【Objective】To investigate the therapeutic effect of Turbidity-resolving and Stasis-removing Prescription(TSP) for the treatment of nonalcoholic fatty liver disease(NFLD).【Methods】One hundred and thirteen NFLD patients were randomized into groups A and B according to their consulting order.Group A(N=61) received oral use of TSP 100 mL,bid,and group B(N=52) received oral use of ursodesoxycholic acid(UDCA) 150 mg,tid.The treatment lasted 2 months.【Results】The total effective rate was 85.2% in group A,superior to 51.9% in group B (P

Objective To analyze the factors related to glare occurred after the phakic intraocular lens (P-IOL) implantation,and to raise the standard for the P-IOL selection.Design Retrospective case series.Participants 104 patients with high myopia underwent P-IOL implantation in Beijing Tongren Hospital.Methods In 104 cases,22 cases (22 eyes) were implanted angle supported Phakic6 designed accord with corneal symmetry,54 cases (54 eyes) were implanted iris fixed Verisyse,and 28 cases (28 eyes) were implanted posterior chamber PRL.Selection of the diameter of P-IOL optics depended on P-IOL diopters.The pupil diameter,the P-IOL optic center position,the pupil and corneal center position were measured with anterior segment optical coherence tomography (OCT).The contrast sensitivity (CS) under different condition (day,day and glare,night,night and glare) and in different space frequency (1.5,3,6, 12,18c/d)were examined with Optec6500 system.Main Outcome Measures Glare incidence,CS,and the influence of pupil diameter and P-IOL location to glare.Results None of the 104 P-IOL eyes occurred glare in day time.59 eyes (56.73%) complained of glare in dime condition.The glare incidence was 63.18% (14/22) in Phakic6 eyes,55.56% (30/54) in Verisyse eyes,and 53.27% (15/28) in PRL eyes (P=0.691).CS of all surgical eyes were improved in day time with or without glare luminous environment (P=0.000).And the CS of halo-complaining eyes was lower than of no halo eyes in night time with or without glare luminous environment (P=0.000).Glare oc- curred more frequently in eyes with the pupil diameter larger than P-IOL diameter in clime condition after surgery (10 in Phakic6 eyes, 20 in Verisyse eyes,12 in PRL eyes,all P

Objective:To utilize MRI and plain films to observe the changes of soft tissue structures in patients with developmental dysplasia of the hip (DDH) after closed reduction, and explore the concentric reduction rate, the "docking" rate and the femoral head necrosis rate after reduction.Methods:Retrospective analysis of unilateral completely dislocated DDH patients with closed reduction and spica casting in our hospital from October 2012 to July 2018. MRI was performed on the day of closed reduction and every 2-3 months after operation. Pelvic plain films were performed before operation and follow-up. The labro-chondral complex (LCC) of the hip was divided into 4 types on MRI images, and the reliability and repeatability of LCC classification were evaluated by intra-class correlation coefficient. Trend chi-square test or Fisher exact probability method was used to analyze the variation of thickening rate of ligamentum teres, transverse ligaments and pulvinar during MRI follow-up, and the difference of cartilaginous acetabular head index was evaluated by analysis of variance of repeated measurements or Mann-Whitney U test. The concentric reduction rate of the femoral head after performing closed reduction, the "docking" rate of the femoral headwhen the cast was changed for the last time were analyzed, and the necrosis rate of the femoral head were followed up for 18 months or more after reduction.Results:A total of 63 DDH patients (63 hips) with closed reduction were included. Intra-class correlation coefficient of LCC classification was 0.84 between observers (95%CI: 0.74-0.91) and 0.94 within observers (95%CI: 0.90-0.97) . Most LCC classifications were type 4 on the day of CR (93.7%, 59/63) , and return to normal (type 1 classifications) at the second follow-up (50.9%, 28/55). ligamentum teres, transverse ligaments and pulvinar were hypertrophic (94.5%-100%) on the day of CR, and decreased to 10.9%-12.7% at the second follow-up, which had statistically differences ( χ2=88.6; χ2=86.4; χ2=97.9, P<0.05). The cartilaginous acetabular head index was 68.1±12.1 on the day of CR, and increased to 84.4±7.0 at the second follow-up, which had statistically difference ( Z=-3.15, P=0.002). 58.7% femoral heads were "docking", 8.6% femoral head had necrosis. Conclusion:The abnormal soft tissue structures in the hip joint mostly recovered gradually after closed reduction, and 60% femoral heads could be docked, the short-term risk of the femoral head necrosis was low.

Objective To find the optimal route of eontralateral C7 nerve transfer for brachial plexus avulsion injuries through autopsy. Methods The bilateral brachial plexus were exposed on 30 sides of 15 cadaverie specimens of adult. The C7 nerve root was sectioned at the junction site of trunk and division, and then dissected proximally to the foramina. The max length of anterior and posterior division of C7 was measured. The distance between the roof of C7 and the upper trunk and the lower trunk at the affected side through vertebral body route, prespinal route and a subcutaneous tunnel on the anterior surface of the neck was measured. Results The max length of anterior and posterior division of C7 was (7.67±1.06) cm and (7.79±1.36) cm respectively. The distance between the roof of C7 and the upper trunk at the affected side through vertebral body route, prespinal route and a subcutaneous tunnel on the anterior surface of the neck was (6.97±0.56) cm and (10.04±0.94) cm and (16.56±1.24) cm respectively, there were statistical significance among them (P < 0.01). The distance between the roof of C7 and the lower trunk at the affected side through vertebral body route and prespinal route and a subcutaneous tunnel on the anterior surface of the neck was (6.82±0.92) cm、(9.91±0. 83) cm and (17.64±0.97) cm, with a significant difference (P<0.01). Conclusion The best way of contralateral C7 nerve transfer for the treatment of brachial plexus injury was through the vertebral body route from the point of anatomy.

AIM: To study the effects of over-expression of tricarboxylic acid cycle intermediates transporter NaDC3 (high affinity sodium-dependent dicarboxylate transporter) on energy metabolism and ROS generation in human renal tubular cells. METHODS: Recombinant retrovirus vector containing NaDC3 gene was constructed and used for infecting human renal tubular epithelial cell HKC. Control vector containing Neo gene was also constructed and infected cells. Liquid scintillation method was used to determine the level of [~3H]-succinate (as a transport substrate of NaDC3) in the cells. Clark electrode method and reverse phase HPLC were used to detect oxygen consumption and ATP content intracellularly, respectively. Mitochondrial membrane potential and reactive oxygen species (ROS) content in HKC were determined with laser confocal microscope after treatment with fluorescent probe JC-1 and CM-H_2DCFDA, respectively. RESULTS: Western blotting analysis showed that the expression of NaDC3 protein in uninfected- and control vector-infected cells was at lower level. After infection with recombinant NaDC3 vector, expression level of NaDC3 protein in HKC cells was increased markedly. Transport assay revealed that the level of [~3H]-succinate in NaDC3-infected cells was noticeably increased. Oxygen consumption and ATP content in NaDC3-infected HKC were significantly higher than those in uninfected- and control vector-infected cells. Laser confocal analysis revealed that mitochondrial membrane potential and ROS level in NaDC3-infected HKC were increased, compared with uninfected- and control vector-infected cells. CONCLUSION: Over-expression of NaDC3 accelerates the speed rate of energy metabolism and increases intracellular ROS generation by transporting an overdose of tricarboxylic acid cycle intermediates in human renal tubular epithelial cells.

Objective To evaluate the outcome of Titanium Elatic Intramedullary Nail (TEINs) for treatment of lengthunstable femoral shaft fracture of children.Methods Retrospectively analyze the data of total of 21 children with length-unstable femoral shaft fractures,from December 2011 to June 2014,were treated with TEINs and end caps.This study involved 15 boys and 6 girls,with age ranged from 5 years and 6 months to 10 years and 10 months,whose average age was 7 years and 5 months.Firstly children were treated with traction for 3-7 days,with traction weight of 1/4 to 1/6 of the weight.After that,shortening and angular deformity were significantly corrected.Then surgeries of close reduction and internal fixation with TEINs were done in general anesthesia.TEINs were supported with double nail C shape.The lateral tip of TEIN located near the epiphyseal plate of greater trochanter,and the medial tip near the epiphyseal plate of femur head.Cut the tail of TEINs,set and screw the end caps into cortex,keeping the tail of TEINs and fracture fixed.Spica casting was used for 4 weeks after operation.The last follow-up time was 2 years,and the follow up results were analyzed.Results 21 children were followed up ranged from 22 to 26 months,with the mean follow up 23.4 months.Remove the spica casting and bear loading at 4 weeks after operation.All fractures healed,with healing time of 5 to 8 weeks (an average of 6.2 weeks).At the last follow-up,the limb force line was good with no angular deformity.Femur overgrew 4.2-21.1 mm,with an average of 6.1 mm.At the last follow-up,the patients were evaluated with Harris score,and the excellent and good rate was 100％.No case of TEINs push-out,limited hip mobility,fracture nonunion,delayed healing or other complications was found.Only 1 case got a mild lameness.All parents were satisfied with their outcome.Conclution TEINs and end caps are effective methods for the length-unstable femoral shaft fracture in children.These results indicated that the risk of TEINs push-out can be reduced.

It is difficult to diagnose and treat local recurrence of the rectal cancer after operation. The early diagnosis is crucial for the recurrence of rectal cancer after operation. MSCT perfusion imaging is valuable in the diagnosis of recurrence of rectal cancer after operation. The application of MSCT perfusion imaging following rectal cancer operation was reviewed in this article.

Objective To evaluate dopamine D2/D3 receptors status in striatal and extra?striatal re?gions with 18 F?Fallypride PET/CT. Methods A total of 11 healthy volunteers ( 4 males, 7 females, age (43.5±13.7) years) underwent PET/CT at 1 h after 18F?Fallypride injection. Imaging data was analyzed u?sing visual and ROI methods. The SUV ratios of different brain regions to cerebellar lobe were calculated. In?formed consent was obtained from all volunteers. The study was approved by the Ethics Committee of the PLA General Hospital. Results 18 F?Fallypride was widely distributed in striatal and extra?striatal brain re?gions. Distribution of 18 F?Fallypride was consistent in all healthy subjects and the rank order of receptor con?centration(brain region SUV/cerebellum SUV) was putamen(15.72±3.69)>pituitary(10.24±6.55)>cau?date(8.38±1.26)>amygdala(6.92±1.32)>thalamus(4.87±1.50)>colliculi(3.91±1.08)>substantia nigra (3.20±0.95)>cortex(temporal cortex: 2.11±1.34, parietal cortex: 1.51±0.57, occipital cortex: 1.31± 0?11, frontal cortex:1?30±0.25). Conclusion 18F?Fallypride PET/CT is suitable to study D2/D3 recep?tors status in striatal and extra?striatal brain regions.

Objective To compare the early treatment results of Pavlik harness and closed reduction plus spica cast?ing in treating developmental dislocation of the hips (DDH). Methods The patients with GrafⅢ/Ⅳtype DDH diagnosed by ul?trasound in our hospital were analyzed retrospectively from January 2009 to December 2013. The subjects with intact clinical and radiologic data and more than 2 years follow?up were included. The present study included 257 patients (298 hips), 31 male and 226 female, with the average age of 74.1±39.2 d (from 30 to 159 d). Pavlik harness underwent in 190, while 67 cases were treated with closed reduction plus spica casting. Acetabular index (AI), Wiberg OE angle (point O was the middle point of proximal me?taphyseal border) and Smith instability index (SI, SI?c:the lateral displacement index, SI?h:the vertical displacement index) on the pelvic X?ray film at 2-3 years of age after successful early treatment were recorded. Femoral head avascular necrosis (AVN) was diagnosed according to the Salter criteria. Results The success rate of reduction of closed reduction was significantly higher than Pavlik harness (97.5% vs. 69.9%, χ2=0.353, P=0.000). There was no significant difference in the incidence of AVN be?tween the closed reduction and Pavlik harness (6.6% vs. 4.6%, χ2=0.106, P=0.745). For GrafⅢ type DDH, the success rate of reduction of Pavlik harness and closed reduction were 80.7% and 98.4% respectively (χ2=11.248, P=0.001), while the Pavlik harness group had significantly worse results of AI, OE and SI?c at the age of 2-3 years (Pavlik harness: 22.9°±3.7°, 16.5°± 6.3° and 0.74 ± 0.06; closed reduction: 21.4° ± 3.4° , 18.9° ± 3.6° and 0.72 ± 0.03; P<0.05). For GrafⅣ type DDH, the success rate of reduction of Pavlik harness was much less than closed reduction (25.6% vs. 94.4%, χ2=24.231, P=0.001), with signifi?cantly worse results of OE at the age of 2-3 years (16.0°±4.1° vs. 18.6°±4.5°, t=-2.141, P=0.038). Conclusion Pavlik har?ness has limitations in treating GrafⅢ/Ⅳtype DDH, with lower success rate of reduction for GrafⅣtype DDH. Closed reduction plus spica casting has better clinical results than Pavlik harness in success rate of reduction and subsequent hip development with? out the additional risk of AVN.

BACKGROUND:Skin transplantation is regarded as the most effective therapy for large-area skin defects, which is limited by donor sources and immune rejection. Therefore, it is extremely accelerate the construction of the dermis in skin tissue engineering.
OBJECTIVE:To investigate the effects of bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane on the repair of ful-thickness skin defects.
METHODS:Bone marrow mesenchymal stem cels were isolated from 15 New Zealand rabbits, and then cultured, amplified, subcultured and purified. Three ful-thickness skin defects were made on the back of every rabbit, and randomly treated with bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane as experimental group, bone marrow mesenchymal stem cels/calcium alginate gel as control 1 group, and calcium alginate gel as control 2 group. The wounds were al covered with amniotic membrane. After 7, 14, 21 days, new wound tissues were taken for hematoxylin-eosin staining, immunohistochemistry staining and image analysis.
RESULTS AND CONCLUSION: Dermis tissues in the experimental group were obviously thicker than those in control 1 and control 2 groups; there were more fibroblasts, vessels and colagen fibers in the experimental group. Especialy at 14 and 21 days after operation, epidermal hyperplasia was faster with a larger coverage area in the experimental group, and at 21 days, the new epidermal tissues mainly exhibited multi-layered structure, which was superior to the control 1 and 2 groups. It folows that the combination of bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane for skin defects can accelerate the repair and regeneration of the dermis, and thus promote the epidermis regeneration and reconstruction.