Purpose: To observe the curative effects of different treatments on genual osteoarthritis.Methods: The 148 cases were randomly divided into 4 groups: acupuncture group; Chinese herbs plus spectrograp irradiation group; comprehensive treatments group and western medicine group. Results:The total effective rate in these groups were 78.9%, 72.7%, 92.3% and 78.9% respectively, and there was not a significant difference among the groups (P＞0.05). The marked effective rate in comprehensive treatments group was higher than that in other three groups (P＜0.05). Conclusion: Acupuncture and Chinese herbs plus sepectrograp irradiation had certain effect on gonitis. Comprehensive therapies could coordinate the actions of acupuncture, and Chinese herbs plus spectrograp irradiation, and raise the curative effect.

Objective To compare the consistency of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in detecting c-erbB-2 status in breast cancer tissues. Methods A total of 50 breast cancer paraffin embedded samples were selected, of which there were 10 cases of c-erbB-2 protein expression (+), 20 cases of (++) and 20 cases of (+++). FISH was used to assess the amplification of c-erbB-2 gene, and SPSS 13.0 software was employed to analyze the difference and consistency between the two methods. Results IHC and FISH methods had a good consistency when detecting c-erbB-2 (+) and (+++) expressions in breast cancer tissues, with the coincidence rate of 89.2%. However, when IHC was used to test c-erbB-2 (++), the result of FISH was quite different, with the coincidence rate of only 35.3%. Conclusion IHC is a preliminary method to detect c-erbB-2 status in breast cancer. IHC and FISH methods have a good consistency in detecting c-erbB-2 (+) and (+++) status in breast cancer tissues. As detection of c-erbB-2 (++) with IHC has a different result from FISH, such patients should receive FISH confirmation for herceptin therapy.

Objective To observe whether appropriate intermittent exercise at the ischemic threshold can safely promote collateral circulation in an ischemic area of the myocardium through the increased expression of vascular endothelial growth factor(VEGF)and its receptor fetal liver kinase-1(Fik-1). Methods A balloon constrictor was surgically implanted in the first obtuse marginal coronary artery(OM1)of miniature pigs.The subjects were divided into 3 groups:a sham-operation group,a pure ischemia group,and an exercise training group.Subjects in the exercise training group performed individualized treadmill programs 30 min daily,5 d per week,for 8 weeks,including 2 two-minute episodes of exercise-induced ischemia.Two pre-exercise episodes of pure ischemia induced by brief OM1 occlusion were also conducted.Only pure ischemia was induced in the pure ischemia group,and the sham-operation group remained sedentary for the experimental period.Relative myocardial blood flow(RMBF)was measured using microspheres.VEGF and Flk-1 expression levels were measured by Western blotting and real time RT-PCR analyses.Cardiac troponin I(ctnI)levels were determined using an enzyme-linked immunosorbent assay(ELISA). Light and electron microscopy were employed to examine myocardia damage in the ischemic area.Results RMBFs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups. RMBFs in the pure ischemia group were significantly higher than those in the sham-operation group.The expression of VEGF and Flk-1 proteins and mRNAs in the exercise training group were significantly higher than those in the pure ischemia and sham-operation groups,and the levels in the pure ischemia group were also significantly higher than those in the sham-operation group.After training,no myocardial damage and no ctnI increase was observed in the pure ischemia group.Microscopy revealed no obvious structural changes. Conclusion Intermittent exercise at the isehemia threshold intension can safely promote coronary collateral formation through upregulation of VEGF and Flk-1 expression in the ischemic myocardial area of a porcine model.

Objective · To investigate the difference in myocardial strain of left ventricle between obstructive hypertrophy cardiomyopathy (HCM) and nonobstructive HCM. Methods · Cardiac magnetic resonance imaging (MRI) exam was performed on 48 sequential enrolled patients with HCM (18 with obstructive HCM, and 30 with nonobstructive HCM), whose left ventricular ejection fractions (LVEF) were over 50%. Twenty-five healthy volunteers were examined as normal controls. Global longitudinal strain (GLS), global radial strain (GRS), global circumferentialstrain (GCS), LVEF, left ventricular end diastolic volume (LVEDV), left ventricularmass (LVM), left ventricular end diastolic volume index (LVEDVI), and left ventricular mass index (LVMI) were collected and compared. Radial strain, circumferential strain and peak radial displacement were also measured in medial segment of left ventricle according to American Heart Association (AHA) 17-segment model. Results · ① LVEF of the patients with obstructive HCM was bigger than those of nonobstructive HCM patients and control group (P<0.05). LVM and LVMI of the HCM groups were bigger than those of control group (P<0.01). ② Left ventricle GLS, GRS, and GCS significantly decreased in the patients with nonobstructive HCM compared to those with obstructive HCM (P<0.05). The three parameters of two HCM groups were significantly lower than those of healthy volunteers (P<0.05). ③ Compared with obstructive HCM patients,the segmental parameters of left ventricule, the medial segment circumferential strain and radial strain of nonobstructive HCM patients significantly decreased (P<0.05), and the two parameters of both HCM groups were lower than those in healthy volunteers. Compared with obstructive HCM patients and healthy volunteers, peak radial displacement of left ventricule medial segment in nonobstructive HCM witnessed a significant decrease, while no significant difference was observed between obstructive HCM patients and healthy volunteers. Conclusion · In the LVEF preserved HCM patients, the myocardial strain of left ventricle in nonobstructive HCM patients decrease significantly than that in obstructive HCM patients, which may result in the different clinical outcomes intwo types of HCM patients. It is suggested that the myocardial strain is more sensitive than ejection fraction in the evaluation of myocardial performance of HCM patients.

Objective To evaluate the safety and efficacy of drug-coated balloon in small branch ostial lesions of coronary arteries (Medina type 0,0,1 lesion).Methods A total of 48 patients were enrolled in the study and they were randomly divided into the Drug-Coated Balloon (DCB) angioplasty group (22 cases) and the Cutting Balloon (CB) angioplasty group (26 cases).They underwent percutaneous coronary intervention (PCI) with either DCB or with CB in small branch ostial lesions of coronary arteries respectively,The immediate outcomes and long-term efficacy were investigated.Results There were no statistical differences between the two groups in baseline clinical date before PCI.There were no coronary perforation,pericardial tamponade,acute thrombotic events in the two groups.There was no significant difference in minimal lumen diameter (MLD) immediately after PCI between the two groups.During followup angiography,the MLD in the DCB group was significantly larger than in the CB group [(1.8 ± 0.2) mm vs.(1.5 ± 0.3) mm,P =0.006].There were no death,nonfatal myocardial infarction or revascularization recorded in the groups during 6 months of follow-up.Conclusion The immediate outcomes between DCB and CB were similar in small branch ostial lesions for coronary arteries angioplasty.The long-term efficacy of DCB angioplasty is better than CB angioplasty.

Objective To compare and evaluate fractional flow reserve (FFR) by intravenous infusion of adenosine 5’-triphosphate (ATP) through femoral veins and hand dosal veins. To find the feasibility of measuring FFR through ATP infusion at hand dosal veins. Methods A total of 27 patients receiving coronary angiography (CAG) were enrolled. FFR was measured by intravenous injection of ATP through femoral veins and hand dosal veins separately in 31 stenosed coronary arteries. Results A linear correlation between ATP infusion measuring FFR through femoral and hand dosal veins was observed. Heart rates, PR intervals and side effects were of no difference between the 2 routes of ATP infusion (P=0.79, P=0.56, P=0.85). It indicated that ATP infusion[160μg/(kg·min)]measuring FFR through hand dosal veins was compatable to which measuring FFR though femoral veins (y=0.945x+0.0043, R2=0.904, P=0.001). Compared with ATP infusion by femoral vein[from (53.7±15.8) s to (58.2±11.6) s], the time to FFR by infusion ATP measurement by hand dosal veins was longer[(48.7±17.9) s, P=0.015]. Conclusions The FFR measurement through ATP infusion at hand dosal veins has similar results with the FFR measured by femoral veins ATP infusion.

ObjectiveTo investigate the clinical characteristics and therapy of fresh cervical spinal cord injury without radiographic abnormality (SCIWORA) in children.MethodsThe materials of fourteen SCIWORA children (13 cases treated with non operative menthod, 1 case treated by atlantoocciptal fusion) were analyzed retrospectively.ResultsOne child was dead, and the other 13 cases had a 3-year follow up. Three children's symptoms had no change. According to ASIA criterion, there were 3 cases with grade A, 5 cases with grade B, 5 cases with grade C and 1 case with grade D before treatment. After treatment, there were 1 case recovered to grade B, 2 cases recovered to grade C, 5 cases recovered to grade D, 2 cases recovered to grade E.ConclusionSpinal cord injury caused by a short time dislocation of cervical vertebrae is the main reason of SCIWORA in children. The degree of the injury of spinal cord is related directly with the recovery of function of nervous system. Most patients can get satisfactory results by non operative methods. Operations are useful to the cases with obvious instability of cervical spine.

Objective To predict and identify liner B-cell epitopes in the hemagglutinin ( HA) of human-infected avian-origin H7N9 influenza virus and analyze the specificity of H7 subtype.Methods Three serum samples collected at different times from the same patient who was confirmed to be infected with H7N9 influenza virus were provided by Shaoxing People’s Hospital, and one serum sample from healthy person was collected as the control.The extracellular region of HA protein was predicted by TMHMM Sever v.2.0.The potential B-cell epitopes were predicted by DNAStar Lasergene’ s Protean, BcePred and ABCpred tools, and the immunogenicity of the predicted B cell antigen epitopes was assessed by indirect enzyme-linked immunosordent assay ( ELISA ) .H7 subtype specificity was analyzed by comparing HA protein amino acid sequence with H7N9 and H1-H16 subtype influenza virus from Genbank using Clustal X 2.1 software, and Cn3D 4.3.1 software was used to detect the distribution and 3D structure of predicted epitopes on the HA protein of H7N9.Results The potential B-cell epitopes may be located in 172-183, 363-380, 452-472 and 491-506 of extracellular N-terminus of HA protein.ELISA showed that four predicted eptiopes specifically reacted with positive serums from patient.Multi-sequence alignment demonstrated that peptide 172-183 and 363-380 had higher H7 subtype specificity compared with amino acid sequences of other subtypes.Moreover, the predicted linear B-cell epitopes all located on the surface of HA protein according to the 3D structure analysis.Conclusion Four potential B-cell epitopes were identified, in which peptide 172-183 and 363-380 have higher H7 subtype specificity, and may be used in the design of epitope-based vaccines and diagnostics tests.

ObjectiveAn increasing number of patients requiring ventricular assist devices (VAD) have had previous valvular corrections,including valve repair,and valve replacement with mechanical or bioprosthetic valves.The operative and peri-operative management of these patients has been varied.MethodsA retrospective study of VADs between Jan 1994 and June 2008 revealed 10 patients with previous prosthetic valves requiring management during and after VAD placement.Three patients were supported post-cardiotomy after valve surgery.Two patients were supported due to cardiogenic shock postopera-tively.Four patients were supported as a bridge to transplantation.One patient was supported as a destination therapy.ResultsThe mitral valve was left untreated during VAD implantation regardless of valve repair or replacement.For aortic valves,the mechanical aortic valve was replaced with tissue valve in two patients and left untreated in one case.One patient had tricuspid valve repair previously and was left untouched.All patients with prosthetic valves in aortic,mitral and tricuspid position during VAD support received anticoagulation therapy.There were 4 deaths,and 4 went on to transplantation.One patient weaned from VAD and discharge from hospital.One patient received HeartMate Ⅰ as destination therapy.The most common causes of death were multisystem organ failure and sepsis.One patient had a thromboembolic event.ConclusionThe survival rate of 60% is encouraging when compared to overall survival rates.The most common cause of death was multisystem organ failure.Patients with prosthetic valves may be safely managed during VAD support.

AIM:To construct a recombinant adenovirus carrying Fhit gene,a tumor suppressor in many types of cancer,and to observe its biological function on the proliferation of colon cancer cells.METHODS:Fhit gene was cloned from the fetal liver cDNA library using the PCR method.The PCR product was inserted into the T vector to construct the plasmid pMD18T-Fhit.The Fhit fragment from the pMD18T-Fhit was inserted into the vector ptrack-CMV to construct a shuttle plasmid ptrack-CMV-Fhit.After PmeI digested and linearized process,ptrack-CMV-Fhit was co-transformed into Escherichia coli strain BJ5183 together with the adenovirus backbone vector pAdEasy-1 to generate a recombinant adenovirus plasmid by homologous recombination.The adenovirus plasmid was identified by PacI digestion and transfected into 293A cells to package a recombinant adenovirus which expressed the Fhit protein.Furthermore,the adenovirus rAd-Fhit was infected into colon cancer cells,and the expression of the ectogenic protein was detected by Western blotting.Finally,the proliferation of colon cancer cells was observed in adenovirus-infected cells by the MTT assay.RESULTS:Constructed the recombinant adenovirus encoding Fhit gene and expressed it in colon cancer cells successfully.Detected that the proliferation of colon cancer cells was inhibited obviously in rAd-Fhit-infected cells with comparison to the control groups.CONCLUSION:Fhit may function as a tumor suppressor in colon cancer cells,and the adenovirus-mediated Fhit can be a novel strategy for the colon cancer therapeutics.