Nonsyndromic cleft of lip with or without palate ( NSCL/P ) is one of the most common congenital birth defects in the maxillofacial region and it is related to genetic factors and environment .Folic acid deficiency , metabolic disorder and the genetic polymorphisms of key metabolic enzymes may be the important factors contributing to NSCL /P .Maternal folic acid intake may reduce the risk of non syndrome cleft lip and palate .This article will review the relationship among the metabolism of folic acid , the genetic polymorphisms of key enzymes in folate metabolism and NSCL /P .

Objective To investigate the effect of methylprednisolone pulse therapy on spinal nerve functions in patients with acute spinal cord injury (ASCI) and evaluate its safety. Methods 200 patients with ASCI treated in our hospital from January 2010 to December 2016 were selected and were randomly divided into two groups,with 100 cases each group. The patients in control group were treated with routine basic treatment while patients in the study group were treated with methylprednisolone pulse therapy. On the basis of the American spinal cord injury Society scoring criteria (ASIA), the neurological functional recovery scores were performed were scored before and 6 weeks after treatment between the two groups and the adverse reactions were recorded. Results The scores of sensory and motor function of the patients in the two groups were higher than those before the treatment and there was statistical difference (P<0.05), and the scores in the study group was significantly higher than those in the control group, and the difference between the two grouPs was statistically significant (P<0.05). The incidence of adverse reactions in the study group (25.00％) was significantly higher than that in the control group (10.00％), and the difference was statistically significant (P<0.05). The incidence of lung infection and gastrointestinal reaction in the study group were significantly higher than those in the control group and there were statistical difference (P<0.05). Conclusion Methylprednisolone pulse therapy has significant effect on the recovery of neurological function in patients with ASCI, but the incidence of adverse reactions is high, so it is necessary to strengthen the monitoring and intervention in clinic.

Objective To measure the fractional anisotropy(FA) values in the language function areas(Broca area,Wernicke area and arcuate fasciculus)by diffusion tensor imaging(DTI),discussing the pathological characteristics in cerebral palsy children with language development delay.Methods DTI was performed in twenty-seven cerebral palsy children with language development delay(observation group) and 20 children with febrile seizures(control group) by Philips 3.0T MRI scanner.The FA values of Broca area,Wernicke area and arcuate fasciculus were measured at Philips Workstation.Results The FA values of control group in the left Broca area,Wernicke area and arcuate fasciculusis were higher than those of the right side,and the difference was statistically significant (all P ＜ 0.05).The FA value of observation group in the left Broca area was lower than that of the right side,and the difference was statistically significant (P ＜ 0.05);the FA values of observation group in the left Wernick area and arcuate fasciculusis were higher than those of the right side,but the difference was not statistically significance (all P ＞ 0.05).The FA values in the bilateral Broca area and arcuate fasciculusis of observation group were lower than those of the control group,the difference was statistically significant (P ＜ 0.05),those in the bilateral Wernick area were also lower than the control group,but the difference was not statistically significant (P ＞ 0.05).Conclusions The main pathogenesis for language development delay in cerebral palsy children was extensive damage in language functional areas,and Broca area and arcuate fasciculus were markedly impaired than Wernick area.

Background The visual evoked potential (VEP) is an important functional index to assess visual cortex plasticity.Monocular form deprivation(MD) of rat is a classic model to study visual cortex plasticity change.Utilizing VEP technique record the shift of ocular dominance in adult rats model is of an important significance for explore the treating opportunities of amblyopia.Objective The present study was to observe the pattern VEP changes in different ages of Long-Evens rats and the adult rats after binocular form deprivation.Methods Thirty-six healthy SPF Long-Evens rats were divided into PW3,PW4,PW5,PW6 groups according to the postnatal weeks,and PW7 rats included 36 SPF Long-Evens rats.The left eye lids of the rats were sutured in PW3,PW6 and PW7 rats for 3,5,7 days respectively,and PVEP in both left and right eye were recorded to assess the rat age that visual cortex plasticity ended.Bilateral PVEP were recorded in PW7 rats,and the bilateral eyelids were sutured to establish the bilateral form deprivation models.The right eyes were opened in 7,10,14 days,and the left eyes were opened in the next 3,5,7 days respectively and the PVEPs were recorded again to find the shift of ocular dominance and whether binocular form deprivation induce the visual cortex plasticity in adult rats.Results The P100amplitudes of the left eyes were gradually declined and those of the right eyes were raised from 3 to 7 days after MD of the left eyes in rats of PW3 group in comparison with before MD ( P＜0.01 ).In PW6 groups,no significant changes in P100amplitudes of both the right and left eyes were found in the third day after MD,but significant raise in the right eyes and lowing in the left eyes were seen in the 5 and 7 days after MD in comparison with before MD(P＜0.01 ).No any P100changes in both eyes were found in 3-7 days after MD compared with before MD in PW7 rats (P＞0.05).The C/I ratio (contralateral VEP amplitude to ipsilateral VEP amplitude in occluded eyes) in the rats of PW3,PW4 and PW5 groups were 1.07±0.15,1.16±0.16 and 1.14±0.15 respectively in 3 days after MD,showing the significant lowing in comparison with before MD (2.69±0.45,2.58±0.4,2.62±0.32) (P＜0.01),but those of PW6 and PW7 were unchanged (2.80±0.48 vs 2.90±0.46,2.59 ±0.36 vs 2.90±0.46,P＞0.05 ),indicating the absence of ocular dominance plasticity in the adult rats.In rats of PW7 with binocular form deprivation for 14 days,a significant decrease was observed in the C/I ratio in rats with next MD for 3 days,demonstrating that the visual cortex plasticity was reactivated after 14 days of binocular form deprivation in PW7 rats( 1.33±0.18 vs 2.70±0.45,P＜0.01 ).Conclusions PVEP can be recorded in Long-Evens rats.It is a major index for identifying the shift of ocular dominance in the Long-Evens rats.Binocular form deprivation can reflect the visual cortex plasticity in the adult rats.

AIM: To observe the clinical effect of amniotic membrane transplantation and penetrating keratoplasty in the treatment of atheromatous corneal ulcer.
METHODS: Thirteen patients ( 13 eyes ) diagnosed atheromatous corneal ulcer from February 2009 to May 2014 in our hospital were retrospectively analyzed. Surgical treatment including amniotic membrane transplantation and penetrating keratoplasty were used to deal the patients with no effects of drugs. All patients were followed up for 4mo to 2a ( mean 8mo ) after surgery. Visual acuity, healing and recipient of ulcer were examined.
RESULTS:There patients were treated conservatively with corneal ulcer slowly healing, healing time was 14~35 ( 21±12. 1 ) d. Seven cases were treated with amniotic membrane transplantation, 2 cases were treated with penetrating keratoplasty, 1 case of corneal ulcer perforation and lost light perception received enucleation of eyeball. Corneal ulcer were cured in patients performed amniotic membrane transplantation and penetrating keratoplasty. All patients had no recurrence during the follow-up period.
CONCLUSION:Atheromatous corneal ulcer is difficult to be cured by conservative treatment. Most patients need operation treatment. Amniotic membrane transplantation and penetrating keratoplasty can be performed to deal with atheromatous corneal ulcer and abtain satisfactory effect. But amniotic membrane transplantation is relatively simple and easy, and it is suitable for promotion in primary hospitals.

AIM: To investigate the preliminary clinical observation of excimer laser phototherapeutic keratectomy ( PTK ) assisted by anterior segment optical coherence tomography ( OCT ) in the treatment of non II type granular corneal dystrophy.
METHODS: A retrospective case series were studied. Totally 8 patients ( 12 eyes ) who were diagnosed as granular corneal dystrophy underwent PTK from April 2011 to January 2013 in our hospital. All patients were excluded from the II type granular corneal dystrophy ( Avellino corneal dystrophy ) by the Avellino corneal dystrophy rapid diagnostic kit and underwent preoperative anterior segment OCT examination, so as to determine the lesion morphology and depth, and used to guide the setting of PTK parameters. They were followed up for the complications after operation, postoperative recurrence, the recovery of visual acuity.
RESULTS: All patients were followed up for 6-12mo, average 9mo after operation. All patients' best corrected visual acuity were significantly improved, superficial corneal opacity lesions were effectively removed, and the corneal opacity recurrence or serious Haze were not found during the follow-up period after operation.
CONCLUSION: In patients with non type II granular corneal dystrophy, PTK assisted by anterior segment OCT can be accurate, effective removal of corneal lesions, obtain good effect after operation.

Objective To compare the clinical efficacy and safety of endoscopic papillary balloon dilation (EPBD) and endoscopic papillary balloon dilation (EPBD) combined with small endoscopic sphincterotomy (SEST) in treatment of large choledocholithiasis. Methods 78 patients with large choledocholithiasis from January 2014 to December 2015 were randomly divided into EPBD group, and combination treatment group. The level of bilirubin, transaminase, alkaline phosphatase (ALP) before and after the operation, the success rates of stone removal, serum amylase of 24 h after the operation, the operation times of endoscopic retrograde cholangiopancreatography (ERCP) and whether complicated with postoperative pancreatitis were compared between the two groups. Results There was no significant difference of the success rates of stone removal, serum amylase of 24 h after the operation, the operation times of ERCP between the two groups. The level of bilirubin, transaminase, alkaline phosphatase (ALP) was declined after EPBD or EPBD and SEST, and the results of the two groups had no statistical significance (P > 0.05). Also there was no significant difference of the incidence of postoperative pancreatitis, postoperative bleeding and postoperative hyperamylasemia between the two groups (P > 0.05). Conclusion EPBD is worthy of promoting because it has a similar clinical efficacy and safety to EPBD and SEST in treatment of large choledocholithiasis.

Delicacy management proves a pressing need in cost management of medical service items in the current hospital operation.This paper first covered the methodology and system of hospital costing.It went on to describe the costing for four major medical service items in a quarter in 2011 using the activity-based costing method with the ultrasonographic section of a large hospital as an example.The outcomes were compared to the traditional costing method and the statutory pricing standards,resulting in the proposal and recommendation on reforming the costing methodology of service item pricing,and applying the activity-based costing management of medical service items in the hospital.

Objective To investigate the effects of penehyclidine (PHCD) pretreatment on nuclear factor kappa B ( NF-kB ) activity during lipopolysaccharide ( LPS )-induced acute lung injury ( ALl ) in neonate rats.Methods Thirty 7-day old Wistar rats of both sexes weighing 18-21 g were randomly divided into 3 groups ( n =10 each): group Ⅰ control (group C); group Ⅱ LPS; group Ⅲ PHCD. Group Ⅱ and Ⅲ received intraperitoneal ( group IP) LPS 3 mg/kg. In group Ⅲ PHCD 5 mg/kg was administered IP at 30 min before LPS respectively. The animals were killed at 4 h after LPS administration. The lungs were immediately removed. The W/D lung weight ratio was measured. The TNF-α, IL-1 βand IL-10 content in the lung were detected by ELISA and expression of NF-kB p65 was detected by immuno-histochemical staining.Results LPS significantly increased W/D lung weight ratio, TNF-α, IL-1 β, IL-10 content and NF-kB p65 expression in the lung as compared with control group. PHCD administered before LPS significantly attenuated the LPS-induced changes. Electron microscopy showed that PHCD before LPS significandy ameliorated the LPS-induced histological damages. Conclusion Pretreatment with PHCD can attenuate LPS-induced acute lung injury though inhibition of NF-kB activation and inflammatory response of lung tissue in neonate rats.

Our college has applied French-English analogy-educating method ( trilingual education )to the medicinal French bilingual-educating course by means of the interactions of different languages. As the kin relations between English and French in the axea of medicine, as well as their interactions from the origin to the modem medical applications, it can be an effective method to use analogy-educating method in the French study course in medicine, which means that the multi-lingual interactions can be used in the bilingual, even the multi-lingual educating activities of bilinguai educating process of other subjects.