Objective To systematically evaluate the efficacy and safety of nivolumab in the treatment of non-small cell lung cancer.Methods PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),Weipu Chinese Science and Technology Journal Database,Wanfang Medical Database were searched for articles published from the establishment of the database to March 2023.Published randomized controlled clirical trials of nivolumab in the treatment of patients with non-small cell lung cancer were selected,overall survival,progression-free survival,and adverse reaction rate as outcome indicators were used.A meta-analysis using STATA version 13.1 statistical software was conducted.Results A total of 8 phase Ⅲrandomized controlled trials involving 4 945 subjects were included.Compared with the traditional chemotherapy group,patients in the nivolumab group had significantly reduced risk of death in terms of overall survival(HR=0.73,95%CI=0.65-0.82,P<0.05),and in terms of progression-free survival,nivolumab significantly reduced the risk of recurrence compared with the traditional chemotherapy group(HR=0.74,95%CI=0.63-0.88,P<0.05).In terms of safety,there was no significant difference between the nivolumab group and the traditional chemotherapy group for diarrhea,but the incidence of nausea,neutropenia,anemia,decreased appetite,and fatigue in the nivolumab group was lower than that in the traditional chemotherapy group.However,it should be worth noting that the incidence of immune-related adverse events such as rash was higher in the nivolumab group than in the traditional chemotherapy group,and the difference was statistically significant(OR=3.85,95%CI=2.05-6.25,P<0.05).Conclusion Compared to traditional chemotherapy,the efficacy and safety of nivolumab in the treatment of non-small cell lung cancer were better,but the risk of immune-related adverse events increased.

Objective To explore the accuracy and influencing factors of contrast-enhanced spectral mammography(CESM)and MRI in the dimension measurement of breast lesions.Methods A retrospective analysis was performed on 104 patients with breast lesions who underwent CESM and MRI examinations within one week.The pathological size was used as the gold standard to com-pare the accuracy of the two measurement methods.Logistic regression analysis was used to compare the influencing factors of the measurement accuracy of CESM and MRI.Results The measured values of CESM,MRI and pathology were 1.70 cm(1.20-2.70 cm),1.65 cm(1.20-2.28 cm),1.75 cm(1.00-2.50 cm),respectively,and there were no statistically significant differences between the two measurement methods and the pathological results(P＞0.05).Bland-Altman plot analysis showed that 95.2％(99/104)of the differences in CESM fell within the consistency interval,and 93.3％(97/104)of the differences in MRI fell within the consistency interval.Logistic regression analysis showed that the independent risk factors affecting the accuracy of CESM and MRI measurement were lesion size and enhancement type.Conclusion Both CESM and MRI show good accuracy.As a potential alternative to MRI technology,CESM can be used for imaging evaluation of breast lesion size.

Objective:To investigate the clinical efficacy of the Guanxinning tablet on the prethrombotic state in older adults with stable angina pectoris.Methods:In this study, 80 elderly patients with coronary heart disease and blood stasis admitted to our hospital between December 2019 and December 2021 were selected as the study subjects, and were randomly divided into a control group and an observation group(40 cases each). The control group was treated with Aspirin alone, and the observation group was treated with the Guanxinning tablet in addition to aspirin.Differences in traditional Chinese medicine(TCM)syndrome scores, weekly angina attacks and intervals between attacks, von Willebrand factor(vWF), thrombomodulin(TM), and granule membrane protein-140(GMP-140)levels between the two groups were compared.Results:There was no statistically significant difference in TCM syndrome scores between the observation group and the control group before treatment(11.34±2.2 vs.11.8±2.3, t=0.184, P=0.856), but there was a statistically significant difference between the observation group and the control group after treatment(6.5±1.8 vs.8.4±2.0 points, t=4.230, P=0.000). The number of weekly angina attacks and the interval between attacks in the observation group were significantly decreased compared with the control group, and the difference was statistically significant(all P<0.01). The levels of molecular markers of the prethrombotic state(vWF, TM and GMP-140)in the observation group were more favorable than those in the control group, with statistical significance(all P<0.05). Conclusions:The Guanxinning tablet can improve angina pectoris symptoms in elderly patients with coronary heart disease and effectively improve the expression of molecular markers of the prethrombotic state.

Objective:To investigate the correlation between serum uric acid levels and thyroid hormones in hospitalized elderly gout patients.Methods:A total of 646 hospitalized gout patients, including 616 males and 30 females, aged(68.8±5.1)years, who were hospitalized at the Department of Gout, Chu Hsien-I Memorial Hospital from April 2014 to December 2019, were retrospectively analyzed.Clinical information was collected and relevant biochemical tests were conducted.Serum uric acid (SUA)levels were divided into quartiles and their associations with thyroid hormone levels were analyzed.Results:With the increase of SUA, body mass index, the prevalence of obesity, the prevalence of dyslipidemia, and the prevalence of fatty liver, the number of involved joints, cholesterol, low-density lipoprotein cholesterol, triacylglycerol, and homeostasis model assessment trended upward significantly( P<0.05); FUA showed a downward trend( F=9.42, P>0.05). The prevalence of subclinical hypothyroidism in older patients was 11.3%(73 cases). With the increase of SUA, the prevalence of subclinical hypothyroidism and free triiodothyronine levels showed an upward trend, whereas free thyroxine levels showed a downward trend( P<0.01). Conclusions:In elderly gout patients, the prevalence of subclinical hypothyroidism increases with SUA levels.Hyperuricemia and multiple metabolic disorders are independent risk factors for subclinical hypothyroidism in these patients.

As a sensor of cytosolic DNA, the role of cyclic GMP-AMP synthase (cGAS) in innate immune response is well established, yet how its functions in different biological conditions remain to be elucidated. Here, we identify cGAS as an essential regulator in inhibiting mitotic DNA double-strand break (DSB) repair and protecting short telomeres from end-to-end fusion independent of the canonical cGAS-STING pathway. cGAS associates with telomeric/subtelomeric DNA during mitosis when TRF1/TRF2/POT1 are deficient on telomeres. Depletion of cGAS leads to mitotic chromosome end-to-end fusions predominantly occurring between short telomeres. Mechanistically, cGAS interacts with CDK1 and positions them to chromosome ends. Thus, CDK1 inhibits mitotic non-homologous end joining (NHEJ) by blocking the recruitment of RNF8. cGAS-deficient human primary cells are defective in entering replicative senescence and display chromosome end-to-end fusions, genome instability and prolonged growth arrest. Altogether, cGAS safeguards genome stability by controlling mitotic DSB repair to inhibit mitotic chromosome end-to-end fusions, thus facilitating replicative senescence.

Objective:To investigate the short-term effects of acute fructose intake on serum antioxidant capacity and liver enzymes in healthy young adults.Methods:From January to June 2019, 64 healthy young subjects were recruited, and divided into 75 g glucose group, 25 g fructose group, 50 g fructose group and 75 g fructose group by random digits table method with 16 cases each. The subjects took corresponding amounts of glucose or fructose according to grouping. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), glutathione peroxidase (GPX), superoxide dismutase (SOD), C-Jun amino terminal kinase (JNK), malondialdehyde (MDA) and 8-OH deoxyguanine (8-OHdG) before taking sugar and 30, 60, 120, 180 min after taking sugar, and the changes of ALT, AST and LDH at 30, 60, 120 and 180 min after taking sugar compared with that before taking sugar.Results:One case in 50 g fructose group, 2 cases in 75 g fructose group and 1 case in 75 g glucose group dropped out due to adverse reaction; finally, 15 cases in 75 g glucose group, 16 cases in 25 g fructose group, 15 cases in 50 g fructose group and 14 cases in 75 g fructose group completed the study. The increase of ALT and AST after taking sugar in 25 g fructose group, 50 g fructose group and 75 g fructose group was significantly higher than that in 75 g glucose group, and there were statistical differences ( P<0.05); there was no statistical difference in the change of LDH after taking sugar among 4 groups ( P>0.05). One hundred and eighty min after taking sugar, the receiver operating characteristic (ROC) curve analysis result showed that there were no statistical differences in the areas under curve of ALT, AST and LDH among 4 groups ( P>0.05). There was no statistical difference in SOD before taking sugar among 4 groups ( P>0.05); the SOD 60 min after taking sugar in 50 g fructose group and 75 g fructose group, and SOD 180 min after taking sugar in 25 g fructose group, 50 g fructose group and 75 g fructose group were significantly lower than those in 75 g glucose group: (4.84 ± 1.88) and (4.38 ± 1.12) μg/L vs. (6.25 ± 1.65) μg/L, (4.46 ± 1.66), (5.22 ± 1.66) and (3.99 ± 0.96) μg/L vs. (6.55 ± 1.78) μg/L, and there were statistical differences ( P<0.05). There were no statistical differences in the changes of JNK, GPX, MDA and 8-OHdG before and after taking sugar among 4 groups ( P>0.05). The ROC curve 180 min after taking sugar analysis result showed that the area under curve of SOD in 75 g fructose group was significantly lower than that in 75 g glucose group (9.06 ± 1.88 vs. 12.74 ± 3.15), and there was statistical difference ( P<0.05); there were no statistical differences in the areas under curve of GPX, JNK, MDA and 8-OHdG among 4 groups ( P>0.05). Conclusions:Acute fructose intake can lead to the decrease of antioxidant capacity, and the increasing of oxidative damage and liver enzymes in healthy adults.

Objective:To investigate the acute effect of fructose intake on serum uric acid, plasma glucose, and insulin levels in healthy young adults.Methods:Sixty-four healthy young subjects were recruited, and randomized to 25 g, 50 g, 75 g fructose group, and 75 g glucose group( n=16) by random number table. The anthropometric parameters, blood pressure, heart rate were measured. Several biochemistry parameters were measured, which were serum uric acid, plasma glucose, plasma insulin, serum total cholesterol, triglyceride, low density lipoprotein-cholesterol (LDL-C) at 0, 60, 120, and 180 min before and after ingestion of fructose or glucose. Results:(1) The serum uric acid level after fructose administration increased significantly than after glucose over 3 h, and peaked at 60 min. The increment of uric acid at 60 min and area under curve of uric acid at 3 h after fructose administration were significantly higher than those of glucose. The increment of uric acid at 60 min increased significantly as fructose dose was increased, especially in the 75 g fructose (increment rate of uric acid at 60 min in 25g, 50g, 75g fructose groups were 9.33%, 13.11%, 17.69% vs 0.75% respectively; Areas under curve of uric acid were 1 674.1±410.38, 1 598.3±417.03, 1 504.6±292.46 vs 1 434.8±328.94, P<0.01). (2) The glucose and insulin levels increased after fructose/glucose intake in four groups with top augment in glucose followed by 75 g fructose. The increase peaked at 30 min, began to decline at 120 min, and returned to fasting level at 180 min. The area under curve of insulin at glucose group was significantly higher than those among fructose groups. With the increase of fructose dose, the increment rate of glucose and insulin at 60 min also increased obviously, especially in the 75 g fructose (the increment rates of glucose at 60 min in 25 g, 50 g, 75 g fructose, 75 g glucose were 7.40%, 8.29%, 13.74%, 28.22% respectively; The increment rates of insulin at 60 min were 54.29%, 115.25%, 185.58%, 730.31% respectively, P<0.01). (3) There were no difference of cholesterol, triglyceride, and LDL-C after fructose/glucose ingestion. Conclusion:Acute fructose intake can lead to the increase of uric acid and insulin; Moreover, the increments of uric acid and insulin after fructose consumption were dependent on fructose dose.

Inflammatory bowel disease (IBD) is a chronic, recurrent, nonspecific inflammatory disease of gastrointestinal tract, and includes ulcerative colitis (UC) and Crohn's disease (CD). Many studies have shown that gut microbiota and its mediated immune responses are the key factors driving the development of IBD. Fecal microbiota transplantation (FMT) is widely recognized as a new and potentially effective method for the treatment of IBD, but the mechanism is unclear. This article reviewed the current application of FMT in IBD, the immune response and the microbiota-immune interaction mechanism after FMT for the treatment of IBD, so as to discuss the potential mechanism of FMT in IBD.

Objective To translate Rheumatoid Arthritis Self-efficacy Scale (RASE) into Chinese and to evaluate its reliability and validity. Methods A total of 188 hospitalized patients with rheumatoid arthritis (RA) were selected as research subjects through convenience sampling method. According to the translation mode of the scale, Chinesization and cultural adjustment were conducted to the English version of RASEto test reliability and validity. Results Item analysis showed that the Chinese version of RASE could discriminate the high-score group from the low-score group (P<0.01). Pearson correlation analysis showed that the correlation coefficient between the score of each item and the total score of the Chinese version of RASE was positively correlated (P<0.01).Exploratory factor analysis extracted a total of 8 common factors, which explained 68.55％of the total variance. The Cronbachαof the Chinese version of RASE was 0.901, and Cronbachαof each dimension ranged from 0.660 to 0.867;the retest reliability was 0.955 after 1 week, and ranged from 0.819 to 0.984 for each dimension;the split-half reliability coefficient was 0.848. Conclusion The Chinese version of RASE has good reliability and validity, which can be applied to the research of self-efficacy of patients with RA in China.