OBJECTIVE To evaluate the efficacy and safety of immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy in the treatment of early-stage triple-negative breast cancer （TNBC）. METHODS A systematic search was conducted in PubMed， Embase， Cochrane Library， CNKI， and Wanfang Data to collect randomized controlled trials （RCT） on the use of immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy （experimental group） versus neoadjuvant chemotherapy and adjuvant chemotherapy （control group） in the treatment of TNBC. After literature screening， data extraction and literature quality evaluation， meta-analysis was performed using Stata 17.0. RESULTS A total of 5 RCT involving 1 498 patients were included. The meta-analysis results showed that the pathological complete response rate （pCR） [RR＝1.34， 95%CI （1.09， 1.63）， P＝0.03]， pCR in patients with positive programmed death-1 （PD-1） and its ligand （PD-L1） [RR＝1.33， 95%CI （1.16， 1.51）， P＝0.01]， pCR in patients with positive lymph nodes [RR＝ 1.56， 95%CI （1.27， 1.93）， P＝0.01]， the incidence of grade 3-4 adverse events （AEs） [RR＝1.07， 95%CI （1.01， 1.14）， P＝ 0.04]， the incidence of serious AEs [RR＝1.57， 95%CI （1.31， 1.87）， P＝0.03]， and the incidence of treatment discontinuation due to AEs [RR＝1.45， 95%CI （1.19， 1.76）， P＝0.01] were significantly higher in the experimental group than control group. There were no statistically significant difference in pCR in patients with negative PD-1/PD-L1[RR＝ E-mail：biejun23@126.com 1.26， 95%CI （0.98， 1.62）， P＝0.08] and pCR in patients with negative lymph nodes [RR＝1.14， 95%CI （0.97， 1.33）， P＝0.17] between the two groups. CONCLUSIONS Immune checkpoint inhibitors combined with neoadjuvant chemotherapy and adjuvant chemotherapy demonstrates significant efficacy in early-stage TNBC patients， with more pronounced benefits observed in those who are PD-1/PD-L1 positive and lymph node- positive. However， the incidence of AEs is relatively high.

Objective To analyse the effect of baseline serum vascular endothelial growth factor(VEGF)level on clinical factors,pathological features and prognosis of patients with non-triple-negative breast cancer.Methods A total of 120 patients with non-triple-negative breast cancer admitted to the hospital from January 2019 to December 2020 were selected as the study objects.According to the TNM stage of the tumor,the stud-y objects were divided into 80 patients with TNM stage Ⅰ and Ⅱ(group A)and 40 patients with TNM stageⅢ(group B).Serum VEGF levels,clinical factors and pathological features were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the optimal cut-off value of serum VEGF level in predicting stage Ⅲ breast cancer.Survival curves for overall survival and disease-free survival were plotted using the Kaplan-Meier method,and comparisons were made using the Log-rank test.The effects of baseline serum VEGF levels on overall survival and disease-free survival in non-triple-negative breast cancer were investigated by multivariate Cox regression model.Results Serum VEGF,D-dimer,fibrinogen(FIB),fi-brin degradation products(FDP),cancer antigen 125(CA-125)and cancer antigen 15-3(CA15-3)in group B were significantly different from those in group A(P＜0.05).ROC curve analysis showed that the area under the curve of serum VEGF in TNM stage Ⅲ of non-triple-negative breast cancer was 0.875,95％CI(0.802-0.948),P＜0.001.The levels of D-dimer,FIB,FDP,CA-125 and CA15-3 in serum VEGF≥180.40 pg/mL patients were higher than those in serum VEGF＜180.40pg/mL patients,and the differences were statistically significant(P＜0.05).In patients with serum VEGF＜180.40 pg/mL,the proportion of tumor T1 stage,tumor N0 and N1 stage,TNM stage Ⅰ/Ⅱ,and Luminal type A were higher than those with serum VEGF≥180.40 pg/mL patients,and the differences were statistically significant(P＜0.05).The disease-free survival rate of serum VEGF＜180.40 pg/mL patients was significantly higher than that of serum VEGF≥180.40 pg/mL patients,and the difference was statistically significant(P＜0.001).After correction,VEGF≥180.40 pg/mL was a risk factor for recurrence and metastasis of non-triple-negative breast cancer[HR=2.563,95％CI(1.772-3.708),P＜0.001].Conclusion High baseline VEGF levels are associated with progression of non-triple-negative breast cancer and are an influential factor in its prognosis.

Objective:To analyze the real clinical effects and prognosis of neoadjuvant therapy for locally advanced resectable esophageal cancer.Methods:Two hundred and one patients with locally advanced resectable esophageal cancer who underwent different neoadjuvant treatments at Nanchong Central Hospital of Sichuan Province from January 2019 to December 2021 were retrospective analyzed. Patients were divided into neoadjuvant chemoradiotherapy group ( n=87), neoadjuvant immunochemotherapy group ( n=69), and neoadjuvant chemotherapy group ( n=45) according to the different methods of neoadjuvant therapy. Patients underwent surgical treatment 4-6 weeks after completing neoadjuvant therapy. The postoperative pathological response of three groups of patients were compared. Kaplan-Meier method was used to draw survival curves. Log-rank tests were performed to analyze overall survival (OS) rate, local recurrence-free survival (LRFS) rate, and distant metastasis-free survival (DMFS) rate in three groups of patients. Results:The pathological complete response rates of the neoadjuvant chemoradiotherapy group, neoadjuvant immunochemotherapy group and neoadjuvant chemotherapy group were 33.3% (29/87), 40.6% (28/69) and 13.3% (6/45), respectively, with a statistically significant difference ( χ2=9.68, P=0.008). The pathological complete response rates in the neoadjuvant chemoradiotherapy group and neoadjuvant immunochemotherapy group were higher than that in the neoadjuvant chemotherapy group, with statistically significant differences ( χ2=6.09, P=0.014; χ2=9.66, P=0.002) ; there was no statistically significant difference between the neoadjuvant chemoradiotherapy group and the neoadjuvant immunochemotherapy group ( χ2=0.87, P=0.351). The major pathologic response rates of the three groups were 58.6% (51/87), 59.4% (41/69) and 31.1% (14/45), respectively, with a statistically significant difference ( χ2=10.89, P=0.004). The major pathologic response rates of the neoadjuvant chemoradiotherapy group and neoadjuvant immunochemotherapy group were significantly higher than that of the neoadjuvant chemotherapy group, with statistically significant differences ( χ2=8.98, P=0.003; χ2=8.74, P=0.003) ; there was no statistically significant difference between the neoadjuvant chemoradiotherapy group and the neoadjuvant immunochemotherapy group ( χ2=0.10, P=0.920). The 3-year OS rates of the three groups were 43.7%, 42.0% and 33.3%, respectively, with no statistically significant difference ( χ2=0.79, P=0.347). The 3-year LRFS rates of the three groups were 67.8%, 66.7% and 46.7%, respectively, with a statistically significant difference ( χ2=7.58, P=0.023), the LRFS rates in the neoadjuvant chemoradiotherapy group and neoadjuvant immunochemotherapy group were significantly higher than that in the neoadjuvant chemotherapy group, with statistically significant differences ( χ2=4.17, P=0.041; χ2=4.15, P=0.042) ; there was no statistically significant difference in LRFS rates between the neoadjuvant chemoradiotherapy group and the neoadjuvant immunochemotherapy group ( χ2=0.01, P=0.923). The 3-year DMFS rates of the three groups were 37.9%, 37.7% and 28.9%, respectively, with no statistically significant difference ( χ2=0.14, P=0.707) . Conclusion:Different neoadjuvant therapies have different therapeutic effects in the treatment of locally advanced resectable esophageal cancer, neoadjuvant chemoradiotherapy and neoadjuvant immunochemotherapy can achieve a better pathological response rates and LRFS rates.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

The effect of porcine SIRT5 on replication of foot and mouth disease virus type O(FMDV-O)and the underlying regulatory mechanism were investigated.Western blot and RT-qPCR analyses were employed to monitor expression of endoge-nous SIRT5 in PK-15 cells infected with FMDV-O.Three pairs of SIRT5-specific siRNAs were synthesized.Changes to SIRT5 and FMDV-O protein and transcript levels,in addition to virus copy numbers,were measured by western blot and RT-qPCR analyses.PK-15 cells were transfected with a eukaryotic SIRT5 expression plasmid.Western blot and RT-qPCR analyses were used to explore the impact of SIRT5 overexpression on FMDV-O replication.Meanwhile,RT-qPCR analysis was used to detect the effect of SIRT5 overexpression on the mRNA expression levels of type I interferon-stimulated genes induced by SeV and FMDV-O.The results showed that expression of SIRT5 was up-regulated in PK-15 cells infected with FMDV-O and siRNA interfered with SIRT5 to inhibit FMDV-O replication.SIRT5 overexpression promoted FMDV-O replication.SIRT5 over-expression decreased mRNA expression levels of interferon-stimulated genes induced by SeV and FMDV-O.These results suggest that FMDV-O infection stimulated expression of SIRT5 in PK-15 cells,while SIRT5 promoted FMDV-O rep-lication by inhibiting production of type I interferon-stimula-ted genes.These findings provide a reference to further ex-plore the mechanism underlying the ability of porcine SIRT5 to promote FMDV-O replication.

Objective To evaluate the efficacy and safety of neoadjuvant arterial interventional chemotherapy(NAIC)and neoadjuvant intravenous chemotherapy(NIVC)for the treatment of locally advanced cervical cancer(LACC).Methods Randomized controlled trials(RCTs)which fit the theme were included by searching PubMed,Web of Science,Embase,CNKI,and Wanfang databases.After study quality assessment and data extraction,statistical analysis was performed using Stata 17.0,and outcome quality was assessed using the GRADE system.Results A total of 14 RCTs were included,with 1 063 LACC patients.The results of the Meta-analysis showed that NAIC and NIVC had a positive effect on the effectiveness indicators:complete response(CR)[RR=1.23,95％CI(0.91,1.67),P=0.174],partial response(PR)[RR=1.10,95％CI(0.86,1.20),P=0.874],total response(TR)[RR=1.10,95％CI(0.95,1.25),P=0.212],no change(NC)[RR=0.62,95％CI(0.33,1.16),P=0.137]and progressive disease(PD)[RR=1.43,95％CI(0.41,4.99),P=0.574]were not statistically significant.Differences in safety indicators:gastrointestinal reactions[RR=0.96,95％CI(0.76,1.23),P=0.755],hepatic and renal impairment[RR=0.71,95％CI(0.41,1.23),P=0.226]were not statistically significant.While in the incidence of myelosuppression[RR=0.62,95％CI(0.45,0.86),P=0.04],NAIC was superior to NIVC.In addition,the GRADE score results showed CR,PR,TR,and NC were high-quality evidence.Conclusion For LACC patients,the incidence of myelosuppression after treatment with NAIV is lower and safer than that with NIVC,and no significant difference was found between the two in terms of other efficacy and safety indicators.Clinicians should choose the appropriate neoadjuvant chemotherapy regimen based on a comprehensive assessment of the patient's actual condition.

Patrinia villosa, regarding its functions in clearing heat and detoxification and eliminating carbuncles and pus, is widely used as a traditional medicinal herb that contains rich nutrition and substances such as various amino acids, vitamins, and soluble su-gar, and it is also an edible wild herb in Chinese folk tradition for 2 000 years. In 1973, Japanese scholars firstly separated three iridoids from Japanese P. villosa, and by 2021, chemical components such as flavonoids, iridoids, organic acids, triterpenoids, phenylpropanoids, and steroids have been found, which have multiple pharmacological effects, including antioxidant, antitumor, anti-diarrhea, antibacterial, sedative, and liver protection capabilities. Studies indicate that flavonoids, saponins, phenylpropanoids, and triterpenoids in P. villosa are vital substances for its pharmacological activities. However, the quality of this medicinal material cannot be controlled due to the unclear records in ancient books in the past dynasties and different drug use habits in different places, and thus its circulation is chaotic. At present, researchers have used flavonoids, organic acids, phenylpropanoids, triterpenoid saponins, and other compounds to conduct studies in this regard. Therefore, on the basis of the existing literature resources, we comprehensively summarize the chemical constituents, pharmacological activities, and quality control of P. villosa to further provide a reference for the safety and effectiveness of clinical drug use and lay a foundation for the follow-up experimental research.
Patrinia/chemistry* ; Flavonoids/pharmacology* ; Saponins ; Triterpenes/pharmacology* ; Iridoids ; Quality Control

Objective To evaluate the efficacy and safety of fully covered self-expandable metal stents (FCSEMS) implanted by endoscopic retrograde cholangiopancreatography (ERCP) for patients with benign biliary stricture (BBS).Methods The clinical data of 38 patients with BBS underwent ERCP and FCSEMS placement between January 2012 and January 2016 were retrospectively recorded.Success rate of BBS,adverse events related to ERCP and stricture recurrence were analyzed.Results A total of 38 patients underwent FCSEMS placement with a mean time of stent in dwelling for 8 months (range:3-13months).During follow-up after the stent was removed,death of 1 patient after liver transplantation was due to unrelated cause.The mean follow-up time was 13 months (range:2-52 months) for other patients.Stricture recurrence occurred in 6 patients,including 2 cases of gallstone-related biliary strictures,1 case of chronic pancreatitis-related biliary strictures,2 cases of liver transplantation-related biliary strictures,and 1 case of post surgical-related biliary strictures.Stricture resolution occurred in 31 cases with 83.8％ (31/37) success rate,including 90.0％ (18/20) gallstone-related biliary strictures,75.0％ (3/4) chronic pancreatitis-related biliary strictures,80.0％ (8/10) liver transplantation-related biliary strictures,and 66.7％ (2/3)post surgical-related biliary strictures.The incidence of post-ERCP complications was 21.1％ (8/38),including mild pancreatitis in 5 case,hyperamylasemia in 2 cases,cholangitis in 1 case.All patients were cured by conservative treatment.Conclusion FCSEMS are effective and safe for BBS.Further studies are needed to assess the indwelling time of FCSEMS,whether FCSEMS are superior to multiple plastic stents and the different efficacy of FCSEMS for BBS caused by different etiology.

Objective To investigate the expression of interleukin-6(IL-6),high mobility group protein B1 (HMGB1)and Survivin in patients with gastrointestinal stromal tumors (GISTs)and the relationship between them.Methods 43 patients with GISTs and 30 healthy controls from Jan.2009 to Dec.2012 in Nanchong Central Hospital was enrolled.Expressions of IL-6,HMGB1 and Survivin in serum were assessed with enzyme linked immunosorbent assay(ELISA) and the correlation among IL-6,HMGB1 and Survivin was analyzed.Results The serum levels of IL-6,HMGB1 and Survivin in patients with GISTs((0.61 ±0.05)ng/ml,(3.54 ±0.74) ng/ml,(0.15 ± 0.04)ng/ml,respectively)were higher those that in the healthy controls((0.32 ± 0.03)ng/ml,(1.81 ± 0.06)ng/ml,(0.07 ±0.02)ng/ml,respectively).Among the 43 GISTs,the expressions of IL-6,HMGB1 and Survivin in benign,potentially malignant and malignant group increased gradually.The expressions of IL-6 in each group were (0.55 ± 0.02) ng/ml,(0.59 ± 0.02) ng/ml,(0.64 ± 0.03) ng/ml,respectively,The expressions of HMGB1 in each group were (2.82 ± 0.55) ng/ml,(3.46 ± 0.16) ng/ml,(4.00 ± 0.61) ng/ml,respectively.The expressions of Survivin in each group were (0.10 ± 0.01) ng/ml,(0.15 ± 0.02) ng/ml,(0.18 ± 0.03) ng/ml,respectively.Expressions of IL-6 and HMGB1,IL-6 and Survivin,and HMGB1 and Survivin were positively correlated(r =0.699,P ＜0.05;r =0.774,P ＜0.05;r =0.595,P ＜0.05,respectively).Conclusion The high expression of IL-6,HMGB1 and Survivin may together contribute to the malignancy,invasion and metastasis of GIST.Detection of these three markers may be useful in judging the malignancy degree and predicting the prognosis of GIST.

Objective To observe the efficacy of medical invisible antimicrobial film to treat Ⅱ/Ⅲpressure sores .Methods Sixty patients who were infected stage Ⅱand stage Ⅲ of pressure ulcer were divided into two equal groups-treatment group and control group .After usual wound treatment , the patients in treatment group were given medical invisible antimicrobial film; while the patients in control group were used for Mabel score stickers.Results The total efficacy of the two groups was 29 cases (Z=-0.565, P>0.05).The treatment time for stage Ⅱand stage Ⅲ pressure ulcers of experimental group were (4.05 ±1.89) days and (8.73 ±1.60) days, respectively.As for control group, the treatment time of stage Ⅱand stage Ⅲ pressure ulcers were (7.89 ±1.99) days and (15.75 ±2.18) days, respectively.The differences were statistically significant (t=-5.740, -8.243; P<0.01).The frequency of changing fresh dressing for a wound was (5.82 ±1.24) times in the treatment group and (9.97 ±2.58) times in the control group, and the difference was significant ( t =-6.396, P <0.01 ).The treatment cost of experimental group was ( 184.21 ± 21.49) yuan, which was significantly lower than (491.41 ±79.92) yuan in the control group (t=-29.972, P<0.01).Conclusions The effect of medical invisible antimicrobial film treatment of pressure sores is significant, and the treatment course is shorter with lower cost.It is worthy of enhancing in the clinical situations.