Objective:To explore the impact of tislelizumab on renal function in bladder cancer patients with hydronephrosisMethods:A retrospective analysis of 34 bladder cancer patients with hydronephrosis treated at the Second Hospital of Tianjin Medical University from July 2020 to September 2023. Among them, 27 were male, and 7 were female, with an average age of (67.41±11.06)years and a body mass index (BMI) of (29.00±7.34) kg/m 2. 18 patients (52.9%) had hypertension, 5 (14.7%) had diabetes, and 5 (14.7%) had coronary heart disease. The baseline serum creatinine (SCr) was 81.15(69.18, 108.90)μmol/L, and the estimated glomerular filtration rate (eGFR) was 73.86(62.17, 91.12)ml/(min·1.73m 2). Of these, 26 patients (76.5%) had eGFR ≥60 ml/(min·1.73m 2)(G60+ group), and 8 patients (23.5%) had eGFR <60 ml/(min·1.73m 2)(G60- group). 10 patients (29.4%) had non-muscle invasive bladder cancer (NMIBC), and 24(70.6%) had muscle-invasive bladder cancer (MIBC). Eleven patients received surgical interventions within 1 month before baseline data collection that might affect hydronephrosis. All 34 patients received tislelizumab (200 mg, intravenous infusion every 3 weeks) combined with albumin-paclitaxel (200 mg, intravenous infusion every 3 weeks). Serum creatinine values were recorded before cycles 1, 2, and 3, and 21 days after cycle 3 (Cr1, Cr2, Cr3, CrE), and corresponding eGFR values (eGFR1, eGFR2, eGFR3, eGFRE) were calculated. A reduction in eGFR >25% from baseline at any of these points was defined as a decline in renal function (DRF), and an increase in eGFR >25% was defined as improvement in renal function (IRF). Differences in renal function changes and IRF, DRF incidence rates were compared between baseline subgroups Results:After 3 cycles of tislelizumab treatment, there was no significant change in eGFR []eGFR1 vs. eGFRE, 73.86 (62.16, 91.12)ml/(min·1.73m 2) vs. 83.82 (60.32, 90.62) ml/(min·1.73m 2), P=0.197]. Subgroup analysis showed that patients with diabetes had a significant increase in CrE compared to Cr1 (88.90 μmol/L vs. 69.40 μmol/L, P=0.043) and a significant decrease in eGFRE compared to eGFR1 [76.47 ml/(min·1.73m 2) vs. 87.73 ml/(min·1.73m 2), P=0.043]. No significant differences were observed in the other subgroups for SCr and eGFR within or between groups. DRF occurred in 4 patients (11.8%), with 1 diagnosed with acute renal injury, but not immune-related. IRF occurred in 8 patients (22.9%). In the subgroup analysis, the IRF incidence was significantly higher in the G60-group compared to the G60+ group (50.0% vs. 15.4%, P=0.044). No other factors were found to be associated with DRF or IRF. Conclusions:Tislelizumab treatment is safe for renal function in bladder cancer patients with hydronephrosis. Most patients with baseline poor renal function or underlying conditions like hypertension, diabetes, or coronary heart disease showed stable renal function during treatment.

Objective:To explore the impact of tislelizumab on renal function in bladder cancer patients with hydronephrosisMethods:A retrospective analysis of 34 bladder cancer patients with hydronephrosis treated at the Second Hospital of Tianjin Medical University from July 2020 to September 2023. Among them, 27 were male, and 7 were female, with an average age of (67.41±11.06)years and a body mass index (BMI) of (29.00±7.34) kg/m 2. 18 patients (52.9%) had hypertension, 5 (14.7%) had diabetes, and 5 (14.7%) had coronary heart disease. The baseline serum creatinine (SCr) was 81.15(69.18, 108.90)μmol/L, and the estimated glomerular filtration rate (eGFR) was 73.86(62.17, 91.12)ml/(min·1.73m 2). Of these, 26 patients (76.5%) had eGFR ≥60 ml/(min·1.73m 2)(G60+ group), and 8 patients (23.5%) had eGFR <60 ml/(min·1.73m 2)(G60- group). 10 patients (29.4%) had non-muscle invasive bladder cancer (NMIBC), and 24(70.6%) had muscle-invasive bladder cancer (MIBC). Eleven patients received surgical interventions within 1 month before baseline data collection that might affect hydronephrosis. All 34 patients received tislelizumab (200 mg, intravenous infusion every 3 weeks) combined with albumin-paclitaxel (200 mg, intravenous infusion every 3 weeks). Serum creatinine values were recorded before cycles 1, 2, and 3, and 21 days after cycle 3 (Cr1, Cr2, Cr3, CrE), and corresponding eGFR values (eGFR1, eGFR2, eGFR3, eGFRE) were calculated. A reduction in eGFR >25% from baseline at any of these points was defined as a decline in renal function (DRF), and an increase in eGFR >25% was defined as improvement in renal function (IRF). Differences in renal function changes and IRF, DRF incidence rates were compared between baseline subgroups Results:After 3 cycles of tislelizumab treatment, there was no significant change in eGFR []eGFR1 vs. eGFRE, 73.86 (62.16, 91.12)ml/(min·1.73m 2) vs. 83.82 (60.32, 90.62) ml/(min·1.73m 2), P=0.197]. Subgroup analysis showed that patients with diabetes had a significant increase in CrE compared to Cr1 (88.90 μmol/L vs. 69.40 μmol/L, P=0.043) and a significant decrease in eGFRE compared to eGFR1 [76.47 ml/(min·1.73m 2) vs. 87.73 ml/(min·1.73m 2), P=0.043]. No significant differences were observed in the other subgroups for SCr and eGFR within or between groups. DRF occurred in 4 patients (11.8%), with 1 diagnosed with acute renal injury, but not immune-related. IRF occurred in 8 patients (22.9%). In the subgroup analysis, the IRF incidence was significantly higher in the G60-group compared to the G60+ group (50.0% vs. 15.4%, P=0.044). No other factors were found to be associated with DRF or IRF. Conclusions:Tislelizumab treatment is safe for renal function in bladder cancer patients with hydronephrosis. Most patients with baseline poor renal function or underlying conditions like hypertension, diabetes, or coronary heart disease showed stable renal function during treatment.

OBJECTIVETo study the distributional feature and clinical characteristics of infectious diarrhea caused by enterohemorrhagic Escherichia coli O157:H7, and to understand its pollution to the environment and the carrier status among livestock and poultry.

METHODSTo describing the incidence of diarrhea, to isolate and culture the pathogenic bacteria from samples of the patients with diarrhea and livestock or poultry with methods of microbiology, molecular biology and cytology, and then to determine the toxic factors.

RESULTSIn the first epidemic area in Suixian county, Henan province, 35 cases had been found during 17 March and 6 July with 91% of them above age of 60. Of them, 32 were complicated with acute renal failure, including 28 death (death rate: 87.50%). One hundred and seven strains of O157:H7 were isolated from the samples of livestock or poultry and 48 strains were isolated from patients. It was found that 67 strains having toxic gene through microbiological, molecular biological and cytological technologies. Five types of toxic factors were found.

CONCLUSIONThe main factor causing death was the complicated acute renal failure from diarrhea infected by E. coli O157:H7. The pathogen from livestock or poultry with high carrying rate might infect people through polluted water, food flies and close contacts. The outbreak of acute hemolytic uremic syndrome in Suixian county was caused by Enterohemorrhagic Escherichia coli O157:H7 infection.

Acute Kidney Injury ; etiology ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Diarrhea ; epidemiology ; Disease Outbreaks ; Escherichia coli Infections ; complications ; epidemiology ; Escherichia coli O157 ; isolation & purification ; Female ; Humans ; Male ; Middle Aged