Objective To investigate the effects of special siRNA targeting TLR4 gene (TLR4-siRNA) on hyperoxia-induced secretion of inflammatory factors from human alveolar epithelial cell line A549.Methods Human alveolar epithelial cell line A549 was purchased from Chongqing Children Hospital and cultured in six-well tissue culture plates and randomly divided into 4 gorups:A549 cells + ambient air group (group C) ; A549 cell + hyperoxia group (group H); A549 cells transfected with TLR4-siRNA + hyperoxia group (group TR) and A549 cells transfected with control-siRNA + hyperoxia group (group NR).TLR4-siRNA and control-siRNA were transfected into A549 cells through lipofectamine 2000.The efficiency of transfection was assessed by detection of FAM expression using flow cytometry.The cells were exposed to 95％ O2-5％ CO2 delivered at 1 L/min for 30 min in groups H,TR and NR.TLR4 mRNA and protein expression was detected by RT-PCR and cytometry respectively.The NF-κB activity in A549 cells was measured by EMSA and the IL-6 and IL-8 levels in supernatant were determined by ELISA.Restults Hyperoxia significantly up-regulated TLR4 mRNA and protein expression and increased NF-κB activity in cells and IL-8 and IL-6 concentrations in supematant in group H as compared with group C.Transfection with TLR4-siRNA significantly attenuated hyperoxia-induced up-regulation of TLR4 mRNA and protein expression and increase in NF-κB activity in the cells and IL-6 and IL-8 concentrations in supernatant in group TR as compared with group H,but transfection with control-siRNA did not.Conclusion TLR4-siRNA could significanly inhibit hyperoxia-induced secretion of inflammatory factors from human alveolar epithelial cell line A549.

Objective To explore the influence of alimentary tract reconstruction on blood glucose level in gastric cancer patients complicated with type 2 diabetes mellitus. Methods Clinical data of 67 gastric cancer patients complicated with type 2 diabetes mellitus and the level of blood glucose before operation, one month, three month, six month after operation were retrospectively analyzed. BMI of 53 patients was lower than 25kg/m2,9 patients between 25～29.9 kg/m2 and 5 patients was higher than 30kg/m2 .Total gastrectomy with P-type jejunal pouch Roux-en-Y esophagojejunostomy was performed in 26 cases, and total gastrectomy with Roux-en-Y esophagojejunostomy was performed in 11 cases, distal subtotal gastrectomy with Roux-en-Y gastrojejunostomy in 30 cases. Results Operations on sixty-seven patients were all uneventfully. The mean fasting blood glucose level in the morning was 9.6±3.3 mmol/L before operation, 7.4±2.6 mmol/L one month after operation, 7.5±2.3 mmol/L three month after operation, and 7.7±2.9 mmol/L six month after operation. There were significant differences between the blood glucose level of before operation and one month after operation (P<0.05), and there were no significant differences between three month,six month and one month after operation (P>0.05). Conclusions Alimentary tract reconstruction has obviousinfluence on blood glucose level in type 2 diabetes mellitus patients. It takes about one month for reveal the effect of operation. This phenomenon is of value for clinical application. Its mechanism needs further research.

Objective To review the results of limb lengthening over an intramedullary nail in management of femoral defect and length discrepancy.Methods Femoral lengthening over an antegrade intramedullary nail was applied to treat length discrepancy of 4 to 7 cm for three cases,and femoral defects of 8 and 11 cm respectively for two cases from January 2001 to December 2003.The nail and an external fixator(Ilizarov external fixator for bone defect and Orthofix limb-reconstruction system for discrepancy)were applied concomitantly at the time of femoral osteotomy.After a mean fixation time of 16.2 days(13 to 24 days),gradual distraction began at a rate of 0.25 millimeter four times a day.When the managed femur reached the expected length,the nail was locked and the fixator was removed in patients with length discrepancy.The procedure was not finished in patients with bone defects until bony consolidation was partially seen.Results All the patients were followed up for a mean time of 36.4 months(range,22 to 47 months).The mean gain in length was 7.2 cm(range,4 to 10 cm)with good consoli- dation,the mean duration of external fixation was 5 months(range,3 to 8 months),and the mean external fixation index was 0.75 month per centimeter(range,0.57 to 1.00 month per centimeter).Neither axial deviation nor re-fracture occurred.At the last follow-up,the mean range of movement of knee was 107?(80?to 135?).Con- clusions In management of defect and length discrepancy of limbs,lengthening over an intramedullary nail has the advantages of short duration of external fixation,good protection against refracture,and earlier rehabilitation of knee joint,as well as disadvantages of long operation time,massive intraoperative bleeding,high cost and much post- operative scarring.

Objective This research is proposed to improve the recognition of the clinical features, therapy and prognosis of palindromic rheumatism.Methods We analyzed the clinical data of 63 palindromic rheumatism patients.Their response to therapy was observed,and they were followed up for 1.5 to 3 years. Results The average onset age of the patients was(40?11)years and the average disease duration was(8?7) years.They were characterized by recurrent attacks of sudden-onset acute arthritis and(or)periarticular tis- sue inflammation,in which most joints were involved.In 46 percent of the patients,the attacks were incited by some events.In 67 percent of them,the attacks recurred more and more frequently.Nonsteroidal anti-in- flammatory drugs and disease modifying anti-rheumatic drugs(DMARDs)was effeeive in variant extents,to palindromic rheumatism patients.Five percent of patients achieved complete remission.Nine percent of them had relapses for a long time.And 5% of them evolved to RA.Conclusion Palindromic rheumatism is a syn- drome characterized by recurrent attacks of sudden-onset acute arthritis and(or)periarticular tissue inflam- mation.The therapy of DMARDs,especially penicillamine and chloroquine diphosphate,is effective on the syndrome.The outcomes of palindromic rheumatism is diverse.

Objective To evaluate the efficacy and safety of diacerhein in the treatment of patients with knee osteoarthritis.Methods The efficacy and safety of diacerhein was randomly investigated in 42 pa- tients with knee osteoarthritis using parallel group methodology and a double-dummy technique to ensure dou- ble blind status with respect to diacerhein and control drugs diclofenac.Results Significant changes were ob- served in 20 meters walk pain,knee joint tenderness scale,WOMAC index scale,5F-36 health survey,knee joint swelling scale,compared with baseline(P＞0.05)in both diacerhein and diclofenac group respectively.No difference was found between diacerhein group and diclofenae group.The patient global assessment and physi- cian's global assessment were similar in diacerhein group and diclofenac group(P＞0.05).The side effect was similar in two groups.All of these side effects in gastrointestinal tract appeared to be transient.Conclusion Diacerhein can effectively relieve pain and swelling of knee osteoarthritis,and provides us a new effective and safe approach for treating knee osteoarthritis.

Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Osteoarthritis, Knee ; therapy

Objective To systematically review the short-term and long-term efficacy of eversion carotid endarterectomy (eCEA) and patch carotid endarterectomy (pCEA) for the treatment of carotid artery stenosis.Methods The published literature on eCEA and pCEA control studies in medline,PubMed,Ovid,CNKI and CBM (1970.5-2016.10) databases were retrieved by computers.Two reviewers selected literature and extracted data independently according to the inclusion and exclusion criteria.Cochrane Collaboration Network Special Software Rev Man 5.2 was used to analyze the meta-analysis of short-term and long-term outcome measures.Results A total of 1 137 articles were retrieved.Ten studies were included and analyzed (3 of them were randomized controlled trial).A total of 3 213 patients were enrolled,including surgical intervention 3 299 case/time (1 512 in the eCEA group and 1 787 in the pCEA group).The results of meta-analysis showed that:(1) the mean operative time in the pCEA group was shorter 22±8 min than that in the pCEA group.The intraoperative utilization ratio of shunt tube,eCEA was significantly lower than pCEA,they were 12.6 %(53/421) and 50.2% (357/711) respectively (OR,0.11,95%CI 0.08-0.15,P<0.01).The postoperative incidence of stroke within 30 d (OR,0.42,95%CI 0.23-0.76,P=0.004) and the incidence of stroke after 30 d in eCEA were lower than those in pCEA (OR,0.26,95%CI 0.09-0.78,P=0.02).There was significant difference.(2) eCEA reduced the incidence of restenosis at day 30 after procedure (OR,0.57,95%CI 0.38-0.86,P=0.008).Conclusion Compared with pCEA,eCEA has the advantages of reducing the operation time and lowering the utilization rate of shunt tube.At the same time,eCEA can reduce the occurrence of stroke within 30 d and 30 d after procedure,and significantly reduce the incidence of restenosis.

Objective To investigate the clinical efficacy of a novel path of lymph node dissection combined with peripheral vascular occlusion for the treatment of gastric cancer in stage ⅢC.Methods The clinical data of 142 patients with gastric cancer in stage Ⅲ C who were admitted to the 175th Hospital of PLA from January 2006 to December 2009 were retrospectively analyzed.Seventy patients received novel path of lymph node dissection combined with peripheral vascular occlusion (combined group) and 72 patients received simple lymph node dissection via the novel path (simple group).The positive rate of mRNA expression of carcinoembryonic antigen (CEA) and the distal metastatic rate of tumor cells between the 2 groups were compared.Patients were followed up via outpatient examination,phone call and in-patient examination till January 2013.The measurement data and the enumeration data were analyzed using the t test and the chi-square test,respectively.Results The operation time,volume of blood loss and number of lymph nodes dissected were (184 ± 26) minutes,(282 ± 80) mL and 28 ± 5 in the combined group,(180 ± 28)minutes,(355 ± 85)mL and 27 ± 5 in the simple group,with no significant difference between the 2 groups (t =0.882,5.267,0.496,P ＞ 0.05).The positive rates of mRNA expression of CEA of the combined group and the simple group were 10.0％ (7/70) and 9.7％ (7/72),with no significant difference between the 2 groups (x2 =0.003,P ＞ 0.05).The positive rates of mRNA expression of CEA after lymph node dissection of the combined group and the simple group were 2.9％ (2/70) and 16.7％ (12/72),with significant difference between the 2 groups (x2 =8.240,P ＜ 0.05).The positive rates of mRNA expression of CEA after total gastrectomy of the combined group and the simple group were 4.3％ (3/70) and 4.2％ (3/72),with no significant difference between the 2 groups (x2=0.001,P ＞ 0.05).All patients were followed up at postoperative year 1,and 139 patients were followed up at postoperative year 3.The median time of follow-up was 33.5 month (range,12.0-42.0 month).The 1-year distal metastatic rate of the combined group and the simple group were 7.1％ (5/70) and 8.3％ (6/72),with no significant difference between the 2 groups (x2=0.070,P ＞0.05).The 3-year distal metastatic rate of the combined group and the simple group were 33.3％ (23/69) and 51.4％ (36/70),with significant difference between the 2 groups (x2=4.660,P ＜0.05).The distal metastatic rates of distal parenchymatous organs of the combined group and the simple group were 10.1％ (7/69) and 44.3％ (31/70),with significant difference between the 2 groups (x2=20.390,P ＜ 0.05).Conclusions Novel path of lymph node dissection combined with peripheral vascular occlusion can block the lymph node and blood backflow,and thus effectively reduces the distal metastatic rate of gastric cancer in stage ⅢC after operation.

Objective To induce mice bone marrow(BM) mono-nuclear cells into dendritic cells(DC) in vitro,and then produce function vaccine of anti-myeloma by bone marrow derived dendritic cells(BM-DC).Methods Mono-nuclear cells separated from mice bone marrow were cultured in tissue culture plastics which supplemented granulocyte-macrophage clonystimulating factor(GM-CSF),IL-4.During the 8 days,there were numerous of mature DCs outgrown,and then fused with SP 2/0 myeloma cells in logarithmic growth phase cultured with 8-azaguaine by polyethylene(PEG).The resulting purified DC/myeloma hybrids were generated by selecting with hypoxanthine-aminopterin-thymidine(HAT).The specific anti-tumor activity was examined in vitro.Results Mono-nuclear cells derived from BM cultured by supplement propriate cytokines milieu in tissue culture plastics,and then exposed to lipopolysaccharide(LPS).There were plenty of mature DCs appear as early as day 8,and exhibit dramatic veils of cytoplasm and extensive dendrites in their surfaces,high express CD11c(83.19%),major histocompatibility complex(MHC)-Ⅱ(95.25%),CD86(89.24%),their capacity to stimulate primary T cell responses in mixed leukocyte reaction(MLR) would be shown strongly.Hybrids could grow well through PEG fusion and HAT selection.These hybrids could stimulate naive T cells into cytotoxic T-lymphocyte(CTLs) directed against SP 2/0 myeloma,and exhibit strong specific killed ability.Conclusions BM-DCs is fused with tumor cells ensure the tumor associated antigens could be processed and presented effectively,and stimulate specific anti-tumor immunity so that prevent or cure this kind of tumor.So it's feasible in practice to produce anti-tumor vaccine by BM-DCs.

Objective To compare the adherence condition of mycobacterium tuberculosis on 2 kinds of artificial joint interface. Methods The Chromium-Cobalt-Alloy with hydroxyapatite ceramic coating and porous coating were cocultured with the bacterial liquid of mycobacterium tuberculosis. The optical density of mycobacterium tuberculosis in different interfaces were detected by turbidimetry. Adherence conditions were observed by electron microscope scanning. Results There was no significant difference between two groups in the optical density value (P>0.05). The electron microscope scanning showed that more mycobacterium tuberculosis adhered to the porous coating than hydroxyapatite ceramic coating (P<0.05). Conclusion The hydroxyapatite ceramic coating has more advantages to the porous coating in prosthetic replacement for patients with joint tuberculosis.