In recent years,immunotherapy has become an important part of the treatment for advanced non-small cell lung cancer (NSCLC).Tumor cells can escape from the body's immune system by mediating various immune escape mechanisms,among which programmed death-1/programmed death ligand-1 (PD-1/ PD-L1) mediated immune escape plays an important role.Currently,chemotherapy,radiotherapy and molecular targeted therapy have certain limitations in the treatment of advanced NSCLC.Recent studies have found that the combined application of PD-1/PD-L1 inhibitor and other treatment methods has certain synergistic effect,thus enhances the anti-tumor effect and further prolongs the survival of patients.Immunotherapy brings not only changes in the treatment patterns of NSCLC,but also challenges in the screening of target population and the management of treatment-related adverse reactions.Summarizing the research progress on immune checkpoint inhibitors in the comprehensive treatment of advanced NSCLC can provide reference for the best treatment of NSCLC.

Background:The musk glands of adult male Chinese forest musk deer(Moschus berezovskii Flerov,1929)(FMD),which are considered as special skin glands,secrete a mixture of sebum,lipids,and proteins into the musk pod.Together,these components form musk,which plays an important role in attracting females during the breeding season.However,the relationship between the musk glands and skin of Chinese FMD remains undiscovered.Here,the musk gland and skin of Chinese FMD were examined using histological analysis and RNA sequencing(RNA-seq),and the expression of key regulatory genes was evaluated to determine whether the musk gland is derived from the skin.Methods:A comparative analysis of musk gland anatomy between juvenile and adult Chinese FMD was conducted.Then,based on the anatomical structure of the musk gland,skin tissues from the abdomen and back as well as musk gland tissues were obtained from three juvenile FMD.These tissues were used for RNA-seq,hematoxylin-eosin(HE)staining,immunohistochemistry(IHC),western blot(WB),and quantitative real-time polymerase chain reaction(qRT-PCR)experiments.Results:Anatomical analysis showed that only adult male FMD had a complete glandular organ and musk pod,while juvenile FMD did not have any well-developed musk pods.Transcriptomic data revealed that 88.24%of genes were co-expressed in the skin and musk gland tissues.Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway analysis found that the genes co-expressed in the abdomen skin,back skin,and musk gland were enriched in biological development,endocrine system,lipid metabolism,and other pathways.Gene Ontology(GO)enrichment analysis indicated that the genes expressed in these tissues were enriched in biological processes such as multicellular development and cell division.Moreover,the Metascape predictive analysis tool demonstrated that genes expressed in musk glands were skin tissue-specific.qRT-PCR and WB revealed that sex-determining region Y-box protein 9(Sox9),Caveolin-1(Cav-1),and androgen receptor(AR)were expressed in all three tissues,although the expression levels differed among the tissues.According to the IHC results,Sox9 and AR were expressed in the nuclei of sebaceous gland,hair follicle,and musk gland cells,whereas Cav-1 was expressed in the cell membrane.Conclusions:The musk gland of Chinese FMD may be a derivative of skin tissue,and Sox9,Cav-1,and AR may play significant roles in musk gland development.

Objective To explore the clinical efficacy and imaging changes of minimally invasive nonsurgical peri-odontal therapy(MINST)assisted by endoscopy for deep intrabony defects and to compare its effectiveness with that of traditional scaling and root planning(SRP)to therefore provide a reference for clinical periodontal treatment.Methods Patients with deep intrabony defects ≥ 4 mm in size were selected and divided into two groups:the MINST(MINST,20 cases,81 sites)group and the classic scaling and root planing(SRP,20 cases,80 sites)group.Before treatment and 12 and 24 months after treatment,probing depth(PD)and clinical attachment loss(CAL)were examined.Moreover,changes in the depth and angle of the intrabony defects were analyzed.Follow-up examination and maintenance treat-ment should be conducted every 3 months for 12 months after the initial treatment and every 6 months thereafter until 24 months.Results The PD and CAL of patients in both groups continued to decrease(P＜0.001),and imaging examinations revealed a decrease in defect depth and an increase in intrabony defect angle(P＜0.001).The changes in the first 12 months were significantly greater than those in the last 12 months in both groups(P＜0.001).The de-creases in PD,CAL,and depth of intrabony defects and increase in angle in the MINST group were significantly greater than those in the SRP group(P＜0.001).At 12 and 24 months after treatment,the PD and CAL in the MINST group were lower than those in the SRP group(P＜0.001).The defect height of the MINST group decreased more than that of the SRP group(P＜0.001),and the defect angle of the MINST group increased more than that of the SRP group(P＜0.001).Conclusion Minimally invasive nonsurgical periodontal therapy can significantly promote the healing of deep intrabony defects and the regeneration of alveolar bone.Imaging reflects that alveolar bone healing is rapid at first and then slows.Compared with traditional SRP,endoscopically assisted MINST can yield better clinical indicators and imag-ing changes in intrabony defects.