Objective To analyze the changes of erythrocyte sedimentation rate (ESR) ,C‐reactive protein (CRP) and serum am‐yloid A (SAA) before and after total hip arthroplasty(THA) .Methods A total of 124 cases of unilateral THA in our hospital from April 2012 to April 2015 were selected as the research subjects .The CRP ,ESR and SAA levels were detected before operation and on postoperative 1 ,3 ,5 ,7 ,14 d ,and 1 ,3 months .The differences of above indexes between the patients with postoperative deep venous thrombosis (DVT ) obstruction and the patients with normal recovery were retrospectively analyzed .Results CRP was sharply increased after operation and reached the peak value on 3 d ,then rapidly faded away ,and recovered to the preoperative level at postoperative 1 month;ESR was continuously elevated until reaching the peak value ,then slowly declined ,and recovered to the normal level at postoperative 3 months;SAA was sharply elevated after operation ,reached the peak value on 3 d ,then slowly de‐clined and could recovered to the normal level at postoperative 3 months .The CRP ,ESR and SAA levels in the patients with post‐operative complications occurrence were significantly higher than those in the patients with postoperative normal recover at the same time ,moreover which could not recover to the preoperative levels .Conclusion Dynamically monitoring CRP ,ERS and SAA after THA could conduce to early discover postoperative lower limbs DVT blockage complication .

Objective To assess the value of exercise treadmill testing (bruce protocol) in diagnosing early atherosclerotic lesions of the lower limb. Methods Between March and September 2008, 173 outpatients with high risks of peripheral arterial disease (PAD) were enrolled randomly from the cardiology clinic of Chinese PLA General Hospital. The patients were subjected to exercise treadmill testing (Bruce protocol) and ankle-brachial index (ABI) determination, as well as lower limb artery ultrasonography within one week. Using ultrasonic findings as diagnostic criteria, the diagnostic sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of exercise treadmill testing for early atherosclerotic lesions of the lower limb were analyzed, and the diagnostic value of exercise treadmill testing was assessed using the ROC curve. Results After exercise, ABI decrement (R value) increased in subjects with high risks for PAD with atherosclerotic lesions of the lower limb aggravating. Using the presence of large atherosclerotic plaques (area > 20 mm2 ), atherosclerotic plaques and atherosclerotic lesions in lower limb arteries as positive diagnostic criteria, the area under curve of ROC was 0. 80 (95% CI: 0.72-0.88), 0.78 (95% CI: 0.71-0.85) and 0. 60 (95% CI: 0.44-0.76), respectively. Using the presence of large atherosclerotic plaques in lower extremities as positive diagnosis, R value was 0.80, with a sensitivity of 54. 0%, a specificity of 96. 7%, a LR+ of 16. 4, and a LR- of 0. 58, meanwhile, R value was 0. 85, with a sensitivity of 70.0%, a specificity of 91.9%, a LR + of 8.64, and a LR- of 0.33. Conclusions Exercise treadmill testing (Bruce protocol) in combination with ABI determination is a safe, accurate, objective tool for detecting early atherosclerotic lesions of the lower limb. Immediately after exercise, 0.85 is the cut-off R value appropriate for diagnosing large atherosclerotic plaques of the lower limb (area > 20 mm2).

Adult ; Child ; Humans ; Male ; Pain ; etiology ; Pharyngeal Diseases ; etiology ; Rabies ; complications

AIM: To investigate whether the bacterial DNA participates in SIRS and its possible mechanism. METHODS: Escherichia coli genomic DNA (EC DNA) was extracted and purified from Escherichia coli 25922 by alkaline lysis method. Mortality of mice challenged with EC DNA and the changes of TNF-? and IL-6 in rat serum were observed. ANA-1 cells were cultured in vitro, after the cells were stimulated by different concentrations of EC DNA and LPS, the level of TNF-? and IL-6 in supernatant were tested. Meanwhile,expression of TLR9 and TLR4 on cell surface was measured. Activation of NF-?B was also observed. RESULTS: The lethal effect of EC DNA on mice with an obvious dose-effect relationship was observed. The death happened within 24 hours. Calf thymus DNA and DNase I-treated EC DNA did not lead to mice to die. The changes of serum TNF-? and IL-6 in rats induced by EC DNA and LPS were similar, but TNF-? peak level of EC DNA group appeared 1 hour earlier than that of LPS group. In vitro, large amount of TNF-? and IL-6 were released from ANA-1 cells stimulated by EC DNA. High expression of TLR9 and TLR4 was observed on surfaces of THP-1 cells. In particularly, LPS induced strong activation of NF?B. The results suggested other pathway possibly took part in the signal transduction inducea by EC DNA. CONCLUSION: EC DNA has the abilities to lead to death of mice, and induces serum TNF-? and IL-6 level to increase in rats and ANA-1 cells to release cytokines in vitro. High expression of TLR9 and TLR4, strong activation of NF-?B may be its important molecular mechanism, but other pathway probably exists to play an important role.

AIM: To construct a recombinant vector containing gloverin and express it in vitro by Rapid Translation System(RTS500). METHODS: The gloverin cDNA was amplified by PCR and inserted into the prokaryotic expression vector pIVEX2.3. The recombinant product was identified by PCR and enzyme digestion. The positive reconstructed expression plasmid pIVEX2.3-G was expressed by RTS500 in vitro. The expressed protein was identified by SDS-PAGE and western blotting. RESULTS: Positive recombinant plasmid pIVEX2.3-G was successfully constructed. Target protein of 13.8 Kda with 6-his tag was detected by SDS-PAGE and western blotting. CONCLUSION: Gloverin polypeptide is successfully expressed in inactive E.coli in vitro.

Objective To investigate the roles of CpG motifs in the release of cytokines induced by bacterial DNA. Methods Mice were sensitized with injection of D GalN (600 mg/kg) into the abdominal cavity 1 h before experiment. Mortality was observed after purified Escherichia coli DNA(EC DNA), calf thymus DNA(CT DNA), phosphorothioate backbone CpG oligodeoxy nucleotides (CpG ODN) and CG sequence inverted oligodeoxy nucleotides (non CpG ODN) were injected venously into mice. The injection dosage of DNA given was 30 mg/kg but ODN was 10 nmol/mouse. THP 1 cell lines were cultured in vitro . After the above reagents were added into the culture, TNF ?, IL 6, IL 1? levels were detected to observe the different abilities of these reagents to induce the release of cytokines. Results EC DNA and CpG ODN could induce the death of mice and the large amount of release of cytokines, but CT DNA and Non CpG ODN could not. Conclusion CpG ODN has the ability to induce macrophage to release cytokines largely. CpG motifs, which may play an important role in the release of cytokines induced by bacterial DNA, may probably be the structural basis of bacterial DNA.

Hepatitis, Viral, Human ; drug therapy ; Humans ; Prostaglandins E ; therapeutic use ; Randomized Controlled Trials as Topic ; Research Design

OBJECTIVEHighland natives adapt well to the hypoxic environment at high altitude (HA). Several genes have been reported to be linked to HA adaptation. Previous studies showed that the endothelial ni- tric oxide synthase (ENOS) G894T polymorphism contributed to the physiology and pathophysiology of hu- mans at HA by regulating the production of NO. In this meta-analysis, we evaluate the association between the ENOS G894T polymorphism and HA adaptation through analyzing the published data.

METHODSWe searched all relevant literature about the ENOS G894T polymorphism and HA adaptation in PubMed, Med- line, and Embase before Step 2015. A random-effects model was applied (Revman 5.0), and study quality was assessed in duplicate. Six studies with 634 HA native cases and 621 low-altitude controls were included in this meta-analysis.

RESULTSFrom the results, we observed that the wild-type allele G was significantly overrepresented in the HA groups (OR = 1.85; 95% Cl, 1.47-2.33; P < 0.0001). In addition, the GG genotype was significantly associated with HA adaptation (OR = 1.99; 95% Cl, 1.54-2.57; P < 0.0001).

CONCLUSIONOur results showed that in 894 G allele carriers, the GG genotype might be a beneficial factor for HA adaptation through enhancing the level of NO. However, more studies were needed to confirm our findings due to the limited sample size.

ObjectiveToevaluatethefeasibilityandresultsof transorallaparoscopic thyroidectomy. MethodThyroidectomy was attempted in 5 cases,including 4 females and 1 male with the average age of 42 years( range 35 -60 years).All patients was diagnosed as single nodule of the thyroid gland confirmed by B-mode ultrasound examination before the operation.The average diameter of nodule was 2.5 cm (range 2 - 3.4 cm). ResultTransoral laparoscopic thyroidectomy was perfoormed successfully in all 5 patients.The operation time was 120 - 210 min,averaging 170 min,blood loss during the operation was 15-60 ml,the postoperative hospitalization was 4 days. There was no conversion to open surgery,no recurrent laryngeal nerve injury,nor parathyroid glands dysfunction. ConclusionsTransoral laparoscopic thyroidectomy is feasible and safe,giving excellent cosmetic results.

Objective To evaluate the efficacy of tibial bone-skin flap grafts in the management of se- vere traumatic osteomyelitis complicated with bone and skin defect in leg to avoid amputation.Methods From March 1998 to Aug.2004,12 cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap graft.The longest flap was 17cm,widethest 10cm, The longest bone flap was 12cm.They were followed up for 0.6 to 5 years.Results All the tibial bone-skin flaps survived completely,2 cases of osteomyelitis recurred.The followed-up,from 0.5 to five years,showed good bone union in all cases,averageing 15 weeks.The infection was under control.The leg function and con- tour were satisfactory.Conclusion The tibial bone-skin flap has the advantages of having distinguished sign of anatomy,highly vascularized,easy to obtain,simply and flexible procedure,improving circulation,short- ens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.