Objective To investigate the clinical effect of sodium hyaluronate combined with glucocorticoid on the treatment of periarthritis of shoulder.Methods106 patients in department of orthopedics, the second hospital of Ningbo with periarthritis of shoulder were randomly divided into 2 groups (n=53).The control group were treated with anti-inflammatory and analgesic treatment, at this basis, the study group were treated with sodium hyaluronate combined with Glucocorticoid.5 weeks for a course of treatment.Levels of serum inflammation, laboratory-related indicators were compared.ResultsCompared with before treatment, shoulder joint activity in the two groups increased, VAS score decreased, the scores of strength of shoulder joint, range of motion and daily activities increased, levels of serum IL-6, IL-10, TNF-α decreased(P<0.05).Compared with the control group, scores of activity in the study group were higher, VAS scores were lower, scores of strength of shoulder joint, range of motion and daily activities were higher, levels of serum IL-6, IL-10, TNF-α were lower(P<0.05).The effective rate in the control group(73.59%) was lower than the study group(90.57%), but there was no statistical difference.ConclusionThe effect is accurate which sodium hyaluronate combined with glucocorticoid was used in the treatment of periarthritis of shoulder, and it can reduce the inflammation index and improve the joint activity.

Objective To observe effects of ginsenoside Rb1 on phosphorylation of microtubule-associated protein 2 (pMAP-2) in hippocampus and amygdala of depressive model rats. Methods Thirty male Wistar rats were randomly divided into control group, model group and treatment group. The depression rat model was produced by giving chronic unpredicted mild stress (CUMS). Treatment group was given daily intragastric administration of ginsenoside RB 1 (1 g/mL crude drug, 1 mL/100 g body weight) for 22 days during modeling. Western blot assay was used to detect expressions of MAP-2 and pMAP-2 protein, and real-time PCR was used to detect expressions of pMAP-2 mRNA respectively. Results The expressions of pMAP-2 protein and mRNA in hippocampus and amygdala were significantly lower in model group than those of control group (P < 0.05). The expressions of pMAP-2 protein and mRNA were significantly higher in treatment group than those of model group (P<0.05). Conclusion Ginsenoside Rb1 can play anti-depression role by inhibiting the phosphorylation of MAP-2 in rats.

OBJECTIVEThe demographic characteristics of acupuncture outpatient in China is investigated so as to provide clinical evidence for the establishment of acupuncture indication.

METHODSClinical epidemiological table was adopted to do cluster multistage random sampling in 36 hospitals of 31 provinces (municipalities and autonomous regions) in 2008. The composition ratios of all indices were analyzed with SPSS 13.0 software. And trend analysis was carried out on the patient's demographic characteristics and the age distribution of clinical indications.

RESULTSIn the year 2008, 31 858 cases of out patients from 36 hospitals of 6 administrative regions were collected. There were totally 14 411 male patients (45.2%) and 17 447 (54.8%) female. The gender ratio of male and female was 82: 100. The average age of the patients was (50.6 +/- 17.7) years old. The number of patients over 45 years old was more obvious than groups of other ages (P<0.05). Age differences can be found in those 6 regions (P<0.05). Clinical symptoms varied according to different ages of the patients. Different characteristics of age distribution of acupuncture indications were held to exist (P=0.000).

CONCLUSIONAt the present, differences of gender, age and region can be found in out patients of acupuncture clinic. And the result shows that the number of female patients is more than male, with a large proportion of patients over 45 years old. Differences of age distribution characteristics of acupuncture indications still exist, which is considered to have the relation with the dominate indications of acupuncture and aging of the population.

Acupuncture Therapy ; utilization ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Demography ; Female ; Humans ; Infant ; Male ; Middle Aged ; Outpatients ; statistics & numerical data ; Young Adult

OBJECTIVETo observe the clinical effect of Chinese medical (CM) syndrome differentiation based Chinese herbs and recombinant human tumor necrosis factor receptor II-antibody fusion protein (etanercept) for treating ankylosing spondylitis (AS) patients.

METHODSTotally 35 AS patients were treated with syndrome differentiation based Chinese herbs and etanercept. Reinforcing Shen and strengthening Du channel, activating meridians to stop pain was principle used in syndrome differentiation based treatment. Etanercept was subcutaneously injected, 25 mg each time; twice per week for the first three months and once a week for the latter three months. The clinical efficacy was evaluated after 3 and 6 months of treatment. Meanwhile, ASAS20 and ASAS50 standards arriving rates were also observed. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), visual analog score (VAS) for spine pain, VAS for night pain, patient global assessment (PGA), VAS for physician global assessment, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, cervical rotation, Schober improved test, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were observed before treatment, 3 and 6 months after treatment.

RESULTSCompared with before treatment, BASDAI, BASFI, VAS for spine pain, night pain, physician global assessment, PGA, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, Schober improved test, ESR, and CRP all decreased after 3 and 6 months of treatment, with statistical difference (P < 0.05). Cervical rotation also decreased after 6 months of treatment, with statistical difference (P < 0.05). Compared with 3 months of treatment, total effective rate of CM syndrome, ASAS20 and ASAS50 standards arriving rates increased after 6 months of treatment, with statistical difference (P < 0.05). There were statistical differences in all indices mentioned above between after 3 months of treatment and after 6 months of treatment (P < 0.05).

CONCLUSIONSyndrome differentiation based Chinese herbs combined etanercept could alleviate inflammatory reaction favorably, control the progression of active AS, and improve joint functions.

Disease Progression ; Drugs, Chinese Herbal ; therapeutic use ; Etanercept ; therapeutic use ; Humans ; Pain ; prevention & control ; Pain Management ; Spondylitis, Ankylosing ; drug therapy ; Treatment Outcome

AIM: To investigate the regulation of sodium pump ?-subunit gene expression in the cortex of kidneys from one kidney one clip (1k1c) hypertensive rats. METHODS: 1k1c hypertensive rats were prepared by partially ligating the left renal artery and removing the right kidney. 4 weeks later, all the rats were killed, the levels of sodium pump ? 1-, ? 2-, and ? 3-subunit mRNA and protein in the cortex of kidney were detected with reverse transcription polymerase chain reaction (RT-PCR) method and immunohistochemical assay, respectively. RESULTS: The mRNA levels of sodium pump ? 1-subunit increased and ? 2- and ? 3-subunit were unchanged in the cortex of kidneys from 1k1c hypertensive rats compared with control rats, while no change has been found for all the three subunits gene expressions at protein level. CONCLUSION: There were some changes in the expression of sodium pump ?-subunit gene in the cortex of kidney of the 1k1c hypertensive rat, which might be related to the development of hypertension in this hypertensive model.

Sacral fractures are usually caused by high-energy violence,often complicated with injury to the lumbosacral plexus.In severe cases,they may cause instability of the posterior pelvic ring or of the lumbosacral junction.Their classifications commonly used in clinic are Denis,Tile,Isler and refined Denis type Ⅲ ones proposed by Roy-Camille and Gibbons.Recently,classifications of the lumbosacral lesions and scoring systems of the injury severity have often been used clinically.At present,internal instrumentation of sacral fractures is developing along the direction of high efficiency,safety and minimal invasion,but different methods of internal fixation have their own indications which should be strictly followed.This review summarizes the classifications of sacral fractures and their treatment advances.

Objective:To study the effect of Ginkgo biloba extract (EGb761) on metabolism of aflatoxin B_1(AFB_1) in Wistar rats. Methods:Seventy one Wistar rats were divided into three groups at random: group A (AFB_1 group), group B (AFB_1+EGb761 group), and group C (control group). The rats in groups A and B were given AFB_1(intraperitoneal injection, 100-200 μg/ kg body weight, 1-3 times/week). The rats in group B were fed the food containing EGb761 while the rats in groups A and C were given normal food. Blood samples were collected and liver biopsy was performed on the 14th, 28th and 42nd week. All the rats were sacrificed at the 64th week. The incidence of hepatoma was observed. The hepatic phase Ⅰ drug-metabolizing enzyme CYP450 and phase Ⅱ enzyme GST were detected by spectrometry. The serum AFB_1-lysine adduct was determined by high performance liquid chromatography (HPLC). The expression of 8-hydroxydeoxyguanosine(8-OHdG) was measured by immunohistochemistry. Results:The incidence of hepatocellular carcinoma (HCC) in group B was significantly lower than that in group A (26.92% vs 76.00%,P<0.001). No hepatocellular carcinoma developed in group C. EGb761 had no effects on the activities of CYP450 and GST in rat liver tissues. The level of AFB_1-lysine adduct reached the peak (4 356.01 pg/mg albumin) at the 14th week in group A. EGb761 significantly inhibited the formation of AFB_1-lysine adducts in serum by 13.07% at the 14th week (P＝0.033), and 73.63% at the 42nd week (P＝0.002). The expression of 8-OHdG protein in rat liver tissues in group B was significantly lower than that in group A at the 28th, 42nd, and 64th week (P<0.05). Conclusion:The main mechanism underlying the effect of EGb761 in blocking hepatogenesis induced by AFB_1 may not be fully related with its influence on the activity of liver phase Ⅰ and phase Ⅱ metabolizing enzymes. EGb761 inhibites the production of AFB_1-lysine addcuts, decreases the expression of 8-OHdG protein, and finally alleviates the DNA oxidative injury, which may be one of the mechanisms for the effects of EGb761 in inhibiting or delaying hepatogenesis induced by AFB_1.

Objective:To study the relationship between the expression of carnitine palmitoyltransferase 1α (CPT1α) and progression of renal interstitial fibrosis and chronic kidney disease (CKD), and to evaluate the value of CPT1α as a biomarker in pathological diagnosis of renal interstitial fibrosis and CKD.Methods:As a retrospective cohort study, information of CKD patients dignosed with tubulointerstitial fibrosis by renal biopsy and receiving follow-up from March 1, 2010 to July 30, 2017 in the Second Affiliated Hospital of Nanjing Medical University were collected. Renal tissues were stained by immunohistochemistry to detect the expression of CPT1α protein and then divided into three groups according to the quartile of proportion of CPT1α positive staining cells, including group Q1(>67.89%), group Q2(49.84%-67.89%) and group Q3(<49.84%). The degree of renal interstitial fibrosis was measured by Masson staining and lipid deposition was represented by Bodipy staining. Messenger RNA of CPT1α and collagen as well as other extracellular matrix genes were detected by real time-PCR. Relationships between proportion of CPT1α positive staining cells and renal interstitial fibrosis and renal function were analyzed by linear regression analysis. The relationship between CPT1α positive cell number ratio and renal function progression was measured by Pearson correlation analysis and generalized linear model. The effect of lipid-lowering medicine on renal function of CKD patients was analyzed by paired comparative analysis.Results:Ninety patients with CKD were included in this study. Renal interstitial fibrosis and lipid droplets deposition area increased in Q2/Q3 group compared with Q1 group by Masson and Bodipy staining (all P<0.05). Messenger RNA level of extracellular matrix-related proteins increased in Q2/Q3 group by real time-PCR than those of Q1 group (all P<0.05). Linear regression analysis showed that fibrosis area was negatively correlated with the proportion of CPT1α positive staining cells ( r=-0.309, P<0.01). The baseline expression of CPT1α in renal issues was negatively related with serum creatinine (Scr) ( r=-2.801, P<0.001), positively related with estimated glomerular filtration rate (eGFR) ( r=1.240, P<0.001). After a medium follow-up of 3.47 years, CPT1α positive cell number ratio was positively correlated with eGFR change rate by Pearson analysis ( r=0.220, P=0.038). Paired stratified analysis showed that taking lipid-lowering medicines attenuated the decrease of eGFR in Q2 group and Q3 group but not in Q1 group (both P<0.05). Conclusions:The decline of CPT1α in renal tissues of CKD patients is associated with the increase of Scr, the decrease of eGFR and renal interstitial fibrosis. CPT1α is a promising molecular marker to evaluate the degree of renal fibrosis and the progression of CKD.

OBJECTIVETo discuss the results and significance of the detection of the CFTR gene mutation in azoospermia patients with congenital unilateral absence of the vas deferens (CUAVD).

METHODSWe collected peripheral blood samples from 6 azoospermia patients with CUAVD for detection of the CFTR gene mutations and single nucleotide polymorphisms. We analyzed the genome sequences of the CFTR gene in comparison with the website of the UCSC Genome Browser on Human Dec. 2013 Assembly.

RESULTSMissense mutation of c. 592G > C in exon 6 was found in 1 of the 6 azoospermia patients with CUAVD and splicing mutation of c. 1210-12T[5] was observed in the noncoding region before exon 10 in 2 of the patients, both with the V470 haplotype in exon 11.

CONCLUSIONMutations of the CFTR gene can be detected in azoospermia patients with CUAVD and the detection of the CFTR gene mutation is necessary for these patients.

Azoospermia ; genetics ; Cystic Fibrosis Transmembrane Conductance Regulator ; genetics ; Exons ; Humans ; Male ; Male Urogenital Diseases ; genetics ; Mutation, Missense ; genetics ; Vas Deferens ; abnormalities

Objective To evaluate the clinical significance of chronic hepatitis B (CHB) with concurrent hepatitis e antigen (HBeAg) and antibody (anti-HBe) during antiviral therapy. Methods A total of 115 CHB patients with concurrent HBeAg and anti-Hbe detection during antiviral therapy were enrolled in this retrospective study. All patients received pegylated-IFN-alpha-2a (Peg-IFNα-2a, n = 50) or entecavir (ETV, n = 65) for antiviral treatment. Their biochemical virological and serological response and clinical outcome were detected and analyzed. Results Among the patients treated with Peg-IFNα-2a, 31 (62.0%) achieved HBeAg seroconversion and 6 (12.0%) achieved HBsAg seroconversion at the end of treatment. About 35.4% of patients, who received ETV, achieved HBeAg seroconversion and none of them achieved HBsAg seroconversion at the end of treatment (P < 0.05). Conclusion High rates of HBeAg seroconversion and HBsAg loss could be achieved in CHB patients, with co-existence of HBeAg and anti-HBe, who received Peg-IFNα-2a, but not ETV therapy.