BACKGROUND: As a primary clinical predictor of fracture risk, bone mineral density (BMD) is partly genetically determined. Osteoprotegerin (OPG) is one important candidate gene in the pathogenesis of osteoporosis. OBJECTIVE: To investigate the association between T245G polymorphisms in the OPG gene and BMD. METHODS: A total of 281 elderly men and postmenopausal women, 182 males and 99 females, who received routine examinations at Peking University People's Hospital between September 2008 and April 2010 were included in this study. T245G polymorphisms in the OPG gene was detected by polymerase chain reaction-restriction fragment length polymorphism together with DNA sequencing. The BMD of the lumbar spine, Ward's triangle, and forearrm was determined by dual energy X-ray absorptiometry. Clinical variables and biochemical measurements were collected simultaneously. The association between T245G polymorphisms and each detection index was analyzed using analysis of variance. RESULTS AND CONCLUSION: The distribution of T245G genotype (alleles T, G) had no difference in elderly men or postmenopausal women (P > 0.05). The GG genotype and TG genotype had higher lumbar spine BMD and TT genotype had lower lumbar spine BMD (P < 0.05). There was no difference in BMD of the Ward's triangle or forearm among different genotypes (P > 0.05). Association between T245G polymorphism and BMD was not found in postmenopausal women. These findings indicate that OPG gene is related to lumbar spine BMD in elderly men.

Objective To study the clinical value of high frequency ultrasonography in acute closed mallet finger.Methods The high frequency ultrasonographic images of thirty-six patients with diagnosed acute closed mallet finger were retrospective analyzed.The ultrasonographic features were analyzed.Results The position and internal structure of extensor tendon could be showed by high frequency ultrasound,the position and injury level of acute closed mallet finger were identified.In 36 patients of acute closed mallet finger,6 cases were complete tear combined avulsion fracture,the ultrasonography showed the disruption in the extensor tendon at the level of the distal interphalangeal joint,the hyperechoic fracture fragment were found in the distal end of extensor tendon.22 cases were complete tear and no avulsion fracture,the longitudinal imaging showed the disruption in the extensor tendon at the level of the distal interphalangeal joint and the retraction of the tendon end.8 cases were partial tear,the ultrasonography showed that extensor tendons were thickened and hypoechoic,the section of extensor tendons were still continuous.Conclusions High frequency ultrasonography is the preferred imaging method for diagnosis of acute closed mallet finger,it will be important value for clinical treatment method.

Objective To investigate the killer cell lg-like receptors (KIR) gene frequency of HIV-1 infected slow progressors(SP) and typical progressors(TP), and to analyze the interaction between KIR alleles and the progression of HIV-1 infection in Chinese population. Methods Eighty-one HIV-1 posi-tive individuals including 43 SPs and 38 TPs were recruited. Carriage of KIR genes was assessed using poly-merase chain reaction sequence-specific primers (PCR-SSP) assays. Results KIR2DS3 gene frequency was significantly lower in SP group (3.6%) than that in TP group (14.2%), P =0. 018 ,OR =0. 210,95% CI =0.053-0.833. The number of activating KIR genes was less in SP group than that in TP group, but was not significant (P = 0. 208). Conclusion Lower KIR2DS3 gene frequency may potentially be associated with slower progression to AIDS in Chinese population.

Objective:To investigate the perinatal risk factors and correlation between bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP).Methods:A retrospective analysis was performed on 173 preterm infants born at less than 32 weeks' gestation with BPD who were admitted to the neonatal intensive care unit (NICU) of the Women and Children's Hospital of Qingdao University from June 2017 to July 2022. According to the diagnostic criteria for ROP, these preterm infants were divided into the ROP group ( n=64) and the non-ROP group ( n=109). Chi-square test, two independent samples t-test, and Mann-Whitney U test were used to compare the general data, treatment, and the incidence of complications between the two groups. Multivariate logistic stepwise regression analysis was used to analyze the independent risk factors of ROP in preterm infants with BPD and the receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of independent risk factors on ROP. The correlation between the severity of BPD and the incidence of ROP was analyzed. Results:The gestational age at birth [(28.0±1.1) vs. (28.8±1.2) weeks, t=4.01], the birth weight [(1 075.9±141.4) vs. (1 143.2±168.6) g, t=2.68], the partial pressure of carbon dioxide [42.5 mmHg (1 mmHg=0.133 kPa) (34.0-51.0 mmHg) vs. 47.0 mmHg (39.0-54.0 mmHg), Z=－2.31], and the total fluid intake on the first day of birth [80.0 ml (72.3-88.7 ml) vs. 83.6 ml (76.6-92.8 ml), Z=－2.28] in the ROP group were all lower than those in the non-ROP group (all P<0.05). While the prothrombin time [15.7 s (14.1-17.7 s) vs. 14.6 s (13.1-16.7 s), Z=－2.17], activated partial thromboplastin time [64.7 s (52.9-77.9 s) vs. 55.8 s (48.4-68.9 s), Z=－2.12], the proportion of patients treated with pulmonary surfactant [71.9% (46/64) vs. 49.5% (54/109), χ 2=8.25], the total duration of oxygen supplementation [50.5 d (40.0-64.0 d) vs. 45.0 d (37.0-52.0 d), Z=－2.77], the duration of invasive ventilation [5.0 d (1.0-11.0 d) vs. 1.0 d (0.0-5.0 d), Z=－4.03], the duration of noninvasive ventilation or high-flow oxygen therapy [(31.7±12.7) vs. (26.4±13.1) d, t=－2.59], and the incidence of neonatal respiratory distress syndrome [76.6% (49/64) vs. 57.8% (63/109), χ 2=6.22] were increased in the ROP group (all P<0.05). There was no significant difference in the proportion of BPD treated with corticosteroids between the ROP and non-ROP groups [60.3% (38/63) vs. 74.3% (81/109), χ 2=3.67, P=0.055]. Multivariate logistic stepwise regression analysis showed that smaller gestational age ( OR=1.599, 95% CI: 1.126-2.272, P=0.009), less fluid intake on the first day ( OR=1.033, 95% CI: 1.004-1.062, P=0.024), and longer duration of invasive ventilation ( OR=1.076, 95% CI:1.017-1.138, P=0.011) were independent risk factors for ROP in BPD infants, while glucocorticoid treatment was an independent protective factor ( OR=0.378, 95% CI:0.173-0.827, P=0.015). Most patients with mild or moderate BPD did not develop ROP [64.6% (73/113) and 66.7% (34/51)], while those with severe BPD were more likely to be complicated by ROP (7/9) ( χ 2=6.84, P=0.033). Conclusions:BPD infants with smaller gestational age, longer duration of invasive ventilation, and less fluid intake on the first day of birth are more likely to develop ROP, while glucocorticoid therapy can reduce the incidence of ROP in this population. Severe BPD may increase the risk of ROP in infants.

Objective To study the amino acid mutations in neutralizing antibody 2F5 and 4E10 conserved epitopes ELDKWA and NWFDIT of HIV-1 membrane proximal external region(MPER)in 92 HIV-infected individuals and AIDS patients in China,and to provide a basis for the neutralizing antobodies immunotherapy and a design of vaccines. Methods Nest-PCR methods were used to amplity genes of the HIV-1 env gp41 region.The amplified fragments were sequenced by double-deoxygen terminal method and translated into amino acids for analysis.The mutations of 2F5 and 4E10 neutralizing epitopes were identified by comparison with the epitopes reference data in HIV-1 Sequence Database.Results There were mutations on both 2F5 and 4E10 neutralizing epitopes.2F5 conserved neutralizing epitopes major mutations tocused on E662A(14.1%),K665S(17.4%),A667K(16.3%),and 4E10 conserved neutralizing epltopes major mutations included N671S(13.0%),D674S(3.3%),T676S(16.3%).The mutation rates of 2F5 and 4E10 epitopes were significanfly different between CRF_B'C-clade and B'-clade(P<0.05).The mutata rates of CRF_B'C-clade were higher than that of CRFOI_AE-clade in 2F5 epitopes(P<0.05).The mutation rates of B'-clade in 4E10 eiptopes showed significant difference in slow progressors,HIV-infected individuals and AIDS patients,respectively(P<0.05).Conclusion The HIV-1 patients in China are demonstrated diversified mutations in 2F5 and 4E10 neutralizing epitopes.The mutation degrees of amlno acids in conserved neutralizing epitopes are different in different subtypes.There may be a correlation between neutralizing epitopes mutations of 4E10 with disease progression.

Objective To study the relationships between neutralizing antibody response against heterologous virus and disease progression in Chinese HIV-1 B'/C infected individuals. Methods Plasmas from HIV-1-infected individuals, grouped as HIV chronically infected or AIDS according to CD4+ count and clinical symptom, were tested for neutralizing activity against the three HIV-1 isolates with very low homology in vitro. Six two-fold dilutions of each plasma sample (from 1/10 to 1/320) were tested against each virus from the panel. Giving a 50% reduction in p24Ag compared with normal human plasma control wells was defined as positive. The breadth of the cross-neutralizing response was defined based on the number of viruses that were effectively neutralized by any given patient-derived plasma sample. The magnitude of the crossneutralizing response was defined based on the average neutralizing titer against all heterologous viruses. Resuits We found that there revealed a significant difference between HIV chronically infected and AIDS group in the breaths and magnitudes of neutralizing heterologous virus. There was higher prevalence for the frequency of neutralizing heterologous virus in HIV chronically infected than AIDS. The results showed that there was positive correlation between the breadths and magnitudes of neutralizing response against heterologous virus and the plasma HIV RNA level in HIV chronically infected group, while not in AIDS group. There was no association between the breadth of the neutralizing responses against heterologous virus and CD4 T cell counts. Conclusion The capacity of neutralizing antibodies against heterologous virus varied among different disease stage. There were higher titers of neutralizing antibodies in HIV chronically infected than AIDS group. The loss of neutralizing antibodies in plasma from AIDS group appears to be associated with a narrowing of the antibody response during disease progression. These suggest that the presence of neutralizing antibodies against hetreologous virus was associated with disease progression.

Objective To investigate the association between APOBEC3G mRNA levels in peripheral blood mononuclear cells(PBMCs)of HIV/AIDS patients and disease progression in Henan province.Methods Real-time PCR was used to detect the mRNA levels of APOBEC3G in PBMCs of HIV/AIDS patients at difierent disease progression stage.Flow cytometry and automated viral load analyzer were used to count CD4+ T cells and plasma HIV viral loads.Results The mRNA levels of APOBEC3G in HIV/AIDS patients were lower than in HIV-negative controls(t=4.887,P＜0.01),and APOBEC3G levels were significantly higher in slow development group than those in HIV and AIDS groups(P＜0.05).The levels of APOBEC3G mRNA correlated positively with CD4+ T cell counts(R2=0.190,P=0.002)and negatively with HIV-1 viral loads(R2=0.094.P=0.038).Conclusions The APOBEC3G mRNA levels in PBMC of HIV infected individuals are associated with HIV disease pmgression. Higher mRNA expression levels of APOBEC3G may be one of the protective factors which can play important role in delaying disease progression.

Objective:To study the relationships between neutralizing antibody response against autologous virus and disease progression of HIV-1 B'/C infected individuals in China.Methods:Twenty-four primary HIV-1 isolates were incubated with autologous plasma collected either freshly or at approximately six months intervals thereafter.Normal human peripheral blood mononuclear cells were incubated with the virus-serum mixtures for 7 days and then the production of p24 antigen was measured.The neutralizing titer of a particular plasma and virus was defined as the reciprocal of the highest dilution giving a 50% reduction in p24 Ag compared with NHP control wells.More than 1∶8 were considered significant and were scored as positive.Results:In neutralizing antibody(Nabs) response against contemporaneous virus,Nabs were produced in all slow progressors(SP) individuals,while only four in 21 of HIV group had.There was statistically significance of the neutralizing antibody titers between SP and HIV.When plasma samples of six months later were tested for their ability to neutralize autologous virus,all of SPs had higher neutralizing antibody titers and the titers of neutralizing antibody in HIV group had increased in different rate.Among the twenty-one individuals of HIV group,12 of these individuals had neutralizing antibody response against autologous virus and other 9 of these individuals had not.NAb titers of SP in six months later plasma were higher than those of HIV.There was a negative correlation between the generation of the neutralizing titer against autologous virus and the plasma HIV RNA level in HIV-1 B'/C infected individuals(including SP,HIV).Conclusion:Neutralizing antibody against autologous viruses in HIV-1 B'/C infected SP is higher than those of HIV group,suggesting that neutralizing antibodies play a vital role in delaying disease progression in these individuals.

Objective To identify the scientific research status of Ershiwuwei-Shanhu pill among the literature review. Methods The literature were retrieved from CNKI, Wanfang and VIP databases (from databases built up to 2017), and quantitative analysis was carried out in the fields of time, journals and types of literature published. Results There were 58 literatures, including 33 clinical studies, 9 pharmacological studies, 14 pharmacological studies and 2 reviews. The literature published 39 kinds of journals, among which there were 81.0％ studies published in the journals holding the impact factors more and equal to 0.15 and 7 were core journals. Conclusions The results showed that the Ershiwuwei-Shanhu pill was in the developing period, mainly focused on clinical research, although there are some studies on pharmacology and pharmacy.The study of the ancient Tibetan medicine to the mature period there is still much space for development.

To explore the application effect of team-based learning (TBL) model in functional experiment teaching. A clinical case related to the animal experiment was selected and distributed to students through Internet before class. Individual tests for students were conducted in class to assess their understanding for the case. Then group tests were carried out, which were completed by in-group discussion. Finally, the clinical case was analyzed within group. The teaching process possesses several characteristics and advantages in helping students retrieve literature, cultivate their spirit of cooperation, their ability of clinical practice and so on, but it also has some shortcomings and deficiencies. Therefore, this paper summarizes the advantages and disadvantages of TBL teaching in functional experiment teaching based on existing experience so as to promote a broader application of TBL in our medical education.