OBJECTIVESTo investigate the different effects of closed suction drainage and non-drainage for total knee arthroplasty(TKA) and to provide reference information for the choice of clinical treatment.

METHODSRandomized controlled trials (RCTs) of closed suction drainage versus non-drainage for TKA were collected from the Cochrane Library, PubMed, EMBase, Springer, CBM, CNKI, VIP and WANFANG database. Methodological quality of the RCTs was independently assessed using the Consolidated Standards of Reporting Trials (CONSORT) checklist. Data analysis was performed by RevMan Version 5.1.6 based on the methods recommended by the Cochrane Collaboration.

RESULTSTwenty-one RCTs without bias were finally enrolled, and 1920 enrolled knees were identified into drainage group (979 knees) and non-drainage group (941 knees). A lower incidence of soft tissue ecchymosis was demonstrated in the closed suction drainage group (OR = 0.30, 95%CI: 0.24 - 0.49); however, compared with the non-drainage group, more loss of blood (MD = 320.03, 95%CI: 235.31 - 404.76) and more need of homologous blood transfusion (OR = 1.83, 95%CI: 1.26 - 3.29) were found in the closed suction drainage group. In addition, there were no significant differences of postoperative infection (OR = 0.53, 95%CI: 0.22 - 1.32), deep venous thrombosis (OR = 1.00, 95%CI: 0.46 - 2.18), and the joint range of motion (MD = -0.04, 95%CI: -1.11 - 1.02) between the two groups.

CONCLUSIONBased on the current evidence, no obvious advantage is demonstrated for closed suction drainage, in comparison with non-drainage for TKA.

Arthroplasty, Replacement, Knee ; Drainage ; statistics & numerical data ; Humans ; Postoperative Complications ; epidemiology ; Randomized Controlled Trials as Topic ; Range of Motion, Articular ; Venous Thrombosis ; epidemiology

AIM:To explore the effect of Wnt/β-catenin signaling pathway in airway smooth muscle cells (ASMC) on asthmatic airway remodeling.METHODS:The asthmatic airway remodeling model in rats was established and the ASMC was isolated and cultured.The protein expression of β-catenin,glycogen synthase kinase-3β (GSK-3β),cMyc and cyclin D1 in the ASMC was determined by Western blot.After depressing the interaction between β-catenin and p300/CBP,the cell activity was measured by CCK-8 assay and the change of cell cycle distribution was analyzed by flow cytometry.Meanwhile,the protein expression of c-Myc and cyclin D1 in the ASMC was determined by Western blot after inhibiting P38 mitogen-activated protein kinase (MAPK) activity.RESULTS:The protein levels of β-catenin,c-Myc and cyclin D1 were significantly increased in asthma group while the protein level of GSK-3β was decreased in the same group (P ＜ 0.05).After depressing the interaction between β-catenin and p300/CBP,the cell activity of ASMC was decreased in asthma group compared with control group (P ＜ 0.05),and the change of the cell cycle distribution in asthma group was also more obvious (P ＜ 0.05).After inhibiting P38 MAPK activity,the protein levels of c-Myc and cyclin D1 were all decreased compared with control group in ASMC asthma and control rats (P ＜ 0.05).CONCLUSION:Wnt/β-catenin signaling pathway may participates in airway remodeling in asthma by increasing the protein expression of c-Myc and cyclin D1,reacting with the P38 MAPK signaling pathway and regulating the growth of ASMC.

OBJECTIVETo investigate the prevalence of viral infections and putative association of viral infection with illness severity in young children with severe lower respiratory tract infection (LRTI) in Chongqing.

METHODRespiratory secretion specimens were collected from 119 hospitalized patients with severe pneumonia from December 2006 to March 2008.After being processed, the samples were detected for respiratory viruses including respiratory syncytial virus (RSV), adenovirus (ADV), human metapneumovirus (hMPV), human bocavirus (HBoV), parainfluenza virus 1, 2, 3 (PIV 1, 2, 3), influenza virus A and B (IVA and IVB) either by PCR or RT-PCR. Clinical data were analyzed along with virological data by using appropriate statistical methods.

RESULTViral pathogens were identified in specimens of 86 (72.3%) cases, among which RSV was detected in 49 (41.2%) patients. More than one virus was detected in 23 individual (26.7%) samples, of which 19 were dual positive for RSV and another virus. Bacterial cultures were performed for 69 patients. Both bacterial and viral pathogens were identified in 53 (76.8%) patients. Bacterial and viral coinfection was demonstrated in samples from 41 (59.4%) cases.

CONCLUSIONViral pathogens are the main etiology of severe pneumonia in young children in Chongqing area during the study period. RSV was the most frequent viral pathogens, followed by ADV and hMPV. Coinfection with respiratory common viruses was relatively common, though co-infection with viruses did not appear to aggravate the patients' condition.

Adenoviridae ; isolation & purification ; Child, Preschool ; China ; epidemiology ; Human bocavirus ; isolation & purification ; Humans ; Infant ; Infant, Newborn ; Influenza A virus ; isolation & purification ; Metapneumovirus ; isolation & purification ; Pneumonia, Bacterial ; microbiology ; virology ; Pneumonia, Viral ; microbiology ; virology ; Respiratory Syncytial Viruses ; isolation & purification ; Virus Diseases ; virology

DNA barcoding method was conducted for the authentication of pollen materials due to difficulty of discriminating pollen materials bearing morphological similarity. In this study, a specific focus was to identify cattail pollen (Puhuang) and pine pollen (Songhuafen) samples from their adulterants which are frequently mixed-together. Regions of the internal transcribed spacer (ITS2) from 60 samples were sequenced, and new primers for cattail pollen were designed according to the sequence information. The results from the NJ trees showed that the species of pine pollen, Puhuang and their adulterants can be classified as obvious monophyly. Therefore, we propose to adapt DNA barcoding methodology to accurately distinguish cattail pollen, pine pollen and their adulterant materials. It is a great help for drug regulatory agency to supervise the quality of medicinal materials.
China ; DNA Barcoding, Taxonomic ; methods ; DNA, Plant ; genetics ; DNA, Ribosomal Spacer ; genetics ; Drug Contamination ; prevention & control ; Drugs, Chinese Herbal ; chemistry ; classification ; Molecular Sequence Data ; Phylogeny ; Pinus ; classification ; genetics ; Pollen ; classification ; genetics ; Quality Control ; Typhaceae ; classification ; genetics

Objective To investigate the relationship between matrix metalloproteinase(MMP)1 gene-519A/G polymorphism and the risk of coronary heart disease(CHD)in Northern Chinese Han population.Methods A total of 517 patients with CHD and 380 healthy adults diagnosed by coronary angiography were genotyped by polymerase chain reaction-restriction fragment length polymorphism and DNA sequence technology for the-519A/G polymorphism in MMP1 gene.Results (1)The frequency of AA genotype was significantly higher in patients with CHD than that in controls[67.70%(350/517) vs.40.26%(153/380),OR=1.64,P＜0.001,95%CI:1.44-1.86].People carrying A allele had increased risk for CHD(OR=1.49,P＜0.001,95% CI:1.33-1.69).(2)The frequency of AA genotype was higher in patients with acute coronary syndrome(ACS)than patients with stable angina pectoris[68.81%(278/404)vs.51.76%(44/85,),P＜0.01,95% CI:1.04-1.27].The A allele carriers were more likely to develop ACS(OR=1.11,95% CI:1.01-1.21,P＜0.05).Conclusion Our data shows MMP1 gene -519A/G polymorphism is associated with the risk of CHD,and A allele carriers are more susceptible for CHD in Northern Chinese Han population.

Mongolian medicine external treatment,which called five kinds of treatment in ancient time,is a kind of exter-nal treatment including fire moxibustion,poultice,soaking and other therapies.The therapy was gradually developed and per-fected in the course of Mongolian people's long-term struggle against diseases,which has characteristics of small trauma and suitable for long-term application.In this paper,the research progress of external treatment of orthopedic diseases in Mongolian medicine in recent years was summarized,and it was concluded that external treatment of orthopedic diseases in Mongolian medicine had distinct characteristics and accurate efficacy.However,there are still deficiencies in the standardization of clini-cal operation and the study of the mechanism of therapeutic action,which need further research and improvement.

OBJECTIVETo investigate the expression of oncoprotein c-erbB2 in primary breast cancer and to analyze its relation to its prognosis.

METHODSImmunohistochemical staining for c-erbB2 was performed on paraffin-embedded specimens of primary breast cancer from 284 patients, and the relation to its prognosis was statistically analyzed.

RESULTSPositive expression rate of c-erbB2 was 26.8% (76/284) in 284 primary breast cancer patients. Expression of c-erbB2 was positively correlated with the status of lymph node metastasis (P = 0.003). Univariate analysis indicated that c-erbB2 expression is a significant prognostic factor for the disease-free survival (DFS) (P = 0.024) and overall survival (OS) (P = 0.002), while multivariate analysis demonstrated that c-erbB2 is an independent prognostic factor for OS (P = 0.023). Moreover, tumors with c-erbB2 positive expression are more tend to metastasis to other viscera than those with c-erbB2 negative. c-erbB2 expression has different prognostic values for patients with different status of estrogen receptor (ER) and lymph node metastasis.

CONCLUSIONc-erbB2 expression is an independent prognostic factor for total survival time in primary breast cancer patients, and its prognostic values are different according to the different ER status and lymph node metastasis.

Adult ; Aged ; Breast Neoplasms ; metabolism ; pathology ; therapy ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; therapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Mastectomy, Radical ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Survival Rate

OBJECTIVETo evaluate the therapeutic effects of pneumatic lithotripsy on children urethral calculi.

METHODSTwenty-two cases of the male children with urethral calculi were treated with pneumatic lithotripsy under ureteroscopy.

RESULTSAll the patients were treated successfully in a single procedure. The time of lithotripsy was (5.5 +/- 2.2) minutes, and no serious complication such as obvious hematuria, infection and urethral stricture occurred.

CONCLUSIONSIt is suggested that pneumatic lithotripsy under ureteroscopy is an effective and simple way for the treatment of urethral calculi in children.

Adolescent ; Child ; Child, Preschool ; Humans ; Lithotripsy ; methods ; Male ; Ureteral Calculi ; therapy ; Ureteroscopy

OBJECTIVETo compare the functional parameters of the small airways and clinical characteristics between patients with typical asthma (TA) and cough-variant asthma (CVA).

METHODSForty-three newly diagnosed asthmatic patients were enrolled, including 15 with TA and positive bronchial provocation test [TA BPT(+)], 12 with TA and positive bronchial dilation test [TA BDT(+)] and 16 with CVA, and 27 healthy subjects served as the control group. All the subjects were required to complete data acquisition, asthma control test, asthma control test scale, fractional exhaled nitric oxide, airway resistance and pulmonary function tests, BPT or BDT.

RESULTSThe interval from onset to a definite diagnosis of TA BDT(+) was longer than that of TA BPT(+), while that of CVA was the shortest (P=0.022). The pulmonary functional parameters of TA BDT (+) was significantly lower than those of the other 3 groups (P<0.05). MMEF, MEF, MEF, and MEFin patients with TA BDT(+), TA BPT(+) and CVA were significantly lower than those in the control group (P<0.01). The resonant frequency, respiratory impedance, resistance at 5 Hz, resistance at 20 Hz, and reactance at 5 Hz were significant higher in patients with TA BDT (+) than in the control subjects, while these parameters showed no significant differences among TA BPT (+), CVA and control groups. The airway resistance in TA BPT(+), CVA, and control groups increased after BPT, and the patients with TA BPT(+) showed greater changes in airway resistance than those in CVA and control groups. In CVA patients, FeNO showed a strong positive correlation with respiratory impedance (r=0.523, P=0.038), resistance at 5 Hz (r=0.542, P=0.030), and resistance at 20 Hz (r=0.524, P=0.037), and the airway responsiveness showed a strong positive correlation with resistance at 20 Hz (Rho=-0.512, P=0.043).

CONCLUSIONCVA is the early stage of TA, and CVA, TA BPT(+), and TA BDT(+) may represent different stages of asthma. Uncontrolled, prolonged CVA may evolve into TA BPT (+), whose further progression can cause damages of the pulmonary function and small airway function and leads eventually to TA BDT (+).

OBJECTIVESTo investigate if hyperinsulinemia or insulin resistance could predict the elevation of blood pressure in non-diabetic adults.

METHODSOne hundred and seventy non-diabetic adults (NGT 107, IGT 63) were included based on the screen by OGTT in 1986. Height, weight, blood pressure were measured. Plasma glucose and insulin concentration at 0.60 and 120 min during OGTT were determined at baseline. All the subjects were followed for six years with blood pressure and plasma glucose examined at the end of the study. Subjects worsening to diabetes were excluded. Insulin area under-curve (INSAUC) and insulin sensitivity index [IAI = (1/FINS x FPG)] were calculated. Stepwise regression analysis was performed to evaluate the effects of INSAUC and insulin sensitivity to the elevation of blood pressure.

RESULTSBoth SBP and DBP levels at the end of the study were increased with increased INSAUC baseline. The SBP were (119.5 +/- 2.3), (122.1 +/- 2.5), (129.4 +/- 2.4) and (128.3 +/- 2.6) mmHg, and the DBP were (78.6 +/- 1.6), (79.7 +/- 1.7), (85.2 +/- 1.4) and (84.0 +/- 1.0) mmHg from the lowest to the highest quartiles of INSAUC respectively. Pearson correlation analysis showed Age, SBP, DBP, BMI, FINS, INS1h, INSAUC at baseline were positively correlated to blood pressure levels at the end of the study. After the adjustment of Age, sex, BMI, smoking, PG2 h and blood pressure at baseline, the INSAUC was significantly correlated to blood pressure six years later, while the insulin sensitivity index was not.

CONCLUSIONThe compensated hyperinsulinemia based on selective insulin resistance rather than insulin resistance to glucose per se could predict the elevation of blood pressure in nondiabetic adults.

Adult ; Aged ; Blood Pressure ; physiology ; Diabetes Complications ; Diabetes Mellitus ; prevention & control ; Female ; Follow-Up Studies ; Glucose Intolerance ; blood ; Glucose Tolerance Test ; Humans ; Hyperinsulinism ; complications ; Hypertension ; etiology ; prevention & control ; Insulin Resistance ; Male ; Mass Screening ; Middle Aged