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 evaluate computed tomographic findings of struma ovarii so as to improve the knowledge of the imaging diagnostics of this disease.Methods Computed tomography (CT)scans and clinical data of 12 pathologically proven struma ovarii were reviewed retrospectively.Scans were evaluated for the laterality,size,margins,configuration,internal architecture,presence of intracystic high attenuation lesions on pre-contrast scans,the presence of calcifications,solid components enhancement,cyst wall enhancement,and ascites.Results All tumors were unilateral and had smooth margins.Cystic (n = 3)or mainly cystic (n = 9) appearance was common to all the tumors.Eight tumors showed a high attenuation lesion in the cyst portion of the mass on pre-con-trast scans.Calcification was found in 5 cases.The solid components showed different degrees of enhancement after administration of contrast medium.The cyst wall showed mild to moderate enhancement after administration of contrast medium.Five cases of tumors accompany a small amount of ascites.On pathology,the solid portions of the tumor consisted of the thyroid tissue and stoma which contained abundant blood vessels and fibrous tissue,and the cystic portions were filled with high gelatinous fluid of eosinophil-ic colloid.Conclusion On CT scans,struma ovarii appeared most often as a smooth marginated multicystic mass with a high attenu-ation lesion and calcification on pre-contrast scans with marked enhancement of the solid components.

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 optimize technology of three can group dynamic countercurrent extraction process of ferulic acid from Angelicae Sinensis Radix.Methods The content of ferulic acid was determined by HPLC. With content of ferulic acid as index, comprehensive test was used to investigate effect of extraction solvent and extraction time on extraction efficiency.Results The optimum process parameters were as follows:extraction solvent with 10 times of water;20 minutes for each extraction time.Conclusion The process which uses method of three can group of dynamic countercurrent extraction of ferulic acid from Angelicae Sinensis Radix is reliable, highly efficient and energy saving.

Objective To explore the clinical characteristics and pregnancy outcomes of twin pregnancies complicated with severe preeclampsia.Methods The pregnant outcomes of 131 twin pregnancies (twin group) and 572 singleton pregnancies (singleton group),all complicated with severe preeclampsia,were analyzed retrospectively.All patients were treated in the Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University from June 2007 to June 2011.The patients' age,onset of disease,gestational weeks at delivery,mean duration of expectant treatment,blood pressure,laboratory parameters and incidence of pregnancy complications,including placental abruption,heart failure,pulmonary edema,postpartum hemorrhage,uteroplacental apoplexy,eclampsia,HELLP syndrome (hemolysis,elevated liver enzymes and low platelets syndrome),hypoproteinemia,retinopathy,intracranial hemorrhage and renal insufficiency,were compared between the two groups.Perinatal outcomes such as premature delivery,perinatal mortality,neonatal intensive care unit (NICU) hospitalization,fetal distress,hypoxic-ischemic encephalopathy (HIE),asphyxia neonatorum,neonatal pneumonia,hyperbilirubinemia and neonatal hypoglycemia of two groups were also compared.Chi-square test,Fisher's exact test or t-test were used for statistical analysis.Results The severe preeclampsia incidence of twin pregnancies (5.03％,131/2604) was higher than that (1.94％,572/29 452) of singleton pregnancy (x2=106.40,P＜0.001).The onset time [(33.6±1.8) weeks] and gestations at delivery [(34.6±2.9) weeks] in twin group were earlier than those in singleton group [(34.4± 2.0) weeks,t=2.364,P＜0.05; (35.6±3.2) weeks,t=3.902,P＜0.05].The duration of expectant treatment of twin group [(6.4±0.3) d] were shorter than that of singleton group [(7.4± 0.5) d,t=5.314,P＜0.01].The incidence of placental abruption [9.9％ (13/131) vs 4.2％ (24/572),x2=7.013,P＜0.01],heart failure [11.5％ (15/131) vs 3.2％ (18/572),x2=16.430,P＜0.01],pulmonary edema [4.6％ (6/131) vs 0.9％ (5/572),x2=9.505,P＜0.01],postpartum hemorrhage [16.0％ (21/131) vs 7.0％ (40/572),x2 =10.990,P ＜ 0.01] and uteroplacental apoplexy [5.3％ (7/131) vs 0.5％ (3/572),x2 =17.650,P＜0.01] of twin group were higher than those of singleton group,respectively.The incidence of premature delivery [77.1％ (202/262) vs 29.9％ (171/572),x2=162.000,P＜0.05],NICU hospitalization [76.2％ (205/262) vs 58.4％(332/572),x2 =31.980,P＜0.05] and HIE [8.4％ (22/262) vs 4.7％ (27/572),x2 =4.392,P＜0.05] of twin group were higher than those of singleton group,respectively.Conclusions Twin pregnancy women are more likely to be complicated with severe preeclampsia and more vulnerable to suffer from severe complications,resulting in poor perinatal outcomes.More attentions should be paid on the management of twin pregnancy.Once hypertensive disorders complicating pregnancy is diagnosed,active management should be provided and timing of termination should be considered.

Objective To investigate the regulative role of N-Acetyl-D-glucosamine(GlcNAc) on the stressed mice macrophages function.Methods The stressed mice model was established by electric footshock method.The mice were divided into 5 groups:normal control group,stressed mice model group,low dose Glc-NAc treatment group(0.25 ml 15% GlcNAc),medium-dose GlcNAc treatment group(0.5 ml 15% GlcNAc) and high-dose GlcNAc treatment group(1 ml 15% GlcNAc).GlcNAc was intragastrically injected to corresponding mice 2 h before the electrical stimulation.Peritoneal macrophage(PM?) phagocytosis capability was detected by phagocytosis saccharomycete assay,and PM? energy metabolism was detected by MTT assay.Results Compared with normal control group,stressed mice PM? phagocytosis capability was significantly lower(P

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 compare coronary artery abnormality between patients with silent myocardial ischemia (SMI)and pa-tients with symptomatic myocardial ischemia using coronary artery CT angiography.Methods Forty-three patients with SMI and 45 patients with symptomatic myocardial ischemia were collected and underwent coronary CT angiography using 128-slices spiral CT scanner,respectively.Results Stenosis of coronary artery detected in 23 patients with SMI was (23/43,53.49%),and stenosis in 21 patients with symptomatic myocardial ischemia was (21/45,46.67%).The difference of incidence had no statistical significance, but the degree of stenosis and the number of stenosis vessel had statistical significance(P <0.05).The number of atherosclerotic plaque of coronary artery detected in patients with symptomatic myocardial ischemia was significantly more than that in patients with SMI(P <0.05).Conclusion There are no significant difference in the incidence of coronary stenosis between the patients with SMI and patients with symptomatic myocardial ischemia.However,the degree of stenosis and incidence of atherosclerotic plaque are sig-nificant different.

ObjectiveTo study the different clinical effects of using 5 kinds of hemostatic surgeries to manage the intractable postpartum hemorrhage and analyse the risk factors of failed hemostasis.Methods From Jan.2007 to Jul.2011,96 patients with intractable postpartum hemorrhage were studied retrospectively and grouped by the first step surgical treatment.The hemostatic surgeries included uterine tamponade (tamponadegroup ), pelvicbloodvessels ligation(ligationgroup), pelvical arterial embolization (embolization group), uterine compression sutures (sutures group)and uterine compression sutures combining tamponade (combined group).The intraoperative and postoperation datum were compared among groups,so dose the treatment outcomes.Multivariate analysis were used for failed hemostasis.Results( 1 ) The blood loss of 96 patients ranged from 1200 to 9100 ml,and 71 patients had a succeed hemoatasis after employing these surgeries and 25 failed.(2) The blood loss before hemostasis surgeries in tamponade group and embolization group was statisically greater than in sutures group ( P ＜ 0.05 ).Blood loss during the hemostasis surgeries in ligation group was statistically greater than in embolization and sutures groups ( P ＜0.05).The operating time of embolization group was statistically shorter than ligation group,sutures group and the combined group (P ＜ 0.05 ).(3) Fine of 96 patients had uterine atony and 43 had a successful hemostasis with the success rate about 78％.Forty-six had placenta previa and 39 success with success rate 85％.Thirty-three had placenta accrete and 13 of which succeed in hemostasis with success rate about 39％.In patients with uterine atony and placenta previa,the difference of hemostasis rate in groups had no statistically significant ( P ＞ 0.05 ).In patients with placenta accrete,the hemostasis rate in embolization group was higher than in others groups (P ＜ 0.01 ). (4) The multivariate analysis found that scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemotasis.The OR value respectively was 2.9 (95 ％ CI:1.1 - 7.6 ),17.9 ( 95 ％ CI:5.6 - 56.3 ) and 16.2 ( 95 ％ CI:3.2 - 83.5 ).Embolization had some extent of protective effection ( OR =0.9,95 ％ CI:0.8 - 0.9 ).Conclusions ( 1 ) Five kinds of hemostatic surgeries were all effective.Though the success rate among groups did show statistical difference,pelvical arterial embolization has the comparative advantage of shorter operating time,less operating blood loss and higher success rate in placenta accrete.(2) Since scar uterus,placenta accrete and coagulation defects were the risk factors of failed hemostasis,sufficient preparation should be made for patients with these risk factors and the hemostatic surgeries should be choosed individually.

Objective Large-conductance culcium-activated potassium (BKCa) channel modulates vascular smooth muscle tone. In the present study, we tested the hypothesis that salt, one of the factors which significantly influence bleed pressure (BP), can regulate BKCa activity and then elevate blood pressure. Methods Male Spragne-Dawley rats aged 6 weeks were randomized into high salt diet group (HS) and control group, fed with high salt diet (containing 5% NaCi) and standard rat chow (containing 0.4% NaCl) respectively for 16 weeks. Tail systolic blood pressure (SBP), body weight (BW) and 24-hour urinary output were tested every 4 weeks. Content of urinary Na+ was detected using flame spectrophotometrical method. At the end of 16 weeks, all the rats were killed, the mesenteric arteries were obtained, and single mesenteric smooth muscle cells were isolated at once. The resting membrane potential (Em), the total potassium currents and the currents after perfusion with TEA solution of the cells were all recorded by whole cell patch clamp. The transcriptions of BKCa channel α and β1 sobunits in mesenteric arterial vascular smooth muscle cells (VSMC) of each group were calculated by real-time RT-PCR. Results There was no difference in SBP and BW at each stage between control group and HS group; the urinary Na+ level in HS animals was elevated significantly after 4 weeks.The negative values of Em in HS group VSMCs were reduced compared with these in the control group. Transcriptions of β1 subanit of BKCa channels were decreased in HS group, but α subunit transcriptions did not differ between the two groups. Whole cell potassium currents did not differ hetween HS and control groups, but BKCa currents of HS group VSMCs were lower than these of control group ones. Conclusion Even without elevating SBP, salt-loading can still modulate the expression and activity of BKCa channel in the mesenteric arterial VSMC and elevate vascular tone.