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Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa having no clear aetiology or pathogenesis. The influence of psychological disturbances on OLP has been widely discussed but still bears the controversy. This study aimed at assessing scientific evidence between the OLP and psychological alterations of the patient. We searched seven important databases for studies on OLP and psychological factors (anxiety, depression, stress, sleep disorders, etc.) published between 1 January 2000, and 1 October 2020. Case-control and cross-sectional studies were incorporated into this study. The meta-analysis used a random-effects model assessed by using the I

BACKGROUND AND PURPOSE: Arterial sclerosis resulting from hypertension slows CSF transportation in the perivascular spaces, showing the intrinsic relationship between the CSF and the blood vasculature. However, the exact effect of hypertension on human CSF flow dynamics remains unclear. The present study aimed to evaluate CSF flow dynamics in treatment-naive patients with essential hypertension using phase-contrast cine MR imaging. MATERIALS AND METHODS: The study included 60 never-treated patients with essential hypertension and 60 subjects without symptomatic atherosclerosis. CSF flow parameters, such as forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, average flow, and net flow volume, were measured with phase-contrast cine MR imaging. Differences between the 2 groups were assessed to determine the independent determinants of these CSF flow parameters. RESULTS: Forward flow volume, forward peak velocity, reverse flow volume, reverse peak velocity, and average flow in the patients with hypertension significantly decreased (all, P

OBJECTIVE: To explore the effect of thoracic paravertebral anesthesia (TPVB) on prognosis of patients undergoing resection of lung cancer. METHODS: This study was conducted among the patients undergoing surgical resection of primary lung cancer under general anesthesia or TPVB combined with general anesthesia (TPVB+GA) between January, 2017 and May, 2018.The patients were enrolled in TPVB+GA group and GA group (control group) using a propensity score matching (PSM) method at the ratio of 1:2 based on their baseline characteristics.The clinical parameters, 5-year overall survival (OS), progression-free survival (PFS) and intraoperative dosage of opioids were compared between the two groups to assess the impact of TPVB on prognosis of the patients. RESULTS: Forty-seven patients were enrolled in TPVB+GA group and 94 in the control group.Kaplan-Meier survival analysis showed a significantly prolonged PFS in the patients with TPVB+GA (log-rank P=0.034), with an odds ratio (OR) of 0.45(95%CI: 0.33-0.89).Consistently, univariate and multivariate Cox regression analyses identified TPVB as an independent protective prognostic factor for patients with lung cancer resection (P=0.002, OR=0.33, 95%CI: 0.16-0.66).Cox regression analyses indicated that a lower intraoperative dose of remifentanil was significantly correlated with a longer PFS of the patients following lung cancer resection (P=0.017, OR=0.47, 95%CI: 0.25-0.87).Chi-square test confirmed that TPVB, but not general anesthesia, significantly reduced intraoperative dose of remifentanil, indicating a possible synergistic effect of TPVB with opioids to affect the survival of the patients. CONCLUSION: TPVB can prolong the survival time and improve the prognosis of the patients undergoing surgical resection of lung cancer.

原发性醛固酮增多症（primary aldosteronism，PA）根据肾上腺病变部位不同分为单侧和双侧PA，前者可手术治疗，后者应药物控制。单侧PA影像学上常表现为肾上腺低密度结节或增粗。肾上腺CT显像“无异常”的单侧PA既往国内未见报道。本文通过对1例肾上腺CT显像“无异常”的单侧PA患者的临床特点及诊治过程进行分析，总结诊治要点并结合文献复习进行讨论，以期为影像学阴性的单侧PA的临床诊治提供一些借鉴和思路。.

Perceived effectiveness (PE) is a validated tool for predicting the potential impact of anti-tobacco public service announcements (PSAs). We set out to evaluate the added predictive value of facial expression analysis when combined with PE in a remote (online) survey. Each of 302 tobacco users watched 3 PSAs and allowed transmission of webcam videos from which metrics for "attention" (head position) and "facial action units" (FAU) were computed. The participants completed scales for their subjective emotions, willingness to share on social media, and intention to quit smoking using the Tobacco Free Florida website. Based on PE, both ready to quit (RTQ) and not ready (NR) respondents favored the same PSAs but RTQs assigned higher PE scores. Negative PSAs ("sad" or "frightening") were more compelling overall but RTQs also favored surprising ads and were more willing to share them on social media. Logistic regression showed that the combination of Attention + FAU+ PE (AUC = .816, p .0001) outperformed single factors or factor combinations in distinguishing RTQ from NR. This study demonstrates that on-line assessment of facial expressions enhances the predictive value of PE and can be deployed on large remote samples.

Critical ultrasonography is widely used in ICU and has become an indispensable tool for clinicians. However, besides operator-dependency of critical ultrasonography, lack of standardized training mainly result in the physicians' heterogenous ultrasonic skill. Therefore, standardized training as well as strict quality control plays the key role in the development of critical ultrasonography. We present this quality control standards to promote better development of critical ultrasonography.重症超声在重症医学相关领域的应用日益广泛，已成为重症专业医生不可或缺的检查、评估与监测手段。但由于超声本身较强的操作者依赖性，且很多医生未能接受规范的重症超声培训，导致认识与应用水平参差不齐。因此，规范重症超声培训及严格质量控制非常关键。为此制定了本标准，以推动重症超声更好地发展。.

BACKGROUND: Alzheimer’s disease (AD) is a major cause of dementia, which is a growing global health problem and has a huge impact on individuals and society. As the modifying role of geniposidic acid (GPA) has been suggested in AD, this study sets out to determine if and how GPA treatment affects AD progression in mice. METHODS: Potential downstream target genes of GPA during AD were identified by bioinformatics analysis, revealing GAP43 as a primary candidate protein. Then, mPrP-APPswe/PS1De9 AD transgenic mice were treated with GPA via intragastric administration. This allowed for gain- and loss-of-function assays of candidate proteins being carried out with or without GPA treatment, after which behavioral tests could be conducted for mice. Cortical neuron apoptosis was measured by TUNEL staining, Amyloid β-protein (Aβ) expression in cerebral cortex by Thioflavin-s staining, and Aβ, IL-1β, IL-6, IL-4 and TNF-α levels in cerebral cortex by ELISA. GAP43 expression in cerebral cortex of mice was detected by immunohistochemistry. Primary cortical neurons of embryonic mice were isolated and induced by Aβ1-42 to construct AD cell model. Cell viability was assessed by CCK-8, and axon growth by immunofluorescence. RESULTS: GPA administration significantly improved the cognitive impairment, reducing Aβ accumulation and neuronal apoptosis in AD mice, and alleviated inflammation and axonal injury of Aβ1-42-induced neurons. GAP43 was shown experimentally to be the target of GPA in AD. Silencing of GAP43 repressed the neuroprotective effect of GPA treatment on AD mice. GPA elevated GAP43 expression via PI3K/AKT pathway activation and ultimately improved nerve injury in AD mice. CONCLUSION: GPA activates a PI3K/AKT/GAP43 regulatory axis to alleviate AD progression in mice.

OBJECTIVE: To investigate the effect of 275 nm and 310 nm ultraviolet irradiation on ovariectomized rats' bone metabolism. METHODS: Twenty four 3-month-old female Sprague-Dawley (SD) rat were randomly divided into control group, sham operated group, 275 nm ultraviolet (UV) irradiation group and 310 nm UV irradiation group. Each group contained 6 rats. The rats in the two irradiation groups were treated with bilateral ovariectomy. The rats in sham operated group received sham operation (They were given the same back incision and a bit of par-ovarian fat were removed). Control group received no disposition. About 24 weeks after operation, all the rats received detailed bone mineral density (BMD) detection again. Detection regions include cervical vertebra, lumbar vertebra, proximal femur, mid femur and distal femur. Next, osteopenia rats in 275 nm irradiation group were UV irradiated 275 nm with fixed illumination intensity (15 μW/cm(2)) everyday for 16 weeks. The osteopenia rats in 310 nm irradiation group were UV irradiated 310 nm with fixed illumination intensity (15 μW/cm(2)) everyday for 16 weeks. The backs of the rats were shaved regularly as irradiation area (6 cm×8 cm). After 16-week irradiation, all the rats' BMD of cervical vertebra, lumbar vertebra, proximal femur, mid femur and distal femur were measured. At the end of the trial, all the rats' blood specimens were obtained and serum 25(OH)D, procollagen type Ⅰ N-peptide (PINP) and osteocalcin (OC) were measured. RESULTS: Compared with control group [(238.78±26.74) mg/cm(3)], the BMD of the whole body were significantly lower in 275 nm [(193.34±13.28) mg/cm(3)] and 310 nm [(191.19±18.48) mg/cm(3)] irradiation groups (P=0.002, P=0.001). There were no significant difference between sham operated group [(227.20±14.32) mg/cm(3)] and control group. After 16-week ultraviolet irradiation, the BMD of the whole body were significantly increased in 275 nm [(193.34±13.28) mg/cm(3) vs. (221.68±25.52) mg/cm(3), P=0.005] and 310 nm groups [(191.19±18.48) mg/cm(3) vs. (267.48±20.54) mg/cm(3), P < 0.001] after corresponding irradiation. The BMD of the four body regions (lumbar vertebra, proximal femur, mid femur and distal femur) had significantly increased after irradiation in 275 nm irradiation group. For 310 nm irradiation group, the BMD in cervical vertebra, lumbar vertebra, proximal femur, mid femur and distal femur also had increased significantly after 310 nm ultraviolet irradiation. The concentration of serum 25(OH)D and OC was higher in 275 nm irradiation group than in control group [(46.78±5.59) μg/L vs. (21.32±6.65) μg/L, P=0.002;(2.05±0.53) U/L vs. (1.32±0.07) U/L, P=0.022]. Compared with the control, the concentration of serum 25(OH)D [(58.05±12.74) μg/L], OC [(2.04±0.53) U/L] and PINP [(176.16±24.18) U/L] was significantly higher (P < 0.001, P=0.015, P=0.005) in 310 nm irradiation group. However, there were no significantly difference between sham operated group and the control. CONCLUSION: Both 275 nm and 310 nm ultraviolet could improve rats' vitamin D synthesis. Both 275 nm and 310 nm ultraviolet could improve osteopenia rats' bone condition. The irradiation of 310 nm might be more effective on bone condition improvement.

To provide references for the diagnosis and treatment of congenital granular cell tumor (CGCT), by comprehensive analysis of the clinical data, histopathological and immunohistochemical results. Patients with CGCT were involede, from March 2015 to November 2020, at the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University. A total of 6 children, aged 3-16 days, 1 male and 5 female, 5 maxillary and 1 mandibular, with maximum tumor diameter of 6-70 mm, were included. The lesions of CGCT were single and connected to the alveolar ridge by a pedicle. The surface of the tumor was covered with a vascular network, and two cases had ulcers on the surface of the tumor. All 6 cases had the tumor removed surgically and there was no recurrence or metastasis in the follow-up visit. Although CGCT is rare, it is a benign tumor and generally does not recur or metastasize after surgery, and has a good prognosis. The prenatal imaging, clinical manifestations after delivery, pathological characteristics and immunohistochemical analyses may provide reference for early diagnosis and treatment of CGCT.选取2015年3月至2020年11月就诊于郑州大学第一附属医院口腔颌面外科的先天性颗粒细胞龈瘤（congenital granular cell tumor，CGCT）患者，通过分析其临床资料、组织病理及免疫组化表现，结合国内外报道进行综合分析，初步探讨CGCT的临床特点、组织病理及免疫组化特点，为其诊断及鉴别诊断提供参考。共纳入6例患儿，术前年龄3~16 d；男性1例，女性5例；上颌5例，下颌1例；肿瘤最大径为6~70 mm。6例CGCT均为单发，通过蒂与牙槽嵴相连。肿瘤表面覆盖血管网，2例瘤体表面出现溃疡。6例患儿均通过手术摘除肿瘤。随访4~61个月未见肿瘤复发或转移。CGCT虽罕见但属于良性肿瘤，一般不复发或转移，预后好。产前影像学检查、娩出后的临床表现、病理特点及免疫组化检查，可为CGCT早期诊断及治疗提供参考。.

Background Intraabdominal surgeries are frequently performed procedures that lead to a high volume of unplanned readmissions and postoperative complications. Patient sex may be a determinant of adverse outcomes in this population, possibly due to differences in biology or care delivery, but it is understudied. The authors hypothesized that there would be no association between patient sex and the risk of postoperative adverse outcomes in intraabdominal surgery. Methods This retrospective, population-based cohort study involved adult inpatients aged 18 yr or older who underwent intraabdominal surgeries in Ontario, Canada, between April 2009 and March 2016. The authors studied the association of patient sex on the primary composite outcome of all-cause death, hospital readmission, or major postoperative complications, all within 30 postoperative days. Inverse probability of exposure weighting based on propensity scores (computed using demographic characteristics such as rural residence status and median neighborhood income quintile, common comorbidities, and surgery- and hospital-specific characteristics) was used to estimate the adjusted association of sex on outcomes. Results The cohort included 215,846 patients (52.3% female). The primary outcome was observed in 24,712 (21.9%) females and 25,486 (24.7%) males (unadjusted risk difference, 2.8% [95% CI, 2.5 to 3.2%]; P < 0.001). After adjustment, the association between the male sex and the primary outcome was not statistically significant (adjusted risk difference, −0.2% [95% CI, −0.5 to 0.2%]; P = 0.378). Conclusions In a large population of intraabdominal surgical patients, there was no differential risk between sexes in the composite outcome of all-cause death, hospital readmission, or major postoperative complications, all within 30 postoperative days. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

经导管主动脉瓣植入术（TAVI）已成为重度主动脉瓣狭窄（AS）的主要治疗方法之一，尤其是对于具有外科手术禁忌或中、高危风险的高龄患者。手术过程中，部分患者由于瓣膜口极度狭小且瓣膜结构不清、瓣叶冗长/黏连/严重钙化等，导丝逆向跨主动脉瓣进入左心室建立轨道的难度较大，由此导致并发症发生率增高、手术成功率降低。该文报道3例重度AS患者行TAVI手术过程中因导丝逆向跨瓣困难而采用顺向导丝结合导丝抓捕技术，成功且快速建立轨道，取得了良好的临床效果。.

OBJECTIVE: To study the clinical characteristics and genetic variants in a family with non-immune hydrops fetalis. METHODS: Peripheral blood samples were collected from a pregnant woman with suspected non-immune hydrops fetalis of the fetus for routine blood analysis, Rh typing and TORCH test. Amniotic fluid sample was collected for G-banded chromosomal karyotyping. The genomic DNA of the proband was extracted for analysis of chromosomal abnormalities using copy number variation sequencing. Whole-exome sequencing (Trios-WES) was performed on Illumina NovaSeq 6000 platform and exonic DNA was enriched using Agilent Sure Select XT Human All Exon V6. Sorting intolerant from tolerant (SIFT), I-mutant2, PolyPhen-2 and PROVEAN were used to predict the potential effects of amino acid substitution on protein function and splicing variation. The spatial structure of codanin-1 was modeled and visualized with Alpha Fold 2 and PyMOL 2.3 software, and the variants with potential clinical significance were confirmed by Sanger sequencing. RESULTS: Fetal ultrasound at 17 weeks of gestation showed extensive subcutaneous edema, ascites, pleural effusion, enlarged liver and spleen, thickened placenta and pericardium defect. NGS reveals that proband has carried c.2140C>T, p.R714W, and c.1264_1265delCT, p.L422* compound heterozygous variants of CDAN1 gene, which were found to be pathogenic and inherited from proband's father and mother respectively. CONCLUSION: We identified a novel heterozygous CDAN1 gene mutation causing fetal-onset congenital dyserythropoietic anemia type 1, which triggers non-immune hydrops fetalis.

A female patient with totally white hair and pink skin had gradual visual loss to hand motion in the right eye within one year. Upon her visit to the Department of Ophthalmology, she was found to have a totally white cataract and a family history of intermarriage, and was finally diagnosed with oculocutaneous albinism and complicated cataract in the right eye. The best corrected visual acuity of her right eye increased to 0.15 at 6 months after phacoemulsification and intraocular lens implantation. Clear choroidal vessels could be seen in the ultra-widefield color fundus image and autofluorescence image. No macular fovea structure was found on optical coherence tomography of the fundus.1例因右眼视力逐渐下降1年至眼前手动，全身毛发呈白色、皮肤粉红色患者就诊眼科，父母为近亲结婚，右眼晶状体全白混浊，诊断为眼皮肤白化病和右眼并发性白内障。右眼行超声乳化白内障吸除人工晶状体植入术后半年最佳矫正视力0.15，超广角彩色眼底图像和眼底自发荧光图像可见清晰的脉络膜大血管，眼底相干光层析成像术检查未见黄斑中心凹结构。（

Pyroptosis is correlated with programmed tumor cell death and the tumor microenvironment. However, the prognostic value of pyroptosis-associated long non-coding RNAs (lncRNAs) in skin cutaneous melanoma (SKCM), a malignant tumor with a poor prognosis, has not been established.In this study, expression profiles and clinical data of patients with SKCM were downloaded from The Cancer Genome Atlas (TCGA) database to identify differentially expressed pyroptosis-related lncRNAs related to overall survival. A lncRNA risk signature was constructed by Cox regression analyses and its prognostic value was evaluated. Associations between the lncRNA signature and immune status, immune microenvironment, tumor stemness, immune checkpoints, and m6A-related genes were further evaluated.Twenty-two pyroptosis-related lncRNAs were identified and incorporated into a prognostic risk signature. The signature was significantly correlated with overall survival, tumor growth, and metastasis in SKCM. The signature demonstrated better diagnostic accuracy than conventional clinicopathological characteristics. A gene set enrichment analysis indicated that the risk signature was enriched in several immune-related pathways. Furthermore, the risk signature was significantly correlated with the immune microenvironment, immune cell infiltration, and immune subtypes, as well as tumor stem cells and some m6A-related genes. The lncRNA expression levels were also significantly related to responses to several anti-tumor drugs. Finally, a nomogram based on the risk score was established.Overall, a risk signature based on 22 pyroptosis-associated lncRNAs was generated, providing a novel perspective on the determinants of prognosis and survival in SKCM and a basis for the development of individualized treatments.

High expression of ecotropic viral integration site 1 (EVI1) has been associated with a poor prognosis in leukemia patients, but the underlying mechanism remains unclear. Aberrant expression of microRNAs plays critical roles in leukemia development. MiR-9 is a putative potential target of EVI1. We have investigated the regulating mechanism of miR-9 by EVI1 in leukemia cells. We first examined the relationship between miR-9 and EVI1 expression levels in nine leukemia cell lines by RT-PCR. Then we forced high expression of EVI1 in UoCM1 and K562 cells to confirm the downregulation of miR-9 by EVI1. Methylation of the miR-9 promoter region was detected by DNA bisulfite sequencing. We treated the EVI1-overexpressing cells with the hypomethylating agent 5-aza-2′-deoxycytidine (5-AZA) to reverse EVI1-induced hypermethylation of miR-9. EVI1 and miR-9 expression was negative related. Forced expression of EVI1 downregulated miR-9 by inducing hypermethylation of the miR-9 promoter. 5-AZA reversed high EVI1-induced hypermethylation of the miR-9 promoter and restored the expression of miR-9. 5-AZA induced extensive apoptosis and inhibited proliferation through cell cycle arrest in EVI1-overexpressing leukemia cells. Our results suggest that EVI1 may be involved in leukemia cell proliferation and apoptosis via the regulation of miR-9 promoter methylation. 5-AZA may represent a promising therapeutic option for EVI1-high leukemia patients.

极简式经导管主动脉瓣置换术（TAVR）采用局部麻醉联合镇静，术中采用经胸超声心动图，通过股动脉入路开展的简化流程的TAVR手术。患者术后恢复快，大部分患者术后第2天即可出院。该文报道1例因外科生物瓣衰败，行极简式TAVR治疗的重度主动脉瓣狭窄病例。术后患者恢复良好，4 h即可下地行走，第2天出院。术后随访30 d，患者无明显不适。.

纵隔感染通常是由牙源性或颈部感染沿颈筋膜扩散侵及纵隔所致的急性纵隔炎，是一种进展迅速且致死率高的严重感染。本文报道河南科技大学第一附属医院重症医学科收治的1例气管切开术后并发纵隔感染患者的诊治过程。该患者经胸腔镜手术以及术后抗感染治疗，成功救治。.

对54例煤矿井下工人滑囊炎病例的临床特点进行回顾性分析。患者以采煤工最多，工龄多在10年以上，髌前滑囊最易受损，双侧发病多于单侧，影像学检查和滑囊穿刺抽液检查可辅助诊断，保守治疗或滑囊穿刺抽液后注射糖皮质激素治疗无效时可考虑滑囊切除术。.

To explore the feasibility of using the posteromedial thigh flap as an alternative source for oral and maxillofacial reconstruction. During January 2019 to January 2020, twenty-three patients underwent oral and maxillofacial tumor ablation and defect reconstruction with 23 posteromedial thigh flaps were enrolled in the Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University. Thirteen of the patients were male and ten were female, with age of (54.5±9.7) years (33-72 years). The numbers and types of perforators, the dimension of flap and the vascular pedicle length were measured. The outcomes of flaps and donor-site complication were recorded. The patients' satisfaction with donor-site cosmesis were evaluated by the visual analogue scale (VAS). More than one sizable perforators was found in each case and the median number of perforators was 2 (range, 1 to 4), and all of the perforators were musculocutaneous. The pedicle length was (9.8±1.5) cm (range, 7.3 to 13.4 cm). The diameters of artery and the larger vein were 2.0 mm (range, 1.5 to 2.5 mm) and 2.0 mm (range, 1.5 to 3.0 mm), respectively. The dimension of the flaps ranged from 8 cm×6 cm to 12 cm×8 cm, and the donor sites were all closed primarily. All of the flaps were clinically survived, only one patient experienced partial wound dehiscence of donor site 14 days postoperatively and no donor site infection or permanent muscular weakness was reported. The VAS scores of the patients' satisfaction with donor-site cosmesis were all more than 8. The perforators of the posteromedial thigh flap is consistent and the donor-site scar is well concealed, which make the posteromedial thigh flap an excellent option for oral and maxillofacial reconstruction.为探讨游离股后内侧皮瓣在口腔颌面部缺损修复重建中的应用，本研究纳入2019年1月至 2020年1月就诊于郑州大学第一附属医院口腔颌面外科的口腔癌患者23例，男性13例，女性10例，年龄（54.5±9.7）岁（33~72岁）。23例患者在口腔癌切除同期均采用股后内侧皮瓣修复口腔颌面缺损。记录皮瓣供区穿支血管数目和类型，切取皮瓣大小、血管蒂长度和动静脉直径，皮瓣临床成活及供区并发症情况，并采用视觉模拟评分量表（visual analogue scale，VAS）评估患者对供区瘢痕隐蔽性的满意度。23例患者股后内侧供区均存在可利用的穿支血管，穿支血管数量为2支（1~4支），血管类型均为肌皮穿支。皮瓣血管蒂长度为（9.8±1.5）cm（7.3~13.4 cm），动脉直径为2.0 mm（1.5~2.5 mm），伴行较粗静脉直径为2.0 mm（1.5~3.0 mm）。切取皮瓣大小8 cm×6 cm~12 cm×8 cm，供区创面均直接拉拢缝合。23例股后内侧皮瓣临床全部成活。所有患者均未发生供区切口感染或肌力下降，仅1例患者术后14 d发生供区切口部分裂开。所有患者对供区瘢痕隐蔽性的满意度VAS评分均大于8。游离股后内侧皮瓣穿支血管较恒定，临床成功率高，供区瘢痕隐蔽，是口腔颌面缺损软组织修复重建的一种较好选择。.

To investigate the clinical significance of serum soluble programmed cell death ligand-1 (PD-L1) in adult patients with community-acquired pneumonia (CAP). A total of 44 CAP patients, 54 severe CAP patients and 30 healthy volunteers were recruited in this study. Serum soluble PD-L1 were detected. Univariate and multivariate regression analyses were used to assess the influence of multiple clinical variables on prognosis. Serum soluble PD-L1 level in severe CAP group was 98.20(57.94, 128.90) ng/L, which was significantly higher than that in the CAP group [59.32(33.55, 92.58) ng/L] and healthy controls [20.44(12.15, 36.20) ng/L] (all通过检测成人社区获得性肺炎（CAP）患者血清可溶性程序性死亡受体配体-1（PD-L1）水平，探讨其临床意义。共纳入44例CAP患者、54例重症CAP患者和30例健康对照者，检测所有研究对象血清中可溶性PD-L1水平，单因素和多因素回归分析各临床参数对预后的影响。结果显示，重症CAP者血清可溶性PD-L1水平为98.20（57.94，128.90）ng/L，高于CAP者［59.32（33.55，92.58）ng/L］和健康对照者［20.44（12.15，36.20）ng/L］（

Small nucleolar RNA host genes (SNHGs) as a subset of long non-coding RNAs (lncRNAs) act critical roles in tumor progression. The present study aimed to elucidate the role and mechanisms of SNHG3 in non-small cell lung cancer (NSCLC). The correlation of SNHG3/miR-340-5p/HOXA10 with the clinicopathological features and outcomes in NSCLC was analyzed by TCGA cohort. In vitro and in vivo functional experiments were conducted to assess the role of SNHG3 in NSCLC cells. Bioinformatic analysis and luciferase gene reporter were used to estimate the interaction between miR-340-5p and SNHG3/HOXA10 3'UTR. The effects of SNHG3 and (or) miR-340-5p on HOXA10 expression were detected by qRT-PCR and Western blot analysis. As a consequence, the elevated expression of SNHG3 and HOXA10 or lowered expression of miR-340-5p was related to the lymph node infiltration, distant metastases and unfavorable prognosis in NSCLC. Ectopic expression of SNHG3 boosted the proliferation and invasion of NSCLC cells in vitro and in vivo, whereas downregulation of SNHG3 reversed these effects. Moreover, SNHG3 could bind with miR-340-5p and reduce its expression levels, and miR-340-5p attenuated SNHG3-induced tumor proliferation and HOXA10 expression in NSCLC cells. Our findings unveiled that SNHG3 might be an oncogenic factor in NSCLC by downregulating miR-340-5p.

The central air conditioning ventilation system plays an important role in the air circulation of buildings such as centralized isolation medical observation points and general public buildings. In order to meet the requirements of COVID-19 epidemic prevention and control, Beijing Preventive Medicine Association organized Beijing CDC and other professional institutes to write up the group standard entitled "Technical specification for health risk investigation of central air conditioning ventilation system during the COVID-19 epidemic (T/BPMA 0006-2020)" . According to the particularity of central air conditioning ventilation system risk control during the outbreak of similar respiratory infectious diseases, based on current laws and regulations and the principle of scientific, practical, consistency and normative, 8 key points of risk investigations were summarized, which were the location of fresh air outlet, air conditioning mode, air return mode, air system, air distribution, fresh air volume, exhaust and air conditioner components. The contents, process, method, data analysis and conclusion of the investigation implementation were also defined and unified. It could standardize and guide institutions such as disease control and health supervision to carry out relevant risk managements, and provided solutions and technical supports for such major public health emergencies in city operations.集中空调通风系统对集中隔离医学观察点和一般楼宇等建筑物内部的空气流通起着重要作用。为满足北京市应对新型冠状病毒肺炎疫情联防联控、平战结合的工作要求，北京预防医学会组织北京市CDC等多单位撰写了《新型冠状病毒肺炎疫情期间集中空调通风系统风险调查实施技术规范（T/BPMA 0006-2020）》团体标准，针对类似呼吸道传染病暴发流行期间集中空调风险防控特殊性，从传染病预防控制角度，以现行法律法规为基础，以"科学性、实用性、统一性、规范性"为原则，梳理归纳了集中隔离医学观察点和一般楼宇集中空调通风系统新风口位置、空调方式、空调回风方式、空调风系统、气流组织、新风量、排风和空调部件8项风险调查要点，并对调查实施内容、流程、方法、资料分析和结论建议等提出明确定义和统一要求。规范和指导疾病控制和卫生监督等机构开展相关风险防控工作，为城市管理中的此类重大突发公共卫生事件提供解决思路和标准支持。.

Long non-coding RNA (lncRNA) LINC00858 has been found to exert oncogenic activity in several types of cancers, except gastric cancer (GC). In the present study, we aimed to explore the potential role of LINC00858 in GC and the underlying molecular mechanism.The expression patterns of LINC00858 were determined using qRT-PCR in GC samples and cell lines. Cell proliferation was examined utilizing CCK-8 assay. Cell migration and invasion were evaluated using transwell assays. We used the bioinformatics software StarBase and TargetScan to predict lncRNA-miRNA and miRNA-mRNA interactions.Our findings revealed that LINC00858 expression was markedly upregulated in GC tissues and cell lines. Loss-of-function experiments demonstrated that LINC00858 silencing inhibited the proliferation, migration and invasion of GC cells. Bioinformatics analysis showed that there were several complementary binding sites between LINC00858 and microRNA (miR)-363-3p, and further Luciferase reporter assay confirmed the interaction between LINC00858 and miR-363-3p. In addition, forkhead box P4 protein (FOXP4) was found to be a target gene of miR-363-3p in GC cells. FOXP4 overexpression reversed the inhibitory effects of miR-363-3p mimics on cell proliferation, migration and invasion of BGC-823 cells.Collectively, LINC00858 acted as an oncogene in GC via regulating miR-363-3p/FOXP4 axis, which indicated that LINC00858 might be a novel therapeutic target for the treatment of GC.

Background The implementation of lateral ventricle puncture (LVP) operation is challenging due to the complex anatomy structure of human brains. Surgical simulator has been proved to be effective in surgical training. However, few works consider the integration of visual and haptic feedback. Methods Aim at achieving a realistic haptic interaction, this paper proposes a haptic-based virtual reality (VR) simulator for the LVP operation. In this simulator, we first reconstruct the three-dimension (3D) model of human brains for tissue/instrument interaction. Then a preoperative planning method based on geometry analysis is introduced to find the feasible entry point of LVP operation. A hierarchical bounding-box collision detection approach is proposed to render haptic feedback that is transferred to humans. Finally, a set of experiments on the proposed simulator and 3D printed models of human brains is carried out. Results Two sets of experiments are conducted to evaluate the effectiveness of the proposed haptic-based simulator: experiments in the simulator and experiments on a 3D printed brain model. The proposed simulator allows neurosurgeons to train the LVP operation by visualizing the 3D virtual human brain and feeling realistic haptic feedback. Conclusions We demonstrated that the proposed haptic-based VR simulator can improve the performance of the LVP operation effectively and reduce the operation time.

Severe patients with coronaviras disease 2019 (COVID-19) are characterized by persistent lung damage, causing respiratory failure, secondary circulatory changes and multiple organ dysfunction after virus invasion. Because of its dynamic, real-time, non-invasive, repeatable and other advantages, critical ultrasonography can be widely used in the diagnosis, assessment and guidance of treatment for severe patients. Based on the recommendations of critical care experts from all over the country who fight against the epidemic in Wuhan, this article summarizes the guidelines for the treatment of COVID-19 based on critical ultrasonography, hoping to provide help for the treatment of severe patients. The recommendations mainly cover the following aspects: (1) lung ultrasound in patients with COVID-19 is mainly manifested by thickened and irregular pleural lines, different types of B-lines, shred signs, and other consolidation like dynamic air bronchogram; (2) Echocardiography may show right heart dysfunction, diffuse cardiac function enhancement, stress cardiomyopathy, diffuse cardiac depression and other multiple abnormalities; (3) Critical ultrasonography helps with initiating early treatment in the suspect patient, screening confirmed patients after intensive care unit admission, early assessment of sudden critical events, rapid grading assessment and treatment based on it; (4) Critical ultrasonography helps to quickly screen for the etiology of respiratory failure in patients with COVID-19, make oxygen therapeutic strategy, guide the implementation of lung protective ventilation, graded management and precise off-ventilator; (5) Critical ultrasonography is helpful for assessing the circulatory status of patients with COVID-19, finding chronic cardiopulmonary diseases and guiding extracorporeal membrane oxygenation management; (6) Critical ultrasonography contributes to the management of organs besides based on cardiopulmonary oxygen transport; (7) Critical ultrasonography can help to improve the success of operation; (8) Critical ultrasonography can help to improve the safety and quality of nursing; (9) When performing critical ultrasonography for patients with COVID-19, it needs to implement three-level protection standard, pay attention to disinfect the machine and strictly obey the rules from nosocomial infection. (10) Telemedicine and artificial intelligence centered on critical ultrasonography may help to improve the efficiency of treatment for the patients with COVID-19. In the face of the global spread of the epidemic, all we can do is to share experience, build a defense line, We hope this recommendations can help COVID-19 patients therapy.重症新型冠状病毒肺炎（COVID-19）患者的特点是病毒侵袭后，肺部损害持续加重，引发呼吸衰竭，并发或继发循环改变与多器官功能障碍。重症超声因其动态、实时、无创、可重复等优点，可广泛用于重症患者的病因诊断、病情评估并指导治疗。现以在湖北省武汉市来自全国参与COVID-19救治的重症专家建议为基础，总结出基于重症超声的重症COVID-19救治的指导建议，皆在为救治COVID-19重症患者提供依据。.

Long noncoding RNA (lncRNA) family with sequence similarity 201-member A (FAM201A) is a novel lncRNA promoting the development of various cancers. However, the biological function of FAM201A on the metastasis of lung squamous cell carcinoma (LSCC) remains unknown. The aim of this study was to explore the molecular mechanism of FAM201A and its target protein in advanced LSCC.Quantitative Polymerase Chain Reaction (qPCR) was applied to evaluate FAM201A expression in lung cancer tissues. The impact of high FAM201A expression on the overall survival in patients with lung cancer was tested using the log-rank test. The relevance between aberrant FAM201A and clinicopathological characteristics in patients with lung cancer was analyzed using the Chi-square tests. Cell proliferation was assayed using the Cell Counting Kit-8 (CCK-8) and a transwell assay, and the mice xenograft models were applied to determine the promoting effects of FAM201A on LSCC in vitro and in vivo. The underlying regulatory mechanism was explored through RNA transfection, qPCR, and Western blotting. The correlation between ATP-binding cassette transporter E1 (ABCE1) and FAM201A expression was verified using Spearman's correlation coefficient.FAM201A is aberrantly elevated in tissues from patients with non-small cell lung cancer. High levels of FAM201A expression were more likely to present in patients with squamous type, M1 stage, and inferior overall survival. Differential expression was found between non-metastatic and metastatic squamous carcinoma, but not in adenocarcinoma. FAM201A knockdown inhibits cell proliferation, migration, and invasion of LSCC cells in vitro, and represses tumor growth in vivo. Furthermore, ABCE1 in LSCC cells was downregulated by silencing FAM201A. The tissue level of ABCE1 was positively correlated with FAM201A expression in patients with LSCC.FAM201A may markedly induce migration and invasion of LSCC, resulting in the M1 stage and poor survival. These findings suggest the FAM201A-ABCE1 axis as a novel therapeutic target in LSCC.

Transesophageal echocardiography(TEE) is valuable in intensive care unit (ICU) because its application meets the requirements of diagnosis and treatment of critically ill patients.However, the current application has not fully adapted to the specialty of critical care. TEE could be more valuablein ICU when used with a new way that under the guidance of the theory of critical care and embedded into the treatment workflow. We have expanded and improved the application of traditional TEE and integrated the concept of critical care, established the concept of transesophageal echocardiography for critical care (TEECC). Chinese Critical Ultrasound Study Group (CCUSG) organized experts in the area to form the consensus based the previous studiesand the long term practice of critical care ultrasound and TEE, aiming at clarifying the nature and characteristics of TEECC, promoting the rational and standardized clinical application and the coming researches.The consensus of Chinese experts on clinical application of TEECC (2019) were 33 in total, of whichthe main items were as follows: (1) TEECC is a significant means, which is expanded and improved from the traditional transesophageal echocardiography according to characteristics of critically ill patients and is applied in ICU based on critically clinical scenarios and requirements by the critical care physician, to promote visualized, refined and precisely management of critically ill patients.(2) TEE possesses distinctive superiority in implementation in ICU. It has characteristics of images with good quality, operations with good stability and low-dependent of operators, monitoring with continuity, and visualization with all-dimensional and detail of heart and blood vessels.(3)As a means of refined monitoring that could resulted in precise diagnosis and treatment, TEECC expands the dimension of intensive monitoring and improves the performance of critical care. (4) Indications of TEECC application include clinical etiological searching and invasive procedures guiding when it acted as a traditional role; and also refined hemodynamic monitoring based on critical care rationale and over-all management under specific critical clinical scenarios. (5) TEE and TTE assessments are complementary; they are not alternative. Integrated assessment of TTE and TEE is required under many critical clinical scenarios.(6) TEE should be a necessary configuration in ICU. (7) All-round and significant information regarding to the mechanism of acute circulatory disorders can be provided by TEECC; it is a non-substitutable means of identifying the causes of shock under some special clinical scenarios. (8) Focal extracardiac hematoma can be accurately and rapidly detected by TEE in patients with open-thoracic cardiac surgery or severe chest trauma when highly suspected pericardial tamponade.(9) The priority of pathophysiologic mechanism of septic shock can be rapidly and accurately identified by TEE; even if its pathophysiological changes are complex, including hypovolemia and/or vasospasm and/or left and right heart dysfunction. (10) Causes of hemodynamic disorders can be rapidly and qualitatively evaluated so that the orientation of treatment can be clarified by TEECC. (11) A full range of quantitative indicators for refined hemodynamic management in critically ill patients can be provided by TEECC. (12) TEECC helps to accurately assess volume status and predict fluid responsiveness.(13) TEECC is specially suitable for accurate quantitative assessment of cardiac function.(14) Mini TEE provides long-term continuous hemodynamic monitoring. (15) Standard views are easy to be acquired by TEECC, which is a premise for accurate and repeatable measurements, and a guarantee for assessment of effect and risk of therapy. (16) Compared with invasive hemodynamic monitoring, TEECC is minimally invasive, with low infection risk and high safety.(17) In patients with acute cor pulmonale (ACP) under condition of right ventricular dysfunction and low cardiac output, TEECC is a key tool for assessment. (18) TEECC should be implemented actively when suspicious of left to right shunt in critically ill patients who occurred hypotension that hard to explain the cause. (19) TEECC should be implemented actively when suspicious of right to left shunt in critically ill patients who occurred hypoxemia that hard to explain the cause. (20) TEECC is preferred in hemodynamics monitoring under prone position of ventilated patients.(21) TEECC is an imperative means to achieve over-all management of extracorporeal membrane oxygenation (ECMO) therapy, especially for all-round hemodynamic monitoring. (22) Three basic views is recommended to be used to simplify TEE assessment during cardiac arrest so that reversible causes could be identified, and resuscitation could be guided. (23) The flow related echodynamic evaluation (TEECC-FREE) workflow is preferred in refined hemodynamics monitoring and therapy. (24) Simple workflow of TEECC could be implemented in special critical clinical scenarios. (25) Application of TEECC is highly secure; however, impairments of procedure should also be alert by operators. (26) Pitfalls in application of TEE should be paid attention to by the critical care physician. (27) Timely and rationally application of TEECC is in favor of diagnosis and treatment of critically ill patients and may improve the prognosis.经食管心脏超声（TEE）因其自身的特点和优势，非常适合重症患者诊治的需求而得以在ICU中应用。但由于重症患者诊治的特殊性，目前的应用方式尚未完全适应重症医学的特点，进而限制了其优势的发挥。因此我们结合自己的临床探索实践及国外研究，在重症医学理论指引下，将传统TEE拓展和改进并整合重症医学理念，确立了重症经食管心脏超声（TEECC）的概念，梳理了相关理念与应用规范，制定了《中国重症经食管超声临床应用专家共识（2019）》，旨在阐明TEECC的本质与特点，推动TEECC合理、规范的临床应用，建立规范的TEECC理论体系，引导TEECC实践和临床科研的规范的健康发展，逐步完善TEECC临床应用的理论与实践，提高临床救治水平。.

To identify the main risk factors of human cystic echinococcosis in Shiqu County, Sichuan Province, so as to provide the reference for the formulation of echinococcosis control strategies in Shiqu County.During the period from November 2015 through June 2017, the patients with cystic echinococcosis (case group) and healthy controls (control group) were randomly sampled from Shiqu County as the study subjects. A questionnaire survey was conducted to capture the study subjects'age, gender, ethnicity, occupation, religion, lifestyle, education level, number of household dogs, bovine and sheep, and density of dog feces in the courtyard. The major risk factors of human cystic echinococcosis were identified using a logistic regression model.Univariate logistic regression analysis showed 7 risk factors with statistical significance between the case and control groups, and age, lifestyle, number of household bovine, number of household sheep, number of house-hold dogs, and the density of dog feces in the courtyard were included in the multivariate logistic regression model (High age, pastoral nomadic lifestyle, high number of house-hold bovine, high number of household sheep, high number of household dogs and high density of dog feces in the courtyard are strongly associated with the riks of human cystic echinococcosis in Shiqu County.

OBJECTIVE: To establish predictive models based on random forest and XGBoost machine learning algorithm and to investigate their value in predicting early stone-free rate (SFR) after flexible ureteroscopic lithotripsy (fURL) in patients with renal stones. METHODS: The clinical data of 201 patients with renal stones who underwent fURL were retrospectively investigated. According to the stone-free standard, the patients were divided into stone-free group (SF group) and stone-residual group (SR group). We compared a number of factors including patient age, body mass index (BMI), stone number, stone volume, stone density and hydronephrosis between the two groups. For low calyceal calculi, renal anatomic parameters including infundibular angle (IPA), infundibular width (IW), infundibular length (IL) and pelvic calyceal height (PCH), would be measured. We brought above potential predictive factors into random forest and XGBoost machine learning algorithm respectively to develop two predictive models. The receiver operating characteristic curve (ROC curve) was established in order to test the predictive ability of the model. Clinical data of 71 patients were collected prospectively to validate the predictive models externally. RESULTS: In this study, 201 fURL operations were successfully completed. The one-phase early SFR was 61.2%. We built two predictive models based on random forest and XGBoost machine learning algorithm. The predictive variables’ importance scores were obtained. The area under the ROC curve (AUROC) of the two predictive models for early stone clearance status prediction was 0.77. In the study, 71 test samples were used for external validation. The results showed that the total predictive accuracy, predictive specificity and predictive sensitivity of the random forest and XGBoost models were 75.7%, 82.6%, 60.0%, and 81.4%, 87.0%, 68.0%, respectively. The first four predictive variables in importance were stone volume, mean stone density, maximal stone density and BMI in both random forest and XGBoost predictive models. CONCLUSION: The predictive models based on random forest and XGBoost machine learning algorithm can predict postoperative early stone status after fURL for renal stones accurately, which will facilitate preoperative evaluation and clinical decision-making. Stone volume, mean stone density, maximal stone density and BMI may be the important predictive factors affecting early SFR after fURL for renal stones.

OBJECTIVE: To analyse the clinical and imaging data of patients with renal cell carcinoma (RCC) with inferior vena cava tumor thrombus (IVCTT), and to assess the diagnostic efficacy of ultrasound, enhanced computed tomography (CT) and enhanced magnetic resonance imaging (MRI) in the diagnosis of RCC with IVCTT combined with bland thrombus was assessed. METHODS: We retrospectively analyzed the clinical and imaging data of 56 RCC patients with IVCTT who underwent radical nephrectomy and IVC thrombectomy between January 2014 and July 2018 in Department of Urology, Peking University Third Hospital. All the patients underwent US, enhanced CT and enhanced MRI preoperatively, and all the cases were confirmed with RCC with IVCTT by histological evaluation. RESULTS: The criteria of RCC with IVCTT combined with bland thrombus was confirmed by intraoperative observation and postoperative pathology. The 56 patients were divided into bland thrombus group (n=18) and non bland thrombus group (n=38). Compared the two groups, it was found that the length of IVCTT was longer [(10.50 ± 5.55) cm vs.(6.66 ± 3.73) cm, P=0.014]; the ratio of diameter of IVCTT to maximum coronal diameter of IVC was closer to 1 [1.0 (0.7, 1.0) vs. 0.9 (0.2, 1.0), P=0.004]; the proportion of lower limb edema was higher [66.7(12/8)% vs.5.3%(2/36), P=0.005];the proportion of segmental resection or interrupt of IVC was higher [66.7%(12/18) vs.15.8%(6/38), P

OBJECTIVE: To summarize the experience of diagnosis and surgical treatment of renal oncocytoma, and to evaluate the surgical results based on follow-up results, in order to find the best strategy. METHODS: In the study, 21 cases with renal oncocytoma from December 2003 to April 2016 in Peking University Third Hospital were retrospectively analyzed, including 4 males, and 17 females, with 10 cases on the right side and 11 cases on the left side. Their age was between 15 to 80 years (average: 58 years). Ultrasound or CT examination after admission was conducted. Ultrasound examination showed solid nodules. CT manifestations were solid masses with enhancement, and the tumor size was between 1.5 cm to 6.5 cm (average: 3.3 cm). Of the 21 cases, 9 were located in the middle of kidney, 7 were located in the upper pole, and 5 were located in the lower pole. After preoperative examination, according to the size and location of the tumor, laparoscopic partial nephrectomy or laparoscopic nephrectomy was performed, respectively. RESULTS: All the operations were successful, in which 17 cases underwent laparoscopic partial nephrectomy (including 3 cases which were converted to open surgery), and 4 cases underwent laparoscopic radical nephrectomy. The operation time ranged from 75 to 274 min (mean: 144 min), and the blood loss ranged from 10 to 1 000 mL (mean: 115 mL). The postoperative hospital stay time ranged from 6 to 13 d (average: 8.2 d). The pathological results were all renal oncocytoma. In the study, 17 cases were followed up while 4 cases were lost to follow-up. The follow-up time ranged from 12 to 175 months (mean: 44 months). One case died in 20 months after operation with unknown reason, and there were no recurrence or metastasis in the other 16 cases. CONCLUSION: Renal oncocytoma is a benign tumor with good prognosis. Enhanced CT is an effective diagnostic method in assistant examination, but it is difficult to differentiate clear cell carcinoma only from the naked eye. It is worthwhile to measure CT value at different stages of the tumor by picture archiving and communication systems (PACS), and to compare with CT value of adjacent kidney tissue may improve the diagnostic efficiency of CT. Laparoscopic surgery is an effective treatment for renal oncocytoma. We recommend laparoscopic partial nephrectomy for the patients with renal oncocytoma as the best choice if conditions permit.

OBJECTIVE: To investigate the efficacy of intraoperative cognitive navigation on laparoscopic radical prostatectomy using 3D prostatic models created by U-shaped convolutional neural network (U-net) and reconstructed through Medical Image Interaction Tool Kit (MITK) platform. METHODS: A total of 5 000 pieces of prostate cancer magnetic resonance (MR) imaging discovery sets with manual annotations were used to train a modified U-net, and a set of clinically demand-oriented, stable and efficient full convolutional neural network algorithm was constructed. The MR images were cropped and segmented automatically by using modified U-net, and the segmentation data were automatically reconstructed using MITK platform according to our own protocols. The modeling data were output as STL format, and the prostate models were simultaneously displayed on an android tablet during the operation to help achieving cognitive navigation. RESULTS: Based on original U-net architecture, we established a modified U-net from a 201-case MR imaging training set. The network performance was tested and compared with human segmentations and other segmentation networks by using one certain testing data set. Auto segmentation of multi-structures (such as prostate, prostate tumors, seminal vesicles, rectus, neurovascular bundles and dorsal venous complex) were successfully achieved. Secondary automatic 3D reconstruction had been carried out through MITK platform. During the surgery, 3D models of prostatic area were simultaneously displayed on an android tablet, and the cognitive navigation was successfully achieved. Intra-operation organ visualization demonstrated the structural relationships among the key structures in great detail and the degree of tumor invasion was visualized directly. CONCLUSION: The modified U-net was able to achieve automatic segmentations of important structures of prostate area. Secondary 3D model reconstruction and demonstration could provide intraoperative visualization of vital structures of prostate area, which could help achieve cognitive fusion navigation for surgeons. The application of these techniques could finally reduce positive surgical margin rates, and may improve the efficacy and oncological outcomes of laparoscopic prostatectomy.