[摘 要] 目的：探究吲哚胺2，3-双加氧酶1（IDO1）在不同类型乳腺癌组织中的表达及其与患者预后和免疫细胞浸润的关系。方法：收集 TCGA 数据库中乳腺癌RNA测序数据和相应临床资料，分析IDO1 mRNA在不同亚型、不同分期、不同绝经阶段及不同年龄等各类型乳腺癌组织与癌旁组织中的表达差异。将IDO1 mRNA表达有明显差异的乳腺癌类型的患者分为IDO1高、低表达组，比较3组间的疾病特异性生存率（DSS），分析IDO1 mRNA在DSS有明显差异的癌组织中的表达水平与免疫细胞浸润的关系。采用免疫组化法检测IDO1蛋白在ER阴性、PR阴性、HER2阳性及Ⅱ期乳腺癌组织中的表达情况，对数据库数据进行验证。结果：IDO1 mRNA在乳腺癌组织中呈高表达，但在不同类型乳腺癌中的表达不同。IDO1 mRNA在ER阴性、PR阴性、HER2阳性、HER2阴性亚型、Ⅱ期、T2期、N0期和M0期分期、绝经前、绝经后和年龄≤ 60岁患者的乳腺癌组织中呈高表达（P < 0.05或P < 0.01或P < 0.001）。ER阴性、PR阴性、HER2阳性和Ⅱ期亚组中，IDO1 mRNA高表达患者的DSS明显高于低表达患者（P < 0.05或P < 0.01）。ER阴性、PR阴性、HER2阳性和Ⅱ期乳腺癌组织中IDO1 mRNA表达与活化的树突状细胞（aDC）、Th1细胞、T细胞、CD56dim NK细胞、CTL和Treg细胞等免疫细胞浸润有关联（均P < 0.001）。IDO1蛋白在ER阴性、PR阴性、HER2阳性及Ⅱ期乳腺癌组织中均呈高表达（均P < 0.001），与数据库数据分析结果一致。结论：IDO1在不同类型的乳腺癌组织中的表达不同，IDO1表达与ER阴性、PR阴性、HER2阳性和Ⅱ期乳腺癌患者的预后和免疫细胞浸润有关联。

Objective To research the procedure for creating an animal model of mitral regurgitation by implanting a device through the apical artificial chordae tendineae, and to assess the stability and dependability of the device. Methods Twelve large white swines were employed in the experiments. Through a tiny hole in the apex of the heart, the artificial chordae tendineae of the mitral valve was inserted under the guidance of transcardiac ultrasonography. Before, immediately after, and one and three months after surgery, cardiac ultrasonography signs were noted. Results All models were successfully established. During the operation and the follow-up, no swines died. Immediately after surgery, the mitral valve experienced moderate regurgitation. Compared with preoperation, there was a variable increase in the amount of regurgitation and the values of heart diameters at a 3-month follow-up (P<0.05). Conclusion In off-pump, the technique of pulling the mitral valve leaflets with chordae tendineae implanted transapically under ultrasound guidance can stably and consistently create an animal model of mitral regurgitation.

Objective To analyze the effect of immune function on the condition and prognosis of asthma in children with asthma. Methods A total of 148 children with asthma diagnosed in Qinghai women and children's Hospital from January 2018 to January 2021 were included in the analysis, the immune function of the children was determined, and the information of all children was followed up for 6 months after treatment; compared The condition and follow-up prognosis of children with immunocompromised and normal immune function were analyzed and discussed, and the correlation between the expression levels of immunoglobulins (IgG, IgA, IgM) and the condition and short-term recurrence prognosis (6 months) of children was analyzed and discussed, so as to guide Prevention and clinical work. Statistical analysis was done using SPSS19.0. Results The average age of 148 children with recurrent respiratory tract infection in the study was (8.94±3.65) years old, including 70 male children. The condition of the children was evaluated and classified into mild/severe cases: 148 children in this study included mild cases. There were 98 cases and 50 severe cases. There were more males and lower BMI levels in severe children (P<0.05) . The levels of IgG, IgA and IgM in children were all lower in severe children (P<0.05) . The follow-up found that the proportion of relapses in critically ill children was higher (P<0.05). Comparing the levels of IgG, IgA, and IgM in mild and severe children, the average levels of IgG, IgA, and IgM in severe children were lower than those in the mild group, and the difference was statistically significant (P<0.05); recurrence within 6 months of follow-up Prognostic evaluation showed that 19 of the 148 children had relapse, and the levels of IgG, IgA, and IgM in severe relapsed children were significantly lower than those without relapse (P<0.05). Analysis of the relevant factors potentially affecting the prognosis of recurrence showed that gender (female) (OR=1.726) , BMI level (weight loss) (OR=1.613) , IgG expression level factor (low expression) (OR=1.898) , IgA expression Level factor (low expression) (OR=3.509) , IgM expression level factor (low expression) (OR=3.217) and disease factor (severe) (OR=3.619) were potential risk factors, which would increase the risk of poor prognosis. Conclusion The asthma attack in children with immunocompromised immune function is relatively severe, and the short-term recurrence probability is higher, which deserves clinical attention and preventive intervention.

Objective To investigate the relationship between gait spatiotemporal parameters and balance function in stroke hemiplegic patients. Methods From September, 2018 to March, 2020, 76 stroke hemiplegic patients (38 in Brunnstrom Ⅳ and V, respectively) were assessed balance function with Active Balancer EAB-100 and Star Excursion Balance Test (SEBT), and gait parameters of speed, cadence and asymmetry, named step length asymmetry ratio (SLA), swing time asymmetry ratio (SWTA), stance time asymmetry ratio (STA), maximum flexion angle ratio (MFA) of hip and knee. The correlation among gait parameters and balance function was analysed. Results The balance and gait parameters were better in those in Brunnstrom V than in Brunnstrom Ⅳ (|t| > 2.268, P < 0.05). The speed and cadence correlated with the most balance indexes (|r| > 0.335, P < 0.05). SLA correlated with SEBT in Brunnstrom Ⅳ patients (r = -0.467~-0.613, P < 0.01), while it correlated with medial-lateral (M-L) stability limits in Brunnstrom V patients (r = -0.356, P = 0.028). SWTA correlated with stability limit of Anterior-Posterior (A-P) (r = -0.335, P = 0.040) and M-L (r = 0.510, P = 0.001), and most of SEBT (r = -0.330~ -0.445, P < 0.05) in Brunnstrom Ⅳ patients. MFA of hip and knee correlated with balance indexes in Brunnstrom Ⅳ patients (|r| > 0.326, P < 0.05), while MFA of knee correlated with most balance indexes in Brunnstrom V patients (r > 0.329, P < 0.05), and MFA of hip correlated with A-P stability limit (r = 0.369, P = 0.023). Conclusion Both speed and cadence of steps can well respond to the balance function in stroke hemiplegic patients. For the asymmetry, it is related with balance in patients with poorer recovery.

Objective: To investigate the status and identify the influencing factors of smoking behaviors among residents in Nanshan District, Shenzhen City, so as to provide insights into tobacco control. Methods: Permanent residents at ages of more than 18 years were recruited from 17 communities in Nanshan District, Shenzhen City using the stratified multistage random sampling method from July to November, 2018. Participants&#39; demographic features, smoking, smoking cessation and exposure to secondhand smoke were collected using the Individual Questionnaire for 2018 Chinese Adult Chronic Disease and Nutrition Surveillance. The factors affecting current smoking were identified using a multivariable logistic regression model. Results: Totally 1 700 questionnaires were allocated, and 1 625 valid questionnaires were recovered, with an effective recovery rate of 95.59%. The respondents included 714 men and 911 women, with a male to female ratio of 1∶1.27, and had a mean age of ( 45.13±13.59 ) years. The prevalence of current smoking was 15.51%, with 28.15% prevalence in men and 5.60% in women. The mean age of starting daily smoke was ( 21.00±5.52 ) years, and the mean daily smoking frequency was (13.53±9.15) cigarettes/d. The prevalence of smoking cessation was 6.58%, with 10.64% in men and 3.40% in women, and the prevalence of exposure to secondhand smoke was 41.42%, including 46.63% in men and 37.32% in women. Multivariable logistic regression analysis showed that an educational level of junior high school ( OR=1.683, 95%CI: 1.088-2.602 ), an educational level of high school/technical secondary school/vocational school (OR=1.687, 95%CI: 1.185-2.402), an occupation of farmers ( OR=2.514, 95%CI: 1.404-4.500 ), and an occupation of commercial and service personnel ( OR=1.939, 95%CI: 1.093-3.439 ) were associated with current smoking. Conclusion The prevalence of current smoking is low among residents in Nanshan District, but the prevalence of current smoking in women is higher than the national level. Educational level and occupation are main factors affecting current smoking.

Objective The knowledge of cervical cancer prevention and control，the cognition of human papillomavirus (HPV) vaccine and the willingness to vaccinate HPV vaccine among college students in Xiangyang were investigated and analyzed to provide a reliable scientific basis for the primary prevention of cervical cancer prevention and control in Xiangyang. Methods By means of stratified sampling method and self-made questionnaire, this paper conducted a questionnaire survey among college students in 3 universities in Xiangyang. Results A total of 8 523 college students participated in the questionnaire survey, and 4 473 of them had sufficient knowledge of cervical cancer prevention and control and HPV vaccine, with the awareness rate of 52.48%. Male students, rural residents and non-medical majors were the influencing factors of insufficient knowledge of cervical cancer prevention and control and HPV vaccine. Among the 6 459 female college students who participated in the survey, 5,993 (92.79%) were willing to be vaccinated, and 859 (13.30%) were already vaccinated. Major, educational background, living expenses and cognitive scores were the influencing factors of HPV vaccination intention. Conclusion College students in Xiangyang City are relatively deficient in the knowledge of cervical cancer prevention and control and HPV vaccine. Targetable science popularization and education can improve college students&#39; correct understanding of cervical cancer prevention and control knowledge, promote the HPV vaccine vaccination plan, and reduce the occurrence of HPV-related diseases and cervical cancer.

AIM:To discuss the effect of Yijing Buyang Huanwu Decoction combined with timolol maleate eye drop on the blood supply and intraocular pressure in patients with primary open angle glaucoma(POAG).

METHODS:The 120 patients with POAG in our hospital from February 2018 to February 2020 were selected, they were divided into decoction group(n=60)and eye drop group(n=60)according to the randomly table. The eye drop group was treated with timolol maleate eye drop, and the decoction group was treated with Yijing Buyang Huanwu Decoction on the basis of the eye drop group, the eye blood supply \〖end diastolic velocity(EDV), peak systolic velocity(PSA), resistance index(RI)of central retinal artery(CRA)and posterior ciliary artery(PCA)\〗, intraocular pressure, visual acuity, visual field \〖mean sensitivity(MS), mean deviation(MD)\〗, efficacy and adverse reactions were compared between the two groups.

RESULTS: The EDV and PSA of the CRA and PCA and the visual acuity, MS in the Decoction group and eye drop group after treatment were significantly higher than those in the before treatment, the RI of the CRA and PCA and the intraocular pressure, MD in the Decoction group and eye drop group after treatment were significantly lower than those in the before treatment, the EDV and PSA of the CRA and PCA and the visual acuity, MS in the Decoction group after treatment were significantly higher than those in the eye drop group, the RI of the CRA and PCA and the intraocular pressure, MD in the Decoction group after treatment were significantly lower than those in the eye drop group(P<0.05). The effective rate in the Decoction group was significantly higher than that in eye drop group(P<0.05). There was no significant difference in adverse reactions between the Decoction group and eye drop group(P>0.05).

CONCLUSION: Yijing Buyang Huanwu Decoction combined with timolol maleate eye drop can effectively improve the blood supply, intraocular pressure and visual acuity, visual field of patients with POAG, it can improve the efficacy, and it has the good safety, it&#39;s worth for further clinical promotion.

AIM:To investigate the curative effect of pterygium excision combined with free conjunctival flap transplantation on primary pterygium and the influence on tear film function.

METHODS:Totally 120 patients(126 eyes)with primary pterygium who were admitted to the hospital between January 2018 and October 2019 were selected as the research subjects. They were divided into two groups according to the random number table method. 62 cases(64 eyes)in the conjunctival transplantation group were treated with pterygium excision combined with free conjunctival flap transplantation. 58 cases(62 eyes)in the amniotic membrane transplantation group were treated with pterygium excision combined with amniotic membrane transplantation. The length of Schirmer&#39;s-Ⅰ test(SⅠt), tear film break-up time(BUT), corneal fluorescein staining(FL)scores, noninvasive Keratograph tear breakup time(NIBUT), determine tear river height(TMH)and conjunctival goblet cell count were determined before surgerry, at 3mo and 6mo after surgery. Patients&#39; quality of life was evaluated with ocular surface disease index(OSDI), and the therapeutic effect and recurrence were evaluated at 6mo after surgery.

RESULTS: There was no significant difference in the average repair time of corneal epithelium or the duration of symptoms between the conjunctival transplantation group and the amniotic membrane transplantation group(P>0.05). At 6mo after surgery, the BUT \〖(11.11±2.77)s vs(10.01±2.41)s\〗, NIBUT \〖(10.01±1.52)s vs (9.52±0.98)s\〗 in conjunctival transplantation group was longer than that in the amniotic membrane transplantation group(P<0.05), and the FL score was lower than the amniotic membrane transplantation group \〖(0.44±0.10)points vs(0.50±0.11)points\〗(P<0.05). The conjunctival goblet cell counts in both groups were increased significantly after surgery(P<0.05). At 3mo and 6mo after surgery, the counts in conjunctival transplantation group were larger than those in the amniotic membrane transplantation group \〖(311.41±58.45)/mm² vs(285.46±68.96)/mm²,(342.41±66.89)/mm² vs(314.41±70.12)/mm²\〗(P<0.05). The OSDI scores of both groups were significantly decreased after surgery(P<0.05), but there was no significant difference between groups(P>0.05). There was no statistically significant difference in the overall curative effect between the two groups(P>0.05). The recurrence rates in the conjunctival transplantation group and the amniotic membrane transplantation group were 6.3% and 6.5%, respectively(P>0.05).

CONCLUSION: Pterygium resection combined with autologous conjunctival flap transplantation is equivalent to amniotic membrane transplantation in terms of postoperative recovery and prevention of pterygium recurrence. Both can improve the stability of patients&#39; tear film function.

AIM: To explore the effect of corneal limbal trapezoid conjunctival flap incision and modified Parks incision on tear film function and postoperative complications in patients with strabismus.

METHODS: A prospective study was conducted in patients with strabismus who had been treated with surgery in the First Affiliated Hospital of Nanyang Medical College between January 2017 and October 2019. The subjects were divided into conjunctival flap incision group(60 cases with 82 affected eyes treated with strabismus surgery via corneal limbal trapezoid conjunctival flap incision)and modified Parks group(62 cases with 83 affected eyes treated with strabismus surgery via modified Parks incision). Therapeutic effects on strabismus were evaluated, and dry eye symptoms were scored before and after surgery. Schirmer I test(SⅠt), tear film break up time(BUT)and cornea fluorescein staining score(FL score)were recorded. Comprehensive ocular surface examination was performed to determine tear river height(TMH)and noninvasive keratograph tear breakup time(NIKBUT). Satisfaction with surgery was surveyed, and adverse reactions were statistically analyzed.

RESULTS: Both groups of patients completed the surgery. Totally 80 eyes and 79 eyes of the conjunctival flap incision group and the modified Parks group were basically in normal position(within±10PD), and there was no statistically significant difference in cure rate between the two groups(P>0.05). S I t and BUT of the modified Parks group were significantly higher than those of the conjunctival flap incision group at 7 and 14d after surgery, and the FL score was significantly lower than that of the conjunctival flap incision group at 7d after surgery(P<0.05). TMH of the modified Parks group was significantly higher than that of the conjunctival flap incision group at 14d after surgery, and NIKBUT was significantly longer than that of the conjunctival flap incision group at 7d and 14d after surgery(P<0.05). The overall incidence rates of complications in the conjunctival flap incision group and the modified Parks group were 7.3% and 2.4%, respectively(P>0.05). The overall satisfaction rates of the conjunctival flap incision group and the modified Parks group were 83.3% and 95.2%, respectively(P<0.05).

CONCLUSION:Surgeries with corneal limbal trapezoid conjunctival flap incision or modified Parks incision can achieve good correction effects on strabismus, but surgery with modified Parks incision has less effect on tear film stability, with higher surgical satisfaction and better clinical application effect.

Objective To analyze the screening results and risk assessment of common malignant tumors among female residents in Deyang from 2017 to 2019, so as to provide basis for cancer prevention and control. Methods Women who underwent physical examinations and completed the survey of common malignant tumors related risk factors from 2017 to 2019 were selected. The high risk rate, screening rate and detection rate of common malignant tumor among female urban residents in Deyang were analyzed. Results From 2017 to 2019, a total of 49,871 female urban residents completed the survey of common malignant tumor related risk factors. The risk rates of breast cancer, lung cancer, cervical cancer and colorectal cancer were 13.24%, 7.65%, 12.92% and 5.53%, respectively. Among all the age groups, women at the age of 50~59 years old were at the highest risk of breast cancer, lung cancer, cervical cancer, colorectal cancer; The screening rates of breast cancer, lung cancer, cervical cancer and colorectal cancer were 24.68%, 11.72%, 34.62% and 14.15%, respectively; The screening rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among women with different educational levels showed significant difference (P<0.05). The screen rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among high risk groups were 24.68%, 11.75%, 26.56% and 14.35%, respectively; The detection rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among the screening groups were 9.33%, 2.68%, 9.82%, and 2.02%, respectively (P<0.05). Conclusion Female residents in Deyang from 2017 to 2019 have high risk and detection rates of breast cancer and cervical cancer, so active screening of malignant tumors among urban female residents can effectively improve the residents&#39; quality of life, and is of vital importance for the early diagnosis and treatment of malignant tumors.