BACKGROUND: The pathological changes of osteoarthritis are similar to that of kaschin-beck disease, but the cause of the latter is still unclear,damage is more serious. From the comparison of pathology changes between them, we hope to find out an effective therapeutic method with the assistance of arthroscope basing on the experiences in osteoarthritis.OBJECTIVE: To make comparison of the histomorphological changes between osteoarthritis and kaschin-beck disease with knee arthroscope,which give clues to the diagnosis and selection of operative technique for kaschin-bock disease under arthroscope.DESIGN: Case control study.SETTING: Department of Orthopaedics, Shaanxi People's Hospital.PARTICIPANTS: Thirty-five patients who needed arthroscope surgery due to severer knee osteoarthritis were randomly selected from Department of Orthopaedics, Shaanxi People's Hospital between April 1998 and September 2000; Meanwhile 31 patients with knee joint functional obstacle caused by kaschin-beck disease (epidemic disease area) were randomly selected from Luochuan Hospital of Shaanxi Province in November 2001.METHODS: Japanese made OLYMPUS series color television arthroscope and surgery system were used to carry out knee joint operations in all participants. During the operation, video recording, postoperative editing, photographs, comparison and analysis were conducted, in order to find out the pathological changes of the two groups in knee joint synovium, patella, femur, tibia and meniscus with the assistance of arthroscope.RESULTS: Totally 66 patients were enrolled in this study and all endamage in Kaschin-beck disease and osteoarthritis: Injuries were graded into grade 0, 1, 2 and 3, there were 0,3,5,23 cases and 0,3,16,16cases correspondingly in kaschin-beck disease group and osteoarthritis cartilage damage was presented by big piece of cartilage peeled off, part of them came off leading to bone exposure, the exposed bone surface is uneven; while cartilage damage in osteoarthritis was presented by the wear of cartilage, moreover cartilage island was found remained in the exposed bone with the surface covered with fiber strips and the exposed observed in 24 patients with Kaschin-beck disease, 5 cases with coarse stress point and 19 cases with burr-like damage, amongst which there were 9 cases displayed both medial and lateral meniscus damages; in osteoarthritis group there were 16 cases showed meniscus damages including edge wears in11 cases and breakage in 5 cases.CONCLUSION: Cartilage damage in knee articular was obviously severer in Kaschin-beck disease than in osteoarthritis, although kaschin-beck disease is no matter resulting in serious knee joint damage, but its pathology changes are different from osteoarthritis, we should pay more attention to the peculiarity of big piece of cartilage peeling off during operations.

Objective To assess the value of ultrasonography in distinguishing pharyngoesophageal diverticulum from thyroid nodule.Methods High-frequency sonography was used to detect the size,shape, echo and blood flow of cervix masses in 1219 patients in a lateral decubitus position after drinking water. Results On enhanced power,the image changing rates of pharyngcesophageal diverticulum and thyroid nodule were 71.43% and 14.19% respectively,and their difference was statistically significant(P<0.05). On drinking water,the image change rates of pharyngoesophageal diverticulum and thymid nodule were 100.00% and 1.98% respectively,and their difference was statisfically significant(P<0.05).The detection rates for pharyngoesophageal diverticulum and thyroid nodule were 0.098% and 17.042% respectively. Conclusions Ultrasound examination is of value in distinguishing pharyngoesophageal diverticulum from thyroid nodule in general health check up and regular health examination.

Objective To investigate the clinical efficacy and safety of repetitive transcranial magnetic stimulation combined with duloxetine in treatment of depression. Methods Sixty-nine cases of depression were randomly divided in?to study group (n=35 patients) and control group (n=34 patients). The study group received duloxetine combined with 1Hz rTMS treatment on the right dorsolateral prefrontal cortex area for 6 weeks whereas the control group received duloxetine combined with pseudo-rTMS treatment for 6 weeks. The Hamilton Depression Rating Scale (HAMD-24) and Treatment Emergent Symptom Scale (TESS) were used to assess the clinical efficacy and the adverse reactions before, 2, 4 and 6 weeks after the treatment, respectively. Results Four patients (two from each group) dropped out of the study. The main effects of time (P<0.001) and groups (P=0.029) were significant and so was the interactive effect of time and group (P<0.001). The clinical curative effect of the study group were significantly better compared with the control group at the 2, 4, 6 weeks following treatment (P<0.001). The adverse reactions were mild in these two groups. Conclusions The combi?nation of 1 Hz rTMS with duloxetine is superior to either medication alone for the treatment depression.

It is critical to regulate the senescence-associated secretory phenotype (SASP) due to its effect on promoting malignant phenotypes and limiting the efficiency of cancer therapy. In this study, we demonstrated that marchantin M (Mar-M, a naturally occurring bisbibenzyl) suppressed pro-inflammatory SASP components which were elevated in chemotherapy-resistant cells. Mar-M treatment attenuated the pro-tumorigenic effects of SASP and enhanced survival in drug-resistant mouse models. No toxicity was detected on normal fibroblast cells or in animals following this treatment. Inactivation of transcription factor EB (TFEB) and nuclear factor-B (NF-B) by Mar-M significantly accounted for its suppression on the components of SASP. Furthermore, inhibition of SASP by Mar-M contributed to a synergistic effect during co-treatment with doxorubicin to lower toxicity and enhance antitumor efficacy. Thus, chemotherapy-driven pro-inflammatory activity, seen to contribute to drug-resistance, is an important target for Mar-M. By decreasing SASP, Mar-M may be a potential approach to overcome tumor malignancy.