To explore the therapeutic efficacy of extracorporeal shock wave (ESW) for persistent heel pain.A total of 98 patients of persistent heel pain were randomly divided into ESW treatment and control groups (n =49 each).Treatment group had ESW while control group received infrared physical therapy.And their visual analogue scale (VAS) scores were assessed.After one course of treatment, VAS heel pain and function scores were (39.6 ± 6.2) and (25.1 ± 4.6) in ESW group versus (32.3 ± 6.5) and (17.4 ±7.2) in control group.And before treatment, (16.5 ±4.6) and (14.4 ±8.6), (16.1 ±4.7) and (14.6 ± 8.4) respectively.Heel pain significantly decreased with functional improvement (all P ＜ 0.05).After one course, the effective rate was 65％ (32/49) in treatment group.And the improvement rate of 31％ (15/49) was better than control group [27％ (13/49) and 63％ (31/49)] (all P ＜ 0.05).ESW treatment of persistent heel pain was more efficacious than physical therapy and it could be applied clinically.

Objective To study the clinical features,diagnosis and management of small cell carcinoma of the bladder (SCCB).Method The clinical data of 18 cases of patients with small cell carcinoma of the bladder were analyzed retrospectively and the literature were reviewed.There were 16 males and 2 females,ages 54 to 81 years (median age,61 years).Clinical manifestations included gross hematuria in 11 cases,urgency in 2 cases,dysuria in 2 cases and postoperative review after TURBT of bladder urothelial carcinoma in 3 cases.The median tumor size was 3.35cm (ranged,1.0 to 6.0 cm).2 cases underwent TURBT and intravesical chemotherapy regularly were followed after surgery.3 cases underwent partial cystectomy,intravenous chemotherapy combined with radiotherapy was followed in one case,the other 2 cases refused the following therapy.13 cases underwent radical cystectomy,intravenous chemotherapy was followed in 2 cases,pelvic radiotherapy was followed in 2 csaes and intravenous chemotherapy combined with radiotherapy was followed in 2 cases,the other 7 cases refused the following therapy.Results 11 cases were pure SCCB,7 cases were mixed SCCB,all with urothelial carcinoma.T1N0M0 in 3 cases,T2N0.1M0 in 4 cases,and T3N0-2M0 in 11 cases.The duration of follow-up was from 5 to 35 months after surgery.9 cases died of tumor metastasis,9 cases are still alive,except 1 case with lymph node metastasis,the other 7 cases are free of tumor recurrence or metastasis.Conclusions SCCB is rare,with high malignant degree and poor prognosis.The prognosis of the pure SCCB may be worse than the mixed SCCB.The diagnosis depends on pathology examination.Radical cystectomy is the main treatment method,the strategy of bladder-preserving may be an attempt for proper SCCB patients.Adjuvant therapy plus surgery may be better.

Objective To investigate the clinical significance of changes of serum amylase, CRP and SAA in the diagnosis of acute pancreatitis. Methods The levels of serum and urine amylase, CRP and SAA in patients of mild acute pancreatitis (MAP) and severe acute pancreatitis (SAP) at 24 h, 48 h, 72 h and the seventh day after the onset of pancreatitis were measured. Results The levels of serum, urine amylase, CRP and SAA in SAP patients at 24h were (904.5±402.2)U/L, (2280.3±1207.3)U/L, (155.6±36.2) mg/L, (521.9±109.4)mg/L, respectively, and significantly higher than those of MAP patients (P＜0.05 or P＜0.001). The peak value of serum amylase appeared at 24h, however, the peak value of urine amylase, CRP and SAA appeared at 48 h, and the corresponding values were (2173.5±1110.6) U/L, (185.3±41.4) mg/L and (717.5±144.2)mg/L, respectively. The levels of serum and urine amylase significantly decreases in MAP and SAP patients at the seventh day (P＜0.05). The levels of serum CRP and SAA significantly decreased in MAP patients at the seventh day (P＜0.05), however, the levels of serum CRP and SAA did not significantly decrease in SAP patients at the seventh day (P＞0.05). Serum levels of CRP and SAA were related to the severity of acute pancreatitis. Meanwhile CRP showed a positive correlation with SAA (r = 0.761, P＜0.05). Conclusions The change of serum levels of amylase, CRP and SAA can help early diagnose acute pancreatitis; CRP and SAA may predict the development of SAP at early stage.

Objective To investigate the reversal effects of tetramethylpyrazine(TMP) and cyclosporin A(CsA) on multidrug resistance(MDR) of human erythroleukemia cells with gene transfer K562/MDR and to discuss the possible correlative mechanism.Methods K562/MDR cells in culture medium were treated with TMP(50—6 400 mg?L-1) and CsA(0.5—256 mg?L1) respectively.The growth rates of these cells were measured by MTT assay.Non-cytotoxic doses of TMP and CsA were determined.There were 5 growps in the experiment:G1(TMP+ADM+K562/MDR),G2(CsA+ADM+K562/MDR),G3(TMP+CsA+ADM+K562/MDR),negative control(K562/MDR subsitituted by K562/S),control(drugs subsitituted by 1640 culture medium),the inhibitory effects of adriamycin(ADM) used alone or in combination with TMP or/and CsA on the proliferation of K562/S and K562/MDR cells were observed by resisting fold and reversal folds.The effects of TMP and CsA on ADM accumulation in K562/S and K562/MDR cells were analyzed by fluorospectrophotometry.The protein level of P-glycoprotein(P-gp) was detected by flow cytometry(FCM).Results The non-cytotoxic doses of TMP and CsA were 320 and 2.0 mg?L-1,respectively.The resistance of K562/MDR cells to ADM was 19.2 folds of that of K562/S cells.When TMP and CsA were added along with ADM to the K562/MDR culture,the reversal folds were 5.2 and 9.6.When TMP in combination with CsA was added along with ADM to the K562/MDR culture,the reversal folds were 15.6.When various concentrations ADM were added to the K562/MDR culture,TMP and CsA could increase the intracellular accumulation of ADM.The effect of TMP in combination with CsA was more evident.Compared with control,TMP and CsA could inhibit the overexpression of P-gp protein(P

Objective To investigate the effects of 3-N-butylphthalide ( NBP ) pretreatment on the score of neurological deficit , oxidative stress and pathomorphology in rats with cerebral ischemia reperfusion injury ( CIRI ) . Methods Ninety male SD rats were randomly divided into sham operation group ( Sham group ) , model group ( IR group), NBP pretreatment low dose group (NBPⅠgroup), NBP pretreatment middle dose group(NBPⅡgroup) and NBP pretreatment high dose group(NBPⅢgroup), 18 rats per group.Pretreatment was given once a day within 1 week before establishing the model of cerebral ischemia reperfusion injury .The model of middle cerebral artery occlusion ( MCAO) was subjected by suture method .The score of neurological deficit was executed after ischemia for 2h and reperfusion for 24h in all the rats.The cerebral infarction was observed by TTC staining .The pathologic change of brain was observed by HE staining under the microscope .Hydroxylamine method was used to detect activity of SOD , chemical colorimetry method was used to measure activity of GSH-PX, and TBA method was used to detect content of MDA .Results (1) In Sham group, the score of neurological deficit and the percentage of infarction volume were zero , the morphology of nerve cell was regular , and activity of SOD, GSH-PX and content of MDA of brain tissue were normal .(2) Compared with IR group , the score of neurological deficit was significantly reduced in NBP pretreatment groups (all P<0.01); the score of neurological deficit was decreased progressively in turn in NBP Ⅰ,Ⅱ,Ⅲgroup (all P<0.05).(3) Compared with IR group, the percentage of infarction volume was cut down progressively in turn in NBPⅠ,Ⅱ,Ⅲgroup (all P<0.05), and neuron injury was also induced obviously in NBP pretreatment groups .(4) Activity of SOD, GSH-PX was largely increased , and content of MDA was greatly decreased in NBP pretreatment groups ( P<0.01 ) .Activity of SOD , GSH-PX went up progressively in turn , and contents of MDA were cut down progressively in turn in NBP Ⅰ,Ⅱ,Ⅲgroup ( all P<0.05 ) .Conclusion 3-N-butylphthalide can significantly up-regulate the activity of SOD and GSH-PX, decrease the content of MDA , reduce the percentage of infarction volume , and relieve the damage of nerve cell to preventively protect the rats with cerebral ischemia reperfusion injury .

BACKGROUND:Excessive lateral pressure syndrome is often associated with lateral retinacular tension and radiographic patel ar tilt. CT scan displayed that lateral retinacular release can effectively correct patel ar tilt. OBJECTIVE:To study the effect of arthroscopic lateral retinacular release combined with intraosseous dril ing and decomposition in the treatment of excessive lateral pressure syndrome. METHODS:Thirty-two patients with excessive lateral pressure syndrome were treated by arthroscopic lateral release combined with intraosseous dril ing and decomposition. The Lysholm scoring system was used to evaluate the treatment effect. RESULTS AND CONCLUSION:The mean duration of fol ow-up was 12 months. After 1 month, pain of al patients was released or disappeared;after 1 year, pain of 26 cases disappeared basical y. Lysholm scoring system assessment showed 20 cases were rated as excellent, six cases were as good, four cases were as fair and two cases were as poor. The excellent and good rate was 83.6%. The patients’ subjective satisfaction rate was 92.8%. The results indicate that arthroscopic lateral release combined with intraosseous dril ing and decomposition is a good method to treat excessive lateral pressure syndromewere. It has the advantages of less trauma and rapid recovery. Patel ar decomposition has a good effect in the treatment of patel ofemoral pain associated with patel ar tilt outward and lightens articular cartilage degeneration without damage to patel ar cartilage surface.

Background and purpose:Hepatocellular carcinoma suppressor gene-1(HCCS1)is a potential hepatocellular carcinoma supressor gene,and it also plays an important role in sorting of some cytoplasmic proteins.Its carcinoma suppressor function may be related to its sorting function.So it is important to identify the minimum region of functional sequence in HCCS1 that related to the transportation.Methods:The expression vectors containing various lengths of HCCS1 gene were constructed and transfected into HeLa cells mediated by liposomes.The localizations of different HCCS1 fragments and the colocalizations of M6PR with various truncated HCCS1 were determined by laser scanning confocal microscopy,respectively.Results:10 different expression vectors containing various lengths of HCCS1 gene were successfully constructed,it had been shown that the polar localization of HCCS1 protein and the co-localizations with M6PR disappeared when HCCS1 gene was truncated to 1 120 bp from the 3'end by laser scanning confocal microscopy.Conclusions:We identified the minimum localization of the HCCS1 functional sequence that related to the transportation.

The ongoing health reform encourages pharmacists of public hospitals to change their traditional role positioning to satisfy patients’urgent needs in medical dosage guidance.This calls for greater capacity of hospital pharmacy services.Pharmaceutical consultation constitutes a major means of quality service of pharmacists for the people.The paper introduced the standard of establishing the pharmaceutical consultation center and the content of assessment system which are jointly worked out by Beijing Municipal Hospital Authority and the hospitals under the administration of the Beijing Municipal Government,and share the practice & effect in assessing and improving their performance.

Objective To explore the effects of umbilical cord-derived mesenchymal stem cells (UCMSCs) on fibroblast-like synoviocytes(FLSs) from patients with rheumatoid arthritis(RA). Methods collagen-induced arthritis(CIA) models were developed on Wistar rats and 1 ×106 UCMSCs were given by intravenous injection from tail vein on the 17th day. On day 42, rats were sacrificed and synovial tissues were obtained to detect matrix metalloproteinase (MMP)-1, MMP-3 and MMP-13. Synovial tissues from patients with RA and osteoarthritis(OA) treated by knee arthroplasty were used to isolate FLSs. RNA of FLSs were extracted to compare MMP-1, MMP-3 and MMP-13 expression. FLSs and UCMSCs were cocultured through transwell for 72 hours. Then levels of MMPs were compared in the supernatants by Luminex. The MMPs expressed by FLSs and soluble factors expressed by MSCs were detected by real time-polymerase chain reaction(PCR). After adding antibodies to soluble factors, the MMPs expressions of RA FLSs were compared. Results MMP-1 (6.9±5.4, 1.3±1.4, P<0.05), MMP-3 (6.0±6.5, 1.4±1.0, P<0.05) and MMP-13 (21.8± 20.8, 1.5±1.6, P<0.05) expression were much higher in CIA rats compared with healthy controls. MMP-1 (1.3±1.4, 6.9±5.4,8.7±6.8, P<0.05), MMP-3(1.4±1.5, 6.0±6.5, 6.0±5.7, P<0.05) and MMP-13(3.0±3.2,
22±21, 22±26, P<0.05) expression were inhibited by UCMSCs in vivo. In vitro, MMP-1 (1.8±0.9, 0.9±0.7, t=2.44, P<0.05), MMP-3(2.6±1.7, 1.1±1.0, t=2.25, P<0.05) and MMP-13(2.4±2.3, 0.6±0.7, t=2.37, P<0.05) levels were higher in RA than OA FLSs. After coculture, MMP-13(1.3±1.2, 0.9±1.2, t=3.63, P<0.05) expressed by FLSs were down-regulated, however MMP-1 (1.5±1.4, 6.6±6.0, t=3.90, P<0.05) and MMP-3 (7±17, 22±35, t=2.86, P<0.05) were up-regulated when analyzed by paired t-test. Soluble factors such as I-DO, HGF and IL-10 were elevated. Anti-IL-10 antibody could decrease the function of UCMSCs by inhibiting MMP-13 expression in RA FLSs. Conclusion UCMSCs ameliorates RA by secreting soluble factor IL-10, which may inhibit MMPs expressed by FLSs.

Aim To study the change of blood pressure in 1079 workers for fifteen years and the effect of anti-hypertension drugs therapy. Methods We investigated the blood pressure of 1079 workers who were enrolled in six organizations in the year 1983 and 1998 respectively. Results During the 15 years: (1)Mean value of blood pressure: systolic blood pressure increased 22 mmHg in man and 16.9 mmHg in women; diastolic blood pressure increased 9 mmHg in man and 12.7 mmHg in women (P<0.05);(2)The incidence of hypertension increased by 25.03% in man and 28.28% in women;(3)The prevalence rate of hypertension is 27.9 percent in people with initially normal blood pressure (1.86%/y) and 72.6 percent in initially broder line hypertension (4.84%/y);(4)The control rate of hypertension is 2.9 percent;(5)The incidence of stroke is highly related to hypertension (P<0.001);(6)46.6 percent patients had a regular drug therapy, mainly reserpini complex(25.2%);(7)Drug therapy has no obviously effect of the control of hypertension and the incidence of stroke. Conclusion Both the mean value of BP and the incidence of hypertension were increased with age. The control rate of hypertension was low and the drug therapy shows little advantage. We should do mach more works to popularize the knowledge of the prevention of hypertension. Improve people's self-prevention. Regular cheek should be given to the hypertension patients.