Objective To explore the role of transforming growth factor (TFG) -β and matrix metalloproteinases( MMPs) in the development of frozen shoulder. Methods Twenty-four patients who underwent shoulder arthroscopy were included, and were divided into frozen shoulder group (n = 12) and control group ( n = 12; n = 2 for shoulder instability, n = 5 for rotator cuff tear and n = 5 for subacromial impingement) . Joint capsule tissues at the rotator cuff interval were obtained, and the expression of TGF-β, MMP-1, MMP-2, MMP-3, MMP-9 and MMP-12 mRNA and protein was detected by Real-time PCR and Western blotting, respectively. Results The expression of TGF-p mRNA in frozen shoulder group and control group was 3.36 × 10~4 ±2.18 × 10~3 and 1.85 × 10~4 ±3.31×10~3, respectively, the expression of TGF-p protein was 1.55 ± 0.33 and 1.13 ±0.21, respectively, and there were significant differences between these two groups (P < 0.05). The expression of MMP1, MMP2, MMP3, MMP9 and MMP12 mRNA and protein in frozen shoulder group was significantly higher than that in control group(P <0.05) . Conclusion The higher expression of TGF-β and MMPs in joint capsule of frozen shoulder may be associated with the development of frozen shoulder.

Objective:To develop a UPLC method for determining four glycosides in microctis folium.Methods:The UPLC deter-mination was performed on an Agilent SB -C18 (3.0 mm ×50 mm, 1.8 μm) colume with 0.05% acetonitrile -phosphate solution as the mobile phase.The detection wavelength was set at 320 nm.The flow rate was 0.3 ml· min-1.The column temperature was 25℃.Results:Narcissoside, isovitexin, kaempferol-3-rutinoside and isorhamnetin-3-O-glucoside all showed good linearity with the re-covery of 98.89%,99.03%, 97.00%and 97.41%, and RSD of 0.41%, 0.84%,0.44%and 0.80%, respectively (n=9).Con-clusion:The method is convenient with good stability , repeatability and sample recovery rate , which provides basis for the quality eval-uation and control of microctis folium.

Objective To analyze the clinical characteristics and treatment Methods of severe com?plications after percutaneous tracheotomy( PDT) in neurosurgery patients,and to provide reference for the treat?ment and rescue of these patients. Methods A retrospective analysis of 578 cases after PDT was performed in Neurosurgery Intensive Care Unit ( NSICU ) of Xuanwu Hospital of Capital Medical University from 2005 to 2015. The types of complications,treatment method and prognosis were analyzed. Follow?up was 3 months to 1 year. Results Eighteen cases with severe complications,including bleeding,wound infection,asphyxia caused by tracheal mucosa suffocation,airway stenosis caused by granulation tissue,subcutaneous emphysema and neu?momediastinum,etc. After treatment and active rescue,most patients recovered,no patients die directly associated with surgery. Conclusion PDT plays an important role in the treatment of patients in NSICU,but it is still pos?sible to have serious complications,so physicians must understand and be prepared for complications,and pay more attention to prevent poor prognosis.

Object To establish an isolation method of theanine reference substance by preparative HPLC. Methods After raw material extracted by water, the water phase was extracted by chloroform saturated with water, then concentrated on a thermostat. After centrifuged, supernatant was isolated and purified by preparative HPLC. Fraction was frozen and dried by Flexi Drier. Crude product was rinsed by methanol. The purity of product was determined by analytical HPLC. Results The purity of product is higher than 98% and theanine yield from raw material by this method exceeds 60%. Conclusion The developed method is simple, rapid, and at low production cost. The product owns the quality of reference substance.

Objective: To study changes of ultrastructure of atrial endothelial cells during acute atrial fibrillation (AF) in canines, and explore the possible mechanism of AF left atrial thrombosis. Methods: A total of 16 healthy adult mongrel canines were randomly and equally divided into blank control group (only received thoracotomy without pacing) and rapid atrial pacing (RAP) group (established acute AF model). Myocardial tissue of left and right appendage were taken from two groups and received hematoxylin eosin (HE) staining, then myocardial cell morphological changes was observed under ordinary light microscope; morphological changes of appendage endothelial cells was observed under electron microscope. Results: (1) Paroxysmal AF was successfully induced in all canines of RAP group; (2) There were no significant difference in morphology of appendage and endocardial tissue under ordinary light microscope between two groups; 3. Under transmission electron microscope, endothelium cell of appendage tissue presented defect of different extent, and some shedding in RAP group; while endothelial cell layer was complete with absence of necrosis and shedding in blank control group. Compared with blank control group, there was significant rise in endothelial cell incompleteness (12.5% vs. 75.0%) in RAP group, P=0.041. Conclusion: When acute atrial fibrillation occurs, endothelial cell ultrastructure has already changed, which may be related to thrombosis adhered to wall during atrial fibrillation.

Objective Bone marrow mesenchymal stem cells (BMSCs) were induced to differentiate to the special histological types of neurons in vitro.The morphological change of cells and positive expression of specific antigen on membrane were studied,and the function of connection between the induced BMSCs was also detected.The feasibility of BMSCs differentiate to the special histological types of neurons was investigated.Methods BMSCs were divided into group Ⅰ (induced with bFGF+GDNF),group Ⅱ (induced with bFGF+GDNF+WHI-P131 +Shh),and control group (no revulsive).The morphologic change of cells was observed,and the positive rate of neuron specific surface antigen and the content of dopamine were detected.Formation of mature synaptic structure was detected by immunohistochemical assay of postsynaptic density protein 95 (PSD-95) expression,and synaptic loop was shown by FM1-43 stain synaptic vesicles.Results By immunohistochemical staining,the positive rates of dopamine transporter (DAT) and tyrosine hydroxylase (TH) in group Ⅱ were significantly higher than those in group Ⅰ,and dopamine can been detected in cell culture supematant of group Ⅱ.After BMSCs was induced into dopamine neuron-like cells,number and length of cell protrusions,positive rate of PSD-95 and fluorescence intensity of FM1-43 in group Ⅱ were significantly higher than those of group Ⅰ.Conclusions There were no significant change in positive rate of neuron-specific surface markers,rate of cell survival and differentiation rate after BMSCs differentiated to dopaminergic neuron-like cells.The number and length of cell protrusions,content of dopamine in cell culture supematant,positive rate of dopaminergic neuron-specific surface antigen (DAT and TH),synaptic function index (positive rate of PSD-95 and fluorescence intensity of synaptic loop) of group Ⅱ were all significantly higher than that of group Ⅰ.

Objective To evaluate the efficacy of decompression craniotomy for the treatment of patients with malignant cerebral venous thrombosis. Methods The clinical characteristics,treatment process and follow - up results of 9 patients with malignant cerebral venous thrombosis treated with decom-pression craniotomy in Beijing Xuanwu Hospital,Capital Medical University from February 2010 to August 2015 were analyzed retrospectively. Results The preoperative Glasgow coma scale (GCS)score of 9 patients was < 9,7 survived and 2 died. The conditions of 6 patients (preoperative GCS 8 in 1 case, GCS 6 in 3cases,GCS 4 in 1case,and GCS3 in 1case)were improved in combination with other control intrac ranial pressure treatment after craniotomy decompression surgery. They recovered well (Glasgow outcome scale, GOS 4 -5). One patient (preoperative GCS 4)had severe disability (GOS 3)after procedure;1 (preoperative GCS 3)was in deep comatose state at the time of discharge and died of complications after 1 month;1 patient with bilateral mydriasis (GCS 5)was treated with craniotomy decompression,and his pupils did not return,he had circulatory failure,gave up the treatment,and died. All patients did not have the complications directly related to the surgery. Seven patients survived and continued to use warfarin anticoagulation therapy for at least 6 moths after discharge. The controlled international normalized ratio (INR)was 2 -3. They were followed up for 3 months to 5 years. The head MRI re-examination did not reveal the recurrence of venous sinus thrombosis. The modified Rankin scales (mRS)score was 0 to 2 in 6 cases after 3 months. The other one (preoperative GCS 4)had ipsilateral cerebral hemorrhage on surgical site at 4 months after discharge. He was improved after withdrawing anticoagulation and using conservative treatment for 20 d (mRS score 4). Conclusions For patients with malignant cerebral venous thrombosis,when the patients have acute cerebral hernia or hernia tendency,the emergency craniotomy decompression surgery may save lives and enable patients to achieve a better quality of life.

Objective:To explore the effect of hydrotherapy combined with breathing training on lung function and mobility of patients with thoracolumbar spinal cord injury.Methods:A total of 80 patients with thoracolumbar spinal cord injury admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from April 2018 to March 2020 were selected as observation objects.A prospective cohort study was conducted and randomly divided into observation group and control group with 40 cases in each group.The control group was given routine rehabilitation therapy combined with respiratory training.On the basis of the control group, the observation group was treated with water therapy.The indexes of lung function, motor function, lower limb muscle tension, function evaluation and activities of daily living were compared between the two groups.Results:After intervention, the observation group′s forced vital capacity (FVC) was (3.86±0.82) L, the forced expiratory volume in the first second (FEV1) was (3.76±0.68) L, the maximum ventilation (MVV) was (102.34±10.38) L/min, the maximum suction pressure (MIP) is (50.36±4.62) cmH 2O; the control group FVC was (3.41±0.76) L, and FEV1 was ( 3.35±0.63) L, MVV was (90.67±11.68) L/min, MIP was (44.38±4.85) cmH 2O, the difference between the two groups is statistically significant ( t=2.546, 2.797, 4.723, 5.646, respectively, all P<0.05). After the intervention, the motor function score of the american spinal injury association (ASIA) of the observation group was (58.62±7.56) points, and the modified ashworth scale (MAS) score was (2.74±0.89) points; The ASIA motor function score of the control group was (42.24±6.40) points, and the MAS score was (3.36±0.94) points.The difference between the two groups was statistically significant ( t=10.459 and -3.029, respectively, all P<0.05). After intervention, the observation group′s spinal cord independence measure (SCIM III) score was (75.33±10.72) points, and the modified barthel index (MBI) was (66.64±6.34) points; the SCIM III score of the control group was (68.34±9.55) points, and the MBI score was (57.52±6.77) points, the difference between the two groups was statistically significant ( t=3.079 and 6.219, respectively, all P<0.05). Conclusion:Hydrotherapy combined with breathing training can significantly improve lung function and respiratory muscle strength in patients with thoracolumbar spinal cord injury, and improve motor function and ability of daily living.

Objective To assess the correlation between tenosynovitis or rupture of the flexor hallucis longus (FHL) and pes planus in patients with rheumatoid arthritis (RA).Methods The data of 47 RA patients (97 feet) with painful feet was retrospectively analyzed which was collected From February 2008 to June 2011.In accordance with the results of the FHL changes got by ultrasonography,the patients were divided into 3 groups.Group A consisted of those with normal FHL (27 feet).Group B consisted of those with FHL tenosynovitis (40 feet),and Group C eonsisted of those with FHL rupture (27 feet).Load bearing lateral radiographs were taken for all the patients.The correlation study was carried out based on the pes planus-related parameters,such as the measurement of heel pitch angle (HPA) and tarsal and 1st metatarsal angle (TM1).Factors like patients' age and course of disease were also taken into the consideration during the study.Results The mean age of those in group A was 49.9±9.2 years vs.56.2±9.2 years in group B and 54.7±8.0 years in group C.The mean duration was 4.7±2.6 years in Group A vs.16.2±7.4 years in Group B 5°±3.6° in Group C.The mean TM1 was 2.5°±2.2° in Group A vs.6.5°±3.2° in Group B and 11.2°±4.9° in Group C.Significant statistics difference were found among the three groups in these parameters.HPA＜ 20° was found among 6/27 feet in group A,31/40 in group B and 27/27 in group C.TM1 ＞4° was found among 5/27 feet in group A,30/40 in group B and 27/27 in group C.Conclusion FHL changes were common in RA patients and its severitv had positive correlation to pes planus.These changes were affected by age and duration,and could be evaluated effectively by ultrasound.

OBJECTIVETo observe and analyze the pathohistological characteristics of capsules which formed around the mammary prosthesis with different contents. And to provide the selective basis for ideal and safe prosthesis in clinical practice.

METHODS20 specimen of the capsules were taken from 20 cases who receive the operation of prothesis removal for different reasons. HE, Masson and Mallory staining were used to analyse the tissue structure and characteristics under the light microscope.

RESULTSThe common structure including the collagen fibers accumulation, inflammatory cells infiltration and the capillary hyperplasia were found in all specimen. A layer of squamous epithelium-like cell was detected in some specimen. The specific characteristics were also found in different capsules formed around different prosthesis. In the capsules around vegetable oil prosthesis, there was excessive collagen fiber accumulation, and the capsules were much thicker. In the PVP (polyvinylpyrolidone) prosthesis capsules, there was severe inflammatory cell infiltration, and the number of eosinophilic granulocyte increased obviously. In the silicone gel and saline prosthesis capsule, the collagen fibers were well-arranged and the inflammatory cells were much less. Synovial metaplasia was detected in two cases.

CONCLUSION1. The capsules form around the prosthesis in all cases after mammary augmentation. 2. There will be synovial metaplasis in some cases, for vegetable oil prosthesis, the collagen over-accumulated which lead the capsules become thicker and harder. So it is not a kind of ideal mammary prothesis. 4. The severe infiltration of the inflammatory cells especially the large quantity of eosinophilic granulocyte indicate the possibility of the delayed hypersensitive reaction mediated by eosinophilic granulocyte. Cautious attitude should be taken during application.