Objective:To compare the clinical efficacy and safety of bronchial artery chemoembolization (BACE) combined with anlotinib (BACE+A) versus BACE alone in patients with stage III-IV non-small cell lung cancer (NSCLC).Methods:A total of 94 patients with advanced NSCLC treated at six interventional centers between November 2020 and November 2021 were retrospectively enrolled. Patients were divided into the BACE+A group ( n=46) and the BACE alone group ( n=48) based on treatment regimen. Baseline and perioperative clinical data were collected and compared between the two groups. Treatment response was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 1, 6, and 12 months after the first BACE procedure. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs) were recorded. Kaplan-Meier survival curves were plotted to compare median OS and PFS between groups. Cox proportional hazards regression analysis was used to identify factors influencing OS and PFS. Results:The Kaplan-Meier analysis showed that the median OS was significantly longer in the BACE+A group (18.8 months, 95% CI 16.3-21.3) than in the BACE group (13.4 months, 95% CI 11.6-15.2) ( P=0.001). The median PFS was also significantly longer in the BACE+A group (9.0 months, 95% CI 7.3-10.7) compared to the BACE group (6.1 months, 95% CI 4.9-7.3) ( P=0.001). At 6 and 12 months post-first BACE, the ORR (43.5%, 40.0%) and DCR (89.1%, 83.3%) were significantly higher in the BACE+A group than in the BACE group (ORR: 20.8%, 14.8%; DCR: 66.7%, 59.3%) (all P<0.05). Multivariate Cox regression identified treatment with BACE+A ( HR=0.42, 95% CI 0.27-0.72, P=0.002), tumor stage ( HR=1.80, 95% CI 1.05-3.07, P=0.031), presence of pre-existing complications requiring intervention ( HR=2.72, 95% CI 1.65-4.50, P<0.001), and >2 BACE procedures ( HR=0.32, 95% CI 0.15-0.68, P=0.003) as independent factors influencing OS. Treatment with BACE+A ( HR=0.49, 95% CI 0.32-0.76, P=0.001), tumor stage ( HR=1.72, 95% CI 1.07-2.77, P=0.025), multi-arterial tumor blood supply ( HR=2.76, 95% CI 1.76-4.31, P<0.001), and>2 BACE procedures ( HR=0.40, 95% CI 0.22-0.71, P=0.002) were independent factors influencing PFS. There was no significant difference in BACE-related adverse events between the two groups (all P>0.05). Hypertension, fatigue, hand-foot syndrome, and anorexia were common anlotinib-specific adverse reactions in the combination group, but no grade 4 or higher adverse reactions were observed. Conclusions:BACE combined with anlotinib demonstrates superior efficacy compared to BACE alone in treating advanced NSCLC, significantly prolonging OS and PFS. The safety profile is manageable, with adverse events remaining within tolerable limits.

Objective To investigate the diagnostic value of plasma short stature homeobox 2(SHOX2),Ras association domain family 1A(RASSF1A)and prostaglandin E receptor 4(PTGER4)gene methylation detection combined with low-dose CT(LDCT)for malignant pulmonary nodules.Methods A total of 153 hospitalized patients with pulmonary nodules scheduled for surgi-cal treatment were selected as study subjects.The Ct values of the target genes SHOX2,RASSF1A,PTGER4 and the internal reference gene ACTB in the patients' plasma were detected,and the ΔCt values(ΔCttarget gene-Ctinternal reference gene)and the three-gene fitting positive index(PI)of each gene were further calculated.The sensitivity and specificity of ΔCt values and the three-gene fitting PI as methylation-positive diagnostic criteria for malignant pulmonary nodules were analyzed.Receiver op-erating characteristic(ROC)curves were plotted to evaluate the diagnostic value of LDCT combined with gene methylation detection for malignant pulmonary nodules.Results According to the pathological results,the patients were divided into benign pulmonary nodule group(47 cases)and malignant nodule group(106 cases).The sensitivity and specificity of the three-gene fitting PI for diagnosing malig-nant pulmonary nodules were 58.49％and 70.21％,respectively.The sensitivities of ΔCtSHOX2,ΔCtRASSF1A and ΔCtPTGER4 values for diagnosing malignant pulmonary nodules alone and their combina-tion were 33.96％,43.40％,49.06％and 75.47％,respectively,and the specificities were 87.23％,72.34％,80.85％and 100.00％,respectively.Compared with the three-gene fitting PI,ΔCt values were more suitable for the differential diagnosis of benign and malignant pulmonary nodules.Based on the pathological diagnosis results,there was a statistically significant difference in the positive rates of malignant pulmonary nodules between LDCT diagnosis and gene methylation combined with LDCT diagnosis(P＜0.001).ROC curve analysis showed that the areas under the curves(AUCs)for diagnosing malignant pulmonary nodules using plasma SHOX2,RASSF1A,PTGER4 gene methylation ΔCt values,LDCT alone,and their combination were 0.604,0.582,0.629,0.668 and 0.981,respectively.The diagnostic value of the combined indicators was higher than that of single indicators.Conclusion LDCT combined with plasma SHOX2,RASSF1A,PTGER4 gene methylation detection has high diagnostic efficacy for malignant pulmonary nodules and can significantly reduce the false-positive rate of LDCT in early screening of lung cancer.

Objective : To explore the molecular mechanism of long non-coding RNA metastasis associated lung ad- enocarcinoma transcript 1 (MALAT1) / microRNA-15b-5p (miR-15b-5p) regulating the Wnt / β-catenin pathway in lipopolysaccharide (LPS) -induced chondrocyte injury in osteoarthritis． Methods : TDC5 cells were treated with 5 mg / L LPS to establish the osteoarthritis cell injury model，and the expression levels of MALAT1 and miR-15b-5p in the cells were detected by RT-qPCR. The MTT，flow cytometry，Alizarin red staining，and ELISA were used to as- sess the effects of MALAT1 and miR-15b-5p on LPS-induced chondrocyte injury．The dual-luciferase reporter gene assay was used to examine the regulatory relationship between MALAT1 and miR-15b-5p．Western blot assay was used to evaluate the expression of relevant proteins． Results : In LPS-induced ATDC5 cells，MALAT1 expression decreased (P＜0. 05) ．Compared to the control group，the LPS group exhibited reduced cell activity，an increased apoptosis rate，elevated levels of tumor necrosis factor-α , interleukin-6，and interleukin-1 β , a higher number of calcified nodules，increased expression levels of extracellular matrix degradation-related proteins MMP13 and AD- AMTS5，decreased expression levels of Collagen Ⅱ and Aggrecan，and increased protein expression levels of Wnt1 and β-catenin (P＜0. 05) ．Overexpression of MALAT1 could mitigate the effects of LPS on chondrocyte activity， apoptosis，inflammatory response，osteogenic differentiation，extracellular matrix degradation，and the Wnt / β-cate- nin pathway (P＜0. 05) ．Additionally，the overexpression of miR-15b-5p enhanced the impact of LPS on chondro- cytes (P＜0. 05) ． Conclusion MALAT1 is lowly expressed in LPS-induced chondrocytes，and it alleviates LPS- induced chondrocyte injury by targeting miR-15b-5p to inhibit the Wnt / β-catenin pathway．

Objective:To compare the clinical efficacy and safety of bronchial artery chemoembolization (BACE) combined with anlotinib (BACE+A) versus BACE alone in patients with stage III-IV non-small cell lung cancer (NSCLC).Methods:A total of 94 patients with advanced NSCLC treated at six interventional centers between November 2020 and November 2021 were retrospectively enrolled. Patients were divided into the BACE+A group ( n=46) and the BACE alone group ( n=48) based on treatment regimen. Baseline and perioperative clinical data were collected and compared between the two groups. Treatment response was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at 1, 6, and 12 months after the first BACE procedure. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs) were recorded. Kaplan-Meier survival curves were plotted to compare median OS and PFS between groups. Cox proportional hazards regression analysis was used to identify factors influencing OS and PFS. Results:The Kaplan-Meier analysis showed that the median OS was significantly longer in the BACE+A group (18.8 months, 95% CI 16.3-21.3) than in the BACE group (13.4 months, 95% CI 11.6-15.2) ( P=0.001). The median PFS was also significantly longer in the BACE+A group (9.0 months, 95% CI 7.3-10.7) compared to the BACE group (6.1 months, 95% CI 4.9-7.3) ( P=0.001). At 6 and 12 months post-first BACE, the ORR (43.5%, 40.0%) and DCR (89.1%, 83.3%) were significantly higher in the BACE+A group than in the BACE group (ORR: 20.8%, 14.8%; DCR: 66.7%, 59.3%) (all P<0.05). Multivariate Cox regression identified treatment with BACE+A ( HR=0.42, 95% CI 0.27-0.72, P=0.002), tumor stage ( HR=1.80, 95% CI 1.05-3.07, P=0.031), presence of pre-existing complications requiring intervention ( HR=2.72, 95% CI 1.65-4.50, P<0.001), and >2 BACE procedures ( HR=0.32, 95% CI 0.15-0.68, P=0.003) as independent factors influencing OS. Treatment with BACE+A ( HR=0.49, 95% CI 0.32-0.76, P=0.001), tumor stage ( HR=1.72, 95% CI 1.07-2.77, P=0.025), multi-arterial tumor blood supply ( HR=2.76, 95% CI 1.76-4.31, P<0.001), and>2 BACE procedures ( HR=0.40, 95% CI 0.22-0.71, P=0.002) were independent factors influencing PFS. There was no significant difference in BACE-related adverse events between the two groups (all P>0.05). Hypertension, fatigue, hand-foot syndrome, and anorexia were common anlotinib-specific adverse reactions in the combination group, but no grade 4 or higher adverse reactions were observed. Conclusions:BACE combined with anlotinib demonstrates superior efficacy compared to BACE alone in treating advanced NSCLC, significantly prolonging OS and PFS. The safety profile is manageable, with adverse events remaining within tolerable limits.

There are a large number of individuals with HBV infection in China, which seriously endangers public health safety. As a first-line drug used in clinical practice, tenofovir alafenamide fumarate (TAF) has the characteristics of strong efficacy, low drug resistance, and bone and kidney safety. This article summarizes the role of TAF in patients with special types of chronic hepatitis B, such as low-level viremia, multidrug resistance, pregnancy, liver failure, and liver transplantation, and the analysis shows that TAF can reduce viral load in patients with low-level viremia to achieve virologic response, provide new regimens for patients with drug resistance, block mother-to-child transmission, reduce the mortality rate of patients with end-stage liver disease, and improve renal function in patients with chronic kidney disease.

Objective　To study the value of mean platelet volume/platelet ratio (MPV/PLT) in evaluating the severity and prognosis of acute cerebral infarction (ACI).Methods　One hundred and twenty-eight patients with ACI treated in our hospital from January 2019 to December 2020 were divided into mild group with NIHSS score (n=72) and moderate as well as severe group with NIHSS score>5 (n=56).The differences of clinical data between the two groups were compared.The prognosis was evaluated according to the modified Rankin Scale (mRS) at 3 months after discharge.mRS 0~3 was good prognosis and mRS 3~6 was poor prognosis.Results　The levels of MPV and MPV/PLT of ACI patients in moderate and severe group were higher than those of mild group (P<0.05).The levels of MPV and MPV/PLT of ACI patients with poor prognosis were higher than those in patients with good prognosis (P<0.05).By ROC curve analysis,MPV level and MPV/PLT level had evaluation value for the severity and prognosis of ACI patients.The sensitivity and specificity of MPV/PLT evaluation were better than MPV.Conclusion　MPV/PLT is valuable in evaluating the severity and prognosis of ACI patients.

Objective    To evaluate the effectiveness of the artificial intelligence-assisted diagnosis and treatment system in distinguishing benign and malignant lung nodules and the infiltration degree. Methods    Clinical data of 87 patients with pulmonary nodules admitted to the First Affiliated Hospital of Xiamen University from January 2019 to August 2020 were retrospectively analyzed, including 33 males aged 55.1±10.4 years, and 54 females aged 54.5±14.1 years. A total of 90 nodules were included, which were divided into a malignant tumor group (n=80) and a benign lesion group (n=10), and the malignant tumor group was subdivided into an invasive adenocarcinoma group (n=60) and a non-invasive adenocarcinoma group (n=20). The malignant probability and doubling time of each group were compared and its ability to predict the benign and malignant nodules and the invasion degree was analyzed. Results    Between the malignant tumor group and the benign lesion group, the malignant probability was significantly different, and the malignant probability could better distinguish malignant nodules and benign lesions (87.2%±9.1% vs. 28.8%±29.0%, P=0.000). The area under the curve (AUC) was 0.949. The maximum diameter of nodules in the benign lesion group was significantly longer than that in the malignant tumor group (1.270±0.481 cm vs. 0.990±0.361 cm, P=0.026); the doubling time of benign lesions was significantly longer than that of malignant nodules (1 083.600±258.180 d vs. 527.025±173.176 d, P=0.000), and the AUC was 0.975. The maximum diameter of the nodule in the invasive adenocarcinoma group was longer than that of the non-invasive adenocarcinoma group (1.350±0.355 cm vs. 0.863±0.271 cm, P=0.000), and there was no statistical difference in the probability of malignancy between the invasive adenocarcinoma group and the non-invasive adenocarcinoma group (89.7%±5.7% vs. 86.4%±9.9%, P=0.082). The AUC was 0.630. The doubling time of the invasive adenocarcinoma group was significantly shorter than that of the non-invasive adenocarcinoma group (392.200±138.050 d vs. 571.967±160.633 d, P=0.000), and the AUC was 0.829. Conclusion    The malignant probability and doubling time of lung nodules calculated by the artificial intelligence-assisted diagnosis and treatment system can be used in the assessment of the preoperative benign and malignant lung nodules and the infiltration degree.

Objective　To analyze the influence of regular unpaid blood donation on the risk factors of cardiovascular and cerebrovascular diseases.Methods　In blood donation files from January 2010 to January 2020,a health survey was conducted on 1000 regular unpaid blood donors aged 45~55，the data of hyperlipidemia,diabetes and hypertension were collected，and compared with those from non-blood donors.Results　The incidence of hyperlipidemia,diabetes and hypertension in regular unpaid blood donors was lower than that in non-donors (P<0.05),and the incidence of regular unpaid blood donors decreased in people who donated more blood donation volume.Conclusion　Regular unpaid blood donation can reduce the incidence of diabetes,hypertension and hyperlipidemia and prevent cardiovascular and cerebrovascular diseases.

Objective　To investigate the efficacy of tirofiban on transient ischemic attack with high risk of recurrence.Methods　156 patients with non-cardiogenic transient ischemic attack with ABCD2 score ≥ 4 points were hospitalized at the Department of Neurology,Sinopharm Tongmei General Hospital from Jan 2019 to Mar 2021.Eight patients were excluded due to incomplete data or drop-off from follow-up.The remaining 148 patients were randomly divided into two groups,78 in the observation group and 70 in the control group.The observation group was given tirofiban treatment (loading tirofiban via a micropump,and continuous intravenous pumping for 48 hours) and intensive lipid-lowering therapy.The control group was given intensive anti-platelet aggregation therapy with Aspirin enteric-coated tablets,hydroclopidogre and intensive lipid-lowering therapy.We made a comparative analysis between two groups about efficacy,safety and short-term stroke incidence.Results　In the observation group,57 cases were cured,14 cases were effective,and 7 cases were ineffective;6 cases (7.69%) had a stroke (cerebral infarction) within 7 days,7 cases (8.97%) had a stroke within 30 days,and 7 cases (8.97%) had a stroke within 90 days.In the control group,39 cases were markedly effective,15 cases were effective,and 16 cases were ineffective;in the control group,13 cases (18.57%) had a stroke (cerebral infarction) within 7 days,15 cases (21.43%) had a stroke within 30 days,16 cases (22.86%) had a stroke within 90 days.No intracerebral hemorrhage occurred in either group within 90 days.The two groups had statistical significance in terms of effective treatment rate (P<0.05).However,there was no significant difference in the number of stroke cases between the observation group and the control group in the short-term 7 days,30 days,and 90 days (P>0.05).There was no significant difference in coagulation,platelet,liver and kidney function between the two groups after 48 hours of treatment (P>0.05).Conclusion　For patients with transient ischemic attack at high risk of recurrence,tirofiban treatment can effectively control TIA attacks,but it cannot reduce the risk of stroke.

Objective　To study the correlation of NLRP3 with inflammatory factors and neurological function recovery in acute ischemic stroke (AIS) patients.Methods　Seventy-one AIS patients were enrolled,blood samples were collected at 3~72 hours after stroke onset.The mRNA levels of NLRP3 were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR).Serum levels of inflammatory cytokines IL-6,IL-1β and TNF-α were detected by ELISA.The modified RanKin sore (mRS) was used to evaluate the recovery of AIS patients 3 months after stroke onset.Thirty-eight healthy normal people were recruited as a controls,blood samples were collected during recruitment.Results　The mRNA levels of NLRP3 in the blood of AIS patients were significantly higher than thos normal control group (P<0.05).Conclusion　Analysis showed that the NLRP3 mRNA levels were positively correlated with the mRS score (r=0.357,P=0.002).In addition,the levels of inflammation-related IL-1β,IL-6,and TNF-α in AIS patients were significantly higher than those in the normal control group,with P<0.05.The mRNA expression of NLRP3 was positively correlated with the levels of inflammatory factor IL-1β(r=0.31,P=0.016),but not significantly correlated with IL-6 (r=0.07,P=0.751) and TNF-α (r=0.14,P=0.186).The prognosis of AIS patients with higher levels of NLRP3 expression in the blood is worse.In addition,the inflammatory factor IL-1β mediates the pathogenesis of NLRP3.