Objective To explore the characteristics of occult damage of cerebral white matter in patients with small vessel disease by using diffusion tensor imaging (DTI)technology,and its relationship with cognitive impairment.Methods Twenty-eight patients with CSVD and twenty-three matched volunteers all received T1 WI,T2 WI,DTI examination and montperllier cognitive function scale (MoCA).Then compare the difference between the two groups,and analysis the correlation between ADC and FA value of each re-gion of interested and MoCA score in CSVD group.Results ①FA values on bilateral frontal white matter in CSVD group were lower than control group,and ADC values were higher than control group,the difference was statistically significant (P <0.05 ).There were no significant differences in FA and ADC values on corpus callosum genu and splenium between two groups (P >0.05 );②In CSVD group,the FA value of bilateral frontal lobe white matter were positively correlated with the MoCA score (P <0.05 ),and the ADC value were negatively correlated with the MoCA score (P <0.05 ).there were no significantly correlations between FA and ADC values on corpus callosum genu and splenium and MoCA score (P >0.05 ).Conclusion Bilateral frontal white matter exist fi-ber occult damage in patients with CSVD,and the change of FA and ADC value can reflect the severity of cognitive impairment on a certain degree in patients with CSVD.

Aiming at status of training the rural order directed free medical educational talents, we should improve the understanding of training the free medical students, perfect the relevant management system, strengthen medical ethics education of students, pay attention to humanistic care of students,strengthen the continuing education of students, standardize the access system of students, reform the medical distribution system, to ensure the quality of training free medical students.

Objective To investigated to implement condition of preventive measure and control effect for endemic fluorosis in Fengshun County from 2005 to 2006.Methods It was investigated according to the National Surveillance Program of Endemic Fluorosis.Hupo,Daizai and Anquan Villages of Tangxi Town in Fengshun County were selected as monitoring spots.The usage of reforming water facilities,fluoride content in drinking water and urine of children aged 8-12 years and the prevalence rate of dental fluorosis of children were investigated.Resul tsin 2005 and 2006.a total of 18 reforming water facilities were surveyed and six of which were damaged or out of service.In 2005,the fluoride content in drinking water in the 3 villages was 2.10,1.22 and 0.15 mg/L The prevalence rate of dental fluorosis of children aged 8-12 years was 54.23%(64/118),38.91%(79/203) and 9.10%(6/66).The urine fluoride content of children was 0.95,0.90 and 1.05 mg/L,respectively.In 2006,the fluoride content in drinking water in Hupo,Daizai and Anquan Village was 2.01,1.57 and 0.21 mg/L.The prevalence rate of dental fluorosis of children aged 8-12 years was 26.47%(27/102),12.50%(23/184)and 6.15%(4/65),respectively.The urine fluoride content of children was 0.97,0.61 and 0.59 mg/L.Conclusions The outcome of surveillance data in Fengshun County has reached the sanle level as that of non-disease area.However,the management of reforming water facilities should be improved.

BACKGROUND:Many in vivo and in vitro experiments indicate that hypoxic co-cultures promote stem cells differentiate into chondrocytes.
OBJECTIVE:To evaluate the influence of hypoxia on the chondrogenic differentiation of three-dimensional co-cultured adipose-derived stem cells and articular chondrocytes.
METHODS:Adipose-derived stem cells and articular chondrocytes were mixed at the ratio of 3:1, then the mixed cells were seeded onto poly(lactic-co-glycolic acid)-gelatin scaffold at the ultimate concentration of 5.0×1010/L. The cells were cultured in normoxia (20%O 2 ) and hypoxic (5%O 2 ) conditions for 6 weeks. After culture, hematoxylin and eosin staining was performed for histological structure analysis, and alcian blue staining was used to evaluate glycosaminoglycan synthesis. Type II col agen expression was detected by immunohistochemistry staining. The content of DNA, glycosaminoglycan and hydroxyproline in the scaffold-cellcomplex was measured.
RESULTS AND CONCLUSION:In the hypoxia group, hematoxylin-eosin staining showed the formation of massive cells and extracellular matrix;alcian blue staining showed massive glycosaminoglycan formation;immunohistochemistry staining detected strongly positive expression of col agen type II, the content of DNA, glycosaminoglycan and hydroxyproline was higher than the normoxia group. Hypoxia promotes in vitro chondrogenic differentiation of co-cultured adipose-derived stem cells and articular chondrocytes. .

Objective To investigate the efficacy of zoledronic acid in the treatment of senile unstable femoral intertrochanteric fractures with anatomical locking plate. Methods 67 patients were randomly divided into two groups. Five days after the operation, group A received one intravenous injection of 5 mg zoledronic acid, while patients in group B did not receive the injection. The two groups were compared in terms of hospitalization time, complications, limb weight-bearing time, fracture healing time, hip function score after operation, preoperative and postoperative serum calcium and serum ALP, bone mineral density of proximal femur before operation and 1 year after operation. Results There were no statistically significant differences between the two groups in age, type of fracture, hospital stay, partial weight-bearing time, fracture healing time, hip function at 1 month and 1 year after operation, preoperative bone mineral density and blood calcium. But the differences were statistically different in hip function at 3 months after operation , averaged bone mineral density of proximal femur and serum ALP 1 year after operation. Moreover, 5 patients in group A developed muscle pain or fever after intravenous injection of zoledronic acid. Conclusion The locking plate combined with zoledronic acid injection in treatment of elderly patients with unstable femoral intertrochanteric fracture could inhibit bone loss, increase bone mineral density, and accelerate limb function recovery after operation. On the other hand, Zoledronic acid has a high incidence of adverse reaction.

AIM:To investigate the effect of oleuropein on interleukin-1β( IL-1β)-induced SD rat articular chondrocytes .METHODS:The SD rat articular chondrocytes were isolated by 2 step enzyme digestions .The chondrocytes were cultured in vitro.Inverted microscopic observation was performed during the culture .Alcian blue staining and type II collagen immunohistochemical staining were used to identify the chondrocytes .The effects of oleuropein on the viability of chondrocytes were determined by CCK-8 assay.The cells in 3rd passage were pretreated with oleuropein at 10, 50 or 100 μmol/L and subsequently stimulated with IL-1βat 10 μg/L for 24 h.Production of prostaglandin E 2 ( PGE2 ) and ni-tric oxide (NO) were evaluated by the Griess reaction and an enzyme linked immunosorbent assay (ELISA).The mRNA expression of matrix metalloproteinase ( MMP)-1 and MMP-13 was measured by real-time PCR.The protein levels of in-ducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and nuclear factor-kappa B (NF-κB) were detected by Western blotting .RESULTS:The cell viability of chondrocytes was not significantly impaired by treating with oleuropein at concentration of 10, 50 or 100μmol/L for 24 h compared with control group .Pretreatment with oleuropein significantly in-hibited the production of PGE 2 and NO induced by IL-1β.Oleuropein also significantly decreased the IL-1β-stimulated MMP-1 and MMP-13 mRNA expression in articular chondrocytes .Pretreatment with oleuropein inhibited the IL-1β-media-ted activation of NF-κB by suppressing the degradation of its inhibitory protein IκBαin the cytoplasm .CONCLUSION:Oleuropein inhibits IL-1β-induced inflammatory gene expression by suppressing NF-κB activation at the transcriptional le-vel, suggesting a new mechanism for the anti-inflammatory effects of oleuropein as a novel agent on treating with osteoarthri-tis.

[ABSTRACT]AIM:Toinvestigatetheinhibitoryeffectsofresveratrolonchondrosarcomaandtherelationwith mitochondrial and PI3K/Akt pathways.METHODS:Chondrosarcoma SW1353 cells were treated with resveratrol at con-centrations of 25, 50 and 100 μmol/L for the time intervals of 24 h, 48 h and 72 h.The viability and apoptosis of the SW1353 cells in the presence or absence of resveratrol were analyzed by CCK 8 assay and Hoechst 33258 staining , respec-tively.The protein levels of Bcl-2, Bax, activated caspase-3, Akt and p-Akt were detected by Western blotting .The cell migration ability was determined by wound scratch assay .RESULTS:Exposure of the cells to resveratrol resulted in a de-crease in the cell viability in a dose-and time-dependent manner (P<0.05).visible nuclei with apoptotic characteristics in resveratrol group were observed .The protein levels of activated caspase-3 and Bax were increased , and Bcl-2 and p-Akt were decreased compared with control group .The total Akt were not significantly changed .Resveratrol also significantly re-duced the migration of tumor cells .CONCLUSION:Resveratrol induces apoptosis of chondrosarcoma , which plays a role of part through mitochondrial and PI 3K/Akt signaling pathways .

Objective To decrease tumor local recurrence after abdominoperineal resection (APR)for low rectal cancer using cylindrical abdominoperineal resection. Methods From February 2009 to February 2010 cylindrical APR was performed in 15 patients of advanced ultralow rectal cancer at the Department of General Surgery, Qilu Hospital of Shandong University, according to the standard protocol as described by Holm. The procedure involves careful mobilization of the mesorectum as far down as the origins of the levator muscle. Ater stoma formation, the abdomen is closed, the patient is rotated into the prone position, and an extended perineal dissection is performed. This includes the sphincter complex and the inferior surface of the levators to a point laterally where they originate on the pelvic sidewall. This point should be just inferior to the level where the abdominal procedure was terminated. The coccyx is often removed in continuity with the main specimen to improve direct visualization of the dissection.Results The cylindrical technique removed more tissue in the distal rectum. There was no bowel perforation, perineal wounds were primary healing. One patient developed perineal seroma. One patient developed peritoneocele hernia of pelvic floor. Conclusions Cylindrical APR performed in the prone position for low rectal cancer removes more tissue around the tumor that leads to a reduction in intraoperative perforations, which should reduce local disease recurrence.

The countywide healthcare reform in Anhui province since 2015 was analyzed in the paper.The reform is based on the integration of healthcare management system and health service system of the new rural cooperative medical system (NCMS).The core of reform is regional global per capita budget of NCMS.The reform promotes the county′s healthcare institutions to shift from profit oriented to costs control, improves their quality of care, emphasizes disease prevention and control, and maintains residents health.Next, we should pay attention to the rationality of funds balance and benefits distribution, and the training of county healthcare personnel.

The technique conditions of decolonization of fermentation broth were successively optimized using single factor assay and orthogonal layout method in Cordyceps jiangxiensis. The optimal condition of decolorization was investigated to be 3g/100mL active carbon, 5 min absorption time, pH5 of fermented broth and 25℃absorption temperature. Under the optimal condition, the maximum decolorization rate of fermented broth reached 89. 6% , simultaneously 10. 7% consuming rate of exopolysaccahride was minimum. Subsequently, the extract condition of exopolysaccharide of C. jiangxiensis was further optimized by orthogonal layout design. The maximum exopolysaccharide production was 0. 38 g/L under the optimal condition, i. e. firstly fermented filtrate decolorized and deproteined was concentrated to 1/7 of its total volume, secondly concentration broth was mixed with four times its volume of absolute ethanol and stirred vigorously, lastly precipitation of exopolysaccharide proceeded at 4℃for 16 hrs and the exopolysaccharide collected by centrifugal ion and dryness.