BACKGROUND:The bone metabolism of osteoarthritis is regulated by estrogen with osteoblasts, osteoclasts and cytokines, as wel as a number of regulatory pathways.
OBJECTIVE:To describe the role of estrogen and estrogen-related compounds for joint protection, repair of bone and cartilage cells, and inhibition of synovitis in osteoarthritis.
METHODS:Author researched PubMed, Embase, Elseveir database from 1992 to 2014, with the key words of“osteoarthritis, estrogens, matrix metal oproteinases, interleukins, tumor necrosis factor-alpha”. After the quality of the included studies was evaluation, valid data were extracted and analyzed.
RESULTS AND CONCLUSION:Estrogen can increase the expression of osteoprotegerin and nuclear factor-κB factor ligands in osteoblasts, inhibit bone resorption, prevent the onset and progression of osteoarthritis. Estrogen upregulates anti-osteoclast cytokines, downregulates pro-osteoclast factors, and contribute to regulate bone metabolism of osteoarthritis patients through bone morphogenetic protein and Wnt signaling. Estrogen promotes the adrenal cortex secretion of glucocorticoids and indirectly inhibits the production of matrix metal oproteinases by the hypothalamus-hypophysis-adrenal gland axis. Exogenous estrogen inhibits bone resorption, which may help to delay the development of osteoarthritis. Estrogen and estrogen-related compounds may inhibit the cartilage loss caused by synovitis and inflammatory factors in the late stage of osteoarthritis.

Objective:To evaluate the clinical value of MR cholangiopancreatography(MRCP) as the only imaging procedure in diagnosing biliary complications after orthotopic liver transplantation(OLT).Methods: The MRCP results were analyzed in 54 consecutive patients presented with clinical or biochemical signs of biliary complications after receiving OLT,and were compared with the findings eventually confirmed by surgery,direct cholangiography,and clinical follow-up.Two different MRCP snapshot techniques were applied: thick-slab T_(2)-weighted sequences and multi-section thin-slab T_(2)-weighted sequences.Results: Surgery,direct cholangiography,and clinical follow-up confirmed that 36 patients had biliary complications.MRCP had a sensitivity of 100%(36/36) in diagnosing biliary complications after OLT,with a positive predictive value of 91.7%(33/36),a false-positive rate of 5.56%(2/36),and an overall diagnostic accuracy of 94.4%(51/54).MRCP as the only imaging procedure achieved a specific diagnosis in 96.3%(52/54) of the patients in the present study.Only 2 patients required additional endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholecystostomy.Direct cholangiography was required only as a therapeutic procedure in 25.9%(14/54) of the patients.Conclusion: MRCP is an effective imaging procedure in the assessment of biliary complications after OLT.Direct cholangiography is not needed for diagnosis but should be reserved as a therapeutic procedure.

Objective To observe the microdose albumin in urine,carotid intima -media thickness(CIMT) of coronary heart disease(CHD)patients′and coronary Gensini score level,to investigate the correlation between the extent of coronary stenosis and microalbuminuria,CIMT.Methods 50 cases of hospitalized patients with CHD and healthy control group of 50 cases were selected,to compare the score between the two groups of microalbuminuria, CIMT and coronary Gensini.Results CHD group:microalbuminuria and CIMT were (38.36 ±19.51 )mg/L, (1.18 ±0.25)mm respectively.Healthy control group:microalbuminuria and CIMT were (27.52 ±15.44)mg/L, (0.76 ±0.17)mm respectively.Differences between the two groups were statistically significant(t =3.080,P =0.002;t =9.823,P =0.000).CHD group:coronary Gensini score was positively correlated with microalbuminuria, CIMT(r =0.288,P =0.430 r =0.308,P =0.290).Conclusion The correlation between CHD patients'microalbu-minuria,CIMT and the degree of coronary artery stenosis is positive.By measuring the microalbuminuria and CIMT,we can predict the extent of coronary artery stenosis.

Hilar cholangiocarcinoma is a type of malignant tumor of the extrahepatic ductal system.Due to hepatic artery and portal vein involvement within the liver hilum,the resection rate is low and the prognosis is poor.However,with several advances in imaging technology achieved during the last decades,the accuracy of diagnosing and assessing the resectability of hilar cholangiocarcinoma has been greatly improved.In fact,some new classification and staging systems have been proposed to evaluate the tumor.This review will discuss the recent advances in the classification,staging,and preoperative resectability assessment for hilar cholangiocarcinoma.

12.Meanwhile 10 healthy elderly subjects of similar age and gender ratio were matched as controls.There was no significant difference of age,gender,education,onset duration and MMSE.Attention task was carded out with silent color-word task:all participants pressed the left or right button to select the answer of congruence or incongruence when color nouns in red,green,blue or yellow ink appearing on the left part of screen and a target color appearing on the right part of the screen by.During the tasks,reaction time,false ratio,missing ratio and fMRI image acquisition was respectively recorded,which were later analyzed on SPSS 11.0 statistical parametric mapping software 2 (SPM2) respectively.Results The reaction time in dAD,AD and control group were (2214.4?1071),(2020.6?558.3) and (840.0?254.5) ms respectively.The false ratio were 8.3%,6.9% and 0.7% respectively,and the omit ratio were 3.6%, 2.9% and 0 respectively.Either AD with or without depression was slower than the controls in reaction time (P

Objective To discuss appropriate strategy about treatment of rotatory fixation or dislocation of atlantoaxial articulation in children. Methods 32 cases of rotatory fixation or dislocation of atlantoaxial articulation in children were analyzed retrospectively from January 2000 to March 2005, 24 males and 8 females; patients' age was from 3 to 12 years old with an average of 5.5 years old. The mean course of diseases was 6.5 weeks (range: 2 days to 50 weeks). According to Fielding-Hawkins clinical classification, typeⅠ17 cases(1 case with os odontoideum), type Ⅱ 12 cases(1 case with os odontoideum and 1 case with congenital absence of the arch of posterior atlas), type Ⅲ 3 cases. 26 cases received conservational treatments which were recommended as 2-3 weeks of cervical traction, traction weight should be controlled to 1.0-1.5 kg. After a successful reduction a proper external fixation was required to maintain reduction. And another 6 serious cases received posterior atlantoaxial or occipitocervical autograft fusion. Indications for posterior atlantoaxial or occipitocervical atuograft fusion includes: 1) have difficulty in reduction even under proper traction; 2) with obvious neurological symptoms; 3) combined with compensatory deformity of atlantoccipital articulation or other occiptocervical deformities. Results All of 32 cases were followed up from 3 to 50 months with an average of 32 months. 26 cases who received cervical traction and external fixation resulted in satisfactory outcome in which all the torticollis were rectified, bilateral masses were symmetrical on AP position, and ADI was less than 4 mm in dynamic extension and flexation lateral view. ROM in rotation and extension and flexion were completely recovered. All the 6 cases surgically treated obtained sound bony fusion and neural symptoms were improved obviously and torticollis were rectified completely in 4 cases and others (2 cases) stopped progressing after operation. Conclusion Conservative treatment including Glission traction, cranial traction, collar, cast or cervicothoracic external fixation has been proved to be very effective in most of rotatory fixation or dislocation of atlantoaxial articulation in children; however, operative treatment should be considered in the following situations: patients with difficulty in reduction, with neural involvement and compensatory deformity of atlantoccipital articulation or other occipitocervical deformities.

retina. Degeneration was found in the epithelial cells of lens at day 30 after radiation. During day 90 to 360 after radiation, lens capsule was thickened, degeneration of epithelial cells, and edema on the posterior surface were found, and cataract ensued. The injurious effect was dose-related. Conclusion High power EMP may cause posterior capsular opacity and subsequent cataract, and the injurious effect was dose-related.

Objective To induce regeneration of dog's tracheal cartilage by implanting the recombinant human bone morphogenetic protein-2 (rhBMP-2) into the tracheal graft in order to prevent the trachea from collapse. Methods RhBMP-2 with the atelopeptide type-1 collagen carrier was implanted around the cartilage ring of the autograft. New cartilage formed was detected with the histological analysis and immunohistochemical stain after 4 weeks. Six different concentrations of rhBMP-2 with collagen carrier were implanted around the cartilage ring in 6 auto transplantation groups respectively. The area of new cartilage regeneration was calculated in choosing the optimal dosage of rhBMP-2. Auto and allo tracheal transplantation were performed with rhBMP-2 implanted around the cartilage ring, the diameter of the grafts, histological analysis, and the area of the new cartilage regeneration were calculated. Results The addition of rhBMP-2 resulted in significantly greater amount of the new cartilage area (P

Objective To investigate the clinicopathological features of hepatitis B virus-associated glomerulonephritis(HBV-GN) in children.Methods Clinical and pathological features were analyzed and correlated in 73 cases with renal biopsy-confirmed(HBV-GN).Sixty-six boys and 7 girls aged from 1 to 14 years old were included in this study,accounting for 14.4% in children under-(going) renal biopsy in the same period.Results Nephrotic syndrome(NS) was the prodominant clinical manifestation(53/73,72.6%),followed by glomerulonephritis(15/73,20.5%) and hematuria with proteinuria(5/73,6.9%).Serologic markers of HBV were found in all cases.Among them,55 cases(75%) were positive for hepatitis B surface antigen(HBsAg),hepatitis B e antigen(HBeAg) and anti-hepatitis B core(anti-HBc),14 cases(19.2%)positive for HBsAg,anti-HBe and anti-HBc,2 cases positive for HBsAg and anti-HBc,1 child positive for HBsAg and HBeAg,and another only positive for anti-HBc.The most common pathological type of HBV-GN was membranous nephropathy(MN),which was found in 69 cases(94.5%),followed by membranoproliferative glomerulonephritis(MPGN) and mesangial proliferative glomerulonephritis(MsPGN),2 cases(2.7%),respectively.All cases with NS presented themselves with MN.The pathological grades were significantly correlated with clinical manifestations through double trend analysis(?~2=5.22 P=0.022).Conclusions MN is predominant in childhood HBV-GN,which mainly presented with NS.Their clinical patterns are somewhat correlated with pathological grades.

Objective To study the clinical significance of transforming growth factor (TGF)-β1 and interleukin (IL)-18 mRNA in the diagnosis and evaluation of disease severity of primary nephrotic syndrome (PNS) in children. Methods The ex-pression levels of TGF-β1 and IL-18 mRNA in peripheral blood mononuclear cells (PBMC) were measured by real-time lfuorescent quantitative polymerase reaction (RT-PCR) in 77 children with PNS and 30 healthy children (control group). Results In children with steroid-sensitive nephrotic syndrome (SSNS), the expression levels of TGF-β1 and IL-18 mRNA before treatment and at 1, 4 weeks after hormone therapy were signiifcantly lower in children with simple type nephrotic syndrome than those in children with nephritic type nephrotic syndrome (P<0.05). The level of TGF-β1 mRNA before treatment was signiifcantly lower in children with SSNS than that in children with steroid-resistant nephrotic syndrome (SRNS). With the extension of hormone therapy, the expression levels of TGF-β1 mRNA showed a trend of declining in children with PNA. In children with SRNS, the expression levels of TGF-β1 and IL-18 mRNA before treatment and at 1, 4 weeks after hormone therapy were signiifcantly lower in children with simple type NS than those in children with nephritic type nephrotic syndrome (P<0.05). In children with SSNS, the levels of TGF-β1 and IL-18 mRNA were signiifcantly higher in acute phase than those in the remission phase. Conclusions At the early stage of PNS, the detection of the expression levels of TGF-β1 and IL-18 mRNA is useful for evaluatation of disease activity, clinical identiifcation of nephritic type nephrotic syndrome and simple type nephrotic syndrome and early prediction of SRNS.