Objective To investigate the effects of bisphosphonate on the proliferator-activated receptor γ(PRARγ)expression of glucocorticoid-induced osteoporosis. Methods ① Twenty-two cases of systemic lupus erythematosus(SLE)patients with glucocorticoids(＞0.5 mg·kg-1 ·d-1)were divided into 2 groups: 9 cases in the treatment group in which patients received alendronate 70 mg qw., 13 cases in the control group without anti-osteoporosis treatment. All of the patients had bone marrow puncture after 24 weeks, bone tissues were embedded, sliced, and the value of average optical density of PPARγwas tested with immunohistochemistry. ② Human bone mesenchymal stem cells were cultured in the same conditions and stimulated to adipocytes. During the adipogenic process, the cells were divided into four groups, three of which were experimental groups treated with 10-5 mol/L(high-dose group), 10-7 mol/L(medium-dose group)and 10-9 mol/L(low-dose group)bisphosphonate respectively, while the other was the control group without bisphosphonate in the medium. The adipocytes were identified by oil Red O stain seven days later. The adipocyte rate was measured by light absorption at 515 nm. The expression of PPARγ was measured by quantitative PCR. Comparisons between groups were tested by One-Way ANOVA analysis and t test. Results The average optical density of PPAR-gamma immunohistochemistry in the treatment group was less than the control group(P＜0.05). Seven days later, the absorbance between adipogenic induction group and low-dose group was not significant(P=0.167). but the adipogenic absorbance between the high-dose group, middle dose group and the control groups(P values were 0, 0.041). There was significant difference in the quantitative PCR results between the high-dose group, middle dose group and the expression of PPARγ adipogenic induction group(P value was 0, 0.01), but there was no significant differences between the low-dose group and adipogenic induction group(P＞0.05). Conclusion Effective concentrations of bisphosphonate can inhibit the expression of PPARγ which in turn lead to the suppression of hMSCs to the adipocytes. The glucocorticoid-induced osteoporosis is also depressed.

Objective To predict the occurrence of hypoparathyroidism following total thyroidectomy. Methods In this study, 124 patients underwent total thyroidectomy, 46 for thyroid cancer and 78 for multinodular goiter, additional neck dissection was performed on cancer patients. Serum calcium and parathyroid hormone (PTH) levels were examined preoperatively and at 1 h, 1 d and 2 d postoperatively. The occurrence of postoperative hypoparathyroidism was observed. Receiver operating characteristic curve analysis was employed to identify the best indicator to early predict the occurrence of clinical hypocalcemic symptoms. Results Fifty-eight (46.8%) patients suffered from postoperative transient hypoparathyroidism, with 22 ( 47. 8% ) cases in thyroid cancer group and 36 ( 46. 2% ) in multinodular goiter group ( λ2 = 0. 033, P = 0. 857). One (0.8%) patient in cancer group had permanent hypoparathyroidism. 90 patients (72.6%) had postoperative hypocalcaemia, 58 (46. 8% ) had subnormal serum PTH levels, 40 (32. 3% ) had hypocalcaemia symptoms. Postoperative serum calcium (F=21. 358,P =0. 000) and PTH ( F = 18.253, P =0.000) levels decreased more in cancer group than in goiter group.Receiver operating characteristic curve analysis demonstrated that the percentage of serum PTH level decline at 1 h postoperatively was most predictive and 76. 6% decline was the best cut-off value for the occurrence of clinical hypocalcaemia symptoms ( area under the curve being 0.933 ) with a sensitivity of 89. 7% and a specificity of 87.9%. Conclusions Neck dissection added to total thyroidectomy can decrease the postoperative serum calcium and PTH levels more seriously, but may not increase the incidence of postoperative transient hyperparathyroidism. The percentage of serum PTH level decline at 1 h postoperatively predicts the occurrence of clinical hypocalcaemia symptoms.

Acupuncture Points ; Aged ; Aged, 80 and over ; Bloodletting ; Female ; Humans ; Middle Aged ; Pruritus ; therapy

Acquired Immunodeficiency Syndrome ; blood ; complications ; diagnosis ; Antibodies, Viral ; blood ; Child ; Cough ; complications ; Fatal Outcome ; Fever ; complications ; HIV-1 ; immunology ; Humans ; Male

Objective To study the clinical significance of recognizing Zuckerkandl tubercle (ZT) during thyroid surgery. Methods One hundred and sixty-one patients (218 sides) having underwent thyroid lobectomy or thyroidectomy were retrospectively analyzed. The presence of ZT, the position and size of ZT, and the relationship between ZT and recurrent laryngeal nerve (RLN), superior parathyroid (SP) were observed. Results In 218 sides, 179 sides (82.1%) found ZT, with right side in 93 cases and left side in 86 cases. The main relationship between ZT and RLN was A type, accounting for 90.5%(162/179). There were no statistical differences in ZT grade and the relationship type between ZT and RLN between left side and right side (P>0.05). There was negative correlation in ZT grade and the relationship type between ZT and RLN (r=-0.269, P<0.01). In right side, 92.3%(72/78) of SP located on the top of ZT at 10-11 o′clock position;in left side, 94.6%(70/74) of SP located on the top of ZT at 1-2 o′clock position. Conclusions ZT is an important anatomical mark in the thyroid surgery, which helps to identify and protect the RLN and SP, so as to reduce surgical complications.

A cross-sectional study of 92 women with polycystic ovary syndrome(PCOS) was performed.The patients were composed of 4 groups according to the Rotterdam criteria and were also divided into 2 groups according to body mass index and divided into 2 groups according to insulin-releasing test.Anthropometric measurements were recorded,and hormonal profile was assessed by measuring FSH,LH,prolactin,and testosterone.The metabolic profile was investigated by measuring glucose and insulin level during oral glucose tolerance test (OGTT),then calculating the homeostasis model assessment (HOMA).Serum lipid levels,including total cholesterol,triglycerides,high-density lipoprotein-cholesterol,and low-density lipoprotein-cholesterol were determirned.The result suggests that the classification according to the revised 2003 Rotterdam consensus on diagnosis does not reflect dyslipidemia in PCOS.Dyslipidemia in hyperinsulinemic group and obesity group were more severe than that in non-hyperinsulinemic group and non-obese group ; this finding needs our attention in early treatment and prevention of late complications of PCOS.

Objective To study the current cases of Keshan disease aims at providing scientific and basic evidence for prevention and control of the disease. Methods In accordance with historical cases, in 2009, an investigation was conducted in the permanent resident population in seriously infected representative villages of landscapes and ways of living such as Xujialeng, Zhuping and some other adjacent villages in Wudu district, Longnan city. People in those areas were examined and carefully observed based on the scheme of Keshan disease surveillance. Then they were enquired about their medical history, given normal clinical examinations and electrocardiogram(ECG) examination, the suspected cases were chest X-rayed. At the same time, some samples of their hair of some children under 12 and adults were collected to be examined for the selenium content. Results Among the total number of 515 subjects, 20 were diagnosed with Keshan disease with a total detection rate of 3.9% (20/515), among whom 13 were potential patients with a detection rate of 2.5%( 13/515), 7 were chronic patients with a detection rate of 1.4%(7/515). In the total number of 515 ECG, 48 were found with abnormal ECG at a detection of 9.3%(48/515). In the 20 patients, the potential patients were mostly featured with incomplete right bundle-branch block(5 cases), complete right bundle-branch block(3 cases), frequent ventricular premature beat (2 cases) and left ventricle high voltage(2 cases), while the chronic patients were mostly featured with incomplete right bundle-branch block(2 cases). Of the 29 chest X-ray films, 17 cases had heart enlargement with a detection rate of 58.6%( 17/29). The selenium content in the hair of 10 adults and 10 children were (0.38±0.09), (0.31±0.12) mg/kg, respectively. Conclusion There are still existing some cases and obvious virulence factors of Keshan disease in Wudu district, Longnan city.

Objective To explore the clinical significance of detection of plasma microRNA-21,-143 in identifying early esophageal cancer and esophageal non-tumor diseases.Methods The expression of plasma microRNA-21,-143 in 27 cases of patients with early esophageal cancer (esophagus cancer group),25 cases of patients with non-esophageal tumor (non-esophageal tumor group)and in the healthy controls were detected by RT-PCR,and detected the levels of plasma CEA and CA72-4 by the electrochemical luminescence technology,which of changes were analysed to observe the relationship between the changes and the esophageal cancer,the benign esophageal diseases for the two markers.Results The expression of plasma microRNA-21,-143 in the esophagus cancer group were 0.93±0.17,0.27±0.05,which of ones in the non-esophagus cancer group were 0.25±0.03,0.99±0.15,and with those in the control group were 0.23±0.03,1.02±0.15.Compared with those in the non-esophagus cancer group,the expression of plasma microRNA-21,-143 were obviously up or down-regulated with significant differences (t=10.87,11.55,P＜0.01).Compared with those in the control group,which of ones were obviously up or down-regulated with significant differences (t=9.20,9.07,P＜0.01),and with no statistical significances in comparison between the esophagus cancer group and the control group (t=1.39,1.19,P＞0.05).The positiverate of plasma microRNA-21,-143 in the esophageal cancer,non-esophagus cancer group and the control group were,81.4 ％ (22/27),4.0 ％(1/25) and 0 (0/24);85.1％ (23/27),4.0％ (1/25),and 0 (0/24),respectively.The positive rate of microRNA-21,-143 in the esophageal group respectively in comparison with those in the non-esophagus cancer group and the control group were significantly higher,the differences had statistical significances (x2 =31.59,34.39,P＜ 0.01;x2 =34.42,37.23,P＜ 0.01).The expression of two markers in the esophagus cancer group were no statistically significant differences compared with control group (x2 =0.980,0.980,P＞0.05).The sensitivity and specificity of microRNA-21,-143 in early diagnosis on the esophageal cancer were 81.4 ％,97.9 ％ and 85.1％,97.9 ％.The sensitivity of microRNA-21,-143 in the esophageal group were significantly higher compared with those of CEA and CA72-4,the differences were statistically significant (x2 =12.79,P＜0.01;x2 =5.33,P＜0.05;x2 =15.03,P＜0.01;x2 =6.95,P＜0.05).The specificity of microRNA-21,-143 in the esophageal cancer group were no statistically significant differences in comparison with those of CEA and CA72-4 (x2 =1.043,0.000,P＞0.05) and (x2=1.043,0.000,P＞0.05),respectively.The analysis results from the spearman correlation test showed that in the esophageal cancer group,the expression of plasma microRNA-21,-143 had a negative correlation (r =0.658,P＜0.01).Which of ones respectively associated with the levels of CEA and CA72-4 (r=0.607,0.623,P＜0.01 and r=0.579,0.610,P＜0.01).Conclution The detection of expression of plasma miRNA-21,miRNA-143 in the patients with the early esophageal cancer and non-esophageal tumor can provide a new train of thought for pathologic diagnosis of early esophageal cancer.

Objective To explore central lymph node metastasis (CLNM) of cN0 papillary thyroid carcinoma(PTC).Methods We evaluate the clinical data of 245 patients with cN0 unilateral TPC undergoing total thyroidectomy and bilateral central lymph node dissection.Results Central lymph node metastasis of cN0 TPC was 36.8％ (91/245),significantly related to gender(x2 =5.626,P =0.018),age (x2 =6.255,P =0.012),tumor size (x2 =20.063,P ＜ 0.001) and capsule invasion (x2 =15.024,P ＜ 0.001).The central lymph node metastasis was 51.7％ (60/116) in 116 patients with tumor size ＞ 1 cm,and the contralateral CLNM was 22.4％ (26/116) which was related to capsule invasion (x2 =9.737,P =0.002) and delphian LNM(x2 =10.982,P =0.001) There were 6 cases (2.4％) suffering from temporary unilateral recurrent laryngeal nerve injury.96 cases (39.2％) suffered from temporary hypoparathyroidism and 3 cases (1.2％) from permanent hypoparathyroidism.The median follow-up time was 40 months.6 cases were found regional lymph node recurrence on the ipsilateral side.Tumor size ＞ 1 cm was significantly related with recurrence (P =0.008),as CLNM with higher recurrence rate (P =0.001).Conclusions CLNM is common in cN0 PTC patients,and central lymph node metastases increase the risk of recurrence.Prophylactic bilateral central lymph node dissection is suggested for tumor size ＞ 1 cm cases.

Objective: To explore the clinical effect of two disinfectors on prevention for central line-associated blood stream infection (CLABSI) in hemodialysis. Methods: 168 patients received blood purification through central venous indwelling catheter were divided into control group (82 cases) and observation group (86 cases) as random table. The patients of control group were disinfected by using iodophor disinfectant on central venous catheter and skin around puncture, while the patients of observation group were disinfected by using medical chlorhexidine gluconate (2% chlorhexidine gluconate, 70% isopropanol and 28%injection) on the same positions. In different stages, before and after central venous indwelling catheter and 24 hours after central venous indwelling catheter, the colony count and incidence of CLABSI of patients between two groups were compared. Results: There was no significant difference between the two groups for colony count around puncture before central venous indwelling catheter (t=-1.478, P>0.05). The colony count of observation group was lower than that of control group after 24 hours of disinfection. According to the diagnosis standards of CLABSI, the incidence of CLABSI in observation group was significant lower than that in control group (x2=6.048, P<0.05). Conclusion: The disinfector of chlorhexidine gluconate can decrease the incidence of CLABSI in hemodialysis and its bacteriostatic time is longer than that of iodophor disinfectant. Therefore, this method is worthy for promotion in clinical practice.