Ankylosing spondylitis （AS） is an inflammatory autoimmune disease with chronic low back pain as the main clinical manifestation， which mainly affects the axial joints， peripheral joints and various organs. In severe cases， the spine is stiff or deformed， which affects the quality of life and health of patients. The pathogenic factors of AS are complex， which are related to heredity， immunity and intestinal flora. The pathogenesis of AS is not clear yet. Among them， inflammatory reaction， bone destruction and heterotopic ossification are the main pathological features of AS， which play an important role in the disease process of AS. Traditional Chinese medicine has multi-target， multi-channel and multi-component pharmacological effects， which can prevent and treat AS by anti-inflammation， inhibiting bone destruction and preventing heterotopic ossification， and the clinical effect is remarkable， but there is no relevant literature report. Therefore， this review expounds the relationship between inflammatory reaction， bone destruction and heterotopic ossification and the occurrence and development of AS， and summarizes the latest research reports of traditional Chinese medicine in treating AS from anti-inflammatory， inhibiting bone destruction and preventing heterotopic ossification， aiming at providing reference and new ideas and directions for further research on the prevention and treatment of AS by traditional Chinese medicine.

Objective To investigate the value of derived neutrophil to lymphocyte ratio(dNLR)as a pre-dictive biomarker for immunotherapy response in advanced non-small cell lung cancer(NSCLC).Methods A total of 92 patients with advanced NSCLC who received anti-programmed cell death receptor(PD-1)combined therapy in the hospital from August 2018 to December 2019 were selected as the research objects.Peripheral blood samples were collected within 24 h before immunotherapy,complete blood cell count was measured,and dNLR was calculated.Patients with advanced NSCLC were treated with PD-1 inhibitors or combination regi-mens,and the response to immunotherapy was evaluated by objective response rate(ORR)and disease control rate(DCR).The receiver operating characteristic(ROC)curve was used to analyze the predictive value of dN-LR for the diagnosis and response to immunotherapy in advanced NSCLC.Multivariate Logistic regression model was used to analyze the relationship between dNLR and immunotherapy response in advanced NSCLC.Kaplan-Meier survival curve and Log-Rank test were used to analyze the overall survival(OS),progression-free survival(PFS)and disease-specific survival(DSS)of the low dNLR group and the high dNLR group.Re-sults The ORR and DCR of advanced NSCLC patients after immunotherapy were 32.61％and 65.22％,re-spectively,and the PFS and OS were 17.0(8.5,25.5)and 24.0(12.7,36.1)months,respectively.The dNLR of DCR group was lower than that of non-DCR group(P＜0.001).The dNLR of ORR group was lower than that of non-ORR group(P＜0.001).The area under the curve of dNLR for predicting DCR or ORR was 0.897(95％CI 0.829-0.965)and 0.874(95％CI 0.795-0.953),respectively.Multivariate Logistic regres-sion analysis showed that dNLR≥2.28 increased the risk of non-response to immunotherapy,and this inde-pendent relationship still existed after further adjustment for objective confounding factors(P＜0.05).Sur-vival curve results showed that patients with high dNLR had significantly shorter PFS,OS,and DSS(P＜0.05).Multivariate Cox regression analysis showed that high dNLR was an independent factor affecting the poor prognosis of patients with advanced NSCLC(P＜0.05).Conclusion High dNLR advanced NSCLC pa-tients are more difficult to benefit from immune therapy,and prognosis is worse.dNLR is promising as a pre-dictive biomarker for immunotherapy response in advanced NSCLC.

Objective:To investigate the effect of serine/arginine-rich splicing factor 2 (SRSF2) on ferroptosis and its possible mechanism in glioblastoma cells.Methods:The online database of gene expression profiling interactive analysis 2 (GEPIA 2) and Chinese Glioma Genome Atlas were used to analyze the expression of SRSF2 in glioblastoma tissue and its association with patients prognosis. To validate the findings of the online databases, the pathological sections of glioblastoma and non-tumor brain tissues from Tianjin Medical University General Hospital, Tianjin, China were collected and analyzed by using immunohistochemistry. Silencing SRSF2 gene expression in glioblastoma cells by siRNA was analyzed with Western blot. The proliferation index was detected by using CCK8 assay. The rescued experiment was conducted by using expression plasmid of pcDNA3.1(+)-SRSF2. The activity of ferroptosis was assessed by using the levels of iron ions and malondialdehyde in glioblastoma cells and the changes in the ratio of glutathione to oxidized glutathione. The changes of gene expression and differential pre-mRNA alternative splicing (PMAS) induced by SRSF2 were monitored by using the third-generation sequencing technology analysis, namely Oxford nanopore technologies (ONT) sequencing analysis.Results:SRSF2 expression was higher in glioblastoma tissues than non-tumor brain tissues. Immunohistochemistry also showed a positive rate of 88.48%±4.60% in glioblastoma tissue which was much higher than the 9.97%±4.57% in non-tumor brain tissue. The expression of SRSF2 was inversely correlated with overall and disease-free disease survivals ( P<0.01). The proliferation index of glioblastoma cells was significantly reduced by silencing with SRSF2 siRNA ( P<0.01) and could be reversed with transfection of exogenous SRSF2. The levels of intracellulariron ions and malondialdehyde increased ( P<0.05), but the glutathione/oxidized glutathione ratio and the expression of key proteins in the glutathione pathway remained unchanged ( P>0.05). ONT sequencing results showed that silencing SRSF2 in glioblastoma cells could induce a significant alternative 3' splice site change on ferroptosis suppressor protein 1 (FSP1). Conclusion:SRSF2 inhibits the ferroptosis in glioblastoma cells and promotes their proliferation, which may be achieved by regulating FSP1 PMAS.

Rheumatoid arthritis(RA)is an autoimmune disease with the basic pathological manifestation of synovial inflammation.Symmetric poly-articular pain and swelling are the main symptoms in clinical practice,and even extra-articular manifestations and comorbidities such as interstitial fibrosis and coronary artery disease are triggered,which seriously affect the quality of life of patients.Traditional Chinese medicine(TCM)has achieved good clinical efficacy in the prevention and treatment of RA with the advantages of multi-pathway,multi-target,multi-component,and less toxic side effects,and plays an important role in the treatment of RA.Recently,many studies have demonstrated that Chinese medicine monomers and Chinese herbal compound can control inflammation,reduce angiogenesis,induce apoptosis of synovial fibroblasts,and inhibit their proliferation,invasion and migration by regulating the PI3K/Akt signaling pathway,so as to play a key role in the treatment of RA.For this reason,the article summarizes current knowledge regarding the PI3K/Akt signaling pathway and its role in RA,as well as summarizes the current research progress of TCM in the treatment of RA by regulating the PI3K/Akt signaling pathway.The aim of this review is to provide theoretical bases for the prevention and treatment of RA and the development of new drugs.

Objective:To investigate the effect of dexmedetomidine on cognitive function and transforming growth factor β(TGF-β)/Smad pathway in elderly patients with gastric cancer after radical operation.Methods:A total of 100 elderly patients with gastric cancer undergoing radical gastrectomy in Taizhou Central Hospital from December 2018 to December 2019 were randomly divided into observation group (50 cases) and control group (50 cases) according to the random digital table method.In the observation group, dexmedetomidine hydrochloride was given intravenously after anesthesia induction.The control group was given sodium chloride injection intravenously after anesthesia induction.The dosage of propofol and remifentanil, the time of operation, the amount of intraoperative bleeding, the occurrence of cognitive impairment (PCOD) on the 3rd and 7th day after operation, and the expression of TGF-β, Smad1 and Smad2 proteins before and after operation were compared between the two groups.Results:The dosages of propofol [(648.71±65.25)mg] and remifentanil [(0.46±0.08)mg] in the observation group were lower than those in the control group [(837.92±57.53)mg and (0.59±0.14)mg] ( t=15.380, 5.701, all P<0.05). There was no statistically significant difference between the two groups in operation time and bleeding volume (all P>0.05). The incidences of PCOD at postoperative 3d and 7d in the observation group (8.00%, 12.00%) were lower than those in the control group (26.00%, 34.00%) (χ 2=5.741, 6.832, all P<0.05). The expression of TGF-β(0.45±0.09), Smad1 (0.37±0.06) and Smad2 (0.36±0.04) in the observation group were lower than those in the control group [(0.60±0.18), (0.47±0.08) and (0.42±0.11)] ( t=5.271, 7.071, 3.625, all P<0.05). Conclusion:Dexmedetomidine can reduce PCOD and downregulate the protein expression of TGF-β/Smad pathway.

Objective To investigate the MRI features of combined hepatocellular-cholangiocarcinoma(cHCC-CC).Methods The MR imaging features of 8 patients with cHCC-CC confirmed by histopathology were analyzed retrospectively.And 3 patients among them performed MR dynamic contrast scanning with gadoxetic acid(Gd-EOB-DTPA)-a hepatocyte-specific MRI contrast agent.Results MRI showed hypointensity on T1 WI and hyperintensity on T2 WI of tumor's solid components.Dynamic MRI enhancement demonstrated peripheral hyperenhancement of the lesion (n =7) and global hyperenhancement(n=1) in arterial phase,progressively delayed or continued enhancement of the central area in portal venous phase and equilibrium phase,meanwhile the peripheral hyperenhancement of the lesion in arterial phase washed out(n=6),edge enhancement continued(n=1),and enhancing area extended progressively(n=1) which the peripheral hyperenhancement in arterial phase remained.Enhancing pseudocapsule were observed in equilibrium phase(n=6).3 patients injected with Gd-EOB-DTPA presented a target-like appearance in hepatobiliary phase,defined as a peripheral hypointense rim compared to the central area with delayed enhancement of the lesion.Conclusion Dynamic MRI can be a certain value in the preoperative dagnosis of cHCC CC.

Avian influenza virus is a new recombinant virus , which can cause severe respiratory symptoms ,such as short course,acute disease,and a high mortality rate.The purpose of this paper was to summarize the current status of this virus in terms of its epidemiology ,genetic evolution and virulence .By introducing the advancement in the research of this subtype virus, we hope to provide data and evidence ,for effective surveillance and prevention of this virus .

Purpose To clarify the role of KAI1/CD82 in metastasis of nasopharyngeal carcinom and to evaluate the clinical efficacy of KAI1/CD82-expressing EPCs in the prevention of nasopharyngeal carcinoma.Method Umbilical vein-derived EPCs were infected with KAI1/CD82-expressing lenti-virus to get a KAI1/CD82-overexpressing EPC cell line (KAI1/CD82-EPCs).A xenograft mouse model of human nasopharyngeal carcinoma was established,and KAI1/CD82-EPCs were injected through the tail vein.The effect of the KAI1/CD82-EPCs on growth and metastasis of the xenograft was observed.Results Time required for tumor formation was 14.70 ± 3.81,15.05 ±3.85,14.20 ± 3.55 days respectively for the EPCs,EPCs-NC,and KAI1/CD82-EPCs groups,with no significant difference among the three groups (P =0.771).Weight of the xenograft was (1.388 ±0.204) g,(1.487 ±0.223) g,(1.485 ±0.234) g respectively for the EPCs,EPCs-NC,and KAI1/CD82-EPCs groups,with no significant difference (P =0.274).Rate of lung metastasis was 55％,45％ and 10％ for the EPCs,EPCs-NC,and KAI1/CD82-EPC groups,and the difference was significant (P =0.005).Number of metastatic lesions was 34.27 ± 5.35,38.44 ± 9.63,17.50 ± 3.54 for the three groups,and the difference was also significant (P =0.007).Immunohistochemistry indicated positive KAI1/CD82 expression in metastatic lesion of the KAI1/CD82-EPCs group,but no KAI1/CD82 expression in the EPCs group or EPCs-NC group.Conclusion KAI1/CD82-expressing EPCs inhibits lung metastasis of the xenograft mouse model of human nasopharyngeal carcinoma.

Objective To study the diagnostic value of endoscopic ultrasonography (EUS)for benign and malignant bile duct stricture.Methods Data of 51 patients who underwent EUS from January 2007 to March 2015 due to distal biliary stricture were retrospectively studied.And their diagnosis with EUS,IDUS,bile duct cytological brushing and final diagnosis were compared.Results Malignant bile duct stenosis were finally confirmed in 19 cases and benign stenosis were confirmed in 32 cases.The sensitivity (73.7％ VS 57.1％) and positive predictive value (73.7％ VS 57.1％) of EUS for the benign and malignant diagnosis of biliary tract stenosis were significantly higher than that of IDUS (P＜0.05),while their specificity(84.4％ VS 84.2％)and accuracy(80.4％ VS 76.9％)were similar.The sensitivity of EUS was significantly higher than that of bile duct cytological brushing (73.7％ VS 50.0％),while their specificity (84.4％ VS 100.0％)and accuracy(80.4％ VS 81.6％)were similar.EUS findings of hypoechoic mass features had higher diagnostic accuracy for detecting malignant distal bile duct stricture than irregular thickening of the lumen in the distal bile duct (100.0％ VS 64.3％,P＜0.05).Conclusion For patients with lesions of the distal bile duct that CT/MRI could not diagnose,EUS has an important value for the further diagnosis of benign and malignant bile duct stricture.

This study intends to explore the potential resource-orientedutilization value of the flower of Sophora flavescents by analyzing alkaloids and flavonoids in the flower of S. flavescens from Shanxi province. This study established a rapid UPLC-TQ-MS/MS method that is used for determination of seven alkaloids and seven flavonoids in the flower of S.flavescens. The different florescences all have the seven detected alkaloids such as cytisine, oxy-matrine, oxy-sophocarpine, sophoridine, N-methylcytisine, matrine, sophocarpine.The total contents of detected alkaloids are as follows: flower buds 1.47%, primal flowers 1.34%, full bloomed flowers 1.17%, faded flowers 1.01%. The top three contents of alkaloids are N-methylcytisine , oxy-sophocarpine and oxymatrine, accounting for about 83% of the total amount of detected alkaloids. All the samples in different florescences have the seven detected flavonoids such as rutin, luteolin, quercetin, isoquercitrin, trifolirhizin, kurarinone, and kushenol I. The total contents of detected alkaloids are as follows: flower buds 495.2 μg•g⁻¹, primal flowers 313.7 μg•g⁻¹, faded flowers 224.2 μg•g⁻¹, full bloomed flowers 193.0 μg•g⁻¹. The content of luteolinis relatively higher than other detected flavonoids, accounting for about 89%-94% of the total amount of detected flavonoids. The results indicated that the flower of S.flavescens could be an important material resource to obtain the resourceful alkaloids. This result can provide scientific basis for resource-oriented utilization and industrial development of the flower of S. flavescens.