Objective To analyze the correlation of serum estradiol (E2),testosterone (T),estradiol/testosterone (E2 /T) ratio and BMD(Bone mineral density), bone turnover markers in postmenopausal women, and then to provide a theoretical basis for the pathogenesis of postmenopausal osteoporosis.It might point to a new diagnostic indicator for postmenopausal osteoporosis (PMOP).MethodsFrom October 2014 to September 2016, 283 cases of postmenopausal women were recruited from the Renmin Hospital of Wuhan University.Bone mineral density was measured by dual energy X-ray absorption apparatus, and the recruiters were classified into three group: normal controls (95 cases), osteopenia (94 cases) and osteoporosis group (94 cases).Serum calium (Ca),alkaline phosphatase (ALP),and propetide of type-Ⅰ procollagen (PINP) and β C-terminal cross-linked telopeptide of type I collagen (β-CTX) were detected by Roche cobas 6000 analyzer.Serum E2 and T were measured by Siemens Advia Centaur XP analyzer.All statistical analyses were carried out using SPSS 15.0 software.Results Compared with the normal controls, Serum E2[(22.65±5.35)pg/ml vs (18.64±6.18 )pg/ml,(17.04±6.73) pg/ml,P<0.01]and E2/T ratio (9.03±3.21 vs 7.44±1.78,6.67±1.50,P=0.01) were significantly decreased in the group of osteopenia and osteoporosis.But the bone turnover marker PINP was significantly increased[(38.92±19.23) ng/ml vs (43.94±15.52) ng/ml,(46.28±19.21) ng/ml,P=0.04].Correlation analysis results showed that serum E2 and E2/T ratio was negatively correlated with PINP (r=-0.273,P<0.05;r=-0.284,P<0.05),but positively associated with total hip BMD(r2=0.053,P=0.001;r2=-0.136,P<0.001).Multiple linear regression analysis showed serum E2 and E2/T ratio could explain 17.6% and 28.9% of the total hip BMD variance after adjustment for age, BMI and years after menopause.The area under curve (AUC) of combined E2 and E2/T as a indicator for the diagnosis of PMOP was 0.824 (95% CI:0.765-0.884,P<0.01), which was significantly better than that of E2 or E2/T (P<0.01) only.Conclusions Serum E2 and E2/T ratio was negatively correlated with PINP, but positively associated with total hip BMD.The decrease of serum E2 and E2/T ratio showed a strong association with PMOP.The combined detection of E2 and E2/T is expected to be a valuable indicator for the prediction of PMOP and to monitor the process of osteoporosis.

Objective To discuss the effect and clinical value of serum sialic acid (SA) and lactadherin(MFG-E8) in the coronary atherosclerotic heart disease(CHD).Methods Selected 295 patients who visited to Wuhan University Renmin's Hospital cardiovascular medicine (from January to June, 2014), and then according to the results of coronary angiography divide the subjects into control group (n =78, the result of coronary angiography completely normal)and coronary heart disease group(n =217, the results of coronary angiography showed that one major coronary stenosis was more than 30％).Detected their serum level of lipid, SA, MFG-E8, hs-CRP index.At last, analyze the differences of SA and MFG-E8 between these groups, and the correlation with the severity of coronary stenosis (symbolize with Gensini score), use the binary logistic regression analysis to research the relationship among the serum level of SA, MFG-E8 and the risk of CHD.Results Compared with the control group, the patients with CHD have a higher level of serum SA and a lower level of MFG-E8 (U =4 402.5, 2 736.0 respectively,P ＜0.001);the AMI group has a higher level of serum SA than the StA and UA groups (U =1 329.0,957.5 respectively, P ＜0.001);the AMI group has a lower level of serum MFG-E8 than the StA groups (U =1517.0, P ＜ 0.001).The spearman correlation analysis showed that the serum SA has a positively correlation with the level of TG, hsCRP and Gensini score, and has a negatively correlated with the level of MFG-E8 (r =0.214, 0.462, 0.378,-0.322 respectively,P ＜0.01);the MFG-E8 has a negatively correlated with the level of TG, hsCRP and Gensini score (r =-0.18,-0.425,-0.564 respectively, P ＜0.01).Binary logistic regression analysis showed that there was a positive correlation between the serum SA and the risk of CHD (OD =4.782, 5.319, 4.179 3.832, 3.648 respectively, P ＜0.001), and the was a negative correlation between the serum MFG-E8 and the risk of CHD (OD =O.118, 0.112, 0.127, 0.135, 0.134 respectively, P ＜ 0.001).Conclusion With the serum SA rised and the MFG-E8 reduced, the risk of coronary heart disease was higher, combined detection these two indexes may be able to diagnose the CHD and assess the degree of stenosis and the risk of CHD.

Objective To observe the clinical effect of neuromuscular electrical stimulation combined with kinesitherapy on dysfunction after brachial plexus injury. Methods 60 cases with brachial plexus injury following dysfunction were divided into two groups. The experimental group (n=30) was treated with neuromuscular electrical stimulation combined with kinesitherapy. The control group (n=30) was treated with kinesitherapy. Two groups were assessed by the brachial plexus function evaluation standard before and 3 months after the treatment.Results Two group all improved 3 months after the treatment (P<0.05), while the experimental group was better than the control group (P<0.01). Conclusion Neuromuscular electrical stimulation combined with kinesitherapy is more effective to improve the function after brachial plexus injury.

Based oncompetence-basedphilosophy of education, core competences of Master of Nursing Specialist (MNS) postgraduates serve as a benchmark for the education quality. Furthermore, the evaluation of core competences is a key link. Our research mainly summarizes the evaluation methods of core competences of MNS at home and abroad, thus providing suggestions to the improvement of domestic core competences evaluation methods of MNS.

Objective To explore the clinical values of applying contact-mode argon plasma coagulation (APC) for retroflex colonoscopic treatment of ultra-lower rectal polyps. Methods 46 wide outsole and applanate polyps smaller than 1.0 cm located at ultra-lower rectum in 17 cases of patients were treated by contact-mode APC under U-type retroflex colonoscopy after failure in regular colonoscopic treatment. Then observe the contacting rate of APC probe with polyps, success rate of curing polyps, rate of probe being adhered and blocked by the solidification structures, incidence of submucosal emphysemas, and incidence of colonoscope ambustion. Results Under U-type retroflex colonoscopy, the probe could contact with polyps in 17 patients. The polyps in every patient were cured by APC in the first time of colonoscopic treatment, whereas all 46 polyps were cured by 97 times of APC spurt. Mild adhesions occurred between the probe and solidification structures at 5 times (5.15 %) among 97 times of APC spurt, without injuries to the coagulation surface from which when the probe separated. The solidification structures blocked the probe only twice (2.06 %). When the solidification structures were cleared, efficiency of the probe restored. No sub-mucosal emphysemas and colonoscope ambustion happened. Conclusion Applying contact-mode APC for retroflex colonoscopic treatment of ultra-lower rectal polyps is safe and effective, it can prevent the damage of colonoscope from the argon knife.

Objective To explore the effect of acupuncture and moxibustion combined with quadriceps exercise on osteoarthritis of knee joint. Methods 82 cases of knee osteoarthritis were randomly divided into the acup-moxibustion group (41 cases, treated with acup-moxibustion and quadriceps exercise treatment) and routine treatment group (41 cases). Lower limb ability of daily life respectively and knee pain of patients before and 30 days after treatment were evaluated. Results Clinical symptoms of patients in both groups were improved significantly after treatment. The acup-moxibustion group was better than traditional group in relieving pain and improving the lower limb ability of daily life (P<0.01). Conclusion The acup-moxibustion therapy combined with quadriceps exercise has preferable clinical curative effect on knee osteoarthritis.

Objective To examine the association between the polymorphisms of brain-derived neurotrophic factor (BDNF)gene with heroin dependence.Methods Genomic DNA was isolated from the venous blood leukocytes of 308 unrelated patients with heroin dependence and 31 7 healthy individuals.Seven single nucleotide polymorphisms (SNPs)were genotyped using MassARRAY system.Data were analyzed using HaploView 4.0 and SPSS 20.0 software.Results There was a significant difference in the genotype frequency of rs6265 between heroin dependence group and healthy control group (χ2 =1 5.1 5 1,P =0.001).The rs6265 G allele was significantly higher than in controls (χ2 =9.864,P =0.002,OR =1.429,95% CI =1.143 -1.786).Furthermore,there was also a significant difference in the genotype frequency of rs13306221 between heroin dependence group and control group (χ2 =7.699,P =0.006).The rs13306221 G allele was significantly higher than in controls (χ2 =7.137,P =0.008,OR =0.539,95% CI =0.340-0.853).Strong linkage disequilibrium (LD)was observed in one block (D’> 0.9;r 2 >0.8),and significantly less G-G haplotype frequency of block 1 (χ2 =4.546;P =0.033)was found in heroin dependence group. Conclusion Our findings support the role of BDNF rs6265 and rs13306221 polymorphisms in heroin dependence and may guide future studies to identify other genetic risk factors for heroin dependence.

Through comparing problem-based learning and lecture-based learning, the PBL teaching can improve the learning interest and self-learning ability of students and also can accomplish the task of teaching better.

Objective:To study the function and possible mechanism of Fufang-Zhongjiefeng aerosol in the treatment of chronic pharyngitis. Method:Sixty SD rats were randomly divided into normal group, model group, low-, medium-, and high-dose Fufang-Zhongjiefeng aerosol group, and positive drug group, with 10 rats in each group. Except the normal group, the pharynx of other groups were injected with group A beta-hemolytic streptococcus (GAS) to establish chronic pharyngitis rat model. After the modeling, the low-, medium-, and high-dose Fufang-Zhongjiefeng aerosol groups were sonicated with 20 ml of 0.9% normal saline to dissolve the Fufang-Zhongjiefeng aerosol 2.33, 4.66, 9.32 g/kg, respectively. The normal group and the model group were given the same volume of normal saline, and the positive drug group was intraperitoneally injected with ampicillin sodium 0.93 g/kg once a day for 14 days. The pathological changes of pharyngeal mucosa were detected by hematoxylin and eosin (HE) staining. The levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and nterleukin-6 (IL-6) in serum were detected by Enzyme-linked Immunosorbent Assay (ELISA). The expression levels of toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor kappa B (NF-κB) p65 protein in pharyngeal mucosa were detected by immunohistochemistry. The expression levels of TLR4, MyD88 and NF-κB p65 mRNA in pharyngeal mucosa were detected by quantitative real-time reverse transcription-polymerase chain reaction (RT-qPCR). Results:Compared with the model group, the serum TNF-α, IL-1β and IL-6 levels of rats in the Fufang-Zhongjiefeng aerosol low-, medium-, high-dose group and the positive drug group were significantly reduced ( P<0.05). The expression of TLR-4, MyD88 and NF-κB p65 protein in the pharyngeal mucosal tissue of rats in the low-, medium-, high-dose Fufang-Zhongjiefeng aerosol group and the positive drug group were significantly reduced ( P<0.05). The expressions of TLR-4 mRNA (1.17 ± 0.41, 2.44 ± 1.06, 1.25 ± 0.34 vs. 3.87 ± 1.43), MyD88 mRNA (1.15 ± 0.53, 1.75 ± 0.36, 1.09 ± 0.14 vs. 2.44 ± 0.19), and NF-κB p65 mRNA (1.97 ± 0.51, 2.64 ± 0.26, 2.31 ± 0.44 vs. 5.08 ± 0.34) in the pharyngeal mucosa tissue of rats in the medium-, high-dose group and the positive drug group were significantly reduced ( P<0.05). Conclusion:Fufang-Zhongjiefeng aerosol can effectively treat chronic pharyngitis, which could inhibit the expression of TLR-4, MyD88, and NF-κB to reduce the expression of inflammatory factors so as to play the rold of anti-inflammatory effect.