Objective:To investigate the incidence of port-site metastasis (PSM) after laparoscopic surgery in patients with epithelial ovarian cancer and prognostic factors influencing outcomes in those with abdominal wall PSM.Methods:Clinicopathological and follow-up data of 22 ovarian epithelial cancer patients diagnosed with abdominal wall PSM after laparoscopic surgery, who were treated in the Sichuan Cancer Hospital between May 2014 and July 2023, were retrospectively collected. A retrospective analysis of PSM characteristics and prognostic factors influencing outcomes, was conducted in these patients.Results:(1) Between May 2014 and July 2023, a total of 369 ovarian cancer patients with a history of laparoscopic surgery performed at other hospitals were admitted. Among them, 24 cases (6.5%, 24/369) were diagnosed with tumor lesions at the abdominal wall port sites via postoperative pathological examination, with a median interval time of 25.5 days (interquartile range: 19.5, 32.0 days) after laparoscopic surgery. Of these, 22 cases with complete clinicopathological and follow-up data were included in this study. (2) The age of the 22 PSM patients was (53.0±8.6) years, and the median follow-up time was 37.6 months (24.7, 63.4 months). Surgical-pathological staging revealed stage Ⅰ-Ⅱ disease in 4 cases and stage Ⅲ-Ⅳ disease in 18 cases. Histopathological differentiation included 5 cases of well-to-moderately differentiated tumors and 17 cases of poorly differentiated tumors. Pathological subtypes comprised 11 cases of high-grade serous adenocarcinoma, 5 cases of low-grade serous adenocarcinoma, and 6 cases of clear cell carcinoma or cystadenocarcinoma. Lymph node status was as follows: negative for lymph node metastasis ( n=16), positive ( n=5), and no lymphadenectomy performed ( n=1). Postoperative residual disease was categorized as no macroscopic residual disease ( n=13), residual disease ≤1 cm ( n=7), and residual disease >1 cm ( n=2). (3) Following secondary cytoreductive surgery combined with postoperative adjuvant therapy, the median progression-free survival and overall survival (OS) time of the patients were 8.8 months (4.6, 14.3 months) and 27.7 months (15.5, 38.4 months), respectively. Univariate Cox regression analysis demonstrated that surgical-pathological stage, histopathological differentiation grade, and lymph node metastasis status were significantly associated with OS time in patients with abdominal wall PSM (all P<0.05). In contrast, age, Eastern Cooperative Oncology Group performance status score, histopathological subtype, preoperative serum cancer antigen 125 level, presence of residual lesions after surgery and poly adenosine diphosphate ribose polymerase inhibitor usage showed no significant correlation with OS time (all P>0.05). Multivariate Cox regression analysis identified surgical-pathological stage ( HR=4.579，95% CI：1.111-18.866； P=0.035) and histopathological differentiation grade ( HR=5.307，95% CI：1.042-27.031； P=0.045) as independent risk factors for OS time in PSM patients. Conclusion:Abdominal wall PSM following laparoscopic surgery for epithelial ovarian cancer maybe adversely affect patient prognosis, particularly in cases with advanced stage and poorly differentiated tumors, which warrants significant clinical attention.

AIM:To compare the efficacy and safety of early combination therapy with ranibizumab and dexamethasone intravitreal implants versus ranibizumab monotherapy for the treatment of macular edema secondary to retinal vein occlusion(RVO-ME).METHODS: A retrospective cohort study was conducted on a total of 62 cases(64 eyes)of patients who were first diagnosed with RVO-ME at the Eye Centre of the Affiliated Hospital of Shandong Second Medical University between February 2022 and February 2023. The subjects were divided into two groups according to the different treatment regimens: 32 cases(34 eyes)in the monotherapy group received only ranibizumab [3+pro re nata(PRN)regimen], and 30 cases(30 eyes)in the combination therapy group were injected with ranibizumab once first, followed by dexamethasone intravitreal implant 3 wk later(1+DEX regimen). The best corrected visual acuity(BCVA), central retina thickness(CRT), foveal avascular zone(FAZ)area, macular vascular density(MVD)at the level of the deep vascular complex(DVC)of the retina, the incidence of ocular adverse effects, the number of drug injections, and the total cost between the two groups were compared before and after treatment.RESULTS: At 3 wk, 3 and 6 mo, and at the final follow-up of the two groups of patients, the improvement in BCVA, CRT, and MVD in the DVC layer was significantly better than that before treatment(all P<0.05); there were differences in the comparisons of BCVA and CRT between the two groups at 6 mo and the final follow-up(all P<0.05), and the increase in the number of letters of BCVA was the most pronounced in the combination therapy group at 6 mo of treatment. Statistical significant difference was observed in the comparison of MVD in the DVC layer between the two groups at 3 and 6 mo after treatment and at the final follow-up(all P<0.05). However, no significant change in FAZ area was evident before and after treatment in both groups(P>0.05). The combination therapy group exhibited a reduced number of injections and total cost in comparison to the monotherapy group. The combination therapy group exhibited a slightly higher incidence of high intraocular pressure and cataract progression compared to the monotherapy group, with no statistical significant difference(all P>0.05). Furthermore, no serious adverse events were observed in either group following treatment.CONCLUSION:Compared with ranibizumab alone, ranibizumab combined with dexamethasone intravitreal implant significantly improved vision, reduced macular edema, and lowered the frequency of injections and total treatment cost in patients with RVO-ME. CRT and MVD in the DVC layer are reliable prognostic indicators for patients with RVO-ME.

BACKGROUND: Poly adenosine-diphosphate-ribose polymerase (PARP) inhibitors (PARPi) have been approved to act as first-line maintenance (FL-M) therapy and as platinum-sensitive recurrent maintenance (PSR-M) therapy for ovarian cancer in China for >5 years. Herein, we have analyzed the clinical-application characteristics of olaparib and niraparib in ovarian cancer-maintenance therapy in a real-world setting to strengthen our understanding and promote their rational usage. METHODS: A retrospective chart review identified patients with newly diagnosed or platinum-sensitive recurrent ovarian cancer, who received olaparib or niraparib as maintenance therapy at Sichuan Cancer Hospital between August 1, 2018, and December 31, 2021. Patient medical records were reviewed. We grouped and analyzed patients based on the type of PARPi they used (the olaparib group and the niraparib group) and the line of PARPi maintenance therapy (the FL-M setting and the PSR-M setting). The primary endpoint was the 24-month progression-free survival (PFS) rate. RESULTS: In total, 131 patients (olaparib: n = 67, 51.1%; niraparib: n = 64, 48.9%) were enrolled. Breast cancer susceptibility genes ( BRCA ) mutations ( BRCA m) were significantly less common in the niraparib group than in the olaparib group [9.4% (6/64) vs . 62.7% (42/67), P <0.001], especially in the FL-M setting [10.4% (5/48) vs . 91.4% (32/35), P <0.001]. The 24-month progression-free survival (PFS) rates in the FL-M and PSR-M settings were 60.4% and 45.7%, respectively. In patients with BRCA m, the 24-month PFS rates in the FL-M and PSR-M settings were 62.2% and 72.7%, respectively. CONCLUSIONS Olaparib and niraparib were effective in patients with ovarian cancer without any new safety signals except for skin pigmentation. In patients with BRCA m, the 24-month PFS of the PARPi used in the PSR-M setting was even higher than that used in the FL-M setting.
Humans ; Female ; Ovarian Neoplasms/drug therapy* ; Piperazines/therapeutic use* ; Middle Aged ; Retrospective Studies ; Phthalazines/therapeutic use* ; Piperidines/therapeutic use* ; Indazoles/therapeutic use* ; Poly(ADP-ribose) Polymerase Inhibitors/therapeutic use* ; Adult ; Aged ; China ; Neoplasm Recurrence, Local/drug therapy* ; Progression-Free Survival

The translocator protein (TSPO) positron emission tomography (PET) can noninvasively detect neuroinflammation associated with epileptogenesis and epilepsy. This study explored the role of the TSPO-targeting radioligand [¹⁸F]F-TFQC, an m-trifluoromethyl ER176 analog, in the PET neuroimaging of epileptic rats. Initially, [¹⁸F]F-TFQC was synthesized with a radiochemical yield of 8%-10% (EOS), a radiochemical purity of over 99%, and a specific activity of 38.21 ± 1.73 MBq/nmol (EOS). After determining that [¹⁸F]F-TFQC exhibited good biochemical properties, [¹⁸F]F-TFQC PET neuroimaging was performed in epileptic rats at multiple time points in various stages of disease progression. PET imaging showed specific [¹⁸F]F-TFQC uptake in the right hippocampus (KA-injected site, i.e., epileptogenic zone), which was most pronounced at 1 week (T/NT 1.63 ± 0.21) and 1 month (T/NT 1.66 ± 0.20). The PET results were further validated using autoradiography and pathological analysis. Thus, [¹⁸F]F-TFQC can reflect the TSPO levels and localize the epileptogenic zone, thereby offering the potential for monitoring neuroinflammation and guiding anti-inflammatory treatment in patients with epilepsy.

Objective:To investigate the incidence of port-site metastasis (PSM) after laparoscopic surgery in patients with epithelial ovarian cancer and prognostic factors influencing outcomes in those with abdominal wall PSM.Methods:Clinicopathological and follow-up data of 22 ovarian epithelial cancer patients diagnosed with abdominal wall PSM after laparoscopic surgery, who were treated in the Sichuan Cancer Hospital between May 2014 and July 2023, were retrospectively collected. A retrospective analysis of PSM characteristics and prognostic factors influencing outcomes, was conducted in these patients.Results:(1) Between May 2014 and July 2023, a total of 369 ovarian cancer patients with a history of laparoscopic surgery performed at other hospitals were admitted. Among them, 24 cases (6.5%, 24/369) were diagnosed with tumor lesions at the abdominal wall port sites via postoperative pathological examination, with a median interval time of 25.5 days (interquartile range: 19.5, 32.0 days) after laparoscopic surgery. Of these, 22 cases with complete clinicopathological and follow-up data were included in this study. (2) The age of the 22 PSM patients was (53.0±8.6) years, and the median follow-up time was 37.6 months (24.7, 63.4 months). Surgical-pathological staging revealed stage Ⅰ-Ⅱ disease in 4 cases and stage Ⅲ-Ⅳ disease in 18 cases. Histopathological differentiation included 5 cases of well-to-moderately differentiated tumors and 17 cases of poorly differentiated tumors. Pathological subtypes comprised 11 cases of high-grade serous adenocarcinoma, 5 cases of low-grade serous adenocarcinoma, and 6 cases of clear cell carcinoma or cystadenocarcinoma. Lymph node status was as follows: negative for lymph node metastasis ( n=16), positive ( n=5), and no lymphadenectomy performed ( n=1). Postoperative residual disease was categorized as no macroscopic residual disease ( n=13), residual disease ≤1 cm ( n=7), and residual disease >1 cm ( n=2). (3) Following secondary cytoreductive surgery combined with postoperative adjuvant therapy, the median progression-free survival and overall survival (OS) time of the patients were 8.8 months (4.6, 14.3 months) and 27.7 months (15.5, 38.4 months), respectively. Univariate Cox regression analysis demonstrated that surgical-pathological stage, histopathological differentiation grade, and lymph node metastasis status were significantly associated with OS time in patients with abdominal wall PSM (all P<0.05). In contrast, age, Eastern Cooperative Oncology Group performance status score, histopathological subtype, preoperative serum cancer antigen 125 level, presence of residual lesions after surgery and poly adenosine diphosphate ribose polymerase inhibitor usage showed no significant correlation with OS time (all P>0.05). Multivariate Cox regression analysis identified surgical-pathological stage ( HR=4.579，95% CI：1.111-18.866； P=0.035) and histopathological differentiation grade ( HR=5.307，95% CI：1.042-27.031； P=0.045) as independent risk factors for OS time in PSM patients. Conclusion:Abdominal wall PSM following laparoscopic surgery for epithelial ovarian cancer maybe adversely affect patient prognosis, particularly in cases with advanced stage and poorly differentiated tumors, which warrants significant clinical attention.

Objective: To assess the safety and immunogenicity of freeze-dried rabies vaccine (Vero-cells) for human use on different immunization procedures in healthy people aged 9-65 years. Methods: A randomized, blind, positive-controlled clinical study was conducted in March 2015. The eligible residents aged 9-65 were recruited in Dengfeng city and Biyang County, Henan Province. A total of 1 956 subjects were enrolled. The subjects were randomly (1∶1∶1) assigned to 5-dose control group, 4-dose trial group and 5-dose trial group, with 652 subjects in each group. The subjects of 5-dose control group were immunized with control vaccine on days 0, 3, 7, 14 and 28. The subjects of 4-dose trial group were immunized with trial vaccine on days 0, 7 and 21 (2-1-1 phases) and the subjects of 5-dose trial group were immunized with trial vaccine on days 0, 3, 7, 14 and 28. A combination of regular follow-up and active reporting was used to observe local and systemic adverse reactions till 30 days after the first and full immunization, and the incidence rate of adverse reactions in three groups was analyzed and compared. The venous blood was collected before the first immunization, 7 days after the first immunization, 14 days after the first immunization and 14 days after the full immunization. The neutralizing antibody of rabies virus was detected by rapid fluorescent focus inhibition test (RFFIT), and the seropositive conversion rate and geometric mean concentration (GMC) of antibody were calculated. Results: The adverse reaction rates in 5-dose control group, 4-dose trial group and 5-dose trial group were 41.87% (273/652), 35.43% (231/652) and 34.97% (228/652), respectively. The adverse reaction rates of 4-dose trial group and 5-dose trial group were lower than those of the 5-dose control group (P<0.05). The local reactions were mainly pain, itching, swelling and redness in injection site, while the systemic reactions were mainly fever, fatigue, headache and muscle pain. The severity of adverse reactions was mainly mild (level 1), accounting for 85.33% (518/607), 89.02% (373/419) and 88.96% (427/480) of the total number of adverse reactions in each group. At 14 days after the first immunization and 14 days after the full immunization, the antibody positive conversion rates of three groups were all 100%. At 7 days, 14 days after the first immunization and 14 days after the full immunization, the GMCs of three groups were 0.60, 0.72, 0.59 IU/ml, 20.42, 23.99, 24.38 IU/ml and 22.95, 23.52, 24.72 IU/ml, respectively, with no significant difference (P>0.05). Conclusion: The freeze-dried rabies vaccine (Vero-cells) for human use has good safety and immunogenicity when inoculated according to 5-dose and 4-dose immunization procedures.
Humans ; Rabies Vaccines ; Antibodies, Viral ; Antibodies, Neutralizing ; Rabies virus ; Vaccination ; Rabies/prevention & control*

Objective:To explore whether the specific synaptic vesicle glycoprotein 2A (SV2A) targeted imaging agent ( R)-4-(3-fluoro-5-(fluoro- 18F)phenyl)-1-((3-methylpyridin-4-yl)methyl)pyrrolidin-2-one ( 18F-SDM-8) can be used to detect epileptic foci. Methods:Twenty male Sprague-Dawley (SD) rats (8-9 weeks) were injected with 1.2 μl of kainic acid (16 rats in the epilepsy group) or saline (4 rats in the control group) into the right hippocampus. 18F-SDM-8 and 18F-FDG mircoPET/CT imaging were respectively performed at 1-2 d (acute phase), 6-7 d (incubation period) and 45-60 d (chronic phase) after the seizure. Asymmetric index (AI) was used to evaluate the epileptic foci identify ability of 18F-SDM-8. Paired t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze data. Results:In the three periods of 18F-SDM-8 imaging, the differences of AI of hippocampus between the epilepsy group and control group were statistically significant ( z values: from -2.64 to 2.67, all P<0.05). Both imaging agents had asymmetric uptake in the epilepsy group (right was lower than left), and the decrease in the medial right temporal lobe was the most significant. The pathological staining results were consistent with the imaging results. In the chronic phase of the epilepsy group, the differences of 18F-SDM-8 SUV mean (right versus left) in each brain area of interest were statistically significant ( t value: from -33.40 to -5.60, all P<0.05). The asymmetric uptake of the two imaging agents in the hippocampus had a better correlation ( r=0.97, P=0.001), and the AI of 18F-SDM-8 ((34.2±8.4)%) in this area was 1.4 times higher than that of 18F-FDG ((24.6±4.7)%). Conclusions:18F-SDM-8 PET is a promising method to test the level of SV2A. It can reflect the changes of SV2A in the rat epilepsy model induced by intrahippocampal injection of kainic acid, and improve the sensitivity of molecular imaging for epileptic foci.

Objective:To investigate the application value of KARL iterative algorithm combined with low-dose CT scanning in young and middle-aged patients with femoral neck fractures.Methods:The clinical data of 132 young and middle-aged patients with femoral neck fractures diagnosed by clinical and CT scan in Taizhou Bo′ai Hospital from August 2019 to May 2022 were collected. There were 68 cases in the conventional dose group reconstructed by projection, and 64 cases in the low dose group reconstructed by KARL iterative algorithm. The subjective image quality score, the excellent and good rates and CT value, signal to noise ratio (SNR) were compared between the two groups. The effective dose (ED), CT dose index (CTDIvol), dose-length product (DLP) were compared between the two groups.Results:There were no significant differences in subjective image quality score, the excellent and good rates between the two groups ( P>0.05). There were no significant differences in CT values and SNR of the trabecular dense area at the central level of the femoral head, the iliopsoas muscle at the same level, and the anterior abdominal wall or buttocks subcutaneous fat at the same level between the two groups ( P>0.05). The levels of CTDIvol, DLP and ED in he low-dose group were lower than those in the conventional dose group: (3.35 ± 1.05) mGy vs. (12.90 ± 2.92) mGy, (66.33 ± 20.26) mGy/cm vs. (253.12 ± 58.57) mGy/cm, (0.99 ± 0.30) mSv vs. (3.79 ± 0.88) mSv, there were statistical differences ( P<0.05). Conclusions:Based on KARL iterative algorithm combined with low-dose CT scanning has no significant effect on the clinical diagnosis and classification of femoral neck fractures, the scanning image has a high objective evaluation value, and can effectively reduce the radiation dose received by patients, which is useful for clinical preoperative diagnosis and surgical planning.

Objective: To explore the effectiveness of preventive treatment for latent tuberculosis infection (LTBI) patients, so as to provide reference for the management and preventive treatment of clustered epidemic in schools. Methods: Data came from the school tuberculosis outbreak of a boarding high school in Kaizhou District, Chongqing, which occurred between June 2017 and March 2018 among 2016 grade high school teachers and students for investigation and analysis. The total incidence, LTBI patients, and the incidence after preventive treatment for 5 years were followed up. Results: A total of 34 cases of pulmonary tuberculosis from June 2017 to March 2018. A total of 1 357 individuals were screened for 6 concentrated contact screenings, with a confirmed tuberculosis rate of 2.43%, a tuberculosis skin test (TST) positive rate of 27.41%, and a strong TST positive rate of 7.39%. Among them, the confirmed tuberculosis rate and TST positive rate in the first case class were much higher than those in other classes, with statistically significant differences ( χ 2=286.30, 98.59, P ＜0.01). 88 cases of LTBI were found, with 31 cases receiving preventive treatment (35.23%), of which 28 completed preventive treatment (90.32%). After five years of follow-up, 73 cases of pulmonary tuberculosis were diagnosed in 2016 by the school senior high school, with a incidence rate of 0.98/10 2 (person/person years). Fifteen of the 88 LTBI patients were diagnosed with pulmonary tuberculosis, and the incidence rate was 3.33/10 2 (person/person years). The incidence rate of the preventive treatment group was 0.7/10 2 (person/person years)lower than that of the medical observation group 4.5/10 2 (person/person years), with a statistically significant difference ( χ 2=4.31, P ＜0.05). Conclusion The classes with higher TST positive rate and strong positive rate have higher incidence rate. Improving the preventive treatment rate of LTBI patients can effectively reduce the incidence rate of tuberculosis.