Short-term efficacy and safety of pembrolizumab combined with neoadjuvant chemotherapy for the treatment of non-small cell lung cancer / 中国胸心血管外科临床杂志

@#Objective    To explore the short-term efficacy and safety of pembrolizumab combined with chemotherapy in the neoadjuvant treatment of non-small cell lung cancer. Methods    The clinical data of 11 male patients with non-small cell lung cancer who underwent pembrolizumab combined with neoadjuvant chemotherapy in the Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University from December 2019 to June 2021 were retrospectively analyzed. The average age of the patients was 52.0-79.0 (62.0±6.9) years. The imaging data and pathological changes before and after neoadjuvant treatment were compared, and adverse reactions during neoadjuvant treatment were recorded. Objective remission rate (ORR) and main pathological remission rate (MPR) and pathological complete remission rate (pCR) were the main observation endpoints. Results    After preoperative neoadjuvant therapy with pembrolizumab combined with platinum or paclitaxel, all patients successfully underwent thoracoscopic radical resection of lung cancer. The ORR was 72.7%, and the MPR was 81.8%. Among them, 45.5% of patients achieved pCR. The main adverse reactions were hypoalbuminemia, decreased appetite and nausea. The mortality rate within 30 days after surgery was 0, and no tumor metastasis was observed. Conclusion    Pembrolizumab combined with neoadjuvant chemotherapy is safe and feasible to treat non-small cell lung cancer, and the short-term efficacy is beneficial.

Thoracic surgery perspective of comprehensive treatment of esophageal cancer with esophagus preserved / 中国胸心血管外科临床杂志

@#Surgery is a classic traditional method for the treatment of early-stage esophageal cancer, and it is also recognized as an effective first-choice method in the medical community. With the development of endoscopic technology, esophagus-preserving comprehensive treatment of esophageal cancer has almost the same or even better effects in some aspects in the treatment of early esophageal cancer than surgery. Many clinical guidelines have also recommended it as the first-choice treatment for early esophageal cancer. The room for surgical treatment of esophageal cancer has been further compressed. This article discusses the comprehensive treatment model of esophageal cancer from the perspective of thoracic surgery, aiming to find a new position of thoracic surgery in the treatment of esophageal cancer.

Treatment of Stage Ia Non-small Cell Lung Cancer in Patients: Comparison of Ablation and Sub-lobectomy / 中国肺癌杂志

BACKGROUND@#Lung cancer has the highest mortality in China. Different treatments are of great significance to the prognosis of patients. By comparing stage Ia non-small cell lung cancer (NSCLC) patients' survival rates for ablation and for sub-lobectomy, we studied the difference in the effects of the two treatments on patient prognosis.@*METHODS@#Using the Surveillance, Epidemiology, and End Results (SEER) database, we screened eligible patients with stage Ia NSCLC from January 2004 to December 2015. Then, 228 patients treated with ablation and 228 patients treated with sub-lobotomy were then selected based on propensity score matching. After stratification, matching, and adjustment the Kaplan-Meier analysis was performed to compare the overall survival rates of patients treated with the two procedures.@*RESULTS@#The Kaplan-Meier survival analysis showed that there is a significant difference between the ablation group and the sub-lobectomy group (P<0.05). In the univarlable analysis, the hazard ratio (HR) of sub-lobotomy group was 0.571 (95%CI: 0.455-0.717) compared with the ablation group. Patients treated with sub-lobectomy had a 0.571 times greater risk of adverse outcomes than those treated with ablation. In the multivariable analysis, the HR for sub-lobectomy group was 0.605 (95%CI: 0.477-0.766) compared with the ablation group. Patients treated with sub-lobectomy had a 0.605 time greater risk of adverse outcomes than those treated with ablation. The results suggested that the overall survival rate of patients with stage Ia NSCLC treated with sub-lobotomy was higher than that of patients treated with ablation.@*CONCLUSIONS@#This study suggests that there is a significant difference in overall survival of stage Ia NSCLC patients treated with ablation and with sub-lobotomy. Patients treated with sub-lobotomy for stage Ia NSCLC had higher overall survival than those treated with ablation.

Animal experiment of magnetic anchor device on lung surface / 中华胸心血管外科杂志

Objective:To verify the feasibility of a self-designed laparoscopic magnetic anchoring device for assisting thoracoscopic wedge resection.Methods:Six healthy Beagle dogs were selected as animal models, and underwent thoracoscopic wedge resection after general anesthesia. We replaced the pulmonary forceps with a magnetic anchoring device to complete the traction exposure of the lobes, and recorded the operation time of the operation, the amount of intraoperative blood loss, and the safety and feasibility of the magnetic anchoring device.Results:Six Beagle dogs successfully completed a thoracoscopic wedge resection with the aid of a magnetic anchoring device. During the operation, the magnetic anchoring device can completely replaced the exposure function of the pulmonary forceps, effectively eliminating the " chopstick effect" between the instruments during the uniportal video-assisted thoracoscopic operation. The magnetic anchoring device provided sufficient traction for the surgery to achieve a clear exposure of the field. Tissue damage and magnetic anchoring pliers slip did not occur during the operation. The operation time was(22.67±3.25)min(range 18-26 min), and the intraoperative blood loss was less than 10 ml. The experimental animals survived well after surgery.Conclusion:Magnetic anchoring device is safe and effective for thoracoscopic wedge resection, which can eliminate mutual interference between operating instruments and has potential for clinical application.

Establishment of gastrointestinal anastomosis by magnetic compression technique in rabbits / 中华消化内镜杂志

Objective:To study the feasibility of establishing gastrointestinal anastomosis by magnetic compression technique in rabbits.Methods:Ten healthy New Zealand rabbits were selected as models for gastrointestinal anastomosis by magnetic compression technique. Daughter and parent magnets suitable for gastrointestinal anastomosis in rabbits were designed and manufactured. A daughter magnet was inserted into the stomach through the purse fistula in the lack of blood vessel area of gastric body, and was pushed into the duodenum along the intestinal tract. And then a parent magnet was inserted through the stomach fistula. The daughter and parent magnets were automatically attracted and pressed the gastric and intestinal walls after they were adjusted in the proper position. The stomach fistula was closed with purse string suture. After ischemia, necrosis, detachment of the tissues between magnets, gastrointestinal anastomosis was established, and the magnets and necrotic tissues were expelled together from the body through the digestive tract. Survival of experimental animals was observed. Anastomotic specimens were obtained one month after operation. The blasting pressure of anastomotic stoma was measured, and the healing of anastomotic stoma was observed with naked eyes.Results:According to the pre-designed operative route, 10 New Zealand rabbits all successfully completed the operation and survived one month after surgery. No complications occurred during perioperative period. The operation time was 35.80±4.71 min (range 28.00-43.00 min), and the magnet discharge time was 11.40±1.56 days (range 9.00-14.00 days). Anastomotic specimens were obtained one month after the operation. Gross observation showed that the anastomotic stoma of gastrointestinal bypass anastomosis healed well, and the surrounding tissues adhered slightly. The anastomotic bursting pressure was 103.00±7.95 mmHg (range 94.00-113.00 mmHg) (1 mmHg=0.133 kPa).Conclusion:The establishment of gastrointestinal anastomosis by magnetic compression technique in rabbits is simple and effective.

Acute meningitis and encephalitis syndrome surveillance disease burden in four China prefectures / 中华预防医学杂志

Objectives@#To explore acute meningitis and encephalitis syndrome (AMES) surveillance in 4 China prefectures, to understand the epidemiological features and disease burden of neisseria meningitides (Nm) meningitis, streptococcus pneumoniae (Sp) meningitis, haemophilus influenza type b (Hib) meningitis and Japanese encephalitis and provide evidence for related disease prevention and control.@*Methods@#AMES surveillance were conducted in Jinan, Shandong Province and Yichang, Hubei Province in September 2006, and in 13 districts of Shijiazhuang, Hebei Province and Guigang City, Guangxi Zhuang Autonomous Region in April 2007. Six hospitals in each city were selected as monitoring pilot hospitals to carry out reports of suspected cases of acute meningitis and encephalitis, case investigation, blood specimens and cerebrospinal fluid specimen collection, anti-JEV IgM antibody enzyme-linked immunosorbent assay, Nm, Sp and Hib culture and polymerase chain reaction detection, etc. According to the age group, the incidence of bacterial meningitis and Japanese encephalitis in local residents <20 years old was estimated.@*Results@#From 2006 to 2013, a total of 19 423 surveillance cases were reported in four cities, of which 11 071 (56.99%) were reported in the pilot hospitals. Of the 11 071 cases, 5 315 were tested for bacteriology and 9 180 were tested for anti-JEV IgM antibodies. Among the bacteriological tests, 176 cases were positive, including 75 cases of Nm positive, 91 cases of Sp positive and 10 cases of Hib positive. The incidence of three bacterial meningitis is estimated for people under 20 years old, with estimated incidence of Nm, Sp and Hib meningitis in children <5 years old was 0.46/100 000-0.71/100 000, 0.34/100 000-0.83/100 000 and 0.32/100 000-0.57/100 000 respectively; the estimated incidence of Nm and Sp meningitis in children aged 5-9 years was 0.59/100 000-1.14/100 000 and 0.50/100 000-1.66/100 000 respectively. In 732 cases of positive JE cases, the positive detection rates of <5 years old, 40-49 years old and ≥50 years old were 9.51% (95/999), 28.09% (66/235) and 33.85% (130/384), respectively. The estimated annual incidence rate of JE was 0.12/100 000-0.79/100 000.ratio of cases 1.19∶1. Most of cases (27.30%) were children and adolescents aged 5-14 years and those (26.84%) aged over 45 year.@*Conclusion@#The study found that primary and secondary school students are the key population of Nm meningitis, suggesting that it is necessary to explore the enhanced immunization study of meningococcal vaccine in this population; Sp has the possibility of occurrence in all age groups; <5 years old children are the main population of Hib meningitis.

Analysis of epidemic characteristics for meningococcal meningitis in China during 2015-2017 / 中华预防医学杂志

Objective@#To analyze the characteristics of epidemiology and neisseria meningitidis (Nm) serogroups distribution for meningococcal meningitis (MM) cases in China from 2015 to 2017.@*Methods@#The data of MM cases were collected from National Notifiable Diseases Registry System (NNDRS) and case-based MM surveillance system (MMSS) from 2015 to 2017; Demographic data are from the National Bureau of statistics. Inclusion criteria: the date of onset was January 1, 2015 to December 31, 2017, the status of infectious disease report card was "final examination card", the cases are classified as "laboratory confirmed cases" and "clinical diagnostic cases", and the card data information of disease name was "Meningococcal meningitis". According to the Diagnostic Criteria for Meningococcal meningitis (WS295-2008), laboratory confirm was made for reported cases or clinically diagnosed cases of meningococcal meningitis.@*Results@#From 2015 to 2017, a total of 325 MM cases were reported in China, with an average annual incidence of 0.007 9 per 100 000 population. And 148 cases were laboratory confirmed. There were 3, 15, 12, 5, 2 and 18 provinces which were reported serogroup A, B, C, W, Y, Others and NG MM Cases, respectively. Except for Tibet and Hainan, other provinces have reported group A cases; The provinces reporting group B, C, W and Y cases increased by 9, 11, 13 and 2 provinces in 2007, respectively compared with 2005. Serogroup B was the primary reason causing the cases of <1 year old and 1-6 years old children; and in this age group, 51.43% (18 cases) and 68.18% (15 cases) of group B were accounted for in laboratory confirmed, respectively; Serogroup C, others and NG was the major reason in the cases of 7-12 and >12 years old students and adults: 33.33% (5 cases) and 26.32% (20 cases) of group C were accounted for in laboratory confirmed respectively, then 26.67% (4 cases) and 34.21% (26 cases) of group others and NG were accounted for respectively; 2 cases of serogroup Y were all >12 years old.@*Conclusion@#The epidemic serogroup of Nm caused MM cases showed a diversifying trend. To develop and provide new vaccines for serogroup B and other bacteria groups should be one of the important tasks for MM control and prevention in the future.

Guidelines for the use of post-traumatic tetanus vaccines and passive immune preparation / 中华预防医学杂志

Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rate of tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, the latest research progress from home and abroad. The guidelines focus on the basic procedures for the prevention and disposition of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and the pre-exposure immunization in high-risk populations of trauma.

Meta-analysis on Serological Effect of the Primary Vaccination for Japanese Encephalitis of the Literatures / 中国疫苗和免疫

Objectives To summary and compare the different seroconversion rates after the primary vaccination for the Japanese encephalitis (JE),and to evaluate the serological effect of 3 kinds of JE vaccines.Method Searching "CHKD","Wanfang" database and "EMCC" databases,the studies of the immunogenicity after the primary JEV vaccination,all randomized controlled trials or non-randomized controlled trials were included,and statistical analysis were made by RevMan 4.2.10 software.Results A total of 12 literatures were included,7 studies had control groups.The seroconversion rates after the primary vaccination,JEV-L,JEV-I (Vero) and JEV-I(PHK),were 86% (95% CI:80% ～ 91%),83% (95% CI:72% ～ 94%) and 64% (95% CI:58% ～ 69%) respectively.Comparing the seroconversion rates of the 3 kinds of vaccines after primary immunization,the rate of JEV-I (Vero) was significantly higher than the rate of JEVI(PHK),other comparisons were no significant difference.Conclusion The serological effects of JEV-L and JEV-I (Vero) after the primary vaccination were higher than that of JEV-I (PHK).

Study Progress on Serogroup B Meningococcal Vaccine / 中国疫苗和免疫

Meningococcal disease,caused by Neisseria meningitidis (Nm),is still one serious threatening infectious disease with high mortality.Vaccination is available for prevention and control of such disease.Based on the chemical structure of capsule polysaccharide,Nm strains were classified into 13 serogroups.Meningococcal polysaccharide vaccines and polysaccharide conjugated protein vaccine against serogroup A,C,W 135 and Y were efficacious and have been widely used.Because of poor immunogenicity and the structurally homologous with neural cell,capsule polysaccharide of serogroup B Nm can not be used as vaccine candidate.In last several decades,B group vaccines develoment focused on the proteins research.Based on the out membrane protein and reverse vaccinology technology,progress of B group vaccine were accelerated.Several meningococcal B vaccine showed favorable immunogenicity and efficacity.Some B vaccines have been licensed and widely used.