Objective To discuss the outcome of repair of limbs bone defect by using mineralized collagen graft.Methods The clinical data of 35 cases who diagnosed the existence of bone defect from January 2013 to December 2013 in our department were retrospectively analyzed.After operation,Lane Sandhu X-ray score standard was evaluated.Results All patients were followed up for 12 months.Postoperative 1 month,Lane Sandhu X-ray score was 3 points in 20 cases and 15 cases with 2 pointss;postoperative 6 months,Lane Sandhu X-ray score was 9 points in 21 cases,10 cases with 8 points and 4 cases with 7 points.Postoperative 12 months,Lane Sandhu X-ray score was 12 points in 28 cases,7 cases with 11 points.The scores of postoperative 6 months were better than the scores of postoperative 1 month [(2.60±0.49)points vs.(8.49±0.12)points,t=107.860,P=0.000].There was significant difference between the scores of postoperative 12 months and scores of postoperative 6 months [(8.49±0.12)points vs.(11.8±0.06)points,t=41.630,P=0.000].Conclusion MC is used as an effective bone substitute material,and its clinical effect is good.

ObjectiveTo study the association of SNP276 in adiponectin gene with impaired glucose regulation (IGR) complicating with the different component numbers of metabolism syndrome (MS) in population of IGR in Han people of Shanxi region.MethodsThe study population consisted of 256 subjects with IGR which was composed of 123 subjects with component numbers of MS ＜2 (IGRA) and 133subjects with component numbers of MS≥2 (IGRB),and 128 subjects with normal healthy (Normal) who were Chinese Hans residents and in Shanxi province.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was applied to test the adiponectin SNP276G/T polymorphism.ResultsThe distributions of genotypes and alleles of SNP276 both displayed significant difference among the three groups ( x2 =16.893,P =0.002 ; x2 =18.149,P =0.000).In the IGRA,the SNP276 non-TT ( GT + GG) genotype was no difference which increased risk of complicating with the different component numbers of MS( P =0.781,P =0.809).In IGRB,the SNP276 non-TT ( GT + GG) genotype was associated with increased risk of complicating with the different component numbers of MS,and after age and sex-adjusted,there was significant difference ( P =0.007,P =0.007).ConclusionsSNP276 in APM1 increased the risk of complicating with the components of MS in population with impaired glucose regulation in Han people of Shanxi region.

Adult ; Arthritis ; diagnosis ; diagnostic imaging ; Female ; Humans ; Radiography ; Tuberculosis, Lymph Node ; diagnosis ; diagnostic imaging ; Tuberculosis, Osteoarticular ; diagnosis ; diagnostic imaging ; Ultrasonography

Objective To evaluate the clinical efficacy and safety of tapering the dosage of recom-binant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR-Fc) combined with DMARDs in the treatment of peripheral joints involvement of ankylosing spondylitis. Methods Sixty patients who met the classification criteria of ankyloding spondylitis were enrolled. Meanwhile, all patients had one or more of the following joint involvement: hip, knee, ankle, and shoulder. Their BASDAI was higher than 4, joint pain VAS≥4, ESR ≥30 mm/1 h and CRP≥8 mg/L. Tuberculosis, hepatitis B, hepatitis C infection or other microorgan-isms infections were excluded. All enrolled patients had no serious heart,liver,kidney, or other internal organ involvement. During the first stage (The first eight weeks patients were matched by age and, disease activity, then randomly divided into the rhTNFR-Fc (the control group) treatment group in which patients were treated with 25 mg rhTNFR-Fc subcutaneous injection twice per week for 4 months) and rhTNFR-Fc dosage tapering group in which 25 mg rhTNFR-Fc were subcutaneously injected once per week for 4 weeks and then followed by 12.5 mg per week for 4 weeks, then once every 10 days for 6 times. Then the dosage of rhTNFR-Fc dosage of the dosage tapering group (the experimental group) was changed to 12.5 mg subcutaneous injection once every 15 days for another 4 times combined with methotrexate 7.5 mg per week and Salfasalazine 2 g daily and thalidomide 100 mg per night. The second stage started from week 9 to 24. In addition to the 30 cases at the first stage, 42 cases were included based on the same inclusion criteria for stage one. Patients' clinical and laboratory parameters were evaluated at week 0, 4, 8, 16 and 24. Results During the first four weeks, all patients of both control group and experimental group reached ASAS20, 97% (29/30) patients reached ASAS50 in the control group, 83% (25/30) patients reached ASAS50 in the experimental group. At week 8, patients in both groups maintained at 100% ASAS20 improvement, 100% (13/13) patients in the control group reached ASAS50, and that of the experimental group was 97% (29/30), the differences between the two groups were not statistically significant (P>0.05). In the second stage, 72 cases (100%) could achieve ASAS20, 63 cases (88%) achieved ASASSO at week 16. At week 24, 72 cases (100%) remained to achieve ASAS20, 71 cases (99%) achieved ASAS50. The safety and compliance of the two groups were good. Two cases developed infection, one patient had mild elevation of serum transaminase. Conclusion Tapering the dosage combined with DMARDs is an effective and safe approach in the treatment of peripheral joints involvement of ankylosing spondylitis. The compliance of this strategy is good and only few patients have serum transaminase elevation. But attention should be paid to the increased rate of infection.

Objective To explore the efficacy and safety of intravenous immunoglobulin and glucocorticoid treatment in elderly dermatomyositis patients. Methods Sixty elderly patients with dermatomyositis were randomly divided into two groups: prednisone alone (n= 30, PA) (first 1 mg per kilogram of body weight daily,then decrease the dose according to disease activity), and the combined treatment (n=30,CT,first 1 mg per kilogram of body weight daily, then decrease the dose according to disease activity, and intravenous immunoglobulin 0. 4 g per kilogram of body weight per month for three months). The improvement of clinical symptoms and the occurrence of side effects were observed at the end of month 3. Results The time of muscle strength recovery, remittences of myasthenia and myalgia visual analogue scale(VAS), the decreasing rates of creatine phospho kinase (CPK) level and the dose of prednisone at the end of month 3 were superior in CT group versus PA group (P<0. 05), while no significant differences in the improvement of rash, muscle strength,erythrocyte sedimentation rate(ESR),C-reactive protein (CRP) and side effects between two groups.Conclusions Combination with intravenous immunoglobulin and oral glucocorticoid is a safe and effective treatment for elderly patients with dermatomyositis, it can alleviate symptoms quickly,decrease CPK level and prednisone dose significantly.

Objective To investigate the anti-inflammatory effect of Resveratrol on type Ⅱ collagen induced arthritis.Methods Collagen induced arthritis (CIA) animal model was established by subcutaneous injection of type Ⅱ collagen emulsified with incomplete and complete Freud's adjuvant to Wistar rats.Fortytwo rats were successfully induced and randomly divided into 7 groups:the experimental group (A),the leflunomide treatment group (B),the TGP treatment group (C),the methotrexate group (D),the low dose Resveratrol group (E),the medium dose Resveratral group (F) and high dose Resveratrol group (G) and the normal control group (H).Symptoms of arthritis were recorded and selalm levels of the anti-C Ⅱ antibody were detected by ELISA.Results For arthritis index.there was no significant difference between groups E and A,neither between groups C and F.The arthritis index was lower in group G than group C,but both of them were higher than groups B and D.② For serum anti-C Ⅱ antibody level,that of group A was higher than groups B,C,D,F and G.There was no difference between groups A and E,and groups C and F.That of Group G was lower than groups C and E.Conclusion High and medium dose of Resveratrol can relieve foot joints swelling in the CIA rats,but low dose does not have similar effect.The effect of medium dose of Resveratrol iS similar to TGP,but weaker than that of leflunomide.Resveratrol may conduct its anti-inflammatory effect via lowering the concentration of the anti-C Ⅱ antibody in the serum.

Objective To investigate the relationship between plasma homocysteine (Hey) level and ankylosing spondylitis (AS).To analyze the association between the NS,N10 methylenetetrahydrofolate reductase (MTFHR) gene polymorphism and AS.Methods One hundred patients with AS and 60 healthy controls were included in the study.The plasma Hey level was examined by enzyme-linked immunoadsorbent assay and MTHFR gene polymorphism was analyzed by the polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP).Results Compared with heahhy controls,the plasma Hey level in AS patients was significantly higher than that of the controls (P＜0.01).There was no significant difference in the frequen-cies of MTHFR genotype and alleles between AS and the controls (P＞0.05),But the ratio of T/T genotype mutation was different between AS and the controls (P＜0.05).The plasma Hey level of T/T genotype was significantly higher than that of C/T or C/C genotype in AS and the controls (P＜0.01).Logisticalregression analysis indicated that Hey was an independent risk factor for AS (P＜0.01,0R=4.582,95%CI=1.984～10.585).Conclusion The plasma homocysteine level is significantly increased in AS patients.Hyperhomo-cysteinemia is an independent risk factor for AS.MTHFR T/T genotype mutation is an important mechanism of hyperhomocysteinemia and may be related with AS.

Objective To observe the effect of resveratrol on the apoptosis and expressions of bal-2 and bax protein in articular chondrecytes of rabbits experimental osteoarthritis (OA) model,and further explore the mechanisms of resveratrol in the treatment of OA.Methods Thirty Newzealand rabbits were randomly divided into 5 groups：group A (normal control group),group B (model control group),group C (resveratrol intervention high dosage group),group D(resveratrol intervention middle dosage group),group E (resveratrel intervention low dosage group).The model of OA was established with Hulth's modeling method in group B,C,D,E.Four weeks later,groups A and B received intragastric administration of distilled water containing 0.1% DMSO daily and group C,D,E received intragastric administration of resveratrol solution daily (concentration was 60 mg/ml) in different dosages for 6 weeks.Daily dosages of group C,D,E were 120,60,30 mg·kg-1·d-1,respectively.Then the rabbits were sacrificed and the cartilage sections of right femoral medial condyle were analyzed by immunohistochemistry for bcl-2 and bax,TUNEL for apoptosis.Results ① The apoptosis rates of chondrocytes in group B,C,D,E were significantly higher than those in group A (P＜0.01).The apoptosis rates of chandrocytes in group C,D,E were decreased compared with those in group B (P＜0.05).②The positive rates of bcl-2 and bax expression in chondrocytes in group B were significantly higher than those in group A (P＜0.01),but the ratio of the positive rate of bcl-2 expression to that of bax in group B was lower than that in group A (P＜0.01).The positive rates of bcl-2 expression in chondrocytes in group C,D,E were much higher compared with those in group B (P＜0.01).The positive rotes of bax expression in chondrocytes in group C,D,E were lower compared with those in group B (P＜0.01).The ratio of the positive rate of bcl-2 expression to that of bax was increased in group C,D,E compared with group B (P＜0.01).Conclusion Resveratrol can suppress the excessive apoptosis of chondrocytes in experimental OA by up-regulating the expression of bcl-2 while down-regulating the expression of bax and improving the ratio of bcl-2 to bax .Suppressing the excessive apoptosis of chondrocytes in experimental OA may be one of the mechanisms for resveratroi's effect in the treatment of osteoarthritis.

objective:To evaluate the sensitivity and predictive value of grey scale and power Doppler ultrasound assessment of bone erosionin disease activity in patients with early rheumatoid arthritis (Ra).
Methods:Fifty-six patients with early Ra underwent blinded sequential clinical, laboratory and ultrasound assessments, and at the same time 20 of these patients underwent X-ray and enhanced MRi. For each patient, 28-joint disease activity score (DaS28), erythrocyte sedimentation rate (eSR), C reactive protein (CRP) and health assessment questionnaire (haQ) were recorded. The presence of bone erosion and synovitis was investigated in 28 joints by gray-scale and power Doppler ultrasonography. The ultrasound joint count and index for active synovitis with power Doppler signal were calculated.
Results:The number of bone erosions detected by ultrasonography was 5.7 times that of X-ray, while both MRi and ultrasonography were consistent (91.5%). The number of synovitis detected by ultrasonography was 1.6 times as much as by physical examination, and consistent MRi (95.7%). PDUS parameters demonstrated a highly significant correlation with DaS28, eSR and CRP, while a negative correlation with haQ.
Conclusion:Grey scale and power Doppler ultrasonography is a sensitive and reliable method to assess bone erosion and inflammatory activity in early Ra. PDUS findings may have a predictive value in disease activity.

In previous study, glutaric acid (GA) induced apoptosis of primary striatal neuron in vitro. In order to investigate the neurotoxic effects of GA on neonatal rat corpus striatum and the possible mechanism, 34 male pups were randomly assigned to NS group, low dose GA (LGA, 5 μmol GA/g body weight) group and high dose GA (HGA, 10 μmol GA/g body weight) group. These pups were subcutaneously administered with three injections from postnatal day 3 to 22 at 7:30 am, 15:00 pm and 22:30 pm and killed 12 h after the last injection. Microscopic pathology in corpus striatum was evaluated by HE staining. The apoptotic cells were identified by TUNEL staining. The transcript levels of caspase-3, 8, 9, Bax, Bcl-2 were detected by using real-time PCR and the protein levels of procaspase-3 and the active fraction were evaluated by Western blotting. In LGA and HGA groups, ventricle collapse, cortical atrophy by a macroscope and interstitial edema, vacuolations, widened perivascular space of bilateral striatum by a microscope were observed. TUNEL assay revealed that the apoptotic cells were increased in LGA and HGA groups. The transcript of caspase-3 was up-regulated to 2.5 fold, accompanied by the up-regulation of caspase-9, Bax and down-regulation of Bcl-2. The protein levels of procaspase-3 and the active fraction were up-regulated in LGA and HGA groups. The rat model for GA I showed mitochondrial apoptotic pathway may be involved in the GA-induced striatal lesion. Further studies should be taken to investigate the underlying mechanisms.