This trial investigates the efficacy of neoadjuvant therapy using rezvilutamide combined with androgen deprivation therapy (ADT), with or without docetaxel, in treating oligometastatic hormone-sensitive prostate cancer (omHSPC).

This prospective, open-label, multicentre trial aims to enrol 100 patients newly diagnosed with omHSPC (defined as ≤5 bone or lymph node metastases confirmed by conventional imaging, without visceral metastasis) who must express a desire to undergo surgery. All patients undergo a prostate-specific membrane antigen positron emission tomography/CT (PSMA-PET/CT) scan at enrolment or within 4 weeks before enrolment to assess and confirm the number of metastases at baseline. Scans should be performed before initiating ADT to avoid compromising test sensitivity. Then patients will be allocated into groups in parallel according to their own preferences: one group will receive an LHRH agonist or antagonist for 24 weeks to maintain continuous ADT or have undergone bilateral orchiectomy. Treatment with rezvilutamide will be maintained daily. The other group will be scheduled to complete up to six cycles of docetaxel within 24 weeks, with maintenance of continuous ADT and rezvilutamide for 24 weeks. Both groups will receive a conventional imaging evaluation at the 12th week. After neoadjuvant therapy, patients will undergo conventional imaging and a second PSMA-PET/CT assessment, followed by cytoreductive radical prostatectomy within the subsequent 6 weeks. After surgery, patients may choose to continue with ADT or rezvilutamide at their own discretion, until disease progression. The primary endpoint is pathological complete response, defined as the absence of residual viable tumour cells in the tumour bed on pathological evaluation of the postoperative specimen. Secondary endpoints include 1 year biochemical progression-free survival, overall survival, radiographic progression-free survival, time to prostate-specific antigen progression, quality of life scores (total and subscale) assessed using the Functional Assessment of Cancer Therapy-Prostate questionnaire, time to symptomatic progression, time to deterioration in Eastern Cooperative Oncology Group performance status, the interval from enrolment to an increase in score from baseline, the proportion of patients with a ≥30% reduction in prostate volume on imaging before cytoreductive surgery compared with pre-neoadjuvant therapy, minimal residual disease and major pathological response. The study plans to enrol a total of 100 patients. Patient recruitment for this study is scheduled to begin in May 2025.

This has been approved by the Ethics Committee in Clinical Research of the First Affiliated Hospital of Wenzhou Medical University (number KY2024-231). Results will be published in peer-reviewed publications.

This study is expected to provide prospective evidence on the feasibility and potential clinical value of rezvilutamide combined with ADT, with or without docetaxel, as neoadjuvant treatment for newly diagnosed omHSPC.

Chinese Clinical Trial Registry (ChiCTR2400093262).

To investigate the correlation between fat-to-muscle ratio (FMR) or other body composition and secondary osteoporosis (OP) in patients with rheumatoid arthritis (RA) and to develop a predictive model using FMR and related clinical factors.

Cross-sectional observational study with machine learning-based risk modelling.

Tertiary hospital in eastern China, secondary care level.

A total of 670 hospitalised RA patients (135 males and 535 females; aged 58.00 (50.00–67.00) years; disease duration 8.00 (2.00–16.00) years) and 126 healthy controls were recruited between October 2019 and October 2022. There were no differences in basic indicators such as gender, age distribution and body mass index between the two groups. RA diagnosis followed American College of Rheumatology (ACR) 1987 or ACR/European League Against Rheumatism 2010 criteria. Exclusion criteria included major organ dysfunction, endocrine disease, infection or long-term hormone or psychotropic drug use.

Primary outcomes included total skeletal muscle mass, fat mass, FMR measured by bioelectrical impedance analysis and bone mineral density measured by dual-energy X-ray absorptiometry. Secondary outcomes included RA disease activity scores (clinical disease activity index (CDAI), simplified disease activity index, disease activity score in 28 joints (DAS28)) and glucocorticoid use. Logistic regression and four additional machine learning algorithms were used to build predictive models for OP.

The RA group (age, 58.00; duration, 8.00; DAS28, 5.03; rheumatoid factor, 104.75; C-reactive protein, 25.65; erythrocyte sedimentation rate (ESR), 59.00) exhibited reduced total skeletal muscle mass (19.49 vs 25.38, p

FMR may serve as a useful clinical indicator of secondary OP in RA patients. A model based on FMR and associated risk factors can predict the possibility of secondary OP.

This study aims to explore the dynamics of neurological functional disability in patients with intracerebral haemorrhage (ICH) using a multistate Markov model and to investigate the factors influencing the shift in neurological functional disability.

A prospective cohort study.

Electronic medical record data for adults, from July 2019 and October 2023 in neurosurgery at 27 national centres in China.

Patients with ICH with cerebral haemorrhage in the supratentorial parenchyma confirmed by CT of the brain within 48 hours of onset of symptoms. Secondary cerebral haemorrhage due to aneurysm, vascular malformation, haemorrhagic infarction, tumour or coagulation disorders was excluded.

Participants evaluated neurological functional status through the modified Rankin Scale, which we graded to construct a multistate Markov model.

After treatment, patients with ICH who achieve good recovery of neurological function are 2.66 times more likely to transition to a state of no neurological impairment than to severe impairment. Patients in states of no neurological impairment and mild impairment tend to remain relatively stable, while those with severe impairment are at higher risk of transitioning to states that could result in mortality. A person with no disability post-ICH can expect to spend 19.42 (12.87~29.30) months in that state, and 9.99 (8.39~11.89) months in state S2 and 8.87 (7.79~10.09) months in state 3 during their lifetime.

In the year following treatment and discharge, the neurological functional disability of most patients with ICH tends to remain stable. For patients undergoing state transitions, the probability of neurological improvement is higher than the likelihood of deterioration. Risk factors associated with deterioration include advanced age, preonset neurological impairment, a history of cerebrovascular disease, larger haematoma volume, and critical conditions. Patients with these risk factors should receive close monitoring after discharge.