BACKGROUND:Epidemiologic investigations and some experiments have shown that there is a close relationship between peripheral blood cells and osteoporosis,but the causal relationship between the two at the genetic level is still unclear. OBJECTIVE:To explore the causal relationship between peripheral blood cells and osteoporosis using Mendelian randomization methods. METHODS:Genome-wide association study data sets on peripheral blood cells,overall bone density at different ages,and calcaneal bone density were obtained from databases such as Blood Cell Consortium and MRC Integrative Epidemiology Unit. Blood cells were used as exposure data,with bone density at different ages and calcaneal bone density serving as outcome data. Mendelian randomization analyses were performed using methods such as inverse variance weighting,MR-Egger,weighted median method,and simple median. The results were assessed for heterogeneity,pleiotropy,and sensitivity using Cochran's Q,MR-Egger regression,and Leave-one-out method. The causal relationship between exposure and outcomes was evaluated using β values. RESULTS AND CONCLUSION:Due to the heterogeneity revealed by Cochran's Q test in the Mendelian randomization results,the results of the study were based on the inverse variance weighting method. The inverse variance weighting results showed that when age-specific bone density was used as an outcome,there was a negative causal relationship between white blood cell count and whole-body bone mineral density at the age of 45-60 years[β=-0.07,95％ confidence interval (CI):-0.13,-0.01,P=0.02],a positive causal relationship between monocyte count and whole-body bone mineral density at the age of 45-60 years (β=0.05,95％ CI:0.00,0.10,P=0.037),a negative causal relationship between white blood cell and basophil counts and whole-body bone mineral density over 60 years old (β=-0.04,95％ CI:-0.07,-0.01,P=0.005;β=-0.04,95％ CI:-0.07,-0.00,P=0.038),a positive causal relationship between hemoglobin concentration and hematocrit and whole-body bone mineral density over 60 years old (β=0.04,95％ CI:0.01,0.08,P=0.012;β=0.04,95％ CI:0.00,0.07,P=0.039),and a negative causal relationship between white cell count and whole-body bone mineral density at an undistinguished age (β=-0.10,95％ CI:-0.16,-0.03,P=0.002). When heel bone mineral density was used as an outcome,there was a negative causal relationship between white cell count and heel bone mineral density (β=-0.04,95％ CI:-0.07,-0.01,P=0.016),and a positive causal relationship between hemoglobin concentration and hematocrit and heel bone mineral density (β=0.05,95％ CI:0.01,0.08,P=0.007;β=0.05,95％ CI:0.01,0.08,P=0.004). To ensure the robustness of the results,meta-analyses of Mendelian randomization results of peripheral blood cells and whole-body bone mineral density as well as heel bone mineral density in different age groups were conducted. The results suggested that for every standard deviation decrease in log-transformed white blood cell count,there was a 5％ reduction in the risk of decreased bone mineral density (OR=0.95,95％ CI:0.94,0.97,P<0.001);whereas for every standard deviation increase in hemoglobin concentration and hematocrit,there was a 4％ reduction in the risk of decreased bone density (OR=1.04,95％ CI:1.03,1.06,P<0.001). In conclusion,increased white blood cell count in peripheral blood is a risk factor for bone mineral density;whereas increased hematocrit and hemoglobin concentration are protective factors for bone mineral density.

BACKGROUND:Epidemiologic investigations and some experiments have shown that there is a close relationship between peripheral blood cells and osteoporosis,but the causal relationship between the two at the genetic level is still unclear. OBJECTIVE:To explore the causal relationship between peripheral blood cells and osteoporosis using Mendelian randomization methods. METHODS:Genome-wide association study data sets on peripheral blood cells,overall bone density at different ages,and calcaneal bone density were obtained from databases such as Blood Cell Consortium and MRC Integrative Epidemiology Unit. Blood cells were used as exposure data,with bone density at different ages and calcaneal bone density serving as outcome data. Mendelian randomization analyses were performed using methods such as inverse variance weighting,MR-Egger,weighted median method,and simple median. The results were assessed for heterogeneity,pleiotropy,and sensitivity using Cochran's Q,MR-Egger regression,and Leave-one-out method. The causal relationship between exposure and outcomes was evaluated using β values. RESULTS AND CONCLUSION:Due to the heterogeneity revealed by Cochran's Q test in the Mendelian randomization results,the results of the study were based on the inverse variance weighting method. The inverse variance weighting results showed that when age-specific bone density was used as an outcome,there was a negative causal relationship between white blood cell count and whole-body bone mineral density at the age of 45-60 years[β=-0.07,95％ confidence interval (CI):-0.13,-0.01,P=0.02],a positive causal relationship between monocyte count and whole-body bone mineral density at the age of 45-60 years (β=0.05,95％ CI:0.00,0.10,P=0.037),a negative causal relationship between white blood cell and basophil counts and whole-body bone mineral density over 60 years old (β=-0.04,95％ CI:-0.07,-0.01,P=0.005;β=-0.04,95％ CI:-0.07,-0.00,P=0.038),a positive causal relationship between hemoglobin concentration and hematocrit and whole-body bone mineral density over 60 years old (β=0.04,95％ CI:0.01,0.08,P=0.012;β=0.04,95％ CI:0.00,0.07,P=0.039),and a negative causal relationship between white cell count and whole-body bone mineral density at an undistinguished age (β=-0.10,95％ CI:-0.16,-0.03,P=0.002). When heel bone mineral density was used as an outcome,there was a negative causal relationship between white cell count and heel bone mineral density (β=-0.04,95％ CI:-0.07,-0.01,P=0.016),and a positive causal relationship between hemoglobin concentration and hematocrit and heel bone mineral density (β=0.05,95％ CI:0.01,0.08,P=0.007;β=0.05,95％ CI:0.01,0.08,P=0.004). To ensure the robustness of the results,meta-analyses of Mendelian randomization results of peripheral blood cells and whole-body bone mineral density as well as heel bone mineral density in different age groups were conducted. The results suggested that for every standard deviation decrease in log-transformed white blood cell count,there was a 5％ reduction in the risk of decreased bone mineral density (OR=0.95,95％ CI:0.94,0.97,P<0.001);whereas for every standard deviation increase in hemoglobin concentration and hematocrit,there was a 4％ reduction in the risk of decreased bone density (OR=1.04,95％ CI:1.03,1.06,P<0.001). In conclusion,increased white blood cell count in peripheral blood is a risk factor for bone mineral density;whereas increased hematocrit and hemoglobin concentration are protective factors for bone mineral density.

Objective To compare the effects of cleaning oral among different nursing methods for patients with dysphagia after brain injury who take food by gastric tube as well as by mouth. Methods A total of 59 patients with dysphagia after brain injury were divided into research group ( 29 cases, mouth nursing by modified method of brushing their teeth and irrigation ) and control group ( 30 cases, mouth nursing by traditional oral care routine) according to the random number table method from October 2012 to May 2014. Results were observed by comparing oral condition, indexes of pharyngeal swab culture and water-swallowing test. Results Incidence rates of halitosis and unclean mouth were all 13. 8% in the research group which were lower than those (73. 3%, 63. 3%) in the control group with statistically significant differences (χ2 =21. 208, 15. 214;P<0. 01). The effective rate of water-swallowing test was 79. 3% in the research group which was higher than that (56. 7%) in the control group (χ2 =12. 202,P<0. 01). There was no statistically significant difference in abnormity rates between two groups before intervention (P >0. 05). The abnormity rate in the research group was lower than that in the control group at 4th week (χ2 =8. 958,P <0. 01). There was statistically significant difference in abnormity rate before interventions and at 4th week in the research group (P<0.01), with no statistically significant difference in the control group (P>0.05). The rate of oral mucosa bleeding was 3. 4% in the research group and 6. 7% in the control with no statistically significant difference (χ2 =0. 316,P >0. 05), but there was no mechanical injury of oral mucosa in two groups. There was no statistically significant difference in index of water-swallowing test between two groups before interventions ( P>0. 05), with significant difference at 4th week (P<0. 01). Conclusions The implementation of mouth nursing by modified method of brushing their teeth and irrigation not only can achieve the purpose to clean oral effectively, but also can reduce oral bacteria and promote the recovery of swallowing function.

Objective:To explore the comprehensive treatment in chemical burn combined with inhalation injury,so as to in-crease cure rate and reduce the incidence of complications and mortality.Methods:The Clinical data of 56 admitted cases of chemical burn combined with inhalation injury were retrospectively analyzed.Results:In the 56 cases,there are 25 cases of lung infection(44.6%);52 cases were cured (92.9%),and 4 cases died.Conclusions:For chemical burn combined with inhalation injury,on site decontamination and early emergency treatment should be placed a premium as well as relieving airway obstruc-tion in time,clearing of respiratory tract with bronchoscope,and maintaining effective respiration by respirator.For deep wound,early escharectomy and skin grafting or skin flaps grafting can reduce the possibility of poisoning and disability rate.

Objective According to the basic theory of Yin and Yang,acute urticaria should be treated with divergent medicine instead of convergence medicine.In order to prove the theory,we carry out the quantifiable and repeatability traditional Chinese medicine screening tests in acute urticaria patients,with double controls of experimental group (divergent Chinese medicine),control group (convergence Chinese medicine)end instrumental quality-control standard substance MEBE.Methods Germany MORA-Super bio-resonance instrument (medical mode) as adopted as objective index.32 cases of acute phase urticaria were selected and treated with divergent or convergence Chinese traditional medicine,to observe the results whether conform to traditional Chinese medicine basic theory of Yin and Yang (That is whether the acute phase urticaria should be treated with divergent Chinese medicine).Results Through the 32 cases repeat experiments,22 out of 23 kinds of Divergent Chinese medicine have been screened out in experimental group; while none has been screened out in 12 kinds of convergence Chinese medicine in control group.There was significant difference between two groups (P＜0.01).The result was entirely consistent with TCM basic theory of opposite relationship between yin and yang.The top five divergent Chinese medicines were divaricate saposhnikovia root,cicada slough,catnip,shrub chastetree rruit,and lily magnolia.Conclusion Treated acute urticaria with divergent Chinese medicine conforms to the basic theory of traditional Chinese medicine.