Abstract:The mammalian brain is highly plastic. Environmental enrichment（EE） has been widely used as a noninvasive means to enhance brain plasticity. EE extensively improves brain functions，including development，aging，recovery from damages and response to stress stimulations，thereby benefits the treatment of neurodevelopmental disorders，neurodegenerative diseases，stroke and traumatic brain injury，affective disorders and substance addiction. However，EE has largely remained a laboratory phenomenon with little translation to the clinical setting. A critical strategy for the clinical translation of EE is to identify key molecular substrate of effects of EE on brain plasticity.

Abstract:Angiotensin converting enzyme 2（ACE2） is an important member of renin-angiotensin system（RAS） in human body，and its physiological function is mainly to catalyze the conversion of angiotensin （Ang）Ⅱ to Ang-（1-7）. The massive outbreak of the novel coronavirus and its rapid infectious capacity have made it a major public health emergency of global concern. According to statistics，a quarter of the patients have complications，and hypertension is the most common one. The novel coronavirus invades cells by binding to ACE2 on the cell membrane of the human mucosal epithelium and replicates in large numbers inside of cells to produce pneumonia. Its infectivity is strong，and at present，there are still not the definite effective treatment way. In patients with COVID-19，the ACE/Ang Ⅱ/AT1R axis and ACE2/Ang-（1-7）/Mas axis are out of balance. According to our previous study results and the findings from other laboratories，we find that Ang-（1-7） protects cardiopulmonary function，relaxes blood vessels，decreases blood pressure and up-regulates ACE2 expression. Exogenous administration of Ang-（1-7） might not only alleviate and reverse the imbalance of RAS inside of the human body，but also play a supporting and protective role in the pulmonary and cardiovascular systems. Therefore，we speculate that Ang-（1-7） has the potential to treat or relieve the COVID-19 in patients with hypertension.

Abstract:Objective：The epidemiological characteristics of covid-19 in Nanjing were analyzed to provide theoretical reference for the prevention and control of covid-19 in this region. Methods：A total of 93 confirmed cases of covid-19 admitted to the isolation ward of Tangshan Branch of Nanjing Second Hospital（Nanjing Public Health Medical Center）from January 23，2020 to March 8，2020 were collected for epidemiological analysis. Results：Nanjing is the city with the largest number of local COVID-19 confirmed cases in Jiangsu province. The confirmed cases are mainly distributed in the main urban area，with 55% of males，mostly aged 18~45 years old，and the occupations are employees，retirees，and industrial and commercial practitioners are the mainstay，with light and common types accounting for the vast majority，accounting for 97.5% of the total confirmed cases. In the early stage of the epidemic，imports were mainly domestic，of which 37 cases were imported from Hubei epidemic area，accounting for 82% of imported confirmed cases. In the middle of the outbreak，local cases were mainly renewed on the basis of imported cases，and initial control period of local outbreak was from February19 to March 8，2020. The cure rate of local COVID-19 in Nanjing was 100%，and there were no deaths or cases of occupational exposure among medical workers. Conclusion：The confirmed COVID-19 cases in Nanjing are mainly distributed in the main urban and people are generally susceptible，the epidemic situation was in transition from imported to local renewal，and with high cure rate，no deaths and health workers infected were due to occupational exposure.

Abstract:Objective：To investigate the role of Gef26 in Drosophilia primary culture. Methods：Through primary culture of Drosophilia wide type，gef26 mutants and gef266/+；Abl4/+ mutants，the cell shape is observed，and by fluorescent staining of F-actin the distribution of cytoskeleton can be observed. Results：In Drosophila primary culture, wild type muscle cells have normal morphology, and the morphology of muscle cells of the gef26 mutants is obviously abnormal. The gef266/+;Abl4/+ mutants muscle cells have a normal morphology, namely the phenotype of gef26 mutant muscle cells with abnormal morphology rescued by Abelson tyrosine kinase（Abl） mutation. F-actin in wild type muscle cells showed a regular morphology and continuous arrangement, while that in the gef26 mutants muscle cells showed irregular morphology and discontinuous arrangement. Meanwhile, F-actin in gef266/+; Abl4/+ double mutant cells showed a regular morphology and continuous arrangement, that is, the phenotype of gef26 mutant with disordered F-actin arrangement rescued by Abl mutation. Conclusion：Gef26 regulates cell cytoskeleton organization through Abl signaling during muscle cells development.

Abstract:Objective：The aim of the study was to evaluate the risk of arrhythmia induced by periplocin，the main active component of Cortex Periplocae，a traditional Chinese medicine preparation. Methods：In this experiment，isolated tissues（guinea pig papillary muscle and rabbit Purkinje fiber）were treated by 0.3，1.0，or 3.0 μmol/L periplocin to assess the effect on action potential. The following parameters and endpoints were assessed：resting membrane potential（RMP），action potential amplitude（APA），maximal depolarization rate of phase 0（dv/dtmax），action potential duration at 30%，50%，and 90% repolarization（APD30，APD50，and APD90）. Results：As compared to the 0 μmol/L group，periplocin-related significant reduction in APD30，APD50 was observed at guinea pig papillary muscle in the 0.3 or 1.0 μmol/L periplocin. Periplocin-related significant decrease in dv/dtmax was observed at rabbit Purkinje fiber in the 0.3，1.0，or 3.0 μmol/L periplocin. Periplocin-related significant reduction in APA was observed at rabbit Purkinje fiber in the 3.0 μmol/L periplocin. Periplocin-related significant reduction in APD30 was observed at rabbit Purkinje fiber in the 1.0，or 3.0 μmol/L periplocin. Conclusion：Periplocin has the potential to induce arrhythmia.

Abstract:Objective：To construct CDs@Tf fluorescent nanoprobe based on carbon dots，and to explore the material preparation and the potential application in fluorescence imaging of ovarian cancer cells. Methods：Using sodium citrate dihydrate and urea as raw materials，a high efficiency fluorescent carbon dots（CDs）were prepared by solvent-free method at high temperature. The cell cytotoxicity of CDs was determined by MTS assay against HO-8910 ovarian cancer cells and EA.hy926 umbilical vein endothelial cells. Major organs（heart，lung，kidney，liver，spleen） were collected from Kunming mice after 7 days and 21 days of CDs injection via tail vein for histological analysis to evaluate the toxicity of CDs in vivo. Using 1-（3-dimethylaminopropyl）-3-ethylcarbonide diimine hydrochloride（EDC·HCl） and N-hydroxysuccinimide（NHS） as chemical coupling agents，the prepared CDs were covalently combined with transferrin（Tf） to form fluorescent molecular probe CDs@Tf. The probe was characterized and applied to cell imaging. Results：The spherical fluorescent CDs with an average diameter of 3.85 nm were prepared. The CDs exhibited an optimal excitation wavelength of 400 nm and a maximum emission wavelength of 520 nm，and a quantum yield of 93%. The CDs had excellent properties such as high fluorescence intensity and low cytotoxicity. The established CDs@Tf molecular probe could target and identify HO-8910 ovarian cancer cells. Conclusion：A novel targeted fluorescent nanoprobe CDs@Tf with excellent optical performance and low toxicity is successfully constructed，which is helpful for the early screening of ovarian cancer.

Abstract:Objective：To investigate the effect of dimethyloxallyl glycine（DMOG）-containing gelatin methacryloyl（GelMA）hydrogel on promoting osteogenic differentiation in vitro，and the effect of repairing calvarial bone defects in rats in vivo. Methods：After synthesizing GelMA-DMOG hydrogel，the surface characteristics were observed by scanning electron microscope，and its degradation time was detected in vitro. Mouse osteoblast precursor cells MC3T3-E1 were cultured on the surface of GelMA and GelMA-DMOG hydrogel. The cytoskeleton morphology was observed by fluorescence，and its cytotoxicity was detected by CCK-8 assay. After cultured cells in osteogenesis induction medium，alkaline phosphatase（ALP），alizarin red staining and qRT-PCR were used to detect the effect of two kinds of hydrogel on osteogenic differentiation of MC3T3-E1 cells. A rat calvarial bone defect model was constructed. The effects of GelMA and GelMA-DMOG hydrogels on bone defect repair were observed after 4 and 8 weeks. Results：Compared with GelMA hydrogel，there was no significant difference in the pore size，distribution，and degradation time of GelMA-DMOG hydrogel. The two groups of hydrogel had no significant effect on the proliferation of MC3T3-E1 cells. Compared with control group，the GelMA hydrogel cultured group slightly promoted osteogenic differentiation of MC3T3-E1 cells，while the GelMA-DMOG hydrogel cultured group significantly enhanced the osteogenic differentiation and the expression of osteogenesis-related genes，such as Runx2，ALP，and osteocalcin（OCN）. In vivo，compared with control and GelMA group，the GelMA-DMOG hydrogel group has a much better calvarial bone repair effect. Conclusion：The physical and chemical properties of GelMA-DMOG hydrogel are not changed compared to GelMA hydrogel. In vitro and in vivo experiments show that the GelMA-DMOG hydrogel can promote the repair of bone defects，which opens up a new clinical application of bone tissue engineering in the treatment of bone defects.

Abstract:Objective：To observe the effect of periodontitis vaccine adjuvant interleukin-15（IL-15）on the proliferation of B lymphocytes in the mesenteric lymph nodes of SD rats，and explore the possibility of using IL-15 to improve the immune effect of gene vaccine. Methods：SD rats were immunized with nasal spray of the periodontitis gene vaccine pVAX1-HA2-FimA/IL-15（group A），pVAX1-HA2-FimA（group B），and normal saline（group C）. Then mesenteric lymph node B cells were isolated and purified by magnetic bead sorting method，the number of B cells was detected by CCK8 method，the relative expression level of CKs2 gene was detected by RT-qPCR，and the expression level of specific IgA in culture medium was detected by ELISA. Results：The proliferation level of B lymphocytes in group A was higher than those in group B and group C（P < 0.05）. The relative expression level of CKs2 mRNA of B lymphocytes in group A was higher than that in group B，but the difference was not statistically significant（P > 0.05）. The level of specific IgA secreted by B lymphocytes in group A was higher than those in groups B and C（P < 0.05）. Conclusion：IL-15 is an effective gene vaccine adjuvant to promote the proliferation of B cells and increase the expression level of specific IgA antibodies in the periodontitis gene vaccine constructed by our team.

Abstract:Objective：To compare the marginal microleakage and hardness between the SonicFill bulk filling resin and the conventional resin，layer and holistic filling in the cavity of the tooth fossa. Methods：Class Ⅱ cavities were respectively prepared on mesial and distal surfaces of forty molars，rinsing and etching enamel，coated with acid etching binger，and illuminated for 20 seconds. The teeth were randomly divided into two groups，in group A，the cavity on one side was filled with SonicFill bulk filling resin，each layer of 2 mm（A1）；the cavity on the other side was filled wity Neofil filling resin，each layer of 2 mm（A2）；in group B，the cavity on one side was filled by SonicFill bulk filling resin integrally（B1），the cavity on the other side was filled by Neofil filling resin integrally（B2）. The Vickers microhardness of the filling materials was detected. Samples were immersed in a 2% methylene blue solution at 37 ℃ for 24 hours，and cut along axis twice，the thickness of slice was about 1 mm，dye leakage was observed under a stereo microscope. Results：There were statistically significant differences in the Vickers hardness and their ratio among different groups，the order was as follow：B1>A1>A2>B2. The marginal microleakages of group A2 and B2 were significantly higher than those of A1 and B1 group，and the difference was statistically significant（P < 0.05）. Conclusion：Compared with Neofil resin，the overall and layered filling of SonicFill bulk resin filling materials have better edge tightness and hardness.

Abstract:Objective：To investigate the expression level of LINC01106 in glioma tissues and cell lines and explore the potential mechanism through which LINC01106 affect the proliferation and invasion of glioma cells. Methods：The expression level of LINC01106 in glioma tissues was analyzed by The Cancer Genome Atlas（TCGA）database. QRT-PCR was carried out to detect LINC01106 expression level in glioma tissues and cell lines. The small interfering RNA（siRNA）and overexpressed plasmid（OE）of LINC01106 were applied to suppress or increase the expression level of LINC01106 in U87 cell lines，respectively. CCK-8 assay，EdU assay and transwell assay were performed to assess the effect of LINC01106 on the proliferative and invasive ability of U87 cells. Bioinformatics analysis and in vitro cell experiments were conducted to further explore the potential mechanism of LINC01106. Results：Analysis of the TCGA database revealed that the expression level of LINC01106 was remarkably decreased in glioma tissues. Besides，the results of qRT-PCR showed that the expression levels of LINC01106 in glioma tissues and cell lines were significant lower that in normal controls. Repression of LINC01106 in U87 cells markedly promoted the proliferative and invasive capacities of glioma cells，while overespression of LINC01106 exerted the opposite effects. Bioinformatics analysis and double luciferase reporter gene assay revealed that LINC01106 could bind to miR-3167 and inhibit its expression，while miR-3167 might target CBFA2T3，which might be a potential mechanism for the progression of LINC01106 in glioma. Conclusion：LINC01106 is down-regulated in glioma，and inhibition of LINC01106 can promote the proliferation and invasion of glioma cells. LINC01106 might play its role as a tumor suppressor in gliomas by competitively binding to CBFA2T3 with miR-3167.

Abstract:Objective：To investigate the protective effect of aloperin on the apoptosis of human umbilical vein endothelial cells（HUVECs）induced by hypoxia/reoxygenation. Methods：HUVECs were cultured and randomly divided into the control group，the hypoxia/reoxygenation group，the aloperin（20，50 and 100 mg/L）pretreatment group and the aloperin+LY294002 group，and treated accordingly. Cell proliferation and apoptosis were detected by MTT assay and flow cytometry，respectively. Caspase-3 activity was detected by colorimetry，and protein expression of Bax，Bcl-2，Akt and p-Akt were detected by Western blot. Results：Aloperin reversed the decrease of proliferation and increase of apoptosis induced by hypoxia/reoxygenation in human umbilical vein endothelial cells（P < 0.05）. Aloperin alleviated the increase of Caspase-3 activity and Bax expression，and the downregulation of Bcl-2 induced by hypoxia/reoxygenation，and increased Bcl-2/Bax value（P < 0.05）. In addition，aloperin significantly upregulated p-Akt protein expression（P < 0.05），while the anti-apoptosis effect of aloperin against hypoxia/reoxygenation was significantly reversed by PI3K/Akt inhibitor LY294002（P < 0.05）. Conclusion：Aloperin could inhibit hypoxia/reoxygenation-induced apoptosis of HUVEC cells by activating the PI3K/Akt pathway.

Abstract:Objective：To study the correlation between physical fitness indexes and cardiovascular disease（CVD）. Methods：We selected the physical examination data of the male physical examination population（a total of 220 males，of which，baPWV was tested in 142 males）who underwent physical fitness in our hospital from January 2018 to July 2019. Based on the scores of Framingham CVD 10-year risk，the total people were divided into groups with low-risk and middle-high risk；according to the speed of baPWV，the people who completed the test were divided into normal group and fast group. The correlation between physical fitness indexes and CVD 10-year risk，baPWV was analyzed. Results：There were significant differences in age，smoking proportion，cardiorespiratory fitness，body fat percentage，single foot stand time，blood pressure，fasting blood glucose（FBG），glycosylated hemoglobin（HbA1c）and triglyceride（TG）between the middle-high risk group of CVD，baPWV accelerated group and the low risk group of CVD，baPWV normal group（P < 0.01 or P < 0.05）. The middle-high risk of CVD and increased baPWV were correlated with age，body mass index（BMI），cardiorespiratory fitness，body fat percentage，single foot stand time，systolic pressure，diastolic pressure，FBG，HbA1c and TG（P < 0.01 or P < 0.05）. Conclusion：Age，smoking，body fat percentage，blood pressure，FBG，HbA1c and TG are the risk factors of CVD. Cardiorespiratory fitness is the protective factor of CVD，which has a good predictive value for the risk of cardiovascular disease.

Abstract:Objective：To investigate the relationship between blood lipid profiles and non-valvular atrial fibrillation（AF）in elderly in-patients，and to definite whether there exist differences between males and females. Methods：A total of 758 elderly in-patients who met the inclusion criteria hospitalized in the Department of Cardiology，Geriatric Hospital of Nanjing Medical University were included in this study，223 patients with non-valvular atrial fibrillation（AF group），the non-AF patients as control group（n=535），compare the correlation between AF and blood lipid profiles in general patients，male patients and female patients. Results：The general patients with AF had significantly lower levels of total cholesterol（TC），low density lipoprotein cholesterol（LDL-C），triglyceride（TG）than the non-AF patients（P < 0.05）. Regrouping by gender，in male patients，the statistical results of blood lipid profiles were similar to those of the general patients，while in female patients，blood lipid profiles had no significant differences between the AF group and non-AF group. Multivariate logical regression analysis of the blood lipid profiles and AF was processed after constructing multiple models. In the general patients，TC（P=0.012），LDL-C（P=0.017），and TG（P=0.003）were negatively correlated with AF. In the male patients，TC（P=0.006），and LDL-C（P=0.020）were also negatively correlated with AF. According to the values of TC and LDL-C in atherosclerotic risk stratification，we compared the incidence of AF. With the increase of TC and LDL-C concentration，the prevalence of AF in men increased at first and then decreased. The prevalence of AF in the male patients with TC≥5.2 mmol/L was only 0.094（P=0.027）compared with the patients with TC<3.1 mmol/L，and the prevalence with LDL-C≥ 3.4 mmol/L was 0.074（P=0.014）compared with the patients with LDL-C<1.8 mmol/L. Conclusion：Elderly in-patients with non-valvular AF had lower levels of TC，TG and LDL-C. Higher levels of TC and LDL-C were associated with lower prevalence rate of AF only in males. There were no significant differences between the prevalences of AF in women by TC and LDL-C risk stratification.

Abstract:Objective：This study aims to evaluate the prognostic value of both left-ventricular systolic and diastolic dyssynchrony in patients with dilated cardiomyopathy（DCM）. Methods：Seventy-four patients with DCM from the First Affiliated Hospital of Nanjing Medical University were enrolled. The phase analysis technique was applied on resting gated short-axis SPECT MPI images to measure left ventricular systolic dyssynchrony（LVSD）and left ventricular diastolic dyssynchrony（LVDD），including phase standard deviation（PSD），phase histogram bandwidth（PBW），and phase entropy（PE）. Patients were divided into cardiac death group and survivor group according to the follow-up data. The Cox regression analysis was applied to determine independent predictors of major adverse cardiac events. Variables with P < 0.10 in the univariate analysis were included in the multivariate Cox analysis to determine independent predictors of major adverse cardiac events. Results：During the follow-up period，29（39.2%）cardiac deaths were observed. Compared to survivor group，patients with cardiac death had lower left ventricular ejection fraction（LVEF）（P=0.011），and more severe LVSD and LVDD（P < 0.01）. The univariate Cox regression analysis showed that hypertension，NT-proBNP，LVEF，left scar burden，systolic PSD，systolic PBW，systolic PE，diastolic PSD，diastolic PBW，and diastolic PE were statistically significantly associated with cardiac death. The multivariate Cox regression analysis showed that systolic PE and diastolic PE were independent predictive risk factors for cardiac death. Conclusion：Both the LVSD and LVDD parameters from SPECT MPI have important prognostic values for DCM patients. Both systolic PE and diastolic PE are independent prognostic factors for cardiac death.

Abstract:Objective：To investigate the value of two-dimensional speckle tracking imagine（2D-STI）in detecting the early myocardial dysfunction of left ventricular in patients with breast cancer after receiving drug treatment with anthracyclines. Methods：Thirty-two female patients with breast cancer were enrolled in our study. After surgery，all the patients were treated with epirubicin-based chemotherapy，besides，two-dimensional echocardiography was performed within one week before chemotherapy（T0），one week after the end of the third cycle（T1），and one week after the sixth cycle was finished （T2）. Routine echocardiographic parameters including left ventricular end diastolic diameter（LVDd），end systolic diameter（LVDs），interventricular septum thickness at diastole（IVSd），left ventricular posterior wall thickness at diastole（LVPWd），left ventricular ejection fraction（LVEF），mitral valve predilatation and late peak（Em，Am），and mitral annular velocity（e’） were obtained. Two-dimensional images were defined as apical four-chamber，long-axis，two-chamber views，and the papillary muscles and apical left ventricular short-axis from the base. The images were stored for off-linc analysis of 2D speckle-tracking myocardial strain. Global peak longitudinal，circumferential and radial 2D systolic strain（GLS，GCS，GRS）were measured. Another twenty-three healthy female volunteers were collceted as control group. ROC curve was used to evaluate the sensitivity and specificity of each strain parameter to evaluate the early impairment of left ventricular function. Results：①LVDd，LVDs，IVSd，LVPWd，and LVEF showed no significant decrease compared with control group（P＞0.05），while Em/Am，e’，and Em/e’ in T2 were significantly lower than those in T0 and control group，the difference was statistically significant（P＜0.05）. ②GLS in T1 and T2 were significantly lower than those in T0 and control group，the difference was statistically significant（P＜0.05），but there was no statistical significance between T1 and T2（P＞0.05）. The GCS in T2 was significantly lower than that in T0 and contol group（P＜0.05）. The ROC curves showed that GLS as the best predictor. The area under ROC（AUC）of GLS in T1 was 0.832，and its optimal cut-off value was -14.1%，with a sensitivity of 83.4% and specificity of 85.2%，AUC of GLS in T2 was 0.906，and its optimal cut-off value was -13.8%，with a sensitivity of 92.2% and specificity of 83.7%，AUC of GCS in T2 was 0.577，and its optimal cut-off valur wsa -20.5%，with a sensitivity of 63.0% and specificity of 57.4%. Conclusion：GLS was the best indicator of subsequent cardiotoxic events. Therefore，GLS can be used as a sensitive parameter to devaluate subclinical left ventricular myocardial dysfunction in patients with breast cancer after receiving anthracycline therapy.

Abstract:Objective：To investigate the relationship between lipoprotein-associated phospholipase A2（Lp-PLA2）levels and vascular endothelial function and arterial elasticity in type 2 diabetes mellitus（T2DM）patients. Methods：A total of 163 individuals with T2DM who were admitted to the First Affiliated Hospital of Nanjing Medical University were enrolled. Latex scattering immunoturbidimetric assay was used to determine plasma Lp-PLA2 levels. Noninvasive peripheral arterial tone measurement（PAT）was performed to evaluated endothelial function by reative hyperemia index（RHI），and pulse wave velocity（PWV）were used to determine the arterial elasticity. Results：In T2DM patients，the vascular endothelial function index（RHI）gradually decreased with the increase of LP-PLA2 level（r=-0.23，P＜0.01），whereas there is no significant correlation between Lp-PLA2 and PWV（r=0.13，P=0.17）. Further multiple linear regression analysis showed that Lp-PLA2 remained as an independent factor for RHI after adjusting for age，gender，LDL-cholesterol，glycosylated hemoglobin，smoking，and body mass index（β=-0.231，P=0.027）. Conclusion：Plasma Lp-PLA2 may be a suitable surrogate marker for evaluation of vascular endothelial function.

Abstract:Objective：To investigate the correlation between 18F-FDG PET/CT metabolic parameters and pathological factors or clinical stages of primary esophageal lesions. Methods：18F-FDG PET/CT image datasets of 82 patients who underwent 18F-FDG PET/CT scan before radical resection surgery were analyzed. Maximum standardized uptake value（SUVmax），metabolic tumor volume（MTV），and total lesion glycolysis（TLG）of primary esophageal lesions were measured. The correlations of the metabolic parameters with the clinical stages and pathological factors were analyzed，and the diagnostic values of the metabolic parameters were evaluated by receiver operating characteristic（ROC）curve. Results：Primary tumors of 82 patients with esophageal cancers were characterized by high 18F-FDG uptake. There were no significant differences between metabolic parameters（SUVmax，MTV，TLG）and gender or age or tumor sites（all P＞0.05）. The statistically significant differences were observed between MTV or TLG and different pathologic stage（T stage，N stage or TNM stage）（all P＜0.05）. SUVmax was associated with T staging（P < 0.05），but not with pathological grading，N staging or TNM（P > 0.05）. T staging was positively correlated with SUVmax，MTV and TLG，respectively（P < 0.05）. And N staging was positively correlated with MTV and TLG，respectively（P < 0.05）. TNM stages were positively correlated with SUVmax，MTV and TLG（all P < 0.05）. The ROC curve of 18F-FDG PET/CT metabolism parameters for predicting lymph node metastasis showed that MTV and TLG had predictive value for lymph node metastasis. When the cutoff values were 28.35 cm3 and 89.87 respectively，the diagnostic efficiency was the highest，the sensitivities were 60.0% and 70.0%，and the specificities were 71.7% and 67.1%，respectively. Conclusion：The metabolic parameters of 18F-FDG PET/CT，especially TLG and MTV，have a good correlation with the clinico-pathological factors of esophageal cancers. TLG and MTV have certain reference value for lymph node metastasis.

Abstract:Objective：To investigate the relationship between dynamic blood phosphorus level and the severity of sepsis in elderly patients and assess its prognostic value. Methods：Elderly septic patients admitted to the ICU of the Geriatric Hospital Affiliated to Nanjing Medical University from September，2014 to June，2018，who met the inclusion and exclusion criteria，were involved for a retrospective analysis. The general data and the serum phosphorus levels of the patients were collected on the 1st，3rd and 7th days of ICU entry. According to the severity of sepsis，the patients were divided into sepsis group，severe sepsis group and septic shock group. The differences of dynamic blood phosphorus levels among the three groups were evaluated. According to the 28-day prognosis，the patients were divided into survival group and death group，and the difference of dynamic blood phosphorus levels between the two groups was evaluated. The receiver operating characteristic curve（ROC）of APACHE Ⅱ score and serum phosphorus levels on the 1st，3rd and 7th days of ICU entry was used to evaluate the prediction for 28-day prognosis. Results：A total of 104 elderly patients with sepsis were involved in this study. No significant difference in blood phosphorus levels on the 1st day of ICU entry was found among the three groups with different severity of the disease（P > 0.05）. However，the blood phosphorus levels on the 3rd and 7th days in the septic shock group were significantly lower than those in the sepsis and severe sepsis groups（P < 0.05）. There was no significant difference in the blood phosphorus levels on the 1st and 3rd day of ICU entry between the survival group and the death group（P > 0.05），and the blood phosphorus level on the 7th day in the death group was significantly lower than that in the survival group（P < 0.05）. ROC curve showed that APACHE Ⅱ score（AUC=0.679）and blood phosphorus level（AUC=0.641）on the 7th day of ICU entry had higher predictive value for the prognosis of elderly septic patients than the blood phosphorus levels on the 1st day of ICU entry（AUC=0.601）and the 3rd day of ICU entry（AUC=0.616）. Conclusion：Dynamic blood phosphorus level is of some significance in indicating the severity and prognosis of sepsis in elderly patients. The blood phosphorus level on the 7th day of ICU entry has better predictive value in the prognosis of sepsis in elderly patients，which is significantly lower in the death group than in the survival group.

Abstract:Objective：To study and compare the genetic polymorphism difference of Lewis related fucosyltransferase-2（FUT2）and fucosyltransferase-3（FUT3）between LiSu minority and Han population in Yunnan. Methods：A total of 149 random samples were collected from LiSu minority in Yunnan. Samples were analyzed using blood typing serological method for Lewis phenotyping. All samples also undergone direct sequencing method for FUT2 and FUT3，and Chi square test was used for statistical analysis. Results：The frequency of Lewis phenotype in the 149 samples were as followed，Le（a-b+）46.3%，Le（a+b-）34.9%，Le（a-b-）18.7%. One FUT2 sequence sample demonstrated a rare allele G428A mutation that was common in Caucasian，however it was accompanied with A171G，C357T，A385T，and G739A mutation. Seven alleles mutation ponits were found in FUT3 sequencing，and C762A mutation was a new discovery. Besides functional Le allele，halotyping indicated 1 possible functional Le allele Le732（732C>T）and 8 non-functional Le alleles. Statistical analysis showed a significant difference in Se357，se357，385，se385，se357，571，se171，428，739，960，le59，le1067，le508，le59，508，between LiSu minority and Han population（P < 0.05）. Conclusion：Alleles FUT2 and FUT3 of LiSu minority in Yunnan province had a wider range of genetic polymorphism.

Abstract:Objective：To explore the relationship between single nucleotide polymorphisms（SNPs）of LGALS1 gene and susceptibility to common influenza infection types in China. Methods：A case-control study method was adopted. The influenza-positive cases monitored by Center for Disease Control and Prevention of Jiangsu province were the case group，and the influenza-like cases with a negative laboratory nucleic acid test and healthy people from Nanjing Hospital were the control group from 2015 to 2017. Pharyngeal swabs and blood were collected，gene polymorphism sites were detected by nested PCR and gene sequencing，and genotype distribution and frequency differences were compared between the two groups. Results：Rs4820294（G/A） and rs2899292（A/G） of LGALS1 were associated with influenza genetic susceptibility（P < 0.05），rs2899292（A/G）was associated with A（H1N1） susceptibility（P < 0.05），and rs4820294（G/A）was associated with B influenza susceptibility（P < 0.05），respectively. Conclusion：LGALS1 SNP is associated with influenza A（H1N1）and influenza B susceptibility，however，the sample size needs to be further expanded to explore its relationship with seasonal H3N2.

Abstract:Objective：This study aims to analyze susceptibility and homology of clinically isolated carbapenem-resistant Klebsiella pneumoniae（CRKP）from ICU ward. Methods：A total of 171 independent CRKP isolates were collected between March 2018 and September 2018 from the First Affiliated Hospital of Henan University of Science and Technology. The isolates were identified by MALDI-TOF MS，characterized by agar dilution，microdilution methods and multilocus sequence typing（MLST）. Carbapenemase phenotype was confirmed by mCIM and eCIM test. β-lactamases and serotype were detected by polymerase chain reaction and DNA sequencing. Results：There were 68（39.8%，68/171）CRKP isolates in the hospital and 46（67.6%，46/68）isolates of CRKP in ICU. The resistant rate of the 46 isolates to ceftazidime/avibactam，tigecycline，colistin，and minocycline were 0，0，4.3%，and 41.7%. MIC90 of meropenem，imipenem，ceftazidime，chloramphenicol，fosfomycin，and aztreonam were over 128. Sequence type（ST）11（43/46，93.5%）were predominant. K47（60.9%，28/46）was the most common serotype，followed by K64（23.9%，11/46）. The isolates all harbored β-lactamases of blaKPC-2，blaSHV，and blaTEM，and harbored blaCTX-M （40/46，86.96%），blaDHA（6/46，13.04%）. Conclusion：Most CRKP in ICU are ST11，which co-carried blaKPC-2，blaSHV，blaTEM，and blaCTX-M. All isolates showed serious antimicrobial resistance. Nosocomial infection control may be should focus on preventing CRKP transfer in ICU.

Abstract:As the largest microecosystem in human body，intestinal microecology is considered as an organ regulating host metabolism. A large number of microorganisms in the human intestinal tract are known as the gut microbiota，their changes in species composition，quantitative imbalance，the colonization and translocation，as well as their metabolites are closely related to the development of hyperuricemia and gout. This review focuses on the correlation between hyperuricemia，gout and gut microbiota，and further explores the correlation including the mechanism，diagnosis，treatment and other aspects，this will provide new ideas for the clinical diagnosis and treatment of hyperuricemia and gout.

Abstract:Acromioclavicular dislocation is a sizeable portion of shoulder injuries. Acromioclavicular dislocation is more common in young men，which seriously affects the quality of life of patients. Accurate diagnosis and classification of these patients are the keys to choosing an appropriate treatment method. At present，there is still a controversy whether to choose surgery for Rockwood type Ⅲ patients. For patients who need surgical treatment，although there are many surgical treatments for acromioclavicular dislocation，the best surgical treatment is still unclear. Because the traditional rigid fixations restricts the patient’s normal activities and requires a second operation to remove the fixation，finding a better surgical method has always been the focus of research. At present，there are some new technologies such as Endobutton and tendon transplantation repair，which have been proved to have good clinical effects. However，the new technology still needs further research on reducing iatrogenic fractures and resolve the sources of tendon transplantation. To improve clinical efficacy，a reasonable treatment should be chosen according to the degree of injury，injury time and the patient’s functional needs.