Objective:To investigate the molecular mechanism of the 5-methylcytosine(m5C)reader Y-box binding protein 1(YBX1)in participating in the development and progression of colorectal cancer(CRC)by regulating the stability of the ferroptosis inhibitor membrane-spanning 4-domains subfamily A 15(MS4A15).Methods:Bioinformatics databases were used to investigate the mRNA and protein expression levels of YBX1 in CRC.RT-qPCR was used to measure the expression level of YBX1 in CRC cells.LC-MS was used to measure the level of m5C modification in CRC cells and nor-mal colorectal mucosal cells.CCK-8 assay was used to observe the effect of YBX1 on the proliferation of CRC cells,Transwell assay was used to observe its effect on the migration ability of CRC cells,and flow cytometry was sued to observe its effect on the apoptosis of CRC cells.Bioinformatics methods were used to identify the ferrop-tosis inhibitors that can interact with YBX1 and potential m5C modification sites.GEPIA2 was used to analyze the association between the expression of YBX1 and MS4A15.The expression of YBX1 was inhibited,and then the mRNA expression level and m5C modifica-tion level of MS4A15 were analyzed.The catRAPID database was used to find the binding sites between YBX1 protein and MS4A15 mRNA.CRC cells were treated with actinomycin D after inhibition of YBX1 expression,and RT-qPCR was used to measure the stabil-ity of MS4A15 mRNA.The expression of MS4A15 was inhibited,and then the proliferative activity,migration ability,and apoptosis rate of cells were measured,as well as the expression levels of the key indicators for ferroptosis,including MDA,ROS,and Fe2+.Results:High mRNA and protein expression levels of YBX1 were observed in CRC,and YBX1 was highly expressed in CRC cells.The m5C modification level of CRC cells was significantly higher than that of normal colorectal mucosal cells.YBX1 could promote the prolifera-tion and migration of CRC cells and inhibit the apoptosis of CRC cells.The bioinformatics analysis showed that YBX1 was positively correlated with the expression level of the ferroptosis inhibitor MS4A15,and there were multiple m5C modification sites on MS4A15.Inhibition of YBX1 expression could reduce the mRNA expression level and m5C modification level of MS4A15 and the stability of MS4A15 mRNA.There were significant reductions in the proliferative activity and migration ability of CRC cells and a significant in-crease in the apoptosis rate of CRC cells after inhibition of MS4A15 expression,with significant increases in the content of MDA,ROS,and Fe2+.Conclusion:These results show that YBX1 promotes the development and progression of CRC by stabilizing MS4A15 via m5C modification,which provides a promising targeted therapeutic strategy for CRC patients.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.

Objective To discuss the hemodynamic features of internal carotid aneurysm,and study the relationship between hemodynamics and occurrence,development and rupture of internal carotid aneurysm .Methods The 3D model of internal carotid aneurysm was established by materialise's interactive medical image control system(MIMICS).The finite element analysis software ANSYS was used to carry out numerical simulation.Results Low wall shear stress of internal carotid aneurysms were located at the same area.The wall shear stress at different region were positive correlation with the blood flow velocity.Conclusion The blood flow velocity and wall shear stress at the top of aneurysm are relatively low.This position is consistent with the rupture position.The significant changes of hemodynamic at the top of aneurysm may trigger a series of mechanical biological effects on the internal carotid aneurysm wall.The changes alters cells'gene and protein's expression,causes rupture of the aneurysm.

Objective To evaluate the long-term prognosis and safety of ABO-incompatible (ABO-I) liver transplantation on type-O patients with acute severe liver disease,analyze and compare the effects and main complications between different donor blood types,and investigate corresponding treatment measures.Methods The clinical data of 65 cases of emergency orthotopic liver transplantation (OLT) for type-O patients with acute severe liver disease from January 2014 to January 2017,including 41 cases of ABO-compatible (ABO-C) OLT and 24 cases of ABO-incompatible OLT (7 with type-A donor,9 with type-B donor,and 8 with type-AB donor) were retrospective analyzed.Results The model for end-stage liver disease (MELD) score in the ABO-incompatible group was 32.5±5.5,significantly higher in the ABO-compatible group (23.3±8.9) (P=0.001).The data of the other perioperative factors showed no statistically significant difference between two groups.The cumulative survival rate in the ABO-compatible group was 87.8 % (36/41),not significantly different from that in the ABO-incompatible group [87.5% (21/24),P=0.924].The 57 cases who had survived after perioperative period were followed up for 4-37 months (mean 18 months).Significantly higher incidence of hepatic artery and biliary complications was found in ABO-incompatible group (P=0.005,and P<0.001,respectively).The incidence of hepatic artery complication and biliary complication in ABO-incompatible group was 29.2% (7/24) and 37.5% (9/24),and that in ABO-compatible group was 4.9% (2/41) and 0 (0/41),respectively.The rate of acute rejection in the ABO-incompatible group and ABO-compatible group was 9.8% (4/41) and 4.2% (1/24) (P=0.463).The infection rate in the ABO-compatible group and ABO-incompatible group was 24.3% (10/41) and 29.2%(7/24),respectively (P=0.598).Conclusion The different donor blood types including ABO-compatible and ABO-incompatible liver transplantation program on type-O patients with acute severe liver disease have a favorable outcome.The long-term cumulative survival rate between two groups shows no significant difference.With the help of effective immunosuppression and intensive perioperative management,ABO-incompatible liver transplantation is an acceptable option to cure type-O patients with acute liver failure in emergency.The incidence of hepatic artery and biliary complications was lower in ABO-compatible group than in ABO-incompatible group.For the type-O patients with ABO-incompatible liver transplantation,the use of rituximab and plasma exchange to decrease the antibody titers of recipients is essential to prevent and cure the hepatic artery and biliary complications.

Objective To evaluate the safety and clinical short-term efficacy of interventional emboliz-ation with hepasphere-loaded microspheres in treating inoperable hepatocellular carcinomas. Methods A total of 15 patients with unresectable hepatocellular carcinoma underwent transcatheter arterial chemoembolization ( TACE ) using hepasphere-loaded microspheres as embolic agent . The clinical data , imaging follow-up materials, complications of interventional treatment, prognosis, etc. were summarized and analyzed. The results were evaluated with modified response evaluation criteria in solid tumors (mRECIST); monthly follow-up was made for all patients. A total of 23 TACE procedures were performed in 15 patients. Results The following-up period ranged from 6 months to 15 months , the median follow-up time being 10 months . According to mRECIST, the 3-month objective response rate (CR+PR) was 73.3% and disease control rate (CR+PR+SD) was 93.3%;the 6-month objective response rate (CR+PR) was 73.3%and the disease control rate (CR+PR+SD) was 86.7%. No severe complications, such as bile leak complicated by infection, liver abscess, abdominal hemorrhage, bleeding due to tumor rupture, gastrointestinal bleeding, etc. occurred in all patients . Conclusion In treating unresectable hepatocellular carcinomas , TACE using newly-developed hepasphere microspheres carries satisfactory clinical short-term efficacy and safety, although thelog-term results need to be further investigated with larger sample trial.

Objective To study the feasibility of using fractional flow reserve (FFR) to guide whether to perform coronary revascularization of non-culprit moderate stenosis in patients with unstable angina and estimate their clinical prognosis. Methods This study enrolled unstable angina patients with multivessel disease. First successful stenting of the culprit artery, then the other non-culprit moderate coronary stenosis were randomized into PCI guided by angiography or guided by FFR measurements. Death from any cause, nonfatal myocardial infarction, unplanned hospitalization leading to urgent revascularization and clinical manifestations with angina were followed during the first year. Results 71 patients were included, among them 35 patiens were randomly assigned to angiography-guided PCI and 36 patients to FFR-guided PCI. In FFR-guided PCI group, FFR was successfully measured in all of non-culprit moderate coronary stenosis. In 23 stenosis, the FFR was greater than 0.80, and stents were not placed in these stenosis. In 13 stenosis with FFR<0.8, stent were inplant and FFR was raised≥0.95 after stenting. The percentage of patients who had a primary end-point event was higher in the angiography-guided PCI group than the FFR-guided PCI group (P<0.05). Neither the rate of mortelity from any cause nor the rate of non-fatal myocardial infarction had significant difference between the 2 groups. Related to the target vessels rates of nonfatal myocardial infarction (5.6%vs. 28.6%) and target lesion revascularization (5.6%vs. 31.4%) were statistically different (P<0.01 and P<0.05, respectively). Conclusions In patients with unstable angina, it is safe to use FFR values to guide decisions on the revascularization of angiographically moderate non-culprit stenosis. Routine measurement of FFR in addition to angiographic guidance, as compared with PCI guided by angiography alone, results in a significant reduction in major adverse events at 1 year, particularly in urgent revascularization, and clinical manifestations with angina get better.

Objective To explore the application of transcatheter arterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE ) in two-stage hepatectomy of hepatocellular carcinoma (HCC).Methods From September 2010 to September 2013,a total of 107 patients with HCC in the right liver lobe who were not suitable for one stage hepatectomy received TACE or TACE combined with SPVE treatment were enrolled.Among them,55 received TACE therapy and 52 accepted TACE combined with SPVE treatment.The technique success rate,complication,adverse reactions,the volume change of each liver lobe and the rate of hepatectomy of HCC were observed.Chi-square test was used for numerical data comparison and Student′s t test for measurement data.Results TACE or TACE combined with SPVE therapy was successfully applied in all the 107 patients,the technique success rate was 100%.During treatment period,no complications such as ectopic embolization, liver function failure,puncture tract bleeding,gastrointestinal bleeding,bile leakage and hepatic abscess were observed.After treatment,the adverse reactions included liver function impairment,pain in hepatic region,fever,nausea and vomiting.Four weeks after the treatment,the volumes of tumor and right liver lobe decreased to certain degree in patients with HCC of both TACE group and TACE combined with SPVE group.The volume of left liver lobe in TACE group had no obvious change,while remarkably increased in TACE combined with SPVE group.The pre-treatment residual liver volume (RLV)of TACE group and TACE combined with SPVE group was (404.0 ± 46.3 )cm3 and (393.9 ± 65 .7 )cm3 , respectively,and the difference was not statistically significant (t=0.927,P =0.356).Four weeks after the treatment,RLV was (415.4 ±45.7 )cm3 and (567.3 ±88.7 )cm3 ,respectively,and the difference was statistically significant (t= -11 .219,P <0.05).Patients were followed up for three to six months,the rates of hepatectomy were 38.2%(21/55)and 86.5 %(45/52)in TACE group and TACE combined with SPVE group,and the difference was statistically significant (χ2 =26.440,P <0.01 ).Conclusion For patients with HCC not suitable for one stage hepatectomy,the treatment of TACE combined with SPVE before operation could effectively control the growth of the tumor,decrease the volume of tumor,increase RLV,and then increase the rate of two-stage hepatectomy.

ObjectiveTo demonstrate the efficacy and safety of Hangzhou tacrolimus capsule (Saishi Tac capsule,Hangzhou Zbongmei Huadong Pharmaceutical Co.Ltd,China) in Chinese liver transplant recipients.MethodsMulticenter,randomized open-labeled,prospective controlled clinical trial was performed in de novo Chinese liver transplant recipients.According to inclusive and exclusive criterion,83 liver recipients from 11transplant centers were enrolled.The recipients accepted Saishi Tac capsule,mycopheolate and steroid 48 h post-operation.The initial dose of Tac was 0.1-0.15 mg kg-1day-1and C0 was 8-12 ng/ml in the first 60 days,followed by 5-10 ng/ml until the terminal observation time poiut (12 weeks after transplantation).The efficacy and safety were estimated during the period.The primary efficacy endpoint of the study was the incidence of biopsy-confirmed acute rejection.Graft survival was the secondary endpoint.Safety was assessed by monitoring laboratory parameters and adverse events reported over the course of the study,such as infection,renal damage,hypertension,hyperlipema and diabetes mellitus and other adverse affairs.ResultsThe dose of Tac at 1st,2nd,4th and 8th week post-operation was (4.1±1.9),(4.5±2.1),(4.5±2.1),(4.4±1.8) and (4.1±2.1) mg,and correspondjng values to the C0 were (8.1±4.5),(8.9±4.5),(8.8±4.3),(8.8±4.1) and (8.0±2.8) ng/ml.During 12 weeks of follow-up,the incidence of biopsy-confirmed acute rejection was 4.8％ (4/83),and all of cases were reversed by implosive therapy.The survival rate of graft hver was 100％.The incidence of lung infection and diabetes mellitus was both 6.02％.ConclusionSaishi Tac capsule was safe and effective to Chinese liver transplant recipients.

The recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) has a major impact on outcome, while the guide of treatment of it is lacked until now. so this review will attempt to sum-marize how best to manage recurrent HCC after LT in detail.

The healing training was an important method to improve living ability and quality of life of patients with schizophrenia.This article introduced a living skill training scheme applied in out-patients whose course of disease shorter than 5 years.