Objective:To evaluate the safety and effectiveness of fuzuloparib for the treatment of ovarian epithelial cancer patients in the real world setting.Methods:A retrospective analysis was conducted on the baseline data of 4 620 ovarian cancer patients who had received fuzuloparib monotherapy or combination therapy. Another 224 ovarian cancer patients who were willing to receive fuzuloparib monotherapy or combination therapy were prospectively enrolled, and their baseline characteristics, drug effectiveness, and safety data were analyzed.Results:(1) Among the 4 620 patients in the retrospective cohort, the median age of patients was 60 years; tumor types: 89.8% (4 149/4 620) had ovarian cancer. Among patients with clearly documented information, the vast majority had a histological type of serous carcinoma (82.9%, 3 770/4 546) and International Federation of Gynecology and Obstetrics (FIGO) staging of Ⅲ-Ⅳ (90.9%, 1 537/1 691). (2) Among the 224 patients in the prospective cohort, the median age of patients was 57 years; tumor types: 83.9% (188/224) had ovarian cancer. Among patients with clearly documented records, the predominant pathologic type was serous carcinoma (91.9%, 193/210), and FIGO stage was Ⅲ-Ⅳ in 79.9% (139/174). (3) Among the 224 prospective patients: 84 patients received first-line fluzoparib maintenance therapy, 92 patients received fluzoparib maintenance therapy after platinum-sensitive recurrence, 23 patients received direct fluzoparib treatment after platinum-sensitive recurrence, 19 patients received direct fluzoparib treatment after platinum-resistant recurrence. The median follow-up durations were 8.5, 8.7, 7.9, and 6.7 months, respectively. The median durations of fluzoparib treatment were 6.7, 4.8, 3.1, and 1.9 months, respectively. The median progression-free survival (PFS) times were not reached during follow-up, 12.6 months, not reached during follow-up, and 4.8 months, respectively. The 1-year PFS rates were 84.1%, 55.0%, 69.8%, and 45.5%, respectively. The remaining 6 patients received other fluzoparib regimens. (4) Among the 224 patients in the prospective dataset, 205 had safety data recorded. Of these, 127 patients (62.0%, 127/205) experienced treatment-related adverse events, with common events including anemia (24.4%, 50/205), thrombocytopenia (21.0%, 43/205), and leukopenia (19.5%, 40/205). Among the 205 patients, 43 (21.0%, 43/205) experienced grade 3 or higher treatment-related adverse events, with common events including anemia (8.3%, 17/205) and thrombocytopenia (8.3%, 17/205).Conclusions:The effectiveness of fuzuloparib in clinical application is generally consistent with other drugs in the same class, with good safety. This study provids new clinical evidence for the treatment of ovarian cancer with fuzuloparib.

OBJECTIVE To explore the effect of oral cleaning with traditional Chinese medicine preparations on de-colonization of oropharyngeal bacteria and hospital-acquired pneumonia(HAP)in elderly patients undergoing non-inva-sive mechanical ventilation.METHODS A total of 520 elderly patients who were treated with non-invasive mechani-cal ventilation in Enze Hospital of Enze Medical Center(Group)from Jan.2022 to Dec.2024 were recruited as the research subjects and were randomly divided into the normal saline group and the traditional Chinese medicine(TCM)preparation group,with 260 cases in each group.The two groups were respectively treated with normal saline and TCM preparations for oral cleaning,twice a day in the morning and evening.The dental plaque index score,isolation rate of oropharyngeal pathogens,incidence of HAP and isolation rates of pathogens causing HAP were observed and compared between the two groups.RESULTS There were no significant differences in the dental plaque index score and the isolation rate of oropharyngeal pathogens between the two groups of patients before the first cleaning.However,the dental plaque index score and the isolation rate of oropharyngeal pathogens were low-er in the TCM preparation group than in the normal saline group after the first cleaning and the continuous clean-ing for 5 days(P＜0.05).The incidence of HAP of the TCM preparation group(3.63％)was lower than that of the normal saline group(8.91％)(x2=5.872,P=0.015).The isolation rate of gram-negative bacteria from lower respiratory tract secretions of the patients with HAP was lower in the TCM preparation group than in the normal saline group(P＜0.05);there were no significant differences in the isolation rates of gram-positive bacteria and fungi between the two groups.CONCLUSION As compared with the normal saline for routine oral cleaning of the elderly patients undergoing non-invasive mechanical ventilation,the TCM preparations may facilitate the decoloni-zation of oropharyngeal bacteria and remarkably reduce the incidence of HAP,which may provide a new idea for decolonization of oropharyngeal bacteria and reduction of incidence of HAP.

Objective This study aimed to explore the ability of ultrasonographic radiomics in predicting the occurrence of in-stent restenosis(ISR)after carotid artery stenting(CAS)by analyzing the correlation between radiomic features of responsible plaques in carotid artery stenosis and the incidence of ISR.Methods A retrospective collection was conducted on 206 cases that underwent CAS treatment at our hospital.The enrolled patients were randomly split into a training set(144 cases)and a test set(62 cases)at a 7∶3 ratio.We utilized the Darwin Intelligent Research Platform to extract radiomic features from each region of interest,and then screened 1125 ultrasonographic radiomic features.Different machine learning algorithms were employed to construct diagnostic models,and the best-performing classifier was selected.Various prediction models were established,including a clinical-ultrasonographic feature model,a radiomic model,and a combined clinical-ultrasonographic-radiomic model.Results Multivariate logistic regression analysis in the training set revealed that hypertension,hyperuricemia,triglycerides,and plaque location were independent risk factors for ISR after CAS.For the clinical-ultrasonographic model,the area under the curve(AUC)values for the training and validation sets were 0.896 and 0.644,respectively.The corresponding AUC values for the radiomic model were 0.961 and 0.715,while those for the combined model were 0.947 and 0.727.Conclusion The radiomic model demonstrates superior performance in predicting ISR compared to the traditional clinical-ultrasonographic model.The combined model exhibited an enhanced ability to predict ISR occurrence,thereby improving the diagnostic performance of traditional assessments.

Objective To investigate the correlation between serum cytotoxic T lymphocyte associated pro-tein 4(CTLA4),high mobility group box 1(HMGB1)and the balance of helper T cell 17(Th17)/regulatory T cell(Treg),and to study their diagnostic significance for unexplained recurrent spontaneous abortion(URSA).Methods A total of 102 patients with URSA admitted to the hospital from September 2022 to September 2024 were selected as the URSA group,and another 80 healthy pregnant women who underwent prenatal examinations in the hospital during the same period were selected as the healthy group.The levels of serum CTLA4 and HMGB1 in the two groups were detected,the levels of Th17 and Treg in the two groups were detected,the Th17/Treg ratio was calculated,and the general data of the two groups were collected and recorded.Pearson was used to analyze the correlations between the levels of serum CLTA4 and HMGB1 and Th17,Treg,and Th17/Treg.logistic regres-sion was used to analyze the influencing factors of URSA occurrence.The receiver operating characteristic(ROC)curve was used to analyze the value of serum CTLA4 and HMGB1 levels in evaluating the occurrence of URSA.Results the serum CTLA4 level in the URSA group was lower than that in the healthy group,the HMGB1 level was higher than that in the healthy group,the Th17 level and Th17/Treg were higher than those in the healthy group,and the Treg level was lower than that in the healthy group(P<0.05).The serum CTLA4 level was nega-tively correlated with the Th17 level and Th17/Treg,and positively correlated with the Treg level(P<0.05).The level of HMGB1 was positively correlated with the level of Th17 and Th17/Treg,and negatively correlated with the level of Treg(P<0.05).Pregnancy frequency,serum CTLA4 level,serum HMGB1 level,Th17 level,Treg level,and Th17/Treg are independent influencing factors for the occurrence of URSA(P<0.05).The areas under the curve(AUC)of serum CTLA4 and HMGB1 levels and the combined evaluation of URSA by the two indicators were 0.841,0.787,and 0.908 respectively,and the Youden indices were 0.652,0.491,and 0.656 respectively.Conclusions The serum CTLA4 level is decreased and the HMGB1 level is increased in patients with URSA,which is related to the change of Th17/Treg balance.The levels of serum CTLA4 and HMGB1 have auxiliary diag-nostic significance for URSA.

Objective:To evaluate the safety and effectiveness of fuzuloparib for the treatment of ovarian epithelial cancer patients in the real world setting.Methods:A retrospective analysis was conducted on the baseline data of 4 620 ovarian cancer patients who had received fuzuloparib monotherapy or combination therapy. Another 224 ovarian cancer patients who were willing to receive fuzuloparib monotherapy or combination therapy were prospectively enrolled, and their baseline characteristics, drug effectiveness, and safety data were analyzed.Results:(1) Among the 4 620 patients in the retrospective cohort, the median age of patients was 60 years; tumor types: 89.8% (4 149/4 620) had ovarian cancer. Among patients with clearly documented information, the vast majority had a histological type of serous carcinoma (82.9%, 3 770/4 546) and International Federation of Gynecology and Obstetrics (FIGO) staging of Ⅲ-Ⅳ (90.9%, 1 537/1 691). (2) Among the 224 patients in the prospective cohort, the median age of patients was 57 years; tumor types: 83.9% (188/224) had ovarian cancer. Among patients with clearly documented records, the predominant pathologic type was serous carcinoma (91.9%, 193/210), and FIGO stage was Ⅲ-Ⅳ in 79.9% (139/174). (3) Among the 224 prospective patients: 84 patients received first-line fluzoparib maintenance therapy, 92 patients received fluzoparib maintenance therapy after platinum-sensitive recurrence, 23 patients received direct fluzoparib treatment after platinum-sensitive recurrence, 19 patients received direct fluzoparib treatment after platinum-resistant recurrence. The median follow-up durations were 8.5, 8.7, 7.9, and 6.7 months, respectively. The median durations of fluzoparib treatment were 6.7, 4.8, 3.1, and 1.9 months, respectively. The median progression-free survival (PFS) times were not reached during follow-up, 12.6 months, not reached during follow-up, and 4.8 months, respectively. The 1-year PFS rates were 84.1%, 55.0%, 69.8%, and 45.5%, respectively. The remaining 6 patients received other fluzoparib regimens. (4) Among the 224 patients in the prospective dataset, 205 had safety data recorded. Of these, 127 patients (62.0%, 127/205) experienced treatment-related adverse events, with common events including anemia (24.4%, 50/205), thrombocytopenia (21.0%, 43/205), and leukopenia (19.5%, 40/205). Among the 205 patients, 43 (21.0%, 43/205) experienced grade 3 or higher treatment-related adverse events, with common events including anemia (8.3%, 17/205) and thrombocytopenia (8.3%, 17/205).Conclusions:The effectiveness of fuzuloparib in clinical application is generally consistent with other drugs in the same class, with good safety. This study provids new clinical evidence for the treatment of ovarian cancer with fuzuloparib.

Objective To investigate the correlation between serum cytotoxic T lymphocyte associated pro-tein 4(CTLA4),high mobility group box 1(HMGB1)and the balance of helper T cell 17(Th17)/regulatory T cell(Treg),and to study their diagnostic significance for unexplained recurrent spontaneous abortion(URSA).Methods A total of 102 patients with URSA admitted to the hospital from September 2022 to September 2024 were selected as the URSA group,and another 80 healthy pregnant women who underwent prenatal examinations in the hospital during the same period were selected as the healthy group.The levels of serum CTLA4 and HMGB1 in the two groups were detected,the levels of Th17 and Treg in the two groups were detected,the Th17/Treg ratio was calculated,and the general data of the two groups were collected and recorded.Pearson was used to analyze the correlations between the levels of serum CLTA4 and HMGB1 and Th17,Treg,and Th17/Treg.logistic regres-sion was used to analyze the influencing factors of URSA occurrence.The receiver operating characteristic(ROC)curve was used to analyze the value of serum CTLA4 and HMGB1 levels in evaluating the occurrence of URSA.Results the serum CTLA4 level in the URSA group was lower than that in the healthy group,the HMGB1 level was higher than that in the healthy group,the Th17 level and Th17/Treg were higher than those in the healthy group,and the Treg level was lower than that in the healthy group(P<0.05).The serum CTLA4 level was nega-tively correlated with the Th17 level and Th17/Treg,and positively correlated with the Treg level(P<0.05).The level of HMGB1 was positively correlated with the level of Th17 and Th17/Treg,and negatively correlated with the level of Treg(P<0.05).Pregnancy frequency,serum CTLA4 level,serum HMGB1 level,Th17 level,Treg level,and Th17/Treg are independent influencing factors for the occurrence of URSA(P<0.05).The areas under the curve(AUC)of serum CTLA4 and HMGB1 levels and the combined evaluation of URSA by the two indicators were 0.841,0.787,and 0.908 respectively,and the Youden indices were 0.652,0.491,and 0.656 respectively.Conclusions The serum CTLA4 level is decreased and the HMGB1 level is increased in patients with URSA,which is related to the change of Th17/Treg balance.The levels of serum CTLA4 and HMGB1 have auxiliary diag-nostic significance for URSA.

Objective This study aimed to explore the ability of ultrasonographic radiomics in predicting the occurrence of in-stent restenosis(ISR)after carotid artery stenting(CAS)by analyzing the correlation between radiomic features of responsible plaques in carotid artery stenosis and the incidence of ISR.Methods A retrospective collection was conducted on 206 cases that underwent CAS treatment at our hospital.The enrolled patients were randomly split into a training set(144 cases)and a test set(62 cases)at a 7∶3 ratio.We utilized the Darwin Intelligent Research Platform to extract radiomic features from each region of interest,and then screened 1125 ultrasonographic radiomic features.Different machine learning algorithms were employed to construct diagnostic models,and the best-performing classifier was selected.Various prediction models were established,including a clinical-ultrasonographic feature model,a radiomic model,and a combined clinical-ultrasonographic-radiomic model.Results Multivariate logistic regression analysis in the training set revealed that hypertension,hyperuricemia,triglycerides,and plaque location were independent risk factors for ISR after CAS.For the clinical-ultrasonographic model,the area under the curve(AUC)values for the training and validation sets were 0.896 and 0.644,respectively.The corresponding AUC values for the radiomic model were 0.961 and 0.715,while those for the combined model were 0.947 and 0.727.Conclusion The radiomic model demonstrates superior performance in predicting ISR compared to the traditional clinical-ultrasonographic model.The combined model exhibited an enhanced ability to predict ISR occurrence,thereby improving the diagnostic performance of traditional assessments.

OBJECTIVE To explore the effect of oral cleaning with traditional Chinese medicine preparations on de-colonization of oropharyngeal bacteria and hospital-acquired pneumonia(HAP)in elderly patients undergoing non-inva-sive mechanical ventilation.METHODS A total of 520 elderly patients who were treated with non-invasive mechani-cal ventilation in Enze Hospital of Enze Medical Center(Group)from Jan.2022 to Dec.2024 were recruited as the research subjects and were randomly divided into the normal saline group and the traditional Chinese medicine(TCM)preparation group,with 260 cases in each group.The two groups were respectively treated with normal saline and TCM preparations for oral cleaning,twice a day in the morning and evening.The dental plaque index score,isolation rate of oropharyngeal pathogens,incidence of HAP and isolation rates of pathogens causing HAP were observed and compared between the two groups.RESULTS There were no significant differences in the dental plaque index score and the isolation rate of oropharyngeal pathogens between the two groups of patients before the first cleaning.However,the dental plaque index score and the isolation rate of oropharyngeal pathogens were low-er in the TCM preparation group than in the normal saline group after the first cleaning and the continuous clean-ing for 5 days(P＜0.05).The incidence of HAP of the TCM preparation group(3.63％)was lower than that of the normal saline group(8.91％)(x2=5.872,P=0.015).The isolation rate of gram-negative bacteria from lower respiratory tract secretions of the patients with HAP was lower in the TCM preparation group than in the normal saline group(P＜0.05);there were no significant differences in the isolation rates of gram-positive bacteria and fungi between the two groups.CONCLUSION As compared with the normal saline for routine oral cleaning of the elderly patients undergoing non-invasive mechanical ventilation,the TCM preparations may facilitate the decoloni-zation of oropharyngeal bacteria and remarkably reduce the incidence of HAP,which may provide a new idea for decolonization of oropharyngeal bacteria and reduction of incidence of HAP.

Humans ; Consanguinity ; Exome Sequencing ; Mutation/genetics* ; Sequence Analysis, DNA ; Ciliary Motility Disorders ; Axonemal Dyneins/genetics*

Objective:To explore the feasibility and efficacy for the dissection and ligation of the superior laryngeal artery in endoscopic surgery for hypopharyngeal cancer.Methods:Eight cadaveric heads were selected, and the laryngopharynxes were harvested. The positions of the superior laryngeal arteries entering the larynxes were dissected and observed under endoscopic vision, and their anatomical characteristics were summarized. Twenty-nine patients (all were male, aged 39-74 years old) with hypopharyngeal cancer who underwent transoral endoscopic surgery at the Department of Otorhinolaryngology Head and Neck Surgery of the Second Xiangya Hospital, Central South University from January 2018 to December 2019 were selected, and the patients were randomly divided into two groups by drawing lots, namely, the superior laryngeal artery was actively dissected and occluded during surgery in observation group ( n=15) or not in control group ( n=14). The differences in surgical time, bleeding volume, postoperative complications, and postoperative disease-free survival rate were compared between the two groups. Statistical analysis was conducted using SPSS 25.0 software. Results:The entry point of the superior laryngeal artery into the larynx was approximately at the level of the superior edge of the thyroid cartilage, and entered the larynx at the posterior one-third of the lateral wall of the pyriform fossa. The superior laryngeal artery might be determined through endoscopic exploration in all patients of observation group. The endoscopic surgery time [(40.00±7.56) minutes] and intraoperative bleeding volume [(24.00±8.28) ml] in the observation group were respectively less than those [(48.57±14.06) minutes and (42.86±15.41) ml] in the control group, and the differences were statistically significant ( t=-2.064, P=0.049; t=-4.064, P=0.001). There was no case with postoperative bleeding in the observation group, but with one case of postoperative bleeding in the control group. Total disease free survival rate was 86.2% and there was no significant difference in disease free survival rates between the two groups during a follow-up period of at least 36 months ( P=0.986). Conclusion:Dissection of the superior laryngeal artery during endoscopic surgery for hypopharyngeal cancer is feasible, and pre-management and occlusion of the superior laryngeal artery can effectively reduce intraoperative bleeding.