Primary Nephrotic Syndrome（PNS）in children is a common glomerular disease whose pathogen⁃ esis is closely related to the abnormal expression of B lymphocyte function. With the application of biological agents，antibody drugs targeting CD20 are divided into three generations.（1）First generation：Rituximab（RTX） as a human⁃mouse chimeric anti⁃CD20 monoclonal antibody，mainly depletes B lymphocytes and reduces cytokine secretion by effectively blocking B cell proliferation and differentiation. Clinically RTX enables children with PNS on long⁃term hormone and immunosuppressant use to reduce the dose or even stop using it，reducing PNS relapse with fewer side effects.（2）Second generation：Ofatumumab，as a monoclonal antibody to the humanised target CD20，is the most promising biologic agent for renal applications other than RTX，recognising a different epitope to RTX and reducing its immunogenicity. It appears to be superior to RTX due to fewer adverse effects when ap⁃ plied at high doses. It is used clinically in PNS with RTX⁃resistant or allergic.（3）Third generation：Obinutuzum⁃ ab，the first glycosylated type II anti⁃CD20 monoclonal antibody，has a glycosylated Fc fragment that improves the specificity of the antibody and its affinity for antigen binding. Biological agentsare expected to be the first⁃line drugs for the treatment of nephrotic syndrome in children.

Objective To observe the effect of Gu Bi mixture，which has the function of promoting blood circulation on the apoptosis of chondrocytes and the expression level of PI3K/AKT signaling pathway ⁃ related pro⁃ teins in knee osteoarthritis（KOA）mice. Methods To cut the anterior cruciate ligament was used to establish in KOA model mice. Eight weeks after the modeling，the Gu Bi mixture group used Gu Bi mixture to fill the stomach， Glucosamine Indomethacin Entric⁃coated Tablets group in mice with Glucosamine Indomethacin Entric⁃coated Tab⁃ lets dissolved in same volume of distilled water to fill the stomach，and normal saline（NS）group used equal vol⁃ ume of NS for gastric lavage，and the cartilage of both knee joints were tested. The morphology of KOA cartilage model was observed by toluidine blue staining，and apoptosis of chondrocytes in each group was detected by TU⁃ NEL method and expression levels of PI3K/AKT and mTOR proteins in chondrocytes in each group were detected by Western blotting. Results Compared with the NS group，the toluidine blue staining was deeper and the carti⁃ lage tissue was significantly improved in the Gu Bi mixture group and the Glucosamine Indomethacin Entric⁃coated Tablets group. Apoptosis of chondrocyte was reduced and the expressions of PI3K，AKT and mTOR proteins in the articular cartilage of the mice in the Gu Bi mixture group were decreased（P < 0.05）；PI3K/AKT and mTOR pro⁃ tein expression in articular cartilage of mice in the Glucosamine Indomethacin Entric ⁃ coated Tablets group de⁃ creased（P < 0.01）. Conclusion Both Gu Bi mixture and Glucosamine Indomethacin Entric⁃coated Tablets had significant improvement effects on KOA mice chondrocytes，，Gu Bi mixture could inhibit the PI3K/AKT signaling pathways，reduce apoptosis of chondrocytes，and to further remit knee osteoarthritis.

Objective Based on the PINK1/Parkin/ROS pathway，to explore the effect of Jiangan Gran⁃ ules on inhibiting the apoptosis of CD4+ T cells in liver cirrhosis and its mechanism. Methods Hepatitis B cirrho⁃ sis（HBC）patients were divided into control group and observation group，and healthy people were selected as the normal group，with 50 cases in each group. The control group was treated with entecavir，and the observation group with Jiangan Granules combined with entecavir. CD4 + T cells in the peripheral blood of each group were screened by magnetic bead sorting method. CD4+ T cells in the normal group were divided into control group，H2O2 group and H2O2+CCCP（Mitophagy inducer）group. The contents of ROS，SOD and MDA were detected by ELISA. The expression of PINK1，Parkin，LC3⁃Ⅱ，Bax and Bcl⁃2 was detected by Western blot. The mitochondrial mem⁃ brane potential and apoptosis rate were detected by flow cytometry. Results CCCP could reverse the promoting ef⁃ fect of H2O2 on ROS and apoptosis rate of CD4+ T cell and the inhibiting effect of LC3⁃Ⅱ expression（P<0.05）. Ji⁃ angan Granules combined with entecavir could down ⁃ regulate ROS，MDA and SOD in serum，while up ⁃ regulate the expression of PINK1，Parkin，LC3⁃Ⅱ and Bcl⁃2 in CD4+ T cells and it could also down⁃regulate the expression of Bax，increase mitochondrial membrane potential and reduce the apoptosis rate（P<0.05）. The effect was better than that of entecavir alone. Conclusion Upregulation of CD4 + T cell mitophagy level could inhibit oxidative stress and apoptosis. Jiangan Granules could inhibit the apoptosis of CD4+ T cell in compensated patients with HBCby inducing mitophagy.

Objective To investigate the association between high density lipoprotein（HDL）and clinical outcomes of continuous ambulatory peritoneal dialysis（CAPD）patients. Methods The clinical data of patients re⁃ ceived continuous ambulatory peritoneal dialysis were followed up in the First Affiliated Hospital of Guangxi Medi⁃ cal University from January 2010 to January 2020. Patients were divided into the maintenance and withdrawal groups. Cox regression analysis was used to explore the association between HDL and clinical outcomes. Results A total of 433 patients were enrolled with 276 in the maintenance group and 157 in the withdrawal group，in which 70 were died，and 87 were transferred to hemodialysis. There were 229 patients with dyslipidemia（52.9%）. The median follow⁃up was 35.33（21.78，61.17）months. The median age of dialysis，serum albumin，total cholesterol （TC）and HDL in withdrawal group were lower than those in maintenance group. According to HDL level，patients were divided into Q1（> 2.17 mmol/L），Q2（1.04～2.17 mmol/L）and Q3（<1.04 mmol/L）groups. The PD drop⁃ out rate and all ⁃cause mortality in HDL ⁃Q3 group were significantly higher than those in HDL ⁃Q1 and HDL ⁃Q2 groups. Decreased HDL level was an independent risk factor for patients to drop out of PD（all P < 0.05）. Conclu⁃ sions Low HDL was an important risk factor affecting all⁃cause mortality and withdrawal in PD patients.

Objective To investigate the effect of multimodal analgesia based on regional block on postop⁃ erative rehabilitation in liver cancer patients with undergoing laparotomy. Methods From June 2019 to May 2020， 80 patients undergoing laparotomy for liver cancer in our hospital were selected. The patients were randomly divid⁃ ed into regional block group（group R）and control group（group C）. The time of awakening and the digital analog pain score（NRS score），the dosage of analgesics and the incidence of postoperative nausea and vomiting（PONV） were compared between the two groups at the moment of awakening，24 h and 48 h after operation. The changes of plasma TNF ⁃α，IL ⁃6 and liver function index，QoR ⁃15 score of postoperative recovery quality and postoperative hospital stay were recorded. Results The time of awakening in group R was significantly shorter than that in group C（P＞0.01），and the NRS score immediately after awakening and within 24 h after operation in group R was sig⁃ nificantly lower than that in group C（all P＜0.05）. The use of postoperative analgesics in group R was significant⁃ ly lower than that in group C，and the incidence of PONV at 24 h after operation in group R was significantly lower than that in group C（P＜0.05）. The levels of TNF⁃an and IL⁃6 at T1 and T2 in group R were significantly lower than those in group C（P＜0.05）. The levels of ALT，TBIL and ALB in group R were lower than those in group C， and the QoR⁃15 score was higher than that in group C. the postoperative hospital stay in group R was shorter than that in group C（P＜0.05）. Conclusion The multimode analgesia scheme of general anesthesia combined with re⁃ gional block could improve the analgesic effect，reduce adverse reactions，effectively inhibit inflammatory factors， improve early analgesic effect of patients with liver cancer after laparotomy，and reduce hospital stay，which is wor⁃ thy of clinical application.

Objective To explore the feasibility of substituting quantitative（reverse）Allen′s test，simpli⁃ fied（reverse）Allen′s test for（reverse）Allen′s test alone in evaluating the collateral circulation and the patency of radial artery before interventional therapy. Methods Patients who underwent selective coronary angiography were selected. Before CAG，Allen′s test，quantitative Allen′s test，simplified Allen′s test were applied in all selected patients to evaluate the collateral circulation of the radial artery. Reverse Allen′s test，quantitative reverse Allen′s test，simplified reverse Allen′ s test were applied to evaluate the patency of radial artery. The results of arterial puncture and complications 1 week after surgery were recorded. The data were statistically analyzed and compared. Results Among the 126 patients，the positive rate of Allen′s test was significantly higher than the rate of quantita⁃ tive Allen′s test（P=0.038）. All patients positive in the Allen′s test successfully completed the interventional treat⁃ ment via the radial artery，and there were no related complications during and after the operation. The positive rates of reverse Allen′s test and quantitative reverse Allen′s test were consistent，in which 50% patients had vascu⁃ lar stenosis or even closed after performing ultrasound and the rest patients revealed no abnormalities but the artery puncture failed. The quantitative（reverse）Allen′s test，simplified（reverse）Allen′s test results were consistent. Conclusions Allen′s test positive should not be prohibited in interventional therapy via radial artery. Reverse Al⁃ len′s test positive could reasonably predict the radial artery puncture failure. Quantitative test，simplified test can replace Allen′s test and reverse Allen′s test to evaluate the collateral circulation and the patency of radial artery.

Objective To study the correlation between ApoE gene polymorphism and atrial arrhythmias， Methods The patients with atrial extrasystole，atrial tachycardia，atrial flutter and atrial fibrillation were selected as atrial arrhythmia group and 120 healthy outpatients（sinus rhythm）as control group. ApoE gene polymorphism was detected by gene chip detection，and the data were statistically analysed. Results There were significant dif⁃ ferences in age，history of hypertension，LAD and LVEF between the two groups. The level of ε3/ε3 genotype in the atrial arrhythmia group was significantly lower than that in the control group，while the level of the ε3/ε4 and ε 4/ε4 genotypes were significantly higher in the atrial arrhythmia group（P < 0.05）. There was no significant differ⁃ ence in the distribution of ApoE2 type between the atrial arrhythmia group and the control group（P > 0.05）. The expression of ApoE3 type in the atrial arrhythmia group was significantly lower than that in the control group（P < 0.05），but the expression of ApoE4 type was significantly higher（P < 0.05）. The rate of ApoE2 type in the atrial bibrillation group was significantly lower and the rate of ApoE4 type was significantly higher than that in the atrial arrhythmia group（P < 0.05）. Conclusion The gene expression polymorphism of ApoE gene is associated with atrial arrhythmia and，ApoE4 may be a sensitive phenotype leading to atrial arrhythmia.

Objective To explore the difference of secretory leukocyte proteinase inhibitor（SLPI）expres⁃ sion in airway between stable and acute exacerbation chronic obstructive pulmonary disease（COPD）patients，and to clarify the correlation between pulmonary function and the expression of SLPI in airway. Methods A total of 40 COPD patients and 40 healthy adults were included as the objects. SLPI concentration in the sputum of healthy adults and COPD patients and lung function were measured. The difference of SLPI level between COPD patients and healthy adults，and between stable and acute exacerbation COPD was compared. The correlation between SLPI expression and lung function was analyzed. Results There was no significant difference in the expression of SLPI in airway between COPD patients and healthy adults［（46.74 ± 2.30）μg/L vs.（47.60 ± 2.50）μg/L，t＝1.321，P＝ 0.190］. The level of SLPI in acute exacerbation COPD patients was significantly lower than that in stable COPD pa⁃ tients［（38.15 ± 3.59）μg/L vs.（46.74 ± 2.30）μg/L，t＝35.707，P＝0.01］. There was no significant correlation be⁃ tween SLPI and FEV1/FVC（r＝0.215，P＝0.183），but SLPI was positively correlated with FEV1% Pred（r＝ 0.466，P＝0.002）in stable COPD patients. There was no significant correlation between SLPI and FEV1/FVC（r＝ 0.088，P＝0.589），but SLPI was positively correlated with FEV1%Pred（r＝0.369，P＝0.019）in acute exacerba⁃ tion COPD patients. Conclusions SLPI in airway of acute exacerbation COPD patients was significantly lower than that of stable COPD patients. SLPI in airway is positively correlated with FEV1% Pred in COPD patients.

Objective To analyze the risk factors for acute moderate to severe postoperative pain in pa⁃ tients after surgery based on data platform of anesthesiology and perioperative medicine. Methods A total of 1 445 adult patients receiving postoperative continuous intravenous analgesia in our hospital from May 2018 to May 2020 were selected and divided into mild pain cohort（VAS＜4，n=976）and moderate to severe pain cohort（VAS≥4，n= 469）according to visual analogue scale（VAS）score in motion at 24 h after surgery. Twenty⁃one perioperative and intraoperative variables which may relate to postoperative pain of patients in cohort were screened by univariate analysis and multivariate logistic regression to stratify the important risk factors of moderate to severe postoperative pain. Results Univariate analysis showed age，gender，method of anesthesia administration，operation grading， no drinking time，duration of surgery and anesthesia，invasive cannulation，intraoperative infusion，sufentanil and muscle relaxants used during surgery were related to moderate to severe pain（P＜0.05）. Multivariate logistic re⁃ gression analysis showed gender，operation grading，time of prohibition of drinking，dosage of sufentanil and arteri⁃ al catheterization were independent risk factors（P＜0.05）. Conclusion The incidence of postoperative acute moderate to severe pain is related to gender，level of surgical complexity，duration of abstinence from drinking，in⁃ traoperative use of sufentanil and arterial puncture and catheterization，which is worthy of further clinical research.

Objective To investigate the relationship between the expression of astrocyte elevated gene⁃1 （AEG⁃1）in gallbladder cancer tissue and clinicopathology and prognosis. Methods A total of 128 patients with gallbladder cancer admitted from January 2016 to June 2018 were selected to take AEG⁃1 detection of cancer tissues after surgery. The survival time was recorded during a 2⁃year follow up. Multivariate COX regression was used to analyze the prognostic factors of patients with gallbladder cancer，while Kaplan ⁃Meier survival curve was drawn. Results The positive rate of AEG⁃1 in cancer tissues of 128 patients was 71.87%. Surgical method，maxi⁃ mum tumor diameter，degree of differentiation，TNM staging，common bile duct infiltration，lymph node metasta⁃ sis and AEG⁃1 expression were the survival factors（P < 0.05）. There was statistically significant difference in sur⁃ vival between AEG⁃1 positive and negative patients（P = 0.009）. Conclusion The expression of AEG⁃1 in gall⁃ bladder cancer tissue is related to the maximum diameter of the tumor，pathological type，degree of differentiation， TNM stage，surrounding tissue invasion，etc.，and the expression of AEG⁃1 is a prognostic factor.

Objective To investigate the relationship between early changes of serum regulatory T lympho⁃ cytes and helper T cell 1/helper T cell 2（Th1/Th2）cytokines and post ⁃traumatic infection in patients with chest trauma. Methods A total of 160 patients with chest trauma were selected and divided into infected group and non⁃ infected group. The basic information of the patient was recorded in detail. White blood cell（WBC），procalcitonin （PCT），CD4+ /CD25+ T lymphocyte count，Th1 related cytokine γ interferon（IFN⁃γ）and Th2 related cytokine inter⁃ leukin⁃4（IL⁃4）levels within 24 h after admission were also recorded. The factors of infection after thoracic trauma were analyzed. Results （1）Among 160 patients with chest trauma，46 cases（28.75%）were complicated with infection，while 114 cases（71.25%）were not.（2）There were significant differences in age，mechanical ventila⁃ tion time，combined brain injury，ISS score and APACHE⁃II score between the infected group and the non⁃infected group（P < 0.05）.（3）The level of PCT，WBC，and IFN⁃γ/IL⁃4 in the infected group was higher than that in the non⁃infected group（P < 0.05）. The level of CD4+ /CD25+ in the infected group was lower than that in the non⁃infect⁃ ed group（P < 0.05）.（4）Multi⁃factor logistic regression analysis showed that the duration of mechanical ventila⁃ tion，combined with brain injury，ISS score，APACHE⁃II score，PCT，IFN⁃γ/IL⁃4，and CD4+ /CD25+ were the sig⁃ nificant or correlated factors of the infection in patients with chest trauma（P < 0.05）. Conclusion In the early stage of post ⁃traumatic infection，patients have immunologic dysfunction. Advanced age，brain injury，high ISS score，high APACHE⁃II score，increased IFN⁃γ/IL⁃4 and decreased CD4+ /CD25+，may increase the risk of post⁃ traumatic infection.

Objective To investigate the relationship between susceptibility to allergic reaction induced by common allergens and HLA DRB1*0901（RS2395185）gene polymorphism in peripheral blood of patients with allergic skin disease. Methods A total of 304 patients who accepted treatment in department of dermatology in Guangzhou were selected. Nineteen kinds of allergens were detected by Western blotting. HLA DRB1 * 0901 geno⁃ types were detected by PCR sequencing. The relationship between HLA DRB1 * 0901 gene polymorphism and the risk of allergic reaction induced by allergens was analyzed. Results The G/G and G/T genotypes of rs2395185 were significantly different between the positive and negative patients（P < 0.05），and might be associated with the risk of house dust mite allergy（OR＝2.940，95%CI：1.167～7.407；OR＝2.889，95%CI：1.136～7.348）. There was significant difference in the distribution of G/T genotype between mild and moderate to severe allergic patients （P < 0.05）. G/T genotype may be a risk factor for the severity of allergic reaction（OR＝8.681，95%CI：1.077~ 69.989）. Conclusion The risk of skin allergy caused by Dermatophagoides pteronyssinus in population of Guang⁃ zhou may be related to the G/G and G/T polymorphisms of HLA DRB1 * 09：01（rs2395185），and the severity of allergy to 19 allergens may be related to the G/T polymorphism of rs2395185.

Objective To study the impact of latency period after preterm premature rupture of mem⁃ branes（PPROM）on early outcomes of preterm infants，and to provide reference for prenatal consultation and man⁃ agement of PPROM. Methods A total of 528 singleton preterm infants before 34 weeks′ gestation who were born after PPROM were enrolled between 2016 and 2019. Statistical analysis was performed for early outcomes of preterm infants. Results For preterm infants with PPROM before 28 weeks′ gestation，latency period after PPROM ≥ 7 d could reduce the total rate of severe morbidity，including moderate and severe bronchopulmonary dysplasia，necrotizing enterocolitis，severe retinopathy of prematurity，intraventricular hemorrhage（≥ grade 3）/ periventricular white matter；latency period ≥3 d could reduce the rate of severe retinopathy of prematurity（ROP） （P＜0.05）. No statistical difference was found in in⁃hospital mortality and rate of early⁃onset sepsis between differ⁃ ent latency period groups（P＞0.05）. For preterm infants with PPROM between 28~34 weeks′ gestation，no statisti⁃ cal difference was found in all the early outcomes between different latency period groups（P＞0.05）. Multivariate logistic regression analysis showed that a smaller gestational age at birth was an independent risk factor for in⁃hospi⁃ tal mortality，early⁃onset sepsis and severe morbidity（OR = 0.229，0.705 and 0.499 respectively，95%CI 0.092 ~ 0.570，0.617 ~ 0.805，0.432 ~ 0.576 respectively），Clinical chorioamnionitis was an independent risk factor for early ⁃onset sepsis（OR = 3.835，95%CI：1.797 ~ 8.181）. Conclusion Prolonged latency period after PPROM could increase gestational age and improve the early outcomes of preterm infants with gestational age＜34 weeks， but attention should be paid to clinical chorioamnionitis. Prolonged latency period to ≥ 7 d was advised for PPROM before 28 weeks′ gestation .

Objective To explore the role of bone marrow TPO and its receptor c⁃Mpl in the diagnosis pri⁃ mary immune thrombocytopenia（ITP），study their correlation with curative effects，and explore the factors influ⁃ encing the therapeutic effect of glucocorticoid. Methods The total number of megakaryocytes，the number of thro⁃ mocytogenic megakaryocytes and the ratio of them in the bone marrows of 50 ITP patients（ITP group），20 hyper⁃ splenism patients（hypertension group）and 16 MDS patients（MDS group）were compared. ABC⁃ELISA and flow cytometry were used to detect the TPO level and expression level of c⁃Mpl in the bone marrows. The data were ana⁃ lyzed by SPSS 19.0. Results The total numbers of megakaryocytes and the thromocytogenic megakaryocytes in the ITP group were significantly larger than those in the MDS group and the hypersplenism group，but the number of megakaryocytes in the ITP group was significantly smaller than those in the MDS group（P < 0.05）and howev⁃ er，the levels of TPO and c⁃Mpl were significantly lower than MDS and hypersplenism（P < 0.05）. The levels of TPO and c⁃Mpl were significantly higher in PLT < 30 × 109 /L ITP sub⁃group than in PLT ≥ 30 × 109 /L ITP sub⁃ group（P < 0.05）. The analysis of the effective group and the ineffective group among the ITP patients showed that the shorter the treatment response time was，the lower the ratio of labor to macrosomia，the higher the bleeding score and the better the treatment response. Conclusion TPO and c⁃Mpl can be used as the indicators for the dif⁃ ferential diagnosis of ITP，MDS and hypersplenism. In the course of ITP treatment，the response time，the ratio of thromocytogenic megakaryocyte to total megakaryocytes and the bleeding score are helpful for investigating the prog⁃ nosis of treatment response，but more case data are needed for further discussion.

Objective To evaluate the effect of Ru′ai Shuhou Recipe（RSR）on 10⁃year disease⁃free survival and overall survival in breast cancer patients. Method To observe and follow up the breast cancer pa⁃ tients who accept the surgery from January 1，2002 to December 31，2010. The patients were divided into Chi⁃ nese medicine group and control group according to whether they took RSR or not. The diseases ⁃free survival （DFS）and overall survival（OS）were recorded. Result The 10⁃year overall survival rate was 93.2% in the RSR group and 83.4% in the control group，and the risk of death was reduced by 65.0% in the RSR group （P < 0.05）. The 10 ⁃ year disease ⁃free survival rate was 89.6% in the RSR group and 85.3% in the control group. But there was no significant difference in disease⁃free survival between the two groups. Conclusion Ru′ ai Shuhou Recipe could bring survival benefits to breast cancer patients after surgery，improve the 10⁃year over⁃ all survival rate，and reduce the risk of death

Objective To investigate the effect of dexmedetomidine on serum inflammatory reaction and perioperative neurocognitive disorder in elderly patients undergoing laparoscopic radiofrequency ablation of liver cancer. Methods Eighty elderly patients undergoing elective laparoscopic radiofrequency ablation for liver cancer were randomly divided into two groups：dexmedetomidine group（group D）and control group（group C）. Venous blood samples were collected to detect the concentrations of TNF⁃α，IL⁃6，IL⁃10，CRP and CD11b in serum. The cognitive function of the patients in the two groups was evaluated with Mini⁃Mental State Examination（MMSE）and Montreal Cognitive Assessment（MoCA）. Results The levels of serum TNF ⁃α，IL ⁃6，CRP and CD11b in both groups were higher than those before operation，and the level of serum IL ⁃10 in group D was lower than that in group C after radiofrequency ablation（60 min），and the level of serum IL⁃10 in group D was higher than that in group C（P＜0.05）. The incidence of perioperative neurocognitive disorder in group D was lower than that in group C（P＜0.05）. Conclusion Dexmedetomidine could reduce the serum levels of pro ⁃inflammatory factors such as TNF⁃α，IL⁃6，CRP and CD11b in elderly patients undergoing laparoscopic radiofrequency ablation for liver can⁃ cer，reduce the inflammatory reaction and reduce the incidence of perioperative neurocognitive disorder.

Objective To explore the laboratory characteristics of multiple myeloma（MM）complicated with renal injury，and evaluate the effectiveness of diagnosis combined with multiple index. Methods The clinical data from 157 patients with MM including 30 complicated with renal injury and 127 without renal injury who had been treated from June 2018 to March 2021 in the department of Hematology，Nanfang Hospital and General Hospital of the Southern Theater of the Chinese People′s Liberation Army were retrospectively analyzed. The laboratory results were compared，the risk factors complicated with renal injury were analyzed，and the diagnostic efficiency of single detection was compared with that of combined detection in MM complicated with renal injury. Results Levels of urea nitrogen，uric acid，β2⁃microglobulin，and calcium⁃calibration，and ratio of neutrophil/lymphocyte （NLR）were higher in MM patients complicated by renal injury than in those without renal injury（P < 0.05）. An increase in calcium⁃calibration，β2⁃microglobulin or NLR were the independent risk factors for MM with renal inju⁃ ry. The combined detection of β2⁃microglobulin，calcium⁃calibration and NLR has higher sensitivity and specifici⁃ ty. Conclusions Calcium⁃calibration，β2⁃microglobulin and NLR were independent risk factors for MM with re⁃ nal injury and have better predictive value.

Objective To explore the value of a radiomics model based on ultrasound imaging in predict⁃ ing the sentinel lymph node status of breast cancer before surgery. Methods A total of 194 patients with early ⁃ stage breast cancer were retrospectively analyzed，all patients underwent preoperative breast ultrasound examina⁃ tion. According to the order of examination time，the patients were divided into training group（n = 103）and vali⁃ dation group（n = 88）. Image J software was used to manually delineate the lesion area in the ultrasound image along the tumor boundary. Pyradiomics was used to extract 1 130 features from each lesion area，and the features were screened using three statistical methods. Finally，an ultrasound imaging radiomics model was built using a lo⁃ gistic regression model. To evaluate the performance and value of an ultrasound imaging radiomics model in predict⁃ ing sentinel lymph node status，the receive operating characteristic curve（ROC），calibration curve，and decision curve were used. Results To construct the ultrasound imaging radiomics model，6 key image features were cho⁃ sen. The area of under the ROC curve of the model in the training group and the validation group were 0.795（95% CI：0.708～0.882）and 0.784（95%CI：0.688～0.881），respectively. The calibration curve showed that the model had a good calibration in both the training and validation groups；Additionally，the decision curve analysis con⁃ firmed that the model could support clinical decision ⁃making. Conclusion Ultrasound ⁃ based imaging radiomics model is of great value in predicting the sentinel lymph node status of breast cancer before surgery.

Objective To understand and compare the differences in aggressiveness and impulsivity of medical students with different family characteristics so as to provide basis for the intervention and adjustment of ag⁃ gressiveness and impulsivity. Methods An online questionnaire survey was conducted among medical students from 3 universities with general information questionnaire of family characteristics，Barratt Impulsiveness Scale⁃11 （BIS⁃11），Chinese version of Buss Perry aggression questionnaire（AQ⁃CV）and Family APGAR Index question⁃ naire（APGAR）. A total of 10，340 effective questionnaires were recovered. Results Medical students with incom⁃ plete family structure and left⁃behind experience were more aggressive and impulsive. Medical students witnessing violent fights between parents and those who were beaten by their parents/guardians were more aggressive and im⁃ pulsive. There were statistically significant differences in impulsivity among students with different family economic status，and differences in impulsivity and aggression among students with different family functions （P<0.05）. Conclusion Incomplete family structure，left⁃behind experience，witnessing violent fights between parents，and beaten by parents/guardians may be risk factors for aggressiveness and/or impulsivity of medical students，and more in⁃depth researches are urgently needed.

Objective To investigate the distribution characteristics of Mycoplasma pneumoniae（MP）， Chlamydia pneumoniae（CP）and Legionella pneumophila（LP）in hospitalized children with acute respiratory in⁃ fection（ARTI）in Yuexue District，Guangzhou from 2012 to 2019. Methods A total of 34，440 ARTI hospital⁃ ized children from January 2012 to December 2019 were selected as research subjects. Whole blood and urine were collected. Serum MP was detected by passive agglutination method respectively. Serum CP was detected by ELISA. Urine LP was detected by immunochromatography. Results Among 34，440 hospitalized children with ARTI，the detection rates of MP，CP and LP were 8，882（25.79%），2，587（7.51%）and 1186（3.44%），respectively. The total MP detection rate was the highest（all P<0.05）. The total detection rates of the three pathogens in 2013， 2014 and 2019 were significantly higher than those in other years（all P<0.05）. The MP detection rate was the highest in each year（all P<0.05）. The three pathogens were detected all year round，with the highest total detec⁃ tion rate in Autumn and the lowest in Spring（all P<0.05）. The MP detection rate was the highest in each season （all P<0.05）. The total detection rate of three pathogens was the highest in the children with acute bronchopneumo⁃ nia and the lowest in those with acute laryngeal and tracheobronchitis（all P<0.05）. Among age groups，the overall detection rate of the three pathogens was the highest in the children aged 5-16 years. The MP detection rate was the lowest in the children aged 0-1 year（all P<0.05）. The detection rate of the same pathogen in the female chil⁃ dren was significantly higher than that in the male children（P<0.05）. The combined infections with MP+CP was the most common among the three pathogens（all P<0.001）. Conclusion MP，CP and LP are important patho⁃ gens that cause ARTI in children in this region，common，with its epidemic peaks probably in 2013 and 2019.

Over the past decades, the incidence of obesity has significantly increased. Obesity is associated with many chronic diseases and threatens health of people greatly. The threat of obesity to health is not only related to the degree of obesity, but also to the distribution of body fat. As compared with subcutaneous adipose tissue, vis⁃ ceral and ectopic adipose tissues link more closely to obesity⁃related metabolic diseases. Incretin⁃based drugs can improve body fat distribution in addition to lowering blood glucose and losing weight. Therefore, these types of drugs are more ideal for controlling blood glucose level and weight, and they are potential medications for non⁃alcoholic fatty liver disease. This review summarizes the effects of incretin⁃based drugs glucagon⁃like peptide⁃1 receptor ago⁃ nist and dipeptidyl peptidase 4⁃inhibitors on body fat distribution.

Objective To explore effective measures for target improvement，based on common questions in the implementation of preoperative discussion system. Methods Quality inspection and statistical analysis were performed in 200 cases of medical records. Results Many problems existed in the medical records，which were re⁃ lated with formalization of preoperative discussion，irregular writing of medical records and the weakened guidance role of senior doctors to junior doctors，etc. Conclusion The paper suggested to improve from five aspects to en⁃ hance the quality of preoperative discussion and to ensure medical safety，which include strict implementation of system for preoperative discussion to ensure surgery safety；enhancing training，standardization of medical re⁃ cords；strengthening quality control of process to ensure content quality；implementation of terminal quality inspec⁃ tion to improve the overall quality.