Objective To investigate the dynamic changes of serum interleukin (IL)-1β,tumor necrosis factor (TNF)-α,cyclooxygenase (COX)-2 levels in patients with acute gouty arthritis with various severityes and to provide evidence for the course of anti-inflammatory drug used in patients with acute gouty arthritis.Methods Ninety patients with gouty arthritis were randomly selected including sixty acute gouty arthritis patients and thirty gout patients in remission (observation group 3).Sixty acute gouty arthritis patients were divided into severe (observation group 1) and mild (observation group 2) subgroups according to the chief complaints and pain score points (VRS-4 method).All acute gouty arthritis patients were given the same dose and duration of etoricoxib and colchicine (14 days in all).Serum IL-1β,TNF-α,COX-2 levels were detected by enzyme-linked immunosorbent assay (ELISA) after the 1,3,7,10 and 14 days after onset.The 2-tailed independent samples t test was used for the analysis of measurement data.ANOVA were adapted for the comparison between groups.Results The serum levels of IL-1β,TNF-α in the observation group 1,2 were significantly higher than those in the control group in day 1 and 7 (P＜0.01),and almost completely returned to normal at day 10 to 14 day anti-inflammatory therapy.The serum COX-2 levels in observation group 1,2 were significantly higher than those in the control group (P＜0.01) in day 1 to 3,and returned to normal at day 7 to 10 after anti-inflammatory therapy.There were no significant differences between observation group3 and the control group (t=-0.880,-1.201,-0.548; P=0.383,0.235,0.586).② The serum levels of IL-1β,TNF-α were significantly higher in observation group 1 than those in observation group 2 [(24±5) pg/ml and(19±3) pg/ml,(323±84) ng/ml and (234±29) ng/ml; P=0.001,0.002],while there was no significant differences between observation group 2 and the control group (P=0.357).The serum COX-2 levels in observation group 1 were significantly higher than those in observation group 2 at day 7 [(12.9±2.0) pg/ml and (9.1±1.6) pg/ml],while there was no significant difference between observation group 2 and the control group (P=0.941).Conclusion Inflammatory factor can return to normal completely after anti-inflammatory therapy for acute gouty arthritis for 10 to 14 days.This study provides evidence for the course of anti-inflammatory drug used in patients with acute gouty arthritis.

Objective To investigate the effects of stromal cell-derived factor-1 (SDF-1) on the adherence of mononuclear cells (MNC). Methods Mononuclear cells were isolated from cord blood and the adherent rate was assayed by using MTT with fibronectin coated in different concentration of SDF-1. Then the expression of adherent molecule VLA-4 by FACS as well as the adherent rate when MNC were cultured in vitro. Results The adherent rate of fresh cord blood MNC was (110.2±2.10) %, (128.3±2.09) %, (141.6±2.62) %, (160.8±3.84) %, (162.3±3.60) %, (165.4±2.73) %, (165.1±2.33) %. When the mass concentration of SDF-1 was 50, 100, 150, 200, 250 ng/ml. When MNC were cultured in vitro,the expression of VLA-4 was 26.37te was (160.2±6.38) %, (194.6±6.09) %, (147.5±6.86) %, (144.7±4.96) %, (118.1±3.64) %. The correlation coefficient between the adherent rate and the expression of VLA-4 is 0.826. Conclusion The adherent rate of fresh cord blood MNC increases along with the concentration of SDF-1, however, it tends to be stable when the concentration of SDF-1 reaches 100 ng/ml. When MNC were cultured in vitro with hemopoietic growth factors, the expression of VLA-4 and the adherent rate of MNC increased in the initial stage, however, the expression of VLA-4 and the adherent rate of MNC both decreased gradually along with time extending. There is positive correlation between the adherent rate of MNC and the expression of adherent molecule VLA-4.

OBJECTIVE To understand the characteristics of nosocomial infection and its risk factors in the department of neurology, and to explore effective prevention and control measures for reducing the incident rate of nosocomial infection. METHODS Target monitoring procedures were setup. Prospective monitoring was done in inpatients in the department of neurology from Jan 2005 to Dec 2006. RESULTS Among 2682 patients, 135 patients (163 cases) suffered from nosocomial infection. The infection rate of the cases was 6.08%. Compared to the rate before monitoring (13.77%), it decreased 7.69%. The most common infection sites of the nosocomial infection were lower respiratory tract (34.36%) and urinary tract (26.38%), respectively. Pathogen test showed that main pathogens were Gram-negative bacilli (50.00%), then the fungi (32.95%). CONCLUSIONS Through target monitoring we can acquire patients′ information accurately in time, and set effective prevention and control measures to reduce the nosocomial infection rate.

ObjectiveTo assess the clinical value of minimally invasive transforaminal lumbar interbody fusion(TLIF) through the Wiltse approach for the treatment of lumbar spondylolisthesis. Methods Sixty-nine patients with lumbar spondylolisthesis were randomly divided into two groups. Group A underwent minimally invasive TLIF via the Wiltse approach, Group B via the traditional approach. There were 31 cases in group A, the affected level was L4.5 in 19 cases and L5S1 in 12. The degree of vertebrae slippage was Ⅰ degree in 17 cases,and Ⅱ degree in 14. There were 38 cases in group B, the affected level was L4,5 in 22 cases and L5S1 in 16. The degree of vertebrae slippage was Ⅰ in 21 cases, and Ⅱ in 17. The Japanese Orthopaedics Association (JOA) score, visual analogue scale (VAS) of low back pain and leg pain were evaluated at 3, 6, and 12 months follow-up. The post-operative dynamic X-rays, CT and/or MRI were used for image evaluation. ResultsThere was no statistically difference in operating time between the two groups. The incision length, blood loss and exposing time of group A were shorter than those of group B. The JOA scores, recovery rate, VAS of low back pain and leg pain, interbody fusion rate and atrophy rate of multifidus in group A were 24.7±3.5, 77.0％±3.1％, 1.0±0.7, 1.1±0.3, 71.0％±5.8％, 2.1±0.2, respectively, and in group B were 24.3±2.8, 73.6％±6.4％, 3.1±0.6, 1.8±0.5, 76.3％±6.1％, 0.5±0.1, respectively. The VAS of low back pain was lower in group A than in group B. The atrophy rate was better in group A than in group B. Conclusion Both TLIF approaches can acquire satisfactory clinical results. Minimally invasive TLIF through the Wiltse approach can significantly reduced damage of multifidus and incidence of chronic low back pain postoperative.

Objective To evaluate the clinical effect of thoracic discectomy via trans-facet-joint approach in the treatment of thoracic disc herniation.Methods Thirty-three cases were included in this group from October 1994 to August 2009.There were 27 males and 6 females.The age ranged from 18 to 72 years old,with an average of 41.8 years.The course of disease ranged from 12 days to 36 months and was lesser than one month in 13 cases.The weakness and numbness of lower limbs occurred after trauma in 9 cases.Fifteen cases were diagnosed as simple thoracic disc herniation.Six cases were associated with ossification of posterior longitudinal ligament and 12 cases were associated with ossification or hypertrophy of yellow ligament.A total of 45 discs were involved,including 32 in lower thoracic segments(71.11%),8 in upper thoracic segments(17.78%)and 5 in middle thoracic segments(11.11%).All the herniated discs and the ossified OPLL were excised via the trans-facet-joint approach.For the cases with ossification or hypertrophy of yellow ligament,the laminectomy and replantation were performed.The screw-rod system was used on both sides in 14 cases,on one side in 19 cases.Results Follow-up was acquired in 27 patients,ranged from 12 to 63 months(mean,37 months).According to Epstein and Schwall grade,there were excellent in 15 cases,good in 10 cases,improved in 2 cases and poor in 2 cases.The excellent and good rate was 86.21% and total effective rate was 93.10%.Postoperative complications occurred in 3 cases,including exacerbation of preexisting deficits in 2 cases and implant failure in 1 case.The former 2 cases were treated with methylprednisolone,dehydrant,neural nutrition and hyperbaric oxygen.One patient had recovered to preoperative level,the other had not recovered to the preoperative level.The implant was removed 18 months after operation for the implant failure.The post-operative CT or MRI showed that all the replanted lamina obtained fusion,and the canal decompression was complete.Conclusion Thoracic discectomy via trans-facet-joint approach can improve the clinical result obviously.

Objective:To investigate the rationality of prophylactic antibiotics application during perioperative period in the pa-tients with type Ⅱ incision operation in gynecology and obstetrics in our hospital after the intervention. Methods:Totally 274 medical records of obstetrics and gynecology patients with typeⅡincision operation in our hospital from April 2012 to March 2013 were collect-ed as the control group, another 321 medical records of obstetrics and gynecology patients with typeⅡincision operation in our hospital from April 2013 to March 2014 were collected as the intervention group. The rationality of prophylactic antibiotics application before and after the intervention was compared. Results:Compared with those in the control group, the average administration time, the hos-pitalization time and the cost of antimicrobial agents were significantly decreased in the intervention group (P<0. 05). The incidence of adverse drug reactions and operation incision infection between the two groups was not significant difference (P>0. 05). Compared with those in the control group, the incidence of irrational choice of antibacterial drugs, the combined use without indication, irrational medication time,over-time use, inappropriate use and improper choice of solvents in the intervention group was significantly reduced ( P<0. 05). Conclusion:After the intervention, the rationality of prophylactic antibiotics application during perioperative period in the patients with type Ⅱ incision operation in gynecology and obstetrics in our hospital is improved significantly.

1?g/ml)could inhibit osteoblasts to grow and proliferate, and showed cytotoxic activity. Conclusion aFGF possesses the effect of triggering osteoblasts to grow and proliferate, and its effective concentration is 10-100 ng/ml.

Objective To observe the clinical advantage of treating the dens fracture with cannulated screws by microendoscopy system and navigation system through anterior approach. Methods From October 2002 to August 2004, 6 dens fracture (type Ⅱ) patients had undergone single cannulated screws fixation by the microendoscopy system and image guidance through the anterior approach, including 2 females and 4 males with an average of 53.2 years (range from 23 to 65 years). The preoperative Frankel grade was D in 1 case and E in 5 cases. 4 cases had fracture displacement. All patients accepted skull traction and external fixation before surgery. The patients accepted the MR examination and the images were reconstructed by the Vector Vision spinal navigation system in order to make the proper surgical plan, including the nails' direction and length in three-dimension. After affirming the reduction of the dens fractures according the C-arm fluoroscopy, the work channel was inserted through 2 cm long incision at the C5 level, then extended to the C2 level, to excise part of inferior C2 vertebral body. Under the navigation system guide, a guidance needle was inserted and the fracture was fixed by cannulated screw through the work channel. The patients did not need any C-arm fluoroscopy during the surgery. After the surgery the patients were with external fixation for 2 months. Results The surgery lasted 80 min (range from 50 to 150 min), blood loss was 75 ml (40 to 90 ml). There was no related complication during and after surgery including odynophagia or dysphagia. Follow-up period extended from 6 to 37 months (mean 13.5 months). All dens fractures were reduced and healed satisfactory during the follow up. All patients' postoperative Frankel grade was E in the most recent follow-up. Conclusion To fix the dens fracture through microendoscopy and navigation system guide can reduce the soft tissue injury and the incidence of odynophagia or dysphagia, make the surgery safer, avert the repeated C-arm check-up during the surgery compared with the traditional anterior fixation method. The procedure is very safe, simple and can reduce the surgical time effectively.

Objectives:To study the soft tissue profile characteristic in the early permanent dentition with Class Ⅲ malocclusion, and then to analyze the relationship between hard and soft tissue. Methods: 50 normal occlusion and 50 Class Ⅲ malocclusion children were examined cephalometrially with the lip at rest. Results:Compared with the normal occlusion group, All measurement except 9 soft tissue variables and 1 hard tissue variables was statistically significant with t-test in the Class Ⅲ malocclusion group (P

Objective To study the effects of chronic ouabain treatment on Na+-K+-ATPase activity and the expression of dopamine D1 receptor in rat kidney cortex. Methods A total of 28 male Sprague-Dawley (SD) rats were randomly divided into ouabain group and control group,which were treated with ouabain or saline for 5 weeks; rat tail systolic blood pressure (SBP) was recorded weekly. Rats were sacrificed after 3 and 5 weeks,respectively. Then Na+-K+-ATPase activity and the expression of dopamine D1 receptor in rat kidney cortex were measured by colorimetric assay and real-time PCR,respectively. Results After 3 weeks of ouabain treatment,the mean SBP did not change significantly,but the Na+-K+-ATPase activity increased (P