Objective To investigate the clinical effectiveness of autologous platelet-rich-plasma (PRP) combined with iliac autograft in reconstruction of bony defective nonunion of humeral condyle.Methods The 27 patients who had been admitted to our department from January 2004 to June 2015 for bony defective nonunion of humeral condyle were analyzed retrospectively.Of them,15 underwent reconstruction with PRP combined with iliac autograft (experimental group) and 12 reconstruction with only iliac autograft (control group).The preoperative demographic data of the 2 groups were not significantly different (P ＞ 0.05).The 2 groups were compared in terms of operation time,hospital stay,bony union time,range of motion of the elbow,and modified Cassebaum scoring.Results The patients were followed up for 12 to 90 months (average,24.6 months).No such complications were observed as displacement of bone blocks,loosening or breakage of implants,re-nonunion,malunion,delayed ulnar neuritis,or olecranon nonunion.There were no statistic differences between the 2 groups regarding operation time,hospital stay,range of motion of the elbow and modified Cassebaum scoring (P ＞ 0.05).The clinical healing time (4.2 ± 1.3 months) and bony healing time (4.8 ± 1.4 months) for the experimental group were significantly shorter than for the control group (6.0 ± 1.1 months and 6.2 ± 1.0 months,respectively) (P ＜ 0.05).Conclusion Autologous PRP combined with iliac autograft can speed up the healing of bony defective nonunion of humeral condyle,promoting functional recovery of the elbow.

Objective To investigate the regulation on cell cycle related factor such as Cyclins and P21waf/cip1 by inhibiting histone deacetylase(HDAC)with valproic acid sodium(VPA).Methods HepG2 hep-tocellular carcinoma cells.BGC-823 gastric carcinoma cells and MCF-7 breast cancer cells were cultured with O.75-4.00 mmoL/L VPA for 48 h in vivo.and the cell cycle was analyzed by flow cytometry with PI assay.The protein and mRNA expression of Cyclin A,Cyclin D1,Cyclin E and P21waf/cip1 were analyzed by indirect immu-nofluorescence technique and RT-PCR.respectively.Results Compared with control groups,VPA at concen-trations 0.75-4.00 mmol/L exerted a significant inhibiting effect on G1 phase of HepG2,BGC-823 and MCF-7 cells(P<0.001).and the effect was dose dependent.Cyclin A was down-regulated both at mRNA and protein level in HepG2 and BGC-823 cells(P<0.001),but no difference in MCF-7 cells(P>0.05).Cyclin D1 was down-regulated both at mRNA and protein level(P<0.001)and P2lwaf/cip1 was up-regulated both at the mRNA and protein level in the three cell lines(P<0.001);Conversely,protein and mRNA expression of Cyclin E were unchanged upon treatment with VPA(P>0.05).Condusion Acetylization of histone intervened with VPA can regulate Cyclin D1 and P21waf/cip1 expressions obviously.To the expression of Cyclin A,it shows some difference according to the histogenesis and phenotypes of different carcinoma types.But there is not any obvious function on Cyclin E.Down-regulating Cychn D1 and up-regulating P21waf/cip1 may be the common target path-way in the inhibition of cell cycle G1 phase exerted by VPA.

Objective:To evaluate a Meta-analysis of randomized controlled trials ( RCTs) in multiple sclerosis ( MS) patients to evaluate the efficacy of vitamin D as add-on therapy. Methods: Searched Pubmed,EMbase,the Cochrane Library,CNKI,Wanfang Data base and so on up to february 2016 using the keywords:multiple sclerosis or MS and the drug names:vitamin D orCholecalciferol. Two authors independently selected the articles and extracted the data. We performed meta-analysis using Review Manager ( RevMan) version 5. 3 software. Results:Four RCTs with a total of 247 patients were selected.①Compared to the placebo, the EDSS score[MD=-0. 33,95% Confidence interval (CI)= (0. 68,0. 01),P=0. 05],the annual relapse rate[MD=-0. 08, 95%CI=(-0.37,0.21),P=0.60]and the number of gadolinium-enhancing lesions[MD=-0.16,95%CI=(-0.57,0.25),P=0. 45] showed no significant difference at 12 months,meanwhile the EDSS score[MD=-0. 48,95%CI=(0. 87,-0. 09),P=0. 02] and the annual relapse rate[MD=-0. 27,95%CI=(-0. 52,-0. 02),P=0. 03] were significantly less in the vitamin D group at 24 months.②Safety evaluation:There was no hypercalcaemia in vitamin D treated patients in each studies,main adverse events reported were diarrhoea, fever, constipation, dyspepsia, headache and so on. These symptoms were mild, after stopping drug can relieve the general. Conclusion: Vitamin D as an added in the treatment of MS showed as same as the placebo in some clinical indicators. However,after a longer treatment, the clinical indicators were significantly lower in the vitamin D group. Due to limited quantity and quality of the included studies,further larger and more prolonged studies are merited to verify the above conclusion.

Objective:To study the effect of glucosamine combined with sodium hyaluronate on serum interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) levels in patients with Kashin-Beck disease (KBD).Methods:In a prospective design, patients with KBD admitted to South Hospital of Yantaishan Hospital from January 2017 to January 2019 were selected and divided into control, observation, and replacement groups. The control group was treated with glucosamine sulfate, the observation group was treated with intra-articular injection of sodium hyaluronate on the basis of the control group, and the replacement group was treated with artificial knee arthroplasty. The clinical efficacy, visual analogue scale (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) of the three groups were compared before treatment, 6 weeks and 6 months after treatment. Blood samples were collected from the patients, and the serum levels of IL-1β and TNF-α were measured by enzyme-linked immunosorbent assay (ELISA) to compare the serum levels of IL-1β and TNF-α in the three groups before treatment, 6 weeks and 6 months after treatment.Results:The age of patients in the control group was (53.76 ± 7.33) years old, including 19 males and 23 females. The age of patients in the observation group was (54.18 ± 7.06) years old, including 20 males and 22 females. The age of the replacement group was (55.17 ± 6.43) years old, including 17 males and 13 females. The total effective rate in observation group (92.86%, 39/42) was significantly higher than that of the control group (76.19%, 32/42, χ 2 = 4.459, P < 0.05). At 6 weeks and 6 months after treatment, the VAS scores in the observation group [(4.10 ± 1.21), (3.16 ± 0.95) points] were significantly lower than those in the control group [(5.48 ± 1.17), (4.06 ± 0.74) points, P < 0.05]; at 6 weeks after treatment, the VAS score in the replacement group [(3.28 ± 0.89) points] was significantly lower than that in the observation group ( P < 0.05). At 6 weeks and 6 months after treatment, the WOMAC scores in the observation group [(40.72 ± 4.19, 25.86 ± 3.02) points] were significantly lower than those in the control group [(48.29 ± 2.16), (36.81 ± 3.13) points, P < 0.05]; the WOMAC scores in the replacement group [(29.68 ± 4.22), (23.57 ± 3.86) points] were significantly lower than those of the observation group ( P < 0.05). The serum levels of IL-1β [(9.28 ± 2.74), (6.85 ± 2.27) pg/ml] and TNF-α [(12.66 ± 4.54), (10.34 ± 3.48) pg/ml] in the observation group were significantly lower than those in the control group [(12.78 ± 2.79), (10.36 ± 2.63), (15.51 ± 4.63), (14.64 ± 4.27) pg/ml, P < 0.05], the serum levels of IL-1β [(6.12 ± 3.55), (5.39 ± 2.23) pg/ml], TNF-α [(10.42 ± 3.13) , (8.19 ± 3.15) pg/ml] in the replacement group were significantly lower than those in the observation group at 6 weeks and 6 months after treatment ( P < 0.05). Conclusion:Glucosamine combined with intra-articular injection of sodium hyaluronate can relieve inflammation, improve pain and promote joint function recovery in patients with KBD, but there is still a certain gap compared with knee arthroplasty.

Objective To investigate the effect and the mechanism of up-regulating histone acetylizad level with a selective inhibitor of HDACs-Valproate acid sodium (VPA) on breast cancer cell proliferation. Methods MCF-7 cells were cultured with 0.75-4.0 mmol/L valproic acid (VPA) for 24, 48, 72, 96 hours in vitro, the inhibiting rate was tested by MTT assay. Cell cycle was analyzed by flow eytome- try with PI assay, and the protein and mRNA expressions of Cyelin A, Cyclin DI, Cyclin E, P21Waf/cipl of MCF-7 cells after 1.5, 3.0 mmol/ L VPA treated were analyzed by indirect immunofluorescence technique and RT-PCR respectively. Results After cultured with 0.75 -4.0 mmol/L valproic acid (VPA) for 24, 48, 72, 96 hours, the inhibiting rate of experimental groups increased significantly(P<0.01) and a dose and acting time dependent manner was found. As to cell cycle, the percentages of GI, S, M phrase in control groups remained the same. Contrary to control groups, 0. 75 -4.0 mmo]/L VPA induced a significant arrest in G1 phrase ( P<0.01), and a total of 55.4% -82.8% G1 phrase ratio were found. P21Waf/cipl was up-regulated both at the mRNA and protein level while Cyclin D1 was down-regulated ( P<0.001). Conversely, neither mRNA nor protein expression of Cyclin A, Cyclin E showed difference ( P>0.05). Conclusions Up- regulating histone acetylizad level can inhibit breast cancer cell proliferation, induce cell cycle arrest in G1 phrase. VPA, as a I class of histone deaeetylase inhibitor, can be used as an option in the treatment of breast cancer. The mechanism may include up-regulating P21Waf/cipl mRNA and protein expression and down-regulating Cyclin D1 mRNA and protein expression.

Objective To investigate the influence of acquisition time of C-arm cone-beam CT on image quality and radiation dose of cerebral angiography.Methods C-arm cone-beam CT of cerebral angiography was performed on the male anthropomorphic head phantom,with DynaCT imaging mode and the acquisition time of 5 s,8 s and 20 s were used.Scanning was performed with each acquisition time for three times,and VR,MIP and MPR images were reconstructed.The attenuation values and their standard deviations of intracranial segment of the internal carotid artery (ICA),middle cerebral artery(MCA),anterior cerebral artery(ACA) and uniformed brain tissues were measured to calculate the image noise,signal to noise ratio (SNR) and contrast to noise ratio (CNR).We used the image noise,SNR and CNR as the objective standard to evaluate the image quality,and One-way ANOVA analysis of variance was used to assess the difference among them.A scale with scores 1 to 5 was used to rate the quality of the reconstructed image of ICA,MCA,ACA as a subjective evaluation,the difference among the evaluation scores were analyzed using Kruskal-wallis.We recorded the dose area product (DAP) of each acquisition time and the effective dose(ED) was calculated to assess the radiation dose,the difference among them were analyzed using One-way ANOVA analysis of variance.Results In C-arm cone beam CT 20 s imaging,the SNR of intracranial segment of the ICA,M CA,ACA were 22.29± 1.41,29.36 ±0.11 and 23.13 ±2.10 respectively,in 5 s imaging13.83 ±0.61,14.65 ±0.16 and 12.79±0.19 respectively,in 8 s imaging 14.92±0.96,18.97 ± 1.24 and 16.65 ±0.46 respectively,all the results showed a significant difference (F valued 58.19,327.29,52.74 respectively,all P valued＜0.01),the CNR of 20 s imaging were higher than that of 5 s and 8 s imaging,the Noise of ICA,MCA,ACA and the uniformed brain tissues of 20 s imaging were lower than that of 5 s and 8 s imaging,all the results showed significant difference (all P valued＜0.01).The subjective evaluation scores of VR imaging of 5 s,8 s and 20 s were 3.61 ±0.49,4.06±0.53,4.72±0.45 respectively,the scores of MIP imaging were 3.42±0.50,3.83±0.65 and 4.50±0.51 respectively,the scores of MPR imaging were 2.83±0.45,3.14±0.35 and 3.67±0.49 respectively,all the results showed significant difference (x2 valued 51.29,42.25 and 43.56 respectively,all P valued ＜0.01).The DAP values in C-arm cone beam CT 5 s,8 s and 20 s imaging were (9.11 ±0.18),(13.81±0.75)and(58.62±0.62)Gy· cm2,ED values were (0.91 ±0.02),(1.38±0.75)and(5.84± 0.11) mSv,all the results showed significant difference (F valued 3 720.30 and 3 654.85 respectively,all P valued＜0.01).Conclusion The image quality and radiation dose of C-arm cone-beam computed tomography are closely correlated with acquisition time.

Objective:To explore the influence of neuregulin- 1 (NRG-1)intervention on pacing threshold of low voltage area in rats after myocardial infarction.Methods:Myocardial infarction model of rat was established via an-terior descending coronary artery ligation.The 34 rats with myocardial infarction were randomly and averagely di-vided into two groups:NRG-1 group (received NRG-1peritoneal injection)and control group (received peritoneal injection of normal saline of the same volume).After two weeks,pacing thresholds were tested in low voltage area related with infarct in rats after myocardial infarction,and Cx43 (an integral membrane protein of the connexin family)expression was measured in low voltage area.Results:After drug intervention two weeks,compared with control group,there was significant reduction in pacing threshold [(1.466±0.503)V vs.(0.7167±0.194)V,P =0.002]in NRG-1 group;there was significant rise in Cx43 expression [(0.30±0.15)vs.(0.95±0.20),P <0.001] in low voltage area in NRG-1 group.Conclusion:Neuregulin-1 significantly reduces pacing threshold of low voltage area in rats after myocardial infarction,the mechanism may be related to increase Cx43 expression and improve e-lectrical conductivity of myocardial cells.

Objective By using lung sound spectrum analysis, the clinical efficacy of asthma -relieving manipulation, which is a gentle massage therapy mainly on the acupoints, on acute exacerbation of children asthma was evaluated. Methods We collected the lung sound of 11 children with acute asthmatic attack before and after asthma-relieving manipulation, and then input to the computer for obtaining lung sound spectrum signal data. The sound intensity, average respiratory muscle strength ( RMS) power, total RMS power and the volume of every 25 Hz frequency spectrum were extracted for comparison. Results After asthma-relieving manipulation, the sound intensity, average RMS power, and total RMS power of the children with acute asthmatic attack were significantly lower than those before the manipulation (P<0.01). The results of lung sound spectrum analysis displayed that lung sound volume was significantly lower at frequency band 0~300 Hz after manipulation ( P<0.05 compared with that before the manipulation) . The difference of the lung sound volume was insignificant over frequency band 300 Hz before and after treatment ( P>0.05). Conclusion Lung sound spectrum analysis can be applied to monitor lung function of asthmatic children objectively and quantitatively, and it is a new sensitive method for clinical detection. Asthma-relieving manipulation shows certain effect on acute exacerbation of children asthma.

Objective: To investigate antisense integrin?V and ?3 gene therapy in Rats mod- el of Pancreatic Carcinoma. Methods: The antisense integrin?V and ?3 expression plasmids wereelectrobloted into pancreatic tumours of rats induced by dimethylbenzanthracine,The tumor inhibit rate was calculated, the tumor microvessel density(MVD)with the immunohistochemical staining and tumor apoptosis with TUNEL were examined. Results: The tumor weight of the control group, ?V group, ?3 group an- d?V?3 group was (1.167?0.79)g(,0.953?0.26)g(,1.013?0.42)g(,0.788?0.56)g respectively. The dif- ference was significant among them(P

Objective:To investigate modulation of a specific HDAC inhibitor,Valproate acid sodium(VPA),on expression of Caspase3,Caspase8,Caspase9 by inhiting HDAC,as well as apoptosis rate of cancer cells treated with VPA and the specific inhibitors of Caspase3,Caspase8,Caspase9.Methods:Heptocellular carcinoma cells-HepG2,gastric carcinoma cells-BGC-823 and breast cancer cells-MCF-7 were cultured with 0.75-4.0 mmol/L of VPA for 48 hrs in vivo,apoptosis was analyzed by flow cytometry with Annexin V/PI assay.The activities and protein expressions of Caspase3,Caspase8,Caspase9 were detected by spectrophotometry and indirect immunofluorescence technique.Results:Contrary to control groups,VPA at concentrations between 0.75 and 4.0 mmol/L induced a significant apoptosis in HepG2,BGC-823,MCF-7 cells(P0.05).The apoptosis rates of cancer cells treated with VPA and specific inhibitors of Caspase3,Caspase9 together was lower than in the groups with VPA treatment singlely(P