BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of subsequent radiotherapy (RT) following first-line treatment with durvalumab plus chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC). METHODS: A total of 122 patients with ES-SCLC from three hospitals during July 2019 to December 2021 were retrospectively analyzed. Inverse probability of treatment weighting (IPTW) analysis was performed to address potential confounding factors. The primary focus of our evaluation was to assess the impact of RT on progression-free survival (PFS) and overall survival (OS). RESULTS: After IPTW analysis, 49 patients received durvalumab plus platinum-etoposide (EP) chemotherapy followed by RT (Durva + EP + RT) and 72 patients received immunochemotherapy (Durva + EP). The median OS was 17.2 months vs . 12.3 months (hazard ratio [HR]: 0.38, 95% confidence interval [CI]: 0.17-0.85, P = 0.020), and the median PFS was 8.9 months vs . 5.9 months (HR: 0.56, 95% CI: 0.32-0.97, P = 0.030) in Durva + EP + RT and Durva + EP groups, respectively. Thoracic radiation therapy (TRT) resulted in longer OS (17.2 months vs . 14.7 months) and PFS (9.1 months vs . 7.2 months) compared to RT directed to other metastatic sites. Among patients with oligo-metastasis, RT also showed significant benefits, with a median OS of 17.4 months vs . 13.7 months and median PFS of 9.8 months vs . 5.9 months compared to no RT. Continuous durvalumab treatment beyond progression (TBP) prolonged OS compared to patients without TBP, in both the Durva + EP + RT (NA vs . 15.8 months, HR: 0.48, 95% CI: 0.14-1.63, P = 0.238) and Durva + EP groups (12.3 months vs . 4.3 months, HR: 0.29, 95% CI: 0.10-0.81, P = 0.018). Grade 3 or 4 adverse events occurred in 13 (26.5%) and 13 (18.1%) patients, respectively, in the two groups; pneumonitis was mostly low-grade. CONCLUSION Addition of RT after first-line immunochemotherapy significantly improved survival outcomes with manageable toxicity in ES-SCLC.
Humans ; Small Cell Lung Carcinoma/therapy* ; Retrospective Studies ; Male ; Female ; Middle Aged ; Lung Neoplasms/therapy* ; Aged ; Antibodies, Monoclonal/therapeutic use* ; Adult ; Immunotherapy/methods* ; Aged, 80 and over

Objective To investigate the prevalence of functional gastrointestinal disorders(FGID)in soldiers stationed on an island based on the Rome IV diagnostic criteria,so as to clarify the incidence and types of FGID and their correlations with the age and psychological status of soldiers.Methods The prevalence of FGID was investigated from September to November 2022 by FGID Questionnaire Survey Platform Management System based on the Rome IV diagnostic criteria.Results A total of 397 soldiers stationed on an island were enrolled in this study.The most common digestive symptoms were diarrhea,belching and constipation.A total of 147 people(37.0%)met the Rome Ⅳ diagnosis of FGID,and common diseases were functional diarrhea,epigastric pain syndrome and postprandial discomfort syndrome.Among the various diagnoses of FGID,the prevalence rates of globus hystericus,functional chest pain and belching syndrome showed statistically significant differences across different age groups(all P<0.001).Among the 324 subjects with no abnormal SDS scores,61.4%(199/324)did not meet the diagnosis of FGID.Among the 71 subjects with SDS scores ranging from 53 to 62,71.8%(51/71)did not meet the diagnosis of FGID.All subjects with SDS scores ranging from 63 to 72 met the diagnosis of FGID.Conclusion Functional diarrhea is the most common disease of FGID among soldiers stationed on the island.The overall prevalence of FGID is not related to the age of the subjects.Relevant drugs and psychological support treatment should be strengthened in the future allocation of health service resources on islands.

ObjectiveTo review the interoceptive assessment tools in terms of structure, content and psychometric properties, based on the framework of the International Classification of Functioning, Disability and Health (ICF). MethodsThe literature on interoceptive evaluation tools was retrieved from databases of CNKI, PubMed, Medline and EBSCO. The principal structures and contents of the assessment tools were analyzed based on the ICF framework, and the quality of the psychometric properties were appraised using COSMIN. ResultsA total of 13 interoceptive assessment tools were ultimately included, involving 16 literature references. There were five interoceptive sensitivity tools, four accuracy tools and four awareness tools. In terms of content, interoceptive sensitivity tools involved 33 categories of body functions, six categories of activities and participation, and one of environmental factors; while interoceptive accuracy tools only involved seven categories of body function, and two of activities and participation items; interoceptive awareness tools involved 30 categories of body function, four categories of activities and participation, and three of environmental factors. In terms of psychometric properties, Body Perception Questionnaire-Short Form (BPQ-SF) was the sensitivity tool with the best reliability and validity (qualified rate of 7/8), followed by Interoceptive Sensitivity Questionnaire (ISQ) (qualified rate of 6/8). Most of the accuracy tools adopted standardized measurement methods, but lacked sufficient reliability and validity verification. The awareness tools were good in reliability and validity (qualified rate above 5/8), especially Multidimensional Assessment of Interoceptive Awareness (MAIA-1) and Body Awareness Questionnaire (BAQ) (qualified rate of 8/8). ConclusionBPQ-SF and ISQ are recommended for interoceptive sensitivity assessment, Water-loading Test and Heart-beat Tracking Task for interoceptive accuracy assessment, and MAIA-1 and BAQ for interoceptive awareness assessment.

Objective To establish a method for predicting the risk of endometrial cancer(EC)and endometrial atypical hyperplasia(AH)in women with postmenopausal bleeding(PMB)by collecting clinical data on routine medical history.Methods The clinical data of a total of 408 PMB patients admitted to Fuxing Hospital,Capital Medical University were consecutively collected in this retrospective study from December 2013 to December 2023.According to the results of endometrial pathology,patients were divided into case group and control group.EC and AH were included in the malignant group(case group)and the other endometrial pathologies were included in the non-malignant group(control group).Clinical data,including clinical history,high risk factors,and common gynecological ultrasound measurement indicators,were collected and studied by univariate and multivariate Logistic regression analysis.Results The mean age of 408 patients was(60.4±7.8)years.A total of 74 cases(18.1％)were in case group and 334 cases(81.9％)were in control group.Based on Logistic regression analysis,the best predictors of endometrial malignant lesions were selected to create a"LRDNT"(light bleeding,recurrent bleeding,diabetes,non-uniform echogenicity & thickness)model.LRDNT scores range from 0 to 22.The score of LRDNT ≥15 has the largest Yoden index,and the sensitivity to predict endometrial malignant lesions is 79.73％,the specificity is 80.84％,and the prediction accuracy is 80.64％.Conclusions The risk prediction model LRDNT,which combines clinical information and common gynecological ultrasound measurement indicators of PMB patients,can help clinicians classify patients at high and low risk of endometrial malignant lesions,and optimize the strategy of diagnosis and treatment.

Objective To compile a comprehension assessment scale of double-conditional phrases for adults and to test its reliability and validity.Methods With reference to the compilation process of local and international word lists,a comprehension assessment scale of double-conditional phrases for adults was developed.The scale was used to assess 40 aphasia patients and 20 ordinary adults as subjects from four hospitals in Shanghai.The internal consistency reliability,split-half reliability,retest reliability and calibration validity of the scale were evaluated and analyzed[the western aphasia battery(WAB)as a calibrated measurcment instrument].Results The scale consists of 30 questions,including five types of phrases:coordinate phrases,verb-object phrases,subject-predicate phrases,endocentric phrases and interface-object phrases.Compared with the ordinary adult group,the total score of the scale and the scores of each dimension in the aphasia group were significantly lower than those in the control group(P＜0.001).The Cronbach's alpha coefficient for the total score was 0.894,the half coefficient was 0.924,and the correlation coefficient for the retest reliability of the total score was 0.923,with retest reliability for each type of word group ranging from 0.731 to 0.903.With the exception of the repetition scores,correlation coefficients be-tween the scale and all other scores of WAB were all＞0.6(P＜0.01).Conclusion The self-developed"Adult Double Conditional Phrases Auditory Comprehension Assessment Scale"demonstrates good reliability and validity.It serves as a scientific and reliable tool for evaluating the auditory comprehension ability of adult patients.

Patients with specific language impairment(SLI)have normal intelligence but experience difficul-ties in language comprehension and expression.At present,the cause of the disease has not been determined,and only a few potential causes are being discussed,among which the relationship between auditory processing abilities and language problems of this group has attracted much attentions.An increasing number of studies employ electro-physiological techniques to investigate the auditory processing abilities of SLI patients,accumulating substantial evi-dence.Therefore,this study reviewed empirical research on the auditory processing abilities of SLI patients from the perspectives of auditory brainstem response,middle-latency response,and long-latency response.It aims to eluci-date the characteristics of auditory processing in SLI patients,analyze its relationship with language disorders,and offer insights into the diagnosis and treatment of SLI patients.

Purpose Based on the WHO(5th edition)classification of cervical adenocarcinoma and Silva infiltra-tion pattern classification,this study explores the value of etiological classification and Silva classification in the clinical treatment and prognosis prediction of cervical adenocarcinoma.Methods The clinical and pathological features of 112 cases of cervical invasive adenocarcinoma were reviewed.Through HE morphological classification,immunohistochemi-cal detection,and Silva classification of infiltration pattern,the related factors and prognosis of patients were statistical-ly analyzed.Results The median age of 112 patients was 46.5 years(30-80 years),with a maximum tumor diame-ter of 0.35-9.0 cm and an average diameter of 3.2 cm.Most patients showed vaginal bleeding after sexual inter-course.89 cases were HPV-associated adenocarcinoma(HPVAs),18 cases were non HPV-associated adenocarcinoma(NHPVAs).There were 5 cases of other types of adenocarcinomas of the uterine cervix,including 4 cases of endome-trial adenocarcinoma and 1 case of serous adenocarcinoma.There were 5 cases(4.5％)of Silva A pattern,30 cases(26.8％)of Silva B pattern,and 77 cases(68.7％)of Silva C pattern.112 cases were followed up for a median time of 34 months(15-78 months),with 16 deaths and 20 metastases.The progression-free survival(PFS)(P＜0.001)and overall survival(OS)(P=0.001)in the NHPVA group were significantly lower than those in the HPVA group.All cases with Silva A and Silva B pattern had a favorable prognosis and survived without tumor.Of the cases with Silva C pattern,16 died after recurrence.The PFS and OS of patients with Silva C type were lower than those of Silva A type and B type(P＜0.05).Conclusion The fifth edition of WHO classification of cervical adenocarcinoma revealed the correlation between etiology and morphology.Silva classification is of great significance for accurately predicting progno-sis and guiding treatment.

Patients with specific language impairment(SLI)have normal intelligence but experience difficul-ties in language comprehension and expression.At present,the cause of the disease has not been determined,and only a few potential causes are being discussed,among which the relationship between auditory processing abilities and language problems of this group has attracted much attentions.An increasing number of studies employ electro-physiological techniques to investigate the auditory processing abilities of SLI patients,accumulating substantial evi-dence.Therefore,this study reviewed empirical research on the auditory processing abilities of SLI patients from the perspectives of auditory brainstem response,middle-latency response,and long-latency response.It aims to eluci-date the characteristics of auditory processing in SLI patients,analyze its relationship with language disorders,and offer insights into the diagnosis and treatment of SLI patients.

Objective To compile a comprehension assessment scale of double-conditional phrases for adults and to test its reliability and validity.Methods With reference to the compilation process of local and international word lists,a comprehension assessment scale of double-conditional phrases for adults was developed.The scale was used to assess 40 aphasia patients and 20 ordinary adults as subjects from four hospitals in Shanghai.The internal consistency reliability,split-half reliability,retest reliability and calibration validity of the scale were evaluated and analyzed[the western aphasia battery(WAB)as a calibrated measurcment instrument].Results The scale consists of 30 questions,including five types of phrases:coordinate phrases,verb-object phrases,subject-predicate phrases,endocentric phrases and interface-object phrases.Compared with the ordinary adult group,the total score of the scale and the scores of each dimension in the aphasia group were significantly lower than those in the control group(P＜0.001).The Cronbach's alpha coefficient for the total score was 0.894,the half coefficient was 0.924,and the correlation coefficient for the retest reliability of the total score was 0.923,with retest reliability for each type of word group ranging from 0.731 to 0.903.With the exception of the repetition scores,correlation coefficients be-tween the scale and all other scores of WAB were all＞0.6(P＜0.01).Conclusion The self-developed"Adult Double Conditional Phrases Auditory Comprehension Assessment Scale"demonstrates good reliability and validity.It serves as a scientific and reliable tool for evaluating the auditory comprehension ability of adult patients.

Objective:To develop a method of employing flow cytometry to directly detect the γ-H2AX expression levels in peripheral blood lymphocytes of mice through fixation and lysis and to evaluate the feasibility of applying this method to research on the radiation-related biological effects and the efficacy evaluation of radioprotective drugs.Methods:A total of 41 male C57BL/6J mice were used. First, 21 mice were randomly divided into 7 groups according to different radiation doses (0, 1, 2, 4, 6, 8, and 10 Gy) with 3 mice in each group. Blood samples were collected from the tail vein of mice at 1, 4, 8, and 24 h after irradiation and immediately fixed with formaldehyde. Red blood cells (RBC) were lysed with Triton X-100, and γ-H2AX was labeled with specific antibodies. DRAQ5 dye was used to further exclude debris and anucleate cells. The mean fluorescence intensity of γ-H2AX in lymphocyte populations was directly analyzed by flow cytometry through forward and side scatter, and dose-effect curves after irradiation were established. Then, the other 20 mice were divided into radiation alone groups and radiation combined with WR-2721 administration groups at 4 and 6 Gy, respectively, with 5 mice in each group. Blood samples were collected from the tail vein of mice at 1, 4, 8, and 24 h after irradiation to detect the average fluorescence intensity of γ-H2AX in lymphocytes, which was used to evaluate the degree of DNA damage in mice and the therapeutic effect of WR-2721.Results:The expression of γ-H2AX in peripheral blood lymphocytes of mice significantly increased with the increase of radiation doses, and reached a peak at 1-2 h and then decreased. The dose-effect relationship was significant ( R2 = 0.9914). At 24 h after 4 and 6 Gy irradiation, compared with the radiation alone groups, the average fluorescence intensity of γ-H2AX in the radiation combined with WR-2721 administration groups was lower (144.8 ± 8.0 and 109.5 ± 9.7, vs. 178.0 ± 18.5 and 136.6 ± 5.4), with statistically significant difference ( t = 3.78, 5.48, P < 0.05). The average fluorescence intensity of γ-H2AX at 24 h after irradiation was consistent with the lowest values of the three blood cell lines at 7 or 14 d after irradiation. Conclusions:The application of flow cytometry with a fixation/dissolution protocol to directly detect the mean fluorescence intensity of γ-H2AX in peripheral blood lymphocytes of mice has significant application value in radiation biology effect research, radiation protection drug screening, and efficacy evaluation.