Abstract:There are many causes of acquired central hypogonadism，among which sellar space-occupying diseases are important factors. Gonadal hormone replacement therapy can restore sexual function，improve metabolism and quality of life，and enhance self-confidence. In this study，sellar space-occupying diseases are classified into three categories；estrogen receptor-positive or estrogen-related tumors，estrogen receptor-negative or ambiguous tumors，and non-tumoral sellar space-occupying diseases. This article reviews each type of sellar space-occupying diseases，the influence of treatment interventions on gonadal function，and the precautions for sex hormone replacement therapy under different circumstances，in order to provide advice and help for the treatment of patients with such diseases. Meanwhile，this article also puts forward thoughts on several issues at present and calls for more clinical observation studies and basic researches to further improve sex hormone replacement therapy for patients with sellar space-occupying diseases.

Abstract:Prolactinoma accounts for 32%-66% of pituitary neuroendocrine tumors and is a benign tumor in most cases，and it is commonly seen in women. However，prolactinoma in men is more aggressive in clinical practice，manifesting as frequent recurrence after surgery，resistance to dopamine agonists，tumor progression after radiotherapy，and pituitary carcinogenesis. This article reviews the literature on the biological characteristics of prolactinoma in male patients in recent years，and it is shown that compared with prolactinoma in female patients，prolactinoma in male patients has unique characteristics in term of cell proliferation，epithelial-mesenchymal transition，angiogenesis，and resistance to dopamine agonist due to aromatase，SF3B1 gene mutation，disruption of E-cadherin/β-catenin complex，transforming growth factor β1 system，and expression of specific genes and unstable genomes directly or indirectly through different signaling pathways. In the future，more studies are needed to further clarify the mechanism of the aggressiveness of prolactinoma in male patients and provide a more comprehensive and accurate theoretical basis for effective targeted therapy.

Abstract:Hyperprolactinemia is a common cause of secondary hypogonadism，which affects the reproductive function of both men and women. There are many challenges in the diagnosis and treatment of hyperprolactinemia. There is a ‘hook effect’ in the measurement of hormone levels，which underestimates the true level of hormone. Macroprolactinemia is characterized by asymptomatic or inconsistent high prolactin levels. In order to reduce misdiagnosis and missed diagnosis，attention should be paid to distinguish the three common causes of physiological，pathological or drug. Dopamine receptor agonist is the first-line treatment，but for patients with drug-resistant hyperprolactinemia，surgery，radiotherapy and other drug trials （such as temozolomide） should be selected after a comprehensive evaluation of the condition. Pregnancy is a period of increased physiological secretion of prolactin，and it is not recommended to use prolactin measurement to evaluate the disease during pregnancy. It is mainly determined by the tumor mass effect and critical condition to decide whether to start drug or surgical treatment. The diagnosis and treatment of resistant/refractory hyperprolactinemia and hyperprolactinemia during pregnancy are recommended under the support of an experienced multidisciplinary team.

Abstract:Childhood brain tumor is one of the most common childhood tumors，which seriously affects children's health. Endocrine dysfunction is one of the major complications for children with long-term survival after treatment of sellar region tumors，posterior fossa tumors and extrapituitary tumors. Moreover，early identification of pituitary dysfunction in children with brain tumors，and prompt treatment is critical for their growth，development，and long-term well-being. In the case of growth hormone deficiency and dysfunction of the hypothalamic-pituitary-thyroid，hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes，early diagnosis of axis impairment can be aided by conducting endocrine function tests. This approach aims to aid in the timely evaluating the child's growth and development. In addition，it is necessary to actively adopt a multi-disciplinary（MD） diagnosis and treatment model involving departments such as neurosurgery，endocrinology，radiology etc，to proactively consider the risk of tumor recurrence in children after surgery，accurately assess the degree of metabolic disorders in children，and provide precise treatment at the hospital to improve the prognosis and quality of life of affected children.

Abstract:The pituitary stalk connects the hypothalamus with the pituitary，which is of great physiological significance. A variety of diseases can cause changes in pituitary stalk thickening（PST）. Different etiology and treatment methods are different，and misdiagnosis and missed diagnosis have a significant impact on the prognosis of patients. Early diagnosis of the cause can enable patients to receive appropriate treatment and improve prognosis.

Abstract:Objective To investigate the effect of endothelial-overexpressed lipopolysaccharide-associated factor 1（EOLA1） on skin wound healing in mice with type 2 diabetes and the related mechanisms.Methods Specific pathogen-free db/db diabetic mice，aged 6 weeks，were used to establish a model of full-thickness skin wound，and the lentivirus with high EOLA1 expression was injected around the wound. The mice were divided into normal control group，empty vector lentivirus group，and EOLA1 lentivirus group. For all mice except those in the normal control group，photos were taken at different time points to observe wound healing； after the samples of the wound and the skin around the wound were collected on day 15 of modeling，HE staining was used to observe wound granulation tissue and inflammatory infiltration，Masson staining was used to observe collagen fiber deposition at the wound，immunofluorescence assay was used to measure ARG1 and iNOS for macrophage typing，and Western blot and real-time PCR were used to measure the protein expression levels of the nuclear factor-kappa B（NF-κB） signaling pathways proteins IκB-α，p-IκB-α，and p65 and the gene expression levels of EOLA1，Toll-like receptor 4（TLR4），tumor necrosis factor-α（TNF-α），and interleukin-1β（IL-1β）.Results Compared with the empty vector lentivirus group，the EOLA1 lentivirus group had a significantly higher speed of skin wound healing and significant increases in the formation of granulation tissue and collagen fibers. The EOLA1 lentivirus group had an increase in the expression of the M2 macrophage marker ARG1 and a reduction in the expression of the M1 macrophage marker iNOS，as well as an increase in the protein expression of IκB-α，a reduction in the protein expression of p-IκB-α，and downregulation of the gene expression levels of TNF-α and IL-1β.Conclusion EOLA1 can inhibit local skin wound inflammation and accelerate wound healing in diabetic mice，possibly by upregulating the expression of IκB-α in macrophages，blocking the activity of p65，and then inhibiting the release of the inflammatory cytokines such as TNF-α and IL-1β，and the phenotype of macrophages changes from M1 type for promoting inflammation to M2 type for promoting healing，suggesting that EOLA1 has the potential to protect diabetic wound from inflammation and promote wound healing.

Abstract:Objective To evaluate the relationship between the monocyte-to-lymphocyte ratio（MLR） and lower extremity arterial disease（LEAD） in patients with diabetic foot disease.Methods We included a total of 243 patients with type 2 diabetic foot problems hospitalized in The First Affiliated Hospital of Army Medical University from April 2020 to April 2023. They were divided into LEAD group（n=103） and non-LEAD group（n=140） to analyze the relationship between MLR and LEAD.Results The MLR in the LEAD group was significantly higher than that in the non-LEAD group（0.46［0.29，0.63］ vs. 0.38［0.26，0.58］，P<0.05）. The logistic regression analysis showed that MLR，age，serum cholesterol，and serum creatinine were risk factors for LEAD in patients with diabetic foot disease（P<0.05）. The receiver operating characteristic curve analysis showed that the optimal cut-off point for MLR predicting lower extremity arterial disease in patients with diabetic foot problems was 0.34，with sensitivity and specificity being 69.9% and 46.4%，respectively.Conclusion MLR is associated with the development of LEAD in patients with type 2 diabetic foot disease.

Abstract:Objective To investigate the effects of inflammatory response on the repair of chronic wounds in Sprague-Dawley（SD） rats with diabetes from the perspective of glycogen synthase kinase-3β（GSK-3β）/β-catenin.Methods A wound model in diabetic SD rats was established by high-fat feeding combined with intraperitoneal injection of streptozocin and surgical preparation of full-thickness skin defects. The model rats were randomly divided into model group（n=15），silver sulfadiazine group（n=15），and Jiedu-Shengji ointment group（n=15），with normal wound group（n=15） set as a control. The wounds in the silver sulfadiazine group and Jiedu-Shengji ointment group were externally treated with silver sulfadiazine ointment and Jiedu-Shengji ointment，respectively，once daily，with no intervention in the model group and normal wound group. On the 3rd，7th，and 14th days after ointment administration，the wound healing status of each group was examined to calculate the wound healing rate. The basic tissue morphology was examined with hematoxylin-eosin（HE） staining. Collagen production was detected by Masson. The structure of endoplasmic reticulum was observed using a transmission electron microscope. The expression of tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） was measured by immunohistochemistry. The protein expression of GSK-3β and β-catenin was determined by Western blot.Results On day 3，the wound healing rate of the Jiedu-Shengji ointment group was significantly higher than that of the model group（P<0.05）. On day 14，the wound healing rate of the Jiedu-Shengji ointment group was significantly higher than that of the silver sulfadiazine group（P<0.05）. HE staining revealed less swelling and more abundant capillaries in the wounds of the Jiedu-Shengji ointment group as compared with the other groups on days 3 and 7 and new skin appendages and intact tissue structure in the wounds of the Jiedu-Shengji ointment group and normal wound group on day 14. Masson staining revealed evenly distributed and orderly organized collagen fibers as well as stronger，evenly distributed，and orderly arranged new collagen fibers in the Jiedu-Shengji ointment group，as compared with the other groups. Under the electron microscope，the Jiedu-Shengji ointment group had abundant endoplasmic reticulum with nearly normal morphological structure. Immunohistochemical results showed that the expression levels of TNF-α and IL-6 were significantly higher in the model group than in the other groups； the Jiedu-Shengji ointment group had a significantly lower TNF-α level than the normal wound group and significantly lower TNF-α and IL-6 levels than the silver sulfadiazine group. Western blot results showed that compared with that in the normal wound group，the expression of β-catenin was significantly up-regulated in the other groups（P<0.05），to the least extent in the Jiedu-Shengji ointment group；compared with the normal wound group，the other groups had significantly down-regulated GSK-3β protein expression（P<0.05）；on day 7，GSK-3β expression was significantly increased in the silver sulfadiazine group and Jiedu-Shengji ointment group（P<0.05），but still lower than that in the normal wound group.Conclusion Jiedu-Shengji ointment can regulate the expression of GSK-3β and β-catenin to down-regulate the expression of the inflammatory factors IL-6 and TNF-α，eventually achieving the healing of chronic wounds in diabetic rats.

Abstract:Craniopharyngioma（CP） is a chronic disease，and at present，multimodality therapy with the goals of controlling CP and improving quality of life is becoming the main treatment method for this disease. Long-term follow-up has shown that tumor recurrence is a common feature of CP and can lead to the reduction in quality of life，and therefore，it is of great importance to identify the risk factors for the recurrence of CP. This article summarizes the high-risk factors for CP recurrence from multiple aspects and factors，in order to provide a basis for further exploring and predicting the risk of recurrence.

Abstract:Objective To investigate the clinical symptoms，endocrine and radiological features，clinical outcomes，and prognosis of patients with pituitary apoplexy.Methods A retrospective analysis was performed for the clinical data of 46 patients who were diagnosed with “pituitary apoplexy” in West China Hospital，Sichuan University，from January 1，2015 to December 31，2021，and the diagnosis of pituitary apoplexy was based on clinical，radiological，and histopathological reports. Clinical symptoms and signs，neuroimaging findings，pathological features，and endocrine results were summarized，and clinical outcome and prognosis were analyzed.Results A total of 46 patients with pituitary apoplexy were included，among whom there were 20 male patients（43.5%） with a mean age of 47.05（15.81） years and 26 female patients with a mean age of 31.96（14.78） years. Most patients had headache（n=38，82.6%） and varying degrees of hormone deficiency，among which pituitary-gonadal axis involvement was the most common type（n=28，60.9%），followed by pituitary-thyroid axis involvement in 21 patients（45.7%），pituitary-adrenal axis involvement in 19 patients（41.3%），GH/IGF-1 axis involvement in 5 patients（10.9%），and posterior pituitary involvement（diabetes insipidus） in 8 patients（17.4%）. All patients with pituitary apoplexy had characteristic changes on MRI，and some patients had the typical sign of liquefaction necrosis. Of all patients，9（19.6%） received antithrombotic therapy and 12 received surgical treatment，among whom 7 experienced the recurrence of pituitary adenoma during follow-up，while no patients died during the acute course of the disease. During follow-up for 5.2±1.9 years，most patients had hypopituitarism and received hormone replacement therapy.Conclusion Pituitary apoplexy is a critical neuroendocrine emergency，and early identification of symptoms and timely treatment，especially the correction of endocrine disorders，are of great importance for avoiding serious complications. Anterior hypopituitarism in pituitary apoplexy should be taken seriously by clinicians to avoid potential risks.

Abstract:Objective Methods A retrospective analysis was conducted on patients with pituitary adenoma who underwent treatment in the same treatment group at the Department of Neurosurgery，Xinqiao Hospital，Army Medical University，from January 2018 to December 2022. A total of 504 patients were included based on the inclusion and exclusion criteria. The differential clinical factors were compared and analyzed between patients with normal HPA or HPT function（normal function group） and those with hypofunction in at least one of the axes. Multivariate logistic regression was used to analyze the risk factors for preoperative hypopituitarism. The recovery of pituitary function within one year of surgery was followed up in patients who had preoperative hypofunction and underwent surgical treatment.Results The normal function group consisted of 434 patients，while the hypofunction group had 70 patients. The hypofunction group had a higher proportion of elderly patients than the normal function group（P=0.049），with a higher proportion of male patients（P=0.001）. An analysis of complications found that the hypofunction group had a lower proportion of patients with hypertension（P=0.037），but had a higher proportion of patients with hyperlipidemia（P=0.033）. A comparison of tumor characteristics revealed a significant increase in tumor volume in the hypofunction group compared with the normal function group（P<0.001）. Additionally，a smaller proportion of intrasellar tumors developed in the hypofunction group than in the normal function group（P=0.012）. A comparison of endocrine classification showed a significantly higher proportion of nonfunctional adenomas in the hypofunction group than in the normal function group（P<0.001）. There were no significant differences in the remaining clinical variables between the two groups. Multivariate logistic regression analysis revealed that being a male，clinically nonfunctional adenoma，and large tumor volume were independent risk factors for hypofunction of the HPA and HPT axes in patients with pituitary adenoma（P<0.05）. The receiver operating characteristic curve demonstrated that a tumor volume of 6.350 cm³ was an optimal predictor of hypofunction of the HPA and HPT axes（area under the curve［AUC］=0.7）. Sixty-eight patients in the hypofunction group underwent surgical treatment，with 41 cases of hypofunctional HPA axis，53 cases of hypofunctional HPT axis，and 26 cases of hypofunction of both axes. The recovery rates for patients with the hypofunction of the HPA axis，HPT axis，and both axes within one year after surgery were 36.6%，39.6%，and 38.5%，respectively.Conclusion male，large tumor volume，and nonfunctional pituitary adenomas are high risks for HPA and HPT axis hypofunction in patients with pituitary adenoma. Surgery can，to varying degrees，help with the recovery in patients with preoperative hypofunction of the HPA and HPT axes.Being a The hypothalamic-pituitary-adrenal（HPA） and hypothalamic-pituitary-thyroid（HPT） axes are the most vital hormonal axes in the human body. This study aims to investigate the risk factors for the preoperative hypofunction of these axes in patients with pituitary adenoma and the postoperative recovery of corresponding hormonal axes.

Abstract:Objective To review the clinical efficacy of liraglutide combined with metformin in the treatment of overweight or obese patients with polycystic ovarian syndrome（PCOS）.Methods 125 patients with PCOS from The First Affiliated Hospital of Army Medical University who met the inclusion criteria from June 2018 to April 2023 were selected as study subjects and divided into hyperrecombination（n=56） and obesity group（n=69） according to body mass index（BMI）≥24 kg/m². Both groups were treated with Liraglutide combined with metformin for 12 weeks to evaluate the clinical efficacy after treatment.Results ①After treatment，the body weight，BMI，waist circumference，hip circumference and alanine aminotransferase in two groups were decreased（P<0.05）. The decrease of body weight and BMI in obese group was more significant（P<0.05）. After treatment，the indexes of glucose and lipid metabolism were decreased in both groups（P<0.05），but there was no significant difference in absolute value between the two groups（P>0.05）. After treatment，sex hormone globulin increased，while total testosterone，free androgen index，luteinizing hormone，luteinizing hormone/follicle-stimulating hormone decreased（P<0.05），and superrecombinant decreased more significantly（P<0.05）. After treatment，the recovery rate of menstruation and dominant follicle formation rate were improved，and the polycystic changes of ovary were decreased（P<0.05）.②The most common adverse reactions in the two groups were nausea，diarrhea and dyspepsia. All of the adverse reactions were gradually reduced within 4 weeks of administration.Conclusion Liraglutide combined with metformin has good efficacy in reducing body weight and body mass index in overweight or obese PCOS patients，improving glycemic and lipid metabolism disorders and ovarian function，especially in obese PCOS patients with more benefits in reducing body weight，and patients with super severe PCOS have more advantages in improving sex hormone levels.

Abstract:Objective The postoperative remission rate of thyroid-stimulating hormone（TSH）-secreting pituitary adenoma（TSHoma） varies greatly among different studies. This study was intended to preliminarily explore the correlation between the expression of somatostatin receptors（SSTRs） and the morphological characteristics，tumor invasiveness，and prognosis of TSHoma.Methods This study retrospectively analyzed the clinical data of 10 patients who were diagnosed with TSHoma in the Second Affiliated Hospital of Army Medical University from October 2015 to April 2019，and nine of them underwent transsphenoidal or transcranial pituitary tumor resection. By reviewing magnetic resonance imaging images，a detailed assessment of tumor volume，invasiveness，and T2 weighted signal intensity in key regions of interest（ROIs） was conducted. Cavernous sinus invasiveness，sphenoid sinus invasion，suprasellar expansion were scored，and their cumulative score was calculated. In addition，the pituitary tissue slices of patients were immunohistochemically stained with SSTRs and scored using the semi-quantitative immune scoring method. According to the median score，patients were divided into high score group（HSG）（≥median） and low score group （LSG）（<median），and the differences in clinical data between the two groups were evaluated.Results The median age of 10 patients with TSHoma was 32.5 years，and the male-to-female ratio was 3∶2. All of them had macroadenomas，with aggressive growth to the suprasellar，parasellar，and cavernous sinus and varied volumes（0.50-93.20 mL）. The SSTRs staining score of TSHoma showed the following trend：SSTR2>SSTR5=SSTR3>SSTR1. The further analysis showed that the TSH level，tumor volume，Knosp grade，and invasion score in the HSG of SSTR2 were higher than those in the LSG，while the remission rate was lower than that in the LSG. On the contrary，the thyroid hormone level，TSH level，tumor volume，Knosp grade，and cavernous sinus invasion score in the HSG of SSTR5/SSTR2 ratio were lower than those in the LSG，and the remission rate was higher than that in the LSG. Unfortunately，the invasiveness degree of TSHoma was not correlated with tumor volume，thyroid hormone level，TSH level，and signal intensity in the ROI.Conclusion The expression level of SSTR2，especially the SSTR5/SSTR2 ratio，is correlated with invasiveness and biochemical levels，which may affect the prognosis after surgery.

Abstract:Objective To strengthen the understanding of pituitary adenoma that produces growth hormone（GH） and thyroidstimulatinghormone（TSH）. And more，to prevent misdiagnosis，missed diagnosis and delayed diagnosis，and to explore its treatment.Methods The clinical manifestations，hormone biochemical examination，imaging examination，treatment and prognosis of 5 patients with pituitary GH+TSH adenoma diagnosed in West China Hospital were analyzed retrospectively.Results ①5 cases of GH+TSH tumors accounted for 2.9%（4 /172） of pituitary tumors diagnosed at the same time in west china hospital. Pathological findings of 2 patients showed that TSH，GH and PRL were all positive，and pathological findings of 3 patients showed that TSH and GH were all positive. ②MRI scan of sellar region showed that 5 cases were large adenomas（diameter > 1cm） and no small adenomas. ③Before operation，the baseline level of GH in 4 patients（cases 2，3，4 and 5） increased significantly（random value > 2.5ng/mL），of which 2 patients were not inhibited by high glucose，and 2 patients were not subjected to high glucose inhibition experiment； Case 1 has been repeatedly treated in the past，and now GH has completely biochemical remission. Four patients（cases 1，2，4 and 5） had elevated 5）FT4 and TSH was not inhibited，among which 2 patients had thyrotoxicosis. The level of gonadal axis decreased in 2 patients. Among the 5 patients，4 cases underwent space-occupying resection in the sellar region through nasal endoscope，and most of their GH，TSH and FT4 decreased significantly after operation（2 cases recovered to the normal range，while the GH level in another case decreased，but not completely relieved，and the TSH and FT4 levels returned to normal，while the GH，TSH and FT4 in the other case did not change significantly）. The remaining case 1 was treated with gamma knife first，then with drug，and the GH level was relieved after the third recurrence was treated with surgery，but TSH and FT4 were still not relieved. The results of postoperative sex hormones suggest that the gonadal function of 2 patients with hypogonadism did not return to normal immediately. The function of pituitary-adrenal axis was normal in 5 patients before and after operation.Conclusion The clinical incidence of pituitary GH+TSH mixed tumor is low，the onset is insidious，and it is often misdiagnosed because of thyrotoxicosis，which is easy to miss the best treatment opportunity. Surgery is still the first-line treatment for this disease.

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Abstract:Objective To design an automatic medical text recognition system based on artificial intelligence（AI）， which can quickly spot and analyze patients’ clinical information then output accurate treatment plans.Methods After discussions by senior neurosurgeons and professional AI teams，we designed the automatic recognition and decision-making system of medical text information for hypertensive cerebral hemorrhage（namely H-system） based on the language representation model and the expert mode. Taking the real treatment plans in the database as the gold standard， the accuracy of the H-system was evaluated as a whole，and then it was compared with the senior neurosurgery to analyze the efficiency of the H-system.Results In the testing sets，the accuracy of the output by H-system was 94.0%（91.5%-96.5%），the specificity was 91.8%（86.3%-97.3%），the sensitivity was 95.5%（89.3%-98.2%），and the AUC was 0.936（0.922-0.950）（P=0.000）. Meanwhile，in the validation sets，the accuracy of the output by H-system was 93.3%（89.5%-97.1%），the specificity was 89.9%（83.4%-96.4%），the sensitivity was 95.8%（92.3%-99.3%），and the AUC was 0.928（0.891-0.966）（P=0.000）. In processing the same 70 cases，the H-system took（334.60±4.46） s compared to （12 550.28±95.45） s for the neurosurgeon；in 50 minutes， the H-system processed（383±3） cases compared to （11±4） cases for the neurosurgeon.Conclusion The H-system constructed in this study can automatically recognize and analyze the medical text data of patients， and quickly output an accurate treatment plan. In clinical practice， it may assist doctors to provide an efficient and reliable treatment for patients with hypertensive intracerebral hemorrhage.

Abstract:Objective Hypertensive response to exercise（HRE） is associated with adverse cardiovascular events，and early identification and proper intervention of HRE is of great importance for the prevention of cardiovascular events. This study aims to investigate the potential association between elevated ambulatory blood pressure（BP） and HRE in patients with non-obstructive coronary artery disease（NOCAD）.Methods A total of 517 patients with suspected coronary heart disease were enrolled in this study，and coronary angiography was performed to observe the degree of coronary artery stenosis. Cardiopulmonary exercise testing（CPET） was performed for the patients with NOCAD，and HRE was diagnosed based on BP records during CPET. The logistic regression model was used to analyze the association between elevated ambulatory BP and HRE.Results Finally，a total of 347 patients with NOCAD were included in the statistical analysis，with a mean age of （61.15±9.14） years，and male patients accounted for 42.4%. Among these patients，51.30% had hypertension and 13.8% suffered from diabetes. The logistic regression analysis showed that elevated ambulatory BP［odds ratio（OR）=2.163，95%CI=1.094-4.275，P=0.026］ was a risk factor for HRE. The subgroup analysis based on sex showed that in the female patients with NOCAD，elevated ambulatory BP（OR=3.310，95%CI=1.387-7.902，P=0.007） was a risk factor for HRE，while in the male patients with NOCAD，elevated ambulatory BP was not found to be associated with HRE （OR=1.154，95%CI=0.370-3.603，P=0.805）.Conclusion Elevated ambulatory BP is associated with HRE in patients with NOCAD，especially in female patients with NOCAD. This finding may help with the early diagnosis of HRE and guide such patients to take proper aerobic exercise during cardiac rehabilitation.

Abstract:Objective To investigate the key technical issues and application value of target line surface tracing in CT-guided percutaneous lung biopsy.Methods A total of 152 patients who underwent lung biopsy from August 2021 to April 2022 were enrolled and randomly divided into group A with 77 patients and group B with 75 patients. The efficacy of the two surgical methods was evaluated by comparing the two groups in terms of the success rate of first-time needle insertion，the number of CT scans，diagnostic accuracy，postoperative complications，and time of operation.Results Both groups A and B had successful puncture with specimens obtained，and the success rate of puncture was 100%. Successful first-time needle insertion was achieved for 64 patients in group A and 62 in group B，with no significant difference between the two groups（χ²=0.005， P=0.941）；18 patients in group A and 54 in group B had an excessive number of CT scans，with a significant difference between the two groups（χ²=36.030，P<0.05）；70 patients in group A and 68 in group B achieved an accurate diagnosis， with no significant difference between the two groups（χ²=0.003，P=0.959）. Hemoptysis was observed in 12 patients in group A and 9 patients in group B， with no significant difference between the two groups（χ²=0.410， P=0.522），and pneumothorax was observed in 10 patients in group A and 11 patients in group B， with no significant difference between the two groups（χ²=0.090，P=0.764）. The mean time of operation was （19.88±4.47） minutes in group A and （32.23±4.95） minutes in group B，and there was a significant difference between the two groups（t-test，P<0.05）.Conclusion The application of target line surface tracing in CT-guided lung puncture is simple and easy and can accurately guide the angle of puncture and reduce the number of CT scans during surgery，and therefore，it holds promise for clinical application.

Abstract:Objective To investigate the changing trend of the expression of plasma coagulation and fibrinolytic markers in patients with chronic kidney disease（CKD），and to provide a basis for the diagnosis and treatment of CKD-related coagulopathies.Methods According to the inclusion criteria，123 patients with CKD were selected from the CKD patients who attended Shaanxi Provincial Hospital of Traditional Chinese Medicine from May 2021 to May 2022，and they were divided into groups based on estimated glomerular filtration rate；40 healthy controls（HCs） were selected from the individuals who underwent physical examination and were established as HC group. Related coagulation and fibrinolytic markers were measured，i.e.，thrombomodulin（TM），thrombin-antithrombin complex （TAT），fibrin-α2 antifibrinolytic complex（PIC），tissue-type fibrinogen activator inhibitor-1 complex（t-PAIC），prothrombin time （PT），activated partial thromboplastin time（APTT），thrombin time （TT），fibrinogen（FIB），fibrinogen degradation product（FDP），and D-dimer（DD），as well as the expression levels of albumin，serum creatinine（SCr），and blood urea nitrogen（BUN）.Results There were no significant differences in PT，APTT，and TT between groups（P>0.05），and the CKD group had significantly higher FIB，DD，and TAT than the HC group （P<0.001）. The level of DD in stage 5 CKD was significantly higher than that in stage 1/2 CKD（P<0.05）. The level of FDP in stage 2-5 CKD was significantly higher than that in the HCs（P<0.05），and the level of FDP in stage 5 CKD was significantly higher than that in stage 1/2 CKD. PIC in stage 3-5 CKD was significantly higher than that in the HCs，and PIC in stage 4 CKD was significantly higher than that in stage 1/2 CKD（P<0.001）. The level of t-PAIC in stage 1-4 CKD was significantly higher than that in the HCs（P<0.05）. TM in stage 2-5 CKD was significantly higher than that in the HCs，and TM in stage 4-5 CKD was significantly higher than that in the other stages（P<0.001）. The CKD groups had a significantly higher TAT/PIC ratio than the HC group，with a significant difference between stage 1-3 CKD and the HCs（P<0.001）. The receiver operating characteristic（ROC） curve analysis of TAT/PIC ratio showed an area under the ROC curve of 0.716 in differentiating CKD from HCs.Conclusion Hypercoagulability is prevalent in CKD patients，and novel coagulation markers have a good ability to reflect the changes in coagulation function.

Abstract:Objective To observe the safety and efficacy of fecal microbiota transplantation in the treatment of inflammatory bowel disease，and to evaluate the effect on inflammatory indexes，disease scores，and composition of gut microbiota after treatment.Methods A total of 14 patients with inflammatory bowel disease who underwent fecal microbiota transplantation in the Anorectal Department of our hospital from December 2018 to December 2021 were selected to compare the clinical efficacy，inflammatory indexes，Mayo and CDAI disease scores，and to compare the composition of gut microbiota by 16s rDNA detection before and after treatment.Results After fecal microbiota transplantation，the clinical remission rate was 85.71%（13/15） in the 15th week；the inflammatory indexes，Mayo and CDAI disease scores，diversity and relative abundance of gut microbiota were improved，and the differences were statistically significant（P<0.05）.Conclusion Fecal microbiota transplantation in the treatment of inflammatory bowel disease has a significant curative effect，few adverse reactions，and high safety，which is worthy of clinical application.