[摘 要] 目的：探讨iSEND免疫评分联合肺癌免疫治疗预后指数（LIPI）在评估非小细胞肺癌（NSCLC）接受免疫治疗预后中的价值。方法：通过回顾性分析2018年2月至2023年2月期间100例接受免疫治疗的晚期NSCLC患者的临床资料，收集并整理患者的iSEND免疫评分和LIPI数据，根据iSEND免疫评分和LIPI分别将患者分为3组（不良组、中等组和良好组），运用Kaplan-Meier方法绘制生存曲线分析所有患者和不同组别患者的无进展生存期（PFS），运用Cox回归分析评估影响患者预后的风险因素。结果：在接受免疫治疗后，NSCLC患者的ORR为42.00%（42/100），DCR为82.00%（82/100）。iSEND免疫评分和LIPI不良组ORR和DCR均最低，良好组均最高，不同组别ORR和DCR比较均有统计学意义（均P < 0.01）。100例NSCLC患者的中位PFS为7.63个月[95% CI（7.23, 8.05）]，iSEND免疫评分不良组、中等组和良好组的中位PFS分别为4.69、6.58和8.99个月，iSEND免疫评分良好组的PFS最长，其次为中等组，不良组最短（χ2=125.391，P < 0.000 1）。LIPI不良组、中等组和良好组的中位PFS分别为4.54、6.39和8.49个月，以LIPI良好组的PFS最长，其次为中等组（χ2 = 115.707，P < 0.000 1）。Cox多因素分析提示，ECOG PS > 1、远处转移、iSEND免疫评分≥ 2分和LIPI ≥ 2分是影响患者独立预后的风险因素。结论：iSEND免疫评分和LIPI可作为评估NSCLC免疫治疗预后的良好指标，具有一定的临床价值。

Objective    To investigate the safety of endoscopic thoracic sympathicotomy in the treatment of primary hyperhidrosis based on ambulatory surgery mode. Methods    Retrospective analysis was performed on the clinical data of 158 patients with primary hyperhidrosis who received endoscopic thoracic sympathicotomy in the Affiliated Hospital of Zunyi Medical University from January 2019 to March 2021. There were 68 (43.2%) males and 90 (56.8%) females with an average age of 14-33 (20.5±3.1) years. The basic information of the patients, operation time, intraoperative blood loss, postoperative pain score, hospitalization expenses and postoperative complications were observed and recorded. Results    All surgeries were successfully completed and the patients were discharged as planned. The operation time was 41.8±13.9 min, the intraoperative blood loss was 10.5±7.3 mL, the postoperative anesthesia recovery time was 15.0±5.9 min, and the pain score was 3.0±0.9 points. The total length of hospitalization was 1.6±1.0 days. The total postoperative expenses were 9 471.7±1 698.9 yuan. Pneumothorax occurred after the operation in 3 patients. Telephone follow-up on the 30th day after the operation showed no recurrence of sweaty hands, pneumothorax or rapid heart rate, and no serious complications or death related to the day operation within 30 days after the operation. Conclusion    Endoscopic thoracic sympathicotomy based on ambulatory surgery mode is safe and effective in the treatment of primary hyperhidrosis.

ObjectiveTo analyze the difference in esophageal microbiome between the patients with esophageal squamous cell carcinoma （ESCC group） and the healthy controls （HC group）， and to screen out the characteristic bacteria in tumor tissues of patients with esophageal squamous cell carcinoma. MethodsEsophageal tissues were collected from 105 patients with esophageal squamous cell carcinoma and 54 healthy controls. The total DNA of the samples was extracted， and the 16S rDNA V4 region was amplified by PCR， followed by high-throughput sequencing. The data were subjected to OTU clustering and diversity analysis to screen the characteristic bacteria in the ESCC group. Finally， the screening results were to be verified by Q-PCR amplification. ResultsDiversity analysis showed that there were differences in diversity and composition between the ESCC group and the HC group. Species analysis showed that the main components of microbiome in the ESCC group were Fusobacterium， Gemella， Neisseria， Porphyromonas and Streptococcus. While in the HC group the main components of microbiome were Fusobacterium， Actinobacillus， Streptococcus and Prevotella. The LEfSe analysis showed that the expression of porphyrin and Fusobacteria in the ESCC group increased and the difference is statistically significant （P<0.05）. The results of Q-PCR showed that the presence of Porphyromonas gingivalis and Fusobacterium nucleatum in the ESCC group significantly increased. ConclusionsEsophageal cancer has its characteristic flora composition. Porphyromonas gingivalis and Fusobacterium nucleatum in esophageal squamous cell carcinoma tumor tissue are the characteristic bacteria.

Malocclusion is one of the three most common oral diseases reported by World Health Organization(WHO). In China, its incidence rate is rising. Malocclusion seriously affects the dental and maxillofacial function, facial appearance and growth development of nearly 260 million children in China, and what is more, it affects their physical and mental health development. Malocclusion occurrence is related to genetic and environmental factors. Early treatment of malocclusion can create a good dental and maxillofacial development environment, correct abnormal growth and control the adverse effects of abnormal genetic factors. It can effectively reduce the prevalence of children's malocclusion and enhance their physical and mental health. This is an urgent need from the economic perspective of our society, so it has great practical and social significance. Experts from the project group "standard diagnose and treatment protocols for early orthodontic intervention of malocclusions of children" which initiated by China National Health Institute of Hospital Administration wrote the "China Experts' Consensus on Preventive and Interceptive Orthodontic Treatments of Malocclusions of Children", which aims to guide and popularize the clinical practice, improve the clinical theory and practice level, and accelerate the disciplinary development of early treatment of children's malocclusion in China. The consensus elaborates the harmfulness of malocclusion and the necessity of early treatment, and brings up the principles and fundamental contents. Based on the law of dental and maxillofacial development, this paper puts forward the guiding suggestions of preventive and interceptive treatments in different stages of dental development ranging from fetus to early permanent dentition. It is a systematic project to promote and standardize the early treatment of malocclusion. Through scientific and comprehensive stratified clinical practice and professional training, the clinical system of early treatment of malocclusion in China will eventually be perfected, so as to comprehensively care for children's dental and maxillofacial health, and improve their oral and physical health in China.
Child ; China/epidemiology* ; Consensus ; Dental Care ; Humans ; Malocclusion/prevention & control* ; Orthodontics, Interceptive

Objective To investigate the distribution and epidemiological characteristics of disease spectrum in patients with pre-hospital care in Urumqi, so as to provide reference for the establishment of mature pre-hospital care system. Methods Data retrieved from Urumqi Emergency Medical Center Command System were collected, and stratified random sampling method was used to selected 2400 patients from 8 districts and counties. The disease spectrum was analyzed, then the epidemiological characteristics was analyzed from the aspects of age, gender, season and aid time. Results The top 6 diseases were trauma in 696 cases (29.00%), cardiovascular disease in 521 cases (21.71%), poisoning in 328 cases (13.67%), respiratory system disease in 245 cases (10.21%), nervous system disease in 202 cases (8.42%) and digestive system disease in 139 cases (5.79%). Trauma and cardiovascular disease were the main types of pre-hospital care for both males and females, moreover, the incidence of trauma, nervous system disease, digestive system disease and other diseases in male was significantly higher than that in female (P<0.05). The distribution of trauma, cardiovascular and cerebrovascular disease, poisoning, respiratory disease, nervous system disease, digestive system disease and other diseases showed significant difference among patients in difference age groups (P<0.05). The distribution of trauma, cardiovascular and cerebrovascular diseases, poisoning, respiratory system diseases, nervous system disease and digestive system diseases showed significant difference in different seasons (P<0.05). The emergency calls in three shifts were the most on middle shift and were the least on night shift in Urumqi, accounting for 43.88%( 1 053 / 2 400) and 15.33% (368 / 2 400). Conclusion The distribution of disease types of pre-hospital care in Urumqi varies with gender, age, season and times, so relevant departments should improve the professional abilities of first aid and allocate first aid resources reasonably.

【Objective】 To study the feasibility of whole blood thromboelastogram (WB-TEG) and its correlative kit for plasma thromboelastogram (P-TEG) detection and the characteristics of P-TEG in healthy subjects. 【Methods】 17 healthy volunteers were detected by WB-TEG instrument and its correlative kit, and the results were compared with those by P-TEG. The P-TEG characteristics of 17 healthy volunteers were analyzed. Three groups (7 cases/group)of plasma samples with different platelet (Plt) count and the other three groups of plasma(7, 6 and 4 cases, respectively) with different fibrinogen(Fib) concentration were tested for P-TEG. The effects of Plt and Fib on P-TEG detection were observed. 【Results】 There was no significant difference in R and MA value (P>0.05)as WB-TEG was compared with P-TEG in healthy subjects, while in K(min) (1.71±0.47 vs 1.07±0.45), A(°) (66.1±5.41 vs 75.59±5.77), and CI value (0.9±1.8 vs 2.52±2.58)(all P <0.05). Various parameters of healthy individuals were basically within the range of 95% CI of WB-TEG, but there were significant diffferences in K, A and CI value(P<0.05). When Plt count (×10¹¹/L) was≥2.5 in plasma, the MA value of P-TEG was significantly extended than that of normal individuals(P<0.05); when Plt count (×10¹¹/L) was 6.0 ~12.0, the MA and CI value of P-TEG significantly decreased(P<0.05). When Fib(g/L) was 6.4~6.91 in plasma, the R and K value of P-TEG were prolonged, but A, MA and CI value all decreased(P <0.05); when Fib(g/L) <1, the A and MA value significantly decreased(P<0.05), and K and CI value could not be detected. 【Conclusion】 The WB-TEG and its correlative kit can be used in P-TEG detection, and corresponding reference values of TEG parameters should be established in combination with the conditions of laboratories.

Primary ureteral plasmacytoid carcinomas is a rare tumor with high grade and poor diagnosis. Pathological and immunohistochemical staining play an extremely key role in diagnosis since there is no specific clinical and radiological evidence. The surgical removement is the first line treatment. Herein, we report a case of ureteral plasmacytoid carcinoma that was well controlled with multimodal therapy.

Objective: To investigate the reversibility of ischemic core defined by CT perfusion imaging in acute ischemic stroke (AIS) patients receiving intravenous thrombolysis within different time windows and influencing factors. Methods: The data of AIS patients who received intravenous thrombolysis in the Department of Neurology of Lishui People′s Hospital from May 2016 to December 2018 were retrospectively reviewed. All patients had finished multi-model CT imaging before thrombolysis and multi-model MRI examination 24-48 hours after thrombolysis. The baseline ischemic core volume (hypoperfusion area with relative cerebral blood flow (rCBF)<30%) was quantitatively assessed based on CT perfusion images using MIStar software, and the final ischemic core volume was assessed based on diffusion weighted imaging acquired 24-48 hours after thrombolysis. The reversibility of ischemic core was defined as baseline ischemic core volume-the final infarct volume ≥5 ml. Then the clinical and imaging features of the patients between reversible group and irreversible group were compared, and the predictors of ischemic core reversibility were analyzed by binary Logistic regression analysis. Results: Finally, 97 patients were enrolled in the present study, of which 64 (66%) patients achieved successful recanalization, 51 (53%) patients with reversible baseline ischemic core. For patients with recanalization, the incidence of reversibility was 76% (26/34), 71% (17/24), 2/5 and 0 (0/1) in patients with time window from onset to thrombolysis (ONT) <3.0 h, 3.0-4.5 h, 4.6-6.0 h, and >6.0 h, respectively. In the non-recanalization group, six patients were also showed with ischemic core reversibility, including 4 (4/12) in the ONT<3.0 h group and 2 (2/12) in the ONT 3.0-4.5 h group. It was found that the reversible volume was positively correlated with baseline ischemic core volume (r=0.805, P<0.001) by Spearman correlation analysis. Finally, binary Logistic regression analysis revealed that the history of hypertension, ONT and recanalization were independent predictors of reversible changes of baseline ischemic core. Conclusions The ischemic core defined by CT perfusion imaging (rCBF<30%) was considerably inaccurate for patients with ONT<6.0 h. If recanalization could be achieved within this time window, most of the patients would manifest with ischemic core reversibility, the predictors of which also included hypertension history and ONT.

Objective: To evaluate the prognostic factors of T1-2N0M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy. Methods: The clinical data of 196 patients with T1-2N0M0 ESCC who were treated with definitive radiotherapy in 10 hospitals were retrospectively analyzed. All sites were members of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG). Radiochemotherapy were applied to 78 patients, while the other 118 patients received radiotherapy only. 96 patients were treated with three-dimensional conformal radiotherapy (3DCRT) and 100 treated with intensity-modulated radiotherapy (IMRT). The median dose of plan target volume(PTV) and gross target volume(GTV) were both 60 Gy. The median follow-up time was 59.2 months. Log rank test and Cox regression analysis were used for univariat and multivariate analysis, respectively. Results: The percentage of normal lung receiving at least 20 Gy (V₂₀) was (18.65±7.20)%, with average dose of (10.81±42.05) Gy. The percentage of normal heart receiving at least 30 Gy (V₃₀) was (14.21±12.28)%. The maximum dose of exposure in spinal cord was (39.65±8.13) Gy. The incidence of radiation pneumonia and radiation esophagitis were 14.80%(29/196) and 65.82%(129/196), respectively. The adverse events were mostly grade 1-2, without grade 4 toxicity. Median overall survival (OS) and progression-free survival (PFS) were 70.1 months and 62.3 months, respectively. The 1-, 3- and 5-year OS rates of all patients were 75.1%、57.4% and 53.2%, respectively. The 1-, 3- and 5-year PFS rates were 75.1%、57.4% and 53.2%, respectively. Multivariate analysis demonstrated that patients′age (HR=1.023, P=0.038) and tumor diameter (HR=1.243, P=0.028)were the independent prognostic factors for OS, while tumor volume were the independent prognostic factor for PFS. Conclusions Definitive radiotherapy is a promising therapeutic method in patients with T1-2N0M0 ESCC. Patients′ age, tumor diameter and tumor volume may impact patients′ prognosis.

Objective: To analyze the variation characteristics of HIV-1 Gp120 sequences in men who have sex with men (MSM) in Guangzhou. Methods: Plasma samples were collected from HIV-1 infected MSM before antiretroviral treatment. Viral RNA was extracted from plasma. Gp120 gene sequences were amplified by reverse transcription and nested-PCR using specific primers. Phylogenetic tree, length polymorphism, amino acid characteristics of V3 loop, co-receptors and signature amino acids were analyzed. Results: The phylogenetic tree were divided into 4 clusters, and the most prevalent subtypes were CRF07_BC (34/61, 55.74%) and CRF01_AE (24/61, 39.34%). Majority of HIV-1 Gp120 sequences had 496-515 amino acids. Among five hypervariable regions, the V1 region had the highest levels of length polymorphism and V3 region had the lowest. The top four peptide of V3 loop were GPGQ (56/58, 96.55%). Most of the co-receptors HIV-1 strains used was CCR5(50/58, 86.21%)according to four methods of comprehensive prediction. There are four signature amino acids in CRF01_AE subtype strains, and the frequency of occurrence was 0.75-0.83; there are eight signature amino acids in CRF07_BC subtype strains, and the frequency was 0.74-0.94. Conclusions The length of Gp120 sequences in MSM in Guangzhou has a high polymorphism. The top four peptide of V3 loop, co-receptor and signature amino acid of V3 ring have formed unique patterns.