Abstract:Depressive disorder is a kind of common mental disease，which is affected by the environment and heredity，but its etiologi－cal and pathophysiological bases are poorly understood. As the core of epigenetics，DNA methylation，affected by both genetic and environmental factors，can give reasonable explanations to the questions that can not be answered by traditional genetics. Currently，researches have confirmed that the hypomethylation or hypermethylation of some genes may have close relation with the pathogenesis of depressive disorder，thus it can provide a new therapeutic target and direction for the diagnosis and treatment of depressive disor－der. In this paper，we reviewed the genes whose DNA methylation was related with depressive disorder indicated by previous re－searches，and recent studies on the DNA methylation in depressive disorder.

Abstract:Objective：To observe the effects of curcumin on the mitochondrial morphology and functions，and on the apoptosis in N2a/APP695swe cells，and to explore the underlying mechanisms. Methods：The experimental cells were divided into four groups：N2a/APP695 group（WT），N2a/APP695swe group（APP），dissolvent control group（DMSO，5 μmol/L） and Curcumin group（5 μmol/L）. Flow cytometry（FCM） method was used to investigate apoptosis，the level of cytosolic ROS and the change of mitochondrial membrane potential. Immunocytochemistry technique was performed to analyze changes of cytochrome C in experimental cells. The morphology of mitochondria was observed by electron microscope. Western blot was carried out to detect the expression of caspase3 and caspase9 protein. And the activities of caspase3 and caspase9 were assessed by spectrophotometry. Results：Apoptosis and cytosolic ROS were significantly lower in the curcumin group than in the APP group（0.05±0.01 vs. 0.18±0.01，P=0.000；49.67±4.16 vs. 197.67±8.08，P=0.000），and the mitochondrial membrane potential was higher in the curcumin group than in the APP group（1.00±0.03 vs. 0.64±0.03，P=0.000）. The electron microscopy found that curcumin could reduce the swelling of the mitochondria and improve its shape. Furthermore，curcumin could reduce the release of cytochrome C and the expression of caspase3 and caspase9 protein in the curcumin group than in the APP group（0.62±0.12 vs. 1.39±0.10，P=0.000；0.64±0.20 vs. 1.78±0.03，P=0.000）. Similarly，the activity of caspase3 and caspase9 was significantly lower in the curcumin group than in the APP group（0.66±0.04 vs. 2.12±0.06，P=0.000；0.58±0.04 vs. 0.93±0.03，P=0.000）. Conclusions：Curcumin could reduce the apoptosis of the N2a/APP695swe cell，and its mechanism may be associated with improved mitochondrial function.

Abstract:Objective：To investigate the activation law of autophagy related protein-12（Atg12） and autophagy microtubule-associated protein light chain 3 antibodyⅡ（LC3-Ⅱ） in the cerebral cortex during focal cerebral ischemia-reperfusion injury（CIR），and to fur－ther explore its influence on brain autophagy on this basis. Methods：The rats were divided into sham operation group（sham group） and ischemia reperfusion group（CIR group），and the CIR group was subdivided into six subgroups：CIR 0，6，12，24，48h and 72 h. Ex－cept that sham group and CIR 24h group had 20 rats in each group（10 were used for model identification），there were 10 rats in other groups，respectively. Focal CIR model was established by middle cerebral artery occlusion. CIR model was identified by neurological score，2，3，5-Triphenyltetrazolium chloride（TTC） staining，and brain water content 24 h later. The expression pattern of Atg12 and LC3-Ⅱ in cerebral cortex was detected by immunohistochemistry methods and Western blot techniques. Results：Compared with sham group，there were obvious neuro－logical deficit symptoms，cerebral infarction and cerebral edema in CIR 24h group. The results of immunohistochemistry showed that the positive rates of Atg12 and LC3-Ⅱ appeared in rat CIR 6 h[（15.49±4.18）%，（18.54±3.62）%]，and peaked at 24 to 48 h[（33.63±3.26）%，（29.62±1.73）%]，then the expression gradually decreased 72 h later[（24.90±3.96）%，（20.36±3.51）%]. The results of Western blot showed that the expression of Atg12 and LC3-Ⅱ appeared in rat CIR 6 h[（0.372 3±0.076 5），（0.148 4±0.011 5）]，and peaked at 24 to 48 h [（0.741 7±0.071 8），（0.451 3±0.019 0）]，then the expression gradually decreased 72 h later[（0.365 0±0.042 0），（0.245 1±0.030 3）]. Conclusion：The expression of Atg12 and LC3-Ⅱ plays an important role in the regulation of brain autophagy during the CIR.

Abstract:Objective：To investigate the feasibility of applying 1H-NMR-based pattern recognition in the studies of plasma metabo－nomics of Sprague-Dawley（SD） rats with diffuse axonal injury（DAI） and identify potential metabolic markers of DAI at early stage. Methods：Modified Marmarou A method was used to establish the model of DAI in SD rats. All animals were sacrificed at 1 d post in－sult. Plasma was prepared with heart blood. 1H-NMR technique was applied for detection of plasma samples from sham-injured group（n=6） and injured group（n=6）. Pattern recognition of partial least squares discriminant analysis（PLS-DA） and orthogonal signal correction-partial least squares discriminant analysis（OPLS-DA） were used to analyze and determine the differences of plasma metabolites between the two groups. Results：Different metabolites between sham-injured group and injured group were found by cor－relation analysis and student’s t test，metabolites were selected on condition that correlation coefficient丨r丨＞0.6 and P＜0.05. Finally，Pyruvate（r=-0.831，P=0.019），Lysine（r=-0.773，P=0.030），Glutamate（r=-0.772，P=0.042），Glutamine（r=-0.772，P=0.042），Isobutyrate（r=-0.631，P=0.045） and Glycerol（r=-0.844，P=0.032） significantly increased in injured group compared with those of sham-injured group. Malonate（r=0.699，P=0.038），L2（r=0.786，P=0.047），L3（r=0.666，P=0.031），L4（r=0.715，P=0.022），L10（r=0.663，P=0.025），β-Glucose（r=0.800，P=0.030） and α-Glucose（r=0.808，P=0.015） significantly decreased in in－jured group compared with those of sham-injured group. Conclusion：1H-NMR technique is effective in the study of plasma metabo－nomics of SD rats with DAI. The different metabolites may suggest the possible pathophysiological mechanism of DAI and lay the foundation for the research of early diagnosis，treatment and forensic identification of DAI.

Abstract:Objective：To explore the method of establishing the bi-directional fluid-solid coupled numerical model based on different thicknesses of aneurysms and arterial wall. Methods：The data series of aneurysm in a patient were got by computed tomography an－giography（CTA） image data. The data series were processed to obtain a surface model of the aneurysm’s vessel segment using MIM－ICS 16.0. The surface model was imported into Geomagic Studio 12.0 and UGS NX 8.5，which were processed to get the bi-directional fluid-solid coupled numerical model of aneurysm. ANSYS Workbench 15.0 software was used to calculate and to evaluate the charac－teristics of intratumoral blood and the stress and strain that Aneurysm wall suffered. Results：The bi-directional fluid-solid coupled model of aneurysm was established successfully and accurately，and it also clearly simulated the blood flow of the intracranial aneurysm，the deformation of the solid wall and velocity of flow lines in a cardiac cycle. Conclusion：Using the above method，the bi-directional fluid-solid coupled model of the aneurysm is established quickly and accurately，which is more accurate and useful than the rigid model and the same thickness aneurysm model. It can also provide excellent model parameters for simulating study of inter－ventional therapy of aneurysm.

Abstract:Objective：To explore the characteristics of event-related potential of MDD（major depressive disorder） patients with suici－dal ideation. Methods：We collected MDD patients with suicidal ideation by certain inclusive and exclusive criterias in Mental Health Center，the First Affiliated Hospital of Chongqing Medical University，and recorded the event-related potent（ERP） of 20 non-treatment MDD patients with suicidal ideation when executing emotional stroop mission. Results：The total average reaction time of MDD patients with suicidal ideation was （695.04±2.16） ms；the reaction time was statistical significant between the different word-facial tasks（P<0.05）；there is no statistical significance in the latentperiodofERP related components：P1，N1，P2，P3 of MDD patients with suicidal ideation under four words-facial interference.There were statistical significancesin the amplitude of ERP related components：N1，P2，P3，which under four words-facial interference. Conclusion：Attentional bias and cognitive function differences existed in different emotional-facial stimulus for MDD patients with suici－dal ideation.

Abstract:Objective：To investigate the occurrence of the postpartum depression（PPD） and its influencing factors in Chongqing. Methods：Totally 371 pregnant women（pregnency≥28 weeks） from 3 hospitals completed the designed questionnaire and the respon－dents were followed 42 days after delivery and completed The Edinburgh postnatal depression scale（EPDS）. The data were collected from September 2014 to June 2016. Then the evaluation and diagnosis were conducted. Results：Sixty women was diagnosed with the PPD，the incidence of the PPD was 16.17%. Multivariate stepwise logistic regression analysis showed that Eysenck Personality Question－naire score（OR=1.038，95%CI=1.013 to 1.065），HAMA score（OR=1.119，95%CI=1.052 to 1.190），unilateral family company（OR=17.998，95%CI=6.715 to 48.241），abnormal in childbirth（OR=66.279，95%CI=23.307 to 188.476），the degree of social utilization are influence factors of PPD. Conclusion：Unilateral family company，abnormal in childbirth，EPQ score，HAMA score are independent risk factors for PPD，and the high degree of social utilization is the protect factor for PPD.

Abstract:Objective：To investigate the characteristics and influencing factors of limb myodynamia in children with severe head in－jury. Methods：A retrospective analysis of 75 children with severe craniocerebral injury in the neurosurgery department of Children’s Hospital of Chongqing Medical University from 2012 to 2014 was conducted. The duration of consciousness obstacle，the time of reha－bilitation intervention and the abnormal rate of limb myodynamia were analyzed. Bonferroni-McNemar-Bowker test was used to ana－lyze the abnormal rate of myodynamia at the time points of recovery of consciousness，neurosurgery at the end of treatment，and dis－charge after 3 months. The effects of the duration of consciousness obstacle and the time of rehabilitation intervention on myodynamia and hospitalization duration of patients with rank were analyzed by rank-sum test and logistic regression. Results：The muscle abnormal rates at three time points mentioned above were 46.7%，27.9% and 16.0% respectively. Movement function damage exerted effect on myodynamia only when recovering consciousness（P=0.09）. Consciousness obstacle > 4 days were more likely to induce myodynamia abnormal at the time points of recovery of consciousness（P=0.005），neurosurgery at the end of treatment（P=0.001），and 3 months af－ter discharge（P=0.021）. Rehabilitation treatment at the end of the treatment was likely to induce myodynamia and delayed rehabili－tation would exert more serious effect on myodynamia（P=0.034）. The OR value was 0.674 and 95% confidence interval was 0.219 to 0.219 among children with short time of consciousness obstacle. The OR value was 0.437 and 95% confidence interval was 0.117 to 0.538 among children with early rehabilitation intervention. The regression model was of significant difference（P<0.05）. Con－clusion：The reasonable nursing for children with serious brain injury at early time is very important，which is consisted of con－sciousness-promoted rehabilitation and psychological interven－tion. We should promote wake at early satgeand rehabilitation.

Abstract:Objective：To explore the clinical value of electroencephalograms（EEG） and neuroimaging（CT or MRI） in children with febrile seizures（FS）. Methods：①According to clinical features，the children with FS were classified as simple febrile seizures（SFS） and complex febrile seizures（CFS）. According to the follow-up results，the children with FS were classified as children with epilepsy group and children without epilepsy group. ②The initial EEGs were recoreded within two weeks after onset in 426 children with FS. And EEGs were followed up regularly. A total of 92 children with FS underwent CT and 310 underwent MRI. Chi-square test and Lo－gistic regression analysis were used to analyze the relationship between EEG，CT/MRI and types of FS，clinical features，and sec－ondary epilepsy. Results：①The abnormal cases of initial EEGs and follow-up EEGs were 71 and 138 respectively，with significant differences（P=0.000）. The abnormal cases of EEG in SFS group and CFS group ranged from 22 to 26，from 49 to 112 respectively. Compared with follow-up results before and after，there was no significant difference in SFS group（P=0.102），and the difference was significant in CFS group（P=0.008）. ②In the follow-up results，the abnormal rate of EEGs were significant different in SFS group （26/426） and CFS group（112/426），children with epilepsy group（97/127） and in children without epilepsy group（41/299）（P=0.001，P=0.001）. ③The abnormal rate of CT/MRI were not significant different in SFS group（CT，8/92；MRI，9/310），CFS group（CT，5/92；MRI，28/310），children with epilepsy group（CT，3/16；MRI，16/110） and in children without epilepsy group（CT，10/76；MRI，21/200）（P=0.574，P=0.755，P=0.559，P=0.293）. ④The abnormali－ties of CT/MRI were not correlated with the abnormalities of EEG（P=0.836，P=0.557）. Conclusion：①EEG，especially the regular follow-up of EEG，has a greater clinical value for chil－dren with CFS，and is of limited value for children with SFS. ②CT/MRI has limited clinical value in neurologically normal chil－dren with FS，and the routine examination is not justified.

Abstract:Objective：To explore the effect of early hyperglycemia on the mortality in children with moderate to severe traumatic brain injury（TBI）. Methods：This retrospective cohort study was conducted in Department of Critical Care Medicine，Children’s Hospital of Chongqing Medical University between May 2012 and October 2014，including patients with moderate to severe TBI[admission Glas－gow Coma Scale（GCS）≤13]. The clinical data were collected. Multivariate logistic regression was used to identify risk factors related to mortality. Hyperglycemia was defined as glucose>200 mg/dL （11.1 mmol/L）. Unequal pupils and fixed pupils were defined as ab－normal pupil reflex. Results：Totally 109 patients with median age of 54 months [interquartile range（IQR） 17 to 82] were enrolled. There were 92 survivals and 17 deaths in hospital. The admission blood glucose of 21 patients was higher than 11.1 mmol/L. The glu－cose level，combined injury and abnormal pupil reflex ratio of death group were significantly higher than those of survival group [（14.31±6.46） vs. （7.08±3.38），76.5% vs. 47.5%，88.2% vs. 7.6%，P=0.000，P=0.010，P=0.000]. Admission GCS is lower in death group than in survival group （4 vs. 9，P=0.000）. Multivariate logistic regression analysis showed that admission hyperglycemia（OR=6.36，95%CI=1.20 to 33.68；P=0.029），abnormal pupil reflex（OR=17.09，95%CI=3.26 to 89.70；P=0.001） and admission GCS（OR=0.62，95%CI=0.39 to 1.00；P=0.048） were independent risk factors for death in children with moderate or severe TBI. However，com－bined injury（OR=1.20，95%CI=0.15 to 9.40；P=0.859） was not an independent risk factor for death in this study. Conclusion：The admission hyperglycemia is an independent risk factor for the prediction of death for moderate to severe TBI in Children.

Abstract:Objective：To investigate the risk factors of cerebral ischemic injury after endovascular coiling for unruptured intracranial aneurysms（UIA）. Methods：A total of 274 patients suffered from UIA for coil embolization including cerebral ischemic injury were enrolled and divided into negative group（n=165） and cerebral ischemic injury positive group（n=109） according to the MRI or clinical manifestation. Their clinical data were selected and analyzed respectively. Single-factor analysis and logistic regression model were used to analyze the risk factors of cerebral ischemic injury after endovascular coiling for UIA. Results：The total rate of cerebral ischemic injury after endovascular coiling was 40%，34% of the patients with micro-embolism and 6% with neurological dysfunction diseases. Age（OR=2.547，95%CI=1.388 to 4.676，P=0.003），hypertension（OR=2.525，95%CI=1.307 to 4.881，P=0.006），hyperglycemia（OR=1.972，95%CI=1.050 to 3.701，P=0.035），previous stroke history（OR=9.325，95%CI=3.564 to 24.396，P＜0.001），cerebral artery atherosclerosis patches（OR=3.680，95%CI=1.523 to 8.891，P=0.004），intraoperative blood clots（OR=17.031，95%CI=4.042 to 71.756，P＜0.001） and procedure duration（OR=4.097，95%CI=2.126 to 7.894，P=0.007） associated significantly with cerebral ischemic injury and they were the risk factors of cerebral ischemic injury after endovascular coiling for UIA proved by logistic regression model. Conclusion：Age，hypertension，hyperglycemia，previous stroke history，cerebral artery atherosclerosis patches，intraoperative blood clots and procedure duration are the risk factors of cerebral ischemic injury after endovascular coiling for UIA.

Abstract:Objective：To understand the mortality，probability of premature death，potential years of life loss and its distribution of stroke in Chongqing and to provide the suggestion for stroke prevention and control. Methods：Death cases between January 1 and December 31，2016 were reported through death case registry system of national center for disease prevention and control. Death cas－es of stroke（ICD-10：I60-I64） were sorted by international classification of disease（ICD-10）. And it was analyzed to calculate the indicators such as mortality，age-specific standardization mortality rate，proportion，probability of premature death，potential years of life loss. The rate was compared by chi-square test between different genders and areas. Results：The crude mortality and age-specific standardized mortality rate of stroke was 117.35/105 and 63.19/105 respectively in Chongqing，2016. The proportion of stroke death cases was 16.04% of all death cases. The crude mortality and age-specific standardized mortality rate of stroke among male residents was 130.74/105 and 75.72/105 respectively，which was higher than those（103.50/105 and 50.51/105） among female residents signifi－cantly（ χ2=21.710，P=0.000； χ2=27.３４６，P＝0.00０）. The crude mortality and age-specific standardized mortality rate of stroke among rural residents was 137.95/105 and 73.44/105 respectively，which was higher than those（63.54/105 and 35.27/105） among urban resi－dents significantly（ χ2＝53.078，P=0.000； χ2=37.19０，P＝0.00０）. The mortality of stroke before 50 years old was below 50/105 and it in－creased rapidly after 50 years old and reached the peak at age group of 85 years old. The probability of premature death of stroke was 2.88% in Chongqing，2016. The male probability of premature death of stroke（3.74%） was higher than it（1.96%） of the female significantly（ χ2=216.999，P=0.000）. The proba－bility of premature death of stroke in rural area（3.33%） was higher than it（1.61%） in urban area significantly（ χ2=191.043，P=0.000）. Conclusion：The mortality of stroke and probability of pre－mature death of stroke is high in Chongqing. Rural residents and the male are vulnerable population and comprehensive preven－tion and control for stroke should be strengthened.

Abstract:Objective：To assess the effects of early enteral nutrition supplemented with probiotics on clinical outcomes in patients with severe head injury. Methods：PubMed，Cochrane Central Register of Controlled Trials，China National Knowledge Infrastructure，Wan－fang database，and Chinese Biomedical Literature were electronically searched for the purpose of identifying the randomized controlled trials investigated the potential of early enteral nutrition supplemented with probiotics on patients with severe head injury，as well as the bibliographies of eligible studies and topic-related reviews were manually checked. Two investigators checked citations，extracted data，appraised risk of bias of included studies，and then STATA 12.0 was used to perform meta-analysis. Results：Totally 18 trials enrolling 1 016 patients were included. Meta-analysis indicated that early enteral nutrition supplemented with probiotics was associated with decreased risk of infection（RR=0.53，96%CI=0.44 to 0.65，P=0.000），decreased risk of mortality（RR=0.56，96%CI=0.38 to 0.82，P=0.003），decreased risk of gastrointestinal complications（RR=0.19，96%CI=0.13 to 0.25，P=0.000），and shortened stays in intensive care unit（MD=-4.55，96%CI=-5.91 to -3.19，P=0.000）. Conclusion：Early enteral nutrition supplemented with probiotics effectively decreases the risk of infection，mortality，and gas－trointestinal complications，as well as shortens the stays in ICU，and thus it should be extensively adopted to manage these given patients.

Abstract:Objective：To systematically review the efficacy and safety of botulinum toxin A injection for the spastic equinus foot in children with cerebral palsy by analyzing the domestic and foreign relevant literature. Methods：All relevant controlled clinical re－searches（randomized controlled trials，RCTs） about the efficacy and safety of botulinum toxin A injection for the spastic equinus foot in children with cerebral palsy from Cochrane Collaboration，Cochrane Library，Medline，PubMed，Chinese periodical full-text database，Wanfang Standards Database and other Chinese and English database were searched，as well as the relevant literatures and confer－ence proceedings. Quality of enrolled literatures was assessed；Meta analysis calculations are made by ReyMan 5.3. Results：A total of seven studies with a total of 576 cases were enrolled including 360 cases of botulinum toxin A and 216 cases of placebo. There was no significant differences in the incidence of adverse events（RR=1.40，95%CI=0.99 to 1.97，P=0.06） between botulinum toxin A and placebo in the treatment of the spastic equinus foot in cerebral palsy. In the gait analysis（RR=2.29，95%CI=1.56 to 3.37，P＝0.000），There were significant differences in the degree of dynamic muscle spasm（MD=8.76，95%CI=5.86 to 11.66，P＝0.000），the degree of arrest muscle spasm（MD=4.88，95%CI=0.96 to 8.80，P=0.01），quality of life change difference（RR=1.49，95%CI=1.08 to 2.06，P=0.02） between two groups. Conclusion：Botulinum toxin A in－jection for the spastic equinus foot in children with cerebral palsy is safe and effective. Therefore，it is worth promoting and applying in clinic.

Abstract:Objective：To evaluate the effect of the collaborative care model on self-care agency and depression in patients with first stroke. Methods：A total of 101 first stroke patients were randomly chosen between January and June of 2016，and randomly assigned into experimental group（52 persons） and control group（49 persons）. The patients in experimental group received collaborative care and the ones in control group only received routine care. After 6 months，the both groups were assessed with the Exercise of Self-care Agency Scale（ESCA） and Self-rating Depression Scale（SDS） to explore the effect of collaborative care on patients’ self-care agency and depression. Results：There was no significant difference in the self-care agency（t=-0.375，P=0.708） and depression（t=-0.258，P=0.797） between the two group before intervention. The self-care agency（t=4.122，P=0.000） and the depression（t=-2.515，P=0.014） of the experimental group were significantly improved compared with those of control group after the intervention，and the self-care agency（t=-2.980，P=0.004），depression（t=10.491，P=0.000） of the experimental group were also significantly improved after intervention. Conclusion：Collaborative care model can significantly improve first stroke patients’ self-care agency and depression.

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Abstract:Objective：To detect the expression of BRAF V600E and PD-L1 in papillary thyroid carcinoma（PTC） and to explore its correlation with clinical features of PTC. Methods：Totally 128 cases of PTC in the First Affiliated Hospital of Chongqing Medical University from the year 2015 to 2017 were randomly collected as the research subjects，and 40 cases of normal thyroid tissue were served as controls. The expression of BRAF V600E and PD-L1 protein was detected using immunohistochemistry. Results：The positive rate of BRAF V600E protein was 67.9%（87/128） in PTC，which was significantly higher than that in normal thyroid tissue（ ?字2=11.693，P=0.000），and it was closely related to the age of patients [more than or equal to 45 years old（ ?字2=22.345，P=0.000）] and thy－roid capsule invasion（ ?字2=4.643，P=0.031）. The positive rate of PD-L1 protein was 57.8%（74/128） in PTC，which was also signifi－cantly higher than that in normal thyroid tissue（ ?字2=9.812，P=0.000），and it was significantly correlated with the age[more than or equal to 45 years old， ?字2=44.390，P=0.000）]，lymph node metastasis（ ?字2=28.584，P=0.000） and thyroid capsule invasion（ ?字2=12.895，P=0.000）. Multiple factors analysis showed that BRAF V600E protein expression was significantly correlated with age≥45（OR=3.003，95%CI=1.218 to 7.404，P=0.017） and thyroid capsule in－vasion（OR=12.341，95%CI=3.944 to 38.620，P=0.000）. PD-L1 protein expression was significantly correlated with age≥45（OR=6.667，95%CI=2.668 to 16.657，P=0.000），lymph node metastasis（OR=3.987，95%CI=1.592 to 9.987，P=0.003） and thyroid capsule invasion（OR=4.249，95%CI=1.447 to 12.478，P=0.008）. Further analysis showed that the PD-L1 expression rate in the PTC patients with positive BARF V600E expression was 75.8%（66/87），which was significantly higher than that in the PTC patients with negative BARF V600E expression 19.5%（8/41）（?资=0.520，P=0.000）. There was a consistency between BRAF protein and PD-L1 protein expression in thyroid papillary carcinoma. Conclusion：This study show immunosuppressive molecule PD-L1 is overexpressed in the PTC patients with positive BARF V600E expression，and the co-overexpression of BRAF V600E and PD-L1 protein in PTC patients is associated with the worse prognosis.

Abstract:Objective：To investigate the efficacy of paclitaxel combined with carboplatin chemotherapy and intensity-modulated radio－therapy（IMRT） in the treatment of elderly patients with advanced cervical cancer and its influence on the quality of life and immune function. Methods：A total of 98 elderly patients with advanced cervical cancer admitted to the department of oncology between January 2012 to January 2014 were selected and randomly divided into the observation group（49 cases） and the control group（49 cases）. The observation group received paclitaxel combined with carboplatin chemotherapy and IMRT，while the control group only received IMRT. Continuous chemotherapy for 3 weeks was taken as one course，and the patients in the two groups underwent continuous 3 to 4 coursed of treatment. The therapeutic efficacy，quality of life score and immune function changes before and after treatment were com－pared between the two groups，followed up for 1 year，2 years and 3 years，and the local recurrence and distant metastasis were recorded. Results：The total effective rate of the observation group（75.51%） was higher than that of the control group（46.94%） （χ2=8.425，P=0.000）. After the treatment，the scores of cognitive function，social function，emotional function，consciousness function and physical function were increased（observation group：t=35.110，23.405，18.263，20.795，17.879；control group：t=23.838，13.479，7.298，13.627，8.138，all P<0.05）；the scores were higher in the obser－vation group than in the control group（t=9.921，9.038，11.774，8.965，9.757，all P<0.05）. CD3+，CD4+ and CD4+/CD8+ were decreased in two groups after the treatment（observation group：t=7.542，7.747，10.243；the control group：t=16.560，12.871，14.326，all P<0.05）. After the treatment，CD3+，CD4+ and CD4+/CD8+ were higher in the observation groupthan in the control group（t=11.082，7.293，7.653，all P<0.05）. The 2 year survival rate and 3 year survival rate of the observation group were higher than those of the control group，and the local recurrence rate and distant metastasis rate of the observation group were lower than those of the control group（χ2=4.602，5.289，6.078，all P<0.05）. Conclusion：Paclitaxel and carboplatin chemotherapy combined with IMRT have signifi－cant short-term and long-term efficacy for elderly patients with advanced cervical cancer，and can improve the quality of life of pa－tients，with little side effect in the immune function，therefore it has important research value.

Abstract:Objective：To investigate the risk factors for gestational diabetes mellitus（GDM） in polycystic ovary syndrome（PCOS） at different gestation，and to further understand the clinical characteristics of PCOS complicated with GDM. Methods：Pregnant women diagnosed with PCOS in the Obstetrics and Gynecology Department of Maternal and Child Health Care Family Planning Service Center of Shapingba District of Chongqing and received standard treatment and prenatal care services during March 2013 to March 2015 were included. According to the result of oral glucose tolerance test at 24th week and 32nd week of gestation，aforementioned pregnant women were divided into GDM group（n=20 at 24 weeks of gestation，n=28 at 32 weeks of gestation） and Non-GDM group（n=77 at 24 weeks of gestation，n=69 at 32 weeks of gestation）. Their basic information and the differences in the level of androgen and insulin in each group were compared，and the risk factors for GDM were analysed. Results：At 24th week of gestation，there were significant differences in the weight gain and level of insulin between GDM group and Non-GDM group [the weight gain in GDM group is （5.54±1.32） kg，while in Non-GDM group is （4.08±0.91） kg，t=2.487，P=0.015；the concentration of insulin in GDM group is （30.35±8.70） pmol/L，while in Non-GDM group is （25.47±7.56） pmol/L，t=3.289，P=0.001]. At 32nd week of gestation，there were significant differences in the weight gain，family history of diabetes，the level of testosterone and insulin between GDM group and Non-GDM group [the weight gain in GDM group is （9.83±0.91） kg，while in Non-GDM group is （8.61±1.23） kg，t=2.283，P=0.025；patients with family history of diabetes in GDM group are 10 cases，while in Non-GDM group are 9 cases， ?字2=3.939，P=0.0４７；the concentration of testosterone in GDM group is （3.49±1.65） nmol/L，while in Non-GDM group is （2.46±1.17） nmol/L，t=2.542，P=0.013；the concentration of insulin in GDM group is （33.78±7.01） pmol/L，while in Non-GDM group is （27.12±6.39） pmol/L，t=4.108，P=0.000]. Logistics regression analysis showed that both the higher weight gain and level of insulin were independent risk factors for GDM in PCOS pregnant women（OR=2.467，95%CI=1.912 to 3.355，P=0.029；OR=1.565，95%CI=1.287 to 1.921，P=0.007） at 24th week of gestation；while the higher weight gain and level of testosterone and insulin were independent risk factors for GDM in PCOS pregnant women（OR=2.640，95%CI=2.392 to 3.588，P=0.033；OR=1.587，95%CI=1.103 to 3.307，P=0.045；OR=2.735，95%CI=1.182 to 4.803，P=0.001） at 32nd week of gestation. Conclusions：Higher weight gain and level of insulin are risk factors for GDM in PCOS pregnant women at second trimester and third trimester. Furthermore，higher level of testosterone is a risk factor for GDM in PCOS pregnant women at third trimester.

Abstract:Objective：To investigate the expression of intercellular cell adhesion molecule-1（ICAM-1） and the lymphatic vessel density（LVD） of D2-40 markers in cervical cancer tissues，and their relationship with clinicopathological factors. Methods：From Mar 2015 to Apr 2016，38 patients with cervical cancers undergoing surgical excision in our hospital were enrolled as experimental group，while 30 samples of the normal cervical tissue and 30 samples of the cervical intraepithelial neoplasia（CIN） tissue from patients undergoing uterus operation in the same period，with age matched，were selected as the control group. Results：There was no significant difference in the baseline information among the three groups. The expression of LVD and ICAM-1 in normal cervical and CIN tissues were sig－nificantly lower than that in cervical cancer tissues，and the difference was statistically significant（P<0.01）. The differences in the ex－pression of ICAM-1 and LVD in cervical cancers were correlated with the invasion depth，lymph node metastasis and FIGO staging. The LVD value in 26 cases of cervical cancers with ICAM-1 positive expression was （15.13±3.22），but in 12 cases of cervical cancers with negative expression，it was （9.85±2.48），and the difference was statistically significant（t=5.021，P=0.004）. Conclusion：LVD and the expression of ICAM-1 in cervical cancers were significantly higher than that in normal cervical tissues，and they were closely related with the lymph node metastasis of cervical cancers.

Abstract:Objective：To observe and compare the response accommodative convergence/accommodation（AC/A） ratio of myopic teenagers with orthokeratology and frame glasses. Methods：This was a prospective case-control study. One hundred and twentyjuve－nile myopia aged 10-16 years were divided into orthokeratology group and frame glasses group according to the test results and wish－es of patients，with 60 cases in each group.The AC/A ratios before and after correction of all the cases in the two groups will be fol－lowed up and compared after one，three，six and twelve months. AC/A ratios were also analyzed in stratification with different diopters in each correction. Data were analyzed using ANOVA for repeated measuring，SNK-q test，two independent t-test. Results：A total of 113 cases completed the study. The AC/A ratios before and after correction in orthokeratology group and frame glasses group were respectively（4.52±0.58），（3.40±0.46），（3.48±0.42），（3.54±0.42），（3.63±0.44）D，（4.54±0.64），（4.46±0.65），（3.88±0.64），（4.11±0.61），（4.48±0.64）D. There was signifi－cant difference in AC/A rate between two refractive correc－tion methods（F=43.737，all P=0.000）. The degree of myopia had no significant effect on AC/A rate in orthokeratology group，but significant effect in frame glasses group. The effects of measurement time on AC/A ratio of each group were significant（F=94.037，F=168.559，F=26.661，P=0.000）. The interaction between the group and the measurement time also had significant effects（F=36.226，P=0.000）. But the interaction between degree of myopia and measurement time had no significant effects（F=0.814，P=0.502，F=0.288，P=0.814）. The AC/A ratio in orthokeratology group after correction were less than frame glasses group respectively（t=-9.898，t=-3.859，t=-5.748，t=-8.093，all P=0.000），but no significant difference was observed between two groups before correction（t=-0.140，P=0.889）. Conclusion：Frame glasses and orthokeratology can both reduce the AC/A ratio，but the effect of wearing orthokeratology is superior to wearing frame glasses.

Abstract:Objective：To explore the digital distance effect of children with school age amblyopia. Methods：A total of 98 children with school age amblyopia in our hospital from January 2015 to January 2017 were enrolled. Among them，31 patients were divided into the 7-year-old group（6 to 8 years old） and 29 patients were divided into the 9-year-old group（9 to 10 years old） and 38 patients were divided into the 12-year-old group（11 to 13 years old）. Another 98 healthy children without school age amblyopia were select－ed as the control group and divided into the 7-year-old group（n=29），the 9-year-old group（n=32） and the 12-year-old group（n=37）. Reaction time and reaction time difference of different numbers in different groups were compared. Results：When number ≥5，the reaction time in the observed 7-year-old group was significantly longer than that in the control 7-year-old group（P<0.05）. The difference of reaction time for 1，2，3 and 4 was without statistical significance（P>0.05）. The reaction time for 1，2，8 and 9 of the 9-year-old group was significantly longer than that in the control group，with statistically significant difference（P<0.05）. The reaction time for 3，4，5，6 and 7 in two groups was not statistically significant（P>0.05）. The reaction time for 1 to 9 in the observed 12-year-old group was longer than that in the control 12-year-old group（P<0.05）. Compared with the same age，the reaction time in the ob－servation group was significantly lower than in the control group（P<0.05）. Among the observed 98 patients，the reaction time for chil－dren with mild amblyopia was shorter than that of children with moderate and severe amblyopia，while the reaction time for children with moderate ambluopia was shorter than that of children with severe amblyopia，with a statistically significant difference（P<0.05）. Conclusion：The reaction time of children with school age amblyopia is longer than that of the normal children（especially≥5） and the digital processing ability of unhealthy children is was slower.

Abstract:Objective：To analyze the characteristics of the chemical composition of urinary calculi in Chongqing and to provide clinical evidence for prevention and treatment of urolithiasis. Methods：Totally 839 samples of urolithiasis were collected and analyzed with infrared spectroscopy and the relevant clinical data were analyzed. Results：There were 55.30% patients from the urban and 44.70% from the rural. The main components of calculi in districts with number≥40 are calcium oxalate monohydrate，dahllite and calcium oxalate dihydrate. All the calculi included 558 cases of mixed components and 281 cases of single component；the composition mode of the former was “calcium oxalate monohydrate+dahllite”，whiel the composition mode of the latter was “calcium oxalate monohydrate+dahllite+calcium oxalate dihydrate. In gender comparison，the proportion of six ammonium magnesium phosphate in female（14.81%） was significantly higher than that of male（4.61%）. In the envi－ronmental comparison，the percentages of calcium oxalate dihy－drate and dahllite in urban patients（45.67% and 61.67%） were significantly higher than those in rural patients（35.98% and 51.88%）. In the comparison between first onset and re－crudesce，dahllite in the first onset patients（56.46%） was sig－nificantly lower than that of the recurrent patients（65.35%）. In the comparison of infection，the six ammonium magnesium phosphate in the infected group（12.33%） was significantly higher than that in the non infected group（5.27%）. In the comparison of duration，dahllite in patients with long duration（63.61%） was signifi－cantly higher than that of short duration（56.18%）. Patients aged 41 to 60 years old accounted for the highest proportion of age（55.54%），followed by 31 to 40 years old（14.30%） and 61 to 70 years old（17.28%）. Conclusion：Urinary calculi in our hospital are mainly composed of mixed components，the main components of which are calcium oxalate（including calcium oxalate monohydrate and calcium oxalate dihydrate） and dahllite. Calculi with mixed components are more common than single component stones. Male patients are more than female patients，while six ammonium magnesium phosphate was more common in female patients. Urban pa－tients are more than rural patients，and calcium oxalate dihydrate as well as dahllite are more common in urban patients. Patients with the first onset was more frequent than recurrent patients，and dahllite is more common in recurrent patients. The infected patients is fewer than the non infected patients，and the six ammonium magnesium phosphate is more common in the patients with infection. Patients with short duration is more than who with long duration，and dahllite is more common in the patients with long duration. The age of patients is mainly concentrated in 30 to 70 years old.

Abstract:Objective：To review the diagnosis and treatment of traumatic bronchial rupture in children and to discuss its appropriate managing strategy. Methods：Medical records of eight children in Children’s Hospital of Chongqing Medical University from January 2014 and January 2017 were retrospectively analyzed. Eight patients with traumatic bronchial rupture（five boys and three girls） were included，with age from 2.5 to 9.7 years old（median age of 6.5 years old） and weight of 12 to 30 kg（median weight of 22 kg）. Bronchus rupture was diagnosed through imaging studies and bronchoscopy. Among the patients，two had right bronchus rupture，and the other six had left bronchus rupture. Results：Diagnosis of the eight patients was clear after the chest CT with 3-dimensional reconstruction techniques and fibreoptic bronchoscopy. All eight patients received surgery：seven children received end-to-end bronchial anastomosis and one received surgical repair consisted of a sleeve resection（right middle lobectomy with reanastomosis of the bronchus intermedius to the right inferior bronchus）. The results were good. There was no operative death and no postoperative bronchopleural fistula. Five of the eight patients were affected with mild to moderate bronchial stenosis，without apparent respiratory symptom or atelectasis on image analysis after a follow-up up to 36 months. Conclusion：Be alert to bronchial rupture after trauma in children is helpful to the diagnosis. Chest CT with 3-dimensional reconstruction techniques and fiberoptic bronchoscopy are the most valuable diagnostic methods. Results of emergency or delayed surgery in children’s traumatic bronchial rupture are excellent.

Abstract:Objective：To analyze the sonographic features of fetal abdominal cysts in prenatal ultrasonography and to identify the cor－responding points in order to reduce the misdiagnosis rate and to improve the accuracy of prenatal ultrasonography in the diagnosis of abdominal cysts. Methods：Retrospective analysis of 68 cases of abdominal cysts in our hospital from June 2014 to June 2016 was conducted. The prenatal ultrasonography results were compared with postnatal reexamination and autopsy results. Results：Compared with the results of prenatal ultrasonography diagnosis and postnatal or autopsy，3 cases were misdiagnosed，and the misdiagnosis rate was 4.4%. In 68 cases of fetal abdominal cyst diagnosed by prenatal ultrasound，postpartum or autopsy found 9 cases of ovarian cyst，10 cases of duodenal obstruction，3 cases of intestinal obstruction，1 case of intestinal obstruction，1 case of anal atresia，8 cases of in－testinal duplication，2 cases of mesenteric cyst，2 cases of biliary atresia，4 cases of renal cysts，3 cases of polycystic kidney. Multicys－tic dysplastic kidney in 11 cases，8 cases of hydronephrosis of grade Ⅲ or above，2 cases of ureteral dilatation，3 cases of giant blad－der，1 case of pancreatic cancer were observed. Conclusion：The disease can be accurately diagnosed by prenatal ultrasound com－bined with observing the position，shape，size，blood flow and adjacent organs of fetal abdominal cyst，and gestational age. This infor－mation can improve the prenatal detection rate of fetal malformation，and provide important clues for prenatal and perinatal manage－ment and early treatment for certain diseases.

Abstract:Objective：To explore the effect of health education pathway on the health knowledge，health belief and self-management in patients with coronary stent implantation. Methods：One hundred and twenty patients with coronary artery disease who were going to receive stent implantation in the department of cardiology of our hospital were selected by convenient sampling，and they were divided into the intervention group and the control group randomly. For patients in the intervention group，health education pathway was used to give health education to them，and for patients in the control group，they received routine health education. Then their health knowl－edge，health beliefs at admission and discharge，as well as the self-management behavior scores at three months after discharge in the two groups were compared. Results：At the day of discharge，the knowledge，belief scores in the intervention group were （55.77±7.71），（18.90±2.06），which were higher than （43.93±9.65），（16.40±2.85） in the control group，and the differences were statistically sig－nificant（P<0.001）. The mode and time of health education had interactive effect on the scores of health knowledge and health belief in patients. At three months after discharge，scores of self-management behaviors in the intervention group was （100.73±8.68），which was higher than （91.13±10.70） in the control group，and the differences were statistically significant（t=5.197，P=0.000）. Conclusion：Health education pathway can improve the knowledge，belief level and self-management behavior of patients with coronary stent implantation.

Abstract:Objective：To establish a systematic and scientific evaluation index of continuing nursing for CHD after percutaneous coro－nary intervention（PCI），and to test the reliability and validity. Methods：Based on literature analysis and qualitative research，the effectiveness evaluation index of patients with CHD after PCI and was developed to determine the content index by Delphi method. Nine experts were invited to perform CVI. The reliability and validity of the index were tested among 231 patients with CHD after PCI in hospital another. Results：The final evaluation index consisted of 4 first indicators，15 second indicators and 35 third indicators. The Cronbach’s alpha was 0.926 for the total index. The Cronbach’s alpha of 4 first indicators were 0.600，0.768，0.918，0.798. The split half reliability was 0.952. The index content validity index was 0.890. Factor analysis was used to extract 6 factors and the cumulative variance contribution rate was 69.26%. Conclusion：The evaluation index is scientific，reliable，practical and feasible. It can evaluated the quality of continuous nursing scientifically and effectively.

Abstract:Objective：To explore the application effect of JUC to prepare skin in gynecological laparotomy surgery. Methods：Patients of 198 in The First Affiliated Hospital of Chongqing Medical University from October 2015 to October 2016 were selected，who aged between 20 and 70 years old and were underwent gynecological laparotomy surgery to treatment gynecological benign disease and had surgical parts in the lower abdomen，and were randomly divided into the experimental group of 100 cases and the control group of 98 cases. JUC was used to prepared skin in the experimental group，while the iodophor lubricant was used in the control group. After preparing skin，bacteriological testing，skin preparing time，skin reaction and postoperative incision healing were immediately com－pared. Results：Results of bacteriological testing，skin preparing time and skin reaction of two groups had no significant difference（P>0.05），but its postoperative incision healing had significant difference（P<0.05）. Conclusion：Using JUC to prepare skin can reduce the rate of incision infection after gynecological laparotomy sur-gery and enhance the postoperative incision healing rate. In ad－dition，its operation method is simple and worthy of promotion.

Abstract:Objective：To explore the feasibility and efficacy of delicate management in the prevention of peripherally inserted central catheter （PICC） occlusion. Methods：A retrospective analysis was conducted in 971 cases admitted to our intensive care unit under－going PICC catheter from July 2014 to June 2017. Totally 530 patients who were admitted from July 2014 to December 2015 were defined as the control group，and 441 patients who were admitted during January 2016 to June 2017 were set as the observation group with application of delicacy management. The catheter occlusion rate，unplanned extraction events rates caused by occlusion and other catheter associated complications in two groups were compared. Results：With the application of delicacy management，the completely PICC catheter occlusion rate（ ?字2=4.522，P=0.038），incompletely PICC catheter occlusion rate（ ?字2=5.897，P=0.020），unplanned extrac－tion rate caused by occlusion（ ?字2=13.749，P=0.000） and catheter associated complications were significantly reduced（ ?字2=6.869，P=0.011）. Conclusion：Delicacy management can effectively prevent catheter occlusion and other catheter associated complications，thus prolongs the catheter indwelling time.

Abstract:Objective：To evaluate the predictive validity of modified Munro pressure ulcer risk assessment scale（Munro scale） for adult perioperative surgical patients. Methods：Firstly，the scale and made cultural adaptation by Brislin’s translation model was translated. Then the prospective cohort study design was adopted，totally 246 surgery patients in two hospitals were recruited by convenience sampling method and investigated by the scales. Results：Seventeen patients（6.9%） developed pressure ulcer. Area under receiver operating characteristic curve was 0.715（95%CI=0.586 to 0.844，P=0.003）. The cutoff score of modified Munro scale was 29.5 for the risk of pressure ulcer，with the sensitivity of 0.588，specificity of 0.799，PPV of 0.178 and NPV of 0.963. Conclusion：The predictive validity of modified Munro scale for perioperative surgical patients with adult is ordinary，and there is room for improvement，but now it could be used to assess pressure ulcer risk of surgical patients.

Abstract:Objective：To evaluate the reliability and validity of questionnaire of health education needs during the period of chemotherapy in patients with gynecological cancer. Methods：The draft questionnaire was developed on the basis of domestic and in－ternational literature review，semi-structured interviews and 3 rounds of experts’ consultation. Then，a questionnaire survey with this draft questionnaire was conducted among one hundred and seventy-three patients with gynecological cancer in the First Affiliated Hospital of Chongqing Medical University from November 2016 to January 2017. The reliability of the questionnaire was tested by in－ternal consistency reliability and test-retest reliability. Meanwhile，the validity of the questionnaire was evaluated by content validity and construct validity. Results：Nineteen items of the questionnaire in six domains were eventually formed，including cognitive health education needs，physical health education needs，safety health education needs，attribution health education needs，self-esteem health education needs and self-realization health education needs. Exploratory factor analysis extracted six common factor totally，the cu－mulative variance contribution rate is 60.77%. The total Cronbach’s α coefficient of the questionnaire was 0.817，and the Cronbach’s αcoefficient of each domain was between 0.649 and 0.764. Test-retest reliability was 0.829，and the content validity index was 0.85. Conclusion：The developed questionnaire has a good reliability and validity. It can be used to evaluate the level of health education needs for gynecological cancer patients during chemotherapy period，and provide reference for medical staff to implement health edu－cation for them.