BACKGROUND:Gait analysis enable to convert qualitative analysis and description used for a long time in orthopedic examination and rehabilitative treatment into objective and precise quantitative assessment. At the present, with the development of science and technology, three-dimensional (3D) gait analysis is more and more widely, extensively used in orthopedic surgery and rehabilitation medicine abroad, while much less in China.OBJECTIVE: To study the parameters of time-distance, kinematics, kinetic and electromyography (EMG) in healthy subjects and patients with backbone, hip, knee or ankle joint diseases.DESIGN: Comparative observation and control study.PARTICIPANTS: From December 2004 to July 2005, 40 healthy subjects and 112 patients suffering from backbone and hip, knee, ankle joint disease were selected from the Department of Rehabilitative Medicine, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University and analyzed by three dimensional gait analysis system (VICON 612 system made by Britain VICON Company). 112 patients including 42 males with the mean age of (46.2 ± 2.3) years and 70 females with the mean age (41.2 ± 3.5) years were screened by skilled clinicians after surgical and rehabilitative treatment.Among them there were 21 patients with cervical vertebra, 26 patients with prolapse of lumbar intervertebral disc and lumbar spinal stenosis. The number of hip, knee, ankle joint disease was 12, 34, 19 respectively. Total hip replacement was included in hip joint disease, anterior cruciate ligament (ACL) reconstruction was included in knee joint disease, talipes equinovarus was included in ankle joint disease. Meanwhile, 40 healthy subjects who were 20-40 years old, male or female, without any clinical symptom of backbone and limbs volunteered in the study.METHODS :Gait analysis were carried out on 40 healthy volunteers and 112 operational and rehabilitative treatment patients with spinal and lower limb diseases using VICON 612 system made by Britain VICON Company.MAIN OUTCOME MEASURES: The time-distance parameters (cadence, step length, walking speed), kinematics parameters (knee flexion/extension degree, hip flexion/extension degree, ankle dorsi/plantar degree), kinetic parameters (knee force in Z axis, hip force in Z axis, normalized force in Z axis) and EMG parameters (vastus lateralis SEMG) of lower limbs were examined.RESULTS: A total of 40 healthy subjects and 112 patients were involved in the analysis of results. ① Time-distance parameter: Cadence, as well as step length and walking speed of patients with backbone disease, patients with hip joint disease, patients with knee joint disease, and patients with ankle joint disease were lower than those of healthy subjects,and the difference between two groups was significant (P ＜ 0.05-0.01). ② Kinematic and kinetic parameters of all joints in upper limbs: One year after left ACL knee reconstruction, the extension of left knee in initial contact phase was 9° less than that of right one and the stress in Z axis of left knee was much less than that of right one; One year after left THA,the flexion of left hip in initial contact phase was 8.5° less than that of right one, the extension of left hip in terminal stance phase was 3° less than that of right one, during stance phase the stress in Z axis of left hip was much less than that of right one; As to an infantile paralysis patient with talipes equinovarus, the dorsiflexion of left ankle in initial contact phase was 12° less than that of right one, the plantar flexion of left ankle in terminal stance phase was 5° less than that of right one. The stress in Z axis of left ankle during stance phase was much less than that of right one. However, the difference in range of motion and stress in Z axis was not significant between the left and right knee joint in healthy people. ③ One year after left total knee arthroplasty, the dynamic surface electromyogram signals of left vastus lateralis is much lower than that of right vastus lateralis in a gait cycle.CONCLUSION: 3D gait analysis enables tprovide objective basis for making operation scheme for orthopedic surgery and after-operation rehabilitation therapy, and assessing curative effect of rehabilitation therapy.

Purpose: Three kinds of embolizing agents, sodium mirrhuate, lipiodol and gelfoam were used together in treating hemangiomas of liver, pharynx, and spleen by embolizing the arteries. Materials and methods: 35 patients with hemangiomas, 30 cases in liver, 1 in spleen, and 4 in pharynx, were treated with embolizing hepatic artery, splenic artery, maxillary arterry, and face artery, respectively. Results: Tumors decreased 20%～90% in size, and none of then had continued to grow after the treatment for 3～36 months. At the same time, the suitable dose of embolizing agent according to the size of the tumor, the injection speed, the observation of the curative effect and the precaution of the embolization were also discussed, It showed that the effect of this method was better than using only one or two kinds of embolizing agents togethes resued in only slight complications. Conclusion: We think this method is safe and effective by combined with embolizing agents in treating hemaiomas of different organs and tissues.

BACKGROUND:Evaluation plan for the neuro-musculo-skeletal system model and motor function was little.However,the three-dimensional gait analysis can transfer qualitative analysis and object description which widely used in orthopedics and rehabilitation medicine to quantitative evaluation with more objective and precise.OBJECTIVE:To evaluate gait kinematics and kinetic changes after total knee replacement based on 12 months follow up using three-dimensional gait analysis.DESIGN,TIME AND SETTING:The comparative observation and case-control study was performed in the Gait Analysis Room of the Department of Rehabilitation Medicine in the Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University from January 2007 to May 2008.PARTICIPANTS:Ten patients with knee osteoarthritis following total knee replacement were chosen as treatment group;concurrently,ten patients whose baseline data were matched with the treatment group without problems in nerve,muscle,skeletal system and equilibrium were selected as the control group.METHODS:Ten patients in the treatment group underwent rehabilitation training,then compared time-distance,kinematic,and mechanical parameters which were measured at 3,6,12 months after total knee replacement with the control group.MAIN OUTCOME MEASURES:Time-distance parameter,kinematic parameter,mechanical parameter and knee functional scores.RESULTS:Pace,step frequency,gait speed,and time of injured leg standing were notably decreased,while time of uninjured leg standing,duration of gait cycle were obvious prolonged compared with the control group(P

Objective To analyze the clinical characteristics and therapy of levofloxacin-induced prolonged Q-T interval in patients with multi-drug resistant tuberculosis ( MDR-TB) . Methods Clinical materials of 6 patients with MDR-TB who developed prolonged Q-T/QTc interval caused by levofloxacin therapy were analyzed. Those cases were collected from the Tuberculosis Prevention and Control of Wuhan City form April 2010 to August 2014. Results The proportion of patients with levofloxacin-induced prolonged Q-T interval was approximately 3.0%.The condition occurred 2-8 months after the administration. The initial value of QTc interval ranged from 397 ms to 439 ms, while the average was (410.17±14.62) ms.The value of QTc interval was extended to 470-486 ms after treatment of levofloxacin, while the average was (476.33±6.16) ms.The increase of QTc interval was 47-85 ms, while the average was ( 66 ± 11. 48 ) ms. None of them developed Tdp. Conclusion The application of high dosage and long treatment course of levofloxacin in patients with MDR-TB could result in the extension of the Q-T/QTc interval, which should arouse our serious attention. In order to detect the abnormal Q-T/QTc interval in early stage, electrolyte level examination as well as ECG examination should be considered as routine tests before initiation of treatment and during the follow-up treatment.

BACKGROUND:Many domestic and foreign scholars and institutions are studying how to relieve radiation damage and to find the most suitable drug, while ginsenosides as the main pharmacological ingredient of ginseng show significant antioxidant effect. OBJECTIVE:To investigate the ease effect of ginsenosides on human hematopoietic stem cels under different intensities of ionizing radiations. METHODS: The CD34+ hematopoietic stem cels were isolated from the healthy cord blood. Then the cels were divided into normal group and ginsenoside-pretreated group, respectively, exposed under 1, 2, 5 Gy of X-ray irradiations for 24 hours. Cel viability was detected in irradiated hematopoietic stem cels by MTT assay. Apoptosis was estimated using the folowing assays: Annexin-V assay, caspase-3 mRNA and protein levels. The generation of reactive oxygen species was evaluated, in the presence or absence of ginsenoside in liquid cultures of CD34+ human hematopoietic stem cels irradiated with 1-, 2- and 5-Gy X-rays, using a flow cytometry assay. The Nrf-2 mRNA and protein levels were also studied by western blot analysis and RT-PCR, respectively. RESULTS AND CONCLUSION: Ionizing radiation at the therapeutic dose could decrease the viability of CD34+ cels and induce the cel apoptosis, and meanwhile, the activity of intracelular reactive oxygen species also showed a progressive increase that was correlated with the dose of ionizing radiation. However, ginsenoside pretreatment could relieve these above-mentioned effects. Ginsenoside inhibited the increase in caspase-3 activity induced by ionizing radiation, and additionaly, enhanced the mRNA and protein expressions of Nrf-2 in CD34+cels. In conclusion, ginsenoside protects CD34+ hematopoietic stem cels from radiation effects, which is probably correlated with anti-apoptosis and anti-oxidant roles of ginsenosides.

BACKGROUND:Preliminary studies of our research group have confirmed that the proliferation of preosteoclasts and the differentiation and function of osteoclasts could be inhibited when they were cultured in lower oxygen tension even hypoxia (2%O 2 ), but the gene expression of osteoclasts cultured in vitro have not been reported.
OBJECTIVE:To examine the effect of oxygen tension on specific gene expression of osteoclasts in vitro and explore the mechanism of osteoclast differentiation influenced by oxygen tension.
METHODS:The preosteoclasts were induced with 10μg/L macrophage colony stimulating facto and 10μg/L soluble receptor activator of nuclear factor-κB ligand into mature osteoclasts. Then the osteoclasts were cultured in normoxia, tissue oxygen and hypoxia (20%, 7%, 2%O 2 ) respectively. cells were then stained for tartarate-resistant acid phosphatase to assess osteoclastic formation. cells were col ected at 1, 2, 3, 4, 5, 6, 7 days after culture respectively. The soluble receptor activator of nuclear factor-κB ligand, tumor necrosis factor receptor-associated factor 6, tartarate-resistant acid phosphatase, and cathepsin K mRNA expression levels were determined using real-time quantitative PCR.
RESULTS AND CONCLUSION:The number of osteoclasts positive for tartarate-resistant acid phosphatase in the hypoxia was significantly lower than that in the tissue oxygen and normoxia (P<0.05). Under different oxygen tension, the mRNA expression levels of soluble receptor activator of nuclear factor-κB ligand in osteoclasts maintained unchanged. The mRNA expression levels of tumor necrosis factor receptor-associated factor 6 reached the peak at 5 days after culture in tissue oxygen and normoxia (P<0.05). The mRNA expression time of tartarate-resistant acid phosphatase and Cathepsin K were delayed accompanied by decreased oxygen tension, but the maximum were maintained in tissue oxygen. Compared with normoxia and hypoxia, osteoclasts cultured in tissue oxygen are more prone to differentiate and maintain the activity and functions.

Objective To compare the effect of traditional open surgery and laparoscopic repair of gastric perforation on postoperative pulmonary function.Methods Fifty patients were divided into two groups according to therapeutic method.Group A underwent traditional open gastric perforation repair(n=25).Group B underwent laparoscopic repair of gastric perforation(n=25).The pulmonary functions were examined at 1 day,3 days and 7 days postoperatively.Results All patients had different degrees of postoperative pulmonary function decline.After operation,the forced vital capacity(FVC)and forced expiratory volume in 1 second(FEV1)and vital capacity(VC)in group A were significantly lower than those in preoperation(P<0.05).The patients in laparoscopic operation group decreased significantly only on the first day postoperative.The postoperative pulmonary function of patients undergoing open surgery was significantly lower than that of patients undergoing laparoscopic surgery(P<0.05).Conclusion Laparoscopic repair of gastric perforation has less damage to the lung function than traditional open gastric perforation repair.Laparoscopic surgery plays an important role in the recovery of postoperative pulmonary function.

AIM: To study the therapeutic effect of Angeng Recipe(AGR) on the female climacteric rats. METHODS: Female SD rats were collected and randomly divided into climacterium,AGR(low dose,medium dose and high dose),nilestriol and young control groups.The level of hormone in serum and hypothalamus was analyzed after using AGR,the alteration of organ coefficient of uterus,adrenal,appendix cerebri and thymus were detected,the apoptosis of ovary granulosa cells was detected by fluorescence microscope and flow cytometer. RESULTS: E_2 contents in high dose group were higher than those in the climacterical group.FSH contents in high dose group were lower than those in the climacterical group.Uterus and adrenal gland viscera coefficient of high dose group,medium dose and low dose group were higher than that of climacterical group,The apoptosis of cells in medium dose group showed lower than that in the climacterical group. CONCLUSION: AGR could adjust the function of endocrine secretion by the effect on ovaries and appendices suprasphenoidalis directly or indirectly,and the mechanism of action was multitarget and the regulation was entirety.AGR could relieve the degeneration of sexual gland axis,and improve symptomatic in climacteric.

Objective To analyze the clinical and ultrasonic features of primary squamous cell carcinoma of the thyroid(PSCCT)and diagnostic value of ultrasonography (US) in PSCCT in order to improve the cognition of PSCCT.Methods The clinical data and ultrasonic characters of 5 patients with PSCCT confirmed by pathology post surgery were retrospectively reviewed.Results The average age of the 5 patients was 62 years (range from 46 to 79).All of 5 patients with PSCCT were presented with a painless neck mass in clinical palpation examination.Of them,2 patients had different degrees of difficulty in breathing and swallowing,2 patients had hoarseness.Four of 5 patients had died after surgery with average survival time of 9.5 months.On US,the size of lesions was large(a maximum diameter of 2.9-5.5 cm),all of 5 lesions appeared as single solid mixed-echogenicity mass including irregular lamellate marked hypoechoic region,with irregular margin and undefined boundary.Of them,2 lesions presented with lobulated,only 1 lesion exhibited microcalcification and another 4 lesions had no calcification,3 lesions exhibited a? sign of breakthrough thyroid envelope.Color Doppler flow imaging showed few blood flow (3/5) and moderate blood flow (2/5),a higher vascular resistance spectrum was detected in 4 lesions (RI 0.72-0.88).Three patients exhibited suspicious cervical lymph nodes.Conclusions The characteristic ultrasonic appearance combined with the clinical features enables a confident preoperative diagnosis of PSCCT.

ObjectiveTo explore the relationship between serum uric acid and prehypertension and the effects of age,obesity,fasting glucose and lipids in Chinese adults.Methods14,451 non-hypertensive cases from a community-based health examination survey in Xuzhou,Jiangsu province of China were enrolled in this study.Blood pressure,BMI,and determination of fasting glucose,lipids and serum uric acid were measured in all cases.ResultsThe odds ratios ( OR,95％ CI ) of prehypertension across increased serum uric acid after adjusting for age,sex were 1.0,1.20 ( 1.07 - 1.35 ),1.55 ( 1.36 - 1.76),1.82(1.60-2.09),2.33(2.03-2.67) (Pfor trend ＜0.01).The odds ratios were 1.0,1,04(0.92-1.18),1.21(1.06-1.38),1.26(1.09 - 1.45),1.36(1.17 - 1.58),( Pfor trend ＜0.01) after adjusting for age,sex,BMI,glucose,and lipids.In addition,fasting glucose significantly interacted with uric acid ( P for interaction ＜ 0.01 ).Conclusions Serum uric acid was associated with prehypertension,which might be an independent metabolic risk factor.Fasting glucose may reinforce the associations.