Objective To retrospectively analyze CT manifestations and clinical features of 23 COVID⁃19patients with re⁃positive nucleic acid. Methods A retrospective analysis was conducted on chest CT manifesta⁃tions and clinical characteristics of 23 COVID⁃19 patients with re⁃positive nucleic acid in Guangzhou No.8 People′sHospital from January 24 to March 15，2020，including 12 males and 11 females，aged 19~79，with an averageage of 46.61 ± 17.86. Results Twenty⁃three cases were all normal COVID⁃19 patients，3 of which had gastricanorexia but without other symptoms. Anal swab of 15 cases was positive（65.2%）；throat swab was positive in 7cases（30.4%）and nasal swab in 1 case（4.4%）. The time nucleic acid converting from negative to re⁃positive inanal swab and throat swab was 6.87 ± 3.31 and 7.14 ± 4.06 days respectively and the time nucleic acid convertingfrom re⁃ositive to negative 6.53 ± 4.93 and 2.71 ± 1.50 days respectively. Chest CT showed that lesions involvedwith bilateral lung lobes in 16 cases and unilateral lobe in 7 cases. Lesions were distributed in the upper and middlelobe in 3 cases；in the lower lobe and under the pleura in 14 cases，and in the lung in 7 cases. There were 20 casesof small patchy or nodular ground glass density changes in the lung，14 cases with increased cord density，4 caseswith thickening of adjacent pleura，1 case of thickening of interstitial septum，and 11 cases of thickening andthickening of bronchovascular bundles in both lungs. The bronchioles were stretched and dilated in 2 cases andpleural effusion in 1 case. Compared with CT images before re⁃positive nucleic acid found，1 case of inflammationwas more severe；5 cases had no significant change and 16 cases of inflammation were improved. Conclusion Inthis paper，data of 23 normal COVID⁃19 patients in Guangzhou are analyzed. After the nucleic acid turned out to bepositive again，there are only 3 cases with gastric anorexia but no sign of pain and no other clinical manifestationsare observed. Re⁃positive nucleic acid is tested out within 14 days after the discharge when patients are still isolated in the designated places then nucleic acid turned out to be negative again within 14 days and no recurrence is foundin the follow⁃up. CT images of patients with re⁃positive nucleic acid showed no severe symptoms than before. Themain manifestations are multiple small ground⁃glass shadows ，increased density of cord⁃like densities ，moreinvolvement of both lungs，more common in the lower lobe of the lung and the subpleural，and more pulmonarybronchial vascular bundles increase and thickening，but few pleural effusions

Objective To construct a colon cancer HCT⁃116 cell line with stable silencing of miR⁃222，and to explore the effect of miR⁃222 on colon cancer cell proliferation，cycle，apoptosis and migration ability.Method HCT⁃116 cells were selected and TuD RNA（Tough Decoy RNA）was used to construct TUD⁃hsa⁃miR⁃222⁃3p Inhibitor lentiviral vector，which was transfected into miR⁃222 Inhibitor（miR⁃222 I）and negative control（NC）. The normal group was not infected with lentivirus cells（HCT⁃116）. MTS method was used to detect cellviability and Annexin V⁃FITC was used to detect cell apoptosis；flow cytometry was used to detect cell cycle；tran⁃swell cell model was used to detect cell migration ability. Results After miR⁃222 inhibitor was transfected intoHCT⁃116 cells and the transfection was confirmed by fluorescence microscopy and RT⁃PCR. Compared with that ofNC group and normal group，cell viability of miR⁃222 I group was significantly reduced；the proportion of cells inthe S phase was significantly reduced，and the early apoptosis rate was significantly increased. The cell migrationability was obviously inhibited. Conclusion Silencing of miR⁃222 gene can reduce colon cancer cell viability andblock cycle progression，promote apoptosis and inhibit cell migration.

Objective To explore the expression and functions of MDSC（myeloid⁃derived suppressorcell）and its immunosuppression for T cells in patients with TSCC（tongue squamous cell carcinoma）. Methods Peripheral blood samples were collected from 40 patients with TSCC and 51 healthy controls. Flow cytometry wasused to detect the proportion of MDSC in peripheral blood and its influence on the proliferation function of CD4+ Tand CD8+ T cells，and the proportion of MDSC in fresh tongue carcinoma specimens was further detected. Results Compared with healthy controls，the proportion of MDSC in TSCC patients significantly increased，and majority ofthese cells were Polymorphonuclear⁃MDSC（PMN⁃MDS）. These MDSCs were able to suppress the proliferation of Tcell，which was dependent on the elevated reactive oxygen species（ROS）level. The proportion of MDSC in thetumor tissues also was higher than that in the adjacent tissues（P < 0.05），which mainly were also PMN⁃MDSCs.Conclusion MDSC may play an important immunosuppressive role in tumor microenvironment of TSCC depend⁃ing on ROS increasing.

Objective To study the protective effect of miR⁃29a on LPS induced rat renal tubular epithelialcell injury by targeting signal transduction and activator of transcription 3（STAT3）. Methods Rat renal tubularepithelial cell line NRK⁃52E was cultured. LPS stimulation was used to establish sepsis cell model and induce cellinjury，then transfected with miR⁃nc，miR⁃29a，pcDNA3.1 plasmid，pcDNA3.1⁃STAT3 plasmid or treated withSTAT3 inhibitor AG490. Then cell viability A490，the expression of STAT3，p⁃STAT3 and Bcl⁃2，TNF⁃α andIL⁃β contents were compared，and miR⁃29a targeting STAT3 was confirmed by double luciferase reporter gene.Result The expression levels of miR⁃29a，Bcl⁃2，the level of A490 of LPS group were lower than those of the con⁃trol group，while the expression of STAT3，p⁃STAT3，the contents of TNF⁃α and IL⁃β were higher than those incontrol group；the expression levels of miR⁃29a，Bcl⁃2，the level of A490 of LPS+miR⁃29a group were higher thanthose of the LPS group，while the expression of STAT3，p⁃STAT3，the contents of TNF⁃α and IL⁃β were lowerthan those in LPS group；the expression levels of Bcl⁃2，the level of A490 of pcDNA3.1⁃STAT3+miR⁃29a were low⁃er than pcDNA3.1+miR⁃29a group，while the expression of STAT3，p⁃STAT3，the contents of TNF⁃α and IL⁃βwere higher than those in LPS group；the fluorescence activity of STAT3 double luciferase reporter gene of miR⁃29agroup was lower than that of miR⁃nc group. Conclusion STAT3 pathway activation is related to LPS inducedinflammatory response and apoptosis of renal tubular epithelial cells，miR⁃29a can reduce LPS induced inflammatoryresponse and apoptosis by targeting STAT3.

Objective To analyze the expression of long⁃chain non⁃coding RNA（lncRNA）lymphocyteleukemia deletion gene 1（DLEU1）in esophageal squamous cell carcinoma（ESCC）and its clinical significance.The effect of DLEU1 on the proliferation，migration and invasion of TE⁃13 was further studied. Methods Real⁃timequantitative polymerase chain reaction was used to detect the expression of DLEU1 in ESCC and adjacent normaltissues. The effects of DLEU1 on the proliferation，migration and invasion of TE⁃13 were analyzed by CCK⁃8，scratchtest and Transwell test. Results The expression of DLEU1 in ESCC was significantly higher than that in adjacentnormal tissues（P < 0.05）. The expression of DLEU1 was correlated with lymph node metastasis and TNM stage（P < 0.05），but not with age，gender，degree of differentiation and depth of invasion（P > 0.05）. After knockdownof DLEU1 in TE⁃13 cells，cell proliferation，migration and invasion were significantly suppressed. Conclusion The expression of DLEU1 was up⁃regulated in ESCC，and the high expression of DLEU1 suggested a poor progno⁃sis. DLEU1 may have a regulatory effect on the proliferation，migration and invasion of TE⁃13 cells，and it maybecome a potential target for ESCC treatment.

Objective To observe the effect of fibroblast activation protein（FAP）on the proliferationand apoptosis of eyelid basal cell carcinoma⁃associated fibroblasts（CAFs）. Methods Eyelid CAFs and normalfibroblasts（NFs）were isolated，cultured and identified. CAFs were randomly divided into control group，overex⁃pression group（FAP），knockdown group（FAP shRNA），empty group（random shRNA）and inhibitor group［FAP shRNA+bpv］. MTT method was used to observe the proliferation；flow cytometry to detect apoptosis andwestern blot method to detect eyelid CAFs FAP，PTEN，phosphatidyl inositol⁃3⁃kinase（PI3K），p⁃PI3K，serine⁃threonine protein kinase（Akt）and p⁃Akt protein. Results Eyelid CAFs and NFs were cultured and identified.Compared with those of the control group and empty group，the absorbance（A）value of the overexpression groupincreased；apoptosis rate decreased；FAP，p⁃PI3K and p⁃Akt protein increased and PTEN protein decreased. Avalue of the knockdown and inhibitor group decreased；apoptosis rates increased；FAP，p⁃PI3K，and p⁃Akt pro⁃tein decreased and PTEN protein increased（P < 0.05）. A value，p⁃PI3K and p⁃Akt protein of the inhibitor groupwere higher than those in the knockdown group，but the rate of apoptosis and PTEN protein were lower（P < 0.05）.Conclusion Overexpression of FAP can promote the proliferation of CAFs and inhibit their apoptosis，possibly byinhibiting PTEN and activating the PI3K/AKT pathway.

Objective To compare the effects of different ratios of protamine to heparin neutralizationcommonly used in cardiopulmonary bypass（CPB）on coagulation by using thromboelastography（TEG）on the basisof activated clotting time of whole blood（ACT）. Methods According to the dose ratio of protamine to initial heparin，patients were randomly divided into 0.6，0.8，1.0 and 1.3 group，with 25 cases in each group. ACT and TEG values，heparin residual rate，postoperative drainage，and protamine adverse reactions in each group were recorded andcompared. Results （1）There was no significant difference in postoperative drainage of the four groups.（2）TEGparameters of the 0.6 group showed a worsening trend after neutralization，which was statistically different fromthose of the 1.3 group.（3）The residual heparin was related to the proportion of protamine，and the residual rate inthe 0.6 group was the highest.（4）The drainage of patients with high residual heparin and that ofpatients withoutresidual in the same group indicated statistical difference. Conclusions When the ratio of protamine to heparinis ≤ 0.8，the residual rate of heparin is higher，and the bleeding risk increases accordingly.When the ratio is 1.0 or1.3，the residual rate of heparin is low，and there is no obvious damage to the coagulation function，and the risk ofbleeding is low.

Objective This study mainly explored the diagnostic value of neutrophil gelatinase⁃associatedlipocalin（NGAL）in chronic obstructive pulmonary disease（COPD）. Methods We collected 97 COPD patientsin respiratory and critical medical departments in the second affiliated hospital of Chongqing medical universityfrom June 2018 to December 2019 as the case group. 50 healthy adults were included as control group. Patientswere further divided into two subgroups：acute exacerbation of chronic obstructive pulmonary disease（AECOPD）and COPD combined community⁃acquired pneumonia（COPD⁃CAP）. Then the patients were divided into 4 sub⁃groups：GOLDⅠ，Ⅱ，Ⅲ，Ⅳ. The serum NGAL level was detected by ELISA method，the basic information andclinical indexes were collected. Single factor analysis was used to identify the factors with significant differencesamong different groups. Then the Spearman correlation between NGAL and other indexes was analyzed. Finally，theROC curve was used to analyze the diagnostic value of NGAL in COPD patients. Results Serum NGAL level ofCOPD⁃CAP patients and AECOPD patients was significantly higher than that of healthy controls，and the serumNGAL level of COPD⁃CAP patients was significantly higher than that of AECOPD patients（P < 0.05）. The NGALlevel in GOLD Ⅲ、Ⅳ group was significantly higher than that in GOLD Ⅱ group（P < 0.05）. Spearman correlationanalysis showed negative correlation between NGAL and FEV1% pred，FVC% pred. ROC survival curves indicatethat NGAL has a high diagnostic value for both AECOPD and COPD⁃CAP. Moreover，NGAL has moderate value ofdistinguishing GOLD Ⅰ Ⅱ from GOLD Ⅲ Ⅳ. Conclusions NGAL plays an important role in the process of COPDacute inflammatory response，meanwhile，NGAL plays a role in classification of lung function severity，indicatingNGAL is correlated with airway remodeling.

Objective To explore the distribution of different types of chromosomal abnormality ofpatients diagnosed as embryo⁃stopping and analyze the risk factors leading to embryonic chromosome abnormality.Method To retrospectively analyze the clinical data of 536 patients diagnosed as embryo⁃stopping and treatedwith villus chromosome analysis in the Third Affiliated Hospital of Guangzhou Medical University from January2016 to June 2019 and analyze the distribution of villi chromosome abnormalities. Logistic regression analysis wasused to explore the risk factors of embryonic chromosomal abnormality. Results （1）The incidence of chromosomalabnormality in early embryo⁃stopping was 61.8%. Ttrisomy，triploid and（45，X）were the three common types ofabnormalities. Among the cases with abnormal chromosome structures，the more common type is deletion. Trisomy16（30.4%）and trisomy 22（21.9%）were the two more common in trisomy.（2）Advanced age was a risk factor forchromosomal abnormality，while assisted reproductive conception a protective factor. The incidence of abnormalchromosome number，aneuploidy，trisomy and compound trisomy in the group with age ≥ 35 were all significantlyhigher than those in the group with age ＜35（P < 0.05）. Chromosomal abnormality rate and triploid rate of theassisted reproductive conception group were significantly lower than those of the natural conception group（P < 0.05）.Conclusion Fetal chromosome abnormality is the main reason for early embryo⁃stopping. Trisomy and triploid and（45，X）are frequently⁃seen and among trisomies，trisomy 16 and trisomy 22 are the two more common. Age is pos⁃itively correlated with embryonic chromosome abnormality；assisted reproductive conception will not increase theincidence of embryonic chromosome abnormalities.

Objective The aim of the study was to investigate the incidence，risk factors and prognosis ofperioperative stroke of total knee arthroplasty（TKA），which could identify a strategy to minimize the prevalence ofthe complication. Methods We performed an observational study of patients undergoing TKA from 2008 to 2018in our hospital. The patients′ demography，risk factors，operational conditions and anesthesia method，transferringto ICU and infusion amount of RBC，PLT or plasma were recorded. χ2 and t⁃test were used to analyze the prognosis，and logistic regression were used to analyze the predictable risk factors. Results Totally，16 490 patients under⁃went TKA，with 3 453 male patients，mean age 62.24 year⁃old（range：18 ~ 90 years）. 11 patients had perioperativeacute ischemia stroke，including three men and eight women，with a mean age of 68.82 years（range：55 ~ 80years），and the institutional perioperative stroke rate was 0.07%. The median time of perioperative stroke was 1 day（range：1 ~ 3 days）. Perioperative stroke patients had significantly lower activity of daily living score（40.50 vs.56.35，P < 0.001）and higher percent of transferring to ICU（1.10% vs. 27.30%，P < 0.001）compared with TKApatients. Univariate analysis demonstrated that hypertension，diabetes，atrial fibrillation，hyperlipidemia，isch⁃emia stroke history，anemia and bilateral TKA were risk factors of perioperative stroke in TKA（P < 0.05）. Multi⁃variate logistical analysis demonstrated that ischemia stroke history（OR = 88.586，95%CI：22.076 ~ 355.561，P <0.001），atrial fibrillation（OR = 18.230，95%CI：1.637 ~ 203.026，P = 0.018）and bilateral TKA（OR = 7.226，95%CI：1.985 ~ 26.304，P = 0.003）were independent risk factors of perioperative stroke in TKA. Conclusion Perioperative stroke in TKA had poor prognosis. High⁃risk patients with previous stroke，atrial fibrillation，or bilateralTKA should be recognized and alert in clinical practice，in order to decrease occurrence of perioperative stroke in TKA.

Objective The aim of this study was to investigate the clinical value of non⁃invasive hemody⁃namics monitoring system（NICaS）in hemodynamics of patients with moderate to severe acute paraquat pesticide（APP）. Methods A total of 102 patients with moderate to severe APP admitted to the emergency department inour hospital from January 2019 to March 2020 were enrolled and randomly divided into non⁃invasive hemodynamicgroup（NICaS group，36 cases），lung thermal dilution group（Picco group，32 cases）and empirical treatmentgroup（34 cases）. The relationships among hemodynamics，survival rate and complications were analyzed. Results The patients age，sex ratio，body mass index（BMI），heart rate，systolic blood pressure，treatment period andadmitted to hospital with acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）score were all no statis⁃tical difference among three groups（P > 0.05）. Compared with the experience group，the in⁃hospital mortality ofAPP patients in NICaS group and Picco group was significantly lower（P < 0.05）. The Cardiac output（CO）wassignificantly correlated with peripheral vascular resistance index （SVRI） at the same time point measured by NICaS and Picco methods. This correlation was more obvious in the interval of 2.7 ~ 6.8 L/min（r = 1.000，P＜0.001）and 520 ~ 2 367 dyn·s·cm⁃5·m2（r = 1.000，P＜0.001）. Bland⁃altmen analysis showed that the consistencyof CO measured by Picco and NICaS was 93.75%（P = 0.278）and that of SVRI was 96.88%（P = 0.579）. Comparedwith the experience group，the average daily infusion volume and daily colloid infusion volume of patients in NICaSgroup and Picco group were lower and the differences were statistically significant（P < 0.05）. Comparison betweenthe groups showed that the first cardiac output was statistically different（P < 0.05）. Conclusion The use of non⁃invasive hemodynamic monitoring system could effectively，quickly and safely monitor hemodynamic indexes in therescue of patients with moderate to severe APP.

Objective To analyze transcriptome profiling of peripheral blood cells of patients withmetastatic bone pain（MBP）to screen key genes and pathways associated with the pathogenesis of the disease.Methods Peripheral blood samples from 11 lung adenocarcinoma patients with MBP were collected，including 5patients with typical MBP clinical manifestations and visual analogue scale（VAS）≥4（Group MBP）and 6 patientswithout suffering any pain（Group C）. Differentially expressed genes（DEGs）were screened by R language.GO（Gene Ontology）and KEGG（Kyoto Encyclopedia of Genes and Genomes）pathways analysis were performed on theDAVID database. The most significant module and key genes were analyzed by protein⁃protein interaction（PPI）network. Gene analysis results were combined with TCGA clinical follow⁃up data for survival analysis. Results Atotal of 2，332 DEGs were identified，consisting of 1，647 up⁃regulated genes and 685 down⁃regulated genes. Theenriched processes and pathways of DEGs included Chemokine signaling pathway and p53 signaling pathway. ThePPI network analysis and survival analysis identified 4 hub genes（CXCL1，CXCL10，CXCR54 and GNG7）. Amongthem，GNG7 was closely related to the survival rate of lung adenocarcinoma patients. Conclusion GNG7 and certainchemokine/chemokine receptors such as CXCL1，CXCL10 and CXCR4 may be possible predictors and therapeutictargets for MBP，which could provide evidence for clinical treatment.

Objective To investigate the clinical value of neutrophil lymphocyte ratio（NLR）in criticallyill patients with acute renal injury（AKI）. Methods A total of 405 patients in intensive care unit of the FirstAffiliated Hospital of South China University from January 1，2016 to December 31，2016 were enrolled. AKI wasdiagnosed according to the KDIGO criteria. The correlation of NLR with the development of AKI ，the kidney recoveryand the hospital mortality was analyzed. Results A total of 202 patients were diagnosed with AKI. There weresignificant differences between AKI and non⁃AKI groups in terms of sex，age，basic creatinine，urea nitrogen，CRRT，albumin，triglyceride，procalcitonin，cystatin C and NLR（P < 0.05）. Further analysis of the prognosis ofAKI patients showed that 139 cases survived，including 92 cases of renal function recovery and 47 non⁃recoverycases . There was no significant difference in NLR between the two groups at the admission to ICU and when serumcreatinine the highest. However，NLR significantly decreased in patients with renal function recovery when leavingICU. Logistic regression suggested that NLR was the independent predictor of AKI（OR = 1.213，95% CI 1.155 ~1.274，P < 0.001）. ROC curve showed that the AUC of NLR for predicting AKI and hospital⁃mortality were 0.794（95% CI 0.749 ~ 0.838，P < 0.001）and 0.588，（95%CI：0.517 ~ 0.658，P = 0.017）respectively. The cutoff valuewas 13.4 and 12.2 respectively. Conclusion A higher level of NLR is associated with the development and progno⁃sis of AKI.

Objective This study tried to observe and evaluate the pros and cons of radial incision com⁃bined with tunnel⁃type floating line drainage for the treatment of high posterior ankle fistula and its clinical efficacy.Methods A total of 80 inpatients meeting the inclusion criteria were collected. According to the order of admis⁃sion，they were divided into a radial incision combined with tunnel⁃type floating thread drainage group（observationgroup，40 cases）and a curved suture（thread hanging）internal drainage group（control group，40 cases）. Thekey indicators of the two groups of cases including operation time，intraoperative blood loss，postoperative pain，etc.，and adverse reaction indicators such as urination disorder，anal function and prognosis follow⁃up indicatorswere all observed and analyzed. Results The observation group was better than the control group in terms of opera⁃tion time，intraoperative blood loss，pain during the 2～4 days after operation and urination disorder（P < 0.05）.The postoperative wound infection rates，anal function，healing time and other aspects，were all no significantdifference between the two groups（P > 0.05）. Conclusion Radial incision combined with tunnel⁃type floatingthread drainage has obvious advantages. The advantages included strong operability，reduction of postoperativeadverse reactions，and better protection of the anal sphincter function. It was an excellent operation for the treatmentof high posterior iron fistula formula.

Objective The aim of this study was to investigate the application of Nd：YAG laser combinedwith Er：YAG laser in the treatment of ankylotomy and summarize the treatment timing and treatment method.Methods 218 patients with ankyloglossia from December 2017 to December 2019 were treated by ankylotomymanaged with Nd ：YAG laser and Er ：YAG laser. The efficacy and recovery were observed before and afterankylotomy surgery. Results Hemorrhage volumes of all the patients in ankylotomy were in a low level. Theirhealing and recovery were fast with no obvious discomfort. The function of the frenulum of the patients returnedto normal measuring by a simplified tool（hazelbaker assessment tool for lingual frenulum function）HATLFF.Conclusions The use of Nd：YAG laser combined with Er：YAG laser for the treatment ankyloglossia coulddecrease the difficulties，complications and postoperative reactions. It is suggested that the operative age of thechildren should be 14 moths. The indication and scope of the operation could also be flexible.

Objective To study the target delineation method of normal spinal cord tissue after implanta⁃tion of 125I radioactive particles. Methods The CT images of chest and abdomen of 5 healthy people were selected.The slice thickness was 0.5 cm，and the 3D treatment planning system was used. At the 12th thoracic vertebrae，the cylindrical tumors with the diameter of 4 cm，3 cm high（group A），5 cm in diameter and 4 cm in height（group B），6 cm in diameter and 5 cm in height（Group C）and 1.0 cm in length，width and height（Group D），5 cm in length，5 cm in width and 5 cm in height（Group E），and 6 cm in length，6 cm in width and 6 cm inheight（Group F）and 1.0 cm in length，width and height were respectively depicted at the 12th thoracic vertebraeThe tumor is a triangular pyramid. According to the rule of sparse in the middle and dense in the periphery，theprescription dose was 135 Gy，and the preoperative plan was carried out. Then the target areas of normal spinalcord tissue were delineated as -1.0，-0.5，0，0.5，1.0，1.5，2，2.5，3.0 cm，respectively. The mean，Max andD2cc of GTV were calculated. Results The particles used the dose of D2cc and the maximum point increases with thesize of the tumor. In group A，B，C，D，E and F，the length of the target area which was delineated normal spinalcord tissue，was not related to the maximum dose received by the spinal cord. With the increase of the length of thetarget area of normal spinal cord tissue，the average dose received by the spinal cord decreased gradually. In groupA，B，C，D，E and F，when the target area of normal spinal cord tissue was less than the GTV layer，the D2ccdecreased with the reduction of the target area of normal spinal cord tissue，greater than or equal to the GTV layerIn face time，D2cc did not change with the increase of target length in normal spinal cord，and was not related totumor shape and size. There was a significant difference in the length of spinal cord sketch between the tumor targetlevel and the tumor target level（P < 0.05）. Conclusion When the target area of normal spinal cord tissue afterimplantation of 125I radioactive particles was longer than or equal to the GTV level ，the amount of spinal cordtissue received has nothing to do with tumor size and tumor shape. It is recommended that the target length of normalspinal cord tissue after implantation of 125I radioactive particles be the visible level of all tumor targets.【Key words】target delineation； spinal cord； 125I particle； the 3D treatment planning system

Objective To evaluate and compare the delivery process and maternal and child outcomes ofperinatal women who were determined to continue or stop using oxytocin after the active period at the time of induc⁃tion. Methods A total of 673 primiparas were selected to induce labor by intravenous infusion of oxytocin，350 incontinuous oxytocin group，and 323 in oxytocin stop group. The delivery process and maternal and infant outcomesof the two groups were compared. Results The comparison of the two groups in terms of duration of active phase，second stage of labor and chorioamnionitis indicated no statistical significance（P > 0.05）. The total usage ofoxytocin，total usage time，cutting contractions，incidence of uterine overstimulation，abnormal heart rate of hyper⁃tension，and incidence of postpartum hemorrhage in the oxytocin discontinuation group were lower than those in theoxytocin continuous application group（P < 0.05）. Conclusion Stopping oxytocin after the active period canreduce the volume of oxytocin，shorten the time of oxytocin，reduce the incidence of cesarean section，hyperstimu⁃lation，abnormal fetal heart rate and postpartum hemorrhage，but not prolong the labor process and increase theincidence of chorioamnionitis. Stopping oxytocin after the active period is a feasible option for labor induction.

Objective It is not clear that some patients with crohn′s disease do not respond to treatmentwith anti⁃umor necrosis factor（anti⁃TNF）agents，such as infliximab. We investigated whether loss of anti⁃TNFagents through intestinal mucosa reduces the efficacy of infliximab in patients with CD. Methods We collectedfecal samples from 32 consecutive patients with moderate to severely active CD during the first 2 weeks of infliximabtherapy. Infliximab concentrations were measured in serum and supernatants of fecal samples using an ELISA. Clinicaland endoscopic responses were assessed 2 and 8 weeks and 3 months after treatment began. Results Infliximabwas detected in 135 of 179 fecal samples（75.4%）. The highest concentrations were measured in the first days afterthe first infusion. Patients that were clinical non⁃responses at week 2 had significantly higher fecal concentrationsof infliximab after the first day of treatment than patients with clinical responses（median concentration，7.01 ±0.71 mg/mL in nonresponders vs. 1.04 ± 0.58 mg/mL in responders，P = 0.031）. We did not observe a correlationbetween fecal and serum concentrations of infliximab. Conclusions Infliximab is lost into stools of patientswith CD. High fecal concentrations of infliximab in the first days after therapy begins are associated with primarynonresponse.

Objective To explore the short⁃term efficacy and safety of low⁃dose combined with recombi⁃nant human brain natriuretic peptide and sacubitril⁃valsartan in the treatment of elderly patients with acute heartfailure. Methods 142 elderly patients with New York Heart Function Ⅲ~Ⅳ and NT⁃roBNP significantlyincreased and ejection fraction significantly decreased were randomLy divided into observation group（group A），conventional + recombinant human brain natriuretic peptide group（group B）and conventional treatment group（Group C），47 cases，47 cases and 48 cases respectively. All patients were treated with diuretics，digoxin and othersymptomatic treatment according to their condition. Group A received 0.5 mg/day recombinant human brain natri⁃uretic peptide（rhBNP）on the basis of routine treatment for the first three days，and at the same time，sacubitril⁃valsartan，25 mg bid orally for the first time，titrated according to blood pressure level；group B received rhBNPfor the first three days on the basis of routine treatment；group C received routine treatment. The clinical symptomrelief，clinical remission time，heart function improvement，six minute walking distance，blood pressure changeand NT⁃proBNP level were compared among the three groups. Results After treatment，the ventricular rate andNT proBNP level of the three groups were significantly lower than that before admission（P < 0.001）. In group A，diastolic blood pressure decreased after treatment（P < 0.001）. The clinical remission in group A were less than those in group C，and there were significant differences between the two groups（P < 0.001）. The six minute walkingdistance in group A was greater than that in group C（P < 0.001）；the diastolic blood pressure in group A was lowerthan that in group C（P = 0.006）；the NT⁃proBNP level in group A was lower than that in group C and group B（P < 0.001）at the first week of treatment；at the same time，the NT⁃proBNP level in group B was lower than thatin group C（P < 0.001）. There was no significant difference in the improvement of cardiac function among the threegroups（P = 0.051）. There were 9 hospital deaths in all patients，3 in each group. The mean age and the NT⁃proB⁃NP level of the patients who died in hospital was significant higher than those of the patients who were alive inhospital（P < 0.001）；the ventricular rate and EF value of the patients who died in hospital were significantly lowerthan those of the patients who were alive in hospital（P < 0.001）. Conclusion Early combined use of rhBNP andsacubitril⁃valsartan in small doses can further improve the short⁃term prognosis of elderly patients with acute heartfailure compared with conventional treatment regimens.

Objective To investigate the relationship between different types of fetal congenital heartdisease（CHD）and chromosomal abnormalities，and to evaluate the value of low⁃depth CNV sequencing in fetalCHD，provide evidence to clinical consultation and assess fetal. Methods A total of 181 pregnant women whowere diagnosed as fetal CHD with or without extracardiac abnormalities by prenatal ultrasound in Liuzhou Maternaland Child Health care Hospital of Guangxi from January 2017 to May 2019. They were divided into two groupswhich one group included 146 pregnant women with independent cardiac malformation groups and another included35 cases with extracardiac abnormalities.we used karyotype analysis and CNV⁃seq analysis to statistically analyzethe chromosomal aberrations of CHD in different types of fetuses，and to follow up the pregnancy outcome andneonatal status of all cases. Results The anomaly detection rate was 11.0%（20/181）by karyotype analysis，and43 cases（43/181，23.8%）CNVs were detected by CNV⁃Seq，of which 28 cases（28/181，15.5%）were pathogenic；Compared with the traditional chromosome karyotype analysis，an additional 8.4% chromosome aberrations weredetected.It was statistically significant in CHD group with extracardiac abnormality compared with independentCHD group（40.0% vs. 9.6%，P < 0.05）. There were 117 live births（64.6%，117/181），62 pregnancy terminations，and 2 intrauterine still births. Conclusion CNV⁃seq improves the detection rate of CHD fetal chromosomal aberra⁃tion，is benefit to the evaluation of fetal prognosis in prenatal clinical consultation，provides more evidence forpregnant women to continue pregnancy，and contributes to the optimization of maternal and infant outcomes. It isalso an effective supplementary detection method for chromosome karyotype analysis，providing a more clinicallyapplicable detection technique for prenatal diagnosis of CHD fetus.

Objective To investigate the correlation of DCAMKL⁃1 and p53 expression with pathologicalcharacteristics of colorectal carcinoma（CRC）and patients′ prognosis. Methods DCAMKL⁃1 and p53 expressionin 126 cases CRCs and ANM. The correlations of their expression with patients′ pathological characteristics andprognosis were evaluated based on Spearman correlation analysis and survival analysis. Results In CRCs，the pos⁃itive rate of DCAMKL⁃1 was 71.4%（90/126），which was significantly higher than that of ANMs（P < 0.05）.There was no correlation between DCAMKL⁃1 expression and patients′ age，gender，clinical stage，lymph nodemetastases（P > 0.05）. The distributions of CRCs and ANMs were 25.4%（32/126），14.3%（18/126），60.3%（76/126）and 92.1%（116/126），7.9%（10/126），0（0/126）in the p53⁃no，mild and strong expression groups，respectively. In CRCs，the strong positive rate of p53 was 60.3%（76/126），which was significantly higher thanthat of ANMs（P <0.05）. The expression of p53 was associated with clinical stage（χ2 = 3.925，P＜0.05）andlymph node metastasis（χ2 = 7.292，P＜0.05）. The CRCs with p53⁃no and p53 strong expression are prone tometastasize（P＜0.05）. Multivariate analysis revealed that clinical stage was independent prognostic factors of CRCpatients（P < 0.05）. Conclusions DCAMKL⁃1 and p53 are closely related to the occurrence of CRC. p53 isrelated to the clinical stage and lymph node metastasis. Clinical stageis independent prognostic indicator of CRC.

Objective To compare the perinatal outcomes of cleavage embryo transfer using time⁃lapse（TL）and conventional culture and evaluate the security of TL. Methods Aretrospective analysis on clinical dataof 1，999 IVF/ICSI⁃ET cycles in our center from January 2016 to March 2019 were performed. According to themethod of embryo culture，they weredivided into TL group（n = 871）and conventional group（n = 1 128）and theperinatal outcomes in the two groups were compared. Results There was no significant difference in the twogroups in terms of endometrium，ectopic pregnancy rate，early abortion rate，late abortion rate，multifetation rate，premature birth rate，adverse neonatal outcome，extremely Low birth weight infants，very low birth weight infant，macrosomic infant，gestational weeks，neonatal weight，malformation rate and sex ratio（P > 0.05）. The numbersof transplanted embryos in the TL group were significantly less than those in the conventional group（P < 0.05）.Clinical pregnancy rate，implantation rate，live birth rate and the rate of holding babieshome in the TL group weresignificantly higher than those in the conventional group（P < 0.05）. Conclusion Without adverse effects on peri⁃natal outcomes of offspring，TL can significantly improve IVF/ICSI clinical outcomes. It is a safe and effective meth⁃od for embryo culture.

Objective To explore the influencing factors of pressure injury in patients undergoing craniofacialsurgery and take targeted nursing intervention measures. Methods Through convenience sampling，we retrospec⁃tively analyzed perioperative pressure injury related factors of 166 patientsfrom the neurosurgery，oral and maxillo⁃facial surgery，otohinolaryngology⁃head and neck surgery in our hospital from August to December 2018. and thelogistic multiple regression equation was used to analyze the risk factors and explore reasonable nursing measures.Results Among the 166 subjects，6 cases had postoperative skin pressure injuries（mainly affect the iliac bones，ankles，and sacrococcygeal），the incidence of pressure sore was 3.61%. Preoperative hemoglobin，preoperativealbumin，operative time，bleeding volume，pressure point skin type and the pressure applied during the operationare the influencing factors of the pressure injury in the craniofacial surgery patients，and the difference is statisticallysignificant（P < 0.05）. Conclusion Patients with low preoperative hemoglobin or albumin，preoperative pressurepoint skin type，long operative time，and excessive intraoperative bleeding volume are more likely to develop pres⁃sure injuries. Master the perioperative nursing points for patients undergoing craniofacial surgery to effectively pre⁃vent and improve the above⁃mentioned perioperative state，and take targeted nursing measures may reduce the inci⁃dence of surgical pressure injuries.

Oral squamous cell carcinoma（OSCC）is the most common oral cancer. More than 300，000new cases are diagnosed every year in the world，most patients are in middle or advanced stage and have a fairlypoor prognosis. So far，biopsy are still the gold standard for diagnosis of oral cancer，butthere are still many limita⁃tions in its clinical application for its invasiveness and surgical complications. In recent years，liquid biopsy hasattracted extensive attention in clinical practice due to its unique simplicity，non⁃invasiveness and repeatability，showing a broad application prospect.In this review，we summarize the new research findings among miRNA in oralsquamous cell carcinoma liquid biopsy

Kaposi′s sarcoma（KS）is an aggressive lymphoangioproliferative tumor. Its occurrence is closelyrelated to the infection of endothelial cells by Kaposi sarcoma associated herpesvirus （KSHV）. KS caused byKSHV is a common concurrent malignant tumor of AIDS，which is more common in Mediterranean and Africa，with high mortality. The treatment of Kaposi sarcoma is one of the difficult problems in clinical practice. In recentyears，KS has achieved a breakthrough. Especially after the advent of CART ，the incidence rate of KS hasdecreased significantly，and the prognosis of patients has improved significantly. This article reviews the progress ofclinical treatment of Kaposi′s sarcoma.

Objective To analysis of the health development status of Guangdong Traditional ChineseMedicine（TCM） hospitals since the establishment of a strong TCM province. Methods Referring to“ChinaHealth Statistics Yearbook”，“National Statistical Extracts of Chinese Medicine”，“Guangdong Health StatisticsYearbook”and“Guangdong Province Chinese Medicine Statistics Information Compilation”，Statistical analysis ofresources and medical services and other related indicators of Guangdong TCM Hospital from 2007 to 2018.Result From 2007 to 2018，the resources and medical service capabilities of Guangdong TCM Hospital continuedto increase. Conclusions That should strengthen overall coordination and promote the high⁃quality development ofChinese medicine hospitals. Improve the quality of talents，improve the training and selection mechanism andenhance the advantages of Chinese medicine talents。