Abstract:It’s certain that chronic hepatitis B is a main risk factor for hepatocellular carcinoma（HCC）. However，it’s uncertain whether occult hepatitis B virus infection（OBI） can result in HCC. We draw the conclusion that OBI is an important risk factor for HCC after reviewing literature at home and abroad. OBI maintains the same carcinogenic mechanisms as overt hepatitis B virus（HBV） infection：for example it also can cis-activate genome by integrating into the host genome，or trans-act to genome/protein by synthe－sising hepatitis B virus X antigen，preS，and hepatitis B surface antigen，which can impact signal path and induce the imbalance be－tween proliferation and apotosis. Secondly，the persistence of low level of HBV can induce slight and continuous necro-inflammation. It’s a cycle of necrosis and regeneration，which can lead to cirrhosis and HCC. Finally，mutation and methylation also play important roles in HCC.

Abstract:Procalcitonin（PCT） is a diagnostic biomarker of severe bacterial infection and sepsis and it has been widely used in clini－cal diagnosis. Whether PCT biosynthesis is affected by the liver disease is uncertain. Some researches revealed that serum PCT was eligible for diagnosing infection accompanied with liver cirrhosis，but some researches disagreed. The level of serum PCT might unusually increase in patients with autoimmune hepatitis or after liver transplantation or with extensive metastatic deposits in liver. Monitoring serum PCT consecutively and dynamically，as well as comprehensive assessment in combination with other makers are valu－able in judging the treatment effect and estimating the prognosis，however，its role in guiding the rational use of antibiotics is still un－certain.

Abstract:Objective：To observe the changes of tissue factor（TF） and coagulation function in rats with acute pancreatitis（AP） and to explore the role of Kupffer cells（KCs） in cruor function in AP rats via TF. Methods：Totally 108 SD rats are randomly divided into 6 groups including sham operation（SO） group，mild acute pancreatitis（MAP） group，severe acute pancreatitis（SAP） group，SO+gadolinium chloride（Gdcl3） group，MAP+Gdcl3 group，SAP+Gdcl3 group. Rats in Gdcl3 pretreatment group were injected with Gdcl3（10 mg/kg，0.1 ml） through the vena caudalis at 24 h before the establishment of AP model. Rats were retrograde infected with 1.5% or 5% of sodium taurocholate through bile duct to establish MAP model and SAP model. The rats were killed at 6，12，24 h after AP treatment or sham operation. Changes in serum amylase and coagulation makers were detected. The content of TF in serum was measured by ELISA. KCs was isolated and cultured， and then the expression of TF protein was detected by Western blot. The TF expression in liver tissues was measured by immunohistochemistry. The pathological damage of the pancreatic tissue was detected by HE staining. Results：The content of serum amylase was significantly higher in MAP and SAP group than in SO group（P<0.01），while there was no significant difference between MAP group，SAP group and MAP+Gdcl3 group，SAP+Gdcl3 group. The contents of TF markedly increased in MAP and SAP groups compared with those in SO group， while distinctively decreased compared with those in MAP+Gdcl3 and SAP+Gdcl3 group（P<0.05）. The TF protein expressions in the livers of rats in MAP and SAP groups distinctively increased compared with those in SO group. TF protein contents of KCs were obviously lower in MAP+Gdcl3 and SAP+Gdcl3 groups than in MAP and SAP groups（P<0.05）. Plasma concentrations of the prothrombin time（PT），activated partial thrombo-plastin time（APTT） and fibrinogen（FIB） in SAP group obviously increased compared with those in MAP groups and SO groups while markedly decreased in SAP+Gdcl3 group compared with those in SAP group（P<0.05）. The pathological section of rat pancreas showed that the pancreatic interstitial of MAP group was oedematous while the pathological damage of MAP+Gdcl3 group was alleviatived compared with that of MAP group. Pancreas of SAP group was in coagulation necrosis with a large number of inflammatory cells while the pathological damage of SAP+Gdcl3 group was obviously alleviatived compared with that of SAP group. Conclusion：Significant increases of TF expression of KCs leading to the change of coagulation makers after the onset of AP. TF expression and the coagulation can be effectively reduced by inhibiting KCs，which can reduce the occurrence and development of AP to some extent.

Abstract:Objective：To explore the role of interleukin-28B during antiviral treatment in patients with chronic hepatitis C. Methods：Anticoagulant whole blood of 46 patients with chronic hepatitis C were collected.Interleukin-28B single nucleotide polymorphism of rs8099917 genotype was tested by improved multiplex ligation detection reaction.At the same time，102 cases of serum samples were collected，including 46 cases of chronic hepatitis C before treatment and 44 cases of chronic hepatitis C after 12-week therapy，12 cases of healthy controls.The serum levels of interleukin-28B were examined by ELISA and the correlation of interleukin-28B with liver function was analyzed. Results：（1）rs8099917 TT genotype was 87.0%（40/46） and rs8099917 GT genotype was 13.0%（6/46） a－mong the 46 cases of chronic hepatitis C. There was no statistical significance in the serum levels of interleukin-28B between chronic hepatitis C group and healthy group，hepatitis C viral genotype 1b group and non-1b group，high viral load group and low viral load group，rs8099917 TT genotype group and GT genotype group（P>0.05）. There was no correlation between serum interleukin-28B and aspartate aminotransferase，alanine aminotransferase，γ-glutamyl transferase，platelet.（2）There were significant differences in expres－sion of interleukin-28B among 44 patients with chronic hepatitis C after 12-week therapy，which was higher in the early virological response group than in non early virological response group（P=0.000）. Conclusion：The rs8099917 genotypes of patients with chronic hepatitis C are mainly composed by TT genotype in Chongqing area.There is no significant difference in the levels of interleukin-28B between rs8099917 TT genotype group and rs8099917 GT genotype group，but the expression of interleukin-28B have ef－fect on early virological response.

Abstract:Objective：To investigate the effect of curcumin combined folinic acid fluorouracil oxaliplatin（FOLFOX） on proliferation inhibition and apoptosis-inducing of the gastric cell line BGC-823，and to explore its possible mechanisms. Methods：Gastric cancer cell line BGC-823 cells were divided into blank control group，curcumin group（10 μmol/L），FOLFOX group（5-FU 0.1 mmol/L+Oxaliplatin 5 mmol/L）] and curcumin combined FOLFOX group. CCK-8 was used to detect the cell proliferation. Cell apoptosis was observed by Hoechst staining. The mRNA and protein expressions of Bcl-2 and Bax were measured by real-time quantitative PCR and Western blot. Caspase-3 vitality was tested by Caspase-3 test kit. Results：The proliferation inhibition rate of BCG-823 cell in curcumin combined FOLFOX group was significantly higher than those in other groups（P<0.05）. Hoechst staining showed that apoptotic cells in medicated groups were higher than those in control group，being the most obvious in FOLFOX group. Compared with those in the control group，the expressions of Bcl-2 mRNA，Bcl-2 protein were decreased in other groups，while the expressions of Bax mRNA，Bax proteins were increased with statistically significant differences（P<0.05）. Caspase-3 activity was also increased significantly in the medicated groups，especially in curcumin combined FOLFOX group（P<0.05）. Conclusion：Curcumin combined FOLFOX could inhibit the proliferation and induce apoptosis of GC-823 cells，which was related with the activation Bax / inactivation Bcl-2 and the activation of Caspase-3.

Abstract:Objective：To investigate the effects of hepatitis B virus replication on the expression of Arid2 in hepatoma cells. Methods：The HBV-stable or transient expression cell models were used to evaluate the regulatory effects of HBV replication on Arid2 expres－sion. For stable replication model，HepAD38 cells were used to express HBV under the control of inducible tetracycline promoter. For transient expression system，Huh7 cells were infected with the replicative recombinant adenovirus Ad-HBV1.1 carrying 1.1 copies of HBV genome. Southern-blot，ELISA and real-time quantitative PCR were employed to confirm HBV replication efficiency in hepatoma cells. The expression levels of Arid2 gene were determined by RT-PCR and Western blot. To further identify which of the viral-en－coded proteins implicated in the regulation of Arid2 expression，Huh7 cells were transfected with hepatitis B virus S protein（HBs），HBp，hepatitis B virus core protein（HBc） or hepatitis B virus X protein（HBx）-expression plasmids，and Arid2 expression level were determined. Results：HBV viroloigal marker and replicative intermediates were detected both in HBV-stably or transient expression system，indicating that HBV-stably or transiently expression cell model can robustly support HBV replication. The expression levels of Arid2 gene were significantly down-regulated both in the HBV stable replication and transient replication cell model. The protein expression level of Arid2 was decreased by 46.10% in Huh7 cells transfected with Ad-HBV 1.1 and by 37.63% in HepAD38 cells（P<0.05）. Among the four viral-encoded expression plasmids，HBV surface antigen and HBx significantly repressed Arid2 mRNA and protein expression，with inhibitory effects of 54.55% and 46.38%（P<0.05） in protein level by HBs and HBx respec－tively. Conclusion：HBV replication represses Arid2 expression in hepatoma cells. Among viral-encoded proteins，HBs and HBx may play important roles in HBV-induced Arid2 repression.

Abstract:Objective：To investigate the effects of autophagy related protein Atg5 on hepatic lipid deposition caused by bisphenol A （BPA） in HepG2 cells. Methods：HepG2 cells were cultured and divided into control group，different concentrations of BPA groups（1，10 μmol/L），and positive control group（a mixture of free fatty acids（FFAs）：oleate 200 μmol/L plus palmitate 400 μmol/L），treated for 24 h. The content of intracellular triglyceride（TG） was measured by enzymic assay kit，and oil red O staining was used to determine the intracellular lipid droplet formation visually. Western blot and real-time PCR were used to detect the protein and mRNA expression of Atg5，respectively. Immunofluorescence was used to detect the expression of Atg5. Results：①The level of TG was significantly higher in 10 μmol/L BPA group than in control group（0.197±0.033，0.094±0.014，P=0.031）. ②Oil red O staining also showed that 10 μmol/L BPA promoted lipid accumulation in HepG2 cells. ③The mRNA expression levels of Atg5 in 10μM BPA group did not change compared with that in control group（0.93±0.088；1.017 5±0.062 4，t=0.811，P=0.428），however，the protein expression levels of Atg5 was lower in 10 μmol/L BPA group than that in control group（0.519±0.059；1.00，t=0.8101，P=0.000）. Besides，immunofluo－rescence indicated that the fluorescent dots were obviously reduced in 10 μmol/L BPA group than in control group. Conclusion：Atg5 could be involved in hepatic lipid deposition induced by BPA.

Abstract:Objective：To observe the effect of blueberry on the mRNA and protein expression of tumor necrosis factor（TNF）-α-R1 and sterol regulatory element-binding protein（SREBP）-1c in acute alcoholic fatty liver（AFL）. Methods：A total of 50 male C57BL/6 mice were randomly divided into normal control group（A），model group（B），high dose blueberry group（20.0 g/kg）（C），low dose blueberry group（10.0 g/kg）（D），and tiopronin group（30 mg/kg）（E），10 in each group. All mice except those in group A were fed with the Lieber-DeCarli diet for 15 d and were gastrogavaged with alcohol on the 16th day to induce AFL model. Mice in groups C－E were respec－tively administered with corresponding drugs by gastrogavage，once per day for 15 d. Detection of alanine transaminase（ALT），aspar－tate transaminase（AST），triglycerides（TG） and cholesterol（TC） in serum were performed by an automatic biochemical analyser. The level of TNF-α in serum was determined by an enzyme-linked immunosorbent assay. The morphological changes of the liver tissue were observed by HE staining. The mRNA and protein expressions of TNF-α-R1 and SREBP-1c in the liver tissue were determined by RT-PCR and Western blot，respectively. Results：Compared with those in group B，the levels of ALT，AST，TG，TC and TNF-α in serum were significantly lower（P=0.000 or P=0.025），the degree of hepatic steatosis and degen－erative necrosis were significantly improved in groups C－E（P=0.000），and the mRNA and protein expression of TNF-α-R1 and SREBP-1c were significantly lower in groups C－E（all P=0.000）. Conclusion：Blue berry has a good protective effect on acute AFL in mice，the mechanism is probably related to the inhibition of the expression of TNF-α-R1 and SREBP-1c.

Abstract:Objective：To investigate protective effect and mechanism of procyanidin in acute liver injury induced by acetaminophen. Method：The KM mice were randomly divided into six groups（n=8），including PBS control group，acetaminophen model group，pro－cyanidin control group（100 mg/kg） and procyanidin pre-treatment groups including low-dose（10 mg/kg），medium-dose（50 mg/kg） and high-dose groups（100 mg/kg）. The activities of alanine aminotransferase（ALT），aspartate aminotransferase（AST），malondialde－hyde（MDA） in the serum and the concentration of MDA in the liver homogenate of the mice were detected by commercial kits. Mean－while，the pathological changes of the liver were observed by HE staining，and the expression of SOD was determined by Western blot. Results：Compared with those in APAP model group，ALT（F=555.20，P=0.000），AST（F=168.51，P=0.000），MDA（F=155.15，P=0.000） in pre-treatment groups of medium-dose and high-dose of procyanidin were significantly lower，while SOD（F=291.84，P=0.000） was markedly higher. The damaged liver structure，hydropic degeneration and the central venous congestion were observed in the APAP model group，but the liver injuries in pre-treatment groups of medium-dose and high-dose of procyanidin were slighter. Based on the results of Western blot，SOD protein expression in APAP model group was inhibited，while the pre-treatment with medium-dose and high-dose of procyanidin could rescue its expression. Conclusion：Procyanidin has a protective role in acetaminophen-induced acute liver injury，and the preliminary mechanism is related to antioxidative character of drug.

Abstract:Objective：To explore the relationship between the expression of neuropilin-2（NRP2） and microRNA-486-5p（miR-486-5p） in gastric carcinoma（GC） and adjacent non-tumorous tissues and lymph node metastasis of GC. Methods：Sixty-five gastric carcinoma and adjacent non-tumorous specimens were collected. Immunohistochemistry（IHC） was used to detect NRP2 protein expression in tissues；quantitative real time PCR was used to detect the expression of miR-486-5p in tissues；microlymphatic density（MLD）was evaluated with lymphatic endothelium-specific marker-D2-40. The relationship between NRP2，miR-486-5p and MLD was analyzed. Results：Compared with those in normal gastric mucosa tissues，the expression of NRP2 was significantly up-regulated in GC tissues（P=0.000），while the expression of miR-486-5p was down-regulated significantly（P=0.000）. Statistic analysis revealed the expression of miR-486-5p in GC tissues was negatively correlated with MLD（P<0.001） and NRP2 was positive correlated with MLD（P=0.015）. Conclusion：The expression of NRP2 and miR-486-5p is closely associated with lymph node metastasis of gastric carcinoma，indicating that miR-486-5p and NRP2 might be used as targets for molecular therapy of gastric carcinoma.

Abstract:Objective：To explore the expression and significance of adipocytokines adiponectin，resistin and Apelin in hepatocyte steatosis induced by oleic acid. Methods：Routinely cultured human L02 cells were used as controls；L02 cells were induced by oleic acid for 24，48，72 h respectively to establish nonalcoholic hepatocyte steatosis models（model groups）. Lipid droplets in cells were observed by oil red staining and the levels of triglyceride were measured with analyzed kit. The expressions of mRNA and protein of adiponectin，resietin and Apelin were measured by qPCR and Western blot. Results：Oil red O staining showed that hepatocyte steato－sis occurred at 24 h after L02 cells being treated with oleic acid and hepatocyte steatosis increased greatly at 72 h. Triglyceride in hep－atocytes of model groups also increased compared with that of control group. In model groups，the expression levels of adiponctin mRNA and protein decreased at 24 h and declined remarkably at 72 h，compared with those of control groups. The expression levels of resistin mRNA increased at 24 h and elevated remarkably at 72 h in model groups，compared with those in control group. The expression levels of resistin protein increased at 48 h and elevated remarkably at 72 h in model groups，compared with those in control group. The ex－pression levels of Apelin mRNA and protein increased at 24 h and elevated remarkably at 72 h in model groups，compared with those in control group. Conclusion：The expressions of adiponectin are down-regulated while those of resistin and Apelin are up-regulated in hepatocyte steatosis model，indicating the regulation of adipocytokines. Adiponectin resistin and Apelin may be jointly involved in hepatocyte steatosis.

Abstract:Objective：To evaluate the effectiveness of Chinese herbal gastrointestinal intubation in the treatment of patients with ileus . Methods：Electronic databases such as PubMed，Web of Science，EMbase，EBSCO，the Cochrane Library，CNKI，WanFang，VIP and CBM were searched from their establishment to July 2014 to meet the inclusion criteria of randomized controlled trials（RCTs） and quasi-randomized trials（quasi-RCTs）. Meta analysis was conducted using RevMan 5.3 and Stata 12.0 software. Results：A total of 35 RCTs or quasi-RCTs involving 3 234 patients were included. The results of Meta analyses showed that the Chinese herbal gastrointesti－nal intubation group was superior to control group in raising the total clinical effective rate（Dachengqi decoction group：RR=1.21，95%CI=1.16 to 1.25，P=0.000；other decoction group：RR=1.23，95%CI=1.16 to 1.31，P=0.000） and the cure rate（Dachengqi decoc－tion group：RR=1.25，95%CI=1.14 to 1.36，P=0.000；other decoction group：RR=1.38，95%CI=1.24 to 1.52，P=0.000） as well as in shortening the hospitalization time（WMD=-4.27，95%CI=-5.95 to 2.60，P=0.000），restoring anus exhausting time（WMD=-6.67，95%CI=-11.74 to 1.60，P=0.001），restoring defecating time（WMD=-13.29，95%CI=-20.75 to -5.84，P=0.001） and disappear time of bowel sound（WMD=-1.28，95%CI=-1.69 to 1.03，P=0.000），with statistical differences. Conclusion：Chinese herbal gastrointestinal in－tubation treatment is superior to basic Western medicine for ileus. Due to limitations to quality of included studies，this conclusion has yet to be carried out in large multicenter study to validate.

Abstract:Objective：To analyze retrospectively the one-year survives of patients with inoperable pancreatic cancer treated by high intensity focused ultrasound by a multiple-center clinical trial. Methods：From January 2013 to January 2014，32 patients with in-operable pancreatic cancer from China and Bulgaria were involved into the trial. They are male/female=20/12，aged 59.8±9.1（41-81） years. The size of tumor is 39.3±9.6（20-60） mm. the number of patient with/without metastasis are 18/14.The treatment protocol is HIFU or HIFU plus Chemotherapy. The complications，pain levels and survives were recorded after HIFU. The overall survival rate（OS） and median survival time（MST） were calculated by Kaplan-Meier method，and the differences between patients with/without adjuvant chemotherapy or metastasis were compared with log-rank method. Results：Two patients with degree Ⅱ° skin burn were recorded in one month post-HIFU and were cured in 1-2 weeks with conservative treatment. Comparison was made on 30 patients with pancreatic cancer related pain pre-HIFU and post-HIFU. Post-HIFU，the pain levels got released in 24 cases（80.0%），no changed in 5 cases（16.7%），worse in 1 case（3.3%）. The OS of all cases in one year was 38.4% and MST was 12 months. The OS of patients accepted HIFU plus adjuvant chemotherapy/HIFU in one year was 57.4% and 20.8% and MST was 12 months and 6 months，respectively with significant dif－ferences. The OS of patients with/without metastasis was 0% and 49.2% and MST was 7 months and 12 months，respectively without significant differences. Conclusion：All patients from China and Bulgaria with inoperable pancreatic cancer completed the HIFU safely. The one year OS and MST are better than other non-operative methods. HIFU plus adjuvant chemotherapy benefits to the survival，while metastasis is a poor prognosis factor.

Abstract:Objective：To investigate hepatitis C virus（HCV） genotypes distribution，evolution and possible clinical significance in Chongqing area，and to provide basic evidence for better treatment and prevention of HCV. Methods：HCV genotype distribution of hepatitis C patients who had information of HCV genotypes from January 2010 to December 2013 diagnosed in the Second Affiliated Hospital of Chongqing Medical University were retro－spectively analyzed and compared with the reported literatures in this area. The possible factors influencing evolution of HCV genotype were investigated. Results：Totally 941 cases were re－cruited in this study. Four genotypes and 9 genetic subtypes of HCV were founded among the 857 cases who had single genotype（the typing rate was 99.1%），and the genotypes were not clearly typed in the other 84 cases. Among those genotypes and genetic subtypes，there were 30 cases（3.5%）genotype 1a，238 cases（27.8%） 1b，42 cases（4.9%） 2a，1 cases（0.1%）2b，132 cases（15.4%）3a，244 cases（28.5%）3b，6 cases（0.7%）3k，124 cases（14.5%） 6a and 40 cases（4.7%） 6b. Compared with the results of 5 years ago，1b and 2a genetic subtype were decreased obviously，and the proportion of genotype 3 and 6 increased. Conclusion：HCV genotype 3b and 1b are the predominant genotypes among HCV infection patients in Chongqing；however genotypes 3a and 6a also have relative high proportion，indicating the diversity and complexity of HCV genotype in Chongqing.

Abstract:Objective：To establish two types of animal model of pancreatoduodenal transplantation in pigs with enteric drainage（ED） and stomachic drainage（SD），to explore a more physiological operation method with fewer complications. Methods：Twenty-four close group white pigs were divided into ED group and SD group randomly；the pigs in each group were randomly subdivided into donor and receptor groups for pancreatoduodenal transplantation with ED or SD. The levels of blood glucose，insulin，glucagon and amylase were measured at the following time：24 h before operation，before the start of anesthesia，30 min after the pancreas removed，after the reperfusion，30 min and 12 h after the pancreatoduodenal transplantation. Postoperative complications and graft function were observed. Results：The success rate of surgery was 100%. The operation time was slightly longer in SD group than in ED group，but without sta－tistically significances（P=0.551）. Complications occurred in 2 cases in ED group：one was graft thrombosis and the other one was pancreatic fistula. One case of anastomotic fistula occurred in SD group. No significant difference was found between the two groups in blood glucose，insulin and serum amylase in each period. The levels of glucagon between the two groups were statistically different（P=0.024 4），but the result may be false positive. The differences between groups were statistically significant. Conclusion：Pancreato－duodenal transplantation in pigs with ED and SD is feasible. SD can facilitate postoperative pathological biopsy to determine the im－mune rejection. Numbers of clinical studies are needed to deter－mine the complications，immune rejection，survival rate，graft survival of the two operative methods.

Abstract:Objective：To investigate clinical efficacy and prognostic factors of transjugular intrahepatic portosystemic shunt（TIPS） in the treatment of patients with refractory ascites. Methods：Totally 23 patients with consecutive postoperative refractory ascites were followed up for an average of 9.7 months（range from 1-26 month），and the remission of ascites，serum parameters（platelet，albumin，total bilirubin，creatinine，prothrombin time，etal），survival rate were observed. Paired t test and nonparametric test were used to ana－lyze the changes in clinical serological indexes before and after TIPS. The survival rate was calculated by Kaplan-Merier method. The preoperative risk factors were used to predict the therapy effect of ascites in three months by logistic regression analysis. Multiple factors COX regression was used to analyze the influence of preoperative risk factors on postoperative survival. ROC and AUC determined the best prediction value. Results：The ascites of patients during the first year after operation improved than those of pre-operation. The ascites of 19 patient（82.6%） were effectively controlled one month after operation. Thirteen patients（52.4%） and 23 patients（100%） had a small amount of ascites after 3 month and 6 month respectively. The hepatic functions were damaged in a short time about one week after TIPS，but gradually recoverd within the next month（prothrombin time prolonged，Z=-2.419，P=0.016，median（minimum，maximum）=19.6（14.0，28.7）；Child-Pugh scores increased，t=-2.714，P=0.013，x±s=9.87±1.71；total bilirubin rised，Z=-3.711，P=0.000，median（minimun，maximun）=37.0（13.2，204.3））. The 3 months，6 months and 1 year cumulative survival rate were 95.5%，85.9% and 78.1% respectively. COX regression analysis showed that serum bilirubin（P=0.007，HR=1.049，95%CI=1.012-1.086） and sodium levels（P=0.027，HR=0.677，95%CI=0.479-0.956） were independent risk factors associated with survival rate by using multi－variate analysis. According to ROC and AUC analysis，we selected the cut-off values of 37 μmol/L for serum bilirubin level（AUC=0.676，sensitivity=66.7%，specificity=94.1%，95%CI=0.335-1.000）. In addition，Kaplan-Meier survival analysis demonstrated that the one year cumulative survival in patients with serum bilirubin level <37 μmol/L was 92.3% as compared to 25% in patients with serum bilirubin level ≥37 μmol/L. Conclusion：TIPS is an effective programme of treatment for refractory ascites. The hepatic functions will be damaged in a short term after TIPS. The serum bilirubin level above 37 μmol/L is a prognostic factor of one year cumulative sur－vival in patients with cirrhosis and refractory ascites treated with TIPS，and which should be clinical basis for a judgment of prognosis.

Abstract:Objective：To analyze the CT manifestation of hepatic lesions with obvious enhancement in arterial phase and to summarize its characteristics. Methods：CT manifestations of 80 cases of hepatic lesions with obvious enhancement in arterial phase were retro－spectively analyzed；all cases were confirmed by operation and pathology. Results：The majority of lesions enhanced in the arterial phase displayed following characteristics：the central scar in focal nodular hyperplasia（FNH），hepatocellular carcinoma and hepatic hemangioma，calcification in fibrolamellar hepatocellular carcinoma，dynamic enhancement pattern of “fast in fast out” in heteroge－neous enhancement of liver cancer，enhancement pattern of “fast in slow out” in hemangioma，“bull eye sign” in liver metastases. Ac－curate diagnosis for most cases can be made based on these characteristics along with other CT manifestations. Conclusion：Character－istics of hepatic lesions with obvious enhancement in arterial phase along with other CT manifestations are of great value in diagnosis and differential diagnosis of the lesions.

Abstract:Objective：To investigate the clinical efficacy and prognosis of placing stapler anvil bottom through oral cavity under the thoracic laparoscopy in the treatment of esophageal cancer. Methods：Totally 100 patients with esophageal cancer in our department from January 2008 to January 2013 for surgical treatment were randomly divided into experimental and control group. The experimental group received oral anvil head system（OrVil） chest laparoscopic esophagectomy intrathoracic esophagogastric anastomosis. The con－trol group received traditional thoracotomy. The intra-operation and post-operation condition，lymph node dissection，postoperative complication rate and one-year follow-up were compared. Results：The operative time，blood loss，drainage on the first postoperative day，drainage tube indwelling time and postoperative hospital stay were significantly lower in experiment group than in control group（P<0.01）. There was no difference in the total number dissected lymph node，number of dissected lymph node group，and number of dissected thoracic and abdominal lymph node，P >0.05）. The short-term complication rate of experimental group was significantly lower than that of control group（P<0.05. There was no difference in postoperative recurrence or metastasis rate，death rate，anastomotic stenosis and regurgitation incidences between the two groups（P >0.05）. Conclusion：With fewer risk，lower complication rate and sim－ilar efficacy as traditional thoracotomy，placing stapler anvil bottom through oral cavity under the thoracic laparoscopy is worthy of clinical application

Abstract:Objective：To summarize our experiences of diagnosing and treating typeⅠcongenital esophageal atresia. Methods：A retro－spective review was performed on 7 patients with typeⅠcongenital esophageal atresia. There were 5 males and 2 females with a gesta－tional age of 34.85－39.30 weeks and a birth weight of 2 100 to 3 000 grams. There were 1 premature infant and 4 low-birth weight infants. Four patients were congenital heart disease and one was congenital intestine malformation. Gastrostomy was performed af－ter typeⅠcongenital esophageal atresia being confirmed；then esophageal replacement with colon was conducted after 2 weeks. Fol－low-ups were implemented for postoperative complications，feedings growth and development. Results：One week after gastrostomy，one patient gave up the surgery due to kernicterus，the other 6 patients were treated by esophageal replacement with colon. After the surgery，one patient had serious pulmonary infection and couldn’t be withdrawn from mechanical ventilation；the other five were dis－charged from hospital without anastomosis orifice fistula. Patients were followed up for 1 to 5 years without suffering from anastomosis orifice stenosis and gastroesophageal reflux. Conclusion：Eesophageal replacement with colon is an effective treatment for typeⅠcon－genital esophageal atresia as lower complications.

Abstract:Objective：To analyze the clinical manifestations，diagnosis，treatment and prognosis of primary small bowel adenocarcinoma （PSBA）. Methods：The clinical data and survival analysis of PSBA in 31 cases were retrospective analyzed. Results：Among the 31 cases，17 cases were male，14 cases were female；the median age was 67 years；mainly originated from duodenum and manifested as anemia. Preoperative diagnosis rate was 38.7%；the proportions of stagesⅠ，Ⅱ，Ⅲand Ⅳ were 9.7%，22.6%，35.5% and 32.2%，respectively. Curative resection was performed on 20 patients；palliative surgery was performed on 5 patients；11 patients re－ceived chemotherapy. The median survival time was 22 months and the 5-year survival rate was only 19%. The median survival time of patients over 65 years，with stageⅢ-Ⅳ or with local invaded lymph-node ≥4 was respectively lower than that of patients below 65 years，with stageⅠ-Ⅱor with local invaded lymph-node ≤3 with statistically significant differences（P <0.05）. However，in terms of gender，pathological grade，primary site，tumor maker and chemotherapy after curative resection，no statistical difference was observed （P=0.396，0.141，0.082，0.877，0.599，respectively）. Conclusion：The clinical manifestations of PSBA are unremarkable；diagnosis is mainly obtained at advanced stages，which indicates the poor prognosis. Surgical resection is the mainly treatment. Age，clinical stage and number of local invaded lymph-node may become the clinical index of survival time.

Abstract:Objective：Mice over-expressing ApN specifically in adipose tissues（AT，ApN-Over） and the mice knocking-out ApN （ApN-KO） were used to identify microRNAs（miRNAs） targeted by ApN in AT. Methods：Male ApN-Over mice，ApN-KO mice and C57/Bl6J mice fed with high-fat diet（HFD） were used. miRNA expression profiling was performed by using microRNA arrays. The expressions of miRNAs and adipokines were quantified by real-time PCR. The gene targets of miR1934 were predicted by bioinfor－matic data base. Results：There were 12 miRNAs differently expressed between AT of ApN-Overex mice and wild-type mice. By PCR validation，the expression of miR532-5p was down-regulated，while that of miR883b-5p and miR1934 was up-regulated in AT of ApN-Over mice. Moreover，the expression of miR1934 in AT of ApN-KO mice was down-regulated，exhibiting a reverse expression pattern compared to ApN-Over mice. The expression of miR1934 was significantly lower in epididymal AT of HFD-induced obese mice than that in chow diet-fed mice（1.00±0.22 vs. 0.54±0.13，P=0.04）. The predicted gene targets of miR-1934，serine/threonine kinase 3（STK3） and chemokine（C-C motif） ligand（CCL19），were annotated to be involved in Jun N-terminal kinases（JNK） signal－ing pathway. Conclusion：We identified a novel miRNA，miR-1934，which was up-regulated by ApN in AT in vivo. The expression of miR1934 was decreased in visceral AT of obese mice. The possible roles of miR-1934 may be involved in the JNK signaling pathway. This novel miRNA may open new therapeutic perspectives for controlling the pro-inflammatory state of obese AT.

Abstract:Objective：To examine the influences of high fat diet-induced maternal overweight on the development of obesity in the offspring and the potential molecular mechanisms with focus on the changes of hypothalamic feeding circuitry. Methods：Female SD rats were allowed to either high fat（HF） diet or normal chow（NC） diet for 14 weeks，and then mated with healthy male rats. The off－spring born to HF or NC dams（designated as HF-O or NC-O） were assigned to normal chow diet. Birth weight and body weight of HF-O and NC-O were measured. Animals were sacrificed on postnatal day 40 and 160（P40 and P160）. The characteristics of orexi－genic NPY（Neuorpeptide Y） and anorexigenic POMC（Proopiomelanocortin） expression in the hypothalamaus were determined by im－munohistochemical staining. Results：Compared with NC-O，HF-O had higher birth weight（t=4.18，P=0.000），and higher body weight during childhood in male（t=3.46，P=0.009） and female（t=21.99，P=0.000）. But HF-O tended to have normal body weights in male（t=2.69，P=0.028） and female（t=2.49，P=0.037） during adult－hood although still higher than NC-O. HF-O also increased gonadal fat pad weight during childhood（t=3.03，P=0.007） and adulthood（t=2.40，P=0.027） compared with NC-O. Immunohis－tochemical staining showed the NPY levels were increased in the hypothalamic arcuate nucleus of HF-O compared with NC-O，but there was no significant change of POMC expression be－tween the groups，both during childhood and adulthood. Conclusion：High fat diet-induced maternal overweight predisposes obese development in the offspring，especially at the beginning of the birth and childhood stage，which may possibly be associated with the altered hypothalamic feeding neural pathways.

Abstract:Objective：To investigate the effect of T cell factor 3（TCF3） gene silencing on the Wnt pathway transcriptional activity and cell growth and migration in non-small cell cancer A549 cells. Methods：The TCF3 gene was silenced by RNAi technology and used as the experimental group，meanwhile the blank control group and negative control group were set up. The mRNA and protein expression levels were detected by real-time fluorogenic quantitative PCR and Western blot，separately. A TOPflash/FOPflash repoter gene was employed for analysis of the Wnt pathway transcriptional activity. The cell proliferation was detected by CCK-8 assay. The apoptosis and cell cycle were analyzed by flow cytometry. Transwell chamber assay was used to examine the migration potential of A549 cells. Results：Compared with those of blank and negative control groups，mRNA and protein levels of TCF3 were lower in the experimental group. The ratio of TOPflash/FOPflash was lower（P=0.00，P=0.00）. The protein expression of Wnt target C-myc was declined（P=0.00，P=0.00）. The cell proliferation was inhibited. The apoptosis was promoted and the percentage of A549 cells in G0/G1 phase was in－creased（P=0.01，P=0.00）and that in S phase was decreased（P=0.01，P=0.00）. The cell migration ability was reduced（P=0.01，P=0.01）. Conclusion：TCF3 seems to act as a transcriptional activator and promote the malignant biological in lung cancer cells.

Abstract:Objective：To investigate the effects of cancerous inhibitor of protein phosphatase 2A（CIP2A） expression on proliferation of laryngeal squamous cell carcinomas cells Hep-2 and its mechanism. Methods：siRNA-mediated CIP2A and negative control sequences were performed in Hep-2 cells. The experiment was designed into CIP2A siRNA group and control siRNA group. Colony formation assay was used to examine the role of CIP2A in cell proliferation. The impact of CIP2A on cell growth and cisplatin sensitivity was evaluated using MTT assay. Flow cytometry was used to examine cell cycle distribution and apoptotic rate. Quantitative real-time PCR and Western blot were applied to assess the expression of CIP2A，c-myc，AKT，p-AKT，and cyclinD1. Results：CIP2A knockdown in Hep-2 cells markedly decreased both CIP2A mRNA and protein expression，reduced the proliferation speed and colony formation（P=0.010） and increased the drug sensitivity of the cells to cisplatin（P=0.001）. In addition，CIP2A depletion blocked cell cycle at G1 phase（P=0.026） and decreased the percentage of S stage cells（P=0.007），and did not significantly alter cell apoptosis rate（P=0.216）. Western blot showed that CIP2A depletion downregulated CyclinD1，c-myc，p-AKT expression（P=0.011，P=0.011，P=0.010），but had no effects on the expression of total AKT protein（P=0.962）. Conclusion：CIP2A depletion inhibits cell proliferation and increases the sensitivity to cisplatin，mechanism of which may be related with decreased c-myc，p-AKT，and cyclinD1.

Abstract:Objective：To obtain the recombine exfoliative toxin A（rETA） by the technique of gene engineering and to provide materi－als to study the pathogenic mechanism of the exfoliative toxin（ET）. Methods：The primers were designed according to the gene se－quence of ETA gene announced by GeneBank. The ETA gene was amplified from the genome of S.aureus and was inserted into the prokaryotic expression vector pQE30. The recombinant plasmid pQE30-ETA was built and was translated into E.coli M15. After the expression conditions being optimized，the recombinant plasmid pQE30-ETA was expressed. The expression product was analyzed by SDS-PAGE and confirmed by Western blot. After being purified with Ni2+-NTA resin，the purified protein was injected into the sub－cutaeous of BALB/C mice and pathological modifications of BALB/C mice were observed to identify the biologic activity of the rETA. Results：The gene sequence analysis of the recombinant plasmid pQE30-ETA showed that the inserted gene fragment was 927 bp and was corresponded with the ETA gene sequence in GenBank database. The analysis of SDS-PAGE showed that the relative molecular mass of expression was 27 kD and the recombinant solubility protein reached the highest expression（20%） when IPTG being at a fi－nal concentration of 0.1 mmol/L and the induction time of 4 h. Western blot showed that the recombinant protein was at the same lo－cation with the ETA protein produced by S.aureus. The purity of the recombinant protein was over 90% after being purified with Ni2+-NTA resin. The splitting and blister were appeared in the epidermis of mouse injected with recombinant protein. Conclusion：The construction of the recombinant plasmid pQE30-ETA and the expression of rETA with biologic activity are successful.

Abstract:Objective：To explore the feasibility of low power focused ultrasound in the treatment of hyperplasia of mammary glands. Methods：Twenty-one patients diagnosed as hyperplasia of mammary glands accepted low power focused ultrasound treatment，and re－ceived examination of breast ultrasonography or mammography. All patients were followed up separately for 1，3，6，12 months after the treatment. Results：Pain score of twenty-one patients was collected at 1，3，6，12 months after treatment. There were statistical differ－ences in pain score before and after the treatment（F=133.45，P=0.00）. There was no statistical difference in thickness of hyperplasia gland between one month after the treatment and before the treatment（P=0.06） due to short time of follow-up. There were statistical differences in thickness of hyperplasia gland between 3，6，12 months after the treatment and before the treatment（F=10.9，P=0.00）. Da－ta system grading of breast image reports decline in 13 patients（13-21，62%）. Conclusion：It is effective to treat hyperplasia of mam－mary gland with low power focused ultrasound.

Abstract:Objective：To determine the median effective concentration of remifentanil on targeted-controlled infusion（TCI） for smooth emergency from total intravenous aneasthesia and tracheal intubation in elderly patients. Methods：Twenty-four ASA Ⅰ-Ⅱ grade fe－male elderly patients undergoing elective jaw cyst surgery were enrolled in this study. Median effective concentration（EC50） was de－termined by Dixon’s up-and-down method. During skin suture，effect-site TCI of remifentanil was titrated to initial concentration of 1 ng/ml for the first patient. If the extubation was defined as smooth extubation，the predetermined concentration for the subsequent patient was decreased by 0.5 ng/ml. If it was considered failed smooth extubation，the predetermined concentration was increased by 0.5 ng/ml for the next patient time. The EC50 of remifentanil was calculated by the Dixon’s up-and-down method and the EC50 and 95％ confidence interval（CI） were analyzed using the probit teat in a logistic regression model. Mean arterial pressure（MAP） and heart rate（HR） were compared in patients with smooth extubation and without smooth extubation. Results：The EC50 of remifentanil for smooth emergency from aneasthesia and tracheal intubation in elderly patients was 0.94 ng/ml by the Dixon’s up-and-down method，the EC50 and 95%CI of remifentanil was 0.99 ng/ml（95%CI 0.52 ng/ml-1.51 ng/ml）by probit analysis respectively． MAP and HR were lower in patients with smooth extubation than in those with failed smooth extubation during tracheal extubation（P<0.05）. Conclusion：Maintaining a remifentanil infusion at the optimal concentration of 0.94 ng/ml can suppress coughing associated with tra－cheal extubation and haemodynamic changes，almost without significantly delaying recovery from anaesthesia and thereby targeting smooth extubation for 50% of the elderly patients.

Abstract:Objective：To study that the effect of different sevoflurane treatments on level of oxidative stress for thoracic surgery pa－tients with one lung ventilation（OLV）. Methods：Totally 80 patients undergoing thoracic surgery with OLV were randomly divided in－to four groups：propofol group（P group），sevoflurane pretreatment group（S1 group），sevoflurane aftertreatment group（S2 group） and sevoflurane whole-treatment group（S3 group）. Anesthesia of four groups was inducted with propofol. In P group，anesthesia was maintained with infusion of propofol and remifentanil. Anesthesia was treated for 30 min before OLV in S1 group and after OLV in S2 group. The patients in S3 group were treated for whole-progressing with 1.0 MAC sevoflurane. Blood samples were taken from radial artery before induction of anesthesia（baseline T0），before OLV（T1），at 30 min after OLV（T2） and at 24 h after OLV（T3）. Meanwhile，bronchoalveolar lavage fluid was taken at T1 and T2. The content or activity of malondialdehyde（MDA），superoxide dismutase（SOD），lactate dehydrogenase（LDH） and nitric oxide（NO） in serum and bronchoalveolar lavage fluid were determined with chemical colori－metric method. Results：The levels or activity of MDA，SOD，LDH and NO in serum in each group were significantly increased at T2 and T3 than at T0 and T1（P<0.05）. But the levels of MDA，LDH and NO were significantly decreased and the activity of SOD were obviously increased in S1-3 groups than in P group（P<0.05），and there was no significant difference among S1，S2 and S3 groups（P >0.05）. After OLV 30 min（T2），the levels or activity of MDA，SOD，LDH and NO in serum in four groups were sig－nificantly increased at T2 and T3，compared with those at T0 and T1（P<0.05）. But the levels of MDA，LDH and NO were significantly decreased and the activity of SOD were obviously increased in S1-3 groups than in P group（P<0.05），and there was no significant dif－ference in S1，S2 and S3 groups（P>0.05）. Conclusion：Different sevoflurane treatments can decrease the content of MDA，LDH and NO，and increase the activity of SOD in serum and bronchoalveolar lavage fluid. The results suggest that sevoflurane possess potential for anti-oxidative stress injuries.

Abstract:Objective：To investigate the current situation and therapeutic strategies for obstetric patients in ICU with invasive me－chanical ventilation（IMV）. Methods：Totally 44 patients in obstetric ICU using only IMV were enrolled，24 patients were survived and 20 patients were died. Patients’ blood gas，respiratory rate，PO2，PO2/FiO2 before entering ICU and at 1 h，8 h，24 h and 48 h after IMV were observed and compared. Acute physiology and chronic health evaluationⅡ（APACHEⅡ） and therapeutic intervention scor－ing system（TISS） were used to assess disease severity and estimated the risk of death for these patients. Results：APACHEⅡ score，mortality risk factor，TISS score，PO2/FiO2，number of pregnancies were different（statistically significant，P<0.05） between survival group and death group.The differences of postpartum hemorrhage，anemia，DIC，shock，MODS，hypertensive disorder complicating pregnancy were statistically significant（P<0.05） between the two groups. SPO2 and respiratory rate were stabilized with 1 h IMV.PO2/FiO2 was improved significantly after 8 h IMV，but internal environment was not significant improved.Patients’pH，PCO2，BE，FiO2 were significantly different with 48 h IMV（P<0.005）. Conclusion：Obstetric patients in the ICU with invasive mechanical ventila－tion have higher mortality rate if they are withdrawn in a short period. APACHEⅡand TISS are valid evaluations for assessing disease severity. Internal environment is not significant improved after 8 h of IMV and hastily reducing ventilator parameters is not desirable. IMV for 8-24 h might be suitable for estimating prognosis；24 h is a preferable observation point than others. Risk of death is higher when IMV>24 ht；it is even worse at 48 h. Deterioration of in－ternal environment such as acid-base imbalance may be the main factors that accounted for patients’ morbidity and should be the focus of treatment.

Abstract:Objective：To investigate and understand the resistance of Streptococcus pneumoniae in children with acute respiratory in－fections in Chongqing. Methods：The respiratory tract specimens（sputum，bronchoalveolar lavage fluid） from January to March，September to November in 2014 in the Children’s Hospital of Chongqing Medical University were collected，and Streptococcus pneu－monia were isolated and cultured，finally the drug sensitivity test results were achieved. Results：A total of 241 strains of Streptococcus pneumonia were isolated，erythromycin had the highest resistance rate，reaching 97.1%，followed by tetracycline 91.7%，clindamycin 89.63%. No drug-resistant strains of vancomycin was detected. Linezolid，chloramphenicol，telithromycin，levofloxacin，moxifloxacin were more sensitive，being more than 90%；Penicillin，meropenem，cefepime were not sensitive，being respectively 47.3%，81.74%，67.22%. The main patterns of resistance were meropenem+erythromycin+clindamycin+cotrimoxazole+tetracycline（21.16%）. Compared with penicillin-susceptible Streptococcus pneumoniae and penicillin-nonsusceptible Streptococcus pneumoniae，the nonsusceptible rates of erythromycin，amoxicillin，cefepime，cefotaxime，meropenem，cotrimoxazole，clindamycin had statistically significant difference（P<0.05）. Conclusion：Erythromycin，tetracycline，clindamycin should not be used in children infected with Streptococcus pneumoniae because of their higher resistance rates in Chongqing；and penicillin and cephalosporins should be carefully used in empirical treat－ment due to their high non-sensitive rates. The clinical medication should pay more attention to the bacterial culture，and rational use of antibiotics should be based on susceptibility test results，so as to prevent the spread and prevalence of drug resistant strains.

Abstract:Objective：To investigate the condylar position differences in three dimensions between centric relation（CR） and maximum intercuspation（MI） in patients with unilateral posterior crossbite and to explore the possible correlation between transverse discrepen－cy and CR-MI displacement. Methods：Thirty-three unilateral posterior crossbite cases（experimental group） and thirty-three normal occlusion cases（control group） were evaluated. Mounting dental casts on articulator with CR bite record and Roth centric registration technique was employed. The three dimensional condylar displacements between CR and MI were measued by measure condyle displacement（MCD）. The arch width of the first molar were measured by digital caliper. Independent t-test，paired t-tests and pearson correlation were used to do statistical analysis；P<0.05 signifies statistical significance. Results：（1）The positive rate of CR-MI dis－crepency in the unilateral posterior crossbite group was higher than that in the normal occlusion group（χ2=38.018，P=0.000）. （2）In the experimental group，the distraction of the condyles was significantly greater on the crossbite side than on uncrossbite side in the vertical plane（t=2.719，P=0.010）. The condylar displacement observed in sagittal plane showed no significant difference between two sides（t=-0.134，P=0.894）. （3）Maxillary intermolar width was significantly smaller in the experimental group than in control group（t=-4.008，P=0.000）；the lower arch width showed no significant differences between groups（t=1.653，P=0.103）. There was no significant corre－lation between transverse arch discrepency and CR-MI displacement in three dimensional directions. （4）The positive rate of occlusion interferences in experimental group（90.91%） was significant higher than that in control group（66.67%， χ2=5.802，P=0.033）. The oc－clusion interferences were mostly found on the posterior teeth. Conclusion：Transverse arch discrepancy influence condyle position in patients with unilateral posterior crossbite. Among them，the vertical displacement is the most significant one. In order to get better treatment，it is important to measure the condylar dis－placement and unmask real jaw relationship before the compre－hensive orthodontic treatment starts.

Abstract:Objective：To investigate glutathione peroxidase，superoxide dismutase and malondialdehyde concentration in gingival crevicular fluid in patients with human peri-implantitis and to provide the basis for diagnosis and adjunctive treatment for peri-im－plantitis. Methods：Peri-implant sulcular/gingival crevicular fluid（GCF） samples were collected from sixty-two patients loaded more than one year. The experiment was divided into 4 groups：peri-implantitis group（PI，n=15），health implant group（HI，n=66），tooth in peri-implantitis group（TPI，n=15），tooth in health implant group（THI，n=66）. After the clinical measurements（probing depth，gingival index，gingival bleeding index，plaque index），GCF samples were collected. Then glutathione peroxidase，superoxide dismutase，malondialdehyde and IL-1β were analyzed by enzyme-linked immunosorbentassays. Results：PLI，PD，mBI，IL-1β and gingival crevic－ular fluid in PI group（2.20±0.78，4.63±0.92，2.60±1.12，21.07±2.29，1.34±0.17） were higher than those of HI group（1.03±0.89，1.76±0.73，1.14±0.97，18.79±2.07，0.83±0.23），（P=0.000，0.000，0.001，0.000，0.000） and TPI group（1.13±0.92，1.53±0.72，1.00±0.93，18.52±2.37，0.74±0.26）（P=0.011，0.000，0.001，0.000，0.000）.SOD and GP-x concentrations were lower in PI group（218.65±16.27，178.66±21.77） than in HI group（243.52±19.71，211.96±21.43）（P=0.000，0.000）and TPI group（230.63±26.91，213.04±25.75）（P=0.016，0.000）. No difference was observed in PLI，PD，mBI，IL-lβ，SOD，GP-x，and gingival crevicular fluid in THI group and HI group. No difference in MDA was observed among all groups. Conclusion：Oxidative stress may play a role in the inflammation and destruction of the implant periodontium in peri-implantitis.

Abstract:Objective：To investigate the clinical application of intracavitary electrocardiographic（EKG） guided peripheral inserted central catheter（PICC） tip location method. Methods：Totally 180 patients with lung cancer were randomly divided into control group （90 cases） and observation group （90 cases）. Then the observation group were subdivided into observation group 1 and 2 by punc－ture sequence. Routine post-procedure chest X-ray was used to confirm the peripheral inserted central catheter tip location for patients in control group while EKG method was applied for patients in observation group. Post-procedure chest X-ray combined with EKG method was employed in observation group 1 to double confirm the catheter tip location. Chest X-ray was used in observation group 2 only when patients’ P wave change was not observed. The catheter in place rate，operation time，PICC-related complication and pa－tients’ satisfaction were measured and compared between control group and observation group，observation group 1 and observation group 2. The catheter in best place rate was compared between control group and observation group 1. Results：The operation time is statistically shorter（z=6.364，P=0.000），but the catheter in place rate and patients’ satisfaction were statistically increased in observa－tion group than in control group（?字2=7.745，P=0.005；63.34%/96.67%，P=0.000）. The catheter in best place rate was lower in control group than in observation group 1（?字2=43.740，P=0.000）. There was no statistical difference in catheter-related complication between groups（P>0.05）. Conclusion：The EKG method is accuracy，safe and can effectively help the catheter in place as well as reduce the time from catheter insertion to infusion therapy. When P wave change can be clearly observed on EKG，routine post-procedure chest X-ray is unnecessary.

Abstract:Objective：To observe the adverse effects of Chinese-moxibustion treatment and the effect of optimized nursing process on minimizing the adverse effects. Methods：After reasons of adverse effects in Chinese-moxibustion being analyzed and nursing process optimized with flowchat，the execution power of nurses and the awareness in patients of adverse effects were observed. Then，the inci－dences of adverse effects in Chinese-moxibustion treatment were compared before and after optimized nursing process. Results：The execution power of nurses and the awareness rate of patients and their families on Chinese-moxibustion treatment were both increased significantly with optimized nursing process. Incidence of adverse effects in Chinese-moxibustion treatment with optimezed nursing process in 2012 was descended significantly than that without optimized nursing process in 2011. Conclusion：Optimized nursing pro－cess in Chinese-moxibustion treatment can reduce the adverse effects occurrences，and also improve the treatment effect in order to enhance the compliance and satisfaction of patients on Chinese-moxibustion treatment.