Objective To study the curative effect of arthroscopic debridement in the treatment of knee osteoarthritis with moderate-to-severe degenerative cartilage. Methods Arthroscopic knee debridement combined with postoperative rehabilitation exercise was carried out in 17 cases (21 knee joints) of knee osteoarthritis with moderate-to-severe degenerative cartilage. Results The operation time was 55~100 min (mean, 75 min). No surgical complications occurred. The postoperative hospital stay was 15~ 20 days (mean, 13 days). The passive range of motion of the knee joint during the surgery was 0?~120? and the range of motion after the surgery, 0?~110?. Follow-up was conducted for 5~36 months (mean, 21 months). The curative effect was classified as “good” in 6 cases (8 joints), “fair” in 9 cases (11 joints) and “poor” in 2 cases (2 joints). The range of motion of the knee was 0?~ 120?. Conclusions Arthroscopic debridement is an effective option for the treatment of knee osteoarthritis with moderate-to-severe degenerative cartilage.

Objective To analyze the space-time characteristics of hand-foot-mouth disease (HFMD) in Shijiazhuang by using geographic information system (GIS).Methods The data of HFMD during 2009 to 2011 in Shijiazhuang were collected and GIS database was created.Special map was drawn by PHGIS software to analyze the space-time characteristics of HFMD in Shijiazhuang.Results The epidemic situation of HFMD in Shijiazhuang appeared sporadic with local centralization.The attack ranked alternately rise year after year and high epidemic areas were geographically complimentary.Overall epidemic levels tend dropping from 2009 to 2011 and there were differences among areas.The high-attack areas of HFMD changed over time.Conclusions GIS can provide direct-viewing of the space-time characteristics of HFMD and further understand the prevalence of HFMD,which could help to provide the scientific basis of HFMD control in Shijiazhuang.

ObjectiveTo evaluate the application of 18fluoro-deoxyglucose positron emission tomography (FDG-PET) to the staging and predicting outcome in patients with lymphoma.Methods 41 patients with newly diagnosed lymphoma(median age 57 years)were explored with FDG-PET prior to and after 4 cycles of chemotherapy.With a median follow-up of 30 months (range 10-68 months),the value of FDG-PET to staging and predicting clinical outcome was assessed. Results The maximum standardized uptake value (SUVmax) of nodal and extranodal lesions was 9.7±6.9 and 8.4±6.8 respectively prior to treatment.There were significant difference (P＜0.05) in aggressive non-Hodgkin's lymphoma and indolent non-Hodgkin's lymphoma,no significant difference(P＞0.05)in non-Hodgkin's lymphoma and Hodgkin's lymphoma(HL), B-cell neoplasms and T-cell neoplasms,germinal center B-cell-like DLBCL and activated B-cell-like DLBCL. In 41 patients, 22 patients (54 ％)were detected extranodal focus by FDG-PET before chemotherapy. FDG-PET imaging upstaged in 6(15％)of initial lymphoma patients.There were 15 patients (37 ％) in stage Ⅰ and Ⅱ and 26 patients(63 ％)in stage Ⅲ and Ⅳ by FDC-PET scan.1 patient (7 ％) in stage Ⅰ and Ⅱ,6 patient (23 ％) in stage Ⅲ and Ⅳ died of disease progression during follow-up.After 4 cycles of chemotherapy,the FDG-PET was negative in 41％(17/41),positive in 59 ％(24/41) respectively.1 patient(6 ％)died of disease relapse among 17 patients who were FDG-PET negative, 6 patient (25 ％)died of disease progression among 24 patients who were FDG-PET positive during follow-up. Conclusion FDG-PET scanning plays an important role in the pretreatment staging and prediction of the prognosis after 4 cycles of chemotherapy in patients with lymphoma.Thus it may offer the potential for change in treatment paradigms.

Objective To probe into impacts of safflor yellow injection on rats with acute myocardial infarction and discuss its mechanism. Methods Forty Sprague-Dawley rats were divided into sham operation group ( 8 rats ) and operation groups(32 rats).The left anterior descending branch of coronary artery was ligated to establish an animal model with acute myocardial infarction.The rats with successful modeling were randomly divided into model control group, 3-, 7- and 14-days safflor yellow group.In the treatment group, the rats were injected with safflor yellow injection(2.5 mg.kg-1.d-1)for 3, 7 and 14 days, respectively.Rats in sham operation and model control group were injected 0.9% sodium chloride solution.Their weights were measured 24 h after the last drug administration, their hearts were removed, and the serum was obtained through centrifugation.The enzymic method was used to measure the lactate dehydrogenase(LDH)and creatine kinase(CK)contents of serum.Hematoxylin eosiny(HE)staining method was used to observe the change of myocardial cells.The chloride three phenyl-tetrazole( TTC) staining method was used to measure the area of myocardial infarction in the rats. The real-time fluorescent quantitative PCR method was used to measure the expression of VEGF and HIF mRNA at the marginal zone of myocardial infarction. Results The levels of LDH and CK were(106.12±35.52),(452.84±60.38)mmol.L-1 in sham operation group, and(385.66±137.58),(2 111.00±1 250.80)mmol.L-1 in model control group.LDH in 3-, 7-, 14-days treatment groups was (249.66±51.86),(104.33±51.08),(110.33±26.76)mmol.L-1, while CK was(1 713.00±584.74),(1 177.66±980.18), (421.33±54.60)mmol.L-1.LDH and CK levels of the 14-days treatment group were significantly lower than those in the model control group(both P<0.05).The area of myocardial infarction was (0.00±0.00)% in sham operation group,(13.12±6.69)% in the model control group, and(8.11±3.45)%,(7.01±2.98)%,(3.44±1.17)% in the 3-, 7-, 14-days treatment groups.The area of myocardial infarction in the 14-days treatment group was significantly lower than that of the model control group(P<0.05).The expression of VEGF and HIF mRNA was 1.99±0.27, 6.21±1.35 in the sham operation group, 1.03±0.15, 1.78±0.57 in the model control group.The expression of HIF mRNA in the 3-, 7-, 14-days treatment groups was 0.50±0.12, 1.23±0.24, 2.20± 0.32, and the expression of VEGF mRNA in the 3-, 7-, 14-days treatment groups was 0.43±1.27, 2.67±0.83, 5.78±1.23. Conclusion The safflor yellow injection has therapeutical effects on the rats with acute myocardial infarction, and the effects will become significant after 14 day.It can reduce the area of myocardial infarction and LDH and CK content at the drug administration groups, which might be related to the increase of the expression of VEGF and HIF mRNA.

Tetrahydrobiopterin (BH4) is an essential cofactor for all three nitric oxide synthase (NOS isoforms), which plays an important role in vascular diseases. GTP cyclohydrolase 1 (GCH 1) is the first-step and rate-limiting enzyme for BH4 biosynthesis in its de novo pathway. Common GCH1 gene variant C+243T in the 3'-untranslated region predicts NO excretion. The present study examined the predictive role of GCH 1 gene 3'-UTR C+243T variant in the long-term outcome of ischemic stroke. A total of 142 patients with first-onset ischemic stroke were recruited and detected for genotype of GCH1 3'-UTR C+243T by a TaqMan SNP Genotyping assay. Subsequent vascular events and death were determined over a 5-year follow-up period. The frequency of GCH1 3'-UTR +243 C/T or T/T genotype was significantly increased in patients with endpoint events as compared with those without events (74% vs 57.8%, P=0.06). Cox regression survival analysis indicated that an increased probability of death or new vascular events was found in patients with GCH1 3'-UTR +243 C/T or T/T genotype compared with those with GCH1 3'-UTR C/C genotype (40.6% vs 25.5%), GCH1 3'-UTR +243 C/T or T/T genotype relative to GCH1 3'-UTR C/C genotype was associated with the increased risk of death or vascular events even after adjustment for other risk factors (OR=2.171, 95% CI: 1.066-4.424, P=0.033). It was concluded that GCH1 3'-UTR C+243T variant was an independent predictor of worsening long-term outcomes in patients with first-onset ischemic stroke.

Objective To investigate the current situation of precision of internal quality control (IQC) in total cholesterol,triglyceride,HDL-cholesterol,and LDL-cholesterol and provide improvement measurements.Methods Web-based External Quality Assessment (EQA) system was used to collect IQCdata of lipid tests from 581 EQA participant laboratories nationwide.The data include the coefficient of variation (CVs) of IQC data under control in April 201 1 and long-term cumulative data.Excel 2007 was applied for data processing after excluding the invalid data.Acceptable rates of CVs of two-lot internal quality controls in 4 lipid testing were calculated according to 6 criteria,that were 1/4TEa,1/3TEa,allowable imprecision of National Cholesterol Education Program (NCEP) and the specifications based on biological variation including the optimal,appropriate and minimal allowable imprecision.Results Four hundred and thirty-five,434,405 and 360 laboratories reported the data of level 1 IQC for total cholesterol (TC),triglyceride (TG),HDL-C,LDL-C respectively,while 214,214,192 and 171 reported the data of level 2 IQC respectively.Acceptable rates of TC,TG,HDL-C,LDL-C based on NECP criteria were 69.2％ (304/435),85.3％ (370/434),61.3％ (48/405) and 69.0％ (248/360) for level 1 respectively while 81.3％(174/214),91.6％ (196/214),75.5％ (145/192) and 81.3％ (139/171) for level 2 respectively.In the group which met the NECP criteria,the proportion of using matching detection system was much higher than the group which did not meet the criteria.Conclusions It is an effective way for clinical laboratories to improve test quality by monitoring the current and cumulative CVs of internal quality control and comparing them against proper evaluation criteria to evaluate if the analysis system can meet quality requirements.

Objective To investigate the dynamic changes of interleukin-1 receptor-associated kinases (IRAK-4) in hypoxic neurons and explore their role in regulation of inflammatory reaction. Methods The B35 cells exposed to hypoxia of 3% O2,5% CO2 and 92% N2 were cultured for 1,3,6, 12,24,48,72 and 96 hours respectively. Then, mRNA and protein expressions of IRAK-4 were detected by RT-PCR and Western blot, the expression of IRAK-4 in the cells were observed by laser scanning con-focal microscope (LSCM), and the concentration of IL-6 was measured by ELISA method. Results After hypoxia, the mRNA and protein expressions of IRAK-4 were increased at one hour, reached the peak at six hours (P<0.05), kept at a high level at 12 hours (P<0.05) , but decreased gradually to the normal oxygen level at 24 hours (P < 0.05) and to below the normal oxygen level at 48 hours (P < 0.05). Immunofluorescence results showed that the fluorescence intensity of IRAK-4 was gradually increased with time. The changes of IL-6 in the supernatant were positively correlated with protein expression of IRAK-4 (r =0.84, P < 0.05 ). Conclusions Hypoxia can increase the expression of IRAK-4 at transcription and translation levels in a certain period of time, which may participate in down-stream inflammatory reaction and lead to increase of IL-6 expression.

Objective To investigate the methylation status in the promoter region of Dickkopf-3 (Dkk3) gene in patients with myelodysplastic syndromes (MDS),and to initially explore the relationship between the methylation of this gene and survival time.Methods Methylation-specific PCR (MSP) was applied to measure the promoter methylation of Dkk3 gene in 43 bone marrow or peripheral blood samples of MDS patients.As controls,70 normal peripheral blood samples from general outpatients were examined.Results In 43 patients with MDS,7 patients (16.3 ％) showed Dkk3 gene methylation.And 5 of them were semi-methylation status,2 of them were exhaustive methylation status.In 70 controls,1 showed Dkk3 gene semi-methylation.The frequency of methylation in MDS patients was significantly higher than that of controls (x2 =8.93,P =0.005).In the Dkk3 methylation group,2/7 were from bone marrow and 5/7 were from peripheral blood.Meanwhile,2 patients were RA,1 patient was RCMD,4 patients were RAEB.There was no significant difference between the different sample source (bone marrow or peripheral blood) for the results of the methylation status (x2 =0.051,P =0.821).Either between the different sex,age,type,chromosome and WPSS score (P ＞ 0.05).The progress of disease didn't influence the methylation frequency (P ＞ 0.05).The smvival analysis showed no relationship between the methylation of this gene and smvival time.Conclusions In this MDS group,there is high level of methyl-modification in Dkk3 gene.The methylation of Dkk3 might be one of the molecular mechanisms that contribute to the progress of patients with MDS.The peripheral blood sample maybe a better substitute in detective of Dkk3 with MDS.

A management window model for patients with atrial fibrillation (AF) was established in Tilanqiao Community Health Service Center cooperated with tertiary hospitals.Patients were screened and treated in the community health service center,and a comprehensive management plan was conducted and patients were followed-up.A total of 105 patients with atrial fibrillation (97.2％) were effectively managed with an average follow-up of 10.6 months.The CHADS2 score ≥ 2 in 78 cases,including 11 cases with administration of warfarin (14.1％) and 26 cases with paroxysmal AF without transition to persistent atrial fibrillation.Compared to the data before management,the rate of taking aspirin and warfarin in managed patients was increased (all P ＜ 0.05),the international normalized ratio (INR) of patients receiving warfarin was improved (P ＜ 0.05) ; the ratio of receiving comprehensive treatment program,standardized treatment and health education were significantly increased (P ＜ 0.05) ; the awareness of the disease,treatment compliance and satisfaction of patients were improved significantly (all P ＜ 0.05).The results suggest that the management widow model is feasible and effective for management of patients with atrial fibrillation in community health service centers.

Objective Analysis the influence risk factors of infants and young children tetralogy of Fallot for radical treatment , and explore the perioperative treatment methods .Methods 195 cases(include death group and survival group)of hospitalized data of TOF resection in this hospital were collected in January 2003 to November 2012 ,then statistical analysis was done .Results Uni-variate analysis of variance showed ,age ,weight ,McGoon ratio ,cardiopulmonary bypass time and aortic clamping time were statisti-cally significant in two groups ,Multivariate Logistic regression analysis showed McGoon ratio <1 .0 ,cardiopulmonary bypass time>90 min ,aortic clamping time>70 min ,age<3 months were related to the postoperative death of TOF radical operation .Conclu-sion It is safe and reliable of radical surgery in infants and young children ,McGoon ratio ,cardiopulmonary bypass time and aortic clamping time ,age are the risk factors of the postoperative death of TOF radical operation .