Abstract:Spinal cord injury（SCI） usually leads to severe neurological dysfunction. Mesenchymal stem cell（MSC） are considered as one of the most promising stem cell types to treat SCI. However，the low migration efficiency，low survival rate and low differentiation rate after MSC transplantation seriously limit the clinical application of MSC transplantation. In addition，numerous studies have shown that targeted migration and integration occurs to very little cells either by intravenous or intraspinal injection. Recent studies have shown that the directional migration of MSC is influenced by cytokine induction，transcriptional gene expression，and tissue engineering. In this review，we summarize the role of MSC migration in terms of cytokines，gene expression regulation，tissue engineering，and the progress of recent research on strategies to treat SCI by promoting MSC migration. It will provide ideas to further improve the effectiveness of treatment of SCI and realize precision medicine.

Abstract:Renal fibrosis（RF） is an important pathway for the progression of chronic kidney disease to end-stage renal disease. Many factors have been found to lead to RF. Stem cells are a kind of primitive undifferentiated cells with the potential of self-replication and multidirectional differentiation. With the increasing popularity of cell therapy，mesenchymal stem cell（MSC） become a promising cell type for the treatment of RF. MSC has a variety of differentiation capabilities and can release a variety of factors to regulate inflammatory and immune responses. In this paper，the factors affecting have been and the application of MSC in the treatment of RF have been reviewed，and the existing problems and prospects have been prospected.

Abstract:Functional cognitive disorder（FCD） is a cognitive disorder that includes one or more cognitive impairments with internal inconsistency between subjective and objective manifestations. It cannot be explained by other diseases，but can be coexisted with other diseases，which can or has impaired the patient's social，work，or other vital functions. FCD currently has problems such as terming confusion and unclear concepts. The studies of the disease diagnosis and treatment are still in the initial stage，and more research needed to be performed. This article makes a systematic review of the current concepts of FCD，and the progress or status in diagnosis and treatment，hoping to improve the domestic colleagues' understanding of the disease and provide ideas for the diagnosis，treatment，and research of the disease.

Abstract:In recent years，China’s infertility rate has continued to rise，and the continuous development of modern assisted reproductive technology has solved the fertility problems of many infertility patients，but the poor ovarian response（POR） is still one of the problems that need to be solved in the reproductive field. At present，China’s three-child policy is liberalized，the pressure of study，life，work and so on makes more and more women postpone the age of childbearing，which has caused the increased number of patients with POR with fertility needs. Therefore，it is of great significance to accurately predict the occurrence of POR and formulate individualized treatment plans in clinical diagnosis and treatment. This paper reviews the prediction of the occurrence of POR and the new progress of its treatment strategies，so as to provide reference for the diagnosis and treatment of patients with POR.

Abstract:Suppressor of cytokine signaling-3（SOCS-3） is a kind of cytokine signaling transduction inhibitory protein，involving in the regulation of multiple signal transduction pathways in vivo. It’s found that SOCS-3 plays an important role in the occurrence and development of liver fibrosis，viral hepatitis and liver tumors，and the antiviral efficacy of interferon is closely related to the genetic expression of SOCS-3. This review briefly summarizes the structure and molecular function of SOCS-3 and related research in liver diseases in recent years.

Abstract:Ferroptosis is a cell death mode caused by the excessive accumulation of iron dependent reactive oxygen species，which leads to the imbalance of redox. Genes related to iron metabolism and lipid peroxidation metabolism are involved in its regulation，and the regulatory mechanism is relatively complicated. Recent studies have reported the important roles of ferroptosis in liver diseases. This paper reviews the regulatory mechanism of ferroptosis and its research progress in liver diseases，with a view to providing a new direction for clinical treatment of such diseases.

Abstract:Cerebral ischemia-reperfusion injury（CI-RI） is a very serious complication after ischemic stroke，which causes irreversible or permanent damage to the neurological function of patients and has a high disability rate and mortality. microRNAs（miRNAs） are small endogenous RNA molecules that inhibit the translation of target mRNAs and regulate the expression of at least one-third of the human genome by hybridizing with the 3'-UTR terminals of one or more mRNAs in a sequentially specific manner. In recent years，more and more studies have found that miRNAs can participate in the pathological process of CI-RI such as cell apoptosis，oxidative stress，neuroinflammation and so on by regulating the downstream target mRNAs，and play an important role in the injury or protection of nerve function. This paper reviews the research progress of miRNAs-mRNAs regulatory axis in the mechanism of CI-RI，and deepens the understanding of the mechanism of miRNAs in the treatment of ischemic cerebrovascular diseases.

Abstract:Due to the in-depth analysis of the next generation sequencing data，many small noncoding RNA with different functions have been revealed. In recent years，transfer-RNA derived small RNAs（tsRNAs） have attracted wide attention. There are two main types：tRNA-derived stress-induced RNA（tiRNA） and tRNA-derived fragment（tRF），which are produced according to their positions in precursor or mature tRNA transcripts. These tRF & tiRNA molecules are heterogeneous in size，the nucleotide composition，biogenesis，and function. New research shows that tRF & tiRNA molecule is not only fragments of tRNA degradation，but also plays a regulatory role in specific physiological and pathological processes. In this paper，the types of tRF & tiRNA are reviewed，and the new concepts of biological functions and mechanisms of tRF & tiRNA molecule are proposed. The potential applications of tRF & tiRNA in human diseases are emphatically introduced，and existing issues and future research directions have been proposed.

Abstract:Radiofrequency ablation（RFA） is an excellent ablation tool and coagulation tool. It has been used in liver surgery earlier，and its role has been extended from simple ablation of liver tumors to bloodless liver resection. However，the application of RFA in spleen diseases is relatively limited，and its clinical value seems to be underestimated. This paper aims to summarize the application of RFA in various spleen diseases，in order to expand the thinking for clinical practice and provide reference for the application of RFA in spleen diseases.

Abstract:Objective:　To explore the correlation between the levels of serum high-mobility group box-1（HMGB1） protein and tumor necrosis factor-α（TNF-α） and the cardiac function in patients with diabetic kidney disease（DKD）. Methods:　A total of 122 DKD patients（DKD group） hospitalized in the Department of Endocrinology, The Affiliated Huai'an No.1 People’s Hospital of Nanjing Medical University between June 2019 to June 2020 were randomly selected into this study. According to the urinary protein-creatinine ratio，the subjects were divided into 58 cases in the microalbuminuria group，42 cases in the macroalbuminuria group，and 22 cases in the renal impairment group. Meanwhile，106 healthy people examined during the same period were collected as a healthy control group. The levels of fasting blood glucose，blood lipids and kidney function（urea nitrogen and creatinine） and urinary protein-creatinine ratio were detected in all subjects. Serum HMGB1 and TNF-α levels were detected by enzyme-linked immunosorbent assay（ELISA）. The left ventricular ejection fraction（LVEF），left ventricular end-diastolic dimension（LVEDD） and left ventricular end-systolic dimension（LVESD） were measured by echocardiography. Analysis of variance was used for comparison between groups. Pearson correlation test was used to analyze the correlation between serum HMGB1 and TNF-α levels and the cardiac function of patients with DKD. Logistic multiple linear regression was used to analyze the influencing factors of cardiac function in patients with DKD. Results:　①The fasting blood glucose，LDL-C，urea nitrogen，creatinine，and UALB/Cr ratio of the DKD group were significantly higher than those of the healthy control group（all P<0.05），while the HDL-C level was lower compared to the healthy control group（P<0.05）. ②HMGB1，TNF-α，LVEDD，and LVESD gradually increased with the progression of DKD，while the LVEF gradually decreased with the progression of the disease. ③Serum HMGB1 and TNF-α levels in the DKD group were negatively correlated with LVEF，and significantly positively correlated with LVEDD and LVESD（all P<0.05）. ④Logistic multiple linear regression showed that HMGB1 had the greatest impact on the cardiac function of patients with DKD. For every increase of 1 mmol/L in HMGB1，LVEF decreased by 0.298%，LVEDD increased by 0.324 mm，and LVESD increased by 0.318 mm. Conclusion:　Both HMGB1 and TNF-α increase with the progression of DKD，and HMGB1 has the greatest impact on the cardiac function of patients with DKD. HMGB1 may play an important role in the occurrence and development of cardiovascular events in patients with DKD. Early detection of HMGB1 can help reduce the occurrence of cardiovascular complications in patients with DKD.

Abstract:Objective:　To analyze the value of radiomics，clinical and combined models for the classification of the cognitively normal（CN）group，mild cognitive impairment（MCI） group and Alzheimer’s disease（AD） group. Methods:　Data of 139 CN cases，162 MCI patients and 128 AD patients with the clinical and imaging information were collected from Alzheimer’s Disease Neuroimaging Initiative（ADNI） database. Patients of every group were randomly divided into the training cohorts and validation cohorts with a rate of 7∶3. Radiomics features were extracted from the regions covering the cortex and subcortical nuclei based on 3D-T1WI MRI. Least absolute shrinkage and selection operator（LASSO） was used to select features and multivariate logistic regression was used to develop radiomics models based on the whole-brain cortex and subcortical nuclei. Clinical features were identified by univariate and multivariate logistic regression. The clinical model and the combined model fusing the radiomics features with the clinical risk factors were developed by multivariate logistic regression model. The receiver operating characteristics（ROC） curve was used to evaluate the performance of the classification models. Results:　The area under the curve（AUC） of radiomics model in CN vs. AD，MCI vs. AD and CN vs. MCI were 0.975，0.957 and 0.929，respectively. The AUC of clinical model in the three groups were 0.839，0.675 and 0.685 respectively. The AUC of combined model fusing radiomics features and clinical variables in the three groups were 0.983，0.959 and 0.950，respectively. Conclusion:　The classification and diagnosis of AD could be accurately conducted using the radiomics model based on the whole-brain cortex and subcortical nuclei and combined model. The combined model is the best recommended model to classify CN，MCI and AD.

Abstract:Objective:　To analyze the prdictors of solitary pulmonary nodules（SPN） and establish a mathematical prediction model to verify the accuracy of the model and compare the diagnostic efficiency with the classical models，in order to improve the accuracy of non-invasive diagnosis of early lung cancer. Methods:　A total of 522 SPN patients treated by The Second Affiliated Hospital of Chongqing Medical University from January 2014 to January 2021 were selected and divided into case group（432 cases） and validation group（90 cases），and their clinical and CT imaging features were retrospectively analyzed to screen out independent predictors of malignant SPN and establish a clinical prediction model. The validation group data were inserted into the model for verification，the diagnostic efficacy was compared with the Mayo model and Peking University model，and the receiver operating characteristic（ROC） curve was drawn. Results:　Binary Logistic analysis showed that upper lobe，spiculation，lobulation，vascular aggregation sign，unclear boundary and the maximum diameter of nodules were independent risk factors for benign and malignant SPN. The established prediction model was P=e^x/（1+e^x），X=-3.742+（0.185×the maximum diameter of nodule）+（1.423×spiculation）+（1.143×lobulation）+（3.783×vascular aggregation sign）+（2.526×unclear boundary）+（0.730×upperlobe）. The area under ROC curve（AUC） of our model（0.875） was significantly higher than that of the Mayo model（0.776） and Peking University model（0.779）（P<0.05）. It was suggested that the diagnostic efficiency of this model might be better than that of Mayo model and Peking University model. Conclusion:　Upper lobe，spiculation，lobulation，vascular aggregation sign，unclear boundary and the maximum diameter of nodules are independent risk factors for benign and malignant SPN，and the diagnostic efficiency of our prediction model might be better than that of Mayo model and Peking University model，which is of great significance for the diagnosis of early lung cancer.

Abstract:Objective:　To explore independent prognostic factors of metachronous dual primary lung cancer（mDPLC） by using retrospective analysis，and establish a prognostic nomogram model. Methods:　Clinical information of mDPLC patients was collected from Surveillance，Epidemiology，and End Results（SEER） database. The dataset was divided into training and validation sets for modeling and validation. Univariate and multivariable Cox regression analyses were used to explore independent prognostic factors of training set，and the survival time of patients was predicted by nomogram. The accuracy and reliability of the prognostic model were evaluated by C-indexes，calibration plots，receiver operating characteristic（ROC） curves，decision curve analyses（DCA） and integrated discrimination improvement（IDI） scores. Results:　A total of 610 mDPLC patients were included in the training set，and 260 mDPLC patients were included in the validation set. Cox regression analysis showed that age（59-76：HR=1.453，95%CI=1.007-2.096，P=0.046；≥77：HR=1.953，95%CI=1.303-2.926，P<0.001），gender（female HR=0.669，95%CI=0.529-0.845，P=0.001），pathological type（adenocarcinoma + squamous carcinoma HR=2.251，95%CI=1.583-3.200，P<0.001），TNM staging（Ⅲ：HR=1.611，95%CI=1.126-2.305，P=0.009；Ⅳ：HR=2.443，95%CI=1.713-3.486，P<0.001），lymph node metastasis（HR=1.653，95%CI=1.199-2.280，P=0.002），surgery（once：HR=1.431，95%CI=1.110-1.844，P=0.006；0：HR=1.845，95%CI=1.183-2.878，P=0.007） and chemotherapy（yes + no：HR=0.603，95%CI=0.433-0.842，P=0.003） were independent prognostic factors. The C-index of training set and verification set were 0.711（95%CI=0.696-0.726，P<0.05） and 0.677（95%CI=0.655-0.699，P<0.05），respectively. The AUC values of 3-year survival rate and 5-year survival rate of ROC curve in training set were 0.756（95%CI=0.713-0.800，P<0.05） and 0.785（95%CI=0.732-0.838，P<0.05），respectively，and the AUC values of the 3-year survival rate and 5-year survival rate of the ROC curve in validation set were 0.695（95%CI=0.621-0.769，P<0.05） and 0.711（95%CI=0.618-0.804，P<0.05）. IDI values of 3 and 5 years were 9.0%（P<0.001） and 11.9%（P<0.001） in the training set，and 6.6%（P<0.001） and 7.8%（P<0.001） in the validation set，respectively. The internal validation showed that the predictive effect of the novel prognostic model was accurate and reliable and was better than that of the model based on TNM system. Conclusion:　This study has established a prognostic prediction model of mDPLC，and the internal validation has shown good efficiency，which could provide accurate and personalized survival prediction for mDPLC patients.

Abstract:Objective:　To explore the clinical application value of “West China Hospital Classification” for central type focal liver lesions. Methods:　The clinical data of 186 patients with central type focal liver lesions were admitted to The First Affiliated Hospital of Chongqing Medical University from July 2014 to December 2019 were retrospectively analyzed. Such indicators as operative time，blood loss，length of stay，and complication rate for each type of “West China Hospital Classification” for centrally located liver lesions were compared. SPSS 16.0 statistical software was used for analysis，and chi-square test was used for comparison of the rates. The measurement data were expressed as median and quartile spacing，and Kruskal-Wallis H test was conducted. When P<0.05，there was statistical significance. Results:　Of the 186 patients included，120 cases were primary liver cancer，40 cases were metastatic liver cancer and 26 were benign lesions. According to “West China Hospital Classification”，there were 55 cases of type I，33 cases of type Ⅱ，36 cases of type Ⅲa，18 cases of type Ⅲb，and 44 cases of type Ⅳ. In the whole group，there were no deaths，the overall postoperative complication rate was 17.7%，and the average postoperative hospital stay was（10±4） d. The median operation time for type Ⅰ，type Ⅱ，type IIIa，Ⅲb and type Ⅳ were 225 min，285 min，182 min，290 min，355 min respectively. The median bleeding loss for type Ⅰ and type Ⅱ，type Ⅲa，Ⅲb and type Ⅳ were 445 mL，550 mL，320 mL，600 mL，1 100 mL respectively. The median amount of red blood cell transfusion for type Ⅰ and type Ⅱ，type Ⅲa，Ⅲb and type Ⅳ were 1.0 U，2.0 U，1.5 U，3.0 U，5.0 U respectively. The incidence of postoperative complications for type Ⅰ and type Ⅱ，type Ⅲa，Ⅲb and type Ⅳ were 7.3%，6.1%，8.3%，11.1% and 27.2%，respectively. Compared with the other four types，type Ⅳ had the characteristics of long operation time，large intraoperative blood loss and high incidence of postoperative complications（all P<0.05）. Conclusion:　Preoperative diagnosis of central type focal liver lesions according to “West China Hospital Classification” is beneficial to individualize and standardize for each type of mesohepatectomy and reduce postoperative complications of patients.

Abstract:Objective:　To examine the effects of hydroxychloroquine（HCQ） treatment on pregnancy outcomes in women with connective tissue disease（CTD）. Methods:　We conducted a retrospective cohort study of pregnant women with CTD in 6 hospitals in recent 10 years（from January 1，2010 to October 30，2020），taking the medical records of Chongqing Medical University Medical Data Scinece Acadmy. A total of 227 patients were included in the study，and classified into two groups according to whether they started HCQ treatment during or six months prior to pregnancy，HCQ treatment group（n=108） and control group（n=119）. Results:　Compared with the patients in the HCQ treatment group，we found that patients in the control group were more likely to have gestational hypertension（5.0% vs. 17.6%，P=0.003），preterm birth（19.3% vs. 25.0%，P=0.303），and low birth weight infant（20.0% vs. 45.0%，P<0.001）. Multivariate analysis showed that HCQ treatment was associated with an exceedingly lower risk of gestational hypertension（OR=0.31，95%CI=0.10-0.93，P=0.037），preterm birth（OR=0.28，95%CI=0.10-0.79，P=0.016） and low birth weight infant（OR=0.31，95%CI=0.13-0.72，P=0.006） after controlling for important confounding variables. Conclusion:　Our study proved that HCQ treatment can significantly improve the pregnancy outcomes of patients with CTD，especially reduce the risk of gestational hypertension，preterm birth and low birth weight infant.

Abstract:Objective:　To explore the predictive value of renal ultrasound for acute kidney injury in patients with multiple injuries. Method:　Patients with multiple injuries admitted to the emergency intensive care unit of the Affiliated Hospital of Nantong University from August 2018 to December 2020 were enrolled in our study. Renal blood grades and renal resistance index（RRI） were assessed by bedside ultrasound. Patients were divided into acute kidney injury（AKI） group and non-AKI group. Firstly，we investigated the correlation between ultrasound indexes and traditional renal indexes，and further detected the value of renal ultrasound indexes in predicting AKI diagnosis and outcomes. Results:　Compared with non-AKI group, renal blood flow of AKI group was significantly decreased（P<0.001），and RRI was significantly increased（0.802±0.077 vs. 0.628±0.035，P<0.05）. RRI at admission had a significant correlation with the worst creatinine during the hospitalization（｜r｜=0.687），and was consistent with the serum biomarker neutrophil gelatinase associated lipids transport proteins（|r|=0.579）. ROC curve analysis further confirmed that the area under ROC was 0.984，and the cut-off value was 0.675，indicating that the diagnosis sensitivity and specificity were 90.9% and 95.7% separately. Conclusion:　Renal blood flow and RRI during the hospitalization are sensitive indicators for predicting the occurrence of AKI in patients with multiple injuries，thus providing a basis for appropriate renal protective measures and blood purification strategies，which could be used as a routine monitoring item.

Abstract:Objective:　To detect the serum molecular markers for diagnosing depth of tumor invasion and FIGO stage in endometrial carcinoma（EC）. Methods:　The expression levels of human epididymal protein E4（HE4），carcinoembryonic antigen（CEA），carbohydrate antigen 125（CA125），carbohydrate antigen 199（CA199），carbohydrate antigen 724（CA724） and alpha fetoprotein（AFP） in 212 EC patients’ serum samples were measured and the correlation between them and pathological parameters was analyzed. The positive expression rates of HE4，CEA，CA125，CA199，CA724 and AFP in the serum were further analyzed，and the sensitivity，specificity and the receiver operating characteristic（ROC） curve were also calculated in each index alone and combined to compare diagnostic efficiency. Results:　The expression level and positive rates of HE4，CA125 and CA199 in serum were statistically different between EC invasion depth < 1/2 myometrial and endometrial cancer invasion depth ≥ 1/2 myometrium，and were also different between FIGO stage Ⅰ/Ⅱ and Ⅲ/Ⅳ. The sensitivity，specificity and accuracy of HE4+CA125+CA199 in the diagnosis of invasion depth ≥ 1/2 and FIGO stage Ⅲ/Ⅳ were relatively higher. The area under the ROC curve of HE4+CA125+CA199 in diagnosing depth ≥ 1/2 and stage Ⅲ/Ⅳ were larger than that of HE4 single diagnosis，CA125 single diagnosis，CA199 single diagnosis，HE4+CA125 combined diagnosis，HE4+CA199 combined diagnosis and CA125+CA199 combined diagnosis. Conclusion:　The combined detection of HE4，CA125 and CA199 in serum supports diagnosing the invasion depth more than a half and FIGO stage Ⅲ/Ⅳ and predicting high-risk factors of EC.

Abstract:Objective:　To investigate the feasibility of choledochoscope assisted Glisson pedicle transection in laparoscopic left hepatectomy for left intrahepatic bile duct stones. Methods:　The clinical data of 10 patients with left intrahepatic bile duct stones treated by laparoscopic choledochoscopy assisted Glisson pedicle anatomical left hepatectomy in the General Surgery Center of the PLA Western Theater General Hospital from December 2016 to February 2020 were retrospectively analyzed. Results:　Among the 10 patients，there were 4 males and 6 females，aged 45-68. The operation was successful among all the 10 patients. The operation time was 245（200，320） min，and the intraoperative blood loss was 300（200，650） mL. During the operation，the left hepatic pedicle was cut off with a disposable cutting stapler under the guidance of choledochoscope，and the position of the cut-off was good，without injury of the reserved bile duct，no massive hemorrhage and bile leakage，no conversion to laparotomy. And the postoperative adverse events were mild，including slight bile leakage in 1 patient and a small amount of pleural effusion in 1 patient. The Clavien-Dindo complication grade was Ⅱ，which was treated conservatively. The recovery time of liquid diet was 90-102 h，the postoperative hospital stay was 8-13 d，and the cost of hospitalization was（4.02 ± 0.36） ten thousand yuan. Conclusion:　The application of choledochoscope assisted with Glisson pedicle transection in the treatment of left hepatolithiasis by laparoscopic left hepatectomy is safe and feasible under the protection of instruments and techniques，and it will not increase the hospitalization expenses of patients.

Abstract:Objective:　To study the analgesic effect of transversus abdominis plane block（TAPB） and quadratus lumborum block（QLB） on postpartum caesarean section of human immunodeficiency virus（HIV）-infected pregnant women and its influence on cellular immunity. Methods:　Sixty HIV-infected pregnant women who underwent cesarean section in Chongqing Public Health Medical Center，aged 22-32，body mass index（BMI） 18-25 kg/m²，ASA Ⅱ. They were randomly divided into TAPB group and QLB group，with 30 cases in each group. Both groups were treated with combined spinal-epidural anesthesia，and underwent patient controlled intravenous analgesia（PCIA） after operation. The QLB group underwent ultrasound-guided bilateral QLB，and ultrasound-guided TAPB was conducted in TAPB group. The scores of resting VAS were recorded at 4 h，8 h，12 h，24 h，36 h after operation. The levels of interleukin（IL）-2，IL-13，interferon-γ（IFN-γ），CD3⁺，CD4⁺，CD8⁺ and CD4⁺/ CD8⁺ in peripheral blood were observed by 1 day before the operation and 1 day，2 days and 3 days after the operation. And the first compression time of the analgesic pump，the number of postoperative salvage analgesia cases，the success rate of one puncture and adverse anesthesia reactions. Results:　Compared with the TAPB group at 4 h，8 h，12 h，24 h，and 36 h after surgery，the static VAS pain scores in the QLB group were significantly lower at each time point（P<0.05）. Compared with the TAPB group 1 day，2 days and 3 days after the operation，the IL-2，IL-13，IFN-γ concentration，CD4⁺ and CD4⁺/CD8⁺ in the QLB group were significantly increased at each time point（P<0.05）. The first compression time of the analgesic pump in the QLB group was significantly later than that in the TAPB group（P<0.05），and the rate of remedial analgesia was significantly lower than that in the TAPB group（P<0.05）. Conclusion:　Post-operative cesarean section for HIV-infected pregnant women has better analgesia effect with QLB and can reduce the impact on the cellular immunity.

Abstract:Objective:　To explore the best combination of adaptive statistical iterative reconstruction-V（ASiR-V） for abdominal computer tomography（CT） enhancement under 80 kV tube voltage. Methods:　The data of normal or thin patients with body mass index（BMI）≤24.9 kg/m² who took enhanced abdominal CT examination were collected，and they were randomly divided into control group and low-dose group，each with 40 cases. The 120 kV tube voltage of the control group was scanned with the 0% pre-ASiR-V，and after the scanning，filtered back projection（FBP） and 20%，40% and 60% post-ASiR-V were used for image reconstruction. In the low-dose group，80 kV tube voltage，arterial phase，venous phase and delayed phase were respectively used with 20% pre-ASiR-V combined with 20%，40%，60% and 80% post-ASiR-V，40% pre-ASiR-V combined with 40%，60% and 80% post-ASiR-V and 60% pre-ASiR-V combined with 60% and 80% post-ASiR-V for image reconstruction. The CT values，contrast to noise ratio（CNR），image noise objective score and subjective image parameters of the two sets of images were compared，and the radiation dose index was recorded. Results:　There were statistically significant differences in CT values between the two groups of images（P<0.05）. There was no statistically significant difference except for A20，A40，V40，D60 CNR between the low-dose group and the control group（P>0.05），and the CNR values of the remaining images of low-dose group were higher than those of the control group. There was no significant difference between the two groups of image noise except for A60，V60 and V80（P>0.05），and the image noise of the other low-dose groups was higher than that of the control group. Except for the 80% post-ASiR-V，the image quality was poor，and the subjective scores of the other two groups of images were all greater than 3 points，which meet the diagnosis. Compared with the control group，the effective dose（ED） of the low-dose group in the arterial phase，venous phase and delayed phase decreased by 66.81%，67.24% and 70.61%，respectively. Conclusion:　For normal or thin patients patients with BMI ≤ 24.9 kg/m²，using 80kV tube voltage combined 40% pre-ASiR-V with 60% post-ASiR-V can obtain images meeting the needs of imaging diagnosis under the condition of reducing the radiation dose，and realize the principle of individualized scanning.

Abstract:Objective:　To summarize high-risk situations and treatment experience of ureteral injuries caused by gynecological operations. Methods:　Clinical resources of 24 cases of ureteral injuries caused by gynecological operations from January 2014 to December 2020 were reviewed to summarize high-risk factors and experience of treatment and diagnosis. Results:　There were 12 cases of injuries during the operation，6 cases of hysterectomy（3 cases of laparoscopy and 3 cases of laparotomy），5 cases of cytoreductive surgery，and 1 case of pelvic lymphadenectomy；7 cases were found with the ureter far-end injuries，and 5 cases were found with near-end and middle-end injuries；5 cases received the ureter crevasse suture，and 4 cases received the end-to-end anastomosis，and 3 received the ureter bladder replantation. After repair surgery，10 cases were found with smooth ureters and no expansion and effusion，and 2 cases suffered from the mild hydronephrosis and expansion of the ureters. All the 12 cases were found to be injured after the operation，all of them underwent laparoscopic hysterectomy，and all were found with the ureter far-end injuries. And 11 cases received the ureter bladder replantation，1 case received the end-to-end anastomosis，9 cases were found with smooth ureters and no expansion and effusion，and 3 cases suffered from the mild hydronephrosis and expansion of the ureters. Conclusion:　The hysterectomy，use of laparoscope energy instruments，tumor’s invasion of ureters，and whether ureters are swollen or adhered to each other are high-risk factors of ureter injuries. Favorable treatment effects can be achieved by immediately discovering and mending.

Abstract:Objective:　To retrospectively analyze the characteristics of blood transfusion reactions in hospital，so as to provide data support for promoting clinical blood transfusion safety. Methods:　Reports of blood transfusion reactions that occurred from August 2017 to February 2020 were collected，and reports of patients using multiple blood components during surgery were excluded. The related data were statistically analyzed by chi-square test or Fisher’s exact probability method. Results:　In two and a half years，the incidence of blood transfusion reactions was 0.42%（153/36 391）. The incidence of blood transfusion reactions varied greatly among blood components transfusion（P=0.000），and the incidence of platelets and suspended red blood cells was higher than that of plasma（χ²=19.098，P=0.000； χ²=10.07，P=0.002）. Suspended red blood cells caused febrile non-haemolytic transfusion reactions（FNHTR） accounted for 71.26% of the total febrile reactions. The 3 cases of transfusion-associated circulatory overload（TACO） were all occurred after transfusion of suspended red blood cells（100%），and allergic reactions were mainly caused by plasma（58.73%） and platelets（25.40%）. The incidence of platelets transfusion reactions was the highest（0.52%）. Red blood cells caused FNHTR and other non-specific clinical symptoms（chest pain，tightness，vomiting，etc.），and plasma mostly caused allergic reactions. Clinical symptoms of allergic reactions varied from mild rash to severe anaphylactic shock. Conclusion:　There is a wide classification of transfusion reactions，and different types can occur separately or together. The patients receiving blood transfusion are mostly concentrated in hematology and intensive care unit（ICU） departments，and these patients often have a variety of underlying diseases that can easily interfere with the rapid diagnosis of transfusion reactions. By analyzing the transfusion reactions caused by blood component in our hospital，we can help provide data support for the improvement of the transfusion early warning system，further enhance the risk awareness of clinical and nursing staff，and protect the safety of patients using blood.

Abstract:Objective:　To compare the predictive validity and the consistency of the modified Munro pressure ulcer risk assessment scale（Munro scale） and Scott triggers（ST） for adult perioperative surgical patients. Methods:　A case-control study was conducted involving 270 patients who underwent surgery in The Second Affiliated Hospital of Chongqing Medical University from 2017 to 2019. Their general data and surgical data were collected. A total of 45 patients diagnosed with intraoperatively acquired pressure injuries were taken as the case group，and according to the same operation period，225 patients without intraoperatively acquired pressure injuries were selected as the control group by the 1∶5 paring method. We used the modified Munro scale and ST to score and record respectively，and the area under the curve（AUC） was calculated，as well as the Jordan index，sensitivity，specificity，positive predictive value（PPV），negative predictive value（NPV） and κ value of the scale. Results:　The Munro scale scores of the case group and the control group were （29.870±3.279） points and （26.460±3.381） points，respectively，and the ST scores were （2.361±0.900） points and （1.650±0.989） points，respectively. The AUC of the Munro scale was 0.764（95%CI=0.692-0.873），and the best diagnostic limit，sensitivity，specificity，PPV，NPV were 28.500，0.667，0.720，0.248，0.934，respectively. And the AUC of ST was 0.691（95%CI=0.610-0.772），and the best diagnostic limit，sensitivity，specificity，PPV，NPV were 1.500，0.822，0.502，0.289，0.923，respectively. The κ value of the two scales was 0.497，with significant difference（P<0.05）. Conclusion:　Both of the modified Munro scale and the ST can effectively evaluate the risk of intraoperatively acquired pressure injuries in surgical patients，with a moderate consistency. In the clinical practice，it’s feasible to use the modified Munro scale and the ST to evaluate the risk of intraoperatively acquired pressure injuries in surgical patients before operation，which is worth popularizing.

Abstract:Objective:　To explore the types of family management for children with malignant tumor，and to provide evidence for formulating more targeted intervention strategies of family management. Methods:　Totally 176 children with malignant tumor and their main caregivers were investigated by using general information questionnaire and family management measure in a tertiary grade A children’s hospital of Chongqing. Cluster analysis was conducted to classify the family management of children，and analysis of variance was used to compare the general characteristics of children with different family management types. Results:　Family management of children with malignant tumor could be divided into Ⅰ-Ⅳ categories：optimistic practical type，anxiety adaptation type，ability deficiency type and management difficulty type，in which Ⅲ and Ⅳ children’s family management level is low. There were statistically significant differences in the length of diagnosis（F=1.855，P=0.039），hospitalization times in the recent half year（F=1.787，P=0.003），type of residence（χ²=16.218，P=0.001）and education level of primary caregivers（χ²=16.319，P=0.012） among the four types of children. Conclusion:　The family management of children with malignant tumor can be divided into different types by cluster analysis，which is conducive to the development of more precise disease management strategies for clinical medical staff and the optimal utilization of medical resources.