Linxian County in Henan Province, Northern China is known as the region with the highest incidence and mortality rate of esophageal cancer worldwide. Since 1959, the Henan medical team has conducted field work on esophageal cancer prevention and treatment in Linxian. Through three generations of effort exerted by oncologists over 65 years of research on esophageal cancer prevention and treatment in Linxian, the incidence rate of esophageal squamous cell carcinoma in this area has dropped by nearly 50%, and the 5-year survival rate has increased to 40%, reaching the international leading level. This article aims to summarize the history, present opportunities and new challenges, and explore the experience of esophageal cancer prevention and treatment in Linxian (referred to as the “Linxian experience”), providing reference and guidance to cancer prevention and treatment research in China.

Objective:To analyze the epidemiological characteristics of respiratory syncytial virus (RSV) infection in children in Tianjin, and provide reference for the prevention and treatment of RSV infection in children.Methods:Clinical data of 2 743 children with acute respiratory infections treated at the Tianjin Fifth Central Hospital from January 2022 to January 2024 were collected. Multiplex fluorescent PCR was used to detect the nucleic acid fragments of six respiratory pathogens including Mycoplasma pneumoniae, human rhinovirus, adenovirus, influenza A virus, influenza B virus and RSV in the throat swabs of the patients. A retrospective analysis was performed on the epidemiological and clinical data of RSV-RNA positive cases. Results:The positive rate of RSV-RNA in the 2 743 children was 15.09% (414/2 743). The positive rate of RSV-RNA was 9.29% (73/786) in 2022 and 16.53% (302/1 827) in 2023, with a statistically significant difference between the two years (χ 2=23.45, P<0.05). The incidence of RSV infection in winter and spring was significantly different from that in summer and autumn (χ 2=19.46, P<0.05). The highest and the lowest infection rates of RSV were found in winter (19.32%, 193/999) and autumn (9.43%, 45/477), respectively. There was a significant difference in RSV infection rate among different age groups (χ 2=71.38, P<0.05), with the highest infection rate in the age group of 0-2 years (21.18%, 230/1 086), and the lowest infection rate in the age group of 6-8 years (6.29%, 27/429). Among the 414 children with RSV infection, 359 cases (84.97%) were infected with RSV alone, while the other 55 cases (13.29%) were infected with mixed pathogens. Fifty-two cases had co-infection of RSV and one other pathogen. The most common pathogens in co-infection cases were human rhinovirus (4.83%, 20/414) and Mycoplasma pneumoniae (6.04%, 25/414). Conclusions:The RSV infection rate among children with acute respiratory tract infection in Tianjin from 2022 to 2024 was 15.09%, with the highest infection rate in spring and the lowest infection rate in autumn. RSV infection can occur in children of all ages, with the highest infection rate in children aged 0-2 years and the lowest infection rate in children aged 6-8 years. RSV infection is often complicated by other respiratory pathogens, and the most common pathogens are human rhinovirus and Mycoplasma pneumoniae.

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Bacteremia induced by periodontal infection is an important factor for periodontitis to threaten general health. P. gingivalis DNA/virulence factors have been found in the brain tissues from patients with Alzheimer's disease (AD). The blood-brain barrier (BBB) is essential for keeping toxic substances from entering brain tissues. However, the effect of P. gingivalis bacteremia on BBB permeability and its underlying mechanism remains unclear. In the present study, rats were injected by tail vein with P. gingivalis three times a week for eight weeks to induce bacteremia. An in vitro BBB model infected with P. gingivalis was also established. We found that the infiltration of Evans blue dye and Albumin protein deposition in the rat brain tissues were increased in the rat brain tissues with P. gingivalis bacteremia and P. gingivalis could pass through the in vitro BBB model. Caveolae were detected after P. gingivalis infection in BMECs both in vivo and in vitro. Caveolin-1 (Cav-1) expression was enhanced after P. gingivalis infection. Downregulation of Cav-1 rescued P. gingivalis-enhanced BMECs permeability. We further found P. gingivalis-gingipain could be colocalized with Cav-1 and the strong hydrogen bonding between Cav-1 and arg-specific-gingipain (RgpA) were detected. Moreover, P. gingivalis significantly inhibited the major facilitator superfamily domain containing 2a (Mfsd2a) expression. Mfsd2a overexpression reversed P. gingivalis-increased BMECs permeability and Cav-1 expression. These results revealed that Mfsd2a/Cav-1 mediated transcytosis is a key pathway governing BBB BMECs permeability induced by P. gingivalis, which may contribute to P. gingivalis/virulence factors entrance and the subsequent neurological impairments.
Animals ; Rats ; Bacteremia/metabolism* ; Blood-Brain Barrier/microbiology* ; Caveolin 1/metabolism* ; Gingipain Cysteine Endopeptidases/metabolism* ; Permeability ; Porphyromonas gingivalis/pathogenicity* ; Transcytosis ; Virulence Factors/metabolism*

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective: To investigate the effects of hepatobiliary metabolie dysfunction on gut microbiota in rats with intrahepatic cholestasis of pregnancy (ICP). Methods: Forty Sprauge-Dawley(SD) rats at 10 days of gestation were randomly divided into two groups,25 for ICP induction and 15 as control. Estradiol benzoate, combined with progesterone, was given to the rats by intraperitoneal injjection from 10 to 14 days after gestation. Hepatic impairment indicators of total bilirubin(TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST),-glutamyl transferase ( GGT), alkaline phosphatase(AL.P), and total bile acids (TBA) in sera of the animals were detected in each group to verify the model construction. Simultaneously, the liver tissues were subjected to pathology examination and fresh faeces samples were collected for 16S rDNA sequencing to explore the gut microbiota profiles. Results: The serum levels of TBIL,ALT,AST,GGT,ALP and TBA in ICP group were significantly elevated compared with the control (P<0. 05 );the ICP rats presented obvious characteristics of hepatobiliary disorders, showing prominent steatosis, necrosis of hepatocytes and infiltration of inflammatory cells, with formation of bile thrombus in some animals. The abundance of Eubacterium, Bacteroides, Parabacteroides distasonis and Bacteroides uniformis remarkably decreased wereas Prevotela and Fusobacterium significantly increased in ICP rats when compared with the control (P<0.05). Conclusion The hepatic injuries and bile acid metabolic disorders occurred in ICP rats,which resulted in dysbiosis of gut microbiota.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.