BACKGROUND: Knee arthroplasty can correct the joint deformity, alleviate the pain and improve the joint function,thereby improving the patients' quality of life. Early rehabilitative training is the key to the functional recovery of the joint.OBJECTIVE: To observe the clinical effectiveness of early gait training on the rehabilitation of patients after knee arthroplasty.METHODS: Eighty-six cases undergoing unilateral knee arthroplasty in the Department of Sports Medicine were selected and randomly divided into experimental and control groups (n=43 per group). The experimental group wasgiven rehabilitation instruction before operation, and the gait training was carried out just after the operation. The patients in the control group only received the basic rehabilitation training. The Visual Analogue Scale and the Hospital for Special Surgery scores were evaluated at baseline and 2, 4, and 8 weeks, and 6 months postoperatively, and the clinical effectiveness was compared between two groups.RESULTS AND CONCLUSION: (1) The range of motion of the knee in the experimental group was significantly higher than that in the control group at 4 and 8 weeks, and 6 months postoperatively (P < 0.05). (2) At 8 weeks and 6 months postoperatively, the Visual Analogue Scale scores in the two groups both were significantly decreased (P < 0.05). (3) At 2 weeks postoperatively, the Hospital for Special Surgery scores in both groups were significantly increased (P < 0.05);the scores at 8 weeks postoperatively in the experimental group were higher than those in the control group (P > 0.05);the scores at 6 months postoperatively in the experimental group were significantly higher than those in the control group (P < 0.05). (4) These findings suggest that compared with conventional training, early gaiting training can significantly improve the range of motion and pain of the knee, as well as enhance the functional recovery of the knee joint, which exhibits remarkable curative efficacy in the rehabilitation following knee arthroplasty.

BACKGROUND:The benefit of cell therapy may be partly due to the secretion of angiogenic and antiapoptotic growth factors.Whether amniotic fluid stem cells (AFS) could secrete some growth factors requires further studies.OBJECTIVE:To isolate and culture AFS cells,and explore the angiogenic or antiapoptotic effect of cytokines secreted by AFS on endothelial cells.DESIGN,TIME AND SETTING:A in vitro cytological experiment was performed at the Institute of Hypertensive Disease,First Affiliated Hospital,Nanchang University from December 2008 to June 2009.MATERIALS:Term amniotic fluid of ten samples,50 mL/case,was obtained following caesarean delivery.The umbilical vein was used to isolate endothelial cells.Written informed content was obtained from all women.METHODS:AFS isolated from human amniotic fluid was cultured and digested by trypsin at confluence of 80%.The third passage of cells at a density of 5×10~8/L were divided into two groups:hypoxia group:the cells were cultured in 2% O_2 + 5% CO_2 +93% N_2;normal group:the cells were cultured in 5% CO_2 + 95% air.Two groups were cultured at 37 ℃ for 24 hours.The supematant of two groups was collected.The second passage of human umbilical vein endothelial cells cultured in vitro was collected and seeded onto 12-well culture plate at a density of 2×10~4 cells/well,and divided into 3 groups:control group was cultured in 2 mL EBM-2 containing 5% fetal bovine serum (FBS);normal group was cultured in 1 mL EBM-2 containing 5% FBS and 1 mL AFS cell culture solution;hypoxia group was cultured in 1 mL EBM-2 containing 5% FBS and 1 mL hypoxia AFS cell culture solution for 3 days,followed by incubation with 10 μg/L tumor necrosis factor (TNF)-α.MAIN OUTCOME MEASURES:AFS surface phenotype was examined by flow cytometry;the secretion level and mRNA expression of vascular endothelial cell growth factor (VEGF) and hepatocyte growth factor (HGF) were examined by ELISA or RT-PCR.The proliferation and apoptotic rates of endothelial cells were examined.RESULTS:AFS cells were long fusiform-shaped and arranged radially after 7 days of culture.The third passage of AFS cells expressed CD29 and CD105 while did not express CD34.AFS cells of normal culture secreted VEGF and HGF;AFS cells of hypoxia condition significantly increased secrete of VEGF (P＜0.01),and VEGF mRNA expression was significantly upregulated (P＜0.05),while HGF and mRNA expression remained unchanged (P＞0.05).Compared with control group,the number of endothelial cells was significantly increased in normal and hypoxia AFS cell groups after 3 days of culture (P＜0.05).After cocultured with TNF-α for 24 hours,the apoptosis rates of endothelial cells in AFS-conditioned medium was significantly decreased (P ＜ 0.05),and the change degree of hypoxia AFS cell group was greater than normal AFS cell group (P ＜ 0.05).CONCLUSION:AFS can secrete cytokines such as VEGF and HGF.Moreover,it significantly promotes endothelial cells proliferation and inhibits apoptosis.Under hypoxia condition,the secretion of VEGF from AFS cells is increased,and the effects on endothelial cells proliferation and apeptosis are enhanced.

Objective To investigate the effect of the Senlm of patients with congestive heart failure(CHF) on the apoptosis of endothelial progentior eelts(EPCs)and protective role of carvedil01.Method Totally 20 patientswithCHF、^mre enrolledfromDepartment ofCardiology ofthe FirstHospital Affdiated ofNanchangUniversity between June and August 2007.Serum WflflL isolatedfrom blood ofthe patients.1lononuelear cells were isolated from blood of20 healthy volunteers by density gradient centrifugation.Attaching cells wel-e harvested after culture for 7 relays and the EPCs were anyzea by flow cytometry and immunofluorescenee method.EPCs were divided into 4 groups:group A,cultured in sE-of volunteers;group B,cultured in serum of CHF;group C,cultured in leNlm of CFIF and Carvedilol;group D,cultured in,erum of CI-IF and metoproM,After euhure for 24 hours,annex.inV/PI wss used to investigate the apoptosis rate ofEPCs and the activity ofcllspafle 3 were exanlilled.ELISA Wills used to detect the level of flerum TNF-a of patients with CHF.Multiple group compalrion Wills conducted with variance analvsis and q test.Results The apoptosis rate and easpase 3 activity of EPCs in group B[(7.5 4-0.9)%v8.(3.0 4-0.25)]were significantly ineased compared with group A[(3.4±0.7)%VS.(1.37±0.2),P

Objective: To study the effects of ursolic acid on the differentiation of cementoblast cell line OCCM-30 cells, and to provide the theoretical basis for the repair of root restoration. Methods: The OCCM-30 cells in logarithmic growth phase were divided into control group and different concentrations of ursolic acid groups. The OCCM-30 cells in ursolic acid groups were treated with different concentrations (0.625, 1.250 and 2. 500 μmol · L-1) of ursolic acid and the cells in control group did not receive any treatment. MTT method was performed to detect the inhibitory rates of proliferation of the OCCM-30 cells in various groups at different time points (24, 48, and 72 h); ALP (alkaline phosphatase) assay was performed to detect the cell differentiation and mineralization; real-time quantitative PCR was used to determine the expression levels of osteopontin (OPN) mRNA during 24 h; the expression levels of OPN protein at 3 and 5 d after administration were detected by Western blotting method. Results: There were no significant differences in the inhibitory rates of proliferation of OCCM-30 cells between control group and different concentrations of ursolic acid groups (P>0. 05). Compared with control group, the ALP activities in the OCCM-30 cells in 2. 500 μmol · L-1 ursolic acid group at 3, 5, and 7 d after administration were significantly increased (P<0. 05). Compared with control group, the expression levels of OPN mRNA and protein in the OCCM-30 cells in different concentrations of ursolic acid groups were significantly increased (P<0. 01). Conclusion: Appropriate concentration of ursolic acid has no effect on the inhibitory rate of proliferation of OCCM-30 cells, but it can promote the differentiation of OCCM-30 cells and up-regulate the expression levels of OPN mRNA and protein.

Objective To investigate the stigma in the public about the patients with depression and diabetes.Methods The stigma situation of the publics (workers,peasants,students,intellectuals and others,collect 300 respectively) were assessed for the patients with depression and diabetes with the Struening Belittle Scale.1500 questionnaires were distributed and 1421 effectual questionnaires were retrieved.Results ① A comprehensive compare of public stigma between depression and diabetes showed that about 89.0％ of the public with stigma and 11.0％ of the public without stigma for the patients with depression,about 32.0％ of the public with stigma and 68.0％ of the public without stigma for the patients with diabetes.There were significant differences in frequency of public stigma for two diseases (x2 =744.906,P ＜ 0.01).②There were significant differences in the total scores((52.8 ± 12.4) vs(32.4 ± 13.6),t =5.328,P ＜ 0.01) and subscale scores of the Stmening Belittle Scale (Patient Belittle Scale:(26.5 ± 8.6) vs (12.4 ± 5.6),t =3.276,P ＜ 0.01 ; Family Belittle Scale:(22.8 ±6.4) vs(9.4 ± 5.2),t =2.988,P＜ 0.01) of the public for the patients with depression and diabetes.Conclusion There is serious stigma in the public for patients with depression.It is more serious and extensive than that for patients with diabetes.

Objective To compare the therapeutic effect between Kirschner wire- loop plating and clavicular hook plate in the treatment of distal clavicle fractures. Methods Forty- two patients with type Neer Ⅱ distal clavicle fracture were selected, among whom 23 patients were treated with Kirschner wire- loop plating (group A), and 19 patients were treated with clavicular hook plate (group B). The operative time, fluoroscopy time, length of incision, intra- operative bleeding volume and hospitalization time etc were recorded. The patients were followed up at 6 weeks, 3 months, 6 months and 12 months after operation. The American shoulder and elbow society (ASES) score was evaluated, and the therapeutic effect was evaluated by Karlsson standard. Results The operative time and fluoroscopy time in group B were significantly lower than those in group A: (63.5 ± 12.4) min vs. (71.5 ± 11.1) min and (3.6 ± 1.9) s vs. (4.8 ± 1.5) s, but the intra- operative bleeding volume, length of incision and cases of postoperative shoulder pain in group A were significantly lower than those in group B:(91.5 ± 18.5) ml vs. (108.7 ± 32.5) ml, (6.6 ± 0.7) cm vs. (11.3 ± 0.9) cm and 2 cases vs. 14 cases, and there were statistical differences (P<0.05 or <0.01). There was no statistical difference in hospitalization time between 2 groups (P>0.05). There was no statistical difference in ASES score at 6 weeks and 3 months after operation between 2 groups (P>0.05); but the ASES score at 6 and 12 months in group A was significantly higher than that in group B: (89.9 ± 12.6) scores vs. (79.7 ± 12.6) scores and (96.1 ± 4.8) scores vs. (86.1 ± 12.4) scores, and there was statistical difference (P<0.05 or <0.01). There was no statistical difference in the cases of good and excellent at 6 weeks, 3 months and 6 months after operation (P>0.05);but the cases of good and excellent at 12 months in group A was significantly more than that in group B:23 cases vs. 13 cases, and there was statistical difference (P<0.05). Conclusions Kirschner wire- loop plating provides a new treatment option for type Neer Ⅱ distal clavicle fractures. It is conducive to decrease the incidence of shoulder pain and improve the range of motion of should joint. Besides, this technology has advantage of small incision, relatively simple operation steps and small damage to the surrounding soft tissues of the acromioclavicular joint. It may be superior to the clavicular hook plate.

Objective To analyze the status of biobanks in public hospitals in Shanghai.Methods A questionnaire survey on biobanks was conducted in 9 representative public hospitals in Shanghai.Results The management system of hospital biobanks in Shanghai was basically shaped,but the human resources and financial inputs were in shortage,and some management and regulations were not in place yet.Conclusions The biobanks of public hospitals need more inputs,improvement,and standardized management.

Objective:To investigate the effects of ursolic acid (UA) on the proliferation and differentiation of osteoclasts (OC), and to explore its role in orthodontic force-induced root resorption and its relationship with OC.Methods:The mononuclear / macrophage cells RAW264.7 were induced to the OC.Tacrolimus acid phosphatase (TRAP) staining and bone resorption lacunae observation were used to identify the induction.CCK-8 method was used to select the appropriate concentration of UA for RAW264.7 cell-free biotoxicity and to observe its effect on the proliferation and differentiation of RAW264.7.In experimental groups, UA with gradient concentrations (1.0,2.5,5.0,10.0,20.0and 40.0 μmol·L-1)were added.UA was not added in control group.Results:The TRAP staining and bone resorption lacunae observation showed that after the RAW264.7 cells were induced for 5 d, the TRAP staining positive cells were found;the resorption lacunae were rounded,and oval, etc,the bottom wall was coarser,and the boundary was clear,which indicated that the RAW264.7 cells were successfully differentiated into the osteoclasts.The CCK-8 detection results showed that high concentration of UA (> 10.0 μmol·L-1) significantly inhibited the proliferation of OC;the appropriate concentration of UA (5.0 μmol·L-1) was in the biological safety concentration range and could inhibit the OC proliferation;low concentration of UA (<2.5 μmol·L-1) had no effect.Conclusion:RANKL can induce the differentiation and maturation of RAW264.7 cells.UA is correlated with the proliferation and differentiation of OC;UA has inhibitory effect on OC at the appropriate concentration (5.0 μmol·L-1) in a time-dependent manner.

[ABSTRACT]AIM:Tostudytherelationshipbetweenhuman8-oxoguanineglycosylase1(hOGG1)gene Ser326Cys polymorphism and severity of coronary artery lesions in the patients with diabetes mellitus .METHODS: We retrospectively analyzed 323 patients with diabetic mellitus receiving coronary angiography .These patients underwent the test of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and were divided into Cys/Cys genotype (n=85), Ser/Ser genotype (n=121) and Ser/Cys genotype (n=117) according to the results of PCR-RFLP. All clinical data including history of diseases , complications and biochemical markers , such as blood glucose , blood lipids and so on, were recorded.hOGG1 mRNA and 8-hydroxydeoxyguanosine (8-OHdG) were measured by RT-PCR and ELISA, respectively.The results of coronary angiography such as number and severity of coronary artery with lesions were analyzed by 2 cardiovascular physicians .Gensini score and SYNTAX score were also detected by the unitary criteria .RE-SULTS:(1)8-OHdG in Cys/Cys genotype was higher than that in Ser /Ser genotype and Ser/Cys genotype (P<0.05), but there was no statistical difference between Ser /Ser genotype and Ser/Cys genotype (P>0.05).(2)hOGG1 mRNA ex-pression in Cys/Cys genotype was lower than that in Ser/Ser genotype and Ser/Cys genotype (P<0.05), and no statistical difference between Ser/Ser genotype and Ser/Cys genotype (P>0.05) was observed.(3)The probability of triple vessel lesions in Cys/Cys genotype was high and the probability of single vessel lesions in Ser /Cys genotype was low , but the difference among 3 genotypes was not statistically significant (P>0.05).(4)Gensini score and SYNTAX score in Cys/Cys genotype were 48.7 ±15.3 and 39.5 ±17.2, respectively, and the ratio of complex lesions in Cys/Cys genotype was 73.0%.These scores and the ratio of complex lesions were higher than the other 2 genotypes (P<0.05), and no statisti-cal difference between Ser/Ser genotype and Ser/Cys genotype was observed (P>0.05).CONCLUSION:hOGG1 gene Ser326Cys polymorphism has relationship with coronary artery lesions in the patients with diabetes mellitus and Cys /Cys genotype might have some impacts on the severity of lesions .The mRNA expression of hOGG1 in the patients with diabetes mellitus carrying Cys/Cys genotype is lower than that in the patients carrying the other 2 genotypes , then decreases the abil-ity of identification and removal of 8-OHdG and the capacity of repairing DNA oxidative damage , and accelerates the devel-opment of atherosclerosis .

Objective To investigate the association between plasma lipoprotein (a) [LP (a)] concentra-tion and in-stent restenosis after coronary stent implantation. Methods 152 patients with successful elective coro-nary stont implantation and percutancous transluminal coronary angioplasty (PICA) undergoing foUow-up angiogra-phy were retrospectively analyzed. These patients were divided into restenosis group( n = 29) and no-restenosis group (n = 123 ). The serum LP (a) levels of all patients were also investigated. The general clinical data were analyzed. Multivariate logistic regression was used for statistical analysis. Results We compared the serum Lap (a) levels, smoking and diabet in the two groups, and there was a statisticaLly significant difference between the restenosis group and no-restenosis group(P<0.05). Multivariate logistic regression showed that the elevation of Lap (a) level re-mained as an independent predictor of restenosis (RR =2. 648,95% CI 1. 066-6. 575,P <0. 05). Other risk fac-tors,such as smoking(P =0.023) ,diabet(P =0. 036) and the type of stent(P = 0.011 ) were also correlated with restenosis. Conclusions High plasma LP (a) concentration is an independent predictor of stent restenosis after stent implantation.