3 cm)ultrasonography image was the absent of rotator cuff image(nonvisualization)or discontinuity(local nonvisualization);moderate full thickness cuff tears(size 1-3 cm)ultrasonography image was the hypoechoic zone extending through the entire substance of the cuff;bursa surface partial thickness was small hypoechoic discontinuities of the external surfaces of the cuff;articular surface partial thickness was small hypoechoic discontinuities of the internal surfaces of the cuff.All the ultrasonography examination results were compared with findings at shoulder operation or arthroscopy as a golden standard.12 shoulders were open repaired;16 shoulders were limited open and arthroscope repaired;6 shoulders were contracted under the radio frequency ablation;22 shoulder were taken acrominal plasty under the arthroscope.Results The ultrasonography correctly depicted 30 of 33 rotator cuff tears with sensitivity 90.91%,specificity 91.30%,positive predictive value 93.75%,negative predictive value 87.50%.6 large to extensive tears,11 small and moderate full-thickness tears,5 acrominal partial-thickness tears,11 articular partial-thickness tears.Conclusion The ultrasonography is a highly accurate diagnostic method for detecting full-thickness rotator cuff tears,but is less sensitive in detecting partial-thickness rotator cuff tears.

Background:Small bowel Crohn's disease (CD) is a chronic nonspecific inflammatory disease with unknown etiology.There is no clear criteria for assessing the progression of CD, and the endoscopic index for assessing disease activity in CD patients is limited to a single parameter.Aims:To investigate the clinical value of endoscopic index in evaluating disease activity in patients with CD and the correlation between different parameters.Methods:Sixty cases of CD patients form Jan.2008 to Dec.2012 at Affiliated Hospital of Yanan Uuiversity were collected, 60 healthy adults were served as control group.CECDAI score, CDAI score and Lewis score were used to evaluate disease activity in patients with CD, and their relationship with CRP and ESR were analyzed.Results:Levels of CRP and ESR were significantly increased in CD patients than in controls (P<0.05).CDAI score and Lewis score were statistically different in different CECDAI score groups (F=5.53, P<0.05;F=22.64, P<0.05).CECDAI score was statistically different in different CDAI score groups (F=3.55, P<0.05), and was statistically different in different Lewis score groups (F=4.26, P<0.05).CECDAI score was correlated with CDAI score, Lewis score, CRP, ESR (P<0.05);CDAI score was correlated with CRP, ESR (P<0.05) and not correlated with Lewis score (P>0.05);Lewis score was not correlated with CRP, ESR (P>0.05) in CD patients.Conclusions:CECDAI score, CDAI score, Lewis score, CRP, ESR can reflect disease activity of CD, and can be used together to assess disease activity of CD patients.

Objective To investigate the pathological and physiopathological difference between the ruptured” and the “degenerated” typed lumbar disc herniation (RDH and DDH) by measurement of the pressure of the herniated lumbar disc both in the herniated site and in the nucleus pulposus during the surgery, combined with the clinical,light microscopical and immunohistochemical properties. Methods Fifty seven cases of lumbar disc herniation undergone operation in the Tianjin Medical University Hospital were included in this study. The patients were divided into 2 groups. 1) Rupture typed lumbar disc herniation in which the herniated chip of the lumbar disc separated from the parent disc and was squeesed or drew out easily when the superficial posterior longitudenal ligament and anulus fibrosis were opened in the herniated site. 2) Degenerated typed lumber disc herniation in which no herniated chip of the lumber disc escaped; the herniated material can not be taken out unless the disc was resected by the instrument. Before the herniated disc was incised, the intervertebral disc pressure was measured using GENERAA710 multifunctional monitor. Both the light microscopical and the immunohistochemical difference between the RDH and the DDH was studied. Results 1) In the herniated site, the pressure in the RDH is higher than that in the DDH(P0.05). 3) In the RDH, the pressure in the herniated site is higher than that in the nucleus pulposus (P0.05). 5) The“lumbar pain score”and the pressure have obviously relationship in all of 35 patients(r=0.539,P

Objective To explore the effect of icariin on stimulating Smad4 mRNA level in MC3T3-E1 cells. Methods MC3T3-E1 cells were treated by 0 ng/ml, 10 ng/ml, 20 ng/ml, 40 ng/ml icariin respectively. MTT method and population diploid time were applied to observe the cell proliferation. The cell ALP level was measured by atomic absorptiometry and the type Ⅰ collagen was observed by immunohisto-chemistry. RT-PCR was used to find the Smad4 mRNA level in the MC3T3-E1 cells. Results Under the inversion phase contrast microscopy, MC3T3-E1 cells were oligodendrocytes-shaped rich with cell organs. The cells density in 10 ng/ml, 20 ng/ml were higher than those in 0 ng/ml,40 ng/ml. Cell growth curve in 10 ng/ml was higher than other 3 groups and the 20ng/ml was higher than 0 ng/ml, 40 ng/ml groups( P

Objective To introduce laminar shelling decompression technique and to discuss its benefit for decompression of thoracic ossification of ligamentum flavum. Methods 102 patients were diagnosed as thoracic ossification of ligamentum flavum, 63 males and 39 females with an average age of 49.7 years (range, 33 to 71 years). 99 cases suffered with sensation disturbance, 73 cases with constriction on trunk or lower limbs, 77 cases with sphincter dysfunction. The IMSOP Standard Neurological Classification of Spinal Cord Injury was applied for localized the level of thoracic spondylopathy. The JOA lower limb motor function standard and sphincter function standard were used to evaluate the ability of lower limb motion and sphincter function respectively. In the decompression the dorsal cortex of lamina was the first layer to resect, the facet joint surface indicate the depth for removing the second layer, then thinning the ossified tissue by shaving with the motor bur until it was somewhat lucent. Finally decompress the spinal canal by moth eaten manner. Results The mean decompression length was 2.8 lamina(2 to 4 lamina). The mean follow-up duration was 18.9 months (3 to 41 months). Among 99 sensation disturbance 69 totally recovered, 30 relived. 73 cases with the feel of constriction of trunk or lower limbs were completely recovered. Postoperative JOA sphincter function score was 2.632?0.407, comparing with the preoperation score, and the difference was significant (t=15.93, P

Objective To investigate the in vivo effects of glutamine(Gln) on inflammatory cytokine release in murine peritoneal macrophages during sepsis. Methods Sixty Kunming mice were randomly divided into sham-operation group(Sham group,n=20),operation control group(Con group,n=20) and Gln-treatment group(Gln group,n=20).Sepsis was induced by cecal ligation and puncture in Gln group and Con group,and Gln(0.75 g/kg) or saline was immediately administered via single tail vein injection.Serum was collected and macrophages were harvested from peritoneal lavage at 6 h in these three groups.Intracellular and serum cytokines of tumor necrosis factor-?(TNF-?),interleukin(IL)-6 and IL-10 were detected by ELISA.The expression of TNF-? mRNA in macrophages was analyzed by RT-PCR,and the expression of heat shock protein(HSP) 72 in macrophages was evaluated by Western blotting. Results Gln group demonstrated significantly lower intracellular TNF-? and IL-6 levels than Con group(P0.05).The serum TNF-? level was significantly lower in Gln group than in Con group(P

Objective To explore the levels of serum chemokine in the patients with gastric cancer using cytometric beads array (CBA) and to find out the laboratory evidence for gastric cancer immunotberapy.Methods Forty-five patients with gastric cancer,thirty patients with benign gastric diseases and forty healthy controls were included.The chemokine levels of interleukin-8 (IL-8),regulated upon activation normal T-cell expressed and secreted (RANTES),monokine induced by IFN-γ (MIG),monocyte ehemoattractant protein-1(MCP-1) and interferon-γ induced protein-10 (IP-10) in serum of these three groups were measured using CBA ,then these data were analyzed using BD CBA analysis software.Results The levels of serum chemokines in healthy controls were (176.4±20.7) μg/L for IP-10,(111.3±17.2) μg/L for MCP-1,(503.9±47.2) μg/L for MIG,(472.4±116.7) μg/L for IL-8,respectively.In gastric cancer patients,the levels were (266.6±24.7) μg/L for IP-10,(100.4,70.8-193.5) μg/L for MCP-1,(1614±275.4) μg/L for MIG,(500.0±164.8) μg/L for IL-8.The levels of serum chemokines in patients with benign gastric disease were (207.9±31.7) μg/L for IP-10,(121.2±23.6) μg/L for MCP-1,(514.5±63.0) μg/L for MIG,(480.2±134.8) μg/L for IL-8,respectively.The levels of IP-10 and MIG among these three groups were significantly different (IP-10:F = 3.52,P < 0.05,MIG:F = 9.27,P < 0.01).The levels of IP-10 were elevated in the cancer patients compared with healthy controls (P < 0.05),while the levels of MIG were elevated significantly in the cancer patients compared with healthy controls and benign disease controls(t=3.29,P < 0.01,t=2.84,P<0.01).Conclusions CBA is a novel method with convenience,sensitivity and accuracy for the detection of serum ehemokines.The concentration of IP-10 and MIG in gastric cancer patients are elevated,indicating its implication in cancer pathogenesis and metastasis.Measurement of serum chemokines will lay the groundwork for therapeutic strategy in gastric cancer by inhibiting and anti-chemokine.

ObjectiveTo observe and analyze the synapses developing process of newly generated connections of autologus activated Schwann cells (AASCs) in combination with fetal spinal cord cell suspension(FSCS) in the surrounding area of the spinal cord injury site.MethodsA total of 42 Wistar rats underwent unilateral ligation of the saphenous nerve.The portion of nerve tissues distal to the ligation site were harvested 1 week after operation.AASCs were isolated,cultured and purified.Spinal cord injury model produced in 42 Wistar rats on T7 by modified Allen impact method.Three days after injury,20 μl FSCS with a density of 1×105/μl prepared from pregnant rats (El4) in combination with AASCs were injected into the epicenter of the traumatized cavity.Animals were sacrificed at 2,4,6,8,10,12 weeks post transplantation.Light and electronmicroscopic studies as well as immunohistochemical assay were carried out to evaluate the graft survival,its differentation and integration with the host.ResultsIn the transplantation area,AASCs showed good growth and differentiation,and glial scarring surrounding the lesions was less.The neuroblast stretched out the terminal endings 4 weeks after implantation,followed by the presenting of the pre- and post-synaptic membrane.Eight weeks post transplantation,the dense or developed projections were observed in the pre- and post-synaptic membrane,the high electron dense substance full filled the synaptic cleft.All the spherical cleat vesicles,granular vesicles,elliptical vesicles and flattened-f type vesicles were discovered under the electron microscope.Ten weeks after injury,the axosomatic,dendrosomatic,dendro-dendritic,axoaxonic,and dendro-axonic synapses coexisted.Light microscopy showed that the graft cell grew gradually.Immunohistochemical assay showed that NF,5-HT,CGRP and GFAP positive fibers were in the graft.Synapses,glia fibers and blood brain barrier integrated each other.Conclusion1) The transplanted FSCS combined with AASCs can develop mature synapses with miscellaneous synaptic vesicles in the acute injured spinal cord.2) Co-existing indicate the possibility of synaptic connection between FSCS and host.

Objective To analyze mutations of the STAT3 gene in a patient with hyper-IgE syndrome (HIES).Methods Clinical data were collected and blood samples were obtained from a 14-year-old patient with hyper-IgE syndrome (HIES) and her parents.Genomic DNA was extracted and subjected to PCR for the amplification of the entire encoding and splice sites of the STAT3 gene followed by bidirectional sequencing.Meanwhile,amplified ribosomal DNA restriction analysis was carried out.Results A heterozygous missense mutation A1843G,which caused a K615E substitution,was found in exon 19 encoding the SH2 domain of the STAT3 gene in the patient,but not in either of her parents.The result of amplified ribosomal DNA restriction analysis was consistent with the findings mentioned above.Conclusion The novel K615E missense mutation in the STAT3 gene may contribute to the development of HIES.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.