Purpose: Human epidermal growth factor receptor 2 (HER2)-low breast cancer has the potential to emerge as a distinct subtype. Several studies have compared the differences between HER2-low and HER2-0 breast cancers, but no consensus has been reached.Additionally, a biomarker to predict pathological complete response (pCR) rates in patients with HER2-low breast cancer remains to be identified. Methods: We collected data from 777 patients across three centers, stratifying them into HER2-low and HER2-0 groups. We compared differences in survival and pCR rates between the two groups and investigated potential biomarkers that could reliably predict pCR. Results: The study found that patients with HER2-0 breast cancer had higher pCR rates compared to patients with HER2-low tumors (289 patients [30.1%] vs. 475 patients [18.1%], p < 0.0001). Survival analysis showed no significant advantage for HER2-low tumors over HER2-0 breast cancers. Binary logistic analysis revealed that androgen receptor (AR) expression predicts poorer pCR rates in both the overall patient group and the HER2-0 breast cancer group (overall patients: odds ratio [OR], 0.479; 95% confidence interval [CI], 0.250–0.917; p = 0.026 and HER2-0 patients: OR, 0.267; 95% CI, 0.080–0.892; p = 0.032). In contrast, programmed death ligand 1 (PD-L1) expression was associated with more favorable pCR rates in the overall patient group (OR, 3.199; 95% CI, 1.020–10.037; p = 0.046). Conclusion There is currently insufficient evidence to classify HER2-low breast cancer as a distinct subtype. Our study revealed that AR expression, along with negative PD-L1 expression, contributes to lower pCR rates.

Over the past decade, pathology technology in China has undergone rapid development. Through continuous efforts to strengthen normative foundations and quality control, the three-tiered quality control network (national, provincial, and municipal) has been consolidated. These efforts have effectively driven the homogenization of pathology technical quality nationwide. Concurrently, the standardization of laboratory quality management systems and the advancement of automated pathological equipment have laid a solid foundation for the evolution of pathological diagnosis. Breakthroughs in cutting-edge technologies, including digital pathology, artificial intelligence, and molecular pathology, are further catalyzing a paradigm shift from traditional morphological analysis toward next-generation diagnostic pathology. Marking the 70th anniversary of this journal, the field's evolution over the past decade and chart its future course were reviwed systematically, aiming to provide an insightful roadmap for the ongoing progress of the discipline.

Objective:To identify factors influencing treatment-free remission (TFR) outcomes in children and adolescent patients with chronic myeloid leukemia (CML) after imatinib (IM) discontinuation.Methods:This multicenter retrospective study analyzed 36 children and adolescent patients with CML from eight hematology centers in China (December 1, 2016, to September 27, 2024) who discontinued IM therapy with documented post-cessation outcomes. Clinical characteristics and molecular response dynamics were assessed. Univariate analysis and multivariate Cox proportional hazards regression models were employed to assess factors associated with TFR outcomes.Results:A total of 36 patients were documented, comprising 17 males and 19 females. The median ages at CML diagnosis and IM discontinuation were 11 years ( IQR: 5,16) and 20 years ( IQR: 14,25), respectively. The median time from IM initiation to first deep molecular response (DMR) was 21 months ( IQR: 13, 38). Pre-discontinuation, patients received IM for a median duration of 96 months ( IQR: 84, 121) and maintained DMR for 74 months ( IQR: 63, 89). With a median post-discontinuation follow-up of 38 months ( IQR: 15, 68), cumulative TFR rates at 6, 12, 24, and 36 months were 74.1%, 60.7%, 60.7%, and 56.0%, respectively, generating an overall TFR rate of 58.3%. Fifteen patients lost major molecular response at a median of 5 months post-discontinuation ( IQR: 3, 11). All 15 patients resumed tyrosine kinase inhibitor therapy, comprising 13 who restarted IM and 2 who switched to dasatinib. By the last follow-up, 13 (86.7% ) patients regained DMR after a median treatment duration of 5 months ( IQR: 3, 17), and no disease progression occurred in any patient. Withdrawal syndrome occurred in 2 (5.6% ) patients. Univariate analysis revealed significantly higher TFR rates in patients with pre-discontinuation IM duration of ≥100 months vs <100 months (82.4% vs 36.8%, P=0.017) and pre-discontinuation DMR duration of ≥72 months vs <72 months (84.2% vs 29.4%, P=0.003). Multivariate Cox analysis identified pre-discontinuation DMR duration as an independent protective factor for TFR ( HR=5.419, 95% CI: 1.524–19.272, P=0.009) . Conclusion:DMR duration was identified as an independent protective factor influencing TFR outcomes in children and adolescent patients with CML after IM discontinuation. Patients who maintained DMR for ≥72 months before IM discontinuation demonstrated a significantly higher TFR rate.

BACKGROUND:The Ilizarov technique is very effective in the treatment of congenital brachymetatarsia of the fourth,but there are still some complications.The optimal proportion of lengthening of the fourth metatarsal is still controversial.OBJECTIVE:To explore the clinical efficacy of Ilizarov technique in the treatment of congenital brachymetatarsia of the fourth and the optimal lengthening ratio.METHODS:Medical records of patients with congenital brachymetatarsia of the fourth treated with Ilizarov technique in Guangdong Provincial Hospital of Traditional Chinese Medicine from August 2021 to October 2023 were collected.American Orthopaedic Foot and Ankle Society scores before and after the treatment,length of the fourth metatarsal before and after surgery,and postoperative complications were evaluated.The prolongation ratio was analyzed by subgroups to assess the best suitable length for the operative conditions.RESULTS AND CONCLUSION:(1)A total of 16 patients were included.The length of the fourth metatarsal before treatment was(43.51±3.75)mm,and the shortening length was(12.53±2.82)mm;the lengthening time during the treatment period was(36.95±4.12)days,and the time with external fixation bracket was(102.30±32.74)days,and the lengthening length after the treatment was(13.90±3.47)mm,and the prolongation ratio was(32.30±9.10)％.(2)American Orthopaedic Foot and Ankle Society scores were significantly increased at the last follow-up compared with that before treatment(t=0.763,P＜0.01).(3)The main postoperative complications were bone nonunion,metatarsophalangeal joint dislocation,metatarsophalangeal joint narrowing,and excessive lengthening of the fourth metatarsal.All patients were free of infection and abnormal sensation in the toe.(4)Subgroup analysis based on prolongation ratio showed that the rate of complications in patients in the prolongation ratio ≤ 35.36％group(17％)was significantly lower than the prolongation ratio＞35.36％group(100％)(t=14.008,P＜0.01).Meanwhile,the postoperative American Orthopaedic Foot and Ankle Society score of patients in the prolongation ratio ≤ 35.36％group(90.25±3.01)was higher than that of patients in the prolongation ratio＞35.36％group(82.00±9.97)(t=2.254,P=0.037).(5)It is concluded that Ilizarov technique for the treatment of congenital brachymetatarsia of the fourth is less traumatic surgery,can significantly improve the foot deformity of patients,especially suitable for the treatment of patients whose prolongation ratio does not exceed 35.36％,with low complication rate and satisfactory results.

Purpose: Human epidermal growth factor receptor 2 (HER2)-low breast cancer has the potential to emerge as a distinct subtype. Several studies have compared the differences between HER2-low and HER2-0 breast cancers, but no consensus has been reached.Additionally, a biomarker to predict pathological complete response (pCR) rates in patients with HER2-low breast cancer remains to be identified. Methods: We collected data from 777 patients across three centers, stratifying them into HER2-low and HER2-0 groups. We compared differences in survival and pCR rates between the two groups and investigated potential biomarkers that could reliably predict pCR. Results: The study found that patients with HER2-0 breast cancer had higher pCR rates compared to patients with HER2-low tumors (289 patients [30.1%] vs. 475 patients [18.1%], p < 0.0001). Survival analysis showed no significant advantage for HER2-low tumors over HER2-0 breast cancers. Binary logistic analysis revealed that androgen receptor (AR) expression predicts poorer pCR rates in both the overall patient group and the HER2-0 breast cancer group (overall patients: odds ratio [OR], 0.479; 95% confidence interval [CI], 0.250–0.917; p = 0.026 and HER2-0 patients: OR, 0.267; 95% CI, 0.080–0.892; p = 0.032). In contrast, programmed death ligand 1 (PD-L1) expression was associated with more favorable pCR rates in the overall patient group (OR, 3.199; 95% CI, 1.020–10.037; p = 0.046). Conclusion There is currently insufficient evidence to classify HER2-low breast cancer as a distinct subtype. Our study revealed that AR expression, along with negative PD-L1 expression, contributes to lower pCR rates.

Purpose: Human epidermal growth factor receptor 2 (HER2)-low breast cancer has the potential to emerge as a distinct subtype. Several studies have compared the differences between HER2-low and HER2-0 breast cancers, but no consensus has been reached.Additionally, a biomarker to predict pathological complete response (pCR) rates in patients with HER2-low breast cancer remains to be identified. Methods: We collected data from 777 patients across three centers, stratifying them into HER2-low and HER2-0 groups. We compared differences in survival and pCR rates between the two groups and investigated potential biomarkers that could reliably predict pCR. Results: The study found that patients with HER2-0 breast cancer had higher pCR rates compared to patients with HER2-low tumors (289 patients [30.1%] vs. 475 patients [18.1%], p < 0.0001). Survival analysis showed no significant advantage for HER2-low tumors over HER2-0 breast cancers. Binary logistic analysis revealed that androgen receptor (AR) expression predicts poorer pCR rates in both the overall patient group and the HER2-0 breast cancer group (overall patients: odds ratio [OR], 0.479; 95% confidence interval [CI], 0.250–0.917; p = 0.026 and HER2-0 patients: OR, 0.267; 95% CI, 0.080–0.892; p = 0.032). In contrast, programmed death ligand 1 (PD-L1) expression was associated with more favorable pCR rates in the overall patient group (OR, 3.199; 95% CI, 1.020–10.037; p = 0.046). Conclusion There is currently insufficient evidence to classify HER2-low breast cancer as a distinct subtype. Our study revealed that AR expression, along with negative PD-L1 expression, contributes to lower pCR rates.

OBJECTIVE: To evaluate the short-term effectiveness of Ilizarov technique combined with steel needle internal fixation in treating Charcot neuroarthropathy (CN) of the foot and ankle. METHODS: Between June 2020 and December 2023, 12 patients with Eichenholtz stage Ⅲ CN of the foot and ankle were treated with Ilizarov technique and steel needle internal fixation. There were 9 males and 3 females with an average age of 48.6 years (range, 19-66 years). The disease duration ranged from 1 to 16 months (mean, 6.8 months). Ankle joint involvement predominated in 7 cases, while midfoot involvement occurred in 5 cases; 3 cases presented with skin ulceration and soft tissue infection. Preoperative American Orthopedic Foot and Ankle Society (AOFAS) score was 31.2±9.0, 36-Item Short-Form Health Survey (SF-36)-Physical Component Summary (PCS) score was 32.6±6.8, and Mental Component Summary (MCS) score was 47.8±8.4. Postoperative assessments included wound healing, regular X-ray film/CT evaluations of fusion status, and effectiveness via AOFAS and SF-36-PCS, MCS scores. RESULTS: All operations were successfully completed without neurovascular complication. Two patients experienced delayed wound healing requiring intervention, and the others achieved primary healing. All patients were followed up 15-43 months (mean, 23.3 months). Imaging confirmed successful joint fusion within 13-21 weeks (mean, 16.8 weeks). At last follow-up, the AOFAS score was 72.5±6.4, and the SF-36-PCS and MCS scores were 63.2±8.4 and 76.7±5.3, respectively, all of which improved compared to preoperative levels, with significant differences ( P<0.05). CONCLUSION Ilizarov technique combined with steel needle internal fixation effectively restores walking function and achieves satisfactory short-term effectiveness in CN of the foot and ankle.
Humans ; Middle Aged ; Male ; Female ; Adult ; Ilizarov Technique ; Arthropathy, Neurogenic/surgery* ; Aged ; Ankle Joint/surgery* ; Treatment Outcome ; Needles ; Fracture Fixation, Internal/instrumentation* ; Steel ; Young Adult ; Foot Joints/surgery*

Objective To investigate the prescription patterns and potential therapeutic mechanisms of traditional Chinese medicine(TCM)in treating laryngopharyngeal reflux disease(LPRD)based on data mining and network pharmacology.Methods The clinical data from 1 016 LPRD patients treated at the Guangdong Provincial Hospital of Chinese Medicine between February 1,2012,and December 30,2023 were collected.Frequency analysis,property and flavor analysis,meridian tropism analysis,efficacy classification,association rule mining,and cluster analysis were performed on the effective TCM prescriptions to identify medication rules.Core herbs were screened,and their therapeutic mechanisms were explored using network pharmacology.Results A total of 1 976 prescriptions involving 139 medicinals(23 644 medicinal frequencies)were analyzed.The top five most frequently-used medicinals were Glycyrrhizae Radix et Rhizoma(Gancao),Poria(Fuling),Citri Reticulatae Pericarpium(Chenpi),Bombyx Batryticatus(Jiangcan),and Galli Gigerii Endothelium Corneum(Jineijin).The herbs predominantly exhibited sweet flavor and neutral property,with a primary affinity for the lung meridian.The most common therapeutic categories were deficiency-tonifying herbs and phlegm-resolving herbs.The herb combination"Gancao-Chenpi-Fuling"was identified as the core prescription for LPRD.Network pharmacology analysis of this combination revealed 11 shared targets between the core herbs and LPRD,including three key targets.The core herbs may alleviate LPRD by modulating the interleukin-17(IL-17)signaling pathway,tumor necrosis factor(TNF)signaling pathway,and cancer-related pathways.Conclusion TCM treatment for LPRD should primarily target the lung,and employs herbs with mild-sweet properties and tonifying effects,supplemented by phlegm-resolving herbs.The core combination"Gancao-Chenpi-Fuling"may exert therapeutic effects by regulating key targets such as IL-1B,TNF,and IL-6,thereby modulating the IL-17 signaling pathway,TNF signaling pathway,and cancer-related pathways to mitigate inflammatory responses in LPRD.

BACKGROUND:The Ilizarov technique is very effective in the treatment of congenital brachymetatarsia of the fourth,but there are still some complications.The optimal proportion of lengthening of the fourth metatarsal is still controversial.OBJECTIVE:To explore the clinical efficacy of Ilizarov technique in the treatment of congenital brachymetatarsia of the fourth and the optimal lengthening ratio.METHODS:Medical records of patients with congenital brachymetatarsia of the fourth treated with Ilizarov technique in Guangdong Provincial Hospital of Traditional Chinese Medicine from August 2021 to October 2023 were collected.American Orthopaedic Foot and Ankle Society scores before and after the treatment,length of the fourth metatarsal before and after surgery,and postoperative complications were evaluated.The prolongation ratio was analyzed by subgroups to assess the best suitable length for the operative conditions.RESULTS AND CONCLUSION:(1)A total of 16 patients were included.The length of the fourth metatarsal before treatment was(43.51±3.75)mm,and the shortening length was(12.53±2.82)mm;the lengthening time during the treatment period was(36.95±4.12)days,and the time with external fixation bracket was(102.30±32.74)days,and the lengthening length after the treatment was(13.90±3.47)mm,and the prolongation ratio was(32.30±9.10)％.(2)American Orthopaedic Foot and Ankle Society scores were significantly increased at the last follow-up compared with that before treatment(t=0.763,P＜0.01).(3)The main postoperative complications were bone nonunion,metatarsophalangeal joint dislocation,metatarsophalangeal joint narrowing,and excessive lengthening of the fourth metatarsal.All patients were free of infection and abnormal sensation in the toe.(4)Subgroup analysis based on prolongation ratio showed that the rate of complications in patients in the prolongation ratio ≤ 35.36％group(17％)was significantly lower than the prolongation ratio＞35.36％group(100％)(t=14.008,P＜0.01).Meanwhile,the postoperative American Orthopaedic Foot and Ankle Society score of patients in the prolongation ratio ≤ 35.36％group(90.25±3.01)was higher than that of patients in the prolongation ratio＞35.36％group(82.00±9.97)(t=2.254,P=0.037).(5)It is concluded that Ilizarov technique for the treatment of congenital brachymetatarsia of the fourth is less traumatic surgery,can significantly improve the foot deformity of patients,especially suitable for the treatment of patients whose prolongation ratio does not exceed 35.36％,with low complication rate and satisfactory results.