Objective To investigate the repair mechanism of adipose ⁃derived stem cells（ADSCs）and Pluronic F⁃127（PF⁃127）complexes on the endometrium of New Zealand white rabbits with intrauterine adhesion （IUA）. Methods Ordinary female New Zealand white rabbits were randomly allocated into，according to different intervention methods，sham operation group，IUA model group，PF ⁃127 hydrogel group，ADSCs group，and ADSCs⁃PF⁃127 group. Uterine tissue was bilaterally harvested from the rabbits 14 days following the intervention in the hydrogel complex group. The endometrial thickness，the number of glands，the ratio of fibrosis area and the transforming growth factor ⁃ beta （TGF ⁃ β） were analyzed through histopathological and immunohistochemical methods to assess endometrial proliferation and fibrosis. Results Compared with those in the IUA model group， the endometrial thickness and the number of glands were significantly increased in the ADSCs ⁃ PF ⁃ 127 hydrogel complex group；the endometrial fibrosis area ratio and TGF⁃β expression were significantly decreased in the ADSCs⁃ PF⁃127 hydrogel group. The pathological characteristics of the PF⁃127 hydrogel group and the ADSCs group did not experience a significant change when compared with that of the IUA model group. Conclusion The ADSCs ⁃PF ⁃ 127 hydrogel complex has marked advantages in the dual repair effect of anti⁃adhesion and promoting endometrial regeneration. This provides a pathway for devising a novel therapeutic regimen to provide reference for future basic clinical studies.

Objective To explore the effect of KLF4 on the proliferation，migration and invasion of ovari⁃ an cancer SKOV3 cells by regulating the TGF ⁃ β pathway to attenuate EMT. Methods Lentiviral vectors of the overexpressed KLF4 and blank control groups were produced and transfected into ovarian cancer SKOV3 cells， which were screened with puromycin to generate the ovarian cancer cell lines of the two groups，respectively. West⁃ ern blotting was used to determine the expression of EMT⁃related proteins in the ovarian cancer cells of each group， MTT assay to detect their proliferation ability and Transwell assay to detect the effect of KLF4 overexpression on their migration and invasion ability. The orthotopic mouse xenograft model was established to verify the effect of KLF4 overexpression on the tumor growth and metastasis. Results According to MTT and Transwell，the overex⁃ pressed KLF4 in the KLF4 overexpression group significantly inhibited not only the proliferation，migration and invasion of ovarian cancer cells，but also the EMT process of ovarian cancer cells by inhibiting TGF⁃ β pathway mediated by Smad（P < 0.05），as compared with the control group. KLF4 inhibited the growth and metastasis of primary tumor in orthotopic mouse ovarian cancer xenograft. Conclusion KLF4 can inhibit EMT by inhibiting Smad mediated TGF⁃β pathway，and in this way it inhibits the proliferation of ovarian cancer，migration and inva⁃ sion. KLF4 /Smad/TGF⁃β/EMT axis is expected to be a new target for the treatment of ovarian cancer.

Objective To explore regulation of long non⁃coding RNA（lncRNA）SOS1⁃IT1 on hepatocellular carcinoma（HCC）cells and the underlying molecular mechanism. Methods Human HCC cell line QGY ⁃ 7703 was served as a cell model. CCK⁃8 assay was performed to detect cell viability，and EdU assay was applied to detect DNA replication activity. The potential miRNA binding sites（miRNA response elements，MREs）were predicted by bioinformatics analysis. The eukaryotic expression plasmid pcDNA3. 1（+）was used in ectopic expres⁃ sions of SOS1⁃IT1，SOS1⁃MRE and miR⁃124. The MREs were cloned into the downstream of an enhanced green fluorescent protein（EGFP）coding region to form fluorescent reporter plasmids. Fluorescent reporter gene assay was performed to detect the specific binding and regulation of miR⁃124 to the MREs. Results In human HCC cell line QGY⁃7703，overexpression of lncRNA SOS1⁃IT1 led to increase cell viability［（1.184 ± 0.114）vs.（0.928 ± 0.104），P < 0.05］and DNA replication［（0.625 ± 0.013）vs. 0.206 ± 0.016），P < 0.05］，while suppression of SOS1⁃IT1 resulted in decreased cell viability［（0.648 ± 0.062）vs.（0.870 ± 0.091），P < 0.05］and DNA replication ［（0.126 ± 0.022）vs. 0.271 ± 0.033，P < 0.05］. Bioinformatics analysis showed that SOS1 mRNA contained three and SOS1⁃IT1 contained one potential miR⁃124 reaction elements（MREs）. Fluorescent reporter gene assay indicated that the first two MREs within SOS1 mRNA and the MRE within SOS1⁃IT1 were the functional binding sites of miR ⁃124. QGY ⁃7703 cells were transfected with the fluorescent reporter plasmid containing SOS1⁃MREs，alongwith SOS1⁃IT1⁃MRE expression plasmid，and an increase in fluorescent intensity was observed［（3.68 ± 0.315）vs. （2.71± 0.180），P < 0.05］. Further overexpression of miR⁃124 led to a fallback of the fluorescence intensity［（1.09 ± 0.143）vs.（4.04 ± 0.079），P < 0.05］. A change in fluorescence intensity did not occur if any of the MREs was mutated［（2.57 ± 0.244）vs.（2.71 ± 0.180）and（2.66 ± 0.20）vs.（2.88 ± 0.169），P > 0.05］. Conclusions lncRNA SOS1⁃ IT1 competitively binds endogenous miR ⁃124 with its host gene SOS1. SOS1⁃ IT1 promotes SOS1 expression and enhances HCC cell viability and DNA replication by the competing endogenous RNA（ceRNA）mechanism.

Objective The aim of this study is to investigate the protection effect of Juglone in shock ⁃ waves induced injuries in type Ⅱ alveolar epithelial cells. Methods The injury of A549 cells caused by lithotripter shock wave（LSW）has been developed.CCK⁃8 was used to detect cell viability and ELISA was performed to detect the content of IL⁃6 and IL⁃8 in the supernatant.A549 cells were pretreated with Juglone（0.5 μg/mL）for 6 hours followed by LSW for 1 000 times，and the cell viability and the content of IL⁃6 and IL⁃8 in the supernatant were detected again，and the western blot analysis was applied to detect the protein expression levels of caspase⁃3 and caspase⁃9. Results The results of CCK⁃8 assays showed that shockwave treatment significantly decreased the viability of A549 cells to（49.2 ± 3.04）%，while increasing the IL⁃6 and IL⁃8 level to（55.6 ± 0.4）pg/mL and （1 480.3 ± 19.1）pg/mL respectively，which indicating that the shockwave injured cell model was established successfully. A549 cells were pretreated with Juglone（0.5 μg/mL）for 6 hours before being exposed to LSW 1 000 times，increasing cell viability to 70. 13.1% while decreasing the content of IL ⁃6 and IL ⁃8 in the supernatant to （37.3 ± 1.2）pg/mL and（1281.9 ± 19.3）pg/mL，respectively. Compared with the shockwaves group，the difference was statistically significant（P < 0.05）. WB assay showed the decreased expression level of caspase⁃3 and caspase⁃9 following pre⁃treated with Juglone（P < 0.05）. Conclusion Juglone plays protecting role in A549 cells caused by shock wave through reducing the apoptosis level and inhibiting inflammatory response.

Objective The purpose of this study was to explore the mechanism of exosomal miR⁃939 in hypoxia⁃induced cardiomyocytes injury via regulating ADCY6. Methods Serum from patients with acute myocardial infarction（Acute myocardial infarction，AMI）was collected，then exosome（exo）were isolated form serum and normal cardiomyocytes and subsequently H9C2 cells were treated with cobalt dichloride （CoCl2） to establish hypoxic cardiomyocyte model. Subsequently H9C2 cells were co ⁃cultured with normal cardiomyocytes derived exo and the expression of miR⁃939 was detected. MTT，transwell assay and flow cytometry was used to detect cell viability，migration and apoptosis individually.Double luciferase report experiment was used to verify the targeting regulatory relations between miR⁃939 and ADCY6. Results The expression of miR⁃939 in serum of AMI patients， serum exo and hypoxia ⁃treated cardiomyocytes were decreased. Normal cardiomyocytes derived exo promoted the proliferation and migration of hypoxia ⁃treated H9C2 cells and inhibited cardiomyocytes apoptosis（all P < 0.05）. Knocking down of miR⁃939 in exo partially counteracted the protective effect of exo. ADCY6 was proved to be a target gene of miR⁃939，exo promoted proliferation and migration but inhibited apoptosis of cardiomyocytes，more obvious effect was observed when exo combined with miR⁃939（P < 0.05）. The effect of exo⁃miR⁃939 on hypoxic cardiomyocytes was partially offset by ADCY6（all P < 0.05）. Conclusion Normal cardiomyocytes derivedexo inhibited the expression of ADCY6 by transfering miR ⁃939 to hypoxia ⁃treated cardiomyocytes，thereby reduced cardiomyocytes damage，the present research provided new molecular target in diagnosis and treatment of AMI.

Objective To study the early miscarriage rate of in vitro fertilization in infertile patients with endometriosis（EMs）. Methods Pregnancy outcomes of 198 infertile patients with EMs and 179 infertility patients with tubal problems treated with IVF or ICSI in our hospital from January 2016 to March 2021 were retro⁃ spectively investigated. Results The early miscarriage rate of natural pregnancy in the endometriosis group was significantly higher than that in the control group（25.60% vs. 14.55%，P < 0.05）. After IVF or ICSI，the fertiliza⁃ tion rate and high⁃quality embryo rate in the endometriosis group were significantly lower than those in the control group，respectively（69.22% vs. 79.53%；51.91% vs. 59.19%，P < 0.05）. The early miscarriage rate after the im⁃ plantation of fresh or frozen embryos in the EMS patients was significantly higher than that in the control group， respectively（24.39% vs. 7.14%，21.31% vs. 4.69%，P < 0.05）. Conclusion The fertilization rate and high⁃quality embryo rate are lower and the early miscarriage rate is higher in the EMS patients，indicating that endometriosis may lead to infertility by impairing the embryo quality and other factors. 

Objective To explore the correlation between heterogeneous nuclear ribonucleoprotein U （HNRNPU）expression and sperm quality parameters in patients with severe and weak sperm disease，and to explore its effect on the clinical outcome of intracytoplasmic sperm injection（ICSI）. Methods Totally 500 semen specimens from men with severe oligoasthenozoospermia requiring ICSI treatment （ICSI group）and 500 from normal men（control group）were collected at our clinic. The sperm HNRNPU mRNA，volume，concentration， morphology，total progressive motile sperm count，Ca2 + ionophore（A23187）⁃induced arcrosome reaction（ARIC） rate，sperm DNA fragmentation index（DFI）and sperm nucleation were detected and outcomes in the ICSI group were recorded. Results The ICSI group（0.38 ± 0.04）showed significantly higher expression of HNRNPU mRNA than the control group（0.14 ± 0.03）（P < 0.05），and the normal morphology sperm，ARIC% and maturity in ICSI group were significant lower than those in the control group（P < 0.001）. HNRNPU mRNA was negatively related with total progressive motitle sperm count，normal morphology sperm，ARIC% and maturity，but positively with DFI （P < 0.001）. HNRNPU mRNA was negatively related with normal fertilization（2PN）rate（P < 0.05），but not with cleavage rate or clinical pregnancy rate of ICSI. Conclusion The increase of sperm HNRNPU mRNA expression may be one of the reasons for the onset of severe oligoasthenozoospermia. It can predict the fertility rate of ICSI to a certain extent.

Objective To summarize the clinical phenotype characteristics of the PRRT2 gene mutation family and analyze the treatment effect in order to provide evidence for the clinical diagnosis and treatment. Methods Clinical data of PRRT2⁃positive patients and their family members who received treatment in our hospital from November 2018 to February 2021 were selected and the therapeutic effect was analyzed. Results A total of 3 patients showed benign familial infantile epilepsy（BFIE） in infancy and paroxysmal kinesigenic dyskinesia （PKD）in adolescence. Four patients were diagnosed with BFIE in infancy，and among them，three are still in early childhood with uncertain PKD phenotype；one adult female patient was only diagnosed with PKD. Six patients with BFIE were not treated and improved within 2 years of age. The symptoms of the 2 patients could be relieved by low⁃dose of oxcarbazepine. The symptoms of the 3 patients with PKD could be relieved by low⁃dose of oxcarbaze⁃ pine. Conclusions The most common clinical phenotypes in families with PRRT2 gene mutations are BFIE and PKD. Some affected populations have BFIE phenotypes in infancy，and PKD phenotypes may appear in adoles⁃ cence. Lower dosage of oxcarbazepine is effective in treatment，while levetiracetam has poor therapeutic effects and may even worsen the attack.

Objective To evaluate the role of perfusion index（PI）in predicting the demands in neonates with septic shockfor vasoactive drugs during early recovery. Methods A total of 56 term infants with neonatal septic shock hospitalized in the neonatal intensive care unit（NICU）of Xinxiang Center Hospital from January 2018 to June 2020 were divided into vasoactive drug group（n = 31）and non⁃vasoactive drug group（n = 25）according to the need to use vasoactive drugs. Results （1）The cut ⁃ off value of PI in predicting the neonates′ vasoactive demands was 0.28，the sensitivity andthe specificity were 90.3% and 96%，respectively and the AUC was 0.96（95% CI：0.91 ~ 1.00；P < 0.001）.（2）The cut⁃off value of the arterial lactate level in predicting their vasoactive demands was 5.45 mg/dL，the sensitivity and specificity were 74.2% and 92%，respectively and the AUC was 0.89（95% CI：0.81 ~ 0.97；P < 0.001）.（3）Other perfusion variables failed to predict their vasoactive demands in the septic shock infants. Conclusion PI and arterial lactate levels can predict the demands in septic shock infants for vasoactive drugs.

Objective To investigate the effect of preoperative systemic immune inflammation index（SII） on postoperative prognosis of patients with pancreatic cancer（PDAC）. Methods The clinical data of PDAC patients who underwent pancreatic cancer resection in the second affiliated Hospital of Zhengzhou University from January 2015 to December 2020 were analyzed retrospectively，including general data（age，sex，underlying disease）and the results of laboratory examination one week before operation（blood routine，CA19⁃9，bilirubin level，tumor size，lymph node metastasis，tumor differentiation）. The SII of patients one week before operation was calculated according to the formula：the platelet count × the number of neutrophils/the number of lymphocytes. The best critical value of SII was determined by ROC curve，the survival curve was drawn by Kaplan⁃Meier，and the relationship between preoperative SII and postoperative survival was discussed by Cox univariate and multivariate regression analysis. Results This study included 150 patients，aged 42.0 ~ 79.0（60.4 ± 9.9）years，76 males（50.67%）and 74 females（49.33%）. According to the ROC curve，the best cut⁃off value of SII was 822，above which there were 71 cases and under which there were 79. By Kaplan⁃Meier curve，the 1，3，5⁃year survival rates of the two groups were（39.7%，5.7%，0.0%）and（71.8%，37.2%，2.1%），respectively，the average survival time was（14.88 ± 1.56）months and（29.92 ± 2.02）months，respectively，and the overall survival rate of the SII ≤ 822 group was significantly higher than that of the SII > 822 group（P < 0.05）. By Cox multivariate survival analysis，the indepen⁃ dent risk factors for their postoperative prognosis were SII > 822，tumor > 3 cm and lymph node metastasis（P < 0.05）. Conclusion The independent risk factors affecting the overall survival of pancreatic cancer patients are preoperative SII > 822，tumor > 3 cm and lymph node metastasis. The higher the SII，the worse the prognosis.

Objective To compare the clinical efficacy of Oxford unicompartmentknee replacement （UKR）and total knee arthroplasty（TKA）in the treatment of medial knee osteoarthritis. Methods A total of 100 patients with medial knee osteoarthritis who underwent UKR and TKA from June 2015 to June 2019 in the first department of orthopedics and orthopedics，Dongzhimen Hospital from June 2015 to June 2019 were selected and divided into single condyle group and total knee group，with 50 cases in each group. Intraoperative blood loss，post⁃ operative total drainage volume，operation time and hospital stay，knee flexion，visual analogue scale（VAS）， American hospital for Special Surgery knee score（HSS）and the incidence of related complications were compared between the two groups. Results Less intraoperative blood loss and postoperative total drainage volume in single condyle group were found and the operation time and hospitalization time were shorter than those in the total knee group，indicating statistical significance（P < 0.05）. Knee flexion and HSS score of single condyle group were higher than those of the total knee group from 1 week to 1 year after operation，but VAS score was lower and the differ⁃ ence was statistically significant（P < 0.05）. The excellent rate of clinical effect in single condyle group from 1 week to 6 months after the operation was higher in single condyle group（P < 0.05）but no statistical difference wasfound 1 year after the operation（P > 0.05）. There was no significant difference in the incidence of postoperative complications between the two groups（P < 0.05）. Conclusion TKA and UKR are feasible treatment for medial knee osteoarthritis. UKR has a better effect on pain relief and knee function recovery within 1 week to 1 year after operation.

Objective To evaluate the effect of endoscopic thyroidectomy combined with parathyroid trans⁃ plantation on recovery of parathyroid function. Methods 72 patients with thyroid nodule who had received surgi⁃ cal treatment from January 2018 to December 2020 in our hospital were selected. The baseline and postoperative serum parathyroid hormone（PTH）in the transplanted and non⁃transplanted sides and serum Ca2+ level in systemic circulation were detected. The postoperative serum PTH concentration in the transplanted and non ⁃ transplanted sides at different time points and the preoperative and postoperative serum Ca2 + concentrations were compared by paired sample t⁃test to judge the survival status and functional recovery of the transplanted parathyroid glands. Results At each postoperative monitoring time point，serum PTH level showed an upward trend，whereasit was higher at different degrees in the transplanted side than in the non⁃transplanted side. There was no significant differ⁃ ence in serum PTH level between the transplanted and non⁃transplanted side on postoperative day 1（P > 0.05）. With the prolonged recovery duration，there was a statistically significant difference in serum PTH between the transplanted and the non⁃transplanted side in postoperative week 1，months 1 to 3，and month 6（P < 0.05）. Serum Ca2 + in the systemic circulation decreased on postoperative day 1 and in week 1 and months 1 to 2. As time went by，Ca2+ gradually increased and basically recovered to the preoperative level by month 3. As compared with preop⁃ erative serum Ca2+ on postoperative day 1 and in week 1 and months 1 to 2，the difference was statistically signifi⁃ cant（P > 0.05）. However，there were no statistically significant differences in serum Ca2 + in systemic circulation between the baseline and postoperative level in months 3 and 6（P > 0.05）. Conclusions Endoscopic thyroidectomy combined with parathyroid transplantation evidently lowered the rate of hypoparathyroidism，effectively improved PTH，and increased Ca2+ level following surgical treatment.

Objective To compare the efficacy of unicondylar replacement and high tibial osteotomy in the treatment of osteoarthritis of the medial compartment of the knee. Methods We selected 40 patients with medial compartment osteoarthritis of the knee in our hospital from January 2017 to December 2020 as the research objects. According to patient′s wishes，they were divided into unicondyle replacement group and high tibial osteotomy group with 20 cases in each. The two groups were compared in terms of inflammatory cytokines，knee joint range of motion，knee joint function score，quality of life score，and complication rate. Results There was no significant difference in knee range of motion，knee function scores，and quality of life score between the two groups before surgery（P > 0.05）. Knee range of motion，knee function scores，and quality of life scores were all higher 1 month after surgery and the difference was statistically significant（P < 0.05）. The quality of life score in the two groups showed nostatistical significance（P > 0.05）. Knee joint function score was higher inunicondyle replacement group than that in the high tibial osteotomy group，and the difference was statistically significant（P < 0.05）. The compli⁃ cation rate of the two groups was the same，indicating no statistical significance（P > 0.05）. Conclusion In clinical treatment of osteoarthritis of the medial compartment of the knee，unicondyle replacement is more helpful than high tibial osteotomy to improve knee joint function，but its disadvantage is that the knee joint has poor mobility.

Objective To investigate the influencing factors of recurrence within one year in patients with first⁃episode mania，and the correlation between disease outcome and functional prognosis after 7 years. Methods A total of 147 patients with first ⁃episode mania from October 2011 to October 2013 were enrolled. The data were collected at the first episode including demography，disease characteristics，biochemical indicators，treatment，etc. The relapse and treatment of the disease in the next 7 years would be investigated，as well as the current situation of demography and global assessment Function after 7 years. Results 101 cases were followed up for 7 years. Patients with aggressive characteristics，the maintenance phase treatment，the appearance factor inYMRS and the support Utilization Score in the recurrent group（recurrence in the first year）were lower than those in the non⁃ recurrent group（non ⁃ recurrence in the first year）. Patients with body Mass Index（BMI），triglyceride，and the proportion of patients with psychotic symptoms were higher than those in the non⁃relapse Group（P < 0.05）. The total seizure frequency in the recurrence group was higher than that in the non⁃recurrence group in 7 years（P < 0.05）. There was no significant difference in Global Assessment Function between the two groups（P > 0.05）. Multivariate logistic regression analysis showed that aggressive characteristics（OR = 0.300），the maintenance phase treatment （OR = 0.314），to the support Utilization Score（OR = 1.370），psychotic symptoms（OR = 7.696）at first onset were associated with recurrence of manic in a year. Conclusion The first mania episode of patients with psychotic symptoms and low utilization of support increased the risk of recurrence in the first year，while those with aggres⁃ sive characteristics and maintenance treatment had relatively low risk of recurrence in the first year.The patients who relapsed within one year would relapse more frequently.

Objective To investigate the effects of laparoscopic and open colon surgery on gastrointestinal function recovery and human hemodynamic changes in patients of redundant colon syndrome with HAPC in plateau area. Methods A retrospective analysisof clinical data of 360 surgery patients with redundant colon syndrome from September 2016 to December 2020 was conducted. The patients complicated with HAPC were selected as the HAPC⁃ complicated group，and those without HAPC as HAPC ⁃free group，with 180 cases in each group. Blood routine， blood coagulation function，blood loss during operation，recovery time of gastrointestinal function，occurrence of postoperative complications and hemodynamics indexes of 2 groups were compared before and after operation. Result RBC，hemoglobin，RBC volume and fibrinogen degradation product（P ⁃FDP）of the HAPC ⁃complicated group（1 d after admission，2 d，3 d and 7 d after operation）were significantly different from those of the HAPC⁃free group（P < 0.05）. Postoperative oxygen saturation，recovery time of gastrointestinal function，occurrence of postoper⁃ ative complications and postoperative hospitalization time in HAPC⁃complicated group were all higher（longer）than the HAPC⁃free group，showing statistical significance（P < 0.01）. The difference of mean arterial pressure（MAP） and heart rate（HR）before and after operation in the HAPC⁃complicated group were greater or higher than those in the HAPC⁃free group，and the difference was statistically significant（P < 0.05）. Conclusion The postoperative intestinal recovery time of patients with redundant colon combined with hypererythema is slower than that of patients without hypererythema，and there is a higher chance of postoperative complications，decreased arterial oxygen saturation，significantly increased postoperative heart rate，and greater changes in human hemodynamics after surgery. Therefore，early preoperative diagnosis，active surgical intervention and active monitoring of hemodynamic changes are the keys to reduce the incidence of postoperative complications and mortality in HAPC patients.

Objective To investigate the drug resistance genes and susceptibility of 96 clinically isolated strains of Acinetobacter baumannii resistant to imipenem and meropenem. Methods Carbapenemase phenotype analysis was performed on 96 clinically isolated strains of carbapenem ⁃ resistant Acinetobacter baumannii，PCR amplification and electrophoresis imaging analysis of drug⁃resistant genes were performed，and drug sensitivity tests were conducted to analyze the sensitivity of the isolates to piperacillin/tazobactam and other 15 drugs. Results The samples were mainly obtained from lower respiratory tract（59 strains，61.5%），venous blood（18，18.75%）， and drainage fluid（8，8.3%）and from ICU（75 strains，78%），rehabilitation medicine department（5，5.2%）， and neurology department（5，5.2%）. 69 strains（approximately 71.9%）were positive in modified Hodge test. The enzyme inhibition test was not consistent with phenotype，and there was compound resistance mechanism. The bacteria was 100% resistance to ticacillin/clavulanate，piperacillin/tazobactam and ciprofloxacin；and 83.3% to cotrimoxazole，85.4% to cefepime，88.4% to tobramycin，91.7% to cefoperazone/sulbactam，96.9% to levofloxacin， 98.9% to doxycycline，99.0% to ceftazidime，1.1% to polymyxin，4.2% to tegacycline，and 36.8% to minocycline. Drug resistance gene OXA ⁃23 was detectable in 95 strains，OXA ⁃51 in 93 and KPC in 3，while other resistant genes were not found. Conclusions Carbapenem⁃resistant Acinetobacter baumannii showed multi⁃drug resistance and pan⁃drug resistance. OXA⁃23 and OXA⁃51 genes were the main drug resistance genes of carbapenemase in our hospital.

Objective To investigate the efficacy and safety of Ezetimibe combined with Atorvastatin on the short ⁃ term prognosis and recurrence of mild ischemic stroke（MIS）and intracranial atherosclerosis（ICA）. Methods Patients with MIS and ICA who were hospitalized in the Neurology Department of the Second Affiliated Hospital of Nantong University from January 2017 to December 2019 were included and divided into control group and treatment group，the former treated only with Ezetimibe and the latter with Ezetimibe combined with Atorvas⁃ tatin. The Modified Rankin Scale（mRS）was used to evaluate the prognosis of patients in both groups at 90 days. MRS ≤ 2 was regarded as good prognosis and > 2 as poor prognosis. The plaque burden of ICA was assessed by high resolution magnetic resonance vessel wall imaging（HRMR⁃VWI）before and 180 days after treatment in both groups. All the patients were followed up for 12 months after discharge to evaluate the recurrence of ischemic stroke within 12 months. Results A total of 212 patients were included，including 74 in the treatment group and 138 in the control group. There was no significant difference in demographic and baseline data between the two groups （P > 0.05）. There was no significant difference in terms of the short⁃term prognosis of 90 days，while the low⁃ density lipoprotein cholesterol and plaque burden of HRMR⁃VWI were significantly lower 180 days later. One case died of cerebral hemorrhage in the treatment group，and 1 case died of acute coronary syndrome in control group， with no statistical significance in the mortality between the groups（P > 0.05）. There was significant difference in the occurrence rate between the groups（2.7% vs. 12.3%，P < 0.05）. Conclusion Ezetimibe combined with Ator⁃ vastatin is effect in reducing the plaque burden of ICA and the recurrence rate of cerebral infarction within one year in patients with MIS and ICA，and its safety is high.

Objective To evaluate the application value of serum protein induced by Vitamin K absence or antagonist⁃Ⅱ（PIVKA ⁃Ⅱ）and alpha fetoprotein（AFP）in primary hepatocellular carcinoma（HCC）basing on decision curve analysis（DCA） and clinical impact curve method. Method A total of 982 cases of outpatients， inpatients and healthy controls in the First People′ s Hospital of Foshan were included，and divided into HCC group，chronic hepatitis B group，cirrhosis group，intrahepatic cholangiocarcinoma group，secondary hepatic malignant tumor group and control group. Serum PIVKA ⁃ Ⅱ and AFP levels were measured. Receiver operating characteristic（ROC），DCA and clinical impact curve were used to evaluate the application value of PIVKA ⁃Ⅱ and AFP in patients with HCC. Results The level of PIVKA⁃Ⅱ and AFP in HCC group was significantly higher than that in other groups（P < 0.001）. The level of PIVKA⁃Ⅱ and AFP in hepatitis group was significantly higher than that in control group（P < 0.001）. The proportion that PIVKA⁃Ⅱ and AFP increased inconsistently in HCC group，chronic hepatitis B group，and cirrhosis group was 35.44%，33.08%，and 35.43%，respectively. Taking patients without HCC as control group，the AUC of PIVKA⁃Ⅱ was better than that of AFP （P < 0.001），which was basically consistent with the joint detection（P = 0.967）. Taking healthy controls as control group，the AUC of joint detection was better than that of PIVKA⁃Ⅱ（P = 0.0385）and the AUC of PIVKA⁃Ⅱ was better than that of AFP（P < 0.001）. Combined with age and gender，the diagnostic value of joint detection for HCC was better than that of AFP. Except for the risk threshold of 0.24 ~ 0.25，the diagnostic value of combined detection was also better than that of PIVKA⁃Ⅱ. When the threshold probability was 0.2， the number of people classified as high risk by thejoint detection scheme was basically consistent with that of true⁃positive patients. Conclusion Serum PIVKA⁃Ⅱ and AFP are good biomarkers for the diagnosis of HCC. In the early screening and diagnosis of HCC，the factors such as patient′s gender，age，PIVKA⁃Ⅱ and AFP level should be taken into consideration in the analysis.

Objective To explore the application value of ADC and rADC values in the differential diagno⁃ sis of PCNSL and HGG as well as the correlation with Ki⁃67 in different tumor regions. Methods Clinical and imaging data of 30 cases of PCNSL and 35 cases of HGG were collected，the characteristics of MRI and DWI of 30 cases of PCNSL and 35 cases of HGG confirmed by clinical and pathology were analyzed. The differences of ADC values in different regions of the two groups of tumors were compared，and ROC curves were drawn to analyze and compare the diagnostic efficacy of ADC and rADC values in the two groups of tumors.The correlation was analyzed between tumor parenchymal ADC and rADC and Ki⁃67 in PCNSL group. Results There were statistically signifi⁃ cant differences in ADC values of tumor parenchyma，proximal peritumor，distal peritumor and contralateral white matter in PCNSL（F = 278.758，P < 0.001）. Pair comparison showed statistically significant differences（P < 0.05）. The parenchymal ADC values，ADC values around the proximal tumor and ADC values around the distal tumor in the PCNSL and HGG groups showed a parabola pattern of rising first and then falling，and a broken line pattern of rising.The ADC value and rADC value of tumor parenchyma and distal peritumor ADC value and rADC value of PCNSL were significantly lower than those of HGG group（P < 0.001），while the ADC value and rADC value of proximal peritumor ADC value and rADC value of PCNSL were significantly higher than those of HGG group（P<0.001）. When the rADC value of tumor parenchymal was 1.045，the sensitivity，specificity and accuracy of differ⁃ ential diagnosis of PCNSL and HGG were 96.7%，85.7% and 90.8%，respectively. The area under the rADC value curve was the largest（AUC = 0.964），and the diagnostic efficiency was the highest.Ki⁃67 expression was negatively correlated with ADC and rADC values. Conclusion The measurement techniques of ADC value and rADC value provide pathological basis and molecular imaging basis for noninvasive determination of tumor and peri⁃tumor micro⁃ invasion state，provide reliable basis for the diagnosis and differentiation of PCNSL and HGG，and also reflect the value⁃added activity of PCNSL at the molecular level.

Objective To explore the clinical value of ultrafast ultrasound imaging（UFUI）in measuring carotid artery elasticity in patients with gouty arthritis（GA）. Methods Totally 102 GA patients were selected， and according to whether combined with bone erosion，they were divided into non⁃bone erosion GA group（n = 52） and bone erosion GA group（n = 50）. In addition，54 healthy volunteers in our hospital for physical examination during the same period were included in the control group. Blood pressure，blood lipids，uric acid，carotid artery⁃ media thickness（IMT），pulse wave velocity at the beginning of the systole（BS），and at the ending of the systole （ES）in all the participants were compared. Results （1）Uric acid，IMT，BS and ES in the GA group were signif⁃ icantly higher than those in the control group（P < 0.05）. There was no difference in age，body mass index，systol⁃ ic blood pressure，diastolic blood pressure，total cholesterol，triglycerides and high⁃density lipoprotein cholesterol in the GA group when compared with the control group（P > 0.05）.（2）In the GA group，the BS，ES and the course of the disease of the bone erosion group were significantly higher than those of the non⁃bone erosion group（P < 0.05）. There was no difference in IMT，age，body mass index，blood pressure，blood lipids and uric acid between the two subgroups（P > 0.05）.（3）BS and ES of GA group were positively correlated with IMT. The pulse wave velocity at the beginning of the systole of the control group，the non⁃bone erosion GA group and the bone erosion GA group were（5.12 ± 0.76）m/s，（5.90 ± 0.84）m/s and（6.81 ± 0.76）m/s，respectively. The pulse wave velocity at the ending of the systole of the control group，the non ⁃bone erosion GA group and the bone erosion GA group were（6.93 ± 0.96）m/s，（8.60 ± 1.19）m/s and（9.50 ± 0.79）m/s，respectively. Conclusion BS and ES are increased in GA patients；carotid artery stiffness is increased and the elasticity is down. UFUI technology can detect the changes of carotid artery elastic function in GA patients in the early time，which provides important referencefor early clinical evaluation of carotid atherosclerosis.

Objective To investigate the transthoracic echocardiography（TTE）features of patients with abnormal coronary artery origin（CAOA）and to evaluate the changes of cardiac function before and after coronary transplantation. Methods We retrospectively collected the imaging and clinical data of 43 CAOA patients confirmed in our hospital（from 2008，1 to 2020，4），and analyzedthe ultrasonic characteristics before and after operation in 16 out of the 43 patients accepting coronary transplantation. Results CAOA were more common in women（65.1%， 28/43），and most of the patients visited the doctor due to heart murmurs during physical examination（22/43， 51.2%）. The abnormal origin of left coronary artery（LCA）was the most common type，accounting for 65.1%（28/43）. For LCA abnormal patients，the most common type was LCA from pulmonary artery（PA）（20/43，46.5%）. 58.1% （25/43）of the CAOA patients didn′t present other malformation. Echocardiography showed enlargement of the left ventricular，massive mitral regurgitation（7/43，16.3%），but no changes in LVEF and FS. During the follow⁃up of 16 patients undergoing surgery，LVEDD and mitral regurgitation were reduced in 6 months after surgery when compared with those before surgery（P < 0.05）. Conclusions Echocardiography showsthe LCA originating from PA is the most common type in CAOA patients，usuallyaccompanied without other malformation，and mainly shows LV enlargement， mitral regurgitation. The left ventricular remolding recovers 6 months after coronary artery transplantation.

Objective To study the spatial distribution characteristics of traditional Chinese medicine hos⁃ pitals in Guangzhou. Methods We collected statistical data on traditional Chinese medicine in Guangzhou as well as data from the government′s official website. Kernel density analysis，Tyson polygon，Average nearest neighbor analysis and Ripley′s K function were used to describe and analyze the spatial distribution characteristics of traditional Chinese medicine hospitals. Results Thenearest neighbor ratio was Ann = 0.85，Z = -1.68，P = 0.09； The ObservedK value is significantly smaller than the ExpectedKvalue and the confidence interval is narrow. Conclusion When only the spatial location is considered，the distribution of TCM hospitals in Guangzhou is weak aggregation；however，when the population weight is increased，the distribution becomes discrete.

Objective To evaluate the safety and clinical efficacy of Nu ⁃based acupuncture therapy in treating knee osteoarthritis（i.e. cold arthralgia in Chinese medicine and cold bone wind in Miao medicine）. Methods Randomized，multicenter and parallel controlled clinical research method was used. A total of 297 cases included in each clinical center according to the inclusion criteria were randomly divided into treatment group， placebo group and acupuncture group. In the treatment group，5 ~ 6 acupoints in the patients were selected according to the symptoms，and they were massaged according to kneading method and point pressing method after the Nu solution was daubed among the knee joint. When the patients felt that the knee joint was hot for 10 ~ 15 minutes， the acupoints were pricked with sterile plum⁃blossom needle dipped in Nu solution，3 ~ 5 times for each acupoint， followed by bamboo cupping for 10 ~ 15 minutes. The placebo control group was treated with placebo instead of Nu solution，and the standard for selecting acupoints and manipulation methods were the same as in the treatment group. The acupuncture control group was given routine acupuncture at other acupoints ，moxibustion or warm acupuncture. The course of treatment was 10 days. Clinical efficacy，VAS score of knee pain，improvement rate of main clinical symptoms，change of onset time，disappearance time，safety index and WOMAC score were observed across the two groups. Results The cure rate，marked effective rate and total effective rate of the treatment group were all significantly higher than the placebo and acupuncture groups（18.33%，0，15.25%；59.16%，1.47%， 50.84%；83.33%，19.12%，82.76%，P < 0.05）. The VAS scores of knee pain in the three groups were significantly different before and after treatment（P < 0.05）. After treatment，the improvement rate and disappearance time of main clinical symptoms such as rest pain，morning stiffness，walking pain and standing pain were significantly different between groups（P < 0.05）. Compared with placebo group and acupuncture group，the WOC score of the treatment group was significantly different（P < 0.05）. No adverse reactions in the treatment group were found. Conclusion Nu⁃based acupuncture therapy is safe and effective in treating knee osteoarthritis.

It always remains difficult to treat post⁃burn scars and improve their color，thickness and flexi⁃ bility of post⁃burn scars. Meanwhile，it is difficult as well to determine an appropriate parameter for lasers used to treat the post⁃burn scars and the overall therapeutic effect of laser treatment remains uncertain yet. This paper aims to systematically review the literature on the clinical application of ablative fraction carbon dioxide laser in burn and scald scar，the improvement of scars after treatment，treatment time，laser related parameter setting，com⁃ bined treatment and adverse reactions，for the purpose of providing the basis for clinicians to better treat burn and scald wound，reducing scar and improving conditions of scars.

Schizophrenia（SZ）is a common，chronic and severe of mental disorder. It is generally believed that schizophrenia is caused by both genetic factors and environmental factors，and the genetic effect is more promi⁃ nent. Long non⁃coding RNA（lnc RNA）is involved in the regulation of gene expression level，which is closely related to schizophrenia. In this paper，the biological characteristics of lncRNA，lncRNA and the occurrence， development，clinical symptoms and treatment of schizophrenia were reviewed.