Objective:To investigate the effect of basket assisted retrograde ureteral soft lithotripsis retrograde intrarenal surgery (RIRS) in the treatment of subcalyceal calculi and its effect on stone clearance.Methods:A retrospective cohort study method was conducted on 120 patients with lower calyx stones treated at Jiaozhou Central Hospital of Qingdao City, from October 2021 to January 2024. There were 66 males and 54 females, aged (48.10±10.11) years old. The patients were divided into two groups based on their surgical methods: 60 patients who received only RIRS treatment were in the control group, while 60 patients who underwent RIRS with the assistance of a stone retrieval basket were in the observation group. The study compared various perioperative indicators (such as intraoperative blood loss, surgical duration, and hospital stay), as well as the stone clearance rates, inflammation levels, and postoperative complications at 3 days (short-term) and 30 days (long-term) after surgery. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s), and t-test was employed for inter-group comparisons. Chi-square test was used for inter-group comparisons of count data. Results:The operation time of the observation group was (78.26±10.54) min, and that of the control group was (70.65±8.67) min. The difference between the two groups was statistically significant ( P<0.05). There was no difference between the two groups in intraoperative bleeding, the first time to get out of bed after surgery and the postoperative hospital stay ( P>0.05). The stone expulsion time in the observation group was (16.38±4.22) d, while that in the control group was (18.96±5.10) d, the stone removal rates of the observation group at 3 days and 30 days after surgery were 88.33% and 95.00% respectively, while those of the control group were 73.33% and 83.33% respectively. There was a statistically significant difference between the two groups ( P<0.05). The stone expulsion time was shorter in the observation group compared to the control group, with a statistically significant difference ( P<0.05). There were no significant differences in postoperative inflammatory factors between the two groups( P>0.05). The incidence of postoperative complications in the observation group was 6.67%, and that in the control group was 20.00%. The difference between the two groups was statistically significant ( P<0.05). Conclusions:Stone basket removal combined with RIRS is safe and feasible, which can not only improve the stone clearance rate, but also reduce the incidence of postoperative complications without increasing the inflammatory reaction, and has a significant effect. However, the clinical application needs to strictly grasp the indications and avoid overtreatment in combination with the individual situation of the patients.

The 2024 World Conference on Lung Cancer (WCLC) and the European Society for Medical Oncology (ESMO) Annual Meeting, two of the most prestigious events in oncology, have concluded sequentially. As the most authoritative annual gatherings in lung cancer and the entire oncology field, the WCLC and ESMO conferences brought together top oncology experts and scientists from around the world to share, discuss, and publish the latest cutting-edge advancements in oncology. In both conferences, lung cancer immunotherapy remained a hot topic of considerable interest. This article aims to summarize and discuss the important research progress on perioperative immunotherapy for non-small cell lung cancer reported at the two conferences.

Objective:To investigate the influencing factors of adverse reactions of reconstructive flaps after postoperative precision radiation therapy for head and neck tumors.Methods:Medical records of 46 patients who underwent radiotherapy after flap reconstruction for head and neck tumors in the Affiliated Hospital of Inner Mongolia Medical University between January 2016 and October 2022 were retrospectively analyzed. The overall survival (OS), local regional control (LRC) and dosimetric parameters after radiotherapy were analyzed. The adverse reactions mainly including radiation dermatitis and flap necrosis at 3 and 6 months after radiotherapy, flap atrophy, flap fibrosis, dysphagia and chewing dysfunction at 12 and 24 months after radiotherapy were recorded. Adverse reactions were graded using the common terminology criteria for adverse events (CTCAE) version 5.0. Quantitative data were analyzed by one-way analysis of variance or rank-sum test. Qualitative data were analyzed by chi-square test or Fisher's exact test. Multivariate analysis of influencing factors of adverse reactions was performed using binary logistic stepwise regression.Results:All 46 patients were aged 57.6 years on average. The median follow-up time was 65 months (12-100 months). After the follow-up, 22 patients died, 6 recurred, and 7 had distant metastases. The 5-year OS rate was 48% and 5-year LRC rate was 69%. The incidence of radiation dermatitis was decreased over time after the end of radiotherapy: 80% (37/46) and 65% (30/46) at 3 months and 6 months after radiotherapy, respectively. The incidence of grade 3 radiation dermatitis was 11% (5/46) and 0 at 3 and 6 months after radiotherapy, respectively. The incidence of grade 2 flap necrosis was 4% (2/46) at 3 months after radiotherapy. At 12 months after radiotherapy, the incidence of flap atrophy and fibrosis was 83% (38/46) and 67% (31/46) , and the incidence of grade 3 flap atrophy and fibrosis was equally 4% (2/46) , respectively. All patients had dysphagia and chewing dysfunction at 12 months after radiotherapy. At 24 months after radiotherapy, 83% (38/46) and 61% (28/46) of patients still had dysphagia and chewing dysfunction. Multivariate regression analysis showed that irradiated flap volume, total radiotherapy dose, pharyngeal constrictor D mean and pharyngeal constrictor V 60 Gy, the interval between surgery and radiotherapy, gender and age were the independent influencing factors of adverse reactions of reconstructive flaps after precision radiation therapy for head and neck tumors. Conclusions:For patients undergoing flap reconstruction for head and neck tumors, under the premise of ensuring tumor control, the dose to normal tissue and flap blood supply area should be strictly limited, the irradiated volume should be reduced, and the interval between surgery and radiotherapy should be shortened (≤6 weeks) to reduce the risk of adverse reactions. Hypo-fractionated radiotherapy plan should be formulated or the total radiotherapy dose should be appropriately adjusted for elderly patients to reduce long-term complications.

Breast cancer is a common clinical gy-necological tumor.According to the 2022 global cancer data statistics,breast cancer ranks second in terms of incidence among newly diagnosed cancer cases worldwide.Modern medicine often adopts surgical operation,chemotherapy,and other meth-ods,which have certain efficacy but also many problems such as high drug resistance rates and sig-nificant adverse reactions.Chinese patent medi-cines exhibit extensive anticancer effects.The study found that Shenyi Capsule,Pingxiao Capsule,and Zhenqi Fuzheng Granules were widely used in the treatment of breast cancer,exerting therapeu-tic effects on breast cancer by inhibiting cell prolif-eration,invasion,and metastasis,suppressing an-giogenesis,reversing cellular drug resistance,and inhibiting precancerous lesions.Meanwhile,the oral administration of Chinese patent medicines in combination with other traditional Chinese medi-cine(TCM)compounds,TCM decoctions,or mod-ern medical treatments can improve patients' quali-ty of life and reduce adverse reactions.Currently,there are numerous studies on the treatment of breast cancer with Chinese patent medicines,but a systematic summary is lacking.Therefore,this study conducted a systematic review of the mecha-nisms of action and clinical applications of Chinese patent medicines as adjuvant therapy for breast cancer,aiming to provide guidance for clinical medi-cation.

Objective To investigate the effects of dihydroquercetin(DHQ)on retinal ferroptosis and visual function in rats with optic nerve injury(ONI),and to elucidate the underlying mechanisms.Methods Thirty-six 8-12-week-old adult male SD rats were randomly divided into three groups:SHAM group(sham surgery without optic nerve damage,fol-lowed by saline injection at the same time points),ONI group(ONI model established by surgery,followed by saline injec-tion),DHQ+ONI group(ONI model established by surgery,followed by intraperitoneal injection of 50 mg·kg-1DHQ on days 1,3,5,and 7 post-surgery).The ONI model was constructed by optic nerve clamping.After 7 days:Brn3a immuno-fluorescence was used to observe morphological and quantitative changes in retinal ganglion cells(RGCs).Immunohisto-chemistry and Western blot were performed to analyze protein expression of nuclear factor-erythroid 2-related factor 2(Nrf2),phosphorylated protein kinase B(p-AKT),and glutathione peroxidase 4(Gpx4),Flash visual evoked potential(F-VEP)was applied to assess visual function changes.Results Immunofluorescence quantification of Brn3a-positive cells:SHAM group:(61.49±3.84)cells·mm-1,ONI group:(25.24±1.81)cells·mm-1,DHQ+ONI group:(46.50±3.51)cells·mm-1.Compared with SHAM group,ONI group showed decreased Brn3a-positive cells(P＜0.001).Compared with ONI group,DHQ+ONI group showed increased Brn3a-positive cells(P＜0.01).Immunohistochemistry and Western blot:Compared with SHAM group,ONI group showed decreased protein expression of Nrf2,p-AKT,and Gpx4(all P＜0.001).Compared with ONI group,DHQ+ONI group showed increased expression of these proteins(all P＜0.01).F-VEP meas-urements:SHAM group:P1 wave amplitude(49.87±0.81)μV,ONI group:(5.87±0.25)μV,DHQ+ONI group:(36.43±0.21)μV.Compared with SHAM group,ONI group showed reduced P1 amplitude(P＜0.001).Compared with ONI group,DHQ+ONI group showed increased P1 amplitude(P＜0.001).Conclusion DHQ may protect and repair RGCs in ONI rats by inhibiting the ferroptosis-related Nrf2/p-AKT/Gpx4 signaling pathway,thereby ameliorating vision impairment caused by ONI.

Objective:To evaluate the short-term safety and efficacy of total laparoscopic, laparoscopy-assisted, and open total gastrectomy in patients with gastric cancer who have undergone neoadjuvant therapy.Methods:In this retrospective cohort study, relevant clinical data on 243 patients who had undergone radical total gastrectomy after receiving neoadjuvant therapy were collected. These patients had been admitted to the First Affiliated Hospital of Air Force Medical University, Yuncheng Central Hospital of Shanxi Province, and Heji Hospital Affiliated to Changzhi Medical College between January 2020 and April 2024. Among them, 202 were male (83.1%) and 41 were female (16.9%), and their average age was 61.3±8.1 years. The patients were allocated to three groups according to surgical procedure: total laparoscopic (68 cases), laparoscopic- assisted (79 cases), and open surgery (96 cases). We compared relevant baseline characteristics, neoadjuvant treatment, intraoperative and postoperative conditions, postoperative histopathological findings, and related complications between these three groups.Results:There were no statistically significant differences in baseline characteristics or neoadjuvant treatment between the three groups (all P>0.05). The operative time was longer in the total laparoscopic group than in the laparoscopic-assisted and open surgery groups (267.7±37.9 minutes vs. 243.9±38.3 minutes vs. 219.7±41.2 minutes, respectively; F=7,112.278; P<0.001). However, more lymph nodes were harvested in the total laparoscopic group than in the laparoscopic-assisted and open surgery groups (27.8±4.8 vs. 27.4±6.3 vs. 27.2±5.1, respectively; F=6.042; P=0.002). Additionally, the total laparoscopic group had shorter times to first postoperative flatus (2.3±0.7 days vs. 2.4±0.7 days vs. 2.6±0.6 days, respectively; F=5.094; P=0.006] and first postoperative bowel movement (2.9±0.5 days vs. 3.0±0.6 days vs. 3.0±0.6 days, respectively; F=3.929; P=0.020). There were no statistically significant differences in intraoperative blood loss, intraoperative transfusion rates, postoperative intensive care unit admission rates, maximum tumor diameter, number of positive lymph nodes dissected, TNM stage, time to first postoperative oral intake, time to drain removal, or length of hospital stay between the three groups (all P>0.05). Among the 243 patients, 22 developed postoperative complications, making the overall complication rate 9.1%. Six patients (8.8%) in the total laparoscopic group developed complications, comprising two (2.9%) Grade IIIa Clavien-Dindo complications. One of these patients (1.5%) was readmitted within 30 days due to complications. Seven patients (8.9%) in the laparoscopic-assisted group developed complications, comprising two (2.5%) Grade IIIa Clavien-Dindo complications. One of these patients was readmitted within 30 days and another was within 90 days due to complications. Nine patients (9.4%) in the open surgery group developed complications, comprising four (4.2%) Grade IIIa Clavien-Dindo complications. Two patients (2.1%) were readmitted within 30 days and another (1.0%) within 90 days due to complications. There were no statistically significant differences among the three surgical approaches in overall postoperative complication rates, Clavien-Dindo grades, or readmission rates 30 and 90 days postoperatively (all P>0.05). Conclusions:In patients with gastric cancer who have undergone neoadjuvant therapy, there are no significant differences in the overall safety and short-term effectiveness of the three surgical procedures. Although the operative time is longer for total laparoscopic total gastrectomy, this procedure offers the advantages of faster postoperative recovery and earlier resumption of feeding.

Objective:To explore the protective effect and mechanism of irisin on liver injury and mitochondrial dysfunction of hepatocytes in mice with acute necrotizing pancreatitis (ANP).Methods:24 mice were randomly divided into the control group, the ANP group, the irisin group and the cilengitide group, with 6 mice in each group. The ANP group was prepared by intraperitoneal injection of 20% L-arginine. The irisin group was injected with 250 μg/kg of irisin intraperitoneally on the basis of the induction of ANP. The cilengitide group was injected with the integrin receptor αVβ3/5 inhibitor cilengitide at 20 mg/kg on the basis of the treatment of the irisin group. The control group was injected with 0.9% normal saline instead of L-arginine. Routine liver histopathological examination and scoring were performed; immunohistochemical staining was used to detect the level of neutrophil infiltration in liver tissue; the ultrastructure changes of mitochondria were observed under transmission electron microscopy; biochemistry was used to detect the ATP content in liver tissue to reflect the changes in mitochondrial function; the total antioxidant capacity of liver tissue was detected by the ferric reducing/antioxidant power (FRAP) method; the DHE fluorescence probe labeling method was used to detect the accumulation degree of oxygen free radicals in liver tissue.Results:The livers of the control group showed no obvious abnormalities. However, the ANP group, the irisin group and the cilengitide group all had liver tissue damage and infiltration of inflammatory cells in the mice. Compared with the ANP group, the liver pathological score, the number of neutrophil infiltration, and the DHE fluorescence staining density in the irisin group were significantly lower [(3.40±0.72) vs (7.26±1.01) points, (14.67±2.51) vs (33.33±3.51) cells, (16.33±5.03) vs (50.33±10.69) cells], while the above indicators in the cilengitide group were all increased [(7.06±1.55) points, (40.33±5.03) cells, (51.00±12.8) cells]; the ATP content [(296.04±64.6), (54.77±18.05), (109.50±56.61), (40.29±11.68) μmol/gprot], and the antioxidant capacity [(0.19±0.01), (0.10±0.01), (0.17±0.02), (0.11±0.01) mmol/g] in the control group, ANP group, irisin group and cilengitide group changed accordingly. The above differences were statistically significant (all P value <0.05). Transmission electron microscopy observation revealed that the abnormal mitophagy of liver cells in the irisin group restored to normal, while the mitophagy abnormality in the cilengitide group was exacerbated. Conclusions:Irisin could improve the disordered mitochondrial function and oxidative stress in liver cells by acting on integrin receptors αVβ3/5, thereby alleviating liver damage and inflammatory responses in ANP mice.

Blinatumomab, a bispecific T-cell engager targeting CD3 and CD19 simultaneously, recruits endogenous T lymphocytes to induce tumor cell apoptosis via cytolytic synapse formation and inflammatory cytokine release.Approved by the U. S.Food and Drug Administration and China′s National Medical Products Administration for relapsed/refractory (R/R) precursor B-cell acute lymphoblastic leukemia (ALL) in adults and children, its clinical applications are expanding into earlier treatment phases.This review synthesizes the therapeutic mechanisms and evolving clinical applications of Blinatumomab in pediatric R/R ALL.

Objective:To evaluate the short-term safety and efficacy of total laparoscopic, laparoscopy-assisted, and open total gastrectomy in patients with gastric cancer who have undergone neoadjuvant therapy.Methods:In this retrospective cohort study, relevant clinical data on 243 patients who had undergone radical total gastrectomy after receiving neoadjuvant therapy were collected. These patients had been admitted to the First Affiliated Hospital of Air Force Medical University, Yuncheng Central Hospital of Shanxi Province, and Heji Hospital Affiliated to Changzhi Medical College between January 2020 and April 2024. Among them, 202 were male (83.1%) and 41 were female (16.9%), and their average age was 61.3±8.1 years. The patients were allocated to three groups according to surgical procedure: total laparoscopic (68 cases), laparoscopic- assisted (79 cases), and open surgery (96 cases). We compared relevant baseline characteristics, neoadjuvant treatment, intraoperative and postoperative conditions, postoperative histopathological findings, and related complications between these three groups.Results:There were no statistically significant differences in baseline characteristics or neoadjuvant treatment between the three groups (all P>0.05). The operative time was longer in the total laparoscopic group than in the laparoscopic-assisted and open surgery groups (267.7±37.9 minutes vs. 243.9±38.3 minutes vs. 219.7±41.2 minutes, respectively; F=7,112.278; P<0.001). However, more lymph nodes were harvested in the total laparoscopic group than in the laparoscopic-assisted and open surgery groups (27.8±4.8 vs. 27.4±6.3 vs. 27.2±5.1, respectively; F=6.042; P=0.002). Additionally, the total laparoscopic group had shorter times to first postoperative flatus (2.3±0.7 days vs. 2.4±0.7 days vs. 2.6±0.6 days, respectively; F=5.094; P=0.006] and first postoperative bowel movement (2.9±0.5 days vs. 3.0±0.6 days vs. 3.0±0.6 days, respectively; F=3.929; P=0.020). There were no statistically significant differences in intraoperative blood loss, intraoperative transfusion rates, postoperative intensive care unit admission rates, maximum tumor diameter, number of positive lymph nodes dissected, TNM stage, time to first postoperative oral intake, time to drain removal, or length of hospital stay between the three groups (all P>0.05). Among the 243 patients, 22 developed postoperative complications, making the overall complication rate 9.1%. Six patients (8.8%) in the total laparoscopic group developed complications, comprising two (2.9%) Grade IIIa Clavien-Dindo complications. One of these patients (1.5%) was readmitted within 30 days due to complications. Seven patients (8.9%) in the laparoscopic-assisted group developed complications, comprising two (2.5%) Grade IIIa Clavien-Dindo complications. One of these patients was readmitted within 30 days and another was within 90 days due to complications. Nine patients (9.4%) in the open surgery group developed complications, comprising four (4.2%) Grade IIIa Clavien-Dindo complications. Two patients (2.1%) were readmitted within 30 days and another (1.0%) within 90 days due to complications. There were no statistically significant differences among the three surgical approaches in overall postoperative complication rates, Clavien-Dindo grades, or readmission rates 30 and 90 days postoperatively (all P>0.05). Conclusions:In patients with gastric cancer who have undergone neoadjuvant therapy, there are no significant differences in the overall safety and short-term effectiveness of the three surgical procedures. Although the operative time is longer for total laparoscopic total gastrectomy, this procedure offers the advantages of faster postoperative recovery and earlier resumption of feeding.

Breast cancer is a common clinical gy-necological tumor.According to the 2022 global cancer data statistics,breast cancer ranks second in terms of incidence among newly diagnosed cancer cases worldwide.Modern medicine often adopts surgical operation,chemotherapy,and other meth-ods,which have certain efficacy but also many problems such as high drug resistance rates and sig-nificant adverse reactions.Chinese patent medi-cines exhibit extensive anticancer effects.The study found that Shenyi Capsule,Pingxiao Capsule,and Zhenqi Fuzheng Granules were widely used in the treatment of breast cancer,exerting therapeu-tic effects on breast cancer by inhibiting cell prolif-eration,invasion,and metastasis,suppressing an-giogenesis,reversing cellular drug resistance,and inhibiting precancerous lesions.Meanwhile,the oral administration of Chinese patent medicines in combination with other traditional Chinese medi-cine(TCM)compounds,TCM decoctions,or mod-ern medical treatments can improve patients' quali-ty of life and reduce adverse reactions.Currently,there are numerous studies on the treatment of breast cancer with Chinese patent medicines,but a systematic summary is lacking.Therefore,this study conducted a systematic review of the mecha-nisms of action and clinical applications of Chinese patent medicines as adjuvant therapy for breast cancer,aiming to provide guidance for clinical medi-cation.