Objective: To explore mechanism of fasudil combined salmeterol and fluticasone propionate powder for inhalation (Seretide) in treating chronic obstructive pulmonary disease (COPD) complicated pulmonary artery hypertension (PAH).Methods: A total of 120 patients accorded with diagnostic standards of COPD and PAH, who hospitalized in our department from Jan 2013 to Oct 2014, were selected.According to random number table method, patients were randomly and equally divided into routine treatment group, fasudil group (received intravenous drip of fasudil based on routine treatment group) and combined treatment group (received additional Seretide therapy based on fasudil group).Levels of nitric oxide (NO), endothelin-1 (ET-1), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured and compared among three groups before and after treatment.Results: Compared with before treatment, after two-week treatment, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in three groups, P<0.05 or<0.01;compared with routine treatment group after treatment, there were significant reductions in levels of CRP[(14.8±3.3) mg/L vs.(12.9±3.6) mg/L vs.(11.4±3.4) mg/L], ESR[(37.3±8.9) mm/h vs.(32.9±8.8) mm/h vs.(29.3±5.6) mm/h]and ET-1[(63.1±11.2) ng/L vs.(57.5±8.1) ng/L vs.(53.1±8.9) ng/L], and significant rise in NO level[(70.2±10.7) μmol/L vs.(76.0±8.0) μmol/L vs.(80.5±11.3) μmol/L]in fasudil group and combined treatment group, P<0.05 or<0.01;compared with fasudil group, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in combined treatment, P<0.05 all.Conclusion: Fasudil hydrochloride combined Seretide can significantly reduce levels of ESR, CRP and ET-1, and increase NO level in COPD + PAH patients.It may improve prognosis in these patients, which is worth extending.

Objective To investigate the differences in expression of Mohawk (MKX) transcription factors and collagen of types Ⅰ and Ⅲ in anterior cruciate ligament (ACL) gratis between 2 remodeling outcomes under arthroscopy.Methods Enrolled for this study were 17 patients who had undergone arthroscopic single-bundle ACL reconstruction with autogenous hamstring tendons and secondary arthroscopic exploration 48 to 131 months (average,83.1 months) after removal of tibial internal fixator at Department of Sports Medicine,The First Affiliated Hospital to Shenzhen University from March 2017 to December 2017.They were divided into a good remodeling group (11 cases) and a fair remodeling group (6 cases) according to the graft quality under arthroscopy (synovial and vascular coverage,and apparent tension,thickness and retear of the grafts).During the secondary arthroscopic procedures,biopsy of the central ACL grafts was performed.Moreover,normal ACL tissues were harvested from 8 contemporary controls of ＜ 60 years old who underwent total knee replacement.Immunohistochemical assay and quantificational real-time polymerase chain reaction were conducted to detect the expression of transcription factors and collagen of types Ⅰ and Ⅲ in all the samples.Results In the samples from good remodeling and control groups,there were abundant well-arranged collagen fibers of types Ⅰ and Ⅲ and MKX-positive cells;in the fair remolding group,the collagen fibers of types Ⅰ and Ⅲ and MKX-positive cells were much decreased in number and the fibers were not well arranged.The former 2 groups scored in immunohistochemical assay significantly higher than the latter one (P ＜ 0.05).qRT-PCR showed that the expression levels of MKX gene (0.44 ± 0.30),COL1A1 gene (0.52 ± 0.27) and COL3A1 gene (0.60 ± 0.22) in the fair remolding group were significantly lower than in the control group (1.00 ± 0.00,1.00 ± 0.00 and 1.00 ± 0.00) and than in the good remolding group (0.97 ± 0.67,0.99 ±0.38 and 1.00 ± 0.35) (P ＜ 0.05).Conclusion Good remodeling ACL grafts with histological maturation under arthroscopy are more similar to normal ACL than fair remodeling ACL grafts in expression of MKX transcription factors and collagen of types Ⅰ and Ⅲ.

Gout is a common metabolic disease. Gouty arthritis is associated with the deposition of urate crystals in the synovial fluid or para-articular soft tissues, which often affects the hands, feet, wrists, ankle and knees joints. However, the shoulder joint is unusual involved. In the present study, a 49-year-old male patient complained of right shoulder pain for 9 months and aggravating with limited range of motion for 2 weeks. Physical examination showed that the external rotation was 10° and hand back was S 5 of the right shoulder. The MRI showed shoulder joint effusion and intra-articular loose bodies. The patient was admitted to the hospital with the diagnosis of "loose bodies of the right shoulder with synovial chondromatosis possibly". Arthroscopic examination revealed that a lots of urate crystals were deposited on synovium, cartilage and rotator cuff. Loose bodies removal and joint debridement were performed. Histopathologic examination of the specimen demonstrated synovitis hyperplasia with urate crystals deposition. Shoulder gouty arthritis characterized by pain and limited movement. The imaging of tophi depends on the calcium-containing deposits. Tophus with calcium deposits can be found on X-ray and CT. MRI can not only evaluate the tophus but also the evaluate the other intra-articular pathologies. Due to no typical manifestations and specific images of shoulder gouty arthritis, pathological diagnosis is the "gold standard". Shoulder arthroscopy provide a minimal invasive technique in diagnosing and treating of the shoulder disease. Undoubtedly, it could be a reliable diagnosis and treatment method for shoulder gouty arthritis.

OBJECTIVE： To study the effects of exogenous methyl jasmonate on the contents of 4 kinds of secoiridoid substance （gentiopicrin， swertiamain， sweroside and amarogentin） and biochemical indexes in the leaves of Gentiana rigescens， and to provide scientific evidence for the application of methyl jasmonate in standardized planting of G. rigescens. METHODS： 2， 4， 6， 8， 10 d after spraying 10， 50， 100， 200 mg/L methyl jasmonate （spraying amount was 500 mL） for G. rigescens strain， the leaves of medicinal material were collected as sample， and the other leaves without spraying methyl jasmonate were collected as control. HPLC method was used to determine the contents of 4 kinds of secoiridoid substance in the leaves of G. rigescens after spraying 4 kinds of concentrations of methyl jasmonate for 10 d. The concentration of methyl jasmonate was optimized （the content of effective component was the highest）. HPLC method was adopted to determine the contents of 4 kinds of secoiridoid substance in the leaves of G. rigescens after spraying the optimal concentration of methyl jasmonate for different time. The levels of relevant biochemical indexes （SOD， POD， CAT， MDA） were determined. RESULTS： 10 d after spraying 10， 50， 100， 200 mg/L methyl jasmonate for G. rigescens strains， the contents of 4 kinds of secoiridoid substance in the leaves were increased to different extent. Compared with untreated leaves， 100 mg/L methyl jasmonate had the best effect after spraying， and the contents of gentiopicrin， swertiamain and sweroside in treated leaves were 1.88， 2.36 and 1.87 times of those in untreated leaves， respectively （P＜0.05）. 2， 4， 6， 8， 10 d after spraying 100 mg/L methyl jasmonate， the contents of 4 kinds of secoiridoid substance in treated leaves were higher than untreated leaves at corresponding stage； the content of secoiridoid had significant difference after spraying for 4 d （P＜0.05）. The contents of active components in general were relatively high after spraying for 6 d， and the contents of gentiopicrin， swertiamain， sweroside and amarogentin in treated leaves were 1.88， 1.88， 1.47， 1.82 times of those in untreated leaves， respectively （P＜0.05）. The levels of relevant biochemical indexes in treated leaves were increased significantly since 4 d of spraying， compared with untreated leaves （P＜0.05）. CONCLUSIONS： After spraying 100 mg/L methyl jasmonate for 6 d， the contents increase of 4 kinds of secoiridoid substance in the leaves of G. rigescens are most obvious， which may be associated with improving the levels of related biochemical indexes.