Objective To investigate the diagnostic efficacy and clinical value of GNB4 and Riplet gene methylation alone and in combination in the diagnosis of primary liver cancer.Methods A total of 313 patients were selected,including 78 patients with primary liver cancer,41 patients with other digestive system tumors,17 patients with non-digestive system tumors,20 patients with postoperative liver cancer,and 157 patients with benign liver disea-ses.The levels of GNB4 and Riplet gene methylation in plasma were detected using quantitative methylation-specific PCR(qMSP).Serum alpha-fetoprotein(AFP)levels were measured by direct chemiluminescence.Results The sensitivity and specificity of AFP in diagnosis were 51.3％and 94.3％,respectively;the sensitivity and specificity of GNB4 gene methylation in diagnosis were 83.3％and 99.4％,respectively;the sensitivity and specificity of Riplet gene methylation in diagnosis were 73.1％and 99.4％,respectively.The sensitivity and specificity of GNB4 and Riplet gene methylation combined diagnosis were 92.3％and 98.7％,respectively;the sensitivity and specificity of AFP,GNB4 and Riplet gene methylation combined diagnosis were 92.3％and 98.7％,respectively;the sensitivity and specificity of combined diagnosis including age and gender were 93.6％and 97.5％,respective-ly.Conclusion The sensitivity and specificity of AFP in the diagnosis of primary liver cancer are limited,while the methylation levels of GNB4 and Riplet genes are higher,and the sensitivity and specificity of their combined de-tection are higher than those of AFP.The sensitivity and specificity of AFP,GNB4 and Riplet gene methylation combined diagnosis are significantly higher than those of AFP,GNB4 and Riplet gene methylation alone.

Objective: To examine the association between noise exposure in daily life and depressive symptoms, so as to provide the evidence for reducing the impact of noise in daily life on depressive symptoms. Methods: Based on the 2015 to 2020 database of National Health and Nutrition Examination Survey, demographic information and noise exposure in daily life were collected from people aged 18 years and over. Depressive symptoms were evaluated using the Patient Health Questionnaire-9. The relationship between noise exposure in daily life and depressive symptoms were analyzed using a multivariable logistic regression model. Results: A total of 3 216 individuals were enrolled, including 1 707 males (53.08%) and 1 509 females (46.92%). The mean age was (49.30±18.07) years. There were 491 individuals with noise exposure in daily life, accounting for 15.27%. There were 265 cases with depressive symptoms, accounting for 8.24%. There were 66 individuals exposed to noise in daily life in the group with depression symptoms (24.91%), and 425 individuals exposed to noise in daily life in the normal group (14.40%), with statistically significant difference in noise exposure in daily life between the two groups (P<0.05). Multivariable logistic regression analysis showed that after adjusting for gender, age, educational level, marital status, household income poverty ratio, sleep duration, alcohol consumption and hearing, individuals who had noise exposure in daily life (OR=1.743, 95%CI: 1.258-2.413) were more likely to have high risk of depressive symptoms. Conclusion Noise exposure in daily life was associated with an increased risk of depressive symptoms.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To investigate whether prophylactic use of metal clips is necessary after cold snare polypectomy (CSP) of colorectal polyps of 6-10 mm.Methods:A total of 200 patients with 6-10 mm polyps that met the criteria of cold snare resection in Chengdu Third People's Hospital from 15 February 2022 to 30 May 2022 were randomly divided into two groups: a group that received preventive metal clip treatment and an observation group. Age, gender, body mass index (BMI), Boston score, endoscopy entry time, wound size, operation time, intraoperative bleeding time, postoperative delayed bleeding rate and cost between the two groups were compared and analyzed.Results:Ninety-eight patients in the metal clip group had 122 polyps removed, and 97 patients in the observation group had 119 polyps removed. There was no significant difference in the age, gender, BMI, Boston score, endoscopy entry time or wound size between the two groups. There were significant differences in the operation time (171.03±90.78 s VS 69.81±43.26 s, t=2.266， P=0.010), intraoperative bleeding time (19.98±17.37 s VS 29.16±17.56 s, t=-2.875， P=0.006) and surgery cost (571.63±110.92 yuan VS 366.32±13.2 yuan, t=18.102， P<0.001) between the metal clip group and the observation group. There was no significant difference in the delayed bleeding incidence［0.0%（0/98）VS 1.0%（1/97）， P=0.497］between the two groups. Conclusion:For patients with continuous bleeding time <60 seconds after CSP of 6-10 mm colonic polyps, the prophylactic use of metal clips may reduce the bleeding time, but may increase the operation time and cost. Metal clips have little effect on preventing postoperative complications.

Objective To explore the effect of long non-coding RNA (lncRNA) NUTM2A-AS1 on the damage of vascular endothelial cells induced by oxidized low density lipoprotein (oxLDL) and its molecular mechanism. Methods Human umbilical vein endothelial cells(HUVECs) were cultured in DMEM medium. The HUVECs treated with 100 μg/mL oxLDL were assigned to oxLDL group, while those cultured under normal conditions were assigned to Con group. After transfection of the lncRNA NUTM2A-AS1 interference expression vector and negative control, microRNA-129-5p mimic and negative control into HUVECs, the cells treated with 100 μg/mL oxLDL were assigned to oxLDL+si-NUTM2A-AS1 group, oxLDL+si-NC group, oxLDL+miR-129-5p group, and oxLDL+miR-NC group, respectively. After co-transfection of the lncRNA NUTM2A-AS1 interference expression vector and miR-129-5p inhibitor or negative control into HUVECs, the cells treated with 100 μg/mL oxLDL were assigned to oxLDL+si-NUTM2A-AS1+anti-miR-129-5p group and oxLDL+si-NUTM2A-AS1+anti-miR-NC group. The levels of malondialdehyde (MDA) in cells, as well as the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were measured using kits. Cell apoptosis was detected by flow cytometry. Protein expression was detected by Western blot. The targeting relationship between NUTM2A-AS1 and miR-129-5p was detected by dual luciferase reporter assay and RNA pull-down experiments. Results Compared with the Con group, the expression level of lncRNA NUTM2A-AS1 was increased, the expression level of miR-129-5p was decreased, the content of MDA was increased, the activities of SOD and GSH-Px were decreased, the apoptosis rate of vascular endothelial cells and the expression levels of cleaved-caspase3 and cleaved-caspase9 were increased in the oxLDL group (P < 0.05). After interference of lncRNA NUTM2A-AS1 expression or overexpression of miR-129-5p, the content of MDA was decreased, the activities of SOD and GSH-Px were increased, cell apoptosis was reduced (P < 0.05). The damage to vascular endothelial cells mediated by knockdown of lncRNA NUTM2A-AS1 under oxLDL conditions can be reversed by downregulation of miR-129-5p. LncRNA NUTM2A-AS1 targeted miR-129-5p for regulation. Conclusion Interference of lncRNA NUTM2A-AS1 expression can inhibit oxLDL-induced vascular endothelial cell damage by targeting miR-129-5p for upregulation.

Objective To investigate the effect of circ_0114427 on apoptosis and inflammation of alveolar epithelial cells induced by lipopolysaccharide (LPS) and its mechanism. Methods Human alveolar epithelial cells were cultured in vitro and transfected with si-circ_0114427, microRNA (miR)-330-5p mimics or co-transfected with si-circ_0114427 and anti-miR-330-5p, and the cellswere then treated with 10 mg/L LPS for 24 hours. The expression levels of circ_0114427 and miR-330-5p in the cells were detected using real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). The protein levels of Cleaved-caspase3 and Cleaved-caspase9 were evaluated using western blot. Enzyme-linked immunosorbent assay (ELISA) was used to assess the expression of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Cell apoptosis was analyzed using flow cytometry. The interaction between circ_0114427 and miR-330-5p was validated using a dual luciferase reporter assay. Results After LPS treatment of alveolar epithelial cells, the expression of circ_0114427 was upregulated, while miR-330-5p expression was downregulated in in the cells (P < 0.05). Knockdown of circ_0114427 or upregulation of miR-330-5p could inhibit LPS-induced apoptosis, Cleaved-caspase3, Cleaved-caspase9, IL-6, and TNF-α levels in alveolar epithelial cells (P < 0.05). Circ_0114427 directly interacted with and negatively regulated miR-330-5p. Downregulation of miR-330-5p reversed the inhibitory effect of circ_0114427 knockdown on LPS-induced cell apoptosis and inflammation. Conclusion Knockdown of circ_0114427 can inhibit LPS-induced apoptosis and inflammation in alveolar epithelial cells, possibly through upregulation of miR-330-5p.

Objective: To investigate the value of combined stool syndecan-2 (SDC2) and tissue factor pathway inhibitor 2 ( TFPI2) gene methylation testing in the early screening of colorectal cancer． Methods : 106 patients with colorectal cancer (colorectal cancer group) ，75 patients with advanced adenoma ( advanced adenoma group) and 35 patients with non-advanced adenoma (non-advanced adenoma group) were selected as study subjects，and 153 patients with other gastrointestinal disorders and 182 patients with negative colonoscopy results during the same period were selected as the control group．The quantitative methylation-specific PCR(qMSP) method was used to detect SDC2 and TFPI2 gene methylation in the stool specimens of all subjects．The sensitivity and specificity of the combined SDC2 and TFPI2 gene methylation assay for the detection of colorectal cancer and adenoma were evaluated using colonoscopy and pathology results as the gold standard. Results : Among 106 patients with colorectal cancer， the sensitivity of combined methylation test was 93. 4% ; among 75 patients with advanced adenoma，the sensitivity of combined methylation test was 62. 7% ; among 35 patients with non-advanced adenoma，the sensitivity of combined methylation test was 34. 3% ; the specificity of the combined SDC2 and TFPI2 gene methylation test for colorectal cancer and adenoma screening was 94. 6%． Conclusion The combined SDC2 and TFPI2 gene methylation test has high sensitivity for colorectal cancer and its early lesions，and it also maintains high specificity.

Objective To investigate the levels of N-terminal probrain natriuretic peptide(NT-proBNP),thrombolomodulin(TM),C-type lectin-like receptor 2(CLEC-2),galectin-3(Gal-3)and their relationships with prognosis in patients with acute coronary syndrome(ACS)after percuta-neous coronary intervention(PCI).Methods A total of 80 patients with ACS were selected as study objects.The patients were followed up for 6 months by outpatient visit or telephone follow-up,and the occurrence of major adverse cardiovascular events(MACE)was recorded in the patients.According to the occurrence of MACE,patients were divided into MACE group(26 cases)and control group(54 cases).The changes of serological indexes were compared between the two groups.Results The expression levels of NT-proBNP,CLEC-2,TM and Gal-3 in serum of patients in the MACE group were significantly higher than those of control group(P＜0.05).Multivariate Logistic regression analysis showed that NT-proBNP,CLEC-2,TM,and Gal-3 were all influential factors for the occur-rence of MACE after PCI in ACS patients(P＜0.05).Conclusion NT-proBNP,CLEC-2,TM and Gal-3 are influencing factors for MACE in patients with ACS after PCI,and have a good predictive role in evaluating the occurrence of MACE.

Objective To investigate the levels of N-terminal probrain natriuretic peptide(NT-proBNP),thrombolomodulin(TM),C-type lectin-like receptor 2(CLEC-2),galectin-3(Gal-3)and their relationships with prognosis in patients with acute coronary syndrome(ACS)after percuta-neous coronary intervention(PCI).Methods A total of 80 patients with ACS were selected as study objects.The patients were followed up for 6 months by outpatient visit or telephone follow-up,and the occurrence of major adverse cardiovascular events(MACE)was recorded in the patients.According to the occurrence of MACE,patients were divided into MACE group(26 cases)and control group(54 cases).The changes of serological indexes were compared between the two groups.Results The expression levels of NT-proBNP,CLEC-2,TM and Gal-3 in serum of patients in the MACE group were significantly higher than those of control group(P＜0.05).Multivariate Logistic regression analysis showed that NT-proBNP,CLEC-2,TM,and Gal-3 were all influential factors for the occur-rence of MACE after PCI in ACS patients(P＜0.05).Conclusion NT-proBNP,CLEC-2,TM and Gal-3 are influencing factors for MACE in patients with ACS after PCI,and have a good predictive role in evaluating the occurrence of MACE.

Current laboratory testing methods of antiphospholipid syndrome(APS) can not satisfy the clinical need for diagnosis and treatment. Inflammation plays an important role in the development of APS. The comprehensive effect of varieties of immune cells, molecular systems, and cytokines renders the body in a pro-inflammatory state. Understanding the inflammatory mechanisms in the pathogenesis of APS is conductive to achieving individualized treatment and improving the efficacy of APS patients. In this article, the inflammation mechanisms and related diagnosis and treatment protocols involved in APS are summarized, aiming to provide reference for the clinical treatment of APS.