Angina Pectoris, Variant ; physiopathology ; Arrhythmias, Cardiac ; Electrocardiography ; Humans ; Male ; Middle Aged

BACKGROUND:At present, it is controversial to choose methotrexate therapy alone or triple therapy in the treatment of rheumatoid arthritis.
OBJECTIVE:To systemical y evaluate the efficacy and safety of methotrexate therapy and methopterin+hydroxychloroquine+sulfasalazine triple therapy in the treatment of rheumatoid arthritis.
METHODS:Computer retrieval was performed on the Cochrane library, PubMed, EMBASE NRR (http://www.updatesoftware.com/National), CCT (http://www.control ed-trails.com) and the Chinese biomedical literature database. Manual retrieval was performed on Chinese major orthopedic journals. Randomized control ed trials of methotrexate therapy alone and methopterin+hydroxychloroquine+sulfasalazine triple therapy treatment for rheumatoid arthritis were col ected. Methodological quality of the included studies was evaluated. The statistical software Revman 5.0 provided by the Cochrane col aboration was used.
RESULTS AND CONCLUSION: A total of four literatures in a randomized control ed trial, a total of 297 cases were included;the methodological quality was al class B. Meta-analysis results showed that blood sedimentation improvements were larger in methotrexate therapy alone than in the triple therapy [mean difference=7.01, 95%confidence interval (CI) (2.82, 11.19), P=0.001). Improvements of joints were better in triple therapy than that in single therapy [OR=0.62, 95%CI (0.41, 0.95), P=0.03). There was no significant difference in adverse events. Meta analysis could not be done in ACR, because literature did not provide detailed data. Compared with the triple therapy treatment, methotrexate therapy alone obviously reduced the sedimentation of rheumatoid arthritis in adults, but in terms of joint function improvement, triple therapy was superior to methotrexate therapy alone. Moreover, on the adverse event, there was no significant difference between the two groups. Because this system evaluation included a less number of cases, it stil needs strict large-sample randomized control ed studies to increase the strength of the evidence.

A magnetic extraction sorbent based on Fe3 O4@poly ( methacrylic acid-co-ethylene dimethacrylate) ( Fe3 O4@MAED ) was synthesized using methacrylic acid and ethylene dimethacrylate as monomer and cross-linker, respectively. The magnetic sorbent was characterized by FTIR spectroscopy, elemental analysis and transmission electron microscopy. At the same time, the Fe3 O4@MAED was used to extract four benzoylurea pesticides in water and juice samples under magnetic dispersive solid phase microextraction ( MDSPME ) format. To obtain the optimal extraction conditions, several parameters, including the amount of sorbent, desorption solvent, extraction and desorption time, pH value, and ionic strength in sample matrix were investigated. Based on this, a fast, simple and sensitive method for the determination of benzoylurea pesticides in water and juice samples was developed by the combination of MDSPME with HPLC equipped with diode array detector. Under the optimized experimental conditions, the developed method possessed expected linear dynamic ranges, coefficients of correlation ( R2>0. 99 ) and sensitivity. The limits of detection (S/N=3) for target analytes were 0. 10-0. 19 μg/L in water and 0. 12-0. 30 μg/L in juice, respectively. The RSDs for intra-day were less than 7% and inter-day RSDs were less than 11%. The developed method was successfully applied to the determination of benzoylurea pesticides residues in water and juice samples and the recoveries of spiked target compounds were in the range of 69. 4%-118. 0%. The results demonstrated that the Fe3 O4@ MAED could extract benzoylurea pesticides effectively through multi-interactions including hydrophobic, hydrogen-bond and ion-exchange interactions between sorbent and analytes.

Objective To explore the diagnosis and treatment of pancreatic duct stones. MethodsClinical data of 29 cases of pancreatic duct stones were analyzed retrospectively. ResultsChronic pancreatitis was complicated in 21 cases, cholelithiasis in 12, pancreatic cancer in 2 . The correct diagnosis rate of ultrosonography, CT, ERCP and MRCP was 89.7%(26/29), 65.0%( 13/20 ),100%(6/6) and 100%(4/4) respectively. Six cases underwent EST,16 cases did transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy, Three cases did sphincteroplasty, pancreaticoduodenectomy and exploratory laparotomy were performed in one each. ConclusionsChronic panreatitis cholelithiasis is the main causes of pancreatic duct stones. Imaging examinations help to make diagnosis preoperatively. Transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy is the therapy of choices for patients with pancreatic duct stones.

OBJECTIVETo investigate therapeutic effects of vacuum sealing drainage (VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.

METHODSFrom October 2007 to February 2011, 397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years (ranging age from 20 to 73 years). According to AO classification, 74 feet were type I, 211 feet were type II, 108 feet were type III and 19 feet were type IV. The mean time from injury to operation was 5.6 h ( 2 to 12 h). The mean treatment time of was 10 months (4 to 19 months).

RESULTSOne hundred and forty-one patients were primarily healed, 97 patients were sutured at stage II. Split-thick skin grafting was performed at stage II was performed in 103 patients; free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure; Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months (averaged 10 months). The wounds healed well.

CONCLUSIONVSD for soft tissue defects caused by ankle injury is a simple and effective method, but can not replace debridement and transfer flap.

Adult ; Aged ; Ankle Fractures ; Debridement ; Drainage ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Skin Transplantation ; Treatment Outcome ; Vacuum ; Young Adult

OBJECTIVETo investigate development of a cell extraction process for preparing human meniscus acellular matrix, and morphology and biomechanical properties.

METHODSHuman meniscus were subjected to modified eight-step detergent, then, the specimens were assessed by staining with haematoxylin-eosin, toluidine blue, sirius red, saffron O, alcain blue and hoechst-33258, et al. The ultrastructure of the specimens was observed with scanning electron microscope. Transient recovery rate of deformation, maximal recovery rate of deformation and maximal compressive strength were tested to determine the biomechanical properties of the scaffold.

RESULTSEvery stain confirmed that the celluar constituents of the specimens were removed. The specimens stained positively by staining with sirius red. Lacuna were found irregularly not only on the surface of the meniscus,but also in the meniscus with scanning electron microscope. Pores in the specinmens were large, the diameter of pores was 80 to 760 microm, porosity was over 67%. The transient recovery rate of deformation was (89.62 +/- 1.04)%, the maximal recovery rate of deformation was 100% and the maximal compressive strength was (3.04 +/- 0.13)N, when the specimens were compressed 30%.

CONCLUSIONThe modified eight-step detergent can remove the immunogenic cell components from human meniscus, in addition, 3D extracellular matrix can be retained. The scaffold has good biomechanical properties. This scaffold stands a good chance to be an implant for future tissue engineering of the human meniscus.

Adult ; Cell Separation ; methods ; Cells ; chemistry ; cytology ; Cells, Cultured ; Humans ; Male ; Menisci, Tibial ; cytology ; Staining and Labeling

Objective The onset and progression of lung cancer correlate closely to individual genetic background .This study evaluated the correlation between the onset risk of lung cancer and short tandem repeat (STR) polymorphisms in order to find a new pathway for investigating the pathogenesis of lung cancer . Methods Using PCR and electrophoresis on 15 STR loci , we studied the gene and genotype frequencies of peripheral vein blood specimens from 120 lung cancer patients and 156 healthy individuals in Nan-jing area.According to the differences in the allele distribution of the 15 STR loci, we evaluated the susceptive and/or resistant factors relevant to lung cancer . Results There were statistically significant differences between the lung cancer patients and healthy controls at alleles 10, 15.2, and 16 of the loci CSF1PO, D19S433, and D3S1358 (P<0.05, OR>1), as well as at alleles 14 and 14.2 of the loci CSF1PO and D19S433 (P<0.05, OR<1). Conclusion It is possible that alleles 10, 15.2 and 16 of the loci CSF1PO, D19S433, and D3S1358 are susceptive factors and alleles 14 and 14.2 of the loci CSF1PO and D19S433 are resistant factors relevant to lung cancer .

BACKGROUND: Anterior cervical decompression and bone graft fusion is always the standard operation type for the treatment of cervical spondylotic radiculopathy and myelopathy. However, secondary degeneration and new symptoms caused by the stress increase of adjacent segments following anterior cervical spinal fusion have been paid more and more attention. Artificial cervical disc replacement provides a new choice for the treatment of cervical syndrome.OBJECTIVE: To observe the therapeutic effect of BRYAN& artificial cervical disc displacement for the treatment of cervical spondylotic radiculopathy and myelopathy.DESIGN: Self-control experiment.SETTING: Department of Orthopaedics, Sixth Hospital of Ningbo.PARTICIPANTS: Seventeen patients with cervical spondylotic radiculopathy and/or myelopathy admitted to the Department of Orthopaedics, Sixth Hospital of Ningbo were involved between December 2003 and February 2005 were involved in the study. Informed consents were obtained, and all participates were approved by Medical Ethics Committee.There were 9 patients with cervical spondylotic myelopathy, and 8 patients with cervical spondylotic radiculopathy.BRYAN& artificial cervical disc system is an artificial cervical intervertebral disc with composite structure. It is constructed by two titanium alloy end plates and polymer core, which can bear loading and took polyisocyanate as matrix.METHODS: BRYAN& artificial cervical disc system was used in the treatment. All the patients underwent single-segment displacement. Two patients underwent the displacement at C3-4, five at C4-5, 8 at C5-6 and 2 at C6-7. At postoperative 1, 3and 6 months, X-ray lateral position, anteflexion position, posterior extension position, the left and right side dynamic position plains were taken to investigate prosthetic stability. Neurologic function was evaluated according to Japanese Orthopaedic Association (JOA) scoring system.MAIN OUTCOME MEASURES: ① Investigating whether or not prosthesis displaced by means of dynamic position plains.② Investigating the recovery of neurologic function by JOA scoring system.RESULTS: ①JOA average scores were elevated to 15 from preoperative 8.5. Nervous system symptoms had improved to different extents, and the mean improvement rate was 75%. At postoperative 1,3 and 6 months, all the patients were followed up and their X-ray plains of cervical lateral position and flexion-extension position showed good stability,indicating that motor function was not lost obviously. No heterotopic ossification was found around the prothesis. ②Wound infection was not found in any patient. At postoperative 3 months, less than 2 mm slight displacement appeared in the prothesis in one patient, and there were no obvious symptoms. Prothesis abrasion, subsidence, bone bridge formation and other rejections were not found in the other prothesis. Prothesis had good biocompatibility, and could be examined by routine CT and MRI.CONCLUSION: Artificial cervical disc replacement can obviously improve the symptoms of patients, and has good therapeutic effects in the treatment of cervical syndrome.

ObjectiveTo investigate the effects of short-term enriched environment on the hippocampal formation and the myelinated fibers in the hippocampal formation of mid-aged female rats. Methods Twenty 14-month female SD rats were randomly divided into 10 enriched environment (EE) rats and 10 standard environment (SE) rats. EE rats were reared in enriched environment and SE rats were reared in standard environment for 4 months. Then, five rats were randomly selected from each group. The spatial learning capacity was assessed with Morris water maze. The hippocampal formation and the myelinated fibers in the rat hippocampal formation were quantitatively investigated with transmission electronic microscopy technique and stereological methods. Results Short-term enriched environment enhanced the spatial learning capacity of the mid-aged female rats. The total length and total volume of the myelinated fibers in the hippocampal formation of the EE rats was significantly increased by 43.3% and 47.4%, respectively, when compared to the SE rats. There was no significant difference in the hippocampal volume and the mean diameter of the myelinated fibers in the hippocampal formation between two groups. The increase of the total length of the myelinated nerve fibers in the hippocampal formation was mainly due to the increase of the myelinated fibers with small diameter. Conclusion Short-term enriched environment had significant effects on the spatial learning capacity and the myelinated fibers in the hippocampal formation of middle-aged female rats.

ObjectiveTo investigate the effects of short-term enriched environment on the hippocampal formation and the myelinated fibers in the hippocampal formation of mid-aged male rats. MethodsTwenty 14-month old male SD rats were randomly divided into enriched group and standard group. Enriched rats were reared in enriched environment and standard rats were reared in standard environment for 4 months. Then, the spatial learning capacity of enriched rats and standard rats was tested with the Morris water maze. After the Morris water maze test, the total volume of the hippocampal formation and the myelinated nerve fibers in the hippocampal formation were quantitatively estimated with transmission electronic microscopy technique and stereological methods. Results There was not significant difference in the spatial learning capacity between enriched group and standard group. The total volume of the hippocampal formation of enriched rats was not significantly increased by 4.6% when compared with that of standard rats. The total volume, total length and mean diameter of the myelinated nerve fibers in the hippocampal formation of enriched rats were significantly increased when compared with those of standard rats. Conclusions Four-months enriched environment significantly affected the myelinated fibers in the hippocampal formation of mid-aged male SD rats. The present results might provide an important theoretical basis for searching the ethology strategy to delay the progress of brain aging in the future.