ObjectiveBy analyzing the transfusion-related data using DRGs data to establish a credible evaluation system for clinical use,thereby enhancing the safe and effective clinical transfusion management.Methods Use the transfusion-related data of DRG-s,and statistical methods of EXCEL database to categorize and analyze the number of blood transfusion,hospital name,hospital type,hospital level,DRGs code and name,times of blood transfusion,volume of transfusion,etc.Results Output the statistics of the city's ratio of institutional use of blood,per capita consumption in patients,distribution and ordering of hospital based blood tranfusion,distribution and ordering of DRGs based blood transfusion,distribution and ordering of single DRGs between hospitals,annual consumption growth in different hospitals and major disease groups of blood tranfusion.ConclusionThe use of DRGs can efficiently control clinical indicators for blood transfusion and evaluate the performance of blood transfusion.it can provide a credible management tool for the health administrative departments and hospitals while offering data support for policy making of management objectives at the same time.

Abstract Bisphenols (BPs), which are mainly used in the production of polycarbonates and epoxy resins, are common endocrine disruptors (EDCs) in natural environments. Human mainly exposes to BPs via ingestion and skin. Previous studies have deteted BPs in human urine, serum, and milk samples, and children and pregnant women have a high level of exposure to to BPs. Based on international and national publications pertaining to BPs since 2009, this review describes the exposure to BPs in human urine, serum, and milk and summarizes neuroendocrine dysfunctions, oxidative stress injury and epigenetics changes caused by BPs, so as to provide insights into reducing the exposure to and health risk of BPs.

Triclosan, widely used in various personal care products, is one of the most common environmental endocrine disruptors in our life. It can be detected from water, soil and dust, and its environmental exposure level increased with consumption. Human body are exposed to triclosan through food and water, but the evidence that triclosan exposure leads to adverse health effects is not sufficient. This paper summarizes the progress of studies related to environmental concentration, population exposure and health risks of triclosan in recent years.

Uveal melanoma(UM)is the most frequent and life-threatening ocular malignancy in adults.Aberrant histone methylation contributes to the abnormal transcriptome during oncogenesis.However,a comprehensive understanding of histone methylation patterns and their therapeutic potential in UM remains enigmatic.Herein,using a systematic epi-drug screening and a high-throughput transcriptome profiling of histone methylation modifiers,we observed that disruptor of telomeric silencing-1-like(DOT1L),a methyltransferase of histone H3 lysine 79(H3K79),was activated in UM,especially in the high-risk group.Concordantly,a systematic epi-drug library screening revealed that DOT1 L inhibitors exhibited salient tumor-selective inhibitory effects on UM cells,both in vitro and in vivo.Combining Cleavage Under Targets and Tagmentation(CUT&Tag),RNA sequencing(RNA-seq),and bioinformatics analysis,we identified that DOT1 L facilitated H3K79 methylation of nicotinate phosphoribosyltransferase(NAPRT)and epigenetically activated its expression.Importantly,NAPRT served as an oncogenic accel-erator by enhancing nicotinamide adenine dinucleotide(NAD+)synthesis.Therapeutically,DOT1L inhi-bition epigenetically silenced NAPRT expression through the diminishment of dimethylation of H3K79(H3K79me2)in the NAPRT promoter,thereby inhibiting the malignant behaviors of UM.Conclusively,our findings delineated an integrated picture of the histone methylation landscape in UM and unveiled a novel DOT1L/NAPRT oncogenic mechanism that bridges transcriptional addiction and metabolic reprogramming.

The reversible and precise temporal and spatial regulation of histone lysine methyltransferases(KMTs)is essential for epigenome homeostasis.The dysregulation of KMTs is associated with tumor initiation,metastasis,chemoresistance,invasiveness,and the immune microenvironment.Therapeutically,their promising effects are being evaluated in diversified preclinical and clinical trials,demonstrating encouraging outcomes in multiple malignancies.In this review,we have updated recent understandings of KMTs'functions and the development of their targeted inhibitors.First,we provide an updated overview of the regulatory roles of several KMT activities in oncogenesis,tumor suppression,and im-mune regulation.In addition,we summarize the current targeting strategies in different cancer types and multiple ongoing clinical trials of combination therapies with KMT inhibitors.In summary,we endeavor to depict the regulation of KMT-mediated epigenetic landscape and provide potential epigenetic targets in the treatment of cancers.

Objective:To evaluate the effects of different pacing modes (unipolar/bipolar) under left bundle branch pacing(LBBP) on ventricular mechanical synchrony and myocardial work using the pressure-strain loop technique.Methods:Twenty-nine patients with LBBP due to symptomatic bradycardia were collected as LBBP group in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from December 2018 to July 2020. Another 29 matched patients with right ventricular pacing (RVP) during the same period were also included as a RVP group. Each LBBP patient was programmed to different pacing modes (uni-/bio-polar) within 1 week after the operation.Under each pacing mode, the inter- and intra-ventricular mechanical synchronization were evaluated. Meanwhile, the global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) were obtained by the left ventricular pressure-strain loops technique.Results:Compared with the RVP group, the mechanical synchrony in the LBBP group was significantly improved (all P<0.05). GWI, GCW, and GWE increased, while GWW decreased, and the differences were statistically significant (all P<0.05), there were no significant differences in ventricular mechanical synchronization, GWI, GCW, GWE, and GWW between unipolar and bipolar pacing in the LBBP group (all P>0.05), there were no significant differences in these parameters when increasing output voltage (all P>0.05). Conclusions:LBBP induces better mechanical synchronization and higher myocardial work efficiency than RVP. Different LBBP pacing modes do not affect ventricular mechanical synchronization and myocardial work efficiency.

Nonalcoholic fatty liver disease （NAFLD） is a common metabolic disease， and in recent years， the incidence rate of NAFLD is gradually increasing， which seriously threatens human health. As a traditional treatment method， external therapy of traditional Chinese medicine （TCM） has shown unique advantages and potential in the treatment of NAFLD. This article provides a detailed analysis of the TCM understanding of the etiology and pathogenesis of NAFLD， the application of TCM external therapy in clinical research， and the research on its therapeutic mechanism， in order to provide reference and guidance for further research in this field.

The influence of circadian rhythm disorder on nonalcoholic fatty liver disease (NAFLD) has attracted more and more attention in recent years, and studies in China and globally have shown that individuals who work in shifts at night or often stay up late have a higher incidence rate of NAFLD-related hepatocellular carcinoma (NAFLD-HCC) than those with regular work and rest. This article summarizes the research advances in the effect of circadian rhythm system on the pathogenesis of NAFLD-HCC by regulating lipid metabolism, glucose metabolism, and intestinal flora, and it is pointed out that restoration of normal circadian rhythm has potential clinical significance in delaying the development and progression of disease.

Autophagy is a process of self-defense and self-repair of cells and tissues and plays an important role in regulating the body's immune inflammatory response and maintaining the homeostasis of liver cells. This article summarizes the mechanism of autophagy in the development and progression of autoimmune hepatitis (AIH) from the aspects of the role of autophagy in regulating immune inflammatory response, regulating immune signal transduction, and preventing overactivated innate immune response. It is believed that autophagy may reveal the mechanism of AIH and provide new ideas and methods for the research on AIH.

Objective: To summarize the experience of the diagnosis, treatment and effects of the cases with coexistence of first branchial cleft anomaly(FBCA) and microtia with congenital aural atresia or stenosis(external auditory canal stenosis, EACS). Method: This was a retrospective study. The clinical data of 5 patients with microtia and EACS in Beijing Tongren Hospital of Capital Medical University from October 2015 to March 2018 were collected, including 3 males and 2 females, aged from 5 to 28 years. The clinical characteristics, imaging findings, treatment methods and effects of 5 patients were analyzed. Result: The 5 cases were all coexistence of EACS and FBCA, three of who associated with cholesteatoma of external auditory canal. CT showed external auditory canal stenosis with soft tissue shadow, sometimes gas or bone septum found inside, filling in the external auditory canal, combined with canal bone destruction irregularly. All patients underwent surgical resection of FBCA, 3 patients accompanied by cholesteatoma resection and canalplasty. The postoperative follow-up ranged from 10 to 39 months, and no recurrence of infection was observed. Conclusions EACS and FBCA both result from maldevelopment of the first branchial cleft. These two malformations, FBCA and EACS with or without cholesteatoma, can occur simultaneously, in which situation CT shows external auditory canal stenosis with soft tissue shadow inside. These patients underwent surgical resection of FBCA combined with cholesteatoma resection with good result.