Objective To explore the value of dual energy CT imaging in the diagnosis of gouty tophus deposition.Methods Sixty-five cases of patients with gout treated in this hospital between December 2012 to December 2015 were selected.Another 65 cases of patients(rheumatoid arthritis,degenerative osteoarthritis and unexplained leg pain) were selected as control group.The re sults of dual energy CT imaging between two group were compared.Three experienced clinicians who didn't understand the imaging results were selected.They had a medical history and physical examination in patients with gout.The differences between clinical evaluation and imaging results were compared.Results Dual energy CT imaging showed that there were no tophi deposition in con trol group;the topi deposition in wrist joint,knee joint and ankle joint were 6.06％oo (33/34),100.00％ (22/22) and 96.49％ (55/57) in gout group.Dual energy CT imaging detected a total of 545 parts of tophus deposition.It was 4.36 times of the result of clinical evaluation(125 parts).Conclusion Dual energy CT imaging shows the advantages of simple noninvasive,high accuracy and low rate of misdiagnosis in diagnosing gout nodules.

Objective_To evaluate the clinical profile of ANI-guided remifentanil administration during posterior lumbar spinal surgery.Methods_Sixty patients undergoing selective posterior lumbar decompression laminectomy and internal fixation were randomized into two groups, ANI-guided analgesia group ( ANI group) and another group which was blinded to ANI ( control group) .In both groups, combined propofol-remifentanil target control infusion ( TCI) was performed, In ANI group, the concentration of remifentanil was adjusted to maintain ANI values be-tween 50 and 70, however, in the control group, remifentanil target concentration was adapted corresponding to HR or BP values.Anesthetics consumption, incidence of unwanted events, interventions, time of open-eyes and extu-bation, VAS0h and VAS1/2h, complementary analgesics, intraoperative awareness, PONV and other symptoms were recorded.Results_Remifentanil consumption was lower in ANI group than that in control group ( P<0.05) . The number of unwanted events( hypotension, bradycardia and total unwanted events) were also less in ANI group than that in control group (P<0.05).Compared with control group, the usage of urapidil was more and the usage of volume expansion was less in ANI group( P<0.05) .There was no significant statistic differences in other index
between two groups.Conclusions_ANI-guided remifentanil infusion resulted in application of lower remifentanil administered dose with more stable hemodynamics in posterior lumbar spinal surgery.

Objective To investigate the species of Acaroid mites breeding in the stored traditional Chinese animal medici?nal materials and the relationship between its community and habitats. Methods A total of 30 samples of traditional Chinese animal medicinal herbs were collected from Wuhu City,Anhui Province,China. The mites were isolated by the directly micro?scopic and floatation microscopic examinations,and then identified and counted under a light microscope. Results Acaroid mites was represented in 28 of the 30 samples,and the breeding rate accounted for as high as 93.3%(28/30). Totally,13 spe?cies of Acaroid mites were identified,which belonged to 4 families and 9 genera. The densities of Acaroid mites were top in 6 Chinese herbal medicines,such as corium erinacei,aspongopus,hirudo,pheretima aspergillum,Apostichopus and huechys. The diversity parameters of these six traditional Chinese animal medicinal herbs were calculated. The highest richness indexes were in aspongopus and hirudo,the highest diversity index was in hirudo,and the highest evenness index was in Apostichopus. Conclusions There are Acaroid mites breeding in parts of the traditional Chinese animal medicinal herbs stored in Wuhu. In the storage and processing of Chinese herbal medicines,we should pay attention to the prevention and control of mites.

Background Chondrocytes' phenotype and biosynthesis of matrix are dependent on having an intact cytoskeletal structure.Microfilaments,microtubules,and intermediate filaments are three important components of the cytoskeletal structure of chondrocytes.The aims of this study were to determine and compare the effects of the disruption of these three cytoskeletal elements on the apoptosis and matrix synthesis by rabbit knee chondrocytes in vitro.Methods Chondrocytes were isolated from full-thickness knee cartilage of two-month-old rabbits using enzymatic methods (n=24).The isolated cells were stabilized for three days and then exposed to low,medium,and high doses of chemical agents that disrupt the three principal cytoskeletal elements of interest:colchicine for microtubules,acrylamide for intermediate filaments,and cytochalasin D for actin microfilaments.A group of control cells were treated with carrier.Early apoptosis was assessed using the Annexin-FITC binding assay by flow cytometry on days 1 and 2 after exposure to the disrupting chemical agents.The components and distribution of the cytoskeleton within the cells were analyzed by laser scanning confocal microscopy (LSCM) with immunofluorescence staining on day 3.The mRNA levels of aggrecan (AGG) and type Ⅱ collagen (Col-2) and their levels in culture medium were analyzed using real-time PCR and enzymelinked immunosorbent serologic assay (ELISA) on days 3,6,and 9.Results In the initial drug-dose-response study,there was no significant difference in the vitality of cells treated with 0.1 μmol/L colchicine,2.5 mmol/L acrylamide,and 10 μg/L cytochalasin D for two days when compared with the control group of cells.The concentrations of colchicine and acrylamide treatment selected above significantly decreased the number of viable cells over the nine-day culture and disrupted significantly more cell nuclei.Real-time PCR and ELISA results showed that the mRNA levels and medium concentrations of AGG and Col-2 were significantly decreased for cultures treated with colchicine and acrylamide when compared with untreated cells at three,six,and nine days,and this inhibition was correlated with higher matrix metalloprotease-13 expression in these cells.Cellular proliferation,monolayer morphology,and matrix metabolism were unaffected in cytochalasin D-treated cells when compared with control cells over the nine-day culture period.Conclusions The disruption of the microtubulin and intermediate filaments induced chondrocyte apoptosis,increased matrix metalloprotease expression,and decreased AGG and Col-2 expression in rabbit knee chondrocyte cultures.Our findings suggest that microtubulin and intermediate filaments play a critical role in the synthesis of cartilage matrix by rabbit knee chondrocytes.

Objective To investigate the cytotoxicity of silica nanoparticles on vascular endothelial cells, and to clarify its action mechanism.Methods The 60 nm silica nanoparticle was selected and the invitro cultured human umbilical vein endothelial cells (HUVECs)were used as cell model.The HUVECs were divided into control and silica nanoparticle exposure groups with concentrations of 12.5,25.0,and 100.00 mg·L-1 .MTT assay was used for the determination of cell viability,lactate dehydrogenase (LDH)release assay for membrane integrity,flow cytometry (FCM)for intracellular reactive oxygen species (ROS)content,and real-time PCR assay for intracellular NF-E2-related factor 2 (Nrf2 ), heme oxygenase-1 (HO-1 ), superoxide dismutase 2 (SOD2 ) and glutamate-cysteine ligase catalytic subunit (GCLC)mRNA levels.Results The MTT results showed that the cell viabilities in each silica nnaoparticle exposure group were decreased compared with control group in a dose-dependent manner. Upon the silica nanoparticle exposure for 12 h,the cell viability was declined significantly only in 100 mg·L-1 exposure group compared with control group (P<0.05).When exposured for 24 h,the cell viabilities in 25.0, 50.0,and 100.0 mg·L-1 exposure groups were declined significantly compared with control group (P<0.05). Under the exposure to silica nanoparticle with the same dose, the cell viabilities were decreased along with the elongation of exposure time.LDH assay and FCM showed that except for that in 12.5 mg·L-1 exposure group, both the LDH activities in media and intracellular ROS levels in other exposure groups were increased compared with control group (P<0.05 ). The results of real-time fluorescence PCR showed that the mRNA levels of Nrf2, HO-1,SOD2 and GCLC in 100 mg·L-1 silica nanoparticle exposure group were increased significantly compared with control group (P<0.05).Conclusion Silica nanoparticles have toxicity to vascular endothelial cells,which includes reducing cell viability,membrane integrity destruction,induction of ROS generation,and tranSCriptional regulation of redox-related factors. Oxidative damage is one of the mechanisms of vascular endothelial toxicity mediated by silica nanoparticles.

Objective To investigate the correlations in target volumes based on positron emission tomography CT (PET/CT) and the end-expiration phase of four-dimensional CT (4D-CT) images for non-small cell lung cancer (NSCLC).Methods Seventeen patients with NSCLC sequentially underwent three-dimensional CT (3DCT),4D-CT and 18F-FDG PET/CT thoracic simulation scans.The gross target volume (GTV) was contoured on the end-expiration phase (50％) of 4D-CT and defined as GTV50％.The internal gross target volumes (IGTV) based on PET/CT images (IGTVPET) were determined by the standardized uptake value (SUV) 2.0 (IGTVPET2.0) and 20％ percentage of the maximal standardized uptake value (SUVmax) (IGTVPET20％).The following parameters were calculated to analyze the correlation between IGTVPET and GTV50％ in volume ratio (VR) and conformity index (CI):maximum transverse diameter of GTV50％,volume of GTV50％,the displacement of GTV in the cranial-caudal direction and 3D Vector calculated from 4D-CT dataset as well as the SUVmax.Results There was no significant correlation between the VR of IGTVPET2.0 to GTV50％ and the maximum transverse diameter of GTV50％,volume of GTV50％,the displacement of GTV in the cranial-caudal direction,3D Vector and the SUVmax (P ＞ 0.05).The VR between IGTVPET20％ and GTV50％ inversely related to maximum transverse diameter of GTV50％,volume of GTV50％ and SUVmax (r =-0.663,-0.669,-0.752,P ＜0.05).The CI between IGTVPET2.0 and GTV50％ positively related to volume of GTV50％ and maximum transverse diameter of GTV50％ (r =0.613,0.483,P ＜ 0.05).Conclusions 3D PET images provide a time-averaged image of the tumor during the numerous breathing cycle.They fail to include the full information of moving tumor.The target volumes based on 3D PET might not reflect the real IGTV of NSCLC.

Objective To investigate the clinical efficacy of umbilical blood stem cell transplantation (UCBSCT) on the treatment of hepatitis B liver cirrhosis. Methods Forty-eight patients with hepatitis B liver cirrhosis were enrolled and divided into the treatment group and the control group. There were 25 patients in the treatment group , who received UCBSCT treatment based on conventional liver protection treatment and 23 patients in the control group , who received conventional liver protection treatment. The changes of liver function , coagulation function, clinical symptoms, signs and side effects were studied before the treatment and at 2, 4, 12 and 24 weeks post-treatment. Results The levels of albumin, cholinesterase, and prothrombin activity in the treatment group were higher than those before treatment and were higher than those in the control group. The parameters in the control group were not significantly changed before and after the treatment (P > 0.05). The levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin in both two groups were not significantly changed before and after the treatment (P > 0.05). After 4-week treatment,the differences on improvement of appetite , lacking in strength , abdominal distension , ascites were statistically significant in the treatment group compared with the control group (P < 0.05). No adverse reactions were observed in all groups. Conclusion UCBSCT on the treatment of hepatitis B liver cirrhosis is safe and reliable.

Objective To investigate the data of gene expression microarray by protein interaction network analysis,establish an interaction network of differentially expressed genes between Kashin-Beck disease (KBD) and osteoarthritis (OA) and choose the central nodes of the network.Methods The articular cartilage samples of degrees Ⅱ ° and Ⅲ ° KBD and OA patients were selected according to the national diagnosis criteria for KBD and the Western Ontario and McMaster Universities (WOMAC) for OA.Chondrocytes of 8 patients with KBD and 7 with OA were selected.About 1 000 different genes detected by gene expression microarray were inputted into STRING 9.1 database online for analysis and establishment of the interaction network.The interaction data were imported into Cytoscape 3.2.1 software for screening the central nodes of the network.KEGG database was exploited for pathway analysis and functional study of the central node genes,Real-time PCR (RT-PCR) was used for verification.Results The protein products of 334 differentially expressed genes between KBD and OA had interrelation,forming a complicated interaction network.About 150 central nodes were selected by Cytoscape 3.2.1 that involved in more than ten signal pathways involved in mitochondria,bone metabolism and inflammatory cytokine.Conclusion The interaction network of the differentially expressed genes between KBD and OA,especially the central nodes of this network,can provide clues to the mechanism and early diagnosis and molecular targeted therapy of KBD and OA.

Objective To assess temporary filter in the inferior vena cava (IVC) for trapping thrombus and preventing pulmonary embolism in patients with deep vein thrombosis. Methods In 58 cases of deep vein thrombus in single lower extremity, Antheor temporary filter (ATF) was introduced into IVC prior to anticoagulation and/or vascular intraluminal procedures. Results All IVC filters were successfully introduced. No symptomatic pulmonary embolism was documented. ATF was removed after a mean of 12.0?2.0 days. Thrombus was trapped in 46 cases (79.3%). Thrombus more than 1 cm in size was trapped in 2 cases. Conclusion Temporary filter was safe and effective in prevention of pulmonary embolism.

Objective To study methods of salvage therapy for acute lower extremity(ALEI) ischemia.(Methods) A restrospectively analyzsis was made on the clinical data of 96 patients with consecutive 106 ALEI limbs.In which Fogarty catheter embolectomy was used as the initial treatment for ALEI in a regular(operating) room or in an intervention therapy room under DSA monitoring,and graft bypass after embolectomy was performed on 8 cases(12 limbs).Results In 70 cases(75 limbs) successful embolectomy of the(iliac),femoral,popliteal and tibial artery was achieved.In 11 cases(12 limbs) embolectomy at distal to the popliteal artery was unsuccessful.Eight cases(12 limbs) with obstruction proximal to the femoral artery were treated by axillofemoral bypass in 4 cases,and femorofemoral bypass in 4 cases.One case of thoracoabdominal aortic dissection aneurysm and lower extremity ischemia had fenestration of the abdominal aoric dissection.Proximal embolectomy and distal amputation was performed in 6 cases.Fimally,76(79.2%) cases had(salvaged) limbs,11(11.4%) patients had amputated limbs,and 9(9.4%) patients died.Seventy-six(patients)(85 limbs) were followed up for 1 to 38 months,7 cases(7 limbs) were reoperated on because of recurrent embolism.Conclusions Embolectomy is the effective treatment method for ALEI.Embolectomy(under) DSA monitoring can improve therapeutic results.The prognosis lies on the duration and extent of(ischemia),and management of complications.