BACKGROUND: Avascular necrosis of the femoral head occurs in the hip joints at high load-bearing areas, it is a special form of aseptic bone necrosis. Bone marrow-derived mesenchymal stem cells may have an excellent repair effect for the necrosis of femoral head. OBJECTIVE: To understand bone marrow mesenchymal stem cell transplantation for treatment of early avascular necrosis of the femoral head, and to lay a foundation for further study. METHODS: Taking avascular necrosis of femur head, femur head necrosis, osteonecrosis, bone marrow mesenchymal stem cells, mesenchymal stem cells, multipotent stem cells in English as search terms, Pubmed database from January 2000 to April 2009 was retrieved; Taking avascular necrosis and bone marrow mesenchymal stem cells in Chinese as search terms, CNKI database from January 1989 to April 2009 was searched, Literatures were limited to English and Chinese languages. Inclusive criteria: Study of the biological characteristics and functions of bone marrow mesenchymal stem cells, the etiology and pathology of avascular necrosis of femoral head, bone marrow mesenchymal stem cell transplantation for treatment of avascular necrosis; Exclusive criteria: duplication of documents. RESULTS AND CONCLUSION: More than 800 literatures were screened out by computer search, according to inclusive and exclusive criteria, 38 documents of which were involved for analysis. Marrow mesenchymal stem cells can differentiate into chondrocytes, osteocytes and dipocytes under suitable cultural condition. With the development of stem cell engineering, marrow mesenchymal stem cell transplantation becomes an effective method for repairing osteonecrosis. This article describes the cause and the pathology of avascular necrosis of the femoral head, analyzes the theory basis for the treatment of avascular necrosis of the femoral head with marrow mesenchymal stem cell, and verifies its effect through comparing both animal and clinical experiments of this aspect at home and abroad, with the hope of seeking a better treatment.

Objective To observe the changes and significance of blood fat and myocardial enzymes in patients with hypothyroid myopathy before and after substitutional treatment.Methods The levels of TC, TG, LDL-C,AST, LDH, HBDH and CKMB were detected in 72 cases with hypothyroid myopathy patients before and after substitutional treatment and 60 healthy controls. Results The levels of TC,TG and LDL-C in hypothyroid myopathy patients before substitutional treatment were significantly higher than those in control group ( all P ＜ 0. 05 ), and then significantly low after treatment,which had no significant difference with control group( all P ＞0. 05). The levels of AST,LDH,HBDH and CKMB in hypothyroid myopathy patients before substitutional treatment were significantly higher than those in control group( all P ＜ 0. 05 ) ,and then significantly low after treatment,which had no significant difference with control group( all P ＞0. 05). Conclusion The levels of blood fat and myocardial enzymes were significantly increased in hypothyroid myopathy patients, and recovery to normal after substitutional treatment.

A multiplex real-time PCR was developed to detect ctxA of Vibrio cholerae, gyrB and tdh of Vibrio parahaemolyticus simultaneously. The multiplex real-time PCR were evalidated by detection for the three genes in 47 toxigenic V. cholerae O1 and O139 strains (ctxA+; O1=3, O139=44), 25 non-toxigenic V. cholerae strains (ctxA-; O1=12, O139=6, non-O1 and non-O139=7), 116 V. parahaemolyticus strains with or without tdh (73 or 43) and 9 other bacteria strains. The specificity and sensitivity of the multiplex real-time PCR in detection for the ctxA and the tdh genes in the strains tested were both 100.0%, compared to the results by routine PCRs. In the detection for V. parahaemolyticus specific gyrB using the multiplex real-time PCR, all of 116 V. parahaemolyticus strains were positive, and 9 other strains and 72 V. cholerae strains were all negative. The multiplex real-time PCR is a sensitive, specific and quick assay not only for detecting virulence genes of V. cholerae and V. parahaemolyticus but also for identifying V. parahaemolyticus at species level. In addition, two real-time PCRs for detection of V. parahaemolyticus virulence genes trh1 and trh2 were also developed.

BACKGROUND:Studies have shown that anterolateral approach for repairing the hip joint capsule has great effects on dislocation after hip replacement, but it remains unclear at present. OBJECTIVE: To study the impact of anterolateral approach for repairing the hip joint capsule on dislocation after artificial hip joint replacement. METHODS: 480 patients, who received artificial hip joint replacement in the First People’s Hospital of Qinzhou from January 2010 to January 2014, were enroled in this study. They were divided into the control group (January 2010 to January 2012) and the observation group (February 2012 to January 2014) according to the order of their admission, each of 240 cases. The control group was subdivided into the total hip replacement group (A1 group) and the femoral head replacement group (A2 group), each of 120 cases; and the observation group was also subdivided into the total hip replacement group (B1group) and the femoral head replacement group (B2 group), each of 120 cases. A1group and A2 group were subjected to artificial hip joint replacementvia anterolateral approach. B1 group and B2 group were subjected to artificial hip joint replacementvia anterolateral approach and the repair of the joint capsule. The postoperative early dislocation rate was analyzed in patients of A1 group and B1 group. Postoperative early dislocation rate was analyzed in patients of A2 group and B2 group. RESULTS AND CONCLUSION: The rate of early postoperative dislocation was 6.7% in A1 group, and 0.8% in the B1 group. The rate of early postoperative dislocation was significantly higher in the A1group than in the B1 group (P < 0.05). The rate of early postoperative dislocation was 3.3% in the A2 group and 0.8% in the B2 group. No significant difference was found between the A2 and B2 groups (P > 0.05). Results showed that anterolateral approach in repairing the hip joint capsule can effectively reduce the incidence of postoperative dislocation after the total hip replacement, but does not obviously impact postoperative dislocation.

Objective To investigate the indications and clinical efficacy of combined application of laparoscope,choledochoscope and duodenoscope in the treatment of extrahepatic cholangiolithiasis.Methods The retrospective cohort study was adopted.The chnical data of 2 364 patients with extrahepatic cholangiolithiasis who were admitted to the First Hospital of Jilin University from January 2008 to December 2015 were collected.Of the 2 364 patients,861 patients had cholecystolithiasis combined with extrahepatic cholangiolithiasis and the diameter of common bile duct ≥ 8 mm,720 patients had cholecystolithiasis combine with extrahepatic cholangiolithiasis and the diameter of common bile duct ＜ 8 mm,783 patients had only extarhepatic cholangiolithiasis.In the patients diagnosed as cholecystolithiasis combined with extrahepatic changiolithiasis,laparoscopic cholecystectomy (LC) + laparoscopic common bile duct exploration (LCBDE) were applied to patients with the diameter of common bile duct≥8 mm,and the T-tube placement or primary suture was used intraoperatively according to the status of individualized patients;endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation (EPBD) + LC were applied to patients with the diameter of common bile duct ＜ 8 mm.For patients with only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy,EST or EPBD was applied,and LCBDE was applied to patients with multiple stones and maximum diameter ＞ 2 cm and unsuitable for EST or EPBD.If residual stones were found after operation in patients with T-tube placement,choledochoscope was used to extract stone;otherwise,EST or EPBD was used.Treatment outcomes including treatment method,success rate of minimally invasive lithotomy,operation time,incidence of complication,duration of postoperative hospital stay and treatment expenses,and the results of follow-up including 1-,3-year recurrence rate of stones were recorded.The follow-up was done by outpatient examination and telephone interview till January 2016.All the patients were reexamined blood routine,liver function and color doppler ultrasonography of the abdomen at 1 month,3 months,6 months,1 year and 3 years after operation.Suspected residual cholangiolithiasis found by ultrasound was varified by computer tomography (CT) or magnetic resonanced cholangiopancreatography (MRCP) imaging examination.For patients with T-tube placement,CT scan and biliary photography were performed at 2-3 months postoperatively to determine whether residual stones existed and T tube could be pulled out.Measurement data were presented as mean (range).Results Of 2 364 patients,2 271 patients received minimally invasive lithotomy successfully.Of 861 patients of cholecystolithiasis combined with extrahepatic cholangiolithiasis and the diameter of common bile duct≥8 mm,836 succeeded in minimally invasive lithotomy,with a success rate of 97.10％ (836/861),the other 25 patients were converted to open surgery.Seven hundred and three patients of 836 patients received T-tube placement in LCBDE,and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 97 minutes (range,41-167 minutes),3.70％ (26/703),6.7 days (range,3.0-32.0 days) and 3.4 × 104 yuan (range,1.5 × 104-6.7 × 104 yuan),respectively.One hundred and thirtythree patients of 836 patients received primary suture,and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 89 minutes (range,39-123 minutes),3.01％ (4/133),4.1 days (range,2.0-17.0 days),2.1 × 104 yuan (range,1.6 × 104-3.4 × 104 yuan),respectively.Of 720 patients with the diameter of common bile duct ＜ 8 mm who underwent EST or EPBD + LC,687 succeeded in minimally invasive lithotomy,with a success rate of 95.42％ (687/720),the other 33 patients were converted to open surgery.The mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses of 687 patients were 101 minutes (range,69-163 minutes),2.91％ (20/687),5.6 days (range,2.0-15.0 days) and 2.8 × 104 yuan (range,2.0 × 104-6.4 × 104 yuan),respectively.In 783 patients with only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy,701 of 725 patients who were treated with EST or EPBD succeeded in minimally invasive lithotomy,with a success rate of 96.69％ (701/ 725),and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses of 701 patients were 47 minutes (range,11-79 minutes),2.28％ (16/701),3.7 days (range,2.0-19.0 days),1.7 × 104 yuan (range,1.3 × 104-5.5 × 104 yuan),respectively;47 of 58 patients who were treated with LCBDE succeeded in lithotomy,with a success rate of 81.03％ (47/58),and the mean operation time,incidence of complications,duration of postoperative hospital stay and treatment expenses were 124 minutes (range,94-170 minutes),8.51％ (4/47),7.9 days (range,5.0-21.0 days) and 3.8 × 104 yuan (range,2.3 × 104-7.9 × 104 yuan),respectively.Of 2 364 patients,2 207 were followed up for a mean time of 38 months (range,1-72 months).The 1-,3-year recurrence rates were 2.74％ (19/693) and 5.08％ (24/472) in patients receiving LC + LCBDE,3.10％ (21/677) and 5.69％ (30/527)in patients receiving EST or EPBD +LC for cholecystolithiasis combined with extrahepatic cholangiolithiasis.The 1-,3-year recurrence rates were 3.22％ (20/621) and 6.11％ (25/409) in patients receiving EST or EPBD + LC,7.32％ (3/41) and 11.11％(2/18) in patients receiving LCBDE for only extrahepatic cholangiolithiasis or recurrent stones after cholecystectomy.Conclusions It is safe and effective to treat extrahepatic cholangiolithiasis based on combined application of laparoscope,choledochoscope and duodenoscope,with choosing appropriate indications as the key to improve the therapeutic effect.Primary suture in the LCBDE is recommended because it can protect patients from T-tube placement.

Objective To observe the therapeutic effect of anti-inflammatory combined with cedilanid and diuretic therapy for treatment of patients with senile pneumonia and lung cancer accompanied by pleural effusion and to investigate the changes of concentrations in plasma levels of B-type natriuretic peptide(BNP)and C-reactive protein(CRP),procalcitonin(PCT)before and after treatment. Methods From July 2012 to January 2013, a prospective study was carried out to investigate 57 emergently hospitalized patients with pleural effusion,and according to the etiology,they were divided into two groups:a senile pneumonia group(30 cases)and a lung cancer group(27 cases). The same therapeutic measures were taken in the two groups,such as anti-infection,enhancement of cardiac function,diuresis,and limitation of the amount of liquid intake. Respectively,all the patients took the CT scan of the chest before treatment and on the 7th day after treatment,and at the same time,plasma concentrations of BNP,CRP and PCT were detected. Results ①According to the gradation of the New York Heart Association (NYHA),before treatment most of the cardiac function of patients in pneumonia group was at the Ⅲ grade,while that in the lung cancer group was at theⅠgrade,and the incidence of congestive heart failure(CHF)in pneumonia group was significantly higher than that in lung cancer group(86.7% vs. 14.8%,P<0.01). Before treatment,the plasma BNP level in pneumonia group was obviously higher than that in lung cancer group(ng/L:582.67±126.53 vs. 146.27±43.77,P<0.01);compared with that before treatment,BNP was significantly decreased in the pneumonia group(ng/L:225.59±131.33,P<0.05)after treatment,but no such obvious change in the lung cancer group(ng/L:149.34±51.05)was seen. The therapeutic effect of pleural effusion in the pneumonia group was markedly better than that in lung cancer group〔cure:70.0%(21 cases)vs. 0(0),P<0.01〕. ②Before treatment,the plasma levels of CRP and PCT in pneumonia group were remarkably lower than those in lung cancer group(both P<0.05);after treatment,CRP and PCT levels were decreased or decreased to close to the normal physiological range in patients of the two groups,but the comparisons between the two groups there were no statistically significant differences〔CRP(mg/L):20.21±16.32 vs. 22.76±18.53,PCT(ng/L):0.46±0.13 vs. 0.55±0.17,both P>0.05〕. Anti-inflammatory effect in pneumonia group was much superior to that in lung cancer group〔basically cured:86.7%(26 cases)vs. 0(0),P<0.05〕. In pneumonia group,the decrease of the above two indexes after treatment was consistent with the pneumonia shadow dissipation,while in the lung cancer group,no such consistency was found,apparently,the latter phenomenon was associated with the tumor invasive occupation. Conclusion To detect the concentration changes of plasma BNP, CRP and PCT has important clinical significance in screening the cardiac insufficiency and evaluating the curative effect of anti-inflammatory combined with cedilanid and diuretic therapy in patients of lung diseases complicated by pleural effusion.

Objective To compare the effect of naive porto-azygous devascularization and that as a remedy therapy after a failed endoscopy for the treatment of bleeding portal hypertension.Method From June 2005 to June 2010,230 portal hypertension patients were treated with porto-azygous devascularization,among them,202 cases were of portal hypertensive cirrhotics,28 cases of alcoholic cirrhosis.Group A (16 patients)received remedial porto-azygous devascularization after endoscopic treatment failed (esophageal variceal ligation,esophageal variceal selerotherapy).Group B(214 patients)received naive porto-azygous devascularization.Results The average operation time in group A was 198 min(115-335)min,mean bleeding amount was 750 ml(300-2000)ml,average post-operative hospital stay was 11 days (8-15)days.The average operation time in group B was 120 min(90-190)min,mean blood loss was 250 ml(150-500)ml,average post-operative hospital stay was 7 days(6-9)days.The average operation time,bleeding amount and post-operative hospital stay was significantly different between the two groups (P＜ 0.05).212(92.2％)patients were followed up,and the mean follow-up time was 2.5 years (1-6)years,mortality rate was 4.2％,rebleeding rate was 5.7％.Conclusions Surrounding the perioesophageal and gastric tissues were fibrotic and hard after the endoscopic treatment,this significantly increased the difficulty of surgery,therefore,porto-azygous devascularization is the choice of therapy for portal hypertension patients.

Objective To investigate the point prevalence rate of social anxiety disorder (SAD) in Chengdu primary school, and analyze the influencing factors. Methods Data came from a large representative sample of Chengdu 1441 primary school students, who were selected by stratified cluster sampling methods. They then finished self-compiled questionnaire, strengths and difficulties questionnaire, Eysenck Personality Inventory (EPI) (age 7 ～ 15 ), Egma Minnen ay Bardndosnauppforstran (EMBU) respectively. And then they had the face to face interviews with the trained psychiatrists, according to development and well - being assessment ( DAWBA,Chinese Version). Results Among 1441 Chengdu primary students, 37 of them were diagnosed SAD,with a point prevalence of 2.6% totally. The point prevalence was different in each grades, for 2.7% in grade 3,4. 1% in grade 4,4.1% in grade 5,3.5% in grade 6( z= -2.3, P=0. 023 ). Compared with the normal counterparts ,the SAD students had statistically significance different in pro-socialization ( z = -2. 1, P = 0.035 ), affection(z=- 5.2, P = 0. 001 ) , moral conduct ( z = - 2.8, P = 0. 004 ), peer( z = - 3.1, P = 0.002 ), excessive interference of maternal education ( z = - 3.1, P = 0.002 ), introversion-extroversion ( z = - 2. 0, P = 0. 046 ), neuroticism ( z =- 3.5, P= 0. 000), concealing tendency ( z= - 2.3, P= 0.018 ). Logistic regression analysis showed that: grade,family location, habitual lifestyle over the past years more emotional problem and excessive interference of maternal education were related with SAD occurrence. Conclusion The point prevalence rate of social anxiety disorder among Chengdu primary students is 2.6% ,and it was influenced by a number of factors .

This study aims to explore the improvement and the mechanism of the Alisma plantago-aquatica Linn. (ApL) on chronic glomerulonephritis (CGN). All animal experiments were followed the regulation of the Experimental Animal Ethical Committee of Shanghai University of Traditional Chinese Medicine. CGN mouse model was established by a single tail-vein injection of doxorubicin (Dox) (20 mg·kg^-1). One week after Dox administration, the mice received water extract of ApL (85 and 255 mg·kg^-1) by gavage once a day for 14 days. At the end of experiment, the urine albumin-to-creatinine ratio (ACR), serum albumin (ALB), blood urea nitrogen (BUN) and serum creatinine (SCr) were detected, kidney histopathological H&E staining was analyzed. Active ingredients and action targets of ApL were collected from TCMSP database, and CGN-related targets were obtained from Genecards database. STRING platform was employed to perform protein-protein interaction (PPI), and Metascape platform was used for KEGG pathway and GO enrichment analysis. The results of experiments demonstrated that ApL (85 and 255 mg·kg^-1) could reduce the ACR and the content of SCr and BUN, and increase the content of ALB in mice. Network pharmacology results predicted that nuclear factor kappa-B (NF-κB)-related pathway and biological process of oxidoreductase activity regulation may be involved in the ApL-provided amelioration on CGN. The verification results showed that ApL could inhibit the activation of NF-κB and the expression of inflammatory factors in mice, and reduce the activity of renal myeloperoxidase (MPO). Meanwhile, ApL promoted the activation of nuclear factor erythroid 2-related factor 2 (Nrf2) and increased the expression of its downstream gene mRNA, and reduced the level of renal malondialdehyde (MDA) and reactive oxygen species (ROS), and further elevated renal glutathione (GSH) level. Based on network pharmacology combined experiments, this study found that ApL may improve CGN in mice through multiple targets and multiple pathways, in which the inhibition of NF-κB signaling and the activation of Nrf2 signaling may be important mechanisms involved.

0.05).Conclusion CYPIA1 MspⅠ polymorphism is not related to the susceptibility to colorectal carcinoma.