Objective To evaluate the morphological and signal intensity changes after anterior cruciate ligament reconstruction , and to analyze the correlations between MRI evaluation and clinical examination .Methods Totally 34 patients who underwent anterior cruciate liga-ment reconstruction in our hospital from July 2013 to June 2015 were given MRI examination .The morphology ,orientation and signal intensity of the anterior cruciate ligament grafts were evaluated on axial ,sagittal and coronal images .The grafts were assessed with Rak method ,and the clinical assessment was adopted with physical assessment method ,including drawer test ,axial shift test and Lachman test .The correlations be-tween MRI evaluation and clinical examination results were further analyzed by SPSS 16.0.Results After anterior cruciate ligament recon-struction,79%of the graft were visualized as a smoothly continuous low signal (well-defined type),15%of the graft showed increased signal intensity with only a small part of low signal bands ( intermediate type ) ,and 6% of the grafts showed remarkably increased signal intensity (indiscernible type).A statistically significant correlation was identified in MRI evaluation and clinical examination results (P<0.05). Spearman’ s correlation coefficient was 0.747 2 which indicating significantly positive correlation .Conclusion Magnetic resonance imaging is a noninvasive high-resolution imaging technology and it is an effective tool for evaluating anterior cruciate ligament reconstruction .

BACKGROUND:Individualized percutaneous cannulated screws fixation with the help of computer-assisted design and cast immobilization are common methods for treating nondisplaced wrist scaphoid fracture. However their clinical outcomes are stil unclear. ＜br> OBJECTIVE:To compare the clinical results of individualized percutaneous cannulated screws fixation with the help of computer-assisted design and cast immobilization for treatment of Herbert type Ib scaphoid fracture. ＜br> METHODS:A total of 36 patients with fresh Herbert type Ib scaphoid fracture were divided into two groups, individualized percutaneous cannulated screws fixation with the help of computer-assisted design group (screw group, 20 cases) and cast immobilization group (cast group, 16 cases). In the screw group, cannulated screws were inserted using 0.8 mm kirschner wires from scaphoid tuberosity based on the preoperative individualization fixation parameters. The direction of the wires was guided under C-arms and Herbert screws were percutaneously immobilized after fluoroscopy. In the cast group, radial deviation and palmar flexion plaster casts were immobilized for 3 months. The time of bone union, rate of bone nonunion, time return to work, wrist motion were recorded and compared in the fol ow-up. ＜br> RESULTS AND CONCLUSION:Al cases were fol owed for 10-24 months. Al patients in the screw fixation group and 13 out of 16 patients in the cast group achieved bone union. The average time of bone union of the two groups was 6 weeks and 14 weeks respectively (P＜0.001). The time of returning to work was 7.6 weeks and 16.8 weeks respectively, with significant differences between the two groups (P＜0.001). The range of motion of screw fixation group at the final fol ow-up was 96.4°-114.4°, average 104.4°, which was significantly higher than that in the cast group (66.4°-104.2°, average 94.2°;P＜0.001). Individualized percutaneous cannulated screws fixation with the help of computer-assisted design can provide mini-invasion, high accuracy and good reproducibility, has better results than cast immobilization in the treatment of Herbert typeⅠscaphoid fractures.

The concepts and relations of explanatory clinical trials and pragmatic clinical trials on randomized controlled trials of acupuncture are stated. The explanatory clinical trials and pragmatic clinical trials are different in the purpose of study, the controlled method, the treatment method and the solution problems. The explanatory clinical trials may enhance the understanding of the mechanism of a treatment; the findings of pragmatic clinical trials may be applied immediately in clinical practice. This paper explains that these clinical trials are of great importance to the methodology and practices of clinical effective evaluation of acupuncture based on TCM theory.
Acupuncture Therapy ; standards ; Humans ; Randomized Controlled Trials as Topic ; methods ; standards

ObjectiveTo explore the expression rule and clinic significance of Twist and E-cadherin and Vimentin in cervical squamous epithelial cancerization.MethodsChronic cervicitis were used as control group,the expression of Twist (using hybridization in situ),E-cadherin and Vimentin( SABC immunohistochemical stain) in tissues of cervical intraepithelial neoplasia (CIN) and cervical squamous carcinoma were detected,and the correlations were analyzed.ResultsThe positive rate of Twist in group of chronic cervicitis,CIN Ⅰ,CINⅡ,CIN Ⅲ and cervical squamous carcinoma was 10.0％,28.1％,29.6％,42.9％ and 64.3％,respectively.The expression rate of Twist in cervical squamous carcinoma group was higher than other groups ( P ＜ 0.05 ).The positive rates of E-cadherin and Vimentin were 80.0％,68.8％,55.6％,51.4％,39.3％ and 0,6.3％,7.4％,31.4％,32.1％,respectively.The difference of E-cadherin and Vimentin expression between the cervical squamous carcinoma ( or CIN Ⅲ group) and the chronic cervicitis group was obvious ( P ＜0.05,respectively).The expression of Twist was negatively correlated with E-cadherin( r =-0.37,P ＜0.01 ),and it was positively correlated with Vimentin in all cases of CIN and cervical squamous carcinoma( r =0.23,P ＜0.05).ConclusionsThere is a close relationship between abnormal expression of Twist and cervical squamous epithelial cancerization.Twist may participate in the genesis of cervical squamous carcinoma through mediating the expression of E-cadherin and Vimentin in cervix tissue.

OBJECTIVETo compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation.

METHODSFrom January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T₁₂ in 2 cases, L₁, in 7 cases, L₂ in 9 cases, L₃ in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups.

RESULTSAll patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence.

CONCLUSIONFor patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

Adult ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Reconstructive Surgical Procedures ; Retrospective Studies ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; injuries ; surgery

Objective To observe the efficacy of Wuteng Ercao decoction in treating active rheumatoid arthritis (RA) and its effects on the levels of cytokine interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α).Methods Sixty-five patients with active RA were randomly divided into treatment group (33 cases) and control group (32 cases). Patients in the control group were administered with methotrexate tablets 10 mg, oral taking, once a week;hydroxychloroquine sulfate tablets 200 mg, oral taking, twice a day;diclofenac sodium sustained release tablets 75 mg, oral taking, twice a day. Patients in the treatment group were administered with Wuteng Ercao decoction additionally, oral taking, three times a day. The treatment lasted for 12 weeks. The changes and untoward effects of various clinical and laboratory indicators were observed before and after treatment.Results After treatment, the tender joint count, swollen joint count, patient’s global assessment, and physician’s global assessment were improved (P<0.05), with statistical significance between the two groups (P<0.05). The levels of ESR, CRP, IL-6 and TNF-α decreased significantly after treatment (P<0.05), but those were more significantly in treatment group (P<0.05). There were 2 cases with untoward effects in the treatment group and 1 case in the control group (P>0.05).Conclusion Wuteng Ercao decoction is effective in patients with active RA and it can reduce the levels of IL-6 and TNF-α.

Objective To examine the changes of serum total and high density lipoprotein cholesterol during whole blood incubation and to investigate the possible mechanisms responsible for the instability.Methods A method for the measurement of serum total cholesterol (TC), total free cholesterol (TFC), high density lipoprotein cholesterol (HDLC) and high density lipoprotein free cholesterol (HDLFC) by high performance liquid chromatography (HPLC) was developed. Whole blood specimens were incubated at 25℃ and 4℃ for various period of time and serum TC, TFC, HDLC and HDLFC were measured.Results The new HPLC method showed a mean within-run CV of 0.22%~0.51%. The averaged changes during the incubations ranged 0.6%~2.0% for TC and 2.0%~4.1% for HDLC.Conclusion An HPLC method has been established that is highly precise and can be used for detecting subtle cholesterol changes in biological samples. Different cholesterol exchanges or transfers between blood cells and lipoproteins exist during various incubations. Prolonged whole blood storage that causes serum TC and HDLC changes should be avoided in clinical lipid measurements.

Objective To investigate the effect of dexmedetomidine (Dex)combined with ischemic preconditioning on liver ischemic reperfusion injury in rats in order to explore its possible mechanism. Methods Sixty healthy male SD rats weighing (251 ±18)g,were randomly (random number)divided into five groups (n =12 in each):sham-operation group (Group S:operation without ischemia), ischemia-reperfusion group (Group IR:hepatic pedicle occlusion for 30 min and reperfusion for 6 h), dexmedetomidine preconditioning group (Group Dex: dexmedetomidine 25 μg/kg was given intra-peritoneally at 30 min before operation),ischemic preconditioning group (Group IP:10 min ischemia,10 min reperfusion,followed by hepatic IR)and Dex combined with ischemic preconditioning group (Group Dex +IP:Dex 25μg/kg was given intra-peritoneally at 30 min befor operation,10 min ischemia and 10 min reperfusion was given followed by hepatic IR).The hepatic inflow of blood stream was occluded for 30 min by Pringle maneuver to establish hepatic ischemic reperfusion injury (HIRI)rat model.At the end of reperfusion for 6 h,the concentration of ALT,AST and LDH (lactate dehydrogenase)in serum were measured.The liver histological changes were examined after HE staining.The liver cell apoptosis were examined by TUNEL. The expression of heme oxygenase-1 were examined by Westeren blot and immunohistochemistry.H2 O2 and GSH (r-glutamylcysteinylglycine ) in liver tissue were detected by spectrophotometer.Differences among the groups were analyzed by one-way analysis of variance (ANOVA) and Student-Newman-Keul test by using SPSS version 17.0 software.Differences were considered significant at P <0.05.Results Serum concentrations of ALT,AST and LDH in group IR,Dex,IP and Dex +IP were significantly higher than those in group S (P =0.000).And those biomarkers in group Dex,IP and Dex +IP,were significantly lower than those in group IR (P =0.000).Furthermore,those biomarkers in group Dex +IP,were significantly lower than those in group Dex and IP (P =0.000).There were no significant difference in the serum concentrations of ALT and AST between group Dex and IP (P =0.550, 0.771),and the serum level of LDH in group Dex was significantly lower than that in group IP (P =0.000).The liver histopathological score and apoptosis index were the lowest in group S and the highest in group IR,and those in group Dex and group IP were significantly lower than those in group IR (P =0.000),and those in group Dex +IP were significantly lower than those in group Dex and group IP (P =0.000),and there were no significant difference between group Dex and IP (P =0.704,0.661 ).The expression score of HO-1 was the lowest in group S and the highest in group Dex +IP,and that in group Dex and group IP was significantly lower than that in group Dex +IP (P =0.000,0.002),and that in group IR was significantly lower than that in group Dex and group IP (P =0.000),and there was no significant difference between group Dex and IP (P =0.099).In respect of H2 O2 level and GSH level in liver tissue, compared with group S,the H2 O2 levels in groups IR,Dex,IP and Dex +IP were significantly higher (P=0.000,0.000,0.000,0.001)while the GSH levels were significantly lower (P =0.000).Compared with group IR,the H2 O2 level in group Dex,IP and Dex +IP was significantly lower than that in group IR while the GSH level was significantly higher (P =0.000 ).The H2 O2 level in group Dex +IP was significantly lower than that in group Dex and IP while the GSH level was significantly higher (P =0.000).There were no significant difference between group Dex and IP (P =0.480,0.667).Conclusions Both of dexmedetomidine and ischemic preconditioning can protect liver from ischemia reperfusion injury in rats to some extent,and the combined application of two gives better effects,which is attributed to the increasing expression of HO-1 to a certain extent.

AIM To study the pharmacokinetics of AZT in mice by encapsulation in liposomes Containing galactosylceramide (GalCer). METHODS AZT was encapsulated in liposomes containing GalCer and the pharmacokinetics of AZT-GalCer and free AZT were observed in mice. RESULTS Higher concentration of AZT in mice injected AZT-GalCer was found in plasma after 30 min and it was ten times as high as in mice injected with AZT. On the other hand, Ke decreased significantly from 0.037 to 0.021 h -1 , T_ 1/2 Ke increased significantly from 19 min to 35 min, and AUC was 2.77 times as high as in mice injected with AZT. CONCLUSIONS AZT-GalCer serving as a dilivery carrier could prolong the effective concentration of AZT in plasma. AZT-GalCer might have great therapeutic potential for treating AIDS.-