Objective:To explore the association between the use of tetracyclines during pregnancy and congenital malformations, with the aim of providing evidence-based guidance for the rational use of antibiotics during pregnancy.Methods:Data from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) and the Canada Vigilance Adverse Reaction (CVAR) database from January 2015 to September 2024 were collected. Five methods including Tree-based scan statistic (TreeScan), proportional reporting ratio (PRR), reporting odds ratio (ROR), the UK Medicines and Healthcare Products Regulatory Agency (MHRA) comprehensive standard, and the Bayesian confidence propagation neural network (BCPNN) were used to detect signals of risk for congenital malformations in offspring following maternal use of tetracyclines during pregnancy. A signal that met the threshold criteria of all above 5 methods was considered as a risk signal. Based on population-based cohort of the drug exposures and adverse pregnancy outcomes (DEEP) data from January 2013 to December 2021 in Xiamen City, propensity score matching (PSM)-based Poisson regression was applied to evaluate the association between the first-trimester tetracyclines exposure and congenital malformations in offspring. Adjusted relative risk (a RR) and its 95% confidence interval ( CI) were calculated. Sensitivity analysis was conducted to validate the reliability of the results. Results:A total of 304 098 reports of adverse events during pregnancy were obtained from the FAERS and CVAR databases. Among them, 5 028 reports were related to tetracyclines, including 1 026 reports of congenital malformations in offspring, involving congenital malformations of musculoskeletal system, other digestive system, and other congenital malformations. Signal detection results suggested that tetracyclines may be a risk signal for above congenital malformations in offspring. The DEEP data included 411 936 pregnant women. After PSM, 240 pregnant women exposed to tetracyclines were included. The results showed no significant association between the first-trimester tetracyclines exposure and congenital malformations in offspring (a RR=0.75, 95% CI: 0.26-2.17), sensitivity analysis also showed no correlation. Conclusions:Data mining from the FAERS and CVAR databases suggests a potential association between tetracyclines use during pregnancy and congenital malformations in offspring. However, the DEEP data study shows no significant correlation.

Background and Aims:Precise localization of lesions and optimization of the surgical approach are crucial in laparoscopic left hepatectomy.Traditional surgical techniques have certain limitations,whereas indocyanine green(ICG)fluorescence navigation can accurately delineate the boundaries of liver lesions.The Laennec's capsule approach aids in clearly exposing intrahepatic structures.This study was conducted to evaluate the clinical effectiveness of combining ICG fluorescence navigation with the Laennec's capsule approach in laparoscopic left hepatectomy.Methods:The clinical data of 44 liver cancer patients who underwent surgery at the Hepatobiliary Surgery Department of Xuanhan People's Hospital from January 2023 to November 2024 were retrospectively collected.Among them,22 patients underwent laparoscopic left hepatectomy with Pringle's maneuver for total hepatic inflow occlusion(control group),while the other 22 patients received laparoscopic left hepatectomy using ICG fluorescence navigation combined with the Laennec's capsule approach(observation group).The two groups were compared in terms of intraoperative surgical time,average blood loss,intraoperative transfusion rate,liver function on postoperative days(POD)1,3,and 7[total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)],average length of hospital stay,gastrointestinal function recovery time,POD 1-6 drainage volume,incidence of postoperative complications,and short-term efficacy.Results:The observation group had significantly shorter average surgical time than the control group[(218.19±39.18)min vs.(245.23±44.36)min,P＜0.05]and less average blood loss[(320.44±78.62)mL vs.(456.37±88.16)mL,P＜0.05].The intraoperative transfusion rate between the two groups was not significantly different(13.64％vs.9.09％,P＞0.05).The observation group had significantly less postoperative drainage POD 1-6 than the control group[(431.19±152.18)mL vs.(528.23±184.36)mL,P＜0.05].The average hospital stay and gastrointestinal function recovery time were shorter in the observation group[(9.21±2.92)d vs.(12.72±3.24)d;(2.24±0.42)d vs.(3.35±0.53)d,both P＜0.05].Postoperative liver function tests(TBIL,AST,ALT)on days 1,3,and 7 were significantly lower in the observation group compared to the control group(all P＜0.05).The difference in the overall response rate between the two groups was not statistically significant(72.73％vs.77.27％,P＞0.05).No severe postoperative complications occurred in either group.Conclusion:The combination of ICG fluorescence navigation with the Laennec's capsule approach demonstrates favorable clinical outcomes in laparoscopic left hepatectomy and is worthy of clinical promotion.

Kidney transplant recipient (KTR) faces significant challenges in long-term survival, with the incidence of post-transplant malignancies being 2 to 3 times higher than that of the general population, making it the second leading cause of death in KTR. Immune checkpoint inhibitors (ICI) represent an important breakthrough in malignancy treatment, significantly improving the prognosis of some malignancy patients by blocking co-inhibitory signaling molecules and activating T lymphocyte activity. However, due to concerns about the risk of rejection, solid organ transplant recipients, including KTR, are usually excluded from ICI clinical trials. Existing evidence shows that the incidence of rejection during ICI treatment can be as high as 40%-50%, with the specific mechanisms not yet clear. Therefore, how to enable KTR to effectively benefit from the anti-tumor effects of ICI while avoiding rejection is crucial. This article focuses on the core contradiction of ICI in the treatment of post-transplant malignancies in KTR, that is, the dual effects of activating anti-tumor immunity and inducing transplant kidney rejection. It systematically reviews the current clinical application status and challenges, and explores optimization strategies for the delicate balance between restoring anti-tumor immunity and triggering rejection.

Objective:To investigate the current status of supportive care needs in lymphoma patients and the influencing factors.Methods:A single-center cross-sectional survey was conducted. By using convenience sampling, lymphoma patients hospitalized in the Fujian Medical University Union Hospital from September 2020 to April 2021 were prospectively selected as the research objects. A self-designed general information questionnaire (including gender, age, residence, education level, occupation, monthly household income per capita, payment method for medical expenses, commercial insurance status, disease duration, and treatment course) and the hematological malignancy specific supportive care needs scale were used for face-to-face interviews in lymphoma patients. Differences in supportive care needs scores among patients with different characteristics were compared, and the unmet rate of supportive care needs for each item was calculated. A generalized linear model was used to analyze the effects of social demographic characteristics and disease characteristics on supportive care needs scores.Results:A total of 340 subjects were enrolled. During data collection, 30 questionnaires that did not meet the requirements were excluded, resulting in 310 valid questionnaires from patients, yielding a qualification rate of 91.2%. The age of the 310 lymphoma patients was (43±14) years, including 176 males (56.8%) and 134 females (43.2%). The median total score [ M ( Q1, Q3)] of supportive care needs was 170 (114, 220) points, ranging from 51 to 255 points. There were 44 items with unmet rate >60% for supportive care needs, accounting for 86.3% of the total 51 items. The total supportive care needs score increased with higher educational level and fewer treatment cycles, and the differences in supportive care needs score between patients stratified by these 2 characteristics were statistically significant (both P < 0.05),while there were no statistically significant differences in the supportive care needs total score among patients stratified by gender, age, monthly household income per capita, payment method for medical expenses, commercial insurance condition, occupation, or disease duration (all P > 0.05). Generalized linear model analysis showed that education level (compared to college or above, high school/vocational school: β = -29.92, 95% CI: -47.42--12.41, P = 0.001), number of treatment courses (compared to 8 courses, 0-4 courses: β = 25.60, 95% CI: 4.76-46.45, P = 0.016), and age (compared to ≥66 years, 41-65 years: β = -29.76, 95% CI: -56.69--2.83, P = 0.030) were independent influencing factors for the supportive care needs score. Interaction effects among independent variables analysis showed that interaction effects were found between education level and payment method for medical expenses ( P = 0.005). Conclusions:Lymphoma patients generally exhibit high levels of supportive care needs. Healthcare professionals should therefore provide personalized supportive care based on factors such as the patients' number of age, treatment cycles, and educational level.

Objective To explore the risk factors of adverse pregnancy outcomes in the patients with cervical incompetence(CI),and to establish a risk warning model of adverse pregnancy outcomes in CI pa-tients based on decision tree model.Methods The clinical data of 159 patients with CI admitted and treated in this hospital from February 2022 to April 2023 were retrospectively analyzed,and the risk factors for adverse pregnancy outcomes were screened and the decision tree model for postoperative adverse pregnancy outcomes was constructed.The internal verification method was 5-fold cross-validation.Results The incidence rate of adverse pregnancy outcome was 22.64%.The pregnant weeks of cervical cerclage,amniotic cystocele,multiple cervical cerclage,preoperative cervical length and amniotic fluid sediment were all influential factors for ad-verse pregnancy outcome occurrence(P＜0.05).The amniotic fluid sediment was the most important factor affecting the postoperative adverse pregnancy outcome in CI patients,and the preoperative cervical length had little influence on the postoperative adverse pregnancy outcomes in CI patients.The area under the curve(AUC)value of logistic regression model was slightly higher than that of the decision tree model.The accura-cy rate of the 5-fold cross-validation model was 78.3%.Conclusion During clinical treatment,the above two models can be combined to find the influencing factors of postoperative adverse pregnancy outcomes in CI pa-tients from different aspects,and provide references for clinical medical staff to evaluate the disease condition of CI patients and formulate the intervention plans.

Objective:To explore the association between the use of tetracyclines during pregnancy and congenital malformations, with the aim of providing evidence-based guidance for the rational use of antibiotics during pregnancy.Methods:Data from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) and the Canada Vigilance Adverse Reaction (CVAR) database from January 2015 to September 2024 were collected. Five methods including Tree-based scan statistic (TreeScan), proportional reporting ratio (PRR), reporting odds ratio (ROR), the UK Medicines and Healthcare Products Regulatory Agency (MHRA) comprehensive standard, and the Bayesian confidence propagation neural network (BCPNN) were used to detect signals of risk for congenital malformations in offspring following maternal use of tetracyclines during pregnancy. A signal that met the threshold criteria of all above 5 methods was considered as a risk signal. Based on population-based cohort of the drug exposures and adverse pregnancy outcomes (DEEP) data from January 2013 to December 2021 in Xiamen City, propensity score matching (PSM)-based Poisson regression was applied to evaluate the association between the first-trimester tetracyclines exposure and congenital malformations in offspring. Adjusted relative risk (a RR) and its 95% confidence interval ( CI) were calculated. Sensitivity analysis was conducted to validate the reliability of the results. Results:A total of 304 098 reports of adverse events during pregnancy were obtained from the FAERS and CVAR databases. Among them, 5 028 reports were related to tetracyclines, including 1 026 reports of congenital malformations in offspring, involving congenital malformations of musculoskeletal system, other digestive system, and other congenital malformations. Signal detection results suggested that tetracyclines may be a risk signal for above congenital malformations in offspring. The DEEP data included 411 936 pregnant women. After PSM, 240 pregnant women exposed to tetracyclines were included. The results showed no significant association between the first-trimester tetracyclines exposure and congenital malformations in offspring (a RR=0.75, 95% CI: 0.26-2.17), sensitivity analysis also showed no correlation. Conclusions:Data mining from the FAERS and CVAR databases suggests a potential association between tetracyclines use during pregnancy and congenital malformations in offspring. However, the DEEP data study shows no significant correlation.

Background and Aims:Precise localization of lesions and optimization of the surgical approach are crucial in laparoscopic left hepatectomy.Traditional surgical techniques have certain limitations,whereas indocyanine green(ICG)fluorescence navigation can accurately delineate the boundaries of liver lesions.The Laennec's capsule approach aids in clearly exposing intrahepatic structures.This study was conducted to evaluate the clinical effectiveness of combining ICG fluorescence navigation with the Laennec's capsule approach in laparoscopic left hepatectomy.Methods:The clinical data of 44 liver cancer patients who underwent surgery at the Hepatobiliary Surgery Department of Xuanhan People's Hospital from January 2023 to November 2024 were retrospectively collected.Among them,22 patients underwent laparoscopic left hepatectomy with Pringle's maneuver for total hepatic inflow occlusion(control group),while the other 22 patients received laparoscopic left hepatectomy using ICG fluorescence navigation combined with the Laennec's capsule approach(observation group).The two groups were compared in terms of intraoperative surgical time,average blood loss,intraoperative transfusion rate,liver function on postoperative days(POD)1,3,and 7[total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)],average length of hospital stay,gastrointestinal function recovery time,POD 1-6 drainage volume,incidence of postoperative complications,and short-term efficacy.Results:The observation group had significantly shorter average surgical time than the control group[(218.19±39.18)min vs.(245.23±44.36)min,P＜0.05]and less average blood loss[(320.44±78.62)mL vs.(456.37±88.16)mL,P＜0.05].The intraoperative transfusion rate between the two groups was not significantly different(13.64％vs.9.09％,P＞0.05).The observation group had significantly less postoperative drainage POD 1-6 than the control group[(431.19±152.18)mL vs.(528.23±184.36)mL,P＜0.05].The average hospital stay and gastrointestinal function recovery time were shorter in the observation group[(9.21±2.92)d vs.(12.72±3.24)d;(2.24±0.42)d vs.(3.35±0.53)d,both P＜0.05].Postoperative liver function tests(TBIL,AST,ALT)on days 1,3,and 7 were significantly lower in the observation group compared to the control group(all P＜0.05).The difference in the overall response rate between the two groups was not statistically significant(72.73％vs.77.27％,P＞0.05).No severe postoperative complications occurred in either group.Conclusion:The combination of ICG fluorescence navigation with the Laennec's capsule approach demonstrates favorable clinical outcomes in laparoscopic left hepatectomy and is worthy of clinical promotion.