Desmoplastic small round cell tumors (DSRCTs) are a rare malignancy found in male adolescents that initially occur mostly in the abdominal cavity. Diagnosis is based on the histologic analysis of biopsies, which typically show small round blue cells in nests separated by abundant desmoplastic stroma. DSRCTs are associated with a unique chromosomal translocation t (11:22) (p 13;q 12) that involves the Ewing's sarcoma (EWS) gene and the Wilms' tumor (WT1) gene. Reverse transcriptase-polymerase chain reaction can be used to detect the fusion gene in fresh or paraffin-embedded tissues, which confirms the diagnosis. The prognosis is particularly poor. The median survival ranges from 17 to 25 months. Management of DSRCT remains challenging despite the use of aggressive ther-apies such as polychemotherapy, debulking surgery, and whole abdominal radiation. Several methods for improving patient survival are being evaluated, such as the addition of chemotherapy and targeted therapies to normal neoadjuvant protocols, complete surgical resec-tion with hyperthermic intraperitoneal chemotherapy, postoperative intensity-modulated radiation therapy, and yttrium-90 microsphere liver embolization for treating hepatic metastases.

Objective To evaluate the advantages of plasma cell enrichment combined with fluorescence in situ hybridization (FISH) based on a panel of probes by the conventional cytogenetic (CC) analysis.Methods Fresh heparinized bone marrow samples were collected by bone marrow biopsy.Plasma cells were enriched in BM samples using a magnetic cell-sorting procedure to select CD138+ cells.The common chromosome abnormalities of MM were detected by FISH based on a panel of probes and CC analysis after short-term culture of the BM cells,in order to compare the differences between these two methods for the frequency of common cytogenetic abnormalities.Results 72 of 95 (75.8％) MM patients were found to carry clonal chromosome abnormalities by FISH.And RB 1 deletion was the highest at 44.2％ (42/95) followed by CKS1B (1q21) amplification (42.1％).The frequencies of CDKN2C (1p32) deletion,TP53 deletion,IGH/CCND1 and IGH/FGFR3 were 8.4％ (8/95),12.6％ (12/95),14.7％ (14/ 95) and 14.7％ (14/95),respectively.IGH/MAF was negative.Thirty-two of 95 (33.7％) patients were found to carry clonal aberrations by CC analysis.The frequency of chromosome abnormalities detected by FISH was significantly higher than CC analysis (75.8％ vs 33.7％,P =0.000).Conclusion Plasma cell enrichment combined with FISH based on a panel of probes can greatly increase the frequency of chromosome abnormalities,which provides cytogenetic basis for risk stratification and prognosis of MM patients.

Background: Insomnia often responds to the orexin receptor antagonist suvorexant. This study aimed to evaluate the efficacy and adverse events of suvorexant for Chinese patients with primary insomnia over 6 months. Methods: A total of 120 patients with primary insomnia were assigned randomly to two groups that received placebo or suvorexant (40 mg) for 6 months. The primary outcomes were the total sleep time (sTST), time to sleep onset (sTSO), and sleep quality (sQUAL). The secondary outcomes were the Insomnia Severity Index (ISI) score and adverse events. Results: A total of 111 patients completed the study and all of them were included in the final analysis. Suvorexant showed greater efficacy than the placebo in enhancing sTST, sTSO, sQUAL and ISI score at months 1 and 6. Serious adverse events were documented in 2 patients (3.3%) in the suvorexant group and 1 patients (1.7%) in the placebo group. The most common adverse event was somnolence, which occurred in 7 patients (11.7%) in the suvorexant group and 2 patients (3.3%) in the placebo group. No death related to suvorexant treatment was recorded. Conclusions: Suvorexant was efficacious and well-tolerated in a group of Chinese patients with primary insomnia over 6 months.
Sleep Initiation and Maintenance Disorders

Objective:To investigate the efficacy and safety of immune checkpoint inhibitors (ICI), programmed death receptor 1 (PD-1) inhibitors and programmed death receptor-ligand 1 (PD-L1) inhibitors in the treatment of extensive-stage small cell lung cancer (ES-SCLC).Methods:The databases of CNKI, Wanfang, VIP, China Biology Medicine disc, PubMed, Embase, and Cochrane Clinical Controlled Trial Center Registry (CENTRAL) were retrieved, and the randomized controlled trial literature on the treatment of ES-SCLC with immune checkpoint inhibitors published from the establishment of the database until October 4, 2023 were reviewed. After screening literature and extracting data according to inclusion and exclusion criteria, the risk of bias in the study was evaluated using Review Manager 5.4 software. The disease remission, prognosis and adverse events (AE) of patients treated with ICI combined with chemotherapy (experimental group) and placebo± chemotherapy (control group) in the whole group and liver metastases and brain metastases subgroups were compared.Results:A total of 11 randomized controlled trials were included, with 2 243 cases in the experimental group and 2 059 cases in the control group. The included research data were complete and showed no selective bias. Compared with the control group, the objective response rate (ORR) of patients in the experimental group was higher [control group vs. experimental group, 64% (864/1 358) vs. 70% (1 088/1 532), RR = 1.08 (95% CI: 1.03-1.14), P = 0.003], and the difference was statistically significant; progression free survival (PFS) [experimental group vs. control group, the median PFS time, 5.14 months (95% CI: 4.88-5.40 months) vs. 4.76 months (95% CI: 4.70-4.82 months), HR = 0.72 (95% CI: 0.67-0.78), P < 0.001] and overall survival (OS) [experimental group vs. control group, the median OS time, 12.89 months (95% CI: 12.18-13.60 months) vs. 10.41 months (95% CI: 10.03-10.79 months), HR = 0.72 (95% CI: 0.67-0.78), P < 0.001] were all improved, and the differences were statistically significant. The OS of patients with baseline liver metastasis in the experimental group was better than that in the control group (experimental group vs. control group, HR = 0.82 (95% CI: 0.71-0.95), P = 0.009], and the difference was statistically significant, while the difference in OS of patients with baseline brain metastases was not statistically significant between the experimental group and the control group [experimental group vs. control group, HR = 0.84 (95% CI: 0.66-1.08), P = 0.170]. The incidence of AE [experimental group vs. control group, 31% (597/1 952) (95% CI: 24%-37%) vs. 14% (255/1 762) (95% CI: 9%-22%), RR = 2.25 (95% CI: 1.67-3.02), P < 0.001] and the incidence of drug discontinuation or dose change caused by AE [experimental group vs. control group, 21% (379/1 774) (95% CI: 12%-41%) vs. 19% (307/1 588) (95% CI: 6%-25%), RR = 1.20 (95% CI: 1.07-1.33), P = 0.001] in the experimental group were higher than those in the control group, and the differences were statistically significant. However, the incidence of severe (≥grade 3) AE in both the experimental group and the control group was 34% (620/1 814, 557/1 632) (both 95% CI: 32%-36%), and the difference was not statistically significant [experimental group vs. control group, RR = 1.00 (95% CI: 0.91-1.10), P = 0.960]. The incidence of hypothyroidism [experimental group vs. control group, 11% (118/1 083) (95% CI: 9%-13%) vs. 1% (11/886) (95% CI: 0-2%), RR = 8.56 (95% CI: 4.63-15.80), P < 0.001] and the incidence of hyperthyroidism [experimental group vs. control group, 7% (75/1 083) (95% CI: 5%-8%) vs. 2% (17/886) (95% CI: 1%-4%), RR = 3.27 (95% CI: 1.95-5.46), P < 0.001] in the experimental group were both higher than those in the control group, and the differences were statistically significant. Conclusions:ICI combined with chemotherapy can effectively improve the OS, PFS and disease remission of patients with ES-SCLC, as well as improve the survival of patients with liver metastases. However, there is no benefit in the survival of patients with brain metastases. The incidence of immune-mediated AE to ICI combined with chemotherapy has increased, but the overall safety is good.

Objective To study the effects of heat shock treatment of rat bone marrow mesenehymal stem cells(MSCs),the apoptosis ratio of treated-cells under low serum condition and the treated-cells transplantation on left ventricular function in rats with myocardiaIinfarction.Methods MSC8 were heat-treated under 42℃for 30 min,then the heat shock protein-70(HSP-70)was detected bv Western blot.The apoptosis ratio of heat-treated MSCs under low serum condition was tested by Annexin kit.The treated-MSCs labeled with Dil were transplanted into infarcted myocardium and 8 weeks later,the cardiac function of rats in each group was evaluated by echocardiography and cardiac catheterization.Results The immunophenotype of heat-treated MSCs did not vary,Western blot confirmed a higher level expression of HSP-70 in the treated-MSCs group as compared with that in the control group.The early apoptosis ratio was lower in treated-MSCs measured by flow cytometry with annexin staining than that of MSCs when cultured with low serum medium.After 8 weeks,LVEF,LVSP,+dp/dtmax,and-dp/dtmax were significantly higher,and the LVEDP was significantly lowar in heat-treated MSCs transplantation group than that in the control group.Conclusions Heat shock pretreatment of MSCs enhances the tolerance of MSCs to low serum medium,whereas does not lcad to the change of the cell immunophenotype.Transplantation of heattreated MSCs might improve the cardiac function in a rat myocardialinfarction model.

Objective To investigate the clinical features of asthma at attack and chronic obstructive pulmonary disease (COPD) occurred at the same time (ACO),in elderly people for correct diagnosis and treatment of ACO.Methods A total of 102 elderly patients with either COPD or asthma who visited the Beijing Chaoyang Hospital from October 2010 to June 2016 were recruited for the study.Comparisons of clinical characteristics pulmonary function,airway inflammation and systemic inflammation,quality of life,acute aggravation,treatment and health care costs and comorbidity were carried out among the patients with COPD,asthma and ACO.Results ACO may present the features of both asthma and COPD.FEV1 and FEV1 FVC in ACO group (43.38±11.55)vs.(45.58±11.26) were significantly lower than those in asthma group(71.28±12.46) vs.(74.61±16.21) (P＜0.05),but there was no statistical difference between ACO group and COPD group (1.78±10.28)vs.(52.59±8.52)(P＞0.05).DLco in ACO group(61.86±13.53) was significantly lower than that in asthma group (86.28±16.54) (P＜0.05) and higher than that in COPD group(49.27±19.63) (P＜0.05).RV TLC in ACO group(49.85±12.59) was significantly higher than that in asthma group(29.58±1 5.43)(P＜0.05),but there was no statistical difference between ACO group and COPD group(52.65±1 1.58) (P＞＜0.05).Fractional exhaled nitric oxide(FeNO) in ACO group (29.37±10.85)was significantly lower than that in asthma group (40.18±11.86) (P＜0.05) and higher than that in COPD group(10.22±9.28) (P＜0.05).The proportion of patients with increased percentage of eosinophils in ACO group 25％ was significantly lower than that in asthma group 44.44％ (P＜0.05) and higher than that in COPD group 3.70％ (P＜0.05).The similar results were seen in IgE and C-reactive protein(CRP).There was significantly statistical difference in asthma control test(ACT) between ACO group and asthma group.There was significantly statistical difference in COPD assessment test(CAT) and the modified British Medical Research Council questionnaire (mMRC) scores between ACO group and COPD group;There was significantly statistical difference in six-minute walking distance (6MWD) among three groups(all P＜0.05).The number of acute exacerbations in ACO group (2.93±0.92) was significantly higher than that in asthma group(1.76±0.79)and COPD group(2.12±0.88) (F=14.09,P＜0.05).There was no statistical difference in treatment and health care costs among three groups(all P＞0.05).There were no statistically difference in comorbidity among three groups (all P＞0.05).Conclusions The clinical characteristics of ACO patients are different from those of COPD and asthma patients,It is necessary to understand the mechanism of ACO in order to improve the diagnosis and treatment.

Objective: To systematically analyze the revisions content and technological development trends of microbiological standards in the Chinese Pharmacopoeia (ChP) 2025 Edition, and explore its novel requirements in risk-based pharmaceutical product lifecycle management.
Methods: A comprehensive review was conducted on 26 microbiological-related standards to summarize the revision directions and scientific implications from perspectives including the revision overview, international harmonization of microbiological standards, risk-based quality management system, and novel tools and methods with Chinese characteristics.
Results: The ChP 2025 edition demonstrates three prominent features in microbiological-related standards: enhanced international harmonization, introduced emerging molecular biological technologies, and established a risk-based microbiological quality control system.
Conclusion: The new edition of the Pharmacopoeia has systematically constructed a microbiological standard system, which significantly improves the scientificity, standardization and applicability of the standards, providing a crucial support for advancing the microbiological quality control in pharmaceutical industries of China.

Objective To investigate the status of leader-member exchange quality , organizational identification and job performance of nurses , to discuss the relationship among them , and to clarify the internal mechanism.Methods Three hundred sixty-nine clinical nurses were surveyed by leader-member exchange scale, organizational identity scales and job performance scale according to the cross-sectional sampling methods.Results Three hundred sixty-nine questionnaires were issued and 267 questionnaires were responsive with an effective response rate of 72.36%.The average score of nurses ’ perception of leader-member exchange was (5.22 ±1.09), and the average score of nurses ’ perception of organizational identification was (5.60 ± 1.09), and the average score of nurses ’ perception of job performance was (5.45 ±1.11), and the average scores of three variables were above average .There were significant positive correlation the nurses ’ perception of leader-member exchange quality and organizational identification (r=0.56, P<0.01), and job performance (r=0.53, P<0.01).There were also significant positive correlation the nurses ’ perception of organizational identification and job performance (r=0.63, P<0.01).The nurses’ perception of leader-member exchange quality had positive influences onorganizational identification (β=0.53, P<0.01) and job performance (β=0.26, P<0.01).The organizational identification played an intermediary role in the relationship between the leader-member exchange quality and the job performance (β=0.254, P <0.01).Conclusions Nursing administrators should strengthen the communication with nurses , form a good psychological and emotional bond , and further to promote the organizational identification and job performance of nurses .