Objective To evaluate the clinical effectiveness of rotatory hinge prosthesis replacement for treatment of giant cell tumors around knee joint. Methods Thirty-one patients with giant cell tumors of bone around the knee from January 2001 to January 2008 in our hospital were reviewed. There were 13 males and 18 females. Their ages ranged from 19 to 56 and the mean age was 33.5. The anatomic site for the lesions were the distal femur (20 cases) and proximal tibia (11 cases). Using Companacci’s staging system: 7 patients were classified as grade Ⅱ and 24 as grade Ⅲ. The patients were grouped as follows: the tumor breaking through the cortex with an extraosseous mass in 2 patients,having pathologic fracture in 3,representing more biologically-aggressive lesions in 5,and having one or more local recurrences in 21. All patients had been treated with en block excision and reconstruction with rotatory hinge prosthesis. Results According to the follow-up for 12 to 96 months,all patients had no local recurrence or metastasis. The mean Musculoskeletal Tumor Society (MSTS) score was 24.0?2.5,with an excellent limb function in 23 patients,good in 6 patients,and fair in 2 patients. The overall excellent and good function was obtained in 93.5% of the patients. Conclusion Rotatory hinge prosthesis replacement is an effective method to treat giant cell tumors of bone around the knee joint. It also can reduce the local recurrence and obtain better the outcomes.

Objective To investigate the distribution of TCM Syndromes of Parkinson's disease(PD).Methods The 125 PD patients were graded according to Hoehn-Yahr(H&Y) criteria for assessment.The assigned TCM physician investigated TCM syndromes of these patients with the structured questionnaire which was based on literature and experience of experts.Results Of 125 cases,96 ones(76.8%) presented a single syndrome,and 29 ones(23.2%) presented complex syndrome.The positive rate of main syndrome was in an order of deficiency of both the Spleen and Kidney(22.4%),yin deficiency of the Liver and Kidney(18.4%),yang deficiency of the Spleen and Kidney(16%),qi deficiency of both qi and yin(15.2%),phlegm-heat stirring up the wind(12.8%),qi deficiency with blood stasis(4.8%),deficiency of both yin and yang(4%),damp abundance due to the Spleen deficiency(3.2%),endoretention of damp heat(1.6%),stagnation of the Liver qi with deficiency of the Spleen and Liver fire flaring(0.8%).There existed a significant difference in the distribution of TCM syndromes in H&Y 1.0~1.5 and H&Y 2.0~3.0(P

Objective To study factors that may increase the expression of human ? synuclein gene in prokaryotic cells. Methods proEXNACP vector was transferred into competence cells. Factors such as IPTG levels, initial concentration of cells, type and pH of media, time and temperature of induction were studied in relation to the production of ? synuclein. Results IPTG concentration and pH change does not have a significance impact on ? synuclein production. But the time and temperature of induction, media and initial concentration of cells significantly affected the expression.Conclusion The best condition for the production of ? synuclein includes factors such as LB media with an initial concentration of cells of 0 5\|0 8 A at 37℃ culture with oxygen of 180?rpm/min for 1 2?hours.

Axial symptoms of Parkinson's disease, such as gait disturbance and postural instability, do not respond well to anti-Parkinson drugs or deep brain stimulation.It has been reported that spinal cord stimulation can improve these symptoms, but the effects are not consistent.This article reviews animal experiments and clinical trials on spinal cord stimulation in the treatment of Parkinson's disease, in order to explore the mechanisms of action of spinal cord stimulation and give some suggestions for future research and clinical application.

Objective To detect the salivary levels of IgA,alpha-amylase and acetylcholinesterase (AChE) and saliva flow rates of IgA in normal controls versus Parkinson disease (PD) patients,and to analyze the correlation of these salivary biochemical indexes with disease duration,H&Y rating scale,SCOPA-AUT score,sialorrhea score,dry mouth score and the use of levodopa.Methods Thirty-eight PD patients including twenty-two patients treated with levodopa,and twenty-one normal controls were selected in our study.About 3 ml saliva was collected from each subject.Salivary IgA was detected by immunoturbidimetry.Alpha-amylase and AChE were tested by enzymatic colorimetry.The protein concentration was analyzed by BCA kit to normalize ACHE.The salivary flow rate and IgA flow rate were also calculated.Results Salivary flow rate (ml/min) was (0.39±0.22) in normal controls,and (0.35±0.28) in PD groups;the level of IgA (mg/L) was (148.3±86.1) in normal controls,and (183.7±126.3) in PD groups;IgA flow rate (μg/min) was (47.8±25.9) in normal controls,and (46.9±27.1) in PD groups;the level of alpha-amylase (U/L) was (1.63 ± 1.21) × 105 in normal control,and (1.35 ± 9.87) × 105 U/L in PD group;and the level of AChE (U/mg) was (0.12±0.08) in normal controls,and (0.09±0.05) in PD group.No statistically significant differences in above indexes were found between PD group and controls.There were negative correlations between salivary flow rate and dry mouth score (r =-0.445,P =0.005) and between alpha-amylase concentration and sialorrhea score (r=-0.327,P=0.045).The positive associations were found between IgA concentration and the SCOPA-AUT score (r =0.438,P =0.006),and between IgA flow rate and sialorrhea score (r =0.411,P =0.01).Conclusions Salivary flow rate and level of alpha-amylases tend to be decreased in PD patients,while IgA concentration has an upward tendency.Salivary alpha-amylases concentration and IgA flow rate are correlated with the symptom of sialorrhea,while IgA concentration correlates with the degree of autonomic symptoms.These measurements can be used as indexes for evaluating the lesions of the autonomic nervous system.

Objective To determine the interleukin(IL)-17 concentrations in serum and synovi-al fluid from patients with knee osteoarthritis(OA),and evaluate their correlation with disease severity. Methods Serum and synovial fluid were collected from 100 patients with primary knee OA;age-and sex-matched 50 healthy subjects provided serum samples as controls.OA severity and grade were assessed u-sing the Lequesne index and Kellgren and Lawrence(K-L)grading system,respectively.The expression of IL-17 was quantified by enzyme-linked immunosorbent assay.Results Serum IL-17 concentrations were significantly higher in patients than in controls(P <0.05).In the patient group,patients with K-L grade 3 and 4 had higher synovial IL-17 levels than those with K-L grade 2(P <0.05).At the same time,com-pared with K-L grade 3,there was a higher IL-17 level in K-L grade 4 patients(P <0.05).Synovial fluid IL-17 concentration was positively correlated with Lequesne index(r =0.6232,P <0.05).There was no correlation between serum IL-17 concentrations and Lequesne index,however.Conclusion The expres-sion of IL-17 was significantly increased in serum and synovial fluid of knee from patients with knee OA. There was a positive correlation between synovial fluid IL-17 concentrations and OA severity.It suggests that the imbalance of IL-17 expression plays a certain role in the pathogenesis of OA.

Objectives This study was to describe the prevalence of depressive and/or anxiety symptom and disorder in outpatients with irritable bowel syndrome (IBS) or functional dyspepsia (FD) in the comprehensive hospitals in big cities, China. Methods This was a hospital-based cross-sectional study conducted in three main cities in China in 2004. Six hundred and eight eligible subjects with IBS or FD were recruited consecutively from the outpatient departments within 3 months. Face-to-face interview was used in data collection together with the self-completed HAD scale for depressive and/or anxiety symptom screening. Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with HAMA scales and HAMD scales by the licensed psychologists or psychiatrists. Results The prevalence of depressive and/or anxiety symptoms was 24. 8% and 23. 6% respectively in outpatients with IBS or FD. And among detected depressive and/or anxiety symptoms, the prevalence of depressive and/or anxiety disorder was 69. 6% and 68. 7% respectively; Less than 12% of subjects had obtained a diagnosis of depressive disorders and been treated, and less than 8% of subjects had obtained a diagnosis of anxiety disorders and been treated prior to the investigation. The prevalence of anxiety symptom in female patients with IBS was significantly higher than male patients (17. 0% vs. 8. 7%; X2=4. 432,P = 0. 035); among detected depressive and/or anxiety symptoms, the prevalence of depressive disorder, anxiety disorder, depressive and anxiety disorder and depressive and/or anxiety dis order in female patients with IBS were higher than those in male patients (52. 6%vs. 25. 0% ,X2 = 4. 612, P=0. 032; 79. 5% vs. 53. 8%,X2=4. 815, P = 0. 028; 51. 4% vs. 21. 7%,X2=5. 112,P = 0. 024; 78. 6% vs. 55. 6%,X2=4. 112,P = 0. 043). Conclusions It is important for healthcare providers and health policy makers to note that the prevalence of depressive and/or anxiety symptoms and depressive and/or anxiety disorders are high and the percentages of previous diagnosis and treatment in outpatients with somatic diseases in general hospitals of urban China are rather low.

Objective To study the chitin enzyme protein(YKL-40),sCD40L,AFP and the correlation of hypertension with cor-onary heart disease(CHD).Methods 75 cases of elderly patients with CHD were selected as observation group,and then were di-vided into hypertension group and non hypertension group according to the blood pressure.103 cases of healthy elderly were select-ed as control group.ELISA method was used to detect YKL-40 and sCD40L,and AFP was detected by chemiluminescence immuno-assay.Results Clinical data comparison revealed that the relative risk of CHD with hypertension group and non hypertension of hy-perlipidemia,drinking,smoking,diabetes mellitus,were 1.56,1.33,1.23,1.15 times,data show that relative risk of CHD with hy-pertension were much greater than CHD without hyperlipidemia.The concentration of YKL-40 in CHD with hypertension(92.66± 12.04)ng/mL was significant higher than that in CHD without hypertension (57.08 ± 10.07 )ng/mL,and the concentration of sCD40L in CHD with hypertension (186.59 ± 69.63 )ng/mL was significant higher than that in CHD without hypertension (128.14±48.37)ng/mL(P <0.05).There was no significant difference in the concentration of AFP in patients with CHD with hy-pertension and non hypertension(P >0.05).Conclusion The levels of YKL-40,CD40L and AFP in the peripheral blood of elderly patients with CHD were significantly increased.And the concentration of sCD40L and YKL-40 was positively correlated with hy-pertension,which can be used to assess the stability and prognosis of CHD.

Objective To discuss the clinical application of MSCT-guided BARD gun biopsy in diagnosing pulmonary lesions. Methods Under MSCT-guidance percutaneous transthoracic biopsy of lung with BARD gun was performed in 68 patients with pulmonary lesions. Results All the procedures were well performed with the technical successful rate of 100%. The final diagnosis was based on the pathological findings or clinical follow-up observation. The accuracy of the qualitative diagnosis was 94.1%. Of 68 patients, squamous cell carcinoma was found in 30, adenocarcinoma in 21, metastases in 7, inflammatory pseudotumor in 3, lung abscess in 2, and tuberculosis in one. The false-negative rate in making diagnosis was 5.9%. The complication occurrence was 8.8%. Conclusion BARD gun has the advantage of making coaxial- multipoint biopsy. With the help of MSCT-guidance and the full use of the operating advantage of BARD gun, this technique is safe and reliable, with higher accuracy and less complications.