Objective:To investigate the clinical effects of arthroscopic debridement combined with intra-articular injection of sodi-um hyaluronate in the treatment of knee osteoarthritis. Methods:One hundred and seventy-two cases with knee osteoarthritis were ran-domly divided into the treatment group and the control group. The control group received arthroscopic debridement, while the treatment group received intra-articular injection of 2. 5ml sodium hyaluronate after arthroscopic debridement. Lequence score, Lysholm score and visual analogue scale for pain were compared between the two groups before the treatment and after the 1-week and 3-month treatment, and the clinical effects were compared after the 3-month treatment as well. Results: Lequence score, Lysholm score and visual ana-logue pain scores after the treatment were lower than those before the treatment with significant differences (P <0.01) in the two groups. After the treatment,Lequence score, Lysholm score and visual analogue pain scores of the treatment group was lower than those of the control group with significant differences (P<0. 05 or 0. 01). After the 3-month treatment,the clinical efficacy of the treatment group was better than that of the control group (P<0. 05). Conclusion:Arthroscopic debridement combined with intra-articular injec-tion of sodium hyaluronate in the treatment of knee osteoarthritis has better efficacy than arthroscopic debridement alone. The combina-tion can effectively improve symptoms, which is worthy of clinical promotion.

Objective Measure the epicondyles of the distal femur on magnetic resonance image(MRI), in order to locate presicely the surgical transepicondylar axis(STEA) in total knee arthroplasty(TKA) and to provide theoretical basis for the designing of the size of the femoral component. Methods Totally 78 normal knees of Chinese individuals were studied. The images of coronal, sagittal and traverse sections of the knee were obtained by magnetic resonance image. Measurement included the width of the STEA, distance between the epicondyles and the joint line, anterior posterior width of the medial and lateral epicondyles, posterior condyle angle. Results The width of the STEA averaged(79.55±4.90)mm in males, and femles(71.18±4.22)mm. The distance from the epicondyles to the joint line was correlated with the width of the STEA, so was the anterior posterior width of epicondyles. PCA averaged(4.22±2.07)°. Conclusion The size of the epicondyles in Chinese is significantly smaller than that of the Westerns. The ratio between anterior posterior width of the medial epicondyle and the width of the STEA is 0.84, and is 0.87 between anterior posterior width of the lateral epicondyle and the width of the STEA. The distance from the epicondyles to the joint line is helpful to locate the STEA. The reliability is poor to locate the STEA by touch or PCL.

Objective To evaluate the effects of the treatment for femoral neck fractures with closed reduction and cannulated screw fixation.Methods The results of stabilization of the femoral neck fracture with cannulated screws in 62 patients(25 male,37 female)from 2001to 2008 were reviewed retrospectively.The mean age of the patients was 68.6 years old.Results 55 patients(88.7%)had cured,30 patients were been cured,25 patients were been good healthy ,7patients were not cured.The duration of follow up was 8-62 months in 62 patients.Conclusion Closed reduction and internal fixation with cannulated screw is an effective method of minimally invasive,safety and inexpensive for femoral neck fractures.

Objective To observe the curative effect on non-obese type 2 diabetes and the effect on change of glucagon-like peptide-1 (GLP-1) of gastric bypass operation. Methods Thirty-two cases of gastric ulcer with non-obese type 2 diabetes were suffered gastric bypass operation. Plasma glucose concentrations, insulin and GLP-1 were measured respectively in fasting and postprandial conditions before operation and in week 1, 2, 3 and month 1, 3, 6 after gastric bypass operation, and the body mass index (BMI), homeostasis model assessment ? cell function index (HBCI) and glycosylated hemoglobin (HbA1c, the index was detected only before operation and in month 3, 6 after operation) were also measured. The turnover of the diabetes condition in the 6th month after surgery was observed. Results Compared with the levels before operation, the fasting and postprandial plasma glucose levels were descending (P0.05). The diabetes control rate was 78.1%(25/32) overall six months after operation. Level of GLP-1 was negatively correlated with level of plasma glucose (P

OBJECTIVE: To study the therapeutic mechanism of salvianolic acid B (SA-B) in treating hepatic fibrosis. METHODS: Twenty-four Wistar rats were randomly divided into 3 groups: normal control group, untreated group and SA-B-treated group. Rats in the untreated and SA-B-treated groups were injected intraperitoneally with 0.5% dimethylnitrosamine (DMN) for 4 weeks, daily for 3 days each week at a dose of 10 microg/kg, to induce hepatic fibrosis. Then, rats in the SA-B-treated group were given SA-B orally for another 4 weeks. Hydroxyproline (Hyp) contents in liver tissue of the rats in 3 groups were determined with HCl hydrolysis, and collagen type I, transforming growth factor-beta 1 (TGF-beta1), transforming growth factor-beta receptor type I (TbetaRI) and transforming growth factor-beta receptor type II (TbetaRII) were detected by Western blotting. RESULTS: The Hyp content and the expressions of collagen type I, TGF-beta1, TbetaRI and TbetaRII in the liver tissue of rats in the untreated group increased significantly as compared with those in the normal control group, while those in SA-B-treated group decreased significantly as compared with those in the untreated group. CONCLUSION: The therapeutic mechanism of SA-B in treating hepatic fibrosis may be related to inhibiting the expressions of TGF-beta1 and its receptors.

Policy background and stakeholder theory were elaborated.It could be concluded that the key stakeholders of the policy were residents,training hospitals,healthcare administrators,primary healthcare institutions and patients of such institutions.Through analysis of these stakeholders,effects on the interests of all parties were investigated and strategies to improve feasibility of the policy were put forward.Two key points were suggested for such policy goals.First,top-level policies should be designed and be effectively implemented.Second,conversion of the residents from permanent hospital employees to “contractors”or“ freelancers”.

Objective To analyze the feasibility of the policy that “Residents service or employment at primary care institutions after standardized training”.Methods Analyzing the feasibility of this policy by using questionnaire survey and in-depth interview.Results Constituent ratios of overall feasibility were 58.3％ (532/912)and 66.1％(603/912)for specialist and general practitioner respectively; percentage of feasibility of in-depth interview was 46.7％ (7/15).Conclusion The policy has feasibility,if government formulates and implements perfect complement policies effectively,and makes this policy to be impassable stage to resident.

Objective To investigate the influence of duodenal diverticula on cannulation time and complication in patients undergoing ERCP.Methods Data of 3 265 patients undergoing ERCP in Drum Tower Hospital affiliated to Nanjing Medical University between January 1,2008 and December 31,2014 were enrolled.The patients' information and endoscopic pictures/videos were collected.The duodenal diverticula,cannulation time,postoperative complications were analyzed.Results There were 2 599 (79.6％) cases of non-diverticula,445(13.6％) cases of one-diverticula,122(3.7％) patients with two or more diverticula,and 99 (3.0％) intradiverticular papilla.Patients with duodenal diverticula accounted for 20.4％ (666/3 265) of all patients who received ERCP procedure.The mean cannulation time was 6.62 minutes in all cases,6.30 minutes in non-diverticula group,7.63 minutes in one-diverticula group,8.07 minutes in two-or-more group,8.58 minutes in intradiverticular papilla group,respectively.There were significant differences in cannulation time and complication rate between the groups.Conclusion Duodenal diverticula may be one of the factors that affect the cannulation time.It may enhance the cannulation complications and prolong the cannulation time,especially in those with intradiverticular papilla.

A comprehensive analytical method based on ultra performance liquid chromatography tandem mass spectrometry has been developed for the simultaneous determination of 16 carcinogenic and allergenous dye stuffs (acid red 26, basic red 9, disperse blue 1, acid violet 49, disperse blue 3, solvent yellow 1, dispersed blue 106, disperse orange 3, disperse yellow 3, basic violet 1, basic violet 3, disperse red 1, solvent yellow 3, disperse blue 124, solvent yellow 2 and disperse orange 37).Various toy samples, including textile, leath er, paper, wood, balloon, modeling clay, limitation tattoo and aqueous liquid, were extracted under ultrason ication.Qualitative and quantitative analysis was carried out for the analyte under the MRM mode after the chromatographic separation on Waters ACQUITY UPLC BEH C_(18)(50 mm x 2.1 mm, 1.7 μm) column.The limits of quantitation(LOQ) for the 16 dyestuffs were in the range of 1.0-8.0 μg/kg.The mean recoveries at the three spiked levels of 5-100 μg/kg were 81.3%-98.6%, with the intra-day precision less than 11% and the inter-day precision less than 14%.The method is accurate, rapid, sensitive, and adapt to the inspec tion of the 16 dyestuffs in toys.

Objective To investigate the effect of gastric bypass on plasma glucose and glucagonlike peptide-1 (GLP-1) during oral glucose tolerance test (OGTT) in non-obese type 2 diabetes mellitus (T2DM) patients suffering from gastric ulcer necessitating a gastrectomy.Methods Thirty-two T2DM patients undergoing gastric bypass (GBP) for gastric ulcer were enrolled in this study.All patients underwent a 3-h OGTT with 75 g glucose (in a total volume of 300 ml) preoperatively and 1 week,1 month,3 months and 6 months after operation.Plasma glucose (PG) and GLP-1 concentrations were measured before (baseline) and then 30,60,120,and 180 minutes after OGTT.Areas under curves (AUC) were calculated by trapezoidal integration.The turnover of the diabetes conditions six months after the surgery were also measured.Results FPG level was (9.5±1.0) mmol/L before surgery,and significantly decreased to (7.4±1.0) mmol/L,one week,(6.5±1.2) mmol/L,one month,(8.0±1.6) mmol/L three months and (5.8±1.0) mmol/L,six months respectively after GBP(P ＜0.01).Peak level and AUC of PG during OGTT significantly decreased at aforementioned four time points after sugery (P ＜ 0.01).Oral glucosestimulated peak levels of GLP-1 was (20±3) pmol/L before GBP,and markedly increased to (83±15)pmol/L,(86±20) pmol/L,(87±22) pmol/L and (92±20) pmol/L respectively after GBP(P＜0.01).Stimulated AUC levels of GLP-1 significantly increased from (2457±395) pmol· min/L to (6499±1227)pmol·min/L,to (7275±1475) pmol·min/L,to (7307±1575) pmol·min/L and to (7974±1594)pmol· min/L during the study respectively(P ＜0.01).BMI levels were similar before and after GBP(P＞0.05).Two patients experienced complications(infection of incision and intractable hiccup).T2DM control rate was 78% when assessed at a time point of six months later.Conclusion Gastric bypass is effective in terms of glucose control and improving gucose tolerance in non-obese T2DM,and the hypoglycemic effect may be contributed to more GLP-1 secretion after GBP,but not to weight loss.