Ankylosing spondylitis is a chronic immunoinflammatory disease that mainly affects the spine and the sacroiliac joint， the mechanism of which is closely related to signaling pathways， such as osteoprotegerin （OPG）/receptor activator of nuclear factor-κB （RANK）/RANK ligand， mitogen-activated protein kinase （MAPK）， Wnt/β-catenin （β-catenin）， phosphoinositide 3- kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR）. Traditional Chinese medicine has the characteristics of multiple components and targets， and is widely used for the treatment of autoimmune diseases due to its low toxicity， strong specificity， and high efficacy. This review found that monomers and compounds of traditional Chinese medicine can exert anti ankylosing spondylitis effects by intervening in the aforementioned signaling pathways， regulating immune inflammatory responses， and inhibiting biological processes such as bone destruction， ectopic osteogenic differentiation， cell apoptosis， and autophagy.

Occupational therapy, as one of the important subdisciplines of rehabilitation therapy, takes occupational activities as the medium or purpose of treatment and life participation as the goal of treatment to meet the growing demand for rehabilitation. According to the Minimum Standards for the Education of Occupational Therapists developed by the World Federation of Occupational Therapists, many countries and regions have formulated educational standards that meet their own national or regional characteristics. Comparatively, the number of occupational therapists is seriously insufficient, the talents cultivation is relatively lagging behind, and the education level is uneven in mainland China; while in Hongkong and Taiwan, occupational therapy has an independent education system and a relatively mature talent training model. This study summarized the practical experience and reviewed the relevant literature. Based on the summary and review, we made a comparative analysis of postgraduate education in mainland China and Taiwan from the aspects of educational system and accreditation, enrollment objects, curriculum setting and teaching methods, which would provide a reference for the improvement of occupational therapy personnel training system in mainland China.

Objective:To evaluate the effect of zoledronic acid administration for osteoporotic vertebral compression fracture (OVCF) after treatment with percutaneous kyphoplasty (PKP).Methods:A retrospective case-control study was performed on 430 elderly patients with OVCF admitted to the Second Affiliated Hospital of Soochow University from January 2012 to December 2016. There were 31 males and 399 females, with age of 52-92 years[(72.8±8.3)years]. Fracture segments were at T 5-T 10 (82 vertebrae), T 11-L 2 (389 vertebrae) and L 3-L 5 (173 vertebrae). In zoledronic acid group ( n=178), patients were given zoledronic acid 3 days after PKP surgery. In basic treatment group ( n=252), patients were only given basic treatment after PKP surgery. Bone mineral density was measured before operation and one year after operation. Visual analogue scale (VAS) and Oswestry disability index (ODI) were assessed before operation, 3 days and one year after operation. Incidence rate of refracture, mortality and complication rate were recorded after operation. Results:All patients were followed up for 12-60 months (mean, 27 months). Before operation and at postoperative 1 year, the vertebral bone mineral density in zoledronic acid group was (-2.3±1.5)SD and (-1.2±2.3)SD ( P<0.05), and that in basic treatment group was (-2.2±1.2)SD and (-2.1±1.1)SD ( P>0.05). At postoperative 1 year, the bone mineral density in zoledronic acid group was significantly better than that in basic treatment group ( P<0.05). At preoperative 3 days, postoperative 3 days and postoperative 1 year, the VAS was (8.6±0.8)points, (2.8±0.8)points, (2.1±0.8)points in zoledronic acid group, and was (8.5±1.1)points, (2.9±0.9)points, (3.0±2.3)points in basal treatment group; ODI was 48.7±5.3, 24.0±2.9, 22.3±3.3 in zoledronic acid group, and was 48.3±6.1, 24.5±3.8, 27.6±4.0 respectively in basal treatment group. The VAS and ODI were significantly reduced in two groups at postoperative 3 days and 1 year compared to those before operation ( P<0.05). Moreover, the VAS and ODI in zoledronic acid group were significantly lower than those in basal treatment group at postoperative 1 year ( P<0.05). At postoperative 2 years, the incidence rate of refracture in zoledronic acid group was 10.1%(18/178), significantly lower than 16.7%(43/252) in basic treatment group ( P<0.05). Mortality rate in zoledronic acid group was 5.1%(9/178), and that in basic treatment group was 6.3%(16/252) ( P>0.05). No serious complications were observed in both groups such as nerve injury or pulmonary embolism. Conclusion:For OVCF patients, zoledronic acid given after PKP can improve the bone mineral density, reduce pain, fasten function recovery, and effectively decrease the refracture rate.

Objective To study the use of laparoscopy in the diagnosis and treatment of obstructive infantile cholestasis.Methods The clinical data of 106 patients with obstructive infantile cholestasis from January 2012 to June 2017 were studied retrospectively.After two weeks of conservative treatments which failed to decrease the bilirubin levels significantly,these patients were subjected to laparoscopic diagnosis and treatment.Results A correct diagnosis was established in all these 106 patients by laparoscopic biliary tract exploration and cholangiography.Eighty-eight patients were diagnosed to have biliary atresia (83.0％),16 patients inspissated bile syndrome (15.1％) and 2 patients biliary hypoplasia (1.9％).Thirty-eight of the 88 biliary atresia patients gave up operative treatment after laparoscopic biliary tract exploration and cholangiography.The remaining 50 biliary atresia patients were treated with open Kasai portoenterostomy.The prognosis of the biliary atresia patients were different from the non-biliary atresia patients.On follow-up for 4 months to 5 years,all the 18 non-biliary atresia patients were in good condition and there was no recurrence of jaundice after laparoscopic cholecystostomy and biliary tract irrigation.Conclusions The laparoscopic minimally invasive technique helped to establish diagnosis and treatment in patients with obstructive infantile cholestasis.For patients with biliary atresia,this procedure gave a definitive diagnosis and offered an opportunity for surgery.For patients with inspissated bile syndrome and biliary hypoplasia patients,laparoscopic cholecystostomy and biliary tract irrigation established the correct diagnosis and reduced liver damage resulted by cholestasis.

Objective To evaluate the effects of perioperative rehabilitation for patients with self-forearm internal arteriovenous fistula.Methods Divided 124 patients with end-stage renal disease into the functional training group (65 cases,A group)and the control group(59 cases,B group) randomly,and then compared certain related indexes between the two groups.Results In the A group,the artery diametcr was obvious widen before functional training without operation,and the vein diameter was obvious widen before functional training without operation too,P ＜ 0.05.After operation,the A group Anastomotic unobstructed was obviously better than B group in one-stage,P ＜ 0.05.A group with thrombosis cases significantly less postoperative than B group,P ＜ 0.05.A group with edema of hands was significantly shorter than B group,P ＜ 0.01.Postoperative fistula time to maturity in the A group was (43.76 ± 2.21) days,which was significantly shorter than that of in the B group,(49.69 ± 5.85) days,P ＜ 0.01.Conclusion Systematic strengthening of perioperative functional exercises can significantly improve preoperative vascular conditions,improve the success rate of operation,reduce risk of thrombosis cases,shorten the time of hand edema and the time of fistula in mature.

Objective To study the correlationship between type Ⅰcollagenα1 (COL1A1) gene polymorphism and the occurrence of osteosarcoma. Methods Peripheral blood from 54 patients with osteosarcoma and 126 normal ones were collected, rs1061970 genotype of COL1A1 gene was amplified with PCR and products were analyzed by pyrosequencing among the samples. Results The allele frequency of TT (13.0%) and CT (48.1%) was significantly higher in pathologi-cal group than that in the normal control group, which manifested a allele frequency of TT(11.9%) and CT(30.2%) (P<0.05). Additionally, allele frequency of T in patients with osteosarcoma was 37.0%, higher than the control group (27.0%), with OR of 1.59 and 0.99-2.57 of 95%CI, with no difference of statistically significant (P>0.05), but the risk was still on the rise of osteosarcoma. Conclusion COL1A1 gene polymorphism may be related with the incidence of osteosarcoma, patients who carry the T allele of gene of COL1A1 may increase the risk of osteosarcoma occurrence.

Objective To investigate the feasibility of measuring femoral neck torsion angle and anteversion angle by laser projection method .Methods The femoral neck torsion angle and anteversion were observed and described .An angle measuring device was designed and produced .With the device , the femoral torsion angle and anteversion angle were measured by laser projection method two times .Statistical analysis was performed on the measured value , and sides difference .Results The differences between femoral neck torsion angle and anteversion angle were observed .There was no significant difference ( P >0.05, power =100%) between the two measurements by laser projection method . Measurements of the femoral anteversion were 13.58 °±6.55 °on the left side , and 12.15 °±5.83 °on the right side . Measurements of the femoral neck torsion angle were 18.50 °±7.38 °on the left and 19.08 °±8.59 °on the right .There was no significant difference between left and right side ( P >0.05 ) .Conclusion The laser projection method is the effective method in measuring femoral neck torsion angle and anteversion angle , and has excellent repeatability .

Malic acid is widely used in food, and chemical industries. Through overexpressing pyruvate carboxylase and malate dehydrogenase in pdc1-deficient Saccharomyces cerevisiae, malic acid was successfully produced through the reductive TCA pathway. No malic acid was detected in wild type Saccharomyces cerevisiae, however, 45 mmol/L malic acid was produced in engineered strain, and the concentration of byproduct ethanol also reduced by 18%. The production of malic acid enhanced 6% by increasing the concentration of Ca2+. In addition, the final concentration reached 52.5 mmol/L malic acid by addition of biotin. The increasing is almost 16% higher than that of the original strain.
Citric Acid Cycle ; Fermentation ; Industrial Microbiology ; methods ; Malate Dehydrogenase ; genetics ; metabolism ; Malates ; metabolism ; Metabolic Engineering ; methods ; Metabolic Networks and Pathways ; Oxidation-Reduction ; Pyruvate Carboxylase ; genetics ; metabolism ; Saccharomyces cerevisiae ; genetics ; metabolism ; Signal Transduction

Objective To know the feasibiliy and the effects of shorten preoperative fasting time for patients with digital cerebral angiography. Methods Divided 110 patients with digital cerebral angiogra-phy into the observation group and the control group according to their sequence enter the hospital. Routine fasting method was used in the control group, shorten fasting time was used in the observation group, com-pared the incidence rate of fasting-related complications between the two groups. Results The incidence rote of belly discomfort, thirstily, strvation and hypoglyeemic during the digital cerebral angiogrsphy in the con-trol group was significant higher than those of in the observation group, while there were no significant difference about the incidence rate of postoperative complication between the two groups. Conclusions For patients with digital cerebral angiography can shorten the preoperative fasting time properly, which can avoid certain complieaitons.

BACKGROUND: Autogenous bone has been used in cervical vertebra graft bone fusion in earliest stage and at most. However, its source is limited, simultaneously, induced many complications such as infection, hemorrhage and postoperative pain in the donor bone region. Recently, above-mentioned complications were avoided or reduced with the usage of new graft bone fusion material. OBJECTIVE: To compare clinical efficacy using MC+~R combination of autogenous bone or calcium sulfate artificial bone in antador cervical fusion.METHODS: A total of 26 patients (34 levels) with cervical spondylotic myelopathy underwent anterior cervical discectomy and cervical intervertebral fusion from January to December 2008. Anterior cervical oblique cut was 3.0-4.0 cm. The endplate were preserved after the cervical intervertebral disc and the posterior longitudinal ligament were removed. Autogenous bone group was filled with autogenous bone. Calcium sulfate artificial bone group was filled with Wdght's Osteoset artificial bone. Anchoring clip was implanted between the cervical vertebrae. Every patient had a short neck incision was assessed with X-ray, JOA grade and Odom's evaluation scale.RESULTS AND CONCLUSION: The two groups of 26 patients (34 segments)were followed up. The JOA score of postoperation was no significant difference between the two groups. According to the Odom's evaluation scale, the excellent and good rate of calcium sulfate group was higher than autogenous bone group, but there was not statistical significance (P>0.05). The fusion rate of autogenous bone group was higher than calcium sulfate group at 3 and 6 months, but the fusion rate of two groups were 100% at 12 months. Although the calcium sulfate group at 6 months, lordosis angle lost more than 0.4°than the autogenous bone group,but no significant statistically between the two groups (P>0.05). MC+ combination of autogenous bone or Calcium sulfate had the same clinical efficacy in the treatment of cervical spondylotic myelopathy, but the calcium sulfate artificial bone could be effectively avoided the complications of donor site.