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

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.

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.

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.

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 investigate prospectively the diagnostic significance of ulnar/median nerve amplitude ratio in motor neuron disorders.Methods Patients referral to our department between May 2009 and February 2012,due to muscle weakness,inflexible,cramps and atrophy,were consecutively enrolled.Conventional nerve conduction studies of 4 extremities (using surface electrodes) and needle electromyography were performed in all patients with fixed examiner.The compound muscle action potentials (CMAP) were recorded from abductor digiti minimi (ADM) and abductor pollicis brevis (APB) with stimulation of ulnar and median nerve at wrist,respectively.Moreover,the ratio of CMAP amplitude between ADM and APB (ADM/APB) was calculated in the patients who met the diagnostic criteria for definite amyotrophic lateral sclerosis (ALS) and Hirayama disease (HD).The patients with Guillain-Barré syndrome (GBS) and other popyneuropathies (PN) were served as case-controls,and 34 healthy volunteers (aged (45.7 ± 16.3) years) as normal-controls.Results (1) There were 78 cases with ALS,25 HD,51 GBS and 140 other PN,with the mean age(years) of 54.7 ± 11.6,17.6 ± 2.2,41.3 ± 18.4 and 57.1 ± 14.3,respectively.(2) ADM/APB in the ALS subgroup was 2.28 ±2.87 (0.12-22.38),HD0.66±0.36 (0.05-1.34),GBS 1.42 ± 1.33 (0.25-9.85),other PN 1.36 ± 1.48 (0.08-14.44) and normal-controls 1.07 ± 0.28 (0.61-1.64,F =6.872,P =0.000),respectively.(3) The areas under receiver operator characteristic curve in patients with ALS was 0.830 (s-x =0.039) and HD 0.691 (sx =0.039,P =0.000) ; the diagnostic sensitivity and specificity for ALS patients were 36.7％ and 93.3％,respectively,with cutoff value of ADM/APB =2; and the diagnostic sensitivity and specificity for HD patients were 53.6％ and 89.0％,respectively,with cutoff value of ADM/APB =0.7.Conclusions The ulnar/median CMAP amplitude ratio increases in ALS,but decreases in HD,which may be served as a relatively specific electrophysiological index.ADM/APB amplitude ratio ＞ 2.0 is suggested to be a diagnostic parameter for ALS and ＜ 0.7 for HD.

Objective To evaluate the anatomical basis of retrohepatic tunnel used for liver hanging maneuver.Methods The anatomy of inferior vena cava ( IVC ) was studied in 20 healthy adult cadavers and 15 patients with advanced cirrhosis who underwent piggyback liver transplantation to confirm the existence of the path of retrohepatic tunnel and count the number of short hepatic veins draining into retrohepatic IVC.Results Short hepatic veins mainly drain into the IVC on its left and right sides.The number of short hepatic veins that drain into the upper or middle portion of the IVC was significantly more than that into the lower portion ( x2 =48.524,P ＜ 0.01 ).On the path of retrohepatic tunnel,most short hepatic veins that drain into the IVC are located on the front side ( F =9.188,P ＜ 0.01 ).There was no significant difference in the number of short hepatic vein between the groups of liver cirrhosis and that of healthy adults ( t =0.405,P ＞ 0.05 ),but anatomic variation of post-hepatic tunnel is common in liver cirrhotics.Conclusions Retrohepatic tunnel was a potential space and had a unique anatomical feature.The establishment of retrohepatic tunnel by liver hanging maneuver is safe in noncirrhotics.However,in advanced posthepatitic cirrhosis,retrohepatic tunnel should be used with caution.

Objective To investigate the dosimetric influence of pure carbon fiber treatment tabletop of Elekta Precise new linear accelerator in radiotherapy.Methods Surface-axis distance (SAD) technology was employed for the measurement.Two groups of fields were set and both of them were SAD opposed portals ( one of them went through the tabletop,while the other did not).A PTW electrometer and a 0.6 cm3 Farmer ionization chamber were utilized for comparison measurement.Then dose attenuation of the main table board,extended body board,the extended board for head,neck and shoulders,and the joints of these boards were calculated.Results Under the energy of 6 MV,the dose attenuations of the following locations were:1.4％ - 7.2％ at the main treatment table board; 2.8％ - 38.7％,1.4％ -30.1％,1.5％ -20.8％ and 1.4％ - 11.2％,respectively at distances of 1,4,7 and 8 cm from the joint of the main table board ;0.5％ - 5.0％ at the extended body board; 4.7％ - 15.4％ at distance of 1cm from the joint of the extended body board; 0.5％ -3.3％ at the neck position of the extended board for head,neck and shoulders; 5.3％ - 16.7％ at the shoulder positions; and 6.8％ -30.4％ at the joint between the extended boards and the main table board.Conclusions The dose attenuations of the new linear accelerator pure carbon fiber treatment tabletop vary at different locations. Considerable higher attenuations are observed at the table board joints than other locations.