3 cm)ultrasonography image was the absent of rotator cuff image(nonvisualization)or discontinuity(local nonvisualization);moderate full thickness cuff tears(size 1-3 cm)ultrasonography image was the hypoechoic zone extending through the entire substance of the cuff;bursa surface partial thickness was small hypoechoic discontinuities of the external surfaces of the cuff;articular surface partial thickness was small hypoechoic discontinuities of the internal surfaces of the cuff.All the ultrasonography examination results were compared with findings at shoulder operation or arthroscopy as a golden standard.12 shoulders were open repaired;16 shoulders were limited open and arthroscope repaired;6 shoulders were contracted under the radio frequency ablation;22 shoulder were taken acrominal plasty under the arthroscope.Results The ultrasonography correctly depicted 30 of 33 rotator cuff tears with sensitivity 90.91%,specificity 91.30%,positive predictive value 93.75%,negative predictive value 87.50%.6 large to extensive tears,11 small and moderate full-thickness tears,5 acrominal partial-thickness tears,11 articular partial-thickness tears.Conclusion The ultrasonography is a highly accurate diagnostic method for detecting full-thickness rotator cuff tears,but is less sensitive in detecting partial-thickness rotator cuff tears.

Objective To investigate the pathological and physiopathological difference between the ruptured” and the “degenerated” typed lumbar disc herniation (RDH and DDH) by measurement of the pressure of the herniated lumbar disc both in the herniated site and in the nucleus pulposus during the surgery, combined with the clinical,light microscopical and immunohistochemical properties. Methods Fifty seven cases of lumbar disc herniation undergone operation in the Tianjin Medical University Hospital were included in this study. The patients were divided into 2 groups. 1) Rupture typed lumbar disc herniation in which the herniated chip of the lumbar disc separated from the parent disc and was squeesed or drew out easily when the superficial posterior longitudenal ligament and anulus fibrosis were opened in the herniated site. 2) Degenerated typed lumber disc herniation in which no herniated chip of the lumber disc escaped; the herniated material can not be taken out unless the disc was resected by the instrument. Before the herniated disc was incised, the intervertebral disc pressure was measured using GENERAA710 multifunctional monitor. Both the light microscopical and the immunohistochemical difference between the RDH and the DDH was studied. Results 1) In the herniated site, the pressure in the RDH is higher than that in the DDH(P0.05). 3) In the RDH, the pressure in the herniated site is higher than that in the nucleus pulposus (P0.05). 5) The“lumbar pain score”and the pressure have obviously relationship in all of 35 patients(r=0.539,P

Objective To explore the effect of icariin on stimulating Smad4 mRNA level in MC3T3-E1 cells. Methods MC3T3-E1 cells were treated by 0 ng/ml, 10 ng/ml, 20 ng/ml, 40 ng/ml icariin respectively. MTT method and population diploid time were applied to observe the cell proliferation. The cell ALP level was measured by atomic absorptiometry and the type Ⅰ collagen was observed by immunohisto-chemistry. RT-PCR was used to find the Smad4 mRNA level in the MC3T3-E1 cells. Results Under the inversion phase contrast microscopy, MC3T3-E1 cells were oligodendrocytes-shaped rich with cell organs. The cells density in 10 ng/ml, 20 ng/ml were higher than those in 0 ng/ml,40 ng/ml. Cell growth curve in 10 ng/ml was higher than other 3 groups and the 20ng/ml was higher than 0 ng/ml, 40 ng/ml groups( P

Objective To introduce laminar shelling decompression technique and to discuss its benefit for decompression of thoracic ossification of ligamentum flavum. Methods 102 patients were diagnosed as thoracic ossification of ligamentum flavum, 63 males and 39 females with an average age of 49.7 years (range, 33 to 71 years). 99 cases suffered with sensation disturbance, 73 cases with constriction on trunk or lower limbs, 77 cases with sphincter dysfunction. The IMSOP Standard Neurological Classification of Spinal Cord Injury was applied for localized the level of thoracic spondylopathy. The JOA lower limb motor function standard and sphincter function standard were used to evaluate the ability of lower limb motion and sphincter function respectively. In the decompression the dorsal cortex of lamina was the first layer to resect, the facet joint surface indicate the depth for removing the second layer, then thinning the ossified tissue by shaving with the motor bur until it was somewhat lucent. Finally decompress the spinal canal by moth eaten manner. Results The mean decompression length was 2.8 lamina(2 to 4 lamina). The mean follow-up duration was 18.9 months (3 to 41 months). Among 99 sensation disturbance 69 totally recovered, 30 relived. 73 cases with the feel of constriction of trunk or lower limbs were completely recovered. Postoperative JOA sphincter function score was 2.632?0.407, comparing with the preoperation score, and the difference was significant (t=15.93, P

Objective To investigate the effect of FTY720 and gemcitabine on the proliferation and apoptosis of H520 and A549 cells in non-small cell lung cancer(NSCLC) cell line.Methods The interventional influence on the in vitro cultured NSCLC A549 and H520 cells was performed by selecting 0,2,4,6,8,10 μmol/L concentrations of FTY720,then the absorbance value was detected at 24,48,72 h after culture and the proliferation inhibiting effects of FTY720 on A549 and H520 were observed under the condition of different concentration of FTY720;adding single 7 μmol/L of FTY720,single 0.2 μmol/L gemcitabine and 37 μmol / L FTY720 combined with 0.2 mol/L gemcitabine into A549 and H520 cells lines,then the differences of inhibition and apoptosis after 48 h in the cells of each group were observed.Results The inhibitory effect of different concentrations of FTY270 on NSCLC A549 and H520 cell lines was statistically significant difference (P＜0.05).The proliferation inhibiting effect of FTY720 on NSCLC H520 and A549 cell lines had the correlation with the concentration and time.The apoptosis rate of FTY720 combined with gemcitabine on A549 and H520 cells was significantly higher than that of single use in these two drugs (P＜0.05).Conclusion FTY720 combined with gemcitabine can significantly inhibit the proliferation of A549 and H520 in human NSCLC,and can effectively promote the apoptosis of cancer cells,and has the higher clinical value.

Various pathologic mechanisms and types of lesion have participated in cognitive impairment in patients with vascular dementia.A number of medications have been used in the treatment of patients with vascular dementia in clinical practice,including cholinesterase inhibitors, N-methy-D-aspartate receptor antagonists,calcium channel blockers and neurotrophic drugs. This article reviews the progress in research on the pharmacotherapy of vascular dementia.

Objective To investigate the effect of Kanglaite injection (KLT) on immunological function of rat models with Lewis lung carcinoma. Methods Forty C57BL/6 mice were used to establish Lewis lung carcinoma models and divided randomly into the high dose(25 mL/kg), middle dose (12.5 mL/kg) and low dose (6.25 mL/kg) of KLT groups and model group(n=10). The mice in the KLT groups were sacrificed after injecting corresponding dose of KLT with intraperitoneal injection for 14 d. No treatment was performed on the rats in model group. The body weight, tumor and spleen weight was weighed, then the ratio of tumor restriction and the index of spleen was calculated. MTT colorimetric method and ELISA were used to detected activity of T cell proliferation and expression of IL-2 in spleen. The expression of NF-κB and IκBα protein was detected by Western blot. Results The ratio of tumor restriction in the high, middle, low dose of KLT groups decreased gradually. The indexes of spleen of the high and middle dose of KLT groups were higher than those in the model group (P<0.05 or P<0.01).Compared with the model group, the activity of T cell proliferation in the high, middle, low dose of KLT groups and the expression of IL-2 in the high and middle dose of KLT groups was increased significantly (P<0.05 or P<0.01). The expression of NF-κB protein in the nuclei of high, middle, low dose of KLT groups increased dose-dependently, and the expression of NF-κB and IκBα protein in the cytoplasm decreased dose-dependently. ConclusionKLT could enhance immunological function by effecting T cell proliferation, expression of IL-2, NF-κB and IκBα, while restricting tumor growth in Lewis lung carcinoma models.

Objective: To explore the effects of 17 β-estradiol (E2) and 2-methoxyestradiol (2ME) on endothelium-1/nitric oxide (ET-1/NO) cascade in experimental rats with hypoxic pulmonary hypertension. Methods: A total of 48 female SD rats were randomly divided into 6 groups:①Sham operation group,②Ovariectomy (OVX) group,③Hypoxia group,④OVX+hypoxia group,⑤OVX+hypoxia+E2 group, the rats received subcutaneous E2 at 20μg/(kg?d) and⑥OVX+hypoxia+2ME group, the rats received subcutaneous 2ME at 240μg/(kg?d).n=8 in each group. Blood levels of ET-1, NO, eNOS activity and the expressions of pulmonary tissue endothelium A receptor (ETAR), ETBR and eNOS were compared among different groups. Results: Compared with Sham operation group, Hypoxia and OVX+hypoxia groups showed small pulmonary artery thickening with lumen narrowing, increased mean pulmonary arterial pressure (mPAP), allP<0.01; the above morphological and mPAP changes were reduced by E2 and 2ME intervention. Compared with Sham operation group, OVX and Hypoxia groups had increased blood ET-1 and pulmonary mRNA, protein expressions of ETAR, decreased pulmonary ETBR, all P<0.01; the above changes were more obvious in OVX+hypoxia group; E2 and 2ME intervention reduced blood ET-1 and pulmonary ETAR expression, but they were still higher than Sham operation group, meanwhile, ETBR expression was elevated, but it was still lower than Sham operation group, allP<0.01; blood ET-1 was lower in OVX+hypoxia+2ME group than OVX+hypoxia+E2 group,P<0.05. Compared with Sham operation group, OVX group had decreased pulmonary eNOS protein expression,P<0.01; Hypoxia group had decreased blood NO and pulmonary eNOS protein expression,P<0.05 orP<0.01; OVX+hypoxia group had decreased blood NO, eNOS activity and decreased pulmonary mRNA and protein expressions of eNOS, allP<0.01; E2 and 2ME intervention elevated the above indexes,P<0.05 orP<0.01, but they were still lower than Sham operation group, allP<0.05. Conclusion: E2 and 2ME could decrease blood ET-1 and pulmonary ETAR expression, increase pulmonary ETBR expression; elevate blood NO, eNOS activity and pulmonary eNOS expression. E2 and 2ME may partially reverse pulmonary hypertension via improving ET-1/NO cascade in experimental rats.

ObjectiveTo observe and analyze the synapses developing process of newly generated connections of autologus activated Schwann cells (AASCs) in combination with fetal spinal cord cell suspension(FSCS) in the surrounding area of the spinal cord injury site.MethodsA total of 42 Wistar rats underwent unilateral ligation of the saphenous nerve.The portion of nerve tissues distal to the ligation site were harvested 1 week after operation.AASCs were isolated,cultured and purified.Spinal cord injury model produced in 42 Wistar rats on T7 by modified Allen impact method.Three days after injury,20 μl FSCS with a density of 1×105/μl prepared from pregnant rats (El4) in combination with AASCs were injected into the epicenter of the traumatized cavity.Animals were sacrificed at 2,4,6,8,10,12 weeks post transplantation.Light and electronmicroscopic studies as well as immunohistochemical assay were carried out to evaluate the graft survival,its differentation and integration with the host.ResultsIn the transplantation area,AASCs showed good growth and differentiation,and glial scarring surrounding the lesions was less.The neuroblast stretched out the terminal endings 4 weeks after implantation,followed by the presenting of the pre- and post-synaptic membrane.Eight weeks post transplantation,the dense or developed projections were observed in the pre- and post-synaptic membrane,the high electron dense substance full filled the synaptic cleft.All the spherical cleat vesicles,granular vesicles,elliptical vesicles and flattened-f type vesicles were discovered under the electron microscope.Ten weeks after injury,the axosomatic,dendrosomatic,dendro-dendritic,axoaxonic,and dendro-axonic synapses coexisted.Light microscopy showed that the graft cell grew gradually.Immunohistochemical assay showed that NF,5-HT,CGRP and GFAP positive fibers were in the graft.Synapses,glia fibers and blood brain barrier integrated each other.Conclusion1) The transplanted FSCS combined with AASCs can develop mature synapses with miscellaneous synaptic vesicles in the acute injured spinal cord.2) Co-existing indicate the possibility of synaptic connection between FSCS and host.

Objective To explore the clinical characteristics and risk factors of re-fracture in patients suffering from osteoporosis-related fractures as well as effective interventions.Methods From January 2006 to January 2008,a total of 273 patients with osteoporosis-related fracture were entered in the study,including out-patients and in-patients who were over 50 years old.The patients were divided into fracture group(n=225)and re-fracture group(n=48).The re-fracture rate was followed up for 2 years,during which 11 patients developed re-fracture.General data including age and sex,fracture types,femoral neck bone mineral density(BMD)T-scores tested by dual-energy X-rays absorptiometry(DEXA),Charlson index,timeinterval between two fractures as well as mobility skill assessment were collected and analyzed.Results The average age at the first fracture was 67.7±8.5 years vs.72.7±9.5 years for the re-fracture cases.Female accounted for 70.2% of the fracture group and 77.1% of the re-fracture group.The most common re-fracture type was vertebral fracture for the first time and femoral neck fracture for the second time during the followup.Risk factors for a second fracture in osteoporotic fractures patients include age(＞75 years,HR=1.23; ＞85years,HR=1.68),female sex(HR=1.36),prior vertebral fractures(HR=1.62),prior hip fractures(HR=1.27),BMD T-score＜-3.5(HR=1.38)and weakened motor skills(HR=1.27).The refracture rate in osteoporosis-related fractures was 4.9% followed up for 2 years.The second fracture happened 3.7 years after the first one on average.Conclusion The risks of second fracture among patients with initial brittle fracture are substantial.Mobility skill assessment is an important risk factor for osteoporosis fractures recurrence.There is adequate time between fracture and re-fracture for effective interventions to prevent or reduce the risks of refracture,especially for the old women with a vertebral or hip fracture.Medication,motor function rehabilitation and fall-down prevention training would be helpful.