BACKGROUND:Parathyroid hormone related peptides are accompanied by the syndrome of humoral hypercalcemia of malignancy. As a potential therapeutic drug of promoting the healing of bone fracture, parathyroid hormone related peptides have significant clinical application value.
OBJECTIVE:To explore the regulating effects of parathyroid hormone related peptides in diabetic osteoporotic fracture
METHODS:A computer-based online research of CNKI and PubMed databases was performed to col ect articles published between 1990 and 2013, with the key words“parathyroid hormone related peptides, diabetes, osteoporotic fracture”in Chinese and English. There were 1 279 articles after the initial survey. A total of 43 articles were included according inclusion and exclusion criteria.
RESULTS AND CONCLUSION:Animal and clinical experiments demonstrated that parathyroid hormone related peptides notably accelerate bone fracture healing, and improve the repair process of islet cellfunction defects that are related with diabetes. Meanwhile, as an analogue, parathyroid hormone has been identified as clinical medication in the treatment of fracture. But the appropriate dose, and method of application at the different stages of bone fracture healing and the problem of drug combination need further investigation.

Objective To study the liver cancer specific DNA damage response/repair/recombination gene expression profile and the difference between liver cancer tissues and their adjacent normal tissues. Methods The cDNA probes labeled with ? 32 P dATP were synthesized from total RNA of cancer tissue and adjacent liver tissues. The cDNA probes were differentially hybridized to two identical Atlas human cancer cDNA expression array membranes containing 588 known genes. A gene specific semiquantitative reverse transcription polymerase chain reaction (RT PCR) method and Northern blot were used to check the expression pattern of two known genes. Results Autoradiographic result analyzed by specific Atlas Image TM (version1.01a) showed among the 588 genes analyzed, 33 genes were related to damage response/repair/recombination and the expression of 4 genes including DNA dependent protein kinase, and DNA topoisomerase Ⅰ were found to be up regulated in liver cancer. The results of RT PCR and Northern blot confirmed the expression pattern of two genes which were detected by Atlas human cancer cDNA expression array. Conclusion The result obtained from Atlas microarray provides a liver cancer specific expression profile comprehensively and systematically. The findings about genes related to DNA damage response/repair/recombination may lead to understanding of the pathogenesis of liver cancer and the mechanism of drug resistant.

Objective To study the clinical significance of glutathione s-transferases expression ingastric carcinoma tissues. Methods The expression of 98 gastric carcinoma was studied by means ofimmunohistochemical technique. Results The glutathione S-transferases were between 25. 0% and 88. 9%in 98 cases of gastric carcinoma. The GST-? was significantly higher in the cases of poorly differentiatedthan those of well differentiated. But it was not correlated with patient age, sex, tumor size, tumor'slocation,and lymph node metastases. Conclusion The determination of GST-? may be useful for diagnosis,prognosis and treatment of gastric carcinoma.

Objective To probe the precision of the magnetic resonance spectroscopy (MRS)in assessing the fat content in the vertebral bone marrow and the changes at different vertebrae.Methods A total of 46 female volunteers were recruited in this study. After routine MRI examination,single voxel (SV)was chosen for the 1 H-MRS acquisition at L1 -L4 vertebral body.Thirty subjects were scanned twice to evaluate the precision of MRS.The fat fraction (FF%),unsaturation index (UI)and coefficients of variation (CV) were calculated by amplitude and area under the peak respectively.The changes of fat content in marrow at L1 -L4 vertebrae was further evaluated.Results The CV related to peak amplitude was 1.7% in quantification of vertebral FF%,while the CV related to peak area was 6.3%.In quantification of vertebral UI,the CV related to amplitude and area was 2.4% and 7.8% respectively.The FF% was ascended from L1 to L4,while UI of bone marrow declined.A significant correlation was observed between FF% and UI (r=-0.714,P <0.01).The correlation of FF% among L1 -L4 were also significantly observed (r =0.612 -0.923,P <0.01). Conclusion MRS at 3.0 T provides reliable measurement for marrow fat content with a good precision associated with amplitude. Meanwhile,there is a preferential increase in saturated lipids compared to unsaturated lipids from L1 to L4.There is a high correlation of FF%among L1-L4.MRS is a valuable tool for providing complementary information on osteoporosis research.

AIM: To investigate the association between HBV infection and HLA-DPB1 gene in population of Guangzhou Chinese. METHODS: 58 unrelated patients (test positive of HbsAg,HBeAg,HbcAb) and 75 unrelated healthy control individuals were typed by sequencing based typing (SBT) method in their HLA-DPB1 gene. RESULTS: The phenotype frequencies of HLA-DPB1 alleles of patients and control have no significant difference. CONCLUSION: These results indicate that there is no association between HLA-DPB1 gene and HBV infection.

Objective　To observe the effect of various concentration of arsenic trioxide (AT) on hepatoma cell line HLE in variable duration. Methods　The cell activity, morphologic changes and apoptosis were studied after being treated with different concentration of AT. Results　The effect of AT on hepatoma cell lines was depending on the time and concentration obviously. Hepatoma cells cultured with different concentration of AT presented apoptosis features, such as intact cell membrane, chromatin condesation, nucleic fragmentation and apoptotic body formation; flow cytometry analysis showed that an arrestment at G2/M phase, an apoptosis peak presented before sub-G1 cell peak, and a mark DNA ladder of apoptosis appeared. Conclusions　AT can obviously inhibit the growth of hepatoma cell through inducing hepatoma cell apoptosis.

Objective Refractory constipation,when complicated with megacolon,is difficult to manage.This study aimed to compare the clinical outcomes of different preoperative nutritional therapies on refractory constipation patients complicated with megacolon.Methods Patients of refractory mixed constipation complicated with megacolon receiving surgical interventions between 2006 Jun and 2011 Jun were enrolled.Perioperafive nutrition support was evaluated in terms of postoperative recovery.Results 78 constipation patients received therapies of NPM,gastrointestinal decompression and total parenteral nutrition during the first 7-14 days.34 patients retained intestine patency and after 2 weeks of enteral nutrition therapy,they (enteral nutrition group) successfully received selective surgery.The other 44 patients (non-enteral nutrition group) received emergency surgery after correcting homeostasis.The surgical procedures included Jinling procedure (n =45),Jinling procedure plus ileostomy (n =6),total colectomy plus ileum-rectum side-to-side anastomosis (n =18) and total colectomy plus ileostomy (n =9).EN group patients had a significant low rate of pneumonia (0％ vs 11.4％),anastomotic leakage (0％ vs 11.4％),anastomotic bleeding (2.9％ vs 18.2％) and ostomy (0％ vs 34.1％),compared with N-EN group.At one month follow up,the nutrition status was significantly better in EN group than that in N-EN group.Condusions Refractory constipation complicated with megacolon required surgical intervention.Recovering the intestinal patency and receiving enteral nutritional support therapy preoperatively benefits patient's recovery.

Objective To investigate the therapeutic effect of Radish Seed Chengqi Decoction combined with glutamine for treatment of patients with sepsis complicated with paralytic ileus. Methods Sixty patients with septic ileus admitted to the Department of Emergency Intensive Care Unit (EICU) of Tianjin Medical University General Hospital from August 2017 to January 2019 were enrolled. The Western medicine treatment group (30 cases) received routine Western medical methods including intravenous drip of glutamine, etc. for symptomatic treatment, and the Radish Seed Chengqi Decoction group (30 cases), based on the treatment in the Western medicine group, were additionally given the decoction by nasal feeding and retention enema twice a day, once 100 mL with the course of 7 days in both groups. The herbal prescription of Radish Seed Chengqi Decoction contained rhubarb 24 g (decocted later), sodium sulfate 15 g (mixed with water to take), magnoliae cortex 15 g, orange frui 10 g, aucklandiae 10 g, henan achyranthes root 10 g and radish seed 15 g, constituting one dose, two doses one day given to a patient, making one dose of herbal medicine to 200 mL of decoction for nasal feeding and retention enema, once 100 mL respectively, twice a day for 7 days. After treatment, the changes of survival rate in ICU, the total effective rate and the level of procalcitonin (PCT) were observed in both groups. Results After treatment, the total effective rate in Radish Seed Chengqi Decoction group was significantly higher than that in the Western medicine treatment group [83.33% (25/30) vs. 66.67% (20/30), P < 0.05], and the ICU 7-day survival rate in Radish Seed Chengqi Decoction group was also significantly higher than that in Western medicine treatment group [90.00% (27/30) vs. 76.67% (23/30), P < 0.05]. After treatment, the levels of PCT (μg/L) in both groups were significantly decreased compared with those before the treatment (Western medicine treatment group: 3.38±1.72 vs. 6.43±3.29, and Radish Seed Chengqi Decoction group: 2.39±1.24 vs. 6.78±2.31, both P < 0.05), and the degree of decrease of PCT in radish seed chengqi decoction group was more obvious than that in Western medicine treatment group (μg/L: 2.39±1.24 vs. 3.38±1.72, P < 0.05). Conclusion Applying alanyl glutamine combined with Radish Seed Chengqi Decoction for treatment of patients with sepsis complicated with paralytic ileus can significantly improve the clinical symptoms, reduce the PCT level and elevate the survival rate of patients.

Objective To explore the three dimensional time of flight (3D-TOF) MR angiography (MRA) manifestations and its clinical significance in duplicated middle cerebral artery (DMCA). Methods The clinical and MRA data of 37 patients with DMCA, admitted to our hospital from July 2013 to April 2017, were collected. The original images were reconstructed by maximum immensity projection (MIP). The imaging features of origin, sizes, walking and distribution of DMCA were observed, and DMCA classification was performed. Results Among the 37 patients with DMCA, 24 patients with type A were from the internal carotid artery (ICA) terminal, and the proximal part was parallel to the MCA-M1 segment; 13 patients with type B were originated between the anterior choroidal artery and the ICA terminal, the proximal end in 8 patients was parallel to the M1 section of the middle cerebral artery and the proximal end in 5 patients was obviously curved to the temporal lobe. The relative size of type A was 0.94±0.07 (0.72-1.00), while that of type B was 0.68±0.22 (0.31-1.00), with statistically significant difference (P<0.05). Conclusions The 3D-TOF-MRA can display the detailed information of DMCA, which can be used as the important methods for its diagnosis. And this vascular variation has important clinical significance, and awareness on this vascular variation should be strengthened in clinical work.

OBJECTIVETo explore the efficacy of different procedures for refractory constipation complicated with megacolon.

METHODSClinical data of 112 patients of refractory constipation complicated with megacolon undergoing surgery in our institute from June 2007 to January 2013 were retrospectively analyzed. Of these 112 patients, the duration of constipation ranged from 4 to 22 years. Seventy-four patients had previous abdominal operations. Surgical procedures: (1)Jinling procedure (subtotal colectomy plus ascending colorectal posterior wall side-to-side anastomosis, n=81), including 24 laparoscopy-assisted procedures, 18 terminal ileostomies. (2)total colectomy plus ileorectal side-to-side anastomosis(n=18). (3)total colectomy plus end ileostomy, and ileorectal posterior wall side-to-side anastomosis 6 months later(n=13). The end ileostomy was reversed 6 months after operation.

RESULTSThe successful rate was 100%, and no surgery-related deaths were found. Postoperative complications included early diarrhea (90 cases, 80.4%), anal pain and incomplete evacuation (22 cases, 19.6%), urinary retention within 24-48 h after catheter removal (16 cases, 14.2%), anastomosis bleeding (9 cases, 8.0%), anastomosis leakage (6 cases, 5.4%), and intestinal obstruction (15 cases, 13.4%). Six patients with intestinal obstruction underwent adhesiolysis, and others were managed by conservative therapy. At the postoperative follow-up at 6 months, the Wexner constipation score was significantly reduced (5.8-8.3 vs. 21.4-28.7, P<0.01), and malnutrition improved as well.

CONCLUSIONSurgical intervention results in good efficacy for refractory constipation complicated with megacolon.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; methods ; Colectomy ; methods ; Constipation ; complications ; surgery ; Female ; Humans ; Ileostomy ; Male ; Megacolon ; complications ; surgery ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult