Abstract:Objective：To analyze the clinical and pathological features of children with Alport syndrome（AS） in southwest of China. Methods：Totally 20 patients with AS in southwest China were retrospectively reviewed and the clinical data were collected. The distri－bution of type Ⅳ collagen α chain in renal and skin tissues was detected by indirect immunofluorescence assay. Clinical and patho－logical features of children with AS were compared among different clinical phenotypes as well. Results：Most children showed micro－scopic hematuria associated with proteinuria as initial symptom. The 24 h urinary protein level was higher in patients with isolated proteinuria than in those with hematuria and proteinuria（H=11.959，P=0.003）. The proportion of uremic patients in the family of chil－dren with proteinuria was（6/16） higher than that in the family of children with hematuria（1/4）. The findings by light microscope mostly revealed mild to moderate mesangial proliferative glomerulonephritis（70.00%）. There was no significant difference in patholog－ical type distribution among AS children with variable clinical phenotypes（χ2=4.149，P=0.900）. About 60% patients with AS had foam cells in kidney interstitium，whose urine protein level was significantly higher than those without foam cells（T=-2.083，P=0.039）. Based on different AS genotypes’ immunofluorescence characteristics of type Ⅳ collagen α5 chains in base membrane，15 patients（75%） were diagnosed as X-linked dominant inherited AS（XLAS） and 5 patients did not determine the inherited types yet according to the deletion of type Ⅳ collagen α5 chains. Two children with AS also detected collagen type Ⅳ α5 chains in epithelial basement membrane and the results were the same as detecting type Ⅳ collagen α5 chains in glomerular basement membrane. Conclusion：In southwest China，hematuria associated with proteinuria is the main initial clinical manifestation in children with AS. The main inheriting type is XLAS（75%）. There was no significant difference in AS children with variable clinical phenotypes，however，the higher the level of proteinuria，the more severe the change in renal tubular interstitial. The diagnosis of XLAS by skin biopsy is consistent with that by renal biopsy and skin biopsy can replace renal biopsy under certain circumstances. Moreover，skin biopsy plays an important role in screening the carriers and making genetic counseling.

Abstract:Objective：To observe the therapeutic effect of improved ACH-10 Asahi Kasei on multiple organ dysfunction syndrome （MODS） in hemofiltration of low birth weight children. Methods：Ongoing continuous venous hemofiltration（CVVHF） by ACH-10 Asahi Kasei was performed on eight low birth weight children with severe MODS. Changes in blood pressure，serum potassium，urea nitrogen，creatinine，lactate，and prognosis were observed. Results：Catheterization and bypass were successfully performed on eight low birth weight children. Blood sampling was not well in all cases，but still successfully bypassed through diluting by the pump. Internal environment disorder and renal function were improved significantly. There was one hypothermia child and one hypotension child after the operation and they were improved after the treatment. No child with lower blood pressure and other complications was observed. Conclusion：Appropriately modified Asahi Kasei ACH-10 can be used in blood hemofiltration for low birth weight children and will help to improve the function of serious important organs of MODS children with low birth weight as well as improve the success rate.

Abstract:Objective：To investigate the clinical features and therapeutic effects of noncompaction of ventricular myocardium（NVM） in children. Methods：From September 2007 to November 2012，20 cases of NVM admitted in the Children’s Hospital of Chongqing Medical University were retrospectively analyzed. The retrospective analysis was carried out according to clinical features，auxiliary examinations（chest X-ray，electrocardiogram（ECG），ultrasonic cardiogram（UCG） and cardiac magnetic resonance（CMR），etc），clinical treatments and follow-up results，etc. Results：Among the 20 cases，2 cases had family history，16 cases（80%） showed cardiac insufficiency，10 cases（50%） demonstrated arrhythmia，and thrombosis or embolic events did not occur during this time. Chest X-ray of 12 cases（60%） showed cardiomegaly. Typical changes of NVM were seen in UCG of all patients：17 cases had only left ventricular pathological changes，2 cases had double ventricular pathological changes，9 cases（45%） had combination of congenital heart disease，3 cases（15%） had combination of dilated cardiomyopathy（DCM），4 cases（20%） had combination of endocardial fibroelastosis（EFE）. After all 20 children being treated in the hospital for the first time，16 children were cured and discharged from the hospital and 4 children gave up the treatment. The average follow-up time of the 20 patients was 7.86 months（1-15 months）. Five children died of the aggravation of heart failure. During the follow-up，symptoms of 8 children were significantly alleviated and modified Ross score was lower than that before treatment. Regular UCG recheck showed that the cardiac function was improved well and ejection fraction of left ventricular can be seen by UCG successfully after the treatment，with statistic significances（t=-3.248，P=0.018）. No statistical difference in shortening fraction of left ventricular，left ven－tricular end diastolic diameter，right ventricular end diastolic diameter and ratio of noncompacted to compacted myocardial layers after the treatment was observed（t=-1.348，P＝０.２２６；t=0.343，P=0.744；t=0.969，P=0.370；t=0.467，P=0.657）. Conclusion：Cardiac insuffi－ciency with different degrees is the chief complaint of NVM patients. The main auxiliary examination for the diagnosis of NVM is color Doppler electrocardiography. With active internal medicine treatment，clinical symptoms and left ventricular dysfunction can be greatly improved in short-term，but the long-term follow-up shows a poor prognosis in conclusion.

Abstract:Objective：To explore the relationship between death cause and vaccine injection and to provide references for coincidental event prevention and vaccination safety. Methods：Data of 31 infants died within 8 d after vaccination were analyzed retrospectively. Results：Male：female ratio was 2.9∶1. Minimum age was 32 gestational weeks and maximum age was 2 years. All 31 cases were coinci－dental event；21 infants died due to vaccination exacerbating the potential infectious diseases without typical symptom and 10 cases had no relationship with vaccination. Conclusion：Intensifying physical examination and inquiry before vaccination is an important method for decreasing coincidental event. It is the key measure to deal with the disputes by autopsy.

Abstract:Objective：To explore the risk factors for premature infants with failed hearing screening. Methods：Clinical data of 665 premature infants were analyzed by Chi-square test and multivariate logistic regression analysis. Risk factors for premature infants who failed hearing screening were identified. Results：Totally 20.8% premature infants failed hearing screening. Single factor analysis indicated that gestational age，birth weight，hyperbilirubinemia，bilirubin encephalopathy，neonatal hypoxic-ischemic encephalopathy （HIE），neonatal syphilis，pyogenic meningitis，neonatal asphyxia might be the risk factors for failed hearing screening in premature infants（P＜0.05）. Multivariate analysis indicated that gestational age，birth weight，hyperbilirubinemia，HIE，syphilis，asphyxia were risk factors for failed hearing screening（respective OR：2.927，2.627，2.956，1.813，5.971，and 1.906）. Conclusion：Gestational age ＜34 weeks，birth weight<1 500 g，hyperbilirubinemia，HIE，syphilis，asphyxia are risk factors of failed hearing screening in premature infants and effective measures should be taken.

Abstract:Objective：To promote the diagnosis and treatment in children with pheochromocytoma. Methods：Clinical data of six pa－tients with pheochromocytoma during thirteen years were analyzed retrospectively and literatures were reviewed. Results：Four cases had an increase of vanilla mandelic acid（VMA） within 24 h；six cases had an increase of blood catecholamine（CA） and were found positive mass by ultrasound，CT and MRI examination；four cases had adrenal mass；two cases had extra-adrenal mass（bladder）. Surgi－cal excision was performed in all of cases under general anesthesia and pheochromocytoma was confirmed postoperatively by histologic appearance. Patients were followed up for 1-13 years；five cases had tumor-free survival；only one case revealed tumor metastases by referral examination and died two months later due to disagreement of further treatment. Conclusion：The radical treatment of pheo-chromocytoma is surgical excision. It is crucial to perform preoperative preparations including volume dilatation and management of hypertension，to avoid intraoperative extrusion of tumor and intraoperative occurrence of severe hypertension，and to control blood pressure postoperatively. Differentiating benign from malignant pheochromocytoma by histologic appearance is difficult. In case of child with malignant hypertension，arrhythmia，palpitation，visual disturbance or abdominal pain，pheochromocytoma need to be consid－ered.

Abstract:Objective：To analyze the clinical characteristics and prognosis of sepsis in children and to provide references for early di－agnosis and treatment. Methods：A retrospective study was performed on 105 patients with sepsis hospitalized in Children’s Hospital of Chongqing Medical University from January 2007 to October 2012. Results：There were 74 males（70.5%） and 31 females（29.5%），and most of them were under 3 years old（65.7%）. The clinical manifestations varied. Sepsis could result in multiple sites of infection and organ dysfunction syndrome（MODS）（64.8%）. The most common sites of infection were lung（92.4%），skin and soft tissue（35.2%），and intracalvarium（32.4%）. The main dysfunctional organs were respiratory system（54.3%），hematologic system（50.5%） and liver（44.8%）. The most common initial site of infection were lung（41.9%），skin and soft tissue（21.0%），and digestive system（17.1%）. In the univariate analysis，variables significantly associated with prognosis were increased dysfunctional organs（Z=-5.940，P=0.000），septic shock（χ2=8.531，P=0.003），white blood count（Z=-2.100，P=0.036），platelet count（Z=-2.925，P=0.003），serum procalcitonin（Z=-2.125，P=0.034），serum D-dimer（Z=-3.748，P=0.000），electrolyte disturbance（χ2=5.899，P=0.015），anti-infective therapy at one hour after admitting to hospital（χ2=4.594，P=0.032）. And the logistic regression model showed increased dysfunctional organs and anti-infective therapy at one hour after admitting to hospital were risk factors associated with prognosis. Conclusion：Most patients with sepsis in children are less than 3 years old. The clinical manifestations of sepsis vary and sepsis could result in MODS. The most com－mon dysfunctional organ and infection site is respiratory system and the most common initial infection site was lung. Increased dys－functional organs and anti-infective therapy at one hour after admitting to hospital are the risk factors for death.

Abstract:Objective：To explore the treatment for complications after percutaneous renal biopsy in children and to summarize nursing experiences in order to provide references for pediatric clinical work. Methods：Clinical data of 2 160 children receiving renal biopsy in our hospital from January 1999 to December 2012 were retrospectively analyzed including related complications and treatment and nursing care methods. Results：There were 1 728 cases（80%） of gross hematuria，367 cases（17%） of perirenal hematoma，216 cases （10%） of back pain，43 cases（2%） of urinary retention，2 cases（0.1%） of renal artery pseudoaneurysm and there was no other organ damage or death. Conclusion：The development and promotion of renal biopsy helps to improve the diagnosis and treatment of child renal disease and promote the development of pediatric nephrology. Scientific treatment and nursing intervention can effectively reduce the incidences of hematuria，hematoma and other complications and improve the poor prognosis.

Abstract:Objective：To investigate the different clinical characteristics of respiratory distress syndrome（RDS）with various gestational ages and to guide the clinician to prevent and treat RDS correctly. Methods：A total of 1 133 cases of RDS whose admission ages were less than 2 d in our department from January 2008 to December 2012 were divided into full-term group and preterm group according to gestational age. According to illness severity，all patients were subdivided into mild group and severe group. The clinical data in each group were analyzed. Results：Mild preterm group had 542 cases（67.3%）；353（65.1%） were performed with cesarean delivery and 354（65.3%） were treated with pulmonary surfactant（PS）. Chest X-ray was improved in 230 infants（65.0%） after using PS with－in 48 h. The time for assisted ventilation was 76.0 h and 41 cases（7.6%） complicated with pulmonary air leak. Mild full-term group had 200 cases（61.0%），187（93.5%） were performed with cesarean delivery（compared with that in mild preterm group， χ2=59.352，P=0.000） and 74（37.0%） were treated with PS（χ2=47.979，P=0.000）. Chest X-ray was improved in 35 infants（47.3%） after using PS within 48 h（χ2=8.108，P=0.004）.The time for assisted ventilation was 90.0 h（Z=-2.261，P=0.024） and 28 cases（14.0%） complicated with pulmonary air leak（χ2=7.713，P=0.007）. Severe preterm group had 263 cases（32.7%）；173（65.8%） performed with cesarean de－livery and 193（73.4%） were treated with PS；13 cases（4.9%） complicated with pulmonary air leak. Severe full-term group had 128 cases（39.0%）（compared with that in severe preterm group，χ2=4.163，P=0.041）；122（95.3%） performed with cesarean delivery（χ2=40.538，P=0.000） and 77（60.0%） treated with PS（χ2=7.050，P=0.008）；19 cases（14.8%） complicated with pulmonary air leak（χ2=11.231，P=0.001）. Conclusion：（1）Different clinical characteristics between preterm RDS and full-term RDS lie in risk factors，illness severity，treatment response，complications and prognosis，etc. Gestational age should be taken into consideration when diagnosing and treating RDS. （2）Full-term RDS are characterized by clinically severity and frequently pulmonary air leak compared with that of preterm RDS，therefore more attention should be paid to its early diagnosis and treatment.

Abstract:Objective：To compare the feasibilities of two operation methods of internal fixation with steel plate and Kirschner wire in the treatment of child Galeazzi fracture with conservative treatment failure. Methods：Fracture of radius in 51 cases was treated with steel plate internal fixation and Kirschner wire internal fixation after open reduction. Anatomic relationship of distal radioulnar joint or distal ulna bone epiphysis fracture was treated with manual reduction. Whether to adopt Kirschner wire to fix distal ulna bone epiph－ysis or distal radioulnar joint was decided based on the its stability，and external fixation by long arm plaster support in the elbow flex－ion was adopted for 4 to 6 weeks. Results：All cases in two groups were followed up with an average period of 15.6 months. Accord－ing to Berton evaluation，among the 28 cases in steel plate group，there were 9 excellent cases，17 good cases，2 middle cases and 0 poor case，with an effective and good rate of 92.9%. Among 23 cases in Galeazzi group，there were 5 excellent cases，9 good cases，7 middle cases and 2 poor cases with an effective and good rate of 60.9%. Statistical significant differences were observed between two groups（P=0.034）. Conclusion：Internal fixation with Kirschner wire combined with external fixation by long arm plaster support can achieve better fracture stability and better function of wrist and forearm in the treatment of child Galeazzi fracture with conservative treatment failure.

Abstract:Objective：To improve the visual effect of the vessels and lesion sites in fundus image and to contribute to clinical diagnosis. Methods：Firstly，mathematical morphology was used to weaken the background so as to preliminary enhance the image. Then，contrast limited adaptive histogram equalization was performed to adjust the uneven brightness in the images. Finally，two-dimensional matched filters were exploited to strengthen vessels and pathological regions and improve the contrast between background and ves－sels. Results：Result showed that the proposed method can efficiently weaken background and enhance contrast. Regions of interest were improved significantly；vessels segmentation in optic disk regions and identification of pathological region became much easier. Conclusion：Proposed enhancement method can be applicable to normal retinal images as well as pathological retinal images，which is useful for clinical diagnosis.

Abstract:Objective：To study differential microRNAs（miRNAs） expression profiles in rat corneal neovascularization（CNV） using mi－croarrays，to establish the potential link between microRNAs and vascular endothelial growth factor（VEGF） signaling pathways and to investigate the function of neovascularization in corneal limbus. Methods：Corneal neovascular model in rats was constructed by corneal stitch. The LAN microarrays were selected and samples were labeled and hybridized with microarray. The results of LAN microarrays were analyzed. Results：Sixteen miRNAs were predicted to target emcee of CNV including 10 miRNAs expressing as up-regulation and 6 miRNAs expressing as down-regulation. The miRNAs expressing as up-regulation included miR-142，miR-146，miR-21，miR-223，miR-214，miR-199，miR-483，miR-322，miR-126 and miR-1224. The miRNAs expressing as down-regulation included miR-30e，miR-101，miR-184，miR-200c，miR-200b and miR-204. The miRNAs correlated significantly with VEGF included miR-142，miR-146，miR-21，miR-223，miR-199，miR-322，miR-200，miR-30e，miR-204，miR-1224. miR-142 miR-200 and miR-322 correlated most with VEGF. Conclusion：Differential expression of miR-142 miR-200 and miR-322 in the rat model of corneal neo－vascularization is closely associated with VEGF signaling pathway.

Abstract:Objective：To explore the effects of Toll-like receptors（TLR2，TLR3） on C3a and C5a in patients with wet-age-related macular degeneration（wet-AMD）. Methods：Peripheral blood samples were collected from 15 patients with wet-AMD and 15 subjects without wet-AMD were taken as controls. Peripheral blood mononuclear cells were then isolated using gradient centrifugation. The iso－lated cells were divided into 7 groups：blank group，C3a group，C5a group，TLR2 on C3a group，TLR2 on C5a group，TLR3 on C3a group and TLR3 on C5a group. Stimulations were added to each group. The supernatant was collected and tested for concentration of AMD-related cytokines，such as interleukin-1Beta，interleukin-6，interleukin-8，interleukin-17，monocyte chemoattractant protein-1，vascular endothelial growth factor by using ELISA. Results：The concentrations of interleukin-1Beta，interleukin-6，interleukin-8 and monocyte chemoattractant protein-1 were higher in TLR2 on C3a group，TLR2 on C5a group，TLR3 on C3a group and TLR3 on C5a group than in C3a group or C5a group. Concentrations of interleukin-1beta，interleukin-6，interleukin-8 and monocyte chemoattractant protein-1 were obviously increased in blank group，C3a group，C5a group，TLR2 on C3a group，TLR2 on C5a group，TLR3 on C3a group and TLR3 on C5a group of patients with wet-AMD than in corresponding group of subjects without wet-AMD. Conclusion：The effects of Toll-like receptors on the complement system may promote the development of wet-AMD.

Abstract:Objective：To investigate the therapeutic value of vitrectomy for uveitis complicated with retinal detachment. Methods：Stan－dard three-incision vitrectomy was performed on 22 patients（22 eyes） with uveitis complicated with retinal detachment，whose age ranging from 5 to 64 years old. In these 22 eyes，C3F8 or silicone oil intraocular tamponade was injected according to the different needs，and triamcinoloneacetonidel（TA） was injected before the finishing of surgery to reduce the degree of postperative inflamation. All patients were treated with systemic immunoppressive therapy after surgery and the uveitis was controlled. Results：Twenty-two eyes were followed up for three months to five years. Retinas of all cases didn’t detached. Twenty-one eyes obtained better visual acuity and one eye was unchanged but without recurrent retinal detachment and obvious hyperplasia. Conclusion：Par-plana vitrectomy as－sisted by TA is an effective method for uveitis. Injection of TA after silicone oil intraocular tamponade can make TA release slowly，equivalent to slow release of hormone，which can prevent recurrent occurrences of uveitis as well as occurrence and development of hyperplasia vitreous retinopathy.

Abstract:Objective：To discuss the efficacy of vitreoretinal surgery using 23-gauge transconjunctival sutureless vitrectomy（TSV） sys－tem for various vitreoretinal diseases. Methods：A total of 154 eyes of patients who underwent vitreoretinal procedures using 23-gauge minimally invasive surgery vitrectomy system in wide field retionscope were enrolled. Efficacy，intraoperative and postoperative compli－cations and operation time were observed. Moreover，intraocular pressure（IOP） and best corrected visual acuity（BCVA） of pre-and post-operation were determined. Results：①All operation were performed successfully. ②Mean duration of operation was （42.0±5.2） min（ranging from 28 min to 83 min）. ③BCVA was improved at 1，2，3 months after operation compared with that before operation. ④Compared with those before operation，both lower and higher IOP were observed on 1 d after operation，higher IOP was observed on 3 d after operation and steady IOP was found on 7 d and 30 d after the operation. ⑤3 eyes（1.9%） had ocular hypotensipon af－ter operation，15 cases（9.7%） had ocular hypertension and no case of endophthalmitis was reported. Conclusion：With the advantages of shorter operation time，less trauma，fewer complications，more convenient and rapid visual recover，23-gauge TSV system is effec－tive in the treatment of vitreoretinal diseases.

Abstract:Objective：To explore the clinical efficacy of Ahmed valve implantation in the treatment of refractory glaucoma. Methods：Totally 61 patients（63 eyes） with refractory glaucoma underwent surgery using Ahmed glaucoma valve. Changes of intraocular pres－sure and postoperative complications were observed. Follow-up was lasted for 24 months. Results：At one month postoperatively，in－traocular pressure（n=63） was changed from （43.53±6.42） mmHg to （16.29±4.02） mmHg and the success rate was 88.9%. For those eyes with the follow-up≥12 months（n=44），intraocular pressure was （17.16±5.05） mmHg and the success rate was 84.1%. Common postoperative complications included：shallow anterior chamber，hyphema，choroidal detachment，tube blockage，tube-endothe－lial touch，etc. Conclusion：Ahmed valve implantation is one of the effective methods for refractory glaucoma and this method can be widely used in clinics.

Abstract:Objective：To observe the risk factors of secondary neovascular glaucoma（NVG） after vitrectomy for proliferative diabetic retinopathy（PDR）. Methods：A retrospective review was conducted on 288 eyes that underwent vitrectomy for PDR. Multiple factors were analyzed for their effect on secondary NVG using Fisher exact probability test. Results：Eight eyes（2.8%） developed secondary NVG. Fisher exact probability test showed that the P values of PDRⅥ，vitreous hemorrhage after vitrectomy and mutiple-surgery were 0.023，0.002，0.006 respectively. Conclusion：PDRⅥ，vitreous hemorrhage after vitrectomy and mutiple-surgery are main risk factors of secondary NVG after vitrectomy for PDR. Effective treatment at early stage of PDR and precaution of complications may reduce the incidence of secondary NVG.

Abstract:Objective：To observe the effects of Yiqi-huayu-huatan-yangyin preparation on the liver histopathology and expression of fibroblast-specific protein 1（FSP1） and protease activated receptor -2（PAR-2） in liver fibrosis rats induced by CCl4. Methods：The SD rats were randomly divided into：normal group，model group，colchicines group and low/moderate /high dosages of Yiqi-huayu-hu－atan-yangyin preparation group. Rats in normal and model group were fed with normal saline，rats in colchicine group were fed with 0.1 mg/（kg·d） colchicine and rats in low/moderate/high dosages of Yiqi-huayu-huatan-yangyin preparation group were fed with Yiqi-huayu-huatan-yangyin[30，60，120 g/（kg·d）] correspondingly.Pathological changes of the liver tissues were observed by light microscopy. Activities of alanine aminotransferase（ALT），aspartate aminotransferase（AST） in liver tissues were evaluated by spec－trophotometry. Levels of hyaluronic acid（HA），typeⅣ collagen（CⅣ） in serum were determined using ELISA kit. Expression of FSP1 and PAR-2 mRNA and protein in the liver tissues was detected by qRT-PCR and Western blot. Results：（1）Levels of ALT，AST，HA and CⅣ in serum and fibrosis changes were increased significantly in model group compared with those in normal group（P<0.05） and the expression of FSP1 and PAR-2 mRNA and pro－tein of liver tissues were increased obviously（P<0.05）. （2）In－flammatory cell infiltration and liver fibrosis were lighter in treatment groups than in model group. Levels of ALT，AST，HA and CⅣ in serum and expression of FSP1 and PAR-2 mRNA and protein in liver tissues were slightly elevated in treatment groups（P<0.05）. Conclusion：Yiqi-huayu-huatan-yangyin preparation may protect the liver and delay the development of liver fibrosis by regulating the mRNA and protein expression of FSP1 and PAR-2.

Abstract:Objective：To observe the effect of electro-acupuncture（EA） on blood lipid，liver function，histology of liver tissue，tumor necrosis factor-α（TNF-α），interleukin-6（IL-6） and interleukin-18（IL-18） in rats with non-alcoholic fatty liver disease（NAFLD） so as to investigate effect of EA intervention on NAFLD. Methods：Totally 48 male Sprague Dawley rats were randomly divided into four groups：normal group，model group，early intervention group，late intervention group. Rats in normal group were fed with normal-fat diet. Rats in the other three groups were fed with high-fat diet for five weeks to form non-alcoholic fatty liver model. At the end of the fifth week，one rat in each group was killed to verify the forming of fatty liver model. Rats in early intervention group were treated with EA at one week after feeding with high fat diet .Rats in late intervention group and early intervention group were treated with EA at the acupoints of Zusanli，Fenglong and Sanyinjiao for 20 min once a day for a consecutive 21 d. In the wake of the 21st d，changes in glutamic-pyruvic transaminase（ALT），glutamic oxalacetic transaminase（AST），total cholesterol（TC），triglyceride（TG），TNF-α，IL-6，IL-18 of rats in each group were observed. Results：Expressions of ALT，AST，TC，TG，TNF-α，IL-6，IL-18 were all higher in model group than in the other three groups，with statistically significant differences（F=103.235，148.117，7.496，6.343，11.402，16.498，11.525；P=0.000，0.000，0.000，0.001，0.000，0.000，0.000）. Expressions of ALT，AST，TC，TG，TNF-α，IL-6，IL-18 were significantly reduced in two intervention groups than in model group，with statistical significances（P<0.05）. Conclusion：EA can treat NAFLD through alleviation of blood lipid and inflammation.

Abstract:Objective：To compare the endogenous metabolites in the plasma of people with qi-deficiency constitution after the inter－vention by Buzhongyiqi pills using nuclear magnetic resonance（NMR）-based metabonomics and to find the possible specific metabo－lites. Methods：Twenty healthy people with qi-deficiency constitution were recruited and divided into control group and intervention group. Buzhongyiqi pills were used to do the intervention and the plasma was tested by NMR-based metabonomics before and after the intervention. Multivariate statistical analysis was done to find the serum-derived metabolic differences after the intervention by Buzhongyiqi pills. Results：The plasma before and after the intervention was analyzed by Simca-P and 45 changed chemical shift val－ues（VIP>1，P<0.05） were selected. Thirty specific metabolites were found through human metabolite database. Conclusion：These differences in metabolites are related to the tricarboxylic acid cycle. Buzhongyiqi pills can improve the disorder of energy metabolism，memory deterioration and fatigue of qi-deficiency population，which may associated with its regulation of GABA，phosphatidyl－choline，blood ammonia concentration.

Abstract:Objective：To study the relationship between propagated sensations and surface electromyography along meridian caused by acupuncture at ‘Quchi’ acupoint. Methods：‘Quchi’ acupoint，non-acupoint of the meridian and non-acupoint control were acupunc－tured and propagated sensations were caused. Amplitude and muscle active duration of surface electromyography on brachioradialis were recorded. Results：There were significant differences in the positive frequency of propagated sensations along meridian at ‘Quchi’ acupoint，non-acupoint of the meridian and non-acupoint control（?字2=28.298，P=0.000）. Positive frequency of propagated sensations along meridian was significantly higher at ‘Quchi’ acupoint and non-acupoint of the meridian than at non-acupoint control（?字2=24.783，P=0.000； ?字2=19.113，P=0.000）. ‘Quchi’ acupoint，non-acupoint of the meridian and non-acupoint control were significantly different in the amplitude and muscle active duration（P=0.000）. Amplitude and muscle active duration showed obvious variation at ‘Quchi’ acupoint than at non-acupoint of the meridian and non-acupoint control. Acupuncture at ‘Quchi’ acupoint，non-acupoint of the meridian and non-acupoint control all caused the amplitude variation of surface electromyography on brachioradialis（P=0.000）. Conclusion：Synchronized surface electromyography on brachioradialis of propagated sensations along meridian caused by acupunc－ture at ‘Quchi’ acupoint is stronger than that caused by acupuncture at non-acupoint of the meridian and non-acupoint control and the effects of acupuncture at ‘Quchi’ acupoint on surface electromyography of brachioradialis show the acupoint specificity.

Abstract:Objective：To investigate the clinical efficacy of electrical stimulation and acupuncture for post-stroke bulbar palsy and to provide references for choosing appropriate treatment plan. Methods：Totally 49 post-stroke true bulbar paralysis patients and 49 post-stroke pseudo bulbar paralysis patients were randomly assigned into electrical stimulation group and acupuncture group：true bulbar paralysis-electrical stimulation group，true bulbar paralysis-acupuncture group，pseudo bulbar paralysis- electrical stimulation group，pseudo bulbar paralysis-acupuncture group. Based on the early rehabilitation training，the four groups were treated with electrical stimulation or acupuncture for 10 d. Results：There was no significant differences in response rate between electrical stimulation group and acupuncture group among pseudo bulbar paralysis patients，88.0% and 83.3% respectively（P >0.05）. However，response rate of electrical stimulation group was significantly higher than that of acupuncture group among true bulbar paralysis patients，76.0% and 41.7% respectively（P<0.05）. Conclusion：Either electrical stimulation or acupuncture combined with rehabilitation training is effec－tive in the treatment of post-stroke pseudo bulbar paralysis. For post-stroke true bulbar paralysis，it is better to choose electrical stim－ulation combined with rehabilitation training.

Abstract:Objective：To review the clinical efficacy of Hybrid surgical treatment for multi-segment cervical spondylosis and to discuss the advantages and disadvantages of Hybrid，anterior cervical discectomy and fusion（ACDF），cervical artificial disc replacement（CDR）and posterior surgery. Methods：The relevant domestic and foreign literatures about the Hybrid，ACDF，CDR and posterior surgery were searched and their advantages，disadvantages and efficacy were analyzed and compared. Results：Hybrid surgery can effectively alleviate the symptoms，keep the motion range of cervical spine and lower the pressure of adjacent vertebral segment disc. Meanwhile，Hybrid surgery was of great significance in maintaining long-term stability of the cervical spine and recovering its biomechanics en－vironment. Conclusion：Hybrid surgery can obtain confirmed short-term clinical effect，but a lot of long-term follow-up studies are still needed to prove its long-term clinical effects.

Abstract:Objective：To compare the clinical outcome between closed suction drainage and nondrainage following primary total knee arthroplasty（TKA） on the basis of the best available evidence. Methods：Randomized controlled trils（RCTs） between 1950 and De－cember 2013 comparing primary TKA patients managed with closed-suction drainage and those without drainage in the databases of Medline，EMBASE，Cochrane Library and CNKI were enrolled. The Review Mananger was used to analyze selected studies. Twenty-two CONSORT criteria were used to evaluate the the quality of the literature. Subgroup analysis was carried out when significant het－erogeneity occured. Results：Sixteen RCTs involving 1 417 knees（713 knees in closed-suction drainage group and 704 in nondrainage group） satisfied the inclusion criteria. In closed-suction drainage group，the incidence of soft tissue ecchymosis was significantly lower compared with that in nondrainage group. Subgroup analysis showed greater differences between the two groups in the setting of simul－taneous bilateral TKA. However，results favored nondrainage group with respect to the total blood loss volume and blood transfusion rates. No significant difference was demonstrated in the prevalence of infection，incidence of deep venous thrombosis（DVT），or postoperative range of motion（ROM） between two groups. Conclusion：Current RCTs demonstrate that the use of closed suction drainage after primary TKA provides no benefit in terms of infection，DVT，and postoperative ROM when compared with nondrainage. Besides，it increases perioperative total blood loss volume and elevates the risk of homologous blood transfusion. The only proven advantage of drainage is a decreased incidence of blood leakage from the wound，especially when simultaneous bilateral TKA is performed.

Abstract:Objective：To construct an eukaryotic vector of pIRES2-EGFP-FGF-2 and to investigate its effect on the proliferation，os－teogenesis and chondrogenesis of mouse mesenchymal stem cells C3H10. Methods：FGF-2 gene was amplified by PCR from plasmid pAd-Trace-FGF-2. After being digested with BglⅡ and SalⅠ，the PCR product was inserted into pIRES2-EGFP to construct pIRES2-EGFP-FGF-2. pIRES2-EGFP-FGF-2 plasmid was transfected into C3H10 by Liposomes，and C3H10 transfected with pIRES2-EGFP and untreated were set up as controls. The mRNA and protein expression levels of FGF-2 were determined by RT-PCR and Western blot respectively. The proliferation activity and cell cycle phase of C3H10 were examined by MTT and flow cytometry. The mRNA transcription levels of collagenⅠ（ColⅠ），osteocalcin（OC），osteoprotegerin（OPG），osteopontin（OPN），collagenⅡ（ColⅡ），aggrecan（ACAN） and Wnt pathway molecules were detected by RT-PCR. The protein expression of ColⅡ was detected by Western blot. Toluidine blue staining was carried out to measure the secretion of cartilage oligomeric matrix protein by cells in culture. Results：Re－striction analysis and sequencing proved that recombinant plas－mid pIRES2-EGFP-FGF-2 was constructed correctly. Both the mRNA and protein expression level of FGF-2 increased signifi－cantly in pIRES2-EGFP-FGF-2 transfected C3H10 cells. Cell proliferation activity of the experimental group increased sig－nificantly（P＜0.05）. The mRNA transcription levels of ColⅠ，ColⅡ and ACAN in C3H10 cells transfected with pIRES2-EGFP-FGF-2 recombinant plasmid increased significantly（P<0.05），however there was no significant increase in the mRNA expression of OC，OPG，OPN（P ＞0.05）. The transcription levels of Wnt5a and Fzd8 decreased significantly（P<0.05）. Toluidine blue staining showed purple metachromatic in the cells FGF-2 overexpressed C3H10 cells. Conclusion：The recombinant eukaryotic expression vector for FGF-2 gene is successfully constructed and overexpression of FGF-2 can promote chondrogenesis and proliferation activity of C3H10 cells but there is no significant effect on osteogenic differentiation in short-term. The effect of FGF-2 on chondrogen－esis maybe involve in the downregulation of Wnt5a and Fzd8.

Abstract:Objective：To compare the analgesic effects between continuous femoral nerve block（CFNB） plus multimodal analgesia （experimental group） and normal multimodal pain controlled analgesia（control group） after total knee arthroplasty for the first time and to evaluate the knee function with six months’follow-up. Methods：From October 2011 to October 2012，48 patients undergoing unilateral total knee arthroplasty were randomly devided into experimental group and control group，24 cases for each group. Two postoperative analgesia methods were applied in two groups respectively and general anesthesia was used in both group. In the periop－erative period，rest，passive and initiative visual analogue scales were used to evaluate perioperative pain. The range of motion（ROM） and complications were observed and recorded. All patients were followed up for 6 months and knee society scoring system was used to assess knee function. Results：All index indicated that analgesia effect was more obvious in experiment group than in control group within 2 d after opertion. There was no significant difference in adverse reactions and ROM at 6 months after the operation（P ＞0.05）. Conclusion：CFNB combined with multimodal analgesia can alleviate the early pain for patients undergoing total knee arthroplasty，especially at 48 hours after operation without increasing adverse reactions． Therefore，it should be considered a better analgesia method for patients after total knee arthroplasty．

Abstract:Objective：To investigate the results of arthroscopic treatment of parameniscal cyst（PC） with intra-articular decompression of cyst and meniscectomy or suture. Methods：From January 2009 to December 2011，22 cases of parameniscal cyst were treated by arthroscopy with intra-articular decompression of cysts and meniscectomy or suture，including 14 males and 8 females，with an aver－age age of 32.7 years（ranging from 22 to 51 years）. Twelve patients suffered in left knees，10 in right ones. Eighteen cases had trau－ma history and the others had no obvious predisposing causes. The average disease duration was 5.2 months（ranging from 3 to 12 months）. Before the operation，the Lysholm score was 60.03±4.89 and the International Knee Documentation Committee（IKDC） sub－jective evaluation score was 64.25±4.22. Four patients had medial parameniscal cyst and 18 patients had lateral parameniscal cyst．There were 7 cysts in meniscal anterior horn，14 cysts in meniscal body and 1 cyst in meniscal posterior horn；all being single cyst and 5 being multilocular cyst. Results：All incisions healed by the first intention without complication. All patients were followed up for 12 to 24 months with an average of 14.5 months. Preoperative symptoms disappeared or reduced and the range of motion of the knee returned to normal. The Lysholm knee score and IKDC subjective evaluation score were significantly increased to 87.20 ± 4.65 and 90.86 ± 3.58 at 1 year after the operation（P<0.05）. According to assessment standard described by Glasgow，the treatment out－come was excellent in 16 cases，good in 5 cases and general in 1 case；the excellent and good rate was 95.45%. No recurrence was found during the follow-up. Conclusion：Arthroscopic management of paramenical cyst with intra-articular decompression of cyst and meniscectomy or suture results in a good clinical outcome with minor invasion and rapid recovery.

Abstract:Objective：To investigate the clinical features and efficacy of vascularized free anterolateral thigh flap（ALTF） for repair of tissue defects in oral and maxillofacial surgery. Methods：Totally 39 patients with maxillofacial defects due to different causes in our department between January 2011 and February 2013 were enrolled in our study including 36 cases caused by extended resection of oral and maxillofacial carcinoma，one case caused by resection of facial giant neurofibroma and 3 cases of maxillofacial soft tissue de－fect by injury. During the surgery，flaps at a size equivalent to recipient area were cut and some flaps with muscle sleeves were used to fill the dead spaces；the descending branch of the femoral artery was end-to-end anastomosed with external maxillary artery and the accompanying vein of the vascular pedicle was end-to-side anastomosed with the internal jugular vein or external jugular vein. The survival of the flap graft and the characteristics of the functional reconstruction of the recipient area were recorded. Results：Of the 39 cases，36 showed survival of skin flaps. One patient with diabetes mellitus presented with venous vascular crisis at 15 h after the surgery and then experienced total necrosis of skin flaps in spite of the active rescue. Two patients presented with venous vascular crisis at 10-15 h after the surgery and survived completely after the rescue. The patients were followed-up for 6-30 months（mean 9.7 months）. There was no shrinkage of the surface area of the flaps in the recipient area. 1/3-1/2 of the subcutaneous adipose tissues were absorbed. Linear scar tissue formed in the donor area yet without no significant deformity and the legs had normal activity. Conclusion：Vascu－larized free ALTF is characterized by advantages of simple operation，easy to learn，plastic，satisfactory in shape and function of the recipient area，rich in tissue dose in the donor area，constant in the location of blood vessels，long in vascular pedicle length and little impact on the appearance and function of the donor area. Thus it can be widely applied in the tissue defect reconstruction in oral and maxillofacial surgery.

Abstract:Objective：To investigate the feasibility and advantages and disadvantages of absorbable screw in the treatment of children humerus lateral condyle fractures. Methods：Clinical data of 183 children who accepted treatment of children humerus lateral condyle fractures in our hospital between January 1，2009 and December 31，2010 were analyzed，among which 100 were male，83 were fe－male，with an average age of 6.5 years. Results：Totally 183 children were all followed up for 6 to 32 months，with an average of 16 months. According to the outcome of Hardacre standards，all cases achieved satisfactory recovery without healing delay，lateral condyle overgrowth，cubitus valgus and varus or other complications expect one case of healing delay. Conclusion：Compared with traditional fixation by K-wires，absorbable screws can significantly decrease complications in the treatment of children humerus lateral condyle fracture without injuring the epiphyseal plate.

Abstract:Objective：To evaluate the clinical efficacy of arthroscopy in the treatment of refractory lateral humeral epicondylitis. Methods：From January 2009 to December 2010，arthroscopic surgery was performed in 20 cases of humeral epicondylitis which was ineffective by conservative treatment. Postoperative visual analogue scale（VAS） was used to evaluate the elbow improvement. Results：All patients accepted 6 to 21 months follow-up，with an average of 13 months. VAS pain score evaluation was conducted and preop－erative and postoperative results were compared with statistically significant differences（P＜0.001）. Conclusion：With the advantages of minimally invasiveness and quick recovery，arthroscopy is effective in the treatment of refractory lateral humeral epicondylitis be－cause it can directly deal with lesions and intra-articular lesions simultaneously.

Abstract:Objective：To discuss advantages and disadvantages of two different incisions in treating medial epicondyle fracture of the humerus in children. Methods：One hundred and six children with medial epicondyle fractures were surgically treated and reviewed. Sixty-seven cases are male and thirty-nine are female. The mean age of patients at the time of accident was 12.7 years. The medial epicondylar fragment was anatomically reduced and fixed in all cases. Mean follow-up was 25 months. Function outcome was as－sessed using mayo elbow performance score. Results：Sixty-one cases were longitudinal incisions and forty-five cases were transverse incisions. The mean length was （7.5０±0.18） cm or （2.2０±０.13） cm and it took about （60.00±3.60） min or （23.00±2.66） min to finish one operation. The final result was excellent in 99 cases，good in 6 cases and bad in 1 case. Elbows were stable and pain-free and normal or little limited elbow range of motion was reported in 105 cases. Bone union was achieved in 105 cases and ununion in one case. No case of cubitus valgus >10° was observed. Two cases experienced radial nerve injury but recovered without another operation. Conclusion：The two incisions are feasible in the treatment of humerus medial epicondyle fracture. With the advantages of smaller incision，less invasiveness，easier operation and quicker recovery，transverse incision is better than longitudinal incision.

Abstract:Objective：To study the relationship between paraoxonase 1（PON1） Leu55Met gene polymorphisms and the risk of chronic periodontitis（CP） with diabetes. Methods：Buccal swab of 50 patients with CP and diabetes，50 patients with CP，50 patients with diabetes and 50 healthy controls were collected. DNA was isolated from buccal swabs of patients with CP and diabetes，CP，diabetes and health controls and were extracted by Chelex-100. PON1 Leu55Met gene polymorphisms were assessed by PCR amplification and digestion with restriction enzyme respectively. Results：There were statistically significant differences in the distribution of PON1 Leu55Met genotype among CP with diabetes group，CP group，diabetes group and health control group（ ?字2＝12.444，P＝0.006）. Conclu－sion：Susceptibility of CP and diabetes may associate with PON1 Leu55Met polymorphisms.

Abstract:Objective：To summarize adverse reactions and clinical effects of bioabsorbable miniplates in the treatment of maxillofacial fractures. Methods：Clinical data of 43 patients with maxillofacial fracture using biodegradable materials to do rigid internal fixation were reviewed and analyzed. All patients were followed for 3 months to 2 years. Results：Totally 41 patients received good recovery after treatment，with good occlusal relationship. One case of aseptic effusion was observed；the wound was healed after 3 weeks of irri－gating and dressing. Absorbable plate exposure was observed in one case；mucosa tissue was healed after several times of grinding exposed absorbable plate. Conclusion：Bioabsorbable plate is the ideal material in the treatment of maxillofacial fractures.

Abstract:Objective：To compare the effect of casein phosphopeptide-amorphous calcium phosphate（CPP-ACP），casein phosphopep－tide-amorphous calcium phosphate fluoride（CPP-ACPF），tri-calcium phosphate fluoride（TCP+F） and Duraphat fluoride var－nish on surface microhardness and surface morphology after toothbrushing abrasion of eroded enamel. Methods：Impacted mandibular third molars were collected at clinic and 50 sam－ples with hardness between 280-330 HV were selected. The samples were processed into enamel slabs and then were randomly divided into five groups. The samples were first immersed into Co－ca-Cola for 5 min，5 times a day for 5 days. Then erosive enamel samples were subjected to brushing abrasion with an electric tooth－brush 2 N brushing load for 3 min，2 times a day for 5 days. Distilled water，CPP-ACP，CPP-ACPF，TCP+F and Duraphat were re－spectively applied during brushing interval and abrasion-remineralization-erosion treatment was provided for ５ days. Microhardness of enamel surface before and after the treatment was measured by microhardness tester and morphology changes of enamel surface was observed by scanning electron microscope（SEM）. Results：Microhardness in CPP-ACP and CPP-ACPF group was decreased，having no significant difference compared with that of distilled water group（P ＞0.05）. Microhardness in TCP+F and Duraphat group was significantly higher than that of distilled water group（P<0.05）. Smooth enamel surface was observed with SEM in other four groups except in distilled water group. Conclusion：Duraphat and TCP+F can prevent the abrasion of constant acid eroded enamel.

Abstract:Objective：To compare the residual dentinal surface following caries removal between Carisolv and conventional bur meth－ods using microhardness test. Methods：Ten decayed primary molars and ten permanent molars with dentinal caries but not involving the pulp were collected. All the teeth were sectioned into two parts along the center of the cavity. Carisolv system was compared with slow-speed bur in eliminating caries. Then microhardness test was performed on the floor of the cavity and the surrounding healthy dentin. Results：Primary teeth：there was no statistically significant difference in caries-affected dentine and healthy dentine after the two methods（P >0.05）. Permanent teeth：there was no statistically significant difference in caries-affected dentine after the two meth－ods（P >0.05）；statistically significant differences were observed in healthy dentine between the two methods（P=0.008）. Conclusion：Carisolv can remove caries efficiently and has similar mineralization of healthy dentine as conventional bur methods.

Abstract:Objective：The gonion and gnathion of human skull play an important role in forensic identification，dental surgery，cosmet－ic surgery and other fields. It is critical to locate them in cone bean（ＣＢ） CT mandible image for forensic identification and preopera－tive preparation. Methods：In this paper，an effective method was proposed to position gonion of mandible accurately and automatically. Firstly，265 CBCT mandible images were processed to extract the outer contour of lower jawbone by mathematics morphology method. Then quintic polynomial equations were carried out to gain fitted curves of mandible contours which were used to find the maximum curvature points. Lastly，distance correlation coefficient was computed to evaluate the accuracy of location of gonion objectively. Re－sults：Data showed that the distance between right and left gonion point to gnathion point had good correlation and the distance corre－lation coefficient was r=0.955. Conclusion：Finding the maximum curvature point with curve-fitting is an effect way to position the gonion in the CBCT mandible image.