BACKGROUND:Studies have found that after stimulation, chemerin can further amplify the inflammatory signal, resulting in the release of inflammatory factors and matrix metaloproteinases. It indicates that chemerin may serve as an important regulator of cartilage metabolism, and plays an important role in the pathogenesis of osteoarthritis. OBJECTIVE: To explore the correlation between level of chemerin in synovia and serum and severity of knee osteoarthritis. METHODS: Eighty patients with knee osteoarthritis were enroled in the study. Knee osteoarthritis grading was evaluated according to the Kelgren-Lawrence classification. Chemerin levels in synovia and serum were examined with enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION:The level of chemerin in synovia and serum in patients with knee osteoarthritis were positively correlated with the Kelgren-Lawrence classification (r=0.981,P< 0.001;r=0.901,P < 0.001). And there was a positive correlation between the level of chemerin in synovia and in serum (r=0.596,P < 0.01). Experimental findings suggest that the levels of chemerin in synovial fluid and serum that are positively correlated with the Kelgren-Lawrence classification can be used as a reference biomarker of severity of knee osteoarthritis.

Objective: To explore influence of p38 mitogen-activated protein kinase (p38MAPK) inhibitor on myocardial cell apoptosis and expression of tumor necrosis factor (TNF)-α in rats with ischemia/reperfusion (I/R) injury. Methods: According to number table method, a total of 30 SD rats were randomly and equally divided into blank control group, I/R group and inhibitor group. p38MAPK mRNA expression, TNF-α level and myocardial cell apoptotic rate were measured, compared and analyzed among three groups. Results: Compared with blank control group, there were significant increase in TNF-α level [(3.68±0.16) μg/L vs. (5.02±0.09) μg/L], p38MAPK mRNA expression [(1.76±0.46) vs. (2.35±0.02)] and myocardial cell apoptotic rate [-(3.51±0.40) % vs. - (1.8±0.23) %] in I/R group, P=0.001 all. Compared with I/R group, there were significant decrease in p38MAPK mRNA expression (2.09±0.16), TNF-α level [(4.15±0.11) μg/L] and myocardial cell apoptotic rate [-(2.9±0.50) %] in inhibitor group, P=0.001 all. Conclusion: Inhibition of p38 mitogen-activated protein kinase expression in myocardium of rats can decrease production of tumor necrosis factor-α and myocardial cell apoptosis, then relieve ischemia/ reperfusion injury of myocardial cells.

Objective To explore the application of integrating 64-slice CT image with three-dimensional electroanatomic mapping(Carto-Merge) in guiding catheter ablation of atrial fibrillation(AF).Methods Fifteen patients with drug-refractory AF received catheter ablation of AF.64-slice CT scan was performee 1-3 days prior to the ablation procedures.Using a novel software package,the left atrium(LA)with PVs was segmented and extracted for image registration with a combination of landmark registration and surface registration.Results The integration of the CT image into the electroanatomic mapping system was performed successfully in all patients with an error of 2.11?0.82 mm.Thirty pairs of PVs were electrically isolated after circumferential rediogrequency pulmorary rein ablation.The mean procedure time was 170.51?38.47 minutes.Cardiac tamponade occurred in one patient.All the fifteen patients were free of AF recurrence after 3 months of follow up including the 2 cases of persistent AF who required antiarrhythmic drugs.No thromboembolic events or stenosis were observed.Conclusion Integration of 64-slice CT image into the CARTO system successfully performed in patients undergoing catheter ablation of AF and enhance the ablation success rate.

[Objective]To evaluate outcome of the treatment of unstable distal radius fractures in the elderly patient using a volar T-shape plate.[Method]From January 2001 to April 2003,42 cases with unstable distal radius fractures older than 60 years(range 60～75 years;mean age 65.1 years) were treated with a T-shape plate fixation.The fractures were classified according to the AO classification of distal radius fracture: 4 A2,7 A3,5 B1,3 B3,9 C l,11 C2,3 C3.Artificial bone graft substitutes were used in 28 cases with severe cortex destruction and insufficient buttress.[Result]All patients were followed up(mean 18.2months,range 12～24months).Final volar tilt was averaged 3.66? and radial tilt 20.1?,and radial shortening averaged 1.59 mm in 6 cases.Step-off or gap of the articular surface was found in 6 cases(mean

[Objective]To study the accuracy of Helfet test in the diagnosis of the knee meniscus tear.[Method]From Apr.2007 to Oct.2007,52 cases of the lateral meniscus tear and 23 cases of the medial meniscus tear were checked-up with Helfet test,McMurray test ,KS test,and arthroscope comparatively.[Result]The Helfet Test was positive in most of the lateral meniscus tear cases.The consistency with McMurray test and arthroscope was lateral meniscus tear,especially to bucket-handle and Horizontal tear high respectively.The rate of accuracy to lateral menicus was 81.4%.The rate of accuracy to bucket-handle and Horizontal tear were 89.6% and 87.2% respectively.[Conclusion]The "Helfet" test is sensitive to the knee lateral meniscus tear.It is fast,simple,reliable,reproducible,positive for diagnose of lateral meniscus tear,and is worth of being used widely.

Objective To investigate the diagnostic accuracy and the clinical usefulness of the combination of troponin I (cTnI) and copeptin detected in patients with suspected non-ST elevation myocardial infarction. Methods 176 patients presenting to the emergency departments with chest chocking or chest pain within 6 hours and without ST elevation on a 12-lead electrocardiogram (ECG) were enrolled in this study. The level of copeptin and cTnI was measured. The diagnosis was adjudicated by 2 independent experts.The diagnostic performance of them was assessed using ROC analysis , and the sensitivity and specificity of them were inferred based on the positive rate of two cardiac markers. Results (1)The levels of copeptin and cTnI in NSTEMI patients were markedly higher than other groups (P<0.05).(2)The AUCs of copeptin and cTnI were 0.846 and 0.683, and the 95%CI of two markers were 0.786 ~ 0.906 and 0.577 ~ 0.789, respectively. (3)Using 10.85 pmol/L as cut off value,the sensitivity and specificity of copeptin were 90% and 64%,and the positive predictive value and the negative predictive valueof NSTEMI diagnose were 42.4% and 95.6%,respectively.Using 0.05 ng/mL as cut off value,the sensitivity and specificity of cTnI were 42.5% and 94.1%,the positive predictive value and the negative predictive value were 68%and 84.8% for diagnosis of NSTEMI. (4)The copeptin level over 10.85 pmol/L in combination with cTnI could be used to detect NSTEMI with higher sensitivity than that of copeptin or cTnI alone (95% vs 90% vs 42.5%). The negative predictive value of the combination of copeptin and cTnI was increased , compared to that of copeptin or cTnI alone (97.7% vs 95.6% vs 85.7%). Conclusions Determination of copeptin in addition to cTnI can improves diagnostic performance , especially early after chest pain onset. It seems to allow a rapid and reliable rule out of NSTEMI.

Aim To investigate the drug-containing serum of Rhizoma drynariae on osteogenesis differentiation of bone marrow mesenchymal stem, and discuss the possible mechanism.Methods BMSCs were cultured in media with different concentrations of medicine containing serum.BMSCs proliferation ability was detected in 3,5,7,9 days by CCK-8.ALP activity was detected after 7,10,14 days′ induction.After 3 weeks culturing, alizarin red staining was performed to observe the formation of calcium nodules.The expression of β-catenin,LRP5,RUNX-2 and Osteriex mRNA were detected using RT-PCR.The protein expression of β-catenin,LRP5 was detected using Elisa method.Results Rhizoma drynariae drug-containing serum could obviously promote the proliferation of BMSCs and calci-fied nodule formation.Besides, the ALP activity was improved in a certain period of time.The expression of β-catenin,LRP5,GSK-3β,RUNX-2 and Osteriex mRNA were significantly up-regulated,and the protein expression of β-catenin,LRP5 was up-regulated too.The expression of GSK-3β was down-trgulated.Conclusions Rhizoma drynariae drug-containing serum promotes mineralization and osteogenic differentiationof BMSCs, and the mechanism is closely related with activating WNT/beta-catenin signaling pathway, raising the beta-catenin, LRP5, RUNX-2, and Osteriex mRNA expression, beta-catenin, LRP5 protein expression,and down-regulation of GSK-3β mRNA expression.

Seminar is an exploratory learning model with problem-based and project-or-ganized characteristics.The application practice of Seminar learning model in the process of teaching and training postgraduates of health management shows that the model has an important influence on improving the quality of postgraduates in our country.

AIM: To observe the protein expression of vascular endothelial growth factor 1 (VEGF-1) in pulmonary arterial endothelial cells and VEGF-1 gene expression in lung tissue in rats with hypoxia-induced pulmonary hypertension and treated with heparin. METHODS: Twenty four male adult SD rats were randomly divided into three groups (8 rats each): a control group (group A), a group with hypoxia for 4 weeks (group B) and a group with hypoxia for 4 weeks and injected with heparin to abdominal cavity simultaneously (group C). Mean pulmonary arterial pressure (mPAP), right ventricle hypertrophy index (RVHI) and vessel morphometry were measured. The morphology of pulmonary artery was observed by HE staining. The expression of VEGF-1 protein in pulmonary arterial endothelial cells was determined by immunohistochemistry. The level of VEGF-1 mRNA in lung tissue was measured by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: mPAP, RVHI, pulmonary artery remodeling parameters, VEGF-1 protein expression in pulmonary arterial endothelial cells and VEGF-1 gene expression in lung tissue of the three groups from high to low were group B, group C and group A. It was statistically significant when compared between either two groups of the three (P<0.01). Linear correlation analysis showed that VEGF-1 protein was positively correlated with pulmonary artery remodeling parameters (r=0.974, P<0.01), and VEGF-1 mRNA was positively correlated with VEGF-1 protein (VEGF 120 mRNA, r=0.919, P<0.01; VEGF164 mRNA, r=0.896, P<0.01). CONCLUSION: Heparin may down-regulate the expression of VEGF-1 at the levels of transcription and translation, resulting in the inhibitory effect on rats with hypoxia-induced pulmonary hypertension.

ObjectiveTo evaluate regional and global systolic function of left ventricle (LV) after mitral valve replacement(MVR) of different methods by 2-dimensional strain (2DS).MethodsAccording to the operational method whether preserve the posterior leaflet and its subvalvular apparatus,48 patients who underwent MVR were divided into two groups,the preservation group (group A) and the resection group (group B).Echocardiography was examinated before and after MVR and the apical four-chamber view,two-chamber view and long-axis view of LV were acquired.Regional peak strain (Sp) and global strain (GS) of LV longitudinal movement were analysed by 2DS software.Results①Compared to preoperation,the Sp in basal segment of posterior septum and inferior wall and middle segment of lateral wall in group A increased significantly ( P ＜0.01 or P ＜0.05).The Sp of group B were improved in both basal and middle segments of posterior septum ( P ＜0.05),while declined in middle segment of lateral wall and anterior wall,basal segment of lateral wall and apical segment of anterior wall significantly (P ＜0.01 or P ＜0.05).②Compared with group A,subtractions between preoperative and postoperative Sp of group B decreased in middle segment and apical segment of anterior wall,middle segment of lateral wall and middle segment of inferior wall significantly ( P ＜0.01 or P ＜0.05).③The GS of group A increased significantly ( P ＜0.05),while that in group B tended to reduce with no statistical significance ( P ＞0.05).Compared with group A,subtractions between preoperative and postoperative GS of group B droped significantly (P ＜ 0.05).ConclusionsAppropriate preservation of the posterior leaflet and its subvalvular apparatus has morebeneficial effect in improving the early regional and global function of LV after surgery,which would be recommended in MVR.Early regional and global systolic function of LV after MVR could be accurately evaluated by 2DS relatively,which has the application value of guiding clinical treatment and estimating prognosis.