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 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.

Anorectal surgery is transitioning from a tradition of experience-based practice toward modern precision medicine. This evolution is driven by greater societal focus on benign diseases, changing disease patterns due to lifestyle shifts and an aging population, and rising patient expectations for painless procedures and rapid recovery, all of which present more complex clinical challenges and higher demands for humanistic care. In this context, the management of benign anorectal diseases continues to advance, supported by theoretical breakthroughs, technological innovations, and shifts in clinical philosophy. From the cushion theory of hemorrhoids and the refined understanding of anal fistula anatomy, to the use of energy devices and high-resolution imaging guidance, treatment goals have shifted from anatomical repair to functional restoration and quality-of-life improvement. This progression demonstrates both the preservation of traditional wisdom and the pursuit of rational surgical innovation. This article systematically reviews the evolution of concepts, techniques, and approaches in benign anorectal disease management, and discusses the value of multidisciplinary collaboration and individualized clinical decision-making.

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.

Anorectal surgery is transitioning from a tradition of experience-based practice toward modern precision medicine. This evolution is driven by greater societal focus on benign diseases, changing disease patterns due to lifestyle shifts and an aging population, and rising patient expectations for painless procedures and rapid recovery, all of which present more complex clinical challenges and higher demands for humanistic care. In this context, the management of benign anorectal diseases continues to advance, supported by theoretical breakthroughs, technological innovations, and shifts in clinical philosophy. From the cushion theory of hemorrhoids and the refined understanding of anal fistula anatomy, to the use of energy devices and high-resolution imaging guidance, treatment goals have shifted from anatomical repair to functional restoration and quality-of-life improvement. This progression demonstrates both the preservation of traditional wisdom and the pursuit of rational surgical innovation. This article systematically reviews the evolution of concepts, techniques, and approaches in benign anorectal disease management, and discusses the value of multidisciplinary collaboration and individualized clinical decision-making.

Cutaneous melanoma is a malignant skin cancer with a poor prognosis.However,re-cent advances in immune checkpoint blockade and targeted therapy have significantly improved outcomes in advanced-stage resectable melanoma,which have made neoadjuvant therapy a viable option for melanoma patients.Currently,several relevant clinical trials on neoadjuvant therapy have achieved significant results.This paper reviews the recent advances in neoadjuvant therapy for cutaneous melanoma,focusing on the selection of neoadjuvant therapy,subsequent surgical considerations after neoadjuvant therapy,prognostic indicators,and baseline biomarkers.

Objective:To compare the effects of drug-loaded microsphere TACE (D-TACE) and iodinated oil emulsion TACE (cTACE) on liver fibrosis in the treatment of advanced hepatocellular carcinoma (HCC).Methods:Clinical data of 113 patients with HCC treated with D-TACE or cTACE at the First Affiliated Hospital of Zhengzhou University from October 2019 to September 2020 were retrospectively analyzed, including 96 males and 17 females, aged (56.8±9.8) years old. According to treatment protocol, patients were divided into two groups: the D-TACE group ( n=57) and the cTACE group ( n=56). Liver fibrosis panel, fibrosis index (FIB-4), aspartate aminotransferase to platelet ratio index (APRI), and liver stiffness measurement (LSM) were compared between the groups at four timepoints: pre-treatment, one month after the first TACE, one month after the second TACE, and 12 months after the first TACE. Follow-ups were conducted through outpatient visits or telephone reviews to assess patient survivals. Data including the progression-free survival (PFS) and number of TACE sessions were compared between the two groups. Results:The D-TACE group received 2.84±1.12 sessions of treatment during the observation period, compared to 4.05±1.44 sessions of cTACE group ( t=4.94, P<0.001). The median PFS in D-TACE and cTACE groups were 10.0 and 5.0 months, respectively ( P<0.001). At one month after the second TACE and at 12 months after the first TACE, patients in cTACE group had a higher serum levels of fibrosis markers including hyaluronic acid, type IV collagen, type III procollagen N peptide and laminin than those in D-TACE group (all P<0.05). At the same timepoints, patients in cTACE group also had higher APRI, FIB-4 and LSM than those in D-TACE group (all P<0.05). Conclusion:Compared to cTACE, patients in D-TACE group received fewer sessions of treatment during the first year after initial TACE, and the degree of liver fibrosis was also lower in D-TACE group.

Objective:To evaluate the efficacy of magnetic resonance imaging (MRI) diagnostic model of perianal fistulizing Crohn′s disease (pfCD) based on deep convolutional neural networks (DCNN) .Methods:A restrospective study was conducted. The patients with pfCD of initial diagnosis ( n = 200) and the patients with cryptoglandular anal fistula (CAF) of initial diagnosis ( n = 200) were enrolled randomly in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2014 to December 2019. The patients were assigned to the training, validation and test sets at a ratio of 8∶1∶1 in each group. The anal MRI images of all the patients were collected and preprocessed to enhance the quality of images. Using the Pytorch deep learning framework and Windows 10 computer operating system, the MRI diagnostic model of pfCD and CAF was constructed based on 4 DCNNs (MobileNetV2, VGG11, ResNet18 and ResNet34) . Each model was divided into transfer learning (T) and untransfer learning (U) types based on whether it incorporated transfer learning strategy. First, the image data of training set (160 pfCD and 160 CAF patients, a total of 78 321 MRI images) was input, and the training was iterated to minimize the loss. Then the best training model was selected based on the results of the validation set (20 pfCD and 20 CAF patients, a total of 9697 MRI images) . Finally, diagnostic efficacy was evaluated on the test set (20 pfCD and 20 CAF patients, a total of 9260 MRI images) . The receiver operating characteristic (ROC) curve for each model was drawn and the area under the curve (AUC) was calculated. The DeLong test was used to compare the difference in AUCs among different models and between models and radiologists with different seniorities. Results:The efficacy of 4 models based on DCNN were MobileNetV2-T (AUC = 0.943, 95% CI: 0.820-0.991) , VGG11-T (AUC = 0.935, 95% CI: 0.810-0.988) , ResNet18-T (AUC = 0.920, 95% CI: 0.789-0.988) , ResNet34-T (AUC = 0.929, 95% CI: 0.801-0.986) , respectively. The AUCs of the 4 models combined with transfer learning strategy were higher than that of junior radiologist (all P<0.05) , and there was no significant difference in AUCs between 4 models with transfer learning strategy and senior radiologist (all P>0.05) . Conclusion:The construction of diagnostic model of pfCD is feasible by using deep learning technology based on DCNN, transfer learning strategy and high-resolution anal MRI images.

The strategy of surgery combined with medical therapy has significantly improved the efficacy of anorectal Crohn′s disease. However, there is still a considerable proportion of patients with complex configuration who need to undergo diverting enterostomy, and even proctectomy followed by permanent stoma. Although diverting enterostomy is considered as an effective treatment for this disease, and the number of surgeries has been increasing year by year, most studies have demonstrated an inferior long-term efficacy. Based on clinical practice and literature review, the author′s team elucidates the treatment difficulties and prospects of diverting enterostomy in order to explore with clinicians.

Objective:To evaluate the efficacy of magnetic resonance imaging (MRI) diagnostic model of perianal fistulizing Crohn′s disease (pfCD) based on deep convolutional neural networks (DCNN) .Methods:A restrospective study was conducted. The patients with pfCD of initial diagnosis ( n = 200) and the patients with cryptoglandular anal fistula (CAF) of initial diagnosis ( n = 200) were enrolled randomly in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2014 to December 2019. The patients were assigned to the training, validation and test sets at a ratio of 8∶1∶1 in each group. The anal MRI images of all the patients were collected and preprocessed to enhance the quality of images. Using the Pytorch deep learning framework and Windows 10 computer operating system, the MRI diagnostic model of pfCD and CAF was constructed based on 4 DCNNs (MobileNetV2, VGG11, ResNet18 and ResNet34) . Each model was divided into transfer learning (T) and untransfer learning (U) types based on whether it incorporated transfer learning strategy. First, the image data of training set (160 pfCD and 160 CAF patients, a total of 78 321 MRI images) was input, and the training was iterated to minimize the loss. Then the best training model was selected based on the results of the validation set (20 pfCD and 20 CAF patients, a total of 9697 MRI images) . Finally, diagnostic efficacy was evaluated on the test set (20 pfCD and 20 CAF patients, a total of 9260 MRI images) . The receiver operating characteristic (ROC) curve for each model was drawn and the area under the curve (AUC) was calculated. The DeLong test was used to compare the difference in AUCs among different models and between models and radiologists with different seniorities. Results:The efficacy of 4 models based on DCNN were MobileNetV2-T (AUC = 0.943, 95% CI: 0.820-0.991) , VGG11-T (AUC = 0.935, 95% CI: 0.810-0.988) , ResNet18-T (AUC = 0.920, 95% CI: 0.789-0.988) , ResNet34-T (AUC = 0.929, 95% CI: 0.801-0.986) , respectively. The AUCs of the 4 models combined with transfer learning strategy were higher than that of junior radiologist (all P<0.05) , and there was no significant difference in AUCs between 4 models with transfer learning strategy and senior radiologist (all P>0.05) . Conclusion:The construction of diagnostic model of pfCD is feasible by using deep learning technology based on DCNN, transfer learning strategy and high-resolution anal MRI images.