Objective To observe the effect of physiotherapy on knee osteoarthritis. Methods 40 knee osteoarthritis patients were dividedinto treatment group (n=20) and control group (n=20). The control group accepted conventional therapy, acupuncture and moxibustion,fumigation, massage, etc. The treatment group accepted physiotherapy in addition, including strength training and joint activity training.They were assessed with Lysholm Knee Scoring Scale (LKSS) and Visual Analogous Scale (VAS). Results The scores of LKSS and VASimproved in both groups after treatment, and improved more in the treatment group than in the control group (P<0.01). Conclusion Physiotherapycan further improve the stability of knee and release the pain in knee osteoarthritis patients.

Objective To provide a simple, convenient, and safe anesthesia method for the establishment of a M1 segment of middle cerebral artery occlusion model in rhesus monkey or other large laboratory animals.Method Twenty male rhesus monkeys weighing 7-11 kg (ages 7-9 years) from Academy of Military Medical Sciences were used in this study.Sumianxin injection combined with 0.1 mg/kg ketamine was given before endotracheal intubation (ID:4.5-5.5#).The animals were then transported to an interventional operation room, where the intravenous access was established and a urinary catheter was inserted into the urinary bladder.Mechanical ventilation was used during the surgery, propofol was continuously injected in a speed of 2-4 mg/kg/h, and Sumianxin-ketamine could be given if necessary to maintain adequate anesthesia depth.The dose was adjusted according to vital signs of the rhesus such as body movements, physiological parameters, and demand of surgery.Brain MRI examination was performed before and after thrombolysis.Anesthetic injection was suspended and the animals were allowed to have a spontaneous breathing every time before the MRI text.Heart rates, temperature, non-invasive blood pressure, and SpO2 were monitored during the whole surgery.Blood samples were taken from the radial artery for blood gas analysis after anesthesia induction and during operation.Results All the 20 animals underwent the operation successfully, no animal had restlessness, respiratory depression, arrhythmia and other serious complications.At the end of the study, animals awake soon.Fifteen of them survived longer than 24 hours, only 5 died from serious cerebral hemorrhage and larger cerebral infarction.Conclusions General endotracheal anesthesia is safe for rhesus monkeys during such interventional operation and MRI examination.

OBJECTIVE:To study the improvement effect of Z-Guggulsterone(Z-GL)on blood coagulation and vascular endo-thelial functions of acute blood-stasis model rats and its mechanism. METHODS:40 rats were randomly divided into normal group,model group,positive group(Aspirin tablet,50 mg/kg)and Z-GL low-dose and high-dose groups(25,50 mg/kg),with 8 rats in each group. They were given relevant medicine intragastrically every 12 h,and normal group and model group were given constant volume of normal saline intragastrically for consecutive 7 times. After the fifth administration,except for normal group, those groups were given adrenalin hydrochloride subcutaneously+ice-cold water to induce acute blood-stasis model. Within 30 min after the last administration,aorta abdominalis sample were selected to detect the coagulation parameters [prothrombin time(PT), thrombin time (TT),activated partialthromboplastin time (APTT),fibrinogen (FIB)],and pathological changes of carotid artery were observed. Human umbilical vein endothelial cells (HUEVCs) were divided into blank group (normal saline),model group (normal saline) and Z-GL low-concentration and high-concentration groups (25,50 μmol/L). After culturing for 24 h,the cells were exposed to glucose and oxygen deprivation for 6 h in model group and Z-GL groups. The expression of p-eNOS protein was detected. Other cells were selected,grouped,administrated and treated as above cells,and the NO level of these cells were detect-ed. RESULTS:Compared with normal group,PT,TT and APTT were all shortened in model group,while FIB content was in-creased (P<0.01);vascular endothelium was injured,and endothelial cells fell off from the wall. Compared with model group, PT,TT and APTT were prolonged in administration groups,while FIB content was decreased(P<0.05 or P<0.01);vascular en-dothelium injury was relieved. Results of p-eNOS protein and NO levels determination showed that compared with model group, p-eNOS protein and NO levels were increased in Z-GL groups(P<0.05 or P<0.01). CONCLUSIONS:Z-GL can significantly im-prove coagulation and vascular endothelium functions of blood-stasis model rats,and its mechanism may be associated with the acti-vation of eNOS and the increase of NO level.

Objective To develop a Gd-based MR probe containing arginine-glyeine-aspartic acid (RGD)motif to reveal integrin avβ3 receptor-expressed tumor.Methods Commercially available HYNICRGD conjugate with co-ligand EDDA was labeled with GdCl3,and the mixture was isolated and purified by solid phase extract(SPE)to get the entire probe Gd-EDDA-HYNIC-RGD.Human HCC cell line BEL-7402 was cultured and the cells harvested and suspended then subcutaneously inoculated into athymic nude mice for tumor growth.In vitro cell binding assay to integrin avβ3 receptor and cell viability experiments were conducted.Then in vivo,imaging of the three arms of xenografts were performed by MR scan with a dedicated animal coil at baseline and time points of 0.30,60,90 mninutes and 24 hour post-intravenous injection(P.i.) via the tail vein.Three arms of nude mice then were sacrificed for histological examination to confirm the imaging results.Results Gd-EDDA-HYNIC-RGD was successfully isolated by SPE and validity was verifled on signal enhancement througll in vitro and in vivo experiments.The T1 relaxation rate of the probe is 3.31 mmol/s:It is well tolerated to living cells when the concentration of the probe is below 0.1 μmol/ml;both BEL-7402 Hunlan Hepatocellular Carcinoma cell Iine and the tumor expressed avβ3receptor;The RGD-iigand was observed specificly binding with avβ3 receptor in vitro;The nude mice model bearing HHCC was well estabhshed.The signal intensity(SI)at the tumor site were 2247.6±39.0 at baseline and 2820.9±35.2 at 90 min p.i.respectively,the SI at 90min increased less than 25%of baseline,which is statistically different(t=-38.031,P＜0.05);while the SI at muscle site were 1824.2±32.8 and 1845.8±27.2 respectively,which is not statistically different(t=-1.424,P＞0.05);The signal to time curve for probe-administrated group is straightforward over time in the span of 0 to 90 minute p.i.while the control arms do not show such tendency.Conclusion Gd-EDDA-HYNIC-RGD has the potential to used as an MR probe detecting integrin avβ3 receptor-expressed tumor.This work may offer possibility of early detection and differentiation of specific tumors.

BACKGROUND:Bone marrow mesenchymal stem cells have the chemotaxis and homing role that promotes immune system reconstruction, eliminate residual lesions and prevent recurrence in patients.
OBJECTIVE:To observe therapeutic effect of human bone marrow mesenchymal stem cells transplantation into high-metastatic potential hepatocellular carcinoma animal models on metastatic potential of high-metastatic potential hepatocellular carcinoma.
METHODS:Nude mouse models of high-metastatic potential hepatocellular carcinoma were established in vivo. In the experimental group, 5×105 cells were injected via the tail vein on day 7 after tumor inoculation, twice a week. In the control group, cellculture medium, 0.2 mL per mouse, was injected by the tail vein. After the start of the experiment, tumor volume was measured every 4 days. After tumor inoculation for 14 days, 21 days, 28 days, 35 days, 42 days, animal models were sacrificed, and then tumor mass and body mass were recorded to calculate the inhibition rate. PCR was employed to detect osteopontin, bone sialoprotein, and integrinα Ⅴ mRNA expression, as wel as bcl-2, bax, caspase3 mRNA expression.
RESULTS AND CONCLUSION:The inhibition rate of tumor mass showed the best results in week 3. As time went on, the tumor inhibition rate was gradual y decreased. Metastasis-related biological factors showed a gradual down-regulated trend, indicating the polarization of tumor apoptotic indexes, that is, anti-apoptotic factor, bcl-2, showed a decreasing trend, while apoptotic factors, bax and caspase3, appeared to have a gradual y increased trend. These findings suggest that human bone marrow mesenchymal stem cells effects to inhibit high-metastatic potential hepatocellular carcinoma animal models appear to vary with time. After human bone marrow mesenchymal stem cells transplantation for 3 weeks, the inhibition performance on high-metastatic potential hepatocellular carcinoma is the best, and then it weakens with time. Human bone marrow mesenchymal stem cells are found to inhibit the metastatic potential of hepatocellular carcinoma.

0.05).There was remarkable low signal intensity on T2-weighed imaging and no evident artifacts for molecular probe when the concentration of Fe2+ was 20 mg/L.The least number of labeled cells detected by MR in vitro was 6?106 when the concentration of Fe2+ was 20 mg/L.Conclusion:Molecular probe,SPIO-OCT,can effectively label breast cells which express SSTR.The reasonable Fe2+ concentration of labeled cells and imaging was 20 mg/L.There is a correlation between MR signal intensity in vitro and the number of labeled cells.

Objective To evaluate the impact of respiratory motion on lung dosimetry using 4D-CT during lung cancer radiotherapy.Methods Ten cases were randomly selected from non-small cell lung cancer (NSCLC) patients treated in our department.The 4D-CT machine was adopted for simulation before treatment and 10 respiratory phases were obtained for each patient.Target volumes were delineated on the maximum intensity projection (MIP) images,and plans were generated on average intensity projection (ALP) images.Plans were transferred to CT images of each respiratory phase,and we calculated the dosage on lungs and subsequently evaluated the volume dosage to lungs and the entire body.Results The mean dosage to lungs are greatly affected by the respiratory phase.This difference also depended on tumor location.When it was inside the lung,the average dosage shows the same trend as the respiratory motion,with the change rate of 2.18％,which was less than the change of lung volume 4.49％ (t =4.189,P ＜ 0.05).When the tumor was located nearby the lung,the mean dosage showed the opposite trend with respiratory motion,with the change rate of 3.76％,which was also less than the change of lung volume 4.49％ (t =25.007,P ＜ 0.05).The effect of respiratory motion on V5,V10,V20 of body was small,and the magnitude of change for whole body dosages were 0.47％,0.28％,0.17％ respectively,which was smaller than the change of lung volume 4.49％ (t =11.371,11.188,11.377,P ＜ 0.05).Volume dose of lung V5,V10,V20 and lung volume change trends were the same,and the magnitude of change for lung volume dosages were 2.39％,1.91％,1.80％ respectively,and were smaller than the change of lung volume 4.49％ (t =2.279,2.298,2.485,P ＜ 0.05).Conclusions The mean dosage to lungs shows a great difference between different respiratory phases.More attention should be paid when evaluating the lung volume during treatment planning.

Under National Health Insurance system ( NHI) , Taiwan implemented “Family Physician Integrat-ed Health care Plan” by focusing on the key functions of primary medical institutions and family physicians. This plan had continuously strengthened the family physician system and the quality of integrated health care provision. Taiwan’s achievements and experiences were valuable for Mainland China. This paper first introduced the health sys-tem and health care provision system of primary medical institutions in Taiwan from the aspects of financing, pay-ment, health care delivery system structure, and market-capture institutions. Then, we made a comprehensive intro-duction on the policy objectives, organization structures, operation system, service schemes and health insurance pay-ment system of this plan. Finally we proposed the suggestion for integrated health care provision system in Mainland China. It is of vital importance that government should design the integrated service provision system by focusing on the key functions of family physicians. It is also of equal significance that the health administrative departments should cooperate with health insurance administrative departments to gain sufficient policy and funding resources for the plan’s successful implementation.

Objective To evaluate the pre- and intra-operative risk factors associated with delayed weaning from ventilator during the early postoperative period in patients undergoing liver transplantation.Methods Two hundred and twelve patients (152 male, 60 female) aged 22-69 yr undergoing liver transplantation from Sept 2004to Aug 2006 were enrolled in this study and were divided into 2 groups according to the time when the patients were weaned from ventilator: normal weaning group (Group A, the patients weaned from ventilator within 24 h after operation) and delayed weaning group (Group B, the patients weaned from ventilator more than 24 h after operation). Routine anesthesia wes performed. Blood and blood products were transfused according to the guidelines for blood transfusion to maintain the mean arterial pressure (MAP)≥60 mm Hg during operation. Sixteen preoperative variables (age＞64 yr, gender, BMI ≥ 30kg/m2, PaO2＜75 mm Hg,pleural effusion, a history of asthma, smoking, drinking alcohol, coronary artery disease, diabetes mellitus, encephalopathy＞grade 3, spontaneous bacterial peritonitis, preoperative MELD score, serum albumin, ascites≥20 ml/kg and moderate hepatopulmonary hypertension) and 7 intraoperative variables (duration of operation, duration of anhepatic stage, transfusions of RBC,fresh frozen plasma (FFP), crystalloid and colloid, and urine output＜ 1 ml·kg-1·h-1) were recorded and compared between the two groups.Results There were significant differences in 9 preoperative variables (age ＞ 64 yr, PaO2＜75 mm Hg, pleural effusion,encephalopathy＞grade 3, spontaneous bacterial peritonitis, preoperative MELD score, serum albumin, ascites≥20 ml/kg and moderate hepato-pulmonary hypertension) and 5 intraoperative variables (transfusions of RBC, FFP, crystalloid and colloid, and urine output＜1 mi·kg-1·h-1) between the two groups (P＜0.05 or 0.01). And logistic regression analysis showed that 5preoperative variables (age＞64 yr, PaO2＜75 mm Hg, encephalopathy ＞ grade 3, preoperative MELD score, and moderate hepato-pulmonary hypertension) and 2 intraoperative variables (transfusion of RBC and urine output＜1 ml·kg-1·h-1) were confirmed to be associated with delayed weaning from ventilator.Conclusion Such variables es age ＞ 64 yr, preoperative PaO2 ＜ 75 mm Hg, encephalopathy ＞ grade 3, preoperative MELD score, moderate hepato-pulmonary hypertension, transfusion of RBC during operation and urine output ＜ 1 ml· kg-1 · h-1 are associated with delayed weaning from ventilator during early postoperative period after liver transplantation.

Objective:To establish two differential gene expression profiles of qi-deficiency and blood stasis syndrome before or after safflower injection treatment by using gene chip technology;compared and analyzed to ensure the effective genes that are responsible for the therapeutic effects of safflower injection against qi-deficiency and blood stasis syndrome in rats.Furthermore,speculated the effect mechanism of the therapeutic genes.Methods:Fifteen SD rats were randomly divided into 3 groups (n=5):control group,model group,and medication group.Qi-deficiency and blood stasis model was established by subjecting the rats to hunger and fatigue for two weeks.After a week of the modeling,safflower injection (100 mg/kg/d) was administered daily via the tail vein for 7 days in medication group,and the rats in model group were injected with saline of the same volume.Control group received normal feeding.At the end of the experiment,rats were killed and whole blood was collected to evaluate the blood stream change and extract mRNAs in blood samples.Qualified mRNAs were reverse transcribed into cDNA which was then used in gene chip hybridization.The genes regulated by safflower injection were determined by the fluorescence signal and the functional mechanisms of safflower injection were confirmed by further querying genealogy databases and reviewing literatures.Results:After two weeks of the modeling,the whole blood viscosity under various shear rates was significantly increased in the model rats which showed faint,blood stasis and weight loss,indicating that the model is made successfully.The increased whole blood viscosity and qi-deficiency and blood stasis syndrome were obviously reversed by safflower injection treatment.Compared with the control group,252 genes up-regulated while 54 genes down-regulated in model group;compared with the model group,196 genes up-regulated while 32 genes down-regulated.Among these,16 differentially expressed genes were involved in inflammation and immune response.Conclusions:Safflower injection was effective in treating qi deficiency and blood stasis syndrome,which was achieved by regulating inflammation related genes.