Objective To compare the body weight,height,head circumference of premature babies fed by different ways,and to analyze the advantages and disadvantages.Methods 260 premature infants were selected as the research subjects,according to random number table,they were divided into four groups.Group A:premature infant formula feeding,80 cases;Group B:pure breast feeding group,60 cases;Group C:normal full term formula feeding,60 cases;Group D:premature infant formula mixed breast feeding,60 cases.All children were fed at the first 12 to 24h after birth.The body weight,height,head circumference and catch up full term time were evaluation index. Results After correct gestational age 40 weeks,group B children'weight,height,head circumference were higher than other groups,group C was the lowest levels,the difference was statistically significant (F =3.563,P <0.05).Correct gestational age 1,3,6 months later,group A children'weight,height and head circumference index were higher than other feeding group,the level of group D was the second,the lowest level was group C,the differences were statistically significant (F =3.011,2.853,2.779,all P <0.05).In 6 months,group A,38.8% (31 /80),was the fastest one to reach the full term infant,the difference was statistically significant (χ2 =29.149,P <0.05).At other time,the pur-suing number of group A was bigger,but there was no statistically significant difference.Conclusion For premature babies,preterm infant formula milk powder or premature infant formula and milk feeding way is better than that of pure breast feeding and normal full term milk powder,which can guarantee the children's nutrition demand,shorten the time of pursuing full term infant,promote baby's health.

Objective:To explore the experience and clinical effect of endoscopic assisted resection of septal cartilage and ethmoid bone vertical plate in rhinoplasty.Methods:Twenty women with short noses underwent septal extension graft from February 2018 to September 2019. Endoscopic technique was utilized to harvest the septal cartilage and ethmoid vertical plate. During the operation, the average area of septal cartilage was 22 mm × 15 mm, the average area of ethmoid bone vertical plate was 26mm × 16mm, and the septum retained a 10 mm wide " L" sturt. The septal cartilage and the vertical plate of the ethmoid bone were used as the columella strut and the extension graft respectively to reconstruct the shape of the tip of the nose. Expanded polytetrafluoroethylene was implanted in the nasal dorsum to increase its height.Results:The patients were followed up for 3-12 months at an average of 9 months. 20 patients achieved straight back of nose, symmetrical arch of nose and no deviation of columella. The tip of nose is soft without rigidity. There was no exposure of prosthesis or perforation of nasal septum. There was significant differences in the distance between the root and tip of nose before and after operation ( P<0.05). 2 patients complained of olfactory hypoesthesia and recovered spontaneously after 4 months. 1 patient was not satisfied with the improvement of the nasal projection. There was no obstruction of nasal ventilation and other dysfunction after operation. Conclusions:Endoscopy can assist the operator to harvest the septal cartilage and ethmoid bone vertical plate safely and accurately. The extension of nasal septum prepared by the cartilage of nasal septum combined with the vertical plate of ethmoid bone can effectively increase the length of nose.

Objective:To explore the experience and clinical effect of endoscopic assisted resection of septal cartilage and ethmoid bone vertical plate in rhinoplasty.Methods:Twenty women with short noses underwent septal extension graft from February 2018 to September 2019. Endoscopic technique was utilized to harvest the septal cartilage and ethmoid vertical plate. During the operation, the average area of septal cartilage was 22 mm × 15 mm, the average area of ethmoid bone vertical plate was 26mm × 16mm, and the septum retained a 10 mm wide " L" sturt. The septal cartilage and the vertical plate of the ethmoid bone were used as the columella strut and the extension graft respectively to reconstruct the shape of the tip of the nose. Expanded polytetrafluoroethylene was implanted in the nasal dorsum to increase its height.Results:The patients were followed up for 3-12 months at an average of 9 months. 20 patients achieved straight back of nose, symmetrical arch of nose and no deviation of columella. The tip of nose is soft without rigidity. There was no exposure of prosthesis or perforation of nasal septum. There was significant differences in the distance between the root and tip of nose before and after operation ( P<0.05). 2 patients complained of olfactory hypoesthesia and recovered spontaneously after 4 months. 1 patient was not satisfied with the improvement of the nasal projection. There was no obstruction of nasal ventilation and other dysfunction after operation. Conclusions:Endoscopy can assist the operator to harvest the septal cartilage and ethmoid bone vertical plate safely and accurately. The extension of nasal septum prepared by the cartilage of nasal septum combined with the vertical plate of ethmoid bone can effectively increase the length of nose.

Objective To explore the feasibility of treating the microtia aided with the digital technology,harvesting the rib cartilage precisely,and carving fabric the ear framework in more details.Methods From July 2015 to January 2017,22 microtia patients accepted clinical therapy aided with digital technology.Preoperatively,the three-dimensional model of the costal cartilage and ear were made to design the cartilage scaffold fabrication.After the operation,the difference of the three dimensional morphology between the reconstructed ear and the normal ear was measured by digital technology.Results With average 7 months follow up,19 cases were satisfied with the outcome of the reconstructed ear including three dimensional position and subunit appearance.The outcomes were acceptable in 3 cases.There were no postoperative complications related to chest wall deformity or affected normal physical function.Conclusions Digital technology can achieve accurate harvesting and reasonable utilization of autogenous rib cartilage,provide accurate guidance for the sculpture of auricle scaffold and objective evaluation for the three-dimensional structure of the reconstructed ear.

Objective:To analyze the impact of lymph node dissection on textbook outcomes (TO) and the prognosis of intrahepatic cholangiocarcinoma (ICC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 376 ICC patients who underwent hepatectomy in 4 medical centers, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from December 2011 to December 2017 were collected. There were 242 males and 134 females, aged 57(range, 48-63)years. According to the criteria of TO, patients were classified as two cate-gories, including patients achieving TO and not achieving TO. Measurement data with normal distri-bution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were represented as absolute numbers, and comparison between groups was conducted using the chi-square test, Yates adjusted chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the non-parameter rank sum test. Univariate and multivariate analyses were conducted using the Logistic regression model. The Kaplan-Meier method was used to draw survival curve. Survival analysis was conducted using the Log-rank test. Results:(1) TO situations. Of the 376 ICC patients who underwent hepatectomy, 199 cases achieved TO, including 40 cases with lymph node dissection and 159 cases without lymph node dissection, 177 cases did not achieve TO, including 76 cases with lymph node dissection and 101 cases without lymph node dissection. (2) Influencing factors for TO after hepatectomy of ICC patients. Results of multivariate analysis showed that lymph node dissection, microvascular invasion, nerve invasion and the volume of intraoperative blood loss >800 mL were independent risk factors for achieving TO after hepatec-tomy of ICC patients ( odds ratio=2.22, 2.95, 3.58, 4.09,95% confidence interval as 1.34-3.69, 1.43-6.07, 1.40-9.17, 1.35-12.43, P<0.05). Of the 116 patients with lymph node dissection, 40 cases achieved TO, 103 cases achieved R 0 resection, 38 cases had postoperative complications, 67 cases had delayed hospital stay. The above indicators were 159, 255, 41, 65 of 260 patients without lymph node dissection. There were significant differences in the above indicators between patients with and without lymph node dissection ( χ2=22.90, 15.16, 13.95, 37.78, P<0.05). (3) Follow-up. All the 376 patients were followed up for 19(range, 1-74)months. Of 199 patients achieving TO, the 1-, 2-and 3-year survival rates of 40 patients with lymph node dissection were 54.0%, 36.6% and 26.1%, respectively, versus 67.7%, 42.7% and 34.4% of 159 patients without lymph node dissection, showing no significant difference between them ( χ2=1.89, P>0.05). Of 177 patients not achieving TO, the 1-, 2-and 3-year survival rates of 76 cases with lymph node dissection were 58.9%, 25.7% and 10.3%, respectively, versus 53.0%, 28.5% and 17.2% of 101 cases without lymph node dissection, showing no significant difference between them ( χ2=0.25, P>0.05). Conclusions:Lymph node dissec-tion, microvascular invasion, nerve invasion and the volume of intraoperative blood loss >800 mL are independent risk factors for achieving TO after hepatectomy of ICC patients. Lymph node dissec-tion may increase the postoperative complication rate, prolong the hospital stay and decrease the rate of achieving TO. However, it does not affect the prognosis of patients.

Objective:To investigate the evaluation efficacy and predictive prognostic value of alpha-fetoprotein (AFP) response in tyrosine kinase inhibitors (TKIs) in combination with PD-1 inhibitors (α-PD-1) for intermediate-to-advanced hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinicopathological data of 205 patients with intermediate-to-advanced HCC who were admitted to 9 medical centers, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from March 2020 to July 2022 were collected. There were 178 males and 27 females, aged (52±12)years. Based on AFP response at 6-8 weeks after treatment, patients were divided into the AFP response group (AFP level decreased by ≥50% compared to baseline) and the AFP no response group (AFP level decreased by <50% compared to baseline). Observation indicators: (1) AFP response evaluation of anti-tumor efficacy; (2) comparison of patient prognosis; (3) analysis of factors affecting patient prognosis. Measurement data with normal distrubution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range) and M( Q1, Q3). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to draw survival curve and calculate survival rate, and the Log-Rank test was used for survival analysis. The COX proportional risk model was used for univariate analysis and the COX stepwise regression model was used for multivariate analysis. Results:(1) AFP response evaluation of anti-tumor efficacy. Before treatment, all 205 patients were positive of AFP, with a baseline AFP level of 1 560(219,3 400)μg/L. All 205 patients were treated with TKIs in combination with α-PD-1, and the AFP level was 776(66,2 000)μg/L after 6 to 8 weeks of treatment. Of the 205 patients, 88 cases were classified as AFP response and 117 cases were classified as AFP no response. According to the response evaluation criteria in solid tumors version 1.1, the objective response rate (ORR) and disease control rate (DCR) were 42.05%(37/88) and 94.32%(83/88) in patients of the AFP response group and 16.24% (19/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=16.846, 25.950, P<0.05). According to the modified response evaluation criteria in solid tumors, the ORR and DCR were 69.32% (61/88) and 94.32% (83/88) in patients of the AFP response group and 33.33% (39/117) and 64.10% (75/117) in patients of the AFP no response group, showing significant differences between them ( χ2=26.030, 25.950, P<0.05). (2) Comparison of patient prognosis. All 205 patients were followed up for 12.4(range, 2.4-34.0)months after treatment. The median progression free survival time and total survival time were 5.5 months and 17.8 months, respectively. The 1-year, 2-year progression free survival rates were 20.8% and 7.2%, and the 1-year, 2-year overall survival rates were 68.7% and 31.5%, respectively. The median progression free survival time, 1-year and 2-year progression free survival rates were 9.7 months, 39.6% and 14.2% in patients of the AFP response group and 3.7 months, 7.8% and 2.0% in patients of the AFP no response group, showing a significant difference in progression free survival between them ( χ2=43.154, P<0.05). The median overall survival time, 1-year and 2-year overall survival rates were not reached, 85.2% and 56.3% in patients of the AFP response group and 14.6 months, 56.3% and 14.5% in patients of the AFP no response group, showing a significant difference in overall survival between them ( χ2=33.899, P<0.05). (3) Analysis of factors affecting patient prognosis. Results of multivariate analysis showed that invasion of large blood vessels, extrahepatic metastasis, combined hepatic artery intervention therapy, and AFP response were independent factors influencing progression free survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio=1.474, 1.584, 0.631, 0.367, 95% confidence interval as 1.069-2.033, 1.159-2.167, 0.446-0.893, 0.261-0.516, P<0.05), and Eastern Cooperative Oncology Group score, invasion of large blood vessels, extrahepatic metastasis, and AFP response were independent factors influencing overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1 ( hazard ratio= 1.347, 1.914, 1.673, 0.312, 95% confidence interval as 1.041-1.742, 1.293-2.833, 1.141-2.454, 0.197-0.492, P<0.05). Conclusions:AFP response at 6-8 weeks after treatment can effectively evaluate anti-tumor efficacy of TKIs in combination with α-PD-1 for intermediate-to-advanced HCC. AFP response is the independent factor influencing progression free survival and overall survival in patients with intermediate-to-advanced HCC who were treated with TKIs in combination with α-PD-1.