Abstract:Thyroid cancer is one of the most common endocrine malignancies. Cancer-associated fibroblasts（CAFs） are important cellular components in the tumor microenvironment of thyroid cancer，with heterogeneities in their cell origins，phenotypes，and functions. CAFs promote tumor progression through its interactions with tumor cells. CAFs can directly or indirectly promote the development and progression of thyroid cancer by altering the structure and function of the extracellular matrix，promoting epithelial-to-mesenchymal transition，and enhancing cytokine secretion and release. Based on the characteristics of CAFs in thyroid cancer，some possible treatment strategies have been proposed. This article reviews the research advances in CAFs and thyroid cancer progression based on the relevant literature.

Abstract:In patients with non-small cell lung cancer（NSCLC） with EGFR driver mutation，EGFR-TKIs is the standard treatment but acquired resistance is inevitable. There is currently no standard treatment for first-line EGFR-TKIs-resistant NSCLC patients. Immunotherapy combined with platinum-containing double-drug chemotherapy and vascular endothelial growth factor inhibitors has shown some efficacy. This paper reviews the research on different programmed cell death 1（PD-1）/PD-1 ligand（PD-L1） immune checkpoint inhibitors in the treatment of NSCLC patients with EGFR mutation，and explores improved treatment modalities for NSCLC patients with EGFR mutation.

Abstract:Cell metabolic abnormalities and dysregulated energy utilization are important markers of cancer. The hexosamine biosynthetic pathway（HBP） is abnormally activated in most tumors. Glucose，fatty acids，amino acids，and glutamine are vital nutrients for tumor growth and serve as the substrates for the biosynthesis of uridine diphosphate N-acetylglucosamine（UDP-GlcNAc） through HBP. UDP-GlcNAc is a donor substrate for O-linked N-acetylglucosamine modification（O-GlcNAc） of proteins，which acts as a “nutrient-sensor” within cells. In recent years，the role of HBP metabolic enzymes in the pathophysiology of cancer has been extensively investigated. HBP-mediated O-GlcNAc modification is closely related to the proliferation，survival，and metastasis of cancer cells. Here，we review HBP and its important roles in tumors，and discuss the potential strategies of cancer treatment by targeting HBP.

Abstract:Vitamin D3（VD₃）-mediated biological effects and moderate interferon（IFN） response are essential for health； however，VD₃ deficiency/insufficiency and impaired IFN response are often observed in the development and progression of various diseases，including microbial infections and tumors. Moreover，the clinical efficacy achieved by the combination of VD₃ and IFN varies significantly depending on the type of disease and the target organs or cells involved，suggesting that there are extremely complex modes and mechanisms of inter-regulation between VD₃ signaling and IFN response. This article gives an overview of this topic，so as to provide a reference for the basic and clinical translational studies in this field.

Abstract:The p53 gene is an important tumor suppressor gene，which plays an important role in female reproduction. Its abnormal activity is related to the occurrence of various reproductive diseases，such as habitual abortion and infertility. In recent years，studies have found that the p53 gene is widely expressed in the female reproductive system，participates in certain reproductive processes，and is closely related to certain reproductive diseases. Based on recent studies in China and globally，this paper summarized the role of the p53 gene in female reproduction and its relationship with some reproductive diseases，with the aim to provide a theoretical basis and new ideas for research in the field of reproduction.

Abstract:Dual-specificity tyrosine-phosphorylation-regulated kinase 2（DYRK2） belongs to the DYRK family and is an evolutionarily conserved enzyme in eukaryotes. The expression of DYRK2 varies greatly in different tissues and tumors. Previous reports on the role of DYRK2 in tumors have shown that it can delay tumor growth by prolonging G₁ phase，promoting apoptosis，and inhibiting epithelial-mesenchymal transition. Recent studies have found that DYRK2 can also play a cancer-promoting role by enhancing cell mitosis，tumor apoptosis resistance，cell invasion and migration，and drug resistance. Here we present a review of the structure and function of DYRK2 as well as its roles in tumor occurrence，development，and prognosis.

Abstract:Objective To explore the effect of ring box protein-1（RBX1） on the proliferation，apoptosis，migration，and invasion of pancreatic adenocarcinoma（PAAD） cells and the potential mechanism of action.Methods The gene expression profile interactive analysis website，quantitative real-time reverse-transcription polymerase chain reaction（qRT-PCR），and Western blot were used to measure the expression of RBX1 in PAAD tissues and cells and to determine its prognostic value. Cell Counting Kit-8，colony formation assay，terminal deoxynucleotidyl transferase dUTP nick end labeling，wound healing assay，and transwell assay were applied to evaluate the effects of RBX1 knockdown on the proliferation，apoptosis，migration，and invasion of pancreatic carcinoma-1（PANC-1） cells. LinkedOmics website was used to investigate the correlation between RBX1 and plant homodomain finger-like domain-containing protein 5A（PHF5A） in PAAD. Functional rescue experiments were performed by measuring the expression of PHF5A after RBX1 knockdown by qRT-PCR and Western blot.Results RBX1 expression was up-regulated in PAAD tissues and cells，which was associated with a poor prognosis（P<0.05）. RBX1 knockdown inhibited the proliferation，migration，and invasion of PANC-1 cells and promoted cell apoptosis（P<0.05）. RBX1 was associated with PHF5A in PAAD（R=0.6918），and RBX1 positively regulated the expression of PHF5A（P<0.05）. Functional rescue experiments showed that PHF5A overexpression partially reversed the effects of RBX1 knockdown on the proliferation，migration，invasion，and apoptosis of PANC-1 cells（P<0.05）.Conclusion RBX1 knockdown inhibits the proliferation，migration，and invasion of PANC-1 cells and promotes cell apoptosis by down-regulating PHF5A.

Abstract:Objective To investigate the intervention effect of coix seed polysaccharides（Coixan） on an in vitro inflammation model of ulcerative colitis（UC） and its mechanism from the perspective of inflammation theory.Methods NCM460 cells were cultured in vitro and were induced by different doses（0，2.5，5，10，20，and 40 μg/mL） of lipopolysaccharide（LPS） to obtain the optimal induction dose of 20 μg/mL，and NCM460 cells were induced by different concentrations（0，5，10，20，40，and 80 μmol/L） of Coixan to obtain the optimal concentrations for promoting proliferation（10，20，and 40 μmol/L）. The cells were randomly divided into blank group，model group（LPS induction），LPS+low-，middle-，and high-dose Coixan（10，20，and 40 μmol/L） groups，and LPS+salicylazosulfapyridine（SASP）（200 μg/mL） group，and after all cells except those in the blank group were stimulated with LPS（20 μg/mL） for 48 hours to establish an in vitro cell inflammation model of UC，Coixan and SASP were used for 48 hours of intervention. ELISA was used to measure the levels of the inflammatory factors interleukin-1β（IL-1β） and tumor necrosis factor-α（TNF-α） in supernatant；immunofluorescence assay was used to measure the expression level of the pyroptosis-related protein caspase-1；qRT-PCR was used to measure the gene expression levels of NLRP3，caspase-1，GSDMD-N，and IL-1β associated with pyroptosis in the NLRP3/caspase-1 pathway；Western blot was used to measure the protein expression levels of NLRP3，caspase-1，and IL-1β associated with pyroptosis in each group.Results Compared with 0 μg/mL LPS，20 μg/mL LPS for 48 hours of induction moderately inhibited the growth of NCM460 cells（P<0.01），and meanwhile，there was a significant increase in the content of the inflammatory factors IL-1β and TNF-α at 48 hours of intervention（P<0.01）；therefore，20 ug/mL LPS induction for 48 hours was selected for modeling. Compared with 0 μmol/L Coixan，there was an increase in cell viability after intervention with Coixan at concentrations of 10，20，and 40 μmol/L，especially Coixan at concentrations of 10 and 20 μmol/L（P<0.05）. Compared with the normal control group，the model group had significant increases in the levels of the inflammatory factors IL-1β and TNF-α，the protein expression levels of NLRP3，caspase-1，and IL-1β，and the gene expression levels of NLRP3，caspase-1，GSDMD-N，and IL-1β（P<0.01）；compared with the model group，the middle- and high-dose groups and the SASP group had significant reductions in the secretion of IL-1β and TNF-α（P<0.01）. Compared with the model group，the middle- and high-dose groups and the SASP group had a significant reduction in the expression level of the pyroptosis-related protein caspase-1（P<0.01）；compared with the model group，the low-，middle-，and high-dose groups and the SASP group had significant reductions in the protein and gene expression levels of NLRP3 and caspase-1（P<0.05 or P<0.01），and the middle and high-dose groups and the SASP group had significant reductions in the gene expression levels of GSDMD-N and IL-1β（P<0.01）；compared with the model group，the middle- and high-dose groups and the SASP group had significant reductions in the expression levels of the pyroptosis-related proteins NLRP3，caspase-1，and IL-1β（P<0.01）.Conclusions Coixan may exert a protective effect on human intestinal epithelial cells by downregulating the expression levels of the pyroptosis-related factors NLRP3，caspase-1，GSDMD-N，and IL-1β and inhibiting the pyroptosis of intestinal epithelial cells.

Abstract:Objective To investigate the influence of type 2 diabetes mellitus（T2DM） on testicular histomorphology，testosterone secretion，and spermatogenesis by establishing a male mouse model of T2DM.Methods A total of 24 male C57BL/6J mice，aged 8 weeks，were randomly divided into control group with 10 mice and T2DM group with 14 mice. The mice in the control group were fed a basal diet，and those in the T2DM group were fed a high-fat diet. After 8 weeks，the mice in the control group were given intraperitoneal injection of citrate buffer，and those in the T2DM group were given intraperitoneal injection of 60 mg/kg streptozotocin（STZ），for 5 consecutive days. The mice were sacrificed after 4 weeks of feeding，and the serum，testis，and epididymis of the male mice were isolated. Sperm count and testosterone level were measured to assess the spermatogenic function of germ cells in male mice；HE staining was used to observe the morphological changes of the testis；TUNEL staining was used to observe the apoptosis of testicular germ cells. ELISA was used to measure the serum levels of superoxide dismutase（SOD），malondialdehyde（MDA），and heme oxygenase-1（HO-1），and Western blot was used to measure the protein expression levels of B cell lymphoma/leukemia-2（Bcl-2），Bcl-2-associated X protein（BaX），and cysteinyl aspartate specific proteinase-3（caspase-3） in testicular tissue of male mice.Results Compared with the control group，the T2DM group had significant reductions in body weight [（26.00±2.85） g vs. （29.71±4.28） g，P=0.000]，sperm number [（4.15±1.01） ×10⁶/L vs. （5.56±0.70）×10⁶/L，P=0.009]，and testosterone level [（0.99±0.41） ng/mL vs. （19.85±10.23） ng/mL，P=0.041]. TUNEL staining showed that the T2DM group had varying degrees of apoptosis in spermatogenic cells at all levels of testicular seminiferous tubules，with a significant increase in the number of apoptotic cells（21.60±5.11，P=0.033）. ELISA showed that the T2DM group had significant increases in the expression levels of the serum oxidative stress markers SOD（4.42±0.47） pg/mL and HO-1（2 968.00±536.10） pg/mL（P=0.000 and 0.008）. Western blot showed significant increases in the protein expression levels of BaX（1.270±0.059） and caspase-3（1.94±0.47）（P=0.008 and 0.041） and BaX/Bcl-2 ratio.Conclusion Male mice with T2DM have a significant reduction in serum testosterone level，a significant increase in the apoptosis of spermatogenic cells，and a significant reduction in the number of mature spermatogenic cells，which affect reproductive capacity.

Abstract:Objective To retrospectively analyze the epidemiological and clinical characteristics of human rhinovirus（HRV） infection in children with lower respiratory tract infections in Yinchuan，China，and to provide a theoretical basis for prevention，diagnosis，and treatment of HRV in children.Methods The lower respiratory secretion specimens from 989 children with lower respiratory tract infections hospitalized in the Department of Pediatrics of Yinchuan Women and Children Healthcare Hospital from 2018 to 2019 were collected for virus detection by multiplex PCR. The basic information，clinical characteristics，and laboratory results of HRV cases were analyzed.Results Among the 989 children with lower respiratory tract infections，the total detection rate of HRV was 38.3%，the rate of HRV infection alone was 9.5%，and the rate of mixed infection with HRV and other viruses was 28.9%. There were 221（58.3%） male children and 158（41.7%） female children infected with HRV. HRV infections occurred all year round，but were mainly prevalent in summer and autumn. Of the children with HRV infection，87.3% were diagnosed with pneumonia and 13.7% with bronchitis and bronchiolitis，and 90.2% were less than six years old. Compared with non-HRV-infected children，HRV-infected children were more frequently to have fever and vomiting（P<0.05），but with no significant differences in clinical features such as cough，wheezing，stridor，and wheezing sounds（P>0.05）. In terms of laboratory indicators，there were significant differences in the levels of hemoglobin，red blood cell count，aspartate aminotransferase，alanine aminotransferase，and lactase（P<0.05）.Conclusion HRV is a common pathogen of lower respiratory tract infections in Yinchuan. Children under six years old are highly susceptible to HRV，with fever as the main symptom，and HRV infection can affect the lower respiratory tract to cause pneumonia，bronchitis，and bronchiolitis. HRV infection often co-exists with other viruses，with seasonal epidemics mainly during summer and autumn.

Abstract:Objective To investigate the application and advantages of robot-assisted unilateral biportal endoscopy in lumbar decompression，fusion，and internal fixation by comparing it with percutaneous spinal endoscopy.Methods A retrospective analysis was performed for 26 patients who were admitted to Center for Diagnosis and Treatment of Spinal Diseases，Gansu Provincial Hospital of Traditional Chinese Medicine，from February 2021 to June 2022 and needed to undergo lumbar decompression and fusion，and according to the surgical procedure，they were divided into R-ULIF group and Endo-LIF group. The patients in the R-ULIF group were treated with robot-assisted unilateral biportal endoscopy for lumbar interbody fusion（R-ULIF），and those in the Endo-LIF group were treated with percutaneous spinal endoscopic lumbar interbody fusion（Endo-LIF）. The two groups were analyzed and compared in terms of general data，fluoroscopy frequency，time of operation，bleeding volume，length of postoperative hospital stay，excellent and good rate of screw placement，fusion rate，the incidence rate of complications，visual analogue scale（VAS） score for postoperative pain，oswestry dysfunction index（ODI） score，and MacNab efficacy evaluation standard.Results All patients completed the operation successfully. There were 13 patients（6 male patients and 7 female patients） in the R-ULIF group，with an age of （53.92±9.86） years，a course of disease of 33.0（6.1，81.0） weeks，a time of operation of （187.85±10.18） minutes，a fluoroscopy frequency of （7.92±0.95） times，an intraoperative blood loss of （54.54±4.72） mL，a length of postoperative hospital stay of 3.92±0.86 days，an accuracy rate of screw placement of 98.1%（51/52），and a fusion rate of 92.3%，and no complication was observed（0%）； there were 13 patients（5 male patients and 8 female patients） in the Endo-LIF group，with an age of 52.38±10.89 years，a course of disease of 48.0（6.0，120.0） weeks，a time of operation of （175.15±23.81） minutes，a fluoroscopy frequency of 13.77±1.48 times，an intraoperative blood loss of （104.31±6.81） mL，a length of postoperative hospital stay of （5.23±1.01） days，an accuracy rate of screw placement of 76.92%（40/52），and a fusion rate of 84.6%，and the incidence rate of complications was 15%（one male patient had dural tear and one female patient had fusion cage sinking）. Compared with the Endo-LIF group，the R-ULIF group had significantly lower fluoroscopy frequency and intraoperative blood loss and a significantly shorter length of postoperative hospital stay（P<0.05）. Both groups had significant reductions in VAS score and ODI score at each time point（P<0.05），and the R-ULIF group had a better ODI score than the Endo-LIF group at 1 and 3 months after surgery（P=0.017 and 0.047），while there was no significant difference between the groups before surgery and at 1 week after surgery（P>0.05）. Based on the MacNab efficacy evaluation standard at 6 months after surgery，there were 9 cases with excellent efficacy，2 cases with good efficacy，1 case with moderate efficacy，and 1 case with poor efficacy in the R-ULIF group，with an excellent and good rate of 84.6%；in the Endo-LIF group，there were 7 cases with excellent efficacy，3 cases with good efficacy，2 cases with moderate efficacy，and 1 case with poor efficacy，with an excellent and good rate of 76.9%.Conclusion Robot-assisted unilateral biportal endoscopy for lumbar decompression，fusion，and internal fixation has a safe and reliable short-term clinical in the treatment of lumbar disc herniation combined with lumbar instability，with a high success rate of screw placement，low radiation exposure，low intraoperative blood loss，and a short length of hospital stay，and therefore，it holds promise for clinical application. In the treatment of lumbar disc herniation combined with lumbar instability.

Abstract:Objective To investigate the correlation between CT features and activity of interstitial lung disease associated with systemic lupus erythematosus.Methods A total of 131 patients with interstitial lung disease in systemic lupus erythematosus were included for analysis of disease activity score，imaging features，and Kazerooni score for pulmonary interstitial fibrosis based on high-resolution computed tomography. The Spearman’s rank correlation coefficient test was used to analyze the correlations between the scores.Results The ground glass opacity score in the Kazerooni scoring system was positively correlated with the systemic lupus erythematosus disease activity index-2000（SLEDAI-2000），and the correlation was statistically significant（r_s=0.388，P<0.001）. There was no significant correlation between Kazerooni fibrosis score and SLEDAI-2000（P=0.837）. The ground glass opacity score was the highest in the diffuse alveolar damage group，the fibrosis score was the highest in the usual interstitial pneumonia group，and the differences were significant（both P<0.001）. There was no significant difference in SLEDAI-2000 between different types of interstitial lung disease（P>0.05）.Conclusion Chest high-resolution computed tomography can help to comprehensively evaluate systemic lupus erythematosus and has great significance for formulation of treatment plans.

Abstract:Objective To investigate the influencing factors for the success rate of vaginal birth after cesarean section（VBAC），to guide clinical decision-making for trial of labor after cesarean section（TOLAC），and to improve the success rate of VBAC and reduce the occurrence of adverse maternal and fetal outcomes.Methods A retrospective analysis was performed for 452 pregnant women who experienced TOLAC in Obstetrics Center of Women and Children’s Hospital of Chongqing Medical University（Chongqing Health Center for Women and Children） from January 2020 to October 2022，among whom 342 experienced VBAC and 110 experienced failed TOLAC. According to the final mode of delivery，110 pregnant women were selected as VBAC group，and 110 were selected as failed TOLAC group. Univariate analysis and multivariate logistic regression analysis were used to investigate the influencing factors for VBAC，and pregnancy outcome was compared between the two groups.Results In this study，the overall VBAC rate was 75.67%（342/452），and the TOLAC failure rate was 24.33%（110/452）. The univariate analysis of prenatal factors showed that there were significant differences between the VBAC group and the failed TOLAC group in gestational age（38.44±2.13 weeks vs. 38.96±1.34 weeks，P<0.05） and the proportion of pregnant women with induction of labor due to the history of abnormal pregnancy（11.82% vs. 2.80%，P<0.05） or pregnancy comorbidities（32.73% vs. 20.56%，P<0.05），and there were also significant differences between the two groups in cervical Bishop score on admission（5.15±1.69 vs. 3.71±1.52，P<0.001），the proportion of women with a history of vaginal delivery（32.73% vs. 20.56%，P<0.001），and the proportion of women with spontaneous delivery（86.36% vs. 17.76%，P<0.001）. The univariate analysis of maternal and infant pregnancy outcomes showed that compared with the failed TOLAC group，the VBAC group had a significantly lower body weight of neonates（3 191.82±489.00 g vs. 3 334.15±375.99 g，P<0.05） and significantly lower blood loss within 24 hours after delivery（408.75±142.31 mL vs. 560.85±168.61 mL，P<0.05）.］There were 7 patients with incomplete uterine rupture in the failed TOLAC group. There were no significant differences between the two groups in blood transfusion，puerperal infection，and 5-minute Apgar score of neonates. There was no death of pregnant and parturient women or perinatal infants. The multivariate logistic regression analysis showed that cervical Bishop score on admission（odds ratio ［OR］=0.122，95%CI： 0.010-1.441），history of vaginal delivery（OR=0.034，95%CI： 1.297-715.194），premature delivery（OR=186.54，95%CI： 2.225-15638.578），and spontaneous labor（OR=52.37，95%CI： 8.949-306.517） were influencing factors for VBAC.Conclusion Gestational weeks，history of vaginal delivery，history of induction of labor due to abnormal pregnancy，pregnancy comorbidities，cervical Bishop score on admission，spontaneous labor，and history of premature delivery are influencing factors for VBAC. The VBAC group has lower blood loss within 24 hours after delivery than the failed TOLAC group.

Abstract:Objective To investigate the high-risk factors for massive hemorrhage during induced abortion for unplanned pregnancy after cesarean section.Methods A prospective cohort study was conducted for the clinical information and imaging data of 228 patients with unplanned pregnancy after caesarean section who underwent induced abortion at the outpatient service of Department of Obstetrics and Gynecology in Chongqing General Hospital from January 2022 to April 2023. Univariate analysis and multivariate logistic regression analysis were used to investigate the risk factors for massive hemorrhage during induced abortion.Results Among the 228 patients，59 experienced massive intraoperative hemorrhage，accounting for 25.87%. The univariate analysis showed that number of births，number of cesarean sections，maximum gestational sac diameter，distance from the gestational sac to the uterine incision scar，cessation of embryonic development，and pregnancy time were risk factors for massive hemorrhage during induced abortion for unplanned pregnancy after cesarean section（P<0.05）. The multivariate logistic regression analysis showed that number of cesarean sections，maximum gestational sac diameter，distance from the gestational sac to the uterine incision scar，cessation of embryonic development，and pregnancy time were independent risk factors for massive hemorrhage during induced abortion for unplanned pregnancy after cesarean section（P<0.05）.Conclusion The risk of massive hemorrhage during induced abortion can be reduced by decreasing the rate of cesarean section and implementing efficient contraception after cesarean section.

Abstract:Objective To investigate the clinical features of patients with scrotal abscess，and to provide a basis for clinical diagnosis and treatment of the disease.Methods We retrospectively analyzed the clinical data of patients with scrotal abscess collected from the electronic medical record system of The Second Affiliated Hospital of Chongqing Medical University from January 2016 to September 2021.Results A total of 24 patients with scrotal abscess were included，with a mean age of （49.29±17.05） years. The clinical symptoms included scrotal pain，redness，swelling，and purulent ulceration and even systemic fever. Epididymitis was the main comorbid condition（7 cases，29%）. Among the 16 patients having a pus culture test，11（69%） were positive for pathogenic bacteria，which were mainly Escherichia coli，Staphylococcus，and anaerobic bacteria. Four（17%） cases were treated conservatively with antibiotics alone； and 20（83%） cases were treated with abscess incision and drainage combined with antibiotic therapy，of whom four patients underwent lesion resection and pathological examination，resulting in a treatment change to anti-tuberculosis drugs in three（13%） cases due to the findings of tuberculous granulomatous inflammation. All the 24 patients had significantly remissions on discharge，with a mean length of hospital stay of （12.96±7.53） days. One patient relapsed three years after discharge with cure.Conclusion Scrotal abscess should be treated with incision and drainage and potent anti-infective treatment as soon as possible once confirmed. Education on health and personal hygiene should be administered to prevent its occurrence.

Abstract:Objective To investigate the effect of early enteral eco-immunonutrition therapy on the nutritional status，postoperative complication，and immune function of patients after pancreatoduodenectomy.Methods A total of 190 patients who underwent pancreatoduodenectomy in Department of Geriatric Surgery，The First Affiliated Hospital of Xi’an Jiaotong University，from January 2019 to December 2022 were enrolled according to the inclusion criteria，and they were randomly divided into study group and control group using the method of simple random grouping in Excel. All 190 patients completed the study，with 95 patients in the study group and 95 patients in the control group. The patients in the study group received individualized enteral eco-immunonutrition therapy since day 1 after surgery，and those in the control group were given conventional nutrition，mainly parenteral nutrition. Related indices were measured before surgery and on days 3，7，10，and 14 after surgery，including serum albumin，pre albumin，urea，creatinine，hemoglobin，total cholesterol，and lymphocyte count（percentage），and the two groups were observed in terms of the amount of red cell suspension and plasma used during surgery，duration of postoperative ventilation，length of hospital stay，drug and in-hospital expenditure，and the total percentage of drug expenditure in hospital. Postoperative complications and the differences in the above indicators were analyzed for the two groups，and a generalized linear regression analysis was used to investigate the factors associated with complications.Results There was a significant difference in the incidence rate of postoperative complications between the study group and the control group［15 cases（15.79%） vs. 36 cases（37.89%），χ²=12.095，P=0.001）. Compared with the control group，the study group had a significantly higher serum albumin level on days 7 and 10 after surgery，a significantly higher serum prealbumin level on days 7，10，and 14 after surgery，a significantly higher lymphocyte count on days 10 and 14 after surgery，a significantly higher percentage of lymphocytes on days 7，10，and 14 after surgery，a significantly higher hemoglobin level on days 3，10，and 14 after surgery，and a significantly higher serum level of total cholesterol on day 10 after surgery（all P<0.05）. The generalized linear regression analysis showed that postoperative complications were positively correlated with female sex，body mass index，international nutrition score，viral hepatitis，length of postoperative ventilation，and amount of plasma transfusion，while postoperative complications were negatively correlated with nutritional therapy.Conclusion Early enteral eco-immunonutrition therapy for patients after pancreatoduodenectomy can significantly improve their nutritional status，reduce the incidence rate of postoperative complications，and enhance their immune function.

Abstract:Objective To compare the accuracy of the conventional freehand technique，three-dimensional printed template-guided technique（TGT），and ball tip technique for second sacral alar iliac（S2AI） screw placement.Methods One hundred and forty-five patients who underwent S2AI screw placement were retrospectively reviewed. According to the screw placement techniques，they were divided into freehand technique group（36 cases），TGT group（48 cases），and ball tip technique group（61 cases）. All the patients underwent computed tomography before operation to identify the parameters of the optimal trajectory of S2AI screws and also after operation to assess the accuracy of the screw trajectory. The accuracy of screw insertion with the three techniques was compared.Results There were no significant differences in the optimal trajectory parameters of S2AI screws between the three groups（P>0.05）. A total of 290 S2AI screws were placed，with 72 in the conventional freehand technique group，96 in the TGT group，and 122 in the ball tip technique group. The inaccuracy rate of screw placement was 18.1%（13/72） for the freehand group，3.1%（3/96） for the TGT group，and 4.1%（5/122） for the ball tip group. The accuracy of the TGT group was significantly higher than that of the freehand group（P<0.05）. The accuracy of the ball tip group was also significantly higher than that of the freehand group（P<0.05）. The accuracy of screw placement was higher in the TGT group than in the ball tip group，but the difference was not statistically significant（P>0.05）.Conclusion The TGT technique and ball tip technique are reliable approaches to S2AI screw placement，both with significantly higher accuracy compared with the freehand technique，and in addition，the ball tip technique is easier to perform compared with the other two techniques.

Abstract:Objective To investigate the differences in clinical features and sleep structure between patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） with or without overweight/obesity，as well as related influencing factors.Methods A retrospective analysis was performed for the clinical data and polysomnography（PSG） results of 458 OSAHS patients who attended The First Affiliated Hospital of Chongqing Medical University from January 2020 to April 2021，and according to body mass index（BMI），they were divided into OSAHS group and OSAHS+overweight/obesity group. For all 458 patients，there were 91 patients（19.9%） in the OSAHS group and 367 patients（80.1%） in the OSAHS+overweight/obesity group. Clinical data and PSG results were compared between the two groups，and univariate analysis and regression analyses were used to explore the influencing factors for OSAHS in patients with overweight or obesity.Results There were significant differences between the two groups in neck circumference，waist circumference，OSAHS severity，daytime sleepiness score，history of hypertension，history of type 2 diabetes mellitus，apnea hypopnea index，microarousal index，mean oxygen saturation（MSaO₂） at night，and lowest oxygen saturation（LSaO₂） at night（all P<0.05）. The multivariate regression analysis showed that BMI（t=2.639，P=0.009），the family history of snoring（t=-2.521，P=0.0012），microarousal index（t=12.813，P=0.000），and LSaO₂（t=-7.407，P=0.000） were the main influencing factors for OSAHS in patients with overweight or obesity.Conclusion There are differences in clinical features and sleep structure between the OSAHS patients with or without overweight/obesity，and elevated BMI，the family history of snoring，an increase in microarousal index，and a reduction in LSaO₂ are independent risk factors for OSAHS in patients with overweight or obesity.