BACKGROUND: Knee joint trauma results in knee instability and movement track changes, which lead to the degradation of articular cartilages. The main component of articular cartilages, such as chondrocytes, collagen and proteoglycan, are also change during this process.OBJECTIVE: To compare the content changes of collagen, proteoglycan and the apoptosis of chondrocytes on two model groups of knee joint instability, additionally, to investigate the occurrence mechanism of early articular cartilages changes in rabbits with knee joint instability.METHODS: A total of 50 white rabbits were randomly divided into anterior cruciate ligament transection group, medial collateral ligament transection + meniscectomy group and normal control group. The specimens were harvested at weeks 1, 2, 3, 4, and 5 after operation. The osteocartilaginous section of the medial femur condyles were observed by gross observation, histological examination, and Markin scores. The contents of proteoglycan and collagen fiber were also measured.RESULTS AND CONCLUSION: Chondrocytes apoptosis were found with certain degrees at different stages of knee joint instability models. The Mankin score of the anterior cruciate ligament transection group was greater than the medial collateral ligament transection + meniscectomy group at each time point except the 1<'st>week (P ＜ 0.05), which was notably greater in the 5~(th) week. At weeks 3 and 4 after operation, the chondrocytes degenerated with proteoglycan lost in the anterior cruciate ligament transection group, and the chondrocytes degeneration was predominant at 5th week. The changes were more seriously in the medial collateral ligament transection + meniscectomy group. Meantime, the collagen fiber content of two experimental groups were less than the normal control group at Weeks 3, 4, 5 after operation (P < 0.05). The results demonstrated that at early knee joint instability, the articular cartilages degenerated extent is related to the number of chondrocytes, the collagen network disrupts and lost of proteoglycan. During chondrocytes degeneration, cartilage repair simultaneously occurred.

Objective] To evaluate the acupuncture treatment of type 2 diabetes peripheral neuropathy clinical curative effect and safety. [Methods] Com-puter retrieval of the CENTRAL, Cochrane, Web Of Science, CBM, CNKI, VIP database, find al about acupuncture and moxibustion treatment of type 2 diabetic gastroparesis of randomized control ed trial(RCT), build library retrieval time until March 19, 2014.At the same time ShouJian into literature references.According to inclusion and exclusion criteria, independently by two researchers after RCT extraction and filtering, data quality evaluation, using Revman5.2 Meta analysis software, use the GRADE system for quality evaluation of evidence. [Results] Seven studies involving 364 patients were includ-ed.Meta analysis showed:(1) effective rate:the acupuncture compared with drugs, the results between the two groups were statistical y significant (RR=3.35, 95% CI=(2.05, 5.48)], suggesting that acupuncture treatment can improve efficiency for the treatment of type 2 diabetes peripheral neuropathy. (2) MNCV:the median nerve, and results showed that the statistical significance was found between the two groups[MD=2.29, 95%CI=(0.61, 3.98)].Includ-ing philalways nervous, the result showed that between the two groups had statistical significance[MD=2.16, 95% CI=(0.16, 4.16)].(3)SNCV:includ-ing median nerve, the results showed that the statistical significance was found between the two groups[MD=1.79, 95% CI=(0.57, 3.02)].Including phi-lalways nervous, the result showed that the two groups had statistical significance[MD=3.59, 95%CI=(2.28, 4.91)].Based on GRADE system ,al the evidence was at low level and weak recommendation. [Conclusion] Acupuncture-moxibustion for the type 2 diabetes peripheral neuropathy is better than the conven-tional medicine treatment.Limited by the guality of the inclusive literalures, it needs more high quality, large sample of RCT further argument.

Objective To study the construction of tissue engineering adipose in vitro with silk fibroin scaffold and human umbilical cord mesenchymal stem cells (hUCMSCs) transfected by recombinant human insulin gene lentivirus.Methods hUCMSCs infected with recombinant lentiviral pLenti6.3-insulin-IRES-EGFP (Group A) by the best MOI=10 were seeded in silk fibroin scaffold; hUCMSCs transfected by EGFP gene (Group B)was regarded as negative control; and then the cell-scaf-fold complexes were cultured in adipogenic differentiation medium. MTT test was used to detect whether recombinant lentiviral affected the growth and proliferation of hUCMSCs and the growth activity of hUCMSCs seeded in silk fibroin.Results After 5-7 days for adipogenic culture,the numbers of fat-like cells in group A were significantly more than those in group B (P =0.007,P＜0.01).RTPCR results showed that the expression of PPARγ-2 in group A was much stronger than that in group B.MTT test showed that there was no significant difference in optical density (A)at each time between transfected group and nontransfected group (P=0.056,P＞0.05).And there was also no significant difference in optical density (A)between cell group and cell-scaffold group (P =0.066,P＞0.05).Conclusions Insulin gene could obviously promote hUCMSCs getting into adipose,and carrying recombinant human insulin gene lentiviral vector transfection of hUCMSCs and silk fibroin scaffolds could effectively construct tissue engineering adipose in vitro.

This study was aimed to observe effect of combined therapy of acupuncture, tapping and auricular needling on fatty-insulin endocrine axis in obesity complicated with hyperlipidaemia patients withyin-deficiency and blood-stasis pattern. A total of 108 patients with obesity complicated with hyperlipidaemia ofyin-deficiency and blood-stasis pattern were randomly divided into the treatment group of combined therapy of acupuncture, tapping and auricular needling, and the acupuncture and tapping group, with 54 cases in each group. The comparison was made to 52 patients in the normal group. Observations were made on changes of fatty-insulin endocrine axis index, lipid index, obesity index, vegetative nerve function index (Y value) and clinical weight-reducing and lipid-reducing effect. The results showed that the pretreatment obesity index, fasting insulin (FINS), fasting plasma glucose (FPG), insulin resistance index (Homa-IR), fasting leptin (FLP), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL-C) and Y value of patients in both groups were significantly higher than those of the normal group (P < 0.01). However, the high density lipoprotein (HDL-C) and insulin sensitivity index (ISI) were significantly lower than those of the normal group (P < 0.01). After treatment, both groups received satisfied effects on weight-reducing and lipid-reducing. The fatty-insulin endocrine axis indexes (FINS, FPG, Homa-IR and FLP) were significantly reduced (P < 0.05); and ISI was significantly increased (P < 0.05). The combined therapy of acupuncture, tapping and auricular needling had better regulation effects on the fatty-insulin endocrine axis level, lipid level and vegetative nerve function level compared with the acupuncture and tapping group (P < 0.05). It was concluded that patients with obesity complicated with hyperlipidaemia ofyin-deficiency and blood-stasis pattern had dysfunction of the fatty-insulin endocrine axis. The combined therapy of acupuncture, tapping and auricular needling, or the therapy of acupuncture and tapping had good regulation effect. However, the combined therapy of acupuncture, tapping and auricular needling had more significant therapeutic effect.

CT perfusion (CTP) has provide a novel approach for the diagnosis of ischemic cerebrovascular diseases. The evaluation indices include cerebral blood flow, cerebral blood volume, time to peak, and mean transmit time. These semi-quantitative indices used for evaluating cerebral blood perfusion have very important significance for the guidance of choosing the best treatment protocol and efficacy observation. CTP is mainly used in acute ischemic stroke to identify penumbra and infarct, as well as predicting hemorrhagic transformation in combination with other means and choosing thrombolytic candidates. In addition, CTP is also used to assess cerebrovascular reserve capacity in patients with chronic ischemic diseases and diagnose cerebral vasospasm in patients with subarachnoid hemorrhage and their efficacy evaluation.

OBJECTIVETo compare the differences of clinical effects in female patients with obesity and hyperlipidemia of yang deficiency of spleen and kidney syndrome between warm acupuncture combined with auricular acupuncture and simple warm acupuncture.

METHODSOne hundred and thirty patients were randomly divided into an observation group and a control group, 65 cases in each one. In the control group, acupuncture was used at Pishu (BL 20), Zhongwan(CV 12), Shenshu(BL 23), Zhongji(CV 3), Guanyuan(CV 4), Mingmen(GV 4), Taibai(SP 3), Fenglong(ST 40), etc.; warm acupuncture was applied at Pishu(BL 20), Zhongwan(CV 12), Shenshu(BL 23) and Zhongji(CV 3); the treatment was required once every two days and for 3 months continuously. In the observation group, based on the treatment in the control group, thumbtack intradermal needles were embedded at auricular points, including pi(CO13), shen(CO10), pangguang(CO9), sanjiao(CO17), neifenmi(CO18), neishengzhiqi(TF2), etc. Obesity indices [body mass(W), obesity degree(A), body mass index(BMI), body fat percentage(F%)] blood lipid indices [serum total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C)] and clinical efficacy were observed before and after treatment in the two groups. Results After treatment in the two groups, the obesity indices of W, A, BMI, F% and the blood lipid levels of TC, TG, LDL-C were obviously decreased compared with those before treatment (all P<0. 01) and the HDL-C levels were apparently increased than those before treatment (both P<0. 01). After treatment, the improvement of TC and HDL-C in the observation group was superior to that in the control group (both P<0. 01). The difference was not statistically significant in the aspect of improving every obesity index between two groups (all P>. 05). The comprehensive total effective rate of the observation group was 95.4% (62/65), which was better than 84. 6% (55/65) of the control group (P<0. 001).

CONCLUSIONWarm acupuncture combined with auricular acupuncture and simple warm acupuncture can both benignly adjust abnormal lipid metabolism of obesity patients with hyperlipidemia, and warm acupuncture combined with auricular acupuncture are superior to simple warm acupuncture treatment on antiobesity action and improving the TC and HDL-C levels.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adult ; Blood Glucose ; metabolism ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Kidney ; physiopathology ; Middle Aged ; Obesity ; metabolism ; physiopathology ; therapy ; Spleen ; physiopathology ; Triglycerides ; metabolism ; Yang Deficiency ; metabolism ; physiopathology ; therapy ; Young Adult

This study was aimed to observe the effect of electro-acupuncture (EA) treatment on Zhong-Xiao (ZX, T2MD) with obesity. A total of 203 patients with ZX accompanied with obesity accepted EA treatment. Before and after 3-month treatment, observations were made on patients' fasting blood glucose (FBS), fasting insulin (FINS), in-sulin sensitivity index (ISI), insulin resistance index (Homa-IR), insulin secretion index (Homa-β), degree of obesity (A), body mass (Kg), body mass index (BMI) and body fat percentage (F%) changes. The results showed that com-pared with pretreatment, the posttreatment FINS, Homa-IR, FBS had a significant decrease among 203 patients (P<0.01); the ISI and Homa-β had a significant increase (P < 0.01). There was a significant statistical difference on islet β-cell function before and after treatment. The A, body mass, BMI, and F% were significantly decreased (P<0.01). It was concluded that EA can significantly correct ZX with obesity patients' glucose consumption, protect the islet β-cell function, and reduce the body mass of patients.

BACKGROUND: Now, the current study has not yet confirmed two treatment methods of the proximal femoral nail antirotation and total hip arthroplasty for treating intertrochanteric fractures in the elderly, which method has more advantages, and there is no clear conclusion at present. OBJECTIVE: To systematical y compare the repair effect of proximal femoral nail antirotation and total hip arthroplasty for treatment of intertrochanteric fractures in the elderly. METHODS: We searched the related literatures from 2011 to 2015 on Wanfang database, PubMed, MEDLINE and Embase database by computer. We retrieved the journals in China by hand and col ected randomized control ed trials on proximal femoral nail antirotation and total hip arthroplasty in the treatment of intertrochanteric fractures in the elderly. Intraoperative blood loss, operation time, hospitalization time, ambulation time after operation, and Harris score were selected as evaluation indexes. Data were analyzed using RevMan 5.2 software. RESULTS AND CONCLUSION: Final y, 7 Chinese literatures were included, with 811 patients. The results of meta analysis showed that the hospitalization time and ambulation time after operation were significantly shorter in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01), which reduced the pain of patients. Operation time and intraoperative blood loss were poorer in the total hip arthroplasty group than in the proximal femoral nail antirotation group (P < 0.000 01). No significant difference in Harris hip score was detected between the two groups (P > 0.05). These results confirmed that the internal fixation of proximal femoral nail antirotation in minimal y invasive therapy when reducing operation time and blood loss has a certain advantage. The total hip arthroplasty can make the recovery of hip function earlier, al ow early weight-bearing walking, reduce the patients’ bedridden time and reduce the complications in bed. Thus, the clinicians in the practical work should choose the appropriate therapy with considering the patient’s condition, damage degree, fracture type, and financial capability.

OBJECTIVE To investigate the common pathogens and predisposing factors of postoperative pneumonia in patients with chest tumor.METHODS The data of 279 cases of postoperative pneumonia for open chest surgery were analyzed retrospectively.RESULTS The prevalence of postoperative pneumonia for open chest surgery were mainly due to Gram-negative bacteria(41.4%).Gram-positive bacteria and fungis weighed 32.6% and 26%.The risk factors of postoperative pneumonia in chest tumor were aged,severe underlying disease, use of broad-spectrum antibiotics,surgery trauma,mechanical ventilation and invasive treatments patients.CONCLUSIONS It is very important to enforce the preoperative comprehensive management of open chest operation in order to reduce the incidence and mortality of postoperative pneumonia in chest tumor.

Objective To explore effective methods of diagnosis and treatment for delayed rupture of the spleen (DRS) through retrospective analysis of 32 cases. Methods A retrospective study was done in 32 cases with DRS. The effects of CT, ultrasound and diagnostic peritoneal lavage on diagnosis of DRS was observed and compared. Results Splenectomy was performed in 26 cases, among which one died four days after splenectomy because of complicated brain injury and six given conservative treatment under continuous monitoring discharged. The mean hospitalization duration was 18.5 days. Conclusions Diagnostic peritoneal lavage can improve the positive rate of peritoneal puncture. Ultrasound is an important method for diagnosing DRS and closely monitoring the patients receiving conservative treatment.