STING inhibitors sensitize platinum chemotherapy in ovarian cancer by inhibiting the CGAS-STING pathway in cancer-associated fibroblasts (CAFs).

Chemotherapy resistance in ovarian cancer hampers cure rates, with cancer-associated fibroblasts (CAFs) playing a pivotal role. Despite their known impact on cancer progression and chemotherapy resistance, the specific mechanism by which CAFs regulate the tumor inflammatory environment remains unclear. This study reveals that cisplatin facilitates DNA transfer from ovarian cancer cells to CAFs, activating the CGAS-STING-IFNB1 pathway in CAFs and promoting IFNB1 release. Consequently, this reinforces cancer cell resistance to platinum drugs. High STING expression in the tumor stroma was associated with a poor prognosis, while inhibiting STING expression enhanced ovarian cancer sensitivity. Understanding the relevance of the CGAS-STING pathway in CAFs for platinum resistance suggests targeting STING as a promising combination therapy for ovarian cancer, providing potential avenues for improved treatment outcomes.

Perinatal outcomes comparison between neuraxial and general anesthesia in pregnant women with placenta accreta spectrum: a multicenter retrospective study.

PURPOSE: We investigated the impact of anesthesia mode on perinatal outcomes in patients with placenta accreta spectrum (PAS) undergoing cesarean delivery and identified factors associated with adverse perinatal events. METHODS: The multicenter retrospective analysis was conducted in patients with PAS who delivered at three medical centers. Patients were classified according to whether they received general anesthesia (GA) or neuraxial anesthesia (NA). We compared the basic clinical characteristics of patients in the pre-propensity score matching (PSM) and post-PSM cohorts and identified factors associated with a high risk of adverse maternal outcomes. RESULTS: This study included a total of 425 patients, with 307 (72.2%) in the GA group and 118 (27.8%) in the NA group. After PSM, 162 patients were identified for analysis. In the post-matched cohort, the NA group exhibited shorter total operation time (P = 0.030) and postoperative length of hospital stay (P = 0.037). Additionally, the NA group experienced lower intraoperative blood loss (P < 0.001) and received fewer units of transfused packed red blood cells (PRBC) (P < 0.001). Multivariate logistic regression analysis indicated that GA (P < 0.001), emergency cesarean delivery (P = 0.010), vascular lacunae within the placenta (P < 0.001), hypervascularity of uterine-placental margin (P = 0.002), hypervascularity of the cervix (P = 0.014), and balloon placement in the abdominal aorta (P < 0.001) were associated with a high risk of adverse maternal events. CONCLUSION: In comparison to GA, cesarean delivery with NA in PAS patients appears to be associated with reduced intraoperative blood loss, PRBC transfusion, operating duration, and postoperative hospital stay.

Medical Education Systems in China: Development, Status, and Evaluation.

Since 1949, China has made many changes to develop its medical education system and now has a complex array of medical degrees. The current system comprises a 3-year junior college medical program, 5-year medical bachelor's degree program, "5 + 3" medical master's degree program, and 8-year medical doctoral degree program; these programs each provide a different path to earning a medical degree. The advantages and drawbacks of such complexity are open to discussion. Since the government set a strategic goal of "Healthy China" in 2019, it has sought to increase the training capacity of its medical education system to establish a high-quality health service system. This article reviews medical education reform in China, discusses the current medical education system, and presents evaluations of medical education programs based on assessments by 1,025 participants (medical students and doctors) recruited from 31 provinces of China. These assessments were compiled via a multicenter self-reported questionnaire administered July 1 to 5, 2021. Participants were training for a medical degree or practicing doctors trained in the 5-year program, "5 + 3" program, 8-year program, or "4 + 4" program. The authors assessed the medical education system to which each of the participants belong and their career stage and career satisfaction, and they requested that participants name the 3 most promising programs. The 8-year program ranked first in work satisfaction (7.92/10), education program satisfaction (7.78/10), and potential (1.91/2). Scores of the 5-year program and "5 + 3" programs were 7.25 and 7.17 for system satisfaction, respectively, and the "4 + 4" program (7.00/10) ranked the next highest. The innovations that have occurred in the Chinese medical education system have offered opportunities to meet the needs of more patients, but the lack of consistency has also posed challenges. Currently, Chinese medical education is becoming more uniform and standardized.