Postoperative vision loss is an extremely rare postoperative complication，which seriously af⁃ fects the quality of life. Up to day，it is assumed in most reports at home and abroad to be related to ischemic optic neuropathy，but its pathogenesis and risk factors are still under exploration. This paper reviews its anatomical ba⁃ sis，pathogenesis，diagnosis，risk factors and prevention strategies at full scale so as to strength the awareness of clinical doctors and help them with preventive strategies for the purpose of preventing the complication.

Objective To investigate the effect of sarcopenia on mortality after osteoporotic thoracolumbar compression fracture（OTLCF）in elderly patients. Methods A total of 114 elderly patients who met the inclusion and exclusion criteria were included from February 2014 to February 2017. The patients were divided into sarcope⁃ nia group and non⁃sarcopenia group according to the SMI diagnosis cut⁃off value. Kaplan Meier was used to analyze the survival curves of the two groups of patients，and the chi⁃square test to compare the survival rate between the two groups 12，24 and 36 months after the surgery. The Cox proportional hazards model was used to analyze the effects of multivariate factors such as sarcopenia，thoracic or lumbar fractures，age，gender，and American Society of Anesthetists（ASA）grade on postoperative mortality of OTLCF. Results There was statistical difference between the 36⁃month mortality rates（P = 0.016）. Patients with sarcopenia and patients with higher ASA grade had a higher mortality rate 36 months after the surgery. Conclusion Sarcopenia increases the risk of long ⁃term（36 months）

Objective This research tried to investigate the clinical efficacy of endoscopic secondary foraminal shaping in the treatment of lumbar spinal stenosis. Methods A total of 68 cases of lumbar spinal stenosis patients were randomly divided into secondary intervertebral foramen forming percutaneous endoscopic group （observation group）and conventional surgery（control group）. There were 34 cases in each group and the follow up lasted for 6～24 months. The surgical complications，operation time，intraoperative blood loss，hospital stay， hospitalization cost and the effect of surgery were all recorded. The clinical efficacy of the observation group was also documented. Results All68 patients were followed up for an average of 16 months. There was no statistical difference in gender，age or preoperative VAS score（P > 0.05）. Compared with the control group，the observation group had a shorter operation time，less intraoperative bleeding，shorter hospital stay，and less hospital cost，with statistically significant differences（P < 0.05）. After 1 week，1 month，6 months and the last follow⁃up，VAS and ODI scores of the patients in the two groups were all statistically different（P < 0.05）within 1 month，but not statistically different（P > 0.05）after 6 months. Moreover，the improved MacNab standard was used to evaluate the efficacy of the patients one year after the operation without statistically significant difference（P > 0.05）. During the observation period，2 patients in the observation group had repeated symptoms within 1 year，who were patients with central canal stenosis. After the second open operation，the symptoms disappeared；1 patient presented symptoms of intra⁃ operative spinal cord hypertension，and successfully completed the operation after active treatment. In the control group，there was no recurrence. One patient developed epidural hematoma after surgery，and the muscle strength of one side decreased. After emergency hematoma removal，the muscle strength of the lower extremity gradually recovered 3 months later. There were no serious complications such as nerve injury，vascular injury and duraltear. Conclusion Percutaneous endoscopic secondary formingis a safe and effective methodfor the treatment of lumbar spinal stenosis. But it should be used with caution for the treatment of central stenosis. At the same time，it has certain advantages in shortening operation time，reducing bleeding，reducing hospitalization cost and shortening hospitalization time，and has certain promotion value.

Objective To compare the efficacy of unilateral and bilateral pedicle screw fixation combined with OLIF in the treatment of lumbar degenerative diseases. Methods A total of 86 patients with lumbar degenerative diseases were treated with OLIF combined with pedicle screw fixation in our Hospital from July 2017 to November 2019. 53 cases were treated with OLIF combined with unilateral pedicle screw fixation，and 33 patients in bilateral pedicle screw fixation group. The clinical effects of the two groups were evaluated by low back pain VAS and ODI. The damage of paraspinal muscles was evaluated by paraspinal electromyography，and the height of intervertebral space was measured by imaging. Interbody fusion was evaluated and related complications were analyzed. Results The VAS score and ODI index of low back pain in the UPS group were lower than those in the BPS group at different time after operation. The operation time，intraoperative blood loss，hospitalization cost and the incidence of paraspinal muscle denervation in the UPS group were significantly lower than those in the BPS group（P < 0.05）. There was no significant difference in the average hospital stay，incidence of complications and fusion rate between the two groups（P > 0.05）. Conclusion Unilateral pedicle screw fixation combined with OLIF via Wiltse approach has a satisfactory clinical effect in the treatment of lumbar degenerative diseases. It has less trauma and lower incidence of paraspinal muscle denervation.

Objective To study the mid⁃and long⁃term clinical efficacy of minimally invasive transforami⁃ nal lumbar interbody fusion for the treatment of double ⁃ segment lumbar spinal stenosis. Methods Sixty ⁃two patients with double ⁃ segment lumbar spinal stenosis who were treated in our hospital from Dec2013 to Dec2015 were retrospectively analyzed. These patients were divided into two group ，MIS⁃TLIF group（32 patients）and O⁃TLIF group（30 patients）. Oswestry disability index（ODI），visual analog scale（VAS）were compared between the two groups at 3 months，6 months，12 months，24 months after surgery and the latest follow⁃up. Complications and intervertebral fusion rate were also analyzed. Results Compared to O⁃TLIF group，MIS⁃TLIF group showed a significant decrease in lumbar VAS and ODI at 3 months and 6 months after surgery，but the difference was not significant between the two groups at 12 months，24 months and the latest follow⁃up. Both the two groups showed an obvious decrease in VAS and ODI at latest follow up compared to pre⁃operation. Adjacent segment degeneration was observed in 4 and 5 patients in MIS ⁃TLIF and O ⁃TLIF group respectively. The fusion rate in MIS ⁃TLIF was 92.2%，and 88.3% for O⁃TLIF group. Conclusion MIS⁃TLIF treatment fordouble⁃segment lumbar spinal stenosis can obtain excellent medium and long⁃term outcomes，and this methoddose not increase the incidence of medium 

Objective To explore the effect of PCVP on the treatment effect and bone cement filling rate in elderly patients with OVCF. Methods A total of 86 elderly patients with OVCF in our hospital were selected and divided into study group（n = 43）and control group（n = 43）. The control group took PVP and the study group took PCVP. The clinical efficacy of the two groups before and after operation were calculated. Results （1） The scores of ODI and VAS of the two groups in the study group were lower than those in the control group at 6 months after operation（P＜0.05）；（2）the height of the anterior edge of the injured vertebrae in the two groups was higher than that before operation at 6 months after operation. The Cobb angle was smaller than that before oper⁃ ation（P＜0.05），and the height of the front edge of the injured vertebrae in the study group was higher than that of the control group，and the Cobb angle of the injured vertebrae was smaller than that of the control group（P＜ 0.05）；（3）the excellent rate of bone cement filling in the study group was higher than the control group（95.35% vs. 81.40%）（P < 0.05）；（4）the complication rate in the study group was lower than the control group（9.30% vs. 25.58%）（P < 0.05）. Conclusion The use of PCVP in the treatment of elderly patients with OVCF can effective⁃ ly reduce their pain，increase the height of the anterior edge of the injured vertebra，reduce the Cobb angle of the injured vertebra，and promote the recovery of lumbar spine function safely.

Objective To investigate the effect and mechanism of N⁃acetyl⁃seranyl⁃aspartate⁃lysyl⁃proline （Ac ⁃ SDKP） in inhibiting experimental silicosis by regulating secreted phosphoprotein 1 （SPP1）/transforming growth factor⁃β1（TGF⁃β1）signaling. Methods Wistar rats were randomly divided into control 24 week group， silicosis 24 week group and Ac⁃SDKP treatment group. RAW264.7 cells were divided into control group，SiO2 induced group and SiO2 + Ac ⁃ SDKPtreated group. As well as control group，recombinant SPP1 induced group， SPP1+Ac⁃SDKP group and SPP1+LY364947 group. Immunohistochemical staining（IHC）was used to detect SPP1 expression and localization. The expression of COL I，monocyte chemoattractant protein ⁃1（MCP ⁃1），TGF ⁃β1， TGF⁃β receptor type I（TGFβRI），TGFβRII，p⁃Smad2/3，Smad2/3 and SPP1 in lung tissue and RAW264.7 cells were measured by western blot. Results IHC and western blot results showed that compared with the control group， the expressions of COL I，MCP⁃1，TGF⁃β1 and SPP1 in the silicosis group were up⁃regulated，and the expressions of COL I，MCP ⁃1，TGF ⁃β1 and SPP1 in the Ac ⁃SDKP group were decreased compared with the silicosis group （P < 0.05）. Compared with the control group，the protein expression levels of COL I，MCP⁃1，TGF⁃β1 and SPP1 were up⁃regulated in the SiO2 ⁃induced group. In addition，the expression levels of COL I，MCP⁃1，TGF⁃β1 and SPP1 in the Ac⁃SDKP treated group were down⁃regulated compared with SiO2⁃induced group（P < 0.05）. Compared with the control group，TGFβRI，TGFβRII andp⁃Smad2/3 were up⁃regulated in the SPP1 induced group. Compared with the SPP1 induced group，the expression of TGFβRI，TGFβRII andp⁃Smad2/3 were down⁃regulated in the Ac⁃SDKP group and LY364947 group（P < 0.05）. Conclusion Ac⁃SDKP can play a suppressing silicosis role by inhibiting the SPP1/TGF⁃ 

Objective To investigate the protective effect of Hui⁃Hui Gan⁃song Yin（HGY）on the glomer⁃ ulus of diabetic nephropathy（DN）in rats. Methods Ten rats were randomized into the normal control group （NC）. The early DN models of SD rats were reproduced by high fat feed combined with streptozotocin. The rat DN models were randomly divided into DN model groups（DN），Glenn sinensis group（DN + Gli，10 mg/kg），spikenard drink high dose group（DN + HH，10 g/kg），and spikenard drinking low dose group（DN + HL，5 g/kg），10 rats in each group. MRNA expression of miR⁃192，the target genes of Zeb2 and TGF⁃β1，Smad3 and Smad7 in renal tissue was detected by real⁃time fluorescence quantitative PCR. Western blot was used to detect the protein expres⁃ sion of the above genes. Results Compared with the blank control group，the mRNA levels of TGF⁃β1，Smad3 and miR⁃192 in the renal tissue of the DN model group was significantly increased（P < 0.01，respectively），while the mRNA expression of Smad7，S1P1 and Zeb2 and Smad7 was significantly decreased（P < 0.01，respectively）. Compared with the DN model group，the mRNA levels of TGF⁃β1，miR⁃192 and Smad3 were significantly decreased （P < 0.01，respectively），and the mRNA expression of Smad7，S1P1，Zeb2 and Smad7 was significantly increased after the treatment of HGY. Conclusion HGY may improve the accumulation of extracellular matrix in the kidney of DN rats by regulating miR⁃192⁃mediated TGF⁃β1/Smads signaling pathway，contributing to protecting the kid⁃ 

Objective To study the inhibitory effect of EGCG（epigallocatechin⁃3⁃gallate）on Echovirus 9 （ECHO 9）and effect of its substrate Hsp70（Heat shock protein 70）in vitro，and to provide basis for the research and development of new chemicals against ECHO 9 virus. Methods According to the maximum working concen⁃ tration of EGCG，the effects of EGCG on the proliferation，protein expression and gene transcriptional inhibition of ECHO 9 in vitro were detected by TCID50 assay，cytotoxicity assay，Western blot and real⁃time quantitative PCR， respectively. RNAi were used to knock down the expression of Hsp70 and the growth curves of virus were exam⁃ ined. Results Toxicity of EGCG on Vero cells showed an obvious gradient dependent effect，with the maximum non⁃toxic concentration of 25 μmol/L. The titer inhibition rate of virus in the cells supernatant reached 62% at the concentration of 20 μmol/L. Meanwhile，Western blot results showed that the virus G protein in EGCG treated cells was significantly inhibited. The results of qPCR on the transcription of virus G protein in cells showed that EGCG reduced the transcription efficiency of virus G protein by about 85.3% . Knocking down the expression level of Hsp70 reduced the titer of the virus by two orders of magnitude. Conclusions EGCG has a good antiviral effect on ECHO 9 in vitro，and may be achieved by inhibiting its specific substrate Hsp70.

Objective To investigate the effects of Nd：YAG laser on TROP2 and the HN6 proliferation， migration and invasion of oral squamous cell carcinoma cells. Methods HN6 cell lines were cultured in vitro， and the effects of laser irradiation on proliferation ability，scratch healing and migration and invasion of HN6 cells were detected，with continuous irradiation by pulsed 1 064 nm Nd：YAG laser after 24 and 48 h. TROP2 expres⁃ sion was detected by the effects of Nd：YAG laser on HN6 cells. Then，TROP2 knockdown plasmid was constructed and transfected into HN6 cells. The effects of Nd：YAG laser were investigated on the proliferation and invasion of HN6 cells. Results With low and medium dose laser irradiation，the proliferation of HN6 cells was stronger，the degree of promoting scratch healing and the invasion ability were improved，and TROP2 expression was higher （P < 0.05）. But under high dose laser irradiation，HN6 cell proliferation was inhibited，the degree of scratch healing was slowed down，the invasion ability was inhibited，and TROP2 expression was lower（P < 0.05）. After After interfering with TROP2 expression，the effects of Nd：YAG laser on the proliferation and invasion of HN6 cells were disappeared. Conclusions The lower dose of Nd：YAG laser irradiation promotes the proliferation， migration and invasion of HN6 cells，while the higher dose of Nd：YAG laser irradiation inhibits the proliferation， migration and invasion of HN6 cells. By regulating the expression of TROP2，the Nd：YAG laser affects the prolifera⁃ tion，invasion and metastasis of HN6 cells.

Objective To investigate the effect of circ_NEK6 on the malignant biological behavior of 131I⁃ resistant differentiated thyroid carcinoma （DTC）cells and its possible mechanism. Methods RT ⁃ qPCR was performed for the detection of circ_NEK6 and miR⁃370⁃3p in DTC tissues and cell lines. The proliferation，apoptosis， migration and invasion abilities of Res⁃BCPAP cells was evaluated by CCK⁃8，flow cytometry，Transwell assay， respectively. Dual⁃luciferase assay was conducted to prove the interaction of circ_NEK6 and miR⁃370⁃3p. Results circ_NEK6 was upregulated in the 131I⁃resistant DTC tissues compared with the 131I⁃sensitive DTC tissues，and its expression in DTC cell lines was higher than that in human thyroid follicular epithelial normal cells，especially in 131I⁃resistant Res⁃BCPAP cells was higher than that in parental BCPAP cells. Knockdown of circ_NEK6 decreased Res⁃BCPAP cell proliferation，migration and invasion，as well as promoted cell apoptosis. Besides，dual⁃luciferase reporter gene assay analysis results showed that circ_NEK6 could directly bind to and negatively regulate miR⁃370⁃ 3p expression. Functionally，circ_NEK6 suppression inhibited the malignant biological behavior of Res ⁃ BCPAP cells via targeting miR⁃370⁃3p. Conclusion Inhibition of circ_NEK6 enhanced the radio⁃sensitivity of 131I in DTC cells via targeting miR⁃370⁃3p，indicating that circ_NEK6 may act as a potential biomarker and therapeutic target for DTC patients with 131

Objective To investigate the inhibitory effect of melatonin in conjunction with 5⁃fluorouracil and its molecular mechanism in esophageal cancer. Methods Human esophageal carcinoma EC⁃9706 and EC⁃109 cells were treated with MLT and 5⁃FU at different concentrations.The effects of MLT on the chemotherapy sensitivi⁃ ty of 5⁃FU were investigated by detecting cell activity，invasion，migration，apoptosis and protein expression，and the possible mechanism was further explored.The synergistic antitumor effect of MLT and 5⁃FU was investigated by tumor⁃bearing experiment. Results MLT inhibited the activity of EC⁃9706 and EC⁃109 cells in a dose⁃dependent manner. Compared with blank controls，melatonin reduced the invasion and migration of EC ⁃ 9706 and EC ⁃ 109 cells（P < 0.01），but increased the apoptosis rate（P < 0.01）. Compared with MLT and5⁃FU alone group，the combinational use of melatonin and 5⁃FU significantly reduced the proliferation，invasion，migration and apoptosis of esophageal carcinoma cells（P < 0.01）. Meanwhile，compared with MLT and5⁃FU alone，the combinational use of melatonin and 5⁃FU significantly reduced EZH2 expression，and overexpression of EZH2 reversed the effects of MLT and 5⁃FU on EC⁃9706 cells（P < 0.01）. In addition，MLT and 5⁃FU combined administration significantly inhibited the growth of esophageal cancer in nude mice compared with 5⁃FU alone（P < 0.01）. Conclusion The combinational use of melatonin and 5⁃FU promotes apoptosis by inhibiting the expression of EZH2，thus improving 

Objective To investigate the effect of long intergenic non⁃coding RNA 00689（LINC00689） on the proliferation and apoptosis of bladder cancer cell T24 and its possible mechanism. Methods Real ⁃time fluorescence quantitative PCR（RT⁃qPCR）was used to analyze the expression of LINC00689 and miR⁃876⁃5p in bladder cancer tissues，adjacent tissues，T24 cells and normal bladder epithelial cells SV⁃HUC⁃1. Dual luciferase reporter gene and RT ⁃qPCR were applied to verify the regulation effect of LINC00689 on miR ⁃876⁃5p. T24 cells were divided into si⁃NC group，si⁃LINC00689 group，miR⁃NC group，miR⁃876⁃5p group，si⁃LINC00689 + anti⁃miR⁃ NC group and si⁃LINC00689 + anti⁃miR⁃876⁃5p group. Cell counting kit（CCK⁃8）and flow cytometry were used to analyze cell viability and apoptosis and western blot was used to analyze expression of cyclin D1（CyclinD1），p21， B cell lymphoma 2（Bcl⁃2）and Bcl⁃related X protein（Bax）. Results The expression of LINC00689 was increased in bladder cancer tissues and T24 cells，but that of miR⁃876⁃5p was decreased（P < 0.05）. LINC00689 negatively regulated miR⁃876⁃5p expression. Compared with those in si⁃NC group，cell viability，expression of CyclinD1 but Bcl⁃2 proteins were reduced，and apoptosis rate，expression of p21 and Bax proteins were increased in si⁃LINC00689 group（P < 0.05）. Compared with those in miR⁃NC group，cell viability，expression of CyclinD1 and Bcl⁃2 pro⁃ teins were reduced，but apoptosis rate，expression of p21 and Bax proteins were increased in miR⁃876⁃5p group （P < 0.05）. Compared with those in si⁃LINC00689 + anti⁃miR⁃NC group，cell viability，expression of CyclinD1 and Bcl ⁃ 2 proteins were increased，but apoptosis rate，expression of p21 and Bax proteins were reduced in si ⁃ LINC00689 + anti⁃miR⁃876⁃5p group（P < 0.05）. Conclusion Inhibiting LINC00689 can reduce the proliferation 

Objective To investigate the effect of SIRT1 gene polymorphism on the clinical efficacy of liraglutide combined with metformin in type 2 diabetes patients with poor glycemic control. Methods 216 type 2 diabetes patients with poor glycemic control were included. Patients were treated with liraglutide combined with metformin. After 26 weeks treatment，the clinical efficacy was evaluated，and the relationship between SIRT1 gene polymorphism and efficacy was analyzed. Results After 26 weeks of treatment with lialulutide combined with metformin，the indexes of HbA1c，FPG，2H PG and BMI of 216 patients were significantly decreased，and the differences were statistically significant compared with those before treatment（P < 0.05）. The indexes of HbA1c， FPG，BMI and 2h PG in TC/CC patients decreased more significantly than those in TT patients，and the differences were statistically significant（P < 0.05）. The polymorphism analysis of SIRT1 gene showed that the genotype distri⁃ bution frequency of Rs12778366 was in line with hardy Weinberg equilibrium. In addition，the STIR1 mRNA expression analysis of 145 patients showed that the mRNA expression level of TT patients was also significantly lower than that of TC/CC patients（P < 0.001）. Conclusions Lilarutide combined with metformin is safe and effective in patients with type 2 diabetes with poor glycemic control，and patients with C allele are more effective. Rs12778366 of SIRT1 gene may affect the clinical efficacy of lylalutide combined with metformin by affecting the mRNA expres⁃ sion of SIRT1 gene.

Objective The aim of this study was to explore the predictive value of the combination of central venous blood and arterial carbon dioxide partial pressure difference（Pcv ⁃aCO2），central venous oxygen saturation（ScvO2）and lactate clearance rate（LCR）on prognosis of patients with septic shock. Methods The clinical data of 70 patients with septic shock from March 2015 to may 2020 were retrospectively collected and ana⁃ lyzed. Pcv⁃aCO2 and ScvO2 were detected at 6 h and 24 h after admission，and LCR at 6 h and 24 h after admission were calculated. All patients received routine treatment and the prognosis were analyzed. Pcv ⁃ aCO2，ScvO2 and LCR were compared between patients with good and poor prognosis. The change rates of Pcv⁃aCO2，ScvO2 and LCR in patients were compared. Receiver operating characteristic curve（ROC）was applied to analyze the predictive efficacy of the combination of the three methods for poor prognosis in patients with septic shock. Results The inci⁃ dence of poor prognosis was 27.14%. Pcv ⁃aCO2 of patients with poor prognosis were higher than those with good prognosis at 6 h and 24 h after admission，and ScvO2 at 6 h and 24 h after admission were lower than those with good prognosis. Meanwhile，LCR at 6 h and 24 h after admission were lower than those in patients with good prog⁃ nosis. The Pcv⁃aCO2 of patients with good prognosis 48 hours after admission was lower than that at 6 h after admis⁃ sion，and ScvO2 was higher than that at 24 h after admission，and the LCR at 24 h after admission was higher than that at 6 h after admission in patients with good prognosis. The change rates of Pcv⁃aCO2，ScvO2 and LCR in patients with poor prognosis were lower than good prognosis. The differences were statistically significant（P < 0.05）. The cut off values of Pcv⁃aCO2，ScvO2 and LCR were 10.32%，4.69% and 32.25% respectively. The sensitivity of combined prediction of poor prognosis of septic shock was similar to that of single prediction. The specificity and AUC of combined prediction were higher than those of single prediction. Conclusion The risk of poor prognosis in patients with septic shock is high. The combination of the change rates of Pcv⁃aCO2，ScvO2 efficiency in predicting poor prognosis.

Objective To study HEART risk score in chest pain patients with coronary heart disease （CHD）in the emergency department（ED）. Methods This retrospective cohort study used a prospectively acquired database. Chest pain patients admitted to the emergency department of Beijing Anzhen Hospital from September 2014 to July 2015 were enrolled. Baseline characteristics of patients were included. The endpoint（major adverse cardiovascular events，MACE）was a composite of acute myocardial infarction，percutaneous coronary interven⁃ tion，coronary artery bypass graft，and all ⁃ cause death within 3 months after initial presentation. Results The study enrolled 377 eligible patients，and 186 patients（49.3%）had a MACE within 3 months. A significant pro⁃ gressive pattern of increasing MACE rate was observed as the score increased（P < 0.001 by chi⁃square for trend）. The area under the receiver operating characteristic（ROC）curve was 0.73［95% CI：0.68 ~ 0.78］in all chest pain patients. Patients were categorized into three groups：low risk（score 2 ~ 3），intermediate risk（score 4 ~ 5）， and high risk（score 6~10）；MACE rates were 8.3%（1/12），38.3%（72/188）and 83.8%（113/177），respectively （P < 0.001）. Recommendations for patient triage were different. Conclusions The HEART risk score was validat⁃ ed in chest pain patients with CHD and may aid patients triage in the ED.

Objective To explore the expression and clinical significance of matrix metalloproteinase ⁃ 2 （MMP⁃2），a disinterring and metalloproteinase 17（ADAM17）and epithelial cadherin E（E⁃cadherin）in colorectal cancer tissues. Methods The expression levels of MMP⁃2，ADAM17 and E⁃cadherin in cancer tissues specimens and adjacent tissues of 210 cases of colorectal cancer were detected by immunohistochemistry and Western blot. The expression levels of MMP⁃2，ADAM17 and E⁃cadherin and their relationship with clinicopathological features were analyzed，and the relationship between the three expression levels and prognosis was analyzed，and its corre⁃ lation was analyzed. Results The positive expression rate of MMP⁃2 in colorectal cancer tissues was significantly higher than that in adjacent tissues（72.38% vs. 19.52%，P < 0.05）significantly higher than that in adjacent tissues［78.10%（164/210）vs. 5.24%，P < 0.05）］. The positive expression rate of E⁃cadherin in cancer tissues was significantly lower than that in adjacent tissues（41.90% vs. 96.67%，P < 0.05）. Western blot results showed that the protein expression levels of MMP ⁃ 2 and ADAM17 in cancer tissues were significantly higher than those in adjacent tissues while the protein expression level of E⁃cadherin was signifi⁃ cantly lower than that in adjacent tissues（P < 0.05）. The positive expressions of MMP⁃2，ADAM17 and E⁃cadherin were associated with TNM stage，differentiation degree，lymph node metastasis and liver metastasis（P < 0.05）， and were not related to gender distribution，age，tumor size and location（P > 0.05）. The median survival time was 22 months（95% CI：20.87～23.58）and the 5⁃year survival rate was 53.42% in MMP⁃2 positive group，and median survival time was 31 months （95% CI：28.95～33.45）and the 5⁃year survival rate was 69.18% in MMP⁃2 negative group，and there was a statistical difference in the survival between the two groups（Log⁃rank χ2 = 4.98，P < 0.05）. The median survival time was 21 months（95% CI：19.93～22.86）and the 5⁃year survival rate was 50.77% in ADAM17 positive group，and the median survival time was 33 months（95% CI：30.48～36.40）and the 5⁃year survival rate was 65.52% in ADAM17 negative group，and there was a statistically significant difference in the survival between the two groups（Log⁃rank χ2 = 7.28，P < 0.05）. The median survival time was 30 months（95% CI： 27.88～31.32）and the 5⁃ year survival rate was 47.92% in E ⁃ cadherin positive group，and the median survival time was 16 months（95% CI：14.60～17.89）and the 5⁃year survival rate was 26.09% in E⁃cadherin negative group， and there was a statistically significant difference in the survival between the two groups（Log⁃rank χ2 = 44.23， P < 0.05）. Spearman correlation showed that MMP⁃2 expression was positively correlated with ADAM17 expression （P < 0.05），and MMP⁃2 expression was significantly negatively correlated with E⁃cadherin expression（P < 0.05）， and ADAM17 expression was significantly negatively correlated with E⁃cadherin expression（P < 0.05）. Conclusion The expression levels of MMP⁃2 and ADAM17 in colorectal cancer tissues are significantly higher than those in adjacent tissues while the expression level of E⁃cadherin in colorectal cancer tissues is significantly lower than that in adjacent tissues. Their expressions are related to clinical stage，differentiation degree，lymph node metastasis and liver metastasis. The expression levels of three proteins are closely related to the prognosis of patients，and the expression of MMP⁃2 is positively correlated with the expression of ADAM17 in colorectal cancer tissues. E⁃cadherin expression is significantly negatively correlated with the expressions of MMP⁃2 and ADAM17. The detec⁃ tion of three protein expression levels can be used as a marker for the diagnosis of colorectal cancer and assessment 

Objective To explore the effect of long non⁃coding lncRNA DBH⁃AS1（DBH⁃AS1）on apoptosis of keloid fibroblasts and its mechanism of action. Methods Real⁃time fluorescent quantitative reverse transcription polymerase chain reaction（qRT⁃PCR）was used to detect mRNA expression levels of DBH⁃AS1，microRNA⁃138 （miR⁃138）and Hypoxia⁃inducible factor⁃1α（HIF⁃1α）in keloids and normal skin tissues. Dual Luciferase Report was applied to analyze the combination of the three proteins. Flow cytometry，qRT ⁃PCR and Western blot were utilized to detect the effect of knockdown or overexpression of DBH⁃AS1 on apoptosis of keloid fibroblasts，the expression changes of miR⁃138 and HIF⁃1α were also analyzed. Results DBH⁃AS1 and HIF⁃1α were significantly up⁃regulated in keloid tissues and cells while miR⁃138 was significantly down⁃regulated（P < 0.05）. The Dual Lucif⁃ erase Report verified that DBH⁃AS1 could have targeted binding with miR⁃138，and miR⁃138 could have targeted binding with HIF⁃1α in keloid fibroblast. Low expression of DBH⁃AS1 or overexpression of miR⁃138 significantly promoted apoptosis of keloid fibroblasts. Knockdown of miR⁃138 could reverse the effect of silencing DBH⁃AS1 on apoptosis of keloid fibroblasts，and knockdown of HIF⁃1α significantly inhibited the effect of silencing miR⁃138 on apoptosis（P < 0.05）. Conclusions Silencing DBH⁃AS1 promoted apoptosis of keloid fibroblasts by regulating the miR⁃138/HIF⁃1α pathway，

Objective To explore the expression of PYCR1 gene in hepatocellular carcinoma（HCC）and its relationship with clinicopathological features and prognosis.Methods Expression levels of PYCR1 mRNA and protein in HCC and adjacent tissues from 80 patients were detected by qRT⁃PCR and Western blot. Cox proportional hazards model was used to analyze the prognostic factors of HCC patients. Kaplan⁃Meier method and the log⁃rank test were used to analyze the prognosis. Results Relative expressions of PYCR1 mRNA and protein in HCC group were higher than that in adjacent tissue group（P < 0.05 for both comparisons）. Expression of PYCR1 was correlated with tumor size，satellite lesions，vascular invasion and TNM stage（P < 0.05 for all comparisons）. PYCR1 expres⁃ sion level was an independent factor for affecting 5⁃year overall survival rate and disease⁃free survival rate in HCC patients（P < 0.05 for both comparisons）. The 5⁃year overall survival rate and disease⁃free survival rate in patients with low expression of PYCR1 in HCC tissues were greater than those in patients with high expression of PYCR1 （P < 0.05 for both comparisons）. Conclusions PYCR1 is highly expressed in HCC tissues，which is related with tumor size，satellite lesions，vascular invasion，and TNM stage. Expression of PYCR1 is closely related with the 

Objective To observe the effects of enteral nutrition（EN）emulsion with low⁃methoxyl pectin in patients with severe traumatic brain injury（sTBI）. Methods Eighty severe craniocerebral trauma patients were randomized into pectin or control group（each n = 40）. The EN support began within 24～48 hours after the patients were transferred to ICU. In addition，the pectin group received low ⁃methoxyl pectin for 7 days. Average blood glucose（GLUave），blood glucose variation coefficient（GLUcv），amount of insulin used and pre⁃albumin （PA）were observed 7 days after EN support. Gastrointestinal tolerance situations，the duration of mechanical ventilation（MV）and incidence of ventilator associated pneumonia（VAP）were studied. Results Significantly lower levels of GLUave and GLUcv were observed in the pectin group compared with those of the control group（P < 0.05）. There were significantly shorter hours of insulin therapy in pectin group than in control group（P < 0.05），but there was no significant difference of numbers of patients treated with insulin between two groups（P = 0.16）. The PA of pectin group was significantly higher than that in control group（P < 0.05），and the indexes of gastrointestinal toler⁃ ance were better in pectin group（P < 0.05）. The duration of MV in pectin groups were shorter than that of control group（P < 0.05），but there was no significant difference in the incidences of VAP between two groups（P = 0.46）. Conclusions Low⁃methoxyl pectin could facilitate blood glucose control and gastrointestinal tolerance in patients with severe traumatic brain injury，and it also could shorten the duration of mechanical ventilation and contribute to the improvement of nutritional status

Objective To investigate the effects of the 3D speckle tracking technique（3D⁃STE）in evalu⁃ ating the changes of left ventricular myocardial function in patients with colorectal cancer before and after chemo⁃ therapy with mFOLFOX6（oxaliplatin+5⁃fluorouracil+calcium folinate）. Method Thirty patients diagnosed with colorectal cancer treated with mFOLFOX6 in our hospital were collected. We used 3D⁃STE to obtain left ventricular parameter：global longitudinal strain（GLS），global area strain（GAS），global circumferential strain（GCS），global radial strain（GRS），left ventricular twist（LVtw）and calculated myocardial composite index（MCI，MCI=GLS × LVtw）. We also compare the changes in the above values before and after chemotherapy. We draw the receiver operating curve（ROC）of each parameter and analyze and compare the correlation among MCI，LVEF，GLS and cTnT. Result Compared with the pre ⁃ chemotherapy state：The absolute values of MCI，LVtw，GLS，GAS，GCS，and GRS of patients decreased with the increase of the cumulative dose of chemotherapeutic drugs. The absolute values of GAS，GLS，MCI and LVtw decreased during the first cycle of chemotherapy（P < 0.05）. The area under the ROC curve of MCI is 0.903 and the area under the ROC curve of GLS is 0.838. The correlation between MCI and cTnT （r = -0.7228，P＜0.001）is stronger than the correlation between GLS and cTnT（r = -0.6008，P＜0.001）. Conclusion 3D ⁃STE is helpful for early detection of changes in left ventricular myocardial function in patients with colorectal 

Objective To evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibi⁃ tor（EGFR⁃TKI）on miliary lung cancer，and to explore the immunophenotyping of tumor microenvironment（TME） and its correlation with the effect of EGFR⁃TKI. Methods We retrospectively analyzed 147 patients with stage IV non ⁃ small cell lung cancer（NSCLC）who had EGFR mutation and received EGFR ⁃TKI treatment in Guangzhou Chest Hospital from March 2017 to March 2019. According to imaging diagnosis，the patients were divided into miliary lung cancer group（group A，n = 49）and non⁃miliary lung cancer group（group B，n = 98）. The efficacy of targeted therapy was compared between the two groups，and the immunophenotyping of TME and its relationship with the efficacy of EGFR ⁃ TKI were analyzed. Results The positive rates of PD ⁃ L1 and CD8 in group A were 40.82% and 53.06%，respectively，which were significantly higher than those in group B（24.49% and 29.59%）. In group A，the median progression⁃free survival time（PFS）of patients with type I TME was significantly worse than that of type Ⅱ/Ⅲ/Ⅳ（5.7 months vs. 7.4 months，P = 0.024）；the same was true in group B（6.0 months and 11.0 months，P = 0.027）. Conclusion Patients with miliary lung cancer benefit poorly from EGFR⁃TKI. The 

Objective To investigate the safety and feasibility of improved technique of incision suture and drainage tube fixation in single ⁃port video ⁃assisted thoracoscopic surgery. Methods We retrospectively analyzed the clinical data of 80 patients who underwent single⁃port video⁃assisted thoracoscopic surgery from January 2019 to December 2019 in our hospital. According to different incision suture techniques，we divided them into observation group and control group. Results There were no statistically significant differences in wound infection rate ， re⁃sewing rate and pleural fluid outflow rate between the two groups. The VAS and BCS of the observation group were better than that of the control group（P = 0.022，0.041），and the suture removal time of the observation group was shorter than that of the control group（P < 0.001）. All scar scores（VSS，POSAS，SCAR）in the observation group were better than those in the control group one month after the surgery（all P < 0.001），and patient satisfaction rate was higher than the control group（P = 0.026）. Conclusion The continuous incision suture with absorbable thread is safe and feasible for single⁃port video⁃assisted thoracoscopic surgery，which realizes the organic combination of minimally invasive and aesthetics，and is conducive to the postoperative rehabilitation and the improvement of 

Objective To investigate the diagnostic value of soluble B7⁃H4 in the patients with SLE. Methods 60 SLE patients and 20 healthy donors were recruited. Disease activity was assessed by SLEDAI scores. The sB7⁃H4 of serum in SLE and healthy donors were analysed using ELISA，and the correlation between sB7⁃H4 of serum in SLE and disease active parameters was analysed too. Results The sB7⁃H4 in serum of SLE patients ［（65.62 ± 21.02）ng/mL］was significantly higher than healthy controls［（55.4 ± 11.2）ng/mL］（P < 0.05）. The sensitivity and specificity of sB7⁃H4 to diagnose active SLE in the SLE group were 56％and 85％respectively，and the area under ROC curve was 0.65．The mean concentration of sB7⁃H4 level in active disease group［（70.99 ± 19.85）ng/mL］were significantly higher than those in inactive disease group［（59.06 ± 20.89）ng/mL］（P < 0.05）， the sensitivity and specificity of sB7⁃H4 to diagnose active disease in the SLE group were 82％and 56％respectively， the area under ROC curve was 0.687. Conclusion The expression of sB7⁃H4 probably may contribute to the diag⁃ 

Objective To investigate the influence factors of hypoglycemia in children with type 1 diabe⁃ tes. Methods Clinical data of 542 children with type 1 diabetes hospitalized from January 2017 to December 2019 were collected，and the influence factors of hypoglycemia were analyzed. Results Blood glucose control rate of diabetic children was 22.0%；incidence of hypoglycemia 60.89%and occurrence density of hypoglycemia 3.89%. The period before meals witnessed high incidence of hypoglycemia in children. The incidence of hypoglycemia in children with type 1 diabetes was influenced by the age of the child，newly⁃confirmed case，and HbAlc（P < 0.05）. Multivariate logistic showed that age was a protective factor for reducing hypoglycemia，while newly⁃confirmed case risk factor for hypoglycemia. Conclusion The incidence of hypoglycemia in children with type 1 diabetes remains high，and the rate of blood glucose control is low. Young children and newly⁃diagnosed children are at a high risk of hypoglycemia.

Chimeric antigen receptor engineered T cell（CAR⁃T）is an engineered molecule that combines the recognition ability of specific tumor antigens with the powerful anti⁃tumor effect of T cells. It is currently one of the important methods of tumor treatment，especially in early clinical trials of patients with B⁃cell acute lymphoblas⁃ tic leukemia，B⁃cell lymphoma and multiple myeloma，which has shown good targeting，killing，proliferation and Persistence. However，the related adverse reactions limit its wide clinical application. Among them，cytokine re⁃ lease syndrome（CRS）and immune effector cell⁃associated neurotoxicity syndrome（ICANS）are the most serious adverse reactions，understanding the classification and management of these adverse reactions can help guide and improve the prognosis. Therefore，in this review，the pathophysiological mechanism，classification and manage⁃ ment of cytokine release syndrome and immune effector cell ⁃associated neurotoxicity syndrome caused by CAR ⁃T cell therapy are discussed，as well as optimization strategies for these adverse reactions. It aims to provide new 

Intermittent fasting（IF）as a periodic energy restriction，has been shown to provide metabolic and immune benefits equivalent to prolonged fasting or calorie restriction in enhancing glucose homeostasis，decreasing fat and weight，and cutting down chronic low⁃grade inflammation in obese individuals. It is expected to be a more acceptable dietary intervention method for obese patients by virtue of its better tolerance and compliance. Studies have indicated that the IF⁃mediated metabolic benefits are attributable in large part to the regulation of pancreatic β⁃cell function and the browning of white adipose tissue（WAT）. What counts is that both autophagy pathway and gut microbiota play a significant role. Furthermore，the amelioration of metabolism and the regulation of immune⁃ related gene expression are also crucial to IF⁃mediated immune benefits. By combining the aforesaid mechanisms， this paper reviews the role of IF in the prevention and treatment of obesity from the three aspects，namely glucose metabolism，lipid metabolism and immunity，in the hope of providing novel insights into lifestyle intervention and clinical application on obesity and related metabolic diseases.