Chemotherapy is a critical treatment modality for cancer,playing an essential role in oncology.However,chemotherapy-related diarrhea(CRD)remains a troubling adverse effect,often leading to reduced chemotherapy doses,treatment delays or discontinuation,and modifications to therapeutic plans.In severe cases,CRD can be life-threatening.5-fluorouracil and irinotecan are the most common chemotherapy drugs that cause CRD.With the increase in the use of triplet combination chemotherapy regimens,diarrhea-related deaths have increased,which may be related to neutropenic enterocolitis.Loperamide is the main drug for the treatment of CRD.In clinical practice,management of diarrhea that is not responsive to loperamide is of utmost concern.Therefore,based on evidence-based medicine and clinical practice experience,the expert panel carried out a comprehensive assessment and discussion on the definition,pathogenesis,classification,evaluation,diagnosis,intervention,and prevention of CRD.Eventually,the Chinese Expert Consensus on Whole-process Management of Chemotherapy-Related Diarrhea(2025 Edition)was formulated to further standardize the whole-process management of chemotherapy-related diarrhea.The consensus has been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2024CN1246.

Objective:To compare the clinical outcomes of single oral dydrogesterone with vaginal progesterone gel plus oral dydrogesterone in gonadotropin-releasing hormone (GnRH) antagonist cycles with fresh embryo transfer.Methods:This study retrospectively analyzed 658 treatment cycles of fresh embryo transfer cycle with GnRH antagonist protocol from December 2015 to December 2020 in the Center of Reproductive Medicine of the University of Hong Kong-Shenzhen Hospital. Each cycle was the first fresh stimulation cycle of the patients. The patients were divided into two groups according to different luteal support regimens. Group A included 368 cycles with a regimen of 30 mg dydrogesterone tablets orally daily, while group B included 290 cycles with a regimen of 90 mg vaginal progesterone gel vaginally daily combined with 20 mg dydrogesterone tablets orally daily. A 1∶1 propensity score matching (PSM) was carried out to adjust for numerical differences and to balance between the two groups, and further they were divided into cleavage stage embryo transfer cycles and the blastocyst transfer cycles according to the different type of embryo for layer analysis, and the laboratory results and assisted reproductive outcomes of the two groups were compared.Results:After matching, the baseline characteristics were comparable between the two groups, with 251 cycles remaining in each group for retrospective analysis. After PSM, statistically significant differences were observed between group A and group B in laboratory data including the number of fertilized oocytes [5 (2, 7) vs. 6 (3, 9), P=0.002], cleavage rate [100.0% (86.31%, 100.0%) vs. 87.28% (75.32%, 100.0%), P<0.001], and available embryo rate [80.18% (54.64%, 100.0%) vs. 67.48% (50.62%, 100.0%), P=0.019]. However, there were no significantly statistical differences in other laboratory data and clinical outcomes (all P>0.05). If we divided the data into two comparison according to the different type of embryo, there were no significantly statistical differences in clinical pregnancy rate, embryo implantation rate, live birth rate, miscarriage rate, multiple pregnancy rate, ovarian hyperstimulation syndrome incidence, and ectopic pregnancy rate neither in day 2 cleavage stage embryo transfer cycles nor in the blastocyst transfer cycles. Conclusion:In this study, the clinical outcomes are similar between taking 30 mg of dydrogesterone tablets orally alone and taking 20 mg of dydrogesterone tablets orally combined with vaginal progesterone gel in the fresh embryo transfer cycle of the GnRH antagonist protocol. Moreover, taking dydrogesterone tablets orally alone can be a new option for luteal support in the fresh cycle of the GnRH antagonist protocol.

Objective:To compare the clinical outcomes of single oral dydrogesterone with vaginal progesterone gel plus oral dydrogesterone in gonadotropin-releasing hormone (GnRH) antagonist cycles with fresh embryo transfer.Methods:This study retrospectively analyzed 658 treatment cycles of fresh embryo transfer cycle with GnRH antagonist protocol from December 2015 to December 2020 in the Center of Reproductive Medicine of the University of Hong Kong-Shenzhen Hospital. Each cycle was the first fresh stimulation cycle of the patients. The patients were divided into two groups according to different luteal support regimens. Group A included 368 cycles with a regimen of 30 mg dydrogesterone tablets orally daily, while group B included 290 cycles with a regimen of 90 mg vaginal progesterone gel vaginally daily combined with 20 mg dydrogesterone tablets orally daily. A 1∶1 propensity score matching (PSM) was carried out to adjust for numerical differences and to balance between the two groups, and further they were divided into cleavage stage embryo transfer cycles and the blastocyst transfer cycles according to the different type of embryo for layer analysis, and the laboratory results and assisted reproductive outcomes of the two groups were compared.Results:After matching, the baseline characteristics were comparable between the two groups, with 251 cycles remaining in each group for retrospective analysis. After PSM, statistically significant differences were observed between group A and group B in laboratory data including the number of fertilized oocytes [5 (2, 7) vs. 6 (3, 9), P=0.002], cleavage rate [100.0% (86.31%, 100.0%) vs. 87.28% (75.32%, 100.0%), P<0.001], and available embryo rate [80.18% (54.64%, 100.0%) vs. 67.48% (50.62%, 100.0%), P=0.019]. However, there were no significantly statistical differences in other laboratory data and clinical outcomes (all P>0.05). If we divided the data into two comparison according to the different type of embryo, there were no significantly statistical differences in clinical pregnancy rate, embryo implantation rate, live birth rate, miscarriage rate, multiple pregnancy rate, ovarian hyperstimulation syndrome incidence, and ectopic pregnancy rate neither in day 2 cleavage stage embryo transfer cycles nor in the blastocyst transfer cycles. Conclusion:In this study, the clinical outcomes are similar between taking 30 mg of dydrogesterone tablets orally alone and taking 20 mg of dydrogesterone tablets orally combined with vaginal progesterone gel in the fresh embryo transfer cycle of the GnRH antagonist protocol. Moreover, taking dydrogesterone tablets orally alone can be a new option for luteal support in the fresh cycle of the GnRH antagonist protocol.

Chemotherapy is a critical treatment modality for cancer,playing an essential role in oncology.However,chemotherapy-related diarrhea(CRD)remains a troubling adverse effect,often leading to reduced chemotherapy doses,treatment delays or discontinuation,and modifications to therapeutic plans.In severe cases,CRD can be life-threatening.5-fluorouracil and irinotecan are the most common chemotherapy drugs that cause CRD.With the increase in the use of triplet combination chemotherapy regimens,diarrhea-related deaths have increased,which may be related to neutropenic enterocolitis.Loperamide is the main drug for the treatment of CRD.In clinical practice,management of diarrhea that is not responsive to loperamide is of utmost concern.Therefore,based on evidence-based medicine and clinical practice experience,the expert panel carried out a comprehensive assessment and discussion on the definition,pathogenesis,classification,evaluation,diagnosis,intervention,and prevention of CRD.Eventually,the Chinese Expert Consensus on Whole-process Management of Chemotherapy-Related Diarrhea(2025 Edition)was formulated to further standardize the whole-process management of chemotherapy-related diarrhea.The consensus has been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2024CN1246.

Objective:To develop a limb function exercise program for patients on extracorporeal membrane oxygenation (ECMO) and provide theoretical guidance for clinical nursing staff.Methods:A research team was formed to systematically review domestic and international literature on functional exercise for ECMO patients, extracting relevant evidence to form the initial version of the limb function exercise program. From June to July 2023, the Delphi method was used to conduct two rounds of expert consultations with 18 experts from three provinces and municipalities directly under the central government, including Shanghai, Jiangsu, and Shanxi. Based on the experts' feedback, the program items were revised to form the final version of the exercise program.Results:In the first round, 18 experts were consulted, with a valid response rate of 94.44% (17/18); in the second round, 17 experts participated, with a 100.00% (17/17) response rate. The expert authority coefficient was 0.859 in both rounds. The coefficient of variation for each level of indicator in the second round ranged from 0 to 0.160, and Kendall's coefficient of concordance was 0.092 to 0.130 ( P<0.01). The final ECMO patient limb function exercise program consisted of four primary indicators (preparation, assessment, exercise methods, and safety monitoring), 13 secondary indicators, and 44 tertiary indicators. Conclusions:The ECMO patient limb function exercise program developed in this study is scientifically sound and reliable, offering a reference and guidance for the implementation of limb function exercises for ECMO patients.

ERK pathway regulated the programmed death ligand-1 (PD-L1) expression which was linked to the response of programmed death-1 (PD-1)/PD-L1 blockade therapy. So it is deducible that ERK inhibitor could enhance the efficacy of PD-1 inhibitor in cancer immunotherapy. In this study, PD0325901, an oral potent ERK inhibitor, strongly enhanced the efficacy of PD-1 antibody

Objective: To investigate the current status and real performance of the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels in China through interlaboratory comparison. Methods: Peking University People’s Hospital (PKUPH) prepared the samples for comparison. That is, the fresh RUNX1-RUNX1T1 positive (+) bone morrow nucleated cells were serially diluted with RUNX1-RUNX1T1 negative (-) nucleated cells from different patients. Totally 23 sets with 14 different samples per set were prepared. TRIzol reagent was added in each tube and thoroughly mixed with cells for homogenization. Each laboratory simultaneously tested RUNX1-RUNX1T1 and WT1 transcript levels of one set of samples by real-time quantitative PCR method. All transcript levels were reported as the percentage of RUNX1-RUNX1T1 or WT1 transcript copies/ABL copies. Spearman correlation coefficient between the reported transcript levels of each participated laboratory and those of PKUPH was calculated. Results: ①RUNX1-RUNX1T1 comparison: 9 samples were (+) and 5 were (-) , the false negative and positive rates of the 20 participated laboratories were 0 (0/180) and 5% (5/100) , respectively. The reported transcript levels of all 9 positive samples were different among laboratories. The median reported transcript levels of 9 positive samples were from 0.060% to 176.7%, which covered 3.5-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.5 to 12.3 (one result which obviously deviated from other laboratories’ results was not included) , 85% (17/20) of the laboratories had correlation coefficient ≥0.98. ②WT1 comparison: The median reported transcript levels of all 14 samples were from 0.17% to 67.6%, which covered 2.6-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.3-13.7, 62% (13/21) of the laboratories had correlation coefficient ≥0.98. ③ The relative relationship of the reported RUNX1-RUNX1T1 transcript levels between the participants and PKUPH was not always consistent with that of WT1 transcript levels. Both RUNX1-RUNX1T1 and WT1 transcript levels from 2 and 7 laboratories were individually lower than and higher than those of PKUPH, whereas for the rest 11 laboratories, one transcript level was higher than and the other was lower than that of PKUPH. Conclusion The reported RUNX1-RUNX1T1 and WT1 transcript levels were different among laboratories for the same sample. Most of the participated laboratories reported highly consistent result with that of PKUPH. The relationship between laboratories of the different transcript levels may not be the same.

PURPOSE: Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND METHODS: Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities. RESULTS: Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21. CONCLUSION: R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
Asian Continental Ancestry Group ; B-Lymphocytes ; Cyclophosphamide ; Disease-Free Survival ; Doxorubicin ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell ; Prednisone ; Prognosis ; Rituximab ; Vincristine

Objective To explore the clinical effect of neoadjuvant chemotherapy of endostar combined with docetaxel plus cisplatin(TP) on patients with advanced ovarian cancer.Methods 76 patients meeting the criterion were enrolled to the study,and they were randomly divided into study group and the control group.The control group were administered with TP,while the study group received endostar combined with TP.The clinical effects,conditions of surgery and long-term survival were observed.Results All patients finished 3 cycles of neoadjuvant chemotherapy.The incidence of adverse reactions (leucopenia,anorexia and fever) in the study group was higher than that in the control group,and the difference had statistical significance (P＜0.05).The level of CA125,tumor load and ascites volume decreased after chemotherapy (P＜0.05).The two groups had no significance difference in intraoperative ascites,blood loss,time of surgery or hospital stay (P＞0.05).The rate of residual lesion≤2 cm was 84.2％ in the study group,higher than that of the control group (60.5％),and the difference had statistical significance (P＜0.05).The overall 1-year and 3-year survival were 84.2％,and 63.1％ for the control group,86.8％ and 60.5％ for the study group,and the difference had no statistical significance (γ2=0.207,P=0.649).One-year and 3-year disease free survival were 89.4％ and 68.4％ for the control group,94.7％ and 76.3％ for the study group (γ2=4.042,P=0.040).Conclusion Endostar combined with TP (docetaxel plus cisplatin) for patients with advanced ovarian cancer is safe and effective,which can improve the success rate of cytoreductive surgery and local control rate of tumor.

OBJECTIVE To investigate the effect of amifostine(Amf)on the differentiation of human megakaryocyte cell line-Dami. METHODS Dami cells were treated with Amf 0.01-5.0 mmol · L-1 for 12 d. Dami cells were counted every day for the growth curve:only cells with a diameter>20μm. The platelet demarcation membrane system was observed by transmission electron microscopy. The expression of CD33,CD34,CD41a and DNA ploidy was detected by flow cytometry. RESULTS Amf 0.1-1.0 mmol · L-1 promoted the differentiation of Dami cells ,but inhibited their proliferation at a concentration>1.0 mmol · L-1. When these cells were treated with Amf 1.0 mmol · L-1 for 12 d,the platelet demarcation membrane system was observed,the percentage of cells with a diameter >20 μm was increased by 24.6%(P<0.01),the expression of CD41a was increased by 11.9%,while the expression of CD33 was decreased by 13.6%(P<0.05). Polyploidy cells(16N)were observed,and 4N,8N and 16N cells were increased to 31.56%,8.83% and 3.43%,respectively(P<0.05). CONCLUSION Amf 0.1-1.0 mmol · L-1 can promote the differentiation of Dami cells,but inhibit their proliferation at a high concentration(>1.0 mmol·L-1).