Abstract:Polygenic risk score predicts cancer risk by integrating the effects of multiple susceptibility loci，which has potential application in the screening of high-risk population. In recent years，the construction method and application of polygenic risk score have been further improved and expanded. This paper reviews the most up-to-date advances in the application of polygenic risk score to the risk prediction of cancer，and summarizes the prospects and challenges.

Abstract:After the completion of the severe acute respiratory syndrome coronavirus-2 （SARS-CoV-2） isolation，culture and genome sequencing，the diagnosis of new coronavirus pneumonia mainly depends on the detection of the SARS-CoV-2 nucleic acid by RT-PCR. In addition，the new room temperature nucleic acid amplification technologies such as recombinase aided amplification（RAA）have been further applied in lab detection. Immunological diagnosis includes colloidal gold and IgM/IgG antibody detection by ELISA technology，which is used for screening and auxiliary diagnosis of the population. New diagnostic technologies based on CRISPR are also in the process of further improvement.

Abstract:Objective：To retrospectively analyze the changes of related laboratory indexes at first admission in patients with coronavirus disease 2019（COVID-19），so as to provide laboratory reference for early clinical diagnosis and treatment. Methods：The laboratory examination indexes，including blood routine，biochemical indexes，inflammatory markers，coagulation function，and lymphocyte subsets count were selected and analyzed at first admission in 91 patients with COVID-19 and admitted to Nanjing Public Health Medical Center. Results：The total white blood cells and the lymphocytes counts in the routine blood examination were decreased in 21.98% and 17.58% of patients，respectively. In biochemical indexes，ALT，AST，and LDH were elevated in 13.19%，14.29%，and 36.67% of patients，respectively； the proportions of patients with elevated phosphocreatine kinase in myocardial enzyme examination were 18.37% in male and 9.75% in female，and creatine kinase isoenzyme，myoglobin，and troponin I were elevated in 5.68%，6.82%，and 19.32% of patients，respectively. The level of inflammatory index procalcitonin was generally normal，while the level of C-reactive protein was increased. There were no obvious abnormalities in the indexes of coagulation function and fibrinolysis. The proportions of patients with normal CD3+T，CD4+T，CD8+T，CD16/56+NK cells，and CD19+B cells were 62.07%，60.92%，65.51%，73.26%，and 95.35%，respectively，and reduced in 32.18%，34.48%，27.59%，24.42%，and 4.65% of patients，respectively. Conclusion：Some laboratory indexes of patients with COVID-19 showed characteristic changes at first admission，which can provide preliminary clinical judgment，comprehensive assessment of the patient’s condition，and provide important reference based on nucleic acid detection.

Abstract:Objective：To investigate the first chest high resolution CT（HRCT）imaging manifestations of corona virus disease 2019（COVID-19）and its pathological basis. Methods：A retrospective analysis of the first chest HRCT images of 61 patients with COVID-19 clinically diagnosed in Nanjing from January 25 to February 18，2020. Lesion distribution，number，location and morphology were analyzed. Results：Lesions were found in the first HRCT of 61 patients，with bilateral lung distribution in 55 cases（90.1%），unilateral lung distribution in 6 cases（9.9%），left lung distribution 2 cases（3.3%）and right lung distribution 4 cases（6.6%）；subpleural distribution of lung in 36 cases（59.0%），25 cases（41.0%）were found subpleural and central distribution at the same time；4 cases（6.6%）got one lesion，57 cases（93.4%）got two and more lesions；ground-glass lesions appeared in 56 cases（91.8%），solid lesions in 5 cases（8.2%），cord-like lesions in 3 cases（4.9%），coexisting lesions of two or more forms in 9 cases（14.8%）；air bronchogram in 35 cases（57.4%），refined net sign in 38 cases（62.3%），paving stone sign in 32 cases（52.5%），halo sign in 6 cases（9.8%）；thickening of blood vessels in 32 cases（52.4%）；5 cases（8.2%）with pleural effusion，3 cases（4.9%）with pericardial effusion，3 cases（4.9%）with enlarged mediastinal lymph nodes；and 7 cases（11.5%）had pleural thickening. Conclusion：HRCT is preferred imaging method of COVID-19. The first chest HRCT manifestations have certain characteristics. Therefore，it could help the early diagnosis of COVID-19 based on epidemiology，clinical manifestations，and nucleic acid testing.

Abstract:Objective：To identify and analyze the elongation factor Tu GTP-binding domain-containing 2（EFTUD2）promoter region for the further study of the gene in transcriptional control and expression. Methods：The EFTUD2 gene structure and potential promoter regions were analyzed by bioinformatics methods，and based on which four EFTUD2 promoter sequences were predicted. Whole-genome synthesis technology and high-fidelity PCR amplification were used to obtain the target promoter sequence. The target band was cloned into the dual luciferase reporter vector psiCHECK-2 by BglⅡ and NheⅠ double digestion，and four different EFTUD2 gene promoter luciferase reporter recombinants covering about 2 kb upstream of the EFTUD2 gene transcription initiation site were obtained. Luciferase assay was used to detect promoter activity. Results：Luciferase reporter assays demonstrated that，compared with the control group，the relative luciferase activity of the EFTUD2-0.5 recombinant increased（P < 0.05），suggesting that the EFTUD2 core promoter may be located in a region of 500 bp near the transcription initiation site. Conclusion：It was identified that the 500 bp upstream of the EFTUD2 gene transcription initiation site has promoter activity，and it is speculated that its core promoter is located in this region.

Abstract:Objective：This study used mendelian randomization method to explore the relationship between telomere length and esophageal cancer，and to provide a theoretical basis for the prevention and treatment of esophageal cancer. Methods：Our study was based on previous esophageal cancer genome-wide association studies（GWAS）data（1 877 esophageal cancer patients and 2 084 controls），and nine telomere length-related single nucleotide polymorphisms（SNPs）reaching genome-wide association significant level were systematically selected as instrumental variables. Genetic risk score（GRS）and the inverse-variance weighting method（IVW）were applied to estimate the causal effect of telomere length on esophageal cancer risk. In addition，a stratified analysis based on age and gender was conducted to explore whether there was interaction between variables. Results：MR analyses indicated that both GRS and IVW methods suggested that there is no significant risk signal between genetically increased telomere length and esophageal cancer risk（GRS：OR=1.19，95%CI：0.81-1.77，P=0.380；IVW：OR=1.22，95%CI：0.81-1.84，P=0.380）. Subgroup analysis revealed significant heterogeneity between different gender. Conclusion：The study has not found a significant association between telomere length and the risk of esophageal cancer.

Abstract:Objective：To investigate the effects of human sperm-associated antigen 5（SPAG5）on proliferation and invasion of breast cancer cells and its molecular mechanism. Methods：The recombinant SPAG5 knockdown/overexpression plasmids siRNA-SPAG5/OE-SPAG5 were designed and constructed respectively transfected with the lentivirus transfection system to prepare stable cell lines. CCK-8 proliferation assay and nude mouse transplantation tumor experimentwere used to detect the proliferation of breast cancer cells.Transwell experiment was used to detect the migration and invasion ability of breast cancer cells.Changes of JAK2/STAT3 pathway and downstream proteins were detected by qRT-PCR and Western blot.The JAK2/STAT3 pathway was inhibited by WP1066 to detect changes in cell proliferation and invasion. Results：The mRNA and protein levels of the SPAG5 in the si1-MDA-MB-231 group were significantly lower than those in the control group，and the mRNA and protein levels of the SPAG5 in the OE-MCF-12A were significantly higher than those in the control group（P < 0.05）. Compared with the control group，the proliferation，migration and invasion ability of the si1-MDA-MB-231 group was inhibited，while these abilities in the OE-MCF-12A group were enhanced（P < 0.05）. Phosphorylation level and downstream protein expression level of JAK2/STAT3 pathway in si1-MDA-MB-231 group were inhibited（P < 0.05），while phosphorylation level and downstream protein expression level of JAK2/STAT3 pathway in OE-MCF-12A group were increased（P < 0.05）. Conclusion：SPAG5 promotes the proliferation and invasion of breast cancer cells through the JAK2/STAT3 signaling pathway

Abstract:Objective：To explore the role and mechanism of piperlongumine in high calcium/phosphate-induced calcification of aortic valve interstitial cells（AVICs）. Methods：Porcine AVICs were isolated and cultured in vitro. AVICs were treated inductively with high calcium/phosphate medium and piperlongumine of different concentrations for 16 hours. Flow cytometry was then performed to measure cell apoptosis. AVICs were treated with 2.5 mmol/L piperlongumine or 100 ng/mL bone morphogenetic protein 2（BMP2）under the condition of high calcium/phosphate. The effect of piperlongumine on calcification was measured using calcium quantification，alkaline phosphatase activity and alizarin red staining. The protein and mRNA levels of osteogenic markers were determined by Western blot and real-time PCR. Results：①Flow cytometry showed that piperlongumine under 5 mmol/L had no obvious effect on AVICs apoptosis treated with high calcium/phosphate medium. ②Calcium quantification，alkaline phosphatase activity and alizarin red staining showed that 2.5 mmol/L piperlongumine attenuated the calcification of AVICs induced by high calcium/phosphate medium. ③Western blot，real-time PCR showed that 2.5 mmol/L piperlongumine inhibited the protein and mRNA expression of osteogenic markers including BMP2，phosphorylated Smad1/5 and RUNX2. ④Exogenous recombinant BMP2 may reverse the effect of piperlongumine in vitro. Conclusion：Piperlongumine attenuates high calcium/phosphate-induced AVICs calcification by inhibiting BMP2/pSmad1/5 signaling.

Abstract:Objective：To study the protective effect and possible mechanism of silibinin on cell damage of SH-SY5Y induced by hydrogen peroxide（H2O2）. Methods：SH-SY5Y cell damage model was established by H2O2 in vitro. After pretreatment with silibinin，the cell viability was determined by MTT，reactive oxygen species（ROS），apoptosis and mitochondrial membrane potential（MMP）were determined by flow cytometry，and the expressions of Cleaved-Caspase-9 and Cleaved-Caspase-3 were detected by Western blot. Results：Compared to the model group，pretreatment with 50 μmol/L and 100 μmol/L silibinin for 3 h attenuated the damage of SH-SY5Y cells treated with H2O2，improved the cell survival rate（P＜0.05），reduced the apoptosis rates（P＜0.05）and the release of ROS，stabilized MMP（P＜0.01），decreased the expression of Cleaved-Caspase-9 and Cleaved-Caspase-3. Conclusion：Silibinin can protect SH-SY5Y cell from H2O2，which may be related to its antioxidant capacity，protection of mitochondrial membrane potential，and reduction of the expression of Cleaved-Caspase-9 and Cleaved-Caspase-3.

Abstract:Objective：To investigate the improvement of cartilage damage and immunomodulatory effects of osthole on type Ⅱ collagen-induced arthritis rats. Methods：A rheumatoid arthritis rat model was inducd by bovine type Ⅱ collagen. Osthole was administered by intragastric injection one week after the modeling was established. The paw volume of each group and the arthritis index were evaluated every 4 days. After 30 days，the spleen index and thymus index were determined by weighing method. Cartilage damage was observed by HE staining. The levels of IL-1β，IL-6 and TNF-α in peripheral blood were measured by ELISA. The expressions of MMP-1，MMP-3 and MMP-13 mRNA were determined by qRT-PCR. The levels of Ki67，PCNA，Caspase-3，Caspase-9，MMP-1，MMP-3，MMP-13，Wnt 1，β-catenin and LRP5 were detected by Western blot. Results：Compared with the model group，the paw volume，arthritis score，spleen index and thymus index of the osthole treated group were decreased，the degree of chondrocyte arrangement disorder and inflammatory cells were reduced，the expressions of Ki67 and PCNA were up-regulated，and Caspase-3 and Caspase-9 were down-regulated，the contents of IL-1β，IL-6 and TNF-α were decreased，the expressions of MMP-1，MMP-3，MMP-13，Wnt 1，β-catenin and LRP5 were down-regulated，and the effects were greatest in the Ost 40 mg/kg group（P < 0.01）. Conclusion：Osthole can alleviate cartilage damage，inflammation，and destruction of collagen in the articular cartilage matrix of rats with rheumatoid arthritis，which may be achieved by inhibiting the activation of the Wnt signaling pathway.

Abstract:Objective：To investigate the distribution of resistant determinants in drug-resistant Enterococcus faecalis（E. faecalis），and their relationships among strains. Methods：Twenty strains of E. faecalis were collected from Jianghan Oil Field General Hospital in Hubei from January 2015 to December 2018. Then，1 kind of resistance gene to penicillin， 4 kinds of resistance genes to aminoglycosides，6 kinds of resistance genes to macrolides，1 kind of resistance gene to streptogramin，2 kinds of resistance genes to tetracycline，3 kinds of resistance genes to vancomycin，2 kinds of resistance genes to quaternary ammonium disinfectants，2 kinds of genetic markers of mobile genetic elements were analyzed by PCR. At last，sample cluster analysis was performed（UPGMA method）. Results：At least 1 resistant determinants，and 7 at the most，were positive in 20 strains of drug-resistant E. faecalis. And 1 kind of resistance gene to penicillin，3 kinds of resistance genes to aminoglycosides，1 kind of resistance genes to macrolides，1 kind of resistance genes to tetracycline，2 kinds of resistance genes to vancomycin，1 kind of genetic markers of mobile genetic elements were positive. The analysis of phylogenetic relationship showed that 20 strains could be divided into A and B two groups. The B group can be divided into 2 subgroups：B-1 and B-2. There were 2 clones in the subgroup B-1（strain No. 4 -14 -17，and strain No. 8 -11）. As well as a clone in the subgroup B-2（strain No. 9-12）. Conclusion：Resistance gene to penicillin，aminoglycosides，macrolides，tetracycline，vancomycin，and genetic markers of mobile genetic elements play a key role in resistance to antimicrobial agents.

Abstract:Objective：To investigate whether gelatin methacrylamide（GelMA）scaffolds made by low-temperature 3D printing could construct high-quality tissue-engineered cartilage. Methods：After pre-cooling，low-temperature deposition 3D printing technology was used to prepare low-concentration gelatin methacrylamide scaffolds. Macroscopic and scanning electron microscopic observation of the macroscopic and microscopic structure of the scaffold were followed by a rheological and biomechanical detection of the hydrogel. Cells were cultured with DMEM as control，cell proliferation（CCK-8 method）and cell activity（Live/Dead staining method）were used to detect the biocompatibility of the scaffold，and histological staining was used to qualitatively analyze the scaffold components. Nude mice were scaffolded subcutaneously for hematoxylin and eosin（HE）staining，alcian blue staining，and safranin staining to highlight the extracellular matrix structure of the cartilage. Results：Macroscopic and scanning electron microscopic observations showed that the 5% GelMA scaffolds had uniform pore diameters and a regular structure. The results of CCK-8 and live/dead cell staining showed that the scaffolds were biocompatible，and the in vivo and in vitro histological staining showed that the constructed tissue-engineered cartilage met the requirements in colors，glycosaminoglycan（sGAG）secretion and other aspects. Conclusion：5% GelMA bio-ink can be used for 3D printing at low temperature and to successfully construct tissue-engineered cartilage.

Abstract:Objective：To investigate the expression of miR-552-3p in hepatocellular carcinoma（HCC）and its mechanism of promoting cell proliferation，migration and invasion. Methods：qRT-PCR was used to detect the expression of miR-552-3p in HCC cell lines and normal human liver cell lines. The microarray data of HCC samples were downloaded from TCGA database，and the expressions of miR-552-3p in HCC tumor tissues and its adjacent tissues were analyzed to show whether they are different or not；miR-552-3p mimics and miR-552-3p inhibitor transfected HCC cells，and luciferase assays verified whether miR-552-3p targets DACH1，while CCK8 and Transwell assays detected the effect of miR-552-3p and its interaction with DACH1 on HCC cell proliferation，migration，and invasion. Results：The analysis of HCC samples from the TCGA database indicated that miR-552-3p was highly expressed in HCC，and qRT-PCR showed that the expression level of miR-552-3p in HCC cell line was significantly higher than that in human liver cell line L02；the high expression of miR-552-3p promoted the proliferation，migration and invasion of HCC cells，while the inhibition of miR-552-3p reversed these functions；the luciferase reporter assays verified that miR-552-3p targets the 3′-UTR of DACH1. Up-regulation of miR-552-3p expression inhibited DACH1 whereas down-regulation of miR-552-3p increased DACH1 expression；DACH1 overexpression inhibited HCC cell proliferation，migration and invasion，but with miR-552-3p overexpression the DACH1 inhibitions of HCC cell-related functions were relieved；miR-552-3p positively regulated the activation of Wnt/β-catenin signaling pathway. Conclusion：miR-552-3p targeting DACH1 promotes HCC cell proliferation，migration and invasion，and regulates Wnt/β-catenin signaling，which may provide potential targets for HCC diagnosis and treatment strategies.

Abstract:Objective：To evaluate the effect of dexmedetomidine on ischemia/reperfusion-induced mitochondrial injury in a rat ex vivo lung model. Methods：Sprague-Dawley rats were randomly divided into four groups（n=6 each）：control group（group C），ischemia/reperfusion group（group IR），1 nmol/L of dexmedetomidine group（group D1）and 10 nmol/L of dexmedetomidine group（group D10）. An interleukin 2（IL-2）ex vivo lung perfusion system was used to establish a rat lung model of ischemia-reperfusion injury. Airway pressure（Raw），lung compliance（Cdyn），perfusion flow（VT）and pulmonary venous oxygen partial pressure（PaO2）were recorded at four points in time：the end of balance（T0），0 min（T1），30 min（T2）and 60 min（T3）of reperfusion. Lung injury was assessed by histopathological changes and lung wet/dry（W/D）weight ratio. The levels of lactate dehydrogenase（LDH），superoxide dismutase（SOD），malondialdehyde（MDA），reactive oxygen species（ROS），and adenosine triphosphate（ATP）were measured. Mitochondrial swelling and mitochondrial membrane potential（MMP）were measured. Results：Compared with group C，the pulmonary function of group IR，D1，and D10 worsened. LDH activity increased，as well as the content of ROS and MDA. SOD activity and the production of ATP decreased. The level of mitochondrial swelling increased，and mitochondrial MMP decreased in group D1 and D10（P < 0.05）. Compared with group IR，the pulmonary function of group D1 and D10 was improved，and pathological changes showed that lung injury was significantly reduced. The activity of LDH decreased，content of ROS and MDA decreased，SOD activity and ATP production increased，mitochondrial swelling decreased，MMP increased（P < 0.05）. Compared with group D1，the pulmonary function of group D10 was improved，Raw and LDH activity decreased while SOD activity increased，and mitochondrial swelling reduced（P < 0.05）. Conclusion：Dexmedetomidine can alleviate lung ischemia/reperfusion injury in a rat ex vivo lung model，and the mechanism may be related to alleviating mitochondrial injury and oxidative stress.

Abstract:Objective：To explore the value of detections for allergens in the management of bronchial asthma. Methods：A total of 108 patients，whose asthmatic symptoms were uncontrolled or partly controlled，were enrolled in this study. The results of inhaled allergens-specific immunoglobulin E（sIgE），food allergens-specific immunoglobulin E，food allergens-specific immunoglobulin G（sIgG）and total immunoglobulin E（IgE）among these patients and their relationship with comorbidities were analyzed. Results：In patients with bronchial asthma，the positive rate of all kinds of allergens-specific immunoglobulins is 82.41% and the positive rates of inhaled allergens sIgE，food allergens sIgE，food allergens sIgG are 58.33%，32.41%，and 56.48%，respectively. The positive rates of inhaled allergens sIgE，food allergens sIgE，food allergens sIgG are 73.33%，30.0%，and 70.0% respectively in the asthmatic patients with allergic rhinitis；66.67%，20.0% and 73.33% respectively in the asthmatic patients with atopic dermatitis；and 48.15%，29.63% and 55.56% respectively in the asthmatic patients with gastrointestinal symptoms. The positive rates of inhaled allergens sIgE and food allergens sIgG are higher than that of food allergens sIgE，and the difference between the overall patients and the asthmatic patients with allergic rhinitis or atopic dermatitis is statistically significant（P < 0.05）. The positive rate of inhaled allergens sIgE in patients with total IgE≥100 kU/L is 69.01%，higher than those with total IgE<100 kU/L（37.84%），and this difference is statistically significant（P < 0.05）. Conclusion：Asthmatic patients with partly controlled or uncontrolled symptoms should be tested for immunoglobulin of inhalation allergens and food allergens. It is recommended that the tests of inhaled allergens sIgE and food allergens sIgG should be taken in asthmatic patients with allergic rhinitis/atopic dermatitis. In the asthmatic patients with gastrointestinal symptoms，food allergens sIgE should be tested too. For the patients with total IgE≥100 kU/L，testing inhaled allergens sIgE is suggested.

Abstract:Objective：To determine the prevalence of q wave in avL，prescribe its characteristics，and evaluate the correlation between the q wave in avL and organic heart disease（OHD）verified by gated single-photon emission computed tomography myocardial perfusion imaging（SPECT-MPI）and coronary angiography（CAG）or coronary computed tomography angiography（CCTA）in the patients with complete left bundle branch block（CLBBB）. Methods：A total of 1 882 CLBBB patients were initially involved in the study，and the results of SPECT-MPI，CAG and CCTA were collected. The prevalence，duration and amplitude of q wave as well as the duration and amplitude of QRS complex in avL were measured，on which the correlation between q wave and OHD were analyzed. Results：In this study，157 patients were involved finally，and 122 of which（77.8%）were confirmed with OHD by SPECT-MPI，CAG and CCTA. Septal q waves were present in 56 of the 122 OHD patients（45.9%）［OHD（+）q（+）group］. Specificity and positive predictive value of q wave in avL for OHD were 97.1% and 98.2% respectively. Comparing with the CLBBB patients in OHD（+）q（-）group，the CLBBB patients in OHD（+）q（+）group have larger end diastolic volume（EDV）（P＜0.001）and end systolic volume（ESV）（P＜0.001），but lower left ventricular ejection fraction（LVEF）（P＜0.001）. Scatter chart and correlation analysis showed no significant linear correlations between the duration，amplitude，areas of q wave and the left ventricular ESV，EDV and LVEF verified by SPECT-MPI. Conclusion：Occurrence of q wave in avL in CLBBB patients indicates serious left ventricular disease，but there is no linear correlation between the characteristics of q wave and the severity of left ventricular disease.

Abstract:Objective：This paper is aimed to analyze the effect of flexible plantar pressure feedback training system on rehabilitation intervention of patients with early ischemic stroke by functional magnetic resonance imaging（fMRI），and to summarize the characteristics and mechanism of brain function remodeling. Methods：Twelve stroke patients were randomly divided into two groups with 30 days walking training，the experimental group for the combination of flexible plantar pressure feedback system training，the control group for traditional training. Lateralization index（LI）was used to analyze the results of brain activation，and the correlation was analyzed with motor function assessment. Results：The locomotion function of the experimental group changed significantly compared with that of the control group（P < 0.001）. Meanwhile，there was a significant correlation between the training of flexible plantar pressure feedback training system and the recovery of locomotion function. In hemiplegic side movement，the LI value of hemiplegic side was significantly correlated with the training of flexible plantar pressure feedback system（r=0.884，P < 0.001）. The similar results happened in contralateral movement. The LI value of contralateral side was also significantly correlated with the training of flexible plantar pressure feedback system（r=0.892，P < 0.001）. Especially after flexible plantar pressure feedback system training，there was a significant correlation between the LI values of ROI in both hemispheres of stroke patients’ brain（r=0.974，P < 0.001）. Conclusion：The flexible plantar pressure feedback training system can significantly improve the motor function of lower limbs and fundamentally accelerate the rehabilitation process of stroke patients.

Abstract:Objective：To explore the value of peripheral blood circulating tumor cells（CTC）combined with ROMA index in the diagnosis of early epithelial ovarian cancer（EOC）. Methods：From June，2017 to April，2019，105 patients with early EOC（malignant group：stage ⅠA and stage ⅠB），152 patients with benign ovarian epithelial tumors（benign group）and 183 healthy women（control group）were selected as subjects. Preoperative venous blood samples were collected and the CTC，human epididymal protein（HE4），and carbohydrate antigen 125（CA125）were measured. The ROMA index was calculated according to the menopausal status of the subjects. The differences of single and combined test results of CTC and ROMA index among the three groups and the differences between theⅠA andⅠB stages of EOC were compared. The efficacy differences in early EOC diagnosesby using CTC and ROMA index and their joint detection were comprehensively evaluated. Results：①The values of CTC and ROMA index，and the positive rates of single or combined detection were all the highest in the malignant group. ②The values of CTC and ROMA index in the ⅠB stage of EOC were higher than those in the ⅠA stage（Z=3.135，P=0.002；t=34.56，P < 0.001）. The difference in the positive rate of combined detection between the ⅠA and ⅠB stages of EOC was statistically significant（χ2=5.24，P=0.02）. ③The specificity and coincidence rate of CTC for early EOC were the highest，but there was no significant difference from those of combined CTC and ROMA detection（P > 0.05）. The combined detection shows the highest sensitivity in the diagnosis of early EOC，and its differences from the single detection of CTC and ROMA index has statistical significance（P < 0.001）. The Youden index of early EOC was the highest by combined detection. The sensitivity，specificity，coincidence rate and Youden index of combined detection are 94.29%，84.18%，86.59%，and 0.785，respectively，showing a relatively high overall efficacy in the diagnosis of early EOC. Conclusion：Single detection of CTC and ROMA index has some significance in the diagnosis of early EOC and the results are correlated with ⅠA and ⅠB staging. Compared with the single detection，combined detection shows a higher comprehensive efficacy in the diagnosis of early EOC and for staging prediction，and thus is of a higher clinical value.

Abstract:Objective：To investigate the effect of hepatitis B virus（HBV）on the HBV associated glomerulone nephritis（HBV-GN）under different alanine aminetransferase（ALT）levels. Methods：A total of 646 HBV-GN patients in the First Hospital of Lanzhou University were analyzed retrospectively. All the selected patients have complete medical records and have undergone renal histopathology. Laboratory tests include：N-acetyl-β-D-glucosidase（NAG），β2 microglobulin（β2M），liver function parameters ALT，renal function parameters creatinine（Cr），blood urea nitrogen（BUN），glomerular filtration rate（GFR）. The HBV loads were measured by quantitative PCR. The distribution of pathological types of 646 HBV-GN was investigated，and the effects of HBV loads on renal function of the HBV-GN and stage of chronic kidney disease under different ALT levels were analyzed. Results：HBV-GN is mainly diffuse membrane hypertrophic nephropathy，accounting for about 60.7%，followed by capillary hyperplastic glomerulonephritis，accounting for about 26.2%，the focal segment glomerulonephritis and mesenteric hyperplastic lesions are rare. In the ALT normal HBV-GN patients group，the effect of HBV on the renal function is minor，while in the ALT abnormal group，the effect is significant，and this difference is obvious in the ALT≥2ULN（upper limit of normal）. With viral load increasing，blood Cr，BUN，24 h urine protein quantification，urine NAG，β2M increased，while GFR decreased（P < 0.05）. In the normal ALT group and the ALT<2ULN group，the viral load has no relationship with chronic kidney disease staging，but in the ALT≥2ULN group the viral load had a significant relationship with the chronic kidney disease staging. Conclusion：In different ALT condition，the effect of HBV on HBV-GN is different. A comprehensive analysis of this phenomenon is conducive to the clinical diagnosis and treatment of this disease.

Abstract:The incidence of periampullary cancer ranks the 8 th~9 th place among malignant tumors，but the fatality rate ranks the 4 th among tumor deaths. Due to the complex and varying anatomical characteristics of this area and the great diversity of lesions，imaging diagnosis and differential diagnosis have always been the focus and difficulty of clinical research. At present，a variety of imaging techniques are used to study the ampulla of Vater and its surrounding tissues，among which CT and MRI are the least invasive and the most widely used. This article reviews the recent progress in the identification of cancers using CT and MRI in the different classifications of periampullary carcinoma，the assessment of resectability，and the related prognosis.

Abstract:Antiplatelet therapy after coronary artery bypass grafting is one of the important drug treatments，which plays an active role in improving the rate of venous bridge patency and reducing the incidence of major adverse cardiovascular events（MACE）. Currently，it has been found that some patients have resistance to the commonly used anti-platelet drug clopidogrel，leading to the increased incidence of postoperative vascular bridge stenosis and MACE events，which may be related to the polymorphism of CYP2C19 gene. However，the anti-platelet effect of the third-generation P2Y12 receptor antagonist was not affected by the CYP2C19 genotype.There is an expert consensus that CYP2C19 genotype testing is recommended to determine the dual antibody treatment regimen，so can the individualized treatment regimen based on CYP2C19 genotype testing reduce the incidence of major postoperative cardiovascular adverse events in patients- This paper will review and analyze the relationship between clopidogrel resistance and CYP2C19 genotype，the status quo of anti-platelet therapy after coronary artery bypass grafting and the existing expert consensus recommendation.