Objective The existing standards of skeletal development for Chinese were revised in this study due to the accelerated growth and development of Chinese children in the past 20 years.Methods Seventeen thousand and four hundred and one (17,401) healthy children of Han nationality (8,685 boys, 8,716 girls), aged 0～20 years, from cities of Shanghai, Guangzhou, Wenzhou, Dalian and Shijiazhuang were served as the sample for standardization. The radiographs were evaluated by a single observer using TW3 method. Furthermore, the new skeletal maturity events were chosen in 4, 5, 6, 7 stages of first metacarpal, proximal and middle phalanges, as well as in 5, 7 stages of radius and 5 stage of ulna in accordance to TW3-RUS. As a result, each stage was divided into two new stages. The fusion stages of radius and ulna were divided to 4 phases. The skeletal maturity scoring was computed by “scaling of categorized attributes” to minimize the overall disagreement between the different bones totaled over the standardizing sample. The new method is called RUS-CHN. The means and standard deviations of maturity score transformed by logarithm in each age group were calculated, and were fitted by quadratic and linear functions of age, respectively.Results The percentile standards of TW_3-C RUS, TW_3-C Carpal, RUS-CHN skeletal maturity scores were established. The revised standards are designated as “The Standards of Skeletal Maturity of Hand and Wrist for Chinese of Han Nationality-China 05”. Ages of the complete maturity of TW_3-C RUS, TW_3-C Carpal and RUS-CHN standards are 16, 13.5 and 18 years in boys and 15, 11.5 and 17 years in girls, respectively. In the verified sample of 2,438 children (1,301 boys, 1,137 girls), aged 1～19 years, the differences between skeletal age and chronological age of all age groups were mostly 0.0～0.3 year in TW_3-C RUS, TW_3-C Carpal and RUS-CHN skeletal maturity standards.Conclusion “The Standards of Skeletal Maturity of Hand and Wrist for Chinese of Han Nationality-China 05” are applicable to contemporary Chinese children.

Objective The reliability of the RUS-CHN of The Standards of Skeletal Maturity of Hand and Wrist for Chinese-China 05 and the TW_3-C Carpal methods was studied and the effects of readers' experience on the measured skeletal age were determined.Methods Under the conditions that readers were blinded to the age and sex of the children,the hand and wrist radiographs of 75 children(skeletal age from 3 to 18 years) were independently read by 11 readers using RUS-CHN method and the radiographs of 46 children(skeletal age from 3 to 13.5 years) were analyzed by 6 readers using TW_3-C Carpal method.The radiographs were re-read by the same readers 20 days later.The percentage agreement in the ratings and the differences of skeletal age in the rereading were used to evaluate the reliability.Results It was found that(a) intraobserver percentage agreement of ratings were 63.4% to 82.2% for RUS-CHN and 65.6% to 83.2% for TW_3-C Carpal respectively,the intraobserver 95% confidence limits for a single reading were ?0.40 year to ?0.76 year for RUS-CHN and ?0.38 year to(?0.71) year for TW_3-C Carpal respectively;(b) interobserver percentage agreement of ratings were 61.3% to 77.3% for RUS-CHN and 77.4% to 88.0% for TW_3-C Carpal respectively;interobserver 95% confidence limits for a single reading were ?0.42 year to ?0.96 year for RUS-CHN and ?0.42 year to ?0.78 year for TW_3-C Carpal respectively.Conclusion The present findings suggest that the reliability of skeletal age assessment between readers is significantly different and that the reliability levels of the experienced and relative experienced readers is higher,which can be obtained for few nonexperienced readers through training of assessment of skeletal age.The assessments of skeletal age are unreliability for the majority of non-experienced readers,so that the further training for them is needed.

Objective Due to the accelerated growth of Chinese children, the secular trend of accelerated skeletal development was observed in this study in order to provide the evidence for using the standards of skeletal maturity in reason.Methods The subjects were the children from two skeletal development surveys in 1980s and 2000s. The appearance age and fusion age of ossification centers in hand and wrist were calculated using the probit regression analysis, and the skeletal ages of children from the survey in 2000s were estimated by CHN method. The CHN skeletal ages were compared with calendar ages. Results Compared with the children in 1960s, the appearance ages and fusion ages of the ossification centers were all advanced in children in 1980s. Compared with the children in 1980s, the metacarpals and phalanges of children in 2000s were advanced by 0.5-1.0 year at age of appearance of ossification centers and 1.0 year in boys and 1.0-1.5 years in girls at the ages of fusion ossification centers. The ages of complete ossification of radius and ulna in children in 2000s were advanced by 0.4 year in boys and 0.3 year in girls. The differences between CHN skeletal age and chronological age of all age groups in 2000s were 0.3-1.1 year in boys and 0.2-1.0 year in girls. Conclusions In the last 40 years, the secular trend of accelerated skeletal development was presented in Chinese children. It should be cautious to estimate the contemporary Chinese children when using the skeletal norms of 1960s or 1980s.

Objective The determination of skeletal maturity is an important measure for selecting sports talent. The characteristics of skeletal development of hand and wrist in Chinese children were investigated in order to compare with overseas experiences. Methods The subjects were 16035 children, aged 2～18 years. The skeletal maturity of hand and wrist of the subjects was estimated by TW3 method and was compared with that of European, European North American and Japanese children. Results In comparison with European and American children, Chinese and Japanese children showed a similar patterns of skeletal maturation. The TW3-RUS skeletal maturity of Chinese children was retarded by 0.3～0.6 year in boys at the age of 8～12 and was very close to European and American in girls at the age of 5～10. Older than 12 years of age in boys and 10 years of age in girls, the TW3-RUS skeletal maturity of Chinese children accelerated and became advanced by 1.1～1.6 years in boys, by 1.2 years in girls. As compared with European and American children, the TW3-carpal maturity delayed by 0.3～0.6 year in Chinese boys at the age of 3～10 and by 0.2～0.4 year in Chinese girls at the age of 2～5. The TW3-carpal maturation accelerated after age of 10 in boys and age of 5 in girls. The age of complete maturity in all carpals was advanced by 1.4 year in boys and girls. Conclusion As compared with European and American children in 1970s-1990s, the delay of skeletal development of hand and wrist in Chinese children was not obvious in childhood, and the extent of advanced skeletal maturity and the age of advanced complete maturity of Chinese children are more evidently.

Objective To discuss the effects of high glucose on human mesangial cells (HMC)Wnt-β-catenin signaling pathway,and the intervention of rhein on it.Methods High concentration of glucose (30 mmol/L) combined with different concentrations of rhein were used to intervene cultured human mesangial cells.The activity of mesangial cell proliferation after all the interventions was examined by MTT measurement.Total Wnt、β-catenin RNA was detected By RT-PCR in normal mesangial cells and cells intervened by high glucose and Rhein.Results ①Inhibition effect to human mesangial cells:compared with NG group for 24 h,48 h and 72 h (OD values were 0.169± 0.051,0.228±0.074,0.285±0.075),human mesangial cells proliferation in HG group(OD values were 0.307± 0.074,0.507 ±0.038,0.711±0.075),HG+R1 group(OD value were 0.241± 0.027,0.334±0.015,0.499±0.063),HG+R2 group (OD value were 0.244±0.081,0.386±0.033,0.531±0.011),and HG+R3 group(OD value were 0.277±0.036,0.407± 0.057,0.594±0.042) were iucreased significantly (P＜0.05、P＜0.01) ; Compared with HG group for 24 h,48 h and 72 h,the HG+R1 group,the HG+R2 group and the HG+ R3 group showed a downward trend at 24 h,but not significantly; but the trend decreased significantly at 48 h and 72 h,and the performance expressed a time,concentration-dependent (P＜0.05,P＜0.01).② In the normal state,the mesangial cells expressed s certain amount of Wnt and β-catenin,when they were stimulated by high glucose,the expression of Wnt、β-catenin in mRNA increased (P＜0.05) ; while the expression of them was significantly reduced in high glucose-induced mesangial cells in HG+R1 group,HG+R2 group and HG+R3 group(P＜0.05).Conclusion Rhein may inhibit the proliferation of high glucose-induced mesangial cells through the Wnt and β-catenin gene expression.

BACKGROUND: Abnormal lipid metabolism is one of the risk factors in patients with ischemic cerebral disorders, and is correlated with the changes of lecithin cholesterol acyltransferase activity.OBJECTIVE: To observe the relationship between the changes of lecithin cholesterol acyltransferase activity and lipid content in red blood cell membrane.DESIGN: A case-control study(experimental group with control as standard level).SETTING: Department of clinical laboratory, emergency room and department of neurology of a hospital affiliated to a medical college of a university.PARTICIPANTS: Totally 105 inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology, Affiliated Hospital of Medical College of Qingdao University, from March 2002 to December 2003. They accorded with the Diagnostic Criteria set at the Second National Conference on Cerebrovascular Diseases. A total of 42 patients with cerebral arteriosclerosis and 63 patients with cerebral infarction were selected as patients group consisting of 67 males and 38 females. Another 65 healthy people receiving physical examination in the hospital, 36 males and 29 females, were selected as control group.METHODS: Venous blood of 8 mL was drawn from the participants on an empty stomach. We assayed the activity of lecithin cholesterol acyltransferase,high density lipoprotein cholesterol, low density lipoprotein cholesterol,apolipoprotein A1 and apolipoprotein B. Red blood cell membrane cholesterol was determined by phthalyl aldehyde-acetometry and red blood cell membrane phospholipid was determined by chemical quantitative analysis.MAIN OUTCOME MEASURES: Changes of lecithin cholesterol acyltransferase activity and lipid content in red blood cell membrane in patients group and control group.RESULTS: According to intention analysis, all the 105 patients in patients group and 65 patients in control group entered the results analysis. Activity of lecithin cholesterol acyltransferase: Activity changes in cerebral arteriosclerosis group and cerebral infarction group were obvious lower than those in control group[(2.14±0.72) kat/L, (2.06±0.80) kat/L, and(2.61± 0. 74) kat/L, P ＜ 0.01 ] . Level of high density lipoprotein cholesterol and apolipoprotein A1: The level in cerebral arteriosclerosis group and cerebral infarction group was obvious lower than that in control group[ (1.32±0.33) mmol/L, (1.37±0.33) g/L, (1.28±0.33) mmol/L; (1.27±0.31) g/L, (1.60±0.43) mmol/L, (1.60±0.43) g/L, t=2.72 to 5.01, P ＜ 0.01 ]. Content of low density lipoprotein cholesterol and red blood cell membrane-cholesterol: The content in cerebral arteriosclerosis group and cerebral infarction group was obvious higher than that in control group [ (2.94 ± 0. 82) mmol/L, (0.63 ±0.05) mmol/g, (3.02 ±0.79) mmol/L;(0.60 ±0.07) mmol/g, (2.56 ±0. 58) mmol/L, (0.57 ±0.05) mmol/g, P ＜ 0. 01 ] . Moreover, the activity of lecithin cholesterol acyltransferase was positively correlated with high density lipoprotein cholesterol and apolipoprotein A1(r=0.247, P ＜0.05; r=0.303, P ＜0.01), but was negatively correlated with low density lipoprotein cholesterol and red blood cell membrane cholesterol(r= -0.212, P ＜0.05;r= -0.346, P ＜0.01).CONCLUSION: In patients with ischemic cerebral disorders, the major change of plasma lipid is the decrease of lecithin cholesterol acyltransferase,but it is not secondary to cerebral infarction. The activity of lecithin cholesterol acyltransferase is positively correlated with high density lipoprotein cholesterol and apolipoprotein A1, but is negatively correlated with low density lipoprotein cholesterol and red blood cell membrane cholesterol.

Objective To sum up the measures for nursing the patients with laparoscopic gastrectomy-induced anastomotic leakage treated by open center vacuum aspiration. Method We retrospectively reviewed the histories of 22 patients with laparoscopic gastrectomy-induced anastomotic leakage to look into the nursing measures to look into the management of open vacuum aspiration , observation of the drainage, leakage care, mental care. Results The time for open center vacuum aspiration was between 10 to 17 days, averaged (15.63 ± 3.22)d. The hospital stay was between 13 to 23 days, averaged (17.21 ± 5.47)d. No complications were observed. Conclusions The nursing measures for managing the anastomotic leakage can be effective in improving the effect of peritoneal irrigation. The mental care can be effective for the reduction of patients′pains so as to promote the heal of the leakages.

OBJECTIVE:To evaluate the therapeutic effect of Xuesaitong soft capsule on symptoms of TCM in patients with stroke and cerebral infraction. METHODS:112 patients were divided into 2 groups,84 cases for experimental group and 28 cases for control group using CDAS 2.0 software. Experimental group were given Xuesaitong soft capsule and stimulation agent of Yinxingye soft capsule 2 pill at a time for 28 days,tid. RESULTS:100 patients including 75 cases for experimental group and 25 cases for control group had been completed experiment. There were statistical significance in difference between 2 groups in respect of improving half paralyzed symptoms,speech lost,dizziness and quarrel skew. Above aspects of experimental group were better than control group. CONCLUSION:Xuesaitong soft capsule have sound effect on blood stasis in stroke patients in recovery period.

Objective To investigate dyslipidemia and the use of lipid-lowering drugs in patients with chronic kidney diseases(CKD)and analyze the related risk factors.Methods A total of 397 out-patients with CKD in our Renal Department from March 2006 to March 2007 were enrolled;258 healthy people with similar age and sex were taken as the control group.Lipid levels were compared between the two groups and related factors were analyzed.Results Among 397 CKD patients,there were 52.1% patients with high triglyceride(TG),41% with high total cholesterol(TC),18.8% with low high-density lipoprotein cholesterol(HDL-C),47.6% with high low-density lipoprotein cholesterol(LDL-C).Compared with controls,rates of hypertriglyceridemia and low high-density lipoprotein cholesterol in CKD group were higher(P

Objective To observe the efficacy of lowering blood pressures and TCM syndrome on the mild to moderate hypertension via the treatment of auricular syndrome differentiation combined with magnetic point application;To provide reference for clinical treatment of hypertension by non-pharmaceutical therapy. Methods Totally 260 patients with mild to moderate hypertension were randomly divided into control group and treatment group, 130 cases for each. The control group was given Norvasc by conventional oral dosage, and the treatment group was given auricular syndrome differentiation and Yongquan (KI1) magnetic point application additionally. SBP, DBP and TCM syndrome scores of the two groups were observed before and after treatment to evaluate the antihypertensive efficacy and TCM syndrome efficacy. The side effects were also observed. Results After treatment, SBP of the two groups decreased significantly (P<0.05), with no significant difference (P>0.05). DBP of the treatment group decreased significantly (P<0.05), with significant difference compared with the control group (P<0.05). There was no significant difference in antihypertensive efficacy between the two groups (P>0.05). TCM syndrome of treatment group improved significantly compared with the control group (P<0.05). The total effective rate of TCM syndromes in treatment group was better than the control group (P<0.05), without side effects. Conclusion Auricular syndrome differentiation combined with magnetic point application can not only significantly improve the TCM syndrome of patients with mild to moderate hypertension, but also has synergistic hypotensive efficacy and high safety.