Abstract:Objective:　To investigate the effect of miR-29b-3p targeting FoxO3 on non-alcoholic fatty liver disease (NAFLD). Methods:　Human hepatocytes HL-7702 (L02) were transfected with miR-29b-3p inhibitor, NC inhibitor or pcDNAFoxO3. After palmitic acid (PA) treatment, oil red O staining was used to determine lipid accumulation, fully automatic biochemical analyzer to detect the content of triglycerides (TG) and total cholesterol (TC), ELISA to detect the content of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA), RT-qPCR to detect the expression of forkhead box class O3 (FoxO3), miR-29b-3p mRNA, Western blot to detect the expression of FoxO3 protein, and dual luciferase experiments to verify miR-29b-3p targeting FoxO3. Results:　Compared with the control group, the expression of TG (2.05 ± 0.22) mmol/L, TC (7.80 ± 1.23) mmol/L, TNF-α (149.67 ± 8.96) %, IL-6 (157.00 ± 18.33) %, IL-8 (177.33 ± 24.58) %, miR-29b-3p (161.00 ± 13.0) %, MDA (0.456 ± 0.028) nmol/mL and the number of lipid droplets dyed red by Oil Red O in the PA group was significantly increased; the content of SOD (12.91 ± 0.53) ng/mL, GSH-Px (0.515 ± 0.038) ng/mL and the expression of FoxO3 (65.93 ± 4.56) % were significantly reduced; miR-29b-3p targeted FoxO3. Compared with PA group, PA + miR-29b-3p inhibitor group, PA + miR-29b-3p inhibitor + pcDNA-FoxO3 group significantly reduced the content of TG, TC, TNF-α, IL-6, IL-8, miR-29b-3p, MDA and the number of oil droplets dyed red by Oil Red O, and significantly increased the content of SOD and GSH-Px. Conclusion:　MiR-29b-3p targeting FoxO3 can reduce PA-induced lipid accumulation and inflammation in L02 cells.

Abstract:Objective:　To investigate the relationship between the expression level of basophil surface molecules in patients with asthma-chronic obstructive pulmonary disease overlap (ACO) in acute period and in remission period. Methods:　Totally 32 healthy people and respectively 14 cases of acute and remission ACO patients admitted to The Third Affiliated Hospital of Jinzhou Medical University were collected in the study. By collecting the venous blood from the elbow, the basophils were obtained by flow cytometry using three gating strategies. In order to compare the expression levels of basophil surface molecules (CD63, CD203c, FcεRI) between patients and healthy groups at different stages, the results and disease states were retrospectively studied. Results:　The Mean fluorescence intensity (MFI) of CD63 in acute basophil was significantly different from that in healthy group (P<0.05), and there was no significant difference in CD203c and FcεRI in acute basophil compared with that in healthy group. The MFI of CD63 and FcεRI in the remission phase was significantly different from that in the healthy group (P<0.05), and the MFI of CD203c in the remission phase was not significantly different from that in the healthy group (P>0.05). There were no significant differences in the MFI of CD63, CD203c and FcεRI in the basophil between the acute phase and the remission phase. The MFI of CCR3⁺, CCR3⁺/CD123⁺HLA-DR^- and CD123⁺HLA-DR^- in acute and remission stages was significantly different from that in healthy groups (P<0.001). Conclusion:　The expression of CD63 and FcεRI on the surface of basophil in the ACO patients is enhanced, suggesting that basophil is involved in the pathogenesis of ACO, and the detection of its surface molecular expression is suggestive to the judgment of ACO condition.

Abstract:Objective:　To investigate the effect of subanesthetic dose of ketamine on gut microbiota among male and female depressed mice. Methods:　The study included in 20 healthy male SPF mice and 20 female C57BL/6 mice, and they were randomly assigned to eight groups (n=5): female control group (FC group), female control with ketamine treatment group (FCK group), female depression group (FD group), female depression with ketamine treatment group (FDK group), male control group (MC group), male control with ketamine treatment group (MCK group), male depression group (MD group) and male depression with ketamine treatment group (MDK group). The ketamine (10 mg/kg) or saline (0.9% NaCl) were administrated by intravenation in each group. FD group, FDK group, MD group and MDK group were modeled by the chronic unpredictable mild stress (CUMS). The behavioral tests included force swimming test, sucrose preference test and open filed test. The gut microbiota of mice was detected by 16S rDNA amplicon sequencing. Qualitative analysis of bacteria in the specimen and predictive analysis of 16S rDNA function genes were conducted. The results were reported as mean values with their standard errors, and submitted to one-way ANOVA regardless sex difference and two-way ANOVA to analyze the effect of sex and ketamine on ameliorate depressive-like behaviors in mice, followed by the Tukey multiple comparisons test, with a statistical significance (P<0.05). Results:　Compared with control group, the scores of forced swimming test were significantly prolonged, the scores of the sucrose preference test was significantly decreased, and the scores of open field test were significantly decreased (all P<0.05). These results were significantly ameliorated to varying degrees after subanesthetic dose of ketamine treatment (P<0.05). The diversity and abundance of intestinal flora in each group did not change significantly after CUMS and ketamine treatment. The reduction of Actinobacteria could be improved by subanesthetic dose of ketamine in depressed mice, regardless of sex difference. Furthermore, the relative abundance of Bacteroidaceae could be alleviated in depressed female mice, and Alistipes increased in depressed male mice. Conclusion:　Mice of different genders showed different changes of intestinal flora in response to CUMS stimulation and subanesthetic ketamine treatment. The depressive-like behaviors can be ameliorated through increasing the abundance of Actinobacteria, alleviating the abundance of Bacteroidaceae in depressed female mice, and increasing Alistipes in depressed male mice after ketamine treatment.

Abstract:Objective:　To explore the function of RNA-binding protein ABCF1 in the development of human acute myeloid leukemia (AML). Methods:　The clinically diagnosed AML patients were enrolled in the experimental group, and normal people in the control group. The expression level of ABCF1 mRNA was respectively detected by RT-qPCR in peripheral blood mononuclear cells (PBMCs) of normal people and bone marrow nucleated cells of AML patients.Human monocytic leukemia cell line THP-1 was infected with two shRNA lentivirus particles targeting ABCF1.The proliferation of THP-1 cells was detected by CCK-8 analysis, and apoptosis and cell cycle were detected by PI and Annexin V staining combined with flow cytometry.RNA pull-down test was carried out by using ss-m6A and ss-A probes, and the binding ability of ABCF1 and m6A was analyzed. Results:　The expression of ABCF1 in AML patients in experimental group was significantly higher than that in control group (P<0.01). ABCF1 knock-down significantly promoted apoptosis (P<0.05), and suppressed cell proliferation (P<0.001), as well as affected the cell cycle of THP-1 cells. Conclusion:　ABCF1 plays an important role of proto-oncogene in THP-1 cells derived from AML cells and regulates the physiological functions of THP-1 cells.

Abstract:Objective:　To analyze the epidemic trends and risk factors of ovarian cancer in Chinese women from 1990 to 2019, and to provide a more scientific basis for the prevention of ovarian cancer in China. Methods:　The estimated numbers and age-standardized rates of incidence, death and disability-adjusted life years of ovarian cancer in China and other areas were obtained from the Global Disease Burden 2019 database, and the changes of epidemic burden and risk factors of ovarian cancer in China were compared and evaluated. The incident numbers and death numbers of ovarian cancer in China from 2020 to 2040 were predicted by the GLOBOCAN database. Results:　Mainland China and Taiwan province in China had increased the incidence of ovarian cancer from 2.56/100 000 and 4.72/100 000 to 4.54/100 000 and 8.68/100 000 during 1990 to 2019, and the age standardized mortality increased from 1.76/100 000 and 2.63/100 000 to 2.77/100 000 and 3.84/100 000, which increased by more than half of the global, including Japanese and Singapore. Among them, women aged 50-54 had the highest incidence and the peak was 70-74 years old. The three major risk factors for ovarian cancer death in 2019 were high fasting blood glucose, high body mass index and occupational asbestos exposure. In the past 30 years, the age-standardized disability-adjusted life year rates (DALY) of ovarian cancer in China increased with rising socio-demographic index (SDI). In addition, according to the prediction of GLOBOCAN database, the disease burden of ovarian cancer in China would continue to increase. By 2040, the incident cases of patients would be expected to increase by 17.9% and the number of deaths would increase by 33.0% compared with 2020. Conclusion:　The disease burden of ovarian cancer among women in China is still heavy and rising. It is necessary to take corresponding effective preventive measures for different age groups and risk groups and strengthen the monitoring of high-risk groups, so as to further reduce the disease burden.

Abstract:Objective:　To analyze the 10-year risk of stroke among hypertensive patients in Chengdu. Methods:　A total of 3 642 patients with hypertension who were treated in the West China Hospital of Sichuan University in Chengdu from November 2019 to June 2020 were selected as the research objects. The basic situation of patients and the risk of stroke were investigated by Framinghan stroke risk assessment scale of the United States. Results:　The mean age of patients in this group was (63.89±10.99) years old, the mean systolic blood pressure was (150.01±21.36) mmHg, the incidence of complications such as diabetes, atrial fibrillation, cardiovascular disease and left ventricular hypertrophy was 14.36%, 6.81%, 30.56% and 6.51%, the smoking rate was 9.25%, and the utilization rates of antithrombotic, lipid-regulating, antihypertensive and hypoglycemic drugs were 53.13%, 37.37%, 93.19% and 5.38%. The 10-year incidence risk of stroke in this group was (15.02±12.58) %, male and female were (16.44±11.57) % and (13.78±13.28) %, respectively. The proportions of male patients with low, medium and high risk were 11.38%, 19.34% and 69.28%, respectively. The proportions of female patients with low risk, medium risk and high risk were 30.88%, 22.97% and 46.15%. Conclusion:　Patients with hypertension in Chengdu have a high risk of stroke in ten years. Cardiologists shall actively help patients control of blood pressure, emphasize the importance to quit smoking, at the same time attach great importance to the diabetes, atrial fibrillation, cardiovascular disease and left ventricular hypertrophy and other complications of detection and early intervention, and reduce the risk in patients with stroke, so as to realize the ultimate goal of reducing the incidence of cerebral apoplexy.

Abstract:Objective:　To understand the common allergens of children, and to provide a scientific reference for the prevention and treatment of allergic diseases of children in Chongqing. Methods:　A retrospective study was conducted among 10 183 children (6 245 males and 3 938 females) who had skin prick tests for allergens in 6 different hospitals in the urban area of Chongqing and its surrounding districts and counties from January 2018 to June 2020. The statistical analysis was made by chi-square test/Fisher’s exact test. Results:　The positive rate of more than one allergen detection was 61.40%. The top three positive rates of inhalation allergen in different allergic diseases were bronchial asthma (45.71%), chronic cough (22.79%) and allergic rhinitis (16.06%). In bronchial asthma, chronic cough, variant rhinitis, cough variant asthma, conjunctivitis, adenoid hypertrophy, the positive detection rate of inhalation was higher than that of ingestion (P<0.05). The positive detection rate of ingestion in allergic dermatitis was significantly higher than that of inhalation (P=0.007). There were differences in the intensity distribution of positive responses to different inhaled allergens (P=0.000), and the positive responses of house dust mites and dust mites were mainly "+++" to "++++". There were differences in the intensity distribution of positive reactions to different ingestion allergens (P=0.000), and eggs were mainly positive reactions of "+++" to "++++". The highest positive proportion of allergens detected in corn pollen was 6.62%, among the different pollens. The distribution of allergens in different age groups between different genders was statistically different (P=0.004). Among them, the proportion of positive allergens in 3-6 years old is higher than that in the 6-18 year old group, and the positive detection rate of boys is higher than that of girls of the same age group, and the difference was statistically significant (P=0.006). The positive detection rate of inhaled allergens increased with age, and the positive detection rate of ingested allergens was highest within 1 year of age. There was a statistical difference between inhaled and ingested allergens between different quarters (P=0.000), in which the first quarter was lower than the third quarter (P=0.000), the second quarter was higher than the third quarter (P=0.004), and the fourth quarter was lower than the third quarter (P=0.049). Conclusion:　The inhaled allergens of children in Chongqing are mainly household dust mites, dust mites and cockroaches, and the ingested allergens are mainly sea crabs, eggs and shrimp. The epidemic trend tends to 3-6 years old and 6-18 years old, male, and high prevalence from April to June, and it is mainly detected in the form of respiratory disease. This study provides direction for the treatment and prevention of children’s allergen diseases in Chongqing, with important reference value.

Abstract:Objective:　To investigate and analyze the detection rate and influencing factors of non-alcoholic fatty liver disease (NAFLD) in adult male healthy subjects in Southeast Chongqing, and to provide reference for the prevention and treatment of NAFLD. Methods:　A total of 16 792 men who underwent physical examination in the physical examination center of a grade three hospital in Southeast Chongqing were selected as the research objects, and their data were retrospectively analyzed. The detection rate of NAFLD was calculated and the related risk factors of NAFLD were analyzed by univariate and multivariate Logistic regression. Results:　Among the subjects, 3 441 were NAFLD patients, with the detection rate of 20.5%, and the detection rate was highest in 51 to 60 years old group (29.4%). The mean levels of body mass index (BMI), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and alanine transaminase (ALT) in NAFLD group were significantly higher than those in non-NAFLD group (P<0.01) and high density lipoprotein cholesterol (HDL-C) was significantly lower than that in non-NAFLD group (P<0.01). Multivariate Logistic regression analysis showed that age, BMI, hypertension, triglyceride and ALT were independent risk factors for NAFLD (P<0.01). Conclusion:　The detection rate of nonalcoholic fatty liver disease in male population in Southeast Chongqing is relatively high, with the highest onset among 51-60 years old group. Ultrasound screening of NAFLD should be focused on those with obesity, hypertension, and rised triglyceride and ALT levels for the prevention and treatment of NAFLD.

Abstract:Objective:　To understand the factors affecting maternal mortality in minority areas of Sichuan Province. Methods:　The maternal death case cards from 2014 to 2018 in the ethnic regions of Sichuan Province were analyzed retrospectively. Results:　The birthplace and death place of pregnant women who died in the minority areas of Sichuan Province were mainly in district and county-level hospitals, and obstetric hemorrhage was the first cause of death. Conclusion:　In ethnic areas of Sichuan Province, efforts should be made to strengthen the prevention and treatment of obstetric hemorrhage and the management of women health care during pregnancy and childbirth.

Abstract:Objective:　To carry out an external validation of the modified S.T.O.N.E. nephrolithometry scoring system, and to evaluate its effectiveness in predicting the stone-free rate (SFR) of flexible ureteroscopic lithotripsy (FURL). Methods:　Clinical data of 396 patients with nephrolithiasis undergoing FURL from May 2018 to October 2021 were collected, and the modified S.T.O.N.E. nephrolithometry scoring system was evaluated. The correlation of modified S.T.O.N.E. nephrolithometry scoring system scores and each variables with one-phase SFR was analyzed. The receiver operating characteristic curve (ROC) was computed to estimate the value of the predictive models, and Hosmer-Lemeshow goodness-of-fit test was used to examine the calibration of the prediction models. Results:　All 396 cases of FURL operation were performed successfully, and the one-phase SFR was 76.8%. The median of the modified S.T.O.N.E. nephrolithometry scoring system score was 6 (4 to 12) in this cohort. The modified S.T.O.N.E. nephrolithometry scoring system score showed significant correlation with the postoperative SFR of FURL (OR=6.627, 95%CI=3.620-12.131, P=0.001). The area under curve of ROC in the state of stone clearance after FURL operation was 0.778 (95%CI=0.723-0.834). Hosmer-Lemeshow goodness-of-fit test showed that the modified S.T.O.N.E scoring system had satisfactory calibration in predicting SFR (χ²=0.824, P=0.844). Conclusion:　The modified S.T.O.N.E. nephrolithometry scoring system can accurately predict postoperative stone-free status of FURL, and provide assistance in pre-operative evaluation and clinical decision-making.

Abstract:Objective:　To compare the clinical efficacy of intelligent pressure controlled negative pressure suction flexible ureteroscopic lithotripsy and ordinary flexible ureteroscopic lithotripsy in the treatment of renal cast stones. Methods:　The clinical data of 64 patients with renal cast stones who underwent flexible ureteroscopic lithotripsy in The First Affiliated Hospital of Chongqing Medical University and Ganzhou People's Hospital from September 2017 to August 2021 were analyzed retrospectively. There were 42 males and 22 females, with an average age of 50.9 years. Among them, 41 cases underwent intelligent pressure controlled negative pressure suction flexible ureteroscopic lithotripsy (pressure controlled group), and 23 cases underwent ordinary electronic flexible ureteroscopic lithotripsy (non-pressure controlled group). The t test, Chi-square test or Fisher's exact test were used to compare the free stone rate, incidence of complications, postoperative white blood cells, operation time, hospital stay and total hospitalization cost between the two groups. Results:　The operation time in the pressure controlled group was longer than that in the non-pressure controlled group [ (78.9±29.8) min vs. (60.7±32.1) min, t=2.278, P=0.026], the free stone rate was higher than that in the non-pressure controlled group (73.1% vs. 0%, χ²=28.808, P=0.000), and the total hospitalization cost was lower than that of the non-pressure controlled group [ (24 215.9±3 848.8) vs. (26 497.9±4 230.2), t=2.196, P=0.032]. There was no significant difference between the two groups in the incidence of complications (19.5% vs. 17.3%, χ²=0.044, P=0.835), the length of hospital stay [ (8.22±2.94) d vs. (6.87±1.79) d, t=1.997, P=0.05] and postoperative white blood cells [ (9.83±5.72) ×10^9/L vs. (9.06±2.49) ×10⁹/L, t=0.067, P=0.546]. Conclusion:　For renal cast stones, intelligent pressure controlled negative pressure suction flexible ureteroscopic lithotripsy has higher free stone rate, less total hospitalization cost and higher benefit for patients than ordinary electronic flexible ureteroscopic lithotripsy.

Abstract:Objective:　To explore the application of bronchoscopy in children with protracted bacterial bronchitis (PBB). Methods:　The clinical data of 50 hospitalized children diagnosed with PBB were retrospectively analyzed, who admitted to the Department of Respiratory of Children's Hospital of Chongqing Medical University from September 2016 to September 2020. Bronchoscopy was performed on all cases. Results:　Among the 50 PBB children, the age ranged from 6 months and 8 days to 12 years and 8 months, with an average age of (55.1±33.0) months, including 4 cases (8.0%) less than 1 year old, 12 cases (24.0%) between 1-3 years old, 24 cases (48.0%) between 3-7 years old, 9 cases (18.0%) between 7-12 years old, and 1 case (2.0%) older than 12 years old. In addition to chronic wet cough, the children with wheezing accounted for 50.0%. All the 50 cases were examined by bronchoscopy and culture of bronchoalveolar lavage fluid (BALF). Bronchoscopy showed a chronic endobronchial inflammation. There were 24 cases with large amount of white secretions, 22 cases with large amount of yellow secretions, 3 cases with little white secretions, and 1 case with phlegm thrombus. The neutrophil ratio of bronchial alveolar lavage fluid fluctuated between 5% and 94%. There were 26 positive cases in both sputum culture and BALF culture, and the positive rate was 52.0%. The main pathogens were Haemophilus influenzae and Streptococcus pneumoniae. The therapeutic drug was mainly amoxicillin clavulanate potassium and the third-generation cephalosporin. Twenty patients adjusted the use of antibiotics according to their clinical symptoms, bronchoscopic manifestations and BALF culture results. At the same time, 17 children were re-hospitalized for multiple bronchoscopic lavage. Individual children chose to improve next generation sequencing (NGS), mucosal biopsy and total exome gene detection to determine the etiology. Conclusion:　PBB is commonly seen in toddler and pre-school age, characterized by persistent wet cough, and easy to be accompanied by wheezing. Bronchoscopy shows chronic endobronchial inflammation changes and more secretions. The specificity and sensitivity of BALF culture can guide the treatment of antibiotics, while NGS, mucosal biopsy and total exome gene detection can be used to assist in the diagnosis and treatment of children with unknown pathogen and poor therapeutic effect. Bronchoscopy combined with antibiotics in the treatment of PBB, can improve the therapeutic effect and prognosis, which has high clinical application value.

Abstract:Objective:　To compare the variation in and internal diameters of the surrounding arteries in patients with gastric cancer and non-gastric cancer and analysis it’s impact on surgery. Methods:　A retrospective analysis of 86 cases of gastric cancer and 92 cases of non-gastric cancer from January 2018 to January 2020. All patients underwent digital subtraction angiography. The variations and the inner diameters in the gastric surrounding arteries were measured by imaging. The anatomical differences between gastric cancer and non-gastric cancer patients were analyzed. The impacts on surgical difficulty and major surgical complications were also analyzed. Results:　There were 165 (92.7%) patients in type I, 11 (6.2%) patients in type II, and 2 (1.1%) patients in type IV according to a simple classification of the left gastric artery. There were 148 (83.1%) right gastric arteries (RGAs) originating from the proper hepatic artery (PHA), 3 (1.7%) originating from the gastroduodenal artery (GDA), and 16 (9.0%) originating from the left hepatic artery or right hepatic artery. The RGA was absent in 11 (6.2%) patients. The average inner diameters of the LGA, RGA, right gastroepiploic artery (RGEA), and GDA were 2.50 mm, 1.42 mm, 1.73 mm, and 2.89 mm, respectively. The average inner diameter of the RGEA was 1.87 mm in gastric cancer patients, which was wider than the 1.60 mm in non-gastric cancer patients (P=0.001). The operation time[ (254.0±54.0) min] and surgical blood loss [ (113.5±43.0) mL] in the patients with the type Ⅰc left gastric artery were significantly prolonged, and we found that the artery variations had no impact on the major complications of the operation. Conclusion:　No difference was found in anatomical variation in patients with gastric cancer and non-gastric cancer. Patients with gastric cancer had a wider inner diameter of the RGEA. The type Ⅰc left gastric artery increased the difficulty of surgery.

Abstract:Objective:　To study the clinicopathological characteristics and CT features of primary malignant melanoma of the esophagus (PMME). Methods:　Clinicopathological characteristics and CT findings of 5 cases of PMME confirmed by surgical pathology were retrospectively analyzed, and available literatures were reviewed. Results:　The PMME of the 5 patients were all located in the middle and lower esophagus. CT scanning showed that the lesions were irregular nodules or masses protruding into the lumen, and the upper and lower diameters were greater than the transverse diameters. The esophageal wall was not uniformly thickened in the lesion area, while the esophageal wall on the opposite side of the lesion was normal. The masses were inhomogeneous or uniformly enhanced in moderate to severe. Pathological examination showed that 5 cases were fungating type with rough surface, 3 cases were dark brown, and 4 cases showed surface erosion. Under light microscope, the tumor cells were in various forms, mostly spindle or round, with voluminous cytoplasm, large nucleolus and common mitosis. Melanin granules were observed in 4 cases. Immunohistochemistry of tumor cells showed positive in S-100, HMB-45 and Melan-A. Conclusion:　PMME is rare and has no specific clinical manifestations. Although CT findings have some features, the diagnosis still depends on pathological examination.

Abstract:Objective:　To explore the value of multi-slice spiral CT (MSCT) combined with serum CA125 in the differential diagnosis of evaginated uterine fibroids and ovarian sex cord stromal tumors. Methods:　A retrospective analysis of 63 cases of pathologically confirmed evaginated uterine fibroids (group A) and 51 cases of ovarian sex cord stromal tumors (group B) was performed. CT images were used to observe the blood supply arteries, relationships of ovarian veins and tumors of the two groups, tumor enhancement characteristics, presence or absence of ascites; meanwhile CT diagnosis was made combined with serum CA125 results, using pathological results as the gold standard to detect the diagnostic accuracy of the two methods. Results:　In group A, the tumor was supplied by the uterine artery and uterine branch with or without ovarian artery. Normal ovarian tissue can be seen through the ovarian vein in most cases. Tumor enhancement is obvious, with "whirlpool sign". Serum CA125 is mostly normal, and it is not easy to be combined with ascites. In group B: The tumor was mainly supplied by the ovarian artery with or without uterine artery and ovarian branch. Ovarian vascular sign (OVPS) can be seen, and tracking the ovarian vein can’t show intact ovarian tissue. After enhancement, the tumor had no or mild delayed enhancement, and the serum CA125 increased, combined with ascites. The diagnostic accuracy rates of CT in group A and B were 90.48% (57/63) and 80.39% (41/51), respectively, and combined with serum CA125 for tumors the figures were 93.65% (59/63) and 86.27% (44/51), respectively. Conclusion:　According to the CT characteristics of the tumor and the results of serum CA125, it has a higher differential diagnostic efficacy for female pelvic evaginated uterine fibroids and ovarian sex cord stromal tumors.

Abstract:Objective:　To compare short-term outcomes between robotic-assisted and laparoscopic total mesorectal excision (TME) for rectal cancer. Methods:　A total of 365 patients diagnosed with rectal cancer in Gansu Provincial Hospital from January 2017 to January 2020 were included in this study, among which 175 patients underwent robotic-assisted TME (R-TME group) and 190 patients underwent laparoscopic TME (L-TME group). The data of intra-operative, post-operative and clinical follow-up were compared between the two groups. Results:　Compared to the L-TME group, the R-TME group had significantly less amount of bleeding [ (94.8±55.6) mL vs. (127.4±42.1) mL, t=-2.739, P=0.007], shorter first aerofluxus time [ (60.3±11.9) h vs. (78.8±12.3) h, t=-12.189, P=0.000], shorter first liquid diet time [ (89.0±15.0) h vs. (113.7±10.1) h, t=-13.597, P=0.000], shorter postoperative hospital stay [ (8.5±1.7) d vs. (10.2±2.4) d, t=-4.150, P=0.000], but more in-patient costs [ (83 538.1±10 911.0) vs. (70 640.4±11 659.0), t=6.338, P=0.000]. There were no significant differences between the two groups in operation time [ (202.9±14.7) min vs. (207.0±14.2) min, t=0.566, P=0.572], postoperative drainage time [ (5.9±1.4) d vs. (6.0±1.4) d, t=-0.516, P=0.557], and the volume of drainage [ (202.7±87.0) mL vs. (200.0±87.1) mL, t=0.335, P=0.738]. There was no significant difference in lymph node dissection, oncological results and overall postoperative complications between the two groups (P>0.05). The circumferential resection margin was negative in both groups. There was no death during the perioperative period. In terms of follow-up, 175 patients (16 lost) in the R-TME group were followed up for an average of 17.4 months, and 3 elderly patients t died of other basic diseases. In the L-TME group, 190 patients (23 lost) were followed up for an average of 16.9 months, and 6 elderly patients died of other basic diseases. No serious complications such as recurrence, incisional abdominal wall hernias and ostomy-related diseases occurred during the follow-up of the two groups. Conclusion:　Compared with laparoscopic surgery, R-TME for rectal cancer with less bleeding and faster recovery of gastrointestinal function post operation, is safe, effective and worthy of clinical application.

Abstract:Objective:　To investigate the clinical characteristics of cervical Castleman' s disease (CD) in children and summarize its clinical symptoms, classification, imaging characteristics, treatment and prognosis. Methods:　The clinical data of 9 cases of CD in children's neck from August 2015 to July 2021 in Children's Hospital of Chongqing Medical University were retrospectively analyzed. Results:　Among the 9 cases, 8 cases were unilateral and 1 case was bilateral, with 8 cases of painless mass in the neck and 1 case of snoring as the main manifestation, all of which were single-center type. The pathological types were all hyaline-vascular type. Surgical resection of the mass was performed in all the treatments, and the patients were followed up for 6–60 months after operation. Eight cases were successfully operated once, and another one underwent a second operation after recurrence. Conclusion:　Children's neck CD disease is mainly characterized by painless mass, and unicentric CD is the main clinical classification. Imaging assessment is an important pre-operative adjunct, but confirmation of diagnosis still needs histopathological analysis. Surgical resection is the most effective treatment.

Abstract:Objective:　To assess the degree of full stomach of full-term parturients and predict the risk of gastric reflux and aspiration. Methods:　A total of 169 full-term parturients with a gestational age of ≥ 36 weeks were selected and divided into two groups according to fasting time < 6 h as full stomach group and fasting time ≥ 6 h as empty stomach group. Bedside ultrasound was used to determine the long diameter, short diameter, and cross-sectional area of the gastric antrum in the right decubitus position at different time points. When the cross-sectional area of the right side decubitus > 10.3 cm2 was defined as a full stomach under ultrasound. At the same time, their age, height, weight, gestational age, fasting time, and type of food eaten at the last meal were recorded. Results:　With the prolongation of fasting time, the gastric antrum cross-sectional area of parturients gradually decreased and tended to be stable. There was statistical significance in gastric antrum cross-sectional area between full stomach group and empty stomach group (P<0.05). There were 46 parturients in full stomach group, including 18 (39.13%) with full stomach under ultrasound and 28 (60.87%) with empty stomach. Among 123 parturients in empty stomach group, 1 (0.81%) had full stomach under ultrasound and 122 (99.19%) had empty stomach. The Kappa coefficient was 0.469 (95%CI=0.341-0.643, P<0.001). The cross-sectional area of gastric antrum of pregnant women with empty stomach under ultrasound was not correlated with age, gestational age, height, weight and BMI (P >0.05). Conclusion:　It is not accurate to judge the degree of full stomach of parturients based on fasting time. For parturients with fasting time < 6 h, bedside ultrasound can reduce unnecessary clinical intervention and improve patient comfort. For parturients with fasting time ≥ 6 h, bedside ultrasound can detect potential satiety patients, improve the safety of anesthesia, and is a fast, convenient and reliable new gastric satiety assess-ment method.

Abstract:Objective:　To explore the clinical etiology and prognosis of hemophagocytic lymphohistiocytosis (HLH). Methods:　Clinical information of 56 patients with HLH was reviewed. The frequency and distribution of general information, clinical characteristic and clinical pathogen were analyzed. Survival curve by Kaplan-Meier method and log-rank test were utilized for analysis of survival time and comparison of prognosis respectively. Results:　Lymphoma was the most common cause (32.14%), followed by infection (30.36%), among which EBV infection was the most common (16.07%). Autoimmune diseases accounted for 17.86%, and primary HLH accounted for 12.50%. The survival rates of 56 patients with HLH in the 1st, 3rd, 6th, 9th, 12th, 18th month were 71.4%, 48.2%, 42.9%, 41.1%, 37.5% and 28.6% respectively. The survival curves of each etiology group were different. The survival rate of autoimmune disease group were significantly higher than that of other groups. EBV-HLH patients had lower survival rate than uninfected patients. Patients without etoposide had lower survival rate than users, and there was no significant difference in the survival rate between patients who used ruxolitinib and those who did not. Conclusion:　Lymphoma is the most common cause of HLH. The incidence and survival rate of HLH are different with different causes. EBV-HLH patients have low survival rates and poor prognosis. The use of etoposide can improve the survival rate of patients, but ruxolitinib can’t.

Abstract:Objective:　To improve clinician’s understanding of dengue fever. Methods:　The clinical data of 201 dengue fever patients admitted to the First People’s Hospital of Liangjiang New Area from August to October, 2019 were retrospectively analyzed. Chi-square was used for discontinuous variables, and t test was used for continuous variables. Results:　Among 201 dengue fever patients, 97 (48.26%) were male, and 104 (51.74%) were female. The number of them over 60 years old was 40 (19.90%). The common manifestations included fever (99.00%), feeble (85.07%), and myalgia soreness (85.57%). Laboratory examination showed that most patients had neutropenia (90.53%), thrombocytopenia (70.00%), and liver function damage (30.00%). The incidence of thrombocytopenia was higher in elderly patients than that in young and middle-aged patients (66.67% vs. 85.25%, P=0.04). In addition, the incidence of liver damage in the elderly patients was higher (50.00% vs. 25.64%, P=0.01), with more serious damage. Etiological examination showed that all patients’ dengue virus RNA (DENA-RNA) were positive, the locally infected patients were genotype 1, and two imported patients were genotype 2 and genotype 3. All patients were treated by symptomatic support to prevent complications, most patients with mild symptoms and with good prognosis. Conclusion:　In 2019, the epidemic of dengue fever in our district is mainly genotype 1, with fever, fatigue, myalgia soreness as typical clinical features, accompanied by neutropenia, thrombocytopenia and liver function damage, especially in elderly patients, which should be paid great attention to.

Abstract:Objective:　To investigate the clinical therapeutic effect of spleen-preserving surgery for traumatic spleen rupture based on radiofrequency ablation (RFA) and autologous blood transfusion (ABT), and to improve the treatment of traumatic splenic rupture in primary hospitals. Methods:　Data of 98 cases with traumatic splenic rupture treated in our hospital from January 2015 to May 2020 were retrospectively analyzed, among which, 37 cases underwent splenectomy (group A), 14 cases underwent traditional spleen-preserving operation (group B) and 47 cases underwent RFA-assisted spleen-preserving operation (group C). The operation effect, complications and postoperative blood platelet (PLT) count of the three groups were compared and analyzed. Results:　The success rate of spleen-preserving surgery in group C was higher than that in group B (P=0.035). There were significant differences among the three groups in operation time (F=20.432, P=0.000). Comparison between groups: the operation time of group C and group A were shorter than that of group B (P=0.000, 0.000), as well as group A had shorter time than group B had (P=0.008). There were significant differences in intraoperative bleeding among the three groups (F=5.462, P=0.006). Comparison between groups: group C and group A had less bleeding than group B had (P=0.010, 0.001), while there was no significant difference between group A and group C (P=0.311). ABT ratio: the differences among the three groups were statistically significant (χ²=7.607, P=0.028); comparison between groups: group C was higher than group A (P=0.012), while there was no significant difference between group A and group B (P=1.000), neither in group B and group C (P=0.124). There were no significant differences among the three groups in postoperative hemoglobin (HB) (F=2.864, P=0.062). The differences in hospitalization time among the three groups were statistically significant (F=3.806, P=0.028); comparison between groups: the hospitalization in group C was shorter than that in group A (P=0.010), while there was no significant difference between group A and group B (P=0.100), neither in group B and group C (P=0.708). Postoperative complications: the incidence in group C was lower than that in group A and group B, without statistical differences (χ²=1.180, P=0.532). PLT was respectively checked for three groups of patients on the 3rd, 7th, 15th and 1st month after the operation, and the results showed that the differences among the three groups were statistically significant (F=8.550, 4.261, 4.304, 11.505, P=0.000, 0.017, 0.016, 0.000); comparison between groups: the level of PLT elevation were lower in group C and group B than in group A (P=0.000, 0.007, 0.008, 0.000; 0.004, 0.047, 0.038, 0.001), while there was no significant difference between group B and group C (P=0.815, 0.929, 0.837, 0.932). Conclusion:　RFA combined with intraoperative ABT is a safe and effective method for spleen-preserving operation in traumatic splenic rupture, with high success rate, shortened operation time, reduced intraoperative bleeding, and decreased degree of PLT elevation, which is suitable for promotion in primary hospitals.

Abstract:Acute respiratory distress syndrome (ARDS) is a common clinical syndrome in intensive care unit. Sepsis is a clinical syndrome, which is with life-threatening organ function damage caused by infection. As an important part of local microcirculation, the structure of alveolar-capillary membrane is easily damaged in the course of sepsis. So sepsis is the most prime and important inducing factor of ARDS, and it has higher mortality and fatality. As an important constitution of renin-angiotensin system (RAS), angiotensin-converting enzyme-2 (ACE-2) has the function of protecting endothelium and regulating the expression of inflammatory factors, so it has received additional attention in recent years. Through the intervention of ACE-2, ARDS and the severity of COVID-19 can be affected to a certain extent, so the role of ACE-2 in septic ARDS is worth discussing. This paper summarizes the biological characteristics and main mechanism of ACE-2, discusses the possible role of ACE-2 in septic ARDS, and finally explores the significance of ACE-2 in the evaluation and treatment of septic ARDS, in order to provide reference and inspiration for clinical treatment of sepsis-related ARDS.

Abstract:Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are currently widely used in osteoporosis com-pression spinal fractures. However, the techniques were once regarded as absolute surgical contraindications for burst fractures involv-ing the posterior wall of the vertebral body or with canal occupation. Osteoporotic vertebral burst fractures (OVBF) often occur in middle-aged and elderly patients. This question whether the patients with OVBF can benefit from PVP and PKP like patients with osteoporotic compression fractures (OVCF) makes more and more scholars at home and abroad begin to study it, through which, they hope to clarify the risks and benefits of this technique in patients with OVBF. In this paper, we mainly review the efficacy and safety of the technique in OVBF in recent ten years.