Antibody-drug conjugates （ADCs） are a novel class of anti-tumor agents composed of a targeted monoclonal antibody， a cytotoxic drug， and a linker connecting the two. They combine the high specificity of antibodies with the potent cytotoxicity of chemotherapeutic agents. Triple-negative breast cancer （TNBC） is characterized by high aggressiveness， elevated risks of recurrence and metastasis， and poor prognosis， largely due to the lack of effective therapeutic targets. This review summarizes the research progress of ADCs in the treatment of TNBC. It has been found that ADCs targeting human epidermal growth factor receptor 2 （such as trastuzumab deruxtecan）， trophoblast cell surface antigen 2 （such as sacituzumab govitecan and datopotamab deruxtecan）， zinc transporter LIV-1 （such as ladiratuzumab vedotin）， HER-3 （such as patritumab deruxtecan）， epidermal growth factor receptor （such as AVID100）， and glycoprotein non-metastatic melanoma protein B （such as glembatumumab vedotin） have all demonstrated promising therapeutic effects against TNBC. Despite challenges including acquired resistance and treatment-related toxicities， ADCs are undoubtedly reshaping the therapeutic landscape for TNBC and are expected to occupy a more central position in TNBC treatment in the future.

Objective To investigate the value of serum α-hydroxybutyric dehydrogenase(α-HBDH),cysteine-rich protein 61(CYR61)and gasdermin D(GSDMD)level testing in patients with sepsis-combined cardiomyopathy for clinical diagnosis and prognostic assessment.Methods A total of 244 sepsis patients who underwent consultation and treatment in Baotou Central Hospital from May 2020 to December 2023 were selected as the study subjects,and were separated into a study group(combined cardiomyopathy,n=106)and a control group(uncombined cardiomyopathy,n=138)according to whether they were combined cardiomyopathy or not.The levels of α-HBDH,CYR61 and GSDMD were measured by enzyme linked immunosorbent assay(ELISA)method.Pearson and Spearman methods were used to analyze the correlation of α-HBDH,CYR61,and GSDMD with systolic and diastolic blood pressure,left ventricular ejection fraction(LVEF)and acute physiology and chronic health evaluationⅡ(APACHE II)score.Multifactorial Logistic regression was used to analyze the factors affecting sepsis-combined cardiomyopathy.Receiver operator characteristic(ROC)curves were used to assess the diagnostic value of α-HBDH,CYR61 and GSDMD for sepsis-combined cardiomyopathy and their validity for prognostic prediction.Results Serum α-HBDH(278.35±18.89ng/ml vs 253.47±12.75ng/ml),CYR61(18.23±4.14mg/L vs 14.48±2.67mg/L)and GSDMD(12.39±3.28mg/L vs 9.46±2.17mg/L)levels were higher in the study group compared to the control group,and the differences were statistically significant(t=12.261,8.572,8.377,all P<0.05).The levels of α-HBDH(291.93±19.22ng/ml),CYR61(20.33±3.43mg/L)and GSDMD(14.01±3.09mg/L)were higher in the death patients compared to the survived patients(268.71±13.09ng/ml,16.74±2.88mg/L,11.24±2.55mg/L),and the differences were statistically significant(t=7.402,5.839,5.044,all P<0.05).Correlation analysis showed that α-HBDH,CYR61,and GSDMD were negatively correlated with systolic blood pressure,diastolic blood pressure and LVEF(r=-0.631～-0.422,all P<0.05),α-HBDH,CYR61,GSDMD were negatively correlated with APACHE II score(r=0.531,0.507,0.611,all P<0.05).Multifactorial Logistic regression analysis showed that systolic blood pressure,diastolic blood pressure,and LVEF were protective factors affecting sepsis-combined cardiomyopathy(Wald χ2=6.823,7.986,10.875,all P<0.05),and α-HBDH,CYR61,and GSDMD were risk factors affecting sepsis-combined cardiomyopathy(Wald χ2=9.376,6.849,7.435,all P<0.05).From the ROC curve analysis,it was known that the combined application of α-HBDH,CYR61,and GSDMD was more effective in the diagnosis of sepsis-combined cardiomyopathy(Z=2.369,2.454,2.573),the combined application of α-HBDH,CYR61,and GSDMD were superior for prognostic prediction in sepsis-combined cardiomyopathy(Z=2.352,2.468,2.581),and the differences were statistically significant(all P<0.05).Conclusion Serum α-HBDH,CYR61 and GSDMD levels are increased in patients with sepsis-combined cardiomyopathy,and they are correlated with prognosis.The combination of these three tests has a higher diagnostic value and prognostic value in sepsis combined cardiomyopathy.

Objective:To observe macular vascular density and structural characteristics in children with transfusion-dependent β-thalassemia (TDT).Methods:A retrospective clinical study. From October 2022 to December 2023, 29 TDT children (58 eyes) diagnosed and examined at the Department of Hematology, Affiliated Hospital of Guangdong Medical University were included in the TDT group, along with 29 age- and gender-matched healthy children (58 eyes) as the control group. All participants underwent optical coherence tomography and angiography. Measurements included central macular thickness (CMT), subretinal choroidal thickness (SFCT), choroidal thickness (ChT), choroidal vascularity index, blood flow density in the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris layer (CC), and choroidal layer of the macular region, as well as the foveal avascular zone (FAZ) area of the SCP and DCP. A generalized estimating equation was used to compare differences in the above parameters between the two groups. Pearson correlation analysis was employed to examine the relationships between fundus structural parameters, blood flow density, and blood indices.Results:Compared with the control group, the TDT group showed significantly thinner CMT ( χ2=6.044) and ChT at 3.0 mm nasal ( χ2=4.451) and temporal ( χ2=4.767) to the fovea ( P<0.05). The TDT group also demonstrated reduced blood flow density in the inferior DCP ( χ2=5.254), whole CC ( χ2=3.996), and superior CC ( χ2=5.094), as well as enlarged FAZ area in DCP ( χ2=4.286) ( P<0.05). Correlation analysis revealed a negative correlation between SFCT and disease duration ( r=?0.357, P=0.006). Conclusions:In children with TDT, CMT and ChT become thinner and the area of FAZ expands. The blood flow densities of DCP and CC in the macular area decreased.

Objective To investigate the value of serum α-hydroxybutyric dehydrogenase(α-HBDH),cysteine-rich protein 61(CYR61)and gasdermin D(GSDMD)level testing in patients with sepsis-combined cardiomyopathy for clinical diagnosis and prognostic assessment.Methods A total of 244 sepsis patients who underwent consultation and treatment in Baotou Central Hospital from May 2020 to December 2023 were selected as the study subjects,and were separated into a study group(combined cardiomyopathy,n=106)and a control group(uncombined cardiomyopathy,n=138)according to whether they were combined cardiomyopathy or not.The levels of α-HBDH,CYR61 and GSDMD were measured by enzyme linked immunosorbent assay(ELISA)method.Pearson and Spearman methods were used to analyze the correlation of α-HBDH,CYR61,and GSDMD with systolic and diastolic blood pressure,left ventricular ejection fraction(LVEF)and acute physiology and chronic health evaluationⅡ(APACHE II)score.Multifactorial Logistic regression was used to analyze the factors affecting sepsis-combined cardiomyopathy.Receiver operator characteristic(ROC)curves were used to assess the diagnostic value of α-HBDH,CYR61 and GSDMD for sepsis-combined cardiomyopathy and their validity for prognostic prediction.Results Serum α-HBDH(278.35±18.89ng/ml vs 253.47±12.75ng/ml),CYR61(18.23±4.14mg/L vs 14.48±2.67mg/L)and GSDMD(12.39±3.28mg/L vs 9.46±2.17mg/L)levels were higher in the study group compared to the control group,and the differences were statistically significant(t=12.261,8.572,8.377,all P<0.05).The levels of α-HBDH(291.93±19.22ng/ml),CYR61(20.33±3.43mg/L)and GSDMD(14.01±3.09mg/L)were higher in the death patients compared to the survived patients(268.71±13.09ng/ml,16.74±2.88mg/L,11.24±2.55mg/L),and the differences were statistically significant(t=7.402,5.839,5.044,all P<0.05).Correlation analysis showed that α-HBDH,CYR61,and GSDMD were negatively correlated with systolic blood pressure,diastolic blood pressure and LVEF(r=-0.631～-0.422,all P<0.05),α-HBDH,CYR61,GSDMD were negatively correlated with APACHE II score(r=0.531,0.507,0.611,all P<0.05).Multifactorial Logistic regression analysis showed that systolic blood pressure,diastolic blood pressure,and LVEF were protective factors affecting sepsis-combined cardiomyopathy(Wald χ2=6.823,7.986,10.875,all P<0.05),and α-HBDH,CYR61,and GSDMD were risk factors affecting sepsis-combined cardiomyopathy(Wald χ2=9.376,6.849,7.435,all P<0.05).From the ROC curve analysis,it was known that the combined application of α-HBDH,CYR61,and GSDMD was more effective in the diagnosis of sepsis-combined cardiomyopathy(Z=2.369,2.454,2.573),the combined application of α-HBDH,CYR61,and GSDMD were superior for prognostic prediction in sepsis-combined cardiomyopathy(Z=2.352,2.468,2.581),and the differences were statistically significant(all P<0.05).Conclusion Serum α-HBDH,CYR61 and GSDMD levels are increased in patients with sepsis-combined cardiomyopathy,and they are correlated with prognosis.The combination of these three tests has a higher diagnostic value and prognostic value in sepsis combined cardiomyopathy.

Objective:To observe macular vascular density and structural characteristics in children with transfusion-dependent β-thalassemia (TDT).Methods:A retrospective clinical study. From October 2022 to December 2023, 29 TDT children (58 eyes) diagnosed and examined at the Department of Hematology, Affiliated Hospital of Guangdong Medical University were included in the TDT group, along with 29 age- and gender-matched healthy children (58 eyes) as the control group. All participants underwent optical coherence tomography and angiography. Measurements included central macular thickness (CMT), subretinal choroidal thickness (SFCT), choroidal thickness (ChT), choroidal vascularity index, blood flow density in the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris layer (CC), and choroidal layer of the macular region, as well as the foveal avascular zone (FAZ) area of the SCP and DCP. A generalized estimating equation was used to compare differences in the above parameters between the two groups. Pearson correlation analysis was employed to examine the relationships between fundus structural parameters, blood flow density, and blood indices.Results:Compared with the control group, the TDT group showed significantly thinner CMT ( χ2=6.044) and ChT at 3.0 mm nasal ( χ2=4.451) and temporal ( χ2=4.767) to the fovea ( P<0.05). The TDT group also demonstrated reduced blood flow density in the inferior DCP ( χ2=5.254), whole CC ( χ2=3.996), and superior CC ( χ2=5.094), as well as enlarged FAZ area in DCP ( χ2=4.286) ( P<0.05). Correlation analysis revealed a negative correlation between SFCT and disease duration ( r=?0.357, P=0.006). Conclusions:In children with TDT, CMT and ChT become thinner and the area of FAZ expands. The blood flow densities of DCP and CC in the macular area decreased.

Beta-thalassemia major(β-TM)is an inherited disease caused by a defect in the synthesis of globin. The disease requires long-term blood transfusion and iron chelator treatment, which can cause various secondary changes in the body and eye tissues. Compared with normal peers, β-TM patients will show changes in the eye such as steeper corneal curvature, shallower anterior chamber, increased lens thickness, shorter axial length, and reduced tear secretion. At the same time, nutritional deficiencies and the use of iron chelator drugs will increase the risk of complicated cataract and retinal degeneration, thus affecting the quality of life of β-TM patients.This article combines relevant domestic and foreign literatures to explore and review the changes in the eye of β-TM patients, with a view to providing valuable insights for clinical practice.

β thalassemia is a hereditary hemolytic disease caused by the defect of β globin gene. Transfusion-dependent β thalassemia patients need long-term blood transfusion to survive, and a series of systemic and ocular complications will occur in the disease itself and long-term blood transfusion. Retinal blood vessel density decreases, retinal thickness thinned and elastic pseudoxanthoxanoma syndrome are found in fundus due to long-term anemia and side effects of iron chelating agent. At present, there are few reports about eye changes in thalassemia patients, and the cognition is relatively scarce. Therefore, it is necessary to be vigilant for physicians, deeply explore the cause and symptomatic treatment, combined with individual disease characteristics, to provide a more scientific and accurate plan for clinical treatment.

Objective:To analyze the present situation and influencing factors of operational efficiency of tertiary public hospitals in Anhui province, so as to provide reference for promoting the development of medical and health care in Anhui province.Methods:The operational efficiency index of performance appraisal of national tertiary public hospitals was taken as the research index system. The operational efficiency data of 75 tertiary public hospitals in Anhui province in 2020 and 2021 were extracted from the " 2021 Performance Appraisal Analysis Report of Anhui Provincial Tertiary Public Hospitals" compiled by the Anhui Provincial Public Hospital Supervision and Management Center. The entropy weight TOPSIS method was used to evaluate the operational efficiency, and logistic regression analysis was used to identify the influencing factors of operational efficiency of tertiary public hospitals in Anhui province.Results:Among the 9 operational efficiency indicators, 7 indicators showed better data in 2021 than in 2020. The proportion of medical service revenue in medical revenue and the proportion of personnel expenses in operating expenses were the key indicators affecting the operational efficiency. Multivariate logistic regression analysis showed that specialized hospitals ( OR=3.350, 95% CI 1.068-11.591) and annual outpatient visits>500 000 ( OR=0.248, 95% CI 0.073-0.845) were the influencing factors on the operational efficiency of tertiary public hospitals in Anhui province ( P<0.05). Conclusions:The operational efficiency of tertiary public hospitals in Anhui province was improved overall in 2021 compared with 2020. It is suggested to further optimize the structure of hospital revenue and expenditure, promote the implementation of hierarchical diagnosis and treatment policy, and optimize the allocation of health resources, so as to guide hospitals to improve operational efficiency through connotative development.

Objective:To analyze the present situation and influencing factors of operational efficiency of tertiary public hospitals in Anhui province, so as to provide reference for promoting the development of medical and health care in Anhui province.Methods:The operational efficiency index of performance appraisal of national tertiary public hospitals was taken as the research index system. The operational efficiency data of 75 tertiary public hospitals in Anhui province in 2020 and 2021 were extracted from the " 2021 Performance Appraisal Analysis Report of Anhui Provincial Tertiary Public Hospitals" compiled by the Anhui Provincial Public Hospital Supervision and Management Center. The entropy weight TOPSIS method was used to evaluate the operational efficiency, and logistic regression analysis was used to identify the influencing factors of operational efficiency of tertiary public hospitals in Anhui province.Results:Among the 9 operational efficiency indicators, 7 indicators showed better data in 2021 than in 2020. The proportion of medical service revenue in medical revenue and the proportion of personnel expenses in operating expenses were the key indicators affecting the operational efficiency. Multivariate logistic regression analysis showed that specialized hospitals ( OR=3.350, 95% CI 1.068-11.591) and annual outpatient visits>500 000 ( OR=0.248, 95% CI 0.073-0.845) were the influencing factors on the operational efficiency of tertiary public hospitals in Anhui province ( P<0.05). Conclusions:The operational efficiency of tertiary public hospitals in Anhui province was improved overall in 2021 compared with 2020. It is suggested to further optimize the structure of hospital revenue and expenditure, promote the implementation of hierarchical diagnosis and treatment policy, and optimize the allocation of health resources, so as to guide hospitals to improve operational efficiency through connotative development.

Objective:To understand the incidence of sleep disorder in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients before antiviral therapy, and to explore its risk factors.Methods:200 newly treated HIV/AIDS patients who visited the Eighth Affiliated City Hospital of Guangzhou Medical University from January to June 2016 were randomly selected. According to the Pittsburgh Sleep Quality Index (PSQI), they were divided into a good sleep group and a Sleep disorder group; The influencing factors of sleep disorder in HIV/AIDS patients were analyzed by univariate analysis and multivariate logistic regression.Results:The incidence of Sleep disorder in 200 HIV/AIDS patients before antiviral therapy was 22.5%(45/200); CD4 + T cell count was (414.13±202.16)/μl; 29%(58/200) of patients had CD4 + T cell counts<200/μl. There were significant differences in CD4 + T cell count and the proportion of patients with syphilis infection, comorbidity anxiety and comorbidity depression between the good sleep group and the Sleep disorder group (all P<0.05). Multivariate logistic regression analysis showed that syphilis infection ( OR=4.606; 95% CI: 1.973-10.752; P<0.001), comorbidity anxiety ( OR=2.496; 95% CI: 1.086-5.737; P=0.031) and comorbidity depression ( OR=2.087; 95% CI: 0.915-4.760; P=0.040) were risk factors for sleep disorder in HIV/AIDS patients before antiviral treatment. Conclusions:The incidence of Sleep disorder in HIV/AIDS patients before antiviral therapy in Guangzhou is high, especially in patients with syphilis infection, comorbidity anxiety and comorbidity depression. The sleep disorder of HIV/AIDS patients should be assessed and detected early, and multiple interventions should be taken to improve sleep quality.