Fifty-six cases of chronic low back pain were randomly divided into electroacupuncture group (n= 30) and control group (n= 26). Patients in electro-acupuncture group were treated with electro-acupuncture plus physical therapy, and patients in control group were treated with single physical therapy. The results showed that Electro-acupuncture plus physical therapy could obviously relieve pain, improve the patients' life quality, and its therapeutic effect was superior to that of the single physical therapy.

ObjectiveTo investigate the expression levels of vascular endothelial growth factor (VEGF)in knee synovial membranes and synovial fluids whether it could be a marker for progressive osteoarthritis.MethodsKnee synovial membranes and synovial fluids of patients with osteoarthritis who were underwent total knee arthroplaaty or arthroscopy were collected. They were classified into four groups according to the radiographic grading[Kellegren-Lawrence(K-L) grade]. Appoint K-L-0-grade patients who suffered from menisci injuries only served as controls. The levels of VEGF in the synovial fluid were measured by enzymelinked immunosorbent assay(ELISA) and VEGF-secreting cells were identified by immunohistochemistry.ANOVA was used for statistical analysis. ResultsVarious degrees of inflammation could be found in all the samplesevaluated histologically on HE-stained sections. Synovial tissue inflammation presented as synovial lining thickening, and inflammatory cells infiltration. VEGF expressed in the synovium linings and surrounding blood vessels. The VEGF levels in the synovial fluids were increased accordingly with K-L grades, which reached the peak level in the late stage of osteoarthritis. The levels of VEGF in the synovial fluids were significantly higher in patients with osteoarthritis[from (1181±116), (1632±140) to (2252±216) pg/ml]than in those with menisci injury (P＜0.01); The percent ages positive cell in each groups were (5±4)％ , (9±4)％,(16±6)％ and (21±6)％ respectively, there were significantly differences too (P＜0.01). ConclusionVEGF originated from synovial tissue may play a role in the pathogenesis of osteoarthritis. High levels of VEGF in the synovial fluids can be regarded as the marker of active osteoarthritis.

OBJECTIVE: To describe and analyze the clinical features of nasal respiratory epithelial adenomatoid hamartom and improve the levels of diagnosis and treatment. METHOD: Fourteen cases of nasal respiratory epithelial adenomatoid hamartom confirmed by pathology were collected and analyzed. RESULT: In 14 cases, primary complaint of Hyposmia(or Anosmia)and nasal obstruction were occured in 13 and 11 cases respectively. Four cases had past history of endoscopic sinus surgery because of the diagnosis of nasal polyps. Polypoid neoplasms could be seen in the bilateral olfactory clefts. Sinus CT showed soft tissue shadows in bilateral nasal cavity and mucous membrane thickening in different sinus. Endoscopic sinus surgery were utilized to eliminate focus in all cases. All cases weren t recurred after 2-20 months' following-up visitings. CONCLUSION Nasal respiratory epithelial adenomatoid hamartom is so rare that clinical and pathological doctors have limited knowledge of it. It has its own characteristics from the clinical symptoms, signs to sinus CT although they are nonspecific. So we should improve the understanding about it to avoid misdiagnosis or missed diagnosis.
Diagnosis, Differential ; Endoscopy ; Hamartoma ; diagnosis ; pathology ; surgery ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Polyps ; Neoplasm Recurrence, Local ; Nose Neoplasms ; diagnosis ; pathology ; surgery ; Paranasal Sinuses

Objective.To study the changes of microcirculation in patients with diabetic retinopathy(DR).Methods.Examination were performed in 153 cases of type Ⅱ diabetes mellitus, among them,72 cases were male,81 cases were female,mean age 57.0±10.0 years, mean disease course 8.2±7.5 years.All cases were examined fundi by ophthalmologist,urinary albumin excretion rate (UAE)in 24 hours was measured by radioimmunoassay.Moreover,we examined the blood glucose,blood pressure,blood viscosity and observed the changes of naifold microcirculation.Results.It was found that there were more evident disturbance of microcirculation,markedly slowed velocity of blood flow(P＜0.05),significantly increased aggregation of blood cells(P＜0.05)and exudation around the loop(P＜0.05)in the group with DR,compared with the group without DR.Conclusion.It was more evident disturbance of nailfold microcirculation in patients with diabetic retinopathy.

Objective:　To compare the dynamic changes of int erleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor (TNF) in intermingled skin graft with those in other types of skin grafts in rats. 　　Methods:　A 10%-15% third-degree burn was created in 180 Spreg ue-Dawley (SD) rats. After removing the scar, skin grafts were performed on the open wounds immediately with autoskin (aus, n=54), allosk in (als, n=54) and intermingled skin (n=36). That is to say, in the intermingled skin graft, a big piece of alloskin (mals) was grafted first, and 3 days later, small pieces of autoskin (maus) wer e embedded in the alloskin. The rest 36 rats were taken as the controls. And the biological activities of IL-1, IL-6 and TNF in graft sheets in each group wer e detected after skin graft. 　　Results:　The levels of IL-1, IL-6 and TNF in the aus group de creased steadily after their initial elevations, whereas in the als group they i ncreased significantly and kept on the peak level in the later phases. In the in termingled group, there appeared a lowest IL-1 level in the mals and a highest one in the maus simultaneously at 7 (4) days (The number out of parenthesis is t he days after transplanting with alloskin sheets, and the number in parenthesis is the days after embedding autoskin sheets in the intermingled skin graft. Simi larly hereinafter.) after skin graft (P<0.01), and the high level in the maus abruptly decreased at 14 (11) days after skin graft. At exactly the same phase on day 7 (4), a prominent peaked IL-6 in the mals occurr ed. In the later phases, the levels of TNF remained relatively low both in the m als and in the maus. From day 7 (4) on, each cytokine fluctuation in the mals sy nchronized with that in the maus. The longer the post transplantation period las ted, the more the positive cytokine correlated between the mals and the maus. 　　Conclusions:　The low levels of IL-1 and TNF may be important f actors to lighten the intensity of local rejection in the intermingled skin graf t. The temporarily peaked IL-6 is both an inducer which induces the production of local IL-1 receptor antagonists and soluble TNF receptors and a signal which indicates a local enhancement of Th2 cells. The mild rejection process and th e synchronized cytokine level during the later phases suggest a possible chimeri sm between the mals and the maus.

Objective To investigate the procedure and efficacy of medial patellofemoral ligament (MPFL) reconstruction assisted with arthroscopy for recurrent patellar dislocation in adolescents.Methods From March 2012 to March 2017,15 adolescents suffered with recurrent patellar dislocation,who underwent MPFL reconstruction operation,were all adopted with autograft semitendinosus.The patellar side used the modified bone tunnels and the minimally invasive percutaneous grafts through bone tunnels,and then fixed in the femoral tunnel with absorbable interference screw.Follow-up included complications,subjective feeling,patellar apprehension test,recurrent dislocation.Knee function was evaluated by the Kujala score and Lysholm score.Results 15 patients were followed up for at least 12 months.All patients were satisfied with the treatment.No recurrent dislocation occurred.All the patients showed negative apprehension test.The Kujala score was improved from 53.2 ±5.27 (preoperative) to 93.0 ±4.13 (postoperative),with significant difference (t =21.84,P ＜ 0.05);the Lysholm score was improved from 54.5 ± 6.24 to 91.2 ±4.72,with significant difference (t =19.37,P ＜ 0.05).Conclusions MPFL reconstruction assisted with arthroscopy is an effective surgical procedure for adolescent patients wih recurrent patellar dislocation,which can improve the knee function with little trauma and complications.

Objective To explore the repair of the open compound wounds in lower extremities caused by multiple factors. Methotis Transplantation of cutaneous.musculo-cutaneous or greater omentum flaps were applied to 155 patients of open compound lower extremity wounds. Results The wound healing rate following first operation was 50% and that following two operations was 14.8%.While the wounds were healed in 7.7% of patients after three operations. Conclusion Transplantations of cutaneous,musculo-cutaneous or greater omentum flaps ale effective to repair and reconstruct the open compound lower extremity wounds.

Objective To investigate the expression of transcription factor forkhead box protein O(FOXO)genes in gastric cancer tissues and their correlation and clinical significance with Helicobacter pylori(Hp)infection.Methods The expression levels of FOXOs genes(including FOXO1,FOXO3,FOXO4,and FOXO6)were detected by immunohistochemistry in cancer tissues and paracancerous tissues from 41 gastric cancer patients with Hp(-)and 29 gastric cancer patients with Hp(+),as well as in gastric tissues from 30 healthy individuals.The correlation between FOXOs expression and Hp infection,clinical pathological features was analyzed.The relationship between FOXOs expression and survival prognosis of gastric cancer patients was analyzed using the Kaplan-Meier plotter.Results Compared with those in the Hp(-)gastric cancer tissues,the expression levels of FOXO1,FOXO4,and FOXO6 were higher in the Hp(+)gastric cancer tissues(P<0.05).Meanwhile,the expression levels of FOXO1,FOXO3,and FOXO4 in the Hp(+)gastric cancer tissues were lower than that in the paracancerous tissues(P<0.05)and normal tissues(P<0.0001).The expression of FOXOs in gastric cancer tissues was closely correlated with the degree of differentiation,depth of infiltration,lymph node metastasis,and TNM stage of gastric cancer(P<0.05).Meanwhile,FOXO1/3 was associated with the survival prognosis of patients with gastric cancer.Conclusion Hp infection promotes the expression of FOXO1/4/6 in gastric cancer tissues.The high expression of tumor suppressor genes FOXO1/4 may be one of the reasons for better prognosis in Hp(+)gastric cancer patients.FOXOs genes are widely involved in regulating the disease progression of gastric cancer,which has certain value for disease treatment.

Background Climbing pylons during high-voltage cable maintenance is not only a labor-intensive task, but also a challenge bringing about heat stress and mental pressure from working at height, which may lead to accumulation of muscle fatigue and work-related musculoskeletal disorders. Objective To record the local muscle fatigue during a simulated climbing task by high-voltage cable electricians based on surface electromyography (sEMG) signals, explore the characteristic changes in sEMG signals and their relationship with subjective fatigue evaluation of the task, and provide data support for developing task specific objective assessment tools for local muscle fatigue and prevention of work-related musculoskeletal disorders. Methods Ten male college students were recruited to conduct a test of a simulated pylon climbing task. The climbing distance was 60 m, and a task segment was set for every 20 m (about 100 s), recorded as T1, T2, and T3, respectively. After completing each task segment, the subjects were required to rate their subjective fatigue using the Borg's RPE Scale. Fatigue was defined by rating of perceived exertion (RPE) score ≥ 14 in this study. The sEMG signals of trapezius, erector spinae, rectus femoris, and gastrocnemius muscles were recorded wirelessly. The standardized maximal voluntary electrical activation (MVE) obtained by standardizing the root mean square (RMS) of the time domain index and the median frequency (MF) of the frequency domain index were estimated for the recorded sEMG signals, and joint amplitude and spectrum analysis (JASA) was used to evaluate local muscle fatigue of target muscles involving in the climbing task. Results The RPE scores of T1, T2, and T3 were 11.9, 15.3, and 17.4, respectively. Subjective fatigue was found in T2 and T3 but not in T1. With the extension of climbing time, the MVE values of left and right erector spinae muscles, left and right rectus femoris, and right gastrocnemius muscle increased gradually, while the MVE values of left and right trapezius muscles and left gastrocnemius muscle increased first and then decreased. The MF values of left and right rectus femoris increased at first, then remained unchanged, while the MF values of the other muscles remained basically unchanged. In T1, three muscles, including left trapezius muscle and both side of erector spinae muscles, showed fatigue; in T2, five muscles, including both sides of erector spina muscles, right trapezius muscle, and both sides of gastrocnemius muscle appeared fatigue; in T3 , except for left rectus femoris, the other seven muscles were fatigue. Conclusion The characteristic changes of electromyography signals in the simulated climbing task are not completely consistent with the typical amplitude increase and left shift of the frequency spectrum of sEMG signals in static tasks, indicating that the application of time-domain and frequency-domain analysis methods in the evaluation of muscle fatigue in climbing tasks needs further discussion. Trapezius muscles and erector spinae muscles are the first to show fatigue in the simulation, and may be the sensitive muscle groups of muscle fatigue associated with climbing movement. Compared with subjective evaluation, surface electromyography is more sensitive in the assessment of body fatigue. Fatigue is reported about 100 s of climbing (the climbing length is about 20 m).

Objective:To systematically evaluate the dose-response relationships of resistance exercise intensity in frail elderly.Methods:A comprehensive search of randomized controlled trials on the dose-response relationships of resistance exercise for frail elderly in PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database. The documents that met the conditions were screened out, and after the data were extracted and the quality of the documents were evaluated, the RevMan 5.3 software was used for Meta analysis.Results:A total of 10 eligible randomized controlled trials were included in this study. The subjects of the study were 454 cases of frail and pre-frail elderly. After Meta analysis, there was a dose-response relationships between the training intensity of resistance exercise and the muscle strength, muscle endurance, and physical function of frail elderly. Both low-intensity and high-intensity resistance exercises can significantly increase the leg muscle strength of frail elderly people ( MD=4.58, 95% CI 3.34-5.82, P<0.05) and muscle endurance ( MD=12.27, 95% CI 6.54-17.99, P<0.05). Compared with low-intensity resistance exercise, high-intensity resistance exercise increased leg muscle strength of frail elderly people ( MD=7.97, 95% CI 0.85-15.09, P<0.05) and muscle endurance ( MD=6.94, 95% CI 5.21-8.66, P<0.05) showed more obvious advantages. The analysis of the results of the chair sitting test and the stairs climbing test shows that low-intensity resistance exercise has no obvious advantage in improving the physical function of frail elderly people, while high-intensity resistance exercise can significantly improve the physical function of frail elderly people ( MD=-5.8, 95% CI -7.3--4.29, P<0.05; MD=-1.20, 95% CI-2.17--0.23, P<0.05). Conclusions:Resistance exercise can significantly improve the muscle strength, muscle endurance and physical function of the frail elderly. High-intensity resistance exercise is more effective than low-intensity resistance exercise.