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The benefit of neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy for treating cancer of the esophagus or the gastroesophageal junction remains controversial. In the present study, we conducted a comprehensive meta-analysis to examine the efficacy of these two management strategies. The MEDLINE (PubMed), SinoMed, Embase, and Cochrane Library databases were searched for eligible studies. We searched for the most relevant studies published until the end of September 2017. Data were extracted independently and were analyzed using RevMan statistical software version 5.3 (Cochrane Collaboration, http://tech.cochrane.org/revman/download). Weighted mean differences, risk ratios (RRs), and 95% confidence intervals (CIs) were calculated. Cochrane Collaboration's risk of bias tool was used to assess the risk of bias. In this comprehensive meta-analysis, we examined the efficiency of neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy for the treatment of cancer of the esophagus or the gastroesophageal junction as reported in qualified clinical trials. Six qualified articles that included a total of 866 patients were identified. The meta-analysis showed that for 3-year and 5-year survival rates in primary outcomes, the results favored neoadjuvant chemoradiotherapy strategies compared with neoadjuvant chemotherapy (RR = 0.78, 95% CI = 0.62-0.98, P = 0.03; RR = 0.69, 95% CI = 0.50-0.96, P = 0.03, respectively). In terms of secondary outcomes, neoadjuvant chemoradiotherapy significantly increased the rate of R0 resection and pathological complete response as well (RR = 0.87, 95% CI = 0.81-0.92, P < 0.0001; RR = 0.16, 95% CI = 0.09-0.28, P < 0.00001, respectively). However, there were no significant differences in postoperative mortality between the two groups (RR = 1.85, 95% CI = 0.93-3.65, P = 0.08). For the results of postoperative complications, revealed that there was a statistically significant difference between the two groups in the incidence of postoperative complications such as pulmonary, anastomotic leak and cardiovascular complications. The subgroup analysis of patients with esophageal adenocarcinoma or squamous cell carcinoma showed that both esophageal adenocarcinoma and squamous cell carcinoma patients achieved a high rate of R0 resection (RR = 0.85, 95% CI = 0.77-0.93, P = 0.0006; RR = 0.88, 95% CI = 0.81-0.96, P = 0.005, respectively) and pathological complete response benefit of neoadjuvant chemoradiotherapy (RR = 0.23, 95% CI = 0.09-0.57, P = 0.001; RR = 0.18, 95% CI = 0.03-0.96, P = 0.05, respectively). Our findings suggested that compared with neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy should be recommended with a significant long-term survival benefit in patients with cancer of the esophagus or the gastroesophageal junction. In view of the clinical heterogeneity, whether these conclusions are broadly applicable should be further determined.

The peritoneum is a frequently involved site of metastasis in gastrointestinal malignancies, posing a major risk to human health. In recent years, treatment methods such as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have significantly prolonged the survival time of patients with gastrointestinal peritoneal metastases. With the continuous advancements in comprehensive treatment for peritoneal cancer, targeted therapy and immunotherapy are gradually being applied to patients with gastrointestinal peritoneal metastases. Gastrointestinal peritoneal metastases are now widely acknowledged as a regional abdominal disease. Consequently, preventing both localized abdominal and systemic recurrences has become a central focus in their diagnosis and management. This article systematically reviews the recurrence patterns of gastrointestinal peritoneal metastatic tumors following surgery, with an emphasis on intraperitoneal, single-site, and multi-site recurrence patterns. It also discusses factors influencing the time to recurrence, such as the degree of cytoreduction and the type of chemotherapy used. The importance of assessment tools for recurrence, such as tumor marker detection, imaging, and laparoscopy, is emphasized. Additionally, strategies for preventing recurrence are outlined, including tumor-free principles, adjuvant chemotherapy, HIPEC, and integrated traditional Chinese and Western medicine. The article highlights new advances in targeted therapy and immunotherapy, aiming to provide guidance for clinical practice and future research.

Immune checkpoint inhibitors (ICIs) combined with chemotherapy have become an important area of clinical investigation in the gastric cancer (GC) and gastroesophageal junction cancer (GEJC). In recent years, bispecific antibody therapies have been increasingly explored, including cadonilimab, a programmed death-1/cytotoxic T-lymphocyte-associated antigen 4 (PD-1/CTLA-4) bispecific antibody. Several phase II studies have reported early signals of antitumor activity with cadonilimab, prompting clinical interest in this strategy. However, treatment outcomes vary across studies, and a systematic assessment of the efficacy and safety of cadonilimab plus chemotherapy remains limited. This study aimed to evaluate the efficacy and safety profile of cadonilimab in combination with chemotherapy for gastric adenocarcinoma and gastroesophageal junction adenocarcinoma (G/GEJ adenocarcinoma) through a single-arm meta-analysis. A systematic search was conducted in PubMed, Embase, the Cochrane Library, Web of Science, and ClinicalTrials.gov to identify eligible studies published up to July 20, 2025. A single-arm meta-analysis was performed to pool and evaluate the objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), pathological complete response (pCR), and the incidence of grade ≥3 treatment-related adverse events (TRAEs). A total of four clinical studies involving 182 patients were included. The pooled estimates were an ORR of 57% (95% CI: 48%-66%), a DCR of 97% (95% CI: 84%-100%), a pCR of 23% (95% CI: 12%-35%), and a median PFS of 7.98 months (95% CI: 6.38-9.57). The overall incidence of grade ≥3 TRAEs was 35% (95% CI: 7%-63%). In subgroup analyses, the incidence of grade ≥3 TRAEs appeared lower in the neoadjuvant setting than in the first-line setting (29% [95% CI: 28%-40%] vs 53% [95% CI: 45%-60%]). The most frequently reported adverse events included nausea (72%), vomiting (60%), neutropenia (51%), and leukopenia (45%). Based on available early-phase evidence, cadonilimab plus chemotherapy showed antitumor activity with a manageable safety profile in G/GEJ adenocarcinoma. Further large-scale, high-quality randomized controlled trials are needed to validate these findings and define the optimal treatment strategy. https://www.crd.york.ac.uk/PROSPERO, identifier CRD420251089855.

Omicron variants of SARS-CoV-2 have spread rapidly worldwide; however, most infected patients have mild or no symptoms. This study aimed to understand the host response to Omicron infections by performing metabolomic profiling of plasma. We observed that Omicron infections triggered an inflammatory response and innate immune, and adaptive immunity was suppressed, including reduced T-cell response and immunoglobulin antibody production. Similar to the original SARS-CoV-2 strain circulating in 2019, the host developed an anti-inflammatory response and accelerated energy metabolism in response to Omicron infection. However, differential regulation of macrophage polarization and reduced neutrophil function has been observed in Omicron infections. Interferon-induced antiviral immunity was not as strong in Omicron infections as in the original SARS-CoV-2 infections. The host response to Omicron infections increased antioxidant capacity and liver detoxification more than in the original strain. Hence, these findings suggest that Omicron infections cause weaker inflammatory alterations and immune responses than the original SARS-CoV-2 strain.

In this study, microcrystalline cellulose modified with Fe3O4 and polyethyleneimine (Fe3O4/MCC-PEI(70K-5)) was synthesized for Congo red (CR) adsorption. Various batch experiments were conducted to explore the effects of initial concentration, contact time, solution pH, and cationic concentration. The results showed that the adsorption process of CR onto Fe3O4/MCC-PEI(70K-5) were spontaneous and endothermic, and strictly followed pseudo-second-order and Freundlich models. The equilibrium time of CR adsorption onto Fe3O4/MCC-PEI(70K-5) at 298 K was 100 min and the maximum adsorption capacity was 862.25 mg/g. Zeta-potential, XPS, and FT-IR analyses proved that the adsorption behavior was primarily ascribed to the electrostatic interactions between Fe3O4/MCC-PEI(70K-5) and CR molecules. Additionally, Fe3O4/MCC-PEI(70K-5) has a good performance of regeneration and reuse, which maintained a high adsorption capacity even after five consecutive regenerations.

In advanced spectroscopy, the classical symmetric optical frequency comb is limited in temporal flexibility and selection freedom, which constrains the efficiency and stability of quantum manipulation. To overcome this limitation, we propose a method to realize precise energy-level manipulation using a femtosecond non-temporally symmetric optical frequency comb in the semiclassical three-level system. Numerical calculations show that the fall time of the pulse is the key parameter to realize the precise manipulation, and a shorter fall time contributes to the efficient accumulation of population. By optimizing the pulse parameters, 99.15% accumulation of population in the target state can be successfully achieved and stably maintained using an asymmetric slowly turned-on and rapidly turned-off (STRT) pulse train. Our demonstration of the non-temporally symmetric optical frequency comb provides a promising approach to efficient quantum-state preparation using spectral modulation.

Most patients with cholangiocarcinoma (CCA) develop extrahepatic malignant biliary obstructions, which require palliative drainage to normalize bilirubin levels and to improve the patients’ overall survival. Here, we report that the infusion of methotrexate-containing plasma-membrane microvesicles derived from apoptotic human tumour cells into the bile-duct lumen of patients with extrahepatic CCA mobilized and activated neutrophils and relieved biliary obstruction in 25% of the patients. Neutrophil recruitment by the microvesicles was associated with an increase in uridine diphosphate glucose and complement C5, and led to the degradation of the stromal barrier of CCA. The microvesicles induced pyroptosis of CCA cells through a gasdermin E-dependent pathway, and their intracellular contents released upon CCA-cell death activated patient-derived macrophages into producing proinflammatory cytokines, which attracted a secondary wave of neutrophils to the tumour site. Our findings suggest a possible treatment for the alleviation of obstructive extrahepatic CCA with few adverse effects, and highlight the potential of tumour-cell-derived microvesicles as drug carriers for antitumour therapies. Methotrexate-loaded tumour-cell-derived microvesicles induce neutrophil-mediated antitumour activity and can relieve biliary obstructions in patients with extrahepatic cholangiocarcinoma.

In this study, the polyethyleneimine (PEI) modified waste bamboo powder (WBP-Na-PEI) was successfully prepared and applied to adsorbing Congo red (CR) dye from aqueous solution. The obtained materials were characterized by field emission scanning electron microscope, X-ray diffraction, Fourier transform-infrared, and thermogravimetric analysis. The results showed that WBP-Na-PEI(1.8 K-5) was synthesized successfully and PEI uniformly covered the WBP-Na-PEI(1.8 K-5) surface. In the process of adsorption, four kinds of influencing factors were discussed, and the adsorption mechanisms such as kinetics, isotherm, thermodynamics were explored. The maximum adsorption capacity of WBP-Na-PEI(1.8 K-5) was 992.94 mg·g−1 at 298 ± 1 K, and the removal efficiency was over 98%. Pseudo-first-order, pseudo-second-order and intra-particle diffusion models were studied, the results showed that the adsorption process conformed to the pseudo-second-order model, and the rate of this process was controlled by many steps. Furthermore, the removal efficiency of the adsorption kinetics reached 85% within 10 minutes. The results of the isotherm model and thermodynamics showed that the adsorption process was consistent with the Langmuir model and was mainly a spontaneous chemical endothermic process of monolayer. And the removal efficiency of the adsorbent reached 93% at the concentration of 400 mg/L, which can be expected to have a broad prospect in the treatment of CR industrial wastewater.

The SARS-CoV-2 Omicron variant evades most currently approved neutralizing antibodies (nAbs) and caused drastic decrease of plasma neutralizing activity elicited by vaccination or prior infection, urging the need for the development of pan-variant antivirals. Breakthrough infection induces a hybrid immunological response with potentially broad, potent and durable protection against variants, therefore, convalescent plasma from breakthrough infection may provide a broadened repertoire for identifying elite nAbs. We performed single-cell RNA sequencing (scRNA-seq) and BCR sequencing (scBCR-seq) of B cells from BA.1 breakthrough-infected patients who received 2 or 3 previous doses of inactivated vaccine. Elite nAbs, mainly derived from the IGHV2–5 and IGHV3-66/53 germlines, showed potent neutralizing activity across Wuhan-Hu-1, Delta, Omicron sublineages BA.1 and BA.2 at picomolar NT 50 values. Cryo-EM analysis revealed diverse modes of spike recognition and guides the design of cocktail therapy. A single injection of paired antibodies cocktail provided potent protection in the K18-hACE2 transgenic female mouse model of SARS-CoV-2 infection. In this study, the authors isolated and characterized neutralizing antibodies from vaccinated individuals with SARS-CoV-2 BA.1 breakthrough infection and show that elite antibodies derived from specific germlines provide potent pan-variant neutralization capacity and in vivo protection.

AbstractAcute lung injury (ALI) is a common lung disease characterized by severe acute inflammatory lung injury in patients with sepsis. Syringaresinol (SYR) has been reported to have anti-apoptotic and anti-inflammatory effects, but whether it could prevent pyroptosis to improve sepsis-induced ALI remains unclear. The purpose of this work was to examine the impact of SYR on sepsis-induced ALI and investigate the underlying mechanisms. The ALI model was induced by caecal ligation and puncture (CLP) in C57BL/6 mice, structural damage in the lung tissues was determined using haematoxylin and eosin (HE) staining, and the levels of related inflammatory cytokines and macrophage polarization were examined by enzyme-linked immunosorbent assays (ELISAs) and flow cytometry, respectively. The activation of the NLRP3 inflammasome and the protein levels of TLR4, NF-κB and MAPKs was measured by western blotting. The results demonstrated that SYR pretreatment significantly reduced lung tissue histological damage, inhibited the production of proinflammatory cytokines and albumin in bronchoalveolar lavage fluid (BALF), and decreased myeloperoxidase (MPO) levels, thereby alleviating lung tissue injury. Meanwhile, septic mice treated with SYR displayed a higher survival rate and lower percentage of M1 macrophages in the BALF and spleen than septic mice. In addition, lung tissues from the CLP + SYR group exhibited downregulated protein expression of NLRP3, ASC, GSDMD caspase-1 p20 and TLR4, along with decreased phosphorylated levels of NF-κB, ERK, JNK and P38, indicating that SYR administration effectively prevented CLP-induced pyroptosis in the lung. SYR also suppressed LPS-induced pyroptosis in RAW 264.7 cells by inhibiting the activation of the NLRP3 inflammasome, which was abolished by an oestrogen receptor-β (ERβ) antagonist (PHTPP). In conclusion, SYR exerted protective effects on CLP-induced ALI via the oestrogen receptor-β signalling pathway.