OBJECTIVE: To investigate the effect of LARS artificial ligament on reconstruction of anterior and posterior cruciate ligament of keen joint.METHODS: Articles addressing reconstruction of anterior and posterior cruciate ligament by LARS artificial ligament were retrieved from VIP database (http://www.cqvip.com/) with the key words of "LARS artificial ligament, cruciate ligament,reconstruction" in Chinese between January 2000 and February 2010.Inclusion criteria: advantages and disadvantages of reconstructing anterior and posterior cruciate ligament by LARS artificial ligament; clinical application of reconstructing anterior and posterior cruciate ligament by LARS artificial ligament.Exclusion criteria: Duplicated studies or old references were excluded.A total of 31 articles were included in the final analysis.RESULTS: Reconstruction of anterior and posterior cruciate ligament by LARS artificial ligament characterized by convenient operation, short operative time, mild trauma, engaging in movement early, great strength, simple implantation, and reliable fixation; however, most patients were not able to bear the high medical cost, thus clinical application was limited.Scholars thought that LARS artificial ligament had great effects on reconstruction of anterior and posterior cruciate ligament.CONCLUSION: Patients who had multi-ligament injury, overhauling of ligament, and early movement were treated with LARS artificial ligament.

The authors first describe the current situation of cooperative medical care in China, pointing out that due to low levels of guarantee, difficulties in fundraising and insufficient government reimbursement, cooperative medical care in rural areas have come across many hardships. It is, therefore, imperative to set up as soon as possible a health security system for people in rural areas. Firstly, it is necessary to break up the dual social security structure of urban and rural areas and set up a model with transitional goals based on the actual situation of the country. Secondly, it is suggested that security taxes begin to be collected, bringing the health security for people in rural areas into line with the social security framework so as to promote the health security for people in rural areas without lowering the level of social security in urban areas.

Objective To investigate the effects of different concentrations of sevoflurane on proliferation and invasion in human prostate cancer PC3 cell line. Methods The cells were randomly divided into four groups:control group and three sevoflurane groups (exposed to 1.7%, 3.4%and 5.1%sevollurane for 2, 4 and 6 h respectively). The ability of prolifera-tion and invasion of PC3 cells were evaluated by MTT and Transwell invasion assays. Western blot analysis was performed to detect the protein expression of hypoxia inducing factor 1 alpha (HIF-1α) in PC3 cells. Results The ability of proliferation and invasion of PC3 cells was significantly increased after being exposed to sevollurane for 2, 4 and 6 h (P<0.05), and the expression of HIF-1αprotein in PC3 cells was significantly higher after being exposed to sevollurane for 2,4 and 6 h (P<0.05), showing the Treat 3 group>Treat 2 group>Treat 1 group (P<0.05). Conclusion Sevoflurane can promote prolifer-ation and invasion in PC3 cells, which are gradually increased with time and concentration of sevoflurane treatment. The mechanism may involve in the up-regulation of HIF-1αexpression.

Objective To investigate the effect of glutamine on energy intake and prognosis of severe burn patients in differ-ent pathway.Methods Using retrospective study method,we brought the patients into our study from October 2010 to April 2014 in accordance with the inclusion criteria.Patients who were given the Gln before 5 days after injury through gastric bowel were brought into the EN group,others who were given the Gln after 5 days after the injury through vein were brought into PN groups. A total of 66 patients were included in this study,with 31 cases of EN group and 35 cases of PN group.Total energy intake,external and internal energy intake,nutrients heating,energy intake/energy consumption ratio,blood glucose control,insulin use and viscera damage(the blood urea nitrogen,creatinine,alanine aminotransferase,aspartate aminotransferase,total bilirubin,creatine kinase,lac-tate dehydrogenase),ICU days,hospital stays and mortality were observed in 1,2,3,4 weeks after injury.Results Within a month after the injury,the energy intake of patients in EN group were more than PN group,especially the energy from intestinal canal.Be-sides,the ICU days of patients in EN group were shorter than patients in PN group (all P <0.05).Other indicators of two groups of patients were no significant statistical difference(P >0.05).Conclusion Supplement of Gln may be more conducive to improve the intestinal function in patients with burns may be more conducive to improve the intestinal function in patients with burns,im-prove the degree of tolerance of enteral nutrition,increase energy intake and conducive to improving the prognosis of patients.

Background and purpose:The E-cadherin as a pivotal structural protein is important for cellular polarity and maintainance of normal tissue morphology and cellular differentiation. Recently some study investigated the impact of the C/A genetic polymorphism at-160 from the site of the E-cadherin gene promoter on susceptibility in NPC. To evaluate the association of the E-cadherin gene promoter-160 C/A single nucleotide polymorphism (SNP) and nasopharyngeal carcinoma risk in a Chinese population, we designed a hospital-based case-control study. Methods:Subjects included in this study were 303 patients deifnitely diagnosed with NPC, and 318 matched healthy controls. We used TaqMan Probe method for analyzing polymorphism. Results:The A/A genotype was associated with increased risk of NPC after being adjusted for age and gender (adjusted OR=2.09, 95%CI:1.03-4.22, P=0.04). When 2 gender groups were analysed respectively, female group with A/A genotypes showed a higher risk (OR=7.57, 95%CI:1.57-36.47, P=0.012). Besides, among NPC patients compared with males A/A genotype, females with A/A genotype had a signiifcant risk(OR=2.66, 95%CI:1.14-6.20, P=0.024). Conclusion:The A/A genotype of E-cadherin promoter-160 C/A might be genetic risk factor for NPC, especially female patients.

Objective To observe the effect of vascular endothelial cell growth factor (VEGF)on apoptosis and matrix metabolism of rat intervertebral.disc cells cultured in vitro. Methods Culture system of rat intervertebral disc cells was established to culture the monolayer intervertebral disc cells in vitro.The well-grown intervertebral disc cells of the second generation were chosen and anti-Fas antibody was applied to induce their apoptosis.Then,VEGF at different concentrations ( 10,100,1 000 μg/L)were used to affect their apoptosis and metabolism.The apoptosis of the cells stained with Propidium Iodide (PI) was detected by using flow cytometry.The levels of hydroxyproline and proteoglycan in the culture medium were detected by using chloramines T method and DMB chromometry method,respectively.Results ( 1 ) The apoptotic ratio of the intervertebral disc cells affected by different concentrations of VEGF (10,100,1 000 μg/L) was (87.62 ±11.06)％,(53.30 ±9.23)％ and (16.75 ±4.21)％ respectively,with significant differences in comparison with the control group (P ＜ 0.01 ).(2)The contents of hydroxyproline [ (6.71 ±0.33) μg/L,(9.12 ±0.41 ) μg/L,( 11.58 ±0.12) μg/L] and proteoglycan [ (23.21 ± 2.87) μg/L,( 32.45 ± 5.23 ) μg/L,(37.18 ± 3.22) μg/] in the culture medium raised with the increase of VEGF concentration ( 10,100,1 000 μg/L),with statistical differences compared with those of the control group (P ＜0.01 ).The contents of hydroxyproline and proteoglycan were positively correlated with the concentration of VEGF (ra=0.972,P＜0.01;rb =0.907,P＜0.01). Conclusion VEGF can inhibit the apoptosis of the rat intervertebral disc cells cultured in vitro and promote collagen and proteoglycan synthesis of the cell matrix.

Objective To prospectively assess the influence of intensity-modulated radiotherapy (IMRT) and conventional radiotherapy on quality of life (QOL) in patients with head and neck cancer (HNC) for clinical guidance. Methods From May 2007 to May 2008, 102 HNC patients were enrolled in this study. Fifty-two patients were treated with IMRT and 50 with conventional radiotherapy. In patients with IMRT, at least one parotid gland was spared, and the contralateral submandibular gland was spared in 24 patients. The parotid and submandibular gland were not spared in patient with conventional radiotherapy.QOL was assessed using EORTC QLQ C30 and HN35 questionnaires at 4 time points (before radiotherapy,end of radiotherapy, 2 months and 6 months after radiotherapy). A change of 10% in scores of the instru-ment range had been previously demonstrated to be clinically significant. Results In the study, 94% (31/33) of the QOL domains were worse after IMRT or conventional radiotherapy, including 49% (16/33) with significant difference (U=2.72-5.98, all values of P<0.01) and 33% (11/33) with clinical signifi-cance. At 2 months after radiotherapy, 12% (4/33) of the domains showed clinically significant improve-ment, however, 15% (5/33) of the domains did not show any improvement (U=3.10-5.93,all value of P < 0.01). Continuous improvement in most domains of QOL was shown at 6 months after radiotherapy. Clini-cally and statistically significant improvement were shown in 21% (7/33) of the domains, and some were even better than pretreatment except in dry mouth and sticky saliva scales (U=4.49 , P<0.01 and U=4.87 ,P <0.01). Compared with conventional radiotherapy, the dry mouth and sticky saliva caused by IM-RT were milder (U=4.57,P <0.01 and U=5.57, P < 0.01) and continuous improvement were shown over time after radiotherapy (U=7.23, P <0.01 and U = 7.57, P < 0.01). Similar improvement weren't shown in patients with conventional radiotherapy. Conclusions QOL in HNC patients is significant worse after ra-diotherapy. QOL can be improved continuously over time after treatment except dry mouth and sticky saliva which are the main factors affecting QOL. IMBT, causing less dry mouth and sticky saliva when compared with conventional radiotherapy, has benefits for the preservation of QOL.

A case of furuncular myiasis was reported for the first time in a 29-year-old young Taiwanese traveler returning from an ecotourism in Peru. Furuncle-like lesions were observed on the top of his head and he complained of crawling sensations within his scalp. The invasive larva of botfly, Dermatobia hominis, was extruded from the furuncular lesion of the patient. Awareness of cutaneous myiasis for clinicians should be considered for a patient who has a furuncular lesion and has recently returned from a botfly-endemic area.

OBJECTIVE:To explore the effect of nifedipine combined with losartan on the blood pressure and renal function of hypertension complicated with coronary heart disease. METHODS:150 patients with hypertension complicated with coronary heart disease were randomly divided into observation group and control group. Control group was orally treated with Nifedipine sustained release tablet 30 mg,once a day;observation group was additionally treated with Losartan potassium capsules 50 mg,once a day. The treatment course for both groups was 1 month. Systolic blood pressure,diastolic blood pressure,renal function indicators be-fore and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,systolic blood pressure and diastolic blood pressure after 3 months was lower than 1 month and lower than before treatment in same group,renal function indicators were significantly lower than before treatment,and observation group was lower than control group,the differ-ences were statistically significant(P<0.05);the incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Nifedipine combined with losartan can well control the blood pressure of hypertension complicated with coronary heart disease,protect renal functions,with good safety.

Objective To investigate the relationship between the plasma neutrophil gelatinase-associated lipocalin (NGAL)and endothelin-1 (ET-1) levels and cognitive dysfunction in chronic obstructive pulmonary disease (COPD) patients.Methods A case-control study was performed,consisting of 128 patients with COPD(68 patients without cognitive dysfunction and 60 patients with cognitive dysfunction) and 70 normal controls.All patients with COPD were diagnosed by pulmonary function tests and plasma levels of NGAL and ET-1 were determined by enzyme immunoassay.The cognitive function was evaluated by the MMSE and MoCA.Results ①Compared with normal control,the levels of plasma NGAL and ET-1 were increased(NGAL:(2.20±0.60) μg/L vs (1.69±0.73) μg/L,P＜0.05;ET-1:(26.19± 10.55)pg/ml vs (13.05±2.37) pg/ml,P＜0.05) in COPD patients without cognitive dysfunction and in COPD patients with cognitive dysfunction(NGAL:(3.80±2.75) μg/L vs (1.69±0.73) μg/L,P＜0.01;ET-1:(37.82±0.29) pg/ml vs (13.05±2.37) pg/ml,P＜0.01).Compared with the COPD patients without cognitive dysfunction,the levels of plasma NGAL and ET-1 were also increased in COPD patients with cognitive dysfunction (all P＜0.05).②The plasma NGAL levels were correlated negatively with MMSE scores(r=-0.524,P＜0.05),and negatively correlated with MoCA scores (r=-0.527,P＜0.05).The plasma ET-1 levels were negatively correlated with MMSE scores(r=-0.549,P＜0.05),and negatively correlated with MoCA scores(r=-0.558,P＜0.05).The levels of NGAL and ET-1 were positively correlated(r=0.564,P＜0.05).Conclusion NGAL and ET-1 may be involved in the pathophysiological process of cognitive dysfunction in patients with COPD,which provides a certain clinical value for the assessment of cognitive dysfunction in patients with COPD.