Parathyroid hormone ( PTH) is an important hormone secreted by parathyroid cells , and regulates the metabolism of calcium and phosphorus in the body .In recent years , the toxic effect of PTH on myocardium has been re-ported.Calcium-sensing receptor (CaSR), a member of G protein-coupled receptor family, can feel the subtle change of extracellular calcium concentration and regulate intracellular calcium concentration through multifarious ways in order to control the secretion of PTH .The expression of CaSR is observed in parathyroid cells , renal tubular epithelial cells , myo-cardial cells, etc.Intracellular calcium, as a second messenger, participates in various cell functions , such as excitation-contraction coupling , fertilization and so on .The injury of myocardial cells is intimately linked with high concentrations of PTH and intracellular calcium , and high expression of CaSR .

ObjectiveTo study the feasibility and effect of microendoscopic discectomy on the central type of enormous intervertebral disc herniation.MethodsFrom 2003 to 2006,23 patients(18 males,5 females) were diagnosed with enormous central type lumbar disc herniation and treated by microendoscopic discectomy.Their clinical data were restropectively analyzed,and postoperative outcomes in hip function were evaluated by Macnab scoring system.ResultsBeing followed up for 3-12 months,21(86.9%) patients were rated as good or excellent for their outcome,and the other two as fair.ConclusionMicroendoscopic discectomy through interlaminar approach achieves satisfied outcome for enormous central type lumbar disc herniation.

Objective To review the preliminary experience on managing the patients suffering from lumbar disc herniation with lateral recess stenosis by microedoscopic discectomy.Methods A total of 79 patients affected with lumbar disc herniation with lateral recess stenosis were treated by MEDⅡ in our hospital from Jan 2002 to Sep 2004.Results All patients were discharged within 7 d postoperatively and no complications occurred.The average duration of follow-up was 12.3 months and the successful clinical outcome was 99%.Conclusion Microendoscopic discectomy is a minimum invasive procedure.The successful clinical outcome could be achieved in properly selected patients.The microendoscopic discectomy is an effective procedure in managing lumbar intervertebral disc herniation with lateral recess stenosis.

Objective To evaluate the effects of sitagliptin on blood glucose,blood pressure,blood lip and carotid artery intima media thickness (IMT) in metabolic syndrome patients with type 2 diabetes.Methods The clinical data were collected for 64 cases of inpatient and outpatient patients with metabolic syndrome with type 2 diabetes.Those patients included anti-diabetes native patients and patients only used the stable metformin dose.After signed off the informed consent form,those patients were randomized to the sitagliptin treatment group or original treatment group,and the metabolic index and carotid artery intima-media thickness were evaluated after 24 weeks treatment.Results The body mass index (BMI),waist circumference (WC),fasting plasma glucose (FPG),triglycerides (TG),high density lipoprotein cholesterol (HDL-C),systolic blood pressure (SBP),diastolic blood pressure (DBP),glycated hemoglobin a1c (HbA1c),and carotid artery IMT in two groups were comparable at baseline.After 12 weeks treatment,the FPG,TG,DBP,and HbA1c in the sitagliptin group were significantly better than original treatment group and the baseline,while there was no different between two groups in other index.After 24 weeks treatment,the FPG,TG,HDL-C,DBP,HbA1c,and carotid artery IMT in the sitagliptin group were significantly better than original treatment group and the baseline.Conclusions Sitagliptin presents the functions of lowering blood pressure,adjusting blood lipid,and protecting vascular endothelial in addition to lowering blood glucose.

BACKGROUND:The treatment of displaced acetabular fractures consists of formal open reduction and internal fixation.However,extensile exposure can lead to a lot of complications Percutaneous screw fixation for acetabukar fractures can decrease these complications Recently developed fluoroscopic-based computerized navigation technology not only allows the surgeon to achieve maximum accuracy of screw fixation but also significantly reduce radiation exposure time.OBJECTIVE:To evaluate the clinical application of the fluoroscopic-based computerized navigation system for percutaneous screwing for acetabular fractures.METHODS:A total of 18 adult patients with 20 non-displaced and displaced acetabular fractures were treated with percutaneous screw fixation under the guidance of a fluoroscopy-based navigation system.All acetabular fractures were acetabular anterior column fractures and posterior column fractures,which were fixed by varied hollow screws Static muscle contraction and limited active and passive motion were performed at 2 days,and weight-bearing exercise was performed at 4 weeks after operation.The time of screw implantation,screw position deviation,screw biocompatibility,as well as adverse effect after screw implantation was observed.In addition.d'Aubigne and Postel scoring was used in follow-up.RESULTS AND CONCLUSION:A total of 30 acetabular screws were inserted.The average operation time for per screw was24.1 minutes from the image acquisition to wound closure.The average fluoroscopic time for per screw was 27.6 seconds.Compared to the final position of the screw,the average wire tip error was 1.5 mm and the average trajectory difference was2.25°.One patient sustained a transient femoral nerve palsy which was attribute to reduction clamp inserting from the use of the limited open reduction method rather than screw fixation itself and resolved 2 months after the operation.No evidence was noted of secondary displacement of the fragment or screw failure Using the rating system of d'Aubigne and Postel,13 patients had excellent results,4 patients had good results,and 1 patient had a fair result.The excellent to good rate was 94%All results demonstrated that percutaneous screw fixation of acetabular fractures with fluoroscopy-based navigation can produce excellent results in selected patients with non-displaced and displaced fracture amenable to closed or limited open reduction,which becomes a safe and effective alternative to traditional open reduction and internal fixation for the treatment of certain acetabular fractures.

Objective To discuss the treatment strategy of medial collateral ligament and combined injury in the terrible triad of elbow.Methods The data of 21 patients with terrible triad of elbow who received treatment from February 2010 to April 2012 was retrospectively analyized.There are 17 males and 4females with12 cases left and 9 right elbows.The average age of them was 37.6 years (16-57).MRI examination was performed routinely,and used as guidance of treatment strategy of medial collateral ligament and combined injury.For the patients without or with partial damage of anterior bundle of medial collateral ligament(AMCL) injury while the continuity of ligament remains complete in MRI image,exploration and repair of the medial collateral ligament is not conventional.For the patients with MRI image showing AMCL avulsion or body disruption,we routinely used antero-medial approach to explore and repair,suture-anchors were used for suture the bony avulsion of the medial collateral ligament,body disruption of ligament and combined flexor-pronator teres complex injury were also be suture repaired.None of the patients used hinged external fixator during operation.A hinged brace was applied after operation.Results All patients were followed up for an average of 12.4 months (6-26).At the last follow-up,the average range of motion of the elbow was 135.2 ±10.2 degrees,average straight limited degrees,6.7±2.2 degrees,an average of 142±11.0 degrees of flexion.Mayo elbow performance score was 92 points (85-100).17 cases were excellent and 4 were good.Complications included:a transient ulnar nerve palsy in 3 cases,heterotopic ossification in 2 cases,tardive ulnar neuritis in 1 case,no elbow residual instability,dislocation,elbow stiffness and other complications.Conclusion Anterior bundle of medial collateral ligament avulsion or body disruption should be routinely suture repaired,which is in favor of restoring elbow immediate stability favoring restore elbow immediate stability.

Objective To investigate whether the non-alcoholic fatty liver disease ( NAFLD) can independently increase the risk of cardiovascular events in type 2 diabetes .Methods The cardiovascular endpoints were observed after 5 years follow up for fat liver group (46 cases, patient with fat liver and with diabetes more than 10 years), non-fatty liver group (50 cases, patients without fatty liver disease and with diabetes more than 10 years), and normal glucose group (46cases, patient with NAFLD and with normal glucose) in the same demographic characteristics.Results ⑴ Patient status before enrollment: The body mass index (BMI), and blood glucose levels in fat liver group and non-fatty liver group were higher than normal glucose group , while the high-density lipopro-tein cholesterol ( HDL-C) was lower than normal glucose group ( P <0.05 ) .There is no significant difference among three groups in blood pressure and triglyceride ( TG) level ( P >0.05 ) .⑵After 5 years observation:The BMI , blood glucose , and TG levels in fat-ty liver disease group were significant higher than other two groups , while the HDL-C was lower than other two groups .The glucose control level of fat liver group was higher than normal glucose group ( P <0.05 ) .⑶After 5 years observation:The incidence of cardi-ovascular events of fat liver group was higher than other two groups ( P <0.05 ) .There is no significant difference between the normal glucose group and non-fatty liver group in the incidence of cardiovascular events ( P >0.05 ) .Conclusions NAFLD can independent-ly increase the risk of cardiovascular events in type 2 diabetes.

Objective To study the effects of unilateral graded facetectomy on lumbar spinal stability in biomechanics and to investigate the biomechanical characteristics of articular process and the safety of decompression produre for lumbar disc herniation.Methods The vertebral column L4/5 function spinal unit(FSU) of 5 adult cadavers was used and graded facetectomy was performed on left articular process of L4/5 resulting in 0,1/4,1/2,3/4,4/4 facetectomy of lateral small vertebral joints.The stability of each model was determined using three-dimension movement test machine of vertebral column.Results When more than 1/2 facetectomy of lateral small vertebral joints was carried out,the circuitation stability of left,right lateral flexion and the left,right axial direction of vertebral column and that of normal vertebral column had significant difference(P

Aim To investigate the effects of paeonol(Pae)in inhibiting the proliferation of HT-29 cell and probe into the possible molecule mechanism by quantitative and qualitative assay.Methods The inhibited rate and apoptotic rate of HT-29 cells were measured quantitatively by MTT assay.We were trying to find out the possible mechanism through the morphologic observation on paeonol-processed HT-29 cell line by TUNEL assay and immunocytochenical method.Results Pae,in the concentration of 0.024～1.504 ?mol?L~(-1),inhibited the proliferation of HT-29 cells in vitro,which showed obvious concentration-effect relationship;The inhibited rate of HT-29 cells was also increased when Pae(0.024～1.504 ?mol?L~(-1))was treated for 24,48,72 and 96 h,which showed obvious time-effect relationship.After treated with the concentration of 1.504 ?mol?L~(-1),the apoptotic rate of HT-29 cells significantly increased,which showed significant difference compared with control;We examined all the experimental groups by flow cytometry,which showed that sub-G_1 peak appeared before G_1 period and the cells in S period increased,while the cells in G_1、G_2 period decreased,the apoptotic rate of HT-29 cells gradually increased along with the increasing of paeonol concentration.The apoptotic rate in experimental groups vs control has significant difference(P

im To study the structure-function relationship of hTNFα . Methods We compared the cytotoxicity, receptor binding ability and toxicity in animal body of wild type(wt)hTNFα with its mutants including R2K-, N30S-, R32W-, L157F-hTNFα , and two multi-site mutants(R32W-L157F-hTNFα and R2K-N30S-R32W-L157F-hTNFα ). Results We found that the two multi-site mutants remained similar cytotoxicity to several human tumor cell lines as wild type hTNFα . However, their cytotoxicity to L929 cells were decreased sharply as compared with those of wt hTNFα . The two multi-site hTNFα mutants had lower binding activity with hTR75 than hTR55. We also found that compared with the wild type, the LD50 of the mutant R32W-L157F-hTNFα was decreased about 300 fold and the dose of mutant R2K-N30S-R32W-L157F-hTNFα resulted in 30％ death was 700 folds lower than LD50 of wt hTNFα . To certify the systematic toxicity of the mutant R2K-N30S-R32W-L157F-hTNFα , we assayed its toxicity to monkeys and found that its systematic toxicity was lower than that of wt hTNFα. Conclusion A 4-site mutants(R2k-N30S-R32W-L157F-hTNFα )of hTNFα is obtained, which the mutant may possess potential application value in clinical therapy.