Objective To investigate the relationship of proximal femur geometry and hip fracture in elderly women. Methods We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. Results The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9?3 1) mm and (13 2?2 9) mm, and the Singh index below Ⅲ? was 86 05% and 66 67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated. Conclusions Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

Objective To study the effects of calcitonin on bone mineral density(BMD), bone strength and bone fragile fracture in osteoporosis. Methods This is a one year, single centered, prospective and randomized, opening study: 135 patients with osteoporosis were divided into calcitonin+calcium group and calcium group. Patients of calcitonin+calcium group received salmon calcitonin(Miacalcic was injected intramuscularly, 50 IU/day in first week, 50 IU/two days in second week and 50 IU/twice/week later) and calcium(calcium 600 mg/day), patients in another group received calcium(calcium 600 mg/day). The determination markers included serum calcium, serum phosphate, serum alkline phosphatase, osteocalcin and urine hydroxyproline before and after treatment, at same time all patients were examined by DEXA(lumbar, hip) and QUS(radius, tibia). Results After 1 year treatment, 53 patients of calcitonin+calcium group and 59 patients of calcium group were followed up. In calcitonin+calcium group, BMD of lumbar spine increased about 1%(P

The cerebral infarction model was made according to Chen et al To evaluate the severity of infarction the quantity of Evan's blue was measured. The cerebral infarction size was determined by TTC stain. The results showed that ligating the right common carotid artery and the right middle cerebal artery and clamping the left common carotid artery could induce cerebral cortex in farction. Berbamine could decreased the level of Evan's blue and reduce the infarction size compared with control group. It suggests that berbamine possesses protective effect on experimental induced cerebral infarction.

To investigate the location of Epstein-Barr virus (EBV) in renal tissues of patients with interstitial nephritis(IN). Methods By in situ hybridization. EBER1 was detected in renal tissues of 12 IN patients and 10 patients with minimal change nephropathy (MCN) as control group. Results EBER1 was found positive in 3 renal tissues of IN patients. It mainly distributed in the nuclei of renal tubular cells, infiltration cells and glomerular cells and 10 MCN patients were all negative. Conclusion EBV infection may play an important role in the pathogenesis of IN. In different types of IN, EBV infection may play different role.

Objective　To investigate the relationship of proximal femur geometry and hip fracture in elderly women. 　Methods　 We compared proximal femur measurements made from the uninvolved hip of 48 plane anteroposterior pelvis radiographs of elderly women without fracture to those of the contralateral hip in a group of 43 cases with hip fracture. Measurements of Singh index, head diameter(HD), neck diameter(ND), femoral neck length(NL), neck shaft angle(NSA) and cortical thinckness of proximal femur were analyzed. 　Results　 The cortical thickness of proximal femur in hip fracture and without hip fracture groups was (10.9±3.1) mm and (13.2±2.9) mm, and the Singh index below Ⅲ° was 86.05% and 66.67%, respectively. No difference in HD,ND,NL and NSA could be demonstrated.　Conclusions　 Singh index and cortical thickness of proximal femur may be used to predict the occurrence of the hip fracture in elderly women.

BACKGROUND: Inhaled glucocorticoids(IGC) are powerful anti_inflammatory agents used in the treatment of asthma. But it is still uncertain whether long-term use of the IGC affects bone metabolism in asthmatic patients, especially women.OBJECTIVE: To investigate if the prolonged treatment with IGC to Chinese asthmatic woman has a detrimental effect on bone mass and metabolism.DESIGN: A matched controlled study based on the patients SETTING:Clinical Laboratory and the Department of Respiratory Medicine, First Affiliated Hospital, Nanjing Medical University.PARTICIPANTS: From February 1998 to February 2002, forty female Chinese patients with bronchial asthma, regularly followed up at our outpatient clinic, all in the Nanjing area, none of them having a history of chronic systemic GC use, agreed to take part in the study, were selected and divided into two groups: therapeutic group (IGC group): 20 asthmatic women, aged 18-63 years, 5 menopausals, received IGC therapy regularly for at least 5 months; Control group: 20 asthmatic women, aged 18-60 years, 5 menopausals, never received IGC received conventional bronchodilators . They were matched individually for sex, age and menopausal status.METHODS: Bone mineral density (BMD) at the lumbar spine (2-4),femoral neck, trochanter, ward's triangle and total body of femur were measured by dual energy X-ray absorptiometry, BMD were expressed as a absolute value and a T score considered as a SD from peak bone mass respectively. Meanwhile, BMD was also expressed as a percentage (%), which was defined by comparing the BMD absolute value of subjects and BMD normal value of isosexual age cohorts. Osteocalcin and some other markers of bone metabolism were measured by radio immunoassay in two groups.daily dose and accumulative total dose of IGC and BMD in the IGC group.RESULTS: There were no significant difference between two groups in BMD and T score (including the lumbar spine (2-4), femoral neck,trochanter, ward' s triangle and total body of femur) (P ＞ 0.05). There were also no significant correlation between daily dose of IGC and BMD of above 5 parts in the IGC group (r=-0.325 to -0.1102, P ＞ 0.05). But,there were significantly negative correlation between the accumulative total dose of IGC and BMD at lumbar spine2-4,femoral neck and ward's triangle(r=-0.495 ,-0.517,-0.531 ,P ＜ 0.05).There were no significant correlation between the accumulative total dose of IGC and T score of above 5 parts in the IGC group (r=0.443to 0.295 ,P ＞ 0.05). There was negative correlation between the age and the BMD at ward's triangle in the IGC group(r=-0.506,P ＜ 0.05). However ,BMD at 5 locus were not correlated with the age in control group (r=-0.079 to 0.326, P ＞ 0.05).Osteocalcin and some other markers of bone metabolism were no significant difference between two groups (P ＞ 0.05).CONCLUSION: The data suggests that there is no significant influence of IGC on bone mineral density and bone metabolism in asthmatic women,but if continuing exposures to high doses over many years,there may be a detrimental effect on bone mass and metabolism in women, especially elder or postmenopausal asthmatic women treated with IGC who may be more susceptible to any bone mineral loss caused by IGC.

Purpose To explore the clinical value of131I-whole body scan (131I-WBS) and 18F-FDG PET/CT on the metastatic management of patients with differentiated thyroid cancer (DTC) after operation.Materials and Methods Serum thyroglobulin (Tg) of 27 patients after DTC surgery was measured one day before131I therapy, and the patients underwent131I-WBS on 3-5 days after131I therapy. According to the results of Tg and 131I-WBS, all the patients were divided into 4 types as follows: type I: Tg (+),131I-WBS (-); type II: Tg (+),131I-WBS (+); type III: Tg (-),131I-WBS (+); and type IV: Tg (-), 131I-WBS (-). Then the patients received18F-FDG PET/CT scan within a week after 131I-WBS. The results of131I-WBS and18F-FDG PET/CT scan were analyzed according to histopathologic findings or clinical and imaging follow-up of at least 6 months as diagnosis standard.Results The examinations uncovered that metastasis occurred in 52 lesions of 22 cases out of the 27 cases.131I-WBS revealed 24 metastatic lesions (46.2%) in 8 cases (36.4%), and18F-FDG PET/CT showed 35 metastatic lesions (67.3%) in 15 cases (68.2%), the difference with statistic significance (χ2=4.46 and 4.74,P<0.05). Metastasis were confirmed in 13 type I cases (100.0%); 5 type II cases (100.0%); 3 type III cases (100.0%) and 1 type IV case (16.7%), respectively. The rate of detecting metastasis by 18F-FDG PET/CT was 100.0% in type I, 20.0% in type II, 0% in type III respectively, the difference with statistic significance (χ2=9.14 and 10.11,P<0.05); and 100.0% in type IV, the difference without statistic significance (χ2=1.25,P>0.05). Based on that, therapeutic plans were modified for 13 patients with type I metastasis and 1 patient with type IV metastasis.Conclusion131I-WBS and18F-FDG PET/CT are complementary for detecting metastatic lesion and help to decide the following treatment of DTC patients after surgery. Moreover,18F-FDG PET/CT shows advantages in detecting metastatic lesion in Tg-positive and negative131I-WBS type of DTC patients after surgery, thus can provide an important clinical guidance for this type of patients.

Background:Chronic inflammation is closely associated with occurrence and development of gastric cancer,and inflammatory cytokines,interleukin-18(IL-18)and IL-1β are involved via a variety of mechanisms. Aims:To determine the serum levels of IL-18 and IL-1β in patients with different gastric mucosal lesions and to explore the role of these two cytokines in gastric cancer and their clinical significance. Methods:Serum levels of IL-18 and IL-1β were detected by ELISA in patients with different gastric mucosal lesions,including 324 gastric cancer,40 chronic non-atrophic gastritis (CNAG),13 chronic atrophic gastritis with or without intestinal metaplasia(CAG/ IM)and 20 mild to moderate dysplasia. Helicobacter pylori(Hp)IgG antibody was detected in patients with gastric cancer. Correlations of serum levels of IL-18 and IL-1β with clinicopathological parameters and Hp infection were analyzed in patients with gastric cancer. RoC curve was used to assess the performance of serum IL-18 and IL-1β for diagnosis of gastric cancer. Results:Serum levels of IL-18 and IL-1β increased gradually from CNAG,CAG/ IM,dysplasia to gastric cancer;except for IL-1β between CNAG and CAG/ IM groups,significant differences were found between any two groups(P < 0. 05). In gastric cancer group,they were positively correlated with tumor size,lymph node and distant metastases,depth of invasion,TNM stage and Hp infection(P < 0. 05). Area under the RoC curve(AUC)of combined detection of serum IL-18 and IL-1β for diagnosis of gastric cancer was superior to that of IL-18 or IL-1β detection alone(0. 867 vs. 0. 837 and 0. 795). Conclusions:Serum levels of IL-18 and IL-1β increase dynamically with the tumorigenesis of gastric cancer,and are closely related to growth, invasiveness and metastasis of gastric cancer. Combined detection of serum IL-18 and IL-1β might be used as a biomarker for diagnosis and tumor progression and prognosis assessment of gastric cancer.

Background:The incidence of inflammatory bowel disease( IBD ) is increasing in recent years,however,its pathogenic mechanism has not been fully clarified. Previous studies revealed that adipokines played crucial roles in regulating intestinal inflammation. Aims:To investigate the role of visfatin,an adipocytokine,and its clinical significance in active IBD. Methods:Ninety-one patients with active IBD including 61 Crohn’s disease( CD)and 30 ulcerative colitis ( UC)at the First Affiliated Hospital of Soochow University and Suzhou Municipal Hospital from May 2015 to Dec. 2015 were enrolled in this study,and 48 healthy subjects were served as controls. Serum level of visfatin was determined by ELISA. Correlation of serum visfatin level with clinical features of IBD was analyzed,its diagnostic performance for IBD was assessed by ROC curve. Results:Serum level of visfatin was significantly higher in patients with active CD and UC than in healthy controls[(385. 24 ± 112. 64)pg/mL and(378. 91 ± 118. 57)pg/mL vs. (321. 11 ± 96. 27)pg/mL, P all ﹤0. 05]. Significant positive correlation was found between serum visfatin level and disease activity index(Mayo score)of UC( r =0. 398,P ﹤0. 05 ),however,no correlations were found between serum visfatin level and disease activity index of CD,CRP and ESR,two common inflammatory indicators for IBD and location of IBD(P all ﹥0. 05). The area under curve( AUC)of serum visfatin for diagnosis of CD and UC were 0. 654 and 0. 622,respectively;the diagnostic accuracy was relatively low. Conclusions:Serum visfatin might be associated with the active intestinal inflammation in IBD and has the potential to be served as a clinical index for active UC.

Objective To investigate the role of RhoA /Rho-kinase pathway in rat models of left heart disease-as-sociated pulmonary hypertension ( PH-LHD) .Methods Twenty male SD rats (3-4 week-old, 90-100 g) were randomly divided into two groups (10 rats in each group):the group C ( control group) with sham operation, and group H ( pulmo-nary arterial hypertension) .The rat model of left heart disease-associated pulmonary hypertension was established by supra-coronary aortic banding in the group H, and the sham surgery was applied for the rats in the group C ( The titanium clip was fixed at the mediastinal tissue adjacent to the artery rather than the ascending aorta).On day 60 after the operation, the cardiac functions, including right ventricular systolic pressure and pulmonary artery pressure were evaluated.After that, all rats were sacrificed and treated with cardiopulmonary lavage in vivo until the lung became white.Then the left lung tissues were fixed in 4%paraformaldehyde for pathological observation while the right lung tissues were frozen for mRNA detec-tion.Results Compared with the group C, both ventricular systolic pressure and pulmonary artery pressure in the group H were increased significantly (P<0.01).Pathological data demonstrated that the pulmonary artery walls in H group were much thicker than that in the group C.Moreover, vascular wall hypertrophy index in the group H was increased greatly compared with that in the group C (P<0.01).QPCR data showed that mRNA levels of Rho kinase, RhoA and ET-A R in the group H were up-regulated compared with the group C ( P<0.01) .Conclusions Rat model of left heart disease-asso-ciated pulmonary arterial hypertension can be successfully established by supracoronary aortic banding.Rho-kinase-media-ted pathway may contribute to the pathogenesis and progress of left heart disease-associated pulmonary arterial hypertension.