ObjectiveTo compare the Children's Hepatic tumors International Collaboration （CHIC） and the new Chinese Children's Cancer Group （CCCG） hepatoblastoma （HB） risk stratification systems in terms of their prognostic prediction efficacy and chemotherapy guidance value for Chinese children with HB， aiming to identify the risk stratification system more suitable for Chinese HB patients. MethodsThis retrospective study analyzed the clinical data of 403 pediatric patients with HB aged ＜ 18 years who were initially diagnosed at The First Affiliated Hospital of Sun Yat-sen University between February 2010 and September 2023. The prognostic predictive efficacy and chemotherapy-guided value of the CHIC and CCCG risk stratification systems was compared. Statistical analysis was performed using SPSS 27.0. Results①Using the new CCCG risk stratification， the 5-year event-free survival （EFS） rates for children who received versus did not receive risk-stratified chemotherapy according to the CCCG-HB-2016 protocol were 82.5% and 67.7% （P=0.002）， respectively， and the 5-year overall survival （OS） rates were 91.5% and 85.1% （P=0.038）. Using CHIC risk stratification， the corresponding 5-year EFS rates for children who received versus did not receive risk-stratified chemotherapy according to the CCCG-HB-2016 protocol were 80.3% and 68.5% （P=0.030）， and the 5-year OS rates were 90.9% and 85.8% （P=0.151）. ②Among children treated with the CCCG-HB-2016 protocol stratified by the new CCCG system， the 5-year EFS rates for the very low-risk （6 cases）， low-risk （20 cases）， intermediate-risk （61 cases）， and high-risk （69 cases） groups were 100%， 94.1%， 94.7%， and 66.2% （P＜0.001）， respectively， and the 5-year OS rates were 100%， 100%， 96.5%， and 82.0% （P=0.017）. Among children treated with the CCCG-HB-2016 protocol stratified by the CHIC system， the 5-year EFS rates for the very low-risk （32 cases）， low-risk （22 cases）， intermediate-risk （37 cases）， and high-risk （54 cases） groups were 93.8%， 95.2%， 76.1%， and 66.8% （P=0.003）， respectively， and the 5-year OS rates were 93.1%， 100%， 89.5%， and 85.6% （P=0.190）. ③For patients receiving CCCG-HB-2016 risk-stratified chemotherapy， the P-values for EFS comparisons between the CHIC and new CCCG systems within the very low-risk， low-risk， intermediate-risk， and high-risk groups were 0.537， 0.879， 0.023， and 0.934， respectively. Among patients who received stratified chemotherapy according to the CCCG-HB-2016 regimen， the intermediate-risk group in the new CCCG risk stratification system exhibited a significant advantage in 5-year event-free survival （EFS） compared with the intermediate-risk group in the CHIC risk stratification system （94.7% vs. 76.1%）. ConclusionCompared to the CHIC risk stratification， the new CCCG stratification may offer better prognostic prediction and guidance value for chemotherapy in Chinese HB patients， with the intermediate-risk group showing superior outcomes.

Under the context of the research-oriented hospital construction strategy and national medical talent cultivation policies,postdoctoral research stations have emerged as vital platforms for assembling high-level innovative talents.Based on the construction practices of the postdoctoral research station at Zhejiang Cancer Hospital,this paper focuses on its development trajectory from humble beginnings to being recognized as the only"Excellent medical institution-affiliated post-doctoral work station"in Zhejiang Province.It analyzes the achievements in constructing high-standard organizational management systems,high-caliber mentor teams,and high-investment talent support systems.Addressing existing challenges,the study proposes development strategies in-cluding broadening recruitment channels,exploring diversified training models,striving for inde-pendent recruitment authority,and promoting synergistic development with research-oriented hos-pital initiatives.The aim is to provide replicable experience and insights for postdoctoral platforms in tumor specialty hospitals to empower the construction of research-oriented hospitals.

Under the context of the research-oriented hospital construction strategy and national medical talent cultivation policies,postdoctoral research stations have emerged as vital platforms for assembling high-level innovative talents.Based on the construction practices of the postdoctoral research station at Zhejiang Cancer Hospital,this paper focuses on its development trajectory from humble beginnings to being recognized as the only"Excellent medical institution-affiliated post-doctoral work station"in Zhejiang Province.It analyzes the achievements in constructing high-standard organizational management systems,high-caliber mentor teams,and high-investment talent support systems.Addressing existing challenges,the study proposes development strategies in-cluding broadening recruitment channels,exploring diversified training models,striving for inde-pendent recruitment authority,and promoting synergistic development with research-oriented hos-pital initiatives.The aim is to provide replicable experience and insights for postdoctoral platforms in tumor specialty hospitals to empower the construction of research-oriented hospitals.

Objective To investigate the changes of residual radioactivity at different time points after 131I treatment in the patients with differentiated thyroid cancer(DTC)and influencing factors.Methods A to-tal of 235 patients with DTC receiving 131I treatment in this hospital from January 2021 to June 2023 were se-lected as the study subjects and divided into the high dose group(＞5.55 GBp,n=56)and low dose group(≤5.55 GBp,n=179)according to the treatment dose.The clinical data of the two groups were collected and the changes of residual radioactivity after 131I treatment were compared between the two groups.The binary re-gression was used to analyze its influencing factors.Results The sex,age,BMI,basic metabolic rate(BMR)and serum thyroglobulin antibody(TgAb)had no statistical differences between the two groups(P＞0.05).The proportions of serum thyroglobulin(TG)＜1 ng/mL,131I first time treatment and residual thyroid ratio prompted by the whole body 131I scan after treatment in the low dose group were significantly higher than those in the high dose group(P＜0.05).The residual radioactivity in the two groups was significantly de-creased with time extension.The residual radioactivity at 24,48,72 h after treatment in the low dose group was significantly lower than that in the high dose group(P＜0.05).The binary logistic regression analysis re-sults showed that the T stage and treatment dose were the influencing factors of residual radioactivity after 131I treatment.Conclusion The residual radioactivity after 131I treatment in the patients with DTC shows the significant decreasing trend with time extension,this change trend has an active significance for further opti-mizing and perfecting the isolation and protection scheme.For the patients with high T stage and big treat-ment dose,the isolation time should exceed 72 h.

Objective To establish an online gel permeation chromatography-gas chromatography/mass spectrometry(GPC-GCMS)method for the determination of etomidate in blood.Methods Blood samples were extracted with acetonitrile,dehydrated with anhydrous sodium sulfate,purified with an online GPC system,and then analyzed by GCMS using large volume injection.The external standard curve method was used for quantification.Results The detection limit of etomidate was 0.002 μg/mL,with good linearity in the concentration range of 0.01～5 μg/mL and a correlation coefficient of 0.9992.The extraction recovery rates ranged between 90%and 120%.In an actual case,the content of etomidate detected in the blood sample was 0.024 μg/mL.Conclusion This method is fast,simple,accurate,and stable,providing a reliable basis for the determination of etomidate content in blood.

Objective To establish an online gel permeation chromatography-gas chromatography/mass spectrometry(GPC-GCMS)method for the determination of etomidate in blood.Methods Blood samples were extracted with acetonitrile,dehydrated with anhydrous sodium sulfate,purified with an online GPC system,and then analyzed by GCMS using large volume injection.The external standard curve method was used for quantification.Results The detection limit of etomidate was 0.002 μg/mL,with good linearity in the concentration range of 0.01～5 μg/mL and a correlation coefficient of 0.9992.The extraction recovery rates ranged between 90%and 120%.In an actual case,the content of etomidate detected in the blood sample was 0.024 μg/mL.Conclusion This method is fast,simple,accurate,and stable,providing a reliable basis for the determination of etomidate content in blood.

Objective:To evaluate the role of minimal residual disease (MRD) monitoring during early induction therapy for the treatment of childhood acute lymphoblastic leukemia (ALL).Methods:This was a multicenter retrospective cohort study. Clinical data of 1 164 ALL patients first diagnosed between October 2016 and June 2019 was collected from 16 hospitals in South China Children′s Leukemia Group. According to MRD assay on day 15 of early induction therapy, they were divided into MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group. According to MRD assay on day 33, they were divided into MRD<0.01% group, MRD 0.01%-<1.00% group and MRD≥1.00% group. Age, onset white blood cell count, central nervous system leukemia (CNSL), molecular genetic characteristics and other data were compared between groups. Kaplan-Meier method was used for survival analysis. Cox regression model was used to analyze prognostic factors.Results:Of the 1 164 enrolled patients, there were 692 males and 472 females. The age of diagnosis was 4.7 (0.5, 17.4) years. The white blood cell count at initial diagnosis was 10.7 (0.4, 1 409.0) ×10 9/L. Among all patients, 53 cases (4.6%) had CNSL. The follow-up time was 47.6 (0.5, 68.8) months. The 5-year overall survival (OS) and 5-year relapse-free survival (RFS) rates were (93.1±0.8) % and (90.3±1.1) %. On day 15 of early induction therapy, there were 466 cases in the MRD<0.10% group, 523 cases in the MRD 0.10%-<10.00% group and 175 cases in the MRD≥10.00% group. The 5-year OS rates of the MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group were (95.4±1.0) %, (93.3±1.1) %, (85.4±2.9) %, respectively, while the RFS rates were (93.2±1.6) %, (90.8±1.4) %, (78.9±4.3) %, respectively ( χ2=16.47, 21.06, both P<0.05). On day 33 of early induction therapy, there were 925 cases in the MRD <0.01% group, 164 cases in the MRD 0.01%-<1.00% group and 59 cases in the MRD≥1.00% group. The 5-year RFS rates in the MRD 0.01%-<1.00% group was lowest among three groups ((91.4±1.2) % vs. (84.5±3.2) % vs. (87.9±5.1) %). The difference between three groups is statistically significant ( χ2=9.11, P=0.010). Among ALL patients with MRD≥10.00% on day 15 of induction therapy, there were 80 cases in the MRD <0.01% group on day 33, 45 cases in the MRD 0.01%-<1.00% group on day 33 and 45 cases in the MRD≥1.00% group on day 33. The 5-year RFS rates of three groups were (83.9±6.0)%, (67.1±8.2)%, (83.3±6.9)% respectively ( χ2=6.90, P=0.032). Univariate analysis was performed in the MRD≥10.00% group on day 15 and the MRD 0.01%-<1.00% group on day 33.The 5-year RFS rate of children with CNSL was significantly lower than that without CNSL in the MRD≥10.00% group on day 15 ((50.0±20.4)% vs. (80.3±4.4)%, χ2=4.13, P=0.042). Patients with CNSL or MLL gene rearrangement in the MRD 0.01%-<1.00% group on day 33 had significant lower 5-year RFS rate compared to those without CNSL or MLL gene rearrangement ((50.0±25.0)% vs. (85.5±3.1)%, χ2=4.06, P=0.044;(58.3±18.6)% vs. (85.7±3.2)%, χ2=9.44, P=0.002). Multivariate analysis showed that age ( OR=0.58, 95% CI 0.35-0.97) and white blood cell count at first diagnosis ( OR=0.43, 95% CI 0.27-0.70) were independent risk factors for OS. The MRD level on day 15 ( OR=0.55,95% CI 0.31-0.97), ETV6-RUNX1 fusion gene ( OR=0.13,95% CI 0.03-0.54), MLL gene rearrangement ( OR=2.55,95% CI 1.18-5.53) and white blood cell count at initial diagnosis ( OR=0.52,95% CI 0.33-0.81) were independent prognostic factors for RFS. Conclusions:The higher the level of MRD in early induction therapy, the worse the OS. The MRD levels on day 15 is an independent prognostic factor for RFS.The MRD in early induction therapy guided accurate risk stratification and individualized treatment can improve the survival rate of pediatric ALL.

Objective:To provide references for achieving long time continuous monitoring of cardiac functional changes of astronauts in spaceflight activities through continuously noninvasive assessment of left ventricular systolic function under exercise load by wearable cardiac sounds and ECG signals synchronization monitoring technology.Methods:Eleven healthy male youths were recruited for the study, and they did incremental load exercise on the recumbent power bicycle, starting at 50 W, increasing by 25 W every 3 minutes, until the maximum of 125 W reached. The subjects′ cardiac sounds and ECG signals at rest, 1 min after each level of load during exercise and 3 min after the end of exercise were selected; the transthoracic cardiac ultrasound examination of subjects was performed before and 5 min after exercise. The correlation between the cardiac sounds and ECG signals and left ventricular ejection fraction (LVEF) was analyzed, and a regression model was established to predict LVEF during exercise.Results:There were significant differences in heart rate, LVEF, electro-mechanical activation time (EMAT) and left ventricular ejection time (LVET) of subjects under different exercise loads ( F=53.22, 45.33, 3.65, 23.19, P<0.001, <0.001, =0.011, <0.001). Compared with the resting state, subjects showed increased heart rate and LVEF and a decreased EMAT and LVET during exercise loading, all of which were statistically significant ( P<0.01 or 0.05). In the correlation analysis, LVEF was negatively correlated with EMAT and LVEF ( r=-0.415, -0.758, P=0.002,<0.001), and positively correlated with the amplitude of the first heart sound ( r=0.606, P<0.001). The model for predicting LVEF was established by EMAT and LVET, and the multiple regression model was LVEF=108.698-0.092×LVET-0.134×EMAT ( r=0.87, P<0.001). Conclusions:The synchronous monitoring technology of cardiac sounds and ECG signals can continuously and non-invasively monitor LVEF changes during exercise. LVET is the most closely related to LVEF. LVEF is hopeful to predict the changes of cardiac function of astronauts in spaceflight activities.

Objective:To provide references for achieving long time continuous monitoring of cardiac functional changes of astronauts in spaceflight activities through continuously noninvasive assessment of left ventricular systolic function under exercise load by wearable cardiac sounds and ECG signals synchronization monitoring technology.Methods:Eleven healthy male youths were recruited for the study, and they did incremental load exercise on the recumbent power bicycle, starting at 50 W, increasing by 25 W every 3 minutes, until the maximum of 125 W reached. The subjects′ cardiac sounds and ECG signals at rest, 1 min after each level of load during exercise and 3 min after the end of exercise were selected; the transthoracic cardiac ultrasound examination of subjects was performed before and 5 min after exercise. The correlation between the cardiac sounds and ECG signals and left ventricular ejection fraction (LVEF) was analyzed, and a regression model was established to predict LVEF during exercise.Results:There were significant differences in heart rate, LVEF, electro-mechanical activation time (EMAT) and left ventricular ejection time (LVET) of subjects under different exercise loads ( F=53.22, 45.33, 3.65, 23.19, P<0.001, <0.001, =0.011, <0.001). Compared with the resting state, subjects showed increased heart rate and LVEF and a decreased EMAT and LVET during exercise loading, all of which were statistically significant ( P<0.01 or 0.05). In the correlation analysis, LVEF was negatively correlated with EMAT and LVEF ( r=-0.415, -0.758, P=0.002,<0.001), and positively correlated with the amplitude of the first heart sound ( r=0.606, P<0.001). The model for predicting LVEF was established by EMAT and LVET, and the multiple regression model was LVEF=108.698-0.092×LVET-0.134×EMAT ( r=0.87, P<0.001). Conclusions:The synchronous monitoring technology of cardiac sounds and ECG signals can continuously and non-invasively monitor LVEF changes during exercise. LVET is the most closely related to LVEF. LVEF is hopeful to predict the changes of cardiac function of astronauts in spaceflight activities.

The extremely low bioavailability of oral paclitaxel (PTX) mainly due to the complicated gastrointestinal environment, the obstruction of intestinal mucus layer and epithelium barrier. Thus, it is of great significance to construct a coordinative delivery system which can overcome multiple intestinal physicochemical obstacles simultaneously. In this work, a high-density PEGylation-based glycocholic acid-decorated micelles (PTX@GNPs) was constructed by a novel polymer, 9-Fluorenylmethoxycarbonyl-polyethylene glycocholic acid (Fmoc-PEG-GCA). The Fmoc motif in this polymer could encapsulate PTX via π‒π stacking to form the core of micelles, and the low molecular weight and non-long hydrophobic chain of Fmoc ensures the high-density of PEG. Based on this versatile and flexible carriers, PTX@GNPs possess mucus trapping escape ability due to the flexible PEG, and excellent intestine epithelium targeting attributed to the high affinity of GCA with apical sodium-dependent bile acid transporter. The in vitro and in vivo results showed that this oral micelle could enhance oral bioavailability of PTX, and exhibited similar antitumor efficacy to Taxol injection via intravenous route. In addition, oral PTX@GNPs administered with lower dosage within shorter interval could increase in vivo retention time of PTX, which supposed to remodel immune microenvironment and enhance oral chemotherapy efficacy by synergistic effect.