BACKGROUND:The bone mineral density is a static parameter that reflects the bone mass in a relatively long time. If you want to know the dynamic changes of bone metabolism, bone metabolism markers should be evaluated.
OBJECTIVE:To explore changes of bone metabolism markers and bone mineral density during perioperative period in patients with spine and joint degeneration and osteoporotic fractures.
METHODS:We retrieved PubMed and Wanfang database for articles published from 2005 to 2016. The key words were“bone metabolic markers, bone mineral density, serum, urine”. Twenty-nine articles were analyzed according to inclusion and exclusion criteria.
RESULTS AND CONCLUSION:At present, bone formation markers commonly used in clinic mainly included bone alkaline phosphatase, osteocalcin, procol agen type I N-terminal peptide, and procol agen type I C-terminal peptide. Bone resorption markers included tartrate resistant acid phosphatase, col agen type I N-terminal telopeptide, col agen type I C-terminal telopeptide, deoxidation pyridinoline, pyridinoline, and hydroxyproline. Bone mineral density had little change, and bone resorption markers were elevated in patients with spine and joint degeneration and osteoporotic fractures, indicating active resorption. Increased bone formation markers in patients with fracture during perioperative period suggested that new bone formed in perioperative period of fracture. In the perioperative period, bone formation markers reduced and bone formation was inhibited in patients with bone degeneration. Increased bone resorption is more obvious in perioperative period in patients with bone and joint disease and fractures, which probably further aggravated the degree of osteoporosis, and should be treated by regular anti-osteoporosis therapy.

Objective To observe and analyze the clinical effect of Modified Decoction for the treatment of lung -qi and spleen -qi deficiency syndrome in patients with stable stage of chronic obstructive pulmonary disease (COPD).Methods 86 patients with lung -qi and spleen -qi deficiency syndrome in stable stage of COPD were divided into the observation group (n =43) and control group (n =43) according to a random number table method. The control group was treated with conventional western medicine therapy,the observation group was given modified Bufei decoction treatment on the basis of western medicine treatment.The clinical therapeutic effect of two groups was assessed.Results The effective rate of the observation group was 83.72%,which was significantly higher than 72.09% of the control group,the difference was statistically significant (χ2 =3.9289,P <0.05).After treatment,the FEV1 ,FEV1 /FVC,FEV1% expected values of the two groups were significantly higher than those before treatment (t =3.6984,3.6915,3.7431,4.2675,4.6821,5.0567,all P <0.05).After treatment,the FEV1 ,FEV1 /FVC, FEV1% predicted value of the treatment group were (2.45 ±0.35)L/s,(63.91 ±7.42)%,(47.29 ±7.52),which were significantly higher than those of the control group (t =3.6884,3.7581,4.1957,all P <0.05).After treatment, the levels of IL -8 and TNF -αwere not significantly changed in the control group.The levels of IL -8 and TNF -αin the observation group were significantly lower than those in the control group (t =8.864,9.571,all P <0.05). Conclusion In COPD patients of stable stage with lung -qi and spleen -qi deficiency syndrome,plus or minus fill lung soup can effectively relieve clinical symptoms and improve pulmonary function of patients,reduce the acute attack,and improve the quality of life of patients,it is worthy of clinical application.

Objective To develop a sensitive, specific, rapid and easy method for detecting E. coli O157 : H7 and other Shiga toxin-producing E. coli in food and clinical specimens. Methods A circular probe and capture probe specific for Shiga toxin-2 (stx2) gene had been synthesized and was used for determining the sensitivity of ramification amplification method (RAM). Different serotypes which contained stx2 gene, including an E. coli O157 : H7, an E. coli O46 : H38, an E. coli O111 : NM, an E. coli O22 : H8 and E. coli ATCC23716 (stx2 gene negative) were used for determining the specificity. All strains were detected by RAM to determine whether they contained stx2 gene. Real-time RAM was further studied to detect stx2 gene. Results The lowest number targets detected by RAM assay was 10 copies of stx2, indicating that RAM assay was as sensitive as conventional PCR. The result of specificity showed that different serotypes of strains were all positive for stx2 gene, while nonpathogenic E. coli ATCC23716 was negative. Among 32 isolates, 28 STEC isolates containing stx2 gene were positive by RAM assay, while others were negative. The RAM results were 100% in concordance with that of PCR. The real-time RAM results also showed that as many as 10 bacteria can be detected and the time of appearance of detectable signal was depended on the target concentration. Conclusion RAM assay can offer an alternative method for PCR to detect E. coli O157 : H7 and STEC in all types of specimens because of its simplicity and isothermal amplification.

Objective To investigate the relationship between serum leptin concentration and type 2 diabetes mellitus (DM) with cerebral infarction (CI). Methods Serum leptin concentrations were measured by enzyme-linked immunosorbent in 128 DM patients (65 male, 63 female and 62 lean, 66 obese and 63 complicated CI. Serum leptin concentration, triglyceride, total cholesterol, blood glucose, blood pressure, and body mass index (BMI) in CI were analyzed by correlation analysis. Results (1)The fast serum leptin concentrations in the obese individual were higher than that in the lean ( P

Objective To study the influence of exchange transfusion therapy on the complications and prognosis in newborns with bilirubin encephalopathy.Methods From June 2013 to June 2016,76 children with bilirubin encephalopathy in Feicheng People's Hospital were selected and divided into study group(n =41) and control group(n =35) according to whether or not accepted the exchange transfusion treatment.The levels of total bilirubin (TBIL),indirect bilirubin(IBIL),direct bilirubin(DBIL) and the ratio of total bilirubin to plasma albumin(B/A)were detected and compared between the two groups.The complications and prognosis of the two groups were recorded.Results After exchange transfusion,the TBIL,IBIL,DBIL and B/A values in the study group were (209.49 ± 48.82) μmol/L,(201.81 ± 39.62) μmoL/L,(21.92 ± 19.47) μmoL/L and (5.15 ± 1.89),respectively,which were significantly lower than those before exchange transfusion [(492.35 ± 42.41) μmol/L,(439.44 ± 52.56) μmol/L,(69.38 ± 21.56) μmol/L and (13.28 ± 0.40)] (t =28.007,23.117,10.461,26.947,all P ＜ 0.05).The incidence rates of anemia,sinus bradycardia and electrolyte disturbances in the study group were 48.78％,48.78,60.98％,respectively,which were significantly higher than those in the control group(17.14％,14.29％,14.29％) (x2 =8.397,10.178,17.228,all P ＜ 0.05).The incidence rates of death,hearing impairment and brain damage in the study group were 7.32％,70.73％ and 12.20％,respectively,which in the control group were 11.43％,71.43％ and 14.29％,respectively,there were no statistically significant differences between the two groups (x2 =0.382,0.004,0.072,all P ＞ 0.05).Conclusion Exchange transfusion can significantly reduce the levels of bilirubin and B/A in the treatment of newborns with bilirubin encephalopathy,but it can increase the incidence rate of anemia,sinus bradycardia and electrolyte disturbances,which has no significant influence on the prognosis of patients.

Objective To evaluate the long-term effect of phacoemulsification (PHACO)+intraocular lens implantation (IOL) for cataract combined with primary angle closure (PAC) in the expansion phase. Methods Thirty-eight eyes of 29 patients which suffered from cataract combined PAC in the expansion phase had undergone PHACO+IOL and goniosynechialysis from June 2005 to December 2006 were retrospectively studied. Results A total of 32 eyes of 24 cases were followed up for 6 to 35 months post-operatively, meanly 19.53?8.93 months. The intraocular pressure (IOP) was significantly decreased from a preoperative mean of (31.61?9.88) mmHg without medication therapy to (16.73?2.13) mmHg in 1 month after operation and (15.61?1.94) mmHg at the end of follow-up. The differences between the untreatment and the treatment were statistically significant (P=0.000). The best corrected visual acuity (BCVA) was significantly improved in all cases (P=0.000). Although the BCVA at the end of follow-up was declined when compared with the acuity 1 month post-operatively, there was no significant difference. The mean central anterior chamber depth was increased from (2.22?0.51) mm preoperatively to (3.59?0.46) mm in 1 month after operation and (3.17?0.35) mm at the end of follow-up with significant differences (P=0.000). The angle of anterior chamber in all operated eyes became wider and the parts of angle closure opened at different degrees. All of patients had no any vision defection. Conclusion PHACO+IOL and combined with goniosynechialysis blocks primary angle-closure glaucoma course, and has better long-term effect.

AIM: To observe the changes of serum nitric oxide and the production level of IL-1 in different period of coxsackievirus B 4 (CB 4V)-induced insulin-dependent diabetic mice.METHODS: The insulin-dependent diabetes mellitus (IDDM) animal model induced by CB 4V infection was established. Serum nitric oxide level was estimated by nitrate reductase method after infection 72 h,1 week, 3 weeks,6 weeks,8 weeks, respectively. At the same time, level of IL-1 produced by peritoneal M? was measued.RESULTS: (1) Changes of serum nitric oxide: serum nitric oxide level in control group remained normal level. The serum nitric oxide level in diabetic group increased significantly at 72 h after infection(P0.05). (2) IL-1 activities: IL-1 activities were increased obviously from 72 h to 3 weeks after virus infection, but decreased to normal level after 6 weeks.CONCLUSION: Nitric oxide may be one of the important factors in the development of CB 4V-induced IDDM.

The paper expounds the scientific management of the science of emergency treatment in the following aspects, organization and structure, quality, computerized information, and special emergency treatment combined with general emergency treatment. It also discusses the management of services facilitating emergency treatment, such as administration, goods provision, human resources, economy, and contingency plans for emergent events.

Objective To investigate the correlation between the incidence of thyroid carcinoma and TSH, and to provide evidence for clinical application.MethodsSelect 450 cases of patients with thyroid from August 2014 to August 2016 in our hospital as the object of study in this group, the analysis of gender and age of patients, lymph nodes, tumor, laboratory examination results, to explore the relationship between TSH levels and thyroid cancer.ResultsThyroid patients with TSH was significantly higher than that in benign tumor group (P<0.05);the level of TSH and patients with lesion diameter, tumor stage, lymph node metastasis and capsule invasion was significantly correlated (P<0.05), but the level of TSH and age, gender, tumor number, vascular invasion and no significant correlation;TSH the level of thyroid cancer patients were significantly increased (P<0.05).ConclusionThe level of TSH in serum is closely related to the occurrence and development of thyroid cancer, and is closely related to lymph node metastasis and tumor stage, and the higher TSH level can increase the risk of thyroid cancer.

Objective:To optimize the clinical dosage regimen of amoxicillin and clavulanate potassium extended release ( ER) tablets based on the PK/PD parameters. Methods:Totally 30 healthy subjects ( half male and half female) were randomly divided into three groups, and orally administered the ER tablets respectively under fasting condition, before the meal and after the meal, and the optimal administration time was determined by comparing the pharmacokinetic characteristics. The subjects in the three groups were ad-ministered the ER tablets respectively at low, medium and high dosage, and the optimal dosage and dosing interval were determined based on the PK/PD parameters. Results:Under fasting condition, the AUC of amoxicillin [(32.2 ±15.0) μg·h·ml-1] was sig-nificantly lower than that before the meal [(41.7 ±1.92) μg·h·ml-1] and that after the meal [(42.6 ±17.7) μg·h·ml-1]. In contrast, the AUC of clavulanate acid after the meal [(1.89 ±0.54) μg·h·ml-1] was significantly lower than that under fasting condition [(2.55 ±0.76) μg·h·ml-1] and that before the meal [(2.58 ±0.76) μg·h·ml-1] (P<0.05). Amoxicillin and clavulanic acid displayed linear pharmacokinetics within the range of 1000-4000 mg and 62. 5-250 mg, respectively. After a single o-ral administration of amoxicillin and clavulanate potassium ER tablets at low, medium and high dose, the duration of blood concentra-tion above the minimum inhibitory concentration (MIC, 2. 0 μg·ml-1) (T> MIC) in 12 h was 5. 5, 7 and 10 h, and the percentage was 46%, 58% and 83%, respectively, and T> MIC in 12 h was 4. 5, 6 and 8 h, and the percentage was 38%, 50% and 67%, re-spectively when MIC was 4. 0μg·ml-1 . Conclusion:It is suggested that amoxicillin and clavulanate potassium ER tablets be taken at the start of a standard meal, 2 tablets per time, twice daily, which is sufficient to achieve T> MIC of 40% -50%.