Specific learning disorder is a neurological disorder that affects a student′ s ability to read， write，spell，reason，and organize information taught in conventional ways. Specific learning disorder symptoms can last for a lifetime，and may have adverse effects on children and adults in education，employment，economy， society and emotion. Specific learning disorder have always been the research focus of medicine，psychology and pedagogy. For decades，specific learning disorder have been the focus of research in medicine，psychology and education，but their understanding is still limited，especially their etiology and pathogenesis are extremely complex. At present，there is no diagnosis and treatment standard or consensus for specific learning disorder in China. This article reviews the epidemiology，social impact，pathogenesis，clinical manifestations and diagnosis of specific learning disorder.

Vestibular migraine（VM）is a common vestibular disease characterized by paroxysmal vertigo/ dizziness. Clinically，VM staging is subjective and lacks standardization. Accurate identification of attack period， intermittent period or chronic duration is the basis of VM clinical diagnosis and treatment and pathophysiological research. Comprehensive analysis of the pathogenesis and pathological nature of VM from the aspects of onset time and frequency，symptoms and signs，scale score，imaging examination and blood test is helpful for objective stag⁃ ing diagnosis of VM.

Objective The research aimed to investigate whether KLF4⁃shRNA carried by adeno⁃associated virus type 1（AAV1）injected into the airway of rats can effectively construct an animal model of pulmonary vascu⁃ lar gene knockdownand its application in pulmonary hypertension. Methods According to the rats′ KLF4 gene sequence，the rat⁃specific siRNA sequence was designed and verified by cell count and cell migration expriments and then the AAV1⁃KLF4⁃shRNA adeno⁃associated virus vector was constructed.A total of 44 rats were randomly assigned to four groups：sham group，saline group，AAV1⁃control vector group and AAV1⁃KLF4⁃shRNA group. The last three groups of rats were injected with normal saline，AAV1⁃carried control vector，and AAV1⁃KLF4⁃shR⁃ NA in the trachea，respectively. After 1 month，the latter 3 groups were whole body exposed to CS for 4 months of smoke. After each group of rats was anesthetized，hemodynamic testing was carried out，the expression of viral vectors in pulmonary blood vessels was observed by immunofluorescence assays，the level of pulmonary vascular remodeling was evaluated by HE staining，and the KLF4 level in pulmonary arteries was measured by PCR method. Then we harvested rats′ heart to calculate right heart hypertrophy index. Results Cell counting and cell migration experiments confirmed that the selected KLF4 ⁃ siRNA strands were effective. Immunofluorescence experiments showed that adeno⁃associated virus vector type 1 injected through the airway of rats was distributed along the pulmo⁃ nary blood vessels. Fluorescence quantitative PCR experiments showed that the mRNA expression of KLF4 in thepulmonary arterioles of the AAV1⁃KLF4⁃shRNA group was significantly lower than other two model groups. Hemo⁃ dynamic test results showed that the right ventricular systolic blood pressure and mean right ventricular pressure in the two groups of pulmonary hypertension models were significantly higher than those in the healthy control group， while the right ventricular systolic blood pressure and mean right ventricular pressure in rats undergoing knockdown of the pulmonary vascular KLF4 gene were significantly lower than those in both model groups. The HE staining and the right heart hypertrophy index results showed that the degree of pulmonary small vessel remodeling and the ventricular remodeling in the two groups of pulmonary hypertension models were significantly higher than those in the healthy control group，while the degree of pulmonary small vessel remodeling and the ventricular remodeling in rats undergoing knockdown of the pulmonary vascular KLF4 gene were significantly lower than those in both model groups. Conclusion The successful construction of a pulmonary vascular ⁃ specific KLF4 gene knockdown model and the successful use in pulmonary hypertension provide a platform and experimental basis for further in ⁃ depth study of the pathogenesis of pulmonary hypertension.

Objective To investigate the effect of wogonin（WOG）on bone fracture healing in rats with osteoporosis（OP）by regulating AMP ⁃activated protein kinase（AMPK）/silent information regulator 1（SIRT1） signaling pathway. Methods Sixty female SPF SD rats were randomly divided into sham operation group（Sham group），osteoporotic fracture（OPF）model group（Model group），low⁃dose WOG group（WOG⁃L group，50 mg/kg）， high ⁃ dose WOG group（WOG ⁃H group，100 mg/kg）and high ⁃ dose WOG +AMPK inhibitor Compound C group （WOG⁃H+CC group，100 mg/kg WOG+0.2 mg/kg Compound C），with 12 rats in each group. Model group，WOG⁃L group，WOG ⁃ H group and WOG ⁃ H + CC group were selected to establish the rat model of osteoporotic fracture （OPF）by bilateral oophorectomy and intramedullary fixation of right femoral shaft fracture. Radiological examina⁃ tion was performed to evaluate the fracture healing. Bone mineral density（BMD）of rat femoral callus was mea⁃ sured by dual energy X⁃ray absorptiometry. The biomechanics of rat femoral bone was tested by three⁃point bending test and compression test. Serum osteocalcin（OC）and procollagen typeⅠcarboxy⁃terminal peptide（PICP）were measured by colorimetry. HE staining was used to observe the pathological changes of callus at the fracture site. Western blot was used to detect the expression of AMPK/SIRT1 signal pathway related proteins in femur. Results Compared with the Sham group，the fracture healing score，BMD of upper and lower femur callus，the maximum displacement，maximum stress and maximum load of callus，the serum OC and PICP levels，AMPK phosphoryla⁃ tion level in femur tissue and SIRT1 protein expression in Model group were obviously reduced（P < 0.05），no callus growth was found at the fracture end，the fracture line was clear，the bone trabecula was thin，the number was reduced，the gap was increased，and the structure was disordered and loose. Compared with the Model group， the fracture healing score，BMD of upper and lower femur callus，the maximum displacement，maximum stress and maximum load of callus，the serum OC and PICP levels，AMPK phosphorylation level in femur tissue and SIRT1 protein expression in the WOG⁃H group were obviously increased（P < 0.05），there was continuous callus wrapping and penetrating the fracture end，the medullary cavity was reopened，the fracture line was unclear，and the shape of bone trabecula was relatively complete. Compound C weakened the promoting effect of WOG on frac⁃ ture healing in OPF rats. Conclusion WOG may promote fracture healing in OPF rats by activating AMPK/SIRT1 signaling pathway.

Objective To investigate the effect and mechanism of lncRNA PCAT19 on the proliferation， migration and invasion of oral squamous cell carcinoma HSC3 cells. Methods The cancer tissues and adjacent tissues of 45 patients with oral squamous cell carcinoma were collected，and the expression of PCAT19 and miR⁃ 769⁃5p in the tissues was detected by qRT⁃PCR. HSC3 cells were cultured in vitro and transfected with PCAT19 siRNA or miR⁃769⁃5p mimic，or co⁃transfected with PCAT19 siRNA and miR⁃769⁃5p inhibitor. Then cell prolifera⁃ tion was detected by CCK ⁃8 method and clone formation assay. Scratch assay and Transwell assay were used to detect cell migration and invasion，respectively. Western blotting was used to detect the expression of E⁃cadherin and N⁃cadherin protein in the cells. The dual⁃luciferase reporter gene experiment was done to verify the regulatory relationship between PCAT19 and miR ⁃769⁃5p. Results The expression of PCAT19 in the oral squamous cell carcinoma was higher than that in the adjacent tissues，but the expression of miR⁃769⁃5p was lower than that in the adjacent tissue，（P < 0.05）. Interfering with PCAT19 or overexpressing miR⁃769⁃5p decreased the OD value，colony formation number，scratch healing rate，invasion number and the expression of N ⁃cadherin protein in the HSC3 cells（P < 0.05），but promoted the expression of E⁃cadherin protein（P < 0.05）. PCAT19 could target and nega⁃ tively regulate miR ⁃ 769 ⁃ 5p. Downregulation of miR ⁃ 769 ⁃ 5p reversed the effects of interfering with PCAT19 on HSC3 cells proliferation，migration and invasion. Conclusion The expression of PCAT19 is up⁃regulated in oral squamous cell carcinoma tissues，and interfering with PCAT19 may inhibit the proliferation，migration and inva⁃ sion of oral squamous cell carcinoma HSC3 cells by targeting up⁃regulated miR⁃769⁃5p.

Objective To investigate the role and mechanism of collagen triple helical repeat 1（CTHRC1） regulating epidermal growth factor receptor（EGFR）signaling pathway in the formation of hypertensive myocardial remodeling. Methods SD rats were randomLy divided into the following three groups：wild⁃type control（WTC） group，AngⅡ + Stuffer group and AngⅡ + CTHRC1 group，10 rats in each group. Rats in the AngⅡ + Stuffer group and the AngⅡ + CTHRC1 group were pretreated by injecting Stuffer or CTHRC1 through the tail vein at a dose of 1 × 1011 v.g. respectively；after injection for 4 weeks，the rats were received AngⅡ［1.5 mg/（kg·d）］with an osmotic minipump for another 4 weeks. Cardiac function was measured non⁃invasively by transthoracic echocar⁃ diography，and the cardiac fibrosis was assessed by Masson′s trichrome staining. Cardiac fibroblasts（CF）were isolated from the hearts of 2⁃ to 3⁃day⁃old SD rats and divided into：Con group，Ang Ⅱ group，AngⅡ+ sh⁃NC group， AngⅡ+ sh⁃CTHRC1 group and Ang Ⅱ group +sh⁃CTHRC1+Colivelin TFA group. Cell proliferation and migration were assessed by CCK8 assay and wound healing assay，reactive oxygen species（ROS）levels were detected by dihydroethidium fluorescence staining，and the expression of CTHRC1 protein and EGFR/Stat3 signaling pathway was analyzed by western blotting. Results Compared with the WTC group，the cardiac tissue fibrosis of the hyper⁃ tensive rats in the AngⅡ+ stuffer group significantly increased（P < 0.05）. CTHRC1 administration further aggra⁃ vated these pathological changes in hypertensive rats（P < 0.05）. Echocardiography showed that the left ventricularejection fraction decreased and the fractional shortening in the AngⅡ+ CTHRC1 group was greater than that in the AngⅡ+ stuffer group（P < 0.05）. Compared with the control group，the proliferation of CF and the expression of EGFR and Stat3 in the Ang Ⅱ group significantly increased（P < 0.05）. CF migration，ROS levels and fibrosis⁃ related signal（COL1A1，COL3A1，TGF ⁃ β）gene expression in Ang Ⅱ group significantly increased compared with those in the control group（P < 0.05）；sh⁃CTHRC1 pretreatment significantly reversed these changes induced by AngⅡ（P < 0.05）. Furthermore，Colivelin TFA addition largely reduced the beneficial effect of sh ⁃CTHRC1 pretreatment on Ang Ⅱ induction（P < 0.05）. Conclusion CTHRC1 overexpression leads to increased cardiac fibrosis，structural damage and dysfunction in hypertensive rats，and its mechanism of action is related to oxidative stress mediated by activation of the EGFR/Stat3 signaling pathway.

Objective To investigate the antihypertensive effect of SPH3127 and its mechanism of vascu⁃ lar endothelial protection. Methods Eighty male SD rats were randomly divided into a sham operation group， model group，high ⁃dose SPH3127 group（20 mg/kg），and low ⁃dose SPH3127 group（10 mg/kg）. Systolic blood pressure（SBP），interleukin⁃6（IL⁃6），tumor necrosis factor⁃α（TNF⁃α），endothelial nitric oxide synthase（eNOS）， and inflammatory injury were measured. Human umbilical vein endothelial cells（HUVECs）were divided into a control group，AngⅡ（1 μmol//mL）group，and SPH3127（10 nmol//mL）group. The ability of proliferation and migration，and mRNA expression levels of eNOS and FXYD1 were detected. Results SPH3127 treatment signifi⁃ cantly reduced blood pressure，increased intimal integrity，decreased expressions of IL⁃6 and TNF⁃α，and increased eNOS，especially in the high⁃dose group（P < 0.05）；The ability of proliferation and migration in HUVECs were increased，and the mRNA expression levels of FXYD1 and eNOS were increased （P < 0.05）. Conclusions SPH3127 can reduce blood pressure in rats. By inhibiting inflammation and promoting the expression of FXYD1，it plays a certain role in protection of vascular endothelium.

Objective To investigate the level and clinical significance of fine typing of memory T lymphocyte subsets before and after initial glucocorticoid（GC）treatment in children with steroid ⁃sensitivenephroticsyndrome （SSNS）. Methods Thirty⁃five children diagnosed with SSNS for the first time were selected as the research group， and twenty healthy children were enrolled as the normal control group. Multicolor flow cytometry was adopted to analyze the fine typing of memory T lymphocyte subsets in children with SSNS before initial treatment and in remission after treatment，and in the control group. Immunosorbent assay（ELISA）was used to detect the level of T⁃cell cytokines ineachgroup，and then the correlation analysis was performed with clinical indexes. Results CD4+ memory T cells（TM），CD4 + central memory T（TCM）cells and CD4 + effector memory T cells（TEM）in the active phase of GC in the SSNS children before initial treatment，CD8+ CD45RO+ TM，CD8+ TEM percentages（% of CD3+ T cells）were higher than those in the remission period and control group after treatment，and the CD4 + naïve T cells（TN）in the active phase were statistically significantly decreased in number compared with those in the remis⁃ sion period（P < 0.05），the percentage of stem ⁃like memory T cells（TSCM）in the active phase was significantly higher than that in the remission phase and the control group（P < 0.001）. Before treatment，the number of T cell cytokines including IL⁃1β，IL⁃8 and IFN⁃γ in the active stage was significantly larger than those in the remission stage and control group（P < 0.05）and CD4+ TEM ratio was significantly negatively correlated withalbuminand CD4+ TN ratio（P < 0.01）and positively correlated with IFN⁃γ levels（P < 0.05）. Conclusion Abnormal distribution of TSCM/TM subsets and disturbance of some T cell cytokines were found in SSNS children，and there was a closed relationship between them ，suggesting abnormal TSCM/TM subsets play an important role in the occurrence anddevelopment of the disease；GC application affected the distribution of TM and TSCM functional subsets in children with SSNS.

Objective To explore the degree of benefit from laparoscopic surgery before in vitro fertilization and embryo transfer（IVF⁃ET）in infertile patients with mild distal tubal obstruction. Methods Retrospective anal⁃ ysis of clinical data，from January 2013 to June 2018，228 patients with tubal infertility who were treated in the Reproductive Medicine Center of Guangdong Women and Children Hospital，underwent Hysterosal ⁃ pingo ⁃contrast sonography or hysterosalpingography showed unilateral or bilateral distal fallopian tube occlusion or smooth obstruc⁃ tion. 148 patients chose laparoscopic surgery at first，followed up the natural pregnancy outcome within 2 years after the operation. Patients who did not have pregnancy at 6 months after laparoscopic surgery transferred to IVF⁃ET as operation group. Those who choose to undergo IVF⁃ET directly as non⁃operation group. Compared the outcome of first IVF⁃ET cycle between two groups，evaluated the degree of benefit from laparoscopic surgery before IVF⁃ET. Results The natural clinical pregnancy rate in 148 patients within 2 years after surgery was 29.73%，about 50% of pregnancies occurred in 6 mouths after surgery. The early abortion rate in operationg group was lower than that in non⁃operation group，and the difference was statistically significant（P < 0.05）；there was no statistically signifi⁃ cant difference in clinical pregnancy rate，ectopic pregnancy rate，and live birth rate（P > 0.05）. Conclusion Natural pregnancy rate of 148 patients with mild distal fallopian tube occlusion within 2 years after laparoscopic surgery was about 30%，and about 50% of natural pregnancy occured within 6 months after laparoscopic surgery. Patients who did not have pregnancy at 6 months after laparoscopic surgery，transferred to IVF⁃ET，compared with patients who choose IVF⁃ET directly，clinical pregnancy rate was similar，early abortion rate was more lower. 

Objective To investigate the changes in the peripheral blood micromolecule ribonucleic acid⁃ 141（miR⁃141）in osteoporosis（OP）patients，as well as its predictive value for fracture risk. Methods 175 hospitalized OP patients in He′nan Hospital of Traditional Chinese Medicine were chosen as the study group，and 156 healthy volunteers of the same age were recruited as the control group. The expression of miR⁃141 was detected， and the study group was followed up for 1 year. Results The expressions of miR ⁃141 of men and women in the study group were higher than those of the control group（P < 0.05）. The study group had a fracture rate of 30.29%， compared to 7.05% in the control group（P < 0.05）. Fractures were more common in women and men in the study group than in the control group（P < 0.05）. The area under the curve（AUC）of miR⁃141 expression in predicting fracture risk in male and female patients with OP were 0.968（95%CI：0.895 ~ 0.996）and 0.726（95%CI：0.631 ~ 0.808），respectively. Conclusion MiR ⁃141 expression is comparatively higher in OP patients，and it is also highly effective in predicting fracture risk.

Objective This study aims to investigate the relationship between subchorionic hematoma in the first trimester and lower genital tract infection and embryonic arrest. Methods The method of prospective random⁃ ized trials was used to select 180 women with pregnancy 5 ~ 9 weeks following subchorionic hematoma. and then divide them into the lower genital tract infection group（n = 54）and normal group（n = 126）according to the results of vaginal secretion culture. The relationships of the lower genital tract infections and chorionic hematoma area with the pregnancy outcomes were analyzed. Results There were no significant differences in the average age，gestational days，gestational times and body mass index between the two groups. There was no significant difference in the duration of vaginal bleeding and the duration of lower abdominal pain（P > 0.05）. Etiological analysis showed that the abnormal vaginal flora，the gestational age of subchorionic hematoma < 6 weeks，and the ratio of hematoma to gestational sac area ≥ 50% and between 25% ~ 50% were all the independent risk factors for embryo suspension in early pregnancy. Conclusion Embryo termination in early pregnancy is related to the imbalance between vaginal microbiota and vaginal microbiota，the gestational age of subchorionic hematoma < 6 weeks，and the proportion of hematoma to gestational sac area ≥ 50% and between 25% ~ 50%. In early pregnancy，attention should be paid to the balance of vaginal microflora，timely adjustment of the microecological balance of vaginal microflora，early B⁃ultrasound examination for detecting and treating subchorionic hematoma，in order to obtain a better outcome.

Objective To evaluate the efficacy of endoscopic metal hemostatic clip combined with esome⁃ prazole in the treatment of Forrest Ⅱb acute non⁃variceal upper gastrointestinal bleeding（NVOGIB），and analyze the economic benefit of the combined therapy. Methods The clinical data of 48 patients with Forrest Ⅱb NVOGIB who were treated with endoscopic metal hemostatic clip combined with esomeprazole were retrospectively analyzed （combined group），and 48 patients with Forrest Ⅱb NVOGIB by a 1：1 match of baseline data such as gender and age treated with someprazole were selected as control group. Clinical efficacy，disease outcomes（blood transfusion rate，hospital stay，7⁃day re⁃bleeding rate）and occurrence of adverse reactions were recorded in the two groups. The mucosal healing status（reproductive mucosal maturity and histological reproductive mucosal maturity）were compared between the two groups after 1 month of treatment. The cost ⁃effectiveness analysis of the two treatment regimens was performed. Results The clinical efficacy of the combined group was significantly higher than that of the control group（P < 0.05），and the hospital stay was significantly shorter than that of control group（P < 0.05）. There were no statistical differences in blood transfusion rate，7⁃day re⁃bleeding rate and occurrence of adverse reactions between the two groups（P > 0.05）. After 1 month of treatment，the reproductive mucosal maturity and histological regenerative mucosal maturity of combined group were better than those of the control group（P < 0.05）. There was higher cost in the combined group（P < 0.05），but the cost⁃effectiveness ratio of 91.45 in combined group was lower than that of 97.07 in the control group. The total effective rate of treatment for every additional unit in the control group needed increased cost of 52.15 yuan compared to combined group. Conclusion Endoscopic metal hemostatic clip combined with esomeprazole has a significant effect in the treatment of Forrest Ⅱb NVOGIB，and it is safe and more economical.

Objective To investigate the clinical outcomes of cytoreductive radical prostatectomy（CRP） combined with androgen deprivation therapy（ADT）for oligometastatic prostate cancer. Methods A total of 67 patients with oligometastatic prostate cancer were enrolled in the study from June 2015 and March 2021. Of the patients，32 were treated with CRP combined with ADT and 35 were treated with ADT alone. The perioperative outcomes were evaluated，the time to CRPC and cancer specific survival（CSS）were observed and compared by Kaplan⁃Meier method. Results No statistical differences in PSA levels，distribution of clinical tumor stage and nodal stage were noted between the two groups. The incidence of postoperative complications in CRP group was 34.38%. Two patients experienced Clavien⁃Dindo I complications，while nine patients experienced Clavien⁃Dindo Ⅱ complications. Tewnty patients progressed to CRPC in the CRP group and 21 in the ADT group. The median time to CRPC was significantly longer among the CRP group（26 months）compared with the ADT group（19 months）. Multivariate analysis identified CRP as a significant predictor for delaying the progression to CRPC. There was no difference in CSS between the two groups. Conclusions CRP combined with ADT was effective in oligometastatic prostate cancer by delaying the progression to CRPC with few minor complications.

Objective To investigate the effects of different doses of dexmedetomidine on the loss of con⁃ sciousness ED95 caused by remimazolam and the stress response to tracheal intubation during induction of general anesthesia. Methods Eighty ⁃ seven patients under general anesthesia with tracheal intubation were selected and randomly assigned to the remimazolam group（group R），0.5 μg/kg dexmedetomidine combined with remimazolam group（group RD1）and 1.0 μg/kg dexmedetomidine combined with remimazolam group（group RD2）. The three groups were infused with saline，dexmedetomidine 0.5 μg/kg and 1.0 μg/kg，respectively，followed by the sequen⁃ tial pumping of remimazolam. The ED95 and 95% CI for loss of consciousness due to remimazolam were calculated. Results The ED95 and 95% CI for remimazolam were 0.250（0.234 ~ 0.397），0.199（0.190 ~ 0.258），and 0.184 （0.172 ~ 0.282）mg/kg in three groups respectively. Conclusion Preinfusion of dexmedetomidine 0.5 μg/kg and 1.0 μg/kg both reduced the ED95 of rimazolam⁃induced loss of consciousness in patients and attenuated intubation stress. However，application of dexmedetomidine 1.0 μg/kg had the risk of causing heart rate slowing.

Objective To investigate the correlation of matrix metalloproteinase ⁃ 9（MMP ⁃ 9）promoter gene⁃1562C/T mutation，MMP⁃9/TIMP⁃1 ratio and intraplaque neovessels（IPN）which were semi⁃quantitatively assessed by contrast⁃enhanced ultrasound（CEUS）. Methods A total of 180 subjects with carotid atherosclerotic plaques were selected and grouped according to IPN grading. The IPN grading was semi⁃quantitatively assessed by CEUS. The ELISA measure was utilized to examine serum MMP⁃9 and TIMP⁃1 levels. Gene sequence was detected by the Sanger measure. Correlation analysis and logistic regression were employed to analyze the effect of each parameter on IPN，and then receiver operating characteristic（ROC）curve was constructed. Results MMP⁃9 serum concentration，MMP⁃91562C/T mutation，MMP⁃9/TIMP⁃1 were positively correlated with IPN grading（r = 0.332， r =0.238，r = 0.683，P < 0.001）. Logistic regression indicated that the imbalance of MMP ⁃9/TIMP ⁃1 proportion was an independent risk factor for IPN（OR = 6.110，95%CI 1.097 ~ 34.033，P = 0.039）. If MMP⁃9/TIMP⁃1 ≥ 2.12，the area under ROC curve of IPN grading ≥ Ⅲ was 0.89，the sensitivity was 84.90% and the specificity was 85.10%. Conclusion The imbalance of MMP⁃9/TIMP⁃1 proportion may be an independent risk factor for IPN. The appropriate adjustment of IPN contrast ⁃ enhanced ultrasound visual grading combining with MMP ⁃ 9/TIMP ⁃1 was beneficial for identification of vulnerable plaques.

Objective To investigate the clinical application of LASEREO endoscopic system in laterally spreading tumor（LST）. Methods Patients who underwent blue laser imaging ⁃bright（BLI ⁃bright）mode，linked color imaging（LCI）mode and white light imaging（WLI）mode of LASEREO colonoscopy from May 2017 to December 2021 at Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine were retrospective analyzed. Among 76 patients，the male to female ratio was 45 to 31 with a median age of 72 years. Subjective visibility analy⁃ sis was performed by 6 endoscopists and divided into 2 groups（experts and trainees groups）with 3 endoscopists for each group.The main observation index was the visibility score（ranking score，RS）. The objective color difference （ΔE）between LST and surrounding mucosa in 3 modes were analyzed by using the L*a*b* color space. Results （1）The RS score of WLI，BLI⁃bright and LCI were（3.27 ± 0.48），（3.05 ± 0.59）and（3.42 ± 0.30），respectively. The RS score of LCI was significantly higher than BLI⁃bright（t = 5.286，P < 0.001）and WLI（t = 2.647，P = 0.010）， while BLI⁃bright was significantly lower than WLI（t = 2.289，P = 0.025）. When we compared between experts and trainees groups，there was no significant difference in experts group（F = 1.126，P = 0.326）；for trainees group， the RS score of LCI（3.32 ± 0.41）was significantly higher than BLI⁃bright（2.64 ± 0.85）（t = 6.19，P < 0.001）andWLI（3.01 ± 0.69）（t = 3.715，P < 0.001）（. 2）The color difference（ΔE）of WLI，BLI⁃bright and LCI were 16.8 ± 6.91，11.32 ± 3.17，and 27.21 ± 7.57，respectively. The color difference（ΔE）of LCI was significantly higher than BLI ⁃bright（t = 30.934，P < 0.001）and WLI（t = 61.411，P < 0.001），while BLI ⁃bright was significantly lower than WLI（t = 12.404，P < 0.001）. Moreover，the difference in brightness（ΔL），red⁃green components（Δa）and yellow⁃blue components（Δb）of LCI were all significantly higher than BLI⁃bright and WLI（P < 0.001），while BLI⁃ bright were all significantly lower than WLI（P < 0.05）. The color difference（ΔE）is mainly produced by red⁃green components（Δa）and yellow ⁃ blue components（Δb）in WLI and LCI，while produced by red ⁃ green components （Δa）in BLI⁃bright. Conclusion LCI mode of LASEREO endoscopic system can effectively improve LST visibility and color difference between LST and surrounding mucosa，LCI is more conducive to the detection of LST for the trainees，which is worthy of clinical application.

Objective To investigate the current status of depression in pregnant women，and analyze the influencing factors. Methods From June 2021 to March 2022，3，159 pregnant women who had been registered in the obstetric clinic of Southern Hospital of Southern Medical University were selected as subjects of the survey. The general information questionnaire and Edinburgh Postpartum Depression Scale were used to investigate，so was logistic regression to analyze the influencing factors of pregnancy depression. Results The incidence rate of depression during pregnancy was 15.07%. Unintended pregnancy（OR = 1.38，95%CI：1.05 ~ 1.81），history of progestational dysmenorrhea（OR = 1.28，95%CI：1.02 ~1.60），history of premenstrual tension before pregnancy （OR = 2.52，95%CI：1.82 ~ 3.49），dissatisfaction with sleep quality（OR = 2.12，95%CI：1.68 ~ 2.67），discord between mother⁃in⁃law and daughter⁃in⁃law（OR = 2.09，95%CI：1.54 ~ 2.85），introversion（OR = 6.36，95%CI： 4.54 ~ 8.92），moderate personality（OR = 1.34，95%CI：1.01 ~ 1.77），high expectations for the sex of the fetus （OR：2.82，95%CI：1.68 ~ 4.74），experienced negative life events during pregnancy（OR = 4.02，95%CI：2.53 ~ 6.40）were independent risk factors for depression in pregnant women. Conclusions The incidence of depres⁃ sion in pregnant women is higher，and it is affected by many factors. Medical institutions should pay more attention to depression in pregnancy. We suggest that screening depression in pregnancy should be included in routine ante⁃ natal examination and education on mental health care should be strengthened for pregnant women.

Objective This study aims to explore the effect of repetitive transcranial magnetic stimulation （rTMS）with different frequencies combined with Buyang Huanwu Decoction on the motor function of patients with stroke of qi deficiency and blood stasis type，trying to find an effective therapy for restoring the limb motor function of stroke patients. Methods A total of 120 patients with subacute stroke of qi deficiency and blood stasis type were enrolled and divided into Traditional Chinese Medicine（TCM）treatment group（n = 30），low frequency rTMS （1 Hz）+ high frequency rTMS（10 Hz）+ TCM treatment group（n = 30），high frequency（10 Hz）+ TCM treatment group（n = 30），and low frequency（1 Hz）+ TCM treatment group（n = 30）. The rehabilitation of limbs，clinical efficacy of rTMS combined with TCM，and the improvement of daily activities were observed and analyzed. The Fugl⁃Meyer Motor Rating Scale（FMA）was used to evaluate the limb motor function of the patients in the four groups before and after treatment，and the TCM efficacy of the four groups was compared. The ADL（Modified Barthel Index）was used to evaluate the improvement of daily activities before and after treatment. Results After treatment，the FMA value and Barthel index of the four groups were improved compared with those before treatment （all P < 0.01）. The effect of high frequency（10 Hz）+ low frequency（1 Hz）+ TCM treatment group was more significant compared with other groups（P < 0.01）. Conclusion rTMS combined with TCM with different frequen⁃ cies can improve moderate⁃severe motor function after stroke. High frequency（10 Hz）+ low frequency（1 Hz） rTMS changes the previous simple high frequency or low frequency mode to adjust the imbalance between the two hemispheres through the dual mode of action. Combined with Buyang Huanwu decoction，it is a new painless and non⁃invasive rehabilitation therapy for stroke patients and it can improve their motor function and daily life. It is of value for clinical application.

Vascular dementia（VaD）is the second most common forms of dementia，which has a serious impact on the daily life of patients and their families. Therefore，it is urgent to improve the cognitive function of patients with VaD. However，there is no specific treatment for the disease. Edaravone dexboeol，as a novel neuro⁃ protective agent，may play a role in the protection of neurons through a variety of mechanism. Its cerebral protec⁃ tive effect has been confirmed by clinical researches at home and abroad. This paper reviews the possible mecha⁃ nism of edaravone dexboeol on the treatment of VaD.

Cardiac surgery can cause significant alterations in hemodynamics and physiology upon the human body，leading to pathophysiological changes in the patients. Postoperative pulmonary complications have a higher morbidity and mortality in the cardiac surgical population，being a leading cause of prolonged hospital stay and repeated ICU stay. This condition has increased consumption of medical resources and financial burden to health care systems. Due to the postoperative nursing for these patients，a physician needs to understand the changes in the cardiopulmonary system and promptly and effectively provides early prevention and treatment for possible complications. In this review，we highlight the prevalence，risk factors，clinical characteristics，and management of the postoperative pulmonary complications after cardiac surgery.

Avatrombopag（Doptelet®）is an orally administered second generation thrombopoietin recep⁃ tor agonists（TPO⁃RA）approved for the treatment of primary chronic immune thrombocytopenia（CITP）in adult patients who are refractory or have an unsatisfactory response to other treatments，as well as for the treatment of thrombocytopenia in adult patients with chronic liver disease（CLD）scheduled to undergo an invasive procedure and granted Orphan Drug Designation for the treatment of chemotherapy⁃induced thrombocytopenia（CIT）. The data of phase Ⅲ studies indicate that avatrombopag is safe and generally well tolerated in three indications. At present， the research is underway on the efficacy and safety of avatrombopag for the treatment of thrombocytopenia in aplastic anemia（AA）and hemapoietic stem cell transplantation（HSCT）. The clinical application of avatrombopag is reviewed in this article.