Abstract:Objective：To analyze epidemiological characteristics and trend of public health emergencies occurred in Chongqing during 2005-2011 and to provide scientific basis for effective pre－vention and control. Methods：Data of all public health emer－gencies occurred in Chongqing during 2005-2011 extracting from national information management system of public health emergency report in Chongqing Centers for Diseases Prevention and Control were collected. Data were analyzed using descriptive epidemiologic method. Results：A total of 2 193 events of public health emergencies were reported，including infectious diseases（2 011 events，91.7%），food and occupation poisoning（50 events，2.28%），mass unexplained diseases（13 events，0.60%），and other events that seriously affect public health（119 events，5.44%）. There were 54 938 events and 167 deaths caused by these events. Number of reported events in 2009 were the highest（727 events，33.15%），with seasonal peak from April to June. Geographically speaking，number of reported events in one hour economic circle was the highest（1 206 events，54.99%），followed by northeast wing（688 events，31.37%） and southeast wing（299 events，13.63%）. Re－gionally speaking，number of reported events in Kaixian district was the highest（190 events，8.66%） and Shuangqiao district was the lowest（3 events，16.05%）. Events occurred mainly in the school（1 769 events，80.67%），especially in township primary school（802 events，45.34%） and township middle school（284 events，16.05%）. Conclusions：Major public health emergencies occurred in Chongqing is infectious diseases，most of which occurred in schools and we should strengthen the prevention and monitoring.

Abstract:Objective：To explore the relationship between blood Zinc（Zn），Calcium（Ca），Copper（Cu），Magnesium（Mg） and Ferrum（Fe） levels and the incidence of coal-burning endemic fluorosis and to find effective anti-fluorine elements for the prevention and control of the disease. Methods：Stratified cluster random sampling method was used and 250 children and 90 adults were investi－gated in fluorosis area and non-fluorosis area for 1∶2 matched case-control study. Fasting venous blood samples were collected by venipuncture in vacuum tubes from all subjects and the concentrations of blood Zn，Ca，Cu，Mg and Fe levels were examined with atomic absorption spectrometer. Spot urine samples were collect－ed from all subjects and the fluoride levels were detected by fluoride ion selective electrode. Results：Blood Zn levels of Wushan children were （78.82±11.40） μmol/L in external con－trols，higher than （73.39±8.99） μmol/L in internal controls and （69.01±6.98） μmol/L in case group. Similarly，blood Zn levels of Fengjie children were （78.82±11.40） μmol/L in external controls，higher than （77.66±12.03） μmol/L in internal controls and （72.76±10.87） μmol/L in case group. Blood Zn levels of Wushan adults were （101.21±11.91） μmol/L in external controls，higher than （97.92±11.51） μmol/L in internal controls and （91.13±10.29） μmol/L in case group，all P<0.05. Blood Cu and Fe levels of children in Wushan and Fengjie were higher in external controls than in internal controls and case group，P<0.01. Urine fluorine were higher in case group than in internal and external controls in Wushan children and adults and Fengjie children，P<0.01. Concentrations of blood Zn，Ca and urine fluorine were （72.76±10.87） μmol/L，（1.82±0.19） mmol/L and （0.83±0.37） mg/L in Fengjie case group，higher than those of （69.01±6.98） μmol/L，（1.41±0.12） mmol/L and （0.65±0.33） mg/L in Wushan case group. Similarly，concentrations of blood Zn，Ca and urine fluorine were （77.66±12.03） μmol/L，（1.85±0.23） mmol/L and （0.53±0.23） mg/L in Fengjie internal controls，higher than those of （73.39±8.99） μmol/L，（1.45±0.21） mmol/L and （0.43±0.18） mg/L in Wushan internal controls，P<0.05 of blood Zn and urine fluoride，P<0.01 of blood Ca. Con－clusions：Blood concentration of Zn，Ca，Cu，Fe are closely related with the process of coal-burning endemic fluorosis in the two coun－ties except the main pathogenic element of fluorine. Patients with fluorosis have lower blood Zn levels and children have lower blood Cu and blood Fe in two counties. Concentrations of blood Zn and blood Ca are decreased with the increase of severity of endemic fluorosis.

Abstract:Objective：To understand the exposures of Benzenes in working environment of a shoe factory in Chongqing and to evaluate the risks to health. Methods：According to the established guidelines for harmful occupational chemical exposure risk assessment in Singapore，the exposure and health examination results of workers exposed to Benzenes were assessed. Results：Risk levels of Benzene，Toluene and Xylene were 3.24，2.57 and 2.40. Leukocyte abnormal rates were statistically different among workers with different types of work（ χ2＝7.236，P＝0.027）. Leukocyte abnormal rates were statistically different between male and female（ χ2＝9.334，P＝0.002）. There was no significant difference in erythrocytes，hemoglobin and platelet abnormal rate among workers（Fisher，P＝0.455-0.777）. Cancer risks of Benzene in sole workshop and heel workshop were significantly higher than the maximum level（10-4） stipulated by the U.S. environmental protection agency. Non-cancer risk of Toluene was higher in soles workshop than the other workshops and was 1.56 times higher than the standard. Conclusions：Serious cancer risks exist in sole and heel workshops，posing health threat to work－ers. The working environment should be improved to ensure the health of workers.

Abstract:Objective：To investigate the life quality and influencing factors among drug users receiving methadone maintenance treat－ment and to provide references for targeted mental intervention. Methods：Drug users receiving methadone maintenance treatment in Nanchang were selected by convenience cluster sampling and were surveyed with questionnaires including self-rating anxiety scale（SAS），self-rating depression scale（SDS），general quality of life inventory-74（GQOLI-74） and self-made general questionnaire. Results：Mean score of GQOLI-74 was 48.96±5.00.There were significant differences among factors of education，character，self-con－sidered economic condition and economic pressure（F=4.877，F=6.481，F=8.934，F=6.162，P<0.05），but there was no significant differ－ence among factors of gender（t=-1.034，P=0.302），profession（t=0.348，P=0.728），living condition（F=1.049，P=0.382），marital status （F=1.955，P=0.101）and specific family income（F=0.725，P=0.485）. Multivariate linear stepwise regression indicated that the main in－fluencing factors of GQOLI-74 total score were relationship with parents and neighbors，fulfillment of family obligations，correct an－swer rate to AIDS knowledge and awareness and standard score of SAS. Conclusions：Life quality among drug users receiving methadone maintenance treatment is low，more love and attention are needed and targeted intervention measures should be taken to improve their life quality.

Abstract:Objective：To evaluate the related factors of radiation pneumonitis（RP） induced by precise radiotherapy for patients with lung cancer. Methods：Clinical data and radiation physical parameters of 115 patients with lung cancer who were treated with precise radiotherapy were retrospectively analyzed and relationship between radiation physical parameters and RP≥2 grades was explored.Results：Nineteen patients（16.52%） developed RP. Single factor analysis found that related factors with statistically significant differ－ences were chronic obstructive pulmonary disease（COPD），diabetes，tumor location，radiation way and planning target volume（PTV）. Results of multivariate logistic regression analysis showed that COPD and PTV were independent risk factors for RP（P<0.05）. Con－clusions：COPD and PTV are independent risk factors for RP. For these patients，radiotherapy planning should be careful optimized.

Abstract:Objective：To investigate periodontal health status，health behavior and the relevant risk factors among students in a medi－cal university of Ningxia and to provide scientific basis for formulating oral health care strategies and methods. Methods：According to the criterion issued by WHO on the basic methods of oral health investigation and the third China oral health epidemiology survey protocol，we conducted inspection and questionnaire for 540 students.The inspection items included bleeding gums，dental calculus，periodontal pocket and periodontal attachment loss. The questionnaire included 30 items. Results：（1）Among 540 students，incidences of bleeding gums，dental calculus，periodontal pocket and periodontal attachment loss≥4 mm were 100%，95％，57％ and 6％，re－spectively. Incidences of impacted tooth among students with periodontal pocket were 32%. There were statistical significances in in－cidences of periodontal pocket between male and female（P<0.01）；there was no statistical significance in incidences of periodontal at－tachment loss≥4 mm and dental calculus between male and female（all P >0.05）. There were statistical significances in incidences of periodontal pocket among students in different grades（P<0.01）；there was no statistical significance in incidences of periodontal pocket between oral and non oral majors（P >0.05）. （2）Unconditional logistic regression multivariate analysis showed that age，gender，born in the city，food impaction after a meal，oral and maxillofacial trauma and Han nationality were correlated with incidence of periodon－tal pocket. Conclusions：（1）Oral periodontal health status of the university students are not ideal．It is necessary to strengthen the propaganda of oral health knowledge to students. （2）Gender is a protective factor. Old age，born in the city，food impaction after a meal，oral and maxillofacial trauma and Han nationality are risk factors.

Abstract:Objective：To observe the carrier status and drug resistance of group B streptococci（GBS） in perinatal pregnant women and their newborns and to improve patients’ life quality. Methods：Totally 426 perinatal pregnant women and 428 newborns were selected in our hospital and were received GBS bacteria identification and drug sensitivity test. Results were recorded and analyzed. Results：Positive rate of 426 cases of perinatal pregnant GBS was 19.01%，significantly higher than that of newborn（1.40%），with statistically significant differences（ ?字2=72.38，P=0.000）. GBS showed 100% sensitivity to ampicillin and penicillin. Drugs mentioned above can be used in clinics to achieve satisfactory effects. Conclusions：GBS test should be employed in the clinical work. If infection confirmed，the active therapeutic measures should be tak－en to avoid mother-to-child transmission，premature delivery，late abortion and to improve the perinatal maternal and neonatal life quality.

Abstract:Objective：To investigate the skeletal age of 1 124 Han adolescents in Chongqing area and to analyze the relationship be－tween skeletal age and growth and development. Methods：Total of 1 124 healthy Han adolescents aged 7-19 years old living in Chongqing area were randomly selected by the stratified-cluster sampling method. Indexes of their body shape and function were measured. Skeletal age at wrist was scored according to standards of skeletal maturity of hand and wrist for Chinese-China 05. Results：There was a high positively correlation between skeletal age and chronological age（male：r=0.924，y=-0.004＋1.039x，P=0.000；female：r=0.880，y=-0.838+1.112x，P=0.000；totally：r=0.902，y=-0.414+1.076x，P=0.000）. There were differences in chronological age，skeletal age，height，body mass index（BMI），diastolic blood pressure，hemoglobin and body fat between male and female（P<0.05）. There was no difference in weight，systolic blood pressure，pulse and blood glucose between male and female（P >0.05）. There were relationships between skeletal age and body fat，height，gender and BMI（P<0.05）. Conclusions：There are differences in skeletal age and height between male and female Han adolescents with different ages in Chongqing area. There is a linear relationship between skeletal age and chronological age. Skeletal age increases with the increase of chronological age.

Abstract:Objective：To explore the possible etiopathogenesis，diagnosis and treatment for malignant giant cell tumor of bone （MGCT）. Methods：Six cases from January 2001 to December 2012 were chosen，who had been clearly diagnosed as MGCT and were followed up successfully. Their clinical data were analyzed and relevant literatures were reviewed. Results：The six cases were all secondary MGCT. Average internal time from initial benign diagnosis to malignant transformation of giant cell tumor of bone was 52.7 months. Histopathologically，three cases presented with fibrosarcoma，two with osteosarcoma and one with malignant fibrous histiocy－toma. Treatments included radical surgeries for three，margin excision with adjunctive therapy for one，high intensity focus ultrasound therapy for one and chemotherapy with palliative treatment. Mean follow-up time was 22.8 months，two cases had no evidences of dis－eases，two were alive with tumors and two died. Conclusions：MGCT accounts for approximately 5％ of the total cases of giant cell tu－mor of bone（GCT）. Radiotherapy and recurrent incomplete curettage might induce malignant transformation. Chromosome instability，heteroploid appearance and centrosome aberration might play an important role in the malignant transformation. GCT displaying local recurrence over 3 years after the initial treatment should be considered the possibility of becoming malignant. Early detection and radi－cal surgery might improve the prognosis.

Abstract:Invasion of extravillous trophoblasts（EVT） is fundamental to the development of placenta during early pregnancy. Being regulated precisely by the secretions of trophoblasts and other cells，trophoblast invasion is also mediated by signaling pathways and regulatory transcription factors. Any factor leading to these regulations uncontrolled will induce dysfunction of trophoblast in gestational diseases such as preeclampsia and fetal growth restriction. This article reviewed the literatures in recent years about molecular regula－tion of human trophoblast invasion，which will improve our understanding about the role of the trophoblasts in gestational diseases such as preeclampsia and other pregnancy complications with incomplete spiral artery remodeling and provide new ideas for the stud－ies of pathogenesis and treatments of these disorders.

Abstract:Objective：To summarize the published evidences and to compare effect of prophylactic administration of cefazolin prior to cesarean section and after cord clamping. Methods：Databases of PubMed，Embase，and CENTRAL in the Cochrane Library were searched for randomized controlled trials and effect of prophylactic administration of cefazolin prior to cesarean section and after cord clamping were compared. Results：Six randomized controlled trials with high quality were included in this Meta analysis. Preoperative administration significantly reduced the risk of postpartum endometritis（RR=0.57，95%CI=0.36 to 0.90，P=0.02）. Preoperative admin－istration of cefazolin was not associated with significant reduction in the risk of wound infection（RR=0.70，95%CI=0.43 to 1.12） and urinary tract infection（RR=1.19，95%CI=0.53 to 2.63）. Furthermore，preoperative administration of cefazolin did not significantly af－fect proven neonatal sepsis（RR=0.82，95%CI=0.47 to 1.42），suspected neonatal sepsis cases which require workup（RR=0.94，95%CI=0.72 to 1.22） and neonatal intensive care unit admissions（RR=0.90，95%CI=0.62 to 1.28）. Conclusion：Prophylactic administra－tion of cefazolin prior to cesarean section can significantly decrease the incidence of postpartum endometritis.

Abstract:Objective：To use Meta analysis to assess the effects of folic acid supplementation before and during early pregnancy on twin pregnancy. Methods：Literatures associated with periconceptional folic acid supplementation between 1966 and 2012 were col－lected systematically from PubMed/Medline，EMBASE，OVID，Cochrane Central Register of Clinical Trials，Google scholarism，CNKI，VIP，Wanfang databases，then were screened according to the pre-established inclusion and exclusion standards. Quality was evaluat－ed strictly. Data were extracted and Meta analysis was conducted using RevMan 5.2.1 software. Results：Three randomized controlled trials（RCTs） were included. Differences in twin pregnancy incidences（RR=1.40，95%CI=0.93 to 2.11），dizygotic incidences（RR=1.27，95%CI=0.61 to 2.67） and monozygotic incidences（RR=0.91，95%CI=0.68 to 1.21） were of no statistically significant between group with folic acid supplementation before and during early pregnancy and control group. Conclusion：Folic acid supplementation before and during early pregnancy can not increase incidences of twin pregnancy.

Abstract:Objective：To analyze the correlation between elective cesarean delivery（ECD） and the risk of neonatal respiratory morbidity by Meta analysis． Methods：Twelve observational studies on relationship between ECD and neonatal respiratory morbidity were re－viewed and analyzed in this study. Random effect model and RevMan 5.0 software were adopted to analyze the data． Results：There were statistical differences in respiratory morbidity of full-term neonates between ECD and vaginal delivery（OR（95%CI）=3.43（2.18，5.14），P＝0.000）. There was no significant correlation in risk for neonatal respiratory disease between ECD and emergency cesarean section（OR（95%CI）=1.97（0.98，3.92），P=0.06）. Respiratory morbidity was significantly increased in neonates born after the 39th gestational week than in neonates born before the 39th gestational week（P＝0.000，OR（95%CI）=2.29（1.66，3.16））. Conclusions：ECD may associate with the risk of neonatal respiratory morbidity.Respiratory morbidity is higher in neonates born after the 39th gestational week than in neonates born before the 39th gestational week.

Abstract:Objective：To evaluate the accuracy of maternal serum free fetal DNA used for noninvasive prenatal diagnosis of chromoso－mal abnormalities. Methods：Medline database was searched with keywords of ‘prenatal’ and ‘aneuploidy’ and ‘noninvasive’ or ‘non-invasive’ and ‘maternal’ by QUADAS tool，then the eligible full-texts were analyzed. Results：Four articles complied with the QUADAS standards. Noninvasive prenatal diagnosis was performed on 4 167 trisomy-21 syndrome cases，with sensitivity of 100.00% and specificity of 99.30%；non-invasive prenatal diagnosis was performed on 3 455 trisomy-18 syndrome cases，with sensitivity of 97.40% and specificity of 99.95%. Conclusion：Maternal serum fetal free DNA used for noninvasive prenatal diagnosis of chromosomal abnormalities is of high accuracy

Abstract:Objective：To evaluate the expression and localization of Krüppel-like factor 8（KLF8） in human villous tissues during ear－ly pregnancy and to explore the effect of KLF8 on trophoblast invasion during early pregnancy. Methods：A total of 22 early pregnan－cy human villous tissues of 6-11 weeks of gestation（weeks） were obtained from elective terminations of apparently normal pregnancies from March 2012 to June 2012 in The First Affiliated Hospital of Chongqing Medical University. And then immunohistochemical SP method was employed to detect the localization of KLF8 protein. KLF8 mRNA level was determined by quantitative real-time PCR technique and Western blot analysis was used to quantify KLF8 and matrix metalloproteinase-9（MMP-9） protein expression levels.Results：（1）There were KLF8 immunoreactivity expressed in villous tissues from 6-11 weeks. It was primarily located in cyto-and syn－cytio-trophoblast in the trophoblast layer of the chorionic villi. （2）KLF8 mRNA levels were gradually increased with gestational ages，peaked at 8-10 gestational ages（being the highest at 8 weeks） and then decreased sharply. （3）KLF8 and MMP-9 protein levels also shared the same pattern of expression in human villous tissues from early pregnancy：gradually increased from 6 weeks，peaked at 8-10 weeks（being the highest at 8 weeks） and then slightly decreased at the end of the first trimester（11 weeks）. （4）There was a posi－tive correlation between the expression of KLF8 and MMP-9 protein in human villous tissues from early pregnancy（r=0.66，P<0.001）. Conclusions：KLF8 immunoreactivity is primarily located in trophoblast layer especially in the invasion-related cyto-trophoblast cells. Besides，its expression has a forward association with MMP-9 levels and trophoblast invasion. These results indicate that KLF8 may play an important role in the regulation of trophoblast invasion during implantation and placentation.

Abstract:Objective：To determine the effects of different degrees of chorioamnionitis（CA） and prenatal glucocorticoid on fetal lung maturation and development in preterm rats. Methods：Totally 36 pregnant SD rats were randomly assigned to 6 groups. A group：normal saline（NS）+dexamethasone（DEX）；B group：lipopolysaccharide（LPS） 0.5 μg DEX；C group：LPS 4.0 μg DEX；D group：NS NS；E group：LPS 0.5 μg NS；F group：LPS 4.0 μg NS. All groups underwent intraamniotic injection with NS，LPS（0.5 μg and 4.0 μg respectively） on gestational day 19；24 h later，rats were intramuscularly injected with DEX 0.4 mg and NS respectively. After another 24 h，pathological inflammation of placenta，chorioamnion and fetal lung were observed. Surfactant protein A，B，C（SP-A，SP-B，SP-C） and interleukin-1β（IL-1β），tumor necrosis factor-α（TNF-α） mRNAs in lung were determined by quantitative real-time PCR（qRT-PCR）. Lung morphologic observation was performed on postnatal day 15（P15）. Results：①fetal rat mortality in C，F groups were higher than that in other groups；rat survival rate in C，F groups were lower than that in other groups（P all <0.05）. ②Pathologi－cal grading of pulmonary inflammation and CA：C and F groups were the highest，followed by B and E groups and A and D groups were the lowest（P all <0.05）. ③Relative expression of SP-A，SP-C mRNAs：D and F groups were lower than other groups，B group was the highest（P all <0.05）；relative expression of SP-B mRNA：D，E，F groups were lower than other groups，B and C groups were the highest（P all <0.05）. ④Relative expression of IL-1β mRNA：F group was the highest（P<0.05）. Relative expression of TNF-α mRNA：C and F groups were the highest while A and D groups were the lowest（P<0.05）. ⑤On P15，C group alveolarization was significantly inhibited. Conclusions：Different doses of intraam－niotic LPS could induce CA and fetal lung inflammation with different degrees. Histological inflammation aggravates with LPS dose increasing. Mild to moderate CA and antenatal DEX will not adversely affect the survival rate nor inhibit fetus and newborn growth. Inflammation was not suppressed but synergistically induced more significant lung maturation. Severe CA and prenatal DEX might cause adverse effects，particularly，increasing the risk of bronchopulmonary dysplasia.

Abstract:Objective：To investigate the expression rules of Dicer in the endometrium of early pregnant mouse and to clarify its role in embryo implantation. Methods：Real-time fluorescence quantitative PCR，immunohistochemistry and Western blot were used to detect the expressions of Dicer mRNA and protein in the mouse endometrium from unpregnant，pseudopregnant and pregnant mouse from d1 to d7. Results：During the implantation window and after the implantation（d4-d7），expression of Dicer mRNA and protein was signif－icantly higher than that before implantation and expression of d5 was the highest（PmRNA=0.000，Pprotein=0.000）. Moreover，Dicer was demonstrated in endometrial stromal cells. Conclusions：There are differences in the time and location of the expression of Dicer in endometrium of early pregnant mouse. Expression rule of Dicer in endometrial stromal cell by regulating cell growth，proliferation and differentiation may be one of the implantation mechanisms.

Abstract:Objective：To explore the role of growth factor receptor bound 7（GRB7） during embryo implantation through detecting its expression pattern in the mouse endometrium. Methods：Expression of GRB7 mRNA and protein in the non-pregnant and pregnant mouse endometrium from d1 to d7 was examined by qRT-PCR，immunohistochemistry and Western blot. GRB7 antisense oligo-nu－cleotide was injected at 8 pm on pregnancy d3 and embryo implantation number on pregnancy d7 was examined. Results：GRB7 mR－NA expressed in uterine endometrium of the non-pregnant and pregnant mouse from d1 to d7 and reached the highest level on preg－nant d5 based on the results of qRT-PCR. Immunohistochemistry and Western blot showed that the expression pattern of GRB7 in mouse endometrium was the same with that detected by qRT-PCR. Moreover，from pregnant d1 to d4，GRB7 was mainly expressed in epithelium and glandular cells and was lowly expressed in stromal cells；on d5 and d6，GRB7 was more intense in epithelium and glandular cells and was obviously expressed in stromal cells，especially on d5. On d6，GRB7 was expressed strongly in primary decid－ual zones at implantation sites and stromal cells at inter-implantation sites，respectively. After horn injecting GRB7 antisense oligonu－cleotides，the number of embryo implantation was obviously decreased when compared with that in control group. Conclusions：Differ－ential expression of GRB7 in pregnant mouse endometrium suggests that GRB7 may involve in the process of embryo implantation.

Abstract:Objective：To explore the expression rules and potential role of mmu-miR-106b in the endometrium mouse during embryo implantation. Methods：Real-time PCR and in situ hybridization were used to detect the expressions of mmu-miR-106b in the en－dometria of pregnant mice on d4，d5 and d6. MTT and flow cytometry were performed to understand its roles in endometrial stromal cell proliferation，cycle and apoptosis after endometrial stromal cells being transfected with mimics and inhibitor. Western blot was car－ried out to predict the potential target genes of mmu-miR-106b by combining anticipated algorithms. Results：Expression of mmu-miR-106b in the endometria on d6 was lower than that on d4（P=0.039） and there was no significant difference in mmu-miR-106b expression between implantation sites and inter-implantation sites of pregnant mice on d5（P=0.606）. Mmu-miR-106b was located in endometrial stromal cells. Increased mmu-miR-106b could promote cell proliferation and reduced mmu-miR-106b would increase cell apoptosis. Related target genes of nucleophosmin1，tumor susceptibility gene 101（Tsg101） and phosphatase and tensin homolog deleted on chromosome ten were achieved by miRGen，Targetscan and Pictar screening and expression of Tsg101 was regulated by mmu-miR-106b in endometrial stromal cells of pregnancy mice（P=0.042）. Conclusions：Mmu-miR-106b may play an important role in the proliferation of endometrial stromal cells during embryo implantation process by targeting Tsg101.

Abstract:Objective：To explore the role of the Notch signaling members Notch1 in the mechanism of human pre-eclampsia. Methods：Placental tissues of normal pregnancy and pre-eclampsia were obtained respectively. Real-time PCR,Western blot and immunohisto－chemical method were used to detect the distribution and expression levels of Notch1 mRNA and Notch1 protein in both placental tissues. Results：Notch1 was expressed in both placental tissues and expression was localized in the membrane. Expression levels of Notch1 in placental tissues of pre-eclampsia（experiment group） were significantly lower than those in placental tissues of normal pregnancy（control group）（P<0.05）. Conclusions：Notch1 may mediate the occurrence and development of placental vasculogenesis and influence the endovascular invasion of embryonic cytotrophoblasts through the Notch signaling pathway and the reduced expres－sion level of Notch1 may be associated with the occurrence of pre-eclampsia.

Abstract:Objective：To determine the influences of triclosan on pregnancy outcome in pregnant rats，to preliminarily study its related mechanism and to provide scientific references for rational use of washing supplies containing triclosan，especially for pregnant wom－en. Methods：Totally 32 pregnant Wistar rats were randomly divided into 4 groups（control group，low dose group，middle dose group and high dose group）and received triclosan by oral gavage（0，30，100，300） mg/（kg·d） in peanut oil for 15 d consecutively from ges－tational day（GD） 6 to GD 20 until necropsy on GD 20. Coefficient of each body organ，number of live fetus，dead fetus and absorbed fetus，biochemistry indicators and blood glucose were recoded. Results：Body weight，food intake and food utilization rate were increased along with the increase of pregnancy. But the increases were higher in high dose group than in control group in the second trimester of pregnancy（P<0.05）. ANOVA for repeated measurement demonstrated that body weight，food intake and food utilization rate were different at different periods of pregnancy among four groups（P<0.05），meanwhile，time factor and processing factor of body weight were interacted（P<0.01）. Fasting plasma glucose levels in high dose group were different within groups（P<0.05）. ANOVA for repeated measurement demonstrated blood glucose levels were different at different periods of pregnancy among groups（P<0.05），meanwhile，time factor and processing factor of body weight were not interacted. Levels of serum methane dicarboxylic aldehyde and total protein were significantly different between high dose group and control group（P<0.05）. Live fetus was more in control group than in high dose group；absorbed fetus was more in high dose group than in control group，without statistical differences. Conclusions：Using a large number of triclosan products may change blood glucose and biochemistry indexes，therefore people should be cautious when choosing personal care products，especially pregnancy women. Triclosan may affect the digestion and energy metabolism of pregnancy women，further influence normal development of fetal brains and bones，so pregnancy women should use triclosan products carefully.

Abstract:Objective：To explore the clinical value of prenatal ultrasonic examination in screening out fetal malformations. Methods：Pregnant women’s ultrasonic examination results in 2012 were analyzed retrospectively. Detection rate，systemmatic distribu－tion and severity of fetal malformations were calculated. Results：A total of 32 667 pregnant women underwent ultrasonography. Detection rate of fetal malformations was 1.27%（414/32 667）. Cardiovascular system malformation was most common（23.43%，97/414），followed by nervous system malformation（17.15%，71/414）. Rate of serious deformations was 54.59%（226/414），most common in nervous system malformation（27.88%，63/226）. Conclusions：Prenatal ultrasonic examination is of great clinical value in screen－ing out fetal malformation and reducing birth birth defects.

Abstract:Objective：To analyze the performance of first-trimester combined screening in the prediction of fetal Down’s syndrome （DS）. Methods：Totally 7 367 cases met the criteria were collected and their pregnant outcomes were analyzed retrospectively. Pre-diction of DS when using nuchal translucency thickness（NT） alone was compared with that when using first-trimester combined screening. Risk cutoff value of first-trimester combined screening was set at 1∶300 and pregnancy outcomes of high-risk and low-risk objects were compared. Performances of NT and first-trimester combined screening were compared taking NT≥3 mm as positive cri－teria. Results：Among the 7 367 cases，positive rate of first-trimester combined screening was 3.4%（252/7 367） and incidence of actu－al abnormal chromosomes was 0.12%（9/252）. High risk group had higher risk of adverse pregnancy outcomes compared with that of low risk group（adverse pregnancy outcomes：6.0% vs. 1.0‰，P＜0.001；abnormal chromosomes：3.6% vs. 0.1‰，P＜0.001）. When using NT value as the only criterion，detection rate of DS was 77.8% and false positive rate was 4.4%；when using first-trimester combined screening，detection rate of DS was 88.9% and false positive rate was 3.3%. Conclusions：First-trimester combined screening can ef－fectively predict abnormal chromosomes and its effect is superior to that of NT alone，therefore，it is recommended for pregnant woman.

Abstract:Objective：To evaluate the risk factor and clinical outcome of severe postpartum hemorrhage（PPH） admitted in ICU and treatment for obstetrics emergency cases. Methods：Retrospective analysis was made in 40 cases of severe PPH admitted in The First Affiliated Hospital of Chongqing Medical University from January 2010 to December 2012. Results：Severe PPH cases admitting in ICU accounted for 16.46% of PPH patients（40/243）. Delivery way of all 243 PPH patients was caesarean section. Main reason of se－vere PPH patients admitting in ICU was hemorrhagic shock，followed by placenta increta，cardiac insufficiency，hyperthyroidism com－plicating with mild eclampsism and cardiorespiratory resuscitation. Twenty-four cases（60.00%，24/40） got bleeding over 2 000 ml. Most patients got at least one system or organ dysfunction and diffuse intravascular coagulation（DIC） was the most common. Severe PPH patients were infused with packed red blood cells（2 544.74±1 782.60） ml，plasma（1 484.85±951.0） ml，platelet （2.7±2.3） U and cryoprecipitate（7.30±10.2） U. Fourteen cases（35.00%，14/40） used nasal oxygen catheters for oxygen，4 cases（10.00%，4/40） used non-invasive ventilator，22 cases（55.00%，22/40） used invasive ventilator. Neonatal case-fatality rate in our hospital was 52.63‰. Conclusions：Main reason of severe PPH patients admitting in ICU is hemorrhagic shock. Severe PPH is one of the important causes of DIC.Intensive life support and component transfusion are the important steps to cure severe PPH. Cooperation between ICU staff and obstetrician is also the effective way to treat critical pregnancies.

Abstract:Objective：To analyze results of prenatal screening for Down’ syndrome in the second trimester of pregnancy in 5 539 cases in the First Hospital of Lanzhou University from 2009 to 2012 and to identify the possible risk factors for high risk pregnant women. Methods：Serum alpha-fetoprotein and free-β human chorionic gonadotropin in pregnant women were detected based on the principal of time-resolved immunoflourometric assay. Risk of fetal Down’ syndrome was calculated by computer software taking into con－siderations of maternal age，gestational age，weight of pregnant women. Results：Among the 5 539 pregnant women，238 cases

Abstract:Objective：To investigate the thrombin function and platelet function of woman with pregnancy associated thrombocytopenia （PAT） and the correlation between platelet count and postpartum hemorrhage and perinatal outcome. Methods：Clinical data of 41 cases of PAT women who delivered in our hospital from September 2012 to December 2012 were analyzed prospectively. Thrombin function，platelet function，volume of bleeding in delivery，occurrence rate of postpartum hemorrhage and birth weight of the newborns were included. All women with PAT were divided into 3 groups as below：group 1 with platelet count of （80-99）×109/L，group 2 with platelet count of （50-79）×109/L and group 3 with platelet count below 50×109/L. Results：There was no significant difference in pro－thrombin time，activated partial thromboplastin time and abnormity rates of platelet aggregation between normal control group and PAT women groups（P ＞0.05）. Volume of bleeding was higher in group 3 than in group 2 and group 1，with significant differences（P＜0.05）. Coefficient of correlation（r） between the weight of the newborns and platelet count was 0.18（P ＞0.05）. Conclusions：Thrombin func－tion and platelet function of PAT women are not affected by platelet count. Risk of postpartum hemorrhage is not higher in mild and middle grade PAT women than in normal pregnant women，but severe PAT women have higher risk of postpartum hemorrhage.De－creasing degree of platelet in PAT women will not affect perinatal outcome.

Abstract:Objective：To investigate the roles of tidal breath flow-volume loop（TBFVL） in monitoring lung function of preterm infants with different degrees’ bronchopulmonary dysplasia（BPD）. Methods：One hundred and thirteen preterm infants without BPD and heart & lung disease-free were erolled as controls and 106 BPD infants were taken as observation group.Observation group was divided into mile，moderate and severe groups according to the definition of BPD. Parameters of lung function test，including TBFVL，functional residual capacity（FRC） and lung clearance index（LCI） were collected and analyzed when the patients were at 44 weeks postmen－strural age（PMA）. Results：①Shape of TBFVL showed that in observation groups：ratio of volume to peak tidal expiratory volume a－gainst expiratory volume（Vpef/Ve） was decreased，peak expiratory flow（TPEF） was markedly higher than peak inspiratory flow（TPIF）.Expiratory descending branch was descended sharply；expiratory descending branch of mild observation group was slightly gradient than that of control group；expiratory descending branch of moderate and severe groups was depressed to volume axis. ②Compared with parameters in control group：except moderate observation group，Vpef/Ve in mild and severe observation group were lower（P<0.05）；TPIF，TPEF，tidal expiratory flow at 75% remaining tidal volume（TEF75） in severe observation group were decreased compared with those in mild observation group and control group（P<0.05）；tidal expi－ratory flow at 25% remaining tidal volume（TEF25） was lower in mild and moderate observation groups than in control group，while it was higher in severe group than in control group（P<0.05）；FRC was lower in moderate and severe observation groups than in control group；only in moderate observation group；LCI was higher than moderate observation group in control group（P<0.05）.③Spearman correlation analysis showed that FRC，Vpef/Ve，TPIF，TPEF，TEF75，TEF25 had strong correlationship with the degree of BPD with statistical significances while LCI not. Conclusions：Because of the dysplasia of pulmonary alveoli and terminal small air－way，expiratory descending branch of TBFVL in BPD infants is descended sharply and in moderate and severe BPD infants even de－pressed to volume axis.TBFVL can directly reflect the lung function condition of BPD infants and can be used in clinical for lung de－velopement follow-up combining with FRC，LCI.

Abstract:Objective：To investigate normal values of tidal breathing parameters in infant at different gestational ages without respira－tory complications and to analyze their differences. Methods：Totally 25 preterm infants less than 34 gestational weeks，30 late preterm infants and 55 healthy full term infants were studied on 1，14，28 d after birth. Tidal breathing parameters were measured by ultrason－ic flow meter. Results：Values of tidal breathing parameters were normally distributed. Ratio of time to peak expiratory flow/expiratory time，ratio of volume to peak expiratory flow/expiratory volume，tidal expiratory flow at 75% remaining tidal volume（TEF75），tidal expi－ratory flow at 50% remaining tidal volume（TEF50），tidal expiratory flow at 25% remaining tidal volume（TEF25） were gradually in－creased on 1，14，28 d after birth in three groups，but respiratory rate（RR） was gradually decreased. Prominence correlation of RR and TEF75，TEF25 was found in full term infants（r=0.469，P<0.01；r=539，P<0.01）；correlation of RR and TEF25（r=0.231，P<0.05） and correlation of RR and TEF75（r=0.130，P >0.05） were found in late preterm infants. There was no correlation of RR and TEF25，TEF75 in preterm infants born less than 34 gestational weeks（r=0.190，P >0.05；r=0.220，P >0.05）. At a matched post men－strual age of 40 weeks，preterm group had lower TEF25，TEF75，TEF25 and tidal volume per kilogram，higher RR compared with those in full term group（P<0.05）；there were no difference in above parameters between late preterm group and full term group（P >0.05）. Conclusions：Lung function of infants in the three groups is improved with the increase of gestational days. At the corrected ges－tational age 40 weeks，preterm infants less than 34 weeks fail to achieve catch-up growth in tidal breath parameters. Correlation of RR and TEF75，TEF25 is found in full term infants not in preterm infants. Infant lung function tests and correlation analysis are very im－portant ways to assess lung development，especially for preterm infant. Tidal breathing parameters in infants at different gestational ages could be used as clinical references.

Abstract:Objective：To infect human bronchial epithelial cell （BEAS-2B） model by pseudomonas aeruginosa（PA） and to observe andrographolide’s effects on the bacterial infection ability and the host cell inflammatory response. Methods：PA01 and clinical strains of PA，Cq1（exoU-） and Cq40（exoU+） were respectively used to infect BEAS-2B. In vitro lysogeny broth culture was conducted and the effect of andrographolide（300 μmol/L） on the bacterial growth was observed. PA invasive capability on BEAS-2B was tested by colony counting method. With double antibody sandwich enzyme-linked immunosorbent assay（ELISA），lactate dehydrogenase（LDH） releasing and inflammatory cytokines，interleukin-6（IL-6） and IL-8 expression were measured. Pretreated by different concentrations of andrographolide（3.0 μmol/L and 4.5 μmol/L），effects of andrographolide on BEAS-2B infection caused by different strains of PA were detected. Results：Similar to PA01，high concentration（300 μmol/L） andrographolide exerted no impact on either exoU or exoU-PA growth. 3.0 μmol/L and 4.5 μmol/L andrographolide significantly reduced the intracellular colony number of PA，LDH releasing and generation of IL-6 and IL-8. Conclusions：Andrographolide can attenuate invasive effects of clinical strains of PA on hu－man bronchial epithelial cell and reduce the related cell damage and inhibit inflammatory response.

Abstract:Objective：To study the incidence，risk factors and pathogens of neonatal necrotizing enterocolitis（NEC） complicated sep－ticemia. Methods：Clinical features were analyzed retrospectively in 277 newborns suffering from NEC. Pathogens results of blood and peritoneal fluid culture samples were analyzed in infants with NEC complicated septicemia，who were medically treated in the Chil－dren’s Hospital of Chongqing Medical University from July 2000 to February 2013. Results：Incidence of NEC complicated septicemia was 28.5%（79/277），higher in preterm group（P=0.049）. Among 79 neonates，there were 32 preterm infants（40.5%）. Average gesta－tional age and birth weight were （36.62±3.26） weeks and （2 551.06±737.90） grams，respectively. Average day of onset was （10.30 ± 12.18） d，of which the preterm group was （12.90±16.23） d；the smaller the gestational age，the later the onset time. Main prenatal factors were infectious diseases，premature rupture of membranes and amniotic fluid abnormalities. Chief clinical manifestations were abdominal distension，vomiting，apathetic and hyperbilirubinemia. The other accompaniments or complications were pneumonia，in－testinal perforation and peritonitis. Seventy two cases（91.1%） met the clinical diagnostic criteria in blood analysis. Finally，19 infants（24.1%） were cured，28 infants（35.4%） were improved，while 9 infants（11.4%） given up and 23 infants（29.1%） died. Most infants belonged to stage Ⅲ（49 cases，62.2%）. Out of 72 blood and peritoneal samples：13 kinds，38 stains were detected. Positive rates of blood and peritoneal culture were 46.9% and 66.7%，respectively. Escherichia coli（29.1%） and Klebsiella pneumoniae（29.1%） were the most common pathogens. Conclusions：Infants with NEC（stageⅡ or Ⅲ） are prone to complicate with septicemia. Once definite diagnosis of NEC has been made，blood cultures should be routinely done. Anaerobic cultures should be emphasized on and labora－torial index should be monitored regularly so as to reduce the possibility of occurrence of gut-derived septicemia.

Abstract:Objective：To discuss the proportional relation between fetal renal longitudinal distance（FRLD） and biparietal diameter（BPD） and its clinical value. Methods：FRLDs of fetus aged between 18 to 41 weeks were measured using uhrasonography and the ratios of FRLD to BPD（FRLD/BPD） were calculated. Results：FRLD/BPD of 600 cases was collected in total. The left kidney FRLD/BPD was 0.44±0.03 and the right kidney FRLD/BPD was 0.44±0.03（P >0.05）. There were 142 cases identified as renal anomaly during the same time. There were statistically significant differences in FRLD/BPD between polycystic kidney，polycystic renal dys－plasia and renal agenesis and normal kidney（P<0.05），with 95% referential FRLD/BPD being（0.38，0.5０）. Conclusions：FRLD/BPD value can be used as reliable index to judge renal development during middle and late pregnancy and can be used to discover renal anomaly at early phase so as to conduct clinical intervention and treatment.

Abstract:Objective：To investigate the effects of methotrexate（MTX） combined with mifepristone and rhubarb mirabilite on reproduc－tive function after ectopic pregnancy. Methods：Totally 202 patients with unruptured tubal pregnancy，stable vital signs，blood human chorionic gonadotropin（HCG） under 2 000 IU/ L，age under 35 years，integrity clinical data and requirements for fertility were enrolled. They were divided into two groups according to their wishes；95 patients in study group chose conservative medical treatment and 107 patients in control group chose laparoscopic surgery and reserved fallopian tubes. Reproductive status and occurrence of complications were followed up for 1.5 to 4.0 years after the treatment. Results：Rates of pregnancy and infertility were 37.9% and 62.1% in study group and 37.4% and 62.6% in control group. Rates of live birth in study group and control group were 61.1% and 62.5% respec－tively，without statistically significant differences（P >0.05）. Rate of recurrent ectopic pregnancy in study group（5.3%） was significant－ly lower than that in control group（22.4%），with statistically significant differences（P<0.01）. Conclusions：Conservative medical treat－ment can achieve similar reproductive outcome as laparoscopic surgery and can reduce incidences of recurrent ectopic pregnancy.Therefore，conservative medical treatment is a safe，effective and inexpensive method and can achieve satisfactory long-term repro－ductive status.