Hepatocellular carcinoma （HCC） is one of the most common malignant tumors， and its high morbidity， high mortality rate， and low survival rate are the basic features of the epidemiology of HCC in China. It has been found that phospholipase A2（PLA2） is involved in the complex processes of phospholipid digestion and metabolism， immune defense and signaling， and actively participates in the inflammatory response of liver tissue， hepatocyte survival， proliferation and apoptosis， and the process of hepatocellular carcinogenesis and development. This paper introduces the role of PLA2 in the development of HCC and points out that PLA2 can be used as a new idea and drug target for drug development and clinical control of HCC. 

Objective To explore whether depression can occur in COPD mouse model induced by chronic exposure to tobacco smoke alone. Methods SPF grade mice were divided into control group（CLT group） and smoke exposure group（CS group）. Mice in CS group were exposed to tobacco smoke for 24 weeks. Open field test and tail suspension test were performed 24 hours after the last smoking，and lung function test was performed after the test. The levels of IL­6 and KC in BALF supernatant were detected by ELISA， as well as the serum levels of 5­HT. H&E staining and Nissl staining were used to observe the pathological changes of lung and brain tissues of mice. Results Compared with CTL group，the body weight of mice in CS group grew slowly （P < 0.001）， FRC and FVC were significantly increased （P < 0.001），and FEV20/FVC and FEV50/FVC were significantly decreased （P < 0.05）. The expression levels of proinflammatory cytokines IL­6 and KC in BALF were increased （P < 0.01），and the content level of 5­HT in serum was significantly decreased （P < 0.001）. The total movement distance， the number of times into the central area and the retention time in the central area of the CS group were significantly decreased in the open field test （P < 0.05）， and the immobility time of the CS group was increased in the tail suspension test （P < 0.05）. H&E staining showed that the mean alveolar intercept of lung tissue in the CS group was significantly increased （P < 0.001）， and Nissl staining showed that the number of damaged neurons in the cortex （P < 0.001） and hippocampus （P < 0.01） in the CS group was significantly increased. Conclusion Chronic exposure to tobacco smoke alone induced COPD mouse models with depression. 

Objective To study the effect of propofol regulating HIF-1α signaling pathway through miR182-5p on biological activity in placental trophoblast cells induced by Hypoxia. Methods Hypoxia-induced in vitro cultured HTR-8/SVneo cells were used in this study. Cells were treated with propofol. CCK-8 was used to detect cell viability； Transwell to determine cell migration and invasion， and TUNEL to detect apoptosis. The relative mRNA expression level of miR-182-5p and HIF-1α was measured by qRT-PCR. Western blot was used to detect the expression level of related pathway proteins. Results Compared with the control group， the hypoxic group showed reduced cell migration and invasion ability， increased apoptosis rate （P < 0.05）， reduced miR-182-5p and MMP-9 expression level， and increased HIF-1α and VEGF expression level （P < 0.05）. Compared with the hypoxic group， propofol intervention restored cell migration and invasion ability， decreased apoptosis rate （P < 0.05）， increased miR-182-5p ， MMP-9 expression level， and decreased HIF-1α and VEGF expression level （P < 0.05）. Transfection with inhibitors reversed the therapeutic effect of propofol. Conclusion Propofol ameliorates hypoxia-induced HTR-8/SVneo cytotoxicity by regulating the miR-182-5p/HIF-1α axis. 

Objective To investigate the effect of bethaneline on expression of rhoA/ROCK pathway protein in pulmonary arterial hypertension （PAH） induced by monocrotaline （MCT） in rats. Methods 72 SD （Sprague Dawley） rats were randomly divided into control group， MCT（50 mg/kg） group， sildenafil （30 mg/kg） group and low， medium， high （100，200，400 mg/kg） group depending on betaine level. Monocrotaline group was adminstered on the 22nd day after successful modeling， and then the right ventricular systolic pressure， right ventricular hypertrophy index and visceral index were measured on the 41st day. The expressions of RhoA， Rock1 and Rock2 in the rat myocardial and lung homogenates were detected by Western blot. Results Compared with MCT， both betaine （400 mg/kg） and sildenafil （30 mg/kg） significantly reduced the mean pulmonary artery pressure （mPAP）， right ventricular systolic pressure （RVSP） and right ventricular hypertrophy index （RVHI）（P < 0.01）. Lung and cardiac tissue expression of RhoA， ROCK1， and ROCK2 proteins were upregulated in the MCT group as compared with the control group， but the expression was significantly suppressed in the betaine group （400 mg/kg）（P < 0.05）. Compared with the control group， the expression of RhoA， ROCK1 and ROCK2 proteins in the lung and heart tissues of the MCT group was up-regulated， but the expression was significantly inhibited in the betaine group （400 mg/kg）（P < 0.05）. Conclusion Betaine can reduce monocrotaline induced pulmonary hypertension in rats. It is speculated that its mechanism may be related to the down-regulated expression of RhoA， ROCK1 and ROCK2 in rat lung and myocardium through the RhoA/ROCK pathway. 

Objective To investigate the effects of baicalin on neuroinflammation and cognitive dysfunction in mice with cerebral ischemia-reperfusion injury （CIRI） by inhibiting PGE2. Methods Adult male C57BL/ 6J mice were randomly divided into two groups， the model of bilateral carotid artery occlusion （tBCCAO） was established. Baicalin was given by gavage or PGE2 was injected into lateral ventricle.The cognitive function of mice was detected by Morris water maze. The lipid peroxidation and neuroinflammation in hippocampus were measured by ELISA at 72 h after operation. The pathological changes of brain tissue were observed by HE staining. Western blot was used to detect the expression of GPX4， DMT1 and PTGS2 in hippocampus. Results CIRI induced cognitive impairment in mice， accompanied by hippocampal neuronal injury， neuroinflammation， lipid peroxidation and abnormal expression of ferroptosis associated proteins （P < 0.05）. Baicalin pretreatment could improve the cognitive impairment induced by CIRI in mice， and was accompanied by a reduction in hippocampal neuronal injury， neuroinflammation， lipid peroxidation and abnormal expression of ferroptosis associated proteins （P < 0.05）.PGE2 was upregulated in the hippocampus of mice after intracerebroventricular injection of PGE2， accompanied by neuroinflammation， lipid peroxidation and abnormal expression of ferroptosis associated proteins （P < 0.05）. Baicalin could decrease the neuroinflammation， lipid peroxidation and abnormal expression of ferroptosis associated proteins in hippocampus by inhibiting PGE2 up-regulation （P < 0.05）. The up-regulation of PGE2 in hippocampus aggravated the cognitive impairment induced by CIRI （P < 0.05）. Baicalin improved cognitive impairment by inhibiting the up-regulation of PGE2（P < 0.05）. Conclusion Baicalin ameliorates the cognitive impairment induced by CIRI， and the mechanism is related to the inhibition of PGE2-related neuroinflammation. 

Objective To investigate the neuroprotective effect of ibuprofen on ischemic stroke （IS） rats by regulating nuclear factor E2-related factor 2（Nrf2）/non-glycosylated xCT （SLC7A11）/glutathione peroxidase 4 （GPX4） signaling pathway. Methods Forty eight IS rats prepared under the middle cerebral artery infarction model were randomly divided into IS group， treatment group （30 mg/kg ibuprofen）， inhibitor group （30 mg/kg ML385）， and treatment + inhibitor group （30 mg/kg ibuprofen + 30 mg/kg ML385）. Another 12 rats were set as a sham-operated group， where the rats were prepared only by separating the blood vessels instead of ligating them. After intervention， the neurological function of the rats was scored， and the rate of cerebral infarction and the content of cerebral edema were detected. After that， the rat brain tissue was removed to observe the morphological changes of neurons，measure the contents of iron ion and detect the expression of proteins related to the Nrf2/ SLC7A11/GPX4 signaling pathway. Results Compared with the sham operation group， the neurological function score， cerebral infarction rate， cerebral edema content and iron ion content in IS group were significantly increased， and the expressions of Nrf2， SLC7A11 and GPX4 were obviously decreased （P < 0.05）； compared with the IS group， the neurological function score， cerebral infarction rate， cerebral edema content and iron ion content in the treatment group were obviously decreased， and the expressions of Nrf2， SLC7A11， and GPX4 were significantly increased as well. The neuroprotection of the treatment group on IS rats was reversed in the inhibitor group. Conclusion Ibuprofen can protect nerve damage in IS rats， which may be related to the activation of Nrf2/ SLC7A11/GPX4 signaling pathway. 

Objective To observe the expression of fructose ­ bisphosphate aldolase C （ALDOC） in colon cancer tissues and cells and to explore its effect on biological behavior. Methods GEPIA database was used to analyze the expression level of ALDOC in colon cancer tissues. The expression of ALDOC mRNA and protein in colon cancer tissues and cancer cells SW620， SW480， HT­29 and HCT­116 were detected by RT­qPCR and immunohistochemistry，and the relationship between ALDOC mRNA expression and clinicopathological factors was analyzed. Colon cancer cell SW620 was divided into control group， NC inhibitor group and ALDOC inhibitor group. ALDOC inhibitor or negative control was transfected into SW620 cells by lentivirus transfection kit.MTT assay and monoclonal formation of cancer cells were used to detect cell proliferation. Scratch test was used to detect cell migration ability， and transwell chamber test to detect the invasion ability of cells. The expression of ALDOC mRNA was detected by RT­qPCR， and that of ALDOC and MMP­2/9 was detected by western blot. Results GEPIA database showed that the expression level of ALDOC in colon cancer tissues was higher than that in normal tissues （P < 0.05）. Compared with those in adjacent tissues or FHC， ALDOC mRNA and protein in colon cancer tissues and cells SW620， SW480， HT­29 and HCT­116 were up­regulated， and ALDOC mRNA level was significantly correlated with tumor differentiation， TNM stage and lymph node metastasis （P < 0.05）. Down­regulating ALDOC mRNA could down­regulate MMP­2 and MMP­9 protein levels， inhibit cell growth， and reduce the number of wound healing and invasive cells （P < 0.05）. Conclusion ALDOC level is up­regulated in colon cancer tissues and cells， and it is closely related to the poor prognosis of colorectal cancer patients. ALDOC regulates the invasion and migration of colon cancer cells by regulating MMP­2/9. 

Objective To investigate the clinical efficacy of single row anchor combined with bone tunnel （SRA-BT） and proximal humeral plate （PHP） in treatment of greater tuberosity （GT） fractures of humerus. Methods The medical records of 44 patients with GT fracture admitted from June 2017 to June 2021 were retrospectively analyzed. They were divided into SRA-BT group （18 cases）and PHP group （26 cases）by different surgical methods. Perioperative related indicators，complications，bone healing， and postoperative re-displacement distance of GT were compared between the two groups. VAS，ASES and protractor measurements were used to evaluate the pain degree ， function status and range of motion （ROM） at 6 months follow-up ， respectively. Results The length of incision，operation time，intraoperative blood loss and in-patients costs in PHP group was significantly higher than that in SRA-BT group （P < 0.05）. The re-displacement distance of GT in SRA-BT group was greater than that of PHP group （P < 0.05）. There was no significant difference in postoperative complications between the two groups （P > 0.05）. The postoperative VAS scores at rest and activity in the two groups were significantly better than those in preoperative （P < 0.05）， but there was no significant difference between the two groups （P > 0.05）. The postoperative ASES scores of the two groups were significantly better than that in preoperative （P < 0.05）， and the postoperative ASES scores of SRA-BT group were higher than those in PHP group（P < 0.05）.The ROM of the RA-BT group was better than that of the PHP group during flexion and abduction （P < 0.05）， but there was no significant difference between the two groups at 0 ° external rotation and 90 ° internal rotation （P > 0.05）. Conclusion Both SRA-BT and PHP can achieve good clinical efficacy and prognosis in the treatment of GT fractures. However， SRA-BT has the advantages of less trauma， low cost， relatively few postoperative complications， and no need for a second operation. 

Objective To investigate the relationship between the expression of SLIT3 and SPARCL1 protein and the recurrence of cervical cancer after radical operation. Methods From October 2019 to April 2021， 107 patients who underwent radical surgery for cervical cancer in the hospital were selected as the study subjects， and 30 patients with benign uterine lesions were selected as the control group； The patients were followed up for 1 year and were divided into relapse group （n = 25） and non relapse group （n = 82） according to the follow-up results. The expression levels of SLIT3 and SPARCL1 mRNA were detected by real-time fluorescence quantitative analysis （qPCR），and the expression levels of SLIT3 and SPARCL1 protein were detected by immunohistochemistry. The correlation between the expression of SLIT3 and SPARCL1 protein and clinicopathological characteristics was analyzed. Cox model was used to analyze the risk factors of cervical cancer recurrence after radical operation. Results The expression of SLIT3 and SPARCL1 mRNA in cervical cancer group was significantly lower than that in control group （P < 0.05）；The levels of SLIT3 and SPARCL1 mRNA in cervical cancer tissues of patients with recurrence were significantly lower than those of patients without recurrence （P < 0.05）.Among 107 patients with radical operation， 25 patients recurred， the recurrence rate was 23.36%. The postoperative recurrence rate of patients with low expression of SLIT3（31.15%） was significantly higher than that of patients with high expression of SLIT3（13.04%）. The postoperative recurrence rate of patients with low expression of SPARCL1（32.31%） was significantly higher than that of patients with high expression of sparcl1（9.52%）. The difference was statistically significant （P < 0.05）. The expression of SLIT3 and SPARCL1 in cervical cancer was correlated with the degree of differentiation， clinical stage， lymph node metastasis and depth of stromal invasion （P < 0.05）， but not with age， pathological type and maximum diameter of tumor （P > 0.05）.Cox univariate analysis showed that the degree of differentiation， clinical stage， lymph node metastasis， stromal invasion depth， SLIT3 protein expression and SPARCL1 protein expression were correlated with the recurrence of cervical cancer patients after radical surgery （P < 0.05）；Cox multivariate analysis showed that moderate/high differentiation， stage IIA， lymph node metastasis， stromal invasion depth > 50%， low expression of SLIT3 protein and SPARCL1 protein were independent risk factors for recurrence of cervical cancer patients after radical surgery （P < 0.05）. Conclusion the expression of SLIT3 and SPARCL1 in cervical cancer tissue is lower than that in normal cervical tissue. The low expression of SLIT3 and SPARCL1 protein is an independent risk factor for the recurrence of cervical cancer after radical operation， and has certain clinical significance in predicting the recurrence of cervical cancer after operation. 

Objective To explore the expression of TRPV2 and its clinicopathological significance in oral squamous cell carcinoma （OSCC）. Methods Immunohistochemistry and western blot were used to detect TRPV2 expression level in OSCC； Pearson χ2 test to analyze the association between TRPV2 expression level and clinicopathological features of OSCC patients； log-rank test to analyze the effect of TRPV2 on survival. Bioinformatics method was used to explore the potential biological function of TRPV2， and immunohistochemistry to verify the relationship between TRPV2 and macrophage infiltration level. Results Immunohistochemistry and western blot confirmed that TRPV2 was highly expressed in OSCC （P < 0.05）. TRPV2 expression was significantly correlated with T stage， tumor histological grade and poor prognosis （P < 0.05）. Bioinformatics method found that TRPV2 participated in PI3K/AKT pathway and regulated the level of immune cell infiltration； TRPV2 expression had strong positive correlation with the macrophage infiltration level （R = 0.562，P < 0.001）. Conclusion The expression of TRPV2 is highly expressed in OSCC and associated with poor prognosis，and may take part in the occurrence and development of OSCC by regulating immune response and PI3K/AKT pathway. 

Objective To explore the relationship between SIRT1 genetic variation （rs1467568， rs4746720） and microscopic polyangiitis（MPA） in Guangxi population. Methods The SIRT1 polymorphisms of 208 patients with microscopic polyangiitis（MPA）and 211 healthy volunteers were genotyped by multiplex polymerase chain reaction （PCR） and high throughput sequencing. The allele frequencies and genotypes were compared. The linkage disequilibrium，haplotype and genetic model were analyzed. The relationship between different genotypes and clinical symptoms and laboratory biochemical indexes was evaluated. Results The results showed no significant difference between the two groups in genotype，allele frequency，and haplotype of SIRT1 rs1467568 and rs4746720（P > 0.05）. In the age group ≥ 54 years old， the dominant model（OR = 0.50，95%CI：0.27 ~ 0.92， P = 0.026），overdominant model（OR = 0.49，95%CI：0.26 ~ 0.92，P = 0.026）and additive model （OR = 0.57， 95%CI：0.33 ~ 0.99，P = 0.045） of SIRT1 rs1467568 were associated with lower susceptibility to MPA. In rs1467568，MPA patients with GG genotype had higher levels of glutamic pyruvic transaminase （P = 0.012），while in rs4746720， MPA patients with TT and TC genotypes had higher levels of glutamic oxaloacetic transaminase （P = 0.036）. Conclusions In this study， SIRT1 rs4746720 was not related to the susceptibility to MPA in Guangxi population， but rs1467568 may be associated with the susceptibility to MPA in some people （≥ 54 years old） in Guangxi， and rs1467568 and rs4746720 were associated with the levels of glutamic pyruvic transaminase and glutamic oxaloacetic transaminase in patients with MPA. 

Objective To explore the risk of contrast-induced nephropathy （CIN） after percutaneous coronary intervention in patients with acute myocardial infarction， and to construct a corresponding model. Methods 144 patients with acute myocardial infarction who had admitted to Liupanshui shenggang shuigang Hospital from May 2021 to March 2023 were retrospectively selected as research objects， and randomly divided into a modeling group （103 patients） and a verification group （41 patients） according to a 2：1 ratio. The patients in the modeling group were divided into a CIN group （38 patients） and a CIN group （65 patients） according to whether CIN occurred after surgery. The LASSO regression model and 10-fold cross-validation method were used to obtain the best risk predictors of CIN after the procedure， and multiple logistic regression was used to analyze the independent risk factors affecting CIN. The nomogram model was constructed and evaluated. Results The postoperative incidence of CIN was 36.89% （38/103）. Age， diabetes mellitus， LVEF， dosage of contrast agent and Scr were independent risk factors for CIN （P < 0.05）. The receiver operating characteristic curve （ROC） and calibration curve constructed by the data sets from the modeling group and validation group showed better predictive efficiency of the line graph model. The risk stratification system divided patients into four subgroups： very low risk group （total score < 65）， low risk group （total score < 150）， medium risk group （total score < 200） and high risk group （total score 200）. There were significant differences in the incidence of CIN among the patients with different risk scores （χ2 = 17.495， P = 0.001）. Conclusions The line graph model constructed by age，diabetes，LVEF，dosage of contrast agent，Scr and other indicators has better predictive value for CIN after percutaneous coronary intervention. 

Objectives To investigate the risk factors of 30-day mortality and postoperative pulmonary complication in neonatal noncardiac surgery and to establish models for predicting the 30 d mortality. Methods Retrospective analysis of clinical data of newborns undergoing cardiac surgery in hospitals from September 2018 to February 2022. Single factor and multivariate logistic regression analysis were used to determine the risk factors associated with postoperative pulmonary complications and postoperative death. And construct a predictive model for postoperative death within 30 days. survival，as well as constructthe prediction model of 30 d mortality. Results Of 140 patients，85（60.7%） experienced a postoperative pulmonary complication and 13（0.93%）died within 30 d after surgery. Among all factors，cardiopulmonary bypass （P=0.002）and intraoperative use of albumin （P=0.038）were associated with PPC. Prematurity （P=0.01），emergency operation（P = 0.009）and surgery length （P = 0.001） were significant contributors to 30 d mortality. According to these three risk factors ，a nomogram model was constructed to predict the 30 d mortality after neonatal noncardiac surgery. The C-index value was 0.862（95% CI： 0.758 ~ 0.966），and the receiver operating characteristic curve and calibration curve showed that the nomogram model had a moderate prediction ability. Conclusion The developed and validated nomogram can be used to calculate the individualized risk of postoperative mortality and become a practical tool for anesthetist and clinicians to achieve better treatment for high-risk newborn infants. 

Objective To investigate the expression and clinical significance of phosphatidylinoinosidine­3­ kinase （PI3K） and matrix metalloproteinase 9（MMP­9） in bronchoscopic alveolar lavage fluid of children with severe pneumonia in pediatric intensive care unit （PICU）. Methods A total of 103 children with severe pneumonia admitted to PICU of the hospital from January 2021 to June 2022 were enrolled. All patients underwent fiberbronchoscopic alveolar lavage. Real­time fluorescence quantitative polymerase chain reaction was used to determine the expression of PI3K， and enzyme­linked immunosorption was used to determine the expression of MMP­9 in alveolar lavage fluid. The patients were followed up for 21 days after admission to evaluate the prognosis. Logistic regression analysis was used to analyze the factors affecting the prognosis. Pearson correlation was used to analyze the correlation between the expression levels of PI3K and MMP­9 in the bubble lavage solution and the child Critical Case Score （PCIS） and child Organ Dysfunction 2（PELOD­2） Scores. The values of PI3K and MMP­9 expression levels in alveolar lavage fluid to predict the prognosis were analyzed by receiver operating curve （ROC）. Results Among the 103 children，29 cases had poor prognosis vs 74 cases had good prognosis. Logistic multivariate regression analysis showed that combined shock （OR = 4.104，95%CI：1.689 ~ 9.974）， PELOD­2 score （OR = 4.764，95%CI：1.960 ~ 11.577）， PCIS score （OR = 5.068，95%CI：2.085 ~ 12.318）， PI3K （OR = 3.924，95%CI：1.614 ~ 9.536） and MMP­9 （OR = 3.873，95%CI：1.594 ~ 9.412） were the prognostic factors of PICU children with severe pneumonia （P < 0.05）. Pearson correlation analysis showed that the expression levels of PI3K and MMP­9 in alveolar lavage fluid were negatively correlated with PCIS scores （r = -0.598，P = 0.000；r = -0.537，P = 0.000）， PI3K and MMP­9 expression levels in alveolar lavage fluid were positively correlated with PELOD­2 scores （r = 0.546，P = 0.000；r = 0.571，P = 0.000）. ROC curve results showed that the sensitivity of PI3K， MMP­9 and their combination to predict the prognosis of PICU children with severe pneumonia was 75.86% （95%CI：56.08% ~ 88.98%），72.41% （95%CI：52.51% ~ 86.55%） and 82.76% （95%CI：63.51% ~ 93.47%）， the specificity was 75.68% （95%CI：64.07% ~ 84.58%）， 79.73% （95%CI：68.47% ~ 87.85%），89.19% （95%CI：79.28% ~ 94.88%）， and the AUC was 0.762（95%CI：0.666 ~ 0.859），0.767（95%CI：0.670 ~ 0.873），0.909（95%CI：0.848 ~ 0.971）. Conclusion The expression of PI3K and MMP­9 in bronchoscopic alveolar lavage fluid was related to the prognosis of children with severe pneumonia in PICU， and the combination in predicting the prognosis was effective， so it has certain clinical value to use them as a sensitive indicator to predict the prognosis of children with severe pneumonia in PICU. 

Objective To investigate the risk factors for choledocholithiasis recurrence after emergency endoscopic choledocholithotomy in elderly patients with choledocholithiasis complicated with acute cholangitis. Methods The clinical data of patients aged over 60 years with choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography （ERCP）， small sphincterotomy （sEST） combined with endoscopic balloon dilation of the nipple （EPBD） in the First Affiliated Hospital of Anhui University of Science and Technology from January 2018 to October 2022 were retrospectively analyzed. According to the postoperative follow­up of choledocholithiasis recurrence， the patients were divided into recurrence group and non­recurrence group. The clinical data of patients with choledocholithiasis were compared between the two groups to analyze the risk factors of choledocholithiasis recurrence. Results The recurrence rate of choledocholithiasis was 18.52% （20/108）. Univariate analysis showed that parapillary duodenal diverticulum， biliary stent， number of common bile duct stones ≥ 2 pieces and mechanical lithotripsis were risk factors for recurrence of common bile duct stones after endoscopic stone removal （P < 0.05）. Multifactor Logis­tic regression analysis showed that biliary stents， the number of common bile duct stones ≥ 2 pieces and mechanical lithotripsy were independent risk factors for the recurrence of common bile duct stones after endoscopic lithotomy （P < 0.05）. Ursodeoxycholic acid for 6 months after surgery could reduce the recurrence of choledocholithiasis （P < 0.05）. Conclusion Biliary stents， the number of choledocholithiasis ≥ 2 pieces and mechanical lithotripsy were independent risk factors for choledocholithiasis recurrence in elderly patients after endoscopic lithotomy， and ursodeoxycholic acid for six months after surgery was beneficial to reduce choledocholithiasis recurrence. 

Objective To investigate the value of morphological abnormalities of uterine artery on Doppler ultrasound combined with serum CC chemokine ligand 19（CCL19） level in predicting adverse pregnancy outcomes （APO） in patients with systemic lupus erythematosus （SLE）. Methods Eighty pregnant women with SLE were selected from January 2015 to January 2022 in Qingdao Women and Children′s Hospital and divided into APO group （34 women） and non-APO group （46 women） according to their pregnancy outcomes. The morphology of uterine artery on Doppler ultrasound and serum CCL19 level were compared between the two groups. The correlation and predictive efficacy of the combined detection with APO in SLE patients were analyzed. Results As compared with non-APO group， APO group had an increase in morphological abnormalities of uterine artery and serum CCL19 level （P < 0.05）. Logistic risk regression showed that the morphology of uterine artery and serum CCL19 were risk factors for APO in patients with SLE （P < 0.05）. The ROC curve showed that the optimal cut-off point for serum CCL19 to predict APO in patients with SLE was 335.89 ng/L， and the area under curve （AUC） for predicting APO in patients with SLE was 0.816. The AUC for morphological abnormalities of uterine artery on Doppler ultrasound to predict APO in patients with SLE was 0.694. The AUC for the combined prediction was 0.858. Conclusions Morphological abnormalities of uterine artery on Doppler ultrasound and serum CCL19 level are risk factors for APO in patients with SLE， and their combined detection has a higher predictive efficacy. 

Objective To explore the relevant factors affecting the occurrence of biliary complications in patients after removing residual stones from intrahepatic and extrahepatic bile ducts through T­tube fistula，and to construct a predictive model. Method A retrospective analysis was conducted on 194 patients who underwent intrahepatic and extrahepatic bile duct stone removal through T ­tube fistula in our hospital from January 2018 to July 2020. Based on the incidence of postoperative biliary complications such as biliary bleeding， abdominal pain， and vomiting， the patients were divided into a non­complication group （n = 132） and a complication group （n = 62）. Relevant data of the patients were collected， and independent influencing factors for the occurrence of related complications were analyzed using univariate and multivariate logistic regression analysis. Another 92 patients who underwent intrahepatic and extrahepatic bile duct stone removal through T­tube fistula in our hospital from August 2020 to August 2022 were selected as external validation. The predictive value of the risk prediction model was evaluated by the receiver operating characteristic curve （ROC）， and the Goodness of fit of the model was judged by the Hosmer Lemeshow test. Results Among the 194 patients who underwent intrahepatic and extrahepatic bile duct stone removal through T­tube fistula，132 did not experience complications， while 62 experienced complications， including 57 cases of abdominal pain， vomiting， biliary tract infection， and 5 cases of biliary bleeding. The results of univariate analysis showed significant differences between the two groups of patients in preoperative albumin， surgical time， bile properties， intraoperative bleeding volume， and bile multidrug­resistant bacterial infection （P<0.05）； No significant difference was noted in age，sex，BMI，course of disease，preoperative total bilirubin， preoperative white blood cells， hypertension， diabetes， hepatitis B，surgeon experience and bile duct diameter in the two groups （P > 0.05）. The results of multivariate analysis showed that preoperative albumin， surgical time， bile properties， intraoperative bleeding， and infection with multidrug­resistant bile bacteria were all independent influencing factors for postoperative complications in patients（P<0.05）；Risk prediction model：Logit （P）=8.564­0.438 ×（Preoperative albumin）+0.092 ×（Surgical time）+2.038 ×（Bile traits）+1.253 ×（intraoperative bleeding volume）1.179 ×（Multi drug resistant bacterial infection），the area under the ROC curve （AUC） of the risk warning model was 0.890（95% CI： 0.875 ~ 0.951），the sensitivity was 89.8%，and the specificity was78.2%. The Hosmer Lime show fitting test showed that，χ² = 10.109，P = 0.57，the model had good fitting validity and high predictive value. The sensitivity of external validation of the model was 85.2%， specificity was 84.6%， and overall accuracy was 84.8%. Conclusion Preoperative albumin， surgical time， bile properties， intraoperative bleeding， and infection with multidrug­resistant bile bacteria were independent influencing factors for postoperative complications in patients. Therefore，constructing a risk prediction model based on these factors has certain predictive power. 

Objective Explored the efficacy， safety and prognostic factors of furoquinitinib alone and in combination with PD-1 monoclonal antibody in advanced metastatic colorectal cancer that failed to be treated with standard regimens. Methods From June 2018 to December 2021，31 patients who were treated with Furoquintinib combined with PD-1 inhibitor，42 patients who were treated with Furoquintinib alone and 35 patients who were treated with fourth-line chemotherapy were included as the research objects. The efficacy，survival time and major adverse reactions of patients were analyzed retrospectively，and the risk factors of progression-free survival （PFS） and overall survival （OS） were discussed. Results Significant differences in PFS were observed in the PD-1 inhibitor combined with furoquinitinib group compared with the chemotherapy group or the monotherapy group， and significant differences in OS compared with the chemotherapy group. The degree of differentiation and treatment regimen were independent risk factors affecting PFS in patients in the furoquinitinib combining PD-1 inhibitor versus chemotherapy group， while the treatment regimen was an independent risk factor affecting patients' OS. The degree of differentiation was an independent risk factor for PFS in patients in the PD-1 monoclonal antibody combination versus single agent group. The incidence of several adverse reactions was reduced with furoquinitinib alone or in combination with PD-1 inhibitor compared with conventional chemotherapy， while the incidence of hypertension was increased. Conclusions Furoquinitinib in combination with PD-1 monoclonal antibody has potential efficacy and a manageable safety profile in the backline treatment of patients with advanced mCRC. The degree of differentiation may be an independent risk factor for PFS in patients. 

Objective To investigate the factors influencing the hesitation of occupational pneumoconiosis patients in Guangdong Province to receive COVID ­ 19 vaccine so as to provide reference for eliminating their “vaccine hesitancy”. Methods From September 2022 to November 2022， a cohort of patients aged 18 years and above were selected from Guangdong occupational pneumoconiosis report system as the subjects in the survey by systematic sampling method. Questionnaire survey was conducted by telephone follow ­ up，and the acquired data were analyzed by multiple stepwise regression. Results A total of 339 questionnaires meeting the requirements were obtained， including 14 items affecting factors of “vaccine hesitation”. According to the standard partial regression coefficient，nine factors were correlated with vaccine hesitancy，in the order from the largest to the smallest correlation，e.g.，“I would be more willing to get vaccinated if recommended by doctors，community and other professionals，”“I believe that vaccines approved by the state are safe，” and “If the government recommends vaccination，I believe it will be beneficial.”，etc. Conclusion The government should carry out psychological interventions for coping strategies and health education measures to provide objective information about existing and developing vaccines and meanwhile pay more attention to the vaccine hesitancy of occupational disease patients so so to increase the vaccination rate and eliminate their vaccine hesitancy for the ultimate purpose of giving full play to the important protective role of the novel coronavirus vaccine in preventing Covid­19. 

Objective To Observe the clinical efficacy of modified Sijunzi decoction in the treatment of heart failure with reduced ejection fraction of Qi deficiency and blood stasis syndrome. Methods A total of 106 patients with heart failure with reduced ejection fraction of Qi deficiency and blood stasis syndrome were selected from September 2021 to September 2022 and divided into an observation group and a control group according to the random number table method，with 53 patients in each group. The control group was continuously treated with conventional Western medicine，while the observation group was treated with modified Sijunzi decoction on the basis of the control group for 10 days. NT-proBNP，left ventricular ejection fraction （LVEF）， the traditional Chinese medicine pattern score，6-minute walk test （6MWT），Minnesota Heart Failure Quality of Life Questionnaire （MLHFQ），Lee's heart failure score，the clinical efficacy and safety were evaluated between the two groups. Results After treatment， there was no significant change in LVEF in both groups compared to the baseline， but NTpro-BNP was markedly declined in both groups （P < 0.05）， but there was no significant difference between the two groups （P > 0.05）. Lee's score， MLHFQ score and the traditional Chinese medicine pattern score in both groups were significantly reduced， and the difference was statistically significant （P < 0.05），those scores were lower in the observation group than in the control group （P < 0.05）. 6MWT in both groups was higher than before （P < 0.05），and 6MWT in the observation group was higher than that in the control group （P<0.05）. The therapeutic effect and safety were higher in the observation group than in the control group. Conclusions Modified Sijunzi decoction combined with conventional Western medicine therapy for the patients with heart failure with  reduced ejection fraction of Qi deficiency and blood stasis syndrome can effectively improve the clinical symptoms and quality of life， and the efficacy is safe. 

Objective To observe the clinical effect of Sancai combined acupuncture on discogenic sciatica. Methods 162 patients with discogenic sciatica admitted to the Department of Rehabilitation Medicine of our hospital from February 2021 to December 2022 were randomly divided into control group， conventional acupuncture group and Sancai acupuncture group. The control group was treated with non-steroidal anti-inflammatory drugs for oral analgesia，the conventional acupuncture group was treated with conventional acupuncture，and the Sancai acupuncture group was treated with combined acupuncture based on Sancai theory， that is， the traditional scalp acupuncture combined with Shanyuan's new scalp acupuncture was used in the sky， the fire needle was used in the ground to rob the root point，and the human body was treated with the movement acupuncture after the press needle was buried. All three groups were intervened for 4 weeks. The pain visual analogue score （VAS）and Oswestry dysfunction index （ODI） were evaluated before，4 weeks after and 2 and 4 weeks after the intervention in the three groups， and the levels of serum substance P （SP）， chemokine ligand 10（CXCL10）， calcitonin related gene peptide （CGRP） were collected before and after the intervention， and the motor conduction velocity （MCV） and sensory conduction velocity （SCV） of the sural nerve were measured. Results There was an interaction between treatment method and time on VAS and ODI （P < 0.05）， and the main effect of treatment method and time on VAS and ODI was significant （P < 0.05）. The VAS and ODI results of the three groups at 4 weeks，2 weeks and 4 weeks after treatment were better than those before treatment， and the difference was statistically significant （P < 0.05）. The VAS score and ODI score of Sancai acupuncture group at the end of 2 and 4 weeks of treatment were lower than those of the other two groups， with significant difference （P < 0.05）； However， after 4 weeks of treatment， the levels of SP， CXCL10 and CGRP in the three groups were lower than those before treatment， and the levels of MCV and SCV were higher than those before treatment， except for CXCL10， MCV and SCV in the control group （P < 0.05）. In comparison between groups， the levels of CXCL10 and CGRP in Sancai acupuncture group were lower than those in the other two groups （P < 0.05）， lower in SP Sancai acupuncture group than those in the control group （P < 0.05）， and there was no difference between the two groups （P > 0.05）. In MCV and SCV， Sancai acupuncture group was higher than those in the other two groups （P < 0.05）. Conclusion Sancai combined acupuncture can effectively intervene the pain and dysfunction of patients， improve many laboratory indicators， and increase nerve conduction velocity， which is worthy of further study. 

Knee osteoarthritis is a common orthopedic disease with treatment difficulties， which has a high incidence rate in middle-aged and elderly people. Its pathological mechanism has not been fully understood. Current researches have found a strong correlation between obesity， abnormal lipid metabolism， and the occurrence and development of knee osteoarthritis. Synovial fluid of joints contains many metabolites and directly participates in the regulation of intra-articular metabolism， which can directly reflect the local lipid metabolism status of joints. The lipid metabolism profile in the synovial fluid of patients with knee osteoarthritis includes a variety of fatty acids and their related metabolites such as carnitine， acetyl coenzyme A， as well as a variety of phospholipids and adipocytokines such as adiponectin， leptin， and resistin. Among them， lipids such as arachidonic acid， some shortchain saturated fatty acids， and related metabolites may have a bidirectional regulatory function in the development of KOA， which is worthy of in-depth study. In this paper， we review the literature on the characteristics of lipid metabolism in synovial fluid of patients with knee osteoarthritis， with the aim of clarifying the correlation between lipid metabolism in synovial fluid and the occurrence and development of knee osteoarthritis， and providing some new ideas for the prevention and treatment of knee osteoarthritis. 

Exosomes are small extracellular phospholipid bilayer vesicles with a diameter of 30～150 nm and rich in proteins，lipids，nucleic acids，and other bioactive substances. They are widely distributed in various body fludis，such as plasma，urine，cerebrospinal fluid，etc.，and secreted by almost all types of cells in the human body. More and more studies have shown proof that exosomes have important biological functions. They not only participate in regulation of a variety of physiological and pathological process，but also play an important role in the diagnosis， development and treatment of diseases. In recent years， exosomes derived from circulating plasma have become a hot topic in exosomes research because they are easier to obtain specimens and carry out real-time detection. In this paper， the related disease research and clinical applications of circulating plasma exosomes are reviewed in order to provide a reference for its further study. 

Objective To formulate a high-quality development evaluation system of public TCM hospitals. Methods According to the relevant national policy documents and referring to the Quality Development Evaluation Indicators of Public Hospitals （Trial）and the Quality Development Evaluation Indicators of Public Traditional Chinese Medicine Hospitals （Trial） attached to the High-quality Development Evaluation Indicators of Public Hospitals （Trial）， the method of combining subjective and objective weights was adopted， and the Delphi method and analytic hierarchy process were combined. Delphi method is used to sort， summarize and screen the three-level indicators to determine the indicators. Then analytic hierarchy process was used to calculate the weights of each index in the overall model， and the data of public TCM hospitals in Guangdong Province from 2019 to 2021 was collected for empirical study. Results An evaluation system for the high-quality development of public TCM hospitals has been formed， including 5 first-level indicators，25 second-level indicators and 36 third-level indicators， and a weight table of indicators has been formed. Conclusion By collecting the data of public TCM hospitals in Guangdong Province from 2019 to 2021，the empirical study proves that the high-quality development evaluation index system of public TCM hospitals can be used to evaluate the high-quality development of public TCM hospitals.