Objective To analyze the relationship between baseline serum γ?glutamyltransferase (GGT) and risk of the metabolic syndrome (MS). Method A total of 4 935 adults from health checkup population in Shenzhen were enrolled into a 10?year follow?up study, of these adults 81.84%were male and 18.16% were female, the average age was 60.54 ± 10.38 years.The follow?up outcome measure was the occurrence of MS. The proportional hazards model was adopted to calculate the hazard ratios (HR) and 95%confidence intervals (95%CI) to analyze the association of GGT with the development of MS. Reslut The mean follow up period was 5.0 ± 2.9 years, and there were 24 713 person?years of follow?up, and 1 689 subjects developed MS. During the follow?up, the cumulative incidence and incidence density of MS were 34.22%and 68.34/1 000 person?years, respectively. For both genders, the association between GGT and MS presented dose?response relationship trend (male: M?C χ2=32.78, P<0.001; female: M?C χ2=18.80, P<0.001). After adjusting for age, gender, body mass index, systolic blood pressure, diastolic blood pressure, high?density lipoprotein cholesterol, low?density lipoprotein cholesterol, triglycerides, uric acid and fasting blood glucose in Cox regression model, the HR for MS in quartiles 3 and 4 level of GGT was 1.45 (95%CI:1.08-1.85) and 1.52 (95%CI:1.15-1.99), respectively. Conclusion The GGT level could be an important risk factor and predictor for the development of MS.

Objective To summarize the research results at home and abroad of raltitrexed on the patients with advanced gastric cancer,and to evaluate the clinical efficacy and adverse reactions of raltitrexed. Methods Clinical controlled trials of evaluating effects of raltitrexed on the advanced gastric cancer were searched in PubMed,EMBase,Ovid,Springer,Wanfang database,VIP database and China Biology Medicine disc. Besides,references and conference abstracts were searched manually. Literature screening and data extraction were performed according to inclusion and exclusion criteria. Then Meta-analysis was performed using RevMan 4. 2. Results Forty-four studies were found and 5 clinical controlled trails including 338 patients were included in this analysis. The results of Meta-analysis showed that there was a significant beneficial effect of raltitrexed on objective effective rate for the patients with advanced gastric cancer(RR = 1. 55,95% CI:1. 21-1. 99,Z = 3. 44,P = 0. 00)compared with other treatments. The incidences of Ⅲ-Ⅳadverse reactions in raltit-rexed group such as neutropenia(RR = 1. 97,95% CI:0. 85-4. 56,Z = 1. 59,P = 0. 11),thrombocytopenia (RR = 1. 56,95% CI:0. 60-4. 07,Z = 0. 92,P = 0. 36),anemia(RR = 2. 43,95% CI:0. 61-9. 78,Z =1. 25,P = 0. 21),arthralgia(RR = 3. 20,95% CI:0. 73-13. 98,Z = 1. 55,P = 0. 12),elevated transaminase (RR = 1. 37,95% CI:0. 29-6. 48,Z = 0. 39,P = 0. 69)were higher than those in other group,with no statis-tical significance. However,the adverse reactions in raltitrexed group such as diarrhea(RR = 0. 18,95% CI:0. 03-1. 07,Z = 1. 88,P = 0. 06),nausea and vomiting(Z = 1. 79,RR = 0. 45,95% CI:0. 19-1. 08,P =0. 07),neurotoxicity(RR = 0. 07,95% CI:0. 01-0. 52,Z = 2. 59,P = 0. 01),hand-foot syndrome(RR =0. 26,95% CI:0. 04-1. 59,Z = 1. 46,P = 0. 14),alopecia(RR = 0. 57,95% CI:0. 13-2. 55,Z = 0. 73, P = 0. 46)were lower than those in other group. There were no statistical significances except neurotoxicity. Conclusion Compared with other treatments,raltitrexed-based chemotherapy has a beneficial effect on objec-tive effective rate and less adverse reactions for the patients with advanced gastric cancer,which is worthy of clinical use.

Salvia miltorrhiza Bge. is a perennial deciduous flowering plant. Its medicinal root and rhizomes part is widely used in the treatment of various diseases. In this study, bioinformatics analysis was performed to identify 4832 genome SSR loci with length longer than or equal to 40 bp from the draft genome assembly of S. miltorrhiza. The re-sults showed that the dinucleotide repeat motifs and trinucleotide repeat motifs constitute the main types of genome SSR loci, accounting for 37.3% and 61.3% respectively. SSR types enriched with A/T bases showed significantly higher abundance than other types, including AT/TA AAT/ATT, ATA/TAT, TAA/TTA, accounting for 30.5%, 21.6%, 17.1%, 20.4% of the total number of SSR loci, respectively. 1079 primer pairs were designed for these genome SSR loci. These primers can be used for genomic diversity analysis, genetic map construction, genetic marker screening. These data could lay the foundation for population genetics and genomics research of S. miltorrhiza.

Objective To explore the teaching effects of physiology lectures and students' attitude to lectures,their suggestions for contents,forms and other aspects of lectures.Methods Random sampling questionnaire survey was conducted among 500 students of 2008 grade and 2009 grade in Xiangya medical school of central south university.The percentage of the option in the questionnaire was calculated and the findings were directly described.Results All students thought that physiology lectures were necessary.Teachers should arrange lectures which students were interested in,pay attention to inspire thinking and enhance teacher-student interaction.67.6％ of students thought that the knowledge learned from lectures can be used in expanding scientific thinking.Conclusions The lectures are popular among most students,playing an important role in cultivating students' ability of strict scientific thinking.

Objective To compare the clinical efficacy of extramedullary fixation system,intramedullary fixation system and hip arthroplasty in treatment of intertrochanteric fractures in the elderly.MethodsThe retrospective study involved 184 patients treated between January 2007 and January 2011,which were assigned to dynamic hip screw (DHS) group (n =99),locking plate group (n =19 ),intramedullary fixation group (n =25) and joint replacement group (n =41 ).There were 80 males and 104 females,at age range of 60-99 years,mean (72.4 ± 3.9) years.According to the modified Evan classification,the fractures included type Ⅰ A in 20 patients,type Ⅰ B in 21,type Ⅱ in 75 and type Ⅲ in 68.The preoperative conditions,postoperative weight-bearing time,fracture heating time,hip function and complications were comparatively studied among four groups.ResultsThe patients were followed up for 7-22 months (mean 12 months).The four groups showed no significant differences regarding the gender,age,fracture types and medical complications.The postoperative weight-bearing time of the joint replacement group was significantly shorter than that of the other three groups,with statistical significance.The fracture healing time was insignificantly different among the four groups.The postoperative complications were found in 24 patients (13％),including 11 patients in the DHS group,six in the locking plate group,five in the intramedullary fixation group and two in the joint replacement group.Harris score was the highest in the joint replacement group,with statistical significance in comparison with the other three groups. ConclusionsIntramedullary fixation should be the treatment of choice for the patients with unstable,or severe osteoporosis fractures and with intolerance of joint replacement.Artificial bipolar femoral head replacement is suitable for the elderly patients with unstable or severe osteoporosis fractures,capability of walk or tolerance of operation.

Objective To discuss the operation skills and clinical effects of C-arm fluoroscopy in arthroscopic reconstruction of anterior cruciate ligament(ACL)with the Ligament Advancement Reinforcement System(LARS)artificial ligaments.Methods The study involved 36 patients with acute ACL rupture treated with the LARS artificial ligaments from June 2006.There were 25 males and 11 females,at age range of 22-51 years(average 28.3 years),involving 19 left knees and 17 right knees.The results of preoperative MRI of all patients suggested discontinuation of ACL,with average score of Lysholm on knee joint for 50.The operation was completed under arthroscope.While the locations of the femoral tunnel portal and the tibial tunnel exit were mainly determined by the C-arm fluoroscopy.The diameter of the LARS artificial ligament was 7.5 mm while that of the interference screw 8 mm.Results All 36 patients were followed up for a mean duration of 18 months(9-20 months).The average Lysholm Score was 52 preoperatively and 92 at the 12th week after operation.The clinical results were graded as excellent in 23 patients,good in nine and fair in four according to the Lysholm's classification,with excellence rate of 89%.Conclusions Arthroscopic reconstruction of anterior cruciate ligament with LARS artifical ligament under C-arm fluoroscopy takes advantages of convenient operation,accurate location and satisfactory clinical effect.

From August 2007 to January 2009 a total of 95 patients with complex renal calculi were treated with CT ( n = 32 ), X-ray ( n = 33 ) or ultrasound ( n = 30 ) guided percutaneous nephrostomy and ureteroscopic holmium laser lithotripsy respectively. The CT guided procedure had lower positioning time,positioning failure rate, complication rate and residual stone rate than those of X-ray and ultrasound localization, particularly had advantages in the stone clearance rate and complications rate ( all P ＜ 0. 05 ).CT guided localization can be chosen in the following conditions: higher kidney position, large staghorn calculi or renal pelvis stones without hydronephrosis, with congenital renal malformations or failure of ultrasound or X-ray localization.

BACKGROUND:Evaluation of vertical jumping ability is usual y only limited to height measurements. The measurements of parameters that describe kinetic factors may provide a better assessment of a patient’s jumping ability.
OBJECTIVE:To determine the deficit in one-legged vertical jumping ability and to clarify the relationships between the maximum jumping height and the maximum power, force and velocity during one-legged vertical jumps after anterior cruciate ligament reconstruction.
METHODS:Twenty-five healthy subjects (10 males and 15 females) and 25 anterior cruciate ligament reconstructed patients (10 males and 15 females) participated in this study. The isokinetic quadriceps femoris strength and one-legged vertical jumping ability were evaluated by the height, power, force and velocity in al subjects.
RESULTS AND CONCLUSION:(1) The maximum height of the one-legged vertical jumps was only significantly correlated with the maximum force in the healthy subjects (P<0.05). (2) However, for the reconstructed and unreconstructed legs in anterior cruciate ligament reconstructed patients, the maximum jumping height was significantly correlated with the maximum power, force and velocity during one-legged vertical jumps (P<0.05). (3) These findings suggest the importance of a knee strategy during one-legged vertical jumps for rehabilitation after anterior cruciate ligament reconstruction. Assessment of the jumping ability after anterior cruciate ligament reconstruction may be determined by the maximum power instead of the maximum jumping height.

ObjectiveTo analyze the clinical outcome of locking plate and hemiarthroplasty in treatment of Neer three- and four-part proximal humeral fractures.Methods A totalof 63 consecutive patients aged over 55 years with Neer three- and four-part proximal humeral fractures were treated surgically from June 2006 to June 2010.In the retrospective study,36 patients were treated by open reduction and locking plate fixation ( locking plate fixation group) and 27 patients treated by hemiarthroplasty (hemiarthroplasty group).Clinical outcomes including operation time,blood loss,visual analog scale ( VAS),Constant-Murley score and complications were evaluated.ResultsThe average 19.7 months follow-up showed complication rate of 28％ in the locking plate group,including one patient with varss malunion,one with axillary nerve injury,one with humeral head necrosis,one with heterotopie calcification and four with impingement syndrome.The complication rate was 24％ in the hemiarthroplasty group,including two patients with tuberosity nonunion,one with tuberosity migration,one with impingement syndrome and one with joint semiluxation.The mean Constant-Murley score of three-part fractures in the locking plate group was ( 76.5 ±5.8) points,better than (69.2 ±7.2) points in the hemiarthroplasty group (P ＜0.05 ).While the two groups showed no significant differences with regards to operation time,blood loss and visual analog scale (VAS).As for the four-part fractures,the mean operation time was shorter and the mean blood loss was less in the hemiarthroplasty group compared with the locking plate group (P ＜0.05),while there were no obvious differences in VAS score and Constant-Murley score between the two groups. Conclusions Both locking plate and hemiarthroplasty are the reliable methods for the three- and four-part proximal humeral fractures.The patients' age,bone quality,fracture type,comminution degree and evaluation of osteonecrosis possibility,are critical for surgery decision.

Objective To investigate the initial effect of LARS artificial ligaments arthroscopically in reconstruction of ipsilateral anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL).Methods A total of 21 patients (13 males and 8 females,at average age of 31.5 years) received ACL and PCL restoration using LARS artificial ligaments since June 2006.Preoperative MRI exactly confirmed them as ACL and PCL ruptures.Lysholm score on knee joint was (47.6 ±6.7) points.Surgery had reconstruction of PCL prior to ACL under arthroscope.Results All patients were followed up for average 42 months (range,36-49 months),which showed no infection,ligament rupture,ligament loosening,or other postoperative complications.At postoperative 3 years,Lysholm score was (90.8 ± 3.7) points and International Knee Documentation Committee (IKDC) score was normal in 14 patients,near normal in six,and abnormal in one,with excellent-good rate of 95％.Conclusions LARS artificial ligaments can attain anatomical reconstruction and stability of the knee joint in treatment of ACL and PCL ruptures.Meanwhile,arthroscopic surgery shows superiorities of micro-wound,rapid recovery and satisfactory curative effect.