BACKGROUND: Continuous passive motion assisted with diathermia will promote the restoration of joint movement of the extremities.OBJECTIVE: To improve joint movement with continuous motion assisted with diathermia after surgical treatment on simple fracture of upper or lower extremity.DESIGN: A randomized controlled trial.SETTING: Huaxi Hospital of Sichuan University.PARTICIPANTS: Eighty-four cases of simple extremity fracture treated in the Orthopedic Department of Huaxi Hospital of Sichuan University from October 2000 to July 2002 were included in this trial. Of them, 16 cases were elbow movement disorder and 68 were knee movement disorder. They were randomly assigned into two groups with 42 cases each.METHODS: The 42 cases in the treatment group were preheated before continuous passive motion while those in the control group just received continuous passive motion. The improvement of joint movement between thetwo groups were assessed and compared according to the joint movement scale.MAIN OUTCOME MEASURES: The joint movement before and after treatment and the indices of joint movement scale in the two groups.RESULTS: All of the eighty-four cases entered the analysis. The joint movement in the treatment group was better than that in the control group [ (101.40 ± 25.76)° vs (86.14 ± 27.66)°, t = 5.25, P ＜ 0.01 ]. The index of joint movement scale in the treatment group was also higher than that of the control group[ (84.32 ± 16.54) vs(64. 89 ± 13.76) ] ( t = 4.24, P ＜ 0.01 ) ].CONCLUSION: Continuous passive motion assisted with diathermia is better than simple continuous passive motion in improving the joint movement and function of elbow and knee.

Objective To verify the significance of the morphological changes of the macula and its relationship to visual function by using optical coherence tomography (OCT) after scleral buckling procdure. Methods The macula of retinae of 68 patients (70 eyes) with reattached retinae after scleral buckling operation for retinal detachment were examined by OCT to scan the macula through fovea vertically and horizontally. Results Among the 70 eyes, 22 eyes revealed normal macula with thickness of neurosensory retina meant (146.47?20.59) ?m. In the other 48 eyes (68.60%) with abnormal macula, 19 eyes showed extensive subretinal interspace, 9 eyes showed local subretinal interspace, 8 eyes showed macula edema, 4 eyes showed thin macula, 4 eyes showed subretinal proliferation and 4 eye showed epiretinal membrane over macula. In the normal macular structure group under the OCT, the visual acuity (VA) of the operated eyes was more than 0.3 in 6 eyes 2 weeks after operation and in 14 eyes 3 mons after operation. In the macula edema group, the VA was more than 0.3 in 1 eye 2 weeks after opoeration and 2 eyes 3 mons after operation. In the subretinal interspace group, the VA was more than 0.3 in 5 eyes 2 weeks after operation and in 23 eyes 3 mons after operation. The proportions of the numbers of operated eyes with the VA more than 0.3 after 3 mons of the operation in macular normal group subretinal interspace group and other macular disease group were significantly different (? 2=18.91, P

Objective To study the effects of glimepiride and short-term intensive therapy with insulin on plasma glucose and beta-cell function in newly diagnosed type 2 diabetic patients.Methods 80 newly diagnosed type 2 diabetic patients were divided into two groups of 40 patients each and randomly treated with insulin or glimepiride plus metformin for 8 weeks.The FBG,2hPBG,HbA_1c,improvement of beta-cell function were measured before and after intensive therapy in each group.Results After the treatment,FBG,2hPBG,HbA_1c were significantly decreased (all P<0.001) in each group;FCP and 2hPCP were increased(P<0.05)in each group.Conclusion Glimepiride or short-term intensive therapy with insulin plus metformin could effectively improve glycemic control and beta-cell function in newly diagnosed type 2 diabetic patients.

Objective To evaluate the method, clinical effects and influential factors of using three dimensional external fixators in the treatment of severe open comminuted tibiofibular fractures 5 cm near the knee or ankle joints. Methods We retrospectively analyzed 32 cases of open comminuted tibiofibular fracture 5 cm near the knee (11 cases) or ankle joints (21 cases). They were treated with three dimensional external fixators from October 2000 to May 2005. The patients with small wounds were treated with manipulative reduction or leverage reduction through the wound under the guidance of C-arm radiography. In case of malreduction or soft tissue being tangled by the fracture ends, visible reduction was carried out after the wound was lengthened or a small incision was added. Limited internal fixation was used in case of necessity. The results were evaluated in terms of shortening of the fractured limbs, X-ray manifestation, bilateral flexion differences and postoperative walking complaints. Results Follow-ups from 5 to 18 months (nine months on average) showed that all the cases achieved osseous union. The mean union time was 5.6 months. The total excellent and good rates of fracture healing and functional recovery were 81.3% and 87.5% respectively. Conclusion Application of the three dimensional external fixator is appropriate for the treatment of severe open comminuted tibiofibular fracture 5 cm near the knee or ankle joints, because its operative procedure is simple, the injury it causes is minimal, its fixation is reliable and its complications are quite limited.

Objective To analyze the X ray findings of enema unreduced (including 4 perforations ) intussusception so as to improve the knowledge about the difficulty of reduction by air enema or the risk of perforation. Methods Of the 552 cases, 506 cases were successfully reduced by air enema. The range of air pressure was 6.67 to 14.67 kPa(60～110 mm Hg). Forty six unreduced cases were cured by operation. The films were taken before and during the reduction period. X ray findings were analyzed compared with that of the operative pathology. Results (1)Abdominal plain films showed total obstruction in 26 cases and asctis in 4 cases; (2) Air enema showed big and lobular masses in 36 cases and the location of masses in distal part of colon in 22 cases; (3)Operation pathology: ileoilecolic intussusception in 35 cases, 15 cases with intestinal necrosis (including 4 perforation cases). In 3 cases, perforations were in the intussusceptum,the other in the intussuscipiens. Conclusion 92% of intussusceptions can be reducted by pressure of air enema. Complex intussusception, with intestinal necrosis and primary intussusceptum, are difficult to reduce, and these patients ought to be operated on time.

Objective To prepare the “bacterial ghost” of E.coli with heat-induction and analyse its lysis rate and configuration. Methods Through immediately shifting the culture temperature from 37℃ to 42℃, E.coli DH5? including plasmid pMuH36 was induced to lyse, and the OD value of culture media was measured every 30 minutes during the induction. After 4 hours of induction, the bacteria samples were collected to examine the lysis rate by CFU (colony formation unit) and the configuration of lysed bacteria was observed by transmission electron microscopy (TEM). Results The OD value of DH5? (pMuH36)began to decline after 1 hour of induction, and increased slowly after 4 hours of induction. The CFU assay showed that the lysis rate was about 95%. TEM observation proved that most of the lysed bacteria were emptied, whereas the whole outmembrane structure, i.e. “bacterial ghost”, remained. Conclusions The E.coli “bacterial ghost” was efficiently prepared and identified, which might provide the basis for further development of a more effective “bacterial ghost” vaccine and adjuvant.

Objective To investigate whether nuclear transcription factor κB(NF-κB) through Toll-like receptors 2(TLR2) was activated by lipid-associated membrane proteins(LAMPs) of Mycoplasma genitalium.Methods LAMPs were extractded and THP-1 cells were stimulated.The activation of NF-κBp65 was detected by ELISA and the expression of TLR2 mRNA was detected by RT-PCR.Effects of TLR2 neutralizing antibody on LAMPs induced the activation of NF-κBp65 was analyzed by ELISA.After LAMPs stimulated 293T cells with the co-transfection pFLAG-TLR2,pNF-κB-luc,pRL-TK,the activity of NF-κB firefly luciferase and pRL-TK Renilla luciferase were detected by the dual-luciferase reporter gene,to analyzed the role of TLR2-mediated NF-κB activation by LAMPs in 293T cells.Results The activation of NF-κBp65 was mediated in LAMPs induced THP-1 cells and was significantly increased by LAMPs in a dose dependent manner.when LAMPs was 4.0 μg/ml,the activation of NF-κBp65 was the highest level.TLR2 mRNA expression was up-regulated by LAMPs in THP-1 cells.TLR2 neutralizing antibody could inhibit the activation of NF-κB by 60% in LAMPs stimulated THP-1.NF-κB fluorescence was significantly increased by co-transfection pFLAG-TLR2 in a dose-dependent manner. ConclusionMycoplasma genitalium-derived lipid-associated membrane proteins activate NF-κB via TLR2 and the activation of TLR2-mediated play an important role in pathogenic process of LAMPs.

Objective To investigate the role of serum and glucocorticoid regulated protein kinase (SGK) 1 in the inflammatory responses mediated by toll like receptors.Methods Mice were injected with lipopolysaccharide (LPS,1 mg/kg) 2 h after the pretreatment of EMD638683 (10 mg/kg) or phosphate buffered saline (PBS) as control.At the time points of 3 and 24 h,pro-inflammatory cytokines (interleukin [IL]-6,IL-12 and tumor necrosis factor [TNF]-α) in serum were measured using enzymelinked immunosorbent assay (ELISA).Livers and lung were harvested at 6 h and 24 h after the injection of LPS,embedded by optimum cutting temperature (OCT) and then stained with hematoxylin and eosin (HE).Peripheral blood mononuelear cell (PBMC) were isolated and stimulated by LPS with or without the pretreatment of EMD or LY294002.Cytokines (IL-6,IL-12 and TNF-α) were measured using ELISA.IKKα/β,IKBα and nuclear factor (NF)-κB p65 were detected by Western bolt.Data were analyzed by one way analysis of variance.Results In the model of LPS-induced endotoxin sepsis,inhibition of SGK1 induced secretion of pro-inflammatory cytokine (IL-6 [t=3.007,P＜0.05],IL-12[t=4.413,P＜0.05] and TNF-α[t=5.403,P＜0.05]),increased inflammatory cells infikration into the liver and lung within 6 h,and induced serious multiple organ damage with collapse of alveoli and fatty degeneration of liver.After 24 h,pharmacological inhibition of SGK1 with EMD638683 increased proinflammatory cytokine (IL-6 [t=18.540,P＜0.01],IL-12[t=16.520,P＜0.01] and TNF-α[t=34.880,P＜0.01]) production in human PBMC upon LPS stimulation and inhibited the phosphorylation of IKKα/ β/IKBα and nuclear factor (NF)-κB p65.Conclusions SGK1 suppresses the toll like receptor 4 mediated inflammatory responses via NF-κB.

Objective:To study the pharmadynamics in association with the clinical effects of Xiaolin powder. Methods: The bacteriostatic, anti inflammatory, antipyretic, analyesic, diuretic and immunologic actions of xiaolin powder were studied on the corresponding pharmacological models.Results: Xiaolin power had these actions above.Conclusion: Xiaolin powder can be used in the treatment of urinary infection such as part of damp heat strangury and blood strangury.

Objective To analyze the clinical effect of intravascular intervention for treating the severe stenosis of bilateral renal arteries (BRASS).Methods A total of 40 patients with BRASS admitted in Fuwai Hospital from September 2008 to December 2010 were retrospectively analyzed.These patients,23 males and 17 females,aged from 21 to 76 years with average age of (59.75 ± 17.59) years,with luminal narrowing over 70％ in bilateral renal arteries,met the criteria of BRASS evidenced by angiography of renal arteries,and were subjected to renal artery interventional therapy. The etiological factors included arteriosclerosis (34 cases),Takayasu arteritis (3 cases) and congenital fibromuscular dysplasia (3 cases).After percutaneous endovascular intervention,the therapeutic effects were evaluated by lowering the systemic blood pressure and serum creatinine level in 12-month follow-up in average after operation. The data were analyzed with SPSS 13.0 statistical software.ResultsAmong the 80 reual arteries in 40 patients,18 arteries were treated with percutaneous transluminal balloon angioplasty (PTBA),while the other 62 arteries were treated with percutaneous transluminal renal artery stenting (PTRAS).Mter endovascular intervention,the mean systolic blood pressure decreased from ( 165.0 ± 27.0) mm Hg to ( 135.7 ± 25.3 ) mm Hg on the second day after operation ( P ＜ 0.01 ) ; and the mean diastolic blood pressure decreased from ( 88.9 ±15.1 ) mm Hg to (74.8 ± 13.2) mm Hg on the second day after operation ( P ＜ 0.01 ).Accordingly,the kinds of anti-hypertension drug used decreased from ( 3.1 ± 0.9 ) to ( 2.3 ± 1.2) ( P ＜ 0.01 ).Only one patient died suddenly 3 months after intervention,and one died of acute myocardial infarction 7 months after operation.The other 38 patients were followed up for 12 months.At last,the mean systolic blood pressure of patients decreased from ( 165.0 ±27.0) mm Hg to ( 133.53 ± 15.94) mm Hg and the mean diastolic blood pressure decreased from (88.9 ± 15.1 ) mm Hg to (77.37 ± 13.47 )mm Hg. Of all 38 patients,2 were cured (5.3％),27 were improved (71.1％) and 9 failed to treatment (23.7％).Of all 38 patients,76.4％ got hypertension lowered.Moreover,renal function (Scr) was improved in 2 patients (6.3％ ),steady in 21 patients ( 65.6％ ),declined in 9 patients ( 28.1％ ) resulted in azotemia stage.Of 38 patients,71.9％ patients got overall benefit from endovascular intervention in respect of renal function improved.Conclusions The procedure of PTBA or PTRAS offered a minimally invasive,relatively safe and effective technique for BRASS patients to decrease blood pressure and stabilize renal function.