Objective To study the effect of knee joint replacement on the elderly patients with osteoarthritis and the influence on the quality of life.Methods This study selected 68 patients(72 knees)with knee joint replacement, followed up for three months,with the aid of HSS scoring method,the function of knee joint and the change of quality of life before and after operation were compared.Results Compared with preoperation,the symptoms of pain[(25.1 ± 1.8)points vs.(13.1 ±1.9)points],activity[(13.1 ±1.3)points vs.(8.1 ±1.5 )points],functional recovery [(23.1 ±1.4)points vs.(9.1 ±3.9)points],muscle strength[(7.9 ±1.7)points vs.(2.1 ±1.3)points]and stability[(8.1 ±1.9)points vs.(4.1 ±2.9)points]were significantly improved after 3 months of operation,the differences were statistically significant(t =7.23,5.75,8.96,6.82,9.71,all P <0.05).Evaluation of the quality of life of the patients after the end of the follow -up period,the scores were significantly improved compared with the preoperation,the scores were increased,the differences were statistically significant(t =5.43,4.48,4.87,3.96, 2.57,2.79,all P <0.05).Conclusion The knee joint replacement can achieve the goal of effective treatment of senile osteoarthritis and can significantly improve the quality of life of the patients and patients'satisfaction.

Objective To develop an RP-HPLC method for simultaneous determination of mangiferin, tectoridin, iridin, tectorigenin, iristectorigenin B, iristectorigenin A, irigenin, dichotomin and irisflorentin in Belamcandae Rhizoma.Methods Separation was carried out on an LeapsilTM C18 column (100 mm×2.1 mm, 3 μm) with an isocratic mobile phase consisting of acetonotrile and formic acid at a flow rate of 0.5 mL/min; The detection wavelength was set at 265 nm; the column temperature was 40℃.Results The linear ranges of mangiferin, tectoridin, iridin, tectorigenin, iristectorigenin B, iristectorigenin A, irigenin, dichotomin and irisflorentin were 0.214 0– 2.568 μg (r=0.999 5), 0.437 0–5.244 μg (r=0.999 3), 0.460 0–5.520 μg (r=0.999 9), 0.078 40–0.940 8 μg (r=0.999 6), 0.138 0–1.656 μg (r=0.999 3), 0.051 00–0.612 0 μg (r=0.997 5), 0.113 0–1.356 μg (r=0.999 9), 0.051 63–0.619 6 μg (r=0.999 8) and 0.151 0–1.812 μg (r=0.999 9), respectively. The average recoveries were 97.73%, 96.81%, 97.78%, 97.55%, 96.86%, 98.60%, 97.77%, 98.04% and 97.89%, respectively; the relative standard deviations were 0.70%, 1.1%, 2.3%, 2.1%, 1.3%, 1.4%, 2.3%, 1.6% and 1.9%, respectively. This method was used to determine the contents of nine active ingrients in 5 batches of Belamcandae Rhizoma.Conclusion The method is accurate and reliable, which can be used for the quality control of Belamcandae Rhizoma.

AIM: To explore the changes in serum TGF ? 1 in type 2 diabetes mellitus. METHODS: Forty-five cases type 2 diabetes mellitus patients were divided into three groups according to urine albumim excretion rate(UAER): normoalbuminuria(NA)group and microalbuminuria(MA) group and macroalbuminuria group (Overt DN). Serum TGF ? 1, fasting blood glucose(FBG), HbA 1c ,BUN,Cr,Ccr,lipidemia were detected in all cases. RESULTS: Serum TGF ? 1 in NA, MA and ODN groups [(35.02?6.70) ?g/L, (39.31?5.35) ?g/L, (58.58?9.56) ?g/L, respectively] was higher than that in control [(23.95?8.01) ?g/L, P

Objective To investigate the situation of oxygen supplement and the incidence and clinical characteristics of long-term oxygen inhalation newborns in neonatal intensive care unit(NICU).Methods The records of oxygen supplement and the related clinical data of 12 155 neonates admitted in our NICU from Oct 2009 to May 2011 were collected and retrospectively analyzed.The results were compared with the data from a survey on 19 hospitals in China which reported by other authors.Results In 12 155 newborns,4 951 were full term,7 204 were preterm.One hundred and two patients (0.84％,102/12 155 ) accepted oxygen for more than 28 days.Among them,88 were preterm,14 were full term,with the average gestational age (31.16 ±3.70) weeks,the average birth weight (1.60 ±0.68) kg and the mean oxygen supplement period (40.60 ± 12.25) d.Finally,98 were cured or improved,4 died.The incidence of bronchopulmonary dysplasia (BPD) in 7 204 preterm infants was 1.22％ ( 88/7 204) according to the standard of continuous oxygen supply more than 28 days after birth.The incidence of BPD in preterm infants less than 32 weeks was 4.92％ (68/1 381 ) according to the standard of continuous oxygen supply more than 28 days after birth,while the rate was only 2.10％ (29/1 381 ) according to the standard of continuous oxygen supply more than 36 weeks postmenstrual age.The rates of BPD according to the two different standards were significantly different ( x2 =16.251,P ＜0.001 ).There were significant differences in the rate of supply oxygen( x2 =119.99) and supply oxygen time( F =109.27 ) among different gestational age groups in overall the 5 499 neonates ( P ＜0.001 ),but no significant differences in the average time of oxygen supply and mechanical ventilation among different gestational age groups in infants with long-term oxygen dependence ( P ＞ 0.05 ).There were significant differences in rates of pulmonary surfactant therapy,heart failure,retinopathy of prematurity,congenital heart disease,other congenital malformation and mortality among different gestational age groups in long-term oxygen dependence infants (x2 =8.789,13.538,23.176,7.778,8.842,8.246,P ＜ 0.05 ).As compared with the data from 19 hospitals,the corrected rate of long-term oxygen supplement in preterm infants in our hospital was obviously lower[0.99％ (71/7204) vsl.54％ (190/12 351),P ＜0.001].Conclusion Theincidence of BPD in our NICU is low.Lower gestational age,immature lung and secondary lung injury may be the mainly cause of neonatal long-term oxygen dependence,but some factors such as congenital heart disease,congenital malformations should be considered in more mature infants.The most appropriate standard for BPD still remains to be discussed.

Objective To summarize the characteristics of treatment and outcomes of extremely low birth weight infants (ELBWI).Methods The clinical data of 81 cases of ELBWI admitted to Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command from October 1st.2008 to August 31st.2011 were retrospectively analyzed.The survival rate and mortality of ELBWI with different gestational age and birth weight were compared with Chi-square test.Results Of 81 ELBWI,43 were male and 38 were female; the mean gestational age at birth was (28.4 ±2.1) weeks; the average birth weight was (903.5 ± 95.4) g.Complications of them included respiratory distress syndrome (68/81,84.0％),patent ductus arteriosus (47/81,58.0％),retinopathy of prematurity (41/81,50.6％),intraventricular hemorrhage (23/81,28.4％),bronchopulmonary dysplasia (17/81,21.0％),sepsis (15/81,18.5％),periventricular leukomalacia (2/81,2.5％) and necrotizing enterocolitis (1/81,1.2％).Among 81 infants,96.3％ (n =78)received oxygen inhalation with the average time was 19.1 d (median 11 d,0-121 d) ; 70.4％ (n=57)received pulmonary surfactant; 27.2％ (n =22) received nasal continuous positive airway pressure;34.6％ (n =28) received normal frequency mechanicalfrequency ventilation.All 47 ELBWI with patent ductus arteriosus received ibuprofen treatment,among which 6 cases received arterial canal ligation after failure of ibuprofen treatment.20 out of 41 cases of retinopathy of prematurity received laser surgery.Total parenteral nutrition was required in 74 infants(91.4％),the average age of beginning enteral feeding was 5.2 d (median 6 d,0-17 d)and achieved full gastrointestinal feeding time was 31 d (median 28 d,7-65 d).The survival rate of ELBWI with gestational age of ≤26,-28 and ＞28 weeks was 25.0％ (4/16),72.0％ (18/25) and 77.5％ (31/40),respectively; the corresponding mortality was 12.5％ (2/16),8.0％ (2/25) and 2.5％ (1/40),respectively.The survival rate of ELBWI with birth weight ≤800,-900 and ＞900 g was 33.3％ (4/12),58.3％ (14/24) and 77.8％ (35/45),respectively; and corresponding mortality of them was 16.7％ (2/12),8.3％ (2/24) and 2.2％ (1/45),respectively.Conclusions The outcome of ELBWI is closely related to gestational age and birth weight.Professional and sophisticated treatment might improve the survival rate and general outcome of ELBWI.

Objective To explore the reasons and preventive measures of early dislocation after total hip arthroplasty in elder patients. Method A retrospective study was done to analyze dislocation time, reason and time of 168 elderly patients with early anti-dislocation after total hip arthroplasty in joint surgery. Results Only 7 patients (4.1%) had type I joint dislocation, including 2 male and 5 female patients aged 65~89 years. The dislocation happened in 4~5 weeks postoperatively, mainly resulting from hip joint over flexion when urinating in bed, sleep-turning, loaded-moving, walking and stoop and diachoresis. Conclusions For the elderly patients after total hip replacement, it is type I dislocation which happened 4 ~ 5 weeks after operation, more femal than male, reasons including over-exercrse. Effective prevention measures includes regular rehabilitation training, early precautions enhanced mental support and safety nursing.

Objective To determine the incidence and risk factors of retinopathy of prematurity (ROP) in preterm infants.Methods Fundus examinations were performed by RetCam Ⅱ ophthalmoscopy on 2185 premature infants (birth weight ≤ 2000 g or gestational age≤34 weeks)admitted into the neonatal intensive care unit of Beijing Bayi Children's Hospital from January 1st 2009 to December 31st 2010.According to the results,all infants were divided into ROP group and nonRO P group.Two-sample t test and Logistic regression analysis were used to investigate the risk factors of ROP.Results Among 2185 premature infants,287 (13.1 ％) cases were diagnosed with RO P.According to International Classification of RO P,34 cases (11.9 ％) were in zone Ⅰ,147 cases (51.2％) in zone Ⅱ,and 106 cases(36.9％) in zone Ⅲ.And there were 117 cases (40.8％) with stage 1 lesion,142 cases (49.5％) with stage 2 lesion,28 cases (9.7％) with stage 3 lesion,and no stage 4 or 5 lesion was identified.Thirty-six cases (12.5 ％) were accompanied by additional diseases.Logistic analysis showed that small gestational age (OR=0.859,95％CI:0.770-0.958,P=0.006),low birth weight (OR=0.729,95％CI:0.6340.838,P=0.000),long duration of oxygen supplement (OR=2.221,95％CI:1.904-2.592,P=0.000),assistant ventilation (OR=3.104,95％CI:2.0964.956,P=0.000),apnea (OR=1.767,95％CI:1.103 2.831,P=0.018) and=anemia (OR=2.242,95％CI:1.641-3.604,P=0.000) were independent risk factors of ROP.Conclusions The incidence of ROP in premature infants is high.Small gestational age and low birth weight,long duration of oxygen supplement,assistant ventilation,apnea and anemia are risk factors of ROP.Preventive measures should be taken against these factors.

Objective Toinvestigateserumalanineaminotransferase(ALT)andtotalbilirubin(TB)concentrationsofchildrenin Panyu district of Guangzhou ,and establish the reference ranges for ALT and TB tests for healthy children of different gender and different age .Methods 4 065 children were chosen randomly ,and their serum ALT and TB were determined .After excluding the outliers ,the results were analyzed statistically .Results After excluding outliers ,a total of 4 000 children were enrolled in the stud-y ,including 2 241 males ,1 759 females ,aged 2- <9 years old .According to statistical analysis ,reference ranges were established . For male the ALT reference ranges were as follows ,2- <3 years old :5 .0-36 .0 U/L ,3- <4 years old :7 .0-21 .0 U/L ,4- <8 years old :6 .0-21 .0 U/L ,8- <9 years old :5 .0-24 .0 U/L ;TB reference ranges of male were as follows ,2- <3 years old :3-12μmol/L ,3- <7 years old :4-15 μmol/L ,7- <8 years old :4-16 μmol/L ,8- <9 years old :7-12 μmol/L .ALT reference range of female were as follows ,2- <3 years old :6 .0-30 .0 U/L ,3- <4 years old:7 .0-22 .0 U/L ,4- <9 years old :6 .0-19 .0 U/L ;female TB reference range ,2- <3 years old :3 .0-12 .0 μmol/L ,3- <4 years old :3 .0-13 .0 μmol/L ,4- <9 years old:4 .0-16 . 0 μmol/L .Conclusion Established the reference ranges of ALT and TB test for healthy children in Panyu district .

AIM:To explore the differential expression of interleukin-19 (IL-19) and its receptors (IL-20R1/IL-20R2) in the samples of chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP and CRSsNP), and to investigate the correlation of IL-19 and its receptors with tissue remodeling factors, including matrix metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP)-1 in CRS.METHODS:The polyps from CRSwNP patients (n=30), the sinus mucosa from CRSsNP patients (n=15) and the inferior turbinal mucosa of nasal septum de-viation patients (n=15) were collected.The expression of IL-19 and its receptors (IL-20R1/IL-20R2) in each group was detected by real-time RT-PCR and immunohistochemistry.The expression of tissue remodeling factors MMP-2, MMP-9 and TIMP-1 in different groups was detected by real-time RT-PCR and ELISA.RESULTS:Increased mRNA and protein expression levels of IL-19, IL-20R1, IL-20R2 and MMP-9 were observed in CRSwNP group compared with CRSsNP and control group (P<0.05), while elevated expression level of TIMP-1 was observed in CRSsNP group compared with CRSwNP and control group (P<0.05).The relative expression of MMP-2 among the 3 groups showed no obvious difference.The expression of IL-19 and its receptors showed significantly positive correlations with MMP-9 in CRSwNP (P<0.05).No significant correlation between IL-19 and/or its receptors with TIMP-1 in CRSwNP group was observed.CONCLUSION:The high expression levels of IL-19, IL-20R1 and IL-20R2 and their positive correlations with MMP-9 in CRSwNP indica-te that IL-19 and its receptors may be involved in the tissue remodeling of chronic rhinosinusitis.

The biosynthesis and maturation of proteins are primarily regulated by the endoplasmic reticulum in its physiological state. Thus, the disruption of physiological homeostasis initiates the buildup of unfolded and misfolded proteins in the endoplasmic reticulum, resulting in endoplasmic reticulum stress (ERS) and unfolded protein response (UPR). One of the important pathways by which UPR maintains intracellular homeostasis under ERS is activating protein kinase R-like endoplasmic reticulum kinase (PERK). The activation of the PERK pathway stimulates eukaryotic translation initiation factor 2 subunit-α (eIF2α) phosphorylation and the selective translation of active transcription factor 4 (ATF4), and PERK induces cell apoptosis by directly binding to the promoter of pro-apoptotic transcription factor C/EBP homologous protein (CHOP). This signaling pathway is also one of the important mechanisms by which UPR participates in the regulation of hematological malignancies and immune cells in a tumor microenvironment. This article provides an overview of advancements in research into the PERK-eIF2α-ATF4-CHOP signaling pathway in hematological malignancies and the potential therapeutic benefits of targeting this signaling pathway.