The bone turnover markers are composed of the metabolic products of bone matrix and bone cells.The changes of these markers in serum and/or urine represent the status of bone metabolism.To measure the level of these markers will offer important information for evaluating the diagnosis and the responses of therapy in metabolic bone diseases,and to predicat the risk of bone fracture.The biochemistry,measurement and clinical aplication will be introduced in this paper.

[ ABSTRACT ] AIM: To investigate the effect of advanced oxidation protein product-human serum albumin ( AOPP-HSA) at different concentrations on the permeability of human umbilical vein endothelial cell ( HUVEC) monolayer and the protective effect of NADPH oxidase inhibitor diphenyleneiodonium ( DPI ) against AOPP-HSA exposure. METHODS: Cultured HUVECs were exposed to 200 mg/L HSA (control) or AOPP-HSA (50, 100 and 200 mg/L).The permeability of the endothelial monolayer was assessed by measuring CMFDA-labeled THP-1 cells across the endothelial cells.The cultured HUVECs were treated with HSA (200 mg/L), AOPP-HSA (200 mg/L), or AOPP-HSA (200 mg/L)+DPI (100 μmol/L), and the activation of NADPH oxidase, endothelial monolayer permeability and cytoskeleton rear-rangement were evaluated.RESULTS: AOPP-HSA increased the permeability of the endothelial cell monolayer, and AOPP-HSA at 200 mg/L significantly increased the phosphorylation level of NADPH oxidase in the cells.Treatment with 100 μmol/L DPI obviously attenuated AOPP-HSA-induced NADPH oxidase activation, the increase in the permeability of the cell monolayer and the cytoskeleton rearrangement.CONCLUSION: AOPP-HSA increases the hyperpermeability of HUVEC monolayer via the phosphorylation of NADPH oxidase, and the NADPH oxidase inhibitor DPI reverses such effects.

Objective To study the dynamic change of polysaccharide from Asarum insigne in Guizhou during different harvest period and its hemostatic effect. Methods Asarum insigne polysaccharide was extracted by water isolation and alcohol precipitation. We measured the polysaccharide content by UV spectrophotometry after impurity and purification and detected the bleeding and clotting time by tail cutting and slide methods in mice. Results There was significant variation in polysaccharide content of Asarum insigne at different harvest time, which was at a higher level in June(1. 78%-1. 82%). The bleeding time in mice of normal control group was (6. 73±1. 21) min,and that in mice treated with refined polysaccharide at high dose was (4. 91±1. 58) min,the difference between two groups was statistically significant(P<0. 01). The clotting time in mice of normal control group was (7. 27±2. 09) min,and that in the refined polysaccharide at middle and high dose groups was (3. 96±1. 78) min and (3. 27±1. 61) min,respectively. The latter two groups were obviously different from the normal control group(P<0. 05 or P<0. 01). Conclusion The polysaccharide is an active hemostatic substance in Asarum insigne and the optimum harvest time of it is in June for the clinical use.

Objective To explore the related pelvic floor anatomy to the pathological vaginal relaxation and key points of the vaginal tightening surgery.Methods The vaginal tightening surgery was performed in 24 cases of vaginal relaxation.The key points of this operation included levator ani muscle suturation and perineal body reconstruction,and anal sphincter reconstruction as in case of the muscle injury grade Ⅲ.Results The degree of levator ani muscle separation was positively correlated with that of vaginal relaxation in all the 24 cases.18 cases were followed up from 6 months to 2 years,and had no complications of rectovaginal fistula and infections.The average level of perineal body was increased from 2.3 cm to 3.5 cm.Vaginal length of 6 cm from vaginal orifice was proper with good tightness.The patients felt strong anal contraction,enhanced ability of vaginal tightening and improved quality of sex life.There were no more infections of genitourinary tract.Conclusions Through levator ani muscle suturation and perineal body reconstruction,it can get the vaginal tightening effect.

OBJECTIVE To observe the efficacy of lemon eucalyptus oil on disinfection of indoor air.METHODS Fumigating method and air sampling method were used to evaluate the disinfection efficacy.Ultraviolet disinfection method was used as control.RESULTS Aerosol spraying disinfection with the lemon eucalyptus oil at a dosage of 10 ml/m3 followed by closing the room for 30 min can killed 95.4% of the natural bacteria of indoor air.Irradiation by 30 W ultraviolet lamp for 30 min under same conditions killed 89.7% of the natural bacteria of indoor air.CONCLUSIONS The efficacy of the lemon eucalyptus oil disinfectant at 10ml/m3 concentration in killing natural bacteria in indoor air fulfils the requirement of eligible disinfection and is better than the disinfection efficacy of ultraviolet irradiation.

Objective To evaluate the histocompatibility of novel manufactured xenogenic tendon matrix materials by an animal experimental study.Methods The study was conducted on 15 dogs,weighing 10-13 kg.The prepared xenogenic tendon matrix materials were implanted into the bilateral area of spine in dogs subcutaneously (experimental group),and the implantation of silicon served as control group.The animals were killed 14,30,60 days after surgery and the specimens were processed in laboratory to receive gross and histology observation.The histological sections were stained with hematoxylin-eosin and analyzed by light microscopy.Scores were assigned to the inflammatory process and statistically compared by two related samples with non-parametric test.Results All dogs survived well during the embedded test.There was no tissue necrosis,effusion or inflammation at all implantation sites in both groups during the test.The xenogenic implant materials promoted slight to moderate inflammation process after 14 days,with no statistically significant difference compared to the control.However,after 30 days,there was a regression of inflammation.After 60 days,it was observed the presence of well-organized connective tissue,and few inflammatory cells.Score evaluation of inflammation response at different time after operation of two groups showed no statistically significant difference (P＞0.05).Conclusions The new xenogenic tendon matrix materials are considered biocompatible with subcutaneous tissue.

Objective To build the indicators system for clinical pathway management as required by clinical pathway control.Methods An indicators system was proposed by means of evidence-based review,focus group discussions,and ratings of the indicators' importance by doctors and nurses.A multidisciplinary panel of 60 experts from across the country were selected.A 3-round Delphi survey was made on the proposed indicators.The weights of the indicators were established by analytical hierarchy process (AHP).The response rate,Cronbach's α,and the authority coefficient of experts were used as a measure of reliability.Results The response rates of the 3 rounds were 85％,70％,and 94％; the experts authority coefficient was 0.80.The ccoefficient of variation falls with the rising number of consultations.The Kendall's W ranged from 0.40 to 0.83.Following the 3 rounds,consensus was achieved among experts as such a system comprising three first-level,9 second-level,and 36 third-level indicators.Conclusion The expert consultation has achieved reliable results.The established indicators system can serve as a useful instrument for standardized development of clinical pathways management and constant improvement.

Objective To study the expression and significance of acid-sensing ion channels(ASICs)in rat articular cartilage with adjuvant arthritis. Methods Complete Freund's adjuvant(CFA) was prepared by suspending heat-killed Bacillus Calmette Guerin(BCG) in liquid paraffin at 10 mg/ml. CFA-induced arthritis was developed by injection of 100 μl CFA emulsion intradermally into the right hind paw. The morphological changes of articular tissues was observed by light microscope; RT-PCR and immunoblotting analyses were used to detect ASICs in rat articular cartilage with adjuvant arthritis. Results RT-PCR and western blot showed that ASIC1a, ASIC2a and ASIC3 were present in the articular cartilage of normal and model group, the ASICs mRNA levels in the model group were higher than in the normal group detected by semiquantitative analysis (P＜0.01), ASICs protein levels in model group were higher than those in the normal group (P＜0.01) when examined by immunoblotting. Conclusion The results show that the expression of ASICs in AA articular cartilage is enhanced and it may be related with articular cartilage breakdown.

Objective To study the clinical topography of lateral ligament of the rectum.MethodsDissection in the mesorectal plane was performed on cadavers of semi-pelvis sectioned in the sagittal plane. Results Ten of 14 semi-pelvises had substantial connective tissue between the mesorectum and the pelvic side wall. Eight of 10 lateral ligaments had middle rectal artery. Six of 8 middle rectal arteries run in the lateral ligament. The median height of the lateral ligament above the denticulate line was 14 mm (ranging 10～44 mm). Eight of 12 surgical cases had lateral ligament bilaterally, the remaining had lateral ligament unilaterally. Histologically the lateral ligament was composed of connective tissue. It consisted of vessel and nerve. The outer diameter of vessel in the lateral ligament was no more than 1.5 mm. Conclusions 1. The lateral ligament of the rectum presents in most people. The site and structure of lateral ligament was not constant, especially in vascular tissue. 2. Half of the cadavers have middle rectal artery. The rectal artery was tiny. Most of middle rectal artery runs in the lateral ligament. 3. The nerve in the lateral ligament was the part of rectal nerve plexus.

BACKGROUND: Osteoporosis is a genetic disease associated with many enes. To date, the genes that regulate bone mass are incompletely defined.OBJECTIVE: To investigate the relationship between polymorphisms of steoprotegerin (OPG) gene promoter with bone mineral density (BMD) in remenopausal and postmenopausal women.DESIGN: Prospective study.SETTING: Peking Union Medical College Hospital.PARTICIPANTS: In July 2002, 495 Han nationality women selected from Peking Union Medical College Hospital were non-related volunteers and gave their informed consent prior to the study, which included 306 premenopausal women aged 20-39 years, 189 postmenopausal women aged 50-84 years.METHODS: ① BMD measurement: BMD was measured at the Lumbar Spine and Femoral Neck, trochanter, Ward's triangle by dual-energy X-ray absorptiometry. ② Genotyping: Whole blood genome DNA was extracted by QIAGEN DNA extraction kit. The PCR product and the result of endonuclease digest were confirmed by sequencing (Bioasia Biotechnology,Shanghai, China). The impact of the polymorphisms on BMD was also investigated using multiple Logistic regression.MAIN OUTCOME MEASURES: ① Distribution of OPG genotypes and the relationship with BMD. ② Association between OPG polymorphisms and osteoporosis.RESULTS: All 495 subjects were involved in the final analysis. ① These polymorphisms were in Hardy-Weinberg equilibrium (χ2= 0.056 -0.222, P＞ 0.05). The frequencies of genotypes of these subjects were as follows: AA (70.1%), AG (26.9 %), GG (3.0 %) for 163A→G polymorphism; TT (71.3 %), TG (25.9 %), GG (2.8 %) for 245T→G polymorphism. BMD was lower in premenopausal women with GG +AG genotype than AA genotype for 163A→G polymorphism, so did GG+TG genotype than TT genotype for 245T→G polymorphism. But there was no significant difference. BMD was lower in postmenopausal women with AG+GG genotype than AA genotype for 163A→G polymorphism at Lumbar Spine 2-4, Femoral Neck, Ward's triangle and Trochanter (P ＜ 0.05). For 245T→G polymorphism, BMD of postmenopausal women with TG+GG genotype was lower at Femoral Neck,Ward's triangle and Trochanter than TT genotype (P ＜ 0.05). For 245T→G polymorphism, BMD of postmenopausal women with TG+GG genotype was lower at Femoral Neck, Ward's triangle, and Trochanter than TT genotype (P ＜ 0.05). ② Age, weight, height, years since menopause, and 163A→G/245T→G genotypes were sewed as covariates. AG+GG genotype was contributed to low BMD at Lumbar Spine 2-4 and Ward's triangle (OR =2.045, OR=2.956, P ＜ 0.05, 95% CI 1.05-6.7). TG+GG genotype was risk factor for osteoporosis at Lumbar Spine 2-4, Ward's triangle,and Trochanter (OR=2.059, OR=2.859, OR=2.123, P ＜ 0.05, 95% CI 1.04-6.5).CONCLUSION: BMD was lower in postmenopausal women with the variant G allele for 163A→G and 245T→G polymorphisms at Femoral Neck,Ward's triangle, and Trochanter. The variant allele G may associate with lower BMD in postmenopausal women.