Objective To explore the fraction risk in patients with osteoporosis and effects of antiosteoporosis therapy on fracture healing.Methods All the recruited subjects were senile patients with fracture in lower extremity and were treated in the Department of Orthopaedics in Shandong Qianfoshan Hospital from Aug.2006 to Feb.2011.In the total 15 cases,10 were female and 5 were male,aged from 53 to 65 years (average 56.7 years old).After surgical reduction and internal fixation,all the 15 patients did free-weight and continous passive motion (CPM) functional exercise and received anti-osteoporosis treatment.X-ray was taken to show the preoperative and postoperative lumbar vertebrae and fracture position.Meanwhile,bone mineral density and blood calcium level and phosphate level were measured.Results Thirteen out of 15 patients were healed for bone fracture after a 3-month treatment,meeting the clinical standards of the fracture healing.The clinical fracture healing rate was 86.67％.Blood calcium level,phosphate level and the bone mineral density were significantly different between that before and after the treatment ( P ＜ 0.05 ).Conclusion Osteoporosis not only increases the risk of fracture,but also has an adverse effect on the bone healing.Anti-osteoporosis therapy has a positive role to the fracture healing in the senile patients with osteoporosis.

Objective To evaluate the alteration of CD4+ regulatory T cells in peripheral blood from patients with ankylosing spondylitis(AS). Methods Seventy-eight AS patients and 50 healthy individuals were included in this study. The proportion of CD4+CD25+CD127lo/- T cell population in CD4+ T cells as well as that cytotoxic T lymphocytes(CTL) and NK cells in lymphocytes was evaluated by flow cytometry. Serum TGF-β and TNF-α were measured by ELISA. The inhibitory function of CD4+CD25+ regulatory T cells was measured by mixed lymphocyte culture. Results The population of CD4+CD25+CD127lo/- T cells in peripheral blood of AS patients accounted for (4.36±1.21)% of CD4+ T lymphocytes, which was significantly lower than that in healthy individuals (P<0.05). The CD4+CD25+CD127lo/- T cells population in AS patients was positively correlated with TGF-β level, but negatively with TNF-α. Compared with healthy individuals, the function of CD4+CD25+ regulatory T cells in the inhibition of alloreactive T cells was lower in AS patients, which was related to the decreased secretion of TGF-β. Conclusion The CD4+ regulatory T cells in peripheral blood of AS patients are significantly decreased and its function is defective, which leads to immune regulatory dysfunction in vivo. It may be one of immune pathogenesis mechanisms of AS.

Objective To examine the incidence and risk factors associated with atrial fibrillation in elderly coronary heart disease patients who underwent off-pump coronary artery bypass surgery.Methods From Jun.2008 to Jun.2009,one hundred and eleven patients received OPCAB in our hospital.Clinical data including coronary angiography,diseased vessels,number of bypass grafts,postoperative electrolyte,postoperative hemodynamic measurements,anti-arrhythmic drugs used and other risk factors for atrial fibrillation was collected and reviewed individually.The mean age of patients was(73.19±2.79)years(range from 70 to 82 years).Seventy-nine patients were male and 32 were female.The mean left ventricular ejection fraction(LVEF)was 0.57±0.12,NYHA Ⅰ-Ⅳ.All patients received OPCAB.Saphenous vein(SV)and left internal mammary artery(LIMA)were harvested and used as grafts.LIMA was routinely anastomosed to the left anterior descending artery (LAD),and SV was anastomosed to the other target vessels.The average number of grafts.was(2.79±0.54)per case.The mean operation time was(3.70±0.88)hours and the duration of ICU-staying was(1.32±0.94)days.The patients were divided into 2 groups:atrial fibrillation group and non-atrial fibrillation group.Results Four deaths occurred perioperatively.The mortality was 3.42%.Major postoperative complications included low cardiac output,respiratory dysfunction and acute kidney injury.Twenty seven out of 111 patients who underwent off-pump coronary artery bypass surgery had atrial fibrillation postoperatively.The incidence was 24.3%.Single factor analysis revealed that CVP,serum levels of potassium,magnesium,and SPO2 were lower significantly in atrial fibrillation group than those in the non-atrial fibrillation group,P<0.05.Conclusion Changes of perioperative electrolytes and circulating blood volume,decline in the oxygen saturation,and the occurrence of perioperative myocardial infarction after coronary artery bypass surgery were the risk factors associated with atrial fibrillation.

Objective To investigate the expression of calpains and calpastatin in diaphragm of a rat model of chronic obstructive pulmonary disease(COPD). Methods Fotry male Wistar rats were randomly divided into the control group and the COPD group. Rats in the COPD group were copied by expo -sing to cigarettes smoking and dripping lipopolysaccharide into trachea. Pathological changes of lung and diaphragm were deteted. Immunohis-tochemistry and RT-PCR were performed to determine protein and mRNA expression of calapins and calpastatin. Results Diaphragmatic atrophy was observed in rats in the COPD group instead of the control group. The protein and mRNA expression of calpains in diaphrag-m of COPD group were Increased than those in the control group(P < 0.05). On the contrary ,the expression of calpastatin was significantly reduced in rats in the COPD group(t =-9.38 and-2.97;P < 0.001 ,P = 0.005). Conclusions An imbalance in the expression of calpains/calpastatin in diaphragm was observed in COPD rats ,and this imbalance may be responsible for diaphragm atrophy.

Objective To study the clinical features and angiographic findings of moyamoya disease (MMD) as well as their relationship. Methods A total of 22 MMD patients received routine digital substraction angiography (DSA). The clinical manifestations and angiographic findings were analyzed. Results Clinical manifestations varied and each patient often had multiple symptoms, including cerebral infarction in 9 patients with an average age of 23.6 (13-39 years) and cerebral hemorrhage in 7 patients with an average age of 31.2 (28-46 years). Angiographic examination found that all the diseased sides showed MMD blood vessels. The patients who received encephalo-myo-arterio-synangiosis (EMAS) had better prognosis than those without receiving the treatment. Conclusion Cerebral infarction is frequent in children and adolescents with MMD, whereas cerebral hemorrhage is common in adults. DSA is a golden criterion for diagnosing MMD. Surgical treatment, EMAS blood supply reconstruction in particular, should be prescribed.

Objective To investigate clinical value of miRNA-27-3p expressed in colorectal cancers,liver metastasis,and the peripheral blood,and analyze its target genes.Methods Among 78 cases of colorectal cancer patients,sera,colorectal cancers,and liver metastases were used to detect miRNA-27a-3p expressions with real-time quantitative polymerase chain reaction (RT-PCR) and analyze its clinical significance.We predicted miRNA-27-3p target genes,and confirmed the target genes and their correlation between miRNA-27a-3p and target genes.Results The expression level of miRNA-27a-3p in 78 cases of colorectal cancers was 3.13 ± 1.72,which was significantly higher than that in matched adjacent cancer tissues (1.06 ± 0.42) and control group (0.68 ± 0.27) (P ＜ 0.05).The expression level of miRNA-27a-3p in 27 cases of liver metastases was 3.48 ± 1.15,which was significantly higher than that in paired colorectal cancer tissues (2.34 ± 1.03) (P ＜0.05) and adjacent tissues (0.81 ± 1.14) (P ＜0.05).Expression levels of miRNA-27a-3p in patients with colorectal cancer tissues and peripheral blood had no significant difference in age,sex,serum carcinoembryonic antigen (CEA) levels,tumor location,and pathological types (P ＞ 0.05);however,it had positive significant difference in lymph node metastasis,liver metastasis,tumor node metastasis (TNM) staging (P ＜ 0.05).The expression of miRNA-27a-3p was negatively correlated with the expression of target gene GP73.Conclusions The higher expression was miRNA-27a-3p in peripheral blood and colorectal cancer tissues,higher risk of liver metastasis occurs.MiRNA-27a-3p might participate in the occurrence and development of colorectal cancer by regulating target gene expression of GP73.In peripheral blood of colorectal cancer patients,miRNA-27a-3p might be used for potential auxiliary diagnosis and predict liver metastasis.

Objective To prepare the long-circulating liposomes of paraoxonase(PON).Methods The long-circulating liposomes of paraoxonase were prepared by film dispersion method.The encapsulation efficiency was determined by gel column.The effects of the factors on the encapsulation efficiency,such as the weight ratio of paraoxonase to phospholipid,cholesterol(Choi) to phospholipid,PEG-cholesterol (PEG-Chol) and the iron strength of water phase,were investigated respectively.Then the formulation was optimized by orthogonal design.Results The encapsulation efficiency of the paraoxonase liposomes was 87.66±3.46%,and the average diameter of the liposomes was about 126 nm.There was no significant change on encapsulation efficiency on 15 d at 4 ℃,and the activity of paraoxonase was maintained basically stable.Conclusion The preparation of PEG-modified paraoxonase liposomes was easy and practicable,and the property investigation in vitro showed that the paraoxonase liposomes were stable.

Objective:To study the molecular mechanism for momordin in inducing apoptosis of multidrug-resistant human chronic leukemia K562/A02 cells. Methods:The growth inhibition value of K562/A02 cells was detected by CCK-8 method. Cell apoptosis was analyzed by Annexin Ⅴ flow cytometry (FCM) and cell morphological examination. FCM was also used in determining expression of P-glycoprotein, p53 protein, bcl-2 protein and caspase activity. Results:Momordin inhibited the proliferation of K562/A02 cells in a dose-dependent manner. It also induced cell apoptosis, reduced the expression of P-glycoprotein, p53 protein and bcl-2 protein, and increased caspase-3 and caspase-8 activity.Conclusion:Momordin reversed the inhibition of apoptosis in multidrug-resistant K562/A02 cells. The molecular mechanism may be related with down-regulation of expression of p53 protein, P-glycoprotein, and bcl-2 protein and up-regulation of caspase-3 and caspase-8 activities.

Objective:The purpose of this study is to evaluate the frequency of MDSCs in peripheral blood of hepatocellular carcinoma patients and to investigate the clinical significance of change of MDSCs in the peripheral blood and provide new ways for e-valuating immune state and prognosis of hepatocellular carcinoma patients.Methods: Blood samples were obtained from 62 patients with HCC and 20 healthy donors.The phenotype of CD3,CD4,CD33,HLA-DR and Th1,Th2 immune subsets in peripheral blood of each group were observed by FCM methods.Results:There were statically different frequencies in the peripheral blood between hepato-cellular carcinoma and healthy control group,which the proportion of total CD3+T lymphocytes and CD3+CD4+T cells were lower and the proportion of CD33+HLA-DR-MDSCs was higher in hepatocellular carcinoma patients.( P<0.05 ).The increase of percentage of MDSCs was greater in patients at Stage C and D than in patients at stage A and B.Conclusion:The Th1/Th2 ratio in the PBMC were of imbalance and MDSCs was significantly increased in peripheral blood of hepatocellular carcinoma patients.The increase of MDSCs was significantly correlated with clinical stage.CD33+HLA-DR-MDSCs may play an important role in prediction in prognosis and tumor immune status of hepatocellular carcinoma.

Objective To investigate the therapeutic effect of exosomes extracted from human adipose-derived mesenchymal stem cells(hAMSCs) on traumatic brain injury (TBI) and its possible mechanism.Methods Mesenchymal stem cells(MSCs) were isolated from healthy human adipose tissue and the exosomes were extracted by ultrafiltration.Rats were divided into four groups: sham group, PBS control group, MSCs treatment group and exosomes treatment group.24 h After TBI, the treatment group was locally injected along the lesion area, 30 μL of PBS, 2×105 MSC, 25 μg protein of exosomes respectively, the total volume was 30 μL.We performed the Modified Neurological Severity Score(mNSS) and the forelimb Foot-Fault Test in all rats before injury and at 1, 3, 7, 10, 13, 16, 21 and 30 days after TBI.The rats were sacrificed at 3 and 7 days after TBI respectively,total RNA was extracted from rat brain tissue.The expression of TNF-α and IL-1β were detected by quantitative PCR.The rats were also killed at 30 days after TBI for testing the neuronal apoptosis in lesion area by tunel-neun double imm-unofluorescence.Results Exosomes treatment significantly promotes the recovery of neurological deficits caused by TBI,and the therapeutic effect is similar to MSCs, its possible mechanism may be the inhibition of the acute inflammation and the reducing of the neurons apoptosis after TBI.Conclusions Exosomes extracted from human adipose-derived mesenchymal stem cellshas promoted neurological functionrecovery after traumatic brain injury, which will provide a new and safer TBI treatment for clinical practice.