Objective To explore expression of IL -33 and IL -33 mRNA in peripheral blood of patients with ankylosing spondylitis,and analyze the clinical significance,so as to provide scientific reference for the treatment and prognosis of the disease.Methods From February 201 4 to May 201 6,32 patients with ankylosing spondylitis were included as study group,30 healthy persons were selected as control group.Real -time quantitative PCR and enzyme -linked immunosorbent assay were used to detect IL -33 mRNA level in peripheral blood and IL -33 level in plasma of subjects.Results Compared with the control group (1 .23 ±0.58),IL -33 mRNA in peripheral blood of patients in the study group was higher(1 .74 ±0.75),and the difference was statistically significant (t =2.981 , P =0.004).ELISA results showed that IL -33 level in plasma of the study group was higher (227.30 ±45.67)pg/mL than the the control group (1 1 4.70 ±39.58)pg/mL,the difference was statistically significant (t =1 0.344,P <0.01 ).Compared with the control group,the ESR,CRP and PLT of the study group were significantly higher[(47.80 ± 4.73)mm/h,(42.60 ±3.38)mg/L,(329.60 ±48.39)×1 09 /L](t =42.542,54.722,1 4.040,all P <0.01 ).IL -33 in plasma and IL -33 mRNA in peripheral blood of ankylosing spondylitis patients were positively correlated with BASDAI(r =0.472,0.457,all P <0.05),CRP(r =0.71 3,0.687,all P <0.05).Conclusion IL -33 and IL -33 mRNA in patients with ankylosing spondylitis significantly increase,indicates that they should play important role in the occurrence and development of ankylosing spondylitis.

Objective To investigate the expression of T help cell 1(Th1),T help cell 2(Th2)and related cytokines interleukin 12 (IL -12)and interleukin 4 (IL -4)in the lumbar disc herniation and their clinical significance. Methods 30 postoperative patients with lumbar disc herniation were included as observation group.The control group included 10 patients with lumbar fracture.Flow cytometry was used to distinguish the Th1 and Th2 cells.ELISA was used to measure the expression of interferon γ(IFN -γ),IL -12(the cytokines secreted by Th1 cells)and IL -4 (the cytokine secreted by Th2 cells).RT -PCR was used to detect the mRNA levels of STAT4 and STAT6.Results The distribution of Th1 /Th2 cells was higher in patients with lumbar disc herniation compared to the control group [(6.24 ±2.89)vs (25.12 ±3.20),t =16.26,P <0.05;(2.68 ±0.58)vs (8.16 ±1.20),t =3.84,P <0.05]. The levels of IFN -γand IL -12 in the study group were significantly higher than the control group,the differences were statistically significant[(23.47 ±5.61)vs (7.65 ±3.21),t =8.422,P <0.05;(1.52 ±0.87)vs (5.34 ± 1.39),t =8.135,P <0.05].The level of IL -4 was undetectable in the control group,however,IL -4 expressed in the study group.The expressions of IL -12,IFN -γand IL -4 in the study group were negatively correlated by Spearman correlation analysis (r =-0.57,P <0.05;r =-0.23,P <0.05).In addition,the mRNA level of STAT4 was higher in patients with lumbar disc herniation compared to the control group[(3.21 ±0.49)vs (1.12 ±0.24), t =13.15,P <0.05].Conclusion The expressions of Th1 cells,Th2 cells and related cytokines were participated in the pathogenesis of lumbar disc herniation.

Objective To investigate the influence of clinical results of early low frequency training for acute Achilles tendon rupture after anchors repair.Methods A total of 35 patients with acute Achilles tendon rupture were treated with early low frequency training after anchors repair,including 28 males and 7 females.Aged 18 to 37 years, mean 26 years old.Duration 2h to 5d from injury to therapy.All patients palpated the discontinuity of Achilles tendon, limitative activity of ankle plantar flexion,Thompson test was positive,and MRI examination was taken.Results 35 patients were followed up for 12 to 18 months,with an average follow -up of 14.5 months.According to the Amer-Lindholm score,excellent in 30 cases,good in 5 cases,the good rate was 100%.All the wounds were healed, without infection,dehiscence,sural nerve injury and re -rupture occurred.Conclusion Early low frequency training after anchors repair for acute Achilles tendon rupture is safe and reliable,patients can receive a better functional outcome.

Objective To retrospectively review the clinical experience of percutaneous kyphoplasty (PKP) in the treatment of severe osteoporotic vertebral compression fracture (OVCF) during 10 years,and to propose a new classified treatment for OVCF.Methods 1200 patients with osteoporotic thoracolumbar vertebral compression fracture underwent percutaneous kyphoplasty from Aug.2003 to Aug.2013.There were 62 severe patients (5.2％,81 vertebraes),aged from 69 to 95 years (average 76.5 years),with 66.7％ to 78.9％ (average 71.3％) of vertebral body compression.Patients were followed up for 12 to 120 months (average 78 months).According to the preoperative imaging data,the fractures were classified into four types:simple type,pseudarthrosis type,cavern type,progressive type.Individualized PKP was performed on each patient.Results All the patients tolerated procedure well.The visual analogue scale (VAS) was reduced from (7.2± 2.1)preoperatively to (2.5±1.7) 3 days after PKP(t=13.197,P＜0.01).The Medical Outcomes Study (MOS) 36-Item Short Form Health Survey (SF-36) scales was improved from (29.5±8.2) to (46.5±9.9) 3 days after surgery(t=22.884,P＜0.01).Most patients were satisfied with the efficacy.The anterior height of vertebral body was increased from (14.21±2.44) mm preoperatively to (19.28 ±4.37) mm 3 days after surgery(t=9.108,P＜0.01).The Cobb angle were decreased from (16.45 ± ±5.37)° to (9.41±4.13)° 3 days after surgery(t=9.355,P＜0.01).The height of vertebrae was lost and the kyphosis angle aggravated with the follow-up time.New vertebral fractures were found in 21 patients (21/62,33.9％) at the last follow-up.Conclusions The preoperative accurate classification of severe osteoporosis vertebral compression fracture and individualized PKP can raise the successful operation rate and reduce the incidences of complications.