Abstract:Fecal microbiota transplantation（FMT） is the core therapy targeting gut microbiota. The clinical FMT in the global is fast increasing for the treatment of gut dysbiosis related diseases. The improved methodology of FMT based on the automatic system supported washing process and the related delivering was named as washed microbiota transplantation（WMT）. The consensus report on the methodology of WMT was released in December，2019. This is a commentary on the key issues that affect the global application of Nanjing consensus on the methodology of WMT.

Abstract:Objective：To construct G protein-coupled receptor associated sorting protein 2（GPRASP2）-modified procine fetal fibroblasts（PFFs） as donor cells for the generation of GPRASP2-disrupted Bama miniature（BM）pigs. Methods：Bioinformatics methods were applied to phylogenetic and homologue analysis of human/porcine GPRASP2，and the secondary structures of human/porcine GPRASP2 proteins were predicted. Two single-guide RNAs（sgRNAs），targeting the upstream/downstream of coding sequence of the porcine GPRASP2，were designed，synthesized and ligated to pX330 plasmid. The recombinant plasmids containing Cas9 backbone were transfected into PFFs. Viable cell colonies were obtained using G418 screening and subjected to genotyping via direct PCR-based sequencing. Results：The human and porcine GPRASP2 proteins are evolutionarily closer，highly homologous，and predicted to have the similar functional Arm2 domains via 2D and 3D structure modeling. CRISPR/Cas9-sgRNA expression vectors targeting porcine GPRASP2 were constructed and transfected into PFFs. GPRASP2-deficient monoclonal PFFs were obtained by drug screening，genotypic analysis and Western blot assay. Conclusion：The human/porcine GPRASP2 proteins are evolutionarily closer and highly homologous. The GPRASP2-deficient cells were successfully constructed via CRISPR/Cas9 mediated gene editing，which provided a substantial foundation for the generation of GPRASP2-disrupted BM pigs.

Abstract:Objective：To investigate the maturity，vascularization and nonrenal differentiation of kidney organoids using induced renal organoids derived human pluripotent stem cells（hPSCs）. Methods：hPSCs were induced into renal organoids cells through a renal epithelial cell differentiation kit. The renal organoids structures were highly expressed with specific kidney markers CDH1，LTL，and PODXl by immunofluorescence method. The microstructures of glomeruli and tubules were observed by transmission electron microscopy；The animals were sacrificed under the renal capsule of SCID mice for 4 weeks，the grafts were taken for histomorphological observation，and the expressions of HNA，CDH1，PODX and MECA-32 were observed by immunofluorescence method. Results：The kidney markers CDH1，LTL，and PODX were positively expressed. Immature podocytes and tubular structures were observed by transmission electron microscopy. The kidney organoid volume increased after transplantation，blood vessels were visible to the naked eye，and HE stained grafts were visible red blood cells and cartilage-like tissues，HNA，CDH1，PODX and MECA-32 were positively expressed. Conclusion：hPSC can induce immature kidney organoids structures in vitro. In vivo，renal orgaoids structures can complete vascularization and continue to grow，but there were a large number of non-renal structures.

Abstract:Objective：To explore the effects of Geminin gene silencing on the biological behavior of human gliomas and the possible mechanism. Methods：Totally 20 pairs of fresh glioma specimens collected from patients who received a surgical resection in the Department of Brain Surgery in the Affiliated Hospital of Nantong University from 2018 to 2019 were analyzed by qRT-PCR combining GEPIA database to study the expression of Geminin gene in glioma tissues. The siRNA sequences that effectively targeted Geminin gene and the negative control sequences were designed and transfected into glioma U251 cells using Lipofectamine- 2000 reagent. The two groups were defined as siRNA-Geminin group and siRNA-NC group，respectively. In 48 h after transfection，qRT-PCR was used to detect the expressions of Geminin mRNA in each group. Then CCK8 method，Transwell assay，and Western blot were used to detect the cell proliferation，migration and invasion ability and the levels of Geminin，HBO1 and Cdt1 protein expression respectively. Results：Results of both qRT-PCR and GEPIA database analyses showed that the expression of Geminin mRNA in glioma tissues was significantly higher than that in adjacent tissue. The siRNA interference in Geminin gene could significantly inhibit its expression in U251 cells. Compared with siRNA-NC group，the cell proliferation ability，cell migrationand cell invasion quantity of the siRNA-Geminin group were significantly reduced，and the expression levels of Geminin，HBO1，and Cdt1 proteins were significantly lowered. Conclusion：Geminin is highly expressed in glioma. Knockdown of Geminin could inhibit the proliferation，migration，and invasion of U251 cells，possibly by down-regulating HBO1 and Cdt1. Thus，Geminin may be expected to be a new molecular target for the treatment of human glioma.

Abstract:Objective：To investigate the mechanisms underlying the effects of microRNA-449a（miR-449a）on proliferation and suppression of neuroblastoma. Methods：After overexpressed miR-449a in BE（2）-C cells，the change of gene expression levels were analyzed by quantitative real-time PCR（qPCR），cell viability was tested by MTT，and the proliferation efficiency of tumor cell was observed by clone formation assay. Meanwhile，we also predicted potential target genes of miR-449a using miRDB，and manipulated the level of MDM4 by overexpression or knockdown the expression of MDM4. Then，the expression of related proteins was analyzed by Western blot and the apoptosis was detected by flow cytometry. Results：Overexpression of miR-449a inhibited cell proliferation and colony formation，and promoted cell apoptosis. MDM4 was confirmed to be a target gene of miR-449a by using software prediction and the experimental verification. In addition，knockdown of MDM4 expression inhibited cell proliferation and colony formation. Overexpression of MDM4 neutralized the increases of apoptosis and p53 protein level induced by miR-449a. Furthermore，miR-449a promoted apoptosis of BE（2）-C cells，but this effect was not observed in p53 knockdown cell line. Conclusion：miR-449a increases p53 protein level by suppressing MDM4 to promote neuroblastoma cell apoptosis. This study implies miR-449a could be a potential therapeutic target of neuroblastoma.

Abstract:Objective：To investigate the effect of urantide，a urotensin Ⅱ receptor antagonist，on the phosphorylation of signal transducers and activators of transcription（STAT3）expression in the fatty liver of atherosclerosis（AS） rats. Methods：A total of 30 male Wistar rats were randomly divided into three groups：control group，AS group and Urantide group. The AS group and Urantide group were induced by an intraperitoneal injection of vitamin D3（VD3）150 μg/（kg·d）for 3 days and by feeding with special high fat food. Following successful modeling，the Urantide group was given urantide 30 μg/（kg·d）for 2 weeks by tail vein injection. The body weight and liver weight of each rat were measured to calculate the liver index. HE staining was used to observe the morphological change of the thoracic aortae and livers of the rats. Biochemical indexes were measured by detecting the change of alanine transaminase（ALT）and aspartate aminotransferase（AST）in the serum of rats. The expression levels of STAT3 mRNA in liver tissues were detected by RT-qPCR. The levels of STAT3 and p-STAT3 protein in liver tissues were detected by Western blot. Immunofluorescence was used to detect the levels of p-STAT3 in the hepatocytes of each group. Results：Compared with the control group，the HE staining of the AS group showed typical AS pathological change of thoracic aortae and typical steatosis of the livers；the liver indexes，the levels of ALT，AST in the serum and the level of p-STAT3 in the livers increased significantly in the AS group. Compared with the AS group，the AS pathological changes and the steatosis of the livers in the Urantide group were significantly alleviated；the liver indexes，the levels of ALT，AST in the serum and the level of p-STAT3 in the livers decreased significantly in the Urantide group. In addition，no significant changes were observed in the expression levels of STAT3 mRNA and protein in the liver tissues of each group. Conclusion：Urantide can alleviate liver injury by inhibiting the activation of STAT3 in the treatment of fatty liver.

Abstract:Objective：This study aims to explore the molecular mechanism of matrine in inhibiting the invasion and migration of human cervical cancer cell line Caski cells based on the Wnt/β-catenin pathway. Methods：Caski cells were treated with different concentration of matrine. Methyl thiazolyl tetrazolium（MTT）assay was used to detect cell proliferation inhibition；Transwell chamber invasion and migration assay was used to detect cell invasion and migration；ELISA assay was used to detect cell matrix metalloprotein 9（MMP-9）and vascular endothelial growth factor（VEGF）secretion；Quantitative real-time PCR（qRT-PCR）was used to detect cell glycogen synthase kinase3β（GSK-3β）and wingless/integrated 2B（Wnt2B）expression；Western blot was used to detect cell β-catenin，p-β-catenin protein content. Results：Matrine had inhibitory effect on the proliferation of cervical cancer cells Caski cells（P < 0.05）and showed a time and concentration dependence. Matrine inhibited the invasion and migration of Caski cells（P < 0.05），and it had a significant effect on Caski cells. The ability to secrete MMP-9 and VEGF has a significant inhibitory effect（P < 0.05）；matrine can significantly reduce Wnt2B mRNA expression and β-catenin protein content in Caski cells，and increase GSK-3β mRNA expression in Caski cells and p-β-catenin protein content. Conclusion：Matrine promotes the expression of GSK-3βmRNA in Wnt/β-catenin pathway of Caski cells，increases the content of p-β-catenin protein，reduces the expression of Wnt2B mRNA，the content of β-catenin protein and the secretion of MMP-9 and VEGF in Caski cells，thereby inhibiting the invasion and migration of Caski cells.

Abstract:Objective：To explore the protective mechanism of curcumin（Cur）on the hippocampal neurons of mice injured by okadaic acid（OA），and to provide a new theoretical basis for the treatment of Alzheimer’s disease. Methods：Mouse hippocampal neuron HT-22 cells were treated with OA，and divided into four groups：control group，Cur group，OA group，and OA+Cur group. The cell viability was measured by MTT assay. The apoptosis was detected by using Annexin V-FITC/PI double staining fluorescence microscope and flow cytometry. DCFH-DA probe fluorescence microscopy and flow cytometry were used to determine the intracellular reactive oxygen species（ROS）production，and Western blot was used to detect the levels of cleaved-caspase-3，Bcl-2，total Tau（t-Tau），and phosphorylated Tau（p-Tau）proteins. Results：Compared with the control group，the cell viability decreased in a dose-dependent manner after HT-22 cells were treated with different concentrations of OA for 24 hours，and the difference was statistically significant. When OA injury lasted for a certain period of time，the level of ROS in the cells increased. OA injury promoted cell apoptosis，reduced expression of anti-apoptotic protein Bcl-2，increased expression of cleaved-caspase-3 protein，and the expression of t-Tau and p-Tau protein increased abnormally. Compared with the OA group，the cell viability increased，the apoptosis rate and the production of ROS decreased in the OA+Cur group，meanwhile，the expression of Bcl-2 protein increased，whereas the expressions of cleaved-caspase-3 protein，t-Tau and p-Tau decreased. Conclusion：Curcumin can protect hippocampal neurons from OA injury in mice. The present results provide a new theoretical basis for the protection of Alzheimer’s disease-related neurons.

Abstract:Objective：To investigate the effects of irinotecan（CPT-11）combined with X-ray treatment on the proliferation and apoptosis of human colon cancer cell line HCT-116. Methods：MTT method was used to detect the effects after treatment with different concentrations of CPT-11（10，20，30，40，50 μg/mL）for 24 hours and single dose of X-ray（3，6，9，12，15 Gy）on the proliferation of HCT-116. The proliferation rates of the three groups of cells were detected by clone formation assay，the apoptosis of the three groups was observed by AO/EB staining，and the levels of p53 and p21 protein were detected by Western blot. Results：CPT-11 inhibited the proliferation of HCT-116 cells in a dose-dependent manner in the range of 10~50 μg/mL. After pretreatment with CPT-11 at 10 μmol/L，combined 3，6，9，12 and 15 Gy X-ray irradiation showed that the inhibition rate of proliferation in the combined treatment group was higher than that in the irradiation group，and the difference was statistically significant（P < 0.05）；compared with the control group and the irradiation group，the combined treatment group had a dose-dependent inhibition effect on the proliferation of HCT-116 cells. The number of colony formation decreased significantly（P < 0.05）；the levels of p21 and p53 in the combined treatment group were significantly higher than those in the other two groups（P < 0.05），and the apoptotic rate also increased significantly（P < 0.05）. Conclusion：Iritican combined with X-ray irradiation inhibits the proliferation and induces apoptosis of human colon cancer cell line HCT-116，which may be related to the activation of p53 and p21.

Abstract:Objective：To establish a fluorescence immunochromatography for placental growth factor（PlGF），evaluate the analysis performance and clinical performance. Methods：Using fluorescent microsphere conjugated-mouse-anti-human PlGF monoclonal antibody，sheep anti-human PlGF polyclonal antibody coated on NC membrane，to establish a fluorescence immunochromatography assay for PlGF，and evaluate the analysis performance，such as linear range，accuracy，repeatability. Using serums of 136 pregnant women，electrochemiluminescence as control，to evaluate the clinical performance. Results：The linear range of fluorescence immunochromatography assay for PlGF was 20.0~9 000.0 pg/mL，accurate was 97.98%，repeatability CV was 3.14%（500.0 pg/mL）and 2.98%（5 000.0 pg/mL）. The assay had good correlation with electrochemiluminescence：y=1.032x-5.002（r=0.991）. Bland-Altman statistical analysis showed that the average value of fluorescence immunochromatography was slightly higher than that of electrochemiluminescence，without significant difference（P > 0.05）. Conclusion：The fluorescence immunochromatography for PlGF has good analysis performance and clinical performance. The assay is suitable for clinical application.

Abstract:Objective：To predict the trend of hand-foot-mouth disease in Nantong by using the autoregressive integrated moving average（ARIMA） model. Methods：Based on the monthly reported case data of hand-foot-mouth disease in Nantong from January 2010 to June 2019，a ARIMA（p，d，q）×（P，D，Q）S model was constructed in accordance with the seasonal time series. The monthly incidence of hand-foot-mouth disease in the city from July to December 2019 was used as verification data to test the prediction effect of the model. Results：A total of 90 766 cases of hand-foot-mouth disease were reported in Nantong from 2010 to 2019. The average annual incidence rate was 124.36/100 000. The epidemic showed seasonality of incidence with two peaks. One was the summer peak and the other was the winter sub-peak. In recent years，the pathogenic spectrum of hand-foot-mouth disease in Nantong was dominated by other intestinal viruses. Using the ARIMA（1，0，1）（1，1，1）12 model，the incidence of hand-foot-mouth disease from July to December 2019 wss predicted to be 7.08/100 000，1.81/100 000，3.74/100 000，7.21/100 000，10.71/100 000，and 11.29/100 000. Compared with the actual incidence，there was no significant difference. Conclusion：The autoregressive integrated moving average model can better predict the incidence of hand-foot-mouth disease，and can be used for short-term early warning and monitoring.

Abstract:Objective：To explore the association of metabolic parameters and thyroid volume in Chinese adolescents. Methods：A total of 1 097 middle school students aged between 12~15 years old（55.6% males）were enrolled. All the participants underwent physical examination，biochemical test，and thyroid gland ultrasonography. The thyroid volume of normal，overweight and obese group was compared. The association between the number of metabolic syndrome components and thyroid volume was analyzed to study the association between metabolic parameters and thyroid volume. Results：In male，the differences of thyroid volume between normal and overweight group（P＜0.01）or between normal and obesity group （P＜0.01） were significant. In female，the difference of thyroid volume between normal and obesity group （P＜0.01） was significant. Among groups with different number of metabolic syndrome components，the difference of thyroid volume was significantly different（F=10.64，P＜0.01）. According to multiple regression model，parameters with significant association with thyroid volume were gender（β=0.607，95%CI：0.406~0.808，P＜0.01），age（β=0.200，95%CI：0.107~0.294，P＜0.01），systolic blood pressure（β=0.010，95%CI：0.002~0.018，P=0.014），waist circumference（β=0.029，95%CI：0.015~0.042，P＜0.01）and the waist-to-height ratio（β=3.317，95%CI：1.661~4.973，P＜0.01）. Conclusion：Overweight，obesity and number of components of metabolic syndrome are significantly associated with the volume of thyroid glands in adolescents.

Abstract:Objective：To analyze prognostic values of systemic inflammation-related indicators in preoperative peripheral blood of breast cancer patients. Methods：Preoperative inflammatory indexes，such as neutrophil-to-lymphocyte ratio（NLR），platelet-to-lymphocyte ratio（PLR），lymphocyte-to-monocyte ratio（LMR） and systemic immune-inflammation index（SII），were obtained from 380 breast cancer patients who complied with the selection criteria. PD-L1 expressions were detected by immunohistochemistry methods in tumor tissues of 36 triple negative breast cancer（TNBC） patients. The survival analysis was performed based on the rate of breast cancer-related death. Results：Levels of NLR and SII were related to maximum tumor diameter and clinical stage of breast cancer patients，while the PLR and LMR had no significant correlations with clinicopathological features. Univariate and multivariate analysis of survival showed that patients with high SII levels had shorter breast cancer specific survival. Meanwhile，levels of SII were probably correlated with PD-L1 expressions in TNBC patients. Conclusion：Preoperative SII levels could be associated with tumor staging and prognosis in breast cancer patients. There may be a correlation between positive PD-L1 expressions and low SII levels in the TNBC subgroup. Systemic inflammation-related indicators of preoperative peripheral blood may provide further choices for disease surveillance of breast cancer patients.

Abstract:Objective：To explore and compare the safety and effectiveness of robotic，laparoscopic，and open hepatectomy for hepatolithiasis. Methods：A retrospective analysis of 23 patients with hepatolithiasis who underwent Da Vinci robot-assisted hepatectomy at the Department of Hepatobiliary Surgery，Nanjing Drum Tower Hospital，The Affiliated Hospital of Nanjing University Medical School from May 2019 to April 2020，was conducted. At the same time，patients who underwent laparoscopic（20 cases）or open hepatectomy（25 cases）for hepatolithiasis were included as controls，in order to make a comparison on the basic clinical information，operation time，blood loss，blood transfusion rate，hepatic port occlusion rate，postoperative hospital stay，postoperative anal exhaust time，postoperative oral intake time，off-bed activity time，visual analogue scale（VAS），liver function，complications，etc. Results：The operation time of the robot group was similar to that of the laparoscopy group，and both were longer than the laparotomy group. There was a long setup time in robot group. When the setup time was excluded，the operative time of the robot group was similar to that of the laparotomy group. As to intraoperative blood loss，the robot group was the least，followed by the laparoscopic group，and the laparotomy group was the most. In terms of total hilar occlusion，the rate of hilar occlusion in the robot group and laparoscopic group was significantly lower than that in the laparotomy group. In addition，robot and laparoscopy hepatectomy were overall superior to open surgery in promoting postoperative recovery，including shorter postoperative hospital stay，faster anal ventilation，earlier oral intake，faster get-out-of-bed，and lower VAS. There was no statistical difference in postoperative liver function and complication rate among the three groups. Conclusion：Robotic and laparoscopic hepatectomies were significantly associated with less intraoperative blood loss，lower rate of total hepatic port occlusion，and better postoperative recovery. Compared with laparoscopic hepatectomy，robotic hepatectomy was associated with significantly less intraoperative blood loss，a shorter operative time，and a shorter postoperative hospital stay.

Abstract:Objective：To investigate the efficacy of postoperative chemotherapy in patients with intermediate risk factors by analyzing the prognosis and life quality of patients undergoing postoperative chemotherapy or radiotherapy. Methods：A retrospective study was conducted on 113 patients at the First Affiliated Hospital of Nanjing Medical University who underwent hysterectomy for clinical stage ⅠB~ⅡA1 with intermediate risk factors during January，2010 to June，2017. Of these patients，56 patients had adjuvant chemotherapy，and 57 patients had radiotherapy. The disease-free survival（DFS），overall survival（OS）and quality of life were compared between the two groups. Results：There was no significant difference in age and pathological type between the two groups. Three-year DFS rates and OS rates were 92.8%，96.4% in chemotherapy group，and 91.2%，96.5% in radiotherapy group. There were no statistically significant difference（P＞0.05）. There were significant differences in body function，role function，social function，appetite and overall quality of life between chemotherapy groupand radiotherapy group，and the former was superior to the latter. In side effects，the chance of lymphedema and menopause symptoms were lower in chemotherapy group than in radiotherapy group，and the difference was statistically significant（P < 0.05）. There are more persons that still have sex in chemotherapy group than in radiotherapy group（66.1% vs. 40.4%）. The quality of sex life was higher in patients treated with chemotherapy after surgery than those who were treated with radiotherapy（P < 0.05）. Conclusion：It is effective for patients who have intermediate risk factors after radical hysterectomy to receive chemotherapy compared to those receiving radiotherapy. Besides，overall quality of life of patients with chemotherapy is better than that of patients with radiotherapy. Systemic chemotherapy may be an alternative treatment choice for adjuvant therapy in intermediate-risk stage ⅠB~ⅡA1 cervical cancer.

Abstract:Objective：To investigate the impact of total hysterectomy on cognitive function in women of reproductive age. Methods：Premenopausal women who underwent total hysterectomy for non-malignant diseases from January 2007 to December 2016 in the Department of Gynecology，Zhongda Hospital Southeast University were collected as the total hysterectomy group（n=296），while subjects who underwent myomectomy at the same time were collected as control group（n=305）. One follow-up questionnaire survey including mini-mental state examination（MMSE），Montreal cognitive assessment（MoCA）and Kupperman menopause index（KMI）was conducted from 2017 to 2018. Results：MMSE score showed that 3 subjects in the total hysterectomy group were found cognitive dysfunction，while no subject was found cognitive dysfunction in the control group. The difference was not statistically significant（P=0.119）. MoCA score showed that 7 subjects in the total hysterectomy group and 1 subject in the control group were found cognitive dysfunction during follow-up，and the difference was statistically significant（P=0.035）. Among those women with normal cognitive function，the incidence of cognitive errors in the total hysterectomy group was higher than that in the control group（P < 0.05）. KMI score showed that the incidence of menopausal symptoms in the total hysterectomy group was significantly higher than that in the control group （P < 0.001）. Conclusion：Cognitive function declines in long-term period in women of reproductive age who undergo total hysterectomy，which may be related to ovarian function decline.

Abstract:Objective：To study the distance between the upper central incisors and the incisive canal，and further discuss the effect of inclination of upper central incisors on the distance. Methods：A total of 67 adult skeletal Ⅱ and angle Ⅱ orthodontic patients were included in this study. CBCT and Dolphin11.9 software were used to measure the distance between the incisive canal and upper central incisor roots at two planes：the palatal opening level（F1），and the root apex level of the maxillary central incisors（F2）. Then，all patients were divided into three groups（procline，upright，and recline）according to ∠U1-PP. One-way ANOVA or rank sum test was performed for statistical analysis. Results：At F1 and F2 planes，the anteroposterior distance between upper incisor roots and the anterior line of incisive canal（Lml）was（3.27±1.02）mm and（3.07±1.35）mm，respectively. As for three groups，Lc of procline group was significantly lower than upright group and recline group at F1 plane；while Lml of recline group was significantly larger than the other two groups at F2 plane. Conclusion：There is strict limit in tooth movement during retraction of the maxillary incisors in adult skeletal Ⅱ orthodontic patients. The upper incisor roots of procline group were much closer to the incisive canal，while the upper incisor roots of recline group were much far away from the incisive canal.

Abstract:Objective：To investigate the application value of high-flow nasal cannula （HFNC）in high-risk patients with extubation failure based on the ultrasound-measured diaphragmatic-rapid shallow breathing index （D-RSBI）. Methods：Patients with mechanical ventilation for more than 48 hours in ICU from September 2017 to November 2019 were selected. Based on the extubation procedure after the SBT，their D-RSBI was measured using ultrasound and those whose D-RSBI ≥ 1.3 times/（min·mm） were evaluated as high-risk patients with extubation failure，who were randomized into two groups：HFNC group and conventional oxygen therapy group （COT group）；The re-intubation rate at 48 h after extubation and，respiratory rate （RR），heart rate （HR），arterial oxygen saturation （SaO2），arterial carbon dioxide partial pressure （PaCO2），oxygenation index （PaO2/FiO2）after extubation at 6 h，24 h，48 h were compared between the two groups. Results：A total of 41 patients who met the inclusion criteria were finally included in this study，of which 21 were in the HFNC group and 20 were in the COT group；RR，HR，SaO2，PaO2/FiO2 in the HFNC group were superior to the COT group at 6，24 h after extubation，the difference was statistically significant （P < 0.05）；and there was no significant difference between the two groups of PaCO2（P > 0.05）；SaO2，PaO2/FiO2 in the HFNC group was significantly higher than that in the COT group 48 h after extubation，and the difference was statistically significant （P < 0.05）；and there was no significant difference between the two groups of RR，HR，and PaCO2 （P > 0.05）. The re-intubation rate at 48 h after extubation in the HNFC group was 4.76%，the re-intubation rate in the COT group was 30.00%，and the difference was statistically significant （P < 0.01）. Conclusion：For patients with high-risk of extubation failure based on D-RSBI assessment，the use of HFNC after extubation can significantly improve the patient’s respiratory function and oxygenation，and significantly reduce the re-intubation rate，which is an ideal sequential treatment strategy.

Abstract:Objective：To investigate the clinical efficacy of losartan potassium in the treatment of cardiac syndrome X（CSX）and to analyze the predictive factors of its therapeutic effect. Methods：A total of 86 female patients with CSX admitted to our hospital from January 2015 to June 2019 were randomly divided into two groups：the treatment group（n=42）received losartan potassium orally for 20 weeks，and the placebo group（n=44）received placebo treatment. The clinical efficacy and predictive factors of treatment effect were compared between the two groups. Results：86 women completed 20 weeks of treatment and repeated the Seattle angina questionnaire（SAQ）assessment. The baseline data of the treatment group and the placebo group matched well. Compared with placebo group，the treatment group was associated with improved frequency of angina pectoris，lower incidence of angina pectoris，better quality of life and body function（P=0.031）. Losartan potassium treatment（P=0.04），Internal carotid artery resistance index（P=0.037）and lower baseline angina freedom（P＜0.001）were important independent predictors of improving angina score. Conclusion：In the absence of obstructive coronary heart disease，losartan potassium therapy can improve microvascular function in CSX women with ischemic symptoms，which is related to the decrease of arterial resistance and angina.

Abstract:In recent years，the adverse reactions caused by irrational use of antibiotics，including allergy，drug resistance and hemolysis，have become a global problem threatening human health. Many countries strictly control the use of antibiotics to avoid unnecessary use of antibiotics，so as to reduce the spread of drug-resistant and drug-resistant problems in the world. At the same time，screening and identification of antibiotic susceptibility genes is the key to overcome the adverse reactions of antibiotics. This paper reviews the research progress of antibiotic use，adverse reactions（ADR），the relationship between antibiotic susceptibility and susceptibility genes，screening and identification of drug antibody susceptibility genes in recent years，which is of great significance for the clinical use and early warning of antibiotics，and the research of antibiotic antibody susceptibility genes in China.

Abstract:The immune system has an important impact on the occurrence，development and prognosis of tumors. With the progress of research，the immunotherapy of tumors has made great progress. Current immunotherapy mainly includes immunological checkpoint blockade，non-specific activation of the immune system，adoptive cellular immunotherapy，tumor vaccine，etc. Among them，programmed death 1（PD-1） and its ligand （PD-L1） signaling pathway and cytotoxic T-lymphocyte antigen 4 （CTLA-4） are the research hotspots of clinical treatment of advanced tumors. This article aims to review the application of immunosuppressive drugs in urinary tumors.

Abstract:Renal cell carcinoma is the most common malignancy in the kidney and its early symptoms are insignificant，with a significant proportion of patients already having metastases when they diagnosed. Renal cell carcinoma is not sensitive to radiotherapy and chemotherapy，which made sunitinib，a receptor tyrosine kinase inhibitor，to be the first-line treatment of metastatic renal cell carcinoma because of its anti-angiogenic effect. Despite the huge success of sunitinib in the treatment of kidney cancer，the emergence of resistance is almost inevitable as treatment progresses. In the human genome，the vast majority of transcribed sequences are non-coding transcripts. Among them，microRNA，long-non-coding RNA（lncRNA），and circular RNA are considered to play an important role in tumorigenesis and progression. In this review，we summarize the microRNAs and lncRNAs that linked to the renal cell carcinoma’s resistance to sunitinib.