BACKGROUND: Incidence rate of cervical osteoarthritis in the middleaged and elderly is high. Some researches on risk factor causing cervical osteoarthritis have been performed abroad, but most of the factors are being discussed.OBJECTIVE: To investigate the occurring cervical osteoarthritis risk factors in the middle-aged and elderly from different regions of China and provide evidences for prevention and intervention of cervical osteoarthritis in community.DESIGN: Cross-sectional study.SETTING: Beijing Hospital, Ministry of Health, together with Second Hospital of Xi'an Jiantong University, Institute of Integrated Traditional and Western Medicine of Hebei Medical University, Shanghai Huadong Hospital, Nanfang Hospital, Second Affiliated Hospital of Harbin Medical University, West China Hospital of Sichuan University.PARTICIPANTS: The investigation was conducted from July to August2005. On the basis of stratified multi-stage cluster sampling method, 6 218formal registered permanent residents of over 40 years old from Xi'an,Shijiazhuang, Shanghai, Guangzhou, Harbin and Chengdu were enrolled.They all agreed to join the investigation voluntarily. There were 2 916males of 40-94 years and 3 302 females of 40-86 years.METHODS: Questionnaire investigation of epidemiology of cervical osteoarthritis was performed in the testees, and radiograph was used in the persons with clinical symptom. The basic sample unit was neighborhood committee (city) and village committee (countryside). Sampling method:Taking each city as a whole, composed of two levels, namely city and countryside, in the first phase the persons were extracted from district (county),in the second phase from sub-district (countryside), in the third phase from neighborhood committee (village eommittee). Diagnosis standard of cervical osteoarthritis was positive clinical symptom and 2 grade or above of radiograph Kellgren & Lawrence grading. The content of questionnaire contained 6 aspects: general condition, history of present illness, history of past illness, physical check-up, radiographs and disease diagnosis, totally94 questions and 141 variation indexes. Influential factors of prevalence rate of cervical osteoarthritis were analyzed using multifactor non-conditional Logistic regression analysis. Odds ratio (OR) was used for expressing index of strength of relationship between disease and exposures. If OR ＞ 1,it was indicated that there was positive correlation between disease occurrence and exposures. If OR ＜ 1, it was suggested that there was negative correlation between disease occurrence and exposures.MAIN OUTCOME MEASURES: Prevalence rate of cervical osteoarthritis in each city and OR.RESULTS: Totally 6 218 investigational subjects were included in the result analysis, without drop out. ①Total prevalence rate of cervical osteoarthritis in population of 40 years or above from 6 domestic cities was23.6%. There was significnat difference of prevalence rate in each city (P＜0.01). ②Result of Logistic regression analysis: Age (OR=1.010-1.058),defecation with squat ting pot (OR =1.024-1.997) and history of hypertension (OR =1.815-3.078) were common risk factor in most areas. In northern area the common risk factor compos ed of daily stair climbing or grade climbing (OR =1.018-1.020), while drinking colored wine (OR=3.451, Xi'an), history of osteoarthri tis of father (OR =2.491, Xi'an), history of diabetes (OR =5.013, Shijiazhuang), history of osteoarthritis of mother (OR =2.045, Shanghai), smoking (OR =6.857, Guangzhou), age of starting drinking (OR =3.044, Guangzhou) and full-time athletic sports (OR=9.020, Harbin), etc. emerged in different areas.CONCLUSION: The onset of cervical osteoarthritis has the same risk factor in 6 domestic areas, and main risk factor in different areas has certain differences, which can provide reference data for the prevention and cure of cervical osteoarthritis for the future and reduce waster of medical resources.

OBJECTIVETo observe the intervention effects of electroacupuncture at "Yishu" (EX-B 3) on rats with type-2 diabetes mellitus (T2DM), so as to provide experiment references for acupuncture to treat T2DM.

METHODSAmong seventy male Wistar clean-grade rats, 8 rats were randomly selected into a control group; the rest rats were made T2DM model. Fifty-two rats which were successfully made T2DM model, according to randomized block method, were divided into a model group (10 rats), a medication group (10 rats), an electroacupuncture at "Shenshu" (BL 23) group (11 rats), an electroacupuncture at "Pishu" (BL 20) group (10 rats) and an electroacupuncture at "Yishu" (EX-B 3) group (11 rats). Seven days after successful establishment of model, the rats in the model group were fixed in the self-made rat bag without receiving any treatment; the rats in the medication group, according to body mass (10 mL/kg), were treated with intragastric administration of glimepiride; the rats in all the electroacupuncture groups were treated with electroacupuncture at "Shenshu" (BL 23), "Pishu" (BL 20) and "Yishu" (EX-B 3), respectively. The continuous wave was selected with a frequency of 15 Hz and a current intensity of 4 to 6 mA. The treatment was given 20 min per treatment, once a day, 5 treatments per week for continuous 4 weeks. Before the establishment of model and continuous 4 weeks after the intervention, blood samples were collected from rats' caudal vein, and fasting blood glucose (FBG) was measured with FBG device each week. After the last intervention, the rats were killed and hypothalamus, pituitary and adrenal gland were collected. The colorimetric method was applied to measure the contents of triglyceride (TG), cholesterol (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C); radioimmunoassay was used to test the contents of glycated serum protein (GSP), fasting insulin (FINS), corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and cortin (CORT).

RESULTSFour weeks after the intervention, except that the rat's body mass in the normal group continued to increase, body mass in the model group, medication group and each electroacupuncture group were significantly reduced (P<0.01, P<0.05). Compared with the model group, the FBG in the electroacupuncture at "Pishu" (BL 20) group and electroacupuncture at "Yishu" (EX-B 3) group were obviously reduced (P<0.05, P<0.01); FBG in the electroacupuncture at "Yishu" (EX-B 3) group was lower than that in the medication group and electroacupuncture at "Shenshu" (BL 23) group (both P<0.05). The contents of TG, HDL-C and LDL-C in the electroacupuncture at "Yishu" (EX-B 3) group were reduced (P<0.05, P<0.01), the content of TG was significantly lower than that in the medication group and electroacupuncture at "Shenshu" (BL 23) group (both P<0.05), the content of LDL-C was significantly lower than that in electroacupuncture at "Shenshu" (BL 23) group (P<0.05). Insulin sensitivity index (ISI) in the medication group, electroacupuncture at "Pishu" (BL 20) group and electroacupuncture at "Yishu (EX-B 3)" group were evidently increased (P<0.05, P<0.01); ISI in the medication group was lower than that in the electroacupuncture at "Yishu" (EX-B 3) group (P<0.05). The content of CRH in the electroacupuncture at "Yishu" (EX-B 3) group was lower than that in the medication group and electroacupuncture at "Shenshu" (BL 23) group (P<0.05, P<0.01); the content of CORT in the electroacupuncture at "Yishu" (EX-B 3) group was lower than that in the medication group and electroacupuncture at "Pishu" (BL 20) group (both P<0.05).

CONCLUSIONElectroacupuncture at "Yishu" (EX-B 3) could reduce the level of CORT to improve the insulin resistance in rats with T2DM, improve insulin sensitivity index, regulate blood lipid metabolism and relieve the hyperactivity of the HPA axis.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; therapy ; Electroacupuncture ; Hormones ; metabolism ; Humans ; Hypothalamus ; metabolism ; Male ; Pituitary-Adrenal System ; metabolism ; Rats ; Rats, Wistar

Objective To observe the levels of serum leptin in Gaves disease(GD)and thyroiditis(HT)Datients and to discuss the immunological role of leptin in the pathogenesis of autoimmune thyroid disease(AITD).Methods 102 newly diagnosed female AITD patients were divided into 3 groups:GD hyperthyroid group,HT hypothyroid group and subclinical hypothyroid group.Age,sex and BMI-matched 27 euthyroid,healthy subjects served as controis.The levels of FT3,FT4 and sTSH were determined by immunofluorometrie assay.ELISA kit was aDplied to measure the levels of serum leptin.Results Serum FT3 and FT4[(19.74±15.39),(78.25±58.68)pmol/L]levels of GD hyperthyroid patients were obviously higher than those of the controls[(4.87±0.25),(15.96±3.15)pmol/L,P＜0.01],but serum sTSH and leptin levels[(0.15±0.08)mU/L,(8.73±1.92)μg/L]were obviously lower than those of the controls[(3.81±0.19)mU/L,(12.38±3.51)μg/L,P＜0.01or＜0.05].Serum FT3 and FT4[(3.36±0.26),(6.95±3.29)pmol/L]levels of HT hypothyroid patients were obviously lower than those of the controls(P＜0.05),but serum sTSH and leptin levels[(45.48±35.83)mU/L,(17.17±3.82)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Serum FT3 and FT4[(4.67±0.60),(14.87±2.14)pmol/L]levels of subclinical hypothyroid patients had not statistical difference comparing with those of the controls(P＞0.05),but serum sTSH and leptin levels[(13.67±8.66)mU/L,(16.25±3.67)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Conclusions Leptin might have an immuoregulation role in the pathogenesis of AITD.In addition,serum levels of leptin in AITD is also influenced by many other related hormones.

Objective To explore the effect of iodine on the pathogenesis of postpartum thymiditis.Methods Forty-four female C57BL/6J mice,8-week old,fed by low iodine dietary(the concentration of iodine≤35 μg/kg),were randomly divided into 4 groups:non-pregnancy experimental autoimmune thymiditis(non-pregnancy EAT)group with 8 mice,EAT of mice was induced by immunization with pig's thyroglobulin(Tg)in the presence of complete Freund's adjuvant.Six mice in non-pregnancy EAT group survived at the end of experiment;normal iodine-PPT(NI-PPT)group,10-fold high iodine-PPT(10HI-PPT)group and 50-fold high iodine-PPT(50HI-PPT)group with 12 mice in each group.The last 3 groups mice,who received the same immunization schedule as the above,were mated with adult male mice followed by induction of EAT.In the end,7,6 and 6 mice were noticed to be pregnant in each group.All animals were killed 4 weeks after postpartum.Histological severity of thyroid specimens was evaluated.The serum level of thyroglobulin antibody(Tg-Ab),thyroid pomxidase antibody(TPO-Ab),TT3 and TT4 were measured by radioimmunoassay(RIA).The expression level of IFN-γ/IL-4 mRNA in spleenwere assayed by RT-PCR.Results Pathological examination showed the infiltration of inflammatory cells.epithelial cell applanation,follicle atrophy or destruction.The severity of inflammation in non-pregnancy EAT bgroup.NI-PPT group and 10HI-PPT group was less serious than that in the 50HI-PPT group,the difference has bstatistical significance(P＜0.05).The level of TPO-Ab in non-pregnancy EAT group,NI-PPI-group,10HI-PPTgroup and 50HI-PPT group wag(14.32±8.85)%,(64.45±10.52)%,(38.46±5.57)%and(90.09±9.98)%.respectively the difference being statistically significant between any two groups(P＜0.05).There was no statisticaldifference(F＝0.484,P＞0.05)of Tg-Ab among non-pregnancy EAT group[(33.74±3.71)%],NI-PPT group [(29.65±2.06)%],10HI-PPT group[(37.21±3.87)%]and 50HI-PPT group[(33.87±4.17)%].There was no statistical difference(F＝1.596,P＞0.05)of TT3 among non-pregnancy EAT group (2.47±0.69)%,NI-PPT group(1.57±0.25)%,10HI-PPT group[(1.60±0.28)%]and 50HI-PPT group[(1.82±0.75)%].The level of TT4 in 50HI-PPT group[(66.68±5.47)%]was lower than that in non-pregnancy group,NI-PPT group and 10HI-PPTgroup[(99.87±5.97)%,(89.13±7.64)%and(91.05±5.82)%],the difference being statistically significant(P＜0.05).The expression level of IFN-γ mRNA was increasing,being 1.02±0.10,1.37±0.10,1.39±0.12 and 1.68±0.06 in non-pregnancy EAT group,NI-PPT group,10HI-PPT group and 50HI-PPT group.The difference had a statistical significance between any two groups except for NI-PPT group and 10HI-PPT group(P＜0.05).The expression level of IL-4 mRNA in 10HI-PPT group(0.49±0.04)and 50HI-PPT group(0.53±0.06)were all higher than non-pregnancy EAT group(0.24±0.05)and NI-PPT group(0.35±O.05),the differences being statistically significant (P＜0.05).Conclusions Adequate iodine supplementation during pregnancy and postpartum period is necessary,but iodine excess could induce postpartum thyroiditis.So iodine supplementation during pregnancy and postpartum should be adequate and reasonable.

Obecfive To study the clinical significance of detecting serum proeollagen type Ⅲ(PCⅢ) and hyaluronie acid(HA)in patients with autoimmune thyroid diseases(AITD).Methods According to the thyroid function,the 114 patients with AITD were divided into hyperthyroidism group(38),hypothyroidism group(35),and sub-hypothyroidism group(41).In addition,40 healthy persons were served as controls.The level of serum PCⅢ was determined with ELISA and that of serum HA with RIA.The level of FT3,FT4 and sTSH were detected by immumnofluorometric assay.Results Serum FT3(18.35±6.19)pmol/L]and FT4[(76.28±23.49)pmol/L]level of patients with hyperthyroidism were obviously higher than those of the controls[(4.75±0.31),(16.12±3.27) pmol/L],but serum sTSH[(0.15±0.07)mU/L]was obviously lower than that of the control[(3.78±0.15)mU/L],the differences were statically significant(P＜0.01).Serum FT3[(3.36±0.26)pmol/L]and FT4 [(6.37±2.19) pmol/L]level of patients with hypothyroidism were both lower than those of the controls(P＜0.05).but serum sTSH[(44.58±13.29)mU/L]was obviously higher than that of the control(P＜0.01).Serum FT3 [(4.86±0.45)pmol/L]and FT4[(15.26±2.78)pmol/L]level of patients with sub-hypothyroidism had no statistical difference compared with those of the controls(P＞0.05),but serum sTSH[(14.26±4.73)mU/L] was obviously higher than that of the controls(P＜0.01).The level of sernm PCⅢ[(4.63±1.22)μg/L]in pafients with hyperthyroidism was significantly higher than that of any other group(P＜0.05).There waB no statistical significant difference in PCⅢ among the patients with hypothyroidism,the patients with sub-hypothyroidism and controls [(3.64±1.12),(3.54±1.17)and(3.56±1.07)μg/L],respectively(P＞0.05).The level of serum HA [(31.13±10.28)μg/L]in patients with hypothyroidism was significantly higher than that of any other group(P＜0.05).There was no statistical significant difference in HA among the patients with hyperthyroidism,the patients with sub-hypothyroidism and controls[(22.24±7.22),(22.43±7.99)and(23.09±9.19)μg/L,respectively,P＞0.05].Conclusions It is very significant to understand myocardial fibrosis early through detecting sernm PCⅢ in patients with hyperthyroidism.Measurement of serum PCⅢ and HA will be useful to discovery hepatic fibrosisearly in patients with a long course of hyperthyroidism.

Objective To investigate the present status of Kaschin-Beck disease(KBD) in Qingzhou at present, and provide a scientific basis for decision-making in controlling the disease. Methods According to The National Technical Scheme for Endemic Disease Control in 2007, children aged 7 to 12 were chosen to receive clinical and X-ray examination in 3 villages of 2 towns in Qingzhou. Local adults aged 16 years and older were clinically diagnosed in 10 villages of 4 towns and divided into different groups according to the clinical degrees and their ages. The Diagnostic Criteria of Kashin Beck Disease(GB 16003-1995) was carded out by clinical and X-ray diagnosis. Results Two hundred and sixty school children aged 7 to 12 were clinically diagnosed, and the patients of I degree upwards of KBD were not detected. One hundred and ninety-eight school children aged 7 to 12 were examined by X-ray, and the detectable rate was 0(0/198). In 7099 adults aged 16 years old upwards clinically tested, 502 patients of degree I and higher of KBD were detected and the detectable rate was 7.07%(502/7099). The patients distributed mainly in the population aged 36 years old and older, accounting for 99.00% (497/502). Conclusions Although KBD in children have been controlled in Qingzhou, it is still serious in adults. So the monitoring of KBD should be carried on and prevention and control for KBD in adults should be strengthened.

OBJECTIVETo establish an enzyme-linked immunosorbent assay (ELISA) for determining anti-themocyte globulin (ATG) levels in serum samples.

METHODSThe microplate was coated with mouse anti-rabbit IgG monoclonal antibody, and sheep anti-rabbit polyclonal antibody conjugated with HRP was used as the second antibody for detecting the serum ATG levels in patients undergoing allogeneic hematopoietic stem cell transplantation.

RESULTSThe optimal concentration of the coating antibody and dilution ratios of the serum samples and IgG-HRP conjugate were 0.2 microg/ml, 1:40 and 1:2500, respectively. The lower sensitivity limit of the assay was 31.25 ng/ml for ATG detection. A linear relationship was established within the concentration range from 40 to 1000 ng/ml, with the coefficients of variation of 7.91 within assay and 5.22 between assays, respectively. Seven patients undergoing stem cell transplantation with ATG pretreatment showed gradually decreased concentration of ATG, and after 90 days ATG could still be detected.

CONCLUSIONThe sandwich ELISA we established provides a specific and sensitive method for quantitative measurement of ATG in the clinical setting. In patients undergoing stem cell transplantation with ATG pretreatment, the ATG concentration gradually decreases but remains detectable 90 days after the administration.

Adolescent ; Adult ; Antilymphocyte Serum ; blood ; therapeutic use ; Child ; Enzyme-Linked Immunosorbent Assay ; methods ; Female ; Humans ; Leukemia ; blood ; therapy ; Male ; Sensitivity and Specificity ; Stem Cell Transplantation ; Young Adult

ObjectiveTo investigate the current status of Kaschin-Beck disease in Shandong province, and to provide a scientific basis for decision-making in controlling the disease. Methods According to the National Monitoring Program of Kaschin-Beck disease requirements, historical serious villages of Kaschin-Beck disease in Qingzhou of Shandong province were selected annually; children aged 7 to 16 were chosen to receive clinical examination and children aged 7 to 12 were taken X-ray examination. Clinical and X-ray diagnosis was carried out according to the Diagnostic Criteria of Kashin Beck Disease(GB 16003-1995). Results From 1996 to 2010, in 53 diseased villages, three thousand three hundred and eighteen school children aged 7 to 16 were clinically diagnosed, and child Kaschin-Beck disease of degree Ⅰ and above were not detected; three thousand and ninety-one school children aged 7 to 12 were examined by X-ray, forty cases were found positive, and the total positive rate was 1.29％(40/3091 ). The year with the highest positive rate was 2002, and the rate was 3.49％(13/372) ; the positive rate was 0 in 1996 and 2008. The difference of the X-ray positive rate between each year was statistically significant(x2 =31.54, P ＜ 0.01 ). ConclusionsChild Kashin-Beck disease in Qingzhou is basically under control.Since etiology of Kashin-Beck disease is still unclear, surveillance of the disease still needs to be strengthened.

Objective To investigate the value of the serum heart fatty acid binding protein (H-FABP) in the assessment of cardiac function in patients with rheumatic heart disease (RHD).Methods Forty-five RHD patients hospitalized in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to December 2016 were selected as the observation group.In addition,45 subjects with normal cardiac function in the same period were selected as control group.The levels of serum H-FABP,B-type natriuretic peptide(BNP),left ventricular end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD) and left ventricular ejection fraction(LVEF) were compared in the groups.The correlation between serum H-FABP and BNP,cardiac function classification was analyzed.Results The serum H-FABP and BNP levels and LVEDD,LVESD in the observation group were significantly higher than those in the control group(P ＜ 0.05),but the LVEF in the observation group was significantly lower than that in the control group(P ＜ 0.05).There were significant differences in the serum H-FABP,BNP levels and LVEDD,LVESD,LVEF among the patients with class Ⅱ,Ⅲ and Ⅳ of heart function (P ＜0.05).The serum H-FABP,BNP levels and LVEDD,LVESD in the patients with class Ⅲ and Ⅳ of heart function were significantly higher than those in the patients with class Ⅱ of heart function(P ＜ 0.05);but the LVEF in the patients with class Ⅲand Ⅳ of heart function was significantly lower than that in the patients with class Ⅱ of heart function(P ＜0.05).Compared with the patients with class Ⅲ of heart function,the serum H-FABP,BNP levels and LVEDD,LVESD in the patients with class Ⅳ of heart function were significantly higher(P ＜ 0.05);but the LVEF in the patients with class Ⅳ of heart function was significantly lower(P ＜ 0.05).The serum H-FABP level was positively correlated with serum BNP level,LVEDD and LVESD in the observation group (r =0.579,0.743,0.740;P ＜ 0.05).but it was negatively correlated with LVEF (r =-0.801,P ＜0.05).Conclusion The serum H-FABP level increases with the aggravation of heart failure in patients with RHD.It can be used as an important index to evaluate the heart function and prognosis of RHD patients.

Objective To analyze the therapeutic effect and prognosis according to a new CT classification of traumatic posterior occipital epidural hematomas (POEH). Methods We classified the CT presentation of 104 patients with POEH by sinus transverses: type Ⅰ hematomas were defined as up-sinus transverses; type Ⅱ hematomas were defined as sub-sinus transverses and type Ⅲ hematomas were defined as straddling sinus transverses. The above types were divided into unilateral or bilateral subtypes. Bone flap craniotomy through a median posterior approach was performed in patients with unilateral hematoma adjacent to the midline. Bone flap craniotomy through a median suboccipital approach was adopted for patients with bilateral middle occipital hematoma. Results Type Ⅰ enjoyed mild symptoms, good curative effect and low mortality rate (7%). Type Ⅱ and Ⅲ had serious symptoms and high mortality rate (13.3%, 16.6%, respectively). Conclusion The classification of the CT presentation of POEH is helpful in confirming the diagnosis, drawing up the scheme of treatment and judging the prognosis.