Objective To explore the mechanism of therapeutic action of needle knife “regulating sinews and treating bones” on knee osteoarthritis (KOA) by observing the effect of needle knife intervention on KOA rabbit behaviors, mechanical characteristics of patellar ligament (PL), and expressions of interleukin-4 (IL-4), matrix metalloproteinase-3 (MMP-3) and aggrecan in knee cartilages.Methods Forty New Zealand rabbits were randomly allocated to blank, model, needle knife and electroacupuncture groups, 10 rabbits each. A rabbit model of KOA was made by the modified Videman method of immobilization in extension position. After model making, the needle knife and electroacupuncture groups received needle knife and electroacupuncture treatments, respectively. A behavioral assessment was made using the modified Lequesne MG knee grade evaluation method in every group after model making and treatment. The samples were taken after treatment. PL tension, stress relaxation and creep state were tested using a Bose Electro Force 3300 protracted test machine. Cartilage cell IL-4 expression was examined by ELISA. MMP-3 mRNA and aggrecan mRNA expressions were detected by real-time PCR.Results After model making, there was a statistically significant difference in the Lequesne MG score between the model and blank groups (P<0.01); there was no statistically significant difference in the Lequesne MG score between the needle knife or electroacupuncture group and the model group (P>0.05). There was a statistically significant post-treatment difference in the Lequesne MG score between the needle knife or electroacupuncture group and the model group (P<0.01,P<0.05) and between the needle knife and electroacupuncture groups (P<0.05). There were statistically significant post-treatment differences in PL maximum stress, maximum displacement, elastic modulus, stress relaxation rate and creep rate between the model and blank groups (P<0.01,P<0.05). There were statistically significant post-treatment post-treatment differences in PL maximum stress, maximum displacement, elastic modulus, stress relaxation rate and creep rate between the needle knife and model groups (P<0.01,P<0.05). There was a statistically significant post-treatment difference in elastic modulus between the electroacupuncture and model groups (P<0.01). The IL-4 content and aggrecan mRNA expression decreased significantly and MMP-3 mRNA expression increased significantly in the model group after model making and there were statistically significant differences compared with the blank group (P<0.01,P<0.05). After treatment, the IL-4 content increased significantly in the needle knife and electroacupuncture groups compared with the model group (P<0.01,P<0.05) and aggrecan mRNA expression tended to increase in the two groups. The regulation of aggrecan mRNA and MMP-3 mRNA expressions was better in the needle knife group than in the electroacupuncture groups, but there was no statistically significant difference compared with the model group (P>0.05).Conclusion The mechanism of action of needle knife treatment on KOA may be that it improves ligament mechanical characteristics, regulates intra-articular stress environment, and modulates aggrecan mRNA and MMP-3 mRNA expressions and inhibits cartilage degeneration through IL-4 mechanical signal pathway, to produce the therapeutic effect of “regulating sinews and treating bones”.

Objective To analyze the relevance between the point-of-care testing (POCT) and routine test in BNP testing .Meth-ods The whole blood samples or plasma samples from 40 inpatients were detected brain natriuretic peptide (BNP) by the Alere Triage? MeterPro fluorescence immunoassay analyzer (POCT ) or the Beckman Coulter Access ?2 chemiluminescence analyzer (routine test) ,respectively .The acquired data were subjected to comparative analysis according to the CLCS EP 9-A2 .Results The linear regression of the BNP content in the blood samples detected by POCT and the routine test was good ,the correlation coeffi-cient(r) was 0 .999 7 .Conclusion POCT and the routine test have good correlation in BNP testing .POCT for BNP testing has higher reliability and is applicable for clinical detection .

Objective To observe the incidence rate of anaemia and analyze the nutritional situation in the elderly population.Methods From April to August 2010,a total of 2052 elderly persons from out-department of Tianjin First Center Hospital were divided into four age groups:65-69years group (n=528),70-74 years group (n=593),75-79 years group (n=423) and 80 years and over group (n= 508).The body mass index (BMI),haemoglobin (Hb),mean corpuscular volume (MCV),triglyceride (TG),creatinine (Cr),serum albumin (ALB) and ferritin (Fer) were tested and evaluated using K-W test.Results (1) Anaemia was found in 90 subjects (4.4 %),4.0% in men and 6.l% in women,9.5% in 80 years and over group.The subjects with Hb level less than 90g/L were all 80 years and over.(2)There were significant differences among the groups in BMI,TG,Cr,ALB,Hb,MCV and Fer levels (all P＜0.01).There were significant differences among four groups in Hb and ALB levels (P＜0.01 ),and partially differences in TG, Cr and MCV levels (P＜0.05).(3)The Hb level was significantly correlated with TG, ALB, Fer and MCV levels (r=0.115,0.211, 0.114 and 0.089, all P＜0.01 ) from Pearson analysis.Conclusions Anemia incidence in elderly population is increased along with aging and is higher in women than in men, especially higher in 80 years and over group.Nutritional situation gets worse with aging.

Objective To compare the clinical efficacy and safety of transurethral plasmakinetic resection of prostate (PKRP) and transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH). Methods Two groups of BPH patients (78 patients in each group) were treated by PKRP and TURP,respectively. The clinical efficacy and safety indices were reviewed and compared for both intra- and inter-groups. Results In PKRP group,the operative time,intraoperative bleeding, the rates of postoperative temporary urinary incontinence (within 2 months) ,secondary hemorrhage (within 4 weeks),and urethral stricture (within 3 months) were ( 64?21) min, ( 247?84) ml, 26. 9% ( 21/78 ) , 1. 3% ( 1/78 ) and 2.6% (2/78) ,respectively; while in TURP group, these parameters were (78?18) min, (432?132) ml, 48.7% (38/78) , 10. 3% (8/78) and 12. 8% ( 10/78 ), respectively; there were significant differences between the 2 groups (P 0. 05). Conclusions PKRP and TURP have similar efficacy in the treatment of BPH,but PKRP is safer than TURP. Thus,PKRP is a better treatment option for BPH.

Objective:To compare the clinical effects of restrictive blood transfusion combined with hyperbaric oxygen preconditioning (HBOPC) and restrictive blood transfusion in the treatment of hip,knee arthroplasty (THA,THA).Methods:40 patients in the period of epidural anesthesia,femoral nerve hysteresis hip and knee arthroplasty were selected and randomly divided into two groups:restrictive transfusion group (maintain 80 g/L≤ Hb ＜100 g/L,n=20) and restrictive blood transfusion combined with HBOPC (HBOPC+maintain 80 g/L =Hb ＜100 g/L,n=20).The red blood cell transfusion,red blood cell transfusion rate,perioperative Hb,blood oxygen saturation (SO2),the incidence of hypotension during operation,hospitalization time and postoperative cerebral infarction,acute pulmonary embolism,pneumonia,myocardial infarction,wound infection rate and 90 days mortality rate were compared between two groups.Results:Compared with the restrictive transfusion group,the postoperative Hb,blood oxygen saturation (SO2) of restrictive blood transfusion combined with HBOPC group were significantly increased(P ＜ 0.05);the red blood cell transfusion,red blood cell transfusion rate,incidence of pneumonia,wound infection rate were significantly decreased (P＜0.05).Conclusion:Restrictive blood transfusion combined with hyperbaric oxygen preconditioning could improve the anoxic state of the hip,knee arthroplasty patients,which could effectively reduce red blood cell transfusion,reduce postoperative complications,has good clinical curative effect.

Objective To investigate the changes in Wnt/β-catenin,bone morphogenic protein (BMP),estrogen receptor (ER) and insulin-like growth factor (IGF) signaling pathways in bone marrow mesenchymal stem cells (BMSCs) differentiation to the osteoblasts after spinal cord injury (SCI) and understand the mechanism of osteoporosis after SCI.Methods Forty 6-week-old male rats were divided into SCI group (n =20) and control group (n =20) according to the random number table.Rats in SCI group were submitted to laminar osteotomy at T10-12 and given lower thoracic cord sharp transection.In control group,rat lower thoracic cord was only exposed without transaction.Femoral bone marrow density (BMD) of rat right side was determined at postoperative 3 months.Femoral bone marrow was harvested from rat left side.After BMSCs osteoblast differentiation,cells were harvested and used for examining expression of genes associated with the signaling pathways in the two groups using microarray technology and real-time PCR analysis.Results BMD in SCI group was significantly lower in the ephiphyses and metaphyses[(0.176 ± 0.017)g/cm2 and (0.170 ±0.016)g/cm2] compared to that in control group [(0.257 ± 0.023) g/cm2 and (0.196 ± 0.013) g/cm2,P ＜0.05].Microarray and PCR analysis revealed Wnt/β-catenin (eg.Wnt1,Wnt3a,Wnt5a,Lrp5,Ctnnb1,Lef1 and Axin),BMP (Tgfb1 and Bmpr1),IGF -1 (eg.IGF1 R,c-fos and c-Jun),and ER (eg.Esr1) signaling pathways in osteoblasts were significantly down-regulated in SCI group compared to these in control group (P ＜ 0.05).Conclusions The Wnt/β-catenin,BMP,ER,and IGF-1 signaling pathways in osteoblasts are significantly down-regulated after SCI,resulting in profound BMD loss.This indicates that these signaling pathways are implicated in the osteoporosis after SCI.

AIM:To study the effect of gossypol on the cognitive function of type 2 diabetic rats,and to explore its mechanism. METHODS:Thirty male Sprague-Dawley rats were divided into three groups randomly:normal group,type 2 diabetic group and gossypol treated group. After fed with high-fat diet for 4 weeks,the later two groups were injected with streptozotocin intraperitoneally to establish type 2 diabetic rat model. The animals in gossypol treated group were given gossypol at dosage of 15 mg/kg once per day for 4 weeks by gavage. Since 5th week,the times of gavages were changed into once per week at the same dosage and lasted to 12th week. Learning and memory abilities of rats were assayed with Morris water maze test. The concentration of blood glucose was measured by biochemical method. The levels of serum corticosterone and insulin were detected by enzyme-linked immunosorbent assay and radioimmunoassay,respectively. The protein expressions of 11?-HSD1 and GR in cerebral cortex and hippocampus were determined by Western blotting. The morphological changes of cerebral cortex and hippocampus were observed under light microscope and transmission electronic microscope,respectively. RESULTS:Compared to normal group,the karyopyknosis,dilation of golgiosome and mitochondria swelling of neuron from cerebral cortex and hippocampus were prominent in diabetic group. The concentrations of blood glucose,serum corticosterone and insulin increased significantly (P

Objective To explore the changes of mTOR signaling in LPS/D-gal-induced acute hepatitis in mice . Methods Twenty-six healthy adult female ICR mice were divided into two groups:the control group and experimental group, 13 mice in each group .LPS/D-gal was used to induce acute hepatitis in the mice .The survival of mice was moni-tored within 24 hours after LPS/D-gal challenge .At 6 hours after challenge , samples of serum and liver tissue were collect-ed for further analysis.Results Injection of LPS/D-gal resulted in acute death of the mice within 24 hours.At 6 hours post LPS/D-gal injection , the blood levels of ALT and AST were significantly increased .The mRNA expression of inflammatory cytokines Tnfa and Il6 was up-regulated in LPS/D-gal-induced hapatitis , in which DNA fragmentation and activation of caspase-3 were subsequently observed .Immunoblot analysis showed that both mTOR pathway and NF-κB pathway were ac-tivated.Unexpectedly , inhibition of mTOR signaling could neither decrease the apoptosis in the liver nor increase the sur -vival of mice .Conclusions The results of the present study indicate that mTOR signaling may play pleiotropic roles in the pathogenesis of LPS/D-gal-induced hepatitis .

Objective To understand the ethics conflict situations between the pre-hospital patients and ambulance staff's determinations. Methods Taking a survey among the pre-hospital emergency physicians(80 people)and nurses(248 people)by Questionnaire of ethics conflicts during pre-hospital emergeney service,to investigate the ethics conflict situations between the pre-hospital patients and ambulance staff's determinations. Resulls (8.046±6.990)%of the patients who needed treatments refused to be treated completely,and(14.544±10.558)%of them refused partially.(14.451±14.747)% of the patients who needed ambulance transport refused to be delivered.In the patients who refused treatments and transportation.payment problem accounted for(23.52±19.79)%,(22.22±20.84)%of them did not believe they needed.(5.77±4.47)%of them wished to die,(19.44.4±18.65)%of them were hard to be idenfified.Other reasons accounted for(30.08±25.78)%.(20.31.4±16.66)% of the patients refused the ambulance crews' judge for some state.(29.66.4±24.02)%of the patients who got the pre-hospital emergency service were not necessary to call an ambulance.(22.1 l±19.52)%of the patients' demand conflicted with pre-hospital emergency services network management system.Conclusions There exists some conflicts between the pre-hospital patients and ambulance crews' determinations.