Abstract:Objective：To study the effects of anti-depressant-fluoxetine exposure on the CNPase+ oligodendrocytes in CA1 of hippocam－pus in the depressed rats which were induced by chronic unpredictable stress（CUS）. Methods：Male Sprague-Dawley（SD） rats were used，and were randomly divided into control group（n=12） and CUS group（n=３８） after the sucrose preference of the rats was normal and regular. Four weeks CUS and separation was used to build CUS depression model of rats. The sucrose preference was used to screen the depressed rats at the end of 4th week and 12 CUS-induced depressed rats were enrolled as CUS group and 12 as FLX group. The FLX group was treated with fluoxetine at dose of 5 mg/（kg·d） from the fifth week to seventh week. Meanwhile，the control group and the CUS group were treated with saline at the same dose. The CUS group and FLX group were continued exposure to CUS. The total number of CNPase+ oligodendrocytes in the CA1 of hippocampus was investigated with the immunohisto－chemical method and the stereological method. Results：After 7 weeks CUS intervention，the body weight of CUS group（251.4±15.9） g was significantly decreased when compared with that of control group（323.3±25.9） g（P=0.000），but the body weight of CUS group was not significantly different from the body weight of FLX group（257.9±22.7） g（P=0.473）. The sucrose preference of the CUS group（62.0±14.2）% was significantly lower than that of the control group（89.2±4.8）%（P=0.000） and FLX group（78.2±12.8）%（P=0.020）. The stereological results showed that CNPase+ cells in the CA1 field of the hippocampus in CUS group（18 650.7±1 812.0） was significantly decreased compared with that in control group（33 606.9±4 471.4）（P=0.007） and that in FLX group（29 080.7±2 877.5）（P=0.042）. Conclusion：The number of CNPase+ oligodendrocytes in the CA1 of hippocampus of the CUS rats is significantly decreased. Fluoxetine might prevent the loss of CNPase+ oligodendrocytes in the CA1 of hippocampus of the depression rats induced by CUS. The oligodendrocytes in the CA1 of hippocampus play an important role in the pathogenesis of depression. The current result might provide structural basis for the future studies that search for the new antidepressant strategies.

Abstract:Objective：To establish and compare valproic acid（VPA） or lipopolysaccharide（LPS） induced rat model of autism，so as to provide a scientific basis for the selection of animal models in autism research. Methods：Rats were injected intraperitoneally with 500 mg/kg VPA or 100 μg/kg LPS on the gestational day 12.5 or day 9.5 to construct autism model in offspring rat（n=28）. The pup’s physical development was continuously monitored，and social interaction，communication ability，stereotype and repetitive patterns of behaviors were detected in the pups. ELISA kits were used to determine the concentrations of plasma inflammatory cytokines（IL-6，IL-1β，IFN-γ and TNF-α） in the pups with or without LPS treatment. Levels of PTEN，p-Akt and p-mTOR protein expressions in the prefrontal cortex of the pups in the present or absent of VPA treatment were confirmed by Western blot. Concentrations of 5-HT in the prefrontal cortex with or without VPA challenge were detected with high performance liquid chromatography（HPLC）. Results：Both of the two autism models displayed a developmental delay and autism related behavioral abnormality. Levels of IL-6，IL-1β，IFN-γ and TNF-α were increased significantly in the rat offspring following LPS treatment（t=2.108，P=0.049；t=2.312，P=0.033；t=2.809，P=0.016；t=2.110，P=0.049）. The VPA challenge significantly decreased the level of PTEN protein expression（t=13.320，P=0.006），and increased the expression levels of p-AKT and p-mTOR in the pups’ prefrontal cortex after the VPA treatment（t=4.633，P=0.044；t=7.984，P=0.015）. The concentration of 5-HT in the prefrontal cortex was also statistically reduced by VPA treatment（t=2.145，P=0.049）. Conclusion：The both rat models with LPS or VPA treatment lead to autism-like behavors，whereas there are different induce molecular mechanisms. Therefore，we should make reasonable choice on the basis of research objectives in scientific study.

Abstract:Objective：To establish a new APP/PS1/LC3 triple-transgenic mice model and to study its autophagy flux activities. Methods：APP/PS1 double-transgenic Alzheimer’s disease（AD） model mouse was breed with CAG-mRFP-eGFP-LC3 transgenic autophagy flux model mouse，then their filial generations were identified by genotyping. Triple-transgenic mice expressing both CAG-mRFP-eGFP-LC3 gene and APP/PS1 gene were selected. Six APP/PS1/LC3 triple-transgenic mice and six CAG-mRFP-eGFP-LC3 transgenic mice were involved in this study，all in their sixth month. The Morris water maze was employed to test learning and memory ability. The activities of autophagy flux were observed under fluorescence microscope and transmission electron microscopy（TEM）. Immunohistochemical staining was used to detect the formation of senile plaques；autophagy related proteins were measured by Western blot. Results：The genotyping confirmed that the APP/PS1/LC3 triple-transgenic mouse model was succ-essfully established. Morris water maze test showed that，compared with those of CAG-mRFP-eGFP-LC3 transgenic mice，the escape latency and path length of APP/PS1/LC3 triple-transgenic mice were significantly increased（F=87.096，P=0.000；F=41.583，P=0.000），and the passing times were decreased（2.000±0.707 vs. 4.800±0.800，t=2.622，P=0.031）. TEM revealed more autophagosomes in APP/PS1/LC3 triple-transgenic mice neurons than in CAG-mRFP-eGFP-LC3 transgenic mice. Compared with those of sixth month CAG-mRFP-eGFP-LC3 transgenic mice，both autophagosomes and autolysosomes were increased in the same age triple-transgenic mice（5.894±0.742 vs. 14.820±3.350，t=0.017，P=0.000；1.204±0.420 vs. 1.840±0.559，t=3.156，P=0.005） in hippocampus area. Autophagosomes were significantly elevated in the cortex region of APP/PS1/LC3 triple-transgenic mice（1.943±0.415 vs. 10.030±4.382，t=6.364，P=0.000），but showed no difference in autolysosome number（0.562±0.207 vs. 0.686±0.195，t=0.156，P=0.878）. The staining showed that sixth month triple-transgenic mice had appar－ently senile plaques deposition in brains，while the CAG-mRFP-eGFP-LC3 transgenic mice had none. Western blot showed that，compared with that of brood CAG-mRFP-eGFP-LC3 transgenic mice，APP protein in the brain of APP/PS1/LC3 triple-transgenic mice increased significantly（0.294±0.070 vs. 0.690±0.275，t=3.423，P=0.007）. The proteins related with autophagy including LC3，Beclin1，P62 also increased in brains of APP/PS1/LC3 triple-transgenic mice（0.241±0.004 vs. 0.534±0.019，t=37.170，P=0.000；0.479±0.020 vs. 1.180±0.255，t=6.820，P=0.000；0.188±0.007 vs. 0.356±0.021，t=18.850，P=0.000），but lysosome membrane pro－tein LMAP1 decreased in APP/PS1/LC3 triple-transgenic mice，compared with brood CAG-mRFP-eGFP-LC3 transgenic mice （1.450±0.065 vs. 0.773±0.043，t=8.705，P=0.000）. Conclusion：Autophagy is induced in APP/PS1/LC3 triple-transgenic mice，and the degradation of autolysosomes is blocked，which is an ideal mice model for researching autophagy flux function in AD.

Abstract:Objective：To investigate the correlation between sex hormone-binding globulin（SHBG） and diabetic peripheral neuropathy （DPN） in type 2 diabetes mellitus（T2DM）. Methods：A total of 238 patients with T2DM were enrolled in our hospital from January 2014 to January 2017. They were divided into T2DM group（n=96） and DPN group（n=142）. DPN patients were divided into three subgroups including mild（n=52），moderate（n=48） and severe（n=42） according to the Toronto score（TCSS）. The clinical data，bio－chemical indexes，neurophysiological indexes，serum SHBG and sex hormone levels were analyzed，and then the correlation between SHBG level and DPN correlation index was analyzed. Finally，logistic regression analysis was used to analyze the influencing factors of DPN. Results：Compared with those of T2DM group，the age of DPN group was significantly higher，BMI value was significantly decreased，with statistically significant differences（P<0.05）. The levels of systolic blood pressure（SBP），triglyc－eride（TG），total cholesterol（TC），low density lipoprotein-choles－terol（LDL-C） and blood uric acid（BUA） were significantly higher in the DPN group than in T2DM group（P<0.05），while diastolic blood pressure（DBP），fasting blood-glucose（FPG），glycosylated hemoglobin（HbA1c），high density lipoprotein-cholesterol（HDL-C），blood urea nitrogen（BUN），alanine aminotransferase（ALT），aspartate aminotransferase（AST），alkaline phosphatase（ALP） and glutamyl transpeptidase（γ-GT） were not（P>0.05）. The levels of serum SHBG，total testosterone（T） and total estradiol（E2） were sig－nificantly decreased in DPN group（P<0.05）. In addition，the MVC and SCV were significantly decreased in DPN group than in T2DM group（P<0.05，P<0.01）. The difference between the three subgroups of DPN was obvious in above indicators，with the increase of DPN severity（P<0.05）. Pearson correlation analysis showed that there were negative correlation between SHBG level and TG，TC，LDL-C and BUA in DPN patients（r=-0.562，-0.412，-0.476，-0.854，P<0.05），and positively correlated with MVC and SCV（r=0.693，0.782；P<0.05）. Logistic regression analysis showed that the levels of SUA，SHBG，E2 and T were the risk factors of DPN（OR=0.678，95%CI=0.321 to 1.093；OR=3.237，95%CI=2.671 to 5.613；OR=1.674，95%CI=1.031 to 3.012；OR=0.741，95%CI=0.423 to 0.881，P<0.05）. Conclusion：The level of SHBG is related to DPN，and the decrease of SHBG may be a risk factor for the occurrence and development of DPN. It may also be one of the most important predictors of T2DM vascular complications.

Abstract:Objective：To investigate the changes of serum plasma proprotein convertase subtilisin/kexin type 9（PCSK9） levels in type 2 diabetes mellitus（T2DM） and to explore its relationship with body mass index（BMI），waist hip ratio（WHR），fasting blood glucose（FBG），glycosylated hemoglobin（HbA1c） as well as other factors. Methods：Fasting serum PCSK9 levels in T2DM（n=54） and normal controls（n=58） were measured by enzyme-linked immunosorbent assay（ELISA）. Relationship between serum PCSK9 levels，and BMI，waist circumference，hip circumference，WHR，FBG，HbA1c were also analyzed. Results：（1）Fasting serum PCSK9 levels in T2DM patients were significantly higher than those in the normal control group[（260.53±141.70） ng/mL vs. （123.74 ± 73.50） ng/mL，P=0.000]. （2）Correlation studies showed that serum PCSK9 levels were positively correlated with BMI，waist circumference，hip cir－cumference，WHR，FBG and HbA1c in the whole study population（r=0.403，r=0.305，r=0.217，r=0.257，r=0.397，r=0.426，P＜0.05），serum PCSK9 levels were positively correlated with BMI，waist circumference，hip circumference，WHR，FBG and HbA1c in the fe－male group（r=0.509，r=0.328，r=0.244，r=0.275，r=0.472，r=0.394，P＜0.05） and positively correlated with waist circumference，FBG and HbA1c in male group（r=0.346，r=0.335，r=0.515，P＜0.05）. （3）Multivariate stepwise regression analysis showed that BMI and HbA1c were independent related factors influencing serum PCSK9 levels in the whole study population. Waist circumference and HbA1c were independent related factors in male group，BMI and FBG were independent related factors in female group. Conclusion：Serum PCSK9 levels are associated with glucose metabolism，and they may contribute，in part，to the pathogenesis of T2DM.

Abstract:Objective：To study the effect of naringenin（NAR） on diabetic nephropathy（DN） mice and the expressions of inflammatory factors tumor necrosis factor alpha（TNF-α） and interleukin-6（IL-6） in glomerular mesangial cells. Methods：Totally 10 male db/db DN mice were randomly divided into two groups：NAR group and DN group. Five db/m control mice were set up as normal group. Mice in NAR group were treated with NAR [50 mg/（kg×d）] by gavage for two weeks. Mice in DN group were treated with the same volume of saline by gavage for two weeks. Mice in normal group were treated with normal diet. Body weight，blood glucose and urinary albumin excretion（UAE） were tested in mice，and the morphology of the renal glomerular was tested by HE staining and electron microscope. Moreover，the glomerular mesangial cells were cultured in DMEM medium with different glucose concentrations（5 mmol/L and 25 mmol/L glucose）. Cells in normal group were cultured with 5 mmol/L glucose. Cells in high glucose group were cultured with 25 mmol/L glucose. Cells in NAR group were cultured with 25 mmol/L glucose containing 400 μmol/L NAR. Then，the expressions of inflammatory factors TNF-α and IL-6 were tested by ELISA，and the expression of NF-κB p65 was tested by Western blot in the cytoplasm and nucleus of the cells. Results：After the treat－ment of NAR in mice，UAE was decreased[（51.48±8.54） μg/24 h] when compared with that in DN group[（99.3±5.15） μg/24 h]（F=254.302，P=0.000）；glomerular mesangial area was smaller[（2 098±571.84） μm2] than that in DN group[（4 240±536.66） μm2]（F=24.468，P=0.000），and the mesangial proliferation was lessened. Additionally，after the treatment of NAR in mesan－gial cells，the expressions of TNF-α and IL-6 were lower（1.99±0.29，1.76±0.15） than those in high glucose group（2.82±0.14，2.53±0.32）（F=111.303，P=0.000；F=65.127，P=0.000），the expression of NF-κB p65 was decreased（0.29±0.01） when compared with that in high glucose group（0.81±0.02）（F=1579.764，P=0.000）. Conclusion：Naringenin may play roles in relieving albu－minuria and mesangial proliferation via inhibiting the expressions of inflammatory factors through NF-κB in DN.

Abstract:Objective：DEP domain containing 1（DEPDC1） is a tumor-related gene found in recent years. Previous studies have shown that DEPDC1 plays an important role in the development and progression of nasopharyngeal carcinoma. In this study，DEPDC1 was used to further investigate the effect of DEPDC1 on the proliferation of NPC cells. Methods：In nasopharyngeal carcinoma cell line CNE-1，the two spliceosomes overexpressing DEPDC1-V1 and DEPDC1-V2 were transfected respectively，and transiently expressed for 48 h，then CCK-8，flow cytometry and pHH3 labeling assays were used to detect cell proliferation. Results：Western blot showed that transient transfection of DEPDC1-V1 and DEPDC1-V2 in CNE-1 cells could overexpress DEPDC1. CCK-8 experimental results showed that，over-expression of DEPDC1-V1 and DEPDC1-V2 significantly promoted CNE-1 cell proliferation. Flow cytometry results showed that compared with the control group，overexpression of DEPDC1-V1 or DEPDC1-V2 resulted in an increase of G2/M phase cells. The result of pHH3 labeling assay showed that mitosis was active after DEPDC1-V1 or DEPDC1-V2 being overexpressed，and the cell cycle progression was accelerated. Further quantitative RT-PCR analysis showed that overexpression of DEPDC1-V1 or DEPDC1-V2 led to the up-regulation of FoxM1 and its downstream target genes CCNB2，PLK1 and MYBL2 in cell cycle progres－sion. Conclusion：In this study，overexpression of two spliceosomes，DEPDC1-V1 and DEPDC1-V2，in nasopharyngeal carcinoma CNE-1 cell lines demonstrate that DEPDC1 overexpression in nasopharyngeal carcinoma cells plays an important role in promoting cell proliferation.

Abstract:Objective：To construct a high sensitive electrochemical biosensor for the detection of microRNA（miRNA） based on the strand displacement amplification（SDA） and catalytic hairpin assembly（CHA） cascading amplification strategy. Methods：Target miR-21 initiated SDA to obtain mass target-related DNA which could further trigger CHA to obtain mass biotin-labeled dsDNA. And then，the obtained biotin-labeled dsDNA was immobilized onto the surface of the electrode modified with auxiliary probe. Later，ST-AP was modified onto the electrode surface by the specific recognition of biotin and streptavidin. When the α-NPP was in the test buffer，α-NPP was catalyzed by ST-AP to in situ produce α-NP on the surface of the electrode. Finally，the electrochemical signal of α-NP was correlated with the concentration of miR-21. Results：Under the optimized experimental conditions，the prepared biosensor showed a linear response to miR-21 range from 0.1 pmol/L to 10 nmol/L with the limit of detection low to 60 fmol/L. Conclusion：The designed biosensor has been exhibited high sensitivity and excellent specificity，which may provide a new idea and new platform for clinical determination of miR-21.

Abstract:Objective：To investigate the expressions of interleukin-18（IL-18），interleukin 18 binding protein（IL-18BP） and inter－leukin 18 receptor（IL-18R） in eosinophil-enriched cells from patients with psoriasis，and the correlation among them. Methods： Blood samples from psoriasis patients and healthy controls（HC） were collected and incubated with the extracts of Artemisia pollen，dust mite，and Platanus pollen. Expressions of IL-18，IL-18BP and IL-18R in blood eosinophils were detected by flowcytometry. SPSS software was employed to analyze the correlation among them. Results：Levels of IL-18+ and IL-18R+ blood eosinophils in psoriasis patients were increased up to 3.7（Z=-3.070，P=0.002） and 4.1 folds（Z=-4.753，P=0.000），respectively. While IL-18 BP+ eosinophil was reduced by 87% compared with HC when cultured with medium only（Z=-4.556，P=0.000）. Dust mite extracts induced approximately 1.5-fold increase in IL-18+ eosinophils of psoriasis patients（Z=-3.548，P=0.000），and Platanus pollen extracts induced approximately 1.1-fold elevation in IL-18BP+ expression（Z=-3.445，P=0.000）. In addition，the proportions of IL-18BP+ and IL-18+ eosinophils in psoriasis patients were highly correlated（r=0.587，P=0.013）. Conclusion：Increased expressions of IL-18，IL-18R，and decreased expression of IL-18BP in eosinophil-enriched blood cells from psoriasis patients may suggest that IL-18，IL-18R and IL-18BP expressed in eosinophils may be involved in the pathogenesis of psoriasis. Anti-IL-18 agents or IL-18R blockers might become potential targets for psoriasis treatment.

Abstract:Objective：To observe the effect of Zinc metalloprotease-1（Zmp1） from Bacillus Calmette-Guerin（BCG） on processing Mycobacterium tuberculosis antigen PPE68 in mouse in vivo. Methods：BALB/c mice of 6 to 8 weeks were randomly divided into five groups：plasmid pBudCE4.1 control group（n=7），plasmid pBudCE4.1-PPE68p group expressing PPE68 peptide（n=9），plasmid pBudCE4.1-PPE68 group expressing PPE68 antigen（n=9），plasmid pBudCE4.1-PPE68-Zmp1 group co-expressing PPE68 antigen and Zmp1（n=10），and plasmid pBudCE4.1-PPE68p-Zmp1 group co-expressing PPE68 antigen and Zmp1（n=8）. Recombinant Salmonella was constructed through the electrotransformation of these plasmids to attenuated Salmonella strain SL7207. All mice were immunized with corresponding recombinant Salmonella for three weeks via gavage. Mice blood and douche fluid of lung and small in－testine were collected and ELISA was used to analyze the level of IL-12，IFN-γ and secretory IgA（sIgA）. Mice splenocytes were sep－arately cultivated and CCK8 was used to analyze the proliferation of splenic lymphocytes. Results：Compared with those of the PPE68 antigen group，levels of IFN-γ（117.29±16.86，P=0.034），IL-12（40.46±7.11，P=0.004），and lymphocyte stimulation index（SI）（3.30±0.49，P=0.004） were decreased in co-expressing group of PPE68 and Zmp1. Compared with those of the PPE68 peptide group，levels of IFN-γ（132.75±28.40，P=0.070），IL-12（55.43±11.78，P=0.198），and SI（4.70±1.57，P=0.124） were not signifi－cantly decreased in co-expressing group of PPE68 peptide and Zmp1. Conclusion：Zmp1 from BCG may have effects on the process－ing of Mycobacterium tuberculosis antigen PPE68 in mouse in vivo，which may be an important factor influencing BCG immune.

Abstract:Objective：To study the pharmacokinetics of pyridostigmine bromide and oil-in-water pyridostigmine bromide novel phos－pholipids complex nanoemulsion（PPCN） in rats，and to compare their relative bioavailability and bioequivalence. Methods：In this study，twelve rats were randomly divided into two groups and the same dose was administered. Blood samples was taken at different time points，and the plasma concentrations of the drugs were determined by HPLC. The DAS（2.1.1） software were used to calculate the main pharmacokinetic parameters and bioequivalence. Results：The Cmax of PB and PPCN were 1.49 mg/L and 2.23 mg/L，re－spectively. The AUC（0-72 h） of PB and PPCN were 7.06 mg·h/L and 14.12 mg·h/L respectively. The Tmax of PB was 1.5 h，and the Tmax of PPCN was 4 h. The Cmax of PPCN was 1.50 times that of PPCN，and the AUC（0-72 h） of PB was 2 times that of PPCN. The results of AUC（0-72 h） Cmax and Tmax were statistically different（P values were 0.000，0.000，0.001，respectively） by student’s t test，analysis of variance and wilconxon rank sum test. Conclusion：PPCN can not only prolong the action time of PB in rats，but also improve oral bioavailability of PB in rats，and PPCN and PB are not bioequivalent，and PPCN is better than PB.

Abstract:Objective：To analyze the expression profile of lncRNA-mRNA in lesion and normal intestines of Hirschsprung’s diseases （HD）. Methods：The lncRNA-mRNA microarray was used to screen the differentially expressed lncRNA and mRNA in 5 HD intestines and 5 paired normal intestines. Seventeen groups of samples were used to do the quantitative real-time polymerase chain reaction（qRT-PCR） on 5 lncRNAs with significant differences. Gene co-expression network was constructed by bioinformatics methods. Results：There were 353 up-regulated and 474 down-regulated expression of lncRNA，and 865 up-regulated and 461 down-regulated expression of mRNA. lncRNA played a role in the pathogenesis of HD，by regulating the corresponding target mRNA，participating in various biological processes like cell proliferation，differentiation，migration et al. Conclusion：There are many differentially expressed lncRNA and mRNA in HD intestines. mRNA and lncRNA are closely related，forming co-expression network. lncRNA may participate in the pathogenesis of HD through regulating the corresponding target mRNA.

Abstract:Objective：To investigate the mechanism of clincal isolates of carbopenem-resistant Enterobacter cloacae. Methods：Antimi－crobial susceptibility test was done on 21 strains of Enterobacter cloacae by Kirby-Bauer method. The minimal inhibitive concentra－tions（MICs） of these antimicrobial agents were determined by microdosis broth dilution method. A modified Hodge test and Carba NP test were used to detect the presence of carbapenemase. The genotype of KPC，IMP，NDM，VIM，IMI，SPM，OXA-23，OXA-24，OXA-48 and OXA-58 was tested by polymerase chain reaction（PCR）. Results：Clinical isolates of carbapenem-resistant Enterobacter cloacae were multi-drug resistance. The positive rate of modified Hodge test and Carba NP test were 61.9%（13/21），90.5%（19/21），respectively. Carbapenemase genes were positive in 19/21 strains of Enterobacter cloacae by PCR. The positive rate of IMP，KPC and NDM were 23.8%（5/21），9.5%（2/21） and 61.9%（13/21），respectively，in which one strain was both IMP and NDM positive. Conclusion：Production of carbapenemases is the main mechanism of carbapenem-resistant Enterobacter cloacae，which should arouse the attention of stalf in hospital infection-control department.

Abstract:Objective：To construct ETS Variant 4（ETV4） truncated mutants and to investigate their role in colorectal cancer cell growth and migration. Methods：Based on our previous constructed ETV4 vector，ETV4 deletion mutants that containing different con－served domains were constructed：ETV4（1-339） and ETV4（340-484）. Each mutant function was analyzed in colorectal cancer cell growth by CCK-8 kit. Each mutant function in colorectal cancer cell migration was detected with wound healing assay. Moreover，each mutant function in EMT was further measured by qRT-PCR. Results：CCK-8 assay showed that mutant ETV4（1-339） didn’t promote cancer cell growth whereas mutant ETV4（340-484） and wide type ETV4 evidently promoted cancer cell growth. Wound healing assay revealed that mutant ETV4（340-484） and wide type ETV4 promoted colorectal cancer cell migration. Further qRT-PCR analysis showed that mutant ETV4（340-484） and wide type ETV4 were able to alter the expression of ETM markers whereas mutant ETV4（1-339） could not. Conclusion：ETS domain of ETV4 is indispensable in ETV4-induced colorectal cancer cell prolif－eration and migration，which is probably related with EMT.

Abstract:Objective：To explore the clinical characteristics and high-risk factors of intestinal necrosis in infants with incarcerated in－guinal hernia. Methods：This retrospective study enrolled 246 infants of incarcerated inguinal hernia at Children’s Hospital of Chongqing Medical University from January 2013 to January 2017. The clinical characteristics were studied and the high-risk factors of intestinal necrosis were identified by univariate analysis and mutivariate logistic regression analysis. Results：The overrall rate of intestinal necrosis was 10.2%（25/246）. Multivariate analysis showed that C-reactive protein（CRP）＞8 mg/L was the independent risk factor of intestinal necrosis in infants with incarcerated inguinal hernia. The ROC analysis showed that in the diagnosis of intestinal necrosis，CRP had a high sensitivity（80.0%） and specificity（93.7%），AUC ROC of 0.868（95%CI=0.820-0.908）. Conclusion：The clinical manifestation of incarcerated inguinal hernia in infants is atypical and incarcerated inguinal hernia in young infants can leads to intestinal necrosis easily. CRP has a good value in diagnosis of intestinal necrosis in infants with incarcerated inguinal hernia.

Abstract:Objective：To explore clinical features of chronic migraine（CM） and to test the International Classification of Headache Disorders-Ⅲ，beta version（ICHD-Ⅲ beta） and Expert Opinion criteria（EOc） in practice. Methods：Demographic characteristics and clinic features of CM patients in neurology outpatient department of the First Affiliated Hospital of Chongqing Medical University from June 2014 to June 2016 were retrospectively analyzed. CM diagnostic criteria according to ICHD-Ⅲ beta and EOc were evaluated. Results：A total of 236 CM patients were included：165 patients（69.9%） were concurrent with medication overuse，just 2 patients （0.8%） used triptans and none used ergotamines. The most common migraine subtype was migraine without aura（MO，70.3%），followed by probable migraine（PM，26.3%） and migraine with aura（MA，3.4%）. All 236 patients met the EOc criteria and only 167 patients（70.8%） met ICHD-Ⅲ beta for CM. For the 69 patients who met EOc but not met ICHD-Ⅲ beta，62 had atypical migraine attacks，which was consistent with PM，and another 7 had typical migraine attacks but less than a total history of 5 attacks. Conclusion：CM patients are often in combination with medication overuse，however，migraine-specific medications including triptans and ergo－tamines，are used infrequently. According to the situation of Chinese CM patients，the EOc is more suitable and may be more appro－priate in the clinical work.

Abstract:Objective：To evaluate hemoglobin monoclonal antibody immune colloidal gold method，hemoglobin and transferrin com－bined immunoassay，pyramidon chemical method for occult blood detection and to identify occult blood detection method consistent with clinical practice. Methods：Hemoglobin solutions of different concentrations were prepared，and the minimum detection limit and the highest test concentration of the three methods were checked. The specificity of these threeoccult blood testing methods was eval－uated with five kinds of animal blood. Feces and gastric juice specimens of hospitalized patientswere collected for three kinds of meth－ods of occult blood test. With endoscopy as the gold standard，the sensitivity，specificity，negative and positive likelihood ratio，and Youden index clinical coincidence rate were calculated. Results：Examination area of Kaichuang and Oritent was 200 ng/mL to 10 mg/mL，and 300 ng/mL to 2.5 mg/mL，respectively. The minimum detection limit ofpyramidon chemical method and combined immunoassaywas 2 500 ng/mL and 10 ng/mL. The clinicalcoincidence rates of Kaichuang，Oritent，pyramidon chemical method，combined immunoas－say in feces and gastric juice were respectively 96.0%，95.8%，79.5%，97.5% and 92.9%，92.9%，94.6%，90.2%. There were obvious differences in fecal occult blood test results between the four groups（P=0.000），but no difference was observed in the gastric occult blood detection results between groups（P=0.083）. Conclusion：For fecesoccult blood test，combined immunoassay is superior to hemoglobin immunization，hemoglobin immune method is better than the chemical method.For occult blood detection of gastric juice specimens，there is no significant difference among the three methods.

Abstract:Objective：To explore the influencing factor of pulse wave velocity in patients with maintenance hemodialysis. Methods：Seventy patients with maintenance hemodialysis were selected from blood purification center of the First Affiliated Hospital of Wannan Medical College. The blood pressure of 24 hours was measured by dynamic blood pressure meter. CfPWV was monitored and biochemi－cal markers were measured by biochemical analyzer. CRP，BNP，NTproBNP，Troponin I and Troponin T were measured by enzyme-linked immunosorbent assay（ELISA）. A simple correlation analysis was performed and further linear regression analysis was per－formed. Results：①Levels of cfPWV were positively correlated with age，24SBP，dSBP，nSBP，24PP，dPP，nPP and BNP in patients with maintenance hemodialysis，r=0.304，0.540，0.548，0.506，0.643，0.651，0.595，0.294；P=0.010，0.000，0.000，0.000，0.000，0.000，0.000，0.014，respectively. Levels of cfPWV were negatively correlated with dialysis age，Ca，24HR and nHR in maintenance hemodialysis patients，r=-0.249，-0.252，-0.311，-0.255；P=0.038，0.038，0.006，0.045，respectively. ②Multivariate regression analysis showed that main influencing factors of cfPWV in patients with maintenance hemodialysis were dPP and Ca. Conclusion：Arterial pressure and serum calcium may be influencing factors of pulse wave velocity in patients with maintenance hemodialysis.

Abstract:Objective：To investigate the changes and clinical significance of intermediate mononuclear cells in preeclampsia in preg－nant women. Methods：Totally 64 preeclampsia women were selected as preeclampsia group. Sixty-four normal pregnant women of prenatal examination were taken as the control group. The pregnant women in the pre-eclampsia group were admitted to hospital. The blood samples of elbow vein were collected during antenatal examination of similar gestational weeks for flow cytometry and serum cytokine levels in healthy pregnant women. Results：Compared with those of control group，the proportion of intermediate and non-classical monocytes in preeclampsia pregnant women was significantly increased，and the proportion of classic monocytes was signifi－cantly decreased（P<0.01）. The percentage of intermediate monocytes in 29 cases of early preeclampsia was significantly lower than that in 35 cases of late preeclampsia（P<0.01）. The percentage of Toll like receptor（TLR）4，CD64 positive cells on the surface of in－termediate monocytes in preeclampsia group was significantly higher than that in control group（P<0.01）. In preeclampsia group，the average fluorescence intensity of triggering receptor expressed on myeloid cell-1（TREM-1）/TLR4 CD64 was significantly higher than that of control group（P<0.01）. The mean fluorescence intensity of tumor necrosis factor-α（TNF-α），interleukin（IL）-6 in interme－diate monocytes in preeclampsia group was significantly higher than that in control group（P<0.01）. The serum levels of TNF-α IL-6 and IL-8 in preeclampsia group were significantly higher than those in control group（P<0.01）. Mesenchymal monocytes and TNF-α in preeclampsia group（P<0.05）. There was no signifi－cant correlation between two projects in the control group. Conclusion：The proportion of intermediate monocytes in the peripheral blood of preeclampsia women is significantly increased，the expression of TREM-1，TLR4，CD64 on the surface of TREM-1，TLR4，CD64 are high，and the level of serum TNF-α/IL-6 is significantly increased，which may be involved in the process of preeclampsia in women with preeclampsia.

Abstract:Objective：To investigate the influence of different bonding ways and appliances on periodontal health in adolescent male patients with fixed treatment. Methods：One hundred and twenty adolescent male patients with fixed treatment were enrolled. The me－dian age of patients was 12.9 years old（ranged from 11 to 16）. The patients were divided into four groups equally：conventional brackets with direct bonding group，conventional brackets with indirect bonding group，self-ligating brackets with direct bonding group and self-ligating brackets with indirect bonding group. The bleeding index（BI），probing depth（PD） and attachment loss（AL） of patients were examined before fixed treatment（T0） and one month（T1），two months（T2） and three months（T3） after the treatment，respectively. Results：The BI and PD of patients markedly increased over time after fixed treatment（P=0.000）. The BI and PD were not significantly different between patients with conventional brackets and patients with self-ligating brackets（P>0.05）. The BI of canines in patients with self-ligating brackets with direct bonding was lower than those with indirect bonding（P=0.001），and the BI of first mo－lars，lateral incisors and central incisors in the two groups were not statistically different（P>0.008）. The BI of canines in pa－tients with conventional brackets with direct bonding was lower than those with indirect bonding（P=0.000），and the BI of first molars，lateral incisors and central incisors in the two groups were not statistically different（P>0.008）. Meanwhile there was no statistical difference in PD between the two groups（P>0.05）. Conclusion：The BI and PD of patients increase over time after fixed treatment. The type of brackets is not the important factor for periodontal health in adolescent male patients with fixed treatment. Compared with indirect bonding，direct bonding is better for periodontal health in adolescent male patients with fixed treatment.

Abstract:Objective：To study the treatment effect of one-visit root canal therapy for molar acute pulpitis using GuttaFlowR 2，thus to provide a more efficient，comfortable way and lay a basis for simpler treatment. Methods：Totally 90 molar teeth were selected and divid－ed into two groups，45 teeth in A group used GuttaFlowR 2 plus single cone obturation treatment，45 teeth in B group used iRoot SP plus thermoplasticized gutta-percha technique. The treatment time，and the difference of pain index and efficiency between two groups after 24 hours，3 days，7 days，one month and three months were compared. Results：Concerning the treatment operation time，the group A was （63.20±6.54） min，while the group B was （86.12±8.08） min，the group A was significantly better than the group B（P<0.01）. The pain index of group A and group B was （2.40±0.54） and （4.60±1.31） at 24 hours after treatment，and （1.80±0.63） and （3.10±1.23） after 3 days respectively，and the difference was statistically significant（P<0.05）. There was a significant difference between the two groups in pain index after 24 h and 3 days（P<0.05），but no significant difference after 7 days，one month and 3 months（P>0.05）. There was no significant difference in the efficiency at each time point（P>0.05）. Conclusion：GuttaFlowR 2 non-heated flowable gutta-percha has a good therapeutic effect in the treatment of one-visit root canal therapy and has its unique ad－vantage. It can be widely used in one-visit root canal therapy in molars compared with hot gum filling. It also provides a new idea for independent innovation.

Abstract:Objective：To estimate the maximum tolerated dose（MTD） of fentanyl for sedations in pediatric caudal block anesthesia us－ing the continual reassessment method（CRM）. Methods：This is a double-blind and prospective study. Six dose levels of fentanyl were chosen before the study started，with the probability of respiratory depression associated with each：1.0 μg/kg（10%）、1.2 μg/kg（20%）、1.4 μg/kg（30%）、1.6 μg/kg（40%）、1.8 μg/kg（50%） and 2.0 μg/kg（60%）. Recruited children were allocated to the same dose of fentanyl by a cohort，each containing 3 individuals. The dose of fentanyl received in each cohort was determined by the responses of all previous patients. MTD was defined as 10% incidence of respiratory depression. Respiratory depression was determined as the respi－ratory rate≤10 b/min，the duration of apnea＞5 s，SpO2＜94% and PETCO2＞70 mmHg. Results：Twenty-seven children were enrolled when it reached to the stopping point according to the principal of CRM. The first decision was to stop the trial when the predetermined fixed sample size was reached. The second stopping decision was due to no change in administered dose level among the next patients（rule 3 above 0.95）. The third decision of stopping based on a sufficient level of reliability in the predictive mean and maximum gain from further patients inclusions on the probability of respiratory depression and width of the associated credibility interval（rule 4 and 6 below 0.05）. The estimated MTD of fentanyl was 1.8 μg/kg with a final estimated probability of respiratory depression of 8.7%（95%CI=1.5% to 26.2%）. Conclusion：CRM can be used to ensure the MTD of fentanyl with limited sample size. The estimated MTD of fentanyl is 1.8 μg/kg.

Abstract:Objective：To investigate the effect of cisatracurium in clinical use of intubating laryngeal mask airway for painless bron－choscopic diagnosis and therapy. Methods：Sixty patients were selected from October 2013 to February 2015 in our hospital who received painless bronchoscopy，and were randomly divided into observation group（n=30） and control group（n=30）. The intubating laryngeal mask airway was used in both groups for mechanical ventilation. The cisatracurium was used for the patients in observation group. Vital signs include mean arterial pressure（MAP），heart rate（HR），pulse oxygen saturation（SPO2），end-tidal carbon dioxide partial pressure（ETCO2） and bispectral index（BIS） were recorded at four points，anesthesia induction（T1），laryngeal mask insertion （T2），fiberoptic bronchoscope passing through the glottis（T3），end of diagnosis（T4）. The spontaneous breathing recovery time，the awakened eye opening time，extubation time and the time of postanesthesia staying in care unit in both groups were recorded and e－valuated. Results：The MAP and HR at T3 point were significantly lower in observation group than in control group（P=0.000）. The SPO2 at T3 point were significantly higher in observation group than in control group（P=0.000）. The ETCO2 at T2，T3，T4 at points were significantly lower in observation group than in control group（P=0.001，P=0.000，P=0.000）. There was no significant difference of BIS in both groups（P=0.235，P=0.614，P=0.455，P=0.546）. The doses of fentanyl and propofol were obviously reduced in observation group than in control group（P=0.000，P=0.000）. There was no significant statistically differences in the outcomes of general anesthesia（P=0.378）. There was no significant differences in the awakened eye opening time，extubation time and the time of postanesthesia staying in care unit in both groups（P=0.057，P=0.071，P=0.094）. The spontaneous breathing recovery time was significantly longer in observation group than in control group（P=0.030）. Conclusion：Low cisatracurium，as a muscle relaxant，is a helpful supplementary drug in clinical use of intubating laryngeal mask airway for painless bronchoscopy with more stable hemody－namics，which also can reduce the consumption of sedative or analgesic drugs and show no increase on the time in PACU.

Abstract:Objective：To explore the safety and effectiveness of transverses abdominis plane block combined with general anesthesia in senile female patients undergoing laparotomy. Methods：Sixty senile women diagnosed as benign diseases were recruited in the study according to certain criteria（ASAⅠ-Ⅲ）. The patients were randomly divided into Group C（30 cases） and Group TAP（30 cases）. The patients in Group C were treated with single general anesthesia during the induction and maintenance periods of anesthesia. The patients in Group TAP received TAP block as anesthesia induction and general anesthesia as maintenance. The mean arterial pressure（MAP），heart rate（HR），adrenaline（A） and noradrenaline（NA） level at the following time：before anesthesia induction（T0），after anesthesia induction（T1），skin incision（T2），suture abdominal cavity（T3），30 minutes after surgery（T4） were recorded. The VAS score，analgesic pump pressure times，the number of sufentanil reme－dies and adverse effects（including nausea，vomit，hypotension，bradycardia，uroschesis and traction reaction） were recorded at following time after surgery 2，4，8，12，24 hours. Results：Com－pared with MAP at T0[（122.8±7.0） mmHg] in Group C，MAP of T1[（111.7±9.4） mmHg]，T2[（102.2±8.0） mmHg]，T3[（101.1±11.9） mmHg] and T4[（105.0±5.3） mmHg] were decreased. Meanwhile the MAP of Group TAP at T1[（113.3±10.9） mmHg]，T2[（110.1±9.4） mmHg]，T3[（109.1±11.2） mmHg] and T4[（116.5±7.2） mmHg] were lower than that at T0[（121.3±9.3） mmHg]. However，during T2-T4，MAP of Group TAP was relatively stable than that of Group C. Additionally，compare with that of Group C，the adrenaline level in serum of Group TAP during T2-T4 [T2：（192.3±22.6） pg/mL，T3：（221.7±16.5） pg/mL，T4：（166.4±14.1） pg/mL] were lower，while noradrenaline level of serum in Group TAP[T2：（140.4±17.0） pg/mL，T3：（149.6±14.4） pg/mL，T4：（116.7±21.1） pg/mL] were also lower. Furthermore，the average VAS scores of Group TAP at 2-12 h after surgery（2 h：2.40±0.50，4 h：2.27±0.45，8 h：2.06±0.71，12 h：2.03±0.61） were lower. Additionally，analgesic pump pressure times[（15.3±4.1） times] and sufentanil remedies cases（3 cases） of group TAP were lower than that of Group C[（36.5±6.9） times，12 cases]. There was no difference between two groups at post-operation. Repeated-measures analysis of variance showed that MAP，HR，A，NA，and VAS at different times were different between the TAP and C groups after correction（P<0.05）. Furthermore，time and group factors of HR，A，NA，VAS were interacted（P<0.05）. Conclusion：Compared to single general anesthesia，ultrasound-guided TAP block combined with general anesthesia has better effect on maintaining stable hemodynamics，reducing stress reaction during operation and relieving post-operative pain on senile female patients undergoing laparotomy.

Abstract:Objective：To investigate the value of dynamic monitoring of extravascular lung water（EVLW） combined with central venous-arterial difference of CO2 partial pressure（P（cv-a）CO2） in early goal-directed therapy（EGDT） for septic shock. Methods：Eighty patients with septic shock，who were admitted to the Intensive Care Unit of the Second Affiliated Hospital of Chongqing Medical Uni－versity and Chongqing Hospital of Traditional Chinese Medicine from 2015 to 2018，were enrolled and randomly divided into EGDT group and EVLW+ P（cv-a）CO2（EP） group. The patients in the EGDT group underwent conventional fluid resuscitation，and those in the EP group underwent fluid resuscitation under monitoring with pulse-induced contour cardiac output. The two groups were compared in terms of the rate of achieving EGDT target after 6-h resuscitation，resuscitation fluid volume，the dose of noradrenaline，urine volume/kg body weight/hour，lactic acid clearance rate，P（cv-a）CO2，EVLW，and 28-day mortality. Results：Compared with the EGDT group，the EP group had significantly higher urine volume/kg body weight/hour and lactic acid clearance rate（P<0.05） and significantly lower 6-h resuscitation fluid volume，central venous pressure，dose of vasoactive agent，P（cv-a）CO2，EVLW，and 28-day mortality（P<0.05）. There were no significant differences in the rate of achieving EGDT target after 6-h resuscitation，mean arterial pressure，and central venous oxygen saturation between the two groups（P>0.05）. Conclusion：In EGDT for septic shock，EVLW combined with P（cv-a）CO2 can help assess the tissue perfusion and volume loading of pa－tients early and accurately，thus guiding fluid resuscitation and reducing the mortality of patients.

Abstract:Objective：To investigate the learning curve of total thymectomy under subxiphoid process thoracoscopy and to summarize the technical points of the operation. Methods：The clinical data of patients undergoing total thymectomy from the beginning of October 2015 to October 2017 in our hospital were retrospectively analyzed. There were 21 males and 16 females. The cumulative sum analysis（CUSUM） analyzed the learning curve of total thymectomy under subxiphoid process thoracoscopy. Results：The average operation time was 123.7 min. The best fitting curve was cubic curve. The fitting equation was CUSUN（min）=89.703 7X-4.594 8X2 + 0.059 9X3（X is the number of operation）. Learning curve across the apex was observed in 13 cases. Taking 13 cases as the boundary，all cases were divided into A group and B group. There was no significant difference between the two groups in the operation time，but there were statistical differences in postoperative hospital stay，postoperative chest drainage tube placement time，postoperative complications between the two groups. Conclusion：In this study，13 cases are the lowest cumulative number of surgeries needed to span the learn－ing curve of total thymectomy under subxiphoid process thoracoscopy.

Abstract:Objective：To evaluate the safety and efficacy of preoperative D-J stent placement in ureteroscopic lithotripsy（URL） by Meta-analysis. Methods：PubMed，Embase，Cochrane Library，VIP，Wanfang and CNKI database were used to collect the randomized controlled trial（RCT） or controlled trials of the effect of preoperative placement and not placement of D-J stent. The data were up－dated to June 2017. Quality of the literature was evaluated. Meta-analysis was performed using Revman 5.2. Sensitivity analysis and publication bias test of inclusion literature were assessed by the Stata 12.0. Results：A total of 12 440 patients were enrolled in 14 clinical studies. Meta-analysis showed that the stone-free rate（SFR） was higher in the intentional preoperative D-J stent（IPS） group than in the not preoperative D-J stent（NPS） group（RR=1.08，95%CI=1.02 to 1.14，P=0.007）. SFR of the renal and proximal ureteral calculi was higher in the IPS group than in the NPS group（RR=1.46，95%CI=1.05 to 2.03，P=0.02），and there was no signifi－cant difference in SFR of distal ureteral calculi between IPS group and NPS group（RR=1.14，95%CI=0.92 to 1.42，P=0.24），and it was the same result in terms of operative time（SMD=-0.21，95%CI=-0.73 to 0.32，P=0.44） and complications（RR=0.78，95%CI=0.52 to 1.18，P=0.25）. Conclusion：Preoperative D-J stent for URL can increase SFR，especially for kidney and proximal ureteral stones patients.

Abstract:Objective：To understand the implementation effects on the quality of life of the adolescent leukemia children in chemotherapy under the humanistic nursing management model，improve the prognosis and the quality of life. Methods：As a case-control study，97 adolescent children receiving chemotherapy from the Affiliated Children’s Hospital of a Medical University were enrolled. The changes of the quality of life before and after the intervention of holistic nursing management model were compared. The current quality of life and the problems of the adolescent leukemia children in chemotherapy was investigated before intervention through the survey using self-designed scale（the quality of life scale for leukemia children of different ages） combined with the semi-structured interviews on children’s quality of life. The holistic nursing management model is applied according to the results and all the indicators of the quality of life were examined after 3 months. Results：The total score and scores in all fields of the leukemia children before and after the intervention were significantly im－proved（P<0.05）. Among them，the mental emotion and social interaction improved most evidently. And there is no obvious difference（P<0.05） before and after the intervention in the school performance in all fields. And there was no obvious dif－ference in parts of the factors（P>0.05） including the weaker performance of the leukemia children in the school activity than the peers，the absence from class due to the illness，the great help of the medical insurance in relieving the economical burden. Conclusion：The holistic nursing management model can re－lieve anxiety and depression in children with leukemia chemotherapy，significantly improve the quality of life and let leukemia chil－dren return to society as soon as possible.

Abstract:Objective：To explore whether MoCA-BJ has universal applicability during different education levels in screening of elderly people with mild cognitive impairment（MCI） in the community. Methods：This research investigated 412 elderly people in Chongqing community by using the Beijing edition of the Montreal cognitive assessment text，and 55 people was detected with MCI. The impact of the education years on the evaluation of MoCA-BJ text was anazlyed. Results：Fifty-five MCI patients were enrolled in this study. There was no significant difference between the three groups in terms of visuospatial/executive function，language，and delayed recall，name，attention，abstraction，orientation，however significant differences between the groups were obsereved in terms of the total score. There were statistically significant diererences between the primary school group，the middle school group，and the high school group in naming，attention，abstract，orienting and the total score. The total score was the only domain that showed differences between the middle school group and high school group（P<0.05）. Conclusion：There are statistically significant differences in the naming，atten－tion，abstract，orientation，and total score when applying Montreal cognitive assessment text to evaluate peopele with different educa－tion levels. The applicability of the scale among people with low education level is lower than that among people with high level. Therefore，Montreal cognition assessment text should be adjusted more suitable for different academic qualifications when applied to community groups.