This paper analyzed the problems existing with the usage of assistive ambulatory devices (AADs) among older adults in America and proposed solutions to improve these problems. The effects of AADs － walker, rollator, and cane － on gait and posture of older adults were assessed. Also, the relationships between AAD usage, fall occurrence, and why older adults continue to fall despite use of AADs were analyzed. It was suggested that in order to prevent from falls among older adults in the community routine assessment and training in correct AAD use should be performed.

OBJECTIVE: To observe the effects of ginsenoside (Gs) and berberine (Ber), two kinds of active components of traditional Chinese herbal medicine, on transforming growth factor-beta1 (TGF-beta1) and prostaglandin E2 (PGE2) in PG cells. METHODS: Co-culture system of human lung carcinoma cell line PG and human T lymphocyte cell line Jurkat was established. PG cells were treated with Gs (100 microg/ml) and Ber (10 mug/ml) for twenty-four hours, and then cocultured with Jurkat cells. After 24-hour coculture, the state of Jurkat cells was observed with inverted microscope. The viable count of Jurkat cells was detected by trypan blue staining after 6- and 24-hour coculture, and the apoptosis of Jurkat cells was evaluated by flow cytometry. PG cells were treated with 100, 50, 25 microg/ml Gs and 10, 5, 2.5 microg/ml Ber respectively, and the content of TGF-beta1 and PGE(2) in PG cells was detected by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) method. RESULTS: After coculture with PG cells treated with Gs and Ber, the number of Jurkat cells was less than blank control group, and the apoptosis rates of Jurkat cells in Gs- and Ber-treated groups were higher than blank control group. Gs and Ber could promote the secretion of TGF-beta1 in PG cells, but could not change the level of PGE(2). CONCLUSION: Gs and Ber can promote the growth inhibition and apoptosis of Jurkat cells induced by PG cells, which may be related to the up-regulation of Gs and Ber on TGF-beta1 secretion in PG cells.

Objective:To test the effect of Ginsenoside Rg1 and Rh1 on the expression of CD25,HLA-DR,CD44,ICAM-1,CD11c and E-selectin on the surface of dendritic cell(DC).Methods:Mature DCs were treated with different doses of Rg1 and Rh1. Certain time later, the expression of adhesion molecular was detected with immunohistochemical method and the results were recorded with imaging data.Results:Except for E-selectin, both of Rg1 and Rh1 could increase the expression of HLA-DR,CD25,CD11c,CD44 and ICAM-1 on DCs.Conclusion:Expression increase of surface molecular, including in two signals required by T cell activation, stimulated by Rg1 and Rh1, is propitious to the formation of DC- T cell cluster that would enhance the antigen-presenting function of DC.

AIM:To investigate the effect of berberine on IL-1 or tumour necrosis factor (TNF) induced polymorphonuclear leucocyte(PMN)-endothelium adhesion and adhesion molecules.METHODS:Based on the model of human umbilical vein endothelial cell (HUVEC), this study adopted Rose Bengal Stain, cell ELISA, immunocyto-chemical techniques to investigate the effect of berberine on PMN-endothelium adhesion and the expression of cell adhesion molecules (CAMs).RESULTS:Berberine inhibited IL-1, TNF-induced HUVEC adhesion for PMN when pretreated HUVEC and antagonised IL-1, TNF-induced upregulation of ICAM-1 on HUVEC. Meanwhile, TNF-stimulated PMN adhesion for HUVEC and CD18 upexpression on PMN was diminished in the presence of berberine.CONCLUSION: Inhibite PMN-endothelium adhesion by downregulating the CAMs expression to inhibite PMN migration across endothelium is one of the mechanisms of antiinflammation of berberine.

AIM: To investigate the effect of phellodendron and three kinds of its main components, which have asuppressive effect on the immune system, on the membrane fluidity of normal murine splenocytes. METHODS: The fluidity ofmembrane lipid regions of splenocytes was determined by the fluorescence polarization technique using 1, 6 - diphenyl - 1, 3, 5- heatriene (DPH) as a fluorescence probe. RESULTS: The results showed that the water extract of phellodendron and one of itsmain components (palmatine) increased the cell membrane fluidity in the inactive state, but the other two components, berberineand jatrorrhizine, decreased the cell membrane fluidity. After activated by ConA, all of them can decrease the cell membrane flu-idity. CONCLUSION: These results suggest that their immunosuppressive function might be due to decreasing the cell membranefluidity.

Objective To observe the influence of intra-articular injection of sodium hyaluronate (HA) on mRNA expression of matrix metalloproteinase (MMP) -1, -3 and tissue inhibitor of metalloproteinase (TIMP)-1 in cartilage and synovium of osteoarthritis (OA) . Methods Sixteen white rabbits underwent unilateral anterior cruciate ligament transection and were divided into 2 groups randomly 5 weeks after transection. Experimental group rabbits received 0.3 ml of intra-articular 1% HA injection once a week. Animals in control group were treated under the same condition using saline. At death, 10 weeks following surgery, histological changes of articular cartilage of medial femoral condyle were evaluated by microscopy. The mRNA expression of MMP-1, MMP-3 and TIMP-1 in cartilage and synovium was analyzed using reverse transcription-polymerase chain reaction (RT-PCR) . Results Cartilage degradation in experimental group was significantly less severe than that in the control group. The expression of MMP-3 mRNA in synovium was significantly suppressed in experimental group compared with the control group (0.40?0.10 vs 0.62?0.13). HA treatment had no effect on MMP-3 expression in cartilage. No significant difference of MMP-1 and TIMP-1 expression in cartilage and synovium was found between experimental group and control group. Conclusion HA can alleviate the degeneration of articular cartilage of OA. One possible mechanism of the therapeutic effect of HA may be inhibition of expression of MMP-3 in synovium during early stage of OA.

Objective To report our usage of a combined flap which is constituted of bilateral hallux nails, skins, bones to reconstruct a finger, and to introduce the method and outcome of this way. Methods Combine two halves of halluxes harvested from both feet to reform a fabricated finger and then transplant it to the finger stump to reconstruct the defect part of the finger. Plantar flaps or some other flaps near the donor sites were transposed to cover them. From June 2003 to June 2009, a total of 20 fingers (20 cases) which had defect degrees range from I to Ⅲunderwent reconstruction surgeries in this way. Results All the 20 fingers transplanted survived completely. Follow-ups 1 to 5 years after each surgery: all the fabricated fingers had very realistic configurations. The MP joints of the reconstructed thrumbs got to the normal range of motion, and the other reconstructed fingers' total ROM were 203 degree on average. All the reconstructed fingers had the sensation function above S3,and their two-point discriminations ranged from 6mm to 10mm. Both halluxes of each case were conserved major parts of nails and had nice, symmetric appearances. All the flaps for the donor halluxes survived completely, and none of the cases showed pains, ulcers or abrasions of their feet. All the cases showed normal gaits during follow-ups. Conclusion The combined flap by bilateral hallux nails, skins, bones is an ideal alteration for finger defect reconstruction for the important advantages of realistic configuration as well as minor destructions to donor sites.

ObjectiveTo investigate the effect of vascular endothelial growth factor (VEGF) on collagen Ⅱ expression in rat articular chondrocytes in vitro.MethodsChondrocytes were isolated and cultured.Then rats were divided into 4 groups:group A(control):without any intervention; group B:10 ng/ml VEGF was added; group C:10 ng/ml IL-1β was added; group D:10 ng/ml VEGF and 10 ng/ml IL-1β were added.Messenger RNA (mRNA) expression of collagen Ⅱ was detected by using real time polymerase chain reaction (real time PCR),and the protein expression level of collagen Ⅱ was detected by Western blotting.Comparisons between groups were performed by one-way ANOVA.ResultsThe collagen Ⅱ mRNA expression levels of group B (0.78+0.07),group C (0.67+0.06) and group D (0.57+0.04) were significantly lower than those of the group A (1.00±0.08),and there was significant difference between B and D,C and D.Compared with group A(0.95+0.21),the expression of collagen Ⅱ protein in group B(0.71+0.14),group C(0.60±0.11) and group D(0.31 +0.09) was significantly suppressed.The expression of collagen Ⅱ protein in group D was significantly lower than those of group B and C.ConclusionVEGF can significantly suppress the expression of collagen II in rat articular chondrocytes.VEGF may play an important role in the development of osteoarthritis.

AIM: To study the effect of berberine on the proliferation of human pulmonary carcinoma cells (PG cells). METHODS: The proliferation of PG cells was determined by using MTT assay. Cell cycle and apoptosis of PG cells were determined by using flow cytometry. Confocal scanning imaging system was used to assay the ROS-releasing level of PG cells. RESULTS: Berberine was shown to inhibit proliferation of PG cells directly and in a concentration-dependent manner (P

AIM:To explore the relationship between apoptosis in the lung tissues and lung ischemia/reperfusion injury,and to observe the effects of human thioredoxin (hTrx) on apoptosis in lung ischemia/reperfusion injury. METHODS:The single lung in situ ischemia/reperfusion animal model was used. Eighty four Wistar rats were randomly divided into control group (control),groups of ischemia for 1 h and reperfusion for different times (IR1h,IR3h,IR5h),and groups of IR + human thioredoxin treatment (IR1h + hTrx,IR3h + hTrx and IR5h + hTrx). Transmission electron microscope (TEM),terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and immunocytochemistry techniques were used to observe apoptosis,apoptosis signal-regulating kinase 1 (ASK1) and expression of Bcl-2 and Bax in various phases of lung ischemia/reperfusion. RESULTS:Cell apoptosis in lung tissues was significantly high,ASK1,Bcl -2 and Bax protein were upregulated in lung tissues of lung ischemia/reperfusion injury as compared to control (all P