Type 2 diabetes mellitus（T2DM）is a group of metabolic disease characterized by chronic hyperglycemia，which tranditional require long⁃term medication with hypoglycemic drugs. However，more recent studies have shown that some diabetic patients can be alleviated by intensive intervention of diet and exercise，hypoglycemic drug which can loss weight，or short⁃term intensive insulin therapy，metabolic surgery. This article will discuss the definition of T2DM remission and intervention methods.

Objective To explore the effect and mechanism of midazolam inducing ferroptosis in cervical cancer cells. Methods Human cervical cancer HeLa cells were cultured in vitro and divided into 5 groups. Low/ medium/high dose midazolam groups were injected with 5 doses，respectively 5，10，20 μmol/L midazolam，high⁃ dose midazolam+nuclear factor E2 related factor 2 activator group injected with 20 μmol/L midazolam and 80 nmol/L Bardoxolone，as well as normal cultured HeLa cells，were used as control groups for further cultivation for 24 hours. CCK⁃8 and clone formation assay were used to detect cell proliferation；PI staining was used to detect cell death； transmission electron microscopy was used to observe mitochondrial morphological changes ；kits were used to detect the levels of iron，reactive oxygen species（ROS），glutathione（GSH），malondialdehyde（MDA）；Western Blot was used to detect the protein expressions of Nrf2/heme oxygenase⁃1（HO⁃1）signaling pathway⁃related proteins and GSH peroxidase 4（GPX4）. Results Compared with the Control group，the L⁃midazolam group，M⁃midazolam group，and H⁃midazolam group showed a decrease in HeLa cell viability，a decrease in clone count，an increase in cell mortality，and a significant ferroptosis feature in mitochondria. The levels of iron，ROS，and MDA in cells increased，while GSH levels and GPX4，nuclear Nrf2，and HO⁃1 protein expression decreased. The H⁃midazolam group showed more significant changes（P < 0.05）. Compared with the H ⁃midazolam group，the H ⁃midazolam+ Nrf2 activator group showed an increase in HeLa cell viability，increased clone count，decreased cell mortality， reduced mitochondrial iron death damage，decreased levels of iron，ROS，and MDA in cells，and increased levels of GSH and GPX4，Nrf2，and HO⁃1 protein expression（P < 0.05）. Conclusion Midazolam can inhibit the prolif⁃ eration of HeLa cells and induce ferroptosis in a dose dependent manner，which may be achieved by inhibiting the Nrf2/HO⁃1 signaling pathway. 

Objective To investigate the therapeutic effects of amygdalin（AMY）on atherosclerosis and to elucidate its possible mechanisms. Methods Treatment with different doses of AMY intervention on human coronary artery endothelial cells（HCAECs），HCAECs were divided into four groups：control，ox⁃LDL，AMY low dose group（50 μg/mL），and AMY high dose group（100 μg/mL）. Pyroptosis proteins（caspase⁃1 and GSDMD） as well as histone demethylase（JMJD3）and galectin ⁃3（Gal ⁃3）expression levels were determined by Western blotting. IL ⁃ 1β and IL ⁃ 18 mRNA expression by RT ⁃ qPCR. TUNEL assay was used to detect the death rate of HCAECs. ChIP assay was used to detect the enrichment of JMJD3 and H3K27me3 on Gal⁃3 promoter region. The ef⁃ fect of Gal⁃3 on Amy inhibition of ox LDL induced pyroptosis in HCAECs was further analyzed after overexpression of Gal⁃3. 40 apolipo protein E⁃deficient（ApoE）-/- male mice were divided into control group，model group，2.5 and 5 mg/kg AMY group. Oil red O staining was used to observe lipid deposition and plaque formation in mice aortas. Serum levels of total cholesterol（TC），triglycerides（TG），high⁃density lipoprotein cholesterol（HDL⁃C），and low⁃density lipoprotein cholesterol（LDL⁃C）were measured by enzymatic colorimetric methods. Results Versus the control group，AMY had no significant effect on cell viability，50 and 100 μg/mL AMY intervened cells showed no significant difference in cell viability compared to the control at 24 h，and a significant decrease in cell viability compared to the control at 36 h and 48 h. Compared to ox⁃LDL，the protein levels of Caspase⁃1，GSDMD， Gal⁃3 and JMJD3，the mRNA expression of IL⁃1β and IL⁃18，and the rate of TUNEL positive cells decreased in a dose ⁃ dependent manner 50 and 100 μg/mL AMY. The enrichment of JMJD3 on Gal ⁃ 3 promoter region was de⁃ creased and H3K27me3 was increased in HCAECs after AMY intervention. The expression levels of Gal⁃3，caspase⁃1， GSDMD，IL⁃1β，and IL⁃18 and the percentage of TUNEL positive cells within HCAECs were increased in the ox⁃LDL+AMY+pcDNA⁃Gal⁃3 group compared with the ox⁃LDL+AMY+pcDNA⁃3.1 group. Compared with the model group，the lipid deposition in the aorta was reduced and the percentage of atherosclerotic lesion area was decreased in 2.5 or 5 mg/kg AMY mice. The concentrations of TG，TC，LDL and the expression levels of Gal⁃3，caspase⁃1， GSDMD，IL⁃1β，and IL⁃18 were decreased in a dose⁃dependent manner，while the content of HDL was increased. Conclusion AMY may contribute to the amelioration of atherosclerosis induced pyroptosis by participating in the regulation of JMJD3 mediated Gal⁃3 demethylation.

Objective To study the effect of vitamin D treatment on bone metastasis of prostate cancer mice induced by octanoic acid and high⁃fat diet. Methods The bone metastasis model of prostate cancer mice was established，and the mice were divided into normal feeding Control group，High fat group fed with high fat diet， Bitter group fed with caprylic acid and Vitamin D group fed with caprylic acid and high fat diet. After the study， the contents of total cholesterol，triglyceride，low⁃density lipoprotein，calcium and 25⁃hydroxyvitamin D（25⁃OH⁃D） in peripheral blood of mice in the three groups were detected，and the degree of bone metastasis and the expression of E⁃cadherin and p38 protein in tumor tissues of mice in each group were detected. Transwell mice were used in vitro to study the effect of vitamin D on the invasion and migration ability of RM⁃1 cells affected by caprylic acid. Results Compared with the control group，the contents of total cholesterol，triglyceride，low density lipoprotein and calcium in the blood of mice in the High fat group and Bitter group，as well as the contents of SUVmin，SUVmax and SUVmean in the 18F⁃NaF PET⁃CT test results were significantly increased（P < 0.05）；And Bitter group was significantly higher than High fat group（P < 0.05），while Vitamin D group was significantly lower than Bitter group（P < 0.05）. In vitro，octanoic acid treatment significantly increased the invasion and migration ability of RM⁃1 cells，but vitamin D could inhibit the invasion and migration ability of RM⁃1 cells promoted by octanoic acid. In vivo，caprylic acid can significantly increase the expression of E⁃cadherin and p⁃p38/p38 protein in tumor tissue of mice with bone metasta⁃ sis of prostate cancer from high⁃fat diet，but vitamin D can significantly reduce the increased E⁃cadherin and p⁃p38/ p38 protein table of caprylic acid. Conclusion Vitamin D treatment inhibited bone metastasis of prostate cancer mice promoted by octanoic acid and high⁃fat diet，and its mechanism may be related to the increase of serum 25⁃OH⁃D content and the inhibition of E⁃cadherin，p⁃p38/p38 protein expression in cancer cells. 

Objective To evaluate the in vivo safety of Bushen Qiangjin capsule（BSQJ）through animal experiments，in order to provide scientific and theoretical basis for clinical application. Methods Forty SPF SD rats were randomly divided into Control group and BSQJ group according to the random number table method，with 20 rats in each group，half male and half male. In BSQJ group，the maximum drug volume that the rats could tolerate was 40 mL/（kg·d）as the drug standard，and it was gavaged three times per day，and the drug dose was equivalent to 20 times the clinical adult drug dose，which was 32 g/（kg · d）. The control group was given an equivalent amount of 0.9% sodium chloride solution by intragastric administration. After continuous gavage for 14 days，the acute toxic reaction，body weight，blood routine，biochemical and hemolytic tests，and histopathological changes of the main organs were evaulated before and after administration. Results Compared with control group，the male and female rats in BSQJ group had no mortality and toxicity（P > 0.05）；had no difference in body weight （P > 0.05）；There were no significant differences in blood routine test（WBC，NEUT，NEUT，LY，RBC，HB and PLT）（P > 0.05），and biochemical and hemolytic test（TP，ALT，AST，ALP，Glu，Bun，SCR and UA） （P > 0.05）. No hemolysis or abnormality was found in heart，liver，spleen，lung and kidney. Conclusion Large dose of Bushen Qiangjin capsule had no acute toxic reaction to rats，without affecting blood routine，liver and kidney function，did not produce hemolysis，and caused no pathological damage to the main organs and tissues， which was safe in vivo. 

Objective To investigate the effects of quadratus lumborum block on inflammatory response and postoperative intestinal function recovery in patients undergoing laparoscopic colorectal cancer surgery. Methods A total of 60 patients scheduled for laparoscopic colorectal cancer surgery were randomly divided into two groups：quadratus lumborum block combined with general anesthesia group（group QA，n = 30）and sole gen⁃ eral anesthesia group（group GA，n = 30）. The patients in group QA received bilateral quadratus lumborum block 30 minutes before induction of general anesthesia，and in group GA received simple general anesthesia，respectively. The concentration of serum TNF⁃α，IL⁃6 and IL⁃10 was measured at the following time points：5 minutes before anesthesia induction（T0），at the completion of pneumoperitoneum establishment（T1），6 h（T2）and 24 h（T3）after operation. The time of first exhaust and first walking time after operation，the incidence and degree of abdominal distension were recorded. Results Compared with the group GA，the levels of inflammatory factors at all time points in the group QA were significantly lower（P < 0.05）. The time of first exhaust in the group QA was signifi⁃ cantly shorter than that in the group GA（P < 0.05），and the first walking time after operation in the group QA was significantly longer than that in the group GA（P < 0.05）. The incidence of postoperative abdominal distension in the group QA was significantly lower than that in the group GA（P < 0.05）. Conclusions Quadratus lumborum block before operation can significantly reduce the inflammatory response and promote the rapid recovery of intestinal function in patients undergoing laparoscopic colorectal cancer surgery. 

Objective To analyze the clinical features and prognosis of patients with post ⁃infarction ventricular septal rupture（PIVSR）undergoing surgical repair or transcatheter interventional closure. Methods The clinical data of 64 patients who were diagnosed with PIVSR at the Heart Center of Henan Provincial People′s Hospital from 2017 to 2020 were reviewed and analyzed. Those undergoing transcatheter interventional closure were assigned as intervention closure group（n = 50）and those undergoing surgical repair as surgical repair group（n = 14）. The baseline data，preoperative，intraoperative，and postoperative results and follow⁃up results were analyzed and compared between the two groups. Results Compared with the surgical repair group，the interventional closure group had a larger number of females，smaller VSR diameter，less severity of disease，lower hospitalization cost， shorter operation time，shorter ICU stay time，and higher residual shunt rate. Follow⁃up results showed that there were no statistically significant differences in left ventricular diastolic diameter（LVEDD），left ventricular ejection fraction（LVEF），6 min walking test one and six 6 months after the operation and the follow⁃up survival rate（P > 0.05）. The Cox regression analysis showed that the Killip classification of cardiac function（Class Ⅱ⁃Ⅳ）was a risk factor affecting the survival of the patients of the two groups. Conclusion PIVSR patients undergoing interventional closure have a good prognosis. After closure，the patients have little trauma，quick recovery，low hospitalization costs，and high long⁃term survival rate. As a minimally invasive and effective therapy，it is likely to become an alternative treatment. 

Objective To investigate whether precise surgical planning based on multimodal image fusion and 3D reconstruction technology can reduce adverse events during clipping in patients suffered from ruptured intracranial anterior circulation aneurysm with severe subarachnoid or intracephalic hematoma. Methods Using 3D Slicer 4.10.2，multimodal image fusion and 3D reconstruction were performed basing on preoperative CT and CTA images of 23 patients with high⁃grade Hunt⁃Hess grade anterior circulation ruptured aneurysms. According to personalized surgical plan its guiding to craniotomy aneurysm clipping，we compare the consistency of preoperative three⁃dimensional imaging results with the actual observation during operation，and evaluate its pros and cons for reducing intraoperative adverse events. Results Accurately guided by the preoperative simulated the head position and craniotomy，we can significantly reduce the adjustment of the patient′s head position during the operation and the secondary grinding off the sphenoid ridge due to poor exposure of the sylvian fissure. According to the intraoperative observation，the sensitivities of the aneurysm neck shape，the poor parts of the transition zone of the aneurysm′s neck to body，and the small perforating vessels beside the neck displayed in the 3D images were 90%，50%，and 75%，respectively，and the specificities were 100%，100%，and 75%，respectively. Kappa coefficients were 0.701， 0.623 and 0.732，respectively. The sensitivity and the specificity of preoperative simulated clipping for the actual intraoperative clipping was 100% and 25% respectively，and the Kappa coefficient was 0.355. Conclusion The precise plan based on preoperative multimodal image fusion and 3D reconstruction technology can effectively help the surgeon to accurately individualize the craniotomy clipping of ruptured anterior circulation aneurysm with severe subarachnoid hemorrhage or intracephalic hematoma and reduce the incidence of intraoperative adverse events. 

Objective To explore the distribution of iliac vessels in the anterior lower lumbar spine using CT angiography，and to provide vascular anatomical references for anterior lower lumbar surgery. Methods Select 100 male and 100 female patients who underwent abdominal CT angiography at Guizhou Provincial People′s Hospital from June 2016 to November 2018 for observation and measurement research；（1）Observe and record the distribution of the bifurcation points of the abdominal aorta and the confluence points of the common iliac vein；（2）Measure the distance from the vertex of the angle between the left common iliac vein and the right common iliac artery to the upper edge of the L5⁃S1 intervertebral space ，and the distance between the left common iliac vein and the inner edge of the right common iliac artery at the upper and lower edges of the L5 ⁃S1 intervertebral space. Results （1）64% of the L4 vertebral body is flat at the bifurcation point of the abdominal aorta. The confluence point of the common iliac vein accounts for 42% of the L4 vertebral body and 40% of the L4⁃5 intervertebral space.（2）Abdominal aortic bifurcation angle：（51.01 ± 9.24）° for males，（50.51 ± 7.92）° for females；The confluence angle of the common iliac vein is（58.82 ± 11.81）° for males and（62.47 ± 12.46）° for females；The angle between the left common iliac vein and the right common iliac artery is（64.92 ± 12.07）° for males and（68.73 ± 13.87）° for females. （3）When the confluence point of the common iliac vein is level with the L4 vertebral body，L4 ⁃ 5 intervertebral space，and L5 vertebral body：① The distance from the vertex of the angle between the left common iliac vein and the right common iliac artery to the upper edge of the L5 ⁃S1 intervertebral space is（26.51 ± 8.11）mm，（16.18 ± 6.70）mm，and（7.82 ± 4.26）mm，respectively；② The distances between the left common iliac vein and the medial edge of the right common iliac artery from the L5⁃S1 intervertebral space are（32.52 ± 9.95）mm，（28.63 ± 11.48）mm，and（16.27 ± 7.71）mm，respectively The distance between the left common iliac vein and the inner edge of the right common iliac artery at the lower edge of the L5⁃ S1intervertebral space is（43.88 ± 9.86）mm， （41.55 ± 11.05）mm，and（33.17 ± 9.40）mm，respectively. ④ The area of the“iliac vascular triangle”is （486.32 ± 246.26）mm2 ，（263.94 ± 178.47）mm2 ，and（85.49 ± 71.45）mm2 ，respectively The surgical windows for the L5⁃S1 intervertebral space are（496.98 ± 114.48）mm2 ，（488.89 ± 127.69）mm2 ，and（344.32 ± 166.63）mm2 ， respectively. Conclusion （1）There are significant anatomical changes at the bifurcation point of the abdominal aorta and the confluence point of the common iliac vein；The bifurcation point of the abdominal aorta is mostly flat on the L4 vertebral body，and the confluence point of the common iliac vein is mostly flat on the L4 vertebral body and the L4⁃5 intervertebral space.（2）When the confluence point of the common iliac vein is level with the L4 verte⁃ bral body，there is sufficient vascular safety zone in front of the lower lumbar spine for surgical operation；When the confluence point of the common iliac vein is located in the L4⁃5 intervertebral space，there is a certain vascular safety zone in front of the lower lumbar spine for surgical operation；When the confluence point of the common iliac vein is flat on the L5 vertebral body，the safety zone of the anterior blood vessels of the lower lumbar spine cannot meet the surgical requirements at this time.（3）When the confluence point of the common iliac vein is level with the L4 vertebral body and the L4⁃5 intervertebral space，there is sufficient surgical vascular safety zone in the anteri⁃ or L5⁃S1 intervertebral space，but the vascular safety zone is gradually reduced. Preoperative CT angiography exami⁃ nation to clarify the vascular safety zone is helpful for surgical safety. 

Objective To explore the association of endometriosis（EMT）with serum soluble vascular endothelial growth factor receptor ⁃1（sFLT1）and C1q/tumor necrosis factor related protein 3（CTRP3）. Methods A retrospective analysis was conducted on 80 EMT patients（EMT group）admitted to Jingdezhen Maternal and Child Health Hospital. According to r⁃AFS staging，43 patients were diagnosed as stage Ⅰ-Ⅱ and 37 as stage Ⅲ-Ⅳ. According to the degree of dysmenorrhea，46 patients were classified as mild and 34 as moderate to severe. The control group consisted of 80 women receiving physical examinations during the same period of time. Serum levels of sFLT1 and CTRP3 were detected and analyzed in both groups The influencing factors of EMT in stage Ⅲ to Ⅳ were analyzed by multivariate logistic regression. The receiver operating characteristic curve（ROC）was applied to evaluate the diagnostic value of serum sFLT1 and CTRP3 for stage Ⅲ-Ⅳ EMT. Results Serum levels of sFLT1 and CTRP3 in the EMT group were lower than those in the control group（P < 0.05），serum sFLT1 and CTRP3 levels in moderate to severe dysmenorrhea patients were lower than those in mild dysmenorrhea patients（P < 0.05）， and serum sFLT1 and CTRP3 levels in r⁃AFS stage Ⅲ to Ⅳ were lower than those in stage Ⅰ to Ⅱ（P < 0.05）. Correlation analysis showed that serum sFLT1 and CTRP3 in EMT patients were negatively correlated with r⁃AFS staging and degree of dysmenorrhea（P < 0.05），respectively. Regression analysis showed that sFLT1 and CTRP3 were the influencing factors for stage Ⅲ-Ⅳ EMT（P < 0.05）. The AUC values of serum sFLT1 and CTRP3 in com⁃ bination with diagnosis of stage Ⅲ-Ⅳ EMT were 0.811，0.832，and 0.931，respectively；the combined diagnostic efficacy was better than that of sFLT1 and CTRP3 alone. Conclusions Serum levels of sFLT1 and CTRP3 decrease in EMT patients，which are related to the degree of dysmenorrhea and r⁃AFS staging and are influencing factors for stage Ⅲ-Ⅳ EMT. sFLT1 combined with CTRP3 is helpful in the assessment of r⁃AFS stage. 

Objective To investigate the therapeutic efficacy of intervertebral disc nerve block in the treat⁃ ment of lumbar disc herniation. Methods The clinical data of 107 patients with lumbar disc herniation treated with nerve block between September 2015 and August 2017 were reviewed retrospectively. Among them，56 under⁃ going intervertebral disc injection with the guidance of fluoroscopy were assigned as IDI group and the other 51 cases undergoing transforaminal epidural injection with the guidance of fluoroscopy as TEI group. The compound of beta⁃ methasone + lidocaine was injected into the intervertebral discs in the IDI group，and into the transforaminal epidural spaces in the TEI group as well. Visual analogue scale（VAS）and Oswestry dysfunction index（ODI）assessments were performed before treatment，immediately after treatment and 3 months after treatment. MacNab scoring was performed at 3 months follow ⁃up after treatment. Results All patients′ symptoms were improved after treatment. The scores by VAS scores and ODI immediately and 3 months after treatment were significantly lower than those before treatment（P < 0.05）both in IDI group and TEI group，but the scores were not significantly different between the two groups（P > 0.05）. According to the MacNab efficacy evaluation criteria，the total effectiveness rate was 100% in IDI group and 96% in TEI group，and the rate of being excellent and good was 75% in IDI group and 71% in TEI group. One patient in IDI group was complicated with infection after treatment and got healed after oral antibiotics and rest treatment. Conclusions Intervertebral disc nerve block is an effective treatment for lumbar disc herniation. It can be used as a supplement of conservative treatment methods. It is a traumatic manipulation which could lead to infection of intervertebral disc，accelerated disc degeneration and other serious complications， so surgeons should be cautious when deciding to adopt this approach.

Objective To investigate the characteristics of varicella zoster virus（VZV）specific cellular immunity in patients with herpes zoster，and to analyze the predictive value for postherpetic neuralgia（PHN）. Methods A total of 10 healthy adults from January 2021 to June 2022 in the Physical Examination Center of our hospital were selected. VZV specific group and control group models were established to analyze the differences of cellular immune factors. Next，70 patients with herpes zoster who were admitted to our hospital at the same time were selected ，and differences in VZV⁃specific cellular immune factor indicators（hereafter referred to as indica⁃ tors）were collected at the first visit. The patients were followed up for half a year to analyze the value of indicators in predicting the occurrence of PHN. Results The proportion of CD4+ T Cell in VZV group was lower than that of the control group，while the proportion of CD8 + T Cell and PD ⁃1 + CD4 + T Cell was higher than that of the control group，with statistically significant difference（P < 0.05）. There was no significant difference in IFN⁃γ and IL⁃2 level in PBMC supernatant between the two groups（P > 0.05）. The TNF ⁃α level in PBMC supernatant of VZV group was higher than that of the control group，and the difference was statistically significant（P < 0.05）. The proportion of anterior pain，the proportion of multi⁃stage disease，the time from onset to treatment and TNF⁃α of PBMC super⁃ natant in PHN group were all higher than those of the non ⁃PHN group. The percentage of CD3 + T Cell was lower than that of the non⁃PHN group，and the difference was statistically significant（P < 0.05）. PBMC supernatant TNF⁃α （HR = 1.148）was an independent risk factor for PHN occurrence（P < 0.05）. TNF⁃α in PBMC supernatant had a good predictive effect on PHN occurrence（AUC = 0.902，P < 0.001，95%CI = 0.821 ~ 0.981）. The cut⁃off value， sensitivity，specificity，positive predictive value，and negative predictive value were > 54.36 pg/mL，82.35% ， 85.11%，66.67%，and 93.02% respectively. Conclusion TNF⁃α in PBMC supernatant is a VZV⁃specific cellular immune factor affecting the occurrence of PHN，which has certain clinical significance in predicting the occurrence of PHN in patients with herpes zoster. 

Objective To observe small intestinal bacterial overgrowth（SIBO）and oral cecal transit time （OCTT）in patients with ulcerative colitis，the therapeutic effect of rifaximin combined with Bacillus subtilis were investigated. Methods All of the people enrolled in the study（UC group = 100 cases，healthy group = 50 cases） were tested for SIBO and OCTT. UC patients with SIBO were randomly divided into two groups：control group： Bacillus subtilis（500 mg，3/d，14 d）；Treatment group：Bacillus subtilis（500 mg，3/d，14 d）and Rifaximin（0.2 g， 4/d，14 d）. After treatment，interleukin⁃6（IL⁃6）and C⁃reactive protein（CRP）were observed. Results （1）SIBO in patients with ulcerative colitis was 41.0%，and that in healthy control group was 18.0%（P < 0.05）. The inci⁃ dence of SIBO was not related to gender and age（P > 0.05）.（2）OCTT in patients with ulcerative colitis was （128.8 ± 20.3）min，and in that control group was（90.7 ± 13.6）min（P < 0.05）（. 3）The OCTT of ulcerative colitis patients with SIBO was（150.5 ± 22.6）min，and in that of patients without SIBO was（108.3 ± 19.7）min（P < 0.05）. （4）65% of the patients in the treatment group turned negative and 23.8% of the patients in the control group turned negative（P < 0.05）.（5）In the treatment group：IL ⁃ 6 and CRP were significantly lower：IL ⁃ 6（50.16 ± 8.5）vs. （20.31 ± 7.1）and CRP（33.36 ± 3.4）vs.（10.22 ± 4.1）（P < 0.05）. Conclusions Patients with ulcerative colitis had a high probability of SIBO. Rrifaximin combined with Bacillus subtilis can effectively alleviate inflammation. 

Objective To investigate the effects of Bacillus subtilis and enterococcus faecium enteric⁃coated capsules on intestinal barrier function and Th9 cell expression in cirrhotic patients with different liver reserve func⁃ tion. Methods A total of 172 patients with liver cirrhosis in our hospital were selected and assigned to observation group（72 children Pugh A grad）and control group（100 children Pugh B⁃C grade）based on different liver reserve functions. All patients were treated with conventional treatment in addition to the use of metoprolol（Bacillus subtil⁃ is enteric coated capsules），and both were observed for 14 days. Results After treatment，the total effective rates in the observation group and the control group were 98.6% and 89%，and the observation group was better than that of the control group（P < 0.05）. there was no significant difference in intestinal flora between the two groups before treatment（P > 0.05），the Bifidobacterium and Lactobacillus in the observation group after treatment were significantly increased（P < 0.05），Candida albicans was significantly lower than that before treatment（P < 0.05）. after treatment，the serum IL⁃6 and TNF⁃α in the observation group and the control group were lower than before treatment（P < 0.05），and the serum IL ⁃6 and TNF ⁃α in the observation group after treatment were lower than those in the control group（P < 0.05）. after treatment，the Th9 cells in the observation group and the control group were（0.11 ± 0.05）% and（0.32 ± 0.10）%（P < 0.05），respectively，which were lower than（0.82 ± 0.32）% and （0.83 ± 0.24）% before treatment，and the Th9 cells in the observation group after treatment was lower than those in the control group（P < 0.05）. Conclusion Compared with patients with poor hepatic reserve function，application of Bacillus subtilis and enterococcus faecium enteric⁃coated capsule in the better hepatic reserve function patients with liver cirrhosis could improve the intestinal barrier function，inhibit the expression of Th9 cells，inhibit the expression of inflammatory cytokines，which play a better therapeutic effect. 

Objective To assess the clinical significance of 16p13.11 microduplications encompassing NDE1 gene and study the genotype ⁃phenotype correlation. Methods Sixty ⁃one patients and 6，144 controls who had undergone chromosome microarray analysis（CMA）for neurocognitive impairment or other reasons were ana⁃ lyzed and then divided into three groups：a group of patients with neurocognitive impairment，a prenatal group with abnormal nervous systems，and a prenatal group with normal nervous systems. The fetuses carrying 16p13.11 micro⁃ duplications were followed up，and the detection rates for the three groups were statistically analyzed. Results 16p13.11 microduplications were not detectable in the group of patients with neurocognitive impairment and the prenatal group with abnormal nervous systems. However，16p13.11 microduplications encompassing NDE1 gene were detectable in 13 fetuses in the prenatal group with normal nervous systems. Of these，one pregnancy was termi⁃ nated because of fetal heart defect，the others chose to continue their pregnancy，and no other structural abnormali⁃ ties were observed in the fetuses. A follow⁃up on postnatal health of the newborns revealed no apparent abnormali⁃ ties. There was no significant difference in the detection rate of 16p13.11 microduplication among the three groups （P > 0.05）. Conclusions Combined with the characteristics of low penetrance，16p13.11 microduplications encompassing the entire NDE1 gene may be benign variants；however，more large⁃scale studies are needed to eval⁃ uate the associated clinical phenotypes. Follow ⁃up to adulthood is recommended for prenatal cases with 16p13.11 microduplication. 

Objective To investigate the application of critical ultrasound in evaluating the systolic move⁃ ment（Sm）peak velocity of mitral annula before weaning vein artery extracorporeal membrane oxygenation（VA ⁃ ECMO）. Methods The weaning test was conducted in 40 patients who received VA⁃ECMO treatment in General Hospital of Ningxia Medical University from February 2019 to February 2023. There were 28 cases having success⁃ fully weaning VA⁃ ECMO（group A）and 12 cases failing to wean（group B）. Before weaning test，Sm，left ventric⁃ ular ejection fraction（LVEF），and left ventricular end diastolic diameter（LVEDD）were measured by critical ultrasonography，and the data of two group were analyzed compared . The predicting values of Sm measured by critical ultrasonography for successful weaning were evaluated with ROC curve. Results Before the weaning test，the Sm of group A were higher than those of group B（P < 0.05）. While there was no significant difference in LVEDD between the two groups before weaning test（P > 0.05）. The area under ROC curve（AUC）of Tei index，Sm and LVEF were 0.896，0.479，respectively. The difference of Sm was statistically significant between two groups（all P < 0.05）， and the optimal cut⁃off values were 0.821 and 0.321，respectively. Conclusion Critical ultrasound evaluation of Sm can be used to predict successful weaning of VA⁃ ECMO in ICU patients. 

Objective To investigate the value of a combined model constructed by transvaginal ultra⁃ sound radiomics and clinical risk factors and its nomogram in predicting preterm birth in late pregnancy. Methods One hundred and seventeen pregnant women from 28 + 0 to 36 + 6 weeks of gestation who attended regular maternity checkups at our hospital from January 2017 to December 2022 were selected as observation subjects，and transvaginal ultrasound cervical standard section images were collected and analyzed for radiomics features，and ultrasound radiomics models were constructed by removing redundant features through dimensionality reduction screening ， using logistic regression，and combining clinical data in the training group The nomogram of the combined models. To compare the efficacy of each model in predicting preterm birth. Results A total of 14 ultrasound radiomics features were screened to construct an ultrasound radiomics prediction model for assessing the risk of preterm delivery in late pregnancy with a model training set AUC of 0.841［95%CI（0.761，0.921）］and a validation set of 0.824［95%CI（0.616，1.00）］. The combined model was established by combining age and cervical length，and the AUC of the model training set was 0.908［95%CI（0.850，0.966）］and the validation set was 0.892［95% CI （0.693，0.100）］. The decision curves showed that the clinical utility of the combined model was better than that of the ultrasound radiomics model within the 0.2 ~ 0.8 threshold. Calibration curves showed that the combined model was more accurate than the ultrasound radiomics model. Conclusion The radiomics based on ultrasound features and clinical characteristics can predict the risk of preterm birth，which can provide a reference basis for clinical diagnosis and treatment. 

Objective To explore the clinical effect of the treatment of primary knee osteoarthritis（Qi stagnation and blood stasis type）with self⁃made Jingu Zhitong Plaster and Huayu Tongluo Moxibustion. Methods 68 patients with primary knee osteoarthritis who met the inclusion criteria were randomly divided into treatment group and western medicine group，with 34 cases each. The western medicine group was treated with anti⁃inflamma⁃ tory and analgesic drugs combined with sodium hyaluronate injection into the joint cavity，while the treatment group was treated with self⁃made Jinggu Zhitong ointment combined with blood⁃stasis and collateral⁃removing moxi⁃ bustion，6 times a week for 2 weeks. The WOMAC bone joint scale，walking test and inflammatory index（tumor necrosis factor（TNFα），Interleukin⁃6（IL⁃6）and the incidence of adverse reactions. Results The total effective rate of the treatment group was 96.7%，which was better than that of the western medicine group（86.7%，P < 0.05）； Compared with before treatment，the knee pain score and TNFα of the two groups of patients after treatment and the inflammatory indexes of IL⁃6 were improved（P < 0.05，P < 0.01）；Compared with the western medicine group， the score of WOMAC bone joint scale and related inflammatory indexes in the treatment group were significantly improved after treatment and at the follow⁃up of one month after treatment（P < 0.01）；There was no significant difference in the incidence of adverse reactions between the treatment group（5.88%）and the western medicine group（14.70%）（P > 0.05）. Conclusion Jingu Zhitong Ointment combined with Huayu Tongluo Moxibustion can effectively reduce the joint cavity effusion and inflammatory index content in patients with primary osteoarthritis of the knee of qi stagnation and blood stasis type，improve the knee joint range of motion，relieve pain，and treat safely and effectively. The curative effect is better than that of using western medicine alone.

Sepsis is an organ dysfunction caused by the host′s uncontrolled response to infection，and is a common cause of death in critically ill patients. Sepsis ⁃induced myocardial injury（SIMI）directly related to the poor prognosis of sepsis. The pathogenesis of SIMI is complex and related to mechanisms such as excessive inflam⁃ matory response，mitochondrial damage，cell apoptosis，and autophagy. Deeply exploring the pathogenic mecha⁃ nism of SIMI can help develop more effective targeted drugs，thereby improving the prognosis of sepsis patients. 

The intestinal microbiome has a long⁃term symbiosis with the body，not only participating in the formation of the intestinal barrier，but also maintaining the body′ s metabolism by producing vitamins and other products necessary for host physiology. Autophagy is a cellular catabolic process used to maintain homeostasis，and it functions at a fundamental level in all tissues. In this review，we will elaborate the changes of autophagy when regulating intestinal microbiome and the changes of intestinal microbiome when autophagy changes，so as to pro⁃ vide more research directions for the treatment of diseases.