Objective:To study the clinical efficacy of salmon calcitonin combined with calcium in the treatment of osteoporosis and the effect on bone metabolism index. Methods:Totally 360 cases of patients with osteoporosis were randomly divided into the ob-servation group and the control group with 180 ones in each. The patients in the control group were given compound calcium carbonate tablets, po, qd, and those in the observation group were given 50IU salmon calcitonin injection additionally, im, qd. After two months of treatment, the changes in pain score, bone density and bone metabolism related indicators of the two groups were compared before and after the treatment. The clinical efficacy and adverse reactions of the two groups were observed as well. Results: After the treat-ment, both groups showed lower pain scores (P<0. 01) when compared with those before the treatment, and the reduction in the ob-servation group was more significant than that in the control group. After the treatment, the bone density had no significant change in the two groups(P>0. 05). The bone metabolism parameters including serum BGP,β-CTX, PTH, BNALP and 25OHVitD were signif-icantly improved when compared with those before the treatment (P<0. 01), and the improvement in the observation group was better than that in the control group (P<0. 01). The incidence of adverse reactions in the observation group was significantly higher than that in the control group (P<0. 01). Conclusion:Salmon calcitonin combined with calcium can significantly improve the efficacy in the treatment of osteoporosis with improved pain scores and bone metabolism related indicators, and the combination is much better than calcium alone, however, the adverse reactions are significantly increased.

Image processing research group applied immersive experience into “medical image processing”. A scheme named “introduction by game, case driven, lecture on specific theme, grouping experiment, and seminar”was designed and practiced. We designed a game for each subject and made students immersed in the game to feel the pleasure of learning. We changed the traditional teaching method which focused on every point of knowledge, presented and then decomposed the case before teaching each knowledge point which was related to the case. By grouping experiment and seminar, students can learn actively. We also developed a virtual experiment platform with .NET and Matlab for students to develop learning.

Objective To investigate the impact of desmoglein 3 (Dsg3) on the proliferation of peripheral T lymphocytes from patients with pemphigus vulgaris (PV).Methods Peripheral blood mononuclear cells (PBMCs) were obtained from 12 patients with PV and 22 normal human controls,cultured with or without the presence of Dsg3 or phytohemagglutinin for 3 days.Flow cytometry was performed to detect the changes of T-lymphocyte subsets in PBMCs stimulated with Dsg3 and proliferation of T-lymphocytes.Results In patients with PV,the percentage of Th2 and Th1 cells was 12.17%±5.32% and 4.08%±1.50%,respectively in Dsg3stimulated PBMCs,9.84%±5.41% and 3.91%±1.38%,respectively in non-stimulated PBMCs.Increased percentage of Th2 cells was observed in Dsg3-stimulated and non-stimulated PBMCs from patients with PV compared with those from normal human controls (both P<0.05).After stimulation with Dsg3,there was a significant proliferation of T cells from patients,and the proliferation rate of CD4+T cells was 4.65%±3.28%,which was significantly higher than that from normal controls(P<0.05).Conclusion Dsg3 can induce the specific proliferation of CD4+T cells,especially Th2 type CD+4 T cells,from patients with PV.

Background Age-related cataract is the leading cause of visual impairment worldwide.To seek the effective prevention and drugs for management of cataract is important.Naphthalene-induced cataract of rat is an ideal animal model for the research of human age-related cataract,and aspirin has been proven to inhibit the development of human age-related cataract.ObjectiveThe present study is to investigate the role of aspirin on naphthalene-induced cataract.Methods Forty-five 150-160 g female SD rats were divided into three groups randomly.Naphthalene was orally taken with 0.5mg/kg per day for 3 days and then 1mg/kg per day for 70 days,and then 100mg/kg of aspirin was given per day for 70 days following four-day washout period in group A.In group B,the animals was given orally only naphthalene at the same way.No any intervention was used in group C.Naphthalene-induced cataract was examined under the slim lamp every week.The experimental animals were sacrificed and lenses were obtained in 70 days.α-Crystalline was extracted from lens homogenate and purified and identified using High Performance Liquid Chromatography(HPLC),2-dimentional electrophoresis gel and Western blot.Different abilities of α-crystalline to protect β low crystalline from aggregation were observed using ultraviolet spectrophotometer.Results Naphthalene-induced cataract formed at the third week in only naphthalene group but at the sixth week in naphthalene+aspirin group under the slim lamp.No significant difference was found in the degree of lenses opacity in the second week among these three groups(F=0.032,P=0.969).However,a statistically significant difference was seen in the degree of lenses opacity in the fourth,sixth,eighth and tenth week among these three groups(F= 5031.130,P=0.000;F=115964.000,P=0.000;F=169846.500,P=0.000;F= 195431.200,P=0.000).Themolecular chaperone-like activity was significantly higher than that of the naphthalene-induced group.Conclusion Aspirin delays the progression of lens opacification through protecting α-crystalline molecular chaperone-like activity.

Objective To evaluate the long-term outcome of acute kidney injury (AKI) during hospitalization after cardiac surgery.Methods 1 770 patients underwent cardiac surgery in Fudan University Zhongshan Hospital from April 2009 to February 2011 were enrolled.Based on the Kidney Disease:Improving Global Outcomes (KDIGO) guideline of AKI,the patients were divided into the AKI and the nonAKI groups,and followed up for 2 years.The 2-year survival rate and incidence of the advanced chronic kidney disease (CKD) was compared between the two groups.Factors influencing the 2-year survival rate and incidence of the advanced CKD were also analyzed.Results Among all the patients,715 (40.4％) of them were developed AKT.(1) The 2-year survival rate of the AKI group was lower than that of the non-AKI group (83.2％ vs 93.6％ ;P ＜0.05).Compared with the non-AKI group,AKI group had an increased risk for death with the hazard ratio of 1.710 (95％ CI 1.250-2.340).COX regression analysis showed that AKI was an independent factor for death with the risk intensity just less than diabetes and chronic cardiac insufficiency.The advanced age,the preoperative history of chronic cardiac insufficiency and the time of staying in ICU also significantly increased the risk of death.(2) Compared with patients without AKI (0.2 ％),the incidence of the 2-year of advanced CKD was higher in patients with AKI (6.7 ％ ; P ＜ 0.05) with an hazard ratio of 31.220 (95 ％ CI 7.550-129.110).COX regression analysis showed that AKI was still the independent risk factor for advanced CKD after adjustment of other factors.In addition,diabetes,the time of the cardiopulmonary bypass and the time of staying in ICU were also associated with the risk for the advanced CKD.Conclusions AKI is common after cardiac surgery,which was associated with a decrease in the 2-year survival rate and an increase in the incidence of advanced CKD of patients,which emphasized the importance of prevention and treatment of AKI,and close follow-up of renal function for the improvement of patient long-term prognosis.

Objective To investigate the association of the major histocompatibility complex class Ⅰ chain-related antigens A (MICA)-129 gene polymorphism and soluble MICA (sMICA) levels with ulcerative colitis (UC) in Hubei Han nationality. Methods The genetic polymorphism of MICA-129 was examined using a polymerase chain reaction-sequence based test (PCR-SBT) in 256 UC patients and 460 healthy controls. From the above subjects, 80 patients and 90 healthy individuals were randomly selected for determining serum sMICA concentrations by ELISA. Results The frequencies of variant allele (G) and genotype (GG) in MICA-129 gene were significantly higher in the UC patients than in the controls(76. 8%vs 72. 2%, P =0. 060; 55.9% vs 46. 3% ,P =0. 016). Serum sMICA levels were significantly elevated in the patients compared to the controls[(576. 47 ±279. 02) ng/L vs( 182. 17 ±73. 11 ) ng/L,P ＜0. 001]. In addition, the sMICA levels were higher in the patients carrying MICA-129 GG genotypes than in those carrying ( GA + AA) genotypes [( 638. 87 ± 347. 15 ) ng/L vs ( 507. 51 ± 152. 87 ) ng/L, P = 0. 035].Conclusions The genetic polymorphism of MICA-129 and sMICA levels are correlated with the UC patients in Hubei Han nationality. Our findings demonstrate that MICA-129 gene may contribute to the pathogenesis of UC.

OBJECTIVETo compare therapeutic effects of locking plates for the treatment of Neer 3-and 4-part proximal humerus fractures.

METHODSFrom January 2009 to June 2011, 64 patients with Neer 3-and 4-part proximal humerus fractures were treated with locked plate fixation. There were 39 patients in the 3-part group including 16 males and 23 females, with an average age of (55.12 +/- 12.52) years old; and 25 patients in the 4-part fractures group including 9 males and 16 females,with an average age of (57.92 +/- 13.14) years old. The American Shoulder and Elbow Surgeons score (ASES), visual analogue scale (VAS) and complications were documented for analysis before and after treatment.

RESULTSAll the patients had incision healing at the first stage. All the patients were followed up, and the duration ranged from 12 to 30 months, with a mean of 16.5 months. Comparably better shoulder function recovery was achieved in the 3-part fractures group with regard to the ASES (76.14 +/- 14.10 in the 3-part fractures group vs. 65.93 +/- 11.82 in the 4-part fractures group, P < 0.05). Moreover,a statistical difference (P < 0.05) was observed regarding the VAS pain score (2.12 +/- 1.63 in the 3-part fractures group vs. 3.90 +/- 2.21 in the 4-part fractures group). For the complications rate,no statistical difference was noted between 3-part fractures group and 4-part fractures group (20.51% vs. 36.00%).

CONCLUSIONThe clinical outcomes of the 3-part proximal humerus fractures is better than the 4-part fractures proximal humerus fractures treated with locking plate. Complex proximal humeral fractures treated with locking plates can be achieved a satisfactory outcome when attention is paid to anatomic reduction, stable fixation, proper screws and plate placement, and reasonable functional exercise postoperative.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To analyze the risk factors and correlation between clinical indicators and the four main pathological lesions of IgA ne?phropathy in the Oxford classification:mesangial hypercellularity(M0/1),endocapillary proliferation(E0/1),segmental sclerosis or adhesion(S0/1), and tubular atrophy/interstitial fibrosis(T0/1/2). Methods Clinical and pathological data were collected from 514 patients with biopsy?proven IgA nephropathy admitted in our hospital from February 17,2006 to October 11,2011. These patients were all above 18 years old. Cases with sec?ondary causes of mesangial IgA deposition were excluded,such as Henoch?chonlein purpura,ankylosing spondylitis and psoriasis et al. The inde?pendent risk factors affecting the pathological classification were analyzed by Spearman rank correlation analysis and two?category and multi?classi?fication logistic regression using SPSS 17.0 statistical software. Results In 514 IgAN patients,the ratio of males to females was 1.06:1. The aver?age age was 35.70±11.99 years,and the average disease duration was 18.31±30.42 months. M0E0S0T0 was the major pathologic classification of isolated hematuria. Chronic kidney disease(CKD)stage,24 hours proteinuria,albuminuria,urine transferrin and IgG levels were positively corre? lated with M lesion;serum albumin,C3 and PLT showed a negative correlation with M lesion. Twenty four hours proteinuria and blood platelet count were the independent risk factors for M lesion. As shown by stratified analysis ,the proportion of M1 in cases with 24 hours proteinuria≥3.5 g/d is much higher than that in cases with non?nephrotic range proteinuria. Age,systolic blood pressure,uRBC,24 hours proteinuria,albuminuria urine transferrin and IgG levels were positively correlated with E lesion,Duration,serum albumin showed a negative correlation with E lesion. Age and duration of nephritis were independent risk factors for E lesion. 73.3%of patients that above 60 years old showed endothelial proliferation. CKD stage,24 hours proteinuria were positively correlated with S lesion. Age,CKD stage,systolic blood pressure,diastolic blood pressure,C4,TC, LDL?C,CRP,Fib,UA,Cys?C and 24 hours proteinuria,urineβ2?microglobulin,albumin,transferrin and IgG levels were positively associated with T lesion;hemoglobin,serum albumin,serum IgG showed a negative correlation with T lesion. Infection history,high CRP levels,DBP more than 90 mmHg,hypoalbuminemia,high low density lipoproteinemia,and anemia were independent risk factors for T lesion. Conclusion Twenty four hours proteinuria,blood platelet count,age,duration of nephritis,hypoalbuminemia,anemia,hyperlipidemia,DBP≥90 mmHg and high CRP lev?els were risk factors for the Oxford classification of IgA nephropathy. Renal biopsy should be carried out in time to make clear the pathological clas?sification and individual treatment,so as to improve the prognosis.

Objective To assess the clinical usefulness and value of the 5 models for the prediction of acute kidney injury (AKI),severe AKI which renal replacement treatment was needed (RRT-AKI) and death after cardiac surgery procedures in Chinese patients.Methods One thousand and sixty-seven patients who underwent cardiac surgery procedures in the department of cardiac surgery in the Zhongshan Hospital,Fudan University between May 2010 and January 2011 were involved in this research.The predicting value for AKI (AKICS),RRT-AKI (Cleveland,SRI and Mehta score) and death (EURO score) after cardiac surgery procedures was evaluated by Hosmer-Lemeshow goodness-of-fit test for the calibration and area under receiver operation characteristic curve (AUROC)for the discrimination.Results The incidence of AKI was 20.34％(217/1067),and 63.13％ of their renal function recovered completely.The incidence of RRT-AKI was 3.56％(38/1067) and the mortality of AKI and RRT-AKI was 9.68％ (21/217) and 44.73％ (17/38) respectively.The total mortality was 3.28％ (35/1067).The discrimination and calibration for the prediction ofAKI of AKICS were low.For the prediction ofRRT-AKI,the discrimination and calibration of Cleveland score were high enough,but the predicated value was lower than the real value (1.70％ vs 3.86％).The discrimination of Mehta score and the calibration of SRI were low.The discrimination and calibration for the prediction of death of EURO score was low.Conclusion According to the 2012 KDIGO AKI definition,none of the 5 models above is good at predicting AKI after cardiac surgery procedures.Cleveland score has been validated to have a proper impact on predicting RRT-AKI after cardiac surgery procedures,but the predicting value is still in doubt.EURO score has been validated to have an inaccurate predicting value for death after cardiac surgery procedures.

Objective:To evaluate the change in hamstring ( H ):quadriceps ( Q ) ratio following anterior cruciate ligament ( ACL) rupture during isokinetic knee extension and flexion at 30 degrees of flexion which is important for knee dynamic function .Methods:A study was performed in 25 male com-plete unilateral ACL ruptures .Isokinetic concentric and eccentric quadriceps and hamstring muscle tests in both the deficient knees and intact knees were performed at 60°/s, respectively.At 30 degrees of flexion, the average torque of quadriceps and hamstring , Qe∶Qc ratios ( ratios of eccentric quadriceps to concentric quadriceps muscle torque ) , He∶Hc ratios ( eccentric hamstring to concentric hamstring ) , Hc∶Qc ratios ( concentric hamstring to concentric quadriceps ) , He∶Qc ratios ( eccentric hamstring to con-centric quadriceps ) , and Hc∶Qe ratios ( concentric hamstring to eccentric quadriceps ) were calculated . Wilcoxon matched-pairs signed-ranks test was used .Results:At 30 degrees of knee flexion , a significant reduction ( P<0.05) in the average torque of quadriceps was observed at concentric and eccentric 60°/s produced by the deficient-side compared with the intact side .In addition, Hc∶Qc, He∶Qc, and Qe∶Qc significantly increased on the ACL-deficient side .Conclusion:The change in H ∶Q ratio in the mode of isokinetic 60 °/s at 30 degrees of knee flexion might therefore be a new tool to objectively document muscle function in ACL-deficient knee .