecological Systems Theory. The results indicated that caregivers faced multiple challenges at the micro-, meso-, and macrosystem levels. At the micro level, caregivers confronted physical and mental health challenges because their daily routines were arranged around child-rearing, and they relied heavily on traditional methods. Issues such as poor family economic conditions, a lack of internal family support, and conflicts in intergenerational parenting concepts were prominent at the mesosystem level. Challenges at the macro level included inadequate community environments, inadequate support systems, traditional parenting beliefs, and insufficient parenting information. Recommendations include enhancing family communication, community support, parenting education, and welfare-based caregiving services, as well as increasing government investments in healthcare, education, infrastructure, and caregiver subsidies. This study offers a new perspective for understanding the ecosystem complexity of rural infant caregivers and provides a basis for formulating precise and effective support strategies.

Background and aims This individual patient data pooled analysis aimed to evaluate the effectiveness, safety, and patterns of use of camrelizumab in a large cohort of advanced esophageal cancer (AEC) patients. Approach and results Adult patients (≥ 18 years) who had received camrelizumab as part of AEC treatment were pooled from three independent, prospective observational cohort studies (NCT04616040, ChiCTR1900027275, and ChiCTR2000039499). The main outcomes were patterns of camrelizumab use, progression-free survival (PFS), overall survival (OS), and safety in the overall population and specific subgroups of underrepresented patients. Among 987 patients, 450 (45.6%) received camrelizumab in the first line, 398 (40.3%) in the second line, and 139 (14.1%) in the third line or later. Most (69.7%) patients received camrelizumab plus chemotherapy regardless of treatment lines. The median PFS was 9.9 (95% CI 7.4, 14.4), 6.6 (95% CI 5.1, 8.8), and 5.7 (95% CI 3.1, 9.6) months in the first line, second line, and third line or later, respectively. The corresponding median OS was 15.5 (95% CI 12.6, 18.4), 12.1 (95% CI 10.0, 14.7), and 10.9 (95% CI 8.1, 14.5) months. Patients with poor performance status (ECOG PS ≥ 2) and with camrelizumab in the second line or later, but not patients with older age (≥ 75 years), were associated with poor survival. Adverse events occurred in 721 (73.0%) patients, with no new safety signals. Conclusions This study provides an overview of camrelizumab use in unselected AEC patients. The real-world effectiveness and safety of camrelizumab are generally consistent with those observed in pivotal trials.

Background Although social withdrawal is common among colorectal cancer (CRC) survivors with permanent stomas, it has been poorly addressed due to a lack of valid assessment tools. The social withdrawal subscale (SWS) from the Internalized Stigma of Mental Illness (ISMI) scale shows promise for assessing social withdrawal. However, there was no available data on its validity for this purpose. This study aimed to investigate the reliability and validity of the SWS as a screening tool for identifying survivors at risk of social withdrawal. Methods Two separate convenience samples of 127 and 245 CRC survivors with permanent stomas were selected. Item analysis and exploratory factor analysis (EFA) were conducted with the first sample of 127 survivors. Confirmatory factor analysis (CFA), reliability analysis, and tests for convergent and discriminant validity were performed with the second sample of 245 survivors. Additionally, the screening cut-off score and accuracy of the SWS scores were determined using receiver operating characteristic (ROC) curves. Results The item-total correlation coefficients of the SWS ranged from 0.530 to 0.787. The EFA demonstrated a single-factor structure for the SWS. The CFA confirmed appropriate construct validity (χ²/df = 103.115/52 = 1.983, goodness-of-fit index (GFI) = 0.925, comparative fit index (CFI) = 0.959, and root mean square error of approximation (RMSEA) = 0.068). The test–retest reliability was 0.849. Pearson correlation analysis showed significant and moderate to large relationships between the SWS and the chosen criterion measures, supporting its good convergent validity. ROC analysis identified SWS scores of ≥ 15 as the optimal screening cut-off, with a sensitivity of 86.5%, specificity of 50.5%, and an area under the curve (AUC) of 0.748 (95% CI: 0.673–0.823, P < 0.001). Conclusion The SWS demonstrates acceptable reliability and validity for measuring social withdrawal among CRC survivors with permanent stomas. Future studies should further evaluate its utility in clinical settings.

Background With the application of immune checkpoint inhibitors (ICIs) and the discovery of the synergistic effect of radiotherapy and immunotherapy, the intracranial benefit of thoracic radiotherapy (TRT) is receiving signiffcant clinical attention. The purpose of this study was to analyze the cranial benefits of ICIs and TRT in patients with extensive-stage small cell lung cancer (ES-SCLC) without baseline brain metastases (BMs). Materials and methods From August 2019 to August 2022, data from patients diagnosed with ES-SCLC without baseline BMs were retroactively recorded. The Kaplan‒Meier method was used to calculate overall survival (OS), progression-free survival (PFS), and brain metastasis-free survival (BMFS), and the differences between the treatment groups were compared with the log-rank test. Risk factors associated with OS were analyzed via the Cox regression model. Results A total of 216 patients were included, with a median follow-up of 24.73 months. Among these patients, 137 (63.4%) received first-line ICIs combined with chemotherapy (ChT), including 32 patients treated with anti-programmed death 1 antibody (αPD-1) and 105 patients treated with anti-programmed death-ligand 1 antibody (αPD-L1), and 79 patients (36.6%) received first-line ChT alone. Compared with the ChT-alone group, the ICI + ChT group demonstrated significantly improved PFS (8.07 vs. 6.87 months; p < 0.001) and OS (19.83 vs. 13.80 months; p = 0.001). The addition of ICIs to the ChT regimen did not significantly delay the onset of BMs compared to that with ChT alone (16.93 vs. 12.67 months; p = 0.379). Notably, the addition of TRT to the αPD-L1 + ChT regimen significantly prolonged BMFS compared to that without TRT (20.27 vs. 8.80 months; p = 0.045). Conclusion In patients with ES-SCLC without baseline BMs, first-line chemoimmunotherapy significantly improves PFS and OS. However, it does not delay intracranial metastasis. The addition of TRT to αPD-L1 + ChT therapy significant delays the development of BMs. Clinical trial number Not applicable.