Objective To study clinical and pathological characteristics and effects of arthroscopic treatment of ankle soft tissue impingement syndrome(ASTIS). Methods A total of 21 cases of ASTIS underwent arthroscopic operations from November 2000 to April 2005.The impingement soft tissues were removed under arthroscope at 13.6?9.9 months after injury.The resected tissues were pathologically examined following surgery.The efficacy of arthroscopy was assessed using the American Orthopaedic Foot and Ankle Society(AOFAS) rating scores. Results Arthroscopic findings showed the most common impingement tissue was synovium(20 cases),followed by distal fascicle of the anterior tibiofibular ligament(5 cases),fibrous scar tissue(4 cases),anterior talofibular ligament(3 cases),and meniscoid tissue(3 cases).ASTIS accompanying cartilage injuries was found in 16 cases.All the cases were followed for 7~60 months(mean,34.3?9.4 months).The AOFAS scores significantly increased postoperatively than preoperatively,with total scores from 67.0?9.7 to 94.0?6.4(t=-7.205,P=0.000) and subjective scores from 20.7?6.6 to 35.7?4.9(t=-5.003,P=0.000). Conclusions Ankle soft tissue impingement syndrome often occurs after ankle sprain along the anterolateral portion of the ankle.Common impingement tissues are synovium,ligament,scar tissue,and meniscoid tissue.Arthroscopic treatment of ankle soft tissue impingement syndrome is satisfactory.

Objective To assess the safety of living environment by the elderly, further clarify the relevant factors of the elderly fall in the living environment. Methods The self- made assessment form of fall-related factors of living environment for elderly patients was used to survey 1 076 elderly. Likert five grades score was used for each item, and the higher score demonstrated the safer living environment. Results In the assessment of the safety of living environment, the indoor physical environment (3.94 points), home furniture safety (3.66 points) score was better;home ground and the channel (3.32 points) and outdoor activities places (3.57 points) score was lower. Scores of home′s ground and channel, furniture safety, indoor physical environment and living environment of urban elderly were (23.56 ± 6.49), (44.52 ± 7.72), (11.93 ± 2.49), (105.03 ± 17.82) points, which were better than (22.46 ± 6.39), (42.73 ± 7.95), (11.53 ± 2.39), (101.55 ± 18.15) points of rural elderly (t=2.471-3.495, P <0.05). Conclusions The indoor physical environment, home furniture safety got higher scores, and the scores of ground-channel environment and outdoor activities places were relatively lower. Scores of the safety of living environment in urban are better than in rural. It suggests the elderly living environment need to reduce the incidence of falls.

After the initial episode of acute pancreatitis (AP), some patients have a tendency to relapse.With the development of imaging technologies and genetic tests, the diagnostic accuracy of the etiological factors of recurrent acute pancreatitis (RAP) such as dysfunction of sphincter of Oddi, pancreas divisum, and genetic mutations are improved.Clinical studies indicate that etiological treatment by endoscopic approaches may reduce recurrence in some RAP patients.In this article, the progress in etiology, diagnosis and treatment of RAP was reviewed.

MicroRNA-7(miR-7)was firstly found in Drosophila melanogaster,which participated in the formation of Drosophila wings,eggs and so on.In human being miR-7 is not only involved in cell prolifera-tion and differentiation,but also plays an important role in the development of tumor,especially in lung cancer. Most studies report that miR-7 is low expression in lung cancer with poor prognosis.Improving the expression of miR-7 can inhibit tumor growth.MiR-7 can regulate the expression of BCL-2,EGFR negatively,meanwhile it can regulate the sensitivity of tumor cells to radiotherapy chemotherapy and targeted therapy.Therefore,as a tumor suppressor,miR-7 is expected to become a new target for treatment of lung cancer.

Objective To provide rational use of vancomycin in elderly MRSA-infected patients, compared its pharmacokinetics in the elderly MRSA-infected patients with healthy young subjects.Methods 15 elderly MRSA-infected patients and 15 healthy young subjects were injected with 1.0g vancomycin.Serum concentrations were determined by fluorescence polarization immunoassay(FPIA) in both groups(n infected=15,n healthy =15),then calculated the pharmacokinetic parameters with program 3p97.Results Compared with the healthy group, the elimination half life (t1/2β)were longer, the apparent volume of distribution (Vd)and the area under curve(AUC)were increased,the creatinine clearance(Ccr)were lower in the infected group.The differences of these pharmacokinetic parameters between the two groups were statistically significant(p<0.01) except the peak serum concentrations(p>0.05).Conclusion Vancomycin should be used with decreased dose or increased interval in the elderly MRSA-infected patients, therapeutic drug monitoring and personalized medicine were required.

Objective: To investigate the interactions between carbohydrate derivatives and sodium-glucose cotransporters 2 (SGLT2) using molecular dynamic (MD) method and to explore the mechanisms and structure-activity relationship of SGLT2 inhibitors. Methods: The homologous structure of SGLT2 was modeled, the GROMACS program was used to model eight structures, such as SGLT2, SGLT2-glucose compound, and SGLT2-carbohydrate compound. And the root mean square fluctuation (RMSF) of the key residues and ligands and the interaction energy between the ligands and SGLT2 was investigated by trajectory analysis. Results: The interaction energy calculated by MD method had the higher correlation with experimental results than that by molecular docking method. H80, K154, D158, and Y290 were the key residues involved in the interaction, N75 and F453 were the important residues, and W291, Q295, and S393 might be the auxiliary residues. The ligands had a relatively consistent conformation, and fragments A and C played the more important roles in receptor binding. And the size, rigidity, and polarity increasing could elevate the bonding strength. Conclusion: MD simulation results could display the good performance of the interaction between the ligands and SGLT2, and could give clear guidance for the design of new SGLT2 inhibitors.

Objective To investigate the effect of Fushenjiangxianning on renal protein kinase C(PKC),renal vascular endothelial growth factor(VEGF),renal platelet-derived growth factor ?(PDGF-?),and renal protection in diabetic nephropathy(DN) rats.Methods The diabetic SD rats induced by STZ were divided into four groups: diabetic control group,Fushenjiangxianning group,Irbesartan group, and Fushenjiagxianning combined with Irbesartan group,and the normal control group as well.After the experimental rats in every group were respectively treated for 12 weeks by above intervention methods,the relative kidney weight,blood sugar,urea nitrogen(Bun),serum creatinine(Scr),and urinary albumin excretion rate(UAER) were detected by routine analysis methods,and PKC and VEGF in renal tissue were detected by immunohistochemical techniques,and PDGF-? in renal tissue was detected by Western blotting,and ultramicrostructure of kidney was observed by transmission electron microscope.ResultsThe expression of renal cortex PKC and VEGF was increased in diabetic rats.The ultramicrostructure of kidney was noticeably changed,and the blood sugar,UAER,BUN,Scr,relative kidney weight,and PDGF-? were significantly increased in diabetic rats.While the above indexes in Fushenjiangxianning group,Irbesartan group,and Fushenjiangxianning combined with Irbesartan group were significantly lower than those in diabetic control group(P

Objective To investigate the effect of Jieju Fushenning(JFN) on platelet-derived growth factor B(PDGF-B) and bone morphogenetic protein-7(BMP-7) expression in renal tissue of rats with diabetes mellitus(DM). Methods The diabetic SD rats induced by STZ were divided into four groups:model group,JJFSN group,irbesartan group and JFN combined with irbesartan group. Meanwhile,a normal control group was set up. The rats in each group received corresponding treatment for 12 weeks. The urinary albumin excretion rate(UAER) was detected by routine analysis method,and PDGF-B and BMP-7 expression in renal tissue were detected by immunohistochemical techniques. PDGF-B expression in renal tissue was detected by Western blot,and the ultrastructure of kidney was observed by transmission electron microscope. Results The expression of BMP-7 was decreased and PDGF-B expression was increased in renal cortex of the model group. PDGF-B expression was obviously decreased and BMP-7 expression was increased in JFN group,irbesartan group and JFN combined with irbesartan group compared with those in the model group(P

Objective To study the ultrastructure of the anterior cruciate ligament.Methods Specimens were procured from seven patients with arthroscopy and observed under scanning and transmission electron microscope. Results Fibrils of normal anterior cruciate ligament arrayed in compact parallel form with waviness.Connecting fibers existed between fibrils.Diameters of fibrils were different with range of 30nm to 60nm mostly.Fibroblasts were distributed along with the fibrils.Active cells excrete filamentous collagen fibrils.Conclusion The ultrastructure of the anterior cruciate ligament was correlated with its function status.Mature fibroblasts existed in the ligament.

[Objective]To study the safety,clinical effect and therapeutic characteristics of distraction apparatus for correcting flexion contracture deformities of the knee joint by evaluating the clinical outcomes and investigating the results of biomechanic test.[Method]Forty-nine patients (included 52 knees) were treated by the standardized distraction apparatus and the comprehensive assessment standard was adopted to evaluate the clinical outcomes.Five patients were examined by three-dimensional CT of the knee joints pre-operatively and post-operatively to observe the changes in the knee structure.To observe the effect of distraction on the popliteal artery and the limb nerves,the popliteal artery diameter and blood flow speed were examined in 15 patients and the regio cruris electromyogram and nerve conduction velocity were examined in 6 patients before and after treatment.Three different means of distraction and measurement were underwent in 3 patients so as to observe the changes in the flexion curve and force of posterior soft tissues of the knee.[Result]All patients (52 knees) regained congruous structure and better function,the final excellent and good result rate was 65%.Three-dimensional CT examination of 5 patients showed that the postoperative knee joint structures were superior to the preoperative ones and there weren't damage of articular surface.The statistic results indicated that the popliteal arteries weren't obviously disturbed by distraction,whereas the limb nerves were probably disturbed temporarily.Three methods of distraction and measurement in 3 patients showed different outcomes,indicating that the effect of distraction on soft tissues was influenced by the distraction method,the ages of patients and the extents of deformities of the limb.[Conclusion]The distraction speed of therapeutic method is safe,reasonable and effective in correcting flexion contracture of the knee joint;The distraction force on posterior soft tissues of the knee is influenced by various elements,thus,the distraction speed should be individualized.Low-load and steady stretch are advantageous to soft tissue regeneration and safer.