Brachytherapy: An emblematic example of extreme hypofractionated regimen

In order to provide more convenient irradiation regimens for patient comfort, radiation facility organization and health expenses, new hypofractionated protocols have been evaluated. Moderately (dose/fraction: 2.3 to 3 Gy), then ultra (dose/fraction: 5.2 to 6.1 Gy) hypofractionated irradiations were first validated. The current question is: is it possible to go forward using extreme hypofractionated regimens (EHR) based on 1 to 3 fractions. Different irradiation techniques are under investigation. However, brachytherapy remains the smartest way to deliver a high dose in a small volume. We report prospective and retrospective study results which evaluated EHR for breast and prostate brachytherapy. While oncological outcome and toxicity profile appear extremely encouraging for low-risk breast cancer after a 1 to 4 fractions (6.25 to 20 Gy/fraction), the use of a single fraction of 19 to 23 Gy appears debatable for prostate cancer. Brachytherapy represents an emblematic example of EHR but longer follow-up and more mature results are awaited in order to specify the right indications and refine the EQD2 calculation method including new biological and technical factors.     

Pan-cancer proteomic map of 949 human cell lines

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北京市三级甲等医院结直肠癌患者就医流向规律分析

目的 分析不同特征的结直肠癌患者就医行为选择在中医院（含中西医结合医院）、西医院及肿瘤专科医院间的差异，为合理引导结直肠癌患者适宜就医及制订相关政策提供依据。方法 收集北京地区2018年1月-2019年12月17家三级甲等医院21894例首诊结直肠癌成年住院患者的病案首页数据，采用EmpowerStats 2.0对数据进行描述性分析。结果 21894例结直肠癌患者中就诊于中医院的有862例（3.93%），西医院的有8723例（39.85%），肿瘤专科医院的有12309例（56.22%）。对于不同医疗机构，男性占比均大于女性，58-68岁患者占比最大。且结直肠癌患者年龄、医疗付款方式及肿瘤分期在不同医疗机构间的分布存在差异（P<0.001）。西医院及肿瘤专科医院结直肠癌Ⅲ期患者占比最大，而就诊于中医院患者中结直肠癌Ⅳ期最多。从地域分布来看，异地就诊比例（57.32%）大于本地，且就诊于肿瘤专科医院的患者中73.66%来自外地。患者来源前三名分别是北京市、河北省及内蒙古自治区。而在北京市内，西医院患者主要来源于朝阳区、海淀区及西城区，中医院患者主要来源于海淀区、朝阳区及丰台区，肿瘤专科医院则主要来源于朝阳区、海淀区及丰台区。结论 应大力倡导年轻以及早期结直肠癌患者向中医院分流，充分施展中医药在结直肠癌患者中的治疗优势；发挥三级医院带动作用，建立对口帮扶医院，减少不必要的跨省流动及提倡结直肠癌的早筛早治，以降低结直肠癌死亡率。     

PARP7 negatively regulates the type I interferon response in cancer cells and its inhibition triggers antitumor immunity

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基于文本挖掘和生物医学数据库的新型冠状病毒肺炎药物发现

目的 基于文本挖掘技术和生物医学数据库对新型冠状病毒肺炎（COVID-19）相关文献进行数据挖掘分析，探究COVID-19及其主要症状发热、咳嗽、呼吸障碍相关基因靶点，筛选潜在有效的化学药和中药。方法 使用GenCLiP 3网站获取COVID-19和其主要症状咳嗽、发热、呼吸障碍共4个关键词的共有靶点，在METASCAPE数据库中对其进行基因本体（GO）和通路富集分析，再利用String数据库和Cytoscape软件构建共有靶点的蛋白质相互作用网络，筛选获得核心基因，运用DGIdb数据库、SymMap数据库针对核心基因进行中西医治疗药物预测。结果 获得COVID-19及其主要症状共有基因靶点28个，其中有IL2、IL1B、CCL2等核心基因16个，使用DGIdb数据库筛选获得与16个关键靶点相互作用的化学药包括沙利度胺、来氟米特、环孢素等28种，中药包括虎杖、黄芪、芦荟等70味。结论 COVID-19及其主要症状的病理机制可能和CD4、KNG1、VEGFA等28个共有基因相关，可能通过介导TNF、IL-17等信号通路参与COVID-19病理过程。潜在有效药物可能通过作用相关靶点通路起到治疗COVID-19的作用。     

儿童颌面部骨折诊疗研究进展

儿童处于生长发育特殊阶段，其颌面部解剖结构、牙列情况及心理状态与成年人有明显区别。颌面部骨折患儿常出现面部发育畸形、张口受限、咬合关系紊乱等，严重影响患儿的日常生活。因此，儿童颌面部骨折的诊疗一直是临床上的难题，也是国内外的研究热点。颌面部骨折好发于青少年，损伤原因多为意外跌倒、交通伤及运动伤。近年来，数字化外科技术为儿童颌面部骨折提供精确的诊断及微创的治疗。国内外学者对于儿童颌面部骨折治疗理念逐渐倾向于手术治疗，选择可吸收材料对儿童颌面部骨折进行固定，降低对儿童面部发育的影响。长期随访对于儿童颌面部骨折患儿具有重要意义，有助于监测患儿面部发育情况。此外，临床医生应注意患儿的心理状态。对于创伤较重或发现有心理问题的患儿，应尽早干预治疗。文章就近年儿童颌面部骨折流行病学特点、诊断、治疗原则及伴发的心理问题做一综述。     

Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature

Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty-four reviews were quantitative or mixed-methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost-effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost-effectiveness of navigation in screening programs.