Abstract:Objective To explore the histone acetylation mechanism of histone acetylases（HATs） to inhibit anacardic acid（AA） attenuating myocardial fibrosis in thoracic aortic constriction（TAC） mice， and provide a new target for the prevention and treatment of myocardial fibrosis.Methods SPF grade Kunming mice of 6-8 weeks were selected as the research animals and randomly divided into five groups：Normal group，Sham group，TAC group，TAC+Vehicle（TAC+Veh） group，and TAC+AA group. TAC mice models were detected by echocardiography in 12 weeks after TAC，and myocardial tissues of mice were collected for analysis. The cardiac morphology and myocardial fibrosis were observed by Masson staining. The expression of KAT8，H4K16ac，TGF-β1，SMAD3，Collagen Ⅰ， and Collagen Ⅲ were assayed by Western blot. The interaction between KAT8 and H4K16ac was detected by co-immunoprecipitation（Co-IP）.Results Echocardiography showed that TAC model mice were successfully constructed. The results of Masson staining showed that the hearts of mice in TAC group were enlarged，collagen deposition in myocardial tissues increased and fibrosis was obvious compared with that in Sham group，while the hearts of mice in TAC+AA group were smaller，collagen deposition in myocardial tissues decreased and fibrosis degree was lighter than that in TAC group. Western blot results showed that the expression of KAT8 and H4K16ac in myocardial tissues of mice in TAC group were significantly higher than those in Sham group（all P<0.05）. And the protein expression levels of TGF-β1，SMAD3，Collagen Ⅰ and Collagen Ⅲ were significantly higher than those of Sham group（all P<0.05）. Compared with TAC group，AA significantly inhibited the overexpression of KAT8 and the hyperacetylation of H4K16ac in TAC mice（all P<0.05）. Meanwhile，the protein expression levels of TGF-β1，SMAD3，CollagenⅠand Collagen Ⅲ in TAC+AA group were significantly decreased compared with TAC group（all P<0.05）. The Co-IP results showed that KAT8 could bind to H4K16ac. In addition，AA significantly improved the survival rate of TAC mice.Conclusion KAT8-mediated hyperacetylation of H4K16ac may be involved in myocardial fibrosis in TAC mice by regulating TGF-β1/SMAD3 signaling pathway，while AA could attenuate myocardial fibrosis in TAC mice by inhibiting KAT8-mediated hyperacetylation of histone H4K16ac.

Abstract:Objective To investigate the effect of electroacupuncture（EA） on the protein expression of adenosine monophosphate activated protein kinase（AMPK）， silent information regulator of transcription 1（SIRT1） and nuclear factor-κB（NF-κB） in testis of aging model rats and its mechanism of delaying reproductive aging.Methods Forty male Sprague-Dawley rats were randomly divided into the control group（n=10） and the model group（n=30）. The aging model rats were replicated by intraperitoneal injection of D-galactose in the model group. Twenty-four rats were randomly selected from the successful model rats and divided into three groups： the model group， the drug group and the EA group， with 8 rats in each group. In the EA group，“Shen yu” and “Guan yuan” were used for EA treatment， once a day，15 minutes each time，5 days of treatment and 2 days of rest，continuous treatment for 8 weeks. The drug group received abdominal subcutaneous injection of testosterone propionate（7 mg/kg once，once every 3 days） for continuous 8 weeks. The control group and model group were given abdominal subcutaneous injection of 0.9% sodium chloride solution. The injection dose and course of treatment were the same as those in the drug group. The levels of serum total testosterone（TT） and free testosterone（FT）were detected before and after treatment. The protein expression of AMPK，p-AMPK，SIRT1 and NF-κB p65 in rat testis were detected by immunohistochemistry and Western blot.Results Before treatment，compared with the control group，the levels of serum TT and FT in the model group，drug group and EA group were decreased（P=0.000，P=0.001；P=0.000，P=0.001；P=0.000，P=0.000）. After treatment，compared with the control group，the levels of serum TT and FT in the model group，drug group and EA group were decreased（P=0.000，P=0.000；P=0.009，P=0.025；P=0.006，P=0.022）. Compared with the model group，the levels of serum TT and FT in the drug group and EA group were significantly increased（P=0.001，P=0.004；P=0.001，P=0.004）. Compared with the control group， the protein expression of p-AMPK and SIRT1 in the model group，drug group and EA group was significantly decreased（P=0.000，P=0.000；P=0.000，P=0.000；P=0.000，P=0.000），and the expression of NF-κB p65 was significantly increased（P=0.000，P=0.000，P=0.005）. Compared with the model group and drug group，the protein expression of p-AMPK and SIRT1 in the EA group were significantly increased（P=0.000，P=0.000；P=0.023，P=0.002），and the protein expression of NF-κB p65 was significantly decreased（P=0.000，P=0.000）.Conclusion EA may inhibit the inflammatory response of Leydig cells by activating the AMPK/SIRT1/NF-κB pathway of Leydig cells， thereby improving the levels of serum TT and FT， which may be one of the mechanisms of EA in delaying reproductive aging.

Abstract:Objective To investigate the expression，clinical significance and cellular functions of anthrax toxin receptor 2（ANTXR2）in pancreatic cancer tissues and cells and to validate the mechanism of miR-145-5p in regulating ANTXR2 in pancreatic cancer cells.Methods Analysis of transcriptional and clinical data from the GEO and TCGA databases for pancreatic cancer was made. Cellular function was validated by CCK-8 assay，flow cytometry，wound healing experiment and Transwell assay. The miRNA target prediction database was used to reversely predict miRNAs that might inhibit ANTXR2 expression through the ceRNA mechanism，and it was validated using dual luciferase reporter assays.Results ANTXR2 expression was upregulated in both pancreatic cancer tissues and cells（all P<0.05），and ANTXR2 upregulation predicted poorer primary tumor grade（P<0.05），tumor cell differentiation grade（P<0.05） and overall survival（P<0.05，HR=1.72）. ANTXR2 inhibited the cell proliferation，migration and invasion（all P<0.05）. ANTXR2 was a target of miR-145-5p（P<0.01），and miR-145-5p could inhibit the proliferation，migration and invasion of pancreatic cancer cells by suppressing the expression of ANTXR2.Conclusion ANTXR2 is overexpressed in pancreatic cancer tissues and cells，can promote proliferation，migration and invasion of pancreatic cancer cells and is associated with patient prognosis. miR-145-5p can inhibit the pro-cancerous effects of ANTXR2 by regulating its expression.

Abstract:Objective To explore the effect of laparoscopic-assisted D2 radical resection for advanced distal gastric cancer on serum pepsinogen（PG），gastrin-17（G-17），hypoxia-inducible factor-1α（HIF-1α），and metastasis-associated in colon cancer-1（MACC1） levels.Methods A total of 110 patients who underwent D2 radical resection for distal gastric cancer in General Hospital of Central Theater Command from October 2017 to November 2021 were selected for clinical and follow-up study. According to the different treatment methods，they were divided into the laparoscopic group and the laparotomy group，with 55 cases in each. Perioperative conditions，serum PG，G-17，HIF-1α and MACC1 levels，and differences in survival between the two groups of patients were compared.Results The length of incision，intraoperative blood loss，exhaust time，eating time，time to first get out of bed， and hospital stay in the laparoscopic group were significantly lower than those in the laparotomy group，and the differences were statistically significant（P<0.05）. On the 7th day after operation， the serum PGⅠ level in the laparoscopy group was significantly higher than that in the laparotomy group（P<0.05），and the levels of G-17，HIF-1α and MACC1 were lower than those in the laparotomy group（P<0.05）. In the early postoperative period，the overall incidence of complications in the laparoscopic group was lower than that in the laparotomy group（5.45% vs. 20.00%）（P<0.05）. The 1-，2-，and 3-year survival rates were 90.91%，80.00%，and 78.18% in the laparoscopic group，and 87.27%，74.55%，and 70.91% in the laparotomy group，and the mortality rate was not statistically significant（P>0.05）. There was no significant difference in survival status between the laparoscopic group and the laparotomy group by log-rank test（P>0.05）.Conclusion Laparoscopy-assisted D2 radical resection for distal gastric cancer has good effect and safety in the treatment of advanced gastric cancer. It can promote early postoperative recovery of patients，and improve patients' PG，G-17，HIF-1α and MACC1 levels.

Abstract:Objective To investigate whether serum thyroxine（TH） and Apelin are associated with cognitive impairment（CI） in patients with cerebral small vessel disease（CSVD）.Methods A total of 85 consecutive patients with CSVD and 30 healthy controls（HC） were recruited in this study. The patients were assessed via the Montreal cognitive assessment scale（MoCA） and further divided into non-cognitive impairment（NCI） group and CI group. The levels of serum TH and Apelin were detected by enzyme-linked immunosorbent assay. MoCA was used to assess the cognitive function. The relationship between the TH，Apelin and CI was explored through Pearson correlation analysis and univariate linear regression analysis. Logistic regression analysis was used to determine risk factors associated with CI onset. The receiver operating characteristic（ROC） curve was used to analyze the diagnostic value of TH and Apelin in CSVD associated CI.Results Compared with HC group and NCI group，patients in CI group had significantly lower free triiodothyronine（FT3） levels and higher Apelin levels. The correlation analysis revealed a negative correlation between Apelin and MoCA in CSVD patients. The logistic analysis adjusted for confounding factors showed that the increase in Apelin and decrease in FT3 significantly correlated with CI risk. ROC curve analysis suggested that FT3，Apelin，and the combination of FT3-Apelin had a significant diagnostic value for CI.Conclusion The decrease of FT3 and increase of Apelin are independently associated with CI and their combination may be useful in identifying who is at risk for CI in CSVD patients.

Abstract:Objective To analyze the prevalence，genotype composition and hematological characteristics of hemoglobinopathy in Chongqing，and to reasonably select screening and diagnostic methods for hemoglobinopathy.Methods Peripheral blood samples were collected from 49 551 patients screened for hemoglobinopathy，and 23 common gene loci of thalassemia and mutations related to hemoglobin variants（HbVs） were detected by multiplex PCR-guided hybridization or sequencing. The results of routine blood test and hemoglobin electrophoresis were retrospectively analyzed to evaluate the value of the combined examination in the screening and diagnosis of hemoglobinopathy.Results A total of 3 511 cases of hemoglobinopathy were detected（7.09%）. Among them，there were 1 840 α-thalassemia and 1 540 cases of β-thalassemia gene carriers，respectively，mainly including --^SEA/αα，-α^3.7/αα，and -α^4.2/αα for α-thalassemia cases，and CD17，IVS-Ⅱ-654 and CD41-42 for β-thalassemia；there were 65 cases of abnormal hemoglobinopathy，with the majority of β-chain variants；there were 64 cases of complex hemoglobinopathy，including 57 cases of α-thalassemia combined with β-thalassemia and 7 cases of thalassemia combined with abnormal hemoglobinopathy. The decrease of hemoglobin，mean corpuscular volume and mean corpuscular hemoglobin in patients with hemoglobinopathy was positively correlated with the decrease of α or β chain synthesis，while adult hemoglobin 2（HbA2） was respectively decreased and increased in α-thalassemia and β-thalassemia，or there were HbVs in abnormal hemoglobiopathies. The detection rate of hemoglobinopathy was 84.29% and 82.67% by routine blood test and capillary electrophoresis，respectively，and the detection rate of combined screening was 99.11%.Conclusion The genotype of carriers of hemoglobinopathy in Chongqing area is diverse. Blood routine combined with Hb electrophoresis is a necessary means for clinical and prenatal screening of hemoglobinopathy. Follow-up genetic analysis is strongly recommended in patients screened for HbVs who present with symptoms such as hemolysis or anemia.

Abstract:Objective To investigate the value of contrast-enhanced computer tomography（CT） in differential diagnosis between gallbladder carcinoma invading the liver and liver cancer involving gallbladder lesions.Methods The clinical and imaging data of 115 patients in our hospital from February 2012 to February 2022 were collected，including 69 cases of gallbladder cancer invading the liver and 46 cases of liver cancer involving the gallbladder. A total of 13 observation indexes were recorded and statistically analyzed，including their gender，age，tumor size，tumor borders，gallbladder morphology，liver cirrhosis， bile duct dilation，high-density shadow in tumor or bile duct system，portal vein tumor thrombus， enhancement mode，degree of intensification，enhancement mode，and distant metastasis.Results There was statistical significance in observation indexes，including gender（P=0.007），age（P=0.002），tumor size（P=0.003），liver cirrhosis（P<0.001），high-density shadow in tumor or bile duct system（P=0.013），portal vein tumor thrombus（P<0.001），enhancement mode（P<0.001） and lymph node enlargement（P=0.034）. Based on bivariate logistic regression analysis，four observation indexes were selected to be significant classification indicators，including age（sensitivity：0.812；specificity：0.457），tumor size（sensitivity：0.630；specificity：0.696），portal vein tumor thrombus（sensitivity：0.326；specificity：0.957） and lymph node enlargement（sensitivity：0.681；specificity：0.522）. The AUC of combined differentiation of four observation was 0.770，with a sensitivity of 0.674 and a specificity of 0.826.Conclusion When contrast-enhanced CT differentiates gallbladder carcinoma invading the liver from liver cancer involving gallbladder lesions，gender，age，tumor size，liver cirrhosis，high-density shadow in tumor or bile duct system，portal vein tumor thrombus，enhancement mode and lymph node enlargement are helpful for differential diagnosis. Meanwhile，combining with age，tumor size，portal vein tumor thrombus and lymph node enlargement is helpful to improve the ability of differential diagnosis.

Abstract:Objective To investigate the accuracy of ultrasound，positron emission tomography/computed tomography（PET/CT） and their combined detection in the evaluation of lymph node metastasis of malignant melanoma（MM），and to guide the preoperative evaluation of lymph node biopsy and dissection in patients with MM.Methods The clinical data of 41 hospitalized patients with MM were collected. Preoperative lymph node imaging data，postoperative lymph node pathological results and the correlation between pathological results and imaging results were analyzed.Results The sensitivity of ultrasound，PET/CT and their combined detection were 47.36%，73.68%，and 78.95%，the specificity were 59.09%， 86.36%，and 50.00%，the accuracy were 53.66%，80.49%，and 63.41%，the positive predictive value were 50.00%，82.35%，and 57.69%，the negative predictive value were 56.52%，79.17%，and 73.33%，and the correct index were 6.45%，60.04%，and 28.95%.Conclusion PET/CT is of great value in assessing preoperative lymph node metastasis of MM，and its degree of accuracy，specificity， positive predictive value，and negative predictive value are higher than those of ultrasound and the joint detection. When the PET/CT examination lymph node metastasis is negative，we should combine with ultrasound to make the joint comprehensive judgment，thereby avoiding missed diagnosis of lymph node metastasis，and improving the detection rate of lymph node metastasis. Early diagnosis and early treatment of MM patients can obtain the best therapeutic effect. Although imaging cannot be used as the diagnostic criteria and final basis，it can guide clinical evaluation before lymph node biopsy surgery to reduce missed diagnosis.

Abstract:Objective To investigate the feasibility of hysteroscopic motive cold-knife system for gestational sac removal in early pregnancy and its value in protecting the fertility of patients.Methods A total of 83 patients who requested termination of early pregnancy in Guiqian International General Hospital from December 2020 to December 2021 were selected as the research objects. According to the wishes of the patients，hysteroscopic cold knife gestational sac resection（41 cases in the experimental group） and ultrasound-guided induced abortion（42 cases in the control group） were performed respectively. The operation time，postoperative residual rate， the time of postoperative bleeding and abdominal pain，postoperative β-human chorionic gonadotropin（hCG） decline，and postoperative incidence of intrauterine adhesions were recorded.Results There were no serious complications in the two groups. The β-hCG values decreased in the same range in the two groups. The operation time，the time of postoperative bleeding and pain in the experimental group were longer than those in the control group. There were no cases of postoperative intrauterine adhesion in the experimental group，while there were 4 cases in the control group.Conclusion The hysteroscopic motive cold-knife system is safe and feasible in the termination of early pregnancy，and it can well protect the fertility of patients.

Abstract:Objective To analyze the risk factors of serious adverse events（SAE）in solid cancer patients with febrile neutropenia（FN），and to compare the predictive efficacy of the clinical index of stable febrile neutropenia（CISNE） and the risk stratification model of Multinational Association of Supportive Care in Cancer（MASCC）.Methods The clinical data of solid cancer patients with FN after chemotherapy from January 2016 to June 2021 in Chongqing University Cancer Hospital were retrospectively collected. The patients were divided into the SAE group and the non-SAE group. The definition of SAE was as follows：①septic shock or other organ failure and necessary transfer to ICU during FN treatment；②or death within 60 days after FN. The clinical data of the two groups were compared，the binary logistic regression analysis was performed to obtain the independent risk factors of SAE，and the patients' CISNE and MASCC scores were calculated to compare the efficacy of CISNE and MASCC scores in identifying low-risk FN.Results A total of 91 patients were enrolled，including 18（19.78%）patients with SAE. The binary logistic regression analysis showed that the independent risk factors of SAE were as follows： ECOG score≥2 points，serum potassium<3.5 mmol/L，procalcitonin（PCT）≥ 0.5 ng/mL，and monocyte count ≤ 0.02×10⁹/L（OR=8.619，11.358，30.612，11.202；95%CI=1.124-66.094，1.696-76.047，5.013-186.947，1.889-66.440，P<0.05）. There were statistical differences in CISNE and MASCC scores between the SAE group and the non-SAE group（P<0.05）. The incidences of SAE in patients with CISNE score=0 point（low risk）and MASCC score≥21 points（low risk） were significantly lower than those in the non-low risk group（P<0.05）. The sensitivity，specificity，positive and negative predictive values of CISNE score=0 point and MASCC score≥21 points for identifying low-risk FN were 21.9%，100.0%，100.0%，24.0% and 91.8%，38.9%，85.9%，53.8%，respectively.Conclusion ECOG score≥2 points，serum potassium<3.5 mmol/L，PCT≥0.5 ng/mL，and monocyte count ≤ 0.02×10⁹/L are independent risk factors of SAE in solid cancer patients with FN. CISNE score=0 point has higher specificity and positive predictive value than MASCC ≥21 points in predicting low-risk FN.

Abstract:Objective To explore the correlation between serum inflammatory cells and electrolyte levels and the severity of hand-foot-mouth disease（HFMD）.Methods Using the Nest case-control study，we selected children hospitalized in Henan Children's Hospital from 2015 to 2019 as research objects， mapped a trend chart for comparison， and built a logistic regression model to predict the risk factors of severe HFMD.Results Multivariate logistic regression analysis showed that the increase of inflammatory cells（leukocyte， neutrophil ratio，platelet count） in the course of mild and severe HFMD（day 1 to day 3） was statistically significant（P<0.05）. The changes of electrolyte levels（increased K⁺，decreased Ca²⁺ and Na⁺） in the course of mild and severe HFMD（day 2 to day 5） was statistically significant（P<0.05）. The rate of high fever in severe HFMD group was significantly higher than that in common HFMD group（P<0.05）.Conclusion The increase of inflammatory cells（leukocyte， neutrophil ratio and platelet count） and the change of electrolyte levels（K⁺ increase，Ca²⁺ and Na⁺ decrease） can indicate the progression of severe HFMD. Monitoring the changes of inflammatory cells and electrolyte levels in peripheral blood of patients with HFMD during the course of the disease has certain clinical value. Health management of HFMD patients with high fever who live in rural areas should be strengthened.

Abstract:Objective To explore the relationship between menarche age and hyperuricemia（HUA） in middle-aged and elderly women and whether this relationship is mediated by body mass index（BMI）.Methods A total of 5 322 women aged ≥45 who had complete data on menarche and uric acid in the China Health and Retirement Longitudinal Study， a prospective study project from 2011 and 2015，were enrolled in this study. Multivariate logistic regression analysis was used to analyze the effect of menarche age on HUA， and restricted cubic spline based on logistic regression was used to analyze the relationship between menarche age and HUA. Mediation analysis was performed to explore the contribution of BMI to the association between age at menarche and HUA.Results Among 5 322 women，274（5.15%） had HUA. When compared with women aged 8 to 13 at menarche， the OR value and 95% confidence interval（CI） of HUA in 16-17 years and 18-22 years groups were 0.643（0.429，0.964） and 0.634（0.411，0.979），respectively，after adjusting for potential confounding factors. There was a linear inverse correlation between age at menarche and HUA，and the risk of HUA decreased by 6% for each 1-year increase of age at menarche. BMI partially mediated the association between menarche age and HUA，and the OR and 95%CI of direct effect and indirect effect were 0.936（0.878， 0.999） and 0.992（0.987，0.997），respectively.Conclusion Late menarche age reduces the risk of HUA，and early age at menarche is associated with an increased risk of HUA. BMI partially mediates the association between age at menarche and the risk of HUA.

Abstract:Objective To analyze the clinical features of neonatal gastric perforation（NGP）in full-term infants，to reduce the occurrence of clinical adverse outcomes.Methods Full-term infants diagnosed with gastric perforation in Children’s Hospital of Chongqing Medical University from January 2009 to October 2020 were included in the study. The data of the infants including clinical manifestations，treatment options and short-term outcomes during three months after discharge from hospital were collected，and the clinical characteristics were retrospectively investigated.Results A total of 26 full-term infants diagnosed with gastric perforation were included in the study. The rate of male was significantly higher than that of female among these cases（88.5% vs. 11. 5%）. The median age at admission and onset were 94.5（48.0，135.0） h and 38.0（0.0，96.0）h. Among the accompanying clinical manifestations，abdominal distension（69.2%），vomiting（46.2%）and poor response（30.8%） were the main manifestations. The main positive pathogen in blood culture was in Enterococcus faecium（15.0%） and Staphylococcus haemolyticus（30.8%） was the first positive pathogen in peritoneal puncture fluid culture，while the negative rates of both the cultures were high（55.0% and 23.1%）. There were 25 cases（96.2%） who underwent abdominal plain film examination and 21 cases（84.0%） showed signs of pneumoperitoneum. Abdominal ultrasonography was performed in 9 cases（34.6%），and no one was found pneumoperitoneum signs but with mainly ascites signs（88.9%）. The most favorite site of gastric perforation was the fundus of the stomach（61.6%），with single site perforation（92.3%） as the main site. Eighteen cases（69.2%） underwent pathological examination，and the majority（66.7%） was hyperemia and hemorrhage associated with necrosis of gastric wall. All cases were treated by emergency surgery，mainly taking gastric perforation repair and abdominal drainage（53.9%）. Follow-up within 3 months after discharge showed that a total of 24 cases（92.3%） recovered well after surgery，and only 1 case（3.9%） died after discharge due to refusal of reoperation and abandonment of treatment.Conclusion NGP usually occurs in males and within 4 days after birth. Infants with performance for abdominal distention，vomiting and poor response should be timely examined by abdominal plain film to discover whether there are signs of pneumoperitoneum. If timely operation can be performed，short-term prognosis of NGP is good.

Abstract:Objective To compare the safety and efficacy of percutaneous nephrolithotomy，flexible ureteroscope，and intelligent pressure-controlled suction system combined with flexible ureteroscope in the treatment of kidney stones with diameter>2 cm.Methods The clinical data of 90 patients（30 cases per group） with kidney stones with diameter>2 cm treated by percutaneous nephrolithotomy， flexible ureteroscope，and intelligent pressure-controlled suction system combined with flexible ureteroscope from January 2019 to March 2022 in Department of Urology，The First Affiliated Hospital of Chongqing Medical University were collected. The operation time，the intraoperative bleeding volume，the postoperative hospitalization time，the hospitalization cost，the incidence of surgical complications，and the stone clearance rate in 1 month after operation were compared among the three groups.Results The operation time in the percutaneous nephrolithotomy group[（54.1±22.7） min] and the flexible ureteroscope group[（53.9±27.0） min] was shorter than that in the intelligent pressure-controlled suction system combined with flexible ureteroscope group[（81.0±28.2） min] with statistical differences（P<0.05）. The intraoperative bleeding volume in the flexible ureteroscope group[（3.2±2.1） mL] and the intelligent pressure-controlled suction system combined with flexible ureteroscope group[（5.7±4.5） mL] was less than that in the percutaneous nephrolithotomy[（16.1±17.2） mL] with statistical differences（P<0.05）. The postoperative hospitalization time in the flexible ureteroscope group[（1.2±0.5） d] and the intelligent pressure-controlled suction system combined with flexible ureteroscope group[（1.5±1.7） d] was shorter than that in the percutaneous nephrolithotomy group[（6.4±5.2） d] with statistical differences（P<0.05）. The hospitalization cost in the intelligent pressure-controlled suction system combined with flexible ureteroscope group[（2.3±0.4） ten-thousand yuan] was less than that in the flexible ureteroscope group[（2.7±0.4） ten-thousand yuan yuan] with statistical differences（P<0.05）. While there were no statistically differences between the percutaneous nephrolithotomy group[（2.6±0.7） ten-thousand yuan yuan] and the other two groups in terms of the hospitalization cost（P>0.05）. The incidence of fever in the flexible ureteroscope group （33.3%） was higher than that in the percutaneous nephrolithotomy group（10.0%） and the intelligent pressure-controlled suction system combined with flexible ureteroscope group（3.3%） with statistical differences（P<0.05）. The incidence of renal calyx tear bleeding was 3.3%，0.0% in the flexible ureteroscope group，and 0.0% in the intelligent pressure-controlled suction system combined with flexible ureteroscope group，respectively，without statistical differences（P>0.05）. The incidence of renal pelvis and renal calyx mucosal injury in the intelligent pressure-controlled suction system combined with flexible ureteroscope group（3.3%） was lower than that in the percutaneous nephrolithotomy group（26.7%） and the flexible ureteroscope group（40.0%） with statistical differences（P<0.05）. The incidence of perirenal hematoma was 3.3%，0.0% in the flexible ureteroscope group，and 0.0% in the intelligent pressure-controlled suction system combined with flexible ureteroscope group，respectively，without statistical differences（P>0.05）. The stone clearance rate in 1 month after operation was 73.3%，20.0% in the flexible ureteroscope group，and 46.7% in the intelligent pressure-controlled suction system combined with flexible ureteroscope group，respectively，with statistical differences（P<0.05）.Conclusion Percutaneous nephrolithotomy，flexible ureteroscope， and intelligent pressure-controlled suction system combined with flexible ureteroscope are optional in the treatment of kidney stones with diameter>2 cm. Percutaneous nephrolithotomy has the most advantageous in the stone clearance rate，but the incidence of surgical complications is high and the complications are more severe. Intelligent pressure-controlled suction system combined with flexible ureteroscope has higher stone clearance rate than the flexible ureteroscope and lower complications rate. The intelligent pressure-controlled suction system combined with flexible ureteroscope is safe and efficient，so it’s worth promoting the application. The three surgical procedures should be selected according to the actual situations.

Abstract:Objective To screen the influencing factors of the incidence of prostatic cancer（PCa），build a risk prediction model for PCa and validate it.Methods Based on the Prostatic Cancer Early Warning Data Set of National Clinical Medical Science Data Center，and after the data processing， the data were randomly divided into a modeling group and a verification group according to 7∶3. Least absolute shrink-age and selection operator（LASSO） regression was used to screen the PCa characteristic indicators of the modeling group， multifactor logistic regression analysis was carried out to analyze the characteristic indicators，and the analysis results were used to build a PCa risk prediction model for the data of the modeling group. At the same time，the data of the modeling group were used for internal evaluation and the data of the validation group for internal verification.Results A total of 880 sample data were included，including 616 in the modeling group and 264 in the validation group. The 14 characteristic indexes screened by LASSO regression analysis were used for multivariate logistic regression analysis. The results showed that only globulin（OR=1.112，95%CI=1.044-1.185），inorganic phosphorus（OR=65.167，95%CI=20.437-207.796），total prostate specific antigen（tPSA）（OR=1.026，95%CI=1.014-1.037） and serum uric acid（OR=0.997，95%CI=0.994-0.999） had significant differences（P<0.05），and they were independent influencing factors for PCa. The calibration curve of the internal evaluation and internal verification of the PCa risk prediction model had high accuracy. The area under curve（AUC） of internal evaluation of the model was 0.766（95%CI=0.728-0.804），and the net benefit rate of decision curve analysis（DCA） of patients was 9%-72%；the AUC of internal validation of the model was 0.704（95%CI=0.639-0.768），and the net benefit rate of DCA of patients was 18%-59% and 63%-64%.Conclusion Globulin，inorganic phosphorus，tPSA and serum uric acid are independent influencing factors of PCa. The risk prediction model constructed by them has a good prediction effect.

Abstract:Objective To explore the prognostic risk factors of patients with primary liver cancer， so as to provide a scientific basis for the clinical diagnosis，treatment and prognosis of the patients with this disease.Methods The patients with primary liver cancer from the 2018 Surveillance，Epidemiology and End Results（SEER） database were served as the research subjects， the demographic data， clinical indicators and prognostic follow-up information were collected，and the risk factors affecting postoperative survival were analyzed by using the univariate and multivariate logistic regression. The consistency index was used to evaluate the prediction ability of the model，and the performance of the prediction model was analyzed by constructing the receiver operating characteristic（ROC） curve. The forest map was used to analyze the treatment methods of liver cancer patients at different stages.Results A total of 1 750 patients with primary liver cancer in 2018 were collected in the study. The univariate logistic regression results showed that the tumor staging，lymph node metastasis，distant metastasis，marital status，radiochemotherapy and surgery were the risk factors affecting the survival of the patients with primary liver cancer（P<0.05）；the multivariate Logistic regression analysis results showed that the tumor staging [T2/T3 relative to T1，OR=5.142/3.390，95%CI=（3.654-7.236）/（2.327-4.939），P<0.001]，distant metastasis（OR=4.810， 95%CI=3.384-6.839，P<0.001），marital status（0.729，95%CI=0.575-0.925，P=0.009），radiotherapy（OR=0.361，95%CI=0.260-0.503，P<0.001），chemotherapy（OR=0.512，95%CI=0.381-0.687，P=0.001） and surgery（OR=0.245，95%CI=0.105-0.574，P=0.028） were the risk factors affecting the survival of the patients with liver cancer. The significant variables in logistic regression were used to conduct the construction of the prediction model. The study showed that the concordance index of the model was 0.786 （95%CI=0.762-0.810），and the area under the curve（AUC） of the model was 0.790（95%CI=0.764-0.812）. The interventional means of radiotherapy alone showed an advantage in the patients with any tumor staging（P=0.003，P=0.013，P=0.003）. In the patients without lymph node metastasis，no matter which intervention means would reduce the mortality of the patients with liver cancer（P<0.001，P=0.001，P<0.001，P=0.004），but in the patients with lymph node metastasis， whether conducting intervention had no effect on the survival of the patients with liver cancer（P>0.05）. Among the patients without distant metastasis，the survival rate of the patients with only radiotherapy，only chemotherapy and chemotherapy + radiotherapy intervention was higher than that of the patients without intervention（P<0.001，P=0.001，P<0.001，P=0.004）. Among the patients with distant metastasis，only the interventional means of radiotherapy showed the advantage（P=0.002）.Conclusion The tumor staging，distant metastasis，marital status， radiochemotherapy and surgery are the risk factors affecting the prognosis of primary liver cancer.

Abstract:Immune system plays critical roles in bone regeneration. Macrophages， as an important component of the immune system， are highly plastic and can polarize to M1 and M2 subtypes depending on microenvironmental changes. Recently， the role of osteoclasts in bone regeneration has gradually gained attention. Although macrophages are precursors of osteoclasts that play an important role in bone regeneration through the macrophage-osteoclast axis， it is still controversial that which subtype of macrophages is more likely to fuse to form osteoclasts. In this paper， we have reviewed the recent research progress related to the relationship between macrophage subtypes and osteoclast formation， aiming to provide a comprehensive basis and more comprehensive knowledge for further research.

Abstract:Urothelial carcinoma（UC） is a common malignancy of the urological system. Under a variety of treatment measures，such as surgery，chemotherapy and immunotherapy，some patients still suffer disease recurrence and metastasis，leading to poor prognosis. Antibody-drug conjugate（ADC） combining the targeting of antibody drugs and the cytotoxicity of chemotherapeutic drugs，has recently become a research hotspot for individualized precision treatment of cancer and a new choice for these patients. At present，the clinical trials related to ADC in the treatment of UC have achieved fruitful results. Enfortomab Vedotin targeting Nectin-4，Sacituzumab Govitecan targeting TROP-2，and Disitamab Vedotin targeting HER-2 have been approved to be applied in clinical practice，and new ADCs for other targets have also begun to emerge. This article intends to review the latest research in this field.

Abstract:Nonalcoholic fatty liver disease（NAFLD） is a type of chronic liver diseases characterized by abnormal accumulation of triglycerides（TG） in the liver. Its incidence is increasing year by year，and it is the most common liver disease at present. Transmembrane 6 superfamily member 2（TM6SF2） is a member of the transmembrane protein superfamily. A large number of studies have confirmed that TM6SF2 plays an important role in the occurrence and development of NAFLD. This article reviews the role and possible mechanism of TM6SF2 in NAFLD.

Abstract:Currently，the pathogenesis of diabetic kidney diseases（DKD） is not fully clear. In recent years，with the development of gene sequencing method，more and more evidence has proved that the DKD is probably the result of genetic and environmental interaction. To understand the relationship between gene polymorphism and diabetic nephropathy is not only conducive to the prevention and diagnosis of DKD，also helps to provide new way for the design research and development of new drugs. This paper elaborates the DKD and the connections between the gene polymorphism.

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Abstract:Objective To investigate the distribution of bone metabolic-related gene polymorphism，such as bone morphogenetic protein 2（BMP2），in the Chongqing Han population and its correlation with coronary artery calcification（CAC）.Methods Clinical data and blood samples were collected from patients with coronary angiography in the Department of Cardiology，The First Affiliated Hospital of Chongqing Medical University from March 2019 to May 2019. The detection of BMP2 rs961253，rs235768，rs1049007；OPG rs2073617，rs2073618 and S100A12 rs2916191 gene were taken into direct sequencing. Serum levels of BMP2，OPG and S100A12 were detected by ELISA.Results There were 167 cases in CAC group，with age of （67.13±9.64） years，and 93 cases in control group，with age of （60.46±9.89） years. Patients with hypertension，diabetes and obesity were more likely to develop CAC. The male morbidity，apolipoprotein A1，C-reactive protein，white blood cell count，serum BMP2，S100A12 and OPG levels in CAC group were significantly higher than those in control group（P<0.05）. The genotype frequency and allele frequency distribution of BMP2 rs961253 were significantly different between CAC group and control group（P<0.05）. In CAC group，the serum BMP2 level of BMP2 TT genotype was significantly higher than that of non TT genotype（P<0.05）. After adjusting gender，age，body mass index，hypertension and diabetes，multivariate stepwise logistic regression analysis found that people with BMP2 rs961253 TT genotype had higher risk of CAC.Conclusion The serum level of BMP2 can be regarded as one of the prediction indicators for CAC. BMP2 rs961253 gene polymorphism is significantly associated with CAC，and BMP2 rs961253 T allele or TT genotype is a high risk factor for CAC.