In the past few years,it has been disclosed that identified epigenetic processes and epigenetic changes are involved in human diseases.Disorders of these processes may influence chromatin structure and gene expression,which may result in complicated syndroms,multiple-factor diseases and cancers. The researchprogress of epigenetic processes of several diseases is reviewed in this paper.

Objective To discuss the value of combining the physiological and operative severity score for enumeration of mortality and morbidity(POSSUM)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)in severe acute pancreatitis(sAP).Methods 60 cases of SAP were divided into surgery group(n=15)and non-surgical group(n=45),Non-surgical group was vahde with APACHE Ⅱ score,the surgery group with POSSUM score,decided to continue conservative treatment or surgery treatment,Observation of two ways with the complications and death.Results The rates of compHcafions and death were(0.37±0.08)and(0.27±0.09)in Single-operation group(n=15)higher than(0.76±0.14)and(0.61±0.15)in surgical group(n=11)(t1=3.125,t2=3.211,P＜0.01);APACHEⅡ score of mortality in operation group and non-surgical group were no significant difference(x2=2.28,x2=1.98,P＞0.05);APACHE Ⅱ score were(10.12±6.27)in survival group(n=46)were lower than (25.75±7.90)in death group(n=14)(t=2.525,P＜0.05.Conclusion The score of dynamic APACHE Ⅱ has better effect to judge the timing of surgery,and the score of POSSUM has high value to predict post-operative complications and deaths occurred in patients with severe acute pancreatitis.

Objective To explore the diagnostic value of flow cytometry in detecting HPV E6／E7 mRNA of human papilloma virus (HPV) in the diagnosis of cervical lesions. Methods From January 2017 to September 2018,119 women with suspected cervical lesions in the department of gynecology and obstetrics of Shanxi Maternal and Child Health Hospital were selected. Flow cytometry was used to detect HPV E6 ／ E7 mRNA in cervical exfoliated cells of women,and the DNA of HPV was detected by the method of hybrid capture 2 (HC2). Results 31. 09%(37／119) HPV E6／E7 mRNA and 57. 14%(68 ／ 119) HPV DNA were positive in 119 cases. The positive rate of HPV E6／E7 mRNA in cervical intraepithelial neoplasia ( CIN)2+ group was 77. 78%(28／36),which was statistically significant compared with 20. 00%(4／20) in CIN1 group (χ2＝15. 246,P＜0. 01),and was statistically significant compared with 7. 94%(5／63) in nilm group (χ2＝50. 286,P＜0. 01) . In nilm group,HPV E6 ／ E7 mRNA positive rate was 7. 94%(5／63) and HPV DNA positive rate was 30. 16%(19 ／ 63),which was statistically significant (χ2＝10. 088,P＝0. 001) . In cin1 group,HPV E6／ E7 mRNA positive rate was 20. 00%(4 ／ 20) and HPV DNA positive rate was

Objective:To explore the relationship between blocking antibody and lymphocyte subsets in elderly patients (age≥35 years old) with recurrent spontaneous abortion(RSA).Methods:A retrospective case-control study was conducted on the patients with recurrent spontaneous abortion who met the inclusion criteria from October 2014 to September 2019 in the Reproductive Center of Women Health Center of Shanxi.They were divided into two groups according to their ages: 66 cases in RSA group and 334 cases in normal pregnant age group.The blocking antibody and lymphocyte subsets were detected by flow cytometry.Results:The negative rate of blocking antibody in elderly recurrent spontaneous abortion patients was 77.27% (51/66), which was not significantly different from that in normal gestational recurrent spontaneous abortion patients (83.53%(279/334)) ( P=0.221), but significantly higher than that in normal women (23.46%(42/179)) ( P=0.001). The blocking antibody′s blocking efficiency results showed that the CD3′s blocking efficiency of elderly recurrent spontaneous abortion patients (0.10 (-0.50, 0.60)) was significantly lower than that of normal women (0.60 (0.00, 1.30)), the difference was statistically( P=0.001). The CD8 blocking efficiency of elderly recurrent spontaneous abortion patients (0.00 (-0.60, 0.63)) was significantly lower than that of normal women (0.30 (0.00, 0.70)), the difference was statistically( P=0.016). Lymphocyte subsets showed that the CD8 + T cell ratio in elderly recurrent spontaneous abortion patients (26.93±7.25) was significantly lower than that in normal gestational recurrent spontaneous abortion patients (29.22±7.29), the difference was statistically significant ( P=0.020). The CD4 + /CD8 + ratio in elderly recurrent spontaneous abortion patients (1.64±0.99) was significantly higher than that in normal gestational age recurrent spontaneous abortion patients (1.37±0.50), the difference was statistically significant ( P=0.030). The ratio of natural killer cells in elderly recurrent spontaneous abortion patients (16.13±7.10) was significantly higher than that in normal women (14.04±2.35), the difference was statistically significant ( P=0.022), and higher than that in normal gestational age recurrent spontaneous abortion women (15.57±7.02). Conclusion:There were differences in lymphocyte subsets between elderly RSA patients and normal pregnant women, and the increase of natural killer cell ratio may be an important factor in the occurrence of RSA, especially in elderly RSA patients.

Objective To compare the efficacy of three different methods in the prevention of adhesion after the HEOS system for different degrees of intrauterine adhesions.Methods 284 patients with mild,moderate and severe intrauterine adhesions,who were treated with the HEOS system,were divided into three groups,the intrauterine device with sodium hyaluronate gel was placed in Group A,Foley water capsule tube with sodium hyaluronate gel was placed in Group B,and sodium hyaluronate gel was placed in Group C only.The recovery of uterine adhesion,improvement of menstruation,endometrial thickness,and adverse reactions were compared among the three groups.Results The mild intrauterine adhesions group showed statistical differences among the three groups(P<0.05).Group A had a higher menstrual improvement rate than Group C(P<0.017),and there was no significant difference in other therapeutic indicators(P>0.017).However,the adverse reaction rate in Group A was also higher than that in Group C(P<0.017).In the moderate intrauterine group,there was a significant difference in the improvement rate of intrauterine adhesions between Group B and the other two groups(P<0.017).Group A and B were higher than Group C in terms of menstrual status,endometrial thickness,and adverse reactions(P<0.017).In severe intrauterine adhesions,Group A had higher efficacy indicators than other groups(P<0.017).Conclusions The curative effect index and adverse reaction rate were analyzed,after operation.For the light,moderate,and severe intrauterine adhesions,sodium hyaluronate gel,Foley water capsule tube with sodium hyaluronate gel,and intrauterine device with sodium hyaluronate gel were the best choice for adhesion.Individual and hierarchical management can achieve good clinical effects,which is worth popularizing.

Objective To comprehend the present condition of sustaining within familial pulmonary rehabilitation for COPD patients,alongside exploring the factors that impact this continuity.Methods A convenience sampling method was used to select 392 COPD patients from outpatient clinics of 2 tertiary-level A hospitals and 1 community health service center in Huaihua in Hunan Province from December 2023 to February 2024 as survey respondents.Patients were surveyed using the general information questionnaire,the COPD Assessment Test,the Modified Medical Research Council Dyspnea Scale,the Exercise Benefits/Barriers Scale,and the Brief 2-Way Social Support Scale.Results We sent out 392 questionnaires and collected 362 valid ones,with an effective response rate of 92.47％.The percentage of COPD patients who never performed home pulmonary rehabilitation was 56.08％,and the maintenance time of health behaviors in home pulmonary rehabilitation was 17.40％for 1-3 months,7.18％for 4-6 months,4.70％for 7-12 months,and 14.64％for more than 1 year.The results of multiple linear regression analysis showed that exercise place,pulmonary rehabilitation health education,exercise habits before having COPD,perceived level of exercise behavior,and two-way social support were influential factors affecting the maintenance of health behaviors in pulmonary rehabilitation in the families of COPD patients,which explained 38.5％of the variability.Conclusion Patients with COPD have a low level of maintenance of health behaviors in home pulmonary rehabilitation,and health education on exercise rehabilitation for COPD patients and caregivers should be strengthened to enhance patients'level of exercise perception and ability to utilize social support.

Objective:To analyze the correlation between simple thyroid nodule and blood lipid and glucose metabolism and iodine nutrition level.Methods:A cross-sectional study was conducted by collecting data of the population undergoing epidemiological investigation in Jinshan District, Shanghai from July to December 2015, to calculate the prevalence of thyroid nodules and analyze relevant functional indicators.Results:Simple thyroid nodules were detected in 603 subjects, with a prevalence of 22.6% (603/2 669). There were 358 female patients with simple thyroid nodules, with a prevalence rate of 26.9%, and 245 male patients with simple thyroid nodules, with a prevalence rate of 18.3%. The prevalence of simple thyroid nodule in female was higher than that in male, and the difference was statistically significant (χ 2=27.686, P<0.001). In addition, the prevalence of simple thyroid nodules increased with age (13.1% (92/704) and 20.2% (104/514) and 25.1% (145/578) and 24.4% (107/439) and 36.3% (98/270) and 34.8% (57/164), χ 2=83.872,P<0.001). In the ≤30 years group (8.0% (30/704) vs. 18.8% (62/331), χ 2=35.716, P<0.001), >30 to ≤40 years old group (14.1% (37/263) vs. 26.7% (67/251), χ 2=12.683, P<0.001), >60 to ≤70 years old group (26.2% (33/126) vs. 45.1% (65/144), χ 2=10.435, P<0.001), and the 70-year-old group (24.4% (21/86) vs. 46.2% (36/78), χ 2=8.521, P<0.001). The prevalence of simple thyroid nodules in males was lower than that in females. In the simple positive thyroid nodule group, Fasting blood glucose (5.12 (4.80, 5.69) and 5.02 (4.72, 5.48)), total cholesterol (1.24 (0.85, 1.86) and 1.13 (0.77, 1.76)), triglyceride (4.77 (4.09, 5.48) and 4.49 (3.92, 5.16)), low density lipoprotein((2.79 (2.26, 3.36) and 2.63 (2.19, 3.16)), and high density lipoprotein cholesterol (1.41 (1.18, 1.66) and 1.35 (1.13, 1.61)) were higher than those in the negative group ( U values were 554 818, 578 468, 535 622, 556 067 and 567 960, respectively, all P<0.01). The BMI index grade distribution of thyroid nodule positive group was higher than that of negative group, and the difference was statistically significant (3.7% (77/2 066), 50.1% (1 034/2 066), 32.4% (669/2 066), 13.8% (286/2 066), 3.2% (19/603), 43.6% (263/603), 38.1% (230/603), 15.1% (91/603), χ2=9.5201, P=0.023). The prevalence of simple thyroid nodules was significantly lower in the iodized salt group than in the non-iodized salt group (20.7% (436/2 102) vs. 29.5% (167/567), χ 2=19.376, P<0.001). The urinary iodine level in the positive thyroid nodule group was significantly lower than that in the negative group (148.4(100.2, 213.7) vs. 169.5(115.4, 241.75), U=545 129.5, P<0.001). After Logistic regression screening, age ( OR=1.57, 95% CI: 1.292-1.908, P<0.001), gender ( OR=1.278, 95% CI: 1.193-1.368, P<0.001), BMI grade ( OR=1.166, 95% CI: 1.022-1.330, P=0.022), total cholesterol ( OR=1.105, 95% CI: 1.005-1.214, P=0.040), iodized salt ( OR=0.689, 95% CI: 0.556-0.854, P=0.001) were independent influencing factors of thyroid nodule. Conclusion:The prevalence of simple thyroid nodules in Shanghai is relatively low. Age, sex, BMI level, total cholesterol and iodized salt are independent factors causing thyroid nodules. In addition, blood glucose level may also be related to the prevalence of thyroid nodules.

Objective:To screen highly expressed inflammatory factors in diabetic nephropathy models using protein microarray, analyze differential genes and their regulatory networks, and predict potential therapeutic small molecular compounds.Methods:The inflammatory factor microarray was used to screen the inflammatory factors with the same tendency in the cell model and animal model of diabetic nephropathy. The differential genes screened by R language were enriched and analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG). STRING builds a protein interaction network online, Cytoscape software analyzes the core subnetwork, and Connectivity Map searches for and predicts small molecule compounds.Results:Diabetic nephropathy model was established using 16-week-old db/db mice and mesangial cells stimulated with high glucose, and the expression of C-X-C motif chemokine ligand 1(CXCL1) was elevated in both models. Multiple GEO datasets indicated a strong association between the high expression of CXCL1 and diabetic nephropathy. Specifically, GSE30122 showed an upregulation of 30 genes and a downregulation of 23 genes. GO enrichment analysis focused on biological processes such as humoral immunity and lipopolysaccharide response; While KEGG enrichment was mainly in pertussis and coagulation cascade pathways. CytoHubba identified 10 hub genes, such as ALB, LUM, and CXCL1. In addition, 10 small molecule compounds were predicted as potential therapeutic drugs using Connectivity Map.Conclusions:CXCL1 may serve as a key gene in the occurrence and development of diabetic nephropathy. ALB, LUM, CXCL1, MMP7, TGFBI, CCL2, S100A4, SOX9, VCAN, and CLU may participate in the regulatory network centered around CXCL1. There are 10 small molecular compounds demenestrating the potential to be therapeutic agents.

Objective:To explore the cognitive function characteristics of children with primary snoring (PS) and obstructive sleep apnea-hypopnea syndrome (OSAHS) using event-related potentials.Methods:From October 2020 to October 2022, 20 children with OSAHS, 20 children with PS, and 22 normal children were recruited for continuous performance task (CPT) and behavioral assessments. ERP and behavioral data were meticulously recorded, with measurements of N1, P2, N2, and P3 wave amplitudes and latencies at F3, Fz, and F4 electrode sites. Statistical analyses were conducted using one-way ANOVA and Kruskal-Wallis test via SPSS 25.0 software.Results:(1) Behavioural test: There was no statistically significant difference in terms of correct responses, response times, and false alarms among the three groups (all P>0.05). (2) F3 Lead: There were statistically significant differences in Go-P2 amplitude, Nogo-P2 amplitude, Nogo-P2 latency, Go-P3 amplitude, and Nogo-P3 latency among the three groups (all P<0.05). Specifically, the OSAHS group exhibited higher Go-P2 amplitude((15.03±5.12) μV vs (10.97±5.50)μV), Nogo-P2 amplitude((14.80±5.84) μV vs (9.67±4.79)μV), and Go-P3 amplitude((11.58±6.02) μV vs (7.49±4.89) μV) compared to the normal group. Additionally, the OSAHS and PS groups exhibited longer Nogo-P2 latency compared to the normal group((223.10±20.61) ms vs (208.00±23.09) ms, (230.60±13.61) ms vs (208.00±23.09) ms), as well as prolonged Nogo-P3 latency((459.20±34.26) ms vs (460.40±24.52) ms and (429.91±31.49) ms) (all P<0.05). Fz Lead: There were statistically significant differences in Go-N1, Go-P2, Nogo-P2, Go-P3, Nogo-N2 wave amplitudes, and Nogo-P3 latency among the three groups (all P<0.05). Compared to the normal group, the OSAHS group exhibited increased Go-P3 amplitude((9.07±5.68) μV vs (5.10±3.51) μV) and decreased Nogo-N2 amplitude((-8.80±5.97) μV vs (-12.84±4.86) μV). Moreover, both the OSAHS and PS groups had prolonged Nogo-P3 latency compared to the normal group((481.60±45.16) ms vs (435.13±28.17) ms and 484.00(443.50, 525.00) ms vs (435.13±28.17) ms) (both P<0.05). F4 Lead: There were statistically significant differences in Go-P2 and Nogo-P2 wave amplitudes among the three groups (all P<0.05). Compared to the normal group, the OSAHS group demonstrated increased Go-P2 amplitude((13.72±5.64) μV vs (9.70±4.59) μV) and Nogo-P2 amplitude((13.90±5.35) μV vs (9.64±3.74) μV) (both P<0.05). Conclusions:Both children with OSAHS and PS exhibit attentional cognitive impairments. However, children with OSAHS demonstrate more pronounced deficits in conflict monitoring, response inhibition, and executive functioning. The prolonged latency of the P3 wave serves as a sensitive electrophysiological marker for the early detection of neurocognitive impairment in children with sleep disordered breathing.

Objective:To investigate the efficacy and prognostic survival of pembrolizumab combined with apatinib and chemotherapy in the treatment of human epidermal growth factor receptor-2 (HER2)-negative advanced gastric cancer.Methods:Patients with HER2-negative advanced gastric cancer were selected from December 2019 to December 2022 as the study subjects. Forty-five patients who received chemotherapy therapy (fluorouracil+cisplatin) were randomly collected and included in control group, and 52 patients who were treated with pembrolizumab combined with apatinib were randomly selected and enrolled as observation group. The difference in short-term efficacy was compared. The levels of serum tumor markers and immune function (CD3 +, CD4 +, CD8 +, CD4 +/CD8 +) were recorded. The long-term efficacy and adverse reactions of patients were compared. Measurement data conforming to the normal distribution were expressed as xˉ± s, and the mean comparison between groups was performed by independent sample t test. Chi-square test was used to compare the rate or composition ratio among enumeration data. P<0.05 was considered statistically significant. Results:At 6 months after treatment, the disease control rate in observation group was significantly higher than that in control group (78.85% (41/52) vs 57.78% (26/45)) ( χ2=5.01, P=0.025), but there was no statistical significance in objective response rate between groups (36.54% (19/52) vs 24.45% (11/45)) ( χ2=1.65, P=0.199). The levels of pepsinogen I, tissue polypeptide specific antigen, carcinoembryonic antigen, carbohydrate antigen 199 and CD8 + in both groups were reduced after treatment, and the levels were lower in observation group than those in control group ( t=6.06, 6.78, 4.68, 11.21, 3.45, all P<0.001). The levels of CD3 +, CD4 + and CD4 +/CD8 + were enhanced significantly in the two groups, and the observation group had higher levels after treatment ( t values were 2.10, 3.74, and 5.19; P values were 0.028, <0.001, and <0.001). After 1 year of follow-up, the survival rate in observation group with 59.62% (31/52) was significantly higher than 37.78% (17/45) in control group ( χ2=4.60, P=0.032). The progression-free survival time ((10.22±1.62) months vs (8.13±1.57) months, t=6.43, P<0.001) and overall survival time ((11.62±1.84) months vs (9.73±1.71) months, t=5.21, P<0.001) in observation group were significantly longer compared to control group. There were no statistical differences in the incidence rates of bone marrow suppression ( χ2=1.92, P=0.165), hand-foot syndrome ( χ2=3.47, P=0.062), gastrointestinal reaction ( χ2=0.32, P=0.574), hypertension ( χ2=0.94, P=0.333) and proteinuria ( χ2=2.39, P=0.122) between the two groups. Conclusion:Compared with chemotherapy, pembrolizumab combined with apatinib shows good short-term efficacy and long-term efficacy in patients with HER2-negative advanced gastric cancer.