Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective To analyze the quality of 19 batches of Ginseng Formula Granules from 11 different manufacturers by using Ginseng water Extract reference substance(GWERS)as references.Methods Thin layer chromatography(TLC)identification and feature map detection were carried out according to the identification items and characteristic maps of Ginseng Formula Granules standard(YBZ-PFKL-2021186)issued by the National Medical Products Administration.Results The results of TLC analysis showed that the 19 batches of Ginseng Formula Granules-labeled samples could be divided into three categories.The overall pattern of the first type of samples was consistent with that of GWERS,and the similarity was high.Pseudoginsenoside F11,a unique component of American ginseng,was detected in the second type of samples.Four blue fluorescent spots were observed in the third type of samples compared to GWERS.HPLC results indicated that all 19 batches of Ginseng Formula Granules showed eight characteristic peaks at the same retention time as that of GWERS chromatogram.Two more chromatographic peaks were found in the chromatogram of three batches of samples from one manufacturer compared to the chromatogram of other samples,whose similarity to the GWERS chromatogram was less than 0.65.The similarity between the chromatogram of the remaining 16 sample and GWERS chromatogram was higher than 0.94.Conclusion At present,the quality of Ginseng Formula Granules on the market varies greatly.It was suspected that American ginseng might appear among them.The application of GWERS for quality analysis of Ginseng Formula Granules has better applicability to the control medicinal materials.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective:To investigate the impact of geniposide(GE)on lung injury in rats with acute respiratory distress syn-drome(ARDS)by regulating AMP-activated protein kinase(AMPK)/silencing information regulator 1(SIRT1)/nuclear factor κB(NF-κB)signaling pathway.Methods:The ARDS rat model was established by tracheal instillation of lipopolysaccharide(LPS).Fifty rats after modeling were randomly group into ARDS group,GE low-dose(GE-L,12.5 mg/kg GE)group,GE medium-dose(GE-M,25 mg/kg GE)group,GE high-dose group(GE-H,50 mg/kg GE)group and GE-H+Compound C(AMPK inhibitor,50 mg/kg GE+250 μg/kg Compound C)group,another 10 normal rats were used as the control group.After the intervention,the bronchoalveolar la-vage fluid(BALF)and lung tissue of the rats in each group were taken out,respectively,and the ratio of lung wet to dry weight(W/D)was detected;ELISA was used to detect the levels of inflammatory factors IL-6,interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)in BALF;the positive expressions of vascular cell adhesion factor(VCAM-1)and vascular endothelial cell growth factor(VEGF)in lung tissue were detected by immunohistochemistry;HE staining was used to observe the pathological changes of lung tissue;Western blot was used to detect the expression levels of AMPK/SIRT1/NF-κB pathway proteins in lung tissue.Results:The levels of W/D,IFN-γ,IL-6,TNF-α,p-NF-κB p65/NF-κB p65 and VCAM-1 in ARDS group were significantly higher than those in control group,the expressions of p-AMPK/AMPK,SIRT1 and VEGF were significantly decreased(P<0.05);after different doses of GE treatment,the levels of W/D,IFN-γ,IL-6,TNF-α,and the expressions of p-NF-κB p65/NF-κB p65 and VCAM-1 were gradually decreased compared with those in ARDS group;the expressions of p-AMPK/AMPK,SIRT1 and VEGF increased gradually(P<0.05);Compound C reversed the protective effect of GE-H on ARDS rats(P<0.05).Conclusion:GE can improve lung injury in ARDS rats and reduce levels of inflammatory factors,which may be related to activation of AMPK/SIRT1/NF-κB signaling pathway.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective The objective of this study was to analyze the incidence and mortality of female breast cancer in canc-er registration areas of Gansu province in 2019 and the change trend of female breast cancer incidence and mortality from 2010 to 2019,so as to provide data support for the prevention and treatment of breast cancer.Methods The incidence and mortality data of breast cancer and related demographic data in all cancer registration areas in Gansu province from 2010 to 2019 were collected.The incidence,mortality,age-standardized incidence by Chinese standard population(ASIRC),age-standardized mortality by Chinese standard population(ASMRC),age-standardized incidence by World standard population(ASIRW)and age-standardized mortality by World standard population(ASMRW),cumulative incidence and other key indicators of female breast cancer in each cancer registra-tion area were calculated according to urban and rural distribution and age groups.Joinpoint linear regression was used to analyze the annual change trend of incidence and mortality of female breast cancer in cancer registration areas in Gansu province from 2010 to 2019.Results In 2019,the number of new cases from female breast cancer in the cancer registration areas of Gansu province was 1,502 cases,accounting for 13.14%of all new malignant tumors in women.The incidence was 33.00/100,000,ASIRC and ASIRW were 23.83/100,000 and 23.81/100,000,respectively,and a cumulative rate of 0-74 years old was 2.34%.The incidence of breast cancer in urban and rural areas was 22.25/100,000 and 26.59/100,000,respectively.In 2019,the number of female breast cancer deaths in the cancer registration areas of Gansu province was 254,accounting for 5.61%of all female malignant tumor deaths.The crude mortality was 5.58/100,000,ASMRC and ASMRW were 3.70/100,000 and 3.90/100,000,respectively.The cumulative rate of 0-74 years old was 0.39%.The ASMRC of breast cancer in urban and rural areas was 3.63/100,000 and 3.79/100,000,respec-tively.The annual change trend in the ASIRC of female breast cancer in the province from 2010 to 2019 was not statistically significant(APC=-0.35%,P=0.81),while ASMRC decreased by an average of 9.85%per year(APC=-9.85%,P=0.03).Conclusion Breast cancer is a high incidence malignant tumor that threatens the physical and mental health of female residents in Gansu province,and it is a kind of cancer that women focus on.We should actively screen the risk group of women.

Hearing loss is one of the most common neurosensory disorders in humans,severely affecting pa-tients'quality of life with lack of ideal treatments.Its pathogenesis is related to oxidative stress,inflammation and apoptosis in the inner ear.Recent studies have demonstrated that members of the signal transducer and activator of transcriptions(STATs)family are involved in regulating gene expression in auditory cells during inner ear develop-ment and physiological activities such as apoptosis,oxidative stress,inflammation and autophagy during auditory disorders.In this paper,we review the research on STATs in inner ear development and hearing loss,and elucidate their specific molecular mechanisms,aiming to provide theoretical guidance and direction for the prevention and treatment of hearing loss.

Apelin is an adipokine family which includes Apelin-13,Apelin-36 and other isoforms and regulates phys-iological functions by immunomodulation,oxidative stress,glycolipid metabolism,and apoptosis and so on.Apelin is closely related to polycystic ovary syndrome,ovarian cancer and other diseases of the female reproductive system so it is expected to be new target molecules and may orient the development of research and clinical treatment.

Objective To assess the impact of intravenous esketamine administered prior to car-diopulmonary bypass(CPB)initiation on ventricular function and internal carotid artery blood flow in pa-tients undergoing heart valve replacement surgery.Methods Sixty patients underwent elective CPB heart valve replacement,38 males and 22 females,aged 18-75 years,BMI 18.5-30.0 kg/m2,ASA physical status Ⅱ or Ⅲ,NYHA cardiac function classification Ⅰ-Ⅲ,and a left ventricular ejection fraction(LVEF)of≥45％,were selected.The patients were randomly divided into two groups:esketamine group(group E)and normal saline group(group C),30 patients in each group.Total intravenous anesthesia was used during the operation.Following the initiation of CPB,group E received an intravenous infusion of es-ketamine at a rate of 0.5 mg·kg-1·h-1 until the conclusion of the procedure,while group C received an equivalent volume of normal saline concurrently at the same rate.HR,MAP,CVP,and cardiac output index(CI)were recorded before anesthesia induction,during skin resection,and within 60 minutes after stopping CPB.LVEF,left ventricular global longitudinal strain(GLS),global longitudinal time-to-peak strain standard deviation(GLTSD),global circumferential strain(GCS),global circumferential time-to-peak strain standard deviation(GCTSD),right ventricular ejection fraction(RVEF),right ventricular GLS,and GLTSD were obtained during skin resection,within 40 minutes of CPB,and 60 minutes after stopping CPB.rScO2,BIS,concentrations of Hb and lactic acid(Lac),peak systolic flow velocity(SPV),quantity of flow-internal carotid artery(Q-ICA),and blood flow resistance index(RI)were recorded before anesthesia induction,during skin resection,within 40 minutes of CPB,and within 60 minutes after stopping CPB.Concentrations of cardiac troponin Ⅰ(cTnⅠ),alanine aminotransferase(ALT),creatinine(Cr),and neuron-specific enolase(NSE)were recorded before anesthesia induction and 6 hours after operation.Spon-taneous resuscitation after CPB,postoperative extubation time,duration of ICU stay,total hospital stay,in-cidence of adverse cardiac events,and 30-day postoperative mortality were recorded.Results Compared with group C,group E exhibited a significant increase in CI within 60 minutes after stopping CPB(P＜0.05).The LVEF,RVEF,and right ventricular GLS demonstrated significant increases within 60 minutes after stopping CPB in group E compared with group C(P＜0.05).The left ventricular GLS and left ven-tricular GCTSD displayed significant increases 30 minutes after stopping CPB in group E compared with group C.The RI exhibited a significant increase within 40 minutes of CPB in group E compared with group C(P＜0.05).There were no significant differences in cTnⅠ,ALT,Cr,NSE,spontaneous resuscitation affter CPB,postoperative extubation time,duration of ICU stay,total hospital stay,incidence of cardiac adverse events,and 30-day postoperative mortality between the two groups.Conclusion Administration of esket-amine following the onset of CPB in patients undergoing cardiac surgery demonstrates a significant elevation in CI post-CPB cessation.Furthermore,it may augment ventricular longitudinal strain,thereby enhancing myocardial contraction,leading to increased postoperative ventricular ejection fraction,and sustaining hemo-dynamic stability.

Objective To explore the correlation between hyponatremia at admission and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Methods The 331 cases of elderly patients with intestinal obstruction(aged ≥ 60 years)who visited the General Surgery Department of Nanjing Meishan Hospital from January 2017 to December 2020 were selected as the research objects for retrospective cohort study analysis.According to the patient's blood sodium level at admission,they are divided into two groups:the hyponatremia group(Na＜135 mmol/L)and the non hyponatremia group(Na≥135 mmol/L).Divided into death group and survival group based on whether death occurred within one year after discharge.SPSS 25.0 software was used for statistical analysis.Independent sample t test,x2 test,Kaplan Meier method,and multivariate Cox regression analysis were used to observe the correlation between admission hyponatremia and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Results A total of 331 patients were enrolled.The incidence of hyponatremia was 32.3％,and 56 deaths occurred within one year,accounting for 16.92％.The one-year mortality rate in the hyponatremia group was 23.4％(25/107),which was higher than 13.8％(31/224)in the non hyponatremia group.The difference was statistically significant(P＜0.05).The survival analysis(Kaplan Meier)results showed that the survival rate of the hyponatremia group was lower than that of the non hyponatremia group(Log Rank P＜0.05).After adjusting for other confounding factors in multivariate Cox regression analysis,hyponatremia(HR=1.88,95％CI:1.07-3.29)was an independent risk factor for one-year all-cause mortality in elderly patients with intestinal obstruction(P＜0.05).Conclusion Hyponatremia at admission is an independent risk factor for all cause mortality in elderly patients with intestinal obstruction within one year after discharge.