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.

Objective:To compare the cost-effectiveness of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus percutaneous endoscopic discectomy (PTED) for the treatment of single-segment lumbar disc herniation (LDH). Methods:This study is a retrospective analysis that included patients diagnosed and treated with either MIS-TLIF or PTED for single-segment LDH at Hefei First People's Hospital from January to December 2022. The study comprised 35 patients in the MIS-TLIF group and 35 patients in the PTED group. Total medical costs, surgery duration, blood loss, time to catheter removal, Visual Analog Scale scores before surgery, and at 3 and 12 months post-surgery, along with the Oswestry Disability Index, were recorded for each group. The cost-effectiveness ratio was compared between the two groups.Results:A total of 70 patients were included, including 35 patients in the MIS-TLIF group and 35 patients in the PTED group. There was no significant difference in general data between the two groups (all P >0.05). The differences in Visual Analog Scale and Oswestry Disability Index scores between the two groups, as well as within each group before surgery, and at 3 and 12 months post-surgery, were not statistically significant (all P > 0.05). The surgery duration for the PTED group [(112.94 ± 53.17) minutes] was significantly shorter than that of the MIS-TLIF group [(210.14 ± 25.68) minutes, Z = 2.21, P < 0.05]. However, the success rate for the PTED group [94.29% (33/35)] was not significantly different from that of the MIS-TLIF group [91.43% (32/35), Z = 0.46, P > 0.05]. The cost-effectiveness ratio for the PTED group was 239.56, while the cost-effectiveness ratio for the MIS-TLIF group was 377.69. Conclusions:PTED offers greater economic advantages in the treatment of single-segment LDH, particularly in terms of reduced blood loss and shorter surgery duration compared with MIS-TLIF. The choice of surgical approach should be made according to clinical requirements.

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.

Objective:To compare the cost-effectiveness of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus percutaneous endoscopic discectomy (PTED) for the treatment of single-segment lumbar disc herniation (LDH). Methods:This study is a retrospective analysis that included patients diagnosed and treated with either MIS-TLIF or PTED for single-segment LDH at Hefei First People's Hospital from January to December 2022. The study comprised 35 patients in the MIS-TLIF group and 35 patients in the PTED group. Total medical costs, surgery duration, blood loss, time to catheter removal, Visual Analog Scale scores before surgery, and at 3 and 12 months post-surgery, along with the Oswestry Disability Index, were recorded for each group. The cost-effectiveness ratio was compared between the two groups.Results:A total of 70 patients were included, including 35 patients in the MIS-TLIF group and 35 patients in the PTED group. There was no significant difference in general data between the two groups (all P >0.05). The differences in Visual Analog Scale and Oswestry Disability Index scores between the two groups, as well as within each group before surgery, and at 3 and 12 months post-surgery, were not statistically significant (all P > 0.05). The surgery duration for the PTED group [(112.94 ± 53.17) minutes] was significantly shorter than that of the MIS-TLIF group [(210.14 ± 25.68) minutes, Z = 2.21, P < 0.05]. However, the success rate for the PTED group [94.29% (33/35)] was not significantly different from that of the MIS-TLIF group [91.43% (32/35), Z = 0.46, P > 0.05]. The cost-effectiveness ratio for the PTED group was 239.56, while the cost-effectiveness ratio for the MIS-TLIF group was 377.69. Conclusions:PTED offers greater economic advantages in the treatment of single-segment LDH, particularly in terms of reduced blood loss and shorter surgery duration compared with MIS-TLIF. The choice of surgical approach should be made according to clinical requirements.

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.