BACKGROUND: Under wear particles stimulation, mononuclear macrophages, fibroblasts, and osteoblasts can produce a large amount of inflammatory factors, leading to periprosthetic osteolysis. But the precise mechanisms remain unclear. OBJECTIVE: To analyze the molecular biological mechanism underlying osteolysis induced by titanium wear particles . RESULTS AND CONCLUSION: Cleaned titanium particles stimulation induced an unbalanced ratio of RANK mRNA to OPG mRNA. Over-expressed RANK bound to RANK ligand and promoted osteolysis. No RANK mRNA expression was detected in the LPS group, but OPG mRNA expression was transiently increased at 4 hours. NF-κB/inflammatory cytokine, rather than RANK/OPG, is the main signal pathway for LPS to induce osteolysis. After LPS binding to titanium particles, these two signal mechanisms, RANK/OPG and NF-κB/inflammatory cytokine, have synergistic effects during artificial joint loosening.

Objective To detect the impact of ultrasound elastography in diagnosis of prostatic cancer,and to evaluate its capability in differentiating benign from malignant lesions.Methods From June 2013 to February 2015, we selected 50 patients with different prostatic lesions,and suspicious for malignancy were included.All patients had a conventional B-mode ultrasound examination and color Doppler imaging,and then real time ultrasound elastography was performed in the same session.Finally,the results were compared to the histopathological results of those lesions. Results The addition of Strain ratio parameter for evaluating the elastography images showed the highest sensitivity of 74.2%,specificity of 73.7% and accuracy of 74.0% at a best cut off point of 5.5 between benign and malignant lesions.Conclusion Prostate US combined with elastography can be a helpful tool for guiding malignant lesions.Also it can help in targeting the biopsy site.

A gas chromatographic method has been developed for determining glycerin concentrations of both therapeutic and physiological levels in serum. The linear relationship was obtained in the range of 1.6-800 ug/ml and the coefficient variations determined within a day and between days were 2.2% and 2.4% respectively. Recoveries of glycerol from serum were about 87%.

Aim To develop a modified model of subarachnoid hemorrhage in rats. Motheds The SAH model was induced by injecting autologous blood into the cisterna magna without exposing the occipitoaxial ligament.The main modified point was a hole bored by a dental drill at the middle point of the boundary between the parietal bone and the occipital bone,then a catheter was inserted 8 mm to cisterna magna and the autologous blood was injected . Hemorrheological parameters were measured after the model was created.The intrinsic oversxidase method was used to show the microvessel of CA_1 region. The diameter, density ,and the aera of microvessel were measured and ananlyzed by Image-Pro Plus image analysis system. Results The total blood viscosity(?b) and erythroagglutation index(AL) in SAH model group increased significantly,however,the microvesse area and microvesse density in SAH model group decreased obviously. Conclusion The modified model of subarachnoid hemorrhage in rats is reliable and easy to operate on.

OBJECTIVETo evaluate the clinical efficacy and safety of phosphodiesterase 5 (PDE-5) inhibitors for erectile dysfunction (ED) in patients with diabetes mellitus and provide some evidence for the clinical treatment of the disease.

METHODSWe searched MedMed, EMbase, Cochrane Library, CNKI, Wan Fang Data, VIP and ZADL for randomized controlled trials on PDE-5 inhibitors for ED in diabetic men and evaluated the methodology of the included trials with the Jadad scale. We used the erectile function domain in the IIEF (IIEF-EF), IIEF questions (IIEF-Q) 3 and 4, SEP-2 and -3, and Global Assessment Questions (GAQ) as the main evaluation indexes and employed the Review Manager 5. 1. 0 software for meta analysis.

RESULTSA total of 13 studies were included, which were all high quality trials with Jadad score > 3. The IIEF-EF scores in 10 of the included studies were subjected to meta analysis using the random-effect model (REM), with a weighted mean difference (WMD) of 5.64 (95% CI 4.41 - 6.83, P < 0.001). The fixed-effect model (FEM) analysis of the IIEF-Q scores in 6 of the studies showed the WMD to be 0.96 (95% CI 0.83 -1.08, P < 0.001) for IIEF-Q3 and 1.11 (95% CI 0.98 - 1.25, P < 0.001) for IIEF-Q4. FEM analysis of the SEP-2 scores showed WMD = 17.67 (95% CI 12. 38 - 22. 97, P < 0.001) in 2 of the studies, and that of the SEP-3 scores WMD = 23.64 (95% CI 17. 49 - 29.79, P < 0.001) in 5 of the studies. The GAQ scores in 11 of the studies were subjected to REM analysis, with OR = 6. 20 and 95% CI 3.65 - 10.52 (P < 0.001). REM analysis was performed on the adverse reactions in 11 of the studies, with OR = 7.43 and 95% CI 4.11 - 13.44 (P < 0.001).

CONCLUSIONPDE-5 inhibitors can effectively and safely improve erectile function in patients with diabetes mellitus.

Objective To study the effect of Rho-kinase inhibitor on experimental allergic neuritis. Methods 54 female Lewis rats were divided into three groups; EAN group, EAN + Rho-kinase inhibitor group, and CFA group. The rats were sacrificed on the 9th day, 17th day, and 26th day after immunized. The changes of weight, EAN incidence, and mean day of onset, mean maximum clinical score, and histopa-thology were observed. Results The clinical course in EAN group reached peak on the 17th day. Compared with EAN group, the weights of Rho - kinase inhibitor group were increased, while EAN incidence, mean day of onset delay, and the clinical scores in Rho-kinase inhibitor group were significantly decreased, ( P < 0.01) , and the demyelization and inflammation cells infiltrating was ameliorated in spinal nerve. CFA group didnt show any clinical manifestation. Conclusions Rho - kinase inhibitor may ameliorate the development of EAN through inhabiting the Rho/ROK signal pathway.

Objective To summarize the experience in application of amputation of secondary structures of splenic pedicle and self-made spleen-removing bag in laparoscopic splenectomy the using 3-hole method. Methods The clinical data of 11 patients receiving the procedure from June 2007 to April 2009 in our hospital were retrospectively analyzed. Results Advantages of the procedure were less bleeding, small wound, quick recovery and no occurrence of postoperative complications. Six cases had slight postoperative pain. All 11 patients were cured. Conclusion The technique of amputation of secondary structures of splenic pedicle is safe and feasible in laparoscopic splenectomy using the 3-hole method.

Objective: To summarize the methods of preventing and managing the complications in thoracoscopic lobectomy. Methods:The participants of this study included 317 patients undergoing lobectomy with video-assisted thoracoscopic surgery in the Department of Thoracic Surgery between January 2007 and December 2012. Intra-operative complications were observed, and countermeasures were summarized. Results: Complications occurred 28 times (8.8%), including bleeding in 16 cases because of accidental vascular injury (5.0%), accidental injury/break of bronchus in two cases (0.6%), vascular stump errhysis from cutting stapler in four cases (1.3%), lung stump air leakage in three cases (0.9%), lung injury in two cases (0.6%), and diaphragmatic injury in one case (0.3%). Conversion to thoracotomy was conducted in 17 cases, with a conversion rate of 5.4%. Thoracoscopic repair operation was performed in 14 cases that exhibited bleeding, with a success rate of 70% (14/20). No mortality was reported during the operation. Conclusion:Thoracoscopic lobectomy is a highly difficult method in thoracic surgeries. The procedure requires substantial attention on the timely prevention and correct management of intra-operative complications, particularly the injury and bleeding of major vessels, to reduce the rate of conversion to thoracotomy and the incidence of post-operative complications, as well as to promote the surgery in clinics.

Objective To study the expression of mRNA of OX40 and OX40L in the sciatic nerve,spleen,peripheral blood mononuclear cells and lymph nodes of EAN under the influence of Rho-kinase inhibitor.Methods All 54 female Lewis rats were divided into 3 groups:the EAN group,the EAN+ Rho-kinase inhibitor group and the complete Freund's adjuvant(CFA)group.The rats were sacrificed at 9,17 and 26 days after immunized.Ox40 and OX40L mRNA were detected by RT-PCR which came from spleens,sciatic nerves,peripheral blood mononuclear cells and lymphonodes.Results In EAN+ Rho-kinase inhibitor group,the mRNA expression of OX40 were 0.266±0.031,0.298±0.024 and 0.113±0.018 at 9.17 and 26 days in the sciatic nerve,the expression were 0.453±0.030,0.496±0.100 and 0.220±0.016 in the lymph nodes.The mRNA expression of OX40L were 0.247±0.018.0.298±0.026 and 0.165±0.013 in the sciatic nerve,the expression were 0.283±0.027,0.306±0.011 and 0.161±0.012 in the lymph nodes.The mRNA expression of OX40 and OX40L in EAN+Rho-kinase inhibitor group was lower than EAN group at the three time points(t=2.24-4.89,P＜0.05),and the demyelination and inflammation cells infiltrating were ameliorated in spinal nerve.CFA group didn't show any clinical manifestation.Conclusion Rho-kinase inhibitor may ameliorate tlIe development of EAN through inhabiting the OX40 and OX40L activation.

Objective To study the clinical and pathological features in the elderly patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Methods The features of the clinical manifestation, cerebrospinal fluid, electromyogram(EMG) and the biopsy results of sural nerve were presented and analyzed in 11 elderly patients with CIDP. Results Two cases had history of upper respiratory tract infection before the onset. As the initial symptoms , there were three cases with distal limb numbness, five cases with both distal lower extremities numbness, two cases with both distal upper extremities numbness and one case with difficulties to raise his head. Motor disorder was common to all the patients. There were eight patients with sensory dysfunction, three with limb muscle atrophy, one with muscle tenderness, eight with tendon reflexes weakened or disappeared, five with cranial nerve damaged, three with the autonomic nerve lesion, one with respiratory muscle involved, three with relapse. The score of the peak incidence as Modified Rankin was 3.02 points on average. Five cases had obvious albuminocytolgoic dissociation by the examination of cerebrospinal fluid, ten cases had neurogenic damage and one case had a combined myogenic and neurogenic damage by the EMG. The biopsy showed that six cases were with amyelination,six cases with inflammatory cell infiltrated, two cases with obvious remyelination, two cases with auxiliary fibers degeneration.And the methylprednisolone therapy was effective for eight cases. Conclusions The numbness of the distal limb is the initial symptom of the elderly patients with CIDP,most of whom are with sensory dysfunction ,and some with cranial nerves and autonomic nerve damage. The sural nerve biopsy has an important value for the diagnosis of the elderly with CIDP. The methylprednisolone therapy is proved to be effective for most patients.