Chinese Medical Journal最新文献

{"title":"gBRCA1 and gBRCA2 mutations in specific different domains affect ovarian cancer prognosis: A multicenter retrospective study.","authors":"Yingying Zhu, Yingying Wang, Zhen Shen, Lina Shen, Hanyuan Liu, Libing Xiang, Xinya Huang, Wei Gou, Mengyun Wang, Rongyu Zang, Ying Zhou, Tingyan Shi","doi":"10.1097/CM9.0000000000003652","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003652","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of germline BRCA1/2 mutations (gBRCA1/2m) in ovarian cancer is controversial, and the clinical implications of specific mutation domains within BRCA1/2 remain underexplored. This study aimed to investigate the impact of distinct gBRCA1/2m domains on survival outcomes in patients with ovarian cancer.</p><p><strong>Methods: </strong>This multicenter retrospective study, conducted between 2010 and 2022 at three major academic centers in China, analyzed 313 patients with epithelial ovarian cancer with pathogenic gBRCA1/2m. We evaluated associations between gBRCA1/2m domains and clinical outcomes including progression-free survival (PFS) and platinum-free interval.</p><p><strong>Results: </strong>Patients who received platinum-based chemotherapy without maintenance therapy with BRCA1 C-terminal domain 1 (BRCT1) mutations showed significantly prolonged PFS (37.8 vs. 22.6 months; hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.19-0.99; P = 0.042), whereas those with Really Interesting New Gene (RING) mutations had shorter PFS (13.1 vs. 23.2 months; HR, 1.82; 95% CI, 0.89-3.72; P = 0.097). In the subgroup of gross residual disease, RING mutations were significantly associated with reduced PFS (12.9 vs. 21.8 months; HR, 3.25; 95% CI, 1.29-8.18; P = 0.008). A higher likelihood of primary platinum-refractory disease (odds ratio, 7.78; 95% CI, 1.25-48.31; P = 0.028) was observed. Across all mutation locations, poly (ADP-ribose) polymerase inhibitor (PARPi) maintenance therapy demonstrated benefits, notably for patients with BRCA1 RING mutations (HR, 0.10; 95% CI, 0.01-0.84; P = 0.010) and BRCA2 RAD51-binding domain (RAD51-BD) mutations (HR, 0.29; 95% CI, 0.11-0.79; P = 0.010).</p><p><strong>Conclusions: </strong>BRCA1 BRCT1 mutations are associated with improved prognosis following platinum-based chemotherapy, whereas BRCA1 RING domain mutations are linked to a heightened risk of primary platinum-refractory disease. Our findings underscore the need for complete resection with no gross residual disease in patients harboring RING mutations. Furthermore, PARPi maintenance therapy exhibits variable efficacy based on mutation location, with BRCA1 RING and BRCA2 RAD51-BD mutations conferring significant benefits.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic gait parameters reveal long-term compensatory characteristics in knee joint function recovery following anterior cruciate ligament reconstruction: A retrospective cohort study.","authors":"Qitai Lin, Zehao Li, Meiming Li, Yongsheng Ma, Wenming Yang, Yugang Xing, Yang Liu, Ruifeng Liang, Yixuan Zhang, Ruipeng Zhao, Wangping Duan, Pengcui Li, Xiaochun Wei","doi":"10.1097/CM9.0000000000003719","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003719","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of early detection and management of emotional distress on length of stay in non-psychiatric inpatients: A retrospective hospital-based cohort study.","authors":"Wanjun Guo, Huiyao Wang, Wei Deng, Zaiquan Dong, Yang Liu, Shanxia Luo, Jianying Yu, Xia Huang, Yuezhu Chen, Jialu Ye, Jinping Song, Yan Jiang, Dajiang Li, Wen Wang, Xin Sun, Weihong Kuang, Changjian Qiu, Nansheng Cheng, Weimin Li, Wei Zhang, Yansong Liu, Zhen Tang, Xiangdong Du, Andrew J Greenshaw, Lan Zhang, Tao Li","doi":"10.1097/CM9.0000000000003599","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003599","url":null,"abstract":"<p><strong>Background: </strong>While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients.</p><p><strong>Methods: </strong>This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS (n = 178,883) and non-BS-GPS (n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively.</p><p><strong>Results: </strong>The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge.</p><p><strong>Conclusion: </strong>Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive clinical and microscopic assessment methods in evaluating efficacy of moderate-to-severe psoriasis treatment.","authors":"Wenju Wang, Jingkai Xu, Yanyan Feng, Yong Cui","doi":"10.1097/CM9.0000000000003660","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003660","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissecting the histological heterogeneity of ovarian carcinosarcoma and high-grade serous ovarian cancer in primary and metastatic tumors by single-cell transcriptomic analysis.","authors":"Kaipeng Xie, Shuang Liang, Nanxi Wang, Qiaoying Zhu, Jiangping Wu, Zhening Pu, Xiaoli Wu, Dake Li, Juncheng Dai","doi":"10.1097/CM9.0000000000003610","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003610","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of deep learning for predicting the growth of ovarian cancer organoids.","authors":"Hongji Wu, Lifang Ma, Ling Wang, Xueping Zhu, Xiaogang Luo, Cong Zhang, Chunfang Ha, Yun Dang, Haixia Wang, Dongling Zou","doi":"10.1097/CM9.0000000000003575","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003575","url":null,"abstract":"<p><strong>Background: </strong>Organoids have attracted enormous interest in disease modeling, drug screening, and precision medicine. However, developing robust patient-derived organoids (PDOs) was time-consuming, costly, and had low success rates for certain cancer types, which limited their clinical utility. This study aimed to develop an interpretable deep learning-based model to predict the cultivation outcome of ovarian cancer organoids in advance.</p><p><strong>Methods: </strong>Longitudinal microscopy images of 517 ovarian cancer organoid droplets were divided into training (n = 325), validation (n = 88), and test (n = 104) sets. Subsequently, growth prediction models were developed based on four neural network backbones (ResNet18, VGG11, ConvNeXt v2, and Swin Transformer v2), and specific optimization methods were designed for better prediction. Finally, 179 samples from multiple centers were collected for prospective validation, and the gradient-weighted class activation mapping (Grad-CAM) method was used for interpretability analysis of the deep model to reveal the basis of the model's decisions.</p><p><strong>Results: </strong>The test set showed that the deep learning models could achieve high-performance prediction at the third stage with area under the curve (AUC) values greater than 0.8 for all four models. The homogeneous transfer learning optimization method improved the AUC from 0.833 to 0.884 (P = 0.0039). In prospective validation, the optimized model achieved an AUC of 0.832, a Brier score of 0.1919 in the calibration curve, and a greater net benefit in the decision curve. Interpretability analysis revealed that the area where organoids are being formed and have already formed is important for prediction.</p><p><strong>Conclusions: </strong>Our developed models achieved satisfactory results in predicting the growth of ovarian cancer organoids. There is potential for further development of the model toward process automation.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of patients with HIV-associated Burkitt lymphoma treated with R-DA-EPOCH regimen: A single-center experience in Shanghai, China.","authors":"Yueming Shao, Zhenyan Wang, Wei Song, Yang Tang, Tangkai Qi, Li Liu, Jun Chen, Yinzhong Shen, Renfang Zhang","doi":"10.1097/CM9.0000000000003666","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003666","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roles of necroptosis and autophagy in a mouse model of sepsis-associated encephalopathy.","authors":"Yupeng Lei, Ruixi Zhou, Xuemei Sun, Qian Liu, Xia Qiu, Shiping Li, Hua Wang, Dezhi Mu","doi":"10.1097/CM9.0000000000003674","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003674","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing, surgical approach, and uterine manipulator use in total hysterectomy after loop electrosurgical excision procedure: Implications for perioperative risks in patients with high-grade squamous intraepithelial lesion.","authors":"Xiaoyu Hou, Junyang Li, Bingjie Mei, Jiao Pei, Mingfeng Feng, Hong Liu, Guonan Zhang, Dengfeng Wang","doi":"10.1097/CM9.0000000000003665","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003665","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness, treatment pattern, and safety of ustekinumab in treating bio-naïve patients with Crohn's disease in the real-world clinical setting in China.","authors":"Lingya Yao, Xiaoqing Lin, Jian Tang, Han Gao, Xiang Gao, Qian Cao, Minhu Chen","doi":"10.1097/CM9.0000000000003694","DOIUrl":"https://doi.org/10.1097/CM9.0000000000003694","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}