We reported a case of rheumatoid arthritis (RA) combined with pigmented villonodular synovitis (PVNS) from Peking University People's Hospital. The clinical data were introduced and the related literature was reviewed. The clinical features, treatment and prognosis of the disease were summarized to improve clinicians' understanding of this rare disease and avoid misdiagnosis and delayed diagnosis. A 45-year-old female, with 15 years of RA history and unregular treatment, was admitted to the hospital with the complaint of aggravating pain and swelling in the right knee for 3 months. The puncture of the right knee was performed and there was a large amount of bloody synovial fluid that could not be explained by her RA history. Moreover, the magnetic resonance imaging (MRI) of the right knee revealed hemosiderin deposition with low-intensity signals on both T1-weighted and T2-weighted images which suggested PVNS to us. Then, the patient underwent knee arthroscopy and biopsy to assist in diagnosis. The arthroscopic appearance and pathology were consistent with PVNS and the hyperplastic synovium was removed during arthroscopy. After the operation, she did active functional exercises and took disease-modifying antirheumatic drugs to control RA. She recovered well and remained asymptomatic after half a year of follow-up. Also, there was no recurrence of the right knee. As we all know, RA is a systemic autoimmune disease characterized by chronic synovitis and joint damage. And PVNS is characterized by synovial proliferation and infiltrative process. Both of them are synovial involvement and the clinical manifestations are quite similar. PVNS has occasionally been reported in association with RA. So it is difficult to make a clear diagnosis of RA combined with PVNS. Literature was searched with RA+PVNS in the WanFang Medical Network Database and China National Knowledge Infrastructure and there were no related Chinese cases. Then we searched literature from PubMed with RA+PVNS. The cases were still rare and eventually 2 related articles were yielded including 2 similar patients. It is necessary to fully understand the disease development, complicated MRI appearance and various pathological morpho-logy. They can contribute to making a correct diagnosis which is effective to guide the proper treatment.
Arthritis, Rheumatoid/diagnosis* ; Arthroscopy ; China ; Female ; Humans ; Knee Joint/diagnostic imaging* ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Recurrence, Local ; Synovitis, Pigmented Villonodular/diagnosis*

BACKGROUND:Angelica polysaccharide has the function of enriching blood and promoting blood circulation, but how to improve the hematopoietic microenvironment and promote hematopoiesis has become one of the hot topics. OBJECTIVE: To investigate the effect of angelica polysaccharide on Sca-1+, CD34+ hematopoietic stem cells and intercellular adhesion molecule 1 level in bone marrow stromal cells in mice. METHODS:Mouse models of hemorrhagic anemia were made and then randomly divided them into control group, low-concentration angelica polysaccharide group and high-concentration angelica polysaccharide group. Angelica polysaccharide groups were intraperitoneally injected with the corresponding concentration of angelica polysaccharide (4, 6 mg/kg) for continuous 6 days, while the control group was injected with equal amount of normal saline. General conditions of the model mice were observed. Peripheral blood red cells were counted by automatic blood cell analyzer. Bone marrow hematopoietic stem cels were counted by magnetic bead sorting technique and flow cytometry. Proliferation of bone marrow stromal cells was detected by MTT method. Expression of intercellular adhesion molecule-1 in bone marrow stromal cells was detected by flow cytometry. RESULTS AND CONCLUSION:Angelica polysaccharide had no obvious effect on the body mass of hemorrhagic anemia mice (P > 0.05). The number of peripheral blood cells, the percentage of bone marrow CD34+ and Sca-1+ cells, the number of bone marrow stromal cells and the level of intercellular adhesion molecule 1 were ranked as follows: high-concentration group > low-concentration group > control group (P < 0.05). To conclude, angelica polysaccharide could promote the proliferation of bone marrow stromal cells and increase the expression of intercellular adhesion molecule 1, thereby promoting the proliferation of hematopoietic stem cells and regulating their functional activities.

BACKGROUND:The microRNAs are involved in regulation of stem cel proliferation, differentiation and aging. To study the effect of Let-7c, a member of Let-7, on the neural differentiation of bone marrow mesenchymal stem cels provides new ideas for stem cel therapy. OBJECTIVE: To investigate the role of Let-7c in the neural differentiation of bone marrow mesenchymal stem cels. METHODS: The lentiviral vectors of Let-7c-up and Let-7c-inhibition were constructed and transfected into rat bone marrow mesenchymal stem cels. Optimal multiplicity of infection was screened. The cels were divided into non-transfected group, negative control group (transfected with empty virus), transfected enhancement group (transfected with LV-rno-Let-7c-up), transfected inhibition group (transfected with LV-rno-Let-7c-5p-inhibition). Bone marrow mesenchymal stem cels were treated with fasudil as an inducer for triggering the cels to differentiate into neurons. The fluorescence expressed by transfected cels was observed under inverted fluorescence microscope. The expression of neuron-specific markers, neuron-specific enolase and microtubule-associated protein 2, were measured by immunocytochemical method. The mRNA expression of microtubule-associated protein 2 was detected by RT-PCR. The cel viability was determined by MTT method. RESULTS AND CONCLUSION:Under the inverted fluorescence microscope, the cels were successfuly transfected with LV-rno-Let-7c-up and LV-rno-Let-7c-5p-inhibition. Fasudil induced bone marrow mesenchymal stem cels to differentiate into neurons. The transfection efficiency and expression levels of neuron-specific enolase and microtubule-associated protein 2 in the transfected enhancement group were significantly higher than those in the negative control group (P < 0.05), while in the transfected inhibition group, they were lower than those in the negative control group (P < 0.05). These findings indicate that the differentiation percentage of bone marrow mesenchymal stem cels is increased by fasudil after transfection with LV-rno-Let-7c-up, and Let-7c may promote the differentiation of bone marrow mesenchymal stem cels into neurons.

Objective To introduce clinical application of retrograde medial pedicled skin flap of the leg to repair the plantar cutaneous deficiency. Methods From January 2002 to May 2008, in our hospital we adopted retrograde medial pedicled skin flap to renovate 12 cases of plantar cutaneous deficiency. The size of the skin flaps ranged from 10 cm× 7 cm to 13 cm × 12 cm. Results Ten cases of retrograde medial pedicled skin flap were survived, the rest had partial necrosis because of distal blood flow obstacle. One was cured by changing dressings; the other was repaired by secondary operation. Morphology and function of soft tissue defects were renovated well with 6-18 months follow-up. Conclusion This operation is an effective and reliable technique for plantar cutaneous deficiency.

Objective To evaluate the role of spinal c?Jun N?terminal kinase ( JNK ) signaling pathway in incisional pain in rats. Methods Sixty?three adult male Sprague?Dawley rats, weighing 200-250 g, were randomly divided into 3 groups ( n=21 each) using a random number table: incisional pain group ( IP group) , dimethyl sulfoxide ( DMSO) group, and JNK inhibitor SP600125 group ( SP group) . A 1?cm longitudinal incision was made through skin, fascia and muscle of the plantar aspect of the hindpaw in anesthetized rats. In group DMSO, 10% DMSO 10 μl was injected intrathecally at 30 min before surgery. In group SP, SP600125 25 μg (in 10 μl of 10% DMSO) was injected intrathecally at 30 min before sur?gery. Six rats in each group were sacrificed, and the mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured at 24 h before establishment of the model and 2, 6, 24, 48 and 72 h after establishment of the model. After measurement of the pain threshold at 24 h before establishment of the model and 6, 24, 48 and 72 h after establishment of the model, the lumbar segment of the spinal cord was removed for determination of the expression of phosphorylated JNK ( p?JNK) by im?munofluorescence. Results The MWT was significantly lower, the TWL was shorter, and the expression of p?JNK was lower at each time point after establishment of the model than at 24 h before establishment of the model in group IP (P<0?05). Compared with group IP, the MWT was significantly increased, the TWL was prolonged, and the expression of p?JNK was down?regulated at each time point after establishment of the model in group SP ( P<0?05) , and no significant change was found in the parameters mentioned a?bove in group DMSO ( P>0?05) . Conclusion Spinal JNK signaling pathway is involved in the develop?ment and maintenance of incisional pain in rats.

Objective To evaluate the preliminary screening effect of the ESS、SAQLI and QOLOSAHS for OSAHS,and find out the most effective preliminary screening method.Methods The scores of ESS、SAQLI、QOL-OSAHS of the 93 participants were analyzed.The predictive values of the three scales for OSAHS were determined by receiver operator curve and discriminatory analysis.Results The sensitivity and specificity of ESS(ESS≥9 points) were 0.486 and 0.870.The sensitivity and specificity of SAQLI (≤246 points) were 0.914 and 0.522.The sensitivity and specificity of QOL-OSAHS (≤161 points) were 0.886 and 0.522.Conclusions ESS、SAQLI、QOL-OSAHS have moderate predictive value for OSAHS.SAQLI is better to drinker than ESS for diagnosis of OSAHS.

Professor YU Shu-zhuang is a distinguished acupuncturist in China. He has practiced the TCM acupuncture-moxibustion clinical, educational and scientific research for 60 years in his life. In clinic, he summarized the experiences "five-ming first"; in treatment, he insisted "dredging" and "regulating", protecting the function of spleen and stomach, and needles should be less but specific. In the meanwhile, he made a deep study on the function and clinical effects of specific acupoints, and used the research results of propagated sensation along channel to guide clinical treatment, forming his special academic points. Professor YU has educated a great number of acupuncture-moxibustion talents in China and foreign countries, making great contribution to the popularization of acupuncture-moxibustion in the worldwide.
Acupuncture ; education ; history ; Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, 20th Century ; History, 21st Century

Objective To investigate the clinical significance of generalized epilepsy with febrile seizures plus(GEFS+ ). Methods The data of one family with GEFS+ were retrospectively analyzed by studying clinical manifestations, physical examinations, electroencephalogram(EEG), 24 hours dynamic EEG monitoring, et al. Some of the patients were examined by CT. Results Ⅳ 12, her chief complaints when admitted to hospital were frequent spasm for 3 days. She began to appear febrile seizures (FS) from 8 months after birth, and frequent generalized tonic - clonic FS appeared during that time. There were 36 people in 5 generations of the family including 14 patients (8 males and 6 females) ,aged from 4 years and 5 months to 82 years. FS presented in 8 cases (Ⅱ 2, Ⅲ1, Ⅲ4, Ⅲ6, Ⅳ1, Ⅳ11, Ⅳ17, Ⅴ2),febrile seizures plus(FS +) in 4 cases ( Ⅳ2, Ⅳ12, Ⅳ13, Ⅳ14), ES + and absence seizures in 1 case ( Ⅴ1 ), uncertain type in 1 case (Ⅰ2). The results of EEG indicated that 12 cases were normal and 4 cases with FS+ and 1 case with absence seizures had epileptic discharges. Apart form Ⅳ13, Ⅳ14 who were treated with magnesium valproate, the dosage for the other patients decreased, or medicine terminated or without medicine, and all the patients had no recurrence of seizures. The intelligence, movement development and neurological examinations of the family were all normal. Head CT scan of 3 cases were normal. Conclusions GEFS+ is autosomal dominant inheritance disease with conspicuous genetic heterogeneity and phenotypic heterogeneity. The apprehension of GEFS+ plays an important role in diagnosis and differential diagnosis of epilepsy in childhood.

Objective To analyse the follow-up of one family with generalized epilepsies with febrile seizures plus (GEFS +).Methods We conducted a family with GEFS + by sexs,ages, seizure manifestation,electroencephalogram (EEG),and so on.Results There were 36 people in 5 generations of the family in all,including 14 patients(8 cases were male and 16 cases were female).Their ages were from 4 years and 5 months to 8 years.There were 8 cases febrile seizures (FS),4 cases with FS + and 1 case with FS + and absence seizures in 13 patients except 1 case without adequate knowledge.The Results of ECG indicted that 12 cases were normaland 4 cases with FS + and 1 case with absence seizures had epileptic discharges.Conclusions GEFS + is a common kind of inherited epilepsic syndrome and occur in childhood.So it is greatly important for epileptic children to know GEFS +

A biosurfactant-producing strain(S_6)was isolated from oil-containing wastewater in oxidation ditch and identified as Pseudomonas aeruginosa based on physiological and biochemical experiments and 16S rDNA sequence analysis.Infrared spectrum analysis revealed that S_6 produced glucolipid in the process of metabolism.It was observed that S_6 decreased the surface tension of water from 72 mN/m to 33.9 mN/m with the critical micelle concentration(CMC)of 50mg/L.The measurement of oil displacement and surface tension demonstrated that the fermented liquid had stable surface activity at varying range of salinity,pH,amount of dissolved oxygen.The optimal culture condition was obtained through orthogonal experiment:glucose 10g/L,urea 5g/L,KH_2PO_4 1g/L,liquor of microelement 2mL,pH 8.0,water 1000mL;and the biosurfactant production under optimal culture condition was 0.173g/L.