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Inetetamab combined with pyrotinib and chemotherapy in the treatment of breast cancer brain metastasis: A case report

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World Journal of Clinical Cases 2024年第3期12卷 575-581页

作者： Qing-Qing Dou Ting-Ting Sun Guo-Qiang Wang Wei-Bing Tong Graduate student Institute Inner Mongolia Medical UniversityHohhot 010000Inner Mongolia Autonomous RegionChina Central Breast Area B Beijing University Cancer Hospital Inner Mongolia HospitalHohhot 010000Inner Mongolia Autonomous RegionChina

BACKGROUND Breast cancer brain metastasis(BCBM)is an advanced breast disease that is difficult to treat and is associated with a high risk of death.Patient prognosis is usually poor,with reduced quality of life.In this context,we report the case of a patient with HER-2-positive BCBM treated with a macromolecular mAb(ine-tetamab)combined with a small molecule tyrosine kinase inhibitor(TKI).CASE SUMMARY The patient was a 58-year-old woman with a 12-year history of type 2 diabetes.She was compliant with regular insulin treatment and had good blood glucose control.The patient was diagnosed with invasive carcinoma of the right breast(T3N1M0 stage IIIa,HER2-positive type)through aspiration biopsy of the ipsilateral breast due to the discovery of a breast tumor in February 2019.Immunohistochemistry showed ER(-),PR(-),HER-2(3+),and Ki-67(55-60%+).Preoperative neoadjuvant chemotherapy,i.e.,the AC-TH regimen(epirubicin,cyclophosphamide,docetaxel-paclitaxel,and trastuzumab),was administered for 8 cycles.She underwent modified radical mastectomy of the right breast in November 2019 and received tocilizumab targeted therapy for 1 year.Brain metastasis was found 9 mo after surgery.She underwent brain metastasectomy in August 2020.Immunohistochemistry showed ER(-)and PR.(-),HER-2(3+),and Ki-67(10-20%+).In November 2020,the patient experienced headache symptoms.After an examination,tumor recurrence in the original surgical region of the brain was observed,and the patient was treated with inetetamab,pyrotinib,and capecitabine.Whole-brain radiotherapy was recommended.The patient and her family refused radiotherapy for personal reasons.In September 2021,a routine examination revealed that the brain tumor was considerably larger.The original systemic treatment was continued and combined with intensity-modulated radiation therapy for brain metastases,followed by regular hospitalization and routine examinations.The patient’s condition is generally stable,and she has a relatively high quality of life.This case report demonstrates that

关键词： Breast cancer brain metastasis Resistance to trastuzumab Macromolecule inetetamab Small molecule tyrosine kinase inhibitor Radiation therapy HER2-positive Case report

The"4+4"medical Doctor(MD)Pilot Program at PUMC:Implementation,Performance,and Prospects

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Chinese medical Sciences Journal 2024年第2期39卷 144-148页

作者： Jing-Jing Yi Wei-Wei Xu Chao Ma He Di Jing Jin Le Zeng Wen-Ji Tu Wen-Wen Sun Qin Zhang Office of Educational Affairs Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Chinese Academy of medical Sciences&Peking Union medical College Beijing 100730China

Peking Union medical College(PUMC)launched the"4+4"medical Doctor(MD)pilot program in 2018,admitting students with non-medical backgrounds from top universities,aligning with national medical talent training policies to foster diverse and eager learners in medicine.On the occasion of the graduation of the first class of the"4+4"MD pilot class at PUMC in 2023,we reviewed the teaching reform in the pilot program and carried out a systematic survey and interviews with students,faculties,and management staff of the pilot class.This article reports on the measures taken by the pilot class at PUMC in enrollment and curriculum setting,and demonstrates the achievements of the pilot class in terms of student academic background structure,knowledge acquisition and skill learning,scientific research ability,and course evaluation.The results indicated that the pilot class had met the national demand for the"Medicine+X"talent training model.More specifically,with a diverse academic backgrounds,the pilot class graduates had academic levels comparable to the eight-year medical education graduates,and their scientific research abilities were satisfactory.The pilot program at PUMC will optimize the curriculum setting,strengthen the construction of faculty,learning resources,and teaching facilities,and reform the academic evaluation methods,thus deepening the reform of medical education and improving the"4+4"MD program as a novel medical education model.

关键词： "4+4"MD pilot program teaching reform medical education

Development of immature ovarian teratoma after mature teratoma in a girl with familial ovarian teratoma:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1442-1447页

作者： U Chul Ju Woo Dae Kang Seok Mo Kim Department of Obstetrics and Gynecology Chonnam National University Medical SchoolGwangju 61469South Korea

BACKGROUND Immature ovarian teratoma is a rare and aggressive neoplasm that affects young women.This report is the first to describe the development of immature teratoma after ovarian cystectomy for mature teratoma of the ovary in an adolescent female with a family history of ovarian teratoma.CASE SUMMARY A 16-year-old girl who had undergone bilateral ovarian cystectomy for mature teratomas 3 years ago showed bilateral adnexal tumors during her regular ultrasonography follow-up every 6 months.She received laparoscopic bilateral ovarian cystectomy,and final histopathology showed grade-1 immature teratoma of the left ovary and mature teratoma of the right ovary.Laparoscopic left salpingo-oophorectomy and staging procedures were performed again.Her mother,maternal aunt,and maternal grandmother had also received surgeries for mature ovarian teratomas.CONCLUSION It is important to have guidance on management of patient and family members with familial ovarian teratomas.

关键词： Familial ovarian teratomas Adolescent female Immature ovarian teratoma Management Case report

Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn’s disease

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 740-750页

作者： Phillip Gu Shishir Dube Norman Gellada So Yung Choi Susan Win Yoo Jin Lee Shaohong Yang Talin Haritunians Gil Y Melmed Eric A Vasiliauskas Niru Bonthala Gaurav Syal Andres J Yarur David Ziring Shervin Rabizadeh Phillip Fleshner Cindy Kallman Suzanne Devkota Stephan R Targan Dalin Li Dermot PB McGovern Department of Medicine Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Imaging Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Biostatistics Shared Resource Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Internal Medicine Keimyung University School of MedicineDaegu 42601South Korea Department of Medicine University of California at Los AngelesLos AngelesCA 90095United States Department of Medicine University of California at San DiegoSan DiegoCA 92093United States Department of Pediatrics Cedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Surgery Cedars-Sinai Medical CenterLos AngelesCA 90048United States

BACKGROUND Evidence suggests inflammatory mesenteric fat is involved in post-operative recurrence(POR)of Crohn’s disease(CD).However,its prognostic value is INTRODUCTION Crohn’s disease(CD)is a debilitating chronic immune-mediated inflammatory disease(IMID)of the gastrointestinal tract that is increasing in incidence and prevalence globally[1].CD patients often undergo surgery for disease-related complic-ations and/or medically refractory disease.Unfortunately,surgery is not curative,and many patients develop post-operative recurrence(POR)of CD with a significant proportion eventually requiring additional surgeries.With advances in early detection and therapeutics,the contemporary 10-year risk of surgery has improved from 50%to 26%,but the risk of recurrent surgery has remained unchanged at 30%,suggesting a need to improve post-operative management strategies[2].Presently,there are two accepted strategies to mitigate POR,but each have potential limitations.Firstly,patients start early post-operative pharmacologic prophylaxis within 4-6 wk after surgery.This strategy can potentially overtreat a subset of patient who may not develop long-term disease recurrence off therapy.Consequently,these patients are at risk of medication-related adverse events and the direct and indirect costs associated with therapy with little or no benefit[3].The second strategy is performing early colonoscopy within 6-12 months after surgery and escalating therapy based on FOOTNOTES Author contributions:Gu P is the guarantor of the article and was involved in concept and design,data collection,statistical analysis,drafting of manuscript,and final approval of manuscript;Dube S and Choi SY were involved in statistical analysis,drafting of the manuscript,and final approval of manuscript;Gellada N,Win S,Lee YJ and Yang S were involved in the data collection,drafting of the manuscript,and final approval of manuscript;Haritunians T and Li D were involved in data analysis and interpretation,drafting of manuscript and final approval of manuscript;

关键词： Crohn’s disease Surgery Visceral adipose tissue Mesenteric adipose tissue Creeping fat Computed tomography

Individual alcohol consumption by the population of Russia versus regional living conditions

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Global Health Journal 2024年第1期8卷 24-31页

作者： Sergey A.Maksimov Svetlana A.Shalnova Galina A.Muromtseva Yuliya A.Balanova Svetlana E.Evstifeeva Anna V.Kapustina Oksana M.Drapkina National medical Research Center for Therapy and Preventive Medicine Moscow 101990Russia

Background:There are substantial regional differences in drinking alcohol in Russia,both at the population and individual levels.However,the causes of these differences have not been studied yet.Objective:The goal of our study was to examine the effect of regional living conditions on individual alcohol consumption by the population of Russia.Methods:For the analysis,we used data from a cross-sectional epidemiological study conducted in 2013-2014.The final analytical sample included 18,130 people aged 25-64 years.We conducted the interviews face to face,based on which any drinking in the last year,as well as alcohol abuse,were considered as a response.Alcohol abuse was recorded when the respondent consumed 5.75 or more grams of pure ethanol per day(75th percentile of average daily alcohol consumption among alcohol drinkers).The assessment of the regional living conditions was accomplished via integral indexing,which was previously performed based on publicly available data for 2010-2014.Associations were assessed using generalized scoring equations with unchanging standard errors.The associations were expressed by odds ratios(OR)and 95%confidence intervals(C).Results:Deterioration of social conditions and increase in demographic depression in the region of residence increased the odds of any drinking(OR 1.51,95%CI:1.33 to 1.72,P<0.001 and OR 1.22,95%CI:1.05 to 1.41,P=0.oo9,respectively).The odds of alcohol abuse increased with the deterioration of social living conditions and the growth of the industrial development in the region:OR 1.35,95%CI:1.14 to 1.59,P<0.001 and OR 1.16,95%CI:1.05 to 1.28,P=0.002,respectively.Conclusion:Our analysis allowed assessing the impact of the regional living conditions on individual drinking alcohol in the population of Russia.

关键词： Alcohol Living environment Regional features Russia

Weight change and all-cause and cause-specific mortality: A 25-year follow-up study

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中华医学杂志(英文版) 2024年第10期137卷 1169-1178页

作者： Yang Huan Wang Jianbing Wang Xiaokun Sun Wanyi Tong Chenyunhao Fan Jinhu Qiao Youlin Abnet Christian C. Department of Cancer Epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Department of Public Health Zhejiang University School of Medicine National Clinical Research Center for Children’s Health Hangzhou Zhejiang China Metabolic Epidemiology Branch Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville MD USA

Background: Whether the dynamic weight change is an independent risk factor for mortality remains controversial. This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial (NIT) cohort.Methods: Body weight of 21,028 healthy residents of Linxian, Henan province, aged 40-69 years was measured two times from 1986 to 1991. Outcome events were prospectively collected up to 2016. Weight maintenance group (weight change final analysis. Compared with the weight maintenance group, subjects with weight loss ≥2 kg had an increased risk of death from all-cause (HRAll-cause = 1.14, 95% CI: 1.09-1.19,P years could increase the risk of total death (HROverweight to normal = 1.18, 95% CI: 1.09-1.27; HRBecoming underweight = 1.35, 95% CI: 1.25-1.46) and cancer death (HROverweight to normal = 1.20, 95% CI: 1.04-1.39; HRBecoming underweight = 1.44, 95% CI: 1.24-1.67), while stable overweight could increase the risk of total death (HRStable overweight = 1.11, 95% CI: 1.05-1.17) and death from stroke (HRStable overweight = 1.44, 95% CI: 1.33-1.56). Interaction effects were observed between age and weight change on cancer mortality, as well as between baseline BMI and weight change on all-cause, heart disease,

关键词： Weight change All-cause mortality Cancer Stroke Heart diseases Body mass index

The mediating role of sleep qualityon the relationship between internet gaming disorder and perceived stress and suicidal behaviour among Indian medical students

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General Psychiatry 2023年第3期36卷 175-188页

作者： Sunny Garg Aakanksha Kharb Deepika Verma Ritu Antil Binika Khanna Ritika Sihag Divya Lamba Psychiatry Bhagat Phool Singh Government Medical College for WomenKhanpur KalanSonipatHaryanaIndia MBBS Internship Bhagat Phool Singh Government Medical College for WomenKhanpur KalanSonipatHaryanaIndia MBBS student final Prof Bhagat Phool Singh Government Medical CollegeforWomenKhanpur KalanSonipatHaryanaIndia

Background In the recent digital era,individuals with internet gaming disorder(IGD)have reported a much higher prevalence of poor sleep quality,perceived stress and suicidal behaviour.However,the underlying mechanisms for these psychological problems remain unknown.Aims The primary aims of this study were to explore the mediating role of sleep quality on the relationship between IGD and the health outcomes of perceived stress and suicidal behaviour and to assess the prevalence and risk factors for IGD among medical students.Methods A cross-sectional study enrolling 795 medical students from two medical colleges in a rural area of North India was conducted from April to May 2022.The study participants were chosen using a stratified random sampling approach.A self-administered questionnaire was used to collect data,including sociodemographic and personal information and gaming characteristics.The study also included the Gaming Disorder and Hazardous Gaming Scale,the Pittsburgh Sleep Quality Index,the Perceived Stress Scale-10 and the Suicide Behaviors Questionnaire-Revised to measure IGD,sleep quality,perceived stress and suicidal behaviour,respectively.Multiple logistic regression for the risk factors and Pearson's correlation test for the relationship between variables were used.Hayes'PROCESS macro for SPSS was employed to carry out mediation analysis.Results Among the 348 gamers with a mean age of 21.03(SD 3.27)years,the prevalence of IGD was 15.23%(95%confidence interval:11.6%to 19.4%).In the correlational analysis,small to large(r:0.32-0.72)significant relationships between scores of IGD and other health outcomes were established.The indirect effect(B=0.300)via sleep quality accounted for 30.55%of the total effect(B=0.982)of IGD on perceived stress(partially mediated),while sleep quality(B=0.174)accounted for 27.93%of the total effect(B=0.623)of IGD on suicidal behaviour(partially mediated).The factors of being male,living in a single-parent family,using the internet for other than academic purposes(1-3 hours

关键词： behaviour internet media

Small Cell Neuroendocrine Carcinoma of the Vulva: Case Report and Literature Review

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 295-300页

作者： Gabriela Françóes Rostirolla Alessandra Guerra Maria Carolina Rey Alt Luiza Tesser Dalla Libera Maria Eduarda Appel Binda Márcia Appel Fernando De Marco dos Santos Department of Obstetrics and Gynecology Caxias do Sul University Caxias do Sul Brazil Department of Pathology UNIVATES Lajeado RS medical student Caxias do Sul University Caxias do Sul Brazil Department of Obstetric and Gynecology Federal University of Rio Grande do Sul Porto Alegre Brazil Department of Oncology Surgeon Caxias do Sul University Caxias do Sul Brazil

Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.

关键词： Vulvar Neoplasms Carcinoma Small Cell Carcinoma Neuroendocrine Genital Neoplasms Female Vulvar Diseases

Long-term tadalafil once daily in Chinese men witherectile dysfunction:a 2-year final analysis of apost-marketing,multicenter,randomized,open-labeltrial

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Asian Journal of Andrology 2024年第3期26卷 282-287页

作者： Hui Jiang Lian-Ming Zhao Su Yan Ji-Hong Liu Zhao-Hui Zhu Jin-Dan Luo Yu-Tian Dai Fu-Biao Li Hao-Cheng Lin Zhi-Chao Zhang Department of Urology Peking University First HospitalBeijing 100000China Department of Urology Peking University Third HospitalBeijing 100191China Department of Urology Peking Union Medical College HospitalBeijing 100730China Department of Urology Tongji HospitalTongji Medical CollegeHuazhongUniversity of Science and TechnologyWuhan 430030China Department of Urology Union Hospital of Tongji Medical CollegeHuazhong University of Science andTechnologyWuhan 430022China Department of Urology The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Departmentof Andrology Nanjing Drum Tower HospitalNanjing 210008China Department of Andrology The First Hospital of Jilin UniversityChangchun 130021China Andrology Center Department of UrologyPeking University First HospitalBeijing 100034China.

The long-term safety and effectiveness of once-daily tadalafil is crucial,but limited data are available in Chinese patients witherectile dysfunction(ED).In this post-marketing,multicenter,randomized,open-label trial with 2-year follow-up,635 ED caseswere randomized to receive daily oral tadalafil 2.5 mg or 5 mg for 3 months,of whom 580 continued once-daily tadalafil 5 mg for21 months.Treatment-emergent adverse events in the 12-month and 24-month period were similar,with the most common beingviral upper respiratory tract infection,upper respiratory tract infection,and headache.Significant improvement from baseline inthe International Index of Erectile Function-Erectile Function(IIEF-EF)score was detected at month 12(least squares mean[LSM]change:7.9,95%confidence interval[CI]:7.5–8.4,Pyear daily application of tadalafil 5mg in Chinese men with ED showed a favorable safety profile and durable improvement in sexual performance and satisfaction.

关键词： clinical trial erectile dysfunction long-term safety once-daily dosing tadalafil