BACKGROUND:The diagnosis of osteoporosis depends upon the bone mineral density T-score of ≤ -2.5 standard deviation or brittle fractures. Bone mineral density measurement combined with vertebral fracture assessment might prevent the missed diagnosis of osteoporosis due to bone mineral density evaluation alone, and improve the diagnosis rate of osteoporosis.
OBJECTIVE:To evaluate the effect of bone mineral density measurements combined with vertebral fracture assessment for the diagnosis of osteoporosis.
METHODS:Bone mineral density measurements of proximal femur and vertebral fracture assessment for lateral thoraco-lumbar images were consecutively done for 217 postmenopausal women who aged ≥ 50 years. The rate of osteoporosis diagnosed with bone mineral density T score was compared with that diagnosed with bone mineral density combined with vertebral fracture assessment. The effects of bone mineral density on the vertebral fracture were analyzed.
RESULTS AND CONCLUSION:92 (42.4%) patients had bone mineral density T score ≤ -2.5, which met the threshold for diagnosis of osteoporosis. 102 (47.0%) patients had osteopanic (-1>T>-2.5) and 23 (10.6%) had normal range of bone mineral density. 158 patients had no vertebral fractures and 59 (27.2%) patients had 101 vertebral fractures. The vertebral fracture rate was 21.6%in the patients with bone mineral density T> -2.5 and 34.8%in the patients with bone mineral density T ≤ -2.5, with significant differences (P<0.05). Bone mineral density in combination with vertebral fracture assessment for the diagnosis rate of osteoporosis was up to 54.8%, which was significantly higher than the rate diagnosed with only bone mineral density (12.4%;P=0.01). Bone mineral density measurement combined with vertebral fracture assessment improves the diagnosis of osteoporosis for postmenopausal women.

Background Cytokines play a crucial role in mediating immune tolerance or immune rejection of corneal transplantation.However,the study on the expression of cytokines in corneal graft is seldom.ObjectiveThe purpose of the study is to investigate the change of cytokine expression in allografts at different time points after corneal transplantation.Methods BALB/c and C57BL/6 mice aged 6 to 8-week old were used to establish autologous and allografts keratoplasty models.BALB/c mouse was use as donor and receipt in autologous group,and the cornea of C57BL/6 mouse was used to graft on the BALB/c mouse in the allografts group.The graft inflammation was clinically scored,and graft inflammatory scores of ≥5 or opaciflcation scores of ≥2 were identified as rejection.BALB/c mice were randomized into normal control group(3 mice)and allografts group(15 mice).Reverse transcriptPCR (RT-PCR) was used to detect the expression of interleukin-4 (IL-4) mRNA,interferon-γ (IFN-γ) mRNA,IL-10mRNA and tumor necrosis factor(TNF-α) mRNA in graft 6 hours and 1 day,3,7,14 days after operation.Results The corneal graft opacification score was ＜2 and inflammatory score was ＜5 in the 10 mice with autologous keratoplasty until 60 days with the survival rate 100％.The edema,opacification and new blood vessel were seen in the BALB/c mice received allografts keratoplasty.The inflammatory score was ≥ 5 and the opacification score was ≥2 24 days after surgery with the rejection rate 100％,in the allografts group,and the graft survival time was (17.80±4.66)days.RT-PCR showed that IL-4 and IFN-γ were positively expressed,and IL-10 and TNF-α were absently expressed in normal mouse cornea.In the allografts keratoplasty mice,positive responses for IL-4,IFN-γ and IL-10 were found in 6hours after operation,but TNF-α was absent.From 1 day through 3 days after operation,the expressions of IL-4,IFN-γand TNF-α were enhanced but IL-10 was disappeared in the graft.IL-10,IFN-γ and TNF-α were expressed till the 7th day,but on the 14th day,only IL-10 was detected in graft in the allografts keratoplasty mice.Conclusions TNF-αis a main factor among the variety of cytokines that may influent corneal allograft rejection locally.

Objective To explore the efficacy of transvaginal color Doppler sonography(TV-CDS)in the diagnosis and differential diagnosis of cornual pregnancy.Methods The characteristics of gray-scale and color Doppler ultrasonography of 30 patients with cornual pregnancy confirmed by surgery and pathology,were studied retrospectively.The position,size,figure,echogenicity and vascular pattern of the pregnancy tissue were evaluated,and the resistance index was calculated.Results The 30 patients were classified into two groups:group A with typical gestational sac and group B with abnormal mass in the area of corner.The overall diagnostic accuracy for these patients was 43.3%(13/3)and classified as 90%(9/10)accuracy for group A and 20%(4/20)for group B.Among the 17 patients who were misdiagnosed or diagnosed unclearly by TV-CDS,one patient in group A was misdiagnosed as a normal pregnancy,11 patients in group B were misdiagnosed as gestational trophoblastic disease and the rest 5 patients in group B were diagnosed unclearly.Conclusions TV-CDS is useful for differential diagnosis of cornual pregnancy.The cornual pregnancy with abnormal mass is usually misdiagnosed,and therefore clinical features and laboratory data should be fully evaluated for its diagnosis.

Objective: To observe the relationship among blood pressure, left ventricular hypertrophy (LVH) and sinus heart rate turbulence (HRT) in patients with essential hypertension (EH) and its clinical significance. Methods: A total of 125 EH patients received 24h ambulatory blood pressure monitoring, dynamic electrocardiogram and echocardiography examination in order to measure 24h mean blood pressure, turbulence onset (TO), turbulence slope (TS) and left ventricular mass index (LVMI). According to 24h mean blood pressure, patients were divided into hypertension stage 1 group (n=46), stage 2 group (n=41) and stage 3 group (n=38); according to LVMI, patients were divided into non- LVH group (n=74) and LVH group (n=51). TO and TS were compared among all groups. Results: TO: Compared with hypertension stage 1 and stage 2 group, there was significant increase in TO [(-2.48±1.75) % vs. (-1.86±1.19) % vs. (-0.87±1.14) %] in hypertension stage 3 group, and that of stage 2 group was significantly higher than that of stage 1 group（P<0.05～<0.01）; compared with non- LVH group, there was significant increase in TO [(-0.15±0.45) % vs. (1.08±1.19) %] in LVH group, P<0.01. TS: compared with hypertension stage 1 and stage 2 group, there was significant decrease in TS [(3.76±1.87) ms/RR interval vs. (2.33±1.48) ms/RR interval vs. (1.55±1.06) ms/RR interval] in hypertension stage 3 group, and that of stage 2 group was significantly lower than that of stage 1 group （P<0.05～<0.01）; compared with non- LVH group, there was significant decrease in TS [(4.76±1.75) ms/RR interval vs. (3.02±1.08) ms/RR interval] in LVH group, P<0.01. Conclusion: The higher the blood pressure is, the more abnormality the heart rate turbulence is; the heart rate turbulence abnormality of patients complicated with LVH is more severe than that of non- LVH patients in patients with essential hypertension, so heart rate turbulence is help to judge prognosis and guide treatment.

Child ; Child Day Care Centers ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Intestinal Diseases, Parasitic ; epidemiology ; prevention & control ; Male ; Nematode Infections ; epidemiology ; prevention & control ; Prevalence

OBJECTIVE: To explore the relevance between writing characteristic and therapeutic effect in schizophrenia and to discuss the influence of aggressive behavior on writing characteristic. METHODS: Recoding the casual and fixed writing in admission, one week, two weeks, four weeks, eight weeks after treatment and rating Positive and Negative Syndrome Scale (PANSS) and Modified Overt Aggression Scale (MOAS). Choosing two characteristics, "relationship between font and grid lines" and "having big strokes or not", and comparing before and after treatment. RESULTS: Eight weeks after treatment, the score of PANSS decreased. The condition of patients and the writing characteristic improved as well. The differences of writing characteristics were statistically significant in patients with aggressive behavior before and after treatment (P < 0.05). CONCLUSION The writing characteristic has relation with therapeutic effects and improved with therapeutic effects in aggressive patients.
Aggression ; Antipsychotic Agents ; Humans ; Schizophrenia/therapy* ; Schizophrenic Psychology ; Writing

Objective:To investigate the clinical characteristics and therapy of laryngeal neuroendocrine carcinoma(LNEC).Method:Ten cases of LNEC treated in our department were retrospectively analyzed.Result:Eight out of 10 cases were were atypical carcinoid:1 case treated as supraglottic horizontal partial laryngectomy died 22 months after operation; 1 case was lost;the other 6 cases were followed up for more than 2 years. Two cases were small cell type,one received supra-cricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) ,neck dissection,and radiotherapy,but died after 14 months;the other was receiving radiotherapy.Conclusion:LNEC is a rare malignant tumor and the diagnosis relies on clinical characteristics, histopathological and immunohistochemistry examination. The different types of LNEC should give different treatment protocols.

Objective: To investigate the blood lead level (BLL) in painters and the inlfuential factors, and to provide the theory foundation for the prevention and control of lead poisoning in painters. Methods: A total of 535 painters from Sany Heavy Industry Company Limited and Xiangjiang Kansai Paint Corporation, who participated in the health examination during October 2012 and December 2012, were recruited and divided into a positive blood lead group and a negative blood lead group according to the level of blood lead. Questionnaires survey and physical/biochemical examinations were performed. Chi-square Test and multivariate logistic regression were used to estimate the factors that contributed to the elevated blood lead. Results: hTe results from 525 questionnaires and physical/ biochemical examination were collected. There were 55 workers (10.4%) whose BLL were 0.04 mg/L. The maximum value of BLLs was 0.35mg/L. hTe multivariate logistic regression showed that smoking (OR=2.424), smoking or eating in the workplace (OR=2.139), not washing hands before smoking or eating (OR=1.624), and the cycle of changing masks longer than two weeks (OR=2.158) were positively associated with BLL. Conclusion: Smoking, smoking or eating in the workplace, not washing hands before smoking or eating, and the cycle of changing masks longer than two weeks are risk factors for higher BLL.

Objective To summarize the imaging features of ultrasound, computed tomography (CT) and gadolinium-ethoxybenzyl-diethylenetriamine pentoacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) of solitary extramedullary plasmacytoma (SEP) of liver, and investigate the key points of identification and diagnosis.Methods The clinical data of 1 patient with SEP of the liver who was admitted to the Southwest Hospital of the Third Military Medical University at 7 May, 2015 were retrospectively analyzed.The patient received contrast-enhanced ultrasound (CEUS) , plain and enhanced scan of CT and Gd-EOB-DTPA enhanced MRI.The patient underwent treatment after preoperative examinations.Pathological examination and immunohistochemical staining were done after operation.The patient was followed up by outpatient examination of color Doppler ultrasonography till 12 November, 2015.The location, size, shape, echo, density or signal, enhancement pattern, secondary performance were recorded by imageological examinations.Surgical treatment, results of pathological examination, immunohistochemical staining, postoperative recovery and recurrence of tumor were recorded.Results CEUS examination demonstrated a hypoechoic hepatic lesion at S7 segment of the right liver measuring 24 mm × 19 mm with clear boundary and dotted blood flow signal in the mass.In the arterial phase, the lesion was enhanced rapidly.Abdominal CT scan showed that the mass at the right liver lobe had slightly low density with clear boundary, the CT value of 34-64 HU, and liver capsule having no significant outer convex.On enhanced CT, the lesion presented a homogeneous enhancement and shape of posterior upper tributaries of right hepatic artery in the arterial phase, the lesion presented continuous enhancement which was slightly lower than that of liver parenchyma in the portal venous phase with the CT value of 77-102 HU, the lesion presented decreased enhancement with the CT value of 41-98 HU in the equilibrium phase.The maximum density projected image showed that the shape of an enlarged vascular image was found inside the lesion in the arterial phase and the lesion was adjacent to inferior vena cava and right hepatic vein which was compressed and displaced in the portal venous phase.On Gd-EOB-DTPA enhanced MRI, the right liver lobe showed a homogeneous T1-weighted and T2-weighted signal with clear boundary and without lipid component, hemorrhage or calcification.The lesion presented obvious enhancement in the arterial phase, homogeneous continuous enhancement which was slightly lower than that of liver parenchyma in the portal venous phase, decreased enhancement in the equilibrium phase.The lesion showed mild signal, adjacent to inferior vena cava and right hepatic vein which was compressed and displaced in the hepatobiliary phase.There was no obvious cirrhotic nodule in the liver.The patient received laparoscopic space-occupying lesion resection at the right liver lobe after finishing inspection.The grayish white lesion in hardness was seen, with clear boundary and capsule, adjacent to anterior wall of inferior vena cava and right hepatic vein in the operation.The results of pathological examination showed that the small tumor cells were scattered in bundle, nuclear were round or oval shape and eccentric with mitosis seen.The results of immunohistochemical staining showed that endothelium cell marker CD34, human multiple myeloma gene MUM1, vimentin, plasmacyte markers 38 and 138, expression of λ light chain protein were positive, the positive cell rate of proliferation activity marker Ki-67 was 10％.The results of blood routine test and blood biochemistry showed that the patient had no anemia, hypercalcemia, abnormal renal function or monoclonal immunoglobulin in the serum or urine.The results of postoperative bone marrow aspiration, immunoglobulin determination and whole body bone scan showed normal.Postoperative examinations confirmed the SEP of right liver.The patient recovered well and was discharged at postoperative day 9.Postoperative change at right liver lobe was detected by color Doppler ultrasonography at 1 month after operation.The patient was followed up for 6 months without tumor recurrence.Conclusion SEP of liver mainly locates at the right lobe of liver, and the imaging features include clear boundary, homogeneous echo, density or signal, adjacent capsule showing no significantly outer convex, surrounding vein demonstrating no violation and shifted by compression, enhancement pattern as fast-in and fast-out.

The morbidity of colorectal cancer has been increasing year by year in China.Screening test of colorectal cancer can effectively decrease the morbidity and mortality of it.However,the current screening technique has obvious defect.Screening of exfoliated colonocytes isolated from human stool for early detection of colorectal cancer is noninvasive and well tolerated by patients;it has a potential for colorectal cancer screening.