Objective: To investigate the efficacy，safety and feasibility of regional lymph node dissection in laparoscopic radical surgery for bladder cancer under the guidance of indocyanine green fluorescence imaging. Methods: A total of 30 patients with muscle invasive bladder cancer (T2/T3NxM0) who volunteered to enter the clinical trial were randomly divided into the indocyanine green imaging guided laparoscopic regional lymph node dissection group (n=15) and the standard pelvic lymph node dissection group (n=15).The number of positive lymph nodes，operation time，intraoperative bleeding volume，incidence of lymph leakage，and tumor recurrence and metastasis rate 2-year after surgery were collected. Results: The number of positive lymph nodes was (4.20±1.66) and (4.60±1.72) respectively in the indocyanine green and standard groups，with no statistically significant difference (P>0.05).There were no statistically significant difference in the tumor recurrence and metastasis rates 2-year after surgery between the two groups (P>0.05).However，the indocyanine green group had shorter operation time，less intraoperative bleeding volume，and lower incidence of lymphatic leakage than the standard group (P<0.05). Conclusion: Indocyanine green fluorescence imaging guided laparoscopic lymph node dissection has comparable clinical efficacy to standard lymph node dissection，but with fewer complications.

Objective To investigate the efficacy,safety and feasibility of laparoscopic lymph node dissection guided by indocyanine green(ICG)fluorescence imaging.Methods A total of 30 patients with muscle-invasive bladder cancer(MIBC,T2/T3NxM0)who were admitled to the Cangzhou People's Hospital during Mar.2018 and Jun.2022 were included.The lymph nodes were cleared with ICG fluorescence imaging first,and then the remaining lymph nodes were cleared according to the standard pelvic lymph node range.The lymph node positive rate of ICG fluorescence imaging guided laparoscopic lymph node precise dissection and standard pelvic lymph node dissection was analyzed by self-comparison.Results ICG fluorescence imaging guided laparoscopic lymph node precise dissection needed shorter operation time than standard pelvic lymph node dissection[(21.80±6.80)min vs.(47.70±10.73)min,P＜0.05].There was no significant difference in the lymph node positive rate between the two approaches[(11.34±9.06)％vs.(12.36±9.43)％,P＞0.05],but the former approach caused less damage on blood vessels and nerves.Conclusion Indocyanine green fluorescence imaging guided laparoscopic lymph node dissection has comparable efficacy to standard pelvic lymph node dissection,which can reduce ineffective lymph node dissection,shorten the operation time,and reduce the risk of complications.

OBJECTIVE To monitor the occurrence of tenofovir disoproxil fumarate （TDF）-induced kidney injury and investigate the risk factors， and provide reference for rational use of TDF in clinic. METHODS The information of inpatients with hepatitis B was collected by China Hospital Pharmacovigilance System （CHPS） from the Second People’s Hospital of Lanzhou during Jan. 1st， 2019 to Dec. 31st 2021. The search criteria were set according to kidney injury criteria， and suspected TDF- induced kidney injury cases were actively monitored； then the clinical pharmacist confirmed the positive patients with TDF-induced kidney injury one by one and calculated the incidence of TDF-induced renal injury； the risk factors for TDF-induced kidney injury in real world were explored by collecting and analyzing the correlation of basic data of patients， main indexes of liver and kidney function， complications and combined use of drugs with TDF-induced renal indexes. RESULTS Totally 1 226 inpatients with hepatitis B using TDF were included. Through active monitoring of CHPS， 160 suspected patients with TDF-induced kidney injury were found， and 64 positive patients were finally confirmed manually. The incidence of TDF-induced kidney injury was 5.22%. Compared with pre-medication， the levels of serum creatinine and cystatin C， the proportion of patients with urinary protein 2+ and above were increased significantly after medication （P＜0.001）， glomerular filtration rate and blood phosphorus level were reduced significantly （P＜0.001） and other indicators had no statistical difference. Treatment time for more than 36 months， disease progresses to decompensated cirrhosis， and concomitant use of more than 10 kinds of drugs were significantly correlated with TDF- related kidney injury （P＜0.05 or P＜0.012 5）. CONCLUSIONS The active monitoring scheme of TDF-induced kidney injury established by CHPS has the characteristics of time-saving， labor-saving and high efficiency； based on real-world evidence， it is imperative to strengthen monitoring kidney function of patients when using TDF， especially when the patient has been on medication for a long time， in decompensated cirrhosis and combination of multiple drugs， and thus， we can identify earlier and avoid adverse effects in high-risk patientseffectively.

Objective To compare the adjuvant activity of oil-in-water emulsion MF59 and aluminum hydroxide on immune responses to HIV-1 multi-epitope protein MEP1 in BALB/c mice. Methods HIV-1 multi-epitope protein MEP1 with MF59 or aluminum was prepared to intramuscularly vaccinate female BALB/c mice for three times. Serum and splenocytes were isolated from the mice 10 d after the first and last vaccination. Specific anti-MEP1 antibodies and the subclasses in serum were detected by ELISA. The num-bers of splenic lymphocytes secreting IFN-γ and IL-4 were measured by ELISPOT. Differences in humoral and cellular immune responses induced by the two different adjuvants were compared. Results After a sin-gle-dose immunization, aluminum adjuvant promoted early humoral and cellular immune responses to MEP1 compared with MF59. After the three-dose immunization, both aluminum adjuvant and MF59 promoted MEP1 to induce Th2-biased humoral immune response, while MF59 also enhanced a balanced Th1/Th2 cel-lular immune response. Conclusions Aluminum adjuvant was a more suitable adjuvant than MF59 for HIV-1 multi-epitope protein MEP1.

Objective To observe the expression of PD-L1 in breast cancer tissue and to investigate its correlation with cellu-lar immunity.Methods One hundred and fourteen paraffin-embedded specimens of breast cancer were collected from the Qian′an Municipal People′s Hospital.The expression of PD-L1 in breast tumor tissue was detected by immunohitochemical technique,then the relationship between PD-L1 expression and tumor clinicopathological characteristics was analyzed;the levels of peripheral blood CD3+,CD3+CD4+,CD3+CD8+,CD3-CD19+,CD3-CD16+CD56+cells and CD4+/CD8+in the patients with PD-L1 negative and PD-L1 positive of the two groups were detected by the flow cytometry.Results Among 114 cases of breast cancer specimen,35 ca-ses(30.7%)were PD-L1 expression positive with the expression rate of 30.7%.The PD-L1 expression was correlated with the tumor size,histological grade and Ki-67 high expression(P<0.05);the cellular immunity status in the patients with PD-L1 negative expression was better than that in the patients with PD-L1 positive expression(P<0.05).Conclusion The PD-L1 expression is closely correlated with the poorer clinicopathological characteristics of breast cancer,its mechanism may be correlated with the dis-ruption of cellular immunity in the patients with PD-L1 positive expression.

Objective To determine the diagnostic value of ractional exhaled nitric oxide (FeNO) in eosinophils (EOS) bronchial asthma and its significance in appraising of therapeutic reaction of inhaled corticosteroids (ICS) for EOS bronchial asthma.Methods A total of sixty-two patients with bronchial asthma in the First Mfiliated Hospital of Xinxiang Medical University from April 2015 to February 2016 were selected as asthma group;at the same time,sixty-two healthy people were recruited as control group.The patients in asthma group were divided into EOS asthma group(n =31) and non EOS asthma group (n =31) according to the induced sputum cell count;the patients in EOS asthma group were divided into mild (n =7),moderate (n =13) and sever asthma group (n =1 1) according to the severity of the disease.The patients in asthma group were given conventional therapy(doxofylline 0.2 g intravenous infusion,two times per day;oral cetirizine 10 mg,one time per night;oral montelukast 10 mg,one time per night;budesonide 2 mg and compound ipratropium bromide solution 2.5 mL by aerosol rebreathing method,two times per day) for seven days.The pulmonary function,asthma control test(ACT) score,FeNO level and the ratio of EOS of patients were detected before and after treatment;the FeNO levels of person in the control group were tested.The FeNO levels of subjects were compared in each group;the correlation between FeNO level and EOS ratio was analysed in asthmatic group;the controlling rates of patients in asthmatic group were compared.Results Before treatment,the FeNO level in control group and asthma group was (9.57 ± 6.61),(30.23 ± 8.9 1) ppb respectively;the FeNO level in control group was significantly lower than that in asthma group (t =7.414,P ＜ 0.05).Before treatment,the FeNO level of patients in EOS asthma group and non EOS asthma group was (59.62 ± 29.04),(18.20 ± 11.33) ppb respectively;the FeNO level in non EOS asthma group was lower than that in EOS asthma group (t =6.568,P ＜ 0.05).In asthma group,the level of FeNO was positively correlated with EOS ratio(r =0.823,P ＜ 0.05).There was no statistic difference in FeNO level of patients in non EOS asthma group before and after treatment(t =2.013,P ＞ 0.05).The FeNO levels of patients in EOS asthma group after treatment were significantly lower than those before treatment (t =7.740,P ＜ 0.05);the FeNO levels of patients in mild,moderate and sever asthma group after treatment were significantly lower than those before treatment(t =3.535,8.171,7.161;P ＜0.05).The control rate of patients in EOS asthma group(67.7％,21/31) was significantly higher than that in the non EOS asthma group(22.6％,7/31) (x2 =12.765,P ＜0.05).The control rate of patients in mild,moderate and sever asthma group was 28.6％ (2/7),76.9 ％ (10/13) and 81.8 ％ (9/11) respectively;the control rate of patients in mild asthma group was significantly lower than that in moderate and sever asthma group (x2 =6.418,7.103;P ＜ 0.05);there was no statistic difference in control rate of patients between moderate asthma group and sever asthma group(x2 =7.103,P ＞ 0.05).Conclusion FeNO level can reflect the degree of airway inflammation,and can be used for the diagnosis of EOS phenotype asthma,and also has certain clinical value in evaluating the therapeutic reaction of ICS for treatment of EOS asthma.

Objective To explore the methods and mesures for the pre-analytical quality control of test specimen and to improve the accuracy and reliability of test results.Methods According to the relevant requirements of IS015189,various measures for the specimen circulation process and collection technology two aspects were taken to control the full links of clinical specimen collection and transport,and the incidence of unqualified specimen before and after the improvements were analyzed.Results After the imple-mentation of the improvement measures,the incidence of unqualified specimens was decreased significantly.Conclusion Implemen-tation of the whole aspect of pre-analytical quality control can effectively improve the quality of specimen in order to improve the test quality.

Objective To investigate Fascin expression in human lung cancer tissues and its clinical significance.Methods Immunohistochemistry was performed in 62 patients with different histological types and clinical stages of lung cancer and 92 cases with other malignant tumors.Fascin positive rate in each group was calculated and the differences of pathological characters between the two groups were analyzed.Results Fascin expression in lung cancer tissues was significantly higher than that in normal lung tissues(P ＜ 0.05),its expression varied by different clinical stage of lung cancer tissue differentiation.As differentiation degree decreased,Fascin positive rate increased.Fascin expression was independent with age,sex,smoking history(P ＞ 0.05).Fascin expression had no significant difference between lung cancer group and other tumor group(P ＞ 0.05).Conclusions Fascin expression raising might be common in malignant tumors.Fascin expression in lung tissues indicated the possibility of lung cancer.In lung tissue,high expression of Fasein was a sign of poor differentiation and malignant status of lung cancer.

Objective To investigate the role of NF-κB activation in the inflammatory mechanism of chronic obstructive pulmonary disease (COPD).Methods Monocyte were collected from patients with COPD and were cultured,and stimulated with lipopolysaccharide (LPS) ; NF-κB p65 activation was measured by immunohistochemistry; SOD ,MDA and IL-8 and lung function were determined synchronously.Results The NF-κB p65 was induced by LPS in monocyte in all subjects, but it was most markedly done in COPD patients with exacerbateions; There was positive correlation between the NF-κB p65 activation of monocytes and levels of IL-8 and MDA in circulation, but it was negative correlation to SOD.Conclusion NF-κB plays a vital role in regulating product of IL-8 in monocyte in COPD.

Objective To explore the changes of plasma endothelin-1 (ET-1), nitrousoxide (NO), blood gas analysis, and blood rheology in patients with chronic bronchitis (CB), pulmonary emphysema (PE) and pulmonary heart disease (PHD) at different periods.Methods The plasma ET-1, NO, blood viscosity, hematocrit (Hct) and aggregation index (AI) of patients in groups of CB, PE and PHD, and the subjects of the control group were tested and compared. Blood gas analysis of subjects in four groups also performed and compared. Each group had 40 cases.Results In PE and PHD patients, the ET-1 level was higher, the indexes of blood gas analysis and blood rheology were abnormal. When PE developed into PHD, the ET-1 and PaCO2 tended to increase, PaO2 tended to decrease. When CB developed into PE and PHD, the blood viscosity, pressure volume and AI tended to increase, but NO tended to decrease.Conclusion When CB developed into PE or PHD, ET-1, PaCO2 tend to increase and NO, pH, PaO2 tend to decrease; increased red blood cells, blood viscosity and AI become severe.