Objective:To investigate the distribution of polymorphism of estrogen receptor (ER) gene in postmenopausal Han women in Beijing as well as its relationship with bone mineral density (BMD).Methods:Xba Ⅰ,and Pvu Ⅱ polymorphisms of ER gene were studied by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) and BMD were determined by DEXA (dual-energy X-ray absorptiometry).The relationship between BMD and polymorphism of ER gene was studied by variance analysis.Results:Pvu Ⅱ polymorphism of ER gene was not associated with BMD of spongy and compact bone of radius;while Xba Ⅰ polymorphism of ER gene was associated with BMD of spongy and compact bone of radius.The lowest BMD was found with XX genotype while the highest BMD was found with xx genotype.Conclusion:There is high correlation between of Xba Ⅰ polymorphism and BMD of spongy and compact bone of radius.Our study suggested some bases to explore the pathogenesis of osteoporosis and to prevent the development of osteoporosis.

Objective: To define the occurrence rate, time course, and potential mechanism of hyponatremia in patients after Frankel Class-A acute cervical spinal cord injury. Methods: Analysis of data obtained from a retrospective review of blood and urine records of 35 hospitalized cases from 1992 to 1998. Results: Patients were admitted after (2.8±1.8) days postinjury and had been hospitalized for (52±13) days. Hyponatremia, the occurrence rate of which was 100%, developed at a mean time of (4.5±1.2) days postinjury, reached its nadir at the end of (14±3) days and recovered to normal at (39±10) days. Fifteen (42.88%) cases did not recover from hyponatremia in the hospitalized period. Patients were suffering from hypercapnia, hypernitremia, polyuria, and hyper-natriuresis besides kalemia. Conclusion: Severe and obstinate hyponatremia is a very common complication of cervical spinal cord injury. The mechanism may be related to the Cerebral Salt Wasting Syndrome.

Objective: To assess the immunological effects by orally administering chicken type Ⅱ collagen(CCⅡ) on collagen-induced arthritis(CIA)mice. To assess the effect on producing IL-1 of peritoneal macrophage in adjuvant arthritis rats by orally administering CCⅡ. Methods: Arthritis were induced in Kunming mice by immunization with chicken type Ⅱ collagen with Freund's complete adjuvant, followed by an interperitoneal injection of CCⅡ 3 weeks later.Chicken type Ⅱ collagen was orally administered from 5 days prior to the induction of arthritis to 14 days after inducing arthritis model. The animals were examined visually twice weekly for polyarthritic signs of swollen and erythemic limbs. Quantitation of antibody level of CIA mice was measured by ELISA method. Subpopulations of T lymphocytes in mice were evaluated by flow cytometry method. IL-1 assay was evaluated by ELISA method. Results: Joint swelling was significantly reduced at a dose of 5 μg.kg-1 and 50 μg.kg-1 of CCⅡ, but not at 250 μg.kg-1. The level of anti-collagen antibodies was also reduced at a dose of 5 μg.kg-1 and 50μg.kg-1 (OD value from CIA model control 0.242±0.073 to CCⅡ 5 μg.kg-1 0.123±0.029 and CCⅡ 50 μg.kg-1 0.110±0.075 respectively). Subpopulations of T-lymphocytes were changed by orally administering of CCⅡ, and the ratio of L3T4+/Lyt-2+ was lowered (the ratio from 1.71 of CIA model control to 1.21, 1.51 of administered CⅡ 5 μg.kg-1, 50μg.kg-1 respectively.) after administering CCⅡ. IL-1 level can be reduced (the value from adjuvant arthritis model control 62.8±0.9 to 43.4±1.3, 49.7±0 ng.L-1 administered CⅡ 5 μg.kg-1, 50μg.kg-1 respectively). Conclusion: Arthritis sign in CIA animal model can be suppressed by oral CCⅡ. The effects may be involved by influencing the mechanisms both humoral and cellular immunity. The effects occurred at lower doses of CCⅡ. These results demonstrated the biologic relevance of by-stander suppression associated with oral tolerance, and the potential use of this approach to treat human inflammatory joint diseases.

Objective:To assess the genetic relationship of clinical isolates of carbapenem-resistant A.baumannii (resistant to both imipenem and meropenem) from January 2007 to March 2008 in Peking University Third Hospital for measures to decrease the isolates; to investigate the characteristics of patients with carbapenem-resistant A. baumannii colonization or infection and to evaluate antibiotic treatment for health care-associated infections caused by carbapenem-resistant A. baumannii. Methods: The medical records of patients with carbapenem-resistant A. baumannii colonization or infection were reviewed. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis. Results: A total of 49 carbapenem-resistant A. baumannii strains were isolated from the 49 patients hospitalized during the study period and pulsed-field gel electrophoresis typing yielded 7 different patterns. A total of 45 (91.8%)genotyped strains showed clonal relationship. The most frequently identified predisposing factors were intensive care unit stay, invasive procedures, and hypoalbuminemia. Chronic obstructive pulmonary disease (12 cases) and cerebrovascular disease (10 cases) were the most common comorbid conditions.The mortality of patients with carbapenem-resistant A. baumannii infection was 38. 1% (8 of 21 patients), and the acute physiology and chronic health evaluation Ⅱ score, initial antibiotic therapy failure rate and the presence of hypoalbuminemia were significantly increased in the death group. Combination therapy regimens had higher success rates than monotherapy regimens (11/13, 84. 6% vs. 3/17,17.6%). Conclusion: There has been clonal spread of carbapenem-resistant A. baumannii strains among patients in our hospital since 2007. Intensive care unit stay, invasive procedures, hypoalbuminemia, chronic obstructive pulmonary disease and cerebrovascular disease were common in patients with carbapenem-resistant A. baumannii colonization or infection. Antibiotic combination therapy may be effective for carbapenem-resistant A. baumannii infection.

Objective:China was categorized as one of the 68 countdown countries to achieve the United Nations Millennium Development Goals (MDG) 5. This paper aimed to analyze the situation of maternal survival, and coverage of proven cost effective interventions in China, where specific attention was paid to disparities. Methods: National maternal and child mortality surveillance data were used to estimate maternal mortality ratio (MMR). Coverage for proven interventions was analyzed based on National Health Services Survey, where experts' consultations were made for complementation. Results: There had been a significant reduction of MMR in China, however great disparities existed, with rural Ⅱ to Ⅳ areas experiencing 2 to 5 times higher maternal mortality risks than urban areas and accounting for over 70% maternal mortality burdens. Postpartum hemorrhage, pregnancy associated hypertension, embolism and sepsis were the leading causes, and over 75% of the maternal mortality was caused by preventable or curable causes. Maternal health services utilization decreased in accordance with region' s development level. Socioeconomic factors like financial difficulties were the main obstacles hindering access of care.Even those who made deliveries in hospitals faced different probabilities in receiving qualified care according to their socioeconomic standings. Conclusion: China is on track to achieve MDG 5, however great disparities exist. It is necessary to specifically target rural types Ⅱ to Ⅳ areas. Major causes of maternal mortality which can be prevented or averted through the provision of essential obstetrical care. Yet as compared with maternity health needs, insufficient coverage of maternal and child health (MCH) care services and poor service quality are the leading predisposing factors contributing to maternal mortality in China.

SUMMARY A 15-year-old boy was admitted with nephritic and nephrotic syndrome,renal dysfunction and decreased serum C3,who suffered from varicella for two months.His renal histopathology revealed endocapillary proliferative glomerulonephritis with podocytes proliferation and severe tubular injury by light microscopy.Direct immunofluorescence showed global granular deposition of IgG,IgA,IgM,C3,Clq and fibrinogen in mesangium and along glomerular capillary wall.Electron microscopic examination showed electron-dense deposits in multiple sites of glomeruli.Furthermore,specific serum IgM antibodies against varicella-zoster virus (VZV) were detected.VZV antigen and mRNA were demonstrated in glomerular and tubular epithelial cells by immunohistochemical staining and in-situ hybridization.Virus particles and virus inclusions were identified by electron microscopy and special staining ( Methylene Blue and Eosion staining or Mann staining).The patient also experienced epileptic episodes and his brain MRI and electroenephalogram indicated herpes encephalitis with secondary epilepsy.Therefore,the diagnosis of VZV-associated glomerulonephritis and encephalitis was established.This is the first case of VZV-associated glomerulonephritis with renal histooathological evidence using in situ hybridization technique.

Objective:To measure components of the circulating transforming growth factor β (TGFβ)system in patients with Turner syndrome (TS) compared to relevant controls and to ascertain correlation with endocrine and cardiovascular parameters.Methods:TGFβ1,TGFβ2 and endoglin (a vascular TGF receptor component) were measured using enzyme-linked immunoassays in the sera of 40 subjects with TS and 40 healthy volunteer women.The cardiovascular phenotype in TS subjects was extensively characterized by cardiac magnetic resonance (MR) and echo.Results:TGFβ1 levels were about 3-fold higher in TS while TGFβ2 levels were about 3.5-fold higher in controls (P ＜0.000 1 for both).Soluble endoglin levels were 25％ higher in TS (P ＜0.000 1 ).Variation in TGFβ system components was not explained by age,blood pressure,platelet count,thyroid function,body proportions or cardiovascular phenotype.Conclusion:There is profound perturbation of the TGFβ system evident in the circulation of individuals with TS.

Noncommunicable diseases (NCDs) are the leading causes of death globally,which kill more each year than all other causes combined.It is estimated that 63％ of global total deaths were due to NCDs.Nearly 80％ of NCD deaths occur in low- and middle-income countries.China contributes the largest number of NCD patients and deaths.NCD rates have been increasing at an alarming rate over the past two decades in China and many other countries.Population-wide interventions can help reduce NCD burden and can be cost effective.Improved health care,early detection and timely treatment are also needed for reducing the impact of NCDs.Strong government commitment,adequate investment,and extensive involvement and collaboration of multiple diverse social sectors with health sectors are critical to fight the NCD burden in all countries,especially in low- and middle-income countries.

This review will discuss aerosol device technologies available for pulmonary vaccine deliveries.The possibilities of adopting aerosol-generation for the purpose of pulmonary immunization are described.Aerosol-generation systems might offer advantages in respect to vaccine stability and antigenicity.The noninvasive,relatively safe and low-cost net of pulmonary delivery may provide great benefits to the public health vaccination campaign.

Structural fat grafting has been considered as a valid option for soft-tissue augmentation in cosmetic surgery.However,its result has often been considered poor or unpredictable and is largely surgeon dependent.Less desirable outcome after fat grafting is probably due to lack of good surgical technique.In order to help plastic surgeons to gain more insight to this valid fat grafting technique,the author conducted a critical review of the current literature in this subject.To better address the findings of the study,the fat grafting technique was arbitrarily classified into 4 essential steps to determine how the donor sites should be selected and how the fat grafts should be harvested,processed,and placed.It becomes clear that several basics in an established fat grafting technique have gained much of scientific support and should be followed in order to achieve an optimal outcome for our patients.These basics include the proper selection of donor sites,to harvest fat grafts with an atraumatic technique,to process fat grafts with centrifugation in an appropriate setting,and to place fat grafts with a unique fashion.