Objective To investigate the prevalence of latent tuberculosis infection(LTBI),and to identify the risk factors in primary schoolchildren from Shanghai through the population-based field investigation combined with the tuberculosis infection enzyme-linked immunospot assay(T-SPOT.TB)assay.Methods The children in grade 4 and 5 were enrolled from four primary schools in Pudong new district and Yangpu district of Shanghai.Questionnaire interview was applied to investigate the soeiodemographic and clinical information related to LTBI.The T-SPOT.TB assay was used to detect LTBI in the enrolled subjects.Univaitate and multivariate analyses were used to identify the risk factors associated with LTBI among the primary schoolchildren.Results Totally 472 schoolchildren were enrolled in the present study,with 439(93.0%)being vaccinated with bacillus calmette-guerin (BCG) and ten (2.1%) having contact history with tuberculosis (TB) patients.Among the 472 eligible subjects,16(3.4%) children were T-SPOT.TB positive,who had no clinical symptoms andsigns relevant to TB and were defined as LTBI.The LTBI prevalence in BCG vaccinated and unvaccinated children were 2.7% and 12.1%,respectively (OR:6.972;95%CI:1.834-26.500);those in TB contacts and children without TB contact history were 30.0% and 2.8%, respectively (OR: 16. 38; 95% CI: 3. 692-72. 700). Conclusions The prevalence of LTBI among senior schoolchildren in Shanghai is 3.4%. BCG vaccination is protective for children from LTBI, while daily contacts with TB patients increases the risk of LTBI in schoolchildren.

Objective To study the pharmacokinetics and pharmacodynamics of recombinant human insulin preparations SciLin TM R and Humulin (R) R,and to evaluate their bioequivalence in Chinese healthy volunteers.Methods In this positive control,single dose,open label,randomized cross-over study,20 male healthy volunteers were recruited from March to October 2007,and tested on two experimental days with an interval of 7-14 days.The volunteers were divided into two groups with a random number table,one group was injected with SciLin TMR for the first time and Humulin (R) R for the second time,the other group was injected with the opposite.The pharmacokinetics and pharmacodynamic properties were evaluated by euglycemic glucose clamp study.Results Time to peak concentration [Tmax,(105.8 ± 19.1) minutes vs.(103.5 ± 18.1) minutes,P =0.389) and time to maximum glucose infusion rate [TGIRmax,(132.8 ± 16.8) minutes vs.(132.8 ± 18.6) minutes,P =0.697] for SciLin TMR and Humulin(R) R were similar.The relative bioavailability of SciLin TMR was (102.2 ± 7.6) ％,and the relative biological effectiveness was (107.4 ± 18.8) ％.The 90％ confidence interval(CI) of peak concentration(Cmax) and area under the curve of blood glucose concentration at 0-10 hours (AUCIns 0-10) of SciLin TM R were 99.32 ％-102.62 ％ (equivalent range 70％-143 ％) and 98.98 ％-104.99 ％ (equivalent range 80％-125％),respectively;90％ CI of the maximum glucose infusion rate (GIRmax) and AUCGIR0-10 were 97.36％ ～ 103.49％ (equivalent range 70％-143％) and 98.72％-113.54％ (equivalent range 80％-125％),respectively,indicating that SciLin TMR and Humulin (R) R was bioequivalent.There was no clinically significant abnormalities in the safety indexes before and after the tests.During the trial,no hypoglycemic events,allergic reactions,or local injection adverse reaction occurred.Conclusion The studied recombinant human insulin preparation SciLin TMR may be bioequivalent as Humulin (R) R.

Objective To study the pharmacokinetics and pharmacodynamics of the 40/60 premixed recombinant human insulin injection preparation,and to compare with 30/70 preparation,regular insulin,and neutral protamine Hagedorn (NPH).Methods In this positive control,single dose,open label,Latin square crossover study,20 male healthy volunteers were recruited from May 2006 to March 2007,and divided into four groups.On 4 test days,40/60 preparation,30/70 preparation,regular insulin,and NPH were administered to each of the 4 groups,the interval was 7-70 days before 2 test days.The pharmacokinetics and pharmacodynamics were evaluated by euglycemic glucose clamp technique.Results According to the analysis of variance,there were statistically significant differences in pharmacokinetics and pharmacodynamics of the 4 insulin formulations between the 4 groups (all P ＜ 0.05).For the 40/60 premixed recombinant human insulin,the pharmacokinetic parameter time to peak (Tmax) and mean retention time (MRT) were (105.00 ±24.33) minutes and (321.77 ± 56.29) minutes,respectively;the glucose-lowering effects reflected by the pharmacodynamic parameter Tmax and MRT were (167.75 ± 26.48) minutes and (248.33 ± 14.96) minutes,respectively.Compared with 30/70 premixed recombinant human insulin,40/60 preparation showed no significant differences in the pharmacokinetics parameters of blood insulin concentration,including peak concentration [(91.67 ± 13.03) mU/L vs.(84.96 ± 14.75) mU/L,P =0.119],Tmax [(105.00 ± 24.33) minutes vs.(122.25 ± 39.35) minutes,P =0.128],MRT [(321.77 ± 56.29) minutes vs.(332.12 ± 49.20) minutes,P =0.645] and area under the curve in 0-16 hours [AUCIns 0-16,(24 918 ± 6 610)h · mU/L vs.(26 768 ± 8 032)h· mU/L,P=0.084];however,statistically significant differences were observed in AUCIns0-4 [(16 991 ± 3 673) h · mU/L vs.(12 407 ± 3 441) h · mU/L,P =0.042] and AUCIns 0-8 [(23 283 ± 4 939) h · mU/L vs.(19 397 ±5 314)h · mU/L,P =0.046].Pharmacodynamic parameters showed no statistically significant differences (all P ＞ 0.05).Compared with 30/70 premixed insulin,the relative bioavailability of 40/60 premixed insulin was (118.9 ± 35.9) ％,and the relative biological effectiveness was (106.6 ± 35.2) ％.There was no clinically significant abnormalities in the safety indexes before and after the tests.No hypoglycemic events,allergic reactions,or local injection adverse reaction occurred in this trial.Conclusions The 40/60 premixed recombinant human insulin preparation demonstrated different properties in insulin absorption in 8 hours after injection compared with the 30/70 preparation,mainly because of the difference in proportions of short-and intermediate-acting insulin in the mixture.This new premixed insulin may provide a new option for personalized diabetes management.

Objective To improve diagnosis accuracy of pineocytoma (PC) by joint analysis of CT,MRI imaging features and differential diagnosis with other lesions in pineal region.Methods Totally 6 pineocytoma patients confirmed surgically and pathologically had their clinical history,CT and MRI data collected and analyzed on lesion morphology,cystic solid changes,existence of necrosis,complications of hemorrhage and or calcification,MRI and enhanced scan of solid component,complications with hydrocephalus and etc.Results Plain scan found 1 case of solid nodule and 5 cases of cystic-solid nodules,2 cases with clearly-bordered lesions and 4 one not as well as 4 cases with significant hydrocephalus and 2 ones with light hydrocephalus.Enhanced scan showed 5 cases of moderate to marked enhancement and one case with no obvious enhancement.CT examination proved there were 1 case of calcification and 1 case of hemorrhage.Conclusion Pineocytoma has the characteristics of benign tumor,and has to be differentiated with other tumors frequently occurring in this region in case of obvious clinical signs due to crushing brain parenchyma or blocking aqueduct cerebri by oversized lesions.

Objective To evaluate the processing line and the range of thoracolumbar (T10-L2) vertebral pedicle channel for vertebral reconstruction.Methods The thoracolumbar vertebrae (T10-L2) of thirty fresh specimens were performed CT scan,slice thickness of 1 mm without interval.Each vertebral body was reconstructed using the software Mimics 10.0 and measured each vertebral body pedicle axis length (L),pedicle length (L0),width (W) and height (H0),vertebral height (H),pedicle entry point in the sagittal plane angle (α) and the pedicle entry point in the cross-section angle (β),and further calculated the volume through vertebral pedicle channel for vertebral reconstruction.Results The average thoracolumbar (T10,T11,T12,L1,and L2) vertebral pedicle axis length was 32.64±5.66,31.80±6.41,38.46±3.52,40.31±4.39,and 42.72±3.36 mm prospectively.The average vertebral pedicle length was 12.38±2.06,11.77±2.15,14.63±2.34,15.46±3.04 and 14.37±1.64 mm.The average pedicle width was 5.09±0.26,5.79±1.10,7.35±1.87,7.17±0.69 and 7.14±0.84 mm.The average pedicle height was 9.76±1.43,10.83±0.77,11.16±0.78,11.33±1.26 and 11.16±0.96 mm.The average vertebral height was 18.12±0.88,19.48±1.02,21.25±1.27,22.88±0.68 and 23.20±0.93 mm.The average α angle was 25.06°±3.84°,30.87°±7.28°,25.12°±5.18°,20.55°±1.54° and 21.74°±2.58°.The average β angle was 43.60°±4.52°,49.48°±10.30°,41.97°±5.19°,40.29°±6.49° and 42.85°±6.47°.The average volume of one side of vertebral body after vertebral reconstruction respectively was 1.02±0.36,1.30±0.43,1.96±0.67,1.84±0.48 and 1.94±0.41 cm3,the corresponding percentage of total vertebral volume was 53.95％,55.68％,52.67％,49.53％ and 48.14％.Conclusion It is possible to use the pedicle channels for vertebral body reconstruction,reduction the end-plates and filling bone graft inside vertebral body.

Objective To study the role of phosphorylation at Serine 129 in regulating the neurotoxicity of ?-synuclein. Methods Wild type and phosphomimic mutant ?-synuclein genes were over-expressed in mouse dopaminergic cells MN9D using retrovirus. The cell viability was examined using CCK-8 assay and cell morphology was observed by immunofluorescence microscopy. Results The result of real time PCR showed that WT/?-SYN and S129D/?-SYN genes were overexpressed in MN9D as compared to uninfected MN9D and vector control group(P

Objective To discuss effect on prevention of postpartum hemorrhage of caesarean section by us- ing calcium gluconate combined with oxytocin and misoprostol.Methods 385 cases of caesarean section were select- ed and randomized into O(Oxytocin) group and OM(Oxytocin+ Misoprostol) group and COM (Calcium gluconate+ Oxytocin+Misoprostol)group.Results The mean operative blood loss in O group and OM group and COM group were (300?50.24)ml,(220?30.83) ml,(150?45.52) ml.The amount of the mean operative blood loss of COM group was significantly lower than those of O group and OM group(P＜0.05).The amount of bleeding of 2 hours after delivery in O group and OM group and COM group were (400?45.52)ml,(260?60.43)mi and(210?50.54) ml.The amount of bleeding of COM group was significantly lower than those of O group and OM group (P＜0.05).Conclusion The prevention by used calcium gluconate combined with oxytocin and misoprostol is efficient in reducing the amount of postpartum hemorrhage of caesarean section.The operation of medicine is easy and safe and economic.

Objective:To validate the clinical value of CT-guided curve-needle percutaneous ethanol injection (CNPEI) for celiac plexus block analgesia. Methods: Thirty-two patients with end-stage cancer, including 13 complicated with extensive retroperitoneal lymph node enlargement and fusion, were enrolled in this study. All patients complained of refractory upper abdominal pain and had received narcotic analgesics and radiotherapy, but the analgesic effect was not good. CT-guided CNPEI was therefore prescribed. Results: The effective rates of CT-guided CNPEI were 100%, 100%, 96.9%, 90.6%, 87.5%, and 84.4% immediately,and at 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after treatment, respectively. All enlarged lymph nodes had obvious necrosis and became shrunk. Conclusion: Combined application of bilateral anterior and posterior diaphragmatic crura block and trans-lymph node block can produce good analgesic effects, and curve-needle puncture make the above technique simpler.

Objective:To validate the therapeutic value of CT-guided percutaneous ethanol injection (PEI) in the treatment of metastatic adrenal tumors. Methods: Thirty-one foci (diameter ranging from 1.5 cm to 7.2 cm) in 25 patients with metastatic adrenal tumors were treated with CT-guided PEI for more than twice. Plain and enhanced CT scans were performed 1-2 months after PEI to observe the size and necrosis of the tumors. Results: Post-PEI enhanced CT scan showed that 18 of the 20 foci with diameters less than 3 cm completely necrotized; 11 foci with diameters between 3 cm and 7.2 cm necrotized partially, and 2 foci completely necrotized after another 2-3 courses of PEI treatment. Conclusion: CT-guided PEI is a simple and minimally invasive means for treatment of metastatic adrenal tumors, and the therapeutic effect is satisfactory.

Objective To establish the technique of hyperinsulinemic euglycemic clamp and to study the reference value of insulin sensitivity index in healthy Chinese. Methods According to the feedback mathematical model developed by DeFronzo, the technique of hyperinsulinemic euglycemic clamp was used in 90 healthy Chi- nese [ male:female =71 = 19; age; (28. 3±6. 1) years; body mass index (20. 9±1.5) kg/m2 ] to study die glu-cose metabolized rate. Blood samples were obtained at timed intervals in the fasting state and during the clamp for the measurement of glucose, insulin and C peptide. Results During the clamp tests, the blood glucose levels were con-trolled within 10% of target value. The coefficient of variation of glucose levels was 3. 8% 0.1%. In the steady state, the insulin sensitivity index (glucose metabolized rate, M value ) was (7.78±2.30) mg· kg-1 min-1, which was distributed normally. The lowest quartile of M value was 6. 286 mg·kg -1 min-1'. The coefficient of variation of M value was 9.4%±2.8%. Conclusion The technique of hyperinsulinemic euglycemic clamp and the reference value of insulin sensitivity index in healthy Chinese are successfully established in our center.