Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) still lacks efficient therapeutic drugs. This study aimed to systematically evaluate the effects of Huangqi Guizhi Wuwu Decoction (HGWD) alone or combined with positive drugs on CIPN prevention and treatment. Methods: The PubMed, Embase, Web of Science, Cochrane, China National Knowledge Infrastructure (CNKI), Wan Fang Data, China Science and Technology Journal (VIP) and Chinese Biomedical (CBM) databases were searched for randomized controlled trials (RCTs) of HGWD for CIPN prevention and treatment. The search time ranged from database establishment to October 17, 2023. The Cochrane risk-of-bias assessment tool was used for quality assessment, Review Manager 5.3 and STATA 12.0 were used for meta-analysis, and GRADEprofiler was used for evidence level assessment. Results: A total of 32 RCTs involving 1987 patients were included. The meta-analysis results revealed the following: 1. In terms of the total CIPN incidence, that in the HGWD group was lower than that in the blank control group. The incidence in both the HGWD and HGWD+positive drug groups was lower than that in the monotherapy-positive drug group. 2. In terms of the incidence of severe CIPN, that in the HGWD group was lower than that in the blank control and positive drug groups. There was no statistically significant difference between the HGWD+positive drug and positive drug groups. Sensitivity analysis revealed that the results of severe incidence in the HGWD group was lower than that in the positive drug group were unstable 3. HGWD did not increase the number of chemotherapy-related adverse events. Conclusion: HGWD can safely and effectively prevent CIPN, reduce symptoms, improve quality of life and reduce the impact of chemotherapy drugs on sensory nerve conduction. However, more high-quality RCTs are needed to compare the efficacy of HGWD with that of positive control drugs in preventing severe CIPN.

INTRODUCTION: Although colorectal cancer (CRC) screening has been incorporated into organized programs in many countries, a universally accepted noninvasive and efficient screening method remains unavailable. This study aimed to assess the diagnostic potential of volatile organic compounds in exhaled breath through electronic nose (eNose) for noninvasive CRC detection. METHODS: The Cyranose320 sensor device was used to collect and analyze breath samples. Supervised machine learning was applied to evaluate the diagnostic performance of the eNose in CRC detection, using a randomly assigned training and validation set. Two-thirds of the breath samples were used to train models, which were then validated on the remaining patients (external validation). Three machine learning methods were applied for classification: random forest, extreme gradient boosting (XGBoost), and quadratic discriminant analysis. RESULTS: A total of 105 patients with CRC and 101 healthy controls were included. After adjusting for baseline covariates (age, sex, smoking, and comorbidities), machine learning models based on volatile organic compound profiles could differentiate patients with CRC from healthy controls, achieving areas under the receiver operating characteristic curve (AUC) of at least 0.72 in both the training and validation sets. The final CRC classification models yielded AUCs of 0.93 for random forest, 0.88 for XGBoost, and 0.89 for quadratic discriminant analysis. Furthermore, eNose classified CRC by stage, with an AUC exceeding 0.70 for early and advanced disease. DISCUSSION: Exhaled breath analysis using an eNose may serve as a promising noninvasive method for CRC detection. Further studies with larger populations are needed to confirm its clinical impact.

BackgroundRadical mastectomy may lead to suppression of cellular immune function in patients with malignant tumors, and affect the quality of life (QOL) of patients. Immune suppression is a common cause of complications and adverse reactions in adjuvant therapy after radical mastectomy of breast cancer. Currently, there are few proven effective treatments for immune suppression. Therefore, it’s necessary to develop a new treatment method. Press needle is widely used in clinical practice. However, there have been relatively few studies that evaluate the effects of press needle on postoperative immune function. The aim of the present study is to assess the effects of press needle on immune function and QOL in female breast cancer patients undergoing radical mastectomy.MethodsThis study will be a single-center, randomized and single-blinded trial. 78 eligible patients will be randomized in a ratio of 1:1 to the press needle group or the sham press needle group. During the treatment phase, patients will undergo five times weekly of verum press needle or sham press needle for 2 weeks, and then they will be followed-up for 2 weeks. The primary outcome measures will be the peripheral blood levels of CD8+, CD4+, CD3+, and CD4+/CD8+ T cells. The secondary outcome measures will be the changes of patients’ QOL, evaluated by the Karnofsky Performance Scale (KPS) score and the EORTC core quality of life questionnaire (EORTC QLQ-C30). Safety and adverse events will be assessed at each visit. DiscussionThe results of this on-going study will provide clinical evidence for the effects and safety of press needle on immune function and QOL in patients after breast cancer resection compared with sham press needle.Trial registrationChinese Clinical Trial Registry, ChiCTR2000040100. Registered on 21 November 2020.

Tumor-adjacent mucosa is commonly used as a normal reference in colorectal cancer (CRC) transcriptomic studies, but its relationship with distant normal mucosa and tumor tissue remains unclear. Here, we performed bulk RNA sequencing of paired distant normal, adjacent, and tumor tissues from 25 patients with CRC and used these three tissue states to construct an ordered normal–adjacent–tumor (N-A-T) expression continuum. Although adjacent mucosa was globally closer to distant normal mucosa and showed no significant differential expression by pairwise analysis, a limma-based linear trend model identified widespread monotonic transcriptional changes along the N-A-T continuum. Tumor-directed genes were enriched in translation, RNA processing, cell-cycle activity, and proliferation-related pathways, whereas genes decreasing along this axis were associated with oxidative metabolism and epithelial homeostasis. A trend gene-based N-A-T score positioned adjacent mucosa between normal and tumor tissues in external bulk cohorts and was associated with proliferative and immune-low molecular states in CRC. Single-cell RNA-seq analysis localized this signal mainly to epithelial cells and associated higher scores with proliferative and stem-like epithelial states. In conclusion, CRC-adjacent mucosa is not fully equivalent to distant normal mucosa but carries coordinated tumor-directed transcriptional changes mainly associated with epithelial-cell programs.