Objective To investigate the feasibility,operation design and postoperative rehabilitation in ankylosing spondylitis patients with bilateral hips and knees bony ankylosis,who were operated on the 4 joints during one hospitalization period. Method Two operations were performed in one hospitalization period in three ankylosing spondylitis patients on the 2 hip joints and 2 knee joints respectively.One case,the left hip replacement was operated in the first operation,and the right hip and the double knees were operated in the second operation;the other two cases,unilateral hip and knee were operated in two operations respectively.Patients began to contract their lower limbs’ muscles initiatively after narcosis.The limbs were put on the CPM,the hips and knees were bent and extended repeatedly on the third day after operations.The patients began to leave bed and learned to walk 2 weeks after operations.They could walk 100 steps with aids when they leaft hospital. Result In six-month follow-up,the range of hip motion(degree)were 105?~145?(average 135?);the range of knee motion(degree)was 45?~60?(average 54?).The hip’ function score adopted Harris score system:the average of 83 and were all good;the knee’ function score adopted American Association of Knee Surgery score system in 1989:all were excellent except a good one(left knee of first case,the score was 74/75). Conclusion Performing operations on the 2 bony ankylosis hips and 2 bony ankylosis knees in the ankylosing spondylitis patients in one hospitalization period can shorten the treatment cycle,release the distress,and lighten the economic load,meanwhile it is convenient for operation and postoperative rehabilitation.It is better to do the unilateral hip and knee in a single operation.

ObjectiveTo discuss treatment experiencing in femur periprothetic fracture after hip arthroplasty in pre-, intra- and post-surgery.Methods From March 2005 to May 2011, 27 patients (11 males, 16 females) aged ＞75 years with femur periprothetic fracture after hip replacement were studied. The mean time from primary hip replacement to femur perprosthetic fracture was 63 months(ranging from 7 to 83 months). According to vanconver classification, type A applying steel wire of character for 8 bind technique was 5 cases, type B applying prolonging stem technique locking compress plate (LCP)technique surrounding instrument technique was 19 cases and type C applying bone graft and plate fixation technique was 3 cases. All patients were followed up from 9 to 25 months (average, 16 months). The results of treatment were evaluated by Harris score and X rays. Results Bony heal was obtained in 22 patients and was not obtained in five cases among whom bony heal occurred in 3 cases and 2 patients could only keep prothetic and limb stable after receiving the bone graft once more. Walking was free in 14 cases,9 cases needed assistant walking instrument,and only 4 cases stayed in the bed freely. Harris score for last follow-up was 52 to 93 (mean 76).Conclusions Based on the patient general status, the fracture types and practical and stable principle, the effective methods can get good results in the treatment of femur periprosthetic fracture in aged patient.

Objective:To investigate the effect of Yishen Bunao Tablet on Alzheimer's Disease(AD).Methods:91 cases of AD were randomly divided into a treatment group(n=46)treated with Yishen Bunao Tablet and a control group(n=45)treated with huperzine A. Their clinical therapeutic effects,changes of superoxide dismutase(SOD)activity,malondialdehyde(MDA)and nitric oxide(NO) contents before and after treatment were determined.Results:There was no significant difference between the two groups in the total therapeutic effect;After treatment,the scores for language comprehend and order obey in the treatment group increased significantly(P0.05).SOD activity increased significantly,and contents of MDA and NO decreased significantly in the control group(P

Objective: To analyze the pulmonary function and clinical features of coal worker's pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD) , coal worker's pneumoconiosis and COPD, in order to improve the diagnosis and treatment of coal worker's pneumoconiosis complicated with chronic obstructive pulmonary disease. Methods: Selected patients in respiratory department of General Hospital of Jincheng Coal Industry Group were classified as pneumoconiosis complicated with COPD group (n=52) , pneumoconiosis group (n=70) and COPD group (n=50) . Clinical data were collected and compared between three groups, including age, history of smoking, BMI, pulmonary function, CAT score and complication with Hypoxemia and respiratory faliure. Results: The mean age, smoking index and BMI of the three groups were not significantly different. The FEV1% pred, FEV₁/FVC%, DLco-SB%, FVC% pred were significantly lower in pneumoconiosis complicated with COPD group than pneumoconiosis group (P<0.05) ; The FEV₁% pred, DLco-SB%, FVC% pred were significantly lower in pneumoconiosis complicated with COPD group than COPD group (P<0.05) , but, the FEV₁/FVC% was no significant different between pneumoconiosis complicated COPD group and COPD group (P>0.05) ; The CAT score for clinical symptoms of pneumoconiosis complicated with COPD group was significantly higher than that of pneumoconiosis group (P<0.05) , but there was no significant difference between pneumoconiosis complicated COPD group and COPD group (P>0.05) . The rate of hypoxemia in coal workers' pneumoconiosis combined with chronic obstructive pulmonary disease was 78.8%, which was higher than that of coal workers' pneumoconiosis group (61.4%) and chronic obstructive pulmonary disease group (72%) ; The respiratory failure rate of coal worker's pneumoconiosis combined with chronic obstructive pulmonary disease group was 44.2%, which was higher than that of coal worker's pneumoconiosis group (4.3%) and chronic obstructive pulmonary disease group (16%) . Conclusion In pneumoconiosis patients, once complicate with COPD, the pulmonary function indexes are worse, the clinical symptoms are heavier, and the probability of hypoxemia and respiratory failure are higher. Compared with the COPD group, the patients with pneumoconiosis complicated with COPD have more restrictive ventilation dysfunction and diffuse dysfunction, and the clinical symptoms are heavier, and the probability of combined respiratory failure is higher.

Objective To investigate the influences of 5-azacytidine (5-Aza) with different concentrations on mesenchymal stem cells (MSCs) proliferation and differentiation into myoblasts. Methods Bone marrow-derived MSCs of 4 weeks Wistar rats were separated and purified, and then treated with 5-Aza with different concentrations. The growth ability of cell was assayed with methyl thiazolyl tetrazolium (MTT) method. The expression of skeletal muscle actin in MSCs was determined with reverse transcription polymerase chain reaction (RT-PCR) and electrophoresis after MSCs were induced. Results The cell proliferation was not affected by 0 and 1 ?mol ? L-1 5-Aza . There were expressions of skeletal muscle actin treated with 3 -12 ?mol ? L-1 5-Aza. Some cells were obviously enlarged at the 9th day after induction and myotubu-like cells were found at the 12th day when treated with 9 and 12 ?mol ? L-1 5-Aza. 20 - 30 ?mol ? L-1 5-Aza induced the toxic effect on proliferation of MSCs. With the increase of concentration, the proliferation ability of MSCs was weakened. Conclusion 5-Aza affects the expression of regulatory gene to the stem cells and regulate MSCs to orientationally differentiate into myotube-like cells.

Objective To evaluate the influence of diabetes mellitus on changes in plasma osmotic pressure during bowel preparation in patients undergoing radical resection for colon cancer.Methods Sixty patients,of ASA physical status Ⅰ or Ⅱ,aged 40-60 yr,weighing 50-75 kg,scheduled for elective radical resection for colon cancer,were included in the study.Of the 60 patients,30 patients with type 2 diabetes mellitus served as test group (group DM),and 30 patients without diabetes mellitus served as control group (group C).Polyethylene glycol electrolyte powder was given orally for bowel preparation before surgery.In the early morning of the day on which preoperative preparation was performed (T1) and before opening venous channels after admission to the operating room (T2),venous blood samples were taken for determination of plasma colloid osmotic pressure (COP) and concentrations of plasma electrolytes (Na+,Cl-,K+) and blood glucose.Thirst was assessed using visual analogue scales at T1 and T2.Results Compared with the baseline value at T1,the plasma COP and degree of thirst were significantly increased at T2 in C and DM groups,blood glucose concentrations were decreased at T2 in group DM,and no significant changes were found in the plasma concentrations of electrolytes at T2 in both groups.Compared with group C,blood glucose concentrations were significantly increased,and no significant changes were found in the plasma concentrations of electrolytes at T1,2,no significant change was found in plasma COP and degree of thirst at T1,and the degree of thirst was decreased at T2,while the plasma COP was increased at T2 in group DM.Conclusion After bowel preparation in patients undergoing radical resection for colon cancer,although the thirsty sensation of the patients with diabetes mellitus is decreased,the plasma COP is obviously increased; thus infusion of appropriate crystalloid solution instead of colloid solution is required in case hyperosmolar coma develops.

Objective To select the strains which can produce tanshinone ⅡA like its host plant Salvia miltiorrhiza bung. Methods A total of 50 strains of endophytic fungi were isolated from healthy, living and symptomless tissues of Salvia miltiorrhiza bung, among which 29 strains were obtained from the root, 14 from the stem, 3 from the leaf, 3 from the flower and 1 from the seed. Their antimicrobial activities against nine different bacteria, including both Gram-negative and Gram-positive bacteria, were measured by Oxford plate agar diffusion bioassay. Results Our data showed that all but four strains had significant antibacterial activities on at least one indicator bacterium to some extent, and five strains (DR1, DR4, DR16, DR18 and DF2) manifested quite prominent antibacterial activities against certain pathogenic bacteria. In some degree, it might indicate that this endophytic fungus isolated from the tissues of Salvia miltiorrhiza bung has a potential value as a natural antibacterial medicine as well. Thin layer chromatography (TLC) and high-performance liquid chromatography (HPLC) were carried out to test selected strains, both inside and outside of the cell to see if any strain can produce tanshinone ⅡA. The result showed that extracts from three strains, labeled as DR12 (outside cell), DR21 (inside cell) and DF3 (inside cell), had a component with the same Rf value in TLC assay as that of authentic tanshinone ⅡA. The extract from DR12 (outside cell) and DR21 (inside cell) had a peak at retention time identical to that of authentic tanshinone ⅡA in HPLC. Conclusion The fungi appear to produce the bioactive compound tanshinone ⅡA, and they could be used to produce tanshinone ⅡA by fermentation. It provides a new way to synthesize this natural medicine.

Objective To evaluate the application value of the one-stepdiabetes education management system in clinic. Methods The “one-step” diabetes education management system was construct.80 newly diagnosed patients with type 2 diabetes mellitus were selected and randomly divided into the control group and the experimental group with 40 patients in each group.The patients in the experimental group received “one-step”diabetes education management system by diabetes specialist nurses,while patients in the con-trol group received routine diabetic education.The fasting blood glucose (FBG),HbAlc,medical compliance behaviors and other indices were compared between two groups. Results FBG,HbAlc and medical compliance were better,and the risk score of complications was higher in the experimental group than those of the control group,there were significant differences between them. Conclusions Application of “one-step”diabetes education management system in treatment and nursing of patients shows maneuverability and practicality.It has clinical application value and deserves to be spread.

Objective To study the relationship between resting heart rate(RHR)and essential hypertension(EH).Methods 215 patients with EH and 82 healthy subjects underwent RHR detection.The relationship between RHR and the state of EH was analyzed.Results RHR in EH group was significantly higher than that in normal group[(78.9±9.1)bpm vs(69.5±10.9)bpm,P＜0.01)],RHR in different stages of EH was significantly different(F=21.280,P＜0.01,respectively),and increased with grades(P＜0.05 orP＜0.01).RHR in EH patients complicated with left ventricle hypertrophy(LVH)was higher than those with no LVH[(83.9±9.1)bpm vs (75.9±8.9)bpm,P＜0.01].There was positive correlation between RHR and LVH(r=0.8097,P＜0.01).Conclusion RHR is related to the development and progress of EH,and it may be one of the index for estimating the state of EH.

Objective To evaluate effect of bone grafting combining with titanium mesh and/or reinforcement cup in reconstruction of acetabular bone defect in total hip arthroplasty (THA).Methods From January 2008 to November 2011,32 patients,including 23 males and 9 females,aged from 51 to 76 years (average,66 years),underwent THA with acetabular defect reconstruction by using bone grafting combining with titanium mesh and/or reinforcement cup.There were 6 cases of primary THA and 26 cases of revision THA.Twelve cases (Paprosky Ⅱ B) and 7 cases (Paprosky Ⅱ C) underwent impaction bone grafting with titanium mesh; 6 cases (Paprosky Ⅱ C) underwent impaction bone grafting with reinforcement cup; 6 cases (Paprosky Ⅲ A) underwent impaction bone grafting and structural bone grafting with winged reinforcement cup; 1 case (Paprosky Ⅲ A) underwent double-layer impaction bone grafting with titanium mesh and reinforcement cup.Harris score and Gill classification were used to evaluate clinical and radiological results,respectively.Results All cases (32 hips) were followed up for an average of 22 months (range,12 to 25months).One year postoperatively,Harris score improved from preoperative 44.00±11.71 to postoperative 78.41 ±9.32.Twenty-four cases were excellent,4 good,4 fair,and the excellent and good rate was 87.5％.Three cases occurred mild displacement of acetabular rotation center; one case occurred dislocation.There was no loosing,subsidence,and bone resorption in other 28 cases at final follow-up.ConcLusion Bone grafting with titanium mesh and/or reinforcement cup is effective in reconstruction of acetabular bone defect in THA,which can improve the stability of acetabular cup.