Objective:To explore the diagnostic value of serum procalcitonin (PCT) level combined with Quantitative Computed Tomography (QCT) in elderly women with painful osteoporosis and its correlation with disease severity.Method:This study is a prospective study. From Jan. 2019 to Apr. 2020, 596 elderly women who underwent physical examination in our hospital were selected as the research subjects. All of them underwent dual-energy X-ray, PCT examination, and QCT examination serum. The diagnostic value of PCT and QCT in elderly women with painful osteoporosis was analyzed; Pearson correlation was used to analyze the correlation between the bone mineral density of lumbar vertebral 1, 2 vertebra, PCT and the severity of painful osteoporosis.Result:Among 596 elderly women, painful osteoporosis patients accounted for 50.84% (303/596) , bone mass reduction accounted for 21.98% (131/596) , and normal bone mass accounted for 27.18% (162/596) . Compared with the results of the diagnosis of painful osteoporosis by DAX, the diagnostic coincidence rates of PCT, QCT, QCT+PCT were 81.88% (488/596) , 93.62% (558/596) , and 97.31% (580/596) . QCT examination, QCT+PCT diagnosis coincidence rate is higher than PCT examination ( χ2=43.650, 83.187, P<0.05) ; QCT+PCT diagnosis coincidence rate is higher than QCT examination ( χ2=9.388, P=0.002) . The sensitivity, specificity, positive predictive value, and negative predictive value of QCT+PCT in the diagnosis of abnormal bone mass are higher than those of PCT ( P<0.05) ; the specificity and negative predictive value of QCT+PCT in diagnosing abnormal bone mass are higher than QCT Check ( P<0.05) . The bone density detected by QCT in the osteopenia group and the painful osteoporosis group was lower than that in the normal bone mass group, and the serum PCT level was higher than that in the normal bone mass group, the difference was statistically significant ( P<0.05) ; the painful osteoporosis group was in QCT detection of bone. The density was lower than that of the osteopenia group, and the serum PCT level was higher than that of the osteopenia group, the difference was statistically significant ( P<0.05) . The severity of painful osteoporosis was negatively correlated with bone mineral density detected by QCT ( r=-0.54, P<0.05) , and positively correlated with serum PCT ( r=0.59, P<0.05) . Conclusion:QCT vertebral bone mineral density determination combined with serum PCT detection has high accuracy, sensitivity, and specificity in the diagnosis of painful osteoporosis, and is closely related to the severity of painful osteoporosis, and can be used for clinical evaluation of the condition of painful osteoporosis patients.

Objective To analyze the changes of distribution and drug resistance of isolated pathogens for ventilator-associated-pneumonia (VAP) in seven intensive care units from January 2013 to December 2015,so that provides information for clinical antibiotic treatment.Methods Collected the patient records diagnosed with VAP to get the distribution and drug resistance of isolated pathogens for VAP in ICU from January 2013 to December 2015.Compared the distribution of isolated pathogens for VAP among three year with Chi-square tests,and compared the drug resistance of main isolated pathogens with Nonparametric tests.Results 177 patients were diagnosed with VAP from January 2013 to December 2015.A total of 192 strains of pathogens were isolated from the VAP patients in ICU.Among which the gram-negative bacteria were dominant.It took up 90.6％.There was no significant statistical difference for the distribution of pathogens (x2 =2.372,P=0.668＞0.05).Analyzed the drug resistance rate and trends for the primary pathogens like Acinetobacter Bauman,Pseudomonas aeruginosa and Staphylococcus aureus,among which,the drug resistance of Acinetobacter Bauman from 2013 to 2015 made statistical difference.Conclusion The major pathogen isolated from VAP patients was gram-negative bacteria from January 2013 to December 2015,especially for Acinetobacter Bauman.Drug resistance of Acinetobacter Bauman was serious.Should administrated appropriate to treat the VAP infection resulted from Acinetobacter Bauman.

BACKGROUND:Mesenchymal stem cel s are multipotent progenitor cel s that can be isolated from the bone marrow, adipose tissue, umbilical cord blood and so on. Mesenchymal stem cel s possess strong immunosuppressive effects on both innate and adaptive immunity.
OBJECTIVE:To summarize the immunomodulatory properties of mesenchymal stem cel s for T lymphocytes, B lymphocytes, natural kil er cel s and dentritic cel s and prospect its therapeutic implication.
METHODS:PubMed and CNKI databases were searched for relevant literatures published from 2000 to 2015. The key words were“mesenchymal stem cel s, immunomodulator, T cel s, B cel s, NK cel s, dendriticc cel s”in Chinese and English, respectively. Then, 61 papers were included and further analyzed.
RESULTS AND CONCLUSION:The immunomodulatory effects of MSCs on lymphocytes, B lymphocytes, natural kil er cel s and dentritic cel s were elicited by cel-cel contact and soluble cytokines. But mesenchymal stem cel s from different sources hold different immunomodulatory effect on immune cel s. When we use mesenchymal stem cel s in clinic, some important factors, such as isolation methods, cel sources, colonization sites, should be taken into account. In order to ensure the clinical safety and effectiveness, there are stil many problems to be further studied before mesenchymal stem cel s can be widely used in clinic.

Objective To explore the instruction value of the color Doppler ultrasonography for the diagnosis and treatment of the pediatric intussusceptions .Methods Retrospective study the color Doppler ultrasonographic performance of 114 patients with diagnosis of pediatric intussusception in the affiliated hospital of Zunyi medical college ,from October 2009 to June 2012 ,reviewed the case ,groups were compared according to the ways of therapeutic methods .Results All the 114 cases of children of the intus-susception are subject to air enema reset or surgery cured confirmed .Age younger than 12 months intussusception children ,air ene-ma reset were more likely to success ;the diameter of concentric circles levy,the length of sleeve for and the thickness of bowel wall were smaller ,the more suitable for outsiders air enema reset .The blood supply of scabbard of bowel wall and the mesenteric was rich ,the air enema reset had a higher success rate ,blood supply was poor and the success rate was lower .The success rate of air enema reset was influenced by the part of intussusception .Conclusion Combined use of conventional color ultrasonic and high fre-quency probe checking ,can raise the diagnosis rate of pediatric intussusception ,the primary lesion confirmed and the detection rate in the position of the disease ,provide guidance for clinical choice reduction treatment .

Objective To explore the mechanism of protecting cells from hypoxia/ reoxygenation (H/R) injury by constructing specific small interference RNA (siRNA) to inhibit NALP3 expression in rat renal tubular epithelial cells (NRK-52E).Methods (1) To establish the H/R injury model of NRK-52E by regulating the pressure of N2 in incubator to hypoxia condition,the cells were cultured with hypoxia for 1 h and then with reoxygenation for 1 h,2 h,4 h,8 h,16 h and 24 h.The activity of lactae dehydrogenase (LDH) in the culture medium,cell count and cell viability,the expression of NALP3 were determined by biochemical method,trypan blue exclusion and Western blotting.(2) The siRNA was transfected into NRK-52E.The irrespective siRNA transfected group wasused as control.NALP3 expression was examined by Western blotting.(3) The cells were divided into 4 groups:control group,H/R group,irrespective siRNA transfected group and NALP3-siRNA transfected group.To establish the H/R injury model of NRK-52E by regulating the pressure of N2 in incubator to hypoxia condition,the cells were cultured with hypoxia for 1 h and then with reoxygenation for 4 h.And the expression of NALP3 was determined by Western blotting.(4)Cellular apoptosis was examined by Annexin V/PI staining and flow cytometry.NF-κB DNA binding activity,IκB-α,Bcl-2 and Bax expression were examined by EMSA and Western blotting.Results (1)Compared with the control group,the activity of LDH significantly increased,cell count and cell viability significantly decreased (all P＜0.05).The expression of NALP3 significantly increased and peaked at 4 h after H/R.(2)The specific siRNA could efficiently inhibit NALP3 expression in NRK-52E.Compared with the irrespective siRNA transfected group,the protein expression of NALP3 was significantly down-regulated in NALP3 siRNA transfected group (P＜0.05).(3)After hypoxia 1 h and reoxygenation 4 h,the activity of LDH and the expression of NALP3 increased.Compared with the irrespective siRNA transfected group,LDH concentration in media and the expression of NALP3 significantly decreased in NALP3-siRNA transfected group.(4)After hypoxia 1 h and reoxygenation 4 h,NF-κB DNA binding activity was increased,IκB-α phosphorylation and degradation,Bcl-2 and Bax were significantly up-regulated.However,compared with the irrespective siRNA transfected group,NF -κB DNA binding activity,IκB-α degradation and Bax/Bcl-2 were significantly decreased (P＜0.05) in NALP3-siRNA transfected group.At the same time,the ratio of apoptosis was significantly increased in three groups than that in control.Compared with the irrespective siRNA transfected group,the ratio of apoptosis in NALP3-siRNA transfected group was significantly decreased (P＜0.05).Conclusions H/R induces the expression of NALP3 in NRK-52E.The synthesized siRNA can inhibit the expression of NALP3 and protect NRK-52E from hypoxia/reoxygenation injury.The mechanism may be via inhibiting the activation of NF-κB,modulating expression of Bcl-2 and Bax,as well as decreasing cell apoptosis.

Objective To investigate the iodine nutrition level of vulnerable people in Inner Mongolia after adjustment of iodized salt standard and to provide theoretical bases for scientific iodine supplementation. Methods In 2013, 3 cities were selected from eastern, central and western parts of Inner Mongolia in accordance with the random number table, 3 or 4 counties were selected from each target city, 5 units according to their sub-area position of east, south, west, north and center were selected from each county, and then 1 township was selected from each unit, 5 groups of target population including school children aged 8- 10, women of childbearing age, pregnant and lactating women and infants each at least 10 people were investigated in each township. Edible salt samples from their homes and urine samples were collected. The direct titration method among the generic methods of iodide testing for salt production industry (GB/T 13025.7-2012) was used to determine the salt iodine level, and As3+-Ce4+catalytic spectrophotometry using ammonium per sulfate digestion (WS/T 107-2009) was used to test the urinary iodine level. Results Totally 3 300 samples of edible salt from local residents had been examined and median iodine was 26.20 mg/kg. The median of urinary iodine was 190.6μg/L of 1 289 school-age children;was 183.6μg/L of 621 women of childbearing age; was 178.2 μg/L o f 876 pregnant women; was 178.6 μg/L of 664 lactating women and was 167.7μg/L of 599 infants. Conclusion After adjustment of iodized salt standard, iodine nutrition level is suitable in all vulnerable people.

OBJECTIVE:To evaluate the effectiveness of Liuwei wuling tablets combined with entecavir in the treatment of chronic hepatitis B (CHB),and to provide evidence-based reference in clinic.METHODS:Retrieved from Cochrane library,PubMed,Web of Science,CJFD,Wanfang database and VIP,randomized controlled trials (RCTs) about Liuwei wuling tablets combined with entecavir (trial group) vs.entecavir alone (control group) in the treatment of CHB were collected.Meta-analysis was conducted by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane systematic evaluator manual 5.1.0.RESULTS:A total of 8 RCTs were included,involving 728 patients.Results of Meta-analysis showed that the levels of ALT [MD=-16.67,95 ％ CI (-19.83,-13.51),P＜ 0.001],AST [MD =-20.52,95％ CI (-25.65,-15.39),P＜0.001] and TBIL [MD=-5.85,95％CI(-11.31,-0.38),P=0.04] in trial group were significantly lower than control group;clinical total response rate [RR=1.23,95％CI(1.03,1.46),P=0.02] and HBeAg negative conversion rate [RR=1.26,95％CI(1.03,1.54),P=0.02] were significantly higher than control group,with statistical significance.There was no statistical significance in the rate of serum HBV DNA negative conversion [RR=1.22,95％ CI(0.99,1.52),P=0.07] between 2 groups.CONCLUSIONS:Compared with entecavir alone,Liuwei wuling tablets combined with entecavir in the treatment of CHB have better efficacy,can significantly improve the biochemical indexes of liver function in patients.

Objective To understand the iodine nutritional status of medical examination people and the thyroid dysfuction rates under different urinary iodine.Methods A total of 2 650 medical examination people from Inner Mongolia National Examination Medical Center from March to December of 2018 were selected.The average age was (46.2 ± 12.5) years old,including 697 males and 1 953 females.Blood samples were collected for determination of thyroid function [thyroid stimulating hormone (TSH),thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),free thyroxine (FT4),and free triiodothyronine (FT3)],and according to the results of the examination,people were divided into normal thyroid function,subclinical hypothyroidism,subclinical hyperthyroidism,hypothyroidism,hyperthyroidism,autoimmune antibody abnormalities,and other abnormal groups.Urine samples were collected to detect urinary iodine levels,to analyze the thyroid dysfuction rates of each group people and different urinary iodine.The thyroid function was detected by automatic electrochemiluminescence immunoassay analyzer,the urinary iodine was determined by arsenic cerium catalytic spectrophotometry.Results Among the 2 650 medical examination people,there were 1 270 patients with abnormal thyroid function,and the total abnormal rate was 47.92％.The abnormal rates of males and females were 28.84％ (201/697) and 54.74％ (1 069/1 953),respectively,and the abnormal rate of females was higher than that of males (x2 =376.19,P ＜ 0.05).The urinary iodine medians of each group were 145.38,152.60,103.21,176.31,134.17,138.92,and 127.00 μg/L,all in the appropriate range of iodine (100-199 μg/L).Thyroid abnormal rates [55.56％ (125/225),50.86％ (445/875)] of urinary iodine ≥ 300 μg/L (iodine excess) group and ＜ 100 μg/L (iodine deficiency) group were higher than that of 100-199 μg/L group [44.70％ (460/1 029),x2 =12.65,12.61,P ＜ 0.05].Among thyroid abnormal people,autoimmune antibody abnormalities people was the most,accounting for 69.61％ (884/1 270).Urinary iodine was positively correlated with FT4 and FT3 (r =0.04,0.05,P ＜ 0.05);FT4 was negatively correlated with TSH and TgAb (r =-0.20,-0.73,P ＜ 0.05),and it was positively correlated with FT3 (r =0.52,P ＜ 0.05);TPOAb was positively correlated with TgAb (r =0.64,P ＜ 0.05).Conclusions Urinary iodine of medical examination people is in the appropriate range of iodine,indicating that the overall iodine nutritional status is good.However,some people still have iodine excess and iodine deficiency,both of which lead to an increase in thyroid abnormal rate.

Objective To understand the current iodine nutritional status of pregnant women in Inner Mongolia, and provide scientific basis for iodine supplementation during pregnancy. Methods In 103 banners (counties, cities and districts) of Inner Mongolia Autonomous Region, 5 townships were randomly selected according to their sub-area positions of east, west, south, north and center in each banner (county, city and district) in 2018. Twenty pregnant women in each township were sampled to collect edible salt and a random urine samples. The iodine in salt was determined by direct titration. Urinary iodine was detected by As3+-Ce4+catalytic spectrophotometry. According to different pregnancy, maternal age and regional type, the iodine nutrition level of pregnant women was analyzed. Results Totally 9809 pregnant women were investigated, the median of salt iodine was 23.4 mg/kg, iodized salt coverage rate was 98.03％(9616/9809), qualified iodized salt consumption rate was 93.32％(9154/9809), and the median of urinary iodine was 167.20 μg/L. Between different pregnancy and different age groups, there were no significant differences in qualified iodized salt consumption rate (P > 0.05). But the difference between different regions was statistically significant(P<0.05). Between different age groups, there was no significant difference in the median of urinary iodine(P > 0.05). In both different pregnancy and different regions, there were statistically significant differences between groups (P < 0.05). Conclusions The current iodine nutrition level of pregnant women in Inner Mongolia is suitable to meet the physiological needs of themselves, and the fetus. But pregnant women in different regions have different levels of iodine nutrition.