The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

Immune checkpoint inhibitors (ICIs) can not only prolong the survival time of patients with non-small cell lung cancer (NSCLC) in a short time, but also achieve a lasting response to the tumor. However, there has been significant heterogeneity in the efficacy of ICIs among patients with different types of NSCLC, and there has been still a lack of universal biomarkers to predict the benefit of ICIs treatment. Inflammation has played a definite role in the occurrence and development of tumors, and a variety of inflammatory markers in serum also have become clinical indicators reflecting immune status, such as lactate dehydrogenase, C-reactive protein, serum neutrophils, lymphocytes, platelets and other indicators. These inflammatory markers are easy to obtain and are associated with the prognosis of a variety of solid tumors.

In recent years, immunotherapy has been used more frequently for metastatic gastric cancer that has progressed after chemotherapy, the most commonly used of which are immune checkpoint inhibitors (ICIs). However, the efficacy of ICIs varies greatly among different patients. Therefore, more and more studies have been carried out on biomarkers that predict the efficacy of ICIs. Microsatellite instability and Epstein-Barr virus subtype are relatively accurate biomarkers indicating the response rate of ICIs treatment. The predictive roles of programmed death ligand-1 and tumor mutation burden are still controversial. Tumor infiltrating lymphocyte, tumor-associated macrophages, fibrinogen-like-protein 1, alternative promoters and other predictors are also being studied.

Objective To clarify the distribution characteristics of serum pepsinogen (PG ) and gastric cancer related tumor markers in the healthy population ,and analyse their value in health examination .Methods The levels of serum tumor markers ,pep‐sinogenⅠ(PGⅠ ) and pepsinogenⅡ(PGⅡ) were detected in 958 subjects who underwent physical examination by using the Lumi‐nex 200 instrument ,and the ratio of PGⅠ /PGⅡ(PGR) was calculated .Meanwhile ,the C13 breath test was carried out ,and relation‐ships among these clinical indicators were analysed .Results In this population ,The serum level of PGⅠ in male subjects was high‐er than that in female subjects ,there was statistically significant difference(P<0 .05) .The levels of serum PGⅠ ,PGⅡ ,carcinoem‐bryonic antigen(CEA) ,carbohydrate antigen 199(CA199) and carbohydrate antigen 242(CA242) were gradually increased with age ,while the PGR was slowly decreased with age .The positive rate of C13 breath test in male subjects was higher than that in fe‐male subjects ,there was statistically significant difference(P<0 .05) .Compared with subjects whose C13 breath test results were negative ,the serum levels of PGⅠ and PGⅡ were higher ,while the PGR was lower in subjects whose C13 breath test results were positive(P<0 .05) .Conclusion The distribution of serum PG might be correlated with age ,gender and the infection of Helicobact‐er pylori in healthy population .It is shown that the effects of tumor markers on gastric cancer screening are limited .

Objective To explore the diagnosis and of immune neutopenia.Methods Clinical data of 150 patients with immune neutropenia were collected and analyzed.Results Of 150 patients with immune neutropenia,35 cases went male(23.3％),115 cases were female(76.7％),and male to female ratio was 1 ∶ 3.3.Based on the difference produced way of granulocytes associated antibody,all patients could be divided into alloimmune neonatal neutropenia 9 cases (6.0％),drug-induced immune neutropenia 28 cases (18.7 ％),primary autoimmune neutropenia 22 cases(14.6％),and secondary autoimmune neutropenia 91 cases (60.7％).Secondary autoimmune neutropenia included 39 cases of systemic lupus erythematous,21 cases of rheumatoid arthritis,2 cases of immune hemolytic anemia accompany with neutropenia,6 cases of immune thrombocytopenia accompany with neutropenia,3 cases of autoimmune hepatitis,16 cases of autoimmune thyroiditis,and 4 cases of Sjogren's syndrome.Conclusion The majority of primary immune neutropenia are female,which is usually secondary to autoimmune diseases.The diagnosis of primary immune neutropenia is very complicated,which requires a long period of clinical observation and follow-up.The majority of granulocytes associated antibody is IgG in the autoimmune neutropenia patients.Yet sometimes two or three kinds of antibodies were increased as well.

The distributions and expressions of the T helper 17 (Th17) cells and interleukin 17(IL-17) are found in a verity of tumor tissues.However,their functions in tumorigenesis,which play antitumor or promote tumor roles,have not yet a final conclusion.Therefore,it is necessary to go further study of their functions in tumor microenvirnment.It is wished that in the process of cancer treatment,people would hasten benefit avoids kill and improve the therapeutic effect.