Clinical Efficacy and Safety of Apatinib for the Treatment of Patients with Metastatic, Recurrent Cervical Cancer after Failure of Radiotherapy and First-Line Chemotherapy: A Prospective Study.

PURPOSE: As a small-molecule tyrosine kinase inhibitor of vascular endothelial growth factor receptor 2 (VEGFR2), apatinib has shown a survival benefit in multiple solid tumors. This study aims to evaluate the efficacy and safety of apatinib in patients with metastatic, recurrent cervical cancer after failure of radiotherapy and first-line chemotherapy. METHODS: A total of 42 patients between June 2018 and March 2019 were involved in this study. All patients orally received apatinib once daily in a 4-week cycle until disease progression or adverse events that prohibit further therapy. The primary endpoint was progression-free survival (PFS), the secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), health-related quality of life (HRQoL) and adverse events. RESULTS: During a median follow-up of 13 months, 8 patients achieved a partial response and 24 cases achieved stable disease. None of them reported a complete response. The ORR and DCR were 19.0 and 76.2%, respectively. The median PFS was 6.0 months (95% CI 4.9-7.1), and the median OS was 12.0 months (95% CI 10.1-13.9). The global health score/HRQoL improved significantly following 3-cycle treatment (50.4 ± 12.5 vs. 60.1 ± 11.8; p < 0.01). The most frequent grade 3-4 adverse events were hand-foot syndrome, hypertension and fatigue. CONCLUSION: Apatinib should be an effective and tolerable treatment option for patients with metastatic, recurrent cervical cancer after failure of radiotherapy and first-line chemotherapy.

The outcome of human mosaic aneuploid blastocysts after intrauterine transfer: A retrospective study.

To explore whether mosaic/aneuploid embryos can be transferred when there is no normal embryo available for transplant.The clinical pregnancy outcomes and amniocentesis outcomes of transplanted mosaic embryos during 28 preimplantation genetic testing (PGT) cycles were retrospectively analyzed. Chromosomes of 4 donated mosaic blastocysts were comprehensively screened by next-generation sequencing.About 10 (35.7%) of the 28 transferred mosaic embryos were implanted and had a gestational sac. But 5 women miscarried due to lack of fetal heartbeat between the 7th and 12th week of pregnancy. Five women had full-term pregnancies and gave birth to 5 healthy babies. Three of the 4 donated mosaic blastocysts had normal trophectoderm and inner cell mass, but the other 1 had abnormal embryonic cell mass.When no normal transplantable embryo is available in the PGT cycles, but the underlying risk must be fully informed.

Alteration of Myeloid-Derived Suppressor Cells, Chronic Inflammatory Cytokines, and Exosomal miRNA Contribute to the Peritoneal Immune Disorder of Patients With Endometriosis.

Immunologic disorder has been reported to promote the progression of endometriosis (EMT). It has been known that myeloid-derived suppressor cells (MDSCs) drive the progression of many types of diseases. Few studies have shown the relation between MDSCs and EMT. To test whether MDSCs play a role in the progression of EMT, we defined MDSCs, cytokines, and the exosomal microRNA (miRNA) profile in peritoneal fluid (PF) from EMT patients. Characteristics of MDSCs, regulatory T cells (Tregs) and effector T cells were quantified by flow cytometry. Peritoneal fluid monocyte chemoattractant protein (MCP) 1/3, hepatocyte growth factor (HGF), chemokine (C-X-C motif) ligand (CXCL) 1/2, and 13 other cytokines were performed by enzyme-linked immunosorbent assay kit. Exosomal miRNA sequencing was prepared from PF of 3 women with early-stage EMT, 3 women with advanced stage EMT, and 3 women from control group. Our results showed that accumulations of monocytic MDSCs (Mo-MDSCs) and Tregs were detected in advanced patients with EMT. Patients with EMT displayed a significantly higher production of PF CXCL1, CXCL2, MCP-1, MCP-3, and HGF as compared to those from controls. MicroRNA sequencing showed 13 exosomal miRNAs (miRNA-1908, -130b, -451a, -486-5p, -4488, -432, -342, -425, -505, -6508, -145, -365a, and -365b) which are involved in immune alteration and cell proliferation and were differentially expressed in patients with EMT (fold-change ± 2.0). In conclusion, our study revealed that Mo-MDSCs, inflammatory cytokines, and exosomal miRNA seem to be involved in the progression of EMT; however, the relation between Mo-MDSCs, cytokines, and miRNA needs further research.

Factors associated with the extent of care-seeking delay for patients with acute myocardial infarction in Beijing.

BACKGROUND: Prehospital delay remains one of the main causes of reduced benefit of reperfusion therapy for patients with acute myocardial infarction (AMI). The largest proportion of prehospital delay involves the interval between the onset of symptoms and the decision to seek medical treatment. The purpose of this study was to examine the factors associated with the extent of care-seeking delay in Beijing for patients with AMI. METHODS: A structured interview was conducted in 102 patients with AMI in eight hospitals in Beijing. RESULTS: The mean decision time in patients with AMI was (204 +/- 43) minutes, and prehospital delay time was (311 +/- 54) minutes. Only 34% of patients sought medical care within one hour and a further 36% of patients presented to one of the eight hospitals within two hours after onset. Educational level, atypical presentation of AMI, and family members at the site where AMI occurred were associated with longer delay time in seeking medical assistance (P < 0.05, respectively), whereas the intensity of chest pain was inversely related to patients' delay time (P < 0.01). Patients who perceived their family relationship as good, attributed their symptoms to AMI origin, knew the time-dependent nature of reperfusion therapy, or used emergency medical service tended to seek medical care in a more rapid manner (P < 0.05, respectively). CONCLUSIONS: Patients with AMI in Beijing delay seeking medical care to a great extent. Health education to increase the level of awareness of the target population at increased risk of AMI, including patients and their family members, is probably beneficial to reduce patients' care-seeking delay.