Objective To compare and analyze the curative effects of mediopatellar plica syndrome under different therapies. Methods 147 patients with mediopatellar plica syndrome were enrolled in the study from January 2011 to January 2015 and divided into three groups refer to treatment: Group A, B and C. Each group was also divided in the youth group and the mid-age group. Different treatments were used in the three groups. Group A: drug therapy and physicotherapeutics; Group B: intraarticular injection regularly; Group C: arthroscopic surgical treatment. All patient conditions were assessed with Lysholm score. Results All patients received an average of 11 (9 ~ 13) months follow-up. No blood-vessel and nerve injured and infection occurred. Before receiving treatment, difference in Lysholm score of the three groups showed no statistical difference (F = 0.08, P = 0.926); after treatment, difference revealed significant difference (F = 15.48, P = 0.001). Compared with those before operation and after operation among the three groups, the Lysholm score was improved (tA = 3.43, tB = 6.74, tC = 7.99, P = 0.001). In the rangeability of Lysholm score, the Group C > B > A (F = 66.43, tAB = 5.97, tAC = 11.52, tBC = 5.55, P = 0.001);The general youth group > the general mid-age (t = 7.91, P = 0.001). Conclusion The best therapeutic method for mediopatellar plica syndrome is the arthroscopy. As for mid-age patients, it is necessary to inform them of possibility that prognosis is not well in preoperative planning.

Objective To investigate gender differences in the curative effects of allograft and autologous hamstring tendon in anterior cruciate ligament reconstruction. Methods One hundred and forty-eight patients with the anterior cruciate ligament injury received surgical treatment were enrolled from January 2011 to January 2015 and divided into two groups,including group M(Men)and group W(Women). Patients in each group were also divided in the allograft group (Group A) and the autologous hamstring tendon group (Group B). The patient condition was separately assessed with the Lysholm,Tegner,VAS score and the value of KT-1000 before and after surgery. Results All patients received an average of 16(13-18)-month follow-up visit. No severe complication , such as blood-vessel and nerve injury ,infection and rupture of graft ,occurred in patients after operations. Compared with those before operation,the Lysholm,Tegner,VAS score and the value of KT-1000 after operation in four groups were significantly improved (P < 0.05,respectively). However,no significant differences were found in the Lysholm,Tegner,VAS score and the value of KT-1000 improvement among group MA,MB,WA and WB post treatment(P>0.05). Conclusions The curative effect of ACL reconstruction between allograft ligament and autologous hamstring tendon has no significant difference in gender. The selection of graft should be considered in more aspects.

BACKGROUND:The use of mesenchymal stem cels in the field of tissue engineering for osteoarticular injury repair is a very promising tool since these cels are readily expandable and able to differentiate into chondrocytes. Abundant evidence suggests that microRNAs play critical roles in chondrogenic differentiation of mesenchymal stem cels.
OBJECTIVE:To observe the chondrogenic effect of human bone marrow mesenchymal stem cels transfected with lentiviral vectors bearing miR-221-3p/222-3p inhibition, thereby provding new strategies for cartilage injury.
METHODS: miRNA microarray technology was applied to detect microRNAs expression profiles at three different stages of chondrogenic differentiation induction after transforming growth factor-β3 treatment and verified by real-time fluorescence quantitative PCR (RT-qPCR). Human bone marrow mesenchymal stem cels were infected with lentivirus bearing miR-221-3p/222-3p inhibition. After co-suppressing the expression of miR-221/222-3p, cel counting kit-8 was used to determine the cel proliferation, the differentiation of bone marrow mesenchymal stem cels towards chondrocytes was verified by type II colagen protein expression through immunohistochemistry and glycosaminoglycan accumulation was also elevated by sarranine O staining. RT-PCR was used to detect type II colagen and aggrecan mRNA expression at 21 days of chondrogenic induction.
RESULTS AND CONCLUSION: The expression of miR-221-3p/222-3p was inhibited after Lv-miR221-3p/222-3p inhibition co-transfected into bone marrow mesenchymal stem cels. microRNA microarray and RT-qPCR results showed that the expression of miR-221-3p/222-3p was declined significantly at the anaphase of chondrogenic differentiation. The expression levels of chondrogenic markers, Aggrecan and type II colagen were significantly increased in the miR-221-3p/222-3p inhibition group and cel proliferation was also inhibited significantly compared with non-transduced cels or transduced with the empty lentiviral vector group. miR-221-3p/222-3p knockdown in bone marrow mesenchymal stem cels could inhibit proliferation but promote chondrogenic differentiation of bone marrow mesenchymal stem cels.

Objective To investigate the imaging characteristics of autoimmune pancreatitis (AIP).Methods MR imaging was performed in 12 patients with AIP proved histopathologically or clinically,of them CT was scanned in 10 patients and endoscopic retrograde cholangiopancreatography (ERCP)in 3.All imaging data were reviewed retrospectively.Results All 12 patients had enlargement of the pancreas either diffusely(n=9)or focally(n=3).The swollen pancreas was hypointense on T_1-weighted images and mildly hyperintense on T_2-weighted images.It also demonstrated decreased enhancement on artery phase of dynamic imaging and moderate enhancement on delayed phase images. Capsule-like enhanced rim was found around the swollen pancreas in 11 patients.Stricture of the distal common bile duct was found in 9 patients,and ERCP showed diffuse and irregular narrowing of the main pancreatic duct in 3 cases.At follow-up,pancreatic abnormalities and common bile duct stricture resolved after steroid therapy in 7 patients.Conclusion AIP showed some characteristic imaging findings,and imaging examinations will play an important role in the diagnosis of AIP.

Objective To compare the curative effect of fixation of adolescent tibial intercondylar emi-nence fracture among suture anchor,hollow screw and wire. Methods Forty-six adolescent cases of the tibial intercondylar eminence fracture treated with surgical treatment were selected from January 2010 to June 2016 and divided into three groups refer to intra-operative fixation suture anchor group(Group A),hollow screw group (Group B)and wire group(Group C).Duration of treatment,total operation time,hospital stay and surgery times were recorded. All patient condition was assessed with the Lysholm,Tegner,IKDC and VAS score. Results All patients received an average of 13(11~14)months follow-up visit. No blood-vessel,nerve and osteoepiphysis injured,infection and fracture displacement occurred.Before receiving treatment,difference in Lysholm,Tegner, IKDC and VAS score of group A,B and C showed no statistical difference.When it comes to hospitalization condi-tion,data were as follows.Group A/B/C:operation time(80.67 ± 16.68/114.00 ± 20.28/111.88 ± 20.07)min, hospital stay(8.40 ± 1.12/ 15.47 ± 1.25/ 15.19 ± 1.17)d,surgery times(1/2/2)times. Moreover,compared with those before operation and after operation in both of groups,the Lysholm,Tegner,IKDC and VAS score were improved(P < 0.05). Besides,the Lysholm,Tegner,IKDC and VAS score of group A,B and C did not have statistically significant difference yet after post treatment(P>0.05).Conclusions The curative effect of fixation of adolescent tibial intercondylar eminence fracture among suture anchor,hollow screw and wire was similar. By contrast,the fixation of fracture by use of suture anchor can decrease operation time and hospital stay to some extent. It had advantage of need not to have a second operation to remove the internal fixation and can be used in preference.

OBJECTIVETo observe the exposure levels of extremely low frequency electromagnetic fields in workplaces and to analyze the effects of extremely low frequency electromagnetic radiation on cardiovascular system of occupationally exposed people.

METHODIntensity of electromagnetic fields in two workplaces (control and exposure groups) was detected with EFA-300 frequency electromagnetic field strength tester, and intensity of the noise was detected with AWA5610D integral sound level. The information of health physical indicators of 188 controls and 642 occupationally exposed workers was collected. Data were analyzed by SPSS17.0 statistic software.

RESULTSThe intensity of electric fields and the magnetic fields in exposure groups was significantly higher than that in control group (P < 0.05), but there was no significant difference of noise between two workplaces (P > 0.05). The results of physical examination showed that the abnormal rates of HCY, ALT, AST, GGT, ECG in the exposure group were significantly higher than those in control group (P < 0.05). There were no differences of sex, age, height, weight between two groups (P > 0.05).

CONCLUSIONExposure to extremely low frequency electromagnetic radiation may have some effects on the cardiovascular system of workers.

Adult ; Cardiovascular System ; radiation effects ; Case-Control Studies ; Electromagnetic Fields ; adverse effects ; Electromagnetic Radiation ; Humans ; Male ; Occupational Exposure ; adverse effects ; Young Adult

Objective:To evaluate the impact and analyze the mechanism of separating drug sales from medical services reform on the total medical expenditure containment of outpatient services in Beijing. Methods:The monitoring data and historical data from 89 third-level,78 second-level public hospitals,and 206 primary health institutions and community health service agencies,which participated in the reform,were analysed to estimate the impacts on outpa-tient service utilization and service price. The analysis was based on the data of the first and second quarters of 2016 outpatient and emergency department fee changes,and analysis of service utilization and service price factors on the im-pact of changes in outpatient and emergency services mechanism. Results:The total outpatients'expenditure in Beijing in the second quarter of 2017 was 17.38 billion yuan,representing a slight decrease of 1.14% than the expenditure in 2016. The growth rate reduced by 2.46%. Expenditure in third-level and second-level hospitals decreased by 2.82% and 3.02%,respectively,with reductions in growth rates of 4.06% and 3.74% respectively. Expenditure in primary institutions increased by 17.09%. The increase rate in the second quarter of 2017 was 26.28%,representing a remark-able increase compared to the rate in 2016(15.84%). The contribution from the medical institution service prices and service utilization to the change of outpatient and emergency medical expenditure containment was 6.98% and -7. 65%,respectively. For third-level hospitals,the contribution was 10.37% and -12.00%,respectively;second-level hospitals were 0.72% and -3.35%,respectively;and the primary health institutions was 6.08% and 9.57%. Con-clusions:Beijing's comprehensive reform of separating drug sales from medical services reform has effectively controlled the rising medical expenditure of outpatient services,mainly by adjusting outpatients service utilization between differ-ent level healthcare institutions.

The United Nations Sustainable Development Goal proposes to achieve universal health coverage by 2030， and the key element is that everyone can enjoy high-quality healthcare services. Cardiovascular diseases， predominantly acute coronary syndromes， have become the largest disease burden on global health. However， the quality of healthcare services for acute coronary syndromes varies significantly across the populations and regions. This study aimed to investigate the difference in the quality of acute coronary syndrome services in multiple countries， regions， hospitals， and patient populations， and then determine the impact of quality improvement initiatives on quality disparity， which may facilitate further improving the equity of clinical service quality for acute coronary syndromes and promoting health equity and universal health coverage.

Objective To analyze the curative effect of fossa intercondyloidea of micro-fracture and comminution of subcutaneous fat pad on meniscal tear healing under arthroscopy. Methods During the clinical operation, the samples of the micro-fracture and fat pad comminution were attracted to the outside of the joint. The source and properties of cells were identified based on preclinical medicine experiment in vitro. In clinical research, 75 cases of the simple meniscus injury were selected from January 2014 to January 2016 and divided into three groups refer to treatment: Group A, B and C. Different treatments were used in the three groups. Group A - micro-fracture group; Group B - fat pad group; Group C - blank group. All patients' conditions were assessed with Lysholm, VAS score and adverse event (Swelling, anterior knee pain). Results In the preclinical medicine experiment, cells released by micro fracture were fibroblast-like cells which tend to grow more rapidly in vortex shape. Cells released by comminution of fat pad contained a small amount of impurities and necrotic cells and are mostly similar to fibroblast in long spindle shape. Besides, the Human MSC Analysis Kit was used to authenticate two cells which were considered to be as BMSCs and IPFPSCs. In clinical research, all patients received an average of 10 (8 ～ 11) months follow-up visit. No severe complication, such as blood-vessel and nerve injury, infection occurred after operations in the patients followed. Before receiving the treatment, difference in Lysholm, VAS score and general condition of joint of Group A and B, C showed no statistical difference (P > 0.05). Compared with those before operation and after operation in both of four groups, the Lysholm and VAS score were improved (P < 0.05). Besides, there had significantly difference between group A and C, B and C after post treatment in Lysholm and VAS score (P < 0.05), however, group A and B did not. Compared group A and C, the early prevalence of adverse event of group B was higher, but last follow-up show no difference between three groups. Conclusion Combined with basic experimental and clinical studies, our research suggest that micro-fracture and comminution of fat pad have good effect on the repair of meniscus injuries. Nevertheless, it should be concerned that early prevalence of increased swelling amd anterior knee pain of comminution of fat pad.

OBJECTIVE: To investigate the expression of miR-451 during erythroid differentiation and its correlation with hematological diseases. METHODS: The expression of miR-451 in erythroid differentiation of mouse hematopoietic stem cells (derived from fetal liver) was analyzed by cell culture, flow cytometry, magnetic bead sorting and qRT-PCR. The expression of miR-451 during erythroid differentiation of mouse erythroid leukemia cells (MEL) was analyzed by cell culture and qRT-PCR. The expression of miR-451 in peripheral blood of mice was detected by qRT-PCR, and the expression of miR-451 in fetal liver (14.5 days) was analyzed by microarray. The nucleated erythroid cells from bone marrow of wild type (WT) mice and β-thalassemia (β-thal) mice were sorted by flow cytometry, and the levels of miR-451 and erythroid genes were detected by qRT-PCR. The expression of miR-451 in peripheral blood of patients with clinical hematological diseases was detected by qRT-PCR. RESULTS: During the differentiation of mouse hematopoietic stem cells (derived from fetal liver) and MEL cells, the expression levels of miR-451 increased gradually. Compared with WT mice, the expression levels of miR-451 in peripheral blood, 14.5-day fetal liver cells and nucleated erythroid cells (sorted from bone marrow) of β-thal mice were significantly increased(P<0.05). Many erythroid differentiation genes in nucleated erythroid cells (sorted from bone marrow) of β-thal mice decreased. Compared with healthy controls, the expression levels of miR-451 was increased in peripheral blood of patients with β-thalassemia and iron deficiency anemia, while the expression levels of miR-451 was decreased in patients with aplastic anemia and myelodysplastic syndrome. CONCLUSION During erythroid differentiation, the expression levels of miR-451 increases gradually. In hematological diseases, the expression levels of miR-451 is different from that of normal controls, which is expected to become an auxiliary diagnostic index for clinical hematological diseases.
Mice ; Animals ; beta-Thalassemia/genetics* ; Cell Differentiation ; MicroRNAs/genetics*