Objective To evaluate the prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly (MODSE). Method A total of 393 patients with pulmonary infection, who were above60 years old, were divided into non MODSE(n =224) and MODSE group(n = 169) and were scored by the early prediction score system of MODSE. Independent-samples t Test was used to analyze the difference of forecast score between MODSE and non MODSE group. Receiver operating characteristic (ROC) curve was drawn,and the area under the curve was calculated. The prediction accuracy of scores for MODSE was assessed using sen-sitivity and specificity, and the optimal forecast point for MODSE was found. Results The score of MODSE group was higber than that of non MODSE[(19.38±12.049) vs. (45.78±20.257), P <0.001]. The area under the ROC curve was 0.889 (P <0.001) ond 95% (0.857～0.920). As the value of forecast score was 27.5, the sensitivity of the early prediction score system of MODSE was 82.8 %, the specificity of the early prediction score system of MODSE was 80.3 %. Conclusions The early prediction score system of MODSE is valuable in predic-tion of MODSE, which may be used to forecast MODSE and find the high risk population of MODSE.

Objective To evaluate the clinical value of fasting blood glucose (FBG) in the diagnosis of multiple organ dysfunction syndrome (MODS) caused by pulmonary infection in elderly patients with diabetes. Methods Patients over 65 years old with diabetic pulmonary infection admitted to Department of Cadres Ward of Bethune International Peace Hospital of PLA from July 2015 to December 2016 were enrolled. According to the patient's highest FBG level during pulmonary infection, all patients were divided in two groups. The cases whose FBG ≥8.83 mmol/L were served as suspicious multiple organ dysfunction syndrome in the elderly (MODSE) group, and those had FBG < 8.83 mmol/L were served as suspicious non-MODSE group. The incidence of MODSE in suspicious MODSE group and suspicious non-MODSE group was compared. The receiver operating characteristic curve (ROC) was drawn, and the clinical value of highest FBG in the diagnosis of MODSE caused by pulmonary infection in elderly patients with diabetes was assessed. Results 119 elderly patients with diabetes and pulmonary infection were enrolled in the analysis. All patients were male, with age of 76-105 years with an average of (89.41±4.16) years. Among 119 patients, 55 of them with suspected MODSE, 64 of them with suspected non-MODSE. The incidence of MODSE in suspicious MODSE group was significantly higher than that in suspicious non-MODSE group (78.2% vs. 12.5%), with statistically significant difference (χ2 = 52.108, P = 0.000). The area under the ROC curve of the highest FBG for diagnosis of MODSE was 0.895, and 95% confidence interval (95%CI) was 0.839-0.951 (P < 0.001). When using FBG ≥ 8.83 mmol/L to diagnose MODSE induced by pulmonary infection in elderly patients with diabetes, the sensitivity was 84.3% and the specificity was 82.4%. Conclusion FBG ≥ 8.83 mmol/L, as an indicator reflecting the changes of metabolic function, have a diagnostic value for MODSE caused by pulmonary infection in elderly patients with diabetes.

Objective To study the effect of NS398, an inhibitor of cyclooxygenase 2 (COX2), on the growth and apoptosis of human squamous cell carcinoma cell line Tca8113. Methods Cultured Tca8113 cells were incubated with NS398 (0, 6.25, 12.5, 25, 50, 100 μmol/L) for 24, 48 and 72 hours, respectively. Thereafter, MTT method, flow cytometry and transmission electron microscopy were applied to detect the proliferation, cell cycle and apoptosis of Tca8113 cells, respectively. Results The proliferation of Tca8113 cells was inhibited by NS398 in a dose- and time-dependent manner (both P<0.05). FCM analysis showed the appearance of a typical hypodiploid apoptotic (Sub-G1) peak, an increase in the percentage of cells at G0/G1 phase and a decrease in that at S and G2/M phases in NS398 ( 100 μmol/L) -treated Tca8113 cells. Moreover, the cell proliferation index was significantly downregulated by NS398 of 100 μmol/L from 41.03 to 24.33 (P<0.05). Under an electron microscope, morphological changes characteristic of apoptosis were observed in NS398-treated Tca8113 cells. Conclusion NS398, an inhibitor of COX2, could effectively inhibit the growth of Tca8113 cells in vitro by induction of apoptosis.

Objective To investigate the results of FasT-Fix technique in repair of degree Ⅲ horizontal meniscus tears.Methods From June 2010 through June 2013,12 patients with degree Ⅲ horizontal meniscus tears underwent arthroscopic vertical mattress suture using the FasT-Fix technique.There were 7 males and 5 females at mean age of 34.7 years.All the patients were diagnosed with combined anterior cruciate ligament (ACL) rupture with preoperative Lysholm score of (64.9 ± 9.4)points.Arthroscopic meniscus repair was performed prior to ACL reconstruction.A second-look arthroscopy examined the healing status of the meniscus at 6 to 18 months postoperatively (mean,12 months).Lysholm score was evaluated during outpatient follow-up.Results All the patients were available to the follow-up of 26 months (range,12-36 months).Second-look arthroscopy showed complete healing in 9 patients and incomplete healing in 3 patients.At final follow-up,Lysholm score was (93.4 ± 5.0) points.Conclusion FasT-Fix technique can repair degree Ⅲ horizontal meniscus tears with vertical mattress sutures and reconstruct ACL,which has advantages of allowing maximal preservation of the horizontally torn meniscus,minor trauma,easy operation and definite efficacy.

Objective To discuss the methods and effects of arthroscopic treatment of posterior and anterior ankle impingement syndrome through anterior approach,tarsal sinus approach plus posterolateral approach.Methods The study enrolled 12 patients with posterior and anterior ankle impingement syndrome treated from January 2012 to March 2014.There were 8 males and 4 females,agedl7-65 years (mean,45 years).Left ankle injury was noted in 9 patients and right ankle injury in 3 patients.Eight patients had a history of obvious ankle injury (5 acute and 3 chronic sprains).Arthroscopic surgery was performed to manage the posterior and anterior ankle impingement syndrome through the combined anterior,tarsal sinus and posterolateral approaches,and prone position and posteromedial incision were not used during operation.Postoperative outcome was evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score.Results Operation time was 45-80 min (mean,62 min).Arthroscopy confirmed anterior bone impingement in all patients.Three patients suffered from posterior bony impingement of the talus,while nine patients os trigonum injury.Duration of follow-up was 10-18 months (mean,14 months).AOFAS score was (91.4-± 6.5) points after operation,significantly higher (34.4 ± 12.6) points before operation (t =14.607,P ＜0.01).All patients had normal ankle range of motion after operation.There were no complications such as neurovascular injury.All the surgical incisions achieved primary healing.Conclusion The procedure avoids body position shift and posteromedial incision during operation,and attains a good vision to the anterior and posterior portions and satisfactory short-term outcome.

Objective:To investigate the effect of osteoblast-derived extracellular vesicles(OB-EVs)on the proliferation and differentiation of osteoclasts,and to explore the possible molecular mechanism of extracellular vesicles involved in the communication between osteoblasts and osteoclasts.Methods:Primary osteoblasts were isolated from newborn mouse calvarial bone and induced by β-glycero phosphate,ascorbic acid and dexamethasone.Osteogenic feature was tested by alkaline phosphatase(ALP)and alizarin red S staining.Extracellular vesicles were isolated by ultracentrifugation from the cell culture supernatant.Vesicle morphology was observed by transmission electron microscopy,and the characteristic markers of tumor susceptibility gene 101(TSG101),ALG-2 interacting protein X(Alix)and cluster of differentiation 9(CD9)on the surface of extracellular vesicles were identified by Western blotting.Cell counting kit 8(CCK-8)assay was used to determine the proliferation effect of OB-EVs on mouse mononuclear macrophage RAW264.7 cells.Furthermore,the expression level of specific markers of osteoclast differentiation in RAW264.7 cells was detected by Western blotting after the combined effect of OB-EVs and receptor activator for nuclear factor κB ligand(RANKL).The number of osteoclasts was observed and compared with OB-EVs-treated mouse bone marrow-derived macrophages(BMMs)by tartrate-resistant acid phosphatase(TRAP)staining,and the effect of OB-EVs on osteoclast differentiation was determined.Results:The extracted OB-EVs showed a double-layer cup-like structure with a diameter of 30-150 nm,and TSG101,Alix and CD9 were expressed.RAW264.7 cells were stimulated with OB-EVs,and the results of CCK-8 assay showed that high concentration of OB-EVs(more than 20 μg/mL)inhibited cell proliferation(P<0.05).Western blotting analysis showed that the expression of osteoclast differentiation marker proteins such as c-Fos,activated T cell nuclear factor(NFATc1)and c-Jun N-terminal kinase(JNK)in RAW264.7 cells were significantly increased,and the promoting effect was enhanced with increasing of OB-EVs concentration(P<0.05).In addition,the combination of OB-EVs and RANKL on BMMs showed that the number of TRAP-positive cells was significantly higher than that of the RANKL induction group alone(P<0.05).Conclusion:OB-EVs can promote the differentiation of osteoclast precursor cells into osteoclasts,but high concentration of OB-EVs can inhibit proliferation of RAW264.7 cells.

This paper is a follow-up study of 329 children in factory-run nurseries in urban Shanghai. The investigation lasted for a period of one year for each index-child, focusing on the conditions of nutrition, development and diseases of the children of various ages.Comparison between nutritionl findings and RDA of China disclosed that calorie intake of most of the index-child groups were 80-85% of RDA, the only exception being the 6-12 months group where the average calorie intake showed 90%. Protein intake of all groups was over 80% of RDA. Fe intake was lower than RDA, except for 18-month-old and over.Weight and height of the children were compared with the anthropo-metric data established in 1985 (1985 data) for Shanghai children under six years of age. It was found that the average weight and height appeared differently according to their age. Average weight of children under one year old was slightly higher than 1985 data, while average height was lower than 1985 data once the children reached 10 months old. Average weight, however, became lower than the 1985 data after the children were two years old. Over 60% of the index between 6-18 months old suffered from anemia (IDA).Accordingly, it is requested that calorie and iron intake should be supplemented.

Periodontal disease is a chronic infectious disease characterized by gingival inflammation and progressive destruction of alveolar bone, and the interaction between plaque microbes and host defense affects the process of the disease. Recent studies have found that autophagy is one of the most primitive host defense responses against pathogenic microbial invasion. Autophagy plays an important role in the development of periodontal disease through such functions as clearing pathogens, regulating inflammatory responses and promoting osteoclast activation to affect bone resorption with inflammatory factors. This review article mainly introduces the research advances on autophagy mechanism and the relationship between autophagy and periodontal disease from the domestic and foreign literatures and expounds the mechanism of autophagy and periodontal pathogens, inflammatory reaction and bone resorption of osteoclasts, so as to enrich the pathogenesis of periodontal disease and provide a new perspective for the treatment of periodontal disease.

Objective To screen the sensing elements for TNT detection in Escherichia coli genome.Methods A genome promoter library with cutting E.coli K-12 MG1655 genome was constructed.Bacterial luciferase luxCDABE was used as a reporter gene during promoter screening.We discovered TNT sensing elements through several rounds of screen-ing.Through analysis of sensitivity, specificity and timeliness, the promoter activity of the elements was evaluated,and the functional sequence of the elements was further confirmed.Results and Conclusion We successfully constructed an E.co-li K-12 MG1655 genome library , from which a TNT sensing element was discovered,which had a good performance in the analysis of sensitivity, specificity and timeliness.In this study, we reported that the topAp4 is a TNT sensing element for the first time.We also verified its excellent promoter activity.

The reform of medical insurance payment system could promote the transformation of medical services from price medical care to value medical care, which is very important to promote the construction of medical alliance. The authors discussed the reform of medical insurance payment system to promote the construction of medical alliance, and the order of medical alliance covering medical services and seeking medical treatment.For medical service providers, the reform of medical insurance payment system helped to promote the construction of closer medical alliance, guided the sinking of high-quality resources, helped to form a smooth referral mechanism, and strengthened the supervision and assessment of medical behavior. For the demanders of medical services, the differentiated medical insurance reimbursement proportion policy within the medical alliancewas more conducive to attracting the first consultation at the grass-roots level. At the same time, patients had a wider choice of medical treatment and more freedom of choice. In view of the problems existing in practice, the authors suggested that a variety of medical insurance payment and performance systems with value-based medical care as the core should be implemented to deepen the development of medical alliance, the medical insurance system and municipal subsidies should jointly undertake the salary subsidies for sinking medical personnel, and integrate the grass-roots fragmented health care business with the help of medical insurance payment tools, and promote the coverage expansion of the medical insurance reform of the medical alliance based on policy guidance.