BACKGROUND: Alendronate has been recently used for treating osteoporosis by inhibiting the activity of osteoclasts, but further clinical observation is necessary to compare its therapeutic effect with exclusive use of calcium supplement.OBJECTIVE: To observe the therapeutic effect of oral alendronate (tianke tablet) on the clinical symptoms and bone mineral density (BMD) of middle-aged and elderly patients for comparison with calcium gluconate.DESIGN: A self-controlled study and controlled trial with concurrent patients.SETTING: Department of Orthopedics, Shenzhen Hospital, Peking UniversityPARTICIPANTS: Sixty-eight middle-aged and elderly patients with osteoporosis were admitted in the Department of Orthopedics, Shenzhen Hospital of Peking University between July 1999 and July 2000. From these patients 62 at the age over 45 years without secondary osteoporosis were selected for this study, who were randomly divided into oral alendronate group (n=32) and oral calcium gluconate group (n=30).INTERVENTIONS: On the basis of comprehensive therapies, the patients in the alendronate group were given 10 mg alendronate daily and those in calcium gluconate group had 20 mL oral calcium gluconate solution (containing 100 mg calcium gluconate, equivalent to 9 mg calcium in every 10 mL) three times daily for three months. According to bodily pain relief, occurrence of new fracture and improvement in BMD, the therapeutic effect was assessed in three grades.RESULTS: Thirty patients in the alendronate group and 26 in the calcium gluconate group completed the study. Alendronate treatment for 3months significantly increased BMD of the patients [(0.716±0.082) g/cm2in comparison with that before treatment [(0.667±0.083) g/cm2, t= 2.473,P ＜ 0.01], whereas the BMD underwent no obvious changes after treatment with calcium gluconate [(0.671±0.081) g/cm2 before vs (0.680±0.073) g/cm2after treatment, t=1.812, P ＞ 0.05]. Significant difference in BMD after treatment was noted between the two groups (t=2.384, P ＜ 0.01). The effective rate was significantly higher in alendronate group than in calcium gluconate group (X2=14.9, P=0.005), but 7 patients complained of abdominal discomfort in the former group and the patients in calcium gluconate group reported no adverse effects.CONCLUSION: Alendronate can inhibit bone absorption, promote the recovery of bone matrix, and increase the bone mass, producing better effect than exclusive use of calcium gluconate oral solution in treatment of the osteoporosis in the middle-aged and the elderly.

Objective: To provide reference for on-site medical emergency preparedness and response to nuclear facilities of our country. Methods: On the basis of laws, regulations and standards as well as our experience and research in this field. Results: To provide effective advice for on-site medical emergency preparedness and response. Conclusion:Introduce unclear accident influence, unclear accident emergency system and so on.

Objective To investigate the role and prognostic impact of E-cadherin( E-cad)on in-vasion and metastasis of gastric carcinoma by analyzing E-cadherin expression at DNA,RNA and protein levels. Methods RNA and protein expression of E-cad were tested in 60 cases of gastric carcinoma and adjacent tissues by streptavidin peroxidase( SP )immunohistochemistry and in situ hybridization. DNA methylation of E-cad was tested with methylation-specific polymerase chain reaction( MSP). Results The positive rates of E-cadherin protein and mRNA in gastric carcinoma were significantly lower than those in adjacent tissues. DNA methylation of E-cad negatively correlated with the E-cad protein and RNA expres-sion in gastric carcinoma respectively(r= -0. 355,r = -0. 271). DNA methylation of E-cad negatively correlated with the 5-year survival rate of gastric carcinoma(r = -0. 381,P ﹤0. 01). However,E-cad protein positively correlated with the 5-year survival rate of gastric carcinoma(r=0. 378,P﹤0. 01). Con-clusion The decreased expression of E-cad is one of the most important biological features in gastric car-cinoma. Methylation of E-cad DNA may be an important agent causing low expression of E-cad protein and mRNA and it can be used as an important indicator in predicting invasion and metastasis of gastric cancer.

BACKGROUND:Diabetes mel itus can give rise to bone metabolic disorders in patients, resulting in the occurrence of osteoporosis and low traumatic fractures. However, the pathogenesis mechanism remains unclear. OBJECTIVE:To review the current research progress in the bone metabolic disorders resulting from diabetes mel itus, and to provide theoretical basis of the prevention and treatment of diabetic osteopathy. METHODS:A computer-based online search was conducted in Pubmed database (http://www.ncbi.nlm.nih.gov/pubmed/) from January 2000 to December 2013. Articles focusing on diabetes mel itus regulating bone metabolism were col ected using the key words of“diabetes mel itus;bone”in English. High-quality relevant studies were included, while repetitions and unidirectional studies were excluded.
RESULTS AND CONCLUSION:A total of 6 979 articles were obtained initial y, and after screening procedures 58 literatures were selectively included in this review. Although type 1 and type 2 diabetes mel itus exert different effects on the bone mineral density, they ultimately result in osteoporosis and low traumatic fractures. It is widely believed that the pathogenesis may be that high glucose breaks the balance between bone formation and bone absorption, so that bone absorption is greater than bone formation. The number of the osteoclasts is increased, while the cytokines of promoting osteogenesis are restrained. As a consequence, those result in low bone mineral density, brittle bone and high incidence of fracture.

0.05). The operation time, blood loss, ambulation time, early complication, medical diseases and restored function after operation, death rate within 1year after operation in prosthetic replacement group were superior over the internal fixation group (P

No abstract available.
Carpal Tunnel Syndrome* ; Humans ; Upper Extremity*

BACKGROUND: Desflurane is a new inhaled anesthetic with the lowest blood/gas partition coefficient and enflurane is one of the major anesthetics in these days. But the effect of volatile anesthetics and the site of action on the blood vessel are still controversial. Since Furchgott (1980) discovered endothelium derived relaxing factor (EDRF) from endothelium, many investigators have studied about the relationship between the EDRF and the effect of the volatile anesthetics on blood vessels. In this study, we evaluated that the effect and the action site of enflurane and desflurane on isolated aortic rings of the rabbit. METHODS: Each of obtained thoracic aorta from rabbits (1.5~2.5 kg) was divided into 4~6 mm rings, and a half of that were denuded. All of the aortic rings were preconstricted with phenylephrine 1.5 10-7 Mole in warm organ bath filled with modified Krebs' solution, and then LNAME (inhibitor of nitric oxide synthase, 3 10-4Mole) was administered to one group of aortic rings. MB (inhibitor of soluble guanylyl cyclase, 2 10-5Mole) was administered to another one group and neither of LNAME nor MB was administered to the other group. And then enflurane (1%, 2%, 3%, 4%) or desflurane (6%, 9%, 12%) was administered to all of aortic rings. The polygraph recorded the changes of tension of aortic ring which was transmitted through the force transducer. RESULTS: It was proved that basal EDRF was released from endothelium by the fact that intact aortic rings were more constricted after LNAME or MB administration. The intact aortic rings were constricted in all concentration of enflurane and both intact and denuded rings were maintained from control tension in all concentrations of desflurane. CONCLUSION: It is concluded that enflurane in all concentrations has an endothelium-mediated vasoconstriction effect and desflurane in all concentrations has no effect on isolated aortic rings of rabbit.
Anesthetics ; Aorta, Thoracic ; Arginine* ; Baths ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Enflurane* ; Guanylate Cyclase ; Humans ; Nitric Oxide Synthase ; Phenylephrine ; Rabbits ; Research Personnel ; Transducers ; Vasoconstriction

Objective To investigate the feasibility of the virtual source model in Monte Carlo dose calculation for clinical radiotherapy.Methods The Monte Carlo simulation was used to obtain the phase space files which recorded the physical properties of the particles emitted by a medical linear accelerator, and the information on the type, energy spectrum, and distribution of particles were extracted from these files and analyzed to establish the semi-empirical model of virtual two-photon source.The GMC dose calculation engine was used to obtain the 3 cm×3 cm, 5 cm×5 cm, 10 cm×10 cm, 20 cm×20 cm, and 30 cm×30 cm fields of radiotherapy and the results of Monte Carlo simulation of dose distribution in three-dimensional water phantom in 2 intensity-modulated radiotherapy ( IMRT) plans.These results were compared with the results of water phantom measurement or the results of Elekta Monaco planning system to verify the accuracy of Monte Carlo dose calculation based on a virtual source.Results As for the percentage depth-dose distribution curves of the central axis of the water phantom and the off-axis dose curves at different depths in the five fields for radiotherapy, the difference between the results of Monte Carlo simulation and the results of measurement was within 1%.As for the two IMRT plans, the three-dimensional passing rates of Monaco calculation results and Monte Carlo simulation results were 98.9%and 99.4%, respectively, for 3%/3 mm, and 95.1%and 95.4%, respectively, for 2%/2 mm.Conclusions Monte Carlo simulation based on the virtual source model can obtain accurate results of radiotherapy dose calculation.

BACKGROUND:Spine infection models are rarely reported in the literature. There are fewer reports on the imaging and histological observations of the animal model of spinal infection.
OBJECTIVE:To develop a canine model of pyogenic spinal infection.
METHODS:Twelve Chinese dogs were adopted in the study. The dogs were in the right arm recumbent. The surgery was conducted by retroperitoneal approach to expose T12/L1 intervertebral space. The intervertebral discs that exposed the intervertebral space were partial y removed, and the end plate of the adjacent two vertebrae was deliberately curetted out. Suspension with different concentrations of Staphylococcus aureus and sodium morrhuate were injected into the dog intervertebral space. The aim of removal of partial intervertebral discs and destruction of endplate was to make the vertebral body bone better in contact with the bacteria. The same operation was conducted in L5/6 clearance of the animal spine. At 14 days after surgery, animals were sacrificed. The infected intervertebral disc and adjacent vertebral bodies were taken out. Bacterial contents of specimens were quantitatively determined. During sacrificing, partial liver tissues and blood samples were col ected for bacterial culture. The occurrence of systemic infection was observed.
RESULTS AND CONCLUSION:(1) Spondylodiscitis of the lumbar spinal column was consistently produced in 90%(9/10) the sites chal enged with 102 colony-forming units (CFU) Staphylococcus aureus. Liver biopsy and blood culture did not show any signs of systematic infections. (2) Two out of four animals implanted the suspension with a concentration higher than 103 CFUs died within 3 days post-implantation. (3) These results suggested that a new canine model of pyogenic spinal infection was developed. This model could be used to test the efficacy of different anti-infection strategies.

Objective To investigate the efficacy of Ganju Bingmei Pill combined with voice therapy in the treatment of vocal nodules .Methods A total of 72 patients with vocal nodules and 60 health people in our hospital were included .Patients were randomly divided into two groups :Group A (36 cases) with Ganju Bingmei Pill thera‐py ,group B (36 cases) with Ganju Bingmei Pill combined with voice therapy .Taking method of Ganju Bingmei Pill was three times a day ,2 tablets every time ,two weeks as one course of treatment with a total of four courses .Voice therapy in Group B was two weeks for one course with a total of four courses .The results were evaluated by voice handicap index ,voice acoustic analysis and laryngostroboscopy .Vocal nodules disappear or significantly reduce indi‐cated that the treatment was effective .Statistical analysis was performed using t - test and chi - square test .Results In group A ,the scores of T ,F ,P ,E were reduced compared with before treatment (P < 0 .05) ,however ,com‐pared with normal control group ,the score of F ,E ,T were still higher than those of normal group (P < 0 .05) .In group B ,the score of T ,F ,P ,E were reduced compared with before treatment (P< 0 .05) ,and compared with normal control group ,the score of F ,P ,E ,T were close to normal(P> 0 .05) .The VHI score in group B were significantly lower than those of in group A (P < 0 .05) .In Group A compared with before treatment ,jitter ,shimmer ,NHR were lower ,F0 was higher(P < 0 .05) ,however ,compared with the group of normal control ,F0 ,jitter ,shimmer , NHR were still statistically significant (P < 0 .05) .In group B with before treatment jitter ,shimmer ,NHR were lower ,F0 was higher (P< 0 .05) ,and jitter ,shimmer were already close to normal(P> 0 .05) .The F0 of group B after treatment was higher than group A ,jitter and shimmer were lower than group A after treatment (P< 0 .05) . After treatment ,there were 28 cases of group A (77 .78% )of patients with vocal nodules disappear or significantly reduce .There were 35 cases of group B(97 .22% ) of patients with vocal nodules disappear or significantly reduce , the effective rate between group A and group B was statistically significant (P< 0 .05) .Conclusion Ganju Bingmei Pill therapy and Ganju Bingmei Pill therapy combined with voice therapy all have curative effect for the treatment of vocal nodules however ,Ganju Bingmei Pill therapy combined with voice therapy is more efficient .