Background and purpose:BRCA1/2 plays an important role in maintaining the genome stability.Whether BRCA1/2 germline mutation could increase the tumor sensitivity to radiotherapy,thereby inducing secondary primary cancer after radiotherapy is unclear.This study aimed to investigate whether postoperative radiotherapy is a risk factor for the development of second primary cancer in triple-negative breast cancer(TNBC)patients with BRCA1/2 germline mutation.Methods:This research was based on a previously reported retrospective cohort,i.e.,the Fudan University Shanghai Cancer Center TNBC cohort.Between January 1,2007 and December 31,2014,a total of 292 female TNBC patients with BRCA1/2 mutation were enrolled.We performed logistic regression analysis in patients without BRCA1/2 germline mutation(n=261)and BRCA1/2 germline mutation patients(n=31),respectively,to assess the risk factors affecting the incidence of second primary cancer.We then performed interactive analysis on the above two analyses to evaluate the interactive effect between BRCA1/2 germline mutation and postoperative radiotherapy.P<0.05 indicates a statistically significant difference.The research was approved by Fudan University Shanghai Cancer Center TNBC Ethics Committee(050432-4-2108),and each patient provided written informed consent.Results:Logistic regression analysis in patients with BRCA1/2 germline mutations showed that postoperative radiotherapy significantly increased the risk of secondary primary disease compared to non-radiotherapy[odds ratio(OR)=2.475,95%confidence interval(CI):1.933-3.167,P<0.001].In patients without BRCA1/2 germline mutation,the effect of radiotherapy on the incidence of second primary tumor was not significant.There was a significant interaction between BRCA1/2 germline mutation and postoperative radiotherapy for the incidence of secondary primary cancer(OR=9.710,95%CI:0.320-295.250,P=0.193).Conclusion:Although statistical analysis results show that patients with BRCA1/2 germline mutations have an increased risk of developing a second primary tumor after postoperative radiotherapy compared to patients who have not received radiotherapy,there is no significant correlation between BRCA1/2 germline mutations and radiotherapy for the development of a second primary tumor.Therefore,patients with BRCA1/2 germline mutations who receive radiotherapy after surgery may not increase the risk of developing a second primary tumor.

[Purpose]To analyze the trend of gastric cancer incidence and age characteristics in Jiangsu cancer registration areas from 2009 to 2019.[Methods]Cancer registration data from 2009 to 2019 meeting quality control requirements were collected from 16 cancer registries in Jiangsu Province.The crude incidence rate and age-standardized incidence rate by Chinese standard population in 2000(ASIRC)were calculated by gender,urban/rural areas and age groups.The inci-dence trends were analyzed by Joinpoint.A birth cohort model was constructed to calculate the in-cidence rate of gastric cancer for men and women born between 1929 and 2019.The age composi-tion of gastric cancer incidence in Jiangsu Province between 2009 and 2019 was calculated and compared.[Results]The crude incidence rate and ASIRC of gastric cancer in Jiangsu cancer regi-stration areas from 2009 to 2019 showed a significant decreasing trend in both male and female or urban and rural areas,in which the decrease in male(AAPC=-1.28％,P＜0.001)was higher than that of female(AAPC=-1.17％,P=0.030),and the decrease in urban(AAPC=-1.66％,P＜0.001)was higher than that of rural(AAPC=-0.72％,P＜0.001).The incidence rates of gastric cancer in age groups of 40～79 years old showed a significant decreasing trend from 2009 to 2019 with the AAPC ranging from-6.75％to-3.54％(all P＜0.05).In age groups of 40～79 years old,the inci-dence rates of gastric cancer among people with different years of birth showed a decreasing trend with the increase of the birth year.For ASIRC,the composition of patients aged 60 years old above increased by 0.63％(95％CI:0.46％～0.81％)per year from 2009 to 2019.[Conclusion]The inci-dence rate of gastric cancer in cancer registration areas of Jiangsu Province from 2009 to 2019 showed a decreasing trend,the average age of incidence showed a trend of backward moving,and for age-standardized incidence the proportion of patients over 60 years old was increased.

Objective:To explore the efficacy and safety of whole-brain low-dose radiotherapy(LDRT)combined with PD-1 inhibitor sin-tilimab and intrathecal pemetrexed(IP)for the treatment of refractory non-small cell lung cancer(NSCLC)with leptomeningeal metastases(LM).Methods:Retrospective analysies were was performed on eight NSCLC patients with LM at the West China Hospital of Sichuan Uni-versity from December 2022 to May 2024.Among the eight patients,there were four were males and four were females,with a median age of 49 years(rangeing,between 34 to 58 years).All patients were treated with whole-brain LDRT combined with immune checkpoint inhibit-or(ICI)and intrathecal chemotherapy regimens,and the therapeutic efficacy was evaluated according to the Response Assessment in Neuro-Oncology(RANO)criteria and the Karnofsky physical status(KPS)score.Adverse reactions were assessed according to the Common Criteria for the Evaluation of Adverse Events(CTCAE version 5.0).Survival analysis was performed using the Kaplan-Meier method.The classification proportion of cerebrospinal fluid subsets before and after treatment was analyzed using by single-cell sequencing,and the differential ana-lysis of gene expression in parallel cells was performed.Results:The best clinical treatment effects in eight patients were were evaluated us-ing the RANO criteria:five patients(62.5%)were evaluated as improved and three(37.5%)as stable.The median KPS score of the eight pa-tients was 30(20-50)before treatment,which was significantly improved to 60(40-90)after treatment(P=0.000 9).The remission rate of neurological symptoms was 100%(8/8)in eight patients.The median neurological progression-free survival(NPFS)was 12 months.The res-ults of single-cell sequencing in CSF of patientss(P1)showed that the proportion of T cells in the patient samples after whole-brain LDRT treatment was significantly higher than that before treatment(6.08%vs.68.87%),and the proportion of tumor cells was significantly lower(12.92%vs.0.6%).The differential analysis of gene expression showed that CCL5 and CXCL13 were significantly upregulated in T cells of CSF after WB-LDRT treatment.Conclusions:The combination of whole-brain LDRT with ICI and IP in the treatment of NSCLC with LM can signific-antly alleviate neurological symptoms,improve quality of life and prolong the NPFS of patients,which is a safe and effective treatment.

Although the development of COVID-19 vaccines has been a remarkable success, the heterogeneous individual antibody generation and decline over time are unknown and still hard to predict. In this study, blood samples were collected from 163 participants who next received two doses of an inactivated COVID-19 vaccine (CoronaVac®) at a 28-day interval. Using TMT-based proteomics, we identified 1,715 serum and 7,342 peripheral blood mononuclear cells (PBMCs) proteins. We proposed two sets of potential biomarkers (seven from serum, five from PBMCs) at baseline using machine learning, and predicted the individual seropositivity 57 days after vaccination (AUC = 0.87). Based on the four PBMC's potential biomarkers, we predicted the antibody persistence until 180 days after vaccination (AUC = 0.79). Our data highlighted characteristic hematological host responses, including altered lymphocyte migration regulation, neutrophil degranulation, and humoral immune response. This study proposed potential blood-derived protein biomarkers before vaccination for predicting heterogeneous antibody generation and decline after COVID-19 vaccination, shedding light on immunization mechanisms and individual booster shot planning.
Humans ; COVID-19 Vaccines ; Leukocytes, Mononuclear ; Proteomics ; COVID-19/prevention & control* ; Vaccination ; Antibodies ; Antibodies, Viral ; Antibodies, Neutralizing

Objective:To explore the risk factors of chronic postoperative inguinal pain for laparoscopic trans-abdominal preperitoneal hernia repair and establish a nomogram prediction model for it.Methods:The clinical data of 576 patients who underwent laparoscopic trans-abdominal preperitoneal hernia repair for inguinal pain at the First Hospital of Lanzhou University from January 2015 to December 2020 were analyzed retrospectively. According to different postoperative outcomes, patients were divided into chronic pain group ( n=54) and non-chronic pain group ( n=522), compared two groups of patients in the material, including gender, age, BMI, smoking history, history of drinking, hypertension, diabetes, chronic bronchitis, abdominal surgery history, history of inguinal hernia, hernia type, the hernial sac size, prophylactic use of antibiotics, VAS score, mesh fixation techniques, operation time, length of stay. Measurement data with normal distribution were expressed as ( ± s) and independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M( Q1, Q3), and the Mann-Whitney U test was used for comparision between groups. Chi-square test was used to compare the measurement data of counting data.Multivariate logistic regression was used to analyze the independent risk factors for chronic postoperative inguinal pain. R software was used to establish the drawing of the nomogram prediction model, and the consistency index, calibration chart and area under the receiver operating characteristic curve was used to evaluate the predictive ability of the nomogram prediction model. Results:According to the results of the Logistic regression analysis, age≤45 years ( OR=2.202, 95% CI: 1.080-4.491), BMI≥24 kg/m 2 ( OR=2.231, 95% CI: 1.204-4.134), hernial sac≤5 cm ( OR=2.623, 95% CI: 1.309-5.257), recurrent hernia ( OR=2.769, 95% CI: 1.118-6.860), preoperative pain ( OR=4.121, 95% CI: 2.004-8.476), suture fixation ( OR=2.204, 95% CI: 1.151-4.219)and Postoperative acute pain (VAS>3) ( OR=5.814, 95% CI: 2.532-13.350) were independent risk factors for chronic postoperative inguinal pain ( P<0.05). Based upon the above independent risk factors, the nomogram prediction model was established and verified. The area under the curve of the nomogram prediction model was 0.779 (95% CI: 0.718-0.840, P<0.01). After internal verification, the concordance index value of the prediction model was 0.779. Conclusion:age≤45 years, BMI ≥24 kg/m 2, hernial sac≤5 cm, recurrent hernia, preoperative pain, suture fixation and Postoperative acute pain (VAS>3) are independent risk factors for chronic postoperative inguinal pain for laparoscopic trans-abdominal preperitoneal hernia repair, the nomogram prediction model has a good accuracy and discrimination with a high value of clinical application.

Objective:To compare the effectiveness and recurrence rate of different types of mesh or without mesh in laparoscopic hiatal hernia repair.Methods:From Jan 2016 to Mar 2022 at the three hospital 90 patients with hiatal hernia, including 26 cases without mesh, 29 cases using synthetic mesh, and 35 cases using biological mesh underwent laparoscopic hiatal hernia repair.Results:The surgical procedures was successful in all the 90 cases without conversion to open surgeny. There were no statistically significant differences in operative time, intraoperative blood loss and postoperative hospital stay among the three groups ( P>0.05), and there were statistically significant differences in hospital cost between the group without mesh and synthetic mesh and biological mesh ( P<0.05). Long-term follow-up was achieved in 87 patients, with a follow-up rate of 96.7% (87/90), and a median follow-up time of 44 months. There were no significant differences in the incidence of postoperative complications (diarrhea, dysphagia, abdominal distension, chest pain), recurrence rate of symptoms (acid reflux, heartburn) and patient satisfaction among the three groups ( P>0.05). Conclusion:In laparoscopic hiatal hernia repair, the mesh should be carefully selected according to the specific intraoperative situation for a satisfactory clinical efficacy.

Objective: To compare the effectiveness before and after the adjustment of schistosomiasis control strategies in Nanjing City, so as to provide the evidence for improving schistosomiasis control interventions. Methods: The prevalence of Schistosomasis japonicum infections in humans, livestock, Oncomelania hupensis and sentinel mice was collected in Nanjing City from 1993 to 2018, and the prevalence of S. japonicum infections in humans, livestock, sentinel mice and O. hupensis, and the areas of snail habitats, areas of infected snail habitats and snail control areas were compared before (1993-2004) and after (2005-2018) the adjustment of schistosomiasis control strategies to evaluate the effectiveness. Results: The prevalence of S. japonicum infections in humans, livestock, O. hupensis and sentinel mice was 0.77% and 0.02% (χ2=6 430.634, P<0.001), 0.46% and 0.01% (χ2=344.401, P<0.001), 0.19% and 0.11% (χ2=239.685, P<0.001), and 34.35% and 1.56% (χ2=1 856.286, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. The median areas (interquartile range) of snail habitats, infected snail habitats and snail control were 4 175.37 (1 301.65) and 2 366.44 (885.27) hm2 (Z=-3.755, P<0.001), 870.49 (1 001.75) and 0 (158.89) hm2 (Z=-3.654, P<0.001) and 1 383.23 (793.57) and 5 031.94 (629.11) hm2 (Z=-4.320, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. Conclusions After the adjustment of schistosomiasis control strategies, remarkable effects on schistosomiasis control has achieved in Nanjing City, where the transmission of schistosomiasis was interrupted. Nevertheless, the strategy requires to be continued and improved to move towards elimination of schistosomiasis in Nanjing City.

Objective: To understand the prevalence of carotid plaque (CP) in population at high-risk for cardiovascular disease (CVD) in Jiangsu province and identify related influencing factors. Methods: Based on the China Patient-centered Evaluative Assessment of Cardiac Events Million Persons Project from 2015 to 2016, a total of 11 392 persons at high-risk for CVD were selected from six project areas in Jiangsu province for the questionnaire survey, physical measurement, laboratory test and bilateral ultrasound examination of carotid arteries. The prevalence of CP and influencing factors of abnormal carotid arteries, CP and plaque burden (CP≥2) were analyzed. Results: Among the persons surveyed, 4 821 (42.3%) were males. The age of the persons surveyed was (59.4±8.9) years. There were 5 971 abnormal carotid arteries cases (52.4%), including 1 782 carotid intima-media thickness thickening cases (15.6%), 3 811 CP cases (33.5%) and 378 carotid stenosis cases (3.3%). Older age (OR=2.253, 95%CI: 2.127-2.386), urban residence (OR=2.622, 95%CI: 2.375-2.895), hypertension (OR=1.439, 95%CI: 1.195-1.732), smoking (OR=1.441, 95%CI: 1.259- 1.650), pulse pressure difference (OR=1.270, 95%CI: 1.198-1.347), fasting plasma glucose (FPG) (OR=1.109, 95%CI: 1.059-1.161) and LDL-C/HDL-C (OR=1.225, 95%CI: 1.164-1.288) were possible risk factors of CP in population at high risk for CVD. Being women (OR=0.558, 95%CI: 0.494-0.630), high BMI (OR=0.948, 95%CI: 0.904-0.994), higher levels of education (OR=0.708, 95%CI: 0.531-0.945), and higher annual household income (OR=0.773, 95%CI: 0.669-0.894) were the possible protective factors. Conclusions Over half of the population at high-risk for CVD in Jiangsu showed abnormal carotid arteries. High blood pressure, high blood glucose, high blood lipids and smoking were the main factors that could be changed.

It is well known that parenteral and enteral nutrition support is helpful to improve clinical outcomes in patients with malnutrition or nutritional risk, and surgical nutrition has been used in China for 40 years. However, there is still insufficient awareness of malnutrition among clinical workers. There were different opinions from many experts after the publications of the European Society for Parenteral and Enteral Nutrition (ESPEN) consensus of malnutrition assessment 2015 and ESPEN guidelines on definitions and terminology of clinical nutrition 2017. Global Leadership Initiative on Malnutrition (GLIM) criteria for the diagnosis of malnutrition has also been published in 2018. Though it is lack of clinical validation, it is a big step forward. In order to achieve better prevention and treatment of malnutrition in clinical work, this present paper analyzes and compares the core contents of malnutrition assessment (diagnosis) in recent years, proposes current practical strategy for Chinese clinical workers, emphasizes that GLIM criteria cannot replace the three steps named "screening-assessment-intervention" .

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.