For ovarian cancer patients undergoing preoperative Neoadjuvant Chemotherapy (NACT), the toxicity of chemotherapeutic agents may cause hepatic and renal function impairment, altered sensitivity of the central nervous system or abnormal pain perception thresholds. These changes can further affect the metabolism and efficacy of intraoperative anaesthetics. However, the optimal intraoperative opioid dosage regimen for this specific patient population remains unclear. Currently, nociceptive stimulation monitoring technology has achieved certain progress in guiding intraoperative opioid administration. Among this technology, the index of consciousness 2 (IOC2), as a representative monitoring indicator in this field, provides important references for optimising opioid dosage regimens. This trial will investigate the opioid requirements and patient outcomes in the anaesthetic management of ovarian cancer patients undergoing preoperative NACT guided by IOC2.

This prospective, single-blind, single-centre randomised controlled trial will randomly recruit 90 patients undergoing open ovarian cancer cytoreductive surgery under general anaesthesia, with equal numbers assigned to the control and experimental groups. The experimental group will adjust the remifentanil plasma target concentration based on the IOC2 value, while the control group will adjust according to the patients' mean arterial pressure. The primary outcome will be intraoperative opioid use (calculated in morphine equivalents per hour). Secondary outcomes include the average intraoperative propofol dose, post-anaesthesia care unit (PACU)-related metrics (including extubation time, time to spontaneous eye opening and morphine consumption in PACU), pain levels at 4, 24 and 48 hours postoperatively, as well as the use of analgesics and antiemetics. Postoperative recovery quality will also be assessed, including time to first flatus, time to ambulation, length of hospital stay and the 24-hour Quality of Recovery-15 (QoR-15) score.

This study involves human participants and was approved by the Ethics Committee of the Jiangsu Cancer Hospital (ethics no: XJS-2024-017). Patients gave informed consent to participate in the study before taking part. The study results will be published in peer-reviewed journals and presented at relevant academic conferences.

ChiCTR2400091897.

The Rio Grande Valley (RGV) is a developing clinical research region characterized by its distinctive demographic profile that offers an opportunity to investigate diverse health issues. This pilot investigation sought to evaluate the demographic and clinical characteristics linked to bone metastases and primary malignant bone neoplasms (PMBNs) in patients from the RGV and to compare the frequency of these conditions with the US general population.

This was a retrospective chart review in which data were gathered from the University of Texas Rio Grande Valley UTHealth electronic database from January 1, 2018 to September 4, 2024. Various statistical analyses were performed to assess the demographic and clinical data.

Individuals in the RGV are more likely to develop a PMBN (P < 0.0163) but less likely to have bone metastasis (P < 0.0015) compared with the general US population. Regarding bone metastases and PMBN, although not statistically significant, patients with bone metastasis were 10 years older on average and exhibited a lower body mass index (-1.7 kg/m²) and weight (-17.6 kg) than those with PMBN.

Our initial research indicates age and body weight variations among individuals with bone metastases and PMBN in the RGV, as well as differences in frequency of bone metastases and PMBN in this medically underserved region compared with the general US population. Despite the limited sample size, our results necessitate further exploration in a larger cohort to elucidate any demographic and clinical differences in bone metastases and PMBN subtypes in medically underserved areas.

Cardiac tumors affect fewer than 1 in 2000 people. This study is a retrospective review of diagnostic procedures, surgical management, and outcomes in patients treated for tumors of the heart at our institution. We compare our management approaches, clinical, and surgical outcomes with those reported in the literature.

The study population includes patients 7 to 79 years old who presented to our institution for tumors of the heart from July 2004 to January 2023. With institutional review board approval, subjects for this study were identified by searching the hospital's database on Current Procedural Terminology codes for tumors of the heart (benign neoplasm of the heart or malignant tumor). All of the data were stored on REDCap.

There were 23 men and 29 women in the patient group. The average patient age was 54 years old. The most common presentation symptoms were dyspnea and fatigue. The most common diagnosis methods were transthoracic echocardiogram, transesophageal echocardiogram, cardiac magnetic resonance image, and computed tomography scan. Operative treatment was offered to 52 people; 47 had resection and 5 had biopsy only. The most common postoperative complication was respiratory insufficiency (22) and sepsis (2). Forty-eight patients were diagnosed as having a benign neoplasm of the heart and 4 diagnosed as having a malignant tumor. There were 49 primary tumors and three secondary tumors. The most common location of the tumor was the left atrium. The most common diagnosed cell type for the cardiac tumors was myxoma (61.5%). The average length of stay in the hospital was 12.5 days. Thirty-nine patients were discharged home in a stable condition. The study population had one operative mortality (death within 30 days after surgery). Forty-four of the 52 patients treated are alive after 2 years.

Data from this study strongly suggest that surgical removal is a viable and largely successful treatment approach for cardiac tumors. Clinical outcomes such as discharge status, postoperative condition, and length of survival after procedures are similar to those from other referral centers for such conditions. Complete resection was possible in 90% of our study cases; 85% of patients in this study surgically treated for cardiac tumors are alive after 2 years.

Objective: To evaluate the efficacy and safety of the Chi-BEAM regimen (chidamide combined with carmustine, etoposide, cytarabine, and melphalan) followed by autologous hematopoietic stem cell transplantation (ASCT) in patients with high-risk or relapsed/refractory lymphoma. Methods: This retrospective case series included 78 patients with newly treated high-risk or relapsed/refractory lymphoma who underwent ASCT with the Chi-BEAM conditioning regimen in the Department of Hematology, the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), from June 2021 to May 2024. Descriptive statistics were employed to evaluate clinical characteristics, efficacy, and adverse events. The Kaplan-Meier method was applied to calculate cumulative progression-free survival (PFS) and overall survival (OS) rates. Results: The median age of the 78 evaluable patients was 47 years (range 16-68), with 8 patients (10.3%) aged ≥60 years. At the first post-transplant assessment (3 months), the objective response rate was 94.9% (74/78). The median follow-up was 20.1 months (range 2.9-44.9). The median PFS time was 20.1 months (range 1.6-45.1), with a 2-year cumulative PFS rate of 81.8%. The median OS time was 20.6 months (range 3.1-45.1), with a cumulative 2-year OS rate of 93.2%. The regimen was well-tolerated; mild-to-moderate hypocalcemia within 1 week post-infusion and transient mild erythrocyturia on the infusion day were the primary adverse reactions. Conclusion: The Chi-BEAM regimen combined with ASCT demonstrates both safety and clinical benefit in patients with high-risk or relapsed/refractory lymphoma.

Objective:To investigate the clinical effect of free anterolateral thigh myocutaneous flap combined with oral repair membrane in the reconstruction of nasal mucosa defect after maxillary malignant tumor surgery. Methods:A total of 12 patients with maxillary gingival squamous cell carcinoma and maxillary sinus cancer who had been treated in Department of Oral and Maxillofacial Surgery, Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital, were selected from November 2020 to November 2023. Free anterolateral thigh musculocutaneous flap transplantation combined with oral repair membrane were used in all patients. Meanwhile, maxillary soft and hard tissue defects and nasal mucosa defects left after tumor operation were repaired and reconstructed. The clinical effect was evaluated after 6-12 months follow-up. Results:Subtotal maxillary resection was performed in 1 case, total maxillary resection in 9 cases and extended maxillary resection in 2 cases. The musculocutaneous flaps of all patients survived, the facial appearance was basically symmetrical, no obvious depression deformity, the swallowing and speech function recovered well, the mouth and nasal cavity were closed completely, the food could be eaten through the mouth, and the lower nasal passage was not blocked. Conclusion:The free anterolateral thigh musculoflap combined with oral repair membrane can be used to repair and reconstruct maxillary malignant tumor complicated with extensive maxillary tissue and nasal mucosa defect after operation, and the appearance and function can be recovered well after operation, which is a choice for maxillary malignant tumor complicated with nasal mucosa defect.

Objective:To summarize the clinical characteristics and surgical outcomes of endolymphatic sac tumor（ELST）, and improve the experience of diagnosis and treatment of this disease. Methods:A retrospective analysis was conducted on the clinical data of patients with ELST who underwent surgical treatment by the Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University from January 2015 to December 2024.The clinical and image features, perioperative management, surgical methods and follow-up results of the disease were summarized. Results:Of the 6 cases, 4 were male and 2 were female. The primary clinical characteristics were hearing loss（6 cases）, tinnitus（5 cases）, dizziness（2 cases）, facial paralysis（1 case）, and headache（1 case）. CT and MRI of temporal bone were performed in all cases. The manifestation of CT was a space occupying lesion centered on the region of endolymphatic sac, accompanied by bone destruction and intertumoral calcification. MRI showed tumor center isosignal and peripheral hypersignal in T1 and T2 sequences in 3 cases, and mixed hypersignal in T1 and T2 sequences in 3 cases. Enhancement was observed in all cases on the enhanced scan. 5 cases underwent DSA examination and showed the tumors were supplied by the occipital artery（2 cases）, posterior auricular artery（4 cases）, and the bunch of internal carotid artery（1 case）. Embolization of the feeding artery was performed in 3 patients. Five patients underwent tumor resection. Translabyrinthine approach were performed in 4 cases, and middle cranial fossa approach was performed in 1 case. All cases followed up for 24 to 70 months with no distant metastases or death. Two patients experienced twice recurrences and were treated with surgical operation. The tumors were found to be closely related to the internal auditory canal or dura during the surgery. Conclusion:The clinical manifestations of ELST are not typical, and hearing loss is the most common clinical symptom. CT and MRI exhibit typical imaging characteristics. ELST has a risk of recurrence, and the tumor should be carefully managed when invade to the internal auditory canal and dura to reduce postoperative recurrence.

Objective:This study aims to investigate the influence of microvessel density（MVD） and microlymphatic vessel density（MLVD） on the prognosis of patients with hypopharyngeal squamous cell carcinoma（HPSCC） and to develop a nomogram prediction model for prognosis based on pathological characteristics. Methods:A retrospective analysis was conducted on clinicopathological and follow-up data from HPSCC patients who underwent surgical treatment at our institution between June 2010 and June 2020. Immunohistochemical staining was performed on tumor tissues and adjacent normal margin tissues to evaluate MVD and MLVD. The associations among MVD, MLVD, and clinicopathological features were analyzed. Univariate and multivariate Cox regression analyses were conducted to identify independent risk factors affecting overall survival（OS）. Based on these findings, a nomogram model was constructed and its predictive accuracy was assessed using C-index, receiver operating characteristic（ROC） curve, and calibration curve. Results:Both MVD and MLVD were significantly higher in HPSCC tumor tissues compared to normal tissues. Patients in the high MVD and high MLVD groups exhibited significantly lower OS rates than those in the low MVD and low MLVD groups. Multivariate Cox regression analysis revealed that N stage, recurrence, nerve invasion, lymph node capsule invasion, MVD, and MLVD were independent prognostic factors of OS. Based on these factors, a nomogram prognosis model was successfully constructed. The nomograms demonstrated superior performance in terms of C-index, area under the ROC curve, and calibration, outperforming the AJCC TNM staging system. Conclusion:Elevated MVD and MLVD levels are associated with poorer prognosis in HPSCC patients. The nomogram model based on pathological features provides valuable insights for clinical assessment and decision-making.

Objective:To summarize the initial experience and evaluate the technical feasibility of the endoscopic transcanal transpromontorial approach（TTA） for vestibular schwannoma resection by analyzing long-term follow-up outcomes. Methods:A retrospective analysis was conducted on the perioperative and long-term follow-up data（mean follow-up time: 5 years） of patients who underwent endoscopic TTA for vestibular schwannoma resection in the Department of Otorhinolaryngology Head and Neck Surgery at Xiangya Hospital, Central South University, between January 2020 and December 2020. Long-term outcomes were systematically evaluated. Results:This study included two patients（one 41-year-old male and one 51-year-old female）. According to the AAO-HNS hearing classification system, preoperative hearing was Class C in one patient and Class D in the other. Preoperative imaging confirmed Koos stageⅠ tumors in both cases. Postoperative transient facial nerve paralysis（House-Brackmann Grade Ⅲ） recovered to Grade Ⅰ within 4 months. No complications such as cerebrospinal fluid leakage, intracranial infection, or intracranial hemorrhage occurred. No tumor recurrence was observed during the 5-year follow-up period. Conclusion:The endoscopic transcanal transpromontorial approach is minimally invasive, facilitates rapid recovery, and demonstrates satisfactory technical feasibility and safety when strict patient selection criteria（Koos stageⅠtumors with non-serviceable hearing） are applied.

Lymphedema is a chronic, progressive condition characterized by excessive fluid retention due to impaired lymphatic drainage. While neuropathic pain is known to affect a significant proportion of chronic pain sufferers, the frequency of neuropathic pain in patients with breast cancer-associated secondary lymphedema remains unclear. This study investigates the prevalence and characteristics of neuropathic pain in women with secondary lymphedema caused by breast cancer treatments.

To determine the prevalence of neuropathic pain in female patients diagnosed with breast cancer-associated secondary lymphedema and to explore that pain's association with lymphedema severity.

A cross-sectional study.

A tertiary hospital physical medicine and rehabilitation center.

This cross-sectional study included 100 women aged 18 to 65 diagnosed with secondary lymphedema related to breast cancer. Neuropathic pain was assessed using the Self-reported Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Douleur Neuropathique 4 (DN-4) questionnaires. Lymphedema was staged according to the International Society of Lymphology classification. Data on pain levels and quality of life were collected using the Numeric Rating Scale (NRS-11) and the Lymphedema Life Impact Scale (LLIS).

Neuropathic pain was identified in 14% of patients through the DN-4 and 17% through the S-LANSS. A significant correlation was found between higher lymphedema grades and increased neuropathic pain scores (P < 0.001). Patients with Grade 3 lymphedema reported significantly higher pain levels than did those with lower grades.

Cross-sectional nature of the study and the single-center design.

Neuropathic pain is prevalent in patients with breast cancer-associated secondary lymphedema, especially in more advanced cases of cancer. Early identification and targeted pain management strategies are crucial to improving the quality of life for these patients.

Tenosynovial giant cell tumor (TGCT) is a rare, mostly benign neoplasm originating in the synovium of joints, tendon sheaths, and bursae that can locally recur after excision and cause osseous erosions. Studies have suggested increased local recurrence with diffuse TGCT, but few have assessed associations of local recurrence or erosions in TGCT of the knee. Our aim was to determine associations of erosions and local recurrence with patient and tumor characteristics in knee TGCT.

A retrospective chart review was performed on 53 patients with intraarticular, biopsy-proven TGCT of the knee diagnosed at our institution from December 2002 to December 2020. Bivariate analysis assessed the significance of associations between patient and tumor characteristics, surgical management, erosions, and local recurrence.

Of 53 patients with intra-articular, biopsy-proven TGCT of the knee, 24 (45%) patients had diffuse, intra-articular TGCT, and 7 (13%) patients had radiographic evidence of osseous erosions. In the diffuse, intra-articular subgroup, 12 (50%) patients had local recurrence, but 5 of 5 patients with erosions had local recurrence. Of the 19 patients with diffuse, intra-articular TGCT without erosion, 7 (37%) had local recurrence (P = .037). Of the 24 patients with diffuse, intra-articular TGCT, both those who had and did not have local recurrence had similar surgical treatment (75% arthroscopic, 25% open). The average recurrent-free survival was 936 days.

Patients with diffuse, intra-articular TGCT of the knee with osseous erosions had a greater incidence of local recurrence than those without. Using erosions as a positive prognostic indicator for local recurrence may assist physicians in risk stratification of patients with diffuse, intra-articular TGCT.