Objective To observe the protective effect of sodium hyaluronate (Na-HA),and its effects on mRNA expression of peroxisome proliferators-activated receptor gamma (PPAR-γ) in cartilage of rabbit osteoarthritis (OA) model.Methods Forty eight white rabbits were divided into A,B,C groups randomly.Group A were normal controls,groups B and C were underwent unilateral anterior cruciate ligament transection (ACLT).The rabbits in group B were injected normal saline after ACLT;Group C rabbits received intra-articular 1% sodium hyaluronate (HA) injections 5 weeks after surgery,0.3 ml once a week.At week 11 after the surgery,all rabbits were sacrificed.The cartilage changes on the medial femoral condyles were graded.Cartilage sections were stained with safranin-O and HE,mRNA expression of PPAR-γ was detected by real time polymerase chain reaction (Real Time-PCR).Results Cartilage degeneration in group B was significantly more severe than in groups A and C.The grey value of Safranin-O of B group were higher than groups A and C.Expression of PPAR-γ mRNA in group B was higher than that in groups A and C.Conclusion NaHA has a protective effect on articular cartilage degeneration,and the inhibitory effect on PPAR-γ mRNA expression may be one of the therapeutic mechanism of Na-HA.

Objective To discuss the risks of hypertension development with relation to the level of lipid variables among populations who had normal blood pressure at baseline study. Methods In April 2000, under the support of project "prevention of metabolic syndrome and multi-metabolic disorders in Jiangsu province", a cohort study was performed to obtain the baseline data among 8685 persons from age 34 to 74. In June of 2006, a follow-up investigation was carried out among those who had been in the study for 5 years after the baseline study started. 2603 persons who met the selection criteria and showed normal blood pressure during baseline study, were recruited in this investigation. The interval from the baseline to the follow-up studies was 6.38 years on average. Relationship between the risk of developing hypertension and the baseline level of lipid variables were analyzed. Results Relations between baseline lipid levels and the incidence of hypertension during the follow-up was discovered. In gender and age adjusted model, the lipid variables were all associated with hypertension(Wend test, P<0.01). In multivariable-adjusted model, HDL-C [aRR=0.71 (95%CI: 0.61-0.99)], non-HDL-C [αRR=1.28 (95%CI: 1.14-1.83)], TC/HDL-C ratio[aRR=1.41 (95%CI: 1.25-2.03)] and TG [αRR=1.49(95%CI: 1.30-2.13)] were again associated with hypertension (trend test, P<0.05). Even the αRR was much weakened after the baseline SBP, DBP were adjusted with Cox model, the significant relation of hypertension to HDL-C, TC/HDL-C ratio and TG still existed. Excluding the two factors of obesity (BMI≥28) and diabetes which had been recognized in marked linking with hypertension, lipid variables were still associated with hypertension. Conclusion Dyslipidemia might occur before being hypertensive. Hypertension was associated with HDL-C, TC/HDL-C and TG or even exclusion of obesity, diabetes and factors of smoking and drinking or baseline level of SBP, DBP were adjusted.

Objective To investigate the daily total fluoride intake in relating to the prevalence of skeletal fluorosis in two villages in Jiangsu Province,in order to provide the scientific evidences for the control and prevention of endemic fluorosis.Methods Adults sampled from a high-fluoride Village,Wamiao,and a low-fluoride Village,Xinhuai,were surveyed in this study according to the fluoride concentration in their household shallow well.The average daily total fluoride intake from difierent sources and the skeletal fluorosis were investigated in each subject.Then the subjects from two villages were allocated into five subgroups(＜2.00,2.00～,3.00～,4.00～,≥5.00 mg/d),the relation fluoride intake and prevalence of osteofluorosis was analyzed.Results The prevalence of skeletal fluorosis in Wamiao Village was 31.06%(41/132),but no skeletal fluorosis case(0/35)was found in Xinhuai Village.According to the daily total fluoride intake,subjects with higher daily total fluoride intake tended to associated with a higher prevalence of skeletal fluorosis in a significant dose-response relationship(regression equation:y=2.624-6.855x+3.424x2:r=0.997).The benchmark dose lower limitation of daily total fluoride intake with 95% confidencewas 2.50 mg/d calculated according to this dose-response relationship,the reference dose(RfD)was 2.50 mg/d.In Wamiao Village a significant difference was also found between daily total fluoride intake in 41 subjects[(5.09±1.20)mg/d]with X-ray detectable skeletal fluorosis and in 91 subjects[(3.08±1.12)mg/d]without X-ray detectable skeletal fluorosis(t=-9.32,P＜0.01).Conclusions These findings indicate that the daily total fluoride intake has a significant dose-response relationship with the prevalence of skeletal fluorosis in an endemic fluorosis area associated with high-fluoride drinking water;and the RfD in this study was lower than that in the national standard of"Chinese hygienic standard for daily total fluoride intake(WS/T 87-1996)"(3.50 mg/d).

Objective To evaluate the causes,prevention and treatment ot laparoscopic comphca- tions in urologic surgery.Methods From May 2000 to May 2004,135 urologic laparoscopies were per- formed,including 17 transperitoneal laparoscopies and 118 retroperitoneal laparoscopies.Of the135 cases,26 had adrenal adenoma extirpation;31 had roof-removal and decompression of renal cyst;25 had radical ne- phrectomy;6 had pyeloplasty;2 had partial resection of renal capsula and encapsulation of the great omen- tum;2 had partial nephrectomy;4 had pelviureteral resection;13 had ligation of renal pedicle lymphatic ves- sel;2 had ureterolysis;7 had ureterolithotomy;12 had ligation of spermophlebectasis;5 had exploration,re- duction and fixation of undescended testis.The intra-and post-operative complications were retrospectively reviewed and clinically analyzed.Results Overall,14 cases(10.4%)had complications.Intraoperative complications occurred in 10 cases,including 6 cases of peritoneal injuries,which were clamped during oper- ation;4 of vascular injuries,which resulted in conversion to open surgery.Postoperative complications oc- curred in 4 cases,including 2 of subcutaneous emphysema,which was spontaneously absorbed at 5 and 7 d after operation;1 of incision seepage,which was drained for 40 d and then disappeared;and 1 of urine reten- tion,for which urethral catheterization was kept for 3 d and then the patient had voluntary voiding.No death occurred in this series.Conclusions Understanding the characteristics of laparoscopic complications in u- rologic surgery and systematic training of the surgeons can reduce the occurrence of complications.

Objective To study the clinicopathologic characteristics of sarcomatoid carcinoma of the lung.Methods Clinicopathologic characteristics and immunohistochemical results of 42 cases with sarcoma- toid carcinoma of the lung were analyzed.Results Forty-two cases were pathologically proved to be spindle cell carcinoma,1 cases;giant cell carcinoma,1 case;carcinosarcoma,4 cases;pleomorphic carcinoma,36 cases.The tumors were composed of both carcinomatous and sarcomatous elements.Immunohistochemistry showed that CK was positive in 24 of 24 cases,EMA was positive in 18 of 20 cases,Vim was positive in 25 of 25 cases.Eighteen cases were survival One-year survival rate was 61.2 %,with mean survival 13.3 months. Conclusion Diagnosis of sarcomatoid carcinoma of the lung depends on pathologic and immunohistochemical results.

Objective Overexpressions of epidermal growth factor(EGF)and EGF receptor have been associ- ated with progression and invasive phenotype of pancreatic cancer.However,the underlying molecular mechanism by which EGF worked in pancreatic cancer cells has not been completely understood.In this study,effect of EGF on the invasion and metastasis of pancreatic cancer cells and its regulatory mechanism were investigated.Methods The effects of EGF on the proliferation,adhesion and invasion of pancreatic cancer cells were detected by WST-1 prolif- eration assay,adhesion assay and invasive assay,respectively.The activity and expression of MMP-2 and MMP-9 were examined by zymography,Western blot and RT-PCR,respectively.The activity of NF-?B was examined by EMSA.Results EGF could significantly promote the invasiveness of pancreatic cancer cells but did not affect cell proliferation or adhesion.The expressions of NF-?B and MMP-9 were significantly increased by EGF,but EGF did not affect the activity and expression of MMP-2.Furthermore,EGF stimulated the NF-?B binding activity.Pre- treatment with NF-?B inhibitors,pyrrolidine dithiocarbamate(PDTC),could significantly inhibit the activity of NF-?B induced by EGF.Meanwhile,the EGF-induced expression and activity of MMP-9,as well as cell invasiveness were also inhibited by NF-?B inhibitor.Conclusion EGF could increase the expression and promote the invasiveness of MMP-9 via the activation of NF-?B in pancreatic cancer cells,which implies that NF-?B inhibitant,such as PDTC,may diminish the invasiveness of pancreatic cancer cells.

Objective To compare the effect of cimetidine associated with bletilla striata,rhubarb on peptic ulcer,cushingulcer,acute erosive gastritis,bleeding of esophagus and gastric funds varicosis of cirrhotic portal hyper- tension and gastri cancer.Methods 136 patients with upper gastrointestinal hemorrhage were randomly divided into 2 groups.The treated group(n=69)was given cimitidine associated with bletilla striata,rhubarb and the control group(n=67)was given cimitidine only.The effects of hemostasis in 2 groups were observed.Results The effect of hemostasis in the treated group was better than that in the control group on peptic ulcer,cushingulcer,acute ero- sive gastritis and gastric cancer(P＜0.05).There were no difference between 2 groups about bleeding of esophagus and gastric funds varicosis of cirrhotic portal hypertension(P＞0.05).Conclusion The effect of hemostasis on up- per gastrointestinal hemorrhage treated by integrated traditional Chinese medicine and western medicine might achieve better on cushingulcer,acute erosive gastritis,peptic ulcer and gastri cancer.It has less adverse effect and more safety.

OBJECTIVE To explore the effect and mechanisms of LW-AFC,a new formula derived from Liuwei Dihuang decoction,on chronic unpredictable mild stress(CUMS)-induced mood and cogni-tion impairment in mice. METHODS C57BL/6J mice were randomly placed into seven groups (n=10):normal control group,CUMS group,Fluoxetine(10 mg·kg-1,once per day)group,Liuwei Dihuang de-coction group(LW,10 g·kg-1,once per day),and LW-AFC(0.8 g·kg-1,1.6 g·kg-1,3.2 g·kg-1,once per day) group. The stressed group was given CUMS for 4 weeks to set up a chronic multiple-stressed model.LW and LW-AFC was oral administered a week prior to CUMS and until the end of the study(a total of 35 d),while fluoxetine was administrated orally for 4 weeks.The anxiety behavior was analyzed using the open field test(OFT)and elevated plus maze test(EPM).The depression behavior was ana-lyzed using the sucrose preference test (SPT) and forced swimming test (FST). Spatial cognition was evaluated using Morris water maze (MWM) test and working memory was evaluated using new object recognition test(NORT). RESULTS CUMS for 28 d increased depressive-and anxiety-like behaviors. LW-AFC (1.6 g·kg-1) significantly increased the numbers of entries into the open arm and time in the open arm of CUMS mice (P<0.05). LW-AFC (3.2 g·kg-1) increased sucrose consumption and de-creased the immobility time of FST (P<0.01) of CUMS mice. The MWM test showed that spatial learning andmemory in CUMS mice were remarkably affected relative to controls,whereas LW-AFC(3.2 g·kg-1)im-proves cognitive functions(P<0.05).CONCLUSION The mood and theability of learning and memory of thestressed group can be affected after exposure to CUS.Oral administration of LW-AFC significant-ly improved CUMS-induced impairments of mood and cognition in mice.

Objective To investigate the clinical value of high resolution ultrasound combined with radiological imaging in the diagnosis of Meckel′s diverticulitis (MD),and to analyze the causes of missed diagnosis as well as misdiagnosis by ultrasound.Methods The image data of 61 patients with MD were retrospectively analyzed,the essentials and the causes of missed diagnosis as well as misdiagnosis of ultrasound were summarized and compared with the results of operation,CT,gastrointestinal contrast,as well as radionuclide.Results The patients were divided into simple type(18,29.5%) and complex type(43,70.5%) according to ultrasonography.The simple type diagnostic accuracy rate was 100%,the ultrasonography showed the right lower abdominal tubular bowel shadow or cystic echo mass,and the structure of diverticulum could clearly showed by ultrasound.In another side,the complex type diagnostic accuracy rate was 55.8%,the ultrasonography showed the right lower abdominal mixed echo mass or concomitant with other alimentary tract malformation,while the diverticulum structure was difficult to be distinguished.The diagnostic accuracy rate of radionuclide imaging was 83.6%,CT was 37.0%,while gastrointestinal contrast was 30.0%.Among 19 cases of misdiagnosis by ultrasound,13 cases of MD were confirmed by radionuclide and CT examination,the diagnostic accuracy rate of ultrasound combined with radiological imaging diagnosis was 90.2%.Conclusions The sonographic features of MD are lack of specificity,especially in the complex type,while the patients with recurrent hemafecia or acute abdomen should be alert to the presence of MD.Patients who are suspected of MD by ultrasound diagnosis should also be examined by radiological imaging in order to make an early diagnosis and surgical treatment to improve the prognosis of patients.

Objective To report the experience of the arterial switch operation(ASO) for Taussig-Bing anomaly and late outcomes.Methods From January 2001 to December 2015,57 patients were underwent arterial switch operation for Taussig-Bing anomaly in Fudan university affiliated children's hospital cardiac center,Median age and weight at operation was 63(37.5-88.5)days, 4.1(3.4-5.0)kg, respectively.29 patients with Arch anomalies(50.9%), 23 patients with unusual coronaries(40.3%),according to have arch anomaly or not and surgery time, dividing the patients into two groups, group A(have, n=29)and group B(not have, n=28), earlier experience into group 1(2001-2008, n=27), later experience into group 2(2009-2015, n=30), respectively.Results The Mortality was12.3%, the mortality of group A and group B was 13.8%, 10.7%(P>0.05),group 1 and group 2 was 22.2%, 3.3%(P<0.05) respectively, follow up was complete in 47 patients with a mean follow-up of(6.2±3.5) years , three patients lost, there was no late mortality, the actual survival at 1, 5year was 87%, 87%, respectively.Reintervention was required in 10 patients(21.3%), the aorta-PA valve diameter ratio was a risk factor for reintervention(group A P=0.02, group B P=0.04) ,and 1,2,5year free of reintervention was 95.6%, 86.6%, 77.2%, respectively.Conclusion The ASO approach can be applied to Taussig-Bing anomaly with acceptable mortality , and it is the procedure of choice at our institution.One stage to repair TBA with aortic arch abnormalities did not influence outcomes.The aorta-PA valve diameter ratio<0.5 was a risk factor for reintervention.