Nucleic acid drugs，as nucleotide drugs play a role on the gene level，have great potential in the treatment of some diseases such as cancer and viral infection. The therapeutic effects of traditional treatments are usually short⁃lived because they target proteins rather than underlying genes. Nucleic acid therapy，by contrast，can achieve long ⁃ term efficacy through gene suppression，addition，replacement or editing.At present，nucleic acid drugs mainly include DNA drugs，mRNA drugs and siRNA drugs. In this paper，we reviewed the working principle of these nucleic acid drugs，as well as the challenges and solutions of nucleic acid drugs in clinical application.

Acute ischemic stroke is a clinical syndrome manifesting nerve function impairment caused by brain ischemia and hypoxia. Antiplatelet therapy is the basis for the prevention and treatment of acute cerebral infarction. As a novel antiplatelet drug and inhibitor of GP IIb/IIIa receptor，tirofiban has been basically mature in the treatment of cardiovascular diseases. However，application of tirofiban for cerebrovascular diseases is still in the exploratory stage，and the administration routes，dosage and safety are still controversial. This paper reviews the application and research progress of tirofiban in the treatment of acute ischemic stroke.

Objective To explore the clinical efficacy of YL⁃1 needle trepanation drainage combined with urokinase injection in the treatment of moderate basal ganglia hemorrhage. Methods We retrospectively analyzed 48 patients with moderate basal ganglia hypertensive cerebral hemorrhage（GCS score 12 ⁃ 15）who were conscious or lethargic with limb and/or speech dysfunction in our hospital from September 2013 to February 2021. The patients received either YL⁃1 needle trepanation drainage combined with urokinase injection（study group）or con⁃ servative treatment（control group）. Differences in time to hematoma elimination，complication rate，and ADL prognosis were analyzed. Results The time to hematoma elimination was（7.50 ± 3.6）days in the study group and （21.14 ± 5.7）days in the control group，and the difference between the two groups was statistically significant （P < 0.05）. There were no statistical differences in the rate of pulmonary infection between the two groups（P > 0.05）. Of the procedure⁃related complications，the incidence was 15.4% for pneumocranium and 3.8% for both intracranial infection and puncture tract bleeding. ADL prognosis assessment one month after the procedure，5 patients were in level Ⅰ，11 in level Ⅱ，8 in level Ⅲ，2 in level Ⅳ，and none in level Ⅴ in the study group；whereas 1 patient in level Ⅰ，4 in level Ⅱ，10 in level Ⅲ，7 in level Ⅳ，and none in level Ⅴ. The difference between the two groups in the number of patients in levels Ⅱ and Ⅳ was statistically significant（P < 0.05）. Conclusions For the treatment of moderate hypertensive cerebral hemorrhage in the basal ganglia area ，YL ⁃ 1 needle trepanation drainage has the advantages of simple operation，minimal invasiveness，faster functional recovery，and better curative effect.

Objective To explore the value of Dickkopf⁃1（DKK⁃1）combined with Thromboelastography （TEG）parameters in assessing the risk of recurrence in patients with acute ischemic stroke（AIS）. Methods A total of 293 AIS patients were selected as the research objects. According to the recurrence of AIS patients，they were divided into recurrence group and non ⁃ recurrence group. The general information and TEG parameters of all subjects were collected. The level of serum DKK ⁃1 was detected by enzyme ⁃linked immunosorbent assay kit. The risk factors of recurrence in AIS patients was analyzed，and the evaluation value of the related indexes on the recur⁃ rence of AIS patients was explored. Results The proportion of atrial fibrillation history in the recurrence group was significantly higher than that in the non ⁃ recurrence group（P < 0.05）. The reaction time（RT），and kinetic time（KT）of the recurrence group were shorter and ADP⁃induced platelet⁃fibrin clot strength（MAADP）and DKK⁃1 were higher than those of the non⁃recurrence group（P < 0.05）. The history of atrial fibrillation and the high level of MAADP and DKK⁃1 were the risk factors for the recurrence of AIS（P < 0.05）. DKK⁃1 combined with MAADP was of high value in assessing the risk of recurrence in patients with AIS，and the area under the curve was 0.891 （95%CI：0.843 ~ 0.938）. Conclusion DKK⁃1 and MAADP are closely related to the recurrence of AIS patients， and the combined application of the two is of high value in assessing the risk of recurrence in AIS patients. 

Objective To explore the surgical method of 3D⁃slicer Software combined with guided frame⁃ less stereotactic puncture for the treatment of brainstem hemorrhage and the prognosis of patients. Methods The clinical data on 31 patients with primary brainstem hemorrhage who had undergone 3D⁃slicer combined with naviga⁃ tion and frameless stereotactic puncture in our hospital from January 2019 to June 2021 were retrospectively ana⁃ lyzed. The grading of activity of daily living（ADL）was used as an index for assessing prognosis. Univariate and logistic regression analyses were used to identify independent risk factors affecting prognosis. ROC curves were drawn to measure the predictive value of risk factors. Results Univariate analysis showed that bleeding volume， hematoma type，PPH score，hydrocephalus，and hematoma volume before extubation were the influencing factors of prognosis（P < 0.05）. Logistic multivariate regression analysis showed that bleeding volume（OR = 1.297，P = 0.043），scores on new types of pontine bleeding（OR = 6.134，P = 0.015），and hematoma volume before extuba⁃ tion（OR = 1.561，P = 0.019）were independent risk factors affecting the prognosis of patients. The ROC curve showed that the bleeding threshold for a poor prognosis was 9.00 mL and the threshold of the residual hematoma before extubation was 2.85 mL. Conclusions The new surgical procedure provides a better prognosis in patients with brainstem hemorrhage. The prognosis is associated with bleeding volume，hematoma volume before extuba⁃ tion，and scores on new types of pontine hemorrhage.

Objective To investigate the clinical efficacy of minimally invasive suction combined with craniotomy and decompression without delay in the treatment of primary cerebral hemorrhage with cerebral hernia. Methods 100 patients of supratentorial primary cerebral hemorrhage with cerebral hernia from January 2018 to December 2020 were prospectively enrolled and randomly divided into observation group（n = 50）and control group（n = 50）. In the observation group，bedside minimally invasive suction and preoperative preparation were performed without delay for craniotomy hematoma removal and bone flap decompression. The control group received conventional craniotomy hematoma removal and bone flap decompression. The severity of cerebral hernia was distin⁃ guished by unilateral or bilateral dilated pupils at admission. The perioperative conditions and outcomes 6 months after operation of the two groups were compared. Results The good recovery/moderate disability rate and death rate in the observation group were significantly better than those in the control group（good recovery/moderate disability： 39.4% vs. 19.6%；death rate：8.3% vs. 26.1%），and the difference in prognosis between the two groups at 6 months after surgery was statistically significant（P < 0.05）. In patients with unilateral dilated pupil，the good recovery/ moderate disability rate in the observation group was significantly higher than that in the control group（59.4% vs. 31.0%），and the difference in prognosis between the two groups at 6 months after surgery was statistically significant （P < 0.05）. In patients with bilateral dilated pupils，there were no statistically differences in prognosis between the two groups at 6 months after surgery（P > 0.05）. In the observation group with unilateral dilated pupil，the good recovery/moderate disability rate of patients with significant contracted pupil after minimally invasive suction was significantly higher than that without significant contracted pupil（78.3% vs. 11.1%，P < 0.01）. In the observation group with bilateral dilated pupils，the persistent vegetative state/death rate of patients with significant contracted pupil after minimally invasive suction was lower than that without significant contracted pupil（36.4% vs. 100.0%，P < 0.05）. Conclusion The outcomes of patients with primary intracerebral hemorrhage accompanied by cerebral hernia treated with minimally invasive suction combined with craniotomy and decompression without delay are better than conventional craniotomy and decompression，and this approach can improve the good recovery/moderate disabil⁃ ity rate of patients with unilateral dilated pupil and reduce the death rate of patients with bilateral dilated pupils.

Objective The major outer membrane protein（MOMP）of Chlamydia trachomatis（Ct）is essential for Ct structural stability and infection of the host cell. MOMP polyclonal antibody was created using the synthetic peptide to further investigate the function and mechanism of MOMP protein. Methods Ct MOMP antigenic epitope was investigated. MOMP⁃specific peptide was designed and synthesized based on the conserved peptides of 15 different Ct serotype MOMPs，and New Zealand white rabbits were immunized after coupling with hemocyanin. MOMP⁃specific peptide was designed and synthesized based on the conserved peptides of 15 different Ct serotype MOMPs，and New Zealand white rabbits were immunized after coupling with hemocyanin.Immunoaffinity chroma⁃ tography was used to separate the immune serum. SDS⁃PAGE was used to determine the purity of the IgG antibody， and ELISA was used to determine the titer of the MOMP antibody. Furthermore，Western blot and immunofluores⁃ cence staining were used to determine the specificity of the MOMP antibody. Results The purity of IgG antibody was 89.6%，and the titer of MOMP antibody was 1∶12800. The results of Western blot showed that the antibody specifically bound to 8 serotypes of Ct protein at 40kDa，and indirect immunofluorescence staining showed that the antibody could specifically combined with Ct MOMP. In addition，the immunofluorescence results showed that the MOMP antibody and the imported commercial antibody were obviously co ⁃localized in the host cells ，and the fluorescence intensities of the two antibodies were comparable. Conclusions This study successfully prepared arabbit polyclonal antibody with high titer and good specificity against Ct MOMP ，providing a useful tool for future research on the biological function of MOMP.

Objective To investigate the effect of miR⁃498 targeting phosphoenolpyruvate carboxykinase 1 （PCK1）on growth of oral squamous cell carcinoma（OSCC）cells. Methods QRT⁃PCR was used to detect expression of miR⁃498 in tumor tissues from 150 OSCC patients and different OSCC cell lines HSC⁃3，SCC⁃15 and SCC⁃9. LipofectamineTM2000 transfection kit was used to transfect miR⁃498 mimics and anti⁃miR⁃498 into SCC⁃15 cells respectively. qRT⁃PCR was used to detect expression of miR⁃498 in the cells，so were Western blot to detect expression of PCK1 protein in the cells，CCK⁃8 to detect cell proliferation，flow cytometry to detect cell apoptosis， Transwell migration assay to detect cell migration and invasion，and dual ⁃luciferase reporter gene assay to detect the targeting relationship between miR⁃498 and PCK1. Co⁃transfection of miR⁃498 and PCK1 was used to further verify the effects of miR⁃498 and PCK1 on proliferation ，apoptosis，migration and invasion of SCC⁃15 cells. Results Compared with human normal oral keratinocyte HOK（1.03 ± 0.14），the expression level of miR⁃498 in human OSCC cell lines HSC⁃3（2.05 ± 0.21），SCC⁃15（2.75 ± 0.31），and SCC⁃9（2.31 ± 0.28）was significantly higher（F = 53.639，P < 0.001），and expression of miR⁃498 was the highest in SCC⁃15 cells. SCC⁃15 cells were then selected for the subsequent research. Compared with the control group and miR⁃NC group ，the number of migration and invasion of SCC⁃15 cells in miR⁃498 mimics group increased significantly（P < 0.05），and the apopto⁃ sis rate decreased significantly（P < 0.05）；compared with the control group and anti⁃miR⁃NC group，the number of migration and invasion of SCC⁃15 cells in anti⁃miR⁃498 group decreased significantly（P < 0.05），and the apoptosisrate increased significantly（P < 0.05）. The expression level of PCK1 protein in SCC⁃15 cells in the miR⁃498 mimics group（0.23 ± 0.02）was significantly lower than that the control group（0.51 ± 0.08）and miR⁃NC group（0.49 ± 0.06，P < 0.05）；The expression level of PCK1 protein in SCC⁃15 cells in the anti⁃miR⁃498 group（1.03 ± 0.05）was significantly higher than that in the control group（0.51 ± 0.08）and anti⁃miR⁃NC group（0.48 ± 0.07，P < 0.05）. miR ⁃498 negatively regulated PCK1 expression. Up ⁃ regulation of PCK1 expression reversed the effects of overex⁃ pression of miR⁃498 on proliferation，apoptosis，migration and invasion of SCC⁃15 cells. Conclusions MiR⁃498 can accelerate the proliferation，migration and invasion of SCC⁃15 cells and inhibit apoptosis of SCC⁃15 by inhibit⁃ ing the expression of PCK1，probably providing new molecular targets for the clinical diagnosis and treatment of OSCC

Objective To explore the regulatory role of mitogen ⁃activated protein kinase kinase kinase kinase 4（Map4k4）in the formation of vulnerable plaques in atherosclerosis（AS）induced by angiotensin Ⅱ（AngⅡ）. Methods Thirty⁃two ApoE-/- mice were randomly divided into four groups（8 in each group）：control，AngⅡ， AngⅡ+shMap4k4 and AngⅡ+Map4k4. Oil red O staining（lipid），Masson staining（collagen），α⁃actin immuno⁃ fluorescence staining（smooth muscle cells）and F4/80 staining（macrophages）were used to detect the stability of aortic sinus plaque. The expression of Map4k4 was analyzed by immunofluorescence and Western blot. Map4k4 knockdown or overexpression macrophages were constructed in vitro to confirm the role of Map4k4 in AngⅡ⁃in⁃ duced apoptosis. Results The atherosclerotic plaque vulnerability and macrophage apoptosis were promoted in ApoE-/- mice by Ang Ⅱ（P < 0.05），accompanied by the upregulation of Map4k4 expression. Compared with the AngⅡ group（P < 0.05），the AS plaque vulnerability［（1.22 ± 0.06）vs.（0.49 ± 0.04）］and macrophage apoptosis ［（8.42 ± 0.40）vs.（3.49 ± 0.31）］of the Ang Ⅱ+shMap4k4 group were significantly reduced（P < 0.05），while the above indicators of the Ang Ⅱ+Map4k4 group were significantly enhanced［（1.22 ± 0.06）vs.（1.45 ± 0.05）； （8.42 ± 0.40）vs（. 14.11 ± 0.78），P < 0.05］. In vitro experiments showed that Map4k4 knockdown effectively atten⁃ uated the increased expression of c⁃Caspase3 and Bax protein induced by AngⅡ（P < 0.05），and enhanced the expression of Bcl ⁃2 protein（P < 0.05）. The overexpression of Map4k4 further enhanced the induction of Ang Ⅱ （P < 0.05）. Conclusion Ang Ⅱ via upregulating Map4k4 expression promotes macrophage apoptosis so as to promote vulnerable plaque formation in AS.

Objective To investigate the effect of loganin on intestinal mucosal barrier，endoplasmic retic⁃ ulum stress（ERS）pathway and epithelial cell apoptosis in rats with burn injuries. Method Healthy male SD rats aged 8 ~ 12 weeks were selected and randomly divided into control group，burn group and intervention group. The control group was given normal saline（50 mg/kg）by gavage for 7 consecutive days before sham burn treatment，while the burn group was given normal saline（50 mg/kg）for 7 consecutive days before burned. The intervention group was treated with loganin（50 mg/kg）by gastric gavage for 7 consecutive days before injury. Rats were euthanized at 24 hours after burn，and intestinal tissue samples were surgically excised. The pathological changes of small intestinal tissue were observed and scored by HE staining ，and the ultrastructure of small intestinal epithelial cells was observed by transmission electron microscope. Flow cytometry was used to detect the proliferation and apoptosis of small intestinal mucosal cells，and Western blot was used to detect the expression changes of ERS⁃related proteins and apoptosis⁃related proteins in small intestinal tissues. Results There were statistically significant differences in the scores of lesion，inflammation，lesion extent，and crypt destruction among the three groups. The scores in the intervention group were lower than those in the burn group and higher than those in the control group（P < 0.05）. The apoptosis of small intestinal epithelial cells in the burn group was more serious than that in the intervention group，and the apoptosis rate was significantly higher than that in the intervention group（P < 0.05）. The protein expressions of Caspase⁃3，Bax，PERK，GRP 78 and CHOP in the intervention group were significantly higher than those in the control group and lower than those in the injury group，while Bcl⁃2 was higher than that in the injurygroup and lower than that in the control group（P < 0.05）. Conclusion Loganin could reduce the pathological damage of intestinal epithelium in rats with burn injuries and protect the structure of intestinal mucosa，and its mechanism may be related to inhibiting the ERS pathway of intestinal epithelial cells and reducing apoptosis.

Objective To investigate the incidence and risk factors of low cardiac output syndrome （LCOS）after off⁃pump coronary artery bypass grafting（OPCABG）. Methods The clinical data of patients with OPCABG in the Department of Cardiovascular Surgery，Affiliated Hospital of Qingdao University from January 2018 to December 2020 were collected retrospectively. According to the diagnosis of aftersurgery，patients were divided into LCOS group and non ⁃LCOS group. The basic clinical characteristics of the two groups were recorder and compared，and the incidence of LCOS was calculated. Multivariate Logistic regression model was used to analyze the risk factors for LCOS after OPCABG. Results A total of 765 patients were included，LCOS group（n = 58） and non⁃LCOS group（n = 707）. The incidence of early LCOS after OPCABG was 7.58%. There were significant differences in preoperative arrhythmia，angina pectoris，restenosis after stent，cerebrovascular disease，pulmonary lesion，cervical vascular lesion，number of diseased branches，degree of left anterior descending artery disease， degree of right circumflex artery lesion，left ventricular ejection fraction（EF），left ventricular ejection fraction， left ventricular end ⁃diastolic diameter and intraoperative blood loss between the two groups. Multivariate Logistic regression analysis showed that preoperative cardiac arrhythmia（OR = 6.315，95%CI：1.404 ~ 28.396，P = 0.016）， angina pectoris（OR = 9.214，95%CI：2.153 ~ 39.424，P = 0.003），cerebral infarction（OR = 3.523，95%CI： 1.246 ~ 9.962，P = 0.018），pulmonary disease（OR = 5.505，95%CI：1.997 ~ 12.733，P = 0.001），carotid stenosis or occlusion（OR = 35.588，95%CI：11.874 ~ 106.662，P < 0.001）was an independent risk factor for postoperative LCOS in patients with OPCABG. Conclusion Preoperative arrhythmia，angina pectoris，cerebral infarction，pul⁃ monary lesion，carotid stenosis or occlusion were independent risk factors for LCOS after isolated OPCB.

Objective This study aims to clarify the expression of fatty acid amide hydrolase（FAAH）in different types of cancer and its relationship with survival prognosis and tumor immune microenvironment. Methods The relationship between the expression pattern and prognosis of FAAH in cancer was analyzed by using the cancer and paracancerous tissue data from 33 types of cancer in the TCGA database combined with the transcriptome of normal tissues and follow⁃up survival data in the GTEx database. The CIBERSORT algorithm and Pearson correla⁃ tion coefficient were used to study the correlation between FAAH expression and tumor immune infiltration. Results The expression map showed that FAAH was significantly highly expressed in 7 types of cancer including breast invasive carcinoma and prostate cancer（P < 0.001），whereas lower in 15 types of cancer including renal clear cell carcinoma and lung squamous cell carcinoma（P < 0.001）. Survival analysis showed that for clear cell renal cell carcinoma or gastric adenocarcinoma，the patients with higher expression of FAAH had better prognosis than those with lower expression（OS，DSS，DFI，and PFI）and longer survival period（P < 0.05）. Immune microenvironment analysis showed that CD4 + T memory cells and γδ T cells were markedly reduced in the lower FAAH expression group with clear cell renal cell carcinoma（P < 0.05），and there was less monocyte infiltration in the lower FAAH expression group with gastric adenocarcinoma（P < 0.05）. Conclusions Pan⁃cancer analysis shows that a lower expression of FAAH is common in multiple types of cancer，significantly associating with poor survival prognosis. The expression of FAAH is associated with immune infiltration，which can be used as a prognostic biomarker and a potential target for cancer immunotherapy.

Objective To investigate the effect of microscope⁃assisted minimally invasive surgery transfo⁃ raminal lumbar interbody fusion（MIS⁃TLIF）versus open transforaminal lumbar interbody fusion（open⁃TLIF）for the treatment of two⁃segment degenerative lumbar stenosis. The short⁃ and medium⁃term outcomes of minimally inva⁃ sive surgery transforaminal lumbar interbody fusion（MIS ⁃TLIF）and open transforaminal lumbar interbody fusion （open⁃TLIF）in the treatment of two⁃segment degenerative lumbar spinal stenosis. Methods A total of 106 patients who underwent surgical treatment for lumbar spinal stenosis at L4⁃S1 segment in our hospital from September 2019 to September 2020 were selected. Fifty⁃one patients treated with microscope⁃assisted MIS⁃TLIF were categorized as the MIS⁃TLIF group，and 55 patients treated with open TLIF were categorized as the open group. The perioperative indexes，functional scores，complications and prognosis，and clinical efficacy of the two groups were compared. Results Intraoperative bleeding，postoperative drainage，time to the floor and hospital stay were significantly better in the microscope⁃assisted MIS⁃TLIF group than in the TLIF group（P < 0.05），and the MIS⁃TLIF group had more operative time and radiation exposure than the TLIF group（P < 0.05），and postoperative VAS scores and ODI scores were significantly lower in both groups compared with preoperative scores（P < 0.05），VAS scores. The MIS⁃ TLIF group was better than the TLIF group at 1 day and 1 month postoperatively（P < 0.05），and the differences between the two groups at 3 months and the final follow⁃up were not statistically significant（P > 0.05），ODI scores： the MIS⁃TLIF group was better than the TLIF group at 1 month and 3 months postoperatively，and the differencesbetween the two ODI scores at the final follow⁃up were not statistically significant（P > 0.05），and the incidence of postoperative complications was not statistically significant（P > 0.05），and the modified There was no significant difference between the two evaluated by MacNab criteria（P > 0.05）. Conclusion The short⁃term clinical efficacy of microscope⁃assisted MIS⁃TLIF for bilateral lumbar spinal stenosis was significantly better than that of open TLIF.

Objective To study the effect of gray model GM（1，1）in predicting birth defects（BD）preva⁃ lence at different levels among the population of Guangxi Zhuang Autonomous Region. Methods Based on the monitoring data of BD in Guangxi from 2016 to 2020，the gray mode GM（1，1）was used to predict the overall BD prevalence and the top five main BD at three levels（year，quarter，and month）. We compared the prediction effect of different levels of gray models. Results The average relative errors for yearly，quarterly and monthly over⁃ all BD prevalence were ⁃0.12%，0.49% and 0.79%，respectively，and the posterior odds ratios were 0.002，0.285 and 0.392，respectively，and the prediction results were good，good and qualified，respectively. The yearly gray model prediction effect of the top five main BD（congenital heart disease，polydactyly，talipes equinovarus，other external ear deformities，and syndactyly）was significantly better than those of quarterly and monthly. Conclusion The prediction effect of GM（1，1）may be related to the volatility of original sequence data. It may be better for predicting the BD prevalence by year.

Objective To observe the effect of ultrasound⁃guided transversus abdominis plane block on stress and early recovery in children after laparoscopic hernia surgery. Methods A total of 60 children aged 2 ~ 4 years who underwent elective laparoscopic hernia surgery were randomly divided into control group（group C，n = 30）and TAPB group（group T，n = 30）. Group C was given general anesthesia with laryngeal mask intubation，and group T was given with 0.5 mL/kg of 0. 25% ropivacaine in transverse abdominis plane block on each side under the guid⁃ ance of ultrasound after general anesthesia. MAP，HR，cortisol（Cor）and blood glucose（Glu）of the two groups were compared at different time points. The time of first postoperative drinking water and hospital stay were record⁃ ed. Postoperative FLACC pain score，autonomic activity and complications were compared. Results Compared with group C，MAP and HR of group T were significantly decreased at T2，while Cor and Glu were significantly decreased at T1 and T2（P < 0.05）. The time of first postoperative drinking water and hospital stay in group T were significantly shorter（P < 0.05）. The FLACC pain scores at 2，4，8 and 12 h were significantly decreased in T group. The first recovery time of ibuprofen was significantly delayed，and the accumulative dosage and frequency of ibuprofen were significantly decreased（P < 0.05）. The proportion of independent sitting up and standing up in group T was higher than that in group C at 4，8 and 12 h after operation，while the incidence of agitation in group T was significantly reduced（P < 0.05）. Conclusion The application of ultrasound⁃guided transversus abdominis plane block based on ERAS concept in laparoscopic hernia repair in children was feasible and effective，which could enhance postoperative analgesia effect，reduce stress response，promote early postoperative activity and eat⁃ ing，and accelerate postoperative recovery.

Objective To investigate the clinical effect of PRP（autologous platelet⁃rich plasma）combined with chitosan probe composite on non⁃acute infectious wounds of orthopedic patients. Methods From September 2020 to July 2021，60 patients with non⁃acute infectious wounds on limbs admitted to the orthopedics department of our hospital were randomly divided by digital random method into groups A，B and C treated with chitosan propolis， chitosan PRP and chitosan propolis PRP composite，respectively，20 in each. The scores of pain，anxiety and quality of life after 3，6，9 and 12 days of treatment were evaluated. The wound healing time，healing area and inflammatory indexes before and after treatment were compared and analyzed. Results The scores of pain，anxiety and quality of life in three groups were significantly improved after treatment（P < 0.05）. The healing time of group C was significantly shorter than that of group A and group B（P < 0.05）. After 6 days treatment，the healing area of group C was significantly larger than those of group A and group B（P < 0.05）. After 12 days treatment，the improvement rate of C⁃reactive protein and white blood cell count in group C was significantly higher than those in group A and group B（P < 0.05）. Conclusion PRP combined with chitosan propolis composite material can effectively fight against bacteria，accelerate wound healing，relieve pain and improve the quality of life in orthopedic patients with non⁃acute infectious wounds.

Objective To evaluate the efficacy of targeted drugs for congenital heart disease（CHD）with pulmonary arterial hypertension（PAH）in children，and to evaluate the role of targeted drugs in the diagnosis and treatment of pulmonary vascular reactivity. Methods A prospective analysis was performed on the children with CHD diagnosed as moderate to severe PAH by cardiac catheterization from January 2017 to March 2021. The patients received targeted drug therapy for at least three months and then underwent repeated cardiac catheterization. Acute vasoreactivity testing（AVT）was performed in 11 patients at the first cardiac catheterization. Results 15 children were enrolled in this study. After treatment with targeted drugs，mPAP and PVRI measured via cardiac catheteriza⁃ tion were lower than before（P < 0.05），so was pulmonary artery systolic pressure（PASP）measured by transtho⁃ racic echocardiography. Eight patients（53.3%）received surgical treatment after drug therapy，while the rest seven continued drug therapy. AVT was positive only in 18.2%（2/11）of all the children. Conclusions Targeted drugs can reduce both mPAP and PVRI in children with CHD complicated by PAH，and even offer the children an option of anatomic radical surgery. For a low positive rate of AVT test in children with CHD，targeted drug therapy can be used as a new standard to assess pulmonary vascular reactivity. 

Objective To explore the association of gestational diabetes mellitus （GDM）complicated with hypertensive disorder during pregnancy（HDP）with cesarean section and pregnancy outcome. Methods A cross⁃sectional study was carried out among 2 754 puerperae who visited the outpatient clinic for 42 days postpartum in the Obstetrics and Gynecology Hospitals in Guangzhou city and Qingyuan city from January to December 2020. A field questionnaire survey was conducted to collect clinical information. On ⁃the ⁃ spot questionnaire survey was used to collect relevant clinical data. Result Among the 2 754 participants，there were 450 with GDM（16.3%），61 with HDP（2.2%），21 with GDM combined with HDP（0.8%）. After controlling maternal age，gravidity and parity，results showed cesarean section delivery was 1.31⁃fold（95%CI：1.05 ~ 1.63），1.87⁃fold（95%CI：1.10 ~ 3.19）and 2.74⁃fold（95%CI：1.11 ~ 6.74），respectively，increased in pregnant women with GDM，HDP and GDM combined with HDP than in those without. Compared with women without GDM or HDP，women with HDP and GDM combined with HDP at a 2.51⁃fold（95%CI：1.17 ~ 5.40）and 3.91⁃fold（OR = 3.91，95%CI：1.30 ~ 11.81）higher risk of premature delivery. Women with GDM combined with HDP increased 8.33⁃fold（95%CI：2.54 ~ 27.23）and 7.77⁃fold（95%CI：1.63 ~ 37.04）risk of low⁃birth⁃weight and neonatal hyperbilirubinemia，respec⁃ tively. Conclusion GDM and HDP comorbidity had a synergistic effect on the risk of maternal cesarean section and perinatal preterm birth，low body weight and hyperbilirubinemia. 

Objective To investigate the deficient diagnosis and treatment of pregnant patients with tuber⁃ culosis and the clinical characteristics of high⁃risk patients so as to provide references for early screening and whole pregnancy management of the patients. Methods The clinical data and case characteristics of 112 pregnant wom⁃ en with tuberculosis treated in the eight hospital of Guangzhou Medical University from January 1，2011 to Decem⁃ ber 31，2019 were retrospectively analysed. The patients with intrauterine pregnancy were divided into natural con⁃ ception group and post⁃IVF⁃ET group. The two groups were compared in terms of the severe disease rate，pregnancy outcome，prognosis and follow⁃up. The categories of severe high⁃risk groups were identified. Results The main onset symptoms were nonspecific，and the median time from onset to diagnosis was 30 days. All the cases with early pregnancy continued，a total of 12 cases（20.0%）of second trimester pregnancy went on to the third trimester. Hematogenous disseminated pulmonary tuberculosis was the main cause of premature birth，and low birth weight infants accounted for 46%（14/30）. Severe cases accounted for 14%（16/112），mainly with hematogenous dissemi⁃ nated pulmonary tuberculosis and/or tuberculous meningitis. There were 4 cases of death and 6 cases with neurologi⁃ cal sequelae. The incidence of hematogenous disseminated pulmonary tuberculosis and tuberculous meningitis in the post⁃IVF⁃ET group was 94.1%（16/17），which was significantly higher than that in the natural conception group. The childless rate of the post⁃IVF⁃ET patients was 50% after 2 to 9 years follow⁃up（all P < 0.05）. Conclusion Pregnancy complicated with tuberculosis is concealed and easily misdiagnosed. Patients with immunosuppressive or immune disorders are prone to severe cases. Screening for latent tuberculosis and tuberculosis should be carried out before in vitro fertilization and embryo transfer. We should strengthen the informed consent about tuberculosis in the early and middle stages of pregnancy，and make use of molecular biological diagnostic techniques for early diag⁃ nosis so that the pregnant women with tuberculosis as well as their infants can both get a good outcome.

Objective To evaluate the effect of Dapagliflozin combined with Entresto on heart failure after emergency intervention in patients with acute myocardial infarction（AMI）. Methods A total of 120 patients with heart failure after an AMI who presented to the emergency department for percutaneous coronary intervention were enrolled and randomly assigned to the control or study groups. The control group was treated with standard therapy based on the addition of Entresto；In the study group，Dapagliflozin was added to the control group. At 6 months of treatment，NT ⁃ proBNP was measured by time ⁃ resolved immunofluorescence and Lp ⁃PLA2 was detected by upper transluminometry，and the patients end systolic left ventricular internal diameter，end diastolic left ventricular inter⁃ nal diameter，end diastolic left ventricular volume，ejection fraction，quality left ventricular index，remodeling index，and mace and adverse effects were recorded during the treatment follow⁃up period. Results After treatment， NT⁃proBNP and Lp⁃PLA2 levels were lower in both groups（P < 0.05），with the study group significantly lower than the control group（P < 0.05）. LVESD，LVEDD，LVEDV，LVMI and LVRI in the two groups were lower than those before treatment（P < 0.05），and LVEF was higher than those before treatment（P < 0.05）；LVESD，LVEDD， LVEDV，LVMI and LVRI in the study group were significantly lower than those in the control group（P < 0.05），and LVEF in the study group was significantly higher than those in the control group（P < 0.05）. At 3 and 6 months of treatment，the level of 6MWT in the two groups was significantly higher than that at 1 month of treatment（P < 0.05） and at 6 months of treatment，the level of 6MWT in the two groups was significantly higher than that at 3 months oftreatment（P < 0.05）. The degree of increase in the study group was significantly higher than that in the control group at the same time，with statistical difference（P < 0.05）. The incidence of mace in the study group was signifi⁃ cantly lower when compared to the control group（P < 0.05）；The incidence of adverse reactions was slightly higher， but there was no statistical significance（P < 0.05）. Conclusions In patients with heart failure after emergency PCI for AMI，the combination of Dapagliflozin and Entresto is superior to Entresto treatment in terms of lowering Lp⁃PLA2，improving cardiac function and left ventricular remodeling，lowering the incidence of mace，and having a good safety profile.

Objective To explore the efficacy and safety of tofatib citrate in the treatment of active anky⁃ lost spondylitis（AS）. Methods A total of 90 patients with active AS hospitalized in our hospital from January 2017 to January 2021 were included and were equally divided into control group and observation group using the random number table method. The patients in the control group received routine treatment for active AS，and those in the observation group were treated with tofatib citrate in addition to the routine treatment regimen as in the control group，and the efficacy was evaluated after continuous treatment for 3 courses. The two groups were com⁃ pared in terms of the scores by Bath Ankylosing spondylitis function Index（BASFI），Bath Ankylosing spondylitis measurement Index（BASMI），total back pain scoring and Jenkins Sleep Assessment Questionnaire（JSEQ），the levels of c⁃reactive protein（CRP）and ESR in peripheral blood，the overall efficacy grades and the occurrence of treatment ⁃ related adverse reactions. Results After 3 courses of treatment，the BASFI，BASMI，VAS and JSEQ scores of the observation group were all significantly lower than those of the control group（P < 0.05）. The levels of CRP and ESR in the observation group were significantly lower than those in the control group（P < 0.05）. The total effective rate in the observation group was significantly higher than that in the control group（P < 0.05）. There was no statistical significance in the occurrence of treatment⁃related adverse reactions between the two groups（P > 0.05）. Conclusion Tofatib citrate can effectively optimize the condition and improve the efficacy in the treatment of active AS with good safety. 

Objective The study tried to explore the value of combined karyotype analysis and chromo⁃ some microarray analysis（CMA）in clinical application of prenatal diagnosis. Methods A total of 4 854 pregnant women underwent invasive prenatal diagnosis for different indications in the Prenatal Diagnosis Center of Jiangxi Maternal and Child Health Hospital from January 2020 to December 2021，and the test results of karyotype analysis and CMA were analyzed retrospectively. Results A total of 848 cases with chromosomal abnormalities were detected in 4 854 prenatal fetal samples，and the abnormal detection rate was 17.47%. 540 cases of them were detected with pathogenic chromosomal abnormalities，with a detection rate of 11.12%. 151 cases with pathogenic copy number variations（CNVs）and likely pathogenic CNVs were detected by CMA，while 108 cases of these had normal karyotypes. Therefore，a detection rate of 2.22% increased by CMA for fetal pathogenic chromosomal abnor⁃ mality compared with traditional karyotype analysis. 75 cases with balanced translocation were detected by karyo⁃ type analysis but showed no obvious abnormality by CMA. Furthermore，9 cases were detected with inconsistent results by karyotype analysis and CMA. Conclusions Combined CMA and traditional karyotype analysis improved the detection rate of fetal chromosomal abnormalities and they complemented each other，which would provide more detailed and accurate information for prenatal diagnosis and genetic counseling as well as a more objective basis of continue pregnancy for these pregnant women.

Objective The aim of this study was to investigate the effect of D5S818 locus allele losson paternity by PowerPlex21 system. Methods Chelex ⁃100 method was used to extract DNA from the samples.Multiplex amplifications of 20 autosomal STR loci were performed in 3248 families using PowerPlex21 system. Thegenotyping of STR loci was analyzed after capillary electrophoresis. The possible allelic loss at D5S818 locus wasverified by amplification by Identifiler system. Results Loss of allele 12 at D5S818 locus were found in sevenindividuals from five pedigrees using PowerPlex21 system and confirmed by Identifiler system. Conclusion Lossof allele was often misinterpreted as“mutation”of the locus，which has some influence on the result of combinedparentage index. For the accurate paternity testing result，different detection systems with the same STR locuscould be used.

The most common electrolyte disorder in clinical small cell lung cancer（SCLC）is hyponatre⁃ mia. Syndrome of inappropriate secretion of Antidiuretic hormone（SIADH）is the main part of this study，and exploring the mechanism is helpful for diagnosis and treatment. It is still necessary to further explore whether tolvap⁃ tan and other treatment plans are more advantageous in normalizing hyponatremia. The choice of different therapeu⁃ tic strategies，such as urea，circulating diuretics，demecycline，lithium，amrubicin and tolvaptan，may improve the prognosis of patients. This article will review the treatment plan and prognostic factors of SCLC complicated with hyponatremia in recent years.

Traditional treatment for allergic diseases is primarily oral anti⁃allergy drugs，but long⁃term use has side effects，particularly in infants，pregnant women，and the elderly. According to research，the distribution and abundance of intestinal flora in patients with allergic diseases exhibit distinct characteristics，such as the bifold⁃ bacteroide inverted distribution phenomenon. Probiotics have been shown in studies to relieve allergic symptoms by regulating immune reactions，making them useful for the prevention and adjuvant treatment of allergic diseases. Probiotics significantly reduce the side effects of traditional anti ⁃ allergy drugs while being relatively inexpensive and having fewer side effects.Therefore，the general public readily accepts probiotics. As a result，probiotic anti⁃ allergic strain research and the development of related preparations have received a lot of attention.However，the mechanism by which probiotics treat allergic diseases is still unknown. Here，we review the progress of research into probiotics′ anti ⁃allergy mechanism，summarize clinical applications of probiotics，and finally forecast the future of probiotics for the prevention and treatment of allergic diseases.

Nonalcoholic fatty liver disease（NAFLD）with high heterogeneity of its pathogenesis is closely associated with obesity，metabolic disorders and cardiovascular diseases. Moreover，nonalcoholic steatohepatitis （NASH）is at the increasing risks of progressing to liver fibrosis ，cirrhosis，end⁃stage liver disease and even hepatocellular carcinoma（HCC）. So far，neither the European drug administration nor the U.S. Food and Drug Administration（FDA）has approved any drugs for the management of NAFLD. The research and development of therapeutic drugs has always been a hot spot. In recent years，a large number of potential targeted drugs with clinical application prospects have emerged. This paper reviews the latest data on the main pharmacological targets of NAFLD.