Abstract:As a minimally invasive treatment，high focused ultrasound（HIFU） has the advantages of less trauma and fewer complica－tions than surgery，and has been widely used in the treatment of tumors. In recent years，HIFU has been widely performed to treat lo－calized prostate cancer. This article reviews current applications of HIFU in prostate cancer.

Abstract:Objective：To investigate the role of inositol polyphosphate 4-phosphatase typeⅡ（INPP4B） in the in vitro proliferation and apoptosis of human acute myeloid leukemia THP-1 cells and the potential mechanism. Methods：Human THP-1 cells were transfect－ed with recombinant plasmid vector pEAK-Flag/INPP4B which carried INPP4B（Flag-INPP4B group），and untreated cells were estab－lished as control group（Mock group）. Western blot and qRT-PCR were used to measure the protein and mRNA expression of INPP4B in the experimental group and the control group；CCK-8 assay was used to assess in vitro proliferative capacity；flow cytometry was used to measure cell apoptosis；Western blot was used to measure the levels of apoptosis-related proteins Bcl-2-associ－ated X/B-cell lymphoma-2（Bax/Bcl-2） and the phosphorylation levels of downstream signal molecules of phosphoinositide-3 kinase（PI3K） protein kinase B（PKB/Akt） and serum and glucocorticoid regulated kinase-3（SGK3）；ELISA was used to measure the levels of PI（3，4）P2 and PI（3）P in cells. Results：After THP-1 cells were transfected with INPP4B recombinant plasmid vector，there were significant increases in the mRNA and protein expression of INPP4B（mRNA：t=9.724，P=0.000；protein：t=19.520，P=0.000），suggesting that INPP4B was successfully overexpressed in THP-1 cells. Compared with the Mock group，the Flag-INPP4B group had a significant increase in vitro proliferative capacity（F=31.870，P=0.000）. Furthermore，INPP4B overexpression significantly reduced the apoptosis rate of THP-1 cells（t=6.999，P=0.002） and the expression of the pro-apoptotic protein Bax（t=24.710，P=0.000） and significantly increased the level of the anti-apoptotic protein Bcl-2（t=6.398，P=0.003）. In addition，INPP4B overexpression significantly increased the phosphorylation level of SGK3 in THP-1 cells（t=10.470，P=0.000），while it did not affect the phosphorylation level of AKT（t=0.285，P=0.790）. INPP4B overexpression also significantly reduced the level of PI（3，4）P2 in THP-1 cells（t=4.515，P=0.011） and significantly increased the level of PI（3）P in THP-1 cells（t=5.681，P=0.005）. Conclusion：INPP4B can promote in vitro proliferation of human acute myeloid leukemia THP-1 cells and inhibits cell apoptosis，possibly by mediating activation of the PI3K/SGK3 signaling pathway，which suggests that INPP4B might be a potential target for the treatment of acute myeloid leukemia.

Abstract:Objective:To study the characteristics of hydroxymethylation of dapper，antagonist of beta-catenin，homolog 1（Xenopus laevis）（DACT1） in childhood acute myeloid leukemia（AML） and its relationship with prognosis，and to identify the new molecular marker for the risk classification of AML. Methods：This study included 188 newly diagnosed AML cases in Department of Hematology，The Children’s Hospital of Chongqing Medical University. Sanger sequencing was employed to analyze the mutation in Wilms’ tumor 1（WT1），isocitrate dehydrogenase 1/2（IDH1/2），or ten-eleven translocation（TET2）. These cases were assigned to either WIT-AML group（n=30） or non-WIT-AML group（n=158） according to the presence or absence of mutation in any of the above genes. The hydroxymethylation（5-hydroxymethylcytosine，5hmC） level of the DACT1 gene and the expression of DACT1 were assessed using glycosylation qPCR and qPCR for 16 WIT-AML cases，14 non-WIT-AML cases，and 14 non-AML cases. The correlation between the hydroxymethylation and expression of DACT1 was investigated by Spearman analysis. Data on the remission，relapse，and survival of children were acquired by follow-up. Cox regression analysis was employed to assess the effect of DACT1 hydroxy-methylation on the overall survival（OS） and event-free survival（EFS） rates of children with AML. Results：Compared with the non-WIT-AML group，the WIT-AML group had a significantly lower 5hmC level at the CpG island of DACT1 a/b（Ua=48.00，Pa=0.008；Ub=19.00，Pb=0.000），as well as significantly reduced DACT1 expression（Uexp=0.00，Pexp=0.000）. Moreover，DACT1 a/b 5hmC level was positively correlated with DACT1 expression（ra=0.812，Pa=0.000；rb=0.789，Pb=0.000）. Reduced DACT1a 5hmC was associated with shorter survival（EFS：hazard ratio[HR]=3.896，95% confidence interval[CI]=1.161-13.073，P=0.028；OS：HR=4.109，95%CI=1.226-13.771，P=0.022）. Conclusion：In WIT-AML，DACT1 5hmC level and DACT1 expression are significantly decreased. Reduced DACT1a 5hmC is associated with shorter survival in children with AML，so it can be used as an independent unfavorable prognostic biomarker for childhood AML.

Abstract:Objective：To investigate the effect of silencing NUPR1 on autophagy in human multiple myeloma（MM） U266 cells and its possible mechanism. Methods：Normal human bone marrow mononuclear cells were taken as control，and quantitative real-time PCR（qRT-PCR） was used to detect the mRNA level of NUPR1 and autophagy-related genes（ATG5 and Beclin1） in MM U266 cells. The NUPR1 shRNA lentiviral vector containing the small hairpin RNA（shRNA） targeting NUPR1 gene was constructed and transfected into MM U266 cells. The experiment was divided into parental group，control shRNA-transfected group and NUPR1 shRNA-trans－fected group. The interference effects of NUPR1，the expression of autophagy related genes（ATG5，Beclin1，P62，LC3Ⅱ/LC3Ⅰ） and related pathway proteins（p-AKT/T-AKT，p-mTOR/T-mTOR） were detected by qRT-PCR and Western blot. Autophagy was mea－sured by monodansylcadaverine（MDC） under fluorescence microscope. Results：The mRNA level of NUPR1（F=7.747，P=0.004），Be－clin1（F=5.548，P=0.013） and ATG5（F=4.031，P=0.034） in MM U266 cells were significantly higher than those in normal human bone marrow mononuclear cells and NUPR1 shRNA-transfected group cells. The expression of NUPR1（F=9.798，P=0.013），ATG5 （F=7.017，P=0.027），Beclin1（F=7.213，P=0.025） and LC3Ⅱ/LC3Ⅰ（F=7.040，P=0.027） at protein level in NUPR1 shRNA-trans－fected group was significantly lower than that in parental group and control shRNA-transfected group，while the expression of P62 （F=52.622，P=0.000），p-AKT/T-AKT（F=6.584，P=0.031） and p-mTOR/T-mTOR（F=7.950，P=0.021） was the opposite. Moreover，the downregulation of NUPR1 suppressed autophagy in U266 cells（F=12.172，P=0.008）. Conclusion：The expression of NUPR1 in MM U266 cells is higher than that in normal human bone marrow mononuclear cells. Silencing NUPR1 can down-regulate the autophagy of U266 cells. The NUPR1 gene may regulate autophagy in U266 cells through the AKT/mTOR signaling pathway.

Abstract:Objective：To investigate the expression and clinical significance of T-cadherin in patients with acute promyelocytic leukemia（APL）. Methods：A total of 60 patients with APL and 60 healthy subjects who underwent physical examination were en－rolled，and immunohistochemistry was used to measure the expression of T-cadherin in bone marrow biopsy samples. The association of the expression of T-cadherin with clinicopathological features, clinical outcomes, and survival/prognosis was analyzed. Results：The low and high expression rates of T-cadherin were 71.7% and 28.3% in APL patients and 25.0% and 75.0% in healthy subjects，and there was a significant difference between the two groups（?字2=26.162，P=0.000）. In APL patients，the expression of T-cadherin in bone marrow biopsy samples was associated with risk classification，percentage of promyelocytes，and recurrence（all P<0.05） and was not associated with age，sex，white blood cell count，hemoglobin，and platelet count（all P>0.05）. The multivariate Cox regression analysis showed that risk classification，percentage of promyelocytes，and low expression of T-cadherin were independent factors for recurrence in patients with APL（all P <0.05）. The low-T-cadherin expression group had a remission rate of 62.8% and an overall response rate of 69.8%，and the high-T-cadherin expression group had a remission rate of 88.2% and an overall response rate of 94.1%；there was no significant difference between the two groups（both P>0.05）. The log-rank test revealed that the five-year survival rate was 53.5% in APL patients with low expression of T-cadherin and 82.4% in those with high expression（?字2=4.294，P=0.035）. The Kaplan-Meier survival analysis showed that the patients with low expression of T-cadherin had a significantly lower 5-year survival rate than those with high expression（P=0.045）. Conclusion：There is low expression of T-cadherin in APL patients，which is associated with risk classification，percentage of promyelocytes，and recurrence. Therefore，T-cadherin may be an important predictor for survival/prognosis.

Abstract:Objective：To prepare the ultrasound microbubbles loaded with the cytidine deaminase-thymidine kinase（CD-TK） double suicide gene，and to investigate its killing effect on lung cancer. Methods：The microbubbles loaded with the CD-TK double suicide gene were prepared，and their morphology and size were observed. Propidium iodide was used for the staining of plasmids to observe fluorescence and calculate the binding rate of microbubbles and genes. Lung cancer H1299 cells were cultured and a nude mouse model of lung cancer was established. The cells were randomly divided into control group，ultrasound（U）+microbubble（M）+CD-TK group，U+M+CD-TK+5-fluorcytosine（5-FC） group，U+M+CD-TK+ganciclovir（GCV） group，and U+M+CD-TK+5-FC+GCV group，with 1×107 cells in each group. The lung cancer H1299 cells were transfected with the microbubbles，and after 24 hours，the expression of green fluorescent protein（GFP） was observed and the effect of GFP transfection and 24-hour apoptosis and cell cycle were measured. In the animal experiment in vivo，there were 6 nude mice in each group；the mice in the control group were treated with the injection of 200 μL phosphate-buffered saline，and those in all the other groups were given the tail vein injection of an equal volume of the microbubbles loaded with the CD-TK double suicide gene. The development of microbubbles was observed，and gene transfec－tion was performed at the tumor site by ultrasound irradiation. Intraperitoneal injection of 5-FC and GCV was performed for one week. The longest and shortest diameters of the tumors of each nude mouse were recorded every week，and the change in tumor volume was calculated and recorded. Tumor samples were collected for the nude mice at week 5；immunofluorescence assay was used to measure the expression of TdT（the TUNEL method） and proliferating cell nuclear antigen（PCNA），and cell apoptosis and proliferation in tumor tissue were assessed. Results：The microbubbles loaded with the CD-TK double suicide gene were successfully prepared. 5-FC and GCV combined with ultra－sound microbubbles loaded with CD-TK double suicide gene had a marked therapeutic effect and significantly promoted apoptosis[an apoptosis rate of (28.45±1.75）%] and inhibited proliferation[（61.40±4.31）% cells in S phase），with a significantly better effect than the control group（P=0.000），the 5-FC group（P=0.002），and the GCV group（P=0.012）. The U+M+CD-TK+5-FC+GCV group had the lowest tumor volume and weight，the highest number of apoptotic cells，and the most significant inhibition of proliferation. Conclusion：5-FC and GCV combined with ultrasound microbubbles loaded with the CD-TK double suicide gene can promote the apoptosis and inhibit the proliferation of lung cancer cells and thus have a marked killing effect on lung cancer.

Abstract:Objective：To investigate the effects of cancer-associated fibroblast（CAF） on migration of human breast cancer BT549 and MDA-MB-231 cells and its possible molecular mechanism. Methods：Effects of CAF on migration of BT549 and MDA-MB-231 were measured by transwell migration test after treated with CAF supernatant. Effects of CAF on migration related proteins E-cadherin and Vimentin were investigated by Western blot after treated with CAF supernatant. After treating the human breast cancer cell line BT549 and MDA-MB-231 with CAF supernatant，SB203580 was used to inhibit the p38/MAPK pathway，then Transwell migration assay and Western blot were used to detect the changes of migration and the expressions of E-cadherin and Vimentin in BT549 and MDA-MB-231 cells respectively. Results：CAF increased the number of migration cells in BT549 and MDA-MB-231 breast cancer cells（P<0.05），inhibited the expression of E-cadherin（P<0.01） and up-regulated the expression of Vimentin in BT549 and MDA-MB-231 cells（P<0.05）. CAF activated the p38 /MAPK signaling pathway of BT549 and MDA-MB-231 breast cancer cells and promoted the expression of p-P38 protein（P<0.01）. The ability of CAF to increase the number of migration cells in BT549 and MDA-MB-231 cells was significantly inhibited（P<0.01），and the expression of E-cadherin protein was up-regulated（P<0.05），while the expression of Vimentin protein was down-regulated（P<0.01） after SB203580 inhibited the p38/MAPK pathway. Conclusion：CAF promotes migration of human breast cancer BT549 and MDA-MB-231 cells via activating the p38/MAPK signaling pathway.

Abstract:Objective：To investigate the effect of proteasome activator complex subunit 3（PSME3） on the invasion and metastasis of triple-negative breast cancer（TNBC） and its mechanism. Methods：The samples collected from TNBC patients were used to detect the expression of PSME3 by immunohistochemistry. The TNBC cell line MDA-MB-231 was used to construct PSME3 overexpression and interference stable strains using the lentiviral packaging system. The mRNA expression of PSME3 was determined by real-time PCR and the protein expression of PSME3 was measured by Western blot. The cell lines were divided into PSME3 overexpression（exPSME3） group，short hairpin RNA targeting PSME3（shPSME3） group，and wild-type control group. When Western blot was used to identify stable strains，PSME3 expression negative control（exNC） group and short hairpin RNA targeting negative control（shNC） group were included in order to exclude the effect of the vector itself on PSME3 expression. The cell migration ability and in－vasion ability were evaluated by wound healing assay and Tran－swell assay，respectively. The expression of vascular endothelial growth factor-A（VEGF-A） and matrix metalloproteinase-9（MMP-9）（migration-related proteins） in each group was mea－sured by Western blot. The protein expression of nuclear factor-kappaB（NF-kappaB） and its active group — phosphorylated-P65（P-P65） was determined by cell slide immunofluorescence and Western blot，respectively. Results：Immunohistochemical results showed that PSME3 expression was significantly higher in the tumor tissues of TNBC patients than in the adjacent tissues（t=36.700，P=0.000）. The wound healing assay indicated that compared with the control group，the migration ability was significantly higher in the exPSME3 group（P=0.000） and significantly lower in the shPSME3 group（P=0.009）. Western blot results showed that compared with the control group，the expression of VEGF-A and MMP-9 was signif－icantly higher in the exPSME3 group and significantly lower in the shPSME3 group. Transwell assay revealed that compared with the control group，the invasion ability was significantly higher in the exPSME3 group（P=0.000） and significantly lower in the shPSME3 group（P=0.000）. Cell slide immunofluorescence results showed that there was no significant difference in the expression of NF-kappaB between the three groups；compared with the control group，the expression of P-P65 was significantly higher in the exPSME3 group（P=0.001） and significantly lower in the shPSME3 group（P=0.001），which was in accordance with Western blot results. Conclusion：The PSME3-NF-kappaB pathway can mediate the invasion and metastasis of TNBC.

Abstract:Objective：To explore the expression of DDIT4（DNA damage-inducible transcript 4） in human cutaneous basal cell carcinoma（BCC） tissues and its regulating effects on cellular protein synthesis，proliferation and autophagy flux of the downstream signals involved in. Methods：Immunohistochemistry and Western blot were used to detect the expressions of DDIT4，pS6K1，p4E-BP1 and LC3 Ⅱ/Ⅰ in 15 cases of human skin BCC and 15 cases of normal skin tissues respectively. Results：The expression of DDIT4（0.247±0.152，P=0.005） in BCC was significantly inhibited as compared with that in the normal tissues. Meanwhile the expression of p4E-BP1（0.290±0.169，P=0.015） and ratio of LC3 Ⅱ/Ⅰ（0.692±0.154，P=0.007） were decreased，but the expression of pS6K1 （0.837±0.050，P=0.000） was significantly increased. Conclusion：DDIT4 expression is inhibited in human BCC cells，which may promote the downstream protein synthesis and proliferation，and inhibit the autophagy flux through the mTORC1 pathway to finally involve in the pathogenesis and development of BCC. DDIT4 and its downstream signals may serve as target for the further treatment and prognosis of BCC.

Abstract:Objective：To establish a mouse model of associating liver partition and portal vein ligation for staged hepatectomy （ALPPS），and to investigate the association of the interleukin-6（IL-6）/STAT3 signaling pathway with liver regeneration promoted by ALPPS. Methods：A total of 45 BALB/C mice were randomly divided into ALPPS group，portal vein ligation（PVL） group，and sham-operated group（SHAM group），with 15 mice in each group. The PVL group was treated with ligation of the portal vein branches for the left lateral lobe，the right side of the middle lobe，and the right lobe while preserving the blood flow in the portal vein branches for the left side of the middle lobe and the caudate lobe. The ALPPS group was treated with partition of the middle lobe along the demar－cation line in addition to the treatment in the PVL group. The SHAM group was treated by dissociating the liver lobes along the hepatic ligaments. The plasma level of alanine aminotransferase（ALT） was measured to evaluate liver function after ALPPS and PVL. The liver regeneration index was used to evaluate liver regeneration. The expression of Ki-67 protein was measured by immunohistochemistry to evaluate the proliferation of hepatocytes. Western blotting was used to examine the change in the IL-6/STAT3 signaling pathway in liver tissue. Results：At 48 hours after surgery，the ALPPS group had a significantly higher ALT level than the PVL group（P=0.000）；from 48 to 96 hours after surgery，both ALPPS and PVL groups had a reduction in ALT level，and there was no signifi－cant difference in ALT level between the ALPPS group and the PVL group at 96 hours after surgery（P=0.094）. At 48 and 96 hours after surgery，the ALPPS had significantly higher liver regeneration index（P48 h=0.000，P96 h=0.000） and percentage of Ki-67-positive hepatocytes（P48 h=0.001，P96 h=0.000） than the PVL group. At 48 hours after surgery，the ALPPS group had significantly higher expression of IL-6 protein and phosphorylation of STAT3 protein than the SHAM group（PIL-6=0.000，PpSTAT3=0.000） and the PVL group（PIL-6=0.011，PpSTAT3=0.003）. Conclusion：A mouse model of ALPPS was successfully established. Compared with PVL，ALPPS can better promote liver regeneration and the IL-6/STAT3 signaling pathway and is closely associated with ALPSS-mediated liver regener－ation in mice.

Abstract:Objective：To explore the antitumor effect of dendritic cells（DCs） vaccine targeting aspartate-β-hydroxylase（AAH） gene against hepatocellular carcinoma（HCC） cells HepG2 and Huh7 for searching DCs vaccine for hepatocarcinoma. Methods：AAH-DCs vaccine was prepared in vitro via infecting DCs with recombinant adenovirus vector encoding AAH. T cells co-cultured with AAH-DCs vaccine were served as the effector cells and human HCC cell lines HepG2 and Huh7 were regarded as the target cells. The prolifer－ation and apoptosis of target cells，after co-culturing with the effector cells for 24h，were detected by CCK-8 and FCM analysis re－spectively. C57BL/6 mice were immunized with AAH-DCs vaccines by three continuous subcutaneous injections，and the cytotoxic effect of T cells against target cells was observed by lactate dehydrogenase（LDH） release assay. Results：Compared with the control groups，the declined proliferation activity of target cells in AAH-DCs vaccine group was found by CCK-8，while increased apoptosis rate of target cells in AAH-DCs vaccine group was tested by FCM（P=0.000）. Additionally，LDH release assay showed that the cytolysis effect of target cells in AAH-DCs vaccine group was higher than that in other control groups（P=0.000）. Conclusion：DCs vaccines targeting AAH can induce the production of cytotoxicity T lymphocytes for fulfilling the killing of HCC cells expressing AAH gene.

Abstract:Objective：To investigate the level of oxidative stress and Klotho promoter methylation in the plasma of patients with non-small cell lung cancer（NSCLC） and their clinical significance. Methods：Plasma samples were collected from 66 patients，who were diagnosed with NSCLC in Sichuan Provincial People’s Hospital（as observation group），and 50 healthy people（as control group）. Assay kits were used to determine the levels of superoxide dismutase（SOD），malondialdehyde（MDA），and catalase（CAT） in plasma. The mRNA and protein expression of Klotho in plasma was measured/determined by qPCR and Western blot，respectively. Pearson correlation analysis was performed for the correlation between Klotho expression level and oxidative stress. Klotho methylation level was determined by methylation-specific PCR（MS-PCR）. The methylation rate of CpG islands was determined by pyrosequencing. Results：Compared with the control group，the observation group had significantly reduced levels of SOD[（79.86±18.24） mU/L vs. （94.56±16.40） mU/L，t=4.487，P=0.000] and CAT[（18.50±4.62） U/mg vs. （25.26±3.54） U/mg，t=8.605，P=0.000]，but there was no significant difference in MDA level between the observation group and the control group[（2.87±2.26） pg/mL vs. （2.52±1.06） pg/mL，t= 1.675，P=0.097]. The mRNA and protein expression levels of Klotho in plasma were significantly lower in the obser－vation group than in the control group（mRNA：0.66±0.16 vs. 1.04±0.10，t=14.93，P=0.000；protein：0.70±0.20 vs. 1.04±0.10，t=10.92，P= 0.000）. There was a positive correlation between the protein expression of Klotho and the levels of SOD（r=0.768，P=0.000） and CAT（r=0.708，P=0.000）. Meanwhile，the observation group had an increased methylation level of CpG islands in the Klotho promoter. Conclusion：Klotho methylation may be a clinical marker of oxidative stress in the plasma of patients with NSCLC.

Abstract:Objective：To evaluate the effect of nutritional support therapy on the clinical efficacy of nueroblastoma（NB）. Methods：A total of 106 children with NB admitted from October 2014 to December 2016 were enrolled and divided into the nutrition treatment group（group A，52 cases） and non-nutritional treatment group（group B，54 cases）. The nutritional status of the two groups at the ini－tial diagnosis was evaluated，and the nutritional indicators，the incidence of complications and the health economics index of the two groups after operation and chemotherapy were analyzed respectively. Results：①The middle upper arm circumferences of the children in group A at the initial diagnosis，after operation and after chemotherapy were （8.2±2.6），（9.5±2.2），and （9.8±2.0） cm respec－tively，while those in group B were （7.0±2.3），（6.5±1.4），（6.5±1.2） cm respectively. The deltoid skin fold thicknesses of the children in group A were （4.8±1.2），（6.2±1.6），（6.4±1.5） mm respectively，while those in group B were （3.9±3.4），（4.5±1.2），（4.6±1.1） mm respectively. The difference between the two groups was significant（P<0.05），and the differences among each two of the three time points in group A were also significant（P<0.05），while which in group B were not significant（P>0.05）. ②Postoper－ative wound dehiscence and infection complications in children were 1.9% in group A and 18.5% in group B，and the difference between the two groups was significant（P<0.05）. ③After 4 courses of chemotherapy，the incidences of myelosuppression，gastrointestinal symptoms and respiratory tract infection in group A were significantly lower than those in group B（P<0.05）. ④The average hospitalization duration，times，and cost，and the unplanned readmission rate in group A were also significantly lower than those in group B（P<0.05）. Conclusion：The standardized nutrition support treatment for NB children can effectively improve the nutritional status，reduce the incidence of complications caused by surgery and chemotherapy，and improve the tolerance of children to tumor treatment.

Abstract:Objective：To discuss the risk factors which influence prognosis and the incidence of secondary bladder cancer in patients with primary ureteral carcinoma. Methods：The clinical data of 58 patients were retrospectively analyzed. All patients were pathologi－cally diagnosed with primary ureteral carcinoma in the First Affiliated Hospital of Chongqing Medical University from June，2010 to September，2017 and then treated by operation. Clinical and pathological factors，seven on prognosis and five on the incidence of sec－ondary bladder cancer，were collected and analyzed with univariate analysis and multivariate analysis respectively. Results：Univariate analysis identified three factors that were associated with prognosis：clinical stage（ χ2=16.441，P=0.000），histological grade of tumor （ χ2=6.941，P=0.008），chemotherapy or not（ χ2=4.934，P=0.026）. But age（ χ2=2.013，P=0.156），gender（ χ2=0.414，P=0.520），method of operation（ χ2=6.565，P=0.010） and multifocal or unifocal tumor（ χ2=0.128，P=0.720） showed no significant influence on prognosis. The depth of invasion（ χ2=5.314，P=0.021），bladder irrigation after operation（ χ2=3.919，P=0.048），histological grade of tumor（ χ2=7.025，P=0.008） and method of operation（ χ2=6.565，P=0.010） were significantly associated with the incidence of secondary bladder cancer. But multifocal or unifocal tumor（ χ2=0.336，P=0.562） had no statistical significance on the incidence of secondary bladder cancer. Multi－variate analysis identified the significant factors for prognosis of ureteral cancer were clinical stage（RR=6.037，95%CI=1.708 to 21.333，P=0.005） and histological grade of tumor（RR=10.032，95%CI=1.161 to 86.695，P=0.036）. The influencing factors on the incidence of secondary bladder cancer were high grade histological of tumor（RR=8.942，95%CI=1.175 to 68.056，P=0.034） and non radical operation（RR=3.819，95%CI=1.424 to 10.244，P=0.008）. Conclusion：The significant factors for prognosis of ureteral cancer are clinical stage and histological grade of tumor. The significant influencing factors on the incidence of secondary bladder cancer after ureteral cancer are the method of operation and histological grade of tumor.

Abstract:Objective：To investigate the expression and clinical significance of Kruppel-like factor 4（KLF4） in the urine exfoliated cells of patients with clear cell renal cell carcinoma（CCRCC）. Methods：Urine samples were collected from 58 patients pathologically confirmed to have CCRCC after operation and 40 healthy volunteers. The expression rate of KLF4 mRNA was determined by RT-PCR，and the expression rate of KLF4 protein was determined by Western blot. The relationship between the expression of KLF4 and the clinicopathological parameters of CCRCC patients was analyzed. Results：The expression of KLF4 in the urine exfoliated cells of CCRCC patients was down-regulated significantly. In the CCRCC group，the negative rate of KLF4 expression was 87.9%（51/58），while the positive rate of its expression was only 12.1%；in the control group，the negative rate of KLF4 expression was 7.50%（3/40），while the positive rate of its expression was 92.5%；there was a significant difference in the negative rate of KLF4 expression between the two groups（P<0.05）. The down-regulation of KLF4 in CCRCC patients was not associated with age（ χ2=0.369，P=0.544），sex（ χ2=0.705，P=0.401），tumor size（ χ2=3.481，P=0.062），clinical stage（ χ2=0.762，P=0.859），degree of tissue differentiation（ χ2=0.064，P=0.996），and lymph node metastasis（ χ2=0.301，P=0.583）. Conclusion：The detection of urine KLF4 may be helpful to the early diag－nosis and postoperative monitoring of CCRCC，and RT-PCR is a feasible detection method in clinical practice.

Abstract:Objective：To explore the manifestations of tumorous and non-tumorous lesions in the spleen on computed tomography （CT） and the application of CT in their differentiation. Methods：A retrospective analysis was carried out on the CT data of 69 patients diagnosed with splenic lesions；the imaging characteristics of tumorous and non-tumorous lesions and their accompanying signs were summarized；the chi-square test was used to analyze related data. Results：Among the 69 patients with splenic lesions，44 had tumorous lesions，and 25 had non-tumorous lesions，with the percentages of patients with unclear boundary，subcapsular effusion，and peritoneal thickening to be 31.8%，4.5%，and 2.3%，respectively，in the former population，versus 56.0%，60.0%，and 24.0%，respectively，in the latter population；there were significant differences in the imaging findings of all three pathological changes between the patients with tumorous lesions and non-tumorous lesions（P<0.05）. Conclusion：Splenic lesions can be clearly shown on CT. By analyzing the boundaries of lesions and accompany－ing signs，it is beneficial to differentiate tumorous lesions from non-tumorous lesions in the spleen.

Abstract:Objective：To compare the major computed tomography（CT） imaging features between clear cell sarcoma of the kidney（CCSK） and favorable histology（FH） Wilms’ tumor（WT） in children，and to identify imaging features for distinguishing between these two diseases. Methods：The clinical，imaging，and pathological data were collected from 22 children pathologically diagnosed with CCSK in our hospital from March 2013 to June 2018. Within the same period，44 consecutive children with WT（FH） were used as controls. Eight major CT imaging features were identified and analyzed in the two groups. The statistical analysis of the data was performed by chi-square test using SPSS 17.0. P-values were adjusted by Bonferroni adjustment. The pathological tissue sections that were significantly different from others were further reviewed. Results：Among the eight major CT imaging features，only the incidence of the sign of “dilated peritumoral cysts” showed a significant difference between the two groups（?字2=7.857，Bonferroni-adjusted P=0.040，95% confidence interval：0.32-0.77 for CCSK and 0.08-0.33 for WT），suggesting that this feature might have clinical signifi－cance in distinguishing between CCSK and WT. The pathological study demonstrated that the structure of the small cyst was a liquid-containing cavity with monolayer or multilayer epithelial cells lining the cyst wall，which accorded with the anatomical features of col－lecting tubules or renal pelvis. Conclusion：It is hard to distinguish CCSK from WT（FH） in preoperative diagnosis because they share many common CT imaging features. “Dilated peritumoral cysts” may be a CT feature with potential significance in the diagnosis of CCSK.

Abstract:Objective：To investigate the effect of cognitive behavioral therapy on treatment compliance and immune function in children with cancer receiving chemotherapy，and to provide a basis for psychological nursing for children with cancer. Methods：Convenience sampling was used to select 50 children with cancer who met related criteria，and after being matched for type of cancer，stage，and age，they were divided into treatment group and control group according to their preference，with 25 patients in each group. The patients in the control group were given routine psychological nursing，and those in the treatment group were given cognitive behavioral therapy；the course of treatment was 5 weeks for both groups. Before and after intervention，Frankl Compliance Scale（FCS），Houpt Behavior Scale（HBS），and peripheral blood lymphocyte content（PBLC） were used to evaluate treatment compliance and immune function，and the results were analyzed and compared between the two groups. Results：After intervention，compared with the control group，the treatment group had significantly higher treatment compliance（3.20±0.40 vs. 2.72±0.61，t=3.256，P=0.002） and content of natural killer cells（20.36±10.76 vs. 16.68±8.44，t=2.356，P=0.024）. The treatment group had a significant increase in T lymphocytes after intervention（72.26±11.34 vs. 76.33±11.07，t=2.460，P=0.021），but in the control group，there were no significant changes in treat－ment compliance and T lymphocytes after intervention（all P>0.05）. Conclusion：In children with cancer，cognitive behavioral therapy can enhance treatment compliance by correcting their distorted understanding of cancer events and thus plays an important role in improving immunoregulation capability and prognosis.

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Abstract:This article reports the diagnosis and treatment process of a patient with retroperitoneal enterogenous cyst with glandular epithelial carcinogenesis. Contrast-enhanced computed tomography performed at initial diagnosis showed right retroperitoneal cystic space-occupying lesions which were likely to be malignant. The patient underwent laparoscopic resection of right adrenal adenoma+nephron-sparing right renal cyst resection+right retroperitoneal cyst resection，as well as four cycles of XELOX chemotherapy after surgery. Reexamination performed half a year later showed recurrence and metastasis of cancerous enterogenous cyst.

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Abstract:Objective：To improve the understanding of clinicians on transcatheter aortic valve replacement（TAVR）. Methods：The di－agnosis and treatment course and intraoperative image data of a patient with TAVR surgery were reported. The indications，artificial valves，surgical complications and prospects were discussed through literature review. Results：The patient was hospitalized for heart failure. The echocardiography indicated severe aortic stenosis；conservative treatment was not effective，and the risk of surgical opera－tion was high，so TAVR was choose. After TAVR，the heart failure symptoms disappeared，and echocardiography showed significant decrease in aortic valve differential pressure. The left ventricular diameter decreased significantly 3 months after surgery. Conclusion：TAVR surgery is less traumatic and patients recover quickly. TAVR surgery has become a choice for severe aortic stenosis patients with middle-high risk of surgery.

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