Nowadays，the world is in a pandemic of novel coronavirus pneumonia（COVID⁃19）. Diabetes combined with COVID⁃19 has a high prevalence and fatality rate. Diabetes mellitus（DM）and COVID⁃19 interact with each other. SARS⁃CoV⁃2 infects islet cells through angiotensin⁃converting enzyme 2（ACE2）receptor to reduce insulin secretion. This virus can also cause cytokine storms and acute systemic inflammatory response， which can damage islet tissues and cause the rise of blood glucose concentration. Meanwhile，hyperglycemia promotes cell infection of SARS⁃CoV⁃2. Diabetic patients with immune dysfunction accelerate the progression of COVID⁃19. Metformin，DPP⁃4 inhibitors and statins have multiple effects to improve inflammation and immunoregulatory func⁃ tion，and should be treatment options for diabetic patients with COVID⁃19.DPP⁃4 has been found to be a potential binding target of SARS⁃CoV⁃2，

Many studies have revealed that Macrophages play an important role in the pathogenesis of many diseases，and different phenotypes and functions can be obtained on exposure to different tissue environ⁃ ments，especially in tumor tissues. Previously known surface markers cannot distinguish macrophage subsets in tumors. The recent rapid development of mass cytometry and single⁃cell RNA sequencing，has made it possible to comprehensively map and study various cells in tumors and their phenotypes and functions. In this review，we summarized recent advances applying these technologies in defining macrophage subsets，further discussed the distinctive characteristic phenotypes and function of tumor ⁃associated macrophages in tumors and searched for new biological markers with therapeutic or prognostic potential to provide a theoretical basis for clinical immunotherapy of tumors in the future.

Objective To investigate the effect of silencing connexin 43（Cx43）on the symptoms of epileptic mice as well as the glucose uptake of hippocampal astrocytes. Methods Mice were divided into sham operation group，epilepsy group，no⁃load group，and silencing Cx43 group. The brain waves were monitored and the average number of discharges per minute was counted，the expression of Cx43 mRNA in hippocampus was detected，the morphology and number of astrocytes were observed，and the duration and frequency of epilepsy were recorded. Astrocytes were divided into blank group，sh ⁃ Cx43 group，and NC group so that the positive rates of Cx43 protein expression and 2⁃deoxyglucose（2⁃NBDG）expression were detected across the three groups. Results The expression of Cx43 mRNA in the epilepsy group increased ，but that in the silence group significantly decreased compared with the model group（P < 0.05）. In the epilepsy group，glial fibrillary acidic protein（GPAP） positive cells increased and arranged disorderly，brain waves were epileptiform discharges and the average discharges per minutes increased. In the silencing Cx43 group，the GPAF positive cells and epileptiform discharges both increased in number，and so it was with the average discharges per minute and the onsets and duration of seizures （P < 0.05）. Compared with the blank group，the expression of Cx43 protein in the sh⁃Cx43 group was significantly lower，and the positive expression rate of 2⁃NBDG was significantly higher（P < 0.05）. Conclusion Silencing Cx43 can promote the glucose uptake capacity of astrocytes so that it exerts anti⁃epileptic effects by improving the 

Objective To investigate the inhibitory effect of dictamnine onepithelial⁃mesenchymal transition of human prostate cancer cells and its mechanism. Methods PC⁃3 cells of human prostate cancer were cultured； PC⁃3 cells were treated with dictamnine，and the semi⁃inhibitory concentration IC50 of dictamnine and its time⁃ dependent effect on the proliferation of PC⁃3 cells were detected by MTS. The invasion ability of cells was detected by transwell assay. The expression levels of E ⁃cadherin，vimentin，β⁃catenin and snail were detected by Western blot. The protein expression of snail and E⁃cadherin was detected by Western blot assay after pc⁃3 cells were treated with Wnt channel activator LiCl and dictamnine. Results Transwell experiment showed that compared with that in the control group，the invasion ability of PC⁃3 cells was decreased after the treatment with dictamnine（P < 0.01）. PCR and western blot showed that the expression of E⁃cadherin mRNA and protein was increased，while the mRNA and protein expression of vimentin and snail and β⁃catenin in nucleus were decreased（P < 0.01）. Compared with that in dictamenine group，the expression of snail mRNA and protein was increased and the expression of E⁃cadherin mRNA and protein was decreased in PC⁃3 cells treated with dictamnine and LiCl（P < 0.01）. Conclusion Dictamenine may inhibit pc⁃3 cell epithelial⁃mesenchymal transformation by inhibiting the Wnt/ catenin/Snail signaling pathway.

Objective To investigate the effect of miRNA ⁃ 155 on autophagy and apoptosis of myocardial cells and Notch signaling pathway in oxygen ⁃glucose deprivation model. Methods Establishing the model of oxygen⁃glucose deprivation（OGD），the cells were divided into normal control group，OGD group，OGD + miRNA⁃ 155 inhibitor negative control group and OGD + miRNA⁃155 inhibitor group. RT⁃qPCR was used to detect the expression of miRNA ⁃155 in myocardial cells in the OGD group and the normal control group. The expression of Notch1，Hes1，Beclin1 and Caspase ⁃3 in OGD group，OGD + miRNA ⁃155 inhibitor negative control group and OGD+ miRNA ⁃155 inhibitor group was detected by Western blots. The activity of myocardial cells in each group was detected by the CCK⁃8 assay. Results The result of RT⁃qPCR showed that the expression of miRNA⁃155 was significantly increased in OGD group，compared with normal control group. The results of Western blots showed that miRNA ⁃155 inhibitor significantly increased the expression of Notch1，HES1，Beclin1 and decreased the expression of Caspase⁃3 in myocardial cells with oxygen⁃glucose deprivation. The results of CCK⁃8 showed that inhi⁃ bition the expression of miRNA⁃155 could significantly increase the activity of myocardial cells with oxygen⁃glucose deprivation. Conclusion MiRNA⁃155 inhibitor exerts the myocardial protection through enhancing the expression of Notch1 and HES1，activating Notch signaling pathway，promoting autophagy，inhibitting apoptosis and increase 

Objective The study investigated the effect and mechanism of salidroside pretreated ADSCs on promoting skin wound healing of diabetic rats. Methods The ADSCs were isolated and treated with low glucose medium，high glucose medium，salidroside combined with high glucose medium respectively. Cell proliferation， migration and expression of cytokeratin 19（CK19），CD31，α⁃smooth muscle actin（α⁃SMA）in three groups were detected. The diabetic skin wounds rat model was prepared and transplanted with ADSCs or salidroside pretreated ADSCs. The wound healing was observed and the expressions of CoL ⁃Ⅰ，COL ⁃Ⅲ，CK ⁃19，CD31 and α⁃SMA were detected. Results The A490，migration numbers and the expression of CK⁃19，CD31，α⁃SMA of ADSCs in the high glucose group were lower than those in control group（P < 0.05）；the A490，migration numbers and the expression of CK⁃19，CD31，α⁃SMA of ADSCs in high glucose+salidroside group were obviously higher than those in high glucose group（P < 0.05）. The wound healing rate and the expression of CoL⁃Ⅰ，COL⁃Ⅲ，CK⁃19，CD31 and α⁃SMA in wound of the ADSCs group and salidroside+ADSCs group were significantly higher than model group （P < 0.05）and the wound healing rate and the expression of CoL ⁃Ⅰ，COL ⁃Ⅲ，CK ⁃19，CD31 and α⁃ SMA in wound of the salidroside+ADSCs group were notable higher than those in ADSCs group（P < 0.05）. Conclusion Salidroside pretreated ADSCs could promote the healing of diabetic skin wounds，and promote the proliferation，

Objective To investigate the mechanism of long⁃chain non⁃coding RNA（LncRNA）HOX transcript antisense RNA（HOTAIR）targeting microRNA ⁃30d（miR ⁃30d）on invasion and migration of nasopharyngeal carcinoma cells. Methods HOTAIR siRNA was transfected into CNE ⁃2 cells of nasopharyngeal carcinoma. Real ⁃ time quantitative polymerase chain reaction（RT⁃qPCR）was performed to measure the transfection effect. Transwell assay was carried out to measure the invasion and migration abilities of tumor cell.Western blot was used to detect the expression of epithelial cadherin，vimentin and glucose regulatory protein78（GRP78）in the cells. Bioinformatics software was used to analyze the binding sites of HOTAIR and miR⁃30d. The binding relationship was determined by double luciferase reporting system.RT⁃qPCR was used to detect the change of miR⁃30d expression after HOTAIR was down⁃regulated in nasopharyngeal carcinoma cells. HOTAIR siRNA and miR⁃30d inhibitor were co⁃transfected into CNE⁃2 cells.The changes of cell invasion and migration were analyzed by the above methods，as well as the expression of E⁃cadherin，vimentin and GRP78 proteins. Results After knocking down the expression of HOTAIR，the invasion and migration abilities of CNE⁃2 cells were decreased；the levels of vimentin and GRP78 were decreased but the level of E⁃cadherin was increased.HOTAIR regulated specifically the expression of miR⁃30d. The knock⁃down of HOTAIR expression could increase the level of miR⁃30d in CNE⁃2 cells.The miR⁃30d inhibitor significantly reversed the effects of HOTAIRsiRNA on invasion and migration abilities of CNE⁃2 cells and the expression of E⁃cadherin，vimentin and GRP78 proteins. Conclusion HOTAIR affects the expression of GRP78 and EMT⁃related proteins by negatively regulating miR⁃30d，

Objective To investigate the mechanism of interleukin（IL）⁃6/signal transducer and activator of transcription 3（STAT3）pathway in macrophage immunity of patients with pulmonary tuberculosis. Methods A total of 92 cases of pulmonary tuberculosis patients（observation group）treated in Wuhan Jinyintan Hospital from October 2017 to October 2019 were recruited as the research objects，and 95 healthy persons（control group） were selected as the control group. Fasting peripheral venous blood was collected. The protein expression levels of STAT3，p⁃STAT3，Nuclear factor⁃κB（NF⁃κB）p65 and p⁃NF⁃κB p65 were detected by Western blot. The levels of serum inflammatory factors IL⁃6，IL⁃10 and tumor necrosis factor⁃α（TNF⁃α）were detected by enzyme⁃linked immunosorbent assay（ELISA）. Macrophages were cultured in vitro and divided into normal group（without treat⁃ ment）and infection group（infected with Mycobacterium tuberculosis）. Western blot was used to detect the protein expression levels of STAT3，p⁃STAT3，NF⁃κB p65 and p⁃NF⁃κB p65 in macrophages，and the levels of IL⁃6，IL⁃10 and TNF⁃α in macrophage supernatant were detected by ELISA. Results Compared with those in the control group， the protein levels of p⁃STAT3/STAT3，p⁃NF⁃κB p65/NF⁃κB p65 in the peripheral blood，and the expression levels of IL⁃6，IL⁃10 and TNF⁃α in serum in the observation group were significantly higher than those in the control group （P < 0.05）. Compared with those in the normal group，the protein levels of p⁃STAT3/STAT3，p⁃NF⁃κB p65/NF⁃κB p65 in macrophages，and the expression levels of IL⁃6，IL⁃10 and TNF⁃α in supernatant of macrophage in infected group were significantly higher than those in normal group（P < 0.05）. Conclusion IL⁃6/STAT3 pathway is activated in pulmonary tuberculosis patients and macrophages infected with Mycobacterium tuberculosis. Macrophages may play an immunomodulatory role in pulmonary tuberculosis by activating IL⁃6/STAT3 pathway.

Objective To study the expression and significance of UFC1 in diffuse large B cell lymphoma （DLBCL）. Methods The expression of UFC1 in DLBCL was detected by immunohistochemical method. The expression of UFC1 in DLBCL was studied by GEPIA and GEO DataSet. The relationship between UFC1 expression and the clinical characteristics of DLBCL was analyzed by GEO DataSet. The relationship between UFC1 expression and DLBCL prognosis was analyzed using GEO Dataset and OSdbl. Linkedomics was used to analyze UFC1 co⁃expressed genes. String⁃db was used to analyze the protein network of UFC1 interaction. Results Immunohisto⁃ chemical results showed that the expression of UFC1 in DLBCL was significantly higher than that of reactive lymph⁃ adentis tissue（P = 0.000），GEPIA analysis showed that the expression of UFC1 in DLBCL was significantly higher than that of normal tissue（P < 0.01），and GSE9327 Dataset analysis also showed that UFC1 was highly expressed in DLBCL（P < 0.000 1）. GSE10846 Dataset analysis showed that high expression of UFC1 was associated with old age（P = 0.003）and non ⁃GCB typing（P = 0.015），and the OS of DLBCL patients with high expression of UFC1 was shorter（P = 0.032 6），while OSdlc analysis showed that PFS（P = 0.015 9）and OS（P = 0.032 5）of DLBCL patients were poor with high expression of UFC1.Linkedomics analysis showed that UFC1 was related to ribosome and oxidative phosphorylation and other tumor mechanisms.String⁃db analysis shows that UFC1 interacts with a variety of tumor markers. Conclusion The expression of UFC1 is increased in DLBCL，and the abnormal high expression of UFC1 is more obvious in the elderly and non⁃GCB type DLBCL. The high expression of UFC1 in 

Objective To explore the expression of Klotho（KL）and VEGFR2 in maternal blood and placenta of pregnant women FGR. Methods A total of 60 pregnant women with fetal growth restriction who were first diagnosed in Xuzhou Maternal and Child Health Hospital affiliated to Xuzhou Medical University from January 2019 to June 2020 and diagnosed after delivery were selected，including 30 in the early ⁃onset group（gestational week of onset <32 weeks），30 cases in the late onset group（gestational week of onset ≥ 32 weeks），and 30 cases of normal full⁃term pregnant women were randomly selected as the control group. The localization and expression of KL and VEGFR2 in placental tissues of 3 groups of pregnant women were detected by immunohistochemistry （IHC），Western blot and RT⁃qPCR.ELISA was used to detect the sKL and sVEGFR2 in serum of the three groups of pregnant women. Results IHC showed that KL protein was mainly expressed in the cell membrane of placental trophoblast cells and vascular endothelial cells，VEGFR2 is mainly expressed in placental vascular endothelial cells. Western blot and RT ⁃ qPCR detection results showed that there were statistically significant differences in the relative expression levels of KL and VEGFR2 between the three groups（P < 0.05）. The expression level of FGR groups was lower than that of the control group，and there was no statistical difference between the early⁃onset group and late⁃onset group（P > 0.05）. ELISA showed that the serum levels of sKL and sVEGFR2 in the three groups were statistically different（P < 0.05）. The expression level of FGR group was lower than that of the control group，and there was no statistical difference between the early ⁃ onset group and the late ⁃ onset group（P > 0.05）. Conclusion The decreased expression of KL and VEGFR2 in pregnant women may be related to the occurrence and development 

Objective To explore the alterations of sputum microbiota in newly diagnosed pulmonary tuberculosis patients during the conventional anti⁃tuberculosis chemotherapy. Methods In this study，16S rRNA gene sequencing was used in 103 sputum samples（V4⁃V5 region）to characterize the diversity and composition of sputum microbiota caused by standard anti ⁃ TB treatment with isoniazid ⁃ rifampin ⁃ pyrazinamide ⁃ ethambutol （HRZE）. Results HRZE treatment could alter taxonomic compositions and overall diversity of sputum microbiota of TB patients. After routine anti⁃TB chemotherapy，Shannon，Chao 1 and Observed_OTUs indexes of sputum flora declined significantly，and the species richness declined more significantly with the extension of treatment time. PERMANOVA analysis showed that there were significant differences in the structure of the bacteria in the untreat⁃ ed group and the treated groups. Furthermore，there was a significant increase of family Veillonellacea，its genera Veillonella and species veillonella dispar post treatment，indicating that they may be a potential markers for evaluating TB treatment. Conclusions TB treatment with HRZE can disrupt sputum microbiotas in patients. Some specific genera are depleted or enriched post treatment，providing potential biomarkers for evaluating the treatment efficacy.

Objective To investigate the effects of intestinal microflora on the peritonitis therapeutic effect and prognosis of elderly patients with liver cirrhosis. Methods All patients were divided into the study group and the control group. To begin with，propensity score matching method was used to match the clinical factors between the two groups before treatment，and the samples with balanced clinical factors before treatment were obtained，then，two independent samples t⁃test was used to compare the peritonitis treatment effect between the two matched groups，furthermore，Cox regression model was used to evaluate the effect of the study group on peritonitis treatment time and liver cirrhosis progression free survival. Finally，Kaplan⁃Meier survival analysis was used to compare abdominal distension，ascites duration cumulative rate and liver cirrhosis free progression survival rate between the two matched groups，P < 0.05，the difference was statistically significant. Results A total of 240 elderly cirrhotic peritonitis patients were enrolled and divided into study⁃ and control group according to differ⁃ ent treatment. Using propensity score matching method，a total of 61 pairs of the two groups were successfully matched. After matching，the liver function and peritonitis indexes of the study group were significantly better than those of the control group after 2 weeks of peritonitis treatment，Cox regression model showed the peritonitis treat⁃ ment time of the study group was significantly shortened（HR：0.62；95% CI：0.35 ~ 0.98；P < 0.05），and the liver cirrhosis free progression survival time of the study group was significantly higher than that of the control group（HR：0.58；95% CI：0.35 ~ 0.98；P < 0.05）；95% CI：0.39 ~ 0.72；P < 0.05）. Kaplan⁃Meier survival analysis showed the lasted for 8 days，10 days and 14 days abdominal distension and ascites accumulation rate in the study group were significantly lower than those in the control group（75.3% ，48.6% ，22.4% vs. 90.2% ， 83.4%，28.2%，P < 0.05）；the 6⁃month，1⁃year，2⁃year liver cirrhosis free progression survival rate in the study group was significantly higher than that in the control group（90.2%，78.1%，23.8% vs 75.2%，54.3%，11.6%， P < 0.05）. Conclusion Probiotics has obvious therapeutic effect on elderly patients with liver cirrhosis complicated with spontaneous peritonitis，at the same time it can prevent liver disease from becoming severe，prolong the liver cirrhosis free progression survival time ，and make patients obtain clinical benefits.

Objective To explore the clinical features，treatment and follow⁃up of spontaneous coronary artery dissection（SCAD）and to provide reference for clinical practice. Methods We studied 16 patients with SCAD diagnosed through coronary angiography combined with intravenous ultrasonography，analyzed SCAD types of coronary angiography，the treatment and follow⁃up. Results SCAD was frequently seen in young and middle⁃ aged women，accounting for 75%（12/16），characterized by acute coronary syndrome. Eighteen dissections involved in coronary angiography mainly occurred in anterior descending branches（8 cases，44.44%）. Ten patients received drug⁃therapy，and six interventional⁃therapy. Patients were followed up for at least 6 months，and the total prognosis was good. Coronary angiography showed coronary artery dissections were highly self⁃healing. Conclusion The possibility of SCAD should be taken into consideration in young and middle⁃aged women without risk factors of coro⁃ nary heart disease，characterized by acute coronary syndrome. Interventionist should master image features of SCAD coronary angiography，

Objective To study the efficacy of 3D printing combined with arthroscopic reduction in the treatment of tibial plateau fractures with arthroscopic monitoring. Methods A total of 62 patients with tibial plateau fractures from March 2018 to March 2020 were selected and randomly divided into control group and obser⁃ vation group，31 cases in each group. The control group was treated with arthroscopy，and the observation group was given 3D printing before operation. The operation indicators including mean operation time，intraoperative blood loss，fracture reduction time and clinical indicators including postoperative recovery time，pain and swelling degrees，complications were compared between the two groups. The knee joint function（HSS）and motor function （FMA）scores were compared in the follow⁃up of 6 months. Results There were 28 patients in control group and 29 patients in observation group in all getting the follow⁃up. The mean operation time and fracture reduction time of observation group were shorter than those of control group，and intraoperative blood loss was less（P < 0.05）. The VAS score in 3 days of observation group was lower than that in control group，and the degree of swelling was reduced（P < 0.05）；while there were no differences of recovery time and complication rate between groups（P > 0.05）. Lastly，the HSS and FMA scores of observation group were higher than those of control group after follow⁃up （P < 0.05）. Conclusion 3D printing before operation assisting arthroscopic minimally invasive treatment for tibial plateau fracture has good clinical effect，which can shorten operation and fracture reduction time，reduce blood loss，lighten pain and swelling after operation，and improve knee joint function and motor function.

Objective To observe the effect of goal ⁃directed fluid therapy based on maximum stroke volume in replantation of severed fingers. Methods Forty ASAⅠ-Ⅱ patients，aged 18 to 60，were randomly divided into two groups according to different experimental methods ：normal control group（group C）and goal⁃ directed fluid therapy group（group G），20 for each group. Mean arterial pressure（MAP），stroke volume（SV） and cardiac output（CO）were recorded at the time points of entering the operating room（T0），before surgery（T1） and at the end of surgery（T2）. Radial artery blood was collected at T1 and T2 to detect blood lactic acid（Lac）， IL⁃1β and IL⁃10. Results The amount of colloid input in group G was significantly higher than that in group C （P < 0.05），but there was no significant difference in the amount of crystalloid fluid input（P > 0.05）；the values of MAP，SV，CO，Lac，IL⁃1β and IL⁃6 in radial artery blood between the two groups at T1 and T2 were statistically significant（P < 0.05）. Conclusions Application of goal⁃directed fluid therapy based on maximum stroke volume in replantation of severed fingers can maintain hemodynamic stability，dynamically optimize microcirculation perfu⁃ sion，reduce arterial blood lactic acid concentration，inhibit expressions of IL⁃1β and IL⁃6 inflammatory factors，

Objective To explore the clinical effects of laparoscopic free pedicled omentum in covering high⁃risk anastomotic stoma after colorectal cancer surgery. Methods A retrospective analysis of clinical data of 239 patients with high⁃risk anastomotic fistula who underwent laparoscopic colorectal cancer resection at the General Surgery Department of Zhengzhou University Cancer Hospital from January 2014 to June 2019. According to the condition that whether the omentum covered the anastomosis during the operation，they were divided into an experi⁃ mental group（115 cases）and a control group（124 cases）. The intraoperative bleeding volume，operation time， incision length，postoperative hospital stay，rate of anastomotic leakage and outcome were compared between the two groups. Results （1）In the experimental group，3 cases had anastomotic fistulas，and the rate of anastomotic leakage was 2.6%. In the control group，11 cases had anastomotic fistula，and the rate of anastomotic leakage was 8.9%. There was a statistical difference between the two groups（P < 0.05）. The intraoperative bleeding volume， operation time，incision length，and postoperative hospital stay were no statistical difference between the two groups（P > 0.05）.（2）Three cases with anastomotic leakage in the experimental group improved after active con⁃ servative treatment. In the control group，3 patients improved after active conservative treatment，7 patients were cured by secondary surgery，and 1 patient died. Conclusion For colorectal cancer patients with high⁃risk factors， laparoscopic free pedicled omentum wrapped anastomotic stoma can effectively reduce the occurrence of anastomotic leakage. It is a safe and effective prevention method.

Objective To investigate the effects of different therapy strategy，including single recombi⁃ nant human growth hormone（rhGH）use，combination of rhGH and letrozole，and combination of rhGH and GnRHa，in improving the prediction of final height in children diagnosed with adolescent idiopathic short stature （ISS）. Methods From May 2014 to June 2019，60 children with ISS in our hospital were randomly divided into three groups，20 cases in rhGH group（rhGH alone），20 cases in GnRHa group（rhGH combined with leuprorelin）， and 20 cases with letrozole group（treated with rhGH combined with letrozole）. All the three groups were treated and followed up for 1 year. Parameters of weight，growth rate，bone age，fasting blood glucose，glycosylated hemoglobin， IGF⁃1 and IGFBP3 were collected and analyzed to predict the final height and adverse reactions. Results：There was no significant difference in basic data among the three groups before treatment（P > 0.05）. After 1 year of treatment， the bone age of rhGH group（14.49 ± 0.51 years old）was higher than that of letrozole group（13.77 ± 0.74 years old） and GnRHa group（13.78 ± 0.52 years old）（P < 0.05）. The bone age growth of letrozole group（0.17 ± 0.14 years old）was significantly less than that of GnRHa group（0.49 ± 0.16 years old）and rhGH group（0.97 ± 0.13 years old） （P < 0.05）. The predicted final height in letrozole group（165.40 ± 2.57 cm）was significantly higher than that in GnRHa group（162.32 ± 2.82 cm）and rhGH group（161.32 ± 1.32 cm）（P < 0.05）. The predicted final height increase in letrozole group（6.86 ± 1.14 cm）was higher than that in GnRHa group（162.32 ± 2.82 cm），that in GnRHa group was higher than that in rhGH group（2.66 ± 0.71 cm）（P < 0.05）. The growth rate of letrozole group （8.19 ± 0.26 cm）and rhGH group（8.44 ± 0.94 cm）was significantly higher than that of GnRHa group（7.51 ± 0.96 cm）（P < 0.05）. There was no significant difference in fasting blood glucose，glycosylated hemoglobin，IGF ⁃ 1， IGFBP3 and adverse reactions among the three groups（P > 0.05）. Conclusion Letrozole is more effective than GnRHa in improving the predict final height of ISS in adolescence.

Objective This study observed the analgesic effect of dexmedetomidine（DEX）combined with ropivacaine for postoperative analgesia after modified radical mastectomy. Methods The patients were randomly divided into group T1，group T2 and group C. Group T1 was treated with 0.375% ropivacaine 20 mL plus Dex 1 μg/kg ，group T2 with 0.375% ropivacaine 20 mL plus Dex 1.5 μg/kg and Group C with 0.375% ropivacaine 20 mL. The onset time and the number of sensory block segments after anesthesia，the use of narcotic drugs during operation，postoperative visual analogue score，postoperative morphine use，blood glucose，high⁃sensitivity C⁃reac⁃ tive protein and complications were recorded. Results The onset time of block in group T was faster than that in group C（P < 0.05）；the number of sensory block segments in group T was more than that in group C（P < 0.05）； the amount of anesthetic drugs used in group T was less than that in group C（P < 0.05）；the VAS score in group T was lower than that in group C（P < 0.05）；the dosage of morphine in group T was less than that in group C（P < 0.05）； the changes of blood glucose and high ⁃sensitivity C ⁃ reactive protein in group T were lower than those in group C （P < 0.05）；the incidence of complications in group T1 was the lowest（P < 0.05）. Conclusion Thoracic para⁃ spinal block with DEX and ropivacaine for radical mastectomy could enhance the effect of postoperative analgesia； thoracic paraspinal block with Dex 1ug / kg had better analgesic effect and fewer adverse reactions.

Objective To explore the efficacy and safety of single therapy with antiplatelet in patients with high bleeding risk after PCI. Methods 156 patients with high bleeding risk after PCI，who had been diagnosed and treated in our hospital from May 2016 to May 2018，were selected. According to the antiplatelet therapy regimen，they were divided into aspirin（ASA）+ clopidogrel（CLO）group（24 patients），ASPL + ticagrelor（TIG） group（26 patients），ASA monotherapy group（30 patients），CLO monotherapy group（35 patients），and TIG monotherapy group（41patients）. All the patients were follow up for 1 year and were detected platelet aggregation rate and recorded serious cardiac events，cardiovascular deaths，and BARC 3 or 5 bleeding events. Results ADP⁃ induced platelet aggregation rate was significantly higher in ASA monotherapy than in the other groups（P < 0.05）， and it was markedly lower in ASA + CLO group and TIG group monotherapy（P < 0.05）. Platelet aggregation rate induced by arachidonic acid was significant higher in CLO monotherapy group than in the other groups（P < 0.05）， and there were no significant differences among the other groups（P > 0.05）. The incidence of bleeding events was significantly lower in TIG or CLO monotherapy group than in the other three groups（P < 0.05）. The cardiovascular events in TIG monotherapy group were lower than those in CLO monotherapy group（P < 0.05）. Cardiovascular mortality in TIG monotherapy or ASA + TIG group was lower，and was significantly lower than that in ASA or CLO monotherapy group（P < 0.05）. Conclusions For patients with high bleeding risk，ticagrelormonotherapy does not increase major bleeding while reduces the incidence of cardiovascular events and deaths.

Objective The aim of thisstudy was to explore the clinical effect of anisodamine combined with montelukast in the treatment of HSP. Methods A total of 120 patients with henoch schonlein purpura were randomly divided into observation group（60 cases）and control group（60 cases）. Both groups were treated with montelukast，while patients in observation group were treated with Anisodamine for 4 weeks. The effect，symptom improvement，stress response，inflammatory factors and recurrence rate were compared between the two groups. Meanwhile，the recurrence risk factors were analyzed. Results The total effective rate of the observation group （93.33%）was significantly higher than that of the control group（73.33%）. The disappearance time of purpura， abdominal pain，joint swelling and pain，the levels of IL⁃4，IL⁃10，inf⁃γ and TNF⁃α were significantly lower than those of the control group（P < 0.05）. In addition，the level of stress related hormones was lower than that of the control group（P < 0.05）and the recurrence rate of the observation group was significantly lower than that of the control group.The recurrent rash，Epstein Barr virus infection and higher blood pressure were observed Small plate，D⁃dimer and renal damage were risk factors for recurrence. Conclusion In the treatment of allergic purpura by using Anisodamine combined with montelukast，the inflammatory and oxidative stress reactions were significantly decreasedand the recurrence was low.

Objective To investigate the feasibility of liquid biopsy in children with medulloblastoma through detecting circulating tumor DNA（ctDNA）in Cerebrospinal Fluid（CSF）. Methods Six patients diagnosed as medulloblastoma pre⁃operation by Magnetic Resonance Imaging（MRI）from Beijing Tiantan Hospital of Capital Medical University，and one patientreceived tumor dissemination from Beijing Shijitan Hospital of Capital Medical University were recruited in this prospective study between April 2019 and Dec 2019. CSF was collected by lumbar puncture 3~4 weeks after surgery. The tumor tissue and peripheral blood were collected at the same time. In order to acquire medulloblastoma associated alterations，the DNA sequencing was applied in tissue，blood and CSF of medulloblastoma cases based on next ⁃ generation sequencing（NGS）technology. Results The quality control of ctDNA extraction was unqualified in three cases. For the remaining 4 cases，the detection rate of ctDNA in CSF was 75%. Medulloblastoma related gene mutations such as KMT2D，KMT2C，TP53，NF1，PIK3CA，SMARCA4 and KMD5A were detected in CSF，but only KMT2D and SMARCA4 were detected in tumor tissues. Conclusion It is feasible to detect ctDNA in CSF in medulloblastoma. Furthermore，there were more detectable medulloblastoma⁃ related alterations in CSF than those in tumor tissue

Objective To investigate the correlation between gait speed and mortality in elderly inpatients with hypertension. Methods From June 2015 to December 2017，we conducted to examine elderly patients aged ≥ 65 years at our hospital. Patients’basic information，biochemical indicators，comorbidities and polypharmacy were recorded at admission. We used 6m walking test to measure gait speed. Activities of daily living was assessed by Katz⁃ADL，cognitive function by mini⁃mental state Examination（MMSE）and nutrition level by micronutrient assess⁃ ment method summary（MNA⁃SF）. After discharge，all⁃cause mortality was followed up for more than 2 year and recorded. We analyzed the correlation between gait speed and mortality. Results A total of 515 patients［（84.1 ± 5.9）years，58.1% men］were enrolled. During a median follow ⁃up of 3.3 years（IQR 2.7，3.9），106 participants （20.6%）died. Spearman correlation analysis revealed that gait speed was negatively correlated with age，CCI and polypharmacy，and positively correlated with 24hDBP levels，Katz⁃ADL，MMSE，and MNA⁃SF scores（P < 0.05）. Gait speed was divided into tertile groups. The Kaplan Meier curve showed that mortality increased with the decrease of gait speed（log rank：P < 0.001）. Cox regression analysis with adjustment for potential confounding variables showed that compared with the highest group，the lowest group had a higher risk of mortality（HR = 2.325，95%CI： 1.113 ~ 4.855，P = 0.025）. Conclusions In elderly in⁃patients with hypertension，low gait speed is associated with 

Objective To explore the effect of eight⁃section brocade combined with herbal tea on balance function and quality of life in patients with osteoporosis. Methods 300 patients with osteoporosis who met the exclusion criteria were divided into control group（n = 150）and test group（n = 150）. The control group was given basic treatment（calcium + vitamin D），and the experimental group was treated with eight⁃section brocade in the basic treatment for 6 months. The changes of balance scale（TUG，BBS），quality of life scale（SF⁃36），bone mineral density and bone metabolism index were observed before and after treatment. Results The difference between the two groups in BBS and TUG scores before and after treatment was statistically significant（P＜0.05）in 6 months. The experimental group is superior to the control group in improving physiological function，body pain， overall health，vitality and emotional function（P＜0.05）. The experimental group was better than the control group in improving the bone mineral density of the lumbar（P＜0.05）. There was no significant difference in hip bone mineral density improvement between groups（P＞0.05）. Conclusion Both basic treatment and combination therapy can improve the balance ability of osteoporosis patients. The effect of combined drug therapy on the balance ability of patients was equal，but the quality of life of patients was significantly improved.

Objective To introduce the EARS nursing mode to the elderly patients with femoral neck frac⁃ ture surgery during the perioperative period and observe its effect on postoperative delirium and rehabilitation quality. Methods 176 elderly femoral neck fracture patients from July 2017 to June 2019 were selected as the research subjects. These patients were divided into traditional nursing group and ERAS group according to the time of admis⁃ sion. Preoperative general data of the two groups were not statistically significant（P > 0.05）. This study observed and compared the incidence of delirium and sleep quality for 24，48，and 72 hours after surgery and the total hos⁃ pital stay，the length of hospital stay，the first landing time and the quality of life at 1，3，6，and 12 months after surgery. Results The incidence of delirium in the ERAS group was lower than that in the traditional nursing group except for 24 hours after operation，and the difference was statistically significant（P < 0.05）. The difference in sleep quality between the two groups of patients after 24 h，48 h and 72 h was statistically significant（P < 0.05）. The time to first landing and hospital stay in the ERAS group were also shorter than those in the traditional nursing group，and the differences were statistically significant（P < 0.05）. The Harris score and SF⁃36 scale scores of patients in the ERAS group were higher than those in the traditional group at 1，3，6，12 months after operation （P < 0.05）. Conclusions This research introduced a ERAS nursing mode to the elderly patients with femoral neck fractures to reduce the incidence of delirium and promote patients to resume their regular lives as soon as possible and shorten the average hospitalization time. This method can improve the quality of life for patients， improve the quality of nursing，and provide ideas for geriatric nursing.

The past decade witnessed important advances in the treatment of advanced prostate cancer and several new drugs have been approved with significant overall survival benefits for metastatic caste ⁃ resistant pros⁃ tate cancer，including docetaxel andcapbazitazidefor chemotherapy and abiraterone andnzalulamidefor hormone therapy and there were targeted therapy，and immunotherapy as well.Compared with hormone therapy alone，che⁃ motherapy and radiotherapy combined with androgen deprivation therapy yielded significant overall survival benefits. The appropriate treatment sequence of these therapies is important to maximize the clinical benefits of patients with sensitive and resistant castration. New treatments are also being explored.

Diabetic glomerulosclerosis is a kind of glomerular disease dominated by vascular damage， mainly related to the inflammatory state of the body. Intestinal flora and its metabolites can influence kidney disease through a variety of metabolic pathways. Early identification of high⁃risk groups of diabetic glomerulosclerosis could delay the progression of diabetic nephropathy. This article focused on the relationship between the intestinal micro⁃ biota and diabetic glomerulosclerosis，aiming to clarify the interaction between the intestinal flora and its metabo⁃ lites and diabetic glomerulosclerosis. Also，we tried to explore the use of exogenous supplementary probiotics as a new method to treat diabetic glomerulosclerosis.