Objective To explore the clinical features and outcomes of diabetic patients complicate with severe and critical COVID ⁃19. Methods The clinical data of severe and critical COVID ⁃19 patients were retro⁃ spectively analyzed，including 10 cases in the diabetes mellitus（DM）group and 35 cases in the non⁃DM group. The differences in clinical characteristics，treatment effects，and prognosis between the two groups were observed. Results The DM group had higher fever scores，fatigue scores，and breathlessness scores，CRP，PCT，SOFA score，antibiotic application rate，and mechanically assisted ventilation rate than those of the non⁃DM groups（P < 0.05），and LYM and PaO2/FiO2 were less than those of the non⁃DM group（P < 0.05）；the range of lung CT lesions was larger than that of the non⁃DM group（P < 0.05）. After treatment，time to change to normal type，fever time，clinical symptom relief time，hospitalization day in the DM group were longer than those of the non ⁃ DM group（P < 0.05）. No difference between was found between the two groups in nucleic acid negative time，nucleic acid re⁃positive rate，PaO2/FiO2，LMY，CRP，PCT，mortality rate at the time of discharge（P > 0.05）. Conclusion The conditions of diabetic patients were aggravated after infected with COVID⁃19 and more susceptible to bacterial infection during hospitalization. However，the prognosis could be improved and the mortality rate could be reduced by actively and effectively controlling blood sugar.

With the wide application of novel anti⁃tumor drugs in clinical practice，the immune⁃related adverse reactions induced by them have also attracted much attention. Abnormal thyroid function is one of the most common adverse reactions. This paper is proposed to make a brief review of the research progress of the effects of two novel drugs on immunotherapy and targeted treatment，so as to improve the rational application of antineoplastic drugs and their safety during cancer treatment，to reduce drug⁃induced diseases，and contribute to a better manage⁃ ment of thyroid function of patients.

Revascularization can improve the prognosis of patients with complex，high⁃risk coronary artery disease. However，the majority of the patients cannot tolerate coronary artery bypass surgery and prefer to choose percutaneous coronary intervention. The potential high risk has become a major challenge for coronary intervention⁃ al physicians. In recent years，the new drugs，devices and technologies provide more guarantee for the interven⁃ tion therapy，but it still remains controversial. This paper reviews the status and progress of coronary interventional therapy for the population with complex，high⁃risk coronary artery disease.

Objective To address the clinical challenges of difficulties in self⁃repair of cartilage defects， and to provide new idea for cartilage repair by exploring the roles and potential mechanisms of miR⁃30b in regulating chondrogenic differentiation of rabbit bone marrow⁃derived mesenchymal stem cells（BMSCs）. Methods BMSCs were separated via density gradient centrifugation，and then the cells were identified through flow cytometry and induced bi⁃directional differentiation assay. Changes in cell proliferation ability and HIF⁃1αexpression were detected via CCK⁃8 and Western blotting under different CoCl2 concentrations. Cell line stably expressing miR ⁃ 30b was generated，and the expressions of SOX9 target genes and Wnt/β⁃catenin signaling pathway were detected by Western blotting. Chondrogenic differentiation was induced under hypoxic circumstances. After 21 days，the expressions of collagen Ⅱ and SOX9 were determined by Western blotting and immunohistochemical staining. Results Flowcy⁃ tometry and bi⁃directional differentiation assay showed that the cells highly expressed CD29 and CD34 but lowly expressed CD44 and CD45，and demonstrated good differentiation ability. On the other hand，the CCK⁃8 revealed that hypoxia induced by CoCl2 solution could promote proliferation of BMSCs（P < 0.05）and expression of HIF⁃1α. After 21⁃day chondrogenic induction of the cells stably expressing miR⁃30b in hypoxic circumstances，immunohis⁃ tochemistry and Western blot results demonstrated significant down⁃regulated expressions of collagen Ⅱ and SOX9 as compared with those in the control group，empty vector group and hypoxia group（P < 0.01）. Conclusions miR ⁃ 30b can reduce chondrogenic differentiation of BMSCs in hypoxic circumstances，providing references for epigenetic regulation of stem cells for cartilage defect repair.

Objective To investigate the effects of Betulinic acid（BA）on the stemness，invasion，migra⁃ tion，adhesion and hypoxia inducible factor⁃1α（HIF⁃1α）expression in human prostate cancer bone metastatic PC⁃3 cells under hypoxia. Methods PC⁃3 cells were treated with various concentrations of BA solution，the cell viability was detected by CCK8 and the IC50 value of 50% inhibition concentration was calculated，and then divided into IC50 concentration BA group and control group to detect the effect of betulinic acid on the proliferation of PC⁃3 cells，PC⁃3 cells were treated with normoxic，Hypoxia group and Hypoxia+IC50（10 μmol/L）BA group，and the effects of BA on cell invasion and migration were detected by Transwell assay. The effect of BA on cell adherence was determined using a cell adhesion test，and the ability of PC⁃3 cells to self⁃renew following BA treatment was determined using a tumor spheroidization assay. The effect of BA on the expression of HIF⁃1α，CD31，and CD44 was detected using polymerase chain reaction（PCR）and Western blot immunoblotting，while the effect of BA on the expression of VEGF，IL⁃8，IL⁃1β，IL⁃6，and TNF⁃α factors was detected using an enzyme linked immunosorbent assay（ELISA）. Results BA inhibited the proliferation of PC ⁃3 cells in a concentration ⁃and time ⁃dependent manner，and its IC50 was 10 μmol/L. PC⁃3 cells stemness，invasion，migration，adhesion ability were significantly increased under hypoxia. However，after BA treatment，the aforementioned phenomenon was reversed. Western blot analysis revealed that BA could inhibit the expression of HIF ⁃ 1α protein，CD31 and CD44 protein in PC ⁃3 cells（P < 0.01）。The results of PCR assay revealedthat BA could downregulation the mRNA expression of HIF⁃1αand mRNA of CD31 and CD44（P < 0.01）. The results of ELISA test showed that BA could inhibit the expression of VEGF，IL⁃8，IL⁃1 β，IL⁃6 and TNF⁃α（P < 0.01）. The results of ELISA test showed that BA could inhibit the expression of VEGF，IL⁃8，IL⁃1 β，IL⁃6 and TNF⁃α（P < 0.01）. Conclusion Under hypoxia，BA inhibits PC⁃3 cell stemness，invasion，migration，and adhesion. It′s possible that BA inhibits the expression of HIF⁃1α，CD31，CD44，and cytokines including VEGF，IL⁃8，IL⁃1β，IL⁃6，and TNF⁃α.

Objective To investigate the therapeutic effect and mechanism of electroacupuncture at acupoint“Zhongji”and“Guanyuan”on detrusor hyperreflexes after sacral spinal cord injury in rats. Methods The neurogenic bladder model of sacrosacral spinal cord injury was established by spinal cord transection. The elec⁃ troacupuncture group received electroacupuncture intervention at acupoint“zhongji”and“guanyuan”（10 Hz/ 50 Hz，intensity 1 mA），and the inhibitor group received capsazepine（2.5 mL，100 nmol/L，30 min）. At the end of the study，urine flow dynamics was performed，and the bladder histomatological changes were stained by HE. The positive expression level of C ⁃Kit and P2X2 receptors in ICC cells was observed by immunofluorescence double ⁃ standard method. mRNA and protein expression levels of TRPV1，C ⁃Kit and P2X2 in rat bladder tissues were detected by Western Blot. Results Compared with those of sham operation group，basal bladder pressure and leakage point pressure of model group increased but maximum bladder volume and compliance decreased（P < 0.01），and protein expressions of TRPV1，C⁃Kit and P2X2 in bladder tissue increased（P < 0.01）. Compared with those of model group，basal bladder pressure and leakage point pressure of electroacupuncture group were decreased； maximum bladder capacity and compliance were increased（P < 0.01），and protein expressions of TRPV1，C⁃Kit and P2X2 in bladder tissue were significantly decreased（P < 0.01）. Conclusion Electroacupuncture at“Zhongji” and“Guanyuan”point can lower the expression of P2X2 receptor on ICC cells，reduce the frequency of smooth muscle contraction and improve bladder function by inhibiting TRPV1 channel.

Objective To investigate the role and mechanism of endoplasmic reticulum stress protein glu⁃ cose regulatory protein 78（GRP78）in the inflammatory activation of astrocytes after intracerebral hemorrhage （ICH）. Methods ICH was induced by autologous whole blood injection in CD1 mice，and GRP78 targeted inhibitor ha15 was used. Forty⁃two prepared mice were randomly divided into 7 groups：sham operation group and groups of 3，6，12，24，48 and 72 hours after ICH. The expression of GRP78 in the area around hematoma was detected by Western blot. Another group of prepared 36 mice were randomly divided into 3 groups：sham operation，ICH + car⁃ rier（PBS），ICH + ha15. Neurobehavioral tests and brain water content were evaluated at 24 h and 72 h after ICH. At 24 h after ICH，TUNEL method was used to evaluate neuronal apoptosis，and Western blot was performed to analyze the expression of caspase 12 and chop protein，the classical downstream markers of ER stress. Results Compared with the sham operation group，the level of GRP78 in the area around the hematoma began to rise at 3 h after ICH and reached the highest at 24 h（P < 0.05）. At 24 h and 72 h after ICH，compared with ICH + PBS group， the neurological deficit in ICH + HA group was significantly improved（P < 0.05），and the brain edema in the basal ganglia and cortex was significantly reduced（P < 0.05）. After HA treatment，astrocytes，GFAP + GRP78 + cells and TUNEL positive neurons in the area around the hematoma decreased significantly （P < 0.05）. After HA treatment，the expression of caspase 12 and chop protein decreased，and ER stress was significantly inhibited. Conclusion ER stress protein GRP78 participates in nerve injury after ICH by mediating the inflammatory activa⁃ tion of astrocytes. HA15 may have a positive effect on neuronal survival after ICH.

Objective To observe the changes of CD107a production by T cells and their subsets in peripheral blood at different stages of patients with chronic HBV infection and during the antiviral treatment with Peg⁃interferon，and to explore the rule of the change of T cell cytotoxicity during different stages of chronic HBV infection and antiviral therapy with interferon. Methods Patients with chronic HBV infection were enrolled into the study，with a cross⁃section cohort（n = 300，treatment⁃naive）and a longitudinal cohort（n = 36，HBeAg⁃positive， ALT > 2 ULN，receiving Peg⁃interferon therapy after enrollment）. Peripheral blood before and after antiviral treat⁃ ment was collected from the two cohorts of patients. The production of CD107a by T cells was detected by flow cytometry. Results （1）The levels of CD107a produced by CD3+，CD4+ and CD8+ T cells in patients of immune⁃ active stage（IA）were significantly higher than that in patients of immune⁃tolerant stage（IT）and inactive carrier stage（IC）.（2）The levels of CD107a production by CD3+，CD4+ and CD8+ T cells was found positively correlated with liver inflammatory indexes（ALT，AST and total bilirubin）.（3）The levels of CD107a production by CD3 +， CD4+ and CD8+ T cells were also showed a significant positive correlation with liver fibrosis（liver stiffness measure⁃ ment，APRI and FIB⁃4 score）.（4）The levels of CD107a production by CD3+，CD4+ and CD8+ T cells were signifi⁃ cantly higher in HBeAg（+）patients than those in HBeAg（-）patients，and those in patients with HBV DNA > 106 IU/mL was significantly higher than those in patients with HBV DNA < 106 IU/mL.（5）The levels of CD107a production by CD3+，CD4+ and CD8+ T cells were significantly increased after 48 weeks of treatment with PEG⁃ interferon compared with those before treatment. Conclusion The cytotoxic effect of T cells to secret CD107a is not only positively correlated with liver inflammation and fibrosis，but also with HBV replication level. The cytotoxic effect of T cells is obvious higher in immune active stage of chronic HBV infection，and moreover，that capacity of T cells could be significantly enhanced after antiviral treatment with Peg⁃interferon.

Objective To observe the clinical efficacy of open synovectomy or open synovectomy combined with total hip arthroplasty for the treatment of pigmented villonodular synovitis（PVNS）of the hip. Methods The data on thirty⁃two patients with PVNS of the hip hospitalized during the period of May 2012 to August 2019 were retrospectively analyzed. 20 patients underwent open synovectomy alone（incision group）and 12 underwent syno⁃ vectomy combined with total hip arthroplasty（arthroplasty group）. Harris hip scores and postoperative complica⁃ tions including recurrence and dislocation were used as evaluation indexes. Results The mean follow⁃up duration was（3.9 ± 2.3）years in 32 patients，and the Harris hip score improved from（56.9 ± 6.1）preoperatively to（87.8 ± 4.4）postoperatively（P < 0.05）. One year after surgery，the score improved from（57.0 ± 6.0）preoperatively to （86.3 ± 3.9）postoperatively in the incision group（P < 0.05）and from（54.0 ± 6.3）to（90.1 ± 2.6）in the arthro⁃ plasty group（P < 0.05），with an improvement of（28.9 ± 3.6）and（35.6 ± 4.3）points，respectively（P < 0.05）. During follow⁃up，recurrence occurred in two patients and hip subluxation developed in one in the incision group only，while none were found in the arthroplasty group. No perprosthetic joint infection and prosthesis loosening or revision were found in the arthroplasty group. Conclusions Open synovectomy and total hip arthroplasty are treatment methods for different degrees of PVNS of the hip，and both can improve hip function in patients. Total hip arthroplasty may achieve better outcomes than open synovectomy. Postoperative recurrence is likely to occur after open synovectomy.

Objective To explore the efficacy of intravenous application of selective non⁃steroidal anti⁃ inflammatory drugs（NSAIDs）for preventing post⁃ERCP pancreatitis（PEP）after endoscopic retrograde cholangio⁃ pancreatography（ERCP）combined with endoscopic sphincterotomy（EST）. Methods The clinical data on 95 patients with choledocholithiasis who had undergone ERCP plus EST from January 1，2019 to January 1，2021 were retrospectively analyzed. After surgical treatment，the study group received selective NSAIDs，while the control group was treated with conventional drugs. According to the relevant risk factors，the total population was divided into a high⁃risk population subgroup and an average risk population subgroup. They were then subdivided into study group a（n = 31），control group a（n = 27），study group b（n = 15），and control group b（n = 22）. The clinical efficacy and safety were compared between the two groups. Results The high⁃risk population：in the study group，the incidence of PEP and the duration of abdominal pain and distension decreased，the time to resum⁃ ing eating and the postoperative hospital stay were shortened，the VAS pain score decreased，the QoR⁃15 score increased，and the levels of postoperative AMS and LPS decreased（P < 0.05）. The average risk population：post⁃ operative ALT levels in the study group and the frequency of vomiting increased，the time to resuming eating was shortened（P < 0.05）. Conclusions For the high ⁃ risk population，intravenous application of selective NSAIDs can prevent the occurrence of PEP，improve prognosis and quality of rehabilitation. However，for the average risk population，NSAIDs do not markedly reduce the occurrence of PEP and do not evidently improve prognosis and quality of postoperative rehabilitation；and it is easy to cause the patients to develop digestive system symptoms and a certain degree of liver damage.

Objective To investigate the expression levels of miR ⁃ 744 ⁃ 5p and miR ⁃ 543 in peripheral blood mononuclear cells（PBMCs）in patients with HIV ⁃ associated neurocognitive disorders（HAND）and their clinical value in the diagnosis of HAND. Methods A total of 76 patients with HIV⁃1 infection were divided into HAND group（n = 45）and control group（n = 31）. qRT⁃PCR was used to detect the expression levels of miR⁃744⁃ 5p and miR⁃543 in PBMCs. ELISA was used to detect the levels of serum IL⁃6，IL⁃10，IL⁃16，IL⁃18 and TNF⁃α； The contents of serum HDL，TG，LDL and TC were detected by automatic biochemical analyzer；The risk factors of HAND in HIV infected patients and the clinical diagnostic value of miR ⁃ 744⁃5p and miR ⁃543 expression in HAND were analyzed by statistical methods. Results Compared with the control group，the expression levels of miR⁃744⁃5p，IL⁃10 and IL⁃16 in PBMCs of HAND group were significantly increased，while the expression levels of miR ⁃543 and HDL were significantly decreased，and the other inflammatory and lipid metabolism indexes had no significant changes；Statistical analysis showed high expression of miR⁃744⁃5p and low expression of miR⁃543 were independent risk factors for HAND in HIV⁃1 infected patients；miR⁃744⁃5p and miR⁃543 had good clinical diagnostic value for HAND，and the combined diagnostic effect was better. Conclusion miR ⁃744⁃5p and miR ⁃ 543 had good clinical diagnostic value for predicting HAND，which may be related to chronic inflammation and lipid metabolism process. 

Objective To explore the value of improved synchronized G⁃banding and chromosomal micro⁃ array analysis（CMA）in prenatal diagnosis of umbilical cord blood. Methods A total of 202 pregnant women who had prenatal diagnosis indications and missed prenatal diagnosis of villus and amniotic fluid in the Eugenic Genetics Department of our hospital from January 2020 to April 2021 were selected. Cord blood samples were collected for the analysis with conventional method and improved synchronous G⁃banding karyotype analysis. At the same time， CMA was used to detect the whole genome copy number variant（CNV）of cord blood DNA. The resolution of G ⁃ banding karyotype and detection rate of abnormality through CMA，synchronized G ⁃ banding and conventional method were compared. Results The resolution of improved synchronous G⁃banding pattern was 500~550 bands， and that of conventional G⁃banding pattern only 320~400 bands. The detection rate of chromosome abnormality of conventional method，improved synchronized G ⁃banding and CMA was 3.47%，4.46% and 9.90%，respectively. Among the 16 CNVs detected by CMA，only 2 microdeletions greater than 5Mb were detected by modified synchro⁃ nized G⁃banding. In addition，there were 3 cases with abnormal karyotype，but normal by CMA. There was signifi⁃ cant difference in the detection rate of chromosome abnormality between improved synchronized G-banding and CMA（χ 2=4.495，P = 0.034）. Conclusion The karyotype resolution of improved synchronized chromosome G⁃banding can be increased to 500~550 bands，which is conducive to detecting more chromosome structural abnor⁃ malities. Together with improved synchronized G⁃banding and CMA，we can improve the detection rate of chromo⁃ some abnormalities，and reduce the birth defects of newborns.

Objective To explore the relationship between tumor necrosis factor⁃α（TNF⁃α），nucleotide⁃ binding oligomerization domain⁃like receptor protein 3(NLRP3),C⁃reactive protein/albumin（CRP/ALB）and carbapenem resistance in the elderly Klebsiellapneumoniae（CRKP）and its influence on the prognosis. Methods A total of 175 elderly patients with CRKP admitted to our hospital from June 2018 to January 2021 were selected and divided into death group(n=32)and survival group(n=143)according to prognosis. Quality index,time from onset to hospital admission,degree of illness,diabetes，hypertension，coronary heart disease，hyperlipidemia， TNF⁃α，NLRP3 mRNA，CRP/ALB levels，TNF⁃α，NLRP3 mRNA，CRP/ALB were compared between the two groups. Spearman was used to analyze the relationship between TNF⁃α,NLRP3 mRNA,CRP/ALB and disease severity,Cox regression was used to analyze the prognostic related factors，and receiver operating characteristic curve （ROC）were used to analyze TNF⁃α，NLRP3 mRNA，CRP/ALB predicts the prognostic value. Results There were statistically significant differences between the death group′s condition，diabetes and the survival group（P < 0.05the death group TNF⁃α（237.89 ± 72.25）pg/mL，NLRP3 mRNA（0.78 ± 0.24），CRP/ALB（3.19 ±1.05）higher than the survival group TNF⁃α（160.33 ± 51.80）pg/mL，NLRP3 mRNA（0.51 ± 0.16），CRP/ALB（2.08 ± 0.65） （P < 0.05）；mild patients TNF⁃α（118.79 ± 33.52）pg/mL，NLRP3 mRNA（0.39 ± 0.10），CRP/ALB（1.79 ± 0.40），TNF⁃ α（179.34 ± 48.47）pg/mL，NLRP3 mRNA（0.52 ± 0.15），CRP/ALB（2.26 ± 0.54），severe patients TNF⁃α（220.14 ± 50.08）pg/mL，NLRP3 mRNA（0.78 ± 0.18），CRP/ALB（2.77 ± 0.49），each index is severe > moderate > mild（P < 0.05）；TNF⁃α，NLRP3 mRNA，CRP/ALB are positively correlated with the disease severity（P < 0.05）；after controlling the disease severity and diabetes，TNF⁃α，NLRP3 mRNA，CRP/ALB are still prognostic related factors（P < 0.05））；The prognostic AUC of TNF⁃α，NLRP3 mRNA combined with CRP/ALB is 0.955，which is higher than 0.703 of TNF ⁃ α，0.778 of NLRP3 mRNA，and 0.771 of CRP/ALB. Conclusion TNF ⁃ α，NLRP3，CRP/ALB were related to the severity and prognosis of elderly patients with CRKP infection. Combined detection could be used as an effective program to predict the prognosis and provide objective evidence for clinical decision⁃making，intervention，and management. 

Objective To explore the value of X⁃ray reevaluation of breast masses with depth⁃width ratio > 1（D/W > 1）and further analyze the clinical and ultrasound features of benign and malignant breast masses with D/W > 1. Methods A total of 317 breast lesions with D/W>1 by ultrasound were included in the study. These lesions were reevaluated by X ⁃ ray and classified by BI ⁃RADS further. According to different principles of clinical treatment，the lesions with BI⁃RADS 1⁃3 categories were evaluated as benign，and the lesions with BI⁃RADS 4⁃5 categories were evaluated as malignant. The diagnostic accuracy of X⁃ray reevaluation was calculated according to the gold standard of pathological results. The clinical and ultrasonic features of the benign and malignant breast masses were analyzed as well. Results Of the 317 cases，221 were diagnosed as malignant and 96 as benign. The diagnostic accuracy after X⁃ray reevaluation was more significantly improved than that only with ultrasound（P < 0.05）. In the clinical data，the age of patients with malignant tumors and the size of tumor in them were significantly larger than that with benign tumors（P < 0.05）. Meanwhile，when the ultrasonic features of D/W > 1 were excluded，there were significant differences between the benign and malignant tumors in terms of shape，edge，internal echo，posterior echo，microcalcification，blood flow，axillary lymph node enlargement（P < 0.05）. Conclusion Some benign lesions with D/W > 1 diagnosed as malignant initially by ultrasound are characterized by small volume and few other suspi⁃ cious ultrasound features. Combined with X⁃ray examination for reevaluation，the diagnostic accuracy can be greatly improved，and the incidence of invasive examinations such as puncture or operation can be reduced effectively.

Objective To evaluate the efficacy and safety of Acotec drug⁃coated balloon（DCB）for chronic ischemic disease in lower extremity. Methods Clinical data of 427 patients with 528 occlusive/stenotic lesions in 481 lower extremities treated by DCB from April 2016 to January 2020 were retrospectively analyzed. The mean age was 67 years. Rutherford stage 2，3，4，5，and 6 were classified in 12（2.5%），168（34.9%），179（37.2%），94 （19.5%），and 28（5.8%）limbs，respectively. The mean length of the targeted lesions was 228.5 mm. Of all lesions， 433 were located at femoral and/or popliteal arteries，and 95 were at infra⁃popliteal arteries. All the patients were followed up for 6 months. The major evaluation endpoints included late lumen loss（LLL），target lesion restenosis， target lesion revascularization（TLR），and severe clinical events including mortality and major amputation. Results The technique success rate was 97.5%. Stents were placed in 59（13.8%）cases for flow ⁃limited dissections or remnant stenosis greater than 50% after DCB angioplasty. The median follow ⁃ up time was 27months（12 ~ 45 months）. The mean LLL was（1.00 ± 0.30），（1.73 ± 0.41），（2.14 ± 0.40）mm，respectively，1，2，and 3 years after operation. The restenosis rate at 1，2 and 3⁃year was 17.1% vs. 24.1%（P = 0.151），18.4% vs. 29.8%（P = 0.070），and 26.7% vs. 36.7%（P = 0.277），respectively，in femoropopliteal and BTK arm，and the TLR rate was 8.0% vs. 16.5%（P = 0.032），9.9% vs. 19.3%（P = 0.065），and 15.9% vs. 23.3%（P = 0.303），respectively. Twenty⁃three patients died and 33 received major amputation. Conclusions Acotec DCB was safe and effective in treating chronic ischemic diseases of lower extremities. Compared with infrapopliteal arteries ，a better clinical outcome was achieved in femoro⁃popliteal arteries.

Objective To compare the effectiveness and safety of laser combined with polidocanol foam sclerosant with those of foam sclerosant alone in the treatment of venous malformations. Methods The data on 96 patients with venous malformations，who had admitted to the first affiliated hospital of Zhengzhou University from May 2019 to October 2020，were retrospectively analyzed. 51 patients receiving laser combined with foam sclero⁃ therapy were included in the study group，while 45 undergoing foam sclerotherapy alone were assigned to the control group. A 6⁃month follow⁃up was conducted after the procedure. The changes in the size of the lesions were assessed after treatment according to the images on MRI. The visual analogue scale（VAS）of pain was compared between the baselines and the posttreatment scores. The complications were recorded during the follow⁃up ，the effectiveness and safety were compared between the two groups ，and the long ⁃term follow ⁃up was continued. Results The posttreatment VAS score of 96 patients was significantly lower than the baselines（2.49 ± 1.57 vs. 4.25 ± 2.09，P < 0.001），indicating that pain symptoms were significantly improved in the patients. Based on intra⁃ operative angiography，the Puig classification was performed in the patients. There was no significant difference in the effective rate between the PuigI or Ⅱ patients in the study group and those in the control group（P > 0.05）； while the effective rate differed significantly between the PuigⅢ or Ⅳ patients in the study group than those in the control group（P < 0.05），and it was more efficient in the study group. The patients in both groups had fewer compli⁃ cations and there was no significant difference between the two groups，and the complications could be eliminated. Conclusions Laser combined with foam sclerosant is a safe and effective way to treat venous malformations，espe⁃ cially for venous malformations with abundant reflux veins（PuigⅢ，Ⅳ），and the combination therapy is more effective than the therapy with foam sclerosant alone.

Objective To compare the efficacy and side effects between early add ⁃ on Nitrodiazepam （NZP）to Lamotrigine（LTG）and sodium valproate（VPA）only on absence epilepsy in children. Methods The children with epilepsy diagnosed by typical clinical manifestations and video electroencephalogram were divided into VPA group（n = 26）and LTG+NZP group（n = 26）. The children were treated with VPA or early add⁃on NZP to LTG respectively（NZP tailed off at 4th month within one month）. The patients were followed up for 1 year to observe seizure control and adverse reactions of the patients. Results In VPA group and LTG+NZP group，12 cases （48.0%）and 10 cases（41.7%）were completely controlled at the first month；14 cases（56.0%）and 12 cases （50.0%）at the 3rd month；15 cases（60.0%）and 14 cases（58.3%），at the 6th month；and 17 cases（68.0%）and 16 cases（66.7%），at 12 months，indicating no statistical significance（P > 0.05）. The total effective rate of VPA group and LTG + NZP group was 68.0% and 66.7% 1 month after treatment，72.0% and 66.7% 3 months after treatment，76.0% and 75.0% 6 months after treatment，and 84.0% and 79.2% 12 months after treatment，respec⁃ tively，showing no significant difference（P > 0.05）. There was no significant difference in the incidence of adverse reactions between 2 groups（P > 0.05）. Conclusion Early add⁃on NZP to LTG onchildren with absence epilepsy has nearly the same efficacy as sodium valproate. Early add ⁃ on NZP to LTG on children with absence epilepsy might take both curative effect and onset time into consideration.

Objective To investigate the clinical application value of bone turnover markers and predic⁃ tion model established by bone turnover markers and PSA and IL⁃6 for prostate cancer bone metastasis. Methods A comparative analysis was conducted for the expression level of serum N ⁃MID Osteocalcin（Osteocalcin），total procollagen type 1 amino⁃terminal pro⁃peptide（TPINP），β⁃isomerized C⁃terminal pro⁃peptide type I collagen Frag⁃ ment（β⁃CTx），total prostate specific antigen（tPSA），and interleukin⁃6（IL⁃6）in prostate cancer patients with or without bone metastasis. Logistic regression analysis was used to screen out the relevant risk factors for prostate cancer bone metastasis from the above serum markers；and based on the screened risk factors，a prediction model for prostate cancer bone metastasis was constructed，whose diagnostic efficacy for prostate cancer bone metastasis was evaluated by ROC curve. Results The expression level of serum Osteocalcin，TPINP，β⁃CTx，tPSA and IL⁃6 in prostate cancer patients with bone metastasis were significantly higher than that in those without bone metastasis （P < 0.05）；among them，serum Osteocalcin，TPINP，tPSA，and IL⁃6 were risk factors for prostate cancer bone metastasis ，with OR value of 1.088，1.021，1.037，1.415 respectively（P<0.05）. the prediction model constructed by the above risk factors was logit（P）=（-5.058）+0.085×（Osteocalcin）+0.020×（TPINP）+0.037×（tPSA）+0.347× （IL⁃6），and the area under the curve（AUC）of this model in the diagnosis of prostate cancer bone metastasis was 0.908（P < 0.001）. Conclusion Abnormal bone metabolism exists in patients with prostate cancer bone metasta⁃ sis，and the prediction model constructed by Osteocalcin，TPINP，tPSA，and IL ⁃6 can predict the occurrence of prostate cancer bone metastasis.

Objective To investigate the effects of vitrification and programmed cryopreservation on human ovarian cortex. Methods Ovarian tissue samples were collected from patients with ovarian disease and were randomly divided into vitrification freezing group，programmed freezing group and control group. We carried out histological analysis of ovarian tissue，isolation and counting of preantral follicles，and in vitro culture of ovarian cortex. The follicle morphology of ovarian tissue，the number of follicles in suspension of ovarian tissue and the estradiol level in the supernatant of ovarian cortical culture were compared among the three groups. Results （1）The intact rate of primordial follicles in the ovarian cortex of the two freezing groups was significantly lower than that of the control group（84.62% & 80.21% vs. 97.93%，P < 0.001），but there was no statistical significance between the two freezing groups（P > 0.05）. Normal rate of secondary follicles in programmed freezing group was significantly lower than that in the control group（37.5% vs. 88.24%，P < 0.05）.（2）The number of primary follicles in suspension of ovarian tissue per unit volume in two freezing groups was significantly lower than that in the control group［（76.50 ± 8.91）&（79.67 ± 10.40）vs.（91.50 ± 8.70），P = 0.001］. There were significant differences in the number of primary follicles and secondary follicles in the 100 microliters in suspension of ovarian tissue between programmed freezing group and the control group［（22.83 ± 3.74）&（9.50 ± 3.46）vs.（27.33 ± 3.02）& （12.55 ± 3.25），P < 0.05］.（3）At the initial stage of in vitro culture（D2⁃D6），the level of E2 secreted by freeze⁃ thawing tissue was lower than that of fresh tissue（P < 0.05），and there was no statistical significance in the E2 level of supernatant among each group（P > 0.05）. Conclusion Both vitrification and programmed freezing can effectively preserve the activity of ovarian tissue. The vitrification method is more effective in preserving secondary follicles than the programmed method，and it is simple and easy to operate，which is more suitable for cryopreservation of ovarian tissue. 

Objective To observe the clinical efficacy of isobaric drainage combined with self ⁃ made WuhuangShengji Decoction wound cavity irrigation in the treatment of multi⁃space perianal abscess，and to explore the application of traditional Chinese medicine. Methods 188 patients with perianal abscess，including 149 in the control group and 39 in the observation group. Propensity score matching method was used to match the baseline of the two groups of patients. There were 33 patients enrolled in each of the two groups with balanced baseline data. The control group used normal saline to wash the wound after the dressing change，while the observation group used WuhuangShengji Decoction to wash the wound. The wound exudation，granulation growth，wound depth，wound healing time，and sloughing time of the wound in the two groups，as well as the hospitalization days，were used to evaluate the efficacy of the two groups of patients. Results After matching，there was no statistical difference in baseline data between the two groups（All P > 0.05）. At 7 days after operation，the score of the observation group was lower than that of the control group，the difference was statistically significant（P < 0.05）；at 5 days and 14 days，the difference was not statistically significant（all P > 0.05）. In the comparison of granulation growth scores， 5 days after surgery，7 days after surgery，14 days after surgery and surgeryafter 21 days，the difference between the observation group and the control group was statistically significant（all P < 0.05）. In comparison of wound depth，14 days（and 21 days）after operation，the difference between the observation group and the control group was statistically significant（all P < 0.05）. However，there was no statistically significant difference in the index 7 days after operation（P > 0.05）. The average wound healing time of the observation group was（33.27±3.43）d， and the control group was（36.94±4.95）d，the difference was statistically significant. There was no significant difference in the time of carrion shedding between the observation group and the control group（P > 0.05）；the average hospital stay of the observation group was（9.97 ± 2.49）d，and the control group was（12.88 ± 3.58）d，the difference was statistically significant（P < 0.05）. Conclusion Following a perianal abscess，using WuhuangSh⁃ engji Decoction to flush the wound cavity can promote wound growth，accelerate wound healing，and shorten the av⁃ erage hospital stay. The effect is superior to standard saline irrigation of the wound cavity.

MicroRNAs，a class of conserved and endogenous small noncoding RNAs，play a vital role in cell proliferation，apoptosis，differentiation and other biological behaviors. MiR⁃29c is highly expressed in the ner⁃ vous system，affecting various signaling pathways and participating in the regulation of a variety of nervous system diseases by modulating different downstream target gene. In this paper，we summarize the research progress in this field，in order to provide new ideas for the clinical diagnosis and treatment of nervous system diseases. 

Helicobacter pylori （Hp） infection is closely associated with inflammation，ulceration and malignancy in the upper gastrointestinal tract. However，with the progressive increase in resistance to commonly used antibiotics，the efficacy of existing eradication regimens has significantly decreased，and there is an urgent need to explore regimens with higher eradication rates. Vonoprazan is a novel potassium⁃competitive acid blockers （P ⁃CABs）with strong and long ⁃lasting acid ⁃ suppressive effects，and has shown good eradication effects against Hp，especially drug ⁃ resistant strains，in clinical practice. This article summarizes the current mechanism of action，efficacy，current status of research and safety of vonoprazan for Hp treatment，aiming to provide a reference for the promotion of vonoprazan for the treatment of Hp infection.