Abstract:Objective：To determine the expression level of vacuolar protein sorting 13 homolog A（VPS13A）during cell differentiation of 3T3-L1 and to explore the effects of VPS13A on 3T3-L1 cells. Methods：Western blot and Q-PCR were used to detect the expression changes of VPS13A during the differentiation of 3T3-L1 cells，and CRISPR（clustered regularly interspaced short palindromic repeats）/Cas9（CRISPR associated with 9）system to establish stable VPS13A knowdown cell lines. Finally，the effect of VPS13A knockdown on 3T3-L1 cell differentiation was detected by Western blot and Oil red staining. Results：The expression of VPS13A was downregulated in the early stage and upregulated in the later stage of 3T3-L1 cell differentiation. Lipid droplets and the expression levels of genes involved in differentiation were increased in VPS13A knockdown 3T3-L1 cells. Conclusion：VPS13A expression is modulated by cell differentiation status in 3T3-L1 cells. Knockdown of VPS13A enhances the differentiation of 3T3-L1 cells.

Abstract:Objective：To investigate the effect of 11β-hydroxysteroid dehydrogenase（11β-HSD1）gene knockout on the metabolism and cognitive function of mice. Methods：A total of 15 mice each in the C57BL/6J genetic background wild control group and 11β- HSD1 gene knockout group were fed with high fat for 20 weeks. We then assessed energy metabolism by metabolic cage，observed their cognitive function by behavioral evaluation，evaluated hippocampus mitochondria by electron microscope，and determined changes in cognitive function，mitochondrial function-related genes，and inflammatory genes by immunofluorescence and RT-PCR. Results：The 11β-HSD1 gene knockout in showed the enhanced learning and memory ability，increased grip strength，improved hippocampal microstructure，amplified mitochondrial content，up-regulated the genes related to cognition and mitochondrial respiratory function，and changed the inflammatory genes. Conclusion：Our study demonstrated that knockout 11β-HSD1 significantly improved cognitive function and grip strength mice fed high-fat diet，therefore may be an effective target for the treatment of cognitive dysfunction.

Abstract:Objective：To determine the roles of Pumilio family in the postnatal development，we established the Pumilio1/Pumilio2 （Pum1 and Pum2）inducible knockout mouse model. Methods：Pum1^flox/flox Pum^2-/- mice were mated with R26-ER_T2Cre/Cre mice to obtain R26-ER_T2Cre/+Pum1^flox/flox Pum^2-/- mice. The experiment group（three week old mice and adult mice）was injected with tamoxifen， while the control group was injected with the same amount of peanut oil. The knockout efficiency of Pum1 at DNA，RNA and protein levels of multiple organs in mice was determined. The histology of the testis as well as cell proliferation and apoptosis of the testicular cells were examined. Results：The Pumilio1 RNA and protein of thymus and testis were knocked down significantly. The knock down efficiency of Pum1 varies from tissues to tissues but reaching a minimum of 50%. The mouse model of Pum1 and Pum2 gene induced knockout was successfully constructed. The weight of thymus，spleen and testis of male mice in the 3-week experiment group decreased significantly，supporting the critical role of PUM in postnatal organ growth. The hematoxylin and eosin（HE），TUNEL and BrdU staining of testis pathology showed disrupted spermatogenesis，increased apoptosis and decreased proliferation of spermatogenic cells in 3-week experiment group testis. Although，the Pum1 of each organ in adult group was knocked down at different levels，the spermatogenesis of adult experimental group was not significantly affected. Conclusion：This inducible Pumilio knockout model provides a new tool to study the roles of Pumilio in postnatal and adult mice，and supports the future development of Pumilio as potential drug targets for diseases involving Pumilio-mediated translational control.

Abstract:Objective：To investigate the expression and prognosis of zinc finger DHHC-type containing 9（ZDHHC9）in non-small cell lung cancer（NSCLC）and explore its effect and mechanism on the proliferation，migration and invasion of NSCLC cells. Methods： The expressions of ZDHHC9 in NSCLC and its relationship with prognosis were analyzed by NCBI GEO datasets and Gene Expression Profiling Interactive Analysis（GEPIA）database. The expression levels of ZDHHC9 in normal bronchial epithelial cell line（16HBE） and NSCLC cell lines（A549，H1299，H1703）were detected by real-time qPCR. ZDHHC9 was knocked down by siRNA in H1703 and A549 cell lines. Cell proliferation was detected by CCK -8 assay. Cell migration and invasion were detected by transwell and scratch assay，and the indicated protein levels were detected by Western blot. Results：The results of GEO datasets and GEPIA data analysis showed that ZDHHC9 was significantly increased in NSCLC tissues compared with para-cancer tissues，and the expression level of ZDHHC9 correlated with disease-free survival of patients by GEPIA data analysis（P < 0.01）. The proliferation activity of H1703 and A549 cells was significantly decreased following ZDHHC9 knockdown. Compared with control，inhibition of ZDHHC9 in both H1703 and A549 cells displayed significant decreases in the migratory and invasive abilities assessed by the wound healing and transwell assays. Of note，ZDHHC9 knocking down decreased the protein levels of key fatty acid synthesis enzymes in NSCLC cells. Conclusion： ZDHHC9 may promote proliferation，migration and invasion of NSCLC cells by regulating fatty acid synthesis.

Abstract:Objective：To study the therapeutic effect and mechanism of Lidocaine（Lido）on cardiac damage（Doxorubicin）in mice. Methods：Thirty -two SPF mice were randomly divided into four groups（n=8）：saline group，Dox group，Dox + Lido group，and Lido group. The observation and detection of body weight，survival rate，Doppler flow imaging，ECG，cardiac ultrasound，plasma creatine kinase isoenzyme（CreatineKinase-MB，CK-MB），Troponin I（Cardiac troponin I，cTnI），tissue factor（TF）in the myocardial tissue， matrix metalloproteinase 9（MMP-9），phosphorylated adenosine 5’-monophosphate-activated protein kinase（p-AMPK），gap junction protein（connexin43，Cx43），inhibitor of cytokine signaling 3（recombinant suppressors of cytokine signaling 3，SOCS3）content. Results：Compared with the saline group，the mice in the Dox group showed the decreased body weight and survival rate，reduced heart rate，limited QRS wave time，prolonged QT interval，cardic contracture，small cardiac cavity，and increased expression of plasma CK- MB and cTnI but decreased expression of p-AMPK，SOCS3 and Cx43. Compared with the Dox group，mouse weight，survival rate and heart rate were increased in the Dox + Lido group. Moreover，the QRS wave time and the QT interval as well as the plasma expression of CK-MB and cTnI were normal in the Dox + Lido group mice. Also，no significant changes in cardiac size were observed. The expression of TF and MMP-9 decreased，but p-AMPK，SOCS3 and Cx43 levels increased in the heart tissues of the Dox+Lido treated mice. Conclusion：Lidocaine can alleviate acute doxorubicin-induced cardiac injury through activation of the p-AMPK/SOCS 3/Cx43 signaling pathway and inhibiting the high TF/MMP-9 expression.

Abstract:Objective：To investigate the effects and the underlying mechanism of major vault protein（MVP）on the proliferation of arterial endothelial cells. Methods：Human aortic endothelial cell（HAEC）were infected with lentivirus to inhibit or overexpress MVP. Cell proliferation and death were detected with CCK-8 assay and flow cytometry. Apoptosis inhibitor Z-VAD and necroptosis inhibitor Nec-1 were used to distinguish the mode of cell death. Annexin V binding and Caspase 3 activity were detected by flow cytometry，and cleaved Caspase was examined by Western blot. Real time PCR and Western blot were performed to investigate target molecules and the regulatory relationship. Results：Knockdown of MVP inhibited the proliferation activity of HAEC and promoted the HAEC cell death. Overexpression of MVP resulted in the opposite results. Treatment with Z-VAD reversed HAEC death caused by MVP knockdown，while Nec-1 did not. Consistently，TNF-α-induced HAEC apoptosis was inhibited by MVP overexpression and exaggerated by MVP knocked down. MVP promoted the transcriptional expression of cellular inhibitor of apoptosis proteins1（cIAP1）by up-regulating interferon regulatory factor 2（IRF2）protein expression. IRF2 knockdown reversed the increase in cIAP1 expression and the decrease in apoptosis caused by MVP overexpression. Conclusion：MVP promoted cIAP1 transcription by up-regulating IRF2 protein expression，thereby inhibiting TNF-α-induced apoptosis and promoting the proliferation of arterial EC.

Abstract:Objective：To explore the correlation between nephrosis-related growth arrest specific 6（Gas6）and nephrotic syndrome and apoptosis.The effect of AP -2 transcription factor a（TFAP2A）on Gas6 was investigated. Methods：The cell model of adriamycin nephropathy（AN）was constructed to detect the expression of Gas6，and MPC5 cells were stimulated with Gas6 protein to measure the expression of nephropathy related indicators.HEK-293T cells were intervened with Gas6 protein to measure apoptosis rate or the expression of apoptosis-related indicators. The luciferase gene reporter recombinant plasmid of Gas6 promoter was constructed to measure the activity of Gas6 promoter in HEK-293T cells. And the potential transcriptional binding sites were predicted and verified. The effects of knockdown or overexpression of TFAP2A on Gas6 gene expression were measured at the promoter，mRNA，and protein levels. Results：Gas6 was highly expressed in AN cell model，and excessive Gas6 may induce the nephropathy-related indicators in MPC5 cells the same trend as that of AN cell model. Apoptosis was significantly reduced in the Gas6 protein group compared to control in HEK -293T cells. The active luciferase reporter plasmid of human Gas6 promoter fragment was successfully constructed，and the binding sites of TFAP2A were included. TFAP2A positively regulated Gas6 at the promoter，mRNA，and protein levels. Conclusion： Gas6 promotes the development of nephrotic syndrome. Gas6 is antiapoptotic in HEK-293T cells. TFAP2A positively promotes the expression of human nephrosis-related gene Gas6.

Abstract:Objective：The current study aims to establish and evaluatee the kindling model of epilepsy induced by kainic acid（KA） microinjection into piriform cortex. Methods：Using c -fos immunofluorescence staining and TdT -mediated dUTP nick-end labeling （TUNEL）staining techniques to find the piriform cortex associated with epilepsy in a acute epilepsy mouse model. Racine score and seizure latency were observed after injection of KA in piriform cortex. Behavioral experiments were performed including testing the learning and memory abilities of mice in a water maze and the exploration ability of mice in a new object. The results of seizures and behavioral experiments were compared with the epileptic model of stereotactic injection of KA into the hippocampus. The electrical activities of new model mouse neurons were measured by electrophysiological techniques. Results：The results of c-fos immunofluorescence and TUNEL staining showed that in addition to the hippocampus，neurons in the piriform cortex and hippocampus were also significantly activated，and apoptosis occurred in the acute epilepsy mouse model. After injecting KA into the piriform cortex， the epilepsy was successfully ignited. Compared with the epilepsy model injected KA into the hippocampus，there was no significant difference in the epileptic seizure score and the seizurelatency was shorter. The behavioral results showed that the epileptic model mice induced by KA injection into the piriform cortex had a reduced spatial memory ability and a reduced ability to explore new objects. These results showed no significant difference compared to the epileptic model induced by KA injection into the hippocampus. The patch clamp recording test showed an increase in firing frequency and the resting membrane potential，and a decrease in amplitude of neuronal discharge. Conclusion：The microinjection of KA into the piriform cortex has successfully induced epilepsy，which may provide a new animal model for studying the pathogenesis of epilepsy.

Abstract:Objective：To investigate the neural circuit of depressive symptoms derived from glucocorticoid（GC）receptor in dorsal raphe nucleus. Methods：Firstly，a stress mouse model was established using a single stimulus coufinement method，and the mice were divided into four groups：control group，stresssd group，mifepristone-treated group and vehicle group，then the mice were injected with GC receptor antagonists to test behavioral changes by tail suspension test and elevated plus maze test. Immunofluorescence was utilized to detect the activation of GC receptors and microgial. Results：①Compared with the control group，the immunofluorescence result showed that the number of GC receptors in dorsal raphe nucleus was increased after stress stimulate. ②After intraperitoneal injection of the GC receptor antagonists（mifepristone，RU486），the amount of GC receptors and the activated microglial cells were decreased in the dorsal raphe nucleus of the mice，and the depression-like behaviors were also attenuated. Conclusion：The above results indicated that mifepristone regulates microglial cell activation in dorsal raphe nucleus to eventually reduce depression-like behavior.

Abstract:Objective：We intended to explore the significance that epicardial adipose tissue（EAT）could provide in decision-making on whether the patient should further undergo the coronary angiography when they were suspected of diagnosing coronary artery disease（CAD based on coronary CT angiography（CCTA）. We further analyzed the correlation of epicardial adipose tissue volume （EATV）and perivascular adipose tissue thickness（PATT）with the severity of coronary vascular disease-SYNTAX score in patients with coronary atherosclerotic heart disease. We also explored the difference in sensitivity and specificity of EAT combined with clinically relevant indicators compared to the SYNTAX score alone in predicting the prognosis of patients. Methods：Our research involved a total of 81 patients with coronary heart disease who underwent coronary CT angiography（CCTA）and coronary angiography in the First Affiliated Hospital of Nanjing Medical University. The characteristics and treatment of all patients were collected，and EATV，PATT，and SYNTAX scores were calculated based on the patients， imaging data. All patients were followed up six months after discharge，and adverse cardiovascular events，including cardiovascular-related death，myocardial infarction，stent reimplantation， cardiovascular-related disease readmission，stable angina，and unstable angina attacks，were recorded during the follow-up. The logistic regression model was used to analyze the decision -making significance of EATV for further coronary angiography（CAG）in patients with suspected coronary heart disease diagnosed by CCTA. We described the association of EATV with SYNTAX scores using person correlation analysis. We constructed a predictive model for the prognosis of patients with CAD based on EATV and related clinical indicators. Results：①EATV could improve the positive predictive value of clinical intervention after CAG examination in CCTA patients suspected of CAD（AUC rise to 0.771 from 0.562）. ② Pearson correlation statistics showed that EATV was positively correlated with SYNTAX score（r=0.828，P＜0.001），and the correlation persisted after EAT was standardized for BMI（r=0.774，P＜ 0.001）. ③EATV combined with clinical indicators：gender，LADHU（anterior descending branch adipose tissue Hounsfield unit），and LVDd（left ventricular diastolic diameter）could predict the occurrence of cardiovascular events after discharge（AUC=0.775）. The prediction accuracy of this model was higher than that of SYNTAX alone（AUC=0.707）. Conclusion：EATV was closely related to CAD and had guiding significance for clinical decision-making of patients with suspected coronary heart disease on CT. It was positively correlated with the SYNTAX score and had predictive relevance for the prognosis evaluation of coronary heart disease.

Abstract:Objective：The current study aims to quantitatively detect myocardial fibrosis of idiopathic inflammatory myopathy（IIM） by 3.0 T cardiac magnetic resonance（CMR），and to analyze the association between myocardial fibrosis of IIM and cardiac injury marker chitinase-3-like protein 1（YKL-40），to explore the value of serum YKL-40 in reflecting the degree of myocardial fibrosis in IIM patients with myocardial injury. Methods：A total of 64 IIM patients who visited the First Affiliated Hospital of Nanjing Medical University between May 2018 and August 2022 were retrospectively included. All patients underwent 3.0T CMR scan and the expression level of serum YKL -40 was measured. We used Student’s t test，Mann -Whitney U test or chi square test to compare the difference of each index between the myocardial injury group and the non-myocardial injury group；Spearman correlation analysis and linear regression were used to analyze the association between serum YKL-40 and CMR parameters in IIM patients. Receiver-operating characteristic（ROC）curve was used to assess the value of YKL-40 in predicting myocardial fibrosis in IIM patients. Results： Compared with patients without myocardial injury，IIM patients with myocardial injury had higher age［（53.0 ± 13.0）year vs.（44.6 ±16.1）year］，serum YKL-40 expression level［73.4（46.9，119.3）ng/mL vs. 48.1（22.5，65.1）ng/mL］，native T1［（1 263.2 ± 50.3）ms vs. （1221.8 ± 59.3）ms］，and extracellular volume（ECV）［（31.7 ± 5.6）% vs.（28.7 ± 3.2）%］，but the left ventricular stroke volume index （LVSVI）was lower［（42.3 ± 10.2）mL/m² vs.（49.0 ± 11.1）mL/m² ］（all P < 0.05）. Serum YKL-40 was positively correlated with ECV（r= 0.373，P=0.004）. Multiple linear regression analysis showed that serum YKL-40 was independently correlated with ECV. YKL -40> 68ng/mL（AUC=0.71，95% CI 0.58~0.84）predicted myocardial fibrosis in IIM with a sensitivity of 0.62 and specificity of 0.86. Conclusion：Serum YKL-40 may reflect the degree of myocardial fibrosis in IIM patients with myocardial injury.

Abstract:Objective：To investigate the value of cardiac magnetic resonance（CMR）based right ventricular-pulmonary arterial coupling（VAC）parameters in assessing risk stratification of connective tissue disease-related pulmonary hypertension（CTD-PH）. Methods：The clinical and CMR data of 62 patients with CTD-PH between June 2018 and April 2022 were retrospectively analyzed， and they were divided into group 1（low-risk and low-to-moderate-risk patients，n=39）and group 2（moderate-to-high-risk and high-risk patients，n=23）according to risk stratification，and the patients’right and left ventricle-related volumetric and functional parameters， left ventricular tissue characterization parameters and VAC were statistically analyzed. The optimal model was sought to predict CTD- PH risk stratification. Results：The differences in right ventricle-related volumetric and functional parameters，and tissue characterization parameters of the right ventricular insertion were statistically significant in the two groups of patients with CTD -PH （P < 0.05）. The right ventricular end-diastolic point（RVIP）volume index（RVEDVI）and VAC were independent predictors，and the combination of RVEDVI and VAC had the best predictive accuracy（AUC=0.839，95% CI：0.735~0.944，P < 0.001）. Conclusion： Right ventricle-related volumetric and functional parameters，and RVIP tissue characterization parameters can be used to assess CTD- PH risk stratification；the combination of RVEDVI and VAC improves the accuracy of assessing risk stratification.

Abstract:Objective：To investigate the predictive value of bone turnover markers，such as（procollagen type Ⅰ N-terminal propeptide，PINP）and（β-cross-linked ctelopeptide of type I collagen，β-CTX）in Parkinson’s disease（PD）complicated with osteoporosis. Methods：Total 105 patients with PD were enrolled and divided into osteoporosis group and non-osteoporosis group according to whether they were complicated with osteoporosis. Bone metabolism indexes，such as 25（OH）D，parathyroid hormone， osteocalcin，β-CTX，and PINP，were detected in all patients，and the relationship between these indexes and the occurrence of osteoporosis was analyzed. Results：① The proportion of oligotonic type，female proportion，PINP，osteocalcin and β-CTX were higher in osteoporosis group than in non-osteoporosis group，while the level of 25（OH）D was lower in osteoporosis group than in non-osteoporosis group，and the differences were statistically significant；② Correlation analysis showed that the incidence of osteoporosis in PD patients was significantly positively correlated with osteocalcin（r=0.28，P=0.005），β-CTX（r=0.36，P=0.001），PINP（r=0.40，P < 0.001），and 25（OH）D（r=-0.30，P=0.002），PINP/β-CTX（r=-0.56，P < 0.001）were negatively correlated；③ Multivariate binary logistic regression analysis showed that 25（OH）D，（OR=0.95，95%CI：0.84~0.98，P=0.041），PINP/β-CTX（OR=0.90，95%CI 0.83~0.98，P=0.017）were risk factors for PD complicated with osteoporosis；④Receiver Operating Characteristic showed that 25（OH）D combined with PINP/β- CTX had the largest area under ROC curve，with AUC=0.82，sensitivity=0.80，specificity=0.84，P < 0.001. Conclusion：Serum25（OH）D level and PINP/β-CTX ratio are closely related to the occurrence of osteoporosis in PD patients. They may have an important predictive value in the occurrence of osteoporosis in PD patients，and the diagnostic value is higher when they are combined.

Abstract:Objective：The current study aims to investigate the correlation between baseline peripheral blood biomarkers and outcomes in patients with non-small cell lung cancer（NSCLC）receiving immune checkpoint inhibitors（ICIs）. Methods：A retrospective analysis was conducted of 84 patients with stage Ⅲ or Ⅳ NSCLC，who received PD-1 inhibitors combined with chemotherapy as first-line treatment in the First Affiliated Hospital of Nanjing Medical University betwee January 2020 and September 2022. The efficacy was evaluated according to RECIST1.1 criteria and the patients were followed up of progression-free survival（PFS）. COX regression models were used in the univariate and multivariate survival analysis to assess prognostic effect of baseline peripheral blood parameters before treatments. Kaplan-Meier method as used for survival analysis. Log-rank tests were used to analyze the survival rates between groups. Results：The median follow-up time was 9.93（5.68~15.38）months，and the median progression -free survival（mPFS）was 9.42（5.63~12.88）months. COX univariate regression analysis and Kaplan-Meier survival curves showed that PD- L1 was an independent predictor of immune efficacy（HR=0.299，P=0.003），patients with a high monocyte percentage（≥8.15%）had a better PFS than those with low monocyte percentage（HR=0.313，95% CI：0.137~0.711，P=0.006，mPFS 14.37 months vs. 7.60 months）. Patients with a high eosinophil percentage（≥1.90%）also had a better PFS than those with low eosinophil percentage（HR= 0.296，95%CI：0.092~0.958，P=0.042，mPFS 13.87 months vs. 7.93 months）. COX multivariate regression analysis showed that both high monocyte percentage and high monocyte percentage parameters were independently associated with better PFS. However， peripheral blood lymphocyte subsets and inflammatory parameters had no predictive role for ICI efficacy. Conclusion：For patients with NSCLC，the percentage of monocytes and eosinophils may be useful predictive markers of response to chemotherapy combined with immunotherapy as first-line therapy，and higher percentages of moncytes and eosinophils were associated with longer progression- free survival time.

Abstract:Objective：To investigate the influence of different puncture needle types and ultrasonic characteristics of thyroid nodules on the sampling satisfaction rate of ultrasound-guided fine needle biopsy specimen. Methods：A total of 185 patients with thyroid nodules（185 nodules）who underwent fine-needle aspiration biopsy in Nanjing Tongren Hospital between August 2020 and August 2022 were included. All nodules received 23 G and 25 G ultrasound guided fine-needle aspiration biopsy. According to nodular ultrasonic characteristics（nodule size，coarse calcification，blood supply，echo），puncture specimens were classified into satisfactory and unsatisfactory categories according to the Bethesda system for reporting thyroid cytopathology . The influence of puncture needle types and nodular ultrasonic characteristics on the sampling satisfaction rate were evaluated. Results：There was no statistical difference in the overall sampling satisfaction rate between the 23 G group and the 25 G group（85.4% vs. 88.1% ，P=0.443）. According to the maximum diameter，the nodules were divided into three groups. The satisfactory rate of specimen collection in the group ≤ 0.5 cm was lower than those in the group 0.5-1.0 cm and group≥ 1.0 cm（P < 0.05）. According to nodule calcification，the patients were divided into coarse calcification group and other groups. The satisfaction rate of 23 G fine needle in the coarse calcification group was higher than that of 25 G fine needle（76.5% vs. 52.9%，P < 0.05）. There was no statistical difference in the satisfaction rate of the two kinds of fine needle in other groups. According to the blood supply，the nodules were divided into the blood supply rich group and the blood supply deficient group. The satisfaction rate of 25 G fine needle in the blood supply rich group was higher than that of 23 G fine needle（83.3% vs. 61.9% ，P < 0.05）. There was no statistical difference in the sample collection satisfaction rate between 23 G and 25 G fine needles in the blood supply deficient group. The nodules were divided into hypoechoic， isoechoic and hyperechoic groups according to their echo. There was no statistical difference in sampling satisfaction rate between 23 G and 25 G fine needles in different echo groups（P ≥ 0.05）. Conclusion：Small thyroid nodule（maximum diameter≤ 0.5 cm）， accompanied by coarse calcification or rich blood supply will affect the sampling satisfaction rate.

Abstract:Objective：To explore a better tracing method of central lymph nodes in papillary thyroid cancer patients by comparing the numbers and staining rate of central lymph nodes between preoperative ultrasound-guided injection and intraoperative injection of nano-carbon. Methods：A total of 227 patients were randomly enrolled into preoperative ultrasoundguided injection group and intraoperative injection group. The rate of dye spillover，the numbers and staining rate of the lymph nodes in each sub-area of central region（linea alba cervical lymph nodes，prelaryngeal lymph nodes，pretracheal and paratracheal lymph nodes）were recorded and analyzed. Results：The proportion of nano-carbon spillover in precperative ultrasound guided injection was lower than that in the intraoperative injection group；while central lymph nodes，pretracheal and paratracheal lymph nodes were more in the preoperative injection group than in the intraoperative injection group（P＜0.05）. For patients with Hashimoto’s thyroiditis，with metastatic central lymph nodes accessed preoperatively，with a tumor diameter more than 1 cm，central lymph nodes were more accessible to be stained by preoperative injection of nano-carbon（P＜0.05）. Conclusion：Preoperative ultrasound guided injection of nano-carbon can reduce dye spillover and improve the staining rate and detection rate of central lymph nodes.

Abstract:Objective：To evaluate the efficacy and safety of ceftazidime avibactam compared with polymyxin based combination therapy in patients with carbapenem resistant Pseudomonas aeruginosa infection. Methods：Retrospective analysis was carried out on the patients infected with carbapenem resistant Pseudomonas aeruginosa in the ICU of the First Affiliated Hospital of Nanjing Medical University between June 2019 and January 2022. They were divided into ceftazidime avibactam group and polymyxin B group. The clinical data of patients were collected，including basic information，such as gender，age，diagnosis，and length of stay. The comparative efficacy indicators included bacterial clearance rate，28- day mortality rate and the incidence of adverse reactions，such as liver and kidney dysfunction. Results：A total of 55 patients were included，including 25 patients in the ceftazidime avibactam group and 30 patients in the polymyxin B group. There was no statistically significant difference in basic indicators，bacterial clearance，28-day mortality，and adverse reactions between the two groups. The length of hospital stay in the ceftazidime avibactam group was longer than that in the polymyxin B group［49.0（34.0，78.0）vs. 26.0（15.8，40.5），P=0.001］，and ceftazidime avibactam group had fewer antibiotic combinations than polymyxin B group. Conclusion：Compared with polymyxin B，ceftazidime averbactam has similar effects in clinical cure and bacterial clearance，and there is no statistical difference in adverse reactions. Ceftazidime averbaltam increases the choice of clinical drugs and helps to reduce the pressure on public health.

Abstract:Scopolamine，a natural tropane alkaloid，was isolated in 1880 from Scopolia japonica and is considered one of the earliest discovered competitive cholinergic receptor antagonists. Compared to other drugs with similar effects，such as atropine，scopolamine exhibits greater permeability across the blood-brain barrier and can remain in the central nervous system longer to exert pharmacological effects. Scopolamine is widely utilized in the treatment of motion sickness，anesthesia，and pain relief，and may be broadly applied to diseases，such as depression. On the other hand，scopolamine can impair central nervous system functions，such as cognition，learning and memory，and attention，which limits its clinical use. Additionally，the neurotoxicity of scopolamine has been widely used in animal models of amnesia and delirium and has become an important tool for studying the central cholinergic system. This review outlines the chemical structure and classification of scopolamine，summarizes its clinical use and toxicity in the central nervous system，discusses its application in cholinergic function research and preclinical studies，as well as the controversy surrounding its central nervous system toxicity. We also provided an outlook for the potential use of scopolamine in central nervous system diseases.

Abstract:Central compartment allergic disease（CCAD）is a newly internationally named subtype of chronic rhinosinusitis（CRS） characterized by a type-2 inflammatory response of inhaled allergens in the mucosa of the central nasal region. In the early stage，it may manifest as mucosal edema and polypoid changes limited to the middle turbinate，superior turbinate and posterosuperior nasal septum. In the late stage，it may lead to obstruction of the adjacent sinus openings and progress to diffuse rhinosinusitis with nasal polyps， which poses more challenges for treatment.This article reviews the clinical symptoms，endoscopic and imaging manifestations， sensitization characteristics and histopathological features of CCAD，summarizes the essential differences between CCAD and other types of CRS，and provides some reference for optimizing clinical treatment strategies.

Abstract:Electrospinning can prepare bio-scaffold materials that mimic extracellular matrix，and good biocompatibility can be obtained by using poly-caprolactone（PCL）as the raw material. The combination of PCL electrospun nanofibers with inorganic materials can improve the hydrophilic and mechanical properties of scaffold materials，regulate the degradation performance and enhance the biomineralization ability，which has promising applications. In this paper，we review the application of PCL electrospun nanofiber-based hybrid biomaterials in dentistry.