Most patients with stage Ⅲ NSCLC are not suitable for surgery because of tumor extension or comorbidities. The absence of loco⁃regional control，predominantly observed within the primary lesion，remains a major cause of treatment failure after radiotherapy for locally unresectable advanced NSCLC. For patients with NSCLC，the tumor control rate increases with the biological effect dose（BED）delivered to the primary tumor. Patients receiving 30 Gy in a single fraction（120 Gy BED）have a local control（LC）rate of 98%. Another dose⁃ response analysis showed that favorable outcomes plateaued around 120 Gy BED. High⁃dose⁃rate（HDR）brachy⁃ therapy can deliver high radiation doses in a single fraction to the target tumor. The dose falls rapidly，maintaining a virtually low dose irradiated to OARs. Moreover，HDR brachytherapy inhibits the accelerated re⁃proliferation oftumor cells，leads to lethal tumor cell damage，and eradicates target deviation attributed to organ movement or setup uncertainties，consequently avoiding unnecessary irradiation to OARs. In the current era of immunotherapy，thoracic radiation has become even more important for ensuring long⁃term survival in patients with NSCLC. Combination of HDR brachytherapy with immunotherapy may lead to better survival. We observed favorable clinical survival and low rates of acute and late toxicities，providing a new treatment strategy for locally advanced NSCLC.

Lung cancer remains one of the most deadly malignant tumors，with a high morbidity and mor⁃ tality rate. The interrelationship between human microbiota and lung cancer has become a hot spot for research with the development of next⁃generation sequencing technology. There is increasing evidence that microbiota are associ⁃ ated with the development of malignant tumors，including lung cancer，but their interaction mechanisms are still unknown. This paper reviews studies on microbiota and lung cancer in humans，including the oral cavity，intes⁃ tine，lung，with the goal of providing new ideas for the clinical diagnosis and treatment of lung cancer，as well as an outlook on the future research direction of human microbiota and lung cancer.

Lung cancer is one of the malignancies with the highest incidence and mortality among all cancers worldwide，but still no effective treatment is available. Chimeric antigen receptor gene modified⁃T（CAR⁃T） cells，a novel adoptive immunotherapy strategy，not only have been used successfully against hematological tumors， but also have opened up new approach for immunotherapy of solid tumors，including lung cancer. However，CAR⁃ T cell immunotherapy still has challenges and obstacles in the treatment of lung cancer due to the heterogeneity of solid tumors，tumor microenvironment immunosuppression，tumor target antigen escape，and off ⁃target toxicity， etc. In this review，we summarized the latest research progress on CAR⁃T cell immunotherapy for lung cancer， including CAR ⁃T cell biological characteristics，targets selection，early clinical research，therapeutic adverse effects，and proposed optimization strategies for CAR⁃T cell immunotherapy in lung cancer，aiming to provide new ideas for clinical immunotherapy for lung cancer.

Large cell lung carcinoma（LCLC）is an undifferentiated non⁃small cell lung cancer that lacks the morphological and immunological markers of adenocarcinoma，squamous cell carcinoma，and small cell carci⁃ noma. LCLC has a low incidence and poor prognosis. The incidence of LCLC is less than 1% of lung cancer surgical specimens. Systemic comprehensive treatment is the main treatment. This article reviews the research progress in the pathological diagnosis and treatment of LCLC in recent years，aiming to provide a reference for further research and treatment.

Objective Lung cancer has become one of the main causes of cancer death. Currently，the therapeutic effect of various kinds of lung cancer is limited. It is urgent to continue exploring potential therapeutic targets for lung cancer. This study is to investigate the function and mechanism of ADGRD1 in non⁃small cell lung cancer（NSCLC）. Methods Analyzing the expression level of ADGRD1 in NSCLC tissues through The Cancer Genome Atlas（TCGA）database，and the relationship between ADGRD1 expression and the prognosis of NSCLC patients. Quantitative polymerase chain reaction（qPCR）was used to detect the expression of ADGRD1 in lung cancer and its adjacent normal tissues. After ADGRD1 overexpression or knockdown in different lung cancer Cell lines，CCK⁃8（Cell Counting Kit⁃8）and cell clone formation assay were used to observe the effect of ADGRD1 on the proliferation of NSCLC cells. Meanwhile，cell migration assay was used to observe the effect of ADGRD1 on the migration of NSCLC cells. The downstream pathway was detected by western blot to explore the potential mecha⁃ nism of ADGRD1. Results TCGA database analysis found that the expression of ADGRD1 in lung cancer tissues was significantly lower than that in adjacent normal tissues（P < 0.05），and decreased ADGRD1 expression was associated with poor prognosis（P < 0.01）. The results of qPCR detection of 20 clinical samples showed that the ADGRD1 mRNA level decreased in lung tumor compared with its adjacent normal tissues（0.56 ± 0.16 vs. 1.00 ± 0.22，P < 0.01）. ADGRD1 Overexpression in A549 and H1299 cells significantly inhibited cell proliferation（P < 0.001）and migration（P < 0.01），while knockdown of ADGRD1 in H1975 cells significantly promoted cell prolif⁃eration（P < 0.01）and migration（P < 0.001）. The study of functional mechanism shows that ADGRD1 may be closely related to the proliferation and metastasis of lung cancer cells through the AKT⁃mTOR pathway. Conclusions ADGRD1 significantly inhibits the proliferation and metastasis of NSCLC，which may be a novel prognostic diagnostic and therapeutic target of NSCLC.

Objective To investigate the impacts of LncRNA SNHG15 on cisplatin（DDP）sensitivity and epithelial⁃mesenchymal transition of non⁃small cell lung cancer（NSCLC）cells and the role of miR⁃483⁃3p/DNA damage⁃induced transcript 4（DDIT4）axis. Methods NSCLC cells（A549）and NSCLC drug⁃resistant cells（A549/ DDP）were cultured in vitro，the IC50 of the two cells to DDP and the mRNA and protein expression of LncRNA SN⁃ HG15，miR⁃483⁃3p and DDIT4 in the two cells were detected.A549/DDP cells were randomly divided into A549/ DDP group，si NC group，si SNHG15 group，si SNHG15+inhibitor NC group，si SNHG15+miR⁃483⁃3p inhibitor group，si SNHG15+miR⁃483⁃3p inhibitor+si NC group，and si SNHG15+miR⁃483⁃3p inhibitor+si DDIT4 group. Western blot was used to detect the changes of E⁃cad，N⁃cad and DDIT4 protein expression in each group anddual⁃ luciferase reporter assay was used to verify the targeting relationship of miR ⁃ 483⁃3p with LncRNA SNHG15 and DDIT4. Results Compared with A549 cells，the IC50，LncRNA SNHG15，DDIT4 mRNA and protein of DDP in A549/DDP cells increased，and the miR⁃483⁃3p level decreased（P < 0.05）. In A549/DDP group，intercellular adhesion was significantly destroyed. The cells of si SNHG15 group and si SNHG15 + miR ⁃ 483 ⁃ 3p inhibitor + si DDIT4 group were relatively closely arranged，showing epithelial characteristics. The cells in the si SNHG15+miR⁃ 483⁃3p inhibitor group were loosely arranged and diffused as compared with the si SNHG15 group. Compared with A549/DDP group，the inhibition rate of A549/DDP cell proliferation and the expression of E ⁃ cad in si SNHG15group increased，while the number of invasive cells，the number of migrating cells，the expression of N⁃cad and DDIT4 decreased（P < 0.05）. Compared with the si SNHG15 group，the proliferation inhibition rate and E ⁃cad expression of A549/DDP cells in the si SNHG15+miR⁃483⁃3p inhibitor group decreased，and the number of invasive cells，the number of migrating cells，N⁃cad and DDIT4 expression increased（P < 0.05）. Conclusion Silencing the expression of SNHG15 in A549/DDP cells can inhibit the proliferation，invasion，migration and EMT of A549/ DDP cells，and reduce the drug resistance of A549/DDP cells to DDP by regulating miR⁃483⁃3p/DDIT4.

Objective Collect case data of patients with small cell carcinoma，including Sex，age， ethnicity，tumor primary site，stage，and survival time，compare and analyze the differences in case characteristics and survival outcomes betweenSCLC andEPSCC to better understand the basic clinical features of thetwo groups. Methods SEER stat software was used to extract SEER database of 112415 cases of small cell carcinoma from 1975 to 2016，including sex，age，ethnicity，tumor primary site，Staging and survival time.Categorical variables are described by n（%），Chi ⁃ square test analyzes the correlation between categorical variables. The Kaplan ⁃ Meier method calculated 5⁃year survival and median survival. Univariate and multivariate COX regression analysis affects factors related to survival. Results A total of112415 patients with small cell carcinoma were collected，including 107165（95.3%）in the lung and 5250（4.7%）in the extrapulmonary area. Among the EPSCC，the primary ones in the urinary system and digestive system accounted for the largest proportion，accounting for 1.5% and 1.4%. Survival analysis showed that the 5⁃year survival rate of EPSCC was much higher than SCLC（P < 0.001），Among EPSCC， the 5 ⁃ year survival rate of head and neck small cell carcinoma was the highest，reaching 28.6% ；followed by uterusandovaries with 27%and 26%；respectively，and the lowest in pancreas，appendix and liver at only 4.3%，0% and 0%. COX multivariate regression analysis showed that sex，age，ethnicity，primary site of tumor and whether surgery and/or chemoradiotherapy were all important factors of survival（P < 0.05）. Conclusion The number ofpatients with SCLC was much higher than that of patients with EPSCC（95.3% vs 4.7%），but SCLC had a lower 5⁃ year survival rate than EPSCC（5.4% vs 17.1%）. In patients with EPSCC，small cell carcinoma primary in the head and neck had the highest 5⁃year survival rate（28.6%），while 5⁃year survival was lowest for the liver and appendix （0%），even lower than SCLC（5.4%）.

Objective This study aimed to investigate the efficacy and safety of anlotinib plus PD ⁃ 1 blockades in patients with advanced non⁃small cell lung cancer（NSCLC）previously treated with immunotherapy. Methods A total of 52 patients with advanced NSCLC previously treated with immunotherapy who had received anlotinib plus PD⁃1 blockades were included in this study. Anlotinib was administered with the conventional usage and dosage，and PD⁃1 blockades were available in China，including sintilimab，camrelizumab and pembrolizumab. The data on the efficacy and safety were retrospectively collected during treatment with anlotinib plus PD⁃1 block⁃ ades and all the patients were followed up regularly to assess the long⁃term survival. Results The best overall response suggested that 12 of the advanced NSCLC patients with previous immunotherapy who received anlotinib plus PD⁃1 blockades achieved partial response，32 were stable，and 8 were progressive，revealing an objective response rate of 23.1%（95%CI：12.5% ~ 36.8%）and a disease control rate of 84.6%（95%CI：71.9% ~ 93.1%）. The median progress⁃free survival（PFS）was 6.3 months（95%CI：2.64 ~ 9.96），the median overall survival（OS） was 16.6 months（95%CI：8.08 ~ 25.12）. 10 patients intolerant to the previous immune⁃related regimens obtained a relatively better prognosis when they received this regimen（median OS：23.4 months vs. 11.5 months，P = 0.034）. Safety profile suggested that the overall adverse reactions related to anlotinib combined with PD⁃ 1 blockades were safe and controllable. Conclusions Anlotinib plus PD ⁃1 blockades demonstrated potential efficacy and tolerabletoxicity among the advanced NSCLC patients previously treated with immunotherapy. Those intolerant to the previ⁃ ous immune⁃related regimens might benefit from this regimen. The finding of this paper need to be further verified via large sample studies. 

Objective To study the effect of short⁃duration mechanical ventilation on the function of the dia⁃ phragm in rats with different degrees of sepsis. Methods Experimental groups included SHAM group，CLP50% group，CLP50%+MV6h group，CLP75% group and CLP75%+MV6h group. Biological signal acquisition system was used to detect diaphragm contraction force and compound muscle action potential（CMAP）；HE staining was used to observe muscle fiber cross⁃sectional area（CSA）；TUNEL method was adopted to detect apoptosis；ELISA was used to detect serum inflammatory factors；the expression of muscle atrophy⁃related proteins was detected by Western blot. Results In the CLP50%+MV6h group，compared with the CLP50% group，diaphragm contractility was decreased， and serum IL ⁃6 levels and atrophy ⁃ related protein levels were increased. In the CLP75%+MV6h group，compared with the CLP75% group，CMAP amplitude was decreased and duration was prolonged；contractility was decreased， CSA was reduced，inflammatory factor levels were increased，and atrophy⁃related protein levels were increased. Com⁃ pared with the CLP50%+MV6h group，the CLP75%+MV6h group showed decreased CMAP amplitude and increased duration，decreased contractility，decreased CSA，increased inflammatory factor levels and atrophy ⁃ related protein expression，and increased apoptotic index. Conclusion In septic rats，a short⁃term of mechanical ventilation could exacerbate diaphragmatic dysfunction，which became more pronounced as the degree of sepsis increased.

Objective To investigate the effect of ITGB6 gene knockout on the biological behavior of human HT⁃29 colon cancer cells. Methods We constructed the ITGB6 knock⁃out HT⁃29 cells by CRISPR/Cas9 technolo⁃ gy（ITGB6⁃KO），which were defined as the knockout group. Meanwhile，the blank transfected cells were defined as the control group. Western blotting was used to detect the expression of ITGB6 in HT⁃29 cells. MTT assay，Plate colony formation assay and Transwell assay were used to detect the effects of ITGB6 knockout on the ability of proliferation，colony formation and invasion of HT⁃29 cells. Results Western blotting and DNA sequencing showed that CRISPR/Cas9 technology could effectively knock out ITGB6 gene. MTT assay，Plate colony formation assay and Transwell assay confirmed that knocking out ITGB6 gene could significantly inhibit the proliferative ability， colony formation ability and invasive ability of HT ⁃ 29 cells（P < 0.01）. Conclusion CRISPR/Cas9 technology can effectively establish a ITGB6 knock⁃out HT⁃29 cell line. After knocking out ITGB6 gene，the malignant biologi⁃ cal behavior of HT⁃29 cells is inhibited，therefore ITGB6 gene is expected to become a potential target for the treat⁃ ment of colon cancer.

Objective To compare the effects of injection needle scalpel，small needle scalpel and sodi⁃ um hyaluronate intraarticular injection in the treatment of knee osteoarthritis（KOA）. Methods One hundred and fifty⁃six patients with KOA were randomly divided into three groups in equal number：groups A，B and C（n = 52）， treated with small needle knife treatment，intraluminal injection of sodium hyaluronate and injection needle scalpel once a week for three consecutive times，respectively. The Visual Analogue Scale（VAS）and Lysholm Knee Scale （LKS）were used for the evaluation at the time points：before operation，3 days，10 days，20 days，1 month，3 months and 6 months after operation. The knee joint range of motion（ROM）was measured before treatment and 1 month after treatment. The curative effect was evaluated 1 month after treatment. Results （1）The VAS pain scores in group C were significantly lower than those in groups A and B（both P < 0.001）. The LKS score in group C was significantly higher than that of groups A and B（both P < 0.001）. The range of motion of knee joint in group C was greater than that of groups A and B（both P < 0.001）. The curative effect of group C was better than that of group A（P = 0.011）and group B（P = 0.009）. The total effective rate of group C was higher than that of group A （P = 0.006）and group B（P = 0.013）.（2）At days 3，10，20，and 1 month after treatment，the VAS score of group B was lower than that of group A（P < 0.001）；The LKS score in group B was higher than that in group A （P < 0.001，< 0.001，< 0.001，= 0.005 for different time points）. Three months after treatment，there was no significant difference in VAS score and LKS score between group A and group B（P = 0.302，P = 0.469）. Six months after treatment，the VAS scores in group A were lower than those in group B（both P < 0.001）. The LKS score of group A was higher than that of group B（P < 0.001）. The total effective rate of group A was higher than that of group B（χ2 = 8.409，P = 0.015）. Conclusion Injection needle scalpel is better than small needle scalpeland sodium hyaluronate intraluminal injection in treating KOA patients at the early and medium stage. The total effectiveness rate of small needle scalpel is higher than that of sodium hyaluronate intraluminal injection. Sodium hyaluronate intraluminal injection takes effect faster than small needle scalpel does. The efficacy of small needle scalpel lasts longer than sodium hyaluronate intraluminal injection does.

Objective To construct a risk prediction model of nerve injury after thoracolumbar burst fracture in the elderly based on nomogram. Methods 169 patients with thoracolumbar burst fractures treated in hospital from January 2020 to January 2022 were selected as the research object. According to the occurrence of nerve injury，they were divided into nerve injury group（n = 54）and non⁃nerve injury group（n = 115）. The vari⁃ ables with statistical differences were screened by univariate analysis for multivariate logistic regression analysis， and the nomogram prediction model was established. Results Univariate analysis showed that there were significant differences between the two groups in age，injured segment T12/L1，intraspinal space occupying and posterior liga⁃ ment complex injury（P < 0.05）. Multivariate logistic regression showed that age ≥ 70 years old（OR = 2.684，P = 0.010），injured segment T12/L1（OR = 2.173，P = 0.042），intraspinal space occupying（OR = 2.595，P = 0.010） and posterior ligament complex injury（OR = 3.416，P = 3.416）were independent risk factors for nerve injury after thoracolumbar burst fracture in the elderly（P < 0.05）. Based on this，a nomogram model for predicting the risk of nerve injury after thoracolumbar burst fracture in the elderly was established. The model verification results showed that the C⁃index was 0.773，the correction curve was close to the ideal curve，and the area under the ROC curve（AUC）was 0.755（95%CI：0.715 ~ 0.794）. Within the range of 8% ~ 82%，the nomogram model had a net benefit. Conclusion Age ≥ 70 years old，injured segment T12/L1，intraspinal space occupying and posterior ligament complex injury will increase the risk of nerve injury after thoracolumbar burst fracture in the elderly. The nomogram model can effectively predict the risk probability of nerve injury after thoracolumbar burst fracture amongst the elderly.

Objective To study the five EB virus antibody profiles in normal physical examination people and nasopharyngeal carcinoma（NPC）patients in Guangzhou，we try to establish a simple，efficient and practical serological screening method，which is suitable for NPC screening in the region. Methods A total of 204 serum samples of the patients with NPC were collected. A total of 2，829 healthy people′s serum samples were collected in Guangzhou cadre Health Management center from December 2019 to November 2020，and the male ⁃female ratio was close to 3∶1. The antibody profiles and the differences of five kinds of EB virus antibody expression between two groups were analyzed，a predictive model for NPC by serological indicators was established through Logistic regression analysis. Results The optimal cut⁃off values of VCA/IgA，NA1/IgA，Rta/IgG，EA/IgA and EA/IgG for the diagnosis of NPC were 1.19，0.31，0.33，0.62 and 0.83，respectively. The AUC was 0.948，0.916，0.951， 0.873 and 0.942，respectively. There was no significant difference in the positive rates of five antibodies between the disease group and the control group（P > 0.05）. The predictive coincidence rates of the two combined predictive models for NPC were 96.5% and 96.2% respectively，and the negative predictive values of both models were greater than 98%. Conclusion The combined detection model of VCA/IgA + NA1/IgA and NA1/IgA + Rta/IgG have good sensitivity and specificity in predicting NPC all. The accuracy of the prediction model in determining non⁃nasopha⁃ ryngeal carcinoma in physical examination population in this area is more than 98.8 %.

Objective To explore the curative effect of high flow humidified oxygen delivery device combined with glutathione（GSH）on patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）and its influences on levels of serum inflammatory factors. Methods A total of 128 patients with AECOPD admitted to the hospital from April 2021 to May 2022 were enrolled as the research objects. They were randomly divided into control group treated with high flow humidified oxygen delivery device and observation group treated with high flow humidified oxygen delivery device and GSH，with 64 cases in each group. Bothgroups were continuously treated for 2 weeks. The clinical curative effect in both groups was evaluated. Before and after treat⁃ ment，changes in levels of serum inflammatory factors［serum cystatin C（CysC），C⁃reactive protein（CRP），pro⁃ calcitonin（PCT），matrix metalloproteinase（MMP）⁃9］，oxidative stress indexes［superoxide dismutase（SOD）， glutathione peroxidase（GSH ⁃ PX），malondialdehyde（MDA），catalase（CAT）］，pulmonary function indexes ［peak expiratory flow（PEF），forced expiratory volume in 1s（FEV1），FEV1/forced vital capacity（FVC）］and blood gas indexes［pH，partial pressure of carbon dioxide（PaCO2），arterial partial pressure of oxygen（PaO2）］ were compared. The incidence of adverse events was recorded. Results The total clinical response rate in the observation group was significantly higher than that in the control group（96.88% vs. 87.50%，P < 0.05）. Levels ofPCT，CysC，CRP and MMP ⁃ 9 in both groups were decreased，which were especially lower in the observation group（P < 0.05）. Levels of SOD，GSH⁃PX，CAT，PEF，FEV1 and FEV1/FVC in the observation group were higher than those in the control group，while MDA was lower than that in the control group（P < 0.05）. pH and PaO2 in the observation group were higher than those in the control group，while PaCO2 was lower than that in control group （P < 0.05）. There was no significant difference in the incidence of adverse events between the two groups（3.12% vs. 4.69%，P > 0.05）. Conclusion Curative effect of high flow humidified oxygen delivery device combined with GSH is good for AECOPD patients，which is conducive to relieving inflammation and stress response，improving pulmonary function and arterial blood gas.

Objective To evaluate the efficacy of combination therapy of mindfulness⁃based cognitive thera⁃ py（MBCT）and duloxetinein patients with somatoform disorder. Methods This was an 8⁃weeks randomized control study. Totally 80 patients with somatoform disorder who met the criteria for inclusion were recruited. All patients were randomly assigned to one of two groups：MBCT and Duloxetine treatment（n = 38）or Duloxetine control（n = 42）. The Five Facet Mindfulness Questionaire（FFMQ）and Hamilton Anxiety Scale（HAMA）were administered to evalu⁃ ate the improvement effect of mindfulness skills and anxiety symptoms. Results ANOVA for repeated measurement results showed that the mindfulness skills of the combined treatment group were significantly improved，and the dif⁃ ferences were statistically significant（F = 96.462，P < 0.001）. In the combined treatment group，the mindfulness skills of the higher education group were improved more than those of the lower education group，and the differences were statistically significant（F = 34.485，P < 0.001）. The scores of each dimension of FFMQ in the combined treat⁃ ment group were significantly improved with the extension of time，and the differences were statistically significant. In terms of efficacy，anxiety was relieved earlier in the combined treatment group. Conclusion MBCT combined with duloxetine can significantly improve mindfulness skills and anxiety symptoms.

Objective To explore the application value of 3D ⁃ printing（3DP）customized steel plate combined with proximal femoral nail antirotation（PFNA）for intertrochanteric fracture of femur（IFF）with commi⁃ nuted lateral wall. Methods A total of 108 patients with IFF with comminuted lateral wall who had been treated in our hospital from October 2018 to March 2021 were selected as research subjects. According to different treatment plans，they were divided into PFNA group（n = 52）and Unite group（n = 56）. The general data，surgical indica⁃ tors，Harris score，inflammatory factors，postoperative complications，and degree of satisfaction were compared and analyzed between the two groups. The random walk model was used to evaluate the improvement in surgical indicators，postoperative hip function and inflammatory factors in both groups. Results As compared with PFNA group，Unite group had shorter fracture healing and ambulation time（P < 0.05）. As compared with PFNA group， unite group had higher scores on pain，function，deformity，and joint range of motion and greater Harris total score 12 months after surgery（P < 0.05），and lower levels of tumor necrosis factor⁃α（TNF⁃α），interleukin⁃6（IL⁃6） and interleukin⁃1（IL⁃1）one month after surgery（P < 0.05）. The evaluation results of random walk model showed that the improvement in surgical indexes，postoperative hip function and inflammatory factors was significantly better in Unite group than in PFNA group. As compared with PFNA group，Unite group had a lower incidence of 12⁃month postoperative complications（P < 0.05）and higher degree of satisfaction（P < 0.05）. Conclusions For IFF patients with comminuted lateral wall，the improvement in surgical indicators，postoperative hip function and inflammatory factors was significantly better in Unite group than in PFNA group，and the incidence of 12⁃month postoperative complications was lower and the degree of satisfaction was higher.

Objective To compare the outcomes of direct singleton pregnancy and singleton pregnancy after reduction of multiple pregnancies with assisted reproductive techniques. Methods Retrospective analysis was done to the data of 300 patients who received assisted reproduction and achieved successful pregnancy in our hospital from January 2013 to December 2020. Among them，109 cases with singleton pregnancy were assigned as group A，91 cases with singleton pregnancy by reduction of multiple pregnancies as group B1 and another 100 with singleton pregnancy for natural fetal loss of multiple pregnancies as group B2. The three groups were compared in terms of complications and neonatal weight. Results The rate of pregnancy complications in group B1（97.8%） was higher than that in group B2（90%）and significantly higher than in group A（P < 0.05）. Pregnancy hyperten⁃ sion in group B1（28.6%）was significantly higher than that in group A（P < 0.05）. The incidences of premature rupture of membranes in the B1 and B2 groups（36.3% and 30%）were both significantly higher than that in group A（P < 0.05）. There were statistical differences in the incidence of anaemia among the three groups（P < 0.05）. The rate of preterm birth in group B was significantly higher than in group A（P < 0.05）. The rate of low weight （14.3%）in group B1 was significantly higher than that in group A and group B2（P < 0.05）. The rate of maternal and infant complications in B1 group at deduction of pregnancy < 8 weeks was significantly higher than in group B2 （P < 0.05）and the rate of preterm birth in B2 group was higher than in B1 group at reduction of pregnancy ≥ 8 weeks（P < 0.05）. Conclusion The rates of pregnancy complications，preterm birth and low neonatal weight among those with singleton pregnancy from reduction of multiple pregnancies are all higher than those among those with initial singleton pregnancy，and therefore prenatal examination should be emphasized after reduction. The rate of maternal and infant complications in those with reduction is higher than that in those for natural fetus loss，and therefore the reduction of multiple pregnancy is suggested between 8 and 12 weeks of gestation. Single embryo trans⁃ fer is recommended for older women undergoing initial assisted reproduction.

Objective To observe the difference of bleeding risk in coronary heart disease（CHD）patients using different anticoagulants during percutaneous coronary intervention （PCI）and its influence on the CMBs. Methods Seventy⁃eight patients with PCI admitted to the emergency department of Hebei Petro China Central Hos⁃ pital from September 2019 to October 2020 were selected and they were divided into heparin group and bivalirudin group according to the anticoagulants used. Susceptibility weighted imaging（SWI）was performed 72 hours after operation. The bleeding site and volume of patients within 2 weeks after operation were collected，and the differences of CMBs，and bleeding events were compared between the two groups；The CMBs of PCI patients before and after the second operation were compared. The patients in heparin group were divided into two sub⁃groups of bleeding group and non⁃bleeding group，and the changes of CMBs in bleeding group were analyzed. Logistic regression analysis was used to analyze the risk factors of bleeding in PCI patients and the impact on the number changes of CMBs. Results （1）The number of CMBs and bleeding rate in heparin group were significantly higher than those in bivalirudin group （P < 0.05）.（2）The CMBs after the second operation were higher than those before the second operation，and the difference was statistically significant（P < 0.05）.（3）Cr，Glu，AA，heparin and CMBs of the bleeding group were higher than those of the non⁃bleeding group（P < 0.05）.（4）Heparin volume and CMBs were independent risk factors for bleeding in PCI patients. Conclusion The stronger the anticoagulant effect and the more action targets， the greater the impact on CMBs. The number of CMBs is significant for predicting the bleeding after PCI.

Objective To application value of fully automatic three⁃dimensional ultrasound right ventricu⁃ lar quantitative software（3DAutoRV）technology in the evaluation of right ventricular systolic function in patients with systemic lupus erythematosus（SLE）. Methods The patients diagnosed with SLE in our hospital from October 2020 to June 2022 were selected. 87 patients were divided into several groups，while 29 healthy people were re⁃ cruited as a control group（group D）. Age，sex，heart rate，body mass index（BMI），and blood pressure were re⁃ corded in all the study subjects. Tricuspid annular displacement（TAPSE），tricuspid annular systolic velocity（S′）， right ventricular area change rate（RVFAC），right ventricular end ⁃diastolic transverse diameter（RVED），right ventricular anterior wall thickness（RVAW）were detected by routine ultrasound examination. 3DAutoRV software obtained right ventricular end⁃diastolic volume（RVEDV），right ventricular end⁃systolic volume（RVESV），right ventricular stroke volume（RVSV），and right ventricular ejection fraction（RVEF），right ventricular basal seg⁃ ment transverse diameter（RVD1），right ventricular median transverse diameter（RVD2），right ventricular length diameter（RVD3），right ventricular free wall longitudinal strain RVLS（SEP），and right ventricular septal longitu⁃dinal strain RVLS（SLS）. Results As compared with SLE patients，there were no significant differences in age， systolic blood pressure，diastolic blood pressure and body mass index in the control group（P > 0.05 for all compar⁃ isons），while heart rate was significantly increased in the group with severe pulmonary hypertension as compared with other groups，and the difference was statistically significant（P < 0.05 for all comparisons）. As compared with the control group，SLE patients had a mild reduction in SLS、RVEF、FWLS and ESV increased. In the moderate likelihood group，TAPSE，FAC，SLS，FWLS，RVEF，and S′ were all reduced，but ESV，EDV increased. TAPSE，FAC，SLS，FWLS，RVEF，and S′ were reduced while ESV，EDV increased in the severe possible group. As compared with the mild possible group，TAPSE，FAC，SLS，FWLS，and RVEF decreased whereas ESV，EDV increased in the moderate possible group，while the difference between S′ was not statistically significant. As compared with the moderate possible group，TAPSE，FAC，S′ ，SLS，FWLS，RVSV and RVEF decreased in the severe possible group，but EDV and ESV increased. The best cut⁃off value of FWLS for predicting SLE⁃PAH was -23.32（AUC = 0.90，P < 0.001）. The consistency test and repeatability analysis showed good repeatability in RVEF and FWLS. Conclusions 3D Auto RV software can provide support for evaluating right ventricular systolic function in SLE patients.

Objective To observe the effect of auricular acupoint pressing beans combined with transcuta⁃ neous acupoint electrical stimulation（TAES）for preventing postoperative nausea and vomiting（PONV）after radi⁃ cal mastectomy. Methods A total of 120 female patients undergoing radical mastectomy under general anesthesia were randomly assigned to four groups：control group（group A），auricular acupoint pressing beansauricular acu⁃ point pressing beans group（group B），TAES group（group C），auricular acupoint pressing beans combined with TAES（group D）. The concentration of plasma 5⁃hydroxytryptamine（5⁃HT），motilin（MTL）and gastrin（GAS）were measured by enzyme⁃linked immunosorbent assay（ELISA）before，12 hours and 24 hours after operation. The inci⁃ dence of PONV 30 minutes，6 hours，12 hours，and 24 hours after operation were recorded. Results Compared with group A，the incidence of PONV 6 h，12 h and 24 h after operation significantly reduced in group C and D（P < 0.05）. Compared with group A，MTL and GAS were elevated in groups B，C and D at 12 h and 24 h after opera⁃ tion（P < 0.05）and the concentration of 5⁃HT 12 and 24 hours after operation was significantly decreased in group C and D（P < 0. 05）. Conclusion Auricular acupoint pressing beans combined with TAES after radical mastecto⁃ my could prevent PONV effectively，regulate gastrointestinal hormones，and reduce the concentration of plasma 5⁃HT without obvious side effects. It is a safe and effective non⁃pharmacological therapy that can be promoted. 

Androgenetic alopecia and alopecia areata are common types of alopecia in clinic. In recent years，laser technology has been developed rapidly，of which the parameter setting and safety of fractional laser therapy for alopecia has attracted more and more attention. Current clinical trials have achieved certain results. Fractional laser can not only change the microenvironment of skin tissue，activate hair follicle stem cells，promote hair growth，but also open the skin barrier and accelerate the absorption of topical drugs. Thus，fractional laser therapy has a promising prospect in non⁃surgical treatment of alopecia. This article reviews the classification，prin⁃ ciple，clinical application and related adverse reactions of fractional laser in the treatment of androgenetic alopecia and alopecia areata.