OBJECTIVESTo investigate whether tibial intercondylar hyperplasia can cause anterior cruciate ligament (ACL) injuries.

METHODSFrom February 2009 to October 2012, 58 cases (including 70 knees) with knee osteoarthritis (KOA) without trauma history were selected from the out-patient department of orthopaedics in Guang'anmen Hospital attached to China Academy of Chinese Medical Science. All cases were tested by MRI scanning, then vertical height of the medial and lateral intercondylar spine in coronal position and the area of abnormal signal of ACL in sagittal position were tested from patients. Correlation between the height of intercondylar spine and the area of abnormal signal of ACL were analyzed.

RESULTSFives cases of 58 cases( 70 knees) were excluded from episome in knee joint, and other 65 knees were in accordance with the inclusion criteria. Among them, there were 10 males and 48 females aged from 39 to 79 years old with an average of 61 years old. The vertical height of the medial intercondylar spine was (10.02 +/- 1.46) mm and lateral was (8.92 +/- 1.69) mm. The area of abnormal signal ACL was (318.42 +/- 130.10) mm2. There was positive correlation between the height of medial intercondylar spine and the area of abnormal signal of ACL (r=0.06, P=0.00). But there was no correlation between lateral intercondylar spine and the area of abnormal signal of ACL (P=0.10).

CONCLUSIONThe height of medial intercondylar spine and the area of abnormal signal of ACL is positively correlated. The clinical significance is in study, while the clinical meaning still need further study.

Adult ; Aged ; Anterior Cruciate Ligament ; abnormalities ; diagnostic imaging ; surgery ; Female ; Humans ; Hyperplasia ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; surgery ; Radiography ; Tibia ; diagnostic imaging ; pathology ; surgery

Objective:To optimize the ethanol extraction process of Rhizoma Corydalis and Salvia miltiorrhiza, and study the effect of comminution degree of the medicinal materials on the effective constituent. Methods:Using the alcohol concentration, alcohol vol-ume, extraction time and extraction times as the impacting factors,the content of tetrahydropalmatine and salvianolic acid as the indi-ces, the extraction process was optimized by orthogonal test of L9(34). Results:The best extraction conditions were as follows:Rhizo-ma Corydalis was crushed into coarse powder, the material / liquid ratio was 1∶6 with 75% ethanol as the extraction solvent,extracting twice with 1. 5h each. Conclusion:The extraction method is appropriate and simple,and can be used in the industrial production.

Animals ; Animals, Newborn ; Bone Marrow Transplantation ; Disease Models, Animal ; Humans ; Hypoxia, Brain ; physiopathology ; prevention & control ; Rats ; Rats, Sprague-Dawley ; Stromal Cells ; transplantation ; Transplants ; trends

Various cancers have seriously threatened human' s health. Screening newer and more effective anticancer agents from natural sources to cure these diseases is the focus in research. As novel sources of potential medicine, a number of metabolites isolated from endophytic fungi have been proved to have anticancer bioactivity. Usually, these endophytic fungi have special biochemical pathway and they can accumulate anticancer agents in cultures such as taxane, alkaloids, cytochalasins, podophyllotoxin, brefeldin A and so forth. The research advance on anticancer agents purified from endophytic fungi is expatiated systemically. In addition, the strategy of screening anticancer agents as well as the prospect on this area is introduced briefly.

BACKGROUND: The key point in the treatment of acute cerebral infarction lies in inproving the blood supply of brain effectively as soon as possible as well as rescue ischemic and half diazonal nerve cells, so as to contract the local of infarction as great as possible.OBJECTIVE: To observe the effect of traditional treatment of cerebral piamatral microcirculation in gerbil with cerebral ischemic reperfusion injury by supplementing qi and activating blood circulation.DESIGN: Contrast animal experiment at random.SETTING: Zhabei Branch of Shanghai Changzheng Hospital.MATERIALS: The experiment was performed in the Institute of Naval Medicine (key laboratory of the whole army). Twenty-two healthy Monglian gerbils of clean grade (six months old) were selected and randomly divided into medicine group and control group with 11 gerbils in each group.METHODS: Animals were routinely anaesthetized and fixed in prone position to open the cranium window in median line and expose the pia mater. The cranium window was protected by being covered with a cotton ball containing artificial cerebrospinal fluid (ACSF) after operation. Gerbils were fixed in dorsal position with an median incision made in the lateral cervical nucleus to isolate and expose bilateral common carotid artery (CCA). The bilateral CCA were occluded by atraumatic micro-bulldog clamp, and the occluded blood flow in the distal end was observed under the microscope. Thirty minutes after occlusion of bilateral CCA, the vascular clamp was unclamped to recover the cerebral blood reperfusion. Gerbils in the medicine group were abdominally injected with 0.4 mL of Huangqi injection (containing 0.8 g of crude drug), 0.3 mL of compound Danggui injection (containing Danggui, Chuanqiong and Honghua, 0.09 g for each)and 0.3 mL of Danshen injection (containing 0.45 g of Shengyao). Animals in the control group were abdominally injected with same-volume of normal saline. The changes of pial microcirculation were quantitatively observed in two groups through cranium window respectively before blockage, at the reperfusion after blockage as well as in 120 minutes after injection by laser microcirculation microscope and the TV video system.MAIN OUTCOME MEASURES: The changes of piamatral microcirculation as well as comparison in venous blood flow velocity in gerbils of each group before and after ischemic reperfusion.RESULTS: All gerbils were involved in the analysis of results with no animal died in the experiment.①When the CCA of animals in the two groups were blocked, obvious contraction of piamatral microcirculation was seen and partial blood vessels were blocked up. Platelet and red blood cells etc.adhered to the arteriolae of grade Ⅰ and veinules below grade Ⅲ with microthrombus formed and large ischemic area appeared. The blood flow rate was obviously slowed down. Moderate and severe aggregations were found in red blood cells, and the white blood cells were significantly increased.There was obvious exudation in the periphery of microvessels. After CCA reperfusion, the arteriolae and veinule were in different thickness, and the thrombus in veinule of grade Ⅰ and Ⅱ formed in the cerebral ischemia were difficult to be removed by blood flow. Red blood cell moderately aggregated, and the number of white blood cells greatly increased. White small thrombus could be seen sometimes, while the exsudation in the periphery of microvessel was not significantly ameliorated. Great changes were found in gerbils of the medicine group after abnormal injection of supplementing qi and activating blood circulation medicine: almost all arteriolae and venulae were opened, and the rate of blood flow was accelerated with the blood flow rate remarkably increased. Deposit in the venulae began to decreased, and the thrombus was gradually dissolved. Red blood cells were moderately aggregated or normal. Blood flow in ischemic spot was improved significantly than that after reperfusion. The exudation in the periphery of microvessels was gradually lessened even dissolved. However,no obvious change was found in gerbils of the control group. ②The blood flow rate of arteriole in the medicine group was 1.04-1.50 mm, which was obviously higher than that in the control group with significant differences (P ＜ 0.5-0.01).③The blood flow rate of veinule in the medicine group was 0.96-1.12 mm/s, which was remarkably higher than that in the control group with marked differences (P ＜ 0.05-0.01).CONCLUSION: The effect on piamatral microcirculation of gerbil with cerebral ischemic reperfusion by supplementing qi and activating blood is exact, which is directly related with accelerated blood flow rate, expanded veinule and arteriolae as well as ameliorated blood-supply of brain.

Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Osteogenesis Imperfecta ; diagnosis ; therapy

Objective To investigate the expression of vascular endothelial cell growth factor(VEGF) and its upregulation of matrix metalloproteinase-2(MMP-2)activation in synovial fluid of patients with rheumatoid arthritis(RA)as well as its role in the pathogeneses of RA.Mathods Expression of VEGF and receptor KDR in mononuclear cell(MNC)of synovial fluid of RA patients and controls were determined by Western blot;VEGF levels of supernantants from MNC was determined by ELISA;supernantants from KDR~+ MNC of synovial fluid of RA patients collected after incubation in serum-free medium with or without VEGF, their activity of MMP-2 was measured by gelatinolytic zymography;Boyden chamber-matrigel in vitro invasion assay was used to detect the invasive capacity in vitro in KDR~+ MNC of synovial fluid of RA patients incubat- ed with or without VEGF.Results The expressions of VEGF/KDR in MNC of synovial fluid of RA patients were significantly higher than those of controls;the MMP-2 activity and invasive ability of co-cuhured KDR~+ MNC with VEGF was higher than those of without VEGF.Conclusion VEGF upregulates MMP-2 activation and promotes invasion of MNC of synovial fluid of RA patients by interacting with receptor KDR,indicating that VEGF plays an important role in RA pathology.

Clinical practice teaching in out-patient department is an important part of general internal clinical teaching for medical students. From 2010, eight-year program medical students in Huazhong University of Science and Technology began their clinical rotation practice in the out-patient department of general internal medicine. The one-on-one tutoring style was used in clinical teaching. We combined teacher demonstration teaching method with teacher supervision teaching method in clinical practice, and carried out periodical case discussion. At the end of each rotation stage, regular teaching evaluation and examination was taken. It has been proved that our teaching mode can not only help the students improve their professional and practical levels of clinical skills, and also help them gain the clinical working abilities and the professional spirits, which is worthy of further promotion.

OBJECTIVETo compare the effect,safety,and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture,and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad.

METHODSFrom June 2010 to March 2013,59 patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster. Patients were enrolled and divided into paperboard and pad treatment group (paperboard group) and short leg plaster treatment group (plaster group) randomly according to the random number table. In paperboard group,there were 29 cases including 9 males and 20 females with an average age of (51.79±11.40) years old; the average course of injury was (11.59±6.58) hours. In plaster group, there were 30 cases including 9 males and 21 females with an average age of (52.13+17.34) years old ;the average course of injury was (11.03±7.06) hours. According to whether the fracture line across the articular surface, in paperboard group there were 14 cases of type A,15 of type B; in plaster group,16 of type A, 14 of type B. According to the degree of dislocation,in paperboard group there were 16 cases of degree I ,13 of degree II ; in plaster group,20 were degree I ,10 were degree II. Fracture was restored according to the type in manual. Patients in paperboard group were treated with paperboard and pad, and patients in plaster group were treated with short leg plaster. Fracture was fixed for 4 to 6 weeks according to fracture healing. On the 2nd, 4th,6th, 8th week and 3rd, 6th month after fixation, patients were followed up, and the foot function score was used to evaluate the function of injured foot. X-ray of injured foot was taken on the 2nd, 4th, 6th and 8th week were used to assess fracture healing.

RESULTSAll patients got complete follow-up. The X-ray result showed that all fracture reached at clinical healing on the 8th week after fixation without skin ulcer,nonunion and displacement of fracture. From the 4th to 8th week after fixation, paperboard group had a higher X-ray score than plaster group, but the difference between two groups had no statistically significance. Repeated analysis result showed that there was interact at different time point and between groups,the difference had statistically significance (P<0.01). The foot function score showed that at all time point, paperboard group had a higher score than plaster group, and on the 2nd, 4th, and 6th week, it had statistically significant difference(P<0.01) between two groups. On the 6th months after fixation,the excellent and good rate of paperboard group was 93.10%, higher than that of plaster group, which was 86.67%. But it had no statistically difference(P=0.483) between two groups.

CONCLUSIONUsing paperboard and pad fixation to treat the fifth metatarsal base fracture has the advantage of simplicity operating,reliable fixation, satisfactory effects, easily obtainable material.

Adult ; Aged ; Casts, Surgical ; Female ; Foot Injuries ; physiopathology ; surgery ; Fracture Fixation ; instrumentation ; methods ; Fracture Healing ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Metatarsal Bones ; injuries ; physiopathology ; surgery ; Middle Aged

ObjectiveTo study the amplification and expression of HER-2 gene and protein in breast cancer and to investigate the relationship between HER-2 gene and Ki-67 、P53 、ER、PR、lymph node metastasisandTNMstaging.MethodsFluorescenceinsituhybridization(FISH) and immunohistochemistry(IHC) method were used to detect the amplification and expression of HER-2 and the expression of Ki-67、P53、ER、PR in 150 cases of breast cancer. Results49 out of 150 cases were amplificated,positive rate of HER-2 gene was 32.68％.In the 32 patients whose expression of HER-2 protein was ( + + + ),HER-2 gene was expressed in 28 cases.In The 46 patients whose expression of HER-2 protein was ( + + ),HER-2 was expressed in 16 cases.In the 26 patients whose expression of HER-2 protein was ( + ),HER-2 was expressed in 3 cases.In the 47 cases that the expression of HER-2 protein was negative,there were 45 cases that the expression HER-2 gene was negative.The expression of HER-2 was correlated with ER,PR expression and TNM staging,but not significantly related with age,Ki-67,P53 and lymph node metastasis.ConclusionsFISH and IHC correlate well with each other in the determination of HER-2 gene amplication and protein expression in cases of invasive breast cancer.