This study aimed to evaluate the efficacy and safety of combining albumin-bound paclitaxel (abpaclitaxel) and anlotinib for ovarian cancer. In this study, 44 patients diagnosed with platinum-resistant ovarian cancer were enrolled. Patients received ab-paclitaxel along with anlotinib until disease progression or intolerable toxicity. Efficacy was assessed according to RECIST 1.1 criteria or Rustin's criteria. The primary endpoint was the investigator-evaluated objective response rate (ORR). 44 patients were enrolled between January 2021 and March 2023 with a median age of 49 years. Twenty-nine had measurable lesions and 15 had non-measurable lesions. Overall, the investigator-evaluated ORR was 56.8% (25/44; 95% CI 0.411-0.713) in intention-to-treat population and 58.1% (25/43; 95% CI 0.422-0.726) in per-protocol population. The median progression-free survival was 9.8 months, and the median duration of response was 7.4 months. For safety, grade 3/4 adverse events (AEs) included leukopenia, gum pain, hypertension, and hand-foot syndrome. The response rates were 55.0% (11/20) in patients with previous use of antiangiogenic reagents and who had previous use of PARP inhibitors. The combination of ab-paclitaxel and anlotinib showed promising anti-tumor activity and a manageable safety profile in platinum-resistant ovarian cancer. Patients with previous use of antiangiogenic drugs or PARP inhibitors still benefited from this protocol.
Humans ; Female ; Middle Aged ; Indoles/therapeutic use* ; Quinolines/therapeutic use* ; Carcinoma, Ovarian Epithelial/drug therapy* ; Adult ; Ovarian Neoplasms/drug therapy* ; Prospective Studies ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage* ; Aged ; Drug Resistance, Neoplasm ; Albumin-Bound Paclitaxel/therapeutic use* ; Neoplasm Recurrence, Local/drug therapy* ; Progression-Free Survival ; Paclitaxel/administration & dosage* ; Treatment Outcome

Objective:To observe the therapeutic effect of moxibustion on rats with acute diarrhea; To explore its potential mechanism in protecting the intestinal mucosal barrier.Methods:Totally 40 SD rats were divided into four groups: normal group, model group, moxibustion group, and montmorillonite powder group according to random number table method, with 10 rats in each group. Except for the normal group, the remaining groups were established as acute diarrhea models using senna leaf decoction administered via gavage combined with cold stimulation. The moxibustion group received suspended moxibustion on bilateral "Tianshu"(Point ST25) and "Shangjuxu"(Point ST37) acupoints, while the montmorillonite powder group was administered 0.81 g/kg of montmorillonite powder via gavage. The normal and model groups received an equal volume of normal saline via gavage, once daily for 7 consecutive days. The diarrhea status of the rats was observed, and the loose stool rate and diarrhea index were calculated. HE staining was used to observe pathological damage to the colonic mucosa. ELISA was employed to measure serum diamine oxidase (DAO) and D-lactate levels. Immunohistochemical staining was used to detect the expressions of colonic tight junction proteins (Occludin) and cytoplasmic tight junction protein 1 (ZO-1). Chemiluminescence was used to measure adenosine triphosphate (ATP) and reactive oxygen species (ROS) levels in the colon. Transmission electron microscopy was used to observe changes in mitochondrial morphology in colonic mucosal cells. Western blot was used to detect the protein expressions of adenosine nucleotide translocator 2 (ANT2), cyclophilin D, and voltage-dependent anion channel 2 (VDAC2) in the colon.Results:Compared with the model group, the moxibustion and montmorillonite powder groups showed decreased loose stool rate, diarrhea index, and serum DAO and D-lactate levels ( P<0.05); the length of colonic mucosal villi increased ( P<0.05), while crypt depth decreased ( P<0.05); the protein expressions of colonic mucosal Occludin and ZO-1 increased ( P<0.05), ATP content increased ( P<0.05), ROS content decreased ( P<0.05), and the protein expressions of colonic mucosal ANT2, cyclophilin D, and VDAC2 decreased ( P<0.05). Conclusion:Moxibustion can improve acute diarrhea in rats and protect the intestinal barrier, and its mechanism may be related to the inhibition of the mitochondrial ANT2/mPTP pathway.

OBJECTIVE: To explore the clinical and genetic characteristics of eight children with Primary hypertrophic cardiomyopathy (HCM). METHODS: Eight children with HCM admitted to the Department of Cardiology of Henan Children's Hospital from January 2018 to December 2021 were selected as the study subjects. Clinical data of the children were collected. Whole exome sequencing was carried out on two children, and trio whole exome sequencing was carried out on the remainder 6 children. Sanger sequencing was used to verify the candidate variants in the children and their parents, and the pathogenicity of the variants was evaluated based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). RESULTS: The patients had included 5 males and 3 females, with their ages ranging from 5 to 13 years old. The average age of diagnosis was (7.87 ± 4.8) years old, and the cardiac phenotype showed non-obstructive HCM in all of the patients. WES has identified variants of the MYH7 gene in 4 children, including c.2155C>T (p.Arg719Trp), c.1208G>A (p.Arg403Gln), c.1358G>A (p.Arg453His), and c.1498G>A (p.Glu500Lys). Based on the guidelines from the ACMG, the first 3 variants were classified as pathogenic, while c.1498G>A (p.Glu500Lys) was classified as likely pathogenic (PM1+PM2_Supporting+PM6+PP3), which was also unreported previously. The remaining four children had all harbored maternal variants, including MYL2: c.173G>A (p.Arg58Gln; classified as pathogenic), TPM1: c.574G>A (p.Glu192Lys) and ACTC1: c.301G>A (p.Glu101Lys)(both were classified as likely pathogenic), and MYBPC3: c.146T>G (p.Ile49Ser; classified as variant of uncertain significance). Seven children were treated with 0.5 ~ 3 mg/(kg·d) propranolol, and their symptoms had improved significantly. They were followed up until September 30, 2022 without further cardiac event. CONCLUSION Genetic testing can clarify the molecular basis for unexplained cardiomyopathy and provide a basis for clinical diagnosis and genetic counseling. Discovery of the c.1498G>A (p.Glu500Lys) variant has also expanded the spectrum of MYH7 gene mutations underlying HCM.
Female ; Male ; Humans ; Child ; Child, Preschool ; Adolescent ; Cytoskeletal Proteins ; Family ; Genetic Counseling ; Genetic Testing ; Cardiomyopathy, Hypertrophic/genetics*

Objective:To explore whether the simulation training system for transesophageal echocardiography (TEE) can improve the effectiveness of standardized training of resident anesthesiologists.Methods:A total of 72 resident anesthesiologists without experience in cardiac ultrasound were randomly divided into traditional teaching group (36 residents) and simulation training group (36 residents). Before and after the teaching, theoretical examinations of 5 knowledge points related to cardiac ultrasound were conducted. After a standardized rotation of 2 months, the students were re-examined for both theories and operations, and clinical indicators were recorded. SPSS 23.0 was used for the t-test, rank sum test, chi-square test, or Fisher's exact test. Results:There was no significant difference in scores of theoretical examinations between the two groups of students before teaching. After teaching, the scores of the simulation training group were higher than those of the traditional teaching group, and the differences were significant in cross-sectional recognition and image diagnosis ( P<0.05). After rotation, there was no significant difference in theoretical examination between the two groups of students, but the score of operation was significantly higher in the simulation training group than in the traditional teaching group ( P<0.05). During the rotation period, the incidence of TEE-related complications was relatively low and the quantitative score of clinical operational skill assessment was relatively high in the simulation training group ( P<0.05). Conclusion:Anesthesia residents who receive training with the simulation system before TEE training can quickly acquire operational skills, reduce related complications, and more accurately identify and obtain standard TEE sections, which has significant value for clinical teaching.

Objective This study aims to investigate the sex difference in the hippocampus and parahippocampus in patients with bipolar disorder. Methods We acquired T1－weighted structural MRI from 133 bipolar type I patients (60 males) and 144 normal controls (81 males). The General Linear Model was used to examine the relationship between sex and brain volumes of the hippocampus and parahippocampus, with age and intracranial volume as covariates. Results Patients showed significantly smaller volumes of the bilateral hippocampus and parahippocampus (P＜0.01). There were sex－by－diagnosis interactions in the left parahippocampus gyrus (F=6.534, P=0.044). Male patients had significant smaller volumes of the left parahippocampus gyrus compared to the male normal controls (P＜0.001) whereas the volumes were not significantly different between female patients and female normal controls (P＞0.05). Conclusion The results suggest sex difference in the left parahippocampus gyrus volume in patients with bipolar type I disorder, which deserves further investigation in the future bipolar imaging researches.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

Objective To investigate the effect of metabolic syndrome and its components on imaging of brain impairment in subcortical ischemic vascular disease.Methods 120 patients with subcortical ischemic vascular disease (SIVD) including 25 cases without metabolic syndrome,25 cases with the risk of metabolic syndrome,70 cases with metabolic syndrome.The diagnostic criteria of metabolic syndrome was the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ).Brain MRI was assessed by the Scheltens scale,and divided into 3 regions:periventricular hyper intensities (PVH),leukoaraiosis (LA),basal ganglia hyper-intensities (BG).Results The assessment scores of PVH,LA,BG and Scheltens scores were higher in patients with the risk of metabolic syndrome and patient with metabolic syndrome than in patient without metabolic syndrome [(3.75±1.60),(4.21±1.09) us.(2.76±1.62),(10.67±5.26),(13.79±5.25) us.(6.36±3.93),(3.21±2.62),(6.90±4.25) us.(1.52±1.50),(17.62±8.32),(24.90±9.25)vs.(10.58± 5.89),respectively,all P＜0.05].Waist circumference had positive correlations with LA and Scheltens scores (r=0.185,P=0.046; r=0.488,P＜0.001).Positive correlation was found between triglyceride (TG) and LA,BG scores (r=0.188,P=0.042; r=0.311,P =0.001).The positive correlations of impaired glucose tolerance (IGT) with LA,BG and Scheltens scores were found (r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027).High density lipoproteincholesterol (HDL-C) was correlated negatively with LA,BG and Scheltens scores (r=-0.238,P=0.010;r=-0.189,P=0.042; r=-0.335,P＜0.001).The further multivariate linear regression analysis showed that IGT,HDL-C had significant correlations with LA assessment score (both P＜0.05),TG had significant correlation with BG assessment score (P＜0.05),and waist circumfernce,IGT,HDL-C had significant correlations with Scheltens scores (all P＜ 0.05).Conclusions Metabolic syndrome and its components correlate with the imagings of cerebral damage in SIVD.Abdominal obesity,TG,IGT,HDL-C are the important risk factors for SIVD.

Objective To investigate the relationship between cognitive impairment and the other clinical features of subcortical damage in patients with magnetic resonance imaging(MRI)-defined subcortical ischemic vascular disease(SIVD).Methods The cohort for this study included 110 SIVD patients who were divided into 3 groups according to cognitive status:patients with noncognition impairment(SIVD-NCI group,n=34),patients with mild cognitive impairment(SIVD-MCI group,n =47) and patients with vascular dementia (SIVD-VaD group,n =29).The cognitive functions were evaluated by the mini-mental state examination (MMSE) and Montreal cognitive assessment(MoCA),the Cambridge cognitive examination-Chinese version(CAMCOG-C),activity of daily living scale(ADL) and clock drawing task(CDT),etc.Depression symptoms were assessed by the geriatric depression scale (GDS),while the other clinical features of subcortical damage were assessed by the timedGet-Up and Go test,etc.Results There were statistically significant differences in the MMSE,MoCA,CAMCOG-C,CDT and ADL scores among the three groups(H=85.36,F=50.32,55.03,H=27.39,40.87,respectively,all P＜0.05).Gait disturbance,urinary disorder,pseudobulbar palsy,depression and falls were statistically significantly different among the threegroups(x2=21.69,21.41,25.51,6.91,21.87,all P＜0.05).In addition,gait disturbance was increasingly aggravated with the severity of cognitive impairment.In SIVD-MCI group,urinary disorder,pseudobulbar palsy and falls were significantly increased as compared with SIVD-NCI group (x2 =15.57,16.31,8.92,both P＜0.017).Depression was statistically significant different between SIVD-NCIandSIVD-VaD group(x2 =6.90,P＜0.017).Among the three groups,there was no significant difference in the feature of emotional incontinence.Conclusions With the decline in cognitive function,the patients with SIVD can present with different clinical features of subcortical damage.Gait disturbance is gradually aggravated with the decline in cognitive function.Urinary disorder,pseudobulbar palsy,and falls can reflect the cognitive impairment from normal to mild on the other hand.Depression can be used as one of the signs that show cognitive impairment reached to dementia.

Objective To explore the relationship of cognitive impairment and depression in subcortical ischemic vascular disease (SIVD).Methods Neuropsychological scales were used to investigate the level of cognitive impairment and depression syndrome.According to the diagnostic criteria,the participants were divided into three groups:non-cognitive impairment group (SIVD-NCI),mild cognitive impairment group (SIVD-MCI),and dement group (SIVD-D).Depending on the clinical syndrome and the Geriatric Depression Scale (GDS),the participants were divided into depression group and non-depression group.The interaction of cognitive impairment and depression was analyzed using Analysis of Covariance (ANCOVA).Results The main effect of cognitive impairment was significant in all the Cambridge Cognitive Examination-Chinese version (CAMCOG-C) subscales,while the major function of depression in most of the CAMCOG-C subscales.The interaction of cognitive impairment and depression was significant only in executive function (F =6.835,P =0.001),attention (F =3.126,P =0.047),language (F =3.352,P =0.038) and comprehension of language (F =5.324,P =0.006).The interaction of cognitive impairment and depression was significant in executive function(F =14.255,P =0.000) and comprehension of language (F =3.971,P =0.049) between SIVD-NCI group and SIVD-MCI group while in attention (F =4.918,P =0.030) between SIVD-MCI group and SIVD-D group.Conclusions Patients of SIVD have varying degrees of cognitive impairment and depressive symptoms.Those with depression symptoms have more cognitive impairment than non-depressed patients.Cognitive impairment and depression show interaction in different subscales of cognitive function in different time.