Acetabulum ; injuries ; surgery ; Fractures, Bone ; surgery ; Humans

Objective Dickkopf-1 (DKK-1) is an antagonist of the Wnt signaling pathway of bone formation and it is the target gene of TNF.When DKK-1 is inhibited,osteoprotegerin (OPG) would increase,OPG can antagonize bone erosion caused by receptor activator of NF-κB ligand (RANKL).Detection the levelsof serum DKK-1,OPG,RANKL and TNF-α of patients with AS before and after applying TNF-α antagonist,the effects of anti-TNF-α treatment on signaling pathway of bone formation was explored.Methods Medical records and serum samples of 43 AS patients receiving TNF-α receptor-Ⅱ IgG Fc fusion protein for 12 weeks were collected and the levels of serum DKK-1,OPG,RANKL and TNF-α were detected by enzyme-linked immunosorbent assay.Paired t-test and Person's correlation analysis were used for data analysis.Results Disease activity indexes in AS patients with anti-TNF-α treatment,including VAS score,time of morning stiffness,BASDAI,BASFI,ESR and CRP,which were [(2.7±2.0) cm,(7±4) min,1.1±1.1,0.8±1.2,(10±9) mm/1 h and (16±26) mg/L] respectively,were reduced when compared with those before treatment,[(7.6±1.9) cm,(46±33) min,6.0±1.3,4.4±2.0,(39±29) mm/1 h and (76±43) mg/L] respectively,and the differences were statistically significant (P＜0.05).Serum levels of DKK-1,(3.3±1.5) μg/L vs (3.2±1.3) μg/L,OPG,(144±71) pg/ml vs (136±62) pg/ml,and RANKL,(71±37) pg/ml vs (68±30) pg/ml,were not changed (t=14.043,8.031,20.166,13.521,7.679,9.563,all P＞0.05).The levels of TNF-α increased from (1.9±1.3) pg/ml to (55.0±50.6) pg/ml (t=6.951,P＜0.05).There were no relations between DKK-1 and TNF-α,RANKUOPG,patient VAS,duration of morning stiffness,BASDAI,BASFI,ESR and CRP,allP＞0.05.Conclusion Clinical indicators are improved significantly by anti-TNF-α therapy; however,it should not be withdrawal suddenly.There is no relationship between serum levels of DKK-1 and level of inflammation in AS patients.

Objective This study evaluated whether liver ischemic preconditioning has delayed protective effect on liver ischemia-reperfusion injury and probe into the protective mechanism.Methods 36 wistar rats were randomly divided into two groups, group A:ischemic preconditioning,Group B:Control. The group A rats were subjected to liver ischemic preconditioning,While group B rats were subjected only laparotomy.After 48 hours,Liver tissue samples were abstained to detect the expression of HSP70.Occlusion the inflow vessels to the left and median lobes 45-minute then reperfuse 90-minute.Liver tissue samples were abstained to detect the expression of TNF-?.Serum ALT was detected before ischemia and after 90-minute reperfusion.Results The serum ALT level in group A is much lower than that in group B (P

Objective:To observe the clinical efficacy of electroacupuncture in the treatment of type 2 diabetes mellitus combined with mild and moderate carpal tunnel syndrome.Methods:Eighty patients with type 2 diabetes mellitus combined with mild to moderate carpal tunnel syndrome were randomly divided into two groups with 40 patients in each group ( n=40). In the course of the treatment, 2 patients in each group dropped out, which means 38 patients in each group were included. All patients were instructed to actively control blood glucose The control group was given Mecobalamin tablets orally, while the treatment group was given electroacupuncture of Daling and Neiguan on the affected side based onthe control group for 6 weeks. The degree of pain was assessed by VAS, and the severity of clinical symptoms was assessed by the symptom scale of Boston carpal tunnel questionnaire (BCTQ). The sensory nerve conduction velocity (SCV), the amplitude of sensory nerve action potential (SNAP) and the distal motor latency (DML) were detected by EMG evoked potential instrument. The clinical efficacy was evaluated and adverse events were recorded. Results:The total effective rate was 81.6% (31/38) in the treatment group and 60.5% (23/38) in the control group, and the difference was statistically significant ( χ2=5.094, P=0.024). After the treatment, the scores of VAS and BCTQ in the treatment group were lower than those of the control group ( t=2.639, 2.790, P=0.010, 0.007); DML (3.62 ± 0.19 ms vs. 4.00 ± 0.17 ms, t=68.891) in the treatment group was lower than that of the control group ( P<0.01), while SCV (47.36 ± 0.18 m/s vs. 42.34 ± 0.14 m/s, t=97.163) and SNAP (14.74 ± 0.18 μV vs. 12.10 ± 0.16 μV, t=51.434) in the treatment group were higher than those of the control group ( P<0.01). During the treatment, no serious adverse events occurred in two groups. Conclusions:Electroacupuncture is safe and effective in the treatment of mild and moderate carpal tunnel syndrome with type 2 diabetes. It can reduce the degree of pain and improve the symptoms of wrist joint.

Objective To study the effects of rehabilitation interventions on the earthquake injured to reduce the incidences of disability,to improve the recovery of overall function of the wounded in the earthquake and to guarantee their return to family and society.Methods The rehabilitation team·work provided one-month comprehensive intervention on 92 fracture patients after earthquake and assessed with scale of participate and activities ability,before,after and in the middle of intervention.Results The ability of understanding and communication,moving body,taking care of oneself,getting along with others,undertaking daily activities.social participating and the scores from the scale of participate and activities ability improved significantly(P<0.05).Conclusion Rehabilitation interventions with team-work can effectively enhance the abilities of the earthquake injured to participate in activities and improve quality of life.

Objective To study the clinical value of anti-ribosomal P0 protein antibodies (anti-P0). Methods Line immuno-assay and immunoblotting methods were used to detect anti-P0 and rRNP antibodies of 49 SEE patients and 61 patients with other rheumatic diseases.The expressions of anti-P0 were compared with those of rRNP antibodies.Possible relations between anti-P0 and clinical features and other antibodies in SLE were explored.Results 36.7%and 6.1% of SEE patients showed positive anti-P0 and rRNP antibodies respectively.Anti-P0 was always negative in patients with other rheumatic diseases (P＜0.01).Among SLE pa tients,incidence of skin rash was 77.8%(35.5%) ff anti-P0 was found to be positive (negative) (P＜0.05). Besides,for patients with positive and negative anti-P0,the chance of positive anti-SmD1 was 61.1% and 19.4% respectively (P＜0.01).Sensitiviy of anti-P0 for SLE diagnosis was 36.73% with specificity and positive predictive value as high as 100%,and 66.30% as the negative predictive value.Conclusion Sera anti-P0 is highly specific for SLE and it is associated with the occurence of rash and the expression of anti-StuD 1 anti bodies in SEE.

The ?-radioactive seed brachytherapy source has been widely employed in the implantation therapy for the prostatic carcinoma and the ophthalmic lesions.In this study the dosimetric parameters for characterization of a low-energy interstitial brachytherapy source 125I were calculated according to dose calculation formalism recommended by AAPM TG-43U1.For data processing,a 0.28 cm active length was used for the geometry function.The dosimetry parameter air-Kerma strength,dose rate constant,radial dose function and anisotropy function were estimated by means of the EGS5 Monte Carlo code.The results obtained from this study are in good agreement with the corresponding values recommended by TG-43U1 and with the data reported by Dolan,et al.

Objective To explore the effects of low molecular weight heparin (LMWH) on the virological and pathological changes of newborn mouse liver congenitally infected with human cytomegalovirus (HCMV).Methods Sixty healthy pure line clean level BALB/c mice which were about 10 weeks old (half were female) were divided into five groups (six pairs in each group).The mice in LMWH intervention group and positive control group were intraperitoneally inoculated with 6.0 lg tissue culture infective dose50 (TCID50) of HCMV AD169; those in blank control group were intraperitoneally injected with 0.5 mL dulbecco's modified Eagles medium (DMEM) ; then all the mice were paired to mate.The pregnant mice in LMWH intervention group Ⅰ were subcutaneously injected with LMWH 1000 U/kg daily for 10 days; those in group Ⅱ were subcutaneously injected with LMWH 1000 U/kg daily for 5 days and their newborn mice were subcutaneously injected with LMWH 1000 U/kg daily for 5 days; those in group Ⅲ were subcutaneously injected with LMWH 1000 U/kg daily for 10 days in their newborn mice.All these newborn mice were sacrificed at day 10 of birth.The liver was removed for virus isolation,dry-wet weight determination,pathology examination and quantitative fluorescence-polymerase chain reaction (PCR) detection.The comparison among groups was done by analysis of variance.Results HCMV was isolated from the supernatant of liver tissue homogenate in 10-day positive control newborn mice,while HCMV was isolated in 24-day newborn mice of the other three groups of LMWH intervention.Pathology confirmed that positive control liver tissue had inflammatory changed,liver cell inflammatory swelling degeneration,vacuoles degeneration,specific HCMV inclusion body in nuclear,and portion of liver cell necrosis,while liver pathological results of LMWH intervention group showed mild liver cell inflammatory changes and slight cell inflammatory swelling degeneration,which were similar to the blank control group.The moisture of liver tissue contents in LMWH intervention group decreased more obviously than positive control group.The HCMV DNA loads in 50 mg liver tissues of LMWH intervention groups Ⅰ,Ⅱand Ⅲ were (3.26±0.43),(3.26±0.41) and (3.32±0.51) lg copy,respectively,which were significantly lower than that of positive control group [(7.38 ± 0.53) lg copy; F =314.620,P0.01],while there were no significant differences among LMWH intervention groups (P＞0.05).Conclusion LMWH intrauterine and postnatal interventions can significantly reduce HCMV DNA replication in hepatocytes,and relieve inflammatory changes in liver tissue.

Objective To investigate the clinical efficacy of ligation of intersphincteric fistula tract (LIFT) for the treatment of high anal fistula.Methods The clinical data of 77 patients with high anal fistula who were admitted to the Puren Hospital and Chaoyang Hospital from January 2011 to June 2012 were retrospectively analyzed.All the patients were treated using the LIFT method (LIFT group,37 patients) or fistulectomy + threaddrawing therapy (thread-drawing group,40 patients).The operation time,healing time,time and severity of postoperative pain,recurrence and anal sphincter dysfunction were compared between the 2 groups.The measurement data,the count data and the rank data were analyzed using the t test,chi-square test,and the rank sum test,respectively.Results The operation time of the LIFT group and the thread-drawing group were (21.4 ± 2.0) minutes and (20.6 ± 1.9) minutes,with no significant difference between the 2 groups (t =1.911,P ＞ 0.05).In the LIFT group,17 patients felt low-grade pain,no patient felt medium-grade or severe pain.In the thread-drawing group,7 patients felt low-grade pain,14 patients felt medium-grade pain,19 patients felt severe pain.The duration of postoperative pain in the LIFT group and the thread-drawing group were (3.0 ± 1.3) days and (14.1 ± 1.5)days,respectively.The severity and duration of postoperative pain of the LIFT group were significant lower and shorter than those of the thread-drawing group (u =-7.189,t =34.534,P ＜ 0.05).The healing time,anal scar area and anal sphincter function score were (26.0 ± 1.9) days,(1.24 ± 0.20) cm2 and 1 in the LIFT group,and (40.7 ± 2.8) days,(2.64 ± 0.25) cm2 and 4 in the thread-drawing group,with no significant difference between the 2 groups (t =26.574,26.868,Z =-7.513,P ＜ 0.05).The effective rate of the 2 treatment methods were 100％.The cure rate and recurrence rate were 51.4％ (19/37) and 5.4％ (2/37) in the LIFT group,and 42.5％ (17/40) and 2.5％ (1/40) in the thread-drawing group.There were no significant differences in the cure rate and recurrence rate between the 2 groups (x2=0.605,0.433,P ＞ 0.05).Conclusion LIFF method has higher cure rate for high anal fistula with short time of postoperative pain and healing,good anal sphincter function and low recurrence rate.