Objective To investigate the relationship between disease activity and osteocalcin,β-isomerized C-terminal telopeptides (β-CTX) in SAPHO syndrome.Methods We studied 58 cases who were diagnosed as SAPHO syndrome.The following indices used to assess the activity of SAPHO were measured:Bath ankylosing spondylitis Disease activity index (BASDAI),Bath ankylosing spondylitis functional index(BASFI),visual analogue scale (VAS) pain and erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),osteocalcin and β-CTX.The SAPHO patients were divided from two groups according to the disease activity.The relationships were analyzed with t-test and Pearson's test.Results The β-CTX of the active group(0.43±0.20) ng/ml was elevated than the stable group (0.23 ±0.09) ng/mL (t=-4.620,P=0.007).And there was no significant difference in the osteocalcin between the active group (2.7±1.0) μg/L and the stable group(2.4±1.0) μg/L (t=-1.169,P=0.820).There was no significant correlation between the serum osteocalcin and ESR or hypersensitive CRP (hs-CRP) (rESR=0.228,PESR=0.088;rhsCRP=-0.085,PhsCRP=0.528).And β-CTX level was related to the VAS (r=0.496,P＜0.01),BASDAI (r=0.401,P=0.002) and BASFI (r=0.295,P=0.025).While no significant relationship between the osteocalcin and pain index was observed in our study.Conclusion The positive correlation between serum β-CTX and disease activity indicates significant bone absorption during the bone destroy process in SAPHO syndrome.

OBJECTIVETo evaluate the short-term and long-term effects on treatment of neck pain caused by cervical spondylosis with the combination of acupuncture and moxibustion with seed-size moxa cone.

METHODSOne hundred and forty-five patients of neck pain were randomly divided into an acupuncture-moxibustion group (49 cases), an acupuncture group (48 cases) and a moxibustion group (48 cases). Acupoints of Bailao (Extra), Dazhui (GV 14), Jianzhongshu (SI15) and Zhongzhu (TE 3) were adopted for all the 3 groups. Acupuncture was applied at all the acupoints with 20 min needling retention for the acupuncture group. Moxibustion with seed-size moxa cone was used with 5 cones on each point for the moxibustion group. And both acupuncture and moxibustion with seed-size moxa cone were adopted for the acupuncture-moxibustion group. The treatment was applied once every 3 days, and 10 treatments should be finished within 4 weeks. Follow-up should be carried out for 3 months. The short-term and long-term effects were evaluated with the scores of Northwick Park Pain Questionnaire (NPQ) and McGill Pain Questionnaire (MPQ) as the indices of therapeutic effect.

RESULTSThe NPQ score and MPQ score of all the 3 groups after the treating course and the 3-month follow-up were both decreased when compared with those before the treatment (all P<0. 05). The scores of NPQ and MPQ the acupuncture-moxibustion group were lower than that of the other two groups. And the difference had obvious significance (P<0. 05). High efficiency of pain relieving for cervical spondylosis could be found in all the 3 groups, which showed that short-term and long-term effects were good for all the 3 groups. And the highest curative effect could be found in acupuncture-moxibustion group.

CONCLUSIONCombination of acupuncture and moxibustion with seed-size moxa cone has reached a superior effect in short-term and long-term for neck pain caused by cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Neck Pain ; etiology ; therapy ; Spondylosis ; complications ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the dynamic change of apoptosis and proliferation of cardiac muscle cells (CMC) after being induced by Angiotensin II (Ang I), and the effect of TCM herbs for supplementing qi and/ or activating blood circulation on it.

METHODSThe cultured CMC of SD suckling rat were treated by Ang II, and the amplitude, rhythm and frequency of cell pulsation, the protein content, area size and apoptosis of cells at various phases as well as the influence of TCM herbs afterwards were determined by image pattern analysis system, flow cytometry and biochemical assay.

RESULTSIn the model group, cell pulsation showed quickened frequency from the 24th to 48th hr after Ang II treatment with the highest amplitude at the 24th hr; the cell area enlarged at the 24th hr, the enlargement became evident at the 48hr. Cell content of protein increased at the 24th hr, which reached to its peak at the 48th hr; an increasing trend of cell number was shown from the 12th to 48th hr; cell apoptosis started to appear at the 24th hr, it increased gradually from the 48th to 72th hr, and reached to the peak at the 72th hr (P < 0.05 or P < 0.01). All the Chinese herbs, both for supplementing qi and/or activating blood circulation, especially when they were used in combination, showed favourable preventive and therapeutic effect on CMC (P < 0.05 or P < 0.01), either at the early phase (24-48th hrs) mainly manifesting hypertrophy and proliferation or the late phase (48-96th hrs) mainly manifesting apoptosis.

CONCLUSIONThere exist characterized phasic windows of CMC after being treated by Ang II, the window of hypertrophy-proliferation phase and the window of cell apoptosis phase. When CMC were mainly in hypertrophic manner, myocardial hypertrophy may appear. Cell apoptosis may be one of the mechanisms for turning myocardial hypertrophy to heart failure, and it could be improved by Chinese herbs for supplementing qi and/or activating blood circulation.

Angiotensin II ; antagonists & inhibitors ; pharmacology ; Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Myocytes, Cardiac ; cytology ; Qi ; Rats ; Rats, Sprague-Dawley ; Time Factors

Objective To evaluate the pulmonary imaging features in patients with severe or critical severe A H1N1 influenza. Methods Clinical and imaging findings of 18 cases with H1N1 pneumonia were retrospectively analyzed. These patients were divided into 2 groups including severe group (n=11) and critical group (n=7). Results Among the severe group, bilateral ill-defined nodules and patch shadows were found in 8 cases, local ill-defined patchy was shown in 3 cases, and consolidation of right inferior lung was demonstrated by CT scan in 1 case. Among the critical group, diffuse ground-glass attenuation with partial consolidation were found in bilateral lungs of 4 cases, subcutaneous emphysema was observed in 1 case. CT showed diffuse ground-glass attenuation and nodular like consolidation in bilateral inferior lungs in 1 case, and other 3 cases showed diffuse consolidation of bilateral lungs. Conclusions The radiologic findings of severe and critical severe pulmonary infections with H1N1 include ill-defined nodules and patch shadows of bilateral lung in sever patients, diffuse peribronchial ground-glass opacity and multifocal consolidation in critical severe patients. The radiologists should learn the features of H1N1 pneumonia on thoracic plain film and CT to make diagnosis in time.

Objective To investigate CT findings of hepatic necrosis and regeneration after liver failure.Methods Five patients with liver failure underwent CT scan before orthotopic liver transplantation.These findings were retrospectively reviewed and correlated with gross specimen and pathologic findings obtained after transplantation.Results Among 5 cases,the CT appearances of liver failure can be divided into 3 types.(1)Massive confluent aggregate foci in 2 patients demonstrated low attenuation and high attenuation as geographical patlerns on CT scans before contrast enhancement.respectively.The histopathological liver changes showed massive necrosis and regencratinn. Regions of necrosis enhanced to attenuation greater than that of normal liver parenchyma in portal-venous phase,the regions of regeneration enhanced to attenuation greater than that of normal liver parenchyma in arterial phase on postcontrast CT images.(2)In 2 patients,diffuse nodules of liver demonstrated high attenuation on plain CT scans,which was nodular necrosis and nodular regeneration pathologically.All enhanced to attenuation greater than that of normal liver parenchyma in arterial phase.The former showed hypointensity in portal-venous phase and equilibrium phase.The latter enhanced to attenuation equal to that of normal liver parenchyma in portalvenous phase and equilibrium phase on postcontrast CT images.(3)Multiple small foci in 1 case demonstrated low attenuatiun on precontrast CT images and enhanced to hyperintensity in portal-venous phase and isointensity in arterial phase and equilibrium phase on postcontrast CT images.The histopathological liver changes showed multiple necrosis.Conclusion Liver failure may reveal characteristic imaging patterns at CT.

Objective To investigate whether the proportions of Th17/Treg balance were impaired in the peripheral blood of patients in different phases of synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome.Methods We studied 22 cases diagnosed as SAPHO syndrome and 11 healthy controls.According to the scores of VAS pain,BASDAI and BASFA,the 22 patients were divided into active group and stable group.By means of flow-cytometry,the frequencies of total and different subsets of Th17 and Treg cells in peripheral blood mononuclear cell of different groups of SAPHO syndrome and healthy controls were studied.The values of Th17/Treg balance were analyzed.The relationship was analyzed with Kruskal-Wallis test,Mann-Whitney test and Pearman's test.Results The mean percentage of Th17 cells was markedly higher in the active group [(2.74±0.25)％] than in the stable group [(1.16±0.09)％] (U=0.000,P＜0.01) and healthy controls [(1.13±0.11)％] (U=0.000,P＜0.01).No differences were found among active group [(2.10±0.20)％],stable group [(2.51±0.20)％] and control group [(2.44±0.22)％] (x2=2.16,P=0.339 4).The ratio of Th17 cells to Treg cells was markedly higher in active group [(1.48±0.25)％] than in the other two groups [(0.47±0.03)％] (U=0.000,P＜0.01).We also found the positive correlation of the ratios of Th17/Treg cells with the values of VAS in SAPHO syndrome patients (r=0.752 7,P＜0.01).Conclusion The results demonstrate that the development of SAPHO syndrome is closely related to the imbalance of systemic Th17/Treg cells,Increased ratio of Th17/Treg cells may be the main factor that cause disease recurrence,and then,lead to the manifestations of high levels of inflammation and joint pain.

ObjectiveTo discuss the application value of high frequency ultrasound (HFUS) characteristics, acoustic radiation force impulse (ARFI) imaging technology and contrast-enhanced ultrasound (CEUS) in the diagnosis of soft tissue hemangioma.MethodsTo retrospectively analyze the clinical data of 44 cases of soft tissue hemangioma that were treated in Capital Medical University Affiliate Beijing Chaoyang Hospital from August, 2013 to May, 2014, and to analyze the difference between the characteristics of HFUS, ARFI and CEUS in soft tissue hemangioma and normal surrounding tissue.ResultsHFUS shows the features of morphological diversity of sinus shape expansion tube structure, unclear boundary, irregular configuration, compressibility and partial strong echo in the phlebolith. Color Doppler ultrasound (CDFI), detects abundant interphase red-blue bloodstream signal slowly and consistently. The blood signal is strengthened after partial compression. CDFI shows more vein spectrum in the lesion. The discrepancy of comparison between VTQ and SWV value of soft tissue hemangioma and surrounding muscular tissue possesses statistical significance [(1.082±0.183) m/svs (1.414±0.331) m/s,P<0.01]. Ultrasound contrast can show the relationship between diseased region and surrounding tissue clearly, which is beneficial to the selection of operation method and prognosis.ConclusionThrough conventional two-dimensional ultrasound and high frequency CDFI, and further combining the acoustic pulse radiation ARFI technology and CEUS technology, the soft tissue hemangioma can’t only be more accurately diagnosed, but also provides more reliable diagnostic basis for clinic.

Objective To investigate the role of glargine in glucose metabolism improvement and antiinflammation of skeletal muscle in Caveolin-1 silenced type 2 diabetic mice.Methods Multiple low doses of streptozotocin (STZ) intraperitoneal injection and high-fat high-glucose (HFHG) were used to induce type 2 diabetic mice model.The mice were divided into normal control group (NC group) and type 2 diabetic model group (T group).Then according to virus injection and glargine treatment,T group were further divided into type 2 diabetes group (T2DM group),type 2 diabetes with insulin treatment group (insulin group),Caveolin-1 silenced with insulin treatment group (LV-CAV1 group),and scramble virus with insulin treatment group (LV-GFP group).Glucose metabolism was accessed by the fluctuation of blood glucose.TNF-α protein expression in skeletal muscle was detected by Western blot.Results The glycemic control of LV-CAV1 group needed more dosages of glargine (P ＜ 0.05).The expression of TNFαin skeletal muscle was elevated in LV-CAV 1 group than that in LV-GFP and insulin group (P ＜ 0.05).Conclusion The anti-inflammation function and glycemic metabolism improvement of glargine may be associated with the expression of Caveoin-1 in skeletal muscle.

Objective To establish a stable animal model of implanted main portal vein tumor thrombus (MPVTT) in rabbits and to evaluate its usefulness in research so as to provide the basis for clinical treatment. Methods Twenty-four New Zealand white rabbits were randomly divided into group A (control group,n=10) and group B (study group,n=14). For the rabbits of the study group, a sac-like pouch was sewed up in the anterior wall of the main portal vein, and then the tumor slice was injected into the portal vein through the pouch and it was hung and fixed on the inner wall of the main portal vein with the help of the reserved suture. For the rabbits of the control group, only a sac-like pouch was sewed up in the anterior wall of the main portal vein after opening the abdomen. After the treatment, the animals were kept under observation on the general condition, body weight and survival time. Postoperative multi-slice spiral CT scan was performed once a week to check the growth of portal vein tumor thrombus and the metastasis. The experimental rabbits were separately sacrificed for pathologic examination, the volume of MPVTT was determined and the metastasis was evaluated. The survival time of the remaining rabbits were analyzed. Results The tumor formation rate of the study group was 100%. The mean body weight of the rabbits of the study group (No.9-No.14 rabbits) and the control group at 35 days after the procedure was (1.48±0.19) kg and (2.08 ±0.17) kg respectively. The mean survival time of the study group (No.9-No.14 rabbits) was (41.7 ±4.72) days. Multi-slice spiral CT scan revealed MPVTT, metastasis and collateral circulation due to portal vein obstruction. Pathological examination confirmed the presence of thrombus in the portal vein and metastasis . Conclusion Stable MPVTT in animal models that can be used for imaging evaluation are successfully established. This study proves that multi-slice spiral CT scan is of great value in diagnosing and monitoring the growth of MPVTT and metastasis, which provides useful basis for clinical research and treatment of MPVTT.

Objective To investigate the correlation between dynamic contrast-enhanced CT and MRI image findings of intrahepatic mass-forming cholangiocarcinoma(IMCC) and pathologic differentiation.Methods The CT and (or) MRI features of ninety-five patients with IMCC proved by pathologic examination were retrospectively reviewed.Sixty-five patients underwent multiphasic dynamic contrast-enhanced CT scan, twenty-nine underwent multiphasic dynamic contrast-enhanced MRI scan and ten patients underwent multiphasic dynamic contrast-enhanced CT and MRI examination simultaneously.According to the case history and laboratory examination, patients were divided into groups: with chronic hepatitis and without chronic hepatitis and according to the maximum diameter of the tumor, they were divided into＜3 cm, 3 to 6 cm and＞6 cm groups.The imaging features of tumor enhancement were reviewed among groups.The pathologic results and imaging features were compared and patients were divided into well differentiated, moderately differentiated, and poorly differentiated groups.Analyzed by Chi-square test, the difference of tumor enhancement between groups were analyzed.Results The patterns of multiphasic dynamic contrast-enhanced CT and MRI in IMCC patients had five types: type 1:60 cases, peripheral rim and (or) separating enhancement during artery phase, followed by centripetal enhancement progressively and(or) separating enhancement in the equilibrium phase;type 2:11 cases, peripheral rim enhancement in the artery phase and hypointensity (hypoattenuating) during equilibrium phase with central nodular enhancement;type 3:15 cases, no enhancement in the arterial phase and internal heterogeneous enhancement during equilibrium phase;type 4: 6 cases, heterogeneous enhancement in the early phase and wash-out during equilibrium phase;type 5 : 3 cases, no enhancement throughout dynamic enhancement.The results showed that in hepatitis group type1 to 5 had 31, 7, 12, 5 and 1 cases and without hepatitis group had 29, 4, 3, 1 and 2 cases.There was no statistical significance between groups(x2=3.567,P=0.059).The maximum diameter＜3 cm group(28 cases) had 9, 8, 6, 3 and 2 case which showed enhancement type1 to 5;3 to 6 cm group(40 cases) had 27, 2, 7, 3 and 1 cases and＞6 cm group(27 cases) had 24, 1, 2, 0 and 0 cases.There was significant difference in groups(x2=19.582,P＜0.01).Pathological well differentiated and moderately differentiated groups(40 cases) had 24, 7,6, 2 and 1 cases presented enhancement type 1 to 5 and poorly differentiated group(55 cases) had 36, 4, 9, 3 and 3 cases.There was no statistical difference in three differentiated groups(x2=0.296,P=0.586).Conclusions CT and MRI enhancement patterns of IMCC are presented with diversity.The imaging features are associated with focus size and had no relationship with pathological differentiated degree.