Obese gene was cloned and its protein product which named leptin was found to be expressed specially in fat tissues in 1994. As a metabolic signal of reproductive system, leptin reflects the situations of nutrition and energy, which the body supplys to the brain, and stimulates reproductive endocrinology system, then regulates the functions of reproduction through hypothalamic-pituitary-gonadal axis. The present status of leptin in this field was reviewed.

Twelve cases of pelvis sarcoma around acetabulum were selected from Department of Orthopaedics, Wuxi Second Hospital, Nanjing Medical University between January 2001 and December 2007 including 5 males and 7 females, aged 51-72 years. According to pathological diagnosis, there were 3 cases of sarcoenchondroma, 2 cases of osteosarcoma, 3 cases of giant cell tumor of bone, 2 cases of adenocarcinoma, and 2 cases of osteoblastoma. According to tumor position by Enneking dividatur sectors, there were 5 cases of Ⅰsector, 4 cases of Ⅱsector, and 3 cases of Ⅲ sector. The Harris score of pre-replacement was 88.5?8.8. All cases were treated by saddle prosthetic replacement successfully, and no accidents happened. The operation time was 2.5-3.5 hours; blood volume was (1 250?407) mL. Twelve cases were followed up for 18 months (range 5-36 months). One case died of tumor metastasis and body exhaustion 5 months postoperation. Infection of incision took place in 1 case, and cured by operation with antibiotic combined with bone cement chain pearls. The Harris scores 4 months post-replacement: 6 cases were between 40-49, 3 cases between 50-59, and 3 cases between 60-69. Twelve cases could walk with double orthosis 3 months postoperation, and 3 cases could walk with single orthosis 6 months postoperation; 1 case walked with near normal walking, but major walking was bad. No artificial joint loosening or dislocation occurred. Although the joint function of major cases treated by saddle prosthetic replacement was not fairly satisfactory, it is a better treating method for malignant tumor whose limbs can be reserved and live their daily life by orthosis.

Obese gene was cloned and its protein product which named leptin was found to be expressed specially in fat tissues in 1994. As a metabolic signal of reproductive system, leptin reflects the situations of nutrition and energy, which the body supplys to the brain, and stimulates reproductive endocrinology system, then regulates the functions of reproduction through hypothalamic-pituitary-gonadal axis.The present status of eptin in this field was reviewed.

Objective To observe the therapeutic effect of scleral buckling procedure on old retinal detachment. Methods The clinical data of 42 patients (46 eyes), including 24 males (27 eyes) and 18 females (19 eyes), with old retinal detachment treated by scleral buckling procedure in our department were retrospectively reviewed. The duration of the disease ranged from 1 month to 2 years. All the patients were with rhegmatogenous retinal detachment and combined with mainly predominantly-subretinal proliferative vitreoretinopathy (PVR) (stage C), including stage C1 of PVR in 16 eyes (34.8%), stage C2 in 19 eyes (41.3%), and stage C3 in 11 eyes (23.9%). Scleral buckling was performed on 13 eyes (283%) and cerclage combined buckling on 33 eyes (71.7%). Sterile air was injected into 36 eyes (78.3%) during the operation, and C3F8 was introvitreal injected into 7 eyes (15.2%) after the operation. Results The follow-up duration was from 6 months to 1 year (mean 7.3 months). Retina was completely reattached in 31 eyes (67.4%), and was alleviated obviously in 12 eyes (26.1%). The subretinal fluid increased after the operation with un-reattached retina and vitrectomy was performed in 2 eyes. One eye underwent vitrectomy due to the development of PVR. After the first operation, the curative ratio of retinal detachment was 67.4%, and effective ratio (cure and alleviation) was 93.5%. The visual acuity improved in 28 eyes (60.9%), kept no change in 11 eyes (23.9%), and decreased in 7 eyes (15.2%). Conclusion Reattachment of retina and improvement of visual acuity can be achieved in some degree in some patients with old retinal detachment who undergo simple scleral buckling procedure without vitrectomy.

Objective To investigate effects of dynamic hip screw (DHS) fixation assisted with blocking screws in treatment of intertrochanteric fracture.Methods A total of 150 patients with intertrochanteric fracture were selected as the combined treatment group,of which the patients managed by DHS intemal fixation were followed by the parallel placement of a blocking screw closely beneath the main screw for stability with its end rested on the plate.Another 87 patients managed by DHS fixation alone were determined as the control group.The surgical outcomes of the two groups were analyzed and compared.Results Good fixation without external displacement of femoral neck and cut-out of the main screw in femoral head was achieved in the combined treatment group.Also,fracture nonunion or death did not exist in the combined group.The patients in combined treatment group could take care of themselves after operation in the absence of severe pain and functional disturbance,with higher excellence rate (98.7％)than that in control group (P ＜ 0.01).Whereas,the operation failure rate was significantly lower in combined treatment group than in control group (P ＜ 0.05).Conclusion DHS fixation assisted with blocking screws is an ideal treatment of incomplete intertrochanteric fracture in medial wall of calcar femorale for it can achieve reliable fixation and definite curative effect,favor fracture healing,early functional exercise and low incidence of postoperative complications.

Objective To investigate the effect of posterior pedicle screw reduction and fixation,decompressive laminectomy and massive autogenous bone grafting using bone particles harvested from resected vertebral body in treatment of lumbar spondylolisthesis.Methods Fifty-six cases of lumbar spondylolisthesis treated from June 2005 and June 2006 were reviewed retrospectively.According to Meyerding classification,35 cases were classified as grade Ⅰslippage and 21 cases as grade Ⅱ slippage.There were 19 spondylolisthesis at L4/5 and 37 at L5-S1.After posterior pedicle screw reduction and fixation,decompressive laminectomy and massive autologous bone grafting using particles of resected vertebral body,surgical outcome was analyzed.Results All cases achieved bone fusion without evidence of nail breakage or nerve injury.According to Macrab criteria,the results were excellent in 53 cases and good in three.Moreover,both the full reduction rate and interbody fusion rate were 100％.Conclusion Posterior pedicle screw reduction and fixation,decompressive laminectomy plus massive autogenous bone grafting is one of the ideal treatments for lumbar spondylolisthesis,for it achieves satisfactory fixation,decompression,reduction and fusion.

PurposeTo explore the relationship between expression of apoptosis-modulating proteins and chemotherapeutic efficacy in acute leukemia. MethodsImmunocytochemical method was used to detect the expression of Bcl-2、Bcl-XL、Bax and Bak in 36 cases of acute leukemia including previously untreated/ drug-sensitive group and refractory/relapse group. ResultsThe average positive cell rates of Bcl-2 and Bcl-XL in refractory/relapse group were (41.68 ± 14.39) % and (35.96 ± 9.95 ) %, while the rates in previously untreated/drug-sensitive group were (15.64 ± 8.51 )% and (12.91 ± 8.63 )%. Statistical analysis showed the average positive cell rates of Bcl-2 and Bcl-XL in refractory/relapse group were higher than those in previously untreated/drug-sensitive group (P ＜ 0.01 ). There was no significant difference in average positive cell rates of Bax and Bak between refractory/relapse group (25.28 ± 15.49) %, (15.53 ± 10.64) % and previously untreated/drug-sensitive group (21.55 ± 12.58)%, (13.23 ± 8.36)%. The Logistic regression of expression of Bd-2 、Bcl-XL、Bax and Bak to complete remission rate (CR) of 36 cases of acute leukemia showed that Bcl-XL was the most risk factor in reducing the CR.ConclusionsBcl-2 and Bcl-XL might play important roles in multi-drug resistance of acute leukemia and Bcl-XL was more important than Bcl-2.

Vitamin D deficiency/insufficiency not only results in disorders of skeletal system, but may also be associated with other nonskeletal diseases.Therefore, measurement of 25 -hydroxyvitamin D has received more and more attentions.Common methods for 25-hydroxyvitamin D testing include vitamin D binding protein -based competitive assays, immunoassays, high performance liquid chromatography (HPLC), and liquid chromatography -tandem mass spectrometry(LC -MS/MS).Vitamin D binding protein-based assays and immunoassays can be performed on automated chemistry analyzers,permitting an easy and quick measurement with high throughput.However, significant variability exists among various assays.They cannot separate 25 -hydroxyvitamin D3 and D2 either.HPLC method can separate D3 and D2,but the sensitivity and specificity are not as good as mass spectrometry.LC-MS/MS is more specific and sensitive and it can measure D3 and D2 individually.However, the methodology is more complicated and its throughput is relatively low.Also, it requires special instrument and operators who need additional training.In addition,most LC-MS/MS methods are developed and validated by individual laboratories,so the standardization of the method is an urgent problem to be solved.Although the specificity of LC -MS/MS method is high, some metabolites may still interfere with the assay.The reference interval of 25 -hydroxyvitamin D is still controversial and how to establish gender -and age-specific reference intervals remains debatable.Besides 25-hydroxyvitamin D,whether its metabolites and free 25-hydroxyvitamin D should be measured is still questionable.Although 25-hydroxyvitamin D testing is primarily used for the diagnosis and treatment of skeletal diseases, epidemiological studies suggest that vitamin D deficiency /insufficiency may be related to the development and prognosis of nonskeletal diseases.However, more evidence is needed in order to determine the causal relationship between them and the mechanism.

Objective To study the relationship between the positive expression of human leukocyte antigen B27 (HLA-B27) in different age groups and genders in Uygur and Han nationality in Xinjiang,and explore the clinical value of HLA-B27 in different ethnic groups.Methods From January 2013 to November 2016,1 416 cases of Uygur and Han patients with positive expression of HLA-B27 were detected by flow cytometry.There were 369 cases of Uygur and 1 047 cases of Han.Results Independent samples t-test showed that the positive expression of HLA-B27 in Uygur and Han population was statistically significant (165.22±8.262 vs 163.99±8.113,t=2.479,P=0.013).In male,there was a significant difference in the positive expression of HLA-B27 between Uygur and Han population (165.40 ± 8.237 vs 163.99 ± 8.164,t =2.187,P =0.029).In the age of 41～60 years old and ＞60 years old,the positive expression of HLA-B27 in Uygur was higher than that in Han nationality (166.18 ± 7.650 vs 164.53 ± 8.018,t =2.215,P =0.027;171.63 ± 8.134 vs 167.40 ± 9.469,t =2.126,P=0.035).There was no significant difference in the positive expression of HLA-B27 between Uygur and Han nationality in women,as well as in the age of 20 years and 21～40 years (t=-0.029～1.257,all P＞0.05).Conclusion The investigation showed that the positive expression of HLA-B27 in Uygur was higher than that in Han nationality.The content of HLA-B27 positive expression has racial difference.

Objective To observe the clinical effects of pars plana vitrectomy (PPV) combined with internal limiting membrane peeling (ILMP) for macular hole (MH) and macular retinoschisis in high myopic eyes,and to analyze factors affecting the MH closure rate.Methods This is a retrospective case study.21 high myopic patients (22 eyes) with MH and macular retinoschisis were enrolled in this study.All eyes were examined for best corrected visual acuity (BCVA),intraocular pressure,slit lamp microscope,indirect ophthalmoscope,A and/or B-scan ultrasound,optical coherence tomography and visual electrophysiological examination.The BCVA was ranged from finger counting to 0.2.The axial length (AL) was ranged from 26.00 to 31.00 mm,with an average of 27.47 mm.Among 22 eyes,AL was between 26.00 mm to 27.00 mm in 9 eyes,27.10 mm to 28.00 mm in 5 eyes,28.10 mm to 29.00 mm in 3 eyes,29.10 mm to 30.00 mm in 3 eyes,and longer than 30.00 mm in 2 eyes.The diameter of MH was ranged from 227 μm to 597 μm and with an average of 432 μm.Among them,the minimum diameter was between 200 μm to 400 μm in 4 eyes,401 μm to 450 μm in 13 eyes,451 μm to 500 μm in 3 eyes,501 μm to 600 μm in 2 eyes.All the eyes were treated with PPV combined with ILMP surgery.The average follow-up time was 17 months after surgery.The efficacy was determined at the final follow up,including the MH closure,the state of macular retinoschisis and the BCVA.MH closure rate with different MH diameters and different AL were compared and analyzed.Results During the final followup,MH were fully closed in 17 eyes (77.3％),bridge-closed in 4 eyes (18.2％) and not closed in 1 eye (4.5％).Retinoschisis was resolved in 19 eyes (86.4％),partially resolved in 2 eyes (9.1％) and not changed in 1 eye (4.4％).MH with smaller diameter had higher MH closure rate (x2=12.036,P=0.032).MH with longer AL had lower MH closure rate (x2=16.095,P=0.003).The final BCVA was ranged from finger counting to 0.25.Among 22 eyes,BCVA or metamorphopsia were improved in 9 eyes (40.9％),stable in 8 eyes (36.4％).BCVA was reduced and metamorphopsia was more severe in 5 eyes (22.7％).Conclusions PPV combined with ILMP is a safe and effective surgical treatment for MH (with minimum diameter ≤600 μm) and macular retinoschisis in high myopic eyes.After surgery,MH was closed and retinoschisis was resolved in most patients.The major factors affect the MH closure were the minimum diameter of MH and AL.