Skin avulsion injuries of the lower leg are common in clinical practice, which can easily lead to skin necrosis and infection of the lower leg, and have a significant impact on the appearance and function of the lower limb. Among them, the open avulsion injury has the highest incidence and is often accompanied by multiple tissue injuries. Therefore, improper diagnosis and treatment may cause skin and soft tissue defects of the lower leg combined with bone exposure or even bone defects, seriously impairing patients′ life and health. In order to have a better understanding of the open skin avulsion injury of the lower leg, achieve precise diagnosis and treatment and improve prognosis, the Chinese Society of Traumatology of Chinese Medical Association and the Chinese Association of Microsurgeons of Chinese Medical Doctor Association organized experts in the related fields to formulate Clinical guideline for the diagnosis and treatment of open skin avulsion injuries of the lower leg ( version 2024) based on evidence-based medicine principles. A total of 16 recommendations were proposed on the diagnosis, treatment, postoperative rehabilitation of open lower leg skin avulsion injury, so as to provide a reference for its diagnosis and treatment.

Skin avulsion injuries of the lower leg are common in clinical practice, which can easily lead to skin necrosis and infection of the lower leg, and have a significant impact on the appearance and function of the lower limb. Among them, the open avulsion injury has the highest incidence and is often accompanied by multiple tissue injuries. Therefore, improper diagnosis and treatment may cause skin and soft tissue defects of the lower leg combined with bone exposure or even bone defects, seriously impairing patients′ life and health. In order to have a better understanding of the open skin avulsion injury of the lower leg, achieve precise diagnosis and treatment and improve prognosis, the Chinese Society of Traumatology of Chinese Medical Association and the Chinese Association of Microsurgeons of Chinese Medical Doctor Association organized experts in the related fields to formulate Clinical guideline for the diagnosis and treatment of open skin avulsion injuries of the lower leg ( version 2024) based on evidence-based medicine principles. A total of 16 recommendations were proposed on the diagnosis, treatment, postoperative rehabilitation of open lower leg skin avulsion injury, so as to provide a reference for its diagnosis and treatment.

A total of 4 patients with renal cancer were admitted to our hospital from October 2006 to September 2015 in a familial renal cancer family. Among the 4 patients, 1 patient showed unilateral multiple clear cell carcinoma, 1 patient showed bilateral multiple clear cell carcinoma, and 2 patients showed bilateral multiple chromophobe cell carcinoma. No mutation of VHL or FLCN gene was found in all patients by genetic analysis.

Immune checkpoint inhibitors (ICIs) can not only prolong the survival time of patients with non-small cell lung cancer (NSCLC) in a short time, but also achieve a lasting response to the tumor. However, there has been significant heterogeneity in the efficacy of ICIs among patients with different types of NSCLC, and there has been still a lack of universal biomarkers to predict the benefit of ICIs treatment. Inflammation has played a definite role in the occurrence and development of tumors, and a variety of inflammatory markers in serum also have become clinical indicators reflecting immune status, such as lactate dehydrogenase, C-reactive protein, serum neutrophils, lymphocytes, platelets and other indicators. These inflammatory markers are easy to obtain and are associated with the prognosis of a variety of solid tumors.

In recent years, immunotherapy has been used more frequently for metastatic gastric cancer that has progressed after chemotherapy, the most commonly used of which are immune checkpoint inhibitors (ICIs). However, the efficacy of ICIs varies greatly among different patients. Therefore, more and more studies have been carried out on biomarkers that predict the efficacy of ICIs. Microsatellite instability and Epstein-Barr virus subtype are relatively accurate biomarkers indicating the response rate of ICIs treatment. The predictive roles of programmed death ligand-1 and tumor mutation burden are still controversial. Tumor infiltrating lymphocyte, tumor-associated macrophages, fibrinogen-like-protein 1, alternative promoters and other predictors are also being studied.