A total of 115 patients with Hoshimoto thyroiditis were classified under 2 groups: one group being treated with selenium and L-throxine (L-T4) and other group with L-T4 alone.All patients were followed up for 3 months.In the selenium treated group thyroid peroxidase antibody level was decreased in 33 patients (56%) and thyroglobulin antibody level was decreased in cases.

Objective To explore the most suitable equation in accessing renal function for the elderly type 2 diabetic patients, and its clinical utility in combination with hypersensitive C-reactive protein (hsCRP). Methods The new Cystatin C-based equations for estimated glomerular filtration rate (Cys-eGFR) and conventional predictive equations were compared with isotopic GFR (iGFR) by linear regression analysis, paired t-test, Bland and Altman procedures and non-parametric receiver operating characteristic (ROC) curves. The new Cys-eGFR equation and hsCRP were also incorporated for detecting renal disease in this population. Results The new Cys-eGFR equation had a better relativity with iGFR (r= 0.767, P＜0.001), a less bias (bias: 0.0007, P＞0.05), a higher conformance (2SD: 21.56), higher sensitivity (90.7%) and specificity (88.6%) for diagnosing moderate decrease in renal function. There was a negative relationship between the new Cys-eGFR and hsCRP (r=-0.655, P＜0.01). When the new Cys-eGFR was 67.06 ml· min-1 ·1.73 m-2 and hsCRP was 5.65 mg/L, the combination of Cys-eGFR and hsCRP was better than the combination of serum creatinine and urine albumin/creatinine ratio in screening stage 3 chronic kidney disease (95%vs.46%). Conclusions The combination of new Cys-eGFR equation and hsCRP may screen an early decrease of moderate GFR.

Objective To observe the bone density, serum osteoprotegerin (OPG) level,relevant parameters of bone metabolism and sex hormones in elderly men with osteoporosis before and after treatment with oral Fosamax for 3 years. Methods The serum OPG level was compared between 72 randomly selected elderly male patients with osteoporosis and age-matched healthy controls. The bone density, serum OPG level, sex hormones, serum calcium and phosphorus,parathyroid hormone (PTH), osteoealein and urine type Ⅰ collegen crosslinked N-telopeptides (NTX),urine calcium and cretinine were tested in all elderly male patients with osteoporosis before and after 3 years of oral Fosamax treatment. The role of OPG in anti-osteoporotic therapy was studied by comparison of the parameters tested during the course of treatment. Results The serum levels of OPG osteoealcin, PTH and urine NTX were obviously higher in elderly men with osteoporosis than in healthy controls [(10.56±2.56) pmol/L vs. (8.91±2.20) pmol/L, (9.544±4.40) g/L vs. (6.774±2.87)rig/L, (70.39±35.58) ng/L vs. (47.11±21.80) ng/L, (72.06±9.78) nmol/L vs. (63.36±14.61)nmol/L, all P<0.05]. After treatment with oral Fosamax , the bone density was significantly increased. However, serum levels of OPG[(8.23±2.96)pmol/L], osteocalcinE(6.18±2.27)μg/L],PTH[(40.46±14.43) ng/L] and urine NTX[(64.83±11.40) nmol/L] were significantly decreased after treatment (all P<0.05). Spearman analysis showed that the improvement of bone density after treatment was closely associated with serum OPG level. Conclusions Serum OPG level in elderly patients with osteoporosis is much higher than that in control group. The improvement in bone density after treatment is associated with the decrease in OPG level. Bone density and relevant parameters of bone metabolism can be improved in elderly male patients with osteoporosis by using oral Fosamax.

ObjectiveTo investigate the role of OPN in human breast cancer cell line ( MDA-MB-231) by using small interfering RNA to specifically knockdown OPN expression. MethodsOPN ShRNA expression vector was stably transfected to MDA-MB-231 cell line.The expression of OPN mRNA and protein were analyzed using reverse transcription polymerase chain reaction (RT-PCR)and Western blot,respectively.The growth of MDA-MB-231 cells were observed by MTT.The effect of OPN siRNA on the transplanted tumor growth and tumor hypoxia were assessed in nude mice. ResultsThe expression level of OPN in MDA-MB-231 cells were significantly lower under hypoxia or normoxia(P ＜ 0.05 ).OPN silence with RNAi significantly inhibited the invasion ability and proliferation of MDA-MB-231 cell lines (P ＜ 0.01 ).Inhibition of OPN with RNAi significantly inhibited the growth ability of MDA-MB-231 cells in vivo(P ＜0.05).The tumor hypoxia significantly decreased(P ＜ 0.05). ConclusionsOPN silence with RNAi can effectively inhibit cell proliferation and tumor growth of MDA-MB-231 cells,and decrease the bypoxia level of MDA-MB-231 transplanted tumor in nude mice.

Objective To observe the effect of raloxifene, a selective estrogen receptor modulator, on osteoporosis in the osteoprotegerin (OPG) gene knock-out female and male mice. Methods Two groups of OPG gene deficient (OPG-/-) female and male mice, 20 mice in each group, were assigned to raloxifene-treated (3 mg The effect of raloxifene was evaluated by comparing the values of bone mineral density (BMD) , bone strength,histomorphometric measurement and osteoclast number between the raloxifene treated group and placebo group.Results As compared with placebo group osteoporotic manifestations were improved in OPG-/- female mice treated with raloxifene orally. BMD was increased both in lumbar vertebrae (P<0.05) and femurs (P<0.01).Bone strength was measured in femurs by three-point bending test and vertebrae by stress test. Results showed that ultimate load, ultimate stress and Young's modulus were increased both at lumbar and femur bone, suggesting decreased risk of fracture. Tartrate-resistant acid phosphatase, a marker enzyme of osteoclasts, was detected, and the number of osteoclasts declined significantly after the treatment of raloxifene. At the same time, results of histomorphometric measurements indicated that bone trabecular volume was increased and bone formation rate decreased from(8.05±4.02)mm3·mm-2·year-1 to (5.48±1.89)mm3·mm-2· year-1(P＜0.05).These findings were found in the group of OPG-/- female mice treated with reloxifene but not in male mice. Conclusions Raloxifene is effective in treating osteoporosis in female OPG-/- mice, indicating that its action is at least in part independent of OPG gene. But it is ineffective in male OPG-/- mice.

Objective To investigate the genetic relation between Cryptococcus neoformans var.the clinical strains in MLMT - 13 genotype and the environmental strains in MLMT - 36 genotype. Methods Multilocus microsatellite typing (MLMT) method was applied for the genotype analysis in our study.Through this method, we recognized two genotypes that distinguish a majority of clinical and environmental strains. In order to compare virulence between the two types, we chose to infect BALB/c mice (6 weeks,female) with 9 MLMT-13 strains and 10 MLMT-36 strains intravenously. Results Forty( 17 clinical and 23 environmental isolates) were analyzed. Of 17 clinical strains, 9 belonged to a major type of MLMT-13 (52.9%). They were mainly isolated from clinical specimens. About 43.5% of strains from the environment belong to a major type of MLMT-36, which are indigenous to environments and which were not isolated from clinical samples. The mortality rate and pathological changes of the above mice were observed during two months after injection. The results showed that the mortality rate of mice infected with MLMT-13 strains was 100%, while the mortality rate with MLMT-36 strains was 7. 5%. The pathological sections showed that lesions of MLMT-13 infected mice appeared in the brain, lungs, liver and kidneys, while the lesions of MLMT-36 infected mice only appeared in the brain. Most brains of MLMT-13 infected mice were distorted,and both the number and size of lesions in such brains were much larger than those of MLMT-36 infected mice. Conclusion Our study illustrated the virulent difference between MLMT-13 and MLMT-36, which are isolated from patients and environment respectively. The results inferred that some genetic changes, such ss microsatellite repeats, might occur between environmental and clinical isolates through their environmental adaptation progress.

OBJECTIVETo evaluate and compare the value of dynamic multiple pelvic angiography and pelvic four-contrast defecography in the diagnosis of functional defecation disorder.

METHODSFrom September 2014 to July 2015, a prospective controlled trial was carried out in Chengdu Anorectal Hospital. A total of 32 patients met the inclusion criteria of functional defecation disorder simultaneously underwent pelvic four-contrast defecography and dynamic multiple pelvic angiography. The diagnostic results of these two methods were compared.

RESULTSThe absolute values of anorectal angle and level of perineum, peritoneum and bladder from rest to defecation were (29.6±13.6)°, (26.2±14.2) mm, (55.5±25.6) mm and (28.9±16.5) mm in dynamic multiple pelvic angiography, and (24.6±5.8)° (18.7±10.6) mm, (34.5±18.4) mm and (19.2±11.8) mm in pelvic four-contrast defecography respectively, whose differences were statistically significant (P = 0.026, 0.022, 0.000, 0.011 respectively). The diagnostic rate of pelvic peritoneal hernia was 93.8%(30/32) and 68.8%(22/32) in dynamic multiple pelvic angiography and pelvic four-contrast defecography respectively with significant difference(P=0.011).

CONCLUSIONDynamic multiple pelvic angiography has significant advantage in the diagnosis of pelvic peritoneal hernia, and can provide a more objective basis for the diagnosis of functional defecation disorder.

Angiography ; methods ; Constipation ; diagnosis ; Defecation ; Defecography ; methods ; Humans ; Pelvis ; Perineum ; Prospective Studies

Objective:To evaluate the relationship between blood transfusion factors (massive transfusion, transfusion of stored red blood cells and anhepatic transfusion) and early postoperative outcomes in the patients undergoing orthotopic liver transplantation.Methods:Patients with end-stage liver disease who underwent orthotopic liver transplantation and intraoperative blood transfusion from January 2021 to March 2022 in our hospital were retrospectively selected, and their clinical data were collected. The patients were divided into massive transfusion group (M group, total red blood cell transfusion ≥10 U) and non-massive transfusion group (NM group) according to the amount of intraoperative blood transfused. The patients were divided into fresh blood group (NS group) and stored blood group (S group, red blood cell storage time > 2 weeks) according to the storage time of red blood cells transfused. The patients were divided into transfusion in anhepatic stage group (group T) and nontransfusion in anhepatic stage group (group NT) according to whether blood was transfused in the anhepatic stage. Multivariate logistic regression, generalized linear model and generalized linear mixed model were used to analyze the relationship between blood transfusion factors and primary outcome measures (postoperative pulmonary complications, circulation overload, acute kidney injury, abdominal infection, thrombosis) and between blood transfusion factors and secondary outcome measures (duration of ICU stay, postoperative hospitalization, postoperative temperature ≥38.5 ℃ at any time point after surgery, postoperative liver and kidney function index, coagulation function index, platelet count and preoperative difference).Results:One hundred and six patients were enrolled in this study. The results of multivariate logistic regression analysis: Massive blood transfusion and infusion of stored blood were risk factors for postoperative pulmonary complications, massive blood transfusion was a risk factor for abdominal infection, Child-Turcotte-Pugh score for liver function and time of anhepatic phase were risk factors for postoperative acute kidney injury, Child-Turcotte-Pugh score was a risk factor for circulatory overload, and age and massive blood transfusion were risk factors for thrombosis ( P<0.05). The results of generalized linear model analysis: Intraoperative stored blood transfusion and blood transfusion during the anhepatic phase were risk factors for prolonged duration of ICU stay, massive blood transfusion, intraoperative stored blood transfusion and blood transfusion during the anhepatic phase were risk factors for prolonged hospitalization ( P<0.05), and there was no correlation between massive blood transfusion, intraoperative stored blood transfusion and blood transfusion during the anhepatic phase and temperature ≥38.5 ℃ at any time point after surgery ( P>0.05). The results of generalized linear mixed model analysis: There was statistically significant difference in the difference between preoperative and postoperative liver and kidney function indexes, coagulation function indexes and platelet counts in the patients with or without massive transfusion, stored blood transfusion or blood transfusion during the anhepatic phase ( P<0.05). Conclusions:Massive blood transfusion and infusion of stored blood are the main risk factors for early adverse outcomes after orthotopic liver transplantation in the patients.

OBJECTIVE： To investigate and analyze the channels by which doctors obtain related information of diagnosis and treatment about diseases， and to provide reference for management institutions to understand related information and execute continue education. METHODS： 14 public general hospitals （12 were second grade class A， 2 were third grade class A） with grade Ⅱ and above in Tangshan were selected， and a self-designed questionnaire was used to conduct a one-to-one paper questionnaire survey on the doctors on duty. The content of the survey focused on the channels to obtain related information of diagnosis and treatment （including internal communication platform for medical experts， professional Chinese medical journals， professional medical network media， professional medical training classes/courses and professional medical academic conferences）. The channels to access relevant information on diagnosis and treatment were analyzed from the hospital level， department， professional title， education backgrounds and medical years. RESULTS： A total of 2 536 questionnaires were sent out， and 2 105 questionnaires were recovered （recovery rate of 83.0％）， among which there were 2 047 valid questionnaires （effective rate of 97.2％）. Doctors in third grade hospitals obtain more relevant information through “professional Chinese medical journals” “professional medical network media” “professional medical training classes/courses” “professional medical academic conferences” and than doctors in second grade hospitals （P＜0.05 or P＜0.01）； there was no statistical significance among different departments （P＞0.05）. Doctors with deputy chief physician or above title chose “internal communication platform for medical experts” “professional Chinese medical journals” and “professional medical academic conference” more than doctors with attending physician or below title （P＜0.05 or P＜0.01）. The proportion of doctors with master’s degree or above choosing “professional Chinese medical journals” “professional medical network media” and “professional medical academic conferences” were significantly higher than that of doctors with bachelor’s degree or below （P＜0.05 or P＜0.01）. The proportion of doctors who had been in medicine experience for 11 years or more choosing “professional Chinese medical journals” and “professional medical training classes/courses” were higher than that of doctors who had been in medicine experience for 10 years or less （P＜0.05 or P＜0.01）. Overall， the doctors who choosing “internal communication platform for medical experts” and “professional medical network media” was significantly higher than that of doctors choosing “professional Chinese medical journals” “professional medical training classes/courses” and “professional medical academic conferences” （P＜0.001）. CONCLUSIONS： Doctors are more likely to choose “internal communication platform for medical experts” and “professional medical network media” channels to obtain disease diagnosis and treatment information. Medical experts’ inner exchange platforms and professional medical network media can be effectively used as an important way for medical staff to conduct continue education and improve the level of disease diagnosis and treatment.

OBJECTIVETo investigate the value of psychological intervention in treating slow transit constipation (STC), and to provide the reference to clinical treatment for STC patients with psychological disorder.

METHODSA total of 94 STC patients with psychological disorder admitted to the Anorectal Hospital of Chengdu from June 2010 to August 2012 were prospectively enrolled and divided into psychological intervention group(subtotal colectomy plus postoperative psychological intervention) and control group (subtotal colectomy without postoperative psychological intervention). Scores of Hamilton depression scale (HAMD), Hamilton anxiety scale(HAMA), Wexner constipation scale (WCS) and gastrointestinal quality-of-life index(GIQLI) were recorded 1, 3, 6, 12 and 24 months after operation. SPSS 17.0 statistical software was used to analyze the data.

RESULTSThere were no differences in baseline data, operative time, blood loss, time to the first flatus and time to the first defecation between two groups(all P>0.05). The scores of HAMD and HAMA were significantly reduced in psychological intervention group compared with control group 3, 6, 12 and 24 months after operation (all P<0.05). Ratios of cure, obvious progress, progress and invalidation of depression symptoms in psychological intervention group were 2.6%(1/39), 66.7%(26/39), 25.6%(10/39) and 5.1% (2/39) respectively at postoperative 24-month, which were better than those [0, 34.2%(13/38), 44.7% (17/38) and 21.1%(8/38) respectively] in control group with significant difference(P=0.013). Ratios of cure, obvious progress, progress and invalidation of anxiety symptoms in psychological intervention group were 10.3%(4/39), 53.8%(21/39), 28.2%(11/39) and 7.7%(3/39) respectively at postoperative 24-month, which were better than those [0, 28.9%(11/38), 55.3%(21/38) and 15.8%(6/38) respectively] in control group with significant difference (P=0.011). The WCS scores in psychological intervention group were lower than those in control group 6, 12, 24 months after operation (all P<0.05). The GIQLI scores in psychological intervention group were higher than those in control group 3, 6, 12 and 24 months after operation(all P<0.05).

CONCLUSIONSubtotal colectomy combined with psychological intervention not only can significantly improve psychological disorder, but also increase the efficacy of surgery in the treatment of slow transit constipation patients with psychological disorder.