Abstract:Objective：To investigate the expression of neuropeptide Y（NPY），Y1 receptor（Y1R），and Y2 receptor（Y2R） in the inter－vertebral disc（IVD） and dorsal root ganglion（DRG） of rats with intervertebral disc degeneration（IDD） and sham-operated rats，and to investigate the correlation of NPY and its receptors with mechanical withdrawal threshold（MWT） and thermal withdrawal latency （TWL） in rats and the relationship of NPY and its receptors with discogenic low back pain. Methods：Twelve 6-month-old female specific pathogen-free Sprague-Dawley rats which were not pregnant were equally and randomly divided into two groups：IDD group and sham-operation group. An IDD model was induced by un－balanced dynamic and static forces in the IDD group，and sham operation was performed in the sham-operation group. At 12 weeks after the operation，whether the establishment of the IDD model was successful was evaluated by magnetic resonance imaging and X-ray，and MWT and TWL were measured. The expression of NPY and its receptors in the IVD and DRG was determined by immunohistochemistry to analyze the correlation of the mean optical density（MOD） of NPY and its receptors with pain behaviors（MWT and TWL）. Results：①Pain testing results showed that the IDD group had significantly lower MWT and TWL compared with the sham-operation group at 12 weeks after operation[（9.44±2.91） g vs. （17.99±4.40） g，P=0.002；（9.17±0.39） s vs. （13.53±1.69） s，P=0.002]. ②Immunohistochemical analysis showed that the IDD group had significantly higher expression of NPY in the IVD and DRG and significantly lower expression of Y1R in the IVD and DRG compared with the sham-operation group（IVD：0.15±0.03 vs. 0.11±0.02，P=0.021；DRG：0.23±0.04 vs. 0.17±0.04，P=0.018；IVD：0.10±0.02 vs. 0.13±0.01，P=0.009；DRG：0.05±0.01 vs. 0.08±0.01，P=0.000）. There was no signifi－cant difference in the expression of Y2R in the IVD and DRG between the two groups（P>0.05）. ③Pearson correlation analysis showed that the MOD values of NPY in the IVD and DRG were negatively correlated with MWT and TWL in the two groups（r=-0.605，P=0.037；r=-0.617，P=0.033；r=-0.603，P=0.038；r=-0.708，P=0.010）；the MOD values of Y1R in the IVD and DRG were positively correlated with MWT and TWL in the two groups（r=0.696，P=0.012；r=0.735，P=0.006；r=0.624，P=0.030；r=0.834，P=0.001）. Conclusion：In the rat model of unbalanced dynamic and static forces，NPY may be involved in the development and progression of discogenic low back pain through peripheral Y1R，but the specific mechanism needs further investigations.

Abstract:Objective：To investigate the mechanism of de novo mutation in the microtubule-associated tumor suppressor 1（MTUS1） gene in the compaction of ventricular myocardium. Methods：Lentiviral vectors containing mutant MTUS1 gene or wild MTUS1 gene or empty vectors were co-infected into CP15-5a cells（mutation group，wild group，and vector group，respectively）. The mRNA expression of MTUS1 and small GTPase-ras homolog family member A（RhoA） was measured by real-time PCR. The protein expression of RhoA was measured by Western blot. The fluorescence intensity of α-tubulin was determined by immunofluorescence assay. Cell mi－gration activity was evaluated by wound-healing assay. Results：Lentiviral vectors containing mutant MTUS1 or wild MTUS1 or empty vectors were successfully co-infected into CP15-5a cells，which was confirmed by fluorescence staining and real-time PCR. Immuno-fluorescence assay results showed that the mutation group had a lower fluorescence intensity of α-tubulin than the wild group（P=0.006，P<0.01）. Real-time PCR and Western blot results showed that the mutation group had significantly higher mRNA and protein expression of RhoA compared with the wild group（P=0.005，P=0.01）. Wound-healing assay showed that the mutation group had sig－nificantly higher migration rates at 6 and 12 hours after scratch compared with the wild group（P=0.000，P=0.000）. Conclusion：A de novo mutation in the MTUS1 gene is a protective mutation for decreasing the incidence of noncompaction of ventricular myocardium via reducing the stability of microtubules in CP15-5a cells and increasing cell migration activity by regulating the expression of RhoA.

Abstract:Objective：To screen PRR11 interacting proteins by the yeast two-hybrid technique，and to provide a basis for further stud－ies of its molecular mechanism of action. Methods：PRR11 bait plasmids were made for the yeast two-hybrid system and tested for auto-activation. Mutants were constructed to obtain lower auto-activation. The human fetal brain cDNA library was screened to obtain initial positive clones. The lacZ reporter gene assay，retransformation，positive clone sequencing，and BLAST sequence alignment analysis were used to rule out false positive and repeated clones and identify candidate PRR11 interacting proteins. Results：PRR11 showed auto-activation and a PRR11 mutant with lower auto-activation was constructed. The yeast two-hybrid screening resulted in 102 initial positive clones. The lacZ reporter gene assay further validated 39 positive clones. According to gene sequencing and se－quence alignment analysis，the 39 clones were from genes encoding 15 different proteins. Finally，four candidate proteins including RNF41 were verified by retransformation. Conclusion：RNF41，SCG5，BCYRN1，and PRR13 are potential PRR11 interacting proteins.

Abstract:Objective：To prepare the phase-change multifunctional lipid nanoparticle containing indocyanine green（ICG） and adri－amycin（ADM） and targeting folate receptor（ICG/FA/Pct-PFPNP：ADM），to investigate its basic properties，targeting ability，pho－tothermal effect，and ultrasonic/photoacoustic bimodal imaging ability，and to provide new strategies for the diagnosis of retinoblas－toma. Methods：ICG/FA/Pct-PFPNP：ADM nanoparticles were prepared by the double emulsification method. A transmission electron microscope was used to observe the morphology of nanoparticles，the Malvern particle size analyzer was used to measure particle size and electric potential，and an ultraviolet spectrophotometer was used to measure the encapsulation efficiency and drug loading rate of nanoparticles. Flow cytometry and confocal laser scanning were used to observe the expression of folic acid on the surface of ICG/FA/Pct-PFPNP：ADM nanoparticles and targeting ability in vitro. CCK-8 assay was used to evaluate the biosafety of nanoparticles. Near-infrared laser（808 nm） was used to excite ICG/FA/Pct-PFPNP：ADM nanoparticles and assess their ultrasonic/photoacoustic bimodal imaging ability. Results：ICG/FA/Pct-PFPNP：ADM nanoparticles were successfully prepared，with a spherical appearance，an average particle size of （374.40±23.48） nm，and an average potential of （-28.0±4.5） mV. The encapsulation efficiency and drug load－ing rate of ICG were （91.85±2.98）% and （9.19±0.29）%，respectively，and the encapsulation efficiency and drug loading rate of ADM were （62.04±5.10）% and （6.20±0.51）%，respec－tively. Both flow cytometry and laser confocal microscopy showed good expression of folic acid on the surface of the nanoparticles；the targeted group had a Y79 cell connection rate of （96.57±3.17）%，which was significantly different from that in the non-targeted group and the antibody blocking group（F=1537.6，P<0.05）. The CCK-8 assay showed no obvious cytotoxicity of ICG/FA/Pct-PFPNP：ADM nanoparticles. The ICG/FA/Pct-PFPNP：ADM nanoparticles showed liquid-gas phase transition after laser irradiation，enhanced ultrasound imaging，and increased local temperature（60.8 ℃）. The intensity of photoacoustic signal increased with the increase in nanoparticle concentration，and there was a good linear relationship between nanoparticle concentration and signal intensity. Conclusion：The phase-change nanoparticles loaded with ICG and ADM were successfully prepared，with good targeting ability and photothermal effect. Such nanoparticles can enhance the quality of ultrasonic/photoacoustic imaging. Therefore，it can be used in the diagnosis of retinoblastoma.

Abstract:Objective：To investigate the relationship between the Wnt/β-catenin/TCF-4 pathway and livin expression in human renal cancer cell line 786-0，and to explore the apoptosis regulation mechanism of this pathway. Methods：786-0 cells were treated with different concentrations of indomethacin. Cell viability was then determined by CCK-8 assay. Flow cytometry was used to determine apoptosis change. The transcriptional changes of β-catenin，TCF-4，caspase-3，and livin were measured by quantitative real-time PCR，while the expression levels of β-catenin，caspase-3，and livin were measured by Western blot. Results：With the increase in the concentration of indomethacin，the cell viability decreased in a dose-response manner（P=0.000）. Flow cytometry showed that the apoptosis rate increased with the increase in the concentration of indomethacin. The apoptosis rates of the 25 μmol/L group，50 μmol/L group，and 100 μmol/L group were （32.07±1.01）%，（40.03±1.95）%，and （72.33±0.02）%，respectively，all showing significant differences compared with those of the control group（P=0.000，0.002，and 0.000，respectively）. Real-time PCR showed that the relative expression levels of β-catenin，TCF-4，and livin decreased significantly（P=0.002，0.000，and 0.000，respectively），while the level of caspase-3 increased significantly（P=0.001）. Western blot revealed that，in the 25 μmol/L group，50 μmol/L group，and 100 μmol/L group，the relative expression levels of β-catenin were 0.568±0.020（P=0.001），0.396±0.030（P=0.000），and 0.142±0.038（P=0.000），respectively；the levels of livin were 0.139±0.016（P=0.005），0.050±0.006（P=0.000），and 0.011±0.001（P=0.000），re－spectively；and the levels of caspase-3 were 0.278±0.035（P=0.046），0.396±0.071（P=0.000），and 0.518±0.015（P=0.000），respectively. Conclusion：Indomethacin-mediated degradation of β-catenin/TCF-4 in renal cancer cells may lead to the tran－scriptional repression of livin and the up-regulation of caspase-3 expression，thereby inducing apoptosis of renal cancer cells.

Abstract:Objective：To investigate the expression of the Rictor gene，an ligand for mTOR，in mice in early pregnancy and its effect on embryo implantation，and to lay a foundation for further research on the role and mechanism of the Rictor gene in mouse embryo implantation. Methods：The mouse model of early pregnancy and uterine-specific knockout of the Rictor gene was established. Results：Immunohistochemistry showed that the Rictor gene was mainly expressed in the luminal and glandular epithelium on days 1-4 of pregnancy and the decidual tissue near the implantation site after embryo implantation. The conditional-knockout mice with genotype Rictorfl/flCre+/- were successfully propagated. Immunohistochemistry，Western blot，and RT-qPCR showed that the expression of the Rictor gene was reduced in mouse uterus，suggesting that a mouse model of conditional knockout of the Rictor gene in the uterus was successfully established. Compared with the control mice，the knockout mice had significantly lower volume and weight of the uterus （P<0.01）. On day 5 of pregnancy，the knockout mice had no embryo implantation sites in the uterus and had significant increases in the expression of Ki67（a marker for proliferation） and MUC1（a marker for endometrial receptivity） in the luminal epithelial cells. Conclusion：There is a significant reduction in embryo implantation rate due to impaired receptivity after conditional knockout of the Rictor gene.

Abstract:Objective：To investigate the expression of activated Cdc42-associated kinase（ACK1） in the placenta of normal women with full-term pregnancy versus pregnant women with preeclampsia（PE），the regulatory effect of ACK1 on invasion of trophoblasts，and the role of ACK1 in the pathogenesis of PE. Methods：Placenta tissue samples were collected from 23 normal women with full-term pregnancy and 23 pregnant women with PE who underwent elective cesarean section in The First Affiliated Hospital of Chongqing Medical University from October 2015 to October 2016. Immunohistochemistry and Western blot were used to measure the expression of ACK1 in the placenta. The trophoblast cell line（HTR8/SVneo cells） was divided into normoxia control group（N group），hypoxia/reoxygenation（H/R） group，and ACK1 lentivirus knockdown group（ACK1 shRNA group）. Transwell assay was used to evaluate the invasion of cells and flow cytometry was used to measure the apoptosis of cells. Western blot was used to measure the protein expression of ACK1，matrix metalloproteinase-9（MMP-9），and tissue inhibitor of metalloproteinase-2（TIMP2） in HTR8/SVneo cells. Results：The expression of ACK1 in the placenta of PE patients was significantly lower than that in the placenta of normal women with full-term pregnancy（t=3.890，P=0.018）. Compared with the N group，the ACK1 shRNA group and the H/R group had significant reductions in the protein expression of ACK1（t=12.260，P=0.000；t=10.740，P=0.000） and MMP-9（t=8.071，P=0.000；t=7.745，P=0.001） and a significant increase in the protein expression of TIMP1（t=10.690，P=0.000；t=14.330，P=0.000）. The ACK1 shRNA group and the H/R group had a significant reduction in the number of cells migrating to the lower chamber（t=12.260，P=0.000；t=11.320，P=0.000）. The H/R group had a significant increase in cell apoptosis rate（t=2.260，P=0.000），while the ACK1 shRNA group had no significant change in apoptosis rate（t=8.317，P=0.088）. Conclusion：Downregulation of ACK1 expression inhibits the invasion of trophoblasts，suggesting that ACK1 may play an important role in the pathogenesis of PE.

Abstract:Objective：To investigate the effect of down-regulating the PKR gene on the proliferation and apoptosis of pancreatic AR42J cells and its mechanism. Methods：AR42J cells were treated with cerulein to establish an acute pancreatitis model，in which the cells with the down-regulated PKR gene mediated by a lentiviral vector were taken as experimental group，and the cells trans－fected with control virus were taken as control group. The cells were tested for proliferation by cell counting kit（CCK-8） and colony formation assay and for apoptosis by flow cytometry（FCM）；the changes in the expression of key genes of the nuclear factor-κB（NF-κB） pathway were measured by both qRT-PCR and FCM. Results：Compared with the control group，the experimental group had significantly reduced relative expression of key genes[NF-κB，tumor necrosis factor-α（TNF-α），interleukin-6（IL-6），and iNOS] of the NF-κB pathway（0.45±0.08，0.26±0.05，0.51±0.25，and 0.38±0.04，respectively，t=7.64，16.41，6.67，and 10.15，respectively，all P<0.05）；the experimental group had significantly enhanced colony formation ability than the control group（colony count：275.33±7.02 vs. 36.00±4.00，t=51.29，P=0.00）；the result of CCK-8 assay showed a significantly enhanced cell proliferation ability in the experimental group compared with the control group，with the cell proliferation rates at 24 h，48 h，and 72 h as （25.00±3.00）%，（50.33±4.04），and （62.33±4.51）%，respectively，for the experimental group versus（12.33±1.53）%，（17.00±1.00）%，and （24.00±2.00）%，respectively，for the control group（t=6.52，13.87，and 13.46，respectively，all P<0.05）. Compared with the control group，the experimental group had significantly reduced values in both early apoptosis rate[（13.4±0.9）% vs. （6.2±0.6）%，t=11.53，P=0.00] and late apoptosis rate[（12.2±0.5）% vs. （4.1±0.2）％，t=26.05，P=0.00]. Conclusion：Down-regulating the PKR gene can slow down the cellular inflammatory response by suppressing the NF-κB pathway，leading to reduced apoptosis and enhanced proliferation of AR42J cells.

Abstract:Objective：To investigate the effect of copper oxide nanoparticles（CuONPs） on autophagy of Raw264.7 macrophages and related signaling pathways involved in the regulation of autophagy. Methods：Transmission electron microscopy（TEM） was used to observe the morphological characteristics of CuONPs. Raw264.7 macrophages were used for in vitro experiment. Raw264.7 macrophages were exposed to different concentrations of CuONPs for 24 hours，and then MTS assay was used to measure cell viability. TEM was used to observe the formation of autophagosome. After transient transfection of macrophages with green fluorescent protein-light chain 3（GFP-LC3） plasmid，a laser scanning confocal microscope was used to observe GFP-LC3 green fluorescent puncta in the cytoplasm of Raw264.7 macrophages before and after CuONPs treatment. Western blot was used to measure the expression of the autophagy-related protein microtubule-associated protein I light chain 3（LC3-Ⅱ/Ⅰ） and the level of phosphorylation of the p38 and ERK signaling pathways in macrophages. Results：CuONPs significantly inhibited the viability of Raw264.7 macrophages in a dose-dependent manner（F=35.987，P=0.000）. TEM images showed the deposition of CuONPs in autophagosome. The laser scanning confocal microscope showed that after the macrophages were transfected with GFP-LC3，the CuONPs treatment group had a significantly higher number of GFP-LC3 green fluorescence puncta than the control group. In addition，Western blot showed a significant dose-dependent increase in LC3-Ⅱ/Ⅰ after CuONPs treatment（F=156.585，P=0.000）. The above results indicated that CuONPs promoted the formation of autophagosome in macrophages. Western blot also showed that CuONPs at a concentration of 10 μg/mL significantly upregulated the protein levels of p-p38 and p-ERK in a time-dependent manner（p-p38：F=72.899，P=0.000；p-ERK：F=123.300，P=0.000）. Conclusion：CuONPs can reduce cell viability and induce the activation of autophagy in macrophages，and the p38 and ERK signaling pathways may be involved in the molecular regulation of autophagy

Abstract:Objective：To investigate the expression of autophagy-related proteins，Beclin-1，P62，and microtubule-associated protein light chain 3B（LC3B），in the lungs of mice infected with Streptococcus pneumoniae. Methods：A standard strain of Streptococcus pneumoniae（D39） in the logarithmic growth phase was adjusted to a concentration of 1.5×109 CFU/mL by sterilized phosphate-buffered saline；then the resulting solution was administered to 50 specific pathogen-free female Balb/c mice aged 6-8 weeks and with a weight of 16-20 g by intranasal instillation. The bronchoalveolar lavage fluid（BALF） and lung tissues of the Balb/c mice were col－lected at 0 h，6 h，12 h，24 h，and 48 h after infection. Cells in the BALF were counted after Wright-Giemsa staining；pathological changes in the lung tissues were evaluated after hematoxylin-eosin（HE） staining. Western blot was used to determine the expression levels of autophagy related proteins Beclin-1，P62，and LC3B in the lung tissues. Immunofluorescence assay was employed to observe the expression of LC3B in the lung tissues. Results：HE staining showed massive inflammatory cell infiltration in the lung tissues of the mice at 12 h and 24 h after intranasal instillation of Streptococcus pneumoniae. The total cell count and neutrophil count in the BALF increased significantly at 6 h after infection（6.272±1.312 and 3.456±1.308，respectively，both P=0.000），reached a peak at 12 h（19.456±0.997 and 15.040±1.012，respectively，both P=0.000），and decreased to a normal level at 48 h（3.520±0.933 and 0.128±0.175，P=0.005 and 0.835，respectively），as compared with the baseline levels of 1.280±0.506 and 0.000±0.000，respectively. Western blot results showed that the autophagy-related protein Beclin-1 increased from 6 h after infection（0.921±0.093，P=0.002） and reached a peak at 48 h（1.884±0.158，P=0.000） compared with the baseline level of 0.626±0.078；the autophagy-related protein P62 decreased from 6 h after infection（2.275±0.269，P=0.000） and decreased to a trough level at 48 h（1.178±0.142，P=0.000） compared with the baseline level of 2.915±0.094；the autophagy-related protein LC3B increased from 12 h after infection（1.429±0.318，P=0.006），reached a peak at 24 h（2.002±0.451，P=0.000），and decreased after 48 h（1.563±0.501，P=0.002），as compared with the baseline level of 0.747±0.197. Immunofluorescence assay showed that the expression of LC3B protein increased at 12 h and 24 h after infection. Conclusion：After infecting the lungs of mice，Streptococcus pneumoniae activates autophagy，which plays an important role in the immune modulation in mice.

Abstract:Objective：To investigate the significance of the expression of microRNA-34a（miR-34a） in lipopolysaccharide（LPS）-in－duced acute respiratory distress syndrome（ARDS） and its mechanism of action. Methods：Forty male Sprague-Dawley rats were ran－domly divided into five groups：control group and 10 mg/kg LPS intraperitoneal injection groups（3，6，12，and 24 hours）；the human alveolar type Ⅱ epithelial cell line（A549） was divided into five groups：control group and 10 μg/mL LPS stimulation groups（3，6，12，and 24 hours）. The A549 cells were transfected with a miR-34a inhibitor and were treated with 10 μg/mL LPS（added 24 hours later） for 24 hours. The wet/dry weight（W/D） ratio of the lungs was measured and the histopathological changes in the lung tissue were evaluated. Quantitative real-time polymerase chain reaction（qRT-PCR） was used to determine the expression of miR-34a in the lung tissue and cells；enzyme-linked immunosorbent assay was used to determine the concentrations of tumor necrosis factor-α（TNF-α） and interleukin-1 beta（IL-1β） in the lung tissue and cells；Western blot was used to determine the protein expression of phos－phatidylinositol 3-kinase（PI3K） and phosphorylated protein kinase B（p-AKT） in the cells. Results：The W/D ratio of the lungs was significantly higher in the experimental groups than in the control group. The hematoxylin-eosin staining indicated that the experimental groups showed the presence of thickened alveolar septa in the lung tissue，pink edema fluids in the alveolar cavities，and inflammatory cell infiltration and hemorrhage in the pulmonary interstitium. The expression of miR-34a，the concentrations of TNF-α and IL-1β，and the protein expression of PI3K and p-AKT were higher in the experimental groups than in the control group at each time point，with a positive correlation observed between the expression of miR-34a and the concentrations of TNF-α and IL-1β. Transfection with the miR-34a inhibitor significantly down-regulated the concentrations of TNF-α and IL-1β and the protein expression of PI3K and p-AKT in the LPS-treated A549 cells. Conclusion：miR-34a can attenuate LPS-induced lung injury by inhibiting the PI3K/AKT signaling pathway，which provides a new target for ARDS treatment.

Abstract:Objective：To investigate the effect of exercise prescription combined with high-intensity focused ultrasound（HIFU） on dysmenorrhea in patients with adenomyosis. Methods：The patients with adenomyosis who underwent HIFU from January 2017 to March 2018 were enrolled. According to the implementation of exercise prescription（aerobic exercise 150 minutes per week） after surgery，the patients were divided into exercise group and non-exercise group. The patients were followed up at 3，6，and 12 months after surgery to observe visual analogue scale（VAS） score of dysmenorrhea and the change in uterine volume. Results：A total of 217 patients were enrolled，with 115 in the exercise group（the rate of compliance with exercise prescription was 53.0%） and 102 in the non-exercise group. There were no significant differences in baseline data and HIFU regimen between the two groups（P>0.05）. Before surgery，there was no significant difference in VAS score between the two groups（P=0.092），and at 3，6，and 12 months after surgery，the exercise group had a significantly lower VAS score than the non-exercise group[3.0（2.0，4.0）/2.0（0.0，3.0）/2.5（1.0，4.0） vs. 3.5 （3.0，5.0）/4.0（2.0，5.8）/4.５（2.0，6.0），all P<0.01]. At 3 and 6 months after surgery，the medians of the reduction in uterine volume were 9.780 cm3 and 14.046 cm3 in the exercise group and 2.935 cm3 and -2.432 cm3 in the non-exercise group，and the exercise group had a significantly greater reduction in uter－ine volume than the non-exercise group（P<0.01）. Conclusion：Exercise prescription after HIFU can effectively reduce VAS score，alle－viate the symptom of dysmenorrhea，and reduce uterine volume. Therefore，exercise prescription can be used as a rehabilitation treatment regimen for adenomyosis after HIFU and can improve patients’ self-evaluation.

Abstract:Objective：To explore the association between serum level of high-density lipoprotein-associated sphingosine 1-phosphate （HDL-S1P） and coronary artery stenosis. Methods：A total of 40 patients confirmed by coronary angiography with coronary artery stenosis were selected as stenosis group，while 40 others confirmed without stenosis were selected as control group. General clinical data of the two groups were collected. HDL was isolated from serum by ultracentrifugation，and HDL-S1P concentration was de－termined by high-performance liquid chromatography. C-reactive protein concentration was determined by enzyme-linked immunosor－bent assay. Multivariate analysis was performed to assess the association of HDL-S1P and C-reactive protein with coronary artery stenosis. Results：Compared with the control group，the stenosis group had significantly lower serum levels of total S1P，HDL-S1P，and HDL and a significantly higher C-reactive protein concentration[HDL-S1P：（34.17±10.62） ng/mL vs. （44.66±11.94） ng/mL，P=0.000；HDL：（1.01±0.24） mmol/L vs. （1.18±0.39） mmol/L，P=0.024；C-reactive protein：（2.96±1.40） mg/L vs. （2.10±0.99） mg/L，P=0.002]. Stepwise logistic regression analysis showed that HDL-S1P was an independent protective factor for coronary artery stenosis（OR=0.904，95%CI=0.856 to 0.956，P=0.000），while C-reactive protein was an independent risk factor（OR=1.734，95%CI=1.121 to 2.682，P=0.013）. Conclusion：HDL-S1P might be an independent predictor of coronary artery stenosis，the development of which may be associated with a decrease in serum HDL-S1P.

Abstract:Objective：Inappropriate acetabular cup placement significantly affects implant survival following total hip arthroplasty （THA）. However，there is a current lack of reliable intraoperative landmarks for guiding the anteversion placement of the acetabular cup during THA for developmental dysplasia of the hip（DDH）. In this study，we analyzed the morphological characteristics of the anterior and posterior acetabular notches（APANs） using three-dimensional（3D） computed tomography（CT） and assessed its potential as a safe reference landmark for anteversion cup placement in THA for DDH. Methods：The 3D-CT data of 22 healthy controls（44 hips） and 66 DDH patients（117 hips） between 2013 to 2018 were reviewed. Three anteversion angles defined by surgery，anatomy，and radiology were measured based on the line connecting the APANs. The relationships between each angle and the corresponding safe cup zone and between the angle and plain radiographic parameters in different hip types were analyzed. Results：The APANs could be clearly identified by CT，and the surgical anteversion of acetabular notch（SAAN） was within the safe zone（6°-36°） for both controls（22.4°±5.5°） and Hartofilakidis A DDH patients（25.5°±7.4°）. Compared with DDH patients with safe SAAN，those with unsafe SAAN had smaller lateral center-edge angle（5.6°±12.3° vs. -2.3°±13.0°，P=0.013），greater lateral subluxation（15.9 mm vs. 20.9 mm，P=0.006），and greater Tonnis angle（30.8° vs. 35.4°，P=0.005）. Conclusion：APANs can be easily identified by CT in healthy controls and Hartofilakidis A DDH patients，and may thereby serve as a good anatomical reference landmark for anteversion cup placement in sagittal view of the pelvis. SAAN-guided antever－sion cup placement should be avoided in DDH patients with reduced LCE angle，increased lateral subluxation，and increased Tonnis angle indicated by plain radiograph.

Abstract:Objective：To investigate the clinical effect and value of knee arthroscopic debridement combined with traditional Chinese medicine（TCM） hot compress in the treatment of knee osteoarthritis（KOA）. Methods：A total of 68 KOA patients who were admitted to our hospital from February 2017 to March 2018 were enrolled and randomly divided into control group and experimental group，with 34 patients in each group. The patients in the control group were treated with knee arthroscopic debridement，and those in the experimental group were treated with knee arthroscopic debridement combined with TCM hot compress. The two groups were observed in terms of pain relief，joint function，and quality of life. Results：Compared with the control group at 2 and 4 weeks and 3 and 6 months after treatment，the experimental group had a significantly lower Visual Analogue Scale score and a significantly higher Lysholm knee joint function score（P<0.05）. The experimental group had a significantly higher overall response rate than the control group（94.12% vs. 76.47%，P<0.05）. After treatment，the experimental group had a significantly higher total score of 36-Item Short-Form Health Survey than the control group（70.45±7.82 vs. 52.76±7.63，P<0.05）. Conclusion：In patients with KOA，knee arthro－scopic debridement combined with TCM hot compress can effectively alleviate pain and improve knee joint function，quality of life，and treatment outcome.

Abstract:Objective：To investigate the clinical effect of dexmedetomidine combined with intravenous general anesthesia in pediatric fiberoptic bronchoscopy. Methods：A total of 80 children aged 1-3 years who planned to undergo fiberoptic bronchoscopy and had an American Society of Anesthesiologists（ASA） grade of Ⅰ-Ⅱ were enrolled and randomly divided into normal saline group（NS group） and dexmedetomidine group（Dex group），with 40 children in each group. All children were given the inhalation of 2% lidocaine hy－drochloride before examination；the children in the Dex group were given dexmedetomidine with a loading dose of 1 μg/kg at 10 min－utes before induction of anesthesia，and those in the NS group were given the same dose of normal saline. All children were given in－travenous general anesthesia，and spontaneous breathing was reserved for nasopharyngeal oxygen therapy. Heart rate（HR），respiration rate（RR），noninvasive mean arterial blood pressure（MAP），and pulse oxygen saturation（SpO2） were recorded before the entrance of bronchoscope（T1），at the time when the bronchoscope reached the pharynx（T2），the glottis（T3），and the carina（T4），and at 10 minutes of the examination（T5）. Related adverse events were observed during fiberoptic bronchoscopy，such as bucking，body movement，glottic spasm，airway spasm，severe hypoxia，and car－diopulmonary resuscitation. The time of examination，awakening time，times and dosage of additional administration of general anesthetics，pediatric anesthesia emergence delirium scale（PAED） score at the time of discharge from operating room，and degree of satisfaction. Results：There were no significant differences in general con－ditions between the two groups（P>0.05）. The NS group had a significant increase in MAP at T2，T3，T4，and T5 and a significant in－crease in HR at T2，T3，and T4，while the Dex group had a significant increase in MAP at T4（P<0.05）. Compared with the NS group，the Dex group had significant reductions in MAP at T2，T3，T4，and T5 and HR at T2，T3，and T4（P<0.05），significantly lower times and dosage of additional administration of general anesthetics and incidence rates of adverse events，and significantly shorter time of examination and awakening time（P<0.05），as well as a significantly lower PAED score at the time of discharge from operating room（P<0.05）. There was no significant difference in degree of satisfaction between the two groups（P>0.05）. Conclusion：Dexmedetomidine is safe and effective in intravenous general anesthesia for infants and children during fiberoptic bronchoscopy. It can stabilize vital signs，reduce the dosage of general anesthetics and the incidence rates of intraoperative adverse events and postoperative agitation，and shorten the time of examination and awakening time

Abstract:Objective：To investigate the expression and significance of SPRY1 gene in the senescence of normal human epidermal keratinocytes（NHEKs） and immortalized keratinocytes（HaCaT cells） from individuals of different ages. Methods：A total of 120 nor－mal skin specimens were collected from individuals of different ages and divided into juvenile group（<18 years），youth group（18-44 years），middle-aged group（45-59 years old），and elderly group（≥60 years），with 30 specimens in each group. Immunohistochem－istry，real-time PCR，and Western blot were used to compare the localization and expression of SPRY1 in keratinocytes between dif－ferent age groups. HaCaT cells were treated with 200 μmol/L H2O2 to establish a model of cellular senescence. Real-time PCR and Western blot were used to measure the expression of SPRY1 in the groups of normal and senescent HaCaT cells. Results：SPRY1 was mainly expressed in the spinous and granular layers of NHEKs and was distributed in the cytoplasm. The mRNA and protein expres－sion of SPRY1 in keratinocytes gradually increased with the increase in age（P<0.05）. Senescence of HaCaT cells was observed after H2O2 treatment. The mRNA and protein expression of SPRY1 was significantly upregulated in senescent HaCaT cells（P<0.05）. Con－clusion：There is an increase in the expression of SPRY1 gene in senescent NHEKs and senescent HaCaT cells，suggesting that the SPRY1 gene is involved in the regulation of keratinocyte senescence.

Abstract:Objective：To investigate the characteristics and treatment outcome of patients during pregnancy with sudden deafness. Methods：A retrospective study was conducted on 88 cases of sudden deafness during pregnancy who were admitted from August 1，2015 to June 30，2018（including outpatients and hospitalized patients）. According to the guidelines for diagnosis and treatment of sudden deafness in 2015，there were 26 cases of flat type and 62 cases of total deafness. For these cases，the time from onset to visit was less than 15 days，and those with contraindications to hormones were excluded from the study. Oral hormone and intratympanic injection were then given at the same time. The results of pure tone audiometry at 1，2，and 4 weeks and 3 months after treatment were analyzed for curative effect analysis. Another 88 patients with sudden deafness who were hospitalized in the same period were selected as control group，consisting of 26 cases of flat type and 62 cases of total deafness（female，no pregnancy）. Results：Flat type and total deafness are the most common types in the experimental group，including 30 cases in the second trimester of pregnancy and 58 cases in the third trimester. In this group，the overall response rate was 39.77%（35/88）. And the cure rate，marked response rate，and response rate of total deafness were 0%（0/62），14.52%（9/62），and 24.19%（15/62），respectively，while the corresponding rates of flat type were 0%（0/26），19.23%（5/26），and 23.08%（6/26），respectively. Regarding the control group，the overall response rate，marked response rate，and response rate of total deafness were 6.45%（4/62），27.42%（17/62），and 38.71%（24/62），respectively. And the corresponding rates of flat type in the control group were 7.69%（2/26），34.62%（9/26），and 38.46%（10/26），respectively. The overall response rate was 75%（66/88） in the control group. There was a significant difference between the experimental group and the control group in terms of the overall response rate（P<0.05）. There were also significant differences with respect to the subjects of total deafness and flat type between these two groups（P<0.05）. All infants’ Apgar scores were normal at birth and they were all healthy during 3 months of follow-up. Conclusion：Total deafness is the most common type of sudden deafness in pregnancy，followed by flat type，with severe hearing loss during pregnancy. And the marked response rate and response rate are worse than those of common sudden deafness，but the sample size still needs to be further increased. Altogether，oral hormone combined with intratympanic injection is a safe treatment.

Abstract:Objective：To investigate the delivery modes，parturition，and outcomes of re-pregnancy after cesarean section. Methods：The clinical data of 630 puerperae of re-pregnancy after cesarean section were retrospectively analyzed，who were admitted to our hospital from January 2015 to December 2017. All the cases were recorded regarding their selections of delivery modes，either elective repeat cesarean section（ERCS） or trial of labor after cesarean section（TOLAC）. The women who chose ERCS delivery were classified as ERCS group，while the women choosing TOLAC were further divided into vaginal birth after cesarean section（VBAC） group（group A） and cesarean section group after failure of vaginal delivery（group B）. The general information（age，body mass index before delivery，gestational weeks，gravidity and parity） was recorded for group A，group B，and the ERCS group. The causes of delivery failure in different modes were analyzed for the TOLAC group，and maternal-infant outcomes were also compared between group A，group B，and the ERCS group. Results：Of the 630 cases，465（73.81%） choosing ERCS were enrolled in the ERCS group，and the remaining 165（26.19%） selected TOLAC，of which 124（75.15%） were enrolled in group A，and 41（24.85%） in group B. There were no significant differences in age，gestational weeks，gravidity，and parity between the three groups（P>0.05）. The BMI before delivery in group B was not significantly different from that in the ERCS group（P>0.05），but the BMIs in group B and the ERCS group were significantly higher than that in group A（P<0.05）. In 165 cases of TOLAC，98（59.39%） underwent spontaneous labor，18（10.91%） received oxytocin induction，and 49（29.70%） were treated with double balloon induction. Among these TOLAC cases，10（10.20%） failed in spontaneous labor，8（44.44%） in oxytocin induction，and 23（46.94%） in double balloon induction. The main reason for failure was that cesarean section was required by the puer－perae. There were no significant differences in the incidence rates of uterine rupture and neonatal respiratory distress syndrome among the three groups(P>0.05). There were no significant differences in the incidence rates of threatened uterine rupture and neonatal admission to intensive care unit between group A and ERCS group（P>0.05），and they were lower than those in group B（P<0.05）. There was no significant difference in the inci－dence rate of postpartum fever between group B and the ERCS group（P>0.05），but the rates in the two groups were both significantly higher than that in group A（P<0.05）. The body mass of neonates was lowest in group A and highest in group B（P<0.05）. Conclusion：ERCS is preferred for re-pregnancy after cesarean section，but TOLAC is more beneficial to maternal-infant health care in China.

Abstract:Objective：To preliminarily explore the clinical effect of pipeline embolization device in the treatment of large or giant wide-necked aneurysms of the internal carotid artery. Methods：A retrospective analysis was performed on the clinical data of 14 pa－tients with large or giant wide-necked aneurysms of the internal carotid artery who were treated with PED from April 2016 to April 2018 in the neurosurgery department of our hospital. And the clinical efficacy was evaluated by Kamran grading，modified Rankin Scale（mRS），and radiological examination. Results：There were 15 aneurysms in 14 patients，all of which were large or giant wide-necked unruptured aneurysms of the internal carotid artery，Two cases were implanted with PED alone，while in the other 12 cases PED was given concurrently with coil embolization. Among these cases，PED was successfully released in 13 cases but failed in 1 case whose PED herniated into the lumen of the aneurysm. Immediately after the successful placement of PED，the contrast agent showed obvious retention in the lumen of the aneurysm. Postoperative complications occurred in 2 cases（14%），cranial nerve palsy worsened in 1 case，and thrombotic events happened in 1 case. At discharge，mRS score was 0 in 12 cases and 1 in 2 cases. At 6 months after surgery，14 patients underwent digital subtraction angiography. Thirteen patients had complete or nearly complete occlusion of aneurysm，and one with PED hernia into the lumen of the aneurysm had occlusion of the artery with aneurysm，and only blepharoptosis was left in this patient. During follow-up at 6 to 21 months，no symptoms of neurological defects were found in the remaining 13 patients. Conclusion：PED in the treatment of large or giant wide-necked aneurysms of the internal carotid artery has good therapeutic efficacy and safety in short-term evaluation. PED combined with coil embolization can improve the occlusion rate and may reduce the risk of postoperative aneurysm rupture and bleeding，but its long-term efficacy still needs further evaluation.

Abstract:Objective：To explore the effect of biofilm on wound healing in diabetic foot（DF） patients and preliminary intervention. Methods：Patients with DF who were hospitalized from August 2016 to August 2018 and received negative pressure suction and iodophor washing were selected for bacterial culture of secretion specimens isolated from debridement during treatment. Gram staining and alcian blue staining were used to observe the basal tissues of the wound in some cases under optical microscope，and the basal tissues of the same wound were also observed under transmission electron microscopy. All data were entered into SPSS 24.0 software for statistical analysis. Results：The results of positive bacterial culture had a positive rate of 58.3%，and Staphylococcus aureus，Ente－rococcus faecalis，and Staphylococcus epidermidis were the most common bacteria. Bacterial biofilms were observed under both op－tical and transmission electron microscopes. After the intervention of negative pressure suction and iodophor washing，the healing rate was 68.3% after 30 days of hospitalization. The median duration of treatment for DF was 20 days（interquartile range：9-35 d）. The mean white blood cell count was （6.920±3.149）×109/L after 30 days of intervention. Conclusion：The suspected substance was con－firmed as bacterial biofilm by optical and transmission electron microscopy in DF wound infection. Negative pressure suction plus iodophor washing can reduce the chance of survival of bacterial biofilm in wounds.

Abstract:Objective：To compare the short-term efficacy between robot-assisted minimally invasive esophagectomy（RAMIE） and video-assisted minimally invasive esophagectomy（VAMIE） for esophageal cancer. Methods：The clinical data of 67 patients were collected who underwent minimally invasive esophagectomy（RAMIE or VAMIE） without any preoperative neoadjuvant therapy in our hospital from January 2016 to March 2018. Of the 67 patients，34 who underwent RAMIE were assigned to robot group，while the re－maining ones who underwent VAMIE were assigned to thoracoscope/laparoscope group. Results：The robot group had significantly longer operation time compared with the thoracoscope/laparoscope group[（387.4±108.5） min vs. （320.6±65.6） min，Z=-2.598，P=0.009]. The mean number of dissected lymph nodes was significantly higher in the robot group than in the thoracoscope/laparoscope group（25.5±6.2 vs. 21.9±7.1，Z=-2.003，P=0.045）. There were no significant differences between the robot group and the thoraco－scope/laparoscope group with respect to intraoperative blood loss[（180.9±383.1） mL vs. （222.1±431.4） mL，t=-0.464，P=0.644]，mean postoperative hospital stay[（16.7±9.8） d vs. （16.0±9.8） d，Z=-0.088，P=0.930]，and overall complications（32.4% vs. 36.4%，χ2=0.119，P=0.730）. Conclusions：Compared with VAMIE，RAMIE is safer and more feasible in the treatment of esophageal cancer and can remove more lymph nodes.

Abstract:Objective：To investigate the clinical value of thoracoscopic pericardial window（TPW） in the diagnosis and treatment of pericardial effusion in children by summarizing related experience. Methods：A retrospective analysis was performed for the clinical data of 63 children who underwent TPW surgery in our hospital from January 2012 to May 2018. There were 39 boys and 24 girls，aged 7.0-194.0 （93.60±43.70） months，with a body weight of 2.95-51.00 kg[20.00（17.00，28.00） kg] and a course of disease of 2-180 days[10（5，27） days]. Of all children，15 had moderate pericardial effusion and 48 had severe pericardial effusion. Results：For these 63 children，the area of TPW was 4-30 cm2[6（4，11） cm2]，intraoperative blood loss was 1-50 mL[5（2，5） mL]，and the time of operation was 15-310 minutes[65（40，90） minutes]. Of all children，4 were converted to open surgery，53 underwent pleural effusion drainage，and 15 underwent pleural exfoliation during the same period. The duration of postoperative mechanical ventilation was 0.00-480.0 hours[0.00（0.00，1.50） hours]. The children stayed in the intensive care unit for 0-27 days[3（2，4） days]，with a duration of chest tube drainage of 2-39 days[5（4，9） days] and a length of postoperative hospital stay of 5.0-57.0 days[11.0（10，15.5） days]. The pain score for all children ranged from 0 to 4 points[1（0，2） points]. The etiological diagnosis showed pyogenic effusion in 4 children（6.3%），paragonimiasis pericarditis in 34 children（54.0%），tuberculous effusion in 3 children（4.8%），idiopathic effusion in 18 children（28.6%），chylopericardium in 3 children（4.8%），and T lymphoblastic lymphoma in 1 child（1.6%）. Of all children，39（61.90%） had a confirmed diagnosis based on pathological examination. As for postoperative complications，2 children experienced atelectasis and 1 experienced postoperative hemorrhage and was given surgical treatment. A total of 62 children were cured and discharged. A total of 56 children were followed up for 6-24 months，and no recurrence of pericardial effusion or pericardial constriction was observed. Conclusion：TPW for children has the advantages of little trauma，mild postoperative pain，and small incision and can be used to obtain the pathological diagnosis of pericardial effu－sion. It is safe and effective and can be used as the preferred diagnostic and therapeutic regimen for children with moderate or severe pericardial effusion in qualified hospitals.

Abstract:Objective：To explore the therapeutic efficacy of intracoronary infusion of bivalirudin in the treatment of no-reflow or slow flow in coronary arteries during primary percutaneous coronary intervention（PPCI） in patients with acute ST-segment elevation myocardial infarction（STEMI）. Methods：A retrospective analysis was performed for the clinical data of 32 STEMI patients with no-reflow or slow flow during PPCI，who were admitted to the department of cardiology at Yongchuan Hospital of Chongqing Medical University from May 2017 to August 2018. All these patients were given intravenous bivalirudin anticoagulant during PPCI. According to the choice of drugs for intraoperative treatment of no-reflow in coronary artery，the patients were divided into two groups：bivalirudin group（bivalirudin 0.375 mg/kg，n=16） and control group（sodium nitroprusside 200 μg，n=16）. The thrombolysis in myocardial infarction（TIMI） blood flow grade of target vessel after treatment，the incidence of postoperative hemorrhage and cardiovascular events during hospitalization and major adverse cardiac events（MACE） 30 days after treatment were observed and compared between the two groups. Results：Compared with the control group，the bivalirudin group had a significantly increased proportion of TIMI grade 3 patients[12（75%） vs. 6 （37.5%），P<0.05]，and there was no significant difference between the two groups in postoperative cardiovascular events（P>0.05）. There were no postoperative bleeding and MACE 30 days after treatment in either group. Conclusion：Intracoronary infusion of bivalirdin，as a treatment with certain safety，can alleviate no-reflow or slow flow in patients with STEMI during primary PCI，and increase the forward flow of TIMI in target vessel after PCI.

Abstract:Objective：To investigate the influence of season on blood parameters based on the data of healthy individuals undergoing physical examination. Methods：The research data were randomly selected from the physical examination database of healthy individ－uals at the Health Management Center & Physical Examination Center of Sichuan Provincial People’s Hospital. A nonparametric rank sum test was used to compare related indices across seasons. Results：Alanine aminotransferase（ALT） reached the peak in winter. Glu－cose（Glu），total cholesterol（TC），high-density lipoprotein cholesterol（HDL-C），red blood cell count（RBC），hematocrit（HCT），and hemoglobin（HGB） were lower in summer and higher in winter. Uric acid（UA），triglyceride（TG），direct bilirubin（DBil），total biliru－bin（TBil），and creatinine（CRE） reached the highest values in summer and the lowest values in winter. Conclusion：Seasonal varia－tion has influence on ALT，Glu，TC，HDL-C，RBC，HCT，HGB，UA，TG，DBil，TBil，and CRE. The results of this analysis provides a basis for the diagnosis，treatment，and monitoring of diseases in different seasons.

Abstract:Objective：To observe the clinical efficacy of pulse-induced contour cardiac output（PiCCO）-guided fluid resuscitation combined with alprostadil in the treatment of acute kidney injury in patients with septic shock and to discuss its mechanism of renal protection. Methods：Sixty-four patients with septic shock who were admitted to the Intensive Care Unit of the Second Affiliated Hospital of Chongqing Medical University or Chongqing Traditional Chinese Medicine Hospital from 2015 to 2018 were enrolled and randomly divided into PiCCO monitoring group（P group） and PiCCO monitoring + alprostadil group（PA group），with 32 patients in each group. After achieving target blood pressure levels，the PA group was slowly given intravenous injection of alprostadil 10 μg + normal saline 100 ml bid for five days；the P group was given normal saline in the same way and at the same dose and speed as the PA group. The two groups were compared in terms of mean arterial pressure（MAP），global end-diastolic volume index（GEDVI），and systemic vascular resistance index（SVRI） after 6-hour resuscitation；serum levels of interleukin-6（IL-6） and tumor necrosis factor-alpha（TNF-α）； urine output，serum levels of creatinine and cystatin C（Cys-C），percentage of patients adopting contin－uous renal replacement therapy（CRRT） over 2 weeks，and 28-day mortality. Results：After 6-hour fluid resuscitation，there was no significant difference in MAP or SVRI between the two groups（P>0.05），while the central venous pressure and GEDVI were significantly lower in the PA group than in the P group（P<0.05）；after 72-hour fluid resuscitation，the PA group had significantly reduced serum levels of IL-6，TNF-α，and Cys-C（all P<0.05），but had significantly increased urine output（P<0.05）. There was no significant difference between the two groups in the percentage of patients adopting CRRT over 2 weeks or 28-day mortality（P>0.05）. Conclusion：PiCCO-guided fluid resuscitation combined with alprostadil shows a better effect in achieving the goal of early fluid resuscitation，but cannot reduce the percentage of patients adopting CRRT or mortality in the treatment of acute kidney injury in patients with septic shock.

Abstract:Objective：To perform genetic testing on two children with growth retardation，unusual facies，and limb abnormalities，and to achieve precise diagnosis of a rare disease and provide guidance for genetic counseling. Methods：Single-gene sequencing and high-throughput whole-exome sequencing were used to detect mutations in children with clinically suspected Cornelia de Lang syndrome （CdLS），which were also confirmed by Sanger sequencing and the sequencing results from the parents. Results：Two children were found to have NIPBL gene mutations：c.2252 dupA，p.Asn751Lysfs and NM-015384.4：c.6179dupA，which had not been reported before. These were also de novo mutations，not detected in their parents. Conclusion：CdLS needs to be considered in children with growth retardation，unusual facies，and limb abnormalities. Genetic testing can be used to achieve precise diagnosis and provide genetic coun－seling for patients and their families.

Abstract:Objective：To investigate the reliability and clinical value of the new 18-lead ambulatory electrocardiography（ECG）. Methods：A total of 41 subjects were enrolled and received both traditional and new 18-lead ECG. The findings of these two ECG methods were compared in terms of P-wave amplitude，shape of QRS wave，Q-wave amplitude，R-wave amplitude，S-wave ampli－tude，J-point，ST-segment shift（60 ms after J-point），and T-wave amplitude. Results：There was a good correlation between the find－ings of these two ECG methods，with the highest correlation coefficient of 0.994 in V8 lead and the lowest correlation coefficient of 0.805 in V5R（P<0.05）. There was no significant difference in Q wave between the two ECG methods（P>0.05）. According to the re－sults of the paired t-test，there were significant differences between the two ECG methods in P-wave amplitude in aVR and V2-V6 leads，R-wave amplitude in V2，V9，V3R，and V4R leads，T-wave amplitude in V3，V4，and V9 leads，and ST-segment shift in V2，V3R，and V4R leads（P<0.05）. Conclusion：The new 18-lead ECG has higher reliability than the traditional ECG，and its combination with the parameters of other leads can improve the accuracy of the diagnosis of transient myocardial ischemia and acute myocardial infarction.