Objective To investigate the clinical efficacy and safety of cryoablation combined with zoledronic acid sequential therapy for bone metastases pain. Methods Twenty-four patients from our depart-ment suffering from malignant tumors with moderate to severe pain due to bone metastases were enrolled in this study. Those patients with 28 metastatic bone tumors were successfully treated with cryoablation operations under CT-guided. Three days after cryoablation they were offered zoledronic acid(4 mg added in 100 ml normal saline,dripping for more than 15 min),once 4 weeks. Pain level and life quality were respectively evaluated by NRS(Numerical rating scale)and KPS(Karnofsky performance status),before cryoablation,3 days after cryoablation,2 weeks and 12 weeks after zoledronic acid sequential therapy. Results Without serious compli-cations,all of 24 patients were successfully punctured to tumor lesions. Patients’pain scores were 7. 70 ± 0. 86 (before cryoablation),3. 29 ± 0. 95(3 d after cryoablation),2. 54 ± 0. 83(2 weeks after zoledronic acid sequential therapy)and 2. 17 ± 0. 76(12 weeks after zoledronic acid sequential therapy),with a significant sta-tistical difference between pretherapy and post-treatment(F = 530. 64,P < 0. 001);during observation period after treatment,the effective rate in pain was 91. 67% . KPS scores were 45. 83 ± 6. 54(before cryoablation), 49. 58 ± 6. 24(3 d after cryoablation),61. 67 ± 7. 01(2 weeks after zoledronic acid sequential therapy)and 78. 33 ± 8. 68(12 weeks after zoledronic acid sequential therapy),with a significant statistical difference between pretherapy and post-treatment(F = 418. 99,P < 0. 001);during observation period after treatment, the effective rate in KPS was 75. 00% . Six months after the treatment,there were 10 cases of CR,11 cases of PR,and the effective rate was 87. 50% . Conclusion Cryoablation combined with zoledronic acid may be an effective therapeutic method with good safety in the treatment of patients with bone metastases pain.

A 39-year-old female with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by lung lesions. The diagnosis of IgG4-related disease was confirmed by laboratory and pathological results. It should be alert to consider the possibility of IgG4-related disease in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as lung disease.

Osteoporosis(OS)is a systemic skeletal disorder characterized by low bone mass and increased risk of fracture.Bone mineral density(BMD)is a gold standard in the diagnosis of OS,but is not sensitive enough for detecting the earlier bone loss.Bone metabolic markers have high sensitivity and specificity.Therefore,they are able to reflect the early changes of bone mass and can be used to monitor the efficacy of anti-OS agents.This article summarizes the research advance in both traditional and newly identified bone metabolic markers.

[Summary] A 19-year-old male patient with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by cervical vertebra lesions.The diagnosis of Langerhans cell histiocytosis was confirmed by laboratory and pathological results.Therefore,it should be alert to consider the possibility of Langerhans cell histiocytosis in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as bone disease.

Nine compounds were isolated from the n-butanol fraction of 95% ethanol extract of the fruit of Alpinia oxyphylla Miq. with a combination of various chromatographic approaches, including MDS resin, silica gel, reverse phase C18 and preparative HPLC. On the basis of spectroscopic data analysis, they were elucidated as (1R, 4R, 10R)-1β, 4α-dihydroxy-11, 12, 13-trinor-5, 6-eudesmen-7-one (1), 1β, 4β-dihydroxy-11, 12, 13-trinor-8, 9-eudesmen-7-one (2), oxyphyllenone A (3), oxyphyllenone B (4), rhamnocitrin (5), staphylionoside D (6), benzyl-1-O-β-D-glucopyranoside (7), 2-O-β-D-glucopyranosyl-(1S)-phenylethylene glycol (8), and (S)-1-phenylethyl-β-D-glucopyranoside (9). Among them, compound 1 is a new sesquiterpene, named as oxyphyllenone C; compounds 8 and 9 are new natural products; compounds 2 and 6 were isolated from the genus Alpinia for the first time, and compound 7 was isolated from A. oxyphylla for the first time.

AIM: To determine the role of LOX-1/PPAR pathway in regulating expression of adhesion molecules elicited by oxidizing low density lipoprotein(Ox-LDL) through Lectin-like oxidized low-density lipoprotein receptor-1(LOX-1) in human umbilical vein endothelial cells(HUVECs).METHODS: HUVECs were incubated with Ox-LDL,poly(I),carrageenan or 15-deoxy-△12,14-prostaglanding J2(15d-PGJ2).PPAR mRNA and protein were examined by real time RT-PCR and Western blotting.ICAM-1 and E-selectin were detected by RT-PCR and Western blotting respectively.RESULTS: Ox-LDL increased PPAR expression in HUVECs,which was inhibited by pretreatment of HUVECs with LOX-1 blockers.Preincubation of HUVECs with 15d-PGJ2 attenuated the expression of intercellular adhesion molecule-1(ICAM-1) and E-selectin in response to Ox-LDL.Upregulation of ICAM-1 and E-selectin mediated by Ox-LDL were suppressed more significantly by the combination of 15d-PGJ2 and polyinosonic acid as compared to either 15d-PGJ2 or polyinosonic acid alone.CONCLUSION: The results indicate that Ox-LDL exerts a biphasic effects on inflammatory response.It evokes harmful effects by inflammatory injury on one side and protective effects by triggering the LOX-1/ PPAR signaling pathway on the other hand.

Objective To investigate the pathogenic bacterial distribution and drug resistance situation of multi‐drug resistant bacterial strain mixed infection among postoperative traumatic patients in Zaoyang area to provide a reference for clinical treatment . Methods A total of 71 traumatic cases of multi‐drug resistant bacterial strain mixed nosocomial infection were selected and per‐formed the bacterial culture and drug resistance analysis according to the samples taking from different infection sites .The the re‐sults were statistically analyzed .Results Among 71 cases of multi‐drug resistant strains mixed infection ,205 multi‐drug resistant strains of bacteria were isolated .Among them ,119 (58 .05% ) strains were Gram‐negative bacteria ,Gram‐positive bacteria was in 83 strians(40 .49% ) and fungus was in 3 strains(1 .46% ) .The resistance of Escherichia coli ,Klebsiella pneumoniae ,Enterobacter and Serratia to more than 10 kinds of antibacterial drugs was more than 50% ,which to ampicillin ,cephalothin ,cefuroxime ,azlocillin ,ce‐fotaxime cefuroxime ,azlocillin ,cefotaxime and cefoperazone was more than 80% ,while which to imipenem and amikacin was only 5 .88% and 28 .57% respectively .The resistance rates of Gram‐positive bacteria represented by Staphylococcus aureus ,Staphylococ‐cus epidermidis ,Staphylococcus haemolyticus and Streptococcus pneumoniae to penicillin G ,oxacillin and ampicillin generally reached 98 .80% ,97 .59% ,and 95 .18% respectively .No Gram‐positive bacteria was resistant to vancomycin ,in addition the resist‐ance to rifampin and chloramphenicol also was only 32 .53% and 34 .94% respectively .Conclusion In early stage of infection ,it is unable to determine the types of pathogenic bacteria and difficult to select sensitive antibacterial drugs ,under this occasion ,the com‐bination of imipenem and vancomycin is a good choice .

AIM: To explore the effect of anthocyanin on cholesterol efflux and elucidate its possible molecular mechanism. METHODS: Mouse Peritoneal macrophages were loaded with 50 mg/L AcLDL to induce macrophage-derived foam cells. Cholesterol efflux from macrophage-derived foam cells induced by anthocyanin was determined by enzymatic methods. PPAR-? mRNA and protein expression in macrophage-derived foam cells was assayed by quantitative PCR and western blotting. RESULTS: Anthocyanins had the capacity of promoting cholesterol efflux from mouse peritoneal macrophage-derived foam cells and increased PPAR-? mRNA and protein expression. CONCLUSION: Anthocyain-induced cholesterol efflux may be related to its enhancing PPAR-? mRNA and protein expression.

Objective To improve the serum quality controlling level ,in order to regularize and standardize the laboratory processes .Methods Gallery of hemolysis ,lipidemia or icterus serum specimens was established by Roche cobas p612 QSI camera system .The trouble serum specimens were screened out through taking photos of interfere serum and comparing with the gallery . The serum indexes of hemolysis ,lipidemia and icterus were detected respectively as reference information of inspection report .Com‐paring the results of 16 710 specimens detected by system screening and visual judgment ,the accuracy of QSI camera system was verified .Results 195 trouble serum pictures were elected in the gallery .The compliance rates of hemolysis ,lipidemia and icterus se‐rum specimen between QSI camera system and visual judgment were 94 .2% ,87 .4% ,and 60 .9% respectively .Conclusion The QSI camera system can replace visual judgment to screen the trouble serum specimens .

To evaluate effects of PDCA cycle in improving residency diagnosis and treatment ability of endocrine and metabolic diseases, this paper selected the problems of insufficient diagnosis and treatment ability in the results of the 2016 endocrinology examination paper as the research breakthrough point, and investigated 62 residents receiving standardized residency training to analyze main reasons of the problems such as "busy clinical work", "special clinical thinking" and "difficult to remember knowledge of endocrinology". The online teaching, daily self-education, following the law of memory to remember and re-recognize knowledge, strengthening the construction of teachers, improving teaching methods were used and evaluated. It’s found that the application of PDCA cycle can improve the residents' ability of clinical diagnosis and treatment in endocrine and metabolic diseases.