Objective To investigate the expression level of Ezrin and its clinical significance in nontraumatic os-teonecrosis of femoral head. Methods Expression level of Ezrin in 38 patients with nontraumatic osteonecrosis of femoral head ( experimental group) and 16 patients with femoral neck fractures ( control group) were detected by immunohistochemistry and RT-PCR analysis. Results The expression level of Ezrin was significantly lower in ex-perimental group than that in control group (P<0. 05). It was correlated with the Ficat Stage, and had no rela-tionship with gender, age, BMI, profession and etiological factor. Conclusion Ezrin may involve in the develop-ment of nontraumatic osteonecrosis of femoral head, and play an important role in regulation.

AIM: To detect the change of urinary concentration of aquaporin-2 (AQP-2) by enzyme linked immunosorbent assay in rat models of different degrees of heart failure and make a comparison with sham-operation group.METHODS: This experiment was carried out between January 2000 and January 2002 in the animal laboratory of Nanfang Hospital of Southern Medical University. Forty-two male adult Sprague-Dawley rats were involved. Twenty-six rat models of chronic heart failure were prepared by ligation of left coronary artery. When left ventricle infarct area was≥20%, the rat models of congestive heart failure were successful (heart failure group, n =13); When left ventricle infarct area was＜20%, the rat models of congestive heart failure were unsuccessful (compensation group, n =13). The other 16 rats were not ligated at coronary rtery (control group). Serum sodium concentration was determined with BeckmanC×3 equipment and urine osmole by cryoscopic method. Urine volume of 24 hours was monitored. Urinary concentration ofAQP-2 level of rats was determined by double antibodies sandwich enzyme linked immunosorbent assay (DABs-ELISA).RESULTS: Forty-two rats were involved in the result analysis. The 24-hour urine volume and serum sodium concentration in the heart failure group and compensation group were significantly lower than those in the control group (P＜0.05-0.01), while urine osmole in two groups was significantly higher than that in the control group (P＜0.05-0.01).②At postoperative 4 and 6 weeks, urinary concentration of AQP-2 level of rats in the control group was significantly lower than that in the other two groups (P＜0.05-0.01), and urinary concentration of AQP-2 level of rats in the compensation group was significantly lower than that in the heart failure group (P＜0.05, 0.01).In the compensation group and heart failure group, urinary concentration of AQP-2 level of rats was significantly higher at postoperative 6 weeks than at postoperative 4weeks (P＜0.05).CONCLUSION:①AQP-2 is the key target protein of water retention and hyponatremia at heart failure.②Detection of urinary concentration of AQP-2 by ELISA can effectively reflect water retention and hyponatremia when heart failure occurs.

Objective To observe The clinical effect of Xingqihuoxue granule combined with low molecular weight heparin to prevent deep vein thrombosis after operation of lower limb fracture surgery.Methods60 patients from February 2014 to February 2015, were randomly divided into observation group 30 cases and the control group 30 cases.The control group received low molecular weight heparin, the observation group received Xingqihuoxue granule.Two groups of patients were followed up and recorded the changes related indicators.ResultsThe level of capillary plasma viscosity, hematocrit, red blood cell and aggregation index values of observation group patients after treatment were (1.52±0.11,41.78±2.30%, 2.19±0.16 points), than the control group (1.42±0.14,39.02±2.07%, 2.01±0.23 points), and the difference was significant (P<0.05).The level of platelets of observation group patients was (189.4±37.0)×10.9 / L, than the control group (259.3±40.1) × 10.9/L, and the difference was statistically significant (P<0.05).The level of PT and APTT of the observation group after treatment were (16.0±2.79,36.78±4.59) s, than the control group (13.96±2.94,33.14±4.47) s, and the difference was statistically significant (P<0.05).The adverse reaction ratio of observation group after treatment was 6.67%, lower than the control group 30.00%, and the difference was statistically significant (P<0.05).ConclusionsThe clinical treatment of Xingqihuoxue granule combined with low molecular weight heparin was better than low molecular weight heparin alone, and the side effects was lower.It is worthy of further research and application.

Objective To evaluate the effect of lidocaine and tramadol on remifentanil combined general anesthesia. Methods Eighty patients undergoing abdominal hysterectomy were divided into group LT,L,T and C by random digits table,each with 20 cases .In group LT,during induction,the patients were intravenously. In group L,only used lidocaine as introduced in group LT. In group T,only used tramadol as shown in group LT. In group C,used the same volume of saline solution. The changes of mean arterial pressure (M A P) and heart rate during the operation, dysphoria grade (RS), Ramsay score (RSS), pain score (VAS),extubation time(ET),medication and dose,complications were recorded. Results In group LT,the dosage of propofol [(450 ± 178) mg] was less (P ＜ 0.05), ET [(15.0 ± 4.8) min] was shorter (P ＜ 0.05),during recovery time, RS was lower, RSS was higher,the cases needad fentanyl (1 case), 48 h after operation, only 1 case needed pethidine to relieve pain was less than those in other groups (P ＜ 0.05). In group L there was a tend that its RS and the cases needed fentanyl and fentanyl dosage were more, RSS was less than those in group T during recovery time,but 48 h after operation,the cases needed pethidine was less than that in group T. Conclusions Using lidocaine during operation may relieve pain after operation, reduce the dosage of analgesic;giving tramadol may alleviate the acute pain and lower dysphoria incidence rate after remifentanil anesthesia. Combining them will get a better effect.

BACKGROUND:Systemic lupus erythematosus is a kind of heterogeneous disease, and the difference of clinical features may also be the risk factors of osteonecrosis besides of treatment with glucocorticoids according to the literature. However, it remains controversial on the risk factors of osteonecrosis in systemic lupus erythematosus patients.
OBJECTIVE:To systematical y review the major risk factors of osteonecrosis in the Chinese patients with systemic lupus erythematosus.
METHODS:The CNKI database, CBMdisc database and Wanfang database were retrieved for the published case-control study literatures on the risk factors of osteonecrosis in the Chinese patients with systemic lupus erythematosus. The literatures met the inclusion and exclusion criteria were included, and a Meta-analysis was conducted by RevMan 5.0 and Stata software. Then, the pooled odd ratio and 95%confidence interval of each risk factor were calculated.
RESULTS AND CONCLUSION:Ten case-control study literatures were included involving 332 cases in the case group and 986 cases in the control group. The pooled odd ratio and 95%confidence interval of each risk factor of osteonecrosis in the Chinese patients with systemic lupus erythematosus were as fol ows:Raynaud’s
phenomenon 3.28(1.69-6.38), dental ulcer 2.95(2.13-4.09), renal involvement 1.21(0.83-1.74), vasculitis 5.64(2.84-11.21), hyperlipidemia 5.11(3.10-8.42), anti-phospholipid antibody 2.32(1.49-3.61) and joints involvement
2.02(1.33-3.07). It has been clear that the glucocorticoids is an independent risk factor of osteonecrosis in the patients with systemic lupus erythematosus. However, it is not the one and only risk factor. The fol owing risk factors of
vasculitis, hyperlipidemia, Raynaud’s phenomenon, dental ulcer, positive anti-phospholipid antibody and joints involvement are the risk factors of osteonecrosis in the patients with systemic lupus erythematosus.

Objective To evaluate the relationship between plasma cortisol levels and the occurrence of postoperative cognitive dystunction(POCD) in adolescent scoliosis patients following orthopedic surgery.Methods Seventy-five adolescent scoliosis patients,aged among 11-18 years,ASA Ⅰ-Ⅱ,who were scheduled for orthopedic surgery with general anesthesia,were enrolled.Cognitive function was evaluated with a set of neuropsychological tests at 1 day before surgery,1 week and 3 months after operation,then the levels of cortisol on second day after admission and second day after surgery were determined.Age,sex,years of education and other intraoperative indexes and postoperative complications were recorded.Results Sixty-six patients conpleted both sample collections and three times of neurocognitive tests.According to the diagnostic criteria,POCD occurred in 28.8％ of patients at 7 days,and 7.6％ at 3 months postoperatively,and then the patients were divided into two groups:POCD and NPOCD,respectively.Statistical analysis showed that significant difference was found between the two 7 days groups in levels of cortisol at 2 days postoperatively(POCD group((311.01±126.82) nmol/L),NPOCD group ((409.63± 179.28) mnol/L,P＜0.05).There was also difference between 3 months groups both in the levels of cortisol at second day after admission and second day after surgery(P＜0.05).The changes of cortisol levels between 7 days groups had significant difference with Mann-Whitney U test(P=0.001).Logistic regression analysis showed that changes of cortisol levels may be a risk factor of POCD(P=0.046,OR=1.004,95％ CI (1.000,1.007)).Conclusion Perioperative changes of plasma cortisol levels may be associated with the occurrence of POCD in adolescent scoliosis patients,which deserve further research.

Objective To detect the methylation status of p16 gene promoter in CD4~+ T cells of patients with systemic lupus erythematosus(SEE),and its significance in the pathogenesis of SLE.Methods The pl 6 gene promoter methylation in peripheral CD4~+ T cells was detected with the Taqman probe-based realtime PCR(Methylight)technology in 28 patients with SLE and 20 healthy human controls.Results The methylation rate of p16 gene promoter in peripheral CD4~+ T cells was higher in patients with SLE than that in the controls(35.7%VS 10%,x~2=4.11,P<0.05).There was no correlation between SLE disease activity index (SLEDAI)and the normalized index of methylation(NIM)of p16 gene promoter(r_s=-0.29,P>0.05).Conclusion The methylation status of p16 gene promoter is aberrant in CD4~+ T,:ells of SLE patients,suggesting that the hypermethylation of p16 gene plays a certain role in the pathogenesis of SLE.

Objective To evaluate the effects of nail polish on measurement of pulse oxygen saturation (SpO2) by different brands of monitors in healthy volunteers.Methods Twenty healthy female volunteers were enrolled in the study.Nine fingers of each volunteer were chosen randomly,8 nails were painted 8 different colors (transparent color,red,yellow,green,blue,purple,black,white),respectively,and the left 1 nail served as blank control.SpO2 and pulse rate (PR) were measured using TuffSat Handheld Oximeter (GE) and MP70 (Philip) and PM-9800 (Mindray) monitors.SpO2 of the 9 nails monitored and the response time for SpO2 and PR were recorded.Results (1) Compared with blank control,when MP70 monitor was used,no significant change was found in each color-induced effect on the value of SpO2 obtained (P ＞ 0.05),and blue prolonged the response time for PR and SpO2 (P ＜ 0.05) ;When PM-9800 monitor was used,black could decrease the value of SpO2 measured (P ＜ 0.05),and no significant change was found in each color-induced effect on the response time for SpO2 and PR (P ＞ 0.05) ; when TuffSat Handheld Oximeter was used,green and blue could decrease the value of SpO2 monitored,and the value of SpO2 obtained was significantly lower when blue was used (P ＜ 0.05).Black,blue,purple and white could sequentially prolong the response time for PR (P ＜ 0.05),and no significant change was found in each color-induced effect on the response time for SpO2 (P ＞ 0.05).(2) For green and blue nail polish,the value of SpO2 measured with TuffSat Handheld Oximeter was significantly lower than that measured with MP70 and PM-9800 monitors(P ＜ 0.05) ; for red,yellow and green nail polish,the response time for PR obtained with TuffSat Handheld Oximeter was significantly shorter than that obtained with MP70 and PM-9800 monitors (P ＜0.05) ; for blank control group and 8 colors of nail polish,the response time for SpO2 measured with TuffSat Handheld Oximeter was significantly shorter than that measured with MP70 and PM-9800 monitors (P ＜ 0.05).For black nail polish,the value of SpO2 measured with PM-9800 monitors was significantly lower than that measured with MP70 and TuffSat Handheld Oximeter(P ＜ 0.05).Conclusion The ability for nail polish recognition and identification is different for each monitor and the color of nail polish can exert obvious effect on the value and response time for SpO2 obtained.The results of this study shows that blue nail polish-induced effect on the value of SpO2 obtained with TuffSat Handheld Oximeter is obvious,and MP70 monitor is the most stable instrument and TuffSat Handheld Oximeter is the most sensitive instrument in obtaining the value of SpO2.

Objective To investigate the diagnostic value of cyclophilin A(CyPA)for chronic heart failure (CHF).Methods Eighty pateints,made a definite diagnosis as CHF,were classified 30 cases as A phase,29 cases as C phase,21 cases as D phase of them.30 healthy subjects were enrolled in this study.Serum CyP A was detcted by ELISA.NT-proBNP was detec-ted with Roche Cobas 6 000 automatic electrochemilu-minescence immunoassay system.Results The amounts of serum CyP A(x-±s,ng/ml)in healthy subjects and each group with CHF were 110.10±49.73,327.85±82.67,331.70±69.34 and 342.46±92.55.Using Oneway Anova,CyP A concentration of CHF was significantly higher than healthy controls (F=58.45,P<0.01).Further using Post Hoc Tests-Multiple Comparisons,the CyP A concentration of each group with CHF was significantly higher than the healthy control group (Mean differences were 217.75~232.36,P<0.01),but showed no significant difference between the groups with CHFs (Mean differences were 3.37~14.61,P>0.05).Results of ROC curves showed the AUC (CyP A)was 0.97.The best cutoff value was 198.39 (ng/ml).The sensitivity was 91.30%,the specificity was 93.30%.The correlation analysis showed that CyP A and NT-proBNP were correlated (r=0.30,P<0.01). CyP A and NT-proBNP combined detections showed the sensitivity was 93.80% and the specificity was 100%.Conclusion The Cyp A levels in CHF group are significantly higher than the control group,suggesting that Cyp A may be a factor for CHF appearance.These results indicate that combined detections may helpful to early diagnosis of CHF.