Overactive bladder (OAB) is a common condition, affecting approximately one-fifth to one-sixth of the world’s population. The American Urological Association and the Society of Urodynamics, Female Pelvic Medicine and Genitourinary Reconstruction guidelines recommend sacral neuromodulation (SNM) as third-line treatment. Although SNM can relieve the symptoms of refractory OAB, several factors, including high cost and the high incidence of adverse effects, limit its large-scale clinical use. Moreover, patient acceptance is low. Acupuncture is an alternative approach for treating OAB that is minimally invasive and has few side effects. Clinical studies have shown that it can reduce the number of episodes of urination and urgent urination within 24 hours and improve the quality of life. However, clinical evidence on the effectiveness of electroacupuncture for treating refractory OAB is limited.

Is to assess the short-term effectiveness of electroacupuncture for improving the symptoms and quality of life of women with refractory OAB and to observe its long-term effects. A secondary objective is to assess whether electroacupuncture is more effective than conventional acupuncture for treating patients with refractory OAB.

The study is designed as a two-arm, parallel, participant-blinded randomised controlled trial (RCT). A total of 60 women between the ages of 18 years and 60 years who are experiencing refractory OAB will be randomly assigned to two groups: one receiving electroacupuncture and the other receiving conventional acupuncture. Each participant will undergo a treatment regimen lasting 4 weeks. During the initial 2 weeks, participants will receive five sessions of either electroacupuncture or conventional acupuncture per week, followed by three sessions per week during the subsequent 2 weeks. In total, each individual will receive 16 treatment sessions throughout the course of the study. The primary outcome measure will be the change in OAB Symptom Score (OABSS) over time between groups. The secondary outcome measures will include the OABSS, the Patient-Perceived Bladder Symptom Grading Scale, the Overactive Bladder Questionnaire, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale during the treatment and follow-up periods. Blinding and safety will also be assessed. Two-sided p values

The study protocol was approved by the Institutional Review Board of Beijing Fengtai Hospital of Integrated Traditional and Western Medicine on 5 February 2024 (Approval No. 2024020101). The results will be disseminated through presentations at scientific conferences and peer-reviewed publications.

ChiCTR2400081448.

As the field of radiation oncology continues to evolve with rapidly advancing technologies, the need for innovative educational methods is critical. Extended reality (XR) technologies—including virtual reality, augmented reality and mixed reality—have emerged as transformative tools in medical education. While the potential of XR in healthcare education is recognised, there is a lack of comprehensive exploration specifically in the context of radiation oncology education. This scoping review aims to map the existing literature on XR technologies in radiation oncology training and education, identify barriers to their adoption and highlight opportunities for broader integration into curricula.

This scoping review will follow the Arksey and O'Malley framework with enhancements by Levac et al and will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search will be conducted across databases, including MEDLINE, Scopus and Web of Science, to identify relevant studies on the use of XR technologies in radiation oncology education. Studies will be selected based on predetermined inclusion criteria using the population, concept, context framework. Data extraction will focus on the types of XR technologies used, educational settings, learning outcomes, barriers to adoption and methodologies for evaluating XR effectiveness. The results will be synthesised through descriptive statistics and qualitative thematic analysis. A consultation phase will engage experts to refine findings and ensure the practical relevance of the review.

This protocol does not require ethics approval at the current stage as it involves a scoping review of publicly available literature. Ethics approval will be obtained prior to initiating the consultation phase involving experts. Written informed consent will be obtained from all individual participants included in the study. The study will be conducted in accordance with relevant guidelines and regulations and was approved by the Chang Gung Medical Foundation Institutional Review Board on 13 May 2025 (ref.: 202500731B0). The findings of this review will be disseminated through peer-reviewed publications, conference presentations and tailored executive summaries aimed at educators, policymakers and stakeholders in radiation oncology education.

Immunotherapy has revolutionised cancer treatment. Immune checkpoint inhibitors have demonstrated significant efficacy across multiple tumour types, including gastric cancer, where several approved programmed cell death 1/programmed cell death-ligand 1 (PD-1/PD-L1) inhibitors show promising antitumour activity. While PD-L1 expression serves as a predictive biomarker for PD-1 inhibitor response, and PD-L1-positive patients generally show better outcomes, therapeutic resistance remains a challenge. Many initial responders eventually develop resistance, and surprisingly, some PD-L1-positive patients fail to achieve expected response rates, indicating emerging resistance mechanisms in potentially responsive populations. Adebrelimab, a PD-L1 inhibitor, demonstrates mechanistic advantages over PD-1 inhibitors, with clinical studies suggesting promising therapeutic potential. When combined with irinotecan, apatinib has shown efficacy in second-line gastric cancer treatment. This study aims to evaluate the efficacy and safety of combining adebrelimab with apatinib and irinotecan for advanced gastric cancer refractory to PD-1 inhibitors.

This single-arm, single-centre exploratory trial will be conducted at Renji Hospital, enrolling 32 patients aged 18–75 years. Eligible patients must have initially achieved partial response, complete response or stable disease with progression-free survival (PFS)≥3 months during prior immunotherapy but subsequently progressive disease on imaging. Treatment will continue until meeting discontinuation criteria. The primary endpoint is objective response rate with Clopper-Pearson 95% CI. Secondary endpoints include disease control rate (95% CI), PFS and overall survival (estimated by Kaplan-Meier method), along with safety assessments.

All participants will provide informed consent. The protocol has been approved by the Shanghai Jiaotong University School of Medicine, Renji Hospital Ethics Committee (LY2023-201-C). The results will be disseminated through peer-reviewed manuscripts, reports and presentations.

ChiCTR2300077329.

To update our previous systematic review to synthesise latest data on the prevalence of long-term pain in patients who underwent total hip replacement (THR) or total knee replacement (TKR). We aim to describe the prevalence estimates and trends in this review.

Systematic review and meta-analysis.

Update searches were conducted in MEDLINE and Embase databases from 1 January 2011 to 17 February 2024. Citation tracking was used to identify additional studies.

We included prospective cohort studies reporting long-term pain after THR or TKR at 3, 6, 12 and 24 months postoperative.

Two reviewers independently identified studies as eligible. One reviewer conducted data extraction, checked by a second reviewer. The risk of bias assessment was performed using Hoy’s checklist. Bayesian, random-effects meta-analysis was used to synthesise the results.

For TKR, 68 studies with 89 time points, including 598 498 patients, were included. Multivariate meta-analysis showed a general decrease in pain proportions over time: 21.9% (95% CrI 15.6% to 29.4%) at 3 months, 14.1% (10.9% to 17.9%) at 6 months, 12.6% (9.9% to 15.9%) at 12 months and 14.6% (9.5% to 22.4%) at 24 months. Considerable heterogeneity, unrelated to examined moderators, was indicated by substantial prediction intervals in the univariate models. Substantial loss to follow-up and risk of bias led to low confidence in the results. For THR, only 11 studies were included, so it was not possible to describe the trend. Univariate meta-analysis estimated 13.8% (8.5% to 20.1%) and 13.7% (4.8% to 31.0%) of patients experiencing long-term pain 6 and 12 months after THR, respectively, though concerns in risk of bias results reduced confidence in these findings.

Our review suggests that approximately 22% of patients report pain 3 months post-TKR, with 12%–15% experiencing long-term pain up to 2 years. At least 14% report pain 6–12 months after THR. Given the prevalence of chronic postsurgical pain, implementing existing and developing new preventive and management strategies is crucial for optimal patient outcomes.

CRD42023475498.