Abstract:The function of wild type p53 is usually inhibited in patients with tumor. The latest research showed that the function of wild type p53 was controlled by apoptosis-stimulating protein of p53（ASPP） family. ASPP family includes three members： iASPP，ASPP1 and ASPP2. Many studies showed that iASPP can inhibit the activity and function of p53；and its expression and function was correlated with clinical characteristics，curative effect and prognosis. It plays important roles in tumor development. In this review，we expect to explore the function and character of iASPP thus to provide a new way for the treatment of tumor using iASPP as target.

Abstract:Objective：To detect the different expressions of GM130，14-3-3ζ and integrin α3 in normal gastric tissues，moderately differentiated gastric cancer tissues and poorly differentiated gastric cancer tissues thus to explore its relationship with gastric cancer. Methods：The expression of ＧＭ130，14-3-3ζ and integrin α3 in gastric carcinoma tissues of 84 patients with gastric cancer and the 84 samples of normal gastric tissues（from 5 cm above the edge of the gastric tumor tissues） were detected by SABC immunohisto-chemistry. The expression of proteins and the clinical pathological data were analyzed. The expression of mRNA and protein of ＧＭ130，14-3-3ζ and integrin α3 were detected by RT-PCR and Western blot. Results：The positive expression rates of ＧＭ1301，14-3-3ζ2 and integrin α33（88.1%，90.5%，95.2%） were significantly higher in gastric cancer tissues than those in normal gastric tissues（52.4%，27.4%，42.9%）；the expression of the above three indicators in poorly differentiated gastric cancer group were higher than those in moderately differentiated gastric cancer group，with statistically significant differences（P1=0.000，P2=0.007，P3=0.000）. Spearman correlation analysis showed that positive correlation were observed in ＧＭ130，14-3-3ζ and integrin α3 in gastric cancer（P＜0.05）. The expression of ＧＭ130，14-3-3ζ and integrin α3 in gastric cancer was obviously related with pathological differentiation and clinical stage（P<0.05），but its correlation with age，gender，tumor location，tumor size infiltration depth or whether the lymph node metastasis was not found（P ＞0.05）. The levels of mRNA and proteins were higher in gastric cancer group than in normal gastric tissue group，higher in poorly differentiated gastric cancer than in moderately differentiated gastric cancer，with statistically significant differences between the two groups（P＜0.05）. Conclusion：The abnormal expression of GM130 may play an important role in the occurrence and development of gastric cancer.

Abstract:Objective：To verify genistein’s anti-angiogenic effect on MKN 45 gastric cancer cells and its subcutaneous xeno-transplanted tumors and to develop an optical imaging method for monitoring this anti-angiogenesis. Methods：MTT assay and VEGF-ELISA were performed to test the inhibitory effect of genistein on proliferation of MKN45 human gastric cancer cells and VEGF expression. IHC was applied to detect VEGF，CD31 and Ki67 expression after MKN45 subcutaneous xeno-transplanted tumors being treated with genistein. The optical molecular probe targeting VEGF：Dylight 680-Bevacizumab-F（ab′）2 was firstly prepared by conjugating near-infrared fluorescent dye Dylight 680-NHS and bevacizumab’s F（ab′）2 fragments. Then，it was applied in in vivo optical imaging to verify tumor VEGF down regulation induced by genistein. Results：Results of MTT（P=0.118） and Ki67 IHC showed that genistein had no significant inhibitory effect on the proliferation of MKN45 human gastric cancer cells and its subcutaneous xeno-trans-planted tumors. VEGF-ELISA results showed geni-stein could significantly down regulate VEGF expression of MKN45 cells and its xeno-transplanted tumors（P=0.000）. Re-sults of genistein treatment indicated that genistein had a certain anti-tumor effect（P=0.034）. IHC results showed tumor VEGF and CD31 expressions were both reduced after genistein treat－ment. In addition，Dylight 680-Bevacizumab-F（ab′）2 applied to in vivo optical imaging could effectively detect reduced VEGF ex－pression. Conclusion：The inhibitory effect of genistein is mainly realized by genistein’s anti-angiogenesis，which significantly inhibit tumor VEGF expression，rather than genistein’s direct tumor proliferation inhibition. Optical molecular probes Dylight 680-Beva－cizumab-F（ab′）2 applied in vivo optical imaging，with favorable clinical prospect，could predict anti-angiogenic effect of genistein at early stage.

Abstract:Objective：To investigate the relationship between forkhead box M1（FoxM1） and alpha-fetoprotein（AFP） in human hepa－tocellular carcinoma（HCC）. Methods：AFP mRNA and FoxM1 protein in 52 HCC tissues were validated by fluorescence quantitative PCR（FQ-PCR） and Western blot. Data of preoperative serum AFP secretion were collected，and the correlation among FoxM1，AFP mRNA and serum AFP were analyzed. HepG2 and HepG2.2.15 cells were treated with thiostrepton（TST） and adenovirus combined with FoxM1B gene. Changes of FoxM1 mRNA and protein were quantified by FQ-PCR and Western blot. AFP in culture supernatant was detected by electrochemiluminescence method. Results：（1）The expression of FoxM1 protein was positively correlated with AFP mRNA and serum AFP（r=0.448，P=0.001；r=0.381，P=0.005）. （2）The decreased expression of FoxM1 could decrease the secretion of AFP in HepG2 and HepG2.2.15 cells（P1=0.000，P2=0.000）. （3）FoxM1 could increase the expression and secretion of AFP in HepG2 and HepG2.2.15 cells（P1=0.000，P2=0.000；P1=0.001，P2=0.000）. Conclusion：FoxM1 protein expression correlates with both in vivo and in vitro AFP production in HCC. FoxM1 possibly play an important role in regulating the expression of AFP.

Abstract:Objective：To study the influence of docetaxel-loaded lipid microbubbles（LDLM） combined with ultrasound targeted mi－crobubbles destruction（UTMD） on proliferation and apoptosis of SMMC-7721 cells. Methods：Suitable concentration of docetaxel was chosen. SMMC-7721 cells were cultured in vitro and divided into 6 groups. Proliferating inhibition rate，ultrastructural change，apop－totic rate and cell cycle distribution were compared among all groups. Results：The proliferating inhibition rate and apoptotic rate of LDLM+US group were the highest compared with that of other groups（P=0.000，P=0.000）. Great amount of apoptotic cells were observed in LDLM+US group by electron microscope and flow cytometry. Proportion of cells at G0/G1 phase was decreased obviously（0.79±0.27）%（P=0.000） while that at G2/M phase was obviously increased（90.54±0.48）%（P=0.000）. Conclusion：LDLM combined with UTMD could inhibit the proliferation and promote the apoptosis of SMMC-7721 cells，which provide evidence for the further study of its mechanisms in protein and gene level.

Abstract:Objective：To determine whether human hepatocytes express aquaglyceroporin 7（AQP7），to detect the differential expression of AQP7 in human hepatocellular carcinoma（HCC） tissues，pair-matched non-tumourigenic liver（NTL） tissues and normal liver（NL） tissues，to investigate its correlation with the occurrence and progress of HCC. Methods：Fresh frozen HCC tissues and pair-matched NTL tissues were collected from 34 patients diagnosed with HCC，and NL tissues were collected from 4 patients with hepatic heman－gioma. AQP7 gene and protein expression of the three kinds of tissues was detected by real-time PCR，Western blot and immunohis－tochemical method. Then the correlation analysis between AQP7 expression and clinical features was done. Results：AQP7 was ex－pressed in hepatocytes，both intracellular and in membrane localized. Both levels of AQP7 mRNA and protein were significantly lower in HCC tissues than in NTL and NL tissues. No obvious difference in AQP7 mRNA and protein levels was found between NTL and NL tissues. AQP7 mRNA levels were not statistically different between NL group and NTL group（P=0.072）. AQP7 protein levels were not statistically different between NL group and NTL group（t=0.264，P=0.798）. AQP7 protein levels were lower in HCC group than in NTL group（t=7.333，P=0.000） and NL group（t=5.648，P=0.011）. Low expression of AQP7 in HCC was correlated with the lymphatic metastasis and the reduction of AQP7 was greater among the patients with lymphatic metastasis（t=-2.837，P=0.008）. Re－gression equation：Y=1.612-0.472 X7（F=8.048，P=0.008）. Conclusion：AQP7 is expressed in hepatocytes，both intracellular and in membrane localized. AQP7 decreases expression in HCC tissues. And the reduction of AQP7 is greater among the patients with lym－phatic metastasis.

Abstract:Objective：To explor the relationship between MiR205 promoter methylation and Barrett’s esophagus cancerous. Methods：The expression of miRNA205 in Barrett’s esophagus，esophageal cancer and normal esophageal mucosa cells before and after demethylation processing was detected by RT-PCR. MiR205 promoter methylation levels were measured by methylation specific polymerase chain reaction（MSP）. Results：miR205 expression was reduced obviously in Barrett’s esophagus and esophageal cancer cells than in normal esophageal，with statistically significant differences（P=0.002）. After demethylation，miR205 expression was sig－nificantly increased in Barrett’s esophagus（BT，B-T10） and esophageal cancer（EC109，TE-10，SEG-1） cells，with statistically sig－nificant differences（P=0.000）. MSP showed miR205 promoter changes to be low-methylation or non-methylation. Conclusion：Re－duced expression of miR205 in Barrett’s esophagus and esophageal cancer cells is related to its promoter methylation. Throughout the carcinogenesis of Barrett’s esophagus，miR205 promoter methylation may become a key molecular biomarker in process of Barrett’s esophagus canceration and may become the prevention and treatment targets of Barrett’s esophagus canceration.

Abstract:Objective：To investigate the effect of Beclin 1 overexpression on the biological behavior of esophageal cancer cell line E－ca109. Methods：The recombinant eukaryotic expression vector pIRES2-ZsGreen-h Beclin 1 was transfected into Eca109 cell line. The mRNA and protein expressions of Beclin 1 were determined by RT-PCR and Western blot. Autophagosome was observed by electron microscopy. Changes in cell growth curve were determined by MTT assay and cell cycle was evaluated by flow cytometry. The effects of Beclin 1 overexpression on the migration and invasion of esophageal cancer cell line Eca109 were detected by Transwell chamber experiment. Vascular formation experiment in vitro was applied to determine the angiogenesis capability of Eca109. Results：The proliferation of Eca109 cells was obviously inhibited in Beclin 1 group than in empty vector group and control group. The cell in－vasion，angiogenesis and migration abilities were reduced Beclin 1 group than in control group（all P<0.05）. The proportion of cells at S stage was decreased significantly and the cell proliferation was inhibited obviously after steady expression of Beclin 1. Conclusion：Beclin 1 may be used as one of suppressor genes for esophageal cancer growth and metastasis.

Abstract:Objective：To establish reversed-phase high performance liquid chromatography-fluorescence detection（RP-HPLC-FLD） method，to determine hepatoma-associated tyrosine and valine amino acid enantiomers（L-tyrosine（L-Tyr），D-tyrosine（D-Tyr），L-valine（L-Val） and D-valine（D-Val）），to compare changes in tyrosine and valine amino acid enantiomers concentrations in plasma between hepatocellular carcinoma（HCC） patients and healthy controls and to investigate their possible relationship. Methods：O-ph－thaldialdehyde（OPA） and N-acetyl-L-cysteine（NAC） were served as the pre-column derivatization reagents. Separation was carried out on a Phenomenex Gemini C18 column（250 mm×4.6 mm，5 μm） with a programmed gradient elution. The mobile phase was con－sisted of 20.0 mmol/L sodium dihydrogen phosphate（pH 6.80） and acetonitrile. The eluted solution was monitored using a fluores－cence detector with excitation wavelength at 350 nm and emission wavelength at 450 nm. Results：The presented method exhibited an excellent linearity for all the analytes over their respective concentration ranges. The recoveries ranged from 90.74% to 106.80%. The detection limits were 6.79 pg/ml，7.81 pg/ml，1.86 pg/ml and 1.95 pg/ml for L-Tyr，D-Tyr，L-Val and D-Val，respectively. Twenty plas－ma samples of healthy humans and 23 plasma samples of HCC patients were tested and the HCC patients demonstated higher levels of L-Tyr（P=0.011） and lower levels of L-Val（P=0.019） and D-Val（P=0.006） in plasma while no change was observed in D-Tyr（P=0.973）. Conclusion：This method is simple，accurate and suitable for routine scientific research and clinical measurement.

Abstract:Objective：To analyze the intrahepatic hepatitis B virus（HBV） covalently closed circular DNA（cccDNA） in hepatocellular carcinoma（HCC） patients. Methods：The specificity and sensitivity of rolling circle amplification（RCA） were investigated. The intra－hepatic HBV cccDNA in 13 pairs of tumor and adjacent non-tumor tissues were amplified by RCA and pre-S deletions were deter－mined by sequencing. Results：The HBV cccDNA（10 copy/μl） could be amplified specifically by RCA. Among 26 samples，the HBV cccDNA in 22 tissues were amplified successfully，and the pre-S deletions were identified in 8 samples（8/22，36.4%）. In addition，the rate of pre-S2 deletion was higher than that of pre-S1（8/8 vs. 2/8，P=0.007）. Conclusion：The pre-S2 deletion of HBV cccDNA is first identified in hepatocellular carcinoma patients，which would be benefit for understanding the relationship between cccDNA pre-S deletion and HCC.

Abstract:Objective：To investigate the correlation between HLA-DRB1*07/12/15 and hepatocellular carcinoma（HCC）. Methods：Articles were identified by electronic search in PubMed，EMBASE，Wanfang data，CNKI. Case-control study trials focusing on the correlation of the risk of HLA-DRB1*07/12/15 with HCC were included. Effective data were extracted from the eligible studies. All Meta analysis were performed by RevMan 5.0 software. ORs were used as effect indicators. Results：HLA-DRB1*12/15 increased the risk of HCC in the whole populations[（OR=1.56，95%CI=1.12 to 2.17，P=0.009）/（OR=1.35，95%CI=1.03 to 1.77，P=0.03）] while HLA-DRB1*07 didn’t correlated with the risk of HCC in the whole populations（OR=0.99，95%CI=0.46 to 2.14，P=0.97）. Subgroup analyzis suggested that：HLA-DRB1*12/15 increased the risk of HCC in Asian populations[（OR=1.65，95%CI=1.17 to 2.32，P=0.004）/（OR=1.55，95%CI=1.14 to 2.11，P=0.006）]，while HLA-DRB1*07 didn’t correlated with the risk of HCC in Asian populations significantly（OR=0.95，95%CI=0.26 to 3.50，P=0.94）. Conclusion：HLA-DRB1*12/15 increases the risk of HCC while HLA-DRB1*07 doesn’t correlate with the risk of HCC.

Abstract:Objective：To investigate the expression of PRDX2 in histological samples of colorectal neoplasm and the normal tissues and to analyze its mechanism. Methods：The expression of PRDX2 was detected by immunohistochemistry and Western blot. In colon cancer cell SW480，interacting proteins with PRDX2 was detected by immunoprecipitation and HPLC-CHIP-MS/MS. Results：Im－munohistochemistry indicated that PRDX2 protein was expressed mainly in the cytoplasm. The expression of PRDX2 was weaker in normal colorectal tissues（21.88%，7/32） than in carcinomas tissue（71.88%，23/32）（P=0.001）. Western blot analysis revealed that the expression of PRDX2 protein was significantly higher in carcinomas than in control colorectal tissues（P<0.01）. In SW480 cells，17 proteins were obtained from immunoprecipitation using specific antibodies against PRDX2，9 of them were regulated by c-Myc gene. Conclusion：PRDX2 play roles in the development and metastasis of colorectal cancer. PRDX2 might be associated with c-Myc gene regulatory pathway.

Abstract:Objective：To investigate the effect of tumor suppressor gene DLC-1 on Wnt/β-catenin signaling pathway in colon cancer cell line SW480. Methods：Human colon cancer cell line SW480 was taken as research object and was divied into 3 groups：pcDNA3.1（+）-DLC-1 group，pcDNA3.1（+） group and SW480 group. Each group was transfected with recombinant lentiviral vector containing DLC-1 gene. MTT was applied to detect cell proliferation and flow cytometry was performed to detect cell apoptosis. Real-time PCR and Western blot were preformed to detect the mRNA and protein expressions of Wnt/β-catenint signaling pathway related genes（β-catenin，GSK-3β and c-my）. Results：The proliferation of SW480 cells was significantly inhibited（the proliferation rate was 0.546）and the apoptosis was increased（the apoptosis rate was 42.422+3.413） in pcDNA3.1（+）-DLC-1 group. Real-time PCR and Western blot determined that the mRNA and protein expressions of β-catenin and c-myc were down-regulated，and the mRNA and protein expressions of GSK-3β were up-regulated（P=0.000）. Conclusion：DLC-1 plays a suppression role in colon cancer cell，which asso－ciates with Wnt/β-catenint signaling pathway. DLC-1 may be the upstream adjustment factor of Wnt/β-catenint signal pathway.

Abstract:Objective：To discuss the strength and weakness of hand-assisted laparoscopic surgery（HALS） and laparoscopic-assisted surgery（LAS） in laparoscopic left colon resection used by beginners and less experienced surgeons and to guide the surgeons to make a selection. Methods：Totally 53 cases underwent HALS and LAS by less experienced laparoscopic surgeons were divided into two groups：A group（29 cases；less experienced laparoscopic surgeons（performing less than 30 cases of laparoscopic colon surgeries） performing HALS） and B group（24 cases；surgeons with the same experience performing LAS）. Clinical data were statistically ana－lyzed. Results：There was no significant difference in general condition between the two groups. There were statistical differences in cases converting to laparotomy（10.3% vs. 16.7%，P=0.688），cases of comfort/slightly discomfort/discomfort（2/15/9 vs. 1/12/7，P=1.000），operative time（（177.7±28.8） min vs. （204.1±36.6） min，P=0.009），blood loss（（104.4 ± 33.7） ml vs. （164.25 ± 65.00） ml，P=0.001） and hospital costs（（45 819.96 ± 4 793.40） Yuan vs. （42 375.50±5 234.74） Yuan，P=0.024）. There was no difference in anal exhaust time，postoperative hospital stay and number of dissected lymph node（（64.4±21.4） h vs. （64.5 ± 19.0） h；（13.6±4.5） d vs. （12.3±3.5） d；（16.0±3.3） unit vs. （17.0±3.6） unit；P=0.985，0.166，0.125）. Conclusion：HALS can be used as one of the preferred methods for less experienced laparoscopic surgeons.

Abstract:Objective：To investigate the correlation between -415T/C and -462G/A single nucleotide polymorphism in the promoter region of chromogranin A（CHGA） and prognosis of critically ill patients. Methods：Totally 294 critically ill patients consecutively ad－mitted to our ICU were recruited. The -415T/C and -462G/A genetic polymorphisms of CHGA were determined the by polymerase chain reaction and DNA sequencing technology，and correlation between genotype and clinical characteristics of patients were ana－lyzed. Results：①There was no significant difference in the minor allele frequency（MAF） of CHGA-415T/C and CHGA-462G/A ge－netic polymorphism between participants of this study and the healthy people in Asia.②The CHGA-415T/C MAF of death group was significantly higher than that of survival group（MAF 0.378 and 0.292 respectively，P=0.046），but there was no significant difference in the CHGA-462G/A genetic polymorphisms between the two groups（MAF 0.096 and 0.107 respectively，P=0.717）. ③ Survival analysis showed that there were significant differences between CHGA-415T/C mutation group（including TC and CC genotypes） and wild group（TT genotype）（Log rank=7.331；P=0.007）. The mortality in mutant group was significantly higher than that in wild group（0.325 and 0.191，respectively；P=0.010）. Binary logistic analysis showed that CHGA-415T/C polymorphism was an independent risk factor for the mortality of critically ill patients（OR=2.055，95%CI=1.051-4.019，P=0.035）. Conclusion：Critically ill patients with CHGA -415T/C mutant genotype display higher 30 d mortality than wild genotype group. Furthermore the death group had higher MAF than survival group. The CHGA -415T/C polymorphism could be an independent risk factor for 30 d mortality in critically ill patients.

Abstract:Objective：To investigate the prevalence and genotypic mutant characteristics of the glucose-6-phosphate dehydrogenase deficiency（G6PD） deficiency in neonates of Chaozhou area. Methods：A total of 2 500 neonates born in Chaozhou Central Hospital were screened for G6PD deficiency by inflorescent spot test（FST）. Then，all positive screening samples were subjected to genotype through high-resolution melting assay or DNA sequencing. Results：The prevalence of G6PD deficiency in Chaozhou was 2.6%（67/2 500）. Of the 67 infants suspected to be G6PD deficiency based on FST，44（3.22%，44/1 365） were males and 23（2.03%，23/1 135）were females. The detected ratio of male and female was 1.91∶1 without statistical differences（ χ2=3.404，P=0.065）. Among these 67 positive screening samples based on FST，58 had gene mutation；7 kinds of mutation were found including 26 cases of 1376 G>T（c.1466G>T，44.83%），22 cases of 1 388 G>A（c.1478 G>A，37.94%），5 cases of 95 A>G（c.185A>G，8.62%），2 cases of 871 G>A（c.961G>A，3.45%），1 case of 392 G>T（c.482G>T，1.72%），1 case of 493 A>G（c.583A>G，1.72%） and 1 case of 1360 C>T（c.1450C>T，1.72%）. Conclusion：The incidence of G6PD deficiency is high in Chaozhou area. More male infants are detected with G6PD defi－ciency than females. G6PD Canton（1376 G>T），G6PD Kaiping（1388 G>A） and G6PD Gaohe（95 A>G） are the three most common variants in this area.

Abstract:Objective：To observe the cardiovascular reactions and complications in elderly patients during general anesthesia extuba－tion after applying dexmedetomidine（DEX） guided by Narcotrend. Methods：Totally 60 elderly patients were randomly divided into DEX group and control group. DEX group：0.5 μg/（kg·h） Dex infusion was given at 30 min before finishing the surgery and narcotrend index（NI） was maintained at 65-79 by adjusting the concentration of DEX postoperatively. Control group：0.125 ml/（kg·h） 0.9% normal saline was given at 30 min before finishing the surgery. Systolic blood pressure（SBP），diastolic blood pressure（DBP），heart rate（HR） and NI values before the induction（T1），at the end of operation（T2），at tracheal suction（T3），at extubation（T4），5 min after the extubation（T5），10 min after the extubation（T6） were recorded. The spontaneous respiration recovery time，dwell time in PACU and complications were also recorded. Results：There were statistical differences in SBP，DBP，HR，NI values in T3，T4，T5 between two groups（P<0.05）. In control group，there were statistical difference in SBP，DBP，HR between T3，T4 and T1（all P=0.000）. There was no difference in the spontaneous respiration recovery time and dwell time in PACU between two groups（P=0.786，P=0.351）. There were statistical differences in the incidence of agitation between two groups（P=0.024）. Conclusion：Giving 0.5 μg/（kg·h） DEX infu－sion at 30 min before finishing the surgery and maintaining narcotrend index（NI） at 65-79 by adjusting the concentration of DEX postoperatively can maintain the stability of circulation and reduce the agitation without extending the spontaneous respiration recov－ery time and dwell time in PACU during general anesthesia extubation.

Abstract:Objective：To observe the changing trends of intestinal microflorae in the postoperative infants with congenital anorectal malformation（ARM）. Methods：Real-time quantitative PCR was used to detect the numbers of three main intestinal microflorae in stools of 21 congenital ARM infants aged 10 d（the day before discharge），1 month and 3-4 months. The number of microflorae was compared between 21 congenital ARM infants and 21 normal infants. Results：（1）In congenital ARM 10 d group，the number of bifi－dobacteria versus the number of escherichia coli（B/E） was <1；the number of B/E was higher than that of bifidobacteria and lactobacilli in congenital ARM 10 d group（P=0.021，P=0.004）；the number of lactobacilli was higher in congenital ARM 10 d group than in normal control group（P=0.001）. （2）B/E was increased in congenital ARM 1 month group（B/E>1） than in congenital ARM 10 d group（P=0.030）. The number of bifidobacteria was increased significantly（P=0.001），higher than that of B/E or lactobacilliin congenital ARM 1 month group（P=0.001 and P<0.001）. The numbers of bifidobacteria and lactobacilli were higher in congenital ARM 1 month group than in normal control group（P=0.004 and P<0.001）. （3）The number of lactobacilli was lower in congenital ARM 3-4 months group than in congenital ARM 1 month group（P=0.005） and there was no difference in the number of lactobacilli congenital ARM 3-4 months group and normal control group（P=0.571）. The number of bifidobacteria was higher in congenital ARM 3-4 months group than in normal control group（P=0.004）. （4）The number of bifidobacteria was higher in infants taking probiotics continuously in con－genital ARM-4 months group than in infants in normal control group（P=0.013） whereas there was no significant difference in the number of bifidobacteria between infants taking probiotics discontinuously in congenital ARM 3-4 months group and infants in nor－mal control group（P=0.032）. Conclusion：（1）B/E is the predominant bacteria and the number of lactobacilli is higher in the con－genital ARM 10 d group. The structure of three main microflorae is different from that in normal control group. （2）Bifidobacteria be－comes the predominant bacteria in congenital ARM 1 month group and normal control group and the number of lactobacilli is still high. （3）The number of lactobacilli is decreased in congenital ARM 3-4 months group. The structure of three main microflorae in congeni－tal ARM 3-4 months group is similar to that in normal control group. （4）Taking probiotics continuously till 3-4 months’ age can keep the high level of bifidobacteria in the intestine.

Abstract:Objective：To evaluate the effects of acid etching and two kinds desensitizing agents on zirconia and dentin in order to pro－vide references for clinical treatment. Methods：Fifty molars（the third molar） without caries were collected and the crowns of the mo－lars were removed to expose the dentin. All samples were divided into control group A and experimental groups B，B1，C，C1（n=10）. All 50 molars were immersed into 1∶3 fetal bovine serum solution and were taken out 1 d after. No treatment was made in group A；molars in groups B and B1 were coated by Gluma desensitizer；molars of groups C，and C1 were treated by water. Before bonding，mo－lars in groups B1 and C1 were treated by phosphoric acid for 15 seconds while no treatment was made in other groups. The dentin of specimens were bonded with zirconia with the same size at the bottom and the shear strength was determined. The results were ana－lyzed by software of SPSS 17.0. Results：The bonding strength：A group（9.626±0.318） MPa，B group（12.577±0.374） MPa，B1 group（15.650±0.344） MPa，C group（9.530±0.391） MPa，C1 group（12.740±0.310） MPa. There were statistical differences between groups（P<0.05） except comparison between group A and group C（P >0.05） and between group B and group C1（P >0.05）. Conclusion：Gluma desensitizer can enhance the bonding strength of Rely XTM Unicem on dentin. Proper phosphoric acid etching of dentin treat－ed by water laser or Gluma desensitization can enhance the bonding strength of Rely XTM Unicem on dentin.

Abstract:Objective：To investigate the expression of high mobility group protein 1（HMGB1） in children with anaphylactoid purpura and its clinical significance. Methods：Expression of serum HMGB1 in 183 children with anaphylactoid purpura was detected by ELISA. HMGB1 mRNA relative expression was detected by real-time PCR. Forty healthy children were enrolled as control group. Results：Serum HMGB1 concentration was higher in anaphylactoid purpura group than in control group（t=7.43，P=0.000） during disease period and after recovery（t=34.257，P=0.000）. HMGB1 mRNA in peripheral blood increased（t=10.362，P=0.000），and decreased after recovery（t=4.651，P=0.000）. There were differences in HMGB1 protein concentration between different genders（t= 0.032，P=0.974），among different ages（F=0.088，P=0.916） as well as between initial onset and recurrence（t=0.449，P=0.654）. There were significant differences in HMGB1 protein concentration between those with and without kidney injury（t=5.672，P=0.000），joint symptoms（t=3.048，P=0.003），and gastrointestinal symptoms（t=2.050，P=0.042）. HMGB1 mRNA relative expression in peripheral blood was higher in those with kidney damage，arthritis symptoms，gastrointestinal symptoms than in those without kidney injury（t=2.867，P=0.005），arthritis symptoms（t=2.733，P=0.007） and gastrointestinal symptoms（t=2.366，P=0.019）. Conclusion：As a new biological marker，HMGB1 could play an important role in diagnosis and treatment of complications of anaphylactoid purpura.

Abstract:Objective：To explore the application of injury severity score（ISS） and new injury severity score（NISS） for assessing the treatment outcomes in blunt trauma patients，and to define the severe injury with ISS and NISS. Methods：Ａbbreviated injury scale （AIS 2005） was used to carry out retrospective analysis among 2 694 blunt trauma patients（≥2 regions，dividing six body regions by ISS） treated at Chongqing Emergency Medical Center from November 2005 to November 2011. In the meantime，the severe in－jury with ISS and NISS were defined and their relations with mortality were analyzed by Chi-square test and t test，logistic regression analysis and ROC. Results：The mortality rate was 6.9%（16/231） when ISS was 21-25 points while that was 13.0%（21/162） when ISS was 26-30 points；the mortality rate was 5.3%（21/399） when NISS was 26-30 points while that was 11.9%（15/136） when NISS was 31-35 points；there was no significant difference between them and 10% mortality（P ＞0.05）. Both ISS and NISS had positive linear correlation with mortality（r=0.787，P<0.001；r=0.845，P<0.001）. Patients with ISS and NISS 0-20 points had lower risk than those with other points of ISS and NISS. With the increase of ISS and NISS points，the risk of death was on the rise. ISS was not superior to NISS in predication of mortality（P＞0.05）. The most Youden indexes were 17.5 and 23.0 for ISS and NISS，respectively. Conclusion：Both ISS and NISS work well in evaluation the treatment outcomes in blunt trauma patients. It is reasonable to definite the severe poly-trauma by ISS≥18 and NISS≥23 in AIS 2005.

Abstract:Objective：To investigate the expression of β-TrCP in breast cancer tissues and its effect on prognosis of patients with breast cancer. Methods：β-TrCP expression in 56 samples of breast cancer and normal tissues and the corresponding samples of tumor-adjacent tissues were detected by immunohistochemistry. The correlation between β-TrCP expression and prognosis was analyzed. Results：The expression of β-TrCP in breast cancer tissues was significantly up-regulated compared with that of the normal tumor-ad－jacent tissues（χ2=37.333，P=0.000）. Clinicopathological evaluation suggested that β-TrCP positive expression was associated with ER positive（P=0.002），PR positive（P=0.004），lymph node metastasis（P=0.007） and TNM stage（P=0.004）. Five-year survival rate was 100%（16/16）in patients with negative expression of β-TrCP and was 72.5%（29/40）in patients with positive expression of β-TrCP（95%CI=0.559 to 0.837）. Results of log-rank test of statistical significance（P=0.015）. Multivariate Cox regression analysis revealed that β-TrCP positive expression was an independent factor for predicting poor prognosis in breast cancer（P=0.005，RR=0.287，95%CI=0.120-0.683）. Conclusion：High-expression of β-TrCP is correlated with the poor prognosis in breast cancer，suggesting β-TrCP may play a key role in development and progression of breast cancer.

Abstract:Objective：To discuss the general clinical factors for patients with breast cancer and to identify predicting function of im－munohistochemistry（IHC） for pathological complete response after neoadjuvant chemotherapy（NAC） （docetaxel + epirubicin/ pirarubicin + cyclophosphamide）. Methods：From 1 January 2012 to 31 December 2012，257 patients treated with NAC were included in this retrospective study．Data were compared using Chi-square，Fisher’s exact tests，likelyhood ratio or multivariate analysis of variance，etc. Results：Of the 257 breast cancer patients receiving NAC，42（16.3%） gained pCR. Five factors were associ－ated with pCR：tumor grade T1（P=0.006），estrogen receptor negative（P=0.000），progesterone receptor negative（P=0.013），Ki67（proliferation scores >30%，P=0.004） and giving birth to one child（P=0.032）. In multivariate analysis，double negative breast cancer（DNBC）（OR=7.248，95%CI=2.453 to 21.416），Ki67（proliferation scores >30%，OR=4.355，95%CI=1.513 to 12.537），giving birth to one child（OR=3.926，95%CI=1.040 to 14.821）were found to significantly correlate with pCR. Conclusion：DNBC，Ki67（prolifera－tion scores >30%），giving birth to one child are more likely to experience pCR to NAC. Childbearing history is newly identified as an important predictor.

Abstract:Objective：To compare the clinical efficacy of bipolar femoral head replacement for intertrochanteric fracture （accompanied Kirschner wires tension band fixation） and femoral neck fracture in eldly and osteoporotic patients. Methods：Bipolar femoral head re-placement combined with Kirschner wires tension band fixation was applied for 132 elderly patients with intertrochanteric fracture and sin-gle bipolar femoral head replacement was used for 135 elderly patients with femoral neck fracture from January 2004 to December 2010. All patients were diagnosed as severe osteoporosis according to the WHO classification.The operating time，blood loss，post-operative am-bulation time，hospital duration，complication during perioperative period and follow-up，Harris score and SF-12 score were compared. Results：All the incisions healed by the first intension postoperatively. A total of 112 cases in intertrochanteric fracture group and 118 cases in femoral neck fracture group were followed-up for 2-5 years successfully，averaged 3.1 years. The operating time of in－tertrochanteric fracture group was significantly longer than that of femoral neck fracture group（Z=13.003，P=0.000） and there was no difference in the other indicators above between two groups（P >0.05）. Two patients in intertrochanteric fracture group and 3 patients in femoral neck fracture group died at 1 month postoperatively；but there was no statistical difference in complication and death inci－dences between two groups（P >0.05）. There was no significant difference in Harris score and SF-12 score at 1.5 months and 2 years postoperatively（P >0.05）. Conclusion：Bipolar femoral head replacement combined with Kirschner wires tension band fixation is effec－tive for intertrochanteric fracture in eldly and osteoporotic patients；its efficacy is similar to that of hip replacement for femoral neck fracture；therefore deserves clinical expansion.

Abstract:Objective：To discuss the serum chemerin level in pregnant women with severe pre-eclampsia and eclampsia and to ex－plore their relationship． Methods：Fifty patients with severe pre-eclampsia and 2 with eclampsia in Second Affiliated Hospital of Chongqing Medical University from 2011 to 2012 were enrolled. There were 32 cases of early onset pre-eclampsia and 18 cases of late onset pre-eclampsia including 12 cases of fetal growth restriction（FGR）． Thirty normal pregnant women during the same period were taken as control group. Serum chemerin level was determined by ELISA in each group． Results：Serum chemerin level of severe pre-eclampsia and eclampsia group（422.30±60.72） ng/L was higher than that in normal group（316.2±47.87） ng/L（P=0.000）． Serum chemerin level of early onset group（420.94±69.71） ng/L did not differ from that in late onset group（424.89±40.22） ng/L（P=0.812）. Serum chemerin level of FGR sub group（482.17±52.93） ng/L was higher than that in non-FGR sub group（404.35±50.97） ng/L（P=0.000）． Correlation analysis showed that serum chemerin level significantly and positively correlated with systolic blood pressure，diastolic blood pressure，blood urea nitrogen，creatinine，triglycerides and low density lipoprotein（r=0.698，0.654，0.277，0.235，0.288，0.475；P=0.000，0.000，0.012，0.034，0.009，0.000），and negative correlated with high density lipoprotein（r=-0.396，P=0.000）. There was no correlation between serum chemerin level and cholesterol（r=0.178，P=0.110）. Conclusion：The elevated serum chemerin level may contribute to the pathogenesis of severe pre-eclampsia，eclampsia and FGR，and may influence the fetal growth．

Abstract:Objective：To investigate the effect of ulinastatin（UTI） and docetaxel（DCT） on immunocyte，immune factors and matrixes in breast cancer immune microenvironment and the tumor growth. Methods：4T1 breast cancer cells were cultured and the BALB/c mice were purchased to establish BALB/c mice model bearing 4T1 cells. Thirty-two mice were randomly divided into four groups：control group，UTI group，DCT group and UTI + DCT group. The tumor size was measured and the inhibition rate was calculated. Line flow cytometric dyeing was used to detect CD4+CD25+Foxp3+Treg content. The expression of interleukin-2（IL-2），IL-6 and IL-10 was detected by ELISA. The expression of matrix metalloproteinases 9（MMP-9） and tissue inhibitor of metalloproteinase 1（TIMP1） was detected by Western blot. Results：Both UTI and DCT can inhibit tumor growth and inhibitory effect was the most significant when UTI combined with DCT（P=0.000）. The rate of CD4+CD25+Foxp3+Treg/CD4+T cells was decreased in UTI group，DCT group and UTI + DCT group than in control group（P=0.000）. The expression of IL-6，IL-10 and MMP-9 was significantly decreased and the expres－sion of IL-2 and TIMP1 was increased in UTI group，DCT group and UTI + DCT group than in control group（P=0.000，P=0.000）. Conclusion：UTI combined with DCT can suppress the tumor growth in mice with normal immune function. The mechanism may be related with regulating CD4+CD25+Foxp3+Treg，IL-2，IL-6，IL-10，MMP-9 and TIMP1 in the tumor microenvironment.

Abstract:Objective：To explore the value of gold immunochromatography assay（GICA） and chemical method in the detection of oc－cult blood in gastric juice. Methods：Totally 311 patients were taken as test samples. Chemical method and GICA were used to detect the gastric juice and vomits. Results：The positive predictive rates of GICA and chemical method were 64.73% and 100%；the negative predicative rates of GICA and chemical method were 79.74% and 70%；diagnostic accordance rates of GICA and chemical method were 53.09% and 65.59%.The combined diagnosis coinci－dence rate can reach 95.38%. The specificity and coincidence of GICA was better than those of chemical method with statis－tically significant differences（P<0.05）. Conclusion：GICA is su－perior to chemical method in negative predictive value and diagnostic accordance. The combination of both methods can improve the accuracy of the diagnostic therapy

Abstract:Objective：To explore the most effective diagnosis and treatment methods for blunt hepatic trauma in children. Methods：Totally 32 children with blunt hepatic trauma were analyzed retrospectively in our center. Trauma causes included traffic accident in 11 cases，tumbling injury in 9 cases，blunt extrusion and blow injury in 7 cases，falling injury in 5 cases. All traumas were classified as grade Ⅰof 19 cases，gradeⅡ of 9 cases，gradeⅢ of 3 cases and grade Ⅳ of 1 case according to the grading method in American So－ciety of Trauma Surgery（AAST） in 1989. Results：Twenty-eight cases were cured after conservative treatment. Four children under－went liver laceration repair and 1 child underwent operation again due to re-bleeding. All children were well recovered. Conclusion：Most children with blunt hepatic trauma could be cured with conservative treatment under the condition of intensive care. The most important point is how to make the critical decision of operation according to ultrasound and computed tomography. Even if there is no significant hemoperitoneum，if the CT indicates severe laceration of the liver，surgical repair should actively performed.

Abstract:Objective：To summarize the usage of cyclosporine A in living related liver transplantation（LRLT） and donation after car－diac death（DCD） liver transplantation for children in our hospital and to provide references for standard dose for children after liver transplantation. Methods：Clinical data of 20 cases of LRLT and DCD liver transplantation during June 2006 to May 2013 in our hos－pital were summarized. These 20 recipients were treated by cyclosporine A-based regimen. Differences in CsA dosage after LRLT and DCD liver transplantation were analyzed. Results：In LRLT group，doses at each time period were：（7-18） mg/（kg·d） at initial peri－od，（7-17.5） mg/（kg·d） at one month after the operation，（7-17.5） mg/（kg·d） at two months after the operation；（5-16） mg/（kg·d） at three months after the operation，（4-13.5） mg/（kg·d） at six months after the operation. In DCD group：（16-20） mg/（kg·d） at initial period，（16-19） mg/（kg·d） at one month after the operation，（13.5-15.5） mg/（kg·d） at two months after the operation，（12.5-15） mg/（kg·d） at three months after the operation，（9-13.5） mg/（kg·d） at six months after the operation. There were statistically signifi－cant difference in the dosage of Cs A between LRLT and DCD liver transplantation（P<0.05）. Conclusion：LRLT recipients require less amount of Cs A than DCD recipients during the first six months after receiving liver transplantation with the same drug concen－trations. Large individual difference between the two groups can be observed.

Abstract:Objective：To observe the acting time of postoperative analgesic effects after applying Parecoxib sodium combined scalp nerve block and to explore whether scalp nerve block combined with Parecoxib sodium is a good analgesic method for craniotomy. Methods：Totally 60 craniotomy patients were randomly divided into scalp nerve block group（control group） and scalp nerve block combined with Parecoxib sodium group（experimental group）. Based on the location of incision，the supraorbital nerve，auriculotempo－ral nerve，greater occipital and lesser occipital nerve were selectively blocked with 0.5% ropivacaine. In experimental group，Parecoxib sodium was given before surgery. Postoperative pain score，sedation score，nausea and vomiting score，vital signs were recorded at 0，1，2，4，12，24 h postoperatively. Results：In experimental group，the analgesic effect acted for 18 h and exerted slight effect on respi－ratory depression，sedation and vital signs. In control group，Parecoxib sodium combined scalp nerve block extended the rescue anal－gesic time，but did not change the dose used. Conclusion：Parecoxib sodium combined scalp nerve block is a good neurosurgical post－operative analgesia method，which might be widely used.

Abstract:Objective：To investigate the risk factors of refractory reflux esophagitis（RRE）. Methods：A total of 212 patients with reflux esophagitis（RE） who received proton pump inhibitors（PPIs） treatment for 8 weeks were enrolled including 93 RRE patients（43.9%）with ineffective treatment and 119 non-refractory reflux esophagitis（NRRE） patients（56.1%） with effective treatment. Clinical data （gender，age，body mass index（BMI），family history，endoscopy grading，anxiety and depression status） were collected and analyzed statistically. Results：There were statistical differences between RRE group and NRRE group in age，BMI，duration of disease，family history（P<0.05） while no significant difference in gender（P ＞0.05）. There were statistically significant differences in anx－iety and depression grading between RRE group and NRRE group before and after treatment（P<0.05） while no statistically significant difference in endoscopy grading（P ＞0.05）. Logistic regression analysis showed that middle-age，obesity，family history of RE，long dis－ease duration and clinical symptom and severe anxiety and depression were higher risk factors for RRE. Conclusion：RRE is related with age，BMI，family history，anxiety and depression status and disease duration. Middle-age，obesity，family history of RE，long dis－ease duration，severe anxiety and depression are risk factors of RRE. There is no parallel association between clinical severity and gas－troscopic severity for patients with RRE.

Abstract:Objective：To analyze clinical characteristics and main treatment points in different age periods among 258 children with congenital duodenal obstruction. Methods：Totally 258 children with congenital duodenal obstruction were treated in our department from 2003 to 2012 and were divided into two groups：neonatal group（184 cases）and non-neonatal group（74 cases）. The clinical char－acteristics and main treatment points were analyzed and reviewed retrospectively. Results：（1）Congenital duodenal obstruction mainly appeared during neonatal period（ ?字2=10.658 3，P=0.005）. （2）Bilious vomiting（76.36%）was the most prominent clinical symptom（ ?字2=37.482 1，P=0.000）. （3）Positive detection rates of abdominal plain film，abdominal Doppler ultrasonography and upper gastrointestinal contrast were 75.87%，73.71% and 100.00%，respectively with significant differences（P=0.000）. （4）The common causes of con－genital duodenal obstruction were congenital intestinal malrotation，duodenal atresia or stenosis and annular pancreas. When the di－agnosis of congenital duodenal obstruction was confirmed，surgical operation should be done as early as possible and the prognosis was significantly better after earlier surgical treatment in most cases（curative rate of 96.88%）. Conclusion：The diagnosis for the children with congenital duodenal obstruction diseases should be established as soon as possible and the prognosis should be better.

Abstract:Objective：To investigate the clinical manifestation and laboratory examination results of infectious mononucleosis（IM） and to improve its clinical diagnosis level. Methods：Clinical data of 39 patients with IM admitted to our department from April 2011 to August 2013 were analyzed retrospectively. Results：Patients aged between 16 and 30 years old accounted for 71.8%. All patients were recovered completely except one severe case developing to Guillan Barre syndrome. Most common clinical symptoms included fever（82.1%），isthmitis（76.9%） and cervical lymphadenopathy（74.4%）. Besides，incidences of splenomegaly，rashes and hepatomegaly were 46.2%，41.0% and 2.5%，respectively. Cases complicated with Graves’ disease or other virus infections were found. Laboratory examination results showed that 66.7% IM patients had white blood cell count more than 10×109/L；87.2% had increased lympho－cyte ratio more than 35% and 72% more than 50%；84.6% had atypical lymphocyte ratio more than 10%；89.7% had liver function damages with increased alanine aminotransferase and aspartate aminotransferase levels. All patients had abnormal lactate dehydroge－nase enzymes and 69.2% had positive Epstein-Barr virus virus capsid antigen antibody（EBV-VCA-IgM antibody）. Conclusion：Chances of misdiagnosis and missed diagnosis could be decreased via better understanding of the diverse clinical features in adult patients with IM.

Abstract:Objectives：To study the effect of appling clinical nursing path in the third stage of chemotherapy for pediatric neuroblas－toma（NB） based on evidence-based nursing. Methods：Totally 120 children with NB who underwent chemotherapy neuroblastoma were randomly divided into experimental group（n=60） and control group（n=60）. Experimental group intended to find evidences from nursing assessment，nursing plan，nursing measures and health education and clinical nursing path table was made and used in this study. Patients in control group were nursed according to conventional nursing methods. Results：Patients in experimental group were more satisfied with hospitalization days and hospitalization expenses than those in control group. Patients in experiment group under－stood health education better than those in control group（P<0.01）. Incidences of chemotherapy side reactions were significantly re－duced in experiment group than in control group（P<0.05）. Conclusion：Clinical nursing path based on evidence-based nursing can effectively reduce the hospitalization days，hospitalization expenses and side effects of chemotherapy. For children and their families， the degree of understanding health education knowledge and the satisfaction of nursing service can be improved obviously.

Abstract:Objective：To explore the symptom clusters and influencing factors for patients with nasopharyngeal carcinoma（NPC） un－dergoing concurrent chemoradiation therapy（CCRT）. Methods：A random sample of patients completed the M. D. Anderson symptom inventory-head & neck（MDASI-H&N）. The exploratory factor analysis was conducted to do cross-sectional investigation. Results：A total of 235 patients completed the survey. Varieties of symptoms were generally identified in NPC patients. The most severe symp－toms were dysgeusia，dry mouth and mouth/throat mucus. The exploratory factor analysis of symptoms revealed four major symptom clusters，which were oral mucosa-associated，gastrointestinal，sickness-behavior and general symptom clusters. Predictors on the in－tensity of symptom clusters were medicare type and health insurance according to the results of multiple regression analysis. Conclu－sion：Symptom clusters are identified in NPC patients. Recognition of these symptom clusters can relieve the symptom of patients and is useful for medical staff to assess and provide effective interventions.

Abstract:Objective：To explore the role of allied health intervention in improving the life quality of the elderly in nursing home. Methods：The 82 elderly were selected through convenience sampling from two nursing homes and allied health intervention was im－plemented. The Mos 36-item short form health survey（SF-36） and the mini nutritional assessment（MNA） were applied to evaluate the life quality at one week and three months after the check in. Results：After three months，the total mean score and eight dimensional scores of SF-36 were improved significantly and there were statistical differences in the scores of the SF-36（P=0.000） but no statis－tical difference in the scores of MNA between one week and three months（P >0.05）. There were positive correlation between the total mean score and eight dimensional scores of SF-36 and MNA score（the total mean score rs=0.684，physical functioning rs=0.643，role physical rs=0.439，bodily pain rs=0.551，general health rs=0.602，vitality rs=0.532，social functioning rs=0.478，role-emotional rs=0.333，mental health rs=0.396. Conclusion：Quality of life of the elderly in the nursing home can be effectively improved through the allied health intervention.