AIM:Although there are many evidences showing positive effects of dehydroepiandrosterone sulfate(DHEA-S) in bone metabolism,the reasonable and thorough experiments are still needed to clear the mechanism of DHEA-S on bone metabolism by excluding the biological effect of its derivative hormone.This experiment is to study the efficacy and safety of DHEA-S in treatment of osteoporosis in elderly males.METHODS:①From October 2005 to October 2006,120 out-and in-patients with primary osteoporosis who were admitted in Shanghai 6th People's Hospital were selected.The diagnosis of primary osteoporosis referred to the new standard from WHO:without the application of sexual hormone,and over 2.5 standard deviation value of bone mineral density lower than the peak value of the same gender subject.All the cases were randomly divided into treatment group and control group(60 cases in every group).② DHEA-S 100 mg and Caltrate-D 600 mg were orally given to the treatment group;Caltrate-D 600 mg was orally given to the control group.③After 6 months,the bone density,serum biochemical markers,markers of bone resorption and formation as well as side effects were measured.RESULTS:120 osteoporosis patients entered into analysis.①Compared to the pretreatment and control group,the bone mineral density in lumbar spine 1,lumbar spine 2-4,femoral neck,and upper part of femoral bone were increased significantly in the treatment group(P 0.05).CONCLUSION:Treatment of osteoporosis in elderly males with DHEA-S is safe and effective without obvious side effects.

Objective To evaluate the role of different kinds of body positon in the stomach CT scanning.Methods It included 30 normal adults who underwent CT scanning in four differnent kinds of body positions.The relationship between the body position and the image appearence in the each part of stomach has been analysed.Results The results showed that the adjusting of body position was useul in revealing gastric wall and perigastric organs.The best imaging result of fundus ventriculi part of stomach can be obtained with the head down and the feet high position while patients lie on his back.The best body position to reveal corpus ventriculi part is in prone position and the best body position to reveal pars pylorica part is in right lateral position.There is a very significant difference between supine position and the best revealing position of each part of stomach prespectively(?

Objective:To evaluate the role of using the double body position CT(DBP-CT)in the staging of advanced gastric cancer.Methods:We performed CT examination in 85 patients with advanced gastric cancer which were divided into the double postion group(55 cases)and the single position group(30 cases),after oral intake water agent.The preoperative CT findings of each group was compared with surgical findings respectively and the accuracy in the CT staging of advanced gastric cancer of each group was estimated.Results:The accuracy in the preoperative CT staging of double position group was 89.09%,and in single postition group was 60%.There was a significant difference(P＜0.05).Conclusion:Our findings show that the DBP-CT is surperior to the single position group in finding lesion,confineing the range of the tumour,and determing the degree of adjacent invasion.It can improve the diagnostic accuracy in the preoperative staging of advanced gastric cancers significantly.

Objective To investigate the changes of serum ferritin and homocysteine of diabetic patients,to explore its correlation with diabetic gastroparesis.Methods Pure 50 patients with diabetes,50 patients with diabetic gastroparesis,and 50 cases of normal control group were chosen.The serum ferritin levels were measured with chemiluminescence method,the serum homocysteine levels were measured with enzyme linked immunosorbent assay (ELISA) method.The changes of serum ferritin and serum homocysteine in each groups were observed.Its relationship with diabetic gastroparesis was studied.Results For all diabetic patients,the serum ferritin and homocysteine levels were significantly higher than those in normal control group (P ＜ 0.01).Patients with diabetic gastroparesis was higher than those of pure diabetes (P ＜ 0.01).Serum ferritin levels was positively correlated with glycosylated hemoglobin and homocysteine (r =0.62,0.78,P ＜ 0.01).Multi-factor analysis showed that serum ferritin,and homocysteine level was positively associated with diabetic gastroparesis (P ＜ 0.05).Conclusions The increases of serum ferritin and homocysteine levels were closely related to the occurrence and development of diabetic gastroparesis.They can be used as one of parameters of diabetic gastroparesis,and provide theoretical basis for clinical intervention therapy.

BACKGROUND: Dehydroepiandrosterone (DHEA) derived from adrenal cortex has an indirect bioeffect through differentiating into androgen or estrogen in the related peripheral tissues. OBJECTIVE: To verify the effects and mechanisms of DHEA on promoting osteoblasts (OBs) proliferation. DESIGN, TIME AND SETTING: The grouping controlled experiment was accomplished in Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University and Institute of Radiation Medicine, Fudan University from January 2006 to February 2007. MATERIALS: Ten SD rats were recruited, 1 day old, regardless of gender. DHEA was the product of American Sigma Company. METHODS: Rat OBs were separated and cultured in vitro. First generation of OBs cultured in a varied concentrations of DHEA (1?10-5, 1?10-7 and 1?10-9 mmol/L) for 72 hours were set up as the experiment group, while those exposed to 1?10-8 mmol/L of estradiol culture were regarded as positive controls and blank control group was set up as well. MAIN OUTCOME MEASURES: The OBs were identified by cell morphology and alkaline phosphatase (ALP) dyeing. Light microscope and methyl thiazolyl tetrazolium assay were used to detect the growth and proliferation of OBs. The formation of mineralized nodus was examined by alizarin bordeaux stain. The concentrations of osteoprotegerin in DHEA culture solution were also measured by double antibody sandwich ABC-ELISA simultaneously. RESULTS: ①Identification of primarily cultured OBs showed ALP dyeing was positive.②Proliferation rate of OBs was increased in experiment groups compared with that of the blank control group, and the most significant increase occurred in the concentration of 1?10-7 mmol/L DHEA culture (P 0.05).③ALP activity in experiment groups was higher, especially in the group with the concentration of 1?10-7 mmol/L DHEA (P 0.05).④ALP activity of unitary cell population was higher in 1?10-9 mmol/L DHEA culture group than that in blank control group (P

Objective To evaluate the relationship between serum levels of leptin, endothelin and diabetic retinopathy in type 2 diabetes patients. Methods Leptin, endothelia, FBG, PBG, HBA1C, CHOL, TG and other clinical characteristics were tested in 80 type2 diabetes patients and 30 control case. All diabetes patients were divided into three group: non-diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy(PDR) according to the examination results of fundus. Correlations between levels of serum leptin and other parameters were analyzed. Results Plasma level of leptin in the type 2 diabetes with PDR group[(17.41±5.81)μg/L] were higher than that in control, NPDR and NDR group (P＜0.01). Plasma level of ET in the type 2 diabetes with PDR group[(80.68±13.57)mg/L] were higher than that in control, NPDR and NDR group (P＜0.01). The serum leptin levels were positively correlated with BMI(r＝0.468,P＜0.01). Conclusions Serum leptin and endothelin levels were elevated in patient with diabetic retinopathy as diabetic retinopathy aggravated and serum level of leptin and endothelin raised.

Objective To study the changes of endothelin,nitric oxide and vascular endothelial growth factor level in patients with type 2 diabetic retinopathy (DR). Methods Eighty diabetes patients (53 with diabetic retinopathy and 27 without). Another 30 healthy volunteers were recruited as control. Plasma ET and VEGF levels were measured by enzyme-linked immunosorbent assay. NO levels were measured by nitrate reductase method. Results Plasma levels of ET were higher in patients with type 2 diabetes with DR (DR)(80. 68 ± 13.57) mg/L than (65. 33 ± 11.24) mg/L, (45.25 ±9. 06) mg/L, in control and in type 2 diabetes patients without DR (NDR) (Ps ＜ 0, 01 ). Plasna levels of NO in DR group (69. 82 ± 14. 89) μmol/L were higher than (37. 85 ±-9. 11 ) μmol'L, in control group,but lower than (77.52 ±± 18.56) μmol/L in NDR group (Ps ＜ 0. 05 ). Plasma levels of VEGF ( 110. 52 ± 25.65 ) μg/L in DR were significantly increased compared with control (82.42 ± 18. 47 ) μg/L, and NDR(97.55 ±25.61)μg/L, (Ps ＜0.05).Conclusion ET, NO and VEGF may be involved in the pathogenesis of type 2 diabetic retinopathy.

Objective To investigate the relationship among health literacy and treatment compliance and prognosis in patients with diabetes combined tuberculosis.Methods One hundred and eighty-one cases patients with diabetes combined tuberculosis were selected as the objectives and evaluated literacy level,compliance scale by the health literacy scale and compliance questionnaires.The control of tuberculosis,blood glucose control,treatment compliance and prognosis were analyzed in the patients with different health literacy level.Results Of 181 patients,there were 89 cases patients'(basic health literacy group) the total scores of health literacy and compliance were＞80 points,the efficacy of pulmonary tuberculosis control and blood sugar control were respectively 84.2％ (75/89) and 93.2％ (83/89);92 cases patients' the total scores of health literacy and compliance were ≤ 80 points,the efficacy of pulmonary tuberculosis control and blood sugar control were respectively 59.7％ (55/92) and 67.4％ (62/92),the differences were significant (x2 =12.78,18.11;P ＜0.05).Pearson correlation analysis showed that the total scores of health literacy were positive correlated with the scores of treatment compliance (r =0.688,P ＜ 0.001).Logistic regression analysis showed that three dimension of health literacy (health knowledge and concept,healthy lifestyle and behavior,health skills) that can combined predict the variance of rehabilitation compliance(P＜0.01).Conclusion The health literacy level of diabetes combined tuberculosis patients can effectively predict the rehabilitation compliance.Measures should be taken to improve the patient's level of health literacy,so as improve the compliance of rehabilitation and prognosis.

Objective The study aimed to explore the relationship between organizational commit ment,leader-member exchange and nurses' organizational citizenship behavior based on an empirical study.Methods A total of 264 nurses recruited from four general hospitals were investigated with the Organizational Commitment Scale,Leader-Member Exchange Scale,and Organizational Citizenship Behavior Scale.Results Affective organizational commitment and leader-member exchange correlated with every factor of organizational citizenship behavior.Both affective organizational commitment and leader-member exchange predicted the variance of identification with organization 0.29,altruism toward colleagues 0.06,interpersonal harmony 0.09,protecting organizational resources 0.12,and conscientiousness 0.28.Conclusions Affective organizational commitment and leader-member exchange had a positive influence on nurses' organizational citizenship behavior,thus,hospital managers should strengthen nurses' affective organizational commitment and leader-member exchange to promote their organizational citizenship behaviors.

Objective:To evaluate the prophylactic application of antibiotics in oral and maxillofacial surgery and to provide a scientific basis for its reasonable use .Methods: The use of prophylactic antibiotics in the oral and maxillofacial surgery was conducted in our hospital from January 2011 to August 2013 based on a retrospective survey , and the conditions and affecting factors were analyzed .Results:The utilization rates of prophylactic antibiotics were respectively 98.9%, 61.8%, and 24.6%, showing a downward trend .But the infection rate of surgical site did not significantly increase , and by Fisher ’ s exact test, the difference was not significant (P>0.05).Surgical site infections (SSI) rates did not rise between using and not using prophylactic antibiotics ( P>0 .05 ) .Conclusion: The use of prophylactic antibiotics is greatly influenced by the policy , and along with the decline in antibiotic usage , SSI have not increased significantly .