BACKGROUND:Osteonecrosis of the femoral head (ONFH) results from an interruption of the blood supply to the femoral head or injury-caused death of chondrocytes and bone marrow components. Many osteogenesis-related factors, such as Runt-related transcription factor 2 (Runx2), bone morphogenetic protein (BMP), osteoprotegerin and osteocalcin, are involved in the subsequent repair process. The Runx2 gene has been shown to control osteoblast differentiation and formation by upregulating the transcription of various mineralization-related protein genes, alowing osteoblast precursors differentiation into osteoblasts, and playing a key role in bone repair.
METHODS/DESIGN:This retrospective, single-center, non-randomized, paralel-controled trial was performed at Shengjing Hospital of China Medical University, China. Fifteen patients with ONFH and 15 patients with osteoarthritis undergoing total hip replacement were included. Primary measure was Runx2messenger RNA (mRNA) expression in femoral head and neck tissue, and secondary measures included BMP-2, BMP-7 and osteoprotegerin mRNA expression, as wel as osteocalcin immunoreactivity. This trial was registered at ClinicalTrials.gov (identifier: NCT02735538) and acquired written approval from the Ethics Committee of Shengjing Hospital of China Medical University (approval No. 2016PS222K). Written informed consent was obtained from each included patient.
DISCUSSION:This study involved in the detection of mRNA expression of several bone repair-related genes, including Runx2, in the femoral head and neck of patients with ONFH was performed between 2010 and 2011. This observational study wil help clarify the role and possible clinical significance of Runx2 in femoral head necrosis, bone repair and reconstruction.

Objective To compare the effect of clustered acupuncture of the scalp combined with constraint induced movement therapy (CIMT) with that of conventional acupuncture of the body points plus conventional rehabilitation intervention after cerebral infarction using blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI).Methods Thirty acute cerebral infarction patients with hemiplegia were equally divided into two groups at random.The test group received the clustered acupuncture of the scalp combined with CIMT,while the control group received the body point acupuncture plus conventional rehabilitation intervention.Before and after two weeks of treatment,blood oxygenation level-dependent functional magnetic resonance imaging at 3.0 T was performed during a passive digital opposition movement.The volume and intensity of the activated areas were compared.Fugl-Meyer assessment (FMA) was carried out as well.Results The most pronounced activation appeared in the contralateral somatosensory motor cortex for both groups.There was no significant difference in average FMA scores between the two groups before the treatment,but after the treatment the averages were significantly different.An increase in activated volume and intensity in the contralateral SMC was observed in both groups after the treatment,but the test group showed a much larger change in both activated volume and intensity.Conclusion The clustered acupuncture of the scalp combined with CIMT can achieve a more significant improvement in functional recovery after acute cerebral infarction than conventional acupuncture of the body points plus conventional rehabilitation intervention.Such combined therapy is worthy of application in clinical practice.

Objective To establish a method for high throughput screening single nucleotide polymorphism(SNP) by tag microarray,and then apply the method to study the gene SNP which is related to the motor function of normal people.Methods The genes related to motor function were firstly defined,and then 48 SNP loci were determined.The rs numbers of these SNP loci were fingered out from PubMed,and the primers were designed with the software in web site "www.autoprimer.com".The primer sequences were then downloaded and sent to the biologic corporation for synthesis.After being synthesized and purified by HPLC these primers were used in the experiments according to the instruction of Bakeman's SNPstream machine.The key techniques of SNPstream machine were tag microarray and single nucleotide extension assay.Once the determination was finished,both the gene frequency and allele frequency of every locus could be statistically analyzed.Results The information of the 48 SNP loci that related to motor function had been determined simultaneously by tag microarray,regardless the number of samples to be detected at the same time.The number of the samples was variable to meet the need.The data of gene frequency and allele frequency of these 48 SNP loci may be used in the subsequent studies.Conclusions Tag microarray used to high throughput screening SNP has the advantages of accuracy,speed,efficiency and reasonable cost.Therefore it can be applied to study the relationship between the SNP and many kinds of diseases.

Objective To discuss the clinical value of intravascular ultrasound (IVUS) in treatinginternal carotid arteries occlusion.Methods The patient was diagnosed with internal carotid artery occlusionthat was confirmed by CTA.Cerebral perfusion imaging showed that low perfusion area was consistent withischemic symptoms.Guided by IVUS,percutaneous transluminal angioplasty (PTA) was performed.By usingmicro-catheter coaxial technology,the micro guide wire was inserted in the carotid artery until it passedthrough the obstructed segment;After IVUS examination proved that the micro guide wire was in the truelumen of carotid artery,angiography through micro-catheter was carried out to confirm that the distal arterywas unobstructed;after adjusting the device position the embolism protector was placed.The plaque andlumen condition were assessed with IVUS,which was reevaluated after pre-expansion of balloon.After normaldirection blood flow was regained,the plaque stability was assessed with IVUS virtual organization sequence.Simple balloon dilatation therapy was adopted as the fibrous cap of plaque was in stable condition and thelumen stenosis rate was ＜40％.Results After balloon dilatation,the obstructed artery was reopened and theblood flow regained normal direction.IVUS examination showed that during the whole operation process thefibrous cap of plaque at the narrowed segment remained in stable condition,the lumen stenosis rate was ＜40％.Cerebral perfusion imaging revealed that after the treatment the low perfusion state was markedlyimproved.Conclusion IVUS plays an important guiding role in performing PTA for internal carotid arteryocclusion.This technique can increase the success rate of vascular recanalization and reduce the incidence ofcomplications.

Objective To explore the changes of inflammatory factors in patients with different stage of rheumatoid arthritis (RA) ,and to study the changes of immune microenvironment in patients with RA .Methods The serum levels of tumor necrosis factor(TNF) ,interleukin‐10(IL‐10) ,interleukin‐6(IL‐6) ,interleukin‐1β(IL‐1β) and interleukin‐4(IL‐4) in patients with RA on ac‐tive stage(36 cases) ,patients with RA on remitting stage and healthy individuals (30 cases)were detected by using cytometric bead array .Results The serum levels of IL‐6 ,IL‐1βand TNF in active stage RA group were higher than those in control group and re‐mitting stage RA group ,while serum levels of IL‐4 and IL‐10 were lower than those in control group and remitting stage RA group , and the differences were statistically significant (P<0 .05) .The serum levels of IL‐6 and IL‐1βin remitting stage RA group were significantly higher than those in control group(P<0 .05) .There were no significant differences in levels of IL‐4 ,IL‐10 and TNF between remitting stage RA group and control group(P>0 .05) .As the disease develops ,except for IL‐6 which tended to be stable , the serum levels of IL‐4 and IL‐10 had a rising trend ,while serum levels of IL‐1βand TNF had a downward trend with the progres‐sion of RA .Conclusion There is an imbalance between Th1 and Th2 cytokines in patients with RA on active stage ,in which Th1 cytokines are dominantly expressed .Periodic detection of inflammatory factors according to the course of RA could provide a relia‐ble basis for the assessment of disease activity .

Objective:To analyze the system of first contact in community health institutions for migrant workers in Shenzhen city with the stakeholder theory. Methods:The report forms of the Social Insurance Fund Administration Bureau and the health bureau of Shenzhen city were used to analyze. All stakeholders of this policy were interviewed. Results:The system of first contact in community health institutions was good for all stakeholders. The number of in-sured migrant workers grew steadily, the business volume of community health service centers increased significantly, and the fund ran smoothly. Conclusions:The effects of the system of first contact in community health institutions for migrant workers in Shenzhen city were obvious. All the stakeholders felt satisfied with the policy.

The system of first contact in community health institutions, as the core element of hierarchical di-agnosis and treatment system, is of great importance for reforming successfully China’ health service system. The sys-tem of first contact in community health institutions implemented among labor workers in Shenzhen City plays an im-portant role in patients ’ distribution and the interested parties can accept this mandatory system. Campared with Shenzhen City, the level of services is enough to meet patients’ primary health demands in some cities which the com-munity health service develops well, and it should be thought highly of the mandatory in the process of policy imple-mentation in order to ensure the implementation effect.

Objective:To explore the utilization of and satisfaction at community health service between migrant and non-migrant workers in Shenzhen city. Methods: Random sampling was used and 8000 community residents in Shenzhen city were investigated, and the data was analyzed with SPSS 18. 0. Results:There was statistically signifi-cant difference on the times of seeking community health services last year between migrant workers and non-migrant workers ( P<0. 0001 ) , and the proportion of more than three times service utilization of migrant workers were greater than that of non-migrant workers. The top three elements inpluencing satisfaction at community health service between migrant and non-migrant workers were service attitude ( 73. 29% vs. 73. 46%) , technical level ( 65. 29% vs. 67. 50%), and its convenience of seeking a doctor (63. 16% vs. 64. 98%). 73. 47% of users (migrant workers:74. 16%, non-migrant workers:69. 71%) were willing to accept the system of first contact in community health in-stitutions. Conclusions:The utilization of community health service has increased since implementing the system of first contact in community health institutions. Both migrant workers and non-migrant workers were very satisfied with the community health services, and the differences on satisfaction between the two groups were not significant. It is feasible to gradually promote the system of first contact in community health institutions over China.

Objective To investigate mupiroein resistance in Staphylococcus aureus (SAU) and the resistance to commonly used antibiotics in mupirocin-resistant strains. Methods Four hundred and ninety clinically isolated SAU strains froin January 2005 to May 2007 in the First Affiliated Hospital,Wenzhou Medical College were screened by mupirocin(5μg)disc diffusion method.Minimum inhibition concentration(MIC)and the amplification of mupA gene were performed to determine the resistance to mupirocin.Resistance to cefoxitin,gentamycin, levofloxacin, trimethoprim/sulfamethoxazole, rifampin, erythromycin, clindamycin, tetracycline and vancomycin in mupirocin-resistant strains was detected by disc diffusion method, and the amplification of mecA gene was performed to confirm the methieillin resistance among mupiroein-resistant strains.Results Twenty-seven mupirocin-resistant strains were obtained,in which 22(81.5%)were hish-level mupirocin resistant(MuH)and the rest were low-level mupirocin resistant(MuL).Among 27 mupirocin-resistant strains,24 were methicillin-resistant Staphylococcus aureus (MRSA)in which 21 were MuH and 3 were MuL strains.Drug sensitivity tests showed that the resistance to gentamycin,levofloxacin,trimethoprim/sulfamethoxazole,rifampin,erythromycin,elindamycin and tetracycline were hish among MuH and MuL strains,and most of these strains were multi-drug resistant.All strains were susceptible to vaneomycin.Conclusions Most of the clinical emerged mupirocin-resistant SAU strains are MuH and show hish resistance to commonly used antibiotics.Therefore,detection and drug sensitivity test of mupirocin-resistant strains should be strengthened in clinic practice in order to prevent it from dissemination.

Objective To inVestigate the Potential mechanism and ProtectiVe effects of osthole on rats with focal cerebral ischemia_rePerfusion injury. Methods Middle cerebral artery occlusion was induced by the suture_occluded method. After 2 h of cerebral ischemia and 24 h of rePerfusion,scores of neurological deficits and infarct Volume were eValuated. The leVels of SOD,MDA,GSH and ATPase were also determined. Results Scores of neurological deficits and infarct Volume were lower in the osthole grouPs than in the model grouP. Meanwhile,the actiVity of SOD and GSH content were increased,while the MDA content was decreased in osthole grouPs. Conclusion Osthole exerts ProtectiVe effects on rats with focal cerebral ischemia_rePerfusion injury.