Abstract:At present，the world is in the stage of rapid aging population growth，the incidence of cardiac disease increases sharply with the age. Mitochondrial dysfunction is a sign of aging and may be the initial cause of it. In this comment，we discuss mitochondrial dysfunction in the process of cardiac aging and specific measures against the mitochondrial related pathways.

Abstract:Objective：In mouse embryonic stem cells（mESC），proximity labeling technology based on engineered ascorbate peroxidase（APEX2）and mass spectrometry were used to identify nucleolar related proteins. Methods：An APEX2-FBL overexpression stable cell line was constructed，biotin-labeled protein was obtained by APEX2 proximity labeling technology，the biotin-labeled protein was enriche with magnetic beads coated with streptavidin，and then liquid chromatography-tandem mass spectrometry（LC-MS/MS），and bioinformatics analysis was used to screen differential proteins. Results：Highly expressed APEX2-FBL stable cell lines were suuessfully constructed；Western blot results showed that a large number of biotin-labeled proteins were obtained by APEX2 proximity labeling technology；837 differential proteins were identified by mass spectrometry，and the biological processes were mostly related to nucleoli. Conclusion：The use of adjacent biotin labeling technology combined with mass spectrometry is a feasible method to identify nucleolar related proteins.

Abstract:Objective：This study aims to investigate the effects of DNA methylation on germ layer differentiation of Xenopus laevis. Methods：Embryos were treated with 30 μmol/L 5-aza-2’-deoxycytidine（5-AZA-CdR）to inhibit DNA methyltransferase 1（DNMT1）in early embryonic cells，then observe the phenotype. Gastrula embryos were collected and the expression of three germ-layer marker genes was detected via in situ hybridization. To knock down endous DNMT1，the specific DNMT1 antisense oligonucleotide（DNMT1MO）were injected into 2-cell stage embryos，and then the expression of three germ-layer marker genes was detected by in situ hybridization. Results：5-AZA-CdR treatment led to abnormal development of embryos and inhibited the expression of the mesoderm marker gene Xbra. Knockdown of DNMT1 promotes expression of the dorsal mesodermal marker genes GSC and Chordin，and inhibits the expression of the ventral mesoderm marker gene Wnt8. Conclusion：DNA methyltransferase is involved in the regulation of the differentiation of the three germ layers of Xenopus laevis.

Abstract:Objective：This study aims to investigate the expression patterns of lncRNA HAND2-AS1，miRNA hsa-miR-520c-3p and integrin subunit beta 8（ITGB8） in placentas of preeclampsia（PE） patients and the role of HAND2-AS1 played in modulating vascular endothelial cells. Methods：Total 25 placentas of PE patients and 20 placentas of healthy controls were collected to detect the expressing abundance of HAND2-AS1，hsa-miR-520c-3p and ITGB8 using qRT-PCR technology. Proliferation，migration and angiogenesis of human umbilical vein endothelial cell（HUVEC） was detected through cell viability assay，wound healing assay and tube formation assay，respectively，when HAND2-AS1 was overexpressed or knock-down. Also，expression of hsa-miR-520c-3p and ITGB8 was detected using QPCR. Results：Compared with healthy controls，expression of HAND2-AS1 and ITGB8 increased and expression of hsa-miR-520c-3p decreased significantly in placentas of PE patients. In placentas of PE patients，the expression of HAND2-AS1 was negatively correlated with hsa-miR-520c-3p and positively correlated with ITGB8. The proliferation，migration and angiogenesis of HUVEC were impaired，the expression of hsa-miR-520c-3p decreased and the expression of ITGB8 increased when HAND2-AS1 was overexpressed. The result was the opposite when HAND2-AS1 was knocked-down. Conclusion：HAND2-AS1 inhibits proliferation，migration and angiogenesis of vascular endothelial cells，of which potential mechanism may be modulating expression of hsa-miR-520c-3p/ITGB8.

Abstract:Objective：This study aims to explore the predictive value of p16/Ki-67 in the progression of high-risk HPV-positive patients with negative cytology. Methods：One hundred and sixty-eight high-risk HPV-positive women with negative cytology were enrolled from May 2017 to June 2017 in the Department of Gynecology，the First Affiliated Hospital of Nanjing Medical University. Follow up were conducted for a period of 2 years to analyze the relationship between the progression and p16/Ki-67 dual staining. Results：①Outcome：88 cases（52.4%）had regressed，54 cases（32.1%）persisted，26 cases（15.5%）progressed；②Univariate analysis showed that age of patient，HC2 HPV value and high-risk HPV genotyping were not risk factors of the progression（P＞0.05），positive p16/Ki-67 dual staining showed higher rates of progression（P＜0.001）. Multivariable logistic analysis showed that positive p16/Ki-67 dual staining was related to the progression；③55 cases had positive p16/Ki-67 dual staining，19 cases（34.5%）of them progressed；113 cases had negative p16/Ki - 67 dual staining，7 cases（6.2%）of them progressed. There were significant difference in progression between patients with positive p16/Ki-67 dual staining and patients with negative p16/Ki-67 dual staining（P＜0.05）. The sensitivity of p16/Ki-67 in prognosis was 73.1%，the specificity was 74.7%，the positive predictive value was 34.5%，the negative predictive value was 93.8%；④High-risk HPV natural changes：152 patients finished the 2-year follow up. The negative conversion ratio at 6，12，18，24 months for women with negative results of p16/Ki-67 dual staining were higher than those with positive results（P＜0.05）. Conclusion：Positive p16/Ki-67 dual staining result was a risk factor for progression and negative high-risk HPV conversion. P16/Ki-67 dual staining had predictive value for progression and showed good risk stratification for TCT-negative and high-risk HPV-positive women.

Abstract:Objective：This study aims to investigate the clinicopathological features of paraganglioma of the bladder and the expression of succinate dehyrogenase B（SDHB），EPAS1 and Ki-67 in pheochromocytoma of the bladder，and its significance for predicting the clinical malignant behavior. Methods：The clinical and pathological data of 43 patients with cystoparaglioma admitted to our hospital were retrospectively analyzed，and the immunohistochemical tests of SDHB，EPAS1，CgA and Ki-67 were performed on 43 samples，and their significance as indicators for the prediction of malignant paraglioma was analyzed. Results：There were 43 cases of bladder paraganglioma in 19 females and 24 males. Ages 26-81，median age 68. The follow-up time was 2-84 months，with a median follow-up time of 51.3 months. There were 3 deaths，9 cases with postoperative metastasis，and 4 cases with recurrent recurrence without metastasis. The rest had no recurrence or metastasis. Microscopically，the neoplastic cells in 30 patients presented classic nest-like arrangement，with rare nuclear division and necrosis，and supporting cells surrounding the nests of neoplastic cells. SDHB expression was negative（-）in 4 cases，EPAS1 expression was strongly positive（+++）in 14 cases，CgA expression was strongly positive（+++）in 18 cases，and Ki-67 expression was ≥3% in 2 cases. Microscopically，there were 13 cases of malignancy. The tumor cells showed diffuse invasive growth or large nests，and nuclear division was common. Neoplastic necrosis and intrascularly neoplastic thrombus were seen. SDHB expression was negative（-）in 8 cases，EPAS1 expression was strong positive（+++）in 9 cases. There were 10 cases with strong positive CgA（+++） expression，11 cases with Ki-67 ≥3%. Among the SDHB negative tumors，66.7% was malignant，and among the SDHB positive tumors，16.1% was malignant. The difference between the two groups was statistically significant（P < 0.05）. The expression intensity of EPAS1 and CgA and the proportion of Ki-67 ≥3% in SDHB negative tumors were significantly higher than that in SDHB positive tumors. The positive expression rates of EPAS1，CgA and Ki-67 in malignant cystoparaglioma were significantly higher than that in benign cystoparaglioma. Conclusion：The negative rate of SDHB immunohistochemistry in the tissues of malignant cystoganglioma was 66.7%. In the tissues of cystoganglioma with negative SDHB expression，EPAS1 was overexpressed，and the positive expression intensity of EPAS1 was positively correlated with the high expression of CgA and Ki-67. SDHB，EPAS1 and Ki-67 are the biological indicators for the prediction of malignant cystoparaglioma.

Abstract:Objective：This study aimgs to investigate the expression of plasma exosomal miR-1260b in patients with lung adenocarcinoma and its correlation with clinical features. Methods：Exosomes were extracted from the plasma of the patients with lung adenocarcinoma. The size and distribution of exosomes were identified by transmission electron microscopy（TEM），nanoparticle tracking analysis（NTA） and Western blot. qRT-PCR was used to detect the expression of exosomal miR-1260b. Results：Exosomes wre widely present in the plasma of patients with lung adenocarcinoma. Subgroup analysis found that plasma exosomal miR-1260b was highly expressed in> 3 cm compared with ≤ 3 cm group（P=0.010）；Compared with the N0 group，plasma exosomal miR-1260b was increased in the N1（P＜0.05）and N2（P＜0.001）groups；Compared with the spread without air spaces group，plasma exosomal miR-1260b was elevated in the spread through air spaces group（P＜0.001）. Compared with the non-relapse/metastasis group，plasma exosomal miR-1260b was highly expressed in the relapse/metastasis group（P=0.038）. Conclusion：Plasma exosomal miR-1260b is highly expressed in patients with lung adenocarcinoma，and is related to tumor size，stas and recurrence/metastasis. It can be used as a molecular target for the diagnosis and treatment of lung adenocarcinoma patients.

Abstract:Objective：This study aims to investigate the effect of three-dimensional computed tomographic angiograph（3D-CTA）virtual imaging guided the preoperative planning in microsurgical clipping of intracranial aneurysm（IA）. Methods：The clinical data of 198 patients with IA who underwent microsurgical clipping were retrospectively analyzed. All patients received 3D-CTA virtual imaging guided the preoperative planning for the surgical approach，bone window position and size，and compared with three-dimensional digital silhouette angiography（3D-DSA）. The short-term efficacy was evaluated by Glasgow Outcome Scale（GOS），incidence of postoperative chronic subdural hematoma（CSDH） was counted. Results：There were total of 223 aneurysms in 198 patients. 220 aneurysms were found by 3D-CTA，and 3 traffic aneurysms were missed，the coincidence rate with intraoperative detection was 99.55%，and the coincidence rate with 3D-DSA results was 98.65%. Total 192 patients were surgically clamped according to the preoperative planning，and the preoperative 3D-CTA imaging was basically consistent with the intraoperative findings，6 patients（3.03%）were not scheduled for surgery with large intracranial hematoma. The postoperative good prognosis rate was 69.19%，the mortality rate was 4.55%，and the incidence of CSDH was 5.29% during follow-up. Logistic regression analysis showed that the unruptured IA（UIA），subarachnoid hemorrhage（SAH）2~3 grade，CT value of lesions ≥40 HU，the subdural fluid collection（SDFC）diameter ≥5 mm and the SDFC volume ≥15 mL at 7 th day after surgery were independent risk factors for postoperative CSDH（P < 0.05）. Conclusion：3D-CTA imaging can obtain stereoscopic 3D model imaging，which can assist in the positioning of aneurysms and adjacent anatomical relationships，reduce the damage during clipping surgery and may reduce the risk of postoperative CSDH.

Abstract:Objective：This study aims to investigate the relationship between metabolic syndrome，its components and Fuhrman grade，TNM stage in clear cell renal cell carcinoma patients. Methods：From January 2018 to December 2019，clinical data of 153 cases in our department was analyzed retrospectively，including age，gender，smoking，drinking，body mass index，hypertension，hyperglycemia，hyperlipidemia，tumor diameter，Fuhrman grade and TNM stage. The pathological grading system used was Fuhrman grading system with grade Ⅰ and Ⅱ accepted as high differentiation，grade Ⅲ and Ⅳ as poor differentiation. In addition，the TNM classification of 2010 was used，with T1a and T1b recognized as low stage，T2a and T2b as high stage. The differences of measurement data were compared through t tests，while the differences of count data was analyzed by Chi-square tests. Moreover，logistic regression analysis was used to find independent risk factors. Results：Metabolic syndrome was significantly associated with histological grade and stage（P < 0.05）. Hypertension，hyperglycemia and hyperlipidemia were also related to histological grade and stage（P < 0.05）. Multivariate Logistc regression analysis also showed that hypertension，hyperglycemia and hyperlipidemia were associated with tumor pathological grade（P < 0.05），while hyperglycemia and hyperlipidemia were associated with tumor stage（P < 0.05）. Conclusion：Patients with metabolic syndrome were found to have significant higher grade and T stage of clear cell renal carcinoma.

Abstract:Objective：This study aims to analyze the real-world data regarding the effect of catheter ablation and the factors related to recurrence after ablation in elderly patients with atrial fibrillation. Methods：Elderly patients（≥60 years old）with atrial fibrillation receiving catheter ablation from January 2013 to December 2016 in our center were enrolled in this study. Clinical data were collected to confirm efficacy，safety，and recurrence-related factors of atrial fibrillation. Results：A total of 482 patients were eligible and the mean age of them was （66.5±4.7） years old. The study group included 297 males（61.6%）and 185 females（38.4%）. There were 239（49.6%）patients diagnosed with paroxysmal atrial fibrillation，and the remains were persistent atrial fibrillation. There were 4 cases of perioperative complication and all of them were relevant to the venipuncture. The mean follow-up was （20.4±5.6） months. During the follow up，a total of 104（21.6%）patients experienced recurrence. The recurrent group and non-recurrent group were significantly different in left atrial diameter，diabetes，heart failure and CHA2DS2-VASc score（P < 0.05）. There were no significant differences in age，gender，hypertension and other factors between the two groups. Conclusion：Catheter ablation of atrial fibrillation is safe and effective in elderly patients. Enlarged left atrium，and some comorbidities may be associated with recurrence of atrial fibrillation.

Abstract:Objective：This study aims to compare the efficiency of ECG diagnosis with single lead artificial intelligence electrocardiography and with traditional Holter. Methods：A total of 152 patients were randomly selected. After elimination of contraindication，they were required to wear single lead artificial intelligent electrocardiograph and traditional multi-lead electrocardiograph for no less than 22 hours according to the clinical examination requirements. Results：There was no statistical difference between the two groups in the total number of cardiac beats，average heart rate，minimum heart rate，atrial premature beats，ventricular premature beats and atrial tachycardia measured by unpaired t test（P > 0.05）. Conclusion：Single-lead artificial electrocardiograph has the same effect as traditional multi-lead electrocardiograph in the recording and interpretation of heart rate. Single-lead artificial electrocardiograph has advantages of low lost，easy to use，artificial intelligence and so on，and it has important value for screening and diagnosis of arrhythmia.

Abstract:Objective：This stndy aims to investigate the clinical effect of minimally invasive surgical ablation in treatment of atrial fibrillation（AF）. Methods：This study retrospectively analyzed adult patients with AF treated by minimally invasive surgical ablation in the First Affiliated Hospital of Nanjing Medical University. Logistic multivariate regression was used to detect the risk factors. The Kaplan-Meier method was used to perform survival analysis. Cox proportional risk model was used to assess risk factors. Results：A total of 245 patients with AF were included in this study，including 158 males（64.5%）and 87 females（35.5%），with median age 63.0 years. The recurrence rate of AF was 33.9% in 83 cases. Compared with patients without AF recurrence，patients in the AF recurrence group had a larger left atrial［（40.2±5.8）mm vs. 42.3±6.0 mm），P=0.010］ and left ventricular end-diastolic dimension［（46.8±4.6）mm vs. （48.0±4.3）mm，P=0.044］. Cox analysis showed AF type［paroxysmal AF as the control，persistent and long-term AF HR（95%CI）=4.67（2.62~8.32），P < 0.000 1］ and left atvial ［HR（95%CI）=1.05（1.00~1.10） per 1 mm P=0.048］ were independent risk factors for AF recurrence. Conclusion：For patients with AF，minimally invasive surgical ablation is effective，and the risk factors should be paid attention to when formulating surgical ablation strategies before surgery to formulate corresponding protective or preventive measures.

Abstract:Objective：To investigate the efficacy and safety of topiramate in the treatment of essential tremor. Methods：80 patients were collected who were clinically diagnosed as essential tremor in the outpatient and inpatient department of Lianyungang second people’s Hospital from October 2017 to December 2019. Every subject was randomly treated with topiramate or propranolol for 4 weeks. The essential tremor rating assessment scale（TETRAS）score was used before and 4 weeks after treatment to assess the efficacy and adverse effect of drugs were also evaluated. Results：Finally，80 patients were enrolled in the study. After drug treatment，the tremor score in topiramate group was significantly lower than that in propranolol group（P < 0.05）. The total effective rate in topiramate group and propranolol group was respectively 92.50% and 72.50%. The difference about curative effect between the two groups was statistically significant（22.5% vs. 45.0%，P < 0.05）. The adverse effect in topiramate group was significantly less than that in propranolol group（P < 0.05）. Conclusion：Topiramate is an effective and safe drug in the treatment of essential tremor with mild side effects，so it can be used as first choice for essential tremor therapy.

Abstract:Objective：This study aims to explore the relationship between serum uric acid（UA）level as a marker of metabolic syndromes（MS）in physical examination adults. Methods：A total of 58 207（41 707 males and 16 500 females）aged 20~70 years were included who received physical examination in Nanjing from 2012-2016. MS were defined according to the criteria of the Adult Treatment Panel Ⅲ. Multivariate logistic regression analysis was used to estimate the odds ratios（OR）of MS，and multiple linear regression analysis was performed to explore the association between UA and characteristic variables. Results：LDL-C，waist，BMI，blood pressure，fasting glucose，triglycerides and cholesterol were increased with quantile UA（P for trend<0.01）. UA increased with the rise of MS components from 0 through 4 or 5（298.00 μmol/L，312.90 μmol/L，328.70 μmol/L，345.20 μmol/L and 360.20 μmol/L respectively，P < 0.01 for linear trend）. Compared with the first UA quartile（Q1），the multiple logistic regression analysis demonstrated that the risk of MS in those with the third and fourth UA quartiles（Q3，Q4）were 1.18（95%CI：1.06~1.31，P < 0.01）and 1.31（95%CI：1.19~1.44，P < 0.01），respectively. After adjusting for age，sex，waist，systolic blood pressure，diastolic blood pressure，glucose and triglycerides. UA was positively related to waist circumference，body mass index，triglycerides，LDL-C with multiple linear regression analysis. The optimal cutoff point of UA by using receiver operating characteristic（ROC） curve to diagnose MS was 346.5 μmol/L. The sensitivity and specificity were 59.7% and 62.6%，respectively. Conclusion：The component number of MS in health examination population has a certain correlation with the level of UA. Higher UA level is associated with higher incidence of MS.

Abstract:Objective：Effects of statin for reducing mortality is controversial in individuals aged 75 years or older. We undertook this study to investigate whether there is an association between statin therapy and the risk of mortality in patients over the 75 years with type 2 diabetes mellitus （T2DM）. Methods：The present study was conducted using the data taken from the Staged Diabetes Targeting Management Study（SDTM），which was started since 2010. A total of 4 285 diabetic patients were enrolled in the SDTM study until September 2017. There were 172 T2DM patients dead for the final analysis. There were 165 age and gender-matched individuals who remained survival during the median follow-up of 7.4 years selected as controls. Details on personal information，history of disease and use of medications were obtained through interviews by the nurses. Results：Logistic regression results showed that there was no statistically significant association between statin and mortality in the total population. After adjusting for age and gender，statins did not reduce the overall risk of death in patients with type 2 diabetes（OR 0.61，95%CI 0.36~1.01）. Further stratified analysis was carried out according to gender，CHD disease history and LDL-c levels. Statin use was associated with a reduced risk of death in female. Odds ratio and 95% confidence interval was 0.538 and（0.256~1.131），respectively. After further adjustment for age，gender and all potential confounders，OR（95%CI） was 0.36（0.15~0.85），P < 0.05. Conclusion：Statin use did not significantly reduce the risk of death in old people with T2DM. However，statin use may reduce the risk of death in women because of hormonal effects.

Abstract:Objective：This study aims to compare the adverse pregnancy outcomes of advanced maternal age women in different age groups and explore the association between age and adverse pregnancy outcomes. Methods：A total of 1 342 women of advanced maternal age from January 2019 to July 2019 in Women’s Hospital of Nanjing Medical University were enrolled in this study. All the women were divided into four groups according to different age using quartiles，the 35~＜36 years group，36~＜37 years group，37~＜39 years group and ≥39 years group. The 35~＜36 years group was taken as the reference group. Comparisons of adverse pregnancy outcomes incidence between another three groups and the reference group were performed. Results：The comparsions of gravidity，parity and conception ways showed no significances among four groups. The incidence of gestational diabetes，placenta previa and cesarean delivery increased with age（P < 0.05）. Conclusion：The incidence of multiple adverse pregnancy outcomes generally increased with age，which is more significant in wowen with ≥39 years old

Abstract:Objective：This study aims to investigate the risk factors of pulmonary hypertension in neonates. Methods：From January 2017 to December 2019，41 neonates with pulmonary hypertension admitted to the neonatal ward of the First Affiliated Hospital of Nanjing Medical University were collected and divided into preterm neonate group and full-term neonate group according to their gestational ages. The relationship between pulmonary hypertension and high risk factors such as primary disease and maternal high risk factors during pregnancy were analyzed retrospectively. Results：During the indicated three years，1 992 premature infants and 3 394 full-term infants were collected. Among them，23 premature（1.15%） and 18 full-term infants（0.53%） with pulmonary hypertension were included. There were significant differences in birth weight and gestational age between the two groups（P < 0.05）. No statistical differences in maternal age，gender，mode of delivery，twin or multiple births，and Apgar scores between the two groups（P > 0.05）. The incidences of premature rupture of membranes，placental abruption，chorioamnionitis and eclampsia in preterm group were higher than those in full-term group（P < 0.05）. The differences were statistically significant in the incidences of gestational diabetes mellitus between the two groups（5 cases in full-term group vs. 1 case in preterm group，χ2=4.437，P=0.035）. Compared with the full-term group，the major primary disease of preterm group was respiratory distress syndrome（χ2=19.158，P＜0.001），pulmonary hemorrhage（χ2=4.433，P=0.035）and intracranial hemorrhage（χ2=8.715，P=0.003），respectively. The primary disease in full-term group was mainly congenital heart disease（ventricular septal defect）（χ2=10.786，P=0.001）. There was a high occurence rate of neonatal pneumonia in both groups，but no statistical difference was shown（χ2=0.327，P > 0.05）. There were no statistical differences in metabolic acidosis，neonatal hypoglycemia，pneumothorax and septicemia between the two groups（P > 0.05）. In preterm group，21 cases were cured and 2 cases died. 15 cases were cured and 3 cases died in full-term group. No statistical difference was found in treatment effect between the two groups（P > 0.05）. Conclusion：The high-risk primary diseases of pulmonary hypertension in premature infants included respiratory distress syndrome，severe pneumonia，pulmonary hemorrhage，premature rupture of membranes and placental abruption. For full-term infants with congenital heart disease such as ventricular septal defect，timely diagnosis and treatment against pulmonary hypertension should be paid more attentions.

Abstract:Objective：This study aims to investigate the risk factors of urethral fistula after Onlay-island flap urethroplasty for middle hypospadias. Methods：We conducted a retrospective and contrastive analysis which contained patients（n=207）receiving Onlay-island flap urethroplasty for hypospadias from March 2017 to June 2019，in the urology department of Nanjing Children’s Hospital Affiliattd of Nanjing Medical University. The data collected included the age，weight，surgeon，operation time，position of urethral opening，length of urethral defect，straightening method and anesthesia method（general anesthesia，general anesthesia combined with Caudal anesthesia）. The possible risk factors of complications were analyzed by single and multiple factors. Results：A total of 267 cases of children conform to the study. The median age was 19 months（5~132 months）. The mean operation time was 87.19 min and weight was 13.33 kg. By univariate analysis，we found that the operative age（P=0.123），weight（P=0.155）and defect distance（P=0.096）were not related to the occurrence of urethral fistula after hypospadias. Similarly，the incidence of urethral fistula in children receiving sacral anesthesia was not significantly different from receiving general anesthesia alone（29.7% vs. 25.8%，P=0.953）. While the operative time（P=0.010），surgeon （P=0.001）and straighting method（P=0.003） affect it.However，Based on the univariate results，we conducted further multivariate analysis and found that experience of surgeons（P=0.031）plays a key role in urinary fistula. Conclusion：The occurrence of urethral fistula after operation of hypospadias has nothing to do with anesthesia technique，age at operation，weight，straightening method and operation time. but has related to surgeon.

Abstract:Objective：This study aims to evaluate the effectiveness and safety of orbital implantation after using medical glue to bond the sclera to the anterior surface of the hydroxyapatite prosthetic implant. Methods：Total 16 patients underwent stage Ⅰ or stage Ⅱ artificial orbital implantation using medical glue were followed up for long-term observations of postoperative complications，eye appearance，and eye socket fullness. The mobility of the prosthetic implant was measured，and the patient satisfaction was questionnaire. Results：All patients had stage Ⅰ healing without postoperative complications such as prosthetic ocular exposure. After wearing the prosthetic tablets，the eye sockets were full，the appearance was natural and realistic，and the eyes were basically symmetrical. And 71.9% of patients had good prosthetic implant mobility，81.3% of patients were satisfied with their appearance，and 75.0% of patients felt comfortable wearing prosthetic tablets. Conclusion：The surgical method of using medical glue to bond the sclera and the front surface of the hydroxyapatite prosthetic implant can simplify the operation and reduce the exposure risk of the artificial orbital implantation. After surgery，good prosthetic orbital implantation mobility and patient satisfaction can be obtained.

Abstract:Objective：This study was designed to assess whether inflation of the endobronchial cuff before lateral positioning would further secure a double-lumen endobronchial tube（DLT）and reduce movement. Methods：Sixty adult patients requiring one-lung ventilation were randomly enrolled into either the endobronchial cuff-inflated group（Group A）or the deflated group（Group B） during lateral positioning. Patients were intubated with a DLT under general anesthesia. Intubation depth was recorded. After the DLT was successfully intubated，the bronchial cuff was inflated in group A while the cuff was not inflated in group B when the lateral position was placed. Location of the double lumen was observed by fiberoptic bronchoscopy in the supine and the lateral position. The incidence and distance of the double lumen displacement in the two groups were recorded（defined as the distance from the tip of the trachea cavity of the double lumen to the trachea carina）. Results：A total of 28 patients（46.7%）in the two groups underwent double lumen displacement after lateral decubitus placement，including 10 patients in group A（33.3%）and 18 patients in group B（60.0%）. There were sigrificant differences between group A and group B （P=0.04）. The displacement distances of the two groups were （9.2±1.7） mm and （9.0±1.9） mm，respectively，with no significant difference（P > 0.05）. Conclusion：When placing the lateral position in thoracic surgery，the DLT is prone to displacement. Inflation of endobronchial cuff can significantly decrease the incidence of displacement of the DLT during lateral positioning.

Abstract:Objective：This study aims to investigate the correlation between the metabolic parameters of 18F-FDG PET/CT and the expression of neuroendocrine markers（Syn，CgA，CD56），TTF-1 and Ki-67，and the value of prognosis in small cell lung cancer（SCLC）. Methods：The immunohistochemical data and 18F-FDG PET/CT data of 96 SCLC cases confirmed by pathology were retrospectively analyzed，the cases collected from January 2009 to May 2017 in the First Affiliated Hospital of Nanjing Medical University. Results：The median of primary lesion maximum standardized uptake value（PSUVmax），whole body lesion metabolic tumor volume（WBMTV）and whole body lesion glycolysis（WBTLG）in 96 SCLC patients were 10.30（1.20~42.90）、108.44（0.41~710.40）cm3、585.73（1.30~10 668.50）；the values of PSUVmax，WBMTV and WBTLG had statistically significant differences between the negative and positive groups of TTF-1（Z=-3.063，-2.235，-2.538，P=0.002，0.025，0.011）. The Spearman correlation analysis shows that there was a positive correlation between PSUVmax and Ki-67 expression（r=0.620，P < 0.001）. Kaplan-Meier single factor analysis shows the expression of TTF-1 and CD56，WBMTV，WBTLG was significantly correlated with overall survival（HR：0.477，0.090，2.862，2.795，all P < 0.05）. Multivariate survival analysis showed that CD56 and WBMTV were independent prognostic factors of overall survival（OS）. Conclusion：The metabolic parameters of 18F-FDG PET/CT in SCLC had a good correlation with the expressions of TTF-1 and Ki-67，and no correlation with neuroendocrine markers. CD56 and WBMTV were the independent prognostic factors of OS.

Abstract:Objective：To explore the value of autogenous arteriovenous fistula（AVF）stenosis assessed by ultrahigh frequency（UHF）ultrasound combined with B-Flow for insufficient flow in hemodialysis patients. Methods：From November 2017 to May 2020，a total of 114 hemodialysis patients with AVF stenosis in our hospital were selected for a retrospective study. UHF ultrasound combined with B-Flow examination was performed to observe and to detect the residual inner diameter，peak systolic velocity（PSV），peak systolic velocity ratio（PSVR）and blood flow of the fistula stenosis. After correlation analysis，the diagnostic efficacy was analyzed by receiver operating characteristic（ROC）curve. Results：The ultrasonography of AVF stenosis showed that the inner diameter of the dialysis access reduced，the blood flow bundle became thinner，and the flow velocity increased. The inner diameter of the fistula stenosis was positively correlated with the blood flow（r=0.761，P < 0.000 1）. There was no correlation between the PSV of the stenosis and the blood flow. The PSVR of the stenosis was negatively correlated with the blood flow（r=-0.457，P < 0.000 1）. The correlation coefficient between the residual inner diameter and the blood flow was greater than that between the PSVR and the flow（Z=3.762 7，P=0.000 2）. The area under curve（AUC）of the residual inner diameter of the fistula stenosis for diagnosing insufficient blood flow was 0.880（95%CI=0.809~0.936，P < 0.000 1），the optimal cut-off value was 1.0 mm，the sensitivity was 82.22% and the specificity was 84.06%. The AUC of PSVR of the fistula stenosis for diagnosing insufficient blood flow was 0.767（95%CI=0.678~0.841，P < 0.000 1），the optimal cut-off value was 4.9，the sensitivity was 73.33% and the specificity was 72.46%. The AUC of the residual inner diameter of the fistula stenosis for diagnosing insufficient blood flow was significantly greater than that of PSVR（P=0.008 2）. The AUC of combined diagnosis for insufficient blood flow was 0.883（95%CI=0.809~0.936，P < 0.000 1），which was significantly greater than the AUC of PSVR of the fistula stenosis for diagnosing insufficient blood flow（P=0.0017）. Conclusion：The residual inner diameter is more effective than PSVR in diagnosing insufficient blood flow，which can be used as an efficient method to provide guidance for early clinical interference.

Abstract:Objective：This study aims to observe the effect of curcumin on the biological behavior of rat bone marrow mesenchymal stem cells（rBMSC）. Methods：Complete medium containing curcumin with different concentration gradient was co-cultured with rBMSC. Cell proliferation was detected by CCK-8 method to determine the optimal concentration of curcumin solution. rBMSC were co-incubated with 4 μg/mL curcumin and treated with 0 μg/mL curcumin as control group. The early osteogenic differentiation of rBMSC was evaluated by ALP staining and activity detection. Alizarin red staining was used to evaluate the mineralization of extracellular matrix in late osteoblast differentiation. Real-time fluorescence quantitative reverse transcription PCR was used to detect the expression of bone morphogenetic protein-2（Bmp2），core binding factor alphal 1（Runx2），osteocalcin（Ocn），osteopontin（Opn），and osteo-specific gene（Osterix，Osx）after 7 and 14 days of osteogenesis induction. Results：CCK-8 results showed that rBMSC in culture medium containing curcumin of different concentrations could proliferate continuously，and the promotion effect of 4 μg/mL curcumin on rBMSC was the most significant（compared with the control group，P < 0.001）. ALP activity in curcumin group was higher than that in control group（P < 0.001）. The results of alizarin red staining showed that the extracellular matrix level of curcumin group was higher than that of the control group. The expression of Bmp2，Runx2，Ocn，Opn and Osx in the curcumin group was higher than that in the control group（P < 0.05）. Conclusion：Curcumin can promote the proliferation and osteogenic differentiation of rat bone marrow mesenchymal stem cells in vitro.

Abstract:Malnutrition is the most common complication of inflammatory bowel disease. Long - term malnutrition could lead to serious outcome and increase the burden of the patient. Individual diet and nutritional support are the main ways to improve malnutrition. Diet may be a potential inducement of the disease. Because the types of diet were complex，so the effect of diet on the disease has not been clear. Nutritional support therapy has become an important treatment for induction and maintenance of remission. In recent years，significant progresses have been made in support methods at home and abroad. Therefore，this review summarized the nutrition risk screening，diet management，nutritional support and nutrient selection，aiming to improve Crohn’s disease nutrition therapy.

Abstract:Primary central nervous system lymphoma（PCNSL）is a rare and and aggressive extranodal non-Hodgkin lymphoma（NHL），which is usually confined to the brain，eyes，spinal cord or leptomeninges without systemic involvement. The diagnosis，treatment and prognosis of PCNSL are different from other types of NHL. Traditional treatment methods，such as surgery，whole brain radiotherapy，chemotherapy based on high dose methotrexate and rituximab，can leads to high initial response rate，but the duration of response is short，the recurrence rate is high，the neurotoxicity are large，and the overall survival period is poor. In addition，the effect of traditional treatment for recurrent/refractory PCNSL patients is not satisfactory，so it is urgent to find a more effective and longer lasting treatment. At present，with the development of the research on the molecular mechanism and the immunotherapies，novel treatments，including Burton tyrosine kinase（BTK）inhibitors，programmed cell death protein 1（PD-1）inhibitors and immunomodulators，bring new light to PCNSL patients.

Abstract:At present，the prevalence of polycystic ovary syndrome（PCOS）is as high as 5%~10% among women of childbearing age. PCOS is characterized by high clinical heterogeneity and unclear pathogenesis. Most studies suggest that PCOS is a multi-gene-regulated，multi-factor-induced disease with abnormal metabolism of glucose，lipid and steroid hormone. In recent years，more and more experts have proposed that PCOS may have different types. Gut microbiota，as a hot research topic in recent years，is associated with disorders of glucose，lipid and steroid hormone metabolism. The relationship between gut microbiota and the pathogenesis of polycystic ovary syndrome is particularly important. This article reviews the possible relationship between gut microbiota and polycystic ovary syndrome.