Objective The study aimed to compare the efficacy and safety of tislelizumab combined with chemotherapy versus pembrolizumab combined with chemotherapy as first-line treatments for advanced lung squa-mous cell carcinoma.Methods We retrospectively reviewed and analyzed the medical records of 116 patients with advanced lung squamous cell carcinoma treated with first-line chemotherapy plus tislelizumab or pembrolizumab in Guangzhou Chest Hospital from September 2020 to April 2024.We focused on analysis of time to treatment failure(TTF)and objective response rate(ORR)as well as disease control rate(DCR)and treatment-related adverse events(TRAEs).Results At a median follow up of 19.7 monyhs,the median TTF was 9.7 months in the tislelizumab group and 7.7 months in the pembrolizumab group(P<0.05).In addition,the ORR in the tislelizumab group was significantly higher than that in the pembrolizumab group(77.6%vs.60.3%,P<0.05),with DCRs of 93.1%and 87.9%,respectively(P=0.342).Regarding safety,the proportions of grade 3 or higher TRAEs and any-grade TRAEs were comparable between the two groups:29.3%and 81.0%in the tislelizumab group,and 32.8%and 87.9%in the pembrolizumab group,respectively.The most common TRAEs in both groups were hematological toxicities.Conclusions Tislelizumab plus chemotherapy demonstrated better efficacy and safety compared to pembrolizumab with chemotherapy as first-line treatment for Chinese patients with advanced lung squamous cell carcinoma.

Objective:To investigate the clinically curative effect of composite dressing of adipose mesenchymal stem cell exosomes and chitosan hydrogel in treating deep Ⅱ burn wound.Methods:A total of 108 patients with superficially deep Ⅱ burns,who admitted to Tangdu Hospital,Air Force Medical University within 48 hours during March 2022 and October 2024,were selected.Patients were randomly divided into conventional treatment group and the combined treatment group by using a random number table,with 54 patients in each group.All patients underwent enzymatic debridement(collagenase ointment)to conduct conventional treatment.The combined treatment group received treatment with composite dressings of adipose-derived mesenchymal stem cell exosomes(ADSCs-Exo)combined with chitosan hydrogel,while the conventional treatment group received treatment with silver sulfadiazine dressings(SSD)on the basis of conventional treatment.The healing rates of wound,Vancouver Scar Scale(VSS)scores,the levels of serum inflammatory factors included interleukin-6(IL-6),interleukin-1β(IL-1β),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α),as well as curative efficacy rates,and adverse reactions between two groups were compared at different time points after treatment.Results:There was not statistically significant difference in healing rates of wound between the two groups at the 7th day after treatment(P>0.05).At the 14th day and the 21th day after treatment,the average healing rates of wound in the combined treatment group were respectively(67.69±8.57)%and(89.46±7.54)%,which were higher than(59.50±4.93)%and(75.52±9.11)%in the conventional treatment group,and the differences were statistically significant(t=6.087,8.662,P<0.05).The average VSS score was(6.42±1.20)points in the combined treatment group after treatment,which was lower than that in the conventional treatment group(8.94±1.58),and the difference was statistically significant(t=9.33,P<0.05).Before treatment,there were not statistically significant difference in VAS scores and the levels of serum inflammatory factor between the two groups(P>0.05).At the 7th day,the 14th day and the 21th day after treatment,the VAS scores in the combined treatment group were significantly lower than those in the conventional treatment group(t=10.008,12.004,13.899,P<0.05),respectively.At the 21th day after treatment,the levels of IL-6,IL-1β,CRP,and TNF-α of the combined treatment group were significantly lower than those of the conventional treatment group(t=3.400,4.490,7.293,5.900,P<0.05).The efficacy rate of clinical treatment in the combined treatment group was 96.30%,which was higher than 83.33%of the conventional treatment group,with a statistical significance(x2=7.942,P<0.05).The incidence of adverse reaction in the combined treatment group was 14.81%,which was lower than 24.07%of the conventional treatment group,without statistical significance(P>0.05).Conclusion:Compared with conventional silver sulfadiazine dressing,the composite dressing of adipose mesenchymal stem cell exosomes and chitosan hydrogel can quickly promote the re-epithelialization process in treating patients with superficially deep Ⅱ burns at the middle to late stage,and improve the healing rate,and relieve the inflammatory reaction and pain perception of patients for wound,and enhance efficiency and safety.

Objective:To investigate the clinically curative effect of composite dressing of adipose mesenchymal stem cell exosomes and chitosan hydrogel in treating deep Ⅱ burn wound.Methods:A total of 108 patients with superficially deep Ⅱ burns,who admitted to Tangdu Hospital,Air Force Medical University within 48 hours during March 2022 and October 2024,were selected.Patients were randomly divided into conventional treatment group and the combined treatment group by using a random number table,with 54 patients in each group.All patients underwent enzymatic debridement(collagenase ointment)to conduct conventional treatment.The combined treatment group received treatment with composite dressings of adipose-derived mesenchymal stem cell exosomes(ADSCs-Exo)combined with chitosan hydrogel,while the conventional treatment group received treatment with silver sulfadiazine dressings(SSD)on the basis of conventional treatment.The healing rates of wound,Vancouver Scar Scale(VSS)scores,the levels of serum inflammatory factors included interleukin-6(IL-6),interleukin-1β(IL-1β),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α),as well as curative efficacy rates,and adverse reactions between two groups were compared at different time points after treatment.Results:There was not statistically significant difference in healing rates of wound between the two groups at the 7th day after treatment(P>0.05).At the 14th day and the 21th day after treatment,the average healing rates of wound in the combined treatment group were respectively(67.69±8.57)%and(89.46±7.54)%,which were higher than(59.50±4.93)%and(75.52±9.11)%in the conventional treatment group,and the differences were statistically significant(t=6.087,8.662,P<0.05).The average VSS score was(6.42±1.20)points in the combined treatment group after treatment,which was lower than that in the conventional treatment group(8.94±1.58),and the difference was statistically significant(t=9.33,P<0.05).Before treatment,there were not statistically significant difference in VAS scores and the levels of serum inflammatory factor between the two groups(P>0.05).At the 7th day,the 14th day and the 21th day after treatment,the VAS scores in the combined treatment group were significantly lower than those in the conventional treatment group(t=10.008,12.004,13.899,P<0.05),respectively.At the 21th day after treatment,the levels of IL-6,IL-1β,CRP,and TNF-α of the combined treatment group were significantly lower than those of the conventional treatment group(t=3.400,4.490,7.293,5.900,P<0.05).The efficacy rate of clinical treatment in the combined treatment group was 96.30%,which was higher than 83.33%of the conventional treatment group,with a statistical significance(x2=7.942,P<0.05).The incidence of adverse reaction in the combined treatment group was 14.81%,which was lower than 24.07%of the conventional treatment group,without statistical significance(P>0.05).Conclusion:Compared with conventional silver sulfadiazine dressing,the composite dressing of adipose mesenchymal stem cell exosomes and chitosan hydrogel can quickly promote the re-epithelialization process in treating patients with superficially deep Ⅱ burns at the middle to late stage,and improve the healing rate,and relieve the inflammatory reaction and pain perception of patients for wound,and enhance efficiency and safety.

Objective The study aimed to compare the efficacy and safety of tislelizumab combined with chemotherapy versus pembrolizumab combined with chemotherapy as first-line treatments for advanced lung squa-mous cell carcinoma.Methods We retrospectively reviewed and analyzed the medical records of 116 patients with advanced lung squamous cell carcinoma treated with first-line chemotherapy plus tislelizumab or pembrolizumab in Guangzhou Chest Hospital from September 2020 to April 2024.We focused on analysis of time to treatment failure(TTF)and objective response rate(ORR)as well as disease control rate(DCR)and treatment-related adverse events(TRAEs).Results At a median follow up of 19.7 monyhs,the median TTF was 9.7 months in the tislelizumab group and 7.7 months in the pembrolizumab group(P<0.05).In addition,the ORR in the tislelizumab group was significantly higher than that in the pembrolizumab group(77.6%vs.60.3%,P<0.05),with DCRs of 93.1%and 87.9%,respectively(P=0.342).Regarding safety,the proportions of grade 3 or higher TRAEs and any-grade TRAEs were comparable between the two groups:29.3%and 81.0%in the tislelizumab group,and 32.8%and 87.9%in the pembrolizumab group,respectively.The most common TRAEs in both groups were hematological toxicities.Conclusions Tislelizumab plus chemotherapy demonstrated better efficacy and safety compared to pembrolizumab with chemotherapy as first-line treatment for Chinese patients with advanced lung squamous cell carcinoma.

OBJECTIVE: We aimed to analyze the current indoor radon level and estimate the population risk of radon-induced lung cancer in urban areas of China. METHODS: Using the passive monitoring method, a new survey on indoor radon concentrations was conducted in 2,875 dwellings across 31 provincial capital cities in Chinese mainland from 2018 to 2023. The attributable risk of lung cancer induced by indoor radon exposure was estimated based on the risk assessment model. RESULTS: The arithmetic mean (AM) and geometric mean (GM) of indoor radon concentrations were 65 Bq/m³ and 55 Bq/m³, respectively, with 13.6% of measured dwellings exceeding 100 Bq/m³ and 0.6% exceeding 300 Bq/m³. The estimated number of lung cancer deaths induced by indoor radon exposure was 150,795, accounting for 20.30% (95% CI: 20.21%-20.49%) of the lung cancer death toll. CONCLUSION This study provided the most recent data on national indoor radon levels in urban areas and the attributable risk of lung cancer. These results served as an important foundation for further research on the disease burden of indoor radon exposure and radon mitigation efforts.
Radon/analysis* ; China/epidemiology* ; Air Pollution, Indoor/analysis* ; Lung Neoplasms/etiology* ; Humans ; Cities/epidemiology* ; Air Pollutants, Radioactive/adverse effects* ; Neoplasms, Radiation-Induced/etiology* ; Risk Assessment ; Radiation Monitoring

Objective:To estimate the lung cancer disease burden of residents caused by indoor radon exposure in living rooms in China, and to provide scientific basis for improving radon prevention and control policies and measures.Methods:Based on the data from the national indoor radon monitoring survey, the study of lung cancer caused by indoor radon, and the basic data such as population and smoking, the attributable burden of disease calculation method was used to estimate the disease burden of lung cancer caused by indoor radon in China.Results:In 2018, it was estimated that the years of life lost due to premature death (YLL), years of life lost due to health disability (YLD) and disability-adjusted life years (DALY) due to indoor radon exposure were 5.109 3 million, 0.052 6 million and 5.161 9 million, respectively. DALY was highest in the 50-54 age group. The disease burden of indoor radon-induced lung cancer in smoking men was more than 9 times that of smoking women, and the disease burden of lung cancer in non-smoking women was more than 5 times that of non-smoking men. Smoking is closely related to the disease burden of indoor radon-induced lung cancer.Conclusions:Indoor radon exposure is a major environmental risk factor associated with lung cancer burden in China. The health hazards of indoor radon require more attention and improved policy measures to address this challenge.

Objective:To estimate the lung cancer disease burden of residents caused by indoor radon exposure in living rooms in China, and to provide scientific basis for improving radon prevention and control policies and measures.Methods:Based on the data from the national indoor radon monitoring survey, the study of lung cancer caused by indoor radon, and the basic data such as population and smoking, the attributable burden of disease calculation method was used to estimate the disease burden of lung cancer caused by indoor radon in China.Results:In 2018, it was estimated that the years of life lost due to premature death (YLL), years of life lost due to health disability (YLD) and disability-adjusted life years (DALY) due to indoor radon exposure were 5.109 3 million, 0.052 6 million and 5.161 9 million, respectively. DALY was highest in the 50-54 age group. The disease burden of indoor radon-induced lung cancer in smoking men was more than 9 times that of smoking women, and the disease burden of lung cancer in non-smoking women was more than 5 times that of non-smoking men. Smoking is closely related to the disease burden of indoor radon-induced lung cancer.Conclusions:Indoor radon exposure is a major environmental risk factor associated with lung cancer burden in China. The health hazards of indoor radon require more attention and improved policy measures to address this challenge.

Objective:To investigate the effect of different P2Y12 inhibitors on the long-term prognosis of patients with diabetes mellitus (DM) and acute coronary syndrome (ACS), with or without the CYP2C19 loss-of-function (LOF) gene. Method:266 consecutive ACS patients undergoing percutaneous coronary intervention (PCI) were enrolled. According to the CYP2C19 LOF genotype, the patients were divided into rapid metabolizing-type (without the CYP2C19 LOF gene) and moderate-slow metabolizing type (with the CYP2C19 LOF gene). Each type was divided into the A group (with diabetes) and the B group (without diabetes). Each group was divided into the ticagrelor subgroup and the clopidogrel subgroup according to the type of P2Y12 platelet inhibitor. The MACE events were recorded for each subgroup over 3 years, and the prognostic impact of the CYP2C19 LOF genotype and the type of P2Y12 used were analyzed. Results:There were no significant differences in MACE, revascularization, stroke, heart failure rehospitalization, major bleeding, or all-cause mortality among subgroups of patients with rapid metabolizing type at 3 years after PCI (all P>0.05). In patients with moderate-slow metabolizing-type, the use of tegretol significantly reduced the probability of MACE events and cardiac revascularization (all P<0.01) and significantly reduced the reoccurrence of heart attack in patients with DM. Conclusions:In DM combined with ACS patients with rapid metabolizing type, the choice of different P2Y12 inhibitors after PCI had no significant effect on their prognosis. In DM combined with ACS patients with moderate-slow metabolizing type, tegretol not only significantly reduced the incidence of MACE, revascularization, and reinfarction, but also did not increase the risk of major bleeding. In terms of reducing the reoccurrence of heart attack, the benefit of using tegretol in the DM patients was greater than in the non-DM patients.

Objective:To develop and validate a useful predictive model for large gestational age (LGA) in pregnancy using a machine learning (ML) algorithm and compare its performance with the traditional logistic regression model.Methods:Data were obtained from the National Free Preconception Health Examination Project in China, carried out in 220 counties of 31 provinces from 2010 to 2012, covering all rural couples with a planned pregnancy. This study included all teams of childbearing age who delivered newborns within 24-42 weeks of gestational age and their newborns. Ten different ML algorithms were used to establish LGA prediction models, and the prediction performance of these models was evaluated.Results:A total of 104 936 newborns were included, including 54 856 boys (52.3%) and 50 080 girls (47.7%). The incidence of LGA was 11.7% (12 279). The imbalance between the two groups was addressed by the under- sampling technique, after which the overall performance of the ML models was significantly improved. The CatBoost model achieved the highest area under the receiver-operating-characteristic curve (AUC) value of 0.932. The logistic regression model had the worst performance, with an AUC of 0.555.Conclusions:In predicting the risk for LGA in pregnancy, the ML algorithms outperform the traditional logistic regression method. Compared to other ML algorithms, CatBoost could improve the performance, and it deserves further investigation.

Objective:To explore the relationship between the selection of different P2Y 12 inhibitors and the long-term prognosis of acute coronary syndrome (ACS) patients with and without CYP2C19 defect gene. Method:289 consecutive ACS patients who underwent percutaneous coronary intervention (PCI) at Tianjin Third Central Hospital from March 2016 to October 2016 were selected for CYP2C19 gene polymorphism detection. According to the detection results, the patients were divided into group A (with CYP2C19 loss-of-function gene, 199 cases) and group B (without CYP2C19 loss-of-function gene, 90 cases). After PCI, different P2Y 12 inhibitors were selected. The patients were followed up for 3 years, and 23 cases were lost to follow-up. Finally, 182 cases were enrolled in group A and 84 cases were enrolled in group B. According to whether there were major adverse cardiovascular events (MACE) within 3 years, the patients in groups A and B were divided into MACE subgroups (58 cases, 32 cases) and non-MACE subgroups (124 cases, 52 cases). The single factor analysis of the two subgroups in groups A and B was carried out based on the patient's clinical data, coronary artery disease and intervention status, and postoperative drug treatment plan. Risk factors with statistical significance ( P<0.05) were selected, and multivariate logistic regression analysis was performed on groups A and B to compare the effects of different P2Y 12 inhibitors on the prognosis of the two groups. Results:The differences in platelet volume, fasting blood glucose, HbA1c, left ventricular end-diastolic diameter, proportion of single-branch lesions, proportion of intervention for left main lesions, and dual antiplatelet therapy were statistically significant between the two subgroups in group A (all P<0.05). The differences in low-density lipoprotein (LDL), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter, proportion of two-branch lesions, proportion of three-branch lesions, and proportion of using tirofeben were statistically significant between the two subgroups in group B (all P<0.05). In the group A, the choice of different P2Y 12 inhibitors was the independent risk factor for the long-term prognosis. Compared with patients treated with Ticagrelor, the probability of long-term MACE was 11.971 times larger ( OR=12.971, 95% CI: 5.028~33.464, P<0.001) among patients treated with Clopidogrel 75 mg/day, and 5.029 times larger ( OR=6.029, 95%CI: 2.278~15.958) among patients treated with Clopidogrel 100 mg/day. No significant correlation was witnessed between different P2Y 12 inhibitors and long-term prognosis in group B. In the group B, different P2Y 12 inhibitors have no significant correlation with their long-term prognosis of patients( P>0.05). Conclusions:For ACS patients with CYP2C19 loss-of-function gene, the choice of P2Y 12 inhibitors is associated with their long-term MACE events after PCI. Ticagrelor therapy brings the lowest risk of long-term MACE. For those without CYP2C19 loss-of-function gene, the correlation between the choice of different P2Y 12 inhibitors and their prognosis is not significant.