Objective To assess the effectiveness of Exenatide on non‐alcoholic fatty liver disease(NAFLD) with diabetes mellitus by evaluating fatty liver index(FLI) variation .Methods One hundred and two NAFLD patients with type 2 diabetes melli‐tus were enrolled and divided into two groups .One group were treated with Exenatide and another with Oral antidiabetic agents . The data of BMI ,blood fat ,HbA1c ,ALT ,AST ,GGT ,FLI and so on were collected at enrollment and the end point of 24 weeks treatment .The effectiveness of Exenatide were analysed by Kolmogorov‐Smirnov and Pearson correlation coefficient (r) analysis . Results The indicators of metabolic disorder ,the parameters of liver biochemistry and fatty liver disease (FLI) were significantly improved (P<0 .05) after 24 weeks treatment by Exenatide .While only BMI showed significant decrease after 24 weeks treatment with Oral antidiabetic agents(P<0 .05) .The rest of the parameters in oral antidiabetic agants group showed no significant differ‐ence (P>0 .05) .Conclusion Exenatide has a positive effect on non‐alcoholic fatty liver disease treatment who with type 2 diabetes mellitus ,especially for liver fat accumulation .

ObjectiveTo investigate the efficacy of acupoint application with direct current in treating ankylosing spondylitis. MethodA clinical controlled trial was carried out. Sixty patients were randomly allocated to two groups. The treatment group was given acupoint application with direct current plus sulfasalazine and the control group, sulfasalazine alone. The course of treatment was two months. Inflammation indices, and the SF-36 health survey, BASDI, BASFI, night pain VAS and spinal pain VAS scores, and liver and kidney functions were observed in the patients before and after treatment.ResultInflammation indices, and the SF-36 health survey, BASDI, BASFI, night pain VAS and spinal pain VAS scores took a turn for the better in both groups after treatment. The therapeutic effect was better and the TCM symptom score was lowerin the treatment group than in the control group (P<0.05). ConclusionAcupoint application with direct current for treating winter diseases in summer has a therapeutic effect on ankylosing spondylitis.

Objective To investigate the association between Down's syndrome(DS) and congenital heart diseases(CHD).Methods A total of 575 cases with DS from Jan.1997 to Mar.2013 in Children's Hospital of Chongqing Medical University were recruited.Retrospective study was conducted to analyze the prevalence and types of CHD in DS children,the relationship between the karyotype of DS and the types of CHD,and pulmonary hypertension (PH) and operation treatment.Results There were 370 cases(64.35％,370/575 cases) with CHD in 575 cases with DS.Among the 370 cases of CHD,322 cases (87.03 ％) were septal defects.In which,57 cases (15.41％) were atrial septal defects,36 cases (9.72％) were ventricular septal defects,12 cases (3.24％) were atrioventricular septal defects,and 157 cases(47.30％) were complex septal defects.Forty-eight cases(12.97％,48/370 cases) were nonseptal defect types of CHD (including patent ductus arteriosus,tetralogy of Fallot,double outlet right ventricle,pulmonary atresia,and so on).There was no statistical significance between the karyotype of DS and the types of CHD.There were 246 cases(66.49％,246/370 cases) with PH.Seventy cases(18.92％,70/370 cases) had interventional or surgical operations.All of them had descending pulmonary artery pressure after operation.Forty cases had other malformations such as gastrointestinal tract malformation,polydactylism / polydactyly,visual impairment,and so on.Conclusions The most common type of CHD with DS was atrial septal defect,and the second one was ventricular septal defect.There was no relationship between the karyotype of DS and the types of CHD.The patients with CHD in DS were prone to develop PH.So the comprehensive treatment plan should be developed as early as possible.

Potential pathogenesis is defined a pathology linking without corresponding symptoms, but as a part of pathogenesis which has important affects on the formation and development of main syndrome. The proposal of potential pathogenesis is a supplement of traditional pathogenesis theory, and has practical signifi cance to the improvement of syndrome pathogenesis theory and raise of the level of determination of treatment based on differentiation of symptoms and sign. Potential pathogenesis has characteristic of logicality, reality and provability. We can understand the relationship between the evaluation of modern medical laboratory and disease sydrome, the principle of batch formula and the skill of medicines compatibility with the potential pathogenesis theory. The explication of potential pathogenesis theory will promote the in-depth exploration of disease syndrome and pathogenesis.

Objective To explore the clinical indication and operative methods for different upper eyelid aging through perieyebrow incision.Methods We collected totally one hundred fifty-two cases in this study,including six males and 146 females,and aged from 26 to 80 years (average 47).There were 29 cases with only ptosis of upper eyelid,and the rest 123 cases were ptosis of upper eyelid with ptosis of eyebrow,sunken upper eyelid,bloated upper eyelid,or over-wide between eyebrow and eye region (compensatory eyebrow elevation).Through the incision of upper or lower margin of eyebrow,we treated these five types of upper eyelid aging by excision of redundant skin,orbicularis oculi muscle,frontal muscle,ROOF,or orbital fat,or ROOF elevation for upper eyelid rejuvenation.Results Patients were followed up for 3 to 120 months,with average 14.4 months.All ptosis of upper eyelid and over-wide between eyebrow and eye region patients were improved obviously.In 36 ptosis of upper eyelid with ptosis of eyebrow,seven of them treated with upper eyebrow margin incision got the best results;and the rest 29 patients treated with lower eyebrow margin incision,fifteen patients were lifted slightly,and the rest fourteen patients got no improvement.All scars of inferior eyebrow margin incision were invisible.Faded and applanate one millimeter wide scars were seen on two patients with superior eyebrow margin incision.In all patients with ptosis of upper eyelid,80％ patients with sunken upper eyelid were improved obviously,and 85 ％ with bloated upper eyelid were improved significantly.Conclusions Upper eyelid aging is divided into five categories.Upper eyelid aging could be corrected by perieyebrow approach.Our methods are simple,safe,fewer complications,and with short convalescence,which is the minimally invasive procedure recommended for Chinese patients with upper eyelid aging.

ObjectiveTo avoid the complications such as scar,alopecie,scalp numbness,hematoma etc,resulted from the conventional coronal incision rhytidectomy,and to explore and solve the issues about endoscopic frontal and temporal rhytidectomy.MethodsThrough 3-5 short incisions in hairline,we dissected under frontal periosteum or gales aponeurotica and in superficial layer of deep temporal fascia.The frontal and temporal cavitites were feedthrough at temporal crest.The corrugator supercilii muscle,superciliary depressor muscle,frontal muscle and orbicularis oculi were treated.Sufficient dissection was done under the periosteum of os orbitale.ResultsThis method had been applied in 186 patients with forehead lift.After operation,transient paralysis of facial nerve frontal branch were found in 3 patients.The depression of glabellum and lateral canthus were found in 5 patients.The depressions were corrected by autologous fat injection. Other 178 patients' results were satisfactory.ConclusionsEndoscopic frontal and temporal rhytidectomy has some advantages,such as minute invasion,less hemorrhage,few complications,and stable operation result,etc.Compared to the conventional coronal incision rhytidectomy,this method will be used more widely.

Objective To evaluate and compare the safety and advantage of different kinds of electrode system (monopolar and plasmakinetic techniques) in transcervical resection of myoma (TCRM). Methods A total of 60 patients undergoing TCRM were enrolled. Serum sodium (Na~+), chlorine (Cl~-), potassium (K+) and glucose (Glu) were measured before and after the operation. Meanwhile, the operation time, absorption volume and bleeding volume were also recorded after the operation. Results ① There were significant decreases in Na~+, Cl~-, K~+ and Glu concentrations in the monopolar group (P<0.05), but Glu increased significantly (P<0.05). Na~+, Cl~-, K~+ and Glu concentrations in plasmakinetic group, however, did not change significantly before and after the operation (P>0.05). ② After the operation, there were significant differences between the two groups in Na~+, Cl~- and Glu changes (P<0.05). The absorption volume and volume of bleeding during the operation were increased in monopolar group compared with those in plasmakinetic group (P<0.05). ③ In monopolar group, Na~+, Cl~- and Glu concentrations, the operation time, absorption volume and volume of bleeding were significantly higher in patients with type Ⅱ myoma than in those with type Ⅰ and 0. In plasmakinetic group, the operation time, absorption volume and volume of bleeding were significantly increased in type Ⅱ myoma patients. No significant difference was observed of Na~+, Cl~- and Glu concentrations between patients with the three types of myoma (P>0.05). Conclusion Plasmakinetic technique is superior to monopolar one in that it does not cause obvious changes in blood electrolytes and glucose and there is less bleeding during the operation. Myoma type has a greater effect on the absorption volume, operation time and volume of bleeding during operation, which are increased in type Ⅱ myoma than in type 0 and 1.

OBJECTIVE:To find out the main problems about quality supervision over Chinese herbal pieces and effective su-pervision strategies. MEDTHODS:First,static and dynamic models of the game between the enterprises engaged in the production and business of Chinese herbal pieces and local food and drug administration were respectively established,to which pure strategy Nash equilibrium analysis and mixed strategy Nash equilibrium analysis were made. Next,the model of the game between the supe-rior regulatory authorities and the basic-level regulatory authorities was established,to which mixed strategy analysis was made to find out the supervision factors relevant to the quality safety of Chinese herbal pieces. RESULTS & CONCLUSIONS:Based on the current situation of quality supervision over Chinese herbal pieces and the analysis results of the game models,it is suggested that at present the Chinese herbal medicine regulatory authorities of China should work hard to promote the reform of the supervision system,reduce supervision cost(including the guidance of the large-scale and centralized production of Chinese medicinal materi-als and unified appliance of approval number to the administration of Chinese herbal pieces),establish a systematic and comprehen-sive system of rewards and punishments,create a professional supervisor staff(including the strengthening of basic-level supervisor staff creation and the improvement of personnel's quality,the standardization of the law enforcement of regulatory authorities and the combination of proper power delegation to lower levels and strict supervision),and balance the relationship between the govern-ment and the public in supervision to increase the public's awareness of responsibility.

Objective To study the clinical diagnosis of pulmonary sarcoidosis,in order to improve the diagnostic accuracy.Methods The clinical data of 20 patients with pulmonaty sarcoidosis was retrospectively analyzed .Results There were 7 males and 13 females in this group with 20 patients age 14～63 years old mean 41 6 years,main symptom was cough(n=16),wet cough(n=8),hard breathing(n=6),fever(n=6),erythema(n=4),visual change(n=3),fatigue(n=2),headache(n=1),X-ray and CT examination results were as followes:bilateral hilar hilifuge larger than normal 19 cases,single hilifuge larger than normal 1 cases,mediastinal lymphadenectasis 12 cases,interstial pulmonary fibrosis 6 cases,bilateral little quantity pleural effusion 3 cases.Bronchofiberoscopy diagnosis in 14 cases,live tissue examination of skin,mucosa and lymph node in 8 cases,Kveim test positive 3 cases,SACE 69 8?12 6?/L.Conclusions Clincal symptom of pulmonary sarcoidosis was not typical,high morbidity was occured among females.In combination of clinical symptom,X-ray examination and bronchofiberoscopy pathologic examination was required to improve diagnosis rate.The therapy of adrenocortical hormone could acquire good efficacy.