Objective:To investigate the efficacy and safety of sindilizumab combined with apatinib in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma.Methods:A total of 74 elderly patients with recurrent and metastatic esophageal squamous cell carcinoma who were admitted to Xuancheng City Central Hospital from March 2019 to August 2020 were selected, and they were divided into study group and control group by random number table method, with 37 cases in each group. The control group was treated with apatinib mesylate, and the study group was treated with sindilizumab combined with apatinib mesylate. All patients were treated for 2 cycles and followed up for 1 year. The efficacy, peripheral blood tumor marker levels, adverse reactions and survival were compared between the two groups.Results:The objective response rate and clinical control rate in the study group were higher than those in the control group [35.1% (13/37) vs. 13.5% (5/37), 67.6% (25/37) vs. 43.2% (16/37)], and the differences were statistically significant ( χ2 = 4.70, P = 0.030; χ2 = 4.43, P = 0.035). After treatment, the levels of carcinoembryonic antigen (CEA), squamous cell carcinoma-associated antigen (SCC-Ag) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) in the two groups were all lower than those before treatment (all P < 0.05); the levels of CEA, SCC-Ag and CYFRA21-1 in the study group were lower than those in the control group (all P < 0.05). There were no differences in the incidence rates of fatigue, proteinuria, bone marrow suppression, and hand-foot syndrome between the two groups (all P > 0.05). After 1 year of follow-up, 20 patients in the study group survived, and the 1-year overall survival (OS) rate was 54.1%; 10 patients in the control group survived, and the 1-year OS rate was 28.6%; the difference in OS between the two groups was statistically significant ( χ2 = 4.06, P = 0.044). Conclusions:Sintilimab combined with apatinib has a good efficacy in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma. This regimen can reduce the levels of tumor markers, improve the short-term survival rate of patients, and has good safety.

Objective: To explore the clinical effect of cervico-acromial fasciocutaneous flap based on the supraclavicular artery as a method for face and neck reconstruction. Methods: From Oct 1990 to June 2014, 17 patients, with the age range of 7 to 51 years, suffering from cicatricle contractures of neck or facial defect, were treated with cervico-acromial fascicutaneous flaps. 29 flaps were used in 12 patients bilaterally or multiply. The donor sites of 2 patients were closed by skin graft; while in the rest 15 patients, the donor sites were closed by expanded flaps. Results: All the 29 flaps were survived, with satisfactory color and texture. Hematoma occurred in 1 case after tissue expander implantation, but the flap was successfully expanded after evacuation of hematoma. The size of flaps ranged from 15 cm×7 cm to 35 cm×15 cm. 10 patients completed 6 months follow-up, and presented with satisfactory appearance and better functional results. Conclusions Cervico-acromial fascicutaneous flap based on the supraclavicular artery is an good choice for reconstruction of neck and facial defects.

OBJECTIVE:To study chemical compounds of Monoraphidium dybowskii,and to investigate the in vitro antibacte-rial and antioxidant activities of isolated compounds. METHODS:The ethanol extract of M. dybowskii were extracted with aether petrolei,ethyl acetate and n-butyl alcohol. The ethyl acetate extract was separated from M. dybowskii and chemical components were analyzed by sillica gel column chromatogram,HPLC and GC-MS. Their structures were identified according to physicochemi-cal properties and NMR. MIC of 4 isolated compounds to Pseudomonas aeruginosa,Candida albicans,Bacillus subtilis and Esche-richia coli were determined by resazurin disc test. Free radical scavenging rate(concluated by IC50)and reducing capacity were mea-sured by 1,1-diphenyl-2-picryl-diazanyl (DPPH) and ferric reducing antioxidant power (FRAP) assay. RESULTS:Compounds 1-6 were obtained from E4 and E5 segments of ethyl acetate extract of M. dybowskii,and their structures were identified as stigmas-terol,diisonoyladipate,indole-3-carboxylic acid,(+)-epiloliolide,(-)-loliolide,5-hydroxy-3,4-dimethy-5-pentyl-2(5H)-furanone. MIC of compounds 3-6 were 10-500 μg/mL,and IC50 ranged 22.02-71.01 μg/mL;FRAP ranged (62.04 ± 5.36)-(281.22 ± 8.3) μmol/L. CONCLUSIONS:M. dybowskii contains multiple lipid and alkanoic acid,and possesses certain in vitro antibacterial and antioxidant activities.

OBJECTIVEAugmentation rhinoplasty is a commonly procedure in clinical work for a plastic surgeon. Autologous costal cartilage is widely used in aesthetic rhinoplasy because of the abundant in quality. However, the cartilage may warp, and it is not easy-handling for inexperienced plastic surgeons. We-used diced cartilage combined with thin strips as columellar struts, which can be easily shaped, and reduce the warping incidence.

METHODSFrom July 2012 to March 2014, 61 patients were performed diced costal cartilage for nasal augmentation via endonasal approach. Standardized photographs are obtained before and after surgery. Postoperative outcome is graded by patient's self-evaluation of the nasal appearance with a satisfaction scale.

RESULTSAmong the 61 cases, 25 were revision cases. The follow-up time was no less than 6 months, with an average time of 10.9 months. 28 patients reported improved or better nasal appearance. One patient required revision surgery because of overcorrection. Supratip step-off was observed in one patient and corrected by external reshaping. No warping, infection, irregularity, absorption, airway obstruction, or donor-site morbidity were observed. All patients were satisfied with the final appearance.

CONCLUSIONSDiced costal cartilage is a reliable option for nasal augmentation and revision rhinoplasty. Good outcomes can be achieved postoperatively, with aesthetically pleasing appearance and simple procedure.

Abstract BACKGROUND: Many cytokines can be detected in saliva and serum, and have more clinical significance in the diagnosis, prognosis and treatment of oral mucosa disease. OBJECTIVE: To compare the interferon-γ and interleukin-10 levels in serum and saliva of patients with different types of oral lichen planus and to explore the feasibility of saliva samples as a substitute of blood samples to study the interferon-γ and interleukin-10 levels in serum and saliva. METHODS:Totaly 45 patients with oral lichen planus admitted at the Department of Periodontology, the Stomatological Hospital of Jiamusi University from January to July 2014 were enroled, including 15 cases of erosion type (erosion group), 15 cases of congestive erythema (congestive erythema group) and 15 cases of reticulate type (reticulate group). Another 15 healthy controls admitted for physical examination at the Department of Physical Examination, the Stomatological Hospital of Jiamusi University were enroled as controls. ELISA method was used to detect the interferon-γ and interleukin-10 levels in serum and saliva in the four groups. RESULTS AND CONCLUSION: Compared with the control group, the interferon-γ levels in serum and saliva were lower in the other three groups (P < 0.01), while there were significant differences in the interferon-γ level among the patients with different types of oral lichen planus (P < 0.01). The interleukin-10 levels in serum and saliva were significantly higher in the erosion group and congestive erythema group than those in the control group (P < 0.01 orP < 0.05) and reticulate groupP < 0.01 orP < 0.05). Experimental findings suggest that the levels of interferon-γ and interleukin-10 in serum and saliva are highly correlated in patients with different types of oral lichen planus, and saliva samples can be instead of blood samples to detect the levels of interferon-γ and interleukin-10 in patients with oral lichen planus.

Objective To observe the difference of vascular endothelial growth factor (VEGF) and myeloperoxidase (MPO) between diabetic and non-diabetic patients with maintenance hemodialysis (MHD),and to explore whether it was associated with duration of hemodialysis.Methods A total of 120 patients with MHD were divided into diabetic group (40 cases) and non-diabetic group (80 cases) according to the primary disease.The blood samples from the patients before dialysis were selected to test the serum VEGF and plasma MPO and other indicators.The blood samples from April 2012 to March 2013 were labeled diabetic group 1(40 cases) and non-diabetic group 1 (80 cases).The blood samples from April 2013 to March 2014 were labeled diabetic group 2 (40 cases) and non-diabetic group 2 (80 cases).Results The serum VEGF and plasma MPO levels were (74.63 ± 47.43) ng/L,(300.63 ± 235.37) μ g/L in diabetic group 1,and (63.69 ± 43.23) ng/L,(275.35 ± 216.32) μ g/L in non-diabetic group 1,and there were significant differences between two groups (P ＜ 0.05).The serum VEGF and plasma MPO levels were (83.32 ± 40.38) ng/L,(414.12 ±265.52) μg/L in diabetic group 2,and (70.89 ±39.74) rig/L,(289.45 ±202.85) μg/L in non-diabetic group 2,and there were significant differences between two groups (P ＜ 0.05).The correlation analysis showed that VEGF was positively correlated with MPO in diabetic group 1 and diabetic group 2 (r =0.632 and 0.763,P ＜ 0.05),and VEGF was positively correlated with MPO in non-diabetic group 1 and non-diabetic group 2 (r =0.610 and 0.713,P ＜ 0.05).Conclusions Compared with those in non-diabetic MHD patients,VEGF and MPO levels are significandy higher in diabetic MHD patients.In non-diabetic MHD patients and diabetic MHD patients,VEGF and MPO levels will rise gradually with duration of hemodialysis.The expressions of VEGF and MPO are associated with each other.

Objective To investigate the status of invasive fungal infection(IFI)associated with hematopathy,and evaluate drug resistance and risk factors of fungal infection.Methods 1 246 cases of infection occurred in patients in a hospital from 2006 to 2010 were analyzed retrospectively,pathogenic features and risk factors of IFI were ana-lyzed.Results There were 281 cases of fungal infection,and 162 fungal isolates were isolated,the main infection site was respiratory tract(134 isolates,82.72%).Four major Candida were Candida albicans ,Candida tropicalis , Candida glabrata ,and Candida krusei ;in 2006-2009,the main fungi were Candida albicans ,while in 2010,the majority were non-Candida albicans .The resistant rates of four isolated Candida to fluconazole and itraconazole were 5.15% and 4.41 % respectively,6 isolated Candida krusei strains were all resistant to both fluconazole and itraconazole,voriconazole-resistant strain was not found.The independent risk factors for fungal infection were dia-betes and duration time of agranulocytosis>14 days.Conclusion The proportion of infection caused by non-Candi-da albicans increased obviously,fluconazole-and itraconazole-resistant non-Candida albicans strains have emerged, comprehensive measures should be adopted to prevent IFI actively and treat patients early.

BACKGROUND:In recent years, many drugs emerge to control tooth movement, and scholars in China begin to investigate Chinese herbs with moderate nature and smal adverse reaction.
OBJECTIVE:To observe the relapse after orthodontic tooth movement, osteoprotegerin and osteoclast differentiation factor expression in periodontal tissue after rats were treated with local tanshinone type IIA at different doses.
METHODS:A total of 48 male Wistar rats were randomly divided into four groups:control, low dose (tanshinone type IIA 0.36 mg/d), medium dose (tanshinone type IIA 0.72 mg/d), and high dose (tanshinone type IIA 1.44 mg/d) groups. Taking anterior teeth as the anchorage, the maxil ary first molar of rats was tracted to mesial movement. In experimental groups, gingival mucosa of the first molar was local injected with tanshinone type IIA 1 day
before the force device was removed, while control group was injected with physiological saline, once a day, for 4 weeks. Immediately, 1 week, and 4 weeks after the force device was removed, the distance between the maxil ary first molar and second molar was measured and body mass was weighted. The animals were kil ed after 4 weeks, osteoprotegerin and osteoclast differentiation factor expression in maxil ary first molar and periodontal tissue were determined using immunohistochemical staining.
RESULTS AND CONCLUSION:There was no obvious change in the body weight of rats in each group (P>0.05). In low, medium and high dose groups, recurrent distance of the teeth was shorter than that in control group (P<0.05), and recurrence percentage was significantly lower than control group (P<0.05). The greater the dose was, the
smal er the degree of recurrence was. Osteoprotegerin expression in the periodontal tissue was significantly higher in the experimental groups than the control group (P<0.05), while osteoclast differentiation factor expression was significantly lower than the control group (P<0.05). The ratio of osteoprotegerin/osteoclast differentiation factor in the periodontal tissue was greater than 1 in both control group and experimental groups, and reached the peak in the high dose group. Local delivery of tanshinone type IIA has no impact on body weight of normal rats, and can effectively control the recurrence rate after orthodontic tooth movement. Within a certain range, high dose achieves the most obvious effect. Regulating osteoclast through adjusting the ratio of osteoprotegerin/osteoclast differentiation factor could be the molecular mechanism of tanshinone type IIA accelerating the periodontal tissue rebuilding.

BACKGROUND:Various studies confirm that smoking can contribute to the resorption of periodontal alveolar bone.
OBJECTIVE:To observe the effect of smoking in alveolar bone resorption of periodontitis rat models.
METHODS:A total of 24 rats were randomly divided into three groups. Normal group:rats were normal y fed without any other pre-treatment;Control group:experimental periodontitis model was established using wire ligation method in rats;Experimental group:rat models were given passive smoking during experimental
modeling period. Al rats were sacrificed after 8 weeks of modeling, periodontal tissue were removed. Hematoxylin-eosin staining was used for examining pathological changes in periodontal tissue, and immunohistochemical analysis was done for observing receptor activator of nuclear factor-κB ligand and osteoprotegrin expression.
RESULTS AND CONCLUSION:After 8 weeks of modeling, expression of receptor activator of nuclear factor-κB ligand factor was significantly higher in alveolar bone of rats from experimental group in comparison to control group (P<0.05), whereas expression of osteoprotegerin in alveolar bone was significantly greater in rats from control group when compared to experimental group (P<0.05). This finding suggests that smoking can increase the expression of receptor activator of nuclear factor-κB ligand protein and reduce osteoprotegrin expression in periodontal rats, thus increasing the resorption of periodontal alveolar bone.

Objective To evaluate a combination of open surgery and multiple interventional methods in the treatment of DVT of the lower extremities. Methods 521 cases (521 limbs,356 male and 165 female) were studied in this group. Age ranged from 16 to 86 years with the mean age of (46 ±9)years. All 521 cases with DVT were treated by Fogarty embolectomy catheter. Among them,348 cases underwent percutaneous transluminal angioplasty (PTA), 135 cases received PTA and ultrasound ablation,stent-grafts were implanted in 108 cases. Results Based on angiography during operation, the obstructed iliofemoral vein received complete recanalization in 511 cases. Among them, the postoperative luminal diameter was more than 90% in 38 cases after Fogarty embolectomy, the average stenosis rate was reduced from 90% ±5% to 24% ±5% in 365 cases after PTA and stent-grafts were implanted in 108 cases with the stenosis rate still over 50% after PTA. Only partial recanalization was achieved in the entrance of common iliac vein to inferior vena cava in 10 cases. Of the 521 cases,472 cases were followed-up with mean time of (53 ± 26) months, ranging from 8 to 108 months and 462 cases reported satisfactory results with normal life,the unsuccessful 10 cases still felt swelling pain especially in erect position. Complications occurred in 33 cases. Conclusions Open surgery combining with multiple interventional methods is a safe and effective method in the treatment of DVT.