Ferroptosis is a unique and new mode of cell death, which is driven by iron-dependent lipid peroxidation and mainly characterized by the accumulation of reactive oxygen species in cytoplasm and lipids. Ferroptosis plays an important role in the pathogenesis of many ocular fundus diseases, such as retinitis pigmentosa, age-related macular degeneration, diabetic retinopathy, retinal detachment, retinoblastoma and so on. The use of ferroptosis-related inhibitors or activators can regulate the course of the disease and provide new ideas for the research, prevention and treatment of ophthalmic diseases.

Objective:To investigate the diagnostic value of ultrasound elastography combined with enhancer of Zeste homolog 2 (EZH2) and breast cancer susceptibility gene 1 (BRCA1) proteins in triple-negative breast cancer.Methods:A total of 116 breast cancer patients selected for treatment in our hospital from 2019 to 2021 were analyzed, and ER and PR were analyzed according to the expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). Patients who were all HER2 negative were classified as TNBC group, with a total of 21 cases, and patients who were positive for ER, PR, and HER2 were classified as non-TNBC, a total of 95 cases. All enrolled patients underwent ultrasonic elastography examination. The positive expression of EZH2 and BRCA1 was detected by immunohistochemistry. Chi-square test was used to analyze the diagnostic value of ultrasound elastography combined with EZH2 and BRCA1 proteins in TNBC.Results:In the TNBC group, the proportion of smooth edges (35.09) and lobulation of lesions (9.52) was higher than that in the non-TNBC group (12.63, 5.26), while the proportion of burrs (28.57) and fuzziness (23.81) was lower than that in the non-TNBC group (50.53, 31.58). The proportion of calcifications (52.38) in the TNBC group was lower than that in the non-TNBC group (85.26). The non-attenuation ratio of rear echo (80.95) was higher than that of non-TNBC group (52.63). The proportion of blood flow grade enrichment (57.14) was lower than that in the non-TNBC group (63.16) (all P<0.05). The positive expression rate of EZH2 in the TNBC group (85.71) was higher than that of non-TNBC (63.16) ( P<0.001), and the positive expression rate of BRCA1 in the TNBC group (19.05) was lower than that of non-TNBC (55.79) ( P<0.05). The posterior echo non-attenuation ratio (88.89) and rich blood supply ratio (88.89) of EZH2 positive patients in the TNBC group were higher than those with negative (33.33, 0) (all P<0.05), and the rear echo non-attenuation ratio (25.00) and rich blood supply ratio (25.00) of BRCA1 positive in the TNBC group were lower than those with negative (52.94, 88.24) (all P<0.05) ; According to the pathological results, the sensitivity, specificity and accuracy of posterior echo for the diagnosis of TNBC were 25.37%, 91.84% and 53.44%, respectively. The sensitivity, specificity and accuracy of EZH2 were 23.08%, 92.11% and 45.69%, respectively. The sensitivity, specificity and accuracy of BRCA1 were 28.81%, 92.98% and 60.34%, respectively. The combined sensitivity, specificity and accuracy of the three were 53.13%, 95.24% and 83.62%, respectively. The sensitivity, specificity and accuracy of blood flow fraction for the diagnosis of TNBC were 25.81%, 90.74% and 56.03%, respectively. The sensitivity, specificity and accuracy of blood flow fraction, EZH2 and BRCA1 were 59.26%, 94.38% and 86.21%, respectively. Conclusion:The joint classification of the posterior echoes and blood flow in ultrasonic elastography combined with EZH2 and BRCA1 has important significance in the diagnosis of TNBC.

Objective To observe the efficacy and safety of endoscope and laparoscope in treatment of acutebiliary pancreatitis.Methods 84 patients with acute biliary pancreatitis from January 2010 to January 2014 in our hospital during treatment were randomly divided into the study group and control group according to the random num-ber table methods,42 cases in each group.The control group was treated with conservative treatment of department of internal medicine,while the study group was treated with duodenoscopy combined with laparoscopy.To observe and compare the efficacy and adverse reactions of two groups.Results Temperature returned to normal time,abdominal pain relief time,recovery time of amylase in urine,recovery time of biochemical index,hospitalization time and cost of hospitalization of the study group after treatment were (3.44 ±1.63)d,(4.73 ±1.12)d,(7.82 ±3.31)d,(9.81 ± 6.42)d,(12.43 ±4.61 )d,which were significantly lower than (5.94 ±2.43)d,(7.53 ±2.12)d,(11.72 ± 2.21)d,(18.41 ±8.62)d,(20.33 ±6.21)d of the control group(t =3.90,4.02,4.26,4.50,5.01,all P <0.05). 2 cases of the study group occured biliary tract bleeding,2 cases with pancreatic pseudocyst,1 case with wound infec-tion,there was no recurrence,the incidence rate of adverse reaction was 11.90%;3 cases of the control group after treatment occurred pancreatic pseudocyst,2 cases with abdominal cysts,5 cases with recurrence,1 case with acute respiratory distress syndrome (ARDS),1 case with renal failure,the incidence rate of adverse reactions was 28.57%, which of the control group was significantly higher than the study group (χ2 =4.21,P <0.05 ).Conclusion Duodenal endoscopy combined with laparoscopy has good clinical effect,shorter hospitalization time,less cost,less adverse reaction and the recurrence rate is low in treatment of acute biliary pancreatitis,which has high application value.

Objective To analyze the characteristics and influencing factors of sleep disorders and nocturnal hypoxemia of patients with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Four hundred and twenty-five patients with snoring were scored by Epworth Sleepiness Scale ( ESS), and monitored by polysomnography (PSG). The possible correlations between sleep structure, hypoxia parameters, ESS and clinical features were analyzed and compared in those patients. Results Four hundred and twenty-five patients were divided into 4 groups according to the apnea-hypopnea index (AHI). There were 65 primary snoring patients (15.3%) and 360 OSAHS patients (84. 7% ) including 187 patients (44. 0% ) in severe OSAHS group. ESS was increased as aggravation of OSAHS. There were significant statistical differences in ESS among each group. Compared with primary snoring group, sleep efficiency, NREM1 + 2, oxygen desaturation index ( ODI), time with pulse oxygen saturation below 90% (T(SpO2 <90% ) ) were significantly higher in the OSAHS groups, and NREM3 +4, lowest pulse oxygen saturation level ( LSpO2 ) were lower. ESS was correlated positively with AHI (r= 0. 474,P <0. 01 ). They were both correlated positively with ODI, T (SpO2 <90% ) and NREM1 + 2( ESSr =0. 392, 0. 356,0. 194;AHI r = 0. 714, O. 682, 0. 365, all P < 0. 01 ), and correlated negatively with LSpO2, NREM3 + 4 ( ESS r = - 0. 414, - 0. 196; AHI r = - 0. 740, - 0. 385, both P < 0. 01 ). LSpO2, ODI and T (SpO2 < 90% ) were the primary influencing factors. Common clinical presentations and subjective symptoms were presented including daytime sleepiness, impaired memory, fatigue, dry mouth, oppressive wake and morning headache, etc. Percentage of individuals with daytime sleepiness in the severe OSAHS group was 73. 3% (137/187). These had serious impact on the patients' quality of life, leading to difficulty concentrating, poor memory and cognitive impairment. Conclusions Sleep disorders are found in the patients with different degrees of OSAHS. The excessive daytime sleepiness interrelated partly with the structure of sleep, and totally with hypoxia parameters. The more severity the patients have, the more nocturnal hypoxia, sleep disorders and higher ESS are found.