Health Promotion ; Humans ; Pilot Projects ; Workplace

Gene Expression Regulation, Viral ; Proteomics ; methods ; trends ; Viral Proteins ; analysis ; genetics ; Viruses ; genetics ; growth & development ; metabolism

Objective:To explore the diagnostic value of serum procalcitonin (PCT) level combined with Quantitative Computed Tomography (QCT) in elderly women with painful osteoporosis and its correlation with disease severity.Method:This study is a prospective study. From Jan. 2019 to Apr. 2020, 596 elderly women who underwent physical examination in our hospital were selected as the research subjects. All of them underwent dual-energy X-ray, PCT examination, and QCT examination serum. The diagnostic value of PCT and QCT in elderly women with painful osteoporosis was analyzed; Pearson correlation was used to analyze the correlation between the bone mineral density of lumbar vertebral 1, 2 vertebra, PCT and the severity of painful osteoporosis.Result:Among 596 elderly women, painful osteoporosis patients accounted for 50.84% (303/596) , bone mass reduction accounted for 21.98% (131/596) , and normal bone mass accounted for 27.18% (162/596) . Compared with the results of the diagnosis of painful osteoporosis by DAX, the diagnostic coincidence rates of PCT, QCT, QCT+PCT were 81.88% (488/596) , 93.62% (558/596) , and 97.31% (580/596) . QCT examination, QCT+PCT diagnosis coincidence rate is higher than PCT examination ( χ2=43.650, 83.187, P<0.05) ; QCT+PCT diagnosis coincidence rate is higher than QCT examination ( χ2=9.388, P=0.002) . The sensitivity, specificity, positive predictive value, and negative predictive value of QCT+PCT in the diagnosis of abnormal bone mass are higher than those of PCT ( P<0.05) ; the specificity and negative predictive value of QCT+PCT in diagnosing abnormal bone mass are higher than QCT Check ( P<0.05) . The bone density detected by QCT in the osteopenia group and the painful osteoporosis group was lower than that in the normal bone mass group, and the serum PCT level was higher than that in the normal bone mass group, the difference was statistically significant ( P<0.05) ; the painful osteoporosis group was in QCT detection of bone. The density was lower than that of the osteopenia group, and the serum PCT level was higher than that of the osteopenia group, the difference was statistically significant ( P<0.05) . The severity of painful osteoporosis was negatively correlated with bone mineral density detected by QCT ( r=-0.54, P<0.05) , and positively correlated with serum PCT ( r=0.59, P<0.05) . Conclusion:QCT vertebral bone mineral density determination combined with serum PCT detection has high accuracy, sensitivity, and specificity in the diagnosis of painful osteoporosis, and is closely related to the severity of painful osteoporosis, and can be used for clinical evaluation of the condition of painful osteoporosis patients.

Objective To investigate the relationship among the activity of protein kinase C (PKC) in platelets of maternal vein and umbilical blood , the pathophysiological changes of pregnancy induced hypertension (PIH) and fetal growth restriction (FGR) in PIH patients. Methods Activities of PKC in membrane and plasma of platelets from maternal vein and umbilical blood taken from 35 PIH patients and 20 normal pregnant women were measured with substrate phosphorylation method. Results No difference was shown in the PKC activities between the mild PIH patients and normal pregnant women in both maternal and cord blood.The PKC activities in moderate and severe PIH patients were significantly higher than those of the normal pregnant group.In normal pregnant women, the PKC activity in membrane and plasm of the platelets had no significant difference. In the moderate and severe PIH group, PKC activity in membrane was far more higher than the plasm 46?6 vs 37?4 pmol/(min?mg protein), P

Objective To investigate the role of hypoxia inducible factor(HIF)-prolyl hydroxylase 1 (HPHl)and factor inhibiting HIF-1(FIH-1)in placentas in the pathogenesis and development of severe pre-eclampsia.Methods RT-PCR and western blot analyses were used to detect the HPH1 and FIH-1expression levels in placentas of 34 patients with severe pre-eclampsia and 24 cases of term pregnancy (normal pregnancy group)and their correlations with symptoms were analyzed.Results (1)The HPHI mRNA and protein expression levels in placentas of severe pre-eclampsia group were 0.40±0.04 and 59.5±3.4 separately,significantly lower than those of normal pregnancy group,0.84±0.12 and 71.6±1.7(P<0.01).The FIH-1 mRNA and protein expression levels in placentas of severe pre-eclampsia group wereQ 31 ±0.05 and 45.6±2.4 separately,significantly lower than those of normal pregnancy group,0.43±0.04 and 54.9±2.1(P<0.01).(2)The mRNA and protein expression levels of HPH1 and FIH-1 in severe pre-eclampsia group were all negatively correlated with mean arterial pressure(MAP)[the Spearman correlation coefficient was-0.854(P<0.01)],urinary protein per 24 hours[the Spearman correlation coefficient was-0.936(P<0.01)1 and the occurrence of fundus oculi artery spasm[the Spearman correlation coefficient was-0.854(P<0.01)].(3)rrhe expression of HPHl mRNA in placentas of all the 58 cases WBB 0.58±0.27.higher than the expression of FIH-1 mRNA,which was 0.39±0.10.There was a positive correlation between them.The pearson correlation coefficient was 0.686(P<0.01).The expression of HPH1 protein in placentas of all the 58 cases was 64.5±6.7,higher than the expression of FIH-1,which was 49.4±5.2.There was a positive correlation between them.The Pearson correlation coefficient was 0.947(P<0.01).Conclusion The expression imbalance of HPH1 and FIH-1in palcenta may play an important role in the pathogenesis and development of severe pre-eclampsia through inhibiting HIF-1a.

Objective To investigate the risk factors of gallbladder carcinoma,so as to provide theoretical base for the prevention of gallbladder carcinoma.Methods The clinical data of 153 patients with gallbladder carcinoma (gallbladder carcinoma group) who were admitted to the Peking Union Medical College Hospital from January 2000 to December 2010 were retrospectively analyzed. A total of 300 patients with cholecystolithiasis (cholecystolithiasis group) and 300 patients without gallbladder carcinoma or cholecystolithiasis (control group)were collected and matched at the ratio of 1∶2 to conduct the controlled study.Data were statistically analyzed by the Chi-square test and conditional Logistric regression.Results Univariate analysis showed significant difference in age,history of cholecystolithiasis,postmenopausal age,accumulated menstrual period,giving birth or not and number of birth between gallbladder carcinoma group and control group ( x2 =58.22,180.14,9.59,24.30,18.66,15.17,P ＜0.05).Age,history of cholecystolithiasis,accumulated menstrual period and number of birth were the independent risk factors of gallbladder carcinoma (x2 =55.76,180.95,24.30,8.54,P ＜ 0.05).The risk of having gallbladder carcinoma in patients who had a history of cholecystolithiasis was 34 times higher than those who did not have the history of cholecystolithiasis (OR =34.22).Late postmenopausal age (51 -55 years old),longer accumulated menstrual period ( ≥30 years),and the number of birth ( 3 times) were associated with higher risk of gallbladder carcinoma (OR =3.96,9.68,3.51 ). Age,course of cholecystolithiasis and accumulated menstrual period and number of birth were the risk factors of gallbladder carcinoma when comparing patients who have history of cholecystolithiasis in the gallbladder carcinoma group with those in the cholecystolithiasis group (x2 =70.66,16.66,11.59,4.69,P ＜ 0.05 ).Age,course of cholecystolithiasis and accumulated menstrual period were the independent risk factors of gallbladder carcinoma ( x2 =64.29,8.82,5.58,P ＜ 0.05).The risk of gallbladder carcinoma increased as the increase of age and course of cholecystolithiasis. The accumulated menstrual period ≥ 30 years was also a risk factor of gallbladder carcinoma. Conclusions Age,history of cholecystolithiasis,course of cholecystolithiasis,accumulated menstrual period and number of birth may be the risk factors of gallbladder carcinoma.For patients with age above 60 years and course of cholecystolithiasis above 3 years,cholecystectomy should be conducted to reduce the incidence of gallbladder carcinoma,and great importance should be attached to female patients with indications mentioned above.

Objective To investigate the management of iatrogenic bile duct injury and evaluate the longterm efficacy.Methods The clinical data of 62 patients with iatrogenic bile duct injury who were admitted to the Peking Union Hospital from January 1982 to April 2012 were retrospectively analyzed.Of the 62 cases of iatrogenic bile duct injuries,24 were caused by laparoscopic cholecystectomy (LC) and 38 were caused by open cholecystectomy. Ten patients received non-surgical treatment, including 8 patients received percutaneous transhepatic cholangiography and drainage (PTCD) and 2 received endoscopic retrograde cholangiopancreatography (ERCP) + stent implantation. Fifty-two patients received surgical treatment,including 47 received cholecystojejunostomy,2 received cholecystoduodenostomy,3 received biliary end-to-end anastomosis. Thirty-six patients received PTCD preoperatively,and 42 received biliary stent implantation intraoperatively.Fifty patients received intraoperative peritoneal drainage to prevent postoperative peritoneal effusion or encapsulated bile collection.Results Of the 52 patients who received surgery,13 patients were complicated by more than 1 complication,including 1 case of wound infection,4 cases of cholangitis,2 cases of anastomotic leakage,2 cases of anastomotic bleeding,1 case of anastomotic occlusion, 1 case of biliary stent falling out and 3 cases of gastrointestinal diseases.Eighteen patients received cholangiography postoperatively,and 2 patients were diagnosed as with bile leakage.Fifteen patients received PTCD + biliary stent implantation,and 1 patient of them received percutaneous puncture drainage.Two patients received reoperation due to anastomotic bleeding.The mean time of peritoneal drainage for the 50 patients was (7.7 ± 2.6) days.No perioperative death was observed,and the mean operation time was (18 ± 12) days.Fifty-five patients were followed up (10 patients received non-surgical treatment,and 45 patients received surgical treatment),with a median time of 93 months.Of the 10 patients who received nonsurgical treatment,1 received reoperation due to bile leakage,3 received PTCD for the second time due to repeated cholangitis after PTCD. Of the 45 patients who received surgical treatment,6 patients had long-term complications,including 6 cases of fever,4 cases of jaundice,3 cases of choledocho-lithiasis and 1 case of bile duct canceration; 4 received reoperation at the second year after operation.Conclusions Early diagnosis of bile duct injury and operation carried out by experienced surgeons are important for a better short- and long-term prognosis.Surgical repair is the first line therapy for bile duct injury.

Insulin resistance, lipid metabolism disorders, independent autonomic neuropathy are high risk factors for gallstone formation in type 2 diabetic patients. In recent years, there have been a lot of new developments on the relationship between type 2 diabetes and gallstones, such as adiponectin, leptin and metabolic syndrome, etc. Based on these studies, the risk factors of type 2 diabetes complicated with gallstones are summarized in this paper.

Objective To determine the risk factors of gallstones. Methods A case-control study was conducted on 4087 patients with gallstones (the study group) and 20435 individuals without gallstones (the control group) at the Health Center of Peking Union Medical College Hospital (PUMCH) between January 2007 to May 2010. Using age and sex, the study and the control groups were matched in 1 : 5 ratio. Data were statistically analyzed using Chi-square test and conditional logistic regression.Results Univariate analysis showed significant differences in diabetic mellitus (DM), systolic blood pressure (SBP), diastalic blood pressure (DBP), triglyceride (TG), high density lipoprotein cholesterol (HDL-CH) and body mass index (BMI) between the study and the control groups (P＜0.05). Multivariate analysis confirmed that DM, SBP, HDL-CH and BMI were associated with gallstones, and their adjusted odds ratio (95％ confidence interval) were 0. 825 (0. 736 ～0. 925), 0. 908 (0. 828～0. 996), 1. 211 (1. 056～1. 389) and 0. 746 (0. 691～0. 805), respectively.The incidences of total cholesterol (TCH) and low deasity dipoprotein cholesterol (LDL-CH) were not significantly different between the two groups (P＞0.05). ConclusionsDM、SBP、HDL-CH and BMI were found to be the risk factors for gallstones. To prevent gallstones, weight reduction, blood pressure control and normalization of blood lipid are important measures.

Objective To summarize the clinical and pathological characteristics of primary gallbladder carcinoma, analyze factors such as surgical procedures, tumor stages that associated with prognosis, and standardize the diagnosis and treatment strategy for primary gallbladder carcinoma.Methods From January 1986 to October 2009, 197 patients of primary gallbladder carcinoma were treated in Peking Union Medical College Hospital (PUMCH). A retrospective study was performed basing on clinical data of these patients, statistical analysis carried out using SPSS version 13.0, Kaplan-Meier estimate employed for the survival analysis and Log-rank test for the group comparisons. Results One hundred and ninety-seven patients were enrolled (73 male and 124 female) with the mean age of 64.4±1.1years. Abdominal pain (77.3%) , obstructive jaundice (33.6%) and fever (19.5%) were the main symptoms of primary gallbladder carcinoma, with accompanying cholecystolithiasis in 99 cases. B-mode ultrasonic examination and CT scan were important for preoperative diagnosis. Nevin stages and surgical modalities were independent prognosis factors. For stage Ⅰ and Ⅱ patients the survival terms were not different between those receiving radical cholecystectomy and simple cholecystectomy. However, for stage Ⅲ, Ⅳ and Ⅴ patients the survival terms were of statistically different between those in radical cholecystectomy group and simple cholecystectomy group. Conclusions For stage Ⅰ and Ⅱ patients, simple cholecystectomy is a good surgical procedure. For those at more advanced stages, radical cholecystectomy is the choice of therapy, while simple cholecystectomy also improves the prognosis compared with laparotomy only.