Objective To study the clinical features ,the high risk features ,the treatments and the outcomes of chronic obstruc-tive pulmonary disease(COPD) patients combined with invasive pulmonary aspergillosis(IPA) .Methods The clinical dates of 48 COPD patients combined with IPA were retrospectively analyzed .Results The clinical manifestations of 48 COPD patients com-bined with IPA were dyspnea ,lung rales ,chest pain ,cough ,cough phlegm ,fever .Radiological findings were presented as pulmonary inflammatory exudation ,consolidation ,cavity of lungs .The treatments were effective in 16 cases ,ineffective in 32 cases .Conclusion Early diagnosis and treatment is important in COPD patients combined with IPA .

Objective To study the influence of cholangiocarcinoma cells on endothelial cells in a co-culture system. Methods A co-culture system of eholangioeareinoma cell line QBC939> and endothelial cells was established in vitro (co-culture group). Endothelial cells were cultured individually during the same time (control group). The mixed supematant of cholangiecareinoma cells and endothelial cells was in the mixed group. Light microscopy and transmission electron micrescopy were used to observe the morphology of the endothelial cells. Changes in expression of ppI25FAK, MMP-2, MMP-9 and uPA of the endothelial cells were detected by mmunofluorescence, and the activities of MMP-2 and MMP-9 were detected by gelatin zymography. All the data were analyzed by paired t test. Results The intercellular space between endothelial cells in co-cuhure group was wider than in the control group. The expression of pp125FAK, MMP-2, MMP-9 and uPA was 394 ±51,455±82, 377±48,422±55 in control group, and was 1096±128,931±72,815±76,801±56 in the eo-euhure group. The difference between the 2 groups had statistical significance (t = 6.53,4.32, 3.61,3.45, P < 0. 05). The values of gray-scale scanning of MMP-2 and MMP-9 in the mixed group were 240.2±15.2 and 2.4±0.8, respectively. The values of gray-scale scanning of MMP-2 and MMP-9 in the co-culture group were significantly increased, they were 687.4 ± 43.6 and 150.9 ± 13.2, respectively (t = 4.89, 5.43, P < 0.05). Conclusions The intercellular space between endothelial ceils and the expression of the proteolytie enzymes are increased after co-culturing endothelial cells with eholangiocarcinoma cells. Proteolytie enzymes may be involved in the process of degradation of subendothelial matrix, and promotes the metastasis of cholangiocarcinoma.

Objective To evaluate the efficacy of ultrasound-guided laryngeal mask airway (LMA) in children.Methods ASA Ⅰ and Ⅱ children (aged 1 to 6 years) scheduled for orthopedic surgery of limbs were recruited in this study.ALMA was inserted after induction of general anesthesia.After mechanical ventilation for 5 minutes,the air-filled cuff was deflated and then inflated with saline.Ultrasonography was then performed by a high frequency linear-array transducer to confirm the correct placement of the LMA.Results The LMA can be easily recognized on the transverse view of the thyroid cartilage notch,appearing as a circle around the glottis,which was called the dumbbell sign.On the sagittal view of the thyroid cartilage,the LMA has an archlike appearance which ended below the thyroid cartilage.Oblique scan over the cricoid cartilage shows the tip of LMA is located at the upper portion of the esophagus.Conclusions Filling the LMA cuff with saline instead of air allows better LMA visualization by ultrasound.This method enhances correct positioning of the LMA,which is crucial to ensure safe ventilation.

BACKGROUND:Pain after arthroscopic treatment can not only affect the patient’s life quality, and is not
conducive to the early reasonable exercise and functional recovery of the patients after treatment. Up to 2012, there are 18 randomized placebo-control ed trials on intra-articular injection of bupivacaine for analgesia after arthroscopic surgery, but the results are different.
OBJECTIVE:To examine the efficacy and safety of intra-articular injection of bupivacaine in the management of pain after arthroscopic surgery through randomized placebo-control ed trials.
METHODS:The MEDLINE database, Cochrane Central Register and Google Scholar database were retrieved for the randomized control ed trials on intra-articular injection of bupivacaine in the management of pain after
arthroscopic surgery up to April 2012. The key words were“bupivacaine, intra-articular, arthroscopic, postoperative pain, placebo”.
RESULTS AND CONCLUSION:Eighteen studies (n=934) were included (461 cases in bupivacaine group and 473
cases in the placebo control group). The Meta-analysis results showed the visual analog scale score of the bupivacaine group was lower than that of the placebo control group (weighted mean difference:-1.39, 95%confidence interval:-2.17 to-0.61, P<0.000 01), and the number of patients required supplementary analgesia was less than the placebo control group (relative risk:0.84, 95%confidence interval:0.62 to 1.66, P=0.010). The time from first supplementary analgesia to postoperative intra-articular injection in the bupivacaine group was longer that in the placebo control group (weighted
mean difference:157.72, 95%confidence interval:16.43 to 299.01, P<0.000 01). There was no significant difference in the incidence of side effect between two groups (relative risk:0.64, 95%confidence interval:0.29 to 1.44, P=0.48). On the basis of the currently available literature, the intra-articular of bupivacaine after arthroscopic surgery can significantly relieve pain without increasing the adverse reactions when compared with the placebo control group.

BACKGROUND:Progressive fracture of the cartilage is considered the characteristic lesion in later osteoarthritis, the expression of osteoarthritis-related factors such as hyaluronic acid, osteopontin and CD44 in osteoarthritic cartilage is increased.
OBJECTIVE:To investigate the effect of hyaluronic acid on the expression of osteopontin mRNA and CD44 mRNA of chondrocytes in the in vitro cultured chondrocytes of patients with knee osteoarthritis.
METHODThe cartilage samples obtained from osteoarthritic patients were cultured and purified into acquire chondrocytes in vitro, and the cells were divided into three groupblank control group, hyaluronic acid (100 mg/mL) group and hyaluronidase (200 mg/mL) group. After 48 hours of cellculture, real-time quantitative polymerase chain reaction assay was used to detect the expression of CD44 mRNA and osteopontin mRNA. The difference of the expression levels before and after the intervention of hyaluronic acid was compared and analyzed using SPSS 17.0 software.
RESULTS AND CONCLUSION:Compared with the blank control group, hyaluronic acid (100 mg/mL) upregulated osteopontin mRNA expression in the chondrocytes, hyaluronidase (200 mg/mL) also reduced osteopontin mRNA expression in the chondrocytes. The CD44 mRNA expression in the chondrocytes of hyaluronic acid (100 mg/mL) group and hyaluronidase (200 mg/mL) group was lower than that in the blank control group. Hyaluronic acid can upregulate the expression of the osteopontin mRNA expression in the osteoarthritic chondrocytes;the biphasic effects of hyaluronic acid on CD44 mRNA expression in osteoarthritic chondrocytes might be associated with the molecule weight of hyaluronic acid.

Objective To study the resistance and molecular profiles of Staphylococcus aureus strains isolated from the clinical specimens.Methods Antimicrobial susceptibility was tested with 56 strains of Staphylococcus aureus isolated from a hospital from May to November 2011.The mecA and pvl genes were detected.The spa genetic types were analyzed.Results A total of 21 (37.5%)Staphylococcus aureus strains were resistant to methicillin (MRSA)and 35 (62.5%)were sensitive to methicillin (MSSA).Nineteen of the 21 (90.5%)MRSA strains carried mecA gene.Compared with MSSA,MRSA were much less sen-sitive to rifampin,fluoroqunolones,tetracycline and gentamicin (P <0.05).All the MRSA isolates were susceptible to vanco-mycin,linezolid,tigecycline,quinupristin-dalfopristin and nitrofurantoin.Six spa types were identified among the MRSA strains.Type t030 was the most prevalent,accounting for 66.7% (14/21)of all the MRSA strains.MRSA-t030 and MRSA-t002 were resistant to multiple antibiotics.Eighteen spa types were identified among the MSSA strains.Type t189,t377 and t034 were the top three spa types of MSSA,accounting for 14.3%,14.3% and 11.4%,respectively.A new MSSA spa typ-ing strain new1 was isolated from pus.There were five Panton-Valentine leukocidin (PVL)-positive isolates,3 of which was MSSA-t189 type. Conclusions Type t030 is the most prevalent spa type among clinical MRSA strains,which is resistant to many kinds of antibiotics and widely spreads in the hospital setting.There are many different spa types a-mong the MSSA strains.Type t389,t377 and t034 are the top three spa types of MSSA.

OBJECTIVETo study the mechanism of Fuzheng Huayu (FZHY) recipe against pulmonary fibrosis relating to MMP-2 activity and type IV collagen expression at lung tissue.

METHODThe pulmonary fibrosis model was induced by intratracheal instillation with bleomycin once in rats. The models were divided into 3 groups: model control, FZHY recipe treated, and methylprednisolone (Solu-Medrol) treated group, each group was of 14 model rats. Normal control group with 10 rats was intoxicated with the same amount of saline. From the second day of intoxication, FZHY recipe treated group orally took FZHY recipe at the dosage of 4.6 g x kg(-1) rat wt, methylprednisolone treated group received intraperitoneal injection with 15 mg x kg(-1) rat wt of methylprednisolone, while model and normal controls took the same volume of saline, 1 time each day and lasting for 4 weeks. Lung and body weights were weighed and the lung/body ratio was calculated. Collagens deposition was check with Masson stain, and lung hydroxyproline (Hyp) content was assayed with Jamall's method. Protein expressions of MMP-2/9 and type IV collagen at lung tissue were analyzed with Western blot and of MMP-2/9 activities by gelatin zymography.

RESULTCompared to normal rats, the model control rats had a high lung/body ratio, remarkable collagen deposition, increased Hyp content and the expressions of type IV collagen, MMP-2 and MMP-9 protein at lung tissue, increased MMP-2 activity, in particular active MMP-2 activity, but decreased MMP-9 activity. Compared to model control, FZHY recipe and methylprednisolone obviously attenuated pulmonary collagen deposition, decreased lung/body ratio and Hyp content, downregulated MMP-2 protein expression and activity, in particular active MMP-2 activity, and FZHU recipe had some better actions than methylprednisolone on lung/body ratio, type IV collagen expression and active MMP-2 activity. But both drug groups had no influence on MMP-9 protein expression and activity.

CONCLUSIONFZHY recipe has a good action against experimental pulmonary fibrosis and its mechanisms are associated with the inhibition of MMP-2 protein and activity, and with the inhibition of over expression of type IV collagen at lung tissue.

Animals ; Bleomycin ; Collagen Type IV ; metabolism ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Hydroxyproline ; metabolism ; Lung ; drug effects ; metabolism ; pathology ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Plants, Medicinal ; chemistry ; Pulmonary Fibrosis ; chemically induced ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo probe the safe depth and angle of needling the point Yaotu for treatment of prolapse of intervertebral disc.

METHODSCT technique was used for scanning investigation of the depth and angle of needling the point Yaotu.

RESULTSWhen the acupuncture needle was inserted vertically to the external space of intervertebral foramen of human body with arrival of qi, the tip of needle could reach to 73 mm deep, which is the best needling depth and angle.

CONCLUSIONThe needle vertically inserting to the external space of intervertebral foramen at the point Yaotu is proper in treatment of prolapse of intervertebral disc.

Acupuncture Analgesia ; Acupuncture Points ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Medicine, Chinese Traditional ; Tomography, X-Ray Computed

Objective: evaluate the efficacy of a single medial locking plate and lag screws based on computer-assisted pre-operation plan (CAPP) for the treatment of pilon fractures. Methods: Between 2013 and 2016, data of 27 patients with pilon fractures who were treated using a single medial locking and lag screws based on CAPP were retrospectively analyzed. All the cas-es were AO/OTA 43-C type pilon fractures. According to the Rüedi-Allgöwer classification, there were 5 cases of type Ⅱ and 22 cases of type Ⅲ. Among 27 patients, 19 patients had fibula fracture. CAPP was performed for all fractures, including simulated re-duction, virtual surgery, and implantation of internal fixation. The time of CAPP, intraoperative realization of preoperative plan, op-eration time, intraoperative blood loss, and pre- and post-operative range of motion of ankle were recorded. Functional outcomes at final follow up were assessed using American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot scale, visual analogue scale (VAS). Results: The mean time of CAPP was 25.8 minutes (range, 14-30 minutes). The average operating time was 138.5 minutes. The average intraoperative blood loss was 225.9 ml. All the twenty-seven patients were followed up for an average period of 18.6 months. The average AOFAS score, VAS score at the final follow-up was 82.9, 2.7 points respectively, which was signifi-cantly improved compared with those before operation (t=-19.358, 7.720; all P< 0.001). Conclusion CAPP system is convenient and efficient, which can facilitate the treatment of type C pilon fractures with a single medial locking plate and lag screws. In addi-tion, satisfactory clinical outcomes can be obtained.

OBJECTIVETo establish an in vitro model applicable for fatty liver lipotoxicity pharmacological research.

METHODSHepG2 cells were cultured with rat serum instead of fetal bovine serum and with long-chain free fatty acid (FFA) added. The tested indices were: the content of serum TNFa, cellular triglycerides (TG) content, Oil Red staining and ultrastructural changes; protein expression and gene expression of cellular TNFa, and the expression and distribution of cathepsin B (Ctsb).

RESULTSAfter incubation with FFA for 24 hours, the TG deposition of HepG2 in the model group increased markedly and TG content was 627.24 mg/g protein (t = 23.6, P less than 0.01), TNFa content in the cell supernatant also increased to 52.04 pg/mg protein (t = 2.6, P less than 0.05). Compared with those of the normal group, the protein expression and mRNA expression of cellular TNFa and Ctsb also increased significantly.

CONCLUSIONFFA could induce a model of HepG2 steatosis with TNFa secretion through the Ctsb signal pathway using rat serum in the culture media. The method is simple and economical, which is an ideal model applicable for fatty liver lipotoxicity pharmacological research.

Animals ; Disease Models, Animal ; Fatty Acids ; toxicity ; Hep G2 Cells ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Triglycerides ; blood ; Tumor Necrosis Factor-alpha ; analysis