6. Induction of labour versus standard care to prevent shoulder dystocia in fetuses suspected to be large for gestational age in the UK (the Big Baby trial): a multicentre, open-label, randomised controlled trial.
作者: Jason Gardosi.;Lauren Jade Ewington.;Katie Booth.;Debra Bick.;George Bouliotis.;Emily Butler.;Sanjeev Deshpande.;Hanna Ellson.;Joanne Fisher.;Adam Gornall.;Ranjit Lall.;Hema Mistry.;Seyran Naghdi.;Stavros Petrou.;Anne-Marie Slowther.;Sara Wood.;Martin Underwood.;Siobhan Quenby.
来源: Lancet. 2025年
The benefits and harms of early induction of labour to reduce shoulder dystocia in fetuses suspected to be large for gestational age (LGA) are uncertain. We aimed to investigate whether early induction of labour is associated with a reduced risk of shoulder dystocia compared with standard care.
8. Gastric cancer.
作者: Raghav Sundar.;Izuma Nakayama.;Sheraz R Markar.;Kohei Shitara.;Hanneke W M van Laarhoven.;Yelena Y Janjigian.;Elizabeth C Smyth.
来源: Lancet. 2025年
Gastric cancer remains a major health challenge worldwide, with nearly 1 million new cases annually contributing to more than 650 000 deaths. Epidemiologically, gastric cancer shows substantial geographical variation in incidence, with higher rates in Asia, South America, and eastern Europe, and a rapid increase in early-onset cases among people younger than 50 years. Key risk factors for gastric cancer include Helicobacter pylori infection, diet, obesity, smoking, and genetic predisposition. Early detection through comprehensive diagnostic procedures is crucial for optimising treatment outcomes. Standard treatment approaches for locally advanced gastric cancer include surgical resection, particularly D2 lymphadenectomy, complemented by chemotherapy and radiotherapy. There is increasing implementation of minimally invasive surgical techniques for operable disease and integration of immune checkpoint inhibitors and targeted therapies for advanced stages. Emerging therapies, such as novel targeted treatments and next-generation immunotherapies, show promise in improving survival and quality of life. Future directions in the management of gastric cancer focus on precision medicine, continued advancement in immunotherapy, novel early detection methods, and a multidisciplinary approach to care. These strategies aim to enhance the overall effectiveness of treatment and prognosis worldwide.
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