BACKGROUND: In the interim analysis of MONARCH plus, adding abemaciclib to endocrine therapy (ET) improved progression-free survival (PFS) and objective response rate (ORR) in predominantly Chinese postmenopausal women with HR+/HER2- advanced breast cancer (ABC). This study presents the final pre-planned PFS analysis. METHODS: In the phase III MONARCH plus study, postmenopausal women in China, India, Brazil, and South Africa with HR+/HER2- ABC without prior systemic therapy in an advanced setting (cohort A) or progression on prior ET (cohort B) were randomized (2:1) to abemaciclib (150 mg twice daily [BID]) or placebo plus: anastrozole (1.0 mg/day) or letrozole (2.5 mg/day) (cohort A) or fulvestrant (500 mg on days 1 and 15 of cycle 1 and then on day 1 of each subsequent cycle) (cohort B). The primary endpoint was PFS of cohort A. Secondary endpoints included cohort B PFS (key secondary endpoint), ORR, overall survival (OS), safety, and health-related quality of life (HRQoL). RESULTS: In cohort A (abemaciclib: n  = 207; placebo: n  = 99), abemaciclib plus a non-steroidal aromatase inhibitor improved median PFS vs . placebo (28.27 months vs . 14.73 months, hazard ratio [HR]: 0.476; 95% confidence interval [95% CI]: 0.348-0.649). In cohort B (abemaciclib: n  = 104; placebo: n  = 53), abemaciclib plus fulvestrant improved median PFS vs . placebo (11.41 months vs . 5.59 months, HR: 0.480; 95% CI: 0.322-0.715). Abemaciclib numerically improved ORR. Although immature, a trend toward OS benefit with abemaciclib was observed (cohort A: HR: 0.893, 95% CI: 0.553-1.443; cohort B: HR: 0.512, 95% CI: 0.281-0.931). The most frequent grade ≥3 adverse events in the abemaciclib arms were neutropenia, leukopenia, anemia (both cohorts), and lymphocytopenia (cohort B). Abemaciclib did not cause clinically meaningful changes in patient-reported global health, functioning, or most symptoms vs . placebo. CONCLUSIONS: Abemaciclib plus ET led to improvements in PFS and ORR, a manageable safety profile, and sustained HRQoL, providing clinical benefit without a high toxicity burden or reduced quality of life. TRIAL REGISTRATION ClinicalTrials.gov (NCT02763566).
Humans ; Female ; Fulvestrant/therapeutic use* ; Breast Neoplasms/metabolism* ; Aminopyridines/therapeutic use* ; Benzimidazoles/therapeutic use* ; Middle Aged ; Aromatase Inhibitors/therapeutic use* ; Aged ; Receptor, ErbB-2/metabolism* ; Adult ; Letrozole/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Anastrozole/therapeutic use*

In recent years,significant progress has been made in screening for and diagnosis of colorectal cancer(CRC),particularly using fecal nucleic acid detection.In addition to fecal occult blood tests,fecal screening technologies including fecal nucleic acid testing,multi-tar-get DNA testing,and protein biomarker detection,have become research hotspots.Numerous studies at home and abroad have identified various fecal nucleic acids and biomarkers with potential value for screening and early diagnosis of CRC.Fecal nucleic acid and biomarker testing can accurately detect early stage cancer and precancerous lesions,thereby improving early detection rates and reducing CRC incid-ence and mortality.This article reviews research progress into fecal nucleic acid testing in CRC screening,discusses the application prospects of biomarkers and optimization of detection techniques,and provides a basis for the development of more accurate and efficient screening methods.

Previous studies have revealed that patients with hypertrophic cardiomyopathy (HCM) exhibit differences in symptom severity and prognosis, indicating potential HCM subtypes among these patients. Here, 793 patients with HCM were recruited at an average follow-up of 32.78 ± 27.58 months to identify potential HCM subtypes by performing consensus clustering on the basis of their echocardiography features. Furthermore, we proposed a systematic method for illustrating the relationship between the phenotype and genotype of each HCM subtype by using machine learning modeling and interactome network detection techniques based on whole-exome sequencing data. Another independent cohort that consisted of 414 patients with HCM was recruited to replicate the findings. Consequently, two subtypes characterized by different clinical outcomes were identified in HCM. Patients with subtype 2 presented asymmetric septal hypertrophy associated with a stable course, while those with subtype 1 displayed left ventricular systolic dysfunction and aggressive progression. Machine learning modeling based on personal whole-exome data identified 46 genes with mutation burden that could accurately predict subtype propensities. Furthermore, the patients in another cohort predicted as subtype 1 by the 46-gene model presented increased left ventricular end-diastolic diameter and reduced left ventricular ejection fraction. By employing echocardiography and genetic screening for the 46 genes, HCM can be classified into two subtypes with distinct clinical outcomes.

OBJECTIVE To investigate the occurrence time and risk factors of anemia in patients with acquired immune deficiency syndrome （AIDS） after taking highly active antiretroviral therapy （HAART） containing zidovudine. METHODS The clinical data of 2 150 AIDS patients who were followed up in the care clinic of Liuzhou People’s Hospital from January 1， 2010 to December 31， 2022 were collected. The occurrence time of anemia was analyzed retrospectively， and the risk factors of anemia were analyzed by univariate analysis and binary Logistic regression analysis. RESULTS A total of 854 AIDS patients receiving HAART containing zidovudine were collected， and 107 patients （12.53%） developed anemia. Most of them （63.55%） developed anemia within 3 months after treatment. Baseline hemoglobin [OR＝2.944， 95%CI （1.195， 7.501）， P＝0.019]， baseline CD4+ T lymphocyte count [OR＝2.472， 95%CI （1.117， 5.469）， P＝0.026] and baseline human immunodeficiency virus-ribonucleic acid （HIV-RNA） [OR＝4.299， 95%CI （1.905， 9.705）， P＜0.001] was associated with anemia. CONCLUSIONS The median time of anemia in AIDS patients receiving HAART containing zidovudine is the second month after initiation of treatment. Baseline hemoglobin≤110 g/L， baseline CD4+ T lymphocyte E-mail：1315775863@qq.com count≤100 /mm3， and baseline HIV-RNA≥100 000 copies/mL are independent risk factors for anemia in these patients.

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).

Breast cancer is one of the most common malignant tumors in women. Because of the abundance of diagnosis and treatment methods and the wide application of targeted therapy drugs in recent years, the survival time of breast cancer patients is longer than before and the mortality rate shows a downward trend. However, the incidence of cardiovascular toxicity associated with targeted drug therapy in breast cancer patients is also increasing. This article reviews the research progress of cardiovascular toxicity associated with targeted drug therapy in breast cancer.

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Objective To investigate clinical and histopathological manifestations of cutaneous plasmacytosis.Methods The clinical and histopathological data were collected from 7 cases of cutaneous plasmacytosis and analyzed retrospectively.Results Of the 7 patients,2 were female,and 5 were male.The average age was 42.4 years,and the duration of disease ranged from 2 to 10 years.All the 7 patients presented with multiple slow progressive brown patches and plaques.No abnormality was observed in routine examinations of blood,urine and faeces,electrocardiogram and abdominal ultrasonography in the 7 patients.Three patients underwent serum IgG detection,and their serum levels of IgG were all higher than reference values.Two patients were subjected to cytological examination of bone marrow,which showed the percentage of plasma cells (mainly mature plasma cells) was up to 5％.Histopathological examination of 7 cases showed pigmentation in the basal layer of the epidermis,and infiltration mainly consisting of lymphocytes and mature plasma cells around the blood vessels in the dermis.Immunohistochemical study revealed that the ratio of κ to λ light chain was approximately 1∶ 1,and the plasma cells were strongly positive for IgG.IgG4 was positive in very few plasma cells in 1 case,and negative in the other 6 cases.Conclusion The etiology of cutaneous plasmacytosis is still unclear,but it has characteristic clinical and histopathological manifestations.

Objective To evaluate the clinical efficacy and safety of celiac continued circulatory hyper -thermia perfusion with chemotherapy in the treatment of cancer with ascites .Methods Databases including the Cochrane Library MEDLINE,PubMed,Embase,CBM,VIP,CNKI and WanFang Data,and the other sources as supplying .The literatures were screened according to the inclusion criteria ,extracted data and assessed the meth-odological quality ,and then meta -analysis was performed using RevMan 5.0.2 software.Results Totally 14 RCTs with 867 patients were included .Meta-analysis showed that compared intraperitoneal chemotherapy ,with celiac continued circulatory hyperthermia perfusion had a significant difference in CR ( OR=3.18,95%CI:2.18~4.64,P<0.00001),PR(OR=2.05,95%CI:1.51~2.77,P<0.00001),overall effective rate(OR=4.88, 95%CI:3.59~6.46,P<0.00001).The incidence of adverse reactions was no statistically significant in the two groups.Conclusion Celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites demonstrates better efficacy and safety ,but it still needs to verify the above conclusion .

Objective To explore the efficacy and adverse reactions of diminishing scheme of cefaclor sustained re-lease tablets in the treatment of recurrent urinary tract infection(RUTI).Methods 60 RUTI patients in a hospital were divided into treatment group(n=30)and control group (n=30),patients in treatment group were treated with diminishing scheme of cefaclor sustained release tablets,patients in control group were treated with diminishing scheme of levofloxacin tablets,clinical therapeutic efficacy and adverse reactions of two groups were observed. Results The curative rate in treatment group was higher than control group ([80.00%,n =24]vs [53.33%,n =16])(χ2 =4.80,P =0.028).The incidence of RUTI in treatment group was lower than control group ([6.67%,n=2]vs [26.67%,n=8])(χ2 =4.32,P =0.038).Incidence of adverse reactions in treatment group was lower than control group (16.67% vs 50.00%)(χ2 =7.50,P =0.006).Conclusion The diminishing scheme of cefaclor sus-tained release tablets in the treatment of RUTI has good curative efficacy,low recurrence rate,fewer adverse reac-tions,and can be used for the treatment of recurrence of RUTI.