Carbon metabolism characteristics of quorum quenching bacteria Rhodococcus sp. BH4 determine the bioaugmentation efficiency under different carbon source conditions.

Carbon sources are critical factors influencing bacterial bioaugmentation, however, the underlying mechanisms, particularly the metabolic characteristics of bioaugmented bacteria remain poorly understood. The bioaugmented bacterium Rhodococcus sp. BH4 secretes the quorum quenching (QQ) enzyme QsdA to disrupt the quorum sensing (QS) in the activated sludge (AS) process, reducing AS yield in-situ. This study investigated the carbon metabolic characteristics of BH4 and explored the effects on bioaugmentation with different influent carbon sources. Because of the absence of glucose-specific phosphoenol phosphotransferase system (PTS), BH4 prefers sodium acetate to glucose. However, the lactones produced during extracellular glucose metabolism enhance BH4 qsdA expression. Moreover, BH4 possess carbon catabolite repression (CCR), acetate inhibits glucose utilization. BH4 microbeads were added to reactors with different carbon sources (R1: sodium acetate; R2: glucose; R3: a mixture of sodium acetate and glucose) for in-situ AS yield reduction. During operation, AS reduction efficiency decreased in the following order: R1 > R3 > R2. R2 and R3 microbeads exhibited similar QQ activity to R1, with less BH4 biomass at 5 d. 13C labeling and Michaelis-Menten equation showed that, due to differences in the competitiveness of carbon sources, R1 BH4 obtained the most carbon, whereas R2 BH4 obtained the least carbon. Moreover, acetate inhibited glucose utilization of R3 BH4. Transcriptome analysis showed that R1 BH4 qsdA expression was the lowest, R2 BH4 was the most serious form of programmed cell death, and the R3 BH4 PTS pathway was inhibited. At 10 d, R1 BH4 biomass and microbead QQ activity were higher than that in R3, and the R2 BH4 lost viability and QQ activity. This study provides new insights into bioaugmentation from the perspectives of carbon source competitiveness, carbon metabolism pathways, and CCR.

Rapid start-up and advanced nutrient removal of simultaneous nitrification, endogenous denitrification and phosphorus removal aerobic granular sequence batch reactor for treating low C/N domestic wastewater.

The rapid start-up and advanced nutrient removal of simultaneous nitrification, endogenous denitrification, and phosphorus (P) removal aerobic granular sequence batch reactor (SNEDPR-AGSBR) is a challenge in the treatment of low carbon/nitrogen (C/N) domestic sewage. In this study, the feasibility of the SNEDPR-AGSBR process was examined in an exceedingly single-stage anaerobic/aerobic/anoxic sequencing batch reactor for treating low C/N ratio (3.3-5.0) domestic sewage. The initial results showed that accompanied by the rapid formation of the mature aerobic granular sludge based on the selection for slow-growing organisms, the rapid start-up (38 d) of the SNEDPR-AGSBR process was successfully realized. The formed mature aerobic granules had a dense structure with an average diameter of 667.7 µm and SVI30 of 30.0 mL/g. Two conditions for achieving the competitive balance between phosphorus-accumulating organisms/denitrifying phosphorus-accumulating organisms (PAOs/DPAOs) and glycogen accumulating organisms/denitrifying glycogen accumulating organisms (GAOs/DGAOs) were revealed by the long-term operation results. First, the dissolved oxygen (DO) concentration needed to be decreased to 3.0 mg/L in the aerobic phase, and then, the aerobic and anoxic phase hydraulic retention time (HRT) should be increased to 3.0 h. Notably, high removal efficiencies for NH4+-N (100%), total nitrogen (84.3%), and P (91.8%) of the SNEDPR-AGSBR process were stably obtained with a low C/N ratio of 3.9 domestic sewage. Simultaneous nitrification and endogenous denitrification (SNED) efficiency of 61.6% was achieved during a long-term operation of 142 days. Finally, microbial community analysis confirmed that GAOs (Defluviicoccus)/DGAOs (Candidatus_Competibacter) were responsible for the removal N, and PAOs (Acinetobacter, Candidatus_Accumulibacter, Hypomicrobinm)/DPAOs (Pseudomonas and Dechloromonas) ensured P removal.

Enhanced aerobic granulation for treating low-strength wastewater in an anaerobic-aerobic-anoxic sequencing batch reactor by selecting slow-growing organisms and adding carriers.

The aerobic granular sludge (AGS) process is a promising technology for wastewater treatment. However, a long start-up period for granulation and instability during long-term operation still hinder the application of AGS technology, especially for low-strength wastewater. To solve these two problems, this study tested a novel strategy involving the selection of slow-growing organisms and the addition of carriers in an anaerobic-aerobic-anoxic sequencing batch reactor (AN/O/AX_SBR). Three identical AN/O/AX_SBRs (R_Ctrl, R_CCM, and R_GAC), fed with low-strength wastewater, were operated for 120 days. R_Ctrl had no carriers, R_CCM contained cell culture microcarriers (CCM), and R_GAC contained granular activated carbon (GAC). Mature AGS was achieved within 80 days in all reactors. The carriers could reduce the maturation period of AGS by approximately 10 days (76, 66, and 69 days in R_Ctrl, R_CCM, and R_GAC, respectively) and improve the physical strength of the AGS. AGS showed a strong structure without excessive proliferation of filamentous bacteria, full-grown size (900-1100 µm), and good settleability (SVI5 was 15.4-19.4 mL/g). Microbiological analysis showed that AN/O/AX_SBRs can provide a metabolic selective pressure to select slow-growing organisms such as nitrifying bacteria (norank_f__NS9_marine_group, Ellin6067, and Nitrospira), glycogen and phosphorus accumulating organisms (GAOs: Candidatus_Competibacter and Defluviicoccus; PAOs: Candidatus_Accumulibacter and Flavobacterium). All reactors showed good performance for simultaneous nitrification, endogenous denitrification, and phosphorus removal. The removal efficiencies of total nitrogen and total phosphorous were above 70% and 80%, respectively. The cycle test showed intermediate PAO-GAO metabolism prevailed in the system, and endogenous denitrification was primarily carried out by denitrifying GAOs.

Upregulated lnc­HRK­2:1 prompts nucleus pulposus cell senescence in intervertebral disc degeneration.

Intervertebral disc (IVD) degeneration is a complicated physiological change involving cellular senescence, inflammation and the degradation of the extracellular matrix. Long non­coding RNAs (lncRNAs) have been identified as new players in IVD degeneration. The present study aimed to identify lncRNAs implicated in IVD degeneration via the regulation of cellular senescence. In the present study, nucleus pulposus (NP) cells isolated from moderately degenerated IVD tissues exhibited a senescent phenotype with increased senescence rates, detected by senescence­associated ß­galactosidase (SA­ß­gal) staining, and reduced growth and migratory abilities. Microarray and target prediction analyses identified 353 differentially expressed lncRNAs, and 251 cis­ and 2,170 trans­acting targets in degenerated NP cells. Bioinformatic analyses revealed that these predicted targets were enriched in the regulation of response to DNA damage stimulus, positive regulation of cell cycle processes and interferon­ß production. In addition, a network of the top 10 upregulated and top 10 downregulated lncRNA targets was constructed, and two trans­acting targets, C­C motif chemokine ligand 5 (CCL5) and polyribonucleotide nucleotidyltransferase 1 (PNPT1) involved in aging or senescence, and their corresponding lncRNAs, lnc­ST8SIA5­1:2 and lnc­HRK­2:1, were identified. Reverse transcription­quantitative PCR validation demonstrated that the two targets and two candidate lncRNAs were significantly upregulated in degenerated NP cells. Overexpression of lnc­HRK­2:1, with validated higher expression levels, in normal NP cells induced a senescent phenotype, with enhanced rates of senescence detected by SA­ß­gal staining in cells, decreased growth and migratory abilities and improved expression levels of CCL5 and PNPT1. Collectively, these results suggested that upregulation of lnc­HRK­2:1 prompted NP cell senescence in IVD degeneration, which may be associated with increased expression levels of CCL5 and PNPT1.

Optimization of nitrogen and carbon removal with simultaneous partial nitrification, anammox and denitrification in membrane bioreactor.

In this study, a membrane bioreactor (MBR) was used to achieve both nitrogen and carbon removal by a simultaneous partial nitrification, anammox and denitrification (SNAD) process. During the entire experiment, the intermittent aeration (non-aerobic time : aeration time, min min-1) cycle was controlled by a time-controlled switch, and the aeration rate was controlled by a gas flowmeter, and the optimal operating parameters as determined by response surface methodology (RSM) were a C/N value of 1.16, a DO value of 0.84 mg l-1 and an aerobic time (T ae) of 15.75 min. Under these conditions, the SNAD process achieved efficient and stable nitrogen and carbon removal; the total inorganic nitrogen removal efficiency and chemical oxygen demand removal efficiency were 92.31% and 95.67%, respectively. With the formation of granular sludge, the membrane fouling rate decreased significantly from 35.0 Pa h-1 at SNAD start-up to 19.9 Pa h-1 during stable operation. Fluorescence in situ hybrid analyses confirmed the structural characteristics and the relative ratio of aerobic ammonia-oxidizing bacteria, anaerobic ammonia-oxidizing bacteria and denitrifying bacteria in the SNAD system.

Turbidity in Combined Sewer Sewage: An Identification of Stormwater Detention Tanks.

Combined sewer overflow remains a major threat to surface water quality. A stormwater detention tank is an effective facility to control combined sewer overflow. In this study, a new method for the selective collection of combined sewer sewage during wet weather based on real-time turbidity control is established to reduce the load of pollutants entering a river using a stormwater detention tank with a limited volume. There was a good correlation found between turbidity and the concentrations of total suspended solids (TSS) (R2 = 0.864, p < 0.05), total phosphorus (TP) (R2 = 0.661, p < 0.01), and chemical oxygen demand (COD) (R2 = 0.619, p < 0.01). This study shows that turbidity can be used to indicate the concentration of TSS, TP, and COD in the sewage of the combined sewer systems in wet weather. Based on the adopted first flush detection approach, total nitrogen (TN) and TP showed the first flush effect, whereas the first flush effect of TSS and COD was not obvious. The results show that it is impossible to effectively control combined sewer overflow by only treating the initial rainwater.

Effect of organic matters on anammox coupled denitrification system: when nitrite was sufficient.

Anaerobic ammonia oxidation (anammox) and denitrification can work together to weaken the influence of organic matter on anaerobic ammonia oxidation bacteria (AAOB) and improve nitrogen removal performance. As the common substrate of anammox and denitrification, nitrite will also affect nitrogen removal performance when it is insufficient, which is not conducive to reflect the endurance of anammox reactor to organic matter. The UASB continuous flow experiment was carried out to investigate the effect of the concentration of glucose and sodium acetate on nitrogen removal performance of anammox reactor under the condition of sufficient nitrite. With glucose as the organic matter, when the chemical oxygen demand (COD) concentration increased to 200 mg l-1, nitrogen removal performance of the system began to deteriorate significantly, and the anammox activity was significantly inhibited. With sodium acetate as the organic substance, the anammox activity was affected when the COD was 20 mg l-1. Adequate nitrite could relieve the inhibition of the coupling system by a low concentration (COD < 200 mg l-1) of glucose organic matter. However, it could not relieve the inhibitory effect of sodium acetate. With the increase of organic concentration, the biological density of AAOB in granular sludge gradually decreased, while the biological density of denitrifying bacteria increased gradually.

[Partial Nitrification Fast Start-up and Stable Performance of 15℃ SBBR].

In this study, controlled C/N effects on fast start-up and stable performance of partial nitrification process at 15℃ in a Sequenced Batch Biofilm Reactor (SBBR) were investigated. The results showed that partial nitrification successfully fast initiated when C/N was 1.5 but failed when C/N was 0/3 during 60 cycles. Fluorescence in situ hybridization and confocal laser scanning microscope (FISH-CLSM) results showed that ammonia oxidizing bacteria (AOB) was found as the dominant bacteria population when C/N was 1.5. When C/N were 0/3, there were almost no existence of AOB and nitrite oxidative bacteria (NOB). Partial nitrification could be stably achieved without carbon source. However, the addition of an appropriate amount of carbon can effectively improve the nitrification performance, and it is better for the stable operation of partial nitrification. In this experiment, partial nitrification was successfully initiated at high dissolved oxygen (DO) (about 9 mg·L-1) conditions. The average DO was maintained at about 6.5 mg·L-1 during the stable operation, which successfully decoupled partial nitrification from low DO concentration. Excessive residual ammonium concentration in the reactors effectively repressed the growth of NOB and guaranteed the stable operation of partial nitrification. At 15℃, full nitritation was more suitable for sidestream wastewater, while mainstream wastewater was more suitable for partial nitritation.

Enhanced nitrogen removal of the simultaneous partial nitrification, anammox and denitrification (SNAD) biofilm reactor for treating mainstream wastewater under low dissolved oxygen (DO) concentration.

The simultaneous partial nitrification, anammox and denitrification (SNAD) process for treating mainstream wastewater was investigated under different intermittent aeration modes. By controlling the aeration time of 20, 60 and 180 min during the intermittent modes, the oxygen concentration remained 3.50, 1.45 and 0.70 mg·L-1. Correspondingly, the reactor achieved the nitrogen removal rate of 0.17, 0.29 and 0.30 kg N·m-3·d-1. Meanwhile, the average total inorganic nitrogen (TIN) removal efficiency reached 93.4%, 87.5% and 92.7%. The effluent NO3--N concentration was very low. High-throughput sequencing analysis indicated that the proportion of nitrite oxidization bacteria (NOB), anammox bacteria and denitrification bacteria was 0.15%, 0.33% and 8.78%. Candidatus Anammoxoglobus was the abundant anammox bacteria genus. Further study on the unclassified sequences revealed the possibility of the high relative abundance of Nitrosomonas-related genus and Candidatus Kuenenia-related genus on the SNAD biofilm.

[Achieving Partial Nitritation in a Continuous-flow Aerobic Granular Sludge Reactor at Different Temperatures Through Ratio Control].

Mature aerobic granular sludge (AGS) was inoculated in a continuous-flow reactor to treat low ammonia sewage, and the feasibility of achieving partial nitritation in a continuous-flow aerobic sludge system and the demand for R value (the ratio of dissolved oxygen and ammonia nitrogen) when partial nitritation is achieved at different temperatures (30, 20, and 10℃) were investigated. The control strategy was designed to maintain a constant ratio between dissolved oxygen (DO) and ammonia nitrogen (NH4+-N). The results revealed that stable nitritation in a continuous-flow aerobic sludge reactor could be achieved via ratio control, and the value of R were 0.50 (±0.05), 0.35 (±0.03), and 0.20 (±0.02) at the temperatures 30, 20, and 10℃, respectively, from which it can be concluded that stronger oxygen-limiting conditions were required when the temperature was lower. The experiment of fluorescence in situ hybridization (FISH) revealed that ammonia oxidizing bacteria (AOB) have a certain concentration, and the relative number of nitrite oxidizing bacteria (NOB) gradually reduced through the ratio control strategy. Based on the ratio control strategy and the characteristics of wastewater quality, full nitritation of high ammonia wastewater may be allowed; however, for low ammonia wastewater, only partial nitritation is recommended.

[Characteristics of Biofilm During the Transition Process of Complete Nitrification and Partial Nitrification].

The objective of the study was to investigate the change of biofilm characteristics when implementing the procedure of partial nitrification. A ratio control strategy (DO/NH4+-N) was taken to achieve partial nitrification, and biofilm samples were obtained at 10.27%, 52.12%, and 93.54% of the nitrite accumulation rate. The amount and spatial distribution of total bacteria, ammonia oxidizing bacteria (AOB), and nitrite oxidative bacteria (NOB) were observed by fluorescence in situ hybridization (FISH) and confocal laser scanning microscope (CLSM) through a three-dimensional excitation emission matrix (EEM) to observe the secretion and composition changes of extracellular polymer substances. Ratio control successfully enriched AOB and achieved partial nitrification under conditions when NOB was not completely washed. Heterotrophic bacteria and nitrifying bacteria coexist in the biofilm. The heterotrophic bacteria were in the outer layer, but nitrifying bacteria were distributed in the biofilm surface at 6-25 µm. During the process of short-range nitrification, the AOB/NOB value gradually increased, and the stable operation period was as high as 15.56. During the operation of the reactor, EPS and microbial flora changes are closely related. When microbial activity decreased, EPS secretion decreased. During the stable operation period of partial nitrification, NOB and other bacteria that are non-resistant to high nitrite nitrous acid declined, and the fluorescence intensity of aromatic protein-like bacteria decreased. However, the three-dimensional fluorescence spectra showed that the chemical composition of EPS was not obvious during the process of partial nitrification.

[Comparison of Start-up and Stable Performance of Nitritation in Activated Sludge and Biofilm Processes in a SBR].

This study investigates the effect of increased hydraulic retention time (HRT) and dissolved oxygen (DO) on the destruction and restoration of the performance of activated sludge and biofilm sequencing batch reactor (SBR) nitritation after the processes were simultaneously started up and stably operated at room temperature (25℃). The results showed that was easier to start nitritation in an activated sludge reactor, but nitritation was destroyed when DO was 2-2.5 mg·L-1. The performance could be restored by reducing DO to 0.5-1 mg·L-1. The biofilm process was not affected by DO. Prolonging HRT destroyed the stable operation of the two processes. Compared with the method of biofilm, the activated sludge method had less resistance, but restoring performance was better than for the biofilm process after shortening the HRT. Subsequently, the temperature (20, 15, and 10℃) was continuously reduced to investigate the synergistic effect of DO and temperature on nitritation stabilization. The results showed that the reduction of temperature destroyed the stable operation of nitritation, but the reduction of DO concentration could compensate for the adverse effects of temperature reduction. In addition, when the temperature was higher than 20℃, the rate of nitritation in the activated sludge process was better than that in thebiofilm method. At low temperature (below 15℃), a stable operation of nitritation was easier to achieve with the biofilm method. The capacity of the activated sludge process was hardly changed at 10℃. The above conclusions were confirmed by molecular microbiological analysis, and it was found that the stable operation of nitritation could be achieved without complete wash-out of the nitrite-oxidizing bacteria (NOB).

[Effect of Two-Stage Aeration on Nitrogen Removal Performance of Aerobic Granular Sludge].

Four mini experiments were conducted at different conditions. The heterotrophic microorganisms on the aerobic granular sludge surface consumed organic compounds at the initial stage of aeration. The denitrification rate and the efficiency of NO2--N and NO3--N removal were relatively low. Therefore, under the normal temperature conditions (20-23℃), aerobic granular sludge sequencing batch reactor (SBR) was operated in the two-stage aeration mode(first in low aeration then in high aeration mode). The low aeration time were carried out at 1, 2 and 3 hours stages respectively, and the characteristics of the granular sludge and its effects on microorganisms were analyzed by scanning electron microscopy (SEM) and fluorescence in situ hybridization (FISH) technique. The results show that the increase in the aerobic granular sludge (AGS) particle size improved the denitrification capacity; the denitrification rate of NO2--N was the highest at low aeration mode with 2 h and reached 9.66 mg·(g·h)-1. The accumulation rate of nitrite increased to 77.84% and the total nitrogen removal rate to 70%. The bacterial count inside the granular sludge increased and they were mainly cocci, bacillus, and ellipsoidal bacteria. Moreover, the proportion of ammonia-oxidizing bacteria in total bacterial count increased from 13.70% to 15.40%. Therefore, the two-stage aeration process achieved shortened simultaneous nitrification and denitrification processes and showed a good denitrification performance.

[Treatment of the recurrent lumbar disc herniation:a comparison between endoscopic surgery and open surgery].

OBJECTIVE: To compare the clinical effect,advantages and disadvantages of endoscopic surgery and open surgery in treating the recurrent lumbar disc herniation. METHODS: From August 2008 to December 2010,the data of 35 patients with recurrent lumbar disc herniation were retrospectively analyzed. The patients were divided into endoscopic surgery group and open surgery group according to operative methods. Fourteen patients in endoscopic surgery group were treated with transforaminal lumbar interbody fusion by micro-endoscopic discectomy (MED) and the other 21 patients in open surgery the group were treated with posterior lumbar interbody fusion by open surgery. All patients were fixed by vertebral pedicle screw. The operation time,volume of bleeding and drainage after operation,analgesic dosage and time in bed after operation were observed. Visual Analogue Scale(VAS),Japanese Orthopedic Association(JOA)and Chinese Oswestry Disability Index(CODI) were used to evaluate the clinical effects before and after operation. RESULTS: There was no significant difference in operation time between two groups(P>0.05). Volume of bleeding and drainage after operation,analgesic dosage and time in bed after operation,VAS score in endoscopic surgery group was less than that of open surgery group (P<0.01). All patients were followed up for 1 year. There was no significant difference in JOA between two groups (P>0.05). CODI in endoscopic surgery group was better than that of open surgery group (P<0.01). CONCLUSION: Both operative methods can obtain good clinical effects,but the transforaminal lumbar interbody fusion operation by micro-endoscopic discectomy (MED) has advantage of less traumatic and less pain,better functional recovery,it is a first choice in treating the recurrent lumbar disc herniation.

[Clinical control study on postmenopausal osteoporosis treated with embedding thread according to syndrome differentiation and medication].

OBJECTIVE: To study the therapeutic efficacy of embedding thread according to staging and wholism syndrome differentiation and its effect on correlated indices of patients with postmenopausal osteoporosis. METHODS: 135 patients with postmenopausal osteoporosis were randomly assigned to the control group A (treated with Calcichew D3 Tablet), the control group B (treated with Calcichew D3 Tablet and Xianling Gubao Capsule), and the treatment group (treated with Calcichew D5 Tablet and embedding thread according to staging and wholism syndrome differentiation). The visual analogue scale (VAS), Chinese medicine syndrome integral, and the quality of life scale before treatment, 3 months after treatment, and 6 months after treatment were assessed. Changes of the lumbar bone mineral density (BMD) and the serum level of estradiol (E2) were also assessed before and after six-month treatment. And the therapeutic efficacy of each group was also assessed after 6 months of treatment. RESULTS: Before treatment, there was no significant difference in scores of VAS, Chinese medicine syndrome integral and the quality of life scale, the.serum level of E2, and the lumbar BMD of the patients in three groups (all P>0.05). After three months of treatment, there was significant difference in scores of VAS, Chinese medicine syndrome integral and the quality of life scale of the patients in the three groups (all P<0.01). Of them, the improvement of the three indices in the control group A was the worst in three groups (P< 0.05, P<0.01). The VAS in the treatment group was superior to those in control group B (P<0.01). But the difference of Chinese medicine syndrome integral and the quality of life scale was insignificant in the three groups. After six months of treatment, significant difference was shown in the scores of VAS, Chinese medicine syndrome integral, or the quality of life scale of the patients in the three groups when compared with the corresponding index before treatment and after three months of treatment (all P<0.01). Of them the improvement of the three indices of patients in the treatment group and the control group B was better than that in the control group A (all P<0.01), and the improvement in the treatment group were superior to that in the control group B (P<0.05, P<0. 01). Significant difference was shown in the serum level of E2 and the lumbar BMD of the patients in the treatment group and the control group B when compared with before treatment of the same group (both P<0.01). But there was no difference in the control group A between before and after treatment, with better effects obtained in the treatment group and the control group B. And the serum level of E, of the patients in the treatment group after treatment was higher than that in the control group B (P<0.01), but there was no difference in the lumbar BMD. The therapeutic efficacy in the treatment group and the control group B were superior to that in the control group A (P<0.01, P<0.05), but no difference existed between the treatment group and the control group B. CONCLUSIONS: The therapy of embedding thread according to staging and wholism syndrome differentiation could reduce the scores of VAS and Chinese medicine syndrome integral, enhance the serum lever of E2, the quality of life scale and the lumbar BMD of patients with postmenopausal osteoporosis. So it was an effective method.

[Postmenopausal osteoporosis of liver and kidney deficiency type treated with acupoint catgut embedding by stages].

OBJECTIVE: To explore the better treatment of postmenopausal osteoporosis of liver and kidney deficiency type. METHODS: One hundred and five cases were randomly divided into an observation group, a control group A and a control group B equally. In control group A, Calcichew D3 tablets were taken with oral administration; in control group B, Calcichew D3 tablets and Xianling Gubao capsule were taken with oral administration. In observation group, Calcichew D3 tablets and acupoint catgut embedding were applied; Shenshu (BL 23), Ganshu (BL 18), Jiaji (EX-B 2) and Weizhong (BL 40) etc. were selected at acute stage; Shenshu (BL 23) and Ganshu (BL 18) etc. were selected at remission stage, once every half a month and 6 months treatment in all. The Visual Analogue Scale (VAS), bone mineral density(BMD), estradiol (E2) and clinical effects were compared among groups. RESULTS: After 3 and 6 months treatment, the scores of VAS were reduced among groups (all P < 0.01); the reduction in observation group and control group B was superior to that in control group A (all P < 0.001), and it was more obvious in observation group than that in control group B (both P < 0.001). After 6 months treatment, lumbar BMD and the serum level of Ez improved obviously in observation group and control group B (all P < 0.01). The comparison among groups after treatment showed that the BMD in observation group and control group B was superior o o that in control group A (P < 0.01, P < 0.05); the serum level of E2 in observation group was superior to that in control group B and control group A (both P < 0.001), and it in control group B was superior to that in control group A. The total effective rate was 91.4% (32/35) in observation group, superior to that in control group A (57.1%, 20/35); and the total effective rate was 82. 9% (29/35) in control group B, superior to that in control group A. CONCLUSION: Calcichew D3 tablets and acupoint catgut embedding therapy can relieve the pain caused by postmenopausal osteoporosis of liver and kidney deficiency, improve the bone mineral density and serum level of estradiol; in brief, it is the better method.

[Controlled clinical trials on the treatment and prevention of shoulder and back fasciitis using horizontal bar exercises].

OBJECTIVE: To explore an exercise method for the prevention and treatment of the patients with shoulder and back fasciitis. METHODS: From 2006.8 to 2008.3, 120 patients with shoulder and back fasciitis were randomly divided into control group (n = 60, including 21 females and 39 males, the average age was (47.0 +/- 12.0) years, and the average course of disease was (14.1 +/- 12.0) months) and treatment group (n = 60,including 19 females and 41 males, the average age was (43.7 +/- 9.9) years, and the average course of disease was (16.4 +/- 13.4) months). The patients in the control group received massage therapy and the ones in the treatment group were treated with massage therapy and horizontal bar exercise. After 3 weeks treatment, the curative effects of the patients in two groups were observed. All the patients were followed up for 6 to 26 months, the recurrence were observed. RESULTS: After 3 weeks treatment, the scores of pain, sense of heaviness, strip sign, tenderness, shoulder and back function of the patients in two groups had significant differences compared with those before treatment (all P < 0.01). After treatment, the scores of pain, sense of heaviness, strip sign, tenderness, shoulder and back function of the patients in the treatment group were lower than those in the control group (P < 0.05). After 6 to 26 months following-up, the rate of recurrence in the treatment group was lower than that in the control group (P < 0.01). CONCLUSION: Horizontal bar exercise is a simple, no expense and effective method in the prevention and treatment of shoulder and back fasciitis, which can improve the effect of the treatment and reduce the rate of recurrence.

[Case-control study on embracing knee and rolling lumbar training for preventing and treating degenerative osteoarthritis of lumbar spine].

OBJECTIVE: To study therapeutic effects of embracing knee and rolling lumbar (EKRL) training on the pain and the function of lumbar of patients with degenerative osteoarthritis of lumbar spine. METHODS: From 2006.8 to 2008.1, 150 patients with degenerative osteoarthritis of lumbar spine were randomly divided into the control group, EKRL training group and the combined group. In the control group (n=50), there were 16 females and 34 males, the average age was (58.8 +/- 10.2) years and the average course of diseases was (16.3 +/- 14.9) months. In the EKRL training group (n=50), there were 13 females and 37 males, the average age was (60.1 +/- 8.2) years and the average course of disease was (17.1 +/- 15.3) months. In the combined group (n=50), there were 15 females and 35 males, the average ages was (59.9 +/- 11.4) years and the average course of diseases was (19.8 +/- 17.2) months. The patients in three groups were treated with Meloxicam tablets, EKRL training and two above methods combination respectively. After 3 weeks treatment, the curative effect, the visual analogous scores and the ODI indexes were observed. All the patients were followed up and the duration ranged from 6 to 24 months; the changes of average ODI indexes were observed monthly. RESULTS: After 3 weeks treatment, the therapeutic effects in three groups had obvious difference after Ridit analyses: there were significant differences between the combined group and other two groups (P<0.01), but no obvious differences existed in other two groups. Compared with before treatment, the visual analogue scale scores and the ODI indexes in three groups reduced significantly (P<0.01). After treatment, the visual analogue scale scores and the ODI indexes of the combined group had significant differences compared with those of other two groups (P<0.01), but the ODI indexes of other two groups had no obvious differences. After 6 to 24 months following-up, the monthly changes of average ODI indexes of EKRL training and combined groups had obvious differences compared with that of the control group (P<0.01). CONCLUSION: EKRL training is a simple, no expense and effective methods for preventing and treating degenerative osteoarthritis of lumbar spine.