Abstract:Peroxisome proliferator activated receptors（PPARs） are a class of nuclear receptor superfamily，which is consisted of PPA－Rα，PPARβ（also named PPARδ） and PPARγ. PPARs has been widely concerned and studied in every field since its discovery. The most studies focused on PPARα and PPARγ. Their physiopathological effects in vivo have been profoundly understood，and some of their ligands have been widely used in clinical treatment. However，there were fewer studies about PPARβ. Recently，it is believed that PPARβ is a connection hub of PPARα and PPARγ，making PPARβ more important. An increasing concern was paid on the role and regulation mechanism of PPARβ in central nervous system diseases，however，the researcheson PPARβ were far behind those on PPARα and PPARγ. This article reviews the role of PPARβ in central nervous system diseases.

Abstract:Chronic hydrocephalus，which is a common complication of intracranial aneurysmal subarachnoid hemorrhage，has a signifi－cant impact on function and quality of life. In traditional theory，chronic hydrocephalus is associated with subarachnoid fibrosis. How－ever，recent research has shown that that chronic hydrocephalus is related to osmotic and hydrostatic pressure in micro-vessel of the central nervous system. The influence factors of chronic hydrocephalus are so complicated that no exact measure of preventions and treatment has been found yet. In this paper，we review the recent advances in risk factors，preventive treatments，and new theories of the pathogenesis of hydrocephalus.

Abstract:Objective：To investigate the changes of the capillaries in the CA1 of hippocampus and dentate gyrus（DG） in the depression rats induced by chronically unpredicted stress（CUS）. Methods：Male Sprague-Dawley（SD） rats were randomly divided into the con－trol group（n=10） and the model group（n=10）. The depression model was established by giving rats CUS for five weeks. The rats in control group did not receive CUS. The sucrose consumption test and open-field test were used to confirm whether the de－pression rat model was successfully made. After the depression model of rats was successfully made，5 rats were randomly se－lected from each group. The immunohistochemistrical technique and the stereological methods were used to quantitatively inves－tigate the capillaries in the CA1 of hippocampus and the DG. The other 5 rats in each group were used for the related molecular biol－ogy studies. Results：The rat weight[（314.81±31.52） g，（349.18±28.23） g，t=2.569，P=0.019]，the results of the sugar water prefer－ence[（82.37±8.44）%，（89.33±3.97）%，t=2.359，P=0.03] and the results of the open-field test[（48.30±39.49），（87.70±38.32），u=-1.988，P=0.047] were significantly different between two groups. The volumes of the hippocampus[（88.84±7.51） mm3，（99.89±12.55） mm3，t=2.388，P=0.028]，the CA1[（27.78±1.84） mm3，（32.38±3.69） mm3，t=3.522，P=0.004] and the DG[（21.02±2.61） mm3，（24.20±3.33） mm3，t=2.377，P=0.029] in model group were significantly lower than those in the control group. The total length[（8.454±1.010） m，（11.012±1.642） m，t=2.967，P=0.018]，total volume[（0.104±0.019） mm3，（0.151±0.021） mm3，t=3.720，P=0.006]，total surface area[（1.025±0.113） cm2，（1.589±0.313） cm2，t=3.794，P=0.013] and average diameter[（3.884±0.458） μm，（4.580±0.419） μm，t=2.509，P=0.036] of the capillaries in the hippocampal CA1 and the total volume[（0.078±0.021） mm，（0.117±0.024） mm，t=2.716，P=0.026]，total surface area[（0.838±0.184），（1.133±0.074） cm2，t=3.32，P=0.011] and average diameter[（3.611±0.493） μm，（4.630±0.635） μm，t=2.834，P=0.022] of the capillaries in the DG were significantly decreased in model group than in control group. Conclusion：Hippocampal capillary changes can be observed in the CA1 and the DG in depression model rats，which might be involved in the pathogenesis of depression.

Abstract:Objective：To explore the role of protease activated receptor2（PAR2） in proliferation of injured spinal cord astrocytes of rats. Methods：High purity spinal cord astrocytes of rats were achieved from primary culture（purity>98%） and the injured astrocytes model in vitro was established. Injured astrocytes were treated by normal saline（injured group），PAR2 inhibitor FSLLRY-NH2（FS－LLRY-NH2 group） and PAR2 antibody Anti-PAR2 antibody（Anti-PAR2 antibody group） immediately. Primary culture cells without any treatment were included in control group. The expression levels of GFAP and Vimentin，marker proteins of astrocytes，were detected using the immunofluorescence staining and Western blot after injured astrocytes model being established and treated. Proliferative ac－tivity of astrocytes was detected by CCK-8 after injured astrocytes model being established and treated. Results：At 24 h and 72 h after injured astrocytes model being established，the expression levels of GFAP and Vimentin were significantly higher in injured group compared with those in control group，FSLLRY-NH2 group and Anti-PAR2 antibody group；proliferative activity of astrocytes was also significantly higher in injured group compared with that in control group，FSLLRY-NH2 group and Anti-PAR2 antibody group at 12，24，72 h after injured astrocytes model being established（P<0.05）. Conclusion：Blocking PAR2 can inhibit proliferation of injured spinal cord astrocytes of rats.

Abstract:Objective：To investigate the effect of valproic acid sodium salt（VPA） on astrocyte and neurotrophic factors in the brain of APP/PS1 double transgenic mice. Methods：Alzheimer’s disease（AD） model was established with APP/PS1 double transgenic mice. Twenty-four mice（3-month-old） were randomly divided into a VPA group and a control group. The mice of VPA group and control group were intra peritoneally injected with VPA 30 mg/（kg·d） and the same amount of normal saline for 4 weeks. Immunohistochemistry staining was applied to detect the number of astrocytes，while Western blot was used to observe the expression of brain-derived neu－rotrophic factor（BDNF） and glial cell line-derived neurotrophic factor（GDNF）. Results：Compared with those of control group，the number of positive cells of the astrocyte marker glial fibrillary acidic protein（GFAP） in the cortex and hippocampus of VPA treatment mice was significantly reduced（t=5.476，8.793，P<0.001） and the expression levels of BDNF and GDNF were significantly increased（t=4.303，P=0.001；t=2.376，P=0.032）. Conclusion：VPA can inhibit the proliferation of astrocytes，enhance the expression of neu－rotrophic factors.

Abstract:Objective：To observe the changes of aquaporin 4（AQP4） polarized expression in the brain following intracerebral hemor－rhage（ICH），and to explore its roles in the brain edema following ICH. Methods：Rats were randomly divided into ICH group and sham group；and autologous blood was injected into the right caudate nucleus to establish ICH model in rats. The hematoma volume was mea－sured by magnetic resonance imaging，the brain water content（BWC） was measured by the wet and dry weight methods，and the po－larized expression of AQP4 was detected by immunofluorescence. Results：On d1 post ICH，the hematoma volume reached the peak，the BWC reached its maximal value（79.769±0.710）%，and the difference between the sham group and the d1 post-ICH group was statistically significant（P=0.000）. In the perihematomal tissue，the polarized expression of AQP4 was lost，and AQP4 was expressed in astrocytic soma. However，in the sham tissue，AQP4 was polarized expressing in astrocytic end-foot membrane. Conclusion：In the per－ihematomal tissue of brain following ICH，the polarized expression of AQP4 is lost，which may contribute to the formation of brain ede－ma following ICH.

Abstract:Objective：To investigate the effect of miR-124-3p on the apoptosis and the concentration of free calcium in cell by regu－lating the expression of Caveolin-1 in Alzheimer’s diseases（AD） cell model of N2a/APPswe cells. Methods：N2a/APPswe and wild type N2a（N2a/WT） cells were cultured in vitro；real-time fluorescence quantitative PCR（real-time PCR） and Western blot（WB） were re－spectively used to detect the expression levels of miR-124-3p and amyloid precursor protein（APP） mRNA and protein. Dual luciferase report experiments were used to detect targeting regulation relationship between miR-124-3p and Caveolin-1. N2a/APPswe cells were transiently transfected by miR-124-3p mimics；real-time PCR and WB were respectively used to detect the expression levels of Caveolin-1 mRNA and protein. N2a/APPswe cells were transiently transfected by miR-124-3p mimics，pcDNA-Caveolin-1，Caveolin-1-siRNA and the rate of cell apoptosis was analyzed by flow cytometry. The intracellular free calcium concentration was measured. Results：Compared with those of WT group，APP mRNA and protein levels were significantly increased（P=0.000，P=0.000） in APP－swe group，miR-124-3p expression was obviously decreased（P=0.000）. Dual luciferase report experiment showed that compared with those of co-transfection with the mutant vector（pGL3- Caveolin-1 3’UTR MUT） group，relative luciferase activities in co-transfection with the wild type vector（pGL3-Caveolin-1 3’UTR WT） group were significantly decreased（P=0.004）. After the transfection of miR-124-3p mimics，Caveolin-1 mRNA and protein levels were significantly decreased（P=0.000，P=0.000） in transfection group than in control group. After the transfection of miR-124-3p mimics and Caveolin-1-siRNA，the cell apoptosis rate and free calcium concentration were decreased（P=0.000） in transfection group than in control group（P=0.000）. After the transfection of pcDNA-Caveolin-1，the opposite results were obtained（P=0.000，P=0.000）. Conclusion：miR-124-3p can inhibit the apoptosis of cell and reduce the concentration of free calcium in cell by targeted down-regulation of Caveolin-1 expression，which plays a neuro－protective role in prevention and cure of AD and provides new ideas and targets for AD.

Abstract:Objective：To investigate the effect of Curcumin on the activity of Calcineurin（CaN） and the expression of ATP-binding cas－sette transporter A1（ABCA1） in N2a/APP695swe cells，and to explore the mechanism of the regulation of Curcumin on the expression of ABCA1 in N2a/APP695swe cells. Methods：MTT assay was used to detect N2a/APP695swe cell viabilities in different concentrations of Curcumin or the CaN activity inhabitor cyclosporinA（CsA） treatment. According to the results determined by MTT，N2a/APP695swe cells were co-cultured with 5 μmol/L Curcumin for 24 h，or 0.5 μmol/L CsA for 48 h，then，the CaN activities were measured by enzyme substrate color metric methods. Western blot and real-time PCR were performed to evaluate the expression of ABCA1. Results：Cell survival rate was （110.495±4.005）%，the highest in 5 μmol/L Curcumin group（P=0.023），followed by （105.532±4.292）%，（115.211±4.826）%，（76.317±4.475）%，（69.177±5.267）%，（54.687±3.912）%，respectively in 0.1，0.5，1，2，4 μmol/L CsA groups. There were significant differences in cell survival rate between untreated group and 0.5，1，2，4 μmol/L CsA groups（P=0.001，0.000，0.000，0.000）. Compared with that（18.519±1.664） nmol/mg of normal group，the CaN activity was increased in N2a/APP695swe cells（24.488±3.041） nmol/mg（P=0.007），CaN activities were distinctly decreased in Curcumin group（16.717±2.055） nmol/mg（P=0.002） and CsA group（4.928±1.232）nmol/mg（P=0.000）. Furthermore，Western blot and real-time PCR showed that the expression of ABCA1 was higher in Curcumin group（real-time PCR：1.988±0.355；Western blot：0.294±0.015） than in the model group（real-time PCR：1.000；Western blot：0.175±0.008）（P=0.009 in real-time PCR and P=0.000 in Western blot）. Compared with that of model group，the expression of ABCA1 in CsA group（real-time PCR：4.000±0.464；Western blot：0.470±0.016） was increased（both P=0.000 in real-time PCR and Western blot）. Conclusion：Curcumin may up-regulate the expression of ABCA1 in N2a/APP695swe cells via inhibiting the CaN activity.

Abstract:Objective：To examine whether HU-210 affects spatial learning and memory ability and senile plaques formation in APP/PS1 double transgenic mice. Methods：APP/PS1 double transgenic mice aged 3.5 months were randomly divided into HU-210 treated and saline-treated groups（n=10）. HU-210（100 μg/（kg·d）） and the same amount of saline were peritoneally injected into APP/PS1 mice for one month. Morris water maze and fear conditioning tests were used to assess the learning and memory abilities of animals.Immunohistochemical staining was applied to exam senile plaques in the brain of APP/PS1 mice. Results：The water maze test showed that HU-210-treated mice took shorter latency and swam a shorter distance to reach the platform than saline-treated controls. HU-210-treated mice had significantly more platform-passing times（5.40±1.52） in the correct quadrant of pool in the probe trial than that of controls（1.60±1.14，P<0.01）. Fear conditioning test showed that HU-210 mice had more freeze times（right after shock：38.30±15.16；24 h post-shock：99.89±5.71） than that of controls（right after shock：17.84±5.33；24 h post-shock：56.00±4.78，P<0.01） after electrical shock. Immunohistochemical staining showed that the number of senile plaques in the brain of HU-210-treated mice was notably decreased（control：3.90±2.51 vs.HU-210：9.70±5.67，P<0.05）. Conclusion：Treatment with HU-210 at early stage can significantly decrease senile plaques formation，which in turn improve the learning and memory abilities of APP/PS1 double transgenic mice.

Abstract:Objective：To investigate the effects of intracerebroventricular injection of streptozotocin on mTOR/P70S6K/IRS-1 signaling pathway. Methods：The 30 male SD rats were randomly divided into control group and model group，fifteen rats in each group. The rats were treated with saline or streptozotocin（STZ，3 mg/kg） intracerebroventricularly（ICV） at the 1st day and the 3rd day of the experi－ment to induce dementia model. Thirty-six days after STZ in－jection，spatial learning and memory of the rats were deter－mined by Morris water maze test. The expression of mammalian target of rapamycin（mTOR），phosphorylated mTOR（p-mTORS－er2448），p70 ribosomal S6 protein kinase（P70S6K），phosphory－lated P70S6K（p-P70S6KThr389），insulin receptor substract-1（IRS-1） and phosphorylated IRS-1（p-IRS-1Ser636） were mea－sured by Western blot. Morphologic changes of neurons in cere－bral cortex and hippocampus were observed by HE staining. Deposition of Aβ in hippocampus was detected by Thioflavin S staining. Results：ICV-STZ can significantly reduce the time spent in the target quadrant（t=8.558，P=0.000） and numbers of platform location crosses（t=6.086，P=0.000）. HE staining demonstrated that some cells were clearly shrank and swelled in cerebral cortex and hip－pocampus of rats treated by STZ. Meanwhile，the deposition of Aβ detected by Thio-flavin S staining was also significantly increased. Compared with that in control group，the expressions of p-P70S6KThr389（t=-8.409，P=0.000），p-IRS-1Ser636（t=-4.417，P=0.002） in the cerebral cortex and p-P70S6KThr389（t=-7.339，P=0.000），p-IRS-1Ser636（t=-5.496，P=0.001） in hippocampus were increased markedly，while the protein levels of P70S6K，mTOR，p-mTORSer2448 and IRS-1 were not affected by ICV- STZ． Conclusion：ICV-STZ results in increased activation of mTOR/P70S6K/IRS-1 signaling pathway，and the increased activation of mTOR/P70S6K/IRS-1 may play important roles in AD pathogenesis．

Abstract:Objective：To investigate the association of brain-derived neurotrophic factor（BDNF） gene polymorphisms with vascular cognitive impairment（VCI） in Chongqing. Methods：Totally 60 patients with VCI（VCI group） 99 health（normal control group） were chosen simultaneously. The genotypes and alleles frequencies of BDNF gene were analyzed by polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP）. The software SHEsis was used to analyze the linkage disequilibrium and the haplotypes between the two groups. Results：G11757C genotypes frequencies between VCI group（GG（30.4%），GC（53.6%），CC（16.1%）） and normal control group（GG（30.9%），GC（47.4%），CC（21.6%））showed no significant difference and alleles frequencies between VCI group（G（57.1%），C（42.9%））and normal control group（G（54.6%），C（45.4%）） also showed no significant difference（ χ2=0.837，P=0.658； χ2=0.180，P=0.671）. G196A genotypes frequencies between VCI group（AA（23.3%），AG（51.7%），GG（25.0%）） and normal control group（AA（22.2%），AG（46.5%），GG（31.3%））showed no significant difference and alleles frequencies between VCI group（A（49.2%），G（50.8%）） and normal control group（A（45.5%），G（54.5%）） also showed no significant difference（ χ2=0.744，P=0.689； χ2=0.413，P=0.520）. C270T genotypes frequencies（CC（8.30%），CT（56.7%），TT（35.0%）vs. CC（24.2%），CT（50.5%），TT（25.3%））and alleles frequencies（C（36.7%），T（63.3%） vs. C（49.5%），T（50.5%）） showed significant differences between VCI group and normal control group（ χ2=6.68，P=0.035； χ2=4.98，P=0.026）. And these were significant differences in the frequency haplotype GGT（Fisher’s P=0.025） between VCI group and normal control group. Con－clusion：The polymorphisms of BDNF gene may be related to VCI in Han population in Chongqing.

Abstract:Objective：To investigate the correlation of clinical characteristics of migraine with metabolic syndrome（MS） and its com－ponents. Methods：Totally 212 migraineurs were recruited in the neurology clinic department. A questionnaire survey was used to col－lect the clinical characteristics of migraine headache and its concomitants，such as analgesic use，psychiatric disorders and disability. The anthropometric measurements and blood biochemistry were measured for the diagnosis of MS，and Transcranial Doppler sonography was conducted for intracranial vascular function. Results：Of 212 migraine patients，145 cases（68.4%） had one and more metabolic abnormalities and 22 cases（10.4%） had MS. Single factor analysis results showed metabolic abnormalities in migraine patients were associated with age，duration of migraine attack，body mass index and waist-to-height ratio（P=0.007，0.008，0.000 and 0.000，respective－ly）. Multivariate logistic regression analysis showed analgesic-overuse was the main risk factor of MS in migraine patients（OR=4.320，P=0.042）. Conclusion：The prevalence of MS in migraine patients is associated with analgesic-overuse. Rational use of analgesics may lower the risk for MS and cardiovascular disease in migraine patients.

Abstract:Objective：To evaluate the feasibility of observing visual center with resting-state functional magnetic resonance imaging （RS-fMRI） in patients with occipitalia tumor. Methods：Nineteen normal subjects and 8 patients with occipitalia tumor underwent RS-fMRI scanning and vision inspection before operation. All visual center networks in Brodmann area（BA） 17 and BA 18 were analyzed using independent component analysis（ICA）. The integrity and distribution of the visual center networks of the subjects were com－pared with the results of visual field examination. Results：In patient group，the strength and range of connection of visual center net－works in BA 17 and BA 18 were reduced to different degrees compared with those of normal control group and healthy side. The visual center function area showed displacement in 5 cases，the integrity of the visual center networks impaired in 6 cases，while the visual function connection in adjacent brain regions showed increase in 6 cases，the connection around tumor demonstrated increase in 4 cases. The integrity of the visual center networks of the 2 patients with visual field defect were damaged and visual function connection in adjacent brain regions showed increase. While the integrity of visual center network of 4 out of 6 patients with normal visual field were damaged，the visual function connection in adjacent brain regions and surrounding tumors showed increase and compensation. Conclusion：RS-fMRI could observe visual center networks of patients with occipitalia tumor，therefore，RS-fMRI scanning can help project operation or radiotherapy planning of the tumor and evaluate prognosis of the visual function.

Abstract:Objective：To explore the clinical characteristics of vestibular migraine（VM） in a neurological clinic and to test the criteria of the International Classification of Headache Disorders 3rd edition beta version（ICHD-Ⅲ beta） in practice. Methods：Retrospective analysis was made on 39 patients with VM referred to the neurological clinic in the First Affiliated Hospital of Chongqing Medical U－niversity from June 2013 to June 2014. The demographic and clinical characteristics of these patients were analyzed. Results：The mean onset age of migraine was （32.7±10.5） years old and vertigo was （36.6±10.3） years old. The most common migraine subtype was migraine without aura（82%），followed by migraine with aura（10%） and chronic migraine（8%）. Spontaneous vertigo was reported in 90% patients and the duration of vestibular symptoms was varied from seconds to days. Photophobia and phonophobia（74%） were the most frequently reported associated symptoms. However，33% patients could not fulfill with criterion C and 8% patients could not fulfill with criterion B. Conclusion：The clinical features of VM in neurological clinic are similar with those in Western studies except the low proportion of migraine with aura among patients with VM. VM diagnostic criteria in ICHD-Ⅲ beta might be further modified，including the definition of vertigo episodes and the new-adding migraine subtypes.

Abstract:Objective：To discuss the clinical significance and application of cavitron ultrasonic surgical aspirator（CUSA） in menin－gioma beside the sagittal sinus and falx cerebri resection. Methods：Fifty-one cases of meningioma beside the sagittal sinus and falx cerebri in our hospital were divided into A，B groups depending on the application of CUSA by retrospective analysis. Twenty-seven cases using CUSA with bipolar electric coagulation resection were enrolled in A group，24 cases using tissue scissors with bipolar co－agulation conventional resection were enrolled in B group. Tumor resection rate，operative time，blood loss，postoperative intracranial pressure（ICP），average hospitalization time，mannitol dose，delayed cerebral hemorrhage were compared between two groups. Results：Based on Simpson standard Ⅰ，Ⅱ，Ⅲ（grade），there were 23，3，1（case） in group A while 15，5，4 in group B；there was no difference in removal rate between two groups（P=0.125）. The average hospitalization time of group A and group B was （15.11±2.50） d and （19.71±4.79） d，respectively，with statistically significant differences between groups A and B（P=0.019）. The operative time was （4.27±0.27） h and （4.86±0.54） h，respectively. The blood was （631.48±240.65） ml and（1050.00±521.70） ml，respectively，with statistically significant differences between groups A and B（P=0.006，P=0.029）. There was no significant difference in ICP within 6 h between two groups（P=0.138）. The ICP was （11.30±3.81） mmHg and （12.59±5.52 ） mmHg in group A within 6-72 h and at 72 h after operation；the ICP was （13.96±9.95） mmHg and （16.83±8.98） mmHg in group B within 6-72 h and at 72 h after operation，with statistically significant differences between groups A and B（P=0.011，P=0.031）. One case of acute renal failure and no case of de－layed cerebral hemorrhage were observed in group A. Four cases of acute renal failure and five cases of delayed cerebral hemorrhage were observed in group B，among which three cases underwent removal of hematoma craniotomy. In 3-month follow-up，24 cases re－covered well and 3 cases recovered poorly in group A. No death case and serious case was observed. Conclusion：In meningioma beside the sagittal sinus and falx cerebri resection，although we can not increase the rate of tumor resection，CUSA is still a practical and effective technology that can shorten the operation time，reduce complications，improve surgical outcome and prognosis.

Abstract:Objective：To explore the most appropriate montage for bedside video-electroencephalography（VEEG） of neonates and preterm infants. Methods：VEEG using monopolar，average reference，and bipolar montages were simultaneously recorded for 22 preterm infants with different conceptional ages. In the same time period，the patterns and numbers of artifacts were analyzed. The pa－rameters that constitute of EEG background activity and the morphological characteristics of the deformed slow waves were analyzed and compared in each VEEG. Results：The number of artifacts recorded by monopolar montage was more than that for average refer－ence and bipolar montages. Monopolar montage had significantly more activation（P=0.000，0.000） and artifacts due to electrodes（P=0.000,0.000），environment（P=0.000，0.001），cardiac（P=0.000），and line/electrical noise（P=0.002，0.004）. The amplitudes of the brainwaves for the three montages were similar（P=0.172，0.099，0.145）. And each brainwave was synchronized ，with no obvious change in brainwave frequencies. Moreover，the morphology，phase，and spatial distribution of the recorded waves by average reference montage resembled the actual situation，better than the bipolar montage. Conclusion：EEG recorded by average reference montage ex－hibits fewer artifacts and better represents the background activities and the deformed waves of preterm infants.

Abstract:Objective：To investigate the morbidity rate and risk factors of delirium after spinal operation in elderly patients. Methods： From January 2011 to December 2012，200 elderly patients after spinal operation were randomly selected. The following factors：pa－tients’ gender，age，anesthesia method，surgical site（cervical vertebra，thoracic vertebra，lumbar vertebra），duration of surgery，postop－erative recovery time，preoperative psychological state，postoperative sleep，whether in complication of underlying diseases（hyperten－sion，coronary heart disease，diabetes，hyperlipidemia，chronic bronchitis），the amount of bleeding，intraoperative blood pressure，were carried on the risk assessment by means of statistical analysis to predict the responsibility rate for elderly spinal operation patients with postoperative delirium. Results：The morbidity rate of delirium after spinal operation in elderly patients was 11%（22/200）. Logis－tic regression analysis indicated that the morbidity rate of delirium after spinal operation was not clearly correlated with factors of pa－tients’ gender，the amount of bleeding and whether in complication with underlying diseases（P ＞0.05）. It was closely related with age，anesthesia method，surgical site，duration of surgery，postoperative recovery time，intraoperative blood pressure，preoperative psycholog－ical state and postoperative sleep（P＜0.05）；the value of OR and its 95%CI were 7.107（0.238 1 to 1.211 6），12.613（0.869 5 to 6.086 2），6.978（-5.865 9 to-1.131 7），3.697（0.1948 to 6.0705），5.367（1.014 1 to 7.701），3.012（0.067 7 to 5.517 9），6.078（1.130 4 to 6.555 2），3.018（-6.798 9 to -0.668 05）. Conclusion：The morbidity rate of delirium after spinal operation in elderly patients is considerablely high and the major risk factors are advanced in years，general anesthesia，duration of surgery or postoperative recovery time，hypoten－sion，unstable mental state in the preoperative and postoperative sleep disorders.

Abstract:Objective：To investigate the efficacy of procedural sedation under the guidance of intracranial pressure monitoring in the treatment of severe craniocerebral injury. Methods：Totally 300 patients in our hospital from July 2006 to July 2014 were divided into 3 groups（conventional group，sedation group and combination group）. Glasgow coma score（GCS） before and after the treatment，hos－pitalization days，mini-mental status examination scale（MMSE） score，Barthel index（ＢＩ） score，rebleeding，mortality，lung infection data were recorded and Excel database was established. Rebleeding，mortality and lung infection rates of three groups were compared using χ2 test；GCS difference，hospitalization days，MMSE score and BI score were analyzed using analysis of variance. Results：There were statistically significant differences in all indicators mentioned above among three groups. GCS difference were significantly dif－ferent between conventional group，sedative group and combination group（P<0.05）. There were statistically significant differences in hospitalization days，MMSE score，BI score and mortality between sedative group and combination group（P<0.05）. There were statisti－cally significant differences in rebleeding rate and lung infection rate between sedative group and conventional group（P<0.05）. Con－clusion：intracranial pressure monitoring procedural sedation is more conducive to improving the prognosis of severe traumatic brain injury，shortening treatment time and reducing lung infection and bleeding in patients.

Abstract:Objective：To systematically review and analyze the effectiveness and safety of postoperative radiotherapy plus temozolo－mide for malignant glioma. Methods：A systematic literature retrieval was conducted in the Cochrane library，PubMed，Elsevier，EB－SCO，CBM，CNKI and Wanfangdata from 2011 to 2014 according to designed searching strategy and relevant words. Published ran－domized-controlled clinical trials（RCTs） concerning the postoperative radiotherapy plus temozolomide for malignant glioma were en－rolled. The quality of the included RCTs was analyzed using Cochrane systematic evaluation. Homogenous studies were analyzed using Cochrane Collaboration’s RevMan 5.0 software and the studies in which the data were unable to be merged were analyzed by de－scriptive qualitative analysis. Results：A total of 11 RCTs involving 590 patients（experimental group：298 patients；control group：292 patients） were included. Significant differences were found in the total effective rate（RR=1.77，95%CI=1.45 to 2.15，P=0.000），1-year survival rate（RR=1.38，95%CI=1.22 to 1.57，P=0.000），2-year survival rate（RR=1.91，95%CI=1.46 to 2.51，P=0.000），3-year survival rate（RR=2.51，95%CI=1.40 to 4.48，P=0.002） between postoperative radiotherapy plus temozolomide and postoperative ra－diotherapy alone. There was no statistical difference in adverse reaction between the two groups. Conclusion：Based on current clini－cal evidence，treatment of malignant glioma with postoperative radiotherapy plus temozolomide can improve effective rate and 1-，2-，3-year survival rates.

Abstract:Objective：To evaluate the efficacy，tolerability，and safety of rotigotine transdermal patch in Parkinson’s disease. Methods：The PubMed，Cochrane Library databases，EMBASE，and Web of Knowledge were searched for the randomized clinical trial（RCT） of rotigotine transdermal patch in Parkinson’s disease. RevMan 5.1 software was used to analyze the data. Results：（1） Seven large-scale RCTs，involving 1 969 patients were included in this meta-analysis. （2）The results showed：①Efficacy：compared with placebo，the use of rotigotine resulted in greater improvement in UPDRS Ⅱ score（WMD=-1.69，95%CI=-2.18 to -1.19，P=0.000） and Ⅲ score（WMD=-3.86，95%CI=-4.86 to -2.86，P=0.000）. ②Tolerability：no difference was found in overall withdrawals（RR=0.88，95%CI=0.64 to 1.21，P=0.44），but rotigotine was associated with a significantly higher rate of withdrawals due to adverse events（RR=1.82，95%CI=1.29 to 2.59，P=0.000）. ③Safety：rotigotine was associated with a significantly higher rate of application site reactions（RR=2.77，95%CI=2.23 to 3.43，P=0.000），vomiting（RR=6.15，95%CI=2.88 to 13.13，P=0.000），and dyskinesia（RR=2.52，95%CI=1.47 to 4.32，P=0.000） compared with placebo. Conclusion：The use of rotigotine can reduce the symptoms of PD. However，rotigotine is also associated with a higher incidence of adverse events，especially application site reactions.

Abstract:Objective：To investigate the expression of Th1/Th2 cytokines in peripheral blood of patients with oral lichen planus（OLP） and to discuss the role and significance of Th1/Th2 cytokines in the pathogenesis of OLP. Methods：Totally 51 cases of OLP with dif－ferent clinical characters（including 23 cases of reticular OLP and 28 cases of hyperaemia erosion OLP） were enrolled. Cytometric bead array was employed to detect the level of type 1 cytokines（TNF-α，INF-γ，IL-2） and type 2 cytokines（IL-4，IL-6，IL-10） of T helper cells in serum of patients with OLP. The relationship between the levels of these cytokines and the clinical characteristics of patients with OLP was analyzed. Results：Expression levels of IL-6 and IL-10 in the peripheral blood of patients with OLP were sta－tistically increased compared with those of controls（P＜0.05），but no statistical difference was observed in level of Th1 cytokines（TNF-α，IFN-γ，IL-2） and IL-4 between OLP patients and controls（P＞0.05）. Expression levels of IL-6 and IL-10 were positively correlated with clinical characters（r：0.285-0.364；P＜0.05）. Conclusion：Th1 cytokines remain unchanged and Th2 cytokines increase in OLP patients，showing the advantage of Th2 immune response. Levels of IL-6 and IL-10 are positively correlated with disease severity，which may be helpful for OLP immunotherapy.

Abstract:Objective：To evaluate the changes of the oncoproteins of breast cancer treated with neoadjuvant chemotherapy（NAC）（Docetaxel+Epirubicin/Pirarubicin+Cyclophosphamide）. Methods：From 2012 to 2013，112 patients treated with NAC were included in this retrospective study. Data were analyzed using chi-square and t-test. Results：The highest changing rate from positive to negative was Ki-67（37.5%），while the lowest rate was estrogen receptor（ER） and P53（both 16.1%） respectively. The highest changing rate from negative to positive was P53（16.1%），while the lowest rate was Ki-67（2.7%）. Significant changes were observed in ER（P=0.043），Ki-67（P<0.001）、HER2（P=0.035），breast cancer subtype（P<0.001） and proliferative fraction of Ki-67（P<0.001）. Conclusion：NAC could make oncoproteins change. General information，such as age，obesity，lymph node，etc has a relationship with the changes of on－coproteins.

Abstract:Objective：To investigate the influencing factors of differentiation degree of early gastric cancer（EGC） and to provide theo－retical basis clinically. Methods：The clinical data of gastric cancer patients with D2 lymph node dissection who underwent surgery in the First Affiliated Hospital of Chongqing Medical University from January 2009 to January 2014 were collected. The clinical data of 97 early gastric cancer patients were retrospectively analyzed. Tumor size，general type，tumor location，depth of invasion，lymph node metastasis，tumor markers，blood line transfer，gender，age and differentiation degree were analyzed using single factor and multiple factors analysis. Results：Logistic regression analysis showed that the undifferentiated carcinoma accounted for 73%（70/97）. Multiple analysis showed that female，<50 years old，1/3 part under the stomach were highly related to undiferentiated carcinoma（P<0.05）； OR，95%CI and P were（4.9，13.7，3.4），（2.4-13.6，4.2-24.1，1.7-8.4） and （0.019，0.013，0.027，respectively. However，there was no correlation between patients’ tumor size，general type，depth of invasion，lymph node metastasis，etc with undiferentiated carcinoma. Conclusion：The degree of differentiation in early gastric cancer has been proved to be mainly correlated with the gender，age，and tu－mor location.

Abstract:Objective：To compare extracorporeal shockwave lithotripsy（SWL），rigid ureteroscopy（RURS），flexible ureteroscopy（FURS） and percutaneous nephrolithotomy（PCNL） and to determine which method was appropriate for proximal ureteral stones. Methods：During six-year period，1 275 patients with proximal ureteal stones were prospectively selected and assigned into groups of SWL，RURS，FURS and PCNL on the basis of patients’ choice. Each group was allocated into three subgroups according to stone size，du－ration and dilated ureter diameter. Stone-free rate，recurrence rate and complication rate were analyzed. Results：Regarding stone-free rate，RURS was higher than SWL while lower than FURS and PCNL（P<0.01）. As for recurrence rate，there’s no difference among RURS，FURS and PCNL（P>0.01）；recurrence rate was lower in RURS，FURS，PCNL than in SWL（P<0.01）. When looking at com－plication rate，there’s no difference among three subgroups of stone size < 1 000 mm3，duration < 3 months and dilated ureter diameter <10 mm（P >0.05）；in the subgroup of stone size≥1 000 mm3，RURS was higher than SWL，FURS and PCNL（P<0.01）；in the subgroup of duration≥3 months，SWL was higher than RURS，FURS and PCNL（P<0.01）；in the subgroup of dilated ureter diameter≥10 mm，FURS and PCNL was lower than SWL and RURS（P<0.01）. Conclusion：Stone size，duration and dilated ureter diameter should be taken into consideration to determine which approach is appropriate. SWL remains the first-choice in the combination of stone size <1 000 mm3，duration < 3 months and dilated ureter diameter<10 mm. PCNL should be the most appropriate approach in the combination of stone size≥1 000 mm3，duration≥3 months and dilated ureter diameter≥10 mm. RURS should be the least preferred single ap－proach for stone size≥1 000 mm3. SWL is not recommended any more for duration≥3 months alone.

Abstract:Objective：To investigate the distribution characteristics of inhaled allergens and its influencing factors in children with al－lergic rhinitis（AR） in Chongqing. Methods：All cases were collected from otorhinolaryngological department of the Children’s Hos－pital of Chongqing Medical University from 1st January，2006 to 29th April，2012. Totally 6 197 children with allergic rhinitis from 4 months to 12 years old in Chongqing urban districts were enrolled. All the patients underwent skin prick test（SPT） with 13 standard－ized common inhalant allergens. The correlation between the positive rates，grades，categories of allergens and gender，age，living en－vironment was analyzed. Results：①Of the 6 197 AR patients，4 048（65.32%） were atopic；dermatophagoides pteronyssinus（65.06%），dermatophagus farinae（63.35%） and blomia tropicalis（40.07%） were the top three prevalent inhalant allergens. ②From 2006 to 2012，the SPT positive rate increased sharply，then tended to be stable，and then decreased slowly（50.64%，80.21%，81.20%，82.36%，77.34%，71.18%，56.01%）. ③With the growth of age，the positive rates，grades and categories of SPT increased，and the preponderance of atopy in boys was more significant. ④In the male infancy and preschool children with AR，the SPT positive rate of central downtown patients was significantly increased compared with those in the suburbs. Conclusion：Dermatophagoides ptero-nyssinus，derma-tophagus farinae and blomia tropicalis are the most prevalent in－halant allergens in AR disease in Chongqing urban districts. With the growth of age，children with allergic rhinitis，espe－cially boys，are more susceptible to inhalant allergens.

Abstract:Objective：To assess the coagulation status of patients undergoing arthroplasty after administration of rivaroxaban with thromboelastograph（TEG） in perioperative period，and to analyze the relation between coagulation status and blood platelet count. Methods：Eighty-six patients undergoing arthroplasty in our department in 2014 were included prospectively. All the patients were treated with 10 mg of rivaroxaban for 12 h after operation to prevent blood clots. TEG parameters and platelet count were analyzed simultaneously on the day before operation and on postoperative days 1，3，5 and 7. The proportion of hypercoagulability and mean platelet count were compared at different time points. And the correlation between hypercoagulable states and platelet count was per－formed with the use of correlation analysis. Results：There were significant changes in the distribution of different hypercoagulable states on days 1-3 and on days 3-7. Seven days after operation，86% patients were found with hypercoagulable state. Of these patients with hypercoagulable state，90.5% patients demonstrated platelet or mixed hypercoagulability（maximal amplitude（MA） values were greater than 70 mm）. On day 3 after operation，the average amount of platelet count decreased slightly than that before opertation（P=0.063），but it were significantly higher（P=0.000） than the preoperative level on day 7 after operation. We also found positive correla－tion between MA and platelet count during the progress. Conclusion：TEG result indicates that the proportion of patients with hyper－coagulable state can not be reduced by a short time application of rivaroxaban. The increase of platelet count after operation may play an important role in the progress of blood hypercoagulability.

Abstract:Objective：To analyze the clinical features and diagnostic methods of small intestinal hemorrhage. Methods：The pathologi－cally confirmed clinical data of 84 patients with small intestinal hemorrhage were collected. All patients were admitted to the First Affiliated Hospital of Chongqing Medical University from January 2011 to December 2013. The manifestation，etiology，lesion and check methods were separately discussed. Results：Tumor was the most frequent cause of small intestinal hemorrhage，accounted for 61.90%（52/84）of all cases，followed by thrombotic diseases，small intestinal diverticulum，ulcer，accounted for 11.90%，8.33%，5.95%，respec－tively. Other rare causes were acute hemorrhagic necrotizing enteritis，intestinal polyps，Crohn’s disease，intestinal tuberculosis，allergic purpura. The clinical manifestation was mainly tarry stool，and accompany symptoms include abdominal pain，fever，abdominal mass，diarrhea，etc. The bleeding lesions were mainly located in jejunum and ileum. Conclusion：Tumor is the major cause of small intesti－nal hemorrhage. It is difficult to diagnose small intestinal hemorrhage. We should combine the various check methods with etiology characteristic of small intestinal bleeding to develop different diagnostic methods.

Abstract:Objective：To summarize the treatment and nursing for hematopoietic stem cell transplantation with Wiskott-Aldrich syn－drome（WAS）. Methods：Treatment and nursing data of 29 patients with WAS who received hematopoietic stem cell transplantation in our hospital from June 2007 to December 2014 were summarized，including reverse isolation，strengthening basic nursing，treatment and nursing of graft versus host disease，infection prevention and control，observation and nursing of hemorrhage，diet nursing，psycho－logical nursing，health education，etc. Results：All 29 patients with WAS who received hematopoietic stem cell transplantation acquired immune reconstitution after careful treatment and care. The follow-up lasted for 2 months to 7 years；22 cases survived with healthy. Conclusion：The keys of success with hematopoietic stem cell transplantation of WAS are the prevention of graft versus host disease and control of infection and nursing.

Abstract:Objective：To investigate the prevalence of the use of warfarin in prevention of stroke in non-valvular atrial fibrillation （NVAF） among physicians from county-level hospitals. Methods：A cross-sectional questionnaire survey was conducted in 292 physicians who were chosen randomly from 9 county-level hos－pitals. The questionnaire mainly consisted of the following con－tents：problems affecting the prescribing of warfarin by physi－cians and the administration of the use of warfarin in patients with NVAF. Results：From June to November in 2013，292 ques－tionnaires were collected and 208（72.2%） of them were analyzed. Around 11.5%（24） of physicians strongly agreed that “they often were not sure whether or not to prescribe warfarin”. 20.2%（42） of physicians strongly agreed that “they fully understood their patients’ views on the benefits and risks of warfarin”. In patients with CHADS2 score or CHA2DS2-VASC score≥2，only 22.1%（46）（case3），19.2%（40）（case4），34.1%（71）（case5） and 21.2%（44）（case12）of physicians prescribed warfarin for the prevention of stroke. In patients with HAS-BLED score≥3patients，only 8.2%（17）（case6），10.6%（22）（case7） and 9.1%（19）（case8） of physicians pre－scribed warfarin for the prevention of stroke in NVAF. Conclusion：This study highlights the deficiency of knowledge regarding the risk stratification and anticoagulant treatment about NVAF in physicians from county-level hospitals. Decisional conflicts of the use of warfarin in the prevention of stroke and being not able to evaluate the benefits and risks brought by warfarin patients appear to be the biggest barriers for anticoagulant in NVAF. Educational programs are needed to improve the situation of the right use of warfarin in NVAF patients.

Abstract:Objectives：To establish the reference intervals of commonly used liver and renal function test items among healthy preschool and school-aged children in Chongqing and to provide better references for clinical diagnosis and treatment. Methods：The stratified randomized cluster sampling method was used to select 545 healthy preschool（1-6 years old） and school-aged（7-12 years old）children（male：320，female：225）. Thirteen commonly used liver and renal function test items in venous blood were detected by the HITACHI 7600；data were analyzed by statistical method. Normal distribution data were used to calculate the reference intervals ac－cording to x±1.96 s and skewness distribution data were used to calculate the reference intervals according to P2.5-P97.5. Results：（1）The population means of liver and renal function test items between healthy preschool and school-aged children in Chongqing were significantly different except the blood urea nitrogen（BUN） item. （2）The population means of total bilirubin（TB），direct bilirubin（DB），total protein（TP），albumin（ALB），alanine aminotransferase（ALT），aspertate aminotransferase（AST），alkaline phosphatase（ALP），gamma-glutamyl transpeptidase（GGT），lactate dehy－drogenase（LDH），BUN，creatinine（CREA） and uric acid（UA） showed no significant difference except blood glucose（GLU） between dif－ferent genders among preschool children. The 95% reference intervals of serum TB，DB，TP，ALB，ALT，AST，ALP，GGT，LDH，BUN，CREA and UA were 5.4-18.9 μmol/L，0－6.7 μmol/L，58-71 g/L，42-50 g/L，8.7-26 U/L，21-41 U/L，112-312 U/L，7.1-15.8 U/L，190-312 U/L，2.3-6.4 μmol/L，14-42 μmol/L，156-366 μmol/L respectively. The 95% reference intervals of serum GLU based on gender were 3.7-6.0 mmol/L for male and 3.4~5.8 mmol/L for female. （3）The population means of Glu，TB，DB，TP，ALB，AST，ALP，LDH，CREA and UA showed no significant difference between different genders among school-aged children except ALT，GGT and BUN. The 95% reference intervals of GLU，TB，DB，TP，ALB，AST，ALP，LDH，CREA and UA were 4.2-6.0 mmol/L，6.6－23.6 μmol/L，0-6.8 μmol/L，60-76 g/L，43-52 g/L，18-36 U/L，116~366 U/L，162-293 U/L，22-51 μmol/L，174-401 μmol/L respectively. The 95% reference intervals based on gender were established as ALT：8.9-28 U/L for male，7.2-29.5 U/L for female；GGT：8.8-21 U/L for male，6.1-22.5 U/L for female；BUN：2.8-7.0 μmol/L for male，2.2-6.2 μmol/L for female. Conclusion：The reference intervals of thirteen commonly used liver and renal function test items are established by Hitachi 7600 system among healthy preschool and school-aged children in Chongqing；it can provide accurate experimental basis for clinical diagnosis and treatment in children.

Abstract:Objective：To analyze the risk factors for adverse perinatal outcomes of twins. Methods：The 251 cases of twin pregnancy in obstetric unit of Chongqing Health Center for Women and Children from January 1 2013 to December 31 2013 were enrolled in the retrospective study. Results：（1）The incidence of adverse perinatal outcomes of twins in the hospital was approximately 34.66%. The incidence of perinatal death was 8.37%.Single factor analysis：there were significant differences in fertilization way，chorionicity，preterm premature rupture of membranes，gestational diabetes（P<0.05）. （3）Logistic regression analysis：cescarean section is a protec－tive factors for perinatal outcomes of twins（P=0.000，OR=0.086，95%CI=0.023 to 0.321）. Preterm premature rupture of membranes（PPROM） and monochrionic twins are risk factors for adverse perinatal outcome（P=0.010，OR=2.979；P=0.043，OR=5.689）. Con－clusion：PPROM，monochorionic are the main risk factors for adverse perinatal twins while cesarean section is the protective factor.

Abstract:Objective：To evaluate the treatment of open reduction，salter acetabular osteotomy，combined with proximal femoral rotation osteotomy for pediatric developmental dysplasia of the hip. Methods：Retrospective analysis from January 2006 to June 2012 was con－ducted and a total of 116 children with developmental dysplasia of the hip were enrolled including 76 males and 40 females（left 40 cases，right 66 cases，both 10 cases）; the average age was 3.4 years old（1.5-6.5 years old）. According to the Tonnies classification system，there were 6 type Ⅱ，72 type Ⅲ，38 type IV；operation on the other side was performed at three months after the first opera－tion. Results：All the patients were available at the final follow up with a mean of 2.4 years old（2.0-4.6 years old）. According to the standard functional evaluation of Mckay，there were 75.40% excellent，19.84% good，3.97% better and 0.97% poor，According to the standard functional evaluation of severin，there were 73.81% excellent，21.43% good，3.17% better and 1.59% poor. One case of redis－location，one case of subluxation，two cases of avascular necrosis of femoral head，and two cases of stiffness of the hip joint were ob－served. Conclusion：The operation indications and surgical skills should be mastered strictly. The treatment of open reduction，salter acetabular osteotomy，combined with proximal femoral rotation osteotomy for pediatric developmental dysplasia of the hip can chieve good results，therefore it should be promoted.

Abstract:Objective：To discuss the pathogensis，clinical features and treatment of growing skull fractures（GSF） in infants and young children. Methods：Eleven subjects with growing skull fractures in past five years were investigated retrospectively in Kunming’s Children’s Hospital between 2009 and 2014. The clinical symptoms，pathogensis and imaging characteristics were analyzed． All patients received the surgery. Cranioplasty was carried out while the dura was repaired. Results：The age of the patients ranged from 6 months to 3.6 years. All 11 subjects had the history of head trauma，and the clinical symptoms included skull defect，soft pulsatile mass and neurologic dysfunction. The cysts in the defect area and encephalomalacia were shown clearly by CT scan. The width of fracture ranged from 1.5 cm to 3 cm. Ten patients under－went the duraplasty and cranioplasty surgery with autogenous bone，and 1 patient underwent cranioplasty with Titanium plate fixation. All patients recovered well. All patients received follow-up from 6 to 24 months. Conclusion：GSF only occur in the infants and young children. The most important factors of GSF include skull fracture and dural tear. The duraplasty and cranioplasty surgery is necessary once the GSF is diagnosed. The key procedure is to perform a watertight dura.