Objective To assess the efficacy and safety of bronchial arterial chemoembolization(BACE)combined with tislelizumab for advanced non-small cell lung cancer(NSCLC).Methods A total of 30 patients in First Affiliated Hospital of Zhengzhou University with stage Ⅲ-Ⅳ NSCLC from December 2021 to August 2022 were enrolled in this study.All the patients received BACE,which was followed by 200 mg tislelizumab once every 3 weeks until the disease progressed,or the patient developed intolerable adverse effects,or the investigator decided to terminate this drug treatment.The primary study endpoint was progression-free survival(PFS),and the secondary study endpoints included overall survival(OS),objective response rate(ORR),disease control rate(DCR),safety,and quality of life(QoL).Results The median follow-up time was 12 months(range of 1.5-12 months),the median PFS was 10.5 months(95％CI:7.8-13.2 months),and the median OS was not available.The 3-month,6-month,and 12-month ORRs were 63.3％(95％CI:43.9％-80.1％),56.7％(95％CI:37.4％-74.5％),and 30.4％(95％CI:13.2％-52.9％)respectively.The 3-month,6-month,and 12-month DCRs were 80％(95％CI:61.4％-92.3％),76.7％(95％CI:57.7％-90.1％),and 47.8％(95％CI:26.8％-69.4％)respectively.The expression ratio of PD-L1 ≥50％(HR=0.29,P=0.039),tumor having a single feeding artery(HR=0.35,P=0.028),and completion of＞10 cycles of tislelizumab therapy(HR=0.42,P=0.064)were the protective factors for PFS.No ≥grade Ⅲ treatment-related adverse events(TRAEs)occurred.The common below grade Ⅱ TRAEs were nausea,fever,and cough.After one cycle of treatment,the patient's QoL,including overall quality of life,physical functioning,and emotional functioning,was significantly improved.Conclusion For the treatment of patients with advanced NSCLC,BACE plus tislelizumab has satisfactory clinical efficacy and safety.

Objective To establish a dynamic model of lipopolysaccharide-induced acute lung injury in mice based on the NLRP3/Caspase-1/gasdermin D(GSDMD)pyroptosis pathway,and observe the result ing lung injury at different time points.We aimed to identify the optimal time for modelling according to the injury at different time points and the expression of pyroptosis pathway-related proteins,to lay the foundation for animal models for subsequent experiments.Methods Fifty-four 6～8 weeks old male SPF BALB/c mice were divided randomly into nine groups,including Con group and model groups at 1,3,6,12,18,24,48,and 72 h.Body weight and lung tissue were detected by general and pathological observations and semi-quantitative scoring,including lung index,lung water content,and wet and dry weight ratio.The white blood cell count and concentrations of tumor necrosis factor-α,interleukin(IL)-6,IL-1β,IL-18,and BCA protein were detected in bronchoalveolar lavage fluid(BALF).The classic pyroptosis pathway-related proteins NLRP3,pro-Caspase 1,Caspase 1,and GSDMD were detected by Western Blot.Results Body weight decreased in all experimental groups,with the most significant weight loss in the 24 and 48 h groups.Gross observation and pathological examination of lung tissue showed that the most severe lung injury occurred at 24～72 h,with significant differences between each group and the control group.The lung index,lung water content,and wet/dry weight ratio were also significantly increased at 24～72 h.White blood cells in BALF started to increase from 6 h after model initiation,48 h can reach a peak,72 h all keep increasing.IL-18 in BALF began to increase at 24 h and continued to increase at 72 h.The inflammatory factors tumor necrosis factor-α,IL-1β,IL-6 were highest at 6 h and significantly reduced at 48 h.Protein concentrations in BALF were significantly increased within 24,48,and 72 h compared with those in the control group.The pyroptosis pathway proteins NLRP3,pro-Caspase-1,Caspase-1,and GSDMD were significantly enhanced in each time series,and channel protein expression was significantly enhanced at 24～72 h compared with that in the Con group.Conclusions Comprehensive analysis of experimental indicators,inflammatory factors,and pathway proteins at different times showed that the mechanism of pyroptosis was closely related to the occurrence and progression of acute lung injury.Expression of the pyroptosis pathway was most obvious and lung injury was most serious at 24～48 h.This study provides a model reference and experimental basis for subsequent studies of the specific mechanism and intervention targets of acute lung injury.

Objective To analyze the levels and clinical significance of macrophage inflammatory protein-3a(MIP-3a),interleukin-37(IL-37)and CC chemokine ligand 5(CCL5)in serum macrophages of patients with colorectal cancer.Methods A total of 158 patients with colorectal cancer admitted to Liaoning Cancer Hospi-tal from January 2018 to December 2020 were prospectively selected as the cancer group,and were divided into the recurrence group(41 cases)and the non recurrence group(117 cases)according to the the follow-up situa-tion.158 healthy volunteers who underwent physical examination in Liaoning Cancer Hospital during the same period were selected as control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect se-rum levels of MIP-3α,IL-37 and CCL5.Pearson correlation was applied to analyze the correlation between ser-um levels of MIP-3α,IL-3 and CCL5 in cancer group.Multivariate Logistic regression was applied to analyze the factors affecting postoperative recurrence in colorectal cancer patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum MIP-3α,IL-37 and CCL5 in combination for postoperative recurrence in colorectal cancer patients.Results The serum levels of MIP-3α and CCL5 in the cancer group were obviously higher than those in the control group,while the level of IL-37 was obviously lower than that in the control group(P＜0.05).Compared with the non recurrence group,the proportion of patients with TNM stage Ⅲ in the recurrence group was higher(P＜0.05),and the serum levels of MIP-3αand CCL5 in the recurrence group were obviously increased,while the level of IL-37 was obviously reduced(P＜0.05).Serum MIP-3α was negatively correlated with IL-37 level(r=-0.540,P＜0.05)and was posi-tively correlated with CCL5 level(r=0.623,P＜0.05),and IL-37 was negatively correlated with CCL5 level(r=-0.551,P＜0.05).TNM stage Ⅲ,increased level of MIP-3α and increased level of CCL5 were risk fac-tors for postoperative recurrence in colorectal cancer patients(P＜0.05),while increased level of IL-37 was a protective factor for postoperative recurrence in colorectal cancer patients(P＜0.05).The area under the curve(AUC)of the combination of serum MIP-3α,IL-37 and CCL5 in predicting postoperative recurrence in colorectal cancer patients was 0.889(95％CI:0.830-0.948),the AUC of MIP-3α,IL-37,and CCL5 alone in predicting postoperative recurrence in colorectal cancer patients was 0.780(95％CI:0.692-0.868),0.755(95％CI:0.673-0.838),and 0.803(95％CI:0.730-0.876),respectively.AUC of the combination of the three was higher than that of MIP-3α(Z=0.015,P=0.022),IL-37(Z=2.596,P=0.005),and CCL5(Z=1.805,P=0.036)alone.The relapse-free survival rate of patients with high MIP-3α expression(55/86,63.95％)was lower than that of patients with low MIP-3α expression(62/72,86.11％,Log-Rank x2=11.709,P＜0.05).The relapse-free survival rate of patients with high IL-37 expression(77/89,86.62％)was higher than that of patients with low IL-37 expression(40/69,57.97％,Log-Rank x2=19.917,P＜0.05).The relapse-free survival in patients with high CCL5 expression(51/84,60.71％)was lower than that in pa-tients with low CCL5 expression(66/74,89.19％,Log-Rank x2=19.366,P＜0.05).Conclusion The high expression of MIP-3α and CCL5 and low expression of IL-37 in the serum of patients with postoperative recur-rence of colorectal cancer are all related to the postoperative relapse-free survival rate of patients,and the com-bination of the three could be used to predict postoperative recurrence of colorectal cancer patients,and the clinical application value is relatively high.

【Objective】 To monitor the positive rates of IgM and IgG antibodies and the changes in S/CO values over time in voluntary blood donors infected with SARS-CoV-2 after recovery, in order to provide theoretical basis and data support for ensuring clinical blood safety. 【Methods】 A total of 54 platelet donors who met the inclusion criteria were selected for this study, and 359 blood samples (plasma) from T1 to T7 (at 7 time points, spanning 14 to 15 weeks) were continuously monitored for SARS-CoV-2 IgM and IgG antibodies using fully automated chemi-luminescence method. 【Results】 Among 359 blood samples (plasma) from 54 donors, 349 were with valid test results.Eleven donors were tested positive for IgM, with a positive rate of 20.37%, and IgM antibody S/CO value gradually increased during T1-T3, but gradually decreased during T4-T7. Fifty-four donors were tested positive for IgG, with the positive rate of 100%, and the S/CO value of IgG antibody gradually decreased over time. During the period of T1 -T7, there was no significant difference in SARS-CoV-2 IgG antibody S/CO value between gender (male/female) or age group (18-39 years old /40-60 years old). 【Conclusion】 The positive rate of SARS-CoV-2 IgG antibody in platelet donors after recovery from SARS-CoV-2 infection was 100% during 2-14 weeks, and the IgG S/CO value gradually decreases over time. The long-term dynamic changes of SARS-CoV-2 serologically specific IgG and IgM antibodies in blood donors are worthy of further study.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Objective:To explore the surgical method and clinical effect of correcting lateral type alar retraction with intercartilaginous graft and lateral crural strut graft.Methods:A retrospective study was performed on the data of patients with moderate to severe lateral alar retraction treated in Shenzhen Mylike Medical Plastic Aesthetic Hospital from October 2018 to June 2020. During the operation, lower lateral cartilages was totally dissected and strengthened by lateral crural strut graft while scroll area was released and lengthened with intercartilaginous graft to correct lateral type alar retraction. The preoperative and postoperative distance from the nostril’s long axis to the alar rim was measured from the side view, the nasal measurements were expressed as Mean±SD, and paired t-test was used for statistical analysis. Results:A total of 32 patients were enrolled, including 5 males and 27 females, with an average age of 31 years (18-47 years). Twenty-three cases underwent primary rhinoplasty and 9 cases underwent second rhinoplasty. The preoperative data of distance from the nostril’s long axis to the alar rim was (4.1±0.5) mm (3.2-5.0 mm). The postoperative effect of nasal alar retraction defomity correction was obvious. After a follow-up period of 20 cases from 6 to 18 months, the distance from the nostril’s long axis to the alar rim was 1.5-2.8 mm [(2.1±0.3) mm on average]. Comparison of preoperative and postoperative measured values showed statistically significant difference ( P<0.01). There was 1 patient emerged complication alar flaring, and no contracture and deformation of the nasal rim occurred. All of patients were satisfied. Conclusions:The intercartilaginous graft combined with lateral crural strut graft is an effective new method for correction of lateral type alar retraction. It has stable clinical effect and high satisfaction.

Objective:To explore the surgical method and clinical effect of correcting lateral type alar retraction with intercartilaginous graft and lateral crural strut graft.Methods:A retrospective study was performed on the data of patients with moderate to severe lateral alar retraction treated in Shenzhen Mylike Medical Plastic Aesthetic Hospital from October 2018 to June 2020. During the operation, lower lateral cartilages was totally dissected and strengthened by lateral crural strut graft while scroll area was released and lengthened with intercartilaginous graft to correct lateral type alar retraction. The preoperative and postoperative distance from the nostril’s long axis to the alar rim was measured from the side view, the nasal measurements were expressed as Mean±SD, and paired t-test was used for statistical analysis. Results:A total of 32 patients were enrolled, including 5 males and 27 females, with an average age of 31 years (18-47 years). Twenty-three cases underwent primary rhinoplasty and 9 cases underwent second rhinoplasty. The preoperative data of distance from the nostril’s long axis to the alar rim was (4.1±0.5) mm (3.2-5.0 mm). The postoperative effect of nasal alar retraction defomity correction was obvious. After a follow-up period of 20 cases from 6 to 18 months, the distance from the nostril’s long axis to the alar rim was 1.5-2.8 mm [(2.1±0.3) mm on average]. Comparison of preoperative and postoperative measured values showed statistically significant difference ( P<0.01). There was 1 patient emerged complication alar flaring, and no contracture and deformation of the nasal rim occurred. All of patients were satisfied. Conclusions:The intercartilaginous graft combined with lateral crural strut graft is an effective new method for correction of lateral type alar retraction. It has stable clinical effect and high satisfaction.

Objective:To investigate the characteristics of natural killer (NK) cell subsets and function in methicillin-resistant staphylococcus aureus (MRSA) sepsis, and to assess the influence of matrix metalloproteinase (MMP) to NK cell function in MRSA sepsis patients.Methods:Twenty-one MRSA sepsis patients who were hospitalized in our department between January 2017 and June 2018 were enrolled. Eleven healthy individuals were served as healthy controls. Peripheral blood mononuclear cells (PBMCs) were isolated. NK cell subsets were investigated by flow cytometry. NK cell function was assessed by measuring CD107a, CD69, and CD16 expression in co-culture system between PBMCs and different target cells. MMP mRNA was semi-quantified by real-time PCR in purified NK cells. The influence of NK cell function was assessed by measuring CD107a expression in co-culture system between NK cells with MMP inhibitor stimulation and target cells.Results:There was no significant difference of total NK cell percentage between healthy controls and MRSA sepsis patients ( P>0.05). CD56brightCD16 -NK [(5.36±1.02)% vs (4.30±0.89)%] and CD56 -CD16 +NK [(24.04±2.92)% vs (9.70±1.54)%] percentage was elevated ( P<0.05), while CD56dimCD16 +NK percentage [(71.22±13.03)% vs (87.64±7.05)%, P<0.01] was reduced in MRSA sepsis. NK cells recognized and killed target cells via different receptors upon activation. CD107a [(33.55±3.84)% vs (25.34±6.20)%] and CD69 percentage [(14.96±1.47)% vs(18.80±1.49)%] was decreased ( P<0.0001), while CD16 MFI was increased [(247.1±50.31) vs (189.4±57.54), P<0.01] in MRSA sepsis patients in comparison with healthy controls. MMP-1/2/3/9 mRNA relative levels were elevated in purified NK cells from MRSA sepsis patients ( P<0.01). Inhibition of MMP in NK cells from MRSA sepsis patients promoted CD107a percentage [(33.67±8.03)% vs (25.87±6.23)%, P=0.018]. Conclusions:NK cell subsets imbalance and exhaustion is existed in MRSA sepsis, which might be due to the MMP-induced down-regulation of antibody-dependent cell-mediated cytotoxicity.

Objective    To analyze whether hypernatremia within 48 hours after cardiac surgery will increase the incidence of delirium which developed 48 hours later after surgery (late-onset delirium). Methods    We conducted a retrospective analysis of 3 365 patients, including 1 918 males and 1 447 females, aged 18-94 ( 60.53±11.50) years, who were admitted to the Department of Cardiothoracic and Vascular Surgery of Nanjing First Hospital and underwent cardiac surgery from May 2016 to May 2019. Results    A total of 155 patients developed late-onset delirium, accounting for 4.61%. The incidence of late-onset delirium in patients with hypernatremia was 9.77%, the incidence of late onset delirium in patients without hypernatremia was 3.45%, and the difference was statistically different (P<0.001). The odds ratio (OR) of hypernatremia was 3.028 (95% confidence interval: 2.155-4.224, P<0.001). The OR adjusted for other risk factors including elderly patients, previous history of cerebrovascular disease, operation time, cardiopulmonary bypass time, lactate, hemoglobin≥100 g/L, prolonged mechanical ventilation, left ventricular systolic function, use of epinephrine, use of norepinephrine was 1.524 (95% confidence interval: 1.031-2.231, P=0.032). Conclusion    Hypernatremia within 48 hours after cardiac surgery may increase the risk of delirium in later stages.

Objective To explore the therapeutic effect of mild hypothermia on the inflammatory response, organ function and outcome in perioperative patients with acute Stanford type A aortic dissection (AAAD). Methods From February 2017 to February 2018, 56 patients with AAAD admitted in our department were enrolled and randomly allocated into two groups including a control group and an experimental group. After deep hypothermia circulatory arrest during operation, in the control group (n=28), the patients were rewarmed to normal body temperatures (36 to 37 centigrade degree), and which would be maintained for 24 hours after operation. While in the experimental group (n=28), the patients were rewarmed to mild hypothermia (34 to 35 centigrade degree), and the rest steps were the same to the control group. The thoracic drainage volume and the incidence of shivering at the first 24 hours after operation, inflammatory indicators and organ function during perioperation, and outcomes were compared between the two groups. There were 20 males and 8 females at age of 51.5±8.7 years in the control group, 24 males and 4 females at age of 53.3±11.2 years in the experimental group. Results There was no obvious difference in the basic information and operation information in patients between the two groups. Compared to the control group, at the 24th hour after operation, the level of peripheral blood matrix metalloproteinases (MMPs) was lower than that in the experimental group (P=0.008). In the experimental group, after operation, the awakening time was much shorter (P=0.008), the incidence of bloodstream infection was much lower (P=0.019). While the incidence of delirium, acute kidney injury (AKI), hepatic insufficiency, mechanical ventilation duration, intensive care unit (ICU) stays, or hospital mortality rate showed no statistical difference. And at the first 24 hours after operation, there was no difference in the thoracic drainage volume between the two groups, and no patient suffered from shivering. Conclusion The mild hypothermia therapy is able to shorten the awakening time and reduce the incidence of bloodstream infection after operation in the patients with AAAD, and does not cause the increase of thoracic drainage volume or shivering.