Ovarian cancer has the highest mortality rate among gynecological tumors. Although complete response（CR）can be achieved in most patients after initial treatment，its prognosis is often poor because of its critical prognostic factor，platinum⁃free interval（PFI）and its relapse within five years still happens in more than half of the affected patients. So far there is no effective treatment for the patients. The main treatment regimen for patients with platinum ⁃ resistant ovarian cancer is currently single ⁃ drug chemotherapy，which is comprehensively practiced clinically as a standard therapy. Meanwhile，an increasing number of studies show that immunotherapy can improve the prognosis of patients with a variety of solid tumors. Here，we reviewed the current evidence for the use of immunotherapy in the treatment of platinum⁃resistant ovarian cancer so as to provide new clues and basis for its clinical treatment. 

Objective To explore the mechanism of miR⁃106a⁃5p targeting signal transducer and activator of transcription 3（STAT3）in regulating the proliferation and invasion of glioma cells. Methods From January 2017 to December 2020，15 cases of tumor tissues and 5 cases of normal adjacent tissues（more than 1.5 cm away from the edge of the tumor）of patients with recurrent glioma who underwent surgical treatment were selected. Normal mouse neuron cells and glioma cell line GL261 were cultured in vitro. The expression of miR⁃106a⁃5p was detected by qPCR. An experimental group and a conctrol group were constructed. The experimental group included miRNA ⁃NC mimics，miR ⁃106a ⁃5p mimics，miR ⁃106a ⁃5p inhibitor plasmids were transfected with GL261 cells. Normally cultured GL261 cells were used as the control group.The expressions of miR⁃106a⁃5p and STAT3 in each group were detected by qPCR. Targeting relationship between miR⁃106a⁃5p and STAT3 was predicted and analyzed by the bioinformatics software and Dual luciferase assay. CCK⁃8 and Transwell chamber assay were used to detect cell proliferation activity and invasion ability of each group cells；The expressions of STAT3，apoptosis⁃related pro⁃ teins BAX，cl⁃cas⁃pase⁃3，and tumor suppressor gene p21 were detected by WB. Results The expression of miR⁃ 106a⁃5p in human recurrent glioma tissues and mouse glioma cells was significantly lower than that in paracancerous tissues and normal mouse nerve cells（P < 0.05）. Compared with that in the control group，the level of miR⁃106a⁃5p in GL261 transfected with miR⁃106a⁃5p mimics was significantly increased，while the expression of STAT3 was significantly decreased（P < 0.01）. Respectively，the expression in miR⁃106a⁃5p inhibitor group was opposite（P < 0.05）. STAT3 was the target gene of miR⁃106a⁃5p by dual luciferase assay. Compared with those in control group， the expression of STAT3，cell viability and number of invasive cells in the miR⁃106a⁃5p mimics group were signifi⁃ cantly decreased（P < 0.05），but the expression of BAX，cl ⁃caspase ⁃3 and p21 was significantly increased（P < 0.05）；However，the expression of these proteins，cell viability and number of invasive cells in the miR⁃106a⁃5p inhibitor group was the opposite correspondingly（P < 0.05）. Conclusion miR⁃106a⁃5p is low⁃expressed in human recurrent glioma tissues and GL261，and regulates the proliferation and invasion of glioma cells through negatively regulation of STAT3，which provides a new target for studying the recurrence mechanism of glioma.

Objective To explore the expression of leptin and leptin receptor proteins in renal tubular cells in the negative energy state which induced by Caenorhabditiselegans muscle expression 3（Mex3c）. Methods FVB/N mice（n = 18）were selected and divided into three groups，i.e. the high⁃fat diet group（HFD group），the control group， and the Mex3c group. Observation of liver，fat and kidney tissues was conducted by pathological staining；LEPR and creatinine concentration in serum were determined by ELISA；the expression of leptin and LEPR in kidney tissues were determined by immunohistochemical staining，Western blotting and RT ⁃PCR. Results Pathological staining results：compared with the livers of the control group，there were lipid droplets in the Mex3c group and large lipid droplets in the HFD group. The abdominal fat cells in the HFD group were larger and fusion phenomena than those in the control group and Mex3c group. Compared with the control group，the gaps between the glomeruli and the cysts in the HFD group and the Mex3c group were larger. Compared with the leptin mRNA results of the control group，both the Mex3c group and the HFD group were highly expressed（P < 0.01）. Compared with the control group′ s LEPR mRNA results，the Mex3c group and the HFD group were all lowly expressed（P < 0.05）. The results of immunohisto⁃ chemistry showed that leptin and LEPR were expressed in the cell membrane of renal tubules. Western blot results showed that compared with the control group′s leptin and LEPR，the Mex3c group had high expression of leptin and low expression of LEPR（all P < 0.05）and the HFD group had high expression leptin and low expression of LEPR （all P < 0.01）. Compared with soluble LEPR of the control group ，the HFD group was highly expressed（P < 0.01）. Compared with the control group，the results of serum creatininein mice showed that the Mex3c group had low expres⁃ sion and the HFD group had high expression（all P < 0.01）. Conclusions The imbalance of positive and negative energy leads to high expression of leptin protein and low expression of LEPR protein in kidney tissue；in particular， imbalance of positive energy causes kidney function damage.

Objective To investigate the survival，differentiation and gene expression of hBDNF⁃BMSCs in the spinal cord of rats and their repair effects on spinal cord injury（SCI）in rats. Methods The BMSCs of a SD rat were extracted and cultured to construct hBDNF ⁃ BMSCs. Another 96 SD rats were randomly divided into sham operation group，injury control group，empty vector ⁃BMSCs group，hBDNF ⁃BMSCs group. The rat SCI model was established by the modified Allen heavy object method，and hBDNF⁃BMSCs transplantation was performed one week later. BBB score and cortical somatosensory evoked potential（CSEP）were used to evaluate the nerve function of rats before and after treatment. The histomorphological changes of injured spinal cord segments in rats were observed. The expressions of NeuN，GFAP，p⁃NF⁃H and GAP⁃43 were detected by immunohistochemistry. Results The BMSCs was successfully extracted and the hBDNF⁃BMSCs was constructed. The neurological function in the hBDNF BMSCs group was significantly improved as compared with the vector⁃BMSCs group and the injury control group（P < 0.05）. After 6 weeks transplantation，the P1 wave latency of the lower limb CSEP in the hBDNF ⁃ BMSCs group was significantly shortened，and the P1 ⁃N1 amplitude was the largest. The hBDNF expression in the hBDNF ⁃ BMSCs group was at the highest level in the first week，and even visible at 6th week. In the hBDNF⁃BMSCs group and the empty carrier⁃BMSCs group，the spinal cord tissue structure in the injured area was relatively complete. The spinal cord tissue structure in the injured control group was disordered，and the glial scar formation was seen. As compared with the injury control group and the empty vector⁃BMSCs group，the NeuN expression was significantly increased， the GFAP expression was significantly reduced，and the p⁃NF⁃H，GAP⁃43 expressions were significantly increased and arranged regularly in the hBDNF ⁃BMSCs group six weeks after transplantation. Conclusion Locally injectedand transplanted hBDNF BMSCs can continuously and stably secrete hBDNF locally，protect the survival of neurons and promote the transformation of transplanted BMSCs into neuron like cells，thus promoting the repair of injured spinal cord in rats.

Objective To investigate the effect of circPTPRA on the proliferation，migration and invasion of breast cancer cell and its possible mechanism. Methods Cancer tissues and corresponding adjacent tissues of 41 breast cancer patients were collected，and the expression level of circPTPRA and miR ⁃ 556⁃3p in the tissues were detected by RT⁃qPCR. Breast cancer cells MDA⁃MB⁃231 were cultured in vitro and transfected with pcDNA⁃ circPTPRA，anti⁃miR⁃556⁃3p or co⁃transfected with pcDNA⁃circPTPRA and miR⁃556⁃3p. Cell proliferation was detected by CCK ⁃ 8 method. Transwell was used to detect cell migration and invasion，and western blotting was used to detect the protein expression of Ki⁃67，MMP⁃2，and MMP⁃9 in the cells. The dual luciferase reporter gene experiment verified the targeting relationship between circPTPRA and miR ⁃ 556⁃3p. Results The expression of circPTPRA in breast cancer tissues was lower than that of adjacent tissues（P < 0.05），while the expression of miR⁃ 556⁃3p was higher（P < 0.05）. After overexpression of circPTPRA or knockdown of miR⁃556⁃3p，the cell OD value，the number of migration and invasion，and the protein expression of Ki⁃67，MMP⁃2 and MMP⁃9 in MDA⁃MB⁃ 231 cells were reduced（P < 0.05）. circPTPRA negatively regulated the expression of miR⁃556⁃3p. Overexpression of miR⁃556⁃3p reversed the inhibitory effect of overexpression of circPTPRA on the proliferation，migration and invasion of MDA⁃MB⁃231 cells. Conclusion Overexpression of circPTPRA may hinder the proliferation，migra⁃ tion and invasion of breast cancer cells MDA⁃MB⁃231 by down⁃regulating the expression of miR⁃556⁃3p.

Objective Minocycline has been shown to be protective on liver injury in uncontrolled hemor⁃ rhagic shock models，but the specific mechanism is not fully understood. Methods After anesthesia and catheter⁃ ization，SD rats were divided into 4 groups：sham operation group（blank group），fluid resuscitation group（con⁃ trol group），MK ⁃ 886 treatment group（experimental group 1），and minocycline treatment group（experimental group 2）. Uncontrolled hemorrhagic shock model was prepared after successful catheterization. ELISA was used to detect TNF⁃α at 3.5h，IL⁃6，LTS，LTB4 and 5⁃LOX；Malondialdehyde（MDA）and myeloperoxidase（MPO）in liver tissue were analyzed and the pathological section was prepared. Automatic biochemical analyzer was used to detect the liver function for 3.5 h：alanine aminotransferase（ALT）and aspartate aminotransferase（AST）. Results The mortality and fluid replacement volume of experimental group 1 and 2 were significantly lower than those of control group，and the mortality and fluid replacement volume of experimental group 2 were lower than those of experimental group 1. The values of TNF⁃α and IL⁃6 in experimental group 2 were significantly lower than those in experimental group 1 and control group（P < 0.05）. The values of liver function（ALT and AST）in experi⁃ mental group 1 and experimental group 2 were significantly lower than those in experimental group 1 and control group（P < 0.05）. The values of LTS，LTB4 and 5⁃LOX in liver tissue of experimental group 1 and experimental group 2 were significantly lower than those of control group（P < 0.05）. Compared with experimental group 2，MDA and MPO of liver and tissue in control group were higher than those in experimental group 1 and 2（P < 0.05；The values of MDA and MPO in liver tissue of experimental group 1 were similar to those of experimental group 2 （P > 0.05），but lower than those of control group. The degree of liver tissue injury in experimental group 1 and experimental group 2 was less than that in control group. There was no significant difference in the Suzuki′ s score of experimental group 1 was compared with that of experimental group 2（P > 0.05）. Conclusions In uncon⁃ trolled hemorrhagic shock models，MC may play an anti⁃inflammatory role by inhibiting 5⁃LOX，and then inhibit inflammatory mediators and cytokines such as TNF⁃α，IL⁃6，LTS，LTB4，MAD and MPO，so as to reduce liver tissue and cell damage after ischemia and reperfusion and play a protective role in liver tissue.

Objective To study the predictive value of prechemotherapy platelet parameters on chemosen⁃ sitivity and prognosis of patients with Ⅳ stage colorectal cancer. Methods A retrospective analysis was conducted in 138 patients with stage Ⅳ colorectal cancer receiving chemotherapy in the Second Affiliated Hospital of Guangzhou Medical University from January 2010 to January 2021. ROC curve was used to analyze the relationship between platelet count（PLT），mean platelet volume（MPV），platelet distribution width（PDW）and plateletcrit（PCT）and chemosensitivity on colorectal cancer，and the best cut ⁃off value for predicting the chemosensitivity for colorectal cancer. A logistic regression model was established to analyze the independent related factors that affected the efficacy of chemotherapy for colorectal cancer. Univariate and Cox regression models were used to analyze the rela⁃ tionship between platelet parameters and other clinicopathological factors and patient survival and progression⁃free survival. Results Prechemotherapy PLT was significantly related to the chemosensitivity of patients with stage Ⅳ colorectal cancer. The best cut⁃off value for predicting chemosensitivity of prechemotherapy PLT was 317 × 109 /L； prechemotherapy PLT > 317 × 109 /L was more sensitive to chemotherapy（P < 0.000 1），and there is no statistical correlation between MPV，PDW and PCT before chemotherapy and chemotherapy sensitivity of stage Ⅳ colorectal cancer. However，compared with prechemotherapy PLT ≤ 317 × 109 /L，prechemotherapy PLT > 317 × 109 /L showed no significant differences of OS（P = 0.143），PFS（P = 0.941）by Kaplan⁃Meier survival analysis. Cox multivariateanalysis showed prechemotherapy PLT > 317 × 109 /L was not the independent risk factor affecting OS and PFS of stage Ⅳ colorectal cancer. Conclusions The prechemotherapy PLT in colorectal cancer is correlated with the che⁃ mosensitivity in stage Ⅳ colorectal cancer，but it has no obvious clinical value in prognosis evaluation.

Objective To explore the efficacy of radical and conservative therapies for unicysticameloblas⁃ toma systematically. Methods The relevant studies on therapies for unicysticameloblastoma，which had published from the establishment of the databases to August 2021，were searched in PubMed，EMbase，CENTRAL and CBM. After screening the literatures and extracting the data，we performed a meta ⁃analysis by using RevMan5.4 software. Results According to the search strategies for searching articles in Chinese or English，72 articles were determined，11 of which met the inclusion criteria. A total of 485 patients with unicysticameloblastomas received either radical or conservative treatment，126 of whom underwent radical surgery and the rest 359 received conserva⁃ tive treatment. The recurrence rate was 3.17% for radical surgery and 19.22% for conservative treatment. The meta⁃ analysis showed a lower risk of recurrence of unicysticameloblastomas in radical treatment than in conservative treat⁃ ment（OR = 0.24，95%CI：0.11 ~ 0.52，P = 0.000 3），but perioperative blood loss was greater（MD = 167.12， 95%CI：140.80 ~ 193.44，P < 0.001）and surgical duration was longer（MD = 158.77，95%CI：96.48 ~ 221.06， P < 0.001）in radical treatment. Conclusions This study shows that although unicysticameloblastoma is a benign tumor，it′ s still very likely to recur. Different treatment strategies have significant statistical differences in recur⁃ rence rates. Conservative treatment is more prone to recurrence than radical treatment，whereas it is safer.

Objective To a analyze serum differential proteins in patients with juvenile idiopathic arthritis （JIA）. Methods Serum differential proteins were analyzed in 18 JIA patients（n = 18），and 20 healthy people⁃ population（n = 20）and rheumatoid arthritis patients（n = 44，RA）by iTRAQ combined with nano LC⁃MS/MS. Results Compared with the healthy group，the JIA group identified a total of 106 differential proteins were identi⁃ fied in the JIA group，with 49 up⁃regulated and 57 downregulated. A total of 63 proteins differential expressed in both JIA and RA group，with 26 up ⁃ regulated and 37 down ⁃ regulated. The blood coagulation and fibrinolysis system，immune system and lipid metabolism were closely related to the pathogenesis of JIA. AHSG and other proteins are candidate proteins for studying JIA mechanism as key nodes of protein ⁃ protein interaction network. Conclusions The serum differential proteins of JIA have been obtained successfully by proteomics technology， which provides a theoretical basis for exploring the diagnosis and pathogenesis of JIA.

Objective To investigate the medium and long⁃term efficacy of posterior percutaneous endo⁃ scopic cervical discectomy（PPECD）in the treatment of cervical spondylotic radiculopathy. Methods A total of 62 patients with cervical spondylotic radiculapathy treated in our hospital from Jan 2018 to Jan 2019 were selected According to different surgical methods，the patients were divided into PPECD group（30 cases），and anterior cervical discectomy and fusion（ACDF）group（32 cases）. Perioperative indexes，clinical efficacy score，cervical curvature and intervertebral height of lesions were compared between the two groups. Results PPECD group had shorter operation time，less bleeding and shorter hospital stay. Postoperative follow⁃up showed that VAS score and NDI score in the two groups were significantly improved when compared with those before the operation ，with the difference statistical significance（P < 0.05）. The cervical curvature Cobb angle and diseased intervertebral height were significantly increased in the ACDF group，and the differences were statistically significant（P < 0.05）， while there was no significant change in the PPECD group. Conclusion With shorter operation time，less bleeding and shorter hospital stay，the medium and long⁃term efficacy of PPECD in the treatment of cervical spondylotic ra⁃ diculopathy is similar to that of ACDF.

Objective The purpose of this research is to evaluate the predictive value of serum CRP，albu⁃ min，bowel wall thickness under transabdominal ultrasound，and intestinal wall elasticity modulus SD value of intestinal stenosis before treatment in patients with active Crohn′ s disease. Methods Prospectively，all patients treated for the first time with either infliximab or adalimumab for active Crohn′s disease between January 2018 and June 2021 were included. All patients were tested for serum albumin ，CRP ，bowel wall thickness under trans⁃ abdominal ultrasound and intestinal wall elastic modulus SD value of intestinal stenosis and were followed up until June 2021. Results A total of 45 active Crohn′s disease patients were included in the study. Forty ⁃three patients（96%）received first ⁃line treatment with infliximab，and 2 patients（4%）received first ⁃line treatment with adalimumab，of which 8 patients had intestinal stenosis before treatment. Clinical responses occurred in all 14weeks of observation；there were no primary non⁃responders ；38 patients（84.4%）showed sustained clinical remission，and 7 patients（15.6%）developed a secondary loss of response. Meantime to develop secondary loss of response was（11.4 ± 7.4）months. There was no statistical difference between the CRP level in the sustained clinical remission group and the secondary failure group，while the serum albumin concentration，intestinal wall thickness， and SD value of stenotic intestine were statistically different. The serum albumin concentration in the sustained clinical remission group was significantly higher than that in the secondary failure group［（38.1 ± 5.2）g/L vs.（31.1 ± 4.6）g/L］；the thickness of the bowel wall under ultrasound was significantly lower than that in the secondary loss of response group［（5.8 ± 1.9）mm vs.（8.2 ± 1.5）mm］，and the SD value of patients with sustained clinical response was also lower［（7.6 ± 1.2）vs.（9.9 ± 2.0）］. Hypoalbuminemia，bowel wall thickness ≥ 8 mm，and SD value ≥ 9 were related to early loss of response. Conclusion Serum albumin concentration，bowel wall thickness and elastic modulus SD value before treatment in patients with active Crohn′s disease are related to the therapeutic effect of anti⁃tumor necrosis factor⁃α monoclonal antibody，while the serum CRP level has nothing to do with the therapeutic effect. Hypoalbuminemia，bowel wall thickness ≥ 8 mm under transabdominal ultrasound and elastic modulus SD value ≥ 9 are closely associated with a higher risk for early loss of response to the anti TNF⁃α monoclonal antibody treatment.

Objective To analyze the characteristics of gut microbiome in pregnant women with gestational diabetes mellitus（GDM）and gestational normal glucose tolerance（GNGT）during the second trimester and its relationship with GDM. Methods A total of 42 pregnant women in the second trimester receiving obstetric exami⁃ nation in our hospital from 2019 to 2020 were selected. Fresh feces were collected on the day of OGTT test. DNA sequencing was performed on the V3⁃V4 variable region of bacterial 16SrRNA using IlluminaHiSeq 2500 platform， and bioinformatics analysis was performed. Results At the phylum level，there were differences in intestinal flora composition between the two groups，and the OTUs and diversity of GDM group were higher than that of GNGT group. Bacteroidetes and genera，Firmicutes，Actinomycetes and rumen bacterium genera ⁃UCG014 were correlat⁃ ed with glucose metabolism. The sensitivity and specificity of Bacteroidetes and Bacteria as markers for predicting GDM reached 70% ~ 80%. Conclusions The composition and diversity of intestinal flora in GDM women and GNGT women during the middle trimester of pregnancy were different；the intestinal flora in the middle trimester of pregnancy was correlated with the glucose metabolism index，and Bacteroidetes and Bacteroides could be used as a marker for predicting GDM.

Objective To analyze the risk factors of delirium in patients with malignant tumors and construct a nomogram prediction model. Methods A total of 312 patients with malignant tumors admitted to the Department of Oncology in Shengjing Hospital of China Medical University from January 2019 to December 2020 were selected. The patients were divided into non⁃delirium group and delirium group according to the DMS⁃ 5 diagnostic criteria. The clinical data of the two groups were analyzed and compared. The independent risk factors for delirium were determined by multivariate logistic regression analysis，which were further utilized to establish the nomogram prediction model of the risk of delirium in patients with malignant tumor. The calibration curve and ROC curve were used to evaluate the accuracy and discrimination of the nomogram prediction model. Results The incidence of delirium was 14.42%（45/312）. Multivariate logistic regression analysis showed age，intracranial lesions，anxiety，pain，and Pittsburgh sleep quality index were independent risk factors for delirium in patients with malignant tumors（P < 0.05）. The prediction nomogram model was constructed based on the independent risk factors mentioned above. In internal validation，calibration curve showed that the prediction curve was basically consistent with the actual observation curve，and ROC curve analysis showed that the area under the curve AUC was 0.919. Conclusion This study constructed a nomogram model to predict the risk of delirium in patients with malignant tumors. It could make early prediction of the risk of delirium in patients with malignant tumors，and help clinical medical staff to early screen the high⁃risk groups of delirium among patients with malignant tumors.

Objective To study the diagnostic value of YKL⁃40，SP⁃A and IL⁃8 combined detection in neonatal pneumonia as well as its significance in determining critical severity. Methods In this study，150 patients with neonatal pneumonia diagnosed in our hospital from January 2017 to January 2021 were selected as the research subjects，including 82 mild patients and 68 severe patients. The control group consisted of another 150 healthy newborns born during the same time period. The levels of YKL⁃40，SP⁃A，and IL⁃8 were compared in the observation group，the control group，and patients of varying severity，and YKL⁃40，SP⁃A and IL⁃8 were analyzed The significance of combined diagnosis in the diagnosis of neonatal pneumonia. Results YKL ⁃40（t = 29.889， P ≤ 0.001）and IL⁃8（t = 26.725，P ≤ 0.001）were significantly higher in the observation group than those of in the control group，while SP⁃A（t = 71.258，P ≤ 0.001）was significantly lower in the observation group than those of in the control group，YKL⁃40（t = 4.171，P ≤ 0.001）and IL⁃8（t = 48.098，P ≤ 0.001）were significantly lower the mild group than those of the control group，and SP⁃A（t = 15.482，P ≤ 0.001）were significantly higher in the observation group than those of the control group；YKL⁃40，SP⁃A，and IL⁃8 effects on neonatal lung cancer，the area under the ROC curve of combined detection was significantly higher than that of single detection，according to the ROC curve analysis. The critical values for YKL ⁃ 40，SP ⁃A and IL ⁃8 were 32.55 ng/mL，4.23 ng/mL and 259.36 ng/mL，respectively，according to the ROC curve analysis. The severity of neonatal pneumonia was found to be negatively correlated with YKL ⁃40 and IL ⁃8，and positively correlated with SP ⁃A using correlation analysis. Conclusion The combination detection of YKL⁃40，SP⁃A，and IL⁃8 is very useful for diagnosing newborn pneu⁃ monia and determining critical severity. 

Objective To investigate the correlations between serum γ⁃glutamyl transferase（γ⁃GT）and carotid atherosclerosis in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods A total of 153 patients who received polysomnography（PSG）from March 2016 to July 2019 were enrolled and divided into control group（n = 51），mild to moderate OSAHS group（n = 58），and severe OSAHS group（n = 44）based on sleep apnea hypopnea index（AHI）. According to carotid intima⁃media thickness（CIMT），they were divided into carotid sclerosis group and non⁃carotid sclerosis group. The differences in the general clinical data，PSG monitoring indexes and biochemical indexes were compared between the groups. The correlation analysis between CIMT and the related indexes was performed，and multivariate Logistic regression analysis was further performed. Results There were significant differences between the three groups in terms of the body mass index（BMI），proportion of hypertension，systolic blood pressure（SBP），diastolic blood pressure（DBP），AHI，oxygen deoxygenation index （ODI），the time when oxygen saturation was below 90% in the sleeping period（TS90%），the lowest nocturnal finger oxygen saturation（L⁃SaO2），triglyceride（TG），fasting blood glucose（FPG），γ⁃GT and CIMT（P < 0.05）. The serum γ⁃GT levels in the severe OSAHS group，the mild⁃moderate OSAHS group and the control group were（41.45 ± 7.14），（34.50 ± 6.62）and（25.26 ± 5.31）U/L，respectively（P < 0.001）. Compared with the non⁃carot⁃ id atherosclerosis group，SBP，AHI，ODI，TS90%，TG，LDL⁃C，FPG，γ⁃GT levels were all significantly higher in the carotid atherosclerosis group，and L⁃SaO2 levels were significantly lower in the carotid atherosclerosis group （P < 0.05）. The serum γ⁃GT levels in the carotid and non⁃carotid atherosclerosis groups were（36.27 ± 6.21）and （28.45 ± 6.39）U/L，respectively（P < 0.001）. Pearson correlation analysis showed that CIMT was positively corre⁃ lated with age，SBP，AHI，ODI，TS90%，TG，FPG，γ⁃GT（P < 0.05），and CIMT was negatively correlated with L⁃SaO2（P < 0.05）. Spearman rank correlation showed that CIMT was positively correlated with hypertension（P < 0.05）. Multiple Logistic regression showed that increased serum γ⁃GT level was an independent risk factor for carotid atherosclerosis in the OSAHS patients（OR = 2.124，P < 0.001）. Conclusion Serum γ⁃GT level gradually may increase with the severity of OSAHS patients，and be positively correlated with CIMT. Serum γ⁃GT level is an inde⁃ pendent predictor of OSAHS patients with carotid atherosclerosis，which is of great significance for clinical practice.

Objective To investigate the influencing factors of indeterminate response（IDR）in patients with differentiated thyroid cancer（DTC）after 131I treatment. Methods A retrospective analysis was performed on 127 patients with DTC who received 131I ablation in the Department of Nuclear Medicine，the First Affiliated Hospital of University of Science and Technology of China from June 2017 to June 2020. According to the treatment response evaluation system，the treatment effect was divided into two groups：ER group：excellent treatment response（ER）（n = 81）and IDR group：indeterminate response（IDR）（n = 46）. Univariate analysis was per⁃ formed by t⁃test and χ2 test，and then factors with P < 0.05 were included in Logistic regression analysis to identify the influencing factors of IDR. Results IDR occurred in 46 patients after treatment with 131I. Single factor analysis showed that there were no significant differences between two groups in gender，age，TSH，maximum size of the tumor et al，while preablative⁃stimulated thyroglobulin，the time interval of 131I therapy and surgery and TgAb was statistically significant（all P < 0.05）. Logistic regression analysis showed that ps⁃Tg ≥ 2.0 ng/mL was an indepen⁃ dent influencing factor of IDR（P < 0.001），and there were no statistically significant differences in the time inter⁃ val of 131I therapy and surgery and TgAb. The Kaplan⁃Meier estimate for IDR showed that the response of patients in the ps⁃Tg（≥ 2.0 ng/mL）group was poorer than that of those in the ps⁃Tg（＜2.0 ng/mL）group. Conclusion Ps⁃Tg is an independent influencing factor for IDR after 131I treatment.

Objective To evaluate the effect of ranibizumab combined with laser photocoagulation in the treatment of diabetic retinopathy（DR）and analyze its influence on the quality of life and retinal microcirculation after operation. Methods Fifty DR patients treated in our hospital from February 2018 to August 2019 were divided into two group. The control group was treated with laser photocoagulation，while the observation group with ranibi⁃ zumab combined with laser photocoagulation. Best corrected visual acuity was measured before and after treatment. Their quality of life was investigated with Chinese Low Vision Quality of Life Questionnaire，and the hemodynamic parameters of central retinal artery and vein were also measured before treatment and after treatment. The complica⁃ tions were also recorded after treatment. Results The mean score of best corrected visual acuity of the observation group was significantly higher than that of the control group after treatment（0.64 ± 0.11 vs. 0.58 ± 0.12，P < 0.05）. The average score in the different dimensions of Chinese Low Vision Quality of Life Questionnaire in the observa⁃ tion group was significantly higher than the control group after treatment（P < 0.05）. The hemodynamic parameters of central retinal artery（including peak systolic velocity，mean velocity，end diastolic velocity，pulsatility index and resistance index）between the observation group and control group were statistically different（P < 0.05）. The hemodynamic parameters of central retinal vein（including maximal velocity，minimum velocity and mean velocity） in the observation group were significantly lower than those in the control group（P > 0.05）. Conclusion Ranibi⁃ zumab combined with laser photocoagulation in the treatment of DR can effectively can improve the retinal microcir⁃ culation of DR patients and therefore their quality of life. 

Objective To evaluate the safety and efficacy of ramazolam toluenesulfonic acid in painless gastrointestinal endoscopy for elderly patients and its effect on early cognitive function. Methods A total of 208 patients aged over 60 years scheduled for painless gastrointestinal endoscopy were randomly divided into 2 groups， 104 in each group. For anesthesia，the patients in the ramazolam group were treated with ramazolam and sufentanil and those in the propofol group with propofol and sufentanil. The vital indices such as mean arterial pressure （MAP），heart rate（HR），respiratory frequency（RR）and blood oxygen saturation（SpO2）were recorded at different times after entering the endoscopy room. The side effects such as hypotension，hypoxemia，body movement，nausea， severe sinus bradycardia and vomiting ，dizzy and drowsiness were also recorded. The degree of postoperative abdominal pain and cognitive function were recorded with NRS questionnaire and MMSE questionnaire. Results The sedative effects，postoperative cognitive function and physician satisfaction in the ramazolam group were better than in the propofol group. Furthermore，the induction time，number of body movements，recovery time and side effects in the ramazolam group were all lower than in the propofol group. There was no significant difference in the time of endoscopic operation and patients′ satisfaction（P > 0.05）. Conclusion Ramazolam toluenesulfonic acid can is safe for anesthesia in the painless gastrointestinal endoscopy for elderly patients，and it can prevent postoper⁃ ative cognitive impairment.

Objective To evaluate the repective and joint values of mycobacterium tuberculosis ⁃specific cellular immunity test and tuberculosis antibody test in diagnosis of tuberculosis in male reproductive system. Methods A total of 174 cases of tuberculosis and inflammation in male reproductive system who were treated in our hospital from January 2017 to June 2020 were retrospectively analyzed to evaluate the diagnostic values of the two tests in assisting the diagnosis of tuberculosis in male reproductive system. The cases were divided into four groups with four test methods respectively（method A：mycobacterium tuberculosis⁃specific cellular immunity test， method B：tuberculosis antibody test，method C：serial test，method D：parallel test）. Results The consistency of the two tests was poor（kappa = 0.022），and the difference in diagnosis results was statistically significant（χ2 = 31.7，P < 0.001）. The sensitivity of method A（81.6%）and method D（84.2%）was sigificanlty higher than that of method B（21.1%，χ2 = 19.4，P < 0.01）and method C（18.4%，χ2 = 22.0，P < 0.01）. The specificity of method B（93.9%）and method C（100.0%）was higher than that of method A（59.2%，χ2 = 11.1，P < 0.01）and method D（57.1%，χ2 = 18.1，P < 0.01）. Se，PPV，and LR+ were at their highest level and α was at the lowest in the method C group. Sp，NPV，Youden index were at their highest level，while β and LR⁃ were at their lowest in the method D group. The AUC areas of methods A to D were 0.704，0.575，0.592，and 0.686，respectively. Conclusion When the two test methods are positive at the same time ，the possibility of reproductive system tuberculosis is the greatest，and the misdiagnosis rate is the lowest. When the two test methods are negative at the same time，the possibility of reproductive system tuberculosis is the least，and the missed diagnosis rate is the lowest. When tested alone，the tuberculosis specific cellular immune test has a higher diagnostic efficiency than the tuberculosis antibody test. When combined，the parallel diagnostic efficiency is higher than the serial diagnostic efficiency.

Objective To explore the values of CT derived fractional flow reserve（CT⁃FFR），coronary artery stenosis and clinical cardiovascular risk factors and their combinationin the risk prediction of major adverse cardiac events（MACE）in patients with obstructive coronary artery disease（CAD）. Methods A total of 133 patients with obstructive CAD who underwent coronary artery CT angiography examination were collected retrospectively. The occurrence of MACE was follow up. Cox proportional hazard regression model was used to analyze the role of clinical cardiovascular risk factors，coronary artery stenosis and CT ⁃ FFR in predicting the risk of MACE. Three models were established for predicting MACE and the under curve of the ROC was used to evaluate the ability of the three models in predicting MACE. Results Multivariate Cox regression analysiss showed that CT⁃FFR value ≤ 0.80（HR = 4.41），coronary artery stenosis ≥ 70%（HR = 3.65），diabetes mellitus（HR = 2.54）were indepen⁃ dent predictors for MACE in patients with obstructive CAD（P < 0.05）. The model based on CT⁃FFR，coronary artery stenosis degree and clinical cardiovascular risk factors（AUC = 0.85）was better than the model based on CT⁃ FFR（AUC = 0.74）and the model based on CT⁃FFR and coronary artery stenosis degree（AUC = 0.79）（P < 0.001）. Conclusion The combined prediction models of CT⁃FFR、coronary stenosis and clinical cardiovascular risk factors which were established to predict the risk of MACE in patients with CAD has good diagnostic power，providing reference information for the timely clinical intervention and improved prognosis of patients with CAD.

Objective To compare the nutrient intake of middle ⁃aged and elderly diabetic foot（DF） patients with different genders and different Wagner grades through dietary survey. Methods A total of 126 middle⁃ aged and elderly DF patients who were hospitalized in the Department of Endocrinology，Sun Yat ⁃ sen Memorial Hospital from August 2018 to December 2019 were included. Dietary frequency questionnaire was used to retrospec⁃ tively investigate the nutritional situation before admission. Results The total energy intake of DF patients was lower than that of dietary nutrient reference intake for Chinese residents. The percentage of energy intake of macro nutrients were basically in line with the reference intake of dietary nutrients. The intake of beans，eggs and milk， three high⁃quality protein sources，was generally insufficient. Intakes of calcium，potassium，phosphorus，magne⁃ sium，selenium，vitamin A，vitamin B1，vitamin B2，vitamin E and vitamin C failed to meet the dietary nutrient reference intakes for Chinese residents in more than 50% patients. Only the intake of iron，copper and niacin reach⁃ es 80%. Zinc intake exceeds 80% only in female patients. When the patients were grouped by DF classification， there was no significant difference in the intake of nutrient and food between group Wagner 3 and below and group Wagner 4. Conclusion In order to improve nutritional status and promote rehabilitation，patients with DF should increase the intake of beans，eggs，milk，and foods which are rich in minerals and vitamins such as calcium，po⁃ tassium，phosphorus，magnesium，selenium，vitamin A，vitamin B1，vitamin B2，vitamin E and vitamin C.

Acquired Immune Deficiency Syndrome，also known as AIDS，is a global public health problem. Due to the widespread use of ART，the disease has become a chronic disease that can be managed and controlled. However，AIDS⁃related diseases still seriously affect the quality of life of patients，and even endanger their lives. Cardiovascular disease has become one of the important causes of death for AIDS patients，which has attracted a lot of attention and needs to be addressed.Studies have suggested that AIDS patients have a higher incidence of cardio⁃ vascular disease than the general population. The risk factors involved are multifactorial，and may be related to chronic inflammation and abnormal immune activation，but the mechanism remains unclear. Therefore，this paper mainly reviews the risk factors，mechanisms and treatment of AIDS⁃related cardiovascular diseases.

Objective To investigate the relationship between DKK⁃1 gene promoter methylation and path⁃ ological osteogenesis in Ankylosing Spondylitis（AS）. Methods Western Blot was used to detect the expression of DKK⁃1 protein in hip joint capsule tissue from 4 patients with AS and 4 with femoral neck fracture（FNF）caused by trauma in the Third Affiliated Hospital of Southern Medical University. DKK ⁃ 1 gene promoter methylation was examined by Methylation ⁃ specific PCR（MSP）. Meanwhile，DNA methyltransferases（DNMTs）were evaluated by Quantitative Real ⁃time polymerase chain reaction（qPCR）. Results The expression of DKK ⁃1 protein in AS hip joint capsule tissue was significantly lower than that in FNF group（P < 0.05），while the methylation status of DKK⁃1 gene promoter was significantly higher（P < 0.05）. And there was no significant difference about DNMTs between two groups. Conclusion Lower DKK⁃1 promotes the pathological osteogenesis of AS through DKK⁃1 gene promoter hypermethylation，which can be used to evaluate the development of AS pathological osteogenesis and provide clues for the treatment of AS.