Abstract:In the field of critical care medicine，the so-called ‘diseases’ are often ‘syndromes’. The same clinical outcome may have different etiologies. In fact，the current assessment of these syndromes does not reflect the whole changes of the patients’ body. Metabolomics is the latest ‘omics’ technique，which analyzes the small molecule metabolites of organisms or specific biological sam－ples comprehensively. And it provides an insight of actual（health or illness） condition of organisms from the cell status. Techniques for a variety of biological fluids，such as gas chromatography-mass spectrometry，liquid chromatograph-mass spectrometry have been used in ICU for the metabolic analysis. And they have been used in the diagnosis and prognosis of the syndromes or diseases，such as sepsis，acute respiratory distress syndrome，acute kidney injury and so on in the ICU. In this review，we will focus on the develop－ment of metabolomics analysis in critical care medicine.

Abstract:With the widespread use of antibiotics，increasing drug-resistant strains bring more challenges to clinical serious infectious disease，therefore，the research and development of the novel antibacterial and agent is in urgency. Phage lysine is a kind of protease which is expressed in the last infectious phase of double-stranded DNA phage and has the ability to crack bacterial cell wall. In re－cent years，studies of phage lysine have showed that it can be cloned and expressed in prokaryocyte，with expressed lysins having po－tency to kill bacteria in vitro and vivo. A number of experiments on animal showed that lysin agents can specifically resist the host bacteria，featuring efficiency，specificity，safety and synergy. These characteristics of phage lysin make it possible to be applied widely in treating clinical drug-resistant diseases.

Abstract:Objective：To determine the regulative effect of Streptococcus pneumoniae MarR family protein SPD_0379 on the biosyn－thesis ofteichoic acid. Methods：EMSA was employed to analyze whether protein SPD_0379 bound to rafX gene promoter sequence. The change of bacterial rafX gene expression was observed by LacZ reporter gene. Dot blot，ELISA techniques and flow cytometry analysis were implemented to reveal the change of the concentration of teichoic acid. Results：A specific binding between proteins SPD_0379 and rafX gene promoter sequence was observed. After spd_0379 gene deficiency，the expressions of bacterial rafX gene were up-regulated（t=10.010，P=0.001），with the concentration of teichoic acid significantly up-regulated in D39Δspd_0379 detected by both dot blotting and ELISA（t=5.848，P=0.004；t=4.653，P=0.001），and the autolysis of spd_0379 deficient strains were signifi－cantly earlier than wide type D39. Conclusion：Protein SPD_0379 regulates the expression of rafX gene，inhibits the synthesis of bacterial teichoic acid，and is involved in the regulation of bacterial autolysis.

Abstract:Objective：To establish a C57bl/6 mouse asthma model the ovalbumin（OVA） free and to evaluate the model using dexam－ethasone（Dex）. Methods：Clean female C57bl/6 mice fed without OVA for over 3 generations were divided into three groups（n=36，12 for each group）. The asthmatic group was sensitized by i.p with OVA aluminium hydroxide gel on day 1 and 14. From 21st day，asthmatic group was aerosolized 1.5% OVA for 7 days. The control group received saline as the substitution of OVA. The treated group was i.p with 5 mg/kg dexamethasone 0.5 h before atomization from 25th to 27th day. Twenty four hour after last atomization，6 mice in each group were used to detect the airway resistance by invasive pulmonary function. The last 6 mice were used to detect airway in－flammatory cells，lung pathological changes，mucus hypersecretion，total IgE in serum and IL-4 by bronchoalveolar lavage fluid（BALF），hematoxylin-eosin（HE） staining，periodic acid-schiff（PAS） staining and ELISA. Results：The airway resistance lung resistant in asthma group was higher than that in control group at 25 mg/mL concentration（F=26.530，P=0.000） and also higher than that in control group at 50 mg/mL concentration（F=18.690，P=0.000）. BALF total cells of asthma group were higher than that in control group（F=1.349，P=0.000） and treatment group（F=1.461，P=0.006）. The eosinophils cells of asthma group was higher than that of control group（F=7.000，P=0.013）. Lung pathological changes and mucus hypersecretion in asthma group were much serious. Total IgE in serum（F=15.10，P=0.036） and IL-4 in BAlF（F=15.10，P=0.036） of asthma group were more serious than those of control group. Conclusion：The C57bl/6 mouse allergic asthma model is es－tablished by the way in this study.

Abstract:Objective：To investigate the role of pre-B-cell colony enhancing factor（PBEF） in the pathogenesis of acute respiratory distress syndrome（ARDS）. Methods：Human pulmonary microvascular endothelial cell line（HPMEC） and human type Ⅱ alveolar epithelial cell line（A549） were constructed by increasing human recombinant PBEF（rPBEF） concentrations（0，50，100，500，1 000，2 000 ng/mL） in a stepwise manner. The cell viabilities to rP－BEF were tested by MTT assay. And then the cells were stimu－lated with 100 and 1 000 ng/mL rPBEF while the blank control group was set up. The cell cycle and cell apoptosis were analyzed using flow cytometry（FCM）. Morphological changes of apoptosis were observed by transmission electron microscopy. The expres－sions of caspase-3，B-cell lymphoma/leukemia-2 gene were detected by Western blot. The expressions of aquaporin 1，interleukin-8 and interleukin-1β were detected using RT-PCR and Western blot. Results：The cell viabilities were significantly inhibited in the rPBEF group with 100，500，1 000，2 000 ng/mL rPBEF compared with those in blank control group（P<0.05）. FCM showed that the percentage of S phase in 100 and 1 000 ng/mL rPBEF groups[HPMEC：（43.847±1.272）%，（63.300±2.102）%；A549：（36.247±2.045）%，（46.400±1.346）%）] were significantly higher than those in the blank control group[HPMEC：（19.347±2.052）%；A549：（17.297±0.800）%]（all P=0.000） and the apoptic rate in 100 and 1 000 ng/mL rPBEF groups[HPMEC：（11.317±0.533）%，（15.227±0.637）%；A549：（6.120±0.439）%，（8.633±0.497）%] were significantly higher than those in the control group[HPMEC：（8.433±0.600）%；A549：（3.877±0.666）%）]（PHPMEC=0.001，PHPMEC=0.000；PA549=0.002，PA549=0.000）. Transmission electron microscopy showed typical apoptosis，such as heterochromatin concentrated which was set in the nuclear membrane and visible apoptotic bodies in 1 000 ng/mL rPBEF group. The expressions of Bcl-2 protein in 100 and 1 000 ng/mL rPBEF groups[HPMEC：（0.418±0.043），（0.190±0.012）；A549：（1.276±0.212），（0.601±0.164）] were significantly decreased（all P=0.000） and the ex－pressions of caspase-3 protein were significantly increased in 100 and 1 000 ng/mL rPBEF groups[HPMEC：（0.763±0.030），（1.170±0.056）；A549：（0.217±0.010），（0.375±0.032）]，respectively，compared with those of blank control group（PHPMEC=0.000，PHPMEC=0.000；PA549=0.001，PA549=0.000）. The expressions of AQP1 gene and protein in 100 and 1 000 ng/mL rPBEF groups were statisti－cally lower than blank control group[mRNA：HPMEC（0.543±0.113），（0.287±0.093） vs. （1.050±0.155）（P=0.002，P=0.000），A549（0.823±0.104），（0.463±0.184） vs. （1.317±0.215）（P=0.013，P=0.001）；protein：HPMEC（0.494±0.038），（0.233±0.030） vs. （0.824±0.067）（all P=0.000），A549（0.850±0.157），（0.484±0.118） vs. （1.344±0.136）（P=0.005，P=0.000）] while the expressions of IL-8 and IL-1βgene and protein were statistically higher than blank control group in 100 and 1 000 ng/mL rPBEF groups（P<0.05）. Conclusion：PBEF may induce the apoptosis of HPMEC and A549 by down-regulating the expression of Bcl-2 and up-regulating the expression of caspase-3 and PBEF could induce low expression of AQP1 which suggests that PBEF may play an critical role in the development of ARDS.

Abstract:Objective：to investigate the dynamic expression of serum miRNA-21and inflammatory cytokine PCT in the course of sepsis，and to investigate its relationships with the severity and prognosis of sepsis. Methods：A total of 58 patients with sepsis and 24 healthy controls were collected，including 32 cases of general sepsis and 26 cases of septic shock.All patients with sepsis were divided into the survival group（n=48） and the death group（n=10） by the 28 day mortality rate. Serum miRNA-21 expressions and PCT were de－tected on 1，3，5 days after admission，and the basic clinical information was recorded. Results：①Compared with those of healthy controls，the serum miRNA-21 level of 1 day after admission in patients with sepsis was significantly higher（Z=-7.061，P=0.000），and the expression of miRNA-21of 1 day was valuable in sepsis diagnosis by ROC curve（area under the curve=0.997，95%CI=0.991 to 1.000，P=0.000）.Serum miRNA-21 more than 0.875 was taken as the cut-off point in the diagnosis of sepsis，and the sensitivity and specificity were 100% and 91.7%. ②In sepsis 5 d course，dif－ferent time points of miRNA-21expression differences were sta－tistically significant（F=67.778，P=0.000），and statistically significant differences in two different time points were ob－served（P=0.000，P=0.000，P=0.000）. Serum miRNA-21 expres－sion of 1 day after admission （1.974±0.886） ng/μL was higher than miRNA-21 expression of 3 day after admission（1.015±0.709） ng/μL；serum miRNA-21 expression of 3 day after admission （1.015±0.709） ng/μL was higher than miRNA-21 expression of 5 day after admission（0.531±0.312） ng/μL. ③In sepsis 5 d course，different time points of PCT expression differences were statistically significant（F=34.304，P=0.000），and statistically significant dif－ferences in two different time points were observed（P=0.000，P=0.000，P=0.000）. Serum PCT expression of 1 day after admission（14.164±13.939） μg/L was higher than PCT expression of 3 day after admission（4.224±4.039） μg/L；serum PCT expression of 3 day after admission（4.224±4.039） μg/L was higher than PCT expression of 5 day after admission（1.614±3.438） μg/L.④In septic shock group，the serum miRNA-21 expression of 1 day，PCT and APACHEⅡ were higher than those in general sepsis group（Z= -6.510，P=0.000；Z=-4.457，P=0.000；Z=-6.517，P=0.000）. The expression of miRNA-21 was positively correlated with APACHEⅡ score（r=0.993，P=0.000）. ⑤The expression of serum miRNA-21 in death group was higher than that in survival group，and there were significant differences between the two groups at each time point（Z=-2.823，P=0.005；Z=-3.664，P=0.000；Z=-4.942，P=0.000）. Conclusion：Serum miRNA-21 may be a potential marker for early diagnosis of sepsis，and has positive clinical signifi－cance in predicting the severity of sepsis and evaluating the prognosis. The dynamic expression of serum miRNA-21 in the course of sepsis may be closely related to the inflammatory response of the body.

Abstract:Objective：To investigate the ‘early hemodynamic intervention’ in the management of hypovolemic shock with unknown cause for providing scientific basis for early treatment. Methods：A total of 56 patients with hypovolemic shock admitted to the De－partment of Critical Care Medicine of The People’s Hospital of Dazu District from September 2013 to January 2017 were enrolled and randomly divided into the experimental group and the control group，with 28 patients in each. In the experimental group，2 patients asked to go to the superior hospital for treatment，and 1 gave up the treatment，while in the control group，2 gave up the treat－ment and 3 were transferred to the superior hospital for treat－ment. Therefore，25 patients in the experimental group and 23 in the control group were finally included in the analysis. The ex－perimental group underwent the early target-directed liquid ther－apy（EGDT） and the fluid resuscitation was guided by central venous pressure（CVP），while the control group adopted the traditional method of volume resuscitation. Both groups were properly de－hydrated to reduce the pre-cardiac load in order to protect the cardiopulmonary function. The scores on acute physiology and chronic health evaluation system Ⅱ（APACHE Ⅱ） before and after treatment，mean arterial pressure（MAP），CVP，lactate clearance rate，the quantity of liquid，and the numbers of patients using vasoactive drugs，with renal damage，pulmonary edema or congestive heart failure were recorded respectively. Meanwhile，the case numbers of patients with repeated insufficient blood volume undergoing re-added blood volume within 72 hours and patients whose standard rate of compliance was corrected at 3 h and 6 h after treatment were also recorded，as well as the ICU admission days and death numbers of both groups. Results：APACHEⅡ scores decreased gradually in both groups，and scores in the experimental group were significantly lower than those in the control group after 24 hours（P<0.05）. Seventy-two hours after treatment，patients on vasoactive drugs，with renal dysfunction or re-shock in the experimental group were fewer than those of the control group respectively（P<0.05），while the patients with pulmonary edema or congestive heart failure in the experimental group were more than those of the control group respectively（P<0.05）. The amount of recovery liquid within 6 h and 24 h of the experimental group was obviously more than that of the control group，while it in 72 h was less than that of the control group（P<0.05）. The lactate clearance rates of the experimental group at 6 h and 24 h after treatment were both superior to those of the control group（P<0.05）. The CVP and MAP in both groups were significantly improved after treatment，and CVP of the experimental group at 6 h，24 h and 72 h after treatment were superior to those of the control group（P<0.05），and MAP of the experimental group at 6 h and 24 h after treatment were superior to those of the control group（P<0.05）. The numbers of cases whose standard rate of com－pliance was corrected at 3 h and 6 h after treatment in the experimental group were higher than those of the control group（P<0.05）. There was no significant difference of the ICU admission days and death numbers between the two groups（P>0.05）. Conclusion：The ‘early hemodynamic intervention’ with EGDT liquid therapy for hypovolemic shock with unknown cause is of significant effect，but still not sufficient in the recovery process due to the fluid overload heart failure and the high incidence of pulmonary edema iatrogenic injury. Therefore，a hypothesis of searching the best pre-cardiac load in the capacity treatment phase is proposed.

Abstract:Objective：To compare the efficacy of 3% hypertonic saline and ambroxol hydrochloride in the treatment of moderate to se－vere bronchiolitis in children. Methods：The 121 children with bronchiolitis were graded when they were on admission according their state of an illness. They were divided into 2 groups randomly. Patients in one group were given aerosol inhalation with 3% hypertonic saline，while those in the other group were given aerosol inhalation with ambroxol hydrochloride，as well as the conventional treat－ment. Three days later，the two groups were all graded again according their state of an illness. Then the difference in efficacy and hospital stay were compared between the two groups. Results：There was no difference in the grades between the two groups when they were on admission（P >0.05）. Three days later，the grades of the two groups were significantly decreased than those before the treatment（P<0.05）. And there was no difference in grades between the moderate bronchiolitis of children（P=0.533）；the grades of severe bronchiolitis of children in the 3% hypertonic saline group were significantly decreased compared with those in the am－broxol hydrochloride group（P=0.013）. There was no difference in hospital stay between the two groups（P >0.05）. Conclusion：The therapies of 3% hypertonic saline and ambroxol hydrochloride are all effective for the moderate and severe bronchiolitis of children，but 3% hypertonic saline is more effective for severe bronchiolitis than ambroxol hydrochloride. There is no significant difference in the hospital stay between the 3% hypertonic saline group and ambroxol hydrochloride group for moderate and severe bronchiolitis of children.

Abstract:Objective：To analyze the drug susceptibility of M.tuberculosis isolates from suspected multidrug-resistant tuberculosis （MDR-TB） patients in Chongqing，so as to provide scientific evidence for MDR-TB discovery and control. Methods：Totally 573 M.tuberculosis isolates from suspected MDR-TB patients were collected from July 2014 to February 2016. Four kinds of first-line anti-TB drugs（INH，RFP，Sm，EMB） and six kinds of second-line drugs（Ofx，Km，Cm，Pto，PAS，Am） were tested for susceptibility by the proportion method. Results：Among the 573 suspected MDR-TB cases，143 cases（25.0%） were identified as MDR-TB，mean－while，55 cases（9.6%） were single drug-resistant tuberculosis（SDR-TB） and 46 cases（8.0%） were poly drug-resistant tuberculosis（PDR-TB）. The proportion of MDR-TB was significantly higher than that of SDR-TB and PDR-TB（P<0.001）. In terms of MDR-TB，the high risk groups had a higher drug resistance rate（26.6%，130/488） than the new patients（15.3%，13/85），P=0.026. Among the high risk groups，the detection rate of MDR-TB was the highest（42.1%，16/38） in the patients who failed in the re-treatment，fol－lowed by those failed in the initial treatment（40.0%，18/45）. Conclusion：The detection rate of MDR-TB is moderately high among the suspected MDR-TB patients in Chongqing. A long way remained to go in controlling MDR-TB. The screening for MDR-TB should target at high risk groups especially the patients failed in the re-treatment and initial treatment.

Abstract:Objective：To investigate the incidence and influential factors of retreatment smear of positive multidrug resistant tubercu－losis patients in Hainan province，and to provide reliable scientific basis for the prevention and control of multidrug-resistant tuber－culosis（MDR-TB）. Methods：From January 2014 to December 2016 ，a total of 694 cases of retreatment smear of positive tuberculosis patients were found in 18 cities and counties of Hainan province. Sputum samples were tested for drug susceptibility test to find the multidrug－resistant tuberculosis patients，and the multidrug－resistance rate was described. Chi-square test and an unconditioned lo－gistic regression were employed to analyze the influential factors of MDR-TB. Results：The retreatment smear positive MDR-TB rate was 18.4%（128/694）. The MDR-TB rates from 2014 to 2016 were 20.9%（49/234），16.2% （39/241） and 18.3%（40/219），and there was no significant difference of MDR-TB rate in the past 3 years in Hainan province（ ?字2=1.793，P>0.05）. The multivariate logistic analysis results showed that the agriculture（OR=1.692，CI=1.047 to 2.734，P<0.05），living in the western region（OR=1.588，CI=1.266 to 1.992，P<0.05），low family income（OR=2.153，CI=1.300 to 3.567，P<0.05），more than once prior anti-TB treatment（OR=1.860，CI=1.222 to 2.831，P<0.05），selecting private hospitals or individual clinics for first health care seeking（OR=1.668，CI=1.128 to 2.467，P<0.05） were found to contribute to higher trend of MDR-TB. Conclusion：The epidemic situation of MDR-TB in Hainan province is close to the national average level. The results indicate that agriculture，living in the western region，low family income，selecting private hospitals or individual clinics for first health care seeking and repeated treatment maybe the risk factors of multidrug resistance.

Abstract:Objective：To explore the clinical features，etiology，diagnosis and treatment of acute pancreatitis in pregnancy. Methods：From January 2010 to December 2016，16 patients with acute pancreatitis were enrolled in this study，and the data of clinical fea－tures，biochemical examination，B-mode ultrasound，computed tomography，therapeutic process and prognosis were retrospectively analyzed. Results：Fourteen cases were diagnosed as mild acute pancreatitis and 2 were as severe acute pancreatitis patients. Eleven of the total 16 patients had maternal live babies. In patients with mild acute pancreatitis，9 cases had fetal maturity（8 had cesarean section termination，1 had vaginal delivery）. For the other 5 cases whose gestational age were smaller，the disease symptoms were improved after conservative treatment. Two patients with severe acute pancreatitis who had hyperlipidemia ended pregnancy by cesarean section and were treated by internal medicine and discharged from hospital. Conclusion：The main pathogeny of pregnancy complicated acute pancreatitis are bile duct disease and hyperlipidemia. Blood，urine amylase and imaging examination are commonly used clinical examination at current. On the base of patients’ safety，individualized therapy should be adopted according to their clinical feature.

Abstract:Objective：To explore the effect of admission anemia on the prognosis 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 traumatic brain injury[Glasgow coma scale（GCS） 3 to 13]. The patients were divided into non-anemia group（Hb≥100 g/L） and anemia group（Hb<100 g/L） according to admission hemoglobin level. Non parametric test and chi square test was used to explore the differences between the groups. Multivariate logistic regression was used to identify risk factors related to mortality. Results：Totally 109 patients were enrolled and 17 patients among them died in hospital. The admission hemoglobin of 52 patients was less than 100 g/L. Compared with those of patients without admission anemia，the ages were younger，GCS and PTS were lower，and the length of hospital stay was longer in pa－tients with admission anemia（P<0.05）. Univariate analysis found that admission anemia，hyperglycemia，GCS<8，pediatric trauma score（PTS）<8，abnormal pupil reflex ratio and polytrauma significantly influenced mortality（all P<0.05）. Multivariate logistic regression analysis showed that admission anemia（AOR=9.383，95%CI=1.086 to 81.094，P=0.042），abnormal pupil reflex（AOR=23.121，95%CI=3.680 to 145.270，P=0.001） and admission hyperglycemia（AOR=15.181，95%CI=2.019 to 114.160，P=0.008） were independent risk factors for death in children with moderate or severe TBI. Conclusion：The admission anemia is an independent risk factor for the mortality of pediatric patients with moderate to severe TBI. And admission anemia is associated with prolonged hospital stay.

Abstract:Objective：To monitor the rules and characteristics of arrhythmia induced by aerosol inhalation of ventolin combined with ipratropium bromide，and to promote clinical rational drug use. Methods：A prospective study was conducted to observe the changes of heart rate before and after inhalation of ventolin combined with ipratropium bromide in 56 patients in Depart－ment of Respiratory Medicine of a three grade hospital. Results：Arrhythmia occurred in 7 cases（12.50%）. The occurrence of arrhythmia was not correlated with age and sex. Most arrhythmia occurs in 8 min after the start of atomization and 71.43% of the pa－tients with arrhythmia had abnormal ECG. Conclusion：In order to strengthen the safety of clinical medication，physicians and nurses should be aware of the adverse effects of inhalation of ventolin combined with ipratropium bromide on cardiac arrhythmias. And health care workers should be aware of rational use of drugs according to the patients’ condition. Observation of combined atomization should be strengthened to reduce and avoid the occurrence of arrhythmia.

Abstract:Spontaneous bacterial peritonitis（SBP） is a common and serious complication of cirrhosis and severe hepatitis with ascites. The mainly therapy is empiric antimicrobial therapy. SBP survivors should use antibiotics to prevent recurrence. With the widespread use of antibiotics，SBP caused by variety of drug-resistant bacteria increased in recent years. The new bacterial spectrum，empirical treatment and prevention need further study.

Abstract:Objective：To predict the epitopes of tree shrew retinol-binding protein 3（RBP3） and to validate its uveitogenic activity. Methods：BLAST was utilized to compare the amino acid sequence homology of RBP3 protein with the IRBP of human，Papio Anubis，bovine，rat and mouse by DNAMAN. The antigenic sites of T cell epitopes of RBP3 and their interaction with murine MHC class Ⅱ molecules were analyzed by DNAStar software. The B10.RⅢ mouse was immunized by the predicted RBP3182-192 antigen peptide and T cell proliferation assay was conducted to assess its immunogenicity and pathogenicity. Results：According to DNAMAN alignment analysis，the amino acid homology of the RBP3 protein in tree shrew with the IRBP of human，Papio anubis，bovine，rat and mice was 83.50%，82.81%，82.23%，82.94% and 82.63%，respectively. Our results showed that T cell epitope of the RBP3 protein con－tained 47 potential T cell epitopes and 34 antigen sites that interacted with murine MHC-Ⅱ molecule. Conclusion：Critically，experimental autoimmune uveitis（EAU） in B10.RⅢ mouse and T cell proliferation have also been successfully induced with the predicted RBP3182-192 antigen peptide，suggesting that the predicted T cell epitopes have uveitogenic activities and im－munogenicity.

Abstract:Objective：To analyze the dynamic changes of cerebrospinal fluid test results in early course in the neonatal purulent meningitis. Methods：In four hundreds and seven neonates who were admitted to five hospitals including the Children’s Hospital of Chongqing Medical University and Shanxi Provincial People’s Hospital during 2010 to 2014，thirty-eight full-term infants without any antibiotics before the lumbar puncture were enrolled in this study. The data were collected retrospectively. Children’s clinical manifestations and cerebrospinal fluid test results were collected to calculate their median for each parameter in different time peri－ods. The natural dynamic changes of cerebrospinal fluid test results without the antibiotic interference were analyｚed. Results：①Neonatal purulent meningitis often lacks the typical clinical manifestations. The main manifestations were fever（30/38，78.95%），and only about 1/3 of the cases have central nervous system involvement manifestations，like apathy or lethargy（14/38，36.84%） and/or convulsions（12/38，31.58%）. ②Most of the main indicators of cerebrospinal fluid within 24 hours were in the normal range. Within the passage of course of disease，there was a dynamic process in cerebrospinal fluid results. The results of cerebrospinal fluid exami－nation showed that，within the first week of the course，the cell number and protein of cerebrospinal fluid reached their peak on the third day and then began to decline. However，the concen－tration of sugar in cerebrospinal fluid was the lowest on the third day after the beginning of disease，and then increased. The chloride levels in cerebrospinal fluid increased only slightly on day 3. Conclusion：Lumbar puncture is the key experimental evi－dence of neonatal purulent meningitis，but we should be alert the false negative cerebrospinal fluid for the infants in early course. Re－peating the lumbar puncture in 2-3 days after the disease can often get more obvious abnormalities.

Abstract:Objective：To analyze the epidemiological characteristics and clinical features of human parainfluenza（HPIV） in hospital－ized children of the Children’s Hospital of Chongqing Medical University from January 2016 to December 2016. Methods：Cases with respiratory immunofluorescence to detect HPIV antigen among hospitalized children were selected. With the inclusion of HPIV as the only pathogen and exclusion of the non-standard cases，a total of 131 cases were enrolled and their clinical features were analyzed. Results：Among 19 632 cases of sputum specimens，there were 1 573 cases of HPIV antigen positive，of which 1 369 cases of HPIV3 （6.97%），184 cases of HPIV1（0.94%），and 20 cases（0.10%） of HPIV2；there were 1 002 male cases（8.21%），and 571 female cases（7.69%）（ χ2=1.660，P=0.203）. The infection rates of spring，summer，autumn and winter were 11.32%，13.21%，5.27% and 3.35%，respectively，and the difference of pairwise comparison was not statistically significant（ χ2=448.253，P=0.000）. There were 1 065 cases（8.80%） in infant group and 406 cases（9.97%） in children group（ χ2=5.054，P=0.025）. Diseases with HPIV as the only pathogen were listed：92 cases of alveobronchiolitis，17 cases of bronchitis，16 cases of pertussis syndrome and 11 cases of bronchiolitis. Conclusion：①HPIV is a common virus in lower respiratory tract infection of hospitalized children in the Children’s Hospital of Chongqing Medical University in 2016，commonly with HPIV3 infection. ②Comparative differences between men and women was not statistically significant，high in spring and summer，more frequently in infants and young children. ③The first four respiratory dis－eases in children with HPIV as the only pathogen are in turn alveobronchiolitis，bronchitis，pertussis syndrome and bronchi－olitis. Most of the children are obviously improved after symp－tomatic treatment.

Abstract:Objective：To observe the efficacy of entecavir in the treatment of chronic hepatitis B virus carriers（CHBc） from the im－munological perspective and to provide the basis for the treatment of chronic hepatitis B virus carriers. Methods：Sixty-one chronic hepatitis B virus carriers were enrolled as experimental group，thirty chronic hepatitis B（CHB） were enrolled as positive control group，thirty healthy people were enrolled as normal control（NC） in this study. CHBc and CHB groups received entecavir for 24 weeks，while NC group did not receive any treatment. Peripheral blood samples were collected before and after 24 weeks entecavir treatment. The frequencies of Treg，Th17 cells were detected by flow cytometric analysis，and the levels of IL-10，TGF-β1 and IL-17 were detected by enzyme-linked immunosorbent assay（ELISA）. Results：Before treatment，the ratio of Treg/Th17 in CHBc（18.58±10.79） group was higher than that in NC（6.26±3.29），CHB（2.68±1.39） groups（P=0.000），and NC group was higher than CHB（P=0.000） group. After 24 weeks entecavir treatment，the ratio of Treg/Th17 in CHBc and CHB groups decreased（P=0.000），and the CHBc（6.60±5.27） group was higher than that in NC（6.26±3.29），CHB（1.09±0.72） groups（P=0.000），and there was no sig－nificant difference between the NC and CHBc（P=0.986） groups. The ratio of Treg/Th17 in CHBc（r=0.827；r=0.353；r=0.391） and CHB（r=0.826；r=0.529；r=0.580） groups were positively correlated with HBV-DNA，HBsAg and HBeAg（P=0.000）. Conclusion：En－tecavir can regulate the immune response of chronic HBV carriers，reduce the ratio of Treg/Th17 and promote the clearance of HBV and HBV markers，forward may slow down the progress of liver fibrosis and cirrhosis. This study confirms that it is necessary for chronic HBV carriers to receive antiviral therapy，and the efficacy is good and safe.

Abstract:Objective：To lay the foundation for the health sector and to provide accurate disease dynamics and early warning by con－structing a variety of prediction models of hand，foot and mouth disease（HFMD） in Chongqing and to evaluate its effect. Methods：Three kinds of single prediction models（SARIMA，BPNN and Elman neural network） and three combined prediction models（SARI－MA-BPNN，SARIMA-Elman，BPNN-Elman） were established for the monthly incidence of HFMD in Chongqing from 2009 to 2014. The models were evaluated by using the monthly incidence data of HFMD in 2015，and the optimal warning model was selected to predict the incidence of HFMD in Chongqing from 2016 to 2017. Results：The results showed that the mean absolute error（MAE），mean error rate（MPAE），prediction accuracy（P），non-linear correlation coefficient（RNL） and mean relative error（MRE） of the SARIMA model，BPNN model，Elman model，SARIMA-BPNN，SARIMA-Elman，BPNN-Elman combined model respectively were 0.595，0.515，0.485，0.551，0.493；0.265，0.229，0.771，0.673，0.029；0.234，0.202，0.798，0.737，0.142；0.248，0.215，0.785，0.714，0.101；0.328，0.284，0.716，0.620，0.103；0.229，0.198，0.802，0.745，0.071. Through comprehensive evaluation of various indicators，the optimal prediction model is BPNN-Elman combination model. The average annual incidence of HFMD of the year 2016 and the year 2017 in Chongqing were 162.8/10 million and 160.9/10 million based on BPNN-Elman combination model with 95% confidence interval of -0.236 to 0.184. Conclusion：The BPNN-Elman combined model has the best prediction effect and can better predict the incidence of HFMD in Chongqing，which provides a scientific basis for prevention and treatment of HFMD.

Abstract:Objective：To assess the prevalence of human immunodeficiency virus（HIV），risky sexual behaviors and the influencing factors of multiple sex partners（≥2 partners） in last 6 months among male students who have sex with men（MSM） in Chongqing and Sichuan. Methods：We adopted non-probability sampling method to recruited students MSM，and 200 students MSM were recruited to finish the survey and field HIV testing. Frequency was used to analyze the prevalence of HIV and logistic regression was used to analyze the influencing factors of multiple sex partners（≥2 partners） in last 6 months among student MSM. Results：There were 200 questionnaires and 193（96.50%） valid questionnaires. HIV antibody positive rate was 8.29%，the HIV antibody posi－tive detection rate of student who studied at secondary school（including high school，technical secondary school and professional high school），junior college and university and above were 17.95%，8.33% and 5.08%，respectively. The HIV antibody positive detection rate whose registered permanent residence was rural and not-receiving HIV testing were 12.70% and 11.11%，respectively. In the last month，82.47%（127 persons） did not use condom ev－ery time when they had sexual intercourse. In the last 6 months，51.81%（100 persons） had multiple sexual partners（≥2 partners）. Logistic regression showed that contributing factors of multiple sex partners（≥2 partners） in last 6 months were student who studied at junior college（OR=4.270，P=0.0083），student who studied at University and above（OR=3.523，P=0.0043），having male sex partner via internet in last 6 months（OR=5.622，P<0.0001），and having unprotected sex intercourse in last 1 month（OR=2.255，P=0.0201）. Conclusion：In Chongqing and Sichuan，the prevalence of HIV infection among secondary school and college students MSM is high，especially among secondary school students MSM and students whose registered permanent residence is rural. And also in Chongqing and Sichuan，high-risk sexual behavior and having had multiple sex partners are still commonly seen among students MSM students. Interventions are needed to prevent HIV transmission in this population．

Abstract:Objective：To know about the human immunodeficiency virus（HIV） testing status and its influencing factors among men who have sex with men（MSM） students during the latest year. Methods：In Chongqing，Sichuan，Guangxi and Xinjiang regions，convenience sampling in different ways was used and 291 MSM students were recruited to finish the survey and field HIV testing. Results：There were 291 questionnaires and 288（98.97%） valid questionnaires. HIV testing rate in latest year was 58.68%. HIV antibody positive rate was 5.90%. Logistic regression showed that contributing factors for having HIV testing during the latest year were aged over or equal to 22（OR=2.59，95%CI=1.24-5.42，P=0.012），acquired immune deficiency syndrome（AIDS） knowledge score over 10（OR=2.45，95%CI=1.37-4.39，P=0.003），and having free AIDS counseling initiatively（OR=6.64，95%CI=3.80-11.60，P=0.000）. Conclusion：The HIV testing rate during latest year is not high among MSM students in Chongqing，Sichuan，Guangxi and Xin－jiang provinces. The influencing factors are age，AIDS knowledge score，and having free AIDS counseling initiatively.

Abstract:Idiopathicpolypoidal choroidal vasculopathy（IPCV） is a retinal disease which is characterized by the choroid presence of polyp-like lesions and branching vascular network（BVN）. The clinical manifestations of PCV are subretinal hemorrhage or fluid ac－cumulation,persistent leakage，recurrently serous pigment epithelial detachment（PED） or serous neurosensory detachment. In recent years，more attention has been paid to the treatment of the disease and considerable progress has been made，however，it remains just controversial enough to getting the best treatment of PCV. Aiming at the problem，this paper gives a brief review of the treatment of IPCV published in recent years.

Abstract:Objective：To study the impact of miR-142 on corneal neovascularization formation and related mechanism. Methods：Con－trol group，negative group，overexpression miR-142 group and knockdown miR-142 group were arranged. Mimic and inhibitor of miR-142 were used to overexpress or knock down miR-142，respectively. CCK-8 proliferation assay was performed to evaluate the im－paction of miR-142 on proliferative ability of human umbilical vein endothelial cells（HUVECs）. Dual-luciferase reporter gene system was used to verify whether AKT2 is the target of miR-142. RT-PCR and Western blot were used to detect effect of miR-142 on AKT2. Results：Results of CCK8 assay showed that absorbance（A） of control group，negative group and overexpression miR-142 group was 872.21±44.20，842.16±49.54，1 407.91±16.58，and the results had statistical significances（F=102.8，P=0.000）. Knockdown miR-142 significantly weakened the proliferation rate of HUVECs（control group=919.69±25.46，negative group=943.43±40.53，knockdown miR-142 group=602.77±25.62，F=72.8，P=0.000）. Consequence of dual-luciferase report gene system indicated that AKT2 wasn’t the target of miR-142（control group=0.36，overexpressed miR-142 group=0.46，P=0.147）. RT-PCR assay revealed that expression level of AKT2 was upregulated by overexpressing miR-142（0.408±0.046） than negative group（0.173±0.022）（P=0.018）；inhibition of miR-142 blocked the expression of AKT2（negative group=0.362±0.068，down-regulated miR-142 group=0.160±0.019，P=0.037）. Western blot assay verified the regulation of miR-142 on AKT2. Further study showed that the facilitation of miR-142 on proliferation of HUVECs was thoroughly blocked by shRNA-AKT2，results of control，overex－pressed miR-142，overexpressed miR-142+shRNA-AKT2 and shRNA-142 were 981.80±75.40，1 357.81±47.56，806.39±49.70，921.59±40.38，respectively，and the results had statistical significances（F=40.97，P=0.000）. Conclusion：miR-142 facilitates the proliferation of HUEVCs via up-regulating AKT2，suggesting that miR-142 could promote the formation of corneal neovascularization.

Abstract:Objective：To explore the inhibitory effect of curcumin on inflammatory responses induced by lipopolysaccharide （LPS） in retinal pigment epithelial（RPE） cells. Methods：ARPE-19 cells were cultured in vitro. Before being stimulated with or without LPS （5 μg/mL），ARPE-19 cells were pre-incubated with different concentrations of curcumin（5，10，20，30，40 ?滋mol/L）. The optimum con－centration of curcumin was detected by CCK-8 assay. The mRNA level of IL-6 and IL-8 was measured by real-time polymerase chain reaction（RT-PCR） and their protein expression was detected by enzyme-linked immunosorbent assay（ELISA）. Protein expres－sion levels of IκB-α and p-IκB-α were examined by Western blot. Results：The CCK-8 results showed that the activities of ARPE-19 cells were not affected by different concentrations of curcumin（P5 ?滋mol/L=0.998，P10 ?滋mol/L=1.000，P20 ?滋mol/L=0.124，P30 ?滋mol/L=0.092，P40 ?滋mol/L=0.078）. Curcumin was indicated to be able to protect ARPE-19 cells since pre-treatment with different concentrations of curcumin following by LPS administration. This protection resulted with a maximal protective effect at 20 μmol/L（P=0.041）. The RT-PCR results indicated that the relative mRNA level of IL-8 in curcumin+LPS group（4.965±3.863） was significantly lower than that in LPS group（106.331±37.314）（P=0.000） and the relative mRNA level of IL-6 in curcumin+LPS group（0.992±0.374） was significantly lower than that in LPS group（2.175±0.560）（P=0.005）. The ELISA results showed that protein expression of IL-8 in curcumin+LPS group[（191.600±18.773） pg/mL] was significantly lower than that in LPS group[（589.025±38.880） pg/mL]（P=0.000） and protein expression of IL-6 in curcumin+LPS group[（113.906±27.947） pg/mL] was significantly lower than that in LPS group[（243.380±38.001）pg/mL]（P=0.000）. Meanwhile，the Western blot results indicated that pre-treatment with curcumin inhibit－ed the phosphorylation of IκB-α（P=0.001） mediated by LPS stimulation. Conclusion：Curcumin inhibits the inflammatory responses induced by LPS via suppression NF-κB activity and protects retinal pigment epithelial cells.

Abstract:Objective：To study the relationship between diopter，anterior corneal aberration and ocular aberration in myopic eyes.Methods：Totally 74 patients（144 eyes） were recruited before corneal refractive surgery. All patients underwent the following exami－nations including mean spherical equivalent（SE），anterior corneal aberration（sirius，CSO），total aberration（wavefront analyzer，VISX）. The root mean square（RMS） of all order aberration（AOA），high order aberration（HOA），coma aberration（Coma），trefoil aberration（Trefoil），spherical aberration（Spherical），vertical coma（Z3-1），horizontal coma（Z31）were collected and the anterior corneal and total aberration measurements were performed on eyes with 6 mm pupil diameter. All data were dealt with Paired sample t-test and Pearson correlation analysis and P<0.05 was considered statistically significant difference. Results：The HOA，Coma，Trefoil and Spherical were significantly lower in ocular aberration than in the anterior corneal high-order aberration，with statistically significant differ－ences（P<0.05），and there was no significant difference in Z3-1 and Z31（P＞0.05）. There was no correlation between the diopter and all of the anterior corneal aberrationsboth in the group of SE≤-6.00 D（89 eyes） and group of SE＞-6.00 D（55 eyes）. The correlation coefficients（r） between diopter and anterior corneal surface aberrations in the group of SE≤-6.00 D were 0.086，0.074，0.060，0.066，0.054，0.112，-0.069，P＞0.05 and in the group of SE＞-6.00 D were 0.522，0.827，0.975，0.497，0.106，0.148，0.226，P＞0.05；significant correlation between the diopter and ocular aberration AOA was observed both in the groups of SE≤-6.00 D（r=0.741） and SE＞-6.00 D（r=0.962）（P＜0.01）. There was significant correlation between the diopter and Spherical of the whole eye in the groups of SE＞-6.00 D（r=0.346，P<0.05）. Conclusion：The intraocular HOA，Coma，Trefoil and Spherical exert compensation effect on the aber－rations of the anterior corneal to reduce the total ocular aberrations. The effect of intraocular Z3-1，Z31 on anterior corneal high order aberration show partial compensation and partial superposition among subjects. The diopter exert obvious effect on low-order aberra－tions of the ocular aberration and spherical aberration of higher-order aberrations，but has no effect on anterior corneal aberrations.

Abstract:Objective：To investigate the effect of carboxymethylcellulose sodium eye drops on the diabetic cataract patients with dry eye after phacoemulsification. Methods：A total of 117 patients underwent operation（151 eyes） with diabetic cataract referred to our hospital from June 2015 to June 2016 were enrolled in the study. Patients were randomly divided the control group（61 patients，84 eyes） and treatment group（56 patients，67 eyes）. The routine antibiotic and anti-inflammatory eye drops were used in control group，while treatment group was received carboxymethylcellulose sodium eye drops therapy except the routine treatment. Tear break-up time，Schimer I test，cornea fluorescein staining were measured，as well as subjective symptoms were graded before and on 1 day，at 1 week，1 month and 2 months after phacoemulsification and intraocular lens implantation. Results：All the subjective symptoms were worse，tear break-up time was shorter，S I t was prolonged and cornea fluorescein staining on epithelium was more commonly seen post-operation as compare to pre-operation（P<0.05）. The subjective symptoms grade and tear break-up time were still worse than the conditions that before operation in the control group 2 months post-operation（P<0.05）. However，the subjective symptoms grade，tear break-up time and cornea fluorescein staining on epithelium 1 month post-operation was similar to that pre-operation conditions（P>0.05），and all the post-opertation index were better in the treatment group than that in control group（P<0.05）. Conclusion：The carboxymethylcellulose sodium eye drops could efficiently relieve the symptoms of dry eye and maintain the tear film stable for the diabetic cataract patients underwent phacoemulsification.