OBJECTIVE:To observe the clinical efficacy and safety of sodium hyaluronate combined with glucosamine in the treatment of knee osteoarthritis. METHODS:1 220 patients with knee osteoarthritis were randomly divided into observation group and control group. The patients in control group were treated with Sodium hyaluronate injection alone,once a week;while the ob-servation group was additionally and orally treated with Glucosamine hydrochloride capsules two tablets,three times a day. The course of treatment was 5 weeks in both groups. The relevant physicotherapeutics and oral medication in the treatment of the dis-ease should be stopped. The clinic efficacy,visual analog scale(VAS)and lysholm knee score before and after treatment,and inci-dence of adverse reaction were observed. RESULTS:Total effective rate of observation group was significantly higher than control group,with statistically significant difference(P<0.05). After treatment,VAS and lysholm knee scores in both groups were signifi-cantly lower than before,and observation group was lower than control group,with significant differences(P<0.05). There were no severe adverse reactions during treatment. CONCLUSIONS:Sodium hyaluronate combined with glucosamine has more signifi-cant clinical efficacy in the treatment of knee osteoarthritis than sodium hyaluronate alone,with good safety.

OBJECTIVE:To explore the effects of levothyroxine on the follicular helper T lymphocyte level of patients with Hashimoto's thyroiditis. METHODS:51 patients with Hashimoto's thyroiditis were selected as levothyroxine group,and another 30 healthy people were control group. Levothyroxine group was orally given 25-50 ug Levothyroxine sodium tablet,once a day,the dose was adjusted based on thyroid function,and the dose maintained when thyroid function turned normal,for continuous 90 d. Free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)and the percentage of Th17 cells account-ed for peripheral blood CD4+ T cells(Th17/CD4+)in levothyroxine group before and after treatment were observed and compared with control group,the correlation of Th17/CD4+ and thyroid function. RESULTS:After treatment,Th17/CD4+ level in levothyrox-ine group were significantly lower than before and higher than control group,the differences were statistically significant(P<0.05). TSH in levothyroxine group were significantly lower than before,FT3 and FT4 were significantly higher than before,the differenc-es were statistically significant(P<0.05);compared with control group,the differences were not statistically significant(P>0.05). Th17/CD4+ showed positive correlation with thyroid function in levothyroxine group. CONCLUSIONS:Levothyroxine can signifi-cantly reduce the Th17/CD4+ and TSH,increase FT3 and FT4,and Th17/CD4+ is involved in the occurrence and progression of Hashimoto's thyroiditis.

AIM:To study the chemical constituents of leaves of Streblus asper Lour. METHODS:The constituents were isolated by column chromatography and their structures were elucidated through spectroscopic analysis. RESULTS:Seven compounds were isolated and identified as salicylic acid(1),?-sitosterol ( 2 ),?-daucosterol(3),oleanolic acid(4),magnolol(5),quercetin(6),taxifolin(7). CONCLUSION:The compounds are all obtained from the leaves of Streblus asper for the first time.

Objective To evaluate regenerative nerve and functional recovery of target muscle in rats with sciatic nerve defect bridged by acellular nerve allograft made through chemical extraction.Methods Sciatic nerve of SD rats was processed in a volume fraction of 3％ Triton X-lO0 solution and 40 g/L sodium deoxycholate solution.Morphology of myelin sheath,axons and basal lamina tubes of sciatic nerve segments was observed under the light microscopy before and after the chemical processing.Twenty-five Wistar rats were divided into acellular nerve allograft group (n =10),autograft group (n =10) and normal control group(n =5) according to the random number table.A 1 cm sciatic nerve defect was created in acellular nerve allograft group and autograft group,and was respectively bridged by acellular nerve allograft and autograft.Sciatic nerve function index (SFI) was measured every two weeks.Twelve weeks after surgery,nerve conduction velocity (NCV),recovery rate of compound muscle action potential (CMAP) and recovery rate of muscle force were measured in each group.Results Cellular components including myelin sheath and axons were removed thoroughly,but the basal lamina tubes were preserved completely.At postoperative 2,4,6,8,10 and 12 weeks,SFI in normal control group (-1.7±5.9,-0.3 ±2.5,0.8 ±4.1,-1.4±3.6,-2.5 ±5.7 and-2.1±3.2) was superior over autograft group (-94.3±3.7,-90.1±4.1,-63.7±7.8,-51.9±8.2,-48.8±8.6 and -44.3 ± 10.5) and acellular nerve allograft group (-97.1 ± 5.3,-91.2 ± 6.1,-70.6 ± 5.5,-60.4±6.2,-58.2 ±10.2 and-56.4 ±8.0) (P ＜0.01).At postoperative 6,8,10 and 12 weeks,SFI in autograft group were better than those in acellular nerve allograft group (P ＜0.05).NCV [(61.6 ± 8.1) m/s],recovery rate of CMAP[(98.7 ± 5.9) ％] and recovery rate of muscle force [(101.8 ± 6.6) ％] in normal control group were higher than those in acellular nerve allograft group [(22.3 ± 4.7) m/s,(40.3 ± 9.2) ％ and (43.8 ± 9.3) ％] and those in autograft group [(29.0 ±5.5) m/s,(52.5 ± 10.6) ％ and (54.3 ± 10.5) ％] (P ＜ 0.01).NCV,recovery rate of CMAP and recovery rate of muscle force in autograft group were better than those in acellular nerve allograft group (P ＜ 0.05).Conclusions Acellular nerve segments are harvested satisfactorily by chemical extraction.Sciatic nerve defect in rats can be cured with the acellular nerve allograft,but the repair effect of autograft is relatively better.

Objective To develop cadres' stress scale for the Chinese people' s armed police forces.Methods Based on the stress theory and principles of the psychometrics,combined with characteristics of armed police forces. The cadres' stress scale was developed by ourselves. 802 cadres were evaluated as samples and statistic the data by item analysis ,factor analysis, reliability and valid analysis. Results The scale included four dimensions: task stress, economy stress, interpersonal stress and development stress. The internal consistency reliability was 0.893 ,the split-half reliability coefficient was 0.812. Retest reliability coefficient was 0.813. The criterion related validity to the stress scale and SCL-90 was good and the correlation coefficient with somatization, anxiety,depression, interpersonal sensitivity was 0. 376,0. 383,0. 396,0. 387 individually (P ＜ 0.05 ). Conclusion Cadres stress scale for cadres of Chinese people's armed police forces has good reliability and validity.

Objective To study the effect of glutamine (Gln) on the intestinal mucosa inflammatory reaction and permeability after intestine ischemia-reperfusion injury in rats.Methods The rat model of intestinal ischemia-reperfusion injury was established by clamping the mesenteric superior artery and then restoring blood flow.Forty-eight model rats were divided into control group (n =24) and model + Gln group (n =24)according to the stochastic indicator method.Both groups were given enteral nutrition with equal energy and nitrogen [energy 125.4 kJ/ (kg · d) and nitrogen 0.2 g/ (kg · d)].The model +Gln group was fed with enteral nutrition plus 3％ Gln,while the control group was fed with enteral nutrition plus 3％ soybean protein.The experiment lasted 8 days after modeling.The intestinal mucosa and the plasma levels of nuclear factor-κB (NF-κB),tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),Gln,D-LACtic acid and diamine oxidase (DAO) were observed in rats before and after modeling and on the 3rb and 8rd day of the experiment.Changes in the morphology of intestinal mucosa were observed by electron microscopy.Results After modeling in control and model + Gln group,the level of NF-κB in intestinal mucosa [18 cases (75.0％) and 17 cases (70.8％)] were significantly higher than those before modeling [0 case (0.0％),P =0.013,P =0.019],the level of IL-6 in intestinal mucosa [(313.27±75.28) pg/g and (321.75±76.46) pg/g] were significantly higher than those before modeling [(227.52 ±58.13) pg/g,P =0.023,P =0.043],and the level of TNF-α in intestinal mucosa [(241.28 ±65.29) pg/g and (240.35 ±64.86) pg/g] were significantly higher than those before modeling [(172.45 ±33.76) pg/g,P=0.036,P=0.011].The plasma level of IL-6 [(150.32 ± 18.74) ng/L and (148.21 ±20.19) ng/L] were significantly higher than those before modeling [(116.37 ± 14.59) ng/L,P =0.032,P =0.025],the plasma level of TNF-α [(127.62 ± 14.24) ng/Land (123.86 ± 13.75) ng/L] were significantly higher than those before modeling [(85.18 ± 8.84) ng/L,P =0.018,P =0.035],and the plasma level of D-LAC [(0.46 ±0.03) mmol/L and (0.51 ±0.04) mmol/L]were significantly higher than those before modeling [(0.27 ±0.02) mmol/L,P =0.041,P =0.018],and the plasma level ofDAO [(2.76±0.57) U/ml and (2.58 ±0.51) U/ml] were significantly higher than those before modeling [(1.52±0.24) U/ml,P=0.015,P=0.037],while the plasma level of Gln [(0.18 ±0.01) g/L and (0.21 ± 0.01) g/L] were significantly lower than those before modeling [(0.39 ± 0.03) g/L,P =0.026,P =0.031].On the 3rd and 8th days of the experiment in the control group,the level of NF-κB in intestinal mucosa [16 cases (66.7％),15 cases (62.5％)] were significantly higher than those before modeling (P =0.027,P =0.002),the level of TNF-α in intestinal mucosa [(226.23 ±55.35) pg/g and (214.76 ±54.82) pg/g] were significantly higher than those before modeling (P=0.042,P =0.038)],the level of IL-6in intestinal mucosa [(297.56 ± 71.39) pg/g and (291.49 ± 68.46) pg/g] were significantly higher than those before modeling (P =0.031,P =0.012).On the 3rd and 8th days in the control group,the plasma level of IL-6[(147.38 ± 17.25) ng/L and (144.65 ± 15.32) ng/L] were significantly higher than those before modeling (P =0.016,P =0.034),the plasma level of TNF-α [(121.75 ± 13.72) ng/L and (113.83 ± 11.69) ng/L] were significantly higher than those before modeling (P =0.025,P =0.041),the plasma level of D-LAC [(0.41 ±0.03) mmol/L and (0.53 ±0.05) mmol/L)] were significantly higher than those before modeling (P =0.029,P =0.030),the plasma level of DAO [(2.51 ± 0.52) U/ml and (1.76 ± 0.34) U/ml] were significantly higher than those before modeling (P =0.034,P =0.016).The plasma level of Gln [(0.22 ±0.01) g/L and (0.21 ±0.03) g/L] were significantly lower than those before modeling (P =0.042,P =0.035).On the 3rd day of the experiment in the model + Gln group,the levels of NF-κB,TNF-α,and IL-6 in intestinal mucosa [14 cases (58.3％),(213.78 ±43.76) pg/g,(293.72 ±69.86) pg/g] were significantly higher than those before modeling (P =0.038,P =0.026,P =0.013) ; the plasma level of IL-6,TNF-α,D-LAC,and DAO [(135.61 ±14.25) ng/L,(117.35 ±11.29) ng/L,(0.45 ±0.03) mmol/L,and (2.26 ± 0.43) U/ml] were significantly higher than those before modeling (P =0.021,P =0.032,P =0.032,P =0.025).On the 8th day of the experiment in the model + Gln group,the levels of NF-κB,TNF-α,and IL-6 in intestinal mucosa [9 cases (37.5％),(184.53 ± 42.16) pg/g,and (236.83 ±66.52) pg/g] were significantly lower than those after modeling and those in the control group (P =0.024,P=0.027; P=0.026,P=0.039; P=0.013,P=0.028) ; the plasma levels of IL-6,TNF-α,D-LAC,and DAO [(126.35±12.74) ng/L,(92.76±9.42) ng/L,(0.31 ±0.02) mmol/L,and (1.76±0.34) U/ml]were significantly lower than those after modeling and those in the control group (P =0.021,P =0.030; P =0.032,P =0.025 ; P =0.024,P =0.037 ; P =0.022,P =0.036) ; the plasma level of Gln [(0.40 ±0.03) g/L] was significantly higher than those after modeling and in the control group (P =0.028,P =0.032).Under the electron microscope,the structure of villus and recess was damaged after modeling,villi were sparse and short,with a lot of inflammatory cell infiltration in the lamina propria.Lymphangiectasia and edema occured after modeling.On the 8th day,compared with after modeling and the control group,intestinal villi and recess structure were significantly restored in the model + Gln group; compared with the after-modeling status,the recovery of intestinal mucosa villi and recess structure was not obvious,and the inflammatory cell infiltration in the lamina propria persisted in the control group.Conclusion Gln repairs ischemia-reperfusion injury in the intestinal mucosa by regulating intestinal mucosa inflammatory cytokine release,inhibitng inflammatory response,and reducing the permeability of the intestinal mucosa.

Objective To investigate the necessity of adding epinephrine to submucosal injection during endoscopic submucosal dissection(ESD).Methods Patients with early cancer and precancerous lesions of digestive system were prospectively enrolled and underwent ESD when the lesion was 2 cm or more in diameter from December 2013 to January 2014.Patients were randomly divided into two groups,the experimental group(n =54)used saline and indigo carmine for submucosal injection,while the control group(n =47) used a mixed solution including saline,indigo carmine and epinephrine for submucosal injection.Several procedure-related indices and delayed complications were compared between groups.Results All the tumors in both groups were removed en bloc,and all resected lesions showed both lateral and deep tumor-free margins.The mean operation time was 39.4 ±22.0 min in the experimental group,and 41.5 ± 18.7 in the control group.There were no statistical differences between two groups in the en bloc resection rate,complete resection rate,and mean operation time (all P ＞ 0.05).There were no intraoperative or delayed perforations in either group.In the experimental group,mild intraoperative bleeding occurred in 39 cases and moderate in 15 cases.In the control group,mild intraoperative bleeding occurred in 34 cases,moderate in 12 cases,and severe in 1 case.Delayed bleeding occurred in 1 case 3 days after ESD in the experimental group,while none happened in the control group.There were no statistical differences between two groups in intraoperative bleeding or delayed bleeding(P ＞ 0.05).Conclusion The therapeutic effect and complication rate are comparable regardless of addition of epinephrine to submucosal injection during ESD.

Objective To compare the effectiveness of hyperbaric oxygen (HBO) therapy and normal pressure oxygen inhalation for lung infection in patients with severe brain injury and tracheotomy.Methods Sixty lung infection patients with severe brain injury and tracheotomy were stratified by age and Glasgow coma scale (GCS) score into an HBO group (30) and a conventional therapy group (30).Both groups were given treatments to reduce intracranial hypertension and protect the brain,surgery,antibiotics,and symptomatic and support therapy.In the conventional group the patients received oxygen therapy at normal oxygen pressure by tracheal cannula.In the HBO group,the patients received HBO therapy through self-made oxygen devices by the authors.The body temperature,cough and expectoration,respiratory sounds and white blood cell (WBC) count were compared between the groups.Results There were statistically significant differences in body temperature,cough and expectoration,respiratory sounds and the normalized time for the count and classification of WBC between the groups.Conclusion HBO had good treatment effectiveness for excretion and expectorant in lung infection patients with severe brain injury and tracheotomy.

Objective This paper aims to find a best position of ephedrine hydrochloride nasal drops by comparing earache occurred in hyperbaric oxygen(HBO )therapy while using ephedrine hydrochloride nasal drops in two positions: laying in lateral position of 45°with head leaning back; laying down flat, so as to supply reference for prevention of earache. Methods We selected 300 cases of HBO patients who were firstly treated by HBO and randomly divided into the observation group and the control group with 150 cases in each group. All these patients were treated by large medical hyperbaric oxygen tank. On the first to third day, ephedrine hydrochloride nasal drops were put into the patients before they were sent into the oxygen tank. Patients in the observation group lay in lateral position of 45°with their head leaning back, and those in the control group were in horizontal position. We put three drops of 1% of ephedrine hydrochloride nasal drops respectively into their nasal cavity. When they came out of the oxygen tank, we asked them if they felt earache and checked their tympanic membrane so as to make a comparison. Results It was found that earache, rate of tympanic membrane injury and the extent of such injury in the observation group was obviously less than that in the control group, there was difference in statistics between these two groups. Conclusions Before HBO treatment, ephedrine hydrochloride nasal drops that put in lateral position of 45°with patients head leaning back can reduce the possibilities of earache occurred in HBO. It was also observed that such position was an ideal one which had anatomical characteristics of Eustachian tube and was safer than laying down flat, so such position is more practical.

Objective To investigate the relationship between impaired fracture healing and the expression of peroxisome proliferator activated-receptor gamma (PPARγ) and core binding factor alpha 1 (Cbfα1) mRNA in the bone marrow of Type 2 diabetic rats.Methods Thirty male Sprague-Dawley rats were divided into a control group (n=15, normal diet) and an experiment group (n=20, high fat and sucrosum diet). After 8 weeks, one eyeball was culled for blood collection. The experiment group was intraperitoneally injected with streptozotocin and the control group received citrate buffer. After another 2 weeks, the other eyeball was culled again to collect blood. The model of distraction osteogenesis in the left tibias of the rats was established. After 14 days, we sacrificed all the rats and collected the blood and left tibias. Both femurs were harvested with germ free. We observed the callus formation in the distraction gap by X-ray and the formation of primary matrix front and microcolumn by histological examination. We observed adipocytes in adjacent bone marrow of left tibia and computed the percentage of adipocytes accounting for the area of bone cavity. We measured the expression of PPARγ and Cbfα1 mRNA in femurs marrow by RT-PCR.Results In the experimental rats, the level of triglyceride was obviously elevated (P＜0.01), so was the total cholesterol (P＜0.05), while the level of fasting blood glucose and serum insulin did not obviously differ (P＞0.05) after 8 weeks. The level of fasting blood glucose and triglyceride was obviously elevated (P＜0.01), and so was the total cholesterol (P＜0.05), while the level of serum insulin was not obviously different in the experiment group after 10 and 12 weeks. Callus formation in the distraction gap was obviously diminished by X-ray in the experimental rats. The array of microcolumn formation was disordered and the area of primary matrix front was catachromasis in the controls by histology examination. The number of adipocytes in both the bone marrow and the percentage of adipocyte accounting for the area of bone cavity increased (P＜0.01) in the experiment group. In the experiment group, the expression of PPARγ mRNA was up-regulated (P＜0.05) while Cbfα1 mRNA was down-regulated (P＜0.05) in double femur marrow. Conclusion Increased expression of PPARγ mRNA and decreased expression of Cbfα1 mRNA in the bone marrow may cause impaired fracture healing in rats with Type 2 diabetes.