Osteoporosis-related fractures are increasing at a rapid rate, especially in Asia due to the ageing population. This would result in increased morbidity and mortality of the seniors as well as creating a strain on the healthcare system. Efforts should be made to prevent osteoporosis, screen for osteoporosis early and timely treatment to reduce the risk of fractures. As falls are a major risk factor for fracture in osteoporotic patients, management of osteoporosis should include efforts to reduce falls. Using a population-wide strategy for women 65 years old couple with high-risk population screening using a combination of tools such as FRAX® and OSTA as well as clinical risk factors for women below 65 years old can detect osteoporosis early for intervention. Treatment options for osteoporosis include bisphosphonates, denosumab, teriparatide, raloxifene, menopausal hormone therapy and tibolone. Drug choices should be individualised to the patient, balancing the risk/benefit ratio.

Objective To discuss the relevance between vitreopapillary traction (VPT) and anterior ischemic optic neu?ropathy (AION). Methods Two patients suffering from AION were underwent routine ophthalmic examination, and visual field (VF), fundus fluorescence angiography (FFA) and optical coherence tomography (OCT) examination. The images were analyzed. Results VPT syndrome was observed by OCT in both cases. In addition, the affected parts of VPT were consis?tent to that of AION. Conclusion Vitreopapillary traction is a possible reason of anterior ischemic optic neuropathy.

Objective To evaluate the effect of rapamycin on proliferation and cell cycle of human bladder cancer cell line 5637. Methods Total?ly 5637 cells were maintained in RPMI 1640 containing 10%fetal bovine serum,100 U/mL penicillin and 100μg/mL streptomycin for adherent cul?ture. Cells were grown at 37℃in a 5%CO2 incubator. The 5637 cells were treated with various concentrations of rapamycin solution(50 nmol/L, 100 nmol/L,200 nmol/L,and 400 nmol/L). The control group was daily treated with single RPMI 1640 without medication. The growth repression rate for 5637 cells was evaluated by MTT. Flow cytometry was used to investigate the effect of rapamycin of different concentrations on cell cycle of 5637 cells. Results Compared to the control group,rapamycin can inhibit the proliferation of 5637 cells in a concentration and time dependent manner. Rapamycin inhibited 5637 cells at G0/G1 thus inhibiting cell proliferation but not inducing apoptosis. Conclusion Rapamycin inhibited growth of 5637 bladder carcinoma cells and arrested cell cycle at G0/G1,indicating that mammalian target of rapamycin may play an important role in proliferation of 5637 cells and act as a new tumor therapeutic target in patients with bladder cancer.

Objective To observe the action of penehyclidine hydrochloride on the treatment for septic shock. Methods Total 40 admitted patients for septic shock,were randomly divided into four groups,Group A:654-2 30 mg, Q 30 min;Group B:penehvclidine hydrochloride 2 mg,Q 1 h;Group C:penehyclidine hydrochloride 2 mg,Q 6 h; Group D:penehyclidine hydrochloride 6 mg,Q 6 h,The medication dosage was not abated until twig were improved.The heart rate (HR),mean arterial pressure (MAP),diameter of the pupil,the time and duration of the twig improvement, saturation of pulse oxygen (SpO_2),consciousness,intestinal sound and the level of lactolose in blood were observed. Results penehyclidine hydrochloride could improve the microcirculation in patients with septic shock.The administration time was few.It didn't make the heart rate increase and inhibit the intestinal motion.Conclusion Penehyclidine hydrochloride would be one of the ideal vasoactive drugs in treatment for septic shock.

Combining the structural features of picotamide and linotroban, a series of N,N'-bis-(halogenophenyl)-4-methoxybenzene-1, 3-disulfonamides were designed and synthesized on the basic principles of drug design. The structures of target compounds were confirmed by IR, 1H NMR and HR-MS, and the in vitro antiplatelet aggregation activity was evaluated by Born turbidimetric method with adenosine diphosphate (ADP) as the platelet aggregation inducers. The assay results showed that twelve compounds (4b, 4f, 4l, 5b, 5d-5g, 5j, 5k, 5m and 5n) were found to have superior anti-platelet aggregation activities than the positive drug picotamide. The preliminary structure-activity relationship (SAR) has been explored.
Adenosine Diphosphate ; Drug Design ; Phthalic Acids ; Platelet Aggregation ; Platelet Aggregation Inhibitors ; chemical synthesis ; chemistry ; Structure-Activity Relationship ; Sulfonamides ; chemical synthesis ; chemistry

Objective To express and purify recombinant protease with thrombolysis activity of Perinereis aibuhitensis Grube and study on its characterization.Methods pMAL-PPA was in- troduced into E.coli DH5?to construct engineering bacteria and overexpression of the prote- ase of fused with maltose binding protein(MBP-PPA)was achieved with IPTG induction. The fusion protein was purified by affinity chromatography on amylose-resin column fol- lowed by chromatography on a DEAE-sepharose FF column.PPA cut with Factor Xa was assayed using casein plates supplied with plasminogen.Results Engineering bacteria express- ing maltose binding protein-thrombolytic protease of P.aibuhitensis were constructed and overexpression of MBP-PPA was achieved with IPTG induction.A recombinant fusion pro- tein of 51kD was purified,and PPA cut down from the fusion protein had a plasminogen-acti- rating activity.The protease showed a good thermal stability with an optimal pH of 8.0. This enzyme was also relatively stable in a pH range of 6.0～9.0 and still active after stored in organic solvents for 20d.Conclusion PPA was verified as a plasminogen activator,and might be a new thrombolytic medicine in the future.

Objective To investigate the correlation between retinal deformation degree and retina thickness (RT) detected by optic coherent tomography (OTC) in patients with idiopathic macular epiretinal membrane (IMEM). Methods The 66 eyes (56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study. After best corrected visual acuity (BCVA), ocular fundus and OCT examination, patients were divided into three groups (mild, medium and severe) according to retinal deformation degrees. The RT value was measured manually. Results There were significant differences in RT values between mild, moderate and severe groups:(311.95 ±51.78) μm, (447.13±41.95) μm and (560.00± 58.23) μm (P<0.05). The values of BCVA were 0.78±0.16, 0.38±0.12 and 0.27±0.14 for mild, moderate and severe groups, there were significant differences between them (P<0.05). There was no significant correlation between RT and BCVA in mild group (r=-0.352,P=0.128). There was negative correlation between RT and BCVA in medium group and serious group (r=-0.768 and-0.482,P<0.05). Conclusion The retinal deformation degree and RT are two objective indicators to assess visual performance in patients of IMEM. When RT is more than 400 μm, it can be used as objective criteria for surgical intervention.

Objective: To observe the effects of manganese( Ⅲ ) meso-tetrakis (N, N'-diethylimidazolium-2-yl) porphyrin (MnTDM) in treatment of early Parkinson's disease(PD) mouse model induced by subcutaneous injection of 1-methyl-4-phenyl1, 2, 3, 6-tetrahydropyridine(MPTP) and to discuss its possible mechanism. Methods:Forty male C57BL/6 mice were evenly randomized into 4 groups: MPTP model group(subcutaneous injection of 25 mg/kg MPTP for 3 days), MnTDM+ MPTP group (15 mg/kg MnTDM was subcutaneously injected 1 h before MPTP injection), MnTDM control group, and normal saline group. Performance of animals in the pole and swimming test was observed 3 days after the last injection. Levels of dopamine (DA) and its metabolites(3,4-dihydroxyphenylacetic acid [DOPAC] and homovanillic acid [HVA]) in the striatum of animals were measured by high-performance liquid chromatography with an electrochemical detector(HPLC-ECD). Thiobarbituric acid (TBA) method was used to examine the levels of malondialdehyde(MDA). Results: Acute injection of MPTP could be used for establishment of PD model. The striatal levels of DA, DOPAC and HVA in MPTP group were significantly lower(P＜0.01)and the striatal level of MDA was significantly higher(P＜0.05) than those of the control group. MPTP had no obvious effect on the behavioral performance of the animals in a short term. MnTDM could partly inhibit the above effects of MPTP. Compared with MPTP group, MnTDM+ MPTP group had significantly higher DA, DOPAC, and HVA levels and significantly lower MDA level(all P＜0.05). There was no significant difference in the behavioral indices of animals between the 4 groups. Conclusion:MnTDM can inhibit lipid peroxidation and promote DA production; it has preventive and therapeutic effects on MPTP induced PD.

With an ageing population, the incidence of osteoporoticfractures leading to deaths and impairment in quality oflife. However, despite the availability of effectivetreatments, osteoporosis is often under-diagnosed andunder-treated. Primary fracture prevention meansdetection of osteoporosis early with timely appropriatetreatment to improve the bone and lifestyle andenvironment optimisation to reduce falls. We propose apopulation-based combined with high-risk prescreeningfor measurement of bone mineral density (BMD) toreduce the incidence of fractures in the population.

Aims:This study aim to gain insights into attitudes,acceptance and knowledge levels among family physicians toward homosexual people,which are important as they may affect care among this at-risk group.Methods:An anonymized self-administered questionnaire in English was posted with the assistance of the College of Family Physicians Singapore in February 2015 to its 1529 members with self-addressed,pre-stamped envelopes for replies.The questionnaire included demographic questions such as age group,gender,religion,ethnicity,marital status and place of practice.Questions and scales that measured attitude,acceptance,knowledge and perception of colleagues who are homosexual were also included in the questionnaire.Results:451 responses (29.5％) were obtained,of which 441 were valid (28.84％).About 52.8％ of participants were found to have negative,8.9％ neutral and 38.3％ positive attitudes toward homosexuality.Most (75.6％)were accepting of homosexuals,with 9.3％ neutral and 15.1％ not accepting.Knowledge levels were poor,with a mean score of 6.9 out of a maximum of 13.A strong correlation was found between the attitudes towards lesbians and gay men (ATLG) and acceptance of homosexuals scales (r =0.69,P ＜ 0.001),with moderate correlations between acceptance and knowledge (r =0.54,P ＜ 0.001) and ATLG and Knowledge (r =0.54,P ＜ 0.001).Conclusion:Despite majority of family physicians having negative attitudes towards homosexuality,most are able to accept homosexuality.With better education in sexual orientation in the medical educational curriculum,the increase in knowledge will lead to better care for people with homosexuality.