In this research, we delved into the predictive potential of three key markers – the neutrophil-to-lymphocyte ratio (NLR), systemic immune inflammation index (SII), and Onodera’s prognostic nutritional index (OPNI), in assessing lymph node metastases in breast cancer patients who had internal mammary lymph node involvement following thoracoscopic surgery. Our study revealed notable pathological distinctions between the groups with and without metastases, while age, tumor size, and histological grade exhibited no significant differences. The analysis unveiled statistically significant variances in NLR, SII, and OPNI when comparing these two groups. Multivariate analysis pinpointed NLR (OR = 1.503), SII (OR = 1.987), and OPNI (OR = 0.612) as robust predictors of lymph node metastases. Remarkably, combining these markers (AUC: 0.897) substantially enhanced the precision of predicting lymph node metastases compared to individual measurements (NLR: 0.749, SII: 0.717, and OPNI: 0.787). In conclusion, this study underscores the pivotal role of NLR, SII, and OPNI in predicting lymph node metastasis among breast cancer patients with internal mammary lymph node involvement post-thoracoscopic surgery, affirming our utility as reliable independent predictors of this critical clinical outcome.

Objective To investigate the factors impacting pathological complete remission (ipCR) of the internal mammary lymph nodes in patients with internal mammary lymph node metastasis (IMLN) after adjuvant chemotherapy. Methods Sixty-five cases of primary breast cancer (BC) with IMLN metastasis who had received neoadjuvant chemotherapy (NAC) were retrospectively analyzed. Postoperative pathology was used to divide the patients into ipCR and non-ipCR groups. Univariate and multivariate analyses were performed on ipCR after NAC. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the factors related to ipCR and a Kaplan-Meier curve was used to analyze prognosis. Results Twenty-nine (44.62%) of the 65 female patients received ipCR after NAC. Significant differences in hormone receptor (HR) negative and axillary pathological complete response (apCR) rates between the ipCR and non-ipCR group (P < 0.05). Multivariate logistic regression analysis showed that HR (OR = 2.698) and apCR (OR = 4.546) were the most significant factors that influenced ipCR (P < 0.05). The ROC curves showed that the area under the curves (AUC) for HR and apCR for the prediction of ipCR were 0.744 and 0.735 respectively. The AUC for the combined detection was 0.905. The average disease free survival (DFS) for patients in the ipCR group was 94.0 months which was significantly longer compared to patients in the non-ipCR group (64.2 months) (χ2 = 4.265, P = 0.039). No significant difference in OS was detected between the two groups (P > 0.05). Conclusions ipCR after NAC is correlated with HR and apCR. HR combined with apCR has value in predicting ipCR. ipCR has prognostic value in patients with IMLN metastasis and may have the potential to inform clinical decision-making. Further validation of these findings is required through larger-scale prospective studies.

Pickering emulsions were prepared by phacoemulsification in an ice water bath with squalene as the oil phase and an aluminum adjuvant as the particle stabilizer. The effects of formulation and process conditions on the size and distribution of the Pickering emulsions were investigated. Pickering emulsions prepared under the optimal prescription and process conditions were mixed with a peptide antigen to obtain a peptide vaccine. The optimal prescription and process condition of the Pickering emulsion is as follows: squalene as the oil phase, ultra-pure water as the water phase with 5 mg/mL aluminum adjuvant, and an ultrasonication time of 4 min at 200 W power. BALB/c mice were immunized with the peptide vaccine, and the ability of the Pickering emulsion as an immunological adjuvant to improve the efficacy of the peptide vaccine was evaluated. Under optimal conditions, a Pickering emulsion with a small particle size (430.8 nm), uniform distribution (polydispersion index of 16.9%), and zeta potential of 31.5 mV, was obtained. Immunological results showed that the serum specific antibody level in the vaccinated group reached 1×104 after three immunizations. The proportion of CD4+T cells and CD4/CD8 cells was significantly higher (P<0.05) in the vaccinated groups than the blank control group. Further, cytokine (TNF-α) secretion decreased in the aluminum adjuvant and Pickering emulsion groups but increased in the Freund's adjuvant group. All three vaccinated groups of mice exhibited low but detectable levels of IFN-γ secretion.

Abstract Objective Complete endoscopic radical resection of thyroid cancer, especially through the areolar approach, can achieve curative and acceptable cosmetic effects in patients with differentiated thyroid carcinoma. However, some inherent characteristics of endoscopic procedures hamper functional protection of the recurrent laryngeal nerve (RLN). Intraoperative neuromonitoring (IONM) is considered the most important accessory to protect the nerves during conventional radical thyroidectomy. This study aimed to evaluate the feasibility and necessity of IONM during complete endoscopic radical resection of thyroid cancer. Methods A total of 106 patients with differentiated thyroid carcinoma were enrolled in the study between February 2013 and April 2018. Based on the use of the IONM technique, all patients were divided into the IONM (n = 54) and non‐IONM groups (n = 52). Overall, 66 RLNs were involved in the IONM group, and 61 RLNs were involved in the non‐IONM group. The time and ratio of RLN identification and the number of transient and permanent RLN injuries between both groups were compared. Results Compared to the non‐IONM group, the IONM group required less time for RLN identification (3.05 ± 1.58 vs. 9.36 ± 4.82 min, p < .01). The ratio of RLN identification in the IONM group was much higher than that in the non‐IONM group (100.00% vs. 88.52%, p = .01). A significant difference was observed in RLN transient injury between the two groups (one case accounting for 1.51% in the IONM group vs. eight cases accounting for 13.11% in the non‐IONM group; p = .03). Conclusion IONM significantly improved RLN identification and reduced transient RLN injuries during complete endoscopic radical resection. Level of Evidence 3b.

Background Compound aluminum sulfate injection (CASI) originated from a Chinese traditional medicine, “Kuzhiye”, and has been used in treating non-muscle invasive bladder cancer (NMIBC). Previous studies suggested that CASI was a potential monotherapeutic drug for NMIBC. However, the efficacy and safety of CASI in the treatment of NMIBC, as well as the long-term recurrence after treatment, need to be further evaluated. Methods A multicenter retrospective single-arm cohort study was conducted. From 2006 to 2009, 101 patients (74 men and 27 women, aged 58.9±11.9 years) with T1 or benign NMIBC were enrolled. Each patient was directly injected with CASI through catheter needle into the root of NMIBC. Vital signs, electrocardiography, blood count, blood biochemistry, and urine analysis were re-examined on day 2 and day 14 after CASI injection, together with a cystoscopic examination 4 weeks after CASI treatment was performed for all patients to assess the clinical activity and safety of CASI. To study long-term efficacy, patients in center 2 were followed up for recurrence with a median follow-up time of 13.8 years. Results For the 101 patients enrolled in this study, demographic characteristics in the 3 centers showed no significant differences. After CASI, 2 patients showed administration site-dependent, but not dose-dependent, increase in their aluminum concentration in 24 hours without obvious abnormality in blood biochemistry. The overall effective rate was 97.03%, including complete tumor necrosis in 94 patients. Treatment-related adverse events occurred in 20 patients (19.80%), including 9 drug-related and 11 cystoscopy-related adverse events (AEs). All AEs were endurable and disappeared within 2 weeks without any treatment. The maximum tolerated single dose of CASI was 21 mL. Among the 43 patients at center 2, 3 patients were excluded because they changed to other treatment regimen. As of April 2022, of the 40 patients enrolled, 22 had no recurrence and 7 relapsed. The follow-up time was 2–16.2 years. The other 11 patients were lost to follow up. Conclusions CASI may be an effective and safe option for the treatment of NMIBC and is expected to be a potential monotherapy regimen for NMIBC.

目的 通过生物信息学方法预测新型冠状病毒Omicron变异株的抗原表位,为病毒抗原表位多肽疫苗的设计开发提供依据.方法 以新冠病毒Omicron变异株(GenBank:OM095411.1)为研究对象,利用生物信息学服务器和免疫学工具预测新冠病毒S、M、N、E蛋白的杀伤性T细胞表位、辅助性T细胞表位和线性B细胞表位.同时,基于免疫表位数据库(IEDB)、抗原性预测(Vaxigen)、致敏性预测(AllerTOP)等表位生物学性质分析数据库对候选表位进行生物学性质分析.结果 筛选得到具有抗原性、无毒性或致敏性的杀伤性T细胞表位38个、辅助性T细胞表位15个和线性B细胞表位6个,主要位于S蛋白和M蛋白.结论 抗原表位的预测筛选方法可行,研究筛选出的候选表位,可为开发针对新冠病毒Omicron变异株多肽疫苗提供借鉴.

Background: To investigate the clinical effectiveness of standard procedure in treating children's locally advanced abdominal neuroblastoma (NB).Methods: Totally 71 consective patients with stage III or IV NB received pre-operative chemotherapy first, followed by standard procedure (including skeletalization of retroperitoneal vessles and grid-shaped excision of tumor) to remove the tumors. The results were analysed and compared with findings in literature.Results: The complete resection (CR) rate was 97.2% (69/72), which was significantly higher than those in previous reports. No severe surgical complication or perioperative mortality was reported.Conclusions: Standard procedure can improve CR and survival rates in pediatric patients with locally advanced abdominal NB.

Background: Epitope selection is the key to peptide vaccines development. Bioinformatics tools can efficiently improve the screening of antigenic epitopes and help to choose the right ones. Objective: To predict, synthesize and testify peptide epitopes at spike protein, assess the effect of mutations on epitope humoral immunity, thus provide clues for the design and development of epitope peptide vaccines against SARS-CoV-2.Methods: Bioinformatics servers and immunological tools were used to identify the helper T lymphocyte, cyto-toxic T lymphocyte, and linear B lymphocyte epitopes on the S protein of SARS-CoV-2. Physicochemical prop-erties of candidate epitopes were analyzed using IEDB, VaxiJen, and AllerTOP online software. Three candidate epitopes were synthesized and their antigenic responses were evaluated by binding antibody detection.Results: A total of 20 antigenic, non-toxic and non-allergenic candidate epitopes were identified from 1502 epitopes, including 6 helper T-cell epitopes, 13 cytotoxic T-cell epitopes, and 1 linear B cell epitope. After im-munization with antigen containing candidate epitopes S206-221, S403-425, and S1157-1170 in rabbits, the binding titers of serum antibody to the corresponding peptide, S protein, receptor-binding domain protein were (415044, 2582, 209.3), (852819, 45238, 457767) and (357897, 10528, 13.79), respectively. The binding titers to Omicron S protein were 642, 12,878 and 7750, respectively, showing that N211L, DEL212 and K417N mutations cause the reduction of the antibody binding activity.Conclusions: Bioinformatic methods are effective in peptide epitopes design. Certain mutations of the Omicron would lead to the loss of antibody affinity to Omicron S protein.