Osteoarthritis (OA) is a kind of chronic and frequently-occurring disease in the elderly.It is also called degenerative disease.Pain,stiffness,swelling,deformity and dysfunction of joints are the main clinical manifestations,which seriously affect the quality of life.Kaschin-Beck Disease (KBD) is a kind of endemic diseases;its main feature is cartilage degeneration and necrosis.Although KBD becomes a typical OA in late stage,it is different from OA.Osteoprotegerin (OPG) and insulin-like growth factor (IGF)-1 participate in the bone growth,repair,and alteration.In this paper,we summarized clinical manifestations and pathological changes of OA,and reviewed the current situation and development of OPG and IGF-1 in OA bone remodeling.

Objective To analyze the treatment effect and factors affecting the prognosis in young people of papillary thyroid carcinoma (PTC).Methods A total of 69 PTC patients were reviewed retrospectively in Sun Yatsen University Cancer Center from Dec 1996 to Oct 2005.The prognostic status were compared using the Kaplan-Meier methods,the factors were analyzed by Log-rank test and the multiple factors were estimated by the Cox regression models.Results There were 26 males and 43 females.The median age was 24 years (mean:23.1 years).The average follow-up time was 113 months ranging from 73 to 174 months.20.3％ patients (14/69) experienced recurrence during follow-up time and 1.4％ patient (1/69) died.All the patients received levothyroxine after operation.The 10 year disease-free survival (DFS) rate of patients with or without extra thyroidal extension (ETE) of PTC was 29.6％ and 80.1％,respectively (P ＜ 0.01).Multivariate analysis showed that young PTC people with ETE had a worse prognosis (P =0.004).Conclusions Young papillary thyroid carcinoma patients had a favorable outcome.Surgical procedure was the first choice for this kind of patients.ETE was an independent factor for the recurrence of young PTC patients.

Wistar rats(n=24) were divided into normal control group(NC), food restriction group(FR), and catch-up group(RN). Serum glucose,lipids, gastrin, the ratio of visceral fat to body fat, adipocyte CCK2R mRNA and protein levels were determined. Compared with NC group, FR rats had lower serum gastrin and visceral fat formation. The adipocyte CCK2R mRNA and protein levels of FR rats were lower than those of NC rats. Serum gastrin level of RN rats was higher than those of FR and NC rats(P＜0.05). The ratio of visceral fat to body fat in RN rats increased compared with FR rats and was close to that of NC rats. The adipocyte CCK2R mRNA and protein levels of RN rats were higher than those of FR and NC rats. Gastrin and its receptor pathway possibly play a role in the mechanism of visceral fat accumulation in catch-up rats.

Objective To compare the clinical therapeutic effect of percutaneous nephrolithotomy (PCNL) and flexible ureteroscope lithotripsy (FUL) for unilateral lower-calyceal calculi with the diameter of 10-20 mm. Methods The clinical data of 65 patients with unilateral lower-calyceal calculi with the diameter of 10-20 mm were retrospectively analyzed. Thirty cases were treated with PCNL (PCNL group), and 35 cases were treated with FUL (FUL group). The operative time, success rate of lithotomy, haemoglobin decrease after operation, postoperative hospital stay, hospitalization expenses and complication were compared between 2 groups. Results Treatment was completed successfully in the patients of 2 groups, without ureteral perforation, avulsion and other serious complications intraoperatively and postoperatively. There were no statistical differences in success rate of lithotripsy, incidence of high fever after operation and postoperative analgesia rate between 2 groups (P>0.05). The operative time and hospitalization expenses in FUL group were significantly higher than those in PCNL group:(95.27 ± 22.69) min vs. (62.25 ± 20.73) min and (17 242 ± 2 679) yuan vs. (14 205 ± 1 654) yuan, and the haemoglobin decrease after operation and postoperative hospital stay time were significantly lower than those in PCNL group:(0.67 ± 0.33) g/L vs. (7.98 ± 4.33) g/L and (3.75 ± 0.78) d vs. (6.54 ± 1.68) d, and there were statistical differences (P<0.05). Conclusions For the treatment of lower-calyceal calculi with the diameter of 10-20 mm, the success rates of lithotripsy of PCNL and FUL are similar. FUL has less trauma, with shorter postoperative hospital stay time, but the cost is relatively high.

Cultured primary human umbilical vein endothelial cells (HUVECs) were divided into 4 groups:normal control( NG ),persistent high glucose ( HG ),hyperglycemia group ( TG ),and mannitol control ( MA )groups.After 1,4,and 7 days of culture,cells were collected.Cell proliferation,cell apoptosis,ROS,SOD,MDA,and NO level,eNOS mRNA and protein level were measured.Endothelial cell proliferation was inhibited in HG,TG,and MA groups compared with NG group.Hyperglycemia memory induced apoptosis of endothelial cells,increased ROS and MDA generation,and down-regulated intracellular SOD level,findings similar to those in HG group.After 24 h of culturing,eNOS expression and NO generation in both HG and TG groups were higher than those in NG group.However,after 7 days of culturing,eNOS expression and NO generation in both HG and TG groups were lower than those in NG group.These results suggest that in hyperglycemia memory cell model,transient hyperglysemia may lead to persistent imbalance in oxidative stress and reduce endothelium-derived relaxing factor NO level,indicating that hyperglycemia memory may play an important role in persistent vascular endothelial cell injury.

Objective To explore the effect of cigarette smoke exposure on testis structure and nitric oxide (NO) level in testis of rats.Methods A total of 160 adult male SD rats were divided into control group and low,medium,high dose groups.The smoke-exposed rats were respectively exposed to the smog for the periods of 2,4,6,8 and 12 weeks,10 rats in each group.The smoke-exposed rats were exposed to cigarette smoke for 0.5 h per day.The testicular tissue structure was observed and the body mass and the NO level of testis were measured.Results Compared with the control group and low dose group,the body mass of the rats was significantly lower in the medium and high dose groups exposed for 4,6,8,12 weeks (P<0.05).Compared with the medium dose groups,the body mass of the rats was significantly lower in the high dose group exposed for 8 weeks and 12 weeks (P<0.05).And with the increase of exposure dose,the reducing was even more obvious.Compared with the control group and low and medium dose groups,NO level in testis of rats was significantly increased in the high dose groups exposed for 2,4,6,8 weeks (P<0.05).Compared with the control group,NO level in testis of rats was significantly increased in the medium dose groups exposed for 8 weeks (P<0.05).Compared with the control group,NO level in testis of rats was significantly increased in the low,medium and high dose groups exposed for 12 weeks (P<0.05);and compared with the low dose group,NO level in testis of rats was significantly increased in the medium and high dose groups(P<0.05).Conclusion Cigarette smoke exposure may have impacts on testis tissue and lead to the increase of NO level in testis of male rats.

Objective To evaluate the feasibility and clinical efficacy of intra-abdominal exposure instruments in laparoendoscopic single-port nephrectomy(LESS-N).Method From February 2012 to July 2016,61 cases of LESS-N were performed in our center.There were 34 males and 27 females with a mean age of (60.3 ± 9.4) years old (ranging 36-72 years old).There were thirty-nine cases of renal tumors and twenty two cases of nonfunctioning kidney.The patients were divided into two groups.Group A included 39 cases that underwent conventional LESS-N (22 radical nephrectomy/17 simple nephrectomy).Group B included 22 cases that underwent intra-abdominal exposure instruments assisted LESS-N (17 radical nephrectomy/5 simple nephrectomy).The perioperative and postoperative data were collected and analyzed retrospectively.Results All the procedures of these two groups were completed successfully.In Group A,four patients were added one 5 cm additional trocar and two patients were converted to open surgery.No additional trocars or conversion to open surgery were needed in Group B.For LESS radical nephrectomy,there were no significant differences of mean tumor diameter (5.7cm vs.5.4 cm,P =0.65) between two groups.The average operative time was (95.1 ± 43.9) min in Group B which was lower than that in Group A (127.4 ± 61.9) min (P ＜ 0.01).The mean renal vascular processing time was declined from (25.4 ± 10.1)rmin in Group A to (18.8 ± 8.9)min in Group B (P ＜ 0.05).The mean estimated blood loss was (128.6 ± 51.1) ml in Group A and (98.7 ±-57.6) ml in Group B (P ＜ 0.05).No severe intraoperative and postoperative complications occurred in both group.Conclusions Intra-abdominal exposure instruments are feasible and effective for LESS-N.This system may shorten the operation time,reduce the amount of bleeding and improve surgical accuracy.

Objective To evaluate the safety and efficacy of recombinant bovine basic fibroblast growth factor in the treatment of corticosteroid-dependent dermatitis.Methods A randomized,double-blind,placebo-controlled clinical trial was carried out.By simple randomization,64 patients with corticosteroid-dependent dermatitis were randomly and equally divided into 2 groups:treatment group topically applying recombinant bovine basic fibroblast growth factor gel twice a day for 4 consecutive weeks,and control group topically applying the gel vehicle twice a day for 4 consecutive weeks.Clinical symptoms and signs were scored before the treatment and after 1-,2-and 4-week treatment.Meanwhile,the water content of the stratum corneum,skin sebum content and transepidermal water loss (TEWL) of the skin lesions were detected.Results Thirty-one patients in the treatment group and 30 in the control group completed the trial.The clinical symptom and sign scores in the treatment group were significantly lower at week 2 and 4 after starting treatment (1.35 ± 0.55 and 1.00 ± 0.45,respectively) than that before treatment (2.77 ± 0.43,both P ＜ 0.05),as well as lower at week 1 (2.06 ± 0.51),2 and 4 after starting treatment than that in the control group (2.43 ± 0.57,2.17 ± 0.53,1.93 ± 0.45,respectively,all P ＜ 0.05).The treatment group showed significantly increased water content of the stratum corneum at week 4 after starting treatment,significantly increased skin sebum content,but decreased TEWL at week 2 and 4 after starting treatment compared with those before treatment (all P ＜ 0.05).Compared with the control group,the treatment group showed significantly higher skin sebum content at week 2 and 4 after starting treatment,higher water content of the stratum corneum,but lower TEWL at week 4 after starting treatment (all P ＜ 0.05).No adverse reactions were observed in either of the 2 groups.Conclusion Recombinant bovine basic fibroblast growth factor is effective and safe for the treatment of corticosteroid-dependent dermatitis,and contributes to repairing and reconstructing the skin barrier function.

Objective: To study the therapeutic effect of laparoscopic ureteral end-to-side anastomosis at pelvic level for duplicate ureteral malformation. Methods: Clinical data of 10 children with unilateral ureteral duplication, who received laparoscopic ureteral end-to-side anastomosis at pelvic level at Department of Urology, Affiliated Children′s Hospital of Nanjing Medical University from September 2016 to November 2017 were reviewed.There were 6 boys and 4 girls with an average age of 13.9 months(1 month and 21 days to 3 years and 9 months). Ultrasonography, intravenous pyelography and magnetic resonance urography were performed before surgery.There were 6 cases of duplication with hydronephrosis in the upper moiety. The rest 4 cases were complicated with ureteroceles.Presentations included urinary dripping and symptoms caused by urinary tract infections.Urine test, ultrasonography, intravenous pyelography were performed during the 3-16 months follow-ups for all the patients after surgery. Results: The laparoscopic ureteral end-to-side anastomosis was performed successfully in all patients at the pelvic level, the average ope-rating time was 98 minutes (60-125 minutes) and mean hospital stay was 7.3 days(7-8 days). All the presentations disappeared after surgery.All the patients were followed up for 3 to 6 months with relieved hydronephrosis.Postoperative examination of intravenous pyelography in 10 cases showed that there was no anastomotic obstruction. Conclusions The laparoscopic ureteral end-to-side anastomosis can be used for duplicate ureter, and it is a safe and effective method for the treatment of ureteral duplication.