The non-randomized controlled study design was adopted. A total of 90 patients with knee osteoarthritis treated in Beijing Yuetan Community Health Service Center from September 2021 to August 2022 were enrolled in the study, including 45 patients received patellar loosening and then the quadriceps femoris pain point release (successive group) and remaining 45 patients received two manipulations simultaneously (simultaneous group). Patients were treated 3 times in a week, and each time received 5 groups of manipulation. The Visual Analogue Scale (VAS) and Lysholm scores were measured before treatment, immediately after treatment and 3 months after treatment. There was no exfoliation and no adverse events in both groups. There were no significant differences in VAS and Lysholm scores between the two groups before treatment ( P>0.05). Immediately after treatment, the VAS pain score in the simultaneous group was lower than that in the successive group ((3.36±1.12) vs.(2.24±0.93), P<0.01), while the Lysholm score in the simultaneous group was higher than that in the successive group ((89.76±6.61) vs.(74.07±16.80), P<0.01); the proportion of VAS score as“painless/mild pain”(88.9% (40/45) vs.64.4% (29/45), P<0.01) and Lysholm score as “excellent/good”(91.1% (41/45) vs. 44.4% (20/45), P<0.01) in the simultaneous group was significantly higher than that in the successive groups. At 3 months after treatment, there were still significant differences in VAS and Lysholm scores between the two groups. The simultaneous manipulations of patellar loosening and quadriceps femoris pain point release can better relieve the pain of patients with knee osteoarthritis.

Objective:To evaluate the role of brain-derived neurotrophic factor-antisense long-chain non-coding RNA (BDNF-AS) in amygdala in the development of neuropathic pain (NP) in rats.Methods:Healthy clean-grade male Sprague-Dawley rats, aged 2 months, weighing 200-260 g, were used to develop NP model via ligation of left L 5-6 spinal nerve, while control group was only subjected to the exposure of L 5-6 spinal nerve without ligation.This study was performed in two parts.Experiment Ⅰ Fifty-six rats were divided into 3 groups by the random number table method: sham operation group (Sham group, n=8), NP group ( n=24) and BDNF ( n=24). In BDNF group, exogenous BDNF was injected into bilateral amygdala at 1, 3, 6, 13 and 20 days after development of the model, with 100 pmol at each side.Eight rats were sacrificed at 7, 14 and 21 days after the model was developed in NP and BDNF groups and after the model was developed in Sham group, the brains were removed, and the amygdala was isolated for determination of the BDNF content (by enzyme-linked immunosorbent assay), the number of BDNF-positive cells (by immunohistochemistry), and expression of BDNF-AS (by real-time quantitative polymerase chain reaction). Experiment Ⅱ Thirty-two rats were divided into 4 groups ( n=8 each) using the random number table method: Sham operation group, NP group, BDNF group and siRNA group.At 1, 3, 6, 13 and 20 days after development of the model, exogenous BDNF 100 pmol and siRNA-BDNF-AS 50 nmol were injected into the amygdala at each side in BDNF group and siRNA group, respectively.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before development of the model (T 0) and at 4, 7, 14 and 21 days after development of the model (T 1-4). After the last behavioral test was completed, the rats were sacrificed, and the spinal cord tissues were collected to measure the contents of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α). Results:Experiment Ⅰ Compared with Sham group, the content of BDNF and the number of BDNF positive cells were significantly decreased, and the expression of BDNF-AS was up-regulated at each time point after development of the model in group NP ( P<0.05). Compared with NP group, the content of BDNF and the number of BDNF positive cells were significantly increased, and the expression of BDNF-AS was down-regulated at each time point after development of the model in group NP ( P<0.05). Experiment Ⅱ Compared with Sham group, MWT was significantly decreased and TWL was shortened at T 1-4, and the contents of IL-1β, IL-6 and TNF-α were increased in NP, BDNF and siRNA groups ( P<0.05). Compared with NP group, MWT was significantly increased and TWL was prolonged at T 1-4, and the contents of IL-1β, IL-6 and TNF-α were decreased in BDNF and siRNA groups ( P<0.05). Conclusions:The mechanism underlying the development of NP may be related to the up-regulation of BDNF-AS expression in amygdala, inhibition of BDNF synthesis and promotion of inflammatory responses in the spinal cord of rats.

Hemophilia B is a genetic disorder caused by coagulation factor Ⅸ(FⅨ) deficiency, mainly manifesting as joint, muscle and deep tissue bleeding. Hemophilia pseudotumor is a mass formed by soft tissue liquefaction and necrosis caused by repeated bleeding. Most pseudotumors occur in the bone and muscle. We report a case of hemophilia B with pseudotumor formation in the pelvis and abdomen, where lesion location is relatively rare. After active and effective hemostasis, the patient's hematuria symptom gradually improved. This case suggests that early and timely hemostatic treatment is crucial for patients with hemophilia.

Objective To investigate the mineral contents of colostrum and peripheral blood and their correlation in pregnant women in Beijing. Methods A total of 80 pregnant women who gave birth in the Affiliated Fuxing Hospital of Beijing Capital Medical University in May 2019 were selected as research subjects, and their colostrum and peripheral blood samples were collected. The contents of 46 minerals in the colostrum and peripheral blood samples were determined by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and Atomic fluorescence spectrum (AFS). The correlation between the contents of minerals in the colostrum and peripheral blood was analyzed by SPSS 21.0. Results Among the 46 minerals detected, the minerals with higher contents in the peripheral blood were sodium, potassium, iron, magnesium, calcium, zinc, rubidium, copper, aluminum and selenium. The minerals with higher colostrum contents included potassium, sodium, calcium, magnesium, zinc, iron, rubidium, copper, strontium and aluminum. The contents of calcium, strontium, cesium, molybdenum, cobalt, uranium and thorium in the colostrum were significantly higher than those in the peripheral blood (P<0.05). There were significant correlations in the contents of sodium, rubidium, selenium, strontium, cesium, arsenic, mercury and cadmium between the colostrum and peripheral blood (P<0.05). In addition, there were significant correlations between some minerals in the colostrum, for example potassium vs manganese (r=-0.236, P=0.043), rubidium (r=0.816, P<0.001) and magnesium (r=0.400, P<0.001); sodium vs selenium (r =0.509, P<0.001), cerium (r=0.353, P=0.002), praseodymium (r =0.337, P=0.003) and thulium (r=0.331, P=0.004); calcium vs iron (r=0.251, P=0.031) and strontium (r =0.365, P=0.001); magnesium vs cesium (r=0.314, P=0.006) and copper (r =0.395, P=0.001); zinc vs selenium (r=0.310, P=0.007), cerium (r=-0.229, P=0.050), gadolinium (r=-0.372, P=0.001) and yttrium (r=-0.380, P=0.001); rubidium vs titanium (r=-0.413, P<0.001); copper vs cesium (r=0.275, P=0.018); strontium vs uranium (r=0.439, P<0.001); cadmium vs molybdenum (r=0.379, P =0.001). Conclusion The correlations of the mineral contents between the colostrum and peripheral blood suggested that some mineral elements could be accumulated from blood to breast milk through various transport mechanisms. The correlations between the mineral elements in the colostrum showed that there were some interactions between these elements, indicating that maintaining the dynamic balance of mineral elements in human milk is very important for the health of their offspring.

Objective: To analyze the genotypes, amino acid vatiations and molecular epidemiological characteristics of respiratory syncytial virus (RSV) infection in pediatric patients in Gansu province for the future research. Methods: A total of 4 556 respiratory tract specimens were colleted from pediatric patients under 10 years of age in five cities in Gansu from 2012 to 2017. These specimens were tested for RSV and its subtypes.The coding region of the RSV G gene was amplified using reverse transcription-polymerase chain reaction (RT-PCR) and sequenced for RSV positive specimens. Sequences were edited using DNA Star software. Sequence alignment and phylogenetic trees were built by MEGA 6.0 software. Results: Out of 4 556 specimens, 1 135 (24.91%) were positive for RSV, totally 216 G protein sequences were obtained. RSV A isolates were clustered into three genotypes: NA1、NA3 and ON1. The nucleotides and amino-acid homology was 84.9%-100% and 77.3%-100%, respectively. The nucleotides and amino-acid homology between this study and prototype long strain was 81.2%-83.3% and 74.1%-88.0%. RSV B isolates were clustered into only BA9 one genotypes. The nucleotides and amino-acid homology was 97.7%-100% and 95.8%-100%, respectively. The nucleotides and amino-acid homology between this study and prototype CH18537 strain was 84.9%-85.7% and 77.9%-80.1%. Conclusions The genetic characteristics and the amino-acid changes were analyzed systematically using data of RSV G gene collected from 2012 to 2017 in Gansu province in this study. These data were used for analyses of the etiology, control and prevention of RSV infection.

Objective To compare the anatomical differences of tibia osteotomy between Han and Uygur populations and to analysis their compatibility with imported prosthesis component.Methods Two hundred patients (400 knees) were selected from the outpatients and healthy volunteers of the non-knee joint disease from September 1,2012 to December 1,2014,with 86 men (172 knees) and 114 women (228 knees).The average age is 44.64-10.8 years (range 21-68 years old).According to the populations,the subjects were divided into Han group and Uygur group.Furthermore,each group was divided into male subgroup and female subgroup.A full-length CT scan of the lower limb was conducted to reconstruct the knee joint in the workstation.The tibial osteotomy was simulated in total knee arthroplasty.The transverse diameter of the tibial cross section,the longitudinal depth of the medial platform and the depth of the lateral platform were measured.The front and back diameter and aspect ratio of the osteotomy were calculated.There parameters were compared between the Han and Uygur groups.Five mm tolerance range method was used to analysis the cover rate of the following three kinds of commercially imported prosthesis,namely Depuy,Link and Zimmer.Results The mean value of the tibial cross section were 72.3±4.3 mm,50.7±3.1 mm,47.8±3.0 mm,49.3±2.9 mm and 0.682±0.021 in Han group,while those were 74.5±4.8 mm,51.4±3.0 mm,48.6±2.8 mm,50.0±2.9 mm and 0.672±0.020 in Uygur group,respectively.Except the aspect ratio,the average value of each parameter in Uygur group was greater than that in the Han group with statistically significant differences between the two populations.The cover rate of the three kinds of prosthesis tibial component were 53.0％,37.0％ and 40.0％ for Han group,but 61.0％,43.0％ and 42.5％ for Uygur group.Depuy prosthesis was fit for the Uygur population better.Conclusion The geometry and anatomy of proximal tibia in Chinese showed significant difference between Han and Uygur populations.The mean covering rates of the imported tibial components were low in the dimensions of the resected surface.We can improve the prosthesis and the matching degree by adjusting the parameters or increasing the model set.

Objective To analyze histomorphometrical characteristics of the bone and bone marrow tissues of the lumbar vertebrae in rabbits with fluoride treatment,and its correlation with signal intensity of MRI.Methods Forty New Zealand albino rabbits aged three months old were randomly divided into fluoride exposure of 30 cases and control of 10 cases,male and female,half each.One hundred milligrams of sodium fluoride were added to the municipal water each liter (fluoride content 100 mg/L) as drinking waterto fluorine for 180 days.Twenty-four of 30 cases with fluoride exposure had complete data (male10 casesand female14 cases).The same municipal water was used as control drinking water (fluoride content ＜ 0.9 mg/L).Eight of 10 cases with control had complete data (male andfemale in half).Twenty-four cases with fluoride treatment and complete data were classified into sensitive and resistant type according to the MRI signal intensity of the lumbar vertebra.Histomorphometrics of the vertebra and its correlation with the MRI signal intensity,and sensitivity in early diagnosis of osteofluorosis and feasibility of susceptibility to osteofluorosis detected with MRI were analyzed.Results Theratios of trabecular bone volume (BV),hematopoietic cell volume (HV) and fluid volume (FV) in bone marrow tissue to total cavernous tissue volume (TT) in group with fluoride treatment were 18.3％±2.6％,45.2％±6.0％ and 10.4％±5.7％ respectively.These were 14.5％±2.8％,36.3％±7.3％ and 6.2％±2.1％ in control group respectively.These parameters in fluoride group were significantly increased compared to control group.The ratio 26.0％± 8.0％ of adipocyte volume (AV) to TV in fluoride group was significantly lower than that 43.3％±5.6％ in control group.Two of 24 cases with fluoride exposure (8.3％,2/24) were sensitive and the remaining 22 (91.7％,22/24) were in resistance.The valuesof BV/TT,HV/TV and FV/TV were considered to be sensitive,resistant and control from large to small,while AV/TV value were opposite.A comparison resuhs of signal intensity in MRI showed that vertebra T1WI contrast to noise ratio (CNR) in the sensitive was the minimum (3.0±0.8),followed by resistance (21.3±3.8) andmaximum in the control (28.3±3.1),but CNR of FsT2WIwas opposite.There were positive associations between T1WI and AV/TV,FV/TV and BV/TV,and between FsT2WI and FV/TV and BV/ TV.There were inverse associationsbetween FsT2WI and AV/TV.Theoptimal threshold value of the vertebra T1WI CNR was 23.2 or lessin early diagnosis of skeletal fluorosis,with sensitivity of 83.3％ and specificity of 100％.FsT2WI was 5.7 or more,with sensitivity of 45.8％ and specificity of 100％.Conclusion The pathogenesis of osteofluorosis is relative to changes in bone marrow microenvironment and cells number in bone marrow tissue,and is correlated to MRI signal intensity.

Objective The study the multislice spiral computed tomography (MSCT) characteristics of gastric glomus tumor. Methods The clinical data of 8 patients with gastric glomus tumor were retrospectively analyzed, and the MSCT characteristics were observed. Results Among 8 patients, 3 cases were male and 5 cases were female, and the age was 25-67 years. The diameter of lesions were 1.3-3.5 cm, and lesions situated in the antrum of the stomach. Gastric glomus tumor showed strong enhancement in the arterial phase, and prolonged enhancement during multiphasic scans. Conclusions Gastric glomus tumor has some characteristics in MSCT. The prolonged enhancement during multiphasic scans of the subepithelial lesion should be suspected of the gastric glomus tumor.

Objective To assess the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of pancreatic neuroendocrine neoplasms (PNEN) and to analyze the factors influencing thepreoperative imaging diagnosis of PNEN.Methods From January 2016 to November 2016, patients with PNEN diagnosed by surgery and biopsy were collected. CT and MRI data of them were analyzed. The CT values or signal intensity of the lesions and the pancreatic parenchyma were measured and the contrast-to-noise ratio (CNR) of the lesion was calculated. Detecting sensitivity and diagnosis accuracy of CT and MRI were compared. Detecting sensitivity of different MRI sequences was also analyzed. Diagnosis accuracy of non-functional PNEN and functional PNEN was compared and analyzed. Lesion CNR was compared between arterial phase and portal venous phase of the contrast enhanced CT. The sensitivity, accuracy and constituent ratio were compared by nonparametric analysis. Independent sample t test and one-way analysis of variancewere performed for the quantitative parameters comparison. Results A total of 54 patients with 56 lesions of PNEN were included for two of whom had two lesions each. CT and MRI were both performed in 44 patients (46 lesions).Detecting sensitivity and diagnosis accuracy of CT were 97.8% (45/46) and87.0% (40/46), respectively. Detecting sensitivity of MRI were 97.8% (45/46) and89.1% (41/46), respectively. There was no significant difference in detecting sensitivity and diagnosis accuracy between CT and MRI (both P>0.05). The CNR of lesion in arterial phase was higher than that of portal venous phase(4.7±3.8 vs 3.4±2.5), and the difference was statistically significant (t=2.949, P<0.05). Detecting rates of T1 weighted imaging with fat suppression (T1WI-FS) image, T2 weighted imaging with fat suppression (T2WI-FS) image, diffusion weighted imagingand dynamic contrast enhanced T1WI-FS image were 90.0% (45/50), 88.0%(44/50), 86.0%(43/50), and 91.7% (44/48), respectively. There was no significant difference in detecting rate among these images sequences (Q=2.526, P=0.510). Tumor diameter in non-functional PNEN was significantly larger than that in functional PNEN ((2.9±1.6) cm vs (1.7±0.7) cm)(t=3.479,P<0.05). The overall diagnosis rate of non-functional PNEN with CT and MRI before operation was 70.8% (17/24), which was significantly lower than that of functional PNEN (100.0%, 31/31) (χ2=10.360，P=0.002).Conclusions CT and MRI are both sensitive in detectingPNEN, and they were two complementary modalities. CT image in arterial phase delineated the lesion better than that in portal venous phase. MRI images with different sequences can becomplementary and there is no significant difference in detecting sensitivity for PNEN among different sequences. CT and MRI play an equal rolein the diagnosis of PNEN before operation. Because of atypical CT and MRI findings, the diagnosis of non-functional PNEN is more difficult thanfunctional PNEN.

Objective To explore the quantitative characteristics of pancreatic ductal adenocarcinoma(PDAC) in single-source dual energy spectral CT imaging. Methods From January 2013 to December 2014, 113 patients underwent dual phase contrast-enhanced gemstone spectral imaging(GSI) on Discovery CT 750 HD. All diagnoses were pathologically confirmed by surgery or biopsy. The spectral HU curves of PDAC were observed, the monochromatic CT values, the effective atomic number(Zef ), the iodine concentration(IC), water concentration(WC), and the corresponding normalized values(normalized monochromatic CT values, normalized Zef , normalized IC, normalized WC)of the lesion and the pancreatic parenchyma in late arterial phase(AP) and portal venous phase(PP) were recorded . The measurements were performed three times repeatedly. Paired t test (normal distribution) or Wilcoxon test (non-normal distribution) were used for analyzing the differences between the two phases and between PDAC and pancreatic parenchyma. Results The monochromatic CT values of PDAC in AP were lower than in PP at each energy level and the difference was more marked at lower energy. The normalized monochromatic CT values increased with the increase of energy level in both AP and PP and the difference was more distinct at lower energy. The Zef , IC and normalized IC of PDAC all had significant differences(P<0.05), while the WC, normalized Zef , and normalized WC had no difference between AP and PP. The Zef and IC of pancreatic parenchyma had significant differences(P<0.05), while the WC had no difference between AP and PP. The differences of Zef , IC, and WC between PDAC and pancreatic parenchyma were significant in both two phases (P<0.05). Conclusions Dual phase CT spectral imaging showed characteristic quantitative parameters of pancreatic ductal adenocarcinoma. The monochromatic CT values, Zef , and iodine concentration of PDAC were lower than those of pancreatic parenchyma in both AP and PP. The monochromatic CT values, Zef , and iodine concentration of PDAC in late arterial phase were lower than those in portal venous phase. The differences were all more distinct at lower energy.