Objective To analyze the clinical effects of small needle -knife therapy with movement exercise on knee osteoarthritis (KOA).Methods The clinical data collected from all the patients with hospital care and other 60 patients with KOA treated in the outpatient department in People's Hospital of Changzhi from February 201 4 to August 201 4.The patients were divided into needle -knife group and hyaluronan group,30cases in each group.The needle -knife group was given small needle -knife therapy to each patient one or two times.The hyaluronan group was given weekly intra -articular hyaluronan treatment,once a week,5times in total.But all the patients must do the same exercise movement as treatment.The clinical efficacy evaluation went on 6 months to follow up the patients.The evaluation for each patient was made at 0.5,1 st,2nd,4th,and 6th months using the following measures:WOMAC (Western Ontario and McMaster University Osteoarthritis Index)global assessment and SF -36 (short form 36). Make a contrast to the efficacy of both therapies on the osteoarthritis of knee joint from pain -easing and functional recovery.And the results were synthetically analyzed.Results In terms of pain assessment,the outcomes obtained by WOMAC on the two groups was statistically effective in the phase of 1 -6 months (t =-5.952,P <0.001 ),while those by SF -36 showed differences between the first 0.5 month and 6th month (t =3.1 21 ,P <0.001 ,t =4.091 , P =0.01 1 ).In terms of the functional assessment,the figures obtained by the WOMAC manifested that the needle -knife group was significantly superior to the hyaluronan group at the second and sixth months (t =-8.579,P <0.001 ,t =-3.993,P =0.003),and SF -36 also displayed that after treatment,the objects from the two groups per-formed distinctively in the first half,first,and sixth month respectively.(t =6.1 32,P <0.001 ,t =5.063,P =0.0068, t =8.1 09,P =0.003).Conclusion Small needle knife with movement exercise can obviously improve activity -related function of knee joint and relief the pain for the patients with KOA.

Pulmonary alveolar proteinosis (PAP) is a rare disease clinically, and at present no western medicine can effectively cure the disease. After the analysis of literatures related to Traditional Chinese Medicine (TCM) for treatment of the disease in the China National Knowledge Internet Database, it was discovered that the syndrome differentiation showed the disease closely associated with phlegm, blood stasis and yin deficiency. In this study, from view point of pulmonary gangrene TCM theory and treatment combined with PAP pathophysiological characteristics, it is emphasized that phlegm accumulation, blood stasis and yang deficiency are the key pathological manifestations of PAP, thus Yanghe decoction, Tounong powder, Kongxian pellet were used for treatment of one such case, the rational thinking in diagnosis and treatment of this patient being consistent with the idea learning western medicine for China use.

Objective To compare the differences between state-owned hospitals and private-funded hospitals in Shanghai on the introduction and application of hospital marketing conception. Methods Questionnaire and interviews were conducted to reflect understandings in marketing conception,advertisements,hospital brand,customers' sense of satisfaction,etc. Results State-owned hospitals were less concerned in marketing conception compared with their private counterparts,even less sufficient in marketing input or management. Conclusion The state-owned hospitals should update their conception and enhance their ability of marketing management.While the private hospitals need to maintain the moderation of marketing and deal with the relationship among marketing,profit and development properly.

OBJECTIVETo investigate whether programmed death ligand 1 (PD-L1) expressed in the periodontal tissue of chronic periodontitis and the correlativity of PD-L1 and different degrees of chronic periodontitis, provide experience for immunoregulation mechanism, clinical treatment and prognosis of chronic periodontitis.

METHODSGingiva and periodontal tissue of healthy people and chronic periodontitis patients were collected. Based on clinical probing, periodontal tissue were classified into three groups: periodontal tissues of healthy people, periodontal tissue of mild chronic periodontitis, periodontal tissue of severe chronic periodontitis. Fluorescent quantitation polymerase chain reaction was applied to explore the expression of PD-L1 mRNA in the periodontal tissue of the different groups. Western blot and immunohistochemistry method were utilized to test the expression of PD-L1 protein in the periodontal tissue of the different groups. Combining with clinical image data, the relationship between differentially expressions of PD-L1 and different degrees of chronic periodontitis was analyzed.

RESULTSThe relative expression quantity of PD-L1 in the periodontal tissue of the mild chronic periodontitis was significantly higher that of the severe chronic periodontitis (P<0.01). The relative expression quantity of PD-L1 in the periodontal tissue of healthy subjects and severe chronic periodontitis had no statistical significance (P>0.05).

CONCLUSIONThe expression of PD-L1 in the periodontal tissue negativelv regulates inflammatory periodontal tissue damage.

Objective To explore the influence of PUMA on radiosensitivity of pancreatic cancer AsPC-1 cells after Slug gene inhibition by transfected short interferencing RNA(siRNA). Methods The AsPC-1 cells were infected with MOI 10,50,100 for 72 h, respectively. The expression of Slug and PUMA was analyzed by Western blotting and immunohistochemistry methods. The transfected and control cells were exposed to 4 Gy γ-rays. The cells inhibition rate was examined by MTT, Hoechst 33342 and IP double staining. DNA ladder and Giemsa staning was used to observe apoptosis. Results The relative value of Slug expression was 0.831 ±0.14,0. 546 ±0.12 and 0.178 ±0.08 after AsPC-1 was infected with Slug-siRNA ( MOI 10,50,100) for 72 h, significantly lower than that of control group ( F = 4. 992,P ＜ 0.05 ).The relative value of PUMA was 0. 325 ±0. 07,0. 593 ±0. 11 and 0. 978 ±0. 12, after AsPC-1 was infected with Slug-siRNA ( MOI 10,50,100) for 72 h, significantly higher than that of control group ( F = 4. 324,P ＜ 0. 05 ). The cell proliferation rate was ( 78.76 ± 9. 36 ) % in transfection combined with radiosensitivity group, significantly higher than that of transfection group [ ( 43.68 ± 6.71 ) % ] and radiosensitivity group alone [( 19.25 ± 3.72)% ] (F = 5.056, P ＜ 0.05). The apoptosis of transfection combined with radiosensitivity group was significantly higher than that of others. Conclusions Slug gene targeting siRNA could inhibit the expression of Slug, and consequently increase the activation of PUMA expression, and so enhance the radiosensitivity to γ-rays.

Objective To summary the pathological and genetic features in nine Chinese limb girdle muscular dystrophy 2I (LGMD2I) patients.Methods Nine LGMD2I patients were recruited from Peking University First Hospital between 2011 and 2016, who came from nine unrelated and non-consanguineous families.The mean age of onset was (8.2±5.2) years (2 to 19 years), and the mean disease duration was (10.4±6.1) years (1 to 24 years).There were six males and three females, present with weakness in limb girdle muscles, four of whom accompanied with calf hypertrophy and three with scapular winging.Serum creatine kinase was 964-23 131 U/L (normal 25-190 U/L).Five of them who conducted electromyogram showed myogenic pattern.Muscle biopsy and next generation sequencing were performed in these patients, then sanger sequencing was performed to determine whether the variants co-segregated with the phenotype in these families.Results Muscle biopsy revealed myopathy features in six patients, dystrophic change in one, and only mild changes in two.Major histocompatibility complex-Ⅰ was positive in six cases, and rimmed vacuoles were found in two.There were seven mutations in fukutin-related protein (FKRP) gene.A reported mutation of c.545A>G (p.Y182C) appeared in eight cases, including three homozygotes and five compound heterozygotes.The mutation of c.1067T>C (p.Ile356Thr) was reported too.And c.1263C>A (p.Tyr421X), c.534G>T(p.Thr178Cys), c.1027G>C (p.Glu343Gln), c.1027G>T(p.Glu343X), c.1448A>G (p.Tyr483Cys) were found to be novel mutations.Conclusions LGMD2I showed large variation in myopathology.The missense mutation A545G(Y182C) is a hot spot of FKRP gene in our series.

Objective To investigate the protein and mRNA expression of HO-1 in the lung tissue of asthmatic rat and the correlation between the percentage of blood carbon monoxide Hb(COHb)and the expressions of HO-1 in the lung tissue of asthmatic rat.Methods Twenty Sprague-Dawley(SD)male rats were randomly divided into 2 groups,control group and asthma group.Each group had 10 rats.The assessment of the percentage content of blood carbon monoxide Hb(COHb)wag performed.The total cell number and differentiation cell numbers in bronchoalveolar lavge fluid(BALF)and the inflammatory cells of airway wall were counted,the protein expressions of HO-1 in airway wall wag detected with immunohistochemistry technique.and the mRNA expressions of HO-1 in airway wall was detected with RTPCR.Results The expression of HO-1 was mainly located in airway epithelium and macrophage.The percentage of the cells in which protein of HO-1was expressed were(5.03±1.22)%,(27.14±4.68)%in two groups.The optical densities of mRNA expression of HO-1 were 0.323±0.05,0.68±0.02.The percent content of blood carbon monoxide Hb(COHb)were(0.45±0.35)%,(3.89±1.15)%.The protein and mRNA expressions of HO-1 and the percent content of COHb in asthmatic group were higher than those of the control group (P＜0.01 respectively).There was a significant positive correlation araong the protein expression of HO-1 in airway wall and the percent content of COHb(r=0.971,P＜0.001),mRNA expressions of HO-1 in lung tissue and the percent content of COI-Ib(r=0.897,P＜0.001).Conclusion The protein and mRNA expressions of HO-1 in the lung tissue,and the percent of COHb in blood were significantly mcreaged in asthmatic rat,which suggested HO-1 may play a significant role in the pathogenesis of asthma.

Objective To evaluate the effect of point-of-care hemoglobin/hematocrit (POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice.Methods A total of 46 378 medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgery in the year of 2011 and 2013 were tracked. Paired t-test was used in intra-group comparison, while t-test of two isolated samples carried out in inter-group comparison. P<0.05 was defined as statistically significant difference.Results In the hospitals where POC HGB/HCT device was used (n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011 (39.86±20.20 vs. 30.49±17.50 Units, t=3.522, P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased (n=12, t=2.290, P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow.Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.

Objective To investigate the alterations in killer cell immunoglobulin-like receptors (KIRs)2D and their specific HLA-Cw ligands in patients with ankylosing spondylitis(AS)and determine whether the changes were correlate to the pathogenesis of AS.Methods Polymerase chain reaction of sequence specific primerB(PCR-SSP)was employed for genotyping the presence or absence of five KIR2D genes(KIR2DL1,2DS1,KIR2DL2,2DL3,2DS2)as well as HLA-Cw01-08 alleles from genomic DNA in 105 individuals with AS,together with 51 individuals with osteoarthritis(OA)and 120 healthy controls.Then HLA-C10-08 was divided into two groups.HLA-Cwasn and HLA-Cwlys to calculate the frequency of KIRID genotype.HLA-Gu alleles and KIR/HLA-Cw genotypes.Results The frequencies of HLA-Cwlys genes were significandy higher in patients with AS(0.269 7)compared with those in OA controls(0.148 2)and healthy controls(0.138 8,P=0.024,P=0.001,respectively).The frequency of KIR2DS1/HLA-Cwlys combination Was also markedly higher in AS group(26.67%)than that in OA controls(11.76%)and healthy controls(13.33%,P=0.039,P=0.018,respectively).Condusion The data suggest that the HLA-Cwlys allele may be associated with genetic susceptibility to AS and moreover.in the existence of HLA-Cwlys.the individuals with KIR2DS1 gene are likely to be at increased risk of AS.

Objective To investigate the function of CFTR in ApoE-/- mice with HHcy-induced hepato-cellular injury. Methods Thirty six 5-week old ApoE-/- mice were divided into three groups , including the ApoE-/- group, the HHcy group and the intervention group, (n = 12). Twelve normal C57BL/6J mice were fed with regular mouse diet as the normal control (SPF grade). HL-7702 human liver cells were intervened by Hcy (100 μmol/L) and 100 μmol/L Hcy + folic acid (100 μmol/L Hcy + F). The changes of Hcy, ALT and AST in the serum and the expression of CFTR mRNA and protein in liver and liver cells were detected. The concen-trations of ALT and AST in the liver cell intervened by VX-770 agonist and CFTR(inh)-172 inhibitor were mea-sured by ELISA. Results Compared with the control group , the levels of Hcy , ALT and AST were higher and the levels of CFTR mRNA and protein were lower in the Meth group (P < 0. 05 ) , while the reverse result in the Meth + F group (P < 0.05). Compared with the control group, the levels of CFTR mRNA and protein were de-creased and the levels of ALT and AST were increased in the 100 μmol/L Hcy group (P < 0.05). Compared with the 100 μmol/L Hcy group , the levels of CFTR mRNA and protein were increased and the levels of ALT and AST were decreased in the 100 μmol/L Hcy + F group (P < 0.05). Stimulated with VX-770 can reduce the concentrations of ALT and AST and the vice versa in the CFTR (inh)-17 group the concentration was increased in liver cells. Conclusion CFTR plays an important role in the regulation of hepatocellular injury by HHcy.