Objective To investigate the effect of G protein ⁃ coupled estrogen receptor （GPER）on ischemia ⁃ reperfusion（I/R）injury. Methods Female ovariectomized（OVX）rats were randomly divided into OVX group，OVX + I/R group，OVX + I/R +G1（GPER agonist）group，OVX + I/R +G15（GPER blocker）+ G1 group. The renal function of rats in each group was detected，HE staining and Paller score were used to evaluate the degree of renal tissue damage ，and the expression position and expression level of renal tissue apoptosis⁃ related proteins were observed. Results Compared with the OVX group，the renal function of the OVX+I/R group was significantly damaged（P < 0.01），Paller score increased（P < 0.01），and the positive expression of Bcl⁃2 protein in renal tubular epithelial cells and the expression of renal tissue were reduced. The positive expression of Caspase⁃3 protein in renal tubular epithelial cells and the expression of renal tissue increased（P < 0.01）. The renal function damage was significantly reduced after G1 intervention （P < 0.01），Paller score significantly decreased（P < 0.01），the expression of Bcl⁃2 significantly increased，and the expression of Caspase⁃3 protein significantly decreased （P < 0.01）. The protective effect of G1 activated GPER G15 group was partially reversed （all P < 0.01）. Conclusion Activated GPER can alleviate renal I/R injury，and its mechanism may be achieved by regulating the apoptosis pathway.

Objective To investigate the mechanism of RBP2 gene silencing on the migration and invasion of the ovarian cancer cell line SKOV3/PTX. Methods The cell line that stably interferes with RBP2 expression was established，and the cells were divided into three groups：RBP2 silence（SKOV3/PTX⁃RBP2i），negative control （SKOV3/PTX⁃NC），and blank control（SKOV3/PTX）. Western blot was used to confirm the silencing effect of the RBP2 gene，wound healing assay was used to detect the migration ability of cells in three groups，transwell inva⁃ sion assay was used to detect the invasive ability of cells in three groups，and RT⁃PCR and western blot methods were used to detect molecular markers（β ⁃ catenin，VEGF and MMP ⁃ 2）. Results The cell line SKOV3/PTX ⁃ RBP2i，which stably inhibits RBP2 expression，was successfully constructed. The RBP2 expression level of silent group was significantly lower than that of negative control group and blank group. There were significant differences in wound healing rate and invasive ability among silent group，negative control group and blank group（P<0.01）. The wound healing rate and invasive ability of cells in silent group were significantly lower than those in negative control group and blank group（P<0.01）. RT ⁃PCR and western blot showed that the mRNA and protein expression levels of β⁃catenin，VEGF and MMP⁃2 in the silent group had significantly lower than those in the negative control group and the blank group（P<0.05）. Conclusion Interfering with RBP2 expression in SKOV3/PTX cells can prevent cell migration and invasion，and the mechanism is thought to be related to the Wnt/ β⁃catenin signaling pathway. 

Objective To study the effect of TRPM2 gene knockout（TRPM2-/-）on lipopolysaccharide （LPS）induced depressive ⁃like behavior and related mechanisms. Methods Male TRPM2-/- mice were divided into TRPM2-/- group（n = 30）and TRPM2-/-+LPS group（n = 30）；male wild type（WT）homogenotypic mice were divided into WT group（n = 30）and WT+LPS group（n = 30）. Then the levels of 5⁃hydroxytryptamine（5⁃HT）， TNF⁃α and IL⁃1β in hippocampus and/or prefrontal cortex were measured by ELISA assay. Expressions of neuronal and glial cell markers were observed by immunofluorescent staining. The protein levels of p⁃GSK3β and t⁃GSK3β were detected by Western Blot and the depressive ⁃like behavior was measured by tail suspension test and forced swim test. Results Compared with that of WT + LPS group，the concentration of 5⁃HT in the hippocampus of TRPM2-/-+LPS group was decreased（P＜0.05）；the number of cells expressing GFAP and Iba⁃1 in the hippocam⁃ pus of TRPM2-/-+LPS group was decreased（P＜0.01）；the expressions of TNF⁃α and IL⁃1β in the hippocampus of TRPM2-/-+LPS group were also decreased（P＜0.01）but the protein level of p⁃GSK3β was increased（P＜0.01）. No differences of t⁃GSK3β protein level was found in the hippocampus of TRPM2-/-+LPS group when compared with the WT+LPS group. Moreover，the mobility time in tail suspension test and forced swim test of the TRPM2-/-+LPS group were significantly shortened（P＜0.05）when compared with the WT + LPS group. Conclusion TRPM2 knockout can improve LPS induced depressive⁃like behavior in mice，and it may be correlated with the increased level of p⁃GSK3β in hippocampus.

Objective To construct and screen the optimal Caprin⁃1 knockout plasmid and to explore the effect of cell proliferation，cell cycle andthe expression of cyclinD1 and cyclinD2 in hepatocellular carcinoma HepG2 cellsafterCaprin ⁃1⁃KO transfectionmediated byultrasound ⁃microbubbles. Method First of all，Caprin ⁃1 knockout plasmids KO⁃1 and KO⁃2 were constructed and the recombinant plasmids were identified by sequencing. Secondly，after transfecting the target plasmid into HepG2 cells through ultrasound transfection conditions which explored in the previous research，the best quality granules were screened by WB. Finally，qPCR was selected to detect the expression of cyclinD1 and cyclinD2. CCK8 and FCM were used to detect the effect of inhibiting Caprin⁃1 expression on cell proliferation and cycle. Results In this study，the primers of Caprin⁃1 knockout plasmid KO⁃1 and KO⁃2 were designed. The extracted plasmids were constructed successfully after electrophoresis and sequenc⁃ ing. The results showed that the expression of Caprin⁃1 in NC group and KO⁃1 group were higher compared to the KO⁃2 group（P<0.05）.After inhibiting the expression of Caprin⁃1，the proliferation of HepG2 cells was significantly inhibited，and the cell cycle was blocked；the expression of cyclinD1 and cyclinD2 was significantly down⁃regulat⁃ ed（P<0.05）. Conclusion Caprin⁃1⁃KO were transfected into HepG2 cells by UTMD. The expression of Caprin⁃1⁃ KO can inhibit the cell proliferation、block the cycle and decrease the expression of cyclinD1 and cyclinD2. This study is expected to provide ideas for further research on the role of Caprin⁃1 in the pathogenesis of liver cancer. 

Objective For the purpose of developing a barrier membrane with osteoimmunomodulatory property，this study prepared electroactive biomembranes and clarified its regulatory effects on macrophage polar⁃ ization typing，and further explored the effect of electroactive biomembrane⁃mediated macrophage polarization on osteogenic differentiation. Methods Preparing charged poly（vinylidene fluoride trifluoroethylene）［P（VDF⁃TrFE）］ membrane. A co⁃culture system of P（VDF⁃TrFE）membrane，macrophages，and bone marrow mesenchymal stem cells（BMSCs）was constructed. Uncharged P（VDF ⁃TrFE）membrane was set as a control group. Flow cytometry and PCR techniques were used to detect the phenotype of macrophages on the charged P（VDF⁃TrFE）membrane. Alkaline phosphatase（ALP）and alizarin red staining techniques were used to detect the osteogenic activity of BM⁃ SCs under the stimulation of P（VDF ⁃ TrFE）membrane ⁃ macrophage conditioned medium. Results Charged P （VDF⁃TrFE）membrane had good electrical stability. Macrophages showed high expression of M2 characteristic protein CD206 on the charged membrane，PCR results also showed that Arg⁃1 and IL⁃10 had higher expression on the charged membrane（P＜0.05），and BMSCs produced more ALP and mineralized nodules in the charged membrane⁃macrophage environment. Conclusion The electroactive P（VDF⁃TrFE）membrane can effectively pro⁃ mote the polarization of macrophages to the M2 phenotype. Under its mediated immune environment，BMSCs show high osteogenic activity，which is of great significance to the regeneration and repair of bone defects. 

Objective To study the effect of different stimulated duration of 200 μmol/L H2O2 on the senescence of human umbilical vein endothelial cells（HUVEC），soas to provide reference for oxidative stress⁃ induced senescence cell model. Methods The HUVEC were divided into control group and stimulated group which was subdivided into 8 groups according to the different stimulated duration of 200 μmol/L H2O2 including 0.5，1，3，6，12，24，48，96 h. MTT assays were performed to assess cell proliferation in each group；senescence ⁃associated β⁃galactosidase（SA ⁃β）staining was performed to measure the senescent cells；ELISA was used to measure the content of endothelin⁃1（ET⁃1）and nitric oxide（NO）；colorimetry assays were performed to assess the content of malondialdehyde（MDA），super oxidase dismutase（SOD）and glutathionperoxidase（GSH⁃px）and western blot was performed to measure the expressions of Bax，Bcl⁃2 and p21. Results Compared with that in the control group，cell proliferation in H2O2 stimulated groups with a short⁃duration（＜3 h）was significantly increased accom⁃ panied with very low positive rate of SA⁃β staining and increased secretion of ET⁃1 and NO. With the prolonging of the stimulated duration of H2O2（3 ~ 24 h），the cell proliferation decreased but the positive rate of SA⁃β staining increased；the secretion of ET⁃1 increased but NO decreased，accompanied with increased expression of p21 but unchanged Bax and Bcl⁃2. In the 48 ~ 96 h，both the cell proliferation and the secretion of ET⁃1 and NO kept decreasing while there was no change of SA⁃ β staining. However，the expression of Bax increased but the Bcl⁃2 decreased while there was no change of the p21. What′s more，compared with that in the control，MDA kept increasing but SOD and GSH⁃px decreasing in the stimulated groups. Conclusion The HUVEC stimulated with 200 μmol/L H2O2 for 24 h may lead to significant senescence while over 24 h stimulation may lead to increased apoptosis. 

Objective To study the effect of different stimulated duration of 200 μmol/L H2O2 on the senescence of human umbilical vein endothelial cells（HUVEC），soas to provide reference for oxidative stress⁃ induced senescence cell model. Methods The HUVEC were divided into control group and stimulated group which was subdivided into 8 groups according to the different stimulated duration of 200 μmol/L H2O2 including 0.5，1，3，6，12，24，48，96 h. MTT assays were performed to assess cell proliferation in each group；senescence ⁃associated β⁃galactosidase（SA ⁃β）staining was performed to measure the senescent cells；ELISA was used to measure the content of endothelin⁃1（ET⁃1）and nitric oxide（NO）；colorimetry assays were performed to assess the content of malondialdehyde（MDA），super oxidase dismutase（SOD）and glutathionperoxidase（GSH⁃px）and western blot was performed to measure the expressions of Bax，Bcl⁃2 and p21. Results Compared with that in the control group，cell proliferation in H2O2 stimulated groups with a short⁃duration（＜3 h）was significantly increased accom⁃ panied with very low positive rate of SA⁃β staining and increased secretion of ET⁃1 and NO. With the prolonging of the stimulated duration of H2O2（3 ~ 24 h），the cell proliferation decreased but the positive rate of SA⁃β staining increased；the secretion of ET⁃1 increased but NO decreased，accompanied with increased expression of p21 but unchanged Bax and Bcl⁃2. In the 48 ~ 96 h，both the cell proliferation and the secretion of ET⁃1 and NO kept decreasing while there was no change of SA⁃ β staining. However，the expression of Bax increased but the Bcl⁃2 decreased while there was no change of the p21. What′s more，compared with that in the control，MDA kept increasing but SOD and GSH⁃px decreasing in the stimulated groups. Conclusion The HUVEC stimulated with 200 μmol/L H2O2 for 24 h may lead to significant senescence while over 24 h stimulation may lead to increased apoptosis. 

Objective To study the clinicopathological features of patients with IgA nephropathy（IgAN） with foot process fusion，and to explore the effect of foot process fusion on renal function in patients with IgAN. Methods The data on 219 patients with IgA nephropathy in our hospital were retrospectively analyzed. According to the appearance of foot processes on electron microscopy，the patients were divided into a group with extensive fusion（≥50% fusion）of foot process（40 patients，18.3%）and a group with no obvious lesion（lesion⁃freeor <50% fusion）of foot process（179 patients，81.7%）. Results Levels of serum creatinine，urea nitrogen，uric acid，dia⁃ stolic blood pressure，cholesterol，triglyceride，low density lipoprotein（LDL）and urinary protein were higher in the group with extensive foot process fusion than in the group without obvious lesions，while serum albumin level and estimated glomerular filtration rate（EGFR）were lower. Increased diastolic blood pressure，urea nitrogen and LDL were independent risk factors for extensive foot process fusion. Logistic results showed that extensive foot pro⁃ cess fusion was an independent risk factor for renal dysfunction in IgA nephropathy（P<0.05）. Conclusions The clinical manifestations are more severe in IgAN patients with extensive foot process fusion. Extensive foot process fusion is an important factor affecting renal function in patients with IgAN. 

Objective To explore the role of PTEN⁃induced kinas 1（PINK1）in predicting prognosis and chemotherapy efficacy in patients with gastric cancer（GC）. Methods A correlation analysis on association of PINK1 expression with prognosis and chemotherapy efficacy was made by using the data from the KM ⁃ Plotter website. Three pairs of fresh GC and precancerous tissue samples，153 samples of formalin ⁃ embedded GC，and clinical data were collected to detect protein expression of PINK1，and further analyze role of PINK1 in predicting prognosis and chemotherapy efficacy in GC patients. Results KM ⁃ Plotter data analysis showed that PINK1 was highly expressed in patients with GC and indicated poor prognosis regardless of tumor staging and presence or absence of distant metastasis. High expression of PINK1 indicated favorable 5⁃ Fu chemotherapy efficacy. In 153 samples of formalin⁃embedded GC tissue and 6 pairs of fresh GC tissue and normal adjacent tissue samples，PINK1 were highly expressed and their expressions were increasing with a rise in tumor staging，especially in those with distant metastasis or lymph node metastasis. In prediction of poor prognosis，cut⁃off value of PINK1 expression was 4.50，Area Under the Curve（AUC）was 0.772，sensitivity was 69.2%，and specificity was 76.0%；in prediction of 5 ⁃Fu chemotherapy efficacy，cut⁃off value of PINK1 expression was 5.50，AUC was 0.735，sensitivity was 60.0%， and specificity was 76.9%. Conclusions PINK1 is highly expressed in GC and plays a role in predicting prognosis and chemotherapy efficacy in patients with GC

Objective To investigate the differences in gut microbiome among patients with ovarian endo⁃ metriosis，those with deep infiltrating endometriosis，and healthy women，and to predict the gene function of flora. Methods Feces were collected from 14 patients with ovarian endometriosis（OE group，n = 14），12 with deep infiltrating endometriosis（DIE group，n = 12），and healthy women（control group，n = 10）during the period of 2019 to 2020. The common conserved region V3⁃V4 of intestinal flora was sequenced by 16S rRNA amplification and the sequencing results among three groups were analyzed；the gene function of microbiome was predicted. Results The diversity of the flora did not differ significantly among the three groups. Negativicutes and Fusicateni⁃ bacter were significantly decreased while NK4A214_group and Eubacterium_coprostanoligenes_group were signifi⁃ cantly increased in OE group and DIE group. Amino acid metabolism and ABC transporter were enriched in OE group. Conclusions Imbalance of intestinal flora was existed in patients with endometriosis. The development of ovarian endometriosis and deep infiltrating endometriosis may be related to amino acid metabolism and transporters. 

Objective The purpose of this study was to determine the median and 95 percent effective doses （ED50，ED95）of propofol and remifentanil for endotracheal intubation without muscle relaxant in pediatric patients using a sequential method. Methods In two stages，70 children undergoing elective surgery were chosen for the sequential trial. In the first stage，the induction dose of propofol was fixed at 3.5 mg/kg，and the ED50 and ED95 of remifentanil were measured. In the second stage，the ED95 of remifentanil was fixed，and the ED50 and ED95 of pro⁃ pofol were measured. Using the probit probability unit process，the ED and 95 percent confidence interval（CI） were measured. Results The ED50 of remifentanil was 2.50（95%CI 1.91，3.28）μg/kg，and the ED95 was 3.91 （3.19，9.53）μg/kg. The ED50 of propofol was 2.34（1.73，2.94）mg/kg，and the ED95 was 3.67（3.02，8.65）mg/kg. Conclusions Propofol and remifentanil can be used safely in children aged 1 to 3 years old for endotracheal intu⁃ bation without the use of a muscle relaxant.Propofol and remifentanil have ED50 and ED95 values that can be used as a guide for specific drug administration。

Objective To investigate the effect of molecular subtype on the margin statusof breast⁃conserving surgery（BCS）and prognosis. Methods We retrospectively reviewed the clinical and histopathologic data of 1 032 consecutive womenat the time of diagnosis with breast cancer deemed suitable for BCS treated with lumpectomy. Univariate and multivariate analyses were used to determine the relationship between the molecular subtype，age， tumor size and positive surgical margins and prognosis. Results 20.3% of the（209/1 032）patients had evidence of cancer intheir cavity margins（CM）. By multivariate analysis，the HER⁃2 BC subtype，EIC，pN stage were sig⁃ nificantly correlated with positive CMs（P < 0.01）. Kaplan ⁃Meier survivalanalysis revealed statistically significant differencesin DFS，LRRFS，and DMFS，among the breast cancer subtypes（P < 0.05）. Conclusion The HER⁃2 positive subtype is the predictive factor that is most associated with positive CMs. The luminal⁃HER⁃2 and HER⁃2 subtypesareindependent prognostic factors for worse outcomes in patients with breast⁃conserving surgery. 

Objective To investigate the effect of MACBAR of sevoflurane in patients with different classi⁃ fications of burn. Methods Sixty severely burned patients admitted to our hospital from June 2017 to May 2019 were divided into group A with second⁃degree burns（30%，n = 20），group B with third⁃degree burn（50%，n = 20） and group C with fourth⁃degree burn（70%，n = 20）. Three groups were given sevoflurane anesthesia induction； the MACBAR of sevoflurane was determined by sequential method，and the preoperative，intraoperative，postoper⁃ ative heart rate（HR），mean arterial pressure（MAP），blood glucose，norepinephrine，bispectral index（BIS）， disappearance time of spontaneous breathing，awakening time，extubation time and sedation ⁃agitation scale were compared. Results The MACBAR，preoperative，intraoperative，postoperative HR，MAP，blood glucos，and nor⁃ epinephrine in group C were higher than those in group B and A，and higher in group B than in group A（P < 0.05）. Disappearance time of spontaneous breathing in group C was longer than that in group B and A，and longer in group B than in group A（P < 0.05）. Awakening time and extubation time in group C were shorter than those in group B and A，and shorter in group B than in group A（P < 0.05）. There was no difference in postoperative seda⁃ tion⁃ agitation scores among the three groups（P > 0.05）. Conclusion With the severity of burn，the MACBAR of sevoflurane was increased but the anaesthetic effect time was shortened. The concentration of inhalation should be appropriately increased and drug maintenance time should be extended in the relevant surgical anesthesia

Objective To investigate the effect of physiological stress on the outcome of different times of IVF⁃ET. Methods We recruited infertile patients with tubal obstruction who received IVF treatment in the Repro⁃ ductive Medicine Center of the Second Affiliated Hospital of Kunming Medical University from October 2017 to October 2019，and analyzed the differences of their basic information，monoamine neurotransmitter levels，ovula⁃ tion inductions and pregnancy outcomes in different times of embryo transfer. Results The FSH of group 3 was higher than group of 1，but the E2 was lower than it. The NE，DA and 5⁃HT in group1 were higher than the group 3. The DA in group 2 was higher than group 3. The dosage of Gn in group1 was lower than groups 2 and 3.Days of Gn use in group2 were more thangroup3. The number of eggs obtained，mature eggs and the thickness of intima in group1 were higher than those in group 3. The intimal thickness in group1 was higher than group 2. The pregnancy rate of the group 1 was higher than that of group 3. Conclusion With the increase of the number of treatments， the secretion of sex hormones was abnormal，the secretion of monoamine neurotransmittersdecreased gradually， and the number of eggs obtained，the number of mature eggs and intimal thickness decreased also，all of these ulti⁃ mately affected the pregnancy outcome of the patients.

Objective To explore the influence of xeroderma pigmentosum group C（XPC）genetic variation on the prognosis and safety of stage Ⅲ patients with colorectal cancer（CRC）receiving oxaliplatin⁃based adjuvant chemotherapy. Methods A total of 186 patients with CRC who were treated with surgical resection and oxaliplatin⁃ based adjuvant chemotherapy were included in this study. Peripheral blood specimens of the patients were collected for genetic variation analysis of XPC gene. The univariate analysis between XPC genetic variation and prognosis was performed by Kaplan⁃Meier survival analysis. The correlation analysis between genotype and adverse reactions was analyzed using chi⁃square test. Results The median disease⁃free survival（DFS）and overall survival（OS） of the 186 patients with CRC was 4.3 years and 5.5 years，respectively. Rs2228001 was of clinical significance with prognosis and safety. Prognostic analysis demonstrated that the median DFS of patients with TT genotype and TG/GG genotype was 3.8 and 5.0 years respectively ，which was statistically significant（P = 0.012）. Fur⁃ thermore，the median OS of the two genotypes were 5.0 and 5.7 years respectively，which was marginal statistical significance（P = 0.021）. The association analysis between rs2228001 genotype and adverse reaction suggested that patients with TG/GG genotype were associated with a relatively higher incidence of neurotoxicity than that with TT genotype（72.9% vs. 55.4% ，P = 0.014）. Conclusion XCP gene rs2228001 polymorphism could be used as a biomarker for prognosis and neurotoxicity evaluation of patients with CRC who received oxaliplatin⁃based adjuvant chemotherapy. 

Objective To explore the role of age，total prostate specific antigen（tPSA），free prostate specific antigen（fPSA）and Gleason scores in the diagnosis of systemic bone metastasis of prostate cancer（PCa）， and to compare the diagnostic value of MRI and bone scintigraphy in pelvic area bone metastasis to provide refer⁃ ence for early diagnosis of bone metastasis. Methods A total of 51 patients with PCa were selected. The results of bone metastases were determined by the clinical criteria of bone metastases lesions. The related factors of whole body bone metastasis were analyzed，and the diagnosis value of pelvic area bone metastasis with MRI and bone scintigraphy were compared. Results （1）Fifty⁃one PCa patients were divided into bone metastasis group（n = 24） and non⁃bone metastasis group（n = 27）. The tPSA，fPSA，and Gleason scores of bone metastasis group were sig⁃ nificantly higher than those of non⁃bone metastasis group（P < 0.05）. When the cut⁃off values of tPSA and fPSA were 68.59 ng/mL and 6.42 ng/mL，the sensitivity and specificity of diagnosing bone metastasis were the best （75.00% ，81.50% and 83.30% ，81.50% ，respectively）.（2）According to pelvic area analysis，patients were divided into bone metastasis group（n = 22）and non⁃bone metastasis group（n = 29 ）. The sensitivity，specificity and accuracy of MRI，bone scintigraphy and their combined diagnosis of bone metastasis were 86.36%，93.10%， 90.20%（P < 0.05）and 90.91%，86.21%，88.24%（P < 0.05）and 95.45%，79.31%，86.27%（P < 0.05），respec⁃ tively. Conclusion （1）The tPSA，fPSA and Gleason scores are risk factors for definitive PCa systemic bone me⁃tastasis. Increased values are a good indication of predicting bone metastasis，especially when the cut⁃off value of tPSA and fPSA are 68.59 ng/mL and 6.42 ng/mL respectively，the diagnosis is the best.（2）The study of the pelvic area found that MRI has the highest specificity for diagnosing PCa bone metastasis，and the highest sensitivity when combined with bone scintigraphy，indicating that the combination of the two can achieve complementary advantages and contribute to the early diagnosis of PCa bone metastasis. 

Objective To investigate the effect of premature epidural analgesia during labor on maternal serum cortisol（COR），endothelin⁃1（ET⁃1）and nitric oxide levels（NO）. Methods According to the principle of voluntary application by the parturients ，the parturients who met the inclusion criteria were divided into an early analgesia group（group P）and a control group（group C）.When group P went into labor，they were given analgesia，whereas group C was not given any analgesia measures. The two groups were evaluated for VAS pain score at the time of labor（T0），full uterine opening（T1），and after delivery（T2），and 3mL of maternal venous blood was taken to detect COR，ET⁃1 and NO concentrations as well as record the labor process Duration，delivery method，umbilical artery blood is taken immediately after the fetus is delivered，and its PO2，PaCO2，and pH values are recorded. Results The first，second，and total stages of labor in group P were longer than those in group C（P＜0.05）；as labor progressed，the VAS score and COR content in group P at T1 and T2 were lower than those in group C（P＜0.05）. At the same time，the ET⁃1 level of group P was lower than that of group C at T1 and T2（P＜0.05），and the level of NO was higher than group C（P＜0.05）. There was no statistical comparison of the two groups of newborns′ Apgar scores，PO2，PaCO2，and pH values. Academic distinction（P > 0.05）. Conclusion It is feasible to implement epidural analgesia ahead of time，it has no effect on maternal or neonatal outcomes，and it can reduce the maternal stress response to pain，which is beneficial to placental circulation and perfusion. 

Objective To compare the clinical efficacy of rhomboid block and peripheral nerve block of knee joint and their combined treatment for knee osteoarthritis. Methods 92 patients with knee osteoarthritis were randomly divided into 3 groups，29 patients in group A（knee peripheral nerve block group），32 patients in group B（rhomboid block group）and 31 patients in group C（knee peripheral nerve block combined with rhomboid block group）.Visual analogue scale（VAS）and Lysholm Scale were performed before treatment and at 3 d，7 d，1 month and 6 months after treatment，and the pain relief rate and knee rehabilitation remission rate were compared. The ratio of the second and third treatments were compared，and adverse reactions during treatment and follow-up was recorded. Results In group A，the VAS and Lysholm scores within 1 month after treatment were significantly different from those before treatment（P < 0.05）；The VAS and Lysholm scores of group B and group C at each time point after treatment were significantly different from those before treatment（P < 0.05）；7 days after treatment， the pain relief efficiency and knee rehabilitation relief efficiency in group B and C were significantly higher than that in group A（P < 0.05）；The ratio of the second and third treatments of group C were significantly lower than those of group A and B（P < 0.05）；No obvious adverse reactions were observed in the 3 groups. Conclusion Peripheral nerve block combined with rhomboid block is more effective in the treatment of knee osteoarthritis with⁃ out obvious adverse reactions. 

Objective This study investigated the prognostic significance of Pcv ⁃aCO2 combined with lactate clearance rate（LCR）as goals of early sepsis resuscitation. Methods From August 2017 to December 2018，68 patients who were diagnosed as sepsis and need for fluid resuscitation in ICU in Binzhou Medical University Hospital were recruited. When patients were admitted to hospital，they were immediately given fluid resuscitation as early as possible. The arterial and central venous blood gases were measured simultaneously at 0 hours（T0）and 6 hours（T6）after resuscitations and calculated the Pcv⁃aCO2 and LCR. Patients were classified into four groups according to Pcv⁃aCO2 and LCR at 6 h after fluid resuscitation：group A（Pcv⁃aCO2 > 6 mmHg and LCR < 30%）， group B（Pcv⁃aCO2 > 6 mmHg and LCR ≥ 30%），group C（Pcv⁃aCO2 ≤ 6 mmHg and LCR < 30%），group D（Pcv⁃ aCO2 ≤ 6 mmHg and LCR ≥ 30%）. General demographics，physiological indicators，laboratory parameters，the volume of fluid entering and the prognosis were compared among the four groups. Results The general clinical data of patients between the four groups before fluid resuscitation treatment，such as acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）score and sequential organ failure assessment（SOFA）score on the first day after admission to the ICU，and source of the primary infection site，was not significantly different（P > 0.05）. At T0 and T6，Pcv⁃aCO2 had correlation with ScvO2. At T6，Pcv⁃aCO2 had correlation with LCR. Conclusions Pcv⁃aCO2 has a good correlation with ScvO2 and lactate clearance rate，the combination of Pcv⁃aCO2 and LCR can assess the condition of septic shock patients，and avoid inadequate fluid resuscitation when the Scv02 goal was false⁃normaliza⁃ tion，which can be used as the goal of fluid resuscitation in patients with severe sepsis or septic shock. 

Objective To investigate the clinical efficacy and safety of Yunke combined with Gugutou Huaisiyu capsule in the treatment of early non⁃traumatic femoral head necrosis. Methods From September 2017 to March 2020，90 patients with early non⁃traumatic femoral head necrosis admitted to Luoyang Orthopedic Hospital （Henan Orthopedic Hospital）were selected for retrospective analysis of clinical data. According to treatment methods，they were divided into observation group and control group，with 45 cases in each group. The study compared the clinical effects，walking ability，pain degree，joint function score，necrosis index and improvement of bone marrow edema in the two groups. Results The treatment effect of the observation group was higher than that of the control group（P < 0.05）；the walking ability，pain degree，joint function score and necrosis index of the two groups improved after treatment. The pain degree and necrosis index of the observation group were lower than those of the control group（P < 0.05）；the walking ability and joint function scores of the observation group were higher than those of the control group（P < 0.05）. Improvement of bone marrow edema：After treatment， bone marrow edema in the observation group decreased from grade 1 to grade 0 in 22 cases，from grade 2 to grade 1 in 9 cases，and from grade 3 to grade 2 in 5 cases；After treatment，bone marrow edema in the control group were reduced from grade 1 to grade 0 in 16cases，from grade 2 to grade 1 in 9 cases，and from grade 3 to grade 2 in 4 cases. There was no statistical significance in the incidence of adverse reactions between the two groups （P > 0.05）. Conclusion Yunke combined with Gugutou Huaisiyu capsule has obvious clinical results in the treat⁃ ment of early non⁃traumatic femoral head necrosis，and the incidence of adverse reactions is low. 

Objective To detect the expression levels and diagnostic value of long non⁃coding RNA cancer susceptibility candidate 9（lncRNA CASC9）and microRNA⁃758⁃3p（miR⁃758⁃3p）in serum of hepatocellular carcinoma（HCC）. Method 72 patients with HCC who were treated in the third people′ s hospital of Zhenjiang City from June 2018 to February 2020 were selected，and they were selected as HCC group. 30 cases for medical examination of health personnel were selected as healthy control group. The binding sites of lncRNA CASC9 and miR⁃758⁃3p were predicted by StarBase v2.0 online software. The expressions of lncRNA CASC9 and miR⁃758⁃3p in the serum of the subjects were detected，and the relationship between them and clinic pathological parameters of HCC patients was analyzed. The diagnostic value of them and AFP on HCC were analyzed. Results The results of Starbase v2.0 software showed that there was a potential complementary binding site between lncRNA CASC9 and miR⁃758⁃3p. Compared with the healthy control group，the expression of lncRNA CASC9 in serum of HCC patients was increased（P < 0.05），and the expression of miR⁃758⁃3p in serum of HCC was decreased（P < 0.05）. The expression of lncRNA CASC9 and miR ⁃ 758 ⁃ 3p in serum of HCC patients were correlated with liver cirrhosis， lymph node metastasis and TNM stage（P < 0.05）. ROC analysis showed that lncRNA CASC9，miR⁃758⁃3p and AFP had certain diagnostic value for HCC. The combined application of the three methods had higher diagnostic value，and the ROC⁃AUC was 0.848（95%CI：0.767～0.937）. Conclusion Serum lncRNA CASC9 and miR⁃758⁃ 3p may be used as serological markers for early diagnosis of HCC. 

Objective To explore T1，T2 mapping and extracellular volume diagnostic value in patients with acute myocardial infarction. Methods 24 patients with acute myocardial infarction were performed T1，T2 mapping sequence and delayed perfusion examination by a Siemens 1.5 T Aera MRI scanner. The images were input to the syng MR D13 post⁃processing workstation，manually drawn the area of interest in the delayed⁃enhanced segment ，and then the T1 values before and after，T2 Values and reinforcement of area of interest and the blood pool were calculated. With Separate the unreinforced section did not strengthen the area for the control group，the same method was used to calculate the T1 values，T2 values and blood pool T1 values. The extracellular fractions were calculated for both groups. T ⁃test and the ROC curve were used to compare the differences between the two groups（P < 0.05）. Results The initial T1 value（1 320.0 ± 28.4）ms in the delayed enhancement was larger than that in the Separate the unreinforced areas（1 196.8 ± 27.0 ）ms（P < 0.05）. The value of T1 in the delayed enhancement region was declining more obvious than that in the enhancement region. The extracellular volume fraction were（38.7 ± 2.1）% and（24.8 ± 2.5）% respectively（P < 0.05）. The area under the ROC curve of each parameter was 0.812，0.840，0.875，0.819，and it has good sensitivity，specificity and accuracy. From the ROC curve，it can be seen that the diagnostic efficiency of ECV for myocardial infarction is higher than that of other parameters. Conclusion T1，T2 mapping and ECV have a high value in identifying and quantifying acute myocar⁃ dial infarction. 

Objective To evaluate the therapeutic effect of acupuncture on Parkinson′s disease by measur⁃ ing the changes of substantia nigra dense zone（SNC）with susceptibility weighted imaging（SWI）. Methods 50 cases of patients with Parkinson′s disease who were treated with acupuncture in our hospital from May 2020 to December 2020 were selected. After 3 months of treatment，they were divided into cure group，remission group and ineffective group according to their therapeutic effects. All patients underwent MRI examination before and after 3 courses of treatment. SWI sequence scanning was used to measure the SNC width，midbrain diameter ratio and Sn area. Results There were no significant differences in SNC width，Sn area，midbrain diameter and SNC/ midbrain diameter ratio among the three groups before acupuncture treatment（P > 0.05）. After 3 courses of treat⁃ ment，the SNC width，Sn area，midbrain diameter and SNC/midbrain diameter ratio of the cured group and remis⁃ sion group were significantly lower than those before treatment（P < 0.05），while there were no significant differ⁃ ences in SNC width，SN area，midbrain diameter and SNC/midbrain diameter ratio of the ineffective group before and after treatment（P > 0.05）. After treatment，the SNC width，SN area，midbrain diameter and SNC/midbrain diameter ratio of the cured group were significantly lower than those of the remission group and the ineffective group （P < 0.05）. Conclusion Susceptibility weighted imaging can clearly show the size change of substantia nigra dense zone in patients with Parkinson′s disease，and it has high value in judging the therapeutic effect of acupunc⁃ ture in patients with Parkinson′s disease. 

Objective To investigate medical staff′s knowledge，attitude and practice toward post⁃stroke cognitive impairment and analyze its influencing factors. This will reflect the status，and serves as a reference for training needs among the staff with a view to facilitate early screening and prompt intervention for cognitive impair⁃ ment among stroke patients. Methods From April 2020 to May 2020，used general information questionnaire and self ⁃ designed medical staff′ s Knowledge，Attitude，Behavior questionnaire to post ⁃ stroke cognitive impairment based on KAP model to investigate 798 medical staff from 2 tertiary hospitals in Guangzhou. Results A total of 780（97.7%）valid questionnaires were collected，the participants′ average scores of knowledge，attitude，and practice related to cognitive impairment after stroke are（50.95 ± 12.994），（49.95 ± 7.687）and（49.19 ± 13.292） respectively. Results of multiple factor analysis showed that occupation，work department，occupational satisfac⁃ tion，training experience and education need are the main influencing factors of KAP of post ⁃stroke cognitive impairment（P < 0.01）. Conclusions The medical staff had a moderate level of knowledge and practice toward cognitive impairment after stroke，their attitude was positive. To ensure good prognosis of post⁃stroke cognitive impairment，early diagnosis and immediate rehabilitation are strongly recommended . However，training needs of medical staff should be prioritized to bridge their knowledge gap in assessment and management of cognitive impair⁃ ment among stroke patients. 

Objective To investigate the differences in survival characteristics and prognostic factors of postoperative patients with left⁃side and right⁃side colonic mucinous adenocarcinoma（MA）. Methods A total of 13 594 patients with colonic MA after surgery from 2006 to 2015 were collected in the Surveillance，Epidemiology， and Final Results（SEER）database. They were divided into right⁃side MA group（n = 9 824）and left⁃side colonic MA group（n = 3 770）. Overall survival（OS）of the two groups was estimated using the Kaplan⁃Meier method and stratified analysis was conducted by stage and degree of differentiation. The prognostic factors of patients with left⁃ side and right ⁃side colonic MA were evaluated using multivariate COX regression analyses. Results There were differences in the tumor characteristics of the left⁃side and right⁃side colonic MA patients. The 5⁃year survival rates of the left⁃side and right⁃side MA were 51.6% and 55.0%，respectively，and there was no difference in overall sur⁃ vival between the two groups（P = 0.234）. Stratified analysis revealed there was no difference in the OS between the left⁃side and right⁃side colonic MA in the AJCC staging stage Ⅰ（P = 0.203），stage Ⅱ（P = 0.156），stage Ⅲ （P = 0.08），well differentiated（P = 0.091），moderately differentiated（P = 0.252）and undifferentiated（P = 0.946）. The OS of the left⁃side group was better than that of the right⁃side group in stage Ⅳ colonic MA（P < 0.001）. However，the OS was better in the right⁃side group compared with that in the left⁃side group in poorly differentiated colonic MA（P = 0.001）. Multivariate COX analysis showed that male，aged over 60，single or unmarried，wid⁃owed，stage T3，stage T4，stage N1，stage N2，stage M1，poorly differentiated，undifferentiated，number of lymph nodes less than 12，CEA positive，and no chemotherapy were independent risk factors of postoperative patients with left⁃side or right⁃side colonic MA. Moderately differentiated was also an independent risk factor for the prognosis of postoperative patients with left colonic MA. Conclusion The survival differences are not completely the same between the right⁃side and left⁃side colonic MA with different differentiations and stages. The independent risk factors for the prognosis of postoperative patients with left ⁃side and right ⁃side colonic MA are not completely the same. 

Objective To investigate the effects of early feeding combined with chiropractic therapy on the post⁃laparoscopic recovery of bowel functions of neonates with duodenal obstruction. Methods A total of 120 children with neonatal duodenal obstruction were randomly divided into three groups：the control group（group A），the early feeding group（group B），the chiropractic therapy group（group C），the group treated with early feeding combined with chiropractic therapy（group D）. Comparisons were done among the four groups with respect to the recovery of postoperative bowel function，the incidence of postoperative feeding intolerance，the length of hospital stay，and hospitalization costs. Results The recovery of postoperative bowel function was better，the hos⁃ pital stay longer，and hospital cost lower in group D，as compared with the other three groups. The incidences of postoperative feeding intolerance in groups C and D were both lower than in groups A and B，and that in group D was the lowest among all the groups. Conclusion Early feeding combined with chiropractic therapy can promote the recovery of post⁃laparoscopic bowel function，and relieve postoperative feeding intolerance in children with neo⁃ natal duodenal obstruction，which can be promoted in clinical practice. 

The incidence of prostate cancer（PC）shows a significant upward trend worldwide，and the prognosis in patients with PC has been paid more and more attention to. At present，assessing the prognosis in patients mainly bases on PSA，GS and TNM stages，but for patients with the same stratification，there is a significant difference in prognosis. It is necessary to find new prognostic markers to further stratify the patients and establish Nomograph for prognosis，so as to achieve the purpose of convenient and accurate prognosis prediction，guide individual treatment and improve the prognosis in patients. Therefore，this paper reviews the research progress on the influences of tumor（GS and GG，IDC ⁃ P，CTC，and Ki ⁃ 67）and molecular biology（non ⁃ coding RNA， mRNA，and DNA）on the prognosis in patients with prostate cancer，in order to provide theoretical support for the establishment of risk stratification and prognosis Nomograph in patients with PC.