Objective:To investigate peak bone mass(PBM) of female adults in Chongqing area and PBM change of females' lumbar vertebrae with age,bodyweight, height and body mass index(BMI),to provide scientific basis for diagnosis and prevention of osteoporosis. Methods:There were 1435 female adults in Chongqing area randomly selected. The assessment of BMD in spine region was performed by NORLAND XR-46 dual-energy X-ray absorptiometer. BMD of lumbar spine with age-related changes was fitted in the whole healthy women population by eight kinds of regression models. Best model equations of fitting were found and the reference databases of BMD in women were established.Group aged from 20 to 50(n=631)was PBM research group. Results:The PBM of the second,third and total lumbar vertebrae occurred in the group aged from 34 to 35,while that of the forth lumbar vertebrae occurred during 26 to 27 and reduction began at the age of 28. BMD would gradually decrease with the advancing of age when it achieved PBM. R square of cubic regression curve was maximum. The research showed height?body weight and BMI could influence PBM values of lumbar vertebrae. The effect of body weight was the most significant among these influential factors. Conclusions:The PBM level of female adults in Chongqing area was lower than that of other related research results in domestic,and the age of PBM was earlier than that of the others. A cubic regression model was the better model to establish a normal BMD reference curve. Proper nutrition and suitable figure keeping could result in higher PBM value in human life.

Objective:To investigate different region's bone mineral density(BMD)changing pattern in female adults in Chongqing area,evaluate the value of different sites in the diagnosis of primary osteoporosis,and provide scientific basis for diagnosis and prevention of osteoporosis.Methods:1435 female adults in Chongqing area were randomly selected.The assessment of BMD in spine region was performed among 1345 female adults with NORLAND XR-46 dual-energy X-ray absorptiometer.BMD of the proximal femur in 308 was measured.All data was processed by relative statistics analysis.Results:BMD change of Wards Tri area occured 5 years earlier than that of others and it decreased obviously.It was the most sensitive site to reflect the BMD change.BMD of each site correlated with those of other sites.A cubic regression model was the better model to establish a normal BMD reference curve.R square of cubic regression curve was maximum value.R square in femoral neck and Wards triangle were larger than that of other sites.There was no significant difference in the incidence rate of osteoporosis in different sites.Conclusions:We should choose different sites to diagnose osteoporosis in different age groups.BMD of proximal femur should be measured in female adults less than 50 years,while BMD of proximal femur and lumbar spine should be measured in female adults older than 50 years.

SUMMARY A patient with previous L3 -4 posterior lumbar interbody fusion,pedicle screws instrumen-tation and L3 -4 decompression,was scheduled for left total hip arthroplasty.Two years ago,due to poor landmarks palpation,the patient experienced a failed lumbar puncture after multiple attempts before her-niorrhaphy.His plain radiography showed bilateral partial laminectomy at L3 -4 level,and between L3 and L4,two posterior pedicle screws connected by metal rods on both sides.This time,we used ultra-sound to locate L4 -5 interlaminar space in paramedian sagittal oblique view and identified the spine midline by transverse interlaminar view before puncture.According to this information,L4 -5 puncture point was verified and the combined spinal-epidural anesthesia was performed in a paramedian approach. After withdrawing clear cerebral spinal fluid,15 mg hyperbaric bupivicaine was injected into intrathecal space.An epidural catheter was then inserted into the epidural space.The sensory block level was fixed at T10 to S within 10 minutes.Intraoperatively,the patient received 10 mL 2% (mass fraction)lido-caine through the epidural catheter in total.The surgery was uneventful.No neurologic complication was observed after the surgery.This case report demonstrates that ultRASound imaging can provide useful in-formation for neuraxial needle placement and can be a valuable tool in managing patients with anatomical change around the spine.

FoxM1 is a specific transcription factor related to proliferation .Previous studies have found that FoxM1 can enhance the proliferation ,metastasis and invasion of cancer cells ,and play a crucial role in canc-er.Recent studies indicate that the abnormal expression of FoxM 1 plays an important role in breast cancer ,and its overexpression is negatively correlated with the overall survival of patients .For the early diagnosis of breast canc-er,clinical prognosis and study on combination therapy provides a new direction .This article reviews the relation-ship between FoxM1 and breast cancer .

Lung cancer is the leading cause of cancer-related death in the world.PD-1 is a member of the CD28 family expressed on the surface of a variety of immune cells.PD-L1, one of PD-1 ligands, plays a pivotal role in the ability of tumor cells to evade the host immune system.A recent study showed that signaling via mutant EGFR in lung tumor cells upregulates directly tumor PD-L1 expression.In this review, the clinical significance of the PD-1/PD-L1 pathway in immunotherapy for non-small-cell lung cancer (NSCLC) and the relevance to targeted therapy were summarized.

[Summary] In recent years , ultrasound guidance has been widely used in local anesthesia , particularly in peripheral nerve blockage .Ultrasound guided neuraxial blockage is also making progress .Previous studies have shown that pre-puncture ultrasound scanning could provide useful information on the correct intervertebral interspace , the midline of the spine , the optimal puncture point , the appropriate angle for needle insertion , and the distance from skin to the spinal canal .In this review, the ultrasonographic techniques and image analysis , as well as its clinical use , including pre-puncture scanning and real-time guidance for spinal and epidural anesthesia , were summarized .

Objective:To establish a SPME-HPLC method for the determination of strychnine and brucine in Stryehnos nux-vomiea Linn. Methods:A novel capillary microtube monolithic column coupled with HPLC was prepared for the selective solid-phase microextraction of strychnine and brucine in Stryehnos nux-vomiea Linn. A Hypersil ODS column(150 mm × 4. 6 mm, 5 μm)was used and the mobile phase was acetonitrile- 0. 01 mol·L -1 sodium heptanesulfonate mixed with the same quantity of 0. 02 mol · L -1 potassium dihydrogen phosphate(adjusting pH to 2. 8 with 10% phosphoric acid)(21 ∶79). The detection wavelength was 260 nm,the sample size was 20 μl,and the column temperature was 25℃ . Results:The linear range of strychnine was 1. 2-90. 0μg·ml -1(r = 0. 999 8)and that of brucine was 1. 0-75. 0μg·ml -1(r = 0. 999 6). The average recovery was 100. 05%(RSD = 0. 58% ,n = 6)for strychnine and 99. 98%(RSD = 0. 27% ,n = 6)for brucine. Conclusion:The method is accurate and highly efficient,which can be used for the determination of strychnine and brucine in Stryehnos nux-vomiea Linn.

Objective To explore the relationships between life events,automatic thoughts,coping style and internet addiction disorder(IAD) of adolescent . Methods 54 cases of the IAD were assessed with the Adolescent Self-rating Life Events,Automatic Thought questionnaire and Coping Style questionnaire. Results Life events, automatic thoughts,and coping style were significantly correlated with IAD (r =0.312,r =0.325,r =0.295) ( P <0.01).There were significant correlations between life events and automatic thought, life events and coping style(r =0.554,r =0.392) ( P <0.01).The multiple linear stepwise regression revealed that only life events entered on the regression equation when the score of IAD server as dependent variable. Conclusion There may be three ways that life events influence in IAD:life events influence in IAD directly,life events influence in IAD by the mediators,automatic thought and coping style indirectly.Automatic thoughts and life events is not a necessary condition that led to internet addiction and life events may be influence in IAD by other ways.

Objective To observe the clinical effect of Qilingjiangsuan granules treatment on gouty nephropathy﹙GN﹚Methods83 patients with Gouty nephropathy were divided randomly into two groups: treatment group(42 cases) and the contrast group(41 cases).The patients in treatment group were given Qilingjiangsuan granules and tablet Allopurinol.The patients in contrast group were given tablet Allopurinol.ResultsThe total effective rate of treatment group was 90.84%,and the comparison group's was 63.41%.There were significant differences between two groups(P

OBJECTIVE:To intensify the governmental monitoring on drug bidding in medical institutions.METHODS:Governmental monitoring network for drug bidding in medical institutions was established by using program of Dreamwcavcr?Mx together with Flash,Photoshop and Fireworks.RESULTS&CONCLUSION:This network can effectively perform the monitoring during the whole process of purchasing and selling of medicine,thus promoting the increase of the ratio of drug purchasing by bidding and facilitating the construction of occupational moral standard.