ABSTRACT Hypothesis: Endoclip can be used as fiducial marker in urology. Objective: To assess the feasibility, cost effectiveness and reliability of endoclips as novel fiducial markers in precision radiotherapy, as part of a trimodality bladder-preserving treatment (TBPT) of muscle-invasive bladder carcinoma. Materials and Methods: This retrospective study was performed at Weifang People's Hospital (Weifang, China) from January 2015 to June 2018. A total of 15 patients underwent TBPT. Endoclips were applied to healthy edges of the resected bladder wall as novel fiducial markers. Radio-sensitizing chemotherapy and routine precision radiotherapy were given. The number and position of the endoclips during radiotherapy sessions were monitored. Complications and tumor recurrence were analyzed. Results: The mean age (±standard deviation) of the patients was 67±10 years (range 46-79). There were 3 females and 12 males. Forty-nine endoclips were applied in all patients (3.3±0.8). The tumor was completely visibly resected in all patients. The number of endoclips remained the same through the planned last radiotherapy session (3.3±0.8), i.e., none were lost. All endoclips were removed after the last radiotherapy session. The average number of follow-up months was 38.9±13.2 (range 11-52). There were no procedure-related complications at discharge or follow-up. At one-year, overall recurrence-free survival was 93.3%. Two patients had recurrences at 18 months and 10 months after TBPT, respectively, and salvage radical cystectomy was performed with no further recurrences. Another patient died due to metastasis 9 months after the completion of therapy. Conclusions: Endoclips are reliable, safe and cost-effective as novel fiducial markers in precision-radiotherapy post-TBPT.

In this study, the effects of sea-buckthorn (Hippophae rhamnoides L.) leaves (SL) on the biochemical parameters and metabolomic profiling in Altay lamb (Ovis aries) were observed. Sixty six-month-old male Altay lambs (body weight 28.0 ± 3.5 kg) were randomly assigned to four groups (n=15). The experimental groups were named as CON, 2.5%, 5.0% and 7.5%. The group CON, contained animals fed with a basal diet. Animals of the other groups were fed a treatment diet consisting of 2.5% (Group 2.5%), 5.0% (Group 5.0%) and 7.5% (Group 7.5%) SL. The experimental period lasted 56 days. The results showed that the average daily gain (ADG) and average daily feed intake (ADFI) increased with the increase in the levels of dietary SL. Dietary SL showed a direct relationship with total protein (TP), albumin, globulin and total cholesterol (TC) content of the experimental animals. However, an indirect relationship was observed between dietary SL and the concentration of urea nitrogen (UN). The concentrations of glucose, high -density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) showed quadratic change. Additional changes occurred in the endogenous metabolites involving multiple pathways. The pathways were tricarboxylic acid (TCA) cycle, the metabolism of protein and amino acid and the metabolism of fatty acid and steroid. The changes in metabolites primarily revealed an increase in amino acids and carbohydrates and a decrease in lipid metabolites. These findings provide a comprehensive insight into the effects of the metabolic aspects of sea-buckthorn leaves on Altay lambs. In addition, the present research results provide a better understanding to the development and utilization of sea-buckthorn as a healthy additive for small ruminant production.

Summary Objective: The aim of this study was to assess the efficacy and safety of ceftazidime-avibactam in the treatment of complicated intra-abdominal infections (CIAIs) and complicated urinary tract infections (CUTIs) with meta-analysis method. Method: We included six randomized clinical trials identified from Medline, Embase, Cochrane Library, “ISRCTN Register” and “ClinicalTrials.gov” which compared ceftazidime-avibactam with comparison group. The meta-analysis was performed using Review Manager software version 5.3. Results: Ceftazidime-avibactam versus active comparisons demonstrated a statistically significant higher rate of microbiological response success on microbiological evaluable populations at the test-of-cure visit (95CI 1.10-2.38, p=0.02) and late-follow-up visit (95CI 1.09-2.23, p=0.02) for the treatment of CUTIs. Ceftazidime-avibactam versus active comparisons demonstrated a statistically significant higher rate of microbiological response success on EME populations at the test-of-cure visit (95CI 1.08-4.27, p=0.03) and late-follow-up visit (OR=1.75, 95CI 1.33-2.29, p<0.0001) for the treatment of CUTIs. Similar results were obtained at the late-follow-up visit (OR = 1.58, 95CI 1.26-1.97, p<0.0001) on microbiologically modified intent-to-treat (mMITT) populations for the treatment of CUTIs. We can find better eradication rates for E. coli and Klebsiella pneumoniae based on mMITT populations. In terms of AEs, SAEs and mortality, ceftazidime-avibactam had a safety and tolerability profile broadly similar to the comparison group. Conclusion: This meta-analysis provides evidence of the efficacy of ceftazidime-avibactam as a potential alternative for the treatment of patients with CUTIs, and CIAIs.