The bone turnover markers are composed of the metabolic products of bone matrix and bone cells.The changes of these markers in serum and/or urine represent the status of bone metabolism.To measure the level of these markers will offer important information for evaluating the diagnosis and the responses of therapy in metabolic bone diseases,and to predicat the risk of bone fracture.The biochemistry,measurement and clinical aplication will be introduced in this paper.

Objective:To explore the clinical effect of Qizhi Weitong granules combined with rabeprazole in the treatment of reflux esophagitis and the influence on the levels of gastrin and motilin. Methods:Totally 80 cases of patients with reflux esophagitis were se-lected, and then randomly divided into the observation group and the control group with 40 cases in each. The control group was treated with rabeprazole, and the observation group was treated with Qizhi Weitong granules additionally. After 4-week treatment, the clinical effect and the influence on the levels of gastrin and motilin in the two groups were compared. Results:By comparing the clinical effect and endoscopic curative in the two groups, the total effective rate of the observation group was 95. 0% and 92. 5%, which was obvious-ly higher than that of the control group. Compared with those before the treatment, the levels of gastrin and motilin in the two groups were significantly improved after the treatment, and the improvement of the observation group was obviously higher than that of the con-trol group with statistically significant difference (P<0. 05). Conclusion: Qizhi Weitong granules combined with rabeprazole in the treatment of reflux esophagitis is effective, which can greatly improve the levels of gastrin and motilin and is worthy of further clinical application.

Objective To investigate the kinesin family member 17 (KIF17) expression and cellular localization in the hippocampus and temporal lobe cortex in the rat lithium-pilocarpine model of epilepsy,and discuss its function in the epilepsy pathogenesis.Methods The animal model was established by lithiumpilocarpine induction in rats.Totally 49 adult healthy male Wistar rats were randomly divided into control group (n =7) and experimental group (n =42).The experimental group included 6 subgroups (n =7)according to sacrifice time (24 h,72 h,7 d,14 d,1 month and 2 months).The expression and localization of KIF17 were examined by western blot and double-label immunofluorescence,respectively.Results In rat hippocampus,the expression of KIF17 protein increased after the onset of seizure (the ration of KIF17/β-actin were:24 h 0.516 ± 0.196,72 h 0.742 ± 0.313),reached its peak in 7 days (0.888 +0.319)and then slowed down (14 d 0.770 ± 0.271,1 month 0.742 ± 0.261,2 months 0.714 ± 0.271),all of which were significantly higher than that in the control group (0.495 ± 0.203).And all the differences had statistical significance (t =7.051,4.974,7.419,8.795,8.264,6.676,all P ＜ 0.05).In rat cortex of temporal lobe,the expression of KIF17 protein increased after the onset of seizure and reached its peak in 30 d.The optical density ration in the experimental groups were higher than that in the control group.Doublelabel immunofluorescence disclosed that the KIF17 localized in the neurons,including excitable neurons and inhibitory neurons,but not in the astrocytes which were performed with anti-microtubule-associated protein 2,anti-brain-specific Na-dependent inorganic phosphate cotransporter,anti-glutamate decarboxylase 1 and anti-glial fibrillary acidic protein,respectively.Conclusion KIF17 may play a potential role in the pathogenetic mechanisms of the rat lithium-pilocarpine model of epilepsy.

Objective:To investigate the pediatricians' needs in the contents of continuing medical education (CME), and the influencing factors of participating in CME, so as to provide references for improving their vocational ability.Methods:Questionnaire survey was carried out for the pediatricians from county-level medical institutions in the nine provinces of China. The questionnaire contents included: basic information, CME contents needs, and influencing factors of participating in CME. SPSS 22.0 was used for chi-square test.Results:A total of 465 questionnaires was recovered, among which 463 were qualified, with a pass rate of 99.6%. Research showed that ① In terms of competency training needs, pediatricians had higher training demand for ability of diagnosis and treatment of children's diseases, pediatrics basic skills and skills related to children's health care, etc. Pediatricians with junior or intermediate title had higher training demand for ability of self-learning and access to learning resources ( P < 0.01); and pediatricians with senior title had higher training demand for teaching ability ( P < 0.05). ② In terms of pediatrics specialty content training needs, pediatricians had higher demand for neonatology, infectious, respiratory, critical medicine, developmental behavior and digestion in order. ③ Regarding the influencing factors of CME, too few opportunities to participate in training, too busy to have time to participate, and defects in curriculum arrangement were the main factors affecting the CME participation of pediatricians. Conclusion:Pediatricians with different professional title had different training needs for CME contents. Lack of CME resources, contradiction between work and study, and curriculum arrangement deficiencies might be the main influencing factors affecting the CME participation of pediatricians working at county-level medical institutions.

Objective:To explore the expressions of miRNA-17-92 (miR-17-92) cluster and mitofusin 2 (MFN2) protein in endometrial cancer (EC) and their clinical significances.Methods:A total of 72 EC tissues, 36 endometrial lesions of patients with endometrial atypical hyperplasia, and 22 normal endometrial tissues from total hysterectomy for grade Ⅲ cervical intraepithelial neoplasia in the Second Affiliated Hospital of Shandong First Medical University from January 2008 to December 2014 were collected; at the same time, all patients' paraffin-embedded tissues were collected. Real-time quantitative polymerase chain reaction was used to detect the expression level of miR-17-92 in each tissue. Immunohistochemical SP method was used to detect the localization and expression level of MFN2 protein in each paraffin-embedded tissue. The correlation of miR-17-92 and MFN2 protein with clinicopathological features of EC patients was analyzed. Kaplan-Meier method was used to draw survival curve of patients with different miR-17-92 and MFN2 levels, and log-rank test was made; Cox proportional hazard regression model was used for multivariate survival analysis.Results:The relative expression of miR-17-92 in EC, atypical hyperplasia and normal endometrial tissues were 1.49±0.46, 1.01±0.30 and 0.69±0.20, respectively. The expression of miR-17-92 in EC tissues was higher than that in the other endometrial tissues, and the differences were statistically significant (both P < 0.01). The high-expression rates of MFN2 protein in EC, atypical hyperplasia and normal endometrial tissues were 20.8% (15/72), 39.4% (13/33) and 85.0% (17/20); the high-expression rate of MFN2 protein in EC tissue was lower than that in the other endometrial tissues, and the differences were statistically significant (both P < 0.012 5). In EC patients, the relative expression of miR-17-92 in patients with histological type Ⅱ was higher than that in patients with histological type Ⅰ ( P < 0.05); the relative expression of miR-17-92 in patients with myometrial invasion depth ≥1/2 were higher than that in patients with myometrial invasion depth <1/2 ( P < 0.05). The high-expression rate of MFN2 protein in patients with histological type Ⅰ was higher than that in patients with histological type Ⅱ ( P < 0.05); the high-expression rate of MFN2 protein in patients with International Federation of Gynecology and Obstetrics (FIGO) grade Ⅰ was higher than that in patients with FIGO grade Ⅱ and Ⅲ ( P < 0.05). When the EC patients were grouped according to the median relative expression of miR-17-92 (1.421), Kaplan-Meier survival analysis showed that the median overall survival (OS) time of the miR-17-92 low-expression group (36 cases) was not reached, and the high-expression group (36 cases) was 36 months (95% CI 32-42 months), and the difference in OS between the two groups was statistically significant ( P = 0.049); the median OS time of the MFN2 high-expression group (15 cases) was not reached, and the low-expression group (57 cases) was 38 months (95% CI 33-41 months), and the difference in OS between the two groups was statistically significant ( P = 0.046). Multivariate Cox regression analysis showed that the expression levels of miR-17-92 and MFN2 were independent influencing factors for the survival of EC patients ( HR = 3.10, 95% CI 1.36-7.07, P = 0.007; HR = 0.30, 95% CI 0.09-0.99, P = 0.048). Conclusion:The high-expression of miR-17-92 and low-expression of MFN2 protein in EC tissues may be involved in the occurrence and development of EC, and they can be used as indicators for judging the prognosis of EC patients.

Objective To investigate the related factors of hemichorea.Methods 15 patients with hemichorea were analyzed retrospectively,including their clinical features,characteristics of neuroimaging and treatment.They were followed up for 0.5～4 years.Results The serum glucose increase in 11 cases.The lacunar cerebral infarctions in the area of basal ganglion were found in 5 patients,and the microvessel lesions in the area of basal ganglion resulted from diabetes mellitus in 10 patients.13 patients accepted medicine treatment,11 cases improved,1 case was ineffective,1 case deteriorated.Conclusion The hemichorea mainly related with cerebrovascular disease.The hemichorea due to diabetes mellitus may related with the ischemic or hemorrhagic microvessel lesions.

ISO 15189:2012Medical laboratories-Requirements for quality and competence was issued on November 1,2012,which replaced the second edition (ISO 15189:2007 Medical laboratoriesParticular requirements for quality and competence).A study on changes in new edition standard will facilitate medical laboratories,regulatory authorities,accreditation bodies to have a good understanding of requirements of this new edition.An implementation of new edition will assist medical laboratory to improve their management to continually meet requirements of international standards.To enable stakeholders mentioned above have a good understanding and application of this new edition,changes in new edition were discussed in depth in this article.

OBJECTIVE To learn about the factors affecting the quality of the air in operating-rooms and discuss the methods of improving their air quality.METHODS The dynamic and static air bacteriology between laminar air flow operating-room and normal operating-room of a fertiary care level hospital of grade Ⅰ in Changchun were observed.RESULTS The passing rate of samples for air static bacteriology between two types of operating rooms at the begining of selective operations(T0) was without difference.At the begining of emergency operations,there was a disparity.The total number of bacteria in normal operating-room increased with the operating-time,but in the laminar flow operating-room,the total number of bacteria increased in fluctuations during the(T2) time(60 ming since operation begain),and descended dramatically during the(T3) time(90 min since operation).CONCLUSIONS The emergency and operation-time are the main factors affecting the air quality in operating-room and the cleaning air-condition could improve the air quality.

4 h,and for class Ⅰ and class Ⅱ operation.

Objective: To study the relationship between Framingham risk score for coronary artery disease (CAD) and cognitive function in healthy community elders.
Methods: A total of 276 healthy community elders were evaluated by Framingham score to predict the risk for suffering from CAD in 10 years. The subjects were divided into 3 groups. High risk group (the risk > 20%), n=46, Mid risk group (the risk at 10%-20%), n=76 and Low risk group (the risk < 10%), n=154. The cognitive function was measured by mini-mental state examination (MMSE) and China adult intelligence scale (CISA). The differences of cognitive function levels to 3 CAD risk groups were studied.
Results: With the increased CAD incidence from Low risk, Mid risk to High risk groups, the MMSE score reduced accordingly (26.9 ± 1.45) vs (24.3 ± 1.53) vs (22.2 ± 1.43), P=0.014. Pearson analysis presented that MMSE score was negatively related to Framingham risk score (r=-0.213, P<0.001). There were several elements of cognitive function related to Framingham risk score including MMSE score, question answering, grid filling, oral arithmetic and word distinguishing (r=-0.247), (r=-0.167), (r=-0.132), (r=-0.152) and (r-0.256), all P<0.05.
Conclusion: CAD risk level was negatively related to cognitive function, the higher Framingham risk score resulted in the lower cognitive function in healthy community elder subjects.