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 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.

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.

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 study the effect of Thy-1.1 stem cell transplantation on endothelial hyperplasia and restenosis.Methods Thirty 4-6 weeks male SD rats were sacrificed to obtain the Thy-1.1 stem cells.Carotid artery were injured by ballon in sixty female SD rat's were randomized to receive stem cell transplantation(5?10~6 Thy-1.1,n=30)or saline approach(n=30).About 5?10~6 Thy-1.1 stem cells were injected into the injured arter- y after carotid artery injury;while the control rats underwent carotid artery injury and was injected the same amount of saline.The animals were sacrificed,3,7,14,21 and 28 days after balloon denudation.The samples of carotid artery were harvested for pathological examination,RT-PCR and in situ hyhridzation(ISH)were used to detect the transplanted cells in the injured artery.Results The intimal thickness was thinner in stem cell transplantation group(I/M,Stem cell transplantation group:2.06?0.28 vs control group 2.42?0.19,P

Objective To study the effect of Haikun Shenxi Capsule(HSC)on endothelin-1(ET-1)and mRNA expression of rats with adriamyein-induced nephrosis and proliferation of glomerular mesangial cells(GMCs)cultured in vitro.Methods The rats were randomized into 6 groups,normal group,sham operation group,model group,benazepril group,HSC low-and high-dose groups.Ten weeks after treatment,ET-1 and mRNA expression were measured with immunohistochemical and hybridization in situ method.Tak- ing the Benazepril group as the control group,the proliferation of GMCs was detected with MTT method.Results In the model group,ET-1 and mRNA expression presented a strong positive,compared with which,that of the HSC low-and high-dose groups was remarkably reduced(P

Objective To evaluate the antidepressant efficacy and adverse reactions of 3 different stimulus dosage of modified electroconvulsive therapy ( MECT) in patients with depressive episode. Methods 120 patients with depressive episode were randomized into low dosage group ( n=40) ,medium dosage group ( n=40) and high dosage group ( n=40) . Low dosage were 50%× age,medium dosage was 70%×age,high dosage was 80%×age . All patients received 6 treatments. Hamilton depression scale?17(HAMD?17) was used to evaluate the clinical symptoms at baseline,3 and 6 treatments. Effects and adverse reactions were compared among three groups.Results Compared with baseline the HAMD?17 scores of the 3 groups were significantly improved after 6 treatments( t=24.026, P=0.000;t=26.541, P=0.000;t=25.904, P=0.000) , but there were no statistically significant differences among the three dosage groups(F=0.409, P=0.665). Compared with low dosage group((27.2±5.4)%),the HAMD?17 scores reductive ratio of medium dosage group((34.3±6.8)%) and high dosage group((33.9±6.9)%)) were significantly improved after 3 treat?ments ( t=-5.513, P=0.000;t=-4.785, P=0.000). Compared with the low dosage group,the incidence rate of headache,nausea and vomiting,delirium were significantly higher in high dosage groups( headache:χ2=14.532, P=0.000;nausea and vomiting:χ2=13.333, P=0.000;delirium:χ2=14.907, P=0.000) . The re?covery time was significantly longer in medium dosage group ( ( 10. 5 ± 1. 6 ) min ) and high dosage group ((11.2±1.8)min) than that in low dosage group((8.8±1.2)min)( t=-5.144,=0.000;t=-6.889, P=0.000).Conclusion Different stimulus dosage of MECT for depressive episode has equivalent curative effect after 6 treatment . Medium dosage and high dosage treatments appear to have an early onset of efficacy,but may also be associated with more adverse reactions.

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.