BACKGROUND: Conservative treatment of osseous gonarthritis (OG) is mainly to reduce the loading of knee joint and maintain muscle exercise,and non-steroidal anti-inflammatory drugs serve as supplements in case of acute occurrence.OBJECTIVE: To investigate the effect of combination of intraarticular in jection of hyaluronate and pain-point injection of betamethasone in improving the pain symptom in patients with OG.DESIGN: Open experiment.SETTING: Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: We selected 45 OG patients, who were aged 40 to 85years and received treatment in the clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between January 2004 and October 2004.METHODS: OG parenteral solution was intraarticularly injected into the knee joint, 2.5 mL once a week, 5 weeks set as a disease course. Pain points around knee joint were searched for following thorough physical examination. Anti-inflammatory analgesic solution of 2.0-3.0 mL was injected at each pain point. Physical examination was repeated before treatment in each week. Injection at pain points was maintained if they were still present. Intraarticular injection of hyaluronate was performed only when the pain points disappeared after treatment.MAIN OUTCOME MEASURES: ① Pain score at rest and at exercise.② Time when pain disappeared and times of betamethasone administration.RESULTS: Totally 45 patients entered the result analysis. ① Pain at rest and at exercise 1 week after combination treatment of intraarticular injection of hyaluronate and pain-point injection of betamethasone was ignificantly lessened compared to that before treatment (P ＜ 0.01). Pain relief was more significant at rest than at exercise (P ＜ 0.01). ② Pain disappeared at (17.07±6.00)days after treatment on average. The average times of betamethasone administration was (2.42±0.78) times. ③ No local joint pain and other adverse reactions occurred after administration in any case.CONCLUSION: Combination of intraarticular injection of hyaluronate and pain-point injection of betamethasone can effectively relieve the pain symptom of osseous gonarthritis, with no obvious adverse reactions.

Objective To investigate the correlation between Toll-like receptor 4 (TLR4) single nucleotide polymorphism (SNP) and the risk,severity and prognosis of sepsis in Chinese patients of Han nationality.Methods One hundred and three Han nationality patients who developed sepsis after surgery,aged 18-80 years,were enrolled in the sepsis group,and 114 Han nationality patients without sepsis after surgery,aged 18-80 years,were enrolled in the control group.Venous blood samples were taken from the peripheral vein and three SNPs in TLR4 gene,rs10759932,rs11536889 and rs2737190,were genotyped by matrix-assisted laser desorption ionization time of flight mass spectrometry analysis.Correction for Logistic regression analysis was made to eliminate the effects of sex,age,underlying diseases and operation methods.The correlation between genotypes of SNP and occurrence of sepsis,organ dysfunction,septic shock and death from sepsis was analyzed.The odds ratio (OR) and 95％ confidence interval (Cl) were calculated.Results Compared with the control group,there was a significant difference in genotype frequency ratios of rs10759932 (P ＜ 0.05),but there was no significant difference in genotype frequency ratios of the other two SNPs in sepsis group (P ＞ 0.05).There was correlation between rs10759932 and the occurrence of sepsis,and the variant allele (CT + CC genotypes) of rs10759932 increased the risk of sepsis (OR =1.86,95％ Cl 1.17-2.97,P ＜ 0.05).There was no correlation between the three SNPs and sepsis-related organ dysfunction,septic shock and death from sepsis (P ＞ 0.05).Conclusion There is correlation between the variant allele of TLR4 rs10759932 and the increase in risk of sepsis after surgery in Chinese patients of Han nationality.

Objective To explore the CT and MR imaging features of nodular fasciitis(NF), which will in return improve the standard and quality of diagnosis. Methods CT (n = 4) and MRI (n = 5) findings of pathologically proved nodular fasciitis in 9 patients were retrospectively analyzed. Results Of 9 NF, 5 were located in the lower extremities, 2 in the abdominal wall, and the others in the acoustic duct. The resected tumor size vary from 1.1 to 9. 5 cm in the largest diameter and mean (3.7±0.3) cm. All lesions appeared as a discrete solid mass on imaging. The CT value of lesions was similar to muscle. MR imaging manifested as a hypo to isointense lesion on T_1WI and hyperintense signal intensity on T_2WI. There was homogeneous or heterogeneous moderate to significant enhancement in the lesions. Conclusion CT and MRI can provide helpful information for the clinical and differential diagnosis of NF.

Objective To investigate the value of the boundary sign and cortex sign in differential diagnosis of solitary brain metastasis and astrocytoma. Methods Thirty-one patients with high grade astrocytoma and 42 patients with solitary brain metastasis diagnosed either pathologically or clinically were included in this study. The differential diagnostic value of the boundary and the cortex sign were analyzed retrospectively. Results The boundary sigh was found in 39 of 73 patients, which included 32 patients with solitary metastasis and 7 patients with astrocytoma. The sensitivity and specificity of the boundary sign was 76.20% and 77.42%, respectively, and the positive predictive value for solitary metastasis was 82.05%. The cortex sign was found in 34 of 70 patients, including 25 with astrocytoma and 9 with solitary metastasis. The sensitivity and specificity of the cortex sign was 80.65% and 78.57%, respectively, and the positive predictive value for astrocytoma was 73.53%. The boundary sigh was singlely foundin 24 patients, including 21 with astrocytoma and 3 with solitary metastasis. The area under the curve for both two signs was 0.85. Conclusion The boundary sign and the cortex sign are specific signs in differentiation between solitary brain metastasis and astrocytoma on routine MR series. Combination of this two signs is very useful in distinguishing solitary brain metastasis from astrocytoma.

Objective To evaluate the value of iterative modal reconstruction (IMR) for reducing radiation dose and controlling image quality in cardiac CT. Methods Ten pigs were included. All pigs were scanned on a 256?slice prospectively ECG?gated cardiac CT utilizing routine dose (group A) and tube current reduced by 30%(group B), 50%(group C) and 70%(group D), respectively. Filtered back projection (FBP), hybrid iterative reconstruction (iDose4) and IMR were used for all data, respectively. Image noise and contrast?to?noise ratio (CNR) of ascending aortic root were measured, while overall image quality and coronary artery image quality was rated (five point scale). All results reconstructed by FBP, iDose 4 and IMR were compared. Objective measurements were compared with one?way analysis of variance, and subjective assessments were compared with Kruskal?Wallis H test andχ2 test. Results Compared with that of FBP and iDose4, image noise of IMR was(15.1 ± 6.1),(18.8 ± 5.5),(22.1 ± 4.8)and(33.0 ± 4.0)HU, respectively in group A, B, C and D with significant reduction (F=82.77, 90.71, 96.59, 95.51 respectively, all P<0.01). Using IMR, groups A, B, C, D had higher CNR (42.0±11.1, 37.2±10.4, 31.4±8.7, 23.7±7.0;F=50.65, 53.55, 76.60, 57.36, all P<0.01) and overall image quality (5.0 ± 0.0, 4.8 ± 0.4, 4.6 ± 0.5, 4.5 ± 0.5;H=20.96, 15.63, 18.66, 23.56, all P<0.01) than FBP and iDose4. Using IMR, group A (100%, 40/40) and group B (100%, 40/40) had no significant difference (P>0.05) in the diagnosis rates of proximal coronary arteries compared with that using FBP and iDose4, while group C (100%, 40/40) and group D(92%, 37/40) had significantly increased diagnosis rates (χ2=20.05, 45.72, both P<0.01). The diagnosis rates of distal coronary arteries of IMR reconstruction which were 100%(50/50), 98%(49/50), 90%(45/50), 78%(39/50), respectively in groups A, B, C, D had significant increase compared with that of FBP and iDose4 reconstruction (χ2=7.39, 16.75, 34.62, 81.33, all P<0.05). Conclusions IMR can significantly reduce image noise, improve CNR and image quality compared with iDose4. Application of IMR can reduce radiation dose but without compromising image quality.

Objective: To investigate the clinicopathological features and immunophenotype of inflammatory myofibroblastic tumor (IMT) and their relationship with IMT diagnosis and prognosis. Methods:A total of 11 IMT cases with follow-up were analyzed morpho-logically and immunohistochemically. Results:The patients included 6 men and 5 women aged 13-66 years. The tumors were found in various anatomical sites, including lung, mediastinum, liver, intra-abdominal, and bladder. Histologically, the majority of the cases com-prised spindled fibroblastic and myofibrobalstic cells accompanied by chronic inflammatory cells in a myxoid or hyalinized stroma;the rest were individual cases of abscess formation. Prognosis mala was indicated for cases with features including atypia tumor cells with two cases demonstrating epithelioid morphology and nucleoli. Immunohistochemical study showed that vimentin, ALK, SMA, S-100, CD117, and CD34 were expressed in 91%(10/11), 55%(6/11), 100%(11/11), 27%(3/11), 18%(2/11), and 9%(1/11) of IMT, respective-ly. Ki-67 was expressed from 3%-40%respectively. CK, H-caldesmon, and DOG1 were negative in all cases. Follow-up data were avail-able for 11 patients and ranged from 4 to 22 months. Data showed that 7 patients were alive with no evidence of disease;4 patients were alive with tumor, whereas 3 showed aggressive biological behavior. Conclusion:IMTs had intermediate behavior or malignant po-tential. Most IMTs with aggressive behavior showed a minority of tumor cells with atypia, epithelioid morphology, and nucleoli. High proliferation index expression, ALK, SMA, and H-caldesmon can aid in IMT diagnosis.

Objective To establish reference values for blood pressure in cynomolgus monkeys in different ages.Methods The blood pressures and blood lipids indexes were detected in 521 cynomolgus monkeys using an American BECKMAN-CX4 automatic biochemical analyzer and a wrist electronic blood pressure monitor.Statistical tests were performed to analyze the data.Results Significant differences were found in blood pressure values of cynomolgus monkeys in different ages.Blood pressure values in the elderly group were higher than those of other groups.The morbidity of hypertension in the elderly group was higher than those of the other groups.Body mass index (BMI) in the hypertension group was higher than that of normal group in the same age.The incidence of hypertension in the elderly group with hyperlipemia was higher than that of other groups.Logistic regression analysis showed that age, BMI and hyperlipidemia in the hypertensive group were 1.435, 1.218, and 2.337 times higher than those of the normal group when predicting the risk of hypertension.Conclusions We have initially established reference values of blood pressure in cynomolgus monkeys in different ages.Age, BMI and hyperlipidemia are risk factors of spontaneous hypertension in cynomolgus monkeys, and the measurement of blood pressure may provide a basis for the screening of cynomolgus monkey model of spontaneous hypertensive and related research.

Objective: To observe the effect of the application of the "3Y" shape Multipore tape combined with transparent dressing in the maintenance of double lumen PowerPICC. Methods: Totally150 patients inserted double lumen powerPICC were randomly assigned to experimental group and control group, each group included 75 patients. when maintaining PICC, the "3Y" shape Multipore tape combined with transparent dressing were used for experimental group, while traditional method were used for control group. The endpoints were: the time for dressing change,the incidence of catheter migration,the incidence of dressing rolling or loosing,the incidence of PICC related complications. Results: The time for dressing change of experimental group (13.14±0.23) min was significant longer than control group (12.99±0.24) min (t=4.025, P<0.05) ; incidence of catheter migration of experimental group (5.3%,4/75) was significant lower than control group (18.7%, 14/75) (χ²=6.424, P=0.04). Incidence of dressing rolling or loosing of experimental group (9.3%,7/75) was significant lower than control group (22.7%,17/75)(χ²=7.028, P=0.03). Incidence of complication of experimental (1.3%, 1/75) was significant lower than control group (9.3%, 7/75) (χ²=4.754, P=0.03) . Conclusions Application of the "3Y" shape Multipore tape combined with transparent dressing in the maintenance of double lumen PowerPICC cost a little bite more time,while reduce the incidence of catheter migration and related complications, improve patients′degree of comfort, worth to be widely used.

Objective To explore connective tissue growth factor(CTGF)and transforming growth factor β1(TGF-β1)detection levels in serum and bronchoalveolar lavage fluid of patients with chronic obstructive pulmonary disease(COPD)and significance.Methods Totally 65 patients with COPD treated in the hospital from March 2016 to March 2017 were selected as the subjects,the patients were divided into acute exacerba-tion group(32 cases)and stable phase group(33 cases)according to the severity of the disease.Another 35 cases of physical examination in the hospital were selected as the control group.Serum and bronchoalveolar lavage fluid CTGF and TGF-β1 levels were detected by using enzyme-linked immunosorbent assay(ELISA) method,and lung function index,such as forced vital capacity(FVC),forced expiratory volume(FEV1),and FEV1/FVC of patients with COPD were detected,and the relationship was analyzed of CTGF and TGF-β1 in serum and bronchoalveolar lavage fluid and lung function.Results CTGF and TGF-β1 levels in serum and bronchoalveolar lavage fluid in acute exacerbation group were significantly higher than those in stable group and control group(P<0.05).CTGF and TGF-β1 levels in serum and bronchoalveolar lavage fluid of the sta-ble group were significantly higher than those in the control group(P<0.05).Lung function results showed that lung function index FVC,FEV1 and FEV1/FVC value in acute exacerbation group decreased significantly when compared with those in stable group and the control group(P<0.05).FEV1 and FEV1/FVC in the sta-ble group was significantly lower than that in the control group(P<0.05).CTGF expression level was posi-tively correlated in serum and bronchoalveolar lavage fluid of acute exacerbation group,and TGF-β1 was also positively correlated.Serum CTGF and TGF-β1 levels were positively correlated,and CTGF and TGF-β1 in alveolar lavage fluid were also positively correlated.Serum CTGF and TGF-β1 levels were negatively correla-ted with FVC,FEV1,FEV1/FVC,and CTGF and TGF-β1 in alveolar lavage fluid were negatively correlated with FVC,FEV1 and FEV1/FVC respectively.Conclusion The high expression of CTGF and TGF-β1 is closely related to the occurrence and development of COPD,and it can be used as an index for monitoring the condition of COPD.

Objective To study and analyze the CT and MRI findings of hepatic eosinophilic infiltration. Methods Twenty nine patients of hepatic eosinophilic infiltration who were confirmed by biopsy or clinical diagnosis were retrospectively analyzed. All the patients underwent CT and/or MRI scan. Twenty seven cases underwent upper abdominal CT plain scan and three phase enhanced scan, and 5 cases underwent upper abdominal MR plain scan and three phase enhanced scan, of which 3 cases underwent CT and MRI scan. Evaluations were made regarding to the numbers of lesion, distribution, size, shape, margin, density or signal characteristic, enhancement parttern and other special features. Pearson correlation analysis was used to analyze the correlation between the number of hepatic lesions and the number of eosinophils in peripheral blood. Results A total of 108 lesions of eosinophilic hepatic infiltration were observed in 29 cases, including 2 cases with single lesion and 27 cases with multiple lesions. Ninety five of the lesions were located in subcapsular parenchyma or surrounding the portal vein. Most subcapsular lesions were wedge-shaped(n=28). Lesions surrounding portal vein were round-shaped(n=32), while the hepatic parenchymal lesions were irregular or round-shaped(n=13). The mean size of lesion was 34 mm, ranging from 3 to 61 mm. The margin of all the lesions were obscure. The lesions showed slightly low density or isodensity on CT pre-contrast images. On MR pre-contrast images, lesions showed slightly low signal or isointense on T1WI, and hyperintense on T2WI. Branches of portal vein were found infilrated by all lesions. Tueleve cases showed“stripe sign”along the portal vein branches, 16 cases showed“halo ring sign”around the portal vein. Pearson analysis indicated a significant correlation between the number of eosinophilic hepatic infiltrated lesions and the increase of eosinophils in peripheral blood (r=0.783, P<0.05). Conclusion The imaging features of EHI had certain characteristics, especially in the three phase dynamic enhanced scanning, from which we can mainly find“progressive enhancement”,“portal vein sign”,“stripe sign”and“halo ring sign”.