Objective To investigate the change of the serum matrix metalloproteinase-13 (MMP-13) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) and the correlations of MMP-13 and TIMP-1 with bone metabolic markers or bone mineral density(BMD) in aged postmenopausal Chinese women.Methods One hundred and twenty women aged 48-65 years with postmenopausal were selected as subjects.They were divided into normal group(n =28),low bone mass group (n =36) and osteoporosis group (n =56) accordance with the WHO standard.The levels of serum MMP-13,TIMP-1,estradiol (E2),Osteoprotegerin (OPG),Osteoprotegerin ligand (OPGL),Procollagen terminal propeptide of N (PINP),and Type Ⅰ collagen cross-linked C terminal peptide(CTX) were measured using enzyme linked immunosorbent assay(ELISA).And the ratios of MMP-13 to TIMP-1 were calculated.Bone mineral density(BMD) of the lumbar spine,femoral neck,Fahrenheit and greater trochanter were measured using dual energy X-ray absorptiometry.Results There was significant difference of serum MMP-13 concentrations in normal controls,low bone mass group and osteoporosis group((27.08 ± 1.41) μg/L,(45.64 ± 1.62) μg/L and (44.25 ± 1.21) μg/L; F =110.314,P =000),and serum MMP-13 concentrations in low bone mass group and osteoporosis group higher than that in normal controls (P ＜ 0.05),serum MMP-13 concentrations in low bone mass group higher than that in osteoporosis group,but there was on significant difference(P ＞ 0.05).But Serum TIMP-1 concentrations in three groups was no significant difference (F =10.721,P =0.801).The ratio between MMP-13 and IIMP-1 was 0.185 ± 0.062,0.311 ± 0.053,0.332 ± 0.063 respectively,and there was significant difference of the three groups (F =137.771,P =0.000),and the ratio of the low bone mass group and osteoporosis group higher than the normal group(P ＜0.05),but there was no significant difference between the two groups.In osteoporosis group,Negative correlations between MMP-13,and BMD,E2 and OPGL,were found (r =-0.296,-0.198,-0.301,-0.298,-0.233 respectively,P ＜ 0.05).Meanwhile positive relations were found between MMP-13 and OPG,PINP,CTX (r =0.228,0.315,0.312 respectively,P ＜ 0.05).In low bone mass group,the level of MMP-13 was significantly relative with BMD (the lumbar spine,Fahrenheit),E2 and CTX (r =-0.188,-0.196,-0.235,0.289 respectively,P ＜ 0.05).Conclusion There are significant correlations between serum MMP-13,ratios of MMP-13 and TIMP-1 and bone metabolism marker and BMD.MMP-13 level may increase with increases in osteoporosis and osteopenia.The increases of serum MMP-13 and the decrease of ratio of MMP-13 to TIMP-1 might be biomarkers in high bone turnover state,such as postmenopausal osteoporosis and early stage of osteopenia.

Objective: The method for separation by capillary zone electrophoresis (CZE) and electrochemical determination of organic acids in fruit juices was developed. Method: In this system, 0.2mmol/L cetylpyridinium bromide (CPB) was used as an electro osmotic flow (EOF) modifier to reverse the direction of EOF. cyclodexfrin ( -CD) was added into running buffer to improve the separation efficiency. Then, the optimal separation conditions were achieved and successfully employed to separate six organic acids, including oxalic, malic, tartaric, succinic, fumaric acid and citric acids. One nano palladium modified carbon paste electrode was used for determination. Results: The calibration curves for all organic acids studied were linear with 2-3 orders (1 10–6-1.0 10–3 mol/L) of magnitude and all the detection limits (S/N=3) were below 2 mol/L. The RSD was between 1.05%-2.15% , and recovery was 93.4% . Conclusion: CZE separation combined with electrochemical detection is suitable for simultaneous determination of organic acids in fruit juices quickly with high sensitivity and selectivity.

OBJECTIVE: Researches on total hip replacements are always the hot spots in recent years. The replacements have obtained satisfactory outcomes in clinic. However, the long-term effect is limited because of the material and technical problems. This paper is to summarize the developmental trend and the prospect of clinical application for total hip replacements in 10 years.DATA SOURCES: A computer-based online search of Medline database was undertaken to identify relevant articles published in English from January 1996 to January 2006 by using the keywords of "total hip replacements, surgical robot, tissue engineering, virtual endoscopy". Meanwhile,Chinese relevant articles published from January 1990 to December 2005 were searched in Wanfang database, the keywords were "total hip replacements, material, virtual endoscopy, surgical robot, tissue engineering" in Chinese.STUDY SELECTION: The articles were primarily checked, and the references in each literature were reviewed. Articles about the study on total hip replacements were involved; Meanwhile, the repetitive studies or Meta analysis were excluded.DATA EXTRACTION: Totally 39 relevant articles were collected, and 22 of them accorded with the. Inclusive criteria, 17 old or repetitive ones were excluded. Of the 22 articles, 5 were about the influence of artificial joint material on prosthetic loosening and its carcinogenesis; 2 about the microinvasion of joint replacement induced by computer-aided surgery navigation; 1 about the introduction of surgical robot; 3 about the development of custom-made and specially made artificial joint; 9 about the possibility for the surface replacement of hip; and 2 about the combination of tissue engineering technique and artificial joint.DATA SYNTHESIS: Modern researches on total hip replacements are exploring wearing tolerant prosthesis to reduce the prosthetic loosening caused by osteolysis and bone resorption. The computer-aided design/made technique is used for special design and manufacture according to the need of disease, so as to solve the fracture around prosthesis and meet the need of limb salvage surgery. The computer-aided surgery navigation realizes the microinvasion of joint replacement and the fast recovery after surgery. The successful rate of total hip replacements is improved by developing localized surgical robot in China. By using the virtual endoscopy, we can accurately know the damaged conditions of intraarticular cartilage and sub-cartilage bone, which are also able to be quantifized, so that more suitable and reliable prosthesis can be selected to increase the accuracy. The tissue engineering technique in repairing defect can increase the synostosis of prosthesis, and perfect the technique of joint replacement.CONCLUSION: In the coming 10 years, total hip replacements will develop towards stability, harmlessness, microinvasion, mechanization, individualization and diversification, so that the total hip replacements will be much stander and safer with higher successful rate.

Objective To explore the changes of the cardiac enzymes in the critical patients after operation and to analyze their relationship with the patient's condition level and the prognostic.Methods Fittyseven critical patients after operation were enrolled to observation group,and 55 small operation patients acted as control group.Their cardiac enzymes in three days after operation were detected and compared.Results The cardiac enzymes of the observation group increased significantly when compared with the control group(aspartate aminotransferase (AST) (153.1 ± 211.0) U/L vs (54.7 ± 39.0) U/L,t =3.404,P ＜ 0.01) ; lactic acid dehydrogenase(LDH) (381.0 ± 216.1) U/L vs (194.6 ± 75.3) U/L,t =6.050,P ＜ 0.01) ; creatine kinase (CK) (882.9 ±630.7) U/L vs (130.1 ± 71.8) U/L,t =8.796,P ＜0.01) ;creatinine kinase,MB isoenzyme (CK-MB)(314.3 ± 164.2) U/L vs (164.9 ± 87.7) U/L,t =5.979,P ＜ 0.01) ; α-hydroxybutyrate dehydrogenas(α-HBDH) (410.1 ± 327.6) U/L vs (27.8 ± 36.3) U/L,t =8.605,P ＜ 0.01) ; The fatality ratio was 24.6％ (14/57) in the observation group.The cardiac enzymes of the survival group existed significant difference compared with the death group(AST:(81.3 ± 40.5) U/L vs (373.6 ±342.1) U/L,t =5.585,P ＜0.01) ;LDH:(303.6±134.0) U/Lvs (618.6±250.1) U/L,t=6.064,P＜0.01) ;CK:(658.5±328.0)U/Lvs (1572.0±829.4) U/L,t =6.001 P＜0.01) ;CK-MB:(303.2±184.3) U/Lvs (738.6±445.6)U/L,t=5.242,P＜0.01) ;α-HBDH:(254.1±118.6) U/Lvs (499.3 ±147.6) U/L,t=6.320,P＜0.01).Conclusion Elevated myocardiac enzymes are common in the critical patients after operation.The change of the cardiac enzymes is related with the degree of disease and the wound.

Objective To evaluate efficacy and clinical feasibility of 125Ⅰ combined with high intensity focused ultrasound(HIFU)therapy for hepatocellular carcinoma.Methods.The study included 10 cases of hepatocellular carcinoma(primary hepatic carcinoma,5 cases.Tumor recurrence of hepatocelluhr carcinoma after hepatecomy,5 cases).All the cases were treated with 125I combined with HIFU.Resultsl The operationWas successfully completed in all the cases.No severe post-operative complication occurred.CT acall found no displacement of 125Ⅰ seeds.CT 8can showed that reduced size of tmnor changed in different degree.The l month,3 month,6 month and l year survival cases were 8,7,5 and 2.During 3 to 18 months follow up,2 cases died within 1 month.Two cases survived more than 22 months.Conclusion Using 125Ⅰ combined with HIFU is safe,minimally invasive and effective for treatment of hepatocellular careinom.

Objective To investigate the effect of vacuum sealing drainage (VSD) technology on prevention and treatment of infection wound and to repair the infectious fracture wound in earthquake. Methods Twenty-two patients with limb fractures and open infection wound received VSD from May 12, 2008 to June 19, 2008 in West China Hospital of Sichuan University. Before the VSD, we debrided all wounds and gave effective systemic antibiotics. A -18 ～ - 14 kPa pressure was exerted to the wound, and the VSD was used for 8 ～ 10 days. We took a germiculture regularly. The capacity, color, and nature of negative pressure drainage, the regression of limb swelling, and systemic inflammatory responses were observed. Results There was no active bleeding wound or transparent film off in all patients. Three patients had drainage clogging, and were kept flowing freely using the sterile saline pipe to remove the blockage of necrotic tissues. During the VSD, granulation tissues grew well in the 13 patients with bone exposure of the wounded. Two patients whose symptom of inflammatory was not obviousy eased had another debridement to completely remove the necrosis, and the symptom was relieved. After 3-5 days of VSD, swelling and fever in the other 20 patients significantly subsided. Conclusion VSD can alleviate the wound inflammation, facilitate the growth of the fresh granulation tissue from the surrounding to the center, and reduce the flap transfer area for the Stage Ⅱ coverage of the exposed bone.

A simple and reliable electroanalytical method for the fast determination of aluminum in natural and drinking waters by a. c. oscillopolarography using solochrome violet RS(SVRS) is described. The alkaline buffer solution used was 0.85 mol/L NH3·H2O- NH4 Cl(pH 8.8) containing 5 × 10-5 mol/L SVRS. A sensitive incision due to the redox reaction of Al-SVRS complex adsorption wave on the Hg-film electrode was observed on the dE/dtE oscillogram at - 1.05 V. The incision depth was linearly proportional to the A1 concentration in the range of 1 ×10-7 ～6 × 10-6 mol/L. No serious interference was found. The detection limit of this method was 5 × 10-8 mol/L,and the relative standard deviation was 5.5% for 2 × 10-7 mol/L Al ( n = 10). This method was successfully applied to the determination Al in 22 real samples. The results were found to be in good agreement with those obtained by inductively coupled plasma-atomic emission spectrometry.

Objective To identify the key factors triggering medical disputes induced by differences in cognition between doctors and patients in order to control the occurrence and development of medical disputes. Methods From 2002 to 2006,the outpatients,inpatients and medical staff of 3 hospitals in Shanghai(class 3 first level general hospital,n=2;class 3 first level special hospital,n=1) were investigated,and random sampling method was employed for the research analysis. Results There were significant differences between doctors and patients in cognition of influential factors triggering medical disputes such as health law,medical services,rights and obligations. Conclusion The differences in cognition between doctors and patients are important causes for medical disputes,and effective prevention and intervention measures must be taken.

Objective Cloning-sequencing is a common method to detect the number of trinucleotide repeats.The aim of the present study is to discuss its reliability.Methods One clinically diagnosed SCA1 patient was recruited in the study.The numbers of CAG repeats in ATXN1 gene were estimated via polymerase chain reaction (PCR) and denaturing polyacrylamide gel electrophoresis (DPAGE).To verify accuracy of CAG numbers estimated, the PCR products were electrophoresed on a 2.5% agarose ge] and separated bands were excised for direct sequencing.Also, the longer separated band underwent cloning-sequencing using a TA cloning kit.Results The patient was identified as SCA1 by DPAGE.After direct sequencing, the numbers of CAG repeats were 26 and 47 in the shorter and longer bands, respectively.However, after cloning-sequencing of the longer band, there are 10 different numbers of CAG repeats, including 50, 47, 46, 41,32, 28, 27, 26, 25 and 24.Furthermore, there are other kinds of trinucleotide repeats, such as CCG, CGG, CTG, CAA and TAT scattered among the CAG repeats.Conclusions It is not reliable to identify the number of trinucleotide repeats by cloning-sequencing alone.To improve the reliability, it is better to combine cloning-sequencing with other methods.

Objective To investigate the effects of cromolyn sodium(CS)on forebrain ischemiareperfusion injury in gerbils.Methods Twenty-four male gerbils weishing 55-70 g were randomly divided into 3 groups(n=8 each):group Ⅰ sham operation;groupⅡ I/R and group Ⅲ CS 50 mg/kg+I/R.Forebrain ischemia was produced by occlusion of bilateral common carotid arteries for 10 min and confirmed by isoelectricity of EEG. CS was injected via lingual vein at 0 and 1 h of reperfusion.All the animals were killed at 2 h of reperfusion for determination of cerebral cortex injury score,cerebral water content[(wet weight-dry weight)/wet weight×100%],cerebral MDA content,SOD activity and histamine content.Results The cerebral cortex injury 8core,cerebral water content, MDA content and histamine content were significantly increased while SOD activity was signiiieantly decreased in I/R group(Ⅱ)aa compared with sham operation group(Ⅰ)(P＜0.05 or 0.01).CS significantly attenuated the I/R-induced changes(P＜0.05 or 0.01).Conclusion CS can attenuate the forebrain ischemia-reperfusion injury by reducing histamine and oxidative response.