OBJECTIVE To evaluate the effects of ABCB1 genotypes on the efficacy and safety of taxanes in the treatment of breast cancer. METHODS By searching Embase，the Cochrane Library， PubMed， CNKI， and Wanfang databases， cohort studies and case-control studies about taxanes in the treatment of breast cancer were collected from the establishment of the database to July 2023. After screeningliterature， extracting data and evaluating quality， meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 11 studies were included， involving 1 321 patients. There was no correlation between the three genotypes and effective rate， the incidence of myelosuppression， the incidence of neurotoxicity （except for the allele and recessive model of ABCB1 C1236T）， and the incidence of hypersensitivity reactions （P＞0.05）. The subgroup analysis showed that there was a correlation between ABCB1 C1236T dominant model and effective rate when using anthracyclines+5-fluorouracil+cyclophosphamide+taxanes （P＜0.05）， there was a correlation between ABCB1 C3435T recessive model and effective rate when using taxanes+trastuzumab （P＜0.05）. ABCB1 C1236T allele model and recessive model were correlated with sample size ≥100 and using cyclophosphamide+epirubicin+5- fluorouracil+paclitaxel or cyclophosphamide+epirubicin+paclitaxel+trastuzumab or cyclophosphamide+epirubicin+5-fluorouracil+ trastuzumab+paclitaxel regimens； recessive model with sample size ＜100 and the African region were correlated with the incidence of peripheral neuropathy； recessive model was correlated with cutaneous adverse reactions （P＜0.05）. ABCB1 C3435T recessive model was correlated with the incidence of reduced neutrophil count with sample size ≥100； the incidence of white blood cell count reduction with sample size ＜100 and using docetaxel+epirubicin+cyclophosphamide was correlated with both the allele model and the dominant model； the incidence of infections was correlated with the dominant model （P＜0.05）. The incidence of neutrophil count reduction with the sample size ＜100 was correlated with allele model of ABCB1 G2677T/A； the incidence of edema with sample size ≥100 was correlated with allele model and recessive model； the incidence of infection was correlated with allele model and dominant model， especially in patients with neutrophil count complicated with fever （P＜0.05）. CONCLUSIONS ABCB1 genotypes are not correlated with effective rate of taxanes in the treatment of breast cancer， but ABCB1 C3435T genotype is associated with decreased neutrophil counts， decreased white blood cell counts and infections； ABCB1 C1236T genotype is associated with neurotoxicity and cutaneous adverse reactions； ABCB1 G2677T/A genotype is associated with decreased neutrophil counts， infections， and edema.

Objective:To investigated the safety and efficacy of donor-derived CD19+ or sequential CD19+ CD22+ chimeric antigen receptor T-cell (CAR-T) therapy in patients with B-cell acute lymphoblastic leukemia (B-ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:The data of 22 patients with B-ALL who relapsed after allo-HSCT and who underwent donor-derived CAR-T therapy at the Zhujiang Hospital of Southern Medical University and the 920th Hospital of Joint Logistics Support Force of the People’s Liberation Army of China from September 2015 to December 2022 were retrospectively analyzed. The primary endpoint was overall survival (OS), and the secondary endpoints were event-free survival (EFS), complete remission (CR) rate, and Grade 3-4 adverse events.Results:A total of 81.82% ( n=18) of the 22 patients achieved minimal residual disease-negative CR after CAR-T infusion. The median follow-up time was 1037 (95% CI 546–1509) days, and the median OS and EFS were 287 (95% CI 132-441) days and 212 (95% CI 120-303) days, respectively. The 6-month OS and EFS rates were 67.90% (95% CI 48.30%-84.50%) and 58.70% (95% CI 37.92%-79.48%), respectively, and the 1-year OS and EFS rates were 41.10% (95% CI 19.15%-63.05%) and 34.30% (95% CI 13.92%-54.68%), respectively. Grade 1-2 cytokine release syndrome occurred in 36.36% ( n=8) of the patients, and grade 3-4 occurred in 13.64% of the patients ( n=3). Grade 2 and 4 graft-versus-host disease occurred in two patients. Conclusion:Donor-derived CAR-T therapy is safe and effective in patients with relapsed B-ALL after allo-HSCT.

Objective:To analyze the research hotspots of self-management in patients with chronic obstructive pulmonary disease (COPD) at home and abroad.Methods:Related literature on self-management of COPD patients were searched in China National Knowledge Infrastructure and Web of Science databases, and the searched period was from January 1, 2013 to June 30, 2023. CiteSpace 5.8 software was used for keyword cluster analysis.Results:A total of 641 articles in Chinese and 1 192 in English were obtained. Domestic research hotspots about self-management of COPD patients mainly focused on health education, continuing care, rehabilitation care, etc. Foreign research hotspots about self-management of COPD patients mainly focused on mobile health, telemedicine and so on.Conclusions:This paper analyzes the research hotspots of self-management of COPD patients at home and abroad and provides reference for future research on self-management of COPD patients.

Objective:To retrieve, evaluate, and summarize the best domestic and international evidence on non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy, providing evidence-based guidance for healthcare professionals to conduct standardized assessment and management of sleep disorders in these patients.Methods:Clinical questions were translated into evidence-based questions using the PIPOST model. A systematic search of domestic and international databases and professional association websites was conducted for literature related to non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy, including clinical decisions, evidence summaries, guidelines, and systematic reviews. The search covered publications up to December 17, 2022. Two researchers trained in evidence-based nursing independently completed the quality assessment, evidence extraction, and summary of the included literature.Results:A total of 16 publications were included, comprising two clinical decisions, one evidence summary, five guidelines, six systematic reviews, and two randomized controlled studies. The best evidence was summarized from seven aspects: multidisciplinary collaboration, identification of risk factors, assessment and monitoring, referral, psychological behavioral interventions, exercise management, and complementary therapies, resulting in 25 key recommendations.Conclusions:This study summarizes the current best evidence for non-pharmacological management of sleep disorders in breast cancer patients undergoing chemotherapy. Healthcare professionals can follow these best evidence practices to standardize the assessment of patient sleep disorder symptoms and choose appropriate intervention plans based on clinical context and patient preferences, thereby improving patient sleep quality.

Three novel,highly oxygenated polyketides,multioketides A-C(1-3),and three previously described multioxidized aromatic polyketides(4-6),were isolated from an endophytic Penicillium sp.YUD17006 associated with Gastrodia elata.Their chem-ical structures were elucidated using extensive spectroscopic data,electronic circular dichroism calculations,and single X-ray diffrac-tion analysis.All metabolites were characterized by a typical α,β-unsaturated ketone fragment and exhibited a high degree of oxidation.Multioketides A and B were identified as a pair of epimers featuring a rare dihydroisobenzofuranone core.Multioketide C possessed a novel 5/6/6/6 heterotetracyclic chemical architecture with unusual 1,4-dioxin functionalities.Plausible biosynthetic pathways for 1-6 were proposed.Additionally,compound 3 demonstrated weak inhibitory activities against both acetylcholinesterase and protein tyr-osine phosphatase 1B.

The medical data processed and analyzed in clinical research often contain a large number of personal information. Therefore, researchers should pay attention to the safety management of medical data during clinical research. The Data Security Law of People's Republic of China and the Personal Information Protection Law of People's Republic of China implemented on 1 st September and 1 st November 2021 respectively establish legal basis for data security and personal information protection and point out the direction for medical data security, which indicate that data governance has entered the 'strong regulatory era'. In the process of medical data collection and application of clinical research, respecting and protecting the privacy and safety of patients, ensuring the quality of medical data, safely managing medical data and carrying out high-quality clinical research will be an important test for the collection and application of clinical scientific research data under the new legal background.

Neuroendocrine tumors of the gallbladder(GB-NET) are rare, and it lacks early clinical manifestations and has no specific tumor markers, it is difficult to distinguish GB-NET from gallbladder adenocarcinoma. The diagnosis of GB-NET is based on histopathology of the tumor and the assessment of proliferation fraction, which makes it difficult to achieve early diagnosis. GB-NET has a high degree of malignancy, 32.39% of patients have liver metastases at diagnosis, and 51.60% of patients have lymph node metastases, the median survival time is 9 to 10 months.There are currently no specific guidelines or consensus for the treatment of GB-NET. The treatment strategies are choosen mainly by the principles of gallbladder adenocarcinoma. We reviews the clinical and basic researches of GB-NET and case reports from China and across the world, as well as the data from SEER database, and we discuss the research progress on the classification, clinicopathological features, diagnosis, treatment advances and the prognosis.

Objective:To study the effect of PRR13 expression and the sensitivity of colorectal cancer cells to oxaliplatin, as well as the effect of PRR13 expression on the apoptosis rate of colorectal cancer cells under the action of oxaliplatin. Methods:Two colorectal cancer cell lines(SW620, SW480) were screened from the colorectal cancer cell lines commonly used by ATCC. Lentiviral vectors were used for cell transfection to construct a PRR13-silent colorectal cancer cell model. MTT oxaliplatin drug sensitivity experiments were conducted and compared. In this study, a colorectal cell model stably transfected with shRNA lentivirus containing the silenced PRR13 sequence was defined as the silent group, and a colorectal cell model stably transfected with empty vector of lentivirus was defined as the control group. After silencing the PRR13, the colorectal cancer cells changed the IC 50 of oxaliplatin, and then used a double staining flow cytometry apoptosis experiment to compare the expression of PRR13 and the rate of apoptosis of colorectal cancer cells under the action of oxaliplatin relationship. The measurement data were expressed as mean±standard deviation ( Mean± SD), and the comparison between groups used independent sample t test. The count data were expressed as percentage (%), and the comparison between groups used chi-square test. Results:The IC 50 of the same cell model decreased significantly with time. At the same time point, the IC 50 of the silent group was significantly lower than that of the control group. In the same cell model with the same concentration, the apoptosis rate of the silent group was significantly higher than that of the control group (SW620 silent group 22.5% vs SW620 control group 11.35%, SW480 silent group 13.63% vs SW480 control group 4.59%), the ratio of viable cells was significantly lower than that of the control cell model (SW620 silent group 76.0% vs SW620 control group 87.2%, SW480 silent group 74.5% vs SW480 control group 89.3%). Conclusion:Silencing the PRR13 can reduce the sensitivity of cells to oxaliplatin and reduce the drug resistance of oxaliplatin and the effect of treatment is more significant.

Objective To compare clinical outcomes between modified invagination pancreaticojejunostomyandmucosa (MIP) to mucosa duct pancreaticojejunostomy(MDP) in pancreaticoduodenectomy.Methods In Department of General Surgery,Beijing Friendship Hospital Capital Medical University,from Jan.2013 to Jan.2019,there were 222 cases performed pancreaticoduodenectomy,with MIP or MDP.According to the operation methods,by matching the sex and year decads,all patients were divided into MIP group (n =111) and MDP group (n =111).The incidence of pancreatic fistula in two groups was observed.The software of SPSS 20.0 was adopted for statistical analysis.Results There was no perioperative death in both groups.The mean operative time of MIP group was significant shorter than that of the MDP group [(212.8 ± 62.4) min vs (231.5 ±51.9) min,P =0.016].However,there were no significant differences in blood loss,blood transfusion,bowel fnnction recovery and liquid diet time.There was no grade C pancreatic fistula in MIP group,but 2 cases in MDP group.There were no significant differences in incidence and classification of pancreatic fistula between two groups.Conclusions There were no significant differences in clinical outcomes between MIP and MDP.The MIP is more easier to performed,so it is of certain spreading value.However,the further evidence need more prospective controlled study.

Objective To analysize the clinicopathologyic features of intraductal papillary neoplasm of the bile duct (IPNB),aiming to increase clinic reorganization of it.Methods Nine patients with IPNB were treated at Department of General Surgery,Beijing Friendship Hospital,Capital Medical University from April 2009 to March 2019,including 5 males and 4 females,aged from 53 to 72 years old.All patients' clinical characteristics,diagnostic methods,treatment and prognosis were retrospectively analyzed.All the patients were followed up from 1 to 119 months (medium 31 months).Results The pathologic diagnosis of all the 9 cases were obtained.Seven cases had occured recurrent abdominal painand fever and 2 cases presented painless jaundice.Five patients had single lesion (4 cases at the distal of common bile duct,1 cases at the hilum),whereas 4 cases had multiple lesions (2 cases diffuse lesionsin the biliary tree,2 cases multicentriclesionsin the common bile duct).Eight patients were underwent surgical procedure,including 7 cases of pancreticoduodenectomy and 1 cases radical resection of hilar cholangiocarcinoma.One patient with diffuse lesions was treated by chemotherapy after pathologic diagnosis was confirmed.One was died at 88 months after surgery,others were survival.Conclusions IPNB is a rear disease.The multicentric lesions have more chances to progress to invasive lesions.Different operative approaches should be chosen for different tumor sites and extents.