OBJECTIVE To evaluate the clinical value of anlotinib in third-line treatment for patients with advanced non-small cell lung cancer （NSCLC） through real-world data. METHODS Clinical data of patients with advanced NSCLC who received treatment at the First Affiliated Hospital of Anhui University of Chinese Medicine from February 2021 to December 2024 were retrospectively collected. They were divided into anlotinib group （27 cases， receiving anlotinib therapy） and immunotherapy group （22 cases， receiving immunotherapy agents alone or in combination with chemotherapy drugs） according to treatment regimens. The progression-free survival （PFS） and overall survival （OS） of patients were compared between the two groups， and the occurrence of adverse drug reactions during the treatment period was recorded. Using a partitioned survival model， an economic evaluation of the two treatment regimens was conducted with a cost-utility analysis approach from the perspective of the healthcare system. RESULTS The median PFS and OS of patients in the anlotinib group were 5.93 months and 11.27 months， respectively； the median PFS and OS of patients in the immunotherapy group were 5.33 months and 9.77 months， respectively； the difference was not statistically significant （P＞0.05）. There was no statistical difference in the total incidence of adverse drug reactions and grade 3-4 serious adverse drug reactions between the two groups （P＞0.05）. Compared with the immunotherapy group， the incremental cost-effectiveness ratio of the anlotinib group was 1 806 724.60 yuan/quality-adjusted life year （QALY）， which was significantly higher than three times China’s per capita gross domestic product in 2024 （287 247 yuan/QALY）. CONCLUSIONS For third-line treatment of advanced NSCLC patients， the efficacy of anlotinib is no worse than that of immunotherapy alone or in combination with chemotherapy drugs， and the safety of the two groups is comparable. However， anlotinib is not cost-effective.

Objective:To investigate the characteristics of attention bias to aggressive information under self-threat priming in college students with different types of high self-esteem.Methods:A total of 650 college students were selected,and high self-esteem participants were selected through the Self Esteem Scale(SES).Then,43 partic-ipants were selected from different types of high self-esteem(fragile and safe)groups through the Implicit Associa-tion Test(IAT).Each group participated in Raven's Standard Progressive Matrices(SPM)with different difficulty levels to complete self-threat priming,and then completed the spatial cue experiment.When the cue was invalid,the attention bias was obtained according to the variation of the reaction time difference(RTI)between the subjects're-sponses to aggressive words and neutral words.Results:The RTI values of the fragile high self-esteem group were higher under high self-threat priming than that of the secure high self-esteem group(P＜0.01).Under low self-threat priming,there was no significant difference in RTI values among different types of high self-esteem groups(P＞0.05).Conclusion:Fragile high self-esteem group are more likely to develop attention bias towards aggressive words under high self-threat priming than that of secure high self-esteem group.

Novel therapies are urgently needed to improve global treatment of SARS-CoV-2 infection. Herein, we briefly provide a concise report on the medicinal chemistry strategies towards the development of effective SARS-CoV-2 inhibitors with representative examples in different strategies from the medicinal chemistry perspective.

Objective:To investigate the risk factors for axial deviation in the treatment of tibial defect susing Orthofix unilateral external fixator and proximal tibial osteotomy for bone transport.Methods:A retrospective study was performed to analyze the clinical data of 90 patients who had been treated for tibial bone defects by the Orthofix unilateral external fixator at Department of Microrepair and Reconstruction, The First Hospital Affiliated to Xinjiang Medical University from May 2012 to June 2019. There were 77 males and 13 females with a mean age of 41.2 years (from 17 to 63 years).The bone defects ranged from 4 to 13 cm in length. According to the Paley criteria for axial deviation, the 90 patients were divided into 2 groups: a deviation-free group with no axial deviation or an axial deviation ≤5° and a deviation group with an axial deviation>5°. The 2 groups were compared in terms of age, number of prior surgery, defect length, placement angle of Schanz screws, external fixation time, external fixation index and bending degree of Schanz screws at the last follow-up.The factors with P<0.05 were analyzed by multivariate logistic regression to find the risk factors for coronal axial deviation. Results:The 90 patients were followed up for an average of 23 months (from 12 to 40 months). The incidence of axial deviation in this cohort was 36.7% (33/90).The deviation group had a significantly larger number of prior surgery [5 (3, 6) times], a significantly longer defect length [8 (8, 9) cm], a significantly longer external fixation time [400.0 (341.8, 426.3) d], and a significantly greater bending degree of Schanz screws at the last follow-up [1.2° (0.4°, 3.5°)] than the deviation-free group [3 (2, 3) times, 6 (5, 8) cm, 340.8 (226.5, 422.8) d, and 0.8° (0.2°, 3.7°)] (all P<0.05). Multivariate logistic regression analysis showed that the number of prior surgery ( OR=2.581, 95% CI: 1.496-4.450, P=0.001) and the defect length ( OR=5.310, 95% CI: 1.952-14.442, P=0.001) were the risk factors for the axial deviation. Conclusion:In the treatment of tibial defect susing Orthofix unilateral external fixator and proximal tibial osteotomy for bone transport, the more prior surgeries and the longer a bone defect, the higher the risk for axial deviation.

Objective To analyze the influence of general anesthesia (GA) on bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in treating Parkinson's disease (PD) through microelectrode recording (MER),and discuss the differences between different modes of anesthesia.Methods A retrospective analysis was performed on clinical data of 31 PD patients accepted bilateral STN-DBS in our hospital from June 2015 to June 2017.Nine patients accepted surgery under GA (A group):4 patients were treated with intravenous anesthesia (A1 group),and 5 patients were treated with inhalation anesthesia (A2 group);22 patients accepted surgery under local anesthesia LA group.MER indexes,including STN discharge frequency,STN recorded length,and maximum target error,and short-term (6 months) efficacy were recorded.A linear regression analysis was performed to find possible influence factors on discharge frequency and improving rate of UPDRS scores.Results The discharge frequencies of B group,A1 group and A2 group were 51.42 Hz±6.28 Hz,35.79 Hz±7.02 Hz and 43.18 Hz±5.87 Hz,respectively,with significant differences (F=12.181,P=0.000);as compared with that in the B group,the discharge frequencies of A1 group and A2 group were significantly lower (P＜0.05).The STN recorded lengths of B group,A1 group and A2 group were 5.48 mm±0.33 mm,5.06 mm±0.15 mm and 5.22 mam±0.16 mm,respectively,with significant differences (F=4.115,P=0.027);as compared with that in the B group,the recorded lengths of A1 group and A2 group were significantly shorter (P＜0.05).A1 group had the maximum target error,but no significant differences were noted among the 3 groups (P＞ 0.05).Six months after the surgery,the UPDRS-Ⅲ scores and Schwab-England scores of A group and B group were decreased and daily levodopa equivalent (LEDD) was decreased.As compared with B group,A group had significantly better improvement in Hoehn & Yahr grading (P＜0.05).Disease durations were positively correlated with discharge frequency (r=0.539,P=0.002);age and improving rate of UPDRS scores were negatively correlated (r=-0.572,P=-0.001);preoperative LEDD and improving rate of UPDRS scores were positively correlated (r=0.725,P=-0.000).Conclusions Bilateral STN-DBS performed under GA in PD enjoys good efficacy,which shows no obvious difference as compared with that under LA.Inhalation anesthesia had less influence on electrophysiology than intravenous anesthesia.

Objective To present our experience with management of craniopharyngiomas by endoscopic endonasal approach Methods A retrospective review of clinical data of 65 patients who were treated for craniopharyngiomas by endoscopic endonasal approach from February 2012 to May 2016. All patients were analyzed by treatment effect, complications, and follow-up result. Results Total removal of the tumors were completed in 52 cases (80.0%), subtotal removal in 11 cases (16.9%), and partial resection in 2 cases (3.1%). The pituitary stalks were identified in 57 cases when surgery, and severed in 41 cases (71.9%). Postoperative visual acuity was improved in 31 cases (47.7%), and 6 cases remained in the preoperative level, whereas worsening occurred in 1 case. Worsening of the anterior pituitary function was reported in 21 cases (32.3%). Transient diabetes insipidus after operation was occurred in 45 patients (69.2%), and long-term diabetes insipidus was occurred in 9 cases (13.8%). Postoperative cerebrospinal fluid (CSF) leak was occurred in 4 cases (6.2%), accompanied with intracranial infection, and all these cases were repaired under endoscope again, 3 cases were saved, but 1 case was dead. Perioperative mortality rate was 4.6%. 52 patients were followed up for 4.0 ~ 45.0 (mean, 20.8) months, and 44 patients (84.6%) returned life to normal. Obesity developed in 8 patients (15.4%), with 2 recurrent cases and no deaths during follow-up period. Conclusion The endoscopic endonasal approach is a safe and effective minimally invasive surgery approach for treating craniopharyngiomas, and has its own unique advantage.

Objective To evaluate the value of the tests of mean corpuscular volume (MCV ) ,mean corpuscular hemoglobin (MCH) in the screening of thalassemia .Methods 603 cases were performed MCV and MCH tests and gene detection of thalasse-mia .The results of gene detection were used as reference standard .The sensitivity ,specificity ,accuracy ,positive predictive value and negative predictive value of single or combined results of MCV ,MCH tests were calculated .Results The sensitivity and specificity of single MCV test were 91 .2% and 76 .1% ,single MCH test were 91 .2% and 70 .7% .The sensitivity and specificity of parallel combined tests of MCV and MCH were 94 .8% and 61 .4% ,serial combined tests of MCV and MCH were 88 .4% and 75 .6% .Con-clusion The sensitivity of single MCV or MCH test in the screening of thalassemia is high .Parallel combined tests of MCV and MCH can improve the sensitivity ,and will be widely used in the in the screening of thalassemia .

Objective To explore the expressions ofmiR-124* and laminin-8 in different grades of human gliomas,and analyze the potential regulatory relationship between them.Methods Thirty human glioma specimens of different stages and two healthy brain tissues,collected in our hospital from January 2011 to December 2012,were used in our study; Western blotting was performed to detect the laminin-8 and miR-124* protein expressions; plasmid vectors carried psiCHECKTM-2-wild-type (WT) laminin β1 chain 3 'untranslated region (3'UTR) and psiCHECKTM-2-mutant (MUT) laminin β1 chain 3'UTR were established,and they were,respectively,co-transfected with the miR-124* mimics,negative control ofmiRNA mimics,miR-124* inhibitors,negative control ofmiRNA inhibitors into the U87 cells;besides,cotransfection with psiCHECKTM-2 into U87 cells was used as blank control group; the fluorescence intensity of each group was determined by dual-luciferase assay 48 h after the cotransfection.Dual-luciferase assay was developed to verify the regulatory effects ofmiR-124* on laminin-8.The nu/nu nude mice were given subcutaneous injection of U87 cells to establish giloma animal models; the expression of β1 chain-containing laminin-8 protein was detected in gliomas by Western blotting; the expression of vascular endothelial cell marker CD31 was observed by immunohistochemical staining.Results Western blotting showed high expressions of laminin-8 protein in high-grade gliomas (WHO grade Ⅲ/ⅣV),but low expressions in low-grade gliomas (WHO grade Ⅰ/Ⅱ); real-time fluorescent quantitative PCR showed that the expression of miR-124* in high-grade gliomas was significantly lower than that in low-grade gliomas.Dual-luciferase assay confirmed that fluorescence intensity of U87 cells carried psiCHECKTM-2-WT laminin β1 chain 3'UTR and miR-124* mimics (2.13±0.25) was significantly weaker than that of cells carried psiCHECKTM-2-WT laminin β1 chain 3'UTR and negative control of miRNA mimics (2.71±0.08,P＜0.05); that of those carried psiCHECKTM-2-MUT laminin β1 chain 3'UTR and miR-124* inhibitors (3.18 ±0.22) was significantly stronger than those carried,psiCHECKTM-2-MUT laminin β1 chain 3'UTR and negative control of miRNA inhibitors (2.70±0.17,P＜0.05).The animal model results indicated the laminin-8 and CD31 expressions in miR-124* treatment group were obviously lower than those in control group.Conclusion MiR-124*,which can affect the malignant degrees of human gliomas through playing its negative regulation role in laminin-8 expression,maybe a target gene for the diagnosis and therapy of gliomas.

ObjectiveTo study the prevalence of chronic kidney disease(CKD) among population with rheumatoid arthritis(RA) in Luohe city.Methods 3072 residents (older than 45 years) with eligible data from Luohe city were randomly selected using a stratified,multistage sampling.All residents were interviewed and given physical examination,tested for sample of uria and blood,and also given special examination about RA.Results The prevalence of RA was 6.90％ in 3072 subjects.The albuminuria was detected in 10.42％ of subjects,hematuria in 8.59％,reduced renal function in 1.82％,Howerer,which was higher in patients with RA,was 14.62％,10.85％ and 4.72％ respectively.Especially the prevalence of albuminuria and reduced renal function in RA patients was significantly higher compared to that in population without RA (14.62％ vs 10.10％,P＜0.05 and 4.72％ vs 1.61％,P＜0.01),but no significant differences in hematuria (10.85％ vs 8.43％,P＞0.05).The prevalence of CKD was 16.93％ in tougher,and RA patients had higher prevalence of CKD than those population without RA (22.17％ vs 16.54％,P＜0.05).ConclusionThe prevalence of CKD among population older than 45 years in Luohe city is high,and the patients with RA have special characteristic in epidemiology of CKD.

Objective To observe the destructive and scavenging effect of ambroxol (AMB) on the biofilm (BF) of Pseudomonas aeruginosa (P.a).To evaluate the synergistically bactericidal effect of AMB along with levofloxacin (LFX) on BF of P.a.Methods The early model (cultured for 3 d) and mature model (cultured for 7 d) of P.a wild strain (PAO1) BF were established,in vitro,respectively.The models were randomly (random number) divided into control group,AMB group and AMB + LFX group.The concentrations of AMB were 256 μg/ml and 512 μg/ml,respectively.When the early BF model and mature BF model were made,different concentrations of AMB were added in AMB group and AMB + LFX (1μg/ml) was added in AMB + LFX group.The number of viable P.a on the BF carrier was counted with the continuous dilution method 24 h after AMB or/and LFX added.Then,the BF morphological changes on the carrier surface were observed by using scanning electron microscopy (SEM).Measured data were analyzed with single factor analysis of variance (One-Way ANOVA).Results Both in the early BF model and in the mature BF model,the SEM examination showed that the BF in AMB group was significantly reduced compared to the control group,and this reduction of BF was in dose-dependent manner.LFX 1 μg/ml could reduce the number of viable bacterial in BF in both early model and mature model (P ＜ 0.05).LFX with addition of different concentrations of AMB showed stronger bactericidal effect than LFX used alone identified by more significant reduction in the number of colonv within the BF (P ＜ 0.05).Furthermore,the LFX combined with 512 μg/ml AMB reduced more significant number of colony apparently than the LFX combined with 256 μg/ml AMB (P ＜ 0.05).Conclusions AMB can destroy the early BF or mature BF partly,and LFX alone can partly reduce the number of viable P.a within BF.When LFX combined with AMB,they exert a synergistically bactericidal effect.