Objective To discuss the method for operative treatment of acetabular fractures and assess corresponding results.MethodTotally 34 cases of acetabular fractures treated operatively from February 2000 to December 2005 were reviewed. There were 22 males and 12 females, with an average age of 39 years (16 to 61).On the basis of X-ray and computed tomography,all fractures were classified according to the Letournel-Judet classification,13 cases were simple fractures and 21 complicated ones. Kocher-Langenbeck approach(23 cases),illioinguinal approach(6 cases) and anterior combined posterior approach(5 cases) were adopted for different fractures with reconstruction plates and screws.The mean operation time was 150 min.The average blood loss was 600 mL.ResultAll cases were followed up for average 31 months(12 to 64 months).According to the criteria of Matta radiographicgrade,there were 18 cases with anatomic reduction, 9 with satisfactory reduction,3 with unsatisfactory reduction and 4 with joint contour reduction.Based on the modified Merle D' Aubigne and Postel clinical grading system for joint functions,11 cases(32.4%)showed excellent results,15(44.1%)good,4(11.8%)fair and 4(11.8%)poor. The excellent and good rate for anatomic and satisfactory reduction groups were 85.2%,while unsatisfactory reduction and joint contour reduction were 42.9%(P

BACKGROUND:Studies have funded that reduced Wnt/β-catenin signaling is involved in the onset and/or progression of bone erosion in rheumatoid arthritis. It can lead to potential new treatment approaches of bone erosion by enhancing Wnt/β-catenin signaling pathway. R-spondin 1 may act as a Wnt agonist, but there is no study in human osteoblasts. OBJECTIVE:To verify the effect of R-spondin 1 on promoting differentiation and maturation of human osteoblasts by inhibiting DKK1. METHODS:S40-transfected human osteoblast lines, hFOB1.19, were treated with R-spondin 1, Wnt-3a and DKK1 to detecting the proliferation, alkaline phoshpatase activity and osteoprotegerin concentration. RESULTS AND CONCLUSION:R-spondin 1 had no effects on hFOB1.19 cel s. Wnt-3a upregulated the activity of alkaline phoshpatase, which could be enhanced by addition of R-spondin 1. R-spondin 1 could reduce the DKK1-mediated inhibition of alkaline phoshpatase activity in hFOB1.19 cel s. R-spondin 1 increased the concentration of osteoprotegerin, and moreover, the promotion of osteoprotegerin by R-spondin 1 alone was stronger than the inhibition by DKK1. These findings suggest that R-spondin 1 can inhibit DKK1 by Wnt/β-catenin signal pathway to promote the differential and maturation of human osteoblasts to excrete osteoprotegerin.

Objective To analyze quality of life (QOL) and its related factors in community middle-aged and aged people with osteoporosis (OP). Methods A total of 152 OP patients in one community in Shanghai were surveyed and their QOL was evaluated with a questionnaire integrated with the QUALEFFO-41 questionnaire. Factors were analyzed using a Kruskal-Wallis test and stepwise multiple regression. Results The QOL scores of these middle-aged and aged people with OP were generally low (62.58 + 14.06). Age, education level, milk intake, a history of fractures or illness, OP grade and menopause time were significant factors predicting QOL scores. Stepwise multiple regression indicated that fractures, illness, education level and menostasis time had a linear relationship with QOL. Conclusion The key points in improving the QOL of middle-aged and aged people with OP in the community are health education, early diagnosis and comprehensive treatment.

Disease-associated autoantibodies (AAB) are important for the diagnosis of respective autoimmune diseases (AID).Autoantibodies can also be used for monitoring of response to therapy and for prognostic purpose.However,significant biological heterogeneity of autoantibody response,the difficulty in simultaneously improving detection sensitivity and specificity of autoantibodies and the lack of standardization in detection methods lead to limitations in its clinical applications and some difficulties in explaining the test results.It is important to search for novel autoantibodies in sera,to establish and standardize automated detection platforms with good quality and to perform well-designed clinical evaluation in the future research and clinical applications of autoantibodies.

ObjectiveTo evaluate the clinical and radiological efficacy of TNFR Ⅱ -Fc combined with methotrexate( MTX ) in treatment of patients with moderate and severe rheumatoid arthritis.MethodsThree hundred and ninty-six RA patients were randomized into the combined treatment group,the TNFR Ⅱ -Fc only group and MTX only group.All patients were treated for 24 weeks.ACR-N,ACR20,ACR50,ACR70,DAS28-ESR and Sharp score of both hands were measured for efficacy,and the side-effects were analyzed by one-way ANOVA.Results After 24-week therapy,the ACR-N of the combined treatment group [( 12.79±9.24)％-year] was significantly improved than that of the TNFR Ⅱ-Fc only group [(9.56±11.16)％-year,P＜0.05] and that of the MTX only group[(5.08±11.10)％-year,P＜0.05],and the TNFR Ⅱ-Fc group was significantly improved than that of the MTX group(P＜0.05).The ACR20 response rate of the combined group(80.4％) was significantly higher than that of the TNFR Ⅱ -Fc group(71.1％,P＜0.05) and the MTX group(56.7％,P＜0.01 ).The ACRS0 response rate of the combined group(53.6％) was significantly higher than that of the MTX group(30.8％,P＜0.01 ).The ACR70 response rate of the combined group was 27.7％,which was significantly different from that of the TNFR Ⅱ -Fc group (15.8％) and MTX group (7.7％,P＜0.05or P＜0.01 ).DAS28-ESR in the combination group was significantly reduced than those of the TNFR Ⅱ -Fc group and MTX group,and the DAS28-ESR of the TNFR Ⅱ -Fc group was significantly reduced than MTX group.The average total Sharp score of both hands,which demonstrated the radiographic changes,was significantly reduced in the combination group than the MTX group(P=0.03).The total adverse events in the combined group(40.9％) was significantly high than that of the MTX group(28.8％,P＜0.05).Conclusion TNFR Ⅱ -Fc combined with MTX can effectively control the activity of RA and radiological progress.

Objective To compare the clinical efficacy of ibuprofen arginate,a new nonsteroidal antiinflammatory drug,with that of ibuprofen,in patients with rheumatoid arthritis or knee osteoarthritis and to evaluate the safety and tolerability of ibuprofen argihate.Methods This is a muhicenter,random,open,active comparator-controlled,parallel clinical trail in which 171 patients with rheumatoid arthritis or knee osteoarthritis were enrolled.Patients were randomized to 2 groups:400 mg of ibuprofen arginate three times daily and 400 mg of ibuprofen three times daily respectively.Clinical efficacy and safety were evaluated after 4-week treatment.Results Ibuprofen arginate,at dosages of 400 mg three times daily,had shown significant efficacy in relieving pain,tenderness and swelling of joints and there was no significant difference when compared to that of ibuprofen.There was no difference in clinical adverse effects between the two groups and no serious adverse effects were repofled.But ibuprofen arginate could initiate effectiveness more rapidly than ibuprofen in both rheumatoid arthritisand osteoarthritis patients.Conclusion Ibuprofen arginate has the same clinical efficacy and safety profiles as itmprofen in treating rheumatoid arthritis and osteoarthritis.However,its onset is more rapid than ibuprofen.