OBJECTIVETo systematically review the effectiveness of minimally invasive total hip arthroplasty (MIS-THA) versus traditional total hip arthroplasty (THA) in patients with hip diseases.

METHODSThrough a method of combining Free words and keywords,we searched databases including PubMed,The Cochrane Library, EMbase,Web of Science, CBM , CNKI and Wanfang Data for randomized controlled trials (RCTs) on the comparison between MIS-THA and THA for hip disease from inception to June, 2014. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies according to the "bias risk assessment" tool recommended by Cochrane Handbook 5.0 for Systematic Reviews. Then, meta-analysis was performed using RevMan 5.3 software.

RESULTSThirteen RCTs involving 1 213 cases of surgeries and total 1 284 hips (MIS-THA: n = 631; THA: n = 653) were identified. The results of meta-analysis showed that statistically significant differences were found in Harris hip score on the 3rd month after operation [MD = 8.37, 95% CI (6.02,10.72)], Hematocrit [MD = 0.02, 95% CI (0.01, 0.03)] and Hemoglobin [MD = 0.50, 95% CI (0.16, 0.85)] at the 48th hour after operation, changed value of femoral offset [MD = 0.30, 95% CI (0.04, 0.56)] between two groups. In the change value of femoral offset, THA was better than MIS-THA; There were no statistically significant differences between two groups in Harris hip score at 1st year after operation [MD = 3.26, 95% CI (-3.25, 9.76)], WOMAC score [MD = -0.53, 95% CI (-3.67, 2.60)] and Oxford score [MD = 1.34, 95% CI (-3.46, 6.13)] at the 6th week after operation, Hematocrit at the 8th hour after operation [MD = -0.01, 95% CI (-0.02, 0.00)], the incidence of hip varus [RR = 0.82, 95% CI (0.45,1.52)] and dislocation [RR = 1.40, 95% CI (0.48, 4.12)].

CONCLUSIONTHA brings less trauma, less hemorrhage and better early clinical outcome compared with MIS-THA, but the difference of the complication rates between the two groups is similar.

Arthroplasty, Replacement, Hip ; methods ; Humans ; Minimally Invasive Surgical Procedures ; methods

This study is to establish the characteristic HPLC chromatogram of phenols in Ephedrae Herba, from which to pick out the marker peaks, followed by the analysis of the regularity of their distribution and content in the herbaceous stems of Ephedra sinica, E. intermedia and E. equisetina. The HPLC-DAD method for the characteristic chromatogram as well as quantitative analysis was established. The separation was carried out on a YMC-Pack ODS-A column (4.6 mm x 250 mm, 5 µm), eluted with the mobile phases as 0.01% formic acid aqueous solution (A) and acetonitrile (B) in a linear gradient (0-10 min, 17% B; 10-25 min, 17%-19% B; 25- 33 min, 19%-48% B; 33-35 min, 48%-51% B; 35-44 min, 51% B). The flow rate was kept at 1.0 mL · min⁻¹. The column tem- perature was 40 °C, and the detection wavelength was set at 350 nm (0-16 min) and 330 nm (16-44 min). Forty-six batches of collected samples from three official origins of Ephedrae Herba were detected, whose liquid chromatograms proven to be helpful to the differentiation of different origins. With principal component analysis and the analysis of distribution of peak area, twelve key peaks from the chromatogram were discussed in details on their contributions to the characteristics and differences of three official origins of the herb: peak area of peak 10, 11, 12 were found out to be significantly higher in E. equisetina than in other two origins, whose sum (higher than 146 mAU in E. equisetina) was useful for the discrimination between E. equisetina and the other two origins; peak area of 1 and 4 were respectively higher in E. sinica and E. intermedia than in other official origins, indicating their important effect on the differen- tiation of corresponding origins; peak 8 and 9 were picked out as two characteristic common peaks in three official origins of the herb, whose peak area showed little difference among different origins; further, peak area of other key peaks in the chromatogram also showed some difference among three origins, which make contributions to the differentiation of origins as well. Then, four phenols as 2"-O-α- L-rhamnosyl-isovitexin (1), vitexin (2), pollenitin B (5) and herbacetin-7-O-β-D-glucoside (6) were quantitative analyzed with the above-mentioned method, with good linear relationship and accuracy (recoveries in a range of 97.8%-102.5%). The content of the four phenols were firstly reported in Ephedrae Herba from official origins, which were respectively trace-1.55 (1), trace-0.160 (2), trace-0.284 (5) and trace-0.620 (6) mg · g⁻¹ in all of the tested samples. In addition, the content of these phenols showed differences in three official origins, especially 1, whose content in E. sinica [(0.670 ± 0.88) mg ± g⁻¹] were significantly higher than in other two origins (lower than 0.16 mg ± g⁻¹ besides sample Ei-060630-2-2), and 6, whose average content in E. equisetina [(0.260 ± 0.039 2) mg · g⁻¹] were twice as high as in E. sinica [(0.120 ± 0.270) mg · g⁻¹] and E. intermedia [(0.136 ± 0.485) mg g⁻¹], indicating the important effects of the two constituents on the differentiation among three official origins of the herb. The method established for the characteristic HPLC chromatogram and quantitative analysis of phenols was simple and accurate, and the marker constituents selected may provide new guides for the discrimination of official origins as well as the improvement of quality criteria of EphedraeHerba.
Chromatography, High Pressure Liquid ; methods ; Ephedra ; chemistry ; Phenols ; analysis

Objective To retrospectively determine the features of stones and calcifications in hepatobiliary system on virtual nonenhanced (VNE) dual-energy computed tomography (CT), and to evaluate the possibility of VNE images in diagnosis for those lesions.Methods A total of 128 gall stones and calcifications of the liver found in 110 patients were examined with triple phase abdominal CT scan from July 2007 to December 2011, in which true nonenhanced (TNE) phase and arterial phase were performed with single-energy CT (120 kVp) and portal venous phase was performed with dual-energy CT (100 kVp and 140 kVp). VNE images were generated from the portal venous phase dual-energy CT data sets by using commercially VNC software. The mean CT values for the stone, liver, bile and paraspinal muscle, mean lesion density and size in area dimension, contrast-to-noise ratio (CNR) of lesion to the liver or bile, and image noise were assessed and compared between VNE and TNE images. The effective dose and size-specific dose estimate (SSDE) were also calculated.Results The mean CT values of the lesions measured on VNE images declined significantly compared with those measured on TNE images (164.51±102.13 vs. 290.72±197.80 HU, P<0.001), so did the lesion-to-liver CNR (10.80±11.82 vs.18.81±17.06, P<0.001) and the lesion-to-bile CNR (17.24±14.41 vs. 21.32±17.31, P<0.001). There was no significant difference in size of lesions area between VNE and TNE images (0.69±0.88 vs. 0.72±0.85 cm, P=0.062). Compared to the 128 lesions found in TNE images, VNE images showed the same density in 30 (23.4%) lesions, lighter density in 88 (68.8%) lesions, while failed to show 10 (7.8%) lesions, and showed the same size in 61 (47.7%) lesions and smaller size in 57 (44.5%) lesions. The CT cutoff values of lesion and size were 229.21 HU and 0.15 cm, respectively. The total effective dose for triple phase scan protocol with TNE images was 19.51±7.03 mSv, and the SSDE was 39.84±11.10 mGy. The effective dose for dual phase scan protocol with VNE images instead of TNE images was 13.29±4.89 mSv, and the SSDE was 27.83±9.99 mGy. Compared with TNE images, the effective dose and SSDE of VNE images were down by 32.05%±3.69 % and 30.63%±2.34 %, respectively.Conclusions Although the CT values and CNR of the lesions decreased in VNE images, the lesions of which attenuation greater than 229.21 HU and size larger than 0.15 cmcould be detected with good reliability and obvious dose reduction. There was good consistency in the size of stones and calcifications in hepatobiliary system between VNE images and TNE images, which ensured the possibility of the clinical application of VNE images.

Acetylcholine ; metabolism ; Animals ; Arcuate Nucleus of Hypothalamus ; metabolism ; Dopamine ; metabolism ; Epinephrine ; metabolism ; Female ; Neurotransmitter Agents ; metabolism ; Norepinephrine ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Synaptic Transmission

OBJECTIVETo compare the roles of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) using the liver acquisition with volume acceleration(LAVA) sequence and diffusion-weighted imaging(DWI) in the detection of hepatic metastases sized ≤3 cm.

METHODSWe retrospectively analyzed the MRI data of 16 patients with hepatic metastases. All the sequences used included T1WI, T2WI,3D-LAVA, and DWI (b value=500 s/mm(2)). All patients were divided into two groups based on the sequences: group A (T1WI, T2WI, and 3D-LAVA enhanced MR) and group B(T1WI,T2WI and DWI). The hepatic metastases were evaluated by analyzing the receiver operating characteristic (ROC) curves.

RESULTSA total of 39 hepatic metastatic lesions were identified. The sensitivity, specificity, Youden index and the area under the ROC curve (AUC) were 97.4%, 88.2%, 0.856, and 0.944 in group A and 82.1%, 91.2%, 0.733, and 0.834 in group B. The ROC curves (p=0.040) and Youden index(p=0.043) in group A were significantly larger than in group B.

CONCLUSIONGadolinium-EOB-DTPA-enhanced MRI has higher accuracy than DWI in the detection of small metastases.

Adult ; Aged ; Aged, 80 and over ; Diffusion Magnetic Resonance Imaging ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; diagnosis ; secondary ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVE: To investigate the genetic polymorphism in the 5' and 3' region of TPH2 gene of Northern Chinese Han population and to explore its application value in forensic medicine. METHODS: The sequence variants and the genetic polymorphisms of 6 SNP loci (rs4570625, rs11178997, rs11178998, rs41317118, rs17110747 and rs41317114) within a 905 bp 5' flanking region and a 1,104bp 3' flanking region of TPH2 gene were analyzed by DNA sequencing in a total of 244 unrelated healthy individuals in Northern Chinese Han population. The statistical analysis was carried out by Haploview v4.2 software. RESULTS: The genotypic distributions of the 6 SNP loci in the TPH2 gene were in accordance with Hardy-Weinberg equilibrium. One C/T variant in 92922 site was found. There was a high linkage disequilibrium among the 3 SNP loci (rs4570625, rs11178997 and rs11178998) in the 5' region and the 3 SNP loci (rs41317118, rs17110747 and rs41317114) in the 3' region of TPH2 gene, respectively. The parameters of population genetics of 6 SNP loci were obtained. CONCLUSION There are great polymorphisms in the 5' and 3' region of TPH2 gene in Northern Chinese Han population, which could be used as genetic indexes for association analysis of the related diseases, as well as for forensic individual identification and paternity testing.
3' Untranslated Regions ; 5' Untranslated Regions ; Asian People/genetics* ; China/ethnology* ; Forensic Genetics ; Gene Frequency ; Genetics, Population ; Genotype ; Humans ; Linkage Disequilibrium/genetics* ; Microsatellite Repeats ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Tryptophan Hydroxylase/genetics*

[Objective]To investigate the effect of human umbilical cord mesenchymal stem cells on infected state of human alve?olar type Ⅱ epithelial cells.[Methods]Human alveolar type Ⅱ epithelial cells A549(1×105/mL)2 mL and PA(3×104 CFU/mL)2 mL has grown after 6 hours,add hUCMSC(1 × 106/mL)2 mL as the experimental group,add equal amounts of phosphate buffer (PBS)for infection,A549 and PBS and the medium has grown as the control group. A549 cells morphological changes between the compared groups(Transmission electron microscope,TEM),A549 cell viability(new CCK-8 cell proliferation assay Kit),A549 cells apoptosis(Annexin V-FITC/PI double staining flow cytometry)and the expression of A549 pulmonary surfactant A(SP-A) (Western blot).[Results]Transmission electron microscope cell morphology observation displayed ,infection group A549 cell dam?aged obviously,cell quality appeared empty bubble degeneration,chromatin height agglutination,visible apoptosis bodies;experi?ment group cell package film structure full,nuclear film full,nucleolus obviously,nuclear chromatin electronic density low,chroma? tin uniform,no apoptotic bodies;control group A549 cell structure full,membrane surface micro-fluff rich,nuclear film full,nucle?ar week clearance structure normal,chromatin uniform;infection group and control group compared,Infection group A549 cell sur?vival significantly reduced[(70.35±2.89)% and(97.37±2.07)%,n=3,P<0.01],apoptosis rate significantly increased[(8.63%± 0.16)%and(2.55±0.11)%,n=3,P<0.01],In the infected group,PA could damage A549 cells and decrease the amount of SP-A ex?pression(n=5,P<0.05). In the experiment group,the protective effect of hUCMSC on the A549 cells after infection may increase the expression of SP-A(n=5,P<0.05);[Conclusions]HUCMSC inhibits the infection of A549 cells apoptosis and protection of A549 cells secrete SP-A.

OBJECTIVETo explore the feasibility of a dual-energy computed tomographic angiography (DECTA) protocol using test-bolus injection with reduction of contrast material (CM) dose in second generation dual-source CT system.

METHODSTotally 57 consecutive patients underwent CT angiography scan covering the cervical and cerebral arteries. CT was performed with second generation dual-source CT system. The time to peak (T) using a test-bolus injection was calculated. The patients were divided into three groups (A, B, and C) with different CM doses (40, 45, and 50 ml) and different delay time points [ (T+1) , (T+1) , and (T+2) s] . All the patients were followed by a 48 ml saline flush. Arterial enhancements were quantified by measuring attenuation values of the aortic arch, bifurcation of common carotid artery, contralateral internal jugular vein of the CM injection, superior vein cava, proximal middle cerebral artery, basilar artery, and straight sinus on source images. Visualizations of intracranial artery and ipsilateral venous effect of the CM injection were rated on a four-point grading scale on CTA images for qualitative assessment.

RESULTSAlthough the attenuation of internal jugular vein and straight sinus were significantly lower in group A than in groups B and C (P<0.05) , the attenuation of aortic arch, superior vein cava, common carotid artery, middle cerebral artery, and basilar artery vessels showed no significant differences among these three groups. The scores of the visualizations of intracranial artery and ipsilateral venous effect of the CM injection were also not significantly different among these three groups.

CONCLUSIONBased on the delay time calculated by a test-bolus injection, a reduced-dose contrast material may provide an equal degree of arterial attenuation and a lower attenuation of vein for dual-energy CTA covering the craniocervical region in second generation dual-source CT system.

Adult ; Aged ; Angiography ; methods ; Contrast Media ; administration & dosage ; Feasibility Studies ; Female ; Head ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Neck ; diagnostic imaging ; Radiation Dosage ; Tomography, X-Ray Computed ; methods

BACKGROUNDLocal hypothermia induced by intravascular infusion of cold saline solution effectively reduces brain damage in stroke. We further determined the optimal temperature of local hypothermia in our study.

METHODSSeventy-eight adult male Sprague Dawley rats (260 - 300 g) were randomly divided into 3 groups: group A, ischemia/reperfusion without cold saline infusion (n = 26) (control group); group B, infusion with 20 degrees C saline before reperfusion (n = 26); group C: infusion with 10 degrees C saline before reperfusion (n = 26). In each group, we chose 15 rats for monitoring physical indexes and the temperature of the brain (cortex and striatum) and body (anus), measurement of brain infarction volume, assessment of neurological deficits and the survival rate of reperfusion at 48 hours. Another 8 rats from each group was chosen for examining brain edema, another 3 from each group for histological observation by electron microscopy (EM) and light microscopy (LM) at 48 hours after reperfusion.

RESULTSThere was no significant difference among the 3 groups for physical indexes during the examination (F((2, 45)) = 0.577, P = 0.568; F((2, 45)) = 0.42, P = 0.78 for blood pressure and blood gas analysis, respectively). The brain temperature was significantly reduced in the group C compared to the other groups (F((2, 45)) = 37.074, P = 0.000; F((2, 45)) = 32.983, P = 0.000, for cortex and striatum temperature respectively), while the difference in rectal temperature between group A and B or C after reperfusion was not significant (F((2, 45)) = 0.17115, P = 0.637). And the brain infarct volume was significantly reduced in group C (from 40% +/- 10% in group A, 26% +/- 8% in group B, to 12% +/- 6% in group C, F((2, 45)) = 43.465, P = 0.000) with the neurological deficits improving in group C (chi(2) = 27.626, P = 0.000). The survival rate at 48 hours after 10 degrees C and 20 degrees C saline reperfusion was increased by 132.5% and 150%, respectively, as compared to the control group (chi(2) = 10.489, P = 0.005). The extent of the brain edema showed no significant difference (F((2, 21)) = 0.547, P = 0.587) after cold saline infusion compared to the control group. No obvious vascular injury was found by electron or light microscopy in either infusion group.

CONCLUSIONSRegional hypothermia with 10 degrees C cold saline infusion can significantly decrease the infarction volume, improve the neurological deficits, and 10 degrees C seems to be the optimal temperature in inducing a cerebral protection effect during stroke. This procedure could be adopted as a further treatment for acute stroke patients.

Animals ; Body Temperature ; Brain ; pathology ; Cerebral Infarction ; pathology ; Hypothermia, Induced ; Male ; Rats ; Rats, Sprague-Dawley ; Stroke ; mortality ; pathology ; physiopathology ; therapy ; Survival Rate ; Temperature