Objective To evaluate the medial longitudinal arch of the foot with and without hallux valgus in order to establish the relationship between hallux valgus and the arch. Methods 34 feet of 24 cases with hallux valgus and 34 normal feet of 18 cases were investigated by roentgenography. On the dorsal plantar view while weight-bearing standing, the hallux valgus angle (HVA), the first intermetatarsal angle, and the position of the tibial sesamoid relative to the first metatarsus were measured respectively. On the lateral view while weight-bearing standing, the top angle of the medial longitudinal arch, the anterior angle of the medial longitudinal arch (also named as the first metatarsal inclination angle) and the relative height of the talus, which are similar to measurement of the height of the medial longitudinal arch, were measured respectively. The characteristics of the medial longitudinal arch of the feet with and without hallux valgus were compared, and the correlation between the height of the medial longitudinal arch and the severity of the hallux valgus, which were manifested by the hallux valgus angle, first intermatatarsal angle, the relative position of the tibial sesamoid, was analyzed. Results The top angle of medial longitudinal arch was 136.9??7.6? in hallux valgus feet and 126.7??2.1? in normal feet; the anterior angle of medial longitudinal arch was 10.8??2.6? in hullux valgus feet and 16.6??1.6? in normal feet; the relative ratio of height of talus was 0.159?0.03 in hallux valgus feet and 0.199?0.01 in normal feet , there was significant difference between two groups. While with the increase of the lateral displacement of tibial sesamoid, the angle of hullxus valgus and the first intermetatarsal angle, the top angle of medial longitudinal arch became larger, the anterior angle of arch became smaller, and the relative height of talus became lower. The medial longitudinal arch of the foot with hallux valgus was collapsed, and there was moderate to high relationship between the height of the medial longitudinal arch and the severity of the hallux valgus. Conclusion Hallux valgus is a three dimensional deformity, which will disturb the normal biomechanics of the foot.

[Objective]To evaluate the clinical result of Weil osteotomy for refer metatarsalgia in hallux valgus. [Method]Between 2004 and 2005, 25 feet of 17 patients with hallux valgus were treated by osteotomy at the base of the first metatarsal and Weil osteotomy of the lesser metatarsal with metatarsalgia. Weight-bearing anterior-posterior and lateral X ray were taken before the surgery and 6 weeks after surgery on follow up. The hallux valgus angle , the intermetatarsal angle between 1st and 2nd metatarsal, and length of the second metatarsal were measured on the X-ray film. AOFAS system was used to judge the clinical result of the surgery. [Result]The hallux valgus before surgery angle was 32??5.7?,after surgery it was 12.8??3.5?; the intermetatarsal angle between lst and 2nd metatarsal before surgery was 24.2??3.7?,after surgery it was 10.5??0.7?; AOFAS score was 45.6?6.9 before surgery , and 86.9?4.6 after surgery ; significant difference was found between the result. The metatarsal after Weil osteotomy was shorten by 3~8 mm, mean 4.5 mm. After surgery 18 feet had pain free, and 7 feet had a signigicant pain relief . All the patient could return to normal life without other treatment. [Conclusion ] The biomechanical changes in the foot with hallux valgus should be analyzed before surgery . Combined use of base osteotomy at the first metatarsal and Weil osteotomy at lesser metatarsal can get satisfactory clinical result in patients with sever hallux valgus and transferred refer metatarsalgia.

Objective:To study the protective effect of electro-acupuncture on glutamate(GLU),glycine(GLY),aspartate(ASP)and NF-?B expression in rat with cerebral ischemia reperfusion.Methods:The middle artery occlusion(MCAO)model was established and high pressure liquid chromatography(HPLC)fluorescence assay was used to detect contents of glutamate(GLU),glycine(GLY)and aspartate(ASP)in rat brain.The effect of electro-acupuncture on the nervous dysfunction score,the water content of cerebral constitution and the expression of NF-?B were observed.The group with non-acupoint group was as control.Results:The nervous dysfunction score,the water content of cerebral constitution,NF-?B,GLUand ASP in model group were higher than those of the sham-operated group.GLY levels had no obvious changes,there was no significant diference between the model group and the non-acupoint group.The nervous dysfunction score,the water content of cerebral constitution,the expression of NF-?B,GLU and ASP in electro-acupuncture group were lighter than that of the model group,GLY levels had no obvious changes.Conclusion:Electro-acupuncture could protect brain cell from damage after focal cerebral ischemia reperfusion injury by inhibiting the cerebral expression of NF-?B and excitatory amino acid.

Objective To investigate the diagnostic value of anti-cyclic citrullinated peptides ( CCP ) antibodies combined rheumatoid factors (RF) on elderly patients with rheumatoid arthritis.Methods From January 2012 to December 2014, 29 cases of elder patients in our hospital with rheumatoid arthritis (elder RA group, age >60 year), 47 cases of elderly health control group (elder RA group, age≥60), and 48 cases of elder patients without rheumatoid arthritis (non-elder RA group, age<60 year) were selected.The anti-CCP antibodies and rheumatoid factor (RF) levels of three groups were detected, and the significance of anti-CCP antibody combined RF on the diagnosis of elderly rheumatoid arthritis was analyzed.Results Diagnostic positive rate of anti-CCP antibodies +RF was significantly higher than that of anti-CCP antibodies, and the difference was significant (χ2 =7.632, P =0.006).Diagnostic positive rate of anti-CCP antibodies +RF was higher than that of RF, but the difference was not statistically significant (χ2 =3.107, P=0.078).The diagnostic positive rate of anti-CCP antibodies, RF, and anti-CCP antibodies +RF for diagnosis of elderly rheumatoid arthritis had no statistically difference with that of non-elderly RA group.The sensitivity and negative predictive value of anti-CCP antibodies +RF was higher than that of only anti-CCP antibodies and RF.The area under the ROC curve of detecting anti-CCP +RF was 0.786, which was higher than that of anti-CCP antibodies (0.699) and RF (0.663), indicated that the reliability of anti-CCP antibodies +RF was higher than that of anti-CCP antibodies and RF.Conclusion The anti-CCP antibodies and RF can diagnose elderly rheumatoid arthritis, and anti-CCP antibodies combined RF has more clinical significance.

Objective To evaluate the expression of human kallikrein10 (KLK10) in different endometrioid tissues and analyse the relationship of KLK10 with ER and PR in endometrioid adenoearcinoma.Methods The expression of KLK10 protein in 12 normal endometria,19 endometrial hyperplasia and 34 endometrial carcinoma were detected by immunohistochemistry.The correlations of the expression of KLK10 protein,ER and PR were analyzed.Results The expression of KLK10 in stage Ⅰ,Ⅱ and Ⅲ were 64.3 ％(9/14),30.0 ％ (3/10),10.0 ％ (1/10),and the difference was statistically significant (P ＜ 0.05).The expression of KLK10 in endometrial carcinoma,normal endometria,endometrial hyperplasia were 66.7 ％ (8/12),33.3 ％(4/12),10.0 ％ (1/10),and the difference was statistically significant (P ＜ 0.05).The expression of KLK10 in G1,G2,G3 were 66.7 ％,33.3 ％,10.0 ％,and the difference was statistically significant (P ＜ 0.05).The positive rate of KLK10 expression was 38.2 ％ and the positive rates of ER and PR expression were 67.6 ％and 55.9 ％,respectively,in 34 endometrial carcinoma.The expression of KLK10 was positively correlated with ER and PR expression (x2 =0.448,P ＜ 0.01).Conclusion Absence or down-regulated expression of KLK10 may play an important role in the formation and development of endometrioid adenocarcinoma.The low expression of KLK10 is correlated with low expression of ER and PR in endometrioid adenocarcinoma.The positive expression of KLK00,ER and PR predicts a better prognosis.

ObjectiveTo test the expression of epidermal growth factor-like domain 7 (EGFL7),microvessel density (MVD) and foeal adhesion kinase pY397 (FAKpY397) in human glioma tissues,and to evaluate their relationship.MethodsThe expression of EGFL7 and FAKpY397 in 56 cases of human glioma and 8 cases of normal brain tissues were detected by immunohistochemistry test,and MVD was detected by CD34 staining.ResultsThere was a significant difference of the positive rates of EGFL7 between normal brain tissue (0) and gliomas (75％),χ2 =17.45,P ＜0.01.With the increased pathological grade,the expression level of EGFL7 increased (χ2 =26.24,P ＜ 0.01 ).There was a significant difference of the positive rates of FAKpY397 between normal brain tissue ( 12.5％ ) and gliomas (73.2％),χ2 =6.23,P ＜ 0.05.With the increased pathological grade,the expression level of FAKpY397 increased (χ2 =6.71,P ＜ 0.01 ). MVD on normal brain was( 15 ± 4 )/HP,on Ⅰ - Ⅱ grade and Ⅲ -Ⅳ grade gliomas was ( 27 ± 3 )/HPand ( 60 ± 4 )/HP respectively,there was a significant difference on MVD between normal brain tissue and gliomas (P ＜ 0.01 ).Higher level of MVD was found in gliomas with higher grade ( P ＜ 0.01 ).There was a positive correlation between EGFL7 and FAKpY397 expressions in gliomas (r =0.314,P ＜0.01 ).There was a significant difference on MVD between positive and negative expression of EGFL7 ( t =26.55,P ＜ 0.01 ). MVD was (56 ± 4 )/HP and (25 ± 3 )/HP respectively.ConclusionThe expression of EGFL7 of human gliomas has a favorable positive correlation with the degree of malignancy,MVD and FAKpY397.It is indicated that EGFL7not only palys an important regulative role in glioma neovascularization,but also it may participate directly in glioma occurrence and invasion.

Objective: To investigate the relationship between blood pressure variability and ambulatory arterial stiffness index (AASI) in both normal subjects and hypertensive patients.
Methods: A total of 280 consecutive subjects without antihypertensive medication were studied. All subjects received ambulatory blood pressure monitoring (ABPM) and AASI was calculated as 1 minus the regression slope of diastolic blood pressure value vs systolic blood pressure value according to ABPM recording.
Results: ① There were 161 subjects with male gender, 138 patients with hypertension, and the average age was (50.4 ± 13.3) years.②Pearson analysis indicated that AASI was related to age (r=0.272, P<0.001), 24-hour mean pulse pressure (r=0.504, P<0.001) , nocturnal diastolic blood pressure dipping (r=-0.334, P<0.001) and standard deviation of 24-hour diastolic blood pressure (r=-0.520, P<0.001).③AASI in anti-dipper hypertensive patients was higher than that in dipper patients, P<0.05;while AASI between dipper and non-dipper patients, dipper and extreme-dipper patients were similar, P>0.05 respectively.④Multiple linear regression analysis demonstrated that with adjusted age, gender, BMI and blood pressure, AASI was independently related to 24-hour mean pulse pressure (β=0.003, P<0.001), nocturnal diastolic blood pressure dipping (β=-0.001, P<0.05), standard deviations of 24-hour systolic blood pressure (β=0.032, P<0.001) and 24-hour diastolic blood pressure (β=-0.064, P<0.001), standard deviation of 24-hour heart rate (β=0.006, P<0.001).
Conclusion:AASI is closely related to blood pressure variability, it’s a comprehensive index for arterial stiffness and blood pressure variability.

Objective To study the clinical efficacy of computer-assisted stereotactic brain transplantation of human retinal pigment epithelium (hRPE) cells into the patients with Parkinson disease (PD). Methods Under the guidance of computed X-ray tomography and magnetic resonance imaging image mergence, 4 × 106 hRPE cells were transplanted into the putamen and ventriculus laterlis of 17 cases of PD by stereotactic surgery. The transplantation sites were contralateral to the side of main symptoms and signs. The curative efficacy were observed at the 7th day, 1st month, and 3rd month after the transplantation. Results The contralateral symptoms were ameliorated continuously after the transplantation. Three months after the surgery, the total effective rate of cell transplantation was 88. 2 %, and 82. 4 % of the cases got significant improvement. The cases that got ipsilateral improvement soon after the surgery gave a total effective rate as high as 88. 2 % at the 3rd month during follow-up period, and 64. 7% among these cases improved significantly. Only a minority of cases had transient dizziness and hemiparesis, but the duration was short. Conclusion The therapy, computer-assisted stereotactic transplantation of hRPE ceils in the treatment of PD, is safe and efficient.

Chloroplast-based expression system is promising for the hyper-expression of plant-derived recombinant therapeutic proteins and vaccines. To verify the feasibility of obtaining high-level expression of the SARS subunit vaccine and to provide a suitable plant-derived vaccine production platform against the severe acute respiratory syndrome coronavirus (SARS-CoV), a 193-amino acid fragment of SARS CoV spike protein receptor-binding domain (RBD), fused with the peptide vector cholera toxin B subunit (CTB), was expressed in tobacco chloroplasts. Codon-optimized CTB-RBD sequence was integrated into the chloroplast genome and homoplasmy was obtained, as confirmed by PCR and Southern blot analysis. Western blot showed expression of the recombinant fusion protein mostly in soluble monomeric form. Quantification of the recombinant fusion protein CTB-RBD was conducted by ELISA analysis from the transplastomic leaves at different developmental stages, attachment positions and time points in a day and the different expression levels of the CTB-RBD were observed with the highest expression of 10.2% total soluble protein obtained from mature transplastomic leaves. Taken together, our results demonstrate the feasibility of highly expressing SARS subunit vaccine RBD, indicating its potential in subsequent development of a plant-derived recombinant subunit vaccine and reagents production for antibody detection in SARS serological tests.
Chloroplasts ; metabolism ; Cholera Toxin ; Protein Interaction Domains and Motifs ; Recombinant Fusion Proteins ; biosynthesis ; SARS Virus ; Spike Glycoprotein, Coronavirus ; biosynthesis ; Tobacco ; metabolism ; Vaccines, Subunit ; biosynthesis

Objective To investigate clinical features of lower motor neuron lesion (LMNL) caused by the single level lower thoracic disc protrusion (LTDP),and to observe clinical outcomes of surgical treatment.Methods Between January 1997 and December 2009,17 patients with LMNL caused by single level LTDP underwent en bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation in our hospital.MRI and CT scans were taken to confirm lesion levels:T10-11 in 4 patients of whom 3 had patellar clonus and ankle clonus,T11-12 in 5 patients of whom 4 had ankle clonus,and T12L1 in 8 patients who only had positive Babinski sign.The neurologic status was assessed using the Japanese Orthopaedic Association (JOA) scoring system.The muscle strength of the tibialis anterior was assessed using the Manual Muscle Test (MMT).Sagittal Cobb angle and cross-sectional area of the dural sac at the level of maximal compression in MRI were also observed.Results All patients were followed up for 22 to 76 months (average,48.6 months).The mean JOA score increased from preoperative 5.88±1.11 to 9.53±0.94 at final follow-up (t=16.143,P＜0.05).The muscle strength of the tibialis anterior recovered to more than grade 4 in all patients.Postoperative Cobb angle was unchanged compared with that before operation.MRI indicated that the cross-sectional area of the dural sac at the level of maximum compression increased from preoperative 35.8±7.3 mm2 to postoperative 132.9±6.5 mm2 (t=70.78,P＜0.05).Conclusion LMNL can be caused by LTDP.The eu bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation can provide a satisfactory decompression effect and marked recovery of neurological function.