Abstract:Objective To investigate the influence of brusatol on ferroptosis in cutaneous squamous cell carcinoma（cSCC） by regulating nuclear factor erythroid-2 related factor 2（Nrf2）/solute carrier family 7 member 11（SLC7A11）/glutathione peroxidase 4（GPX4） signaling pathway.Methods The proliferation rate of human cSCC cell line A431 cells after treatment with 0，100，250，500，700，900 nmol/L of brusatol was detected by CCK-8 method，and the appropriate concentration of brusatol was screened out. The A431 cells cultured in vitro were randomly separated into control group，low-dose brusatol group， high-dose brusatol group，tert-butylhydroquinone（TBHQ；Nrf2 activator） group，and high-dose brusatol+TBHQ group. After treatment with brusatol and TBHQ，respectively，the proliferation and apoptosis of A431 cells in each group were detected by CCK-8 method and Hoechst 33342 staining method；Kits were applied to detect the levels of antioxidant factors［glutathione（GSH），catalase（CAT），and superoxide dismutase（SOD）］ and ferroptosis indicators［iron content，reactive oxygen species（ROS） and malondialdehyde（MDA）］ in A431 cells in each group；the expressions of proliferation，apoptosis and Nrf2/SLC7A11/GPX4 signaling pathway-related proteins of A431 cells in each group were detected by Western blot.Results Compared with the control group，the cell proliferation rate，GSH，CAT，SOD levels，PCNA，Bcl-2，Nrf2，SLC7A11，and GPX4 protein expressions in the low and high dose brusatol groups were all decreased（P<0.05），and the apoptosis rate，iron content，ROS and MDA levels，and Bax protein expression were all increased（P<0.05）；the cell proliferation rate，GSH，CAT，SOD levels，proliferating cell nuclear antigen（PCNA），Bcl-2，Nrf2，SLC7A11，and GPX4 protein expressions in the high-dose brusatol group were further decreased than the low-dose brusatol group（P<0.05），and the apoptosis rate，iron content，ROS and MDA levels，and Bax protein expression were further increased（P<0.05）；the cell proliferation rate，GSH，CAT，SOD levels，PCNA，Bcl-2， Nrf2，SLC7A11，and GPX4 protein expressions in TBHQ group were increased（P<0.05），and the apoptosis rate，iron content，ROS and MDA levels，and Bax protein expression were decreased（P<0.05）. Compared with the high-dose brusatol group，the cell proliferation rate，GSH，CAT，SOD levels，PCNA，Bcl-2，Nrf2，SLC7A11，and GPX4 protein expressions in the high-dose brusatol alcohol+TBHQ group were increased （P<0.05），and the apoptosis rate，iron content，ROS and MDA levels，and Bax protein expression were decreased（P<0.05）.Conclusion Brusatol promotes ferroptosis，induces apoptosis of cSCC cells，and inhibits its proliferation by down-regulating Nrf2/SLC7A11/GPX4 signaling pathway.

Abstract:Objective To explore the changes of autophagy of mouse embryonic palatal mesenchymal cells after the changes of Shh signaling pathway in mouse embryonic palatal mesenchymal cells treated with dexamethasone（DEX） and smoothened agonist（SAG）.Methods C57BL/6J mouse palatal mesenchymal cells were cultured in vitro for 14.5 days and divided into 4 groups according to the interventions：blank control group，DEX group，DEX + SAG group and SAG alone group. The number of autophagosomes or autophagy lysosomes in each group was observed by transmission electron microscope，and the expression of Shh，Ptch1，Smo，Gli3A/R，Cyclin D1 and autophagy markers LC3 Ⅱ/Ⅰ，P62 and Beclin-1 were detected by Western blot.Results The results of electron microscopy showed that there was no significant difference in the number of autophagosomes/autophagy lysosomes between control group and DEX group， but a large number of autophagosomes/autophagy lysosomes could be observed after SAG intervention. The results of Western blot showed that compared with the control group，the expression of P62， Ptch1，Smo，Gli3A/R and Cyclin D1 in DEX group decreased significantly（P<0.05），while the expression of LC3Ⅱ/Ⅰ and Beclin1 had no significant change in DEX + SAG group and SAG group（P>0.05）. The expression of Ptch1，Smo，Gli3A/R and Cyclin D1 in DEX+SAG group and SAG group was significantly higher than that in DEX group（P<0.05），but there was no significant difference in Shh expression（P>0.05）. The Beclin1 expression increased significantly（P<0.05） and P62 expression significantly decreased（P<0.05）. Compared with SAG group，the expression of Smo，Gli3A/R，Ptch1 and Cyclin D1 in DEX+SAG group was significantly lowered down（P<0.05），while the expression of Shh was not significantly different（P>0.05）. And LC3Ⅱ/Ⅰ，Beclin1 and P62 expression were significantly increased（P<0.05）.Conclusion DEX can inhibit the Shh signaling pathway of mouse embryonic palatal mesenchymal cells and activate Shh signaling pathway. It can induce autophagy of mouse embryonic palatal mesenchymal cells and reactivate the Shh pathway，and autophagy turns more obvious.

Abstract:Objective To investigate the positive effects of ginsenoside Rg1 on non-alcoholic fatty liver disease（NAFLD） and regulation of the intestinal microbiota.Methods The 24 SD rats were randomly divided into the control group，high-fat and high-sugar （HFHS） group， ginsenoside Rg1 low dose treatment group，and ginsenoside Rg1 high dose treatment group. The NAFLD model rats were fed with HFHS diet. After 4 weeks’ treatment of ginsenoside Rg1，the rats were sacrificed under anesthesia. Then，their body weight and liver weight were measured. Meanwhile，the liver weight/body weight ratios were calculated. Enzyme-linked immunosorbent assay（ELISA） was used to detect the levels of total cholesterol（TC），triglyceride（TG），alanine aminotransferase（ALT），aspartate aminotransferase（AST），low density lipoprotein cholesterol（LDL-C），high density lipoprotein cholesterol（HDL-C），glutathione peroxidase（GSH-px），superoxide dismutase（SOD） and malondialdehyde（MDA） in peripheral blood serum. Hematoxylin eosin（HE） staining was used to observe liver steatosis. Additionally，16S rRNA gene bioinformatics analysis and statistics were conducted to detect the changes in microbial diversity of rats among the four groups.Results Ginsenoside Rg1 could reduce NAFLD-induced body weight（P<0.01） and liver weight（P<0.05）. The HE staining results showed that ginsenoside Rg1 intervention could effectively reduce liver steatosis in NAFLD rats（P<0.05）. ELISA test results showed that ginsenoside Rg1 intervention could reduce the expression of serum TG，TC，ALT，AST，LDL-C and MDA in NAFLD rats（P<0.05），while HDL-C and GSH-px were significantly increased after ginsenoside Rg1 intervention（P<0.05）. The α diversity results showed that high dosage ginsenoside Rg1 intervention could increase the community richness and community diversity of the intestinal microbiota in NAFLD rats（P<0.05）. The β diversity results showed that ginsenoside Rg1 intervention could change the structure of the intestinal microbiota in NAFLD rats（P<0.01）. The LEfSe（linear discriminant analysis effect size） analysis results showed that after high dose ginsenoside Rg1 intervention，the dominant species of intestinal microorganisms were Lachnospiraceae，Bifidobacterium，Bacteroides，Anaerobiospirillum and other intestinal probiotics.Conclusion Ginsenoside Rg1 intervention could alleviate liver fatty lesions and oxidative stress response in NAFLD rats. The pharmacological activity of ginsenoside Rg1 is probably related to the improvement of intestinal microbial structure and diversity，especially increasing the beneficial intestinal microbiota in NAFLD rats.

Abstract:Objective To establish a reversibly immortalized aortic valve mesenchymal cell line with rapid proliferation.Methods Valve tissue was clamped with spring scissors under stereomicroscope，and the valve tissue was digested with collagenase and affected with immortalized retrovirus. The cell proliferation ability was detected by crystal violet，CCK-8 and flow cytometry. The osteogenic ability of the cells was detected by ALP staining and alizarin red calcium salt deposition assay. The osteogenic markers were detected by q-PCR and Western blot.Results By light microscopy and immunofluorescence identification，we confirmed that the mesenchymal cells were successfully obtained. After affected with immortalized virus，light microscopy and immunofluorescence confirmed that there was no phenotypic change in valve mesenchymal cells，and a large amount of SV40T could be detected in immortalized cells（P<0.001）. The results of crystal violet staining，CCK-8（P<0.001） and flow cytometry showed that the proliferation rate of valve mesenchymal cells was faster after immortalization. After addition of osteogenic inducible factors BMP9，immortalized valve mesenchymal cells showed better osteogenic ability，and the most of osteogenic markers were significantly increased at the molecular level. There was no significant change in the morphology of valve mesenchymal cells after deimmortalization，and q-PCR results showed that SV40T was significantly reduced（P<0.001）. Cell proliferation was significantly decreased， and the cell cycle was arrested in the G₀/G₁ phase. Deimmortalization valve mesenchymal cells induced by BMP9 also had osteogenic differentiation ability，and most osteogenic markers were significantly increased.Conclusion We have successfully established reversibly immortalized valve mesenchymal cell lines，which can be induced by BMP9 for osteogenic differentiation and can be used for subsequent studies of calcified aortic valve disease.

Abstract:Objective To investigate the relationship between the preoperative abundance of fine-needle aspiration（FNA）-BRAF^V600E mutations and clinicopathological features of papillary thyroid cancer（PTC）.Methods Retrospective analysis was performed on the clinical data of 301 patients who underwent radical thyroidectomy in Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine from January 30，2021 to February 28，2022. Preoperative FNA of all patients showed BRAF^V600E mutation. All patients underwent preoperative mutant abundance detection， and PTC was confirmed by postoperative pathology analysis. The relationship between BRAF^V600E mutant abundance and clinicopathological features was analyzed.Results A total of 301 patients were enrolled，including 91 males and 210 females. The median age of the patients was 42（33-51） years old， ranging from 18 to 69 years old. The abundance of BRAF^V600E mutation in patients with tumor diameter more than 1 cm was higher than that in patients with tumor diameter no more than 1 cm［29.05（18.03-37.56） vs. 18.35（6.74-29.61），P<0.001］. The abundance of BRAF^V600E mutation in patients with cervical lymph node metastasis was higher than that in patients without cervical lymph node metastasis［24.72（8.08-34.32） vs. 18（8.68-28.54），P=0.040］. The abundance of BRAF^V600E mutation in female patients with cervical lymph node metastasis was higher than that in patients without cervical lymph node metastasis［25.75（9.62-34.30） vs. 17.47（7.27-26.86），P=0.007］，but there was no statistical significance among male patients（P=0.654）. The receiver operating characteristic（ROC） curve for predicting cervical lymph node metastasis in female PTC patients was constructed with the abundance of BRAF^V600E mutation（AUC=0.609，95%CI=0.532-0.686），and the cutoff value was 25.65%. Multivariate analysis showed that the following aspects had a significant correlation with cervical lymph node metastasis in female PTC patients（P<0.05），such as less than 55 years old（OR=0.138-0.735，P=0.007），BRAF^V600E mutant abundance no less than 25.68%（OR=1.271-4.65，P=0.007），multifocality（OR=1.282-4.623，P=0.007） and tumor diameter more than 1 cm（OR=2.257-11.927，P<0.001）.Conclusion The abundance of BRAF^V600E mutation was significantly correlated with tumor diameter and cervical lymph node metastasis in PTC patients. The rate of cervical lymph node metastasis of female PTC patients with BRAF^V600E mutant abundance of no less than 25.68% has been significantly increased.

Abstract:Objective To explore the role of SET and MYND domain-containing protein 2（SMYD2） in the glucose metabolism of cervical cancer cell，and further study whether it is related to cervical cancer proliferation.Methods Gene expression profiling interactive analysis（GEPIA） was used to analyze the expression profile and prognosis of SMYD family members in cervical cancer，and survival differences were compared by log-rank test. The role of SMYD2 in glucose metabolism in cervical cancer was studied by shRNA knockdown or overexpression of SMYD2.Results The expression of SMYD2 in cervical cancer tissues was not related to age，gender and the degree of tissue differentiation，but was related to clinical stage（F=4.520， P=0.004）. The high expression of SMYD2 predicted poor overall survival. Bioinformatics analysis revealed that SMYD2 played a regulatory role in regulating the Warburg effect in cervical cancer. The deletion of SMYD2 inhibited aerobic glycolysis of cervical cancer cells by functional loss experiments，which showed decreased glucose uptake，lactic acid production and extracellular acidification. SMYD2 overexpression promotes glycolysis metabolism of cervical cancer cells. In addition， SMYD2 was essential for the growth of cervical cancer cells， and this carcinogenic activity was mainly dependent on glycolysis.Conclusion SMYD2 is overexpressed in cervical cancer cells and plays an important role in tumor metabolism， which can promote the proliferation of cervical cancer cells by regulating aerobic glycolysis.

Abstract:Objective To investigate the role of mitochondrial calcium uniporter（MCU） and leucine zipper/EF hand-containing transmembrane-1 （LETM1） in regulating mitochondrial calcium homeostasis and its effect on the metastasis of oral squamous cell carcinoma cells.Methods Oral squamous cell carcinoma CAL-27 cell line was selected as the research objects. MCU lentiviral interference vector and overexpression plasmid were constructed. LETM1 siRNA interference sequence was synthesized. Cell scratch test and Transwell cell invasion test were used to detect the effect of MCU expression level on the invasion and migration of CAL-27 cells. Intracellular calcium fluorescent probe（Fluo-4 AM ） and JC-1 mitochondrial membrane potential assay were used to detect the effect of MCU expression level on intracellular calcium concentration and mitochondrial membrane potential of CAL-27 cells. The expression levels of MCU，LETM1 and epithelial-mesenchymal transition （EMT）-related proteins in CAL-27 cells were detected by immunofluorescence and Western blot.Results Migration and invasion of CAL-27 cells were promoted by overexpression of MCU. Migration and invasion of CAL-27 cells were significantly inhibited in MCU silencing group and MCU overexpression combined with LETM1 siRNA interference group（F=45.302，1 300.246； all P>0.05）. The intracellular calcium fluorescence intensity and mitochondrial membrane potential were significantly increased in MCU overexpression group，and significantly decreased in MCU silencing group and MCU overexpression combined with LETM1 siRNA interference group（F=75.585，141.767；all P<0.01）. The protein expression levels of MCU，LETM1，N-cadherin and Vimentin in MCU overexpression group were significantly increased，while the protein expression level of E-cadherin was significantly decreased. The protein expression levels of MCU，LETM1，N-cadherin and Vimentin in MCU silencing group were significantly lower than those in other treatment groups，while the protein expression level of E-cadherin was significantly increased（all P<0.01）.Conclusion MCU can regulate the expression of LETM1 and EMT markers. Interference with LETM1 can block MCU up-regulation of mitochondrial calcium concentration and mitochondrial membrane potential and reduce the invasion and migration of oral squamous cell carcinoma cells.

Abstract:Objective To evaluate the predictive role of triglyceride-glucose index（TyG index） in long-term major adverse cardiovascular events（MACE） in patients with acute myocardial infarction（AMI） undergoing percutaneous coronary intervention.Methods Patients with AMI undergoing percutaneous coronary intervention who were admitted to Beijing Shijingshan Hospital from December 2012 to October 2018 were retrospectively analyzed. The formula for TyG index was： ln［fasting triglyceride（mg/dL） × fasting blood glucose（mg/dL）/2］. Patients were divided into three groups based on TyG index tertiles，and their clinical and laboratory data and MACE （including all-cause death，non-fatal myocardial infarction， or re-vascularization） were recorded. Cox risk regression analysis was used for univariate and multivariate analysis.Results The median follow-up time was 31（21-41） months，45 cases（9.3%） died and 91 cases（24.2%） had MACE. With the increase of TyG index， the incidence of MACE significantly increased（P=0.027）. Patients with MACE were older， and had higher levels of TyG index，fasting blood glucose，glycated hemoglobin（HbA1c） and uric acid. In addition，older patients had a higher proportion of previous diabetes，cerebrovascular history，Killip grade > 1 and three-vessel lesions. TyG index was an independent predictor of long-term （more than 1 year） mortality after adjustment for other confounders in multivariate Cox regression analysis（HR=1.656；95%CI=1.226-2.237；P=0.001）. Kaplan-Meier analysis showed that patients with high TyG index had the lowest survival rate of MACE（P=0.011）.Conclusion TyG index is an independent predictor of long-term MACE in AMI patients undergoing percutaneous coronary intervention.

Abstract:Objective To explore the correlation between computed tomography（CT） signs and infiltration degree of pure ground-glass nodule（pGGN） lung adenocarcinoma，and establish a prediction model of CT signs and infiltration degree.Methods The clinical data and CT signs of 424 patients with lung adenocarcinoma confirmed by surgical resection，pathological biopsy and chest CT findings of pGGN were analyzed retrospectively，and according to the results of pathological biopsy，they were divided into four groups： atypical adenomatous hyperplasia，adenocarcinoma in situ，minimally invasive adenocarcinoma and invasive adenocarcinoma. The Chi-square test or Fisher’s exact probability test was used for statistical analysis of differences between groups. For the results with statistical significance，six learning algorithms in Waikato environment for knowledge analysis（WeKa） were used to build the prediction model，verify the accuracy，and select the prediction model most suitable for this study.Results The differences in nodule diameter and nodule density between the four groups were statistically significant（P<0.001），with the corresponding mean diameters of 6.90，8.65，10.71 and 14.56 mm，and the corresponding mean densities of -633.16，-543.04，-401.03 and -322.94 HU，respectively. The diameter and density of the nodules showed an obvious upward trend with the increase of the degree of invasion of the lesions. There were statistically significant differences among the four groups in nodule boundary，lobulation，burr，vascular perforation，pleural indentation，air bronchogram sign，and vacuole sign（P< 0.05），but there were no statistically significant differences in nodule growth position，age，smoking history，family history of lung cancer in immediate family（P>0.05）. The prediction accuracy of the model constructed by the random forest algorithm fluctuated between 76.42% and 79.72%，the Kappa coefficient fluctuated between 0.597 and 0.670， and the area under the receiver operating characteristic（ROC） curve was greater than 0.9，which was the best among the error indicators. Thus，it is the most suitable prediction model for this study.Conclusion The different CT signs of pGGN are closely related to the degree of infiltration， and can be used to establish a prediction model. Based on the model built by random forest algorithm，the average accuracy of quickly identifying the pGGN infiltration degree in the early stage before invasive intervention is 78.07%，which is the highest accuracy，and can potentially be used in the prediction of lung cancer in the future.

Abstract:Objective To investigate the trend of perioperative heart rate variability（HRV） in patients undergoing off-pump coronary artery bypass grafting （OPCABG），and the extent to which hypertension and/or type 2 diabetes mellitus（T2DM） factors influence this trend.Methods A retrospective study was conducted to reflect the early changes in HRV in the hospitalization of 521 patients with OPCABG from December 2020 to March 2022 who needed OPCABG for treating coronary atherosclerotic heart disease during hospitalization. According to whether the patient had previous hypertension or/and T2DM，patients were divided into four groups：A，B，C，and D. Among them，patients in group A had hypertension combined with T2DM（n=118）， patients in group B had simple hypertension （n=183），patients in group C had T2DM alone（n=81），and patients in group D had no previous hypertension and no T2DM（n=139）. An independent-samples t-test was performed on 521 patients to observe the changes of the standard deviation of NN interval（SDNN） and the root-mean-square of difference-value of adjacent RR interval（rMSSD） in the OPCABG perioperative period. At the same time，the univariate ANOVA test was performed with 4 groups of patients，and Bonferroni post hoc test was performed to explore the relationship among hypertension，diabetes and HRV.Results The time-domain indexes SDNN and rMSSD of perioperative HRV of OPCABG decreased compared with those before the operation［SDNN：（89.744±23.350） ms vs. （58.027±13.565） ms；rMSSD：（29.184±13.060） ms vs. （20.132±9.298） ms，all P<0.05）. The SDNN indexes［（51.258±10.358） ms］ in the hypertension combined with T2DM group were lower than those in the hypertension group［（59.271±11.858） ms，P<0.001］，and those were lower in hypertension combined with T2DM group［（51.258±10.358） ms］ than in the T2DM group［（55.273±9.538） ms，P=0.182］. The rMSSD index after OPCABG （20.132±9.298） was lower than that before surgery（29.184±13.061，P<0.001）.Conclusion HRV function is seriously impaired in early postoperative patients. The decline in SDNN index is most obvious in patients with prior hypertension and T2DM after OPCABG， and T2DM factor plays a greater role in the decline of HRV in the early postoperative period than hypertension，and T2DM plays a greater role in the coordination and dysfunction of sympathetic and parasympathetic nerves in the early postoperative period. The overall decline in vagus nerve function in postoperative patients，and the effects of hypertension and T2DM factors on the decline of vagus nerve function in the early postoperative period are not specific

Abstract:Objective To compare the clinical efficacy of dismembered pyeloplasty via different surgical approaches in the treatment of ureteropelvic junction obstruction（UPJO） induced hydronephrosis in children.Methods The clinical data of 90 children with hydronephrosis caused by UPJO admitted to Anhui Children’s Hospital from January 2019 to October 2021 were retrospectively selected. According to the approach of the dismembered pyeloplasty，they were divided into laparoscopic group（n=49） and conventional group（n=41）. The laparoscopic children were treated with three-hole laparoscopic dismembered pyeloplasty， and the conventional group were treated with the dismembered pyeloplasty through the transverse incision of the waist and abdomen. The anastomotic time，the amount of bleeding，the length of incision and the amount of paracetamol after operation were compared between the two groups. Comparison of anterior and posterior renal pelvis diameter and renal cortical thickness before and after surgery in the two groups was also made. The average hospitalization time， average feeding time and hospitalization expenses after operation were compared between the two groups. The incidence of complications such as incision infection，urinary exostosis and fever were compared between the two groups.Results Children in the laparoscopic group had shorter intraoperative anastomosis time and incision lengths，and lower intraoperative bleeding and postoperative acetaminophen doses than children in the conventional group（P<0.05）. After surgery， children in the laparoscopic group had lower anterior and posterior pelvic diameters and higher renal cortical thickness compared to the conventional group（P<0.05）. Children in the laparoscopic group had a shorter average postoperative hospital stay，a shorter average postoperative feeding time and lower postoperative hospital costs than children in the conventional group（P<0.05）. The complication incidence of children in the laparoscopic group was 12.24%（6/49） lower than that of children in the conventional group，which was 36.58%（15/41）（P<0.05）.Conclusion The results of dissecting pyeloplasty for hydronephrosis due to UPJO in the pediatric population are significantly better with a three-hole laparoscopic procedure than with a conventional transverse lumbar abdominal incision.

Abstract:Objective To investigate the effect of transcutaneous electrical acupoint stimulation（TEAS） combined with ultrasound-guided pudendal nerve block on analgesia and pregnancy outcome of pregnant women in vaginal delivery.Methods A total of 106 primiparas who delivered vaginally in our hospital from July 2021 to January 2022 were selected in the study and randomly divided into two groups with 53 cases in each group：TEAS combined with ultrasound-guided pudendal nerve block（TP group） and pure epidural analgesia（EP group）. Visual Analog Scale（VAS） scores and β-endorphin（β-EP） concentrations were observed at before intervention（T₀），uterine opening to 6.0 cm（T₁） and the fetal head crowned（T₂）. Besides，the duration of labor，1-minute Apgar score of newborns，perineum condition and complications after delivery were compared between the two groups.Results The VAS scores of the two groups of parturients were both obviously decreased since the beginning of analgesia（P<0.01），and the degree of decrease of VAS scores was different at different time points；the VAS score of TP group was higher than that of EP group at T₁，but lower than that of EP group at T₂（P<0.05）；compared with the EP group，the β-endorphin concentration of the TP group increased at T₁ and T₂（P<0.05）；the first stage of active labor and the second stage of labor time of TP group was shorter than that of EP group，and the rate of maternal perineal lateral resection of TP group was significantly lower than that of EP group（P<0.05），without statistically significant difference in the Apgar score and device-assisted rate of newborns between two groups（P>0.05）.Conclusion The analgesic effect of TEAS is not as significant as that of epidural block in the first stage of labor，while TEAS combined with ultrasound-guided pudendal nerve block can reduce labor pain in the whole process of labor to a degree，shorten the labor process and protect the perineum. And there is no adverse effect，especially when parturient are not suitable for intraspinal analgesia，it can be used as a safe and effective multimodal analgesia in clinic.

Abstract:Objective To investigate therapy response and progression-free survival（PFS） with different doses of ¹³¹I in postoperative patients with low- and intermediate-risk differentiated thyroid carcinoma（DTC）.Methods A total of 201 DTC patients with a total of 236 person-time ¹³¹I treatments with different doses of ¹³¹I were retrospectively analyzed. Serological and imaging indexes at 6 to 12 months after treatment were determined to evaluate the response of patients. And they were divided into four groups（G1 to G4 group） according to ¹³¹I administered activity（1.1 GBq once，1.1 GBq twice，3.0 GBq，3.7 GBq）. The patients were followed up for 12 to 90 months，and their serological， imaging and treatment records were collected after ¹³¹I therapy to assess the progression. Chi-square test and Fisher’s exact test were performed to compare the differences in efficacy response and influencing factors among the treatment groups. Kaplan-Meier method and log-rank test were used to compare the PFS. Cox proportional risk model was used to evaluate the independent risk factors for PFS.Results ①Total rate of excellent response（ER）/indeterminate response（IDR）/biochemical incomplete response（BIR）/structural incomplete response（SIR） among 4 groups were 41.5%（98/236），44.9%（106/236），6.8%（16/236） and 6.8%（16/236） respectively. ②The ER rates of G1 to G4 groups were 16.67%（10/60），42.86%（15/35），56.52%（13/23），and 50.85%（60/118）；the IDR rates of the four groups were 60.00% （36/60），45.71%（16/35），30.43%（7/23），and 39.83%（47/118）；the BIR rates of the four groups were 10.00%（6/60），0.00%（0/35），4.35%（1/23），and 7.63%（9/118）；the SIR rates of the four groups were 13.33%（8/60），11.43%（4/35），8.70%（2/23），and 1.69%（2/118） respectively. ③There was statistically significance in the rate of ER between G1 and G2/G3/G4（P=0.005；0.000；0.000） and SIR between G1 and G4（P=0.003）. ④The median follow-up time was 30 months，with progression observed in 18 patients（8.96%）. There were no significant differences in PFS among different doses of ¹³¹I（P=0.112）. Multivariate analysis showed that age and therapy response were independent prognostic factors for PFS.Conclusion The short-term ablation efficacy of ¹³¹I between multiple low-dose（1.1 GBq twice） group and high-dose（3.0 and 3.7 GBq） groups has no significant difference in postoperative patients with low- and intermediate-risk DTC. Different doses of ¹³¹I are not significantly related to PFS. For patients with ER and aged < 55 years，there is a PFS benefit.

Abstract:Objective To discuss the relationship between the chromosomal abnormal karyotype and the indication of antenatal diagnosis.Methods To perform amniocentesis under the B-ultrasonic guidance and then conduct the amniotic cell culture and karyotype analysis，from the 2 860 cases of pregnant women with different indication of antenatal diagnosis，who came to the Department of Obstetrics and Gynecology，Woman and Children's Hospital of Chongqing Medical University from January 2019 to December 2019.Results The success rates of amniotic cell culture were 96.2%. Total 119 chromosomal polymorphisms cases were detected with 4.33% ratio and 153 cases were abnormal karyotypes with detection rate of 5.56%，among which the ratio of numerical abnormality was 43.1%（66/153），the ratio of abnormal structure was 38.6%（59/153），and the ratio of chimera abnormality was 18.3%（28/153）. In the prenatal diagnosis indication，the detection rate of known family history of chromosome disorders was highest（32.93%），and secondly was that of NIPT（non invasive prenatal testing）（28.99%）. Chromosomal abnormal karyotype detection rate in very advanced maternal age（≥40） with other prenatal diagnosis indication was significantly higher than that of in advanced maternal age（35-39） with other prenatal diagnosis indication and in very advanced maternal age（≥40） without other prenatal diagnosis indication.Conclusion Chromosome karyotype analysis of amniotic cells in pregnant women can provide theoretical reference for prenatal diagnosis and prenatal consultation.

Abstract:Objective To explore the correlation between chronic hepatitis C（CHC） and thyroid dysfunction（TD），and the predictors of TD induced by hepatitis C.Methods A total of 95 patients diagnosed with CHC in The First People's Hospital of Yunnan Province from June 2018 to December 2021 were selected， and they were divided into low hepatitis C virus（HCV）-RNA group（<10⁵ IU/mL） （37 cases） and high HCV-RNA group（>10⁵ IU/mL）（47 cases），according to their HCV-RNA expression level. And 41 healthy controls were selected randomly from whom made the physical examination in our hospital at the same period. Relevant laboratory indicators， including thyroid stimulating hormone（TSH），thyroxine（T4），triiodothyronine（T3），free thyroxine（FT4），free triiodothyronine （FT3），aspartate transaminase（AST），alanine aminotransferase（ALT），alkaline phosphatase（ALP），total bilirubin（TBIL），direct bilirubin（DBIL），total protein（TP），albumin（ALB），globulin（GLB），blood urea nitrogen（BUN），creatinine（Cr），and glucose（G），were collected to explore the relationship between thyroid hormone and related biochemical indicators and HCV-RNA load in CHC patients. According to whether they had TD or not， they were divided into hepatitis C group and hepatitis C combined with TD group. Fourteen cases of hepatitis C combined with TD group and 15 cases of hepatitis C group were selected，and 15 cases of healthy people were randomly selected as the control group. The laboratory indicators of the three groups were statistically analyzed.Results Among 95 patients with CHC，15 patients were complicated with TD，and the detection rate was 15.79%. Compared with the control group，the low HCV-RNA group and the high HCV-RNA group were significantly different in T4，T3，FT4，FT3，AST，ALT，DBIL，ALB and GLB（P<0.05）. Disordered multiple logistic regression analysis showed that GLB（OR=1.379，95%CI=1.060-1.5793，P<0.05） might be a predictor of increased viral load. Compared with the control group，GLB（OR=1.425，95%CI=1.094-1.856，P<0.05） could be a predictor， FT3 （OR=3.543， 95%CI=1.472-8.356，P<0.05） could be a predictor. There were significant differences in TSH，FT4，FT3，AST，ALT，ALP，ALB and GLB among the control group， hepatitis C group and hepatitis C combined with TD group（P<0.05）.Conclusion The level of viral load in patients with CHC is related to the level of thyroid hormone， which has certain guiding significance for clinical practice.

Abstract:Objective To investigate shear wave elastography（SWE）and fine-needle aspiration washout thyroglobulin（FNA-Tg）in the diagnosis of cervical lymph node metastasis of thyroid papillary carcinoma.Methods The data of 159 patients with papillary thyroid carcinoma（PTC） confirmed by pathology were analyzed retrospectively，and 211 suspected lymph nodes in the neck were examined by ultrasonic examination，SWE E_mean and FNA-Tg. The diagnostic efficacy of each method was compared with the postoperative pathological results as the gold standard.Results ①The SWE E_mean metastasis group [（50.96±27.66） kPa] was significantly higher than the non-metastasis group [（32.20±17.34） kPa]，with a statistically significant difference（t=8.761，P<0.01）. The receiver operating characteristic（ROC） curve analysis showed that SWE E_mean optimal diagnostic threshold of 40.42 kPa had a higher predictive value for cervical lymph node metastasis of PTC，with an area under the curve（AUC） of 0.849（95%CI=0.795-0.902，P<0.01）. ②Compared with SWE E_mean，the sensitivity，specificity，diagnostic value，positive predictive value and negative predictive value were significantly increased（χ²=7.724，28.230，35.094，21.731，9.890；P=0.005，<0.000，<0.000，<0.000，0.002）. Compared with FNA-Tg，the sensitivity，specificity，diagnostic value，positive predictive value and negative predictive value of the combined method were significantly increased（χ²=7.724，6.014，13.526，6.137，7.602；P=0.005，0.014，<0.000，0.013，0.006）. ③The accuracy of SWE E_mean was 53.8% with and 79.8% without cystic changes in lymph nodes，respectively，with a statistical significance（χ²=4.819，P=0.028）. The accuracy of FNA-Tg was 92.3% and 87.4%，respectively，with no significant difference（χ²=0.275，P=0.600）.Conclusion FNA-Tg has a high accuracy in the diagnosis of PTC metastatic lymph nodes，and is not affected by the presence or absence of cystic changes in lymph nodes. The combination of SWE E_mean and FNA-Tg can significantly improve the diagnostic efficiency.

Abstract:Objective To investigate the distribution of pathogenic bacteria，risk factors and countermeasures of nosocomial infection in elderly patients in gastroenterology department.Methods A total of 265 elderly patients admitted to the Gastroenterology Department，Chongqing Emergency Medical Center from May 2019 to October 2022 were selected as research objects. According to whether the patients had infection during hospitalization，they were divided into the infected group（n=87） and the non-infected group（n=178）. The infected sites of elderly patients with nosocomial infection in the department and the distribution of pathogenic bacteria after isolation and culture were observed. Binary logistic regression model was used to analyze the risk factors of nosocomial infection in elderly patients in the gastroenterology department.Results Among 265 elderly patients in the gastroenterology department，87 cases were infected，including 33 cases of respiratory tract infection，15 cases of urinary tract infection，20 cases of digestive system infection，13 cases of skin and soft tissue infection，and 6 cases of catheter-related bloodstream infection. And 87 strains of pathogenic bacteria were isolated from 87 elderly patients with nosocomial infection in the gastroenterology department by bacterial culture，including 28 strains of Gram-positive bacteria（32.18%），52 strains of Gram-negative bacteria（59.77%） and 7 strains of fungi（8.05%）. There was no significant difference in gender，course of disease，history of hypertension，smoking history，drinking history and BMI between the infected group and the non-infected group（P>0.05）. There were statistically significant differences in age，duration of antibiotic use，length of hospital stay，mechanical ventilation，diabetes，indignant catheter，hemoglobin，albumin，and indignant gastric tube（P<0.05）. Logistic regression analysis showed that age > 70 years old，duration of antibiotic use > 48 h， duration of hospital stay > 15 d，mechanical ventilation，diabetes，indignant catheter，hemoglobin < 90 g/L，albumin< 30 g/L and indignant gastric tube were independent risk factors for nosocomial infection in elderly patients in the gastroenterology department（P<0.05）.Conclusion Staphylococcus aureus，Acinetobacter baumannii and Pseudomonas aeruginosa dominate the pathogenic bacteria in elderly patients with nosocomial infections in the gastroenterology department，and the occurrence of nosocomial infections is related to age，antibiotic use time，hospital stay，mechanical ventilation，diabetes，indignant catheter，hemoglobin < 90 g/L，albumin < 30 g/L，indignant gastric tube and other factors. Clinical attention should be paid to reducing the incidence of nosocomial infection through relevant intervention measures.

Abstract:Cancer metabolic reprogramming caused by genomic instability is considered to be a unique marker of tumor，providing a necessary energy source for the rapid growth and proliferation of cancer cells. Circular RNAs are a class of noncoding RNAs with a closed circular structure. They can function by interacting with other RNAs or proteins to affect the protein level. Recently，increasing studies have shown that circular RNAs are involved in the regulation of cancer metabolic reprogramming. However，there are few reviews on the role of circular RNAs in cancer metabolism. Therefore，in this paper，we will systematically elaborate the relationship between circular RNA and cancer metabolism， providing a better theoretical basis for the diagnosis and treatment of clinical cancer.

Abstract:Estrogen-related receptor α（ERRα） is a member of the nuclear receptor superfamily. ERRα is an orphan receptor，which does not need to bind with ligands to perform biological functions. ERRα is involved in the estrogen signal pathway and is an important transcription factor regulating cellular energy metabolism. In recent years，studies have found that ERRα is closely related to the progression of estrogen-dependent and non-estrogen-dependent tumors，and regulates the occurrence，progression， metastasis and drug resistance of various tumors. This article reviews the physiological function of ERRα and its role in a variety of cancers， and summarizes the new progress in this field.

Abstract:Paraneoplastic neurological syndromes（PNS） are a group of rare immune-mediated diseases in which tumors affect the nervous system through remote effects. Clinical symptoms are diverse and usually accompanied by specific neural antibodies. In 2021，the international expert group revised the 2004 version of the PNS diagnostic criteria，developed a new clinical scoring system， and highlighted the relationship between “phenotype-antibody-tumor”. This review aims to summarize the progress of the diagnosis of PNS， with a special focus on the new diagnostic criteria.

Abstract:Diffuse large B-cell lymphoma（DLBCL） is an aggressive lymphoma usually treated with CD20 monoclonal antibodies （mAb），rituximab in combination with chemotherapy. However，there are still some relapsed/refractory（R/R） patients who cannot be cured. In recent years，many novel monoclonal antibodies have been developed to treat DLBCL，which has significantly improved the prognosis of R/R DLBCL. In this review，we systematically discuss these mAb，including traditional mAb，bispecific antibodies （bsAb），and antibody-drug conjugates（ADCs）. Firstly，other traditional mAb rather than rituximab are introduced in this review， mainly involving the improvement of monoclonal antibody structure and targeting more targets. Then，we elaborate the basic structure and mechanism of bsAb，as well as various possibilities brought by various combination from different binding sites. Finally，the mechanism and structure of ADCs are analyzed and compared in detail. The article also reviews the latest clinical trial data of these antibodies in treatment of DLBCL，including response rates，progression-free survival and other efficacy results，as well as major adverse reactions.