Objective To investigate the normal references of standardized bone mineral density (sBMD) and provide important basis for diagnosis and treatment of osteoporosis. Methods Using Dual Energy X－ ray Absorptiometry (DEXA), the bone mineral density was measured in 2 331 people aged above 20 years in parts of China by the method of random sampling， the study was standardized by equations. Results The normal references and peak values of sBMD in lumbar spine and proximal femur were determined based on sex and age. Conclusion This study provides the treatment references and the diagnosis references of sBMD for osteoporosis.

A comprehensive overview of CR equipment in the system to use various types of image artifacts and accurate analysis of the reasons for the formation of artifacts; described in detail to avoid and eliminate the artifact method, and measures to solve the work encountered in the actual artifacts of the problem.

Objective To assess the efficacy of endoscopic papillary balloon dilatation(EPBD)for bile duct stones.Methods Four hundred and six patients with bile duct stones who had been treated by ERCP from January 2000 to December 2000 were divided into EST group(n=205)and EPBD group(n=201)according to the admission time.The differences upon incidences of early and long-term complications,clearance rate of bile duct stones between the 2 groups were detected.Results There was no significant difierence upon the incidence of early complications.clearance rate of bile duct stones and incidence of pancreatitis between the 2 groups(χ2=0.540.0.058.0.010,P＞0.05).The incidence of eholecystitis and recurrence rate of bile duet stones in EST group were significantly higher than those in EPBD group(χ2=4.002,4.263,P＜0.05).Conclusions The incidence of cholecystitis and recurrence rate of bile duct stones after patients being treated by EPBD are significandy lower than EST.EPBD is superior to EST in protecting the sphincter of Oddi.

Objective To investigate the operative techniques for refractory cholelithiasis. Methods The clinical data of 521 patients with refractory cholelithiasis who had been admitted to People's Hospital of Hunan Province from January 1990 to December 2007 were retrospectively analyzed. Results All patients received surgery. After the operation, 3 patients died of liver and kidney failure, the remaining 518 patients were cured without severe complications. The results of B ultrasound and computed tomography showed residual stones in 78 patients (15.1%). Four hundred and twenty-three patients (81.7%) were followed up for 5 months to 17 years (mean, 7.5 years), and the rate of positive effect was 90.1% (381/423). Conclusions Most of the refractory cholelithiasis can be cured radically. Individualized surgical planning, fine and standard surgical procedure are key to the treatment effect.

Objective To evaluate the sensitivity and specificity of prenatal ultrasound for detecting fetal cleft lip and palate,and the diagnosis rate of associated congenital structural and chromosomal abnormalities.Methods Thirty one thousand two hundred and forty five singleton pregnant women accepted prenatal examination and delivered in Guangzhou Women & Children' s Medical Center from Jan.2006 to Dec.2010 were recruited in this study.All pregnant women underwent prenatal ultrasound screening during second trimester,and whose fetuses were suspected to be cleft lip and palate were suggested to accept karyotype analysis.All babies delivered received oral examination to diagnose cleft lip and palate.Results Cleft lip and palate was diagnosed in 48 cases (1.5‰,48/31 245).Among which,there were 16 cases (33.3％,16/48) of cleft lip,21 cases (43.8％,21/48) of cleft lip with cleft palate and 11 cases (22.9％,11/48) of cleft palate.Prenatal ultrasound screening suggested 18 cases of cleft lip and 14 cases were comfirmed after birth with the accuracy rate of 77.8％,3 cases were diagnosed to be cleft lip with cleft palate and one cases was misdiagnosed.Prenatal ultrasound screening suggested 18 cases of cleft lip with cleft palate in accordance with the diagnosis after birth.Thirteen cases were normal in prenatal ultrasound screening,but two were diagnosed as cleft lip and 11 were diagnosed as cleft palate after birth.The sensitivity of prenatal ultrasound screening for cleft lip and cleft lip with cleft palate was 86.5％(32/37),and the sensitivity for cleft lip and palate was 66.7％ (32/48),the false positive rate was 2.1％ (1/48).Ten cases (27.8％,10/36) of cleft lip with cleft palate were found to be complicated with other abnormalities.Nine of the 18 cases prenatally diagnosed cleft lip with cleft palate accepted karyotype analysis and 7 were abnormal.Twenty-three of 36 cases with fetal cleft lip and palate in prenatal ultrasound screening were induced.Conclusions Ultrasound screening has a high sensitivity for detection of cleft lip with or without cleft palate,but difficult to detect cleft palate.The risk of combining with chromosomal defects in cleft lip fetus is very low,but might increase once associated with cleft palate.

Objective Queuing theory is the mathematical study of how waiting lines or queues are formed and dissipated o -ver time, which aims to work out the optimal design and optimal control of queuing systems based on the research of probability and regularity of various queuing systems .The aim of paper was to find out the maximum acceptable waiting time for outpatients in stomatol -ogy department and explore the rational allocation of dentists based on queuing theory model . Methods Questionnaires , worktime measurement and queuing theory model were applied to calculate indicators of queuing system in outpatient services of Stomatology De -partment , getting the maximum waiting time accpetable for patients and the reasonable number of dentists . Results The maximum acceptable waiting time for outpatients was 34.02 ±7.07 minutes, and it was reasonable to allocate 25 doctors in the morning and 16 doctors in the afternoon . Conclusion Applying queuing theory helps to optimize dentist number in outpatient services of Stomatology Department and provide scientific reference to improve medical efficiency .

For better adaptation to clinical work and scientific research as well as self-development,medical postgraduates are required to improve their reading ability to harvest information from medical English articles.Constructing formal schema based on linguistic schema and enriching content schema can significantly enhance medical English reading ability,according to schema theory and education practice.Therefore,the learning mode was explored based on schema theory and this theory was applied in practice to elevate reading ability by means of reading report.

Objective To establish the quantitative detection of capsule associated protein 10 (CAP10)and virulence-associated DEAD-box RNA helicase 1(VAD1)genes in Cryptococcus neoformans (CN) and compare the diagnostic values of single gene test and combined gene test in CN meningitis.MethodsTwenty-three CN meningitis patients with fungal culture or ink staining or CN antigen detection positive in cerebrospinal fluid (CSF) were recruited and patients with craniocerebral trauma were recruited as controls.Standard plasmids were constructed using standard CN strain.Real time fluorescent quantitative polymerase chain reaction (RT-FQ-PCR) was established to detect the mRNA expressions of CAP10 and VAD1 genes in the CSF of patients with CN meningitis,which were compared with the results of CSF ink staining,fungal culture and antigen detection.The diagnostic values of single gene test and combined gene test were compared by chi square test.Results Among 23 CN meningitis patients,22 (95.6％) were CAP10 mRNA positive detected by RT-FQ-PCR,which was significantly higher than both ink staining (16/23,69.6％,x2 =4.167,P＜0.05) and fungal culture (15/23,65.2％,x2=5.143,P＜0.05),respectively; but not significant different from antigen detection (21/23,91.3％,x2=0.500,P＞0.05).There were also no statistical significant differences between combined detection of CAP 10 + VAD1 and CAP 10 or VAD1 single gene test (P＞0.05).ConclusionRT-FQ-PCR detection is successfully established using virulence genes as target,which is superior to the conventional methods.

As an emerging tumor marker, the rarity and heterogeneity of circulating tumor cells (CTCs) increase the difficulty of detection. In recent years, CTCs enrichment technology based on biophysical, biochemical and microfluidic properties has been continuously developed, which has promoted the research and application of CTCs in malignant tumors diagnosis, clinical treatment and prognosis evaluation. Although there are still some deficiencies in the detection of CTCs, with the interdisciplinary integration, CTCs will play increasingly important roles in the diagnosis and treatment of malignant tumors.

AIM:To investigate the changes of Wnt signaling pathway in catalpol-induced proliferation of rat bone marrow mesenchymal stem cells (BMSCs).METHODS:The BMSCs were isolated from SD rats , purified by differ-ential time adherent method and divided into control group and catalpol (1.0 mg/L) group.Flow cytometry was used to de-tect the proliferation index of BMSCs .The mRNA levels of Wnt3a, Wnt5a, Wnt11 and β-catenin was evaluated by real-time PCR.In addition, the protein expression level of β-catenin was determined by Western blotting .RESULTS:Prolife-ration index was increased from 8.90%±0.46% to 17.93%±1.68% after treatment with catalpol (P<0.01).Com-pared with control group , the mRNA expression of Wnt5a, Wnt11 andβ-catenin was all increased with catalpol treatment . No difference of Wnt3a mRNA expression between control group and catalpol group was observed .Meanwhile, the protein expression of β-catenin was increased in catalpol group compared with control group .CONCLUSION:Catalpol promotes BMSCs going into the cell cycle .Classical and non-classical Wnt signaling pathways are activated in this process .