BACKGROUND: Patellar tendinopathy is tiny damage at tendon insertion. Changes in the strength balance between vastus medialis and vastus lateralis in the quadriceps may lead to patellar abnormal motion, even an impact to the tendon insertion. OBJECTIVE: To analyze the mechanism and influence of patellar tendinopathy on the knee joint and surrounding muscles motion. METHODS: Ten male athletes with patellar tendinopathy and ten male athletes with matched sports item, body height and age were selected, and the knee-joint strength and surface electromyography were tested using CON-TREX Isokinetic Measurement System. The change of knee-joint flexor peak torque, extensor peak torque and surface electromyography of the quadriceps were compared with and analyzed. RESULTS AND CONCLUSION: Result showed during isometric exercise, extensor peak torque of the patellar tendinopathy group was significantly lower than the control group, and ratio of flexor peak torque to extensor peak torque was significantly higher than the control group; during isokinetic exercise, extensor peak torque of the patellar tendinopathy group was significant smaller than that of the control group, and notably changed with the increasing motion angular velocity; during isometric exercise and isokinetic exercise, the ratios of vastus medialis/vastus lateralis of the patellar tendinopathy group were lower than that of the control group. There were significant differences between knee-joint flexor and extensor of patellar tendinopathy athlete. The activity of vastus lateralis is low and vastus medialis and vastus lateralis are not in balance.

Objective To objectively evaluate the effectiveness of reminder system in reducing catheter-associated urinary tract infections.Methods Databases were electronically searched to collect the trials.According to the inclusion and exclusion criteria,the literatures were screened,the data were extracted and the methodological quality of the included studies was assessed.Then Meta-analysis was performed by using RevMan 5.0 software.Results A total of 10 literatures involving 5 662 participants were included.The results of Meta-analysis showed that the reminder system group was superior to the control group in decreasing the incidence rate of catheter-associated urinary tract infections,shortening the days of indwelling catheter,and there were statistical differences.Conclusions Reminder system can shorten the days of indwelling catheter,decrease catheter-associated urinary tract infections,

Objective To investigate the effects of aerobic exercises on the pulmonary ventilation function and electrocardiac activity of simple obesity primary school students. Methods 30 simple obesity boy students were recruited for this study. All the subjects participated in a 12-week aerobic training program (40 min/day,4 days/week). Body composition,pulmonary function and electrocardiogram were tested at the beginning and the end of the training program. Results Decreases of fat mass and body fat ratios were found in response to the exercise stimulus (P<0.05). Free-fat mass(FFM) significantly increased. No statistically significant differences of waist hip ratio (WHR) were found. Among the pulmonary ventilation function indexes,MVV、FEV_1、V_(50)/Ht and PEFR increased significantly (P<0.05, P<0.01). Among the EEG indexes,QTd value and QTcd value decreased significantly (P<0.05,P<0.01). Conclusion Aerobic exercises could improve the pulmonary ventilation function of simple obesity primary school students,and had favorable regulations on electrocardiac activity.

Objective To investigate the prevalence and features of thyroid nodules in middle and aged patients with type 2 diabetes mellitus(T2DM). Methods High-resolution ultrasonography was used to detect thyroid nodules in 132 cases middle and aged patients with type 2 diabetes and 89 patients without diabetes.The nodule features and its relationships with related indicators in diabetic patients were analyzed. Results The prevalence of thyroid nodules in middle and aged patients with type 2 diabetes was higher than that without diabetes (67.4％ vs. 53.9％,P＜0.05),and most occurred in 50 to 59 age group (66.7％ vs. 42.9％) without dependence on changes in thyroid functions and volumes.In diabetes group,the prevalence of thyroid nodules were 59.5％ in male and 81.3％ in female (P＜0.05),no obvious difference was observed in the size and number of thyroid nodules between male and female,multiple nodules and micronodule (＜ 1.0 cm) had the higher incidences in both sexes.The prevalence of thyroid nodules was increased with aging,but not with diabetes duration and glycosylated hemoglobin (HbAlc) level (x2 =0.797,P=0.372; x2 =1.078,P =0.229). Conclusions It is common that thyroid nodules combined with diabetes in middle and aged patients,thyroid ultrasound screening and regular following-up of patients aged ≥50 years have important clinical significance.

Objective To analyze clinical outcome of kidney transplantation from elderly livingrelated donors. Methods The clinical data of living-related kidney transplantation between November 2005 to June 2011 in the First Affiliated Hospital of Zhengzhou University were retrospectively analysed.The patients were divided into elderly donor kidney transplantation group (elderly group,36 cases) and non-elderly living related donor kidney transplantation group (nonelderly group,208 cases).The mean recipients' serum creatinines before and 3 days,7 days,1 month,3 month,6 month,12 month,24 month,36 month after surgery,peri-operation complications,the incidence rate of acute rejection,calcineurin inhibitor (CNI)-induced renal toxicity,delayed graft function(DGF),1 year and 3 year recipient/kidney survival were compared respectively between the two groups. Results The serum creatinine levels were higher in elderly group than in non-elderly group at 3 days,7 days,1 month after surgery [(245.2±135.2)μmol/L vs.(185.6±148.4)μmol/L,(150.5±86.8)μmol/L vs.(122.2± 136.8)μmol/L,(140.6±42.5)μmol/L vs.(117.8±33.2)μmol/L,t =84.07,31.90,21.54; all P =0.000].In addition,the incidence rate of CNI induced renal toxicity was higher in the elderly group than in non-elderly group [22.2％(8/36)vs.1.9％(4/208),x2=27.04,P=0.000].Nevertheless,there were no significant differences between the two groups in recipients' serum creatinines before and 3 month,6 month,12 month,24 month,36 month after surgery,in peri-operation complications,the incidence rate of acute rejection,delayed graft function,and in 1 year and 3 year recipient/kidney survival (all P ＞ 0.05). Conclusions With stringent screening and overall assessment of elderly donors,healthy elderly donors should not be barriers to organ donation.Renal toxicity of CNI agents should be carefully monitored in recipients of elderly donor.

Objective To systematically evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in the investigation of bile duct anatomy of liver transplantation living donors.Methods A search in Cochrane library,MEDLINE,EMBASE,CBMdisc (China Biology Medicine disc) was performed to identify relevant English and Chinese-language abstracts,supplemented by Springer,OVID,Sciencedirect full text database,etc.Criteria for inclusion were based on validity criteria for diagnostic research published by the Cochrane collaboration.With Meta analysis package for Stata10.1,heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity,positive likelihood ratio,negative likelihood ratio. Summary receiver operating characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally,sensitivity analysis was performed.Results Seventeen articles with 34 studies were included.Heterogeneity analysis revealed heterogeneity between studies and the source was MRCP imaging methods spotted by meta-regression analysis. Subgroup analysis according to MRCP imaging methods showed homogeneity within subgroups.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odd ratio of breath-holding thick slice MRCP,3D MRCP,the combination of the prior two methods,contrast enhance MRCP were 0.89,0.78,4.1,0.14,29; 0.92,0.80,4.5,0.10,45;0.95,0.82,5.2,0.06,85; and 1.00,0.76,4.1,0,1228,respectively with fixed effect model analysis.The area under the SROC curve was 0.83,0.92,0.96 and 0.99 respectively.Conclusion The combination of thick slice and 3D MRCP is a practical and effective method with good sensitivity and specificity to investigate bile duct anatomy of living liver transplantation donors,which fully meets the requirements of the preoperative assessment of bile duct structure.

Objective To investigate the effect of icariin on renal ischemia-reperfusion injury (IRI) and the action mechanism.Methods SD rats were divided into 3 groups.The model of unilateral renal IRI was established in SD rats,and Icariin (100 mg/kg) was orally administrated by gavage daily from 2 days before operation to 12 days after operation (icariin group).The vehicle of icariin was administrated to IRI model rats as control group,while in the sham-operation group the renal pedicel was only dissociated without treatment.Body weight and kidney function were monitored within 14 days after reperfusion.The kidney was harvested at 24 h after reperfusion,and then malonaldehyde (MDA) and activity of reactive oxygen species (ROS) scavenger enzymes were examined.Histopathological changes were observed at postoperative day (POD) 3 and 14.Results At POD 3,7,11 and 14,the creatinine clearance rate was significantly higher in icariin group than in control group (P＜0.01). Icariin group had significantly lower Paller scores which indicated tubules injury than in control group at day 3 after reperfusion (P＜0.01 ).In icariin group,MDA level was obviously decreased at 24 h after operation.Compared to control group,icariin group had statistically higher activity of glutathion reductase (GR),catalase and superoxide dismutase (SOD),as well as higher level of reduced glutathione (GSH) (P＜0.05).Conclusion Icariin has protective effects on renal IRI,and can promote recovery of kidney function. Icariin can reduce oxidative stress through increasing activity of ROS scavengers.

Objective To analyze the clinical effectiveness of using marginal donor kidney in living kidney transplant. Methods From November 2005 to June 2011,274 cases of living kidney transplant were performed in the First Affiliated Hospital of Zhengzhou University.The cases were divided into the marginal donors group ( Donor ages over 60 years old,suboptimal renal anatomy or physiology) of 66 cases and standard donors group of 208 cases.The clinical data were retrospectively analyzed.The criteria of marginal donors were as follows:36 cases of donors with age over 60 yrs (6 cases with renal cysts and 1 case with renal calculus),22 cases of renal cysts ( with diameter range from 4 mm to 40 mm ),4 cases of renal calculus (with diameter range from 3 mm to 6 mm),4 cases of low GFR (under 35 ml/min.The mean recipients' serum creatinine before surgery and after surgery on day 3,day 7,month 1,month 3,month 6,month 12,related complications,the rate of acute rejection and delayed graft function,1 year,3 year recipient/kidney survival were compared between the 2 groups,respectively. Results The serum creatinine levels in the marginal donor group and standard donor group were (242.7 ± 132.2 vs 185.6 ± 148.4) and ( 156.7 ±86.8 vs 122.2 ± 136.8 ) on day 3,day 7 respectively ( P ＜ 0.05 ).Nevertheless,there were no significant differences between the 2 groups in recipients' serum creatinines before surgery and after surgery on month 1,month 3,month 6,month 12,peri-operative complications,the rate of acute rejection and delayed graft function,1 year,3 year recipient/kidney survival (P ＞ 0.05). Conclusions Healthy old donors and donors with renal cyst (the diameter of renal cysts under 40mm) should not be the barriers to organ donation.To those living donors with low GFR,we should consider of donor age,donor/recipient body weight,donor/recipient body surface area and whether we could deal with the problem by surgical operation.Donor with renal calculus should be carefully evaluated.

Objective To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). Methods A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled. Thirty-six healthy cases were enrolled as control during the same time. The levels of serum complement C3, C4 and C5b-9 on 1, 3 and 7 days after admission and myocardial function indicators were analyzed. Major adverse cardiovascular events (MACE) and readmission rate were analyzed after 1 year follow-up. The correlation between serum complement levels and myocardial function indicators was analyzed by Pearson correlation analysis. Results ① The levels of serum C3, C4 and C5b-9 on the first day in NSTE-ACS group and STEMI group were significantly higher than control group [C3 (g/L): 1.04±0.33, 1.26±0.35 vs. 0.39±0.21, C4 (g/L): 0.31±0.14, 0.33±0.10 vs. 0.19±0.07, C5b-9 (g/L): 575.46±197.26, 659.26±160.77 vs. 501.40±141.51, all P < 0.05]. There were no changes of serum C3, C4 in NSTE-ACS group, but C5b-9 decreased after a peak (g/L: 700.63±218.42) at 3 days. Serum complements in STEMI group reached peak on the third day [C3 (g/L): 1.37±0.33, C4 (g/L): 0.42±0.12, C5b-9 (g/L): 754.72±136.22]. The levels of serum C4 and C5b-9 in STEMI group were higher than NSTE-ACS group on the third and seventh day. ② The levels of troponin T (TnT), creatine kinase-MB (CK-MB), solution intercellular adhesion molecule-1 (sICAM-1), global registry of acute coronary events (GRACE) scores and percutaneous coronary intervention (PCI) numbers in STEMI group were significantly higher than those in the NSTE-ACS group, which were as opposite as left ventricular ejection fraction (LVEF). However, there were no significant differences in levels of serum N-terminal pro-brain nitric peptide (NT-proBNP), Fibrinogen (Fib), readmission rate and incidence of MACE between STEMI and NSTE-ACS groups. ③ According to GRACE, patients with ACS were divided into low risk group (≤ 108 scores, 26 cases), intermediate risk group (109-140 scores, 61 cases) and highest group (> 140 scores, 83 cases). TnT and sICAM-1 in intermediate risk group were significantly increased as compared with low risk group. Levels of TnT, sICAM-1, C3, C4 and C5b-9 in the highest group were significantly higher than the low and intermediate risk groups, however the lowest LVEF was found in the highest group. ④ It was shown by Pearson correlation analyses that levels of serum C3, C4, C5b-9 were positively correlated with TnT (r value was 0.481, 0.367, 0.292, respectively, all P <0.01), sICAM-1 (r value was 0.298, 0.249, 0.365, respectively, all P < 0.01), but negatively correlated with LVEF (r value was -0.384, -0.260, -0.200, respectively, all P < 0.01). In addition sICAM-1 positively correlated with TnT (r = 0.536, P = 0.000), but negatively correlated with LVEF (r = -0.341, P = 0.001). Conclusions Serum complements activation was found in the acute phase of ACS patients. Serum complement C3, C4 and C5b-9 are involved in the process of myocardial injury, and may reflect severity of myocardial injury and cardiac dysfunction.

BACKGROUND:The obesity has led to a plenty of diseases including hypertension, coronary heart disease, fatty liver, hyperlipidemia, and type 2 diabetes. Therefore, understanding the mechanism of adipocyte differentiation is of far-reaching significance to the prevention and treatment of obesity. For the current studies of the mechanism of adipocyte differentiation pay more attention to microRNA, rather than long non-coding RNAs (lncRNAs). OBJECTIVE:To obtain the lncRNAs whose fold change was apparent during adipogenic differentiation, and to further screen the lncRNAs that possibly play a crucial role in adipogenic differentiation for verification. METHODS:Subcutaneous fat was obtained from human abdomen. Adipose-derived stem cells were col ected using tissue culture method. The third passage of adipose-derived stem cells was used for adipogenic differentiation. Through microarray technology, the expression levels of lncRNAs and mRNA were analyzed at 0, 5 and 12 days in adipogenic differentiation. Combining with bioinformatics report, lncRNAs apparently presented fold change were screened and verified by qRT-PCR. RESULTS AND CONCLUSION:Fold change 1.5 (P<0.05) was considered as a criterion during adipogenic differentiation. The number of up-regulated lncRNAs was 748 for 5 days versus 0 day, 847 for 12 days versus 0 days, 593 for 12 days versus 5 days. At the same time, the down-regulated number was 828 for 5 days versus 0 day, 1 113 for 12 days versus 0 day, 750 for 12 days versus 5 days during adipogenic differentiation. In combination with bioinformatics analysis results, 3 of 28 lncRNAs were related to lipid metabolism:AK304548, BP216319 and DA852857, according to the standard that fold change in 0, 5 and 12 days was higher, and the target genes were known to be associated with adipogenesis-related genes. PCR results showed that the expression of AK304548 and BP216319 and its target gene presented an up-down trend, which is consistent with the microarray sequencing results. These results indicated that lncRNA plays a critical regulatory role in the adipogenic differentiation.