Purpose: This study aimed to evaluate the safety and efficacy of gemcitabine and cisplatin (GP) regimen in combination with immune checkpoint inhibitor sintilimab as neoadjuvant therapy for muscle-invasive bladder cancer (MIBC) patients and the feasibility of the following selective bladder sparing surgery. Materials and Methods: Patients with histopathologically confirmed urothelial carcinoma without distant metastases (T2-4a, N ≤ 1, M0, American Joint Committee of Cancer 8th) and with adequate organ function will be enrolled. The therapeutic regimen was sintilimab 200 mg once on day 8, gemcitabine 1,000 mg/m2 and cisplatin 35 mg/m2 once on days 1 and 8, every 21 days for four cycles. The primary endpoint was pathologic complete response (pCR, pT0N0) rate. The secondary end points were ypT < 2 rate, R0 resection rate, event-free survival, and safety. Results: From May 4, 2020, to May 20, 2023, 55 patients were enrolled. Forty-six patients were evaluated for efficacy. Among the 42 patients who underwent surgery, 16 patients (38.0%) achieved pCR. Thirty-three patients (78.6%) achieved pT < 2. With a median follow-up of 15.7 months, the 1-year event-free survival was 91.3%. Notwithstanding the poor pathological baseline characteristic of a high T3-T4a proportion (39.1%), a promising bladder preservation (including 22 patients transurethral resection of bladder tumor, 5 patients partial cystectomy, and 4 surveillances) rate was achieved (67.4%). The most common grade ≥ 3 treatment-related adverse events was neutropenia (n=15, 27.3%), which was related to chemotherapy. There were no grade 3 immune-related adverse events. Conclusion Neoadjuvant GP plus sintilimab is a promising regimen for MIBC patients, with relatively high pT < 2 rate and triggering the emerging roles for the multi-disciplinary team decision-making for bladder sparing surgery.

Geriatric oral health care encounters significant challenges with the increase in the proportion of older individuals. Age-related changes in the dentition, muscles, and joints result in a decline in objective masticatory function, subjective restoration requirements, and acceptability among the elderly population, with individual variations influenced by systemic health. Considering functional requirements, the adaptability of stomatognathic and systemic health conditions, health economics and other factors, the authors believe that it should not be limited to the conventional "one-to-one" strategy for replacing missing teeth in geriatric prosthodontics. There is an urgent need for a precise and adaptable restoration strategy that is more suitable for older individuals. The proposal of a new concept of functional tooth loss updates the minimal restoration standards for elderly patients and establishes the theory of age-friendly functional restoration. Based on the restoration strategy of functional tooth loss, this paper proposes a new concept termed "age-friendly functional restoration of the stomatognathic system", which integrates treatment considerations including endodontics, periodontology, mucosa, muscles, temporomandibular joint, and systemic health. Efforts should be made in four areas as follows. Firstly, the "assessment of accessible function" should be enhanced by considering the interrelationship between stomatognathic and systemic health. Secondly, the "evaluation of appropriate function" is supposed to be optimised in view of subjective needs and objective evaluation of the stomatognathic system. Moreover, the "formulation of treatment plans" needs to be accomplished with the aid of assistive technologies, such as artificial intelligence, to accurately exert appropriate functional restoration. Lastly, the "management and maintenance of health" is likely to be strengthened through follow-ups, propaganda and education, and preventive healthcare, so as to improve quality of life and ultimately achieve healthy ageing among older individuals.
Humans ; Tooth Loss/therapy* ; Aged ; Stomatognathic System ; Oral Health ; Dental Care for Aged ; Dental Restoration, Permanent/methods*

Laparoscopic technology has been widely used in the surgical treatment of gastric cancer, but the operating space inside the abdominal cavity is mostly created by CO? artificial pneumoperitoneum. There is a paradoxical result of CO? artificial pneumoperitoneum, which may increase the risk of complications in elderly patients with poor cardiopulmonary function. Therefore, people have been trying non pneumoperitoneum techniques. This article focuses on the establishment of CO? pneumoperitoneum as the core technology of minimally invasive abdominal surgery in laparoscopic minimally invasive techniques both domestically and internationally over the years, as well as the complications caused by CO? artificial pneumoperitoneum. It explores the use of "no pneumoperitoneum" in minimally invasive abdominal surgery and summarizes the exploration of the author's center in this field. The article also looks forward to the prospects of this technology.

Objective:To investigate the role and possible mechanism of tripartite motif-containing protein 72 (Trim72) in acute viral myocarditis (AVMC) in mice.Methods:A mouse model of AVMC was established by intraperitoneal injection of Coxsackievirus B3 (CVB3, 2.0 × 10 5 PFU/mouse). Forty mice were randomly divided into the negative control (NC) + phosphate-buffered saline (PBS) group (NC+PBS group), Trim72 overexpression + PBS group (Trim72 + PBS group), NC + CVB3 group, and Trim72 + CVB3 group ( n = 10). Fourteen days before modeling, mice in each group were injected with adeno-associated virus type 9 vector (AAV9) encoding either negative control or Trim72 overexpression (5.0 × 10 11 VG/mouse) via tail vein. Subsequently, PBS or CVB3 was injected intraperitoneally in the PBS and CVB3 groups, respectively. After seven days, the surviving mice were euthanized, and the heart and serum samples were collected. HE and TUNEL staining were used to observe the cardiac pathological changes and cardiomyocyte apoptosis, respectively. The mRNA expression levels of Trim72 and pro-inflammatory cytokines TNF-α, IL-6, and IL-1β in myocardial tissues of each group were detected by RT-qPCR. The protein levels of cTnI, TNF-α, IL-6, and IL-1β in serum were detected by ELISA. The expression levels of Trim72, apoptosis-related proteins (Bax, Bcl-2, Cleaved caspase-3, Caspase-3), TLR4, p-p65, and p65 were detected by Western blot. Results:The protein and mRNA expression levels of Trim72 in myocardial tissues of mice in the NC+CVB3 group were significantly downregulated compared with those in the NC + PBS group ( P<0.05). Compared with the NC + CVB3 group, Trim72 overexpression significantly increased the protein and mRNA expression of Trim72 in myocardial tissues ( P<0.05), ameliorated myocardial inflammatory injury, decreased the apoptotic index of cardiomyocytes ( P<0.05), and reduced the levels of pro-inflammation cytokines TNF-α, IL-6, and IL-1β in the myocardium and serum ( P<0.05). Additionally, Trim72 overexpression also downregulated the protein expression of Bax, Cleaved caspase-3/Caspase-3, TLR4, and p-p65, and upregulated the protein expression of Bcl-2 in myocardial tissues ( P<0.05). There was no significant difference in the indexes of mice between the NC + PBS and Trim72 + PBS groups ( P>0.05). Conclusions:Trim72 overexpression attenuates AVMC in mice by inhibiting myocardial inflammatory injury and apoptotic imbalance, and the mechanism may be related to the negative regulation of the TLR4/NF-κB signaling pathway.

Laparoscopic technology has been widely used in the surgical treatment of gastric cancer, but the operating space inside the abdominal cavity is mostly created by CO? artificial pneumoperitoneum. There is a paradoxical result of CO? artificial pneumoperitoneum, which may increase the risk of complications in elderly patients with poor cardiopulmonary function. Therefore, people have been trying non pneumoperitoneum techniques. This article focuses on the establishment of CO? pneumoperitoneum as the core technology of minimally invasive abdominal surgery in laparoscopic minimally invasive techniques both domestically and internationally over the years, as well as the complications caused by CO? artificial pneumoperitoneum. It explores the use of "no pneumoperitoneum" in minimally invasive abdominal surgery and summarizes the exploration of the author's center in this field. The article also looks forward to the prospects of this technology.

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

Objective To investigate the long-term prognostic factors of acute pulmonary embolism (APE) among internal medicine inpatients with type 2 diabetes mellitus (T2DM),and establish a prediction model of long-term prognosis. Methods This study included 156 internal medicine inpatients with T2DM and APE (T2DM+APE group) admitted to internal medicine of Xinjiang 474 Hospital and The Fifth Affiliated Hospital of Xinjiang Medical University from July 2019 to June 2022. At the same time,156 inpatients with APE from the department of hematology were selected as APE group. All patients were fo llowed up for 1 year to evaluate the prognosis. Patients in T2DM+APE group were divided into good prognosis subgroup (n=108) and poor prognosis subgroup (n=48). The risk factors for poor prognosis were analyzed and a prediction model was established. Results The incidence of adverse events in T2DM+APE group was higher than that in APE group (P<0.05). Logistic regression analysis found that N-terminal precursor of B-type natriuretic peptide (NT-proBNP),cardiac troponin T (c-TnT),heart-type fatty acid binding protein (H-FABP) and simplified Pulmonary Embolism Severity Index (sPESI) score were risk factors for poor long-term prognosis of T2DM complicated with APE. The area under the curve(AUC),sensitivity and specificity of this model for predicting poor prognosis of T2DM complicated with APE were 0.938,83.3％ and 96.3％,which were higher than those of prediction with single indicator. Conclusions Patients with T2DM and APE have worse long-term prognosis than those with simple APE.The establishment of a prediction model is helpful for clinical evaluation of long-term prognosis.

Objective To investigate the long-term prognostic factors of acute pulmonary embolism (APE) among internal medicine inpatients with type 2 diabetes mellitus (T2DM),and establish a prediction model of long-term prognosis. Methods This study included 156 internal medicine inpatients with T2DM and APE (T2DM+APE group) admitted to internal medicine of Xinjiang 474 Hospital and The Fifth Affiliated Hospital of Xinjiang Medical University from July 2019 to June 2022. At the same time,156 inpatients with APE from the department of hematology were selected as APE group. All patients were fo llowed up for 1 year to evaluate the prognosis. Patients in T2DM+APE group were divided into good prognosis subgroup (n=108) and poor prognosis subgroup (n=48). The risk factors for poor prognosis were analyzed and a prediction model was established. Results The incidence of adverse events in T2DM+APE group was higher than that in APE group (P<0.05). Logistic regression analysis found that N-terminal precursor of B-type natriuretic peptide (NT-proBNP),cardiac troponin T (c-TnT),heart-type fatty acid binding protein (H-FABP) and simplified Pulmonary Embolism Severity Index (sPESI) score were risk factors for poor long-term prognosis of T2DM complicated with APE. The area under the curve(AUC),sensitivity and specificity of this model for predicting poor prognosis of T2DM complicated with APE were 0.938,83.3％ and 96.3％,which were higher than those of prediction with single indicator. Conclusions Patients with T2DM and APE have worse long-term prognosis than those with simple APE.The establishment of a prediction model is helpful for clinical evaluation of long-term prognosis.

Objective:To probe into the potential prognostic value of lymphocyte subsets in gastric cancer.Methods:This study included patients who underwent radical gastrectomy for gastric cancer from Aug 2014 to Dec 2016. The immunological differences was analyzed in different infiltration patterns. The overall survival of patients was analyzed by Kaplan-Meier method and Log-rank test. COX regression was performed to assess independent prognostic factors of the patients, and finally constructed nomogram.Results:The median number of peripheral CD4 and CD19 cells in infiltration pattern c was 750 (94-2 504) cells/μl and 186 (17-820) cells/μl; the median number of peripheral CD4 and CD19 cells in infiltration pattern a was 802 (203-2 071) cells/μl and 213 (5-948) cells/μl, the number of peripheral CD4,CD19 cells in infiltration pattern c was lower than that in infiltration pattern a, with statistically significant differences (CD4: Z=-3.061, P=0.002; CD19: Z=-2.016 , P=0.044). CD19 lymphocytes ( P=0.023) were associated with infiltration pattern a, CD8 lymphocytes ( P=0.027) were associated with infiltration pattern b, and CD4 lymphocytes ( P=0.026) were independent risk factors associated with the prognosis of infiltration pattern c. A nomogram can be constructed to evaluate the prognosis of patients. Conclusion:There are differences in the number of peripheral lymphocyte subsets in patients with different INF types. A nomogram can be constructed from lymphocyte subsets and clinicopathological features to assess patient prognosis.