Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To investigate the clinical application of three-point wiring localization in mandibular angle osteotomy.Methods:A total of 180 patients with mandibular angle long curve osteotomy were selected in Sichuan Friendship Hospital from July 2021 to April 2022, aged 19-45 (mean age 26.0±10.0) years, including 30 males and 150 females. Preoperative bilateral mandible was symmetry as CT showed, and all of them undergo operation of mandibular angle long curve osteotomy by using three-point wiring localization method under tracheal intubation general anesthesia.Results:Bilateral osteotomy bone of mandibular angle was basically symmetrical in all patients, the arc of osteotomy was good, and there were no obvious complications after surgery. The postoperative follow-up was 3-12 months, and all cases had good postoperative face contour and bilateral symmetry.Conclusions:Using three-point wiring localization method at operation of long curve mandibular angle osteotomy can ensure bilateral symmetry, accuracy and safety of the osteotomy.

Objective:To explore a simple and effective clinical method for improving facial sagging while performing maxillofacial contouring surgery.Methods:From October 2020 to October 2021, 50 patients with mandibular angle and malar surgery in the Plastic Surgery Department of Sichuan Friendship Hospital were selected, aged 30-43 years, with the average age of 37 years, including 44 females and 6 males. Maxillofacial contouring surgery was performed under transnasal intubation general anesthesia, the interorgual jaw groove incision was performed with a swing saw for bilateral long arc osteotomy, and the maxillary gingival groove incision and sideburn skin incision were performed for zygomatic osteotomy reduction and zygomatic arch incision. A small incision about 3 mm long was taken 1 cm from the edge of the temporal hair; a special conical cannula stripper was used to perform subcutaneous tunnel peeling to the zygomatic fat pad and masseter muscle ligament, anterior appendage ligament, then a two-way barb line was placed through the casing to lift vertically upwards, pierce above the posterior papillae of the ear, and the excess thread was cut off.Results:Following-up for 3-12 months, all recipients recovered well after surgery, the skin of the middle and lower parts of the postoperative body was lifted to varying degrees, the cheek fat pad was lifted, the jaw contour line was clearer, and the nasolabial fold was significantly improved as compared with that before the operation.Conclusions:At the same time as facial contouring surgery, the use of minimally invasive tunnel separation and lifting technique can effectively improve the skin sagging in the middle and lower parts, and it is simple and effective, and the clinical application effect is good.

Background:Acute lung injury(ALI)is the most common organ dysfunction in severe acute pancreatitis(SAP).Somatostatin analogue octreotide is a common used drug in acute pancreatitis.Aims:To explore the protective mechanism of octreotide on lung injury in SAP mice.Methods:In the first part,the experimental mice were randomly assigned into four groups.SAP model was induced by caerulin and lipopolysaccharide,and the mice were sacrificed 24 hours,48 hours and 72 hours after establishment.HE staining was used to observe the pathological score of pancreas and lung.Serum amylase and lung tissue myeloperoxidase(MPO)activity were detected.Real-time quantitative PCR was used to detect mRNA expressions of pyroptosis-related molecules apoptosis-associated speck-like protein containing a CARD(ASC),caspase-1,Gasdermin D(GSDMD),interleukin(IL)-1β,IL-18 and inflammatory factors IL-6,tumor necrosis factor(TNF)-α,high mobility group protein B1(HMGB1)in lung tissue.Western blotting was used to detect protein expressions of NOD-like receptor thermal protein domain associated protein 3(NLRP3),caspase-1,GSDMD and IL-1β in lung tissue.In the second part,mice were randomly divided into control group,SAP group,and octreotide group.HE staining was used to observe the pathological score of pancreas and lung.Serum amylase and lung tissue MPO activity were detected.Real-time quantitative PCR was used to detect mRNA expressions of pyroptosis-related molecules caspase-1,ASC,IL-1β,IL-18 and inflammatory factors IL-6,TNF-α,HMGB1.Immunofluorescence was used to detect protein expressions of NLRP3,caspase-1,GSDMD,ASC,IL-1β in lung tissue.Results:In the first part,compared with control group,pathological score of pancreas and lung tissue,serum amylase and MPO activity were significantly increased in SAP group(all P<0.05),mRNA expressions of pyroptosis-related molecules caspase-1,ASC,GSDMD,IL-1β,IL-18 and inflammatory factors IL-6,TNF-α,HMGB1 were significantly increased(all P<0.05),protein expressions of NLRP3,caspase-1,GSDMD and IL-1β in lung tissue were significantly increased(all P<0.05),especially in 24 hours after establishment group.In the second part,compared with SAP group,pathological score of pancreas and lung tissue,serum amylase were significantly decreased in octreotide group(all P<0.05),mRNA expressions of pyroptosis-related molecules caspase-1,ASC,IL-1β,IL-18 and inflammatory factors IL-6,TNF-α,HMGB1 were significantly decreased in lung tissue in octreotide group(all P<0.05),protein expressions of NLRP3,caspase-1,GSDMD,ASC and IL-1β in lung tissue were significantly decreased(all P<0.05).Conclusions:Cell pyroptosis is involved in the occurrence and development of lung injury in SAP mice,and octreotide may attenuate lung injury in SAP mice by inhibiting pyroptosis.

Objective:To investigate the application of internal fixation technique using Z-shaped titanium plate during operation of reduction malarplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent reduction malarplasty in Sichuan Friendship Hospital from June 2021 to March 2022. The intraoral maxillary vestibular groove mucosal incision and a small incision at the sideburns were used, and according to the height of the zygomatic body to be lowered before surgery, the zygomatic body was inverted F-shaped osteotomy, so that the zygomatic complex anterior was completely loosened. Zygomatic arch anterior to the temporomandibular joint was osteotomy using reciprocating saws and then push inward. The 3-hole titanium plate was bent into a Z-shape, the length of the middle arm of the Z-shaped titanium plate was the distance that the zygomatic arch needs to push inward, for the asymmetry of the zygomatic arch width on both sides, the length of the middle arm of the Z-shaped titanium plate on both sides can be adjusted and fixed with 2 titanium nails. Adjust the anterior zygomatic body so that the osteotomy line was well aligned and fixed with an L-shaped titanium plate. Selected 20 cases with complete three-dimensional(3D) CT data before and 3 months after surgery by random number table, and measured the vertical distance from the outermost point of the zygomatic arch to the median line based on the 3D CT head up position, and the surgical effect was evaluated. SPSS 25.0 software was used to statistically analyze the data, and the quantitative data conforming to the normal distribution were represented by Mean±SD, and the vertical distance from the outermost point of the zygomatic arch to the median line was compared by paired-sample t-test, P<0.05 indicates that the difference is statistically significant. Results:A total of 78 zygomatic plastic surgery patients were enrolled, including 18 males and 60 females, aged 19-37 years old, with an average age of 26 years. All patients’ incision had no complications after surgery, followed up for 3-12 months, the width of the zygomatic arch on both sides was significantly reduced, CT showed that the unilateral zygomatic arch was reduced by 3-8 mm, the transition between the zygomatic and temporal regions was smooth, and the zygomatic arch width on both sides was symmetrical. The difference of the vertical distance from the outermost point of the zygomatic arch to the median line was statistically significant between preoperative and postoperative, on the left side of the patient [(66.5±5.2) mm vs. (61.9±3.2) mm] and [(67.4±4.7) mm vs. (62.1±2.7) mm] ( P<0.05) for the right side. There was no significant difference between the left and right sides after surgery ( P>0.05). Conclusion:The Z-shaped titanium plate internal fixation technique can better control the zygomatic arch internal push distance in reduction malarplasty, and a symmetrical and gentle facial morphology can be obtained after surgery.

Objective:To investigate the application of internal fixation technique using Z-shaped titanium plate during operation of reduction malarplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent reduction malarplasty in Sichuan Friendship Hospital from June 2021 to March 2022. The intraoral maxillary vestibular groove mucosal incision and a small incision at the sideburns were used, and according to the height of the zygomatic body to be lowered before surgery, the zygomatic body was inverted F-shaped osteotomy, so that the zygomatic complex anterior was completely loosened. Zygomatic arch anterior to the temporomandibular joint was osteotomy using reciprocating saws and then push inward. The 3-hole titanium plate was bent into a Z-shape, the length of the middle arm of the Z-shaped titanium plate was the distance that the zygomatic arch needs to push inward, for the asymmetry of the zygomatic arch width on both sides, the length of the middle arm of the Z-shaped titanium plate on both sides can be adjusted and fixed with 2 titanium nails. Adjust the anterior zygomatic body so that the osteotomy line was well aligned and fixed with an L-shaped titanium plate. Selected 20 cases with complete three-dimensional(3D) CT data before and 3 months after surgery by random number table, and measured the vertical distance from the outermost point of the zygomatic arch to the median line based on the 3D CT head up position, and the surgical effect was evaluated. SPSS 25.0 software was used to statistically analyze the data, and the quantitative data conforming to the normal distribution were represented by Mean±SD, and the vertical distance from the outermost point of the zygomatic arch to the median line was compared by paired-sample t-test, P<0.05 indicates that the difference is statistically significant. Results:A total of 78 zygomatic plastic surgery patients were enrolled, including 18 males and 60 females, aged 19-37 years old, with an average age of 26 years. All patients’ incision had no complications after surgery, followed up for 3-12 months, the width of the zygomatic arch on both sides was significantly reduced, CT showed that the unilateral zygomatic arch was reduced by 3-8 mm, the transition between the zygomatic and temporal regions was smooth, and the zygomatic arch width on both sides was symmetrical. The difference of the vertical distance from the outermost point of the zygomatic arch to the median line was statistically significant between preoperative and postoperative, on the left side of the patient [(66.5±5.2) mm vs. (61.9±3.2) mm] and [(67.4±4.7) mm vs. (62.1±2.7) mm] ( P<0.05) for the right side. There was no significant difference between the left and right sides after surgery ( P>0.05). Conclusion:The Z-shaped titanium plate internal fixation technique can better control the zygomatic arch internal push distance in reduction malarplasty, and a symmetrical and gentle facial morphology can be obtained after surgery.

Objective : To explore the medication law and mechanism of traditional Chinese medicine compounds in the treatment of periodontal disease through data mining, network pharmacology, and molecular docking. Methods: First, data mining was used to search single medicinal materials for the treatment of periodontal disease, and the active components and their action targets were screened. Second, the disease target database was employed to download the targets related to the pathogenesis of periodontal disease, map them with the action targets of traditional Chinese medicine, and obtain the targets that are considered potential targets of traditional Chinese medicine in the treatment of periodontal disease. Potential targets were analyzed for gene ontology function and signaling pathway. They were then screened to obtain the key targets for the treatment of periodontal disease. Finally, the active components were docked with key targets. Results: Among the traditional Chinese medicine prescriptions for the treatment of periodontal disease, Shudihuang, Mudanpi, Danggui, Fuling, Jinyinhua, Shanyao and Zhimu had the highest frequencies. Forty-three active components and 118 action targets were screened, and 52 potential targets were obtained by intersection with 856 disease targets. The molecular functions and biological processes in which potential targets may participate mainly focus on vitamin D biosynthesis and RNA polymerase Ⅱ regulation and involve 96 signaling pathways. Through the analysis of network topology parameters, 11 key targets were obtained. The results of molecular docking showed that the active components and RAC-alpha serine/threonine-protein kinase (AKT1), cellular tumor antigen p53 (TP53), and mitogen-activated protein kinase-1 (MAPK-1) have good binding activity. Conclusion Traditional Chinese medicine compounds may play a role in the treatment of periodontal disease by inhibiting alveolar bone absorption, have antibacterial and anti-inflammatory properties, and promote tissue repair. The effective treatment of periodontal disease by traditional Chinese medicine compounds provides a more scientific reference to the sustainable development of traditional Chinese medicine.

Background::Understanding the characteristics of newly diagnosed primary human deficiency virus-1 (HIV-1) infection in the context of the post-antiretroviral therapy era and HIV drug prophylaxis is essential for achieving the new target of 95-95-95-95 by 2025. This study reported the characteristics of newly diagnosed primary HIV-1 infection in Shenzhen.Methods::This is a real-world retrospective study. Eighty-seven newly diagnosed primary HIV-1-infected patients were recruited from January 2021 to March 2022 at the Third People’s Hospital of Shenzhen. Demographic, epidemiological, diagnostic, drug resistance, and medical data were described and analyzed.Results::Overall, 96.6% (84/87) of the newly identified primary HIV-1-infected patients were male, including 88.5% (77/87) men have sex with men (MSM), with a median age of 29.0 years (Q 1-Q 3: 24.0-34.0 years); of these, 85.1% (74/87) reported high-risk sexual behaviors with casual partners. The rate of condom usage was only 28.7% (25/87). The overall rate of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) was 8.0% (7/87, including 4 PrEP and 3 PEP cases) around the potential exposure, although 41.4% of the patients had prior awareness of such interventions. Moreover, only 19.5% (17/87) had previously used PrEP or PEP. Of those, 58.8% (10/17) of the patients obtained drugs from the internet, and only 35.3% (6/17) reported good compliance. A total of 54.0% (47/87) of subjects were diagnosed by the HIV nucleic acid test. Acute retroviral syndrome appeared in 54.0% (47/87) of patients. The prevalence of transmitted drug resistance (TDR) mutation was 33.9% (19/56), including 6 (10.7%) against nucleoside reverse transcriptase inhibitor (NRTI) plus non-nucleoside reverse transcriptase inhibitor (NNRTI), 8 (14.3%) against NNRTI, and 5 (8.9%) against protease inhibitor (PI) only. Conclusions::Owing to the low utilization rate and incorrect usage of PrEP and PEP, massive efforts are needed to promote HIV-preventive strategies in the MSM population. The extremely high prevalence of TDR mutation in this population implies the need for future pretreatment drug resistance surveillance.

Objective:To understand the clinical features and risk factors of the first seizures in children with febrile seizures, to guide clinicians to take appropriate intervention measures for children with risk factors, and to reduce the incidence of febrile seizures.Methods:A total of 616 children with first-onset febrile seizures admitted in our hospital from August 2016 to August 2018 were enrolled in this study.The clinical characteristics and risk factors of first-onset seizures were retrospectively analyzed.And 601 children with fever but no seizures were randomly selected as the control group.Results:There were 616 children with febrile seizures, including 344 males and 272 females, 584 Hans and 32 Mongolian.A total of 126 cases (20.5%) were under 1 year old, 405 cases (65.8%) were 1-3 years old, and 85 cases(13.7%) were over 3 years old.The upper third of the episodes were acute upper respiratory tract infections[53.6%(330/616)], herpetic angina[25.9% (160/616)], and infant acute rash[10.5%(65/616)]. There were 570 cases(92.5%) with seizures at 38.0 ℃ and above, 16 cases(2.6%)had fever after seizures.A total of 534 cases(86.7%) had seizures within 24 hours of fever, and 608 cases(98.7%) presented with a generalized seizures.The duration of seizures was less than 5 min in 548 cases (89.0%), 5-14 min in 48 cases (7.8%), 15-29 min in 16 cases (2.6%) and more than 30 min in 4 cases (0.4%). Of the 572 patients (92.9%), only one seizure occurred in a single heat stroke.In the clinical type, simple febrile seizures accounted for 88.3%(544/616), complex febrile seizures accounted for 11.0%(68/616), and seizures persisted in 0.7%(4/616). Risk factors analysis showed that age, low sodium, low iron and low zinc, cesarean section, abnormal birth history, vaccine exposure history one week before convulsion, and family history of febrile seizures were statistically different between the febrile seizure group and the control group( P<0.05). Logistic regression analysis found that the age of first febrile seizures, low iron, cesarean section, low sodium and family history of febrile seizures were the independent risk factors for the first episode of febrile seizures ( P<0.05). Conclusion:The first episode of febrile seizures are more common in infants and young children under 3 years old.It is mainly caused by simple febrile seizures.The temperature of seizures is high and it is easy to occur within 24 hours after fever.Viral infection is the most common cause.The risk factors for the first episode of febrile seizures are episode age, low iron, cesarean section, low sodium and family history of febrile seizures.Taking appropriate interventions for risk factors can reduce the incidence of febrile seizures.