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Promoting active health with AI technologies: Current status and prospects of high-altitude therapy, simulated hypoxia, and LLM-driven lifestyle rehabilitation approaches. 用人工智能技术促进积极健康:高原治疗、模拟缺氧和llm驱动的生活方式康复方法的现状和前景
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-07-04 Epub Date: 2025-04-29 DOI: 10.5582/bst.2025.01105
Mingyu Liu, Wenli Zhang, Junyu Wang, Kehan Bao, Ziyi Fu, Boyuan Wang

In the context of the rising global prevalence of obesity, traditional intervention measures have proven insufficient to meet the demands of personalized and sustainable health management, necessitating the exploration of innovative solutions through innovative technologies. This study explores how advanced digital technologies, including Internet of Things (IoT) and Artificial Intelligence (AI), can manage weight and enhance full-lifecycle health in individuals with obesity under simulated high-altitude hypoxic conditions (HC). The findings suggest that integrating simulated HC with digital health technologies offers a novel and safe approach to obesity rehabilitation. By leveraging environmental stimuli, real-time monitoring through wearable devices, and intelligent evaluation using large language models (LLMs), this method enables more scientific weight loss, prevents rebound weight gain, and fosters proactive healthy lifestyles, significantly improving weight control outcomes for individuals with obesity. Future research should evaluate the efficacy of simulated HC in weight management and its long-term impact on obesity control. Establishing an integrated framework that combines simulated HC, lifestyle interventions, and smart health ecosystems is crucial for advancing rehabilitative healthcare and addressing the global burden of obesity through digital innovation.

在全球肥胖患病率不断上升的背景下,传统的干预措施已不足以满足个性化和可持续健康管理的需求,需要通过创新技术探索创新解决方案。本研究探讨了包括物联网(IoT)和人工智能(AI)在内的先进数字技术如何在模拟高海拔缺氧条件(HC)下管理体重并增强肥胖个体的全生命周期健康。研究结果表明,将模拟HC与数字健康技术相结合,为肥胖康复提供了一种新颖而安全的方法。该方法通过利用环境刺激、可穿戴设备实时监测和大型语言模型智能评估,实现更科学的减肥,防止反弹性体重增加,培养积极的健康生活方式,显著改善肥胖个体的体重控制结果。未来的研究应评估模拟HC在体重管理中的功效及其对肥胖控制的长期影响。建立一个结合模拟HC、生活方式干预和智能健康生态系统的综合框架,对于推进康复医疗和通过数字创新解决全球肥胖负担至关重要。
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引用次数: 0
Traditional Chinese medicine modulates hypothalamic neuropeptides for appetite regulation: A comprehensive review. 中药调节下丘脑神经肽对食欲的调节:综述。
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-07-04 Epub Date: 2025-06-15 DOI: 10.5582/bst.2025.01087
Yuqi Wang, Fanghua Qi, Min Li, Yuan Xu, Li Dong, Pingping Cai

Obesity has emerged as a global health crisis, imposing substantial burdens on both individual well-being and socioeconomic development. The pathogenesis of obesity primarily stems from disrupted energy homeostasis, wherein the hypothalamus plays a pivotal role through its complex neuropeptide networks that regulate appetite and energy balance. Recent advances have highlighted the therapeutic potential of traditional Chinese medicine (TCM) in modulating hypothalamic appetite regulation. This comprehensive review systematically evaluates current evidence from PubMed and China National Knowledge Infrastructure databases, focusing on the mechanisms by which TCM interventions influence hypothalamic neuropeptide signaling pathways. Our analysis reveals that various TCM modalities, including bioactive compounds (e.g., berberine and, evodiamine), herbal formulations (e.g., Pingwei Powder, Fangji Huangqi Decoction), plant extracts (e.g., Cyclocarya paliurus aqueous extract), and Chinese patent medicines (e.g., Danzhi Jiangtang Capsules and Jingui Shenqi Pills), have significant effects on key appetite-regulating pathways. These effects are mediated through modulation of critical neuropeptide systems, particularly AgRP/NPY and POMC/CART neurons, as well as leptin signaling. These findings not only provide mechanistic insights into TCM's anti-obesity effects but also demonstrate the value of integrating traditional medicine with modern pharmacological approaches. The synergistic potential of TCM formulas, when combined with contemporary research methodologies, offers promising avenues for developing novel therapeutic strategies for obesity and related metabolic disorders.

肥胖已成为全球健康危机,给个人福祉和社会经济发展带来沉重负担。肥胖的发病机制主要源于能量稳态的破坏,其中下丘脑通过其复杂的神经肽网络发挥关键作用,调节食欲和能量平衡。近年来的研究进展强调了中药在调节下丘脑食欲方面的治疗潜力。本综述系统评估了PubMed和中国国家知识基础设施数据库的现有证据,重点关注中医药干预影响下丘脑神经肽信号通路的机制。我们的分析显示,各种中药剂型,包括生物活性化合物(如小檗碱和evodiamine)、草药制剂(如平胃散、方鸡黄芪汤)、植物提取物(如环己烷水提物)和中成药(如丹栀降糖胶囊和金桂参芪丸),对关键的食欲调节途径都有显著影响。这些作用是通过调节关键神经肽系统介导的,特别是AgRP/NPY和POMC/CART神经元,以及瘦素信号传导。这些发现不仅提供了中医抗肥胖作用的机制见解,而且证明了传统医学与现代药理学方法相结合的价值。中药方剂的协同潜力,与当代研究方法相结合,为开发肥胖症和相关代谢紊乱的新治疗策略提供了有希望的途径。
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引用次数: 0
Advances in research on receptor heterogeneity in breast cancer liver metastasis. 乳腺癌肝转移受体异质性的研究进展。
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-05-09 Epub Date: 2025-04-15 DOI: 10.5582/bst.2025.01046
Qinyu Liu, Runze Huang, Xin Jin, Xuanci Bai, Wei Tang, Lu Wang, Kenji Karako, Weiping Zhu

Breast cancer liver metastasis (BCLM) presents a critical challenge in breast cancer treatment and has substantial epidemiological and clinical significance. Receptor status is pivotal in managing both primary breast cancer and its liver metastases. Moreover, shifts in these statuses can have a profound impact on patient treatment strategies and prognoses. Research has indicated that there is significant heterogeneity in receptor status between primary breast cancer and liver metastases. This variation may be influenced by a multitude of factors, such as therapeutic pressure, inherent tumor heterogeneity, clonal evolution, and the unique microenvironment of the liver. Changes in the receptor status of BCLM are crucial for adjusting treatment strategies, and liver biopsy plays an important role in the treatment process. Directions for future research targeting changes in receptor status include in-depth study of molecular mechanisms, combined treatment strategies for receptor status reversal, development of artificial intelligence deep learning models to predict receptor status in liver metastases, and clinical research on new drug development and combination therapies. That research will provide more precise treatment strategies for patients with BCLM and improve their prognosis.

乳腺癌肝转移(Breast cancer liver metastasis, BCLM)是乳腺癌治疗的一个重要挑战,具有重要的流行病学和临床意义。受体状态在原发性乳腺癌及其肝转移的治疗中起关键作用。此外,这些状态的变化会对患者的治疗策略和预后产生深远的影响。研究表明,原发性乳腺癌和肝转移性乳腺癌的受体状态存在显著的异质性。这种变异可能受到多种因素的影响,如治疗压力、固有的肿瘤异质性、克隆进化和肝脏独特的微环境。BCLM受体状态的变化对调整治疗策略至关重要,肝活检在治疗过程中起着重要作用。未来针对受体状态变化的研究方向包括深入研究分子机制、受体状态逆转的联合治疗策略、开发人工智能深度学习模型预测肝转移中受体状态、新药开发和联合治疗的临床研究等。该研究将为BCLM患者提供更精确的治疗策略并改善其预后。
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引用次数: 0
Exosomes derived from olfactory mucosa mesenchymal stem cells attenuate cognitive impairment in a mouse model of Alzheimer's disease. 来自嗅觉粘膜间充质干细胞的外泌体减轻阿尔茨海默病小鼠模型的认知障碍。
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-05-09 Epub Date: 2025-03-18 DOI: 10.5582/bst.2025.01065
Xiqi Hu, Ya-Nan Ma, Jun Peng, Zijie Wang, Yuchang Liang, Ying Xia

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, neuroinflammation, and endoplasmic reticulum (ER) stress. In recent years, exosomes have garnered significant attention as a potential therapeutic tool for neurodegenerative diseases. This study, for the first time, investigates the neuroprotective effects of exosomes derived from olfactory mucosa mesenchymal stem cells (OM-MSCs-Exos) in AD and further explore the potential role of low-density lipoprotein receptor-related protein 1 (LRP1) in this process. Using an Aβ1-42-induced AD mouse model, we observed that OM-MSCs-Exos significantly improved cognitive function in behavioral tests, reduced neuroinflammatory responses, alleviated ER stress, and decreased neuronal apoptosis. Further analysis revealed that OM-MSCs-Exos exert neuroprotective effects by modulating the activation of microglia and astrocytes and influencing the ER stress response, a process that may involve LRP1. Although these findings support the potential neuroprotective effects of OM-MSCs-Exos, further studies are required to explore their long-term stability, dose dependency, and immunogenicity to assess their feasibility for clinical applications.

阿尔茨海默病(AD)是一种以认知能力下降、神经炎症和内质网应激为特征的进行性神经退行性疾病。近年来,外泌体作为神经退行性疾病的潜在治疗工具引起了极大的关注。本研究首次探讨了嗅粘膜间充质干细胞外泌体(OM-MSCs-Exos)在AD中的神经保护作用,并进一步探讨了低密度脂蛋白受体相关蛋白1 (LRP1)在这一过程中的潜在作用。通过a β1-42诱导的AD小鼠模型,我们观察到om - msc - exos显著改善行为测试中的认知功能,减少神经炎症反应,减轻内质网应激,减少神经元凋亡。进一步分析表明,om - msc - exos通过调节小胶质细胞和星形胶质细胞的激活并影响内质网应激反应来发挥神经保护作用,这一过程可能与LRP1有关。尽管这些发现支持om - msc - exos潜在的神经保护作用,但仍需进一步研究其长期稳定性、剂量依赖性和免疫原性,以评估其临床应用的可行性。
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引用次数: 0
Comparative analysis of human gut bacterial microbiota between shallow shotgun metagenomic sequencing and full-length 16S rDNA amplicon sequencing. 浅层霰弹枪宏基因组测序与16S rDNA全长扩增子测序对人肠道菌群的比较分析。
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-05-09 Epub Date: 2025-04-04 DOI: 10.5582/bst.2024.01393
Suwalak Chitcharoen, Vorthon Sawaswong, Pavit Klomkliew, Prangwalai Chanchaem, Sunchai Payungporn

The human gut microbiome is increasingly recognized as important to health and disease, influencing immune function, metabolism, mental health, and chronic illnesses. Two widely used, cost-effective, and fast approaches for analyzing gut microbial communities are shallow shotgun metagenomic sequencing (SSMS) and full-length 16S rDNA sequencing. This study compares these methods across 43 stool samples, revealing notable differences in taxonomic and species-level detection. At the genus level, Bacteroides was most abundant in both methods, with Faecalibacterium showing similar trends but Prevotella was more abundant in full-length 16S rDNA. Genera such as Alistipes and Akkermansia were more frequently detected by full-length 16S rDNA, whereas Eubacterium and Roseburia were more prevalent in SSMS. At the species level, Faecalibacterium prausnitzii, a key indicator of gut health, was abundant across both datasets, while Bacteroides vulgatus was more frequently detected by SSMS. Species within Parabacteroides and Bacteroides were primarily detected by 16S rDNA, contrasting with higher SSMS detection of Prevotella copri and Oscillibacter valericigenes. LEfSe analysis identified 18 species (9 species in each method) with significantly different detection between methods, underscoring the impact of methodological choice on microbial diversity and abundance. Differences in classification databases, such as Ribosomal Database Project (RDP) for 16S rDNA and Kraken2 for SSMS, further highlight the influence of database selection on outcomes. These findings emphasize the importance of carefully selecting sequencing methods and bioinformatics tools in microbiome research, as each approach demonstrates unique strengths and limitations in capturing microbial diversity and relative abundances.

人类肠道微生物群对健康和疾病越来越重要,影响免疫功能、代谢、心理健康和慢性疾病。浅层散弹枪宏基因组测序(SSMS)和全长16S rDNA测序是两种广泛使用、经济高效且快速的肠道微生物群落分析方法。这项研究比较了43个粪便样本的这些方法,揭示了分类和物种水平检测的显着差异。在属水平上,两种方法中拟杆菌属(Bacteroides)的丰度最高,Faecalibacterium的趋势相似,但普雷沃特菌(Prevotella)在全长16S rDNA中丰度更高。全长16S rDNA检测到Alistipes和Akkermansia属较多,而Eubacterium和Roseburia属在SSMS中较多。在物种水平上,Faecalibacterium prausnitzii(肠道健康的关键指标)在两个数据集中都很丰富,而Bacteroides vulgatus在SSMS中检测到的频率更高。拟杆菌门和拟杆菌门中主要采用16S rDNA检测,而copri Prevotella和valericigenes Oscillibacter的SSMS检出率较高。LEfSe分析共鉴定出18种(每种方法9种),不同方法之间的检测结果差异显著,说明方法选择对微生物多样性和丰度的影响。分类数据库的差异,如16S rDNA的核糖体数据库项目(RDP)和SSMS的Kraken2,进一步突出了数据库选择对结果的影响。这些发现强调了在微生物组研究中仔细选择测序方法和生物信息学工具的重要性,因为每种方法在捕获微生物多样性和相对丰度方面都表现出独特的优势和局限性。
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引用次数: 0
Artificial intelligence in colorectal cancer liver metastases: From classification to precision medicine. 人工智能在大肠癌肝转移中的应用:从分类到精准医学。
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-05-09 Epub Date: 2025-04-15 DOI: 10.5582/bst.2025.01045
Runze Huang, Xin Jin, Qinyu Liu, Xuanci Bai, Kenji Karako, Wei Tang, Lu Wang, Weiping Zhu

Colorectal cancer liver metastasis (CRLM) remains the leading cause of mortality among colorectal cancer (CRC) patients, with more than half eventually developing hepatic metastases. Achieving long-term survival in CRLM necessitates early detection, robust stratification, and precision treatment tailored to individual classifications. These processes encompass critical aspects such as tumor staging, predictive modeling of therapeutic responses, and risk stratification for survival outcomes. The rapid evolution of artificial intelligence (AI) has ushered in unprecedented opportunities to address these challenges, offering transformative potential for clinical oncology. This review summarizes the current methodologies for CRLM grading and classification, alongside a detailed discussion of the machine learning models commonly used in oncology and AI-driven applications. It also highlights recent advances in using AI to refine CRLM subtyping and precision medicine approaches, underscoring the indispensable role of interdisciplinary collaboration between clinical oncology and the computational sciences in driving innovation and improving patient outcomes in metastatic colorectal cancer.

结直肠癌肝转移(CRLM)仍然是结直肠癌(CRC)患者死亡的主要原因,超过一半的患者最终发展为肝转移。为了实现CRLM的长期生存,需要早期发现、稳健的分层和针对个体分类的精确治疗。这些过程包括肿瘤分期、治疗反应的预测模型和生存结果的风险分层等关键方面。人工智能(AI)的快速发展为应对这些挑战带来了前所未有的机遇,为临床肿瘤学提供了变革潜力。本文总结了目前CRLM分级和分类的方法,并详细讨论了肿瘤学和人工智能驱动应用中常用的机器学习模型。它还强调了利用人工智能改进CRLM亚型和精准医学方法的最新进展,强调了临床肿瘤学和计算科学之间的跨学科合作在推动创新和改善转移性结直肠癌患者预后方面的不可或缺的作用。
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引用次数: 0
Combating syphilis resurgence: China's multifaceted approach. 抗击梅毒复发:中国多管齐下。
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-05-09 Epub Date: 2025-01-27 DOI: 10.5582/bst.2024.01382
Rongfeng Zhou, Kai Sun, Ting Li, Hongzhou Lu

Syphilis, a chronic infection caused by Treponema pallidum, is experiencing a global resurgence, posing significant public health challenges. This study examined the escalating trends of syphilis in the United States, China, and some other countries highlighting the impact of the COVID-19 pandemic, changes in sexual behavior, coinfection with the other infectious diseases such as AIDs, and the role of public health funding. The analysis revealed a stark increase in syphilis cases, particularly among high-risk groups such as men who have sex with men (MSM). China's National Syphilis Control Program (NSCP), initiated in 2010, is a comprehensive approach to syphilis management that incorporates health education, access to testing and treatment, partner notification, safe sex promotion, community interventions, and stigma reduction. The success of the NSCP in reducing early syphilis incidence rates and congenital syphilis in Guangdong Province, that may be served as a model for international syphilis control efforts. This study highlights the necessity for targeted public health interventions and the importance of robust healthcare infrastructure in combating the syphilis epidemic.

梅毒是一种由梅毒螺旋体引起的慢性感染,正在全球范围内死灰复燃,对公共卫生构成重大挑战。本研究调查了梅毒在美国、中国和其他一些国家的上升趋势,强调了COVID-19大流行的影响、性行为的变化、与艾滋病等其他传染病的合并感染以及公共卫生资金的作用。分析显示梅毒病例明显增加,特别是在高危人群中,如男男性行为者(MSM)。中国国家梅毒控制规划(NSCP)于2010年启动,是一项综合梅毒管理方法,包括健康教育、获得检测和治疗、伴侣通知、安全性行为宣传、社区干预和减少耻辱感。该项目成功降低了广东省早期梅毒和先天性梅毒的发病率,可作为国际梅毒控制工作的典范。这项研究强调了有针对性的公共卫生干预的必要性和强大的医疗基础设施在抗击梅毒流行中的重要性。
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引用次数: 0
Investigating perioperative pressure injuries and factors influencing them with imbalanced samples using a Synthetic Minority Over-sampling Technique. 应用合成少数过采样技术研究不平衡样本围手术期压力损伤及其影响因素。
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-05-09 Epub Date: 2025-04-15 DOI: 10.5582/bst.2025.01013
Yiwei Zhou, Jian Wu, Xin Xu, Guirong Shi, Ping Liu, Liping Jiang

This study investigates the use of machine learning (ML) models combined with a Synthetic Minority Over-sampling Technique (SMOTE) and its variants to predict perioperative pressure injuries (PIs) in an imbalanced dataset. PIs are a significant healthcare problem, often leading to prolonged hospitalization and increased medical costs. Conventional risk assessment scales are limited in their ability to predict PIs accurately, prompting the exploration of ML techniques to address this challenge.We utilized data from 7,292 patients admitted to a tertiary care hospital in Shanghai between May 2017 and July 2023, with a final dataset of 2,972 patients, including 158 with PIs. Seven ML algorithms-Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), Extreme Gradient Boosting (XGBoost), Extra Trees (ET), K-Nearest Neighbors (KNN), and Decision Trees (DT)-were used in conjunction with SMOTE, SMOTE+ENN, Borderline-SMOTE, ADASYN, and GAN to balance the dataset and improve model performance.Results revealed significant improvements in model performance when SMOTE and its variants were used. For instance, the XGBoost model hadan AUC of 0.996 with SMOTE, compared to 0.800 on raw data. SMOTE+ENN and Borderline-SMOTE further enhanced the models' ability to identify minority classes. External validation indicatedthat XGBoost, RF, and ET exhibited the highest stability and accuracy, with XGBoost having an AUC of 0.977. SHAP analysis revealed that factors such as anesthesia grade, age, and serum albumin levels significantly influenced model predictions.In conclusion, integrating SMOTE with ML algorithms effectively addressed a data imbalance and improved the prediction of perioperative PIs. Future work should focus on refining SMOTE techniques and exploring their application to larger, multi-center datasets to enhance the generalizability of these findings, and especially for diseaseswith a lowincidence.

本研究探讨了机器学习(ML)模型结合合成少数过采样技术(SMOTE)及其变体在不平衡数据集中预测围手术期压力损伤(pi)的使用。pi是一个严重的保健问题,经常导致住院时间延长和医疗费用增加。传统的风险评估量表在准确预测pi方面的能力有限,这促使ML技术的探索来应对这一挑战。我们使用了2017年5月至2023年7月期间入住上海一家三级医院的7292名患者的数据,最终数据集为2972名患者,其中包括158名pi患者。七种ML算法——支持向量机(SVM)、逻辑回归(LR)、随机森林(RF)、极端梯度增强(XGBoost)、额外树(ET)、k -近邻(KNN)和决策树(DT)——与SMOTE、SMOTE+ENN、Borderline-SMOTE、ADASYN和GAN一起使用,以平衡数据集并提高模型性能。结果显示,当使用SMOTE及其变体时,模型性能有显著改善。例如,XGBoost模型在SMOTE上的AUC为0.996,而在原始数据上为0.800。SMOTE+ENN和Borderline-SMOTE进一步增强了模型识别少数族裔的能力。外部验证表明,XGBoost、RF和ET具有最高的稳定性和准确性,其中XGBoost的AUC为0.977。SHAP分析显示,麻醉等级、年龄和血清白蛋白水平等因素显著影响模型预测。综上所述,SMOTE与ML算法的结合有效地解决了数据不平衡问题,提高了围手术期pi的预测。未来的工作应侧重于完善SMOTE技术,并探索其在更大的多中心数据集上的应用,以增强这些发现的普遍性,特别是对于低发病率的疾病。
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引用次数: 0
Development and validation of a nomogram model for predicting immune-mediated hepatitis in cancer patients treated with immune checkpoint inhibitors. 开发和验证一个nomogram模型,用于预测接受免疫检查点抑制剂治疗的癌症患者的免疫介导性肝炎。
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-05-09 Epub Date: 2025-02-01 DOI: 10.5582/bst.2024.01351
Qianjie Xu, Xiaosheng Li, Yuliang Yuan, Zuhai Hu, Wei Zhang, Ying Wang, Ai Shen, Haike Lei

Immune checkpoint inhibitors (ICIs) have been widely used in various types of cancer, but they have also led to a significant number of adverse events, including ICI-induced immune-mediated hepatitis (IMH). This study aimed to explore the risk factors for IMH in patients treated with ICIs and to develop and validate a new nomogram model to predict the risk of IMH. Detailed information was collected between January 1, 2020, and December 31, 2023. Univariate logistic regression analysis was used to assess the impact of each clinical variable on the occurrence of IMH, followed by stepwise multivariate logistic regression analysis to determine independent risk factors for IMH. A nomogram model was constructed based on the results of the multivariate analysis. The performance of the nomogram model was evaluated via the area under the receiver operating characteristic curve (AUC), calibration curves, decision curve analysis (DCA), and clinical impact curve (CIC) analysis. A total of 216 (8.82%) patients developed IMH. According to stepwise multivariate logistic analysis, hepatic metastasis, the TNM stage, the WBC count, LYM, ALT, TBIL, ALB, GLB, and ADA were identified as risk factors for IMH. The AUC for the nomogram model was 0.817 in the training set and 0.737 in the validation set. The calibration curves, DCA results, and CIC results indicated that the nomogram model had good predictive accuracy and clinical utility. The nomogram model is intuitive and straightforward, making it highly suitable for rapid assessment of the risk of IMH in patients receiving ICI therapy in clinical practice. Implementing this model enables early adoption of preventive and therapeutic strategies, ultimately reducing the likelihood of immune-related adverse events (IRAEs), and especially IMH.

免疫检查点抑制剂(ici)已广泛用于各种类型的癌症,但它们也导致了大量的不良事件,包括ici诱导的免疫介导性肝炎(IMH)。本研究旨在探讨接受ici治疗的患者发生IMH的危险因素,并建立和验证一种新的nomogram模型来预测IMH的风险。详细信息收集于2020年1月1日至2023年12月31日之间。采用单因素logistic回归分析评估各临床变量对IMH发生的影响,然后采用逐步多因素logistic回归分析确定IMH的独立危险因素。根据多变量分析结果,建立了nomogram模型。通过受试者工作特征曲线(AUC)下面积、校准曲线、决策曲线分析(DCA)和临床影响曲线(CIC)分析来评价nomogram模型的性能。共有216例(8.82%)患者发生IMH。根据逐步多因素logistic分析,肝转移、TNM分期、WBC计数、LYM、ALT、TBIL、ALB、GLB和ADA是IMH的危险因素。模态图模型在训练集中的AUC为0.817,在验证集中的AUC为0.737。校正曲线、DCA结果和CIC结果表明,nomogram模型具有良好的预测准确性和临床应用价值。nomogram模型直观、直接,非常适合于在临床实践中快速评估接受ICI治疗的患者发生IMH的风险。实施这一模式有助于早期采取预防和治疗策略,最终减少免疫相关不良事件(IRAEs),特别是IMH的可能性。
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引用次数: 0
The profile and clinical predicting effect of non-rash dermatologic toxicity related to targeted therapy in stage-IV non-small cell lung cancer patients. iv期非小细胞肺癌患者与靶向治疗相关的非皮疹皮肤毒性的概况及临床预测效果
IF 5.7 4区 生物学 Q1 BIOLOGY Pub Date : 2025-05-09 Epub Date: 2025-03-03 DOI: 10.5582/bst.2024.01424
Yanmei Peng, Collin M Costello, Zhaoheng Liu, Ashok V Kumar, Zhong Gu, Nikhila Kosuru, Jason A Wampfler, Pedro A Reck Dos Santos, Jonathan D'Cunha, Vinicius Ernani, Ping Yang

Dermatologic toxicities associated with targeted therapies may impact drug intolerance and predict drug response, among which rash is most frequently reported and well delineated. However, the profile and effect of non-rash dermatologic toxicity are not fully understood. We identified stage-IV non-small cell lung cancer patients diagnosed at Mayo Clinic in 2006-2019 and systematically analyzed demographics, targeted agents, toxicity, response, and survival outcomes of patients who received targeted therapy. Five toxicity subgroups-none, only non-rash dermatologic, concurrent non-rash and rash (concurrent) dermatologic, only rash, and others-were compared; multivariable survival analyses employed Cox Proportional Hazard models. This study included 533 patients who had taken targeted therapies: 36 (6.8%) had no toxicity, 26 (4.9%) only non-rash dermatologic, 193 (36.2%) only rash, 134 (25.1%) concurrent dermatologic, 144 (27.0%) other toxicities. Non-rash dermatologic toxicities predominately included xerosis (12.8%), pruritus (8.5%), paronychia (7.0%). Rash was the most frequent (59.4%) and the earliest occurring (21 median onset days [MOD]) dermatologic toxicity; paronychia was the latest (69 MOD) occurring. In 329 epidermal growth factor receptor inhibitors-treated patients with dermatologic toxicity, mild toxicity occurred the most frequently in patients with only non-rash (81.8%), then those with only rash (64.8%), and the least in the concurrent (50.4%, P=0.013). Patients with concurrent dermatologic toxicities had a significantly higher response rate (67.9%) than those with only non-rash (53.8%) or only rash (41.1%, p < 0.001). Multivariable analysis demonstrated concurrent dermatologic toxicity independently predicted a lower risk of death (harzard ratio [HR] 0.48 [0.30-0.77], p < 0.001). Compared to rash, non-rash dermatologic toxicity might be a stronger predictor of better treatment response and longer survival in patients who received targeted therapy.

与靶向治疗相关的皮肤毒性可能影响药物不耐受并预测药物反应,其中皮疹是最常被报道和描述清楚的。然而,非皮疹皮肤毒性的概况和效果尚未完全了解。我们确定了2006-2019年在梅奥诊所诊断的iv期非小细胞肺癌患者,并系统地分析了接受靶向治疗的患者的人口统计学、靶向药物、毒性、反应和生存结果。比较了5个毒性亚组——无毒性、只有非皮疹性皮肤病、并发无皮疹和皮疹(并发)皮肤病、只有皮疹和其他;多变量生存分析采用Cox比例风险模型。本研究纳入533例接受靶向治疗的患者:36例(6.8%)无毒性,26例(4.9%)仅无皮疹,193例(36.2%)仅皮疹,134例(25.1%)并发皮肤病,144例(27.0%)其他毒性。非皮疹性皮肤毒性主要包括干燥症(12.8%)、瘙痒症(8.5%)、甲沟炎(7.0%)。皮疹是最常见的(59.4%)和最早发生的(21中位发病日[MOD])皮肤毒性;甲沟炎是最近发生的(69 MOD)。在329例表皮生长因子受体抑制剂治疗的皮肤毒性患者中,轻度毒性在仅无皮疹的患者中发生率最高(81.8%),其次是仅皮疹的患者(64.8%),同时出现轻度毒性的患者发生率最低(50.4%,P=0.013)。伴有皮肤毒性的患者的有效率(67.9%)明显高于无皮疹(53.8%)或仅皮疹(41.1%,p < 0.001)。多变量分析表明,并发皮肤毒性独立预测较低的死亡风险(风险比[HR] 0.48 [0.30-0.77], p < 0.001)。与皮疹相比,非皮疹皮肤毒性可能是接受靶向治疗的患者更好的治疗反应和更长的生存期的一个更强的预测因素。
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Bioscience trends
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