Objective To investigate the relationship of serum IL-6 levels with cognitive dysfunction among patients with obstructive sleep apnoea syndrome (OSAS).Methods Patients diagnosed with OSAS by polysomnography (PSG) received assessment of cognitive function with Montreal Congnitive Assessment (MoCA).According to the result of MoCA assessment,patients were divided into two groups,without cognitive dysfunction group (n =47) and with cognitive dysfunction group (n =55);30 health volunteers were used as control.Serum IL-6 levels were detected by enzyme-linked immunosorbent assay (ELISA) in three groups;according to the apnea hypopnea index (AHI),OSAS patients with cognitive dysfunction were divided into three groups,light group (n =15),moderate group (n =16),and severe group (n =24),and differences in MoCA scores and serum IL-6 levels were analyzed among three groups.The correlation of serum IL-6 levels and MoCA scores were analyzed in OSAS patients with cognitive dysfunction.Results Serum levels of IL-6 in OSAS patients with cognitive dysfunction [(197.3 ± 72.58) pg/ ml] were significantly increased than those without cognitive dysfunction [(155 ± 39.3)pg/ml] as well as health control [(87.39 ±33.44)pg/ml] (P ＜0.01).For OSAS patients with cognitive dysfunction,MoCA scores were decreased and the level of serum IL-6 was increased among patients with poor AHI grade,with statistically significant difference.Pearson correlation analysis showed serum IL-6 levels were significantly negatively correlated with MoCA scores among OSAS patients with cognitive dysfunction (r =-0.65,P ＜ 0.01).Conclusions Serum levels of IL-6 in OSAS patients with cognitive dysfunction were significandy increased and correlated with the cognitive dysfunction.OSAS patients with cognitive dysfunction experiencing sever AHI grade have more serious cognitive dysfunction and the higher serum levels of IL-6.

Objective To compare the safety and the clinical outcomes between proximal femoral nail antirotation (PFNA) and InterTan nail in treatment of femoral intertrochanteric fracture using a Meta analysis.Methods A computer-based online search was performed of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese Biomedical Literature Database,PubMed,Ovid database for clinical trials regarding PFNA and InterTan nail in the treatment of femoral intertrochanteric fractures.A Meta analysis was done to compare operation time,intraoperative bleeding,time for fracture healing,postoperative Harris hip score,and postoperative complications between the 2 groups using statistical software RevMan 4.2.Results A total of 7 studies were included (one of 7 points and 6 of 2 points by Jadad quality grading),involving 491 patients (all one-sided).PFNA was used in 266 patients and InterTan nail in 225.The operation time in the PFNA group was significantly shorter than in the InterTan nail group [WMD=-15.58,95％ CI (-21.60,-9.56),P ＜0.001].The Harris hip score at the last follow-up was significantly lower in the PFNA group than in the InterTan nail group[WMD =-2.33,95％ CI (-4.14,-0.53),P =0.01].There were no statistically significant differences between the 2 groups in bleeding volume [WMD =-33.89,95％ CI (-71.88,4.11),P =0.08],bone healing time [WMD =1.60,95％ CI (-2.32,5.52),P =0.42],or postoperative complications [OR =1.90,95％ CI (0.98,3.69),P =0.06].Conclusions Although InterTan nail may lead to longer operation time than PFNA,the risk of surgery may not be much increased and the former has an advantage of better hip functional recovery than the latter.

Objective To compare the safety and clinical outcome between minimally invasive internal fixation and open reduction in treatment of calcaneus fracture based on Meta analysis.Methods A computer-based online search of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese biomedical literature database,PubMed,Ovid database and all was performed for clinical trials regarding minimally invasive internal fixation and open reduction in treatment of calcaneus fracture.Meta analysis was used to analyze the postoperative local soft tissue,calcaneal last follow-up Bohler angle and Gissane angle.Results A total of 17 studies were included(used Jadad quality grading,one is 7 points,two is 4 points,four is 3 points,ten is 2 points),involving 1138 patients,including 569 patients used minimally invasive internal fixation and 569 used open reduction.Meta analysis showed that the incidence of postoperative local soft tissue poor healing used minimally invasive internal fixation is lower than used open reduction about,the difference was statistically significant [OR =0.26,95％ CI:(0.14,0.47),P ＜ 0.01].Meta analysis showed that the calcaneal last follow-up Bohler angle of minimally invasive internal fixation was lower than open reduction,the difference was statistically significant [WMD =-1.29,95％ CI:(-2.39,-0.19),P =0.02].There were no statistically significant differences in the calcaneal last follow-up Bohler angle between minimally invasive internal fixation and open reduction[WMD =1.01,95％CI:(-3.02,5.04),P =0.62].Conclusions Regardless of the calcaneal fracture type,minimally invasive internal fixation or open reduction,the postoperative Bohler angle and Gissane angle at the calcaneus mechanical recovery characteristics are the same.However,the postoperative soft tissue healing of minimally invasivc internal fixation is less better than open reduction.

BACKGROUND:In osteoarthritis cartilage degeneration, connective tissue growth factors as the important effector molecules play an important role in chondrocyte proliferation and differentiation. Clinical application of diacerein for the treatment of osteoarthritis has achieved good effect, but the exact mechanism of the treatment is unclear. OBJECTIVE:To observe the effect of different concentrations of diacerein on the expression of connective tissue growth factor in the articular cartilage induced with interleukin-1βin vitro. METHODS: Chondrocytes of Sprague Dawley rats were culturedin vitro, and then the chondrocytes were induced with recombinant human interleukin-1β to prepare the osteoarthritis model. Rats in the normal control group received no treatment; rats in the model group were treated with recombinant human interleukin-1β; rats in the experimental group were treated with different concentrations of diacerein+10 μg/L recombinant human interleukin-1β. The proliferation of chondrocytes was observed withMTT assay, and Western blot was used to detect the expression of connective tissue growth factor. The experiments above were repeated for three times. RESULTS AND CONCLUSION:The MTT assay results showed that compared with the normal control group, the diacerein could promote the proliferation activity of chondrocytes, and more significant in the concentration of 10-5 mol/L (P < 0.01); the proliferation capacity of chondrocytes in the experimental group was decreased after induced with interleukin-1β (P < 0.05), but when compared with the normal control group, the diacerein with the concentrations of 10-4 mol/L and 10-5 mol/L could promote the MTT proliferation capacity of chondrocytes with or without interleukin-1β (P < 0.05). Western blot results showed that interleukin-1β could reduce the expression of connective tissue growth factor (P< 0.01), and 10-5 mol/L diacerein could significantly promote the expression of connective tissue growth factor induced with interleukin-1β, and the effect was significantly higher than that in the model group (P < 0.01). Diacerein can promote expression of connective tissue growth factor induced with interleukin-1β, it may be one the mechanism of diacerein for promoting chondrocytes differentiation and proliferation and the treatment of osteoarthritis.

Objective To isolate and determine the structures of chemical constituents from the roots and rootstalks of Rheum emodi.Methods The chemical constituents were isolated and purified by silica gel and polyamide column chromatography.Chemical methods and spectroscopic methods,such as 1H-NMR,13C-NMR,and MS spectra were used for the structure identification.Results Eighteen compounds were obtained.Sixteen of them were identified as:chrysophanol(1),physcion(2),?-sitosterol(3),emodin(4),aloe-emodin(5),rheumin(6),daucosterol(7),d-catechin(8),piceatannol(9),piceatannol-4'-O-?-D-glucopyranoside(10),piceatannol-4'-O-?-D-(6″-O-p-coumaroyl)-glucopyranoside(11),chrysophanol-8-O-?-D-glucopyranoside(12),physcion-1 and 8-O-?-D-glucopyranoside(13a and 13b),emodin-8-O-?-D-glucopyranoside(14),and sucrose(15).Meanwhile,one compound structure simi-lar to rhein was detected.Conclusion Compound 11 is a new compound named rheoside,compounds 13a and 13b are obtained from R.emodi for the first time.

Objective To evaluate the effect of tourniquet on incisional infection based on animal model,and evaluate the effect of ischemia preconditioning on incisional infection,so as to provide experimental basis for the ra-tional use of tourniquet in clinic.Methods 100 BALB/c mice were randomly divided into 4 groups,with 25 mice in each group.Group A:tourniquet+methicillin-resistant Staphylococcus aureus (MRSA)incisional infection;group B:ischemic preconditioning+ MRSA incisional infection ;group C :MRSA incisional infection;group D:blank control.The survival rates,temperature,routine blood testing,and change in soft tissue beside femoral incision were compared among 4 groups.Results During observation period ,the survival rate in group A was 68%,in group B,C,and D were all 100%,group A was lower than group B,C,and D (P <0.05).The temperature at each time point was significantly different among group A,B,and C (P <0.01 );temperature curves of 4 groups were significantly different (P <0.01 );except basal body temperature,temperature at the other time points among 4 groups were significantly different(all P <0.01);routine blood testing results (white blood cell count,total granu-locyte count,and total lymphocyte count)among 4 groups on the third,and seventh day were significantly different (all P <0.05);on the seventh day,routine blood testing results of 4 groups all returned to normal level,but group A was slightly higher than group B,C,and D.Section of epithelial tissue revealed that epithelial tissue in group A was not healed,inflammatory response of peripheral tissue was most serious;epithelial tissue in 10 mice in group B was healed,partial peripheral tissue revealed inflammatory response;epithelial tissue in 4 mice in group C was healed,most peripheral tissue revealed inflammatory response.Conclusion Mice incisional infection will be aggrava-ted by using lower limb tourniquet,incision healing and body function recovery time will be delayed,even lead to death.Ischemic preconditioning before making an incision model can reduce the severity of incisional infection,and shorten wound healing time.

Objective To study the histocompatibility of tissue engineered skin with the observation of the effects of selectins E and P on the immunological rejection after skin allograft in rats. Methods Tissue engineered skin was prepared as follows: The materials obtained from the neonatal SD rats were cultured and then grafted onto the adult Wistar rats. The expression of selectins E and P in the grafted skin was determined with immunohistochemical staining. Results The expression of selectins E and P was significantly higher in the rats with allograft than in the rats with the grafts of tissue-engineered material. Conclusion Selectins E and P play an important role in the immunological rejection after allograft of skin but the tissue-engineered skin graft possesses favorable histocompatibility and shows no obvious immunological rejection.

BACKGROUND: The depressive emotion and cognition impairment after cerebral stroke are closely connected with the evolution and curative effect and prognosis of the disease, so how to improve depressive emotion and cognition impairment with reasonable drug has important significance to enhance clinical rehabilitation for the patients.OBJECTIVE: To treat patients with post-stroke depression with fluoxetine hydrochloride, andevaluate the changes of their depressive emotion and cognitive function with self-rating depression scale (SDS) and P300 potential.DESIGN: A randomized controlled trial based on patients. SETTING: Henan Provincial Psychiatric Hospital. PARTICIPANTS: Eighty-two inpatients with the first-attack of poststroke depression, who were selected from the Department of Neurology,Henan Provincial Psychiatric Hospital between December 1999 and June 2003, were divided randomly into treatment group (n=41) and control group (n=41).METHODS: All the patients were given neurological routine treatment;besides, those in the treatment group were treated with fluoxetine hyhad taken other psychotropic drugs before entering the group, fluoxetine oxetine was 20 mg, which was taken orally by 1 tablet every morning. All the patients were evaluated with SDS and P300 potentials test at 1 week (the first evaluation) and 6 weeks (reevaluation) after treatment.latencies of N1, P2, N2 and P3 waves and amplitude of P3 wave in P300 potentials.RESULTS: All the patients in the treatment group (n=41) and control group fore treatment, the scores of SDS and the results of P300 potentials were not Reevaluation: After treatment, the score of SDS in the treatment group was significantly lower than that in the control group (40.32±7.2, 48.31±8.02,t=3.89, P ＜ 0.01); the latencies of N2 and P3 waves in P300 potentials test in the treatment group were obviously lower than those in the control group [(235.5±22.9), (248.3±23.4) ms; (339.1±25.3), (348.6±25.5) ms, P ＜ 0.05],and the amplitude of P3 wave was obviously higher than that in the controlgroup [(6.3±1.9), (4.9±2.0) μV, P ＜ 0.05]. CONCLUSION: Fluoxetine hydrochloride can improve the depressive status and cognitive function after cerebral stroke.Song JG, Zhang ZH, Wang XH, Mu JL.Effects of fluoxetine hydrochloride on depressive symptoms and P300 after cerebral stroke.

Objective To investigate the association of vascular calcification,fetuin A and Creaction protein (CRP),and explore the influence on cardiovascular events.Methods Sixty peritoneal dialysis (PD) patients were enrolled in this study.Carotid intima-media thickness (cIMT),fetuin A and CRP,along with the other serum related parameters were detected to find out their influence on vascular calcification in PD patients.The relationship between cIMT,fetuin A,CPR and cardiovascular events was analyzed in PD patients with 18 months followed-up.Results Of the 60 PD patients,carotid intima-media thickness (cIMT) was increased in 38 patients(63.3％).Compared with the non-increased cIMT patients,serum fetuin A concentration was significantly decreased(P ＜ 0.05),CRP(P＜0.01) and calcium × phosphate products(P＜0.05) were significantly increased in the highincreased cIMT group.Compared with the low-increased cIMT patients,fetuin A concentration was obviously lower(P ＜ 0.05) and calcium×phosphate products were obviously higher(P ＜ 0.05) in the highincreased cIMT group.Linear regression analysis discovered an obvious negative correlation between CRP and fetuin A(R2 =0.629,F=47.522,P ＜ 0.01),as well as fetuin A and calcium×phosphate products (R2=0.299,F=11.948,P=0.002).Multiple regression analysis indicated that fetuin A was independently negatively correlated with cIMT(B=-0.019,t =-6.042,P ＜ 0.01).At 18 months,there were 36 newly-happened cardiovascular events and among which 6 cases died.Logistic regression analysis found that increased cIMT was risk factor to cardiovascular events in PD patients(OR=3.691,95％CI 1.467-9.258,P=0.006).Conclusion Decreased fetuin A and increased calcium×phosphate products deteriorate carotid calcification in PD patients.Micro-inflammation of PD patients represented by high CRP levels may increase calcium×phosphate products by depressing the fetuin A level,and in the end will stimulate carotid calcification.Increased cIMT is a risk factor for cardiovascular events.

Against the deficiencies of the current preventive medicine education curriculum,training programs and curriculum were reformed according to the training objectives of the modem preventive medicine, while new ideas of preventive medical personnel training were explored in order to cultivate practical professionals with a certain ability to innovate and to adapt the development of modern public health and preventive medicine preferably.