Abstract:Objective：We using bioinformatics methods to screen differentially expressed miRNA（DE miRNA） and its target genes and esophageal squamous cell carcinoma（ESCC） differentially expressed genes（DEGs） in ESCC，we perform GO and KEGG enrichment. Then，we screen for genes associated with the of esophageal squamous cell carcinoma. Methods：Gene expression profile datasets and microRNA（miRNA） expression profile datasets were downloaded from the NCBI gene expression omnibus（GEO） database，DE miRNA and DEGs in ESCC tissues were screened using GEO2R tool. The target genes of DE miRNAs were predicted by using the online databases TargetScan，StarBase，miRWalk and miRDB. The target genes of DE miRNA and DEGs were taken together，GO and KEGG enrichment analysis was performed using DAVID online database，the survival analysis was performed using GEPIA website. Results：Four DE miRNAs were screened from the GEO database（miR-34c-5p，miR-944，miR-133b and miR-139-5p expression） and the expression of DE miRNA in ESCC tissues and normal esophageal tissues were analyzed. GO enrichment analysis of can－didate genes indicated that it was mainly involved in cell proliferation，apoptosis，migration et al. KEGG enrichment analysis indicated that it was mainly enriched in PI3K/AKT、Rap1、P53 signaling pathway，survival analysis found COL1A1，SOX4 is associated with poor disease-free survival（DFS）. Conclusion：MiR-34c-5p，miR-944，miR-133b and miR-139-5p may play a role in the develop－ment of esophageal squamous cell carcinoma. Through the pre－dictive analysis of target genes of four DE miRNAs，it provides a theoretical basis for further research on the pathogenesis of esophageal squamous cell carcinoma.

Abstract:Objective：To identify differentially expressed genes in esophageal cancer as targets for further treatment of esophageal cancer. Methods：Gene data sets GSE20347，GSE92396 and GSE1420 were downloaded from the GEO database，and differentially expressed genes in esophageal cancer tissues and normal esophageal tissues were selected on the basis of GEO2R analysis tools. GO analysis and KEGG pathway analysis were performed using the DAVID online database. the protein-protein interaction analysis was carried out via the STRING online database. Cytoscape software was used to screen the core network genes in the protein-protein in－teraction network，and the differential expression was verified in the TCGA database. Results：A total of 274 differentially expressed genes were revealed. 269 genes had the same expression trend，of which 96 were up-regulated and 173 were down-regulated（P<0.05 after adjustment，|log2FC|>1）. GO enrichment analysis（P<0.05） showed they were mainly involved in biological processes such as epidermal development，peptide bond cross-linking，keratinocyte differentiation，and extracellular matrix tissue formation. Molecular functions include extracellular matrix structural components and molecular activities，the function of calcium ion and platelet-derived growth factor binding，and cell composition analysis suggested that these differential genes are mainly concentrated in the ex－tracellular matrix. The KEGG enrichment pathway analysis（P<0.05） showed that the main signaling pathways include those of amebiasis，the extracellular matrix，glycolysis and gluconeogen－esis. MCODE analysis revealed that TIMP metallopeptidase inhibitor 1（TIMP1），matrix metallopeptidase 3（MMP3），secreted phos－phoprotein 1（SPP1），serpin family E member 1（SERPINE1），periostin（POSTN），insulin like growth factor binding protein 3（IGFBP3），collagen type Ⅲ alpha 1 chain（COL3A1） and desmoglein 2（DSG2） may be the key genes for the development of esophageal carci－noma（P<0.05）. These eight genes were verified by TCGA database，and COL3A1，IGFBP3，MMP3，SPP1 and TIMP1 were further screened as key genes，all of which were highly expressed in esophageal squamous cell carcinoma and adenocarcinoma（P<0.05）. Conclusion：Bioinformatics method can effectively screen the differentially expressed genes between esophageal cancer and normal esophageal tissue. In this study，five genes including COL3A1，IGFBP3，MMP3，SPP1 and TIMP1 were screened，indicating that they may be new biomarkers for the pathogenesis of esophageal cancer.

Abstract:Objective：To investigate the feasibility of a dual-scope method in the treatment of thoracic esophageal foreign bodies. Methods：73 patients were divided to a traditional surgery group（n=34） and a dual-scope surgery group（n=39）. In the traditional group，a 20cm skin incision was made above the 5th intercostal space，through which the researcher entered the chest，dissociated and cut open the esophagus，and then removed the esophageal foreign body. Four intercostal incisions were made in the dual-scope group. Light from the orally-inserted gastroscope was used to help the researcher dislocate and cut open the esophagus and then remove the esophageal foreign body. In the traditional group，patients with aorto-esophageal fistula were treated with thoracic endovascular aortic repair（TEVAR） first，and esophageal foreign body clearance，esophageal repair，and arterial hemostasis were performed afterwards. In the dual-scope group，TEVAR was performed simultaneously with esophageal foreign body clearance，while esophageal repair was performed later via video-assisted thoracoscopic surgery. Results：Accuracy rate of CT for diagnosis of thoracic esophageal foreign body and esophageal muscle injury was 100% and 90.41%，respectively. In traditional group operation time was 100（90，135） min，bleeding volume during operation was 200（150，300） mL. In dual-scope surgery group operation time was 90（90，110） min，bleeding volume during operation was 200（150，300） mL. There was no significant difference in operation time and bleeding volume during operation between the two groups. In the traditional group，11 cases had esophageal fistula and 6 cases had pneumonia. There were 1 case of esophageal fistula in the double-mirror group and 4 cases of pneumonia. There was a statistically significant difference in the incidence of esophageal fistula between the two groups；that of pneumonia was statistically insignificant. Aorto-esophageal fistula developed in 3 patients（1 patient in traditional group，2 patients in dual-scope group）. The patient in traditional group died after TEVAR，but the patients in the dual-scope group recovered and discharged successfully after TEVAR was performed si－multaneously with esophageal foreign body clearance. High risk factors of esophageal fistula in the thoracic esophageal foreign body patients include operation method，age，the course of disease as per results of logistic regression analysis；regression coefficients were -92.538，11.973 and 1.783，respectively. Conclusion：The dual-scope method can reduce the complications of thoracic esophageal foreign body surgery.

Abstract:Objective：To screen differentially expressed genes between gastric cancer and normal gastric mucosa by bioinformatics analysis；to analyze and predict its value in the development and prognosis of gastric cancer. Methods：RNA-seq data from gastric cancer patients were downloaded from the Cancer Genome Atlas（TCGA） database，and differentially expressed genes were screened using the software R-Studio. The DAVID database was used to perform genetic ontology（GO） enrichment analysis and Kyoto Ency－clopedia of Genes and Genomes（KEGG） pathway analysis for differentially expressed genes. The gene with the most significant differ－ence in expression in the PI3K-Akt signaling pathway was identified for further study：its expression level and clinicopathological were analyzed using UALCAN，the website STRING was used to construct its protein-protein interaction networks，and Kaplan-Meier Plotter was used to analyze its correlation with the prognosis of gastric cancer patients. Results：A total of 5704 differentially expressed genes were obtained，including 1225 up-regulated and 1479 down-regulated protein-coding genes；KEGG pathway analysis identified integrin binding sialoprotein（IBSP） as the key gene. IBSP was highly expressed in gastric cancer tissues（P<0.001），which was signif－icantly associated with the clinicopathological features and poor prognosis in patients with gastric cancer（P<0.05）. Conclusion：As a potential oncogene in gastric cancer，IBSP may regulate the early progress of gastric cancer through PI3K-Akt signaling pathway and lead to poor prognosis of gastric cancer patients，and it is expected to become a new clinical diagnosis and prog－nostic marker for gastric cancer.

Abstract:Objective：To investigate the expression changes of SOX9 in gastric cancer tissues and its relationship with clinicopatho－logical characteristics and prognosis of patients with gastric cancer. Methods：The clinical data of 180 patients with gastric cancer treated in our hospital from June 2014 to June 2017 were collected. The expression of SOX9 protein in the patients’ gastric cancer tissues and adjacent normal tissues were detected using immunohistochemical staining. The relationship between SOX9 protein level and clinicopathological features，prognosis and prognostic factors of patients with gastric cancer was analyzed. Results：Immuno－histochemical staining showed that SOX9 protein was mainly expressed in the nucleus of gastric cancer and adjacent tissues. The ex－pression of SOX9 protein in 180 gastric cancer tissues and adjacent tissues was 154（85.56%） and 34（18.89%），respectively. The difference in SOX9 protein expression between the two groups was statistically significant（ χ2=160.317，P=0.000）. The expression of SOX9 protein was correlated with clinical stage，degree of differentia－tion，lymph node metastasis and invasion of muscular layer（ χ2=6.868，P=0.009； χ2=9.554，P=0.002； χ2=30.456，P=0.000； χ2=29.738，P=0.000）. The median progression-free survival and total survival of patients with positive SOX9 expression were significantly lower than those of patients with negative expres－sion（log-rank=3.193，P=0.015；log-rank=5.109，P=0.009）. In Cox proportional risk regression model，the expression of SOX9 pro－tein was an independent risk factor affecting the overall survival and progression-free survival（P=0.009，P=0.006）. Conclusion：The expression level of SOX9 protein is closely related to the clinicopathological characteristics and prognosis of gastric cancer patients，and can be used as an auxiliary marker in the diagnosis of gastric cancer.

Abstract:Objective：To detect the expression of sine oculis homeobox homolog-6 （SIX6） in gastric adenocarcinoma，and analyze its value in judging prognosis. Methods：A total of 79 cases of gastric adenocarcinoma tissue were collected as the observation group，while another 79 cases of normal gastric mucosa tissue with a distance > 3 cm to tumor boundary were collected as the control group. All cases were took the fresh tissue and conducted the paraffin-embedded tissue. Immunohistochemisty was used to detect the expres－sion of SIX6 protein in paraffin-embedded tissue，Western blot was used to detect the semiquantative expression of SIX6 protein in the fresh tissue，survival analysis was used to observe the relationship between SIX6 and survival time，and real-time fluorescence quantitative PCR was used to detect the expression of SIX6 mRNA in 15 cases gastric adenocarcinom tissue and 15 cases of normal gastric mucosa tissue. Results：Positive rate of SIX6 expression in two groups had statistically significant differences in two groups （53.2% vs. 6.3%， χ2=41.461，P=0.000）. In the experimental group，expression of SIX6 was correlated with tumors' maximum diameter（33.3% vs. 69.8%， χ2=10.446，P=0.001），infiltrated depth（21.9% vs. 74.5%， χ2=21.149，P=0.000），vascular thrombus（44.0% vs. 69.0%， χ2=4.594，P=0.032），lymph node metastasis（31.8% vs. 80.0%， χ2=18.175，P=0.000） and inflammatory cell infiltration（25.9% vs. 67.3%， χ2=12.223，P=0.000），but not with gender，age and cell differentiation（P>0.05）. Survival analysis results showed that expression of SIX6 was correlated with survival time（ χ2=4.243，P=0.040）. Semiquantative expression of SIX6 protein（1.21±0.06 vs. 0.92±0.04，t=3.85，P=0.000） and mRNA（1.30±0.18 vs. 0.82±0.11，t=2.25，P=0.033） in the experimental group were higher than those in the control group. Conclusion：Higher expressions of SIX6 protein and mRNA in the experimental group are significantly increased in the gastric adenocarcinoma tissue，which plays a certain adjusting role in the formation and development of tu－mor. SIX6 is correlated with the prognosis of gastric adenocarci－noma.

Abstract:Objective：To investigate the clinical effect and safety of paclitaxel peritoneal perfusion combined with systemic chemotherapy in the treatment of advanced gastric cancer with malignant peritoneal effusion. Methods：A total of 60 patients with ad－vanced gastric cancer and malignant ascites were randomly divided into paclitaxel group and cisplatin group，with 30 patients in each group. The patients were given peritoneal perfusion with paclitaxel or cisplatin after peritoneal effusion drainage. Three times of per－fusion was one course of treatment，and the clinical effect was evaluated after two courses. All patients were given systemic chemother－apy with two drugs in addition to peritoneal perfusion，and clinical outcome and safety were evaluated. Results：All patients were avail－able for evaluation. The paclitaxel group had a response rate（RR） of 60.0%，a disease control rate（DCR） of 83.3%，a median time to progress（TTP） of 10 months，and a KPS score of （78.000±13.235） points；the cisplatin group had an RR of 40.0%，a DCR of 73.3%，a median TTP of 7 months，and a KPS score of （71.000±13.222） points. The paclitaxel group tended to have a better clinical out－come than the cisplatin group（Z=-1.245，P=0.213）. There were significant differences between the two groups in the improvements in TTP and KPS after treatment（TTP：χ2=15.864，P=0.000；KPS：Z=-2.067，P=0.039）. Major adverse reactions included bone marrow suppression，nausea and vomiting，abdominal pain，diarrhea，muscle joint pain，and oral mucositis，and the symptoms were mild and were alleviated after symptomatic treatment，which did not affect the treatment. No allergic reaction or marked liver/renal dysfunction was observed，and there were no treatment-related deaths（P>0.05）. Conclusion：Paclitaxel peritoneal per－fusion chemotherapy has a better clinical effect than cisplatin in the treatment of advanced gastric cancer with malignant peritoneal effusion，with fewer toxicities and side effects. Such treatment has good tolerability in patients and can improve quality of life and prolong TTP.

Abstract:Objective：To compare differences of clinical efficacy，postoperative outcomes and survival between the oxaliplatin com－bined with tegafur（SOX） and the oxaliplatin combined with calcium folinate and fluorouracil（FOLFOX6） neoadjuvant chemotherapies in patients with locally advanced gastric cancer. Methods：From January 2012 to August 2013，data of 87 patients with locally ad－vanced gastric cancer underwent operation and received SOX and FOLFOX6 chemotherapies were retrospectively analyzed. According to chemotherapy scheme，these patients were divided into the observation group（SOX，n=45） and the control group（FOLFOX6，n=42）. Chemotherapeutic efficacy，adverse reactions，surgical conditions，postoperative outcomes，complications and survival conditions in two groups were compared. Results：There were no significant differences in chemotherapeutic efficacy，dissection rate of D2 lymph node，R0 dissection rate，incidence rate of postoperative complications and pathological tumor regression grade between two groups（P > 0.05）. There were no adverse reactions of Ⅲ-Ⅳ level in two groups. The incidence of nausea，vomiting and diarrhea（Ⅰ-Ⅱ level） during chemotherapy in the observation group was significantly lower than that in the control group（35.56% vs. 73.81%，χ2=12.799，P=0.000；6.67% vs. 30.95%， χ2=8.537，P=0.003）. The progression-free survival rate in the observation group at 1，3，5 years were 95.56%，55.56%，28.89%，respectively；those in the control group at 1，3，5 years were 92.86%，45.24%，23.81%，respectively，without statisti－cally significant differences（logrank χ2=0.474，P=0.491）. The cumulative survival rate in the observation group at 1，3，5 years were 97.78%，62.22%，31.11%，respectively；those in the control group at 1，3，5 years were 97.62%，50.00%，26.19%，respectively，without statistically significant differences（logrank χ2=0.666，P=0.414）. Conclusion：For treating the locally advanced gastric cancer，SOX has a similar efficacy FOLFOX6，but has amilder risk of gastrointestinal adverse reactions recommending for clinical use.

Abstract:Isolation and identification of liver sinusoidal endothelial cells（LSECs） are the bases to study their physiological functions，and immunophenotype is the key to this work. However，the lack of specific immunophenotype on LSECs is the major challenge in their researches. The immunophenotype of LSECs is transformed with the functional changes of the liver at different stages，influenced by the metabolic microenvironment in hepatic lobules and regulated by cytokines，with the property of heterogeneity. This article reviewed the expression，physiological functions，heterogeneity and causes of LSECs’ immunophenotype and briefly analyzed the research advances of the LSECs’ immunophenotype.

Abstract:Objective：To investigate the molecular mechanism of cisplatin-induced hepatitis B virus（HBV） replication. Methods：HepAD38 cells with stable expression of HBV were treated with different concentrations of cisplatin，and the optimal concentration of cisplatin was chosen according to trypan blue staining for cell viability. The level of HBV DNA was measured by real-time PCR and Southern blot，and the expression of HBsAg and HBcAg was measured by Western blotting. The cisplatin-induced group of Hep－AD38 cells were treated with or without N-acetyl-L-cysteine（NAC）. Intracellular reactive oxygen species（ROS） levels were deter－mined with CellROX Orange Reagent under laser scanning confocal microscopy，and the level of HBV DNA and expression of HBsAg and HBcAg proteins were measured. Results：The op－timal concentration of cisplatin was 6 μmol/L according to trypan blue staining. The results of real-time PCR showed that com－pared with 515.152±18.924 in the PBS group，the copies（per cells） of HBV DNA were 1 215.758±49.001（P=0.000），1 678.182±117.223（P=0.000），and 2 110.606±143.640（P=0.000） after being treated with 0.5，2，and 6 μmol/L cisplatin，respectively. Moreover，cisplatin treatment increased HBV DNA levels in a dose-dependent manner as measured by Southern blot，the same as results of real-time PCR. The results of Western blot showed that compared with the PBS group，the 6 μmol/L cisplatin treatment group had a relative HBsAg expression level of 3.102±0.099（P=0.000） and a relative HBcAg expression level of 4.001±0.200（P=0.000），suggesting that cisplatin contributed to HBV replication and protein expression. After HepAD38 cells were treated with cisplatin and NAC，the results of real-time PCR showed that the copies（per cells） of HBV DNA in in the cisplatin group and cisplatin+NAC group were 2 180.444±82.573（P=0.000） and 1 041.778±50.918（P=0.000），respectively；there was a significant difference in the level of HBV DNA between the two groups. According to the results of Western blot，the cisplatin group had a relative HBsAg expression level of 3.139±0.061（P=0.000） and a relative HBcAg expression level of 3.812±0.109（P=0.000），and the cisplatin+NAC group had a relative HBsAg expression level of 2.101±0.088（P=0.000） and a relative HBcAg expression level of 1.613±0.073（P=0.000）；there were significant differences in the relative expression levels of HBsAg and HBcAg between the two groups. Conclusion：Cisplatin enhances HBV replication by increasing intracellular ROS levels，and NAC can partially reverse cisplatin-induced HBV replication.

Abstract:Objective：To construct a human glutathione S-transferase zeta 1（GSTZ1） gene knockout model in the HepG2 cell line based on the CRISPR/Cas9 system and to investigate the effect of GSTZ1 knockout on the proliferation and migration of HepG2 cells. Methods：A 20-bp sgRNA oligonucleotide sequence targeting GSTZ1 was designed and synthesized. After annealing，it was cloned into the lentiCRISPR-V2 vector. And HEK293T cells were co-transfected with lentivirus packaging plasmids. Then the lentivirus was packaged and HepG2 cells were infected. The positive cell lines were screened for by an appropriate concentration of puromycin，and monoclonal cells were obtained by limited dilution method. All the experiments were divided into three groups，namely parental group，KO1 group，and KO2 group. MTS assay，colony-forming assay，and wound healing assay were used to determine cell proliferation and migration capacity. Results：The success－ful construction of GSTZ1 knockout monoclonal cells was veri－fied by Western blot and DNA sequencing，while MTS assay was used to determine changes in the proliferation capacity of HepG2 cells in each group at different time points. The results showed that the KO1 group had significantly increased proliferation capacity compared with the parental group at 48 h[（24.758±1.508）% vs. （20.185±0.720）%，P=0.002]. The proliferation capacity in the KO1 group was significantly higher than that in the parental group at 72 h[（23.903±0.840）% vs. （28.634±1.848）%，P=0.014]. The proliferation capacity in the KO1 group was also significantly elevated compared with the parental group at both 96 h and 120 h （P<0.05）. The same effects were observed in KO2 cells，indicating that GSTZ1 knockout could promote the proliferation of HepG2 cells. Colony-forming assay showed that the colony-forming numbers in GSTZ1 knockout cell lines（KO1 and KO2） were significantly higher than that in their parental cell line（73.330±1.528 and 82.330±4.163 vs. 42.330±2.517，P=0.000，P=0.000），suggest－ing that GSTZ1 knockout remarkably increased the proliferation capacity of hepatoma cells. In addition，wound healing assay showed that both GSTZ1 knockout cell lines had a significant increase in relative migration ratio compared with the parental cell line at 48 h（0.327±0.041 and 0.371±0.013 vs. 0.184±0.045，P=0.003，P=0.001），suggesting that GSTZ1 knockout enhanced the migration capacity of hepatoma cells. Conclusion：GSTZ1 knockout significantly promotes the proliferation and migration of human hepatocel－lular carcinoma cells，suggesting that GSTZ1 may regulate the development and progression of hepatocellular carcinoma as a tumor suppressor gene.

Abstract:Objective：To investigate the clinical effect of multipath（cystic duct or common bile duct） and three endoscopies（la－paroscopy + choledochoscopy + duodenoscopy） combined with nasobiliary drainage and primary suture in the treatment of small-di－ameter common bile duct stones. Methods：Retrospectively analyzed clinical data of 98 patients with small-diameter common bile duct stones（≤0.8 cm） who underwent three endoscopic transcyctic common bile duct exploration/common bile duct exploration + nasobiliary drainage through abdomen + primary suture from January 2016 to December 2018 in our department. Results：All 98 pa－tients underwent operations successfully and recovered well. Among them，77 patients underwent three endoscopic transcyctic common bile duct exploration + nasobiliary drainage through abdomen + primary suture of common bile duct，while another 21 patients under－went three endoscopic common bile duct exploration + nasobiliary drainage through abdomen + primary suture. The estimated intra－operative bleeding volume was （25.0±6.5） mL and the operation time was （183.2±51.9） min. On the first day after operation，the drainage volume through abdominal cavity drainage tube was （46.5±52.4） mL；the drainage volume of nasobiliary duct was （187.3±119.8） mL. Except one patient discharged with a tube（abdominal drainage tube and nasobiliary duct），the other 97 patients removed abdominal drainage tube on （6.5±2.0） d after operation，and removed the nasobiliary tube on （5.3±1.9） d after operation. Hospital－ization time was （12.1±4.1） d. Two patients（2.0%） had postoperative bile leakage，and one of them（50%） complicated with mild peritonitis；18 patients（18.4%） complicated with mild pancre－atitis；one patient（1.0%） had residual stones（muddy stones）；one patient（1.0%） was re-operated due to obstruction of naso－biliary drainage. No complications of intestinal perforation and bleeding after operation；no conversion to laparotomy or periop－erative death. Conclusion：With the total comprehension of op－eration indication and the support of reliable endoscopic suture，simultaneous three endoscopies through multipath combined with nasobiliary drainage and primary suture is safe and feasible for treating the small-diameter common bile duct stones，and the clinical effect is good.

Abstract:Objective：To investigate the effect of sufentanil combined with tramadol（for patient-controlled intravenous analgesia，PCIA） on postoperative analgesia and stress response in preschool children with choledochal cyst. Methods：A total of 40 children undergoing an elective total choledochal cyst excision were enrolled and randomized into PCIA group（group P） and control group（group C）（n=20）. The group P was given a formulation of 2 ?滋g/kg sufentanil，5 mg/kg tramadol，5 mg dexamethasone，and 4 mg ondansetron，diluted to 100 mL by normal saline；the group C was not given any postoperative analgesics. The Wong-Baker scores and adverse reactions of the children were collected at 1 hour before surgery（T1） and 12 hours（T2），24 hours（T3），and 48 hours after surgery（T4）；meanwhile，peripheral venous blood samples were collected from the children at the above four time points for testing of plasma levels of epinephrine（E），norepinephrine（NE），and 5-hydroxytryptamine（5-HT） by ELISA. Results：There was no significant difference between the two groups in the general condition of the children. A repeated-measure analysis of variance showed that there were significant differences in the Wong-Baker score between different groups and at different time points，with a significant group × time interaction effect observed（P<0.05）；there were significant differences in the plasma levels of NE and 5-HT between different groups and at different time points（P<0.05），with an increasing trend followed by a decrease observed in the plasma levels of E，NE，and 5-HT. Compared with the group C，the group P had significantly lower Wong-Baker scores（5.30±1.63 vs. 3.90±1.65，4.50±1.10 vs. 3.10±1.37，2.40±1.23 vs. 1.50±1.28；all P<0.05） and plasma levels of NE（574.71±100.95 vs. 514.13±75.32 pg/mL，483.56±53.47 vs. 441.32±69.53 pg/mL，404.61±59.36 vs. 364.83±49.33 pg/mL；all P<0.05） and 5-HT（290.81±47.31 vs. 262.35±30.31 pg/mL，248.40±48.52 vs. 209.38±39.02 pg/mL，232.16±33.75 vs. 199.48±30.94 pg/mL；all P<0.05） at T2，T3，and T4，respectively. There were no significant differences between the two groups in the number of analgesia-related adverse reactions，incidence of short-term postoperative complications，and length of hospital stay after surgery（P>0.05），but the unplanned extubation rate was significantly lower in the group P than in the group C（P<0.05）. The plasma levels of NE and 5-HT were positively correlated with the Wong-Baker score，with correlation coefficients of 0.38 and 0.56，respectively（P<0.05）. Conclusion：PCIA using sufentanil combined with tramadol is safe for postoperative analgesia in preschool children with choledochal cyst. It can effectively relieve postoperative pain，promote postoperative recovery，and reduce postoperative stress response in children without obvious adverse reactions.

Abstract:Stable gut micro-ecology is an important guarantee and necessary condition for maintaining human health. The imbalance and disorder of gut micro-ecology are related to the occurrence and development of many diseases，and its relationship with intestinal diseases is particularly close. Radiation enteritis is a radiation injury of the intestines in patients with abdominal and retroperitoneal malignant tumors after radiotherapy. The process of is occurrence and development is complex，and gut micro-ecological imbalance is an important factor in the formation of the disease. Effect of conventional drug treatment effect is very limited for radiation enteritis，and therapies focusing on gut micro-ecology has shown better therapeutic effect and safety. Therefore，this paper reviews the mecha－nism of the influence of gut micro-ecology on the development of radiation-induced enteritis in hope of providing a basis for the clin－ical treatment of radiation enteritis via regulation of gut micro-ecology.

Abstract:Inflammatory bowel disease（IBD），with unclear pathogenesis，is a kind of chronic and recurrent intestinal inflammation. Exosomes，widely spread in various biofluids，are the nanosized extracellular vesicles secreted by different types of cells and contain diverse bioactive molecules，transfer to adjacent or distal cells via body circulation and participate in the intracellular and intercellular communication. Studies have found that exosomes influence the occurrence and development of IBD through immune regulation and other ways，but the role of exosomes in IBD should be further elaborated. This article reviewed the research progress of exosomes in the pathogenesis，diagnosis and treatment of IBD，and provides ideas for exploring new diagnosis and treatment methods of IBD.

Abstract:Objective：To observe the role and mechanism of interleukin-18（IL-18） in intestinal mucosal barrier in dextran sulfate sodium（DSS）-induced colitis in mice. Methods：Mice were randomly divided into three groups：control group，DSS group（fed with DSS continually for 7 days） and DSS+IL-18 group（fed with DSS continually for 7 days and given injections of IL-18）. The weight of the mice were measured every day. Seven days later，colon tissues were collected and histology analysis were performed；goblet cell amount in histological sections was measured；the expression of the IL-18 and Kruppel-like factors-4（KLF4） were analyzed by Western bolt. Results：Compared with control group，the mice weight of DSS group loss significantly（P=0.000）. Damaged intestinal mucosa，reduced villous height，and deterioration of tissue integrity was corroborated by histological examination of distal colon sections performed on DSS group. The number of goblet cell in histological sections showed a dramatic decrease in DSS-treated mice compared to control group（control group：43.600±7.092，DSS group：16.000±6.205，P=0.000）. The protein expression of IL-18 in DSS group increased（control group：0.444±0.073；DSS group：0.649±0.062；P=0.006），but the KLF4 expression decreased（control group：0.777±0.081；control group：0.934±0.053；P=0.018）. Compared with DSS group，the weight of mice in DSS+IL-18 group decreased more significantly（P=0.000），the intestinal mucosa was damaged more severely，the number of goblet cell reduced dramatically（DSS+IL-18 group：3.200±2.863，P=0.004），the expression of IL-18 increased obviously（0.903±0.037，P=0.002），and the expression of KLF4 decreased（0.469±0.037，P=0.001）. Conclusion：IL-18 may aggravate ulcerative colitis by inhibiting the development of goblet cells through KLF4 expression reduction in mice.

Abstract:Objective：To explore the protective effects of recombinant human granulocyte-macrophage colony-stimulating factor （rhGM-CSF） on intestinal mucosal barrier in rats with severe acute pancreatitis. Methods：36 male SD rats were randomly and evenly divided into 3 groups：control group（sham operation group），severe acute pancreatitis model group（SAP group），and rhGM-CSF group（SAP rats treated with rhGM-CSF）. The SAP rat models were established via retrograde injection of 3% sodium taurocholate to the pancreatic duct. Rats in rhGM-CSF group were hypodermically injected with rhGM-CSF with dose of 3 ?滋g/kg per day for 5 days. All rats were executed on day 5，and the intestinal mucosal damage，the ratio of CD4+/CD8+ and the composition of intestinal flora were analyzed. Results：There was no death in rats with SAP，and obvious pathological changes appeared in the mucosa of both groups. Compared with SAP group，damage to intestinal mucosa of rats in rhGM-CSF group were significantly reduced，the epithelial cells were almost intact，the villi were closely arranged，the small intestine gland was deepened and the number was larger，the numbers of goblet cells and vascular endothelial cells were increased，and the mucosal thickness and intestinal wall edema were alleviated；The number of CD8+ lymphocytes in lamina propria was significantly reduced，and the CD4+/CD8+ ratio was obviously higher. The intestinal flora in SAP group changed evidently compared with control group. The content of Bifidobacteria and Lactobacilli of observation group were higher than those of SAP group[（6.34±4.64） ln/g vs. （3.71±4.96） ln/g，（9.52±3.86） ln/g vs. （5.17±2.14） ln/g，P<0.05]，while Escherichia coli and Enterococci were lower[（7.98±2.23） ln/g vs. （11.36±3.74） ln/g，（4.65±1.85） ln/g vs. （7.28±2.63） ln/g，P<0.05]. Conclusion：rhGM-CSF may improve effect of intestinal mucosal barrier in rats with severe acute pancreatitis.

Abstract:Objective：To investigate the expression and prognostic significance of tumor abnormal protein（TAP） on peripheral blood in colorectal cancer patients. Methods：A total of 237 colorectal cancer patients from June 2014 to December 2016 were enrolled and followed up. The pre-treatment TAP expression in peripheral blood was detected，the chi-square test was used to analyze the correla－tion between TAP expression and clinical features of colorectal cancer patients，the expression data of traditional tumor markers CEA and CA19-9 in peripheral blood of patients were collected，and the relationship among TAP expression，CEA and CA19-9 were ana－lyzed. Kaplan-Meier survival curve and univariate and multivariate Cox regression were used to analyze the relationship between TAP expression and prognosis in colorectal cancer patients. Results：Among 237 colorectal cancer patients，59.92% patients had positive expression of TAP in peripheral blood. Peripheral blood TAP expression was associated with tumor cell differentiation，depth of myome－trial invasion，lymph node metastasis，and tumor stage（Dukes stage），with statistically significant difference（P<0.05）. After multivari－ate Cox regression’s correction of age，gender，cell differentiation，invasion degree，lymph node metastasis，Dukes stage，CEA expres－sion and CA19-9 expression，TAP expression in the peripheral blood was significantly associated with overall survival time of colorectal cancer（HR=2.511，95%CI=1.494-4.221，P<0.05）. In addition，the risk ratio of peripheral blood TAP for predicting survival outcome in colorectal cancer patients was higher than that of CEA and CA19-9. Conclusion：The expression of TAP in peripheral blood of colorectal cancer patients is related to the malignant degree of cancer，and can be used as an independent prognostic indicator for colorectal cancer，with predicating function for patients’ overall survival time.

Abstract:Objective：To investigate the clinical and computed tomography（CT） differential diagnosis of colonic mucinous adenocar－cinoma and colonic lymphoma，and to improve the accuracy of preoperative diagnosis. Methods：A retrospective analysis was per－formed for the clinical and CT imaging data of 57 patients with pathologically confirmed colonic mucinous adenocarcinoma and 18 patients with pathologically confirmed colonic lymphoma. Results：Compared with the lymphoma group，the mucinous adenocarcino－ma group had significantly higher enhancement rate（ΔR1，ΔR2，and ΔR3） and rate of blurry fatty space（P<0.05）. Compared with the mucinous adenocarcinoma group，the lymphoma group had significantly higher plain scan density of the solid portion of the lesion，homogeneity of tumor during plain scan and contrast-enhanced scan，and proportion of patients with lymphadenectasis and intus－susception（P<0.05）. Among the patients with colonic mucinous adenocarcinoma，6 were found to have hepatic metastasis during follow-up，1 had intestinal perforation with abscess，and 1 had psoas major invasion. There were no significant differences between the two groups in age，sex，clinical symptoms，the location of tumor，shape of bowel wall-thickening，CT values in each enhancement phase，mesenteric and peritoneal involvement，and incidence rates of ileus and peritoneal effusion（P>0.05）. Conclusion：The homogeneity of tumor，plain scan density of the solid portion of the lesion，enhancement rate，invasiveness of tumor，hepatic metastasis，and intussusception may help with the differential diagnosis of colonic mucinous adenocarcinoma and colonic lymphoma.

Abstract:Objective：To investigate the BELL staging criteria and the frequency of seven clinical metrics of metabolic derangement （MD7），so as to evaluate the appropriate surgical intervention opportunity of neonatal necrotizing enterocolitis（NEC） for improving the accuracy of treatment. Methods：Clinical data of 209 NEC patients of our hospital from April 1st，2015 to October 1st，2018 were retrospectively analyzed and patients were grouped according to BELL staging criteria and frequency of MD7. Cure rate and mortality rate between groups were compared，and differences of conservative treatment effect and operative treatment effect in each group were analyzed. Results：Stage Ⅰ was mainly received conservative treatment. Improved stage Ⅱ was divided into ⅡA stage and ⅡB stage. There was no significant difference in cure rate and mortality rate between the conservative treatment effect and the operative effect in ⅡA stage，while cure rate was higher and mortality rate was lower in ⅡB stage. Ⅲ stage had a even higher cure rate and a even lower mortality rate. When MD7 frequency was less than 4，cure rate and mortality rate between conservative treatment and operative treatment had no statistically significant difference. When MD7 frequency was more than or equal to 4，the effect of operative treatment was significantly higher than that of conservative treatment. Meanwhile，when patients had stage ⅡB or above and MD7 frequency more than or equal to 4，the intestinal necrosis rate via operative exploration was nearly 100%. Conclusion：NEC patients，with improved BELL stage of ⅡB stage，should receive operative intervention actively；NEC children，with MD7 frequency≥4，should receive operative intervention actively. The results of the two evaluation systems of BELL staging criteria and MD7 frequency can be used as an important supplement to NEC operative indications except the absolutely indicated pneumoperitoneum，so as to seek a better long-term prognosis for patients.

Abstract:Objective：To investigate risk factors influencing prognosis of neonatal necrotizing enterocolitis（NEC） in full-term infants and preterm infants. Methods：The clinical data of 287 NEC patients（BELL stage≥Ⅱ） were retrospectively analyzed and divided into full-term group（n=128） and the preterm group（n=159） according to gestational age. and then use The univariate and multivariate logistic regression analysis was used to summarize risk factors influencing NEC prognosis in full-term and preterm infants. Results：NEC analysis in the full-term group showed that Ⅲ-stage NEC（OR=63.052，95%CI=2.373-1674.987，P=0.013） and complication of respiratory failure（OR=85.917，95%CI=3.005-2456.151，P=0.009） were independent risk factors for prognosis；probiotics（OR=0.036，95%CI=0.002-0.809，P=0.036） was protective factor. NEC analysis in the preterm group showed that sepsis（OR=5.669，95%CI=1.829-17.569，P=0.003） was independent risk factor influencing prognosis，and probiotics（OR=0.172，95%CI=0.054-0.547，P=0.003） was protective factor. Conclusion：There are some differences in risk factors of NEC prognosis in preterm and full-term infants，and clinical treatment should be individualized to improve prognosis.

Abstract:

Abstract:Long non-coding RNAs（lncRNAs） are defined as gene sequences with a length exceeding 200 nt. As transcripts of RNA polymerase Ⅱ， they are not translated into proteins due to the lack of an open reading frame in their gene segments. HOX transcript antisense（HOTAIR），one of the most popular lncRNAs in current research，which is widely involved in the regulation of gene expres－sion and protein modification，plays an important role in regulating the pathological and physiological processes in the body. HOTAIR is found to be upregulated in the digestive system tumor tissues to act as a bridging scaffold between PRC2 and LSD1 complexes，methylate specific histone genes，and induce silencing of coordinated ligand chromatin genes. HOTAIR，which regulates multiple sig－naling pathways to participate in the development and progression of tumor and to induce increased resistance of tumor cells to chemotherapeutic agents，is an important cause of high relapse rate，poor prognosis，and short survival at progressive stage among patients diagnosed with digestive system cancers.

Abstract:Severe acute pancreatitis（SAP） is one of the common abdominal emergencies，which is often characterized by severe con－dition，high mortality and poor prognosis. However，immunosuppression plays a promoting role in SAP progression. Autophagy，as a cel－lular activity，not only participates in the activation of trypsinogen during SAP，but also significantly influences the immune system. In different stages of SAP，immune cells and autophagy demonstrates different forms. This paper reviewed the potential function and sig－nificance of autophagy in SAP immunosuppression.

Abstract:Objective：To explore the value of prostaglandin E2 （PGE2） level in peritoneal fluid in the diagnosis of spontaneous bac－terial peritonitis（SBP） and prediction of in-hospital mortality. Methods：Patients with decompensated cirrhosis and ascites admitted to The First Affiliated Hospital of Chongqing Medical University from August 2016 to February 2018 were enrolled. Patients’ demograph－ic information and laboratory test results were collected. Peritoneal fluid samples were collected，and the PGE2 levels were measured by enzyme-linked immunosorbent assay. The sensitivity and specificity of PGE2 level in the diagnosis of SBP were analyzed by the receiver operating characteristic（ROC） curve. Univariate and multivariate logistic regression analyses were used to evaluate the pre－dictive value of PGE2 level for in-hospital mortality. Results：A total of 193 patients with liver cirrhosis and ascites were enrolled，and 30（15.5%） of them were diagnosed with SBP. The SBP group had a significantly lower PGE2 level than the non-SBP group[32.77（26.05-39.68） pg/mL vs. 49.72（37.35-55.14） pg/mL]. The ROC analysis showed that in the diagnosis of SBP，PGE2 level in peri－toneal fluid had an area under the ROC curve of 0.80，and had a sensitivity of 93.3% and a specificity of 58.3% at a cut-off value of 40.30 pg/mL. Peritoneal fluid PGE2≤32.88 pg/mL was a predictor of in-hospital mortality in patients with decompensated cirrhosis （OR=7.690，95%CI=2.357-25.088，P=0.001）. Conclusion：PGE2 level in peritoneal fluid can be used as a valuable biomarker for the diagnosis of SBP and the prediction of in-hospital mor－tality in patients with decompensated cirrhosis.

Abstract:Objective：To analyze the hemodynamics before and after endovascular and conservative treatment for spontaneous isolated superior mesenteric artery dissection（SISMAD），and to provide hemodynamic evidence for effectiveness of the two therapies. Methods：A retrospective analysis was performed on 30 patients with type Ⅰ and type Ⅱ SISMAD from November 2015 to March 2018. The pa－tients were divided into endovascular treatment group（12 patients） and conservative treatment group（18 patients）. Based on imaging data from computed tomography angiography，a computational fluid dynamics analysis was conducted to evaluate hemodynamic changes after treatment in the two groups of patients. Results：Both groups of patients received safe and effective treatment. Hemody－namic results showed low blood flow velocity，high wall pressure，and low wall shear stress（WSS） in the dissected segment of the su－perior mesenteric artery（SMA） on admission，with the lowest WSS in the false lumen. After endovascular treatment，blood flow in the SMA returned to a stable level，the wall pressure decreased，and the WSS increased to a stable state. During the conservative treatment，with false lumen thrombosed and absorbed，the true lumen was remodeled，blood flow in the SMA gradually returned to a stable level，the wall pressure gradually decreased，and the WSS gradually increased to a stable state. Conclusion：Hemodynamic parameters of type Ⅰ and type Ⅱ SISMAD can gradually return to a stable state after conservative treatment，and therefore，conservative treatment，as the preferred strategy for type Ⅰ and type Ⅱ SISMAD，is safe and effective.