Abstract:Objective：To investigate the association between distance of pregnant women’s living place to main road and various ad－verse pregnancy outcomes. Methods：This is a prospective cohort study in Chongqing. A questionnaire survey was conducted to collect information of 703 pregnant women who received the first prenatal examination in the First Affiliated Hospital of Chongqing Medical University from September 2015 to August 2016. The pregnant women were divided into two groups according to the distance between the residence and the main road：a total of 618 pregnant women lived ≥250 meters from the main road and a total of 85 pregnant women lived <250 meters. The pregnancy outcomes of two groups were followed up and were enrolled in multivariate analysis. The logistic regression was used to analyze the relationship between residential proximity to main road and premature birth，gesta－tional diabetes mellitus，preeclampsia，premature rupture of mem－branes，low birth weight and macrosomia，respectively. Multiple linear regression was used to explore the association among residential proximity to main road and neonatal weight and body length. Results：Taking the pregnant woman’s residence at a distance of ≥250 meters from the main road as control，after adjusting the basic demographic characteristics of pregnant women，the distance <250 meters was not a risk factor for preterm birth（OR=0.669，95%CI=0.153-2.972，P=0.593），gestational diabetes mellitus（OR=0.784，95%CI=0.454-1.353，P=0.382），preeclampsia（OR=1.650，95%CI=0.454-5.991，P=0.447），premature rupture of membranes（OR=1.120，95%CI=0.672-1.867，P=0.664），low birth weight（OR=1.626，95%CI=0.455-5.809，P=0.454） and macrosomia（OR=1.932，95%CI=0.763-4.890，P=0.165），nor did it influence the weight（OR=0.037，95%CI=-49.746-146.518，P=0.333） and length（OR=0.009，95%CI=-0.350-0.445，P=0.813） of the newborn. Conclusion：The distance between living place of pregnant women and the main road <250 meters is not a risk factor of adverse pregnancy outcomes.

Abstract:Objective：To study the effect of progranulin（PGRN） on the expression of interleukin（IL）-10 and the polarization of pulmonary macrophages through the regulation of regulatory T cells（Tregs） in mouse model with acute lung injury（ALI）. Methods：The C57BL/6 mice were randomly divided into the normal control group（Control group），the lipopolysaccharides（LPS） group and the LPS+PGRN treatment group（LPS+PGRN group）. The ALI mouse model was induced by LPS（2.5 mg/kg） via intratracheal instillation. The LPS+PGRN group was treated with 0.1 mg/kg PGRN after half an hour of LPS instillation. The mice were anesthetized with 3% chloral hydrate at 24h after LPS instillation，lung tissues and heparin anticoagulant blood were taken. The severity of lung injury was evaluated by histopathology with hematoxylin and eosin staining. The Tregs in peripheral blood was detected by flow cytometry. The expression of IL-6，tumor necrosis factor（TNF）-α and IL-10 in plasma were tested by enzyme linked immunosorbent assay. The phenotype of macrophages in lung tissue was detected by immunofluorescence. Results：The ratio of Tregs in peripheral blood，the expression of IL-6，TNF-α，and IL-10 in plasma，and the proportion of M1 and M2 macrophages in the lung tissue between different groups had statistically significant differences（F=69.340，P=0.000；F=73.100，P=0.000；F=17.800，P=0.000；F=11.780，P=0.003；F=67.560，P=0.000；F=197.100，P=0.000）. After PGRN treatment，the lung injury of ALI mouse model was significantly reduced and the proportion of Tregs in peripheral blood was higher[LPS：（4.714±0.265）%，LPS+PGRN：（8.930±0.255）%，P=0.000]. The expression of proinflammatory cytokines IL-6[LPS：（3 021.000±294.900） pg/mL，LPS+PGRN：（276.700±148.000） pg/mL，P=0.000] and TNF-α[LPS：（90.980±10.240） pg/mL，LPS+PGRN：（20.410±9.190） pg/mL，P=0.002] was significantly decreased. The expression of anti-inflammatory cytokine IL-10 in plasma significantly was increased[LPS：（296.400±44.280） pg/mL，LPS+PGRN：（2551.000±655.100） pg/mL，P=0.014]，and M1 lung macrophages was decreased[LPS：（17.870±1.890）%，LPS+PGRN：（4.436±0.248）%，P=0.000]，while M2 lung macrophages was increased[LPS：（2.284±0.444）%，LPS+PGRN：(11.920±0.458）%，P=0.000]. Conclusion：PGRN can increase the expression of IL-10 and M2 lung macrophages through the regulation of Tregs in ALI mouse model，so as to influence the polarization of lung macrophages.

Abstract:Objective：To investigate the effect of two different dosages asiatic acid on the fracture healing in mice. Methods：Thirty-six C57 mice of 12 weeks were suffered right femoral fracture and were divided into three groups（n=12）：the blank control group which was treated with saline of 0.2 mL；the low-dose asiatic acid group which was treated with asiatic acid at a dose of 5 μg/g and amount of 0.2 mL；high-dose asiatic acid group which was treated with asiatic acid at a dose of 15 μg/g and amount of 0.2 mL. All treatments were performed twice a week via subcutaneously in－jections. X-ray images of the right lower limb were performed before and 8 weeks after drug administration. After 8 weeks of administration，micro-computer tomography（CT） analysis，three-point bending mechanical test and decalcified bone histological analysis were performed. Results：After 8 weeks of treatment，healing in three groups was in different degree. X-ray data showed that callus formation was incomplete in the blank control group and the low-dose asiatic acid group；callus formation was com－plete and density of trabecular bone was uniformly in the high-dose treatment group. Results of micro-CT showed that the bone volume ratio（BV/TV） or bone mineral density（BMD） in the low-dose treatment group was increased by 13.0%（P=0.264） or 7.6%（P=0.215） than that in the blank control. In addition，BV/TV or BMD in the high-dose treatment group was also increased by 28.3%（P=0.020） or 15.8%（P=0.009） than that in the blank control. Data of the mechanical test showed that asiatic acid was able to enhance the femur’s mechanical property；maximal load and Young’s modulus were increased by 26.37%（P=0.025） and 10.00%（P=0.183） in the low-dose group or 42.89%（P=0.007） and 25.19%（P=0.035） in the high-dose group. And histological results showed that mineralization was incomplete and non-union at the fracture ends inside the callus in the control group，while mineralization was complete in two asiatic acid treatment groups，with a better bone healing effect in the high-dose group. Conclusion：The high dose of asiatic acid can promote the ossification and accelerate the healing process of fracture，and enhance the mechanical properties in mice.

Abstract:Objective：To investigate the effect of miR-30-5p on the proliferation and migration of esophageal cancer cells and its molecular mechanism. Methods：A total of 120 samples of esophageal cancer and 120 samples of adjacent tissues were collected in department of cardiothoracic vascular surgery of Kaifeng Central Hospital and thoracic surgery of Henan People’s Hospital from June 2014 to June 2019，and fluorescence quantitative PCR was used to detect the expression of miR-30-5p. Lentivirus was used to estab－lish miR-30-5p overexpression cell lines（the miR-30-5p group） and control cell lines（the miR-control group） in esophageal cancer cell line EC109. The EdU staining was used to analyze the proliferation in two groups. Transwell was used to analyze migration in two groups. Bioinformatics and double luciferase reporter gene were used to analyze target genes of miR-30-5p. Influence of overexpres－sion gene on cell proliferation and migration in the miR-30-5p group and the miR-control group was analyzed. Results：Compared with adjacent tissues，the expression of miR-30-5p of esophageal cancer tissues was significantly increased，with statistically signifi－cant difference（P<0.05）. Compared with the miR-control group，the proliferation and migration ability in the miR-30-5p group signifi－cantly decreased，with statistically significant difference（P<0.05）. Bioinformatics and double luciferase reporter gene showed that BCL-9 was the target gene of miR-30-5p. Overexpression of BCL-9 in the miR-control group was able to significantly increase cell proliferation and migration，with statistically sig－nificant difference（P<0.05）. Over-expression of BCL-9 in the miR-30-5p group had no statistical significance on cell proliferation and migration（P<0.05）. Conclusion：The expression of miR-30-5p is low in esophageal cancer，which can up-regulate the expression of its target gene BCL-9 and promote proliferation and mi－gration of esophageal cancer cells.

Abstract:Objective：To investigate the effect of miR-206 on proliferation，invasion and migration of prostate cells by regulating pro－grammed cell death 10（PDCD10）. Methods：Prostate cancer specimens of 61 cases in Sinopharm Hanjiang Hospital were selected and 40 benign prostatic hyperplasia tissues were selected as controls. Expression levels of miR-206 and PDCD10 were detected by in situ hybridization，and the relationship between expressions of miR-206 or PDCD10 and clinicopathological parameters of patients with prostate cancer was analyzed. The interaction between miR-206 a and PDCD10 were verified by dual luciferase reporter gene assay. Prostate cancer PC3 cells were transfected into miR-206 mimics+PDCD10 pcDNA overexpression vector，miR-206 mimics，PDCD10 pcDNA overexpression vector，the mimics NC group and the mimics NC+PDCD10 pcDNA group，respectively. The expres－sion of PDCD10 mRNA was detected by RT-qPCR and the expression of PDCD10 protein was detected by Western blot. The proliferation，migration and invasion of prostate cancer cells were detected by MTT and Transwell. Results：In situ hy－bridization showed that the positive expression rate of miR-206 in prostate cancer tissues（24.59%，15/61） was significantly lower than that in benign prostatic hyperplasia tissues（87.5%，35/40）（χ2=38.248，P=0.000）. The positive expression rate of PDCD10 in prostate cancer tissues（73.77%，45/61） was significantly higher than that in benign prostatic hyperplasia tissues（27.5%，11/40）（χ2=20.397，P=0.000）. Both miR-206 and PDCD10 were associated with TNM clinical stage and Gleason score（P<0.05），and were not associated with age and preoperative PSA levels（P>0.05）. Linear regression and correlation analysis showed that miR-206 expression had a significant negative correlation with PDCD10 expression（r=-0.959，P<0.001）. After co-transfection of miR-206 mimic with the PDCD10 wild-type reporter vector，the luciferase activity in cells was decreased（P<0.01）. The expression level of PDCD10 mRNA and protein was the lowest in the miR-206 mimics group. Overexpression of miR-206 significantly inhibited the proliferation，migration and invasion of PC3 cells. Overexpression of PDCD10 was able to significantly increase the proliferation，migration and invasion of PC3 cells，and overexpression of PDCD10 was able to reverse the inhibitory effect of miR-206 on the cell proliferation，migration and invasion abilities of PC3 cells. Conclusion：The miR-206 can inhibit the proliferation，migration and invasion of prostate cancer cells，whose mechanism is related with the targeted negative regulation of PDCD10 expression.

Abstract:Objective：To compare the long-term prognosis of the elderly patients with unruptured intracranial aneurys（UIA），treated by observation，cliping or coiling，and analyze the risk factors. Methods：The clinical data of 177 cases of patients（≥65 years old） with unruptured intracranial aneurysms admitted in our hospital from January，2012 to August，2018 were retrospectively analyzed. In all，65 patients were treated with coiling，and 38 patients were treated with clipping. The remaining 74 patients were placed under conservative observation. The modified Rankin scale（mRS） was used to assess prognosis（≥1 year）. Risk factors were explored through univariable and multivariable logistic regression analysis. Results：There was no significant difference of long-term prognosis in patients with UIA among observed（12.16%），coiling（6.15%） and clipping group（5.26%，P=0.324）. However the mortality of observed group was significantly higher than others（9.46% vs. 3.08% vs. 0.00%，P=0.031）. The annual rupture rate of observation group was 3.3%. The multivariate analysis showed that aneurysm size（P=0.022，OR=0.111，95%CI=0.017-0.731） and morphology （P=0.021，OR=10.032，95%CI=1.417-71.035） were independent risk factors for unfavorable outcome of UIA in observed group Symptomatic cerebral infarction（P=0.022，OR=64.750，95%CI=1.834-2 286.561） and aneurysm size（P=0.047，OR=17.867，95%CI=1.041-306.749） were also significantly associated with unfavorable outcome of UIA managed with operation. Conclusion：Aggressive treatment of high-risk unruptured aneurysms in elderly patients should be considered positively. Coiling and clipping are both safe and effective treatment methods，and age is not the contraindication.

Abstract:Objective：To investigate the identification value of vascular displacement direction in carotid space on lymph node-de－rived and neurogenic lesions in neck Ⅱ-Ⅳ area. Methods：A total of 33 patients whose lesions were pathologically confirmed in the neck Ⅱ-Ⅳ area from 1st January 2017 to 15th April 2019 were collected, including lymph node-derived lesion（n=26，including seven patients of lymph node tuberculosis，eight patients of lymph node metastasis，seven patients of lymphoma and four patients of lymphnoditis） and neurogenic lesion（n=7，including six patients of schwannoma and one patient of neurofibroma）. Besides the obvi－ous signs of lesion size，boundary，shape，density and enhancement ways and degree, the vascular displacement direction received more attention. Results：There were no significant differences in size（Z=-1.456，P=0.145），boundary（ ?字2=0.480，P=0.652），shape（?字2=2.257，P=0.190），density（ ?字2=1.451，P=0.378），ways of enhancement（ ?字2=1.188，P=0.664），and degree of enhancement（ ?字2=5.579，P=0.084） between two groups. In contrast，26 patients（100%） with lymph node lesion had inward displacement，carotid space vascular moving inside，six patients with neurogenic lesion（85.7%） had outward displacement，and one patient with neurogenic lesion（14.3%） had inward displacement, with statistically significant differences（ ?字2=27.238，P=0.000）. Conclusion：The direction of vascular displacement in carotid space can be used to identify the lesion from lymph node or nerve in the neck Ⅱ-Ⅳ area.

Abstract:Objective：To analyze the survival of patients with rectal cancer who have special medical insurance in Chongqing，and provide reference for prognosis evaluation and prevention of rectal cancer. Methods：The retrospective cohort study was conducted and a total of 3 734 patients with rectal cancer were enrolled who were diagnosed and treated from January 2010 to December 2018 in the Chongqing Malignant Tumor Treatment System. Observation indicators：①Demographic characteristics：age，gender，nation－ality，marriage and occupation. ②Habits：smoking history and alcohol-drinking history. ③Clinical treatment and pathological examination：surgery，pathological type and TNM stage. ④Results of patient follow-up：survival status. ⑤Analysis of prognostic factors. Follow-up by telephone and out-patient review. Death was regarded as end point and follow-up was ended on Decem－ber 31，2018. The mean ± SD（x±s） was used to demonstrate the measurement data，and the absolute number（%） was used to demon－strate counting data；the survival rate was calculated by Kaplan-Meier method；the log-rank test was used for single factor analysis；the Cox proportional hazards regression model was used for multivariate analysis；GraphPad Prism 8.0 was used to draw survival curves. Results：①The demographic characteristics of 3 734 patients with rectal cancer were：25-107 years old，with an average age of （63.48±12.07） years old；male patients of 2 389，accounted for 63.98%；Han nationality accounted for 99.09%；married patients accounted for 94.80%. ②Results of living habits：974 patients kept smoking，accounting for 27.25%；929 patients kept drinking，ac－counting for 26.23%. ③Results of clinical treatment and pathology：patients with infiltration depth of T4 accounted for 43.35%，patients with positive lymph nodes accounted for 51.54% and patients with distant metastasis accounted for 11.72%. Patients with stage Ⅲ-Ⅳ accounted for 76.64% and patients with adenocarcinoma accounted for 94.09%. ④Follow-up results：2 971 patients（79.57%） finished followed up. The median survival time was 99.29 months（95%CI=91.01-107.57），and observed survival rates at the 1st，3nd and 5th year were 91.62%，74.47% and 62.98%，respectively. ⑤Analysis of prognostic factors：univariate analysis showed that survival prognosis of age，gender，marital status，smoking history，infiltration depth（T），positive lymph nodes（N），distant metastases（M），TNM staging，surgical treatment，and tissue differentiation had statistically significant differences，but nationalities，occupations，drinking history and pathological types had no statistically significant differences. Multivariate analysis indicated that age，infiltration depth（T），positive lymph nodes（N），TNM staging and tissue differentiation were likely to be risk factors influencing prognosis of rectal cancer patients. Conclusion：There are many factors influencing prognosis of rectal cancer patients，among which age，infiltration depth（T），positive lymph node（N），TNM staging and tissue differentiation may be risk factors. Enhancing health education and early screening di－agnosis are beneficial to improve the prognosis of rectal cancer patients.

Abstract:Objective：To analyze the mood disorder and its influencing factors in diabetic nephropathy patients with maintenance hemodialysis，so as to provide evidence for the clinical treatment and psychological counseling of patients. Methods：A total of 150 patients with diabetic nephropathy received maintenance hemodialysis in our hospital were selected，and 150 non-diabetic nephropa－thy patients with matching age and gender received hemodialysis were selected. Clinical data and biomedical data were collected. Zung self rating anxiety scale（SAS） and Zung depression self rating scale（SDS） were used to survey mood disorders in two groups，to analyze the related factors of mood disorders in diabetic nephropathy patients with hemodialysis. Results：There was no significant difference in age and gender between two groups. Among the 150 diabetic nephropathy patients with hemodialysis，the incidence of anxiety and depression and sleeping scores were higher than those in non-diabetic nephropathy patients，with statistically significant differences（P=0.05）. Among diabetic nephropathy patients with hemodialysis，the number of women with mood disorders was signif－icantly higher than that without mood disorders（P=0.000）；but differences in hemoglobin，serum albumin，serum calcium，serum phosphorus，iPTH，single compartment urea clearance rate（spKt/V） level of diabetic nephropathy patients in the normal group and the depression group had no statistical significance（P>0.05）. Cardiovascular and cerebrovascular complications，restless legs，skin itching，sleep disorder and bone pain in the depression group were significantly higher than those in the normal group，with statistically signif－icantly differences（P<0.05）. Conclusion：Patients with diabetic nephropathy are prone to have emotional disorders during hemodialysis，and female，cardiovascular disease，cerebrovascular disease，bone pain and other complications as well as low social support are independent risk factors for mood disorders in diabetic nephropathy patients with hemodialysis.

Abstract:Objective：To explore the differentiating value of linear circular enhancement on abscess and primary necrotic tumor. Methods：CT imaging data of 112 patients and relevant pathological images of 93 patients with abscess and primary necrotic tumor confirmed by pathology，operation or clinical following-up from January 2016 to October 2018 were retrospectively analyzed. Occurrences of linear circular enhancement in two kinds of diseases were counted and the result was analyzed by using the chi-square test. Results：Among 73 patients with abscess and 39 patients with primary necrotic tumor，65 and 2 had linear circular enhancement，with percentage of 89.0% and 5.1%，respectively. Among 8 patients with misdiagnosed abscess，7（87.5%） had this sign，while 3 misdiagnosed cases of primary necrotic tumor had no sign，with significant differences between abscess and primary necrotic tumor（P<0.05）. Furthermore，pathological images showed that major inflammatory granulation tissue wrapped around the necrotic area in abscess，containing many capillaries；the edge of necrosis area in tumor was tumor cells，disorderly and few nourishing vessels. Conclusion：Manifestation of lin－ear circular enhancement as inflammatory granulation tissue in enhanced CT images can an iconographical differentiating index for both abscess and primary necrotic tumor.

Abstract:Objective：To explore the capacity management of critical ultrasound and pulse-indicated continuous cardiac output（PiCCO） in patients with acute heart failure（AHF） and to compare the early therapeutic effect of those two methods，so as to provide a scientific basis for timely treating patients. Methods：AHF patients who met the admission criteria were selected from January 2017 to September 2018 in the intensive care unit（ICU） of Dazu District People’s Hospital and were randomly divided into the experimental group（n=30） and the control group（n=28）. The experimental group was guided by critical ultrasound monitor－ing，while the control group was guided by PiCCO monitoring. The N-terminal pro-brain natriuretic peptide（NT-proBNP），central venous pressure（CVP），mean arterial pressure（MAP），lac－tate clearance rate and central venous oxygen saturation（ScvO2） within 72 hours were compared among patients in two groups. The in－cidence of pulmonary infection，mechanical ventilation time，ICU occupancy time，28-day mortality rate，survival curve，6-hour re－covery and the number of cases that can be monitored within 3 hours were statistically recorded. Pre-and-post-treatment cardiac function and blood volume indexes of the two monitoring methods were compared. Results：NT-proBNP，CVP，MAP，lactate clearance and ScvO2 at the 72nd hour in two groups had no statistically significant difference（P>0.025）. The incidence of pulmonary infection in the experimental group was higher than that in the control group，with statistically significant difference（P<0.025）. The number of cases of capacity management that could be monitored within 3 hours in the experimental group was significantly higher than that in the control group，with statistically significant difference（P<0.05）. The number of cases of capacity management that could be moni－tored within 6 hours in two groups had no statistically significant difference（P>0.05）. Mechanical ventilation time，ICU stay time，28-day mortality and survival time in two groups had no statistically significant difference（P>0.05）. Comparison of cardiac function indexes before and after treatment：in the experimental group，the indexes of CO and LVEF before treatment were lower than those after treatment，with statistically significant difference（P<0.05）；in the control group，the indexes of CI and GEF before treatment were lower than that after treatment，with statistically significant difference（P<0.05）. Comparison of blood volume indexes before and after treatment：in the experimental group，the respiratory rate of inferior vena cava，LVEDV and SV after treatment were higher than those before treatment，and IVC after treatment was lower than that before treatment，with statistically significant difference（P<0.05）；in the control group，SVI after treatment was higher than that before treatment，and GEDI after treatment was lower than that before treatment，with statistically significant difference（P<0.05）. Conclusion：According to the clinical study of capacity management on critical ultrasound and PiCCO in patients with AHF，we find that both methods can accurately assess capacity and predict volume responsiveness. However，compared with PiCCO，critical ultrasound can significantly shorten the delay time in the course of treatment，can also be operated and monitored in time under the condition of hemodynamic changes，and belongs to non-invasive operation which can be repeatedly checked in the treatment. Real-time capacity management can reduce certain operational and therapeutic risks，such as the catheter-related infection and pulmonary infection，improving the early treatment ability for AHF patients. The short－comings of PiCCO and critical ultrasound can’t reduce the mortality，so it is necessary to further study other comprehensive treatment schemes to reduce the risk of death and improve the survival rate of patients with AHF.

Abstract:Objective：To investigate the application of autologous blood transfusion on surgery of uncomplex congenital heart disease in children for decreasing the need for clinical blood transfusion. Methods：A total of 110 patients with uncomplex congenital heart disease who underwent surgical treatment in our hospital from January 2019 to June 2019 were selected and divided into two groups：38 patients used autologous blood transfusion as the case group and 72 patients not used autologous blood transfusion as the control group. The number of intra-and-post-operation blood transfusions was collected and analyzed in two groups. Results：Compared with the control group，the number of intra-and-post-operation blood transfusions in the case group was significantly reduced（P=0.019，P=0.000）；the number of allogeneic red blood cell（RBC） and fresh frozen plasma transfusions during operation in the case group were significantly reduced（P=0.006，P=0.016）；the number of allogeneic RBC transfusion after surgery in the case group was significantly reduced（P=0.001）；levels of hemoglobin（Hb） and hematocrit（Hct） after surgery in the case group were higher（P=0.001，P=0.010）. Conclusion：The use of autologous blood transfusion during the operation can significantly reduce intraoperative and postopera－tive allogeneic blood transfusions in the children with uncom－plex congenital heart disease requiring surgical treatment，which is worth clinical promotion.

Abstract:Objective：To analyze the new 810 cases of childhood leukemia in the past five years，and to explore its incidence trend，risk factor and prognosis，laying a foundation for the prevention and treatment of leukemia. Methods：The epidemiological data of 810 cases of childhood leukemia in our hospital from January 2014 to December 2018 were retrospectively analyzed，including age，gen－der，onset season，initial symptoms，morphology classification，immunology typing，cytogenetics typing and molecular biology typing. And the influencing factor of children’s leukemia outcome were obtained through binary logistic regression. Results：Among the 810 children with leukemia，the number of boys was more than that of girls，and the number of boys with acute lymphoblastic leukemia（ALL） at all ages was higher than that of girls. ALL was most common in 1-4 years age group，but there was no significant difference in the age distribution of acute myeloid leukemia. Patients of 10% had a family history of cancer and 34.44% had been exposed to toxic chemicals. According to results of MICM，ALL took dominant position in morphology classification（79.26%）；acute B-lymphocytic leukemia（B-ALL） took dominant position in immunology typing；patients had clonal abnormalities had a detection rate of 41.56%；the highest positive rate of ETV6/RUNX1（TEL/AML1） in children with ALL was 14.86%；the positive fusion gene in children with acute T-ALL was SIL/TAL1；the detection rate of PML/PARα in children with acute myeloid leukemia（AML） was the highest（35.25%）. Results of binary logistic regression analysis showed that family tumor history，cytogenetic typing and ETV6/RUNX1 fusion gene were influencing factors of leukemia outcome，and OR values were 5.234（1.166-23.485），3.442（1.666-7.115） and 0.131（0.031-0.556），respectively. Conclusion：Family tumor history，cytogenetic typing and ETV6/Runx1 fusion gene may be the pre－dictive factors of leukemia prognosis. The family tumor history and non-low-risk cytogenetics may be the risk factors of leukemia prognosis，and the positivity of ETV6 / Runx1 fusion gene may be the protective factor.

Abstract:Objective：To evaluate the relationship between intraoperative crystalloid administration and postoperative outcomes in pe－diatric patients with neonatal necrotizing enterocolitis（NEC）. Methods：A total of 172 NEC patients undergoing surgery from January 2012 to September 2018 in our hospital were retrospectively analyzed and were divided into the low crystalloid group[<25.89 mL/（kg·h）] and the high crystalloid group[>25.89 mL/（kg·h）] by taking median after correcting input crystalloid amount as standard. First time to enteral feeds，first defecation，the incidence of complications，the postoperative length of NICU or ICU stay，postoperative death and incomplete enteral nutrition within 90 days after surgery were monitored and compared. Results：The univariate analysis showed that the incidence of postoperative complications was significantly different in two groups（P<0.05）. Variables with P<0.05 in univariate analysis were included in stepwise backward logistic regression analysis and it was identified that crystalloid administration was an independent protective factor of postoperative complications（OR=0.955，95%CI=0.914－0.997，P=0.036）. Conclusion：The intraopera－tive crystalloid administration can reduce the risk of postoperative complications.

Abstract:Objective：To observe the effect of dexmedetomidine combined with lidocaine pretreatment on perioperative cardiac events in patients undergoing thoracoscopic lung cancer surgery. Methods：Eighty patients undergoing thoracoscopic lung cancer surgery were randomly divided into two groups：the dexmedetomidine combined with lidocaine pretreatment group（group DL，n=40） and the control group（group C，n=40）. 1 μg/（kg·h） dexmedetomidine and 2 mg/（kg·h） lidocaine in group DL，and saline in group C was administered during anesthesia induction and last for 30 minutes. The serum level of hs-cTnT and NT-proBNP was measured before operation，as well as 24 h，48 h and 72 h after operation，and the incidence of cardiac events during operation and within 30 days after operation was recorded. Results：There was no significant difference in levels of hs-cTnT and NT-proBNP between the two groups before operation（P>0.05），but the levels of hs-cTnT at 48 h and 72 h and the levels of NT-proBNP at 24 h，48 h and 72 h after operation were significantly higher than those before operation. The levels of hs-cTnT at 48 h and the levels of NT-proBNP at 24 h，48 h and 72 h after operation in group DL were significantly lower than those in group C（P<0.05）. There were no myocardial infarc－tion and cardiac arrest event after operation in both groups. The incidence of intraoperative atrial premature，asymptomatic myocardial ischemia and arrhythmia in group DL was significantly lower than those in group C（P<0.05）. Conclusion：Pretreatment of dexmedeto－midine combined with lidocaine can reduce the levels of my－ocardial injury markers and the incidence of cardiac events in patients undergoing thoracic lung cancer surgery.

Abstract:Objective：To investigate the epidemiologic feature and related risk factors of different type of autoimmune liver diseases （ALD）. Methods：A total of 111 patients with ALD from August 2012 to August 2018 in our hospital were selected as study objects and were divided into autoimmune hepatitis（AIH），primary biliary cirrhosis（PBC），primary sclerosing cholangitis（PSC） and AIH-PBC overlapping syndrome（OS） according to the diagnosis. The PSC group had only one patient and was excluded. The differences of gender，age，personal history，documents related with concomitant diseases and laboratory examination in each group were retrospec－tively analyzed. Results：The average onset age in AIH，PBC，and OS groups was（53.29±12.43） years old，（62.91±11.61） years old and （63.05±11.40） years old，respectively；the difference among groups was statistically significant（P<0.01）. The genetic family history was statistically significant among groups（P<0.05）. The positive rate of anti-mitochondrial antibody M2 in the AIH，the PBC and the OS group were 23.2%，52.8% and 70.5%，respectively，with statistical significance（P<0.01）. Aspartate aminotransferase（P<0.01） and cholinesterase（P<0.05） were statistically significant between the AIH group and the PBC group. Aaspartate aminotrans－ferase（P<0.05），cholinesterase（P<0.05） and alkaline phosphatase（P<0.05） among three groups had significant differences. Smoking，drinking，gender，medication history，clinical symptoms，EB virus and cytomegalovirus infection，and humoral immunity were not sta－tistically different among three groups（P>0.05）. Conclusion：AIH is the most common type of ALD. AIH has a younger onset in all types of ALD，and different types of ALD have a certain genetic predisposition. Aspartate aminotransferase and cholinesterase are par－ticularly elevated in AIH，and cholinesterase is more prominent in PBC. The positive rate of anti-mitochondrial antibody M2 type is the highest in OS. As for risk factors，smoking，gender，drinking，medication history，EB virus and cytomegalovirus infection have limit－ed significance in the group identification of ALD.

Abstract:Objective：To explore the virological response，anti-fibrosis efficacy and safety of sofosbuvir and velpatasvir in hepatitis C patients. Methods：Eighty patients with chronic hepatitis C and without cirrhosis were selected as subjects for retrospective analysis. Forty patients in the control group received subcutaneous injection of pegylated interferon α-2b injection and oral ribavirin；forty patients in the observation group one received oral sofosbuvir and velpatasvir；both groups were treated for 12 weeks. Meanwhile，18 patients with compensatory cirrhosis and chronic hepatitis C were selected as the observation group two，which received treatment of sofosbuvir and velpatasvir. HCV-RNA，biochemical indicators，liver transient elastography and adverse reactions before and after medicine treatment were compared. Results：The end of serum virological response rate（95%） and sustained virological response rate（95%） in the observation group were higher than those of 80%（P=0.043） and 72.5%（P=0.006） in the control group. AST and ALT were decreased dramatically after medicine treatment in both groups，especially in the observation group one（P<0.05）. After 12 weeks of treatment，the PCⅢ（125.616±14.683 vs. 25.783±14.006，t=22.091，P=0.000），HA（329.927±66.372 vs. 163.883±55.623，t=8.066，P=0.000） and liver hardness values（19.627±3.594 vs. 15.300±3.645，t=3.456，P=0.003） of patients complicated with compensated cirrhosis in the observation group two were significantly lower. The incidence of adverse reactions in the control group（52.5%） was nearly twice than that in the observation group one（25%）（P<0.05）. Conclusion：Compared with combination of pegylated interferon α-2b combined and ribavirin，combination of sofosbuvir and velpatasvir has better curative effect，lower adverse effect and higher safety and can also delay the progression to liver fibrosis.

Abstract:Objective：To compare the image quality of gradual and non-gradual breath training protocols in gadoxetate disodium （Gd-EOB-DTPA） upper abdomen-enhanced magnetic resonance at hepatic arterial phase，combing with dilution method of 1∶1，so as to explore the most reasonable combination of breath training and injection program. Methods：A total of 95 patients underwent Gd-EOB-DTPA upper abdomen-enhanced MR imaging in our department from May to September 2019 with no significant difference in the population statistics were selected and divided into three groups：the group 1（30 patients were trained by gradual protocol with the breath time from 5 s，10 s，15 s to 20 s，as no ups and downs of whole abdomen for the standard），the group 2（33 pa－tients were trained by non-gradual protocol with the breath time of 20 s，as no ups and downs of whole abdomen for the stan－dard），and the group 3（32 patients were trained with the same protocol as the group 2）. The Gd-EOB-DTPA injection rate in the group 1 and the group 2 was 1 mL/s，with 20 mL normal saline flushing. The 1∶1 diluted with saline Gd-EOB-DTPA injection rate in the group 3 was 2 mL/s，with 20 mL normal saline flushing. All arterial phases were detected by MR fluoroscopic triggering technique. The scoring standard for image quality included：1= no artefact，2=mild and diagnosable artefact，3= moderate and diagnosable arte－fact，4=severe and diagnosable artefact and 5=undiagnosable. Imaging score of hepatic artery，portal vein，abdominal aorta and liver parenchyma was evaluated and the total score were calculated，and differences of the 3 group were analyzed by the Kruskal-Wallis test and Mann-Whitney test. Results：The mean score of hepatic artery，portal vein，abdominal aorta and liver parenchyma and the total score in the group 3 were slightly higher than those in the group 1 and the group 2（P=0.065，0.229，0.819，0.340，0.080）. The breath－ing artefact in the group 3 was significant smaller than that in the group 1 and the group 2（P=0.004，0.046）. The non-gradual diluted method had a smaller respiratory artefact. Conclusion：Holding breath for 20s in the group 3 is adopted and Gd-EOB-DTPA diluted 50% injection method can significantly decrease the respiratory motion artefacts.

Abstract:Objective：To evaluate the effect of transvaginal bilateral sacrospinous ligament suspensions fixation on treating anterior and middle pelvic organ prolapse. Methods：Fifty-seven patients with pelvic prolapse of degree Ⅱ or above who had clinical symptoms and surgical intention were selected and were underwent transvaginal bilateral sacrospinous ligament suspensions fixation. Patients’ age，operation time，bleeding volume，and pre- and post-operation POP-Q score and PFDI-20 score were recorded and were analyzed. Results：The average operation time was （57.70±21.42） min and the average blood loss was （45.44±40.00） mL. Scores of Aa，Ba，C and PFDI-20 before and after surgery had statistically significant differences（P<0.05）. Conclusion：Transvaginal anterior sacrospinous ligament suspensions fixation is a safe and effective method for treating patients with anterior and middle pelvic organ prolapse.

Abstract:Objective：To investigate the clinical curative effect of central uterine body ectomy combined with gonadotropin releasing hormone agonist（GnRH-a） under laparoscope on the treatment of adenomyosis. Methods：From January 2015 to December 2017，35 patients with adenomyosis who chose central uterine body ectomy under laparoscope in our hospital were selected as the study group and were treated with GnRH-a（zoladex） for 6 months after operation，and 35 patients with adenomyosis chose to laparoscopic hys－terectomy were taken as the control group. Patients in the two groups were followed up for 6-12 months；the operation time，intraoper－ative blood loss，the recovery time of gastrointestinal function after operation，dysmenorrhea improvement，the quality of sexual life after operation，perimenopausal symptoms as well as relative sexual hormone levels and postoperative satisfaction degree were com－pared between two groups. Results：The operation time in the study group was longer than that in the control group，the intraoperative blood loss was more than that in the control group，with statisti－cally significant difference（P=0.000）. There was no significant difference in the recovery time of gastrointestinal function be－tween two groups（P=0.874）. The dysmenorrhea in two groups after operation were significantly less than that before opera－tion，with statistically significant difference（P=0.000）. The quality of sexual life in the study group was higher than that in the control group（P=0.000）. Level of estradiol（E2） and follicle-stimulating hormone（FSH） before operation and one year after operation in the study group had no significant difference（P=0.076，P=0.253）. In the control group，the level of E2 one year after operation was lower than that before operation，and the level of FSH was higher than that before operation（P=0.002）. The postoperative satisfaction in the study group was significantly higher than that in the control group（P=0.000）. Conclusion：Central uterine body ectomy combined with zoladex under laparoscope on the treatment of adenomyosis can improve the clinical symptom，meet patients’ desire to retain the uterus and avoid adverse effects of total hysterectomy，after which patients enjoys a better recovery and satisfaction，and is a preferable choice for patients with adenomyosis who need to retain the uterus.

Abstract:Objective：To analyze clinical features and prognosis of elderly patients with candidemia，and to provide basis for clinical diagnosis and treatment of candidemia. Methods：A total of 165 cases of candidemia diagnosed in a hospital were collected from January 2015 to December 2018，including the basic data，treatment records，outcomes，and laboratory reports. According to the hospital stay，the patients were divided into two groups：the first group（104 cases） was no more than 28 d，the second（61 cases） was over 28d. Results：Candida isolated from blood culture of 165 cases were mainly Candida albicans（78 cases），Candida parapsilosis （40 cases），and Candida tropicalis（40 cases），which were mainly distributed in ICU（82 cases），internal medicine（25 cases），and surgery（18 cases）. All patients were accompanied by other diseases in different degrees with a mortality of 54.5%. The mortality of the second group was higher than that of the first group（P<0.05），and the mortality of the cases without antifungal drugs was higher than the cases with antifungal drugs（P<0.05）. In addition，WBC，PCT，（1，3）-β-D-glucan and IL-6 were increased in varying degrees，however，there were no specificity for the early diagnosis of candidemia. Conclusion：The clinical features of candidemia is not obvious and the prognosis of patients is seriously affected. Clinicians should put a high value on candidemia and improve the routine inspection of blood culture. Antimicrobial agents should be used rationally，in order that early diagnosis and treatment of candidemia can be achieved and the prognosis of patients can be improved effectively.

Abstract:Objective：To investigate the change between serum homocysteine（Hcy） and tumor necrosis factor-α（TNF-α），inter－leukin-6（IL-6），plasma endothelin（ET） and nitric oxide（NO） in patients with elderly hypertension and their correlation，and to investigate the mechanism of Hcy in the elderly hypertension from the perspective of immune inflammatory factor and vascular endothelial factor. Methods：The serum Hcy，TNF-α，IL-6，ET and NO in 177 patients with elderly hypertension were tested，and patients were divided into the group Q1，the group Q2 and the group Q3 according to serum Hcy concentration. One-way ANOVA was used to analyze the difference of parameters among three groups. The correlation between Hcy and TNF-α，IL-6，ET and NO was analyzed by Pearson correlation coefficient. Binary Logistic regression was used to analyze the particular impact of Hcy on TNF-α，IL-6，ET and NO. Results：Hcy，TNF-α，IL-6 and ET in the group Q2 and group Q3 were significantly higher than those in the group Q1，while NO was significantly decreased（all P<0.05）. Pearson correlation analysis showed that Hcy was positively correlated with TNF-α，IL-6 and ET（r values were 0.676，0.852 and 0.730 respectively） and was negatively correlated with NO（r=-0.637），with statistically signif－icant difference（all P<0.05）. After correcting other factors，logistic regression analysis showed that Hcy was a risk factor for elevation of TNF-α，IL-6 and ET（all P<0.05），and was a protective factor for NO elevation（P<0.05）. Conclusion：Serum Hcy and TNF-α，IL-6，ET and NO in patients with elderly hypertension has correlation. The high Hcy may lead to immune inflammation damage and vascu－lar endothelial dysfunction，and then participate in the pathologic process of elderly hypertension.

Abstract:Objective：To investigate the changes of blood cell parameters with age and the differences between men and women at different ages of Tibetan people on the plateau，and to provide precise medical data for the health of Tibetan people and Tibetan aid cadres. Methods：This paper retrospectively studied 2 550 health examiners in Ganzi Tibetan Autonomous Prefecture of Sichuan Province and compared them with 4 596 low-altitude Han nationality examiners in Yibin. The blood cell parameters were red blood cell count（RBC），hemoglobin（Hgb），hematocrit（Hct），red blood cell distribution width-standard deviation（RDW-SD），red blood cell distribution width-variation coefficient（RDW-CV） and mean platelet volume（MPV）. People were divided into 5 groups according to age，A≤10 years old，1050 years old. Comparisons and statistical analyses were made from the general condition of each group，between people in different groups，between different genders of people in the same group，and between people in adjacent groups. Results：We found that before the age of 30，the increase of RBC，Hgb，Hct in Plateau Tibetan males was more obvious than that in plain Han males. After the age of 30，the increase of RBC，Hgb and Hct in Plateau Tibetan women was a gradual trend while those of Han nationality in the plain were declining，with statistical significance（P＜0.01）. In the comparison of each group of the Tibetan plateau with the total sample，RBC had obvious statistical significance（P<0.01），Hgb in groups B，D，and E，and Hct and MPV in groups D and E showed significant differences（P<0.01）. In the comparison between different genders of Tibetan plateau，RBC，Hgb，Hct，RDW-CV had significant statistical differences in groups B，C，D，E（P<0.01）；from the specific value fluctuation and difference，the difference between males and females，RBC，Hgb，and Hct were particularly obvious in groups C and D. In the grouping analysis of plateau Tibetans and plain Hans，there was no significant difference in Hgb and Hct in group A（≤10 years old）（P>0.01）. Conclusion：The parameters of RBC，Hgb，HCT，RDW-SD，RDW-CV and MPV of Tibetan people in Plateau vary obviously according to different ages and genders，with statistical significance for some parameters. Compared with the Plain Han nationality，the difference is also obvious. Understanding these differences and changes will be beneficial to the Tibetan population in the plateau and the large number of Tibetan aid cadres in the diagnosis and treatment of diseases and health care.

Abstract:Objective：To compare the accuracy of two Montreal cognitive assessment five-minute protocols in stroke patients. Methods：A prospective observational study enrolled stroke patients and healthy subjects from the Department of Rehabilitation Medicine of The Second Affiliated Hospital of Chongqing Medical University. National institute for neurological disorders and stroke-Canadian stroke network（NINDS-CSN），Montreal cognitive assessment 5-minute protocol（Hong Kong version），Montreal cognitive assessment（MoCA）and neurobehavioral cognitive status examination（NCSE） were administered to each participant. Results：A total of 29 patients with stroke and 20 healthy controls were enrolled in this study. The results of the two Montreal cognitive assessment five-minute protocols were consistent with the results of the MoCA with correlation coefficients of 0.918 6（P<0.001） and 0.918 1（P<0.001），respectively. NINDS-CSN is better than the Montreal cognitive assessment 5-minute protocol（AUC=0.934；95%CI=0.825-0.985）. Conclusion：The validity of the two Montreal cognitive assessment five-minute protocols is consistent with that of MoCA. The NINDS-CNS five-minute assessment is more suitable for clinical community promotion and application than the MoCA 5-minute protocol.

Abstract:Objective：To evaluate the effect of continuous nursing mode based on network and telephone follow-up on the compliance of colonoscopy screening in high-risk populations with colorectal cancer. Methods：A total of 300 patients with high-risk colorectal cancer which were evaluated by risk evaluation model from January 2017 to November 2017 were selected and were randomly divided into the intervention group and the control group，with 150 people in each group. Basic information were collected and patients in both groups received routine health education related with colorectal cancer. In addition，patients in the intervention group received the continuous nursing intervention conducting through WeChat and telephone. Colonoscopy screening in two groups were observed during the 3-month and 6-month follow-up period，and differences were compared by using t-test，chi-square analysis and logistic regression analysis. Results：During the 6-month follow-up，266 patients were completely followed up，including 137 in the intervention group and 129 in the control group. According to the t-test or chi-square analysis showed that baseline data between the intervention group and the control group had no statistically significant difference（P>0.05）. The compliance of colorectal screening at the 3rd and 6th month in the intervention group was higher than that in the control group，and the difference was statistically significant （P<0.05）. Multivariate logistic regression analysis of the effect of the 3-month intervention showed that continuous nursing inter－vention based on network and telephone follow-up was the in－dependent factor influencing high-risk populations with col－orectal cancer to accept colonoscopy screening（RR=2.697，95%CI=1.307-5.567；P<0.05）. Multivariate logistic regression analysis of the effect of the 6-month intervention also showed that continuous nursing intervention based on network and telephone follow-up was the independent factor influencing high-risk populations with colorectal cancer to accept colonoscopy screening（RR=2.574，95%CI=1.396-4.749；P<0.05）. Conclusion：Continuous nursing intervention based on network and telephone follow-up can improve the colonoscopy screening rate in high-risk populations with colorectal cancer，with a certain promoted value for early detection，early diagnosis and improving diagnosis.

Abstract:Objective：To explore the effect of postoperative limb positions on limb swelling and range of motion after total knee arthroplasty. Methods：Between June 2014 to June 2016，100 patients in our hospital who received primary total knee arthroplasty were recruited and randomly divided into two groups（n=50）. In the Group A，50 patients had their lower limb placed with the hip flexed 30° and the knee mild flexed 30° for the first 72 h after operation. In the Group B，50 patients had their lower limb placed with the hip flexed 30° and the knee high flexed 60° for the first 72 h after operation. Degree of swelling，subcutaneous ecchymosis area，the number of blister and skin temperature after 72h were observed，and angles of passive flexion and active flexion of the operated knee were recorded. Results：There were statistically significant differences in the degree of lower limb swelling，subcutaneous ecchy－mosis area，number of the blister，and skin temperature between two groups（P<0.05）. There was also a significant difference in the angles of active flexion of the operated knee（98°±8.91° vs. 83°±7.65°，P=0.023），while there was no significant difference in the angles of passive flexion（115°±12.16° vs. 110°±10.38°，P=0.072） between two groups. Conclusion：Findings of this study indicate that postoperative position of the hip by 30°，with the knee flexed 30°，is more effective than the position hip flexed 30°with the knee flexed 60°，in alleviating knee swelling and increasing range of motion.

Abstract:Objective：To report one case of cystic fibrosis（CF） caused by S945L variation，and to investigate the present state and perspectives of molecular targeted therapy for this disease in China. Methods：The clinical data and gene mutation of a CF case caused by S945L mutation in cystic fibrosis transmembrane conductance regulator（CFTR） special site in Children’s Hospital of Chongqing Medical University were analyzed. The literature till July 2019 was searched with key words of “cystic fibrosis” and “China” in the database of CNKI，Wanfang，VIP，PubMed and Embase. The clinical data and gene mutation of patients with cystic fibrosis caused by special mutations of CFTR gene reported in China were summarized and analyzed in combination with the literature. Results：The patient had recurrent respiratory tract infection and poor nutritional status，with chest CT suggesting extensive bronchiectasis. Results of sweat chloride concentration test were 74 mmol/L and 75 mmol/L，respectively. Gene detection demonstrated CFTR gene R851X/S945L compound heterozygous mutation，which ws finally diagnosed as CF. According to the literature review，90 patients with CF were reported in China，and 5 patients carried specific mutation sites that could be treated with molecularly targeted treatment. The 15 children with the G970D mutation were most likely to be treated with gene targeting therapy，without confirmed clinical study. Conclusion：Children with recurrent respiratory tract infection，slow growth development and extensive bronchiectasis should guard against CF and the CFTR is in need. In China，more CF patients meet the requirements of targeted drug ther－apy，with considerable treatment prospect. Therefore，more clin－ical studies should be carried out when necessary，so as to in－crease patients’ life span and improve life quality.

Abstract:Objective：To report the clinical and genetic features of a newborn with hyperekplexia，to review the related literature and to investigate the early diagnosis and treatment of neonatal hyperekplexia. Methods：The clinical and genetic data of a newborn diag－nosed with hyperekplexia，who was admitted to our NICU in September，2019，was analyzed. In addition，key words including “Neonatal hyperekplexia”，“newborn” and “startle disease” were searched in Wan Fang and PubMed database（from establishment to September，2019），and cases with early diagnosis at home and abroad（within 2 months）were summarized and analyzed by positive gene test. Results：A total of 19 cases（one case in our hospital and 18 cases from reports） were analyzed. Onset of all patients was in the neonatal period，and patients had excessive startle response to unpredictable stimulation，among which 57.8% patients（including one patient in our hospital） had tonic-apneic spells requiring resuscitation. All cases were positive in nose-tapping test，and there was no specific abnormality in EEG and cephalography. Clonazepam has a good effect on this disease. Vigerano manoenvre was able to alle－viate the acute attack. In our report，gene variation detected by all exon gene sequencing was consistent with clinical condition. The gene mutation GLRB c.844_846delGTT p.（Val282del） originated from father and GLRB c.527G>A p.（Argl76Lys） from mother. A total of 73.6% included patients were GLRA1 mutations，15.8% SLC6A5 mutations and 10.5% GLRB mutations. Conclusion：Patient in this study has the typical clinical manifestation of hyperek－plexia and gene mutation analysis demonstrates that it is corre－lated with GLRB mutation. The disease can be treated but usu－ally be misdiagnosed，often occurs life-threatening systemic stiffness and apnoea attack in the neonatal period，suggesting the importance of early diagnosis. The positive result of nose-tapping test can be used as the characteristic clue of diagnosis. Because multiple genes are involved，the whole exon second generation gene can be sequenced. Clonazepam has a good effect on this disease，but the accurate dosage and time need further clinical study.

Abstract: