Objective To measure the bone mineral density in children with dual-energy X-ray absorptiometry and examine the relevance of bone mineral density with the risk of pediatric upper limb fracture.Methods A total of 864 children (8-14 years of age) admitted into our hospital in 2009 were involved in the study.The bone mass density (Z score) at the left radius was measured using dual-energy X-ray absorptiometry.Children were grouped according to their Z score and age to observe correlations of Z value and age with the incidence of fractures.Results Thirty-three children were lost to follow-up.For the other 831 children,the mean duration of follow-up was 2 years.Z sore was ≤-2 in 66 children and ＞-2 in 765 children.There was significant difference in fracture incidence between children with Z score of ≤-2 and ＞-2 (27.27％ vs 5.49％,P ＜0.01).Furthermore,fracture incidence in children at age group of 8-10 years and 11-14 years revealed significant difference (10.83％ vs 5.03％,P ＜ 0.01).Conclusions Bone mineral density is closely related to upper limb fracture in children and increases with aging.Early application of dual-energy X-ray absorptiometry to detect the bone density is an effective primary measure for prevention of fractures in children.

Objective To explore the diagnosis and treatment of upper limb trauma fracture complicated with deep vein thrombosis ( DVT) during preoperative period. Methods The data of 16 patients with upper limb trauma fractures complicated with DVT was analyzed retrospectively. The methods of diagnosis included color Doppler ultrasonography,multi slice CT angiography ( CTA) ,artery and vein visual-ization of upper limbs,and D-dimer detection. The treatment was majored in thrombolysis by urokinase and anticoagulation by low molecular heparin. Results There were 14 patients with increased levels of D-dimer,8 patients diagnosed by color Doppler ultrasonography,3 patients diagnosed by CTA and 5 by artery and vein visualization. The DVT of 5 patients before operation were disappeared after treatment and cured. Among the 10 patients received operation,8 cases were succeeded and 2 cases complicated with pulmonary embolism,and 1 case was died. Conclusion The color Doppler ultrasonography is the first priority for diagnosis of upper limb trauma fracture complicated with DVT. The patients should be discovered in time and arranged thrombolysis and anticoagulation in early time.

Objective To investigate the effect and significance of regulating endoplasmic reticulum stress on the expression of histone methyltransferases SET7/9 in the kidneys of db/db mice.Methods Db/db mice were randomly divided into two groups according to random number table method:diabetic nephropathy model group (DN group,n=18) and betaine treatment group (DN+B group,n =18),db/m mice were defined as normal control group (NC group,n =18).At the end of 4,8 and 12 weeks,the expression of GRP78,SET7/9,H3K4me2,and monocyte chemoattractant protein 1 (MCP-1) was determined by real-time fluorescence PCR and Western blotting.24-hour urinary protein excretion rate (UPER) and urine MCP-1 were measured by enzyme linked immunosorbent assay (ELISA).The dynamic changes of blood glucose(BG),serum creatinine (Scr),blood urea nitrogen (BUN) were tested by completely automatic biochemistry analyzer.The morphology of kidney was estimated by special staining of periodic acid-schiff (PAS).Results The levels of BG,BUN,UAER and MCP-1 were significantly higher in DN group than those in NC group (P ＜ 0.05),and were in time-dependent manner.Glomerular basement membrane thickening and mesangial cells proliferation began to emerge in DN group at the end of week 4 and mesangial matrix expansion was more obvious at the end of week 12.The mRNA and protein expression of GRP78 and SET7/9 were elevated significantly in DN group as compared to NC group.The H3K4me2 protein expression level was also increased in time-dependent manner.Compared with the DN group,in DN+B group glomerular lesions attenuated and the GRP78 and SET7/9 expression levels obviously decreased (P ＜ 0.05).Furthermore,the levels of BG,BUN,UPER,MCP-1,H3K4me2 in DN+B group were also reduced (P ＜ 0.05).Conclusion Endoplasmic reticulum stress may be the upstream mechanism of mediating the expression of SET7/9 in the kidneys of DN mice.

Objective To observe the effects of fluorosis on the levels of endogenous cystathionine beta-synthase (CBS) and hydrogen sulfide (H2S) in rats.Methods According to body weight,forty-eight Sprague-Dawley rats (body weight 105-180 g) were divided into three groups by a random number table(16 rats in each group,half male).Fluorine contents of the feed in control group,low-fluoride group and high-fluoride group were 9.80,15.40 and 23.80 mg/kg.After 6 months of fluorine exposure,the fluorine contents of urine and bone were determined by the method of fluorine ion-selective electrode ; H2S levels in serum and brain and the activity of CBS in brain were detected by methylene blue; and protein expression of CBS was detected by Western blotting.Results Compared with control group,dental fluorosis was found in rats of low-fluoride and high-fluoride groups.The differences of fluorine contents of urine and femur were statistically significant between groups(F =65.16,67.93,all P ＜ 0.05).The urinary and femoral fluorine in low-fluoride groups [(5.25 ± 0.45)mg/L,(1 196.54 ± 72.78)mg/kg] and high-fluoride groups[(13.17 ± 0.98)mg/L,(2 656.61 ± 170.12)mg/kg] were higher than those of control groups [(3.64 ± 0.20)mg/L,(870.71 ± 71.51)mg/kg,all P ＜ 0.05],and the increases were in a dose-dependent fashion(all P ＜ 0.01).The differences of H2S contents in serum and brain were statistically significant(F =4.83,1 456.13,all P ＜ 0.05).The H2S content in serum was higher in high-fluoride group [(17.64 ± 2.38) μ mol/L] than that of the control group [(10.29 ± 0.74) μ mol/L,P ＜ 0.01].The H2S contents in brain were higher in the low-fluoride [(364.74 ± 2.06)μmol/L] and high-fluoride groups [(513.43 ± 4.18) μmol/L] than those of the control group[(314.94 ± 0.72)μmol/L,all P ＜ 0.01],and the increase was in a dose-dependent fashion (P ＜ 0.01).The difference of CBS activity was statistically significant between groups (F =760.63,P ＜ 0.01).The CBS activities were lower in low-fluoride [(438.90 ± 2.83) mmol· kg-1· min-1] and high-fluoride groups [(529.83 ± 2.37)mmol· kg-1· min-1] than those of the control group [(596.33 ± 2.75) mmol · kg-1· min-1,all P ＜ 0.01],whereas the protein expression of CBS in brain in high-fluoride group (1.49 ± 0.08) was higher than that of the control group (1.19 ± 0.06,P ＜ 0.05).Conclusion Chronic fluorosis can affect the levels of endogenous CBS and H2,S,and the increases are in a dose-dependent fashion in addition to CBS activity.

Objectives To study the value of CT and MRI in diagnosing focal nodular hyperplasia (FNH).Methods The CT and MRI findings of 16 patients with FNH confirmed histopathologically were analyzed retrospectively.Both plain and dynamic enhanced CT scannings were performed in all the patients.Plain and dynamic enhanced MRI were carried out in 9 patients.Results (1) There were 16 patients with 19 lesions,and 8 lesions were in the left lobe,5 lesions in the right lobe,4 lesions between the left/right lobes and 2 lesions in the caudate lobe.The morphology of the lesions showed 15 lesions to have clear boundaries and 4 lesions to have fuzzy boundaries.The tumor diameters varied from 2.2 to 9.6 cm,(average 4.3 cm).(2) Sixteen patients underwent CT examination.On plain CT,the lesions were isotonic (n＝ 5),or slightly low-density (n=11).In 7 lesions,there was a slit-like,stellate-shaped low density central scar.Nine patients underwent MRI examination.On T2WI,6 lesions showed slightly higher signal while the remaining 3 lesions showed iso-signal.On T1WI,4 lesions showed slightly lower signal,3 lesions showed iso-signal and 2 lesions showed slightly higher signal while in 1 lesion the local signal showed reduction in anti-phase 1.A central scar was seen in 6 lesions which showed high signal on T2WI,and low signal on T1WI.(3) Enhanced CT: 15 lesions were significantly enhanced and 1 lesion showed mild enhancement at the arterial phase.For the patients with mild enhancement,the scar in the center of the lesion showed no enhancement.In all lesions,the central scar did not enhance.In 5 lesions,enhancements of thickened and torturous arteries were seen.In all the lesions with enhancement,the enhancement was reduced at the portal venous phase,with 12 lesions showing slightly higher density,3 lesions isodensity and 1 lesion low-density.Three lesions showed mild enhancement of the central scar.All the substantial parts of the lesions with enhancement declined at the delay phase,with 3 lesions showing slightly higher density,9 lesions of isodensity and 4 lesions slightly low density.In 7 lesions with central scar delayed enhancement,they showed slightly higher density.Nine patients underwent MRI enhancement and the enhancement characteristics were similar to CT,but the arterial phase magnitude was higher than that of CT.In 4 lesions,the central scar began to enhance at the portal venous phase,while 6 lesions continued to enhance,thus showing slightly higher signal at the delay phase.In a large lesion,there was persistent delayed enhancement in the capsule.(4) On DWI,6 lesions showed inhomogeneous,slightly hyperintensity with the center showing a slit-like low signal area.Three lesions showed iso-signal.The ADC values of the lesions were (1.31±0.08)× 10-3 mm2/s,and the normal liver parenchyma were (1.22± 0.14)× 10-3 mm2/s,(difference not statistically significant).Conclusions CT and MRI using plain and dynamic enhanced scans could show fully and accurately the pathological features and the characteristics of blood supply of FNH.The characteristic signs on both CT and MRI make an accurate diagnosis of FNH.MRI when compared with CT was slightly better.A combined use of both CT and MRI has an important value in the diagnosis of FNH.

Objective To investigate the renal expression changes of microRNA-215(miR-215) and its role in diabetic nephmpathy of type 2 diabetic db/db mice. Methods Fourweek-old diabetic db/db mice and norml control group non-diabetic db/m mice were selected.Real-time PCR was used to detect the relative level of miR-215 at the age of 8,12 and 16 weeks.Catenin beta interacting protein 1 (CTNNBIP1) mRNA and protein level were measured by realtime PCR,WesteRN blotting and immunohistochemisty.A lueiferase reporter assay was used to determine whether CTNNBIP1 was a direct target of miR-215. Results (1)With the growth of db/db mice,the major pathological characteristics of kidney included glomerular hypertrophy,segmental mesangial cells proliferation and mesangial matrix expansion.(2)Compared with the db/m mice,the db/db mice of 8,12 and 16 weeks showed obvious increase in body weight(BW),blood glucose (Glu) and 24 hour urinary albumin excretion (UAE) (P＜0.05,respectively).(3)Compared with the db/m mice,special miR-215 was highly expressed in the kidney of db/db mice and was up-regulated significantly according to the development of DN (P＜0.05).(4)The mRNA and protein expression of CTNNBIPl of kidney were consistently down-regulated in db/db mice than those in controls (P＜0.05,respectively). (5)By luciferase reporter,miR-215 could negatively regulate CTNNBIP1 gene by targeting its 3'-UTR sequence (P＜0.01). Conclusion High expression level of miR-215 plays a potential role in the initiation and progression of DN by down-regulating the expression of CTNNBIPl.

Objective:To investigate the azole susceptibility of Candida albicans (C. albicans) from vulvovaginal candidosis patients and to analyze the relationship between ERG11 gene mutations in these isolates and azole resistance.
Methods:Three hundred and two clinical isolates of Candida species were collected. Azole susceptibility was tested in vitro in microdilution studies. The ERG11 genes of 17 isolates of C. albicans (2 susceptibles, 5 dose-dependent resistants and 10 resistants) were amplified and sequenced.
Results:Of the 302 isolates collected, 70.2%were C. albicans, of which 8.5%, 3.8%and 4.2%were resistant to fluconazole, itraconazole and voriconazole, respectively. In total, 27 missense mutations were detected in ERG11 genes from resistant/susceptible dose-dependent isolates. Among them, Y132H, A114S, and Y257H substitutions were most prevalent and were known to cause fluconazole resistance. G464S and F72S also has been proved to cause fluconazole resistance. Two novel substitutions (T285A, S457P) in hotspot regions were identified.
Conclusions:Twenty seven mutations in the ERG11 gene were identified in azole-resistant C. albicans isolates, which indicated a possible relation with the increase in resistance to azole drugs and the recurrence of vulvovaginal candidosis. The relationship of two novel substitutions (T285A, S457P) with fluconazole resistance needs to be further verified by site-directed mutagenesis.

Objective To investigate the correlation between plasma proteasome and endothelial dysfunction in patients with uremia. Methods Forty-five uremic patients who did not receive hemodialysis were defined as A group; seventy-five uremic patients who had received hemodialysis for 6 to 12 months were divided into sufficient hemodialysis group (44 cases,B group)and insufficient hemodialysis group (31 cases,C group).The primary disease of these patients was chronic glomerulonephritis.Fifteen healthy people were defined as healthy control group (D group).The diameter of radial artery lumen (DRL),intima-media thickness (IMT),intima-media area (IMA),endothelium-dependent or independent dilation (EDD or EID) of radial artery in right forearm were detected by diasonography.The levels of 20S proteasome,tumor necrosis factor α (TNF-α),C-reaction protein (CRP) and transforming growth factor β 1 (TGF-β1) of plasma and supernatant of cultured human umbilical veins endothelium (HUVEC) were determined by enzyme linked immunosorbent assay (ELISA).20S proteasome activity was analyzed by special substrate.Results Compared with D group,the level and activity of 20S proteasome,as well as TNF-α,CRP and TGF-β1 in A,B and C groups were significantly increased.Compared with A group,these plasma indices levels were significantly decreased in B group but strongly increased in C group.IMT and IMA were elevated,while DRL,EDD and EID were decreased significantly in A,B and C groups when compared with D group.These parameters were worse in C group than those in A and B groups.After co-culture of HUVEC with above mentioned human uremic serum,the level and activity of 20S proteasome and TNF-α were higher in A,B,C groups than that in D group.In A and C groups,there were negative correlations of EDD with the level or activity of 20S proteasome,TNF-α,CRP and TGF-β1,and there were positive correlations of 20S proteasome level or activity with TNF-α,CRP and TGF-β1. Conclusions 20S proteasome level and activity are significantly increased in uremic patients.There is a close correlation between 20S proteasome and endothelial dysfunction of radial artery.

Objective To explore the prevalence of mild cognitive impairment (MCI) among elderly veterans. Methods 2 674 veterans ( aged 60 years and over) from 26 military sanatorium in Shijiazhuang city were studied. The Mini-Mental State Examination, Global Deterioration Scale, Activity of Daily Living, Hachinski Ischemic Scale and Hamilton Depression Scale were served as screening tools. Results The prevalence of total MCI was 8 08% in elderly people. The standardized prevalence of MCI was 6 87% in male and 10 38% in female (P

Objective To investigate the clinical value of 123I-metaiodobenzylguanidine (MIBG) SPECT/CT imaging in the diagnosis and treatment of pediatric patients with neuroblastoma ( NB) . Methods A total of 196 NB patients (103 males, 93 females;age 1-14 years) who underwent 123I-MIBG SPECT/CT imaging in Beijing Friendship Hospital between February 2018 and December 2018 were reviewed retrospec-tively. All patients underwent whole-body planar imaging and local SPECT/CT imaging. According to the clinical data and 123 I-MIBG imaging results, patients were divided into 3 groups ( group 1: patients under-went preoperative planar imaging; group 2: patients with positive results in postoperative planar imaging;group 3:patients with negative results in postoperative planar imaging). The final diagnosis was made ac-cording to pathological results, other related imaging results and clinical follow-up results. The diagnostic consistency between planar imaging or SPECT/CT imaging and final diagnosis in each group was calculated and compared using χ2 test. Results For group 1 ( n=34) , the diagnostic consistencies of planar imaging and SPECT/CT imaging with the final diagnosis were 38.2％(13/34) and 82.4％(28/34) respectively (χ2=13.82, P<0.01), while those were 13.3％(12/90) and 74.4％(67/90) for group 2 (n=90;χ2=68.24, P<0. 01). In these two groups, SPECT/CT imaging improved the planar imaging results by 44.12％(15/34) and 61.11％(55/90) respectively. For group 3 (n=72), the diagnostic consistencies of planar imaging and SPECT/CT imaging with the final diagnosis were 88.9％(64/72) and 94.4％(68/72;χ2=1.45, P>0.05), and planar imaging results in only 5.56％(4/72) patients were improved by SPECT/CT imaging. Conclu-sions For patients undergoing preoperative imaging and those with positive results in postoperative planar imaging, SPECT/CT imaging should be added. For patients with negative results in postoperative planar im-aging, unnecessary SPECT/CT imaging should be limited.