Osteoarthritis (OA) is a bone and joint disease caused by multiple factors, which seriously threatens human health. It is mainly manifested as joint pain and dysfunction. In severe cases, it can cause deformity. The mechanism of OA is not very clear, and there is a lack of effective therapeutic drugs; the exploration of etiology, pathogenesis and preventive measures of OA has always been an important research direction in this field. Studies have found that the transforming growth factor-β (TGF-β)/Smad signaling pathway plays a key role in the occurrence and development of OA. This article reviews the research progress of TGF-β/Smad signaling pathway in OA in recent years at home and abroad.

Public-private partnership(PPP)serves as a useful attempt for an adjustment of existing number of public hospitals and incremental development of private hospitals in an effort to implement policies of the health reform and optimize the allocation of medical resources.Investment-OperationTurnover(IOT) is a way to introduce the PPP practice,regarded as an institutional innovation in reforming public hospitals.This paper traced back the IOT model in its development and analyzed its connotation and form,as well as its strengths and weaknesses in a feasibility study,and presented the existing IOT projects in China for reference and open discussion.

Objective To analyze the value of the serum BHMT for diagnosis of hepatic injury in patients with acute poisoning.Methods ELISA method was used to detect BHMT in serum samples,and the samples were detected in the sera of normal persons and patients with acute poisoning.Results 300 samples were detected in the sera of normal persons by ELISA method.The average level of human serum B HMT content in 300 samples was 9.02 ng/mL(6.19-12.84 ng/mL),and the 95 ％ medical reference value of BHMT content in healthy people ranges from 0.00 to 28.01 ng/mL.BHMT and ALT were detected in 43 samples from acute liver injury,the Spearman analysis indicating a good positive correlation between BHMT and ALT(rs =0.757 62,P＜0.001).The comparison of the content of BHMT was made between the serum samples from 20 renal damage patient and 20 normal human serum,there was no significant difference in the BHMT content between the serum of patients with renal injury and the normal human serum(P＞0.05).Conclusion The medical reference value range for of serum BHMT content in healthy population ranges from 0.00 to 28.01 ng/mL.There was a good positive correlation between BHMT and ALT.BHMT might not be closely related to kidney injury,while be more specific to liver injure.BHMT could be a better marker of acute poisoning liver injury.

Microcirculation is closely related to occurrence and development of disease, so it is of significance in noninvasive imaging of microcirculatory structure and function in vivo.Photoacoustic imaging is one of the main techniques in microcirculation imaging, which has the characteristics of high contrast, high detection depth and high sensitivity to tissue function.A review of the literature showed that photoacoustic technique can noninvasively image and quantitatively measure microcirculatory structure, vasoconstriction and vasodilation, concentration of hemoglobin, oxygen saturation, blood velocity and direction, oxygen metabolism level in a certain depth of living tissue in real time.Research progress in photoacoustic imaging of microcirculation in subcutis, cerebral cortex, tumor, eye and other tissues is reviewed in this paper.

Objective To analysis the relationship between blood homocysteine concentration in diabetic retinopathy patients with vascular endothelial cell damage and platelet activation.Methods 80 type 2 diabetes mellitus(T2DM)patients,including 50 no diabetic retinopathy(NDR group)and 30 diabetic retinopathy(DR group)and 30 normal controls were selected to measure the concentration of Hcy as well as circulating endothelial cells(CEC),Endothelin(ET),Yon Willebrand(vWF)and platelet activation markers CD62p and CD63.Results The level of CEC,ET,vWF,CD62p,CD63 and Hcy in T2DM group were,distinctly higher than those of control(P＜0.01),furthermore,the level of these markers in DR group were also higher than that in NDR group(P＜0.01).Blood CEC level Was positively related with ET(r=0.839,P＜0.05),and the same relationship was found in Hcy and CEC(r=0.615,P＜0.05),ET(r=0.642,P＜0.05),CD62p(r=0.623,P＜0.05)and CD63(r=0.542,P＜0.05).Conclusions High blood Hcy,CEC,ET,vWF,CD62p and CD63 level were tighdy related with DR.High level of Hcy,vascular endMermis cell damage and platelet activation maybe play an important role in the pathogenesis of DR.

Objective To analyze the factors related to glare occurred after the phakic intraocular lens (P-IOL) implantation,and to raise the standard for the P-IOL selection.Design Retrospective case series.Participants 104 patients with high myopia underwent P-IOL implantation in Beijing Tongren Hospital.Methods In 104 cases,22 cases (22 eyes) were implanted angle supported Phakic6 designed accord with corneal symmetry,54 cases (54 eyes) were implanted iris fixed Verisyse,and 28 cases (28 eyes) were implanted posterior chamber PRL.Selection of the diameter of P-IOL optics depended on P-IOL diopters.The pupil diameter,the P-IOL optic center position,the pupil and corneal center position were measured with anterior segment optical coherence tomography (OCT).The contrast sensitivity (CS) under different condition (day,day and glare,night,night and glare) and in different space frequency (1.5,3,6, 12,18c/d)were examined with Optec6500 system.Main Outcome Measures Glare incidence,CS,and the influence of pupil diameter and P-IOL location to glare.Results None of the 104 P-IOL eyes occurred glare in day time.59 eyes (56.73%) complained of glare in dime condition.The glare incidence was 63.18% (14/22) in Phakic6 eyes,55.56% (30/54) in Verisyse eyes,and 53.27% (15/28) in PRL eyes (P=0.691).CS of all surgical eyes were improved in day time with or without glare luminous environment (P=0.000).And the CS of halo-complaining eyes was lower than of no halo eyes in night time with or without glare luminous environment (P=0.000).Glare oc- curred more frequently in eyes with the pupil diameter larger than P-IOL diameter in clime condition after surgery (10 in Phakic6 eyes, 20 in Verisyse eyes,12 in PRL eyes,all P

The production conditions of glutathione with shaking flask fermentation by the mutant Saccharomyces J-X25, a methionine-defected strain were studied, and the optimum culture conditions are as follows: initial pH6. 0, temperature 30℃, 100ml in 500ml flask, the inoculum size 10% and agitation rate 220r/min. The emphasis was on the stimulating effect on the cells by dioxogen and the sodium lactate as surfactant. Both of which were added at the logarithmic phase of fermentation, and the GSH production was up to 0. 253g/L , 52% higher than the control without the additions. Compared with the production of GSH initial strain that by the mutant in optimum conditions was increased by 79%.

To compare the adjuvant therapeutic effect of silicone oil and ointment applied to the lacrimal laser angioplasty.METHODS: Totally, 134 eyes of 102 cases who were diagnosed as lacrimal duct obstruction ( except chronic dacryocystitis) were divided into two groups. Sixty eyes were performed laser plastic operation and silicone oil filling. Seventy - four eyes were adopted laser plastic operation with cloth enzyme dexamethasone eye ointment filling. All patients were followed up for 3 ~ 15mo. The clinical effect and the number of irrigation of two groups were compared 3mo after treatment, and to assess the merits of the method.RESULTS: The efficiency of the silicone oil group was 87% and that of the eye ointment group was 84%. There was no statistically significant difference (P>0. 05). The number of lacrimal duct flushing of the silicone oil group was 7. 20±1. 22 times among postoperative 3mo, and that of the eye ointment group was 7. 96 ± 1. 79 times. The number of lacrimal duct exploration through of the silicone oil group was 0. 62 ± 0. 87 times, that of the eye ointment group was 1. 43 ± 1. 48 times. There was statistically significant differences compared between the two groups (both P<0. 05).CONCLUSlON:The effect of laser plastic operation and silicone oil filling treating obstructive diseases of lacrimal duct is similar to laser plastic operation with cloth enzyme dexamethasone eye ointment, but the postoperative care of the former is more simple. Patients can significantly reduce the frequency of lacrimal duct flushing and lacrimal duct exploration through.

Objective To improve the efficiency of donated organs and to investigate the possi- bility and operation protocol of heart and lung transplantation from the same donor to different reci- pients.Methods The organs of heart and lung were obtained from three donors through the method of orthotopic lavage and whole cutting,and transplanted to end-stage patients with heart diseases or lung diseases.First,the donor was subjected to mechanical ventilation,thoracotomy and lavage of heart and lung.The heart and lung were cut in whole and separated.The recipients were subjected the re- trograde lavage of heart and lung.In the patients receiving unilateral lung transcription,the left and right lungs were isolated.Among 3 recipients of lung transcription,one underwent left unilateral lung transplantation and 2 bilateral lung transplantation.Three cases received orthotopic cardiac transplan- tation by using bicaval orthotopic heart transplantation (BOHT) anastomosis method.Results One recipient of left unilateral lung transplantation recovered well after operation.In one recipient under- going bilateral lung transplantation,right upper lung embolism occurred.After re-operation of cutting the right upper lung on the 9th day of the first one,he recovered from the illness.In another recipient receiving bilateral lung transplantation,anastomotic stenosis of trathea and pulmonary infection occurred after operation.After expectant treatment,he recovered from the illness,but died from serious infection 7 months after operation.One of the heart recipients was found having renal failure of first stage,and recovered from disease after hemodialysis treatment.Quality of life was good in all 3 heart recipients after operation and their heart function achieved the restoration of 0-Ⅰstage.Conclusion The treatment protocol of transplantation from the same donor to different recipients at the same time, which can make full use of the organs from donors,is feasible and has good effect.

Objective To review the study of noninvasive imaging methods for evaluating liver fibrosis.Meth- ods The current literatures on the use of the ultrasonography,CT and MRI for the evaluation of liver fibrosis were reviewed.The principles,applications and advancement of each imaging methods were described and summarized re- spectively.The features of the newly developed imaging techniques were also discussed.Results In addition to the morphologic information,the imaging examinations can also provide functional information about the circulation sta- tus,diffusion and metabolism features of liver.The potential diagnostic value of MR elastography for liver fibrosis has been addressed.Conclusion The imaging examinations,especially the functional MRI techniques,are reliable noninvasive alternatives for the evaluation of hepatic fibrosis,with bright potentiality for clinical application.