At present，conization is the main treatment for cervical high ⁃ grade squamous intraepithelial neoplasia（HSIL）. Women treated for HSIL had a higher risk of developing cervical cancer than the general popula⁃ tion. Women with persistent high⁃risk human papillomavirus（HR⁃HPV）infection after treatment have an increased risk of disease recurrence，which can progress to cervical cancer. Factors related to the persistence of HR⁃HPV af⁃ ter conization for HSIL included patients' HPV subtype，preoperative HPV load，multiple infections，type of con⁃ ization，age and menopausal status，lesion grade，resection margin status and vaginal microecology etc.，though their relations with the persistent HR⁃HPV remain controversial. Determining risks of persistent HR⁃HPV infection after cervical excision is useful for identifying women at a higher risk of disease recurrence. Thus，this paper， based on relevant domestic and foreign researches，discusses the risk factors of persistent HR⁃HPV infection after conization for HSIL.

Objective To explore the relationship between attempted suicide and thyroid hormone and plasma cortisol in patients with depression. Method A total of 158 inpatients who met the diagnostic criteria of DSM⁃5 depressive episode were collected. The patients were divided into two groups：those with a history of suicide attempted and those without a history of suicide attempted. Hamilton Depression Scale（HAMD）and Hamilton Anx⁃ iety Scale（HAMA）were used to assess the severity of depression and anxiety，respectively. The plasma concentra⁃ tions of thyroid hormone and cortisol were measured. Result The levels of TSH and FT4 in attempted suicide group were significantly lower than those in non ⁃ attempted suicide group（P＜0.05）. Total HAMD scores were higher in attempted suicide group compared with non ⁃ attempted suicide group（P＜0.05）. No differences in the plasma cortisol levels were found between the two groups. According to the age stratification，the level of FT4 in the attempted suicide group under 40 years old was significantly lower than that in the non⁃attempted suicide group （P＜0.05）. Multivariate logistic regression analysis showed that FT4（OR = 0.029），TSH（OR = 0.399），positive family history（OR = 5.203）and HAMD score（OR = 1.207）were high risk factors. Conclusion There is a thyroid hormone irregular in depression with attempted suicide. The patients with positive family history and severe disease，the lower levels of FT4 and TSH，the higher risk of suicide，and the patients less than 40 years old should pay more attention to the level of FT4. No correlation between plasma cortisol and attempted suicide is found in this study.

Objective To explore the relationships between academic stress，sleep quality，meaning in life and depression in medical students and its mechanism so as to provide reference for medical students to prevent depression. Methods A total of 923 medical students were enrolled in the survey using Adolescent Self ⁃Rating Life Events Checklist（ASLEC），Patient Health Questionnaire⁃9（PHQ⁃9），Pittsburgh Sleep Quality Index（PSQI） and Personal Meaning Profile Brief（PMP⁃B）. Results The depression of medical students was positively correlated with academic stress and sleep quality（r = 0.42，0.53，P < 0.01）and negatively with meaning in life（r = -0.41， P < 0.01）. Sleep quality plays a mediating role between academic stress and depression. Meaning in life regulated the predictive effect of academic stress on sleep quality，for the effect of academic stress on sleep quality of medical students with low level of the meaning in life was more obvious. Conclusion Academic stress is a risk factor for depression in medical students，and sleep quality plays a mediating role in the process. As a positive psychological resource，the meaning in life can buffer the effect of academic stress on sleep quality，and then reduce the occur⁃ rence of depression in medical students.

Objective To study the sleep quality of hypertensive patients with comorbid depression as well as its influence factors. Methods A total of 3 637 people diagnosed with hypertension during the Hebei provincial mental disease epidemiological survey in 2016 were selected as the research subjects. The American Diagnostic and Statistical Manual of Mental Disorders（DSM⁃4）AXIS Ⅰ Clinical Examination for Disorders（SCID⁃I） was used for the diagnosis of mental disorders，and the Pittsburgh Sleep Quality Index（PSQI）was used to evalu⁃ ate sleep quality. Results The incidence of poor sleep quality of the hypertensive patients with depression was significantly higher than that in the patients with hypertension alone（74.44% vs. 18.29%，P < 0.01），and the inci⁃ dence of poor sleep quality in the hypertensive patients with major depressive disorder（81.42%）and dysthymia （84.38%）was more prominent. The total score of PSQI and the scores of its dimensions in the hypertension patients with depression were higher than those in the patients with hypertension alone（P < 0.05）. The patients with both hypertension and depression went to bed earlier，slept longer，but their actual sleep time was shorter. Logistic regression analysis showed that female，low education level，low family income，long course of hyperten⁃ sion，positive family history of mental illness，depression were the risk factors affecting the sleep quality of patients with hypertension. Conclusion The incidence of poor sleep quality among hypertensive patients with depression， especially among those patients with major depressive disorder and dysthymia，is much higher than among those with hypertension alone. Comorbid depression is the most common cause of poor sleep quality.

Objective To understand the prevalence of post⁃stroke depression in China by using a meta⁃ analysis. Methods After searching the databases including CNKI，Wangfang，VIP，and Pubmed，we collected the relevant literature on the prevalence of post ⁃ stroke depression in China before February 28，2021. The Stata 11.0 software was used for meta⁃analysis. Results A total of 50 articles were included，with a total sample size of 22 822 persons. The prevalence of post⁃stroke depression in China was 34.9%（95%CI：3.17% ~ 38.1%）. A sub⁃ group analysis showed that the prevalence of female was higher than that of male，and the prevalence of recurrent patients was higher than that of incipient patients，the differences were statistically significant（P < 0.05）. There were no significant differences in marital status，education level，age，residential region，survey year，stroke types and stroke location. Conclusions The prevalence of post ⁃ stroke depression is higher in China. Clinicians should identify patients with post⁃stroke depression as early as possible，and carry out proper treatment and inter⁃ vention.

Objective To explore the effects of blood glucose fluctuations on cardiovascular autonomic neuropathy in diabetic rats and related mechanism studies，as to provide references for clinical treatment. Methods 45 SD rats were observed，of which 15 were in the blank control group（NC）. Remaining 30 rats were used to prepare diabetes models by STZ method and then randomly divided into two groups with equal number of rats：the persistent hyperglycemia group（DS）and the fluctuating hyperglycemia group（DF）. The DF group was given regular glucose gavage and insulin injection every day，and the DS group and NC group were given the same amount of normal saline at corresponding times every day. After maintaining for 4 weeks，the differences in the levels of neurotrophic factors，inflammatory factors，CHAT，TH，and TH/CHAT in each group were compared. Results After 4 weeks of feeding，the rats in the DS group and the DF group showed a certain degree of wildness and emaciation，disordered and lackluster hair，polyuria，polydipsia and polydipsia. Moreover，compared with the DS group，the DF group rats were thinner，less active，with lower body mass and the differences were statistically significant（P < 0.05）. Compared with the NC group，TH，TH/CHAT，GAP⁃43，NCF，TNF⁃α，IL⁃6，IL⁃1 and TNF⁃ were significantly increased in the DS group and DF group，while CHAT and CNTF levels were significantly decreased，and the above indicators were significantly improved in the DF group（P < 0.05）. Conclusion Blood glucose fluctuation can affect the levels of neurotrophic factors and inflammatory factors，induce sympathetic vagus nerve disorder，and aggravate the cardiovascular autonomic neuropathy in rats.

Objective To observe autophagy of human tenon′s capsule fibroblasts（HTFs）induced by arte⁃ sunate（Art）and explore the possible mechanism. Methods The cultured in vitro HTFs were divided into control group and Art（50，100，150，200 μg/mL）groups. After treatment for 24 and 48 h，cell activity was determined by methyl thiazol tetrazolium（MTT）assay. 48 h later，quantitative reverse transcriptase PCR（qRT⁃PCR）and Western Blot analysis were employed to assay the relative expression of microtubule⁃associated protein light chain 3（LC3）⁃ Ⅱ and Becline ⁃1 in HTFs. The autophagy activity of HTFs was evaluated by a Cyto ⁃ ID autophagy detection kit， and then the autophagic flux was evaluated by counting the Cyto ⁃ ID positive cells. Results The results of MTT showed that Art could significantly inhibit the growth of fibroblasts in vitro in a concentration and time dependent manner（P < 0.05），and the inhibition rate increased from 4.7% to 68.6% with increase of concentration and prolongation of time. qRT⁃PCR results showed that LC3⁃Ⅱand beclin⁃l mRNA relative expression increased after Art treatment，from（1.367 ± 0.214）to（4.765 ± 0.371），and（1.235 ± 0.164）to（3.487 ± 0.356），respectively. The difference between the groups had statistical significance（FL = 20.920，P < 0.01；FB = 26.370，P < 0.01）. Western Blot results showed that LC3⁃Ⅱand beclin⁃l protein relative expression increased after Art treatment，from（0.101 ± 0.025）to（0.808 ± 0.102），and（0.098 ± 0.036）to（0.784 ± 0.064），respectively. The difference between the groups had statistical significance（FL = 32.852，P < 0.01；FB = 29.874，P < 0.01）. Cyto⁃ID staining showed that the percentage of autophagic cell increased dramatically from（13.302 ± 2.301）% to（53.274 ± 7.851）% upon the exposure of HTFs to 150 μg/mL Art（t = 8.804，P < 0.01）. Conclusion Artesunate can effectively promote the production of LC3⁃Ⅱand Beclin⁃l，increase the Ievel of autophagy in HTFs，and inhibit the growth of fibroblasts.

Objective To investigate the role of cAMP/PKA signaling pathway in docetaxel（DTX）⁃ induced neuropathic pain. Methods The rat model of chemotherapy⁃induced neuropathic pain was constructed by injecting DTX via tail vein，and PKA inhibitor H⁃89 and PKA agonist SP⁃CAMP were used for intervention. The mechanical withdrawal threshold（MWT）and thermal withdrawal latency（MWT）were measured by behavioral test. The content of cAMP in dorsal root ganglion and the level of IL⁃1β，IL⁃6 and TNF⁃α in spinal cord was detected by ELISA. The expression of astrocyte activation marker GFAP in rat spinal cord was observed by Immunofluores⁃ cence. The protein expression of cAMP/PKA signaling pathway was detected by Western blot. Results Intervention with H⁃89 significantly increased the value of MWT and TWL in model rats（P < 0.05），but decreased the protein expression level of phospho⁃cAMP⁃response element binding protein（p⁃CREB）and PKAc，as well as the level of IL⁃1β，IL⁃6 and TNF⁃α and the mean fluorescence intensity of GFAP（P < 0.05），while SP⁃CAMP intervention showed the opposite effect，but both had no significant effect on the content of cAMP in the dorsal root ganglia （P > 0.05）. Conclusions Inhibition of cAMP/PKA signaling pathway can improve DTX⁃induced neuropathic pain in rats，and the mechanism may be related to inhibition of astrocyte activation and the reduction of inflammatory factor release

Objective To explore the association of oxcarbazepine（OXC）⁃ induced cutaneous adverse reactions（CARs）with HLA ⁃B*1502 and HLA ⁃B*1301 genes. Methods A multicenter case ⁃control study was performed. Patients with OXC ⁃induced CARs，OXC ⁃tolerant patients，and healthy controls were recruited from January 2017 to December 2020. DNAs were extracted from peripheral blood. The genotype of HLA⁃B was detected by polymerase chain reaction（PCR）and Sanger sequencing. Chi⁃square test and Fisher′s exact test were used to compare the differences in the rate of HLA⁃B*1502 and HLA⁃B*1301 alleles between OXC⁃induced CARs group and OXC⁃tolerant group or normal control group. Results 15 patients with OXC⁃induced CARs，64 OXC⁃tolerant patients，and 100 healthy individuals were included in this study. One patient with OXC⁃induced SJS/TEN carried HLA⁃B*1502 gene. The rate of HLA⁃B *1502 gene in mild OXC⁃induced MPE group was 14.28%（2/14），which was not significantly higher than that in OXC ⁃tolerant group or normal control group（P > 0.05 for both compari⁃ sons）. The rate of HLA ⁃B*1301 gene was 42.86% in OXC ⁃induced CARs group，which was significantly higher than that in OXC⁃tolerant group or normal control group（P < 0.05）. Conclusions HLA⁃B*1502 was probably associated with OXC induced SJS/TEN，whereas HLA⁃B*1301 was related to OXC⁃induced MPE.

Objective To investigate the effect of thyroid function changes on the number of acute exacer⁃ bations and the decrease of lung function in COPD patients. Methods 80 patients with COPD and 72 healthy con⁃ trols were included continuously. The forced expiratory volume in the first second（FEV1），forced vital capacity （FVC）and the ratio（FEV1/FVC），serum thyroid stimulating hormone（TSH），free triiodothyronogen Amino acid （FT3），free tetraiodothyronine（FT4），total triiodothyronine（TT3），total tetraiodothyronine（TT4）were mea⁃ sured for the two groups of subjects；the above indicators were retested after 1 year of follow-up，and the number of acute exacerbations were counted. Results The FEV1，FVC，FEV1/FVC，TT3 and FT3 in the COPD group were significantly lower than those in the control group（all P < 0.05）. In both the two groups，the indicators of TT4，FT4 and TSH were not significantly different（all P > 0.05）；FEV1，FVC，FEV1/FVC，TT3，and FT3 in COPD group were lowered compared with that of 1 year ago（P < 0.05）. TT4，FT4，TSH indicators were not lower than 1 year ago，and these were no significant changes（all P > 0.05）；FEV1，FVC，FEV1/FVC，TT3，FT3， TT4，FT4，and TSH had no significant changes in patients in the control group compared with 1 year ago（all P > 0.05）；In COPD group，the decline of TT3 and FT3 has significantly positive correlation with the decline of FEV1，FVC，FEV1/FVC and the number of acute exacerbations of COPD（all P < 0.01）. Conclusion There were obvious changes about thyroid function in COPD patients. The decrease of T3 level was closely related to the decrease in lung function and the number of acute exacerbations in COPD patients.

Objective To explore the feasibility of measuring of arterial and venous circulation time of jugular brain based with 4D⁃CTA data of head and neck range，and to provide reference for CT angiography of head and neck range. Method A retrospective analysis of 298 patients who underwent 4D ⁃CTA imaging of head and neck range from January 2018 to March 2021 was conducted. The CT value and peak time of the arteries（aortic arch，common carotid artery，vertebral artery，middle cerebral artery M1，middle section of basilar artery）and veins（internal jugular vein，sigmoid sinus，superior sagittal sinus）in the head and neck area were measured. The circulation time from aortic arch to intracranial artery，from aortic arch to superior sagittal sinus，from superior sag⁃ ittal sinus to internal jugular vein，the average peak time of arterial system and venous system and the difference between them were calculated. The differences of peak time among patients with different genders，BMI（< 18.5， 18.5 ~ 23.9，23.9 kg/m2）and body weight（< 60 kg，60 ~ 80 kg，> 80 kg）were compared. Result In this study， the circulation time from aortic arch to intracranial artery ，from aortic arch to superior sagittal sinus and from superior sagittal sinus to internal jugular vein was（1.91 ± 0.78）s，（6.61 ± 1.40）s and（1.52 ± 1.43）s，respectively. The peak time of arterial system and venous system was（21.77 ± 3.09）s and（28.76 ± 3.68）s respectively，and the difference between the peak time of arteriovenous system was（6.99 ± 1.01s）. The peak time of aortic arch， arterial system，venous system and arteriovenous peak time in male and female patients were（20.65 ± 3.61）s， （22.55 ± 2.83）s，（29.90 ± 3.13）s，and（7.36 ± 0.90）s and（19.00 ± 3.05）s，（20.56 ± 3.15）s，（26.99 ± 3.83）s，and（6.44 ± 0.92）s，respectively. The difference was statistically significant（P < 0.05）. According to the BMI and body weight，the peak time difference of arteriovenous injection was similar，and the peak time of arteriovenous injection gradually prolonged with the increase of body weight，but no between ⁃group statistical significance was found（P > 0.05）. Conclusion Except the earlier peak time and shorter arteriovenous circulation time in women， there is no significant difference in peak time and circulation time between patients with different body weights and different BMI. The clinical application of 4D ⁃CTA technology to measure the circulation time of head and neck vessels was feasible，and the interval between the optimal arterial period and the optimal venous period was 6.99 s.

Objective To explore the value of serum soluble tumor factor 2 inhibitor（sST2），galectin⁃3 and uric acid（UA）levels for predicting the prognosis of patients with post ⁃ cardiac arrest syndrome. Methods The clinical data of 182 patients with post ⁃ cardiac arrest syndrome were retrospectively analyzed. Results The poor prognosis rate was 73.63%. The baseline serum levels of sST2，Galectin⁃3 and UA in the patients with poor prognosis were higher than those in the patients with good prognosis（P < 0.05）. Increased baseline serum levels of sST2，Galectin⁃3，UA and acute physiology and chronic health（APACHE II）increased the risk of poor prognosis （P < 0.05），while increased lactate clearance decreased the risk of poor prognosis（P < 0.05）. The sensitivity， specificity and area under curve（AUC）of the combined prediction for the poor prognosis were higher than those of respective detection. Conclusion The mortality rate of the patients with post⁃cardiac arrest syndrome is high. The baseline serum levels of sST2，Galectin⁃3 and UA are higher in the patients with poor prognosis，and it is of higher value to predict the risk of poor prognosis by combing the three levels.

Objective To learn about the impact of HIV low⁃level viraemia on subsequent virological failure in people living with HIV/AIDS undergoing antiretroviral therapy（ART）. Methods A retrospective observational study was conducted based on the data of Yunnan′s cases extracted from National HIV/AIDS Comprehensive Information Management System from January 1，2004 to December 31，2018. Multivariate Cox regression was used to analyze the Hazard Ratio（HR）of virological failure in patients with different levels and frequencies of low⁃level viraemia compared with those without occurrence of low⁃level viraemia. They were divided into first⁃line ART cohort （regimen without LPV/r）and second ⁃line ART cohort（regimen with LPV/r ）. Results A total of 93，944 cases were included in the analysis. In the first⁃line treatment cohort，compared with that without low⁃level viraemia，the risk rate of virological failure in the 51 ~ 199 copy /mL group was the same，but 1.39 times increased in the 200 ~ 399 copy /mL group，and 2.02 times in the 400 ~ 999 copy /mL group. Regarding to the frequencies of low viraemia occurrence，the risk of virological failure was gradually increased in cases suffering from low ⁃level viraemia once （HR = 1.28，95%CI：1.21 ~ 1.36，P < 0.001），twice consecutively（HR = 1.38，95%CI：1.22 ~ 1.55，P < 0.001） and several times consecutively（HR = 1.76，95%CI：1.48 ~ 2.10，P < 0.001）. In the second⁃line treatment cohort， the risk of virological failure was unchanged in the 51 ~ 199 copy/mL group，1.33 times increased in the 200 ~ 399 copy/mL group，and 2.26 times in the 400 ~ 999 copy/mL group，when compared with cases without low⁃level virae⁃ mia. There was an increased risk of virological failure in cases suffering from low⁃level viraemia once（HR = 1.27， 95%CI：1.11 ~ 1.46）and twice consecutively（HR = 1.38，95%CI：1.01 ~ 1.88）. Conclusion The ART cases suffering from viraemia with 200⁃999 copy /mL，or suffering from viraemia for once or or two or more times have the increased risk of subsequent virological failure. 

Objective To investigate the effect of neoadjuvant chemotherapy combined with total endo⁃ scopic Mckeown procedure on serum transforming growth factor⁃β1（TGF⁃β1），squamous cell carcinoma（SCC）⁃ associated antigen and long ⁃term curative effect in patients with middle and upper esophageal cancer. Methods The clinical data of 96 patients with middle and upper esophageal cancer in the hospital were retrospectively analyzed. According to the treatment method，they were divided into two groups. Patients in the study group were treated with neoadjuvant chemotherapy and subjected to total endoscopic Mckeown procedure，while patients in the control group were subjected to total endoscopic Mckeown procedure alone. The levels of TGF ⁃ β1 and SCC in the two groups were compared，and quality of life，recurrence，survival rate and the incidence of long⁃term complications in the two groups were analyzed. Results At 3 months after operation，serum TGF⁃β1 and SCC level in the two groups were significantly lower than those before operation（P < 0.05，respectively），and serum TGF⁃β1 and SCC level in the study group were significantly lower than those in the control group（P < 0.05，respectively）. Before operation，no significant difference in quality of life scores was observed between the two groups（P > 0.05），but patients in the study group had significantly higher quality of life scores than those in the control group at 6 and 9 months after operation（P < 0.05）. The recurrence rate and recurrence time in the study group during the follow⁃up period were significantly lower and shorter than those in the control group（P < 0.05，respectively）. One year after operation，there was no significant difference in the survival rate between the two groups（P > 0.05），but the sur⁃ vival rate in the study group was significantly higher than that in the control group at 3 and 5 years after operation （P < 0.05）There was no significant difference in the incidence of long⁃term complications between the two groups（P > 0.05）. Conclusion Neoadjuvant chemotherapy combined with total endoscopic Mckeown procedure could effectively lower serum TGF⁃β1 and SCC levels in patients with middle and lower esophageal cancer.

Objective To study the effect of air pressure wave therapy on lower extremity deep venous thrombosis in high⁃risk pregnant women. Methods A total of 400 high⁃risk pregnant women who delivered in the Department of Obstetrics of the Second People′ s Hospital of Panyu District from October 2019 to October 2020 were selected as the research objects. They were randomly divided into two groups with 200 cases in each group. The control group was given routine measures to prevent postpartum venous thrombosis，and the observation group was given air wave pressure therapeutic instrument intervention on the basis of the control group. The indexes of coagulation function and venous blood flow velocity were analyzed. All parturients were followed up for 1 month to observe the formation of lower extremity venous thrombosis. Results In the control group，the thigh circumference on the 3rd day after delivery was significantly smaller than that on the 1st day after delivery，the thigh circumfer⁃ ence and calf circumference on the 7th day after delivery were significantly smaller than that on the 1st and 3rd days before delivery（P < 0.05）. On the 3rd and 7th day after delivery，the thigh circumference and calf circumfer⁃ ence of the observation group were significantly smaller than those of the prenatal group，the 1st day after delivery and the control group（P < 0.05）. The levels of D⁃D，FIB，blood viscosity，platelet aggregation rate，hematocrit and plasma viscosity in the control group on the 7th day after delivery were significantly lower than those before delivery（P < 0.05）. The levels of Pt，APTT，TT，PLT，D⁃D，FIB，blood viscosity，platelet aggregation rate，he⁃ matocrit and plasma viscosity in the observation group on the 7th day after delivery were significantly lower than those before delivery and the 7th day after delivery in the control group（P < 0.05）. The blood flow velocity of exter⁃ nal iliac vein，common femoral vein，deep femoral vein and popliteal vein in the observation group on the 7th day （P < 0.05）. The two groups were followed up for one month after delivery，3 cases（1.50%）of the control group had lower extremity venous thrombosis. No lower extremity vein thrombosis was found in the observation group. There was no significant difference between the two groups（χ2 = 3.023，P = 0.082）. Conclusion Air pressure wave therapy is of value clinically for preventing deep venous thrombosis of lower limbs in high⁃risk pregnant women. 

Objective To explore the clinical application value of highly selective spermatic vein ligation under the outer ring for varicocele（Varicocele，VC）. Methods A total of 120 VC patients admitted to our hospital from January 2014 to January 2018 were selected and randomly divided into treatment group（n = 60）and control group（n = 60）. Highly selective spermatic vein ligation under the microscope were performed in the treatment group and spermatic vein ligation under the microscope were used in the control group. The therapeutic effects between the two groups were compared. Results The operation duration，intraoperative blood loss，24 h body tem⁃ perature and hospital stay of the study group were（35.26 ± 10.36）min，（4.19 ± 0.63）mL，（36.54 ± 0.21）℃， （7.62 ± 1.28）days，respectively，and were shorter than those of the control group（P < 0.05）. While，the semen quality of the study group 24 h after surgery was significantly higher than that of the control group（P < 0.05）；the total incidence of postoperative complications in the study group was 3.33% ，which was lower than that of the control group 13.33%（P < 0.05）. Conclusion The high⁃selective spermatic vein ligation under the outer ring of the microscope is safe and effective for VC. It could shorten the recovery time of patients to a limited extent and is worthy of clinical application.

Objective To investigate the effect of parity on the external cephalic version（ECV）for breech presentation at term and its impact of parity on the perinatal outcome. Methods A total of 368 cases of singleton pregnant women with breech pregnancy at 37 ~ 40 weeks from January 2015 to February 2021 in Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University were retrospectively analyzed. All subjects were divided into the multipara group and the primipara group according to the parity. The success rate of ECV，cesarean section rate，vaginal delivery rate，retroversion rate，postpartum hemorrhage rate，neonatal asphyxia rate were compared between the two groups. Results A total of 368 pregnant women received ECV and the total success rate was 41.30%（n = 152）. The success rate in the multipara group was 56.43%（79/140）vs 32.02%（73/228）in the primipara group（P < 0.01）. The total vaginal delivery rate was 33.97%（125/368），which was higher among the multipara group（50.00%，70/140）as compared with the primipara group（24.12%，55/228）（P < 0.01）. After successful ECV，the vaginal delivery rate was 82.24%（125/152），which was 88.61%（70/79）in the multipara group vs. 75.34%（55/73）in the primipara group. There were no significant difference（P > 0.05）among the reversion rate after successful ECV，postpartum hemorrhage rate and neonatal asphyxia rate between the two groups. Conclusions The multiparas are more suitable for ECV，and the success rate of the operation and the vaginal delivery rate increase significantly，which is instructive to select suitable candidates for ECV.

Objective To investigate the correlation between sperm DNA fragmentation index（DFI）and male infertility or early recurrent abortion occurred in the subjects′ spouses. Methods A total of 330 men who had received sperm DFI test in our center from December 2018 to December 2020 were retrospectively analyzed. According to the fertility status of their spouses，they were divided into infertility group（group A，n = 96），early recurrent abortion group（group B，n = 86），and normal fertility group（group C，n = 148）. The sperm DFI index and sperm parameters were compared among the three groups. Results There was no significant difference in age among groups A，B and C（P > 0.05）. Concentration of sperms，sperm activity，and rate of sperms with progres⁃ sive motility were lower，while rate of sperms with abnormal morphology was higher in group A or B than in group C（P < 0.01 for all comparisons）. DFI ≥ 30% was 52.1% in group A，46.5% in group B，and 6.8% in group C. DFI in group A or B was significantly higher than that in group C（P < 0.01）. Conclusions An increase in sperm DFI has a negative impact on male sperm，leading to male infertility and early recurrent abortion，to which should be paid attention. Sperm DFI index could be used in the evaluation of male infertility，which is worthy of clinical application.

Objective To investigate the clinical efficacy and safety of tolvaptan in the treatment of the patients with cirrhosis ascites during the perioperative period. Methods 110 cirrhosis patients who were hospitalized and required surgical treatment from October 2018 to May 2020 were enrolled and randomly divided into observa⁃ tion groupand control group. 56 cases in observation group were treated with Tolvaptan and spironolactone，while 54 cases were treated with spironolactone. Surgical operation was performed according to the main diagnosis.During the perioperative period，the changes in ascites degree，abdominal circumference，weight，length of hospital stay， blood electrolytes，and safety were compared between the two groups using the same conventional comprehensive treatment. Results The proportion of patients with massive ascites after operation in the observation group was significantly lower than that in the control group（day 5 after operation：24.53% vs. 57.69%；day 30 after operation： 7.14% vs. 22.22%）；The difference in ultrasound fibro touch to measure liver stiffness between preoperative and 1 month after surgery of the observation group was higher than that of the control group［（0.75 ± 0.20）vs.（0.28 ± 0.19），P < 0.05］；The abdomen circumference difference value and the weight difference value on patient admission day and hospital discharge day of the observation group were higher than those of the control group.［（2.59 ± 0.16）cm vs.（1.66 ± 0.18）cm，P < 0.05］；［（1.20 ± 0.08）kg vs.（0.92 ± 0.07）kg，P < 0.05］；respectively. The urine output and the serum sodium concentration on the day 3 and day 5 after operation of the observation groupwere higherthan those of the control group（P < 0.05）. But the hospital stays in the observation group was less than that in the control group［（6.40 ± 0.12）d vs.（7.33 ± 0.12）d，P < 0.05］；There was no significant difference in the serum potassium concentration between the two groups during the perioperative period（P > 0.05）. Conclusions In perioperative patients with cirrhosis，tolvaptan therapy can effectively control ascites，promote increased urine volume，facilitate rapid recovery，and improve hyponatremia without affecting blood potassium concentration，which is highly safe.

Objective To evaluate the value of autoantibodies combined with high resolution CT in predicting the invasion of lung adenocarcinoma in pure ground⁃glass nodule. Methods The surgical pathological biopsy of 101 cases of lung adenocarcinoma from Hubei Province′s third people′s hospital，and their chest high resolution CT revealed a single pure ground ⁃glass nodule. The patients were divided into two groups：preinvasive and invasive. The positive rate of autoantibodies and imaging signs in the two groups were observed and compared. Results There were no significant differences in lobulation ，Burr，vacuole sign ，air bronchus sign ，pleural indentation sign，and vascular bundle sign between preinvasive and invasive lesions（P > 0.05）. The diameter， average CT value and autoantibodies positive rate of invasive lesionswere significantly higher than those of preinva⁃ sive lesions，the differences were statistically significant（P < 0.05）. According to the receiver operating character⁃ istic curve，the best critical value of lesion diameter was 10.33 mm，and the mean CT value was⁃526.21 HU. To differentiate between preinvasive and invasive lesions，the sensitivity was 75.5 % and 92.5 %，respectively，the specificity was 89.6 % and 68.7 %，and the area under the curve was 0.888 and 0.737. The combined autoantibod⁃ ies′ sensitivity，specificity，and area under the curve were 92.5%，89.6%，and 0.956，respectively. Conclusion The size ，mean CT value ，and autoantibodies of a pure ground ⁃glass nodule can help to determine whether adenocarcinoma of the lung is invasive. When high resolution CT is combined with autoantibodies，it becomes more valuable.

Objective To investigate the current status and affecting factors of blood pressure monitoring at home in maintenance hemodialysis patients with hypertension. Methods From June 2019 to August 2019，a cross ⁃sectional survey on blood pressure monitoring at home was conducted in 681 maintenance hemodialysis patients with hypertension. The affecting factors of regular home blood pressure monitoring at home were analyzed. Results The rate of self⁃measurement at home was 61.1%。 The standard implementation rates of monitoring frequency，time to measurement，number of repeated measurement，and records of measurement results were 76.5%，46.0%，31.4% and 15.3% ，respectively. Multivariate logistic regression analysis showed that use of antihypertensive drugs was the affecting factor of regular measurement of blood pressure. Conclusions The self ⁃measurement rate of blood pressure was generally higher in maintenance hemodialysis patients with hypertension. However，the measurement was still lack of standardization in most of the patients. The patients who do not take antihypertensive drugs， smoke，and have prolong dialysis are at high risk for not monitoring home blood pressure normatively.

Objective To understand the characteristics of seasonal supplies of suspended red blood cells and ABO blood types to the top 15 hospitals in Guangzhou from 2010 to 2019，in order to analyze the reasons， predict future development trends and offer rational solutions to ensure clinical blood use. Methods The distribution data on red blood cells from 15 hospitals for recent 10 years were collected to calculate amount of each quarter and blood type，respectively. Results A total of 2，723，978 U of red blood cells were distributed to 15 hospitals in the past 10 years，accounting for 71.09% of the total distribution（2，723，978/3，831，751.5），the total distribution was increasing year by year. The annual composition of red blood cell distribution in each quarter was relatively stable， the distribution amount was higher in the second and fourth quarters than in the first and third quarters. There were statistically significant differences in blood distribution among four seasons（F = 3.155，P < 0.05），and the differences between the first quarter and the second quarter or the fourth quarter were statistically significant（P < 0.05）. The annual composition of red blood cell distribution in each blood type was relatively stable；type O had the most distribution while type AB had the least distribution. There were also statistically significant differences in blood distribution among four blood types（P < 0.05）but the differences in the other groups were statistically significant except between A type and B type（P < 0.05）. Conclusions The distribution of red blood cells in 15 hospitals had been increasing year by year so that the shortage of seasonal and structural distribution had existed. All departments should adjust the strategies for blood collection and distribution in time including an increase in group blood dona⁃ tion ，accurate donor recruitment ，and rational distribution to alleviate the contradiction between supply and demand，thereby meeting the needs for clinical use.

Objective To explore the effects of different frequencies of whole body vibration training on the balance and walking function of stroke patients. Methods A total of 60 hospitalized stroke patients from January 2018 to June 2019 were included and randomly divided into 15 Hz group（n = 30）and 30 Hz group（n = 30）. Both groups received routine rehabilitation training. Additionally ，the 15 Hz group received 15 Hz whole body vibration training and the 30 Hz group received 30 Hz whole body vibration training for 6 weeks. Before and after training，the berg balance scale（BBS）was used to assess the patient′s balance function，and the weight⁃bearing time，step length，pace，and functional ambulation category（FAC）were used to assess the patient′s walking function. Results The BBS scores of the two groups after training were significantly higher than those before training（P < 0.05），and the 30Hz group was significantly better than the 15 Hz group（P < 0.05）. The weight⁃ bearing time，step length，pace，and FAC classification of the two groups after training were significantly increased than before training（P < 0.05），and the 30 Hz group was significantly better than the 15 Hz group（P < 0.05）. Conclusion Both 15 Hz and 30 Hz whole body vibration training can improve the balance and walking function of stroke patients，and the effect pf 30 Hz whole body vibration training is better than that of 15 Hz training.

Long non⁃coding RNA（lncRNA）is a kind of non⁃coding transcripts longer than 200nt. Abnormal expression of lncRNAs is associated with various types of tumors. MALAT1，one of the first lncRNAs to be discov⁃ ered，can regulate the proliferation，apoptosis，metastasis and invasion of tumor cells through different pathways and affect the progression of tumors. The present study reviews the current status of MALAT1 in many kinds of tumors，and provides a novel perspective on the diagnosis and treatment of tumors.