Objective:To investigate the efficacy of radiotherapy in postoperative metastatic human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer treated with pyrotinib, and to identify potential subgroups that may benefit from this strategy.Methods:The clinical data of 187 patients with postoperative distant metastatic HER2-overexpressing breast cancer who received pyrotinib at the First Affiliated Hospital of Bengbu Medical University from January 2018 to July 2022 were retrospectively analyzed. The Kaplan-Meier method was used to assess changes in survival outcomes in patients undergoing radiotherapy. Univariate and multivariate analyses were conducted to identify prognostic factors, and the log-rank test was used to determine potential subgroups that may benefit from radiotherapy.Results:Among the 187 patients, 76 received radiotherapy. The median follow-up duration for the entire population was 16.9 months (range: 3.1-37.9 months), and the 2-year overall survival (OS) was 75.0%. Multivariate analysis showed that age, metastatic status, and radiotherapy were independent factors affecting OS (3.86-6.76, P<0.05). Further subgroup analysis showed that radiotherapy significantly improved OS in patients aged ≥50 years, those with oligometastases or bone metastases, those not receiving endocrine therapy, and those resistant to trastuzumab ( P<0.05). Conclusions:Radiotherapy, in addition to pyrotinib, can enhance the survival rate of patients with postoperative metastatic HER2-overexpressing breast cancer. The benefits of radiotherapy may be more pronounced in patients with a low tumor burden, inadequate systemic treatment, and drug resistance.

Objective:To investigate the efficacy of radiotherapy in postoperative metastatic human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer treated with pyrotinib, and to identify potential subgroups that may benefit from this strategy.Methods:The clinical data of 187 patients with postoperative distant metastatic HER2-overexpressing breast cancer who received pyrotinib at the First Affiliated Hospital of Bengbu Medical University from January 2018 to July 2022 were retrospectively analyzed. The Kaplan-Meier method was used to assess changes in survival outcomes in patients undergoing radiotherapy. Univariate and multivariate analyses were conducted to identify prognostic factors, and the log-rank test was used to determine potential subgroups that may benefit from radiotherapy.Results:Among the 187 patients, 76 received radiotherapy. The median follow-up duration for the entire population was 16.9 months (range: 3.1-37.9 months), and the 2-year overall survival (OS) was 75.0%. Multivariate analysis showed that age, metastatic status, and radiotherapy were independent factors affecting OS (3.86-6.76, P<0.05). Further subgroup analysis showed that radiotherapy significantly improved OS in patients aged ≥50 years, those with oligometastases or bone metastases, those not receiving endocrine therapy, and those resistant to trastuzumab ( P<0.05). Conclusions:Radiotherapy, in addition to pyrotinib, can enhance the survival rate of patients with postoperative metastatic HER2-overexpressing breast cancer. The benefits of radiotherapy may be more pronounced in patients with a low tumor burden, inadequate systemic treatment, and drug resistance.

Objective To explore the machine learning model and risk factor analysis for hospital infection caused by carbapenem-resistant enterobacteriaceae(CRE).Methods The clinical data of totally 451 patients infected with extended-spectrum β-lactamases(ESBL)producing Enterobacteriaceae treated in the hospital from 2018 to 2022 were retrospectively collected.The patients were divided into CRE group(115 cases)and sensitive group(336 cases)according to the susceptibility of carbapenem.Four machine learning methods in-cluding Logistic regression analysis,random forest,support vector machine,and neural network were used to build prediction models and receiver operating characteristic curve was used to evaluate.Based on the predic-tion model with the best performance,risk factors for CRE infection were analyzed.Results Random forest model had the best performance,with the area under the curve of 0.952 3.The risk factors for predicting CRE infection by the random forest model included 15 clinical data items,namely fever for more than 3 days,cere-bral injury,drainage fluid sample,trunk surgery,first-level or special-level nursing,ICU treatment,procalcito-nin,anti-anaerobic bacteria,the use of third-generation cephalosporins,age,pre-albumin,creatinine,white blood cell count,and albumin.Conclusion The CRE prediction model developed in this study has good predic-tive value and the risk factors have guiding significance for the early prevention and treatment of CRE infec-tion in clinical practice.

Objective:To retrospectively analyze the distribution and changes in common pathogenic bacteria isolated from inpatients in department of neurosurgery and their resistance,so as to provide a basis for the rational use of antimicrobial drugs and the control of pathogen resistance rates.Methods:The results of 7 636 specimens from neurosurgery inpatients admitted to the hospital between Jul 1,2020,and Jul 1,2023 were collected and analyzed.The distribution and resistance rates of infecting pathogens were analyzed as well.Results:Out of 7 636 specimens,3 205 strains of pathogenic bacteria were isolated.Sputum specimens were the most common,totaling 2 790 strains,accounting for 87.05%of all.Gram-negative bacteria were the predominant isolates,with 2 586 strains,accounting for 80.69%.The resistance rates of both Gram-negative and Gram-positive bacteria showed an increasing trend,while the resistance rate of fungi showed a decreasing trend.Gram-positive bacteria remained highly sensitive to vancomycin and linezolid.Conclusion:Among the cultured specimens obtained from inpatients in neurosurgery,Gram-negative bacteria are the predominant isolates,and there is an overall increasing trend in the resistance rates of the pathogens over the years.

Experimental studies showed that the water extract of rhubarb had low content of anthraquinone and a strong purgative while the alcohol extract a high content of anthraquinone and was free of purgative action,even tannin was eliminated.The purgative action of the water extract was also last when mixed with alcohol extract. The experimental results coincide with the traditional experience in Chinese medicinal theory:"the fresh Rhubarb has a purgative action while rhubarb prepared with wine can promote blood circulation and remove blood stasis."However, from the angle of anthraquinone and tannin, the explanation is unreasonable. It is indicated that the purgative action of rhubarb is greatly influenced, even disappears when prepared with alcohol. So, attention should be paid in the preparation process of Chinese patent drugs containing rhubarb.