Objective To improve the understanding of osteoarticular pain presented as rheumatic syndromes of cancers and malignant skeleton metastasis associated. Methods To analyse the clinical data of 32 patients initially manifested as osteoarticular pain. Results Forteen patients of 32 cases was diagnosed as cancer associated rheumatic syndromes, characterized by gradually deteriorated chronic recurrent vague pain. The effect of non-steroid anti-inflammatory drugs (NSAIDs) and glucocorticoid was not satisfactory. Pain subsided after removal of carcinous mass. Eighteen patients had malignant skeleton metastasis, vague pain at onset, but gradually progressed to be, severe persistent pain. NSAIDs and glucocorticoid were ineffective. Narcotic analgesics could produce short time relief. The nature and distribution of tumour were comparatively extensive. The clinical misdiagnosis rate was high. Conclusion Clinical doctors often neglect the coexistence of tumor because they are not familiar with the relation between osteoarticular pain and tumor. So patients who is over sixty and is not sensitive to commonly used analgesics and glucocorticoid with osteoarticular muscular pain should be considered the possibility of malignant tumor after excluding diffuse connective tissue disease.

Objective:To investigate the changes of serum neopterin (NPT) level in adults patients with Kashin-Beck disease (KBD) in Qinghai Province.Methods:In July 2018, according to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), in KBD endemic region of Xinghai and Guide counties in Hainan Tibetan Autonomous Prefecture of Qinghai Province, adult KBD patients and healthy people over 20 years old were selected as KBD group and internal control group, respectively. At the same time, healthy people over 20 years old were selected as the external control group in non-KBD endemic region of Xunhua County with similar production scale and lifestyle. Fasting elbow vein blood samples of the 3 groups of people were collected, serum NPT levels were determined by enzyme linked immunosorbent assay (ELISA).Results:Totally 272 people were enrolled in the study, 104 cases (50 males and 54 females) in KBD group, aged (47.61 ± 12.72) years old; 95 cases (35 males and 60 females) in internal control group, aged (48.28 ± 14.87) years old; and 73 cases (35 males and 38 females) in external control group, aged (51.88 ± 13.93) years old. There were no significant differences in gender composition and age among the 3 groups (χ 2 = 3.135, F = 2.236, P > 0.05). The serum NPT levels of KBD, internal control, and external control groups were (504.35 ± 413.92), (417.34 ± 109.90) and (397.49 ± 118.07) ng/L, respectively, and the difference among the 3 groups was statistically significant ( F = 4.129, P < 0.05). Among them, the serum NPT level of KBD group was significantly higher than that of internal control group and external control group ( P < 0.05); there was no significant difference in the serum NPT level between internal control group and external control group ( P > 0.05). Conclusion:The serum NPT level of adult KBD patients in Qinghai Province is elevated.

Objective:To investigate the effects of celecoxib and anti-osteogenesis tablets on urinary biomarkers pyridinoline (PYD) and deoxypyridinoline (DPD) in adult patients with Kashin-Beck disease (KBD) in Qinghai Province, and to provide scientific basis for treatment of adult KBD.Methods:According to the "Diagnosis of Kaschin-Beck disease" (WS/T 207-2010), in July 2017, 120 cases of adult KBD that were selected from the KBD area in Qinghai Province were divided into non-drug treatment group ( n = 66) and drug treatment group ( n = 54), and 89 healthy adults were selected as control group. The drug treatment group was taken celecoxib and anti-osteogenesis tablets for 6 months. Morning urine samples were collected from the three groups. The contentss of PYD and DPD in urine were detected by enzyme linked immunosorbent assay (ELISA), and the test results were corrected with creatinine (Cre). Results:There were no statistically significant differences in gender ratio and age among non-drug treatment group, drug treatment group and control group (χ 2 = 0.820, F = 0.379, P > 0.05). The medians of urinary PYD in the three groups were 1 106.39, 812.18, 702.53 ng/μmol Cre, and the medians of DPD were 1 325.58, 802.54, 752.38 ng/μmol Cre, respectively. The differences were statistically significant among the three groups ( H = 13.849, 34.621, P < 0.01). The contents of PYD and DPD in drug treatment group were lower than those in non-drug treatment group ( P < 0.05). Conclusion:Celecoxib and anti-osteogenesis tablets can reduce the urinary levels of PYD and DPD in adult patients with KBD.

Objective To study medial umbilical ligament in the prevention of recurrence of indirect inguinal hernia with large sac by laparoscopic treatment in children.Methods The clinical data of 178 cases of indirect inguihal hernia with large sacs in children were retrospectively analyzed.After high suture ligation of the internal ring with pediatric laparoscopy,all of the internal tings were covered with the same side of medial umbilical ligament to further strengthen.Results All cases were discharged from hospital 1～2 days after surgery.No recurrence and no any other complications could be found after following up 3～18 months.Conclusion Pediatric laparoscopic application of medial umbilical ligament to further cover the internal ring could significantly reduce the rate of recurrence for indirect inguinal hernia with large sac.This method of operation waft safe and feasible.It Was worth promoting.

Background:Screening of colorectal cancer (CRC) and colorectal adenoma (CRA), the precursor of CRC, is crucial for CRC prevention.It is believed that opportunistic screening of CRC in high risk population would narrow down the screening scope and save the health resources, and is suitable for the present status in China.Aims:To analyze the performance of high risk factors in predicting CRC/CRA, for exploring the feasibility of opportunistic screening for CRC in high risk population.Methods:A total of 1 862 outpatients and health examination subjects undergoing colonoscopy from Feb.2015 to Aug.2016 at the PLA 281 Hospital were recruited and asked to complete a questionnaire of high risk factors for CRC and CRA before colonoscopy.The questionnaire was designed based on the updated consensus on the screening and management of early colorectal cancer and precancerous lesion in China.Using the results of colonoscopy as gold standard, the predictive performance of high risk factors for CRC/CRA was analyzed.Results:Four hundred and sixty-eight (25.1%) individuals with high risk factors for CRC/CRA were screened out by the questionnaire.The detection rate of CRC in individuals with high risk factors was significantly higher than those without (17.5% vs.0.9%, P=0.000).The sensitivity, specificity, positive and negative predictive values of high risk factors in predicting CRC were 87.2%, 78.2%, 17.5% and 99.1%, respectively, and the missed diagnosis rate was 12.8%.For CRC/CRA, the corresponding figures were 83.2%, 87.0%, 57.3%, 96.1% and 16.8%, respectively.The risk ratios (RR) of high risk factors for CRC and CRC/CRA were 20.35 and 14.78, respectively.Conclusions:Opportunistic screening of CRC in high risk population is feasible and applicable in China under present condition.

BACKGROUND: Increasing evidence identifies the immune system not as an isolated system with automodulations, but one that interacts with the central nervous system.OBJECTIVE: To investigate the distribution of c-fos expression in the lung and brain tissues of asthmatic rats and explore is significance.DESIGN: Randomized controlled study.SETTING: Department of Oncology, Southern Hospital, and Department of Neurosurgery, Zhujiang Hospital, Southern Medical University.MATERIALS: The experiment was conducted Department of Oncology,Southern Hospital, and Department of Neurosurgery, Zhujiang Hospital,Southern Medical University, between January and August 2004. Fourteen healthy male rats were randomized into experimental group (n=10) and control group (n=4).METHODS: On the first day of experiment, the rats in experimental group received intraperitoneal injection of 2 mL of the suspension containing 10 mg albumen, 200 mg aluminum hydroxide powder and inactivated pertussis vaccine (5×109), and subjected to inhalation of ultrasonically atomized 10 g/L albumen from on the 15th day, 2 times per hour for totally 3 days, to induce asthma in the rats. The rats in the control group received intraperitoneal injection of 2 mL normal saline on the 1st day and inhalation of ultrasonically normal saline on the 15th day, 30 mL a day for totally 3 days. The lung and brain tissues of all the anesthetized rats were fixed by perfusion, and immunohistochemical method with ovin-biotin-peroxidase complex and imaging analysis system were used to observe the distribution of Fos protein in the lung and brain.MAIN OUTCOME MEASURES: Distribution of c-Fos protein in lung and cerebrum.c-Fos in the lung and brain tissues was obviously higher in asthmatic group than in the control group (P ＜ 0.05), located mainly in the parietal-fontal cortex, limbic forebrain (cingulum cortex, pyriform cortex and central amygdaloid nucleus and so on), thalamus paraventricular nucleus, hypothalamus paraventricular nucleus, supraoptic nucleus, lateral region of the hypothalamus, hypothalamus periventricular nucleus, nucleus of solitary tract,area postrema and ventrolateral medulla. No obvious Fos expression was observed in the cerebellum. A large number of c-Fos-positive cells were observed in the wall of the airway and lungs in asthmatic rats, mainly distributing in the mucous membrane and submucous layer and around the smooth muscles; in the control rats, no positive cells or only occasional cells with weak c-Fos positivity were found in the wall of the airway and lungs.CONCLUSION: c-Fos expression increases obviously not only in the lungs of asthmatic rats, but also in medullar and its ascending projecting nuclei (hypothalamus, amygdala and so on), suggesting that the expression of protooncogene c-fos might be closely related with neuroimmunomodulation in asthma.

Objective To explore the effects of Jiedu Quyu Ziyin Recipe (JQZR) on the apoptosis and expressions of bcl-2 and bax mRNA of peripheral-blood lymphocyte in MRL/lpr mice. Methods 80 MRL/lpr mice were randomly divided into model group,TCM group, Western medicine group and TCM and Western medicine group,20 mice in each group, meanwhile,20 Kunming mice were selected as normal group, then intragastrically administered normal sodium, JQZR apozem, prednisone suspension and JQZR apozem and prednisone suspension, 0. 5ml every time,once daily for 12 weeks respectively. At the end of the 12th week, peripheral-blood lymphocytes of every mice purified by gradient centrifugation were cultivated for 48 hours ,then the apoptosis was detected by flow cytometry. Furthermore,the expressions of bcl-2 and bax mRNA of peripheral-blood lymphocyte were detected by RT-PCR. Results At Oh or 48h,the apoptosis ratios of PBLC in normal group, TCM group,Western medicine group and TCM and Western medicine group are higher than model group and the differences are significant(P <0. 05 ,P <0. 01 ) ,while,at Oh,which are not significant within Western medicine group, normal group and TCM and Western medicine group ( P > 0. 05) ,even if which are significant between TCM group and TCM and Western medicine group or between model group and TCM and Western medicine group( P < 0. 05 ). At 48h, the differences of apoptosis ratios of PBLC are significant between Western medicine group and TCM and Western medicine group( P < 0. 05 ), and between TCM group and TCM and Western medicine group or between model group and TCM and Western medicine group which are significant, too( P < 0. 01 ). The ratios of bcl-2/bax mRNA of normal group,TCM group and TCM and Western medicine group are significantly lower than which of model group or Western medicine group ( P < 0. 05, P < 0. 05, P <0. 01 ,respectively) ,but there is no significant difference between which of model group and Western medicine group.Conclusion JQZR has adjustable effects on the apoptosis and expressions of bcl-2 and bax mRNA of peripheralblood lymphocyte in MRL/lpr Mice.

Objective To investigate the clinical manifestations and laboratory findings of patients with the late onset systemic lupus erythematosus(LOSLE) and the elderly onset SLE. Methods Forty one patients with SLE onset beyond the age of 50 years(including 20 patients SLE onset beyond the age of 60 years) were identified and compared with 41 patients who had SLE onset before the age of 50 (General SLE). Patients in the group of general SLE were selected by 1 to 1 individual matching according to sex, course of diseases, date of admission. The presenting clinical features, laboratory findings, incidence rate of complication, efficacy of glucocorticoid and the prognosis of patients in two groups of LOSLE and general SLE were compared and analyzed. In addition, 20 cases of elderly onset SLE were also compared and analyzed. Results There were significant differences in symptoms between groups of LOSLE and General SLE. The LOSLE group had less occurrence of rash (39 0% vs 73 2%, P

Background:Detection and removal of colorectal polyp by colonoscopy is of great importance for prevention of colorectal carcinoma. Aims:To investigate whether the clinical symptoms of patients undergoing colonoscopy may hint colorectal polyp and carcinoma,and provide reference for candidate selection in colonoscopic screening. Methods:A total of 2 366 patients undergoing colonoscopy were recruited and the history information such as symptoms at outpatient visits, site and nature of the lesions was collected for analyzing the detection rates of colorectal polyp and carcinoma and the correlations of clinical symptoms with the risk and site of the disease. Results:The overall detection rates of colorectal polyp and carcinoma were 20. 5% and 5. 4% ,respectively,in 2 366 patients. The detection rates were significantly higher in symptomatic patients than those in asymptomatic patients(24. 2% vs. 4. 5% for polyp and 6. 4% vs. 0. 9% for carcinoma,P all = 0. 000). Moreover,when patients were classified by major symptoms,the detection rate of colorectal polyp was significantly increased in patients with diarrhea(OR = 1. 213),hematochezia(OR = 2. 076),and changing of stool consistency(OR = 1. 503)(P all < 0. 05),and the detection rate of colorectal carcinoma was significantly increased in patients with abdominal pain( OR = 1. 568),hematochezia( OR = 2. 837),changing of stool consistency( OR =2. 206),and tenesmus( OR = 1. 735)( P all < 0. 05). The major symptoms being hematochezia,changing of stool consistency and tenesmus were associated with lesions locating at rectum or left hemicolon(P all < 0. 05). Conclusions:Diarrhea, hematochezia and changing of stool consistency hints risk for colorectal polyp, while abdominal pain, hematochezia,changing of stool consistency and tenesmus hints risk for colorectal carcinoma. Colonoscopy is strongly recommended for patients with these symptoms.

ObjectiveTo compare the clinical results of small surgical incision of bilateral spinous process and traditional open surgical incision in posterior single level lumbar interbody fusion,and assess the application value of the small surgical incision of bilateral spinous process in posterior single level lumbar interbody fusion.MethodsFrom December 2006 to June 2008,70 patients with lower lumbar vertebral diseases underwent single segment posterior lumbar interbody fusion.Patients were randomly divided into small surgical incision of bilateral spinous process group(Hereinafter referred to as small incision group) of 36 cases and 34 cases of conventional open group.Small incision group included 20 males and 16 females with an average age of 52.0 years.Traditional open group included 16 males and 18 females with an average age of 53.2 years.Two groups of operative time,blood loss,postoperative drainage,X-ray projection operation frequency,hospital stay,complication rate,creatine phosphokinase (CPK) level,multifidus cross-sectional area,postoperative low back pain visual analogue scale(VAS),Oswestry disability index(ODI),interbody fusion rate were compared,respectively.ResultsAll of 70 cases were followed up for 12-24 months (average,16).There were no statistically differences in the operation time,the number of X-ray projection,complication rate,and fusion rate between the two groups (P＞0.05),but there were significant differences in blood loss,postoperative drainage,the first day and the third day of postoperative the level of CPK,postoperative multifidus muscle cross-sectional area,postoperative low back pain VAS,hospital stay,and postoperative ODI between the two groups(P＜0.05).ConclusionSmall surgical incision of bilateral spinous process and traditional open surgical posterior lumbar interbody fusion were satisfied with the efficacy,but small surgical incision of bilateral spinous process with less trauma,shorter hospital stay,and rapid postoperative recovery.