Objective To study the relationship between GTPase Rab25 and chemotherapy resistance in colorectal cancer. Methods MTT colorimetric method was used to detect the drug resistance of cells. Whole tran⁃ scriptome sequencing technology was used to screen the GTPase Rab family genes related to the drug resistance of colorectal cancer cells. Bioinformatics was used to analyze the correlation of Rab25 with patient prognosis and multi⁃ drug resistance biomarkers. RT⁃PCR and Western Blot were used to verify the RNA and protein expression level of Rab25 in cells. Flow cytometry was used to detect the cycle and apoptosis of drug⁃resistant cells before and after the overexpression of Rab25. Results The cell survival rate of drug⁃resistant strains was significantly higher than that of parental strains treated with anticancer drugs（P < 0.01）. Rab25，Rab32，and Rab38 were significantly lower expressed in drug⁃resistant strains（P < 0.001）. Colorectal cancer patients with high expression of Rab25 had a longer overall survival（HR = 0.4，P < 0.05）and Rab25 was negatively correlated with the expression of multidrug resis⁃ tance markers ABCB1，ABCC1 and ABCG2（P < 0.01）. Compared with HCT⁃8，the RNA and protein level of the drug⁃resistant strain Rab25 was significantly reduced，and the RNA and protein level of the drug⁃resistant strain was significantly increased after transfection of the Rab25 plasmid（P < 0.001）. Up ⁃ regulation of Rab25 enhanced the sensitivity of drug⁃resistant cells to drugs（P < 0.001）. Up⁃regulation of Rab25 enhanced drug⁃resistant cell G0/G1 blockade，and promoted drug⁃induced apoptosis of drug⁃resistant cells Effect（P < 0.001）. Conclusion Up⁃regulation of Rab25 can significantly reduce the chemotherapy resistance of colorectal cancer drug⁃resistant cell lines. 

Objective To investigate whether cinobufagin can improve the rituximab resistance of diffuse large B⁃cell lymphoma（DLBCL）cell lines induced by Interleukin（IL）⁃17A，and to analyze the possible mecha⁃ nisms. Methods CCK⁃8 assay was used to detect the proliferation of DLBCL cell lines（SU⁃DHL⁃2 and SU⁃DHL⁃4 cells）；PI/Annexin vassay was used to detect cell apoptosis；flow cytometry was used to analyze the percentages of Th17 cells and IL ⁃ 17 + Foxp3 + Treg cells；Western blot was used to detect the expressions of cleaved PARP and cleaved caspase⁃3；and ELISA were used to study the expressions of IL⁃17A，TGF⁃β and IL⁃10. Results Cinobu⁃ fagin reversed the rituximab resistance of DLBCL cell lines induced by IL⁃17A；IL⁃17A attenuated the apoptosis of DLBCL cell lines induced by rituximab，while cinobufagin reversed this effect；cinobufagin promoted the apoptosis of DLBCL cell lines by increasing the expressions of cleaved PARP and cleaved caspase⁃3；cinobufagin inhibited the differentiation of Th17 and IL⁃17+ Foxp3+ Treg cells in tumor microenvironment，and then decreased the level of IL-17A. Conclusion Cinobufagin reverses the rituximab resistance of DLBCL cell lines induced by IL-17A，which is expected to be one of the combination drugs in the treatment of DLBCL in the future.

Objective To investigate the mechanism of electroacupuncture（EA）in the regulation of the phosphatidylinositol 3⁃kinase（PI3K）/ protein kinase B（AKT）/ glycogen synthase kinase⁃3β（GSK⁃3β）signaling pathway mediated by glucagon ⁃like peptide ⁃1 receptor（GLP ⁃1R）in the substantia nigra（SN）of mice with Parkinson′s disease（PD）. Methods Forty⁃eight C57/BL6 mice were randomly divided into normal group（NC）， model group（M），EA group（EA）and DPP⁃4 inhibitor group（DI），with 12 mice in each group. The behavioral changes were determined by the open field test. The level of tyrosine hydroxylase（TH）in the SN was determined by immunohistochemistry. The expression levels of GLP⁃1R，PI3K，AKT and GSK⁃3β in the SN were detected by Western blot. Results Both EA and DPR⁃4 inhibitor effectively improved the behavioral indexes of PD mice（all P < 0.05），increased the TH level in the SN（all P < 0.01），up ⁃ regulated the expression levels of GLP ⁃ 1R， PI3K，AKT and down⁃regulated the expression level of GSK⁃3β（all P < 0.01）. Conclusions EA may play a pro⁃ tective role in PD by regulating the GLP⁃1R⁃mediated PI3K/ Akt /GSK⁃3β signaling pathway. 

Objective To investigate the effect and mechanism of Shewanella algae（S.algae）and its specific lipopolysaccharide（LPS）on colorectal adenoma（CRA）. Methods Twenty⁃four female C57BL/6J mice were divided into four groups：the control group，the AOM/DSS group，the AOM/DSS+LPS group，and the AOM/ DSS+S.algae group. qRT⁃PCR and immunohistochemistry（IHC）were used to detect the level of macrophages and the proliferation and cycle of tumor cells in mice. qRT⁃PCR and ELISA were used to evaluate the change of tumor inflammatory microenvironment. The expression of the TLR4/NF ⁃ κB pathway proteins in mice was detected by Western Blot. In vitro experiments were conducted to verify the effects of M1 macrophages and S.algae specific LPS on the proliferation，migration and cycle of colorectal tumor cells. Results Compared with the AOM/DSS group， the degree of atypical hyperplasia of intestinal epithelial cells and the level of M1 macrophage increased，the expression of cell proliferation，cyclin and proinflammatory factor also increased，and TLR4/NF ⁃κB pathway was activated after S.algae and its LPS intervention. In vitro studies have also shown that S.algae and its LPS can promote the proliferation，migration and cycle of colorectal tumor cells. Conclusions S.algae specific LPS may promote the occurrence and development of colorectal adenoma through M1 macrophages.

Objective To explore the effect of hsa_circ_0023642 on the malignant biological behavior of thyroid cancer cells and its molecular mechanism. Methods The cancer tissues and adjacent tissues of 25 patients with thyroid cancer in our hospital were selected，and the expression level of hsa_circ_0023642 and miR⁃653 were detected by real⁃time fluorescent quantitative PCR（RT⁃qPCR）；thyroid cancer cells SW579 were divided into si⁃NC group，si⁃Hsa_circ_0023642 group，miR⁃NC group，miR⁃653 group，si⁃Hsa_circ_0023642+anti⁃miR⁃NC group，and si ⁃Hsa_circ_0023642+anti ⁃miR ⁃653 group. Tetramethylazolium salt colorimetric method（MTT）was used to detect cell viability；clone formation test to detect the number of colonies formed；flow cytometry to detect cell apoptosis rate；western blot to detect protein expression；cell scratch test to detect scratch healing rate； Transwell to detect the number of cell invasion；and dual luciferase reporter experiment to detect the targeting relationship between Hsa_circ_0023642 and miR ⁃653. Results The expression of Hsa_circ_0023642 in thyroid cancer tissue was increased，and the expression of miR ⁃ 653 was decreased（P < 0.05）. After interference with hsa_circ_0023642 or with over⁃expression of miR⁃653，cell viability was decreased；the number of colonies formed was decreased；apoptosis rate was increased；Bcl⁃2 related X（Bax）expression was increased. Meanwhile，B⁃cell lymphoma/leukemia⁃2（Bcl⁃2）expression，and cell scratch healing rate were decreased，and the number of inva⁃ sive cells all showed a downward trend（P < 0.05）. Hsa_circ_0023642 targeted and regulated miR⁃653；inhibiting miR ⁃653 can reverse the effect of hsa_circ_0023642 on the proliferation，apoptosis，migration and invasion of thyroid cancer cells. Conclusion Interference with hsa_circ_0023642 can inhibit the proliferation，migration and invasion of thyroid cancer cells by regulating miR⁃653，and promote cell apoptosis. 

Objective To compare the clinicalefficacy of electromagnetic⁃navigation guided transforaminal endoscopic spinal discectomy（See electromagnetic⁃navigation endoscopic spinal surgery system，SEESSYS）and C⁃arm fluoroscopy guided transforaminal endoscopic spinal discectomy（Transforaminal endoscopic surgical system，TESSYS）in the treatment of lumbar disc herniation. In addition，the use of electromagnetic navigation technology in the application of percutaneous endoscopic lumbar discectomy will be discussed for its safety and benefits. Methods From September to December 2018，a retrospective analysis was performed on 44 cases of LDH patients who had surgical therapy in our hospital. According to the varied surgical procedures，they were classified into two groups：SEESSYS and TESSYS，with 22 cases in each group. The two groups were compared on perioperative indi⁃ cators such as operation time（working tube placement time and endoscopic decompression time），intraoperative fluoroscopy timings，and length of hospital stay. The surgical complications were also recorded. Results The work⁃ ing tube placement time，total operation time and the number of intraoperative C⁃arm fluoroscopy of the SEESSYS group were significantly shorter than those of the TESSYS group（P < 0.01），however，there were no significant difference in the time of endoscopic decompression and the length of hospital stay between the two groups（P > 0.05）. The postoperative ODI，back and leg VAS were significantly lower than those of pre⁃operation in both groups（P < 0.01），but there was no significant difference in the VAS and ODI scores between the two groups（P > 0.05）. At the 2⁃year follow⁃up，the excellent and good rate of SEESSYS group was 95.5%，and TESSYS group was 90.91%.Conclusions At a 2⁃year follow⁃up，the SEESSSYS has a satisfactory clinical effect when compared to traditional C ⁃ arm fluoroscopy guidance. Furthermore，electromagnetic navigation aids in reducing radiation exposure to medical personnel during the procedure，as well as effectively shortening the working tube placement and the over⁃ all operation time.

Objective To investigate the expression and clinicopathological significance of piR ⁃ 1366 in non⁃small cell lung cancer（NSCLC）and its effect on tumor metastasis. Methods piRNA microarray was used to analyze the expression profile of piRNAs in NSCLC. The expression of piR⁃1366 in NSCLC was confirmed again by qRT⁃PCR；The expression of piR⁃1366 in 87 cases of NSCLC was detected by RNA in situ hybridization(RISH),，and the correlation was analyzed between the expression of piR⁃1366 and clinicopathological parameters of patients. Transwell chamber was used to detect the effect of piR ⁃1366 on the migration of lung cancer cells，and lung metastasis model of nude mouse was used to detect the effect of piR⁃1366 on the metastasis. Results The expression level of piR⁃1366 were increased in NSCLC by piRNAs expression profile and qRT⁃PCR，and the positive expression of piR⁃1366 was showed in FISH. There were statistically significant differences in lymph node metasta⁃ sis between pir⁃1366 high⁃expression group and low⁃expression group（P<0.05），but there were no statistically significant differences in age，gender，tumor site，tumor size，tumor grade and TNM stage（all P>0.05）. Transwell results showed that over⁃expression of PIR⁃1366 promoted the migration of A549 and H1650，while silencing of PIR⁃ 1366 inhibited the migration of LUNG cancer cells（P < 0.05）. In the nude mouse model of lung metastasis，there were fewer nodules of lung metastasis in the silenced PIR⁃1366 group（SI⁃PIR⁃1366）than in the control group（P< 0.05）. Conclusion piR⁃1366 could promote the metastasis of lung cancer cells，and provide targeted basis for the study of piR⁃1366 in the treatment of metastatic NSCLC.

Objective To investigate the clinicopathological features and long ⁃term outcomes of patients with abdominal paraganglioma（PGL）. Methods A retrospective study of relevant databases were performed to analyze theclinicopathological features and long⁃term follow⁃up outcomes of patients with abdominal PGL. Kaplan⁃ Meier survival analysis was performed to explore the influencing factors of postoperative recurrence or death of abdominal PGL. Results A total of 24 patients were confirmed with abdominal PGL. The average age of diagnosis was 58.9 years. The average tumor size was 5 cm and they were predominantly located in the infrarenal position. The mean follow⁃up period was 54 months. All patients with metastases had pheochromocytoma of the Adrenal Gland Scaled Score（PASS）of ≥ 4. One patient presented with synchronous metastases while 2 developed local recurrence and distant metastases. One patient died 9 years after diagnosis. Kaplan⁃Meier curve analysis showed recurrence or death in patients with PASS score of 4 ~ 7 was significantly higher than patients with PASS score of 0 ~ 3（P = 0.03）. Conclusions Abdominal PGL is a rare tumor with excellent long⁃term prognosis. Recurrence， although common，can occur decades after initial diagnosis. Long⁃term follow⁃up is therefore recommended for all patients with PGL，especially in patients with PASS of ≥ 4.

Objective To observe the TMB，immune infiltration and PD ⁃L1 expression in patients with gene⁃negative NSCLC after neoadjuvant immunotherapy，and analyze the prognostic factors. Methods 51 NSCLC patients from the Affiliated Tumor Hospital of Harbin Medical University since 2015 were collected and retrospective. The driver gene of lung tissue punctured patients were negative by the 9⁃in⁃1 lung cancer test kit，and the patients underwent neoadjuvant immunotherapy before surgical resection. High⁃throughput sequencing technology was used to detect the TMB of patients，anti⁃CD8 and anti⁃PD⁃L1 antibodies were used to detect immune infiltration and PD⁃L1 expression. The patients were followed up for up to 5 years，the PFS of the patients was recorded，and the Kaplan⁃Meier method was used to analyze the prognostic factors in patients with driver gene⁃negative NSCLC after neoadjuvant immunotherapy. Results The PFS between PD ⁃L1 positive patients（PD ⁃L1 +）and PD ⁃L1 negative patients（PD⁃L1-）had no significant difference（P = 0.461 1）. The PFS of TMB high mutation patients（TMB+） were longer than TMB low mutation patients（TMB-）（P = 0.004 7）. The PFS of CD8 positive patients（CD8 +） were longer than CD8 negative patients（CD8-）（P = 0.001 4）. The PFS of PD⁃L1+ /TMB+ patients were longer than others（P = 0.001 9）. The PFS between PD⁃L1- /TMB+ patients and others had no significant difference（P = 0.361 1）. The PFS of CD8 + /TMB+ patients were longer than others（P = 0.036 9）. The PFS of CD8 + /PD ⁃L1 + patients were longer than others（P = 0.016 1）. The PFS of TMB+ /CD8+ /PD⁃L1+ patients were longer than others（P = 0.037 7）.Conclusion For operable NSCLC patients with negative driver genes，a comprehensive analysis of TMB，PD⁃L1 expression and immune infiltration is helpful to choice the treatment paln for patients.

Objective To investigate the association between classical transient receptor potential channel 3（TRPC3）gene polymorphism and microalbuminuria（MAU）in patients with essential hypertension. Methods A total of 449 patients were recruited and the patients were assigned to two groups：Hypertension group（EH group，n = 378）and hypertension with MAU group（EH+MAU group，n = 71）according to microalbuminuria in 24 h. PCR amplification，Mass Array were used for genotyping the single nucleotide polymorphism（SNP）sites of the TRPC3 gene. Results There were significant differences in age，body mass index，triglycerides，24 h mean systolic blood pressure，and 24 h mean diastolic blood pressure between the two groups（P < 0.05）. There were significant differences in the genotype，allele and dominant model（GG/GT + TT）at rs953691（P < 0.05）. Logistic regression analysis showed triglycerides，24 h mean systolic blood pressure（≥ 150 mmHg），and GG genotype at rs953691 were risk factors for MAU in patients with essential hypertension. Conclusion The GG genotype at rs953691 in the TRPC3 gene may increase the risk of MAU in hypertensive patients.

Objective To analyze the brain structure and central mechanism of temporo mandibular disorders（TMD）under MRI examination. Methods 12 patients with TMD were selected as TMD group，and 12 healthy people matched with TMD patients were selected as healthy group.Two groups of patients completed the self rating scale，TMD patients received visual analog score，all subjects received brain magnetic resonance examina⁃ tion，analysis of the two groups of patients with brain regional consistency and functional connectivity，in order to analyze the correlation between TMD pain and brain central mechanism. Results The local consistency analysis showed that the ReHo value in the open state was higher than that in the closed state，and the difference was statistically significant（P < 0.05），the ReHo value of the two groups in the open state was statistically significant （P < 0.05）. Functional connectivity analysis showed that the two functional connectivity of TMD group were lower than that of healthy group，the difference was statistically significant（P < 0.05），And it is related to the intensity of pain. Conclusion TMD related pain is related to the local activity consistency of important brain regions，and also related to the abnormal functional connection between the related brain regions. In addition，the main reason for the abnormality of the related brain regions is psychological factors.

Objective To investigate the correlation with advanced glycation end products（AGEs）and soluble receptor for advanced glycation end products（sRAGE）with sepsis⁃related organ failure assessment（SOFA） in patients with sepsis as well as the risk factors that affect the prognosis of patients with sepsis. Methods From January 2020 to May 2021，A total of 180 patients with sepsis admitted to the Intensive Care Unit of the Second Affiliated Hospital of Hainan Medical University were selected as the research objects，and the patients were divided into survival groups（n = 144）and death group（n = 36）according to the 28⁃day prognosis. The clinical data were collected，and the SOFA score，Charlson comorbidity index（CCI）were calculated within 24 hours after admission. Serum levels of procalcitonin（PCT），C⁃reactive protein（CRP），lactic acid（Lac），and plasma levels of AGEs and sRAGE were measured. The PCT，CRP，SOFA scores，and plasma AGEs and sRAGE levels of the two groups were compared. The 28⁃day mortality，and plasma AGEs and sRAGE levels in different SOFA score evaluation groups were compared. Spearman correlation analysis was used to explore the correlationship between plasma levels AGEs and sRAGE with SOFA score. Multivariate logistic regression was used to analyze the influencing factors of 28⁃day prognosis in patients with sepsis. The receiver operating characteristic（ROC）curve was used to evaluate the predic⁃ tive value of plasma AGEs，sRAGE，SOFA scores and their combination on the 28⁃day prognosis of patients with sepsis. Results Compared with the survival group，the age and incidence of diabetes was higher in the death group. The CCI score，SOFA score，serum levels of PCT and Lac，and plasma levels of AGEs and sRAGE were significantly increased（P < 0.05）. With the increase of SOFA score，the 28 ⁃ day mortality and plasma levels of AGEs and sRAGE increased significantly（P < 0.05）. Plasma levels of AGEs and sRAGE were significantly positively correlated with SOFA score（rs = 0.293，0.309，P < 0.05）. CCI score，SOFA scores，AGEs and sRAGE were the risk factors for 28⁃day mortality in patients with sepsis（P < 0.05）. The Cut⁃off values of SOFA scores，AGEs and sRAGE for predicting 28⁃day mortality in patients with sepsis were 8 points，28.21 μg/mL and 2 465.32 pg/mL，respectively. The area under ROC curve（AUC）of combined prediction of 28⁃day mortality in patients with sepsis was significantly greater than that of each marker alone（Z = 2.245，P = 0.025；Z = 2.717，P = 0.007；Z = 2.485，P = 0.013）. Conclusion Plasma levels of AGEs and sRAGE can better reflect the severity and prognosis of patients with sepsis. Plasma levels of AGEs and sRAGE combined with SOFA scores can effectively predict the 28⁃day prognosis of patients with sepsis. 

Objective To explore the effect of coronary artery bypass grafting in off⁃pump coronary artery bypass grafting（OPCABG）using non⁃touch acquisition technology（No⁃touch），endoscopic⁃assisted acquisition of the great saphenous vein（EVH），and traditional incision method to obtain the great saphenous vein（OVH）. Methods A total of 268 patients who were treated with the great saphenous vein as bypass graft material and elective OPCABG were selected from January 2017 to October 2019. They were divided into three groups based on the vein acquisition method，with 91 cases in the No⁃touch group，89 cases in the OVH group，and 88 cases in the EVH group. The postoperative incision，complications and follow⁃up were observed. Results The size of the EVH incision was significantly smaller than that of the No⁃touch group and the OVH group；during the perioperative， 6⁃month and 1⁃year follow⁃up of the EVH group，the incidence of leg incision complications was significantly lower than that of the No⁃touch group and the OVH group（P < 0.05）；the recent patency rate of the No⁃touch group was statistically significant compared with the EVH group and the OVH group（P < 0.05）；the operation time of the No⁃ touch group and the OVH group were statistically different in the time to obtain the great saphenous vein Scientific significance（P < 0.05）；morphological structure comparison，No⁃touch group and EVH group have more complete vascular endothelial cells than OVH group. Conclusion In the three types of great saphenous vein harvesting oper⁃ ations，EVH has obvious advantages over No⁃touch group and OVH group in terms of incision size，perioperative period and postoperative complications；No⁃touch group and EVH group have vascular endothelial cells preserva⁃tion under light microscope more complete and clinically. EVH is relatively safe and feasible.

Objective To investigate the pattern of recurrence and metastasis of breast cancer in young patients and analyze the related factors. Methods The clinical and pathological data of 350 cases of breast cancer aged ≤ 40 years together with such prognostic data like the recurrence and metastasis and deaths were analyzed retrospectively. Results Median follow⁃up was 38.5 months，median disease⁃free survival（DFS）was 33 months， median visceral metastasis free survival（VFS）was 38 months，and median overall survival（OS）was 38 months. By Kaplan ⁃Meier analysis and Cox Regression Analysis，DFS were associated with the factors such as ER status （ER+/ER- = 0.102，P < 0.001），N stage（N1/N0 = 1.920，P = 0.044；N2/N0 = 2.546，P = 0.004；N3/N0 = 3.375， P < 0.001）and molecular types（Luminal B/Luminal A = 1.872，P = 0.084；overexpressed HER2/Luminal A = 0.327，P = 0.080；triple negative/Luminal A = 0.211，P = 0.017）and VFS were with such factors as ER status （ER +/ER- = 0.320，P < 0.001），N stage（N1/N0 = 2.596，P = 0.041；N2/N0 = 4.079，P = 0.004；N3/N0 = 8.021，P < 0.001）and age less than 35 years（the number aged less than 35 years/≥ 35 years = 3.337，P < 0.001）. OS was associated with such factors as N Stage（N1/N0 = 1.133，P = 0.802；N2/N0 = 2.114，P = 0.122；N3/N0 = 2.99，P = 0.014），neoadjuvant chemotherapy（those with neoadjuvant chemotherapy：HR = 2.389，P = 0.015）and ER status（ER+/ER- = 0.329，P < 0.001）. Conclusion Visceral metastasis of breast cancer in young patients is closely related to ER status，N stage and age.

Objective To analyze the value of peripheral blood mucous ⁃associated invariant T（MAIT） cell level on the 90⁃day prognosis of patients with acid⁃on⁃chronic liver failure（ACLF）. Methods The ratio of MAIT cells to CD3+ T cells in peripheral blood of 51 ACLF patients and 30 healthy controls was determined by flow cytometry. The expression level of MAIT cells in ACLF patients and control subjects was compared. At the same time，the ratio of MAIT cells of ACLF patients was compared with that of patients with virus infection or other chronic liver diseases. According to the 90 ⁃ day survival，the patients were divided into improvement group and death group. After logistic regression analysis of risk factors for death in patients with ACLF，the patients were divided into high expression group and low expression group according to the median of MAIT cell proportion as the demarcation value. The Kaplan ⁃ Meier method was used to draw the survival curve. Results The proportion of MAIT cells in peripheral blood of ACLF patients（2.03 ± 1.19）% was significantly lower than that of control group （5.07 ± 1.22）%（P < 0.05），and the change was not related to virus infection［（2.08 ± 1.27）% vs.（1.82 ± 0.81）%， P > 0.05］. MAIT cell level in ACLF patients with basic cirrhosis was significantly lower than that in patients without cirrhosis［（1.69 ± 0.84）% vs.（3.29 ± 1.49）%，P < 0.05］. MAIT cell level in decompensated cirrhosis patients（1.54 ± 0.80）% was lower than that in compensated cirrhosis patients（2.18 ± 0.80）%（P < 0.05）. Logistic regression analysis showed that the proportion of MAIT cells and the model for end stage liver disease（MELD）score were risk factors for the prognosis of ACLF patients（P < 0.01）. According to the median MAIT ratio at admission（1.96%），ACLF patients were divided into high MAIT group（≥ 1.96% ，26 cases）and low MAIT group（< 1.96%，25 cases）. Kaplan⁃Meier method was used to draw the survival curve. The survival rate of MAIT ≥ 1.96% was 80.77%，while MAIT < 1.96% 36.00%，and the difference in survival between the high MAIT group and the low MAIT group was statistically significant（P = 0.000 3）. Conclusion The level of MAIT cells in peripheral blood is of certain value in predicting the 90⁃day prognosis of ACLF patients.

Objective To explore the impacts of 3D conformal radiation therapy（3D⁃CRT）or intensity⁃ modulated radiotherapy（IMRT），time interval from surgery to radiotherapy，and use of chemotherapy on the recur⁃ rence pattern and survival. Methods The data on 36 patients with medulloblastoma who had been treated from May 2009 to September 2017 were analyzed. The impacts of different clinical stages，pathological types，and treat⁃ ment methods on the survival stage were analyzed in each group. The Kaplan ⁃Meier method was used to compare the survival differences between differentgroups. Results Seven of the 9 patients in the 3D ⁃CRT group and 9 of the 27 in the IMRT group had recurrence. The 5⁃year progression⁃free survival（PFS）rate was significantly higher in the IMRT group than in the 3D⁃CRT group（65.8% vs. 22.2%，P < 0.05），but there was no statistical difference in the 5⁃year overall survival（OS）（62.1% vs. 44.4%，P > 0.05）. The PFS and OS were better in the M0 group than in the M2/M3 groups（P < 0.05）. The PFS of surgery to radiation interval time < 12⁃week group was superior to that of the > 12⁃week group（P < 0.05）. In the multivariate Cox proportional hazards analysis，residual lesions， recurrence，or metastasis before radiotherapy were independent prognostic factors for PFS（P < 0.05）. Conclusions IMRT has a lower risk of spinal cord recurrence than 3D ⁃ CRT. The interval between surgery and radiotherapy should be shorter than or equal to 12 weeks. The PFS and OS were higher in patients without residual lesions ， recurrence，and spread before radiotherapy.

Objective To study and analyze the value of whole ⁃ body bone scanning（WBS）combined with target/non⁃target ratio（T/NT）in the diagnosis of bone metastases. Methods A total of 157 patients with sus⁃ pected bone metastases admitted to our hospital from January 2，2019 to November 25，2020 were included in this study. WBS were performed on all subjects，and T/NT was measured and calculated using a GE post ⁃ processing software system. The results of pathological diagnosis were used as the gold standard to analyze the efficacy of differ⁃ ent examination methods in the diagnosis of bone metastases. In addition，the differences of T/NT in different bone metastases were compared. Results The results of pathological diagnosis showed that there were 75 cases of bone metastases and 82 cases of benign lesions among 157 suspected patients with bone metastases. The T/NT of patients with bone metastases was（12.40 ± 3.15），which was significantly higher than that of patients with benign lesions （6.69 ± 2.01），and the difference was statistically significant（P < 0.05）. The sensitivity，specificity and accuracy of WBS combined with T/NT in the diagnosis of bone metastases were 93.33%，95.12% and 94.27% respectively， according to the pathological diagnosis results as the gold standard. All of them were higher than those of WBS （81.33%，85.37%，83.44%）and T/NT（68.00%，81.71%，75.16%）. The difference was statistically significant （all P < 0.05）. T/NT of bone metastases from ribs was lower than that of bone metastases from pelvis，spine and other sites，and T/NT of bone metastases from pelvis was lower than that of bone metastases from spine and other sites（all P < 0.05）. Conclusion WBS combined with T/NT has high sensitivity and specificity in the diagnosis of bone metastases. 

Objective To observe the clinical effect modified Canshi decoction on postoperative rehabilita⁃ tion in patients with ankylosing spondylitis kyphosis. Methods A total of 80 cases were randomly assigned to control group and observation group. Methotrexate and modified Canshi decoction were administered for 4 weeks to the two groups，respectively. The BASMI，BASDAI，BASFI，TCM symptoms were observed. The serum inflammatory factors（TNF⁃α，MIF，IL⁃1β，IL⁃6），serum and articular fluid ossification⁃associated proteins（DKK⁃1，AMPK⁃α， SOST，FOXO3a）were detected. The clinical efficacy and safety were observed. Results The total effective rate was 97.5% in the observation group vs 80.0% in the control group（P < 0.05）. Compared with the control group after treatment，the BASMI，BASDAI，BASFI，TCM syndromes，TNF⁃α，MIF，IL⁃1β，IL⁃6 were decreased in the observation group（P < 0.05），and the serum and articular fluid DKK⁃1，AMPK⁃α，SOST，FoxO3⁃α were increased in the observation group（P < 0.05）. The incidence of adverse reactions was 2.5% in observation group vs. 30.0% in control group（P < 0.05）. Conclusion Modified Canshi decoction could effectively promote postoper⁃ ative rehabilitation of patients with ankylosing spondylitis kyphosis.

Gap junction（GJ）is a special cell membrane structure composed of connexin protein（Cx）. The exchange of material and energy between adjacent cells through GJ is called gap junction cell communication （GJIC）. Junction protein connexin 43（Cx43）is the main junction protein involved in the formation of GJIC. The serine and proline rich in Carboxyl terminal（CT）at the end of its carboxy group are potential targets for Cx43 phosphorylation modification，and important domains of protein interaction. The phosphorylation of Cx43 carboxy terminal regulates the transport of Cx43，the assembly and degradation of GJ，and the gating of GJ channel，which is very important to regulate GJIC in neurous system. This review summarizes the current understanding of Cx43 carboxy terminal phosphorylation modification and the effect of Cx43 phosphorylation modification on GJIC，and provides feasible ideas for further research in cerebral ischemia.

Multiple sclerosis（MS）is an immune disease with white matter lesions in the nervous system. It affects young people in most cases and often leads to disability. Recently，more and more cases of MS have been found with the development of imaging technology，electrophysiology and other technologies，which is gaining more attentions from clinicians. In etiology，this disease closely attributes to heredity，environment and autoimmunity， among which the last one has become the focus of current research from the perspective of immune mechanism. The aim of this study is to review the role of cytokines，B cells，T cells and estrogen in the immune mechanism of multi⁃ ple sclerosis.

 With the use of broad ⁃spectrum antibiotics，the resistance of bacteria and fungi to antibiotics continues to increase，and the clinically available drugs are becoming more limited. Biofilm is an important means for drug ⁃ resistant bacteria to adapt to the environment and produce drug resistance. In recent years，continuous studies have shown that traditional Chinese medicine（TCM）extracts can be used alone or in combination with anti⁃ biotics to play a good anti⁃biofilm effect in biofilm⁃related infections. It suggested that TCM is likely to be an auxil⁃ iary or even an alternative drug for resistant bacterial infections. And in vivo research is a link of TCM to clinical practice. In this review，we will review the mechanism of biofilm resistance and the inhibitory effects of various TCM extracts on biofilms of different drug⁃resistant bacteria in vivo experiments，in order to provide reference for the application of TCM in clinical biofilm⁃related drug resistant bacteria infection。

Ischemic stroke is a disease with a high mortality and disability rate. According to most reports at home and abroad，its cause is related to cerebrovascular occlusion，and new treatment is urgently needed for clinical intervention. Stem cells can secrete neurotrophic factors to replace damaged neurons；they can play a neuro⁃ protective effect by inhibiting intracranial and extracranial inflammation and anti ⁃apoptosis. They can also release nutrients and growth factors that enhance endogenous repair mechanisms to protect and repair nerves. Therefore， the use of stem cell transplantation to treat ischemic stroke is expected to become a new option. This article summa⁃ rizes the mechanism of stem cells transplantation in the treatment of ischemic stroke and its clinical application， the role of nanomaterials in stem cell therapy，and post⁃transplantation tracking and monitoring of stem cell imag⁃ ing methods for stem cell treatment of ischemic stroke.