OBJECTIVE To investigate the effects of calcitriol on sepsis-induced immunosuppression and its potential mechanism. METHODS A sepsis-induced immunosuppression mice model was established using cecal ligation and puncture （CLP）. The 7-day survival rate， serum levels of tumor necrosis factor- α （TNF- α）， interleukin-6 （IL-6）， and IL-1β were determined in sham operation group， CLP group and calcitriol group （1 μg/kg）； the morphological changes of lung tissue in mice were observed. Lipopolysaccharide （LPS） tolerance macrophage models （representing sepsis-induced immunosuppression） were established using mice macrophage cell line RAW264.7 cells. The levels of TNF-α and IL-6 in cell supernatants as well as mRNA expressions of IL-1β， nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3）， IL-18 and caspase-1 were assessed in culture medium group， LPS group， LPS tolerance group， and calcitriol （5 μmol/L） group. The following parameters were measured： propidium iodide （PI）-positive cell ratio， caspase-1 activity， lactate dehydrogenase （LDH） release， and Ca2+ levels. RESULTS Compared with CLP group， 7-day survival rate and serum levels of TNF-α， IL-6 and IL-1β were increased significantly in calcitriol group （P＜0.05）. Additionally， pulmonary tissue damage was markedly attenuated in calcitriol group. Compared with LPS tolerance group， the levels of TNF-α and IL-6 in cell supernatants， mRNA expressions of IL- 1β， NLRP3， IL-18 and caspase-1， PI-positive cell ratio， caspase-1 activity， LDH release， and Ca2+ levels were all increased significantly in calcitriol group （P＜0.05）. CONCLUSIONS Calcitriol can reverse sepsis-induced immunosuppression， and the mechanism of action may be E-mail：yarfwy@163.com achieved by the binding of calcitriol to vitamin D receptor，which promotes the release of Ca2+ from the endoplasmic reticulum， thereby driving the NLRP3/caspase-1-mediated pyroptosis pathway.

OBJECTIVE To evaluate the effectiveness， safety and economy of lorlatinib in the treatment of non-small cell lung cancer（NSCLC）， and provide evidence-based reference for the introduction of new drugs in hospitals and clinical medication decisions. METHODS Retrieved from PubMed， Embase， Cochrane Library， Epistemonikos， CNKI， VIP， Wanfang data， SinoMed databases and The International Network of Agencies for Health Technology Assessment （INAHTA）， the results of the included studies were descriptively analyzed after literature screening， data extraction and quality evaluation. RESULTS A total of 19 literature were included， involving 13 system assessment （SR）/meta-analyses and 6 pharmacoeconomic reviews. Compared with the patients who received other anaplastic lymphoma kinases （ALK）-tyrosine kinase inhibitor（TKI）（such as crizotinib， brigatinib， alectinib， ensartinib， and ceritinib）， those using lorlatinib obtained best progression-free survival （PFS）. However， in the Asian population， lorlatinib did not show a significant advantage in prolonging PFS， compared to ensartinib， low-dose alectinib， and brigatinib. In terms of objective remission rate， lorlatinib and low-dose alectinib showed significant advantages over other ALK- TKI. At the same time， alectinib had the best overall survival. In terms of safety， lorlatinib possessed a poor safety profile with a high incidence of grade 3 or higher adverse events. Existing economic studies showed that lorlatinib brought health benefits to first- line treatment of patients with ALK-positive advanced NSCLC at the same time as higher treatment costs. CONCLUSIONS Lorlatinib has good efficacy in the treatment of NSCLC， but its safety and economy need to be studied.

Surgical resection in patients with advanced primary carcinoma of liver has high risks of early recurrence and incidence of portal vein tumor thrombus, caused by insufficient resi-dual liver volume after two-steps hepatotomy. At present, the treatment for patients with advanced primary carcinoma of liver is limited, thus can't satisfy the requirement of patient for treatment. The authors introduce the clinical experience of a patient with hepatocellular carcinoma and insufficient residual liver volume who underwent preventive immunotherapy plus target therapy after associa-ting liver partition and portal vein ligation for staged hepatectomy, in order to provide reference for relevant treatment.

Dental erosion is characterized by progressively destroyed teeth, which has no relation to bacteria but to chemicals. Some internal factors, such as gastroesophageal reflux induced by bulimia, anorexia, gastrointestinal diseases, or drugs, and external factors, such as diet, drugs, and occupational acid exposure, are considered promotive factors for this disease. This article presents a patient suffering from severe dental erosion in the whole dentition, especially in the maxillary teeth, due to gastroesophageal reflux induced by glucocorticoid therapy for optic neuritis. This article discusses the mechanism between optic neuritis glucocorticoid therapy and dental erosion.
Humans ; Glucocorticoids/therapeutic use* ; Tooth Erosion/therapy* ; Gastroesophageal Reflux/complications*

Ojective To enhance the ability of diagnosis and therapy for occult indirect inguinal hernia. Methods Surgical exploration was performed for patients highly suspected with occult indirect inguinal hernia based on clinical manifestations and physical examinations in the initial stage. At present, herniography was used to confirm the diagnosis. High ligation of the hernial sac, non-mesh methods of open groin hernia repair or tension-free inguinal hernia repair was performed for the patients. Results Forty-four cases were given surgical exploration in the initial stage and 41 cases were confirmed and treated by operation. Misdiagnosis was found in 3 cases and surgical exploration revealed no sign of disease. Relapse occurred in two cases within 5 years. Nineteen out of 30 patients were confirmed by herniography in the last five years and operated on. There was no false-positive herniogram in this series. Follow-up evaluation of the patients showed disappearance of preoperative symptoms. Groin hernia has not recurred so far. Conclusions The ability of diagnosis for occult indirect inguinal hernia can be enhanced by herniography. Blind surgical exploration can be reduced. Herniography is a safe, reliable and practical diagnostic procedure.