Abstract:Objective：To investigate the expression of leukemia inhibit factor（LIF） in degenerative disc nucleus pulposus and its role in degenerative nucleus pulposus extracellular matrix synthesis. Methods：Forty adult New Zealand white rabbits were randomly divid－ed into 5 groups（1 group as the control group，the remaining 4 groups as the experimental group），8 rabbits in each group. Interverte－bral disc degeneration model was established by puncturing the L4/5 and L5/6 intervertebral discs in the experimental group. MRI scoring was performed on the discs at 0，2，4，8 weeks immediately after the operation，and the discs were obtained and stained with hematoxylin and eosin to get histological scores and to determine the degree of degeneration. Immuno-histochemical staining was used to semi-quantitatively detect the expression of LIF in nucleus pulposus. Rabbit nucleus pulposus cells were harvested for primary culture；the expressions of Aggrecan，COLLA2α1 in human in－tervertebral disc nucleus pulposus cells were detected by Western blot at 24，48，72 h after treated with gradient concentration hu－man recombinant LIF protein. In maximal concentration group and control group，Aggrecan expression was again verified by immunofluorescence and the expressions of tissue inhibitor of metalloproteinases-1（TIMP-1） and matrixmetalloproteinase-3（MMP-3） were detected by Western blot. Results：The imaging scores and histological scores showed that the degeneration of intervertebral disc increased with the prolongation of modeling time，and there was a significant difference（1.000±0.000，2.000±0.535，2.750±0.463，3.875±0.354，P=0.000；4.000±0.000，7.375±0.518，9.375±1.302，11.750±0.463，P=0.000）. The LIF expression in puncture 2-week group was significantly higher，as disc degen－eration aggravated，the expression decreased gradually，and the expression level of each experimental group was higher than that of the 0 week group，the difference was statistically significant（559.608±68.689，16 135.613±577.329，8 149.739±457.189，2 018.254±211.870，P=0.000）. Cytology experiments showed that after stimulation of different LIF concentrations，Aggrecan，COLLA2α1 protein expression and LIF stimulus concentration was positively correlated，and there was a significant difference between each concentration group and the control group（0.191±0.020，0.212±0.020，0.321±0.041，0.511±0.032，0.561±0.042，P=0.000），and Aggrecan immunofluorescence results were consistent. TIMP-1 expression in the treatment group was significantly higher than that of control group（0.454±0.022，0.211±0.012，P=0.000）；MMP-3 expression in the treatment group was significantly lower than that in the control group（0.243±0.013，0.362±0.021，P=0.000）. Conclusion：LIF expression in degenerative nucleus pulposus is increased，and LIF can promote the synthesis of extracellular matrix，and its underlying mechanism is related to up-regulating TIMP-1 and down-regulating MMP-3.

Abstract:Objective：To investigate the expression of leukemia inhibit factor（LIF） in degenerative disc nucleus pulposus and its role in degenerative nucleus pulposus extracellular matrix synthesis. Methods：Forty adult New Zealand white rabbits were randomly divid－ed into 5 groups（1 group as the control group，the remaining 4 groups as the experimental group），8 rabbits in each group. Interverte－bral disc degeneration model was established by puncturing the L4/5 and L5/6 intervertebral discs in the experimental group. MRI scoring was performed on the discs at 0，2，4，8 weeks immediately after the operation，and the discs were obtained and stained with hematoxylin and eosin to get histological scores and to determine the degree of degeneration. Immuno-histochemical staining was used to semi-quantitatively detect the expression of LIF in nucleus pulposus. Rabbit nucleus pulposus cells were harvested for primary culture；the expressions of Aggrecan，COLLA2α1 in human in－tervertebral disc nucleus pulposus cells were detected by Western blot at 24，48，72 h after treated with gradient concentration hu－man recombinant LIF protein. In maximal concentration group and control group，Aggrecan expression was again verified by immunofluorescence and the expressions of tissue inhibitor of metalloproteinases-1（TIMP-1） and matrixmetalloproteinase-3（MMP-3） were detected by Western blot. Results：The imaging scores and histological scores showed that the degeneration of intervertebral disc increased with the prolongation of modeling time，and there was a significant difference（1.000±0.000，2.000±0.535，2.750±0.463，3.875±0.354，P=0.000；4.000±0.000，7.375±0.518，9.375±1.302，11.750±0.463，P=0.000）. The LIF expression in puncture 2-week group was significantly higher，as disc degen－eration aggravated，the expression decreased gradually，and the expression level of each experimental group was higher than that of the 0 week group，the difference was statistically significant（559.608±68.689，16 135.613±577.329，8 149.739±457.189，2 018.254±211.870，P=0.000）. Cytology experiments showed that after stimulation of different LIF concentrations，Aggrecan，COLLA2α1 protein expression and LIF stimulus concentration was positively correlated，and there was a significant difference between each concentration group and the control group（0.191±0.020，0.212±0.020，0.321±0.041，0.511±0.032，0.561±0.042，P=0.000），and Aggrecan immunofluorescence results were consistent. TIMP-1 expression in the treatment group was significantly higher than that of control group（0.454±0.022，0.211±0.012，P=0.000）；MMP-3 expression in the treatment group was significantly lower than that in the control group（0.243±0.013，0.362±0.021，P=0.000）. Conclusion：LIF expression in degenerative nucleus pulposus is increased，and LIF can promote the synthesis of extracellular matrix，and its underlying mechanism is related to up-regulating TIMP-1 and down-regulating MMP-3.

Abstract:Objective：To investigate the role and mechanism of Notch signaling pathway in bone morphogenetic protein 9（BMP9） in－duced osteogenic differentiation of mesenchymal stem cells line C3H10T1/2. Methods：The cells were divided into five groups：the blank（n=3），BMP9（n=3），BMP9+Control（n=3），BMP9+NICD（n=3），BMP9+DAPT（n=3）. The effect of Notch pathway on early and late osteogenic differentiation was detected by ALP and calcium staining. Furthermore，the expressions of NICD，Hey1 and the osteogen－esis-related genes Smad-1/5/8，p-Smad-1/5/8，OPN，Runx2，OCN，JunB were detected by qRT-RCR and Western blot after transfecting C3H10T1/2 cells with NICD plasmid. Results：The staining and activity of ALP showed that the NICD-activated Notch pathway could significantly inhibit the formation of ALP on 5 d and 7 d during the C3H10T1/2 cell differentiation[5 d：（33 167.66±2 018.45） vs. （146 451.00±14 889.67），P=0.000；7 d：（58 981.33±4 724.70） vs. （89 588.66±5 928.32），P=0.000]，and when DAPT inhibited Notch pathway，it came to the same result [5 d：（44 812.66±4 174.94） vs. （146 451.00±14 889.67），P=0.000；7 d：（64 622.93±4 724.70） vs. （89 588.66±5 928.32），P=0.000]. Alizarin S staining showed that NICD inhibited the formation of alcium salt nodules，while DAPT blocking Notch pathway significantly promoted the formation of calcium salt nodules during the osteogenic differentiation of C3H10T1/2 cells. qRT-RCR results showed that the expres－sion of NICD and target gene Hey1 in NCID group was significantly higher than that in the control group[（3.90±0.02） vs. （0.35±0.01），P=0.000；（19.79±0.01） vs. （11.80±0.02），P=0.000]，and Western blot got the same result. Furthermore，the expressions of JunB，Runx2，OCN and OPN were markedly inhibited by NICD[（0.10±0.01） vs. （0.53±0.01），P=0.000；（0.18±0.01） vs. （0.30±0.02），P=0.000；（0.36±0.01） vs. （0.62±0.02），P=0.000；（0.07±0.01） vs. （0.48±0.01），P=0.000]，but the expressions of Smad-1/5/8 and p-Smad-1/5/8 were not affected[（0.74±0.02） vs. （0.73±0.03），P=0.000；（0.63±0.01） vs. （0.58±0.04），P=0.000]；however，the expres－sions of the above-mentioned related genes significantly increased after DAPT blocking Notch pathway. Conclusion：The results first demonstrate that the inhibitory effect of NICD on the BMP9-induced osteogenic differentiation of C3H10T1/2 cells may be mediated by the inhibition of JunB gene，rather than the regulation of BMP9/Smad signaling pathway.

Abstract:Objective：To investigate the role and mechanism of Notch signaling pathway in bone morphogenetic protein 9（BMP9） in－duced osteogenic differentiation of mesenchymal stem cells line C3H10T1/2. Methods：The cells were divided into five groups：the blank（n=3），BMP9（n=3），BMP9+Control（n=3），BMP9+NICD（n=3），BMP9+DAPT（n=3）. The effect of Notch pathway on early and late osteogenic differentiation was detected by ALP and calcium staining. Furthermore，the expressions of NICD，Hey1 and the osteogen－esis-related genes Smad-1/5/8，p-Smad-1/5/8，OPN，Runx2，OCN，JunB were detected by qRT-RCR and Western blot after transfecting C3H10T1/2 cells with NICD plasmid. Results：The staining and activity of ALP showed that the NICD-activated Notch pathway could significantly inhibit the formation of ALP on 5 d and 7 d during the C3H10T1/2 cell differentiation[5 d：（33 167.66±2 018.45） vs. （146 451.00±14 889.67），P=0.000；7 d：（58 981.33±4 724.70） vs. （89 588.66±5 928.32），P=0.000]，and when DAPT inhibited Notch pathway，it came to the same result [5 d：（44 812.66±4 174.94） vs. （146 451.00±14 889.67），P=0.000；7 d：（64 622.93±4 724.70） vs. （89 588.66±5 928.32），P=0.000]. Alizarin S staining showed that NICD inhibited the formation of alcium salt nodules，while DAPT blocking Notch pathway significantly promoted the formation of calcium salt nodules during the osteogenic differentiation of C3H10T1/2 cells. qRT-RCR results showed that the expres－sion of NICD and target gene Hey1 in NCID group was significantly higher than that in the control group[（3.90±0.02） vs. （0.35±0.01），P=0.000；（19.79±0.01） vs. （11.80±0.02），P=0.000]，and Western blot got the same result. Furthermore，the expressions of JunB，Runx2，OCN and OPN were markedly inhibited by NICD[（0.10±0.01） vs. （0.53±0.01），P=0.000；（0.18±0.01） vs. （0.30±0.02），P=0.000；（0.36±0.01） vs. （0.62±0.02），P=0.000；（0.07±0.01） vs. （0.48±0.01），P=0.000]，but the expressions of Smad-1/5/8 and p-Smad-1/5/8 were not affected[（0.74±0.02） vs. （0.73±0.03），P=0.000；（0.63±0.01） vs. （0.58±0.04），P=0.000]；however，the expres－sions of the above-mentioned related genes significantly increased after DAPT blocking Notch pathway. Conclusion：The results first demonstrate that the inhibitory effect of NICD on the BMP9-induced osteogenic differentiation of C3H10T1/2 cells may be mediated by the inhibition of JunB gene，rather than the regulation of BMP9/Smad signaling pathway.

Abstract:Objective：To observe Lrtm1 expression in C2C12 cells，to construct a lentiviral vector overexpressing Lrtm1 gene effectively in C2C12 cells，to determine its role in myoblast differentiation and to explore the mechanism by which the expression level of Lrtm1 protein is regulated. Methods：The differentiation of C2C12 cells was induced and the nucleus was stained by Hoechst. The mouse Lrtm1 gene was recombined with lentiviral vectors pLJM1-GFP. C2C12 cells which overexpress ectopic Lrtm1 were selected. After treating with C2C12-Lrtm1-DDK cell lines with MG132，the expression of endogenous Lrtm1 protein was observed. Results：Myotubes had formed during its differentiation. The expression of Lrmt1 and Myosin mRNA increased during differentiation.The recombinant pLJM1-Lrtm1-DDK vector was successfully constructed and stable cell lines were screened. The results of real-time PCR at 144 h showed that the Myogenin mRNA level in the Lrtm1-DDK group（272.1±18.22） was lower than that in the GFP group（332.41±41.21）（P<0.05）. The Myosin mRNA level was significantly lower in Lrtm1-DDK group（76.11±10.47） than in GFP group（145.51±10.02） （P＜0.05）. Lrtm1 protein was degraded by the proteasome in C2C12 cells. Conclusion：Lrtm1 gene is highly expressed during myogenic differentiation. Overexpression of Lrtm1 partially inhibits the expression of Myogenin and Myosin. Lrtm1 protein is degraded by the proteasome.

Abstract:Objective：To observe Lrtm1 expression in C2C12 cells，to construct a lentiviral vector overexpressing Lrtm1 gene effectively in C2C12 cells，to determine its role in myoblast differentiation and to explore the mechanism by which the expression level of Lrtm1 protein is regulated. Methods：The differentiation of C2C12 cells was induced and the nucleus was stained by Hoechst. The mouse Lrtm1 gene was recombined with lentiviral vectors pLJM1-GFP. C2C12 cells which overexpress ectopic Lrtm1 were selected. After treating with C2C12-Lrtm1-DDK cell lines with MG132，the expression of endogenous Lrtm1 protein was observed. Results：Myotubes had formed during its differentiation. The expression of Lrmt1 and Myosin mRNA increased during differentiation.The recombinant pLJM1-Lrtm1-DDK vector was successfully constructed and stable cell lines were screened. The results of real-time PCR at 144 h showed that the Myogenin mRNA level in the Lrtm1-DDK group（272.1±18.22） was lower than that in the GFP group（332.41±41.21）（P<0.05）. The Myosin mRNA level was significantly lower in Lrtm1-DDK group（76.11±10.47） than in GFP group（145.51±10.02） （P＜0.05）. Lrtm1 protein was degraded by the proteasome in C2C12 cells. Conclusion：Lrtm1 gene is highly expressed during myogenic differentiation. Overexpression of Lrtm1 partially inhibits the expression of Myogenin and Myosin. Lrtm1 protein is degraded by the proteasome.

Abstract:Objective：To determine the H3K79me2，3 level in osteosarcoma cells during mitosis and to investigate its potential influence on mitotic progression. Methods：Western blot was used to detect the H3K79me2，3 level in osteosarcoma cells after mitotic synchro－nization. Time-lapse imaging was performed with a laser confocal fluorescence microscope to monitor the mitotic progression of U2OS cells with or without inhibitor EPZ5676. Results：The H3K79me2，3 level in osteosarcoma cells declined in the prometaphase and then increased gradually with mitosis exit. Depletion of H3K79me2，3 and the following increase caused an increase in the percentage of chromosome missegregation，with no significant effect on the kinetics of mitosis exit（χ2=4.99，P=0.026）. Conclusion：The H3K79me2，3 level shows variations during mitosis in osteosarcoma cells and is related to the regulation of chromosome segregation.

Abstract:Objective：To determine the H3K79me2，3 level in osteosarcoma cells during mitosis and to investigate its potential influence on mitotic progression. Methods：Western blot was used to detect the H3K79me2，3 level in osteosarcoma cells after mitotic synchro－nization. Time-lapse imaging was performed with a laser confocal fluorescence microscope to monitor the mitotic progression of U2OS cells with or without inhibitor EPZ5676. Results：The H3K79me2，3 level in osteosarcoma cells declined in the prometaphase and then increased gradually with mitosis exit. Depletion of H3K79me2，3 and the following increase caused an increase in the percentage of chromosome missegregation，with no significant effect on the kinetics of mitosis exit（χ2=4.99，P=0.026）. Conclusion：The H3K79me2，3 level shows variations during mitosis in osteosarcoma cells and is related to the regulation of chromosome segregation.

Abstract:Objective：To evaluate the biomechanical changes on C4 superior endplate with different types and diameters of transcorpo－real tunnels. Methods：A C2~T1 finite element model was built with CT data of neck from a healthy male volunteer. After validation of the FE model，two groups（A and B） of C2~T1 models was built with C4 tunneled with or without endplate excision and diameters of 6 mm，8 mm and 10 mm（1/2，2/3 and 6/5 of anterior C4 vertebral body height）. 1 N/m of flexible moment was loaded to FE models and the biomechanical changes on C4 superior endplate was evaluated. Results：There were stress concentration on the margin of ex－cision on C4 superior endplates in group A；in group B only B10 showed stress concentration on C4 superior endplate. All the areas and values of stress concentration increased with diameter in two groups. Maximum stress on C4 superior endplates in two groups was A6：11.51 MPa，A8：17.33 MPa，A10：18.49 MPa and B6：2.57 MPa，B8：2.89 MPa，B10：3.65 MPa. One-way analysis of variance of the stress distribution of C4 on superior endplate between tunneled model and intact model showed that B6 and anterior of B8 end－plates had no significant difference with the intact model（P>0.05），while in other models the differences were significant（P=0.000）. Evaluation of the risk of fracture on endplates showed that there were different amounts of high risk elements（A6：0.8%；A8：2.3%；A10：7.2%） in group A while few risk elements in group B. Conclusion：Those tunnels on vertebrae with endplate excision would cause stress concentration and risks of end－plate fracture. Maintaining the integrity of superior endplate can avoid those risks. In order to avoid risks of endplate fracture，diameter of tunnels on vertebrae without endplate excision should be limited within 2/3 of anterior vertebral body height，diameter of tunnels on vertebrae with endplate excision should be limited within 1/2 of anterior vertebral body height.

Abstract:Objective：To evaluate the biomechanical changes on C4 superior endplate with different types and diameters of transcorpo－real tunnels. Methods：A C2~T1 finite element model was built with CT data of neck from a healthy male volunteer. After validation of the FE model，two groups（A and B） of C2~T1 models was built with C4 tunneled with or without endplate excision and diameters of 6 mm，8 mm and 10 mm（1/2，2/3 and 6/5 of anterior C4 vertebral body height）. 1 N/m of flexible moment was loaded to FE models and the biomechanical changes on C4 superior endplate was evaluated. Results：There were stress concentration on the margin of ex－cision on C4 superior endplates in group A；in group B only B10 showed stress concentration on C4 superior endplate. All the areas and values of stress concentration increased with diameter in two groups. Maximum stress on C4 superior endplates in two groups was A6：11.51 MPa，A8：17.33 MPa，A10：18.49 MPa and B6：2.57 MPa，B8：2.89 MPa，B10：3.65 MPa. One-way analysis of variance of the stress distribution of C4 on superior endplate between tunneled model and intact model showed that B6 and anterior of B8 end－plates had no significant difference with the intact model（P>0.05），while in other models the differences were significant（P=0.000）. Evaluation of the risk of fracture on endplates showed that there were different amounts of high risk elements（A6：0.8%；A8：2.3%；A10：7.2%） in group A while few risk elements in group B. Conclusion：Those tunnels on vertebrae with endplate excision would cause stress concentration and risks of end－plate fracture. Maintaining the integrity of superior endplate can avoid those risks. In order to avoid risks of endplate fracture，diameter of tunnels on vertebrae without endplate excision should be limited within 2/3 of anterior vertebral body height，diameter of tunnels on vertebrae with endplate excision should be limited within 1/2 of anterior vertebral body height.

Abstract:Objective：To explore the effect of ultrasound（US）-mediated destruction of cationic nanobubbles（CNBs） expressing brain-derived neurotrophic factor（BDNF/CNBs） on nerve regeneration in rats following spinal cord injury（SCI）. Methods：Ninety-six adult male sprague-dawley rats were randomly divided into four treatment groups after Allen hit models of SCI being established. The groups were：normal saline（NS） group，BDNF/CNBs group，BDNF and US group，BDNF/CNBs and US group. Histological changes after SCI were observed by hematoxylin and eosin staining. Neuron viabi-lity was determined by Nissl staining. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling（TUNEL） staining was used to examine cell apoptosis. BDNF gene and protein expression were detected by quantitative reverse-trans-cription PCR and Western blot. Green fluorescent protein（GFP） expression in the spinal cord was examined using an inverted fluorescence microscope. The recovery of neural function was determined using the Basso, Beattie, and Bresnahan（BBB） test. Results：The mean diameter of the BDNF/CNBs was （339.8±210.3） nm and the zeta potential was （24.30±6.24） mV. BDNF therapy using US-mediated BDNF/CNBs destruction significantly increased BDNF expression（0.61±0.10 vs. 0.70±0.13 vs. 0.83±0.15 vs. 1.55±0.19，P=0.000；31.65±1.30 vs. 45.62±1.50 vs. 49.55±1.20 vs. 75.83±2.10，P=0.000）, attenuated histological injury, improved the expression of Nissl body and decreased neuron loss（51.00±4.95 vs. 90.80±6.87 vs. 99.60±7.50 vs. 159.40±8.56，P=0.000），inhibited neuronal apoptosis in injured spinal cords（60.19±1.84 vs. 54.97±2.40 vs. 36.70±2.23 vs. 17.08±1.42，P=0.000），and increased BBB scores in SCI rats（10.10±0.33 vs. 10.60±0.43 vs. 11.70±0.36 vs. 17.20±0.45，P=0.000）. Conclusions：UTMD-mediated BDNF/CNBs destruction effectively transfects the BDNF gene into target tissues and has a significant effect on the injured spinal cord. The combination of US irradiation and gene therapy through BDNF/CNBs holds great promise for the future of nanomedicine and the development of non-invasive treatment options for SCI and other diseases.

Abstract:Objective：To explore the effect of ultrasound（US）-mediated destruction of cationic nanobubbles（CNBs） expressing brain-derived neurotrophic factor（BDNF/CNBs） on nerve regeneration in rats following spinal cord injury（SCI）. Methods：Ninety-six adult male sprague-dawley rats were randomly divided into four treatment groups after Allen hit models of SCI being established. The groups were：normal saline（NS） group，BDNF/CNBs group，BDNF and US group，BDNF/CNBs and US group. Histological changes after SCI were observed by hematoxylin and eosin staining. Neuron viabi-lity was determined by Nissl staining. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling（TUNEL） staining was used to examine cell apoptosis. BDNF gene and protein expression were detected by quantitative reverse-trans-cription PCR and Western blot. Green fluorescent protein（GFP） expression in the spinal cord was examined using an inverted fluorescence microscope. The recovery of neural function was determined using the Basso, Beattie, and Bresnahan（BBB） test. Results：The mean diameter of the BDNF/CNBs was （339.8±210.3） nm and the zeta potential was （24.30±6.24） mV. BDNF therapy using US-mediated BDNF/CNBs destruction significantly increased BDNF expression（0.61±0.10 vs. 0.70±0.13 vs. 0.83±0.15 vs. 1.55±0.19，P=0.000；31.65±1.30 vs. 45.62±1.50 vs. 49.55±1.20 vs. 75.83±2.10，P=0.000）, attenuated histological injury, improved the expression of Nissl body and decreased neuron loss（51.00±4.95 vs. 90.80±6.87 vs. 99.60±7.50 vs. 159.40±8.56，P=0.000），inhibited neuronal apoptosis in injured spinal cords（60.19±1.84 vs. 54.97±2.40 vs. 36.70±2.23 vs. 17.08±1.42，P=0.000），and increased BBB scores in SCI rats（10.10±0.33 vs. 10.60±0.43 vs. 11.70±0.36 vs. 17.20±0.45，P=0.000）. Conclusions：UTMD-mediated BDNF/CNBs destruction effectively transfects the BDNF gene into target tissues and has a significant effect on the injured spinal cord. The combination of US irradiation and gene therapy through BDNF/CNBs holds great promise for the future of nanomedicine and the development of non-invasive treatment options for SCI and other diseases.

Abstract:Objective：To investigate the effect of a complex solution system of sodium hyaluronate and human urine-derived stem cells （hUSCs） in repairing articular cartilage by intra-articular injection in beagles with knee cartilage defect. Methods：The centrifugation and adherence method was used to isolate hUSCs from fresh urine of healthy adults，and primary cell culture and subculture were performed. Surface markers and multipotential differentiation were identified. Sodium hyaluronate was used as a cell carrier and mixed with the fourth-generation hUSCs to prepare cell suspension. A total of 12 beagles were used to establish a model of full-thick－ness cartilage defect with a diameter of 5 mm at the medial and lateral epicondyles of the femur in the knee joint. At 3 weeks after the model being established，the beagles were equally and randomly divided into sodium hyaluronate cell suspension treatment group，sodium hyaluronate treatment group，and normal saline blank control group，and injection into the knee joint was performed accord－ingly. The beagles were sacrificed at 12 weeks after injection，and related samples were collected. Gross specimens were used to ob－serve the morphological changes of cartilage defect，and HE staining and toluidine blue staining were performed for sections to evaluate the repair of knee cartilage. Results：At 12 weeks after treatment，the sodium hyaluronate cell suspension treatment group had a sig－nificantly better improvement in knee cartilage defect than the sodium hyaluronate treatment group and the normal saline blank control group，and gross evaluation showed that in the sodium hyaluronate cell suspension treatment group，the area of cartilage defect was almost filled with newly formed cartilage-like tissue and had a smooth surface. HE staining and toluidine blue staining of sections showed that compared with the sodium hyaluronate treatment group and the normal saline blank control group，the sodium hyaluronate cell suspension treatment group had the columnar arrangement of cartilage cells and good coverage of hyaline cartilage tissue in the area of defect，which was fully inte－grated with the adjacent cartilage tissue and was slightly thinner than the adjacent normal cartilage tissue. Conclusion：The complex solution system of sodium hyaluronate and hUSCs has a marked effect in repairing articular cartilage defect，which provides an ex－perimental basis for a new treatment regimen for cartilage defect.

Abstract:Objective：To investigate the effect of a complex solution system of sodium hyaluronate and human urine-derived stem cells （hUSCs） in repairing articular cartilage by intra-articular injection in beagles with knee cartilage defect. Methods：The centrifugation and adherence method was used to isolate hUSCs from fresh urine of healthy adults，and primary cell culture and subculture were performed. Surface markers and multipotential differentiation were identified. Sodium hyaluronate was used as a cell carrier and mixed with the fourth-generation hUSCs to prepare cell suspension. A total of 12 beagles were used to establish a model of full-thick－ness cartilage defect with a diameter of 5 mm at the medial and lateral epicondyles of the femur in the knee joint. At 3 weeks after the model being established，the beagles were equally and randomly divided into sodium hyaluronate cell suspension treatment group，sodium hyaluronate treatment group，and normal saline blank control group，and injection into the knee joint was performed accord－ingly. The beagles were sacrificed at 12 weeks after injection，and related samples were collected. Gross specimens were used to ob－serve the morphological changes of cartilage defect，and HE staining and toluidine blue staining were performed for sections to evaluate the repair of knee cartilage. Results：At 12 weeks after treatment，the sodium hyaluronate cell suspension treatment group had a sig－nificantly better improvement in knee cartilage defect than the sodium hyaluronate treatment group and the normal saline blank control group，and gross evaluation showed that in the sodium hyaluronate cell suspension treatment group，the area of cartilage defect was almost filled with newly formed cartilage-like tissue and had a smooth surface. HE staining and toluidine blue staining of sections showed that compared with the sodium hyaluronate treatment group and the normal saline blank control group，the sodium hyaluronate cell suspension treatment group had the columnar arrangement of cartilage cells and good coverage of hyaline cartilage tissue in the area of defect，which was fully inte－grated with the adjacent cartilage tissue and was slightly thinner than the adjacent normal cartilage tissue. Conclusion：The complex solution system of sodium hyaluronate and hUSCs has a marked effect in repairing articular cartilage defect，which provides an ex－perimental basis for a new treatment regimen for cartilage defect.

Abstract:Objective：To investigate the effect and mechanism of cedrelone for osteoarthritis treatment. Methods：C28/I2 cells were used to establish the cell model. MTT was used to detect the toxicity of cedrelone. Western blot and immunofluorescence were used to detect the effect of cedrelone on mTOR inhibition and autophagy activation. The right knees of C57BL/6J mice（n=40） were used to establish the osteoarthritis model，and the left knees of the same mice were used as the control；the mice were given cedrelone（n=20） and normal saline（n=20） treatment through intraperitoneal injection. The effects of cedrelone on mTOR inhibition and synovial in－flammation，activation of autophagy and protection of cartilage were detected through Western blot，safranin O stain，immunohisto－chemistry，immunofluorescence，semi-quantitative scoring sys－tem and inflammation grading system. Results：①For the C28/I2 cell，cedrelone could inhibit the mTOR phosphorylation in the site of Ser-2448，and suppress the phosphorylation of ribo－somal protein S6（rpS6） in the site of Thr-389 and Ser-371. The optimum dose was 40 μmol/L（Ser-2448：t=13.42，P=0.000；Thr-389：t=19.06，P=0.000；Ser-371：t=9.52，P=0.000），and the best time was 24 h（Ser-2448：t=34.82，P=0.000；Thr-389：t=3.14，P=0.007；Ser-371：t=19.32，P=0.000）. ②The value of LC3II/LC3I（t=8.15，P=0.002） and the number of autophagosome positive cells（t=9.71，P=0.000） were significantly increased by cedrelone treatment in C28/I2 cells. ③In the osteoarthritis model，cedrelone could inhibit the phosphorylation level of mTOR（t=19.03，P=0.005） and the number of rpS6 positive cells（t=27.97，P=0.000），as well as enhance the level of LC3II/LC3I（t=24.65，P=0.000） and the number of LC3 positive cells（t=33.89，P=0.000）. ④Cedrelone also could reduce the degradation of extracellular matrix through ADAMTS-5 in－hibition（F=1.82，P=0.002），and then reduce the severity of osteoarthritis（t=8.32，P=0.009），increase the number of chondrocytes（F=3.59，P=0.013）. ⑤In addition，in the synovial tissue，synovial inflammation was suppressed（F=5.44，P=0.029） by cedrelone through IL-1β inhibition（F=3.20，P=0.000）. Conclusion：Cedrelone acts as a potential mTOR inhibitor，not only reducing the severity of osteoarthritis and protection chondrocytes through autophagy activation，but also inhibiting the degradation of extracellular matrix and synovial inflammation by ADAMTS-5 and IL-1β inhibition in mice，however，the protective effect and mechanism of cedrelone for cartilage injury in osteoarthritis need to be further studied.

Abstract:Objective：To investigate the effect and mechanism of cedrelone for osteoarthritis treatment. Methods：C28/I2 cells were used to establish the cell model. MTT was used to detect the toxicity of cedrelone. Western blot and immunofluorescence were used to detect the effect of cedrelone on mTOR inhibition and autophagy activation. The right knees of C57BL/6J mice（n=40） were used to establish the osteoarthritis model，and the left knees of the same mice were used as the control；the mice were given cedrelone（n=20） and normal saline（n=20） treatment through intraperitoneal injection. The effects of cedrelone on mTOR inhibition and synovial in－flammation，activation of autophagy and protection of cartilage were detected through Western blot，safranin O stain，immunohisto－chemistry，immunofluorescence，semi-quantitative scoring sys－tem and inflammation grading system. Results：①For the C28/I2 cell，cedrelone could inhibit the mTOR phosphorylation in the site of Ser-2448，and suppress the phosphorylation of ribo－somal protein S6（rpS6） in the site of Thr-389 and Ser-371. The optimum dose was 40 μmol/L（Ser-2448：t=13.42，P=0.000；Thr-389：t=19.06，P=0.000；Ser-371：t=9.52，P=0.000），and the best time was 24 h（Ser-2448：t=34.82，P=0.000；Thr-389：t=3.14，P=0.007；Ser-371：t=19.32，P=0.000）. ②The value of LC3II/LC3I（t=8.15，P=0.002） and the number of autophagosome positive cells（t=9.71，P=0.000） were significantly increased by cedrelone treatment in C28/I2 cells. ③In the osteoarthritis model，cedrelone could inhibit the phosphorylation level of mTOR（t=19.03，P=0.005） and the number of rpS6 positive cells（t=27.97，P=0.000），as well as enhance the level of LC3II/LC3I（t=24.65，P=0.000） and the number of LC3 positive cells（t=33.89，P=0.000）. ④Cedrelone also could reduce the degradation of extracellular matrix through ADAMTS-5 in－hibition（F=1.82，P=0.002），and then reduce the severity of osteoarthritis（t=8.32，P=0.009），increase the number of chondrocytes（F=3.59，P=0.013）. ⑤In addition，in the synovial tissue，synovial inflammation was suppressed（F=5.44，P=0.029） by cedrelone through IL-1β inhibition（F=3.20，P=0.000）. Conclusion：Cedrelone acts as a potential mTOR inhibitor，not only reducing the severity of osteoarthritis and protection chondrocytes through autophagy activation，but also inhibiting the degradation of extracellular matrix and synovial inflammation by ADAMTS-5 and IL-1β inhibition in mice，however，the protective effect and mechanism of cedrelone for cartilage injury in osteoarthritis need to be further studied.

Abstract:Objective：To investigate the in vitro release mechanism of rifapentine-loaded poly（lactic-co-glycolic acid）（PLGA） microspheres. Methods：Rifapentine-loaded PLGA microspheres were prepared by the emulsification-solvent evaporation method. The in vitro release tests were carried out in phosphate buffer solution（0.2 mol/L，pH7.4），and the in vitro release profiles were prescribed by the zero-level equation，one-level equation and Higuchi equation，respectively. Results：Rifapentine-loaded PLGA microspheres were successfully prepared with drug loading of （8.04±0.29）%，（17.16±0.40）% and （23.93±0.48）%（F=1 195.325，P=0.000）. The microspheres were spherical particles with good dispersion. Rifapentine was evenly distributed in the PLGA matrix. The drug release was faster during the first two days and the cumulative drug releases of the three rifapentine-loaded PLGA microspheres were （9.07±0.11）%，（13.33±0.04）% and （15.5±0.09）%（F=4 414.474，P=0.000），which slowed down from the third day. The total cumulative drug releases were （72.10±0.26）%，（80.22±0.56）% and （78.60 ± 0.63）%（F=212.916，P=0.000）. The correlation coefficients of the Higuchi equation were closer to 1 among that of the three fitting equations. Conclusion：Rifapentine-loaded PLGA microspheres exhibit an initial burst followed by a period of slow release in vitro，and the release profiles is more consistent with the Higuchi equation.

Abstract:Objective：To investigate the in vitro release mechanism of rifapentine-loaded poly（lactic-co-glycolic acid）（PLGA） microspheres. Methods：Rifapentine-loaded PLGA microspheres were prepared by the emulsification-solvent evaporation method. The in vitro release tests were carried out in phosphate buffer solution（0.2 mol/L，pH7.4），and the in vitro release profiles were prescribed by the zero-level equation，one-level equation and Higuchi equation，respectively. Results：Rifapentine-loaded PLGA microspheres were successfully prepared with drug loading of （8.04±0.29）%，（17.16±0.40）% and （23.93±0.48）%（F=1 195.325，P=0.000）. The microspheres were spherical particles with good dispersion. Rifapentine was evenly distributed in the PLGA matrix. The drug release was faster during the first two days and the cumulative drug releases of the three rifapentine-loaded PLGA microspheres were （9.07±0.11）%，（13.33±0.04）% and （15.5±0.09）%（F=4 414.474，P=0.000），which slowed down from the third day. The total cumulative drug releases were （72.10±0.26）%，（80.22±0.56）% and （78.60 ± 0.63）%（F=212.916，P=0.000）. The correlation coefficients of the Higuchi equation were closer to 1 among that of the three fitting equations. Conclusion：Rifapentine-loaded PLGA microspheres exhibit an initial burst followed by a period of slow release in vitro，and the release profiles is more consistent with the Higuchi equation.

Abstract:Objective：To establish the model of temporomandibular joint osteoarthritis（TMJ-OA） in rats induced by unilateral occlusal trauma，and to evaluate the histopathological changes of the condylar cartilage. Methods：The rats were randomly divided into two groups，the control group and the experimental group，and each group was divided into four subgroups（4，8，12 ，16 weeks group，6 rats in each group）. Metal-wire was attached to the right maxillary first molar by rein and the occlusion was elevated by 0.5 mm. The weight was recorded in 1，2，3，4，8，12，16 weeks after the operation. The rats were sacrificed at 4，8，12，16 weeks after occlusal trau－ma，respectively. The histopathological changes of condylar cartilage were evaluated by HE and safranin-O fast green staining，and the change of cartilage thickness was measured and analyzed. Results：①At the early stage of the operation，occlusal trauma had a great influence on the weight（t1=4.757，P1=0.000；t2=3.096，P2=0.003）. ②At the 8th week，the condylar cartilage of the experimental side showed obvious lesion of OA（Mankin score=8.67±1.37，t=-7.267，P=0.000）. There were horizontal fissures in fibrous cartilage. The chondrocytes were arranged irregularly in proliferating layer and showed the OA-like lesions. ③The histopathological damage caused by occlusal trauma to condylar cartilage was time-related. Conclusion：Model of TMJ-OA is successfully established in rats by unilateral occlusal trauma and the obvious pathologicalchanges are detected at 8 weeks. This could be a promising model for the study of the pathogenesisof TMJ-OA.

Abstract:Objective：To establish the model of temporomandibular joint osteoarthritis（TMJ-OA） in rats induced by unilateral occlusal trauma，and to evaluate the histopathological changes of the condylar cartilage. Methods：The rats were randomly divided into two groups，the control group and the experimental group，and each group was divided into four subgroups（4，8，12 ，16 weeks group，6 rats in each group）. Metal-wire was attached to the right maxillary first molar by rein and the occlusion was elevated by 0.5 mm. The weight was recorded in 1，2，3，4，8，12，16 weeks after the operation. The rats were sacrificed at 4，8，12，16 weeks after occlusal trau－ma，respectively. The histopathological changes of condylar cartilage were evaluated by HE and safranin-O fast green staining，and the change of cartilage thickness was measured and analyzed. Results：①At the early stage of the operation，occlusal trauma had a great influence on the weight（t1=4.757，P1=0.000；t2=3.096，P2=0.003）. ②At the 8th week，the condylar cartilage of the experimental side showed obvious lesion of OA（Mankin score=8.67±1.37，t=-7.267，P=0.000）. There were horizontal fissures in fibrous cartilage. The chondrocytes were arranged irregularly in proliferating layer and showed the OA-like lesions. ③The histopathological damage caused by occlusal trauma to condylar cartilage was time-related. Conclusion：Model of TMJ-OA is successfully established in rats by unilateral occlusal trauma and the obvious pathologicalchanges are detected at 8 weeks. This could be a promising model for the study of the pathogenesisof TMJ-OA.

Abstract:Objective：To investigate the stress distribution of maxillary premolar with different residual ferrule locations after post-core crown restoration using the finite element analysis. Methods：An extracted maxillary premolar was embedded in acrylic resin block. Cone-beam CT scan and a finite element analysis software were used to establish five models of post-core crown restoration with dif－ferent residual ferrule locations（group A：teeth with a circular ferrule；group B：teeth with a complete palatal ferrule；group C：teeth with a complete buccal ferrule；group D：teeth with a complete mesial ferrule；group E：teeth with a complete distal ferrule；the height of the ferrule was 2 mm in all groups）. A load of 200 N at a 45° angle to the long axis of the tooth was applied at the top 1/3 of the lingual surface of the buccal cusp. The maximum von Mises stress and the maximum principal stress were analyzed. Results：Group C had the highest maximum von Mises stress of 64.53 MPa，while group A had the lowest maximum von Mises stress of 50.87 MPa. The maximum von Mises stresses in group B，group D，and group E were 55.31，60.61 and 59.73 MPa，respectively. The maximum principal stresses in groups A to E were 43.04，43.60，47.34，45.39 and 46.91 MPa，respectively. Conclusion：A complete ferrule can effectively prevent stress concentration at the dentinal tissue of the tooth and enhance fracture resistance of the diseased tooth. When the re－maining dentinal tissue is not sufficient，preservation of the palatal ferrule can protect the integrity of the adhesive layer，increase the fracture resistance of the adhesive layer between the dentin and resin，and thus enhance the anti-fracture ability of the diseased tooth.

Abstract:Objective：To investigate the stress distribution of maxillary premolar with different residual ferrule locations after post-core crown restoration using the finite element analysis. Methods：An extracted maxillary premolar was embedded in acrylic resin block. Cone-beam CT scan and a finite element analysis software were used to establish five models of post-core crown restoration with dif－ferent residual ferrule locations（group A：teeth with a circular ferrule；group B：teeth with a complete palatal ferrule；group C：teeth with a complete buccal ferrule；group D：teeth with a complete mesial ferrule；group E：teeth with a complete distal ferrule；the height of the ferrule was 2 mm in all groups）. A load of 200 N at a 45° angle to the long axis of the tooth was applied at the top 1/3 of the lingual surface of the buccal cusp. The maximum von Mises stress and the maximum principal stress were analyzed. Results：Group C had the highest maximum von Mises stress of 64.53 MPa，while group A had the lowest maximum von Mises stress of 50.87 MPa. The maximum von Mises stresses in group B，group D，and group E were 55.31，60.61 and 59.73 MPa，respectively. The maximum principal stresses in groups A to E were 43.04，43.60，47.34，45.39 and 46.91 MPa，respectively. Conclusion：A complete ferrule can effectively prevent stress concentration at the dentinal tissue of the tooth and enhance fracture resistance of the diseased tooth. When the re－maining dentinal tissue is not sufficient，preservation of the palatal ferrule can protect the integrity of the adhesive layer，increase the fracture resistance of the adhesive layer between the dentin and resin，and thus enhance the anti-fracture ability of the diseased tooth.

Abstract:Objective：To achieve accurate individualized reconstruction of mandibular defects with fibula myocutaneous flap based on virtual surgery and 3D-printed plates，and to explore the role of 3D-printed plates in improving the reconstructive accuracy of mandibular defects. Methods：The resection of mandibular lesions and reconstruction of fibular graft in 10 patients was performed using computer simulation before surgery. The 3D-printed plates were designed and produced in reconstruction of mandible during surgery. The difference between practical and simulative operations was determined using image fusion technology after surgery and the differ－ence values were analyzed statistically. Results：The 3D-printed plates were successfully implanted. The features and occlusal relationship of patients were well recovered. The measurements showed that the maximum margin of error between practical and sim－ulative osteotomy was （1.57±0.80） mm. Conclusion：The ap－plication of digital 3D-printed plates ensure a high accuracy in reconstruction of mandibular defects with fibula myocutaneous flap. The application of condylar positioning plates in fixing residual mandible effectively stabilized condylar position on the affected side and improved the reconstructive accuracy.

Abstract:Objective：To achieve accurate individualized reconstruction of mandibular defects with fibula myocutaneous flap based on virtual surgery and 3D-printed plates，and to explore the role of 3D-printed plates in improving the reconstructive accuracy of mandibular defects. Methods：The resection of mandibular lesions and reconstruction of fibular graft in 10 patients was performed using computer simulation before surgery. The 3D-printed plates were designed and produced in reconstruction of mandible during surgery. The difference between practical and simulative operations was determined using image fusion technology after surgery and the differ－ence values were analyzed statistically. Results：The 3D-printed plates were successfully implanted. The features and occlusal relationship of patients were well recovered. The measurements showed that the maximum margin of error between practical and sim－ulative osteotomy was （1.57±0.80） mm. Conclusion：The ap－plication of digital 3D-printed plates ensure a high accuracy in reconstruction of mandibular defects with fibula myocutaneous flap. The application of condylar positioning plates in fixing residual mandible effectively stabilized condylar position on the affected side and improved the reconstructive accuracy.

Abstract:Objective：To explore the three-dimensional differences in the morphological features of the craniofacial bone and dental arch between children with different sagittal skeletal malocclusions in the mixed dentition. Methods：This study included 180 children（aged 8-12 years） in the mixed dentition who consulted with the doctor for the first time in the Department of Pediatric Dentistry，Stomatological Hospital of Chongqing Medical University，and they were assigned to three groups：skeletal class Ⅰ malocclusion group （60 cases），skeletal class Ⅱ malocclusion group（60 cases），and skeletal class Ⅲ malocclusion group（60 cases）. Lateral cephalometric radiograph and the measurement data of 3D scanning model were compared between these groups. Results：Compared with the skele－tal class Ⅰ malocclusion group，the skeletal class Ⅱ malocclusion group showed significant reductions in SNB angle（74.60±3.13 vs. 77.33±3.74，P=0.00） and mandibular length（Cond-Pog）（90.20±4.72 vs. 92.90±5.44，P=0.00） and significant increases in SNA angle（81.42±3.13 vs. 79.77±5.39，P=0.03），Y-axis angle （67.45±3.99 vs. 64.72±6.82，P=0.00），and inclination of the lower anterior teeth（IMand-ML）（96.93±5.48 vs. 93.13±6.53，P=0.00）. The skeletal class Ⅱ malocclusion group had a smaller upper posterior maxillary width（UPMW） than the skeletal class Ⅲ malocclu－sion group（31.17±2.33 vs. 32.36±5.19，P=0.07）. Compared with the skeletal class Ⅰ malocclusion group，the skeletal class Ⅲ malocclusion group showed significant reductions in SNA angle（76.00±4.21 vs. 79.77±5.39，P=0.00），maxillary length（ANS-PNS）（38.53±3.63 vs. 42.60±2.90，P=0.00），upper total arch length（UTAL）（24.37±2.68 vs. 25.68±2.24，P=0.00），anterior cranial base length（N-S）（57.12±3.05 vs. 58.67±3.10，P=0.01），facial height（N-Me）（99.70±4.91 vs. 101.77±5.78，P=0.03），Y-axis angle（62.50±4.22 vs. 64.72±6.82，P=0.02），and IMand-ML（85.17±6.81 vs. 93.13±6.53，P=0.00），and had a forward mandibular position（S-Co）（13.92±2.57 vs. 15.15±2.79，P=0.01）. Conclusion：The morphological features of the craniofacial bone and dental arch vary between different sagittal skeletal malocclusions in the mixed dentition. The main manifestations of skeletal class Ⅱ malocclusion are smaller mandibular length，higher IMand-ML，and slightly smaller UPMW；the main manifestations of skeletal class Ⅲ malocclusion are smaller maxillary length，N-S，and N-Me，forward mandibular position，lower IMand-ML，and smaller UTAL. These results provide a reference for early identification and cor－rection of skeletal and dental developmental abnormalities in children with malocclusions.

Abstract:Objective：To explore the three-dimensional differences in the morphological features of the craniofacial bone and dental arch between children with different sagittal skeletal malocclusions in the mixed dentition. Methods：This study included 180 children（aged 8-12 years） in the mixed dentition who consulted with the doctor for the first time in the Department of Pediatric Dentistry，Stomatological Hospital of Chongqing Medical University，and they were assigned to three groups：skeletal class Ⅰ malocclusion group （60 cases），skeletal class Ⅱ malocclusion group（60 cases），and skeletal class Ⅲ malocclusion group（60 cases）. Lateral cephalometric radiograph and the measurement data of 3D scanning model were compared between these groups. Results：Compared with the skele－tal class Ⅰ malocclusion group，the skeletal class Ⅱ malocclusion group showed significant reductions in SNB angle（74.60±3.13 vs. 77.33±3.74，P=0.00） and mandibular length（Cond-Pog）（90.20±4.72 vs. 92.90±5.44，P=0.00） and significant increases in SNA angle（81.42±3.13 vs. 79.77±5.39，P=0.03），Y-axis angle （67.45±3.99 vs. 64.72±6.82，P=0.00），and inclination of the lower anterior teeth（IMand-ML）（96.93±5.48 vs. 93.13±6.53，P=0.00）. The skeletal class Ⅱ malocclusion group had a smaller upper posterior maxillary width（UPMW） than the skeletal class Ⅲ malocclu－sion group（31.17±2.33 vs. 32.36±5.19，P=0.07）. Compared with the skeletal class Ⅰ malocclusion group，the skeletal class Ⅲ malocclusion group showed significant reductions in SNA angle（76.00±4.21 vs. 79.77±5.39，P=0.00），maxillary length（ANS-PNS）（38.53±3.63 vs. 42.60±2.90，P=0.00），upper total arch length（UTAL）（24.37±2.68 vs. 25.68±2.24，P=0.00），anterior cranial base length（N-S）（57.12±3.05 vs. 58.67±3.10，P=0.01），facial height（N-Me）（99.70±4.91 vs. 101.77±5.78，P=0.03），Y-axis angle（62.50±4.22 vs. 64.72±6.82，P=0.02），and IMand-ML（85.17±6.81 vs. 93.13±6.53，P=0.00），and had a forward mandibular position（S-Co）（13.92±2.57 vs. 15.15±2.79，P=0.01）. Conclusion：The morphological features of the craniofacial bone and dental arch vary between different sagittal skeletal malocclusions in the mixed dentition. The main manifestations of skeletal class Ⅱ malocclusion are smaller mandibular length，higher IMand-ML，and slightly smaller UPMW；the main manifestations of skeletal class Ⅲ malocclusion are smaller maxillary length，N-S，and N-Me，forward mandibular position，lower IMand-ML，and smaller UTAL. These results provide a reference for early identification and cor－rection of skeletal and dental developmental abnormalities in children with malocclusions.

Abstract:Objective：To probe into the operative techniques and clinical outcomes of treating compound acetabular fractures through single ilioinguinal approach. Methods：From September 2011 to October 2015，13 cases of compound acetabular fractures undergoing operation were followed up. Of them，there were 10 males and 3 females with an average age of 34.8 years. The interval between injury and surgery was 5 to 13 days，with an average of 8 days. All the cases underwent operation by single ilioinguinal approach. Results：All the 13 cases were followed up，and the mean follow-up period was 23.4（8 to 49） months. All the cases were evaluated by Matta reduction criteria and the modified D’Aubigne and Postel clinical scoring. Matta reduction criteria were excellent in 8 patients，good in 4 and poor in 1. D’Aubigne and Postel clinical scoring were excellent in 7 patients，good in 4 and poor in 2. There was complica－tion of fat liquefaction in 2 cases，one cured by changing dressing and the other by surgery. Another complication was continuing bleeding，cured by blood transfusion and pressure dressing. There was damage of lateral femoral cutaneous nerve in 4 cases，which became better in the following 3 to 6 months. There was traumatic arthritis in 1 case after surgery. Conclusion：Acetabular fractures associate with anterior and posterior hemi-transverse fractures；both column fractures and T shape fractures can be treated through single ilioinguinal approach which can result in satisfactory functional outcomes by preoperative planning and careful operation.

Abstract:Objective：To probe into the operative techniques and clinical outcomes of treating compound acetabular fractures through single ilioinguinal approach. Methods：From September 2011 to October 2015，13 cases of compound acetabular fractures undergoing operation were followed up. Of them，there were 10 males and 3 females with an average age of 34.8 years. The interval between injury and surgery was 5 to 13 days，with an average of 8 days. All the cases underwent operation by single ilioinguinal approach. Results：All the 13 cases were followed up，and the mean follow-up period was 23.4（8 to 49） months. All the cases were evaluated by Matta reduction criteria and the modified D’Aubigne and Postel clinical scoring. Matta reduction criteria were excellent in 8 patients，good in 4 and poor in 1. D’Aubigne and Postel clinical scoring were excellent in 7 patients，good in 4 and poor in 2. There was complica－tion of fat liquefaction in 2 cases，one cured by changing dressing and the other by surgery. Another complication was continuing bleeding，cured by blood transfusion and pressure dressing. There was damage of lateral femoral cutaneous nerve in 4 cases，which became better in the following 3 to 6 months. There was traumatic arthritis in 1 case after surgery. Conclusion：Acetabular fractures associate with anterior and posterior hemi-transverse fractures；both column fractures and T shape fractures can be treated through single ilioinguinal approach which can result in satisfactory functional outcomes by preoperative planning and careful operation.

Abstract:Objective：To compare the clinical and imaging outcomes between meniscus allograft transplantation（MAT） and MAT combined with intra-articular platelet-rich plasma（PRP） injection. Methods：A total of 27 patients were retrospectively included and divided into two groups. Group A contains 15 patients who underwent MAT and group B contains 12 patents who underwent MAT combined with intra-articular PRP injection. The Lysholm，International Knee Documentation Committee（IKDC），Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC），Tegner activity level and Visual Analog Scale （VAS） for pain scores were used to evaluate the outcomes for all patients. Magnetic resonance imaging scans were performed postoperatively to assess graft position and chondral degeneration. Results：There was no significant difference in Tegner score postoperatively（P>0.05）. Group B achieved higher Lysholm，WOMAC and VAS at 6-month follow-up than group A（P<0.05）. However，no significant differences was found in these scores at 1-year and 2-year follow-up（P>0.05）. Group B demonstrated higher IKDC than group A at 6-month and 1-year follow-up（P<0.05），yet there was no significant difference between them at 2-year follow-up（P>0.05）. There was no significant difference in the distribution of the grade of chondral damage and graft extrusion between two groups at 2-year follow-up（P>0.05）. There was one patient in each group resulted decreased function scores after surgery. One in group A showed a focal Ⅳ grade chondral damage and another in group B showed a moderate quadriceps femoris atrophy. Conclusion：MAT combined with intra-articular PRP injection shows higher improvements in pain relief and knee function than MAT during 1 year postoperatively.

Abstract:Objective：To compare the clinical and imaging outcomes between meniscus allograft transplantation（MAT） and MAT combined with intra-articular platelet-rich plasma（PRP） injection. Methods：A total of 27 patients were retrospectively included and divided into two groups. Group A contains 15 patients who underwent MAT and group B contains 12 patents who underwent MAT combined with intra-articular PRP injection. The Lysholm，International Knee Documentation Committee（IKDC），Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC），Tegner activity level and Visual Analog Scale （VAS） for pain scores were used to evaluate the outcomes for all patients. Magnetic resonance imaging scans were performed postoperatively to assess graft position and chondral degeneration. Results：There was no significant difference in Tegner score postoperatively（P>0.05）. Group B achieved higher Lysholm，WOMAC and VAS at 6-month follow-up than group A（P<0.05）. However，no significant differences was found in these scores at 1-year and 2-year follow-up（P>0.05）. Group B demonstrated higher IKDC than group A at 6-month and 1-year follow-up（P<0.05），yet there was no significant difference between them at 2-year follow-up（P>0.05）. There was no significant difference in the distribution of the grade of chondral damage and graft extrusion between two groups at 2-year follow-up（P>0.05）. There was one patient in each group resulted decreased function scores after surgery. One in group A showed a focal Ⅳ grade chondral damage and another in group B showed a moderate quadriceps femoris atrophy. Conclusion：MAT combined with intra-articular PRP injection shows higher improvements in pain relief and knee function than MAT during 1 year postoperatively.

Abstract:Objective：To investigate the short-term efficacy of minimally invasive multi-planar soft tissue lysis in the treatment of congenital clubfoot. Methods：A retrospective analysis was performed on 32 patients（45 feet） with congenital clubfoot who underwent minimally invasive multi-planar soft tissue lysis in our hospital from July 2014 to June 2017. The Dimeglio scores and the degrees of six angles on X-ray before treatment and at the last follow-up were collected. The efficacy was evaluated and the correlations between Dimeglio score and degrees of six angles were analyzed. Results：All patients were followed up for （12.6±4.8） months（ranged from 6.2 to 24.9 months）. The median Dimeglio score at the last follow-up was 2.0（1，3），which was significantly better than that before treatment（P=0.000）. There were significant changes in the degrees of six angles on X-ray after treatment（P<0.05）. Only the degree of the anteroposterior talus-first metatarsal angle was positively correlated with Dimeglio score（r=0.346，P=0.020）. Conclusion：Minimally invasive multi-planar soft tissue lysis has good short-term efficacy because of its minimal invasion，unobvious postoperative scar，and good outcomes in ankle joint function and flexibility in the treatment of congenital clubfoot

Abstract:Objective：To investigate the short-term efficacy of minimally invasive multi-planar soft tissue lysis in the treatment of congenital clubfoot. Methods：A retrospective analysis was performed on 32 patients（45 feet） with congenital clubfoot who underwent minimally invasive multi-planar soft tissue lysis in our hospital from July 2014 to June 2017. The Dimeglio scores and the degrees of six angles on X-ray before treatment and at the last follow-up were collected. The efficacy was evaluated and the correlations between Dimeglio score and degrees of six angles were analyzed. Results：All patients were followed up for （12.6±4.8） months（ranged from 6.2 to 24.9 months）. The median Dimeglio score at the last follow-up was 2.0（1，3），which was significantly better than that before treatment（P=0.000）. There were significant changes in the degrees of six angles on X-ray after treatment（P<0.05）. Only the degree of the anteroposterior talus-first metatarsal angle was positively correlated with Dimeglio score（r=0.346，P=0.020）. Conclusion：Minimally invasive multi-planar soft tissue lysis has good short-term efficacy because of its minimal invasion，unobvious postoperative scar，and good outcomes in ankle joint function and flexibility in the treatment of congenital clubfoot. cirrhosis，and 90 had Child-Pugh class C cirrhosis，and 35 individuals who under－went physical examination during the same period of time were enrolled as controls. The indices including liver function parameters，liver fibrosis indices，and platelet count were measured and analyzed. Results：There were significant differences between the two groups in hyaluronic acid（HA），laminin（LN），type Ⅲ collagen（PC-Ⅲ），type Ⅳ collagen（Ⅳ-C），aspartate aminotransferase（AST），alanine aminotransferase（ALT），and aspartate aminotransferase-to-platelet ratio index（APRI）（P<0.05）. HA，PC-Ⅲ，Ⅳ-C，LN，and AST had an area under the ROC curve of 0.910，0.804，0.833，0.753，and 0.730，respectively. HA，PC-Ⅲ，and Ⅳ-C were positively correlated with Child-Pugh class（r>0.7，P<0.01），and APRI was positively correlated with Child-Pugh score（0.4

Abstract:Objective：To determine whether chewing gum can enhance the recovery of bowel function in patients after posterior lumbar fusion（PLF） surgery. Methods：A retrospective comparative study was performed on 65 patients who were diagnosed with lumbar disc herniation and received PLF surgery between January 2016 and September 2016 in Department of Orthopedics in The First Affiliated Hospital of Chongqing Medical University. Thirty patients in the study group started chewing gum every 4 hours，2 grain every time，and at least for 15 minutes，3 hours after they were awaken of the anesthesia. When the first passage of flatus happened，the chewing frequency was increased to every 8 hours，until 5 days postoperative. While the other 35 patients in the control group chewed nothing. The time of first bowel sounds heard，the first passage of flatus，the first passage of defecation，and hospitalization，hospitalization ex－penses and complication were all recorded and analyzed. Results：Patients in the study group had less time of the first bowel sounds heard[（12.35±2.87） h vs. （17.10±2.59） h，t=-7.007，P=0.000]，the first passage of flatus[（17.34±2.86） h vs. （24.12±3.18） h，t= -8.974，P=0.000]，and the first passage of defecation [（51.89±5.16） h vs. （74.81±4.76） h，t=-18.612，P=0.000]. But no significant difference was found in hospitalization[（11.67±2.12） d vs. （12.03±2.33） d，t=-0.650，P=0.518]，hospitalization expenses[（66 554.13±16 325.18） yuan vs. （65 707.26±11 765.25） yuan，t=-0.493，P=0.809] and complication rate（10/30 vs. 12/35， ?字2=0.007，P=0.936） between the two groups. Conclusion：Chewing gum enhances the recovery of bowel function after PLF surgery. Large sample，multi-center prospective study are needed to verify this conclusion.

Abstract:Objective：To determine whether chewing gum can enhance the recovery of bowel function in patients after posterior lumbar fusion（PLF） surgery. Methods：A retrospective comparative study was performed on 65 patients who were diagnosed with lumbar disc herniation and received PLF surgery between January 2016 and September 2016 in Department of Orthopedics in The First Affiliated Hospital of Chongqing Medical University. Thirty patients in the study group started chewing gum every 4 hours，2 grain every time，and at least for 15 minutes，3 hours after they were awaken of the anesthesia. When the first passage of flatus happened，the chewing frequency was increased to every 8 hours，until 5 days postoperative. While the other 35 patients in the control group chewed nothing. The time of first bowel sounds heard，the first passage of flatus，the first passage of defecation，and hospitalization，hospitalization ex－penses and complication were all recorded and analyzed. Results：Patients in the study group had less time of the first bowel sounds heard[（12.35±2.87） h vs. （17.10±2.59） h，t=-7.007，P=0.000]，the first passage of flatus[（17.34±2.86） h vs. （24.12±3.18） h，t= -8.974，P=0.000]，and the first passage of defecation [（51.89±5.16） h vs. （74.81±4.76） h，t=-18.612，P=0.000]. But no significant difference was found in hospitalization[（11.67±2.12） d vs. （12.03±2.33） d，t=-0.650，P=0.518]，hospitalization expenses[（66 554.13±16 325.18） yuan vs. （65 707.26±11 765.25） yuan，t=-0.493，P=0.809] and complication rate（10/30 vs. 12/35， ?字2=0.007，P=0.936） between the two groups. Conclusion：Chewing gum enhances the recovery of bowel function after PLF surgery. Large sample，multi-center prospective study are needed to verify this conclusion.

Abstract:Objective：To improve the diagnosis and treatment of spontaneously ruptured extensor pollicis longus（EPL） after non-oper－ative treatment of distal radius fractures. Methods：Causal analysis and standard operative treatment were conducted on 30 cases of spontaneously ruptured EPL with old distal radius fractures but without new wrist trauma. Results：Friction theory and Pressure theory would lead to EPL spontaneous rupture after distal radius fractures with or without displaced fracture. Once ruptured tendons were found，at early stage，the end to end in-situ remediation could be performed；at late stage，the reconstruction of EPL function by trans－ferring extensor indicis proprius（EIP） was more appropriate. Conclusion：Friction theory and Pressure theory need to be fully under－stood，and only the high risk factors for EPL spontaneous rupture were early found and properly treated，the lower incidence of EPL spontaneous rupture would become a reality.

Abstract:Objective：To improve the diagnosis and treatment of spontaneously ruptured extensor pollicis longus（EPL） after non-oper－ative treatment of distal radius fractures. Methods：Causal analysis and standard operative treatment were conducted on 30 cases of spontaneously ruptured EPL with old distal radius fractures but without new wrist trauma. Results：Friction theory and Pressure theory would lead to EPL spontaneous rupture after distal radius fractures with or without displaced fracture. Once ruptured tendons were found，at early stage，the end to end in-situ remediation could be performed；at late stage，the reconstruction of EPL function by trans－ferring extensor indicis proprius（EIP） was more appropriate. Conclusion：Friction theory and Pressure theory need to be fully under－stood，and only the high risk factors for EPL spontaneous rupture were early found and properly treated，the lower incidence of EPL spontaneous rupture would become a reality.examinations during the same period were tested for their serum SOD activity，levels of urine iodine and IP-10，and other indices related to thyroid function. SOD activity，the levels of IP-10 and thyroid hormones，and the incidence of HT were compared between the subjects with different nutritional status. The correlation between iodine，SOD，and IP-10 was analyzed. Results：Compared with the control group，the elderly patients with HT had higher mean levels of urinary iodine（216.63 μg/L） and IP-10（194.41 ng/L），but lower SOD activity（92.99 U/mL）. The group with adequate iodine had significantly increased levels of thyroid stimulating hormone，free triiodothyronine，free thyroxine，and IP-10，but significantly decreased SOD activity. A correlation analysis showed that urinary iodine was negatively correlated with SOD activity and positively correlated with serum IP-10 level，and serum SOD activity was negatively correlated with the IP-10 level（r=0.662）. Conclusion：Excessive iodine intake is associated with HT in the elderly. High iodine level can affect the thyroid function，oxidative stress，and chemotactic factor level of patients.

Abstract:Objective：To explore the characteristics and treatment for ulnar coronoid fracture in 20 children. Methods：From January 2012 to January 2017，20 children suffered from fracture of the coronoid process of the ulna were treated in the Children’s Hospital of Chongqing Medical University，including 16 boys and 4 girls，aged from 1 to 15 year with a mean age of 9.9 years. According to Regan-morrey classification，there were 10 cases of type I，7 cases of typeⅡ，3 cases of type Ⅲ. Eight cases were comminuted fracture，12 cases were concomitant with other fractures，3 cases were accompanied with elbow dislocation，and no case of ‘terrible triad of the elbow’ or ligament rupture was found. A total of 6 cases were treated conservatively while the other 14 cases were managed by operation：cannulated screw in 1 case，cartilage nails in 7 cases，Kirschner wire in 2 cases，absorbable suture in 1 case，removing the small bone fragments in 3 cases. Results：Mean follow up was 2.7 years（1 to 5 years）. According to Mayo scale，the functional re－covery assessed as excellent in 16 cases，good in 3 cases and fair in 1 case. Conclusion：In children，the incidence of ulnar coronoid fracture is rare，while most of them are comminuted fracture，and few are concomitant with the ‘terrible triad of the elbow’ and liga－ment rupture. The lateral X-ray examination can reduce the missed diagnosis. The prognosis of ulnar coronoid fracture is good，with few complications. The anterior approach is recommended for operation in cases with comminuted fracture in which cartilage nail or the Kirschner wire is recommended to fix.

Abstract:Objective：To explore the characteristics and treatment for ulnar coronoid fracture in 20 children. Methods：From January 2012 to January 2017，20 children suffered from fracture of the coronoid process of the ulna were treated in the Children’s Hospital of Chongqing Medical University，including 16 boys and 4 girls，aged from 1 to 15 year with a mean age of 9.9 years. According to Regan-morrey classification，there were 10 cases of type I，7 cases of typeⅡ，3 cases of type Ⅲ. Eight cases were comminuted fracture，12 cases were concomitant with other fractures，3 cases were accompanied with elbow dislocation，and no case of ‘terrible triad of the elbow’ or ligament rupture was found. A total of 6 cases were treated conservatively while the other 14 cases were managed by operation：cannulated screw in 1 case，cartilage nails in 7 cases，Kirschner wire in 2 cases，absorbable suture in 1 case，removing the small bone fragments in 3 cases. Results：Mean follow up was 2.7 years（1 to 5 years）. According to Mayo scale，the functional re－covery assessed as excellent in 16 cases，good in 3 cases and fair in 1 case. Conclusion：In children，the incidence of ulnar coronoid fracture is rare，while most of them are comminuted fracture，and few are concomitant with the ‘terrible triad of the elbow’ and liga－ment rupture. The lateral X-ray examination can reduce the missed diagnosis. The prognosis of ulnar coronoid fracture is good，with few complications. The anterior approach is recommended for operation in cases with comminuted fracture in which cartilage nail or the Kirschner wire is recommended to fix.

Abstract:Objective：To Investigate the safety zone and indications of placing the upper sacral sacroiliac screw into the dysplastic sacra based on CT data. Methods：Totally 267 three-dimensional models of pelvis were reconstructed by Mimics（Materialize’s inter－active medical image control system） 16.0 software based on CT data and then the dysplastic sacra were detected. The virtual trans－verse screw which pass through the bilateral sacroiliac joint was planned to place into the dysplastic sacra，if not safe to be placed，the conventional unilateral sacroiliac screw was placed，and then the safety zone was measured. The skin around pelvic surface was recon－structed，and then the surface projections of the upper sacral central screw’s entry point P，anterior superior iliac spine’s vertex N，iliac crest point M were determined as P1，N1 and M1，respectively. The lengths of P1N1，P1M1 and M1N1 were measured in section. Results：Among 267 specimens，30.3 percent of sacra belonged to main dysplasia（upper sacral transverse sacroiliac screw could not be placed） and 9.0 percent of sacra belonged to minor dysplasia（upper sacral transverse sacroiliac screw could be placed）. For the main dysplastic sacra，the length of P1N1 was （162.52±21.23） mm in male and （163.52±20.39） mm in female（P=0.761）. The length of P1M1 was（129.29±17.38） mm in male and （111.56±17.84） mm in female（P=0.000）. The length of M1N1 was （146.92±11.08） mm in male and （146.72±15.05） mm in female（P=0.924）. The angle of the central screw oriented from posterior to anterior was （21.80±3.56）° in male and （19.97±3.02）° in female（P=0.000）. The angle oriented from caudal to cranial was （29.97±5.38）° in male and （28.15±6.21）° in female（P=0.047）. The length of the central screw in the Denis Ⅲ zone was （14.41±4.40） mm in male and （14.09±5.04） mm in female（P=0.665）；the length in the Denis Ⅱ and Ⅲ zones was （36.25±3.40） mm in male and （38.04±4.60） mm in female（P=0.005）. Conclusion：When the upper sacra have the feature of ‘the sacrum is not recessed within the pelvis’ and/or ‘the alar slope is acute’，the entry point of the upper sacral sacroiliac screw is more backward and caudal than the normal pelvic，and the angle oriented from posterior to ante－rior is about 20°，from caudal to cranial is about 30°. For the dysplastic sacra，the upper sacral sacroiliac screw is recommended to fix Denis Ⅰ zone sacral fracture and the sacroiliac dislocation. And there is no significant difference between man and women.

Abstract:Objective：To Investigate the safety zone and indications of placing the upper sacral sacroiliac screw into the dysplastic sacra based on CT data. Methods：Totally 267 three-dimensional models of pelvis were reconstructed by Mimics（Materialize’s inter－active medical image control system） 16.0 software based on CT data and then the dysplastic sacra were detected. The virtual trans－verse screw which pass through the bilateral sacroiliac joint was planned to place into the dysplastic sacra，if not safe to be placed，the conventional unilateral sacroiliac screw was placed，and then the safety zone was measured. The skin around pelvic surface was recon－structed，and then the surface projections of the upper sacral central screw’s entry point P，anterior superior iliac spine’s vertex N，iliac crest point M were determined as P1，N1 and M1，respectively. The lengths of P1N1，P1M1 and M1N1 were measured in section. Results：Among 267 specimens，30.3 percent of sacra belonged to main dysplasia（upper sacral transverse sacroiliac screw could not be placed） and 9.0 percent of sacra belonged to minor dysplasia（upper sacral transverse sacroiliac screw could be placed）. For the main dysplastic sacra，the length of P1N1 was （162.52±21.23） mm in male and （163.52±20.39） mm in female（P=0.761）. The length of P1M1 was（129.29±17.38） mm in male and （111.56±17.84） mm in female（P=0.000）. The length of M1N1 was （146.92±11.08） mm in male and （146.72±15.05） mm in female（P=0.924）. The angle of the central screw oriented from posterior to anterior was （21.80±3.56）° in male and （19.97±3.02）° in female（P=0.000）. The angle oriented from caudal to cranial was （29.97±5.38）° in male and （28.15±6.21）° in female（P=0.047）. The length of the central screw in the Denis Ⅲ zone was （14.41±4.40） mm in male and （14.09±5.04） mm in female（P=0.665）；the length in the Denis Ⅱ and Ⅲ zones was （36.25±3.40） mm in male and （38.04±4.60） mm in female（P=0.005）. Conclusion：When the upper sacra have the feature of ‘the sacrum is not recessed within the pelvis’ and/or ‘the alar slope is acute’，the entry point of the upper sacral sacroiliac screw is more backward and caudal than the normal pelvic，and the angle oriented from posterior to ante－rior is about 20°，from caudal to cranial is about 30°. For the dysplastic sacra，the upper sacral sacroiliac screw is recommended to fix Denis Ⅰ zone sacral fracture and the sacroiliac dislocation. And there is no significant difference between man and women.

Abstract:Objective：To explore the periprosthetic bone mineral density（BMD） changes in patients undergoing total hip arthroplasty（THA） with the anatomic cementless femoral stem during the short to midterm follow-up period，and to provide a theoretical frame－work for prosthesis design in the future. Methods：A total of 28 patients undergone primary unilateral cementless THA（T.O.P. hip ac－etabular cup/Ribbed stem，Link） more than one years were chosen and followed in the study. Periprosthetic and contralateral bone mineral density（BMD） in seven Gruen zones was measured with dual energy X-ray absorptiometry（DEXA）. These data were ana－lyzed subsequently using SPSS software. Results：Twenty-eight patients who underwent THA during April 2010 and January 2015 with an average follow-up of 35.5 months were included in this study，of which 13 were males and 15 were females，at a mean age of （61.36±9.40） years（range，41-75 years）. Their body mass index was （24.78±2.80） kg/m2. The disease spectrum leading to primary THA consist of vascular necrosis of the femoral head（10 cases），developmental dysplasia of the hip（8 cases），femoral neck fractures （6 cases），and hip osteoarthritis（4 cases）. Periprosthetic BMD changes were most pronounced only in the distal Gruen zone 4[surgi－cal side BMD（1.58±0.28） g/cm2，non-operated control side BMD（1.66±0.20） g/cm2；t=-2.216，P=0.035]，and no significant differ－ences were detected when compared with the non-operated control side in other Gruen zones. Conclusion：The Ribbed anatomic cementless femoral stem contributes to periprosthetic bone ingrowth in patients undergoing THA，proximal load transfer comparatively approximates normal bio-stress，the features of which are well worth learning from in the future.

Abstract:Objective：To explore the periprosthetic bone mineral density（BMD） changes in patients undergoing total hip arthroplasty（THA） with the anatomic cementless femoral stem during the short to midterm follow-up period，and to provide a theoretical frame－work for prosthesis design in the future. Methods：A total of 28 patients undergone primary unilateral cementless THA（T.O.P. hip ac－etabular cup/Ribbed stem，Link） more than one years were chosen and followed in the study. Periprosthetic and contralateral bone mineral density（BMD） in seven Gruen zones was measured with dual energy X-ray absorptiometry（DEXA）. These data were ana－lyzed subsequently using SPSS software. Results：Twenty-eight patients who underwent THA during April 2010 and January 2015 with an average follow-up of 35.5 months were included in this study，of which 13 were males and 15 were females，at a mean age of （61.36±9.40） years（range，41-75 years）. Their body mass index was （24.78±2.80） kg/m2. The disease spectrum leading to primary THA consist of vascular necrosis of the femoral head（10 cases），developmental dysplasia of the hip（8 cases），femoral neck fractures （6 cases），and hip osteoarthritis（4 cases）. Periprosthetic BMD changes were most pronounced only in the distal Gruen zone 4[surgi－cal side BMD（1.58±0.28） g/cm2，non-operated control side BMD（1.66±0.20） g/cm2；t=-2.216，P=0.035]，and no significant differ－ences were detected when compared with the non-operated control side in other Gruen zones. Conclusion：The Ribbed anatomic cementless femoral stem contributes to periprosthetic bone ingrowth in patients undergoing THA，proximal load transfer comparatively approximates normal bio-stress，the features of which are well worth learning from in the future.

Abstract:Objectives：To acknowledge the patient reported outcomes of total hip arthroplasty 3 months after surgery and analyze the influencing factors. Methods：The cross-sectional study was adopted to select the patients undergoing total hip arthroplasty from May 2016 to October 2016. The “Simplified Chinese version of Hip dysfunction and Osteoarthritis Outcome Score” was used to measure the patient reported outcomes. And then the possible influencing factors，such as individual characteristics were analyzed，for which，the data input was done with Excel，statistical analysis with SPSS 19.0，single factor analysis with t test and multi-factor analysis with multiple linear regression. Results：A total of 326 patients were enrolled in the study and the score of patient reported outcomes was （372.05±54.79） 3 months after surgery. The multiple linear regression analysis found that the influencing factors included the post－operative satisfaction of therapeutic effects（β=58.837，95%CI=54.773 to 61.958，P=0.000），age（β=-0.928，95%CI=-0.992 to -0.575，P=0.000），compliance（β=9.749，95%CI=6.008 to 11.827，P=0.000），postoperative complication（β=-13.968，95%CI=-17.211 to -8.123，P=0.000），the patient reported outcomes score at discharge（β=0.174，95%CI=0.064 to 0.224，P=0.002），unplanned readmission（β=-27.514，95%CI=-37.446 to -17.702，P=0.002），the degree of preoperative pain（β=-1.506，95%CI=-2.368 to -0.639，P=0.034） and preoperative expectations for recovery time（β=1.905，95%CI=1.257 to 3.347，P=0.036）. And the determination coefficient of regression equation was R2=0.661. Conclusion：The high attention should be paid to the patients with severe preoperative pain，older ages，high preoperative expectation，postoperative complication，dissatisfaction with therapeutic effects，unplanned readmission，and the lower patient reported outcomes score at discharge. And the ef－fective intervention for these patients while in hospital and the continued care after discharge should be strengthened.

Abstract:Objectives：To acknowledge the patient reported outcomes of total hip arthroplasty 3 months after surgery and analyze the influencing factors. Methods：The cross-sectional study was adopted to select the patients undergoing total hip arthroplasty from May 2016 to October 2016. The “Simplified Chinese version of Hip dysfunction and Osteoarthritis Outcome Score” was used to measure the patient reported outcomes. And then the possible influencing factors，such as individual characteristics were analyzed，for which，the data input was done with Excel，statistical analysis with SPSS 19.0，single factor analysis with t test and multi-factor analysis with multiple linear regression. Results：A total of 326 patients were enrolled in the study and the score of patient reported outcomes was （372.05±54.79） 3 months after surgery. The multiple linear regression analysis found that the influencing factors included the post－operative satisfaction of therapeutic effects（β=58.837，95%CI=54.773 to 61.958，P=0.000），age（β=-0.928，95%CI=-0.992 to -0.575，P=0.000），compliance（β=9.749，95%CI=6.008 to 11.827，P=0.000），postoperative complication（β=-13.968，95%CI=-17.211 to -8.123，P=0.000），the patient reported outcomes score at discharge（β=0.174，95%CI=0.064 to 0.224，P=0.002），unplanned readmission（β=-27.514，95%CI=-37.446 to -17.702，P=0.002），the degree of preoperative pain（β=-1.506，95%CI=-2.368 to -0.639，P=0.034） and preoperative expectations for recovery time（β=1.905，95%CI=1.257 to 3.347，P=0.036）. And the determination coefficient of regression equation was R2=0.661. Conclusion：The high attention should be paid to the patients with severe preoperative pain，older ages，high preoperative expectation，postoperative complication，dissatisfaction with therapeutic effects，unplanned readmission，and the lower patient reported outcomes score at discharge. And the ef－fective intervention for these patients while in hospital and the continued care after discharge should be strengthened.University and Chongqing Hospital of Traditional Chinese Medicine from 2015 to 2017 were enrolled and randomly divided into early goal-directed therapy（EGDT） group with 28 patients and EVLW+P（cv-a）CO2/C（a-cv）O2 group with 22 patients（P/C group）. Mean arterial pressure（MAP），heart rate（HR），and central venous pressure（CVP） were con－tinuously monitored for all patients，and arterial blood samples and central venous blood samples were collected for blood gas analysis to measure PaCO2，PcvCO2，PcvO2，ScvO2，Hbcv，PaO2，SaO2，Hba，and blood lactate at the time of ICU admission and at 6 hours after resuscitation. P（cv-a）CO2/C（a-cv）O2 was calculated；CaO2=1.34×Hba×SaO2+0.003×PaO2，CcvO2=1.34×Hbcv× ScvO2+0.003×PcvO2，and C（a-cv）O2=CaO2-CcvO2. For patients in the P/C group，extravascular lung water（EVLW） was measured by pulse-induced contour cardiac output（PiCCO），once every 3 hours，and the mean value of three consecutive measurements was recorded. Lactate clearance rate was calculated according to the following equation：lactate clearance rate=（blood lactate value at the time of ICU admission-blood lactate value at 6 hours after resuscitation）/blood lactate value at the time of ICU admission×100%. The dose of the vasoactive agent norepinephrine within 6 hours after resuscitation was compared between the two groups. The 28-day mortality rate was calculated. Related indices after fluid resuscitation were compared between the two groups. Results：There were no significant differences between the two groups in MAP，ScvO2，and the proportion of patients achieving EGDT target at 6 hours after fluid resus－citation（P>0.05）. Compared with the EGDT group，the P/C group had significantly higher lactate clearance rate at 6 hours after fluid resuscitation and urine volume per hour（P<0.05），as well as significantly lower resuscitation fluid volume，CVP，P（cv-a）CO2/C（a-cv）O2，and dose of vasoactive agent（P<0.05）. There was no significant difference in 28-day mortality rate between the two groups（P>0.05）. Conclusion：EVLW combined with P（cv-a）CO2/C（a-cv）O2 can be used to guide EGDT for septic shock. It can accurately evaluate tissue perfusion and volume load in patients with septic shock as early as possible and guide the rational use of liquid therapy and vasoactive drugs in clinical practice.

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