Effects of micropulse laser photocoagulation under threshold on serum malondialdehyde and chemokine levels in patients with proliferative diabetic retinopathy / 中国基层医药

Objective:To investigate the effects of micropulse laser photocoagulation under threshold on serum malondialdehyde(MDA) and chemokine levels in patients with proliferative diabetic retinopathy(PDR).Methods:From October 2014 to February 2016, 102 patients with PDR who were treated in Lishui People's Hospital were selected and divided into two groups by random number table method, with 51 cases in each group.The patients in the control group were treated with traditional grating laser, and the patients in the observation group were treated with micropulse laser photocoagulation under threshold.The levels of MDA and chemokine were compared before and after treatment, and the changes of vision and clinical efficacy were observed.Results:The total effective rate of the observation group was 90.20%(46/51), which was higher than that of the control group [76.47%(39/51)](χ 2=19.585, P<0.01). Before treatment, there were no statistically significant differences in serum MDA, chemokine and visual acuity between the two groups(all P>0.05). After treatment, the serum MDA and chemokines in the observation group were (8.57±2.48)μmol/L and (1.58±0.51)ng/L, respectively, which were lower than those in the control group [(10.92±3.16)μmol/L and (2.83±0.92)ng/L]( t=4.178, 8.486, all P<0.05), which in both two groups after treatment were lower than those before treatment(all P<0.05). The visual acuity of the observation group was (0.66±0.19), which was higher than that of the control group(0.43±0.13)( t=7.135, P<0.05). Conclusion:Micropulse laser photocoagulation under threshold can effectively alleviate oxidative stress and reduce serum MDA and chemokine levels in patients with PDR.

Role of TLR4/NF-κB pathway for early change of synovial membrane in knee osteoarthritis rats / 中国骨伤

OBJECTIVE@#To study role of TLR4/NF-κB pathway for early change of synovial membrane in knee osteoarthritis rats.@*METHODS@#Eighteen male SD rats weighted (200±20) g were randomly divided into 2 groups, namely control and model group, and 9 in each group. Knee OA model group was established by using modified Hulth method in model group. Control group was not treated. Synovial tissue and serum was extracted at 4 and 21 d after operation. Expression of CD14, TLR4, IL-1β, TNF-α, ADAMTS-4, MMP-13 were detected by real-time PCR respectively. NF-κB p65 protein was detected by Western-blot; serum concentrations of haluronic acid (HA), N-propeptide of type III procollagen(PIIINP) was detected by Elisa.@*RESULTS@#Expression of CD14, ADAMTS-4, and NF-κB p65 in model group were higher than that of control group at 4 and 21 days after operation, while expression of TLR4, IL-1β, TNF-α and MMP-13 were higher than that of control group at 21 days after operation(<0.01). Concentration of PIIINP and HA in model group were higher than that of control group at 4 days after operation, while there was no significant difference at 21 days after operation.@*CONCLUSIONS@#NF-κB pathway could mediate occurrence of KOA by early activating and triggeringg synovial increasingly secreting inflammatory secretion CD14, TLR4, IL-1β, TNF-α, ADAMTS-4, MMP-13, PIIINP and HA.

Case-control study on close reduction combined with minimally invasive percutaneous plate osteosynthesis for the treatment of distal fracture of tibial shaft / 中国骨伤

<p><b>OBJECTIVE</b>To compare the effects of close reduction combined with minimally invasive percutaneous plate osteosynthesis for distal fracture of tibial shaft.</p><p><b>METHODS</b>From March 2009 to May 2013, there were 124 patients (89 males and 35 females, 30 of them were injured in a traffic accident and 94 were falling down in daily life, the ages ranging from 21 to 81 years old) who suffered from distal fracture of tibial shaft. Sixty-six patients (48 males and 18 females, 45 cases of type A, 12 cases of type B and 9 cases of type C) were treated with close manipulative reduction combined with minimally invasive percutaneous plate fixation. After close reduction, a minimal incision was made and a anatomic plate was inserted just along the medial tibia periostea, and then the fracture was fixed without fracture exposure. The other 58 patients (41 males and 17 females, 41 cases of type A, 10 cases of type B and 7 cases of type C) were treated with conventional open reduction and internal fixation. Length of the incision, operating time, early postoperative pain (recorded using the Visual Analog Scale score) and the outcome results (recorded using the evaluation standard of Johner-Wruhs) were compared.</p><p><b>RESULTS</b>The length of incision was meanly (7.34 ± 1.42) cm in MIPPO group and (21.82 ± 2.35) cm in ORIF group; operation time was (44.48 ± 10.00) min in MIPPO group and (59.42 ± 11.84) min in ORIF group. The postoperative radiographs verified good position of all screws and satisfactory bone fracture reduction in both groups. All the patients were followed up, and the duration ranged from 10 to 24 months (mean 15.2 months) in both groups. In MIPPO group,only one patient had delayed union and got union after Chinese herb therapy. The other 65 patients got bony union during 15 to 20 weeks. While in ORIF group, 3 patients suffered from nonunion and received reoperation with bone grafting, and 4 patients got bone infection.</p><p><b>CONCLUSION</b>Treatment of distal fracture of tibial shaft, combined with close reduction and MIPPO technique, has the advantages such as less invasion, less damage of blood supply, simplified procedure of operation and higher union rate, which is an ideal methods and is accordant to the biological demand.</p>

Regulating effect of anodonta glucan HBP-A on chondrocytes through Wnt pathway / 中国骨伤

<p><b>OBJECTIVE</b>To investigate regulation function of anodonta glucan HBP-A on chondrocytes through Wnt pathway in vitro.</p><p><b>METHODS</b>Rat chondrocytes were cultured and differentiated induced with IL-1beta (10 ng/ml) in vitro. Chondrocytes were divided into five groups:IL-13 group,IL-1beta + IWP-2 (5 microM,Wnt pathway inhibitor) group, IL-1beta + HBP-A (0.3 mg/ml) group and IL-1beta + IWP-2 + HBP-A group. Wnt-3a, beta-catenin (24 h,48 h,72 h) and MMP-13(72 h) genes expression were detected by Rt-PCR, while beta-catenin, MMP-13, Sox-9 and coll-II (48 h) protein expression were measured by Western-blot.</p><p><b>RESULTS</b>After induction of IL-1beta, gene expression of Wnt-3a, beta-catenin and MMP-13 were increased,so were the protein expression of beta-catenin and MMP-13. In contrast,protein expression of Sox-9 and Coll-II were declined. Following addition of HBP-A, Wnt-3a, beta-catenin and MMP-13 were shown as induction of IL-1beta, but protein expression of Sox-9 and Coll-II were upgraded. Combining HBP-A with IWP-2 led to the lowest level in Wnt-3a, beta-catenin gene and beta-catenin protein expression and highest expression of Sox-9 protein.</p><p><b>CONCLUSION</b>HBP-A could not only delay the differentiation of chondrocytes through downgrading the signal expression of Wnt/beta-catenin,but also adjust the expression of Wnt-3a, beta-catenin and Sox-9 when combinated with the Wnt inhibitor.</p>

Application of biomarker CTX- II in osteoarthritis / 中国骨伤

Effective biomarkers for clinical usage of osteoarthritis are still limited. It was confirmed that C-terminal crosslinking telopeptide of type I collagen (CTX- II) was a specific marker reflecting degradation of articular cartilage. Detection of CTX- II could promptly reflect level of cartilage injury and degradation ,diagnose OA,predict its progress,monitor effects of drug treatment, thus, reflect the condition of osteoarthritis patient indirectly. Application of CTX- II focused mainly on in the early stage of OA and need together to detect with other biomarkers,in order to more accurately reflection of the pathological changes of OA,but the specific clinical significance of CTX- II results still need to improve further.

Study on the diagnostic value of whole-organ magnetic resonance imaging score (WORMS) in knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To explore the diagnostic value of whole-organ magnetic resonance imaging score (WORMS) in knee osteoarthritis (KOA).</p><p><b>METHODS</b>From November 2009 to January 2011,70 patients with KOA combined with knee effusion among outpatient and inpatient were analyzed retrospectively. Among the patients, 12 patients were male, 58 patients were female,ranging in age from 46 to 75 years,with a mean age of (59.66 +/- 9.93) years. The clinical symptoms were evaluated by WOMAC, the imaging of KOA was assessed by K-L score and WORMS, and COMP and CTX- II were measured respectively by ELISA. The correlation analyses and multiple linear regression analysis were studied to determine associations among biomarkers, clinical variables and radiographic findings of knee joints.</p><p><b>RESULTS</b>The average scores of WOMAC and WORMS were (57.50 +/- 8.20) and (64.54 +/- 16.45) respectively. The median of CTX- II nd COMP were 2.42 ng/ml and 4.56 ng/ml respectively. Grouped by less than the lowest quartile and more than the highest quartile of WORMS, COMP was significantly different (Z=2.04, P=0.039), but there was no significant difference in CTX-II (Z=0.79, P=0.427). WORMS were positively correlated with WOMAC and K-L score (r=0.777, P<0.01; r=0.716, P<0.01; respectively); WOMAC was also positively correlated with K-L score (r=0.692, P<0.01). WORMS's cartilage, osteophytes and synovitis were positively correlated with WOMAC, K-L score and COMP respectively (r=0.771, P<0.01; r=0.509, P<0.01; r=0.917, P<0.01). It was determined by stepwise regression that the KOA was mainly affected by WORMS, K-L score (P=0.015, P=0.025 respectively) when WOMAC as a dependent variable, age, gender, K-L score, WORMS, COMP and CTX- II as independent variables (F=20.327, P<0.01).</p><p><b>CONCLUSION</b>WORMS has a better reference value for diagnosis of KOA. The expression of COMP is high in the synovial fluid when WORMS at the high point. The clinical symptoms of knee osteoarthritis are mainly affected by WORMS and K-L score.</p>

The diagnostic value of color Doppler ultrasonography in breast infiltrating ductal carcinoma / 中国基层医药

Objective To explore the ultrasound images features of breast infiltrating ductal carcinoma. Methods Retrospective analysis of operation pathology ,55 patients diagnosed preoperatively infiltrating ductal carcinoma of color Doppler ultrasound diagnostic information. Results Before operation, 55 patients with breast tumors had color Doppler shows in 49 cases,no color doppler showed 6 cases,color Doppler shows with pathologic diagnosis is 89.1%. An infiltrating ductal carcinoma ultrasound image characteristics:the larger mass was irregular form,no coated, posterior acoustic attenuation,burr levy ,and crabs foot shape more inside,bump such change for not uniformity hypoechoic,with tiny clusters of calcified or irregular flare,shadow,blood flow distribution after silent for AlderⅡmore performance level Ⅲ,axillary lymph node enlargement,a different level hilus structure was clear,the peak systolic velocity in 12-80cm/s (average 35.1 cm/s ) , resistance index in 0.62-0.92 (average for 0.79 + 0.10). Conclusion Color doppler ultrasonography had important value in early diagnosis of infiltrating ductal carcinoma.

Minimally invasive surgery to treat severe acromioclavicular dislocation combined with coracoid process fracture / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the diagnosis and minimally invasive surgical treatment on severe acromioclavicular dislocation combined with coracoid process fracture.</p><p><b>METHODS</b>Using 2 incisions of shoulder to expose and fix coracoid process and acromioclaricular joint and to repair damaged acromioclavicular ligament in 7 cases from March 1998 to March 2009. There was 2 males and 5 females in the patients. The age was from 23 to 57 years with an average of 44 yeas. The time from injury to operation was 3-7 d with an average of 4 days. According to Eyres typing, 2 cases were type 11 B, 5 cases were type III B.</p><p><b>RESULTS</b>Seven patients were followed up from 6 months to 2 years with an average of 1 year. According to Karlsson criteria, 7 cases got grade A.</p><p><b>CONCLUSION</b>Using 2 incisions of shoulder to expose and fix acromioclaricular joint and coracoid process with strong pertinence, reliable fixation and small tissue injury, which is a minimally invasive and effective method for severe acromioclavicular dislocation combined with coracoid process fracture.</p>

Effects of intrathecal ouabain and tizanidine injection for treatment of neuropathic pain in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of intrathecal ouabain and tizanidine injection for treatment of neuropathic pain in rats.</p><p><b>METHODS</b>Male SD rats weighing 250-300 g were randomly divided into 5 groups (n = 6), namely the control group, ouabain group, tizanidine group, combined ouabain and tizanidine injection group, and the antagonist group. Intrathecal catheter was implanted 7 days before spinal nerve ligation to establish the neuropathic pain model. Mechanical withdrawal threshold (MWT) before and after intrathecal administration of the agents was recorded in the rats. Isobolographic analysis was performed to evaluate the interactions between the agents.</p><p><b>RESULTS</b>Intrathecal injection of ouabain (0.25-5 microg) or tizanidine (0.5-5 microg) alone produced dose-dependent analgesic effect against the neuropathic pain (P < 0.05). Isobolographic analysis revealed a synergistic interaction between ouabain and tizanidine. Intrathecal pretreatment with atropine (5 microg) or yohimbine (20 microg) antagonized the effects of ouabain and tizanidine administered alone or in combination (P < 0.05).</p><p><b>CONCLUSION</b>Intathecal injection of ouabain or tizanidine produces dose-dependent analgesic effects against neuropathic pain, and their synergistic effect after combined injection probably involves the cholinergic transmission and alpha2 receptor.</p>

Factors analysis and unstabe plaques of carotid atherosclerosis in ischemic cerebrovascular patients / 中国基层医药

Objective To explore the relative factors of unstable plaques of carotid atherosclerosis in ischemic eerebrovascular patients.Methods Carotid arteries of a total of 132 cases with ischemic cerebrovascular disease of carotid artery system were inspected by color Doppler ultrasound.The plaques discovered were classified according to ultrasonic appearance and their stability was judged.The relation between hypertension,diabetes,hyperlipemia, smoking and unstable plaques of carotid atheroselerosis was analyzed.Results The most common site of plaque for- mation was the bifurcate of the common carotid artery(56.99%),and the second commonest was carotid artery (23.12%).The incidence of unstable plaques in the patients with smoking,hypertension and diabetes was higher than those without them(P

Examination about stability of carotid atherosclerotic plaque by color ulrasound imagin and evaluation of treatment with medicine / 中国基层医药

Objective To explore the examination methods about stability of carotid atherosclerotic plaque and evaluate the curative effect of medicine on carotid atherosclerosis.Methods 150 patients with carotid atherosclerotic plaque in acute stage ischemic stroke were divided into treatment group and control group at random.Stable or instable plaques were assessed and carotid artery intima-media thickness(IMT) were measured according to the characteristics of carotid atherosclerotic plaque on supersound imagin.The treatment in treatment group were different from that in control group.The therapeutic efficacy was observed respectively.Results After the treatment 1 month and 3 months,in treatment group carotid artery IMT decreaced more than that at accidence of treatment group and that of control group,the carotid atherosclerotic plaques stabilizese increasingly.Conclusion The stability of carotid atherosclerotic plaque may be evaluated through the ultrasound imagin.Statin and aspirin can lighten carotid atherosclerosis and stabilize the plaque.

Observation curative effect of treating 36 uterine muscle tumor with the use of guizhifulin capsules and mifepristone / 中国基层医药

Objective To explore the therapeutic effect of treating uterine muscle tumor conservatively with the use of Guizhifulin capsules and mifepristone.Methods 36 outpatients suitable for conservative therapy after gynecological and B ultrasonic checking were studied.Each patient took orally 3 capusles of Guizhifulin each time,three times a day.Meanwhile each one took orally 12.5mg mifepristone once a day,three months as a course of treatment.The size of uterine muscle tumor and the variations of symptom were observed.Results 2 cases were totally recovered,11 cases had obvious effects,22 cases had some effects,the whole effective rate was 97%.Conclusion It is an ideal,safe,convenient,medicament therapy to treat uterine muscle tumor by using Guizhifulin capsules combined with mifepristone,which has apparent curative effects but little side effects or low tate of recurrence.

Occurrence and predictive factors of hepatitis B virus polymerase YMDD variation among patients with chronic hepatitis B and liver cirrhosis during lamivudine therapy / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the incidence and the predictive factors of HBV polymerase YMDD variation among patients with chronic hepatitis B and liver cirrhosis during lamivudine therapy.</p><p><b>METHODS</b>The clinical data and serial sera of 313 chronic HBV infected patients (249 chronic hepatitis B and 64 liver cirrhosis) treated with lamivudine were collected. YMDD variations were determined by mispairing PCR-RFLP assay. The data were analyzed using SPSS software.</p><p><b>RESULTS</b>The cumulative rates of variation among patients with chronic hepatitis B and liver cirrhosis were 8.84% and 17.19%, 20.91% and 32.40%, 26.92% and 39.56%, 26.92% and 58.79% after 12, 24, 36 and 48 months of lamivudine treatment, respectively. The results of log-rank test and Cox's proportional hazard model analysis indicated that lamivudine monotherapy, low ALT level, high HBV DNA level, and the patients with liver cirrhosis at baseline were significantly related to an occurrence of YMDD variation.</p><p><b>CONCLUSION</b>This study suggests that lower ALT and higher HBV DNA levels at baseline before lamivudine treatment, lamivudine monotherapy without combining alpha-interferon, and the patients with liver cirrhosis seem to be statistically significant for predicting the occurrence of YMDD variation.</p>