ObjectivesTo provide an updated systematic review and meta-analysis of published randomized controlled trials (RCTs) of the efficacy and safety of programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors combined with chemotherapy versus chemotherapy alone in the treatment of extensive-stage small-cell lung cancer (ES-SCLC).MethodsPubMed, Web of Science, Embase, Clinicaltrials and the Cochrane Library were systematically searched to extract RCTs concerning the efficacy and safety of PD-1/PD-L1 inhibitors combined with chemotherapy versus chemotherapy alone in the treatment of ES-SCLC from the time of database inception to October 31, 2022. The literature was independently selected, information was extracted and the risk of bias of the RCTs was evaluated according to the inclusion and exclusion criteria. Stata14.0 was used for the meta-analysis.ResultsSix studies involving 2,600 patients were included in the analysis. The results of the meta-analysis showed that the combination of PD-1/PD-L1 inhibitors significantly improved the OS (HR: 0.73, 95% CI: 0.66-0.80; P<0.0001), prolonged PFS (HR: 0.66,95% CI: 0.55-0.79; P<0.0001) and did not increase overall incidence of treatment-related adverse events (TRAEs) (RR: 1.03, 95% CI: 0.97-1.09; P=0.330) in ES-SCLC patients compared with chemotherapy alone. The subgroup analysis found that patients with negative PD-L1 expression (< 1%) benefited in OS, whereas patients with positive PD-L1 expression (≥1%) had no statistically significant difference in OS. There was a statistically significant difference in PFS between PD-L1-negative (< 1%) and PD-L1-positive (≥1%) patients. The addition of a PD-1 inhibitor or PD-L1 inhibitor to the chemotherapy regimen can improve OS and prolong PFS in patients with ES-SCLC.ConclusionsPD-1/PD-L1 inhibitors combination chemotherapy significantly improves PFS and OS in ES-SCLC patients without increasing the overall incidence of TRAEs.
In order to reduce turbulence-induced scintillation and deal with alignment problems, a
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multiple-input multiple-output (MIMO) underwater wireless optical communication (UWOC) system is proposed and experimentally demonstrated. With help of the large divergence angle of light beams and large field of view (FOV) of the detectors, the effect of high-density air bubbles is greatly eliminated. Simulation and experimental results confirm that, in most intensity-modulation/direct-detection (IM/DD) MIMO-UWOC systems, the repetition coding (RC) scheme performs better than the space–time block coding (STBC) scheme. In a 50 m swimming pool, the maximum horizontal offset can reach 97.9 cm, which is 421% and 192% higher than that of STBC multiple-input single-output (MISO) and RC-MISO/STBC-MIMO schemes, respectively. With a data rate of 233 Mbps and a transmission distance of 50 m, the large detection range can meet a variety of underwater wireless communication requirements. The experiment indicates that, when the difference in the transmission distance between the two optical signals is higher than 1 m, the bit error rate (BER) of the RC scheme increases sharply, while the BER of the STBC scheme is stable. The MIMO coding scheme needs to be selected according to the actual application environment.
Nanosecond dissipative soliton resonance pulse is a demonstration of an all polarization-maintaining (PM) thulium-doped fiber laser in a nonlinear amplifying loop mirror (NALM)-based figure-eight configuration. Each loop of the apparatus includes a controllable power amplifier. With increased amplifier power, pulse width broadens linearly from 3.6 to 13.5 ns, and maximum single pulse energy can reach 27.5 nJ. Interestingly, the output peak power presents two completely opposite proportional effects in terms of the variation of settings for two amplifiers, respectively. The experimental results show that the NALM loop plays an important role for tunable pulse duration, and the unidirectional ring part makes a significant contribution for power scaling.
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