Objective To study the relationship between intraoperative findings during knee joint replacement and clinical manifestations in elderly patients with knee osteoarthritis.Methods A total of 150 cases of senile knee osteoarthritis(182 knee joints) was selected for total knee replacement.Their X-ray examination results were gathered for recording the impairment of the articular surface,the joint space narrowing,and the location and amount of osteophytes.An MRI examination was performed in some of the cases for recording changes of fibrocartilage and locations of meniscus.Results Out of the 150 cases,there were 108 cases of genu varum(mean inversion angle,12.5?;range,0?~25?),21 cases of genu valgum(mean eversion angle,18.3?;range,15?~25?),and 21 cases of flexion contracture (mean angle,15.3?;range,0?~40?).The X-ray findings showed varying degrees of joint space narrowing in all the 150 cases,and osteophytes on the posterior border or at lateral part of the knee joint in 131 cases(152 joints).MRI examinations were performed in 11 cases(15 joints),in which discontinuous,cystoid,and worn-out fibrocartilages were seen.Radial displacement of the meniscus was found.Intraoperative findings proved that the fibrocartilage on the articular surface on the side with joint space narrowing was severely worn away,the collateral ligaments were contracted,the osteophytes were seen at the posterior part of the tibia and the femur,and abrasion or radial displacement of the meniscus on the side with joint space narrowing.Conclusions Joint space narrowing,varus or valgus deformity,osteophytes,and radial displacement of the meniscus are usually found in aged patients with knee osteoarthritis.

Traditional drug development and pre-clinical tests are based on animals and involve large numbers of animals,costs and long periods. Meanwhile,inter-species differences are difficult to overcome. Human embryonic stem cells (hESCs),which can self-renew and directly differentiate to types of cells,have become a new tool for toxicity alternative testing. hESC-Based alternative testing models,such as the reproductive toxicity test system,neuro development toxicity test system and metabolic model,can be used to predict target organ toxicity and toxic mechanisms of chemicals, analyze metabolic pathways and to search for potential toxicity biomarkers, when combined with omics such techiniques as metabonomics , proteomics and genomics. Therefore, hESC-based alternative testing models have extensive application to toxicology.

OBJECTIVE ToexplorethepossiblemechanismoractiontargetsofT-2toxinembryo toxicity by observing the effect of T-2 toxin on mitochondrial function of differentiated murine e mbryonic stemcells(mESCs).METHODS Duringdifferentiationat24,72and120h,ESCswereexposedto T-2 toxin 0.5 μg·L-1 .Meanwhile,mESCs were pre-treated with antioxidant Trolox (200 μmol·L-1 )for 30 min and exposed to T-2 toxin (0.5 μg·L-1 )for 72 h.The mitochondrial ultrasture of differentiated mESCs was observed under a transi mission electrical microscope (TEM).The differentiated ESC mito-chondrial function,including respiratory control ratio (RCR),ATP synthase activity and mitochondrial membranepotential(MMP),wasmeasuredat144hafterdifferentiation.RESULTS Significant decrease of the mitochondrial number,deformation of mitochondrial structure,and lack of complete mito-chodrial crest were observed through TEM in the groups of T-2 toxin exposed for 72 and 1 20 h,respec-tively.Compared with the normal control group,RCR declined by 49.5% and 55.1%,ATP synthase activity decreased by 84.9% and 89.3%,and MMP decreased by 23.2% and 35.2% in T-2 toxin 0.5 μg·L-1 exposure 72 and 1 20 h group,respectively.However,the inhibition of mitochondrial function by T-2 toxin in differentiated mESCs recovered significantly in the presence of the antioxidant Trolox. CONCLUSION T-2toxininducesoxidativestressandinhibitsmESCsmitochondrialfunctionindifferenti-ated mESCs,and ROS-induced mitochondrial malfunction plays an i mportant role in T-2 toxin e mbryonic toxicity mechanis m.

Objective To explore the clinical characteristics and prognosis of the patients of acute myocardial infarction complicated with heart failure by analyzing the prognostic factors of these patients.Methods This was a single-center prospective study of 349 patients with acute heart failure and ECG documented acute ST elevated myocardial infarction.All patients were treated with primary PCI.After PCI,clinical,angiographic and ECG characteristics,and prognosis of those with preserved (≥50％) or reduced (＜ 50％) left ventricular ejection fraction (LVEF) were assessed.Heart failure patients were divided into two groups:124 with reduced EF (HFREF) and 225 with preserved EF (HFPEF).After 367 days of average follow-up,the primary outcome and number of death were recorded.Results Of them,4 (1.8％) patients in the HFPEF group vs.6 (4.8％) in the HFREF group died.The difference in rate of death between two groups was not significant (P =0.314).There were significant difference in main adverse cardiac and cerebra vascular events (MACCE) occurred during follow-up period between the two groups (P =0.022).The Killip Classification of heart failure (HR =1.092,95％ CI 1.040 ～ 1.149,P ＜0.01) was significantly related to the death rate during follow-up.Conclusions The independent factors affecting prognosis in patients with acute heart failure after coronary revascularization were closely consistent with the stratums of the Killip Classification.Patients with HFPEF had a similar prognosis as those with HFREF after primary stenting.

Objective To observe toxic symptoms and signs , toxic damage extents and reversibility in rats after oral administration of Tangwang Mingmu granules .Methods Four dose groups with 40 rats in each group were designed in this study, including control group fed with distilled water and three groups at different dosages of the test drug .Tangwang Mingmu granules were orally administered to SD rats at the dosage of 8.4, 4.2 and 2.1 g/kg for 3 weeks and 14.0, 8.4 and 4.2 g/kg for 23 weeks, for 26 consecutive weeks .The general state of the rats was observed every day , while body mass and food consumption were calculated once a week .Halfway through and at the end of the administration (13 and 26 weeks) and after four weeks of recovery, parameters of body mass, hematology, hematological biochemistry, organ/body mass ratio and histopathology were measured .Results Compared with the control group at the same time-point, body mass of male rats in the other three groups was slightly reduced .Food consumption in high and medium dose groups was reduced (P<0.05), MCHC, ALT, TBIL and Na +in high dose group were decreased (P<0.05), TP, ALB and D-BIL were increased (P<0.05), the mean body mass and relative organ weight of thymus in medium dose male rats were decreased (P<0.05), relative organ weight of the liver and kidney in high dose male rats was increased (P<0.05), and focal chronic inflammation to different extent was observed in the liver , kidney and prostate gland .No dose-effect relationship was found in these perturbations that were all within the normal range of animals .No significant drug-related pathological changes were found.Conclusion The NOAEL of Tangwang Mingmu granules is considered to be 14.0 g/kg body mass/day (equal to 50 times the proposed clinical adult dosage ) for the 26-week repeated dose oral toxicity study in male andfemale rats.

OBJECTIVE To investigate the role of gonadotropin-releasing hormone (GnRH) in es-tradiol(E2 ) induced advance of puberty onset in rats. METHODS Postnatal day 18 SD rats were given a daily intragastric administration of corn oil or E2(50 μg.kg-1 ) for consecutive 5 d. The day of vaginal opening (VO), pathological changes in ovary and protein expression levels of GnRH, G protein-coupled receptor 54 ( GPR54) and phospholipase C ( PLC) in hypothalamus were observed. RESULTS As compared to corn oil controll group, VO was advanced by about 12.2 d, corpus luteum was observed in the ovary section, and the protein expression levels of GnRH,GPR54 and PLC in hypothalamus were significantly increased by 47%, 55% and 56% in E2 group, respectively. CONCLUSION E2 induced onset of puberty advance may be closely related to regulation of the expression of GnRH, GPR54 and PLC in hypothalamus.

OBJECTIVETo compare the clinical efficacy of 3 approaches of vertebroplasty in the treatment of severe osteoporotic vertebral compression fractures.

METHODSTwenty-five patients with severe osteoporotic vertebral compression fractures were observed, whose average age was 72 years with average disease history of 12 days and average compression of the affected vertebral bodies of 73%. The patients were divided into 3 groups for 3 different fracture types according to Rao's classification of osteoporotic vertebral structure and deformity, namely wedge type (group A, n= 12), biconcave type (group B, n= 7) and crush type (group C, n=6). Unipedicular approach was adopted in group A, far lateral bipedicular approach in group B, and posterior wall vertebroplasty and pedicle screw fixation in group C. The average follow-up time was 1 year. Visual analog scale (VAS), analgesic use and the mobility were measured in the patients preoperatively and 3 days (7 days in group C) and 6 months after the operation, respectively, and the success rates and complications were observed.

RESULTSAll the surgical procedures were successful. The average operation time was 35 min in group A, 50 min in group B, and 2 h in group C. The average volume of cement injected into each vertebral body was 2.0 ml. The average blood loss was 30 ml in groups A and B, and 600 ml in group C. The procedure increased mobility and decreased analgesic use. VAS was decreased by a mean of 4.8 in Group A, 6.2 in group B 3 days after the operation and 5.4 in group C 7 days postoperatively, and remained stable till 6 months after the operation (P<0.01). Cement extravasation occurred in 9 cases, cement in the vertebral canal in 2 cases with transient neurological symptoms, and cement extravasation in the intervertebral space and the anterior space of the vertebral bodies took place in 5 and 2 cases, respectively. No neurological complications were observed.

CONCLUSIONDifferent types of severe osteoporotic vertebral compression fractures require management with different approaches of vertebroplasty for adequate filling of the remaining vertebral body, which provides significant pain relief with wider indications.

Aged ; Female ; Fractures, Compression ; etiology ; surgery ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Osteoporosis ; complications ; Spinal Fractures ; etiology ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome ; Vertebroplasty ; methods

SUMMARY Thehumanembryonicstemcells(hESCs)serveasaself-renewable,genetically-healthy, pluripotent and single source of all body cells,tissues and organs.Therefore,it is considered as the good standard for all human stem cells by US,Europe and international authorities.In this study,the standard and healthy human mesenchymal progenitors,ligament tissues,cardiomyocytes,keratinocytes,primary neurons,fibroblasts,and salivary serous cells were differentiated from hESCs.The human cellular health-safety of NaF,retinoic acid,5-fluorouracil,dexamethasone,penicillin G,adriamycin,lead ace-tate PbAc,bisphenol A-biglycidyl methacrylate (Bis-GMA)were evaluated selectively on the standar-dized platforms of hESCs,hESCs-derived cardiomyocytes,keratinocytes,primary neurons,and fibro-blasts.The evaluations were compared with those on the currently most adopted cellular platforms.Parti-cularly,the sensitivity difference of PM2.5 toxicity on standardized and healthy hESCs derived fibroblasts, currently adopted immortalized human bronchial epithelial cells Beas-2B and human umbilical vein endo-thelial cells (HUVECs)were evaluated.The results showed that the standardized hESCs cellular plat-forms provided more sensitivity and accuracy for human cellular health-safety evaluation.