Objective To systematically review the efficacy of anti-inflammatory drugs in the treatment of diabetic nephropathy(DN).Methods Databases including PubMed,The Cochrane Library,EMbase,Web of Science,Scopus,Ovid,ProQuest,CBM,CNKI,WanFang Data,VIP and Duxiu data were electronically searched to collect randomized controlled trials(RCTs)of anti-inflammatory drugs for DN from inception to April 5,2022.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.RevMan 5.4 software were then used to perform Meta-analysis.Results A total of 29 literature and 26 RCTs involving 4 095 patients were included.The results of Meta-analysis showed that compared with conventional treatment,conventional treatment combined with anti-inflammatory drugs could effectively reduce urinary albumin to creatinine ratio[SMD=-0.17,95％CI(-0.31,-0.03),P=0.02],urinary albumin excretion rate[SMD=-0.37,95％CI(-0.56,-0.18),P=0.000 1],urinary protein excretion rate[SMD=-0.97,95％CI(-1.29,-0.64),P=0.000 01],and glycosylated hemoglobin[SMD=-0.17,95％CI(-0.27,-0.08),P=0.000 4],while there was no significant difference in reducing serum creatinine[SMD=-0.04,95％CI(-0.19,0.1),P=0.57],urea nitrogen[MD=-0.23,95％CI(-0.50,0.04),P=0.09]and fasting blood glucose[SMD=-0.15,95％CI(-0.32,0.02),P=0.08].There was no statistically significant difference in changing glomerular filtration rate(GFR)[SMD=-0.04,95％CI(-0.15,0.07),P=0.47]with multiple drugs,except for a few drugs.Conclusion Conventional treatment combined with anti-inflammatory drugs can better improve the level of proteinuria in patients with DN,but the improvement of renal function is not obvious.Due to the limitations of the number of included studies and the duration of treatment,the above conclusion needs to be verified by more high-quality studies.

BACKGROUND: Immune checkpoint inhibitors (ICIs) are increasingly used as first-line therapy for patients with advanced non-small cell lung cancer (NSCLC) harboring no actionable mutations; however, data on their efficacy among patients presenting with intracranial lesions are limited. This study aimed to explore the efficacy and safety of ICIs combined with chemotherapy in advanced NSCLC patients with measurable brain metastasis at initial diagnosis. METHODS: Our study retrospectively analyzed clinical data of a total of 211 patients diagnosed with driver gene mutation-negative advanced NSCLC with measurable, asymptomatic brain metastasis at baseline from Hunan Cancer Hospital between January 1, 2019 and September 30, 2021. The patients were stratified into two groups according to the first-line treatment regimen received: ICI combined with chemotherapy ( n = 102) or chemotherapy ( n = 109). Systemic and intracranial objective response rates (ORRs) and progression-free survival (PFS) were analyzed. Adverse events were also compared between the groups. RESULTS: Compared with the chemotherapy-based regimen, the ICI-containing regimen was associated with a significantly higher intracranial (44.1% [45/102] vs . 28.4% [31/109], χ2 = 5.620, P = 0.013) and systemic (49.0% [50/102] vs . 33.9% [37/109], χ2 = 4.942, P = 0.019) ORRs and longer intracranial (11.0 months vs . 7.0 months, P <0.001) and systemic (9.0 months vs . 5.0 months, P <0.001) PFS. Multivariable analysis consistently revealed an independent association between receiving ICI plus platinum-based chemotherapy as a first-line regimen and prolonged intracranial PFS (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.37-0.73, P <0.001) and systemic PFS (HR = 0.48, 95% CI: 0.35-0.66, P <0.001). No unexpected serious adverse effects were observed. CONCLUSION: Our study provides real-world clinical evidence that ICI combined with chemotherapy is a promising first-line treatment option for driver gene mutation-negative advanced NSCLC patients who present with brain metastasis at initial diagnosis. CLINICAL TRIAL REGISTRATION https://www.clinicaltrials.gov/ , OMESIA, NCT05129202.
Humans ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Immune Checkpoint Inhibitors/therapeutic use* ; Retrospective Studies ; Brain Neoplasms/genetics*

Metastasis is crucial for the mortality of non-small cell lung carcinoma (NSCLC) patients. The epithelial-mesenchymal transition (EMT) plays a critical role in regulating tumor metastasis. Glioma-associated oncogene 1 (Gli1) is aberrantly active in a series of tumor tissues. However, the molecular regulatory relationships between Gli1 and NSCLC metastasis have not yet been identified. Herein, we reported Gli1 promoted NSCLC metastasis. High Gli1 expression was associated with poor survival of NSCLC patients. Ectopic expression of Gli1 in low metastatic A549 and NCI-H460 cells enhanced their migration, invasion abilities and facilitated EMT process, whereas knock-down of Gli1 in high metastatic NCI-H1299 and NCI-H1703 cells showed an opposite effect. Notably, Gli1 overexpression accelerated the lung and liver metastasis of NSCLC in the intravenously injected metastasis model. Further research showed that Gli1 positively regulated Snail expression by binding to its promoter and enhancing its protein stability, thereby facilitating the migration, invasion and EMT of NSCLC. In addition, administration of GANT-61, a Gli1 inhibitor, obviously suppressed the metastasis of NSCLC. Collectively, our study reveals that Gli1 is a critical regulator for NSCLC metastasis and suggests that targeting Gli1 is a prospective therapy strategy for metastatic NSCLC.

Objectives:To study the clinical significance of time to positive (TTP) of blood culture for neonatal sepsis.Methods:From August 2016 to June 2019, a retrospective study was conducted in patients with positive blood cultures admitted to the Neonatology Department of our hospital. The patients were assigned into different groups according to the species of pathogen, types of neonatal sepsis and the samples contaminated or not. TTP of different groups were analyzed.Results:A total of 307 cases with positive blood cultures were identified from 10 035 cases with blood culture specimens. Among the 307 cases, 162 were contaminated (the contaminated group) and 145 (1.4%) were diagnosed of neonatal sepsis (the pathogenic group). The proportion of TTP <24 h, 24~<48 h, 48~<72 h and ≥72 h in the 145 sepsis cases were 90.3% (131/145), 7.6% (11/145), 1.4% (2/145) and 0.7% (1/145), respectively. The median TTP was 9.0 h in early-onset sepsis (EOS) group and 11.5 h in late-onset sepsis (LOS) group. The median TTP of the contaminated group was 24.5 (19.9, 30.5)h, which was longer than 11.1 (8.1,16.2)h of the pathogenic group ( P<0.05). The median TTP of Gram (+) group was 14.0 (9.4,18.8)h, which was longer than 9.6 (7.5,11.3)h of Gram (-) group ( P<0.05). The median TTP of fungi group was 32.5 (25.5, 39.0) h, which was longer than 10.6 (8.1, 15.5)h of bacteria group ( P<0.05). Conclusions:Different pathogens has different TTP for neonatal sepsis. If blood culture maintains negative for more than 72 h, empiric use of antibiotics may be discontinued for patients of suspected sepsis without specific clinical manifestations or other lab results.

Objective:To investigate the feasibility and safety of laparoscopic liver tumor resection in children.Methods:The clinical data of 6 children undergoing laparoscopic liver tumor resection from June 2018 to March 2020 in the Affiliated Tumor Hospital, Zhengzhou University were retrospectively analyzed.Results:There were 4 males and 2 females among the 6 cases, with the average age of (7±2)years.All the children were admitted to the hospital with a liver occupying examination due to physical discomfort.Preoperative diagnosis: 3 cases of hepatoblastoma, 1 case of primary liver cancer, 1 case of hepatic adenoma and 1 case of hepatic nodular hyperplasia.All the children successfully completed laparoscopic liver tumor resection without conversion to open surgery.Among them, 3 children obtained left hemihepatectomy, 1 child underwent hepatic left lobectomy, 1 child was given VI hepatectomy, and 1 child accepted hepatic caudate lobectomy.The operation time was(90±9)min, and the average intraoperative blood loss was (83±26) mL.All children had no blood transfusion during or after operation.There were no bleeding, bile leakage, infection and liver failure after operation.All children had no gastric tube before surgery and the fluid diet was given on the first day after operation, and the postoperative median hospital stay was 4(3-5) days.The pathology were consis-tent with the preoperative diagnosis, and the resections were all radical operation resections.The follow-up period was from 2 to 23 months, and all the children recovered well and no recurrence was observed.Conclusions:Laparoscopic liver tumor resection in children is safe and feasible, which can minimize trauma, reduce intraoperative bleeding and shorten the hospital stay without increasing the incidence of postoperative complications.Laparoscopic liver tumor resection in children has certain advantages.

Objective To study the safety and efficacy of artificial ascites-assisted ultrasound guided percutaneous radiofrequency ablation (RFA) of liver tumors adjacent to the gastrointestinal tract.Metbods After ultrasound-guided percutaneous placement of a central venous tube,saline was injected into the abdominal cavity.The presence of fluid between the liver tumor and its adjacent gastrointestinal organs forms a zone of isolation.Radiofrequency ablation (RFA) was then carried out.This is a retrospective study on 32 patients whose lesions were adjacent to the gastrointestinal tract treated from January 2015 to December 2016 with RFA after establishment of artificial ascites.One month after ablation,CT/MR was performed to evaluate whether the lesions were completely ablated.Results All the 39 lesions in the 32 patients were successfully treated with RFA after establishment of artificial ascites.The complete ablation rate was 92.3 ％ (30/32) after one ablation session.One patient developed a high fever after surgery,another patient had nausea and vomiting during surgery,and two more patients complained of right shoulder and back pain.There were no severe complications such as hemorrhage or gastrointestinal perforation.There was no treatment related deaths.Conclusions For liver tumors which were adjacent to the gastrointestinal tract,establishment of artificial ascites significantly improved the visual field under ultrasound,and reduced the chance of collateral gastrointestinal thermal injury.The treatment of ascites-assisted ultrasound guided percutaneous radiofrequency ablation of liver cancer was safe and efficacious.

Objective To study the diagnosis,treatment and prognosis of patients with solid-pseudopapillary tumor of the pancreas (SPTP).Methods The clinical and follow-up data of 68 patients with SPTP treated in the Affiliated Tumor Hospital of Zhengzhou University from January 2008 to March 2017 were retrospectively analyzed.Results There were 6 males and 62 females,with an average age +/-S.D.of (32.0 ± 12.0) years.The mean tumor size was (4.4 ±2.3) cm.The primary symptom was abdominal pain,and a pancreatic mass was subsequently detected.All the patients underwent surgical resection which included pancreaticoduodenectomy,duodenal preserving pancreatic head resection,distal pancreatectomy,middle pancreatectomy,local excision,resection of pancreatic tail plus splenectomy and distal pancreaticosplenectomy.Postoperative histopathological examination confirmed solid pseudopapillary tumor of the pancreas in all these patients.Twenty-one patients (30.9％) developed postoperative complications,which included pancreatic fistula in 12 patients (17.7％),hemorrhage in 2 patients (2.9％),pleural effusion in 2 patients (2.9％),incision infection in 3 patients (4.4％),and gastric emptying disorder in 2 patients (2.9％).There was no in-hospital mortality.The average length of hospital stay was (26.0 ± 10.0) days.Of the 57 patients (83.8％) who were followed-up (mean 38 months,range 3 to 114 months),11 patients developed postoperative indigestion and 2 patients diabetes.No patient developed tumor recurrence,metastasis and death.Conclusions SPTP is a low grade malignant tumor,which is found primarily in young women.The clinical characteristics are non-specific,and preoperative diagnosis is difficult.Excellent prognosis can be achieved with surgical resection which is the preferred treatment for SPTP.

Sorafenib is the only molecular targeted drug therapy for advanced liver cancer recommended by the European Association for the study of liver diseases (EASL), American Association for the study of liver diseases (AASLD) and the United States Food and Drug Administration (FDA). As a multi kinase inhibitors, sorafenib can inhibit multiple signal transduction pathways of tumor cell proliferation and angiogenesis and obviously prolong the late stage of disease progression time and overall survival in patients with hepatocellular carcinoma (HCC). Criteria for evaluation of the efficacy of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC) is increasingly perfect. The author gives a brief overview of the molecular mechanism, efficacy and safety and efficacy evaluation criteria of sorafenib in the treatment of advanced liver cancer.

Objective To study the expression of Notch3 in pancreatic ductal adenocarcinoma (PDAC) and to find out its relationship with clinical features and overall survival in patients with pancreatic ductal adenocarcinoma.Methods PDAC and adjacent non-cancerous tissues from 80 patients who under went surgery for primary PDAC in the Affiliated Tumor Hospital of Zhengzhou University were collected between 2008 and 2015.The specimens were divided into two subgroups by immunohistochemical staining of Notch3:the low expression group (0-4 points) and the high expression group (5-12 points).Correlations between expression of Notch3 with clinical features and prognosis of patients with PDAC were analyzed.Results A high expression of Notch3 gene was significantly associated with tumor grade,metastasis,venous invasion and TNM staging.Univariate Cox regression analysis showed that metastasis,venous invasion,TNM stage and protein expression of Notch3 were strongly correlated with overall survival of patients.Multivariate analysis showed that metastasis,TNM stage and Notch3 were independent risk factors of overall survival in patients with PDAC.Kaplan-Meier survival curves indicated that a high expression of Notch3 was an important risk factor of poor survival.Conclusions A high expression of Notch3 was significantly associated with progression and poor prognosis of PDCA.Notch3 may serve as a new indicator of PDAC progression and patient survival outcomes.

Objective To investigate the value of the Habib 4x bipolar radiofrequency device in resection of hepatic cancer complicated with liver cirrhosis.Methods The clinical data of 35 patients who underwent hepatectomy at the Affiliated Tumor Hospital of Zhengzhou University from May 2014 to May 2016 was collected.The preoperative diagnosis was based on the abdominal enhanced CT or MRI.The intra and postoperative indexes were recorded.Patients were followed up regularly.Measurement data with normal distribution and with skewed distribution were presented as (x-)± s or M (range),respectively.Results All the 35 patients successfully underwent hepatectomy.There were no serious postoperative complications.During the follow-up,2 patients had intrahepatic recurrences,none were on the surgical margin.As of the end of follow up,all the 35 patients were alive.Conclusions Habib 4x frequency hematischesis cutter assisted resection of hepatocellular carcinoma complicated with cirrhosis is safe,feasible.