Benign esophageal stricture is a common disease caused by chronic non⁃tumor esophageal injury and fibrosis. With the rapid increase of endoscopic submucosal dissection（ESD）and radical esophageal surgery for early esophageal cancer in recently years，the incidence of benign esophageal stricture is also increasing. Endo⁃ scopic dilation is the first choice. However，for refractory esophageal benign stricture，the repeated dilation often leads to procedure⁃related perforation and bleeding with lower efficiency. MMC was originally an anti⁃tumor agent， and it was also used as an anti⁃fibroproliferative drug. MMC has been used in the treatment of benign esophageal stricture for nearly 20 years，and its safety and effectiveness have been confirmed. However，the delivery method and concentration varied greatly in different reports. Therefore，this article will review the clinical application of MMC in benign esophageal stricture. 

Immune checkpoint inhibitors（ICPIs）including anti ⁃cytotoxic T lymphocyte antigen 4，anti ⁃ programmed cell death 1 and anti⁃programmed cell death 1 ligand antibodies are novel therapeutic agents targeting a variety of cancers and show good therapeutic effect in clinical practice. However，a wide range of immune⁃related adverse reactions（irAEs）are reported during their application，during which the endocrine organ damage is the most common，and it affects the anti⁃tumor effect and patient′s quality of life.This article reviews the clinical char⁃ acteristics，possible pathogenesis and management strategies of immune⁃related adverse reactions of ICPIs therapy. 

Objective To probe into the efficacy of thymoquinone in the treatment of cerebral small vessel disease（CSVD）by investigating the effect of thymoquinone on oxidative stress in CSVD mice and exploring the mechanism of thymoquinone in the treatment of CSVD. Methods Thirty SHRsp rats were equally divided into model group，low⁃dose and high⁃dose thymoquinone group at random，and 10 SD rats were used as control group. Morris water maze test and new object recognition test were used to detect the cognitive function of the rats，and determine such oxidative stress related indicators in the rat brain assuperoxide dismutase（SOD），catalase（CAT）， and glutathione（GSH），malondialdehyde（MDA），and reactive oxygen species（ROS）. Results Compared with the model group，the escape latencies of the low and high dose thymoquinone groups were significantly shortened （P < 0.05），the target quadrant staysweresignificantly lengthened（P < 0.05），the frequencies forcrossing the original platform quadrant were significantly increased（P < 0.05），the time to explore new objects was significantly increased（P < 0.05），and the ability to distinguish between new and old objects was significantly increased（P < 0.01）. In addition，the activities of SOD and CAT were both increased（P < 0.05），the content of GSH increased （P < 0.01），and the levers of MDA and ROS decreased as well（P < 0.05）. Conclusion Thymoquinone can effec⁃ tively improve the cognitive impairment related to cerebral small vessel disease，which is related to its inhibition to oxidative stress. 

Objective Human serum albumin ⁃ sorafenib nanoparticles（HSA ⁃ SRF ⁃NPs）were prepared and then their anti⁃hepatic tumor activity was evaluated in vitro. Methods HSA⁃SRF⁃NPs were prepared by chem⁃ ical cross⁃linking method，and their characterization was studied by a laser granulometer and a transmission elec⁃ tron microscope. The drug loading volume and encapsulation rate were calculated. Accumulation of nanoparticles in BEL ⁃ 7402 cells was observed by a fluorescence microscope，the proliferation inhibition of BEL ⁃ 7402 cells by nanoparticles was evaluated by the IncuCyte ZOOM system，and the proapoptotic effect of HSA⁃SRF⁃NPs on BEL⁃ 7402 cells was detected by flow cytometry and Western blotting. Results The particle size of HSA⁃SRF⁃NPs was （75.8 ± 2.6）nm and the Zeta potential was（-19.00 ± 1.02）mV，and the drug loading volume and encapsulation rate were（4.23 ± 0.03）% and（92.52 ± 2.40）% ，respectively. HSA ⁃ SRF ⁃ NPs could accumulate in BEL ⁃ 7402 cells，the proliferation inhibition and proapoptotic effect of HSA⁃SRF⁃NPs were significantly stronger than those of sorafenib. Conclusions HSA⁃SRF⁃NPs possess better properties，which can significantly improve the anti⁃hepatic tumor activity of sorafenib. They have potential prospect of clinical applications. 

Objective To investigate the effect and mechanism of trillin on high glucose⁃induced retinal vascular endothelial cells（HRVEC）injury. Methods 5，10，and 20 μmol/L of trillin were applied to HRVEC cells induced by glucose of 30 mmol/L，or 30 mmol/L of glucose was induced HRVEC cells transfected with miR⁃ 1247⁃3p mimic，or 20 μmol/L of trillin was applied to 30 mmol/L glucose⁃induced HRVEC cells transfected with miR⁃1247⁃3p inhibitor. DCFH⁃DA method was used to detect intracellular ROS level；enzyme⁃linked immunosor⁃ bent assay was used to detect levels of MDA and SOD；flow cytometry was used to detect cell apoptosis；Western Blot method was used to detect the protein expression levels of Bcl⁃2 and Bax；RT⁃qPCR method was used to detect the expression level of miR⁃1247⁃3p. Results Trillin reduced the levels of ROS and MDA，apoptosis rate， and protein expression of Bax in glucose⁃induced HRVEC cells（P < 0.05），while increased SOD activity and expressions of Bcl⁃2 protein and miR⁃1247⁃3p（P < 0.05）in a dose⁃dependent pattern. Overexpression of miR⁃1247⁃ 3p reduced the levels of ROS and MDA，apoptosis rate，and protein expression of Bax in glucose⁃induced HRVEC cells（P < 0.05），while increased SOD activity and expression of Bcl⁃2 protein（P < 0.05）. Inhibition of miR⁃1247⁃ 3p reversed the effect of trillin on oxidative stress and apoptosis of HRVEC cells induced by high glucose（P < 0.05）. Conclusions Trillin may inhibit high glucose⁃induced oxidative stress and apoptosis in HRVEC cells by up⁃regu⁃ lating the expression of miR⁃1247⁃3p，alleviating cell damage.

Objective To explore the role of SFRP1/Wnt/β⁃catenin signaling pathway in cervical cancer stem cells. Methods Flow cytometry was performed to sort SP cells and NSP cells in SiHa cells. The in vivo and in vitro functional assays were conducted to verify the ability of proliferation，cloning，spheroidization and subcuta⁃ neous tumor formation between SP and NSP cells，and stem cell markers，including CD133，CD44 and Nanog， were detected by Western blot assay. After treatment with radiotherapy and chemotherapy，the ability of cell prolif⁃ eration and clone formation was determined. Protein expression of SFRP1，activation of Wnt/β⁃catenin signal were detected，expression of β ⁃catenin was detected by immunofluorescence assay，and the secretion of SFRP1 was detected by ELISA. Results The proliferation，clone formation，spheroidization and subcutaneous tumor formation abilities of SP cells were significantly stronger than those in NSP cells，and the level of stem cell markers of SP cells were significantly higher than those in NSP cells.After radiotherapy and chemotherapy，the proliferation and cloning abilities of SP cells were significantly stronger than those in NSP cells. The expression of SFRP1 in SP cells was significantly higher than that in NSP cells，while the concentration of secreted SFRP1 in SP cells was signifi⁃ cantly lower than that in NSP cells. Wnt/β⁃catenin pathway was activated in SP cells and β⁃catenin was significantly expressed in the nucleus of SP cells. Conclusion Cervical cancer stem cells may activate the Wnt/β⁃catenin path⁃ way by reducing the secretion of SFRP1，promoting their proliferation，cloning and subcutaneous tumor formation， and enhancing their resistance to radiotherapy and chemotherapy. 

Objective To explore the influence and mechanism of amlodipine on prostatic hyperplasia. Methods A total of 42 male mice randomly assigned to 6 groups（n = 7 in each group）. The rats were sacrificed， and the prostatic ventral lobes were removed and weighed. The volume of the lobes was measured to calculate the PI. Hematoxylin and eosin staining were used to observe the histopathological changes，and in situ VEGF expression was evaluated by IHC. Western blot was used to detect Bcl⁃2 and Bax expression levels，and RT⁃PCR was used to detect the AR expression level. Results Low⁃dose amlodipine significantly decreased the VEGF expression in the prostate tissues，in addition to decreasing the Bcl⁃2 levels and the Bcl⁃2/Bax ratio. Conclusions Amlodipine inhibited prostatic hyperplasia by downregulating VEGF，AR，Bcl⁃2 and the ratio of Bcl⁃2/Bax to induce apoptosis. 

Objective To observe the effects of bronchoalveolar lavage under bronchoscope on the efficacy， suPAR，sTREM⁃1 and CRP of bronchiectasis complicated with infection Methods A total of 107 cases of bronchi⁃ ectasis complicated with infection admitted in our hospital from September 2018 to January 2020 were selected. All patients were divided into control group（n = 51）and treatment group（n = 56）. The control group received routine bronchodilation and anti⁃infective therapy，and the treatment group was given bronchoalveolar lavage under broncho⁃ scope on the basis of control group. Results After treatment，the total clinical effectiveness rate of the observation group（94.64%）was significantly higher than that of the control group（76.47%）（P ≤ 0.05）；the levels of FEV1， FEV1/FVC，SaO2 and PaO2 in both groups were significantly higher than those before treatment，and the levels of FEV1，FEV1/FVC，SaO2 and PaO2 in the treatment group were significantly higher than those in the control group （P ≤ 0.05）；the expression levels of suPAR，sTREM⁃1 and CRP in both groups were significantly lower than those before treatment，and the expression levels of suPAR，sTREM⁃1 and CRP in the treatment group were significantly lower than those in the control group（P ≤ 0.05）. Conclusions Bronchoalveolar lavage under bronchoscope could not only effectively enhance the therapeutic effect in patients with bronchiectasis and infection，but also protect lung function，improve the level of blood gas，and reduce the inflammatory reaction，which is of clinical significance. 

Objective To explore the difference of clinical significance of modified neutrophil CD64 （nCD64）index and traditional nCD64 index in diagnosing infection. Methods We include 32 patients with auto⁃ immune diseases（AID），32 patients with hematologic tumors，59 patients in the emergency department and 41 healthy cases.Among which 76 were diagnosed with infection and 47 were non ⁃infected. Fluorescence intensity of CD64 on the peripheral blood lymphocytes，monocytes and neutrophils was detected by flow cytometry. The modi⁃ fied nCD64 index and the traditional nCD64 index were calculated and were used to make a ROC analysis. Results The modified nCD64 index and the traditional nCD64 index in infected patients were significantly higher than those in non⁃infected patients and healthy control（all P < 0.05）. The AUCs of modified nCD64 indexes and traditional nCD64 index were 0.782 and 0.770，respectively（all P < 0.05），and their optimal cut⁃off values were 1.00 and 4.74，respectively. The traditional nCD64 index only had good diagnostic efficacy in AID patients（AUC = 0.887， P < 0.05）. The modified index had preferable diagnostic efficacy in all three diseases（all AUCs > 0.75，P < 0.05）. Conclusion Both modified nCD64 index and the traditional nCD64 index have potential diagnostic efficacy in the differential diagnosis of infection，and their diagnostic values are best in AID. The modified nCD64 index is more valuable in auxiliary diagnosing infection in patients with fever symptom from emergency department or patients with hematological malignancies than the traditional nCD64 index. 

Objective To investigate the feasibility，safety and clinical application value of the oocyte vitrification technology in assisted reproductive technology（ART）. Methods The data of 113 cycles performed oocyte vitrification and intracytoplasmic sperm injection ⁃embryo transfer（ICSI ⁃ET）were analyzed retrospectively （oocyte freezing group），and 339 fresh ICSI⁃ET cycle performed in same period were selected randomly as the control group according to the ratio of 1∶3. The causes of oocyte vitrification were analyzed，the fertilization and clinical pregnancy outcomes were compared between the two groups. Results The reasons for oocyte vitrification included no viable sperm，failing to ejaculate，family emergency events on the day of oocyte retrieval and the wom⁃ an gets more oocytes（≥ 25 oocytes），etc. The recovery rate of oocytes was 85.73% after thawing. The rate of no available embryo cycle in the oocyte freezing group was significantly higher than that in the control group，while the cleavage rate and day 3（D3）′s high⁃quality embryo rate in the oocyte freezing group were significantly lower than those in the control group（P < 0.05）. There were no statistical differences in fertilization rate，available embryo rate on the D3，implantation rate，clinical pregnancy rate and the live birth rate between the two groups（P > 0.05）. Conclusion Vitrification of oocytes could obtain similar clinical outcomes to fresh oocytes. Moreover，vitrification of oocytes could be used as a remedy for no available sperm on the day of oocyte retrieval and a method of preserva⁃ tion of female fertility. 

Objective To investigate the value of Expiratory time constant（RCEXP）in the measurement of routine ventilatory pulmonary function test of school⁃aged children. Methods A total of 442 school⁃aged children received routine pulmonary function measurements in the Third Affiliated Hospital of Zhengzhou University，Luohe Second People′s Hospital and Luoyang Maternal and Children Health Hospital between August 2018 and August 2020 were selected. RCEXP differences between sexes，ages，and heights were investigated，and RCEXP values were calculated between groups with normal lung function and groups with various airway obstructions. Furthermore，the corresponding ROC curves were created. The relationships between RCEXP and pulmonary function parameters were investigated. Results RCEXP of girls was significantly lower than that of boys（P < 0.001），RCEXP of younger age group was significantly lower than that of older age group（P < 0.05），and RCEXP of lower height group was signifi⁃ cantly lower than that of higher height group（P < 0.05）；The RCEXP of girls was significantly lower than that of boys. The RCEXP of low age group was significantly lower than that of high age group and the RCEXP of low height group was significantly lower than that of high height group（P < 0.05）；RCEXP in the normal group was significant⁃ ly lower than that in the airway obstruction group（P < 0.001），and the cutoff value of RCEXP was 0.436. RCEXP in the normal group was significantly lower than that in the large airway obstruction group（P < 0.001），and the cutoff value of RCEXP was 0.575. In addition，RCEXP in the normal group was significantly lower than that in the small airway obstruction group（P < 0.001），and the cutoff value of RCEXP was 0.434；RCEXP was negatively correlated with FEV1/FVC%. Conclusion High RCEXP in school⁃aged children suggests airway obstruction. Airway obstruc⁃ tion，large airway obstruction，and minor airway obstruction were indicated by RCEXP values greater than 0.436 s，0.575 s，and 0.434 s，respectively. 

Objective To analyze the overall expression of serum lactate dehydrogenase（LDH），alkaline phosphatase（ALP），white blood cell（WBC）and high sensitivity C ⁃ reactive protein（hsCRP）in children with acute intestinal obstruction before and after surgical and non⁃surgical treatment，and to explore its clinical signifi⁃ cance. Methods Retrospectively analyzed the expression of serum LDH，ALP，WBC and C⁃reactive protein before and after treatment in 66 children with acute intestinal obstruction（33 cases with surgical treatment and 33 cases with non⁃ surgical treatment）in our hospital（November 2016⁃December 2019）. Results Comparison between surgical and non ⁃ surgical groups：the levels were significantly different before treatment in LDH，ALP and hsCRP but not in WBC ，The levels were significantly different after treatment in LDH but not in WBC，ALP and hsCRP. Conclusion LDH，ALP and hsCRP can reflect the severity of acute intestinal obstruction in chil⁃ dren. Compared with ALP，LDH and hsCRP can evaluate children with acute intestinal obstruction better. 

Objective Using the comprehensive complication index（CCI）score to assess the impact of breast reconstruction on complication severity after mastectomy. Methods 227 patients who underwent breast reconstruction after mastectomy from January 2017 to August 2020 in the plastic surgery department of the second affiliated hospital of Soochow university were collected. Data included demographic variables and clinical variables. Results 462 cases（27.3%）had major complications score（CCI ≥ 26.2），and 165 cases had minor complications score（CCI < 26.2）. Autologous valve reconstruction（OR = 4.69，P < 0.001），BMI ≥ 30 kg/m2（OR = 7.87，P < 0.001）， delayed reconstruction（OR = 9.13，P < 0.001）and preoperative radiotherapy（OR = 22.70，P = 0.006）were major risk factors for postoperative complications. In terms of hospitalization time，the CCI ≥ 26.2 group was significantly longer than the CCI < 26.2 group（13.5 vs. 8，P < 0.001）. Conclusions According to CCI score，Autologous valve reconstruction，BMI ≥ 30 kg/m2，delayed reconstruction，preoperative radiotherapy maybe the major postop⁃ erative complications，which are crucial for patients and surgeons when making breast reconstruction decisions. 

Objective To investigate the clinical value of vascular endothelial growth factor（VEGF）and angiopoietins 2（Ang ⁃ 2）in diagnosis of papillary thyroid carcinoma（PTC）and its concomitant cervical lymph node metastasis. Methods A total of 86 PTC patients confirmed by pathology（41 PTC patients without cervical lymph node metastasis and 45 PTC patients with cervical lymph node metastasis）were selected. The expression levels of VEGF and Ang⁃2 in PCT tissues and adjacent normal thyroid tissues were detected by MaxVisionTM method of immunohistochemical staining，and the above related clinical data were recorded. Results （1）The expression level of VEGF in PTC tissues was significantly higher than that in adjacent tissues（P < 0.05）. There was no differ⁃ ence in the expression level between PTC without cervical lymph node metastasis and PTC with cervical lymph node metastasis（P > 0.05）.（2）The expression of Ang⁃2 in PTC tissues was significantly higher than that in para⁃ carcinoma tissues（P < 0.05）. There was no difference in expression levels between PTC tissues without cervical lymph node metastasis and those with cervical lymph node metastasis（P > 0.05）. Conclusion VEGF and Ang⁃2 have certain clinical significance in assisting diagnosis of PTC. VEGF and ANG⁃2 may have no diagnostic value in predicting whether PTC associating with cervical lymph node metastasis. 

Objective To investigate the physical and neurological prognosis of extremely preterm infants （EPIs）at corrected age of 6 months in order to provide basis for parents and doctors to make treatment decisions. Methods Retrospectively，the follow⁃up data of EPIs who survived and discharged from our hospital from 2015 to 2019 within corrected age of 6 months were analyzed. Results （1）Totally，63 EPIs survived and discharged in our hospital，11 out of follow⁃ups after discharge，and then 52 included in this study. The gestational age at birth was 26.18 to 27.55 weeks，and the birth weight 840 to 1040 g.（2）The incidence of extrauterine growth retardation （EUGR）in weight was 75.00%，38.46%，23.07% the incidence of EUGR in head circumference was 78.84%， 23.08%，25.64%，and the incidence of EUGR in body length was 76.92%，40.38%，12.82% at discharge，the corrected gestational age of 40 weeks and corrected age of 6 months，respectively.（3）By Infant Neurological Inter⁃ national Battery（Infanib），transition 51.28% of them were scored between 49 ~ 65，a medium level and 48.72% higher than 66，a normal level，at the corrected age of 3 ~ 6 months.（4）By Gesell Development Scale the propor⁃ tion of mild to moderate abnormal development quotient（DQ）of gross motor movement，fine movement，adaptabil⁃ ity，language and personal social contact at the corrected age of 3 ~ 6 months were 32.43%，10.81%，32.43%， 10.81%，13.51%，respectively；Among them，21（56.75%）were scored > 75 in the five functional areas.（5）By Bayley Development Scale at the corrected age of 6 months，1 case（2.70%）was scored < 70 for MDI，3 cases （8.11%） < 70 in PDI，1 case（2.70%）< 70 in MDI and PDI，and 19 cases（51.35%）≥ 80 in both MDI and PDI. MDI or PDI with the score <80 was associated with long hospital stay and necrotizing enterocolitis（NEC）.（6）blindness or deafness was found. Conclusion At the corrected age of 6 months，40% ~ 50% of the premature in⁃ fants are in a mild abnormal state neurologically. Further standardized follow⁃up and early neurological intervention are needed for these children in order to reduce the occurrence of adverse neurological prognosis. 

Objective To compare the therapeutic effects between Mutiloc intramedullary nail and Philos plate in the treatment of Neer two⁃ or three⁃part proximal humerus fractures（PHF）. Methods Clinical data of 93 patients with Neer two⁃ or three⁃part PHF admittedin our hospital from January 2015 to June 2019 were analyzed retrospectively and were divided into Mutiloc intramedullary nail group（n = 30）and Philos plate group（n = 56） according to internal fixation procedures.The operation time，intraoperative estimate blood loss and postoperative complications were recorded，visual analogue scale（VAS）score，American Shoulder and Elbow Surgeons（ASES） score and Constant shoulder function score of the shoulder joint were used to evaluate the shoulder joint function at 12 weeks after operation and the last follow⁃up，and the above indexes were compared between two groups. Results The follow ⁃up time was（59.2 ± 26.5）weeks. Compared with the Philos plate group，the Multiloc intramedullary nail group had shorter operation time（P = 0.013）and less intraoperative blood loss（P＜0.001）. At the follow⁃up of 12 weeks after operation，the VAS score was lower（P＜0.001），ASES score and Constant score were higher （PASES = 0.011，Pconstant = 0.030），and the difference was statistically significant. At the last follow⁃up，there was no significant difference in VAS score，ASES score，Constant score and the incidence of complications between the two groups（Pvas = 0.308，PASES = 0.105，Pconstant = 0.15，Pcomplications = 0.818）. Conclusion Both Mutiloc intramedullary nail and Philos plate fixations couldachieve good short⁃term outcomesin the treatment ofNeer two⁃ or three⁃part PHF， and the former has shorter operation time，less intraoperative blood lossand better postoperative rehabilitation.

Objective To investigate the characteristics of anorectal manometrics of functional constipa⁃ tion（FC）patients with different genders，ages，and symptoms，and furthermore guide the application of this tech⁃ nique to better assist clinical diagnosis and treatment. Methods A retrospective analysis was carried out on 85 pa⁃ tients，enrolled from Gastrointestinal Movement Department of Geriatics Institute of Guangdong Provincial People′s Hospital，with FC and defecation disorders. Among them，32 were younger than 60 years old（non⁃elderly group）， 53 were 60 years old and above（elderly group）. Three ⁃dimensional high ⁃ resolution anorectal manometry（3DH ⁃ ARM）was used to measure anorectal pressure，and unravel characteristics of pressure changes in patients with FC of different gender，age，and different symptoms. Results 3DH⁃ARM showed that the resting pressure and maxi⁃ mum systolic pressure of the anal canal，anal laxation rate and anorectal pressure difference were significantly dif⁃ ferent between the elderly and non⁃elderly groups（P＜0.05）. Maximum systolic pressure of the anal canal，rectal pressure and anal laxation rate were observed significantly different with gender in non ⁃elderly group（P＜0.05）. While in theelderly group，significant gender difference was found in resting pressure and maximum systolic pres⁃ sure of the anal canal，anorectal pressure difference（P＜0.05）. Patients were further divided into Bristol 1 ~ 3 and Bristol 4 ~ 7 groups based on different stool characteristics. The rate of anal laxation of Bristol4⁃7 group was higher than that in Bristol1⁃3 group（P < 0.05），no significant difference was observed in other anorectal manomet⁃ rics（P > 0.05）. Conclusions FC in either age was caused by insufficient rectal propulsion and uncoordinated contraction of pelvic floor muscles. Furthermore，FC in older age was associated with a weaker rectal propulsion. whereas uncoordinated contraction of rectus lead to FC in non ⁃elderly patients. Contractility of the anal canal low anal laxation rate was present among non⁃elderly male with FC，while those non⁃elderly female patients feature elderly male patients，indicating the decreased pressure gradient could be a major cause of FC in the elderly male. 3DH ⁃ARM features good application value in the diagnosis and treatment of FC caused by defecation disorders， and was worth being applied in clinical practice. 

Objective To observe and analyze the effectiveness and safety of sacubitril⁃valsartan for dia⁃ stolic heart failure. Methods A total of 113 participants confirmed with diastolic heart failure and ejection fraction of 50% or more from the cardiovascular department of the 928th Hospital of the Chinese People′s Liberation Army and the First Affiliated Hospital of Hainan Medical University from June，2019 to June，2020，were selected and randomly assigned to control group（n = 57）andexperimental observation group（n = 56）. The control group received conventional anti ⁃ heart failure therapy. The treatment plan of the observation group replaced the ARB/ ACEI with sacubitril⁃valsartan instead. During the 6 month of observation and regular follow⁃up，we collected the baseline characteristics and clinical information before the research and analyzed the levels of blood pressure ， 6⁃min walking test（6MW）results，serum N⁃terminal pro⁃brain natriuretic peptide（NT⁃proBNP），AST，ALT， SCr，and potassium levels of the two groups. Meanwhile，cardiac ultrasonography related index of the two groups were tested and analyzed. Additionally，readmission rate，MACE and adverse reactions rate of the two groups were collected and compared. Results The clinical effective rate of the observation group was significantly higher than that of the control group. Greater reductions from baseline were found in patients who received sacubitril⁃ valsartan，including 6MW，NT⁃proBNP，LVEDVI，LVESVI，and mitral E/e′ ratio. The effectiveness of the drugs and the protection of the kidneys in the experimental group were also better than those in the control group. Readmission rate and adverse reactions rate were decreased in the experimental group. However，there were no statis⁃ tically differences in the blood pressure，liver function，serum potassium，EF%，LAVI levels and MACE between the two groups. Conclusions Sacubitril ⁃ Valsartan was effective and safe in the treatment of. clinical diastolic heart failure. 

Objective To investigate the clinical significance of evolocumab in patients with incomplete revascularization of multi ⁃vessel coronary artery disease complicated with hyperlipidemia. Methods The data of 128 patients with incomplete revascularization of multi⁃vessel coronary artery disease complicated with hyperlipid⁃ emia were retrospectively analyzed. Sixty⁃two patients received evolocumab therapy（the treatment group）and sixty ⁃six patients received conventional therapy（the control group）. All patients were followed up for 3 months. The total cholesterol，triglyceride，low⁃density lipoprotein cholesterol（LDL⁃C），LDL⁃C control rate，Seattle Angina Ques⁃ tionnaire（SAQ）were compared before treatment and 3 months after treatment between the two groups. Results Three months after treatment，the total cholesterol，triglyceride，LDL⁃C after treatment in study group were signifi⁃ cantly lower than those in the control group（P < 0.05），the LDL ⁃C control rate after treatment in the treatment group，and scores of 4 dimensions（stable state of angina pectoris，attack of angina pectoris，physical limitation， treatment satisfaction）in SAQ were significantly higher than those in the control group（P < 0.05）. Conclusions Evolocumab could rapidly change the level of blood lipid in patients with incomplete revascularization of multi ⁃ vessel coronary artery disease complicated with hyperlipidemia，significantly improve in the LDL ⁃C control rate， and could significantly relieve the angina symptoms. 

Objective Quantitative CT was used to investigate the relationship between skeletal muscle and fatty degree of L3 vertebral plane and sarcopenia in the elderly. Methods The CT images and clinical data of 200 patients who underwent abdominal CT scan in the 2nd Hospital of Hebei Medical University from January 2020 to August 2020 were retrospectively analyzed. According to the diagnostic criteria of Asian sarcopenia working group，they were divided into sarcopenia group（n = 16）and non⁃sarcopenia group（n = 184）.“X Section”software of GE ADW4.6 workstation was used to quantitatively measure the skeletal muscle and intermuscular fat of L3 verte⁃ bral plane，and the area and average CT value were recorded. The skeletal muscle area of L3 vertebral plane（L3 SMA），body surface area（BSA），L3 vertebral area and height were standardized in different ways. Chi⁃square test or Fisher′s exact test was used to compare the differences between enumeration data in the two groups. Independent sample t test or nonparametric rank sum test（Mann⁃Whitney U test）was used to compare the differences between the measurement data in two groups. Receiver operating characteristic（ROC）curve was used to analyze the skeletal muscle area of L3 vertebral plane and the effectiveness of different standardized results in the diagnosis of sarcope⁃ nia. Results There were 16 cases（8.00%）diagnosed as sarcopenia，including 6 males（3.00%）and 10 females （5.00%）. There was no significant difference in gender，age between the two groups（P＞0.05）. BMI in sarcope⁃ nia group was lower than that in non⁃sarcopenia group，The difference was statistically significant（P＜0.05）. The L3 SMA，average density of total skeletal muscle in L3 vertebral plane（L3 SMD）and muscle space area of the non⁃ sarcopenia group were higher than those of the sarcopenia group，but only L3 SMA had significant difference between the two groups（P＜0.05）. ROC curve analysis showed that L3 SMA was standardized by the BSA（L3 SMB）had the highest diagnostic efficiency for sarcopenia，with area under the curve of 0.802，sensitivity of 73.9% and specificity of 75.0% . Conclusions The incidence of sarcopenia was 8.00% in the elderly. CT quantitative measurement of skeletal muscle has high reliability. The sensitivity and specificity of L3 SMB in the diagnosis of sarcopenia were 73.9% and 75.0%，respectively. The optimal critical values for male and female sarcopenia were 435.15 cm2 /m2 and 365.08 cm2 /m2，respectively. 

Objective To evaluate the diagnostic value of multi⁃slice spiral CT（MSCT）enhanced scan⁃ ning in diagnosing the serous borderline ovarian tumor（S⁃BOT）and mucinous borderline ovarian tumor（M⁃BOT） based on the pathological diagnosis. Methods The preoperative imaging，clinical and pathological data of 39 cases of S ⁃BOT and 46 cases of M ⁃BOT confirmed by surgical pathology were retrospectively analyzed in our hospital， and the MSCT manifestations of the tumors were analyzed and compared. Results Taking the pathological results as the gold standard，MSCT enhanced scanning had a sensitivity of 87.2%，a specificity of 89.1%，an accuracy of 88.2%，and a Kappa value of 0.763 in the diagnosis of S⁃BOT and M⁃BOT. S⁃BOT and M⁃BOT had statistically significant differences in chamber distribution，homogenization of cystic fluid，thickening of the cyst wall/septum， maximum diameter of the mass，the CT value and the enhancement degree of the solid component（P＜0.05）. S⁃BOT mostly appeared as a single or double chamber cyst，M ⁃BOT showed mostly multi ⁃chamber performance；S ⁃BOT cystic fluid density was more homogenous than that of M⁃BOT；M⁃BOT was more common than S⁃BOT in the thick⁃ ening of the wall / septum；The maximum diameter of S⁃BOT was smaller than that of M⁃BOT；the solid component CT scan value of S⁃BOT was lower than that of M⁃BOT；both S⁃BOT and M⁃BOT showed delayed enhancement． The enhancement rate of S⁃BOT in each phase was higher than that of M⁃BOT. Hemorrhage and calcification had no statistical difference between the S ⁃BOT and the M ⁃BOT（P＞0.05）. Multivariate logistic regression showed that the characteristics of the chamber distribution，thickening of the wall/septum and the CT value of the solid compo⁃ nent had independent predictive value in identifying S⁃BOT and M⁃BOT. Conclusion MSCT enhanced scanning had a good consistency between the diagnosis of S⁃BOT and M⁃BOT and pathological diagnosis，and it may be used as an effective approach for the differential diagnosis of S⁃BOT and M⁃BOT. 

Objective To study the effect of prednisone combined with astragalus injection on the positive detection rate of antineutrophil cytoplasmic antibody（ANCA）in systemic lupus erythematosus. Methods A total of 86 patients with systemic lupus erythematosus who had been treated in our hospital from May 2017 to June 2020 were selected as research objects，and they were divided into two groups according to a random number table，with 43 in each group. The control group was treated with prednisone，while the study group was treated with astragalus injection. The efficacy，adverse reactions，recurrence rate，pretherapeutic and post⁃therapeutic positive detection rate of ANCA，SLEDAI score，24⁃hour urine protein，and inflammatory cytokines were compared between the two groups. Results As compared with the control group（76.74%），the study group（95.35%）had a higher total efficacy of treatment（P < 0.05）. As compared with the control group，the study group had lower SLEDAI scores and 24⁃hour urine protein levels after treatment（P < 0.05）. As compared with the control group，the study group has lower levels of IL⁃10 and β⁃arrestin1 but higher IL⁃12 levels（P < 0.05）. As compared with that in the control group （30.23%），the incidence of adverse reactions was lower in the study group（6.98%）（P < 0.05）. As compared with the control group（23.26%），the study group（4.65%）had a lower recurrence rate（P < 0.05）. As compared with that in the control group（27.91%），the positive detection rate of ANCA was lower in the study group（6.98%） （P < 0.05）. Conclusions Prednisone combined with astragalus injection in the treatment of patients with systemic lupus erythematosus can effectively reduce the recurrence rate and regulate immune indexes ，and it has less adverse reactions. 

Objective By combining zhuangyi acupoint therapy with press⁃needle，to facilitate spontane⁃ ous delivery of pregnant women at term and reduce adverse outcomes. Methods A random number table was used to divide 120 eligible full⁃term pregnant women into two groups，A and B，with 60 cases in each group. For two days，Group A received Zhuang doctor acupoint therapy combined with pressing acupuncture ，while Group B received low⁃dose oxytocin. Results After 2 days of intervention，the cervical score of group A（5.7 ± 1.5）was significantly higher than the score of group B（3.3 ± 1.0）；the quantitative symptom score of group A（4.6 ± 1.2） was significantly higher than the score of group B（2.3 ± 0.9）；The interleukin⁃6（IL⁃6）value（4.2 ± 1.4）of group A was significantly higher than the IL ⁃ 6 value of group B（1.8±0.7），and the differences in the data of the three groups were statistically significant. The occurrence of adverse reactions was not statistically significant in groups A and B（P > 0.05）. Conclusion The acupuncture therapy of Zhuang medicine combined with acupuncture to promote cervical ripening is simpler，safer and more effective than traditional oxytocin.This method may be effec⁃ tive by increasing IL⁃6 levels. 

Objective To explore the application value of Shenqi Jiangtang granules combined with lira⁃ glutide for type 2 diabetic patients who do not respond to metformin therapy. Methods A total of 150 patients with type 2 diabetes who received treatment in our hospital from April 2017 to October 2019 were divided into three groups：A，B，and C，with 50 subjects in each group. All patients received metformin，group A was given liraglu⁃ tide，group B was given Shenqi Jiangtang granules，and group C was given Shenqi Jiangtang granules combined with liraglutide. The blood glucose levels，efficacy，visfatin，pancreatic islet function，TCM syndrome scores and adverse reactions of the three groups were compared before and after the treatment. Results After treatment，the blood glucose level of group C was significantly lower than that of group A and group B（P < 0.05）. The total effec⁃ tive rate of group A、B and C was 78%，82% and 96%，respectively. The total effective rate of group C was signifi⁃ cantly higher than that of group A and group B（P < 0.05）. The level of visfatin in group C was significantly lower than that in group A and group B（P < 0.05）. The HOMA⁃β of group C was significantly higher than that of group A and group B（P < 0.05）. The TCM syndrome score of group C was significantly lower than that of group A and group B（P < 0.05）. No serious adverse reactions were found in the three groups（P > 0.05）. Conclusion Shenqi Jiangtang granules combined with liraglutide could significantly improve the efficacy without increasing adverse drug reactions，and could be applied to type 2 diabetes patients who do not respond to metformin. 

With the increasing prevalence of chronic kidney disease in China and the world，accurate assessment of renal function has become a hot topic of the day. Glomerular filtration rate is the most accurate meth⁃ od to evaluate renal function. Therefore，this paper reviews the relevant literature recentlyand presentsa systematic review on the development，advantages and disadvantages of glomerular filtration rate evaluation formula and its applicability in different populations，mainly including patients suffering from cancer，diabetes and heart failure， and elderly patients. 

Objective To review the experience of enhanced recovery after surgery（ERAS）in a tertiary hospital，and to analyze the influence factors of ERAS on treatment outcome of patients. Methods Descriptive analyses of the overall implementation process of ERAS，longitudinal and horizontal comparative analyses of the changes of the average hospitalization days，average hospitalization costs in composition and operative complica⁃ tions of patients before and after the full implementation of ERAS from 2018 to 2019. Results Overall，the average hospitalization days，costs and the incidence of operative complications of patients with ERAS were significantly lower than those before the implementation of ERAS，which were decreased by 0.7 days，1.2% and 41.5%，respec⁃ tively. Among the 12 representative types of operations，compared with non⁃ERAS patients in 2018 and 2019，the hospitalization days of stay，average hospitalization costs，drug costs，consumable materials and the incidence of surgical complications of ERAS patients were significantly lower than those of non ⁃ ERAS patients in 2018 and 2019. Conclusion The promotion of ERAS diagnosis and treatment mode can shorten the hospitalization days of surgical patients，reduce medical expenses and operative complications，and be beneficial to the improvement of economic and social benefits of the hospital.