Objective To investigate the risk factors for osteoporosis (OP) in aged people at Beicai Town in Shanghai, to provide proofs for preventing OP. Methods Questionnaire survey was carried out on bone density in 608 aged people (aged from 60 to 79 years) who were randomly chosen from 4 resident committees of Beicai Town in Shanghai. Everyone underwent bone mineral density (BMD) assay of lumbar spine and total hip by DEXA machine. Results The rate of OP was 23 % in male group, and 61% in female group. It was 40% in 60-64 years old group, 44% in 65-69 years old group, 53% in 70-74 years old group and 66% in 75-79 years old group. The rate of OP was 52% in manual work group, and 42 % in non-manual work group. In males, it was 54 % in current weight less than 60 kg group, 19% in 60-70 kg group, 15% in 70-80 kg group and 23% in over 80 kg group. In females, it was 76% in current weight less than 50 kg group, 67% in 50-60 kg group, 63% in 60-70kg group, 30% in over 70 kg group. It was 56% in low body weight group, 41% in normal weight group and 58% in over weight group in their 25-year-old. It was 61% in normal body weight group, 43% in overweight group. It was 41% in non-fracture history group, 67% in once fracture group,74% in fracture history more than twice group. It was 60% in mother humpback history group, and 47% in no history of mother humpback group. Logistic regression analysis showed that gender, age,history of fracture, mother's humpbacked history, disease of internal secretion and metabolism system were the risk factors for OP. Conclusions The occurrence of OP is related with many factors in aged people at Beicai Town in Shanghai, especially for the aged women, who suffer from diseases of internal secretion and metabolism, and has the history of fracture and mother's humpbacked, the attention should be payed to the prevention and treatment of OP.

OBJECTIVETo study injury of liver and kidney among the workers exposed to terephthalic acid(TPA), ethylene glycol(EG) and(or) dowtherm A(DOW), and research for early biological monitoring indexes.

METHODSBy using the method of occupational epidemiology, an investigation of industrial hygiene in a chemical fibre corporation was carried out and the changes of the liver and kidney functions were analyzed among the workers who had been exposed to TPA, EG, DOW.

RESULTSThe values of serum gamma-glutamyl traspetidase(GGT) and total bile acid(TBA) in TPA + EG + DOW group men were (35.45 +/- 16.09) U/L, (10.29 +/- 6.76) mumol/L respectively and the values of serum alanine transaminase(ALT) and TBA in TPA + EG + DOW group women were(30.68 +/- 8.58) U/L, (9.53 +/- 6.63) mumol/L respectively, significantly higher than those in TPA, DOW and control groups(P < 0.05, P < 0.01). Compared with TPA, DOW and control groups, the values of urine N-acetyl-beta-D-glucosaminidase(NAG) and beta 2-2-microglobulim (beta 2-MG) in TPA + EG + DOW group of both men and women increased significantly(P < 0.05, P < 0.01), with(5.68 +/- 4.01) U/mmol Cr and (23.49 +/- 13.44) mg/mol Cr, and(6.68 +/- 4.68) U/mmol Cr and (22.80 +/- 13.00) mg/mol Cr, respectively. Analysis of regression indicated that both liver and renal injuries of the workers were evidently correlated with their exposure to TPA, EG and DOW after adjustment for the confounding factors such as sex, smoking, drinking, etc(P < 0.001).

CONCLUSIONBased on available knowledge, it is reasonable to assume that the joint actions should be considered on the injury of liver and kidney caused by TPA, EG and(or) DOW among the workers. Serum ALT, GGT, TBA, urine NAG and beta 2-MG should be suggested as biomarkers for liver and kidney damage.

Acetylglucosaminidase ; urine ; Alanine Transaminase ; blood ; Bile Acids and Salts ; blood ; Ethylene Glycol ; toxicity ; Female ; Humans ; Kidney ; drug effects ; Liver ; drug effects ; Male ; Occupational Exposure ; adverse effects ; Phenyl Ethers ; toxicity ; Phthalic Acids ; toxicity ; gamma-Glutamyltransferase ; blood

OBJECTIVE:To explore the association between the mitochondrial DNA(mtDNA)3537A/G,5351A/G variant and type 2diabetes mellitus(T2DM)in northem Chinese population.METHODS:The subjects including 614 patients with T2DM in Dalian City,61 of them were collected from family survey,497 of them were collected from Department of Endocrine,Dalian Municipal Central Hospital,and the remained 56 were selected from diverging T2DM patients in Dalian City.Additional 344 cases with normal carbohydrate toierance were served as controls.The mtDNA 3537A/G.5351A/G variants in 614 patients with T2DM and 334 healthy control subjects were examined.By sequencing the mtDNA in 24 cases and 26 controls,2 candidate SNPs in mtDNA were determined,and then genotyping was carried out by using PCR restriction fragment length polymorphism(PCR-RFLP)analysis.RESULTS:The frequency of mtDNA A3537G and A5351G mutation was 2.0%and 2.6% in T2DM patients,respectively,which was 2.1%and 4.2% in the control group.No significant difference had been observed between case and control(P＞0.05).After stratifying by body mass index and blood pressure,we found that the frequency of A5351 G in obesity patients with T2DM was 1.61%,and in obesity control was 15.38%,which had significant difference(P_(Fisher)=0.02,OR=2.76),however,A3537G stili showed no significant difference in all groups(P＞0.05).CONCLUSION:5351A/G in mtDNA ND2 gene may be a variance associated with T2DM in northem Chinese.

Objective To investigate the characteristics of peroperative blood pressure and heart rate in patients with normotensive incidental pheochromocytomas in order to provide the basis for peroperative treatment. Methods This retrospective study collected the data of 104 patients with a pathological diagnosis of unilateral pheochromocytoma at PLA General Hospital during January 2011 to December 2016. They were divided into normotensive incidental pheochromocytomas(NIP) group (n＝50) if the patients were normotensive and HIP group ( n＝54) if the patients were with hypertension. The clinical features, imaging features and peroperative hemodynamics were analyzed. Results ( 1) The age, urinary norepinephrine, daily dosage and duration of phenoxybenzamine in NIP group were less than those of HIP group (all P<0.05). (2) Preinduction blood pressure, maximum blood pressure, and total fluid intake in NIP group were lower than those in HIP group(all P<0.05). The blood pressure range, heart rate range, increased blood pressure, minimum mean arterial pressure, vasoactive medication were without statistical significance between these two groups. ( 3) The times and rate of intraoperative systolic blood pressure more than 30% baseline, 200 mmHg (1 mmHg＝0.133 kPa), 180 mmHg, 160 mmHg, intraoperative tachycardia, bradycardia, intraoperative hypotension and postoperative hypotension were without statistical significance between these two groups. (4) Stratified analysis of age (50 years), phenoxybenzamine (40 mg/d), tumor diameter (50 mm) and preinduction blood pressure (130/80 mmHg) showed that intraoperative blood pressure and heart rate were without statistical significance between these two groups. ( 5) There was no correlation between phenoxybenzamine ( daily dosage or duration ) and peroperative hypotension. Applying phenoxybenzamine or vasoactive medication was not correlated with peroperative hypotension in NIP group. Conclusion The peroperative blood pressure and heart rate of patients with NIP are similar to those of patients with HIP. Adequate peroperative treatment should be applied to NIP to avoid hemodynamic instability.

Objective To characterize the baseline status of Chinese diabetic patients based on data derived from Chinese cohort from SOLVETM study.Methods Patients with type 2 diabetes initiating basal insulin detemir at the decision of the physician were eligible for the study.Data on demographics,medical history,glycemic profile and treatment regimen at baseline were collected by physicians.Results A total of 3272 patients [female 42％,male 58％,mean age (56.2 ± 10.8) years] were included in the study.Their BMI was (25.3 ± 3.3) kg/m2.The duration of diabetes was 4.0 (0.1-27.0) years,and the duration of treatment with oral antidiabetic drugs (OADs) was 3.0(0.0-20.2) years.The proportions of subjects with diabetic macro-and micro-vascular complications were 15.8％ (515 cases) and 27.1％ (866 cases),respectively.The hemoglobin Al c (HbAl c) at baseline was (8.33 ± 1.70) ％,and the fasting blood glucose (FPG) was (9.5 ± 2.6) mmol/L.Conclusions A large proportion of patients with type 2 diabetes remain in poor glycemic control,and the prevalence of diabetic complications is high,which requires optimal therapeutic strategy for the patients with suboptimal glycemic control.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

The transgender children and adolescents （TCAs） face serious social dilemmas in the process of gender identity and expression， which hinders this group from seeking reasonable and equal rights to survival and development. From the perspective of equal rights and the theoretical framework of social dilemma， by interviewing TCAs who seek help from medical social workers in a hospital’s multi-disciplinary transgender clinic， this paper revealed that under the traditional system of “binary gender”， TCAs lacked social inclusiveness and infrastructure， which led to the two major social dilemmas of “social traps” and “social barriers” encountered by this group in the process of gender expression and gender identity. Specifically， the social gender selection of TCAs often leads to collective irrational reactions and gender punishment， preventing their legal and effective medical services. To this end， the research team used critical methodology to construct a joint disciplinary diagnosis and treatment path for TCAs with the participation of medical social workers， as well as verified that the path has significant intervention effects in rationalizing the needs of TCAs and their families， alleviating their psychological pressure and social adaptation problems in the process of gender identity， fostering a diverse dialogue environment in their families， as well as enhancing their self-efficacy and social participation， to provide assistahce to the TCAs groups in social difficulties， assisting their rights and interests be included in the child-friendly indicator system， and improving the whole society’s tolerance and understanding for TCAs group.