Objective To investigate the effect of BX⁃912（PDK⁃1 Specific inhibitor）on bone destruction in mice with bone metastases in prostate cancer. Methods In vitro experiment：BX⁃912 was used to intervene in mouse prostate cancer cells（RM⁃1）with increasing concentrations，and the effect of BX⁃912 on the activity of RM⁃1 was detected by Cell Counting Kit⁃8（CCK⁃8），The effect of BX⁃912 on RM⁃1 migration was observed through cell scratch experiment，the effect of BX⁃912 on the independent viability of RM⁃1 was studied by cell cloning experi⁃ ment. In vivo experiment：30 mouse model of prostate cancer bone metastasis were randomly divided into three groups： the control group，the low concentration group，and the high concentration group. Each group was injected with the corresponding concentration of BX⁃912. After 14 days，the tumor was detected by micro⁃CT and weighed after resection. Results CCK⁃8 results showed that the BX⁃912 concentration at 0.625 μmol/L or below had no signifi⁃ cant effect on the activity of RM⁃1（P > 0.05），while the BX⁃912 concentration at 1.25 μmol/L or above had signif⁃ icant inhibitory effect on RM⁃1（P < 0.05）. The scratch test showed that BX⁃912 could significantly inhibit the mi⁃ gration of RM⁃1（P < 0.05）. The clone experiment showed that BX⁃912 significantly inhibited the clone formation rate of RM⁃1（P < 0.05）. BX⁃912 can significantly inhibit the growth of prostate cancer and inhibit the bone destruction in the mouse model of prostate cancer bone metastasis（P < 0.05）. Conclusion BX⁃912 can inhibit the proliferation，migration and cloning of RM⁃1 and ameliorate the bone destruction in the mouse model of bone metastasisin prostate cancer，which has potential significance for the treatment of bone metastasisin prostate cancer.

Objective To investigatethe effect and mechanism of anal lotion on repairing wounds inanal fistula model rats. Methods Forty rats were randomly divided into the normal control group，model group，anal lotion group and positive control group，with 10 rats in each group. After the 14⁃day experiment，the wound healing rate was calculated by taking pictures of the wound with a fixed focal length，and angiopoietin⁃I（Ang⁃I），angiopoi⁃ etin⁃Ⅱ（Ang⁃Ⅱ），vascular endothelial growth factor（VEGF），prostaglandin E2（PGE2），interleukin⁃2（IL⁃2） and interleukin ⁃ 1β（IL ⁃ 1β）were detected by enzyme ⁃linked immunoassay（ELISA）. The pathological changes were detected by HE staining. MRNA expression of AMPK，mTOR and Aktwasdetected by RT⁃PCR. Protein expres⁃ sion of AMPK，mTOR and Aktwasdetected by Western blot assay. Results Anal lotion could significantly im⁃ prove the wound healing ratein anal fistula rats，decreased the expression of PGE2，IL⁃1β andIL⁃2，increased the expression of Ang⁃Ⅰ，Ang⁃Ⅱand VEGF，as well as promoting the mRNA and protein expression of AMPK，mTOR andAkt. HE staining results showed that the neonatal epidermal creeping，capillary neovascularization，dense and orderly arrangement of collagen fibers，neonatal hair follicles and other more complete or maturing skin appendages were seen in the wounds of rats in the anal lotion group. Conclusion Anal lotion can inhibit the inflammatory reaction of anal fistula in rats，promoting angiogenesis and wound healing，which may be achieved by regulating the AMPK/mTOR/Aktsignal pathway.

Objective To explore the effect of Cyclin L1（CCNL1）on the biological behaviors and regula⁃ tory mechanism of human trophoblast cells. Methods We used HTR ⁃ 8/SVneo as the model and divide it into CCNL1 overexpression group，CCCNL1 overexpression control group，CCNL1 interference group 1，CCNL1 inter⁃ ference group 2，CCNL1 interference group 3 and interference control group. The mRNA expression level of CCNL1 was detected by Quantitative Real⁃time PCR（qPCR）；the protein expression level of CCNL1 by Western Blot and cell proliferation by CCK⁃8. Cell migration and invasion were detected by Transwell assay and cell cycle and cell apoptosis by flow cytometry. Results Overexpression CCNL1 significantly decreased the migration and invasion ability of trophoblast cells（P < 0.05），the proliferation ability of trophoblast cells（P < 0.05），and the number of S cells（P < 0.05）. Interfered CCNL1 significantly increased the migration and invasion ability of tropho⁃ blast cells（P < 0.05），and the proliferation ability of trophoblast cells（P < 0.05）. Conclusion CCNL1 gene may affect placental function by regulating the migration，invasion and proliferation of trophoblast cells.

Objective To investigate the expression of lncRNA HOXA⁃AS2 in pancreatic cancer tissues， and the effect of silencing this gene on the proliferation and invasiveness of pancreatic cancer cells. Methods A total of 97 cases of patients with pancreatic cancer underwent radical surgery in our hospital were selected from August 2015 to August 2020. The human pancreatic cancer PANC⁃1 and AsPC⁃1 cells were cultured and were divide into si⁃HOXA⁃AS2 group，si⁃Con group and blank group，respectively，transfected with the interference sequence，negative control sequence and no treatment. RT⁃PCR was used to detect the expressions of HOXA⁃AS2 in pancreatic cancer and adjacent tissues，as well as the expression of HOXA⁃AS2 of cells in different groups. CCK⁃8 and Transwell methods were used to detect cell proliferation activity and cell invasiveness. Results The expression level of HOXA⁃AS2 in pancreatic cancer tissue was（2.21 ± 0.20），which was higher than（1.03 ± 0.14）in adja⁃ cent tissues，and the difference was statistically significant（t = 48.030，P < 0.001）. The differences of the expres⁃ sion levels of HOXA⁃AS2 in pancreatic cancer tissues between different TNM stages，degree of differentiation and whether lymph node metastasis were statistically significant（P < 0.05）. In PANC⁃1 and AsPC⁃1 cells，compared with the si⁃Con group and the blank group，the expression level of HOXA⁃AS2 in the si⁃HOXA⁃AS2 group was sig⁃ nificantly decreased（P < 0.05），and the absorbance OD values at 24，48，72 and 96 h in the si ⁃HOXA ⁃AS2 group were lower than those in the si⁃Con group and the blank group（P < 0.05），and the number of invasive cells in the si⁃HOXA⁃AS2 group was lower than that in the si⁃Con group and the blank group（P < 0.05）. Conclusion The expression level of HOXA⁃AS2 is increased in pancreatic cancer tissues and in correspondance to clinical indi⁃ cators of malignant progression. Silencing its expression can reduce cell proliferation and inhibit cell invasion.

Objective To explore the efficacy and safety of re⁃induction regimen of decitabine in combina⁃ tion with CAG for patients with acute myeloid leukemia after failed standard induction chemotherapy in the first course. Methods Eighty⁃four patients with failed standard induction chemotherapy in the first course included in the study were divided equally into three groups：DCAG，IA3+7，and IDCB，treated with the regimens of DAC combined with CAG，IA（3+7）and Intermediate⁃dose Ara⁃C⁃based chemotherapy（IDCB）including IA3+3 and CLAG，respectively. After re⁃induction therapy，the clinical efficacy and adverse reactions were compared among the 3 groups. Results No significant difference in the complete remission（CR）was found between the three groups （P = 0.091），but the rates of overall response（OR）（complete remission（CR）and partial remission（PR））in the DCAG group was significantly higher than the IDCB group（P = 0.049）. The median duration of thrombocytopenia in the DCAG group was significantly shorter than IA3+7 and IDCB groups（P = 0.001；P = 0.023）. No significant difference in the median time of neutropenia was found among the 3 groups（P = 0.061）. The incidence rates of lung infection and febrile neutropenia in the DCAG group were significantly lower than the IA3+7 group（P = 0.018； P = 0.004）. The 2⁃year OS of the DCAG，IA3+7 and IDCB groups was 69.4%，43.8% and 33.2%，respectively， and the 2⁃year RFS was 70.6%，50.3% and 41.4%，respectively. The OS and RFS of DCAG were significantly longer than the IA3+7 and IDCB groups（P = 0.038 and P = 0.023 for OS；P = 0.016 and P = 0.048 for RFS）. Conclusions DCAG regimen may represent a better alternative option with good response and safety for AML patients failing in the first course of standard induction chemotherapy.

Objective To investigate the prognosis of diabetes mellitus（DM）patients complicated by postherpetic neuralgia（PHN）and analyze the risk factors affecting the poor prognosis of PHN patients. Methods Fifty⁃five patients with DM complicated with PHN in the department of pain of our hospital were enrolled as an exposed group（group D）and another 56 patients with non⁃DM PHN were set as an unexposed group（group N） during the same period. Both groups received the oral drug therapy combined with the thoracic paravertebral therapy by ultrasound ⁃guided pulsed radiofrequency. The two groups were compared in terms of the scores of Numerical Rating Scale（NRS），Hospital Anxiety and Depression Scale（HADS），Self⁃rating Scale of Sleep（SRSS）before and after treatment. The amount of consumed analgesic medication and the incidence of total adverse reactions in the two groups were recorded. The Logistic regression analysis was used to determine the factors affecting the prog⁃ nosis of the PHN patients. Results The scores of NRS，HADS，SRSS in both groups after treatment decreased significantly as compared to the scores before treatment（P < 0.05）. Compared with group N，the scores of NRS， HADS，SRSS in group D were significantly higher than those in group N（P < 0.05）at all the time points but 1 week after treatment. The amount of consumed analgesic medication and the incidence of total adverse reactions in group D were significantly higher than those in group N（P < 0.05）. The Logistic regression analysis showed that the risk of poor prognosis in the PHN patients complicated with DM was 3.16 times higher than that in non⁃DM patients（95%CI：1.28 ~ 7.80，P < 0.05）. Besides，the duration of postherpetic neuralgia was significantly associ⁃ ated with an increased risk of poor diagnosis（95%CI：1.14 ~ 1.85，P < 0.05）. Conclusion DM and duration of PHN are important risk factors of poor prognosis. PHN patients complicated with DM have severer clinical symp⁃ toms such pain，depression，anxiety，and sleep，which increases the consumption of analgesics.

Objective To observe the effect of pars plana vitrectomy（PPV）combined with or without in⁃ ner limiting membrane peeling in the treatment of refractory diabetic macular edema（DME）and its effect on visual function. Method We conducted a retrospective analysis of 40 patients with refractory DME diagnosed in our hos⁃ pital from May 2018 to May 2020 who received PPV combined with or without inner limiting membrane peeling， including 20 patients received PPV combined with inner limiting membrane peeling as the combination group，and 20 patients received PPV combined without inner limiting membrane peeling as the control group. The best correct⁃ ed visual acuity（BCVA），central macular thickness（CMT），retinal mean sensitivity（RMS），fixation stability and complications were compared between the two groups. Result In the last follow⁃up，BCVA of the two groups was significantly higher than that before operation（P < 0.05），and BCVA of the combination group was better than that of the control group（P < 0.05）. The CMT of the combined group and the control group decreased 1 month after the operation（P < 0.05）；at 1，3 and 6 month，the CMT in the combination group was thinner than that in the control group（P < 0.05）. The RMS of the combined group increased after surgery（P < 0.05），and the RMS of the contralateral eye in the combination group was better than that in the surgical eye 6 month after operation（P < 0.05）. After treatment，the fixation stability of the combined group was improved，but the difference was not statis⁃ tically significant（P > 0.05）. Conclusion In the treatment of refractory DME，PPV combined with inner limiting membrane peeling can effectively improve BCVA and reduce CMT and improve fixation stability to a certain extent.

Objective To explore the clinical effect of platelet rich plasma（Platelet rich plasma PRP）for the treatment of flexor tendon stenosing tenosynovitis. Methods From January 2017 to December 2019，65 patients with flexor tendon stenosing tenosynovitis were diagnosed and treated at our hospital using the random number table method，and were randomly divided into 32 cases in observation group and 33 cases in control group. The observa⁃ tion group received PRP injections，while the control group received triamcinolone acetonide injections. Before and after treatment，finger range of motion and visual analogue pain score（VAS），Quinnell score，total effective rate of treatment，and complications were assessed. Results There was no statistically significant difference in VAS， Quinnell，or complications between the two groups before and after treatment（P > 0.05）. At 4 and 8 weeks after treatment，the VAS，range of motion of finger joints，Quinnell score after treatment，and total effective rate were compared between the two groups，and the differences were statistically significant （P < 0.05）. Conclusion Platelet rich plasma（PRP） is an effective treatment for flexor tendon stenosing tenosynovitis，which can effectively alleviate the clinical symptoms，shorten the course of disease，and has no risk of complications. It is a treatment that should be promoted.

Objective To study the clinical prognosis and pathological characteristics of patients with soft tissue tumors and bone tumors in the foot and ankle. Methods We selected 120 patients with foot and ankle soft tissue tumors and bone tumors admitted to our hospital，and analyzed the clinical pathological characteristics of the subjects and related factors affecting clinical prognosis. Results 69 cases were followed up after operation，50 cases of soft tissue malignant tumors，19 cases of bone malignant tumors. The 1⁃year survival rate of patients with bone malignant tumors was 75.36%，which was significantly higher than the 3⁃year of 55.07% and 5⁃year of 55.07%. Univariate analysis found the 5⁃year survival rate of 69 patients with foot and ankle malignant tumors was affected by adjuvant treatment，functional status and tumor size（P < 0.05），but gender，age，surgical method，tissue type， and location of tumor had no significant impact on the prognosis of patients（P > 0.05）；Multivariate analysis found that tumor size and functional status were independent risk factors affecting the survival rate of 69 patients with foot and ankle malignant tumors（HR = 7.251，6.194，P = 0.005）. Conclusion Benign soft tissue tumors of the foot and ankle are mostly hemangioma，while malignant tumors are mostly synovial sarcoma；tumor size and functional status are the main factors for the poor prognosis of patients with malignant tumors of the foot and ankle ，and patients with malignant tumors > 5 cm have a worse clinical prognosis.

Osbjective To investigate the effect of pre⁃hospital delay on cardiac function after primary intervention for acute anterior wall myocardial infarction. Methods Fifty ⁃ seven patients with acute anterior wall myocardial infarction who received primary interventions in our hospital from June 2018 to March 2019 were divided into a long⁃delayed group and a short⁃delayed group according to the pre⁃hospital time. The two groups were compared in terms of cardiac function and global Longitudinal Strain⁃average GLS⁃AVG on the second day and 1 week after the intervention as well as GLS⁃AVG 6 months after intervention. Results There were no significant differences in LVEDD，LVEDVI and LVESVI on the second day between the two groups（P > 0.05）. LVEF on the second day was significantly different as well（P = 0.02）. One week after the operation，there was no significant difference in LVEDD，but LVEDVI and LVESVI were significantly lower in the short ⁃ delayed group than in the long⁃delayed group，and LVEF was significantly higher than in the long⁃delayed group（P < 0.05）. There was a statistically difference between the two groups（P = 0.046）in GLS⁃AVG. During the 6⁃month follow⁃up，there was still significant difference in the cardiac function index between them（P < 0.05）. Conclusion Reducing the pre⁃ hospital delay and revascularization as soon as possible can improve the left ventricular systolic function in patients with acute anterior wall myocardial infarction within 1 week and 6 month

Objective To investigate the correlation between the efficacy of computer ⁃assisted cognitive training（CCT）for mild cognitive impairment and Lp ⁃ PLA2 and ApoEε4 genes，and discuss the mechanism of their related action. Methods Among the patients confirmed as mild cognitive impairment，55 cases were randomly assigned to the experimental group and 35 cases to the control group. The interventions were CCT for 3 months，3 times per week，20 minutes each time. The neuropsychological scale was used to evaluate the serum Lp⁃PLA2 level and apoEε4 before and after the treatment，and to evaluate the correlation between them. Results The level of cognitive assessment in the experimental group was significantly higher than that in the control group（P＜0.05）. The level of cognitive changes in the experimental group was similar to that of Lp⁃PLA2（P＜0.05）showed signifi⁃ cant negative correlation. The cognitive change level of ApoEε4 carriers was significantly higher than that of non⁃ carriers（P＜0.05）. Whether ApoEε4 is carried or not，the level of Lp⁃PLA2 has statistical difference（P＜0.05）. Conclusion CCT is effective for patients with mild cognitive impairment，and the results are influenced by APOEε4 gene and the level of Lp ⁃PLA2，which are not completely independent，and may synergistically act on the process of cognitive decline.

Objective To observe the abnormal blood pressure in children after operation on coarctation of aorta （CoA），and explore the relationship between abnormal blood pressure and endothelial disfunction. Methods We enrolled 23 children with CoA who underwent surgery between January and October in 2010 in Guangzhou Women and Children′s Medical Center and 20 health children. According to blood pressure（BP）results during an 8⁃ year follow ⁃ up ，children with CoA were divided into a post ⁃ operative abnormal blood pressure group（CoA BP（+）group）and a post⁃operative normal blood pressure group（CoA BP（⁃）group）. All participants underwent measurements of systolic blood pressure（SBP），diastolic blood pressure（DBP），echocardiography，flow⁃ mediated dilation（FMD）of the right brachial artery，and serum soluble E⁃selectin（sE⁃selectin）at baseline（1 week after surgery）and during an 8⁃year follow⁃up（after surgery）. Results We collected data from the 8⁃year follow⁃up of 17 children with CoA and 15 health children. 41.18% of the children with CoA had abnormal blood pressure， amongst which 5 had elevated blood pressure and 2 met the hypertension standard. There were no differences in DBP among there groups at baseline and 8⁃year follow⁃up（P > 0.05）. Both CoA BP（+）children and CoA BP（-）children had decreased FMD and higher serum levels of sE⁃selectin than health children at baseline and during the 8⁃year follow⁃up（P < 0.05）. And CoA BP（+）children had decreased FMD and higher serum levels of sE⁃selectin than CoA BP（-）children at baseline and 8⁃year follow⁃up（P < 0.01）. Conclusion Some children after operation on CoA had abnormal BP during a long⁃term follow⁃up. Compared with children with normal BP after CoA surgery，chil⁃ dren with abnormal BP after CoA operation had more obvious vascular endothelial dysfunction. 

Objective To investigate the effect of uterine artery embolization on ovarian function of patients with scar pregnancy. Methods From January 2012 to December 2016，patients with uterine scar pregnancy aged less than 40 years in Handan central hospital were randomized into the uterine artery embolization group （study Group）and other methods treatment group（control group），92 cases in each group. The patients were followed up for 3 years. The menstrual cycle length，follicle stimulating hormone（FSH），estradiol（E2）and the number of ovarian antral follicles of the two groups were regularly monitored and analyzed. Result In UAE group， the number of menstrual cycle，FSH，E2 and ovarian antral follicles were（30.12 ± 3.05）days，（5.10 ± 1.08）IU/L， （55.00 ± 11.07）pg/mL and（5.89 ± 1.47）in the 6th month，（29.97 ± 1.98）days，（5.24 ± 1.14）IU/L，（58.35 ± 12.23）pg/mL and（5.65 ± 1.67）in the 12th month，（30.17 ± 1.73）days，（5.43 ± 1.25）IU/L，（57.67 ± 10.87）pg/mL and（5.51 ± 1.67） in the 24th month，and（29.78 ± 2.1）days，（5.42 ± 1.29）IU/L，（59.00 ± 12.07）pg/mL， and（5.61 ± 1.65）in the 36th month after treatment，respectively. There was no significant difference in each period （all P > 0.05）. Conclusion Uterine artery embolization in the treatment of scar pregnancy and other treatment methods will not cause ovarian function and menstrual cycle changes in 3 years.

Objective To evaluate the efficacy and safety of endoscopic papillary balloon dilation （EPBD）combined with endoscopic sphincterotomy（EST）for the treatment ofnon ⁃ dilated extrahepatic bile duct stones（Non⁃DEBDS）. Methods The clinical data of patients with dilated extrahepatic bile duct stones（DEBDS） and NDEBDS treated with endoscopic retrograde cholangiopancreatography（ERCP）were collected and analyzedto compare the efficacy and safety of ERCP between the two groups. According to the therapies they received，the patients with non⁃dilated extrahepatic bile duct stones were divided into EPBD group（n = 75），minor EST group （n = 75），and minor EST combined with EPBD（EST⁃EPBD）group（n = 87），and the efficacy and safety of the three groups were evaluated. Results The DEBDS group was less likely to develop with hyperamylasemia（HP）and post⁃ERCP pancreatitis（PEP）than the Non⁃DEBDS group within one week after surgery（P < 0.05），some cases developed with mild or moderate pancreatitis，but none with severe conditions. All the treatment methods were effective for clearing the stones completely in the non⁃DEBDS patients（P > 0.05）. The pairwise comparison results showed that the incidences of HP and PEP in the EPBD group were both higher than in other groups，respectively （P < 0.05）. Conclusion The endoscopic papillary balloon dilation combined with endoscopic sphincterotomy achieves a better effect in treatment of non⁃dilated extrahepatic bile duct stones，with lower incidences of PEP and HP. It is of higher value clinically in terms of reduced operation and surgical costs.

Objective To compare the Effects of dexmedetomidine and propofol on diaphragm function and weaning from mechanical ventilation of patients. Methods One hundred and forty patients who received mechanical ventilation were randomly divided into dexmedetomidine group（n = 72）and propofol group（n = 68）. On the basis of conventional treatment and used butorphanol for analgesia，dexmedetomidine and propofol were added to the treatment respectively.Evaluation of diaphragm function by ultrasonography ，The changed of the diaphragm function such as diaphragmatic thickness at the end of expiration ，diaphragm thickening fraction ， diaphragmatic displacement and the Success rate of first weaning and mechanical ventilation time were compared and analyzed. Results There was a significant difference in diaphragm function during first spontaneous breathing trial change between the two groups. The diaphragmatic thickness at the end of expiration，diaphragm thickening fraction and diaphragmatic displacement in dexmedetomidine group were significantly higher than those in propofol group（P < 0.05）. The the success rate of first weaning in dexmedetomidine group were significantly higher than those in propofol group（P < 0.05）. The mechanical ventilation time in dexmedetomidine group were significantly lower than that in propofol group（P < 0.05）. Conclusion Compared with propofol，dexmedetomidine has less effect on diaphragm function in patients with mechanical ventilation，can improve the weaning success rate of mechanical ventilation and shorten the duration of mechanical ventilation.

Objective To investigate and analyze the effect of intracavitary infusion of elemene combined with nedaplatin on clinical efficacy and quality of life of patients with malignant ascites. Methods Eighty ⁃five patients with malignant ascites from February 2014 to January 2017 were randomly divided into observation group （n = 44）and control group（n = 41）. The control group was given intracavitary injection of nedaplatin and dexa⁃ methasone and the observation group was treated with elemene injection on the basis of the control group. The two groups were compared in terms of remission of pleural and ascites，changes in quality of life，adverse reactions and living conditions. Results The total effective rate of relieving pleural and ascites in the observation group was significantly higher than that in the control group（P < 0.05）. After treatment，the scores of the six dimensions of general health，emotional and social functions，physiological functions，vitality，physiological functions and men⁃ tal health in relation with the quality of life in the observation group were all significantly higher than those in the control group（P < 0.05）. The living conditions of patients in the observation group was significantly better than that in the control group（P < 0.05）. Conclusion Elemene combined with nedaplatin intracavitary injection in the treatment of malignant ascites is more effective clinically，more tolerable for the patients and conducive to their improved quality of life. Moreover，it can significantly improve their long⁃term survival and prognosis. Therefore it is worthy of clinical application.

Objective To explore the application value of three ⁃dimensional computed tomography ⁃lym⁃ phography（3D CT ⁃ LG）in the identification and classification of lymphatic drainage pathway of breast cancer. Methods 3D CT ⁃LG was performed in 100 cases diagnosed as breast cancer to reconstruct and distinguish the type of breast lymphatic drainage pathway before operation. Intraoperative methylene blue combined with indocya⁃ nine green was used to verify the accuracy of 3D CT⁃LG. Results A total of 93 cases（93%）could be classified by 3D CT⁃LG：63 cases（65.6%）as type Ⅰ（single lymphatic connected with one sentinel lymph node）；12 cases （13.5%）as type Ⅱ（single lymphatic connected with multiple sentinel lymph nodes）；4 cases（5.2%）as type Ⅲ （multi⁃root lymphatic connected with a sentinel lymph node）and14 cases（15.6%）as type Ⅳ（multi⁃root lymphatic connected with multiple sentinel lymph nodes）. Ninety⁃five cases could be classified by tracer method（95%）：62 cases（65.3%）as typeⅠ；12 cases（12.6%）as type Ⅱ；6 cases（6.3%）as type Ⅲ and 15 cases（15.8%）as type Ⅳ. Kappa value in consistency analysis was 0.912（P < 0.05）. Conclusion 3D CT⁃LG can accurately identify lymphatic drainage pathway of breast cancer and plays an important role in the classification.

Objective To establish a predictive model based on shear wave elastography combined with two ⁃dimensional ultrasound，and to explore its predictive value for central lymph node metastasis in papillary thyroid carcinoma（PTC）. Methods A total of 501 patients with PTC were selected，and the two ⁃dimensional sonographic features and shear wave elastography of the nodules were retrospectively analyzed. Using postoperative pathology as the gold standard ，the patients were divided into central lymph node metastasis group and non⁃ metastatic group. The receiver operating characteristic（ROC）curve was used to analyze the shear wave elasticity measurement to determine the best cut⁃off value for the central lymph node metastasis. Single⁃factor and multi⁃ factor analysis of independent risk factors affecting central lymph node metastasis were used to establish a predictive model. After the model was established，131 papillary thyroid carcinoma nodules were included for verification to evaluate the predictive ability，compared with postoperative pathology. Results Logistic regression analysis showed that the factors that affected the central lymph node metastasis were tumor size，multifocality，capsular infiltration，and Emean value. The ROC curve with the predicted probability value was drawn，and the area under curve of the ROC was 0.908.The verification group was used to verify that the accuracy was 93.1%，the sensitivity was 90.5%，the missed diagnosis rate was 9.5%，the specificity was 93.2%，and the misdiagnosis rate was 6.8%. Conclusion The prediction model based on shear wave elastography combined with two ⁃dimensional ultrasound has a good predictive value for lymph node metastasis in the central area of papillary thyroid carcinoma，which helps to improve the preoperative diagnosis rate of central lymph node metastasis in PTC. To a certain extent，it provides help for the choice of clinical treatment plan.

Objective To explore the diagnostic value of CT ⁃ based radiomics nomogram in predicting lymph node metastasis of head and neck cancer. Methods A retrospective analysis was performed on the patients who visited the first people′s Hospital of Hefei from January 2017 to October 2020. They had clear lymph node pathology and had good quality CT scan before treatment. A total of 201 lymph nodes were collected from 75 patients with head and neck malignant tumors. One hundred and thirteen lymph nodes from January 2017 to November 2019 were enrolled into the training group，and 88 lymph nodes from December 2019 to October 2020 were enrolled into the test group. Mazda software was used to extract the radiomics features，and lasso method was used to reduce the dimension and establish the radiomics tags. After the multivariate logistic regression screening，the plain scan CT value，enhanced arterial phase CT value and radiomics tags were seperately used to establish radiomics nomogram diagnostic models. Receiver operator characteristic（ROC）curve，area under curve（AUC）and calibration curves were used to evaluate the diagnostic efficacy. Results In each CT scan，298 3D features were extracted from the cervical lymph node region. Through dimensionality reduction，6 ~ 7 most relevant radiomics features were selected to establish the radiomics tags. The AUC of nomograph prediction model of radiomics tags plus plain CT value in training set and test set was（0.955，0.885），and that of radiomics tags plus enhanced CT value in training set and test set was（0.982，0.920），which were higher than that in the only radiomics tags model（0.940，0.905）（P < 0.05）. The accuracy of plain CT value plus plain radiomics tags，enhanced CT value plus radiomics tags，radiomics tags and CT sign diagnosis model were 0.920，0.930，0.801 and 0.716，respectively，and the sensitivity was 0.925，0.925，0.877 and 0.792，respectively，and the specificity was 0.916，0.926，0.716 and 0.632，respectively. At the same time，it had satisfactory calibration. Conclusion CT⁃based radiomics nomogram has a good diagnostic effect on lymph node metastasis of head and neck cancer，which is simple，safe and reliable.

Objective In order to improve clinical treatment and STD control，we profiled the infection characteristics of herpes simplex virus （HSV） in sexually transmitted disease （STD） clinics in Guangzhou. Methods In 488 outpatients at Guangdong Provence Dermatology Hospital′s STD department，polymerase chain reaction（PCR）was utilized to identify HSV⁃1/2 DNA，with 286 cases also tested for HSV IgM/IgG antibodies using an enzyme ⁃linked immunosorbent assay （ELISA）. The characteristics of HSV infection were analyzed. Results Among the nucleic acid test results of 488 patients aged from 17 to 86，136 were positive for HSV⁃2，6 were positive for HSV ⁃1，and 1 was double positive for HSV ⁃1 and HSV ⁃2 among them，with a positive rate of 28.89%（141/488）. In the positive detection，the HSV⁃2 to HSV⁃1 ratio was 22.67∶1（136/6）. HSV⁃2 DNA was found in 85 of 351 male patients（24.22 %）and of 137 female patients（40.88%），which was significantly higher than men（P < 0.001）. There was no significant difference in the positive detection rate among age groups：< 30， 30 ~ 40，41 ~ 50，51 ~ 60 and > 60（P > 0.05）. In the male positive samples，the positive rates of samples taken from the glans prepuce，penis，scrotum，mound，urethra swab，anus，buttock were 70.59%（60/85），12.94%（11/85）， 11.76%（10/85），1.18%（1/85），1.18%（1/85）and 2.35%（2/85），respectively. In the female positive samples， the positive rate of samples from vulva，cervix，vagina，anus，buttock were 73.21%（41/56），7.14（4/56），16.07% （9/56）and 3.57%（2/56），respectively. The results of the serum antibodies tests were carried out at the same time in 286 of the 488 patients. Among the 68 HSV⁃2 DNA positive patients，the positive rates of HSV⁃2 IgM and HSV⁃2 IgG were 5.88%（4/68）and 66.18%（45/68），respectively. Conclusion HSV⁃2 is the most common cause of HSV infection，but HSV⁃1 is not uncommon. Suspicious patients should be tested for HSV⁃1/2 DNA. Male prepuce glans and female vulva are predilection sites for genital herpes. The combined detection of HSV⁃2 DNA and IgG antibody is helpful for the diagnosis of initial genital herpes and recurrent genital herpes.

Objective To explore the clinical value of 3D printing technology in infantile craniostenosis surgery. Methods A total of 60 cases with infantile craniostenosis were collected and randomly divided into 3D printing group and control group with 30 cases in each group. In 3D printing group，3D printing technology was applied to reconstruct the skull model before operation，assist the frontal orbital girdle to move forward or retracted， and guide the surgical treatment of stenosis. Routine imaging examination was performed in the control group before the operation，and the operation was completed by the same operator. Surgical efficacy of the two groups was com⁃ pared. Results At the 3⁃month follow⁃up，the cephalic index（CI）of brachycephaly in the 3D printing group was （80.70 ± 1.10）and that in the control group was（89.30 ± 4.50）. The CI of scaphoid head in the 3D printing group was（78.30 ± 1.40）and that in the control group was（69.00 ± 4.20）. The anial vault asymmetry index（CVAI）in the 3D printing group was（1.60 ± 0.80）%，and that in the control group was（5.60±1.00）% . All the differences were statistically significant. Conclusion 3D printing⁃assisted frontal orbital girdle advancement or retraction tech⁃ nology in the operation of craniotomy can significantly improve the surgical treatment of various infantile cranioste⁃ nosis，and its effect is better than that of traditional surgery. It is worthy of clinical promotion.

Objective To observe the clinical efficacy of large manipulation release under brachial plexus anesthesia combined with small acupotomy on scapulohumeral periarthritis. Methods 120 patients were randomly divided into control group（60 cases）and observation group （60 cases）. The control group was treated with small acupotomy，and the observation group was treated with large manipulative release under brachial plexus anesthesia combined with small acupotomy for 2 weeks. Range of motion of shoulder joint and McGill pain scale were observed in the two groups. The clinical efficacy，safety and recurrence rate of the two groups were compared follow ⁃up. Results The total effective rate of the observation group was 98.3%（58/59），which was higher than that of the control group（80.7%，46/57）（P < 0.05）. The follow⁃up recurrence rate of the observation group was 1.7%（1/58）， lower than the control group's 28.3%（13/46）（P < 0.05）. The anterior flexion，posterior extension and abduction of upper limbs in the observation group were significantly improved compared with the control group（P < 0.05）. PPI，VAS and PRI scores in the observation group were significantly lower than those in the control group（P < 0.05）. Conclusion Large manipulation release under brachial plexus anesthesia combined with small acupotomy on scapulohumeral periarthritis is effective. 

Objective To observe the effect of Shanzha Xiaozhi Capslue on essential hypertension with carotid arteriosclerosis（the stasis⁃phlegm combined pattern from the perspective of TCM）. Methods According to the inclusion criteria，a total of 79 patients with essential hypertension combined with carotid atherosclerosis were randomly assigned to treatment group（n = 39）and control group（n = 40）. All patients received routine treatment and those in the treatment group were additionally given Shanzha Xiaozhi Capslue for 6 months. The change of TCM pattern，the change of carotid intima media thickness（IMT），brachial⁃ankle pulse wave velocity（baPWV），ankle ⁃brachial index（ABI），homocysteine（HCY），lipoprotein associated phospholipase A2（Lp⁃PLA2）and safety were observed. Results After treatment，the total effective rate for TCM pattern was 87.18% in the treatment group and 67.50% in the control group（P < 0.05）；The levels of baPWV，ABI and HCY in the two groups were significantly improved（P < 0.01），and those in the treatment group were significantly improved（P < 0.01）. The levels of LMT and Lp⁃PLA2 were not significantly improved in the control group（P > 0.05），but were significantly improved in the treatment group（P < 0.01），which was better than the control group（P < 0.05）. In terms of safety，there were no significant abnormalities in liver function，renal function，or creatine kinase in the two groups. Conclusion Shanzha Xiaozhi Capslue was effective and safe for essential hypertension combined with carotid arteriosclerosis.

Long non⁃coding RNA（lncRNA）is a multifunctional non⁃coding RNA involving in the regula⁃ tion of the development of a variety of tumors. GSK⁃3β is a serine and threonine kinase that plays an important role in tumor regulation through Wnt/β⁃catenin，PI3K/Akt，Notch，NF⁃κB and Hedgehog signaling pathways. In recent years，increasing studies have shown that the interactions between lncRNA and GSK⁃3β related signaling pathways play an important role in various tumors and are closely related to patient prognosis. In this paper，the roles of lncRNA and GSK ⁃ 3β related signaling pathways in various tumors are reviewed，so as to provide reference and thinking for clinical treatment and future research.