Newly arise variants of severe acute respiratory syndrome coronavirus 2（SARS⁃Co2），especial⁃ ly variants of concern（VOC），bring great challenge to the anti⁃SARS⁃Co2 campaign. The Alpha，Beta，Gamma， Delta and Omicron are the 5 VOC now. With the variants，the effect of vaccine on prevention of infection and severe disease are decreased significantly. And new protocols are needed. In this review，the effect of vaccine on prevention of infection and severe disease for different variants are described. Potential solutions are listed.

From late December 2019，A form of COVID⁃19 caused by severe acute respiratory syndrome coronavirus 2（SARS⁃CoV⁃2）spread rapidly across the globe. Through active prevention，control and timely treat⁃ ment，the epidemic in China has been basically brought under control，with only local outbreaks and a few imported cases occurring in a few regions. However，the epidemic is still spreading in some countries and regions，and no specific drug is available for COVID⁃19 at present，so there is still an urgent need for effective and safe drugs to fight SARS⁃CoV⁃2 infection to control the pandemic of COVID⁃19 in the world. This article provides a brief review of the clinical use of drugs for the treatment of COVID⁃19 and their efficacy and safety.

Objective To analyze the results between colloidal gold method for SARS ⁃CoV ⁃ 2 and real ⁃ time RT⁃PCR test and to verify whether colloidal gold method for SARS⁃CoV⁃2 can be used as a rapid auxiliary diagnosis of COVID⁃19 infection. Methods Positive and negative SARS⁃CoV⁃2 samples（60 nasal swabs and 30 pharyngeal swabs，respectively）were collected from the biological resource bank of Henan Center for Disease Control and Prevention from July to August，2021. All samples were detected by RT⁃PCR for ORF1ab and N gene and colloidal gold method for SARS ⁃CoV ⁃2 antigen. Thirteen positive samples were selected for 10 multiples and 100 multiples dilution and tested by two methods. The positive and negative consistency was analyzed by Kappa analysis. Results The positive and negative coincidence rates of colloidal gold method was 98.89% and 100.00% respectively（Kappa =0.989）. The positive coincidence rates of gold standard method after 10 multiples and 100 multiples dilution was 100%，84.61% respectively. Conclusion Colloidal gold method for antigen detection can be used as an early auxiliary diagnosis method for SARS⁃CoV⁃2.

Sepsis is one of the most common causes of death in critically ill patients. Sepsis⁃related liver injury is a common complication of sepsis，which is related to microcirculation dysfunction，oxygen free radical injury，intestinal bacterial and endotoxin translocation，and excessive production of inflammatory factors. It is believed that the gut ⁃liver axis is involved in the development of sepsis ⁃ related liver injury. Further study on the role of gut⁃liver axis in the pathogenesis of sepsis⁃related liver injury will help to find more effective treatment mea⁃ sures and improve the success rate of rescue in sepsis patients.

Sepsis is a serious organ dysfunction syndrome caused by a host′s imbalance in response to infection. It has a high incidence rate and high mortality rate. Sepsis can seriously damage the epithelial tissue， especially the intestinal epithelium. On the contrary，the damage of intestinal barrier will lead to the translocation of intestinal bacteria and endotoxin，which will aggravate sepsis. At present，there is no systematic and in⁃depth literature on the mechanism of intestinal barrier dysfunction in sepsis. From the perspective of intestinal epithelial cell，inflammation，immunity，microcirculation，coagulation function，intestinal enzymatic response，intestinal flora and short chain fatty acids（SCFAs），this paper systematically and deeply summarizes the molecular mecha⁃ nism of intestinal barrier dysfunction in sepsis and the role of intestinal barrier dysfunction in sepsis in recent 10 years，in order to provide theoretical basis and new therapeutic targets for clinical and drug development to treat sepsis from the protection of intestinal barrier.

The diagnosis and treatment of sepsis has been continuously improved，but its mortality remains high. Its complex mechanism and high heterogeneity are the main causes of mortality in Intensive Care Unit（ICU）. The phenotype of sepsis is the key research directions to the reduction of the mortality. This paper aims to review and summarize the recent research on sepsis phenotype.

Objective To explore the risk factors and reliable evaluation indicators that affect the death of patients with sepsis after abdominal surgery，and to establish a predictive model in intensive care unit（ICU） Methods This is a retrospective case⁃control study ，analyzing the clinical data of patients with sepsis after abdominal surgery admitted to the Department of Intensive Care Medicine，Affiliated Hospital of Guizhou Medical University from January 2018 to December 2020. The information of sex，age，body mass index，heart rate，and mean arterial pressure when transferred to the ICU，the Acute Physiology and Chronic Health Evaluation Ⅱ （APACHEⅡ）score and the Sequential Organ Failure Assessment（SOFA）score for the first 24 hours of entering the ICU，and data of blood routine，biochemistry，arterial blood gas analysis，procalcitonin，surgical site，opera⁃ tion time，ICU length of stay，mechanical ventilation time，and total length of stay were collected and analyzed for the correlation of prognostic factors. Conditional forward method and multivariate logistic regression analysis were adopted to automatically screen the independent variables when the best balance between the fitting degree of the prediction model and the number of independent variables was achieved then the predictive model was established. Results From January 2018 to December 2020，a total of 256 patients with sepsis after abdominal surgery met the inclusion criteria. Among them，there were 160 males and 96 females，with an average age of 64（19，93）years. There were 199 cases in the survival group and 57 cases in the non⁃survival group. The mortality was 22.3%. Univariate analysis showed that heart rate，lactic acid，creatinine，procalcitonin，APACHEⅡ score and SOFA score within 24 hours in the non survival group were significantly higher than those in the survival group，while hemoglobin，bicarbonate and platelet were lower. The mortality of patients with septic shock and hypertension were higher. Multivariate logistic regression found that high APACHEⅡ score（OR = 1.088；95%CI：1.007 ~ 1.175； P = 0.033），tachycardia（OR = 1.02；95%CI：1.005 ~ 1.035；P = 0.007）and combined shock（OR = 5.672； 95%CI：2.204 ~ 1 5.898；P = 0.001）were risk factors for death in these patients，while high hemoglobin（OR = 0.984；95%CI：0.970 ~ 0.998；P = 0.024），and high bicarbonate（OR = 0.85；95%CI：0.764 ~ 0.945；P = 0.003） were protective factors. The maximum area under curve predicted by joint variables was 85.6% ；the sensitivity 0.856，and the specificity 72.4%. The predictive value was better than that of above⁃mentioned five single variables. Conclusion APACHEⅡ score ，heart rate ，septic shock ，hemoglobin and bicarbonate are the key factors affecting the death of patients with sepsis after abdominal surgery. The accuracy of combined variables in pre⁃ dicting the prognosis of abdominal postoperative sepsis is higher than that of single variables，and the diagnostic value is higher.

Objective To explore the role of MAGI2⁃AS3/miR⁃374b⁃5p/HOXB7 axis in the pathogenesis of sepsis⁃associated encephalopathy（SE）. Methods Sepsis was induced in adult C57BL/6J male mice by cecal ligation and perforation（CLP）surgery. Randomly selected CLP mice were transfected with short interfering RNAs （siRNAs）against MAGI2⁃AS3，or with miR⁃374b⁃5p mimics and related controls. Cognitive behavior was tested 8 ~ 12 days after the surgery using a Morris water maze. Hippocampal neuronal apoptosis indicators in CLP mice were then detected. The hippocampal neuron damage model was induced by LPS. Next，the neurons were，respec⁃ tively，transfected with si⁃MAGI2⁃AS3 or miR⁃374b⁃5p mimics to determine the proliferation inhibition and apopto⁃ sis of hippocampal neurons. The interactions between MAGI2⁃AS3，miR⁃374b⁃5p and HOXB7 were assessed using dual luciferase reporter gene assay. Results CLP mice showed progressive increases in MAGI2⁃AS3 levels and progressive decreases in miR ⁃374b ⁃5p levels on the 3rd，7th，and 14th after CLP surgery，accompanied by im⁃ paired cognitive function. MAGI2⁃AS3 silencing and miR⁃374b⁃5p elevation improved spatial learning ability and memory ability，and depressed neuronal apoptosis in CLP mice. MAGI2⁃AS3 silencing and miR⁃374b⁃5p elevation increased viability and limited apoptosis of LPS ⁃treated hippocampal neurons. MAGI2⁃AS3 specifically bound to miR⁃374b⁃5p，and miR⁃374b⁃5p targeted HOXB7. Conclusion MAGI2⁃AS3 silencing inhibits the apoptosis of hippocampal neurons in CLP mice by up⁃regulating miR⁃374b⁃5p and down⁃regulating HOXB7. 

Objective To explore the effect of apoptosis⁃inducing factor mitochondria associated 3（AIFM3） on colorectal cancer cells and its mechanism. Methods The relationship between the expression of AIFM3 and the tissue type and prognosis of colorectal cancer was detected bybio⁃informatics and verified by immunohistochemistry. We knockdown the expression of AIFM3 in cell lines HCT116 and SW620 by lentivirus. The silencing effect of AIFM3 gene was verified by Western blot，the proliferation ability of cells was detected by CCK8 experiment and plate cloning experiment，and the migration ability of cells was detected by transwell migration assay. Results The expression of AIFM3 in colorectal cancer was lower than that in adjacent tissues，and its expression was related to the prognosis of colorectal cancer；knockdown of AIFM3 could significantly inhibit the proliferation and migration of HCT116 and SW620 cells. GSEA analysis showed that there was a correlation between AIFM3 and STAT3 signal pathway. Western blot showed that the protein expression levels of STAT3 and p⁃STAT3 were significantly up⁃regu⁃ lated after knockdown of aifm3. Conclusions The expression of aifm3 was significantly down regulated in colorectal cancer. Knockdown the expression of aifm3 in HCT116 and SW620 cells could increase cell proliferation and migra⁃ tion，and its mechanism may be related to STAT3 signaling pathway.

Objective The drug⁃resistant cell lines were constructed by oxaliplatin（OXA）concentration gradient method to explore the drug resistance mechanism of OXA in the treatment of gastric cancer and provide experimental basis for reversing drug resistance strategy. Methods The OXA concentration gradient was used to culture human gastric cancer cells MGC⁃803 to replicate the OXA resistant cell line model（MGC⁃803/OXA）. Use an inverted microscope to observe the morphological changes of the cells and detect the cell resistance index RI. Flow cytometry was used to detect cell cycle distribution and apoptosis. RT⁃qPCR was used to detect the expression of MDR⁃1，MRP，and ERCC1 mRNAs related to drug resistance. Western Blot detects the expression of drug resis⁃ tance⁃related gene proteins MDR⁃1，MRP，ERCC1 and autophagy⁃related proteins P62，Beclin⁃1 and LC3. At the same time，the number and structure of autophagosomes in the cells were observed with a fluoroscopy electron microscope. Results OXA concentration gradient culture successfully constructed drug⁃resistant cell line MGC⁃803/ OXA. The half inhibitory concentration（IC50）is 62.33 μmol/L，and the RI is 7.01（RI > 5 meets the requirements of resistant strains）. The cell proliferation of the MGC⁃803/OXA cell line slows down，the G2/M phase of the cell cycle is prolonged，and the cell apoptosis rate is reduced. The expression of resistance⁃related genes and proteins such as MDR ⁃1，MRP，ERCC1 is higher than that of MGC ⁃803. It shows that the GC drug ⁃ resistant cell model MGC⁃803/OXA has been successfully constructed. Compared with MGC⁃803，P62 expression in MGC⁃803/OXA decreased，Beclin⁃1 expression and LC3⁃Ⅱ/Ⅰ ratio increased. And there is a typical vacuole bilayer membrane⁃like structure of autophagosomes containing cytoplasmic components ，and the number has increased significantly. Conclusions The OXA concentration gradient method can successfully construct drug⁃resistant cell lines，which are characterized by slower proliferation，prolonged G2/M phase，reduced apoptosis，and enhanced autophagy levels.

Objective The drug⁃resistant cell lines were constructed by oxaliplatin（OXA）concentration gradient method to explore the drug resistance mechanism of OXA in the treatment of gastric cancer and provide experimental basis for reversing drug resistance strategy. Methods The OXA concentration gradient was used to culture human gastric cancer cells MGC⁃803 to replicate the OXA resistant cell line model（MGC⁃803/OXA）. Use an inverted microscope to observe the morphological changes of the cells and detect the cell resistance index RI. Flow cytometry was used to detect cell cycle distribution and apoptosis. RT⁃qPCR was used to detect the expression of MDR⁃1，MRP，and ERCC1 mRNAs related to drug resistance. Western Blot detects the expression of drug resis⁃ tance⁃related gene proteins MDR⁃1，MRP，ERCC1 and autophagy⁃related proteins P62，Beclin⁃1 and LC3. At the same time，the number and structure of autophagosomes in the cells were observed with a fluoroscopy electron microscope. Results OXA concentration gradient culture successfully constructed drug⁃resistant cell line MGC⁃803/ OXA. The half inhibitory concentration（IC50）is 62.33 μmol/L，and the RI is 7.01（RI > 5 meets the requirements of resistant strains）. The cell proliferation of the MGC⁃803/OXA cell line slows down，the G2/M phase of the cell cycle is prolonged，and the cell apoptosis rate is reduced. The expression of resistance⁃related genes and proteins such as MDR ⁃1，MRP，ERCC1 is higher than that of MGC ⁃803. It shows that the GC drug ⁃ resistant cell model MGC⁃803/OXA has been successfully constructed. Compared with MGC⁃803，P62 expression in MGC⁃803/OXA decreased，Beclin⁃1 expression and LC3⁃Ⅱ/Ⅰ ratio increased. And there is a typical vacuole bilayer membrane⁃like structure of autophagosomes containing cytoplasmic components ，and the number has increased significantly. Conclusions The OXA concentration gradient method can successfully construct drug⁃resistant cell lines，which are characterized by slower proliferation，prolonged G2/M phase，reduced apoptosis，and enhanced autophagy levels.

Objective To investigate the possible mechanism of PM2.5⁃induced reproductive dysfunction in rats. Method Thirtymale SD rats were randomly divided into normal saline control group，low concentration of PM2.5（PM 4.3 mg/mL）exposure group and high concentration of PM2.5（PM 12.9 mg/mL）exposure group，with 10 rats in each group. The suspension of PM2.5（dose：1 mL/kg）was given by intratracheal drip every 2 days. After successive 4 weeks，the growth of the rats was observed；the testis coefficient was calculated；the morphological changes of testicular tissue and cells were observed，and the serum testosterone content and the expression of protein related NF⁃κB inflammatory signal path were detected. Results Compared with those in the control group，testis weight and testis coefficient decreased in the experimental group. Light microscope found that in the experimental group，the wall of seminiferous tubule of testicular tissue in rats was thinner；spermatogenic cells at all levels were arranged loosely and disordered，and the number of mature sperm in the lumen decreased. Compared with that in the control group，the testosterone level in the experimental group was significantly decreased（P < 0.05）. Q⁃PCR results showed that the expression quantity of inflammatory factorIL ⁃ 6，and TNF ⁃ α mRNA in the experimental group were higher than those in the control group，and the differences were statistically significant（P < 0.05）. Western blotting showed that the expressions of protein IKK（IκB kinase），NF⁃κB，p⁃NF ⁃κB P65 and p⁃I κB⁃α related NF⁃κB signal path increased significantly when compared with the control group，and the differences were statistically significant（P < 0.05）. Conclusion PM2.5 may up ⁃ regulate the expression of IL ⁃ 6 and TNF ⁃ α through inducing NF⁃κB inflammatory signal path，then cause reproductive dysfunction in male rats.

Objective To investigate whether pristimerin（PRIS）enhances the anti⁃cancer effect of cispla⁃ tin and its underlying mechanism. Methods Patient ⁃derived lung cancer cells were established by conditional reprogramming technology. MTS was used to detect the proliferation activity. Calcein ⁃AM/PI double staining was used to detect the cell state. Transwell assay was used to detect the migration and invasion ability of cells. Annexin V⁃APC flow cytometry was used to detect cell apoptosis. DCFH⁃DA staining was used to measure the ROS levels of the cells. JC ⁃ 1 staining and DiOC6 staining were used to determine the mitochondrial membrane potential qualitatively and quantitatively. qRT⁃PCR and Western Blot were used to detect the mRNA and protein expression. Results As compared with a monotherapy，pristimerin combined with cisplatin significantly inhibited the viability， migration and invasion of the cells（P < 0.01）. Besides，the combination of the two drugs significantly improved the intracellular levels of ROS（P < 0.01）while reduced cell mitochondrial membrane potential（P < 0.01）and inhibited the expressions of NRF2 and HO ⁃1，thus increasing apoptosis（P < 0.01）. Conclusions Pristimerin may enhance the anti⁃cancer ability of cisplatin，whose mechanism may be involved in inhibiting the expressions of NRF2 and HO⁃1 in the KEAP1⁃NRF2/HO⁃1 signaling pathway.

Objective To explore the role of microRNA⁃223（miR⁃223）in ketamine⁃induced pyrolysis of hippocampal neurons in rats at a developmental phase by regulating the Nod⁃like receptor pyrin domain⁃containing protein 3（NLRP3）/cysteinyl aspartate specific proteinase 1（Caspase⁃1）pathway. Methods Rats were divided into a control group，ketamine group，agomir⁃NC group，agomir⁃223 group，agomir⁃223+BAY11⁃7082 group，10 for each group. Western blot was used to detect expressions of NLRP3，cleaved Caspase⁃1 and GSDMD⁃N in the rat hippocampus. Results As compared with the control group，the incubation period，hippocampal histopathology， neuronal apoptosis，levels of interleukin⁃18（IL⁃18），interleukin⁃1β（IL⁃1β），NLRP3，cleaved Caspase⁃1，and GSDMD⁃N increased in the ketamine group；while the number of crossing platforms，the proportion of time staying in the third quadrant，and the level of miR⁃223 reduced（P < 0.05）. As compared with the ketamine group，the incubation period，hippocampal histopathology，neuronal apoptosis，levels of IL ⁃18，IL ⁃1β，NLRP3，cleaved Caspase⁃1，and GSDMD⁃N reduced in the agomir⁃223 group，whereas the number of crossing platforms，the proportion of time staying in the third quadrant，and the level of miR ⁃ 223 increased（P < 0.05）. Conclusions Overexpression of miR⁃223 may improve ketamine⁃induced hippocampal neuronal pyrolysis in rats at a developmental phase by inhibiting the NLRP3/Caspase⁃1 pathway.

Objective To explore the efficacy of elastic intramedullary nail and lesion curettage combined with autologous bone marrow and allogeneic bone powder transplantation in the treatment of proximal humeral bone cysts in children. Methods A retrospective analysis was performed on the clinical data of 56 children（observation group）with proximal humeral bone cysts who received elastic intramedullary nail and lesion curettage combined with autologous bone marrow and allogeneic bone powder transplantation in our hospital between July 2018 and September 2020，and the clinical data of 51 children who underwent single lesion curettage combined with autolo⁃ gous bone marrow and allogeneic bone powder transplantation in our hospital during the same period were included in control group（n = 51）. The differences in postoperative efficacy and healing time were compared between the two groups；the complications were explored in the two groups，and the differences in limb function［Musculoskeletal Tumor Society（MSTS）function score］and quality of life［Pediatric Quality of Life Inventory TM version 4.0（Ped⁃ sQLTM 4.0）］of the two groups were analyzed before surgery and 6 months after surgery. Results Six months after surgery，the cure rate of children in the observation group was higher than that of the control group，and the cure time of children in observation group was shorter than that of control group（all P < 0.05）. There were no significant differences in the incidence rates of treatment complications between the two groups during 6 months of follow⁃up（all P > 0.05）. Six months after surgery，the scores of MSTS and PedsQLTM 4.0 of the two groups were increased when compared with those before surgery，and the scores in observation group were higher than those in control group（all P < 0.05）. Conclusion Elastic intramedullary nail and lesion curettage combined with autolo⁃ gous bone marrow and allogeneic bone powder transplantation has a significant efficacy in the treatment of proximal humeral bone cysts in children，and it shortens the healing time and improves the limb function and the quality of life，and will not lead to increased complications.

Objective To explore the characteristics of patience in medical postgraduates，and to provide reference for the prevention and intervention of depression among them. Methods A total of 687 students were surveyed with the Patient Health Questionnaire⁃9（PHQ⁃9）and Patience Scale through an online survey. The patience of medical postgraduates was classified based on the results of latent class analysis，and the relationship between patience and depression was determined by correlation analysis，analysis of variance and chi⁃square test. Results （1）There was significant negative correlation between patience and depression in medical postgraduates （r = -0.12，P < 0.01）.（2）Four latent class models of patience had been found among medical postgraduates： “patience group（39.0%）”，“repression group（30.4%）”，“self⁃discipline group（18.8%）”and“impulsion group （11.8%）”.（3）There was difference in terms of depression in the four latent class models（F = 23.60，P < 0.01） and in terms of positive rate of depression（χ2 = 49.67，P < 0.01）. Higher depression score［（9.10 ± 4.25）vs. （7.83 ± 4.27）vs.（6.26 ± 3.84）vs.（6.20 ± 3.83）］and higher positive screening rate（37.8% vs. 24.7% vs. 14.2% vs. 10.9%）were found in the“repression group”and“impulsion group”than those in the other two groups. Conclusion The psychological performance of patience among medical postgraduates is correlated with depressive symptoms，revealing that students who suppress emotions and act impulsively present more signs of depression， whereas those with higher patience and delayed gratification show fewer signs of depression. 

Objective To investigate the efficacy and safety of continuous veno⁃venous hemofiltration dialysis（CVVHDF）with regional citrate anticoagulation （RCA）in critical patients with elevated lactic acid. Methods A retrospective analysis was conducted. A total of 235 patients with complete data of regional citrate anticoagulation continuous renal replacement therapy（CRRT）admitted to intensive care unit of our hospital from January 2019 to December 2020 were enrolled and divided into normal lactate group（Lac < 2 mmol/L，group A， n = 125）and elevated lactate group（Lac 2 ~ 10 mmol/L，group B，n = 110）. The basic information of patients in the two groups were compared，including lactic acid value，blood gas analysis（PH，bicarbonate），iCa2+，total serum calcium，total calcium/iCa2 + and Na + before and 24 h of CRRT treatment，and the occurrence of complica⁃ tions and the use of filters were recorded. Results There were no statistically significant differences in lactic acid value，PH and HCO3- before and after treatment in group A（P > 0.05），while lactic acid value decreased and PH and HCO3- increased after 24 h of CRRT treatment in group B（P < 0.05）. Before CRRT treatment，lactic acid in group B was higher than that of group A，while PH and HCO3- were lower than that of group A，with statistically significant differences（P < 0.05）. There were no significant differences in lactic acid，PH and HCO3- between two groups（P > 0.05）24 h after CRRT treatment. Six patients were diagnosed with citric acid accumulation（2.55%）， and all died with poor prognosis. There was no significant difference in the incidence of CRRT complications between group A and B（P > 0.05）. Conclusion Regional citrate anticoagulation was safe and effective for critical patients with elevated lactic acid during CVVHDF，but patients' blood gas，electrolytes and other indicators need to be closely monitored. The incidence of citric acid accumulation was low ，which only occurs in patients with severe lactic acidosis caused by multiple organ failure，and once occurred，it also indicated poor prognosis.

Objective To evaluate the predictive value of tumor budding for lymph node metastasis of stage ⅠA2⁃ⅠB1 cervical squamous cell carcinoma（CSCC）. Methods The clinicopathological characteristics of 108 cases of stage FIGO（2009）ⅠA2⁃ⅠB1 CSCC were collected. Tumor budding（TB）was counted at HE sections and the correlation between TB and clinicopathological features was analyzed. In 33 cases，the agreement of bud counts was determined using H&E and Pan⁃CK immunostaining. Results Lymph node metastasis tended to occur more frequently in the high TB group than in the low TB group，but there was no significant difference between the two groups（P = 0.084）. High TB was significantly associated with poor tumor differentiation（P = 0.004），but not with patient age ，tumor invasion depth and lymphovascular invasion.There was a highly significant correlation between lymph node metastasis and conventional clinicopathological characteristics. The consistency rate of tumor budding categories assessed using HE and Pan ⁃ CK immunostaining was 81.8%（kappa = 0.629）. Conclusion More research on the methods of TB counts，high TB thresholds，and the predictive value of TB for lymph node metastasis of early⁃stage CSCC is needed.

Objective To analyze the content of circulating tumor cells（CTCs）in autologous blood recov⁃ ered during brain tumor resection and the effect of autologous blood transfusion on prognosis，to evaluate the safety of autologous blood recovery combined with leukocyte filter in brain tumor resection in children. Methods The content of CTCs in children undergoing brain tumor resection before and after autologous blood transfusion was analyzed，and the effect of leukocyte filter on removing circulating tumor cells was evaluated. The intraoperative blood loss，blood transfusion and prognosis of children in autologous blood transfusion group and allogeneic blood transfusion group were compared. The effect of autologous blood transfusion on postoperative recovery was analyzed. Results There was no significant difference in the content of CTCs in autologous blood transfusion group before and after the operation（P > 0.05）. The operation and anesthesia time of the autologous blood transfusion group were longer and the amount of intraoperative bleeding was more when compared with the allogeneic blood transfu⁃ sion group（P < 0.05），but there was no significant difference in the amount of allogeneic red blood cell，plasma and cold precipitation between the two groups（P > 0.05）. There was no significant difference between the two groups in terms of postoperative complications，duration of postoperative mechanical ventilation，postoperative hospital stay and postoperative recurrence rate（P > 0.05）. Conclusion The application of autologous blood recovery combined with leukocyte filter in pediatric brain tumor resection has no effect on postoperative tumor recurrence and prognosis，and it can be safely applied in clinical practice.

Objective To observe the clinical effect of Radiofrequency Acupotomy combined with Ozone injection into Articular Cavity in the treatment of hemiplegic shoulder pain. Methods 70 cases of patient with hemiplegic shoulder pain in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2020 to May 2021 were selected and randomly divided into control group（35 cases）and treatment group （35 cases）. Control group of patients were treated with Acupotomy. Treatment group of patients were treated with Radiofrequency Acupotomy combined with Ozone injection. After the treatment，clinical efficacy was evaluated，and VAS scores，FMA scores and ADL scores before and after the treatment in the two groups were compared. Results After treatment，the clinical efficacies in the control and treatment groups were 77.14% and 91.43%. The effect of the treatment group was better than that of the control group（P < 0.05）. The VAS scores in two groups were significantly decreased（P < 0.05）. The FMA scores and ADL scores were significantly increased（P < 0.05）. The scores of the treatment group were better than that of the control group（P < 0.05）. The levels of TNF⁃α，IL⁃1β and hs ⁃CRP in two groups were significantly decreased（P < 0.05）. All the above ⁃mentioned indices in treatment group were significantly lower than those in the control group （P < 0.05）. Conclusion Radiofrequency Acupotomy combined with Ozone injection into Articular Cavity has curative effect in the treatment hemiplegic shoulder pain， which can significantly relieve pain，improve shoulder joint function and improve the quality of rehabilitation.

Objective To explore the clinical characteristics and pregnancy outcomes in older parturient⁃ women，and study the influence of examination at first trimester and number of prenatal visits on pregnancy out⁃ comes among them. Methods A total of 108 734 parturient women from six urban districts of Nanning with both household registration and delivery registered in Nanning were recruited and allocated to the control group（aged 20 ~ 34 years）and the older group（aged ≥ 35 years）. The data of clinical characteristics and pregnancy outcomes were collected and retrospectively analyzed. Results The rate of the women who took the examination at first trimester andprenatal visits ≥ 5 times in the control group was significantly lower than that in the older group（P < 0.01）. The rates of those with the history of pregnancy ≥ 3 times，multiparity orcesarean section，spontaneous or induced abortion ≥ 3 times，assisted reproductive technology，multiple pregnancy，exposure to suspected teratogenic substances，or severe high⁃risk pregnancy in the older group were significantly higher than those of the control group （all P < 0.01）. The incidence rates of deliverywith < 37w gestation，lowbirth weight，extremely low birth weight， full ⁃term underweight，fetal growth restriction，macrosomia，Apgar scores below 7 at 5 min，cesarean section， birth defects and stillbirthin the oldergroup were significantly higher than those in the control（all P < 0.01）. Bymul⁃ tivariateLogistic regression，the examination at first trimester and prenatal visits ≥ 5 times were the protective factors of adverse pregnancy outcomes of elder parturient women such as delivery with < 37 w gestation，low birth weight，fetal growth restriction，Apgar scores below 7 at 5 min，cesarean section and stillbirth（all P < 0.05）. Conclusion Older parturient women are prone to adverse pregnancy outcomes，and fulfilled standard antenatal care may decrease the risk of adverse pregnancy outcomes among them.

Objective To evaluate the median effective dose of alfentanil combined with propofol for inhibiting double lumen bronchial intubation response. Methods Patients undergoing double ⁃lumen bronchial intubation were assigned to male group and female group. All patients were given propofol 2.0 mg/kg combined with alfentanil intravenous anesthesia. Dixon sequential method was used to observe the effect of medication on patients. Probit regression analysis was used to calculate median effective dose（ED50）and 95% confidence interval（95% effective dose，ED95）of alfentanil for inhibition of response to dual⁃lumen bronchial intubation. Results The ED50 and 95% confidence interval of male group were 77.9（34.4 ~ 92.9）μg/kg. The ED50 and 95% confidence interval were 66.7（60.5 ~ 76.0）μg/kg in female group，and the difference was statistically significant（P < 0.05）. Conclusion When combined with propofol 2 mg/kg ，the ED50 of alfentanil inhibiting double⁃lumen bronchial intubation response was 77.9 μg/kg and 66.7 μg/kg in male and female groups，and there was gender difference in the ED50 of alfentanil inhibiting double⁃lumen bronchial intubation response.

Objective Effective regimens were relatively rare as the further line treatment for patients with advanced Esophageal Squamous Cell Carcinoma（ESCC）. The results of previous clinical study exhibited that anlotinib demonstrated superior efficacy and manageable safety profile as the second ⁃line treatment for advanced ESCC. However，preliminary clinical data in the real world are still not available. Consequently，the purpose of present study was to investigate the efficacy and safety of anlotinib monotherapy for patients with advanced ESCC in real world. Methods This study was designed as a retrospective study. A total of 63 patients with advanced ESCC who met the eligibility criteria and received anlotinib monotherapy from June 2018 to October 2020 were included. The initial dosage of anlotinib was 12 mg and 10 mg. Basic demographic data of patients，efficacy data of the treatment，survival status and safety profile during the treatment were documented and analyzed through the medical records of the patients in the department and the electronic medical record system in the hospital. The primary endpoint of this study was progression free survival （PFS），the secondary endpoints were objective response rate（ORR），disease control rate（DCR），overall survival（OS），safety profile and prognostic analysis according to adverse reaction. Results All the 63 patients corresponded with the eligibility criteria and were available for the evaluation of efficacy and adverse reactions. The best overall response of the patients indicated that partial response was observed in 6 patients，stable disease was noted in 35 patients and progressive disease was seen in 22 patients. Therefore，the ORR of the 63 patients receiving anlotinib monotherapy was 9.5% and DCR was 65.1%. Prognostic data suggested that the median PFS of the 63 patients with advanced ESCC was 3.6 months（95% CI：2.45 ~ 4.75），and the median OS was 7.5 months（95%CI：5.05 ~ 9.95）. In terms of the safety profile，the relatively common adverse reactions of the patients with advanced ESCC who were treated with anlotinib were hypertension（35 patients，55.6%），fatigue（33 patients，52.4%），loss of appetite（27 patients，42.9%）and hand⁃ foot syndrome（25 patients，39.7%）. Given that hypertension was the most common adverse reaction，we performed the association analysis between hypertension status and PFS. And the results suggested that the median PFS of the patients with hypertension was longer than that of those without hypertension（4.8 months vs. 2.8 months），and the difference was statistically significant（P = 0.03）. Conclusion Anlotinib monotherapy demonstrated potential and preliminary efficacy and tolerable safety as the further line treatment for patients with advanced ESCC.

Objective To compare the efficacy of vindesine and vincristine in treating children with primary acute lymphoblastic leukemia（ALL）. Method Ninety patients with primary ALL，who were admitted to our hospital from May 2015 to December 2018，were divided into control group（45 cases）and experiment group（45 cases）. The control group was treated by vincristine，while the experiment group by vindesine. Patients in the two groups received chemotherapy once a week. The administration varied from 3 to 5 times based on personal conditions. Short⁃term efficacy ，myelogram，adverse reactions and the treatment effect in the two groups were compared. Results There was no difference in myelogram on Day 15 and Day 33，and no significant differences were found in terms of recovery time of fever，fatigue，pain，abdominal distension and edema between the two groups（P > 0.05）. The white blood cell（WBC）count and the absolute lymphocyte count significantly decreased after treatment in both groups. Meanwhile ，the WBC count and the absolute lymphocyte count of the experiment group were significantly lower than those of the control group （P < 0.05）. There were statistical differences in the inci⁃ dence of adverse reactions such as neurotoxins，thrombocytopenia and anemia between the two groups（P < 0.05）. Conclusion Both vindesine and vincristine can achieve a good therapeutic effect in treating children with ALL， which can be used in clinical practice.

Objective To analyze the prevalence of pregnancy with diabetes mellitus and provide evidence for the prevention and control of pregnancy with diabetes mellitus in Guangdong Province. Methods Based on an obstetric quality report from 2 440 medical institutions in 21 cities of Guangdong province from 2016 to 2020，we analyzed the current status of prevalence of gestational diabetes mellitus in Guangdong and the relationship between gestational diabetes mellitus and adverse pregnancy outcomes including cesarean section，premature infants， perinatal death. Results During the study period，a total of 8 553 069 pregnant women were monitored，and 639 637 of them were reported as having pregnancy with diabetes，with a prevalence rate of 7.48% in Guangdong. The prevalence of pregnancy with diabetes mellitus from 2016 to 2020 showed a trend of linear growth，and it was statistically significant（χ2 = 35 738.01，P < 0.001）. Among all the cities，Foshan had the highest prevalence rate of 14.20 %，while Jieyang had the lowest rate of 0.45%；Division by administrative regions，the Pearl River Triangle area had the highest rate of 10.53%，whereas Yuexi had the lowest rate of 2.84%. There were significant differences in the prevalence rate among different administrative regions（P < 0.05）. Division by medical institutions，the third⁃ level hospitals had the highest rate of 11.08%，while the first⁃level hospitals had the lowest rate of 2.22%. There were significant differences in the prevalence rate among different medical institutions（P < 0.05）. In the correlation analysis on pregnancy with diabetes mellitus and adverse pregnancy outcomes，pregnancy complicated with diabetes was positively correlated with Cesarean section，premature infants and perinatal death（P < 0.05）. Conclusions During the period of 2016 to 2020，the prevalence of pregnancy with diabetes in Guangdong province increased significantly，with a significant regional difference. The disorder was positively correlated with adverse pregnancy outcomes.

Scapulohumeral periarthritis，also known as frozen shoulder or adhesive capsulitis，mainly manifested as a progressive limitation in active and passive activity of shoulders，accompanying by severe pain. This disorder often seriously affects the daily life of patients. At present，magnetic resonance imaging（MRI）is regarded as the gold standard for the diagnosis of scapulohumeral periarthritis by clinicians. In recent years，the development of musculoskeletal ultrasound（MSKUS）has brought a new imaging diagnostic method for patients with scapulohumeral periarthritis. This paper mainly reviews the research progress of musculoskeletal ultrasound in the diagnosis of scapulohumeral periarthritis.