Central nervous system（CNS）is a complex system closely related to anesthesiology. The molecular biological mechanisms of many CNS diseases were not exactly clear. Long noncoding RNA（lncRNA） H19 is abundant in human brain and plays an important role in the regulation of various CNS diseases. Besides， lncRNA H19 is also involved in the mechanism of several anesthetics. In this review， we emphasized the role and addressed the specific mechanisms of lncRNA H19 in CNS diseases and anesthetics， hoping to provide a new theoretical basis for future researches.

Objective To explore the classification and changes of macrophage subsets in liver transplant rejection. Methods Rat liver transplantation model were established and divided into immune tolerance group （B-B）， where the liver of BN rat donors was transplanted to BN rat recipients， and immune rejection group （L-B）， in which the liver of Lewis rat donors was transplanted to BN rat recipients. Single-cell RNA sequencing and high-throughput RNA sequencing were used to distinguish the macrophage subsets of rat liver transplantation， and to find differential gene in rejection reactions. Immunohistochemistry was used to determine the changes and distribution of protein expression and cell subsets. Results CD68 positive macrophages were higher in the rejection group than that in the tolerance group （P < 0.05）， and macrophages could be divided into 9 subsets. During the rejection reaction， the CXC chemokine ligand 9 （CXCL9） in the 8th subsets of macrophages was significantly increased， while the gene for white blood cell differentiation antigen 74 （CD74） in the 5th subsets was significantly increased （P < 0.05）. CD74 ranked first in the differential gene synthesis of macrophages during rejection， followed by CXCL9. Compared with the tolerance group， a large number of CD74 positive macrophages were observed in the hepatic portal area of the rejection group， and the infiltration of CD74 positive macrophages in the hepatic sinuses was also significantly increased （P < 0.05）， while a large number of CXCL9 positive macrophages were observed in the hepatic portal area and hepatic sinuses of the rejection group， especially in the portal area （P < 0.05）， and CD14 positive cells were significantly increased （P < 0.05）. Conclusions The CD74 positive macrophage subsets and CXCL9 positive macrophage subsets may be key subgroups in promoting liver transplant rejection， improving the mechanism of macrophage action in liver transplant rejection.

Objective To investigate the hepatoprotective effect and anti-hepatocyte pyroptosis effect of Yinchenhao decoction synergized with umbilical cord mesenchymal stem cells （UcMSCs） in vitro and vivo models of acute liver failure （ALF）， as compared to single?drug treatment. Methods UcMSCs were extracted from umbilical cords and identified using electron microscopy and flow cytometry. Then the exosomes released from ucMSCs （UcMSCs?exo） were isolated through ultracentrifugation， and ucMSCs?exo were identified by nanoparticle tracking analysis （NTA）， transmission electron microscopy， and Western blot for CD63 and CD9. Human hepatocyte cell line LO₂ cells were stimulated by 100 ng/mL lipopolysaccharide （LPS） and 5 mmol/L adenosine triphosphate （ATP） to construct a vitro model of ALF. The cells were randomly divided into the following groups： a normal control group， a model group， a Yinchenhao decoction treatment group， a ucMSCs?exo treatment group， and a combination treatment group. The morphological changes of LO₂ were observed under the electron microscope， the mortality of LO₂ cells was detected by flow analysis， the expression of pyroptosis?related proteins Caspase?1 and Cleaved?Caspase?1 was detected by Western blot， and the expression of pyroptosis?related cytokines IL?1β and IL?18 was detected by ELISA. Then， fifty 6?8?week?old male C57BL/6 mice were randomly divided into the following groups： normal control group， model group， Yinchenhao decoction treatment group， ucMSCs?exo treatment group， and combined treatment group. Each group consisted of 10 mice. The ALF mouse model was constructed by intraperitoneal injection of 10 μg/kg LPS and 800 mg/kg D?galactosamine （D?GalN）. After successful modeling， each group was given the appropriate drug interventions， and the ucMSCs?exo and combined treatment groups were injected with ucMSCs?exo interventions in the tail vein， and the drugs were administered continuously for 3 days. After 12 hours of intervention， serum specimens and liver tissues were collected from each group. The expression levels of ALT and AST were detected， and the liver tissues were stained with HE to observe the pathological changes. Results In the ALF cell model， hepatic cell death was inhibited in the Yinchenhao decoction treatment group， the ucMSCs?exo treatment group， and the combination group （P < 0.05）. The rate of hepatic cell death in the combination treatment group was significantly reduced （P < 0.05）. Initially， the study aimed to explore the effect on hepatic cell pyroptosis， and it was found that the combination treatment group could effectively suppress hepatocellular cell death more effectively compared to the single treatment groups. The combined treatment group significantly reduced the expression of the pyroptosis?related protein Cleaved?Caspase?1， as well as the cytokines IL?1β and IL?18 （P < 0.05）. However， there was no statistically significant difference in the expression of Caspase?1 （P > 0.05）. In the vivo model， the single Yinchenhao decoction treatment group， the ucMSCs?exo treatment group， and the combined treatment group were able to effectively reduce the serum ALT and AST levels compared to the model group（P < 0.05）. Additionally， these treatments were found to attenuate hepatocellular necrosis and the infiltration of inflammatory cells. Compared to the group treated with only Yinchenhao decoction or only ucMSCs?Exo， the group that received combined treatment showed a greater decrease in serum ALT and AST levels. Additionally， there was a reduction in the infiltration of inflammatory cells and the extent of cell death in the liver tissues （P < 0.05）. Conclusions The combination of Yinchenhao decoction and ucMSCs?exo demonstrated a significantly better hepatoprotective effect in the ALF vivo model compared to the individual treatments of Yinchenhao decoction or ucMSCs?exo alone. Furthermore， this combination treatment was able to effectively inhibit hepatocyte pyroptosis.

Objective To investigate the impact of lncRNA DSCAM-AS1 on the malignant biological behaviors of thyroid cancer （TC） cells by regulating the miR-150-5p/BRAF axis. Methods The expression of DSCAM-AS1 in TC cells was detected by qRT-PCR，and the best intervention cell line was screened.； the relationship between DSCAM-AS1， BRAF and miR-150-5p targeting regulation was verified by FISH， pull down and double Luciferase reporter gene experiment； The proliferation，migration and invasion of SW579 cells were detected； Western blot was applied to detect the expression of BRAF， E-Cadherin， and vimentin proteins； the tumor formation experiment in mice was applied to verify the effect of DSCAM-AS1 on TC tumor growth. Results DSCAM-AS1 was highly expressed in TC tissue and cells （P < 0.05）； There is a targeted regulation relationship between DSCAM-AS1，BRAF and miR-150-5p； inhibition of DSCAM-AS1 expression or overexpression of miR-150-5p obviously inhibited the proliferation， migration， invasion， and EMT of SW579 cells （P < 0.05）； Inhibition of miR-150-5p expression or overexpression of BRAF reversed the inhibitory effect of inhibition of DSCAM-AS1 expression or overexpression of miR-150-5p on the malignant behavior of SW579 cells （P < 0.05）； in vivo experiments showed that inhibiting the expression of DSCAM-AS1 obviously inhibited the growth of transplanted tumors in mice （P < 0.05）. Conclusion DSCAM-AS1 is up-regulated in TC cells， inhibiting the expression of LncRNA DSCAM-AS1 can inhibit the malignant progression of TC by regulating the miR-150-5p/BRAF signaling axis.

Objective To investigate the effect and mechanism of miR?27a?3p on nerve cell apoptosis induced by oxygen glucose deprivation/reoxygenation （OGD/R） through regulation of Rho family GTPase 3（Rnd3） expression. Methods PC12 neurons were cultured in vitro and reoxygenated for 3， 6， 9 h and 12 h after 2 h oxygen glucose deprivation. Cell viability， miR?27a?3p expression and Rnd3 mRNA expression were assessed at each time point and the optimal reoxygenation time point was screened. After transfection of miR?27a?3p Mimic， miR?27a?3p Inhibitor and their negative control， transfection of shRnd3 and its negative control， or co?transfection of shRnd3 and miR?27a?3p Inhibitor through lentivirus， CCK?8 assay was used to detect cell activity. The apoptosis rate of the cells was detected using flow cytometry. Expression of miR?27a?3p and Rnd3 mRNA was detected by RT?qPCR. Expression of apoptosis?related protein and Rnd3 protein was detected by Western blot. The dual luciferase reporter assay confirmed the targeting relationship between miR?27a?3p and Rnd3. Results Upregulation of miR?27a?3p increased cell viability， decreased total cell apoptosis rate， suppressed pro?apoptotic proteins Cleaved Caspase?3 （C?caspase?3） and Bax， and promoted expression of anti?apoptotic protein Bcl?2 （P < 0.05）； The opposite result was found when down?regulating miR?27a?3p. The double luciferase reporter gene assay showed that Rnd3 was the target gene of miR?27a?3p. Down?regulation of Rnd3 increased cell viability， decreased the total rate of apoptosis， suppressed the pro?apoptotic protein C?caspase?3， Bax， and promoted expression of the anti?apoptotic protein Bcl?2 （P < 0.05）. However， miR?27a?3p Inhibitor reversed the protective effect of shRnd3. Conclusion miR?27a?3p alleviates OGD/R?induced damage to PC12 neurons by targeting Rnd3 to inhibit cell apoptosis.

Objective To explore the pathogenesis of steroid-induced osteonecrosis of the femoral head （SONFH） and the mechanism of Traditional Chinese Medicine（TCM）-based prescription for “Bringing Blood Downward” targeting SONFH through the OPG/RANKL/RANK signaling pathway. Methods Fifty male SD rats were randomly divided into model group and control group. The rats in the model group were treated with LPS and methylprednisolone to build a SONFH model. After 6 weeks， two rats were randomly selected respectively from the two groups， and the SONFH model was confirmed by histomorphological examination under light microscopy. The rats in a low， medium and high dose treatment groups （group L， M， and H） were intragastrically administrated with the Prescription for “Bringing Blood Downward” at concentrations of 2.5/5/10 g/kg. While the rats in the model group and control group were intragastrically administrated with normal saline at a concentration of 5 g/（kg·d）. The pathological changes and expression levels of OPG， TRAF-6， and RANKL in each group were examined 4 weeks later. Results Compared with the model group， chondrocytes and cell matrix of groups L， M and H were less reduced， osteoclastic absorption and trabecular structure were less destroyed and the cells were less adipose. The adipocyte density in the control group and each treatment group was significantly lower than that in the model group （P < 0.01）. In the control group， the bone marrow cavity area was smaller than that in the model group（P < 0.05）， but there was no significant difference between each dose treatment groups and the model group （P > 0.05）. The expression levels of OPG， RANKL， TRAF-6 and OPG/RANKL ratio in the control group and groups L， M and H were significantly lower than those in the control group （P < 0.01）. Conclusion The TCM-based prescription for “Bringing Blood Downward” works to treat SONFH byregulating the activity of osteoclasts and osteogenic differentiation process of osteoblasts， improving the microcirculation environment of the femoral head， and inducing the formation of trabecular bone through the OPG/RANKL/RANK signaling pathway. It functions with its multitargetsin diverse methods.

Objective To explore the efficacy of debridement combined with antibiotic-loaded artificial bone in the treatment of clavicular osteomyelitis. Methods The data of 45 patients with clavicle osteomyelitis admitted to Luoyang Orthopedic Hospital （Henan Orthopedic Hospital） in Henan Province from January 2012 to June 2022 were retrospectively analyzed. They were divided into treatment group （n = 24） treated with debridement combined with antibiotic-loaded artificial bone， and control group （n = 21） treated with debridement. We compared the operation time， the duration of drainage tube placement， wound healing time， white blood cells （WBC）， C-reactive protein （CRP）， and erythrocyte sedimentation rate （ESR） in the two groups. Preoperative visual analog scores （VAS） and VAS 1 month after operation， and preoperative Constant-Murley score （CMS） and CMS 12 months after operation were observed. Infections， recurrence and complications in the two groups were recorded in the follow-up. Results All the 45 patients completed the surgery successfully and were followed up for 13 to 35 months， with an average of （23.53 ± 5.11） months. The operation time and the duration of drainage tube placement of the treatment group were longer than those of the control group （P < 0.05）， and there was no significant difference in the wound healing time （P > 0.05）； preoperative and 14-day postoperative WBC， CRP， and ESR， VAS 1 month after operation， and CMS 12 months after operation were all significantly improved in the two groups. The differences were all statistically significant （P < 0.05）， and the CMS of the treatment group was higher than that of the control group （P < 0.05）. During the follow-up， there were less cases of infection recurrence in the treatment group when compared with that in the control group （2/24， 8.33% vs. 5/21， 23.81%）. There were 2 cases of aseptic exudation in the treatment group. There were 1 case of bone defect in the treatment group and 5 in the control group， all of which had healed after the second-stage iliac implantation， and the rest did not have the complication of aseptic exudation， bone defects and pathologic fracture. Conclusion Debridement and antibiotic-loaded artificial bone can effectively control the infection and preserve the shape and function of the clavicle， with a low recurrence rate of postoperative infection， simple surgical operation， and no serious complications. It is worthy of clinical promotion.

Objective To investigate the value of tumor volume to uterine volume ratio （N/U） combined with tumor apparent diffusion coefficient （ADC） in predicting the pathological grade of endometrial carcinoma （EC）. Methods Data of 107 patients with EC admitted from July 2020 to January 2023 were retrospectively analyzed. All patients underwent preoperative magnetic resonance imaging （MRI）， and pathological diagnosis was used as the gold standard. Patients with low differentiation were included in the high grade group， and patients with medium and high differentiation were included in the low grade group. The factors affecting the pathological grading of EC patients were analyzed， and the value of MRI index in predicting the pathological grading of EC patients was analyzed. Results The pathological examination showed that there were 24 high-grade patients and 83 low-grade patients.. Logistic multivariate regression analysis showed that N/U， ADC， rADC internal obturator muscle were factors affecting the pathological grade of EC patients （ P < 0.05）. ROC curve results showed that the sensitivity of N/U， ADC， rADC internus obturator muscle and their combination to predict the pathological grading of EC patients were 70.83%， 75.00%， 79.17%， 83.33%， the specificity were 71.08%， 79.52%， 78.31%， 85.54%， and the AUC were 0.734， 0.756， 0.741 and 0.891. Conclusion The combination of N/U， ADC， rADC and obturator internal muscle was effective in predicting the preoperative pathological grading of EC patients.

Objective To investigate the impact of autologous platelet-rich plasma on postoperative bleeding and patient prognosis in individuals undergoing heart valve surgery. Methods This study is a retrospective cohort study that included patients who underwent heart valve surgery at Xiamen Hospital， Zhongshan Hospital， Fudan University from September 2018 to January 2023. The patients were divided into two groups based on whether they underwent autologous platelet-rich plasma （aPRP） collection before surgery： Group A （no PRP collection） and Group B （PRP collection group）. The main endpoint measure was the volume of pericardial mediastinal drainage on the day of surgery （D0）， the first postoperative day （D1）， and the second postoperative day （D2）. The secondary endpoint indicators included postoperative mechanical ventilation time， duration of mediastinal drainage tube retention， length of stay in the intensive care unit （ICU）， postoperative hospitalization time， incidence of adverse events during postoperative hospitalization， and postoperative coagulation function. Propensity score matching was used to balance preoperative baseline characteristics， including gender， age， Body Mass Index （BMI）， prothrombin time （PT）， International Normalized Ratio （INR）， platelet count （PLT）， activated clotting time （ACT）， ASA grade， NYHA grade， surgical name， surgical method， and preoperative comorbidities. Based on the matched data， the effect of PRP on postoperative bleeding and prognosis in patients following heart valve surgery was investigated. Results After propensity score matching， Group B patients showed a significant decrease in D2 drainage volume compared to Group A ［（132.42 ± 84.11） vs. （218.39 ± 160.39）， P = 0.01］. Additionally， Group B had significantly shorter postoperative mechanical ventilation time ［（1.88 ± 0.99） vs. （2.7 ± 2.47）， P = 0.015］， ICU stay time ［（3.07 ± 2.01） vs. （4.97 ± 6.26）， P = 0.006］， and pericardial mediastinal drainage retention time ［（5.72 ± 1.85） vs. （9.23 ± 5.05）， P = 0.01］. Moreover， the overall incidence of adverse events was reduced in Group B compared to Group A ［5（8.3%） vs. 14（23%）， P = 0.024］. At D0， D1， and D2， there was no statistically significant difference in hospital stay or postoperative coagulation function between the two groups of patients. Conclusions PRP has been proven to minimize pericardial mediastinal drainage on the second postoperative day， as well as the duration of mechanical ventilation， ICU stay， retention of pericardial mediastinal drainage， and overall incidence of postoperative adverse events.

Objective To explore the characteristics of opportunistic infections （OIs） in HIV?infected individuals with suboptimal immune reconstitution after ART treatment so as to provide a reference for preventing and managing HIV infections. Methods The clinical data including opportunistic infections specifically were acquired from 112 HIV?infected individuals with suboptimal immune reconstitution from the outpatient department of Wuming Hospital， Guangxi Medical University. The impact of baseline CD4⁺T lymphocyte counts on the incidence， type， and mixed infection rates of the opportunistic infections were analyzed. Results The opportunistic infection rate among the 112 HIV?infected individuals with suboptimal immune reconstitution was 42.86%， among which fungal infections were the most commonly seen. The opportunistic infection rate of the patients with a baseline of CD4⁺T lymphocyte counts ≤ 50/μL was significantly higher than that of the patients with a baseline of CD4⁺T lymphocyte counts > 50/μL， and there was no significant difference in the type of opportunistic infections as well as the rate of mixed infections. Conclusion HIV?infected people with suboptimal immune reconstitution in Guangxi are susceptible to HIV OIs. Among them， the group with a baseline CD4⁺ T lymphocyte counts ≤ 50/μL has a higher rate of OIs， mainly fungal infections.

Objective To investigate the efficacy and influencing factors of allo?HSCT in the treatment of MDS patients with ASXL1⁺. Methods The second?generation sequencing technique was used to detect 22 gene mutations in 247 newly diagnosed MDS patients in our hospital. The patients were divided into chemotherapy group and transplant group according to treatment style. The differences of OS and PFS between the two groups were compared， and the influencing factors of prognosis of transplant patients were analyzed. Results ASXL1+ was detected in 75 patients （30.36%）， with a median mutation ratio of 42.93 （18.10，58.39）%， 10 received supportive treatment， 43 received demethylation therapy or demethylation combined with pre?excitation therapy， and 22 received allo?HSCT. 2?year PFS rate and OS rate of transplantation group were significantly higher than that of chemotherapy group （P < 0.05）. The 2?year OS rate in the low ASXL1 mutation load group （VAF ≤ 42.93%） was significantly higher than that in the high ASXL1 mutation load group （VAF > 42.93%） （P < 0.05）. In the context of allo?HSCT in patients with ASXL1⁺， 2?year OS and PFS rates were significantly reduced in patients with RUNX1⁺ or ASXL1⁺ （P < 0.05）； Multivariate analysis showed that high mutation load of ASXL1 or U2AF1⁺ were independent risk factors for OS in transplant patient （P < 0.05）. U2AF1⁺ were the risk factors for PFS （P < 0.05）. Conclusion allo?HSCT significantly improved the prognosis of patients with ASXL1⁺ MDS. High ASXL1 mutation load or U2AF1⁺ were independent risk factors affecting the outcome of allo?HSCT.

Objective To evaluate the efficacy and safety of high intensity focused ultrasound （HFIU） combined with endometrial ablation in the treatment of adenomyosis （AM） patients with heavy menstrual bleeding （HMB）. Method A total of 199 patients with AM combined with HMB who underwent HIFU treatment at the Obstetrics and Gynecology Center of Affiliated Hospital of Chengdu University of TCM from July 2020 to September 2022 were selected and divided into two groups according to the ablation range. The combined ablation group included 80 cases with lesion and endometrial ablation （endometrial ablation rate ≥ 30%）， while the lesion ablation group 119 cases with simple lesion ablation. A 1∶1 propensity score matching was performed on the two groups， resulting in 59 patients in each group. A 6-month follow-up was conducted. The clinical manifestations （menstrual volume， degree of dysmenorrhea， uterine and lesion volume）， quality of life （MS-QOL， UFS-QOL）， and postoperative adverse reactions between the two groups before and 6 months after surgery was compared. Results Menstrual volume， degree of dysmenorrhea， uterine and lesion volume， MS-QOL score， and UFS-QOL score of the both groups were improved 6 months after surgery， when compared to those before surgery （P < 0.05）. Significantly reduced menstrual volume， degree of dysmenorrhea， and lower MS-QOL score were observed in the combined ablation group when compared with the lesion ablation group （P < 0.05）， but there was no statistical significance in uterine and lesion volume and UFS-QOL score （P > 0.05）. There was no difference in the incidence of adverse reactions between the two groups （P > 0.05）， but the combined ablation group had longer vaginal bleeding and fluid flow time （P < 0.05）. Conclusion The combined HIFU and endometrial ablation can effectively reduce menstrual flow， alleviate dysmenorrhea， and improve quality of life in patients with AM combined with HMB. Although it increases vaginal bleeding and fluid flow time， reasonable symptomatic management can effectively prevent the occurrence of adverse consequences such as infection.

Objective By analyzing the clinical data from 88 infants or young children with allergic rhinitis （AR）， we explore the clinical characteristics of AR in those pediatric patients as well as the improvement in symptoms after drug treatment. Methods A retrospective analysis was conducted on 88 infants or young children initially diagnosed with AR who visited the pediatric respiratory clinic of the first affiliated hospital of Guangzhou medical university from February 1， 2020 to August 1， 2020. Telephone follow-ups were conducted from 6 to 12 months after the first visit. Based on the follow-up results， we summarized the clinical characteristics， complications， and efficacy of therapies of AR in infants and young children. Results Among 88 infants or young children aged 3 to 36 months with AR， 34 （38.6%） had mild AR and 54 （61.4%） had moderate to severe AR. Runny nose and nasal congestion were the most common clinical symptom （87.5%， 77/88）， followed by sneezing （47.7%， 42/88） and nasal itching （37.5%， 33/88）. Coughing （56.8%， 50/88） was the most common complications， followed by snoring （52.3%， 46/88）， wheezing （27.3%， 24/88） and mouth breathing （12.5%， 11/88）.The top three positive rates of serum specific IgE testing were 53.4% （47/88） in milk， 46.6% （41/88） in dust mites and 36.4% （32/88） in eggs. After 2 to 8 weeks of medication uses， the remission rate of rhinitis symptoms was significantly higher in mild AR than in moderate to severe AR ［94.1% （32/34） vs. 75.9% （41/54）， χ ² = 4.883， P = 0.027］. 24.1% of patients with moderate to severe AR still had recurrent symptoms at follow-up visits， which was significantly higher than 5.9% in the mild AR group （χ ² = 4.883， P = 0.027）. Conclusion The main symptoms of AR in infants and young children are runny nose and nasal congestion， and the main complications include cough and snoring. The main allergens are dust mites， milk， and eggs. The symptom relief rate is better in mild AR than in moderate to severe AR after treatment. The symptoms in moderate to severe AR are prone to relapse.

Objective To evaluate the efficacy and safety of anlotinib monotherapy and combined therapy in patients with advanced pheochromocytoma/paraganglioma. Methods Nine patients with advanced pheochromocytoma/paraganglioma （PPGL） who were admitted to the Department of Urology， Sun Yat-sen University Cancer Center from January 2018 to June 2023 were collected. Patients were divided into four groups according to different treatments： anlotinib monotherapy group （3 patients）， anlotinib combined with PD-1 monoclonal antibody immunotherapy group （3 patients）， anlotinib combined with immunotherapy and chemotherapy group （2 patients）， and anlotinib combined with chemotherapy group （1 patients）. The effectiveness and safety of different treatment regiments of anlotinib were analyzed. Results Objective response rate （ORR） ： （44%）， Partial response（PR）： （44%）， Stable disease（SD）： （44%）， Progressive disease（PD）： （11%）， Disease control rate （DCR）： （89%）. The ORR of 2 patients with SDH gene mutation， SDHB and SDHD respectively， was 100%. Median overall survival time（OS） was 16.3 months （IQR： 11.3 ~ 21.8 months）. Median progression-free survival （PFS） was 16.3 months （IQR： 9.8 ~ 20.8 months）. There were 2 patients with adverse events grade ≥ 3/4， all of which were hypertension. Conclusions Anlotinib monotherapy and combined therapy have preliminary efficacy and manageable safety in the treatment of advanced pheochromocytoma/paraganglioma.

Objective To evaluate the efficacy and safety of chocolate balloon assisted drug-coated balloon （DCB） angioplasty for the treatment of TASC Ⅱ type C/D femoropopliteal artery lesions. Methods The clinical data of 58 patients with TASC Ⅱ type C/D femoropopliteal artery lesions treated with chocolate balloon +DCB or plain balloon+DCB at Fuwai Central China Cardiovascular Hospital from January 2021 to October 2022 were retrospectively analyzed. A total of 27 cases were assigned to the observation group （chocolate balloon + DCB）and 31 cases tothe control group （plain balloon + DCB）. The rate of dissection and the clinical outcomes between the two groups were compared. Results The technical success rates of the observation and control groups were 88.9% and 80.6%， respectively. The rates of dissection， flow-limiting dissection， and bailout stenting were significantly lower in the observation group than of the control group （all P < 0.05）. Postoperative clinical symptoms of patients in both groups improved significantly compared with the preoperative period. The 12-month cumulative primary patency rate of the observation group was significantly higher than that of the control group （P < 0.05）. There was no significant difference in the 12-month cumulative freedom from clinically driven-target lesion revascularization rate between the two groups （P > 0.05）. Conclusion Chocolate balloonassisted DCB angioplasty was safe and effective for TASC Ⅱ type C/D femoropopliteal artery lesions. It reduced the rates of dissection and bailout stenting， and had better near-term outcomes than plain balloon + DCB.

Objective To investigate the correlations of triglyceride glucose index（TyG） levels at different baselines with the risk of new-onset acute pancreatitis （AP） among the workers at Kailuan Group. Methods A total of 124 516 subjects were enrolled from 2006 to 2009 and followed up by health examinations of the workers in the group. The subjects with a history of AP or incomplete information on TG and FPG data were excluded. The cumulative incidence rate was determined by Log-Rank method. Multivariate Cox proportional hazards regression model was used to calculate hazard ratios （HR） for AP related to baseline TyG level after adjusting for the effects of multiple confunding factors. Results The subjects were divided into four groups （TyG ≤ 6.59， 6.59 < TyG ≤ 6.98， 6.98 < TyG4 ≤ 7.46， TyG > 7.46） according to the TyG levels， and the incidence of new-onset AP was observed in all the groups. For a follow-up of （12.59 ± 0.98 ）years， 399 cases of AP were observed. The corresponding incidence of AP in each tertile was 1.67， 2.32， 2.53， and 3.65 events per 10，000 person-years， respectively. After Cox analysis and correction of multiple confounding factors， the risk of AP incidence was increased in the TyG > 7.46 group， with an HR of 1.94［（95%CI（1.42， 2.65）， P < 0.01］. Conclusion TyG at its baseline of above 7.46 can increase the risk of AP.

Objective To explore the potential impact pathways of self?management behavior based on COM?B model， in maintenance hemodialysis （MHD） patients， and provide reference for the intervention of self?management behavior. Methods Judgment sampling was used to select 350 MHD patients undergoing dialysis at the hospital in a certain district of Guangzhou， and a questionnaire survey was conducted among them. Smart PLS software was used to construct a partial least squares structural equation model and perform path analysis. Results Self?management behavior score of MHD patients was （57.06 ± 13.28）. Univariate analysis showed that age， education background， employment status， occupational classification， per capita monthly income of families， and the number of comorbidities could directly affect self?management behavior of MHD patients （P < 0.05）. PLS?SEM model showed that self?efficacy （β = 0.246）， family care level （β = 0.124） and social support （β = 0.140） positively impacted patients′ self?management behavior， while disease perception negatively affected self?management behavior（β = -0.097）. Self?efficacy can mediate the impact of disease perception and social support on self?management behavior of MHD patients （P < 0.05）. Conclusions Self?management behavior of MHD patients is currently at a low level. Therefore， when devising intervention plans for these patients， it is crucial to consider the combined effects of disease knowledge education， disease perception reconstruction， opportunity provision， and motivation. The primary focus should be on enhancing patients' self?efficacy， which will ultimately elevate their overall level of self?management.

Objective To establish a PCR-based capillary electrophoresis （PCR/CE） to detect Survival Motor Neuron 1 （SMN1） and Survival Motor Neuron 2 （SMN2） genes and to evaluate its performance. Methods PCR/CE and Multiplex Ligation-dependent Probe Amplification （MLPA） for SMA gene diagnosis were used to blindly test the samples in sync. The performance of PCR/CE was assessed using MLPA results as the standard. Results A total of 336 samples were included in this study， consisting of 50 homozygous deletion types （14.9%）， 65 heterozygous deletion types （19.3%）， and 221 non-deletion types （65.8%）. The results of PCR/CE for detecting SMN1 and SMN2 copy numbers （0， 1， 2， 3， ≥ 4） were in complete agreement with the results of the MLPA. Conclusions PCR/CE for gene testing related to SMA could accurately detect copy numbers of exon 7 and exon 8 of the SMN1 and SMN2 genes （0， 1， 2， 3， ≥ 4）.

Objective To explore the effect of head acupuncturing therapy combined with massaging key head acupoints on language and cognitive function in children with autism. Methods 60 children with autism who visited the Department of Pediatric Rehabilitation of our hospital from January 2021 to June 2022 were selected as subjects， who were then randomly divided into the conventional group treated with the conventional rehabilitation training and the combination group treated with head acupuncturing therapy combined with massaging the key acupoints， apart from conventional rehabilitation training 30 cases in each group. The cognitive function， developmental status， and parental quality of life before and after the treatment were compared between the two groups， and so were the language function and safety. Results There were no significant differences in the scores by Autism Behavior Checklist （ABC） and Childhood Autism Rating Scale （CARS）， adaptability scores， language scores， and individual?social interaction scores between the conventional group and the combination group before the treatment （P > 0.05）. After the treatment， the scores by ABC and CARS were significantly decreased in both groups， and the scores of the combination group were significantly lower than those in the conventional group （P < 0.05）； The adaptability scores， language， individual?social interaction scores were significantly increased in both groups， and the scores of the combined group were significantly higher than those of the conventional group （P < 0.05）. The abnormal rates of symbolic expression， language comprehension， action?oriented subjects， and language development delay in the combined group were all significantly lower than those in the conventional group （P < 0.05）. There was no significant difference in the scores by the QL?Index between the conventional group and the combined group before the treatment （P > 0.05）， but after the treatment， the QL?Index scores of the conventional group and the combination group were increased， and the score of the combination group was significantly higher than that of the conventional group （P < 0.05）. The results of blood routine， urine routine， stool routine， liver function， and kidney function in both groups were not significantly abnormal. There was one case of mild swelling and pain at the acupunctured site in the combination group， which was improved without intervention. Conclusion Head acupuncturing therapy combined with massaging the key head acupoints can improve language function， cognitive function， and development of autistic children. In addition， it can enhance parental quality of life and have a high level of safety.

Metastatic pheochromocytoma and paraganglioma （MPPGL） is a rare neuroendocrine tumour in which genetic factors play an important role. In recent years， with the continuous progress of genetic testing technology， more and more susceptibility genes have been proved to be associated with MPPGL， making early identification of MPPGL possible. Recent studies have shown that genes associated with the development of MPPGL include SDHA， SDHB， SDHC， SDHD， SDHAF2， FH， MDH2， VHL， IDH1， PDH1/2， SLC25A11， GOT2， DLST， CSDE1， MAML3， H3F3A， MERTK， PCDHGC3， and KIF1B， with SDHA， SDHB， SDHC， SDHD， and SDHAF2 being the common pathogenic genes. Potential mutations affect the clinical manifestations of MPPGL， such as malignant potential and genetic prediction， which can help to better understand the clinical course and treat accordingly. Genetic testing for pheochromocytomas and paragangliomas allows for early detection of genetic syndromes and facilitates close follow-up of high-risk patients. This article provides a review of the progress of research on susceptibility genes identified in MPPGL in recent years， with a view to providing a certain theoretical basis for further related research.

Astrocytes constitute the most abundant cell type in the central nervous system. Under physiological conditions， astrocytes have a variety of functions， and play an important role in maintaining the homeostasis of the central nervous system. However， in response to insults such as injury， inflammation and hypoxia， astrocytes undergo rapid changes in gene expression， morphology and function， and these responses collectively called as astrocyte reactivity. Activated astrocytes have been divided into neurotoxic phenotype （type A1） and neuroprotective phenotype （type A2）. Recent studies have shown that A1 astrocytes are widely involved in the occurrence and development of various central nervous system diseases. Therefore， targeted regulation of activated astrocytes by combining multiple techniques is expected to be a potential treatment for central nervous system diseases. Here， we review recent advances of A1 astrocytes， including the molecular mechanism of phenotypic transformation and its role in neurodegenerative and neuroinflammatory diseases.