OBJECTIVE:To observe clinical efficacy and safety of intraarticular injection of betamethasone and hyaluronate in the treatment of elderly knee osteoarthritis. METHODS:A total of 76 elderly patients with knee osteoarthritis were selected from our hospital during Jul. 2012 to Jul. 2015,and then divided into control group and observation group according to random number table,with 38 cases in each group. Control group was given intraarticular injection of Sodium hyaluronate injection 2 mL,once a week,for consecutive 3 weeks. Observation group was given Compound betamethasone injection 1 mL in the first week,and given sodium hyaluronate 2 mL,every week,in the following 2 weeks. Clinical efficacies and the occurrence of ADR as well as VAS score,WOMAC score,GQOLI-74 score and MMP levels before and after treatment were compared between 2 groups. RESULTS:Total response rate of observation group was 92.11％,which was significantly higher than 73.68％ of control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in VAS score,WOMAC score,GQOLI-74 score, MMP-1 level or MMP-3 level between 2 groups(P>0.05). After treatment,VAS,joint stiffness,joint pain and daily activity re-striction score as well as MMP-1,MMP-3 were decreased significantly in 2 groups,compared to before treatment;physical pain, physiological function,physiological limitations,vitality,social function,emotional function,mental health and GQOLI-74 total score were increased significantly,and the each index of observation group was significantly better than that of control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:The intraarticular in-jection of betamethasone and sodium hyaluronate in the treatment of elderly knee osteoarthritis can effectively reduce pain degree, improve knee function and quality of life,have good therapeutic efficacy and safety,the mechanism of which may be associated with the reduction of MMP level.

Recent important applications of inductively coupled plasma mass spectrometry in biological samples analysis are reviewed.The sample preparation,sample introduction techniques,interference correction and typical applications are introduced in detail with 154 references.

Objective To study the effects of TNF -?and sTNFRⅠon IL -8production and proliferatio n of psoriatic keratinocytes.Methods In vitro cultured keratinocytes were treated with TNF -?,sTNFRⅠand an-ti -TNFRⅠ.IL -8levels in supernatants were me asured by enzyme-linked immunosobent assay.Expression of IL -8mRNA in keratinocytes was observed by semiquantitive RT -PCR and Southern blotting.Proliferation index wa s measured by MTT colorimetry.Results IL -8levels,mRNA expression and pro liferation index were significantl y higher in psoriatic patients than th ose in control group(P

Purpose To establish a new method for detecting p16INK4a in cervical tissues with time-resolved fluoroimmunoassay (TRFIA).Methods 126 cases of paraffin imbedding tissues of cervix were selected for immunohistochemistry (IHC) of EnVision two-step and TRFIA.Results There were 20 cases of no intraepithelial lesion or malignancy,24 cases of low-grade squamous intraepithelial lesion (LSIL),53 cases of high-grade squamous intraepithelial lesion (HSIL) and 29 cases of squamous cell carcinoma (SCC).In the groups of no intraepithelial lesion or malignancy,LSIL,HSIL and SCC,p161NK4a positive was seen in 1,19,53 and 28,respectively.TRFIA test results displayed p16INK4a positive in 3,17,50 and 27 cases,respectively.Positive of p16 using by TRFIA in no intraepithelial lesion or malignancy,LSIL,above HSIL was 15.00％,70.83％ and 93.90％,respectively (P ＜ 0.01).Conclusion TRFIA is suitable for detecting of p16INK4a protein and demand low detection equipment,p16INK4a expression detected by TRFIA may helpful for large scale detection in various clinical institution.

Objective To explore the value of modified early warning score (MEWS) in clinical status assessment and outcome prediction of heat stroke patients.Methods The clinical data of 46 heat stroke patients were collected.According to the severity,the subjects were divided into mild group and severe group;and alternatively,according to the treatment outcomes,the subjects were also divided into survival group and death group.The MEWS at admission was employed for comparison of the differences in severity and outcome of heat stroke between groups.Receiver operating characteristic curve (ROC curve) was used to evaluate the accuracy of MEWS used at admission in assessing severity and predicting outcome of heat stroke patients.Results The results of MEWS calculated at admission in mild and severe heat stroke patients showed significant difference between them (3.00 ± 1.70 vs.6.85 ± 3.03,P =0.004).The area under the ROC curve (AUC) of MEWS got at admission for the diagnosis of severe heat stroke was 0.864 ± 0.056.The results of MEWS obtained at admission in survived and died heat stroke patients were 5.13 ± 2.96 and 9.25 ± 2.05,respectively (P =0.037).The AUC of MEWS used at admission for predicting the death of heat stroke patients was 0.867 ± 0.061.Conclusions The initial MEWS is useful to accurately assess and predict the outcome of heat stroke patients.Heat stroke patients with higher level of MEWS used at admission than 4.5 could be diagnosed as severe heat stroke,and whereas the value of MEWS got at admission higher than 7.5 could be the indicator of the poor prognosis.

Objective To study the protective mechanism of dl-3-n butylphthalide (NBP)on oxidative stress injury induced by hydrogen peroxide(H2O2)in rat bone marrow stem cells(rBMSCs).Methods The rBMSCs were divided into control,H2O2 and different concentration NBP pretreatment groups.The control group received no treatment.An oxidative stress injury model was induced by H2O2 for 4 hours with the final concentration 600 μmol/L in the H2O2 group.In the NBP pretreatment groups,the rBMSCs were pretreated with different NBP concentrations(0.1,1,10,and 100 μmol/L)for 24 hours,then treated with H2O2 for 4 hours with the final concentration 600 μmol/L.The cell viability was detected by MTT method.The apoptosis rate was detected by flow cytometry.Superoxide dismutase(SOD)activity and malondialdehyde(MDA)content were measured with SOD and MDA commercial kits.Results The cell activity(A)was 0.487 ±0.018 in the H2O2 group,and it was significantly lower than 0.750 ±0.016 in the control group(P =0.000);they were 0.597 ±0.024,0.666 ±0.033,and 0.658 ±0.012 in the NBP 1,10,and 100 μmol/L pretreatment groups,they were all significantly higher than the H2O2 group(all P =0.000),and showed a dose dependent manner.The apoptosis rate was(44.96 ± 2.84)% in the H2O2 group,and it was significantly higher than (0.15 ±0.07)% in the control group(P= 0.000).The apoptosis rates were(31.79±1.60)% 、(21.41 ± 1.92)% and(22.59 ± 1.78)% in the NBP 1,10,and 100 μmol/L pretreatment groups,they were all significantly lower than the H2O2 groups(all P= 0.000),and showed a dose-dependent manner.The SOD activity was(24.01 ± 2.85)U/mg in the H2O2 group(P = 0.000),and it was significantly lower than(43.58 ± 2.72)U/mg in the control group(P =0.000);they were(28.29 ± 1.19),(34.06 ± 1.83),and(31.76 ± 1.75)U/mg in the NBP 1,10,and 100 μmol/L pretreatment groups,and they were all significantly higher than the H2O2 group(all P = 0.000).The MDA content was(7.98 ± 0.55)nmol/mg in the H2O2 group,and it was significantly higher than(4.73 ± 0.53)nmol/mg in the control group(P =0.000);they were(6.97 ±0.29),6.09 ±0.28),and(6.15 ±0.41)nmol/mg,respectively in the NBP 1,10,and 100 μmol/L pretreatment groups(P = 0.000),they were significantly lower than the H2O2 group,and showed a dose-dependent manner.Conclusions NBP has obvious protective effects on oxidative stress injury induced by H2O2 in rBMSCs.Its mechanism may be associated with the role of antioxidant oxidative stress of NBP.

Objective To summarize our experience in robotic-assisted laparoscopic surgery for adrenal diseases Methods The clinical data of 243 patients with adrenal tumor treated by robotic-assisted laparoscopic surgery from March 2010 to February 2017 were retrospectively reviewed.There were 99 men and 144 women.The mean age was 51.6 years (range, 19-84).Tumors located at left adrenal in 140 cases, right in 97 cases,and both sides in 6 cases.The average diameter was 3.32 cm (range, 0.8-12 cm).However, there were 41 cases whose tumor diameter were greater than 5 cm.Results There were 2 cases of conversion during operation, 1 case converted to open surgery and the other to the traditional laparoscope surgery.The mean operative time was 35 min (range, 20-130 min).Estimated blood loss was 80 ml (range,20-1 200 ml).Blood transfusion was needed in 6 cases.The mean postoperative hospital stay was 5d (range, 3-20 d).The pathological diagnosis included 37 cases of pheochromocytoma, 149 cases of cortical adenoma, 3 cases of cortical carcinoma, 5 cases of metastatic tumor, 9 cases of adrenal myelolipoma, 3 cases of adrenal cyst, 2 cases of bronchogenic cyst, 25 cases of adrenal nodular hyperplasia,2 cases of angiomyolipomas, 1 case of mature teratoma, 1 case of diffuse large B-Cell lymphoma, 1 case of angioma, and 4 cases of neurofibromatosis.Conclusions Robotic-assisted laparoscopic adrenalectomy was safe and effective.Robotic-assisted laparoscopic surgery has the advantages over laparoscopic surgery in treatment of complicated adrenal tumor, such as large adrenal tumors, pheochromocytoma, bilateral adrenal diseases, overweight and obese patients with adrenal diseases.

Objective To explore the clinical efficacy and safety of off-clamping in robotic-assisted partial nephrectomy (RAPN) for the treatment of renal tumors.Methods From January 2015 to March 2017,the data of 48 patients who underwent off-clamping RAPN were reviewed retrospectively.There were 31 males and 17 females,and the mean age was 57 years (range:23-84 years).The mean tumor size was 3.1 cm (range:1.2-6.4 cm),with the upper,middle,and lower polar tumors account for 35.4％,27.1％,and 37.5％,respectively.The clinical tumor stage was T1N0M0 in all 48 cases,according to the AJCC tumor staging system for renal cancer.Results RAPNs were performed successfully in all 48 cases,without conversion to open surgery.In those patients,the application of off-clamping in robotic-assisted partial nephrectomy was performed in 44 cases.The renal artery and vein was exposed,dissected,isolated and then clamped in 4 cases due to bleeding.The mean surgical time was 85 min (range:75-185 min).The mean estimated blood loss was 134 ml (range:60-270 ml),and no blood transfusion was needed.The wound surface was closed using interrupted suture with Hem-o-lok clips securing each needle point.The mean time for renorrhaphy was 22 min (rang:11-31 min).No intraoperative severe complications such as vascular injury,trauma of abdominal organ occurred.There were 5 complications,including 2 cases of hematuria,2 cases of delayed healing of incision,and 1 case of pneumohypoderma.The pathological diagnosis included 40 cases of renal clear cell carcinoma,3 cases of papillary renal cell carcinoma,and 5 cases of angiomyolipomas.No tumor recurrence or distant metastasis was observed during the average follow-up of 17 months (range 3-27 months).Conclusions Off-clamping RAPN is safe and feasible approach to excise certain kidney tumors.It carries the benefits of less complication,quick recovery,and less ischemia reperfusion renal injury.Off-clamping RAPN would be suitable for those patients with solitary kidneys,renal insufficiency,and bilateral tumors.

Objective:To investigate the regulatory effect of long non-coding RNA (lncRNA) FTX on gastric cancer cell proliferation through miR-22-3p/NOD-like receptor protein 3 (NLRP3) inflammasome pathway.Methods:The gastric cancer cell line NCI-N87 were divided into blank control group, si-FTX-NC group, si-FTX group, si-FTX+miR-22-3p inhibitor-NC group and si-FTX+miR-22-3p inhibitor group. Quantitative real-time fluorescent PCR was performed to analyze the expression levels of lncRNA FTX and miR-22-3p, clone formation assay was performed to analyze the proliferation ability of NCI-N87 cells, western blotting was performed to analyze the expressions of NLRP3 inflammasome pathway proteins, and dual-luciferase reporter assay was performed to analyze the targeting relationship between lncRNA FTX and miR-22-3p.Results:The relative expressions of lncRNA FTX in the blank control group, si-FTX-NC group, si-FTX group, si-FTX+miR-22-3p inhibitor-NC group and si-FTX+miR-22-3p inhibitor group were 1.03±0.09, 1.01±0.15, 0.42±0.08, 0.45±0.06 and 0.46±0.13 respectively, with a statistically significant difference ( F=52.19, P<0.001). The relative expressions of miR-22-3p were 1.04±0.12, 0.97±0.08, 2.26±0.15, 2.23±0.13 and 1.15±0.11 respectively, with a statistically significant difference ( F=178.53, P<0.001). Compared with the blank control group and si-FTX-NC group, the relative expressions of lncRNA FTX in the si-FTX group, si-FTX+miR-22-3p inhibitor-NC group and si-FTX+miR-22-3p inhibitor group decreased (all P<0.001). Compared with the blank control group, si-FTX-NC group and si-FTX+miR-22-3p inhibitor group, the relative expressions of miR-22-3p in the si-FTX group and si-FTX+miR-22-3p inhibitor-NC group increased (all P<0.001). The clones of the five groups were 115.50±7.25, 112.33±8.46, 54.83±5.17, 56.17±6.32 and 85.67±9.43, with a statistically significant difference ( F=91.67, P<0.001). The levels of NLRP3 protein in the five groups were 1.84±0.17, 1.86±0.12, 0.95±0.09, 0.97±0.11 and 1.28±0.19, with a statistically significant difference ( F=60.62, P<0.001). Compared with the blank control group and si-FTX-NC group, the number of clones and the level of NLRP3 protein of the si-FTX group, si-FTX+miR-22-3p inhibitor-NC group and si-FTX+miR-22-3p inhibitor group decreased (all P<0.05). Compared with the si-FTX+miR-22-3p inhibitor group, the number of clones and the level of NLRP3 protein in the si-FTX group and si-FTX+miR-22-3p inhibitor-NC group decreased (all P<0.05). The dual-luciferase reporter assay found that miR-22-3p was the target gene of lncRNA FTX. Conclusion:Silencing the expression of lncRNA FTX can inhibit the proliferation of gastric cancer cells, and the mechanism may be related to the regulation of lncRNA FTX on the miR-22-3p/NLRP3 inflammasome pathway.