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Background: TFE3-rearranged renal cell carcinoma (TFE3-rRCC) is a rare but highly heterogeneous renal cell carcinoma (RCC) entity, of which the clinical treatment landscape is largely undefined. This study aims to evaluate and compare the efficacy of different systemic treatments and further explore the molecular correlates. Methods: Thirty-eight patients with metastatic TFE3-rRCC were enrolled. Main outcomes included progression-free survival (PFS), overall survival, objective response rate (ORR) and disease control rate. RNA sequencing was performed on 32 tumors. Results: Patients receiving first-line immune checkpoint inhibitor (ICI) based combination therapy achieved longer PFS than those treated without ICI (median PFS: 11.5 vs. 5.1 months, P = 0.098). After stratification of fusion partners, the superior efficacy of first-line ICI based combination therapy was predominantly observed in ASPSCR1-TFE3 rRCC (median PFS: not reached vs. 6.5 months, P = 0.01; ORR: 67.5% vs. 10.0%, P = 0.019), but almost not in non-ASPSCR1-TFE3 rRCC. Transcriptomic data revealed enrichment of ECM and collagen-related signaling in ASPSCR1-TFE3 rRCC, which might interfere with the potential efficacy of anti-angiogenic monotherapy. Whereas angiogenesis and immune activities were exclusively enriched in ASPSCR1-TFE3 rRCC and promised the better clinical outcomes with ICI plus tyrosine kinase inhibitor combination therapy. Conclusions: The current study represents the largest cohort comparing treatment outcomes and investigating molecular correlates of metastatic TFE3-rRCC based on fusion partner stratification. ICI based combination therapy could serve as an effective first-line treatment option for metastatic ASPSCR1-TFE3 rRCC patients. Regarding with other fusion subtypes, further investigations should be performed to explore the molecular mechanisms to propose pointed therapeutic strategy accordingly. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the prevalence of healthcare-associated infection (HAI) in the China-Japan Friendship Hospital, a tertiary level hospital in Beijing, China.Methods: We defined HAI using the criteria established by the Ministry of Health of the People's Republic of China. Three cross-sectional surveys were conducted from 2012 to 2014. Inpatients who had been hospitalized for at least 48 h were surveyed. Information on HAI prevalence, isolated pathogens and use of antibiotics were collected. Logistic regression models were used to assess the associations between HAI and potential risk factors.Results: During three cross-sectional surveys, a total number of 4,029 patients were included (1,233 patients in 2012, 1,220 patients in 2013 and 1,576 patients in 2014). The overall prevalence of patients with HAI was 3.6 % (95 % confidence interval (CI) 3.1 %-4.2 %). Respiratory tract infections were the most common type (64.7 %) of HAIs, followed by urinary tract infections (12.6 %) and bloodstream infections (5.4 %). HAI occurrences were significantly associated with male sex (odds ratio (OR) = 2.25, 95 % CI 1.53-3.32), age over 85 years (OR = 4.74, 95 % CI 2.54-8.83), hospitalization in the intensive care units (ICUs) (OR = 2.42, 95 % CI 1.31-4.49), indwelling urinary catheter (OR = 4.21, 95 % CI 2.46-7.20) and mechanical ventilation (OR = 2.31, 95 % CI 1.30-4.09). Gram-negative bacteria were found to be the most isolated pathogens (67.1 %), with gram-positive bacteria and fungi accounted for 20.3 % and 10.5 %, respectively. Antibiotics were administered to 34.3 % of the included patients over the study period.Conclusions: The overall HAI prevalence in our hospital is similar to previous studies that were conducted in other areas of China, and the respiratory tract infection should be the priority in HAI reduction control within China. We should focus HAI reduction efforts on patients with advanced age, hospitalization in the ICU and indwelling devices. [ABSTRACT FROM AUTHOR]

Background: Definitive concurrent chemoradiotherapy (dCCRT) is the gold standard for the treatment of locally advanced esophageal squamous cell carcinoma (ESCC). However, the potential benefits of consolidation chemotherapy after dCCRT in patients with esophageal cancer remain debatable. Prospective randomized controlled trials comparing the outcomes of dCCRT with or without consolidation chemotherapy in patients with ESCC are lacking. In this study, we aim to generate evidence regarding consolidation chemotherapy efficacy in patients with locally advanced, inoperable ESCC., Methods: This is a multicenter, prospective, open-label, phase-III randomized controlled trial comparing non-inferiority of dCCRT alone to consolidation chemotherapy following dCCRT. In total, 600 patients will be enrolled and randomly assigned in a 1:1 ratio to receive either consolidation chemotherapy after dCCRT (Arm A) or dCCRT alone (Arm B). Overall survival will be the primary endpoint, whereas progression-free survival, locoregional progression-free survival, distant metastasis-free survival, and treatment-related toxicity will be the secondary endpoints., Discussion: This study aid in further understanding the effects of consolidation chemotherapy after dCCRT in patients with locally advanced, inoperable ESCC., Trial Registration: ChiCTR1800017646., (© 2024. The Author(s).)

Background: This study aimed to investigate the prevalence of healthcare-associated infection (HAI) in the China-Japan Friendship Hospital, a tertiary level hospital in Beijing, China., Methods: We defined HAI using the criteria established by the Ministry of Health of the People's Republic of China. Three cross-sectional surveys were conducted from 2012 to 2014. Inpatients who had been hospitalized for at least 48 h were surveyed. Information on HAI prevalence, isolated pathogens and use of antibiotics were collected. Logistic regression models were used to assess the associations between HAI and potential risk factors., Results: During three cross-sectional surveys, a total number of 4,029 patients were included (1,233 patients in 2012, 1,220 patients in 2013 and 1,576 patients in 2014). The overall prevalence of patients with HAI was 3.6 % (95 % confidence interval (CI) 3.1 %-4.2 %). Respiratory tract infections were the most common type (64.7 %) of HAIs, followed by urinary tract infections (12.6 %) and bloodstream infections (5.4 %). HAI occurrences were significantly associated with male sex (odds ratio (OR) = 2.25, 95 % CI 1.53-3.32), age over 85 years (OR = 4.74, 95 % CI 2.54-8.83), hospitalization in the intensive care units (ICUs) (OR = 2.42, 95 % CI 1.31-4.49), indwelling urinary catheter (OR = 4.21, 95 % CI 2.46-7.20) and mechanical ventilation (OR = 2.31, 95 % CI 1.30-4.09). Gram-negative bacteria were found to be the most isolated pathogens (67.1 %), with gram-positive bacteria and fungi accounted for 20.3 % and 10.5 %, respectively. Antibiotics were administered to 34.3 % of the included patients over the study period., Conclusions: The overall HAI prevalence in our hospital is similar to previous studies that were conducted in other areas of China, and the respiratory tract infection should be the priority in HAI reduction control within China. We should focus HAI reduction efforts on patients with advanced age, hospitalization in the ICU and indwelling devices.

Background: Not enough is known about the prevalence of overweight and obesity in rural China in the current decade. We aim to update our knowledge of the prevalence of obesity and its associated risk factors and comorbidities in a large population sample in rural Northeast China., Methods: A population-based survey of 11,579 participants aged 35 years and older was conducted in rural areas of Liaoning Province during 2012-2013. Anthropometric measurements, information on health-related variables and blood biochemical indexes were collected by well-trained personnel., Results: The prevalence of general obesity and overweight was found to be 7.8% and 37.2%, respectively. The overall prevalence of abdominal obesity was 15.1%. Female gender, ethnic minority, middle-school education and a family income of 5,000-20,000 CNY per year were found to be risk factors for general obesity, while older age, female gender, ethnic minority and longer sleep duration (>8 h/d) increased the risk of abdominal obesity, after adjusting for confounders. Overweight and obese participants had significantly higher risks to develop prehypertension, hypertension, high LDL-C and low HDL-C compared with normal weight participants, while abdominal obesity was associated with increased risks of diabetes and high TG after adjusted for multiple factors. Compared with participants with a normal BMI and no abdominal obesity, the participants classified as abdominally obese and normal BMI; as abdominally obese and overweight; and abdominally obese and generally obese each had a progressive increase in the odds of hypertension (OR: 1.961, 95% CI: 1.154 to 3.331, OR: 2.744, 95% CI: 2.126 to 3.541, and OR: 8.990, 95% CI: 5.858 to 13.795, respectively) and high TG (OR: 3.165, 95% CI: 2.183 to 4.588, OR: 3.980, 95% CI: 3.332 to 4.755, and OR: 4.340, 95% CI: 3.574 to 5.271, respectively)., Conclusions: The prevalence of obesity in rural Northeast China exhibited a remarkably increasing upwards trend. General and abdominal obesity were associated with different subtypes of cardiometabolic comorbidities, the combined effects of which on the comorbidities dramatically increased.