BACKGROUND:Traditional imaging examinations have lower sensitivity in diagnosing articular cartilage injury, and the effects of biomarkers in body fluid on diagnosing severity of cartilage injury should be evaluated.OBJECTIVE: To investigate the significance of the biomarkers, including cartilage oligomeric matrix protein (COMP), matrix metalloproteinases-1 (MMP-1), matrix metalloproteinases-3 (MMP-3) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), in serum and synovial fluid in evaluating the early sports injury of articular cartilage.DESIGN: A randomized controlled trial.SETTING: the 105 Central Hospital of Chinese PLA.MATERIALS: Eighteen adult male hybrid dogs (15-25 kg, average 22.5 kg) were divided into three groups randomly: ①plain-running group (n =8): the dogs ran on the plain; ② slope-running group (n =8): the dogs ran on the slope of 10°; ③control group (n =2): the dogs could move freely.METHODS: Dogs in the plain-running group and slope-running group were trained daily, rurning for an hour in the morning and in the afternoon respectively(total two hours per day), 4 m/s, and the training lasted for 10 weeks. Serum and synovial fluid were collected on the dayof training, and at the 2nd, 4th, 8th and 10th weeks respectively in both the plain-running group and slope-running group, and the concentrations of COMP,MMP-1, MMP-3, TIMP-1 were detected with ELISA. Standard curves were built by the standard concentrations and A values, according to which corresponding concentrations of specimens were obtained. Knee joint MRI examination was performed, and the training was canceled on the day of examination. All the dogs were killed after 10 weeks, and the knee joint cartilages weight loading region of femur condyles were observed histologically.MAIN OUTCOME MEASURES: Concentrations of COMP, MMP-1, MMP-3, TIMP-1 in serum and synovial fluid on the day of training, and the 2, 4, 6, 8 and 10 weeks in each group; Results of MRI examination of knee joint; Results of the histological observation of knee joint cartilage after 10 weeks.RESULTS: All the 18 dogs were involved in the analysis of results. ① Results of examination in serum. ② Results of examination in synovial fluid: In the slope-running group, the COMP concentrations at 2, 4, 6, 8 and 10 weeks were obviously higher than those in the plain-running group (P ＜ 0.01), MMP-1 concentration at 2, 4 and 6 weeks were higher than those in the plain-running group (P ＜ 0.05-0.01), MMP-3 concentrations at 2, 4, 6 and 8 weeks were higher than those in the plain-running group (P ＜ 0.01);The MMP-3/TIMP-1 ratios at 2, 4 and 8 weeks were higher than those in the plain-running group(P ＜ 0.05-0.01).③ The concentrations of COMP,MMP-1,MMP-3 and TIMP-1 and the MMP-3/TIMP-1 ratio in serum were significantly correlated with the corresponding biomarkers in synovial fluid (r =0.631,0.502, 0.748, 0.651, 0.667, P＜ 0.01). ④ Results of histological observations: In both the plain-running group and slope-running group, obvious pathological changes of articular cartilage injury were observed at 10 weeks, the activity of articular chondrocytes in the surface layer was obviously decreased, which was severer in the latter group than in the former one. ⑤Results of MRI examination: Early sports injury changes of knee joint appeared at 2 weeks, and progressive aggravation occurred in both the plain-running group and slope-running group.CONCLUSION: Repetitive, impacted, torsional, shearing motions with long time and great intensity are easy to induce sports injury,even osteoarthritis.The sensitivity of these biomarkers is better than MRI in reflecting the pathological changes of articular cartilage.

Objective To study the adaptation process and extent of changes in articular cartilage in the canine knee joint to the intensified training, in order to elucidate the influence of different movement training on remodeling and reconstruction of articular cartilage. Methods Twenty adult dogs were randomly divided into three groups. Eight dogs were assigned to the short training group, and they were allowed to run on a slope of 10? with the speed of 200m/min. Eight dogs were assigned to short intensified training group, and they were allowed to run on a slope of 10? with a speed of 300m/min. Four dogs served as controls, and they were allowed to have unrestricted activity in the cage. Dogs in training group and intensified group were asked to, run for an hour both in the morning and in the afternoon every day (tolally two hours per day). The training lasted for ten weeks. All the dogs were euthanized after ten weeks, and all the knee joints were harvested and examined histologically. Results Histological examination after ten weeks of exereises demonstrated that the signs of cartilage damage and repair were obvious in canine knee joint in training group and intensified group. Remodeling process was better promoted in the intensified group compared with training group, but there was no significant difference in Mankin score between these two groups. Conclusion Movements for a long time with great intensity are prone to induce sport injury. It is followed by repair process. Intensified training promotes a better remodeling reconstruction of articular cartilage than ordinary training.

Objective To explore the significance of such biological markers as cartilage oligomeric matrix protein (COMP), matrix metalloproteinases-1(MMP-1), matrix metalloproteinases-3 (MMP-3) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in serum and synovial fluid to evaluate early motional injury on knee joint cartilage induced by different modes of training. Methods Twenty adult dogs were randomly divided into three groups, i.e. common training group (n=8), short intensified training group (n=8) and control group (n=4). Magnetic resonance imaging (MRI) examinations were performed regularly (0, 2, 4, 6, 8, 10 weeks) to investigate the changes in the knee joint cartilage, while the concentrations of COMP, MMP-1, MMP-3 and TIMP-1 in serum and synovial fluid were measured by ELISA. Results It was revealed by MRI that the motional injury to knee joint cartilage occurred both in common training group and short intensified training group 2 weeks after training with different intensity, with severest injury occurring during 4~6 weeks after training, and then subsided gradually. The concentrations of COMP, MMP-1, MMP-3, TIMP-1 and MMP-3/TIMP-1 in serum and synovial fluid elevated in various degrees during training period with the lapse of time. Generally, the concentrations of MMP-1, MMP-3 and MMP-3/TIMP-1 in short intensified training group were lower, while that of COMP was higher, than that in common training group. The results suggested that the possibility of incurring articular injury in short intensified training group was lower than that in common training group, while the possibility of repairing the injury was on the contrary. Furthermore, the changes in levels of biomarkers in both serum and synovial fluid showed a close correlation. Conclusions Intensified training may result in moulding reconstruction better than the common training did. A combined determination of several biomarkers could be more sensitive than MRI examination on predicting the injury and repair of articular cartilage and on monitoring the course of illness. Therefore they are valuable for clinical application.

As a high-throughout technique after DNA chips in biomedical research, protein arrays are developing, with high sensitivity and veracity. They have drawn increasing attention because they can provide a new technological platform for life science studies. There has been no effective diagnosis instrument for common articular cartilage injuries when they are at an initial stage, but when the disorders progress into an advanced stage, visible functional disturbances often arise. Protein arrays may offer a solution to the lasting tough problem in orthopaedic field. In this paper, we review the development and research of protein arrays, the regulation of proteins, their biochemical functions and their potential interaction partners, as well as changes of cartilage biomarkers in body fluid after injury. In addition, the feasibility and rationality of using protein microarrays for diagnosing early articular cartilage injuries are discussed.

Through comparison of teaching approach of problem-based learning (PBL) and subject-based learning in physiotherapy of rehabilitation sciences, it is important for lecturer to understand the inevitable trend of PBL in future, the choice of the subject and the requirement for the lectures and students when using this new method, the detailed teaching methods and the significance of application were also discussed in this article respectively.

It has a vital clinical implication in applying the bilingual education teaching approach in physiotherapy of rehabilitation sciences, it is inevitable trend for reforms in teaching approach of school system. The effect of bilingual education in teaching of physiotherapy of rehabilitation sciences was analyzed in this article. The inevitable trend for reforms in teaching approach of school system, the problems and strategies exited when applying the teaching approach of bilingual education were also discussed respectively, the teaching program of bilingual education were planned in detail.

Purpose:To study the therapeutic effects of beta-ultrasound guided percutaneous alternating cryogenic- heating therapy(ACHT) through liver puncture combined with other regional therapy for advanced hepatocellular carcinoma. Methods:68 patients with advanced hepatocelluar carcinomas were divided into 4 groups.Group A,17 patients are treated with ACHT plus transcatheter hepatic arterial chemoembolization(TACE).Group B,16 patients were treated with ACHT plus intravenous chemotherapy;GroupC,19 patients were treated with TACE only;GroupD,16 patients were treated with in- travenous chemotherapy only.Results:In ACHT+TACE group,the rate of complete response(CR) plus partial response (PR) was 88.2%,the 0.5-,1-year survival rates were 94.1%,94.1%,the rate of AFP decreased was 84.6%.In ACHT+ ICT group,the rate of complete response(CR) plus partial response(PR) was 87.5%,the 0.5-,1-year survival rates were 87.5%,68.8%,the rate of AFP decreased was 78.6%.In the TACE group,the rate of complete response(CR) plus par- tial response(PR) was 57.6%,the 0.5-,1-year survival rates were78.9%,42.1%,the rate of AFP decreased was 69.2%. In ICT group,the rate of complete response(CR) plus partial response(PR) was 25.0%,the 0.5-,1-year survival rates were 50.0%,18.8%,the rate of AFP decreased was 41.7%.For CR+PR,ACHT+TACE group and ACHT+ICT group were significantly higher than TACE group and ICT group,but significant changes between ACHT+TACE group and ACHT +ICT group were not found.For survival rates,ACHT+TACE group was significantly higher than the other 3 groups, ACHT+ICT group was significantly higher than ICT group.There were no serious side effects after chemotherapy except that 5 patients' leucocytes decreased to degree Ⅲ.The postoperative complications after ACHT included bleeding,hemoglo- binuria and reactive thoracic,which disappeared after short term treated.Conclusions:Alternating cryogenic-heating therapy (ACHT) through liver puncture combined with other regional therapy is effective in treating advanced hepatocellular carci- noma and its side effects and postoperative complications are mild.

Posterior ischemic optic neuropathy is a kind of ischemic optic neuropathy, the incidence rate of which is lower with less obviously clinical features, less positive signs and more difficultly diagnosis when compared with anterior ischemic optic neuropathy.Meanwhile, therapeutic method of posterior ischemic optic neuropathy has remained controversial.This article will summarize the research development of the auxiliary examination, diagnosis, differential diagnosis and therapeutic method of posterior ischemic optic neuropathy.

Objective To investigate the clinical efficacy and safety of combined acupuncture and medicine in treating polycystic ovarian syndrome infertility.Methods Ninety patients with polycystic ovarian syndrome infertility were randomly allocated to treatment and control groups, 45 cases each. The control group received oral administration of clomifene citrate tablets plus muscular injection of chorionic gonadotropin and the treatment group, electroacupuncture in addition. The ovulation rates, pregnancy rates, incidences of ovarian hyperstimulation syndrome (OHSS), ectopic pregnancy rates and early miscarriage rates were compared between the two groups of patients. Results The ovulation rate and the pregnancy rate were 97.8 % and 37.8%, respectively, in the treatment group and 75.6% and 17.8%, respectively, in the control group; there was a statistically significant difference between the two groups (P<0.05). Of 17 pregnant patients in the treatment group, 2 had early miscarriage, accounting for 11.8% and none had ectopic pregnancy, accounting for 0.0%. Of 8 pregnant patients in the control group, 4 had early miscarriage, accounting for 50.0% and none had ectopic pregnancy, accounting for 0.0%. The incidence of OHSS was 4.4% in the treatment group and 6.7% in the control group; there was no statistically significant difference between the two groups (P>0.05).Conclusions Combined use of acupuncture and medicine can increase the ovulation rate and the pregnancy rate in patients with polycystic ovarian syndrome infertility. It does not significantly cause ovarian hyperstimulation and ectopic pregnancy and may decrease the early miscarriage rate.

Objective:To investigate the inhibitory effect of recombinant human endostatin(ES)combined with rAd/P53 on transplanted human breast cancer cell MCF-7 in nude mice.Methods:Animal breast cancer model was established by inoculating MCF-7 cells in nude mice.The animals were randomized into control group,ES group,rAd/P53 group,and ES+ rAd/P53 group.The tumor growth was observed in each group and immunohistochemical method was employed to examine the microvessel density(MVD) and the expression of vascular endothelial growth factor(VEGF).Results:Tumor growth was significantly inhibited in all the 3 treatment groups(P