Objective To investigate the effects of Leptin on the base of anthropometry,densitometry,and biochemistry and reveal the role of Leptin in bone metabolism in postmenopausal women with osteoporosis (OP).Methods From January 2008 to January 2014,data of 82 postmenopausal females with or without OP were analyzed.They were randomized into two groups:OP (n=40) and conditional control group (CON) (n=42).The expression of Leptin receptors in osteoblasts was observed by immunohistochemistry.1 × 10 ng/ml,1 × 102 ng/ml,1 × 103 ng/ml,1× 104 ng/ml of Leptin were added respectively.Then the proliferation,differentiation and mineralization of osteoblasts were measure at 24 h,48 h and 96 h.The gene expressions of bone marrow mesenchymal stem cells (BMSCs) derived osteoblasts and adipocytes treated with Leptin were examined by quantitative analysis of Real time-PCR.Results The expression of Leptin receptors in osteoblasts was observed on plasma membranes and cytoplasm in the normal group and osteoporosis group.In osteoporosis group,different concentrations of Leptin enhanced cell proliferation,cell differentiation and cell mineralization.The growth rate of MTT and the concentration of ALP in the serum of were significantly increased with the effects of 1×10 ng/ml,1×102 ng/ml and 1×103 ng/ml of Leptin,and the action of 1×102 ng/ml Leptin was the most powerful with time dependence.Within 96 hours,the growth rate of osteoblasts increased gradually,and the concentration of ALP increased gradually in 3 weeks.The expression of RANKL/OPG in bone marrow BMSCs derived osteoblasts treated with Leptin were significantly increased.Conclusion Leptin receptor is present in osteoblasts,and Leptin affects biological behaviors of osteoblasts through receptors.The direct effect of Leptin may relate the expression of RANKL/OPG.Then,the balance between bone resorption and bone formation was broken and finally osteoporosis occurred.Lepin may promote osteogenesis and inhibit bone resorption in the differentiation of BMSCs.

Objective To observe the effects of low frequency electrostimulation(LFES)on sleep disorder of patients after acute cerebral infarction(ACI)as evaluated by using polysomnography,and on the recovery of neurological deficits. Methods Seventy cases of acute cerebral infarction were randomly divided into two groups,a treatment group and a control group.Both groups were treated with routine drugs, and the treatment group was also treated with LFES in addition.The changes of neurological deficits(ND) scores and such parameters of polysomnography as sleep latency(SL),total sleep time (TST),sleep efficiency(SE%),sleep maintenance(SMT),rapid eye movement sleep(REM),REM latency(RL),REM time(RT),REM activity(RA),REM density(RD).stage 1 sleep(S1),stage 2 sleep(S2)and deep sleep (S3+4) were observed.Results It was shown that,after treatment,both groups got significant improvement in terms of the ND scores and all the polysomnography parameters except RA,S1 and S2,(P<0.01),and the treatment group improved to a significantly greater extend when compared with the control group (P<0.01).Conclusion It is concluded that LFES could promote recovery of neural function and sleep disorder of ACI patients.

Objective To assess the correlation between the shear wave velocity(SWV) and the ratio of type Ⅰ /type Ⅲ collagen fibers in plaques using virtual touch tissue imaging quantification(VTIQ).Methods Fifty four patients (54 plaques) who scheduled to carotid endarterectomy(CEA) were enrolled in this study.Their carotid plaques were preoperatively examined using VTIQ.The value of SWE of each plaque was obtained.The SWV of the plaque was evaluated by VTIQ.The endarterectomy specimens were transferred to the pathological department immediately after surgery to evaluate the plaque types and the distribution of collagen fibers in plaques.According to HE staining,the 54 plaques were divided into stable and unstable group.Results Among 54 plaques,14 were stable plaque and 40 were unstable plaques.The thickness and stenosis rate had no significant difference between stable group and unstable group (both P ＞ 0.05).The mean value of SWV and the ratio of type Ⅰ/typeⅢ collagen fiber in stable plaques were higher than those in the unstable plaques (both P ＜0.05).Based on ROC analysis,a cut-off value of SWE of 3.725 m/s (AUC=0.936) showed a sensitivity of 92.9％,a specificity of 80.0％ and an accuracy of 83.3％ for predicting stable plaques (95％ CI 0.818-0.982,P ＜0.05).The value of SWVs was closely correlated to the ratio of type Ⅰ/typeⅢ collagen fiber in plaques(r =0.882,P ＜0.05).Conclusions SWV of the carotid atherosclerotic plaque can be used to reflect the ratio of the type Ⅰ/typeⅢ collagen fiber in the plaques,and to evaluate the stability of plaque.

Objective To study the application of contrast-enhanced ultrasonography (CEUS) in the evaluation of the stability of carotid atherosclerotic plaque (CAP).Methods 162 patients with CAP were selected as study group.Meanwhile,34 patients with carotid artery strong echo plaques were selected as control group.The color doppler ultrasound was used to observe the CAP.Results The proportions of lipid type,fiber type,calcification and ulcer plaque in the study group were 21.60%,33.33%,34.57% and 10.37%,which were higher than those of the control group (5.88%,2.94%,2.94% and 2.94%),the differences were statistically significant (χ2=4.537,12.859,13.629 and 3.855,all P<0.05).There were 75 patients of soft plaques,36 patients with mixed plaques,51 patients with hard plaque in 162 patients.The new blood vessels classification in soft plaque group (36.00%,45.33% and 10.33%) were higher than the mixed plaque (30.56%,41.67% and 8.33%) and hard plaque group (31.37%,13.72% and 7.84%).The peak intensity (-86.41±7.81) %,tmax (8.34±1.62)s,mean transit time (24.18±8.67)s in the soft plaque group were significantly lower than the mixed plaque [(-100.73±6.52)%,(9.79±2.14)s and (28.93±9.11)s] and hard plaque patients [(-104.14±6.15)%,(10.23±2.33)s and (30.07±9.48)s],the differences were statistically significant (t=9.518,6.966,2.658,13.592,5.374 and 3.064,all P<0.05),but there were no statistically significant differences between mixed plaque and hard plaque (all P>0.05).The plaque diameter (4.13±0.75)mm diagnosed by CEUS was significantly larger than that of conventional ultrasound [(3.62±1.14)mm],the difference was statistically significant (t=4.757,P=0.000).Conclusion The CEUS can qualitatively detect the atherosclerotic plaque angiogenesis,can quantitatively assess plaque,evaluate the stability of the plaques,and the sensitivity is high.

Objective To investigate the epidemiology of adults acute viral gastroenteritis in Shanghai Changning district. Methods All of 1 554 stool specimens of adults acute gastroenteritis in Shanghai Changning district from June 2010 to December 2013, and the enzyme-linked immunosorbent assay and multiple polymerase chain reaction was used to detecte different viruses. Results In all of 1 554 cases, the average age was (46.19 ± 15.59) years. Among them, 691 persons were male, 863 persons were female. Virus infection was detected in 407 cases, and the detection rate was 26.19%. Among them, 395 cases (97.05%) were single virus infection, and 12 cases (2.95%) were mixed infection. The peak of epidemic was from every November to next February. The incidence of watery diarrhea, vomiting and fever in virus positive group was significantly higher than that in virus negative group:95.09%(387/407) vs. 88.14%(1 011/1 147), 31.20%(127/407) vs. 18.83%(216/1 147), and 11.06%(45/407) vs. 7.59%(87/1147), P<0.01 or<0.05. Conclusions Rotavirus infection is common in adults with acute viral gastroenteritis. Patients with positive virus infection had a higher incidence of watery diarrhea, vomiting and fever. The peak of epidemic is winter.

Objective To retrospectively evaluate and analyze the clinical effect of posterior pedicle subtraction osteotomy in treating chronic, posttraumatic thoracolumbar kyphosis. Methods Nineteen patients (11 males and 8 females) with chronic, posttraumatic thoracolumbar kyphosis were corrected surgically. The patients were at age range of 29-61 years (mean 42 years). Preoperative kyphosis Cobb angle ranged from 31° to 63° (mean 47°) and trauma history ranged from 8 months to 63 months (mean 29 months). All patients were treated with pedicle subtraction osteotomy according to the size of Cobb angle, extent of spinal stenosis and source of compression. Results Sagittal alignment was improved to average 40.2°, with a correction rate of 85.8%. Two patients developed postoperative leakage of cerebrospinal fluid. Among them, one was combined with encephalic infection and cured with active treatment, and the other developed postoperative wound infection, which were treated conservatively with antibiotics and local wound care. There were no other severe complications. The average follow-up period was 15 months (range 6-41 months). At the last follow-up, clinical symptoms and neurological function were improved significantly. Neither loss of correction nor failure of internal fixators was observed. X-ray and dynamic X-ray films showed a 100% fusion in all patients. Conclusions The single-stage posterior pedicle subtraction osteotomy is a safe and effective procedure for correction of posttraumatic thoracolumbar kyphosis. It is possible and safe to obtain a correction within 55° on single segment by this technique.

OBJECTIVETo investigate the effects of exogenous hydrogen sulfide (H2S) on β-site APP cleaving enzyme 1 (BACE-1) and β-amyloid peptide (Aβ) metabolism in primary culture of neurons under high-glucose condition.

METHODSThe cortical neurons in primary culture under normal and high glucose (60 mmol/L) conditions for 24 h were exposed to 25, 50 and 100 µmol/L NaHS. Aβ1-42 concentration in the cell culture was measured by ELISA, and BACE-1 mRNA and protein levels were detected by fluorescent quantitative real-time PCR and Western blotting, respectively.

RESULTSCompared with the neurons cultured in normal glucose, the neurons exposed to high glucose showed significantly increased Aβ1-42 concentration and BACE-1 mRNA and protein expressions (P<0.05). Exposure to 25, 50 and 100 µmol/L NaHS significantly decreased Aβ1-42 concentration and BACE-1 mRNA and protein expressions in the high-glucose cell culture (P<0.05).

CONCLUSIONNeurons exposed to high glucose exhibit increased Aβ1-42 levels and BACE-1 mRNA and protein expressions, which can be concentration-dependently decreased by NaHS.

Amyloid Precursor Protein Secretases ; metabolism ; Amyloid beta-Peptides ; metabolism ; Animals ; Aspartic Acid Endopeptidases ; metabolism ; Cells, Cultured ; Culture Media ; chemistry ; Glucose ; chemistry ; Hydrogen Sulfide ; pharmacology ; Neurons ; drug effects ; metabolism ; Peptide Fragments ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective: To analyze the drug resistance of clinical isolates of Candida tropicalis in patients with infectious diseases, and preliminarily study their molecular characteristics. Methods: 95 strains of Candida tropicalis were isolated from the fungal culture specimens of 87 patients with infectious diseases in Shanghai Public Health Clinical Center from 2012 to 2015. Meanwhile, basic clinical data of patients were collected. The drug resistance of the strains to fungal drugs was analyzed by ATB FUNGUS 3 drug sensitivity test strips. All strains were classified by Multilocus sequence typing(MLST). Then, homology analysis was conducted by MEGA 5.2 software, and the evolutionary tree was mapped by using UPGMA method. Results: Patients distribution of strains was rendered as following: 31 strains from TB patients, 21 strains from HIV/AIDS patients, 19 strains from patients with liver disease, and 24 strains from rare cause infection or fever patients. The drug resistance rate to five antifungal drugs commonly used in clinical (amphotericin B, 5-fluorine cytosine, fluconazole, itraconazole, voriconazole) were 2.11% (2 strains), 0, 26.32% (25 strains), 26.32% (25 strains), and 26.32% (25 strains) respectively. Among the 25 azole-resistant strains: 14 strains were from rare cause infection or fever patients, 8 strains were from HIV/AIDS patients, and 3 strains were from tuberculosis patients. In MLST, 72 sequence types (ST types) were produced, 70 of which were new types. Evolutionary tree analysis showed that 95 strains of clinical strains distribute as three large clusters. 24 azole resistant strains (96.0%) were located in CLUSER Ⅰ. Conclusion The isolated Candida tropicalis were mainly resistant to azole drugs. MLST typing indicates that they was closely related to their genetic background.

Objective It compared the power consumption and electrical parameters between Thulium fiber laser devices(TFL)and Holmium laser devices(HoL)in transurethral enucleation of prostate(TUEP).Methods A sin-gle surgeon conducted TUEP by THL or HoL in 10 patients respectively.The enucleation efficiency,the laser energy output and the electric parameters were recorded and analyzed.Results The data from both groups of surgeries were tested for normal distribution,and the t-test found that the difference in the enucleation efficiency between the two surgeries was not statistically significant(P=0.818),and the energy consumption indexes of the two devices were comparable.The difference in the total kilojoules of laser emission between the two lasers during surgery was not statistically significant(P=0.148),but the power consumption of the thulium laser was about one-tenth of that of the holmium laser(P＜0.001),suggesting that the former utilised electrical energy significantly more efficiently than the latter.The maximum current of the HoL was significantly higher than that of the TFL(P＜0.001),requiring a spe-cial high-power power outlet.Conclusion TFL was superior to HoL in terms of lower power consumption,higher en-ergy-efficient and electrical convenient in transurethral enucleation of the prostate.

Objective It compared the power consumption and electrical parameters between Thulium fiber laser devices(TFL)and Holmium laser devices(HoL)in transurethral enucleation of prostate(TUEP).Methods A sin-gle surgeon conducted TUEP by THL or HoL in 10 patients respectively.The enucleation efficiency,the laser energy output and the electric parameters were recorded and analyzed.Results The data from both groups of surgeries were tested for normal distribution,and the t-test found that the difference in the enucleation efficiency between the two surgeries was not statistically significant(P=0.818),and the energy consumption indexes of the two devices were comparable.The difference in the total kilojoules of laser emission between the two lasers during surgery was not statistically significant(P=0.148),but the power consumption of the thulium laser was about one-tenth of that of the holmium laser(P＜0.001),suggesting that the former utilised electrical energy significantly more efficiently than the latter.The maximum current of the HoL was significantly higher than that of the TFL(P＜0.001),requiring a spe-cial high-power power outlet.Conclusion TFL was superior to HoL in terms of lower power consumption,higher en-ergy-efficient and electrical convenient in transurethral enucleation of the prostate.