Search

Background and purpose: There is a consensus within the medical community regarding the perioperative treatment of locally advanced gastric cancer (LAGC), yet the selection of an efficient and safe treatment strategy remains a contentious issue. Previous studies have validated the effectiveness of chemotherapy in conjunction with immune checkpoint inhibitor (ICI) and anti-angiogenic agents in the perioperative treatment of LAGC. This study aimed to investigate the perioperative treatment regimen combining ICI, anti-angiogenic drugs and chemotherapy, in order to provide additional references for the selection of perioperative treatment strategies for patients with LAGC. Methods: This was a prospective, single-arm exploratory study designed to assess the efficacy and safety of perioperative treatment with penpulimab combined with anlotinib and chemotherapy for potentially resectable stage T3-4N+M0 LAGC. Patients diagnosed with LAGC at the Inner Mongolia Autonomous Region People’s Hospital from January 2022 to December 2023 were enrolled in the study. The primary endpoints were pathological complete response (pCR) rate and major pathological remission (MPR) rate, while secondary endpoints included surgical conversion rate, objective response rate (ORR), disease-free survival (DFS), progression-free survival (PFS) and adverse reactions. Quality of life before and after treatment was evaluated using the European Organization for Research on Treatment of Cancer (EORTC) QLQ-STO22 Chinese version questionnaire. This study was reviewed and approved by the Ethics Committee of Inner Mongolia Autonomous Region People’s Hospital (number: 202404604L). Results: A total of 32 patients participated in the study, with an ORR of 78.1% (25/32). Of these, 18 patients underwent surgical treatment, achieving a pCR rate of 22.2% (4/18) and a MPR rate of 38.9% (7/18). The median PFS for patients who did not undergo surgery was 9.8 months (95% CI: 7.6-13.1), and the median follow-up duration was 16.4 months (95% CI: 11.7-22.5). For patients who received radical surgical resection, the median DFS was not reached, and the 1-year DFS rate was 88.8% (16/18). Common adverse reactions following the treatment included myelosuppression, liver function abnormalities, diarrhea and neurotoxicity, with most adverse events being grade 1-2, a few grade 3 adverse events, and no grade 4 or 5 adverse events. According to the EORTC QLQ-STO22 Chinese version questionnaire, significant improvements were observed in the domains of difficulty swallowing, pain and eating restrictions. Additionally, improvements were noted in anxiety and reflux symptoms, while changes in body image were less pronounced. Conclusion: In the perioperative treatment of LAGC, the combination therapy of oxaliplatin, tegafur, anlotinib and penpulimab can improve the efficacy while ensuring safety, and is expected to become a new treatment for LAGC.

Background: Interprofessional teamwork improves patient care quality, safety, and health outcomes. Interprofessional education (IPE) is crucial in today's medical education to prepare students for the workforce as integral members of a collaborative team. The diversity of IPE learners indicates the importance of exploring the relationship between learning styles and attitudes toward IPE. The purpose of this study was to investigate the relationship between learning styles and attitudes toward IPE. Methods: A cross-sectional study was conducted between August 2023 and September 2023 in 49 colleges located in the south-eastern region of China. A convenience sampling approach was employed, selecting 500 students majoring in Clinical Medicine and Nursing. The students completed an online questionnaire, which included sociodemographic characteristics, educational characteristics, interprofessional educational characteristics, learning styles, and the readiness for interprofessional learning scale, and Kolb's learning style inventory. Descriptive statistics, Spearman's correlation, and multiple linear regression analysis were used to analyze the data. Results: The most learners are diverger (93.2%), followed by assimilator (3.4%), accommodator (2.6%), and Converger (0.8%). The total score on the RIPLS was 69.70 (7.42), ranging from 48 to 88. A statistical relationship could be established between learning styles and attitudes toward IPE. Conclusion: Abstract conceptualization and active experimentation learning modes and convergers were closely linked with positive attitudes toward IPE. Gender, age, and study stress can affect attitudes toward IPE. This study highlights the need for medical education curricula to integrate innovative teaching methods such as PBL, role-playing, scenario simulation and clinical early exposure to strengthen professional identity, and improve abilities related to interprofessional learning. [ABSTRACT FROM AUTHOR]

Background and Aims: Variants in ZFYVE19 underlie a disorder characterised by progressive portal fibrosis, portal hypertension and eventual liver decompensation. We aim to create an animal model to elucidate the pathogenic mechanism., Methods: Zfyve19 knockout ( Zfyve19 -/- ) mice were generated and exposed to different liver toxins. Their livers were characterised at the tissue, cellular and molecular levels. Findings were compared with those in wild-type mice and in ZFYVE19-deficient patients. ZFYVE19 knockout and knockdown retinal pigment epithelial-1 cells and mouse embryonic fibroblasts were generated to study cell division and cell death., Results: The Zfyve19 -/- mice were normal overall, particularly with respect to hepatobiliary features. However, when challenged with α-naphthyl isothiocyanate, Zfyve19 -/- mice developed changes resembling those in ZFYVE19-deficient patients, including elevated serum liver injury markers, increased numbers of bile duct profiles with abnormal cholangiocyte polarity and biliary fibrosis. Failure of cell division, centriole and cilia abnormalities, and increased cell death were observed in knockdown/knockout cells. Increased cell death and altered mRNA expression of cell death-related signalling pathways was demonstrated in livers from Zfyve19 -/- mice and patients. Transforming growth factor-β (TGF-β) and Janus kinase-Signal Transducer and Activator of Transcription 3 (JAK-STAT3) signalling pathways were upregulated in vivo, as were chemokines such as C-X-C motif ligands 1, 10 and 12., Conclusions: Our findings demonstrated that ZFYVE19 deficiency is a ciliopathy with novel histological features. Failure of cell division with ciliary abnormalities and cell death activates macrophages and may thus lead to biliary fibrosis via TGF-β pathway in the disease., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)