Objective To explore the mechanism of therapeutic action of needle knife “regulating sinews and treating bones” on knee osteoarthritis (KOA) by observing the effect of needle knife intervention on KOA rabbit behaviors, mechanical characteristics of patellar ligament (PL), and expressions of interleukin-4 (IL-4), matrix metalloproteinase-3 (MMP-3) and aggrecan in knee cartilages.Methods Forty New Zealand rabbits were randomly allocated to blank, model, needle knife and electroacupuncture groups, 10 rabbits each. A rabbit model of KOA was made by the modified Videman method of immobilization in extension position. After model making, the needle knife and electroacupuncture groups received needle knife and electroacupuncture treatments, respectively. A behavioral assessment was made using the modified Lequesne MG knee grade evaluation method in every group after model making and treatment. The samples were taken after treatment. PL tension, stress relaxation and creep state were tested using a Bose Electro Force 3300 protracted test machine. Cartilage cell IL-4 expression was examined by ELISA. MMP-3 mRNA and aggrecan mRNA expressions were detected by real-time PCR.Results After model making, there was a statistically significant difference in the Lequesne MG score between the model and blank groups (P<0.01); there was no statistically significant difference in the Lequesne MG score between the needle knife or electroacupuncture group and the model group (P>0.05). There was a statistically significant post-treatment difference in the Lequesne MG score between the needle knife or electroacupuncture group and the model group (P<0.01,P<0.05) and between the needle knife and electroacupuncture groups (P<0.05). There were statistically significant post-treatment differences in PL maximum stress, maximum displacement, elastic modulus, stress relaxation rate and creep rate between the model and blank groups (P<0.01,P<0.05). There were statistically significant post-treatment post-treatment differences in PL maximum stress, maximum displacement, elastic modulus, stress relaxation rate and creep rate between the needle knife and model groups (P<0.01,P<0.05). There was a statistically significant post-treatment difference in elastic modulus between the electroacupuncture and model groups (P<0.01). The IL-4 content and aggrecan mRNA expression decreased significantly and MMP-3 mRNA expression increased significantly in the model group after model making and there were statistically significant differences compared with the blank group (P<0.01,P<0.05). After treatment, the IL-4 content increased significantly in the needle knife and electroacupuncture groups compared with the model group (P<0.01,P<0.05) and aggrecan mRNA expression tended to increase in the two groups. The regulation of aggrecan mRNA and MMP-3 mRNA expressions was better in the needle knife group than in the electroacupuncture groups, but there was no statistically significant difference compared with the model group (P>0.05).Conclusion The mechanism of action of needle knife treatment on KOA may be that it improves ligament mechanical characteristics, regulates intra-articular stress environment, and modulates aggrecan mRNA and MMP-3 mRNA expressions and inhibits cartilage degeneration through IL-4 mechanical signal pathway, to produce the therapeutic effect of “regulating sinews and treating bones”.

Objective To observe the incidence rate of anaemia and analyze the nutritional situation in the elderly population.Methods From April to August 2010,a total of 2052 elderly persons from out-department of Tianjin First Center Hospital were divided into four age groups:65-69years group (n=528),70-74 years group (n=593),75-79 years group (n=423) and 80 years and over group (n= 508).The body mass index (BMI),haemoglobin (Hb),mean corpuscular volume (MCV),triglyceride (TG),creatinine (Cr),serum albumin (ALB) and ferritin (Fer) were tested and evaluated using K-W test.Results (1) Anaemia was found in 90 subjects (4.4 %),4.0% in men and 6.l% in women,9.5% in 80 years and over group.The subjects with Hb level less than 90g/L were all 80 years and over.(2)There were significant differences among the groups in BMI,TG,Cr,ALB,Hb,MCV and Fer levels (all P＜0.01).There were significant differences among four groups in Hb and ALB levels (P＜0.01 ),and partially differences in TG, Cr and MCV levels (P＜0.05).(3)The Hb level was significantly correlated with TG, ALB, Fer and MCV levels (r=0.115,0.211, 0.114 and 0.089, all P＜0.01 ) from Pearson analysis.Conclusions Anemia incidence in elderly population is increased along with aging and is higher in women than in men, especially higher in 80 years and over group.Nutritional situation gets worse with aging.

Objective:To compare the clinical effects of restrictive blood transfusion combined with hyperbaric oxygen preconditioning (HBOPC) and restrictive blood transfusion in the treatment of hip,knee arthroplasty (THA,THA).Methods:40 patients in the period of epidural anesthesia,femoral nerve hysteresis hip and knee arthroplasty were selected and randomly divided into two groups:restrictive transfusion group (maintain 80 g/L≤ Hb ＜100 g/L,n=20) and restrictive blood transfusion combined with HBOPC (HBOPC+maintain 80 g/L =Hb ＜100 g/L,n=20).The red blood cell transfusion,red blood cell transfusion rate,perioperative Hb,blood oxygen saturation (SO2),the incidence of hypotension during operation,hospitalization time and postoperative cerebral infarction,acute pulmonary embolism,pneumonia,myocardial infarction,wound infection rate and 90 days mortality rate were compared between two groups.Results:Compared with the restrictive transfusion group,the postoperative Hb,blood oxygen saturation (SO2) of restrictive blood transfusion combined with HBOPC group were significantly increased(P ＜ 0.05);the red blood cell transfusion,red blood cell transfusion rate,incidence of pneumonia,wound infection rate were significantly decreased (P＜0.05).Conclusion:Restrictive blood transfusion combined with hyperbaric oxygen preconditioning could improve the anoxic state of the hip,knee arthroplasty patients,which could effectively reduce red blood cell transfusion,reduce postoperative complications,has good clinical curative effect.

Objective To analyze the relevance between the point-of-care testing (POCT) and routine test in BNP testing .Meth-ods The whole blood samples or plasma samples from 40 inpatients were detected brain natriuretic peptide (BNP) by the Alere Triage? MeterPro fluorescence immunoassay analyzer (POCT ) or the Beckman Coulter Access ?2 chemiluminescence analyzer (routine test) ,respectively .The acquired data were subjected to comparative analysis according to the CLCS EP 9-A2 .Results The linear regression of the BNP content in the blood samples detected by POCT and the routine test was good ,the correlation coeffi-cient(r) was 0 .999 7 .Conclusion POCT and the routine test have good correlation in BNP testing .POCT for BNP testing has higher reliability and is applicable for clinical detection .

Objective To compare the clinical efficacy and safety of transurethral plasmakinetic resection of prostate (PKRP) and transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH). Methods Two groups of BPH patients (78 patients in each group) were treated by PKRP and TURP,respectively. The clinical efficacy and safety indices were reviewed and compared for both intra- and inter-groups. Results In PKRP group,the operative time,intraoperative bleeding, the rates of postoperative temporary urinary incontinence (within 2 months) ,secondary hemorrhage (within 4 weeks),and urethral stricture (within 3 months) were ( 64?21) min, ( 247?84) ml, 26. 9% ( 21/78 ) , 1. 3% ( 1/78 ) and 2.6% (2/78) ,respectively; while in TURP group, these parameters were (78?18) min, (432?132) ml, 48.7% (38/78) , 10. 3% (8/78) and 12. 8% ( 10/78 ), respectively; there were significant differences between the 2 groups (P 0. 05). Conclusions PKRP and TURP have similar efficacy in the treatment of BPH,but PKRP is safer than TURP. Thus,PKRP is a better treatment option for BPH.

Objective To investigate feasibility and effect of external fixator plus steel plate in treatment of open tibiofibular fractures combined with tibial defect.Methods The study involved 21 patients with open fractures of tibia and fibula (15 patients with type Gastilo ⅢA,five with type Gastilo ⅢB and one with type Gastilo ⅢC) with concurrent tibial defect of 2-6 cm.External fixator plus fibular steel plate was performed at the first stage,followed by iliac bone grafting for bone defect at the second stage.Results All patients showed successful reconstruction of the tibial defects with length difference between affected and healthy extremities less than 2 cm in follow-up for (14.0 ± 10.5) months (range,8-24 months).Meanwhile,no talipes equinovarus existed.Conclusions External fixator plus steel plate is an effective method for treating open tibiofibular fractures combined with tibial defect.The length and function of the extremities of patients with open tibiofibular fractures combined with tibial defect of less than 6 cm can be successfully restored.

ObjectiveTo induce human peripheral blood mononuclear cells differentiate into hepatocyte-like cells by hepatocyte growth factor (HGF) and fibroblast growth factor-4 (FGF-4) in vitro and determine whether PKH26 could be used to serve as an effective tracer for the cells,and observe the ability of transplanted hepatocyte-like cells differentiate into hepatic cells in nude mice.MethodsGroup A and B were set up respectively.In Group A,mononuclear cells were cultivated without hepatocyte growth factor (HGF) and fibroblast growth factor-4 (FGF-4) in cell culture.They were used as negative control group.In Group B,mononuclear cells were cultured with the administration of both HGF and FGF-4 to induce the differentiation into liver hepatocyte-like cells.The changes in cell morphology were observed and the expressions of AFP and CK 19 were detected by immunocytochemical staining in two groups at different times after induction.The hepatocyte-like cells differentiated from human peripheral blood mononuclear cells labeled by the fluorescent dye PKH26 injected into caudal vein in nude mice is experimental group.The nude mice injected with equal amount of normal saline in control group.The migration of the labeled cells into the liver are observed by the fluorescence microscope in the hepatic tissue sections of nude mice and the expressions of ALB were detected by immunocytochemical staining two weeks after the cells transplantation.ResultsCells in group B have a strong proliferative activity.It becomes large and oval,grows in colonies following induction.Cells in group A that showed spherical shape when peripheral blood mononuclear cells were just isolated are gradually becoming inconformity in morphology,spindle or fibroid,and a few cells are round:cells developed apoptosis and cracked following incubation.The expressions of AFP and CK19 were positive after induction in group B as detected by immunocytochemicat staining.Inversely,the expressions of AFP and CK19 were negative in group A after incubation.The experimental group showed numerous PKH26 labeled cells in the hepatic tissue sections of nude mice.But the control group did not show PKH26 labeled cells.The expressions of ALB were positive in the experimental group as detected by immunocytochemical staining after two weeks of the cells transplantation.ConclusionHuman peripheral blood mononuclear cells have the potential to differentiate into hepatocyte-like cells under the induction of HGF and FGF-4.Additionally,PKH26 is an effective tracer in hepatocyte-like cell transplantation.The hepatocyte-like cells settled in hepatic tissue begin to differentiate into mature hepatocyte after two weeks of the cells transplantation.It plays hepatic cells function and expresses alhnmin.

Objective To improve the differential diagnosis between autoimmune pancreatitis (AIP) and pancreatic cancer (PC) by a contrast analysis of imageological features.Methods Thirty-six patients who had postoperative pathological with Asian AIP standards and 95 patients who had postoperative pathological consistent with PC.The imageological results of these AIP and PC patients were analyzed.Results AIP was significantly less than PC in the enhanced CT of a mass or enlargement of the pancreatic head,enlargement of the lymph nodes around the pancreas,dilation and interrupt in pancreatic and bile duct,peripheral vascular and organ involvement (11/27 vs.28/40,2/27 vs.17/40,13/27 vs.32/40,1/27 vs.10/40,8/27 vs.26/40,2/27 vs.15/40,0/27 vs.15/40,0/27 vs.10/40,P ＜ 0.05).AIP was significantly more than PC in the enhanced CT of a diffusely enlarged pancreas,calcification or pancreatic calculus,capsule-like rim or the vague peripancreatic fat interval (4/27 vs.0/40,7/27 vs.0/40,10/27 vs.6/40,P ＜ 0.05).AIP was significantly less than PC in the three-dimensional ultrasonography of dilation diameter of pancreatic duct and dilation of common bile duct [(0.421 ± 0.270) cm vs.(0.594 ± 0.270) cm,1/18 vs.16/26,P＜ 0.05].AIP was significantly less than PC in the magnetic resonance cholangiopancreatography of dilation of common bile duct and interrupt in pancreatic duct (7/13 vs.16/18,1/13 vs.10/18,P ＜ 0.05).Conclusion AIP as a unique type of chronic pancreatitis can be distinguished from PC on distinctive imageological features

BACKGROUND:In recent years, tissue engineering has made great progress, and skin tissue engineering is especialy noteworthy. Artificial dermis (PELNAC) is relatively used widely, but there is a lack of relevant reports on wound repair in children. OBJECTIVE:To investigate the clinical efficacy of Pelnac? METHODS:In a retrospective study, 22 patients with the wound of severe trauma were treated with Pelnac as skin graft dressings on treatment of the wounds of severe trauma in children. ? graft, negative-pressure wound therapy and split-thickness skin graft as experimental group (Pelnac? group), and another 19 patients treated with granulation formation dressing and split-thickness skin graft as control group. We colected data including the graft livability, the required re-operative times and the epithelization time after the skin graft. During the folow-up, the skin color and texture of survival skin, subcutaneous fulness, scar hyperplasia and the joint function were also evaluated. RESULTS AND CONCLUSION: In the Pelnac ? group, the graft livability was up to 90% within 10-14 days after grafting. The secondary split-thickness skin graft was required in two cases in the Pelnac? group and in eight cases in the control group. There was a significant difference in the graft livability (P < 0.05). The average epithelization time after the skin graft was (13.86±3.09) days in the Pelnac? group, which was significant shorter than the control group, (19.10±4.62) days, after the first time operation (P< 0.05). During the 10 months folow-up, the survival skin color and skin elasticity in the Pelnac? group was significantly better than that in the control group (P< 0.05). Better subcutaneous fulness and milder scar hyperplasy in the injured sites were obtained in the Pelnac? group compared with the control gorup. Five cases had certain joint function limitation in the Pelnac? group, compared to 10 cases in the control group, with a significant difference (P < 0.05). Artificial dermis Pelnac? has a stronger anti-infectious ability and higher graft livability. Pelnac? graft combined with negative-pressure wound therapy, granulation culture and split-thickness skin graft can shorten the epithelization time, improve wound healing and aleviate harm to the joint function after the skin graft.