Adolescent ; Adult ; Cholecystitis ; complications ; drug therapy ; surgery ; Cholecystolithiasis ; complications ; drug therapy ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis ; drug therapy ; etiology ; surgery ; Phytotherapy ; Postoperative Period ; Sphincterotomy, Endoscopic

Dust ; Humans ; Lung ; pathology ; Mining ; Occupational Exposure ; adverse effects ; Tin ; adverse effects

Objective: To investigate the prevalence and influencing factors of dyslipidemia among adult residents in Hefei City, so as to provide the evidence for formulating the dyslipidemia control strategy. Methods: A total of 10 812 permanent residents at ages of 18 years were randomly sampled from 5 counties (districts) in Hefei City using a multi-stage stratified cluster random sampling method. Participants' demographic features, dietary behaviors and development of chronic diseases were collected using questionnaire surveys, and the height, body weight, waist circumference and blood lipids were measured. The prevalence of dyslipidemia was analyzed, and the factors affecting the development of dyslipidemia were identified using a multivariable logistic regression model. Results: Totally 10 812 valid questionnaires were recovered, with an effective recovery rate of 92.02%. The participants had a male to female ratio of 0.85∶1, a mean age of (51.89±12.56) years. The prevalence of dyslipidemia was 25.20%, and hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C) were predominant types of dyslipidemia, with prevalence of 12.70% and 10.20%, respectively. Multivariable logistic regression analysis showed that urban areas (OR=1.340, 95%CI: 1.219-1.474), age of 40 years and older (40 to 59 years, OR=1.181, 95%CI: 1.047-1.333; 60 to 88 years, OR=1.321, 95%CI: 1.154-1.513), alcohol consumption (OR=1.205, 95%CI: 1.093-1.329), insufficient physical activity (OR=1.217, 95%CI: 1.111-1.332), static behavior duration of 3 h/d and longer (OR=1.126, 95%CI: 1.027-1.234), overweight (OR=1.162, 95%CI: 1.045-1.291), obesity (OR=1.310, 95%CI: 1.097-1.564), central pre-obesity (OR=1.236, 95%CI: 1.102-1.387), central obesity (OR=1.414, 95%CI: 1.247-1.603), hypertension (OR=1.279, 95%CI: 1.107-1.477), diabetes (OR=2.192, 95%CI: 1.820-2.640), medical insurance (OR=0.594, 95%CI: 0.395-0.893) and self-rated “very good/good” oral health (OR=0.731, 95%CI: 0.576-0.927) were factors affecting the development of dyslipidemia. Conclusion The risk of dyslipidemia is high among adult residents living in urban areas, middle-aged and elderly residents, residents with alcohol consumption, insufficient physical activity, overweight, obesity, central pre-obesity, central obesity, hypertension and diabetes.

Objective To investigate the expressions of microRNA-21 in cholangiocarcinoma tissues and the relationship between epithelial-mesenchymal transition (EMT) and the prognosis of patients.Methods Forty-one samples of cholangiocarcinoma and 10 samples of adjacent tissues from 10 patients who received radical resection of cholangiocarcinoma at the Provincial Hospital of Anhui Medical University from January 2005 to January 2010 were collected.The expressions of microRNA-21,E-cadherin and N-cadherin were detected by in situ hybridization and immunohistochemistry,and effect of their expressions on the prognosis was analyzed.Enumeration data were analyzed using chi-square test.The correlation between microRNA-21 and EMT markers was analyzed using the Spearman correlation coefficient.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.Results The expression rate of microRNA-21 in the cholangiocarcinoma tissues was 63％,which was significantly higher than 30％ of that in the adjacent tissues (x2 =0.324,P ＜ 0.05).The expression of microRNA-21 was closely related with the tumor differentiation degree,lymph node metastasis,perineural invasion (x2 =6.365,0.552,11.896,P ＜ 0.05),but not with gender,age,tunor location and tumor type (x2 =0.322,0.588,0.510,0.256,P ＞ 0.05).The expressions of E-cadherin and N-cadherin were related with lymph node metastasis and perineural invasion (x2 =4.630,5.512;6.600,7.152,P ＜0.05),but not with gender,age,tumor location,tumor differentiation degree and tumor type (x2 =0.266,0.013,0.067,0.666,0.003; 1.036,0.997,1.808,2.997,0.812,P ＞0.05).A positive correlation between the expression of microRNA-21 and EMT related markers E-cadherin and N-cadherin was detected (r =0.373,0.614,P ＜0.05).The results of survival analysis showed that the overall survival rate and tumor-free survival rate of patients with low expression of microRNA-21 were significantly higher than those of high expression of microRNA-21 (x2 =3.999,4.376,P ＜ 0.05).Conclusion Over expression of microRNA-21 in cholangiocarcinoma and metastatic lymph nodes may accelerate the invasion and metastasis of cholangiocarcinoma through inducing EMT,microRNA-21 might predict the prognosis of patients.

Objective To investigate the bone metabolism of children with leukemia and its relationship to tumor necrosis factor-?(TNF-?)pre-and post-treatment.Methods Serum bone gla protein(BGP),the excretion rate of urianry deoxypyridinoline(DPD)and TNF-? were measured in 35 children with leucocythemia pre-and post-treatment and 30 normal children(control group).Results The results showed that BGP,the excretion rate of DPD and TNF-? in children with leucocythemia before treatment were significantly higher than those in control group.However,the excretion rate of DPD decreased after chemotherapy but still significantly higher than that of control group(P0.05).Conclusions In children with leukemia,there are bone absorption and bone dissolution before chemotherapy,while there is osteogenesis dysfunction and bone absorption after chemotherapy.TNF-? can be used as a parametre for evaluating treatment effect and monitoring relapse.

Objective To observe the changes of lung parameters,the ratios of B and T lymphocyte attenuator(BTLA) and serum cytokines in patients with knee osteoarthritis (KOA),and explore possible molecular mechanism of them.Methods Forty-seven cases of knee osteoarthritis from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from 2011 October to 2012 July were analyzed in this study.Pulmonary parameters were detected by spirometer; B and T lymphocyte attenuator(BTLA) was detected by flow cytometry ; Interleukin (IL)-1β,IL-10,matrix metalloproteinase-9 (MMP-9),tissue inhibitor of matrix metalloprotease-1 (TIMP-1) were detected by ELISA;ESR was determined by Westergren method ; hs-CRP was determined by the automatic biochemistry analyzer.Results (1) Compared with NC group,levels of FVC,FEV1,FEV1/FVC,PEF,MEF25.75,MEF50,MEF25,CD3 + BTLA+ T cell,CD4+ BTLA+ Tcell,IL-10,TIMP1 were significantly decreased,IL-1 β,MMP9 were significantly increased.(2)Correlation analysis showed FVC was negatively correlated to Lequesne MG,symptom classify quantization scores,course,MMP9,while positively related to CD3+ BTLA+T cell,IL-10,TIMP1 ;FEV1 was positively correlated to CD3 + BTLA+T cell,CD4+ BTLA+T cell,TIMP1,while negatively correlated to course ; MEF50 was positively related to CD3+BTLA+T cell,CD4+ BTLA+T cell.Conclusion While articular cartilage lesions occurred in KOA patients,the lung function was also declined.The mechanism may be associated with the declination of expression of BTLA,which can cause up-regulating of IL-1 β,MMP9 and down-regulating of IL-10,TIMP1,thus leading to immune dysfunction and abnormal immune response.Those may induce airway injuries and result in lung function decline finally.

This study was aimed to explore the mechanism of Xin-Feng capsule (XFC) on pulmonary function of Sjogren's syndrome (SS) rat model based on the TGF-β1-ERK1 signal pathway. A total of 50 SD rats were ran-domly divided into the normal control (NC) group, model control (MC) group, hydroxychloroquine sulfate (HCQ) group, radix paeoniae alba (total glucosides of paeony capsules, TGP) group, and the XFC treatment group, with 10 rats in each group. Except the NC group, the complete Freund's adjuvant (CFA) and the same rat sub-mandibular gland antigen induced method were applied to each rat after metatarsus injection on two feet and CFA after sufficient emulsification of 0.2 mL submandibular gland protein mixed antigen induced SS. The water drink-ing quantity, body weight change, pulmonary function, ERK1, TGF-β1 protein expression and serum cell factor (IL-17, IL-4) changes were detected in each group. The results showed that compared with the NC group, the body quality and serum IL-4 of MC rats were obviously decreased, and the water drinking quantity, submandibu-lar gland / lung index, submandibular gland pathological score, ERK1, TGF-β1 integral and IL-17 were increased (P < 0.01 or P < 0.05), and the pulmonary function parameter was decreased (P < 0.01 or P < 0.05). Compared with the MC group, the body quality, pulmonary function parameters FEF50 and MMF of the XFC group were in-creased, the IL-4 expression was increased, the water drinking quantity, submandibular gland / lung index, sub-mandibular gland pathological score, serum IL-17 expression, ERK1 and TGF-β1 integral were decreased (P <0.01 or P < 0.05). Compared with the HCQ group, the body quality and IL-17 were significantly decreased in the XFC group (P < 0.01), FEF25, FEF75 and MMF were increased (P < 0.01 or P < 0.05). Compared with the TGP group, the lung index and IL-17 were decreased in the XFC group (P < 0.01 or P < 0.05). It was conclud-ed that the lung function of SS rats was declined, which is closely related to the activation of TGF-β1-ERK1 sig-nal pathway. Traditional Chinese medicine of XFC is able to downregulate the TGF-β1 expression and to restrain epithelium-mesenchymal cell transformation, in order to inhibit ERK1 phosphorylation activation and proliferation, decrease immune inflammation, in order to improve SS and lung function.

Objective To explore imaging features of the lateral atlanto-dental interval (LADI) of atlanto-axial joint and its value in the diagnosis of atlanto-axial joint dislocation/subluxation. Methods Two hurdred and forty healthy volunteers without atlanto-axial joint dysfunction and 32 patients with torticollis and/or functional impairment at atlanto-axial joint were enrolled into this study. All subjects were examined with multi-slice CT in both neutral and max rotation positions to the left/right. Clinical endpoints including VBLADI, variance range of the VBLADI and asymmetric conditions were evaluated. x2 test is used to evaluate the variance of incidence of bilateral LADI asymmetry in different age groups, Pearson-test(2-tailed) is used to evaluate the correlation between VBLADI and rotary function of atlanto-axial joint,precise test of fourfold table is used to compare normal group with patient groups. Results ( 1 ) In the normal control group: asymmetry of bilateral LADI were observed in 204 among 240 (85.00%) healthy volunteers including 60 youngsters( ＜ 15 years) and 180 adults( ≥ 15 years). The median and P95% of |VBLADI| were 0.850 mm,2.450 mm in the young ( ＜ 15 years) and 0.700 mm,2.051 mm in the adult(≥15 years),there were 2 and 10 volunteers whose |VBLADI| ≥P95% in the young and in the adult respectively. There was no correlation between VBLADI( -2.146 to 2.114 mm,Median 0.000 mm) and LA(22.949° to 44.649°, Median 34.500°), RA (25.284° to 45.334°, Median 35.300° ), VLRA ( - 11.643°to 8.623 °, median 0.000 ° ) respectively in normal people ( r = - 0.030, - 0.005,0.026, P ＞ 0.05 ). ( 2 ) In the study with 32 patients including 25 youngsters( ＜ 15 years) and 7 adults( ≥ 15 years). Seventeen of 32 had atlanto-axial lateral subdislocation (AALSD),in 16 youngsters( ＜ 15 years), the median of the |VBLADI| was 3.350 mm and 14 cases |VBLADI| ≥2.450 mm;1 adult patient(≥ 15 years) had |VBLADI| ≥ 2.051 mm; 7 of 32 patients had atlanto-axial rotatory dislocation (AARD) including 4 youngsters |VBLADI| ＜2.450 mm,median 1.200 mm,3 adults |VBLADI| ＜2.051 mm,all of the 7 patients with AARD had unilateral parasol LADI in neutral position;8 of 32 patients had atlanto-axial complicated dislocation(AACD) including 5 youngsters |VBLADI| ≥2.450 mm,3 adults |VBLADI| ≥2.051 mm. There are more cases whose |VBLADI| ≥P95% in group AALSD and group AACD than in abnormal group( P<0.01 ), but there is no difference between group AARD and normal group( P = 0.738 ).Conclusion The imaging finding of "asymmetry of bilateral LADI" may be either a physiological variation or a pathological condition, clinical manifestations and other imaging findings should be evaluated to make a diagnosis.

Objective To evaluate the early clinical outcomes of anterior cruciate ligament(ACL)reconstruction combined with anterolateral tenodesis procedure in patient with high grade pivot-shift after ACL injuries.Methods Among the 140 patients diagnosed as ACL injury and undergoing operations in our hospital between June and December 2015,18 presenting high grade pivot-shift 2+ or 3+ under anesthesia were included into this study.During their surgeries,the anterolateral tenodesis procedure using iliotibial tract ITB was applied together with ACL reconstruction.The anteroposterior stability of the knee was examined and pivot-shift test was conducted right after the operation as well as 6 and 12 months after that.The Lysholm score was used to evaluate the clinical function of their knees.Results The mean follow-up period of the 18 patients was 12.7 ± 2.4 months.There were 14 males and 4 females,with an average of 28.3 ± 7.1 years.No patients complained about unstable symptoms during the follow-up.The mean side-to-side difference of anteroposterior knee laxity assessed using KT1000 at 30 degree knee flexion was 2.3 ± 0.7 mm,which was significantly improved compared with preoperative assessment(9.2 ± 2.6 mm)(P＜0.01).For the preoperative examination,the pivot-shift examination indicated 2+ in 13 patients and 3+ in 5 patients.However,all were negative right after the operation.Seventeen patients presented negative pivot-shift at the final follow-up,while 1 had 1+ rotational laxity.Significant differences were found in the Pivot-shift test before and after the operation.The average Lysholm score improved significantly from 67.7 ± 5.9(ranging from 55 to 78)before the operation to 89.0-± 4.6(ranging from 75 to 95)after that.Conclusion The high grade pivot-shift rotational instability could be effectively restored using the anterolateral tenodesis procedure,in addition to ACL reconstruction.The early stage clinical outcomes indicate significant improvement of the knee stability postoperatively.

BACKGROUND:Although the therapeutic effect of total knee arthroplasty for severe gonarthritis is reliable, deep vein thrombosis also occurred in many patients. Therefore, deep vein thrombosis has been a major reason for unexpected death after total knee arthroplasty. OBJECTIVE:To study the incidence of deep vein thrombosis after total knee arthroplasty with general and epidural anesthesia. METHODS:We searched“PubMed”,“Medline”,“Elsevier”,“Embase”, Cochrane library,“Wanfang”,“China National Knowledge Infrastructure”for papers published from January 2000 to March 2015. The mesh words were“total knee arthroplasty”,“TKA”,“thrombosis”,“DVT”,“randomized control ed trial”,“RCT”for studies concerning deep vein thrombosis after total knee arthroplasty with different anesthetic methods. The double blind method was used for data extraction and assessment of literature quality. Revman5.3 software was utilized to analyze the extracted data using meta-analysis. RESULTS AND CONCLUSION:There were 8 studies including 885 patients. The heterogeneity of the included studies was very low (I2=0, P=0.72). The combined OR was 0.25 (95%confidence interval:0.18, 1.35), indicating that continuous epidural anesthesia in total knee arthroplasty could apparently reduce the possible formation of postoperative deep vein thrombosis. Because of lack of the changes in coagulation factors under general anesthesia and epidural anesthesia, the mechanism underlying epidural anesthesia to reduce the incidence of deep vein thrombosis deserves further investigations. Among patients with deep vein thrombosis, continuous epidural anesthesia could diminish the possible formation of deep vein thrombosis. Thus, epidural anesthesia should be used firstly for knee replacement in patients with high risk of deep vein thrombosis.