Objective To investigate the effect of zoledronate on the clinical efficacy and IL-8, IL-10 and osteocalcin levels in perimenopausal women with osteoporosis.Methods A total of 72 cases menopausal syndrome with osteoporosis from January 2014 to March 2015 in Hangzhou Third People's Hospital of Yuhang District were randomly divided into two groups with 36 cases in each group.Patients in the control group were treated with routine oral administration of calcium carbonate D3 and alpha D3, and the observation group was treated with zoledronate acid sodium on this basis for four weeks.Serum inflammatory factor and bone metabolism index were measured before and after treatment , VAS score and bone mineral density were measured, and the clinical effect was compared.Results Compared with before treatment, two groups of serum ALP, BGP levels and VAS score were significantly decreased (P<0.05), IL-8 and TNF-αlevels decreased (P<0.05), IL-10 level increased (P<0.05), lumbar(L1 ~4), bilateral hip and femoral neck BMD increased (P<0.05); compared with the control group, serum ALP, BGP levels and VAS score in the observation group was lower (P<0.05), IL-8, TNF-αlevels were lower (P<0.05), IL-10 level was higher (P<0.05), lumbar(L1 ~4), bilateral hip and femoral neck BMD were higher (P<0.05), the treatment effective rate was higher (P <0.05).Conclusion Zoledronate in the treatment of perimenopausal syndrome with osteoporosis is significant clinical efficacy, it can effectively relieve the inflammatory symptoms and bone and joint pain, inhibit bone reduction.

Objective To evaluate plasma natriuretic peptide brain (BNP) levels in elderly male patients with type 2 diabetes and primary osteoporosis.Methods A total of 122 elderly male patients with type 2 diabetes were divided into 3 groups according to bone mineral density(BMD):normal group (41 cases),osteopenia group (40 cases) and osteoporosis group (41 cases),and another 33 age matched healthy subjects as control group.Plasma BNP levels were determined by ELISA.Results Plasma BNP levels in osteoporosis group [(1.95 ± 0.49) pmol/L] and osteopenia group [(1.64±0.48) pmol/L] were significantly elevated compared with that in normal group [(1.32±0.38) pmol/L] and control group [(1.26±0.39) pmol/L] (all P＜0.01).There was a statistical difference between osteoporosis group and osteopenia group (t=3.539,P＜0.05),and also between normal group and control group (t=2.726,P＜0.05).Plasma BNP levels had negative correlation with BMD of 2na-4th lumbar vertebra (r=-0.366) and femoral neck (r=-0.375),body mass index (r=-0.288) and estrodiol (E2) (r=-0.352) (all P＜0.05); while had a positive correlation with parathyroid hormone (PTH) (r=0.353,P＜0.05).Conclusions With BMD declining,plasma BNP levels are elevated in elderly male type 2 diabetes,which may be related to the compensatory increase in PTH and the decrease in estradiol.

Adult ; Antineoplastic Agents ; therapeutic use ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Signet Ring Cell ; drug therapy ; metabolism ; pathology ; surgery ; Cell Transformation, Neoplastic ; pathology ; Cisplatin ; therapeutic use ; Female ; Humans ; Hysterectomy ; Keratin-20 ; metabolism ; Ovarian Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Teratoma ; drug therapy ; metabolism ; pathology ; surgery

Objective To discuss and analyze the CT appearances and differential diagnosis of pulmonary tuberculomas. Methods 40 cases of pulmonary tuberculomas proved by surgery and pathology were included in the study and compared to 40 cases of peripheral-type bronchogenic carcinomas, which were also surgico-pathologically proved. Results Tuberculomas were most found in the posterior segments of the lung and exhibited well-demarcated lesions of homogeneous density. Some lesions also possessed characteristics like rough spiculation, minute calcification within the lesion and marginal calcification. Thick-walled, thin-walled or stellate cavities were also found. On contrast enhanced scans, tuberculomas showed little or ring enhancement. In addition, satelite lesions or pleural thickening were often found near the tuberculomas. Hilar and mediastinal lymph-nodes were calcified but not enlarged. Anti-tuberbulosis therapy often resulted in little or even no absorption.Conclusion More accurate diagnosis of pulmonary tuberculomas could be made after careful analysis of all CT signs and the clinical data. CT-guided needle biopsy could be used when the dignosis could not be made clearly.

The relationship between M3 cholinergic receptor agonist (carbachol) hyperstimulation-induced pancreatic acinar cellular injury and trypsinogen activation or NF-kappaB activation in rats was studied in vitro. Rat pancreatic acinar cells were isolated, cultured and treated with carbachol, the active protease inhibitor (pefabloc), and NF-kappaB inhibitor (PDTC) in vitro. Intracellular trypsin activity was measured by using a fluorogenic substrate. The cellular injury was evaluated by measuring the leakage of LDH from pancreatic acinar cells. The results showed that as compared with control group, 10(-3) mol/L carbachol induced a significant increase of the intracellular trypsin activity and the leakage of LDH from pancreatic acinar cells. Pretreatment with 2 mmol/L pefabloc could significantly decrease the activity of trypsin and the leakage of LDH from pancreatic acinar cells (P < 0.01) following the treatment with a high concentration of carbachol (10(-3) mol/L) in vitro. The addition of 10(-2) mol/L PDTC didn't result in a significant decrease in the activity of trypsin and the leakage of LDH from pancreatic acinar cells treated with a high concentration of carbachol (10(-3) mol/L) in vitro (P > 0.05). It was concluded that intracellular trypsinogen activation is likely involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro. NF-kappaB activation may not be involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro.
Carbachol/*pharmacology ; Cholinergic Agonists/pharmacology ; NF-kappa B/*metabolism ; Pancreas/metabolism ; Pancreas/*pathology ; Rats, Wistar ; Receptor, Muscarinic M3/agonists ; Trypsinogen/*metabolism

Objective To compare the myocardial protective effects of isoflurane versus sevoflurane in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods Forty ASA Ⅱ or Ⅲ patients (NYHA Ⅱ or Ⅲ ) of both sexes, aged 40-55 yr, weighing 55-94 kg, scheduled for elective OPCABG, were randomly divided into 2 groups ( n = 20 each): isoflurane group ( group Ⅰ) and sevoflurane group ( group S). Anesthesia was induced with midazolam, sufentanil and vecuronium. Patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with inhalation of isoflurane or sevoflurane and infusion of sufentanil and vecuronium. In group Ⅰ, the initial end-tidal concentration of isoflurane was 1.2%. In group S, the initial end-tidal concentration of sevoflurane was 1.7 %. BIS value was maintained at 40-50 by adjusting the end-tidal concentration of isoflurane or sevoflurane. The central venous blood samples were collected immediately before skin incision, at the end of surgery, 2 and 24 h after surgery for determination of plasma creatine kinase-MB (CK-MB) activity and cardiac troponin Ⅰ (cTnI) concentration. The adverse cardiovascular events were recorded. Results The incidences of ventricular premature beat, tachycardia, bradycardia, ventricular fibrillation and S-T segment elevation ( ＞0.1 mV) during surgery and the plasma CK-MB activity and cTnI concentration after surgery were significantly higher in group S than in group Ⅰ ( P ＜ 0.05). Conclusion Isoflurane has better myocardial protective effect than sevoflurane in patients undergoing OPCABG.

ObjectiveTo review the clinical characteristics of patients with gastric mucosa-associated lymphoid tissue(MALT) lymphoma and to investigate the effects of Helicobacter pylori (Hp) eradication therapy in these patients.MethodsClinical data of ninety-five patients with gastic MALT lymphoma were reviewed with respect to their clinical manifestations,endoscopic features,histopathological features and Hp infection.The follow-up data of patients treated by Hp eradication therapy were analyzed.The survival curve was calculated with Kaplan-Meier,while the predictive factors for resistance to Hp eradiation were then analyzed by using Cox proportional hazards model.ResultsThe clinical manifestations and endoscopic features of 85 patients with gastric MALT lymphoma were non-specific.Hp positive was found in 97.9％ (93/95) patients at presentation,and 36 patients were treated by Hp eradication with a median follow-up duration of ( 58.1 ± 29.9) months.Total remission was achieved in 94.4％ ( 34/36),including 24 complete remission 10 partial remission.Therapy failure occurred in 2 patients.3-year survival rate of patients treated by Hp eradication were 86.2％ (25/29). Cox multivariate analysis showed that age ( ≥60 years),multiple lesions and non-superficial lesions were independent predictors of resistance to Hp eradication therapy.ConclusionGastric MALT lymphoma is associated with Hp infection.Eradication of Hp can effectively induce remission in these patients.

Objective To investigate the relationship of plasma fibrinogen (FIB) and non-highdensity lipoprotein cholesterol (non-HDL-C) with diabetic nephropathy in the elderly with type 2 diabetes. Methods Totally 152 patients (aged 60 years and over) with type 2 diabetics were divided into normal albuminuria (UAER＜30 mg/24 h,n=89) and abnormal albuminuria (UAER≥ 30 mg/24 h,n=63) groups,with high FIB (＞4.00 g/L,n=88) and normal FTB (2.00-4.00 g/L,n=64)sub-groups.The body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),postprandial blood glucose (2 hPG),glycated hemoglobin (HbAlc),serum triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),FIB and 24-hour urinary albumin excretion rate (UAER) were measured.The non-HDL-C and estimated glomerular filtration rate (eGFR) were calculated. Results Compared with normal albuminuria group,the values of age,hypertension rate,SBP,Scr and FIB in abnormal albuminuria group were increased [(74.6 ± 7.3) years,57 cases (90.5％),(146.8±23.2)mm Hg,(1.010.7)μmol/L,(4.8±1.5)g/Lvs.(71.6±7.2)years,59 cases (66.3％),(137.7±19.2) mm Hg,(0.8±0.3)μmol/L,(4.2±1.3)g/L,t=-2.536,-2.656,- 2.474,-2.857,x2 =11.936,all P＜0.05] while eGFR was significantly decreased [(68.5±31.2)ml · min-1 · 1.73 m-2 vs.(81.4±25.9)ml · min-1 · 1.73m-2,t=2.791,P＜0.05].The number of patients with high FIB was enhanced in abnormal albuminuria group than normal albuminuria group[45 cases (71.4％) vs. 18 cases (28.6％),x2 =8.085,P=0.004]. The proportion of abnormal albuminuria in high FIB group was lower than that in normal FIB group [(62.6±30.5) ml· min-1 · 1.73 m-2 vs.(83.2±28.7) ml· min-1 · 1.73 m 2,t=2.459,P=0.017].The Pearson analysis revealed that UAER was positively correlated with FIB,TG,TC and non-HDL-C (r=0.276,0.268,0.243,0.176,all P＜0.05).Stepwise regressive analysis showed that FIB was an independent risk factors of urinary albumin in the elderly with type 2 diabetes.Conclusions Higher levels of FIB and non-HDL-C are well correlated with diabetic nephropathy in the elderly with type 2 diabetes.

Objective To improve the orotracheal intubation verifying technique and reduce the complication of backflow in rat experiment.Methods A new position evaluation of anti-backflow device was designed and made of safety IV catheter and closed IV catheter system.60 adult male Sprague Dawley rats 216±20 g were randomly assigned to two groups: group A (n=40) for verifying placement, group B (n=20) for anti-backflow test.Group A was further divided into group A1 using self-designed positioning device, group A2 using aerosol, group A3 taking cotton fiber for positioning judgment.The group B was divided into two subgroups, B1 and B2, counting escaped bubbles as a means of positioning observation, the difference is that group B1 using frustum of a cone shape anti-backflow device, while the group B2 using common airway tube.Routine endotracheal intubation was performed to observe and record the time of positioning, the location of exhalation phase, and the length of inspiratory phase countercurrent water column.The group A1 further performed tracheotomy under direct vision clearly to confirm the anatomic positioning status.Results During the exhalation cycle,three or more bubbles were observed to escape continuously, indicating that the intubation tube was properly placed and open in the airway.Positioning time: It took 1.75±1.02 respiratory cycles in group A1,3.30±0.95 respiratory cycles in group A2 and 4.10±0.99 respiratory cycles in group A3 to complete the assessment the positioning status.There was no statistically significant difference between groups A2 and A3 (P> 0.05).The time needed for group A1 was significantly shorter than that of groups A2 and A3 (P < 0.01).The longest countercurrent water column length in group B1 was 3.23±0.53 cm, and 8.48±1.01 cm in the group B2.Conclusions The new designed anti-backflow positioning evaluation device is a simple and convenient appliance to evaluate the location of orotracheal intubation in rat experiment.It can effectively improve the positioning efficiency and has practical application value.

Background and purpose:It has a signiifcant effect for erlotinib on treatment of patients with epidermal growth factor receptor mutation in advanced non-small cell lung cancer (NSCLC). But almost all patients will eventually progress for the resistance of drug. This study was to evaluate the efifcacy and safety of retreatment of erlotinib in patients with advanced NSCLC. Methods:It was a retrospective analysis of the 46 advanced NSCLC patients who previously treated with erlotinib and had clinical beneift. The patients were given erlotinib 150 mg orally once daily after failure to other medications until disease progression or the occurrence of intolerable toxicity. The clinical features, therapeutic effect and survival were analyzed. Results: The objective response rate of retreatment with erlotinib was 28.3%. The disease control rate was 60.9%. The rate of symptom relief was 45.7%. The median progression-free survival was 3.6 months. The median overall survival was 7.3 months. One-year survival rate was 8.7%. The median progression-free survival was signiifcant longer in the patients who stopped taking erlotinib more than 6 months than those less than 6 months (P=0.002). The median overall survival was signiifcant longer in the patients whose ECOG ≤2 than those ECOG >2 (P=0.038). The most common drug-related adverse events were rash and diarrhea. Conclusion:The retreatment of erlotinib could possibly prolong the survival time of patients who previously treated with erlotinib and had clinical beneift.