Objective To evaluate the efficacy and safety of evolocumab， a proprotein convertase subtilisin/kexin type 9 （PCSK9） inhibitor， in lowering LDL-C levels in patients with coronary heart disease complicated with mild renal insufficiency. Methods Clinical data of patients diagnosed with coronary heart disease complicated with mild renal insufficiency in Department of Cardiology （estimated glomerular filtration rate （eGFR） 60-90 mL/（min·1.73 m²）） were retrospectively collected. All patients were divided into two groups according to the LDL-C lowering strategy. In the experimental group （n=50）， patients were treated with evolocumab， a PCSK9 inhibitor， combined with statins （rosuvastatin calcium tablets）， and their counterparts in the control group （n=42） were treated with statins （rosuvastatin calcium tablets） alone. LDL-C level， renal function indicators， side effects and adverse cardiovascular events at 1 and 3 months were observed between two groups. Results Compared with the control group， the LDL-C level at 1 month was significantly lower in the experimental group （（1.27±0.90） mmol/L vs. （1.75±0.82） mmol/L， P < 0.05）， and the LDL-C level 3 months was even lower （（0.94±0.44） mmol/L vs. （1.53±0.53） mmol/L， P < 0.05）. However， no significant differences were noted in the changes of renal function indicators at l and 3 months between two groups （all P > 0.05）. During 3-month treatment period， no adverse reactions， such as new-onset diabetes mellitus and neurocognitive dysfunction， were observed in both groups. The incidence of cardiovascular events （readmission for unstable angina， acute myocardial infarction and repeated percutaneous coronary intervention） and other adverse reactions （rash and myalgia） did not significantly differ between two groups （all P > 0.05）. Conclusions In coronary heart disease patients complicated with mild renal insufficiency， evolocumab combined with rosuvastatin can significantly reduce LDL-C levels at 1 and 3 months and maintain high safety compared with compared to rosuvastatin alone.

Helicobacter pylori （Hp） is a major human pathogen. Hp infection will cause a series of gastrointestinal diseases， such as chronic gastritis， peptic ulcer and gastric cancer， etc. In recent years， with the increasing incidence of these diseases， their etiology and pathogenesis have attracted more and more attention from many scholars around the world. The pathogenic mechanism of cytotoxin-associated gene A （CagA）， one of the virulence genes of Hp， has captivated widespread attention. EPIYA motif and Hp infection-associated gastropathy have become a hot topic. In this article， the relationship between EPIYA motif and gastropathy related to Hp infection was briefly reviewed.

Objective To investigate the clinical characteristics， diagnosis and treatment of Goodpasture syndrome complicated with lung infection. Methods Clinical data of one case of Goodpasture syndrome complicated with pulmonary infection were retrospectively analyzed. Literature review was performed from PubMed， Embase， Web of Science， China National Knowledge Infrastructure （CNKI） and Wanfang Data Knowledge Service platform using “Goodpasture syndrome” and “infection” as search terms from the database inception date to September 2022. Clinical manifestations and prognosis of Goodpasture syndrome complicated with pulmonary infection were summarized. Results The 51-year-old male patient， was admitted to our hospital due to elevated serum creatinine level for more than one month and blood in sputum for over 10 d. The patient had a cough of yellow-green purulent sputum. Moist rales were heard in bilateral lungs. Renal biopsy showed crescentic glomerulonephritis， and anti-glomerular basement membrane IgG antibody was weakly positive. Chest CT scan revealed multiple inflammations in both lungs. The culture of bronchoalveolar lavage fluid showed the phenomenon of phagocytosis. Sputum fungal smear and fluorescent staining， alveolar lavage fluid culture， next-generation sequencing （NGS） of alveolar lavage fluid indicated a variety of microbial infections. The diagnosis of Goodpasture syndrome complicated with lung infection was considered. He was discharged after receiving renal replacement， immunosuppression， and anti-infection therapies. Three months later， the patient was transferred to ICU due to “severe pneumonia， septic shock， and respiratory failure” and eventually died. A total of 27 cases of Goodpasture syndrome complicated with pulmonary infection were researched. The common pathogens of pulmonary infection were invasive pulmonary Aspergillus， Pneumocystis carinii， Mycobacterium tuberculosis and cytomegalovirus， etc. Thirteen patients died， and 4 of them died of respiratory failure and/or respiratory infection. Conclusion Extensive attention should be diverted to the risk of infection in patients with Goodpasture syndrome， especially severe lung infection.

Exhaled nitric oxide （eNO）， as a marker of eosinophilic inflammation in the airway， has been widely utilized in the diagnosis and treatment of asthma. The fractional concentration of exhaled NO （FeNO） mainly reflects the degree of airway inflammation. By establishing a pulmonary dynamic model for extended analysis， nitric oxide parameters can be obtained， which contribute to deepen the understanding of the degree of airway inflammation. In this article， recent studies were reviewed to summarize the clinical value of nitric oxide parameters in asthma， aiming to supplement a novel dimension for the evaluation and management of asthma.

Photodynamic therapy （PDT） is a non-invasive treatment method that combines light sources and photosensitizers. It is currently widely applied in clinical practice to treat acne， genital warts， and multiple tumor diseases. The mechanism of PDT is complex. Researches have found that the efficacy of PDT seems to be closely related to the degree of acute inflammation it causes. IL-6 is a common pro-inflammatory factor that belongs to the category of interleukin （IL）. It is produced by fibroblasts， monocytes/macrophages， and T lymphocytes. It exerts multiple effects on inflammation and immune responses. IL-6 can be induced by PDT in vivo and in vitro. In this article， research progress in the application of IL-6 in PDT was reviewed.

Objective To investigate the clinical characteristics of hypophosphatemia in diabetic ketoacidosis （DKA） complicated with pulmonary infection. Methods A patient with DKA complicated with Aspergillus fumigatus pneumonia who developed severe hypophosphatemia was reported. Revelant studies were searched from PubMed，CNKI， Wanfang Data and Chongqing VIP using“diabetic ketoacidosis”and“hypophosphatemia”as the keywords.Clinical data of retrieved cases of DKA complicated with hypophosphatemia were collected and analyzed. Results The 35-year-old male patient were diagnosed with diabetes mellitus complicated with DKA， Aspergillus fumigatus pneumonia and severe hypophosphatemia. After fluid rehydration， hypoglycemic and antifungal treatment， serum phosphorus level was restored to normal range spontaneously along with DKA correction and pulmonary infection control. The patient was discharged after improvement. According to literature review， 16 cases of DKA complicated with hypophosphatemia with complete clinical data were searched. Clinical manifestations mainly include respiratory failure， rhabdomyolysis， seizures， cardiac arrest， fatigue， and no symptoms， etc. Some patients can spontaneously recover， whereas other patients require supplemental phosphorus therapy. Conclusions DKA patients complicated with pulmonary infection are prone to hypophosphatemia with non-specific clinical manifestations， which can be life-threatening in severe cases. Early recognition is helpful to improve clinical prognosis.

Objective To evaluate the clinical efficacy of camrelizumab combined with lunvatinib or bevacizumab in the treatment of hepatocellular carcinoma （HCC）. Methods Clinical data of 60 patients with HCC were retrospectively analyzed. All patients were divided into group A （camrelizumab combined with lunvatinib） and group B （camrelizumab combined with bevacizumab）. Short-term clinical efficacy and the expression levels of serum tumor markers （alpha-fetoprotein，carcinoembryonic antigen，neuron-specific enolase，cytokeratin 19 fragment），matrix metalloproteinase-9 （MMP-9） and vascular endothelial growth factor （VEGF） were compared between two groups. The degree of cancer-related fatigue （CRF） before treatment was compared between two groups by using CRF scale. The incidence of adverse reactions，progression-free survival （PFS） and overall survival （OS） during the treatment were analyzed between two groups. Results No significant differences were observed in the short-term clinical efficacy，incidence of adverse reactions，PFS and OS between two groups （all P > 0.05）. After treatment，the expression levels of serum tumor markers，MMP-9，VEGF and CRF scores in two group were significantly lower than those before treatment，and the values in group B were lower than those in group A （all P < 0.05）. Conclusions No significant difference is observed in the clinical efficacy between camrelizumab combined with lunvatinib or bevacizumab in the treatment of HCC patients. However，combined use of camrelizumab and bevacizumab can significantly lower the expression levels of serum tumor markers，MMP-9 and VEGF and mitigate CRF in HCC patients.

Objective To investigate the association between fibrinogen/albumin ratio （FAR） and the severity of coronary artery lesions in patients with premature coronary artery disease （PCAD）. Methods Clinical data of patients who initially underwent coronary angiography （CAG） due to chest pain， male patients aged < 55 years old and female aged < 65 years old， were collected. A total of 261 patients were recruited in this study. According to CAG results， all patients were divided into the non-coronary heart disease group and PCAD group. Relevant indexes and data of patients in two groups were collected and FAR was calculated. The degree of coronary artery lesions was evaluated according to the Gensini score （GS）. The differences of fibrinogen （Fib）， albumin （ALB） and FAR levels were compared between two groups， and the relationship between these three indexes and GS was discussed. Results Compared with the non-coronary heart disease group， the Fib and FAR levels were increased， whereas the ALB level was decreased in the PCAD group， and the differences were statistically significant （all P < 0.05）. Spearman correlation analysis showed that Fib and FAR levels were positively correlated with GS， while albumin level was negatively correlated with GS. Among three indexes， FAR had the highest correlation. Logistic regression analysis suggested that increased Fib and FAR levels were the risk factors for increased degree of stenosis of coronary lesions （OR>1）， whereas increased ALB level was a protective factor （OR<1）.The receiver operating characteristic （ROC） curve showed that the area under the ROC curve （AUC） of Fib was 0.800， the sensitivity was 73.90% and the specificity was 83.20%. The AUC of ALB was 0.925， the sensitivity was 95.70% and the specificity was 85.30%. The AUC of FAR was 0.991， the sensitivity was 97.80% and the specificity was 93.70%. FAR was more valuable in predicting the degree of stenosis of coronary artery lesions than Fib and ALB. Conclusions FAR is positively correlated with GS， and closely correlated with the severity of coronary artery lesions in PCAD patients. FAR yields better value in predicting the severity of coronary artery lesions in PCAD patients than Fib and ALB.

Objective To evaluate the changes in vitamin D levels in patients with intrahepatic cholestasis of pregnancy （ICP） and to analyze the correlation between vitamin D and total bile acids （TBA） levels. Methods A total of 60 pregnant women were selected （30 in the normal group and 30 in the ICP group）. Demographic characteristics and perinatal data were recorded and collected. Serum TBA concentration，liver function，total cholesterol，triglyceride and serum 25 （OH） D levels were measured. Results No significant differences were observed in maternal age at pregnancy，body mass index （BMI），ALT，AST，γ-glutamyltransferase levels between two groups （all P > 0.05）. The Apgar scores at 5 minutes of all newborn infants were 10. In the ICP group，the gestational age of pregnant women was younger and the birth weight of newborn infants was lower compared with those in normal group （both P < 0.05）. Serum 25 （OH） D level was （24.84±1.88） μg/L in the ICP group，lower than （31.72±2.39） μg/L in the normal group （P < 0.05）. In the ICP group，25 （OH） D level in the umbilical vein blood was （13.61±1.24） μg/L，lower compared with （21.96±2.69） μg/L in the normal group （P < 0.01）. The 25 （OH） D level in the umbilical vein blood was positively correlated with serum 25 （OH） D level in pregnant women in both groups （normal group：r=0.763，P < 0.001； ICP group：r=0.726，P <0.001）. In the ICP group，serum 25 （OH） D level was negatively correlated with TBA level in the ICP group （r=-0.692，P < 0.001）. There was no correlation between serum 25 （OH） D and TBA levels in normal pregnant women （P > 0.05）. There was no significant differences in serum total cholesterol and triglyceride levels between two groups （both P > 0.05）. Conclusions The vitamin D levels in serum and umbilical vein blood of pregnant women in the ICP group are lower than those of normal pregnant women，which may be related to high TBA level in ICP patients. For ICP pregnant women，supplemental dose of vitamin D may be appropriately increased to promote intrauterine development.

Exosomes are lipid bilayer membrane vesicles that are widely distributed in peripheral blood， saliva， urine， ascites and other fluids. A variety of tumor-related genes in exosomes are involved in the information exchange between cancer cells and normal cells， as well as the process of tumor cell proliferation and metastasis， play an important role in tumor development， and are potential biomarkers for tumor liquid biopsy. In recent years， surface plasmon resonance （SPR） is considered to have great application potential in the characterization of exosomes due to its high sensitivity， small sample size required for testing， short detection time and low background interference， etc. In this article， the basic principle of SPR and the application prospect of SPR-based biosensing platform in exosomes characterization were mainly illustrated.

Objective To explore the advantages of artificial intelligence-assisted compressed sensing （ACS） combined with three types of fat-suppressed T₂WI techniques in image quality， scanning time and scheme selection. Methods In 30 patients with low back pain who underwent conventional lumbar magnetic resonance imaging （MRI） plain scan， ACS combined with 5 groups of sagittal （SAG） fat-suppressed T₂WI sequences were added to original examination sequence. Frequency-selective fat saturation （FS）， water-fat separation （WFI） and short tau inversion recovery （STIR） techniques were employed. ACS-SAG-T₂WI-FS （group A， n=30）， Acs-SAG-T₂WI-WFI （group B， n=30）， ACS-SAG-STIR （group C n=30）， SAG-T₂WI-FS （group D， n=30）， SAG-T₂WI-WFI （group E， n=30） and SAG-STIR sequences （group F， n=30） were employed. Objective evaluation indicators of signal-to-noise ratio （SNR） and contrast-to-noise ratio （CNR） and subjective evaluation by two radiologists were carried out to assess the effect. Results The SNR and CNR of the fourth vertebra， the fourth and fifth intervertebral discs and the same spinal cord in group A were higher than those in group D. The SNR and CNR of the fourth vertebra， the fourth and fifth intervertebral discs， and the same spinal cord in group B were higher than those in group E. The SNR and CNR of the fourth vertebra， the fourth and fifth intervertebral discs， and the same spinal cord in group C were higher compared with those in group F （all P < 0.01）. The imaging time in group A was shortened by 13.2% compared with that in group D. The imaging time in group B was reduced by 8.9% compared with that in group E. The imaging time in group C was reduced by 12.4% compared with that in group F （all P < 0.01）. The subjective scores by two radiologists for groups A， B and C were significantly higher than those in groups D， E and F （all P < 0.01；The scores of the two physicians were consistent， Kappa=0.972， P <0.01）. Conclusions The combination of ACS and three types of fat-suppressed T₂WI techniques （FS， WFI and STIR） is superior to use of fat-suppressed T₂WI techniques alone. ACS-SAG-T₂WI-FS sequence is recommended with the shortest imaging time and the highest image quality. ACS-SAG-T₂WI-WFI sequence provides multiple groups of phase images， and the time advantage difference is the second choice. ACS-SAG-STIR sequence has the most stable fat-suppression capability， which can be used as the last option.

The incidence of prostate cancer （PCa） has been increased year by year， mainly occurring in elderly men. Currently， prostate-specific antigen （PSA） is still used as a marker for diagnosing PCa in clinical practice. However， the accuracy and sensitivity of PSA remain relatively low. Identifying more clinical detection parameters for assisting diagnosis becomes a research hotspot. Most of patients with malignant tumors are in a hypercoagulable state. Studies have found that plasma fibrinogen （FIB） is differentially expressed in PCa. In addition， FIB has been considered as a potential tumor-promoting factor in PCa. In this article， the discovery， biological structure， physiological function， pathological changes （inflammation and tumor） and functions of plasma FIB， especially the relationship between plasma FIB and PCa， were systematically reviewed， aiming to provide reference for relevant clinical research.

Objective To investigate the correlation between ApoB/ApoA1 and vitreous hemorrhage （VH） secondary to diabetic retinopathy （DR）. Methods 187 patients with DR from August 2021 to December 2022 were recruited and divided into VH （n=96） and non-VH groups （n=91）. Baseline data were compared between two groups. The risk factors of VH secondary to DR were analyzed by Logistic regression analysis. Results There were no significant differences in age， gender， course of disease， body mass index （BMI）， history of hypertension， smoking and drinking between two groups （all P > 0.05）. In the VH group， fasting plasma glucose （FPG）， glycosylated hemoglobin A_1c （HbA_1c）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， ApoB/ApoA1 and FIBrinogen （FIB） were significantly higher compared with those in the non-VH group， and the differences were statistically significant （all P < 0.05）， while there were no significant differences in TG， APTT， PT and TT between two groups （all P > 0.05）. HbA_1c （OR=1.438 （1.179-1.864））， ApoB/ApoA1 （OR=25.274（5.699~112.092）） and FIB （OR=1.471（1.022~2.118）） were the risk factors for VH （all P < 0.05）. Conclusions HbA_1c， ApoB/ApoA1 and FIB are closely related to VH. Monitoring blood glucose， lipid and coagulation and timely intervention can delay the progression of DR and reduce the incidence of VH.

Osteoporosis （OP） is a systemic bone disease and a common orthopedic disorder in elderly patients. High morbidity， disability and mortality rates and medical cost of OP bring huge burden to the patients and their family. Serine/threonine protein kinase（AMPK）/ mammalian target of rapamycin （mTOR） signaling pathway plays a significant role in cell metabolism and apoptosis. Traditional Chinese medicine monomer or compound can prevent and treat OP by regulating the expression levels of related factors through the AMPK/mTOR signaling pathway， whereas the specific mechanism remains elusive. In this article， the effect of AMPK/mTOR signaling pathway upon osteoblasts and osteoclasts， and the regulatory role of traditional Chinese medicine were reviewed， aiming to provide novel perspectives and ideas for prevention and treatment of OP.

Objective To analyze potential pathogenic gene mutations related to sebaceous carcinoma （SC） of the parotid gland by whole exome sequencing （WES）. Methods One sample from a patient pathologically diagnosed with SC of the parotid gland and 1 sample from 1 patient with sebaceous adenoma （SA） of scalp were collected and prepared for WES by Illumina Hiseq 2500 platform. Suspicious single nucleotide variation sites were selected for mutation conservation and functional analysis. SciClone software was used to track subclone evolution and clonal map information was obtained for each tumor sample. The high-frequency significant gene mutations in the tumor samples were screened by MutSigCV software， and compared with the known driver genes. Results There were 57 driver genes harboring mutations in SC of the parotid gland compared to those of SA of the scalp. Conclusion SC of the parotid gland yields gene mutations and mutation patterns different from malignant tumors.

Hypothyroidism is not only involved with multiple organs and systems， but also the hematopoietic system. Anemia is the most common hematological involvement， whereas the influence of other cell lines is extremely rare. In this article， the diagnosis and treatment of a 55-year-old female patient with hypothyroidism presenting with pancytopenia as the initial manifestation were reported， and relevant literature review was conducted， aiming to improve clinicians’ diagnosis and treatment levels for this disease.

Globally，the incidence of malignant lung tumors is the highest among all cancers，posing a serious threat to human health. Current treatment options for advanced lung cancer have not significantly improved the 5-year survival rate，thus necessitating urgent development of new therapeutic strategies. Recent studies have shown that ferroptosis garners notable attention. The initiating mechanisms include the inactivation of glutathione peroxidase and accumulation of intracellular lipid peroxide. These changes collectively result in cell membrane damage，accompanied by an iron-dependent increase in reactive oxygen species production. The aim of this article is to delve into the role of ferroptosis target genes in lung cancer development and to evaluate their potential as therapeutic strategies.

The diseases pathologically manifested with endothelial cell hyperplasia can present with multiple clinical manifestations， which correspond to different types of clinical diseases. Comprehensive analysis of clinical characteristics of the patients combined with light microscopy， immunofluorescence and electron microscopy can make the corresponding diagnosis. Early and accurate diagnosis is of significance for the treatment， prognosis and management of renal diseases. In this article， renal diseases pathologically manifested with endothelial cell hyperplasia were illustrated， and the diagnostic thinking was briefly summarized.

Metastatic urothelial carcinoma （mUC） yields poor prognosis and is difficult to treat. Immunotherapy strategies have developed rapidly in recent years， and clinical prognosis of mUC patients has been significantly improved. However， immune checkpoint inhibitors （ICIs） alone have limited efficacy， and some ICIs monotherapy indications for mUC have also been withdrawn in recent years. Therefore， combined therapy based on ICIs has become a research hotspot in the treatment of mUC. At present， multiple clinical studies of ICIs combined with chemotherapy， antibody-drug conjugates， and dual immunotherapy for multiple lines of treatment of mUC have proved that combined therapy possesses promising development prospect. In this article， latest progress in ICI-based combined treatment for mUC was reviewed， aiming to provide reference for clinicians.

Objective To assess the relationship between pathological features of chronic gastritis and typeⅠHelicobacter pylori （Ⅰ-Hp） and typeⅡ Helicobacter pylori （Ⅱ-Hp） and the value in clinical application. Methods 2 583 samples were selected from patients diagnosed with chronic gastritis by gastric mucosal biopsy. Hp was detected and typed by fluorescence quantitative PCR. The relationship betweenⅠ-Hp andⅡ-Hp，and the degree of inflammatory response，activity，intestinal metaplasia and lymphatic follicular formation in chronic gastritis was analyzed. Results There were significant differences in inflammatory response，activity and intestinal metaplasia in chronic gastritis betweenⅠ-Hp andⅡ-Hp infection （all P < 0.05）. Inflammatory activity was an independent risk factor forⅠ-Hp infection （P < 0.05）. Conclusions Ⅰ-Hp andⅡ-Hp infection have different manifestations in inflammatory response，activity and intestinal metaplasia in chronic gastritis. Active inflammation suggests the potential incidence of Ⅰ-Hp infection.

Phosphatidylinositol-3， 4， 5-triphosphate-dependent Rac exchange factor 1 （PREX1） is a coding gene that is abnormally expressed in a variety of tumors. As a guanine nucleotide exchange factor （RacGEF） of small GTP binding protein Rac1， PREX1 gene-encoded protein can form PREX1/Rac pathway through activating Rac1， crosstalk with a variety of classical signaling pathways， participate in the regulation of various receptor reactions in the tumor process， affect the epithelial-mesenchymal transformation process of the tumor microenvironment and play a role in tumor proliferation，metastasis and prognosis.

Extracorporeal membrane oxygenation （ECMO） is an advanced life support modality for patients with respiratory or cardiac failure. During ECMO，various factors impair coagulation function，resulting in an imbalance between procoagulation and anticoagulation，thus increasing the incidence of bleeding and posing a significant challenge to the development of clinical work. In this article，the epidemiology，causes，anticoagulation and monitoring of high-risk bleeding during ECMO were reviewed，aiming to provide reference for clinical practice.

Objective To investigate the acceptance， participation rate， and awareness rate of real-time three-dimensional pelvic floor ultrasonography among the female population， and to analyze the influence factors. Methods A total of 855 women were face-to-face surveyed by using the general data questionnaire. The acceptance， participation rate， and awareness rate of real-time three-dimensional pelvic floor ultrasonography were analyzed. According to the survey results， all participants were divided into those who accepted pelvic floor ultrasonography group （acceptance group） and those who rejected pelvic floor ultrasonography group （rejection group）. The differences in education level， type of medical insurance， annual household income per capita， clinical symptoms， history of disease and awareness of pelvic floor ultrasonography were compared between two groups. The influencing factors of low acceptance of pelvic floor ultrasonography in female population were analyzed. Results A total of 808 valid questionnaires were returned. Among all valid respondents （n=808）， 86.6% （n=700） were willing to receive real-time three-dimensional pelvic floor ultrasonography. 95 participants （11.8%） had received pelvic floor ultrasonography before. The majority of respondents （92.6%） had little or no knowledge of pelvic floor ultrasonography. “Paying attention to their health and finding problems as early as possible” was the main reason for being willing to accept pelvic floor ultrasound examination， while the main reason for rejection was“do not understand the work of the project”. Significant differences were observed in the educational level， type of medical insurance， annual household income per capita， clinical symptoms， and awareness rate between two groups （all P < 0.05）. Multivariate Logistic analysis showed that the population without urinary leakage symptoms （OR=0.162， 95%CI：0.064-0.408， P < 0.001） and the population with low annual household income per capita （OR=0.495， 95%CI： 0.319-0.766， P = 0.002） were less willing to receive pelvic floor ultrasonography. Conclusions Real-time three-dimensional pelvic floor ultrasonography has high acceptance， low participation rate， and low awareness rate in the female population. Clinical symptoms and annual household income per capita are important factors associated with the acceptance of pelvic floor ultrasonography.

Objective To evaluate the value of different combinations of alpha-fetoprotein （AFP）， alpha-fetoprotein-L3 isoform ratio （AFP-L3%） and des-γ-carboxyprothrombin （DCP） for early diagnosis of hepatitis B virus （HBV）-related hepatocellular carcinoma （HCC）. Methods A total of 167 patients were enrolled in this study， including 100 patients with HCC and 67 patients with infection-related liver cirrhosis （LC）. The levels of serum AFP， AFP-L3% and DCP were detected by chemiluminescence enzyme immunoassay. The receiver operating characteristic （ROC） curve was delineated for subsequent analysis. Results The levels of AFP， AFP-L3% and DCP in HCC patients were significantly higher than those in LC patients （all P < 0.05）. There was no significant difference in AFP and AFP-L3% levels between stage 0 and stage A patients in HCC group （both P > 0.05）. DCP levels in stage 0 patients were significantly lower than those in stage A patients in HCC group （P < 0.05）. The sensitivity and specificity of AFP， AFP-L3% and DCP in the diagnosis of early HCC were 51.5%， 92.5%， 28.3%， and 95.5%， 60.0%， 84.7%， respectively. Analysis of the area under the ROC curve （AUC） results showed that the AUC values of AFP， AFP-L3% and DCP for the diagnosis of early HCC were 0.760， 0.619 and 0.749， respectively. The AUC value of combined detection of AFP and DCP was 0.810， which yielded the highest diagnostic efficiency. Conclusion AFP has important diagnostic value in the diagnosis of early HCC. The combination of AFP and DCP can improve the diagnostic efficiency of HBV-related early HCC.

Objective To evaluate the effects of different oxygen concentrations on the oxygenation index of obese patients during the non-ventilation period after general anesthesia induction. Methods 75 American Society of Anaesthesiologists （ASA） gradeⅡ-Ⅲobese patients （30 kg/m²<body mass index （BMI）<40 kg/m²）， aged 18-65 years， were recruited and divided into H， M and L groups according to the inhaled oxygen concentration during anesthesia induction. Induction drugs were given according to the ideal body weight. After the patients’ eyelash reflex were absent and spontaneous respiration was terminated， the oropharyngeal airway was placed， the mandibular mask was supported with both hands and mechanical ventilation was pre-administered with oxygen （100% oxygen concentration in group H， 80% oxygen concentration in group M， and 60% oxygen concentration in group L）. The tracheal tube was intubated under the guidance of a visual light rod， and oxygen was temporarily not connected. The ventilator was connected when O₂ saturation declined to 92%. The main outcome indexes included the oxygenation index of obese patients before anesthesia induction （T₀）， after preoxygenation （T₁）， and before PACU entry （T₂）. The secondary outcome indexes included the number of cases of attasis at each time point of T₀， T₁， and T₂. The time of SpO₂ decreasing to 92% （time interval between SpO₂ decreasing to 92% and the start of intubation）， the time of SpO₂ restoring to 100% after ventilator connection， intubation time and operation time were recorded. The incidence of postoperative pulmonary complications and the length of hospital stay were compared among different groups. Results Compared with group H， oxygenation indexes at T₁ were lower in groups M and L （both P < 0.05）. At T₁ and T₂， the incidence of atelectasis in groups M and L was significantly lower than that in group H （both P < 0.05）. Among the three groups， the time of SpO2 declining to 92% in group H was （197±57） s，（157±31） s in group M， and （131±23） s in group L， respectively. Compared with group H， the time of SpO₂ declining to 92% in groups M and L was significantly shortened （both P < 0.05）. The time of SpO₂ restoring to 97% in group H was shorter than that in groups M and L （both P < 0.05）. No significant differences were observed in the incidence of postoperative pulmonary complications and the length of hospital stay among three groups （all P > 0.05）. Conclusions During general anesthesia induction in obese patients， the oxygenation index at 100% oxygen concentration is higher than those at 80% and 60% oxygen concentrations， which is conducive to the restoration of SpO₂ after oxygen administration. The incidence of postoperative pulmonary complications and the length of hospital stay do not significantly differ among three groups.

With widespread application of nanofibers in various industries， electrospinning， as a technology for preparing nanofibers， has also received attention. The nanofiber membrane prepared by electrospinning has excellent advantages in drug loading due to its high specific surface area， high porosity， and easy addition of various components， similar to the extracellular matrix. In current studies， drugs have been loaded into nanofibers， achieving sustained release of drugs. Electrospinning membrane has been applied in the treatment of ocular surface diseases， corneal transplantation， glaucoma， and retinal diseases. Based upon existing evidence， the principle， application， and prospect of electrospinning technology in treating ophthalmic conditions were illustrated in this article.

Lung cancer is the leading cause of cancer-related deaths worldwide. Lung microbiome is defined as the microbial organisms located in the lung. With rapid development of next-generation sequencing， microbiome has been found to affect the host’s nutrition， immunity， metabolism and the occurrence or development of diseases including cancer. Dysbiosis of lung microbiome causes persistent airway inflammation and immune disorders， which affects the occurrence and development of lung cancer. In-depth exploration of lung microecological characteristics of lung cancer patients can be applied to early diagnosis， treatment and prognosis of lung cancer， which is beneficial to improve clinical efficacy of lung cancer. In this article， research progress on lung microbiome in lung cancer was reviewed.

Chung-Jansen syndrome （CHUJANS），an autosomal dominant genetic disorder，is a newly discovered rare obesity syndrome，mainly manifesting as developmental delay，mental retardation，obesity and dysmorphism. We reported one CHUJANS child with obesity and small testes as the main manifestations. The patient had developmental delay，mental retardation，complicated with left renal agenesis and hypogonadotropic hypogonadism. Genetic testing prompted PHIP gene mutation at c.600+1G>C. The child was diagnosed with CHUJANS. After long-term comprehensive treatment，the long-term quality of life was significantly improved. As Chung-Jansen syndrome is low in prevalence and multi-systemic，this case report expands the spectrum of mutations in CHUJANS，which can deepen clinicians’ understanding of this disease. Early diagnosis and intervention contribute to enhancing clinical prognosis.

Objective To explore the risk factors of re-positive after eradication therapy in patients with peptic ulcer（PU） complicated with Helicobacter pylori（Hp）infection， and to establish and verify a risk warning. Methods A total of 120 patients with PU complicated with Hp infection who underwent eradication therapy were selected. According to whether the patients were re-positive， they were divided into the re-positive group（n = 17）and non-re-positive group（n = 103）. Logistic regression analysis was performed on potential related factors， and a risk model was constructed and verified. Results The re-positive rate of 120 PU patients complicated with Hp infection after eradication therapy was 14.17%. Logistic regression analysis showed that smoking history（OR = 3.255）， alcohol abuse history（OR = 5.170）， NSAID application history（OR = 3.136 ， gastroscopy after eradication therapy（OR = 6.545）， SAS score（OR = 1.119）， SDS score（OR = 1.210）， maximum diameter of ulcer（OR = 4.450）and number of ulcer（OR =1.307）were the independent risk factors for re-positive after eradication therapy in patients with PU complicated with Hp infection（all P < 0.05）. Regular eating habit （OR = 0.034 ） was the independent protective factor（P < 0.05）. The area under the ROC curve （AUC） was 0.949（P < 0.001，95%CI 0.899-0.998）， the sensitivity was 88.20%， the specificity was 92.20%， and the maximum Youden index was 0.804. The prediction accuracy in clinical application was 81.67%. Conclusions The re-positive of PU patients complicated with Hp infection after eradication therapy is affected by multiple factors. The risk warning model established based on these risk factors yields high predictive efficacy.

Objective To analyze the etiology of 22q13 deletion syndrome. Methods Genetic analysis was performed for a baby with 22q13 deletion syndrome using G-banded chromosome karyotype analysis and single nucleotide polymorphisms array （SNP-array） techniques. Chromosomal karyotype analysis of peripheral blood of parents was also conducted to identify the origin of chromosomal abnormality. Literature review was performed using the keywords of “t（13； 22）” in PubMed，CNKI，Wanfang Data，Chongqing VIP databases. Cases of parental genetic t（13； 22） unbalanced translocation were analyzed. Results The mother’s karyotype was 46，XX，while the father’s karyotype was 46，XY，t（13； 22）（q31； q13.3）. The results of SNP-array analysis showed 35.80 Mb fragment duplication in 13q31.1q34 and 1.10 Mb fragment deletion in 22q13.3 in the premature baby. The karyotype of the premature baby was 46，XY，der（22）t（13； 22）（q31； q13.3）pat. According to literature review，three patients presented with mental retardation，epilepsy，facial deformity and atrial septal defect，etc. One of them died 11 d after birth. Conclusions The child carries a paternally inherited der（22）t（13； 22）（q31； q13.3） translocation. Specifically，35.80 Mb fragment duplication is observed in 13q31.1q34，which is abnormal and pathogenic. 1.10 Mb fragment deletion is noted in 22q13.3，which includes 22q13 deletion syndrome （PMS）.

Objective To investigate the effect of ApoB/ApoA1 ratio on the all-cause mortality of patients with pulmonary embolism at admission. Methods One hundred and seventy-seven patients with hemodynamically stable pulmonary embolism were retrospectively collected. The time of admission was the start of follow up， June 30， 2022 was the end of follow up， and all-cause death was the outcome. The best cut-off value of ApoB/ApoA1 to predict all-cause death was calculated according to the receiver operating characteristic （ROC） curve. All patients were assigned into high ratio group （ApoB/ApoA1 ≥0.8） and low ratio group （ApoB/ApoA1 <0.8）. The effect of ApoB/ApoA1 ratio on the prognosis of pulmonary embolism patients was analyzed by univariate and multifactorial Cox regression models， and Kaplan-Meier analysis and Log-rank test was used to compare the survival. Results During the follow-up period， 43 patients died with a mortality of 24.3%. The best cut-off of ApoB/ApoA1 was 0.8 according to ROC and the area under the curve （AUC） was 0.805 （95% CI=0.738-0.872）. There were 39 deaths and 4 deaths in high ratio group and low ratio group， respectively， with a mortality of 52.0% and 3.9%， respectively. Univariate Cox proportional hazards regression model analysis showed that age， hazards stratification， D-Dimer， MPV/D-Dimer， blood urea nitrogen （BUN） and ApoB/ApoA1 were significant for the prognosis of pulmonary embolism patients （P < 0.05）. Multivariate Cox proportional hazards regression model analysis showed that age （P = 0.005）， ApoB/ApoA1 ratio （P < 0.001） and BUN （P < 0.001） were independent factors of the prognosis of pulmonary embolism patients. Log-rank test indicated that survival rate in high ratio group was significantly lower than that in low ratio group （χ²=58.166， P <0.001）. Conclusion A higher ApoB/ApoA1 ratio at admission is related to the higher risk of death in pulmonary embolism patients， and is an effective factor to predict all-cause mortality in pulmonary embolism patients.

Objective To investigate the correlation between the serum level of 25-hydroxyvitamin D （25（OH）D） and liver function in children with infectious mononucleosis （IM）. Methods Ninety children with acute IM were enrolled into the IM group， and 40 healthy children who underwent physical examination during the same period were allocated into the control group. Serum level of 25（OH）D was determined by electrochemiluminescence and the viral load of Epstein-Barr virus DNA （EBV-DNA） in plasma was determined by quantitative fluorescent RT-PCR. Clinical data and serum 25（OH） D levels were compared between two groups. The correlation between 25（OH）D level and atypical lymphocytes， liver function parameters and plasma EBV-DNA in children with IM was analyzed. Results Serum 25（OH）D level in the IM group was significantly lower， whereas the 25（OH）D inadequacy rate was significantly higher than those in the control group （both P < 0.05）. Serum 25（OH）D level was negatively correlated with atypical lymphocytes in the IM group （P < 0.05）. The levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， glutamyl transpeptidase （GGT）， and adenosine deaminase （ADA） in IM children with serum 25（OH）D inadequacy were higher than those in their counterparts with adequate serum 25（OH）D （all P < 0.05）. No significant differences were found in total bilirubin （TBIL）， direct bilirubin （DBIL） and plasma EBV-DNA load between the adequate and inadequate subgroups （all P > 0.05）. In the IM group， serum 25（OH）D level was negatively correlated with ALT， GGT， and ADA （all P < 0.05）， whereas positively correlated with CHE （P < 0.05） and had no correlation with AST， TBIL or DBIL （all P > 0.05）. Conclusions Serum vitamin D insufficiency occurs in children with IM. Vitamin D may be involved in the incidence and development of the course of IM， which is probably associated with liver function impairment.

Objective To investigate the association between different anthropometric parameters and the risk of type 2 diabetes mellitus （T2DM），aiming to provide scientific evidence for early prevention of T2DM. Methods 299 pairs of T2DM patients and healthy controls were recruited in this case-control study. Logistic regression models were used to analyze the association between BMI，waist circumference （WC），waist-hip ratio （WHR） and waist-to-height ratio （WHtR） and the risk of T2DM. Results After potential confounding factors were adjusted，compared with the healthy BMI group （BMI 18.5-23.9 kg/m²），the odds ratio （OR，95%CI） in the overweight （BMI 24.0-27.9 kg/m²） and obesity groups （BMI≥28.0 kg/m²） was 2.35 （1.56-3.57） and 6.47 （2.92-14.33），respectively. Compared with the normal WC（male < 85 cm，female < 80 cm），the OR （95%CI） of T2DM risk in the pre-central（male 85-89.9 cm，female 80-84.9 cm） and central obesity （male ≥90 cm，female≥85 cm） groups was 2.99 （1.81，4.95） and 3.88 （2.43，6.22），respectively. The risk of T2DM was 4.35 times （95%CI：2.48-7.64，P < 0.001） higher in the highest WHR group （Q4） and 3.45 times （95%CI：1.94-6.14，P < 0.001） higher in the highest WHtR group （Q4） compared with those in the lowest WHR and WHtR groups （Q1）. Conclusion Overweight，general obesity，pre-central and central obesity may increase the risk of T2DM.

The increased incidence of gout in men and postmenopausal women suggests that gout is closely associated with sex and affected by sex hormones. However， how sex hormones are involved in the onset of gout and the exact relationship between these two are poorly understood. In this article， recent advances in the study of gout were summarized， and the mechanism underlying the role of sex hormones in the pathogenesis of gout was reviewed.

Atherosclerosis is an inflammatory disease of arterial stenosis caused by the imbalance of lipid metabolism and atherosclerotic plaques clustered on the arterial wall. It is the main pathological process of vascular diseases， such as stroke and coronary heart disease， etc. Atherosclerotic diseases yield high disability and death rates. Recent relevant studies have reported that ADAMTS9 is closely correlated with vascular pathophysiological processes. ADAMTS9 can degrade and assemble extracellular matrix， enhance vascular smooth muscle cell proliferation and migration， provoke pro-inflammatory response， promote intimal thickening， accelerate plaque rupture， and exert anti-angiogenesis effect. In this article， the role and mechanism of ADAMTS9 in the incidence and development of atherosclerosis were mainly summarized.

Liver fibrosis is a key factor in the progression from various chronic liver diseases to cirrhosis，which is the result of the combined action of multiple types of cells，cytokines，and mediators in the liver. Hepatic stellate cells （HSCs） play an important role in the stage of liver fibrosis. Vitamin D with 1，25-dihydroxy vitamin D₃ as the active form，has been found to be a steroid hormone closely associated with the severity of chronic liver disease，which plays a key role in the regulation of HSCs. Vitamin D can regulate the expression of related target genes and inhibit HSC activation through the TGF-β/SMAD，Wnt/β-catenin，ERK/MAPK，NLRP3 and NF-κB cell signaling pathways，thereby controling the progression of liver fibrosis. In this article，research progress in the relationship between vitamin D and HSCs，the mechanism of vitamin D regulating HSCs in liver fibrosis and anti-fibrosis therapy were reviewed.

Objective To investigate the characteristics and associated factors of arthritis self-efficacy in outpatients with rheumatoid arthritis （RA）. Methods A cross-sectional study was conducted. Consecutive patients with RA who received treatment and follow-up in Department of Rheumatology and Immunology were recruited. Clinical data of RA patients were collected. The arthritis self-efficacy of RA patients was investigated by Arthritis Self-efficacy Scale-8 （ASES-8）. The influencing factors of self-efficacy were assessed by linear regression analysis. Results A total of 400 RA outpatients completed the questionnaire，including 342 females （85.5%） with a mean age of （48.8±12.7） years. The median ASES-8 of outpatients with RA was 59 （47，70）. With the increase of disease activity，the self-efficacy of RA outpatients was decreased successively. Multivariate linear regression analysis showed that patient global assessment （PtGA），Visual Analogue Scale （VAS） for pain，the Stanford Health Assessment Questionnaire Disability Index （HAQ-DI），and use of glucocorticoids in the previous 6 months were associated with the self-efficacy of RA outpatients （all P <0.05）. VAS for pain and follow-up duration by rheumatism specialist showed interaction effect upon the self-efficacy. Conclusions Outpatients with RA receiving regular follow-up have high arthritis self-efficacy，which is associated with disease control and mild dysfunction. Extensive attention should be paid to successful response of patients to early treatment. During long-term follow-up，the outcomes reported by patients should be highlighted.

Objective To evaluate the efficacy of individualized rehabilitation combined with gonadotropin-releasing hormone antagonist （GnRH-A） protocol in women with high-risk ovarian hyperstimulation syndrome （OHSS）. Methods Eighty-six patients with high-risk OHSS were selected and randomly divided into the rehabilitation （n=43） and control groups （n=43）. All patients in both groups were treated with GnRH-A regimen to promote ovulation. On this basis，patients in the control group received routine rehabilitation therapy，and their counterparts in the rehabilitation group were given with individualized rehabilitation regimen. The overall incidence of OHSS，length of hospital stay，time of symptom remission，anxiety and depression status and patients’ degree of satisfaction with rehabilitation were compared between two groups. Results After corresponding interventions，the overall incidence of OHSS，length of hospital stay，time of symptom remission，the scores of Hamilton Rating Scale for Depression （HAMD） and Self-rating Anxiety Scale （SAS） in the rehabilitation group were significantly lower than those in the control group （all P< 0.05）．The degree of satisfaction in the rehabilitation group was higher compared with that in the control group after corresponding interventions （P <0.05）. Conclusion Individualized rehabilitation combined with GnRH-A protocol can effectively prevent the incidence of OHSS，shorten the length of hospital stay and the duration of discomfort symptoms，improve the psychological status and enhance the patients’ degree of satisfaction with rehabilitation.

Objective To explore the role of arginine-and serine-rich coiled coil 1（RSRC1） in the proliferation and metastasis of esophageal squamous cell carcinoma（ESCC）. Methods The expression of PTEN in ESCC was detected by biogenic analysis. The expression of RSRC1 in ESCC cells was detected by qRT-PCR and Western blot（WB）. The effect of RSRC1 on the proliferation and metastasis of ESCC cells was elucidated by CCK-8， cell migration and invasion tests. The expression of related factors in PTEN/PI3K/AKT signaling pathway was analyzed by WB. Results The biogenic analysis showed that PTEN was low in ESCC tissue. Molecular experiments showed low expression of RSRC1 in ESCC cells. Cell experiments showed that RSRC1 knockdown can promote ESCC proliferation and metastasis， and can regulate PTEN/PI3K/AKT signaling pathway. Conclusion RSRC1 inhibits ESCC proliferation and metastasis through targeted regulation of PTEN/PI3K/AKT pathway. RSRC1 may be a new diagnostic marker and therapeutic target for ESCC.

Non-suicidal self-injury （NSSI） is a global public health problem with increasing prevalence in adolescents with depression. There is a lack of evidence for NSSI intervention theories， especially for evidence-based treatment. NSSI severely affects physical and psychological health of adolescents， which has captivated increasing concern from the society. Psychotherapy， drug therapy， diet therapy， physical therapy and movement therapy are the main therapeutic options for NSSI. In this article， recent research progress on the treatment of NSSI in depression was reviewed， aiming to provide novel ideas for clinical treatment and research for NSSI in adolescents with depression.

Objective To compare the display effect and image quality between synthetic magnetic resonance imaging （SyMRI） and conventional MRI sequences for the collateral branch artery after arterial occlusion in acute ischemic stroke caused by chronic middle cerebral artery occlusion，and analyze the superiority and inferiority of two imaging modalities. Methods MRI findings of 67 cases of acute ischemic stroke induced by chronic middle cerebral artery occlusion were retrospectively analyzed. Conventional MRI sequences included T₂-weighted image （T₂WI），T1 fluid-attenuated inversion recovery （FLAIR），T₂ FLAIR，time-of-flight magnetic resonance angiography （TOF-MRA），SyMRI included MAGiC sequence. Paired Kolmogorov-Smirnov test was utilized to compare and analyze the display effect of TOF-MRA and MAGiC phase-sensitive inversion recovery （PSIR） Vessel on the lateral branch artery after arterial occlusion. The signal-to-noise ratio （SNR） between conventional MRI sequences and SyMRI was compared. Image quality was assessed by two independent radiologists using blinded method. The agreement of results was assessed by kappa coefficient. Results The scan time of MAGiC sequence （imaging time 247 s） was 51% shorter than that of conventional MRI sequences （imaging time 438 s）. MAGiC PSIR Vessel showed more collateral branches after arterial occlusion than TOF MRA （P < 0.001）. MAGiC sequences had a higher SNR than conventional MRI sequences （P < 0.001）. The total average score of SyMRI image quality （8.85） was significantly higher than that of conventional MRI sequences （7.32），and the total average score of MAGiC PSIR Vessel image quality （5.32） was higher than that of TOF-MRA （4.82），and the differences were statistically significant （both P < 0.05）. Bland-Altman analysis showed good agreement between two radiologists in results of. Conclusions In acute ischemic stroke caused by chronic middle cerebral artery occlusion，SyMRI scan is less time-consuming than conventional MRI sequence scan. The image quality of SyMRI is better than that of conventional MRI sequence. MAGiC PSIR Vessel has a more significant advantage over TOF MRA in displaying collateral branches of middle cerebral artery occlusion.

Objective To evaluate the application value of bedside fiberoptic bronchoscopy in the extubation of chronic obstructive pulmonary disease （COPD） patients with mechanical ventilation. Methods A prospective controlled study was conducted in 64 patients with COPD who required endotracheal intubation and mechanical ventilation. All patients were randomly divided into the experimental and control groups， with 32 cases in each group. Patients in the control group were directly extubated after successfully passing the spontaneous breathing test （SBT）. Patients in the experimental group received 30-min bedside fiberoptic bronchoscopy after successfully passing SBT， followed by extubation. Gender， age， APACHE Ⅱ score before extubation， reintubation rate， white blood cell （WBC）， C-reactive protein （CRP）， procalcitonin （PCT）， indicators of arterial blood-gas analysis， the length of ICU stay after extubation， and 28-d mortality rate were statistically compared between two groups. Results There was no significant difference in gender， age and APACHEⅡ score before extubation between two groups （all P > 0.05）. Compared with the control group， the reintubation rate of patients was reduced， WBC， CRP， PCT and PaCO₂ post-extubation were decreased， PaO₂ and PaO₂/FiO₂ were increased， and the length of ICU stay was shortened （all P < 0.05）. However， there was no significant difference in the 28-d mortality rate between two groups （P > 0.05）. Conclusion Bedside fiberoptic bronchoscopy for COPD patients with mechanical ventilation before extubation can improve oxygenation， alleviate inflammatory reaction， reduce reintubation rate， and shorten the length of ICU stay.

Osteoporosis （OP） is a bone disease characterized by systemic bone loss and destruction of bone microstructure. The fundamental cause is the imbalance between bone formation and bone resorption mediated by osteoblasts and osteoclasts，and bone resorption is greater than bone formation. Autophagy plays an important role in the occurrence and development of osteoporosis，and the change of autophagy level is a key factor affecting bone balance. Studies have confirmed that autophagy-related molecules of Beclin-1 and P62 directly regulate the formation of autophagosomes at different levels，thus affecting the occurrence and development of OP. In this article，the expression mechanism，functional characteristics and targeted therapy of Beclin-1 and P62 in OP were reviewed，aiming to provide a theoretical basis for the prevention，treatment and subsequent research of OP.

Objective To investigate the relationship between the changes of arterial stiffness parameters and neurological functional improvement in patients with acute cerebral infarction. Methods According to clinical prognosis， 107 patients with acute cerebral infarction were divided into the discharge group （n = 90） and in-hospital mortality group （n = 17）. Patients in the discharge group were further divided into functional improvement group （n = 51） and non-functional improvement group （n = 39）. On the 1st and 7th d after admission， 24-h non-invasive blood pressure was monitored and arterial stiffness parameters including arterial stiffness index （ASI） and pulse wave velocity （PWV） were measured. The severity of cerebral infarction was determined by National Institutes of Health Stroke Scale （NIHSS）. The recovery of neurological function was evaluated by modified Rankin scale （mRS）. The independent predictors of in-hospital mortality and neurological functional improvement were identified by Logistic regression analysis. Results NIHSS score， ASI and PWV upon admission of patients in the in-hospital mortality group were significantly higher than those in the discharge group （all P < 0.05）. Logistic regression analysis found that NIHSS score upon admission and ASI were the independent predictors of in-hospital mortality. In the neurological functional improvement group， the PWV measured on the 7th d was significantly lower than that measured on the 1st d （P < 0.05）. There were significant differences in PWV measured on the 1st and 7th d between patients with and without neurological functional improvement （both P < 0.05）. Decline in PWV and central diastolic blood pressure （CDBP） were the independent predictors of neurological functional improvement （both P < 0.05）. Conclusions Increased ASI is associated with higher in-hospital mortality in patients with acute cerebral infarction. Additionally， PWV decline is correlated with neurological functional improvement in patients with acute cerebral infarction during hospitalization.

Objective To investigate the changes of bone metabolism in the second and third trimesters of pregnancy and puerperal period in re-pregnant women， aiming to provide reference for calcium supplementation during pregnancy and lactation in re-pregnant women. Methods Pregnant women who underwent regular obstetric examination were enrolled and divided into the re-pregnant group （n=100） and first pregnant group （n=100） according to their self-reported birth frequency. Patients in each group were divided into three subgroups according to age （25-30 years old， 31-35 years old and 36-40 years old）. Bone metabolism indexes in the second and third trimesters of pregnancy and puerperal period were compared between two groups. Bone metabolism in pregnant women of different ages was also compared. Bone mineral density （BMD） was measured in the puerperal period， and the pregnancy complications of pregnant women with different bone metabolism were compared. Results The β-collagen degradation product （β-CTX） level in the second and third trimesters of pregnancy and puerperal period in the re-pregnant group was higher， whereas the level of carboxy-terminal propeptide （PICP） of type I procollagen was lower than those in the first pregnant group （both P < 0.05）. There were no significant differences in the serum parathyroid hormone （PTH）， N-terminal fragment of osteocalcin （N-MID）， β-CTX and PICP levels in pregnant women of different ages during the second and third trimesters of pregnancy and puerperal period （all P >0.05）. The levels of 25-hydroxyvitamin D₃（25（OH）D₃） in the second and third trimesters of pregnancy and puerperal period were the highest in re-pregnant women aged 25-30 years （all P < 0.05）. The incidence of hypothyroidism and gestational diabetes mellitus in patients with abnormal bone mass during pregnancy was higher than that in those with normal bone mass （both P < 0.05）. Conclusions The β-CTX levels in the second and third trimesters and puerperal period of re-pregnant women are higher， whereas the PICP levels are lower compared with those in first pregnant women. Age and parity can affect partial bone metabolism indexes， and women with abnormal bone mass have a higher incidence of pregnancy complications.

Multiple myeloma （MM） is a malignant plasma cell disease with bone pain， renal insufficiency， anemia and hypercalcemia as the main symptoms. It is likely to be misdiagnosed and missed diagnosis because of complex clinical manifestations. MM with temporomandibular arthritis as the initial symptom is rare. In this article， the diagnosis and treatment of one case of IgD MM with temporomandibular arthritis as the initial symptom were reported. The 48-year-old male patient presented with pain and numbness in the right temporomandibular area as the initial symptoms. He was admitted to different local hospitals. Imaging examination was highly indicative of MM， which was eventually confirmed by bone marrow aspiration and immunofixation electrophoresis. This case prompts that clinicians should deepen the understanding of MM， especially IgD MM that is relatively difficult to diagnose， aiming to lower the risk of misdiagnosis and missed diagnosis.

The etiology of primary biliary cholangitis （PBC） is unclear， which may be associated with genetic， hereditary and environmental factors， etc. Ursodeoxycholic acid （UDCA） is the first-line drug for the treatment of PBC. Eosinophilic granulomatous with polyangiitis （EGPA） is a systemic vascular inflammatory disease characterized by necrotizing vasculitis， infiltration of eosinophils in tissues and organs， and formation of extravascular granulomas. In this report， a 65-year-old male patient presented with recurrent rashes on four limbs， recurrent abnormal liver function， asthma-like wheezing， microscopic hematuria， abnormal renal function， and eosinophilia. He was finally diagnosed with PBC complicated with EGPA. This case suggests that the possibility of rheumatic immune system disease should be considered for patients with unexplained eosinophilia complicated with multiple organ damage， such as skin， lung， liver， kidney， and immune system.

Protein O-mannosyl-transferase 1 （POMT1） gene-encoded protein participates in the initial step of protein O-mannosylation modification and plays an important role in various physiological processes，such as cell connection and neuronal migration，etc. α-dystroglycanopathy （α-DGP） is a group of muscular dystrophy-related diseases caused by defects in α-dystroglycan （α-DG） O-glycosylation. As one of the causative genes of α-DGP，POMT1 gene is usually closely correlated with clinical phenotype of α-DGP with severe symptoms and poor prognosis. In this article，clinical diagnosis and treatment，genotype-phenotype relationship，and possible pathogenesis of α-DGP associated with POMT1 gene variation were reviewed，aiming to further explore the pathogenic mechanism of POMT1 variation and provide new ideas for the molecular biology-level treatment of POMT1 gene variation-related α-DGP.

Sarcoidosis is a systemic disease characterized by non-caseous epithelioid cell granuloma，which can involve with multiple organs，especially the lung. Sarcoidosis is characterized by diverse clinical manifestations and high incidence rate. Partial patients with pulmonary sarcoidosis can spontaneously relieve，whereas it is likely to recur after drug withdrawal. Some patients with fibrotic sarcoidosis persistently progress and obtain poor prognosis. Therefore，how to deliver clinical treatment is highly important and challenging. At present，although a preliminary consensus has been reached on the treatment of sarcoidosis，it remains to be further refined. Meantime，with continuous development of drugs，some biological agents can be employed to effectively treat sarcoidosis. In this article，research progress on drug treatment for sarcoidosis was reviewed. Glucocorticoid and immune-suppressants may be the key to the treatment of sarcoidosis. Biological agents are the focus of subsequent research.

Congenital hepatic fibrosis （CHF） complicated with Caroli’s disease is a rare autosomal recessive genetic disease with non-specific clinical and imaging manifestations， mainly including portal hypertension and complications， which is likely to be missed and misdiagnosed. In this article， a 32-year-old male patient developed unexplained cirrhosis on physical examination， and he was diagnosed with Caroli’s disease confirmed by histopathological examination of liver puncture and genetic testing. This case suggests the importance of liver puncture for the diagnosis of CHF.