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Objective To investigate the molecular mechanism of IL-6 regulating the expression of secretory phosphoprotein 1 (SPP1) in human placental-derived mesenchymal stem cells (hfPMSCs) and influencing the polarization of macrophages. Methods hfPMSCs were prepared by enzymatic digestion and cultured in a defined, serum-free medium. The morphology of hfPMSCs was observed under a microscope, and the expression of surface markers CD14, CD34, CD45, CD73, CD90, CD105, and human leukocyte antigen DR (HLA-DR) was detected by flow cytometry. hfPMSCs were treated with IL-6 at the final dosage of 100 ng/mL for 24 hours. ELISA, Western blot, and real-time quantitative PCR were used to detect the expression of SPP1 at the protein and mRNA levels; after being treated with IL-6, hfPMSCs infected with SPP1 interference lentivirus were co-cultured with activated macrophage THP-1 cells induced by 100 ng/mL lipopolysaccharide (LPS) and 80 ng/mL phorbol 12-myristate 13-acetate (PMA), and flow cytometry was used to detect the proportion of CD11c and CD206 positive cells in THP-1 cells; hfPMSCs were treated with IL-6 and/or specific inhibitors of nuclear factor kappa B p65 (NF-κB p65), SC75741, and Western blot was used to detect the expression of genes in the NF-κB signaling pathway and SPP1. Results IL-6 significantly upregulates the expression of SPP1 in protein and mRNA levels in hfPMSCs; interference of SPP1 significantly downregulates the expression of SPP1 in hfPMSCs and significantly reduces the positive cell ratio of CD206 in co-cultured macrophages; IL-6 significantly upregulates the expression of p-p65 in hfPMSCs, activating the NF-κB signaling pathway; SC75741 significantly downregulates the expression of p-p65 and SPP1 in hfPMSCs treated with IL-6. Conclusion IL-6 upregulates the expression of SPP1 through the NF-κB signaling pathway in hfPMSCs, which enhances the capability to induce macrophages to polarize towards the M2 phenotype.

Objective: To estimate the impacts of different anesthetic protocols on the speed and quality of postoperative resuscitation in patients undergoing painless gastroscopy. Methods: This was a prospectively designed randomized control study that included 150 patients who underwent painless gastroscopy in Hainan Cancer Hospital affiliated to Hainan Medical College between April and December of 2023. All the patients, classified as American Society of Aneshesiologists (ASA) Grade Ⅰ or Ⅱ, were randomly divided into three groups with different anesthetic protocols, including propofol group (group P), remimazolam group (group R) and remimazolam with flumazenil group (group RF). There were eventually 50 patients in each group. The three groups of patients were compared for their resuscitation time and the time that they stayed in the resuscitation room (addressed as"room time"below). At 10 min and 20 min after resuscitation, each patient was tested for recognition ability (orientation score), walking ability and fine motor skill (including reaction speed, quick-click ability and visual memory), respectively, with possible adverse reactions recorded spontaneously, such as hypotension, dizziness, nausea and vomitus. Results: There were 29 males and 21 females in group P with an average age of (34±6) years, 27 males and 23 females in group R with an average age of (36±8) years, and 26 males and 24 females in group RF with an average age of (33±7) years, respectively. All examinations for each patient were successfully completed with no interruptions. The resuscitation time and room time of group RF were (47±15) s and (26±5) min,respectively, which were both shorter than those in either group R [(489±92) s and (35±6) min] or group P [(196±61) s and (31±7) min] (all P <0.05). The orientation score of patients in group RF at 10 min after resuscitation was (79.0±10.5), which was significantly higher than that in group R (70.0±11.7) ( P <0.05). The patients' walking ability score of group RF at 10 min and 20 min after resuscitation were [(23.6±10.8), (48.0±4.5)], which were better than those in group R[(15.4±11.1), (47.6±4.8)] (both P <0.05). The patients' reaction speed and quick-click scores of group RF were [(851.0±150.9), (547.0±114.0) ms] and [(758.0±73.2), (629.0±128.9) ms], which were better than those in either group R [(1 151.0±206.0), (732.0±135.1) ms], [(893.0±110.9), (765.8±125.8) ms] or group P [(985.0±225.3), (613.0±123.2) ms], [(831.0±87.7), (691.0±115.8) ms] (all P <0.05). The incidence rate of hypotension in group P was 18% (9/50), higher than that in either Group R [4% (2/50)] or group RF [2% (1/50)] (all P <0.05). The incidence rates of dizziness, nausea and vomitus were comparable among all the three groups with no statistical differences (all P >0.05). Conclusion: In patients undergoing anesthesia with remazolam, the use of flumazenil can not only shorten the resuscitation time and the time that the patients need to stay in the resuscitation room, but also speed up the recovery of the patients' recognition, walking and fine motor skill abilities.

This paper introduces a moxa floss shaping and spreading device for governor vessel moxibustion. This device is consisted of a storage unit and a propulsion unit, capable of automatically shaping moxa sticks for governor vessel moxibustion. The device allows for the flexible adjustment of moxa stick length, better conforming to the physiological curvature of the spine, and avoiding potential burns associated with governor vessel moxibustion. It simplifies the operational procedures for healthcare professionals, offering the advantages of ease of use, safety, and efficiency.

Objective: To understand the prevalence, genetic characteristics and drug resistance features of Salmonella Kentucky ST314 in Shenzhen., Methods: Whole genome sequencing of 14 strains of Salmonella Kentucky ST314 collected from 2010-2021 by the Foodborne Disease Surveillance Network of Shenzhen Center for Disease Control and Prevention for phylogenetic evolutionary analysis, drug resistance gene and plasmid detection; drug susceptibility experiments were performed by micro-broth dilution method., Results: A total of 57 strains of Salmonella Kentucky were collected from the foodborne disease surveillance network, 14 of which were ST314. The Shenzhen isolates were clustered with isolates from Southeast Asian countries such as Vietnam and Thailand on clade 314.2, and the single nucleotide polymorphism distance between local strains in Shenzhen was large, indicating dissemination. In this study, a total of 17 drug resistance genes/mutations in 9 categories were detected in the genome of Salmonella Kentucky ST314, carrying 3 extended spectrum beta-lactamases(ESBLs), including bla&#95;(CTX-M-24)(14.3%, 2/14), bla&#95;(CTX-M-55)(7.1%, 1/14), and bla&#95;(CTX-M-130)(14.3%, 2/14), all located on plasmids. Regarding quinolone resistance factors, two plasmid-mediated quinolone resistance(PMQR) genes were identified in the genome: qnrB6(71.4%, 10/14) and aac(6')Ib-cr(78.6%, 11/14), a quinolone resistance quinolone resistance-determining regions(QRDR) mutation T57 S(100%, 14/14). The multi-drug resistance rate of Salmonella Kentucky ST314 in Shenzhen was 92.86%(13/14)with the highest rate of resistance to tetracycline and cotrimoxazole(100%, 14/14), followed by chloramphenicol(92.86%, 13/14), cefotaxime and ampicillin(78.57%, 11/14), ciprofloxacin and nalidixic acid(71.43%, 10/14), and ampicillin-sulbactam had the lowest resistance rate(21.43%, 3/14)., Conclusion: ST314 is the second most prevalent ST type among Salmonella Kentucky in Shenzhen, mainly isolated from food, especially poultry; phylogenetic analysis suggests that ST314 is a disseminated infection and the genome shows a highly genetically conserved phenotype. Drug resistance of Salmonella Kentucky ST314 is very serious, especially QRDR mutation, PMQR gene co-mediated quinolone resistance and plasmid-mediated cephalosporin resistance are prominent and deserve extensive attention.

Carbon dioxide (CO 2 ) absorption and capture is an effective measure to achieve the "dual carbon" goal of carbon peak and carbon neutrality in China. Organic amine compounds are widely used in the industrial separation and recovery of CO 2 . Thus, the establishment of analytical methods for organic amine compounds is of great significance for the research and development of carbon capture and storage (CCS) technology and carbon capture, utilization and storage (CCUS) technology. In this study, a method was developed for the determination of nine organic amine compounds in CO 2 absorption liquid by hydrophilic interaction liquid chromatography (HILIC)-electrostatic field orbitrap high resolution mass spectrometry. The sample was diluted with water and filtered through a 0.22 μm nylon membrane before sampling and analysis. An Accucore HILIC column (100 mm×2.1 mm, 2.6 μm) was used for separation at 30 ℃. Gradient elution was conducted using 90% acetonitrile aqueous solution containing 5 mmol/L ammonium formate and 0.1% formic acid as mobile phase A and 10% acetonitrile aqueous solution containing 5 mmol/L ammonium formate and 0.1% formic acid as mobile phase B. Determination was performed using an electrospray ion source (ESI) in the positive ion mode. The quantitative analysis was carried out by standard addition method. The chromatographic retention performance of different chromatographic columns and the influence of different mobile phases on the separation of the organic amine compounds were compared, and the method was validated. The results showed that the linear ranges of the nine organic amine compounds were 0.04-25000 ng/mL with the linear correlation coefficients ( R 2 ) greater than 0.9910. The limits of detection (LODs) of the method were in the range of 0.0004-0.0080 ng/mL, and the limits of quantification (LOQs) of the method were in the range of 0.0035-0.0400 ng/mL. The average recoveries of the method ranged from 85.30% to 104.26% with relative standard deviations (RSDs) of 0.04%-7.95% at the spiked levels of 1, 1.5 and 3 times sample concentration. The established method was applied to detect the absorption waste liquid of a cement plant, and nine organic amine compounds could be effectively detected. The stability of the actual sample was tested, and the RSDs were 0.10%-6.35% in 48 h at 4 ℃. The method is sensitive, rapid and accurate for the determination of the nine organic amine compounds in industrial waste water. It can provide reference for the detection of organic amine compounds, and provide strong technical support for the research and industrial application of CO 2 capture technology.

Objective: To provide survival evidence of anthracycline-free neoadjuvant chemotherapy for patients with stages Ⅱ-Ⅲ human epidermal growth factor receptor-2 (HER-2) positive and hormone receptor (HR) negative breast cancer. Methods: The prospective cohort study was conducted at the Department of Medical Oncology of Cancer Hospital, Chinese Academy of Medical Sciences. Patients with HER-2 positive and HR negative breast cancer in stages Ⅱ-Ⅲ were enrolled to receive neoadjuvant therapy (NAT) of dose-dense paclitaxel (175 mg/m(2)) plus carboplatin (AUC=4.0) biweekly for 6 cycles in combination with trastuzumab (PCbH), and matched patients who received standard adjuvant therapy of physicians' choice were recruited for survival and safety comparison. Results: From July 2013 to November 2019, 166 patients were included (neoadjuvant 51, adjuvant 115). Compared with those who received adjuvant therapy, patients receiving NAT were younger (<35 years: 19.6% vs 5.2%, P =0.014), had larger tumors (T3: 62.7% vs 7.8%, P <0.001) and more advanced diseases (stage ⅡA: 2.0% vs 41.7%, P <0.001). Patients in the neoadjuvant group all received surgery, and 96 (83.5%) in the adjuvant group received anthracycline-and-taxane-containing regimens. A total of 98 patients (49 pairs) were matched, and the covariates between the two groups were acceptably balanced. Within a median follow-up of 46.5 (range, 14-87) months, the 4-year recurrence-free survival (RFS) rate among patients who received NAT was 73.3% (95% CI: 59.0%-87.6%), versus 80.6% (95% CI: 67.9%-93.3%) among those in the adjuvant group without statistical difference ( P =0.418). A similar result was observed for the 4-year overall survival (OS) [neoadjuvant versus adjuvant: 91.5% (95% CI: 81.7%-100.0%) vs 97.8% (95% CI: 93.5%-100.0%), P =0.314]. Compared with standard adjuvant therapy, PCbH was related to less neutropenia and better cardiac safety. Conclusions: These results support the consideration of anthracycline-free neoadjuvant chemotherapy combined with anti-HER-2 therapy for patients with stages Ⅱ-Ⅲ HER-2-positive and HR-negative breast cancer. Optimized regimens with both efficacy and safety are needed and to be further investigated.

Objective: To determine the changes in the expression of circular RNA Circ-PALLD in heart failure and explore the biogenesis of Circ-PALLD., Methods: We analyzed second-generation sequencing results of human and murine heart failure samples to identify the candidate CircRNAs. Sanger generation sequencing was performed after PCR amplification, and the sequencing results were compared to determine the reverse splicing pattern of the corresponding CircRNAs. We further examined the expressions of CircRNAs and linear RNAs in 8 patients with heart failure admitted in our hospital, and RT-qPCR was performed to detect the expression levels of Circ-PALLD and PALLD in the failing myocardium. Bioinformatic analysis was performed to predict the transcription factors that may regulate PALLD. Small interfering RNAs (siRNAs) against GATA4 were used to determine the regulatory effect of the transcription factor GATA4 on PALLD., Results: Sanger sequencing and sequence alignment verified the reverse splicing of Circ-VWA8, Circ-VMP1, Circ-PRDM5, Circ-PLCL2, Circ-PALLD, Circ-NFATC3, Circ-MLIP, Circ-FAM208A, Circ-ANKIB1, and Circ-AGTPBP1, demonstrated their loop-forming nature and determined the exon arrangement of reverse splicing. Semi-quantitative PCR results showed that the expression levels of CircPALLD, Circ-NFATC3 and Circ-AGTPBP1 were significantly increased while the expression level of linear PALLD was significantly decreased in the myocardial tissues of heart failure patients. Bioinformatic analysis suggested that the transcription of PALLD was regulated possibly by the transcription factor GATA4. RT-qPCR showed that the expression level of Circ-PALLD was significantly increased, while PALLD expression was significantly decreased in the failing myocardium, which was consistent with the results of semi-quantitative PCR. In primary mammary rat cardiomyocytes, GATA4 knockdown resulted in lowered expressions of both Circ-PALLD and PALLD., Conclusion: Circ-PALLD is highly expressed in heart failure and can be used as a novel molecular marker for chronic heart failure, and GATA4 may play important role in regulating its transcription. Circ-PALLD points a new direction for investigating the molecular mechanism of heart failure and may also serve as a potential therapeutic target for heart failure.

Lung cancer is the leading cause of cancer death, and non-small cell lung cancer (NSCLC) accounts for 85%. Immunotherapy has significantly improved the clinical prognosis of patients with NSCLC. However, because of the complexity and heterogeneousness of the tumor microenvironment, only a subset of individuals can benefit from immunotherapy. Therefore, it is necessary to explore effective predictive biomarkers for immunotherapy of NSCLC. Tertiary lymphoid structure (TLS) is an ectopic lymphoid organ that is highly similar to secondary lymphoid organs (SLO), and the presence of TLS has been found to be closely associated with a good prognosis in immunotherapy for a variety of solid tumors, including NSCLC. This article provides a review of the prognostic role of tertiary lymphoid structures in immunotherapy of NSCLC, in order to offer references for screening suitable candidates for immunotherapy of NSCLC and develop personalized and precise treatment plans.
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Objective: To explore the feasibility of superb microvascular imaging (SMI) in evaluating microcirculation damage of the finger of systemic sclerosis (SSc), and determining the optimal scanning method by assessing the effect of scanning position (finger pulp or nail bed), plane (transverse or sagittal) and Doppler gain on the results., Methods: In the study, 32 SSc patients and 32 non-SSc volunteers admitted to Peking University Third Hospital from February to October 2022 were included. The SMI image under different gain set (40 dB or 35 dB) of the third fingertip (sagittal scans or transverse scan of nail bed or pulp) of both hands were collected while vascular index (VI) was measured., Results: Non-SSc volunteer presented abundant SMI signal distributed in the third fingertip. Arteriole of nail bed was observed on the dorsal side of the distal phalanx under SMI and gave off multiple vertical branches towards the nail. The arteriole of finger pulp ran parallel to the skin and gave off vertical branches towards the skin distributing subcutaneously as a network. In SSc group, the SMI signal in nail bed and finger pulp was reduced. The arteriole of nail bed and finger pulp was discontinuous and presented as sporadic dots and short rod-like color signal under SMI. The vascular index of the SSc patients was significantly lower than that of the non-SSc controls ( P < 0.001). Among different positions and sections, the area under the receiver operating characteristic curve (AUC) of the sagittal plane of nail bed was the highest. Under low gain, the AUC of sagittal plane of nail bed was 0.871, the cut-off value was 5.4%, the sensitivity was 90.6%, and the specificity was 74.2%. Under high gain, the AUC was 0.893, the cut-off value was 14.0%, the sensitivity was 75.0%, and the specificity was 93.6%. Multivariate analysis showed that there was statistical significance on the diagnostic impact of the sagittal plane of nail bed ( P < 0.005 for high gain condition; P < 0.05 for low gain condition)., Conclusion: SMI can be used to evaluate the abnormal changes of vascular in patients with SSc. Using the sagittal scan of nail bed with high gain can evaluate the vascular loss of the fingertip in SSc patient accurately and specifically.

Objective: To explore the effect of fully automatic image segmentation of adenoid and nasopharyngeal airway by deep learning model based on U-Net network. Methods: From March 2021 to March 2022, 240 children underwent cone beam computed tomography（CBCT） in the Department of Otolaryngology, Head and Neck Surgery, General Hospital of Shenzhen University. 52 of them were selected for manual labeling of nasopharynx airway and adenoid, and then were trained and verified by the deep learning model. After applying the model to the remaining data, compare the differences between conventional two-dimensional indicators and deep learning three-dimensional indicators in 240 datasets. Results: For the 52 cases of modeling and training data sets, there was no significant difference between the prediction results of deep learning and the manual labeling results of doctors（ P >0.05）. The model evaluation index of nasopharyngeal airway volume: Mean Intersection over Union（MIOU） s （86.32±0.54）%; Dice Similarity Coefficient（DSC）: （92.91±0.23）%; Accuracy: （95.92±0.25）%; Precision: （91.93±0.14）%; and the model evaluation index of Adenoid volume: MIOU: （86.28±0.61）%; DSC: （92.88±0.17）%; Accuracy: （95.90±0.29）%; Precision: （92.30±0.23）%. There was a positive correlation between the two-dimensional index A/N and the three-dimensional index AV/（AV+NAV） in 240 children of different age groups（ P <0.05）, and the correlation coefficient of 9-13 years old was 0.74. Conclusion: The deep learning model based on U-Net network has a good effect on the automatic image segmentation of adenoid and nasopharynx airway, and has high application value. The model has a certain generalization ability., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the safety and effect of laparoscopy for the treatment of biliary stricture after the biliary dilatation operation. Methods: The clinical data of 78 patients,including 27 males and 51 females aged (48.6±14.2)years(range:17 to 76 years),who presented biliary stricture after biliary dilatation operation from January 2017 to June 2021 in the Department of Minimally Invasive Hepatobiliary Surgery,Hunan Provincial People's Hospital,were retrospectively collected,with 38 cases in the laparoscopy group and 40 cases in the laparotomy group. Of the 78 patients,there were 67 cases of cholangiojejunostomy stricture and 11 cases of stricture of the high intrahepatic bile duct. Statistical methods such as t -test and χ 2 test were carried out to compare perioperative clinical data and follow-up information between the two groups. Results: Less intraoperative blood loss((102.6±76.4)ml vs. (162.5±105.9) ml, t =-2.874, P =0.005),shorter postoperative stay length of stay((10.5±3.7)days vs. (14.5±6.4)days, t =-3.379, P =0.001) and shorter waiting time for postoperative anal exhaust((2.0±0.6)days vs. (2.5±0.9)days, t =-2.827, P =0.006) were found in the laparoscopy group than that in the laparotomy group,with statistically significant differences. While there was no statistically difference in the operative time((252.8±54.7)minutes vs. (257.4±68.6)minutes, t =-0.331, P =0.742). Postoperative review and follow-up did not show statistically significant differences between the two groups in the residual stone rate(5.3%(2/38) vs. 5.0%(2/40)) and the incidence of recurrent biliary stricture(5.3%(2/38) vs. 7.5%(3/40))(both P >0.05). Conclusion: Laparoscopy may be safe and effective in the treatment of biliary stricture after the biliary dilatation operation,with less trauma,faster recovery compared to laparotomy.

Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.

Solitary fibrous tumor (SFT) is an uncommon spindle cell tumor that occurs mainly in the pleura, but also in other parts of the body. Intraocular SFT is very rare. This paper reports 2 cases of choroidal SFT which were diagnosed by clinical, imaging, histopathological and immunohistochemical staining. The patient remained asymptomatic with no sign of recurrence and metastasis after operation.

Objective: To detect variants of IVD gene among 4 neonates with suspected isovalerate acidemia in order to provide a guidance for clinical treatment., Methods: 111 986 newborns and 7461 hospitalized children with suspected metabolic disorders were screened for acyl carnitine by tandem mass spectrometry. Those showing a significant increase in serum isovaleryl carnitine (C5) were analyzed for urinary organic acid and variants of the IVD gene., Results: Four cases of isovalerate acidemia were detected, which included 2 asymptomatic newborns (0.018‰, 2/111 986) and 2 children suspected for metabolic genetic diseases (0.268‰, 2/7461). The formers had no obvious clinical symptoms. Analysis of acyl carnitine has suggested a significant increase in C5, and urinary organic acid analysis has shown an increase in isovaleryl glycine and 3-hydroxyisovalerate. Laboratory tests of the two hospitalized children revealed high blood ammonia, hyperglycemia, decreased red blood cells, white blood cells, platelets and metabolic acidosis. The main clinical manifestations have included sweaty foot-like odor, feeding difficulty, confusion, drowsiness, and coma. Eight variants (5 types) were detected, which included c.158G>A (p.Arg53His), c.214G>A (p.Asp72Asn), c.548C>T (p.Ala183Val), c.757A>G (p.Thr253Ala) and 1208A>G (p.Tyr403Cys). Among these, c.548C>T and c.757A>G were unreported previously. None of the variants was detected by next generation sequencing of 2095 healthy newborns, and all variants were predicted to be likely pathogenic based on the guidelines from the American College of Medical Genetics and Genomics., Conclusion: The incidence of isovalerate acidemia in Liuzhou area is quite high. Screening of metabolic genetic diseases is therefore recommended for newborns with abnormal metabolism. The discovery of novel variants has enriched the mutational spectrum of the IVD gene.

Objective: To analyze the epidemiological characteristics and transmission chain of an epidemic of COVID-19 in Haidian district, Beijing. Methods: Descriptive epidemiological method was used to analyze the epidemiological characteristics of the epidemic, and field investigation and big data technology were used to analyze the transmission chain of the epidemic. Results: From April 27 to May 13, 2022, an epidemic of COVID-19 occurred in Haidian district. The strains isolated from the cases were identified by whole genome sequencing as Omicron variant (BA.2.2 evolutionary branch). A total of 38 infection cases were detected, including 34 confirmed cases and 4 asymptomatic cases. Most cases were mild ones (88.2%), no severe, critical or death cases occurred. The early clinical symptoms were mainly sore throat (50.0%) and cough (29.4%). The epidemic lasted for 17 days, resulting in 7 generations of the cases and involving 3 community transmissions, 2 working place transmissions and 8 family transmissions; the main infection routes were co-residence (47.6%) and co-space exposure (31.6%). The intergenerational interval M ( Q 1 , Q 3 )was 3 (1, 6) days. The overall secondary attack rate was 1.5% (37/2 482), and the family secondary attack rate was 36.7% (18/49). Conclusions: The cases in this COVID-19 epidemic caused by Omicron variant had mild clinical symptoms, but the case clustering in families and communities was obvious, the transmission was rapid, and the risk for co-space exposure was high. It is necessary to use information technology to identify close contacts in the local population for the rapid and effective blocking of the epidemic spread.

Objective To investigate the mechanism of miR-153 targeting activated protein C (APC) to regulate lipopolysaccharide (LPS)-induced lung injury in rats with sepsis. Methods Female SD rats were divided into control group, LPS group, LPS combined with miR-153 inhibitor (miR-153 inhibitor) group, LPS combined with miR-153 inhibitor negative control (inhibitor NC) group, LPS and miR-153 inhibitor combined with APC small interfering RNA (si-APC) group, LPS and miR-153 inhibitor combined with APC small interfering RNA negative control (si-NC) group. Except for the control group, the other groups were given corresponding treatments, and then LPS were given to establish rat sepsis injury models. Real-time quantitative PCR was used to detect the expression of miR-153 and Western blot analysis to detect the protein expression of APC, B-cell lymphoma 2 (Bcl2) and cleaved caspase-3 (c-caspase-3). The rat alveolar epithelial cells were isolated and cultured, and their cell viability was detected by CCK-8 assay, along with cell apoptosis detected by flow cytometry. ELISA was performed to test the expression levels of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin 6 (IL-6), IL-1β and tumor necrosis factor α (TNF-α) in rat serum; and the dual fluorescein reporter experiment detects the relationship between miR-153 and APC. Results Compared with the control group, rat model of sepsis lung injury showed significantly increased expression of miR-153 and reduced APC. The cell viability, Bcl2 protein expression and SOD activity of the LPS group were significantly reduced, and the apoptosis rate, c-caspase-3 protein expression, MDA, IL-6, IL-1β, and TNF-α content significantly escalated. Compared with the LPS combined with inhibitor NC group, the cell viability, Bcl2 protein expression and SOD activity of the LPS combined miR-153 inhibitor group significantly increased, while the apoptosis rate, c-caspase-3 protein expression, the content of MDA, IL-6, IL-1β and TNF-α dropped considerably. miR-153 can target and regulate the expression of APC. Compared with the LPS and miR-153 inhibitor combined with si-NC group, the cell viability, Bcl2 protein expression and SOD activity of the LPS and miR-153 inhibitor combined with si-APC group significantly down-regulated, and the apoptosis rate, c-caspase-3 protein expression, MDA, IL-6, IL-1β, and TNF-α contents increased significantly. Conclusion LPS induces increased expression of miR-153 in lung tissue, inhibits APC expression, promotes apoptosis, oxidative stress and inflammatory response in lung tissue of septic rats, and aggravates damage.

Objective: To evaluate the efficacy and survival outcomes of dose-dense (biweekly) carboplatin plus paclitaxel (PC) as neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC), and to explore an optimal neoadjuvant chemotherapy regimen for TNBC. Methods: Patients diagnosed as TNBC(cT1-4N0-3M0) in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Between January 2008 and September 2018 who received dose-dense PC and standard 3-weekly PC as NAC were 1∶1 matched using propensity score matching (PSM) to compare the efficacy, safety and survival outcomes. Results: One hundred of TNBC patients were enrolled (50 patients were divided in dose-dense group, 50 patients in standard group). The objective response rate (ORR) of dose-dense group and standard group were both 90.0% (45/50). The grade 3-4 neutropenia in dose-dense group was less than that of standard group (32.7% vs. 68.0%, P =0.001), while the rate of ALT/AST elevation in dose-dense group was higher than that of standard group (57.1% vs. 32.0%, P =0.012). The pathological complete response (pCR) rates were 34.0% (17/50) in dose-dense group and 38.0% (19/50) in standard group, without statistically significance ( P =0.677). The median follow-up time was 55 months (3-150 months). The 5-year recurrence-free survival (RFS) in dose-dense group and standard group were 83.5% and 75.2%, respectively the 5-year overall survival (OS) in dose-dense and standard group were 87.9% and 84.5% the difference were not statistically significant ( P =0.322 and 0.647, respectively). Patients with residual disease (tumor size≥1 cm or lymph node positive) had poor prognosis, the 5-year RFS and OS were 59.3% and 68.5%, respectively. Conclusions: Dose-dense PC has similar efficacy with standard 3-weekly PC and has a good safety profile. Since dose-dense regimen can shorten the duration of therapy, it can be an alternative in TNBC.

Objective: To investigate the relationship between serum uric acid and cardiovascular risk factors and cardiovascular risk factor clustering(CVRFC) in children and adolescents in Yinchuan, Ningxia., Methods: A present study design was adopted, and 1486 children and adolescents aged 10-18 years in urban areas of Yinchuan City were selected as study subjects with a mean age of(14.3±1.4) years in 2015, 2017 to 2018 by stratified clustering sampling, including 728(49.0%) boys, 1157(77.9%) Han, 170(11.4%) Hui and 159(10.7%) from other ethnic groups. All study subjects completed questionnaires, physical measurements and biochemical tests., Results: Hyperuricemia(HUA) was significantly positive associated with abdominal obesity(OR=3.23, 95%CI 2.37-4.40), hypertension(OR=1.64, 95%CI 1.21-2.23), dyslipidemia(OR=1.51, 95%CI 1.17-1.96), CVRFC≥2(OR=3.71, 95%CI 2.80-4.93) and CVRFC≥3(OR=6.92, 95% CI 4.18-11.64)(P&lt;0.05). There was an additive interaction between HUA and gender on cardiovascular risk factors and their aggregation. Compared with non-HUA girls, HUA girls have 3.57 times(95%CI 2.26-5.64) the risk of abdominal obesity, dyslipidemia, CVRFC≥2 and CVRFC≥3, respectively, 1.65 times(95%CI 1.10-2.47), 4.10 times(95%CI 1.10-2.47) and 7.63 times(95%CI 3.67-15.89). HUA boys have 1.75 times(95%CI 1.16-2.65) the risk of abdominal obesity, dyslipidemia, CVRFC≥2 and CVRFC≥3, respectively, 2.14(95%CI 1.51-3.03) times, 4.27 times(95%CI 2.98-6.13) and 7.97 times(95%CI 4.11-15.44), (P&lt;0.05)., Conclusion: Hyperuricemia was significantly positive associated with cardiovascular risk factors and their aggregation in children and adolescents in Yinchuan, and there was an additive interaction between hyperuricemia and gender.

Objective: The 6th edition American Joint Committee on Cancer (AJCC) staging system for breast cancer classifies ipsilateral supraclavicular lymph node metastasis (ISLM) downing stage from M1 to N3, suggesting more patients might receive radical treatment. The aim of this study was to analyze the effect of ISLM on the prognosis of N3 breast cancer and verify the rationality of modified staging. Methods: A total of 321 breast cancer patients with N3 according to the 6th edition AJCC staging system were retrospectively analyzed. Propensity Score Matching (PSM) was used to pair the different subgroups of N3. The primary end point was disease-free survival (DFS), the secondary end point was overall survival (OS). Kaplan-Meier method was used to calculate the DFS and OS. The differences between two groups were analyzed by the Log-rank test. Results: After PSM pairing twice, 78 patients with none-ISLM and 78 patients with ISLM were enrolled in the first group; 51 patients with none-ISLM was compared patients with isolated ISLM in the second group. The results of the two groups showed that patients with none-ISLM have a prolonged DFS (the first group: 58.9 months vs 32.1 months, P =0.101; the second group: 59.0 months vs 44.0 months, P =0.533), while the OS was opposite (the first group: 87.4 months vs 140.4 months, P =0.289; the second group: 87.4 months vs 137.1 months, P =0.289). Conclusions: The prognosis of breast cancer patients with ISLM is similar to that of patients with none-ISLM in stage N3. It is reasonable to include ISLM in N3 in the 6th edition AJCC staging system. Yet, prospective studies with larger sample size are needed to further confirmation.

Objective: To observe the analgesic and sedative effects of acupuncture in elderly patients with severe pneumonia during invasive mechanical ventilation., Methods: A total of 188 elderly patients with severe pneumonia were randomly divided into an observation group and a control group, 94 cases in each group. Both groups were treated with routine nursing and treatment of severe pneumonia such as invasive mechanical ventilation, analgesia and sedation. Based on these, the observation group was treated with acupuncture at Neiguan (PC 6), Hegu (LI 4), Yintang (GV 29) and Baihui (GV 20), twice a day until the mechanical ventilation was offline. The critical care pain observation tool (CPOT) score and Richmond agitation-sedation score (RASS) were observed before treatment and 0.5 h after analgesia and sedation; the average time of reaching the standard, the reaching standard rate of shallow sedation and analgesia within 0.5 h and 72 h as well as the dosage of analgesic and sedative drugs and compilations were compared between the two groups. The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR) and blood oxygen saturation (SpO 2 ) were observed before treatment and 0.5 h, 1 h and 2 h after analgesia and sedation. The levels of partial pressure of blood oxygen (PaO 2 ), partial pressure of carbon dioxide (PaCO 2 ) and lactic acid (Lac) were observed before treatment and 12 h, 24 h, 48 h, 72 h, 96 h, 120 h and 144 h after analgesia and sedation. The white blood cell (WBC), neutrophil percentage (NEUT%), high-sensitivity C-reactive protein (hs-CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatinine (Cr) were observed before treatment and 72 h after analgesia and sedation. The tracheal intubation time and ICU hospitalization time were compared between two groups., Results: At the time point of 0.5 h after treatment, the CPOT and RASS scores in the two groups were lower than those before treatment ( P <0.05); the average time of reaching the standard in the observation group was shorter than that in the control group ( P <0.01); the 30 min reaching standard rates of CPOT and RASS scores as well as the rate of reaching the shallow sedation and analgesia within 72 h in the observation group were higher than those in the control group ( P <0.01, P <0.05). The dosage and duration of dexmedetomidine, propofol and butorphanol in the observation group were less than those in the control group ( P <0.05), and the occurrence times of hypotension, respiratory depression, bradycardia, constipation as well as average tracheal intubation time and average ICU hospitalization time in the observation group were less than those in the control group ( P <0.05). After 0.5 h, 1 h and 2 h of treatment, the HR and RR were lower than those before treatment in the two groups ( P <0.05), MAP and SpO 2 were higher than those before treatment in the two groups ( P <0.05); the MAP 0.5 h after treatment in the observation group was higher than that in the control group ( P <0.05); the HR after 1 h and 2 h of treatment in the observation group was lower than that in the control group ( P <0.05). Compared before treatment, the levels of PaCO 2 and Lac were reduced and the levels of PaO 2 were increased 12 h, 24 h, 48 h, 72 h, 96 h, 120 h and 144 h after treatment in both groups ( P <0.05); compared before treatment, the WBC, NEUT%, hs-CPR, ALT and Cr were reduced 72 h after treatment in the two groups ( P <0.05), and the hs-CRP in the observation group was lower than that in the control group ( P <0.05)., Conclusion: Acupuncture has analgesic and sedative effect in elderly patients with severe pneumonia during invasive mechanical ventilation, which could reduce the dosage of sedative and analgesic drugs and the occurrence of complications, improve blood oxygen, and has good safety.

Objective: To investigate the clinicopathologic features and differential diagnosis of ocular Kimura disease (KD) and epithelioid hemangioma. Methods: It was a retrospective case series study. The data of 10 patients with ocular KD and 3 patients with ocular epithelioid hemangioma from the Pathology Department of Eye & ENT Hospital of Fudan University from January 2010 to December 2019 were retrospectively analyzed, including clinical manifestations, morphology and immunophenotypes. Results: Among patients with ocular KD, there were 9 males and 1 female with an age from 7 to 75 years (mean, 30 years). There were 6 unilateral cases and 4 bilateral cases. The disease mainly involved the orbit in 3 patients, the lacrimal gland in 5 patients and the eyelid in 2 patients. The ophthalmic presentation included a palpable periorbital or eyelid mass with eyelid swelling and ptosis, proptosis and displacement of the eyeball, and ocular dysmotility. Three patients had a history of lymphadenopathy. The disease course ranged from 6 months to 7 years (mean, 34 months). All the patients had elevated peripheral blood eosinophilia. Three patients of ocular epithelioid hemangioma were all males with age from 25 to 60 years old. They were all unilateral cases with 1 right eye and 2 left eyes. The disease respectively involved eyelid and orbit, the eyebrow skin and the inner canthus skin. They presented with eyelid swelling, orbital mass or subcutaneous nodule for 5 months to 2 years. All patients (11 eyes) with KD underwent incisional or excisional biopsy. The histopathology revealed follicular hyperplasia of lymphoid tissue with active germinal centers in orbital fibroadipose tissue. There were massive interfollicular eosinophils with eosinophilic microabscesses. Some swelling endothelial cells of proliferating vessels were seen. All the 3 patients (3 eyes) with ocular epithelioid hemangioma underwent excision of the lesions. Histopathological examination showed proliferation of small and medium blood vessels. The vessels were lined by endothelial cells with abundant eosinophilic cytoplasm which protruded into the lumen. The endothelial cells were positive for CD31, factor Ⅷ-related antigen and E26 transformation-specific related gene immunohistochemically. There was a moderate amount of lymphocytes, plasma cells and eosinophils surrounding blood vessels without eosinophilic microabscess. Conclusions: Both ocular KD and epithelioid hemangioma are more commonly seen in males and share the common histopathological features of vascular proliferation, swelling endothelial cells and eosinophilic infiltration. KD is an allergic benign lymphoid tissue proliferation characteristic of massive eosinophilic infiltration, whereas epithelioid hemangioma is a benign neoplasm of blood vessels with plump and epithelioid endothelial cells. (Chin J Ophthalmol, 2021, 57: 689-695) .

Objective: To analyze the difference of life expectancy and healthy life expectancy among Shanghai residents of different gender and age groups. Methods: Compare the trends of life expectancy among Shanghai and other longevity countries/regions. With the disability weights of GBD, Sullivan method was applied to calculate the healthy life expectancy in Shanghai and analyze the loss of healthy life years among the population of different age groups and genders. Results: In the past 40 years, life expectancy had increased by 10.86 years in Shanghai. In 2016, the life expectancy of Shanghai residents was 83.18 years old, and 80.83 years old for males and 85.61 years old for females. The healthy life expectancy of Shanghai residents was 69.46 years, and 68.68 years for males and 70.23 years old for females. The gap with life expectancy was 13.72 years old, 12.15 years old and 15.38 years old, respectively. They account for 16.49%, 15.02% and 17.97% of life expectancy, respectively. The healthy life expectancy of women in all age groups is higher than that of men with the average gap of 1.76 years. The difference between the two is as small as 1.36 years at 20-24 years old, and as large as 2.24 years at 70-74 years old. The loss rate of healthy life expectancy increases with age, with women higher than men before age 65 and vice versa after age 65 years old. Conclusions: The life expectancy in Shanghai has reached the world leading level, but the healthy life loss is still large. It is necessary to further improve the life quality with the reducing mortality rate, especially for women and men over 65 years old.

Objective: To investigate health status and calculate health life expectancy (HE) of residents in Shanghai, analyze health related factors and provided foundation of health policy. Methods: A multi-stage stratified random sampling was used to obtain self-reported health survey in Shanghai. WHO questionnaire was used to evaluate the health quality of life which was designed for the world health survey, Sullivan's method was used to calculate HE. Results: The self-assessment disability measure for adults over 18 years old in Shanghai was 0.25, higher for women (0.28) than for men (0.23). LE was 65.76 years for adults over 18 years old, higher for women (68.22) than for men (63.39). HE for adults over 18 years old was 47.99 years old, higher for men (49.05) than women (47.14). HE's proportion in LE gradually decreases with age. It accounts for 72.97% in the 18 years old and 39.00% in the 85 years old. Conclusions: The health of adult male in Shanghai is higher than that of female, and the proportion of HE loss of elderly is higher than young people. It is necessary to focus on the aging problem and strengthen the long-term care and health support system for the elderly. Improve the prevention and control of major diseases such as chronic diseases,which affect the quality of life expectancy seriously. Promotes the health level and quality of life in Shanghai.

Objective: To understand the prevalence of cardiovascular metabolic risk factors among 12-18 years old children and adolescents in Yinchuan City., Methods: A survey was conducted among 12-18 years old middle school students in Yinchuan from September 2017 to September 2019. A total of 1956 subjects were collected by using convenient sampling method, with an average age of(14. 4±1. 4) years. Boys and girls accounted for 52. 1% and 47. 9%, respectively, The Han and Hui nationalities accounted for 77. 7% and 16. 4%, respectively. Basic data such as age and gender were collected through questionnaire survey, and physical examination was used to measure height, weight, waist circumference and blood pressure. Fasting blood glucose, triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C) were measured by laboratory blood pressure biochemistry., Results: The detection rates of obesity, abdominal obesity, hypertension, hyperglycemia, high TG, high LDL-C, low HDL-C, high LDL-C and dyslipidemia among 12-and 18-year-olds in Yinchuan City were 8. 3%, 17. 9%, 12. 4%, 1. 9%, 13. 2%, 2. 4%, 18. 6%, 1. 9% and 30. 1%, respectively. The detection rates of obesity, hyperglycemia, low HDL-C, high TG and dyslipidemia in boys were significantly higher than those in girls. Obesity, abdominal obesity and hypertension in 12-15-year-old group were higher than those in 16-18-year-old group, and the detection rates of high TC, low HDL-C, high LDL-C and dyslipidemia were lower than those in 16-18-year-old group(P& lt; 0. 05). The prevalence of cardiovascular risk factors in different age groups of boys and girls were compared. The detection rates of obesity, abdominal obesity and hypertension in the 12-15 age group were higher than those in the 16-18 age group, while the rates of high TG, low HDL-C, high LDL-C and dyslipidemia were higher in the 12-15 age group, but these differences were only significant in boys. Among girls, the detection rate of high TC and high LDL-C was higher in the age group of 12 to 15 years old(P& lt; 0. 05). The detection rate of metabolic syndrome in 12-18-year-old adolescents was 7. 9%. The detection rate of metabolic syndrome in boys(10. 1%) was higher than that in girls(5. 5%). The detection rates of metabolic syndrome in 12-15 years old and 16-18 years old were 9. 1% and 4. 9% respectively, and the differences were statistically significant(P& lt; 0. 05)., Conclusion: The prevalence of cardiovascular metabolic risk factors in 12-18 years old adolescents in Yinchuan City is at a high level, boys are higher than girls, and the prevalence of obesity, abdominal obesity and hypertension are higher in 12-15 years old group. Dyslipidemia varies greatly in different gender and age groups.

Objective: To analyze the relationship between children lipid accumulation product(CLAP) and body mass index(BMI) and cardiovascular risk factors in children and adolescents., Methods: A current situation study design was adopted. A total of 936 children and adolescents aged 12 to 18 years old in Yinchuan City were selected from September 2017 to September 2019 by a convenient sampling method. Among them, 537(57. 40%) boys and an average age of(14. 82±2. 08) years old, the number of Han and other ethnic groups were 705(75. 30%) and 231(24. 70%) respectively. And conduct questionnaire surveys(using Yinchuan Children&apos;s Blood Pressure Survey-standard questionnaire, which mainly includes basic information, birth and infant feeding, physical activity and sleep, etc. ), physical examination(including height, weight, blood pressure and body components) and biochemical index detection(including fasting blood glucose and blood lipids), using binary classification Logistics regression to analyze the correlation between CLAP and BMI and cardiovascular risk factors, and ROC curve analysis of the accuracy of CLAP and BMI in the diagnosis of cardiovascular risk factors., Results: The association between CLAP≥P75 and BMI normal weight and cardiovascular risk factor aggregation≥2 was 38. 13(95%CI 23. 83-61. 00) times(P&lt;0. 05) of CLAP&lt;P75 and BMI non-obese, which was higher than that of other different combinations and cardiovascular risk factors Correlation. The accuracy of CLAP≥P75 combined with BMI in the diagnosis of cardiovascular risk factor aggregation≥2 was 0. 87(95%CI 0. 85-0. 89), higher than other diagnoses., Conclusion: CLAP and BMI are associated with cardiovascular risk factors.

MicroRNA (miRNA) is a type of highly conserved nucleotide sequence composed of 18 to 25 nucleotides, which can specifically bind to the 3'-noncoding regions of mRNA, and then play a negative regulatory role in degrading mRNA or inhibiting translation. Long non-coding RNA (lncRNA) is a type of nucleotide sequence that exceeds 200 nucleotides in length and cannot encode proteins or can only encode protein peptides. It regulates gene expression at the levels of epigenetic, transcriptional and post-transcriptional. As an important energy storage organ, fat plays an important role in regulating the energy balance of animals, and is closely related to meat production traits such as meat production and meat quality. And the disorder of fat function can lead to hyperlipidemia, type 2 diabetes and a series of cardiovascular diseases, so the molecular regulation mechanism of animal fat deposition has attracted more attention. In recent years, more and more studies have found that miRNA and lncRNA play a crucial role in animal fat deposition. We review here the current research progresses in the role of miRNA and lncRNA in animal fat deposition, to provide theoretical guidance and new ideas for further revealing the molecular regulation mechanism of animal fat deposition.

Objective: To determine the composition and distribution of beta-thalassemia-associated genotypes in Liuzhou area of Guangxi, China., Methods: From January to December 2017, 13 847 individuals who came for premarital examination, maternity examination or health check were recruited with informed consent. The subjects were analyzed by reverse dot blotting (RDB) for 17 common beta-thalassemia-associated variants among the Chinese population. Individuals with inconsistent results by blood test, electrophoresis, and RDB were subjected to Sanger sequencing to detect rare variants of the beta globin gene., Results: In total 2098 individuals were found to harbor beta-thalassemia-associated variants, which included 2075 heterozygotes (98.90%), 12 compound heterozygotes (0.57%) and 11 homozygotes (0.52%). CD41-42 (48.43%) and CD17 (31.45%) were the most common variants. Three hundred and thirty eight-individuals were found to also carry heterozygous variants of the alpha globin gene, with the most common types being --SEA/aa, -a3.7/aa, aCSa/aa, -a4.2/aa. Through Sanger sequencing, rare genotypes such as beta-32/betaN, betaCD41-42/betaIVS-II-5 and betaCD30/betaN were detected., Conclusion: Liuzhou area has a high incidence of beta-thalassemia, but with a complex variant spectrum and clinical phenotypes different from other regions. Genetic counseling and prenatal diagnosis for the carrier population is crucial for the reduction of the related birth defects. Our result may provide valuable information for the prevention and control of beta-thalassemia in this area.

Objective: To investigate the safety and feasibility of longitudinal transpancreatic U-sutures invaginated pancreatojejunostomy (Chen's pancreaticojejunostomy technique) in laparoscopic pancreaticoduodenectomy (LPD). Methods: Clinical data of 116 consecutive patients who underwent LPD using Chen's pancreaticojejunostomy technique in Hunan Provincial People's Hospital from May 2017 to December 2018 were retrospectively analyzed. Among these patients, 66 were males and 50 were females. The median age was 58 years old (32-84 yeas old). All 116 patients underwent pure laparoscopic whipple procedure with Child reconstruction method, using Chen's pancreaticojejunostomy technique. The intraoperative and postoperative data of patients were analyzed. Results: All 116 patients underwent LPD successfully. The mean operative time was (260.3±33.5) minutes (200-620 minutes). The mean time of pancreaticojejunostomy was (18.2±7.6) minutes (14-35 minutes). The mean time of hepaticojejunostomy was (14.6±6.3) minutes (10-25 minutes). The mean time of gastrojejunostomy was (12.0±5.5) minutes (8-20 minutes). The mean estimated blood loss was (106.0±87.6) ml (20-800 ml). Postoperative complications were: 11.2%(13/116) of cases had postoperative pancreatic fistula (POPF), including 10.3% (12/116) of biochemical fistula and 0.9%(1/116) of grade B POPF, no grade C POPF occurred; 10.3%(12/116) had gastrojejunal anastomotic bleeding; 3.4%(4/116) had hepaticojejunal anastomotic fistula; 3.4%(4/116) had delayed gastric emptying; 4.3% (5/116) had localized abdominal infection; 12.1%(14/116) had pulmonary infection; postoperative mortality were 0(0/116) and 1.7%(2/116) within 30 days and 90 days, respectively. One patient died of massive abdominal bleeding secondary to Gastroduodenal artery pseudoaneurysm rupture, the other patient died of extensive tumor recurrence and metastasis after surgery. Conclusions: Chen's pancreaticojejunostomy technique is safe and feasible for LPD.It is an option especially for surgeons who have not completed the learning curve of LPD.

Objective: To identify potential variant in a child diagnosed as infantile neuroaxonal dystrophy., Methods: Genomic DNA was extracted from peripheral blood samples from the patient and his parents and subjected to next generation sequencing. Suspected variant was verified by PCR and Sanger sequencing. Pathogenicity of the mutation was predicted by using bioinformatic software including SIFT and PolyPhen-2., Results: The child was found to carry compound heterozygous variations c.668C>A (p.Pro223Gln) and c.2266C>T (p.Gln756Ter) of the PLA2G6 gene, which were respectively inherited from his father and mother. c.2266C>T has changed codon 756 (glutamine) into a stop codon, resulting premature termination of peptide chain synthesis. c.2266C>T has not been reported previously and was predicted to be harmful., Conclusion: The compound variants of c.668C>A (p.Pro223Gln) and c.2266C>T (p.Gln756Ter) of the PLA2G6 gene probably underlies the disease in the child. Above finding has enriched the variant spectrum of the PLA2G6 gene.

Objective: To analyze variations of TYR and P genes among 14 patients with clinically diagnosed oculocutaneous albinism., Methods: Potential variations of the TYR and P genes were detected by Sanger sequencing. Novel variations were predicted with bioinformatics software including SIFT and PolyPhen-2., Results: No variation was found in the TYR gene, while 9 types of variations were found in the P gene among the 14 patients, which included c.803-3C>G (7/26), c.1327G>A (p.Val443Ile) (5/26), c.632C>T (p.Pro211Leu) (4/26), c.1832T>C (p.Leu611Pro) (3/26), c.1349C>A (p.Thr450Lys) (2/26), c.2363C>T (p.Ser788Leu) (2/26), c.2228C>T (p.Pro743Leu) (1/26), c.1525A>G (p.Thr509Ala) (1/26), and c.1349C>T (p.Thr450Met) (1/26). Only 1 heterozygous variation was detected in 2 families. c.2363C>T (p.Ser788Leu), c.1832T>C (p.Leu611Pro) and c.1525A>G (p.Thr509Ala) were not reported previously and predicted as "harmful" to the protein function., Conclusion: The main type of ocular albinism is oculocutaneous albinism type II in Liuzhou region, where the most common variations of the P gene were c.803-3C>G and c.1327G>A (p.Val443Ile). Above finding has enriched the variation spectrum of the P gene.

Objective: To determine the incidence and mutational types of fatty acid oxidation disorders (FAOD) in central-northern region of Guangxi., Methods: A total of 62 953 neonates were screened for FAOD during December 2012 and December 2017. Acyl-carnitine profiling of neonatal blood sample was performed by tandem mass spectrometry using dry blood spots on a filter paper. The diagnosis of FAOD was confirmed by organic acid profiling of urea and genetic testing., Results: Eighteen cases of FAOD were diagnosed among the 62 953 neonates. Among these, primary carnitine deficiency (PCD) was the most common type (n=13), which was followed by short-chain acyl-CoA dehydrogenase deficiency (SCADD) (n=2), medium-chain acyl-CoA dehydrogenase deficiency (MCADD) (n=1), multiple acyl-CoA dehydrogenase deficiency (MADD) (n=1), and carnitine palmitoyltransferase II deficiency (CPT II D) (n=1). Genetic testing has revealed two previously unreported variants, i.e., c.337G to A (p.Gly113Arg) of ACADS gene and c.737G TO T (p.Gly246Val) of ETFA gene., Conclusion: PCD is the most common FAOD in central-northern Guangxi. Tandem mass spectrometry combined with genetic testing may facilitate early diagnosis of FAOD.

Objective: To screen for potential variants of GCDH gene in 3 patients clinically diagnosed as glutaric aciduria type Ⅰ., Methods: GCDH gene variants was detected by Sanger sequencing among the three children and their family members., Results: Sanger sequencing showed that patient 1 carried compound heterozygosity variants of c.532G>A (p.Gly178Arg) and c.655G>A (p.Ala219Thr) of the GCDH gene, while his father and mother respectively carried heterozygous c.532G>A(p.Gly178Arg) and c.655G>A (p.Ala219Thr) variants. Patient 2 carried c.532G>A (p.Gly178Arg) and a novel c.1060G>T (p.Gly354Cys) compound heterozygous variant, while his father and mother respectively carried heterozygous c.532G>A (p.Gly178Arg) and c.1060G>T (p.Gly354Cys) variant. Patient 3 carried homozygous c.532G>A (p.Gly178Arg) variant of the GCDH gene, for which both of his parents were heterozygous carriers., Conclusion: The GCDH gene variant probably underlie the glutaric aciduria type Ⅰ among the 3 patients. Identifcation of the novel variant has enriched the spectrum of GCDH gene variants.

Objective: To explore the molecular pathogenesis for a pedigree affected with hypocalcemia secondary to hypomagnesemia., Methods: Sanger sequencing was used to detect potential variant of the TRPM6 gene in the patient and their parents., Results: The results showed that the patient has carried novel homozygous c.3311C>T (p.Pro1104Leu) variant of the TRMP6 gene, for which both of his parents were heterozygous carriers. Analysis of protein functions using software predicted high risk of pathogenicity., Conclusion: The homozygous c.3311C>T (p.Pro1104Leu) variant of the TRPM6 gene probably underlies the disease in this patient.

Objective: To carry out mutation analysis and prenatal diagnosis for a family affected with primary carnitine deficiency., Methods: Genomic DNA of the proband was extracted from peripheral blood sample 10 days after birth. The 10 exons and intron/exon boundaries of the SLC22A5 gene were subjected to PCR amplification and Sanger sequencing. The proband's mother was pregnant again two years after his birth. Fetal DNA was extracted from amniocytes and subjected to PCR and Sanger sequencing., Results: Tandem mass spectrometric analysis of the proband revealed low level of plasma-free carnitine whilst organic acids in urine was normal. Compound heterozygous SLC22A5 mutations c.1195C>T (inherited from his father) and c.517delC (inherited from his mother) were detected in the proband. Prenatal diagnosis has detected no mutation in the fetus. The plasma-free carnitine was normal after birth., Conclusion: Appropriate genetic testing and prenatal diagnosis can prevent further child with carnitine deficiency. The identification of c.517delC, a novel mutation, enriched the spectrum of SLC22A5 mutations.

Objective: To assess the safety and feasibility of the application of the laparoscopic modality in the perioperative treatment of central liver tumors. Methods: Collecting all the clinical information of a total of 40 patients with central liver tumors who received laparoscopic resection treatment carried out at Department of Hepatological Surgery of People's Hospital of Hunan Provincial from January 2016 to December 2018 to take a retrospective review. There were 19 males and 21 females.The age was (59.5±14.5) years (range: 15 to 71 years) . There were 26 cases of primary hepatic carcinoma (24 cases of hepatocellular carcinoma, 2 cases of cholangiocellular carcinoma) , 8 cases of hepatic cavernous hemangioma, 1 case of metastatic hepatic carcinoma, 5 cases of hepatocellular adenoma. The maximum diameter of tumors were (6.2±2.9) cm (range: 2 to 13 cm) . The patient's information about hepatectomy methods, blocking mode and time of blood flow, operation time, intraoperative blood loss, intraoperative blood transfusion rate, post-operative hospitalization time, perioperative reoperation and postoperative complications were collected. Results: A total of 40 patients all were treated with laparoscopic surgery. The surgical procedure was as follows: 2 patients received the right hepatic lobectomy (Ⅴ, Ⅵ, Ⅶ and Ⅷ segments) , 2 patients received the left hepatic lobectomy (Ⅱ, III and Ⅳ segments) , 13 patients received mesohepatectomy (Ⅳ, Ⅰ and Ⅷ segments) , 2 patients received left hepatic trisegmentectomy (Ⅱ, Ⅲ, Ⅳ and Ⅷ segments) , 2 patients received right hepatic trisegmentectomy (Ⅳ, Ⅴ, Ⅵ, Ⅶ and Ⅷ segments) , 7 patients received Ⅷ segmentectomy, 1 patient received Ⅳ segmentectomy, 3 patients received Ⅴ and Ⅷ segmentectomy, 5 patients received hepatic caudate lobe resection (Ⅰ, Ⅸ segments) , and 3 patients received local tumors resection.Pathological results: there were 26 cases of primary hepatic carcinoma (24 cases of hepatocellular carcinoma, 2 cases of cholangiocellular carcinoma) , 8 cases of hepatic cavernous hemangioma, 1 case of metastatic hepatic carcinoma, 5 cases of hepatocellular adenoma; the pathological reports of all malignant tumor cases all showed negative incisal edge. The operative time was (333±30) minutes (range: 280 to 380 minutes) ; the intraoperative hepatic portal occlusion period was (58±13) minutes (range: 30 to 90 minutes) ; the intraoperative hemorrhage was (173±129) ml (range: 20 to 600 ml) ; the intraoperative blood transfusion rate was 2.5% (1/40) ; the postoperative incidence of bile leakage was 2.5% (1/40) , the hospital discharge of 1 patient with bile leakage was approved after conservative treatments like T pipe decompression and adequate drainage; there was 1 case of abdominal infection and 1 case of pulmonary infection, both of which were discharged from the hospital with conservative treatments; there were no other serious postoperative complications. The postoperative hospital stay was (10.7±2.7) days (range: 6 to 16 days) ; there were no perioperative mortality and reoperation cases. Conclusion: In the centers with abundant laparoscopic hepatectomy experiences, the laparoscopic resection is proved to be safe and feasible in the perioperative treatments of central liver tumors by the highly selective cases, the adequate preoperative assessment and reasonable surgical techniques and approach.

Objective: To identify potential mutation in a child clinically diagnosed as Noonan syndrome and to provide genetic counseling and prenatal diagnosis for his family., Methods: Genomic DNA was extracted from peripheral blood samples of the patient and his parents, and amniotic fluid was taken from the mother during the second trimester. Next generation sequencing (NGS) was used to screen potential mutations from genomic DNA. Suspected mutation was verified by Sanger sequencing., Results: A heterozygous c.4A>G (p.Ser2Gly) mutation of the SHOC2 gene was identified in the patient but not among other family members including the fetus., Conclusion: The Noonan syndrome is probably caused by the c.4A>G mutation of the SHOC2 gene. NGS is helpful for the diagnosis of complicated genetic diseases. SHOC2 gene mutation screening is recommended for patient suspected for Noonan syndrome.

Objective: We aimed to examine the feasibility and toxicity of EC-T dose-dense regimen and to demonstrate the suitable dose of epirubicin in a Chinese early-stage breast cancer population with high recurrence risk. Methods: 370 patients with early-stage breast cancer at high risk of recurrence were treated with EC-T dose-dense adjuvant chemotherapy and prophylactic administration of recombinant human granulocyte stimulating factor (G-CSF). The incidence of delayed chemotherapy, drug reduction and adverse reactions were retrospectively analyzed. Results: 370 patients completed the planned eight cycles of chemotherapy, 50 patients experienced chemotherapy delay, and 90 had chemotherapy dose reductions. Overall, 61.1% of the patients experienced grade 3 or 4 hematology toxicities, 4.1% of the patients experienced grade 3 gastrointestinal toxicity, 16.3% experienced grade 3 or 4 liver malfunction, and 1.9% experienced grade 3 alopecia. In the multivariate analysis, pretreatment epirubicin levels were associated with comprehensive and hematology toxicity risk ( OR =1.268, P =0.046; OR =1.244, P =0.036). With G-CSF support, the probability of grade 3-4 dose limiting toxicity, i. e. neutropenia, abnormal liver function, and gastrointestinal adverse effects did not increase as the epirubicin dose level increased( P >0.05). However, there were no statistically significant associations between epirubicin grade and treatment delay ( P =0.814) or dose reduction ( P =0.282). Conclusions: EC-T dose-dense chemotherapy shows tolerable toxicity. High dose level is not a limiting factor for this regimen. With G-CSF support, epirubicin 85-90 mg/m(2) is appropriate tolerance dose for Chinese early breast cancer patients with high recurrence risk.

Objective: To investigate the screening indices and their cut-off values for full-term neonates carrying β-thalassemia gene., Methods: A retrospective analysis was performed for the clinical data of 1 193 full-term neonates who underwent β-thalassemia screening (hemoglobin analysis with dried blood spots on neonatal heel blood filter paper and mutation detection of 17 β-globin genes). A multivariate logistic regression analysis was used to investigate the association between screening indices and β-thalassemia gene, and the receiver operating characteristic (ROC) curve was used to analyze the value of screening indices in determining the presence or absence of β-thalassemia gene., Results: Of the 1 193 neonates, 638 carried β-thalassemia gene. Of the 1 193 neonates, 637 (53.39%) had no HbA 2 , among whom 310 carried β-thalassemia gene and 327 did not carry this gene; 556 (46.61%) had HbA 2 , among whom 328 carried β-thalassemia gene and 228 did not carry this gene. As for the neonates without HbA 2 , the β-thalassemia gene group had a significantly lower HbA level and a significantly higher HbF level than the β-thalassemia gene-negative group (P<0.01). As for the neonates with HbA 2 , the β-thalassemia gene group had a significantly lower HbA level and significantly higher HbF and HbA 2 /HbA ratio than the β-thalassemia gene-negative group (P<0.01). In the neonates without HbA 2 , HbA, gestational age, and HbA combined with gestational age had an area under the ROC curve (AUC) of 0.865, 0.515, and 0.870, respectively, in determining the presence or absence of β-thalassemia gene (P<0.01), and HbA and HbA combined with gestational age had a similar AUC and a certain diagnostic value. In the neonates with HbA 2 , HbA, HbA 2 /HbA ratio, and HbA combined with HbA 2 /HbA ratio had an AUC of 0.943, 0.885, and 0.978, respectively, in determining the presence or absence of β-thalassemia gene. The HbA combined with HbA 2 /HbA ratio had the largest AUC. In the neonates without HbA 2 , HbA had the largest AUC in determining the presence or absence of β-thalassemia gene at the cut-off value of 11.6%, with a sensitivity of 85.81% and a specificity of 79.82%. In the neonates with HbA 2 , an HbA of 16.1%-22.0% and an HbA 2 /HbA ratio of >1.4 had the largest AUC in determining the presence or absence of β-thalassemia gene, with a sensitivity of 91.38% and a specificity of 91.89%., Conclusions: HbA and HbA 2 /HbA ratio are effective indices for screening out full-term neonates carrying β-thalassemia gene.

Objective: To evaluate the value of minimum ADC(ADC(min))and mean ADC(ADC(mean)), lesion to spinal cord signal intensity ratio (LSR) in diagnosis of metastatic hilar and mediastinal lymph nodes in patients with lung cancer. Methods: A total of 34 patients (89 lymph nodes) pathologically diagnosed as lung cancer were enrolled into this study who were examined in the Second Affiliated Hospital of Nantong University from January 2016 to June 2017. All patients underwent MRI scan 1 week before surgery or endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The short-axis diameter, ADC(mean) and ADC(min) of lymph nodes were measured and recorded respectively by two radiologists.The signal intensity of lymph nodes and spinal cord was also measured on DWI images (b=800 s/mm(2)). According to pathological findings, all lymph nodes were divided into metastasis group (58 lymph nodes) and non-metastasis group(31 lymph nodes). An independent sample t -test was used to compare the differences between the two groups of short-axis diameter, LSR, ADC(mean) and ADC(min) between two groups.The diagnostic performance of short-axis diameter, LSR, ADC(mean) and ADC(min) was analyzed by ROC curves. Results: There were significant differences in short-axis diameter, ADC(mean), ADC(min) and LSR values between two groups (all P <0.01). The short-axis diameter and LSR of the metastatic group were higher than that in non-metastasis group, while ADC(mean) and ADC(min) in metastatic group were lower than that in non-metastasis group.The ROC curve analysis showed that ADC(mean), ADC(min) and LSR achieved excellent but comparable diagnostic performance with an AUC of 0.977, 0.972 and 0.941, respectively ( P <0.05). While the short-axis diameter of lymph nodes demonstrated poor diagnosis performance with an AUC of 0.798 ( P <0.05). The thresholds of short-axis diameter, ADC(mean), ADC(min) and LSR were 9.86 mm, 1.88×10(-3) mm(2)/s, 1.57×10(-3) mm(2)/s and 0.80, respectively.Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for ADC(mean) were 96.6%, 90.3%, 94.9%, 93.3% and 94.4%, respectively, and those for ADC(min) were 98.3%, 90.3%, 95.0%, 96.6% and 94.4%, respectively, those for LSR were 91.4%, 90.3%, 94.6%, 84.8% and 89.9%, respectively, while those for short-axis diameter were 79.3%, 71.0%, 83.6%, 64.7% and 76.4%, respectively.There were significant differences in the area under the ROC curve between short-axis diameter and LSR, short-axis diameter and ADC(mean), short-axis diameter and ADC(min) ( P <0.05). But there was no significant difference in the area under ROC curve between LSR and ADC(mean), LSR and ADC(min), ADC(mean) and ADC(min) ( P >0.05). Conclusion: LSR, ADC(min) and ADC(mean) are the reliable parameters for the differentiation of metastatic and non-metastatic lymph nodes in lung cancer patients, and have good performance.

Objective: To screen for carriers of SMN1 gene mutation, which underlies spinal muscular atrophy (SMA), in 4931 pregnant women from Liuzhou region of Guangxi, and to determine the carrier rate., Methods: Combined denaturing high-performance liquid chromatography (DHPLC) and multiple PCR techniques were used to detect the copy number of SMN1 gene. The carrier frequency was calculated. The spouse of the carrier was also screened, and prenatal diagnosis was provided to the couples who were both positive., Results: Among the 4931 pregnant women, 61 were found to harbor only one copy of the SMN1 gene, which yielded a carrier rate of 1.2%. Subsequent testing has identified 1 fetus carrying homozygous deletions of the SMN1 gene., Conclusion: The carrier rate of SMA mutation in Liuzhou region is slightly lower than that of other regions of southern China. DHPLC can effectively screen the carriers of SMA mutation and provide a basis for genetic counseling and prenatal diagnosis.

Objective: To explore the curative effect of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs) combined with Traditional Chinese Medicine (TCM) versus single EGFR-TKIs for Advanced non-small-cell lung cancer (NSCLC)., Methods: A total of 59 NSCLC patients with EGFR mutation were divided (2:1) into treatment group and control group. Patients in treatment group (39 cases) take EGFR-TKIs plus TCM and control group (20 cases) take EGFR-TKIs. Analysis the progression-free survival (PFS), disease control rate (DCR) and treatment-related adverse events of two groups., Results: The DCR of the treatment group and control group was 94.1% and 84.2% respectively ( P =0.24). In the total population, PFS was 12.1 months in treatment group and 9.1 months in control group [hazard ratio ( HR ) 0.46; 95% CI 0.23-0.9; P =0.025]. Among patients with exon 19 deletion (19-del), PFS between treatment group and control group was 10.5 months and 9.5 months respectively ( P =0.17). For patients with exon Leu858Arg point mutation (L858R), PFS was significantly longer with treatment group than withcontrol group (median 13.2 months vs. 7.8 months; HR 0.32, 95% CI 0.10-0.97; P =0.046). Grade 3-4 treatment-related adverse events were less common withtreatment-group (8.33 %) than control group (15.00%) ( P =0.65)., Conclusion: For NSCLC patients with EGFR mutation, EGFR-TKIs combined with TCM has a certain effect to prolong PFS, especially for the patients with L858R., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).)

Objective: To construct an eukaryotic expression plasmid for AY358935 gene and explore its function., Methods: cDNA of the AY358935 gene was amplified by reverse transcription-PCR and cloned into pGEM-Teasy. The pGEM-T-AY was validated by sequencing and served as a template for the construction of eukaryotic expression plasmid. The pcDNA3.1-AY recombinant was validated by double enzyme digestion and used for transient transfection of M14 cells. Expression of the AY358935 protein and proliferation of the M14 cells were determined respectively by Western blotting and 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide (MTT) colorimetry., Results: The amplicons of RT-PCR were confirmed to have similar size with the cDNA fragment of the AY358935 gene as well as cloned region of pcDNA3.1-AY. The cloned region of pGEM-T-AY was sequenced to be identical with cDNA sequence of the AY358935 gene. M14 cells were transfected by the AY358935 gene, pcDNA3.1 and liposomes, respectively. After 48 h, expression of the AY358935 protein in M14 cells transfected with the AY358935 gene was significantly higher than other two groups. They also had a significantly higher absorbance value (A=0.74) than other two groups (A=0.39 and 0.46, respectively; P<0.05)., Conclusion: An eukaryotic expression plasmid of the AY358935 gene was successfully constructed. Product of the AY358935 gene may promote the proliferation of M14 cells.

Objective: To observe the regional homogeneity (ReHo) of resting-state brain function in the healthy subjects of gastric distention treated with acupuncture at the back- shu and front- mu points of the stomach, Weishu (BL 21) and Zhongwan (CV 12) and the correlation with gastric motility so as to explore the mechanism on the central integration of the front- mu and back- shu points of the stomach., Methods: The crossover test design was adopted. Twenty-four healthy subjects were assigned to a Weishu group, a Zhongwan group and a combined-point group separately, 8 cases in each one in each of the three times. Totally, 24 subjects were included in each group. Under the water load condition, the subjects received acupuncture at Weishu (BL 21), Zhongwan (CV 12) and the combined Weishu (BL 21) and Zhongwan (CV 12). Before and after each acupuncture, the resting-state brain functional magnetic resonance imaging (fMRI) scan and electrogastrogram (EGG) test were applied. The ReHo value was calculated in the collected fMRI imaging data. The changes in ReHo values were analyzed and compared before and after acupuncture in each group, as well as among the groups. The gastric motility was analyzed before and after acupuncture. Additionally, the correlative analysis was conducted between the gastric motility and ReHo changes before and after acupuncture., Results: (1) After acupuncture, EGG amplitudes in the subjects of each group were lower remarkably as compared with those before acupuncture (all P <0.01). The EGG frequencies were not different significantly as compared with those before acupuncture (all P >0.05). The EGG amplitudes in the Weishu group and the Zhongwan group were higher than those in the combined-point group (both P <0.05). (2) As compared with the conditions before acupuncture, acupuncture at the combined front- mu and the back- shu points as well as Weishu (BL 21) and Zhongwan (CV 12) separately all induced the changes in the brain ReHo. Acupuncture at the combined front- mu and the back- shu points significantly increased Reho values in the right inferior temporal gyrus, the left thalamus, the precuneus and the posterior cingulate gyrus (all P <0.05) and remarkably reduced the ReHo values in the the middle temporal gyrus of the right temporal pole, sulcus calcarinus and precuneus (all P <0.05). Compared with the single point groups, acupuncture at the combined front- mu and the back- shu points induced the increase of ReHo value in the posterior cingulate gyrus and the decrease of ReHo in the temporal pole (all P <0.05). (3) The correlative analysis showed that the changes in the ReHo values in the posterior cingulate gyrus, the thalamus and the precuneus were positively correlated to the changes of the gastric motility amplitudes. The changes in the ReHo values in the temporal pole was negatively correlated to the changes of the gastric motility amplitudes., Conclusion: Acupuncture at the combined back- shu and front- mu points of the stomach, as well as acupuncture at single Weishu (BL 21) and Zhongwan (CV 12) induce the ReHo changes in the different brain regions. Acupuncture at the combined back- shu and front- mu points of the stomach may induce the ReHo changes in some new brain regions as compared with the acupuncture at the single point. The thalamus, the posterior cingulate gyrus and the precuneus may be the the important integrated brain regions for acupuncture at the back- shu and the front- mu points in regulating the gastric motility. The effects of acupuncture at the back- shu and the front- mu points for the regulation of the gastric motility are closely related to the thalamus, the limbic system and the default network of the brain regions.

Objective: Using microarray technology, to research characteristic circRNA and miRNA expression profile of acute myocardial infarction (AMI), and then explore the role of these circRNA and miRNA in gene regulation. The aim is to explore the mechanism of development of AMI. Methods: The patients hospitalized in the Cardiovascular Research Center of the First Affiliated Hospital of Xinxiang Medical University between November 2016 and January 2017 were included and divided into control group and AMI group according to diagnostic criteria. We collected their whole blood and extracted the total RNA, and the expression profiles of circRNA and microRNA genes in peripheral blood of AMI were analyzed by gene chip. We predicted circRNA which was possible to combine with miRNA, and drew a network diagram, and the differentially expressed circRNA was analyzed by GO and Pathway. Results: There was difference in circRNA expression profile between the control group and the AMI group. The results showed: (1) a total of 1 670 circRNA had differential expressions, and in the analysis of miRNA expression, 13 miRNA had differential expressions ( P <0.05, fc≥2); (2) multiple circRNAs-miRNAs were involved in the occurrence of AMI; (3) the analysis of GO and Pathway for differentially expressed circRNAs showed that many pathways, disease and function participated in it. Conclusion: CircRNA, as an important post transcriptional regulator, is closely related to the development of AMI with miRNA.