Abstract:Objective：To investigate whether miR-150 promotes angiogenesis in cerebral ischemic rats and to identify its possible mechanisms. Methods：SD rats were divided into four groups（n=15）：Sham group，MCAO（middle cerebral artery occlusion） group，MCAO+miR-150 group and MCAO+miR-NC group. Except for the Sham group，the other groups established MCAO models by electrocoagulation method. MCAO+miR-NC group and MCAO+miR-150 group were injected with PEG liposome embedded miR-NC or miR-150（2.4 mg/kg，iv），respectively. On the 14th day after modeling，the changes of neurological function，nerve damage and angiogenesis of MCAO rats were observed. The oxygen-glucose deprivation（OGD） brain microvascular endothelial cells（BMECs） models were established to determine the roles and possible mechanisms of miR-150 in angiogenesis. The binding site between miR-150 and vascular endothelial growth factor（VEGF） was verified by luciferase activity assay. Results：In vivo，miR-150 was signifi－cantly down-regulated in MCAO rats compared with the Sham group（1.00±0.03 vs. 0.34±0.04，P<0.05）. Up-regulation of miR-150 reduced neurological deficit scores（day 7：6.9±1.0 vs. 5.3±0.6，day 14：6.4±0.7 vs. 3.9±0.5，both P<0.01） and infarct volume[（13.8±1.6）% vs. （5.1±0.6）%，P<0.001]，and promoted angiogenesis in cerebral ischemic rats. Luciferase reporter gene analysis confirmed that VEGF gene was the target gene of miR-150，and the up-regulation of VEGF expression was observed in MCAO rats treated with miR-150. In vitro，up-regulation of miR-150 increased the co-expression of VEGF/VEGFR2 in OGD induced BMECs and promoted the tube formation. Mechanism analysis showed that the effect of miR-150 on promoting angiogenesis was related to the activation of VEGF pathway，and the activating effects of miR-150 were inhibited by SU1498. Conclusion：miR-150 regulates neurologic impairment and angiogenesis in MCAO rats by targeting VEGF.

Abstract:Objective：To investigate the effect of mangiferin on glucose uptake in mouse myoblasts（C2C12） and its pharmacokinetic features in SD rats. Methods：After C2C12 differentiated into mature myotubes，it was divided into normal C2C12 cells（Nor-C2C12） and insulin resistance C2C12 cells（IR-C2C12） （palmitic acid modeling）. The glucose uptake of cells was observed after intervention with different concentrations of mangiferin. Then we administered 20 mg/kg mangiferin by gavage to 6 SD rats，and detected the blood concentration of mangiferin in the rats at different times by LC-MS，and analyzed its pharmacokinetic parameters. Results：The glucose uptake of IR-C2C12 was significantly lower than that of Nor-C2C12（P<0.01）. And whether it was normal cells or IR cells，mangiferin at higher doses（1 000，500，250 μg/mL） could significantly increase the glucose uptake of cells（P<0.01）. Pharmacokinetic study results showed：mangiferin HL_Lambda_z=1.34 h；Tmax=1.75 h；Cmax=90.65 ng/mL；AUClast=318.40 h·ng/mL；AUCINF_pred=327.10 h·ng/mL；MRTlast=2.47 h；Vz_F_pred=136.42 L/kg；Cl_F_pred=67.48 L/（h·kg）. Conclusion：Mangiferin has the activity of increasing the glucose uptake of C2C12 cells and alleviating the IR state of cells. This drug acts relatively quickly and has high bioavailability，which has the poten－tial to be developed into a good hypoglycemic drug or health care product.

Abstract:Objective：To analyze the independent risk factors affecting type 2 diabetes mellitus-carotid atherosclerosis（T2DM-CAS） patients complicated with diabetic kidney disease（DKD），and construct a personalized clinical prediction model to predict the risk of DKD in T2DM-CAS patients. Methods：A total of 883 patients with T2DM were selected in the study，and their basic characteristics，laboratory tests，auxiliary examinations and concomitant diseases of the patients were collected. LASSO regression was applied to screen the optimized variables by running cyclic coordinate descent. Multivariate logistic regression analyses were applied to build a prediction model，which incorporated the selected features. It relied on the receiver operating characteristic curve（ROC curve），calibration curves，and Hosmer-Lemeshow test to validate and evaluate the discrimination and calibration of the clinical prediction model；while the decision curve analysis（DCA） was used to evaluate its clinical validity. Results：A multivariable prediction model included diabetes duration，systolic blood pressure（SBP），fasting plasma glucose（FPG），triglycerides（TG），blood urea nitrogen（BUN），serum creatinine（Scr），cystatin C（Cys C） and diabetic retinopathy（DR）. This clinical prediction model demonstrated very good discrimination with an AUC of 0.831（95%CI=0.800-0.863），while the internal validation AUC was 0.825（95%CI=0.766-0.884）. The Hosmer-Lemeshow test showed very good fitting degree（P=0.822）. DCA showed the risk threshold of 30% and demonstrated a clini－cally effective prediction model. Conclusion：A Nomogram model with eight clinical predictor variables can be used to predict the risk of DKD in T2DM-CAS patients.

Abstract:Objective：To isolate and culture glioma stem cell-like cells from human glioma U251 cell line，identify the radiosensitivity，and investigate the relationship between signal transducer and activator of transcription 3（STAT3） gene and radiosensitivity of glioma stem cells. Methods：The CD133+ glioma U251 cells were isolated by magnetic bead sorting method，and the spheroidizing ability and radiosensitivity of CD133+ U251 cells were detected. The shRNA silencing expression plasmid and lentiviral over expression plasmid of STAT3 gene were constructed and identified. The U251 cells were transfected with recombinant plasmid，and the relationship between STAT3 expression and radiosensitivity of glioma cells was investigated by flow cytometry and Western blot. Results：The CD133+ U251 cells sorted by magnetic beads had stronger spheroidizing ability. The inhibition rate of CD133+ cells was significantly lower than that of CD133- cells and normal U251 cells after 2，4，6，8 and 10 Gy doses of irradiation（P=0.000），and the apoptosis proportion was lower. CD133+U251 cells transfected with shRNA silencing plasmid of STAT3 gene and lentivirus overexpression plasmid showed that STAT3 protein expression decreased in the silencing group by Western blot. After 2，4，6，8 and 10 Gy doses of irradiation，the STAT3 silencing group had higher cell inhibition rate than the overexpression group（P=0.000），and the cell cycle was inhibited and the apoptosis increased. Conclusion：The CD133+ glioma cells sorted by magnetic beads have the radiation resistance characteristic of stem cell. The glioma cell radiosensitivity can be improved by down regulating the STAT3 expression.

Abstract:Objective：To investigate an early，accurate and rapid gene detection method and procedure using next-generation sequencing（NGS） full screening and Sanger sequencing based verification for diagnosing a rare genetic disease，hepatolenticular degeneration. Methods：The proband Ⅲ-3 DNA was extracted and the bioinformatic data of high throughout genomic sequences（HTGS） was established to confirm the possible pathogenic sites by using the NGS；then the DNA of all 13 members of the family was extracted，including the proband，in order to design the primer and amplify the target fragment by PCR，then the possible pathogenic sites were verified by using the biopolar generation sequencing. Results：A heterozygous missense mutation（rs121907990；chr13：51937570） was detected on the proband Ⅲ-3’s ATP7B gene exon 8. Three family members，Ⅱ-4，Ⅱ-5 and Ⅲ-4，carried the same heterozygous sense mutation，and their genetic pattern showed mutation located on the same chromosome. The proband’s ATP7B mutation came from the matriarchal origin. Conclusion：The rapid identification method and procedural flow chart designed by our research，which combines the NGS technique and Sanger sequencing based verification technique for the pathogenic site in genealo－gy，has the potential to provide reference for gene diagnosis procedure，and contribute to the timeliness and accuracy of early diagnosis of rare genetic disease.

Abstract:Objective：To discuss the relationship between irisin level in blood and obesity and type 2 diabetes mellitus（T2DM） related parameters. Methods：We recruited 79 T2DM patients and 80 non-diabetic controls. According to body mass index（BMI），these sub－jects were further divided into normal group，obese group，T2DM group，and T2DM obese group. Obesity and T2DM related parameters were measured by automated biochemical analyzer，automated glucose analyzer and automated glyco-hemoglobin analyzer，and the level of irisin and interleukin-1β（IL-1β） was tested by enzyme-linked immunosorbent assay（ELISA）. Analysis of variance（ANOVA） and linear regression analysis were used to analyze the data. Results：The irisin level in T2DM obese group was significantly higher than that in normal group. The irisin level in both obese and T2DM obese group was significantly higher than that in T2DM group. The IL-1β levels in diabetic groups were significantly higher than the level in normal group，and the level of IL-1β in T2DM obese group was significantly higher than that in obese group. Irisin was positively correlated to weight and BMI. The receiver operating character－istic（ROC） curve analysis showed that the area under the curve of irisin in non-diabetic groups and diabetic groups was 0.653 and 0.854 respectively. Conclusion：The irisin level may be related to obesity to a certain extent，but not related to T2DM，which has a certain diagnostic value for obesity in non-diabetic and diabetic populations.

Abstract:Objective：To explore the relationship between triglyceride（TG） and the risk of type 2 diabetes mellitus（T2DM） in Chinese population. Methods：This study was a retrospective cohort study. A total of 211 833 participants were included in the study and completed at least two follow-up visits within 5 years. The Cox proportional hazard regression model was used to evaluate the independent relationship between the continuous variables TG and TG tri-groups and the T2DM risk，and to calibrate the potential confounding factors. This study used a generalized additive model to identify whether there was a nonlinear relationship，and used the principle based on the maximum likelihood method to automatically calculate the critical point of the threshold effect through recursive experiments. Results：The Cox proportional hazard regression model adjusted for various possible influencing factors，showing that TG could be used as a risk factor for T2DM events（HR=1.20，95%CI=1.15-1.24，P<0.001）. There was a non-linear relationship between TG and the risk of T2DM. The inflection point of TG calculated by piecewise linear regression model was 1.27 mmol/L（P<0.001 for log-likelihood ratio test）. On the left side of the critical point，TG was significantly positively correlated with the incidence of T2DM（HR=2.30，95%CI=1.89-2.79，P<0.001）. On the right side of the critical point，the relationship between TG and the risk of T2DM tended to be saturated（HR=1.08，95%CI=1.03-1.13，P<0.001）. Conclusion：TG can be used as a risk factor for the occur－rence of T2DM events in the Chinese population，and there is a non-linear relationship and a threshold saturation effect between TG levels and the occurrence of T2DM events.

Abstract:Objective：To investigate the relationship between serum level of repulsive guidance molecule a（RGMa） and leptomeningeal collateral status（LMCs） in patients with acute cerebral infarction. Methods：This study included in 96 patients with acute ischemic stroke with middle cerebral artery occlusion，and meanwhile 33 healthy controls. According to regional leptomeningeal collateral（rLMC） score，they were classified as poor LMCs group and good LMCs group. The serum RGMa levels were detected by enzyme-linked immunosorbent assay（ELISA） test. Multivariate logistic regression analysis was used to examine the independent predictors of poor LMCs in the patients. The receiver operating characteristic curve（ROC curve） was obtained to explore RGMa levels in predicting poor LMCs. Results：Serum RGMa levels in poor LMCs group[5 588.8（4 247.9，10 311.5） pg/mL] were significantly higher than those in good LMCs group[3 103.9（2 096.5，3 970.2） pg/mL] as well as healthy controls[3 528.6（2 801.2，5 328.5） pg/mL] （all P<0.05）. Based on the ROC curves，the best cut-off point of serum RGMa for predicting poor LMCs was 4 197.745 pg/mL，and the sensitivity and specificity were 76.5% and 80.0%，respectively. The logistic regression analysis showed that RGMa≥4 197.745 pg/mL remained an independent predictor of poor LMCs（OR=0.119，95%CI=0.030-0.469，P=0.002）. Conclusion：Serum RGMa is an independent predictor of poor LMCs in patients with acute cerebral infarction.

Abstract:Objective：To investigate the short-term clinical effect of femoral neck system（FNS） on femoral neck fracture. Methods：A retrospective case-control study was performed to analyze the clinical data of 45 patients with femoral neck fracture admitted to the hospital from January 2019 to December 2020，including 23 males and 22 females，aged 28 to 68 years old[（52.3±11.2） years old in average]. According to the Pauwels classification，6 cases were type Ⅰ，23 type Ⅱ and 16 type Ⅲ. Twenty-four cases were fixed with cannulated screws（group A），and 21 patients were fixed with FNS（group B）. The operative time，intraoperative blood loss，reduction quality，time of weight-bearing，time of fracture healing，necrosis of femoral head，nonunion of fracture，shortening of femoral neck，nail removal of internal fixator and hip function score of the last follow-up were compared between the two groups. Results：All patients were followed up for 6-29 months，while the operative time of group A was （65.2±21.5） min and （58.4±14.5） min in group B（P >0.05），and the surgical blood loss of group A[（35.6±51.2） mL] was less than that of group B[（72.1±62.1） mL]（P<0.05）. According to the reduction standard proposed by Haidukewych et al.，20 patients in group A had good reduction quality，3 were average and 1 was poor，with an excellent and good rate of 83.33%；19 patients in group B had good reduction quality，2 were average and 0 was poor，with an excellent and good rate of 90.48%（P >0.05）. The weight-bearing time of group A was （2.9±1.3） months，and group B was （3.1±1.5） months（P >0.05）. The fracture union time in group A was （4.4±1.4） months，and that in group B was （4.5±1.5） months（P >0.05）. In group A，there were 2 cases of femoral head necrosis，4 cases of fracture nonunion and 7 cases of femoral neck shortening. In group B，there was 1 case of femoral head necrosis，3 cases of fracture nonunion，and 6 cases of femoral neck shorten－ing（P >0.05）. In group A，4 cases（17.67%） had screw with－drawal and there was no case of screw withdrawal in group B（P =0.05）. The Harris scores of group A in the last follow-up were （91.2±6.9） points，those of group B were （92.0±7.5） points（P >0.05）. Among patients with Pauwels Ⅲ，the Harris scores of the patients in group A were （89.7±4.8） points at the last follow-up and those in group B were （93.4±6.3） points（P >0.05）. The overall incidence of nonunion and necrosis of femoral head in group A was 33.33%，and there was no nonunion and necrosis in group B（P >0.05）. Conclusion：The treatment of femoral neck fracture with FNS can achieve the same clinical efficacy as cannulated nail treatment，and FNS may be a new option for the treatment of femoral neck fracture.

Abstract:Objective：To evaluate the therapeutic effect of greater trochanteric epiphysiodesis（GTE） on Legg-Calve-Perthes disease（LCPD） in children. Methods：A total of 78 patients with LCPD treated by surgery in Children’s Hospital of Chongqing Medical University from January 2013 to June 2019 were included in the study. They were divided into crisis group and no-crisis group according to that if there were radiographic crisis of overgrowth of the greater trochanter（OGGT） based on X-ray films before the surgery，and the patients in crisis group were divided into the GTE group and the non-GTE group according to different surgical pro－cedures. The GTE group were treated with inclusive surgery combined with GTE including 14 cases（16 hips），and the non-GTE group were only treated with inclusive surgery including 33 cases（33 hips）. There were 31 cases and 31 hips in the no-crisis group. The above cases were followed up and the therapeutic effect was evaluated by the clinical symptoms and radiographic data. Results：The patients were followed up for 12 to 89 months（mean，30.6 months）. The rate of OGGT in the non-GTE group（75.8%） was sig－nificantly higher than that in the no-crisis group（6.5%）（P<0.001），and the rate of OGGT in the GTE group（21.4%） was significantly lower than that in the non-GTE group（75.8%）（P=0.001）. According to the comparative analysis of the development of the greater trochanter between the affected side and the healthy side in the GTE group，the growth of the greater trochanter that underwent GTE was inhibited by 1.32 mm/year，while greater inhibition（1.77 mm/year） was noted in children who underwent the hollow nail epiphysiodesis. The clinical effect in the GTE group was also better than that in the non-GTE group. Conclusion：Radiographic crisis of OGGT has definite predictive significance and can be the indication for GTE，and selective GTE can effectively inhibit the growth of greater trochanter and avoid OGGT. Combined with traditional inclusive surgery，the therapeutic effect can be improved.

Abstract:Objective：To investigate the clinical efficacy of robot-assisted radical nephroureterectomy（RRNU） for patients with non-metastatic high-risk upper tract urothelial carcinoma（UTUC） compared with laparoscopic nephroureterectomy（LRNU）. Methods：We retrospectively analyzed 70 cases of non-metastatic high-risk UTUC treated by radical nephroureterectomy from January 2018 to December 2020，including 19 cases of RRNU and 51 cases of LRNU. The perioperative outcomes and oncology prognosis were ana－lyzed. Results：There was no death caused by major vascular injury and other serious complications. There were no significant differ－ences in recurrence between the two groups（P >0.05）. There were statistically significant differences in postoperative hospital stay（d）[5（4，6） vs. 6（5，8），Z=2.076，P=0.038]，postoperative drainage volume（mL）[75（20，186） vs. 160（90，245），Z=2.411，P=0.016]，drainage tube retention time（d）[2（3，4） vs. 3（4，5），Z=2.276，P=0.023] and cost（ten thousand yuan）[8.33（7.51，8.78）vs. 3.91（3.46，4.94），Z=6.319，P=0.000]. There were no significant differences in intraoperative blood loss and operation time（P >0.05）. Conclusion：There are no significant differences in recurrence between RRNU and LRNU in the treatment of non-metastatic high-risk UTUC. RRNU has the advantages of shortening postoperative hospital stay，reducing postoperative drainage and drainage tube retention time，and accelerating the recovery of patients，but the cost of RRNU is more expensive.

Abstract:Objective：To explore the association between famine exposure in early life and the risk of diabetes，hypertension and hy－perlipidemia in Chongqing. Methods：The present study was performed on 7 466 participants who were born between October 1956 and September 1964，and who had physical examination in the Health Management（Physical Examination） Center of The Second Affiliated Hospital of Chongqing Medical University in 2018. In order to reduce the bias caused by age factors，1 818 participants born before the famine（from October 1956 to September 1958） and 4 156 participants born after the famine（from October 1962 to September 1964） were combined as the control group（n=5 974），and those who were born during the famine year（from October 1959 to September 1961） were designated as the famine exposure group（n=1 492）. Chi-square test was used to compare the preva－lence of diabetes，hypertension and hyperlipidemia between the famine exposure group and control group，and the effect of famine in early life on diabetes，hypertension and hyperlipidemia in adulthood was examined using a logistic regression model. Results：The total prevalence of type 2 diabetes among partici－pants was 11.3%，and the prevalence of diabetes in control group and famine exposure group was 10.7% and 13.6%，respectively，with statistically significant differences（P=0.001）. The mean fasting glucose of the famine exposure group was higher than that of the control group[（5.89±1.86） mmol/L vs. （5.76±1.65） mmol/L，P=0.005]. The total prevalence of hypertension and hyperlipidemia was 29.7%，and 35.3%，respectively，and there was no statistically significant difference between the control group and the famine exposure group. Logistic regression analysis showed that famine exposure in early life was the risk factor of type 2 diabetes（OR=1.321，95%CI=1.112-1.569，P=0.001），but not of hypertension and hyperlipidemia. The analysis of stratification by gender showed that famine exposure in early life was the risk factor of type 2 diabetes of males in adulthood but not of females（OR=1.458，95%CI=1.197-1.776，P=0.000）. Conclusion：In Chongqing，exposure to famine in early life may increase the risk of type 2 diabetes in adulthood，which is mainly present in males. However，it may have no effect on the occurrence of hypertension or hyperlipidemia. Therefore，balanced nutrition in early life is of great significance to prevent the occurrence of type 2 diabetes in adulthood.

Abstract:Objective：To explore the effect of glycemic variability（GV） on the prognosis of critically ill children and to find the best indicators of GV. Methods：A total of 280 critically ill children admitted to the pediatric intensive care unit（PICU） of the Children’s Hospital of Chongqing Medical University from January 1st，2020 to August 31st，2020 were prospectively included in the study. The patients were divided into survivors or non-survivors according to the 28-day outcomes after PICU admission. Physiological parameters and outcomes data were recorded for 72 h after PICU admission，and the statistical analyses were made by several statistical methods such as the receiver operating characteristic（ROC） curve and logistic regression analysis. Results：①In different indicators of GV，glycemic standard deviation（SD）（AUC=0.759，95%CI=0.688-0.830，P<0.001） and glycemic lability index（GLI）（AUC=0.752，95%CI=0.680-0.825，P<0.001） were superior to the others for the prognosis. Multivariate logistic regression analysis also showed that SD（OR=3.356，95%CI=1.536-7.332，P=0.002），PIM（pedi－atric index of mortality） scores（OR=1.155，95%CI=1.023-1.303，P=0.020） and stay of PICU（OR=0.895，95%CI=0.837-0.956，P=0.001） showed an independent association with PICU 28-day mortality. ②Different from adult studies，there was a heteroge－neous effect of GV on children，and subgroup analysis disaggregated by tertiles of Mean and GV revealed that critically ill children in the lowest tertile of the Mean and in the highest tertile of GV had significantly highest mortality. Conclusion：GV can increase the risk of mortality in critically ill children，and among all glucose parameters，SD and GLI may be the dominant predictors representing for GV. Clinicians should pay more attention to GV as well as average blood glucose.

Abstract:Objective：To evaluate the efficacy and safety of belimumab in patients with active or refractory systemic lupus erythe－matosus（SLE）. Methods：Retrospective analysis was made of 7 patients with SLE who were treated with belimumab for more than half a year in the Department of Rheumatology and Immunology，The Second Affiliated Hospital of Chongqing Medical University. Systemic lupus erythematosus disease activity index（SLEDAI），prednisone and immunosuppressor dose，complete blood count，anti-dsDNA antibody，C3 and C4 were collected，and serum creatinine，urine routine，and total proteinuria of patients with renal involvement were collected at the same time. Then，the above indexes were collected every 3 months，and adverse events during follow-up were also recorded. SPSS software was used for statistical analysis. Results：Seven patients（all female） received belimumab for more than 6 months. The most common clinical manifestation of belimumab was impaired blood system（71.4%），followed by renal impairment（42.9%）. The SLEDAI decreased during the follow-up，with statistical significance（P=0.006）. During the treatment，the anti-dsDNA antibody level significantly decreased（P=0.022） and the complement C4 level significantly increased（P=0.017）. The mean dose of prednisone decreased over time，reaching a maximum at baseline and a minimum at 6 months[（40.71±12.72） mg/d to （14.64±15.91） mg/d，P=0.001）]. Patients were well tolerated with belimumab，and 3 patients（42.9%）had adverse events，including 1 case of urinary tract infection，1 case of herpes zoster，and 1 case of viral conjunctivitis. Conclusion：In 7 patients with systemic lupus erythe－matosus treated with belimumab，SLE disease activity and glucocorticoid dose were significantly reduced，with good safety.

Abstract:Objective：To investigate the prevalence and characteristics of infectious diarrhea caused by diarrheagenic Escherichia coli（E. coli） from 2015 to 2019 in a district of Shanghai，and to provide reference for prevention and control of infectious diarrhea. Methods：The surveillance data of the newly diagnosed suspected bacterial diarrhea in a tertiary hospital in Qingpu District of Shanghai from 2015 to 2019 were collected，and the epidemiological characteristics were analyzed by descriptive epidemiological method. Results：From 2015 to 2019，among the 4 494 patients’ stool or anal swab specimens，513 cases of diarrheagenic E. coli were detected，with the detection rate of 11.42%，and the mainly was enterotoxigenic E. coli（66.08%，339 cases），followed by enteroaggregative E. coli（18.91%，97 cases） and enteropa-thogenic E. coli（14.42%，74 cases）. The detection rate of diarrheagenic E. coli from 2015 to 2019 respectively was 9.10%，11.35%，16.57%，10.30% and 10.67%，and the differences among years were statistically significant（ ?字2=116.962，P<0.001）. The infectious diarrhea caused by diarrheagenic E. coli was commonly to see in summer and autumn. The main diarrhea symptom was watery stool（87.13%，447 cases），and some were accompanied with abdominal pain，nausea，vomiting or fever，among which 86.16% was single infection. The fever rate and abdominal pain rate of composite infection group were lower than those of single infection group，with statistical significance（fever： ?字2=4.936，P=0.026；abdominal pain： ?字2=17.079，P＜0.001）. There was significant difference in the detection rate among different age groups（ ?字2=40.672，P<0.001），with the highest detection rate in 21-30-year-old group（15.97%）. The detection rate of cadre staff（17.48%），medical staff（18.18%） and teachers（18.60%） was relatively high，with significant differences among the detection rate among different occupations（ ?字2=23.554，P=0.001）. Conclusion：The detection rate of diarrheagenic E. coli in Qingpu is quite high，mainly enterotoxigenic E. coli，showing local epidemic characteristics，mainly found in workers，and the differences among different ages and occu－pations are statistical significant. To survey its prevalence and characteristics can effectively provide scientific data for the prevention and control.

Abstract:Objective：To observe the characteristics of bronchial ultrasound imaging in patients with bronchial anthracofibrosis（BAF）and provide effective clinical clues for the prevention and treatment of the disease. Methods：From April 2018 to October 2019，113 patients with BAF who underwent bronchoscopy and treatment in the Department of Respiratory and Critical Care Medicine of People’s Hospital of Honghuagang District，Zunyi were selected as the research objects. BAF patients were classified into 31 cases of flat type，38 cases of deep retraction type，and 44 cases of mucosal protrusion type under the microscope. Except for black lesions，the lesions under microscope were statistically counted，such as bronchial swelling，bronchial occlusion，etc. The segmental and sub-segmental bronchus were examined by ultrasound with a small ultrasound probe to analyze the maximum tube wall and submucosal thickness，and to compare the average of the submucosal and bony tissue area of each subtype of BAF. Results：In this study，13 patients（11.5%） had a history of tuberculosis in the BAF group. In addition，57 patients（50.4%） were exposed to biofuels in the BAF group. The average exposure time was（17.4 ± 6.2） years，and the incidence of BAF accounted for 10% of the total number of bronchoscopy in our hospital. Using Image J 18.0 to magnify the airways of each BAF subgroup and measure the various indicators of the tube wall，it was found that the maximum wall thickness of the deep retracted type [（17.3±5.7） mm] and the black protruding type [（19.3±5.4） mm] was significantly higher than that of the flat group [（12.5±5.0） mm]，with statistically significant differences（P<0.05）. The maximum thickness of the submucosa of the deep retracted type [（9.8±3.0） mm] and the black protruding type [（14.5±5.0） mm] was significantly increased compared with the flat type [（6.6±3.5） mm]（P<0.05）. The area ratio of the bone tissue between the flat BAF group and the black protrusion type was （33.3±9.3）% and（34.9±12.1）%，which was significantly reduced than that of the deep retracted type [（65.2±8.7）%]（P<0.05），and the black protrusion type [（34.9±12.1）%] had no significant change compared with flat type（P>0.05）. Conclusion：The distal airway of patients with BAF has abnormal ultrasound imaging characteristics，and there are differences in the airway mucosal structure and bony imaging of different subtypes of BAF. Therefore，we speculate that bronchial ultrasound imaging and airway wall structure analysis may become important reference indicators for the diagnosis of different subtypes of BAF，and also provide clinical clues for understanding the characteristics of the distal airway.

Abstract:Objective：To compare the clinical effects of elastic intramedullary nail and steel plate in the treatment of tibial shaft fracture in children. Methods：A total of 110 children with tibial shaft fractures treated in the Department of Orthopaedics of Dazhou Central Hospital from January 2017 to January 2021 were selected，including elastic intramedullary nail group（n=58） and steel plate group（n=52）. The intraoperative blood loss，total incision length，operation time，hospital stay，hospitalization expenses，fracture healing time，functional recovery scores and complications were compared between the two groups. Results：The total incision length[（4.1±0.8） cm]，operation time[（42.0±6.2） min]，hospitalization cost[（15 000±7 000） yuan] and fracture healing time[（10.6±1.1）weeks] in the elastic intramedullary nail group were lower than those in the steel plate group[（10.2±1.4） cm，（65.0±7.6） min，（21 000±5 000） yuan and （12.4±1.3） weeks]. The excellent and good rate of functional recovery in the elastic intramedullary nail group（98.3%） was significantly higher than that in the steel plate group（86.5%）（P<0.05）. There was no significant difference in intraop－erative blood loss（using tourniquet） and hospital stay between the elastic intramedullary nail group and the steel plate group（P >0.05）. In terms of complications，the infection rate in the elastic intramedullary nail group（1.7%） was lower than that in the steel plate group（13.5%），and the joint stiffness rate in the elastic intramedullary nail group（15.5%） was higher than that in the steel plate group（3.8%）. There was no significant difference in fracture alignment，delayed fracture healing or nonunion and unequal length of both lower limbs between the two groups（P >0.05）. Conclusion：The indications of elastic intramedullary nail and steel plate are different. Elastic intramedullary nail has more advantages in the selection of internal fixation of tibial shaft fractures in children，and is suitable for clinical application.

Abstract:Objective：To investigate the early imaging features of pulmonary nodules which are ≤ 10 mm in diameter by computed tomography（CT）. Methods：A total of 152 cases with pulmonary nodules which were pathologically confirmed from April 2014 to November 2020 were collected，including 51 benign cases and 101 malignant cases. Imaging features including average diameter，density（solid，mixed ground glass，purely ground glass），position，relationship between lesions and pleura（subpleural，away from the pleura），shape（round，oval，irregular），boundary（clear，unclear），margin（lobulation，spiculation sign），air-bronchogram sign，vacuole sign，vessel convergence sign，central vessel signs，pleural indentation sign，satellite foci and alteration of the adjacent bronchioles were assessed. The sensitivity，specificity，accuracy，the positive predictive value and negative predictive value were calculated by comparison of the results analyzed by Shenrui Pulmonary Nodule Analysis Software and the gold standard to determine valuable imag－ing features. Results：According to the analysis of the software，among the 152 cases，there were 94 malignant cases（62 cases of lung adenocarcinoma，30 cases of carcinoma in situ，1 case of carcinoid and 1 case of squamous cell carcinoma），47 benign cases（5 cases of tumor-like hyperplasia，3 cases of hamartoma，34 cases of inflammatory granuloma，3 cases of inflammatory pseudotumor，1 case of fungal infection and 1 case of fibrous carbon nodule）. The results of the lung nodule analysis software demonstrated the sensitivity，specificity，accuracy，the positive predic－tive value and negative predictive value were 93.06%，92.15%，92.76%，95.91% and 87.03% respectively，which were consistent with the pathological results after surgery. Conclusion：CT-imaging analysis based on AI pulmonary nodule analysis software has a great differential value in qualitative diagnosis of pulmonary nodules ≤ 10 mm in diameter.

Abstract:The dynamic changes of inflammatory immunity in critically ill patients usually run through the occurrence and develop－ment of the disease. Immunoregulation under dynamic monitoring will be a future direction in the treatment of severe patients. Dexmedetomidine（DEX），a derivative of imidazole，is a strongly selective α2-adrenergic agonist with anti-anxiety，sedative and analgesic effects. Due to its combined analgesic and sedative effects and no obvious risk of respiratory depression，it is beneficial to cooperative or semi-conscious sedation in severe patients. It is usually used for mild to moderate sedation in intensive care unit and widely recognized. At the same time，DEX also has anti-inflammatory，antioxidant，anti-apoptosis and other immune regulatory effects，and has potential therapeutic value in severe patients with abnormal inflammatory immune state. At present，the immunomodulatory effects of DEX in sepsis，acute respiratory distress syndrome and other organ damage have attracted much attention. In this paper，the research progress of the immunomodulatory effects of DEX in severe patients and its mechanism are reviewed.

Abstract:Psoriasis is a common chronic inflammatory skin disease. Diabetes is a group of metabolic diseases characterized by chronic hyperglycemia due to absolute or relative deficiencies in insulin secretion and insulin resistance. Current epidemiological studies indi－cate that patients with psoriasis have a significantly higher risk of developing diabetes than the general population. Patients with psoriasis have significantly higher levels of tumor necrosis factor-α（TNF-α） which plays an important role in insulin resistance. It has been found that four susceptible genes of psoriasis，CDKAL1，PSORS2，PSORS3 and PSORS4，are related to type 2 diabetes mellitus. In addition，our previous studies suggested that an hypoglycemicdrug，thiazolidinediones，can also improve the psoriasis skin lesion symptoms by changing the hypodermic chronic inflammatory state while treating the type 2 diabetes mellitus. Therefore，this paper summarizes the relevant research progress，analyzes the possible pathophysiological mechanisms，and related therapies for these two diseases.

Abstract:Glomerular filtration rate（GFR） is an ideal indicator for estimating renal function. In the past，exogenous inulin or endoge－nous serum creatinine and creatinine-derived formula were used to estimate GFR，with many shortcomings. Therefore，a rapid and accurate way to assess GFR is in urgent need，avoiding the omission of early diagnosis of irreversible kidney injury. Recent studies have shown that new endogenous markers（β-trace-protein and β2-microglobulin，etc.） combination method，new exogenous bedside rapid determination of GFR technology（visible fluorescent injection），new prediction formula method（new type Xiangya equation，KeGFR equation，etc.），and metabolomics provide possibilities for rapid clinical evaluation of GFR. The article has briefly reviewed the traditional GFR assessment methods，discussed the improvement of traditional GFR assessment methods，and analyzed advantages and disadvantages of new GFR assessment technology，so as to promote the clinical transformation of new GFR technologies.

Abstract:Neovascular age-related macular degeneration（nAMD） is an ocular disease causing blind，characterized by choroidal neovascularization（CNV）. Anti-vascular endothelial growth factor（VEGF） therapy has become the first-line treatment of nAMD and gains good therapeutic effects on improving and maintaining eyesight. At present，the frequency of anti-VEGF therapy is not unanimous，but main therapeutic strategies at home and abroad contain monthly and bimonthly fixed treatment，PRN regimen，treat and extend（T & E） regimen. In recent years，studies have found that T & E regimen shows the superiority in guaranteeing visual benefits and reducing injections，which is recommended by experts recently. However，the therapeutic effect and frequency still need to be studied. This review summarized the recent updates on T & E regimen among various anti-VEGF agents for the treatment of nAMD，hoping to supply a reference for clinical treatment.

Abstract:

Abstract:Objective：To observe the neuroprotective effect of overexpression of neuroglobin（Ngb） on the cognitive function of Alzheimer’s disease（AD） double transgenic（APPswe/PS1dE9） mice，and to explore its mechanisms. Methods：The Ngb plasmid pNgb and empty vector pCDNA3.1 were successfully constructed and injected into the lateral ventricle of AD double transgenic（APPswe/PS1dE9） mice，which both led to overexpression of Ngb. Morris water maze was used to evaluate the effect of overexpression of Ngb on learning and memory ability and spatial exploration ability of AD mice；immunohistochemistry was used to detect the production of amyloid β-protein 42（Aβ42） in the brains；Caspase-3 and Caspase-9 activity detection kits were applied to detect Caspase-3/9 enzyme activity. Finally，the expression of p-Akt（ser473），total Akt and Caspase-3/9 in the brain tissues were detected by Western blot. Results：Overexpression of Ngb signif－icantly improved the learning and memory and spatial explo－ration ability of the AD mice（P<0.05），and reduced the activities of Caspase-3 and Caspase-9 and the generation of Aβ42 in the hippocampus（P<0.05）. Finally，Western blot results showed that overexpression of Ngb could inhibit the expression of Caspase-3 and Caspase-9 in the hippocampus of the AD mice（P<0.05），and also promote the phosphorylation of p-Akt（ser473）（P<0.05）. While，after the treatment of phosphatidylinositol-3 kinase（PI3K） inhibitor LY294002，the activities of Caspase-3 and Caspase-9 were evidently increased（P<0.05）. Conclusion：Overexpression of Ngb has a significant neuroprotective effect on the AD double transgenic（APPswe/PS1dE9） mice，and the mechanisms may be related to the reduction of generation of Aβ42，and the activation of PI3K/Akt signaling pathway，and then the inhibition of Caspase-dependent apoptosis pathway by Ngb.