A 55-year-old female patient took acarbose, benazepril, and levamlodipine besylate intermittently and aspirin enteric-coated tablets and atorvastatin calcium regularly due to type 2 diabetes mellitus and hypertension, etc. After changing to bezafibrate for lipid-lowering and Gansulin 30R for glucose lowering (other treatments continued), the patient developed muscle soreness of both lower limbs and dark brown urine 7 days later. Laboratory tests showed aspartate aminotransferase (AST) 213 U/L, creatine kinase (CK) 8 655 U/L, CK-MB 555 U/L, lactate dehydrogenase (LDH) 579 U/L, α-hydroxybutyrate dehydrogenase (α-HBDH) 505 U/L, and myoglobin (MYO) 135 μg/L. Rhabdomyolysis was considered, which might be related to bezafibrate. Then bezafibrate was stopped. The patient was asked to drink plenty of water and urinate frequently, and the symptomatic and supportive treatments such as rehydration, alkalization of urine, liver protection, and kidney protection were given. After 11 days of drug withdrawal, her symptom of muscle soreness was relieved and the color of urine became lighter; laboratory tests showed CK 105 U/L and MYO 119 μg/L. After 18 days of drug withdrawal, the patient′s myalgia disappeared, urine color returned to normal; laboratory tests showed AST 37 U/L, CK 75 U/L, CK-MB 45 U/L, MYO 75 μg/L, and LDH 241 U/L.

A 55-year-old female patient took acarbose, benazepril, and levamlodipine besylate intermittently and aspirin enteric-coated tablets and atorvastatin calcium regularly due to type 2 diabetes mellitus and hypertension, etc. After changing to bezafibrate for lipid-lowering and Gansulin 30R for glucose lowering (other treatments continued), the patient developed muscle soreness of both lower limbs and dark brown urine 7 days later. Laboratory tests showed aspartate aminotransferase (AST) 213 U/L, creatine kinase (CK) 8 655 U/L, CK-MB 555 U/L, lactate dehydrogenase (LDH) 579 U/L, α-hydroxybutyrate dehydrogenase (α-HBDH) 505 U/L, and myoglobin (MYO) 135 μg/L. Rhabdomyolysis was considered, which might be related to bezafibrate. Then bezafibrate was stopped. The patient was asked to drink plenty of water and urinate frequently, and the symptomatic and supportive treatments such as rehydration, alkalization of urine, liver protection, and kidney protection were given. After 11 days of drug withdrawal, her symptom of muscle soreness was relieved and the color of urine became lighter; laboratory tests showed CK 105 U/L and MYO 119 μg/L. After 18 days of drug withdrawal, the patient′s myalgia disappeared, urine color returned to normal; laboratory tests showed AST 37 U/L, CK 75 U/L, CK-MB 45 U/L, MYO 75 μg/L, and LDH 241 U/L.

Objective To compare the safety and effectiveness between ozone (O3) and hyaluronic acid (HA) in treating knee osteoarthritis(KOA) by using the meta analysis method.Methods The relevant randomized controlled trials(RCTs) in PubMed,Cochrane Library (issue 1,2016),Embase,CNKI,CBM,VIP,and Wan-Fang databases were retrieved from their establishment to January 23,2016.Two reviewers independently screened the literatures,extracted the data and evaluated the quality of the included RCTs.The results were performed the statistical analysis by using the RevMan5.3 and Stata13.0 software.Results Twenty RCTs involving 2 136 KOA patients were included.Compared with the HA treatment of KOA,the O3 treatment had higher treatment effective rate[odds ratio(OR) =2.78,P＜0.01],and better pain relief effect[at 1,3,6 month after treatment:mean difference(MD) =-0.25,-0.71,-1.70,P＜0.01].There were no statistically significant differences in complications between the two treatment methods[OR=0.84,P=0.56].Conclusion Current evidences indicate that the short-term therapeutic effect of O3 for KOA is superior to HA,and the safety is similar.

BACKGROUND: Patients with hip instability due to cerebral palsy, hemiplegia, infantile paralysis and extensive damage in gluteus medius, appear with high dislocation rate after arthroplasty, which is a great challenge for clinicians.OBJECTIVE: To investigate the reconstruction of the hip joint stability with the dual-mobility acetabular cup, and to prevent the dislocation after replacement in patients with hip neuromuscular lesions.METHODS: Twelve cases of hemiplegia, infantile paralysis, developmental dysplasia of the hip and recurrent dislocation after hip arthroplasty admitted in the Orthopedic Treatment Center, the Second Affiliated Hospital of Henan University of Chinese Medicine from January 2010 to July 2014 were enrolled, then underwent joint replacement or revision with dual-mobility cup, and the dynamic stability of the hip was achieved by adjusting the abductor lever arm.RESULTS AND CONCLUSION: (1) The followed-up time was from 20 to 60 months. (2) One year later, one case suffered Vancouver A right femoral fracture and received conservative treatment at 1 year postoperatively; one case of dislocation at postoperative 1 week, and dislocation, infection and loosening occurred in none cases. (3) These results manifest that those patients with neuromuscular disease and hip instability treated with hip joint arthroplasty using dual-mobility acetabular cup can reconstruct the stability of the hip joint and prevent the occurrence of postoperative dislocation.

BACKGROUND:Autologous bone marrow mesenchymal stem cels (BMSCs) transplantation has been used for clinical treatment of dilated cardiomyopathy. But the efficacy and safety of autologous BMSCs transplantation remains controversial. OBJECTIVE: To systematicaly assess the efficacy and safety of autologous BMSCs transplantation for treatment of dilated cardiomyopathy by using meta-analysis approach. METHODS:PubMed, Cochrane Library (Issue 2, 2016), Embase, CNKI, CBM, VIP, WanFang were systemicaly searched for relevant randomized controled trials (RCTs) about autologous BMSCs transplantation and conventional drugs for the treatment of dilated cardiomyopathy. After information extracting and quality assessing, Meta-analysis of left ventricular ejection fraction, left ventricular end-diastolic diameter, 6-minute walking distance, percentage of myocardial perfusion defect, mortality, incidence of malignant arrhythmia events and heart transplantation rate during treatment and folow-up was performed using R3.1.0 software. RESULTS AND CONCLUSION:A total of 7 RCTs involving 341 patients were included. Meta-analysis results showed that for efficacy, compared with the conventional drugs, BMSCs can increase the left ventricular ejection fraction [1 month post-treatment: mean difference (MD)=3.02, 95% confidence interval (CI) (1.55, 4.49); 3 months post-treatment:MD=4.38, 95%CI(3.55, 5.52); 6 months post-treatment:MD=6.47, 95%CI(4.78, 8.15);≥ 12 months post-treatment:MD=8.23, 95%CI(5.15, 9.19)]; decrease the left ventricular end-diastolic diameter after 3 months [3 months post-treatment:MD=-0.65, 95%CI(-0.72,-0.59); 6 months post-treatment:MD=-0.12, 95%CI(-0.21,-0.03);≥ 12 months post-treatment:MD=-0.19, 95%CI(-0.24,-0.13)]; increase 6-minute walking distance after 6 months [6 months post-treatment:MD=87.70, 95%CI(51.55, 123.85);≥ 12 months post-treatment:MD=143.83, 95%CI(122.73, 164.93)]; and decrease percentage of myocardial perfusion defect at 3 months [MD=-3.56, 95%CI(-5.57,-1.55)]. For safety, BMSCs can decrease the mortality [risk ratio=0.46, 95%CI(0.24, 0.89)], but there is no significant difference in the incidence of malignant arrhythmia events and heart transplantation rate between two treatment groups. To conclude, these results indicate that BMSCs transplantation for dilated cardiomyopathy is one of effective and safe treatments.

BACKGROUND:Comparative study results between the efficacies of traditional Chinese medicine (TCM) therapy with Western medicine therapy in the treatment of knee osteoarthritis remain controversial. Currently, meta-analysis studies mainly focuson comparison of the efficacy between TCM and Western medicine,butlack investigations among TCM therapies. Itmakes usdifficult tofulyunderstand the efficacy of TCM therapy for knee osteoarthritis.
OBJECTIVE:To compare the efficacies of TCM therapy with intra-articular injection of hyaluronic acid for knee osteoarthritis using a networkMeta-analysis method.
METHODS:PubMed, The Cochrane Library (tissue 10, 2015), EMbase, CNKI, CBM, VIP, Wangfang databaseswere searchedup to October 20, 2015forrelevantrandomized controled trialsaddressingthe efficacies of TCM therapyversusintra-articular injection of hyaluronic acid for knee osteoarthritis. Two reviewers independently selected the studies, extracted information, and assessed the quality of included trials. Data extraction from eligible studies was pooled and meta-analyzed using Stata12.0 and WinBUGS1.4.3softwares. Odd ratios with their 95% confidence interval were estimated as effect size between treatments.
RESULTS AND CONCLUSION:A total of 59 randomized controled trials involving 6 155 patients with knee osteoarthritis and 12 treatment strategies were included. The results of network meta-analysis showed that TCM comprehensive therapy wassuperior to the TCM monotherapy and intra-articular injection of hyaluronic acid. Among thesetherapies, the efficacy of needle scalpel combined with acupuncture is optimal. TCM comprehensive therapies may be the best choice to treat patients with knee osteoarthritisofKelgren-LawrenceII-III. Morelarge-scaleand wel-designedrandomized controled trials are stil warranted due to the limitation of the present study.

BACKGROUND: Tendon injury and dysfunction often occurs in military training, but the exactly epidemiological, pathological, physiological, healing and remodeling mechanisms of tendonopathy is still unclear, even the pain due to chronic tendon dysfunction should be further studied.OBJECTIVE: To evaluate the effect of forced training on the muscular strength of ankle joint and the cross-sectional area (CSA) of achilles tendon of infantry soldiers, and look for effective training methods.DESIGN: One-sample contrasting study.SETTING: Fourth Military Medical University of Chinese PLA; InStitute of Military Training-related Medical Sciences, the 150 Hospital of Chinese PLA.PARTICIPANTS: The study was carried out in the Institute of Military Training-related Medical Sciences, the 150 Hospital of Chinese PLA from March to June 2004. Thirty male light infantry recruits and thirty one-year-trained male soldiers were regarded as recruit group and one-year soldier group. The enlisted age ranged from 17 to 18 years. Recruits did not have the history of special training and injury of ankle joints. All of them were able to undertake routinely physical training.METHODS: The recruits participated in routinely physical trainings, such as grenade throwing and 5 km cross-country race, and forced trainings, such as dorsiflexors and plantarflexors on ankle joint, twice a day for each training item for 8 successive weeks. The forced training included calf raise for 50 times and sit-ups for 50 times on 45° arched board.Moreover, one-year soldiers were undertaken routinely physical trainings. Eight weeks later, the isokinetic testing of ankle joint and CSA of achilles tendon were measured before and after trainings.MAIN OUTCOME MEASURES: Comparisons of CSA of achilles tendon and changes of muscular strength of ankle joint between recruits before routine training and after 8-week forced training and one-year soldiers after routine training.RESULTS: All 60 soldiers were involved in the final analysis. Partial correlation was showed between CSA and body weight (r =0.446, P=0.015), and there was no difference in CSA before and after training. The relative peak torque, endurance and torque acceleration energy of plantarflexors, dorsiflexors and evertors were distinctively higher in recruit group and one-year soldier group after training than those in recruit group before training (P ＜ 0.05); however, there was no difference between recruit group and one-year soldier group after training.CONCLUSION: Forced training method can improve physical readiness in a short time. No changes of CSA of achilles tendon after training show that the improvement of ankle muscular strength may be through the rebuilding of its inner-structure rather than through the hypertrophy of the tendon.

Thirteen cases of developmental dysplasia hip underwent total hip arthroplasty with cementless biocon cup and femoral stem at the Department of Orthopedics,Second Hospital Affiliated to Henan College of Traditional Chinese Medicine from January to 2004 to December 2006 were selected.They consisted of 5 male with 5 hips and 8 female with 8 hips with the average age of 51 years(range,28-62 years) and 9 cases of Crowe-Ⅲ and 4 cases of Crowe-Ⅳ.Before operation,the lower limbs were shortened from 3 to 6 cm.13 patients were followed up for 24 months(range,12-36 months),the lower limbs were lengthened from 2 to 6 cm,and both lower limbs basically recovered the balance.There were no complication appeared such as dislocation,femoral fracture,femoral nerve or sciatic nerve injury,as well as prosthetic loosening.The hip pain and dysfunction in all the patients were obvious relieved after operation.

[Objective] To evaluate the treatment with total hip arthroplasty(THA)using Zweym?ller system for short females with Crowe-Ⅲ and Ⅳ developmental dysplasia hip(DDH).[Method]From January 2004 to December 2006,thirteen THA procedures were performed in 12 female patients with 13 hips.The age of the patients was from 28 to 62 years old(average 51 years).The height was from 1.48 to 1.55 meters.Based on Crowe classification,8 patients with 9 hips were type-Ⅲ,and 4 patients with 4 hips were type-Ⅳ.before surgery,the discrepancy of lower limbs was from 3 cm to 5 cm.All patieds had severe hip pain and dysfunction.The Harris hip score ranged from 35 to 64 points with 40 points on the average.In all procedures the soft tissue was released entirely,the acetabular component was placed in the true acetabulum without femoral osteotomy.[Result]After operation,the legs lengthened from 2 to 5 cm.During the follow-up of 12 to 36 months(average 24 months),no femoral fracture,femoral or sciatic nerve palsy or loosening was detected except one dislocation according to clinical outcomes and X-ray findings.The Harris score was improved from 60 to 95.There was significant difference between before and after operation(P

Objective To investigate the changes of collagen and proteoglycan of Guinea pig’s Achilles tendon suffering from different loads of training. Methods Achilles’ tendons of Guinea pigs were harvested after training, stained by picrosirius and toluidine blue respectively. Collagen Ⅰ, Ⅲ and proteoglycan were observed by polarization microscopy and atomic force microscopy (AFM) and analyzed semiquantitatively. Results After enforced training, the relative content of collagen Ⅲ was(16.71?1.37)% in Group A and (13.43?3.16)% in Group B, that were significantly increased compared with (9.57?1.90)% in control group (P