Objective To observe the protective effect to Ulinastatin combined with Xingnaojing Injection (XI) for acute cerebral hemorrhage. Methods One hundred and eight cases of acute cerebral hemorrhage were randomly divided into treatment group ( N=56) and control group ( N=52) . All of the patients were given conventional western medical treatment including relieving cerebral edema, regulating blood pressure, maintaining electrolyte balance, anti-inflammation, preventing epilepsy. Additionally, the control group was given intravenous drip of Ulinstatin, and the treatment group was given intravenous drip of Ulinstatin and XI. The clearance of intracranial hematoma in the two groups was observed on treatment day 3, 7, 14, the absorption of cerebral edema was observed after treatment for one treatment course of 14 days, neurological deficit scores ( NDS) were compared on treatment day 14, 30, and the clinical efficacy was evaluated. Results ( 1) After treatment, hematoma area was reduced in the two groups ( P<0.05 compared with that before treatment); on treatment day 3, the difference of hematoma area was insignificant between the two groups (P>0.05); on treatment day 7 and 14, hematoma area in the treatment group was less than that of the control group, the difference being significant (P<0.05) . (2) On treatment day 14, the total effective rate for absorption of cerebral edema was 89.3% in the treatment group, and was 65.4% in the control group, the difference being significnat ( P<0.05) . ( 3) After treatment, NDS of the treatment group was less than that of the control group, and the total effective rate on NDS was 89.3% in the treatment, higher than 71.2% in the control group, the difference being significant ( P<0.05) . ( 4) In the treatment group, 3 cases had slight increase of aminotransferase. Eight cases of the control group had increased aminotransferase, and then the aminotransferase level recovered to normal after suspension. In the treatment group, 2 cases were dropped out for receiving emergency operation due to rehaemorrhagia during the treatment, and 3 cases were death for illness deterioration. In the control group, 7 cases gave up the treatment for illness deterioration and then were dead during the follow-up. Conclusion Ulinastatin combined with XI shows certain protective effect in treating acute cerebral hemorrhage.

Objective To set up an experiment model on cellular level in order to investigate the effects of aconitine on Connexin43(Cx43)in cardiomyocytes of rat.Methods The cultured cardiomyocytes of rat were incubated with aconitine at 6 different concentrations of 0.25,0.5,0.75,1.0,1.5 and 2.0 ?mol/L.The changes of Cx43 phosphorylation status of each group were investigated by Western blot analysis and immunofluorescent microscopy techniques.Results The total amount of Cx43 had not changed in cardiomyocytes after aconitine incubation by western blot analysis,but it began to induce Cx43 dephosphorylation after incubation of the cultures with 0.5 ?mol/L aconitine and Cx43 underwent significant dephosphorylation when the concentration of aconitine elevated to 1.0 ?mol/L,and the dephosphorylation effects of 1.5 and 2.0 ?mol/L aconitine on Cx43 were similar to that of 1.0 ?mol/L aconitine.Quantitative immunofluorescent microscopy revealed that Ser368,one of the serine amino acid phosphorylation sites in the C-terminal domain of Cx43,underwent significant dephosphorylation when incubation of the cardiomyocytes with 1.0 ?mol/L aconitine.Conclusion Under certain concentration conditions,aconitine can induce significant dephosphorylation of Cx43 in the cardiomyocytes of rat.

Objective:To study the correction factor of the chamber wall of the reference air kerma rate reference ionization chamber (NIM-Ir-SG-100 type) for 192Ir radioactive source. Methods:The photon spectrum and ionization chamber wall correction factor of the radioactive source housing and irradiator model are calculated by Monte Carlo code. And then the photon energy, wall thickness and ionization chamber diameter, which affect the result of the chamber wall correction factor, are simulated.Results:After calculation, the simulation result of the correction factor of spherical graphite cavity ionization chamber wall was 1.037 7. Controlling a single variable, photon energy (0.3-1.3 MeV), wall thickness (0.2-0.5 cm), inner diameter (0.5 -15 cm), the maximum deviations of wall correction result were 1.62%, 3.30% and 2.86%, respectively.Conclusions:The self-made spherical graphite cavity ionization chamber has good performance, and the corrected kwall value of the chamber wall is within a reasonable range. The completion of the chamber wall correction factor is an important step to measure the reference air kerma rate of the 192Ir radioactive source and establish the measurement benchmark.

Objective To analyze the clinical effects of arthroscopic en masse repair with footprint ending shift using double-row suture-bridge technique for delaminated rotator cuff tears under tension.Methods A total of 58 patients with delaminated rotator cuff tears under tension from August 2013 to August 2016 who underwent arthroscopic en masse repair using doublerow suture-bridge technique were retrospectively analyzed.There were 33 males and 25 females with a mean age of 53.0±7.8 years (range 39-74) with 24 patients left side involved and 34 right side.They were divided into 2 groups to receive en masse repair either footprint ending shift or on the footprint.There were 28 patients with footprint ending shift and 30 patients on the footprint.Clinical effects were evaluated by University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant-Murley score and shoulder range of motion at preoperatively and postoperatively.Results The average follow-up duration was 23.2±0.8 months (range 21-24).The two groups were compatible with no significant difference in age,gender,tear size,follow-up duration,preoperative function and range of motion of the shoulder joint (P＞0.05).At the last follow up,the UCLA,ASES,VAS,Constant-Murley scores and shoulder range of motion in the group footprint ending shift were respectively 32.4±2.5,12.8±0.9,1.0±1.1,93.4±5.6,158.3°±9.3°,58.9°±5.0° with significantly differences compared with preoperative scores (P ＜ 0.05).The postoperative value in the group on footprint were respectively 31.6±2.9,12.8±0.9,0.7 ± 1.2,91.3±7.1,156.1°± 10.7°,59.6°±4.6° with significantly differences compared with the preoperative scores (P ＜ 0.05).There were no significant difference between the two groups (P ＞ 0.05).The operation duration in the group footprint ending shift was 100.9±6.0 min,while that in the group on footprint was 106.6±6.1 min.There was significantly difference in the operation duration between two groups (t=-3.600,P=0.001).Conclusion Arthroscopic en masse repair using double-row suture-bridge technique can successfully treat delaminated rotator cuff tears under tension.Compared with arthroscopic en masse repair on footprint using double-row suture-bridge technique,the footprint ending shift is easier and time saving without significant difference in function of the shoulder joint and the range of motion in repair of delaminated rotator cuff tear under tension.

Objective To investigate the association between serum 25(OH)D3 and high sensitive C -reac-tive protein (hs-CRP),tumor necrosis factor -alpha (TNF-α),interleukin-6 (IL-6) inflammatory markers in non-obese patients with type 2 diabetes mellitus (T2DM).Methods From June 2015 to September 2015,in this cross-sectional study,120 non-obese patients with T2DM(female in 58 cases,male in 62 cases) in Taiyuan Central Hospital were selected as T2DM group,and 120 non-obese patients with T2DM and 96 healthy subjects ( control group) were recruited.The serum concentrations of glucose,HbA1c,insulin,25( OH) D3 and inflammatory markers including TNF-α,IL-6 and hs-CRP were measured.A homeostatic model of insulin resistance (HOMA-IR) was also evaluated.The clinical and biochemical characteristics of T 2DM were observed in the group of vitamin D deficien-cy group,vitamin D insufficiency group and vitamin D normal group.And the relativities were analyzed between it with hs-CRP,TNF-α,IL-6,HOMA-IR,INF,FBG,BMI,WHR,and so on.The relativities were observed between 25(OH)D3 with all the factors.Results The mean serum concentration of 25(OH)D3 in the non -obese T2DM group was (10.65 ±3.55)ng/mL,which was significantly lower than (18.44 ±5.21)ng/mL in the normal control group (t＝-6.84,P ＝0.012).The levels of serum TNF -αand IL -6 in the T2DM group were (15.51 ± 4.87)ng/L and (18.12 ±4.13) ng/L,respectively,which were significantly higher than those in the control group [(8.99 ±2.54)ng/L,(8.89 ±2.07)ng/L](t＝7.95,10.04,P＝0.017,0.007).The proportions of deficiency,insufficiency and normal of vitamin D in T2DM patients were 60.83%,31.67%and 7.50%,respectively .The levels of TNF-αand IL-6 in the serum 25(OH) D3 deficiency group were significantly higher than those in the normal 25(OH)D3 group [(17.93 ±4.94)ng/L vs.(10.30 ±4.52)ng/L,F＝6.897,P＝0.026;(20.14 ±4.99)ng/L vs. (16.39 ±5.06)ng/L,F＝10.589,P＝0.017].There was a significant correlation between serum 25(OH)D3 and HOMA-IR(r＝-0.041;P＝0.030),TNF-α(r＝-0.229;P＝0.040) and IL -6 levels (r＝-0.299;P＝0.032),but there was no significant correlation with inflammatory factor hs -CRP and fasting blood glucose. Conclusion Vitamin D deficiency is common in patients with T2DM,and systemic chronic inflammation may also play an important role in the pathogenesis of T 2DM.This study shows that vitamin D may play an important role in the pathogenesis of insulin resistance and chronic systemic inflammatory response,an important pathogenesis of T2DM.

This study was performed to investigate the impact of nobiletin(NOB)on fracture healing in osteoporosis(OP)rats through the stimulator of interferon gene(STING)/nuclear transcription factor kappa B(NF-κB)signal pathway.A rat model of OP fracture was established by ovariectomy and right femoral shaft fracture intramedullary fixation;the rats after modeling were randomly grouped into model group,high dose(NOB-H,30 mg/kg NOB),medium dose(NOB-M,20 mg/kg NOB),low dose(NOB-L,10 mg/kg NOB)NOB group and NOB-H+ STING activator(DMXAA)group(30 mg/kg NOB+25 mg/kg DMXAA),and 18 rats experienced only ovaries expose were used as sham operation group.After the intervention,the fracture healing status of rats were measured;Micro-CT was used to detect the changes of bone trabecular microstructure in rats;commercial kits were used to detect the serum levels of bone metabolism related indicators(alkaline phosphatase(ALP),calcium,phosphorus)and inflammatory factors(tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β));HE was used to detect the morphological changes and trabecular area of femur,while Western blot was applied to detect the expression of STING/NF-κB pathway related proteins.Compared with the control group,the fracture line in the model group was clear,the trabecular structure was disordered and the gap was large,furthermore,the levels of TNF-α and IL-1β,the expression of STING and p-NF-κB p65/NF-κB p65 were significantly increased,the trabecular area,the levels of ALP,calcium,phosphorus,and bone mineral density(BMD),bone volume fraction(BV/TV),bone trabecular number(Tb.N)and bone trabecular thickness(Tb.Th)were significantly decreased(P<0.05);compared with the model group,the fracture line of NOB-L group,NOB-M group and NOB-H group gradually blurred,the trabecular structure arranged orderly,and the gap gradually decreased,and the trend of the index changes mentioned above were opposite to that of the model group(P<0.05).STING activators attenuated the promotion of fracture healing by NOB in OP rats and increased the inflammatory responses.In conclusion,NOB can reduce inflammatory reaction and promote fracture healing in OP rats,which may be related to the inhibition of STING/NF-κB signal pathway.

Objective To evaluate the clinical efficacy of arthroscopic bursal layer-only double-row suture-bridge repair for delaminated rotator cuff tear which is difficult to reposit in comparison with separate double-layer repair and whole-layer repair.Methods From May 2013 through June 2016,82 patients with delaminated rotator cuff tear difficult to reposit were treated at Department of Joint Surgery,The Affiliate Hospital to Chengde Medical University.They were 47 males and 35 females with a mean age of 53.0 ± 7.9 years.They were divided into 3 groups according to their surgical procedures.In group A,28 cases were treated by arthroscopic whole-layer double-row suture-bridge procedure;in group B,29 cases were treated by arthroscopic separate double-layer double-row suture-bridge procedure;in group C,25 cases were treated by arthroscopic bursal layer-only double-row suture-bridge procedure.The 3 groups were compared in terms of University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant shoulder score,range of motion of shoulder joint and rotator cuff retear preoperatively and postoperatively.Results The patients in the 3 groups were comparable because their preoperative general data showed no significant significances (P ＞ 0.05).The operation time for groups A,B and C was respectively 105.5 ±5.6 min,117.4 ±6.9 min and 88.0 ±4.2 min,showing significant differences between the 3 groups (P ＜ 0.05).The 82 patients were followed up for 21 to 24 months (average,23.3 months).At 24 months postoperatively,UCLA,ASES,VAS,Constant score,shoulder anteflexion and lateral extorsion were respectively 32.4 ± 2.5,12.8 ± 0.9,1.0 ± 1.1,93.4 ± 5.6,158.3° ± 9.3°and 58.9°±5.0°in group A,32.2±2.5,12.9±1.0,0.9±1.0,92.8±6.0,156.4°±9.5°and 59.3°± 5.6° in groups B,and32.4±2.4,12.9±0.9,0.7±0.9,94.3±5.2,156.0°±9.5°and57.6°°5.4°in group C,showing no significant differences between the 3 groups (P ＞ 0.05).The occurrence of rotator cuff retear in groups A,B and C were respectively 17.9％ (5/28),13.8％ (4/29) and 12.0％ (3/25),showing no significant differences between the 3 groups (P ＞ 0.05).Conclusions In repair of delaminated rotator cuff tear difficult to reposit,although the arthroscopic bursal layer-only double-row suture-bridge repair is similar to conventional arthroscopic whole-layer double-row suture-bridge repair and arthroscopic separate double-layer double-row suture-bridge repair in functional recovery and range of motion of the shoulder and incidence of rotator cuff retear,it can reduce obviously operation time and make the operation easier.