Alzheimer′s disease（AD）is a neurodegenerative disease in the central nerve system with insid⁃ ious onset and progressive memory loss，cognitive decline，psychotic and behavioral changes. AD has been mainly considered as a grey matter disorder. Nevertheless，recent evidence suggests that myelin impairment may play an important role in AD pathology. It has also been found that myelin pathology may even precede Aβ and tau patholo⁃ gies. We summarized the evidence of white matter abnormalities from pathology and imaging studies，the role of my⁃ elin in cognition and possible mechanism of myelin damage in AD. Myelin damage combined withother pathological injury contributes to the process of AD. Many factors，such as aging，gene，Aβ⁃mediated toxicity and tau，isch⁃ emic injury also cause myelin breakdown. Therefore，elucidating the exact mechanisms leading to the disruption of myelin in AD may help a better understanding of AD，and thereby its prevention and treatment. 

Objective To investigate the effects of neural stem cell⁃derived exosomes（NSC⁃Exos）on TGF⁃ β1 signal transduction and inflammatory factors in astrocytes during cerebral ischemia ⁃ reperfusion injury in rats. Methods 40 SD rats were randomly divided into Sham group，MCAO group，PBS group and NSC ⁃Exos group. The rat model of MCAO was established. NSC⁃Exos was injected into right lateral ventricle. After 3 days，the neural deficit score was performed，and the brain was taken for relative infarct volume determined，histopathology and expression detection of IL⁃6，IL⁃1β，and TGF⁃β1 protein respectively. The colocalization of MAP⁃2 and exosome⁃ labeled probe PKH26 was detected. Results NSC ⁃Exos intervention could reduce the neurological deficit score and cerebral infarction volume（P < 0.05），increase the number of neurons，reduce the expression rate of GFAP positive cells and neuronal apoptosis index（P < 0.05），and decrease the expression of protein IL⁃6 and IL⁃1β. TGF⁃ β1 expression was increased（P < 0.05）. PKH26 and MAP ⁃2 positive cells were colocalized in CA3 region of hippocampus. Conclusions NSC⁃Exos may inhibit TGF⁃β1 signaling in astrocytes and repair brain injury by reducing astrogliosis and expression of inflammatory factors while enhancing the expression of TGF⁃β1. 

Objective To investigate the efficacy and mechanism of injectable conductive hydrogel Polypyrrole⁃Chitosan（PPY⁃CHI）on long⁃term improvement of cardiac function after chronic myocardial infarction. Methods PPY⁃CHI，a conductive complex，was synthesized by coupling Polypyrrole to a Chitosan（CHI）back⁃ bone. A rat chronic myocardial infarction model was constructed in vivo，post⁃infarction SD female rats were ran⁃ domly divided into three groups（PPY⁃CHI，CHI and Saline groups，n = 5）. PPY⁃CHI was implanted in and around the infarct area four weeks later. Long⁃term improvement in cardiac function was assessed by ultrasound，Masson staining，immunofluorescence and myocardial resistivity. Results After 22 weeks of transplantation of the bioma⁃ terials，in vitro evaluation revealed that intracardiac injection of PPY⁃CHI had lower tissue resistance ，greatly increased capillary density，significantly increased ventricular wall thickness in the scar area，and a（10.6 ± 0.55）% increase in LVFS compared to post ⁃infarction compared to CHI and Saline injections. Conclusions Intracardiac injection of PPY ⁃CHI promoted angiogenesis，reduced tissue resistance in the scar region，and inhibited adverse ventricular remodeling，which enhancethe recovery of cardiac function after chronic infarction. 

Objective To investigate the motor ability and skeletal muscle pathology in mice with Duch⁃ enne muscular dystrophy（DMD）and to explore the therapeutic effects of Deflazacort on DMD. Methods Ten ⁃ weeks⁃old transgenic DMD mice were selected and randomly divided into normal control group，model group and Deflazacort ⁃ treated group according to their body weights，seven in each group. The mice in all groups were weighed once a week for an experimental period of 8 weeks. At 10，14 and 18 weeks of age，the mice were assessed for locomotor activity by hanging test，pole climbing test and grip strength test，and at 18 weeks of age，the mice were observed for changes in limb stride distance，followed by testing their walking speeds by gait test. After eutha⁃ nasia，muscle lesions were assessed by measuring serum creatine kinase，lactate dehydrogenase，muscle pathology histology and morphological analysis. Results Compared to the DMD mice，there were no significant changes in body weight in Deflazacort ⁃treated mice，but the suspension time was prolonged（P < 0.05），the pole climbing elapsed time reduced（P < 0.01），the forelimb grip increased（P < 0.05），and the stride distance and walking speed both increased（P < 0.01）. Meanwhile，the serum creatine kinase values were lowered，and the areas of skeletal muscle inflammatory cell infiltration（P < 0.01）and fibrosis were reduced. Conclusion Deflazacort is effective in treating hypokinesia，gait bradykinesia and skeletal muscle inflammatory damage in mice with DMD. 

Objective To investigate the effect of heparanase（HPSE）on invasion and migration of gall⁃ bladder cancer cells and ERK/MMP⁃9 signaling pathway. Methods Lentivirus transfection was used to bidirectional regulate the expression of HPSE gene in gallbladder cancer cells（GBC ⁃ SD）to obtain a transgenic gallbladder cancer cell line with overexpression of HPSE and a gallbladder cancer cell line with very low expression of HPSE. The overexpression and interference effects of HPSE were detected by qRT⁃PCR and Western blot. Transwell and cell scratch test were used to detect the invasion and migration ability of gallbladder cancer cells in negative control group，HPSE knockdown group and HPSE overexpression group before and after transfection. At the same time，the mRNA transcription levels of HPSE and MMP ⁃9 were detected by qRT ⁃PCR，and the protein expression levels of MMP⁃9，HPSE，p⁃ERK，ERK，N⁃cadherin and E⁃cadherin were detected by Western blot. Results The gallbladder cancer cell lines of HPSE gene overexpression group and interference group were successfully constructed（P < 0.05）. Overexpression of HPSE significantly promoted the migration and invasion of gallbladder cancer cells，and the expression of MMP⁃9 mRNA and protein，p⁃ERK and N⁃cadherin protein was up⁃regulated，while the expression of E⁃cadherin was down⁃regulated. After knockdown of HPSE expression，the situation was opposite（P < 0.05）. In addition，the co ⁃treatment of HPSE overexpression and ERK inhibitor reversed the promotion effect of HPSE gene overexpression on the biological function of gallbladder cancer cells（P < 0.05）. Conclusions Heparanase enhances the invasion and migration of gallbladder cancer cells by activating ERK signaling pathway and upregulating MMP⁃9.

Objective To investigate the expression of miR⁃30b⁃5p in esophageal cancer cells and its effect on the proliferation，migration，and invasion of esophageal cancer cells. Methods The expression level of miR⁃30b⁃5p was detected in tumor and adjacent tissues of 70 patients with esophageal cancer who received surgical treatment in our hospital from January 2016 to December 2020. The expression level of miR⁃30b⁃5p in esophageal cancer cell lines was detected by qRT⁃PCR. miR⁃30b⁃5p mimics were transfected into TE⁃13 and ECA109 cells， and the expression levels of miR⁃30b⁃5p and MKRN3 in the transfected cells were detected. The proliferation， migration and invasion ability of esophageal carcinoma cells were determined by cell proliferation assay，Transwell assay and nude mouse tumorigenesis assay. The target gene of miR⁃30b⁃5p was verified by double luciferase assay. Western blotting was used to explore the molecular mechanism of the effect of miR⁃30b⁃5p on esophageal carcino⁃ ma. Results The expression of miR⁃30b⁃5p in esophageal carcinoma cells and tissues was significantly decreased compared with normal epithelial cells and paracancer tissues（P < 0.05）. Cell proliferation experiment showed that the proliferation rate of miR⁃30b⁃5p mimics group was significantly lower than that of NC group（P < 0.05）. Tran⁃ swell experiment results showed that the mobility and invasion rates of miR⁃30b⁃5p mimics group were significantly lower than those of NC group（P < 0.05）. Dual luciferase assay showed that MKRN3 was the direct target gene of miR⁃30b⁃5p. Western blot analysis of JAK/STAT signaling pathway protein showed that the histone of miR⁃30b⁃5p mimics was lower than that of NC group（P < 0.05）. Conclusion miR⁃30b⁃5p shows low expression in esophageal cancer，and miR⁃30b⁃5p inhibits the proliferation，migration and invasion of esophageal cancer cells by down⁃regu⁃ lating the expression of MKRN3.

Objective To investigate the therapeutic effect of polybutylcyanoacrylate nanoparticles loaded with TXNDC5 gene RNA interference chip（TXNDC5 siRNA）on human gastric adenocarcinoma cell implanted tumor bearing model animals. Methods Nano⁃microspheres loaded with TXNDC5 siRNA（TXNDC5 siRNA⁃PBCA⁃ NP）were prepared by emulsion polymerization. The tumor bearing animal model of gastric adenocarcinoma was established by subcutaneous implantation. TXNDC5 siRNA ⁃ PBCA ⁃NP was injected into nude mice bearing trans⁃ planted tumor through caudal vein. At the same time，the blank control group of polybutylcyanoacrylate nanoparticles （PBCA⁃NP），5⁃fluorouracil（5⁃FU）and normal saline groups were established. After treatment，the inhibition of implanted tumor in each group was detected and compared between groups. Results The tumor inhibition rates of the TXNDC5 siRNA⁃PBCA⁃NP treatment group and the 5⁃FU treatment group were（66.98 ± 4.02）% and（64.10 ± 7.55）%，both significantly higher than those of the other control groups（P < 0.05）. At the end of treatment，the aver⁃ age tumor masses of the TXNDC5 siRNA ⁃ PBCA ⁃ NP treatment group and 5 ⁃ FU treatment group were（381.27 ± 24.22）mg and（414.53 ± 29.59）mg，both significantly lower than those of other control groups（P <0.05）. Conclusion The preliminary therapeutic effect on the nude mouse model of gastric cancer shows that TXNDC5 siRNA⁃PBCA⁃NP has a significant therapeutic effect on tumor in vivo. It could have a promising expectation of further study. 

Objective The incidence rate of papillary thyroid carcinoma（PTC）and Hashimoto′s thyroiditis （HT）are on the rise. The objective of this article is to explore the clinicopathological features of PTC with concomi⁃ tant HT，and further discuss the relationship between them. Methods A retrospective analysis was conducted of 347 patients who underwent thyroid cancer surgery in the Second Department of General Surgery of the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2016 to November 2022 and were patho⁃ logically diagnosed as papillary thyroid cancer after surgery. The clinicopathological characteristics of patients with or without HT were compared. Results Among 347 PTC patients，98（28.24%）were accompanied by HT. Univariate analysis showed that when compared with those in PTC group alone，higher proportion of women （85.7% vs. 74.3%）；higher proportion of patients with aspect ratio > 1 higher（57.1% vs. 41.8%）；lower proportion of invasive patients（16.3% vs. 27.7%）；greater total number of lymph nodes in the central area［（7.31 ± 6.132） vs.（3.98 ± 3.592）］；lower positive rate of lymph nodes in the central area［（14.55 ± 28.99）% vs.（25.93 ± 35.91）%］， higher level of thyroid ⁃ stimulating hormone（TSH）［（2.70 ± 1.99）mIU/L vs.（1.99 ± 1.36）mIU/L］，significantly higher level of thyroid peroxidase antibody（TPOAb）［（185.48 ± 264.77）IU/mL vs.（18.17 ± 89.57）IU/mL］，and that of thyroglobulin antibodies（TgAb）［（150.88 ± 235.23）IU/mL vs.（21.59 ± 86.44）IU/mL］were observed in the PTC combined with HT group，showing statistical significance（all P < 0.05）. Multiple linear regression analysis showed that the positive rate of lymph nodes in the central region of PTC was markedly affected by the presence of microcarcinoma，age，sex，and the presence of HT（all P < 0.05）. Conclusion Female PTC patients are more likely to be accompanied by HT，and the combination of HT will increase blood TSH，TPOAb and TgAb of PTC patients，but reduce the invasion of PTC and the risk of central lymph node metastasis. PTC patients with concomitant HT are prone to having node with longitudinal growth，and increased risk of PTC. The impact of HT on PTC pa⁃ tients is a“double⁃edged sword”. In addition，microcarcinoma，age，sex and HT are independent risk factors for central lymph node metastasis of PTC. 

Objective To investigate the effect of Life′s Simple 7（LS7）intervention on chemotherapy⁃ related cardiovascular system damage in HER2 positive patients with breast cancer after radical surgery. Methods A total of 120 HER2 positive patients who received standardized chemotherapy for breast cancer were randomly divided into control group and LS7 group. The control group was addressed with standard chemotherapy scheme，and LS7 group was treated with LS7 intervention for 12 months on the basis of the control group. The improvement effect of cardiovascular system damage in the two groups was evaluated by comparing the degree of cardiovascular system damage，anxiety，depression，and quality of life before and after treatment. Results Compared with the control group，the LS7 group had better overall LS7 score and 7 cardiovascular health indicators（P < 0.05）. The LS7 group had higher LVEF（P < 0.05），lower NT⁃proBNP（P < 0.05），lower anxiety and depression score（P < 0.05）， and higher quality of life score（P < 0.05）. Conclusion LS7 intervention can significantly reduce chemotherapy⁃ related cardiovascular system damage in HER2 positive breast cancer patients and improve the mental health and quality of life of breast cancer patients，which is worthy of clinical promotion. 

Objective Comparison of saphenous nerve radiofrequency ablation and intra ⁃articular injec⁃ tion of triamcinolone for treatment of knee osteoarthritis. Methods From June 2021 to June 2022，60 patients with knee osteoarthritis who met relevant criteria were admitted to our hospital and randomly divided into two groups，control group and study group，with 30 patients in each group. Patients in the study group were treated with ultrasound ⁃ guided saphenous nerve pulse radiofrequency therapy，while patients in the control group were treated with intra ⁃articular triamcinolone injection. The visual analogue scale score and WOMAC score of the two groups were compared and analyzed before treatment，1 week，1 month and 6 months after treatment，and whether there were complications between the two groups was observed. Results No complications were found in both groups. The VAS scores of patients 1 week and 1 month after treatment were statistically different（P < 0.05），and the VAS scores of the study group 1 month and 6 months after treatment were lower than those of the control group. The difference in WOMAC scores of 1 week，1 month and 6 months after treatment was statistically significant between the two groups，and the WOMAC scores of 1 month and 6 months after treatment in the control group were higher than those in the study group（P < 0.05）. Conclusion Ultrasound⁃guided saphenous nerve pulse radiofre⁃ quency can effectively relieve the pain of osteoarthritis，and its clinical efficacy is better than that of intraarticular hormone injection. 

Objective To observe the therapeutic effect of digital subtraction angiography（DSA）guided gradient pressuring by staged balloon dilation on anastomotic stenosis.in patients with esophageal cancer. Methods Totally，120 patients with anastomotic stenosis admitted to our hospital from August 2020 to August 2022 were enrolled in the study. Fifty ⁃seven of them treated with endoscopic gradient pressuring by staged balloon dilatation were set as the control group，and the other 63 ones treated with DSA guided gradient pressuring with staged balloon dilatation were set as the observation group. The two groups were compared in terms of total response rate， dilation times，and complications of postoperative esophageal stenosis，swallowing function，anastomotic stenosis diameter，quality of life score，and nutritional index before and after surgery. Results The total response rate in the observation group and the control group was 98.41% and 89.47%，respectively，with significant difference between them（P = 0.037），The number of expansion in the observation group was significantly lower than that in the control group（P < 0.001）. Reduclower swallowing function scores in both groups were significantly lower as compared with preoperative swallowing function and the score of the observation group was significantly lower than that of the control group after operation（P < 0.001）. The diameters of anastomotic stenosis in both groups after operation were significantly increased as compared to the preoperative，and that of the observation group was significantly larger than that of the control group after operation（P < 0.001）. The incidence of postoperative bleeding in the observation group was significantly lower than that in the control group（20.63% vs. 47.37%，P = 0.002）. The scores of QOL in both groups were elevated one month after surgery as compared with the preoperative and the scores of emotional function and social function in the observation group were significantly higher than those of the control group（P = 0.015，0.016）. After surgery，the levels of serum retinol⁃binding protein（RBP），hemoglobin（Hb）and transferrin （TF）were all increased in both groups，and the levels in the observation group were significantly higher than those in the control group（P < 0.001）. The postoperative level of ALB was significantly higher than the preoperative one in the observation group（P < 0.05）and after operation，the level of ALB in the postoperative observation group was significantly higher than that in the control group（P = 0.045）. Conclusion DSA guided gradient pressuring with staged balloon dilation has better therapeutic effect on anastomotic stenosis in esophageal cancer patients and the nutritional index level in the patients is higher，thereby deserving clinical spreading. 

Objective Idiopathic venous thromboembolism（VTE）has high prevalence，risk and recur⁃ rence. The purpose of this study was to investigate whether prolonged anticoagulation can reduce the incidence of VTE outcome events. Methods We selected 306 patients diagnosed with idiopathic VTE in Kailuan General Hos⁃ pital，from January 1，2013 to December 31，2016. All the patients（aged 24 to 85 years）with anticoagulation for 3 months were randomly divided into conventional anticoagulant group and prolonged anticoagulant group with a follow⁃ up of36 months. The primary outcome event was the recurrence of VTE and secondary outcome events were bleed⁃ ing，including major bleeding and clinically related non ⁃ major bleeding. Results A total of 306 VTE patients were included in the analysis，with a mean age of（61.54 ± 11.54）years and 184 males（60.13%）. In the conven⁃ tional anticoagulation group（n = 155），there were 45 VTE recurrence，3 major bleeding，and 21 clinically relevant non ⁃major bleeding；in the prolonged anticoagulation group（n = 151），there were 8 VTE recurrence，5 major bleeding and 30 clinically relevant non⁃major bleeding. Prolonged anticoagulation therapy significantly reduced the incidence of VTE recurrence when compared with conventional anticoagulation therapy（log⁃rank test，P < 0.000 1）， and no significant increase of major bleeding and clinically relevant non ⁃major bleeding（log ⁃ rank test，all P = 0.458 8）were observed. Prolonged anticoagulation therapy significantly reduced the risk of VTE recurrence com⁃ pared to conventional anticoagulation therapy（HR = 0.44，95%CI：0.19 ~ 0.99）. Moreover，prolonged anticoagula⁃ tion therapy didn′t increase the risk of major bleeding and clinically relevant non⁃major bleeding in VTE，with HR （95%CI）of 1.00（0.24，4.19），1.71（0.83，3.51），respectively. Conclusion The recurrence rate of VTE patients in the prolonged anticoagulant group is lower than that in the conventional anticoagulant group，and the incidence of major hemorrhage and clinically related non⁃major hemorrhage donot increase. The prolonged anticoagulant therapy has high application value for preventing the recurrence in patients with idiopathic VTE. 

Objective To compare the clinical effect of endoscopic radical thyroidectomy with non⁃inflat⁃ able axillary approach and transthoracic mammary approach. Methods A total of 168 patients with thyroid cancer admitted to our hospital from January 2019 to February 2022 were divided into study group and control group by random number table method，with 84 cases in each group. The control group received laparoscopic radical thyroid⁃ ectomy via breast and thoracobreast approach，while the study group received the thyroidectomy via inflatable axil⁃ lary approach. The surgical operations and the changes of parathyroid function of the two groups were analyzed. The two groups were compared in terms of postoperative pain，perioperative stress，postoperative complications and patients′ satisfaction with the incision. Results The operation time and postoperative drainage volume in the study group were longer and higher than those in the control group（P < 0.05），but there was no significant difference in the number of lymph node dissection between them（P > 0.05）. There were no significant differences in PTH and serum calcium between them either before and after operation（P > 0.05）. The VAS scores showed significant differences in each group before surgery，1 month after surgery and 3 months after surgery，respectively（P < 0.05）， but no significant differences between the two groups at the three time points（P > 0.05）. There was no significant difference in the varying trend of VAS scores between the two groups（P > 0.05）. The levels of adrenalin（Adr） and cortisol（Cor）were significantly different within each group at the three time points（P < 0.05），but there were no differences in the level of Adr and Cor between the two group at respective time point. There were no significant differences in the varying trends of Adr and Cor scores between the two groups（P > 0.05）. There was no significant difference in total complication rate between the groups（P > 0.05）. The rate of patient′s satisfaction with incisional cosmetics in the study group was significantly higher than that in the control group（P < 0.05）. Conclusion The effect and safety of non⁃inflatable axillary approach are similar to those of transthoracic mammary approach for laparoscopic radical thyroidectomy. Although it takes longer time and has larger postoperative drain⁃ age，the non⁃inflatable axillary approach is better from the perspective of postoperative cosmetic effect. 

Objective To compare the efficacy and safety of layered hand ⁃sewn end to end invagination anastomosis versus instrument anastomosis in combined thoracoscopic and laparoscopic definitive resection for esophageal cancer. Methods The present study was designed as a retrospective exploratory study，patients with newly diagnosed esophageal cancer who were admitted to the department from January 1st 2018 to December 31st 2019 were assigned to experimental group（layered hand ⁃ sewn end to end invagination anastomosis）and control group（instrument anastomosis）based on the actual surgical therapeutic options received in clinical practice. The baseline clinical characteristics and perioperative clinical manifestations of the patients were collected and were followed up regularly after hospitalization to obtain the prognostic data of the patients. Regarding the observational endpoints，the differences of perioperative indicators and adverse events between the two groups were compared. The disease⁃free survival（DFS）and overall survival（OS）were compared between the two groups. Results A total of 123 patients with esophageal cancer who underwent surgical resection were enrolled，including 63 patients in the experimental group and 60 patients in the control group. All patients were followed up regularly，the incidence of anastomotic leakage in the experimental group was significantly lower than that of the control group after 36 months （1.6% vs. 10.0%，P = 0.045）. The incidence of anastomotic stenosis in the experimental group was significantly lower than that of the control group after 36 months（6.3% vs. 20.0%，P = 0.024）. Furthermore，the incidence of gastroesophageal reflux in the experimental group was significantly lower than that of the control group（22.2% vs. 41.7%，P = 0.021）. In terms of perioperative safety profile，no significant differences in adverse reactions such as pulmonary infection，incision infection，arrhythmia and pleural effusion between the two groups were noted（P > 0.05）. Prognostic data showed that the median DFS of the experimental group was longer than that of the control group（47.1 months vs. 39.3 months，χ2 = 4.300，P = 0.038）. The median OS of the experimental group was longer than that of the control group（NR vs. 44.1 months，χ2 = 5.733，P = 0.017）. Conclusion Layered hand ⁃ sewn end to end invagination anastomosis combined with thoracoscopic and laparoscopic definitive resection of esophageal cancer might attenuate the incidence of anastomotic leakage，anastomotic stenosis and gastroesophageal reflux with tolerable safety profile. Preliminary prognostic data suggested that it might bring long⁃term survival benefits for the patients. The conclusions should be confirmed in prospective clinical trials subsequently.

Objective To analyze two identical novel MOCS1 gene variant sequences in the same family⁃ with different clinical features，and to provide reliable clinical data for future research on this correlation study. Method The pathogenic gene of the proband′ s family was detected by high ⁃throughput sequencing technology， and clinical features and gene variation sequences of the two patients with type A molybdenum cofactor deficiency from the same familywere retrospectively analyzed. Result The proband was a full⁃term infant with no history of asphyxia，who had difficulty feeding after birth，and had convulsions on the second day. Head MRI showed bilateral basal ganglia hypoxic⁃ischemic damage and softening lesions. His 5⁃year⁃old sibling sister had no abnormal psycho⁃ motor development after birth，but at 10 months，sudden fever and convulsions，feeding difficulties，and progres⁃ sive overall neurodevelopmental regression were observed. Head MRI also showed hypoxic ⁃ischemic in the basal ganglia. Therefore，the whole exon high⁃throughput sequencing of 5 members of the family were performed. The pro⁃ band and his affected sister were NM of MOCS1 gene_ 001358530.2，c.1275delA（p.Gly426Aspfs Ter10）homozy⁃ gous variant，but the parents and another healthy sister all heterozygous variants. This variant site had not been reported. Conclusion The proband and his affected sister have the same MOCS1 gene mutation sequence but dif⁃ ferent clinical processes.It is speculated that the mild phenotype of the proband may result in the residual function of sulfite oxidase activity 

Objective To investigate the clinical efficacy and safety of early application of Dapagliflozin in patients undergoing emergency percutaneous coronary intervention（PCI）after acute myocardial infarction（AMI）. Methods AMI patients undergoing emergency PCI（n = 68）were chosen from the Tengzhou Central People′s Hospital from September 2020 to September 2021，and divided randomly into control group（n = 34）and research group（n = 34）. Both groups of patients were given aspirin，ticagrelor，etc after PCI. The control group received conventional treatments such as metoprolol perindopril ，and the research group received dapagliflozin on bases of conventional oral medicine，a course for 6 months. The level of N ⁃terminal pro ⁃B ⁃type natriuretic peptide（NT ⁃ proBNP），left ventricular ejection fraction（LVEF），left ventricular end diastolic volume（LVEDV），left ventricular end systolic volume（LVESV），ventricular remodeling rate，the incidence of heart failure，the readmission rate， and incidence of adverse reactions were compared between the two groups. Results After 1 month and 6 months of treatment，the levels of NT⁃proBNP in the two groups were significantly lower than before treatment（P < 0.05）， and LVEF was significantly higher than before treatment（P < 0.05）. After 6 months of treatment，compared with control group，the levels of NT ⁃ proBNP、LVEDV、LVESV 、ventricular remodeling and Incidence of heart failure were significantly lower（P < 0.05），and LVEF was evidently higher in the study group（P < 0.05）. However，There were no significant differences in the rates of readmission and adverse drug reactions between the two groups（P > 0.05）. Conclusions Early application of dapagliflozin can effectively reduce ventricular remodeling and improve cardiac function in patients with acute myocardial infarction after emergency PCI，with relatively good safety. 

Objective To explore the effect of flurbiprofen axetil combined with low molecular weight heparin sodium on VAS score and oxidative stress response in elderly patients with hip replacement. Methods A total of 204 elderly patients with osteonecrosis of the femoral head in our hospital from June 2018 to June 2019 were selected and all the patients were divided into two groups by digital random table method. The study group （102 patients）was treated with flurbiprofen axetil combined with low molecular weight heparin sodium，and the control group（102 patients）received sufentanil mixed with 100 ml normal saline. The visual analogue score，VAS score index，and levels of oxidative stress reaction index NE，GSH PX and ang Ⅱ during the treatment were observed in the two groups. The incidence of postoperative complications and treatment satisfaction were compared. Results The VAS score was significantly lower in the study group than in the control group at 12/24 h（P < 0.05）； level of increases in NE and ang Ⅱ in the study group was significantly lower than that in the control group，and a decline in GSH PX value was significantly lower than that in the control group（P < 0.05）. There was no significant difference in the incidence of postoperative complications between the two groups（P > 0.05）. Conclusions Flur⁃ biprofen axetil combined with low molecular weight heparin sodium for elderly patients with hip replacement plays an analgestic role more effectively. This therapy significantly reduces the VAS scores，maintains the normal level of oxidative stress reaction，lowers the incidence of postoperative complications，and improves treatment satisfaction， which is worthy of clinical application. 

Objective To detect the expression level of exosome PD⁃L1（ePD⁃L1）in the plasma and tissue space of patients with gastric cancer and to explore the relationship between its expression and clinicopatho⁃ logical features，while to evaluate its diagnostic value in gastric cancer. Methods Forty patients with gastric cancer admitted to our hospital from December 2021 to December 2022 and 20 healthy control cases were selected. Plasma exosomes were purified and identified，and plasma ePD⁃L1 expression was determined by enzyme⁃linked immuno⁃ sorbent assay（ELISA）. During the same period，10 gastric cancer tissues and paracancellular tissues were collected to determine the expression of ePD⁃L1 in the intertissue space and verify the origin of plasma ePD⁃L1. The relation⁃ ship between ePD⁃L1 expression and clinical data was analyzed，and the diagnostic efficacy of EPD⁃L1 was evaluat⁃ ed by receiver operating（ROC）curve. Result Plasma ePD⁃L1 expression in gastric cancer patients was signifi⁃ cantly higher than that in healthy patients（P < 0.001），and its high expression was significantly correlated with CA19⁃9，tumor size，invasion depth，lymph node metastasis，and pTNM staging（P < 0.05）. Pearson correlation analysis showed a significant positive correlation between ePD⁃L1 expression in plasma and tissue（r = 0.7315，P = 0.0162）. The area under ROC curve（AUC）was 0.796（95%CI：0.658 ~ 0.935，P < 0.001）. Conclusion The expression of ePD ⁃L1 is associated with the progression of gastric cancer. There is a positive correlation between plasma and tissue ePD⁃L1 expression. Plasma ePD⁃L1 has certain diagnostic value in gastric cancer. 

Objective To investigate the correlation between MRI diffusion kurtosis imaging （DKI） parameters and clinical stage of nasopharyngeal carcinoma（NPC）. Methods 86 patients with pathologically proved NPC were scanned byDKI. DKI parameters included fractional anisotropy（FA），mean diffusivity（MD）， axial diffusivity（Da），radial diffusivity（Dr），mean kurtosis（MK），axial kurtosis（Ka），radial kurtosis（Kr）. FA of kurtosis（FAK）value. The consistency of the parameters of tumor focus DKI measured by the two observers was tested by intraclass correlation coefficient（ICC）. To analyze the correlation between DKI parameters and NPC clinical stage，T stage and N stage. When the parameter values between the two groups were in accordance with the normal distribution，the differences of different groups were compared by two independent sample t ⁃test. Results The values of DKI parameters of nasopharyngeal carcinoma lesions measured by the two observers were in good agreement（ICC > 0.75）. The MD values of DKI parameters in the high⁃grade group were lower than those in the low⁃grade group in the clinical stage，the MK value in the high⁃grade group was higher than the low⁃grade group in the clinical stage，the MD value in the T⁃stage high⁃grade group were lower than those in the low⁃grade group，and the MK value was In T stage，the high stage group was higher than the low stage group，the MD value in the N stage group were lower than those in the low stage group，and the MK value in the N stage high stage group was higher than the low stage group，and the difference was statistically significant（P < 0.05）. The values of DKI parameters FA，Da，Dr，FAK，Ka and Kr were not statistically significant in NPC clinical stage，T stage and N stage. Conclusion The MD value and MK value of DKI parameters were related to the clinical stage，T and N stage of NPC. The clinical stage，T stage and N stage were high，the MD value decreased and the MK value increased. 

Objective To conduct an in⁃depth analysis of the screening of cervical cancer and breast cancer and its cost⁃effectiveness among rural women in Guangdong Province from 2017 to 2019，and to provide reference for the health administrative departments to formulate future plan. Methods The detection rate，early diagnosis rate，average cost of early detection and early detection cost index（EDCI）were analyzed using cases and quarterly reports from cervical cancer and breast cancer screening program in Guangdong Province. Results From 2017 to 2019，Guangdong Province provided free screening of cervical cancer and breast cancer for more than 1.3 million rural women，with an average age of（48.04 ± 7.94）years. The detection rate for cervical cancer was 56.50 per 100 000，with an early diagnosis rate of 94.15%. Average cost of detecting early cases was 29 598 yuan， and the EDCI was 0.71，showing considerable cost ⁃effectiveness. The breast cancer detection rate was 40.91 per 100 000，with an early diagnosis rate of 60.16%. Average cost of detecting early cases was 304 200 yuan，and the EDCI was 7.31，showing acceptable cost ⁃ effectiveness. Conclusion From 2017 to 2019，cervical cancer and breast cancer screening program for rural women in Guangdong Province had cost⁃effectiveness value. It is worth to promoting the program for women of appropriate age in Guangdong Province with the cooperation of healthcare department，finance department，women's federations and other administrative departments，and further expanding the coverage of screening to urban and rural populations. 

Objective The study aimed to investigate the association between the body height and the risk of novel cerebral infarction in the elderly with hypertension. Methods 9 574 elderly hypertension patients were monitored in this cohort research based on the Kailuan research group for cerebral infarction. Patients were categorized into quartile groups.The life table method was used to calculate the cumulative incidences of outcomes in different groups. Cox proportional hazards model was used to analyze hazard ratios（HR）with the corresponding 95% confidence interval（CI）of outcomes in different groups. Results Compared to the body height ≤ 161.5 cm （Q1）group，the multivariate Cox proportional hazard regression model showed that the hazard ratio［HR（95%CI）］ for cerebral infarction in model 2 were 0.95（0.78 ~ 1.16），1.00（0.81 ~ 1.23）and 0.71（0.56 ~ 0.90） respectively in 161.5 ~ 166.0 cm（Q2），166.0 ~ 170.0 cm（Q3）and ≥ 170.0 cm（Q4）；in model 3，cerebral infarction［HR （95%CI）］in each group were 1.01（0.81 ~ 1.24），1.10（0.89 ~ 1.36）and 0.76（0.60 ~ 0.96）respectively；in model 4 were 0.98（0.79 ~ 1.21），1.06（0.85 ~ 1.33）and 0.72（0.56 ~ 0.93），respectively. Conclusion In the elderly with hypertension，a taller body height is connected with a decreased incidence of cerebral infarction.

Tunneling nanotubes（TNTs）are intercellular pipe structures formed mainly by actin，which are equivalent to bridges connecting cells. As a newly discovered mechanism of intercellular communication， TNTs realize long⁃distance communication and directional transport of substances between cells. TNTs mediate the transfer of organelles，nucleic acids，small molecular proteins and other substances between cells. TNTs use communication and transportation functions to influence the occurrence and development of neurodegenerative diseases，tumors，cancers and other diseases，and provide some new ideas and new targets for the treatment of related diseases. This review introduces the morphological structure，formation mechanism，formation related regu⁃ latory factors，functions and physiological significance of TNTs. 

Glioma is a tumor of the central nervous system，mainly derived from glial cells. Currently， surgical resection combined with radiotherapy，chemotherapy，electric field therapy and other comprehensive thera⁃ pies are used in clinical practice. However，glioma is difficult to be completely removed，and it is easy to escape from the primary tumor and pass through the brain tissue，leading to relapse and even death of patients. N6⁃methyl⁃ adenine（m6A）gene modification is widely distributed in eukaryotic cells as post ⁃transcriptional modification of mRNA. The modification process is completed by a series of proteins，which can be divided into methyltransferase， demethylase and binding protein according to the different roles of proteins in the methylation process. Dynamic and reversible m6A modification affects the biological behaviors of glioma，such as the occurrence and develop⁃ ment，invasion and metastasis，and angiogenesis. In addition，it plays a clinical role in the diagnosis，treatment and prognosis assessment for glioma. This article reviews the biological effects and applications of m6A modification in glioma，providing a new idea for the treatment of glioma.