Objective To investigate the role of high-mobility group box-1 (HMGB1) in the pathogenesis and the treatment of rheumatoid arthritis (RA) and the pathogenesis of TWP in treatment of RA.Methods A rat model of collagen induced arthritis (CIA) was developed and CIA rats were divided into the model group, the TWP group, the MTX group and the combination treatment group. And the tissues and blood were drawn from the rats 4 weeks later. HMGB1 expression in synovium, joint and the sera were tested by immunohistochemical stain and ELISA. Results HMGB l expression of the model in the synovium, joint and serum [(23.8±2.2) ng/ml] were remarkably higher than the control [(7.4±1.6) ng/ml] (P＜0.01); HMGB1 expression of the treatment groups in synovium, joint and serum [ (13.3±3.1), (17.4±4.9), (11.7±1.5 ) ng/ml]is obviously lower than the model (P＜0.01), and were higher than that of the controls(P＜0.05). Conclusion HMGB1 participates in the hyperplasia of synovial membrane, cartilage and bone destruction of CIA. The molecular mechanism for the TWP and MTX in the trentment of synovitis and bone destruction of RA is correlated with the expression of HMGB1.

Four compounds were isolated from the ethanolic extract of the bark of Alseodaphnehainanensis Merr. , The structures were identified as: a neolignan eusiderin A [(7R, 8R)-3,4,5,3′-tetram-ethox-△8’，9’-8-o-4’，7-o-5’lignan]（I）two benzylisoquinoline alkaloids (6,7-dimethoxyisoquinolinyl)-(4′-methoxyphenyl) methanone(Ⅱ), and( 6, 7-methylenedioxyisoquinolinyl )-( 4′-methoxyphenyl ) methanone (Ⅲ), and 4-hydroxy-3-methoxy benzoic acid ( Ⅳ ) on the basis of HR-SIMS，1HNMR，13CNMRand 2D-NMR spectroscopic analysis. CompoundsⅠ～Ⅲ were obtained from the Alseodaphne genus forthe first time.

Objective To observe the effect of osteopontin (OPN) and integrin αtvβ3 in collageninduced arthritis (CIA) and the possible mechanism of Tripterygium wilfordii polyglycoside (TWP) in the treatment of rheumatoid arthritis (RA). Methods CIA rats model were developed and were randomly divided into the experimental group and the TWP group.And tissue samples were obtained 4 weeks later.Then the expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of each group were determined by immunohistochemical stain and ELISA.Variance analysis was used for data analysis.Results The concentrations of OPN of the normal controls,experimental group and the TWP group in the serum were (5.7±2.9), (7.8±6.2), (5.0±1.9) ng/ml respectively and there were significant differences between these 3 groups (F=6.74,P=0.016).The concentration of OPN (measured by mean grey value) in the synovium and cartilage of the three groups were 229±15,81±15,93±13 and 211±17,91±19,100±15 and there were significant differences between the three groups (F=52.48,P＜0.01; F=18.98,P=0.01).The concentrations of protein αvβ3 (measured by mean grey value) in the synovium and cartilage were 235±16,91±16,131±14 and 198±10,99±15,113±14,respectively and there were significant differences between the three groups (F=23.03,P=0.002; F=12.04,P=0.008).The expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of the experimental group were markedly higher than that of the controls.The expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of the treatment group were obviously lower than the experimental group.Conclusion OPN and integrin αtvβ3 are involved in the hyperplasia of the synovium,cartilage and bone destruction in CIA rats.The underlying molecular mechanism that TWP is effective in treating synovitis and bone destruction of RA is possibly related to down-regulation of the expression of OPN protein and integrin αvβ3.

Mesenehymal stem cells(MSCs)have been successfully isolated from almost all tissues in Mammals,and their multi-lineage differentiation ability leads to the attractive application of MSCs in regenerative medicine.More understanding of the biological characteristics of MSCs,the interaction between MSCs and the local environment,the molecules regulating MSC homing and differentiation have been achieved,which will benefit the effective clinical trials using MSCs as repair cells and/or vehicles for exogenous genes.

Objective To investigate the expression of osteopontin and matrix metalloproteinase-9 (MMP9),and the relationship of osteopontin and MMP9 in malignant melanoma.Methods Expression of osteopontin and MMP9 was measured by immunohistochemical SP method in 23 patients with primary cuta- neous malignant melanoma,17 patients with metastatic melanoma and 20 patients with pigmented nevus. Results Osteopontin and MMP9 were expressed respectively in 87.5% and 75.0% of 40 malignant melanoma specimens,15.0% and 10.0% of 20 pigmented nevus specimens.The expression of both osteo- pontin and MMP9 was significantly higher (both P＜0.05) in malignant melanoma than in pigmented ne- vus.There was no correlation between the expression of osteopontin and MMP9,with age,sex,lymph node metastasis or location of lesions (P＞0.05).Twenty-nine cases were positive for both osteopontin and MMP9,4 negative for either osteopontin or MMP9.Conclusion Both osteopontin and MMP9 were over- expressed in malignant melanoma,but neither was related to lymph node metastasis.

Objective To evaluate and analyse the effectiveness of surgical treatment for fibrous dysplasia in proximal femur with severe varus deformity.Methods A retrospective study was performed in 21 patients (24 femora)of fibrous dysplasia who were treated in our hospital between August 2000 and May 2009.All patients had severe femoral varus deformity.The four-step procedures were performed orderlv as valgus osteotomy,lesion curettage,impacting of massive bone allograft,and fixation by femoral intramedullary nail.There were 6 patients with monostotic disease,15 with polyostotic diseases,including 12 males and 9 females with a mean age of 22.7 years(range,14-39 years).The average neck-shaft angle and femoral varus angle was 75°(range 55°-105°)and 30°(range,18°-45°),respectively.The average length of thigh shortened 3.4 cm(range,2.0-4.5 cm)compared with the contralateral thigh.Results All of the 21 patients were followed up from 21 months to 7 years with an average period of 3 years and 4 months.There were 30 osteotomy sites in 24 femurs,28 osteotomy sites showed bone union after 3-6 months from surgery.Two distal location of the double-level osteotomy showed nonunion,which received bone grafting again and got bone union after 3 months finally.The femoral mechanical alignments of the 21 patients had been recriticd.The average neck-shaft angle was 118°(range,95°-135°)postoperatively,the femoral varus angle disappeared.The average extremity lengthening was 2.8 cm(range,1.8-3.6 cm)postoperatively.There were no infection,recurrent fracture and progression of deformity.The visual analogue scales(VAS)score of 17 patients decreased to zero postoperatively from 7-10 preoperatively,and that of the other 4 patients decreased to 3-4 postoperatively from 8-10 preoperatively.The result of Harris hip functional score was excellent in 12 cases,good in 6,and fair in 3.Conclusion The valgus osteotomy can rectify varus deformity effectively.The reconstract nail of the fumer can support the stability of femur.Impacting of massive bone allograft can improve the capacity of the femur.

Objective To analyse the clinical and therapeutic features as well as laboratory findings in bullous pemphigoid with non-bullous lesions as initial manifestation. Methods Clinical data on 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation were retrospectively analyzed. Results The male to female ratio was 1.83 :1, with a mean age of onset at 59.79±15.63 years. Before typical bullae appeared, patients presented with erythema, papules, papulovesicles' plaques" wheals, nodules,or erythema muitiforme-like lesions, with the most common lesions being erythematous papules and plaques (occumng in 35.29% of these patients). Conclusions Among these patients, nearly 1/3 displayed various skin lesions at the onset; simultaneous erythematous papules and plaques are the most common initial manifestation.

Objective To determine the risk factors associated with surgical site infection in closed calcaneal fractures.Methods A retrospective analysis was made on the clinical data of 312 patients with closed calcaneal fracture who had been treated by open plate osteosynthesis at our trauma centre from January 2008 to November 2014.They were 182 males and 130 females,from 18 to 75 years of age (average,44.3 years).By Sanders classification,52 cases were type Ⅱ,146 type Ⅲ,and 114 type Ⅳ.The fractures were caused by fall from a height in 159 cases,traffic accident in 97 ones,and crushing in 56 ones.All the patients received open reduction and internal fixation via a typical L-shaped lateral incision.Gender,age,cause for injury,smoking history,diabetes,interval between injury and operation,operation time and bone grafting were analyzed as possible risk factors in the study.Multivariate logistic regression was conducted for significant risk factors derived from the univariate analysis.Results The patients were divided into an infection group (28 cases,9.0％) and a non-infection group (284 cases,91.0％).The univariate analysis showed that the rate of smoking was significantly higher,the operation time significantly longer,the interval between injury and operation significantly shorter in the infection group than in the non-infection group (P ＜ 0.05).However,the logistic regression analysis revealed that operation time was the only independent risk factor for surgical site infection (P =0.005,OR =43.870).Conclusion Since operation time may be an independent risk factor for surgical site infection in closed calcaneal fracture,it is important to speed up surgery as quick as possible in control of surgical site infection as long as the surgical quality is ensured.

OBJECTIVE: To study the optimum supercritical- fluid extraction technique for Xiangjiang Granula essential oil. METHODS: The orthogonal test was adopted to optimize the extraction process using the content of Ligustilide and the yield rate of essential oil as indicators, and 95% ethanol as co- solvents. The content of Ligustilide was determined by HPLC, using Phenomenex Luna C18( 250nm? 4. 6nm, 5? m) as column and methanol- 0. 5% glacial acetic acid( 30∶ 70) as mobile phase, with the detection wavelength set at 280 nm. RESULTS: The optimal extraction conditions were: temperature at 50℃ , pressure at 45MPa, extraction time for 3h, and 95% ethanol as co- solvents. The Ligustilide had a good linearty relationship between 5. 1～ 25. 5? g? mL- 1( r=0. 999 8) . CONCLUSIONS: This technique is easy, convenient and workable, and can provide theoretical support for production.

Objective To understand health literacy levels in elderly people aged 60 years and above in Hunan, and explore factors related to health literacy.Methods Hunan residents aged 60 years and above were randomly recruited by the multistage stratified cluster sampling method.A total of 611 elderly people from 13 counties of Hunan were included in the study, which was conducted through questionnaires.Results The median health literacy score for elderly people aged 60 years and above was 51.00 (4-90), and it was lower than that for people under 60 years old, which was 56.00.Single factor analysis found that education level, occupation, number of family members, and household income each had an influence on health literacy scores (H=59.526, 20.609, 17.214, and 50.749, respectively;P=0.000, 0.002, 0.001 and 0.000, respectively).The number of people with basic health literacy accounted for 10.6％ (65/611) of the total.Multiple logistic regression analysis found that chronic disease was a factor affecting basic health literacy.Compared with elderly people without chronic diseases, a higher percentage of people with basic health literacy was among elderly people with chronic diseases (OR =1.870, 95％ CI: 1.037-3.373).Conclusions The health literacy level is lower in elderly people aged 60 years and above than those under 60 years old in Hunan.Only 10.6％ (65/611) of them show basic health literacy.Education level, occupation, number of family members, and household income are the factors related to health literacy.Health education about healthy lifestyle and behavior as well as chronic disease prevention and control should be increased in order to improve the health literacy level in elderly people.