Objective To investigate the correlation between peripheral blood total bilirubin(TBIL)levels and the efficacy and prognosis of immunotherapy in advanced non-small cell lung cancer(NSCLC),as well as its relationship with immune inflammation.Methods A retrospective analysis was conducted on 246 patients with advanced NSCLC who received immunotherapy from June 2019 to June 2022.Pre-treatment TBIL levels were collected,and the optimal cutoff value for TBIL was determined using the"X-tile"software and the ROC curve.The impact of pre-treatment TBIL on the short-term efficacy and long-term prognosis of advanced NSCLC was an-alyzed.Results The optimal cutoff value for TBIL was identified as 10.5μmol/L using the"X-tile"software and the ROC curve.A-nalysis of short-term efficacy indicated that patients with higher TBIL levels had a significantly better objective response rate(ORR)compared to those with lower levels(51.3％vs 33.8％,P=0.006).The disease control rate(DCR)was also higher in the higher TBIL level group compared to the low level group(92.9％vs 81.2％,P=0.007).Kaplan-Meier survival analysis revealed that patients with elevated TBIL levels had a longer median progression-free survival(PFS)compared to those with lower TBIL levels,with 13.0 vs 7.0 months,respectively(P＜0.001).Similarly,the median overall survival(OS)was greater in the higher TBIL level group than in the lower TBIL level group,with 16.0 vs 12.0months,respectively(P＜0.001).Additionally,there were significant differences in neutro-phil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII)between two groups of different TBIL levels(P＜0.05).Conclusion In immunotherapy for advanced non-small cell lung cancer,patients with higher baseline levels of TBIL exhibit a positive correlation with the efficacy and prognosis of immunotherapy.TBIL might be served as an important predictive marker for immunotherapy in patients with advanced NSCLC.

Objective To analyze the correlation of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)with short-term outcome and long-term prognosis in patients with advanced non-small cell lung cancer(NSCLC).Methods A retrospective study was conducted.A total of 215NSCLC patients who received a complete 4-cycle chemotherapy combined with immunotherapy or chemotherapy alone in the Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Xuzhou Medical University from January 2021 to January 2023 were selected as the research subjects.The patients were divided into remission group(n=97)and non-remission group(n=118)based on the efficacy of the treatments,and the differences in NLR,PLR,SII,and decline rate of each index were compared between the two groups.NLR,PLR,SII and decline rate before and after treatment were grouped by the best cut-off value or median,and the differences in progression-free survival and overall survival were analyzed by each index group.Results NLR and PLR in the remission group before each cycle of treatment were signifi-cantly lower than those in the non-remission group,and SII in the remission group before cycles 2nd,3rd,and 4th of treatment were sig-nificantly lower than those in the non-remission group(P＜0.05);From initial treatment to before the fourth treatment cycle,NLR and SII decline rates in the remission group were significantly higher than those in the non-remission group(P＜0.05);the tumor stage,NLR before cycle 4th of treatment were independent influencing factors of short-term efficacy in patients with advanced NSCLC(P＜0.05);patients with low NLR,PLR,SII and higher rates of decline in NLR and SII before cycle 4th treatment had longer progression-free survival and overall survival(P＜0.05).Conclusion Tumor stage and post-treatment NLR are significantly correlated with the short-term outcomes of patients with advanced NSCLC,and high post-treatment NLR often suggests a poorer response to treatment.The prognosis of advanced NSCLC patients with higher NLR decline rate and higher SII decline rate after treatment is better.

Objective To analyze the correlation of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)with short-term outcome and long-term prognosis in patients with advanced non-small cell lung cancer(NSCLC).Methods A retrospective study was conducted.A total of 215NSCLC patients who received a complete 4-cycle chemotherapy combined with immunotherapy or chemotherapy alone in the Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Xuzhou Medical University from January 2021 to January 2023 were selected as the research subjects.The patients were divided into remission group(n=97)and non-remission group(n=118)based on the efficacy of the treatments,and the differences in NLR,PLR,SII,and decline rate of each index were compared between the two groups.NLR,PLR,SII and decline rate before and after treatment were grouped by the best cut-off value or median,and the differences in progression-free survival and overall survival were analyzed by each index group.Results NLR and PLR in the remission group before each cycle of treatment were signifi-cantly lower than those in the non-remission group,and SII in the remission group before cycles 2nd,3rd,and 4th of treatment were sig-nificantly lower than those in the non-remission group(P＜0.05);From initial treatment to before the fourth treatment cycle,NLR and SII decline rates in the remission group were significantly higher than those in the non-remission group(P＜0.05);the tumor stage,NLR before cycle 4th of treatment were independent influencing factors of short-term efficacy in patients with advanced NSCLC(P＜0.05);patients with low NLR,PLR,SII and higher rates of decline in NLR and SII before cycle 4th treatment had longer progression-free survival and overall survival(P＜0.05).Conclusion Tumor stage and post-treatment NLR are significantly correlated with the short-term outcomes of patients with advanced NSCLC,and high post-treatment NLR often suggests a poorer response to treatment.The prognosis of advanced NSCLC patients with higher NLR decline rate and higher SII decline rate after treatment is better.

Objective To investigate the correlation between peripheral blood total bilirubin(TBIL)levels and the efficacy and prognosis of immunotherapy in advanced non-small cell lung cancer(NSCLC),as well as its relationship with immune inflammation.Methods A retrospective analysis was conducted on 246 patients with advanced NSCLC who received immunotherapy from June 2019 to June 2022.Pre-treatment TBIL levels were collected,and the optimal cutoff value for TBIL was determined using the"X-tile"software and the ROC curve.The impact of pre-treatment TBIL on the short-term efficacy and long-term prognosis of advanced NSCLC was an-alyzed.Results The optimal cutoff value for TBIL was identified as 10.5μmol/L using the"X-tile"software and the ROC curve.A-nalysis of short-term efficacy indicated that patients with higher TBIL levels had a significantly better objective response rate(ORR)compared to those with lower levels(51.3％vs 33.8％,P=0.006).The disease control rate(DCR)was also higher in the higher TBIL level group compared to the low level group(92.9％vs 81.2％,P=0.007).Kaplan-Meier survival analysis revealed that patients with elevated TBIL levels had a longer median progression-free survival(PFS)compared to those with lower TBIL levels,with 13.0 vs 7.0 months,respectively(P＜0.001).Similarly,the median overall survival(OS)was greater in the higher TBIL level group than in the lower TBIL level group,with 16.0 vs 12.0months,respectively(P＜0.001).Additionally,there were significant differences in neutro-phil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII)between two groups of different TBIL levels(P＜0.05).Conclusion In immunotherapy for advanced non-small cell lung cancer,patients with higher baseline levels of TBIL exhibit a positive correlation with the efficacy and prognosis of immunotherapy.TBIL might be served as an important predictive marker for immunotherapy in patients with advanced NSCLC.

Objective: To perform an epidemiological survey of the first case with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Pinghu City of Jiaxing City, Zhejiang Province on March 13, 2022, so as to provide insights into the management of coronavirus disease (COVID-19) epidemics. Methods: According to the requirements of the Protocol on Prevention and Control of COVID-19 (8th Edition), epidemiological investigations were performed among 39 cases with SARS-CoV-2 infections in Pinghu City from March 13 to 20, 2022. Cases' demographics, clinical symptoms, history of immunization and exposure were collected, and close contacts were identified. Pharyngeal swabs were sampled from infected cases for detection of SARS-CoV-2 nucleic acid and whole-genome sequencing, and the source of infection and transmission route were investigated. Results: The index case for this COVID-19 epidemic was an imported case from Shanghai Municipality, who infected 6 persons via aerosol transmission when playing in the badminton venue of Pinghu National Fitness Center on March 9; subsequently, one of these infected cases infected another 18 persons when playing in the badminton venue of Jiadian Village Resident's Fitness Center in Zhapu Township on March 12. Sixteen confirmed cases were reported, and all cases were mild; another 23 asymptomatic cases were diagnosed, with no death reported. This epidemic occurred from March 11 to 20, with 3 generations of spread and a median incubation period of 3 days. The SARS-CoV-2 infected cases had a median age of 33.5 (interquartile range, 12.0) years and included 36 cases with a history of COVID-19 vaccination. There were 16 cases with fever, cough, runny nose and sore throat, and 13 cases with imaging features of pneumonia. The effective reproductive number (Rt) of the COVID-19 epidemic was 7.73 at early stage, and was less than 1 since March 21. Whole-genome sequencing identified Omicron BA.2 variant among 33 cases, which had high homology with the index cases. Conclusion This epidemic was a cluster of COVID-19 caused by imported Omicron BA.2 variant infection from Shanghai Municipality, and the COVID-19 transmission was mainly caused by indoor aerosols.

Many factors contribute to a successful total knee arthroplasty, and postoperative coronal lower limb alignment has always been a focus of joint surgeons. Previous researches have suggested that neutral alignment can bring higher prosthesis survival rate and better knee function. However, the theory has been challenged in recent years.In this article, the author introduces the axis, alignment and osteotomy of total knee arthroplasty briefly and reviews the studies on the neutral alignment and kinematic alignment of recent years in order to provide some advice for the clinical operation.

OBJECTIVETo explore the pathogenesis of a child with growth retardation, liver damage and congenital heart disease.

METHODSG-banded chromosomal karyotyping, high-throughput next-generation sequencing (HT-NGS)and fluorescence in situ hybridization(FISH) were used to characterize the structural chromosomal aberration.

RESULTSThe child was found to have a karyotype of 46, XX, t(1;2) (q25;q21), t(7;20) (q21;p13). HT-NGS has detected a microdeletion at 2q21.3 and 7q21.11, respectively, which were verified by FISH.

CONCLUSIONCombined cytogenetic and molecular analysis can detect chromosome micrdeletions more precisely. The abnormalities of the child may be attributed to heterozygous deletion of ZEB2, ABCB4 and SEMA3A genes.

Chromosome Aberrations ; Chromosome Banding ; methods ; Female ; Heart Defects, Congenital ; genetics ; Humans ; Infant ; Intellectual Disability ; genetics ; Karyotyping ; methods ; Liver Diseases ; genetics

OBJECTIVE:To study the pharmacokinetics of the active ingredients of Shenmai injection,including ginsenoside Rg1 and ginsenoside Re,in normal Beagle dogs and those with myocardial ischemia. METHODS:6 Beagle dogs were given isopro-terenol hydrochloride (1.1 mg/kg) sc to establish the model of myocardial ischemia (model group). Another 6 Beagle dogs were given isometric normal saline (2.2 ml/kg) sc as controls group. The two groups of dogs respectively received corresponding drugs sc at 8:00 am and 13:00 pm on day 1 and at 8:00 am on day 2. Each group of dogs were given Shenmai injection(1.6 ml/kg)iv 1 h after administration on day 2,and such intravenous drip lasted for about 1 h. Blood was collected from each group 0,0.25, 0.5,0.75,1(the end of iv),1.5,2,3,4,6,8,12 and 24 h from the start of iv. Liquid chromatography-mass spectrometry was adopted to determine the concentrations of ginsenoside Rg1 and ginsenoside Re in blood,and WinNonlin 6.3 was used to calculate pharmacokinetic parameters for comparison. RESULTS:For ginsenoside Re in the dogs of the model group,t1/2 was(2.69±1.12) h,AUC0-24 h was(2 060.78±812.18)h·μg/L,Vz was(46.16±20.98)ml and CL was(9.02±4.45)ml/h;compared to the normal control group,AUC0-24 h was much greater and Vz and CL were significantly lower,showing a statistically significant difference(P<0.05). No significant difference in the pharmacokinetic parameters of ginsenoside Rg1 was shown between 2 groups(P>0.05). CON-CLUSIONS:Myocardial ischemia may affect the removal of ginsenoside Re in Beagle dogs,but has no effect on the pharmacoki-netic process of ginsenoside Rg1.

Objective To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease.Methods A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December,2015 were enrolled as observation group,and 20 healthy volunteers (40 wrists) were enrolled as the control group.Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament.The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured,as well as the cross-sectional area of the median nerve at the level of pisiform bone.Results In the 29 patients with hand-arm vibration disease patients in the observation group,8 experienced entrapment of the median nerve in the carpal canal,among whom 5 had entrapment in both wrists;there were 13 wrists (23％) with nerve entrapment and 45 wrists (77％) without nerve entrapment.Compared with the control group,the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the crosssectional area of the median nerve at the level of pisiform bone (P＜0.05),while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the crosssectional area of the median nerve at the level of pisiform bone (t=-9.397 and-4.385,both P＞0.05).Conclusion Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.

Objective To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease.Methods A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December,2015 were enrolled as observation group,and 20 healthy volunteers (40 wrists) were enrolled as the control group.Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament.The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured,as well as the cross-sectional area of the median nerve at the level of pisiform bone.Results In the 29 patients with hand-arm vibration disease patients in the observation group,8 experienced entrapment of the median nerve in the carpal canal,among whom 5 had entrapment in both wrists;there were 13 wrists (23％) with nerve entrapment and 45 wrists (77％) without nerve entrapment.Compared with the control group,the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the crosssectional area of the median nerve at the level of pisiform bone (P＜0.05),while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the crosssectional area of the median nerve at the level of pisiform bone (t=-9.397 and-4.385,both P＞0.05).Conclusion Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.