Purpose: Combinations of immune checkpoint inhibitors (ICIs) and chemotherapy have become the standard first-line treatment for human epidermal growth factor receptor 2 (HER-2)-negative advanced gastric cancer. However, primary resistance remains a challenge, with no effective biomarkers available for its prediction. This retrospective study explores the relationship between the baseline inflammatory burden index (IBI) and primary resistance in such context. Materials and Methods: We analyzed 62 patients with HER-2-negative advanced gastric cancer who received ICIs and chemotherapy as their first-line treatment. The IBI was calculated as follows: C-reactive protein (mg/L) × neutrophil count (10 3 /mm 3 )/lymphocyte count (10 3 /mm 3 ). Based on disease progression within 6 months, patients were categorized into the primary resistant or the control group. We compared baseline characteristics and IBI scores between the groups and assessed the predictive value of the IBI using the receiver operating characteristic curve. Both univariate and multivariate binary logistic regression analyses were conducted to identify factors influencing primary resistance. Results: Nineteen patients were included in the primary resistance group, and forty-three patients were included in the control group. The IBI was significantly higher in the resistant group compared to the control group (P<0.01). The area under the curve for the IBI was 0.82, indicating a strong predictive value. Multivariate analysis identified the IBI as an independent predictor of primary resistance (P=0.014). Conclusions The baseline IBI holds promise as a predictor of primary resistance to combined ICIs and chemotherapy in patients with HER-2-negative advanced gastric cancer.

Purpose: Combinations of immune checkpoint inhibitors (ICIs) and chemotherapy have become the standard first-line treatment for human epidermal growth factor receptor 2 (HER-2)-negative advanced gastric cancer. However, primary resistance remains a challenge, with no effective biomarkers available for its prediction. This retrospective study explores the relationship between the baseline inflammatory burden index (IBI) and primary resistance in such context. Materials and Methods: We analyzed 62 patients with HER-2-negative advanced gastric cancer who received ICIs and chemotherapy as their first-line treatment. The IBI was calculated as follows: C-reactive protein (mg/L) × neutrophil count (10 3 /mm 3 )/lymphocyte count (10 3 /mm 3 ). Based on disease progression within 6 months, patients were categorized into the primary resistant or the control group. We compared baseline characteristics and IBI scores between the groups and assessed the predictive value of the IBI using the receiver operating characteristic curve. Both univariate and multivariate binary logistic regression analyses were conducted to identify factors influencing primary resistance. Results: Nineteen patients were included in the primary resistance group, and forty-three patients were included in the control group. The IBI was significantly higher in the resistant group compared to the control group (P<0.01). The area under the curve for the IBI was 0.82, indicating a strong predictive value. Multivariate analysis identified the IBI as an independent predictor of primary resistance (P=0.014). Conclusions The baseline IBI holds promise as a predictor of primary resistance to combined ICIs and chemotherapy in patients with HER-2-negative advanced gastric cancer.

Purpose: Combinations of immune checkpoint inhibitors (ICIs) and chemotherapy have become the standard first-line treatment for human epidermal growth factor receptor 2 (HER-2)-negative advanced gastric cancer. However, primary resistance remains a challenge, with no effective biomarkers available for its prediction. This retrospective study explores the relationship between the baseline inflammatory burden index (IBI) and primary resistance in such context. Materials and Methods: We analyzed 62 patients with HER-2-negative advanced gastric cancer who received ICIs and chemotherapy as their first-line treatment. The IBI was calculated as follows: C-reactive protein (mg/L) × neutrophil count (10 3 /mm 3 )/lymphocyte count (10 3 /mm 3 ). Based on disease progression within 6 months, patients were categorized into the primary resistant or the control group. We compared baseline characteristics and IBI scores between the groups and assessed the predictive value of the IBI using the receiver operating characteristic curve. Both univariate and multivariate binary logistic regression analyses were conducted to identify factors influencing primary resistance. Results: Nineteen patients were included in the primary resistance group, and forty-three patients were included in the control group. The IBI was significantly higher in the resistant group compared to the control group (P<0.01). The area under the curve for the IBI was 0.82, indicating a strong predictive value. Multivariate analysis identified the IBI as an independent predictor of primary resistance (P=0.014). Conclusions The baseline IBI holds promise as a predictor of primary resistance to combined ICIs and chemotherapy in patients with HER-2-negative advanced gastric cancer.

Botulinum toxin(BoNT)is currently the first-line method for treating focal dystonia,which causes muscle paralysis by chemical denervation.Recent neuroimaging studies have found that BoNT treatment could alter neuroplasticity in the brain of patients with focal dystonia.However,the specific central nervous system mechanisms have not been fully elucidated.To this end,here we review the neuroimaging studies on BoNT treatment for dystonia from three aspects:functional magnetic resonance imaging,structural magnetic resonance imaging,and positron emission tomography imaging.It suggests that BoNT may improve the symptoms of dystonia patients by affecting functional connectivity,microstructure,and metabolic levels of the cortex,basal ganglia,thalamus,and cerebellum,etc.Therefore,this review will provide a theoretical reference for further exploring the mechanism and developing potential therapeutic targets of dystonia.

Age-related hearing loss(ARHL)is a common chronic disease that poses a serious threat to the physical and mental health of the elderly in an aging society.It is a sensorineural hearing loss characterized by the loss of auditory hair cells,stria vascularis lesions,apoptosis of spiral ganglia,and degeneration of the audi-tory central nervous system,reducing the quality of life of the patients.This article reviews the research progress in the relationship of ARHL with Alzheimer's disease,depression,and frailty,as well as the daily intervention in ARHL.This review aims to improve people's awareness and attention to the health hazards of ARHL and to delay the occurrence and development of ARHL by implementing daily intervention measures to form a healthy lifestyle.

Objective To explore the risk factors of early traumatic coagulation(TIC)in elderly patients with chest trauma.Methods The data of 113 elderly patients with chest trauma admitted in a hospital from January 2016 to January 2022 were retrospectively analyzed.Patients were divided into TIC group and non-TIC group according to whether they had early TIC.The risk factors of early TIC in elderly patients with thoracic trauma were analyzed by single factor and multi factor methods.Analysis of the predictive value of early TIC in elderly patients with thoracic trauma using multifactor model.Result Of all the patients included in the study,27 were determined as TIC,and the rest 86 were non-TIC.The results of univariate analysis showed that there were statistically significant differences in the data of shock index,platelet count at admission and plasma fibrinogen at admission between patients in TIC group and non-TIC group(P＜0.05).Multivariate analysis showed that the shock index at admission,platelet count at admission,and plasma fibrin at admission were all independent influencing factors of early TIC in elderly patients with chest trauma(all P＜0.05).The P value of multivariate model and independent variables predict the early TIC of elderly patients with chest trauma.The Yoden index is 36.95％,42.89％,75.58％and 78.85％respectively.Conclusion The shock index,platelet count and plasma fibrin at the time of admission can affect the early occurrence of TIC in elderly patients with chest trauma.

With the rapid changes in lifestyle, natural and social environment, the reproductive health status of couples in childbearing age continues to decline, and long-term outcomes of the rapidly increasing offspring conceived by assisted reproductive technology (ART) needs to be evaluated urgently. Therefore, the focus of research now needs to be extended from death and severe diseases to full life cycle and full disease spectrum. In order to meet the demand for such research, we launched the China National Birth Cohort (CNBC) study, an ongoing prospective and longitudinal study aiming to recruit 30 000 families underwent ART and 30 000 families with spontaneous pregnancies. Long-term follow-up programs will be conducted for both spouses and their offspring. Data of couples and their offspring, such as environmental exposure, reproductive history, psychological and behavioral status, will be collected during follow-up. Peripheral blood, urine, umbilical blood, follicular fluid, semen were also collected at different follow-up nodes. Based on high-quality data and biological samples, CNBC will play an extremely important supporting role and have a far-reaching impact on maternal and children's health care and reproductive health in China. This paper is exactly a brief introduction to the construction and basic design of CNBC.

Objective:To explore the effects of environmental, genetic factors as well as the interactions in early life on the short-term and long-term health of offspring and to systematically evaluate the pregnancy outcomes and health of offspring after birth between families with assisted reproductive technology (ART) conception and families with spontaneous conception.Methods:The China National Birth Cohort (CNBC), a multicenter prospective birth cohort study, includes both families with ART conception and families with spontaneous conception. Since 2016, CNBC has recruited families from 24 hospitals located in 12 provinces, municipalities and autonomous regions throughout China. Information and biospecimens were collected before ART treatment, embryo transfer, at early, second, third trimester and delivery, and at 42 days, 6, 12 and 36 months after birth.Results:By June 2020, CNBC had included 27 044 families with ART conception and 29 589 families with spontaneous conception. The majority of the participants are urban residents. Among the families with ART conception, 65.5% of the men and 63.7% of the women had college degrees or higher. The mean age distribution of men and women was (33.83±5.52) and (32.38±4.67) years. 83.2% of women were primiparas, and the prevalence rates of current regular smokers and current alcohol drinkers were 0.8% and 2.1% in women. Among the families with spontaneous conception, 81.5% of the men and 86.5% of the women had college degrees or higher. The mean age distribution of men and women was (32.06±5.09) and (30.40±4.27) years. 67.2% of women were primiparas, and the prevalence rates of current regular smokers and current alcohol drinkers were 0.1% and 2.2% in women. The baseline characteristics were different between the families with ART conception and spontaneous conception in different regions.Conclusion:CNBC provides a powerful and rich resource in studying the impact of genetic, environmental factors and interactions in early life and ART treatment on the health of offspring after birth.

Objective To explore the characteristics and significance of functional connectivity (FC) of affective network (AN) in patients with postpartum depression (PPD) under resting state. Methods A total of 23 patients with PPD (PPD group) and 28 healthy postpartum women (control group) were examined using resting-state fMRI. As two critical nodes of AN, amygdala (AMYG) and subgenual anterior cingulate cortex (sgACC) were selected as the regions of interest (ROI) to analyze the differences of functional connectivity strength (FCS) of two regions from other brain regions between two groups, followed by Pearson correlation analysis on the abnormal FCS and the Edinburgh postnatal depression scale (EPDS) score in PPD group. Results Compared to the control group, the patients in PPD group showed the extensively reduced FCS (P<0.05, Alphasim correction) between AMYG and frontal cortex, temporal cortex, hippocampus, cerebellum and orbitofrontal cortex, while there were enhanced FCS (P<0.05, Alphasim correction) between sgACC and parietal cortex, occipital cortex, thalamus, superior temporal gyrus and cingulate cortex. Moreover, in PPD group, the reduced FCS between left AMYG and left medial orbitofrontal cortex was negatively correlated with EPDS scores (r=-0.62, P=0.02). Conclusion Patients with PPD have dysfunctional connectivity of AN in multiple brain regions. The weaker FCS between left amygdala and left medial orbitofrontal cortex is, the more severe depression. The dysfunctional connectivity of AN may provide an effective mechanism-based biomarker underlying PPD.

Objective To investigate the clinical value of the massive transfusion protocols (MTP) in abdominal surgical patients with traumatic shock.Methods An analysis was made on the clinical data of patients before and after the use of MTP,including the general condition,amount of blood transfusion,transfusion components and ratio,blood and coagulation function test,and blood transfusion related complications and mortality.Results Before implement of MTP,the average RBC transfusion in the first 24 hours was 19.5U,FFBwas 12.6U,and the ratio ofRBC ∶ FFB was 1.55 ∶ 1.After implement of MTP,the average RBC transfusion in the first 24 hours was 17.3 U,and the ratio of RBC:FFB was 1 ∶ 1.There were no significant statistical differences between the two groups about PT,APTT,Hb and PLT on admission.After 24 hours of admission,there was no significant difference in Hb between the two groups,there were significant differences of PT,APTT and PLT.Blood transfusion related complications were 11 (14.9％) in control group and 7 (11.9％) in MTP,group,and the mortality was 9.46％ and 6.78％ respectively.Conclusions MTP improves blood coagulation function,reduces blood transfusion and enhances survival rate of abdominal surgical patients with traumatic shock.