Osteoarthritis (OA) is the most common form of arthritis, and is the major cause of pain and chronic disability worldwide, causing enormous social and economic burden.Once OA was considered as a 'wear-and-tear' condition and obesity is considered to be one of the most powerful predisposing factors of OA in the weight-bearing joints.However, studies have also linked obesity to OA in non-weightbearing areas, suggesting systemic effects exerted by metabolic factors other than simple local biomechanics perhaps play a role in the high prevalence of osteoarthritis in obese population.Recent studies have shown that systemic metabolic abnormalities, including obesity, diabetes, hypertension, lipid metabolism disorders, atherosclerosis and cardiovascular disease, play an important role in OA pathological process.Metabolic diseases promote the incidence and development of OA through a variety of ways, inducing causing low-grade systemic inflammation, increasing release of adipokines, anabolic cytokines and inflammatory mediators, leading to glucose and lipid metabolism disorders of chondrocytes, upregulating of cartilage extracellular matrix degrading enzymes, raising oxidative stress injury, increasing apoptosis of articular chondrocytes and reducing the cartilage and subchondral bone nutrition supply.These metabolic changes ultimately accelerate the damage of cartilage and promote the incidence and development of OA.Further research on OA and metabolic diseases, has the potential to provide new ideas and methods for the prevention and treatment of OA.

Objective To investigate the value of bone morphogenetic protein-7 (BMP-7) and the kidney shear wave velocity (SWV) in the diagnosis and treatment of diabetic nephropathy.Methods 150 cases of patients with diabetic mellitus were divided into three groups according to 24h urinary albumin excretion (Ualb):normalbuminuria (NA) group,microalbuminuria (MA) group and clinical proteinuria (CA) group;50 healthy subjects were selected as the control group (NC).The levels of blood BMP-7 were detected and the virtual touch tissue quantification (VTQ) was used to detect renal SWV in four groups.Both the BMP-7 level and the renal parenchyma SWV were compared among four groups.Then correlation analysis was made between blood of BMP-7 level and renal SWV in diabetic nephropathy groups.Results Blood BMP-7 level:the lowest was CA group,the middle one was MA group,and the highest was NA group (P ＜0.05),the NC group and the NA group had no significant difference (P ＞0.05); SWV measured values:CA group was the highest,MA group was middle one and the NA group was the lowest (P ＜ 0.05),the difference between NC group and the NA group was not significant statistically (P ＞0.05).The blood levels of BMP-7 and renal SWV had a significant negative correlation (r =-0.612,P ＜0.05).Conclusions The blood BMP-7 levels downregulate with the progressing of diabetic nephropathy,but the renal SWV increases with the diabetic nephropathy deterioration,and may indirectly reflects blood BMP-7 levels.Both of them have important application values in the diagnosis or treatment of diabetic nephropathy.

0.05). Ac-cording to the classification criteria of ARIA in 2001, 26 children suffered from intermittent A(R22 mild cases,4 moderate-severe cases),while 22 suf-fered from persistent AR(10 mild cases,12 mod-erate-severe cases). Forty percent patients with AR also had bronchial asthma. Domestic decora-tion was an important factor in the induction of AR and 27.1% of the children with AR had inher-ent predisposition. CONCLUSION The prevalence rate of AR in children aged from 9 to 10 in Nanjing is 5.1 %. Strategy of prevention and treatment of AR should beworked out according to the epidemic feature of AR.

This paper was aimed to explore the relationship between different commercial specification and chemical constituents on Radix Rehmanni,which provided experimental evidences for drawing up the commodity commercial specification and grading criteria of Radix Rehmanni.Several classified indexes,including grade,surface color,section color,section texture were carried to explore the change rules of chemical constituents by setting the contents of iridoid glycoside,sugars,water content,total ashes,acid-insoluble ashes and water extract as the markers.The results showed that the grade,surface color and section texture had less impact on chemical constituents.However,the section color had more influence.Along with the section color gradually being deepened,the contents of iridoid glycoside and oligosaccharides of Radix Rehmanni were lower,and the contents of monosaccharide and polysaccharide were higher.It was concluded that there was correlation between commercial specification and chemical constituents of Radix Rehmanni.

Objective To evaluate the effects of sevoflurane on proteome in the cortices of neonatal rats.Methods Thirty neonatal rats at postnatal day 7 (6 rats each litter,5 litters in total) were randomly assigned into 2 groups (n =15 each):control group (C group) and sevoflurane group (S group).The rats were exposed to air and 1.8 ％ sevoflurane for 4 h in C and S groups,respectively.One rat from each litter was chosen in each group at the end of anesthesia and the puncture needle was inserted into the left ventricle via the chest wall.Arterial blood samples were then collected for blood gas analysis and for determination of blood glucose.One rat from each litter was sacrificed in each group at 3 and 72 h after the end of anesthesia,and their cortices were then dissected.Two-dimensional differential in-gel electrophoresis (2-D DIGE) was used to identify patterns of protein expression in cortices cross-labeled with different CyDyes.The differentially expressed proteins were analyzed by using matrixassisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS).Results Acid-base imbalance,anoxia or lycopenia were not found at 3 h after the end of anesthesia in both groups.The analysis showed there were 6 differentially expressed proteins at 3 h after the end of anesthesia in S group compared with C group.Among the 6 proteins,the expression of 4 proteins (class 2 c beta-tubulin,neuron-specific class Ⅲ beta-tubulin,CRMP-1 and CRMP-4) which belonged to cytoskeleton/neuronal growth proteins was down-regulated,the expression of 1 protein (ATP synthase beta subunit) which belonged to hydrolyses and transferases was down-regulated,and the expression of 1 protein (guanine nucleotide binding protein beta1) which belonged to signal transduction proteins was up-regulated (P ＜ 0.05).No significant changes in protein expression were identified at 72 h after 1.8％ sevoflurane anesthesia (P ＞ 0.05).Conclusion 1.8％ sevoflurane-induced 4 h anesthesia can induce short-time changes in the expression of proteins which are related to neuronal migration,differentiation,energy metabolism and signal transduction in cortices of neonatal rats,which may contribute to its neurodegenerative effects in brains of rats during the development period.

Objective To investigate the clinical effect of pedicle screw fixation in the treatment of fracture and dislocation of atlantoaxial spine via posterior approach .Methods 19 patients with fracture and dislocation of atlantoaxial spine in this hospital from June 2011 to December 2013 were selected and treated with open reduction and pedicle screw fixation via posterior approach . The X‐radiographs were postoperatively re‐examined at regular time for understanding the correction of fracture and dislocation and implant fusion results ,the neurological functions were evaluated according to the Japanese Orthopaedic Association(JOA) scores . Results All cases got bony fusion without the occurrence of internal fixation loosening ,broken screw or broken rod .The JOA score was improved from preoperative (7 .35 ± 2 .39) points to postoperative (13 .21 ± 2 .53) points (P<0 .05) .Conclusion The posteri‐or atlantoaxial pedicle screw fixation and fusion for treating upper cervical spine injury has satisfactory effect .

Abstract?AlM:To investigate the effects of the MUC5AC levels and ocular function of the patients with glaucoma and cataract with combined surgery.? METHODS: Twenty - eight patients treated with glaucoma and cataract combined surgery were chosen as the observation group from December 2011 to June 2014 in our hospital, and other 28 cases of glaucoma and cataract did not undergo surgical treatment were selected as the control group, 30 healthy subjects were as healthy control group. the MUC5AC level and ocular surface score of the three subjects before surgery 1d, after 3 and 6mo were compared.?RESULTS: The NUC5AC of the two groups of patients was significantly lower than that of the healthy control group before surgery (P<0. 05), the ocular function score was significantly higher than the healthy control group ( P<0. 05). After 1mo, the MUC5AC of the observation group were significantly lower than that of before surgery ( P<0. 05), after 3mo MUC5AC content gradually increased to preoperative levels, after 6mo the MUC5AC were significantly higher than before surgery (P<0. 05). After 1mo, ocular function scores were significantly higher than the preoperative ( P< 0. 05 ), while after 3mo, ocular function scores decreased after 6mo of ocular surface function scores were significantly lower than the preoperative (P<0. 05). While the control group after 6mo, with the passage of time, the MUC5AC content gradually reduce, ocular function score increased gradually. ?CONCLUSlON:To treat the patients with glaucoma and cataract with combined surgery, the level of MUC5AC can temporary decrease. Ocular function score can temporary increase in, but after 3mo, it can be gradually improved.

Objective To investigate the relations between serum adiponectin and coronary artery calcification score (CACS) and to find the risk factors for coronary artery calcification in maintenance hemodialysis(MHD) patients.Methods Twenty-seven MHD patients(MHD group) and 13 healthy persons (control group) were enrolled in this study.The serum adiponectin was measured by enzyme-linked immunosorbent assay method.CACS was calculated by multi-row spiral CT.The circulating parameters such as hemoglobin (Hb),calcium,phosphate,calcium-phosphate product,intact parathyroid hormone (iPTH),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),albumin (Alb),high sensitive C-reactive protein (hs-CRP),and so on were detected.Results The level of serum adiponectin in MHD group [(15.00 ± 7.47) mg/L] was significantly higher than that in control group [(2.07 ± 0.83) mg/L],and there was significant difference (P＜ 0.01).Coronary artery calcification(CACS ＞ 0 score) was observed in 88.9％ (24/27) in MHD group and 10/13 in control group.The mean CACS in MHD group was significantly higher than that in control group [655 (0-3 570) scores vs.126 (0-731)scores],and there was significant difference (P ＜ 0.05).Eleven MHD patients and 1 healthy person had severe coronary artery calcifications,(CACS ≥ 400 scores).There was significan t difference in dialysis duration,diastolic pressure,phosphate calcium-phosphate product and adiponectin (P ＜ 0.05 or ＜ 0.01).Spearman analysis showed that CACS of MHD patients was positively correlated with dialysis duration,phosphate,calcium-phosphate product,serum creatinine and adiponectin (P ＜ 0.01 or ＜ 0.05).Only calcium-phosphate product remained as independent predictor of CACS in multivariate analysis (P ＜0.01).Conclusion Coronary artery calcification is common in MHD patients and which is correlated with dialysis duration,serum phosphate,calcium-phosphate product,serum creatinine and adiponectin.

OBJECTIVE To observe the effect of administration intranasal corticosteroids on small airway disfunction for allergic rhinitis (AR) patients. METHODS AR patients with small airway disfunction were administrated intranasal corticosteroids for twelve weeks. Before treatment, nasal VAS, RQLQ were recorded, pulmonary function test were given. After therapy, VAS, RQLQ were obtained again at the 4th, 8th and 12th week. Pulmonary function test were performed at the 4th and 12th week. RESULTS VAS, RQLQ were all improved after therapy (P <0.01). The indices of FEV1/FVC%, MMEF pred%, MEF75pred%, MEF50pred%, MEF25pred%were also improved significantly (P<0.05), especially for MMEFpred%, MEF75pred%, MEF50pred% (P<0.01). CONCLUSION Small airway lesions can be obviously improved by the intranasal corticosteroids applied for AR. It has positive significance for preventing AR from developing into asthma.

Methods The clinical data of 4445 cases (5 530 hernias) who underwent LIHR at Ruijin Hospital from Jan 2001 to Dec 2015 were analyzed retrospectively.2 125 cases underwent 2 402 trans-abdominal preperitoneal procedure(TAPP),2 306 cases did 2 907 totally extraperitoneal (TEP),and 21 IPOMs in 20 cases.There were 3 216 indirect hernias (60.3％),1 164 direct hernias (21.8％),399 recurrent hernias (7.5％),479 complex hernias (9.0％),and 72 femoral hernias (1.4％).The median time of follow-up is 51 months with a range between 7 and 187 months.Results The average operation time was 27.1 ± 8.7 min for unilateral hernia repair,and 43.0 ± 11.0 min for bilateral hernia repair.The average hospital stay was 1.4 ± 1.1 d.There were 250 seroma (4.7％),68 urinary retention (1.3％),23 transient neuropraxia (0.4％) and 3 paralytic obstruction of intestines (0.1％).Severe complications included 1 port site hernia,1 intestinal injury,and 1 mechanical intestinal obstruction.After a medium follow-up of 51 months,there were 13 recurrent cases (0.24％),including 5 cases after TAPP,7 after TEP,1 after IPOM.Conclusion LIHR is a safe and efficient technique for hernia repair.