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Abstract Background Immunotherapy has revolutionized cancer treatment. Recent studies have suggested that the efficacy of immunotherapy can be further enhanced by the influence of gut microbiota. In this study, we aimed to investigate the impact of bacteria on the effectiveness of cancer immunotherapy by combining analysis of clinical samples with validation in animal models. Methods In order to characterize the diversity and composition of microbiota and its relationship with response to immune checkpoint inhibitors (ICIs), 16S ribosomal RNA (rRNA) and GC–MS sequencing was performed on 71 stool samples from patients with advanced non‐small cell lung cancer (NSCLC) prior to treatment with immune checkpoint blockade (ICB). Furthermore, fecal microbiota transplantation (FMT) was performed from different patients into mice and a subcutaneous tumor model established using the Lewis lung cancer cell line to evaluate the therapeutic effect of PD‐1 on mice with varying gut microbiota. Results The results demonstrated a significant association between elevated gut microbiota diversity and response to treatment with ICIs, p 0.05. The diversity of gut microbiota consistently correlated with an optimistic prognosis in NSCLC patients with immunotherapy, which could be functionally mediated by SCFAs. Conclusion The findings of the present study indicated that the diversity of gut microbiota and SCFAs is related to the efficacy of immunotherapy. FMT can effectively delay tumor progression, and enhance the effect of immunotherapy, thus providing evidence for improving the efficacy of immunotherapy in NSCLC patients.

Abstract Background The initial phase II stuty (NCT03215693) demonstrated that ensartinib has shown clinical activity in patients with advanced crizotinib‐refractory, anaplastic lymphoma kinase (ALK)‐positive non‐small cell lung cancer (NSCLC). Herein, we reported the updated data on overall survival (OS) and molecular profiling from the initial phase II study. Methods In this study, 180 patients received 225 mg of ensartinib orally once daily until disease progression, death or withdrawal. OS was estimated by Kaplan‒Meier methods with two‐sided 95% confidence intervals (CIs). Next‐generation sequencing was employed to explore prognostic biomarkers based on plasma samples collected at baseline and after initiating ensartinib. Circulating tumor DNA (ctDNA) was detected to dynamically monitor the genomic alternations during treatment and indicate the existence of molecular residual disease, facilitating improvement of clinical management. Results At the data cut‐off date (August 31, 2022), with a median follow‐up time of 53.2 months, 97 of 180 (53.9%) patients had died. The median OS was 42.8 months (95% CI: 29.3‐53.2 months). A total of 333 plasma samples from 168 patients were included for ctDNA analysis. An inferior OS correlated significantly with baseline ALK or tumor protein 53 (TP53) mutation. In addition, patients with concurrent TP53 mutations had shorter OS than those without concurrent TP53 mutations. High ctDNA levels evaluated by variant allele frequency (VAF) and haploid genome equivalents per milliliter of plasma (hGE/mL) at baseline were associated with poor OS. Additionally, patients with ctDNA clearance at 6 weeks and slow ascent growth had dramatically longer OS than those with ctDNA residual and fast ascent growth, respectively. Furthermore, patients who had a lower tumor burden, as evaluated by the diameter of target lesions, had a longer OS. Multivariate Cox regression analysis further uncovered the independent prognostic values of bone metastases, higher hGE, and elevated ALK mutation abundance at 6 weeks. Conclusion Ensartinib led to a favorable OS in patients with advanced, crizotinib‐resistant, and ALK‐positive NSCLC. Quantification of ctDNA levels also provided valuable prognostic information for risk stratification.

Objective To analyze the clinical efficacy of full-visualization single-channel endoscopic lumbar interbody fusion (PE-PLIF) in the treatment of lumbar degenerative diseases, and to explore the application skills and significance of endoscopic spinal canal decompression and interbody fusion. Methods From January 2021 to December 2022, 50 patients who underwent PE-PLIF in The Affiliated Huai ‘an No.1 Hospital of Nanjing Medical University were selected retrospectively. A total of 56 lower lumbar segments were treated with spinal canal decompression and interbody fusion. The expandable cage implantation technique was used for spinal canal decompression, intervertebral fusion, and percutaneous pedicle screw internal fixation. The visual analogue scale (VAS) score of low back pain and lower limb pain, Oswestry disability index (ODI), and modified MacNab scoring system were used to evaluate the clinical efficacy before and after operation. Results The VAS scores of low back pain were 5.2±1.1, 2.2±0.7, 1.5±0.6, 1.3±0.7, 1.0±0.9 before operation, 1 day, 3 months, 6 months after operation and at the last follow-up, respectively. The VAS scores of lower limb pain were 7.2±1.0, 2.0±1.0, 0.5±0.3, 0.3±0.2, 0.3±0.2, respectively. The ODI was 66.3±7.4, 16.6±5.0, 12.4±3.6 and 10.7±3.3 before operation, 3 months, 6 months after operation and at the last follow-up, respectively. The VAS score and ODI score decreased after operation, and the differences were statistically significant compared with those before operation (P

Introduction Postoperative delirium (POD) is the most common acute fluctuating mental state change after hip fractures in older adults. Postoperative pain is a Grade A risk factor for POD and is closely related to the prognosis of patients undergoing hip fracture surgery. The fascia iliac block has a definite analgesic effect and few side effects, and several studies have reported that it reduces the occurrence of POD in patients undergoing general anaesthesia for hip fracture surgery. Liposomal bupivacaine is a local anaesthetic with a long half-life that significantly reduces the use of opioids and is conducive to patient prognosis and recovery. However, whether regional nerve block analgesia can decrease the occurrence of POD in elderly patients undergoing hip fracture surgery has not been reported.Methods and analysis This is a single-blinded, randomised, parallel-controlled prospective clinical study. Participants will be randomly assigned preoperatively to either the liposomal bupivacaine (ie, Exparel) or ropivacaine groups by block randomisation. Then, the occurrence of POD (primary outcome) and postoperative pain (secondary outcome) will be evaluated.Ethics and dissemination This research protocol complies with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 guidelines and is approved by the Ethics Committee of Shanghai General Hospital (ID 2023–437). The original data are expected to be released in July 2029 on the ResMan original data-sharing platform (IPD-sharing platform) of the China Clinical Trial Registry, which can be viewed on the following website: http://www.medresman.org.cn.PROSPERO registration number ChiCTR2300074022.

The accurate assessment of tree volume is crucial for developing forest management plans, and this can be achieved using tree volume models. In this study, data on individual trees were collected and calculated, including the diameter at breast height (D), ground diameter (DG), tree height (H), and tree volume (V). A total of 400 Populus × tomentosa Carrière, 400 Populus tomentosa Carr, and 400 Populus × canadensis Moench trees were sampled. Two compatible volume model systems were established using corresponding methods. The models consisted of the following five types: V-DH, V-D, V-DG, H-D, and DG-D. In our calculations, before the horizontal line was the dependent variable, and behind the horizontal line was the independent variable. Variations in preferences for the H-D models were observed among the tree species, with the logistic function proving the most suitable for Populus × tomentosa Carrière, Chapman–Richard function for Populus tomentosa Carr, and power function for Populus × canadensis Moench. Among the three volume models, the V-DH model exhibited a superior performance, with its R2 values ranging from 0.965 to 0.984 and mean estimated error (MPE) values ranging from 1.26% to 1.78%. Following this was the V-D model, with R2 values between 0.9359 and 0.9704 and MPE values between 1.71% and 2.46%. The V-DG model ranked third, with R2 values ranging from 0.8746 to 0.9501 and MPE values ranging from 2.33% to 3.16%. In the H-D model, the R2 and MPE values ranged from 0.4998 to 0.7851 and from 1.31% to 1.45%, respectively. For the DG-D model, the R2 values ranged from 0.9563 to 0.9868 and the MPE values ranged from 0.47% to 0.68%. Comparing both compatible methods, the nonlinear seemingly uncorrelated regression (NSUR) was more effective. The three volume models demonstrated high levels of accuracy and compatibility, providing a reliable scientific foundation for forest management and the formulation of harvesting plans in Beijing, with significant practical implications.