Objective To evaluate the diagnostic value of peripheral blood T-SPOT.TB and pleural effusion′s adenosine deami-nase(ADA)activity in patients with tuberculous pleurisy.Methods Sixty-two patients with suspected tuberculous pleurisy were enrolled in the study,whose peripheral blood T-SPOT.TB and pleural effusion ADA were measured and the best diagnostic thresh-old was determined by ROC curve.Results According to the diagnostic criteria of tuberculous pleurisy,24 patients were diagnosed with tuberculous pleurisy,33 were non-tuberculous pleurisy and 5 undiagnosed in the end.The sensitivity of T-SPOT.TB for the diagnosis of tuberculous pleurisy was 91.7 %,the specificity was 81.8%,Positive predictive value was 78.6%,negative predictive value was 93.1%.The ADA activity was (40.5±15.4)IU/L in tuberculous pleurisy group,which was higher than in non tubercu-lous pleurisy group[(2.4 ±9.5 )IU/L](P <0.01 ).The cut-off value of ADA was 22.5 IU/L in tuberculous pleurisy diagnosis, while its sensitivity and specificity were 83.3% and 84.8% respectively.The sensitivity of the combined detection of T-SPOT.TB and ADA was 95.8%.Conclusion The combined detection of peripheral blood T-SPOT.TB and pleural effusion ADA has a higher sensi-tivity in diagnosis of tuberculous pleurisy,and has important auxiliary diagnostic value for patients with suspected tuberculous pleurisy.

New studies have shown that metabolism of bone is controlled by the central nervous system.Gonadotropins secreted by the anterior pituitary stimulate the formation and function of osteoclasts which are closely related to the bone turnover and changes of bone mass. This study overviews the relationship between gonadotropins and bone metabolism.

The osteocyte has been found to be an orchestrator of bone remodeling.The damage of bone leads to osteocyte apoptosis.Sclerostin secreted by osteocyte causes feedback inhibition of bone formation,so inhibition of sclerostin expression has become a new target of treatment for osteoporosis.It seems resonable to direct clinical practise and treatment of metabolic bone diseases through understanding the function of osteocyte in the process of bone remodeling.

Objective To observe the effect of 17? estradiol (E 2) on the expression of membrane type 1 matrix metalloproteinase (MT1 MMP) in human osteosarcoma cell line MG 63. Methods The expression of MT1 MMP protein in MG 63 cells were assayed with Western blot and immunohistochemical method. The activity of MMP 2 was determined by gelatin zymogram and ELISA. Results Treatment with different concentrations of E 2 in MG 63 cells resulted in a dose dependent enhancement in expression of MT1 MMP protein (P

Objective To compare bone mineral density(BMD) at relevant measurement sites between two hips in normal subjects. Methods BMD was measured by dual energy X-ray absorptiometry(DEXA) in the two hips in 70 normal volunteer, 15 to 86 years of age(mean age 53 years). Result Highly significant correlations were found between BMD of the two hips at every measurement sites(r=0.696～0.979, P<0.001),There were small(approximately 2%～3%)but significant differences between BMD of the two hips , The right hip BMD were consistently higher than the left hip BMD at relevant measurement sites (P<0.01)； There were significant positive correlation between BMD and body weight(r=0.289～0.488, P<0.05)except Ward’s triangle. Conclusions BMDs of the two hips are highly correlated at relevant measurement sites; There are strong agreement between BMD of the two hips.

Objective To study the changes of microarchitecture, bone mineral density (BMD) , and bone mineral content (BMC) in apolipoprtein E knockout( ApoE-/-) mice. Methods Male ApoE-/- mice at 15, 28, and 40-week of age and sex-age-matched wild-type (WT) mice were involved in the study. The trabecular and cortical bone microarchitecture were assessed by micro-CT( μCT) in the right distal femur. The total body BMD of the left femur was determined by dual-energy X-ray absorptiometry ( DXA). The relationships among BMD, microarchitecture, and BMC were analyzed. Results Compared with WT mice,the advancing age ApoE-/- mice showed an increased volumetric BMD (vBMD), tissue BMD (tBMD) , BMC, bone volume fraction (BV/TV), trabecular number (Tb. N ) , trabecular thickness (Tb. Th) with an decreased bone surface fraction ( BS/BV), trabecular separation (Tb. SP) , and the structure mode index (P <0. 05 ) in the cancellous bone of femur. The cortical bone microarchitecture parameters as inner perimeter, outer perimeter, cortical area, marrow area, total area and moment of inertia were also increased, but cortical BMD, cortical bone mineral content (C. BMC) and cortical thickness retained constant. At the age of 28 weeks,the total body BMD in ApoEE-/- mice revealed higher than WT mice (P<0. 05) and there was no changes in 15 and 40-week-old mice compared with the sex-age-matched controls. vBMD was positively correlated with BMC, BV/TV,Tb. Th, BS/BV, and C. BMC, with the correlation coefficients 0.955,0.944,0. 834,0.923, and 0.903 .respectively, and there was no correlation between vBMD and the other parameters. Conclusions ApoEE-/- mice display an increased bone mass, suggesting that ApoE has an important role in bone remodeling.

Dual-energy X-ray absorptiometry(DEXA),scanning electron microscopy,and bone biomechanical test were used to assess comprehensively bone quantity and quality of ovariectomized rats. In OVX rats,not only bone mineral density (BMD) of lumbar vertebrae in vivo and vitro,but also BMD of femora (except for R3 region) and proximal metaphysis(R1 region) in vitro decreased obviously (P<0.01)，whose bone loss rates of L5 and L6 were the highest and achieved 13%; the trabeculae of OVX rats were few，fine, and discontinued and there were lacunae on the surface;in OVX rats,both compressive strength of vertebral bodies and the mechanical properties of femora decreased;the falling degree of the former was greater;the maximal compressive power of lumbar vertebrae decreased with 33.32%. We conclude that after 4-month post-ovariectomy, the bone quantity and quality of six-month-old rats decreased, especially in the area of abundant cancellous bone such as vertebral bodies,distal femora; the assessment of the efficiency of new drugs to prevent and treat postmenopausal osteoporosis using rat models should include these drugs' effects to the bone mass, the bone structure, and the bone strength.

Objective To summarize experience to prevent the main postoperative complications after hypospadias repairs. Method The clinical data of 189 cases of hypospadias repairs was from May 2005 to August 2010,retrospectively analyzed. Results One hundred and seventy-four cases were surgically cured by single-stage operation. All cases had been followed up for 4-36 (18.5 ± 5.5) months, the cases who had become adults were normal penile development and erectile function. Postoperative complications occurred in 15 cases,9 cases of them were urethral fistulas,6 cases were urethral strictures,all were cured or improved after symptomatic treatments. Conclusions Some methods are necessary to raise single-stage urethroplasty success rate and decrease the incidence of fistulas and strictures, such as preoperative antibiotic prophylaxis,appropriate procedure,intraoperative suprapublic urinary diversion,the good blood supply of the flap, modified enswathement, postoperative manage and nursing.

Objective To observe and compare the changes of bone mass and microarchitecture in ovariectomized rat left tibia by dual energy X-ray absorptiometry(DXA)and microCT(μCT).Methods Forty seven-month-old SD rats were randomly divided into ovariectomized(OVX)and sham-operated(SHAM)groups,twenty in each group.After killed at 3 weeks and 15 weeks post-surgery,DXA scanning were performed in the left tibia in vitro.The images of left tibia were divided into seven isometric regions of interest(ROI1-7).When analysis finished,bone density(BD)of each ROI and the total bone were determined.The samples were fixed by 4% paraformaldehyde and then placed in the specimen holder filled with deionized water.The sensitive regions for bone mass changes were selected for scanning by Fluro.After scanning,the regions involving 0.4mm slice thickness and 2.5mm distance far end from tibial growth plate were selected as the ROI of cortical bone analysis.The regions selected as ROI of cancellous analysis,were involved in 1.2mm slice thickness and 0.7mm distance at the far end from tibial growth plate.After three dimension reconstruction.2D images of the maximum intensity projection and pictures of 3D microarchitecture were obtained.and BD and microarchitectural parameters were quantitatively identified.All data was statistically processed with SPSS for Windows.Results At the 3rd week,BD of ROI1 in rat left tibia in OVX(0.2346±0.0280)g/cm2 was much lower than that(0.2660±0.01990)g/cm2 in SHAM(P＜0.05).While at the 15th week,BD of ROI1(0.2527±0.0161)and ROI2(0.1862±0.0052)g/cm2 in OVX were both lower than SHAM(0.2793±0.0229)and(0.1986±0.0102)g/cm2 respectively,P＜0.01 for both).Compared wim SHAM rat[cortical area(Ct-Ar)=(0.3138±0.0621)mm2,marrow area(Ma-Ar)=(8.44±1.25)mm2,total area(T-Ar)=(8.75±1.26)mm2,moment of inertia(Mm)=(3.485±0.373)mm4],there were significant increases in Ct-Ar(0.4306±0.1308)mm2,Ma-Ar(10.31±1.98)mm2,T-Ar(10.74±2.05)mm2,and Mm(4.101±0.726)mm4 in OVX mice at the 3rd week(P＜0.05 for all).While at the 15th week,only cortical thickness(Ct-Th)(0.0235±0.0024)mm showed a decrease in OVX group(P＜0.05).In OVX group,Ct-Th(0.0235±0.0024)mm and Ct-Ar(0.2528±0.0367)mm at 15 weeks were lower than that[Ct-Th=(0.0377±0.0098)mm,Ct-Ar=(0.4306±0.1308)mm2 at 3 weeks(P＜0.01 for both)].In SHAM group,inner perimeter(In-Pm)(13.38±0.54)mm,outer perimeter(Ot-Pm)(13.59±0.56)mm and Mm(4.096±0.364)mm4 at 15 weeks were higher than that[In-Pm=(12.41±0.74)mm,Ot-Pm=(12.63±0.75)mm,Mm=(3.485±0.373)mm4 at 3 weeks(P＜0.01 for all)].OVX rats had much lower volume BD(vBD)(288.2±48.2)mg/mm3,tissue BD(tBD)(604.5±45.3)mg/mm3,bone volume fraction(BVF)(25.1±5.1)%,and trabecular mumeer(Tb-N)(6.04±2.94)mm-1(P＜0.01 for all),but higher structure model index(SMI)3.09±0.27 and trabecular separation(Tb-Sp)(0.186±0.129)mm than SHAM 2.63±0.21 and(0.078±0.038)mm respectively at the 3rd week(P＜0.01 and P＜0.05 respectively).At the 15th week,vBD(271.2±50.9)mg/mm3,BVF(21.6±5.2)%and Tb-N (3.21±1.92)mm-1 in OVX were still lower than SHAM[vBD=(389.8±77.0)mg/mm3,BVF=(30.9±6.0)%,Tb-N=(7.44±3.53)mm-1 respectively(P＜0.01 for all)],SMI 3.11±0.36 and Tb-Sp(0.370±0.215)mm in OVX were also higher than SHAM 2.58±0.36 and(0.141±0.104)mm(P＜0.01 for both),but no significant difference of tBD could be found.In OVX group.the scores of tBD(691.0±36.7)mg/mm,Tb-Th(0.040±0.009)mm,Tb-N(3.21±1.92)mm-1,Tb-Sp(0.370±0.215)mm in the 15th week were higher than that[tBD=(604.5±45.3)mg/mm,Tb-Th=(0.030±0.002)mm,Tb-N=(6.04±2.94)mm-1,Tb-Sp=(0.186±0.129)mm respectively]in the 3rd week (P＜0.05 for all),while there were no differences between the 3rd and the 15th week in SHAM group.Conclusions DXA is weak in detecting the tiny changes of BD though it is convenient and non-invasive.μCT is suitable to detect the changes of bone mass and microarchitecture.

Objective The aim of this study was to investigate the femoral head trabecular heterogeneity in Chinese male patients with osteoporotic fracture and their effects on osteoporotie fracture.Methods Human femoral heads were obtained from 11 male osteoporotie fracture (OP) patients ranged from 51 to 82 years old [average age (65±9 ) years old], and 7 male trauma ( TM ) patients ranged from 46 to 75 years old [average age (61±11 ) years old] who underwent total hip arthroplasty within two hours after either osteoporotic or trauma hip fracture.The OP was defined as having a fragility fracture.After laying femoral head as living body position and locating mark, nine trabecular specimens were obtained from femoral heads, each of 6 mm × 6 mm× 7 mm.The cortical shell was not included in each specimen.One cube was selected as the primary compressive trabecular region and the other 8 specimens as non-primary compressive trabecular region.These cubes were scanned using high-resolution microcomputed tomography scanner (μCT).After scanning, the data of total cubes, primary compressive trabecular region and noncompressive trabecular region were used for analysis by t test.Results In OP group volumetric bone mineral deosity(vBMD) [( 182.15±66.00) mg/mm3 vs (223.97±70.92) mg/mm3, t =3.041], tissue bone mineral density (tBMD) [(538.76±64.72) mg/mm3 vs (580.01±63.86 ) mg/mm3, t = 3.160],bone volume fraction (TV/BV) [(0.22 ± 0.06) % vs (0.26 ± 0.07 ) %, t = 2.821], trabecular thickness (Tb.Th.) [( 161.07 ±42.75 ) μm vs ( 205.47 ± 74.44 ) μm, t = 3.233] were significantly decreased while bone surface/bone volume ( BS/BV ) [( 13.75 ± 2.55 ) mm-1 vs ( 12.28 ± 2.70 ) mm-1, t =-2.777] was significantly increased in the non-primary compressive trabecular region than that in the primary compressive trabecular region ( P < 0.05 ).vBMD [( 182.15 ± 66.00) mg/mm3 vs ( 248.05 ±105.48) mg/mm3, t = - 3.598], tBMD [(538.76 ± 64.72) mg/mm3 vs ( 570.54 ± 100.32) mg/mm3,t=-2.108],TV/BV [(0.22±0.06) % vs (0.28±0.12) %, t= -3.466], Tb.Th.[(161.07±42.75) μm vs (200.31 ±96.63) μm, t= -2.866], trabecular number (Tb.N.)[(1.46±0.23)/mm3 vs ( 1.57 ± 0.29)/mm3, t = - 2.396] were significantly decreased while trabecular separation ( Tb.Sp.) [(780.82 ± 144.85 )μm vs ( 653.09 ± 119.64) μm, t = 5.470], degree of anisotropy (DA) ( 1.57±0.20 vs 1.47±0.18, t = 2.930 ) were significantly increased in OP than in TM in the non-compressive trabecular region( P < 0.05 ).No significant differents were found between OP and TM for any of the parameters measured in the primary compressive trabecular region.Tb.Th.[(199.37±68.22)μm vs (176.33 ±71.21 )μm, t = 2.060,P < 0.05] were significantly increased in the primary compressive trabecular region than that in the non-primary compressive trabecular region and no significant differences were found in the other parameters in the all 18 specimens.Conclusions The femoral head trabeculae had a heterogenic distribution in OP.Bone loss in OP primarily takes place in non-compressive trabecular region.Femoral neck fracture cannot be prevented though the bone microstructure do not loss in the primary compressive trabecular region.Tb.Th.in the femoral head could be an interesting parameter which is closely related to the femoral neck fracture.