Osteoporosis is a systemic metabolic degenerative skeletal disease, characterized by reduced bone mass and disrupted bone microarchitecture, leading to enhanced bone fragility, decreased bone strength and increased susceptibility to frac?tures. Its occurrence and development is an extremely complex biological process, which is a multi factor, multi gene and multi stage experience. Osteoporosis is the fourth chronic disease in our country, which mainly affects postmenopausal women and the el?derly. Bone mass is jointly maintained by the action of bone resorption by osteoclasts and bone formation by osteoblasts. If the im?balance between the two occurs, resulting in reduced bone formation and increased bone resorption, bone homeostasis is changed to cause osteoporosis. Traditional treatment for osteoporosis are drugs which just to depress bone resorption (such as bisphospho?nates and estrogen), or just to promote bone formation (such as PTH and statins), or just to supply the source of calcium. This sin?gle point of local treatment is clearly difficult to play a long?term part in complex lesions of osteoporosis. In recent years, research?ers have studied the molecular signaling pathways related to osteoporosis. The current studies reveal that signaling pathways in os?teoporosis include MAPK, PI3K/Akt, Wnt/β?catenin, RANKL/RANK/OPG, Hedgehog and Notch signaling pathways. These signal?ing pathways play an important role in the molecular pathogenesis of osteoporosis. In addition, there are GH/IGF?1, PPAR?γ, PTH signaling pathways and so on. Taking these signaling pathways as targeting points is a new strategy for the development of new anti osteoporosis drugs or the prevention of osteoporosis. But there are cross?talks and/or interactions between these signaling pathways related to osteoporosis and the pathogenesis of osteoporosiswhich make its therapy more difficult. This paper reviews the research progress of signaling pathway in osteoporosis in order to explore the molecular mechanism of its occurrence. Thus these signaling pathways can be taken as new targets to develop safer and more effective anti?osteoporosis drugs.

Hemodialysis is a major method to treat acute and chronic renal functional failure; while, dialysis-membrane is a major component of dialyzer, determining dialysis effect by the physical and chemical characteristics. In this study, we investigated the development orientation of hemodialysis, application of common membrane materials, and biocompatibility of dialysis-membrane materials; in addition, we also summarized the improvement of dialysis-membrane materials and the effect on hemodialysis during recent years.

Golgi phosphoprotein 3 (GOLPH3 )is closely related to the development and prognosis of cancer,such as non-small cell lung cancer,breast cancer,gastric cancer,esophageal cancer,colorectal cancer,etc.The mainly tumor pathogenisis related GOLPH3 includes modulating the response to DNA damage, vesicle trafficking,mTOR signaling pathway,mitochondrial functions,cytokinesis and Golgi vesicular malignant secretion,and then promoting cell proliferation,invasion and metastasis.GOLPH3 is expected to be a new tar-get for cancer therapy,which may become an important biomarker for the diagnosis,treatment and prognosis of cancer.

Objective To evaluate the anesthetic effect and safety of ropivacaine combined with lidocaine caudal block in the treatment of pediatric laparoscopic hernia surgery.Methods A total of 70 cases with pediatric hernia surgery in Ningbo Women and Children’s Hospital from May 2014 to October 2015 in this study were divided into control group and experimental group with 35 cases in each group.The patients in the both groups were given routine examination, preoperative anesthesia induction, adopted 7 scalp injection needles to prick into the hiatus sacralis,patients in control group were treated by 1% lidocaine hydrochloride injection mixed liquid 1 mL/kg;patients in the experimental group were treated by 0.25%lidocaine hydrochloride injection and 0.25% ropivacaine hydrochloric injection mixed liquid 1 mL/kg; pediatric hernia surgery, intraoperative continuous pumped into propofol injection 4-6 mL/kg and maintain the mask to the oxygen.The visual analog pain scored( VAS) , visual satisfaction scored ( VSS) and adverse reactions were compared at the end of operation, after operation 0 h,0.5 h,1 h,2 h,4 h,8 h and 24 h.Results The sensory and motor block effective time in the experimental group were later than the control group, the sensory and motor block duration time were shorter than the control group (P<0.05).VAS score of the experimental group was significant lower than control group after operation 2 h ( P<0.05 ) . After operation, postoperative 0.5 h, postoperative 1 h, the VSS score of the experimental group was significant lower than control group ( P<0.05 ) .Lower limbs numbness discomfort duration time of the experimental group was significant lower than control group after operation ( P<0.05 ) . Postoperative agitation rate of the experimental group 8.57% was significant lower than the control group 34.29% (P<0.05).The incidence of adverse reactions of experimental group 5.71% was significant lower than the control group 25.71% ( P<0.05 ) .Conclusion Ropivacaine combined with lidocaine caudal block in the treatment of pediatric hernia surgery has the remarkable effect, with high safety.

Objective To survey the bacterial species and drug resistance of bacteria isolated from blood, urine and other samples in 12 military hospitals located at different areas in China. Methods A total of 1099 non-repetitive bacterial isolates were collected from 12 military hospitals and sent to the General Hospital of PLA for re-identification and drug susceptibility test. The minimal inhibitory concentrations (MICs) of antimicrobial agents were determined by agar dilution method. The results were evaluated according to the standards of CLSI (2007) and analyzed by WHONET 5.4 software. ESBLs, AmpC ?-lactamases were detected using the confirmatory test and APB discs method, respectively. Results Gram positive cocci and gram negative bacilli constituted 39.7% and 60.3% of 1099 clinical isolates respectively. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 62%, and methicillin-resistant coagulase negative Staphylococcus (MRSCN) accounted for 92%. ESBLs-producing and AmpC-producing strains of Escherichia coli accounted for 51.1% and 11.3%, respectively, and of Klebsiella pneumoniae accounted for 45.1% and 16.2%, respectively. As to caftazidime, amikacin, cefotaxime, cefoxitin and levofloxacin, the resistance rate in Escherichia coli (E. coli) and Klebsiella pneumoniae isolated from blood was lower than that isolated from urine. However, as to meropenem, ceftazidime, polymyxin and minocyclin, the resistance rate in Pseudomonas aeruginosa and Acinetobacter spp isolated from blood was higher than that isolated from urine. Conclusion MRSA, MRSCN, and producers of ESBLs and AmpC ?-lactamases are common in military hospitals. Resistance pattern of bacteria from blood differs from that of bacteria from urine. It is necessary for military hospitals to take the bacterial distribution and resistance levels to antimicrobial agents under surveillance in order to guide the proper use of antibiotics for military doctors, and the results may serve as guidelines in the use of antimicrobial agents in war time.

Objective To study the function of aminophenylboronic acid(APB)and clavulanate(CA)for detecting ESBLs in Enterobacter cloacae.Methods The phenotype of ESBLs of 61 Enterobacter cloacae isolates was detected with adding single beta-lactamase inhibitor CA to ceftazidime(CAZ)and cefotaxime(CTX),and double beta-lactamase inhibitors CA/APB to ceftazidime(CAZ)and cefotaxime(CTX)respectively.PCR was used to detect ESBLs genes of 61 Enterobacter cloacae isolates.The results of the enzymatic inhibitor potentiation test and PCR were compared and analyzed.Results With adding single enzymatic inhibitor CA to CAZ,28 isolates of Enterobacter cloacae producing ESBLs were detected,while 14 isolates were detected with adding CA to CTX.With adding double enzymatic inhibitors CA/APB to CAZ,28 isolates of Enterobacter cloacae producing ESBLs were detected,while 44 isolates were detected with adding CA/APB to CTX.By PCR positive ESBLs genes were detected in 47 isolates of Enterobacter cloacaes.Conclusions The potentiation test with double beta-lactamase inhibtion can be used to detect ESBLs in Enterobacter cloacae.

OBJECTIVE To know the present status of endoscopes′ cleaning and disinfection in hospitals in Wuxi,(to find) the problem of existence in endoscopes disinfection management,and puts forward the suggestion.(METHODS) According to Technical Operation Standard for Endoscopes Cleaning and Disinfection(2004)′s(requirement),a survey and sampling of disinfected endoscopes were carried out. RESULTS Every hospital all had the rules and regulations of endoscopes management,personnel training rate was 50.00%,personnel protection fitting rate was 64.71%,the rate of the room special for disinfection was 35.29%,cleaning and disinfection(installation) reaching the designated position rate was 41.18%,the standard rate of cleaning and disinfection order was(11.76%,) the fitting rate of endoscopes to preserve inside condition was 23.53%,the eligible rate of(endoscopes) disinfectants in the use was 100.00%,the disinfecting eligible rate of body surface such as attraction bottle,cleaning slot,enzyme slot and washing slot was 100.00%,and the eligible rate of disinfected endoscopes in use and in preserve were 50.00% and 36.36%,respectively.CONCLUSIONS Our hospital is developing endoscope standard including the use of disinfectants as well as the object surface disinfectiong,but all exist the problems in personnel training,personnel protection,speciaized disinfection room,basic cleaning and disinfection(installation),the process of cleaning and disinfection,preservation and disinfection effect of endoscopes,and the work(remains) further standardize.

Objective To investigate effect of different doses of propofol infusion on serum lipid metabolism and pulmonary function in patients with cervical cancer operation.Methods 120 patients with cervical cancer were randomly divided into A, B, C three groups, 40 cases in each group, were treated with laparoscopic cervical cancer radical operation, the 4 mg/(kg· h), 6 mg/(kg· h), 8 mg/(kg· h), and the pulmonary function and lipid profiles were detected.Results Compared with the B and C groups, the recovery time and the the awake time of the patients in B ,C group was shorter (P<0.05).The recovery time and the the awake time of the patients in A group had not significantly different.Compared with before operation, TG, TC and LDL levels were elevated, HDL decreased in theree groups after the operation(P<0.05);compared with the A and B groups, the levels of TC, LDL, TG and were higher, the level of HDL were lower (P<0.05),there were no significant differences in level of TC, HDL, TG and LDL between group A and group B;there was no significant difference between P(A-a) O2 and RI among three groups before surgery, P(A-a) O2 and RI levels were elevated in the three groups after surgery(P<0.05), compared with the A and B groups, P(A-a)O2 and RI levels in group C were lower(P<0.05), there was no significant difference in P(A-a)O2 and RI between group A and group B.Conclusion 4 mg/(kg· h)of propofol can significantly shorten the recovery time and awake time, improve the level of lipid metabolism and pulmonary function.

The influence of MRI on severity grading and activity staging in thyroid associated ophthalmopathy (TAO) was evaluated.The results showed that MRI had a higher detection rate in abnormal extraocular muscle than NOSPECS scores(χ~2 = 19.37,P = 0.000).MRI had higher sensitivity,specificity,and accuracy in detection of active TAO than clinical activity score (100% vs 95.7%,88.2% vs 35.3%,96.9% vs 79.7%,respectively).Therefore,MRI improves early detection of atypical grade 4 cases.Signal intensity elevation in adipose suppressed T2WI is helpful to define active stage.