Total knee arthroplasty (TKA) identified as an effective treatment for ultimate knee joint disease can effectively relieve pain, correct deformity, improve knee function and enhance the quality of life of patients. Patient satisfaction has been increasingly considered as an important factor in evaluating the success of primary TKA. Anterior knee pain that usually appears in the region of the anterior knee is a recognized complaint for primary TKA and has a strong impact on the improvement of knee function and patient satisfaction of primary TKA. Accordingly, the relief of anterior knee pain has become one of the primary goals of primary TKA. At present, soft tissue lesions around the patellar caused by patellar maltracking and the elevation of internal pressure in subchondral bone because of the high contact stress of patellofemoral joint are both considered as the mechanism of anterior knee pain. For the past few years,on increasing number of studies have focused on the prevention of anterior knee pain following primary TKA. However, none of the past treatment such as patellar resurfacing, patellar denervation without patellar resurfacing or a mobile-bearing prosthesis has a good and affirmative effect on it. The prevention and treatment of anterior knee pain following primary TKA still is a difficult solved problem. To address this problem, we need further researches about the cause of anterior knee pain, knee joint prosthesis and biomechanics of patellofemoral joint, as well as lots of randomized controlled trials.
Arthralgia ; etiology ; prevention & control ; Arthroplasty, Replacement, Knee ; adverse effects ; Humans ; Knee Joint ; surgery ; Randomized Controlled Trials as Topic

Background:Excessive immune cell activation-inflammatory factor theory is one of the most important pathogenic mechanisms of acute pancreatitis(AP). As the release of inflammatory factors is associated with systemic inflammatory response syndrome,seeking of serum cytokine markers for severity assessment of AP is of great clinical importance. Aims:To determine the dynamic changes of interleukin-6(IL-6),hepatocyte growth factor(HGF),and angiopoietin-2(Ang-2) in peripheral blood of AP patients in the first week after admission,and investigate preliminarily the clinical significance of these markers in AP. Methods:Seventy-two AP patients were prospectively recruited from Apr. 2014 to Oct. 2014 at the First Affiliated Hospital of Soochow University and were assigned into three groups:mild AP(MAP,n = 54),moderately severe AP(MSAP,n = 12)and severe AP(SAP,n = 6)according to the Atlanta classification of AP-2012. Thirty healthy subjects were served as controls. Serum levels of IL-6,HGF and Ang-2 were determined by ELISA on the 1st,3rd and 7th day after admission. Results:In the first week after admission,serum levels of IL-6,HGF and Ang-2 were significantly higher in AP patients than in controls(P < 0. 05). In MAP group,all three markers were gradually decreased in the first week;while in MSAP group,IL-6 was gradually increased,Ang-2 was gradually decreased,and HGF decreased after reaching the peak;in SAP group,IL-6 decreased after reaching the peak and HGF and Ang-2 increased again after a decrease. Serum levels of IL-6,HGF and Ang-2 were higher in MSAP group and SAP group than in MAP group at all the time points,but no statistically significant differences were observed between MSAP group and SAP group(P > 0. 05). Conclusions:IL-6,HGF and Ang-2 might play important roles in the pathogenesis of AP,and being the promising serum markers for severity assessment and dynamic monitoring of AP.

Objective To study the prevalence of thyroid diseases in systemic lupus erythematosus (SLE) patients and to analyze the prevalence of subclinical hypothyroidism (SCH) with lupus nephritis (LN).Methods A total of 813 hospitalized SLE patients were retrospectively analyzed.The demographic,clinical and biochemical data were collected.The prevalence of different thyroid diseases was calculated.Among all patients,83 patients with SCH and 562 patients without any thyroid diseases were recruited according to thyroid hormone,thyroid stimulating hormone (TSH) and anti-thyroid antibodies levels.Case control study was performed to explore the potential risk factors for SCH in SLE.T test,Mann-Whitney U test,x2 test and Logistic regression analysis were used for statistical analysis.Results Among the 813 patients,13 (1.6％) had clinical hypothyroidism,83(10.2％) had SCH,13 (1.6％) had central hypothyroidism,27(3.3％) had autoimmunethyroid disease (AITD),10 (1.2％) had hyperthyroidism,95 (11.7％) had euthyroid sick syndrome (ESS) and 11 (1.4％) had nodules.SCH was more frequent in patients with LN (13.7％,50/366) than those without LN [7.4％(33/447),x2=8.654,P＜0.01].Meanwhile,prevalence of LN was also significantly higher in SCH group in case control study [60.2％(50/83) vs 42.9％(241/562),x2=8.800,P＜0.01].Besides,SLE patients with SCH had more severe proteinuria,hypoalbuminemia,and hyperlipidemia,which were complications of LN.In addition,the SCH group presented significantly higher anti-dsDNA antibody positive rate [50.6％(42/83) vs 33.7％(212/562),x2=5.026,P＜0.01].In Logistic regression models,24-hour urine protein and serum creatinine was retained as independent correlated factors with SCH after adjusted for demographic variables,risk factors,and other potential confounders.The presence of SCH was associated with increased 24-hour urine protein levels,occurring in 10.4％ of subjects with 24-hour urine protein ≤ 150 mg,11.9％ with 24-hour urine protein 150.1-1 500 mg,17.2％ with 24-hour urine protein 1 500.1-3 500 mg,and d24.4％ with 24-hour urine protein ＞3 500 mg (P＜0.05 for trend).In addition,when eGFR ≥30 ml·min-1· 1.73 m-2,the prevalence of SCH was increased as eGFR decreased:occurring in 12.8％ with eGFR ≥90 ml·min-1· 1.73 m-2,12.6％ with eGFR 60-89.9 ml·min-1· 1.73 m-2 and 20.0％ with eGFR 30-59.9 ml ·min-1· 1.73 m-2.Conclusion Thyroid diseases are common in SLE patients,and SCH is closely related with LN and disease activity.

Objective To observe the expression of STEAP4 gene(a novel obesity-related gene) during the period of human preadipocyte differentiation and to explore the relationship between the STEAP4 gene expression and adipocytes differentiation,adipogenesis.Methods Human preadipocytes were cultured and differentiated into the matured adipocytes in vitro.Adipocytes morphology and lipid accumulation were observed during this process.Total RNA was extracted from adipocytes at various time points (preadipocyte,Day 0,Day 4,Day 6,Day 8,Day 11,Day 14,and Day 17) and the level of STEAP4 mRNA expression was measured by fluorescent real-time quantitative reverse transcriptase-polyme-rase chain reaction(RT-PCR).Results The level of STEAP4 mRNA expression remained high in preadipocytes.In the presence of differentiation medium (Day 4),there was a transient upregulation in the expression of STEAP4 gene.After that,with the human preadipocytes being differentiated into matured adipocytes,the expression of STEAP4 mRNA was downregulated and reached the lowest level in fully differentiated adipocytes.There was a significant difference between any 2 detected phases in the level of STEAP4 mRNA expression (Pa

The influence of inner cell mass (ICM) and trophectoderm (TE) score on pregnancy outcomes in frozen-thawed blastocyst transfer cycles was analyzed. A retrospective analysis of 741 cycles of frozen-thawed blastosysts transfer was performed. All cycles were divided into four groups based on the number and morphological score of blastocysts: S-ICM B/TE B group (n=91), the single blastocyst transfer of ICM B and TE B; D-ICM B/TE B group (n=579), double blastocysts transfer of ICM B/TE B; D-ICM B/TE C group (n=35), double blastocysts transfer of ICM B/TE C; and D-ICM C/TE B group (n=36), double blastocysts transfer of TE B/ICM C. The pregnancy outcomes were compared among the four groups. As compared with D-ICM B/TE C group, the clinical pregnancy rate, implantation rate and multiple pregnancy rate were increased in D-ICM B/TE B group (74.96% vs. 57.14%, 57.43% vs. 37.14%, and 48.62% vs. 25%, respectively, P<0.05 for all). Clinical pregnancy rate and implantation rate in D-ICM B/TE B group were also higher than in D-ICM C/TE B group (74.96% vs. 50%, and 57.43% vs. 33.33%, both P<0.05). Multivariable Logistic regression analysis indicated that ICM score was a better predictive parameter for clinical pregnancy (OR=3.05, CI 1.70-5.46, P<0.001), while the trophectoderm score was a better one for early abortion (OR=0.074, CI 0.03-0.19, P<0.001). Clinical pregnancy rate and multiple pregnancy rate in S-ICM B/TE B group were significantly lower than those in D-ICM B/TE B group (46.15% vs. 74.96%, and 2.38% vs. 48.62%, both P<0.05), but there was no significant difference in the implantation rate between the two groups. It was suggested that the higher score of ICM and TE may be indicative of the better pregnancy outcomes. The ICM score is a better predictor of clinical pregnancy than TE, while TE score is a better one in predicting early abortion. Single ICM B/TE B blastocyst transfer in frozen-thawed cycles can also get satisfactory pregnancy outcomes.

Objective To assess the safety among acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.Methods We searched database including Wanfang,CNKI,VIP,Pubmed,EMBASE,EBSCO HOST and Metstr data for all the cohort studies on the use of thrombolysis for acute ischemic patients with asymptomatic intracranial aneurysm,and ascended the correlated references listed on the articles.Meta-analysis was conducted based on the methods recommended by the Cochrane collaboration.The outcomes of the meta-analysis were intracerebral hemorrhage (ICH),symptomatic intracerebral hemorrhage (sICH),subarachnoid hemorrhage (SAH).Results Four cohort studies included 707 patients,of whom 48 patients had asymptomatic cerebral aneurysms.The risk ratio prevalence of ICH among those patients did not differ statistically with those without aneurysms (RR =1.17,95％ CI 0.69-1.99,P =0.56).No statistical differences were found in both odds ratio prevalence of sICH (OR =1.70,95％ CI 0.44-6.59,P =0.45) and SAH (OR =1.13,95％ CI 0.20-6.27,P =0.89) between the patients with asymptomatic cerebral aneurysms and those without.Conclusion Current evidence did not indicate that the risk of hemorrhage increased in acute ischemic stroke patients with asymptomatic intracranial aneurysm after the administration of intravenous thrombolysis.

Aim To investigate the role of captopril in insulin resistance of endothelial cells induced by high glucose.Methods 1 .Improvement effect of captopril on insulin resistance in HUVECs was observed.The HUVECs were seeded in a 6-well plate and were ran-domly divided into 5 groups,namely,control group, IR group,IR together with different Cap concentrations (low,medium and high concentration),respectively. 2.Improvement effect of Cap on insulin resistance was mediated by PPARγin HUVECs.HUVECs were ran-domly divided into 6 groups,namely,control group, control +PPARγinhibitor (PI)(1 .0 μmol · L -1 ) group,IR group,IR +PI(1 .0 μmol·L -1 )group,IR +Cap(1 ×1 0 -5 mol·L -1 ) group,and IR +Cap +PI (1 .0 μmol·L -1 )group.All indicators were detected. Results After HUVECs were incubated with media containing 33 mmol·L -1 of glucose for 48 h,the NO levels were significantly decreased while ET-1 levels were significantly elevated,showing a significant differ-ence between IR group and control group (P <0.01 ). The expression levels of PPARγmRNA and its protein were somewhat up-regulated,but there was no signifi-cant difference between IR group and control group (P>0.05).When the HUVECs in IR group were treated with DMEM containing glucose (33 mmol·L -1 )for 48 h and insulin for 30 min,the expression levels of PPARγmRNA and its protein in Cap groups were simi-lar to those in the IR group,and there was no signifi-cant difference between the two groups (P >0.05 );however, the expression levels of phosphorylated PPARγprotein in Cap groups were increased compared with IR group (P <0.05).The levels of NO were sig-nificantly increased whereas the levels of ET-1 were decreased in Cap groups,which had significant differ-ences compared with IR group (P <0.05).Nonethe-less,pre-treating with GW9662,a PPARγinhibitor, the improvement effects of Cap were markedly abol-ished.Conclusions Captopril could improve high glucose-induced insulin resistance of endothelial cells mediated by PPARγ,and the underlying mechanisms are related to the activation of PPARγ,rather than its expression.

Primary breast lymphoma (PBL) is a kind of rare primary extranodal lymphoma, which is of relatively poor prognosis and so far there is no unified treatment. In the case diagnosed by Our hospital where one patient recurring breast diffuse large B cell lymphoma (DLBCL) many times, has been treated with good therapeutic effect through surgery, chemotherapy, targeted drug therapy and radiotherapy. A multidisciplinary discussion is made concerning the treatment of the patient in this article for the purpose of further discussing the standard treatment procedure for PBL and promoting multi-disciplinary team.

Objective To observe the clinical effect of Chuanxiong-Chatiao San in treatment hemicrania. Methods All patients were randomly recruited into a control group (75cases) and a treatment group (78 cases). The control group was treated with Gastrodin injection, Ligustrazine injection and Mailuoning injection; on this basis, the treatment group was treated with Chuanxiong-Chatiao powder. Both groups were treated for 14 days with a 7 days interval. Results The excellent rate and effective rate were 91.03% and 96.08% in the treatment group respectively; and 70.66% and 94.67% in the control group respectively. The difference between the two groups was significant (χ2= 12.7143,P<0.01) . Conclusion Chuanxiong-Chatiao powder combined with western medicine is effective in treating hemicrania.

This study was aimed to clone human intercellular adhesion molecule-1 (ICAM-1) gene, to transfect the constructed eukaryotic expression vector ICAM-1-GFP into CHO cells, as well as to detect ICAM-1-GFP expression in CHO cells binding with Molt-4 cells. ICAM-1 cDNA gene was amplified by RT-PCR and inserted in PMD(18)-T vector. Then ICAM-1 cDNA from pMD18-ICAM-1 vector was subcloned into eukaryotic expression vector pEGFP-C1 to construct recombinant ICAM-1-pEGFP-C1 vector. Restriction analysis and DNA sequencing were used to confirm the recombinant vector. After stable transfection of CHO-K1 cells with the recombinant vector, the expression and subcellular localization of ICAM-1-GFP were detected by RT-PCR, flow cytometry and fluorescence microscopy. The function of ICAM-1-GFP fusion protein was assessed by the binding of ICAM-1-GFP/CHO cells to Molt-4 cells. The results showed that 1622 bp full-length ICAM-1 cDNA obtained and was successfully ligated with pMD(18)-T-vector, subcloned to construct recombinant ICAM-1-pEGFP-C1 vector. Restriction analysis and DNA sequencing indicated that recombinant ICAM-1-GFP was successfully constructed and ICAM-1-GFP was expressed stably in CHO cells. ICAM-1-GFP expression was only observed in the cytoplasm of ICAM-1-GFP/CHO cells by fluorescence microscopy. The ICAM-1-GFP/CHO cells were bound to PMA-treated Molt-4 cells. The expression of MEM-148 was very weak in PMA-treated Molt-4 cells. It is concluded that the ICAM-1-GFP eukaryotic expression vector has been constructed successfully and expresses stably in CHO cells. PMA can increase the binding of Molt-4 cells to ICAM-1-GFP/CHO cells by inducing specialized form of ICAM-1 clustering.
Animals ; CHO Cells ; Cricetinae ; Cricetulus ; DNA, Complementary ; genetics ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Intercellular Adhesion Molecule-1 ; genetics ; Recombinant Proteins ; genetics ; Transfection