Abstract:In the development of surgery，gynecology is one of the earliest disciplines adopting endoscopic technology. From the con－ventional multi-site laparoscopy to the single site，then to the scarless transvaginal natural orifice transluminal endoscopic surgery （vNOTES） and from 2D and 3D laparoscopy to robotic surgical system，laparoscopic technology has developed rapidly in gynecology. The robotic-assisted laparoendoscopic single site surgery（R-LESS），combining laparoendoscopic single site surgery（LESS） and Da Vinci robotic surgical system，is able to complete a variety of benign and malignant tumors，which is safe and feasible，and is also a major breakthrough in the field of minimally invasive surgery.

Abstract:Objective：To explore the safety and feasibility of Da Vinci robot-assisted laparoendoscopic single-site（LESS） in the com－plete staging of endometrial cancer. Methods：Clinical data of nine cases of early stage endometrial cancer complete staged surgery under the LESS assisted by Da Vinci robotic surgery system from February to September 2019 in the Department of Gynecology of The First Affiliated Hospital of Army Medical University were retrospectively analyzed. Results：Nine cases of endometrial cancer were treated with total fascial hysterectomy + bilateral appendectomy + class Ⅱ pelvic lymphadenectomy，and all operations were successful. Among the nine patients，five were grade Ⅰ and four were grade Ⅱ according to the histological grade of FIGO before surgery；the operation time was （251.67±78.32） min，the intraoperative blood loss was （261.11±92.80） mL，the time to get out of bed was （16.00±2.66） h，urinary tube removal time was （20.00±1.58） h，anal exhaust time was （21.56±4.53） h，drainage tube removal time was （27.22±17.87） h and postoperative hospital stay was （4.44±0.53） d. All patients had no intraoperative and postoperative complications. in Eight cases in IA staging and one case in IB stage（complementary brachytherapy） in postoperative clinicopathologi－cal staging. After follow-up of one month，no dehiscence at the upper end of vagina occurred and the umbilical incision recovered well. Conclusion：Physicians with experienced robotic surgery system and single-hole laparoscopic surgery can implement safely Da Vinci robotic surgery system to assist single-hole laparoscopic endometrial cancer in all stages.

Abstract:Objective：To summarize the main point and experience of Da Vinci robot laparoendoscopic single-site（R-LESS） on nurs－ing coordination in the comprehensive operative stage of endometrial cancer. Methods：Clinical data and nursing cooperation during operation of nine cases of Da Vinci R-LESS endometrial cancer surgery were retrospectively analyzed. Results：Operations of nine patients were successfully completed and the postoperative recovery was good. There were no medical and nursing complications dur－ing and after the operation. Conclusion：Professional robotic surgery team，thorough surgical plan，sufficient nursing preparation and skilled and smooth intraoperative nursing coordination ensure the successful implementation of R-LESS surgery.

Abstract:

Abstract:Objective：To study the effects of NAR on myocardial remodeling as well as its effects on NLRP3 inflammasome in dia－betic mice. Methods：Male C57BL/6 mice（n=35） were randomly divided into normal group（N group，n=7） and experimental group （n=28）. The mice in the experimental group were injected with STZ for 3 days to induce diabetes mellitus. Random blood glucose was measured after 7 days. Mice with random blood glucose over 16.7 mmol/L were regarded as diabetes mellitus. Finally，all the twenty-eight mice in the experimental group were successfully modeled. Twenty-eight diabetes mice were randomly divided into diabetes group（DM group），diabetes+low dose of NAR group（DM+LN group），diabetes+ middle dose of NAR group（DM+MN group），and dia－betes+high dose of NAR group（DM+HN group）. The mice in treatment group received different doses of NAR through intraperitoneal injection for 8 weeks. At the end of the study，the mice were sacrificed to observe the effects of NAR at different dose on the body weight and blood glucose. HE staining was used observe pathological changes of myocardial tissue. The myocardial CVF was calculated by Masson staining. Apoptosis was detected by TUNEL fluorescent staining. Western blot was applied to deter－mine the protein levels of NLRP3，ASC，Caspase-1，IL-1β，type Ⅰ collagen，and FN. PCR was used to analyze mRNA of NLRP3，ASC，Caspase-1，and IL-1β. Results：Masson staining showed that the CVF was significantly higher in DM group[（37.68±1.14）%] than in DM+LN group[（13.58±0.86）%]，DM+MN group[（9.50±0.59）%] and DM+HN group[（6.38±1.41）%]（P=0.000）. TUNEL fluorescent staining showed that cell apoptotic rate was significantly higher in DM group[（64.94±5.25）%] than in DM+LN group[（48.80±6.11）%]，DM+MN group[（31.85±4.44）%] and DM+HN group[（13.64±1.79）%]（P=0.000）. Western blot results demonstrated that the DM group（0.52±0.03） had significantly higher expression of NLRP3 compared with the DM+LN group（0.33±0.07），DM+MN group（0.23±0.06） and DM+HN group（0.15±0.04）（P=0.000）. Moreover，the DM group（0.69±0.09） had significantly higher expression of IL-1β than the DM+LN group（0.42±0.09），DM+MN group（0.25±0.04） and DM+HN group（0.09±0.03）（P=0.000）. Conclusion：NAR significantly attenuates the myocardial fibrosis and apoptosis in the diabetic mice，and its mechanism may be associated with inhibiting NLRP3 inflammasome activation，reducing the level of inflammation.

Abstract:Objective：To investigate the change of the functional connectivity（FC） of default mode network（DMN） and visual net－work（VIS） in type 2 diabetes mellitus（T2DM） patients by using independent component analysis（ICA）. Methods：T2DM patients with retinopathy（R+，n=25） and without（R-，n=22） retinopathy were recruited as the T2DM group and 29 healthy controls were en－rolled（HCs group）. Resting-state fMRI scanning，data preprocessing and ICA analysis were performed and DMN and VIS networks were selected. changes of FC between groups were compared and correlation between FC scores in different brain regions，and clinical parameters and cognitive scores was analyzed. Results：Compared with the HCs group，the FC of DMN in the T2DM group was signif－icantly decreased in the left supplementary motor area and the left superior frontal gyrus，while was increased in the bilateral medial cingulate cortex；the FC of VIS decreased in the right calcarine gyrus，the right cuneus cortex and bilateral lingual gyrus，but no FC of VIS was increased. Compared with the R- group，no significant differences about the FC of DMN in the R+ group；the FC of VIS was decreased in the left calcarine gyrus，the right middle occipital gyrus and the right inferior parietal lobule，but no FC of VIS was in－creased. FC scores of the right lingual gyrus were negatively correlated with the body mass index（BMI）（r=-0.434，P=0.003） in T2DM patients. Conclusion：The abnormal FC of DMN and VIS in T2DM patients suggests the impairment of some brain networks，especially the VIS in the R+ group，which may provide a possible imaging pathway for early diagnosis of cognitive dysfunction in T2DM.

Abstract:Objective：To investigated the predictive value of the lipid accumulation product（LAP） for prediabetes development of diabetes and compared its predictive power with various anthropometric indices. Methods：The participants in this study were selected from the epidemiological study of cancer risk of Chinese patients with type 2 diabetes mellitus in Luzhou area. A total of 1 125 participants with prediabetes were selected from the baseline survey. The subjects were divided into four groups（Q1，Q2，Q3，Q4） according to the quartiles of the LAP and followed for five years. We assessed the predictive power of adiposity indices by performing univariate and multivariate binary logistic regression analysis and calculating the area under the receiver operating characteristic（ROC） curve according to their quartiles. Results：Of the 1 064 participants who completed the follow-up，237 were diabetic. The comparison of the four groups of subjects into diabetes showed that Q4 group（92 cases）>Q3 group（69 cases）>Q2 group（48 cases）>Q1 group（28 cases），the difference was statistically significant（χ2=49.308，P=0.000）. Logistic regression analysis showed that after adjusting for any variables and adjusting for age，gender，height，systolic blood pressure，TG，HDL-C，smoking and tea consumption，individuals in higher LAP quartiles at baseline were more likely to develop diabetes than those in lower LAP quartiles. The area under the ROC curve for LAP was significantly greater than that of other adiposity indices，indicating that LAP，compared with BMI，waist circumference（WC） and waist-to-hip ratio（WHR），had a better value in predicting the outcome of predia－betic subjects to diabetes. Conclusion：LAP was strongly asso－ciated with an increased risk of diabetes in prediabetes，and the association was numerical-dependent. LAP may be a predictor of the pro-gression from prediabetes to diabetes. Our data demonstrate that the LAP was a better predictor of diabetes than the BMI，waist circumference and waist-to-hip ratio in prediabetes.

Abstract:Diabetes mellitus and coronary atherosclerotic heart disease are common chronic diseases at present. Patients with diabetes mellitus of 70%-80% die of cardiovascular system diseases. In addition to epicardial coronary atherosclerosis and myocardial cell damage，diabetic patients also have coronary microvascular dysfunction. Insulin resistance，hyperglycemia，oxidative stress，inflamma－tory factors and free fatty acids are going to decrease the bioavailability of NO，leading to endothelial dysfunction. When endothelial cells are damaged in the body，impaired vasodilation caused by vascular remodeling and hypoxia also occurs，co-working to lead to the coronary microcirculation dysfunction. We reviewed the advance and mechanism of diabetes mellitus in coronary microvascular dysfunction.

Abstract:The risk of arteriosclerotic cardiovascular disease（ASCVD） in patients with type 2 diabetes mellitus（T2DM） is significantly higher than that in non-diabetic patients. Abnormal lipid metabolism and abnormal glucose metabolism are risk factors and pathogen－esis of ASCVD. The sodium-glucose cotransporter-2 inhibitor（SGLT-2i） is a new type of hypoglycemic agent excreting glucose via kidneys. Recent large clinical trials have shown that SGLT-2i shows significant cardiovascular and kidney benefits，but its mechanism remains unclear. This article reviewed effects of SGLT-2 inhibition on lipid metabolism in T2DM and analyzed its possible relation－ship with above protective effects.

Abstract:Protein kinase Cβ（PKCβ） is a classical PKC subtype，which can be induced and activated by hyperglycemia，leading to a variety of diabetes complications. Activated PKCβ causes endothelial dysfunction，induces white blood cell adhesion，regulates the ex－pression of cytokines and transcription factors through downstream signaling pathways，leading to macrovascular complications，such as atherosclerosis，cardiomyopathy and apoplexy and microvascular complications，such as diabetic nephropathy，retinopathy and pe－ripheral neuropathy. In this paper，the role of PKCβ in diabetic complications and its related research in clinical treatment were described.

Abstract:Diabetic nephropathy is one of the main causes of end-stage renal disease. At present，the most effective treatment for this disease is conservative treatment with by using renin-angiotensin system inhibitors to strictly regulate blood glucose and blood pres－sure. However，this can only control the further deterioration of diabetic nephropathy，and some diseases will develop into the end-stage renal disease. Therefore，to find new therapeutic targets for treating the diabetic nephropathy is in urgent needs. Studies have shown that autophagy is an important way to maintain cell homeostasis. The deregulated autophagy can lead to glomerular and tubulointerstitial lesions of kidneys in diabetic patients，which may be one of the pathogenesis of diabetic nephropathy. This article reviewed researches of autophagy and diabetic nephropathy，in order to summarize the research advance of autophagy in the pathogen－esis of diabetic nephropathy and to investigate the significance of autophagy in the treatment of diabetic nephropathy.

Abstract:Type 2 diabetes mellitus（T2DM） has become one of the main enemy threating human health，and its management has become an important public health problem. Content and distribution changes of body composition（including fat，muscle and bone mineral density） in the management of T2DM have attracted extensive attention. A growing evidence demonstrates that there are differences in body composition between patients with and without T2DM. In addition to uncontrollable factors such as age，gender and race，controllable factors such as metabolism，hypoglycemic drugs and lifestyle also influence the body composition of T2DM. Currently，the association between body composition and T2DM is still inconclusive. Based on this，this paper reviewed relevant studies on the body composition of T2DM，summarized its content and distribution characteristics，and reviewed effects of metabolism，hypo－glycemic drugs and lifestyle on it，providing an important basis for the management of T2DM，especially the prevention and treatment of diabetes-related complications.

Abstract:Objective：To detect the inherited metabolic disorders（IMDs） by gas chromatography-mass spectrometry（GC-MS） and to preliminarily investigate the prevalence of IMDs in Chongqing. Methods：A total of 3 377 patients with suspected IMDs in our hospital from May 2016 to May 2018 were underwent the urine organic acid analysis via GC-MS. According to the detecting results and combining with patients’ clinical manifestation，liquid chromatography tandem mass spectrometry（LC-MS/MS） and gene analysis to diagnose the disease；patients’ onset age was obtained by looking through medical history or telephoning their parents. Results：There were 69 patients diagnosed as positive and 20 kinds of IMDs，with a positive detection rate of 2.04%. Among all disorders，there were 30 patients with aminoacidopathy，with the most common one of neonatal intrahepatic cholestasis caused by citrin defi－ciency（NICCD）（17，56.7%） and followed by ornithine tran－scarbamylase deficiency（OTCD）（9，30%）. There were 26 pa－tients with organic acidemias，with the most common one of methylmalonic acidemia（MMA）（13，46.4%），followed by glutaric acidemia type Ⅰ（GA-Ⅰ）（4，14.3%） and propionic acidemia（PA）（3，10.7%）. There were 11 patients with fatty acid metabolic disease，with the most common one of multiple acyl-CoA dehydro－genase deficiency（MADD）（4，36.4%）. Among the six common disorders，40 patients’ onset age was more than one month，except seven patients with MMA，one patient with NICCD，one patient with GA-I and patient with PA. Conclusion：IMDs are not rare，and NICCD，OTCD，MMA，GA-I，PA and MADD are the common disorders in Chongqing，which occurs more frequently in the late neonatal period.

Abstract:Objective：To investigate the genetic and environmental factors influencing bronchial asthma in children in Chongqing area. Methods：A total of 310 children with bronchial asthma who visited medical institutions in three different districts and counties of Chongqing from May 2016 to May 2019 were selected as the case group，and 310 non-asthmatic children with same gender and age group during that period were selected as the control group. Factors related to the incidence of asthma between two groups，such as the basic situation throughout pregnancy，infant feeding and disease and social and family factors were investigated. The chi-square test was used to screen the single factor with P<0.05，which was used as the independent variable of the logistic regression model for multi-factor analysis，obtaining risk factors influencing children’s bronchial asthma. Results：There were 16 single factors influencing children’s asthma. After logistic multiple factor regression analysis，11 were independent factors influencing children’s asthma among which the independent high risk factors of asthma were the allergic diseases of consanguinity，smoke inhalation during pregnancy，pet exposure，urban living and fathers’ high pressure，while breastfeeding within 6 months of age，feeding with hydrolyzed protein formula when insufficient breast milk，parents with bachelor or above degree were the protection factor. Conclusion：It is important to identify，avoid or utilize the risk factors and protective factors of childhood asthma.

Abstract:Objective：To analyze the etiological factor of recurrent lower respiratory tract infection（RLRTI） in children under six years old in Chongqing，so as to provide pediatricians references for diagnosis and treatment. Methods：Clinical data of 417 children under six years old in Chongqing with recurrent RLRTI hospitalized in the respiratory ward of Children’s Hospital of Chongqing Medical University from June 2015 to May 2019 were collected and analyzed retrospectively. The 417 patients were divided into three groups according to ages：the < 1 year old group（197 patients），the 1-3 years old group（129 patients） and the < 6 years old group（91 patients）. Examination results and treating ways in three groups were analyzed. Results：According to results，children < 1 year old had malnutrition（moderate to severe） of 17 cases，gastroesophageal reflux of 30 cases，tracheoesophageal fistula of 9 cases，tracheal ring of 7 cases（3.55%），bronchial softening（moderate to severe） of 11 cases，pulmonary artery sling of 6 cases，congenital heart disease of 70 cases，congenital pulmonary cyst（CPC） of 3 cases and unclear etiology factors of 44 cases. Children between 1-3 years old had cough variant asthma（CVA） of 12 cases，bronchial asthma of 41 cases，primary immunodeficiency disease（PID） of 5 cases，congenital heart disease of 19 cases，congenital pulmonary cyst of 5 cases，bronchial foreign body of 7 cases，occlusive bronchi－olitis of 3 cases，congenital adenomatoid malformation of 2 cas－es，primary ciliary dyskinesia of 5 cases，bronchiectasis of 11 cases and unclear etiology factors of 19 cases. Children between 3-6 years old had CVA of 21 cases，asthma of 37 cases，PID of 5 cases，bronchiectasis of 12 cases，bronchial foreign body of 2 cases，CPC of 1 case，intracranial space-occupying diseases of 1 case and unclear etiology factors of 12 cases. Conclusion：Etiological factors of RLRTI in children under six years old in Chongqing are closely related to age. Patients less than one year old are closely related with congenital dysplasia，while patients over one year old are closely related with asthma.

Abstract:Objective：To explore the current situation of clinical diagnosis and treatment of children food allergy，and to analyze ex－isting problems，so as to provide reference for improving levels of diagnosis and treatment of children food allergy. Methods：Self-de－signed questionnaires were used to investigate the situation of diagnosis and treatment of children food allergy in 40 maternal and child health hospitals in Chongqing，including the diagnostic criteria，diagnostic methods，treatment methods，problems and demands. Results：Among the 40 maternal and child health hospitals，24 hospitals（60%） conducted the diagnosis of children food allergy，19 （79.17%） hospitals carried out the skin prick test，21 hospitals（87.5%） carried out detection of specific IgE，5 hospitals（20.83%） carried out detection of IgG，7 hospitals（29.17%） carried out elimination diets and 1 hospital conducted the open food stimulation test. In 2018，a total of 19641 cases of SPT tests and 1922 cases of sIgE were conducted in Chongqing maternal and child health care institutes. The survey of doctors revealed：91.9% doctors of child health care thought that patient’s clinical history was the most im－portant in diagnosis of food allergy；69.80% primary doctors thought that positive SPT or sIgE results combined with symptoms of skin or digestive tract（whether closely related to food or not） could diagnose food allergy without elimination diets and food challenge；89.5% doctors thought that negative SPT and sIgE results sug－gested non-food allergy；65.08% doctors believed that IgG was significant in the diagnosis of food allergy. Ninety-five percent parents didn’t know SPT/sIgE and thought that the negative results were not allergic. If the child was considered to be cow’s milk protein allergy，11.11% doctors would advise mothers to stop breastfeeding；25.40% doctors suggested to change to partial hydrolysis formula. If the children were allergic to eggs，7.94% doctors advised the use of partial hydrolysis formula while stopping eggs，and 26.98% doctors advised the use of deep hydrolysis formula. Some doctors applied the food elimination or replacement，but the time was different Doctors in primary levels have high expectations for standardized diagnosis and treatment training and operational processes of food allergy. Conclusion：The diagnosis and treatment of food allergy in children is not standardized in primary medical institutions. Therefore，comprehension of recent food allergy guidelines and consensus in doctors should be strengthened，the training of the diagnosis and treatment can be carried out at different levels and the diagnosis and treatment of food allergy should be standardized，so as to improve the level of diagnosis and treatment of food allergy.

Abstract:Objective：To investigate the clinical characteristics of children sitosterolemia and its treatment，and to conduct the litera－ture review. Methods：In November 2018， a Chinese boy who presented as cutaneous xanthomatos for 9 months was admitted. Retro－spective analysis was conducted to collect his clinical case data and the clinical characteristics and treatment were summarized. Key words of “sitosterolemia”“xanthoma”，“phytosterol”，“hypercholesterolemia” and “ABCG5 gene” both in Chinese and English were retrieved and sitosterolemia literatures reviews were collected from China national knowledge infrastructure database and PubMed literatures database；the clinical characteristics of sitosterolemia from these literatures were summarized. Results：This patient presented with xanthoma and hyperlipidemia and diagnosed with sitosterolemia caused by ABCG5 gene mutation. After a 3-month dietary of strict phytosterol and animal sterol restrictions，the serum level of LC and LDH-C were significantly reduced，almost to the normal range. Skin xanthoma had no changes and some lipomas were going to be enlarged. Conclusion：The clinical features of sitos－terolemia are heterogeneous and xanthomas may be one specific feature. Therefore，pediatricians should enhance knowledge of this disease，avoiding missed diagnosis and misdiagnosis.

Abstract:Objective：To investigate the role of SIRT1 in intestinal ischemia-reperfusion injury in rats. Methods：45 rats were divided into sham-operated group，model group and SIRT1 group. The sham-operated group and model group were intraperitoneally injected with adeno-associated virus of empty vector and the SIRT1 group was intraperitoneally injected with adeno-associated virus of over－expression SIRT1. After 21 days of injection，rats in model group and SIRT1 group were treated with superior mesenteric artery oc－clusion-relaxation occlusion to establish small intestinal ischemia-reperfusion model，while rats in sham-operated group were only treated with superior mesenteric artery separation. 24 hours after reperfusion，rats were killed. Serum and small intestine samples were collected. The levels of inflammatory factors of interleukin-1β（IL-1β），interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） in peripheral blood of three groups of rats were detected by ELISA kit. The levels of glutathione peroxidase（GSH-PX），superoxide dis－mutase（SOD） and malondialdehyde（MDA） in small intestine tissue were detected by ELISA kit. The expression level of apoptotic protein in small intestine tissue of three groups of rats was analyzed by Western blot. The apoptotic index of small intestinal villus cells was analyzed by TUNEL staining. Results：Compared with sham-operated group，the levels of inflammatory factors（IL-1β，IL-6 and TNF-α） and MDA in peripheral blood significantly increased，but GSH-PX and SOD level decreased significantly in small in－testine of rats in model group and SIRT1 group（P<0.05）. Compared with the model group，the levels of inflammatory factors（IL-1β，IL-6 and TNF-α） and MDA in peripheral blood in SIRT1 group decreased significantly，but GSH-PX and SOD level increased sig－nificantly（P<0.05）. Compared with sham-operated group，the expression of Caspase-3 and Bax in intestinal tissue of model group and SIRT1 group increased significantly，while the expression of Bcl-2 decreased significantly（P<0.05）. Compared with model group，the expression of Caspase-3 and Bax in small intestine tissue of SIRT1 group decreased significantly，while the expres－sion of Bcl-2 increased significantly（P<0.05）. Compared with the model group，the apoptotic index of intestinal epithelial cells in SIRT1 group decreased significantly（P<0.05）. Conclusion：Overexpression of SIRT1 can protect small intestinal tissues by reducing the levels of inflammation，oxidative stress and cell apoptosis in rats with small intestinal ischemia-reperfusion，which provides some guidance for clinical practice.

Abstract:Objective：To explore the effect of electroacupuncture（EA） pretreatment on cerebral ischemia/reperfusion（I/R） injury in rats and its relevant mechanism. Methods：Seventy-five healthy adult male Sprague-Dawley rats were randomly divided into Sham group，I/R group，EA+I/R group，corpus striatum infection with adeno-associated virus-vector control（AAV-VC，an empty virus vector）+EA+I/R group，and corpus striatum infection with adeno-associated virus-Beclin1（AAV-Beclin1，a Beclin1-overexpressing virus）+EA+I/R group，with 15 rats in each group. The neurological function scores of the rats in each group were evaluated 1，2，and 3 days after a middle cerebral artery occlusion（MCAO）；the rats were sacrificed 7 days after the MCAO，and their cerebral infarct volumes were measured by TTC staining；cerebral cell apoptosis was evaluated by TUNEL staining；the protein expression levels of the autophagy-related molecules LC3-Ⅰ，LC3-Ⅱ，AMPK，and Beclin1 were determined by Western blot；the interaction between Beclin1 and Vps34 was evaluated by co-immunoprecipitation assay. Results：Compared with the Sham group，the I/R group showed significant increases in cerebral infarct volume and neurobehavioral score（both P<0.05）. The mechanism research showed a significantly increased LC3-Ⅱ/LC3-Ⅰ ratio and up-regulat－ed expression of the autophagy regulatory proteins AMPK and Beclin1（all P<0.05） with increased formation of Beclin1 and Vps34 complex after I/R treatment；meanwhile，the number of apoptotic cells increased significantly. The above indices were significantly improved after EA pretreatment（all P<0.05）. However，intracerebral overexpression of the key autophagy-related protein Beclin1 prior to EA pretreatment reversed the protective effect of EA pretreat－ment against I/R injury（P<0.05）. Conclusion：EA pretreatment may play a neuroprotective role through inhibiting the AMPK-Beclin1/Vps34 pathway to reduce autophagy.

Abstract:Objective：To explore the protective effect of erythropoietin derived peptide on renal ischemia-reperfusion injury in mice and to investigate its influence on PI3K/Akt signal transduction pathway. Methods：The mice were divided into the sham operation group，the model group and the study group. The animal model of renal ischemia-reperfusion injury was repeated. Erythropoietin derived peptide was injected into the abdominal cavity of mice in the model group 6 hours before operation，and normal saline was injected into the abdominal cavity in the sham operation group and the model group. Serum creatinine（Scr） in different groups was detected by picric acid rate method，urine nitrogen（BUN） level was detected by enzymology rate method，renal pathological changes were examined through pathological section，renal cell apoptosis was analyzed by in situ end labeling，and expression levels of nase B，protein kinase B（Akt），phosphorylated protein kinase B（p-Akt），cysteine aspartate protease（caspase-3） were detected by Western blot. Results：Levels of SCR and BUN in the model group were significantly higher than those in the sham operation group，while in the study group were significantly lower than those in the model group（P<0.05）. The renal pathological damage in the study group was significantly weaker than that in the model group，only a small part of the renal tubular epithelial cells were swollen，rare renal tubular epithelial cells had necrosis and abscission and the renal tubular lumen was normal. The score of renal pathological in－jury was significantly higher than that in the sham operation group，and in the study group was significantly lower than that in the model group（P<0.05）. The apoptosis score of the renal tubular epithelial cells in the model group was significantly higher than that in the sham operation group，and in the study group was significantly lower than that in the model group（P<0.05）. The expression level of renal caspase-3 protein in the model group was significantly higher than that in the sham operation group（P<0.05） and the expression level of Akt and p-Akt protein in the operation group was significantly lower than that in the sham operation group（P<0.05）；the expression level of renal caspase-3 protein in the study group was significantly lower than that in the sham oper－ation group，and the expression level of Akt and p-Akt protein was significantly higher than that in the sham operation group（P<0.05）. Conclusion：Erythropoietin derived peptide has a significant improvement on renal ischemia-reperfusion，which may be achieved by regulating PI3K/Akt signal transduction pathway and regulating the expression of apoptotic protein.

Abstract:Objective：To analyze the association of thymidine kinase 1（TK1） with drug resistance of ovarian cancer. Methods：GEPI－A online tool was used to detect the mRNA expression of TK1 in normal ovary tissue and ovarian cancer tissue. KM-Plot was used to perform OS survival rate. GEO profiles database was used to analyze the mRNA expression of TK1 in cisplatin sensitive and cisplatin resistant A2780 cell lines. Comprehensive bioinformatic analyses，protein interaction analysis，genetic pathway enrichment analysis，text mining and miRNA-mRNA interaction analysis were performed to further demonstrate TK1 regulated ovarian cancer drug resis－tance and investigate its potential mechanism. Results：The TK1 expression in the cancer tissue was significantly higher than that in the normal tissue. The high TK1 expression was related with patients’ low survival rates. The TK1 expression in cisplatin resistant A2780 was higher when compared with cisplatin sensitive A2780. Most genes that were closely interacted with TK1 were associated with drug resistance of ovarian cancer. By using genetic pathway enrichment to analyze genes interacted with TK1，it was found that most enriched pathways were related with metabolism. Text mining showed that cell cycle，cell proliferation，S phase，endocytosis and phosphorylation were significantly associated with TK1 protein，ovarian cancer and drug resistance. According to the miRNA-mRNA interaction analysis，it was showed that 11 TK1-targeted microRNAs were related to drug resistance of ovarian cancer or other cancers. Conclusion：Up-regulation of TK1 is associated with drug resistance of ovarian cancer.

Abstract:Objective：To explore the biological mechanism of myocardial infarction and unstable angina pectoris，so as to provide a direction for clinical researchers. Methods：Gene chip GSE29111 was extracted based on GEO database，differential target genes were screened on the basis of GWAS database，and all were analyzed via bioinformatics. Results：A total of 188 differential target genes identified by GEO database GEO2R had significant differences in protein expression（P<0.05）. After gene/region P value setting of -log10P≥3 in GWAS database，a total of 7 target genes related to myocardial infarction and unstable angina pectoris were screened，including MACF1，TANC2，PSMF1，CD59，MYO18B，GALNT10 and TFPI. Metascape annotation tool was used and it was found that 7 differential target genes were mainly related to the negative regulation of proteolysis and wound healing. The David tool was used to perform the online GO analysis and KEGG analysis of 7 differential target genes and it was showed that these differential target genes were related to the negative regulation of endogenous peptidase activity，coagulation，endogenous peptidase inhibitor activity，actin binding and complement system. Conclusion：Differential target genes of myocardial infarction and unstable angina pectoris are mainly related to the activity of endopeptidase inhibitors and complement system，and main regulated differential target genes are CD59 and TFPI.

Abstract:Objective：To investigate the role of PTEN induced putative kinase 1（PINK1）/parkin-mediated mitophagy in diaphragm dysfunction caused by mechanical ventilation（MV）. Methods：Twenty-four adult male SD rats were randomly divided into the Control group（n=6），the MV-6h group（n=6），the MV-12h group（n=6），and the MV-24h group（n=6）. Rats in the Control group were without any treatment，in the MV-6h group were mechanically ventilated for 6 h，in the MV-12h group were mechanically ventilated for 12 h and in the MV-24h group were mechanically ventilated for 24 h. Using RM6240 multi-channel physiology signal collection and pro－cessing system was used to detect diaphragm compound action potential（CMAP），hematoxylin and eosin staining method was used to measure the cross-sectional area（CSA） of the diaphragm，and Western blot was used to detect levels of muscle atrophy F-box（MAFbx），muscle specific ring finger 1（MURF1），mitochondrial fission protein（drp1），mitofusin-2（mfn2），autophagy-related protein of PINK1，parkin and P62，and microtubule-associated protein 1 light chain 3（LC3）. Results：The amplitude of CMAP in the MV-12h group[（3.15±0.52） mV] and the MV-24 group[（2.44±1.26） mV] was significantly decreased（P=0.000）. The duration of CMAP in the MV-24h group[（7.05±0.61） ms] was significantly longer（P=0.000）. Compared with the Control group[（5 308.67±228.18） μm2]，the CSA of diaphragm in the MV-6h group[（3 378.33±393.40） μm2]，the MV-12h group[（2 969.67±35.16） μm2] and the MV-24h group[（2 115.33±130.23） μm2] was significantly de－creased（P=0.000）. Compared with the Control group，the level of MAFbx in the MV-12h group[（2.59±0.19）] and the MV-24h group[（4.11±0.19）] was significantly increased（P=0.000），the level of MURF1 in the MV-12h group[（1.96±0.26）] and MV-24h group[（2.88±0.29）] was significantly increased（P=0.000）. drp1 in the MV-24h group（5.55±0.36）（P=0.000） was significantly increased and mfn2 in the MV-12h group（0.47±0.13） and the MV-24h group（0.35±0.10） was significantly decreased（P=0.002）. Compared with the Control group，PINK1 in the MV-12h group（2.53±0.25） and the MV-24h group（4.78±0.31） was significantly increased（P=0.000），parkin in MV-24h group（3.73±0.16） was significantly increased（P=0.000），P62 in MV-12h group（2.28±0.06） and MV-24h group（3.69±0.17） was significantly increased（P=0.000），and LC3Ⅱ/Ⅰ ratio in MV-24h group（1.57±1.32） was increased significantly（P=0.002）. Conclusion：MV can change the PINK1/parkin-mediated mitophagy，leading to diaphragm dysfunction and atrophy.

Abstract:Objective：To explore the association of LDL-C to HDL-C ratio（LHR） with metabolic syndrome（MetS） and cardiovascu－lar outcomes in patients with non-ST segment elevation myocardial infarction（NSTEMI）. Methods：A retrospective cohort study was conducted，involving 408 patients diagnosed with NSTEMI（male accounted for 67.4%） who were admitted to the cardiology department in our hospital from January 2019 to July 2019. According to the median LHR，the subjects were divided into the low LHR group（≤2.72，204 cases） and the high LHR group（>2.72，204 cases）. Clinical data and laboratory parameters were compared between the two groups；the correlation between LHR levels and MetS was analyzed；the association of LHR with major adverse cardiovascular events（MACE） was evaluated during 12 months follow-up after admission. Results：The high LHR group had a higher incidence of MetS and MACE than that of the low LHR group in patients with NSTEMI（P<0.05）. Multivariate logistic regression analysis showed that LHR was significantly correlated with MetS（OR=1.424，95%CI=1.031-1.965，P=0.032） and high LHR level might be an independent risk factor for MetS. After 12 months of follow-up，totally 69 cases developed MACE（16.9%） including 48 cases in the high LHR group and 21 cases in the low LHR group. Multivariate COX regression analysis further indicated that LHR level was significantly associated with increased MACE risk（HR=1.309，95%CI=1.021-1.678，P=0.034）. High LHR might be an independent predictor of MACE（HR=2.271，95%CI=1.345-3.836，P=0.002）. Conclusion：LHR may be an independent risk factor for MetS and MACE and calculating LHR contributes to controlling cardiovascular risk in patients with NSTEMI.

Abstract:Objective：To compare the dosimetric difference of target areas and organs-at-risk（OAR） between extended-field tomosyn－thesis（HT） and fixed-field intensity-modulated radiation therapy（IMRT） for postoperative cervical cancer. Methods：Twenty patients with extended-field HT who underwent cervical cancer radical surgery from November 2016 to April 2018 in Chongqing University Cancer Hospital were enrolled. The same doctor outlined the target area and OARs（bladder，rectum，intestine bags，the femoral heads，spinal cord and kidneys） and the same physicist designed the HT and IMRT plans separately. Conformity index（CI） of target area，homogeneity（HI），and OAR parameters of two plans were compared. Results：The HI parameter in the HT group（0.06±0.02） was significantly better than that in the IMRT group（0.09±0.03），with statistically significant difference（P=0.000），but the CI parameter in the HT group（0.78±0.05） was slightly lower than that in the IMRT group（0.92±0.04），with statistically significant difference（P=0.000）. OAR parameters in the HT group were superior to those in the IMRT group，except the V40 Gy of intestine pouch in the HT group（83.46 cm3） was greater than that in the IMRT group of 76.29 cm3，with statistically significant difference（P=0.000）. The gradient index（GI） parameter in the HT group was significantly superior to than that in the IMRT group，with statistically significant dif－ference（P=0.000），and the drop in the internal dose was more obvious in the range of 30% to 50%. Conclusion：Both HT and IMRT can meet the clinical needs，but HI of HT has better ho－mogeneity. HT has a preferable advantage for protecting OAR.

Abstract:Objective：To investigate the status of Group B Streptococcus（GBS） colonization in pregnant women in Chongqing and analyze the impact on pregnancy outcomes. Methods：A total of 454 pregnant women were selected as the research objects. The vaginal swabs and anal swabs were taken for examination，and GBS test and drug sensitivity test were performed. The impact of GBS col－onization on pregnant women and newborn outcomes was statistically analyzed. Results：①Among 454 pregnant women，33 were posi－tive anal swab，28 were positive vaginal swab and 25 were positive for both. Either swab is positive was regarded as pregnant women complicated with GBS positive rates and the GBS positive rate in the whole group of pregnant women was 7.9%（36/454）. ②A total of 46 strains of GBS were isolated. The susceptibility test showed that the sensitivity of cefixime and vancomycin were 97.83% and 100%，respectively. The sensitivity of roxithromycin，clindamycin and levofloxacin was only 21.74%. 23.91% and 19.57%. ③Com－pared with the GBS-negative group，the incidence of premature rupture of membranes，chorioamnionitis，and postpartum hemorrhage in the GBS-positive group were significantly higher（P<0.05）. ④GBS colonization had adverse influences on newborns. Compared with the GBS-negative group，the incidence of adverse outcomes such as neonatal pneumonia，neonatal sepsis，hyaline membrane disease，neonatal asphyxia，and amniotic fluid fecal infection in the GBS-positive group was significantly higher（P<0.05）. Conclusion：GBS colonization has obvious adverse effects on pregnancy outcome and neonatal outcome. Cefixime is more sensitive to GBS and can be used as the best choice for preventing infection.

Abstract:Objective：To evaluate the detection ability of modified carbapenem inactivation method（mCIM）/EDTA-carbapenem inac－tivation method（eCIM） test and modified Hodge test for carbapenemase of different genotypes in Enterobacteriaceae，and to analyze the minimum inhibitory concentration（MIC） of carbapenem-resistant Enterobacteriaceae（CRE） on common clinical medicines，so as to aid the clinician to choose reasonable medicines. Methods：Forty CRE strains isolated from clinical specimens in our hospital from June 2018 to December 2018 were collected. VITEK 2 Compact automatic bacterial identification/drug sensitivity system was used to conduct the identification and drug sensitivity；E-test method was used to detect the imipenem，meropenem，tegacycline，amikacin，levofloxacin and compound sulfamethoxazole on MICs of CRE；broth microdilution method was used to detect the MIC of polymyxin. The mCIM/eCIM test and modified Hodge test were used to detect the situation of CRE to produce carbapen－emase. PCR was used to detect carbapenem resistance genes（blaKPC，blaNDM，blaIMP，blaVIM and blaOXA-48），extended-spectrum β-lactamase genes（SHV，TEM，CTX andOXA-1），AmpC enzyme-encod－ing genes（FOX），and membrane pore proteins ompK35 and ompK36 genes. Results：Among 40 CREs，38 strains carried the carbapen－emase gene，including blaKPC of 35 strains，blaNDM of 7 strains，blaKPC+blaNDM of 4 strains. Positive rates of the modified Hodge test，mCIM/eCIM test to KPC carbapenemase were 100%（38/38）. Positive rates of mCIM/eCIM test to NDM carbapenemase were 100%（3/3）. Positive rates of the modified Hodge test to NDM carbapenemase were 0. Drug resistance analysis：drug-resistance rates of 40 CRE strains to common clinical antibiotics，such as the third and the fourth generation of cephalosporins，enzyme inhibitor mix－ture，aztreonam，imipenem and meropenem，were all 100%；those to levofloxacin，amikacin and compound neotamin were 90.0%，60.0% and 42.5%，respectively. It is not found that strains were resistant to tigecycline and polymyxin. Conclusion：Both mCIM/eCIM test and modified Hodge test have high sensitivity to KPC carbapenemase，but mCIM/eCIM test is more sensitive than modified Hodge test to NDM carbapenemase，suggesting to select suitable antibiotics for CRE to different drug resistance phenotypes.

Abstract:Objective：To compare the clinical outcome of primary total arthroplasty via orthop dische chirurgie München（OCM） and traditional posterolateral approach（PLA）. Methods：A total of 82 patients underwent total hip arthroplasty in our hospital from August 2014 to October 2016 were randomly divided into the OCM group and the PLA group in accordance with different approaches. The length of incision，operating time，gross blood loss，blood transfusion rate，postoperative off-bed time，preoperative and postoperative Harris score of hip joint，visual analogue scores（VAS） and postoperative radiological positioning of implants were compared and assessed. Results：Statistical significant differences were found between two groups in the length of incision，operating time，gross blood loss，off-bed time，VAS at 24 h，48 h and 72 h，and postoperative Harris scores of hip joint at the 1st week，the 1st month and the 3rd month（P<0.05），while no statistical significant differences were found between two groups in the rate of blood transfusion，postoperative VAS at the 1st week，postoperative Harris scores of hip joint at the 6th month，the 12th month and the 24th month，and implants position（P>0.05）. No postoperative dislocation was observed during follow up. However，one femoral calcar fracture happened intraoperatively in the OCM group（0.71%） which was fixed with steelwire cerclage，and was stable during the follow-up，without loosening and subsidence. Conclusion：Compared with the PLA，the OCM approach for primary total arthroplasty has advantages of shorter incision length，less bleeding and better clinical outcomes in early stages.

Abstract:Objective：To evaluate the relationship between soluble ST2（sST2） and global registry of acute coronary events（GRACE） score in patients with non-ST-segment elevation acute coronary syndrome（NSTE-ACS），so as to provide early risk assessment in the early stage and subsequent clinical treatment for patients with acute coronary syndrome（ACS）. Methods：A total of 121 patients with NSTE-ACS who made a definite diagnosis were selected and were divided into the non-ST-segment elevation myocardial infarction （NSTEMI） group and the unstable angina pectoris（UA） group. After admission，patients’ GRACE score was obtained and patients were grouped. Ulnar vein blood was collected on an empty stomach at the second day. The plasma expression level of soluble ST2 was detected with ELISA method. And 60 patients with stable coronary heart disease were taken as the control group. Results：Compared with the control group，the level of sST2 in the low-risk，medium-risk and high-risk groups showed an upward trend and the level of sST2 in the high-risk group showed a significant increase，with statistically significant differences（P<0.05）；the sST2 level was increased with the increasing degree of GRACE risk，with statistically significant difference（P<0.05）. Results of correlation analysis showed that sST2 had a positive correlation with GRACE scores（r=0.444，P<0.01）；the level of sST2 was positively associated with neutrophil-to-lymphocyte ratio（NLR）（r=0.442，P=0.000，P<0.01）. The area under ROC curve of ST2 diagnosing ACS was 0.788，with the optimal critical point of 44.5 ng/mL，sensitivity of 66.3% and specificity of 86.4%. Conclusion：The level of plasma sST2 in patients with NSTE-ACS is significantly increased and is closely related. Combination of sST2 and GRACE score has vital clinical value on early risk classification，prognosis evaluation and selecting treat－ment.