Objective Bioinformatics techniques were used to analyze the key genes that affect the survival of patients with breast cancer,so as to provide theoretical basis for the prognosis evaluation and targeted therapy of breast cancer.Methods The dif-ferentially expressed genes between breast cancer samples and normal breast samples were screened by TCGA database,enriched and analyzed by gene ontology(GO)and Kyoto Encyclopedia of Gene and Genome(KEGG).The protein-protein interaction network was constructed and the key genes were screened.The Kaplan-Meier method was used to find and verify the genes that might be used as potential prognostic biomarkers for breast cancer,and to explore the correlation between prognostic target genes and molecular typing and staging.The Timer database was used to analyze the correlation between prognosis-related target genes and immune cell infiltra-tion.Results A total of 1,285 differentially expressed genes were screened,including 318 up-regulated genes and 967 down-regu-lated genes(|log2FC| ≥ 1,P＜0.05).Differentially expressed genes were mainly enriched in cytokine-cytokine receptor interac-tions,PI3K-AKT signaling pathway,cAMP signaling pathway,and so on.A total of 10 key genes(AURKB,CDC20,CCNA2,NCAPG,BUB1,TOP2A,BUB1B,CCNB1,CDK1,and KIF11)were screened from the protein interaction network.Among them,the ex-pression of CCNA2,NCAPG and BUB1 in breast cancer tissues were higher than those in normal tissues.Their high expression was as-sociated with the poor prognosis of patient's overall survival(P＜0.05),and was significantly associated with the molecular typing and staging of breast cancer.The results of immune infiltration showed a significant correlation between the expression of CCNA2,NCAPG,BUB1 and the infiltration of immune cells such as B lymphocytes,CD8+T lymphocytes,neutrophils,dendritic cells and other immune cells.Conclusion CCNA2,NCAPG and BUB1 may be key genes in the occurrence and development of breast cancer,and their high expression is related to poor prognosis of breast cancer patients,which can be used as potential biomarkers for the prognosis of breast cancer.

Objective To explore the effect of endovascular re-operation on iliac limb occlusion(ILO)after endovascular aneurysm repair(EVAR).Methods Clinical data of 6 patients with ILO after EVAR from March 2018 to March 2023 were retrospectively analyzed.All the patients underwent ipsilateral femoral artery incision with Fogaty balloon thrombectomy and iliac artery balloon dilation,3 of which were combined with stent implantation and 1 of which with popliteal artery thrombectomy of Rotarex.Results The recanalization rate of the 6 patients with iliac branch occlusion was 100%(6/6).The median follow-up time was 24 months(range,6-48 months).The symptoms of lower extremity ischemia disappeared in 5 patients(Rutherford 0 grade).One patient had limb ischemia and dry gangrene(RutherfordⅢgrade).Conclusion It is necessary to carefully analyze the causes and choose personalized endovascular treatment plans for ILO after EVAR.

Objective: To investigate the sleep characteristics of children aged 3-12 years old in Shanghai, and to provide a reference for improving pediatric sleep health. Methods: From April to June 2019, 16 542 children aged 3-12 years old were randomly selected from 31 kindergartens and 17 primary schods in Shanghai, and a cross sectional epidemiological survey was conducted using multi stage cluster sampling. The Children s Sleep Habits Questionnaire (CSHQ) was used to evaluate sleep characteristics. Results: The bedtime routine of children in Shanghai was (21:27±00:36) and (21:46±00:46) on weekdays and weekends, respectively. Corresponding wake up times were (6:52±00:28) and (7:47±00:48), total sleep duration was (9.05±1.07) and (9.52±1.17)h, and the prevalence of inadequate sleep was 81.0% and 55.4%. The average score of sleep problems was (51.56±8.04), and the prevalence of disturbed sleep was 93.5%. With advancing age, the total sleep time of children in Shanghai decreased, and the difference in weekend weekday sleep patterns increased. Furthermore, two major sleep problems were observed, namely, short sleep duration and daytime sleepiness, which became increasingly more prominent. Girls usually went to bed later on weekdays and woke up later on weekends, and a greater difference in weekend weekday sleep patterns was observed. Moreover, psychological problems such as sleep anxiety were more serious among girls. Conclusion At present, children in Shanghai have insufficient sleep time and late bedtimes. Large differences in weekend weekday sleep patterns were observed, and various sleep problems were identified. Sleep related anxiety and differences in weekend weekday sleep patterns were particularly high among girls.

Objective:To investigate the effect of thrombin in preventing endoleaks and promoting sac regression after endovascular repair of abdominal aortic aneurysm.Methods:Retrospective study was performed on patients with abdominal aortic aneurysm (AAA) who were admitted to Peking University Third Hospital for endovascular repair (EVAR) from May 2018 to May 2023. Thrombin injection was performed during EVAR in patients with high risk of endoleaks, and the success rate of the operation, perioperative mortality (30 d), incidence of endoleak, thrombin-related allergic reactions and ectopic embolism were observed.Results:In 83 patients, the technical success rate was 100% (83/83). The average operation time was (89.9±17.1) min. The average hospitalization was (5.8±1.3) days. There were no thrombin-related allergic reactions and ectopic embolism in peri-operation. The median follow-up time was 36 months. Five patients lost follow-up. During the follow-up period, 3 patients died, of which 2 died of acute myocardial infarction at 16 and 24 months, respectively, and 1 died of lung cancer at 34 months. The remaining 75 patients survived, with an overall survival rate of 96.2% (75/78). Type Ⅱ internal leakage occurred in 3 of the 75 patients, with an incidence of 4.0%. The maximum diameter and volume of the sac did not increase significantly during follow-up, and conservative treatment was performed. The mean maximum sac diameter of 75 patients was (43.8±7.4) mm, which was significantly lower than that of (61.4±14.4) mm before EVAR ( P<0.001). The sac volume was also significantly decreased [(125.5±54.1) cm 3vs. (239.3±145.1) cm 3, P<0.01]. Conclusions:The use of thrombin in the prevention and treatment of endoleak during EVAR is safe and effective after mid-term follow-up. In the follow-up of EVAR, attention should be paid to the change of sac volume.

Objective To explore the relationship between the polymorphisms of the primary gout predisposing gene (BCAS3) rs11653176 locus and the incidence of gout in Han Chinese men in coastal areas of Shandong Province. Methods One hundred and fifty-two cases of patients with gout remission,68 cases of acute stage,252 patients with hyperuricemia, and 280 healthy subjects, total males, were enrolled. Genotyping the rs11653176 locus of BCAS3 gene by TaqMan probe technique. The expression level of BCAS3 gene mRNA in each PBMC was measured by RT-qPCR. The levels of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and interleukin-18(IL-18)in serum were measured by ELISA. Results The change of allele frequency of rs11653176 locus in BCAS3 gene was associated with gout(P<0.01). BCAS3 mRNA in patients with gout was significantly higher than that of healthy people and patients with hyperuricemia(P<0.01). In gout patients, the expression level of BCAS3 gene containing C allele was higher than that of T allele(mRNA,P<0.05). The inflammatory factors in the acute phase of gout were significantly higher than those in phases of remission and hyperuricemia(P<0. 01). Conclusion Changes in the allele frequency of BCAS3 alleles rs11653176(high C, low T)may contribute to the expression of this gene,and lead to gout. And the onset of gout is closely related to the production of inflammatory factors.

Objective: To examine the prevalence of allergic diseases in schoolaged children from Shanghai and to explore related factors so as to produce epidemiological data regarding allergic diseases in children. Methods: Multistage cluster sampling was used to carry out the study in Shanghai from April to June 2019. A total of 10 686 children aged 7-12 years from 17 primary schools participated in the survey. The International Study of Asthma and Allergies in Childhood (ISAAC)Scale was used to evaluate allergic diseases. Multivariate Logistic regression analysis was performed to analyze the related factors. Results: The overall prevalence of allergic diseases among schoolaged children in Shanghai was 47.0%. A higher prevalence was observed among boys (50.4% vs 43.3% in girls, χ2=54.44, P<0.01). Common allergic diseases included asthma (13.9%), allergic rhinitis (18.2%), and atopic dermatitis (34.3%). The Logistic regression analysis showed that the common risk factors of asthma, allergic rhinitis and atopic dermatitis included the following:male gender (OR=1.52,1.44,1.22); mother has a bachelors degree or above (OR=1.26,1.77,1.84); family history of allergic diseases (OR=2.87,4.24,2.57); only child (OR=1.16,1.28,1.22); curtain cleaning frequency <1 time/month (OR=1.41,1.79,1.77); room not cleaned daily (OR=1.14,1.18,1.20); and dust exposure frequency ≥1 time/month (OR=1.45,1.56,1.42), all P<0.05. These three types of allergic diseases were also associated with unique risk factors that dependent on socialenvironmentalbehavioral factors. Conclusion Compared with previous data, the prevalence of allergic diseases among schoolaged children in Shanghai increased significantly in 2019. The related influencing factors involve multiple variables including demographics, environmental exposure and behavior, which warrant further exploration.

Objective: To explore the association between exclusive breastfeeding and sleep onset delay among school aged children, and to provide a reference for promoting childhood sleep health. Methods: A total of 10 686 children aged 7-12 years old were recruited from 17 primary schools in Shanghai using the multi stage sampling method from April to June 2019. The duration of sleep onset delay and exclusive breastfeeding were identified using the Children s Sleep Habits Questionnaire and a self designed questionnaire, respectively. The association between the duration of exclusive breastfeeding and the score and the risk of sleep onset delay were estimated using linear regression and a Logistic regression model, respectively. Results: After adjusting for confounding factors, compared with never exclusive breastfeeding, the score of sleep onset delay decreased by 0.07, 0.08 and 0.05 in cases that involved exclusive breastfeeding for less than 3 months, 3-6 months and more than 6 months, respectively; and the odds of sleep onset delay decreased by 39.0%(OR=0.61, 95%CI=0.47-0.79), 41.1%(OR=0.59, 95%CI=0.47-0.75) and 21.1%(OR=0.79, 95%CI=0.65-0.96), respectively. Similar findings were observed in analyses stratified by gender, although the association was stronger among boys. Moreover, administration of probiotics or yogurt only improved sleep onset delay in those who were exclusively breastfed for no more than 6 months. Conclusion Longer durations of exclusive breastfeeding were associated with a lower risk of sleep onset delay among school aged children. However, exclusive breastfeeding for over 6 months diminished the protective effect that was otherwise observed on sleep onset delay.