Objective:To investigate the microsurgical anatomy of the far lateral suboccipital approach and to evaluate its application to surgical approach. Methods:Fourteen cadaveric heads(28 sides) were dissected through far lateral suboccipital approach to obtain the anatomical data of this approach.A retrospective analysis of microsurgical treatment in 12 cases of tumors situated at lower clivus and foramen magnum was performed. Results:Transverse process of C_1 and inferior occipital trangle were important anatomical marks in the far lateral occipital approach.Drilling the condyle and jugular tubercle was benefit to expand the surgical space.Total removal of the turmors was achieved in 9 patients,subtotal removal in 3 patients,and without any surgical morbidity. Conclusion:Study on the microsurgical anatomy of the far lateral suboccipital approach was helpful in resecting tumors situated at lower clivus and foramen magnum.

Objective:To analyze the cancer incidence and mortality in Yixing City， Jiangsu Province in 2019. Methods:The cancer incidence and mortality in Yixing residents in 2019 were collected. Based on the data， the incidence and mortality rate， standardized incidence and mortality rate and age-specific incidence and mortality rate of cancer were calculated， and the incidence and death of major malignant tumors were also analyzed. Life table method was used to calculate life expectancy and life expectancy without cause of death. Results:The crude incidence of cancer in Yixing in 2019 was 308.61/10⁵， the ASR China was 175.24/10⁵， and the ASR World was 134.56/10⁵. The crude mortality of cancer was 258.78/10⁵， the ASR China was 125.19/10⁵， and the ASR World was 93.01/10⁵. The cancer incidence rate and mortality rate in males were higher than those in females. The top 5 cancers in incidence were lung， gastric， colorectal， thyroid， and esophageal cancers. The top 5 cancer deaths were lung， gastric， liver， esophageal， and colorectal cancers. In 2019， the life expectancy of Yixing residents was 82.53 years old， and the life expectancy without cause of cancer death was 86.15 years old. The biggest loss of life expectancy in the population was caused by lung cancer， followed by gastric cancer and liver cancer. Conclusion:The mortality rate of malignant tumors in Yixing is at a high level. Cancer prevention and treatment should be focused on lung cancer， thyroid cancer and malignant tumors of the digestive tract.

Objective: By analyzing the examination results of physical examination of workers exposed to DMF among 32 factories in some areas of a province, to investigate the working years of dimethylformamide (DMF) poisoning and the impact on the health status of exposed workers, and to explore the targeted intervention strategies. Methods: From February to May 2018, 2, 457 workers exposed to DMF in some areas of Jiangsu Province were selected as survey targets. Cross-sectional survey was conducted to investigate the health status of workers exposed to health, And the health surveillance data, detection data of occupational disease risk factors in the workplace were collected and analyzed, respectively. Results: The positive rate of abnormal liver function and B-ultrasound of males exposed to DMF was significantly higher than that of females. The abnormal rates of liver function, blood pressure and B-ultrasound in workers aged between 60 and 69 were higher in contrast to those in any other age groups. And the differences was statistically significant. In particular, the highest rate of abnormal blood pressure was found in workers exposed 21-30 years (39.2%) , the highest rate of abnormal liver function was found in workers exposed 11-20 years (44.3%) , and the highest rate of abnormal B-ultrasound was found in workers exposed 0-10 years (60.4%) . Conclusion Long-term exposure to dimethylformamide can affect workers’ liver function and blood pressure. Specifically, with the increase of contact age, the degree of chronic damage to liver, cardiovascular and other organs also increases.

Objective To investigate the effects of cognitive therapy combined with picture recognition training on depression after stroke (PSD).Methods Sixty patients with PSD after cerebral infarction were randomized into study and control groups.All accepted routine rehabilitation therapy.In addition,the study group accepted cognitive therapy combined with picture recognition training.The effects were assessed in terms of average reaction time and accuracy in picture recognition,and using the Hamilton depression rating scales (HAMDs) and the Barthel index (BI) before and after 4 weeks of treatment.Results The average reaction time and accuracy in picture recognition and the HAMD and BI scores improved significantly in both groups.The effects in the study group were significantly better than those of the control group.Conclusion Cognitive therapy combined with picture recognition training can alleviate depression symptoms and improve ability in the activities of daily living after stroke.

AIM: To investigate the relationship between human cholesteryl ester transfer protein CETP gene polymorphism and postoperative neurocognitive disorders (PND). METHODS: A total of 124 elderly patients over 65 years of age who underwent elective non-cardiac surgery were enrolled in the study while 25 healthy volunteers matching age and sex were recruited as the control group. Neuropsychological tests were performed 1 day before surgery, 7 days, and 3 months after surgery. PND was determined using the Z value method. The venous blood sample of the surgical patient was taken before the operation, followed by direct gene sequencing. Statistical methods were used to calculate the correlation between CETP gene polymorphism (rs5882) and PND. RESULTS: The incidence of PND was 29.3% and 18.2% at 7 days and 3 months after operation respectively. The A allele frequency of PND patients was significantly higher than that of non-PND patients 7 days and 3 months after surgery (65.52% vs. 41.43%, 34.48% vs. 58.57%, P=0.001), while the G allele frequency in PND group lower than that of non-PND (58.33% vs. 37.86%, 41.67% vs. 62.14%, P=0.004).AA genotype in PND patients was 34.48%, 38.89% at 7 days and 3 months after surgery respectively, significantly higher than 14.29%, 16.05% of non-PND (P=0.023, P=0.029). CONCLUSION: CETP rs5882 polymorphism is associated with PND and AA genotype may be a predisposing factor for postoperative PND in Chinese Han elderly patient.

OBJECTIVE： To establish a method for simultaneous determination of 8 non-anthraquinone constituents in Rheum palmatum. METHODS： HPLC method was adopted. The determination was performed on Symmetry C18 column with mobile phase consisted of methanol-0.1％ phosphoric acid （gradient elution） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃ and detection wavelength was 280 nm. Sample size was 30 μL. RESULTS： The linear range of gallic acid， catechin， epicatechin， resveratrol 4′-O-glucopyranoside， epicatechin gallate， resveratrol 4′-O-β-D-（6″-O-galloyl）-glucopyranoside， sennoside A， 4′-hydroxyphenyl-2-butanone-4′-O-β-D-（2″-O-galloyl-6″-O-p-hydroxy cinnamyl）-glucopyranoside were 6.16-2 464 ng（r＝0.999 9）， 37.4-14 960 ng（r＝0.999 9）， 7.635-3 054 ng（r＝0.999 7）， 7.63-3 052 ng（r＝0.999 9）， 8.32-3 328 ng（r＝0.999 9）， 11.5-4 600 ng（r＝0.999 9）， 16.08-6 432 ng（r＝0.999 9）， 29.3-11 720 ng（r＝0.999 9）， respectively. The limits of quantitation were 3.48， 4.30， 6.40， 4.40， 3.39， 2.87， 8.40 and 4.95 ng， respectively. The limits of detection were 2.32， 2.58， 2.40， 2.64， 2.26， 1.23， 4.20， 2.97 ng， respectively. RSDs of precision， stability and reproducibility tests were all lower than 5％. Recoveries were 94.32％- 100.54％（RSD＝2.78％，n＝6）， 91.15％-99.36％（RSD＝3.72％，n＝6）， 92.16％-98.04％（RSD＝2.39％，n＝6）， 93.41％-100.73％（RSD＝3.17％，n＝6）， 93.89％-98.40％（RSD＝1.99％，n＝6）， 92.61％-101.74％（RSD＝3.71％，n＝6）， 92.66％-103.40％（RSD＝3.76％，n＝6）， 95.45％-102.70％（RSD＝3.06％，n＝6）， respectively. CONCLUSIONS： The established method is simple， accurate and specific， and can be used for the simultaneous determination of 8 non-anthraquinone constituents in R. palmatum.

Objective:To analyze the inflammatory mechanism and potential intervention drugs related to angiotensin converting enzyme 2 (ACE2) inhibitory mutations in order to provide reference for the treatment of corona virus disease 2019 (COVID-19).Methods:The data of lung adenocarcinoma with ACE2 mutations were screened from the cancer genome atlas (TCGA) database. The data were analyzed by R program language edgeR package and cluster Profiler package, gene ontology (GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Using String online analysis website for protein-protein interaction (PPI) network analysis, screening out the core genes, and finally using the Epigenomic Precision Medicine Prediction Platform (EpiMed) for multi-group association analysis of key genes, and drug candidates prediction.Results:A total of 1 005 differential genes were obtained, of which 91 were up-regulated and 914 down-regulated. A total of 71 GO were enriched, including 45 items related to biological processes, 16 items related to cell components, and 10 items related to molecular function. A total of 13 KEGG pathways were enriched, mainly in inflammatory pathways, various viral infectious diseases, transcriptional regulation, drug metabolism and protein digestion and absorption pathways. The differentially expressed genes were introduced into String online analysis website for PPI network analysis, a total of 252 proteins were obtained, and 10 core genes were H2A clustered histone 16(HIST1H2AL), H3 clustered histone 2 (HIST1H3B), H3 clustered histone 7 (HIST1H3F), H3 clustered histone 11 (HIST1H3I), H3 clustered histone 3 (HIST1H3C), H2B clustered histone 3 (HIST1H2BB), H2B clustered histone 6 (HIST1H2BI), H4 clustered histone 2 (HIST1H4B), H1-4 linker histone (HIST1H1E), H2A clustered histone 4 (HIST1H2AB). Interferon-α, resveratrol, celecoxib, heartleaf houttuynia herb, weeping forsythia capsule, dexamethasone, Chinese pulsatilla root, tumor necrosis factor-α inhibitors, liquorice root and famciclovir might be drugs for the treatment of ACE2 mutation-related inflammation.Conclusions:Inflammation associated with ACE2 inhibitory mutations is similar to the pathogenesis of COVID-19, which could lead to disease by promoting the activation of inflammatory pathways such as mitogen-activated protein kinase (MAPK), the Janus kinase signal transducer and activator of transcription (JAK/STAT), mammalian target of rapamycin (mTOR). Celecoxib, interferon and resveratrol may have the potential therapeutic effects on COVID-19.

Objective:To investigate the omics mechanism of SARS-related immune injury and predict targeted therapeutic drugs through clinical bioinformatics analysis of the transcriptome data of SARS virus in order to provide reference for clinical treatment of COVID-19.Methods:The transcriptome data of SARA virus were collected from the Gene Expression Oibus (GEO) and used to screen differential genes. Enrichment analysis and protein interaction analysis were performed to investigate the mechanism of immune damage associated with SARS. A platform of epigenetics in precision medicine (EpiMed) was established to predict potential therapeutic drugs.Results:The mechanism of SARS-related immune injury was complex, involving affecting the function of immune cells through signaling pathways such as Toll-like receptors, increasing cytokines in plasma through Th17 signaling pathway and inducing autoimmune responses after autoantibodies were generated by molecules such as IL-6, NF-κB, and TNF. Drugs such as Chuanqiong and Etanercept might have therapeutic effects on SARS-related immune damage.Conclusions:SARS virus could cause abnormal expression of many immune-related molecules and signaling pathways. Drugs such as Chuanqiong and Etanercept might have therapeutic effects on SARS-related immune damage. This study might provide reference for clinical treatment of COVID-19.

Objective : To observe the changes of soft tissue in patients with Angle class Ⅱ division Ⅰ malocclusion during mixed dentition treated with MRC functional appliance. Methods : Twenty patients with Class Ⅱ division Ⅰ malocclusion of Angle were treated with functional MRC. The facial features before and after treatment were measured by software and the results were analyzed statistically. Results: The patients′soft tissue profiles were improved significantly before and after treatment, The OE-Prn-Pos angle, OE-N′-B′ angle, OE-N′-Pos angle, OE-Prn-N′angle, Cm-Sn-UL angle, and N′-Sn-Pos angle increased significantly (P < 0.05). The OE-Sn-UL angle, and Sn-N′-B′ angle decreased significantly (P < 0.05); the distance between the lateral soft tissue line and the middle Sn-H line, UL-E line and LL-E line were significantly different (P < 0.05). The distances were all reduced, and the difference was statistically significant (P < 0.05). Conclusion The application of an MRC functional appliance can improve the relationship among nasolabial soft tissue, upper and lower lip soft tissue, and chin-lip soft tissue, thus improving the protrusion profile of patients.

Objective:To explore the risk factors for lower extremity deep vein thrombosis (DVT) in patients with a spinal cord injury (SCI).Methods:The medical records of 276 hospitalized SCI patients were analyzed retrospectively. They were divided into a DVT group ( n=63) and a no-DVT group ( n=213). Gender, age, blood type, smoking history, surgical history, the time from SCI to admission, cause of SCI, fracture, SCI segments, American Spinal Cord Injury Association grade and complications were compared between the two groups. Binomial logistic regression was used to isolate the risk factors for lower extremity DVT among such patients. Results:Among 84% of the 63 with a lower extremity DVT, it was a calf muscle venous thrombosis. Anemia, hyponatremia and time from SCI to admission (which ranged from 74 to 195 days) were the most serious DVT risk factors.Conclusions:SCI patients are of high risk for DVT, with anemia and hyponatremia being independent risk factors.