Joint prosthesis is one of the most successful procedures in orthopaedic surgery and has considerably improved the quality of life for patients affected by terminal joint disease. However,a number of joint prosthesis ultimately failed because of aseptic loosening. There have been major advances in the understanding of aseptic loosening. The RANKL-RANK-OPG-NF-?B system has been shown to play a fundamental role in aseptic loosening. We review how the RANKL-RANK-OPG-NF-?B system regulates aseptic loosening and aseptic loosening drug intervention.

[Objective]To investigate the inhibitory effect of zoledronic acid(ZA) on osteolysis induced by human periprosthetic tissue in a novel animal model.[Method]Human periprosthetic tissue that was harvested from a patient receiving total hip revision was grafted on the calvaria bone of SCID beige mice. ZA was injected directly beneath the scalp of mice once,2 days post surgery. The mice were sacrificed 2 or 4 weeks after transplantation and the calvaria with grafted human tissue was collected for further detection.[Result]The grafted tissues were found survive for at least 4 weeks in the animals. Bone collagen collapse of the calvaria caused by periprosthetic tissue was demonstrated by HE staining. Significantly higher level of TNF-?,IL-6,RANKL and CPK both in gene expression and protein release were detected in PT grafted group,as compared with the control. Once administration of ZA remarkably reduced the expression of RANKL and CPK in both gene and protein level without affecting TNF-? and IL-6.[Conclusion]Once and local injection of ZA effectively inhibits the osteolysis induced by human periprosthetic tissue with a long lasting effect. The novel animal model could serve for evaluating the pharmaceutical effect on periprosthetic osteolysis.

Objective To evaluate the etiology, pathogenesis, clinical manifestation, imaging features, treatments and factors related to prognosis of acute spinal spontaneous hematoma.Methods The clinical data of 38 patients with acute spinal hematoma treated in our hospital from 2011 till now were analyzed retrospectively.Duration of follow-up was 6 months.The factors influencing the prognosis were analyzed.Results Acute epidural hematomas (n=29) were much more common than subdural (n=5), subarachnoid (n=1) and intramedullary (n=3).Most hematomas were located in the cervical and thoracic vertebra regions.The etiology of acute spinal spontaneous hematoma was unknown in most patients.Twenty-nine patients were dealt with surgical intervention and 9 patients were treated conservatively.After 6-month follow up, recovery rate measured by JOA score in patients of spinal injury ASIA level A and B was (51.26 ±38.97), and level C, D and E was (80.33 ±25.83), P<0.05.Recovery rate in patients with hematoma discovered in less then 24 hours treated with surgical decompression was (64.79 ±36.10), and that in those with hematoma present over 24 hours was (34.54 ±30.17), P<0.05.Conclusions Acute spinal hematoma always caused by unknown etiology, and usually manifests itself in a sudden onset of pain and neurological deficits.The early diagnosis mainly depends on MRI.Patients presenting with severe neurologic dysfunction or showing signs of progressive deficit should have immediate surgical intervention. The status of neurological deficits before surgery and the length of interval between onset and surgical intervention are associated with recovery.

Objective To investigate the effect of intermittent use of low molecular heparin (LMWH) on microembofic signal (MES) in patients with ischemic stroke on the basis of anti-platelet aggregation and statin therapy.Methods Ninety MES-positive patients with acute ischemic stroke detected by transcranial Doppler were randomly divided into a non-LMWH group (n =44) and a LMWH group (n =46).The non-LMWH group was treated conventionally with enteric-coated aspirin and atorvastatin.On the basis of conventional therapy,the LMWH group was treated with LMWH,subcutaneous injection of LMWH calcium 4 100 AXaIU every 3 months,twice a day,and one week as a course of treatment (a total of 3 courses).The number of MES,MES-positive rate and incidence of ischemic cerebrovascular events at 3 and 6 month were compared in both groups.Results There was no significant difference in the MES-positive rates at 3 month after treatment between the non-LMWH group and the LMWH group (70.45％ vs.61.36％ ;x2 =1.357,P =0.244),but the number of MES in the non-LMWH group was higher than that in the LMWH group (12.07 ± 10.16 vs.8.09± 8.13; t =1.470,P =0.043); the MES-positive rate at 6 month after treatment in the non-LMWH group was significantly higher than that in the LMWH group (36.96％ vs.19.57％;x2=3.982,P=0.046),and the number of MES in the non-LMWH group was also significantly higher than that in the LMWH group (10.32 ±9.93 vs. 1.46 ± 3.27; t =5.450,P =0.000).There was no significant difference in incidence of ischemic cerebrovascular events at 3 month (2.17％vs. 9.09％,P =0.198 ),but the incidence of ischemic cerebrovascular events at 6 month in the LMWH group was significantly lower than that in the non-LMWH group (4.35％ vs.20.45％,P =0.025).Conclusions On the basis of anti-platelet aggregation and statin therapy,the intermittent use of LMWH may decrease the MES-positive rate and the incidence of ischemic cerebrovascular events in the MES-positive patients with ischemic stroke at 6 month.

Objective To investigate the effect of JNK signal pathway in acute necrotizing pancreatitis (ANP) associated lung injury.Methods A total of 24 SD rats were randomly divided into sham group and ANP group,ANP rats were induced by retrograde injection of 5％ sodium taurocholate into common bile duct.The rats were sacrificed 12 and 24h later,and the pancreas and lung tissue were resected and underwent routine pathologic examination,ELISA method was used to detect the level of TNF-α and IL-1β in lung tissue.Expression of JNK mRNA was detected by real time PCR,and the expression of JNK protein were evaluated by Western blotting.Results There was bleeding,necrosis,large amount of inflammatory cells infiltration in pancreatic tissue; and there was edema,pulmonary consolidation,interstitial edema,inflammatory cells infihration in lung tissue in ANP group.The levels of TNF-α and IL-1β,JNK mRNA,JNK protein,phosphorylation JNK were ( 374.3 ± 124.0) pg/ml,(649.0 ± 114.9) pg/ml,2.57 ± 0.76,1.40 ± 0.81,0.81 ± 0.20 in ANP group,which were significantly higher than those in with sham group[( 218.2 ± 68.4)pg/ml,(524.3±58.4)pg/ml,1.03±0.11,0.32±0.11,0.32±0.11,P＜0.05].Conclusions JNK signal pathway plays an important role in experimental ANP associated lung injury in rats.

Objective To explore the impact of iodine nutrition on 8-10 years old children after adjusting the iodine content in iodized salt in Hangzhou.Methods Twelve counties (areas,cities) were divided into urban,suburban and rural areas in Hangzhou.By population proportion survey (PPS),every county(area,city) was divided into east,west,south,north and middle districts; one school was selected in each district; forty children (half male and half female) aged 8-10 years old in each school were selected; family salt and urine samples of each student were collected.The levels of salt and urinary iodine were measured by picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer method (WS/T 107-2006),respectively.Results Two thousand seven hundred and twenty-five household salt samples were collected.The median of salt iodine,the iodized salt coverage rate,the qualification rate of iodized salt and the consumption rate of qualified iodized salt were 24.00 mg/kg,4.35％(2 571/2 725),91.02％(2 340/2 571) and 85.87％(2 340/2 725),respectively.The medians of salt iodine in urban,suburb and rural areas were 24.10,22.12,24.30 mg/kg,respectively.A total of 2 664 children urine samples were collected.The median of urinary iodine (MUI) of the children was 177.24 μg/L.The MUIs in urban,suburb and rural areas were 175.00,178.55,178.00 μg/L,respectively; in male was 183.00 μg/L and female was 170.50 μg/L.When non-iodized and unqualified iodized salt were taken,the differences of urinary iodine within groups were statistically significant in urban,suburb and rural areas(x2 =18.652,14.686,all P ＜ 0.05).In rural area,the difference of urinary iodine of 8-10 years old children who ingested different types of iodized salt was statistically significant(x2 =39.07,P ＜ 0.05).Conclusion After adjusting the iodine content of salt in Hangzhou,the iodine-nutritional status of 8-10 years old students is at a appropriatelevel.

Objective To investigate the prevalence of thyroid disease in early pregnancy women of Hangzhou,and further to discuss the necessity of screening thyroid function in early pregnant women.Methods From March to October 2013,1 165 cases of women in the center of community health service (or health) for routine prenatal care during early pregnancy were used as research subjects.Household salt,fasting morning urine and serum samples were collected.The salt iodine level was measured by direct titration of sodium thiosulfate.The urinary iodine level was measured by arsenic-cerium contact process method.The levels of serum TSH,FT4,and thyroid peroxidase antibody (TPOAb) were measured by chemiluminescence method.Results The median of urinary iodine of the early pregnancy women was 135.2 μg/L,and only 26.7％ of early pregnancy women' s iodine-nutrition status were optimal.These were no significant difference in median urinary iodine as well as the frequency distribution between urban and suburban(P＞0.05).The abnormal rates of TSH and FT4 in early pregnancy women with negative TPOAb were 6.8％ (71/1 039) and 8.9％ (92/1 039),and the abnormal rates of TSH and FT4 in suburban areas were higher than those in urban areas(P=0.035,P =0.001).The prevalences of hypothyroidism,subclinical hypothyroidism,and hypothyroxinemia in early pregnant women of Hangzhou were 0.3％ (3/1 165),2.0％ (23/1 165),and 4.8％ (56/1 165) respectively,and the prevalence of hypothyroxinemia in suburban areas was significantly higher than that in urban areas (6.1％ vs 3.5％,P =0.040).The positive rate of TPOAb was 9.9％ (114/1 153).The early pregnant women with positive TPOAb have an increased risk of thyroid dysfunction,the ratio of TSH over the reference values was significantly higher than that in the negative group and more prone to subclinical hypothyroidism (OR =3.34,95％ CI 1.29-8.65).Conclusion The early pregnant women in rural areas or with positive TPOAb have an increased risk of abnormal thyroid function,thyroid function and iodine nutrition screening or monitoring should be highlighted.

OBJECTIVE: To investigate the expression and significance of related receptors of Notch signaling pathway in mouse model of allergic rhinitis (AR). METHOD: Sixteen BALB/c mice of seven-eight weeks old were randomly assigned to two groups,including controls group and model group. AR model mice was sensitized with ovalbumin(OVA). Symptom score, hematoxylin-eosin for pathological alteration and infiltration of inflammatory cells in nasal mucosa were analyzed as well as enzyme linked immunosorbent assay was taken to detect IgE in pe- ripheral serum. Nasal septum mucosa and peripheral blood mononuclear cells were collected from 16 BALB/c mouse(8 Allegic rhinitis,8 controls). Notch 1-4 were checked by real-time quantitative polymerase chain reaction and flow cytometry from different levels. RESULT: BALB/c mice model of allergic rhinitis was established successfully. The mRNA of Notch1, Notch3, Notch4 in nasal septum mucosa of allergic rhinitis mice model groups were obviously higher than that in normal controls, and the difference were statistically significant (P < 0.01). However, The expression of Notch2 is lower than the control group and the difference was statistically significant (P < 0.05). In line with the above, the protein expression of Notch1, Notch3, Notch4 in peripheral blood mononuclear cells (PBMC) of model groups were significantly higher than that in health controls, and the difference were statistically significant (P < 0.01). But comparing control, expression of Notch2 was lower and the difference was statistically significant (P < 0.05). CONCLUSION There were significant changes of Notch genes in mouse model of AR. This intimated that related genes of Notch signaling pathway may paly important roles in the development and progression of AR and provide ideas for in depth study of the pathogenesis of AR.
Animals ; Disease Models, Animal ; Leukocytes, Mononuclear ; Mice ; Mice, Inbred BALB C ; Nasal Mucosa ; RNA, Messenger ; Receptors, Notch ; metabolism ; Rhinitis, Allergic ; metabolism ; Rhinitis, Allergic, Perennial

Objective To explore the impact of iodine nutrition on pregnant women after adjusting the iodine content in iodized salt in Hangzhou and provide a scientific basis for supplementation of iodine to pregnant women.Methods After adjusting the iodine content of salt from 2012 to 2014,proportional probability sampling method was used to select 300 families and 100 pregnant women from every county (area,city) of Hangzhou City,and the household salt and urine samples were collected to detect iodine.Results Totally 3 904,3 900 and 3 900 samples of household salts were collected with the medians of salt iodine concentration of 23.77,22.75 and 23.30 mg/kg of each year from 2012 to 2014,respectively.The qualified rate of iodized-salt was 95.87％ (3 550/3 703),97.04％ (3 510/3 617) and 96.53％ (3 564/3 692) and the consuming rate of qualified iodized salt was 90.92％ (3 550/3 904),90.01％ (3 510/3 900) and 91.38％ (3 564/3 900),respectively,from the year 2012 to 2014.Totally 1 300,1 217 and 1 315 urine samples of pregnant women were collected and the median of urinary iodine (MUI) of each year from 2012 to 2014 was 119.90,136.40 and 124.00 μg/L,respectively.Conclusion After adjusting the iodine content of salt in Hangzhou,the salt iodine consumption levels of pregnant women's family are stable,but the level of urinary iodine is low,which should be pay attention to.

Type 2 diabetes mellitus is an independent risk factor of cognitive impairment. In addition to the vascular damaged with high glucose and metabolic disorder, the disruption of neuronal calcium homeostasis, neurotransmitter and inflammatory response may be pathogenesis of cognitive impairment in type 2 diabetes mellitus patients.