In the era of cancer immunotherapy， with the release of more clinical trial results， the use of ICIs is more and more widely， but about 40% of these patients will experience irAEs， even some patients with fatal irAEs， early identification of irAEs can reduce irAEs related deaths and medical costs， and biomarkers are an important indicator of early identification of toxic reaction caused by ICIs. We review the latest progress in predicting biomarkers of irAEs， guiding the study of more convenient and fast predictors or predictive models through the combing of biomarkers， ultimately serving clinical work.

Objective To investigate the role of hepatocyte growth factor and its receptor （c-Met） （HGF/c-Met） signaling pathway in early follicular development in mice via detecting the expression of HGF/c-Met in early mouse ovarian tissue and then analyze the biological process of HGF/c-Met signaling pathway and its possible involvement in intracellular signaling pathways by using bioinformatics for the purpose of further studying the molecular mechanism of the signaling pathway in the early follicle development. Methods Thirty-five female Kunming mice and 15 male ones were fed in 15 cages with the female-to-male ratio of 2∶1. The ovaries of mice at 3， 7， 14 and 21 days after birth were collected. Immunohistochemical staining and Western blotting were applied to detect the expression levels of HGF and c-Met protein in the ovarian tissues. Quantitative Real-time PCR （q-PCR） was used to detect the expression levels of HGF and C-Met mRNA in the early ovarian tissues of mice. Results HGF and c-Met proteins were expressed in the ovarian tissues of the mice at 3， 7， 14 and 21 days， presenting an increasing trend with the increase of age by day （P < 0.05）. The mRNA levels of HGF and c-Met also showed the same trend （P < 0.05）. Bioinformatics analysis revealed that the HGF/c-Met signaling pathway involved in a variety of biological processes and signaling pathways such as PI3K/AKT. Conclusions HGF/c-Met signaling pathway is involved in early follicular development in mice. It may regulate primal follicular initiation and follicular development through intracellular signaling pathway PI3K/AKT.

Objective This study aims to explore the role of connexin 43 （Cx43） in the autophagy of RAW264.7 cell induced by oxidized low-density lipoprotein （ox-LDL）. Methods The ox-LDL （100 μg/mL， 24 h） was used to establish the model of autophagy and foam cell formation. RAW264.7 mouse mononuclear macrophage lines were randomly divided into control group， ox-LDL group， ox-LDL+Gap26 group and ox-LDL+Gap19 group. The mRNA levels of Cx43， autophagy protein Beclin-1 and LC3B were detected by qRT-PCR. The protein levels of Cx43， Beclin-1 and LC3B were detected by Western blot. The expression and localization of Cx43， Beclin-1 and LC3B were detected by cellular immunofluorescence. Results The results of oil red O staining showed that red lipid droplets appeared in the cell plasma of the ox-LDL group and cells were foamy 24 h after ox-LDL intervention in RAW264.7 cells. By Western blot， qRT-PCR and immunofluorescence 24 h after ox-LDL intervention in RAW264.7 cells， the expression level of Cx43 in the cells of the ox-LDL group was increased， the expression levels of Beclin-1， LC3B mRNA and protein were decreased in the cells of the ox-LDL group compared with the control group， the expression levels of Beclin-1 and LC3B were decreased in the ox-LDL+Gap26 group compared with the ox-LDL group， and the expression levels of autophagy-related proteins in the ox LDL+Gap19 group were increased compared with the ox-LDL group. Conclusion Cx43 blocking can significantly promote RAW264.7 autophagy induced by ox-LDL.

Objective To evaluate the effect of chronic high fat diet （HFD） on brain injury in ischemia/reperfusion （I/R） rats and its mechanisms. Methods Sixty male Wistar rats were randomly divided into normal diet （ND） group （n = 30） and high fat diet （HFD） group （n = 30）. Each group was further divided into Sham group and I/R group， with 15 rats in each group. Neurobehavioral method was used to evaluate the neurological deficits of rats in each group； HE staining was used to detect the pathological changes of brain tissue of rats in each group； the survival rate of neurons in each group was measured by Nissl staining； western blotting method was used to detect the Pyroptosis-related proteins （NLRP3， Caspase-1， IL-1β， and HMGB1/TLR4/NF-κB signal pathway protein expression in brain tissue of rats in each group. Results Compared with the ND group， the body weight， visceral adipose tissue， triglyceride， total cholesterol and glucose water of rats in HFD group were increased （all P < 0.05）. In the I/R group， compared with the ND rats， HFD rats showed more severe neurological impairment； HE staining showed that HFD rats had more damaged cells； niss staining showed that the number of surviving neurons in HFD rats decreased； the expressions of pyroptosis related proteins （NLRP3， Caspase-1， IL-1β） were higher in HFD rats； high expression of HMGB1 and its downstream factors TLR4 and NF-κB in HFD rats （all P < 0.05）. Conclusion HFD intake could aggravate pyrodeath and enhance the expression of HMGB1/TLR4/NF-κB signaling pathway after brain I/R injury， leading to adverse outcomes after I/R.

Objective To investigate the impacts of chlorprothixene on autophagy and apoptosis in human acute myeloid leukemia （AML） cells by regulating the protein kinase B （Akt）/mammalian target of rapamycin （mTOR） pathway. Methods Two cell lines， SKNO-1 and MOLM-13， were used as the research objects， and they were treated with （0， 20， 40， 60） μmol/L chlorprothixene for （6， 12， 24） h， respectively， CCK-8 was performed to detect cell proliferation.Experiments were divided into control group （normal culture）， SC79 group （5 mg/L SC79 treated cells for 2 h），chlorprothixene group （40 μmol/L chloroprotixol treated cells for 12 h）， chlorprothixene + SC79 group （40 μmol/L chlorprothixene was added to the cells for 12 h on the basis of the group），monodansylcadaverine （MDC） staining was performed to measure the occurrence of autophagy；flow cytometry was performed to measure cell apoptosis rate；Western blot was performed to measure autophagy-related protein SQSTM1/p62， microtubule-related protein 1 light chain 3B （LC3B）， apoptosis-related protein poly （ADP-ribosyltransferase） （PARP）， aspartate-specific cysteine protease 3 （caspase3）， activated caspase3 （cleaved caspase3） and Akt/mTOR signaling pathway related proteins Akt， phosphorylated （p）-Akt， mTOR and p-mTOR. Results In SKNO-1 and MOLM-13 cells， at （6， 12， 24） h， compared with 0 μmol/L chlorprothixene， （20， 40， 60） μmol/L chlorprothixene treatment increased the inhibition rate of cell proliferation （P < 0.05）；at the same time point， as the concentration of chlorprothixene increased， the inhibition rate of cell proliferation increased， and 40 μmol/L chlorprothixene treatment for 12 h was used for the next study.In SKNO-1 and MOLM-13 cells， compared with the control group， the apoptosis rate， autophagosome positive rate， LC3B， PARP， cleaved caspase3/caspase3 protein expression levels in SC79 group decreased （P < 0.05）， the SQSTM1/p62， p-Akt/Akt and p-mTOR/mTOR protein expression levels increased （P < 0.05）；the chlorprothixene group showed the opposite trends （P < 0.05）；after adding chlorprothixene on the basis of SC79 group， the apoptosis rate， autophagosome positive rate， LC3B， PARP， cleaved caspase3/caspase3 protein expression levels decreased than chlorprothixene group （P < 0.05）， the protein expression levels of SQSTM1/p62， p-Akt/Akt and p-mTOR/mTOR increased （P < 0.05）. Conclusion Chlorprothixene can inhibit the Akt/mTOR pathway and promote autophagy and apoptosis in human AML cells.

Objective Analyze the effect of LncRNA SNHG16 targeted regulation of miR?516a?5p on the proliferation， invasion， and migration ability of colorectal cancer cells. Methods Real time fluorescence RT?PCR was used to detect the expression of lncRNA SNHG16 and miR?516a?5p， and SW480 cells were constructed to inhibit lncRNA SNHG16 expression. SW480 cells were transfected and divided into a NC group， a si?NC group， a si?SNHG16 group， a miR?NC group， a miR?516a?5p group， a si?SNHG16+anti miR?NC group， and a si?SNHG16+anti miR?516a?5p group to detect cell proliferation， apoptosis， invasion， and migration in each group. Results Compared with adjacent tissues， the expression level of lncRNA SNHG16 in colorectal cancer tissue increased， while the expression level of miR?516a?5p decreased （P < 0.05）. Compared with the FHC group， the expression levels of lncRNA SNHG16 and miR?516a?5p were increased in the HCT116， SW620， and SW480 groups， while the expression levels of miR?516a?5p were lower. The SW480 group had the highest lncRNA SNHG16 and the lowest miR?516a?5p levels （P < 0.05）. Compared with the si?NC group， the expression level of lncRNA SNHG16 in the si?SNHG16 group decreased （P < 0.05）， indicating the successful construction of SW480 cell lines that interfered with lncRNA SNHG16 expression. Compared with the si?NC group， the si?SNHG16 group showed a decrease in CyclinD1， MMP?2， MMP?9， OD value， number of migrating and invading cells， and an increase in apoptotic cells （P < 0.05）. Compared with the miR?NC group， the miR?516a?5p group showed an increase in miR?516a?5p expression levels （P < 0.05）， indicating the successful construction of SW480 cell lines with high expression of miR?516a?5p. Compared with the miR?NC group， the miR?516a?5p group showed a decrease in CyclinD1， MMP?2， MMP?9， OD value， number of migrating cells， and number of invasive cells， while an increase in apoptotic cells （P < 0.05）. The dual luciferase report test showed that compared with the miR?NC group， miR?516a?5p could reduce the luciferase activity of SNHG16 （P < 0.05）， and had a small impact on the luciferase activity of MUT?SNHG16 （P > 0.05）. Compared with the si?NC group， inhibiting the expression of lncRNA SNHG16 resulted in an increase in miR?516a?5p expression and apoptotic cells in SW480 cells， as well as a decrease in CyclinD1， MMP?2， MMP?9， OD value， number of migratory cells， and number of invasive cells （P < 0.05）. Compared with the si?SNHG16+anti miR?NC group， the si?SNHG16+anti miR?516a?5p group showed a decrease in miR?516a?5p expression and apoptotic cells， while the cyclinD1， MMP?2， MMP?9， OD value， number of migratory cells， and number of invasive cells increased （P < 0.05）. Conclusion Interfering with lncRNA SNHG16 expression can regulate the expression of miR?516a?5p， inhibit the proliferation， invasion， migration， and promote apoptosis of colorectal cancer cells.

Objective To investigate the influence of pristimerin （Pris） on rat hepatocellular carcinoma （HCC） induced by diethylnitrosamine （DEN） by regulating ROS/ASK1/JNK signal pathway. Methods Six SD rats were randomly selected as the control group， and the remaining rats were injected with DEN to construct the rat model of HCC. The rats successfully modeled were randomly grouped into HCC group， Pris group （0.8 mg/kg Pris）， Vaccarin group （100 mg/kg ROS/ASK1/JNK signal pathway inhibitor Vaccarin）， and Pris+Vaccarin group （0.8 mg/kg Pris+100 mg/kg Vaccarin）， with 6 rats in each group， and were injected continuously for one week. HCC group and control group were injected with the same amount of normal saline. Body weight， liver weight and liver weight ratio were measured； liver function， inflammatory factors， antioxidant index and ROS level were detected by ELISA； HE staining was applied to detect the pathological changes of liver； western blot was applied to detect the expression of apoptotic markers （Bax， Bcl-2 and cleaved-Caspase-3） and ROS/ASK1/JNK signal pathway protein. Results The rats in the control group showed normal liver tissue structure. In HCC group， necrosis of some hepatocytes and focal nodular hyperplasia were observed， body weight， Bax， cleaved-Caspase-3， ROS， p-ASK1/ASK1， and p-JNK/JNK level in HCC group were obviously lower than those in the control group （P < 0.05）， but liver weight， liver weight ratio， ALT， AST， ALP， LDH contents， IL-6， TNF-α， CCL-2 contents， SOD， GR， GPx， CAT contents， and Bcl-2 protein level were obviously higher （P < 0.05）. Hepatocyte necrosis and focal nodular hyperplasia in Pris group were improved， and body weight， Bax， cleaved-Caspase-3， ROS， p-ASK1/ASK1， and p-JNK/JNK level in Pris group were obviously higher than those in HCC group （P<0.05）； liver weight， liver weight ratio， ALT， AST， ALP， LDH contents， IL-6， TNF-α， CCL-2 contents， SOD， GR， GPx， CAT contents， and Bcl-2 protein level were obviously lower （P<0.05）. The opposite trend was observed in Vaccarin group； Vaccarin reversed the anticancer effect of Pris on HCC rats. Conclusion Pris may play a certain role in inhibiting HCC rats by activating ROS/ASK1/JNK signal pathway.

Objective To use resting?state functional magnetic resonance imaging （rs?fMRI） to study amplitude of low?frequency ?uctuation （ALFF） and regional homogeneity （ReHo） changes in brain function in patients with anti?N?methyl?D?aspartate receptor encephalitis with cognitive impairment （ANMDARE?CI）. Methods A total of 33 patients with anti?N?methyl?D?aspartate receptor encephalitis （ANMDARE） and 18 healthy volunteers （Controls） underwent rs?fMRI， the Beijing version of the Montreal Cognitive Assessment （MoCA?B） and neuropsychological scales. The cognitively impaired （ANMDARE?CI， n = 17） and the cognitively normal （ANMDARE?CN， n = 16） were divided according to the assessment of the MoCA?B scale. Differences in brain activity between the ANMDARE?CI， ANMDARE?CN and control were analysed using ReHo and ALFF. One?way ANOVA was performed using SPM12， ReHo and ALFF values for differential brain regions were extracted for independent samples t?tests for two?way comparisons and correlation analysis between clinical data and ANMDARE scales. Results Compared with ANMDARE?CN and Control， in ANMDARE?CI，ALFFs of bilateral cerebellar were reduced， and the right superior frontal gyrus and left central anterior gyrus ALFF were increased （P < 0.01）. Compared to Controls， in ANMDARE?CI and ANMDARE?CN， ALFFs of bilateral thalamus and ReHo of the right anterior cerebellar lobe were decreased （P < 0.01）. ReHo of Left Anterior Cingulate in ANMDARE?CN was significantly lower than ANMDARE?CI and Controls （P < 0.01）. Increased ALFF values on the right superior frontal gyrus were inversely correlated with MoCA?B performance scores （r = -0.586， P = 0.013）. Increased left central anterior gyrus ALFF was negatively correlated with the MoCA?B directional score （r = -0.668， P = 0.003） and positively correlated with HAMA （r = 0.665， P = 0.004）. No correlation between ReHo values and clinical data was found （P > 0.016）. Conclusions Abnormal brain function in ANMDARE_CI may be associated with altered spontaneous cerebellar activity.

Objective To investigate the efficacy of lateral recumbent sling posture in thoracoscopic lobectomy. Methods We consecutively collected 100 patients who underwent thoracoscopic lobectomy in our hospital from January 2019 to 2021， and were divided into 50 cases for both observation group and control group， respectively， according to the random number table method. The control group took the traditional lateral decubitus position， and the observation group took the hanging posture from lateral decubitus position. Duration of placement， the data about Fromme surgical field quality （SSFQ） score， Kolcaba comfort questionnaire （GCQ） score， and incidence of postoperative adverse effects were collected and then compared between the two groups. Results Compared with the control group， the placement time and SSFQ score were significantly lower （P < 0.05）， and the GCQ score were significantly increased in the observation group （P < 0.05）； moreover， the incidence of postoperative adverse effects was significantly lower in the observation group compared with the control group （P < 0.05）. Conclusion The side up hanging posture has achieved good performance in thoracoscopic lobectomy， which can not only effectively shorten the placement period， improve the operation quality of the surgical field， but also significantly reduce the incidence of adverse effects owing high clinical implementation value.

Objective To evaluate the therapeutic efficacy and safety of perioperative electroacupuncture on postoperative abdominal pain in patients undergoing general anesthesia laparoscopic surgery. Methods A total of 130 patients undergoing general anesthesia laparoscopic surgery were randomly divided into control group and experimental group. The control group received surgery under endotracheal intubation general anesthesia， while the experimental group received one session of electroacupuncture analgesia before and during anesthesia in addition to routine general anesthesia. The preoperative and postoperative pain Numerical rating scale （NRS）， Pain Catastrophizing Scale （PCS）， Bruggrmann comfort scale （BCS）， heart rate， and blood pressure were compared between the two groups. The occurrence of common adverse reactions after surgery， such as significant itching， rash， nausea， and vomiting， was observed. Results No significant difference in activity NRS score was found between the two groups after surgery （P = 0.618）. Compared with the control group， the experimental group had lower resting NRS score ［（2.05 ± 1.138），（1.62 ± 0.878）， P = 0.017］， lower PCS score ［（20.57 ± 8.538），（17.09 ± 8.291）， P = 0.020］， and higher BCS score after surgery ［（2.08 ± 1.035），（2.55 ± 1.046）， P = 0.010］， and decreased heart rate ［（76.17 ± 14.500），（70.85 ± 11.990）， P = 0.024］. There was no significant difference in systolic blood pressure between the two groups 12 and 24 hours after surgery （P > 0.05）. A decrease in systolic blood pressure 24 hours after surgery was found in the experimental group when compared to that before surgery ［（125.6 ± 15.725）， （123.60 ± 16.781）， P = 0.040］. Conclusion Perioperative electroacupuncture stimulation can relieve postoperative abdominal pain， reduce heart rate and blood pressure， but does not increase the occurrence of adverse reactions.

Objective To investigate the expression of mucin 5AC （MUC5AC） in airway of children with mycoplasma pneumoniae pneumonia（MPP）， and to provide clinical value for early diagnosis and treatment of MPP mucus plug. Methods A total of 94 children with MPP who were hospitalized for alveolar lavage from April 2022 to October 2022 were included in the MPP group. According to whether mucus plug was observed under the first fiberoptic bronchoscope， the MPP group was divided into mucus plug group （n = 41） and non-mucus plug group （n = 53）. Relevant clinical data and laboratory examination data were collected. Results Compared with non mucus plug group， the mucus plug group had a longer heat duration and hospital stay， and the levels of CRP， LDH，PCT， D-dimer， MP-DNA copy value of lavage fluid， IL-17， MUC5AC were all increased，with statistically significant differences （P < 0.05）. MUC5AC was positively correlated with LDH and IL-17 levels （r = 0.54， P = 0.002； r = 0.39， P = 0.019）. The ROC curve plotted based on the level of MUC5AC had an area under the ROC curve of 0.811， a sensitivity of 86.2% and a specificity of 71.4% for predicting formation of mucus plug in MPP. Conclusions There was an increase in the level of MUC5AC in children with mucus plug group in MPP， and the level of MUC5AC had a certain value for predicting mucus plug formation.

Objective This study mainly explores the role of serum microRNA-200a （miR-200a） and microRNA-152 （miR-152） in gestational trophoblastic tumors （GTN） prognosis. Methods One-hundred GTN chemotherapy patients who treated in our hospital were collected as the observation group， according to the efficacy of chemotherapy， patients were divided into the good prognosis group （80 cases） and the poor prognosis group （20 cases）； 103 healthy women who underwent physical examination were collected as the control group. Real-time fluorescence quantitative PCR method was applied to detect the expression levels of miR-200a and miR-152 in serum. Results The serum miR-200a expression level in the observation group was higher than that in the control group， while the miR-152 expression level was lower than that in the control group （P < 0.05）. With the prolongation of chemotherapy time， the expression level of miR-200a in the serum of the good prognosis group and the poor prognosis group decreased sequentially， while the expression level of miR-152 increased sequentially （P < 0.05）. The expression level of miR-200a in the serum of the poor prognosis group before and after chemotherapy were higher than that of the good prognosis group， while the expression level of miR-152 was lower than that of the good prognosis group （P < 0.05）. There was a statistically significant difference in the International Federation of Obstetrics and Gynecology （FIGO） prognosis score and pre chemotherapy blood HCG levels between the group with good prognosis and the group with poor prognosis （P < 0.05）. The AUC of predicting poor prognosis in GTN chemotherapy patients with serum miR-200a and miR-152 expression levels before chemotherapy alone and in combination were 0.793， 0.844， and 0.887， respectively. MiR-200a， miR-152， and FIGO prognosis scores≥7 are associated with poor prognosis in GTN chemotherapy patients （P < 0.05）. Conclusion High expression of miR-200a and low expression of miR-152 before chemotherapy may be associated with poor prognosis in GTN chemotherapy patients， which can provide reference for the evaluation of chemotherapy prognosis.

Objective To investigate the expression of ECM1 in bladder cancer tissue and its relationships with clinical pathological features and prognosis. Methods A total of 60 patients with bladder cancer who underwent radical surgery at Department of Urology， Affiliated Hospital of Guizhou Medical University from January 2018 to December 2019 were enrolled in this study. The mRNA expression of ECM1 in the bladder cancer tissues and adjacent normal tissues of the patients was compared. The relationships of the ECM1 expression with the clinical pathological features and the prognosis of bladder cancer patients were analyzed. Cox proportional hazard regression model was used to evaluate the factors affecting prognosis. Results The expression of ECM1 in the bladder cancer tissues was significantly increased. The positive rate of ECM1 protein in the cancer tissues was 56.67%， and the positive rate in the paracancerous tissues was 13.33%. The expression of ECM1 in the bladder cancer patients with pathology stage Ⅲ， TNM stage Ⅲ-Ⅳ， and lymph node metastasis was higher than that in those with pathology stage Ⅰ-Ⅱ， TNM stage Ⅰ-Ⅱ， and no lymph node metastasis. The patients with high expression of ECM1 had lower overall survival rates and poorer prognosis than those with low expression. Cox regression analysis showed that ECM1 was an independent risk factor affecting the prognosis of the patients. Conclusion The increased expression of ECM1 in bladder cancer tissues of bladder cancer patients is correlated with pathological grading， lymph node metastasis， TNM staging， and their prognosis. High expression of ECM1 is an independent risk factor for poor prognosis of the patients.

Objective To investigate the relationshipsof serum uric acid （UA） and brain natriuretic peptide （BNP） levels with structural remodeling of atrial fibrillation in patients with heart failure with preserved ejection fraction （HFpEF） complicated with atrial fibrillation （AF）. Methods A total of 100 patients with HFpEF and AF admitted to Baoding No.1 Hospital from May 2020 to May 2022 were selected as the research objects. According to the medical history and dynamic electrocardiogram results， they were divided into paroxysmal AF group （n = 46） and persistent AF group （n = 54）. Another 100 patients only with HFpEF during the same period were selected as control group. Serum UA and BNP levels and left atrial internal diameter （LAD） and left atrial volume index （LAVI） were compared between the three groups and correlation analysis was performed. The diagnostic value of serum UA and BNP levels for structural remodelling of AF in those patients with HFpEF and AF was analysed by plotting subject operating characteristic curves （ROC）. Results The serum UA and BNP levels were higher and LAD and LAVI were significantly higher in the paroxysmal AF and persistent AF groups compared with the control group（P < 0.05）. The serum UA and BNP levels were higher and LAD and LAVI were greater in the persistent AF group compared with the paroxysmal AF group （P < 0.05）. The serum UA and BNP levels in the patients with HFpEF and AF were both positively correlated with LAD and LAVI （both P < 0.05）. Elevated serum UA and BNP levels were both risk factors for the structural remodeling of AF in the patients with HFpEF and AF （P < 0.05）. The AUC of the combined serum UA and BNP for the diagnosis of structural remodeling of AF in the patients with HFpEF and AF was 0.853， with the sensitivity and specificity of 85.00% and 70.00%， respectively. Conclusion Serum UA and BNP are expressed at a high level in patients with HFpEF combined with AF. Both of them are positive correlation with LAD and LAVI， indicating that then can be used as important indicators for the diagnosis of structural remodeling of AF to some extent.

Objective To investigate the clinical effect of lateral vascular chain flaps with dorsal branches of nerve and digital artery in different donor sites in the repair of finger tip or finger abdomen defects. Methods From June 2017 to April 2021. Forty-nine patients （57 fingers） with the defect of the 2nd to 5th finger end or finger abdomen were repaired with the lateral vessel chain flap of the dorsal branch of digital artery in the emergency department of Tangshan Second Hospital. A prospective research was conducted. The patients were divided into dorsal proximal segment group ［23 cases， 25 fingers， including 13 males and 10 females， with mean age of 37 years （18-55 years）］ and dorsal middle segment group ［26 patients， 32 fingers， including 15 males and 11 females， with mean age of 35 years （20-53 years）］. Intraoperative end-to-end adventitia anastomosis was performed between the cutaneous nerve carried by the flap and the stump of the intrinsic digital nerve in the wound in both groups. The donor site wounds of patients in the two groups were repaired with free full-thickness skin grafts from the proximal forearm or medial upper arm. The blood supply of flaps in the two groups was observed after operation. Sex， age， injury index， side， defect area， flap area，operation time and follow-up time were compared between the two groups. At the last follow-up， static two-point distance perception of the flap was measured. Satisfaction with the appearance of the affected finger flap was evaluated according to Michigan Hand Function Questionnaire. Vancouver Scar Scale was used to evaluate the appearance of the donor site， and the range of motion of metacarpophalangeal and proximal interphalangeal joints were measured. The data were analyzed by using t test or χ² test. Results All flaps and skin grafts survived after operation. No significant differences were found in sex， age， injury index， side， defect area， operation time and follow-up time between the two groups （P > 0.05）， but there was statistical significance in the area of the flap （P < 0.05）. At the last follow-up， the range of motion of metacarpophalangeal and interphalangeal joints in the two groups were significantly higher （P > 0.05）. The satisfaction with the appearance of the affected finger flap， the appearance of the donor site and the static two-point discrimination of the flap in the dorsal middle segment group were significantly better than those in the dorsal proximal segment group （P < 0.05）. Conclusion The flap with the dorsal branch of the proximal or dorsal middle segment as the donor site has the advantage of constant anatomy and simple operation. It is suitable for emergency repair of finger tip or finger abdomen defects， but compared with the dorsal proximal segment group， the dorsal middle segment group has a smaller incision area， better appearance of the injured finger and better feeling of the skin flap.

Objective To investigate the risk factors for osteoporotic vertebral compression fractures （OVCFs） in patients with chronic hepatitis B （CHB） and magnetic resonance imaging （MRI） findings of paravertebral muscles in the lumbar spine. Methods Six hundred and twenty-seven patients with CHB from April 2019 to April 2023 were selected. They were divided into OVCFs group （n = 124） and Non-OVCFs group （n = 503） based on T2-weighted MRI. Risk factors for OVCFs were analyzed after propensity score matching. R software was used to create column line plots. A risk stratification system was established by recursive segmentation.Cox model was used to analyze the association between MRI performance and OVCFs. Results The OVCFs group （n = 73） and Non-OVCFs group （n = 73） were balanced at baseline after matching （P > 0.05）. Multifactorial analysis showed that osteocalcin （OST） ［HR = 2.742 （1.653 ~ 4.572）］， β-collagen crosslinking （β-CTX） ［HR = 2.590 （1.984 ~ 3.391）］， type 1 procollagen amino-terminal extension peptide （P1NP） ［HR = 2.291 （1.672 ~ 2.860）］， sagittal Cobb's angle ［HR = 5.143 （3.375 ~ 6.622）］， and kyphosis ［HR = 1.772 （1.491 ~ 2.095）］ were risk factors for OVCFs. Bone mineral density ［HR = 0.682 （0.551 ~ 0.834）］， history of vitamin/calcium supplementation ［HR = 0.671 （0.563 ~ 0.792）］， and history of exercise ［HR = 0.890 （0.674 ~ 0.923）］ were protective factors. AUC = 0.926 （0.854 ~ 0.997） after column line plot validation. The mean error of calibration curve was 0.012. OVCFs were divided into very low risk group （< 105， n = 50）， low risk group （105 ≤ score < 204， n = 52）， medium risk group （204 ≤ score < 341， n = 26） and high risk group （≥ 341， n = 18）. There was an association between net muscle content， fat infiltration area and risk of OVCFs in L_3/4， L_4/5 erector spinae and multifidus muscles in each subgroup （P_trend < 0.05）. However， there was no interaction between the subgroups （P_interaction > 0.05）. Conclusion OST ≥ 15 ng/mL， β-CTX ≥ 0.5 ng/mL， P1NP ≥ 40 ng/mL， sagittal Cobb angle ≥ 55°， bone mineral density < -3.0， kyphosis deformity， not taking vitamin/calcium supplements， and lack of exercise are risk factors for OVCFs in CHB. With increased risk of OVCFs， CHB patients showed degenerative changes in the erector spinae and multifidus muscles at the L_3/4 and L_4/5 levels.

Objective To investigate the efficacy of sakubactril valsartan combined with ivabradine in the treatment of heart failure with reduced left ventricular ejection fraction （HFrEF） in elderly patients， as well as its effect on left ventricular remodeling， and identify the predictors of recurrent cardiac and cerebrovascular events. Methods A total of 144 HFrEF patients were randomly divided into observation group （n = 74， completed by 72 cases） and control group （n = 74， completed by 72 cases） using a random number table. The control group and the observation group were treated with ivabradine and sacubactril valsartan combined with ivabradine， respectively. After 6 months of treatment， the two groups were compared in terms of the clinical efficacy and cardiac output index （CI）， left ventricular myocardial mass index （LVMI）， tumor necrosis factor α （TNF-α），interleukin6 （IL-6） and troponin T（cTnT）， serum transforming growth factor-β1 （TGF-β1）， serum amino terminal brain natriuretic peptide precursor （NT-proBNP）， myocardial energy metabolism （MEE） and incidence of adverse reactions before and after treatment. Recurrent adverse cardiac and cerebrovascular events were assessed in both groups within 12 months of follow-up and a receiver operating characteristic curve （ROC） was used to select predictors of recurrent adverse cardiac and cerebrovascular events. Results After 6 months of treatment， the clinical efficacy of the observation group was better than that of control group （Z = -5.352， P < 0.001）； The total effective rate of the observation group was higher than that of control group （χ² = 4.765， P = 0.029）. CI， LVMI， TNF-α， IL-6， cTnT， TGF-β1， NT-proBNP， and MEE in both groups were significantly improved after treatment， and the improvement in these indicators was more significant in the observation group （all P < 0.05）. There was no significant difference in the incidence of adverse drug reactions between the two groups （χ² = 0.085， P = 0.771）. The levels of CI and LVMI were highly correlated with the levels of NT-proBNP， MEE， TNF-α， IL-6， cTnT and TGF-β1 in the two groups before treatment （all |r| > 0.90， P < 0.001）. Both NT-proBNP and cTnT had high predictive efficiency and they were complementary. Conclusions Sacubactril valsartan combined with ivabradine can improve cardiac function in patients with HFrEF， enhance clinical efficacy， delay and improve ventricular remodeling. Its mechanism may be related to its inhibition of inflammatory response and myocardial fibrosis， reduction of neuroendocrine factors， alleviation of myocardial damage， and reduction of myocardial energy metabolism， indicating good safety. NT-proBNP and cTnT can be used as predictors of the recurrent cardiac and cerebrovascular events.

Objective To construct and verify a predictive model based on bilirubin levels in umbilical cord blood and clinical risk factors to predict the risk of hyperbilirubinemia in ABO neonatal hemolysis disease. Methods A total of 500 ABO-HDN children were selected as the modeling set. 100 ABO-HDN children served as the verification set. Depending on whether neonatal hyperbilirubin was occurring， they were divided into hyperbilirubinemia group and non-hyperbilirubin group（Non-HB）. The bilirubin level in umbilical cord blood was detected and the general and clinical data of children and mothers were collected. Multivariate Logistic regression analysis and ROC curve were used to evaluate the prediction efficiency of the prediction model of bilirubin levels in umbilical cord blood combined with clinical risk factors for the risk of NHB in ABO-HDN. Results There were 225 cases of NHB of the 500 ABO-HND children in the modeling set with an incidence of 45%. Unifactorial analysis showed that influencing factors were maternal age， premature rupture of membranes， pregnancy with hypertension， diabetes， thyroid disease and anemia， intrauterine distress， cranial hematoma， infection， gestational age， neonatal asphyxia， feeding patterns， low birth weight， intracranial hemorrhage， and respiratory distress（P < 0.05）. Multivariate Logistic regression analysis showed that the independent risk factors were premature birth， neonatal asphyxia， infection， G-6-PD deficiency，intracranial hemorrhage and respiratory distress（OR = 2.377， 7.457， 54.438， 45.487， 2.788，5.407， all P < 0.05）. Three models of bilirubin levels in umbilical cord blood，clinical risk factors and bilirubin levels in umbilical cord blood combined with clinical risk factors predicted the occurrence risk of NHB in ABO-HDN. And the area AUC values under ROC curve were 0.817（95%CI： 0.776 ~ 0.859）， 0.876（95%CI： 0.845 ~ 0.907） and 0.944（95%CI： 0.921 ~ 0.966）， respectively， all P < 0.05. The prediction model of bilirubin levels in umbilical cord blood combined with clinical risk factors was used to verify the practical efficacy of 100 ABO-HDN children in the verification set. The area AUC value under ROC curve was 0.951（95%CI： 0.776 ~ 0.859），P < 0.05. Conclusion The prediction model of bilirubin levels in umbilical cord blood combined with clinical risk factors can ccurately predicted the occurrence risk of NHB in ABO-HDN. It could provide objective reference for prevention， diagnosis， treatment and standardized management of NHB in ABO-HDN.

Objective To evaluate the application value of the fluorescence PCR probe melting curve（MeltPro） technique in the detection of isoniazid drug- resistance of Mycobacterium tuberculosis （MTB） in sputum samples. Methods In this study， we collected sputum samples of PTB that were identified as MTB by GeneXpert MTB/RIF method（MTB positive） from 2021 to 2022. These sputum samples were detected including smear， Mycobacterium culture， GenoType MTBDRplus，and isoniazid drug?resistance test by MeltPro technique. We did the proportional drug sensitivity test （DST） of isoniazid for culturing positive strains， analyzed the influence of the amount of bacteria in sputum samples on the results of MeltPro technique， compared the difference in the detection rate of isoniazid resistance by proportional DST， GenoType MTBDRplus， and MeltPro technique； The proportional DST results of isoniazid were used as a standard to evaluate the isoniazid drug?resistance detection efficiency of MeltPro technique and GenoType MTBDRplus. Results 157 qualified MTB positive sputum samples were collected， after Mycobacterium culture， we got 130 strains. The rate of success for isoniazid in sputum samples detected by MeltPro technique was84.1%（132/157）. Among different grades of sputum smear results， there is a difference in the successful rate of MeltPro technique （H = 24.169，P = 0.000）， increased with the grade of sputum smear results， the successful rate was increased from64.8% （32/54，the negative sputum）to 100.0%（17/17、6/6，the positive sputum grade 3+、4+）； the successful rate also increased with the increase of MTB grade detected by GeneXpert MTB/RIF， from54.8%（17/31，the very low sputum） to 96.4%（27/28，the high sputum）and the difference between each grade was statistically significant （H = 27.763，P = 0.000）. The detection rate of isoniazid resistance using MeltPro technique， GenoType MTBDRplus and proportional DST were 22.0%（29/132），15.3%（19/124），和14.6%（19/130）， respectively. There was no statistically significant difference between the three methods （χ² = 2.997，P = 0.223）. Based on the results of proportional DST， the sensitivity， specificity， positive predictive value and negative predictive value of MeltPro technique in the detection of isoniazid were 84.6%（11/13）、91.2%（93/102）、55%（11/20）、97.9%（93/95）， respectively， Kappa is 0.614. The sensitivity， specificity， positive predictive value and negative predictive value of GenoType MTBDRplus in the detection of isoniazid were 55.6%（10/18）、92.3%（84/91）， 58.8%（10/17）， 91.3%（84/92） ，respectively， Kappa is 0.490. Conclusion The MeltPro technique has high sensitivity and specificity in detecting MTB isoniazid resistance in sputum samples of pulmonary tuberculosis patients， and can quickly and accurately screen for isoniazid resistance in patients； To improve the success rate of testing， it is necessary to pay attention to the selection of sputum samples when promoting the application in grassroots laboratories.

Objective To explore the clinical predictive value of skin cholesterol and electrocardiogram treadmill exercise （EET） for coronary heart disease （CHD） in patients with atypical chest pain. Methods One hundred and twenty-eight patients with atypical chest pain admitted from April 2020 to April 2021 were enrolled. All patients did not take any lipid-lowering drugs or anti-myocardial ischemia drugs within 1 month before admission. Skin cholesterol content test， EET test， coronary angiography， Gensini score and number of diseased vessels were completed during hospitalization. According to the results of coronary angiography， the patients were divided into CHD group and non-CHD group. General clinical data， skin cholesterol content and EET results of the two groups were analyzed. Correlation analysis was performed between skin cholesterol content and Gensini score. Multivariate logistic regression was used to screen factors with predictive value for the diagnosis of CHD in patients with atypical chest pain. Results The content of cholesterol in skin increased significantly in patients with CHD. With the increase of the number of coronary artery lesions， the content of cholesterol in skin also increased significantly. Skin cholesterol content was positively correlated with Gensini score. Logistic regression analysis showed that skin cholesterol content and EET positive were predictors of CHD. The area under ROC curve of skin cholesterol content and EET in predicting the diagnosis of CHD in patients with atypical chest pain was 0.879 and 0.617， the corresponding sensitivity 86.2% and 67.3%， and the specificity 74.3% and 49.3%， respectively. The area under ROC curve of the combination of the two in predicting the diagnosis of CHD in patients with atypical chest pain was 0.917， and the sensitivity and specificity were 91.5% and 82.3%， respectively. Conclusion Skin cholesterol content is of good value in the diagnosis of CHD in patients with atypical chest pain， and EET can further improve the sensitivity and specificity of diagnosis.

Spinal cord injury （SCI） is a serious disease of the central nervous system （CNS）， which often leads to motor dysfunction and is associated with a variety of serious complications， seriously affecting the quality of life of patients. N6-methyladenosine （m6A） is a methylation modification that occurs at the N6 site of adenosine， also known as the m6A methylation modification， which is of great interest because of its great potential for diagnosis and treatment of neurological diseases. m6A modifications are catalyzed by methyltransferases， removed by demethylases， recognized by methyl-recognition proteins， and its associated regulatory proteins can affect the development of SCI and its secondary damage through various pathways. Up to now， the mechanism of m6A modification in SCI has not been fully elucidated. In this paper， we review the basic functions of m6A modification and its role and mechanism in SCI.

Allergic asthma （AA） is one of the most common allergic respiratory diseases. CD4⁺ T cell subtypes play an important role in the pathogenesis of AA. IL-18 and IL-37b are involved in the pathogenesis of AA via binding to IL-18Rα and thus regulating the differentiation of na?ve CD4⁺ T cells. In view of this， understanding the role of IL-18 and IL-37b in the differentiation of na?ve CD4⁺ T cells in AA is of great significance for the pathogenesis， diagnosis and treatment of AA， and for the research and development of biological agents.

A common complication after colorectal cancer surgery is delirium， which has a high incidence and remains challenging to treat and prevent. At present， there are fewer reports on postoperative delirium in colorectal cancer at home and abroad， and more in-depth diagnostic and treatment research is needed. In this article， we review the clinical features， pathogenesis， assessment tools， treatment and prevention methods of postoperative delirium in colorectal cancer in order to promote the early identification and optimal treatment of postoperative delirium in colorectal cancer， and to improve the prognosis and quality of life of patients.