Guangdong Province Women and Children Hospital

Abstract Metabolic adaptation to nutrient stress is a key but poorly understood driver of fungal virulence. Here, we show that a dominant East Asian lineage of Cryptococcus neoformans (VNIa-5), which disproportionately infects immunocompetent hosts, has undergone lineage-specific rewiring of glucose-responsive stress pathways. Integrating population genomics, transcriptomics, and experimental infection models, we demonstrate that VNIa-5’s clinical dominance is not explained by environmental prevalence. Instead, selective activation of Snf1 signalling links glucose limitation to mitochondrial tubularisation, extracellular vesicle remodelling, and enhanced melanization. Under low-glucose conditions, VNIa-5 exhibits marked mitochondrial plasticity and extracellular vesicle compositional shifts resembling hypervirulent outbreak lineages of Cryptococcus gattii . Following experimental induction of dormancy, VNIa-5 shows significantly increased virulence in vivo compared with the closely related but clinically rare VNIa-31 subclade, with host survival tightly correlated with mitochondrial morphology. These findings identify metabolic stress integration as a central mechanism shaping cryptococcal virulence and disease in immunocompetent human hosts.

Abstract Background: RJBC 1501 (NCT02455141) is a prospective phase III study to compare the efficacy and safety of adjuvant epirubicin plus cyclophosphamide (EC) followed by taxanes (T) versus same regimen plus carboplatin (EC-TCb) in early-stage triple negative breast cancer (TNBC). Methods: Patients with node positive or node negative (with tumor size ≥1.0cm) TNBC who received definitive surgery were randomized 1:1 to receive EC-T or EC-TCb. Taxanes consisted of either weekly paclitaxel for 12 doses or docetaxel every 3 weeks for 4 cycles. Carboplatin was given weekly (AUC 2) for 12 doses or every 3 weeks (AUC 5-6) for 4 cycles, concurrent with taxanes. The primary endpoint was disease-free survival (DFS) in the intention-to-treat (ITT) population. Secondary endpoint includes distant DFS (DDFS), overall survival (OS), and safety. Results: Between March 2016 and March 2023, 786 patients were randomized (EC-T: n = 391; EC-TCb: n = 395). Baseline characteristics were balanced: median age ≤50 years (49.6%), T1 stage (46.6%), node-negative (72.3%). A majority of patients (76.5%) received 3-weekly docetaxel. After a median follow up of 4.52 (IQR 2.83 to 6.06) years, 103 events were reported: 62 in the EC-T group and 41 in the EC-TCb group. Addition of carboplatin significantly improved DFS (hazard ratio [HR], 0.66; 95% CI, 0.44 to 0.97, P = 0.034), with 3-year DFS of 89.8% (95%CI 86.8 to 92.9%) for EC-T and 93.1% (95%CI 90.5 to 95.7%) for EC-TCb. EC-TCb regimen was also associated with a superior DDFS (HR, 0.61; 95% CI, 0.38 to 0.98, P = 0.040) and OS (HR, 0.39; 95% CI 0.16 to 0.94, P = 0.029) compared to EC-T treatment. Grade 3-4 adverse events were more frequent among EC-TCb arm (49.9%) than EC-T arm (38.7%), primarily driven by higher rates of neutropenia (47.0% vs 37.8%) and thrombocytopenia (4.5% vs 0%). Other grade 3-4 toxicities were comparable between groups. Conclusion: Adding carboplatin to adjuvant EC-T chemotherapy significantly improves DFS, DDFS, and OS in patients with early-stage TNBC. While additional carboplatin treatment was associated with increased hematologic toxicity, no new safety signals emerged. Citation Format: X. Chen, J. Huang, H. Shi, J. Zhu, W. Wu, G. Ye, Q. He, Y. Shi, A. Zhang, X. Xie, X. Wang, X. Chen, W. Wu, J. Wu, Z. Li, Z. Li, Y. Dai, W. Ren, Q. Shao, Y. Chen, Y. Zeng, M. Pegram, K. Shen. Adjuvant epirubicin plus cyclophosphamide followed by taxanes with or without carboplatin for early stage triple-negative breast cancer (RJBC 1501): a randomized controlled phase III trial [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr RF2-03.

ObjectivesTo assess the diagnostic performance of the Node Reporting and Data System (Node-RADS) in ultrasonographic evaluation of cervical lymph node (LN) metastasis in papillary thyroid carcinoma (PTC) and compare it with conventional suspicious sonographic features.Materials and methodsThis retrospective study included 227 PTC patients (269 LNs) who underwent preoperative cervical LN ultrasound and biopsy (September 2022–December 2023). Two radiologists independently assigned Node-RADS scores (1–5) based on LN size and morphologic features (shape, border, echogenicity). Diagnostic performance was evaluated using ROC analysis, with histopathology as the reference standard. Node-RADS was compared to five American Thyroid Association (ATA)-defined suspicious features (microcalcifications, cystic changes, etc.). Multivariable analysis assessed an integrated model combining Node-RADS with peripheral vascularity.ResultsMetastatic LNs (63.9%, 172/269) exhibited higher Node-RADS scores (malignancy rates: 35.7% for score 1 vs. 88.2% for score 5). Node-RADS achieved an AUC of 0.720 (95% CI: 0.662–0.773), surpassing individual features (best AUC: 0.703 for peripheral vascularity). Inter-reader agreement was good (κ = 0.67). A combined Node-RADS and peripheral vascularity model significantly improved diagnostic performance (AUC: 0.825, p < 0.01).ConclusionsNode-RADS offers standardized, reproducible risk stratification for cervical LN metastasis in PTC, with moderate diagnostic accuracy. Integration with peripheral vascularity enhances performance, supporting its potential clinical utility in preoperative assessment.

PurposeIntense pulsed light (IPL) treatment may cause transient erythema, dryness, and barrier dysfunction, highlighting the need for effective postprocedural care. This study aimed to assess the efficacy and safety of a fibronectin-containing skincare regimen in restoring skin barrier function and relieving these IPL-related manifestations.Patients and MethodsIn this 28-day, split-face study, 32 healthy female participants undergoing IPL treatment applied a fibronectin-containing serum to one side of the face and a control serum to the opposite side. Skin hydration, transepidermal water loss (TEWL), erythema, and radiance were evaluated at baseline, immediately post-IPL, and on days 3, 7, and 28.ResultsCompared to the control, the fibronectin-treated side showed significantly greater improvements in skin hydration (P < 0.01) and significantly lower TEWL on days 3 (P < 0.05), 7 (P < 0.01), and 28 (P < 0.01). By days 7 and 28, skin radiance and erythema also improved more significantly (P < 0.01). Both dermatologist and participant assessments confirmed the superior efficacy of the fibronectin serum. No adverse events were rePorted.ConclusionPost-IPL aPPlication of a fibronectin-containing serum effectively imProves skin hydration, reduces barrier dysfunction and erythema, and enhances radiance with good tolerability. These findings suPPort its Potential utility in Post-IPL skincare regimens.

BackgroundTo compare the clinical outcomes and visual quality following bilateral implantation of Vivity IOLs with mini-monovision.MethodsPatients who underwent sequential bilateral cataract surgery with implantation of Vivity EDOF IOLs at our institution were divided into two groups: Group A was designed with a myopic refraction of ≥ 0.5 D and < 1.0 D in the non-dominant eye, while the refractive target for the dominant eye was emmetropia. Group B exhibited emmetropic refractive targets bilaterally. Outcome measures evaluated at 1 month postoperatively included: monocular uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), monocular objective visual quality, monocular and binocular uncorrected defocus curves, VF-14 score, Quality of Vision (QoV) score and patient satisfaction.ResultsThe study comprised a total of 61 patients (122 eyes). Statistically significant differences were not observed between the groups in terms of UDVA, UIVA, mean modulation transfer function (MTF), Strehl ratio (SR), aberrations, VF-14 scores, QoV scores and satisfaction. In Group A, the UNVA of the non-dominant eye was superior to that of Group B (0.36 ± 0.05 vs. 0.54 ± 0.06 LogMAR, P=0.024). The defocus curve of the non-dominant eye revealed that Group A attained superior visual performance at defocus levels ranging from − 2.0D to -3.5D (0.50 m to 0.29 m). However, these differences did not achieve statistical significance.ConclusionThe findings of this study indicate that bilateral implantation of EDOF IOLs with a mini-monovision design improves near visual acuity without significantly compromising distance visual acuity, visual quality or increasing aberrations.

This study aimed to evaluate the sonographic features of giant fetal hepatic hemangioma (GFHH) as predictors of complications and outcomes. We conducted a retrospective analysis of prenatally diagnosed GFHH cases between 2014 and 2024, reviewing ultrasonographic features, complications, and neonatal outcomes. Among 36 fetuses, 38.9% exhibited homogeneous masses and 61.1% showed heterogeneous masses. Peripheral annular or semi-annular blood flow was observed in 88.9% of cases. Heterogeneous echogenicity was more frequent in the complicated group (93.3%, 14/15) than in the uncomplicated group (38.1%, 8/21) (p<0.01). Significant differences were identified between the complicated and uncomplicated groups regarding the presence of vascularity, arteriovenous fistula (AVF), hepatic artery peak systolic velocity (HAPSV) (> 106cm/s), and hepatic vein dilation (≥ 3 veins) (all p<0.05). The survival rate was 100% among the 21 fetuses in the uncomplicated group, compared with 73.3% among the 15 fetuses in the complicated group. The typical presentation of GFHH is a well-defined hypoechoic mass with peripheral circular or semicircular vascularity. Homogeneous masses are predictive of favorable outcomes, whereas within heterogeneous masses, features such as hypervascularity, AVF, HAPSV > 106cm/s, and dilation of three hepatic veins are closely correlated with an increased risk of complications.

PURPOSETo evaluate the efficacy and safety of adjuvant epirubicin plus cyclophosphamide followed by taxanes (EC-T) versus EC-T plus carboplatin (EC-TCb) in patients with early-stage triple-negative breast cancer (TNBC).PATIENTS AND METHODSIn this phase III trial, patients with TNBC with node-positive or node-negative (tumor size ≥1.0 cm) disease who received definitive surgery, were stratified by lymph node status and randomly assigned in a 1:1 ratio to receive four cycles of EC followed by four cycles T with or without carboplatin adjuvant chemotherapy. The primary end point was disease-free survival (DFS). Secondary end points included distant DFS (DDFS), overall survival (OS), and safety. This study had 80% power to detect a DFS hazard ratio (HR) of 0.64, with a two-sided type I error of 0.05.RESULTSA total of 786 patients were randomly assigned to receive EC-T (n = 391) or EC-TCb (n = 395) between March 2016 and March 2023. With a median follow-up of 4.52 (IQR, 2.83-6.06) years, 62 and 41 events were reported in the EC-T and EC-TCb arm, respectively. Adding carboplatin significantly improved DFS (HR, 0.66; [95% CI, 0.44 to 0.97]; P = .034), DDFS (HR, 0.61 [95% CI, 0.38 to 0.98]; P = .040), and OS (HR, 0.39 [95% CI, 0.16 to 0.94]; P = .029). Grade 3 to 4 adverse events were more frequent among the EC-TCb arm (49.9%) than the EC-T arm (38.7%), primarily driven by higher incidence of neutropenia (47.0% v 37.8%) and thrombocytopenia (4.5% v 0%). Other grade 3 to 4 toxicities were comparable.CONCLUSIONAdding carboplatin to adjuvant EC-T chemotherapy significantly improves DFS, DDFS, and OS in patients with early-stage TNBC. Although increased hematologic toxicity was observed, no new safety signals emerged.