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The powder of the hematite sample was isothermally reduced with a hydrogen-water vapor gas mixture at 1023K-1273K. The results indicate that the overall reduction process of hematite can be divided into three stages (Fe2O3-Fe3O4-FeO-Fe) each of which should be investigated. At 1023K, the average reaction rate decreased by 53.6% in stage 1 when the water vapor content of the reaction gas increased from 0% to 50%, and it decreased by about 77.2% in stage 2. However, in stage 3, when the water vapor content increased only from 0% to 20%, it decreased by about 78.1%. The results also show that the influence of water vapor on the reduction reaction increases with increasing reaction temperature in all stages of the reduction reaction. The microstructure of the reduction products showed that they still had some holes; that did not seriously block the channel for hydrogen diffusion. Various models were considered to further clarify the influence of water vapor in the reduction stage The range of apparent activation energy of the different stages obtained by the model fitting was about 20-70 kJ/mol, which also confirmed the absence of the solid-state diffusion phenomenon.

We investigate the distribution of atoms and diatomic metal-oxide molecules in femtosecond laser-induced plasmas generated at and after the laser beam focal plane, where non-linear phenomena give rise to the formation of a weakly ionized air plasma channel. We use direct plasma imaging and optical emission spectroscopy to study plasma expansion, and the associated physical and chemical separation processes. Plasma splitting occurs upon the interaction of the weakly ionized plasma with the sample and is accompanied by a change in the spatio-temporal distribution of the molecules and atoms compared to sampling at the focus. Furthermore, molecular emission is favored at specific locations and is enhanced over atomic emission as the sample is moved underneath the laser focus. These findings support the ability to enhance or impede the formation of molecular versus atomic species at specific spatio-temporal locations in the laser-induced plasma.

Chemical imaging applications using Laser Induced Breakdown Spectroscopy (LIBS) involve laser ablation sampling at interfaces or boundaries between materials with different thermophysical and optical properties, leading to the formation of two initially isolated plasmas. The mechanisms of mixing in these plasmas and their direct implications on spectral emission and chemical imaging remain largely unknown. We investigate the mixing dynamics of isolated plasmas produced using femtosecond (fs) laser pulses at the interface between two different model Cu and Sn–Pb samples. Specifically, we study the spatial and temporal mixing dynamics and outer plasma expansion dynamics of the fs plasma components. The time-resolved degree of component mixing, horizontal and vertical expansion, mixing speed, and temperature and electron density of the heterogeneous plasma are characterized. Mixing processes are initiated early on,

Qingen Da,1,2,&ast; Mingming Ren,2,&ast; Lei Huang,2 Jianhua Qu,1 Qiuhua Yang,3 Jiean Xu,4 Qian Ma,4 Xiaoxiao Mao,4 Yongfeng Cai,4 Dingwei Zhao,4 Junhua Luo,5 Zilong Yan,1 Lu Sun,2 Kunfu Ouyang,2 Xiaowei Zhang,6 Zhen Han,2 Jikui Liu,1 Tao Wang2 1Department of Hepatobiliary Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, People’s Republic of China; 2Department of Cardiovascular Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, People’s Republic of China; 3Vascular Biology Center, Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA; 4Shenzhen Graduate School, Peking University, Shenzhen, People’s Republic of China; 5Department of Urological Surgery, Peking University Shenzhen Hospital, Shenzhen, People’s Republic of China; 6School of Basic Medical Sciences, Peking University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jikui Liu, Department of Hepatobiliary Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, People’s Republic of China, Email liu8929@126.com Tao Wang, Department of Cardiovascular Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, People’s Republic of China, Email szwangtao@126.comObjective: We aimed to explore the prognostic patterns of ferroptosis-related genes in papillary renal cell carcinoma (PRCC) and investigate the relationship between ferroptosis-related genes and PRCC tumor immune microenvironment.Methods: We obtained the mRNA expression and corresponding clinical data of PRCC from the public tumor cancer genome atlas database (TCGA). The PRCC patients were randomly divided into two cohort, training cohort and verification cohort, respectively. Univariate Cox regression, LASSO Cox regression, multivariate Cox regression analysis were utilized to construct ferroptosis signature for PRCC patients. And then, risk prognostic model was established and verified. The correlation of ferroptosis-related signature with survival and immune microenvironment was systematically analyzed.Results: A 4-genes ferroptosis signature (CDKN1A, MIOX, PSAT1, and RRM2) was constructed. Multivariate Cox regression assay indicates that the risk score of ferroptosis signature was an independent prognostic indicator (HR=1.391, p< 0.001). The survival curve shows that the high-risk group has a poorer prognosis than the low-risk group (p< 0.001). The risk prognostic model was established based on prognostic factors of clinical-stage, hemoglobin, and risk score. The time-dependent receiver operating characteristic curve (ROC) analysis proves the predictive capacity of the ferroptosis signature, the 3 years area under the curve (AUC) is 0.890, and the 5 years AUC is 0.733. Further analysis suggested that cell cycle, pentose phosphate pathway, P53 signaling pathway were significantly enriched in the high-risk group. The significantly different fractions of dendritic cells resting, macrophage cells, and T cells follicular helper were observed in risk groups.Conclusion: This study implicates a ferroptosis signature which has a good predict capacity of the prognosis in PRCC patients. Ferroptosis-related genes may have a key role in the process of anti-tumor and serve as therapeutic targets for PRCC.Keywords: papillary renal cell carcinoma, ferroptosis, gene signature, prognosis model, tumor immune microenvironment

Xiaowei Mao,1,2,&ast; Jiabing Liu,3,&ast; Fang Hu,1,&ast; Yanjie Niu,1 Feng Pan,1 Xiaolong Fu,3 Liyan Jiang1 1Pulmonary and Critical Care Medicine, Shanghai Jiao Tong University, Shanghai Chest Hospital, Shanghai, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Radiation Oncology, Shanghai Jiao Tong University, Shanghai Chest Hospital, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Liyan Jiang; Xiaolong Fu, Email jiang_liyan2000@126.com; xlfu1964@126.comBackground: Transformation to a lung neuroendocrine tumor (LNET) is a mechanism of resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI). Serum neuron-specific enolase (NSE) is a useful marker in the detection of LNET. Therefore, we explored the clinical significance of serum NSE levels in the detection of transformed neuroendocrine tumors after EGFR-TKI therapy.Methods: We report a cohort of 5 cases in our treatment group. The characteristics of the patients, pathological diagnoses, immunohistochemistry with molecular detection, laboratory examination, and treatment histories are analyzed. The tumor markers of serum NSE were analyzed. Additionally, we reviewed the publications reporting the tumor markers before and after LNET transformation during EGFR-TKI therapy.Results: Most patients are female (3/5), aged < 60 years old (4/5), nonsmokers (4/5) and harbor the EGFR 19 exon deletion (4/5). The median time of LNET transformation was 19 months (range: 12– 31 months). The clinical characteristics were similar to those reported in previous studies. Laboratory examination revealed an increased NSE level before the LNET is defined. Sixteen publications were reviewed. Of those, 86.67% (13/15) publications showed an increased level of NSE when the LNET transformation was defined.Conclusion: Adenocarcinoma tumors in non-smokers, young patients harboring the EGFR 19 exon deletion tended to transform to LNETs after EGFR-TKI therapy. Combining our findings and a review of the literature, we suggest that serum NSE may be a useful tumor marker to predict neuroendocrine tumor transformation.Keywords: transformation, EGFR-TKI, target therapy, lung neuroendocrine tumor, neuron-specific enolase

Objective: To investigate whether immediate frozen–thawed embryo transfer (FET) in the next month following coronavirus disease 2019 (COVID‐19) recovery affects ongoing pregnancy outcome. Methods: This was a retrospective cohort study carried out at a university‐affiliated reproductive medicine center. The study group (post‐COVID‐19 group) comprised women who were affected by COVID‐19 in December 2022 and immediately underwent FET in January 2023 after recovery, with transferred embryos not exposed to the infection. The control group comprised women treated during the pre‐COVID‐19 period (January 2019). Multivariable logistic regression analysis and a propensity score matching (PSM) approach were used to control for potential confounders and selection bias. Results: A total of 200 women were included in the post‐COVID‐19 group and 641 women were enrolled in the control group. The rate of ongoing pregnancy was comparable between the study cohorts in both the unadjusted and confounder‐adjusted logistic regression models. Other reproductive outcomes, including the odds of a positive pregnancy test, implantation, clinical pregnancy and early pregnancy loss, were similar between the comparison groups. PSM models further confirmed the lack of significant differences in pregnancy outcome between the post‐COVID‐19 group and the control group. Conclusions: Among patients affected by COVID‐19 for whom the transferred embryos were generated prior to infection, an immediate FET cycle in the next month after recovery does not seem to compromise ongoing pregnancy outcome. Thus, women who have frozen embryos from preinfection cycles should be counseled and encouraged to undergo FET as soon as possible after COVID‐19 recovery. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Experimental investigations into the characteristics of laser-induced plasmas indicate that LIBS provides a relatively inexpensive and easily replicable laboratory technique to isolate and measure reactions germane to understanding aspects of high-explosive detonations under controlled conditions. Spectral signatures and derived physical parameters following laser ablation of aluminum, graphite and laser-sparked air are examined as they relate to those observed following detonation of high explosives and as they relate to shocked air. Laser-induced breakdown spectroscopy (LIBS) reliably correlates reactions involving atomic Al and aluminum monoxide (AlO) with respect to both emission spectra and temperatures, as compared to small- and large-scale high-explosive detonations. Atomic Al and AlO resulting from laser ablation and a cited small-scale study, decay within ∼10-5 s, roughly 100 times faster than the Al and AlO decay rates (∼10-3 s) observed following the large-scale detonation of an Al-encased explosive. Temperatures and species produced in laser-sparked air are compared to those produced with laser ablated graphite in air. With graphite present, CN is dominant relative to N2+. In studies where the height of the ablating laser's focus was altered relative to the surface of the graphite substrate, CN concentration was found to decrease with laser focus below the graphite surface, indicating that laser intensity is a critical factor in the production of CN, via reactive nitrogen.

Through computer simulation on experimentally acquired optical spectra, uranium isotopic analysis by laser ablation molecular isotopic spectrometry and laser induced breakdown spectroscopy were studied. The use of only one spectral feature, either the strong UO band at 593.55 nm or the nearby U I 593.382 nm line, are similar in precisions (~ 1.5% in absolute 235U abundances). Precision improves to 0.72% with the use of a group of U atomic lines from 591.6 to 596.5 nm. The use of both molecular bands and atomic lines further advances the precision to 0.42% and compares well with the U II 424.437 nm single-line benchmark (0.48% precision).

OBJECTIVE: Frozen shoulder is a prevalent condition among individuals in their middle and later years. Invasive therapy has shown promising results in the treatment of frozen shoulders, but its widespread adoption has been hampered by high costs and the need for advanced medical technology. As a result, patients with frozen shoulders often turn to non-steroidal anti-inflammatory drugs (NSAIDs) for symptomatic relief. However, the oral administration of NSAIDs can lead to troublesome adverse effects on the gastrointestinal, cardiovascular, and urinary systems. In contrast, topical NSAIDs have gained attention for their excellent efficacy and lower adverse effects in various chronic pain conditions. Therefore, our study aimed to investigate the efficacy and safety of topical NSAIDs in improving pain and mobility among patients with frozen shoulders. PATIENTS AND METHODS: A total of 108 patients experiencing moderate to severe pain and mobility impairment due to frozen shoulder were enrolled in this study. The participants were randomly assigned to either the experimental group (n=72) or the control group (n=36). The experimental group received daily treatment with the loxoprofen hydrogel patch (LOX-P) in addition to basic rehabilitation physiotherapy. The control group was treated with flurbiprofen cataplasm (FLU-C) twice a day, along with rehabilitation physiotherapy. The primary endpoint for evaluating the efficacy of the two patches was the Constant-Murley score (CMS). Clinical symptom data, adverse events, and patient satisfaction were also recorded. RESULTS: After 14 days of treatment, the effective rate was 66.67% (n=48) in the experimental group and 41.67% (n=15) in the control group. The overall difference in the effective rates was 25.00% (95% CI=5.20-42.52; p=0.013). The safety profiles of the two topical agents were similar, with only a few adverse events reported. CONCLUSIONS: The loxoprofen hydrogel patch demonstrates a significant ability to alleviate shoulder pain and restore shoulder function in the treatment of frozen shoulder, with minimal adverse reactions [ABSTRACT FROM AUTHOR]

Laser-induced breakdown spectroscopy (LIBS) operated under ambient pressure has been evaluated for isotopic analysis of uranium in real-world samples such as soil, with U concentrations in the single digit percentage levels. The study addresses the requirements for spectral decomposition of 235U and 238U atomic emission peaks that are only partially resolved. Although non-linear least-square fitting algorithms are typically able to locate the optimal combination of fitting parameters that best describes the experimental spectrum even when all fitting parameters are treated as free independent variables, the analytical results of such an unconstrained free-parameter approach are ambiguous. In this work, five spectral decomposition algorithms were examined, with different known physical properties (e.g., isotopic splitting, hyperfine structure) of the spectral lines sequentially incorporated into the candidate algorithms as constraints. It was found that incorporation of such spectral-line constraints into the decomposition algorithm is essential for the best isotopic analysis. The isotopic abundance of 235U was determined from a simple two-component Lorentzian fit on the U II 424.437 nm spectral profile. For six replicate measurements, each with only fifteen laser shots, on a soil sample with U concentration at 1.1% w/w, the determined 235U isotopic abundance was (64.6 ± 4.8)%, and agreed well with the certified value of 64.4%. Another studied U line - U I 682.691 nm possesses hyperfine structure that is comparatively broad and at a significant fraction as the isotopic shift. Thus, 235U isotopic analysis with this U I line was performed with spectral decomposition involving individual hyperfine components. For the soil sample with 1.1% w/w U, the determined 235U isotopic abundance was (60.9 ± 2.0)%, which exhibited a relative bias about 6% from the certified value. The bias was attributed to the spectral resolution of our measurement system - the measured line width for this U I line was larger than its isotopic splitting. Although not the best emission line for isotopic analysis, this U I emission line is sensitive for element analysis with a detection limit of 500 ppm U in the soil matrix; the detection limit for the U II 424.437 nm line was 2000 ppm.

The fundamental analytical accuracies and precisions attainable by laser ablation molecular isotopic spectrometry (LAMIS), with emphasis on the impacts from spectral interferences and measurement noise, were investigated by means of computer simulation. The study focused on the analysis of a minor isotope at sub- to single-percentage abundance level. With a natural abundance about 1.1% for 13C, the C2 Swan band (d 3Πg-a 3Πu) with Δν = + 1 was selected as a representative system. The characteristics (e.g., noise amplitude and distribution, signal strength, and signal-to-background ratio) of the simulated spectra were experimentally characterized. Partial least square (PLS) regression was used to extract isotopic information from the simulated molecular spectra. In the absence of any spectral interference and with the use of a calibration set consisting of eleven isotopic standards, the theoretical accuracies and precisions with signal accumulation from 100 laser shots are about 0.002% and 0.001%, respectively, in absolute percentage abundance of 13C. The theoretical analytical accuracies slightly degrade, but are adequate for many applications, to 0.004% and 0.008% respectively, for calibrations involving only three and two isotopic standards. It was found that PLS regression is not only immune to both source-flicker and photon-shot noise, but is also effective in differentiating the spectral patterns from the analyte against those from spectral interferences. The influences of spectral interference from single or multiple atomic emission lines were simulated, and new ways to minimize their impacts were formulated and demonstrated. It was found that the wavelength range selected for the computation of the normalization factor should not contain any spectral-interfering peak, and a properly chosen wavelength range increases the tolerance of spectral interference by at least one order of magnitude. With matrix-matched calibration standards, the precisions (expressed as RSDs of the determined 13C isotopic abundances) degrade from ∼ 1% in the absence of spectral interference, to ∼ 3%, 10% and 20% with multiple spectral-interfering peaks that are 10 ×, 100 × and 1000 ×, respectively, stronger than the molecular bandhead of the analyte. The study concluded that PLS regression is a powerful and indispensable tool for extraction of isotopic information from LAMIS spectra.

While femtosecond Laser Induced Breakdown Spectroscopy has been studied in the macro-scale (i.e. ablation crater sizes of tens to hundreds of micrometers), the spectral emission mechanisms at the micron/sub-micron scale remain largely unknown, mainly because of the challenges associated with spectral emission acquisition from the limited amounts of ablated mass at these small lengthscales. In this work we study the limits of detection, the laser-induced plasma properties and spectral emission efficiency of Cu at the micron/submicron scale. Although the corresponding number electron densities and temperatures are similar to those reported for macroscale laser ablation, our findings suggest less efficient luminous spectral emission per ablated volume as we scale down in laser energy and crater sizes. These results provide a first insight into fs laser-induced plasma properties at the micron/sub-micron scale regime.

A new remote sensing technology for real-time isotopic analysis is introduced: Femtosecond Filament-Induced Laser Ablation Molecular Isotopic Spectrometry (F2-LAMIS). The technique combines femtosecond (fs) laser filamentation and ablation-based molecular isotopic spectroscopy, thereby enabling isotopic analysis of samples at a distance, in ambient air and at ambient pressure conditions. Isotopic analysis of zirconium (Zr) samples by F2-LAMIS is demonstrated, and the molecular and atomic emission intensity, and properties of the filament-induced plasma generated at different filament propagation distances were investigated. Spectral fitting of F2-LAMIS spectra enabled semi-quantitative isotopic analysis without the use of calibration standards, which was independent of the filament propagation distance for the studied range. This technology provides new capabilities for direct isotopic ratio measurements at remote distances.

Diling Pan1 ,* Binhua Dong2,3 ,* Hangjing Gao,2 Xiaodan Mao,2,3 Huifeng Xue,4 Pengming Sun2,3 1Department of Pathology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, People’s Republic of China; 2Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350001, People’s Republic of China; 3Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350001, People’s Republic of China; 4Fujian Provincial Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, Fujian, People’s Republic of China*These authors contributed equally to this workCorrespondence: Pengming SunFujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, 18 Daoshan Road, Fuzhou 350001, Fujian, People’s Republic of ChinaTel +86-591-87558732Fax +86-591-87551247Email sunfemy@hotmail.comPurpose: Little is known about the performance of extended high-risk human papillomavirus (HR-HPV) genotyping triage of cytology showing atypical squamous cells of undetermined significance (ASC-US). This study aims to evaluate the effectiveness of triage with different HR-HPV genotype models among women with ASC-US.Materials and Methods: In this study, all women who underwent cervical cytology and HR-HPV genotyping were enrolled from 2014 to 2017 in China, and those with cytology showing ASC-US were referred for colposcopy and/or biopsy. The endpoint was histological detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). The outcome indicators were the sensitivity, specificity, positive predictive values (PPVs), negative predictive values (NPVs) and colposcopy referral rates.Results: In all, 56,788 women were enrolled in this study, and 2658 (4.97%) women were reported to have ASC-US; 10.1% (242/2393) of women with ASC-US were identified as having CIN2+. The HR-HPV infection rate was 95.0% among all women with ASC-US who were identified as CIN2+, and the top five genotypes with prevalence and risk of CIN2+ were HPV16 (OR=26.38), HPV58 (OR=7.04), HPV18 (OR=4.44), HPV33 (OR=3.38), HPV31 (OR=2.97) and HPV52 (OR=2.96). The HPV16/18/31/33/52/58 model achieved higher sensitivity [91.3 (87.8– 94.9)], specificity [70.0 (68.1– 72.0)], PPV [25.5 (22.4– 28.2)] and NPV [98.6 (97.3– 98.7)] for the triage of ASC-US patients than the other HR-HPV-type combination models, but the colposcopy referral rate (36.2%) was significantly lower than that of the recommended HR-HPV nongenotyping model (47.6%).Conclusion: This study confirms that the specific HR-HPV genotype HPV16/18/31/33/52/58 is an alternative strategy for ASC-US triage and can effectively reduce the high burden of colposcopy referrals in China.Keywords: human papillomavirus, genotyping, atypical squamous cells of undetermined significance, cervical intraepithelial neoplasia

Ziqi Ye,1,* Jie Chen,2,* Yanfang Zhang,1 Xi Hu,1 Zixue Xuan,3 Si Yang,1 Xiaohong Mao,3 Yuefeng Rao1 1Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Department of Pharmacy, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 3Department of Pharmacy, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuefeng Rao Department of Clinical PharmacyThe First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, People’s Republic of ChinaTel +86-571-8723-6531Email raoyf@zju.edu.cnXiaohong Mao Department of PharmacyZhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, 158 Shangtang Road, Hangzhou 310014, People’s Republic of ChinaTel +86-15990151723Email maoxhzhz@163.comObjective: We sought to evaluate the efficacy of using a quick response (QR) code within video education to guide proper use of fentanyl transdermal patches and control pain, depression, and anxiety levels in cancer patients.Methods: Patients using a fentanyl transdermal patch for the first time were enrolled in the study and then given an information leaflet as well as an informed consent form. We asked them to complete the first questionnaire (Q1) prior to first use of the fentanyl transdermal patch, and then used a random number table to randomize those who completed it into two groups. Participants in group A received a QR code (to make it easier for them to obtain additional video information) and a traditional information leaflet, whereas those in group B (control group) only received a traditional information leaflet. Thereafter, we requested all participants to complete standard questionnaires, which comprised a Numeric Rating Scale (NRS), a Spielberger State-Trait Anxiety Inventory (STAI), as well as a Hospital Anxiety and Depression Scale (HADS). The resulting continuous (with a normal distribution) and categorical data were analyzed using Student’s t- and chi-square tests, respectively. We also recorded parameters such as NRS, STAI, and HADS, as well as the frequency of rescue medication in both groups.Results: A total of 154 cancer patients who first used a fentanyl transdermal patch were recruited during the study period, from April to May 2020. Among these, 138 completed follow-up, with 70 and 68 in group A and B, respectively. Participants in both groups had similar baseline and clinical characteristics, whereas significant differences were observed between the groups with regard to the other parameters. Specifically, participants in group A recorded a lower STAI state (38.2 vs 38.9, P=0.027) and HADS (3.9 vs 4.2, P=0.001) anxiety scores, as well as NRS (2.1 vs 2.4, P=0.025) and frequency of rescue medication (0.4 vs 1.4, P< 0.001) than those in group B, following 14 days of using a fentanyl transdermal patch.Conclusion: Our results indicated that incorporating a QR code within additional video education leads to proper use of a fentanyl transdermal patch and relieves pain and anxiety levels in patients with cancer. Based on this, we recommend a new style of education during care of cancer patients who first use a fentanyl transdermal patch.Keywords: QR code, video education, fentanyl transdermal patch, anxiety, depression

Liang Zeng,1,2,* Yizhi Li,2,* Qinqin Xu,3,* Wenjuan Jiang,2 Analyn Lizaso,4 Xinru Mao,4 Yongchang Zhang,2 Nong Yang,2 Zhenxing Wang1 1Department of Medical Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215006, People’s Republic of China; 2Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, People’s Republic of China; 3Department of Medical Oncology, Qinghai Provincial People’s Hospital, Xining, People’s Republic of China; 4Department of Medical Affairs, Burning Rock Biotech, Guangzhou, 510300, People’s Republic of China*These authors contributed equally to this workCorrespondence: Nong YangDepartment of Medical Oncology,Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, People’s Republic of ChinaTel +86 73189762327Email yangnong0217@163.cnZhenxing WangDepartment of Medical Oncology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, People’s Republic of ChinaTel +86 73189762327Email zhenxw316@163.comIntroduction: Reliable diagnostic approaches to detect ALK rearrangement are critical for selecting patients eligible for crizotinib therapy. This study aimed to compare next-generation sequencing (NGS) and Ventana immunohistochemistry (IHC) in evaluating ALK rearrangements and evaluate their impact on first-line crizotinib efficacy.Patients and Methods: A total of 472 NSCLC patients were identified as ALK-positive by NGS and/or IHC between March 2014 and February 2020. The concordance of ALK detection, overall response rate (ORR), and progression-free survival (PFS) were analyzed for 319 patients who received front-line crizotinib.Results: First-line crizotinib (n=319) significantly prolonged PFS in comparison with chemotherapy (n=46; 12.0 vs 6.8 months; p< 0.0001). Of the 76 crizotinib-treated patients whose ALK status was assessed by both NGS and IHC, 78.9% of the patients had concordant ALK status (NGS-positive/IHC-positive), 18.4% patients were NGS-positive but IHC-negative, and 2 patients were IHC-positive but NGS-negative. Different detection assays confer no statistical difference in ORR and PFS with first-line crizotinib. The ORR in NGS only, IHC only, and both NGS and IHC was 84.3%, 90.1%, and 88.1%, respectively, while PFS was 11.4, 13.0, and 11.0 months, respectively. The ORR in NGS-positive/IHC-positive and NGS-positive/IHC-negative patients was 85.4% and 92.8%, respectively. Compared to NGS-positive/IHC-positive patients, those with NGS-positive/IHC-negative results had a trend of shorter PFS but statistical significance was not reached (mPFS, 5.9 months vs 11.5 months, p=0.43).Conclusion: Our results demonstrate that ALK status detected by NGS and/or IHC is reliable in identifying patients with ALK-positive NSCLC who will benefit from ALK inhibitor therapy.Keywords: ALK status evaluation, ALK IHC, ALK inhibitor

Xiaoyun Mao, Feng Jin Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, People’s Republic of ChinaCorrespondence: Feng JinDepartment of Breast Surgery, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang City, Liaoning Province, People’s Republic of ChinaTel/Fax +86 24 83282618Email jinfeng66cn@hotmail.comAbstract: Cancer cell plasticity is the ability of cancer cells to reversibly interchange between distinct cell status, which plays a key role in cancer progression. Cancer cell plasticity is now known to be shaped by the secreted nanoparticles termed exosomes which transport proteins and lipids as well as nucleic acids. These aspects have emerged as key determinants of tumor progression and targeting, with approaches such as immunotherapy showing promise in the clinic. While significant strides have been made in this research area, some very interesting questions still warrant more and deeper investigation. We provide a review of the interplay between exosomes and breast cancer cell plasticity, and the potential implication in metastases and drug-resistance.Keywords: exosome, breast cancer, cancer cell plasticity