Abstract:Diminished ovarian reserve （DOR） is one of the important causes of reduced fertility in women， with a complex etiology and unclear specific mechanisms， making it one of the challenges in the field of reproduction. Recent studies have shown that gut and genital tract microbiota play a critical role in the pathogenesis of DOR. Therefore， this article focuses on the new research advances in DOR and gut and genital tract microbiota，so as to provide new ideas for the research on the mechanism of DOR.

Abstract:Pyroptosis is a type of cell death that culminates in the loss of membrane integrity as a result of the activation of inflammasome sensors. Pyroptosis plays an important role in the development and progression of inflammation and diseases because of a leakage of the cellular contents into the extracellular space. Cells live in a complex mechanical environment and are subject to various mechanical stimuli originating from the microenvironment and external forces. Appropriate mechanical stress contributes to the normal physiological process of cells，but excessive mechanical stress can activate stress signaling pathways，such as death pathways，resulting in cell tissue damage and inflammation. In this paper，we review the literature on the molecular mechanisms of cell pyroptosis and how mechanical stress affects cell pyroptosis，aiming to provide a basis for future research on pyroptosis-related diseases.

Abstract:The pathogenesis of dry eye is complex，and various etiology will eventually lead to corneal and conjunctival injury and cause a series of eye discomfort symptoms. Understanding the pathological changes of the ocular surface in patients with dry eye is of great significance for the diagnosis and treatment of the disease. In recent years，in vivo confocal microscopy（IVCM） has been increasingly used to study the microscopic world of dry eyes. IVCM is a non-invasive imaging tool that can examine the changes in corneal cells and nerve fibers noninvasively in real time，evaluate various structures such as meibomian glands，and provide better help in understanding the pathogenesis of dry eye and histological changes at the cellular level. This paper summarizes the changes of ocular surface of different types of dry eye under IVCM in order to further understand the pathological changes of each type of dry eye and assist clinical diagnosis and treatment.

Abstract:Objective To investigate the impact of acetyl-CoA carboxylase 2（ACC2） on the proliferation and migration of hepatocellular carcinoma cells（HCCs） as well as the potential mechanism of action.Methods The expression of ACC2 in the liver tissue of patients with HCC and its prognostic significance were analyzed in The Cancer Genome Atlas， Gene Expression Omnibus，and Clinical Proteomic Tumor Analysis Consortium databases. The ACC2-knockdown cell lines of HCCs were established using the CRISPR-Cas9 system；the changes in proliferation，migration，and cell cycle of the HCCs were observed. The expression of cell cycle-related proteins was measured using Western blot assay.Results ACC2 showed low expression in the HCC tissue（P<0.05） and was associated with unfavorable prognoses（P<0.05）. In vitro cell functional experiments revealed that the decrease in ACC2 expression significantly enhanced the proliferation and migration of the HCCs（P<0.05）. Flow cytometric analysis of cell cycles proved that ACC2 knockdown promoted the G1/S phase transition（P<0.05），with decreased expression of CyclinE2 and p21 and increased expression of CyclinA2 and p-RB among the cell cycle-related proteins.Conclusion ACC2 promotes the proliferation and migration of HCCs，which is achieved by accelerating the G1-to-S phase transition of the HCCs.

Abstract:Objective To investigate the effect of tumor necrosis factor-α（TNF-α） on the expression of tight junction proteins ZO-1 and Claudin-5 in rat pulmonary microvascular endothelial cells and to explore the injury mechanism of TNF-α on pulmonary vascular barrier in rats.Methods Rat pulmonary microvascular endothelial cells cultured in vitro were divided into control group，and TNF-α 24 h，48 h，and 72 h groups（TNF-α 10 mg/L）. The ultrastructure of rat pulmonary microvascular endothelial cells was observed by a transmission electron microscope. The proliferation inhibition rate and apoptosis rate of cells in each group were determined by MTT assay and flow cytometry. The distribution of ZO-1 and Claudin-5 was determined by the immunofluorescence method. The mRNA and protein expression levels of ZO-1 and Claudin-5 in cells of each group were determined by real-time fluorescence quantitative polymerase chain reaction and Western blot.Results Endothelial cells in the control group contained a large number of mitochondria and endoplasmic reticulum，with a normal structure. Cells in the TNF-α groups showed a decrease in the number of mitochondria，mitochondrial swelling，cristae lysis，karyopyknosis，and an increase in apoptotic cells，with a significant time-dependent increase in the proliferation inhibition rate and apoptosis rate compared with the control group（all P<0.05）. ZO-1 and Claudin-5 were distributed at the junction of endothelial cells，showing linear fluorescence. Compared with the control group，the TNF-α groups showed a significant decrease in the transcription and expression levels of ZO-1 and the transcription level of Claudin-5（P<0.05）； the TNF-α 48 h and 72 h groups showed a significant decrease in the protein expression level of Claudin-5（P<0.05）； the TNF-α 24 h group showed no significant difference（P>0.05）.Conclusion TNF-α downregulates the expression of ZO-1 and Claudin-5 in rat pulmonary microvascular endothelial cells，induces cell injury and apoptosis，destroys the lung barrier，and leads to lung injury.

Abstract:Objective To explore the role of RNA m⁶A methylation in insulin resistance in adipocytes.Methods We collected redundant subcutaneous adipose tissue samples from patients with type 2 diabetes and patients without type 2 diabetes to measure the RNA m⁶A modification level. A insulin resistance（IR） model was established by feeding C57BL/6J mice with a 60% high-fat diet for 16 weeks（n=5），while the control group was fed with a 10% low-fat diet for 16 weeks（n=5）. After successful modeling，the adipose tissue around the epididymis was taken to detect m⁶A methylation using epitranscriptomic microarrays. The changes in insulin signaling-related genes were determined by MeRIP-qPCR assay，RT-qPCR，and RIP assay. The effects of the small-molecule inhibitor STM2457 targeting methyltransferase like 3（METTL3） on insulin signaling-related genes in mice feeding a high-fat diet were investigated.Results The overall m⁶A modification levels were significantly increased in the adipose tissue of patients with type 2 diabetes and IR mice（patients 200 ng RNA，t=-8.375，P<0.001；patients 100 ng RNA，t=-3.722，P=0.006；patients 50 ng RNA，t=-4.937，P=0.001；mice 100 ng RNA，t=-3.590，P=0.023；mice 50 ng RNA，t=-2.760，P=0.025）. The epitranscriptomic assay detected high m⁶A methylation levels in 1 175 genes and low m⁶A methylation levels in 55 genes；182 genes showed significantly high m⁶A modification and low expression，including five key insulin signaling-related genes（AKT2，INSR，PIK3R1，ACACA，and SREBF1）. Direct binding between AKT2，INSR，ACACA，and SREBF1 and METTL3 was validated，and their m⁶A modification levels were positively regulated by METTL3. STM2457 significantly increased insulin sensitivity，and significantly upregulated the transcriptional levels of AKT2，INSR，ACACA，and SREBF1，suggesting a significant improvement in IR phenotype.Conclusion High-fat diet induces IR through METTL3，which mediates m⁶A hypermethylation of AKT2，INSR，ACACA，and SREBF1 to downregulate their expression and block insulin signaling in adipocytes.

Abstract:Objective To explore the effect of Ginsenoside Rg3 on bone metabolism and intestinal calcium absorption in osteoporosis（OP） rats.Methods 60 SPF grade female Wistar rats were randomly divided into blank group，model group，positive group，and experimental group，with 15 rats in each group. Except for the blank group，all other rats were used to prepare OP rat models using the OVX method. After successful modeling，the blank group and the model group were given normal saline by gavage[10 mL/（kg·d）]，the positive group was given alendronic acid sodium and vitamin D3 by gavage[6.25 mg/（kg·w）]，and the experimental group was given ginsenoside Rg3[80 mg/（kg·d）] by gavage for 12 consecutive weeks. Bone mineral density changes of femur and tibia in each group were detected. Serum osteoprotegerin（OPG），procollagen type I N-terminal peptide（PINP），tartrate resistant acid phosphatase（TRACP） Changes in the content of Type I collagen cross-linked C-terminal peptide（CTX-I）；TUNEL method was used to analyze the apoptosis of intestinal mucosal tissue cells in each group；Masson's method was used to analyze the pathological changes of intestinal mucosal tissue fibers in each group；Immunohistochemical method was used to detect the protein expression of vitamin D membrane associated rapid response steroid binding（1，25-D3-MARRS） in intestinal mucosa tissues of each group；Protein immunoblotting and RT-PCR were used to detect the expression levels of Jagged1，Notch1，Hes1 protein and mRNA in each group.Results After modeling，the bone density of the femur and tibia in rats decreased significantly，and the levels of OPG，PINP，TRACP，and CTX-I in serum showed significant changes（P<0.05）；Significant pathological changes occur in the intestinal mucosa tissue，with increased fibrosis and increased degree of cell apoptosis；The expression of 1，25-D3-MARRS protein in intestinal mucosal tissue decreased（P<0.05）. After treatment，compared with the model group，the bone density of the femur and tibia of the positive and experimental groups were significantly increased，and the serum levels of OPG，PINP，TRACP，and CTX-I were significantly improved（P<0.05）；The pathological changes of intestinal mucosa tissue have significantly improved，with reduced fibrosis and reduced degree of cell apoptosis；The expression of Jagged1，Notch1，Hes1 proteins and mRNA in intestinal mucosal tissue was significantly improved（P<0.05）.Conclusion Ginsenoside Rg3 can increase bone density of OP rats，reduce apoptosis and fibrosis of intestinal mucosa，increase the expression of 1，25D3-MARRS protein in intestinal mucosa，and improve intestinal calcium absorption.

Abstract:Objective To investigate the molecular mechanism of Buzhong Yiqi Decoction in coordination with Siβ-catenin in intervention against cisplatin resistance in A549/DDP cells by regulating the Wnt/β-catenin signaling pathway.Methods The expression of β-catenin was silenced by siRNA interference，and Western blot was used to measure the relative protein expression of β-catenin in A549/DDP cells in the normal serum group，the cisplatin group，the siCTNNB1-235 group，the siCTNNB1-510 group，and the siCTNNB1-547 group. After β-catenin interference，Western blot was used to measure the protein expression levels of β-catenin and Survivin in A549/DDP cells of each group； MTT assay was used to determine the IC₅₀ of cisplatin in A549/DDP cells of each group； Annexin V/PI staining was used to measure the cisplatin-induced apoptosis rate of A549/DDP cells in each group.Results Compared with the normal serum group（1.00），the siCTNBN1-235 group（0.323±0.021） had an inhibition rate of 67% on β-catenin expression（P=0.000）. After β-catenin was silenced by RNAi technique，compared with the normal serum group（1.00），the Buzhong Yiqi Decoction+cisplatin group had significantly greater reductions in the protein expression of Survivin（0.247±0.015） and β-catenin（0.257±0.015）（P=0.000，P=0.000）. As for the IC₅₀ of cisplatin in A549/DDP cells，compared with the normal serum group（28.330±1.029） μmol/L，serum containing Buzhong Yiqi decoction alone（20.350±1.155） μmol/L or siCTNNB1-235 transient transfection alone（15.577±1.535） μmol/L reduced the IC₅₀ of cisplatin in A549/DDP cells（P=0.000，P=0.000），and the combination of the two methods（10.453±0.999） μmol/L further reduced the IC₅₀ of cisplatin（P=0.000）. Compared with the normal serum group（9.130±0.384）%，the siCTNBN1-235 transient transfection+cisplatin group（64.393±0.244）% and the Buzhong Yiqi Decoction+cisplatin group（70.120±0.400）% had a significant increase in overall apoptosis rate（P=0.000，P=0.000）.Conclusion Serum containing Buzhong Yiqi Decoction and siβ-catenin transient transfection have a synergistic effect on inhibiting the Wnt/β-catenin signaling pathway and improving cisplatin resistance in lung adenocarcinoma，and Buzhong Yiqi Decoction has a siβ-catenin transient transfection-like effect.

Abstract:Objective To investigate the effects of M1 microglia-derived exosomes（M1-exo） on the function of an in-vitro blood-brain barrier（BBB） model and the expression of tight junction proteins between vascular endothelial cells.Methods Mouse microglia-derived BV2 cells were stimulated with lipopolysaccharide to be polarized towards the M1 phenotype，and exosomes were isolated and extracted after the phenotype was confirmed by flow cytometry. An in-vitro BBB model was constructed using the mouse brain microvascular endothelial cell line b.End3 and primary cultured mouse astrocytes. The BBB model was co-cultured with exosomes of different sources in three groups：normal culture for b.End3 cells（b.End3 group）；b.End3 cells + 25 μg/mL exosomes derived from normal BV-2 cells（b.End3+BV2-exo group）；and b.End3 cells+25 μg/mL M1-exo（b.End3+M1-exo group）. Trans-endothelial electrical resistance（TEER） and Lucifer yellow permeability were examined. The expression of tight junction complex proteins（claudin-1，occludin，zonula occludens-1［ZO-1］，and junctional adhesion molecules） was measured by Western blot.Results Microglia were successfully polarized to the M1 type，and the positivity rate of the M1 marker CD16/32 was significantly increased compared with the control group（P=0.023）. After co-culture with M1-exo，the TEER of the in-vitro BBB model was significantly decreased（P<0.001），and Lucifer yellow permeability was significantly increased（P<0.001）. Compared with the b.End3 group and b.End3+BV2-exo group，the b.End3+M1-exo group showed significantly decreased expression levels of claudin-1，occludin，and ZO-1.Conclusion M1-exo can disrupt the integrity of BBB and interfere with its normal function.

Abstract:Objective To investigate the expression level of proteasome activator subunit 1/2（PSME1/2） in endometrial carcinoma and its effect on the proliferation and invasion of endometrial carcinoma cells.Methods The expression levels of PSME1/2 and cyclin-dependent kinase 15（CDK15） were measured in endometrial cell lines and primary cultured cells，and knock-down strains were used to analyze the correlation between PSME1/2 and CDK15 and the effect of PSME1/2 on tumor proliferation and invasion. The expression levels of PSME1/2 and CDK15 were compared between endometrial carcinoma tissue and paracancerous tissue，and the influence of PSME1/2 and CDK15 on the prognosis of patients with endometrial carcinoma was analyzed.Results Compared with normal human endometrial cell lines，human endometrial adenocarcinoma HEC1B cells and primary cultured cells had high mRNA and protein expression levels of PMSE1/2 and a reduction in the protein expression of CDK15. Compared with the control group and the double knock-down group，there was an increase in the protein expression level of CDK15 in the HEC1B line with PSME1/2 knock-down，suggesting that CDK15 might be inhibited by PSME1/2. There was a high expression level of PMSE1/2 and a low expression level of CDK15 in endometrial carcinoma. There were no significant differences in age，postoperative diagnosis and typing，degree of tumor differentiation，and postoperative stage between the high PSME1/2 expression group and the low PSME1/2 expression group（P>0.05）. There was no significant correlation between the expression of PSME1/2 and CDK15 and the poor prognosis of patients with endometrial carcinoma（P>0.05）.Conclusion PSME1/2 can inhibit the expression of CDK15 and promote the proliferation and invasion of endometrial carcinoma cells，and PSME1/2 can also promote endometrial carcinoma.

Abstract:Objective To investigate the risk factors for poor wound healing（PWH） in patients undergoing thoracolumbar tuberculosis surgery.Methods A retrospective analysis was performed for 124 patients who underwent posterior thoracolumbar tuberculosis debridement，bone graft fusion，and internal fixation in Department of Orthopedics，The First Affiliated Hospital of Chongqing Medical University from January 2019 to October 2021，among whom there were 16 patients with PWH and 108 patients without PWH. According to the presence or absence of PWH after surgery，they were divided into PWH group and non-PWH group. The two groups were compared in terms of preoperative data，including sex，age，smoking/drinking history，comorbidity of hypertension/pulmonary tuberculosis/diabetes，number of surgically fixed segments，body mass index，mean corpuscular volume（MCV），mean corpuscular hemoglobin（MCH），mean corpuscular hemoglobin concentration（MCHC），hemoglobin（Hb），platelet count（PLT），neutrophil count and percentage，lymphocyte count and percentage，monocyte count and percentage，prealbumin，albumin，erythrocyte sedimentation rate（ESR），and C-reactive protein（CRP）. The univariate analysis，the multivariate binary logistic regression analysis，and the receiver operating characteristic（ROC） curve analysis were used to investigate related influencing factors.Results The univariate analysis showed that pulmonary tuberculosis（χ²=5.458，P=0.019），number of surgically fixed segments（Z=-3.407，P=0.001），PLT（Z=-2.766，P=0.006），MCV（Z=2.957，P=0.004），MCH（Z=-3.001，P=0.003），MCHC（Z=2.379，P=0.019），absolute neutrophil count（Z=-3.723，P<0.001），percentage of neutrophils（Z=-3.678，P<0.001），lymphocyte percentage（Z=3.798，P<0.001），Hb（Z=-3.225，P=0.001），prealbumin（Z=3.988，P<0.001），albumin（Z=-3.562，P<0.001），ESR（Z=-2.971，P=0.003），and CRP（Z=-4.305，P<0.001） were significant risk factors. The multivariate binary logistic regression analysis showed that the number of surgically fixed segments，preoperative percentage of neutrophils，preoperative absolute neutrophil count，preoperative lymphocyte percentage，and CRP were independent risk factors for postoperative PWH in patients with thoracolumbar tuberculosis. The ROC curve analysis showed that the cut-off values of the number of surgically fixed segments，preoperative percentage of neutrophils，preoperative absolute neutrophil count，preoperative lymphocyte percentage，and CRP were 5 segments，71.5%，5.29×10⁹/L，19.45%，and 40.95 mg/L，respectively.Conclusion Incision length can be shortened to reduce surgical trauma，and preoperative monitoring of neutrophils，lymphocytes，and CRP can reduce the risk of PWH in patients after thoracolumbar tuberculosis surgery.

Abstract:Objective To investigate the clinical effect of myofascial release combined with acupuncture in the treatment of lower limb spasticity after stroke.Methods A totalof 45 patients with lower limb spasticity after stroke were enrolled and randomly divided into control group with 22 patients and experimental group with 23 patients. The patients in the control group were given acupuncture alone，and those in the experimental group were given myofascial release combined with acupuncture. After 6 weeks of treatment，the two groups were compared in terms of the clinical effect of rehabilitation and the changes in related indicators. Modified Ashworth Scale（MAS） was used to evaluate the muscle tension of knee flexor muscles，and the treatment was considered effective if there was a reduction in MAS score. Fugl-Meyer Assessment of Lower Extremity（FAM-LE） was used to evaluate the motor function of lower limbs，Clinical Spasticity Index（CSI） was used to evaluate the degree of spasticity，and the serum level of homocysteine（Hcy） was measured.Results After treatment，the experimental group had a significantly higher response rate than the control group（P<0.05），and both groups had a significant reduction in the serum level of Hcy and significant increases in FMA-LE and CSI scores（P<0.05）. Compared with the control group，the experimental group had significantly lower MAS score and serum Hcy level and significantly higher FMA-LE and CSI scores（P<0.05）.Conclusion For patients with lower limb spasticity after stroke，myofascial release combined with acupuncture can effectively reduce muscle tension，alleviate spasticity，improve the motor function of lower limbs，and reduce serum Hcy level.

Abstract:Objective To investigate the change in liver/spleen stiffness and the correlation with hepatic venous pressure gradient （HVPG） in patients with viral liver cirrhosis.Methods We included 82 patients with viral liver cirrhosis treated in The Second People's Hospital of Lanzhou from September 2020 to December 2021. HVPG and liver and spleen stiffness were measured. Pearson correlation analysis was used to evaluate the correlation between changes in liver and spleen stiffness and HVPG in these patients. A receiver operating characteristic（ROC） curve was used to evaluate the predictive value of liver and spleen stiffness for HVPG ≥12 mmHg in patients with viral liver cirrhosis.Results HVPG，liver stiffness，and spleen stiffness were significantly higher in the Child-Pugh class B patients and the Child-Pugh class C patients than in the Child-Pugh class A patients（P<0.05）. HVPG was significantly positively correlated with liver stiffness and spleen stiffness（r=0.591，0.502，P<0.001）. The areas under the ROC curves for predicting HVPG ≥12 mmHg using liver stiffness，spleen stiffness，and their combination in patients with liver cirrhosis were 0.866，0.821，and 0.914，respectively.Conclusion Liver and spleen stiffness are significantly positively correlated with HVPG in patients with viral liver cirrhosis， which have certain predictive value for portal hypertension in a noninvasive way.

Abstract:Objective To investigate the feasibility of gastric tube-guided transanal decompression tube placement for the treatment of rectal cancer with obstruction.Methods We retrospectively analyzed the data of 55 patients with rectal cancer with obstruction undergoing placement of a decompression tube through the anus under the guidance of a gastric tube from January 2018 to February 2022. We calculated the success rate，the clinical remission rate of intestinal obstruction，and the incidence of complications including bleeding and perforation，and recorded their conditions within one year after surgery.Results Of the 55 patients，51 had successful tube placement，with a technical success rate of 92.7%；there were 47 cases of complete clinical remission，two cases of partial clinical remission，and two cases of no clinical remission，with a clinical success rate of 96.1%. One patient's tube detached due to an accidental pull three days after placement，and was successfully replaced. No bleeding or perforation was observed. Emergency open surgery was performed for one case of failed tube placement and two cases of poor decompression after tube placement，while elective surgery was performed for the remaining 52 patients（open surgery for 1 and laparoscopic-assisted surgery for 51）. Within one year after surgery，1 case developed liver metastasis，while the remaining 54 cases had no local recurrence or distant metastasis，and there were no deaths.Conclusion Under the guidance of a disposable gastric tube，a decompression tube can be inserted more efficiently and safely through the anus to effectively relieve intestinal obstruction caused by rectal cancer，which is suitable for promotion and application in primary medical institutions without digestive endoscopy equipment.

Abstract:Objective To investigate the safety and efficacy of abdominal aortic balloon occlusion versus uterine artery embolization（UAE） as the pretreatment for cesarean scar pregnancy（CSP）.Methods A retrospective analysis was performed for 104 patients with CSP who were admitted to Chengdu Women and Children's Central Hospital from January 2018 to December 2019 and were diagnosed based on clinical and radiological examinations，among whom 47 received abdominal aortic balloon occlusion before surgery and 57 received UAE before surgery.Results There were no significant differences in general information and treatment outcome between the two groups（P>0.05）. There were significant differences between the two groups in hospital costs，pain after interventional surgery，duration of interventional radiation and body surface radiation dose under X-ray fluoroscopy，and postoperative menstrual changes（P<0.05）.Conclusion Both abdominal aortic balloon occlusion and UAE can effectively control intraoperative bleeding as the pretreatment for CSP，and compared with UAE，abdominal aortic balloon occlusion significantly reduces the duration and dose of radiation for both medical staff and patients，with no severe pelvic pain and a few postoperative complications such as the reduction in menstrual volume and amenorrhea. Abdominal aortic balloon occlusion has no near-term effect on uterine and ovarian function，but with a relatively high price.

Abstract:Objective To explore Mycobacterium tuberculosis（MTB） infection and the expression of the Notch signaling pathway in patients with primary lung cancer.Methods A total of 96 patients with primary lung cancer who underwent radical surgery at Chongqing University Cancer Hospital between January 2022 and June 2022 were enrolled as research subjects. MTB and its L-forms in the lung tissue were detected using in situ molecular hybridization and acid-fast staining. Drug resistance was analyzed using a drug susceptibility test. Mutations at the sites of target genes were identified using sequencing. The expressions of Notch1，Notch2 and Notch3 proteins in the lung tissue were determined using Western blot.Results Of the 96 patients with primary lung cancer，the positive rate of MTB-L forms was 38.54%（37/96），with 68 MTB-L strains isolated from the sputum samples of the positive patients. The resistance rate of the isolated MTB-L strains to first-line anti-tuberculosis drugs was 60.29%（41/68），with the highest drug resistance rate of 22.06% for the combination of isoniazid，streptomycin，rifampicin，and ethambutol. The resistance rate of the isolated MTB-L strains to second-line anti-tuberculosis drugs was 36.76%（25/68），with the highest drug resistance rate of 14.70% for ofloxacin alone. The target genes with the top three mutation rates at the drug sites of the MTB-L strains were isoniazid katG S315T（45.58%），streptomycin rpsL K43R（42.65%），and rifampicin rpoB S450L（20.59%）. The relative expression levels of Notch1，Notch2，and Notch3 proteins in the lung tissue of patients with positive MTB-L infections were higher than those in the lung tissue of patients with negative MTB-L infections（P<0.05）.Conclusion MTB infection in patients with primary lung cancer is mainly caused by MTB L-forms，and drug resistance is severe. Abnormal activation of the Notch signaling pathway is observed in patients with MTB-L infection.

Abstract:Objective To investigate the application value of dual-energy CT（DECT） linear blending imaging（LBI），nonlinear blending imaging（NBI），and noise-optimized virtual monoenergetic imaging（VMI+） techniques in laryngeal squamous cell carcinoma （SCC）.Methods A retrospective analysis was performed for the DECT data of 61 patients with pathologically confirmed laryngeal SCC from June 2019 to March 2022. DECT images were reconstructed using LBI with weighting factors 1 （80 kV） and 0.6（M0.6），NBI，and VMI+（40 keV and 55 keV） techniques. The five groups of images were compared in terms of objective image quality ［contrast-to-noise ratio （CNR），tumor CT value，and noise］ and subjective image quality（tumor delineation score and overall image quality score）.Results The 40 keV images had significantly higher CNR，tumor CT value，and tumor delineation score than 80 kV，M0.6，NBI，and 55 keV images（all P<0.05）. The NBI images had a significantly higher overall image quality score than the 80 kV，M0.6，40 keV，and 55 keV images（all P<0.05）. The NBI images had a significantly lower noise than the 80 kV，40 keV，and 55 keV images（all P<0.05）.Conclusion In DECT for laryngeal SCC，the VMI+（40 keV） technique can provide images with better CNR，tumor CT value，and tumor delineation，while the NBI technique can provide images with lower noise and better overall image quality.

Abstract:Objective To investigate whether the computed tomography（CT） signs of biochemically negative paragangliomas and pheochromocytomas （PPGLs） differ from those of biochemically positive PPGLs and whether there are differences in CT signs between different phenotypes of biochemically positive PPGLs.Methods A retrospective analysis was performed for the preoperative abdominal contrast-enhanced CT images of 131 patients with PPGLs，including tumor location，size，shape，cystic change and necrosis，fluid-fluid stratification，calcification，nodular centripetal enhancement，large blood vessels in tumor，enhancing capsule，absolute percentage washout，and relative percentage washout. According to biochemistry，the patients were divided into biochemically positive group and biochemically negative group，and the biochemically positive group was further divided into norepinephrine phenotype group，adrenaline phenotype group，and dopamine phenotype group. CT signs were compared between each group and different phenotypes.Results Compared with the biochemically negative group，the biochemically positive group had significantly larger PPGLs（Z=-2.064，P=0.039） and a significantly higher proportion of patients with cystic change and necrosis（χ²=6.610，P=0.010） or nodular centripetal enhancement（χ²=3.909，P=0.048），and compared with the norepinephrine phenotype group，the epinephrine phenotype group had significantly larger PPGLs（Z=-2.036，P=0.042） and a significantly higher proportion of patients with enhancing capsule（χ²=7.242，P=0.007）.Conclusion The CT signs of tumor size，cystic change and necrosis，and nodular centripetal enhancement can help with the diagnosis of biochemically negative PPGLs before surgery，and tumor size and enhancing capsule can help to explain the mechanism of different clinical manifestations of PPGLs with norepinephrine phenotype or epinephrine phenotype.

Abstract:Objective To investigate the quality of life in children with osteogenesis imperfecta in southwest China， and analyze the influencing factors， and to provide a reference for the management of this disease at home.Methods A mixed methods design was employed to study the quality of life of children with osteogenesis imperfecta. In the qualitative phenomenological research part，we conducted semi-structured interviews with 20 osteogenesis imperfecta caregivers from a tertiary class-A children's hospital，and used Colaizzi's seven-step method to analyze the interview data. In the quantitative research part，we used the Pediatric Quality of Life Inventory to assess the quality of life of 34 children with osteogenesis imperfecta in southwest China，and determined the influencing factors through univariable and multivariable linear regression analyses，with age-matched healthy children as the control group.Results Five themes were identified in the qualitative research about quality of life：worry about fractures，a high pain tolerance，a lack of walking aids， a lack of peer communications，and a friendly school atmosphere. The quality of life of children with osteogenesis imperfecta was lower than that of healthy peers，with significant differences in the total score（t=-6.732，P<0.001），the physiological function score（P<0.001），and the social dimension（P<0.001）. Independent walking ability（t=3.490，P=0.001） and fixed playmates（t=3.164，P=0.003） entered the multiple regression equation，which co-explained 40.9% of variations in the quality of life score.Conclusion Family's disease management ability is needed to improve the quality of life for children with osteogenesis imperfecta. Medical staff need to establish chronic disease management at home from the aspects of knowledge popularization， medical guidance， future planning， and avoiding potential problems.

Abstract:Objective Development and validation of a novel acute ischemic stroke（AIS） scoring system： Anterior and posterior circulation infarction image score（APCIIS）.Methods Retrospective analysis of clinical data from 163 patients with acute ischemic stroke admitted to the First Affiliated Hospital of Chongqing Medical University from 2020/6 to 2021/6. The patients were divided into anterior circulation AIS group（n=109） and posterior circulation AIS group（n=54）. Univariate and multivariate analyses were performed to identify risk factors affecting the prognosis of patients with AIS. Using the Clot Burden Score（CBS） and the Basilar Artery on Computed Tomography Angiography score（BATMAN） as references，receiver operating characteristic（ROC） curves were plotted to analyze the predictive value of the novel scoring system（APCIIS） for prognosis assessment.Results In the anterior circulation AIS group，although the prognostic value of APCIIS was not superior to CBS，it demonstrated relatively higher sensitivity of 86.8%，specificity of 90.1%，and an area under the curve of 0.939. In the posterior circulation AIS group，APCIIS showed better prognostic value than the BATMAN score.Conclusion APCIIS is a convenient and reliable method for predicting the prognosis of patients with AIS.

Abstract:Objective To explore the expression of Methylthioadenosine phosphorylase（MTAP） in different clinical stages of prostate cancer and its correlation with immune cells.Methods The expression profile of MTAP was obtained from TCGA and GTEx databases，and pancarcinoma was analyzed by bioinformatics method. Immunohistochemistry verified the conclusions above and explored the correlation between MTAP and clinicopathological features. The expression levels of MTAP in different prostate cancer cell lines were detected by RT-qPCR and Western blot，and the correlation between MTAP and the degree of malignancy was analyzed. The correlatoin between MTAP and immune cells in prostate cancer was analyzed by bioinformatics and verified by immunohistochemistry.Results In prostate cancer，the expression of MTAP increased at early stage and then decreased gradually，and was negatively correlated with T stage and Gleason score（r_s=-0.576，P=0.000，r_s=-0.284，P=0.020）. MTAP was correlated with a variety of immune cells，among which MTAP was positively correlated with CD4⁺T cells（r=0.643，P=0.000），was significantly negatively correlated with NK CD56^bright cells（r=-0.570，P=0.000）.Conclusion In prostate cancer，the expression of MTAP increased at the early stage and then decreased gradually，which was negatively correlated with T stage and Gleason score. MTAP can regulate the infiltration and function of immune cells，and is a potential biomarker and immunotherapy target.