Medial Epicanthoplasty With the Classic and Modified Skin Redraping Method: A Retrospective Case Control Study.

ABSTRACT: The skin redraping method for medial epicanthoplasty is characterized by some shortcomings which warrants modification. In this study, clinical data of 193 patients who underwent medial epichanthoplasty by the modified skin redraping technique or the classic skin redraping technique were reviewed retrospectively. The patients underwent operation between May 2018 and June 2020 and were followed up for not less than 6 months. Interepicanthal distance, interpupillary distance, patient satisfaction, and postoperative complications were evaluated. In terms of interepicanthal distance/inter-pupillary distance ratio (P > 0.05) and satisfaction score (P = 0.759), the modified skin redraping technique and the classic skin redraping technique were similar. In the classic skin redraping group, there were 3 cases of visible scarring in the lower eyelid, corresponding to significantly more cases than in the modified skin redraping group (n = 0, P < 0.001). There were more out-fold cases in the modified skin redraping group (76/90) than in the classic skin redraping group (17/88) (P < 0.001). Utilizing the modified skin redraping medial epicanthoplasty can prevent medial hooding of the upper eyelid, reduce the probability of visible scarring, and produce more out-fold with concurrent double eyelidplasty compared with classic skin redraping epicanthoplasty. Level of evidence: IV.

Upregulation of circFLNA contributes to laryngeal squamous cell carcinoma migration by circFLNA-miR-486-3p-FLNA axis.

BACKGROUND: Accumulating evidence shows that circular RNAs (circRNAs) plays vital roles in tumor progression. However, the biological functions of circRNAs in laryngeal squamous cell carcinoma (LSCC) metastasis is still unclear. METHODS: qRT-PCR was used to detect circFLNA, miRNAs and FLNA mRNA expression. Transwell assay and western blot were performed to evaluate cell migration ability and to detect FLNA, MMP2 and MLK1 protein expression, respectively. RNA pull-down analysis was used to find the binding-miRNAs of circFLNA. Luciferase reporter assay was used to examine the effect of circFLNA on miRNAs and miR-486-3p on FLNA expression. RESULTS: In this study, we confirmed that a Filamin A (FLNA)-derived hsa_circ_0092012 known as circFLNA, was upregulated in LSCC, and the higher expression of circFLNA was correlated with LSCC lymph node metastasis. Increased circFLNA facilitates LSCC cell migration ability through upregulating FLNA and MMP2 protein expression. Mechanistically, we find that circFLNA sponges miR-486-3p in LSCC cells, relieving miR-486-3p-induced repression of FLNA which promotes LSCC cell migration. Accordingly, FLNA mRNA is overexpressed in LSCC tissues and a higher FLNA level is correlated with poor survival. Dysregulation of the circFLNA/miR-486-3p/FLNA regulatory pathway contributes to LSCC migration. CONCLUSIONS: In summary, our study sheds light on the regulatory mechanism of circFLNA in LSCC migration via sponging miR-486-3p, which downregulates the FLNA protein expression. Targeting circFLNA/miR-486-3p/FLAN axis provides a potential therapeutic target for aggressive LSCC.

[Ultrasound-aided biodegradable osteosynthesis system: application in fixation of oral and maxillofacial fractures].

OBJECTIVE: To evaluate the effectiveness and complications of an ultrasound-aided biodegradable osteosynthesis system in the treatment of midfacial fractures. METHODS: From January 1, 2010 to March 1, 2013, a total of 193 midfacial fractures patients were recruited. There were 120 males and 73 females. Among them, 93 patients were treated with SonicWeld Rx system (KLS Martin, Tuttlingen, Germany) while 100 patients FIXSORB MX (Takiron Co., Ltd, Osaka, Japan). The effectiveness, short-term and long-term complications were assessed by clinical examinations and computed tomography during an average follow-up period of 18 months. RESULTS: All fractures healed well without dislocation, malunion, delayed union or nonunion. Pin insertion was completed with a total success rate of 99% in SonicWeld Rx group versus 98% in FIXSORB MX group. Three patients in SonicWeld Rx group and 2 in FIXSORB MX group developed postoperative local inflammation and healed with antibiotics therapy. Hardware visibility or palpability occurred in 3 and 8 patients in two groups respectively. One patient in SonicWeld Rx group and 4 in FIXSORB MX group experienced sterile abscess at Months 12-15 postoperatively and resolved by the removal of biodegradable materials. Two cases of implant looseness were observed in FIXSORB MX group. No other procedure-related complication was noted in either group. CONCLUSION: The ultrasound-aided biodegradable osteosynthesis of SonicWeld Rx system is both effective and safe in the treatment of midfacial fractures. And its complication rate is equal to that of traditional biodegradable fixation.

A modified preauricular-temporal approach for fixing comminuted and redisplaced zygomatic arch fractures with the resorbable bone plate.

OBJECTIVE: To evaluate the effectiveness of the rigid internal fixation for comminuted and redisplaced zygomatic arch fractures by modified preauricular-temporal approach with the resorbable bone fixation. METHODS: Totally twenty patients aged from 14 to 68 years and admitted to our hospital between September 2006 and June 2011 were reviewed, of whom seventeen had a unilateral comminuted zygomatic arch fracture and three re-displaced arch fracture after failed closed reduction. The fracture segments were aligned to restore the preinjury form of the arch by rigid fixation with resorbable plates and screws through a modified preauricular-temporal incision. RESULTS: The fractures were well reduced, preauricular-temporal scar and lateral facial contour were aesthetically satisfying, and no case had limited mouth opening as well as facial palsy. The resorbable plates were not palpated one year after the operation. CONCLUSION: The rigid internal fixation through the preauricular-temporal approach with the resorbable bone is an effective method for the comminuted and redisplaced zygomatic arch fractures.

[Application of absorbable plate in oral maxillofacial fractures].

OBJECTIVE: To explore the biological features and clinical efficacies of absorbable plates and screws for rigid internal fixation. METHODS: From June 2006 to June 2010, 201 FIXSORB(TM)-MX absorbable plates were used in 57 patients, including 41 males and 16 females aged from 11 - 81 years. And 185 plates were used in 53 patients of maxillofacial fracture and 16 plates in 4 undergoing orthognathic operations with rigid internal fixation. RESULTS: All wounds healed primarily and there were no major complications. Forty-five cases were followed up for an average period of 12 months (range: 3 - 36). No obvious adverse effect and absorbable implants rejection were observed. The fracture lines were in the right position in 56 cases. CONCLUSION: As a kind of fine material for internal fixation with strong elasticity and strength, absorbable plate shall be widely used clinically.

[Comparative study of clinical efficacy between surgery by intraoperative MRI navigation versus traditional surgical resection for malignancy of parapharyngeal space].

OBJECTIVE: To investigate the clinical efficacy between mobile intraoperative magnetic resonance imaging (iMRI) navigation with a high field strength and routine surgical resection for malignancy of parapharyngeal space. METHODS: The surgical efficacy indexes of patients at our hospital during the time range from February 2010 to February 2011 were compared between two groups consisting of 29 or 42 individuals undergoing surgery with the assistance of the technique of iMRI navigation with a high field strength 1.5T or routine operation. RESULTS: No difference existed between two groups in terms of age, gender, maximal diameter of tumors, tumor stages, surgical approach or pathologic diagnosis (P > 0.05). The operative duration of the group by iMRI navigation was more than the group of routine operation ((3.1 ± 0.6) h vs (2.7 ± 0.7) h, P < 0.05). And the hemorrhagic loss ((185 ± 20) ml vs (230 ± 22) ml), the volume of drainage in 72 hours, the positive rate of initial surgical margins, the postoperative hospital stay ((9.1 ± 2.1) d vs (10.3 ± 2.3) d) and the complication incidence rate (3.4% vs 9.5%) were less (all P < 0.05). CONCLUSION: The operation by the iMRI navigation offers a much better clinical efficacy than the traditional surgery in the resection of malignancy of parapharyngeal space.

[Operation plus brachytherapy of iodine 125 seeds implantation for salivary gland malignant tumors].

OBJECTIVE: To evaluate the efficacy and safety of brachytherapy plus operation for salivary gland malignant tumors. METHODS: From June 2006 to June 2011, a total of 105 patients with salivary gland malignant tumors undergone brachytherapy by implantation of iodine 125 seeds. The effectiveness was evaluated by periodical radiological film and computed tomography. The complications were analyzed. RESULTS: Among them, 92 patients were observed for 12 - 60 months. The rates of clinical response rate (CRPR) and no change (NC) were 91.3% (84/92) and 8.7% (8/92) respectively of the patients. Pain, mucosa ulcer, skin darkness and radiation osteomyelitis were common complications. CONCLUSION: The combined regimen of operation and brachytherapy of iodine 125 seed implantation for salivary gland malignant tumors is quite effective and convenient. And it has fewer complications.

EGFR-targeted therapies combined with chemotherapy for treating advanced non-small-cell lung cancer: a meta-analysis.

PURPOSE: The epidermal growth factor receptor (EGFR) is one of the four human epidermal receptors. The efficacy and safety of EGFR-targeted therapies for treating non-small-cell lung cancer (NSCLC) remained controversial. The aim of this study was to systematically evaluate EGFR-targeted therapies plus chemotherapy for advanced NSCLC. METHODS: Cochrane Central Register of Controlled Trials, PubMed, and Embase were searched for relevant studies. Quantitative analysis was carried out to evaluate survival, response, and toxicity of EGFR-targeted therapies. RESULTS: Ten randomized controlled trials (RCTs) involving 5,936 patients were identified out of 107 studies. There was no statistical difference in overall (OS) and 1-year (OYS) survival rate when small-molecule tyrosine kinase inhibitors (TKIs) plus platinum-based doublet chemotherapy (PBDC) were compared with PBDC alone. However, progression-free survival [hazard ratio (HR)=0.87, 95% confidence interval (CI) 0.76-0.99] and overall response rate (ORR) were marginally improved. Prolonged OS (HR=0.87, 95% CI 0.78-0.96) and increased ORR and OYS were found when cetuximab plus PBDC was compared with PBDC alone. Adverse events in the combination arms were similar in incidence to those of the chemotherapy-alone arms, with the exception of an increased incidence of rash and diarrhea. CONCLUSIONS: Cetuximab adds benefits to NSCLC patients compared with PBDC alone. Small-molecule TKIs plus PBDC lead to a slightly additive efficacy compared with PBDC alone.

Inflammation-mediated age-dependent effects of casein kinase 2-interacting protein-1 on osteogenesis in mesenchymal stem cells.

BACKGROUND: The casein kinase 2-interacting protein-1 (CKIP-1) is important in the development of osteoblasts and cardiomyocytes. However, the effects of CKIP-1 on osteoblast precursor mesenchymal stem cells (MSCs) remain unclear. This study aimed to determine whether CKIP-1 affects osteogenic differentiation in MSCs and explore the relationship of CKIP-1 and inflammation. METHODS: Bone marrow MSCs of CKIP-1 wild type (WT) and knockout (KO) mice were cultivated in vitro. Cell phenotype was analyzed by flow cytometry, colony formation was detected to study the proliferative ability. Osteogenic and adipogenic induction were performed. The osteogenic ability was explored by alizarin red staining, alkaline phosphatase (ALP) staining and ALP activity detection. Quantitative real-time polymerase chain reaction (qRT-PCR) was carried out to determine the mRNA expression levels of osteoblast marker genes. The adipogenic ability was detected by oil red O staining. Content of the bone was analyzed to observe the differences of bone imaging parameters including trabecular bone volume/tissue volume (BV/TV), bone surface area fraction/trabecular BV, trabecular number (Tb.N), and trabecular spacing (Tb.sp). Interleukin (IL)-1ß was injected on WT mice of 2 months old and 18 months old, respectively. Difference in CKIP-1 expression was detected by RT-PCR and western blot. The relationship between CKIP-1 and inflammation was explored by RT-PCR and western blot. RESULTS: ALP assays, alizarin red staining, and qRT-PCR showed that MSCs derived from CKIP-1 KO mice exhibited a stronger capability for osteogenesis. Micro-computed tomography detection showed that among 18-month-old mice, CKIP-1 KO mice presented significantly higher bone mass compared with WT mice (P = 0.02). No significant difference was observed in 2-month-old mice. In vivo data showed that expression of CKIP-1 was higher in the bone marrow of aging mice than in young mice (4.3-fold increase at the mRNA level, P = 0.04). Finally, the expression levels of CKIP-1 in bone marrow (3.2-fold increase at the mRNA level, P = 0.03) and cultured MSCs were up-regulated on chronic inflammatory stimulation by IL-1ß. CONCLUSIONS: CKIP-1 is responsible for negative regulation of MSC osteogenesis with age-dependent effects. Increasing levels of inflammation with aging may be the primary factor responsible for higher expression levels of CKIP-1 but may not necessarily affect MSC aging.

[Application of neuronavigation in stomatology: report of three cases].

OBJECTIVE: To evaluate the clinical value of neuronavigation system in stomatology. METHODS: The clinical data of 3 patients were reviewed. Thin-slice CT scanning was conducted on the 3 patients and the CT data were input into the CT neuronavigation system that in turn guided the operations later. Patient I with trigeminal neuralgia, aged 51, underwent puncture of oval foramen and radiofrequency thermo-coagulation therapy. Patient II of canister shots injury, aged 32, with 3 metal grains in the face and 1 metal grain in the neck, underwent removal of the metal grains. Patient III with relapse of tongue cancer after operation, aged 62, underwent plantation of radiate granules. RESULTS: Guided by neuronavigation, puncture was accurate and curative effect was excellent in patient I, and no visible complication was seen; all the metal grains in face were found and removed in patient II, however, because of registration error, the metal grain in neck failed to be positioned; and the radiate granules were implanted accurately in patient III. CONCLUSION: Neuronavigation significantly increases the successful rates of puncture into the oval foramen, orientation of metal grains, and implantation of radiate granules, and reduces the complications rate.

[The finite element study on zygomatic injury by impact in child].

OBJECTIVE: The purpose of this study was to establish the constructive of craniofacial suture in the three-dimensional finite element model of craniofacial complex in child, to analyse the response procedure of the zygomatic impact, to explore the biomechanics characteristic of the children craniofacial trauma. METHODS: A 7-year-old female was adopted for study The complex cranial geometry was measured from a series of two-dimensional CT images. The multi-lay spiral CT scans were transformed with a self-developed preprocessor into a finite element mesh. The craniofacial sutures were constructed through the MSC Patran program. Identical impact and boundary conditions were used for the zygomatic impact simulations. RESULTS: It has been shown that the finite element model (FEM) exhibited fine morphological and mechanical comparability. The higher stress was showed in the zygomatic regions and atlas occipital articular in 3d FEM. The maximum von Mises stress was found at the zygomatic regions and atlas occipital articular. CONCLUSION: The concentrations of shear stress and tension stress in the suture and articular would increase the risk of injury in this area. But the conduction of the stress might be weakening in the suture of child skull.

[Effects of testosterone and cortisol in sports fatigued organism by Chinese material medica of shixiang yaofa].

OBJECTIVE: To study the endogenous hormone of testosterone and cortisol that secretes volume and rhythm in sports fatigued human bodies and animals. To determine secretory volume and rhythm in sports fatigued human bodies and animals when Shixiang yaofa's drug are used. METHOD: Radio-immunity method was used to determine secretory volume and rhythm in sports fatigued human bodies and animals and to analyze secretory volume and rhythm. According to the secretory volume and rhythm of testosterone and cortisol, the Shixiang Yaofa's drugs were used. Doses: wenyang jihuo bead 10 g/sack 2 sack, ziyin xiuyang capsule 0.5 g/pill 8 pill pd in human bodies for 28 days. Wenyang jihuo bead 10 g x kg(-1) of crude drug, ziyin xiuyang capsule 4 g x kg(-1) of crude drug pd for hight doses in animals. Other groups for low doses 5 g x kg(-1) and 2 g x kg(-1) of crude drug pd for 15 days. The blood samples were collected for determination. RESULT: (1) In human bodies the peak value of testosterone was appeared in 8:00 and valley value was appeared in 18:00, ranges: 176.93-281.73 x 10(-5) mg x L(-1). The peak value of cortisol was appeared in 8:00 and valley value was appeared in 22:00, ranges: 1.31-16.13 x 10(-3) mg x L(-1). In the same condition, the mouse peak value of testosterone was appeared in 20:00 and valley value was appeared in 0:00, ranges: (0.56 x 10(-5) - 124.0 x 10(-5)) mg x L(-1). The rhythm in animals was compatible with human bodies, howerer, the peak value was delayed for 12 hours. (2) The testosterone was step up and the cortisol was cut down in sports fatigued human bodies and animals when shixiang yaofa's drug were used (P < 0.05, P < 0.01). CONCLUSION: The secretion of testosterone and cortisol in sports fatigued human bodies and animals are existed conclusive biologic rhythm. The secretory volume can be available accommodation by shixiang yaofa's drugs.

[Reactivity of a novel monoclonal antibody ZCH-7-2D3 on leukemia cells and its clinical significance].

OBJECTIVE: To analyze the reactive pattern and its clinical significance of ZCH-7-2D3 monoclonal antibody on leukemia cells. METHODS: Bone marrow samples from 100 leukemia patients (male 59: female 41, 34 cases of children and 66 adults, aged 11 months - 77 year) were collected. A CD45 gating strategy and multi-parameter flow cytometry were used to analyze the leukemia cells. RESULT: The positive rate (10/31) of 2D3 antibody on acute lymphocytic leukemia (ALL) patients was significantly lower than that (39/55) of acute myelogeneous leukemia (AML) (P <0.01). 2D3 was positive for all three cases of B/myeloid mixed lineage leukemia, but negative in 6 cases of chronic myelogeneous leukemia (CML), significantly lower than that in AML (39/55, P<0.01) patients. There was no difference between the positive rates of chronic lymphocytic leukemia (CLL, 3/5) and B lineage ALL (9/28, P = 0.2389). The antibody was not found to recognize the differentiation stages of either ALL and AML subtypes. CONCLUSION: 2D3 monoclonal antibody primarily recognizes AML cases. Further studies on cloning of gene encoding the antigen protein and its biological functions are warranted.

[Department of a finite element model of the Head Model of HYBRID III Dummy with the Human Mandible].

OBJECTIVE: To analyze the biomechanics of impact injury in the condition of the simulate impact on mandible. METHODS: A finite element model of human mandible was developed from the CT scan images by the technologies of three-dimensional reconstruction, image processing and meshing. The mandible model was connected to a modified head model of HYBRID III dummy with joint according to the anatomic structure and mechanical characteristics of the temporomandibular joint. RESULTS: A finite element model of human head with true anatomic structure mandible has been developed. This model has been validated with the cadaver test results. The higher stress was showed in the condyle rejoins and coracoid in the model when mandible was in impact simulation. CONCLUSIONS: This model can be used to research the mechanism of craniofacial blunt-impact injury and assess the injury severity. The model of HYBRID III dummy with the human mandible was helpful for the boundary design of mandibular model in the impact simulations.

[The preliminary study of the use of MRI navigation in identifying the safe surgical margin of the maxillofacial malignancy].

OBJECTIVE: To evaluate the feasibility of MRI navigation in identifing the safe surgical margin of the maxillofacial malignancy. METHODS: The pathology results of the surgical margin identified by the technique of MRI navigation form 20 patients with maxillofacial malignancy were compared with those of 45 patients with maxillofacial malignancy who underwent the routine operation without MRI navigation. RESULTS: There was no difference between the two groups of patients in age, sex, size of tumor, tumor stages, pathologic diagnosis (P > 0.05). The negative rate of the surgical margin of the lesions treated by surgery with the technique of MRI navigation was significantly lower than that of the lesions treated without MRI navigation (P = 0.007) and highly correspondent with the pathology results. CONCLUSIONS: MRI navigation was helpful in identifying the safe surgical margin of the maxillofacial malignancy.

[Experiment on inducing human periodontal ligament stem cells into adipose cells].

OBJECTIVE: To explore the capability of human periodontal ligament stem cells (PDLSCs) differentiating into adipose cells in vitro and to determine their changes in cell morphology, structure and function during differentiation. METHODS: PDLSCs isolated by magnetic-activated cell selection were treated continuously with adipogenic medium for 21 d. Then the cell morphology, ultrastructure, adipose specific markers of low density lipoprotein (LPL) and peroxisome proliferator activated receptor-gamma (PPAR-gamma) were analyzed by inverted contrast microscope, trans mission electron microscope (TEM), flow cytometry, immunofluorescence, RT-PCR and Western blot, respectively. These adipose-like cells were also identified by oil red O staining to determine the formation of lipid droplet, and the non-induced cells were used as control. RESULTS: After continuous induction, the treated cells differentiated into adipose-like cells with round shape, and large amount of lipid drop in cytoplasm. 96.54% of the PDLSCs were found to differentiate into adipose cells as showed by flow cytometry, the specific markers of LPL mRNA and PPAR-gamma mRNA, and oil red O staining, respectively. Further, PPAR-gamma protein was detected in the induced cells in a time-dependent manner. CONCLUSION: Human PDLSCs have the potential of differentiating into adipose cells under appropriate condition, and the differentiated cells exhibited characteristics of adipose cells both from cell morphology and from their functions.

Improvement of phase stability and accurate determination of optical constants of SnO thin films by using Al2O3 capping layer.

In this letter, it is proposed that the usage of Al(2)O(3) capping layer can tremendously improve the phase stability of SnO thin films, which allows the accurate determination of the optical constants of the SnO films without the perturbation arising from impurity phases. For the SnO films, the refraction index and extinction coefficient are significantly influenced by the crystallinity. The nondirect optical bandgap of the amorphous SnO films is determined to be 2.27 eV, whereas two nondirect optical transitions are observed in the polycrystalline SnO films and the corresponding gap energies are estimated to be 0.50 and 2.45 eV, respectively.

[Three-dimensional finite element analysis for different directions distraction at midface].

OBJECTIVE: To investigate the biomechanical changes with different directions distraction at midface. METHODS: An anteriorly directed 500 g force was applied to the floor of apertura piriforms in different directions to the occlusal plane. Three-dimensional finite element analysis was used to evaluate the biomechanical change of craniofacial complex. RESULTS: As the force direction was moved downward, the sagittal distraction length of the craniofacial complex decreased and vertical movement changed from upward to downward. The craniofacial complex was moved anteriorly when the downward force was applied about 20-30 degrees to the occlusal plane. The forces could generate the uniform stress distribution in the craniofacial sutures and avoid counterclockwise rotation of the maxilla. CONCLUSIONS: The craniofacial complex can be effectively distracted anteriorly when the downward force is applied to the floor of aperture piriforms in direction of 20-30 degrees to the occlusal plane.

[Preparation of the immunotoxin 2E8-norcantharidin and its targeting killing effect in vitro].

OBJECTIVE: Monoclonal antibody (mAb) conjugated with certain toxin to generate immunotoxin bears an important and promising effect as a new therapy for patients with hematopoietic malignancies. However, most toxic moieties conjugated with antibody proteins reported in the literature were toxic proteins which presented immunogenicity to patients capable of inducing anti-toxin antibody. Norcantharidin (NCTD) is a small molecule toxin. It does not have the immunogenicity to human body so that it bears a promising potential for development of new targeting drug. In this study, a new clone of self-made anti-CD19 mAb named ZCH-4-2E8 conjugated with NCTD was used to investigate its targeting efficacy against CD19+ lymphoid malignant Nalm-6 cells in vitro to provide the experimental data for the further development of this new targeting agent. METHODS: A monoclonal antibody named 2E8 was prepared from mouse ascites and purified by gel chromatography. The purity of the antibody protein was checked by SDS-PAGE assay. Immunotoxin 2E8-NCTD was successfully generated through conjugating CD19 mAb protein and Norcantharidin by the activated ester method. The binding activity of the immunoconjugate (2E8-NCTD) against CD19 antigens on cell surface and the expression levels of CD19 antigens on Nalm-6 and K562 cells were examined by flow cytometry. Comparisons of the inhibitory effects among PBS, purified 2E8 antibody, norcantharidin and immunotoxin 2E8-NCTD groups on cell growth of either Nalm-6 cells or K562 cells were made. RESULTS: The purity of the purified 2E8 antibody was higher than 99.00% demonstrated by SDS-PAGE assay. 2E8 antibody in the supernatant reacted with 99.34% of Nalm-6 cells, while only 0.98% of K562 cells reacted with this antibody. The newly generated immunotoxin (2E8-NCTD) had a positive rate of 99.90% on Nalm-6 cells with little reduction of binding activity. From the in vitro study, both 2E8-NCTD and norcantharidin were shown to have significant inhibitory effects on the growth of CD19+ Nalm-6 cells (P < 0.001), while the purified 2E8 antibody did not show any significant influences on the growth of Nalm-6 cells. Since no significant inhibitory effects were identified among immunotoxin 2E8-NCTD, 2E8 antibody and control groups on CD19(-) K562 cells, a significant targeting effect of the 2E8-NCTD against Nalm-6 cells was confirmed. CONCLUSIONS: The immunotoxin 2E8-NCTD was successfully synthesized by activated ester method with an excellent targeting killing effect on CD19+ Nalm-6 leukemia cells in vitro, which provides some experimental data for the further development of this new targeting agent.