Objective To investigate the mid-term outcome of high tibia osteotomy (HTO) combined with tibial tuberosity limited rotation in the treatment of disorder of patellofemoral joint with knee varus.Methods HTO was performed in all 42 patients.The lower limb alignment,lateral femoral tibial angle,medial proximal tibial angle,Q angle and TF-TG were measured before and after operation.All the patients with disorder of patellofemoral joint were divided into three types based on preoperative patellar trajectory and TF-TG.According to different types we chose the limided rotation of distal tibia through adjustment of tibial tubercle location to improve patellar track.Type Ⅰ in 10 cases and type Ⅱ in 12 cases only accepted HTO,type Ⅲ in 20 cases accepted HTO and tibial tubercle rotation.The rotation angle was determined according to preoperative imaging results and foot forward angle.Before and after operation patellar tilt angle,patellofemoral angle and lateral patellar angle were measured.Results 42 patients were followed up for more than 5 years,an average of 72.20± 12.60 months (60-88 months).No nerve damage,infection and bone nonunion occurred.The patellar tilt angle was improved from 12.45°±3.76° to 6.98°± 1.78° 5 years after operation.The patellofemoral angle was improved from 12.51°±4.71° to-4.70°±2.57° 5 years after operation,and the lateral patellar angle was improved from 1.50°±4.90° to 7.80°±3.10°.Preoperative lateral femoral tibial angle was improved from 182.45°±2.20° to postoperative 174.60° ±3.50°,medial proximal tibial angle was improved from preoperative 78.75°± 3.50° to postoperative 93.25°±1.95°.The Lysholm score was improved from preoperative 53.10±5.60 to 92.70±5.50.The preoperative IKDC subjective score was improved from 47.50±6.40 to 91.30±6.90.The Kujala score was 62.40±8.70 before operation and 87.30±4.10 5 years after operation.Visual analogue score (VAS) was 7.50±2.45 before operation and 1.50±0.90 5 years after operation.The short and mid-term follow-up,knee patellar trajectory and lower limb alignment was good,postoperative symptoms was satisfactory and acceptable.Conclusion HTO combined with limited rotation of the tibial tubercle could improve patellar trajectory and lower limb alignment to relieve pain,and has satisfactory mid-term outcome in the disorder of patellofemoral joint with knee yarus patients.

Objective To observe the changes in the pathological diagnosis rate of Graves'disease(GD) and Hashimoto's thyroiditis(HT)in the past 28 years and to probe its relationship to the environmental factors. Methods Statistic analysis was performed on data of thyroid disease,GD,HT and the complications of HT in Department of Pathology(1978-2005)in General Hospital of Tianjin Medical University with Run test,Cox-stuart test,ANOVA,t or t'test and Chi-square test.Results In 28 years there were 243 403 biopsies(average 8 693/ year)including 6 771 cases of thyroid disease(27.8‰),216 cases of GD(0.89‰),352 cases of HT (1.45‰).The biopsy rate of thyroid disease and GD showed a descending tendency since 1982 but an ascending tendency from 1995,furthermore,with GD it showed a descending tendency from 2001 to 2005 once more.While the biopsy rate of HT and GD+HT showed a descending tendency from 1986 and an ascending tendency after 1996,being 1-4 years later than thyroid disease and GD.The biopsy rate of GD+HT and the proportion of HT showed a descending tendency in 2002-2005 and 2003-2005 respecitvely.The average age of total and female patients with GD showed a descending tendency from 1997.The average age of GD was 13.7 years younger than HT,the patients of GDⅠ-type andⅡ-type being younger thanⅢ-type.The average age of lymphoid type(L), oxyphilie epithelium type(O),pronounced epithelium destruction type(P)in HT increased sequentially.In 28 years,there were more female patients with GD and HT,especially with HT.There existed 7.95% hyperthyroidism,6.25% nodular goiter,2.27% carcinoma in HT(more in L-type)and 2.56% hypothyroidism in HT(more in P-type).Conclusion Within 28 years,according to the pathological diagnosis rate,GD,HT,and GD+HT showed phasic tendencies related to drinking low iodine water and the implement of universal salt iodization policies in 1994 and 2000.Therefore,on the levels of genetics and environment,the factors that influence autoimmunity of thyroid gland could not exclude the variations of iodine intake,infection,affection or emotional stress.The mechanism of the changes in the pathological diagnosis rate needs further study.

OBJECTIVETo evaluate the effect of concentrated growth factor extract (CGFe) on the proliferation and differentiation of MC3T3-E1 osteoblasts attached to sandblasted and acid etched titanium surfaces.

METHODSTrials were divided into experimental and control groups. The experimental group used a-MEM that contained CGFe (10% FBS), whereas the control group only used a-MEM (10% FBS). MTT assay was employed to detect the number of osteoblasts on the first, third, and fifth days. Alkaline phosphatase (ALP) activity and scanning electron microscope (SEM) were used to detect the osteoblast differentiations on the third and fifth days and to observe the osteoblast extensions on titanium surfaces for 12 h, respectively. Meanwhile, the levels of the osteogenetic biomarkers Runt-related transcription factor-2 (Runx2) and Osterix (Osx) on the third and seventh days were quantified via real-time polymerase chain reaction (PCR).

RESULTSMTT assay indicated that on the first, third, and fifth days, the absorbance in the experimental group significantly increased than that in the control group (P < 0.05). ALP activity: on the third and fifth days, the absorbance of the experimental group was significantly higher than that of the control group (P < 0.05). SEM: at 12 h, the extension of the experimental group cells was larger than that of the control group. Real-time PCR: given the standardization in the group, the gene expression level of the control group on the third day was 1, and the Runx2 and Osx gene expressions in the experimental group were larger than those of the con- trol group.

CONCLUSIONCGFe can efficiently stimulate the proliferation, differentiation and extension of MC3T3-E1 cells.

OBJECTIVE To set up a kind of Helicobacter pylori(Hp) detection method which can determine the Hp infection and its clinical value for the digestive diseases.METHODS Gastric biopsy was used with gastric mucosa Hp rapid urease test,Hp-IgG was detected by ELISA,and Hp-DNA of feces by fluorescent gene quantitation method.RESULTS From the 96 patients positively determined by gastric biopsy,the positive rate of Hp-DNA of feces was 95.8%,but the positive rate of Hp-IgG was 47.9%.From the 59 Hp-IgG positive patients,the positive rate of gastric biopsy was 45.8%.CONCLUSIONS Gastric biopsy and HP-DNA quantitation of feces are both reliable methods which can determine the Hp infection,but Hp-DNA quantitation of feces is a simple,rapid,reliable and atraumatic test,it can be put into practice widely and more easily.

Objective To retrospectively analyze the serum enzymes in childhood amputees as a result of earthquake,and to discuss their clinical significance.Methods From 150 children amputees who were victims of Sichuan Wenchuan earthquake in 2008 and Sichuan Lushan earthquake in 2013,45 cases with complete records of serum enzymes examinations were reviewed retrospectively.They were divided into three groups:amputation group (n=6),fasciotomy decompression group (n =5),general trauma without injury to extremity group (n =34).Serum enzyme examination data were compared for statistical analysis to find the difference among groups.Ten children who were not victims of earthquake were selected from department of orthopaedics to serve as controls,and 20 adult amputees as a result of earthquake served as another control group.Results There were significant differences in injury severity scale (ISS) and the contents of all serum enzymes,including aspartate transaminase (AST),alanine aminotransferase (ALT),creatine kinase (CK),lactate dehydrogenase (LDH),and hydroxybutyrate dehydrogenase (HBDH),between the amputation group and other patients (FISS=15.474,P＜0.001 ; FAST=10.770,P＜0.001 ; FALT=12.799,P＜0.001 ; FcK=12.848,P＜0.001; FUDH=13.126,P＜0.001; FHBDH=13.186,P＜0.001),and the difference in amputation group was even more significant.AST,LDH,HBDH in childhood amputees group were significantly higher than those in adult amputation group.The contents of ALT and CK were slightly increased.Serum enzyme contents were found to be significantly helpful for prediction of disease condition and prognosis.It was also found that CK was extremely helpful in assessing the degree of illness in patients with severe trauma,especially in patients complicated by severe soft tissue injury.In all the groups,of patients,it was found that CK rose from (129 ± 62) U/L in non-earthquake induced trauma group to (44 208 ± 39 788) U/L in earthquake amputation group,and it was thus increased more than 300 times.Its highest value even reached 117 513 U/L,which was more than 840 times of the normal.If a timely amputation or muscle compartment decompression was performed,CK might decline rapidly down to the normal value.Conclusions The comprehensive and continuous assessment of serum enzymes is mandatory during the treatment of children with acute trauma.It is of important clinical significance to correctly judge the condition and to determine optional treatment measures.

In this article we report the results on the synthesis and accumulation of PHAs by Rhodocista pekingensis (strain 3-p), a phototroph that was isolated from wastewater treatment plant. Our results showed that the optimal conditions for PHAs accumulation with strain 3-p were as following: 0.01% Yeast Extract, 0.01% NH 4Cl, Acetate 5 g/L, and medium pH of 7.0～7.2.Under optimized conditions, strain 3-p accumulated PHAs up to 60% of its cellular dry weight. Enzymatic activities of ?-ketothiolase, acetoacetyl-CoA reductase, and PHA polymerase were detected and their activities increased as PHA synthesis initialized. Based on these study, we proposed the metabolic pathway of this strain should be:Acetate (or other fatty acids) - Acetyl-CoA --- thiolase Acetoacetyl-CoA --- reductase D (-)-?-Hydroxybutyryl-CoA ----- PHA polymerase PHAs.

Objective:To evaluate the effect of cryopreservation on clonogenic ability and apoptosis rate of mono-nuclear cells and CD34+cells in umbilical blood (UB), and to choose the index to present the freezing injury and optimize the cryopreservation of UB. Methods:hTe mono-nuclear cells (MNC) and CD34+cells were separated from UB and frozen.Atfer 30 days, they were thawed in warm water. Clonogenic capacity and clonogenic recovery before and atfer the cryopreservation was compared. We also used Annexin V-FITC-PI to investigate the apoptosis rate of the cells before and atfer the cryopreservation of these 2 types of cells. Results:hTe number of colony forming unit-granulocyte/monocyte (CFU-GMs) was not changed atfer freezing and thawing in both MNCs and CD34+cells, while the number of colony forming unit-granulocyte, erythrocyte, monocyte and megakaryocyte (CFU-GEMM) was obviously reduced after freezing in CD34+cells. The 2 types of cryopreserved cells had certain degree of apoptosis before the cryopreservation. MNC-type cryopreservation increased the cells apoptosis a little, while CD34+-type cryopreservation increased more. Conclusion:hTe cells have certain degree of apoptosis before the cryopreservation. hTe freezing and thawing procedure does affect the early stage progenitor cells-CFU-GEMM in the CD34+-type cryopreserved cells in UB. hTe damage may be induced by the cell apoptosis.

Brain natriuretic peptide (BNP) is one of the most sensitive and specific laboratory indicators during cardiac dysfunction.N-Terminal pro-brain natriuretic peptide (NT-proBNP) is the N-terminal precursor of BNP.The functions of both are not consistent,but its physicochemical properties are superior to BNP.Now it has been widely used in the diagnosis and treatment monitoring of cardiovascular diseases.In the field of stroke,the testing and application of BNP,especially NT-proBNP is less.This article reviews the roles of NT-proBNP in cardio-cerebrovascular diseases,especially in ischemic cerebrovascular disease.

Objective To study the implact of tacrolimus blood concentration (Tac) after renal transplantation on blood lipid and fasting glucose (FBG) in recipients.Method The recipients who regularly given Tac + mycophenolate mofetil + prednisone after renal transplantation were chosen and those had normal preoperative levels of blood lipid and fasting glucose as subjects.The recipients were classied into high concentration group,normal concentration group and low concentration group by comparing Tac blood concentration of different postoperative periods with corresponding normal concentration range.The changes of biochemical indexes such as steady Tac valley blood concentration,blood lipid and FBG were monitored,and the differences in blood lipid and FBG levels at different periods among three concentration groups were compared.Result TG level was significantly higher (P＜0.05),and HDL-C level was significantly lower in high concentration group than in normal and low concentration groups one month after operation (P＜0.05).Three months after operation,TG and FBG levels were significantly higher in high concentration group than in normal and low concentration groups (P＜0.05 and 0.01,respectively).Six months after operation,TC,TG and FBG levels were significantly higher in high concentration group than in normal and low concentration groups (P＜0.05,0.01 and 0.05,respectively).There was no significant difference between normal and low concentration groups in various biochemical indexes at any time point (P＞0.05).Conclusion The higher blood concentration of Tac and the longer used after renal transplantation,the easier it might cause drug-induced hyperlipidemia and diabetes.

Objective To observe the effects of progesterone on the mRNA and protein expressions of nerve growth factor(NGF) and brain-derived neurotrophic factor(BDNF) in the focal cerebral ischemia-reperfused rats,and to explore its mechanism of brain protection. Methods Totally 96 healthy male SD rats were randomly divided into sham surgery group,ischemic reperfusion group,vehicle-treated group and progesterone-treated group (n=24 for each).The model of focal brain ischemia-reperfusion injury was induced by middle cerebral artery occlusion (MCAO).After 2 h temporary MCAO,rats were subjected to reperfusion for 3 h,6 h,12 h and 24 h,respectively.The mRNA and protein expressions of NGF and BDNF were analyzed by real time-PCR and Western blot,respectively. Results In the injured cortex,the mRNA and protein expressions of NGF and BDNF in ischemic reperfusion group came to the peak at 6 h after reperfusion,and then gradually declined to the level of sham operation group at 24 h after reperfusion.In progesterone treatment group,BDNF and NGF mRNA and protein expressions reach the peak at 12 h after reperfusion,and were still higher at 24 h after reperfusion than in ischemic reperfusion group(P＜0.05). Conclusions Progesterone plays a protective role in focal cerebral ischemia-reperfusion by increasing the expressions of BDNF and NGF in rats.