Tianjin Chest Hospital

Background: Neoadjuvant immunochemotherapy improves pathological response in resectable non-small cell lung cancer (NSCLC), but the need and intensity of postoperative adjuvant therapy across different pathological response rate (PRR) strata remain uncertain. Methods: In this single-center retrospective cohort, 105 patients with resectable NSCLC received neoadjuvant platinum-based chemotherapy with or without PD-1/PD-L1 inhibitors followed by R0 resection. PRR was defined as 1-residual viable tumor fraction and categorized as 0-60%, 60-90%, and ≥90% (major pathological response, MPR). Postoperative strategies included no further therapy, chemotherapy alone, or immunotherapy ± chemotherapy. Event-free survival (EFS) was analyzed using Kaplan-Meier estimates, multivariable Cox models, and restricted cubic spline-based treatment × PRR interaction. Results: Deeper PRR was associated with lower ypT/ypN stage and improved EFS. In the PRR 0-60% subgroup, immunotherapy-containing adjuvant regimens were associated with better EFS, whereas chemotherapy alone did not outperform observation. In the PRR 60-90% and MPR strata, EFS curves for different postoperative strategies largely overlapped, and in MPR patients, hazard ratios were close to 1. Interaction modeling suggested that the absolute 3-year EFS benefit of immunochemotherapy peaked at intermediate PRR (≈60-80%) and diminished as PRR approached ≥90%. Conclusions: The robustness of these findings was further confirmed through a sensitivity analysis focusing on a homogeneous cohort of clinical stage II-III patients receiving adjuvant therapy. Among NSCLC patients treated with neoadjuvant systemic therapy, PRR is a strong prognostic marker and modulates the benefit of postoperative immunotherapy. These data support a response-adapted strategy, with adjuvant immunotherapy intensification in low-PRR patients and potential de-escalation or surveillance alone in MPR patients, warranting validation in prospective PRR-stratified trials.

While omalizumab has demonstrated clinical efficacy in severe allergic asthma, its impact on small airway function and structural changes remains underexplored. We aimed to evaluate the multidimensional effects of omalizumab using physiological, symptomatic, and quantitative CT (QCT) measures. This prospective observational study included 25 patients with severe allergic asthma treated with omalizumab for 16 weeks. Assessments included blood eosinophils, fractional exhaled nitric oxide (FeNO), spirometry, body plethysmography, Asthma Control Test (ACT), modified Medical Research Council (mMRC) dyspnea scale, 6-minute walk test (6MWT), inspiratory and expiratory quantitative computed tomography (QCT) scans. Changes before and after treatment were analyzed using paired Student’s t-tests, and Pearson’s correlation was used to explore inter-domain relationships. After 16 weeks of omalizumab treatment, patients showed significant reductions in airway inflammation, with Eosinophil counts showing a downward trend. FeNO decreasing from 69.3 ± 33.3 to 44.8 ± 23.8 ppb (p < 0.001). Maximal expiratory flow at 50% of forced vital capacity (MEF₅₀) increased from 1.89 ± 1.31 to 2.20 ± 1.19 L/s (p = 0.001), and maximal expiratory flow at 25% of forced vital capacity (MEF₂₅) increased from 0.61 ± 0.41 to 0.75 ± 0.52 L/s (p = 0.002). The residual volume/total lung capacity (RV/TLC) ratio decreased from 48.7 ± 10.2% to 41.7 ± 9.3% (p < 0.001). Asthma Control Test (ACT) scores improved from 17.4 ± 0.8 to 20.3 ± 1.2 (p < 0.001). Physical capacity increased, with 6MWT from 296.3 ± 54.5 to 327.9 ± 54.1 m (p < 0.001). QCT revealed a significant reduction in expiratory gas trapping volume from 382.4 ± 248.7 to 285.4 ± 176.1 mL (p = 0.004). Omalizumab was associated with short-term (16-week) improvements in type 2 inflammatory markers, pulmonary function, symptom control, and QCT-derived structural measures in patients with severe allergic asthma. QCT imaging showed reduced gas trapping over 16 weeks, suggesting that quantitative imaging may complement symptom-based assessment of biologic response. However, larger studies with longer follow-up are also needed to confirm the durability of these changes and their long-term clinical relevance.

The transportation sector powered by fossil fuels is a significant contributor to PM2.5 pollution. Systematic evaluation of traffic-related PM2.5 on acute coronary syndrome (ACS) onset is not yet characterized, and the health benefits of reduced traffic-related PM2.5 and evidence-based mitigation strategies are currently absent. We investigated the association of ACS onset with short-term traffic-related PM2.5 exposure in a nationwide time-stratified case-crossover study, using 627,828 ACS cases extracted from the China Cardiovascular Association. We evaluated the risks of ACS onset associated with traffic-related PM2.5, calculated the attributable onsets, and then conducted cluster analysis using the K-means algorithm to identify priority cities for emission reduction. We found a robust association between traffic-related PM2.5 and ACS onset, i.e., an increased risk of 2.39% (95% CI: 1.79–3.00%) for same-day (lag 0) PM2.5 per 10 μg/m3 increase. The greatest health benefits due to a 1 μg/m3 PM2.5 reduction were achieved by traffic-related PM2.5, reaching 10,267 (95%CI: 4503–16,063) onsets per year. In addition, three obvious categories were clustered, and traffic-polluted cities were highlighted (cluster 2, not belonging to megacities), with high emissions and concentrations of traffic-related PM2.5. Therefore, intensified efforts to mitigate traffic-related PM2.5 emissions should be promoted, and the prioritization of emission reduction strategies in these traffic-polluted cities is imperative for safeguarding public health.

ABSTRACT Magnetically steerable guidewires show significant advantages in vascular intervention surgery by enabling precise and minimally invasive navigation. Guidewires with embedded magnetic materials are widely studied. However, when an external magnetic field directly acts on the distal tip, it often experiences high acceleration, which leads to unpredictable motion and potential vessel injury. In contrast, coil‐based magnetic guidewires allow precise adjustment of magnetic forces and torques through current, and immediate de‐energization eliminates this risk. Nevertheless, single‐coil designs provide limited deflection angles, which restrict their steering performance in complex vessels. To address these issues, this paper presents a dual‐coil magnetic guidewire (DCMG) that achieves dual‐attraction, dual‐repulsion, and spoon‐shaped modes under an external magnetic field. These three modes provide adaptable curvature control, that is, the dual‐attraction/repulsion mode enhances bending range and axial force transmission, and the spoon‐shaped mode facilitates compliant and safe navigation in tortuous vessels. Thermal characterization under static and flow conditions confirms safe operating temperatures under continuous energization. Furthermore, the deflection characteristics are experimentally measured under different current inputs. Steering performance is evaluated in a 90° glass channel under three actuation modes and validated through in vitro navigation experiments in a 3D heart aortic arch phantom. The results demonstrate that the DCMG achieves smooth curvature steering and controllable navigation, showing strong potential for future clinical application in vascular intervention surgeries.

Silicon photonic biosensors can be fabricated via standard CMOS microfabrication techniques, with many sensing sites integrated on the same chip. In this work, we report the design and validation of a cascaded 1×4 racetrack-shaped microring resonator (rsMRR) based on SOI (Silicon-On-Insulator), optimizing key parameters such as the waveguide width, coupling gap, and ring radius. Moreover, we, comprehensively characterize the sensing performance of the rsMRR. The experimental results show that the resonator achieves a sensitivity of 117 nm/RIU within a glucose concentration range of 0–3.3 mg/mL. Compared with traditional structures, this design reduces optical loss through its racetrack-shaped layout, reaching a quality factor of 510, and has advantages such as high integration density, anti-interference capability, and miniaturization. This work reveals the potential of silicon-based rsMRRs for practical glucose-sensing applications.

PROMIS effectively assesses patient health, but its use in evaluating the quality of life in acute coronary syndrome (ACS) patients on PCSK9 inhibitors (PCSK9i) remains unexplored. This study examined the impact of PCSK9i on quality of life in ACS patients, comparing PCSK9i plus statin versus statin-only therapy using PROMIS-10, and analyzed the association between PROMIS scores and major adverse cardiovascular events (MACE). The EMSIACS trial is a prospective, randomized, open-label, parallel-group, multicenter study registered at ClinicalTrials.gov (NCT04100434). This paper presents the exploratory outcomes of this trial. From September 2020 to March 2022, a total of 500 ACS patients were enrolled. Patients were randomly assigned in a 1:1 ratio to receive Evolocumab plus statin therapy or statin-only therapy. The quality of life was assessed using PROMIS 10 at baseline, week 12, and week 48. PROMIS 10 includes two summary scores: Global Physical Health (GPH, including physical health, physical function, fatigue and pain intensity) and Global Mental Health (GMH, including overall quality of life, mental health, satisfaction with social activities, and emotional problems). At week 48, MACE were evaluated in two groups. At week 12, Evolocumab significantly improved Global Physical Health (GPH) (P < 0.001) and Global Mental Health (GMH) scores (P < 0.001), particularly in pain intensity, mental health, and social activity satisfaction (P < 0.001). By week 48, both groups improved significantly from baseline, with no significant differences between them(GPH: P = 0.120; GMH: P = 0.105). Emotional problems worsened in patients with MACE (P = 0.015). Exploratory analysis suggested that PCSK9i significantly improved short-term quality of life in ACS patients outperforming statins especially in pain intensity, mental health, and social activity satisfaction. In the long term, PCSK9i sustained quality of life improvements. The occurrence of MACE in ACS patients may associate with emotional problems.Clinical trial registration number: NCT04100434.