Objective:To analyze the change of bone mineral density (BMD) in postmenopausal women,and to study the relationship between BMD and the estrogen,cytokines,and serum levels of bone metabolism.Methods: 135 postmenopausal women were divided into the OP group (n=54),Osteopenia group (n=43) and normal group (n=38) according to the results of lumbar spine bone mineral density (BMD) scan.To detected the concentration of serum estradiol (E2),bone alkaline phosphatase (BALP) and osteocalcin (BGP),tartrate resistant acid phosphatase-5b (TRAP-5b),interleukin-6 (IL-6),tumor necrosis factor alpha (TNF-α),transforming growth factor beta (TGF-β1) and IL-10 of research objects in the three groups.And to analyze the relationship between BMD and the levels of E2,BALP,BGP,TRAP-5b,IL-6,TNF-α,TGF-β1 and IL-10.Results: In the OP group and the Osteopenia group,BMD and the levels of E2,TGF-β1 and IL-10 were obviously lower than that in the normal group (P<0.05),and the levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were obviously higher than that in the normal group (P<0.05).When compared with the Osteopenia group,the BMD and E2 level in the OP group was more lower (P<0.05),and the levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were more higher (P<0.05).E2 and TGF-β1 showed the significant positive correction with BMD (P<0.05),and the BALP,BGP,TRAP-5b,IL-6 and TNF-α were all negatively corrected with BMD (P<0.05).However,no significant difference of relevance was seen between IL-10 and BMD (P>0.05).The low serum E2 levels and high serum levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were the independent factors affecting the reduction of BMD (P<0.05).Conclusion: The E2 level in patients with PMOP decreased obviously,which caused the imbalance of bone remodeling and inflammatory reaction,and which was related to the decrease of BMD.

Objective To investigate the clinical characteristics of 40 patients with ocular toxocariasis (OT) on the first attendance.Methods A total of 40 consecutive patients who were clinically and serologically diagnosed with OT were retrospectively reviewed.Results The mean age of patients was (12.12±10.42) years.There were 29 males and 11 females.29 cases presented with decreased vision,4 children with leukocoria,2 cases with strabismus and 5 cases was found abnormal during regular eye examination.Initially 8 eyes (20％) were misdiagnosed as retinoblastoma (1 eye),Coat' s disease (1 eye),cataract (2 eyes),iridocyclitis (2 eyes) and retinal detachment (2 eyes).23 eyes had retinal detachment,19 eyes had cataract.OT was the initial diagnosis for 15 patients (37.5％).The best corrected visual acuity (BCVA) were NLP to 0.7.Ultrasound biomicroscopy (UBM) were performed in 29 eyes,and identified peripheral granulomas in 23 eyes and adjacent tractional retinal detachment in 12 eyes.We also identified 17 cases (68.0％) with elevated IgE level among 25 patients with positive serological antibody test.Conclusions Tractional retinal detachment,vitreous opacities and cataract are the common clinical findings at the first attendance of OT patients.The adjunctive test of serum total IgE level may be helpful for the diagnosis.The application of UBM and specific IgG detection in serum and intraocular fluid,can also improve the diagnosis.

Objective:To explore the effect on sex hormone functional of extracts of Herba Epimedii /Fructus Ligustri Lucidi in osteoporosis rats.Methods:50 cases of 3 months Wistar rats were rando mly divided into normal group ,model group,extract low dose group(extract-L),extract middle dose group(extract-M),extract high dose group(extract-H),10 cases in each group,in addition to the normal group,other 4 groups were bulided OP model by filling and feeding retinoic acid for 15 d,then normal group and model group were filling physiological saline;extract-L,extract-M,extract-H were respectively feeding extracts of Herba Epimedii /Fructus Ligustri Lucidi at 50 mg/kg,100 mg/kg,200 mg/kg,both for 3 weeks.Measured the bone mineral density (BMD),observed the femoral pathology change of left femur with hematoxylin and eosin ( HE ) staining, measured trabecular bone tissue morphology related parameters ,analyzed the hormone receptor protein expression with immunohistochemistry .Results:The BMD of the whole femur ,femur head,and femur neck in normal group were all significantly higher than that of model group ,the BMD of the whole femur ,femur head, and femur neck in extract-M and extract-H group were all significantly higher than that of model group ,the BMD of the whole femur in extract-L group was significantly higher than that of model group ,the differences were statistically significant (P<0.05 or P<0.01).The bone trabecular number had significantly increased ,integrity,continuity improved significantly ,bone histomorphometry such as Tb.Ar, Tb.Th,and Tb.N in model group were decreased ,and Tb.Sp was increased,extract-M and extract-H group had remarkable effect on each index ,while extract-L group only had a remarkable effect on Tb .Ar and Tb.Th ( P<0.05 or P<0.01 ) , compared with model group.The expression of AR , ER in normal groups were significantly higher than that of model group , the expression of AR , ER in extract-H group was significantly higher than that of model group , the differences were statistically significant ( P<0.05 or P<0.01 ) . Conclusion:This study demonstrated that the combination with TFE and TIFL had potential protective effects on osteoporosis rats induced by retinoic acid .The combination with TFE and TIFL is able to increase BMD ,reverse pathological changes of bone tissue ,co-ordinate hormones of the hypothalamic-pituitary-gonadal axis ,and upregulate the expression of sex hormone receptors .

Objective To investigate the association between SLC10A1 gene mutations in c.800G>A mutation and c.356 +1098C >T mutation, and the susceptibility to HBV infection by mother-to-child transmission ( MTCT) .Methods Totally 306 individuals born to HBeAg-positive mothers with high load HBV and without receiving nucleotide analogues treatment, including 247 HBV-infected cases and 59 non-HBV-infected ones were enrolled from Southwest Hospital during May 2011 and July 2015.Blood samples were collected from all the subjects, then genomic DNA was extracted and c.800G>A mutation and c.356+1098C>T mutation of SLC10A1 were genotyped .Chi-square test (Pearsonχ2or continuity correctionχ2) was performed to identify the difference in genotypes between two groups.Results Among vaccinated individuals (55 HBV infected and 56 not infected), the frequency of genotype GA of c.800G>A mutation in non-infected ones was 14.3%(8/56), there was a tendency of increasing compared with HBV infected ones (5.5%, 3/55), but the difference was not statistically significant (χ2 =2.424, P =0.119). Similarly, the frequencies of genotypes CC, CT and TT of the c.356+1098C>T mutation in HBV infected ones were 20.0%(11/55), 47.3%(26/55) and 32.7%(18/55), while those in non-infected ones were 12.5% (7/56), 69.6% (39/56) and 17.9% (10/56), and the difference was not of statistical significance (χ2 =5.766, P=0.056).In all subjects (vaccinated and non-vaccinated), the frequency of genotype GA of c.800G>A mutation in non-HBV infected group had an increasing tendency compared with HBV-infected offspring (13.6% vs.6.9%), but the difference was not statistically significant (χ2 =2.010, P=0.156);the frequencies of genotype CC, CT and TT of c.356+1098C>T mutation in HBV infected patients were 20.2%(50/247), 49.8%(123/247) and 30.0%(74/247), while those in non-HBV-infected group were 11.9%(7/59), 69.5%(41/59) and 18.6%(11/59), and the difference was statistically significant (χ2 =7.436, P =0.024 ) .Within the HBV infected group, the frequencies of genotype GA of c.800G>A mutation were 5.5%(3/55) in vaccinated individuals and 7.3%(14/192) in non-vaccinated individuals, and the difference was not of statistical significance (χ2 =0.030, P=0.863);Similarly, the frequencies of genotype CC, CT and TT of c.356 +1098C >T mutation in vaccinated individuals were 20.0%(11/55), 47.3%(26/55) and 32.7%(18/55), while those in non-vaccinated individuals were 20.3%(39/192), 50.5%(97/192) and 29.2%(56/192), and the difference was not of statistical significance (χ2 =0.274, P=0.872).Conclusion c.356+1098C>T mutation in SLC10A1 may be associated with susceptibility to HBV infection of child born in HBeAg positive pregnant women infected with high load HBV.

Objective To explore the correlation between human cytomegalovirus(HCMV) infection with infantile hepatitis syn‐drome(IHS) and hepatic function damage .Methods The real‐time fluorescent quantitative polymerase chain reaction(PCR) was a‐dopted to test the urine HCMV DNA in 236 infants with IHS and 236 healthy infants ,respectively .The hepatic functions in 254 in‐fants with HCMV infection were analyzed retrospectively .Results Among these 236 cases of IHS ,the positive rates of HCMV DNA in urine sample was 62 .7% (148/236) .The positive rates of HCMV DNA and HCMV IgM in the IHS group were significant‐ly higher than those in the control group with statistical difference(P< 0 .01) .The liver function indexes in 254 infants with HCMV infection showed that the serum concentrations of total bilirubin (TBIL ) ,gamma glutamyl transpeptidase (GGT ) ,total bile acid (TBA) ,aspartate aminotransferase(AST ) and alanine aminotransferase(ALT ) were higher than the normal reference ranges ,and the differences were statistically significant(P < 0 .01) .Conclusion The detection rate of HCMV infection is high among the in‐fants with IHS in Guangxi area and HCMV is an important pathogen of IHS .HCMV may lead to hepatic function damage .

OBJECTIVETo compare the clinical characteristics of rifampin-dependent (R-dependent Mycobacterium tuberculosis) and rifampin-resistant (R-resistant Mycobacterium tuberculosis) patients with pulmonary tuberculosis.

METHODSThe clinical data including the demographic data, age groups, course of disease, history of chemotherapy with anti-TB drugs, and results of drug susceptibility test were collected from 61 cases of R-dependent pulmonary tuberculosis and 148 cases of R-resistant pulmonary tuberculosis treated between October, 2008 and January, 2012.

RESULTSMost of the R-dependent and R-resistant patients were between 30 and 44 years of age. The R-dependent patients included 12 receiving the first treatment patients and 49 with previous treatments, and the R-resistant patients included 11 without and 137 with previous treatments. The multi-drug resistant rate was 80.3% in R-dependent group, as compared to 92.6% in R-resistant group.

CONCLUSIONMost of the patients infected with R-dependent Mycobacterium tuberculosis are young or middle-aged, often having serious disease conditions. Detecting rifampin dependence is important for patients with initial treatment failure. Multi-drug resistance therapy guideline should be applied to patients infected with R-dependent Mycobacterium tuberculosis to improve the cure rate.

Adolescent ; Adult ; Aged ; Antitubercular Agents ; pharmacology ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; drug effects ; Rifampin ; pharmacology ; therapeutic use ; Tuberculosis, Multidrug-Resistant ; drug therapy ; microbiology ; Tuberculosis, Pulmonary ; drug therapy ; microbiology ; Young Adult

Objective To investigate the diabetic foot occurrence and influence factors of the type 2 diabetes patients in order to provide the reference for the prevention and treatment of diabetic foot. Methods Three hundred and fifty-seven type 2 diabetes patients treated in the endocrinology department of our hospital from June 2012 to June 2014 were chosen as the research objects, the clinical data of them were collected by self-made questionnaire after consult-ing a large number of references. The clinical data was analyzed by descriptive statistics and binary classification logis-tic regression analysis of SPSS19.0 statistical package to find out the occurrence and influence factors of diabetic foot in type 2 diabetes patients. Results The diabetic foot incidence of type 2 diabetes patients was 6.44%(23/357). Multi-ariable Logistic regression analysis revealed that high degree of culture (β=-1.26, P=0.000), the degree of the related knowledge of diabetic foot (β=-1.44, P=0.000) and PDCA cycle management of diabetic foot (β=-1.68, P=0.000) were the postoperative factors of type 2 diabetes patients complicated with diabetic foot, abnormal glycosylated hemoglobin (β=1.16, P=0.000) was a risk factor for type 2 diabetes patients complicated with diabetic foot. Conclusion The diabetic foot incidence of the type 2 diabetes patients is high, it is affected by many factors. In clinical medical process, we should strengthen health education and blood glucose monitoring,and then optimize the prevention countermeasures for diabetes in order to effectively control the patients' blood sugar, reduce the occurrence of diabetic foot and improve the prognosis of patients.

OBJECTIVETo describe the incidence and related risk factors of fatty liver disease in the general population of Northwest China.

METHODSThe study was a cross-sectional survey with multiplestage stratified cluster and random sampling. All participants were 18 years or older and resided in northwest provinces of China.Demographic and behavioral data was gathered by questionnaire.Clinical data such as height, body weight, waist circumference, biochemical function (standard tests) and liver status (ultrasonographic examination) were also collected.

RESULTSAmong the 2 300 total study participants, 1 523 were habitual drinkers (total drinking rate: 66.2%). This population of drinkers was composed almost exclusively of males. There were 201 cases of alcoholic liver disease (total prevalence:8.7%), represented by mild alcoholic injury (prevalence: 4.2%), alcoholic fatty liver (3.8%), alcoholic hepatitis (0.5%), and alcoholic cirrhosis (0.3%).When examined according to provinces of residence, the prevalence of alcoholic liver disease followed this pattern: Shaanxi (14.0%), Gansu (8.6%), and Xinjiang autonomous region (5.0%). Of the total 337 cases of nonalcoholic fatty liver disease (total prevalence: 14.7%), the prevalence by province was: Shaanxi (18.5%), Gansu (10.3%), and Xinjiang autonomous region (16.6%). Individuals with alcoholic liver disease had significantly higher mean age (years), body weight, body mass index (BMI), waist circumference, average daily alcohol intake, and level of aspartate aminotransferase (AST), and alanine aminotraasferase (ALT) (vs. Those with no liver disease, P less than 0.05). Individuals with nonalcoholic fatty liver disease had significantly higher mean age (years), height, body weight, BMI, waist circumference, level of AST and ALT, and presence of obesity, abdominal obesity, hyperlipidemia, diabetes mellitus and hypertension (vs. Those with no liver disease, P less than 0.05). Multiple logistic regression demonstrated that alcoholic liver disease was closely related to age, sex, and average daily alcohol intake. The prevalence of nonalcoholic fatty liver disease was positively correlated to age, female sex, hyperlipidemia, diabetes mellitus, and BMI.

CONCLUSIONThe drinking-rate and prevalence of fatty liver disease is high in Northwest China, but the most prevalent type is nonalcoholic fatty liver disease.Fatty liver disease is closely related to age, sex, average daily alcohol intake, hyperlipidemia, diabetes mellitus, and BMI.

Aspartate Aminotransferases ; Body Mass Index ; Body Weight ; China ; Cross-Sectional Studies ; Diabetes Mellitus ; Fatty Liver ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Logistic Models ; Male ; Obesity ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Waist Circumference

Objective To evaluate the diagnostic efficacy of Kwak and ACR( 2017 ) thyroid imaging reporting and data systems ( T I‐RADS ) for thyroid nodules . Methods Cases of thyroid nodule who underwent surgery from January 2015 to M arch 2018 in 15 hospitals in Sichuan province were collected and the ultrasonographic features of thyroid nodules were retrospectively analyzed by trained senior ultrasound physicians using Kwak and ACR T I‐RADS classification methods . Totally ,12 712 thyroid nodules were observed ,7 023 thyroid nodules in 7 023 cases with complete ultrasound and surgical and pathological data were eventually enrolled in the study . T hyroid nodules with solid ,hypoechoic or very hypoechoic ,tall/wide ratio ≥ 1 , margin ill‐defined and microcalcification were classified as malignant signs of ultrasound . M alignant percentage was calculated and diagnostic tests were performed . Results ① T here was a statistical difference between the benign and malignant nodules in the two types of T I‐RADS classification ( P＜0 .01) . ② T he area under ROC curve of Kwak and ACR in the diagnosis of malignant nodules were 0 .89 and 0 .84 ,respectively . T he Youden index of Kwak and ACR were 0 .66 and 0 .57 ,respectively . ③Taking Kwak T I4B and ACR T R4 as critical points for malignancy ,the sensitivity ,specificity ,positive predictive value and negative predictive value of Kwak T I 4B were 75 .0% ,90 .9% ,83 .2% ,and 85 .9% , respectively . T he accuracy of Kwak T I4B was 84 .9% ; T he sensitivity ,specificity ,positive predictive value and negative predictive value of ACR T R4 were 88 .2% ,68 .9% ,62 .9% ,and 90 .8% ,respectively . T he accuracy of ACR T R4 was 76 .2% . T he Kappa value of Kwak TI4B and ACR T R4 was 0 .52 . T he χ2 value of Kwak T I4B and ACR T R4 was 2 174 .6 ( P ＜ 0 .01 ) . Conclusions T he diagnostic values of two T I‐RADS classification methods for thyroid malignant nodules are high . T he overall efficiency of Kwak T I‐RADS classification method is better than that of ACR TI‐RADS classification method .

ObjectiveTo investigate the improvement of the efficacy of Osteoking in patients with knee osteoarthritis in the onset and remission stage and to systematically explore its potential intervention mechanism， so as to provide a certain reference for improving the clinical application value of Osteoking and guiding its clinical rational drug use. MethodThrough the real-world study of the treatment of knee osteoarthritis with Osteoking， the data was obtained and entered into the "Osteoking for the treatment of knee osteoarthritis case registration system"， and 105 patients with episodic and remission knee osteoarthritis from the outpatient or inpatient orthopedic department of 20 medical institutions， including the Third Affiliated Hospital of Beijing University of Chinese Medicine， Peking Union Medical College Hospital， Wangjing Hospital of the Chinese Academy of Chinese Medical Sciences and Hunan Aerospace Hospital， from May 1， 2020 to December 31， 2021， were selected in the system. It included 60 patients treated with Osteoking and joint injection， and 45 patients treated with joint injection alone. The WOMAC osteoarthritis index score， visual analogue （VAS） pain score， individual types of pain symptoms （cold pain， hot pain， tingling， dull pain， soreness） and other TCM symptoms were observed and compared between the two groups， and statistically analyzed. In order to further elucidate the potential molecular mechanism of Osteoking combined with joint injection in the treatment of knee osteoarthritis in the treatment of onset and remission， this study used the "Bone Injury Cross Database （http：//bone-xtrans.com/database，BX-Data）" to collect the gene set of knee osteoarthritis disease， the traditional Chinese medicinal materials， chemical composition， material base， candidate target， candidate target， sodium hyaluronate candidate target data for screening， and constructed an interaction network of "disease target". ResultsAmong the 105 patients with knee osteoarthritis enrolled， 15.24% （16/105） were in the episodic period， 84.76% （89/105） were in remission， and there were no convalescent patients. There were 72 cases （68.57%） in women， 33 cases （31.43%） more than men， 60 cases in the observation group and 45 cases in the control group in 105 patients. There were 20 patients with a VAS score of 5 and 19 patients with a score of 6 in the observation group， accounting for 65.00% of the observation group. The comparative results of VAS scores between groups before and after treatment showed that the scores of the two groups were （4.42±1.01） scores， （5.00±1.02） scores.4 weeks after treatment， and （3.12±1.04） scores and （3.56±1.08） scores，8 weeks after treatment， respectively， which were lower than those before treatment （6.23±1.28） scores，（ 6.02±1.22） scores （P<0.05）， and the comparative results of the pain properties of the two groups showed that the improvement rates before and after thermal pain and tingling in the observation group were 3.3%（2/60） and 16.7%（10/60）， respectively. The control group was 2.2% （1/45）and 15.6%（7/45）［（χ²=4.034、13.583，P<0.05）］， respectively， and the improvement rate of cold pain and soreness in the observation group was 5.0%（3/60） and 3.3%（2/60）， which was higher than that of the control group . The results of comparing the WOMAC scores before and after treatment of the two groups showed that the difference between the stiffness score before and after treatment in the observation group was （1.68±1.42） scores， the difference between the score before and after treatment in the control group was （1.20±1.60） scores （P<0.05）， and the pain score before and after treatment was （3.43±2.88） scores， the difference before and after daily activity score was （12.37±10.21） scores， and the total score before and after treatment was （17.48±12.76） scores， which were also higher than those in the control group （2.82±3.29）， （10.80±9.63），（14.82±12.62） scores. The results of comparing the improvement of other symptoms before and after treatment showed that the improvement rate of less sleep and more dreams in the observation group was 28.3%（17/60）， which was significantly higher than that of the control group of 2.2%（1/45）（χ²=5.914，P<0.05）， and the improvement rates of the five symptoms of thirst and drinking， irritability， dry mouth and pharynx， dull complexion and hand， foot and mouth fever in the observation group were 3.3%（2/60）， 10.0%（6/60）， 8.3%（5/60）， 10.0%（6/60） and 5.0%（3/60）， respectively， which were higher than those in the control group -2.2%（1/45）， 2.2%（1/45）， 2.2%（1/45）， 4.5%（2/45）， -6.7%（3/45）. Through network analysis， it was found that the enrichment pathway of Henggu bone wound healing agent mainly acted on the three mechanisms of bone improvement， energy metabolism and anti-inflammatory and analgesic， and the sodium hyaluronate enrichment pathway mainly acted on the anti-inflammatory and analgesic mechanism. ConclusionThe efficacy of Osteoking combined with intra-articular injection of sodium hyaluronate in the treatment of patients with knee osteoarthritis in attack and remission is better than that of sodium hyaluronate alone， especially in anti-inflammatory and analgesic， and the two drugs have synergistic effect. Osteoking may play its role in relieving the symptoms of joint stiffness， tingling， heat pain， and less sleep and more dreams by improving bone quality and regulating the body's energy metabolism pathways， which is worthy of clinical promotion.