Analysis and prediction of thyroid cancer morbidity and mortality trends in China / 中华流行病学杂志

Objective: To analyze the morbidity and mortality trends of thyroid cancer in China from 1990 to 2019, explore the causes of the trends, and predict morbidity and mortality in the future. Methods: The morbidity and mortality data of thyroid cancer in China from 1990 to 2019 were collected from the 2019 Global Burden of Disease database. The Joinpoint regression model was used to describe the change trends. Based on the morbidity and mortality data from 2012 to 2019, a grey model GM (1,1) was constructed to predict the trends in the next ten years. The model was tested by the posterior error method and residual test method. Results: In all populations, men and women, the AAPC values of the crude morbidity rates were 4.15% (95%CI: 3.86%-4.44%, P<0.001), 5.98% (95%CI: 5.65%-6.31%, P<0.001) and 3.23% (95%CI: 2.94%-3.53%, P<0.001) respectively, the AAPC values of age-standardized morbidity rates were 2.47% (95%CI: 2.12%-2.83%, P<0.001), 3.98% (95%CI: 3.68%-4.29%, P<0.001), 1.65% (95%CI: 1.38%-1.93%, P<0.001), the AAPC values of crude mortality rates were 2.09% (95%CI: 1.92%-2.25%, P<0.001), 3.68% (95%CI: 3.45%-3.90%, P<0.001), 0.60% (95%CI: 0.50%-0.71%, P<0.001). The age-standardized mortality rates in men showed a fluctuating trend of first decrease (1990-1994), then increase (1994-2012), and then decrease (2012-2019) (AAPC=1.35%, 95%CI: 1.16%-1.53%, P<0.001). The age-standardized mortality rate in women continuously decreased (AAPC=-1.70%, 95%CI: -1.82%- -1.58%, P<0.001). The GM (1,1) models can be used for medium and long-term predictions. The results of the residual test show that the average relative error values of all models are less than 10.00%, the prediction accuracy values are more than 80.00%, and the prediction effects are good. The results of the posterior error method show that all the prediction results are good except the qualified prediction of the age-standardized morbidity rate in men. In 2029, the crude morbidity rates would increase to 3.57/100 000, 2.78/100 000, and 4.40/100 000, respectively, and the age-standardized incidence rates would increase to 2.38/100 000, 1.89/100 000, and 2.88/100 000, respectively, the crude mortality rates would increase to 0.57/100 000, 0.62/100 000 and 0.53/100 000, and the age-standardized mortality rates would decrease to 0.33/100 000, 0.42/100 000 and 0.27/100 000 in all population, men and women in China. Conclusions: The overall, gender- specific age-standardized mortality rates showed downward trends in the last decade or so, and the prediction results showed that it might further decline. However, the crude morbidity rates, age-standardized and crude mortality rates have been on the rise, and the population aging is becoming increasingly serious in China, which requires close attention and targeted prevention and control measures.

Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center retrospective cohort study / 医学前沿

The Coronavirus disease 2019 (COVID-19) has spread globally. Although mixed liver impairment has been reported in COVID-19 patients, the association of liver injury caused by specific subtype especially chronic hepatitis B (CHB) with COVID-19 has not been elucidated. In this multi-center, retrospective, and observational cohort study, 109 CHB and 327 non-CHB patients with COVID-19 were propensity score matched at an approximate ratio of 3:1 on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, disease severity, and clinical outcomes were compared. Furthermore, univariable and multivariable logistic and Cox regression models were used to explore the risk factors for disease severity and mortality, respectively. A higher proportion of CHB patients (30 of 109 (27.52%)) developed into severe status than non-CHB patients (17 of 327 (5.20%)). In addition to previously reported liver impairment markers, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin, we identified several novel risk factors including elevated lactate dehydrogenase (⩾ 245 U/L, hazard ratio (HR) = 8.639, 95% confidence interval (CI) = 2.528-29.523; P < 0.001) and coagulation-related biomarker D-dimer (⩾ 0.5 µg/mL, HR = 4.321, 95% CI = 1.443-12.939; P = 0.009) and decreased albumin (< 35 g/L, HR = 0.131, 95% CI = 0.048-0.361; P < 0.001) and albumin/globulin ratio (< 1.5, HR = 0.123, 95% CI = 0.017-0.918; P = 0.041). In conclusion, COVID-19 patients with CHB were more likely to develop into severe illness and die. The risk factors that we identified may be helpful for early clinical surveillance of critical progression.

Effects of a pulsed electromagnetic field on intervertebral disc degeneration and A2A adenosine receptor-mediated reactive oxygen signaling / 中华物理医学与康复杂志

Objective:To observe any regulatory effect of a pulsed electromagnetic field (PEMF) on A2A adenosine receptors (A2ARs) in the nucleus pulposus of rats with intervertebral disc degeneration (IDD), and to explore any combination with the A2ARs′ agonist-mediating ROS/PI3K/Akt signaling pathway.Methods:Fifty Sprague-Dawley rats were randomly divided into a control group, an intervertebral disc degeneration group (the model group), an A2AR agonist CGS-21680 treatment group (the agonist group), a PEMF group and a PEMF combined with CGS-21680 treatment group (the observation group). IDD was modeled in all except the rats in the control group. 100μL of CGS-21680 (100μg/kg) was injected into the L 5-6 intervertebral discs of the agonist group, while the PEMF group was given 30 minutes of PEMF intervention daily for 14 days at 1.5mT and 75Hz with a pulse width of 150μs. The observation group was injected with CGS-21680 and then given the same PEMF intervention. Primary nucleus pulposus cells from each group (50ng/mL) were cultured and the expressions of 8-OHDG, SOD, MDA and ROS were detected by immunohistochemistry, immunofluorescence or with an ELISA kit. The A2AR, PI3K, AKT and p-AKT protein levels were detected using western blotting. Results:The nucleus pulposus cells and the annulus fibrosus were obviously wrinkled, necrotic and broken in the model group but the annulus fibrosus was intact and the nucleus pulposus was almost normal in the observation group. Compared with the model group, the levels of SOD and A2AR, PI3K, p-AKT and AKT protein were higher in the agonist, PEMF and observation groups, while the expressions of MDA, ROS and 8-OHDG were weaker. The ROS level in the observation group was significantly lower than that in the agonist and PEMF groups, and the phosphorylation level of p-AKT in the observation group was significantly higher than in the agonist and PEMF groups. The average levels of SOD, A2AR, PI3K, p-AKT and AKT protein in the nucleus pulposus cells of the agonist, PEMF and observation groups were significantly higher than the IL-1β group′s average, while the average levels of MDA, ROS and 8-OHDG were significantly lower. The ROS levels in the observation group were significantly lower than in the agonist and PEMF groups, while the A2AR protein content and p-AKT phosphorylation in the observation group were significantly greater. The average Bax levels in the nucleus pulposus cells of the agonist, PEMF and observation groups were significantly lower than that in the IL-1β group, and the expression of Bcl-2 was significantly increased. There was significantly less apoptosis observed in the observation group than in the agonist and PEMF groups, while the expression of Bcl-2 was significantly higher.Conclusions:PEMF plays an anti-oxidative stress role by up-regulating A2AR activity and reducing ROS generation. Treatment with PEMF and A2AR agonist could further activate the phosphorylation of PI3K/Akt, down-regulate Bax and up-regulate Bcl-2, thus inhibiting the apoptosis of nucleus pulposus cells and alleviating the malignant progression of IDD.

Clinical analysis on the root fracture of the maxillary first molar / 华西口腔医学杂志

OBJECTIVES@#This study aimed to investigate the common types and directions of root fractures of the maxillary first molar and the influence of root canal treatment on the prevalent sites of root fractures.@*METHODS@#A total of 274 maxillary first molars with root fractures diagnosed via cone beam computed tomography were included. The root fractures of nonendodontically and endodontically treated teeth were identified to be spontaneous and secondary root fractures, respectively. The sites, types, and directions of spontaneous and secondary root fractures were determined.@*RESULTS@#Among the spontaneous root fractures, the proportion of palatal root fractures (56.1%) was higher than those of mesial buccal root fractures (36.1%) and distal buccal root fractures (7.8%). Among the secondary root fractures, the proportion of mesial buccal root fractures (52.7%) was higher than those of palatal root fractures (36.5%) and distal buccal root fractures (10.8%). The distribution of predominant fracture sites was statistically significant (@*CONCLUSIONS@#This study provided an epidemiological basis for the clinical features of root fractures of the maxillary first molar. During the dia-gnosis and treatment of the maxillary first molar, the possibility of palatal root fractures should be considered. The occurrence of mesial buccal root fractures may be related to root canal treatment. Therefore, the risk of mesial buccal root fractures caused by iatrogenic factors should be minimized.

Effect of anatomical parameters of maxillary sinus on the outcomes of transcrestal sinus lift / 华西口腔医学杂志

OBJECTIVE@#To investigate the effect of three anatomical parameters (maxillary sinus width, maxillary sinus angle, and residual bone height) on the outcomes of transcrestal sinus lift with simultaneous implant placement.@*METHODS@#A total of 60 maxillary sinuses in 42 patients were included in this study. All patients were treated with transcrestal sinus lift procedure associated with simultaneous implant placement using a composite graft material of autogenous bone and Bio-Oss. For each patient, beam computed tomography (CBCT) scans were performed preoperatively, immediately after surgery, and 6 months after surgery. The parameters were measured on the preoperative and postoperative CBCT images. The correlation of three anatomical parameters with graft resorption was analyzed using Pearson's correlation test.@*RESULTS@#The average residual bone height was (4.46±1.55) mm. The average width of maxillary sinus was (13.86±2.71) mm. The average sinus angle was 78.09°±10.27°. A significant positive correlation was observed between maxillary sinus width and graft resorption (P<0.01). A positive association was also found between sinus angle and graft resorption (P<0.01).@*CONCLUSIONS@#The findings show that graft bone resorption in elevated sinus has a positive correlation with the sinus width and sinus angle.

Clinical results of arthroscopic anterior cruciate ligament reconstruction with short femoral tunnel / 中国骨伤

OBJECTIVE@#To evaluate the clinical outcome of arthroscopic reconstruction of anterior cruciate ligament (ACL) with short femoral tunnel.@*METHODS@#From May 2013 to June 2017, 128 patients with anterior cruciate ligament reconstruction were performed with Transportal technique. Among them, 32 cases had short femoral tunnel were included, including 13 males and 19 females, aged 25.8 (17 to 43) years old, with a mean history of (4.5±1.1) months. The tibial tunnels were drilled in the middle of the footprint of the ACL, and femoral tunnels were drilled by transportal technique. Grafts were fixed with Endobutton at the femoral side and with interference screw at the tibial side. The changes of symptoms and signs were observed and the anterior tibial displacement was measured. The function of knee joint was evaluated by Lysholm score and Tegner score.@*RESULTS@#All patients were followed up for over 2 years. At the latest follow-up, 30 patients were negative and 2 patients were positive in knee shift test; 28 patients were negative in Lachman sign, 4 patients were positive in degree I; 30 patients were negative in anterior drawer test, 1 patient was positive in degree I and 1 patient was positive in degree II. The anterior displacement of the tibia increased by (2.6±1.8) mm compared with the healthy side, which was significantly different from that before operation (=19.77, <0.05). Lysholm score of 82.2±6.1 was significantly higher than that before operation (=17.33, =0.001). According to Lysholm score evaluation, 15 cases got an excellent result, 10 were good, 7 were fair, and no bad results, with a significant difference compared with that before operation (=-7.151, <0.05). Tegner motor function score of (7.4±0.6) was significantly different from that before operation (=9.11, =0.000 5). After operation, the knee joint movement ability of the patients improved significantly. Twelve patients could participate in antagonistic sports and 15 patients could participate in non-antagonistic sports. Fifteen patients were very satisfied with the curative effect, 13 patients were satisfied with the curative effect.@*CONCLUSIONS@#The incidence of short femoral tunnel in anterior cruciate ligament reconstruction with transportal technique is 25%. At present, the clinical effect of patients with short tunnel is acceptable. However, due to the lack of comparative study, the effect of short tunnel on the curative effect is still unclear.

Clinical results of needle Dao for the treatment of subacromial impingement syndrome / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical results of needle Dao for the treatment of subacromial impingement syndrome.</p><p><b>METHODS</b>From September 2013 to August 2014, 90 patients with subacromial impingement syndrome were treated, including 61 females and 29 males, with the average age of (55.21±8.30) years old(ranged, 45 to 65 years old), and mean course of disease (3.49±2.98) months (ranged, 4 weeks to 7 months). Twenty-six patients had pains in left shoulder, and 64 patients had pains in right shoulder. Under local anesthesia, needle Dao was performed to release the pain point at the lower edge of the acromion and the subacromial adhesion. By observing the abduction of shoulder joint, anterior flexion and lifting, internal rotation and external rotation, shoulder pain score, the number of cases cured, markedly effective, effective and ineffective after treatment were counted, and the curative effect of needle Dao for the treatment of subacromial impingement syndrome was evaluated.</p><p><b>RESULTS</b>All the patients completed the treatment successfully without obvious adverse reactions. All the patients were followed up for more than 12 months. The visual analogue scale(VAS) decreased from preoperative 7.72±5.42 to postoperative 1.35±0.78(=15.89, <0.01). The Constant score at the 12th month after operation increased from preoperative 58.89±15.63 to 83.17±19.11(=28.48, <0.01). Overall efficacy evaluation was that, 46 cases were cured, 33 cases were markedly effective, 11 cases were effective, and 0 cases were invalid.</p><p><b>CONCLUSIONS</b>The advantage of needle Dao in the treatment of subacromial impingement syndrome is the minimally invasive treatment of the underlying lesions. The disadvantage is that it can not deal with the impact caused by bone abnormalities.</p>

Chaenomelesalkaloid A, a new alkaloid from the fruits of Chaenomeles sinensis (Thouin) Koehne / 药学学报

The chemical constituents of the fruits of Chaenomeles sinensis (Thouin) Koehne were investigated using chromatographic methods, including Diaion HP-20, Toyopearl HW-40, MCI Gel CHP-20, ODS, Silica gel chromatography and semi-preparative-HPLC. Three compounds were isolated and their structures were elucidated with spectral data and physicochemical properties, which were identified as chaenomeles alkaloid A (1), ginsenine (2) and 1,2,3,4-tetrahydro-1-methyl-β-carboline-3-car-boxylic acid (3). Among those, compound 1 is a new alkaloid, compound 2 and 3 were isolated from this plant for the first time. To investigate the protective effect of compounds 1-3 on Rat adrenal pheochromocytoma (PC-12) injury induced by the β-amyloid protein (Aβ25-35). The results show that compounds 2 and 3 have a significant protective effect on the PC12 cells exposed to Aβ25-35.

Synthesis and hepatoprotective activity of Mannich base derivatives of silybin / 药学学报

Two novel Mannich base derivatives of silybin, SLB-DEA and DHSLB-PIP, were designed and synthesized. All the structures of new Mannich base derivatives of silybin were characterized by 1H NMR and HR-MS. Their protective action against CCl4-induced liver injury in mice were investigated. The changes of alanine aminotransferase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH), total cholesterol (TC) and triglyceride (TG) were determined and the histopathological changes in liver tissues were examined. Pretreatment with a higher dosage of DHSLB-PIP (40 mg·kg-1) prevented CCl4-induced liver injury as indicated by the reduced levels of ALT, AST, LDH and TG. Meanwhile, liver histopathological improvement was observed in the model groups. The pharmacokinetics study in rats showed that the relative bioavailability of SLB-DEA and DHSLB-PIP were 172.5% and 259.8% compared with silybin. All the results suggest that SLB-DEA and DHSLB-PIP may protect liver against injury by CCl4 and the relative bioavailability was significantly increased, which is worth of further investigation for their druggability.

Regulatory factors in the articular cartilage repair of knee osteoarthritis / 中国组织工程研究

BACKGROUND:Knee osteoarthritis is a joint and articular cartilage degenerative disease,and its biological changes mainly include proliferation and apoptosis of chondrocytes.Articular cartilage holds poor regeneration ability,and tissue-engineered cartilage is of great significance for the articular cartilage repair,while cytokines is a major concem for this repair process.OBJECTIVE:To overview the main regulatory factors involved in the articular cartilage repair and chondrocyte apoptosis.METHODS:PubMed and WanFang databases were retrieved for the literature addressing articular cartilage repair and main regulatory factors involved in articular cartilage repair and chondrocyte apoptosis published from 1999 to 2016.Finally 44 eligible articles were included for analysis.RESULTS AND CONCLUSION:Various cytokines in different human tissues are closely related to articular cartilage repair,chondrocyte apoptosis and pathological changes of osteoarthritis,which are involved in chondrocyte damage,degradation of cartilage matrix,synovial degeneration and periostosis.There is an increase in the levels of interleukin 1 β and 6,and tumor necrosis factor α following articular cartilage injury.Thereafter,blocking the expression of these cytokines can protect the articular cartilage from damage.Insulin-like growth factor and transforming growth factor play an important regulatory effect on the chondrocyte proliferation and matrix synthesis.Furthermore,various cytokines regulate the articular cartilage repair and reconstruction via complicated pathways.

Fluorescent Detection of p-Nitroaniline Based on an Anionic Pyrenyl Probe / 分析化学

p-Nitroaniline ( PNA) was one kind of highly toxic aromatic amine and becomes an environmental pollutant in recent years. Here we reported the construction of a fluorescent sensor based on an anionic pyrene, 8-hydroxypyrene-1,3,6-trisulfonic acid trisodium salt (HPTS), for the rapid and visual detection of PNA in aqueous media. The fluorescence quenching of HPTS caused by the presence of PNA was through non-covalent interactions. A good linear relationship between fluorescent intensity of HPTS at 512 nm was obtained in the range of 10-120 μmol/L. The detection limit (3σ) of this approach was 4. 6 μmol/L. The results showed that the method was suitable for rapid detection of PNA in real samples with good sensitivity, selectivity, anti-interference, low cost and easy operation.

Fluorescent Detection of p-Nitroaniline Based on an Anionic Pyrenyl Probe / 分析化学

p-Nitroaniline ( PNA) was one kind of highly toxic aromatic amine and becomes an environmental pollutant in recent years. Here we reported the construction of a fluorescent sensor based on an anionic pyrene, 8-hydroxypyrene-1,3,6-trisulfonic acid trisodium salt (HPTS), for the rapid and visual detection of PNA in aqueous media. The fluorescence quenching of HPTS caused by the presence of PNA was through non-covalent interactions. A good linear relationship between fluorescent intensity of HPTS at 512 nm was obtained in the range of 10-120 μmol/L. The detection limit (3σ) of this approach was 4. 6 μmol/L. The results showed that the method was suitable for rapid detection of PNA in real samples with good sensitivity, selectivity, anti-interference, low cost and easy operation.

Radiologic observation of the blood supply changes around the knee with osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To compare blood supply changes around the knee joint between normal and osteoarthritis knee.</p><p><b>METHODS</b>From June 2014 to June 2015, 30 patients with knee osteoarthritis and 30 healthy adults were recruited. In osteoarthritis group, there were 9 males and 21 females, with a mean age of (65.967±7.132) years old(ranged, 53 to 82 years old), and the mean arterial pressure was(93.462±7.633) mmHg. In control group, there were 9 males and 21 females, with a mean age of (62.867±6.356) years old(ranged, 50 to 75 years old), and the mean arterial pressure was (92.122±9.675) mmHg. Inspection methods included color ultrasonic and computed tomography angiography of lower limbs. The patients were observed with: (1)collateral circulation; (2)artery circuity; (3)artery malformation; (4)artery stenosis; (5)arterial wall plaque formation. Stenosis was divided into 5 levels: level 1 as no narrow, level 2 as mild stenosis (1% to 49%), level 3 as moderate stenosis (50% to 70%), level 4 as severe stenosis (70% to 99%), level 5 as total obstruction. Diameter and blood flow dynamics of popliteal artery, pretibial artery, and posterior tibia artery in two groups were measured and compared.</p><p><b>RESULTS</b>The study was accomplished with complete data collection, none of the patients was eliminated, and there were no loss of follow up. There were 3 cases in OA group and 4 cases in control group with the formation of collateral circulation, and the difference had no statistically significance. There was none in OA group and 2 in control group with the formation of artery circuity, and the difference had no statistically significance. There were no cases in both groups with artery malformation. In OA group, there was mild in 14 cases, moderate in 7 cases, severe in 9 cases. In control group, there was no arterial stenosis in 9 cases, mild in 10 cases, moderate in 6 cases, severe in 4 cases, total obstruction in 1 case. The difference between two groups was statistically significant; artery stenosis in OA group was more severe than that of the control group. Artery plaque formed in 30 cases in OA group and in 20 cases in control group. The difference between two groups was statistically significant; the rate of artery plaque formation in OA group was obviously higher than that of control group. In OA group, plaque calcification rate was 100% while 63% in control group. Difference of pretibial artery diameter was statistically significant, pretibial artery diameter is larger in OA group. Difference of popliteal artery flow velocity was statistically significant; velocity was faster in OA group. Difference of the posterior tibial artery flow velocity was statistically significant; velocity was faster in OA group. The differences of the three arteries had no statistical significances in related to arterial flow.</p><p><b>CONCLUSIONS</b>Local artery system changes with the onset of knee joint osteoarthritis. Main pathological changesof local blood vessels were stenosis and plaque formation, but the amount of local artery blood flow was roughly the same as the control group. Possible mechanism is that the local artery stenosis speed up the artery blood flow velocity, resulting local perfusion. The local tissue ischemia and hypoxia caused a series of pathological changes. It is better to improve local vascular lesions than to accelerate the blood flow velocity in clinical treatment. Further more, interventional therapy for vascular pathology will be a new trend of osteoarthritis treatment.</p>

cDNA cloning, difference expression in various organs, and bioinformatic analysis of HMGS gene in Sambucus chinensis / 中草药

Objective: To clone 3-hydroxy-3-methylglutaryl coenzyme A synthetase (HMGS) gene from Sambucus chinensis and analyze the difference expression. Methods: The sequence of HMGS gene was cloned from S. chinensis by using RT-PCR strategy. The physiochemical properties, secondary structure, and three-dimensional structure of HMGS protein were forecasted and analyzed, and its structure and function were predicted. And the difference expression of HMGS gene in the rhizome, stems, leaves, and flowers of S. chinensis was analyzed by fluorescent quantitative PCR. Results: The cDNA contains a 1 401 bp open reading frame and encodes a predicted protein of 466 amino acids. No transmembrane region and no signal peptide were present in HMGS protein. Relative real-time PCR analysis indicated that HMGS gene showed the higher transcript abundance was in the flowers and rhizomes, while was lower in the leaves. Conclusion: The HMGS gene is first cloned from S. chinensis and the result will provide a foundation for elucidating the mechanism of the gene in the metablism pathway of terpenoid in S. chinensis.

Biomechanical evaluation of the locking titanium cable in the fixture of distal tibiofibular syndesmosis injury / 解放军医学杂志

Objective The article aims at evaluating the biological properties of tibiofibular titanium cable fixation device in terms of both anti-separation and stress shielding by comparison to the interior fixation with lag screw based on experimental observation. Methods Six corpse ankle specimens were first tested of pressure-separation and stress measurement, the data from which were compared to the normal group, and then a syndesmosis injury model was established. All the samples are randomly divided into 2 groups of 3 specimens each, which were treated with tibiofibula locked titanium cable and lag screw fixation respectively for syndesmosis injury. Then, the samples were tested for pressure-separation and stress measurement. The biomechanical properties as anti-separation ability and stress shielding were analyzed and compared between the two fixation method. Results Both tibiofibula locked titanium cables and lag screws were able to provide enough strong lateral anti-separation ability, but strong fixation screws were inferior to tibiofibular titanium cable fixation device in fibular longitudinal stress transduction. Conclusion Tibiofibular titanium cable fixation device not only provide sufficient lateral anti-separation, but also reduces the tibial and fibular longitudinal stress shielding, thus being superior to the traditional lag screw in biomechanical properties.

Effect of GRK6 on Proliferation of Multiple Myeloma MM1R Cells and Its Mechanism / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the regulatory effect of GRK6 on the proliferation of multiple myeloma cells and its mechanism.</p><p><b>METHODS</b>A lentivirus vector shRNA interfering in human GRK6 gene expression was constructed and trans-fected into multiple myeloma cells to obtain the cell line MM1R with stable down-regulation of GRK6 gene expression. The real-time quantitative PCR and Western blot were used to confirm the effectiveness of the GRK6 gene expression down-regulation mediated by lentivirus vector. The MM1R cells with most obvious down-regulation were selected to detect the effect of GRK6 gene on cell proliferation.</p><p><b>RESULTS</b>The lentivirus vector GRK6-shRNA interfering in human GRK6 gene was constructed succesufully and transfected into multiple myeloma cells, thereby the MM1R cell line with stable down-regulation of GRK6 gene was obtained. The CCK-8 assay showed that the proliferative viability of MM1R cells in experimental group was significantly lower than that in control group (P<0.05); the flow cytometry showed that cells in experimental group were arrested in G/Gphase(P<0.05); the Western blot detection showed that the Cyclin D1 and CDK4 levels in experiment group obviously decreased as compared with control group.</p><p><b>CONCLUSION</b>A lentivirus vector which can specifically interfere in GRK6 gene expression is constructed successfully, The MM1R cell line with stable down-regulation of GRK6 expression is obtained by transfection and screening. The down-regulation of GRK6 expression can arrest MM1R cells in G/Gphase, moreover inhibits the proliferation of MM1R cells by inhibition of Cyclin D1 and CDK4 levels.</p>

Arthroscopic reduction and utilization of Suture Bridge tech reconstructing footprint area structure for the treatment of anterior cruciate ligament avulsion fracture / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the preliminary curative effect of arthroscopic reduction and utilization of Suture Bridge tech reconstructing footprint area structure for anterior cruciate ligament avulsion fracture.</p><p><b>METHODS</b>From March 2010 to September 2012, 6 patients suffered anterior cruciate ligament avulsion fracture were treated with arthroscopic Suture bridge fixation for anterior cruciate ligament tibial side footprint reconstruction. There were 2 males and 4 females, ranging in age from 14 to 52 years old. There were 2 cases of type III and 4 cases of type IV displaced fractures classified by Meyers-McKeever-Zaricznyj. Preoperative ADT and Lachman tests were positive.</p><p><b>RESULTS</b>All the patients was follow up more than 2 years. Postoperative ADT and Lachman tests were negative without limitation of knee extension. Postoperative X ray and MRI showed that displaced fracture with a good reduction and union, recovered normal shapeness of ACL. The postoperative Lysholm and IKDC scores at different time points(3 months, 1 year, 2 years after operation) improved significantly comparing with preoperative, and the differences were statistically significant (<0.01).</p><p><b>CONCLUSIONS</b>Suture Bridge tech reconstructing footprint area structure for ACL avulsion fracture is an effective and safe method, especially for adolescent patients with unclosed epiphysis and comminuted avulsion fracture.</p>

Total hip arthroplasty for patients with failed internal fixation of acetabular fractures / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical result and healing of meniscal suture under arthroscopy for the treatment of the middle aged patients with meniscal injury.</p><p><b>METHODS</b>From March 2014 to January 2015, 40 middle-aged patients included in the standard with injury of meniscus, which were repaired by meniscal suture technique under arthroscopy, involving 24 males and 16 females with an average age of (52.65±3.63) years ranging from 50 to 60 years; 28 cases were on left knee, 12 cases were on right knee. Average flexion angle averaged (117.50±7.16) ° ranging from 110° to 130°. Lysholm knee score averaged 54.30±14.72 ranging from 23 to 71; IKDC score averaged 50.65±15.95 ranging from 18 to 78; the WOMAC score averaged 23.80±19.39 ranging from 2 to 75. All-inside meniscus suture under arthroscopy was performed.</p><p><b>RESULTS</b>All operations were successful without serious complications. Postoperative follow-up was 6 to 12 months, none of the patients lost to follow-up. All patients maintain a category 5 degree muscle strength, normal knee joint mobility, can completely straight and completely buckling. Average flexion angle was (125.00±5.13) ° (110° to 130°) (=3.47,=0.003). Final Lysholm scale, IKDC scores and WOMAC scores averaged 79.50±8.70 (=7.790,=0.000), 79.40±10.40 (=8.431,=0.000), 8.15±6.77 (=3.988,=0.001) separately. Follow-up MRI showed that meniscus healed in 4 cases, partially healed in 22 cases, haven't healed in 14 cases. Failure rate of small lesion was 27.3%(6/22), and failure rate of large lesion was 44.4%(8/18).</p><p><b>CONCLUSIONS</b>Clinical effect of meniscal suture under arthroscopy for the treatment of the middle aged is good. The failing rate was 35% because of healing ability is poor in middle-aged adults. Failure rate of large lesion was higher than that of small lesion.</p>