Objective To study the relationship between chronic obstructive pulmonary disease (COPD) and osteoporosis by measuring the bone mineral density (BMD),lung function,blood gas analysis,calcium ion,high sensitive C reactive protein (hs-CRP) and the quality of life.Methods BMD measuring was performed by ultrasound dry bone densitometer in 32 patients with COPD (COPD group) and 35 healthy controls (control group).The ultrasonic transmission speed (SOS),SOS T,fracture risk factor (OSI) and bone strength (TI) were measured at the sites of the left calcaneus.COPD group was divided into three groups according to lung function,3 cases of mild,14 cases of moderate and 15 cases of severe.According to the level of BMD,there were another three groups,3 cases with normal BMD,24 cases with lower BMD,and 5 cases with osteoporosis.According to the history of systemic glucocorticoid application,COPD group was divided into two groups,10 cases with glucocorticoid application and 22 cases without glucocorticoid application.The levels of BMD between COPD group and control group were compared,and the correlation between BMD and lung function,blood gas analysis,calcium ion,hs-CRP and the quality of life in patients with COPD was analyzed.Results COPD group had lower BMD than that in control group (P ＜ 0.05).In COPD group,the severe patients had lower BMD than the moderate patients (P ＜ 0.05),and the severe patients had only lower SOS than the mild patients(P ＜ 0.05),but there was no statistic significant difference in BMD between the moderate and mild patients(P ＞ 0.05).According to the level of BMD,the osteoporosis patients had lower arterial oxygen tension (PaO2) and higher hs-CRP and COPD assessment test (CAT) than the normal BMD and lower BMD patients,and the lower BMD patients had lower PaO2 and higher CAT than the normal BMD patients (P ＜ 0.05),but there was no statistic significant difference in calcium ion among them(P ＞ 0.05).According to the history of systemic glucocorticoid application,the patients with glucocorticoid application had lower level of BMD than the other patients (P ＜ 0.05).SOS,SOS T,OSI and TI was correlated with one second forced expiratory volume percent predicted (FEV1％) (r =0.389,0.262,-0.295,0.265; P＜0.05),also correlated with PaO2 (r =0.391,0.100,-0.374,0.122;P＜0.05),and also correlated with CAT (r =-0.659,-0.463,0.175,-0.178 ; P ＜ 0.05).There was only a negative correlation between SOS and hs-CRP (r =-0.390,P ＜ 0.05).Further in Logistic regression analysis,the results showed that both PaO2 and FEV1％ were the risk factors of BMD reduction.Conclusions Patients with COPD have lower BMD than their peers of healthy.The reduction of blood oxygen pressure and lung function are the risk factors of BMD reduction.There is a conjecture that the reduced BMD is correlated with chronic inflammation in patients with COPD.

Objective To investigate the expression of transient receptor potential vanilloid subtype 1 (TRPV1) in uterosacral ligament and its correlation with pain in endometriosis.Methods Total of 54 patients undergoing endometriotic lesions excision in uteroscaral ligament by laparoscopy due to pelvic pain were enrolled in this study.According to visual analogue scale(VAS) scores,27 patients with VAS 5 - 10 were in group A and 27 patients with VAS 0 - 4 were in group B.In the mean time,20 patients with dysmenorrhea without endometriosis (VAS:0 -4 ) were matched as group C.Specimens (including the sacro-ligaments of 20 women without endometriosis) were immunostained with specific antibodies of TRPV1.Western blot and real time PCR were performed to detect TRPV1 expression in endometriosis lesions and control group.Results( 1 ) Immunohistochemnistry:the positive area of TRPV1 was found in endometriotic lesions in uterosacral ligament in group A,B and tissue of uterosacral ligament group C.The semi-qualitification of TRPV1 expression were 3 in group A, 1 in group B and 1 in group C by immunohistochemistry staining.There was significantly different expression between group B and group A ( P =0.005 ) or group C ( P =0.027 ).(2) mRNA expression:the expression of TRPV 1 was 1.84 in group A,0.80 in group B,0.24 in group C,respectively.With higher VAS scores,the expression of TRPV1 exhibited increasing trends.The expression of TRPV1 mRNA was higher in group A than thai in group B ( P =0.022).There was statistically different expression between group B and group C ( P =0.031 ).( 3 ) Western blot:the expression of TRPV1 protein was 0.63 in group A,0.19 in group B,0.02 in group C.There was significant differences between group A and group B ( P =0.022 ),and between group B and group C (P ＜ 0.01 ).Conclusion The expression of TRPV1 was correlated with the degree of pain in patient with endometriosis.

Objective To evaluate the status of P-selectin and platelet activating factor(PAF) in vivo in patients with deep venous thrombosis(DVT) and to observe their changes under interneving of medicines.Methods P-selectin and PAF of fourty patients and twenty normal subjects were fluorescence labled with corresponding monoclonal antibodies by flow cytometry( FCM ) and immunologic method respectively. Results P-selectin and PAF in patients with DVT were higher than that in normal subjects in early period of the disease, and they significantly decreased in different time after patients were treated. P-selectin was significantly different between patients who received sodium ozagrel treatment and those who not (P ＜0.05 ), but PAF was similar( P ＞ 0. 05 )after fourteen days. One month later, P-selectin and D-dimer in DVT patients were lower than before. However, the positive rate of P-selectin of DVT was still higher than normal subjects. Conclusions The platelet is activated in vivo in patients with DVT, so does fibrinolysis. Sodium ozagrel can decrease activity of platelet. P-selectin and PAF may be used diagnostic markers. Post-discharge patients are still at high-risk and must be regularly followed-up.

Objective To explore and analyze the effect of standard large trauma improved operation ( slow decompression ) and standard large trauma conventional surgical procedures ( sudden decompression ) in the treatment of elderly patients with severe craniocerebral injury ( SCCI) .Methods 100 elderly patients with SCCI were randomly divided into the control group and the observation group ,50 cases in each group .The control group was treated with conventional methods ( standard large trauma traditional surgical treatment ) , the observation group was treated with standard large trauma surgery improved operation .The effects and postoperative complications were observed and recorded.Results 1d,3d,5d,15d after operation,the intracranial pressure of the two groups were (272.3 ±19.1)mmHg, (285.4 ±18.2) mmHg,(218.2 ±18.3) mmHg,(168.4 ±17.3) mmHg;(302.1 ±23.1) mmHg,(310.3 ± 19.2)mmHg,(221.1 ±19.2)mmHg,(148.2 ±16.4)mmHg,which were changed significantly compared with preop-eration,the intracranial pressure gradually decreased as time passed ,the decrease of intracranial pressure in the con-trol group was more obvious than the observation group .The incidence rates of epilepsy ,cerebral infarction ,hydroceph-alus in the observation group were 2.0%,6.0%,0.0%,which were significantly lower than those in the control group (30.0%,36.0 %,26.0%),the differences between the two groups were significant (χ2 =14.85,13.56,14.96,all P<0.05).The number of patients with good prognosis ,the residual in the observation group were significantly more than the control group , while the number of severely disabled and vegetative state patients in the observation group were significantly less than the control group ,(χ2 =4.88,3.93,4.33,7.44,all P<0.05).Conclusion Standard large trauma improved operation ( slow decompression ) can effectively reduce intracranial pressure in elderly patients with severe fluctuations ,reduce the incidence of complications ,improve treatment prognosis ,it should be popularized in clinical practice .

Developing enterprise education in medical colleges and universities must have the following basic conditions:renewing medical educationconcept;establishing a teacher troop on teaching enterprise;building a good enterprise education atmosphere and strengthening practice teaching.

Objective To determine the relationship between normal weight obesity (NOW) and cardiovascular risk factors.MethodsA total of 940 adults who received a health examination in out hospital were recruited in a cross-sectional study,and 407 with a body mass index (BMI) of18.5 to 25 kg/m2were enrolled for further analysis.Body fat percentage ( BF％ ) was measured by bioelectrical impedance analysis (BIA),and the subjects were assigned to the NOW group ( BF％ ≥25％ for male or BF％ ≥35％for female) or the control group ( BF％ ＜ 25％ for male or BF％ ＜ 35％ for female).Cardiovascular risk factors and their detection rates were compared between the two groups by using independent sample t test and x2 test.The correlationbetweenNOW and cardiovascular risk factors was assessedbylogistic regression.Results The prevalence of NOW in men and women were13.1％ and14.9％,respectively.The prevalence of NOW was increased with age ( x2 =6.90,P ＜0.05 ).Systolic blood pressure (SBP),diastolic blood pressure ( DBP ),total cholesterol ( TC ),triglycerides ( TG ),low-density lipoprotein cholesterol ( LDL-C) and serum uric acid (SUA) were significantly increased in the NOW group (t values were 2.97,2.44,2.54,5.09,2.71and 3.91,respectively; all P ＜ 0.05 ) ; whereas high-density lipoprotein cholesterol ( HDL-C) was significantly decreased in the NOW group (t =-3.90,P ＜ 0.05 ).The prevalence of hypertension,hyperglycemia,high triglyceride,low HDL-C,dyslipidmia and hyperuricemia was increased in the NOW group in comparison with the control group ( x2 values were 6.76,5.58,14.50,11.97,10.97 and 8.76,respectively;allP＜ 0.05 ).LogisticregressionshowedNOWincreasedtheriskof hypertension,hyperglycemia,dyslipidmia or hyperuricemia by 2.186,2.120,2.088 or 4.175 times.After adjustment for age and gender,the risk for hyperuricemia was decreased to 3.491,but remained statistically significant higher.Conclusions NOW may be correlated with cardiovascular risk factors,and those with NOW could be at higher risk for cardiovascular diseases.

Objective To evaluate the relationship of metabolic syndrome (MS) and MS components with thyroid nodule. Methods A total of 10 357 subjects ( age ＞ 18 years old) who received physical checkup at the Second Affiliated Hospital of Dalian Medical University between June 2009 and June 2010 were enrolled in this retrospective study. Anthropometric parameter, fasting plasma glucose (FPG),serum lipid profile, blood uric acid, alanine aminotransferase and thyroid ultrasonography were measured. Results The prevalence of thyroid nodule,MS,and thyroid nodule + MS was 46. 96% ,23. 6%,and 11.6%, respectively. The prevalence of thyroid nodule was significantly higher in MS patients than in non MS patients ( 75.9% vs 38. 0%, P ＜ 0. 05 ). Multifactor logistic analysis showed that MS, body mass index (BMI) and FBG (β vales were 0. 78,1.22,and 0. 62,respectively; odds ratios were 4. 167,3. 876,and 2. 359, respectively; all P ＜ 0. 05 ) were independently correlated with the development of thyroid nodule. Conclusions Significantly increased prevalence of thyroid nodule could be found in MS patients. BMI and FBG may be independent risk factors of thyroid nodule.

Objective To obtain area strain parametersuse of left ventricle in patients with coronary heart disease (CHD) by three-dimensional speckle tracking imaging(3D-STI),evaluate the systolic function and synchronization of left ventricle depending on different degrees of coronary artery stenosis,and then search new evidence for evaluation and diagnosis of the systolic function of left ventricle.Methods 94 patients were recruited diagonosed as CHD were recruited and their 3D-STI dynamic images were stored 24 hours before coronary angiography.All patients were divided into three groups (the severe stenosis group,the moderate stenosis group,and contrast group) according to the results of coronary angiography.Then the conventional echocardiographic parameters,area strain(AS),area strain dyssynchrony index(ASDI),and the standard deviation of the peak time of AS(AS-SD) were measured.Results There were no significant differences among conventional echocardiographic parameters of the three groups.Compared to the moderate stenosis group and the contrast group,the AS,ASDI and AS-SD of the severe stenosis group were significant different (P ＜0.001),however there were no differences between the moderate stenosis group and the contrast group (P ＞0.05).The ROC curve showed that the diagnostic value was the highest to detect severe stenosis when using ASDI≥1.90％ as the cutoff value,with 84.2％ of the sensibility,and 94.1％ of the specificity.Conclusions The area strain parameters of 3D-STI are effective indice as clinical references to evaluate the systolic function of left ventricle and the degree of coronary artery stenosis,in particular,the ASDI is the most effective parameter.

Objective To study the effect of rosiglitazone, a ligand of peroxisome proliferator-activated receptor gamma (PPAR?), on the expression of PPAR? in hepatic stellate cells (HSCs) and its effect on the biological characters of HSCs. Methods The activated HSCs were devided into three groups:control, 3??mol/L rosiglitazone group, and 10??mol/L rosiglitazone group. The expression of PPAR?, ?-smooth muscle actin(?-SMA), and type Ⅰ and Ⅲ collagen was detected by means of RT-PCR, Western blot and immunocytochemistry respectively. The cell proliferation was determined with MTT colorimetric assay. The cell apoptosis was demonstrated with flow cytometry. Results The expression of PPAR? at mRNA and protein level markedly increased in HSCs of 10??mol/L rosiglitazone group(t≥4.627, P

ObjectiveTo explore the bone anabolic effects after a single local injection of simvastatin into femoral cavities of osteoporotic rats.MethodsThirty-six female SD rats(3 months old,body weight 250-300 g) were ovariectomized(OVX) and low-calcium-diet fed for 3 months,OVX rats were randomized into 3 groups(n=12).Left femurs of group A,B and C were injected with 0,5 and 10 mg simvastatin,respectively.Half of the rats in each group were randomly euthanized separately 1 and 5 months after simvastatin injection.Left femurs were taken out for bone mineral density (BMD) assessment with dual energy X-ray absorptiometry,bone histomorphometic changes were analysized by Micro-CT,and two kinds of biomechanical tests were used to evaluate the osteogenic effects.ResultsOne and five months after injection,BMD in mid-diaphysis significantly increased in simvastatin-injected groups compared to the control group.For Micro-CT analysis,significant increase in total bone volume/total tissue volume,cortical wall thickness,trabecular thickness,trabecular number,and a significant decrease in trabecular spacing were observed in simvastatin-injected groups compared to the control group.For both biomechanics (the three-pointbreaking test of condyles and axial compressive testing of proximal femur),the values were significantly higher in simvastatin-injected groups than the control group.ConclusionLocal simvastatin treatment showed a positive effect on improving mechanical strength,structure of osteopenic femurs and BMD.Our findings may provide a new strategy for the prevention and treatment of osteoporosis,especially for osteoporotic fractures.