Objective To evaluate the methodological quality and analysis content of clinical practice guidelines and expert consensus for chronic constipation，and screen high⁃quality guidelines to provide reference for future guidelines. Methods Systematically search domestic and foreign databases and guideline websites for clinical practice guidelines for chronic constipation published since 2016，and evaluate the quality of included guidelines using the guideline evaluation tool AGREE Ⅱ. Results A total of 19 guidelines were included，among which 14 B ⁃level guidelines and 5 C ⁃level guidelines. There were 3 high ⁃ quality guidelines selected，all from abroad. The standardization scores of AGREE Ⅱ in six fields respectively were：clarity of expression（78.36%），scope and purpose（62.57%），preciseness of formulation（35.47%），editorial independence（33.99%），participants（33.19%） and applicability（27.85%）. Totally，26 recommendations on diagnosis and treatment of chronic constipation were summarized. Conclusion The overall quality of the included clinical practice guidelines/expert consensus on chronic constipation is not high，and the areas of participants，rigor，application and editorial independence need to be further improved. The guidelines cover a comprehensive range of treatments，but some are controversial，so guideline recommendations need to be further refined to optimize clinical practice.

Objective To observe the effect of intravenous injections of sub ⁃ dose esketamine combined with midazolam before anesthesia induction on postoperative delirium （POD）in elderly patients receiving hip replacement. To explore the role of ESKE combined with MI in glutamate ⁃ induced HT22 cell injury. Methods 120 patients older than 65 who had undergone hip replacement were randomly assigned to group C，MI，ESKE or ESKE plus MI，30 for each group. 10 minutes before anesthesia，group MI received intravenous midazolam of 0.02 mg/kg，group ESKE received esketamine of 0.2 mg/kg，group ESKE plus MI received esketamine combined with midazolam，while group C received saline. The incidence of POD within 72 hours was observed. HT22 cells were divided into groups NC，G，MIC，ESKEC and ESKEC plus MIC. CCK8 was detected in each group following treatments based on relevant design. Rates of apoptosis and necrosis were measured by flow cytometry. Results The general data and hemodynamic index in the patients were not statistically significant（P > 0.05）. The inci⁃ dence of POD was lower in group ESKE plus MI than in group C，while glutamate level was higher in group POD than in group NPOD（P < 0.05）. The OD value and rates of necrosis and apoptosis in group NC，as compared with group C，were statistically significant（P < 0.05）. The OD value was greater in groups ESKEC and ESKEC plus MIC than in group G（P < 0.05）. The rates of apoptosis and necrosis were higher in group G than in groups ESKEC and ESKEC plus MIC（P < 0.05）. Conclusions Uses of sub ⁃dose esketamine combined with midazolam before anesthesia can reduce the incidence of POD in elderly patients undergoing hip replacement. ESKE combined with MI can relieve the apoptosis and necrosis of HT22 cells induced by glutamate，whose mechanism may be related to the decline in the incidence of POD.

Objective To investigate the role of vascular endothelial progenitor cells（EPCs）angiogenesis induced by SDF⁃1α/CXCR4 in neurological rehabilitation after stroke. Methods Flow cytometry and ELISA were used to analyze the effects of EPCs on oxygen⁃glucose deprivation（OGD）⁃induced apoptosis and SDF⁃1α levels in human brain microvascular endothelial cells（HBMECs）. A rat model of MCAO was established. EPCs were pretreat⁃ ed with EPCs，HBMECs⁃pEPCs or AMD3100（CXCR4 antagonist），respectively. Cognitive function was assessed by Morris water maze test at week 6，and angiogenesis in cerebral cortex was observed by immunofluorescence staining at week 7. Results EPCs treatment decreased the apoptotic rate of HBMECs induced by OGD（P < 0.05） and increased the number of vascular ring（P < 0.05）. OGD⁃HBMECs induced an increase in SDF⁃1α expression in EPCs，and CXCR4 knockdown alleviated the anti⁃apoptosis effect of EPCs on OGD⁃HBMECs（P < 0.05）. The number of EPCs and vessels with positive Claudin5 and level of SDF⁃1α protein in cerebral cortex of MCAO rats markedly increased on day 4 after the model establishment（P < 0.05）. As compared with EPCs treatment，HBMECs⁃pEPCs treatment significantly increased vascular density（P < 0.05）and improved deficits of learning and memory in the rat model of MCAO，while AMD3100 reversed the therapeutic effect of HBMECs⁃pEPCs. Conclusions HBMECs⁃ pEPCs can effectively promote neurovascular remodeling and cognitive function recovery via SDF⁃1α⁃CXCR4 axis in the rat model of MCAO.

Objective To investigate the effect of rissoflavones on proliferation and apoptosis of H2O2 ⁃ induced oxidative damage⁃induced astrocyte. Methods Astrocytes of SD neonatal rat were isolated；after treating astrocytes with 5，10，20 μmol/L isoflavones for 12 h，and adding H2O2 for 24 h to induce oxidative damage model， the cell proliferation in each group was detected by CCK8 method. In order to screen the appropriate treatment concentration of mullein，the experiment was divided into control group，H2O2（100 μmol/L）model group，H2O2 （100 μmol/L）+ Calycosin（20 μmol/L）intervention group；CCK8 method was used to detect the effect on the proliferation of astrocytes；Flow cytometry was used to detect astrocyte apoptosis；immunofluorescence was used to detect the level of Brdu in each group of cell samples；Western blot was used to detect the protein expression of p⁃AKT，GP130 and IL⁃6 in each group of cells. Results Compared with the control group，the proliferation activity of astrocytes in the H2O2 group was decreased，the degree of apoptosis was aggravated，and the protein expressions of p⁃AKT，GP130 and IL⁃6 were significantly increased（P < 0.05）. After treatment，the proliferation activity of astrocytes was significantly increased，and the apoptosis was effectively inhibited，and the protein expressions of p⁃AKT，GP130 and IL⁃6 were down⁃regulated（P < 0.05）. Conclusion Calycosin could promote the proliferation of H2O2 ⁃ induced oxidatively damaged astrocytes and inhibit their apoptosis by inhibiting the PI3K/Akt signaling pathway.

Objective To verify the protective lung protection of non ⁃injurious double lung hypoxia pre⁃ conditioning in patients undergoing one⁃lung ventilation surgery. Methods Sixty adult patients undergoing elective thoracic surgery were randomly divided into group A（n = 30）and group O（n = 30）. Anesthesia was induced and maintained totally by intravenous target ⁃ controlled infusion，followed by mechanical ventilation after inserting a double⁃lumen bronchial tube. In group A，hypoxic preconditioning was performed：At towel laying，the respiratory circuit continuously switched off for three times，each time with mechanical ventilation off for 1 minute and on for 1 minute. Group O was as a control group. Vital signs，oxygenation index（OI），IL⁃6，TNF⁃ α，superoxide dismutase （SOD）were recorded and compared between the two groups before surgery，20 minutes after OLV，30 minutes after extubation and 6 hours after surgery. Results The patients in group A had significantly higher OI during OLV and after operation than group O（P < 0.01），and the incidence of hypoxemia in group A was significantly lower than that in group O. The levels of IL⁃6 and TNF⁃α in group A were significantly lower than those in group O after operation（P < 0.01），and the SOD was significantly higher than that in group O a well（P < 0.01）. Conclusion Non ⁃injurious double lung hypoxia preconditioning can improve oxygenation and reduce the level of inflammation expression and the incidence of pulmonary complications in patients undergoing one⁃lung ventilation surgery，play⁃ ing a positive role in lung protection.

Objective To investigate the clinical efficacy of minimally invasive transforaminal lumbar interbody fusion and oblique lumbar interbody fusion by microscope assisted for degenerative lumbar stenosis. Method A total of 120 patients with degenerative lumbar stenosis were selected from March 2017 to March 2019 and were assigned to minimally invasive transforaminal lumbar interbody fusion group （Mis ⁃ TLIF group）and oblique lumbar interbody fusion group（OLIF group）. Parameters including operative duration，hemorrhage volume and perioperative complications were collected. The therapeutic effects were assessed by visual analogue scale， Oswestry disability index during follow⁃up period（postoperative 1 week，3 months and 6 months）. The surgical effect was evaluated by the modified MacNab criteria. Results Compared with Mis⁃TLIF group，the intraoperative blood loss，postoperative hospital stay，and postoperative complications of OLIF group were significantly shorter or less（P < 0.05）. The VAS score and ODI score of the two groups were all significantly improved after treatment（P < 0.05）and there was significant difference in ODI score between two groups（P < 0.05）. According to the modified MacNab criteria，no significant difference was found between two groups at follow ⁃ up（P > 0.05）. Conclusion Compared with Mis⁃TLIF，OLIF by microscope assisted was safe and feasible，which not only had less hemorrhage volume，but also shortened the postoperative hospital stay. OLIF by microscope assisted could get satisfying effect in the treatment of degenerative lumbar stenosis. 

Objective To investigate whether patients with acute⁃on⁃chronic pre⁃liver failure（pre⁃ACLF） have survival advantage compared to patients with acute ⁃on ⁃chronic liver failure（ACLF）in artificial liver treat⁃ ment. Methods A retrospective，multicenter and observational cohort study was conducted. Patients with serum hepatitis B surface antigen⁃positive for at least 6 months，serum total bilirubin ≥ 171 μmol/L and receiving at least one session of artificial liver treatment，were enrolled from January 2019 to December 2020 consecutively. Fifty⁃two patients were included in the pre⁃ACLF group，and 233 patients in the ACLF group. All patients were followed up for 12 weeks，and the survival and prognostic factors were analyzed. Kaplan Meier method and Cox regression were used to analyse the survival data. Results The 12⁃week mortality of the pre⁃ACLF group（5.8%，3/52）was lower than that of the ACLF group（34.8%，81/233），and also lower than that of early stage of ACLF group（19.9%，30/151）， middle stage of ACLF group（57.9%，33/57）and late stage of ACLF group（72.0%，18/25），respectively（all P < 0.05）. Survival analysis at 12 weeks showed that the survival for pre⁃ACLF group was better than ACLF group，and also better than that for early，middle and late stage of ACLF group，respectively（all P < 0.05）. Cox regression anal⁃ ysis showed that pre ACLF，serum alpha fetoprotein，serum sodium，age，blood leukocytes and total bilirubin were independent predictors of death（all P < 0.05），and the death risk of pre⁃ACLF patients was only 0.238 times that of ACLF patients. Conclusion Compared with ACLF patients，pre⁃ACLF patients are the survival advantage group of artificial liver treatment. Therefore，pre⁃ACLF may be the golden window of artificial liver treatment.

Objective The aim of the study was to evaluate the clinical efficacy of posterior pedicle screw fixation with long segment，short segment transinjured vertebrae and short segment transinjured vertebrae for type A thoracolumbar fractures. Methods Seventy⁃three patients with type A thoracolumbar fractures from July 2011 to July 2021 were selected and treated by long⁃level fixation（Group A，n = 28），short⁃level through fractured verte⁃ brae fixation（Group B，n = 24），and short⁃level across fractured vertebrae fixation（Group C，n = 21）respectively. Evaluation indexes included operation time，intraoperative blood loss，VAS scores，ODI，Cobb angles，anterior height ratios of fractured vertebrae，and Pearce classification. Results The average follow ⁃ up duration was 18.9 months. Back pain，functional performance，Cobb angles，and anterior height ratios of fractured vertebrae were efficiently improved after surgery（P < 0.05）. But there was no significant differencein VAS scores，ODI，and Pearce classification among the three groups（P > 0.05）. There were significant differences in terms of operation time and intraoperative blood loss between group A and group B and C（P < 0.05）. In addition，although Cobb angles and an⁃ terior height ratios of fractured vertebrae were significant corrected at one⁃year post⁃operative，the loss of correction in group C was significant larger when compared with that in group A and B（P < 0.05）. Conclusions Compared with long⁃level fixation，short⁃level fixation has an advantage of less operation⁃related trauma. Moreover，short⁃level through fractured vertebrae fixation also leads to as good long⁃term correction of deformity as long⁃level fixation.

Objective To investigate the effects of ultrasound ⁃ guided stellate ganglion block（SGB）on stress response and early recovery quality of elderly patients undergoing robot⁃assisted laparoscopic radical prostatec⁃ tomy. Methods A total of 116 elderly patients scheduled for RALRP were selected and randomly divided into study group（group S）and control group（group C）. Group S received ultrasound⁃guided SGB before induction of anesthe⁃ sia，and group C was treated with normal saline in the same way. The heart rate（HR）and mean arterial pressure （MAP）were recorded and compared between the two groups at the time points of before anesthesia induction（T0）， immediately after tracheal intubation（T1），1 min（T2），10 min（T3），20 min（T4）after pneumoperitoneum and at the end of surgery（T5）. The concentration of serum cortisol（Cor），epinephrine（E）and norepinephrine（NE）were measured and compared as well at T0，T2，T4 and 2 h after surgery（T6）. The NRS pain scores，the consumption of sufentanil within 48 h after surgery and the（MMSE）scores on preoperative day（D0）and day 1（D1），day 3（D3）， day 5（D5）after surgery were recorded. The two groups were compared in terms of the NRS pain scores after surgery， consumed amount of sufentanil，scores of Mini ⁃mental State Examination（MMSE），early recovery index and inci⁃ dence of adverse reactions. Results Compared with group C，HR and MAP in group S were significantly decreased at T1 and T2（P < 0.05）. Group S presented remarkably lower concentrations of plasma Cor at T2，T4 and T6；and lower concentrations of plasma E and NE at T2 and T4（P < 0.05）. No statistical difference was found in the NRS scores， the consumption of sufentanil after the operation and MMSE scores between the two groups（P > 0.05）. Group S showed significantly shorter recovery time of bowel sounds and the first anal exhaust time and lower incidence of adverse reactions compared with group C. Conclusion Ultrasound⁃guided SGB can inhibit the stress response，reduce the incidence of adverse reactions and accelerate the recovery of intestinal function in elderly patients undergoing RALRP.

Objective To evaluate the efficacy of endoscopic and surgical treatment of gastric stromal tumors with a diameter of 2 ~ 5 cm，and to explore the clinical value of endoscopic resection of gastric stromal tumors of 2 ~ 5 cm in diameter. Methods A total of 225 cases of gastric stromal tumor with a diameter of 2 ~ 5 cm and confirmed by postoperative pathology in the First Affiliated Hospital of Zhengzhou University from July 2012 to January 2021 were collected. They were divided into endoscopic group（n = 104）and surgical group（n = 121）. The general data，operation time，postoperative hospital stay，postoperative fasting time，intraoperative and postop⁃ erative complications and long ⁃ term follow ⁃ up tumor recurrence were compared and analyzed between the two groups. Results There was no significant difference between the two groups in age，sex，tumor site，operation time，and complete resection rate（P > 0.05）. There were statistically significant differences in tumor diameter， tumor growth pattern，clinical manifestations，risk grading，and mitotic figures between the two groups（P < 0.05）. The postoperative hospital stay and postoperative fasting time in the endoscopic group were shorter than those in the surgical group，and the differences were statistically significant. The incidence of complications in the endoscopic group（6.7%）was lower than that in the surgical group（20.7%），showing statistical difference. With a median follow⁃up of 40 months，1 case of recurrence in the endoscopic group（the recurrence rate was 1.0%）and 2 in the surgical group（the recurrence rate was 1.7%）were found，and there was no significant difference in the recur⁃ rence rate between the two groups（P > 0.05）. Conclusion Endoscopic treatment of non⁃metastatic gastric stromal tumors with a diameter of 2⁃5cm is a safe and effective method. The prognosis of patients with endoscopic treatment is comparable to that with surgical treatment. It can be used as one of the main methods for the treatment of gastric stromal tumors.

Objective To investigate the efficacy and advantage of modified holmium laser enucleation of the prostate（HoLEP）with preservation of partial urethral mucosa in the treatment of benign prostatic hyperplasia （BPH）. Methods 180 patients diagnosed with BPH were enrolled in the study. They were randomly divided into three groups，A，B and C，with 60 patients in each group. Group A received modified HoLEP，group B received conventional HoLEP，and group C received transurethral resection of the prostate（TURP）. Clinical data of preoper⁃ ative，intraoperative and postoperative follow ⁃up were recorded and compared. Results There was no significant difference in the preoperative baseline characteristics among the three groups（P > 0.05）. In terms of operation time and tissue resection efficiency，the modified HoLEP group was superior than the conventional HoLEP group and TURP group（all P < 0.05）. There was no significant difference between the modified HoLEP group and the conventional HoLEP group in bladder irrigation time，indwelling catheter time，the amount of tissue resection and intraoperative blood loss（all P > 0.05），but they were both superior than those of TURP group（P < 0.01）. The incidence of postoperative urinary incontinence in the modified HoLEP group（6.7%）was significantly lower than the conventional HoLEP group（23.3%）（P < 0.05）. Over the follow⁃up period of 6 months，the maximum urinary flow rate，post⁃vociding residual，international prostate symptom score and quality of life score were significantly improved（all P < 0.01）. Conclusion Compared with TURP，conventional HoLEP has low gland residue rate， less intraoperative blood loss and faster postoperative recovery. Modified HoLEP can further improve the enucle⁃ ation efficiency and reduce the incidence of urinary incontinence after operation. Therefore，modified HoLEP is superior for the treatment of BPH and worthy of promotion. 

Objective To explore the feasibility and safety of the delivery ball exercise for correcting breech presentation in women after 34 weeks，and to analyze the factors that affect the success rate，so as to pro⁃ vide a theoretical basis for improving the success rate of delivery ball correction for breech presentation. Methods The data of pregnant women who performed delivery ball exercise to correct breech position from September 2020 to March 2022 was selected. The general data of patients and relevant information during delivery ball movement were collected，and the correction success rate，delivery ball movement time，and adverse events were counted to evalu⁃ ate its feasibility and safety. The influencing factors of the correction success rate were analyzed，and univariate analysis was used to determine whether each factor was an influencing factor of the correction success rate. Logistic regression analysis was used to test whether the above factors were independent influencing factors of the correction success rate. Results A total of 157 subjects were included in this study，of which 87 were successfully corrected， with a success rate of 55.4%. The average exercise time was（109.77 ± 19.60）minutes；no adverse reactions such as premature birth，premature rupture of membranes and fetal distress occurred. Maternity history and amniotic fluid volume are the main factors affecting the success rate of correcting breech presentation. Conclusion After 34 weeks of gestation，it is feasible and effective to apply delivery ball exercise to correct breech position，with moder⁃ ate exercise time and high safety. Pregnancy history and amniotic fluid volume are the main factors affecting the success rate of correcting breech position. 

Objective The of this study was to explore the risk factors of pulmonary hypertension（PH） in acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and to find potential predictors. Methods A retrospective analysis was made of 120 AECOPD patients who admitted to The Second Affiliated Hospital of Zhengzhou University from March 2019 to March 2022. According to the status of PH，patients were divided into AECOPD group（n = 59）and AECOPD complicated with pH group（n = 61）. Multivariate logistic regression analysis was applied to explore the influencing factors of AECOPD complicated with PH. The receiver characteristic operating curve（ROC curve）was used to analyze the diagnostic value of each index for AECOPD complicated with PH. Results C⁃reactive protein to albumin ratio（CAR），neutrophil⁃to⁃lymphocyte ratio（NLR）， platelet⁃to⁃lymphocyte ratio（PLR），C⁃reactive protein（CRP），interleukin⁃6（IL⁃6），albumin，lymphocyte count， neutrophil count，prothrombin time，D ⁃ dimer and N ⁃terminal pro ⁃ brain natriuretic peptide（NT ⁃ proBNP）were higher than those in AECOPD group（P < 0.05）. Regression analysis showed that CAR，NT⁃proBNP and D⁃dimer were independent risk factors for AECOPD complicated with PH（P < 0.05）. The results of ROC curve analysis showed that the AUCs of CAR，NT⁃proBNP and D⁃dimer were 0.854，0.885 and 0.729. Conclusions AECOPD patients with higher CAR，NT ⁃proBNP and D ⁃dimer were more likely to develop PH. CAR and NT ⁃proBNP are better than D⁃dimer in the diagnosis of AECOPD complicated with PH. 

Objective The study was designed to investigate the clinical efficacy of clonidine transdermal patch combined with vitamin D3 drops in the treatment of tic disorder in children and to analyze the relationship between the serum 25 hydroxy vitamin D level and its clinical efficacy. Methods A total of one hundred and fifteen children with tic disorders who attended our pediatric neurology outpatient department from January 2020 to June 2022 were randomly divided into three groups：45 cases in the clonidine transdermal patch+vitamin D3 drops group，45 cases in the clonidine transdermal patch group，and 30 cases in the vitamin D3 drops group. Comparison of Yale General Tic Severity Scale（YGTSS）score and serum 1⁃25 hydroxy vitamin D levels between the three groups of 0，4 and 12 weeks after treatment were made to determine efficacy and safety. Results Compared with pre ⁃treatment，YGTSS scores were lower in all three groups at 4 and 12 weeks of treatment compared with pre ⁃ treatment（P < 0.05）. At 4 weeks after treatment，YGTSS scores were reduced in the clonidine transdermal patch + vitamin D3 drops group and clonidine transdermal patch compared with the vitamin D3 drops group（P < 0.05）. At 12 weeks after treatment，YGTSS scores were lower in the clonidine transdermal patch + vitamin D3 drops group compared with the other two groups（P < 0.05）. Serum 25 hydroxyvitamin D levels were higher in all three groups after 12 weeks of treatment compared with those before treatment（P < 0.05）. Conclusion Clonidine trans⁃ dermal patch + vitamin D3 dr ops group was more effective than other 2 groups in treating tic disorder in chil⁃ dren，and vitamine D may be helpful in the treatment of Tic disorder.

Objective To investigate the clinical value of fully automated three⁃dimensional echocardiog⁃ raphy right ventricular quantification software（3D Auto RV）in evaluating right ventricular systolic function in patients with chronic pulmonary heart disease（CPHD）. Methods According to clinical manifestations，88 patients with CPHD were divided into the compensated group（n = 48）and the decompensated group（n = 40），and 40 healthy subjects served as controls. To measure the routine ultrasound parameters of the subjects ，and apply 3D Auto RV measures right ventricular end ⁃ diastolic volume（RVEDV），right ventricular end ⁃ systolic volume （RVESV），right ventricular stroke volume（RVSV），right ventricular ejection fraction（RVEF），tricuspid annular plane systolic excursion（TAPSE），right ventricular fractional area change（RVFAC），longitudinal strain of free wall（FWLS），longitudinal strain of ventricular septum（SLS），and the difference among groups were compared. Results （1）Compared with the control group，TAPSE，RVFAC，RVEF，FWLS and SLS were decreased，while RVEDV and RVESV were increased in CPHD groups（P < 0.05）. The RVSV of the decompensated group was significantly lower than that of the control group and the compensated patients（P < 0.05），but there was no sig⁃ nificant difference between the compensatory group and the control group（P > 0.05）. Compared with the compensated group，TAPSE，RVFAC，RVEF and FWLS were further decreased，RVEDV and RVESV were further increased in the decompensated group（P < 0.05），and SLS had no significant difference（P > 0.05）.（2）FWLS had a high correlation with RVEF（r = -0.721，P < 0.001）.（3）The optimal cut⁃off value of RVEF for predicting the decompensated phase of CPHD was 41.35%（AUC = 0.95，P < 0.001）.（4）Repeatability test showed that both RVEF and FWLS had good repeatability. Conclusion 3D Auto RV can accurately evaluate the right ventricularsystolic function in patients with CPHD，which is expected to become a new method for clinical evaluation of the severity of CPHD.

Objective To investigate the effect of early lung rehabilitation training of Traditional Chinese medicine on quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods A total of 57 patients with AECOPD admitted to Guangdong Provincial Hospital of Chinese Medicine from April 2019 to April 2020 were selected，28 cases were randomly assigned to control group and 29 cases to experimental group. The control group received conventional treatments，and the experimental group received lung rehabilitation training of Traditional Chinese medicine，including six ⁃word formula breathing training，upper and lower limbs training and walking training，combined with conventional treatments . The 6⁃minute walking distance， COPD assessment Test（CAT）score and dyspnea Scale（mMRC）scores were compared between the two groups before and at 1st week，6th week and 12th week after intervention. Results The difference between control group and experimental group was statistically significant（P < 0.05）. After 12 weeks of intervention，dyspnea in the experimental group was significantly improved compared with control group（P < 0.05）. The longer the intervention time was，the better the effect was（OR values of the 1st，6th and 12th weeks were 0.721，0.434 and 0.102，re⁃ spectively）. The increase of exercise endurance in experimental group was better than control group（F = 8.658， P < 0.05）. The quality of life in experimental group was significantly improved compared with control group（F = 4.209，P < 0.05）. Conclusion Early application of pulmonary rehabilitation training of Traditional Chinese medi⁃ cine in patients with AECOPD acute exacerbation stage was safe and feasible，which could relieve the dyspnea symptom，improve exercise endurance and quality of life. 

Primary burning mouth syndrome（BMS）is defined as a chronic intractable mucosal painful disease characterized with tongue as the main lesion and ongoing（chronic）or recurrent burning in the mouth as the main symptoms，but without significant clinical damage，histological changes and obvious causes. Due to its unclear epidemiology，etiology and pathogenesis，there is lack of standardized diagnostic criteria and effective treatment. The present study reviews five aspects of BMS，including the evolution of BMS terminology and classifi⁃ cation，pathophysiological mechanisms，diagnostic methods（questionnaires，imaging examinations，and serum or saliva tests），and therapeutic diagnosis. In the future，with the in⁃depth clinical practice and research，BMS patients may benefit from a deeper understanding of the pathological mechanism and the proper use of diagnostic tests.

Interleukin⁃22（IL⁃22），produced by the CD4 + T cell subpopulation，plays a role in host defense and epithelial protection. As a pro⁃inflammatory cytokine，IL⁃22 plays an important role in airway inflam⁃ mation in asthma. Meanwhile，IL ⁃22 can aggravate subepithelial fibrosis，promote EMT，increase mucus secre⁃ tion，and hyperplasia and hypertrophy of airway smooth muscle，thus aggravating airway remodeling in asthma. As a pro⁃inflammatory and pro⁃fibrogenic factor，the specific mechanism of IL⁃22 in airway remodeling in asthma is still unclear. This article reviews the role of IL⁃22 in airway remodeling in asthma. 

Osteoporosis is a disease where low bone mineral density and microstructure deterioration lead to low bone strength and high risk of fracture. Because metabolic disorders will accelerate bone loss and renal failure，which can increase the risk of osteoporosis that will lead to fracture or even death. Denosumab is a receptor activator of nuclear factor⁃κB ligand inhibitor that is widely used in the treatment of osteoporosis. In recent years， there are increasing applications of denosumab in hemodialysis patients with osteoporosis. This paper reviews the application and research progress of denosumab in the treatment of osteoporosis in hemodialysis patients