Pelvic organ prolapse (POP), whose etiology is influenced by genetic and clinical risk factors, considerably impacts women's quality of life. However, the genetic underpinnings in non-European populations and comprehensive risk models integrating genetic and clinical factors remain underexplored. This study constructed the first polygenic risk score (PRS) for POP in the Chinese population by utilizing 20 disease-associated variants from the largest existing genome-wide association study. We analyzed a discovery cohort of 576 cases and 623 controls and a validation cohort of 264 cases and 200 controls. Results showed that the case group exhibited a significantly higher PRS than the control group. Moreover, the odds ratio of the top 10% risk group was 2.6 times higher than that of the bottom 10%. A high PRS was significantly correlated with POP occurrence in women older than 50 years old and in those with one or no childbirths. As far as we know, the integrated prediction model, which combined PRS and clinical risk factors, demonstrated better predictive accuracy than other existing PRS models. This combined risk assessment model serves as a robust tool for POP risk prediction and stratification, thereby offering insights into individualized preventive measures and treatment strategies in future clinical practice.
Humans ; Female ; Pelvic Organ Prolapse/epidemiology* ; Middle Aged ; Risk Assessment/methods* ; China/epidemiology* ; Multifactorial Inheritance ; Aged ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease ; Case-Control Studies ; Adult ; Polymorphism, Single Nucleotide ; Genetic Risk Score ; East Asian People

Aim To explore the safety and efficacy of simple drug-coated balloon(DCB)compared with provi-sional stenting(PS)in the treatment of pseudo-left main(pseudo-LM)bifurcation lesions.Methods A retrospective analysis was performed on 175 patients who underwent coronary angiography for pseudo-LM bifurcation lesions and interven-tional treatment at the Second Affiliated Hospital of Zhengzhou University from January 2018 to January 2023.According to the treatment strategy,they were divided into drug-eluting stent(DES)group(99 cases)and DCB group(76 cases).Preoperative and immediate postoperative quantitative coronary angiography(QCA)data were recorded,and patients were followed up.The follow-up endpoints included the occurrence of major adverse cardiovascular events(MACE)and hospi-tal re-admission.Coronary angiography and QCA data during follow-up were also recorded.Results The immediate postoperative minimum lumen diameter and lumen gain in the left main(LM),left anterior descending(LAD),and left circumflex(LCX)arteries of the DCB group were smaller than those of the DES group(P＜0.05),while the degree of re-sidual lumen stenosis immediately after surgery was greater than that of the DES group(P＜0.05).QCA was performed on the coronary angiography results of follow-up patients.The minimum lumen diameter in LM,LAD,and LCX was smaller in the DCB group than in the DES group during follow-up(P＜0.05).The degree of residual lumen stenosis dur-ing follow-up was greater in the DCB group than in the DES group(P＜0.05),but the late lumen loss in LM,LAD,and LCX was smaller in the DCB group than that in the DES group,with statistically significant differences(P＜0.05).There was no significant difference in the incidence of postoperative MACE between the two groups during the follow-up period(P＞0.05).Cox regression analysis showed that the choice of interventional treatment(DCB vs.PS)had no significant impact on the risk of MACE(P＞0.05).Conclusion Compared with PS,DCB alone demonstrates relatively satisfac-tory efficacy and safety in the treatment of pseudo-LM bifurcation lesions and can be considered as an alternative treatment strategy for interventional therapy of such lesions.

Aim To explore the safety and efficacy of simple drug-coated balloon(DCB)compared with provi-sional stenting(PS)in the treatment of pseudo-left main(pseudo-LM)bifurcation lesions.Methods A retrospective analysis was performed on 175 patients who underwent coronary angiography for pseudo-LM bifurcation lesions and interven-tional treatment at the Second Affiliated Hospital of Zhengzhou University from January 2018 to January 2023.According to the treatment strategy,they were divided into drug-eluting stent(DES)group(99 cases)and DCB group(76 cases).Preoperative and immediate postoperative quantitative coronary angiography(QCA)data were recorded,and patients were followed up.The follow-up endpoints included the occurrence of major adverse cardiovascular events(MACE)and hospi-tal re-admission.Coronary angiography and QCA data during follow-up were also recorded.Results The immediate postoperative minimum lumen diameter and lumen gain in the left main(LM),left anterior descending(LAD),and left circumflex(LCX)arteries of the DCB group were smaller than those of the DES group(P＜0.05),while the degree of re-sidual lumen stenosis immediately after surgery was greater than that of the DES group(P＜0.05).QCA was performed on the coronary angiography results of follow-up patients.The minimum lumen diameter in LM,LAD,and LCX was smaller in the DCB group than in the DES group during follow-up(P＜0.05).The degree of residual lumen stenosis dur-ing follow-up was greater in the DCB group than in the DES group(P＜0.05),but the late lumen loss in LM,LAD,and LCX was smaller in the DCB group than that in the DES group,with statistically significant differences(P＜0.05).There was no significant difference in the incidence of postoperative MACE between the two groups during the follow-up period(P＞0.05).Cox regression analysis showed that the choice of interventional treatment(DCB vs.PS)had no significant impact on the risk of MACE(P＞0.05).Conclusion Compared with PS,DCB alone demonstrates relatively satisfac-tory efficacy and safety in the treatment of pseudo-LM bifurcation lesions and can be considered as an alternative treatment strategy for interventional therapy of such lesions.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the effects of dynamic lung compliance(Cdyn)-guided indi-vidual positive end-expiratory pressure(PEEP)titration on pulmonary function in elderly patients undergoing laparoscopic colorectal cancer surgery.Methods Sixty-eight elderly patients were selected for laparoscopic radical resection of colorectal cancer,37 males and 31 females,aged 65-79 years,BMI<30 kg/m2,ASA physical status Ⅱ or Ⅲ.The patients were divided into two groups using the random number table method:individualized PEEP group(group P)and control group(group C),34 patients in each group.In group P,the patients received recruitment maneuvers and PEEP titration test at immediately after intubation,immediately after establishing pneumoperitoneum-Trendelenburg position and immediately after pneumoperitoneum.The patients in group C received PEEP 5 cmH2 O during procedure.The three best titra-tion PEEP and the actual tidal volume(VT)in group P were also recorded.PaO2,PaCO2,PETCO2 10 mi-nutes after the tracheal intubation(T1),10 minutes(T2)and 1 hour(T3)after establishing pneumoperito-neum-Trendelenburg position,at the end of the surgery but before extubation(T4)were recorded,and the oxygenation index(OI),physiological dead space to tidal volume(Vd/VT),alveolar arterial oxygen differ-ence(A-aDO2),driving pressure,and Cdyn were calculated.Concentrations of interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),Clara cell secretoyr protein(CC16)and lung alveolar surface active sub-stances-D(SP-D)in the serum samples were determined by ELISA before anesthesia induction(T0)and 10 minutes after extubation(T5).Postoperative pulmonary complications(PPCs)were also recordrd.Results The individualized PEEP of Cdyn?guided PEEP titration was 4 cmH2O. Compared with group C, the PaO2 and OI in group C were significantly increased at T4, the Cdyn was significantly increased at T1,T3, and T4, the driving pressure was significantly decreased at T1 -T4, the serum concentration of CC16 was significantly decreased at T5 ( P < 0. 05). There were no significant differences in PaCO2, PET CO2,A?aDO2, and Vd/ VT between the two groups. There was no severe PPCs in the two groups. Conclusion Pressure?controlled ventilation modes combined with Cdyn?guide PEEP titration can increase the Cdyn, reduce thedriving pressure, and improve OI at the end of the operation, reduce the concentrations of CC16 at postop?eration, improve pulmonary function in elderly patients undergoing laparoscopic colorectal cancer surgery.

Objective To establish a rapid screening method for 60 types of natural toxins in whole blood by ultra-high performance liquid chromatography-quadrupole/electrostatic field orbitrap high reso-lution mass spectrometry(UPLC-Q/Orbitrap HRMS).Methods The chromatographic and mass spectro-metric information of 60 standard samples of natural toxins were analyzed and recorded,and a screening database was built.Whole blood was pretreated by protein precipitation method combined with ultrasonic-assisted dispersion,and then a Hypersil GOLDTM C18 column was used with 5 mmol/L ammonium for-mate aqueous solution(containing 0.1%formic acid)and acetonitrile as mobile phase for gradient elu-tion.In the positive ion mode,the data were collected in full scan/data-dependent secondary scan(Full MS/dd-MS2)mode.Based on the established screening library,the rapid screening of 60 types of natural toxins in whole blood was realized by TraceFinder software.Results A UPLC-Q/Orbitrap HRMS method was developed for the screening of 60 types of natural toxins in whole blood.Except for the limit of detection(LOD)of oxymatrine(20 ng/mL)and strophanthidin(40 ng/mL),the LOD for the other 58 natural toxins was in the range of 0.05-5 ng/mL.Conclusion This method has a simple and efficient pretreatment process and can achieve rapid screening of 60 types of natural toxins in whole blood.

Objective:Glucorticoid therapy has the potential to mitigate immunogical effect of naxitamab. Ketamine is an anesthetic medica-tion and cause weak or shallow breathing. This article is to analyze the effect of modified conditioning regimen with substitution re-mifentanil for ketamine and without glucorticoid therapy on adverse events associated with naxitamab. Methods:Clinical data with naxit-amab infusion under modified conditioning regimen in Sun Yat-sen University Cancer Center between June 2023 and June 2024 were re-trieved to analyze adverse events and risk factors. Results:Overall,seventeen patients underwent 201 infusions. The most frequent adverse events were as follows:neurological pain (all grades) 93.0％,hypertension 55.7％,hypotension 34.8％,respectively. Bronchospasm and hyp-oxia were seen in 3.0％ and 10.9％ infusions,respectively. Fever occurred less frequently in the second cycle of infusion. No patients suspen-ded infusion due to severe adverse event. Conclusions:The infusion of naxitamab is tolerable under the modified conditioning regimen and adverse event is less than expected and controllable.

Objective:Glucorticoid therapy has the potential to mitigate immunogical effect of naxitamab. Ketamine is an anesthetic medica-tion and cause weak or shallow breathing. This article is to analyze the effect of modified conditioning regimen with substitution re-mifentanil for ketamine and without glucorticoid therapy on adverse events associated with naxitamab. Methods:Clinical data with naxit-amab infusion under modified conditioning regimen in Sun Yat-sen University Cancer Center between June 2023 and June 2024 were re-trieved to analyze adverse events and risk factors. Results:Overall,seventeen patients underwent 201 infusions. The most frequent adverse events were as follows:neurological pain (all grades) 93.0％,hypertension 55.7％,hypotension 34.8％,respectively. Bronchospasm and hyp-oxia were seen in 3.0％ and 10.9％ infusions,respectively. Fever occurred less frequently in the second cycle of infusion. No patients suspen-ded infusion due to severe adverse event. Conclusions:The infusion of naxitamab is tolerable under the modified conditioning regimen and adverse event is less than expected and controllable.

Lung cancer is the malignant tumor with the highest morbidity and mortality in China. Non-small cell lung cancer (NSCLC) is the main pathological subtype of lung cancer. On April 13, 2023, the National Comprehensive Cancer Network (NCCN) released the third edition of the 2023 NCCN Oncology Clinical Practice Guidelines: Non-small Cell Lung Cancer, which reflects the latest advances in international lung cancer research. This article will interpret the main updated contents of the new edition of the guidelines, and compare it with the third edition of the NCCN guidelines in 2022, so as to provide references about the diagnosis and treatment of NSCLC for clinical medical personnel in China.
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Humans ; Carcinoma, Non-Small-Cell Lung ; China ; Lung Neoplasms ; Thorax

With a deepened understanding of the pathophysiology and pathogenesis of thoracic malignancies, the treatment has been transited from traditional treatment on the basis of surgery, radiotherapy, and chemotherapy to individualized and precise targeted therapy and immunotherapy. As an antitumor immunotherapy, chimeric antigen receptor gene-modified T (CAR-T) cells have been approved by the FDA for the treatment of hematological malignancies in five CAR-T products. They have also achieved good therapeutic effects in solid tumors. However, significant challenges remain in the clinical application of CAR-T cell immunotherapy in thoracic malignancies. In this review, the latest research progress of CAR-T cell immunotherapy in the treatment of thoracic malignancies were summarized, including the basic characteristics of CAR-T cells, the popular target antigens, and the existing problems and challenges, to provide new ideas and strategies for clinical immunotherapy of thoracic malignancies.