BACKGROUND: In the healing process of fracture, if the callus tissue around the location of fracture is cleared, the end of fracture is difficult to be integrated completely, and more or less there would be some bone de fect. We deduce that these callus tissues are the necessary product during the process of bone reparation, which ought to be useful. Concerning this,we observed histological content and the volume of transforming growth factor-β1 (TGF-β1) with histological analysis and hybridization in situ of the frozen section of these calluses to investigate the effects of callus graft in the healing process of fracture.OBJECTIVE: To understand the salvaging value of bony callus organization around fracture in delayed operation by means of determining histological substances and contents of TGF-β1.DESIGN: Hybridization in situ of the callus tissue and randomized-grouping and controlled experiment.SETTING: Department of Orthopaedics, the Second Hospital of Xi'an Jiaotong University, and Department of Orthopaedics, Central Hospital of Taizhou City PARTICHANTS: Totally 51 inpatients who received delayed fracture operations in the Department of Orthopaedics of the Second Hospital of Xi 'an Jiaotong University and Central Hospital of Taizhou City from July 1994 and October 2003 were recruited. In some cases of delayed fracture operation, callus was obtained with the consent of patients, Dig labeled kit was bought from Boehringer Mannheim Corp. CTT GCT GTA CTGTGT GTC CAA, TGF-β1 oligonucleotide probe sequence, was synthe sized by DNA synthesizer. Computer X-ray system was bought from Japan Fuji Corp. METHODS: 2,4,6,8 weeks after fracture, a small amounts of callus was obtained. Frozen section was made from undecalcified callus tissue, and noneisotope Dig labeled hybridization in situ, observe gene expression of TGF-β1 in callus. In the operation, after clearing the bone stump and fas tening the fracture, original bony callus was grafted to the bone defect and around the fracture. Simple callus graft, flank bone graft or both were adopted respectively on patients in delayed operation with follow-up obser vations were given for 1-4 years, with the average of 1 year and 9 months,at outpatient clinic for recheck.MAIN OUTCOME MEASURES: ① Histological substance and TGF-β1 content of bony callus at different phases of the fracture. ② Effect of different mode of bone graft on the time of fracture healing. RESULTS: Totally 51 cases were treated, and 7 cases were not followed up for death or moving to other areas. Data of the followed-up 44 patients were collected into the stage of result analysis. ① Gene expression of TGF-β1 in bone callus: In the second week after fracture, there were a small amount of fibrous bone callus and comparatively much cartilage bone callus,and TGF-β1 was hypso-expressed in cartilage cells inside the cartilage islet; about four weeks later, TGF-β1 was notably expressed in os teoblasts; about eight weeks later, a host of calluses grew, mainly carti laginea, and the numbers of formed fibroblast, callus, osteoblasts and tra becular bone were increasing. TGF-β1 expression in all kinds of cells dis appeared after six weeks but had a tendency to rise again in bone matrix in the eighth week. ② There were no significant difference of healing time in different modes of bone graft .CONCLUSION: TGF-β1 plays an important role in balancing bone healing, and necessary connections exist between tissue change in bone callus and change in expression of TGF-β1. As callus is a product of recovery and reconstitution of organism, we regard callus graft salvage as a feasible method in reducing pain and damage to patients who need graft.

Objective To study the expression of the tumor suppressor gene TSHR and pl6 in papillary thyroid carcinoma (PTC) and explore the relationship of the tumorigenesis and the promoter aberrant methylation of the two above genes. Methods RT-PCR was used to detect the mRNA expression of two tumor suppressor genes in 50 cases of PTC, 20 cases of nodular goiter and 12 cases of thyroid adenoma tissue. The promoter methylation status of the two genes were detected by methylation-specific PCR technique (MSP) (which of p16 by nested PCR). The promoter hypermethylation of the two genes was tested by randomly gene sequencing. Results Hypermethylation of promoter region were detected from 68.0 % (34/50) TSHR gene and 54.0 % (27/50) pl6 gene in PTC, while 21.9 % (7/32) and 15.60 % (5/32) in controls. The rate of promoter methylation in PTC was significantly higher than that in controls (χ2 = 16.61, P <0.05 vs χ2 =12.08 P <0.05). The relative mRNA expression of TSHR gene and pl6 gene were (0.41±0.11) and (0.51±0.17) in PTC, respectively, while those were (0.63 ±0.08) and (0.72 ±0.22) in controls, respectively. The mRNA expression of the TSHR gene and pl6 gene was obviously lower in PTC than that in controls (t = 3.86, P < 0.05 vs t =3.66, P <0.05). By the sequencing, it was confirmed that the CG in methylated promoter of the two genes was not changed, while the CG in unmethylated promoter was changed into TG. Conclusion Methylation of the TSHR gene and p16 gene in promoter region is a common molecule event and may be invovled in the genesis and development of human PTC.

Background Multimorbidity imposes a heavy burden on individuals, families, and society. There are relatively few studies exploring patterns of multimorbidity among middle-aged adults in China. Objective To explore the current status of multimorbidity, associated risk factors, and multimorbidity patterns among adults aged 45-64 years in China, so as to provide a scientific basis to prevent and control multimorbidity in China. Methods A total of 5494 adults aged 45-64 years from the Chinese Health and Nutrition Survey (CHNS) in 2018 were selected. Of these, 2494 (45.39%) were men and 3000 (54.61%) were women. The nine diseases included were hypertension, diabetes, dyslipidaemia, obesity, mild cognitive impairment (MCI), myocardial infarction, stroke, asthma, and tumor. The prevalence of each disease or multimorbidity was expressed as N (%). Comparisons of multimorbidity prevalence between different groups were performed using the χ² test or Cochran-Armitage trend test. Association rule with the Apriori algorithm was used to explore the pattern of multimorbidity, with parameters set at a minimum conditional support of 3.00%, a minimum rule confidence of 50.00%, and a lift of >1.20. Logistic regression was used to evaluate the associations between selected risk factors and multimorbidity. Results In 2018, 37.44% of participants reported multimorbidity in 15 provinces of China. The prevalence of diseases in descending order was dyslipidaemia (39.99%), hypertension (39.48%), obesity (16.42%), MCI (14.47%), diabetes (14.16%), tumor (1.09%), stroke (1.04%), myocardial infarction (0.71%), and asthma (0.64%). A total of seven multimorbidity patterns were identified in this group. Obesity paired with hypertension, and diabetes paired with dyslipidemia were the two major patterns of multimorbidity in the general population and age or sex subgroups. The multimorbidity patterns of different populations were concentrated in the combination of obesity, hypertension, diabetes, and dyslipidemia. The risk of multimorbidity was lower in females than in males (OR=0.85, 95%CI: 0.75, 0.97). The multimorbidity risk was 1.56 times higher in the 55-64 years group than in the 45-54 years group (OR=1.56, 95%CI: 1.40, 1.75). Drinking in the past year increased the risk of multimorbidity by 25% (OR=1.25, 95%CI: 1.08, 1.45) compared to no alcohol comsumption in the past year. High and medium levels of physical activity were associated with a decreased OR (high: OR=0.74, 95%CI: 0.65, 0.85; medium: OR=0.81, 95%CI: 0.70, 0.93) with low level of physical activity as reference. Conclusion In 2018, there was a high prevalence rate of multimorbidity among middle-aged adults in China. The main multimorbidity patterns were obesity-hypertension and diabetes-dyslipidemia. Surveillance and interventions should be strengthened particularly for men, individuals with alcohol consumption or insufficient physical activity, and those with major multimorbidity patterns.

Background Diabetes is a major contributor to global burden of disease. The role of magnesium in the prevention of diabetes has aroused concern. However, the research results on the impact of dietary magnesium on the risk of diabetes are hitherto inconsistent. Objective To evaluate the association between dietary magnesium intake and the risk of diabetes through a systematic review. Methods PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang databases were searched for prospective studies that contained risk estimates for magnesium intake-associated diabetes and were published from January 1, 2000 to December 31, 2021. Two researchers independently screened the literature according to a set of pre-prepared inclusion and exclusion criteria, extracted the data according to an unified data extraction table, and evaluated the quality of included articles with Newcastle-Ottawa Scale (NOS). R 4.0.3 software and Stata SE16.0 software were used for meta-analysis and subgroup meta-analysis, and Higgins I² statistics were used to test the heterogeneity of the included studies. The sources of heterogeneity were analyzed by univariate meta regression. Results A total of 14 articles involving 17 prospective cohort studies (1065267 participants and 40506 patients with diabetes) were included in the study. The NOS scores ranged from 8 to 9, with an average of 8.6, indicating that the included studies were classified as being high quality. The highest quintile of magnesium intake group reduced the risk of diabetes by 22% (RR=0.78, 95%CI: 0.73-0.82) compared with the lowest quintile group. This association was not substantially modified by geographic region, sex, or follow-up length. The highest quintile of dietary magnesium intake in the Americas and Asia were associated with 22% and 26% reductions in the risk of type 2 diabetes respectively compared with the lowest quintile group (the Americas, RR=0.78, 95%CI: 0.73-0.84; Asia, RR=0.74, 95%CI: 0.63-0.88); The highest quintile of dietary magnesium intake in female, male and without gender stratified were associated with 22%, 19% and 46% reductions in the risk of type 2 diabetes respectively compared with the lowest quintile group (Female RR=0.78, 95%CI: 0.73-0.84; Male RR=0.81, 95%CI: 0.74-0.89; Both RR=0.54, 95%CI: 0.42-0.68); Compared with the lowest quintile groups, the groups with the highest quintile of dietary magnesium intake with a follow-up time of less than 10 years and more than 10 years reduced the risk of type 2 diabetes by 26% and 20% respectively (≤10 years, RR=0.74, 95%CI: 0.65-0.83; ＞10 years, RR=0.80, 95%CI: 0.75-0.85). After adjusting for hypertension, the highest quintile of dietary magnesium intake group reduced the risk of type 2 diabetes by 20% compared with the lowest quintile group (RR=0.80, 95%CI: 0.74-0.85). The year of publication (P<0.05) or the sex of the subjects (P<0.05) may be the source of heterogeneity by meta regression test. The results of Egger’s test for funnel plot asymmetry suggested publication bias. Conclusion The combined data supports a role for high magnesium intake in reducing the risk of type 2 diabetes. Because it is difficult to separate the effect of magnesium intake on diabetes risk from other factors, large-scale and clinical randomized controlled trials are needed to directly assess the impact of magnesium on the incidence rate of diabetes.