Background::Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China.Methods::Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups. χ2 or Fisher’s exact test was used for comparison of categorical variables. Results::A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery. Among patients who underwent medical castration, only 4.0% (45/1118) received gonadotropin releasing hormone antagonists, in stark contrast to the grim situation of CVD prevalence and risk.Conclusions::PCa patients in China are diagnosed at an advanced stage. A heavy CVD burden was present at the initiation of treatment. Patients who accepted ADT-related therapy showed an original higher risk of CVD, but the awareness of cardiovascular protection was far from sufficient.

Objective To evaluate the efficacy,safety and economics of romiplostim for treating primary immune thrombocytopenia(ITP)by rapid health technology assessment,and to provide an evidence-based basis for policy makers and clinical practice.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data and VIP databases and the official websites of health technology assessment agency were electronically searched to collect high-quality clinical evidence and pharmacoeconomics evaluation literature of romiplostim for the treatment of ITP from inception to January 18,2024.Two researchers independently screened the literature,extracted information,and accessed the quality of included the literature,the extracted results were categorized and evaluated.Results A total of 14 literature were included,in which 8 systematic reviews/Meta-analysis and 6 pharmacoeconomic studies.In terms of efficacy,treatment with romiplostim significantly elevated platelet response rate,sustained platelet response rate,and mean platelet count in patients with ITP compared with placebo(P＜0.05).Romiplostim did not show a significant advantage in elevating patients'platelet response rate and sustained platelet response rate compared with other agents used to treat ITP(P＞0.05).In terms of safety,the incidence of serious adverse events was statistically lower with romiplostim compared to placebo(P＜0.05),while no significant differences were seen in the incidence of adverse events,bleeding events and thrombotic events(P＞0.05).There were no significant differences in the incidence of adverse events,serious adverse events,bleeding events,or thrombotic events when comparing romiplostim to other drugs for the treatment of ITP(P＞0.05).From an economic standpoint,most studies considered eltrombopag to be more economic advantages than romiplostim.Conclusion Romiplostim has good efficacy and safety in the treatment of ITP,and no advantage was shown in terms of economy.

Chimeric antigen receptor T-cell (CAR-T) has changed the treatment landscape of lymphoma. Plenty of research progresses have been made at 63rd annual meeting of American Society of Hematology. Studies with long-term follow-up indicated that CD19 CAR-T is expected to cure 30%-40% of relapsed or refractory large B-cell lymphoma (LBCL). A few studies indicated that CD19 CAR-T would be applied in the second-line or first-line therapy for LBCL. Real world studies further confirmed the efficacy and safety of CD19 CAR-T in treatment of relapsed or refractory follicular lymphoma and mantle cell lymphoma. CAR-T therapy has a promising prospect in the cinical application.

Hospital culture plays an important role in the orderly operation of large shelter hospitals as well as epidemic prevention and control.From April to May 2022, the shelter hospital of the National Convention and Exhibition Center(Shanghai) had created the large shelter hospital culture co-built by doctors and patients with a greater sense of belonging by taking measures such as joint party building between doctors and patients, giving play to the vanguard force of party members, carrying out various forms of cultural, sports and science popularization activities, encouraging enthusiastic patients to participate in activity planning, focusing on key groups, formulating shelter " residents convention", and so on. These measures ultimately formed cultural adaptation, cultural synchronization and cultural shaping, which were conducive to enhancing the empathy of doctors and patients, improving the effectiveness of medical implementation, and promoting the standardization of shelter management system. This harmonious, warm and autonomous culture co-built by doctors and patients effectively ensures the safe and orderly operation of the shelter hospital, and provides reference for the construction of the cultural system of large shelter hospitals in China.

Chimeric antigen receptor T (CAR-T) cell has achieved excellent efficacy in hematological tumors, especially for lymphoma. Many products have been approved to market all over the world, and 2 products targeting CD19 have been approved to treat relapsed and refractory large B-cell lymphoma in China. The current experiences of using CAR-T cells come from previous clinical studies. How to use CAR-T cells in a standardized and rationalized way is still a challenge faced by our clinicians. Based on the CAR-T cell treatment experiences from Peking University Cancer Hospital and the latest research progresses in CAR-T in China and abroad, this article will elaborate on patient screening, peripheral blood mononuclear cell collection, bridging treatment, lymphocyte depletion chemotherapy, CAR-T cell infusion, the monitoring and treatment of adverse events after infusion, and long-term follow-up after infusion, in order to guide clinicians to better use CAR-T cell and to bring maximum benefits to patients.

Objective:To investigate the clinical features, risk factors and prognosis of Clostridium difficile infection/colonization (CDI/CDC) in emergency intensive care unit (EICU) of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, then provides theoretical basis for clinical treatment. Methods:A retrospective case-control study was conducted. The data of EICU patients admitted to Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from June 2016 to June 2020 were collected. Taking the CDI/CDC patients as research objects [ Clostridium difficile (CD) positive group] and the CD negative patients with the same gender and age difference less than 5 years who were admitted to the hospital during the same period as the control (CD negative group). Demographic information, risk factors, prognosis and stool samples were collected. Single factor analysis and binary Logistic regression were used to analyze the CD positive infection rate, risk factors, and hospital death of patients with different clinical characteristics. Results:About 487 patients in EICU were included, 76 cases were taken into CD positive group, CD positive rate was 15.6%, including CDI 11 cases, CDC 65 cases. Among the CD positive group, all of the cases used proton pump inhibitor (PPI), and 75 cases used at least one antibiotic. Seventy-six CD negative patients with or without diarrhea (CD negative group) were included in this study. Among them, 75 patients used PPI and 74 patients used at least one antibiotic. Univariate analysis showed that acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), duration of hospitalization, and carbapenem use were the risk factors for CDI/CDC. There were significant differences in the above indicators between CD positive group and CD negative group [APACHEⅡ: 18.0 (12.2, 25.8) vs. 10.0 (7.0, 14.0), duration of hospitalization (days): 46.0 (30.5, 72.5) vs. 18.5 (9.2, 37.0), proportion of carbapenems: 81.6% (62/76) vs. 64.5% (49/76), all P < 0.05]. Binary Logistic analysis regression analysis showed that APACHEⅡ score [odds ratio ( OR) = 0.802, 95% confidence interval (95% CI) was 0.730-0.882, P < 0.01] and duration of hospitalization ( OR = 0.960, 95% CI was 0.942-0.978, P < 0.01) were independent risk factors for CDI/CDC. There was no difference in overall mortality between the CD positive group and CD negative group [27.6% (21/76) vs. 38.2% (29/76), P = 0.167]. Conclusions:Critically ill patients in EICU routinely use PPI and antibiotics, and the use of antibiotics does not affect the CD positive rate. The independent risk factors of CDI/CDC are the APACHEⅡ score and the duration of hospitalization, but fecal CD positive has no obvious influence on death.

Objective To compare the clinical effects of guided tissue regeneration (GTR) combined with different bone graft materials, including Bio-Gene, Bone3 and Bio-Oss, in the treatment of periodontal intra-bony defects. Methods Eighteen patients with chronic periodontitis with periodontal intra-bony defects were randomly divided into the Bio-Gene group, the Bone3 group and Bio-Oss group. After periodontal debridement, periodontal bone grafting combined with GTR surgery was performed in all patients. The clinical and radiographic parameters of patients were collected before surgery, suture removal (2 weeks after surgery), and 6 months after surgery, including periodontal exploration depth (PD), clinical attachment loss (CAL), gingival recession (GR), and residual alveolar bone height (RBH). Results The wounds healed well in all patients when the suture was removed. The stage Ⅰ healing was obtained without infection or wound dehiscence, and the postoperative discomfort was acceptable. At 6 months after periodontal bone grafting combined with GTR treatment, the PD and CAL indexes in the three groups were significantly improved compared with those before surgery (all P<0.05), and there was no significant difference in PD and CAL between the three groups (all P>0.05). Imaging results showed that new bone formation was observed in the original bone defect area in all three groups after 6 months of the treatment, the bone density was similar to the surrounding bone tissue. Besides, the RBH％increased significantly compared with that before the treatment (all P<0.05), and there was no significant difference in RBH％among the three groups (all P>0.05). Conclusions Bio-Gene, Bone3 and Bio-Oss are all reliable bone graft materials for the treatment of alveolar bone defects caused by periodontitis, which can significantly improve the osteogenesis effect.

Objective To observe the clinical effect of the Bushen-Qiangjin capsule and calcium D in the treatment of aromatase inhibitors-associated bone loss (AIBL) in breast cancer patients. Methods A total of 65 patients were randomized into a treatment group and a control group, 32 in the control group taking calcium D, and 33 in the treatment group taking calcium D and Bushen-Qiangjin capsule. After a 3-month treatment, the bone mineral density T (BMD), bone-specific alkaline phosphatase (BALP), bone gla protein (BGP) and tartrate resistant acid phosphatase (TrACP) of two groups were evaluated. Results The BMD increased significantly after treatment in both groups (P<0.05), and the therapeutic efficacy of the treatment group was better than of the control group (P<0.05). After treatment, the level of BALP (308.76 ± 10.99 U/L vs. 280.00 ± 7.44 U/L, t=8.170) and the BGP (42.21 ± 3.04 ng/ml vs. 34.38 ± 2.06 ng/ml, t=6.818) of the treatment group were significantly higher than those of the control group (P<0.01). The level of TrACP decreased significantly after treatment in both groups (P<0.05), and the TrACP (60.12 ± 4.58 U/L vs. 67.25±4.06 U/L, t=1.653) of treatment group was significantly lower than that of the control group (P<0.05). Conclusions The Bushen-Qiangjin capsule can produce a content efficacy in treating AIBL in breast cancer patients, improving the BMD and bone metabolism.

Objective To explore the application of MR diffusion weighted imaging (DWI)in the prognosis evaluation of liver cancer after treatment of transcatheter arterial chemoembolization(TACE).Methods Forty-five patients with primary hepatocellular carcinoma and treated with TACE were included in the study.Digital subtraction angiography(DSA)was used as the gold standard to evaluate the value of DWI in the prognosis evaluation.Results The average apparent diffusion coefficient (ADC)value of tumor necrosis tissue was (1.89±0.22)×10-3mm2/s,which was significantly different from that of tumor residual tissue of (1.39±0.27)×10-3mm2/s (P<0.05).Receiver operating characteristic curve showed that the sensitivity and specificity of diagnosing the necrotic tissue were 82.6% and 85.3% respectively with the ADC threshold of 1.68×10-3mm2/s.The sensitivity,specificity and positive likelihood ratio of traditional MRI enhancement were 86.9%,87.8% and 7.12,respectively.The sensitivity,specificity and positive likelihood ratio of MRI enhancement combined with DWI were 95.7%,82.9% and 5.59,respectively.Conclusion DWI can distinguish tumor necrosis from tumor residual in the prognosis evaluation of liver cancer treated with TACE.Traditional MRI enhancement combined with DWI are better in detecting tumor residual and recurrence of liver cancer treated with TACE.

Objective: To evaluate the prognostic value of ¹⁸F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods: Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival. Results: ①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ²=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ²=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ²=22.75, P=0.001) and OS (97.1% vs 40.0%, χ²=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell’s C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell’s C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell’s C index in OS (Harrell’s C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively). Conclusions Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.