BACKGROUND:Increasingly studies report that the normal balance of bone metabolism may be destroyed in the case of postmenopausal osteoporosis or osteoarthritis. The concrete metabolic process of bone turnover could be revealed sensitively by measuring the bone turnover markers in the serum or urine.
OBJECTIVE:To study the bone density and bone metabolic index of knee osteoarthritis (KOA) and postmenopausal osteoporosis (PMO), and to discuss the characteristics of bone density and bone metabolic index in KOA and PMO.
METHODS:A total of 248 postmenopausal women were detected for bone mineral density and knee X-ray. Final y 180 patients were included in this study and were divided into three groups:KOA group, PMO group, and control group. The levels of bone turnover markers (bone alkaline phosphatase, bone gla protein, col agen type I cross-linked C-telopeptide, and tartrate-resistant acid phosphatase 5b) in serum from the participants were measured. The correlation between bone turnover markers and the disease progression was analyzed by Logistic regression analysis.
RESULTS AND CONCLUSION:The bone mineral density in the KOA group was higher than the control group but col agen type I cross-linked C-telopeptide was lower. The levels of bone gla protein, col agen type I cross-linked C-telopeptide, and tartrate-resistant acid phosphatase 5b in serum from PMO group were higher than the control group. The decrease of col agen type I cross-linked C-telopeptide was associated with the incidence of KOA, and the increases of bone gla protein, col agen type I cross-linked C-telopeptide, and tartrate-resistant acid phosphatase 5b were associated with the incidence of PMO. The lower bone absorption can be seen in postmenopausal women with KOA. PMO patients showed a higher bone turnover rate. The difference of bone metabolism between patients with KOA and PMO led to negative relationship of bone mineral density. The serum levels of bone gla protein, col agen type I cross-linked C-telopeptide, and tartrate-resistant acid phosphatase 5b can assist clinical diagnose and therapeutic effect detection of both KOA and PMO.

Objective To compare three dimensional arterial spin labeling(3D-ASL) and dynamic susceptibility contrast-perfusion weighted imaging(DSC-PWI) in evaluating the cerebral hemodynamic of Moyamoya disease. Methods Approved by the institutional review board, 26 cases of Moyamoya patients who were diagnosed by DSA were enrolled. Diffusion weighted image, 3D-TOF-MRA, 3D-ASL, DSC-WPI, and T1WI were performed in 3.0 T MR scanner. ROI were positioned in the abnormal perfusion areas and the control area according to the arterial dominant territory to obtain quantitative parameters of perfusion. Perfusion parameters including cerebral blood flow(CBF) of ASL, cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), and time to peak(TTP)of DSC-PWI , and relative parameters (ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, DSC-rTTP) that the ratio of abnormal perfusion area and the control area were calculated. Meanwhile, the areas of the lower perfusion region of ASL and TTP images in the same slice were measured. Difference of the above-mentioned parameters and areas was processed by paired Student′ t test. Furthermore, correlation of relative values of perfusion parameters(ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, and DSC-rTTP) was processed by Pearson correlation test. Results There were significant statistics differences between values of ASL-CBF, DSC-MTT, and DSC-TTP in abnormal perfusion [(28.18 ± 10.19)ml · 100 g-1 · min-1,(7.98 ± 2.22)s,(29.93 ± 3.95)s] and the control areas [(49.50 ± 11.37)ml · 100 g-1 · min-1,(6.07 ± 1.11)s,(27.34 ± 2.58)s] (t=-12.818, 4.193, 6.163, all P<0.01). There was no significant statistics difference in the lower perfusion area between ASL-CBF [(5 729.63 ± 4 563.79) mm2]and DSC-TTP[(5 875.33 ± 4 723.08)mm2](t=-1.774,P>0.05). Furthermore, the Pearson correlation test showed significant linear dependence between ASL-rCBF(0.56±0.14)and DSC-rMTT(1.34± 0.42), and DSC-rTTP(1.09 ± 0.69)(r=-0.630,-0.748, P<0.01). Conclusions There is a correlation between 3D-ASL and DSC-PWI in assessing the magnitude and areas of the reduction of blood perfusion of Moyamoya patients. Moreover, the ASL technique possesses advantages of non-invasion use of the gadolinium contrast.

Objective:To study the association between non-syndrome cleft lip and palate (NSCL/P)and MAFB (rs6072081, rs6065259,rs17820943,rs11696257)gene polymorphism in NingXia Hui and Han population.Methods:512 cases of NSCL/P,258 case of Hui nationality and 254 of Han,174 cases of complete 3 core family members(patients and their parents),142 cases of single parents families(patients and their single parents),were collected in patient group.505 cases of healthy newborns were collected in control group.The MAFB gene SNPs were determined with TaqMan SNPs genotyping methods and the data were analyzed by case-con-trol analysis,transmission disequilibrium test(TDT)and family based association test(FBAT).Results:Case-control analysis found that,there was a statistical significance of the genotypes and allele frequency between patients and the controls in MAFB of the 4 locus (P <0.05);but all of the 4 locus showed no difference in patients with cleft palate(P >0.05).Conclusion:The 4 locus single nucle-otide polymorphism was associated with NSCL/P in Ningxia population.

OBJECTIVE: To detect the levels of neutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C ) in blood and the level of kidney injury molecule 1 (KIM-1) in urine in elderly patients with renal calculi at diff erent times, and to explore the eff ect of percutaneous nephrostolithotomy (PCNL) combined with flexible ureteroscopy (FU) on early postoperative renal function. METHODS: A total of 46 patients with renal calculi were selected, and their blood or urine specimens were collected respectively at preoperative and postoperative 2, 12, 24, 48, and 72 h. The concentrations of NGAL, Cys-C, KIM-1 were detected. RESULTS: The levels of NGAL and Cys-C began to increase respectively at postoperative 2 and 12 h, and reached peak at postoperative 12 to 24 h. There was significant difference in the levels of NGAL and Cys-C between the postoperative 12 and 2 h or between postoperative 48 and 24 h (all P<0.05). The levels of NGAL and Cys-C began to decline and eventually returned to preoperative levels respectively at postoperative 48 and postoperative 72 h. The KIM-1 began to increase at postoperative 2 h and peaked at postoperative 24 h, which was significant difference between the postoperative 24 and 12 h or postoperative 48 and 24 h (both P<0.05). The level of KIM-1 began to decline and eventually returned to preoperative levels at postoperative 48 h. CONCLUSION After the combined treatment of percutaneous nephrostolithotomy with flexible ureteroscopy, the concentrations of NGAL, Cys-C and KIM-1 are significantly increased, suggesting injuries on renal function. The time of renal tubular injury and recovery is earlier than that of renal glomerulus.
Acute-Phase Proteins ; urine ; Aged ; Cystatin C ; blood ; urine ; Hepatitis A Virus Cellular Receptor 1 ; Humans ; Kidney ; physiopathology ; Kidney Calculi ; surgery ; Lipocalin-2 ; Lipocalins ; blood ; urine ; Membrane Glycoproteins ; blood ; urine ; Nephrostomy, Percutaneous ; Postoperative Period ; Proto-Oncogene Proteins ; blood ; urine ; Receptors, Virus ; blood ; Ureteroscopy

OBJECTIVETo investigate the association between rs142167, rs7216231 single nucleotide polymorphism (SNP) in Wnt3 and nonsyndromic cleft lip and palate (NSCL/P) in Hui and Han population of Ningxia Autonomous Region.

METHODSThe study consisted of 371 NSCL/P patients from Ningxia Hui and Han population (Han population 166, Hui population 205), their parents (196 fathers, 224 mothers, 150 trios) and 258 normal controls (Han population 190, Hui population 68). Polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) was used to identify rs142167, rs7216231 genotypes of the samples. The data was analyzed by case-control analysis, transmission disequilibrium test (TDT) and family based associated test (FBAT).

RESULTSCase-control study showed that no differences in cleft lip, cleft palate, cleft lip and palate, and the total case group compared with the control group at rs142167 and rs7216231 (P > 0.05) in Hui and Han population and in stratified comparison. TDT test showed that rs142167 and rs7216231's allele had not over-transmitted (P > 0.05) in NSCL/P. FBAT test showed that G-G specific haplotypes showed statistically significant (P < 0.05).

CONCLUSIONWnt3 gene polymorphism is not relevant with NSCL/ P in Ningxia Hui and Han population.

Brain ; abnormalities ; Case-Control Studies ; Cleft Lip ; Cleft Palate ; Genotype ; Humans ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide

OBJECTIVETo investigate the life quality and their influence factors in cleft lip and palate parents and to provide evidences for improving the life quality of the parents.

METHODSOne hundred and forty-three parents whose children accepted the primary surgery of cleft lip and palate were selected as the case group, and 109 normal adults as the control group. Both groups were investigated by 3 questionnaires that included questionnaire of general status, generic quality of life inventory-74 (GQOLI-74), social support rating scale (SSRS). The results of two groups were analyzed and the influence factors on life quality were studied by stepwise multiple regression analysis.

RESULTS1)The scores of the life quality, mental function, social function, material life in the case group were significantly low compared with the control group(P<0.05). 2)The social support total scores, subjective support and utilization of social support were lower than the control group(P<0.05). 3)Social support, objective support, subjective support positively correlated with life quality scores and every dimension score in the case group. 4)The relevant factors affecting life quality were social support and income.

CONCLUSIONThe life quality and social support of cleft lip and palate patients is poor, we should give more support and help to improve their life quality.

Adult ; Cleft Lip ; Cleft Palate ; Humans ; Parents ; Quality of Life ; Social Adjustment ; Surveys and Questionnaires

Objective:To investigate the pathogen spectrum of acquired immunodeficiency syndrome (AIDS) patients with pulmonary opportunistic infections in the local area, and to evaluate the clinical application of metagenomic next-generation sequencing (mNGS) in these patients.Methods:From January to December 2021, AIDS patients with pulmonary infections admitted to Zhongnan Hospital of Wuhan University were enrolled. Their bronchoalveolar lavage fluid (BALF) was subjected to mNGS and coventional pathogen detection.Routine pathogen detection methods included smear, culture, polymerase chain reaction (PCR), and immunochromatographic colloidal gold. Fisher′s exact probability method was used for statistical analysis.Results:A total of 69 patients were included, and all of them were tested positive for mNGS. Among them, 53 cases (76.8%) were positive for fungi and viruses, 40 cases (58.0%) were positive for bacteria (excluding Mycobacterium tuberculosis (MTB) and nontuberculous mycobacteria (NTM)), six cases were positive for MTB, 11 cases were positive for NTM, and seven cases were positive for other pathogens. Mixed infections with two or more pathogens were found in 89.9%(62/69) of the patients. Among the conventional pathogen detections of BALF, 79.7%(55/69) of the patients were positive for pathogens, including 42 cases positive for Pneumocystis jirovecii PCR, 16 cases positive for BALF culture, nine cases positive for MTB PCR, and five cases positive for Cryptococcus antigen. The total detection rate of mNGS was 100.0%(69/69), which was higher than that of the conventional pathogen detection rate of 79.7%(55/69), and the difference was statistically significant (Fisher′s exact probability method, P<0.001). The specificity of mNGS detection was 88.4%. Combining clinical and two detection methods, the top five pathogens were Pneumocystis jirovecii (62.3%(43/69)), Candida (29.0%(20/69)), MTB (20.3%(14/69)), NTM and Talaromyces marneffei (15.9%(11/69), each). Fifty-three patients (76.8%) had co-infection with virus. Conclusions:The main cause of pulmonary infection in AIDS patients in this area is mixed infection, and Pneumocystis jirovecii is the most common pathogen. mNGS could significantly improve the pathogen detection rate in AIDS patients with pulmonary infections.

Objective To investigate the safety and efficacy of wide local excision surgery combined with 5-aminolaevulinic acid(ALA)-photodynamic therapy(PDT)in treating Paget's disease of the scrotum in elderly people.Methods Patients with an average age of 68.4 ± 4.7 years undergoing wide local excision surgery combined with ALA-PDT for Paget's disease of the scrotum from June 2014 to February 2018 were followed up.All patients underwent wide local excision surgical treatment first and were then enrolled in ALA-PDT study after the diagnosis of Paget's disease of the scrotum was confirmed.Four cases were eliminated as a result of two patients refusing photodynamictherapy for various reasons and two patients lost during follow-up after ALA-PDT.A total of 16 patients were included in the study,of whom 6 cases were in Ray stage A1,7 cases in stage A2 and 3 cases in stage B.Patients underwent 3 courses of ALA-PDT after operation.Then the efficacy,shortand medium-term complications were followed up.Results The duration of disease among the 16 patients ranged from 4 to 76 months before diagnosis,with an average of 35.7 months.Surgery was performed immediately after diagnosis.Ten patients underwent resection and suture and 6 patients were treated with skin flap transfers.Of the patients treated with surgery,3 patients received suspicious lymph node dissection and 1 patient underwent reoperation due to skin flap necrosis.Patients were followed up for 3 months to 3 years and 6 months after ALA-PDT.Recurrence and distant metastasis occurred in 2 cases,with 1 case of brain metastasis and 1 case of systemic metastasis,and the overall recurrence rate was 12.5％.During the follow-up,there were no other serious complications except for 1 case(6.3 ％)with lower limb movement disorders.Conclusions Wide local excision surgery combined ALA-PDT has good clinical outcomes,low recurrence rates and few complications for the treatment of Paget's disease of the scrotum in elderly people.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.