Abstract:Objective To investigate the positive rate of thalassemia genes，genotypes，and distribution characteristics in children in Chongqing area of China.Methods Common α- and β-thalassemia gene mutation sites were detected for 28 287 children with suspected thalassemia who underwent hematological screening at Children’s Hospital of Chongqing Medical University from January 2011 to December 2022，and related analyses were performed to investigate the changing trends of detection rate and the composition ratio of thalassemia carriers，as well as genotype distribution.Results Among the 28 287 children with suspected thalassemia，there were 15 249 children with thalassemia，with a positive rate of 53.91%. The positive rates of α-，β-，and αβ-thalassemia were 22.41%（6 340 cases），30.43%（8 609 cases），and 1.06%（301 cases），respectively，and the positive rate of moderate-to-severe thalassemia was 2.47%（698 cases）. From 2011 to 2022，the linear regression k-values of the composition ratio of α-thalassemia carriers in each age group were -0.002，0.004，0.006，0.010，and 0.012，respectively，while those for β-thalassemia were 0.011，0.004，0.002，and -0.001，respectively. A total of 21 α-thalassemia genotypes were detected，among which --SEA/αα was the main genotype accounting for 69.58%. A total of 46 β-thalassemia genotypes were detected，with the main genotypes of CD17/βN，CD41-42/βN，and IVS-II-654/βN，accounting for 31.75%，27.92%，and 25.21%，respectively，and 84.88% in total.Conclusion There is a relatively high positive rate of common thalassemia gene mutation sites in children in Chongqing area，as well as a relatively high proportion of children with moderate-to-severe thalassemia. From 2011 to 2022，the detection rate of α-thalassemia carriers increases with age，while that of β-thalassemia decreased with age，indicating that some β-thalassemia patients receive genetic diagnosis at an older age. In Chongqing area，the main thalassemia genotypes are --SEA/αα，CD17/βN，CD41-42/βN，and IVS-II-654/βN in children，which are consistent with those in adults，but are different from those in the areas with a high incidence rate of thalassemia，such as Guangdong and Guangxi provinces. These results have significant implications for the intervention and prevention of thalassemia in Chongqing area.

Abstract:Objective To explore the correlation between serum sterol regulatory element binding protein-2（SREBP-2） and acute cerebral infarction（ACI）.Methods From October 2020 to March 2021，134 ACI patients were recruited as the ACI group and 34 healthy individuals were recruited as the control group. Serum SERBP-2 concentration was detected by enzyme-linked immunosorbent assay（ELISA） and subgroup analysis was conducted based on trial of Org 10 172 in acute stroke treatment（TOAST） classification and whether patients had diabetes mellitus. National Institutes of Health Stroke Scale（NIHSS） score was used to evaluate the disease severity of patients and the correlation between serum SREBP-2 and the severity was analyzed. The modified Rankin scale was used to assess the 90-day functional prognosis of the ACI group. The ACI patients were classified into favorable outcomes group and unfavorable outcomes group and serum SREBP-2 concentration of two groups were compared. Logistic regression was used to analyze whether serum SREBP-2 was related to ACI prognosis.Results Serum SREBP-2 concentration of the ACI group was significantly lower than that of the control group［72.60 （57.50， 83.35） ng/mL vs. 86.80（77.20，97.90） ng/mL，P=0.000］. The area under the curve for serum SREBP-2 concentration to identify patients with ACI and healthy people was 0.782（P=0.000）. Serum SREBP-2 concentrations of subtype of large artery atherosclerosis，cardio-embolism and small artery occlusion were all lower than that of the control group（P=0.000，P=0.003，P=0.000）. Serum SREBP-2 concentration of ACI patients with diabetes mellitus was higher than those without（P=0.021）. In the ACI group，serum SREBP-2 concentration was not correlated with the NIHSS score at admission（P>0.05）. Serum SREBP-2 concentration of the favorable outcomes group was lower than that of the unfavorable outcomes group，but the difference had no statistical significance（P>0.05）. Logistic regression analysis showed that serum SREBP-2 concentration was not associated with 90-day functional prognosis of ACI（OR=1.016，95%CI=0.991-1.042，P=0.205）.Conclusion Serum SREBP-2 concentration decreases significantly in ACI patients. Serum SREBP-2 has a certain efficacy in identifying patients with ACI and healthy people. However，serum SREBP-2 has no correlation with the severity and prognosis of ACI patients.

Abstract:Objective To investigate the regulatory effects of estrogen receptor G protein-coupled receptor 30（GPR30） on oxidative stress injury and inflammatory response in oxygen-glucose deprivation and reperfusion（OGD/R） BV-2 cells，and to investigate its protective effect on OGD/R BV-2 cells and its related mechanism.Methods BV-2 cells were treated with ODG for 4 h and then reperfused for 2 h，4 h，6 h or 12 h. The protein expression level of GPR30 was detected by Western blot. BV-2 cells were transfected with packaged pcDNA3.1，PCDNA3.1-GPR30，sh-NC，sh-GPR30 lentiviruses，and then reperfused for 12 h after treated with ODG for 4 h. qRT-PCR was used to detect the expression level of GPR30 mRNA to verify its transfection efficiency. Western blot was used to detect the protein expression levels of GPR30，thioredoxin-interactingprotein（TXNIP），NOD-like receptor thermal protein domain associated protein 3（NLRP3），cleaved cysteinyl aspartate specific proteinase-1（cleaved Caspase-1） in cells. The levels of reactive oxygen species（ROS），malondialdehyde（MDA），superoxide dismutase（SOD），tumor necrosis factor-α（TNF-α），interleukin-6（IL-6），interleukin-1β（IL-1β）and interleukin-18（IL-18） in cells were detected by ELISA.Results The expression level of GPR30 increased significantly after OGD/R，and reached the peak at 6 h. There was no significant difference compared with Control group at 12 h. And then the time points of OGD treatment for 4 h and reoxygenation for 12 h were determined for subsequent experiments. The lentivirus transfection was verified by qRT-PCR. Compared with the control group，the levels of ROS，MDA，TNF-α，IL-6，IL-1β，IL-18 and the protein expression levels of TXNIP，NLRP3，cleaved Caspase-1 in OGD/R group were significantly increased. And SOD activity was significantly decreased（P<0.05）. Overexpression of GPR30 inhibited the levels of ROS，MDA，TNF-α，IL-6，IL-1β，IL-18 and the protein expression levels of TXNIP，NLRP3，cleaved Caspase-1，and it enhanced SOD activity； while interference with GPR30 expression had the opposite effect.Conclusion GPR30 can inhibit the expression of protein of TXNIP/NLRP3 signaling pathway in BV-2 cells，and inhibit the oxidative stress injury and inflammation induced by ODG/R in BV-2 cells，which may be one of its molecular mechanisms for protecting ODG/R cells.

Abstract:Objective To investigate the impact of abnormal mechanical load on cartilage degeneration of the temporomandibular joint （TMJ） in rats.Methods A total of 36 female Sprague-Dawley rats，aged 8 weeks，were randomly divided into control group（Con group），collagenase type Ⅱ group（CⅡ group），wide mouth opening group（MS group），and collagenase type Ⅱ+wide mouth opening group （CII+MS group）. HE staining and safranin O-fast green staining were used to observe the histopathological changes of cartilage， and immunohistochemistry was used to measure the expression levels of the inflammatory factors matrix metalloproteinase 3（MMP3） and A disintegrin and metalloproteinase with thrombospondin motifs 5（ADAMTS5）.Results Compared with the Con group，the CII，MS， and CII+MS groups had significant reductions in the total thickness，calcified layer thickness， and safranin O-positive area ratio of the TMJ posterior zone（P<0.05） and significant increases in the positive expression of MMP3 and ADAMTS5（P=0.000）. Compared with the CⅡ and MS groups，the CⅡ+MS group had a significant reduction in the calcified layer thickness of cartilage（P=0.000） and a significant increase in the expression of ADAMTS5（P=0.000）. The MS and CII+MS groups had a wavy tidal line in the posterior zone of cartilage.Conclusion Abnormal mechanical load promotes the degeneration and reconstruction of the posterior zone of condylar cartilage，which may help with the research on the mechanism of TMJ osteoarthritis caused by abnormal mechanical load.

Abstract:Objective To analyze the correlation between the serum vitamin D and triglyceride glucose-body mass index（TYG-BMI） of type 2 diabetes mellitus（T2DM） patients complicated with nonalcoholic fatty liver disease（NAFLD），and to explore the roles played by TYG-BMI in the vitamin D deficiency of T2DM living with NAFLD.Methods A total of 434 patients with T2DM hospitalized at Department of Endocrinology，Hebei General Hospital were included in the study. These patients’ demographics and clinical data were collected. Abdominal ultrasonography was performed to diagnose NAFLD. Vitamin D deficiency was defined as that 25-hydroxyvitamin D［25（OH）D］ vitamin levels were less than 20 ng/mL. Spearman correlation was used to test for an association among 25（OH）D，TYG-BMI and risk factors of NAFLD in T2DM. Multiple logistic regression was used to determine the association in 25（OH）D，TYG-BMI and NAFLD. Mediation analysis was used to explore whether TYG-BMI mediated the association between 25（OH）D and NAFLD.Results ①In all included T2DM patients，the 25（OH）D level in patients with NAFLD was significantly lower［15.89（12.33，19.94） vs. 18.27（14.05，24.63），P<0.05］ and TYG-BMI was significantly higher［213.59（191.92，237.60） vs. 176.91（159.55，196.86），P<0.05］ compared with those without NAFLD. The data showed the same trends for males and females（P<0.05）. ②According to different 25（OH）D levels，the prevalence of NAFLD in the vitamin D deficiency group（60.1%） was higher than that in the vitamin D insufficiency group（45.4%） and the vitamin D sufficiency group（23.3%），and the difference was statistically significant（P<0.05）. ③Serum 25（OH）D level was negatively correlated with TYG-BMI， both in women and in men（men： r=-0.215，P<0.001；women： r=-0.271，P<0.001）. ④After adjusting for confounding factors，multivariate logistic regression analysis revealed that Vitamin D deficiency was a risk factor for NAFLD in T2DM patients（Model 1 OR=2.347，95%CI=1.423-3.871，P=0.001；Model 2 OR=2.478，95%CI=1.472-4.172，P=0.001；Model 3 OR=2.057，95%CI=1.172–3.610，P=0.012）. Gender-specific subgroup logistic regression analyses showed vitamin D deficiency was an independent risk factor for NAFLD in T2DM for women（Model 1 OR=5.52，95%CI=2.008-15.177，P=0.001；Model 2 OR=5.342，95%CI=1.776-16.061，P=0.003；Model 3 OR=3.734，95%CI=1.108-12.578，P=0.034）. ⑤TYG-BMI was positively correlated with the prevalence of NAFLD in all T2DM patients，male patients and female patients（P<0.05）. ⑥Mediation analysis indicated that TYG-BMI partly mediated the indirect effect of 25（OH）D on NAFLD incidence（percentage of mediation： 58.66% of all patients，and 38.07% of female patients）.Conclusion Vitamin D deficiency is associated with an increased incidence of NAFLD only in female subjects with T2DM. The association between vitamin D deficiency and higher prevalence of NAFLD in T2DM may be at least partially mediated by TYG-BMI.

Abstract:Objective To investigate the mechanism of action of Danggui Shaoyao Powder in the treatment of inflammatory response in rats with nonalcoholic fatty liver disease（NAFLD） induced by high-fat diet（HFD）.Methods Rats were randomly divided into normal group，HFD group， avastatin group，Danggui Shaoyao Powder low-dose group，and Danggui Shaoyao Powder high-dose group. The rats were given HFD（containing 59.3% fat） for 6 weeks，while the rats in the normal group were given normal diet. Since week 5，rats in the avastatin group were given 25 mg/kg of Avastatin by gavage for 2 weeks， while rats in the low-dose Danggui Shaoyao powder group were given 12.9 g/kg of Danggui Shaoyao powder by gavage for 2 weeks， and rats in the high-dose Danggui Shaoyao powder group were given 25.8 g/kg of Danggui Shaoyao powder by gavage for 2 weeks，and the serum levels of alanine aminotransferase（ALT），aspartate aminotransferase（AST），triglyceride（TG），cholesterol（TC），and cytokines were measured. Meanwhile，the expression levels of the sirtuin 1（Sirt1）/nuclear factor kappa-B（NF-κB） signaling pathway proteins in rat liver were also measured.Results Compared with the model group，Danggui Shaoyao Powder significantly reduced the serum levels of ALT，AST，TG，TC，and cytokines and improved the pathological changes of the liver. In addition，it significantly increased the expression of Sirt1 and inhibited the expression of NF-κB in rat liver.Conclusion Danggui Shaoyao Powder exerts a therapeutic effect on rats with NAFLD induced by HFD through the Sirt1/NF-κB pathway.

Abstract:Objective To compare the clinical effect and health economics between the Da Vinci robot-assisted transoral-vestibular thyroidectomy（robot group） and conventional open thyroidectomy（conventional group）.Methods The clinical data of 62 patients undergoing unilateral thyroidectomy by the robot-assisted method or conventional surgery in the Department of Breast and Thyroid Surgery，Daping Hospital of Army Medical University，from December 2017 to April 2021 were retrospectively analyzed. The operative time，drainage tube placement，total postoperative drainage volume，drainage tube placement time，pain score，length of hospital stay，and hospitalization expenses were observed and analyzed.Results The operative time of the robot group was significantly longer than that of the conventional group，while the drainage tube placement，total postoperative drainage volume，drainage tube placement time，and length of hospital stay of the robot group were significantly better than those of the conventional group（all P<0.01）. However，the hospitalization expenses were significantly higher in the robot group than in the conventional group（P<0.001）.Conclusion The Da Vinci robot-assisted transoral-vestibular thyroidectomy is superior to conventional open thyroidectomy in postoperative hospital management and length of hospital stay，with good postoperative cosmetic effect，which is worthy of promotion and application.

Abstract:Objective To investigate the value of advanced lung cancer inflammation index（ALI） in predicting the all-cause mortality of patients with atrial fibrillation（AF） and heart failure（HF）.Methods Related clinical data were collected from the patients with AF and HF in The First Affiliated Hospital of Chongqing Medical University，and the receiver operating characteristic（ROC） curve was used to assess the value of ALI in predicting all-cause mortality. Youden index was used to determine the cut-off value of ALI，and the patients were divided into ALI>16.99 group and ALI≤16.99 group according to the ALI value on admission. The Kaplan-Meier curve was used to analyze survival time，and finally the multivariate Cox stepwise regression analysis was used to investigate the influence of ALI on the all-cause mortality of this population. The samples were divided into valvular and non-valvular AF for subgroup analysis.Results A total of 614 patients with AF and HF were enrolled，among whom 49 patients were lost to follow-up，and a statistical analysis was performed for the remaining 565 patients，with 370 patients in the ALI>16.99 group and 195 patients in the ALI≤16.99 group. There were 113 cases（57.9%） of all-cause mortality in the ALI≤16.99 group and 104 cases（28.1%） of all-cause mortality in the ALI>16.99 group. Compared with the ALI>16.99 group，the ALI≤16.99 group had significantly higher age，brain natriuretic peptide，D-dimer，percentage of neutrophils，blood urea nitrogen，creatinine，high-sensitivity C-reactive protein，activated partial thromboplastin time，white blood cell count，NYHA class，and HAS-BLED score，as well as significantly lower body mass index，hemoglobin，lymphocyte count，albumin，total cholesterol，low-density lipoprotein，and high-density lipoprotein（all P<0.05）. ALI had an area under the ROC curve of 0.660（95%CI=0.614-0.705，P<0.001） in predicting all-cause mortality of patients with AF and HF. The multivariate Cox regression analysis showed that ALI≤16.99，creatinine，age>65 years，and primary hypertension were independent risk factors for all-cause mortality of patients with AF and HF，and the subgroup analysis showed that ALI≤16.99 was an independent risk factor for all-cause mortality in patients with valvular or non-valvular AF-HF.Conclusion ALI is associated with all-cause mortality in patients with AF-HF，and ALI≤16.99 is an independent risk factor for all-cause mortality in such patients. Therefore，ALI may help to assess the prognosis of patients with AF-HF.

Abstract:Objective To investigate the prevalence of HBsAg in B-cell non-Hodgkin’s lymphoma（B-NHL） and the effect of hepatitis B virus（HBV） infection on the clinical features of B-NHL.Methods The carrier rate of hapatitis bsurface antigen（HBsAg） and hepatitis B infection status in patients with non-Hodgkin’s lymphoma（NHL） were analyzed，and the differences in HBsAg positivity rate and HBsAg positive diffuse large B-cell lymphoma（DLBCL），chemotherapy response and 2-year survival rate of HBsAg positive DLBCL and HBsAg negative DLBCL were compared.Results A total of 597 eligible NHL patients were enrolled as the NHL group，including 461 B-NHL patients and 103 T-cell non-Hodgkin’s lymphoma（T-NHL） patients. HBV infection rate in B-NHL patients（17.1%） was significantly higher than that in the control group（5.7%）（P=0.003）. However，there was no significant difference in the HBsAg positive rates of T-NHL patients（10.7%） as compared with the control group（5.7%）（P=0.796）. Univariate analysis of the overall survival rate of 351 DLBCL patients showed that female，≥ 60 years old，HBsAg positive，abnormal liver function， elevated serum lactate dehydrogenase（LDH），Ann Arbor stage III–IV and International Prognostic Index（IPI） scores of 3–5 were unfavorable factors（all P<0.05），while remission was a favorable factor. Cox regression analysis showed that patient age，HBsAg status，Ann Arbor stage， and response to treatment were independent risk factors affecting patient prognosis. Compared with HBsAg negative DLBCL，HBsAg positive DLBCL patients were younger at onset（P=0.017）， with higher IPI scores（P=0.036），and at later Ann Arbor stage（P=0.001）. The effective rate of chemotherapy（complete remission + partial remission） and the 2-year survival rate of patients with HBsAg positive DLBCL were significantly lower than those of patients with HBsAg negative DLBCL（P=0.026，P=0.031）. However，there were no significant differences in LDH elevation rate and spleen involvement rate between the two groups.Conclusion HBsAg positive patients may be at higher risk for B-NHL，and HBV may negatively affect the clinical features and prognosis of B-NHL. HBV not only increases the risk of B-NHL，but also aggravates the disease， reduces the effect of chemotherapy， and affects the long-term prognosis of patients.

Abstract:Objective To construct and validate a risk predictive model for new-onset atrial fibrillation（NOAF） in patients with acute ST-elevation myocardial infarction（STEMI），and to provide a basis for the early identification of high-risk populations and timely intervention measures.Methods A total of 1 080 STEMI patients who were hospitalized in Department of Cardiology in our hospital from January 2017 to December 2021 were enrolled，among whom 87 patients with NOAF during hospitalization were established as NOAF group，and 199 patients were randomly selected from the STEMI patients without NOAF and were established as control group. The two groups were compared in terms of demographic features and clinical data on admission，and the LASSO regression model was used to analyze the risk factors for NOAF in STEMI patients during hospitalization. The patients enrolled in this study were divided into model group and validation group at a ratio of 7∶3，and a personalized predictive model for NOAF during hospitalization was constructed and validated.Results The LASSO regression analysis showed that age，heart rate on admission，Killip grade≥II，right atrial diameter，mitral regurgitation above the moderate level，and N-terminal pro-brain natriuretic peptide were important predicative factors for NOAF in STEMI patients（P<0.05）. A nomogram model was constructed using the above six predictive factors. In the model group，the model had an area under the ROC curve（AUC） of 0.842（95%CI=0.780-0.905） and an accuracy of 0.840（95%CI=0.782-0.888）； in the validation group，the model had an AUC of 0.858（95%CI=0.774-0.943） and an accuracy of 0.826（95%CI=0.729-0.899）. Meanwhile，the calibration curve showed that the predictive model had a good calibration ability.Conclusion This study successfully constructs a predictive model for the risk of NOAF during hospitalization in STEMI patients，and related indicators show that this predictive model has good predictive efficiency and clinical applicability. The nomogram can help clinicians to identify the patients at a high risk of NOAF and formulate targeted intervention measures，thereby providing a basis for performing early prevention and treatment and improving prognosis.

Abstract:Objective To investigate the clinical features and prognostic factors of microscopic polyangiitis（MPA） with pulmonary involvement.Methods A retrospective analysis was performed for the clinical data of 237 MPA patients with pulmonary involvement who were diagnosed and followed up till March 1，2021 in The First Affiliated Hospital of Chongqing Medical University from January 1， 2014 to March 1， 2021. The Kaplan-Meier method and the Cox proportional-hazards regression model were used to analyze survival data and obtain cumulative survival rate and prognostic factors.Results The MPA patients with pulmonary involvement had a mean age of 65.18 years and a median follow-up time of 26.13 months. Among the 237 patients enrolled in this study，98（41.35%） had MPA with diffuse alveolar hemorrhage（DAH）. The 1-，3-，and 5-year cumulative survival rates were 67.50%， 54.10%， and 43.00%，respectively，for the MPA patients with pulmonary involvement， with a median survival time of 45.03 （0.10， 97.73） months. The 1-， 3-，and 5-year cumulative survival rates were 63.30%，49.40%，and 40.20%，respectively，for the patients with MPA with DAH. The multivariate Cox regression analysis showed that age>65 years［hazard ratio（HR）=1.981，95%CI=1.244-3.154，P=0.004］，white blood cell count（WBC）>10×10⁹/L（HR=1.860，95%CI=1.170-2.956，P=0.009），serum creatinine（SCr）>250 μmol/L（HR=1.987，95%CI=1.217-3.243，P=0.006），PaO₂/FiO₂<300 mmHg（HR=2.780，95%CI=1.696-4.557，P<0.001），and Birmingham vasculitis activity score version 3（BVASv.3） at the time of diagnosis（HR=1.040，95%CI=1.006-1.075，P=0.020） were independent influencing factors for survival time（P<0.05）.Conclusion MPA patients with pulmonary involvement tend to have a low survival rate. Age>65 years，WBC>10×10⁹/L，SCr>250 μmol/L， PaO₂/FiO₂<300 mmHg， and BVASv.3 at the time of diagnosis are independent risk factors for the poor prognosis of MPA with pulmonary involvement.

Abstract:Objective To investigate the clinical effect of masseter muscle flap in improving the complications after resection of benign tumors at the anterior edge of the superficial lobe of the parotid gland.Methods A retrospective analysis was performed for 42 patients who underwent resection of benign tumors at the anterior edge of the superficial lobe of the parotid gland in The First Affiliated Hospital of Chongqing Medical University from January 2020 to January 2021， among whom 18 patients in the experimental group underwent masseter muscle flap rotation repair simultaneously，and 24 patients in the control group did not undergo muscle flap transfer and only received closure and suture. These patients were followed up to record the incidence rate of salivary fistula within six months after surgery， the incidence rate of Frey’s syndrome（FS） within one year after surgery， and the subjective and objective ratings of depression deformity within one year after surgery.Results The statistical analysis using SPSS 25.0 showed that there were significant differences in the subjective and objective ratings of depression deformity between the experimental group and the control group（subjective： 1.33±0.84 vs. 2.46±0.78， P=0.000；Objective 1.00±0.77 vs. 2.58±0.65，P=0.000）， while there were no significant differences between the two groups in the incidence rates of salivary fistula （5.56% vs. 16.67%，P=0.370） and FS （0.00% vs. 4.17%，P=1.000）.Conclusion Masseter muscle flap has certain clinical significance in repairing depression deformity after resection of benign tumors at the anterior edge of the superficial lobe of the parotid gland， and it might be a new method for defect repair after surgery for parotid gland tumors.

Abstract:Objective To investigate the clinical features of adult patients with upper airway cough syndrome（UACS） and the differences in clinical features between patients with allergic rhinitis（AR） and those with non-allergic rhinitis（NAR）.Methods A prospective analysis was performed for the clinical data of 139 patients with UACS who were treated in the Otolaryngology Department of The First Affiliated Hospital of Chongqing Medical University from July 2021 to June 2022，and they were divided into NAR group and AR group.Results There were 139 patients with a confirmed diagnosis of UACS，with a median age of 39 years，and female patients accounted for 55.4%. Among these 139 patients，there were 49 patients with AR（35.3%） and 90 patients with NAR（64.7%）. The median course of cough was 8（4，24） months，and the mean Leicester Cough Questionnaire（LCQ） score was 13.39±2.60. The most common symptoms were rhinorrhea（84.2%） and nasal congestion（72.7%），and the most common abnormalities on sinus CT were nasal septum deviation（55.3%） and nasal turbinate hypertrophy（52.4%）. UACS was the sole cause of chronic cough in 93 patients （66.9%）. The AR group had a significantly higher proportion of patients with asthma than the NAR group（40.8% vs. 3.3%，P<0.001），and there were no significant differences between the two groups in age，sex，course of the disease，quality of life score，and white blood cell count.Conclusion NAR is the most common cause of UACS. Except that patients with chronic cough and AR tend to have itchy nose，the other clinical features are similar between chronic cough with AR or NAR. Nasal septal deviation is more common in patients with NAR，while turbinate hypertrophy is more common in patients with AR. Further studies are needed to prove the association between NAR and UACS.

Abstract:Objective To compare the application value of laparoscopic surgery and open surgery in early ovarian cancer.Methods We collected the clinical data of 81 patients with early ovarian cancer diagnosed and treated in the Department of Gynecology of The First Affiliated Hospital of Chongqing Medical University，including 43 patients undergoing laparoscopic surgery and 38 patients undergoing open surgery. The patients were followed up after operation. The clinical indicators of the laparoscopy and laparotomy groups were compared.Results The laparoscopy group showed significantly shorter urinary catheter indwelling time，length of hospital stay， and time to first flatus than the laparotomy group（all P<0.05）. The two groups had no significant differences in intraoperative blood loss，the incidence of complications，the incidence of tumor rupture，and three-year local recurrence rate，distant metastasis rate，and survival rate（all P>0.05）.Conclusion In the treatment of early ovarian cancer，laparoscopic surgery does not differ from laparotomy in the three-year local recurrence rate，distant metastasis rate，or survival rate，but laparoscopic surgery can shorten the postoperative catheter indwelling time，hospital stay，and time to first flatus of patients.

Abstract:Objective To investigate the clinicopathological features of patients with endometrial carcinoma（EC） affecting lymph-vascular space invasion（LVSI）， and to identify independent risk factors.Methods A retrospective analysis was performed for the clinicopathological data of 196 patients with EC who underwent treatment in Affiliated Hospital of Zunyi Medical University and The Second Affiliated Hospital of Zunyi Medical University from January 2019 to August 2022. The risk factors evaluated included preoperative carbohydrate antigen 125（CA125），preoperative carbohydrate antigen 199，pathological type，histological grade，tumor size，depth of myometrial invasion，neutrophil-to-lymphocyte ratio，expression of mismatch repair proteins，Ki67，and P53. The chi-square test and the logistic regression analysis were used to determine the risk factors for LVSI in EC.Results Among the 196 patients with EC，23 were positive for LVSI，with a positive rate of 11.7%. The multivariate analysis showed that preoperative CA125≥35 U/mL[odds ratio（OR）=3.539，95%CI=1.252-10.008，P<0.05]，myometrial invasion depth≥1/2（OR=3.893，95%CI=1.323-11.451，P<0.05），and poor differentiation（OR=3.206， 95%CI=1.030-9.978，P<0.05） were independent risk factors for LVSI in patients with EC.Conclusion Preoperative CA125≥35 U/mL，myeloid invasion depth≥1/2，and poor differentiation（histologic grade） are independent risk factors for LVSI in patients with EC，and the emphasis on preoperative predictive factors combined with the assessment of LVSI status in patients with EC can help surgeons to further evaluate lymph node involvement and prognosis and better select the surgical approach， so as to realize individualized precise treatment.

Abstract:Objective To investigate the clinical application value of related parameters of modern acoustic cardiography techniques in the diagnosis of patients with angina pectoris.Methods A total of 150 patients who were admitted due to angina pectoris and underwent coronary angiography were enrolled， and all patients underwent routine electrocardiography and acoustic cardiography.Results Among the 150 patients with angina pectoris， 81 had a confirmed diagnosis of coronary artery disease by coronary angiography， and coronary artery disease was excluded in 69 patients after coronary angiography. There were significant differences between the two groups in S4 and ST-T changes on electrocardiography（P<0.05）； ST-T changes on electrocardiography had a sensitivity of 54.3% and a specificity of 84.1% in the diagnosis of angina pectoris，while S4 had a sensitivity of 74.1% and a specificity of 82.6%. ST-T changes combined with S4 had a sensitivity of 87.7% and a specificity of 81.2% in the diagnosis of angina pectoris.Conclusion S4 combined with ST-T changes can improve the diagnostic level of patients with angina pectoris， and therefore， they can be used as important auxiliary indices for the diagnosis and evaluation of patients with angina pectoris.

Abstract:Objective To study the changes and clinical significance of neutrophil-lymphocyte ratio（NLR），platelet-lymphocyte ratio （PLR） in peripheral blood，mean platelet volume（MPV） and platelet hematocrit（PCT） in preeclampsia.Methods The peripheral blood routine data and clinical data of 160 pregnant women with preeclampsia were retrospectively studied，including 80 cases of mild preeclampsia（MPE） and 80 cases of severe preeclampsia（SPE）. The control group included 80 normal pregnant women visited our department during the same period. The NLR，PLR，MPV，and PCT were compared among SPE，MPE and the control group.Results There were significant differences in neutrophil，PLR，MPV，PCT among the three groups（P<0.05），but no significant difference in lymphocyte（P>0.05）. There was significant difference in neutrophils between the MPE group and the control group（P<0.05）. There were significant differences in neutrophil，platelet，PLR，MPV and PCT between SPE group and control group（P<0.05），and there were significant differences in neutrophil，platelet，PLR，MPV and PCT between SPE group and MPE group（P<0.05）.Conclusion The detection of PLR，MPV and PCT in peripheral blood has certain value in the diagnosis of preeclampsia，and it can also reflect the severity of preeclampsia.

Abstract:Objective To investigate the clinical features，diagnosis and treatment，and prognosis of rare chlamydia psittaci pneumonia，and to improve the understanding of this disease in related clinical fields.Methods A retrospective analysis was performed for the clinical data of 15 patients who were diagnosed with chlamydia psittaci pneumonia in The First Affiliated Hospital of Gannan Medical University from January 2017 to December 2022，and the clinical features，diagnosis，and key points for differential diagnosis were summarized and analyzed. Meanwhile，related articles in China and globally were searched to systematically discuss the latest advances in the diagnosis and treatment of chlamydia psittaci pneumonia.Results Among the 15 patients with chlamydia psittaci pneumonia included in this study，there were 10 male patients（66.67%） and 5 female patients（33.33%），with an aged of 62（32-79） years. Among these patients，14（93.33%） had poultry contact history，8（53.3%） had the history of underlying diseases，and 5（33.33%） developed severe pneumonia. Among the 15 patients，8 had normal white blood cell count（WBC）（53.3%），5 had elevated WBC（33.3%），and 2（13.3%） had a reduction in WBC；9（60.0%） had normal hemoglobin，and 6（40.0%） had a reduction in hemoglobin；13（86.7%） had an increase in the percentage of neutrophils； all patients（100.0%） had a significant increase in C-reactive protein；13（86.67%） had an increase in procalcitonin，and 12（80.0%） had an increase in lactate dehydrogenase；11（73.33%） had abnormal liver function，8（53.33%） had abnormal renal function，and 6（40.0%） had abnormal coagulation function；13（86.7%） had electrolyte disturbance. In addition，arterial blood gas analysis showed varying degrees of reduction in the partial pressure of blood oxygen in 11 patients（73.33%），and 8 patients（53.33%） had an oxygenation index lower than 300 mmHg； 4 patients（26.67%） had no obvious dyspnea and thus did not undergo arterial blood gas analysis. All patients in this study underwent bronchoscopy，with bronchoalveolar lavage fluid obtained for metagenomic next-generation sequencing（mNGS），and all patients were infected with multiple pathogens besides chlamydia psittaci. All 15 patients underwent lung CT and other imaging examinations，among whom 7（46.67%） had unilateral pulmonary consolidation and 8（53.33%） had bilateral pulmonary consolidation；9 patients（60.0%） also had pleural effusion，and some of them showed various imaging findings，including consolidation opacities，ground-glass opacities，mass opacities，reversed halo sign，and mediastinal and hilar lymph node enlargement. All 15 patients with chlamydia psittaci pneumonia received standard anti-infective therapy after diagnosis，and among the 5 patients with severe pneumonia，2 received ECMO adjuvant therapy. No treatment-related adverse reactions or adverse events were observed，with a mean length of hospital stay of 13.9 days. No death was observed，and all patients were discharged after improvement.Conclusion Chlamydia psittaci pneumonia lacks specific clinical features and manifestations and tends to develop into severe exacerbation，and mNGS detection of bronchoalveolar lavage fluid can help to achieve an accurate diagnosis. Early administration of tetracycline and quinolone antibiotics can improve the prognosis of patients to the greatest extent.

Abstract:Objective According to the trough concentration，anti-infective efficacy，and hepatotoxicity of voriconazole in Individualized Medication of Voriconazole：A Practice Guideline of the Division of Therapeutic Drug Monitoring， the judgment based on medium-quality evidence cannot meet clinical needs. This article will perform dynamic monitoring of the trough concentration of voriconazole in adult inpatients to investigate the association of trough concentration with therapeutic efficacy and adverse reactions.Methods A total of 107 blood samples were collected from 63 adult patients who were treated with voriconazole， and enzyme immunoassay was used for dynamic monitoring of the trough concentration of voriconazole. The patients were observed in terms of treatment outcome and adverse reactions，and the correlation of the trough concentration of voriconazole with clinical indices was analyzed.Results After treatment with voriconazole at the conventional dose，the trough concentration of voriconazole was 0.5-5.0 μg/mL in 57.9%（62/107） of the samples，with a averge concentration of 2.7 μg/mL；the trough concentration of voriconazole was <0.5 μg/mL in 3.7%（4/107） of the samples，with a averge concentration of 0.3 μg/mL；the trough concentration of voriconazole was >5.0 μg/mL in 38.4% （41/107） of the samples，with a median concentration of 8.7 μg/mL. The patients with a trough concentration of <0.5 μg/mL had a response rate of 50.0%，while those with a trough concentration of ≥0.5 μg/mL had a response rate of 74.5%，and there was no significant difference between the two groups（P=0.624）. The dose was increased for one patient who had a trough concentration of <0.5 μg/mL and had no response to treatment，and the symptoms of infection were improved after effective trough concentration was reached. Adverse reactions were observed in 10 patients（15.8%）， and the incidence rate of adverse reactions was 18.2% in patients with a trough concentration of >5.0 μg/mL and 14.6% in those with a trough concentration of ≤5.0 μg/mL， with the main adverse reaction of abnormal liver function. There were significant differences in alkaline phosphatase and gamma-glutamyl transpeptidase between the patients with a trough concentration of >5.0 μg/mL and those with a trough concentration of ≤5.0 μg/mL（P<0.05），and when the trough concentration of voriconazole was >5.0 μg/mL，there was a significant reduction in procalcitonin after anti-infective therapy（P<0.05）.Conclusion There is a large difference in the plasma concentration of voriconazole between individuals， and its trough concentration must be monitored regularly. The trough concentration of voriconazole is associated with liver function parameters and infection indicators， and it may be necessary to increase sample size or perform CYP2C19 genetic testing to observe the association of trough concentration with therapeutic efficacy and adverse reactions.

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