Objective To explore the effects and mechanism of miR ⁃ 330⁃3p on the proliferation and apoptosis of gastric cancer cells，and aerobic glycolysis process by targeting pyruvate kinase M2（PKM2）gene. Methods The expression levels of SGC⁃7901 in gastric cancer cells and GES⁃1 miR⁃miR⁃330⁃3p in gastric muco⁃ sal epithelial cells were detected by reverse transcription⁃polymerase chain reaction（RT⁃PCR）. The miR⁃NC，miR⁃ 330⁃3p⁃inhibitor，miR⁃330⁃3p⁃mimcs，miR⁃330⁃3p⁃inhibitor+PKM2⁃NC，miR⁃330⁃3p⁃inhibitor+PKM2⁃shRNA， miR⁃330⁃3p⁃mimcs+LV⁃NC and miR⁃330⁃3p⁃mimcs+LV⁃PKM2 were transfected into gastric cancer cells. The proliferation，invasion and apoptosis of cells were detected by CCK8，Transwell assay and Annexin V/PI method. The glycolysis indexes such as glucose utilization rate，production of lactic acid，activities of hexokinase（HK） and lactate dehydrogenase（LDH）were detected. The expression of PKM2，GLUT1，HK2，Bax and Caspase ⁃ 3 proteins was detected by Western Blot. The targeted relationship between miR⁃330⁃3p and PKM2 was detected by double luciferase reporter gene assay. Results （1）The expression level of miR⁃330⁃3p in gastric cancer cell line was higher than that in gastric mucosal epithelial cells，while expression level of PKM2 was lower（P < 0.05）.（2） reporter gene assay showed that compared with that in miR⁃NC group，activity of PKM2 wild⁃type luciferase was decreased in miR⁃330⁃3p group（P < 0.05）.（3）Compared with those in miR⁃NC group，absorbance and number of invasion cells were increased in miR⁃330⁃3p⁃inhibitor group；number of apoptosis cells was decreased；cellular glucose consumption，production of lactic acid，HK and LDH activities were decreased；expression of PKM2， GLUT1 and HK2 was increased，and expression level of pro⁃apoptosis proteins（Bax and Caspase⁃3）was decreased （P < 0.05）. The increase or decrease amplitude in miR⁃330⁃3p⁃inhibitor+PKM2⁃shRNA group was lower than that in miR⁃330⁃3p⁃inhibitor group（P < 0.05）.（4）Compared with that in miR⁃NC group，expression level of miR⁃ 330⁃3p was increased in miR⁃330⁃3p⁃mimcs group（P < 0.05），absorbance and number of invasion cells were decreased，number of apoptosis cells was increased，cellular glucose consumption，production of lactic acid，HK and LDH activities were increased，expression of PKM2，GLUT1 and HK2 was decreased，and expression levels of pro⁃apoptosis proteins（Bax，Caspase⁃3）were increased（P < 0.05）. The increase or decrease amplitude in miR⁃ 330⁃3p⁃mimcs+LV⁃PKM2 group was lower than that in miR⁃330⁃3p⁃mimcs group（P < 0.05）. Conclusion The expression of miR⁃330⁃3p is related to proliferation and apoptosis of gastric cancer cells，and aerobic glycolysis pro⁃ cess，

Objective To investigate the effect of abnormally increased α ⁃synuclein（α ⁃Syn）on the expression of Dopamine receptor D1（D1DR）in the brain and colon of mice. Methods Sixteen C57BL/6J mice were randomly divided into control and model groups：the model group was injected with α⁃Syn preformed fibrils （PFF）into the striatum to build a mouse Parkinson′s disease（PD）model，and the control group with equal volume of PBS. Balance beam，pole ⁃ climbing and open field tests were performed to detect their behaviors at 6 months after operation；Western blot（WB），immunohistochemistry（IHC）and immunofluorescence（IF）were used to detect the expressions of D1DR，α⁃Syn，and tyrosine hydroxylation（TH）in the substantia nigra and colon. Results Compared with the controls，the model mice exhibited prolonged time in balance beam and pole⁃climbing （P < 0.001），and slower average moving speed in open field test（P < 0.001）. By WB，IHC and IF，the D1DR and TH positive cells were significantly reduced in number（all P < 0.05）and the expressions of D1DR and TH in the substantia nigra and colon of the model mice were lower than those in the control group（all P < 0.05）. The relative expression in the substantia nigra and colon was positively correlated（r = 0.8943，0.9026，P < 0.05）. Conclusion The expressions of D1DR and TH are decreased in the substantia nigra and colon of PD model mice built by injection of α⁃Syn PFF into the striatum，which provides a basis for application of colon biopsy to the path⁃ological assessment of central nerves of early PD patients. 

Objective This study intends to verify whether the regulation of CK1δ and PER1 on ischemic stroke may be achieved by regulating the function of mitochondria. Methods In this experiment，mouse microglia （BV2 cells）were used as the research objects. The cells were treated with cobalt chloride（CoCl2）to simulate the hypoxic state of the cells during stroke.The functions of Per1 and mitochondria were detected by inhibiting，knock⁃ ing down and overexpressing CK1δ. Results The overall expression levels of CK1δ and Per1 in BV2 cells treated with 200 μmol/L CoCl2 for 24 h were decreased.Under the hypoxic conditions，the inhibited and silenced CK1δ increased PER1 protein levels in the nucleus，elevated Mfn1 expression，and suppressed Drp1 expression，but the overexpressed CK1 δ suppressed Mfn1 expression and elevated Drp1 expression. In addition，the proportion of linear mitochondria was elevated upon CK1δ inhibition or silencing，while the proportion of punctate mitochondria was significantly increased upon CK1δ overexpression. Conclusion Under hypoxic conditions，CK1δ and PER1 can regulate the mitochondrial morphology of BV2 cells so that ischemic stroke is mediated.

Objective To explore the effect of DISC1 on the synaptic plasticity，learning and memory ability of APP/PS1 transgenic alzheimer′s disease mice. Methods Western blot was used to detect the expression of DISC1 in the brain tissues between normal people and AD patients. C57BL/6J fetal mouse neurons were cultured in vitro and divided into GFP group，GFP + Aβ group and DISC1 + Aβ group. Laser confocal microscope was used to observe neuron dendritic spines. Two⁃month⁃old C57BL/6J mice were injected into the hippocampus with GFP virus or DISC1⁃overexpressed virus，and then brains were sliced for Aβ treatment. After Aβ treatment，patch clamp technique was used to detect long⁃term potentiation（LTP）of each group to evaluate synaptic plasticity. C57BL/6J mice were divided into WT + GFP group，TG + GFP group，and TG + DISC1 group. Immol/Lunofluorescence stain⁃ ing was used to detect Aβ plaque deposition in the brain and Morris water maze to detect the learning and memory abilities of mice in each group. Results Compared with the none ⁃AD people，the expression of DISC1 in the brain of AD patients decreased（P < 0.05）. Compared with the GFP group，the number of dendritic spines in the GFP + Aβ group decreased，while the number of dendritic spines increased in the DISC1 Aβ group compared to the GFP Aβ group. After Aβ treatment，LTP of mouse brain slices weakened compared with the control group，and with overexpressed DISC1，LTP was enhanced compared with Aβ treatment only. The number of Aβ plaques in the hippocampus of TG + DISC1 group was significantly smaller than that in TG + GFP group（P < 0.05）. In Morris test，the time to find the platform was significantly shorter and the number of times to cross the platform was larger （P < 0.05）. Conclusion Overexpressed DISC1 can protect the synaptic plasticity of APP/PS1 transgenic AD mice and improve its learning ability and memory.

Objective To explore the mechanism of extracellular signal ⁃ regulated protein kinase 1/2 （ERK1/2）inhibitor U0126 on airway hypersecretion of mucin 5ac（muc5ac）protein in chronic obstructive pulmo⁃ nary disease（COPD）mice. Methods The pulmonary function indexes，interleukin 4（IL ⁃4）and interferon γ （IFN⁃γ）levels of each group of mice after 7 days of intervention with different drugs were detected.HE staining to observe the pathological changes of lung tissue. RT⁃qPCR was used to detect the expression levels of muc5ac and ERK1/2 mRNA in lung tissues. Western blotting was used to detect the expression levels of muc5ac，ERK1/2，and p⁃ERK1/2 proteins in lung tissue. Results Compared with the model group，the levels of FEV0.3，FVC，FEV0.3/ FVC and IL⁃4 in the inhibitory drug group and the western drug group were increased，whereas the levelsof IFN⁃γ， muc5acmRNA，and the protein expression levels of muc5ac and p⁃ERK1/2 were decreased（P < 0.05）. The patho⁃ logical changes of lung tissue improved. Conclusion ERK1/2 inhibitors can reduce the expression of muc5ac by inhibiting the ERK1/2 signaling pathway and improve the symptoms of COPD.

Objective To explore the mechanism of miR⁃511⁃3p regulating macrophage polarization and allergic inflammation in children with cough variant asthma. Methods After THP⁃1 cells were induced to form M1 and M2 macrophages by LPS and IL⁃4 respectively，the secretion of TNF ⁃ α and TGF ⁃ β in M1 and M2 cells was detected by ELSA；mir ⁃511⁃3p expression cells were constructed by cell transfection method ，RT ⁃ PCR and Western blot were used. The expression of M1 macrophage related marker protein was detected by blot；the CVA mouse model was established by ovalbumin activation method sensitized by aluminum hydroxide and ovalbumin； the macrophages were isolated by flow cytometry；the expression and secretion of macrophage polarization related markers TNF⁃α，TGF⁃β and IRF3 in lavage fluid were detected by ELSA；RT⁃PCR and Western blot were used The transcription level of mir⁃511⁃3p in plasma samples of patients with CVA was detected by blot. Results By transfection of mir⁃511⁃3p，we found the relative expression of TNF⁃ α decreased and CCL17 increased in M1 macrophageswhen mir⁃511⁃3p was overexpressed（P < 0.05）；the phosphorylation levels of TNF ⁃ α and IRF3 decreased and TGF⁃β increased in CVA mice model（P < 0.05）；at the same time，compared with non⁃asthma patients，the expression of mir⁃511⁃3p decreased in CVA patients（P < 0.05）. Conclusion MiR⁃511⁃3p could regulate the phosphorylation level of IRF3 in children with cough variant asthma，promote the polarization of macrophages in the direction of M2 and inhibit allergic inflammation in the body.

Objective To study the expression and clinical significance of autophagy ⁃ related proteins in sepsis patients with acute respiratory distress syndrome（ARDS）. Methods The mRNA and protein expression levels of autophagy⁃related factors（Beclin⁃1，LC3⁃II，p62）in each group of mononuclear cells（PBMCs）were detected by qRT⁃PCR and western blotting；The related cytokines（IL⁃1β，TNF⁃ α，IL⁃6，IL⁃10）levels were measured by enzyme⁃linked immunosorbent assay（ELISA）. The differences of the above indicators in each group were compared and the prognostic value of autophagy⁃related proteins in sepsis patients with ARDS was evaluated. Results Compared with the non⁃ARDS group，the mRNA and protein expression levels of Beclin⁃1 and LC3⁃II in the PBMCs，and IL⁃10 in peripheral blood of ARDS group were significantly reduced，while the mRNA and pro⁃ tein expression levels of p62，the IL⁃1β，TNF⁃α and IL⁃6 levels in peripheral blood were increased（P < 0.05）. Compared with the survival group，the mRNA and protein expression levels of Beclin⁃1 and LC3⁃II in the PBMCs， and IL⁃10 in peripheral blood of ARDS group were significantly reduced，while the mRNA and protein expression levels of p62，the IL⁃1β，TNF⁃α and IL⁃6 levels in peripheral blood were increased（P < 0.05）. In ARDS group， Beclin⁃1 and LC3⁃II mRNA were significantly negatively correlated with peripheral blood IL⁃1β and TNF⁃α levels， respectively；while p62 mRNA was significantly positively correlated with peripheral blood IL⁃1β and TNF⁃ α levels. ROC curve analysis showed that the AUCs of Beclin⁃1 mRNA，LC3⁃II mRNA and p62 mRNA to distinguish surviving and non⁃surviving patients were 0.818（95%CI，0.743 ~ 0.913），0.829（95%CI，0.738 ~ 0.921），and 0.794（95%CI，0.705 ~ 0.883），respectively. Those sensitivity was 75.96%，81.82% and 71.19%；the specificity was 80.49% ，75.61% and 71.23% ，respectively. Conclusion The reduction of autophagy was involved in the occurrence and development ofsepsis complicated with ARDS. It has certain clinical value for the evaluation of prognosis by detecting the level of autophagy.

Objective To evaluate the value of cross⁃sectional area（CSA）of multifidus muscle in predict⁃ ing postoperative recurrence in patients with lumbar disc herniation treated by PETD so as to provide reliable basis for clinical treatment and reduce postoperative recurrence rate. Methods A total of 155 patients with L5 ⁃S1 disc herniation treated by PETD in the Department of Pain，Xuzhou Medical University Hospital from January 2016 to February 2020 were divided into recurrent group（n = 17）and non⁃recurrent group（n = 138）. The clinical data were analyzed and compared. MRI was performed in all patients，and the CSA and the Degree of Fat Infiltration （DFF）of multifidus muscle of lumbar disc herniation were measured by Image J software. Logistic regression analysis was used to analyze the independent risk factors of recurrence，and ROC was used to evaluate the predictive value of multifida CSA. Results There was no significant difference in sex，course of disease，time of operation， time for resuming work ，location of intervertebral disc herniation and height of intervertebral space between recurrent group and non⁃recurrent group，but there were significant differences in age，BMI，smoking，drinking， diabetes，CSA and DEF between the two groups. ROC showed that CSA had high sensitivity and specificity in predicting recurrence after PETD. Conclusion CSA is an independent risk factor for recurrence after PETD and can accurately predict the recurrence rate after PELD. 

Objective To develop and validate a risk prediction model for Gestational Diabetes Mellitus （GDM）based on demographic characteristics，clinical features and biochemical indicators. Methods A self ⁃ administered questionnaire and the hospital electronic medical record system were used to collect data. A prediction model for GDM was established using logistic stepwise regression analysis. The area under curve（AUC），the calibration curve and decision curve analysis were used to evaluate the discrimination，the consistency and clinical usability of the model respectively. A nomogram was performed.Results The AUC of a GDM prediction model based on age，history of GDM，mean arterial pressure and HbA1c constructed through logistic regression analysis was 0.75（95%CI：0.71 ~ 0.80）. The calibration curve showed good consistency. By decision curve analysis，the model showed a positive net benefit when the threshold probability ranged between 0.05 ~ 0.75. Conclusion The GDM prediction model has good predictive performance，and provides an effective assessment tool for GDM.

Objective To investigate the value of detecting fractional exhaled nitric oxide（FeNO）in different parts of the airway in chronic obstructive pulmonary disease（COPD）.Methods A total of 82 COPD patients admitted to our hospital from January 2019 to May 2020 were selected for an observational study. Among them，37 patients with stable COPD and 45 patients with acute exacerbation of COPD were selected，while 20 healthy subjects were selected as the control group. The exhaled nitric oxide（NO）concentration in each group was determined，and the concentration of NO in central airway（FeNO50）and alveolar NO（CaNO）were recorded. Clinical variables such as lung function，white blood cell count（WBC），eosinophil percentage（EOS%），C⁃reactive protein （CRP） and CAT score were collected as the observation indexes.Results CaNO ，CRP and WBC in acute exacerbation of COPD were significantly higher than those in COPD stable group and control group ，and the difference was statistically significant（P < 0.05）. There was a significant positive correlation between CaNO and CAT score（r = 0.627，P < 0.001）and a significant negative correlation between CaNO and FEV1%（r = -0.457， P = 0.002）in COPD with acute exacerbation，while FeNO50 was not significantly correlated with CAT score and FEV1%. Stratified analysis showed that CaNO was significantly increased in CAT score > 20 and FEV1% < 50% groups（P < 0.05），but there was no difference in FeNO50 between the two groups（P > 0.05）. Conclusion The concentration of NO in different parts of the airway was different in COPD patients.CaNO may be a better biological indicator of small airway inflammation in patients with COPD and can be used to monitor inflammatory activity during acute exacerbation of COPD. 

Objective To investigate the expression of oncostatin M（OSM），inhibitor of cell Differentia⁃ tion⁃1（Id⁃1）and Foxp3 in gastric cancer tissues and their correlation with pathological feature. Methods Seventy⁃ two patients with gastric cancer who underwent surgical treatment in our hospital from June 2019 to June 2020 were selected. The resected cancer tissues and adjacent tissues of all patients were taken for immunohistochemical stain⁃ ing，and the relative expression levels of inhibin M，Id⁃1 and Foxp3 were detected by Western blot. The correlation between the expression of inhibin M，Id⁃1 and Foxp3 in the cancer tissues of gastric cancer patients was analyzed.Results Compared with that in the adjacent tissues，the relative expression of tumor suppressor M and Id⁃1 was higher，but that of Foxp3 was lower in gastric cancer tissues（P < 0.05）. Compared with patients without lymph node metastasis，patients with gastric cancer with lymph node metastasis had higher relative expression of inhibin M and Id⁃1 but lower relative expression of Foxp3（P < 0.05）. Compared with patients with intraserous invasion， patients with extraserous invasion of gastric cancer had higher relative expression of inhibin M and Id⁃ 1 but lower relative expression of Foxp3（P < 0.05）. Compared with patients with stage Ⅰ and Ⅱ，patients with stage Ⅲ and Ⅳ gastric cancer had lower relative expression of Foxp3（P < 0.05）. The relative expression of inhibin M and Id⁃1 was higher and the relative expression of Foxp3 was lower（P < 0.05）in patients with moderately differentiated gastric cancer when compared with patients with moderately differentiated gastric cancer. The relative expression of gastric cancer when compared with patients with moderately differentiated gastric cancer（P < 0.05）. The expres⁃ sion of inhibin M and Id⁃1 was positivelycorrelated（r = 0.310，P = 0.008）；but the expression of inhibin M and Foxp3（r = -0.422，P = 0.001）and that of Id⁃1 and Foxp3 was negatively correlated（r = -0.308，P = 0.009）.Conclusion The expression of inhibin M，Id⁃1 and Foxp3 is abnormal in gastric cancer，and the relative expres⁃ sion changes of inhibin M，Id⁃1 and Foxp3 are correlated with lymph node metastasis，invasion degree，TNM stage and differentiation degree in gastric cancer patients，and the expression of M，Id⁃1 and Foxp3 is correlated to some extent，which jointly participate in the development and evolution of gastric cancer. 

Objective To explore the feasibility of acoustic stimulation test（AST）in monitoring of fetal hearing with hypertensive disorders of pregnancy（HDP）. Methods The pregnant women with HDP were divided into mild group and severe group according to the severity of HDP，and then into full ⁃term group and premature group according to gestational age. ASTs were performed for all subjects，and those neonatal hearing were screened and diagnosed. The pregnant women without HDP hospitalized during the same period were randomly selected as the control group. The comparisons were done among the groups in terms of AST and hearing results. Results The positive rates of the AST in the severe HDP group was significantly lower than that in the mild HDP group and non⁃ HDP. The hearing loss rate of the severe HDP group was significantly higher than that of the mild HDP group and non⁃HDP group in the negative AST. The majority of hearing loss was mild to moderate in the positive AST，while the hearing loss of the non⁃HDP group was moderate to severe in both ears，and the majority of the loss in the HDP group was mostly in a single ear or/and both ears，from moderate or severe in the negative AST. Conclusion The AST is effective and feasible for the prediction and monitoring of the fetal hearing. The rate of hearing loss is higher in severe HDP with negative AST ，and the emphasis should be put on strengthening hearing monitoring and rescreening. 

Objective To investigate the relationship between p53 Arg72pro gene polymorphism and chemoradiotherapy sensitivity of cervical cancer. Methods The cervical cancer patients in ⅡB~ⅣA stage who received concurrent chemoradiotherapy during January 2013 to March 2016 were selected in the study，with their p53 Arg72pro（rs1042522）locus detected by PCR fluorescent probe. The efficacy of concurrent chemoradiotherapy was evaluated by solid tumor RECIST 1.1 standard. Genotype，age，stage，degree of differentiation，tumor size， lymph node metastasis and other factors were included in the Logistic regression model to analyze the influencing factors of the sensitivity of concurrent chemoradiotherapy for cervical cancer，and evaluate the predictive effect of the Logistic model. Results A total of 105 eligible patients were included，with the median follow ⁃up time of 6 months. The genotype of p53 Arg72pro was in line with hardy⁃Weinberg balance，and the multivariate Logistic regression analysis showed that C/G and G/G genotypes increased tumor chemoradiotherapy sensitivity. However， elderly age，low differentiation，lymph node metastasis，tumor > 4 cm and other clinical factors significantly reduced chemoradiotherapy sensitivity（P < 0.05）. Conclusion p53 Arg72pro genepolymorphism is an independent factor in predicting the concurrent chemoradiotherapy sensitivity of cervical cancer，among which C/G and G/G genotypes can increase the chemoradiotherapy sensitivity of tumor. 

Objective To explore the effectiveness and value of vacuum sealing drainage combined with micro⁃dynamic vacuum pack dressing in accelerating healing of the wounds in grade Ⅱ~Ⅳ diabetic foot. Methods 60 patients were divided into two groups. The control group received conventional treatment ，vacuum sealing drainage，ordinary dressing change，and dressing coverage；while the study group received conventional treatment， vacuum sealing drainage，and micro⁃dynamic vacuum pack dressing. The treatment situation including target ulcer complete healing rate，ulcer area reduction rate，ulcer complete healing time，number of dressing changes，and ulcer recurrence rate during the last one month follow⁃up，and adverse events such as bleeding，pain，redness and swelling were observed. Results The healing rate was greater in the study group（100%）than in the control group （93.3%）；the wound reduction rate was greater（P < 0.05），the healing time was shorter，the number of dressing changes was smaller，and the one⁃month recurrence rate were lower in the study group（P < 0.05）. The incidence of adverse reactions in the study group（16.7%）was lower than that in the control group（46.7%）（P < 0.05）. Conclusions Vacuum sealing drainage combined with micro ⁃dynamic vacuum pack dressing has a significant effect in the treatment of Ⅱ~Ⅳ diabetic foot wounds and has fewer adverse reactions. It may boost growth of granu⁃ lation tissue and epithelium and accelerate wound healing. 

Objective To investigate the guiding role of CYP2C19 gene polymorphism in predicting vori⁃ conazole related adverse reactions in patients with Aspergillus infection and to provide evidence for individualized drug use in such patients. Methods Retrospective non⁃randomized control method was used to select the patients who were diagnosed as invasive pulmonary aspergillosis and used voriconazole in our hospital from January 2018 to December 2019. Clinical records and course records of all patients were consulted to determine whether there were adverse reactions and types. Results Totally 168 patients were selected，including 84 patients with detected gene polymorphism in experiment group and another 84 patients in control group. There was no significant difference in age，gender and weight between the two groups（P > 0.05）. Fast，medium and slow metabolisms in genomic patients were 39.29%，45.24% and 15.47% respectively. There were significant differences in the types of adverse drug reactions（ADR）in 168 patients. The incidence of liver dysfunction was the highest（46.23%），followed by renal dysfunction（17.86%）and gastrointestinal discomfort（14.28%）. There was significant difference in the incidence of ADR between the experiment group and the control group（P < 0.05）and that was higher in the exper⁃ iment group. Inter⁃group comparison of ADR incidence in patients with fast，medium and slow metabolism showed statistical significance（P < 0.05），and ADR incidence in patients with slow metabolism（53.8%）was the highest， followed by those with intermediate metabolism（52.6%）and those with fast metabolism（24.2%）. Conclusion Identification of genotype of CYP2C19 in patients with pulmonary Aspergillus using voriconazole is helpful for the targeted disposal of drug⁃related ADRs and improving the safety of drug use. 

Objective To investigate the effects of positive pressure ventilation combined with leukotriene receptor antagonists on immune function in children under 6 years of age with obstructive sleep apnea（OSAHS）. Methods Ninety children under 6 years old with OSAHS were selected and randomly divided into leukotriene group and combination therapy group（n = 45）in our hospital from January 2019 to January 2020. The levels of T lymphocyte subsets，NK cell counts，and SaO2 levels in the two groups were compared. To examine the changes in the levels of AHI，lat，LHT，IgA，IgG，and IgM in the two groups，the treatment response rate and the incidence of adverse effects were compared between the two groups. Results Children receiving combination therapy had lower levels of CD3+，CD4+，CD8+，lat，LHT，AHI，IgA，IgG，IgM，SaO2 and higher levels of NK than children on leukotrienes（P < 0.05）. The total effective rate of treatment was higher in the combination group（P < 0.05）. Conclusion Positive pressure ventilation combined with leukotriene receptor antagonist could regulate T lympho⁃ cytes and improve NK cells and immunoglobulin factors in children under 6 years of age with OSAHS，which has with significant clinical effects. 

Objective To explore the effect of ultrasound ⁃ guided thoracic paravertebral nerve block on pain⁃relieving during dressing change of mastitis. Methods Ninety⁃six patients with granulomatous mastitis were selected and randomly divided into two groups：the control group（group L，n = 49，receiving local anesthetic infiltration）and the experimental group（group T，n = 47，receiving thoracic paravertebral block）. Vital signs before and after the procedure were recorded. The number of anesthesia complications in group T was recorded. VSA score and regional block time in two groups were recorded. Results There was no significant difference in vital signs between before and after block in group T. There were 23 cases of Horner′s syndrome in group T without serious complications. There were significant differences in analgesia duration and VSA score between the two groups. Conclusion Ultrasound guided thoracic paravertebral nerve block was safe and effective for pain reliving during dressing change of mastitis and had fewer complications，which could improve the therapeutic effect and speed up the recovery.

Objective This retrospective study was aimed to compare the efficacy and safety of dapa⁃ gliflozin combined with metformin and sitagliptin combined with metformin in the treatment of overweight and obese type 2 diabetes. Methods A total of 217 patients with type 2 diabetes in whom the body mass index （BMI）> 25 kg/m2 were divided into dapagliflozin group（n = 107）and sitagliptin group（n = 110）according to different treatment options. After 24 ⁃ week treatment，fasting blood glucose （FBG），glycosylated hemoglobin （HbA1c）and other related metabolic indicators before and after treatment were compared. The adverse reactions during medication were recorded. Results After 24 ⁃ week treatment，FBG，HbA1c，blood lipid and uric acid were decreased in both groups（P < 0.05），but there was no statistical difference between the two groups（P > 0.05）. Body weight，waist circumference，systolic and diastolic blood pressure were decreased in the dapagliflozin group （P < 0.05）. Urogenital tract infection was increased in the dapagliflozin group，and diabetic ketoacidosis with normal blood sugar occurred，with more adverse reactions than that in the sitagliptin group，showing statistical difference（P < 0.05）. Conclusion Dapagliflozin combined with metformin and sitagliptin combined with metformin had the same hypoglycemic effect on overweight and obese patients with type 2 diabetes. Dapagliflozin could effectively reduce the body weight，waist circumference and blood pressure，but its risk of urogenital tract infection and diabetic ketoacidosis should be noticed. In terms of safety，Sitagliptin is much better than Dapagliflozin.

Objective To explore the value of multimodal 3D volume rendering reconstruction in preoperative evaluation of microvascular decompression. Methods A total of 34 patients（20 with trigeminal neuralgia and 14 with hemifacial spasm）who underwent microvascular decompression with 3DSlicer volume rendering reconstruction before operationwere assigned as reconstruction group and another 28 patients（19 of trigeminal neuralgia and 9 of hemifacial spasm）with microvascular decompression without three⁃dimensional reconstruction in the same operation group as non⁃reconstruction group. The two groups were compared in terms ofthe accuracy in preoperative judgment of responsibleblood vessels，surgical outcome and postoperative complications. Results Compared with the non⁃ reconstruction group，the accuracy in preoperative judgment of responsible vessels was significantly higher and the postoperative short⁃term and long⁃term surgical outcomes in the reconstruction group were significantly better. The postoperative complication rate and recurrence rate in the reconstruction group were both significantly lower than those in the non⁃reconstruction group. Conclusion The method of multimodal 3D volume rendering before operation can not only judge the responsible vessels more effectively，but also simulate the operative field scene accurately， and help the operators to distinguish the responsible vessels quickly and accurately during microvascular decom⁃ pression. It can improve the surgical effect and reduce surgical complications. 

Objective Investigate the clinical value of fecal calprotectin （FC）combined with blood indicators in the diagnosis and evaluation of the activity of ulcerative colitis（UC）. Methods 100 patients with UC diagnosed in Jiangsu Province Hospital from December 2017 to October 2020 were retrospectively analyzed， and 100 patients diagnosed with functional gastrointestinal disease in our hospital during the same period were selected as the control group，FC content was detected and compared between the two groups. According to the Ulcerative Colitis Endoscopic Severity Index（UCEIS），100 ulcerative colitis patients were divided into remission group，mild endoscopic activity group，moderate endoscopic activity group and severe endoscopic activity group， blood⁃related indicators（CRP，ESR，WBC，NLR，Hb，ALB）were detected respectively. FC and blood⁃related indicators of patients with different UC groups were compared. The ROC curve was drawn to analyze the diagnostic efficacy of FC combined with blood ⁃ related indicators to determine whether the UC endoscopy is active. Results The FC concentration of UC patients was significantly higher than that of the control group. The FC level of UC patients in the active phase was also higher than that of the control group（P < 0.05）. FC was combined with blood⁃ related indicators to make ROC curve，single FC had a high diagnostic value，and the evaluation value of FC com⁃ bined with blood indicators was better than FC single index. Conclusion FC is a good evaluation index to judge the disease activity of UC patients，and it can be used as an auxiliary index to evaluate the disease activity of UC patients.

Objective To investigate the value of bronchoalveolar lavage fluids（BALF）metagenome next⁃ generation sequencing in the diagnosis of severe community ⁃ acquired pneumonia in children. Methods From March 2019 to February 2020，29 children with severe community⁃acquired pneumonia treated with bronchoalveolar lavage were included in the study. The BALFs obtained during lavage were detected by both traditional etiology and metagenomics next generation sequencing（mNGS）simultaneously，and the diagnostic efficacy of the two detection methods for etiology of severe community⁃acquired pneumonia was analyzed. Results The detection rate of bacteria in the BALFs of all 29 children by mNGS was significantly higher than that by the traditional detection methods （58.6% vs. 20.7%）（P = 0.003）. The positive rate of pathogens and the infection detection rate of more than two pathogens by mNGS were significantly higher than by the traditional detection method（93.1% vs. 72.4%，34.5% vs. 0%；P = 0.041，P = 0.001）. In terms of the consistency between MNGS and traditional detection results，the negative results of culture were more than the negative results of MNGS in the pathogens with inconsistent results of the two detection methods. The detection rate of compound infections by mNGS was significantly higher than by the traditional detection methods（58.6% vs. 27.6%，P = 0.017）. Conclusion In children with severe community⁃ acquired pneumonia，the detection rate of bacterial pathogens from BALF by way of mNGS is higher than by tradi⁃ tional detection methods，especially for bacterial and compound infections. So mNGS can provide early diagnosis and treatment basis for severe community⁃acquired pneumonia.

Objective To investigate and analyze the TCM syndrome types and postoperative fatigue situa⁃ tion in patients after endoscopic thyroidectomy，and to clarify the distribution of syndrome types and the relation⁃ ship between them. Methods According to the theory of traditional Chinese medicine and the clinical practice of surgery，the“questionnaire of TCM syndromes and postoperative fatigue of patients with thyroid tumor”was estab⁃ lished，and the patients with postoperative fatigue syndrome after endoscopic thyroidectomy were investigated. Results Among 201 cases，71 cases（35.32%）were the syndrome of liver depression and qi stagnation，78 cases （38.81%）were the syndrome of phlegm and blood stasis，24 cases（11.94%）were the syndrome of Qi and blood deficiency，28 cases（13.93%）were the syndrome of spleen and kidney yang deficiency. There were no significant differences in the distribution of TCM syndrome types among patients with different gender，age and course of disease（P > 0.05）. Among the common postoperative fatigue symptoms，the patients with the whole body pain or surgical area pain（54.73%），insomnia（49.25%），shortness of breath and disinclination to talk（39.30%）， lassitude of spirit and lack of strength（37.31%）and nausea and vomiting（33.33%）had the highest frequency. Insomnia，anxiety and the syndrome of liver depression and qi stagnation were significantly correlated（P＜0.05）； Somnolence and the syndrome of spleen and kidney yang deficiency was significantly correlated（P＜0.05）；Lassi⁃ tude of spirit and lack of strength，shortness of breath and disinclination to talk were significantly correlated with the syndrome of Qi and blood deficiency（P＜0.05）；The whole body pain or surgical area pain was significantly correlated with the syndrome of phlegm and blood stasis（P＜0.05）. Conclusions The study on the distribution of TCM Syndrome types and the correlation between TCM syndrome types and postoperative fatigue situation in patients after endoscopic thyroidectomy has certain guiding significance for clinical syndrome differentiation treat⁃ ment and rapid postoperative recovery.

The Rome Ⅲ criteria has been updated to 2016 Rome Ⅳ，in which the definition of functional dyspepsia（FD）and irritable bowel syndrome（IBS）has been revised and the diagnosis of and illness overlap between the diseases has changed. So in this paper，based on Roman Ⅳ criteria and literature review，we attempt to sort out and summarize the studies on the overlap between FD and IBS between 2016 and 2020，so as to provide reference for better understanding the present situation of overlap between FD and IBS. 

Bone defect arising secondary to trauma and cancer remains a major challenge for surgeons. Currently，mesenchymal stem cells are showed to be potential in its role in bone regeneration at clinical practice. The critical researches on the fate of stem cells in bone microenvironment as well as the interaction between them are still in the exploratory stage，which limits the development of stem cell⁃based therapies. Proteoglycans，the essential components and regulatory factors of the mesenchymal stem cell microenvironment，involve in the regulation of stem cell homestasis and osteogenic differentiation. Growing evidence has demonstrated that proteoglycans play a key role in regulating the regeneration of bone defects. Therefore，the domestic and foreign researches are now focusing on further revealing the mechanisms of proteoglycans in regulating the osteogenic differentiation of mesen⁃ chymal stem cells，and gradually promoting its topical application in the bone reconstruction field. This article has reviewed and summarized the latest research on the role of proteoglycans in regulating the osteogenic differentiation of different mesenchymal stem cells，its underlying mechanism and its current clinical application. 

Environmental fine particulate matter（PM2.5），an air pollutant，is one of the major prevent⁃ able threats to public health. It is a globally recognized substance with adverse effects on human health and has become a huge problem for global public health. In recent years，the problem of air pollution had become increas⁃ ingly serious. A number of studies have showed that air pollutants exert adverse effects on human health，including damage to the heart，lungs，testicles and other multifunctional organs. Studies also showed that PM is a risk factor for male semen quality deterioration. As a kind of atmospheric pollutants，PM2.5 affects male sperm quality， genes，chromosomes and hormones. It was gradually explored by researchers and they began to explore PM2.5 on male reproductive system function and mechanism of injury. However，its mechanism is not fully clear. This paper summarized the research progress about the damage of PM2.5 to male reproduction system in recent years.