OBJECTIVE To evaluate the efficacy and safety of immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy in the treatment of early-stage triple-negative breast cancer （TNBC）. METHODS A systematic search was conducted in PubMed， Embase， Cochrane Library， CNKI， and Wanfang Data to collect randomized controlled trials （RCT） on the use of immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy （experimental group） versus neoadjuvant chemotherapy and adjuvant chemotherapy （control group） in the treatment of TNBC. After literature screening， data extraction and literature quality evaluation， meta-analysis was performed using Stata 17.0. RESULTS A total of 5 RCT involving 1 498 patients were included. The meta-analysis results showed that the pathological complete response rate （pCR） [RR＝1.34， 95%CI （1.09， 1.63）， P＝0.03]， pCR in patients with positive programmed death-1 （PD-1） and its ligand （PD-L1） [RR＝1.33， 95%CI （1.16， 1.51）， P＝0.01]， pCR in patients with positive lymph nodes [RR＝ 1.56， 95%CI （1.27， 1.93）， P＝0.01]， the incidence of grade 3-4 adverse events （AEs） [RR＝1.07， 95%CI （1.01， 1.14）， P＝ 0.04]， the incidence of serious AEs [RR＝1.57， 95%CI （1.31， 1.87）， P＝0.03]， and the incidence of treatment discontinuation due to AEs [RR＝1.45， 95%CI （1.19， 1.76）， P＝0.01] were significantly higher in the experimental group than control group. There were no statistically significant difference in pCR in patients with negative PD-1/PD-L1[RR＝ E-mail：biejun23@126.com 1.26， 95%CI （0.98， 1.62）， P＝0.08] and pCR in patients with negative lymph nodes [RR＝1.14， 95%CI （0.97， 1.33）， P＝0.17] between the two groups. CONCLUSIONS Immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy demonstrates significant efficacy in early-stage TNBC patients， with more pronounced benefits observed in those who are PD-1/PD-L1 positive and lymph node- positive. However， the incidence of AEs is relatively high.

OBJECTIVETo evaluate the risk factors associated with pathogenesis of cerebral palsy (CP) in young children.

METHODSA cross-sectional survey on the prevalence of CP was conducted in young children aged one to six years in Leshan area, Sichuan Province. Cluster sampling and a 1:2 case-control design were used to investigate the risk factors for pathogenesis of CP.

RESULTSTotally, 148,723 children were surveyed, in which 308 (2.07 per thousand ) were diagnosed as CP. Low birth weight, twins and premature birth were associated with significantly increased prevalence of CP, 16.32, 4.16 and 22.21 times as that in normal birth weight, single birth and full-term birth, respectively. Simple factor analysis showed varied factors involved in pathogenesis of CP. The multivariate analysis revealed that delivery at home, low Apgar score in five minutes, illness during the first month of life, maternal "cold" with fever in their early gestation, low protein (meat and egg) intake during pregnancy and lower education level of mother were risk factors for CP.

CONCLUSIONSPrevalence and clinical features of CP in Leshan was comparable to those in the developed countries. Relevant risk factors could be seen primarily in gestational and perinatal periods, which might involve in mothers, children, environment and heredity, etc. To attach more importance in gestational and perinatal care for mothers and babies will be crucial measures to reduce occurrence of CP in young children.

Case-Control Studies ; Cerebral Palsy ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Multivariate Analysis ; Prevalence ; Risk Factors