Non-small cell lung cancer(NSCLC)accounts for the majority of lung cancer cases and remains the leading cause of cancer-related mortality worldwide.Firstly,this review explores the limitations of conventional therapies,chemotherapy,radiotherapy,and surgery,focusing on the development of drug resistance and significant toxicity that often hinder their efficacy.Thereafter,advancements in targeted therapies,such as immune checkpoint inhibitors(ICIs)and tyrosine kinase inhibitors(TKIs),are dis-cussed,highlighting their impact on improving outcomes for patients with specific genetic mutations,including c-ros oncogene 1 receptor tyrosine kinase(ROS1),anaplastic lymphoma kinase(ALK),and epidermal growth factor receptor(EGFR).Additionally,the emergence of novel immunotherapies and phytochemicals is examined,emphasizing their potential to overcome therapeutic resistance,particu-larly in advanced-stage diseases.The review also delves into the role of next-generation sequencing(NGS)in enabling personalized treatment approaches and explores the clinical potential of innovative agents,such as bispecific T-cell engagers(BiTEs)and antibody-drug conjugates(ADCs).Finally,we address the socioeconomic barriers that limit the accessibility of these therapies in low-resource settings and propose future research directions aimed at improving the long-term efficacy and accessibility of these treatments.

Non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases and remains the leading cause of cancer-related mortality worldwide. Firstly, this review explores the limitations of conventional therapies, chemotherapy, radiotherapy, and surgery, focusing on the development of drug resistance and significant toxicity that often hinder their efficacy. Thereafter, advancements in targeted therapies, such as immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs), are discussed, highlighting their impact on improving outcomes for patients with specific genetic mutations, including c-ros oncogene 1 receptor tyrosine kinase (ROS1), anaplastic lymphoma kinase (ALK), and epidermal growth factor receptor (EGFR). Additionally, the emergence of novel immunotherapies and phytochemicals is examined, emphasizing their potential to overcome therapeutic resistance, particularly in advanced-stage diseases. The review also delves into the role of next-generation sequencing (NGS) in enabling personalized treatment approaches and explores the clinical potential of innovative agents, such as bispecific T-cell engagers (BiTEs) and antibody-drug conjugates (ADCs). Finally, we address the socioeconomic barriers that limit the accessibility of these therapies in low-resource settings and propose future research directions aimed at improving the long-term efficacy and accessibility of these treatments.

Objective:To investigate the impact of " staging" hybrid coronary artery revascularization (HCR) on the short-and long-term efficacy of patients with multiple coronary artery lesions.Methods:A retrospective case-control study was conducted. Eighty patients with multiple coronary artery lesions admitted to the Baoding Second Central Hospital from January 2017 to October 2018 were selected and divided into two groups according to different surgical methods. Forty patients were treated with " staging" HCR and were designated as the HCR group, and 40 patients were treated with off-pump coronary artery bypass grafting (OPCAB) and were designated as the OPCAB group. The perioperative related indicators and perioperative serious complications were compared between the two groups. The serum myocardial injury marker levels were detected preoperatively and 48 hours postoperatively, including heart-type fatty acid binding protein (H-FABP) and troponin I (cTnI). All subjects were followed up for at least 3 years to calculate the incidence of major adverse cardiovascular and cerebrovascular events (MACCE).Results:The bypass surgery time, mechanical ventilation time, ICU stay time, and total hospital stay time in the HCR group were all less than those in the OPCAB group (all P<0.05), and the incision length in the HCR group was shorter than that in the OPCAB group ( P<0.05). The intraoperative bleeding volume, postoperative 24-hour drainage volume, red blood cell transfusion volume, and plasma transfusion volume in the HCR group were all less than those in the OPCAB group (all P<0.05). Forty-eight hours after surgery, the serum H-FABP and cTnI levels in both groups were significantly higher than those preoperatively (all P<0.05), but the increase was more significant in the OPCAB group (all P<0.05). The perioperative serious complication rate in the HCR group was 2.50%(1/40), which was significantly lower than that in the OPCAB group [20.00%(8/40)] ( P<0.05). During the 3-year follow-up after surgery, the MACCE incidence in the HCR group was 12.50%(5/40), and that in the OPCAB group was 22.50%(9/40). There was no significant difference in the long-term MACCE incidence between the two groups ( P>0.05). Conclusions:" Staging" HCR treatment for multiple coronary artery lesions can achieve ideal surgical results. Compared with OPCAB, its short-term efficacy is more significant, and long-term efficacy is equivalent.

Objective:To compare the efficacy and safety of ticagrelor and clopidogrel in antiplatelet aggregation after 2-staged hybrid coronary revascularization (HCR).Methods:A prospective randomized controlled trial was conducted. According to the postoperative antiplatelet therapy scheme, the patients with coronary artery multivessel disease who underwent 2-staged HCR operation in our hospital were divided into ticagrelor group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 90 mg orally twice daily for 1 year) and clopidogrel group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 75 mg orally once daily for 1 year). The general condition, platelet aggregation funtion [maximum platelet aggregation rate (MPAR) and P2Y12 reaction unit (PRU) ] at different time points before and after operation, and platelet inhibition rate [aspirin resistance (AA), ticagrelor or clopidogrel resistance (ADP)], major adverse cardiovascular events (MACE), bleeding events, and adverse reactions after operation were analyzed and compared between the 2 groups.Results:A total of 124 patients were enrolled in the study, 62 patients each in the ticagrelor group and clopidogrel group. There were no statistically significant differences in baseline data (gender, age, New York Heart Association cardiac function classification, concomitant diseases, etc.) between the 2 groups (all P>0.05). The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group and clopidogrel group were lower than those before operation [(50±9)%, (36±8)%, (29±6)% vs. (65±11)% and (59±10)%, (47±9)%, (38±7)% vs. (65±12)%, all P<0.001]. The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group[(50±9)% vs. (59±10)%, (36±8)% vs. (47±9)%, (29±6)% vs. (38±7)%, all P<0.001]. The PRUs at 24 h, 7 d, and 1 month after operation in the 2 groups were lower than those before operation (all P<0.001). The PRUs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group(all P<0.001). There was no significant difference in the incidence of AA 24 hours after operation between the 2 groups ( P>0.05); the inhibition rate of ADP in the ticagrelor group was higher than that in the clopidogrel group ( P<0.001). At the 24th month of follow-up, the incidence of MACE in the ticagrelor group was lower than that in the clopidogrel group (11.3% vs. 27.4%, P<0.05). At the 12th month of follow-up, there was no statistically significant difference in incidence of bleeding events between the 2 groups (3.2% vs. 8.1%, P>0.05) . There was no statistically significant difference in the incidence of adverse reactions between the 2 groups (16.1% vs. 11.3%, P>0.05) . Conclusions:Compared with clopidogrel+aspirin regimen, ticagrelor+aspirin regimen is more effective in inhibiting platelet aggregation and reducing postoperative MACE after 2-staged HCR. Both antiplatelet aggregation regimens do not increase the risk of bleeding and have no serious adverse reactions. Both regimens have good safety.

Objective:To compare the efficacy and safety of ticagrelor and clopidogrel in antiplatelet aggregation after 2-staged hybrid coronary revascularization (HCR).Methods:A prospective randomized controlled trial was conducted. According to the postoperative antiplatelet therapy scheme, the patients with coronary artery multivessel disease who underwent 2-staged HCR operation in our hospital were divided into ticagrelor group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 90 mg orally twice daily for 1 year) and clopidogrel group (after the operation, the patients were given aspirin enteric coated tablets 100 mg orally once daily and ticagrelor tablets 75 mg orally once daily for 1 year). The general condition, platelet aggregation funtion [maximum platelet aggregation rate (MPAR) and P2Y12 reaction unit (PRU) ] at different time points before and after operation, and platelet inhibition rate [aspirin resistance (AA), ticagrelor or clopidogrel resistance (ADP)], major adverse cardiovascular events (MACE), bleeding events, and adverse reactions after operation were analyzed and compared between the 2 groups.Results:A total of 124 patients were enrolled in the study, 62 patients each in the ticagrelor group and clopidogrel group. There were no statistically significant differences in baseline data (gender, age, New York Heart Association cardiac function classification, concomitant diseases, etc.) between the 2 groups (all P>0.05). The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group and clopidogrel group were lower than those before operation [(50±9)%, (36±8)%, (29±6)% vs. (65±11)% and (59±10)%, (47±9)%, (38±7)% vs. (65±12)%, all P<0.001]. The MPARs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group[(50±9)% vs. (59±10)%, (36±8)% vs. (47±9)%, (29±6)% vs. (38±7)%, all P<0.001]. The PRUs at 24 h, 7 d, and 1 month after operation in the 2 groups were lower than those before operation (all P<0.001). The PRUs at 24 h, 7 d, and 1 month after operation in the ticagrelor group were lower than those in the clopidogrel group(all P<0.001). There was no significant difference in the incidence of AA 24 hours after operation between the 2 groups ( P>0.05); the inhibition rate of ADP in the ticagrelor group was higher than that in the clopidogrel group ( P<0.001). At the 24th month of follow-up, the incidence of MACE in the ticagrelor group was lower than that in the clopidogrel group (11.3% vs. 27.4%, P<0.05). At the 12th month of follow-up, there was no statistically significant difference in incidence of bleeding events between the 2 groups (3.2% vs. 8.1%, P>0.05) . There was no statistically significant difference in the incidence of adverse reactions between the 2 groups (16.1% vs. 11.3%, P>0.05) . Conclusions:Compared with clopidogrel+aspirin regimen, ticagrelor+aspirin regimen is more effective in inhibiting platelet aggregation and reducing postoperative MACE after 2-staged HCR. Both antiplatelet aggregation regimens do not increase the risk of bleeding and have no serious adverse reactions. Both regimens have good safety.

（正）Luketich 等[1]2000 年首次报道了胸腹腔镜联合食管癌微创手术（minimally invasive esophagectomy， MIE）病例。随着近 10 多年的发展，食管癌微创外科已经进入一个技术成熟的阶段，能使广大食管癌患者受益。2009 年美国国立综合癌症网络（NCCN）临床指南[2]已将 MIE 列为标准食管癌术式之一。

Objective: To compare the efficacies of the two techniques of "micro-hemostasis and micro-cutting" with straight bipolar electrocoagulation forceps and traditional clamp-ligation for hemostasia in thyroid surgery. Methods: A total of 228 patients who underwent surgical treatment for thyroid neoplasms in our hospital between January 2015 and December 2018 were retrospectively analyzed, including 50 males and 178 females, aged 23-68 years old. Of those, 150 cases as electric knife group received traditional thyroid surgery between January 2015 and December 2018 and 78 cases as bipolar electrocoagulation group received thyroid surgery by using the technique of bipolar electrocoagulation with meticulous anatomy between January 2018 and December 2018. The total operation time, single operation time, intraoperative hemorrhage, postoperative drainage volume on the first day, postoperative hoarseness and hypocalcemia were compared between the two groups. SPSS 16.0 was used to analyze the data. Results: The total operation time and intraoperative hemorrhage in the bipolar electrocoagulation group were significantly lower than those in the electric knife group ((59.33±18.29)min vs (77.21±25.39)min, (14.83±9.22)ml vs (36.86±11.80)ml, all P<0.01). The single operation time of the bipolar electrocoagulation group was shorter than that of the electric knife group((10.25±6.16) min vs (20.34±7.24)min, (16.25±7.15)min vs (35.68±8.25)min, (12.12±5.25)min vs (20.68±7.26)min, t value was 3.948,16.262,8.238, all P<0.01).There was no significant difference between the two groups in postoperative drainage volume on the first day (P>0.05) and the incidence of postoperative hoarseness (P>0.05), while the incidence of hypocalcemia in the bipolar electrocoagulation group(10.26%) was lower than that in the electric knife group(21.33%,χ²=4.353, P<0.05). Conclusions The fine dissection for thyroid operation can be achieved by using straight bipolar electrocoagulation tweezers. The use of "micro-hemostasis" and "micro-cutting" technique with bipolar electrocoagulation tweezers can greatly reduce intraoperative bleeding, operation time and postoperative complication.

Objective To investigate the mechanisms of paeoniflorin in protection of retinal ischemia injury.Methods Fifty-four male specefic pathogen free (SPF) degree Wistar rats were randomly divided into normal control group,model control group and paeoniflorin group.Retinal ischemia injury was induced by raising the intraocular pressure of right eyes of rats to 110 mmHg for 30 minutes.The rats of paeoniflorin group were administrated through intraperitoneal injection of 5 mg/kg paeoniflorin each day for 14 days.OCT and electroretinogram (ERG) were performed to detect the thickness of retinal nerve fiber layer+retinal ganglion cell layer+inner plexiform layer (NGI)and electrophysiological changes of retina,respectively.Retrograde labelling of retinal ganglion cells (RGCs) was used to evaluate the survival number of RGCs.Western blot analysis was used to detect NLRP3,apoptosis-associated speck-like protein containing a caspase activation and recruitment domain (ASC),cleaved caspase 1 (c-caspase 1),IL-18,and IL-1β expression.The use and care of animals complied with the statement of the Association for Research in Vision and Ophthalmology (ARVO) and Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The thickness of retinal NGI in model control group was (58.2 ± 1.7) μm,which was significantly lower than (84.8 ± 1.9) μm in normal control group and (71.1 ±2.4) μm in paeoniflorin group (both at P＜0.05).The amplitudes of A and B waves in paeoniflorin group and normal control group were significantly higher than those in model control group (both at P＜0.05).The number of RGC in model control group was significantly lower than that in paeoniflorin group and normal control group (both at P＜0.05).The relative expressions of NLRP3,ASC,c-caspase 1,IL-18 and IL-1β in model control group were significantly higher than those in normal control group and paeoniflorin group (all at P＜0.05).Conclusions The paeoniflorin can prevent retinal ischemia induced injury of the retina through NLRP3 inflammasomes pathway,which provides a new treatment strategy for clinical therapy.

[Abstract] Objective: To investigate the expression and clinical significance of lncRNAANRIL in glioma tissues. Methods: 129 cases of glioma tissues and 25 cases of normal brain tissues as control were collected from patients treated in Sichuan Provincial People’ s Hospital from January 01, 2012 to December 30, 2016. Real-time quantitative PCR was used to detect the mRNA expression of lncRNAANRIL; and the relationship between lncRNAANRIL expression and sensitivity of patients to temozolomide as well as the clinical prognosis of glioma patients were analyzed. Results: Compared with control group, the expression of lncRNAANRIL in 129 cases of glioma tissues was significantly increased ([8.730±0.336] vs [1.090±0.137], t=9.957, P<0.01). The expression of lncRNAANRIL in WHO Ⅰ-Ⅱ grade patients was significantly lower than that of patients at grade Ⅲ-Ⅳ ([4.198±0.260] vs [10.550±0.291], t=13.03, P< 0.01). lncRNA ANRIL expression was significantly correlated with WHO stage，the sensitivity to temozolomide（TMZ）and survival status（all P<0.05）, but not associated with gender, age, KPS score and tumor size (all P>0.05). Moreover, Kaplan-Meier analysis demonstrated that decreased lncRNAANRIL expression contributed to significantly longer overall survival ([29.17±0.64] vs [13.54±0.74] months, P<0.01) and recurrence-free survival time ([9.08±0.56] vs [15.88±0.83] months, P<0.01). Univariate and multivariate analysis also indicated that lncRNAANRIL expression, WHO stage and chemosensitivity could be independent prognostic markers for glioma (P<0.05). Conclusion: Higher pathological grade of glioma patients indicates higher lncRNA ANRIL expression and shorter survival time. lncRNAANRIL is involved in the occurrence and development of glioma, and can be used as a molecular marker for the diagnosis and prognosis of glioma.

Objective To investigate the mechanisms of paeoniflorin in protection of retinal ischemia injury. Methods Fifty.four male specefic pathogen free ( SPF) degree Wistar rats were randomly divided into normal control group,model control group and paeoniflorin group. Retinal ischemia injury was induced by raising the intraocular pressure of right eyes of rats to 110 mmHg for 30 minutes. The rats of paeoniflorin group were administrated through intraperitoneal injection of 5 mg/kg paeoniflorin each day for 14 days. OCT and electroretinogram ( ERG ) were performed to detect the thickness of retinal nerve fiber layer+retinal ganglion cell layer+inner plexiform layer ( NGI) and electrophysiological changes of retina, respectively. Retrograde labelling of retinal ganglion cells ( RGCs ) was used to evaluate the survival number of RGCs. Western blot analysis was used to detect NLRP3,apoptosis.associated speck.like protein containing a caspase activation and recruitment domain (ASC),cleaved caspase 1 (c.caspase 1), IL.18,and IL.1β expression. The use and care of animals complied with the statement of the Association for Research in Vision and Ophthalmology ( ARVO ) and Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results The thickness of retinal NGI in model control group was ( 58. 2 ± 1. 7)μm, which was significantly lower than ( 84. 8 ± 1. 9)μm in normal control group and(71. 1±2. 4)μm in paeoniflorin group (both at P<0. 05). The amplitudes of A and B waves in paeoniflorin group and normal control group were significantly higher than those in model control group ( both at P<0. 05 ) . The number of RGC in model control group was significantly lower than that in paeoniflorin group and normal control group ( both at P<0. 05). The relative expressions of NLRP3,ASC,c.caspase 1,IL.18 and IL.1β in model control group were significantly higher than those in normal control group and paeoniflorin group (all at P<0. 05). Conclusions The paeoniflorin can prevent retinal ischemia induced injury of the retina through NLRP3 inflammasomes pathway,which provides a new treatment strategy for clinical therapy.