The performance of digital chest radiographs in the detection and diagnosis of pulmonary nodules and the consistency among readers / 中华肿瘤杂志

Objective: To investigate the detection and diagnostic efficacy of chest radiographs for ≤30 mm pulmonary nodules and the factors affecting them, and to compare the level of consistency among readers. Methods: A total of 43 patients with asymptomatic pulmonary nodules who consulted in Cancer Hospital, Chinese Academy of Medical Sciences from 2012 to 2014 and had chest CT and X-ray chest radiographs during the same period were retrospectively selected, and one nodule ≤30 mm was visible on chest CT images in the whole group (total 43 nodules in the whole group). One senior radiologist with more than 20 years of experience in imaging diagnosis reviewed CT images and recording the size, morphology, location, and density of nodules was selected retrospectively. Six radiologists with different levels of experience (2 residents, 2 attending physicians and 2 associate chief physicians independently reviewed the chest images and recorded the time of review, nodule detection, and diagnostic opinion. The CT imaging characteristics of detected and undetected nodules on X images were compared, and the factors affecting the detection of nodules on X-ray images were analyzed. Detection sensitivity and diagnosis accuracy rate of 6 radiologists were calculated, and the level of consistency among them was compared to analyze the influence of radiologists' seniority and reading time on the diagnosis results. Results: The number of nodules detected by all 6 radiologists was 17, with a sensitivity of detection of 39.5%(17/43). The number of nodules detected by ≥5, ≥4, ≥3, ≥2, and ≥1 physicians was 20, 21, 23, 25, and 28 nodules, respectively, with detection sensitivities of 46.5%, 48.8%, 53.5%, 58.1%, and 65.1%, respectively. Reasons for false-negative result of detection on X-ray images included the size, location, density, and morphology of the nodule. The sensitivity of detecting ≤30 mm, ≤20 mm, ≤15 mm, and ≤10 mm nodules was 46.5%-58.1%, 45.9%-54.1%, 36.0%-44.0%, and 36.4% for the 6 radiologists, respectively; the diagnosis accuracy rate was 19.0%-85.0%, 16.7%-6.5%, 18.2%-80.0%, and 0%-75.0%, respectively. The consistency of nodule detection among 6 doctors was good (Kappa value: 0.629-0.907) and the consistency of diagnostic results among them was moderate or poor (Kappa value: 0.350-0.653). The higher the radiologist's seniority, the shorter the time required to read the images. The reading time and the seniority of the radiologists had no significant influence on the detection and diagnosis results (P>0.05). Conclusions: The ability of radiographs to detect lung nodules ≤30 mm is limited, and the ability to determine the nature of the nodules is not sufficient, and the increase in reading time and seniority of the radiologists will not improve the diagnostic accuracy. X-ray film exam alone is not suitable for lung cancer diagnosis.

Spatio-temporal distribution characteristics of Oncomelania hupensis in Anhui Province from 2011 to 2020 / 中国血吸虫病防治杂志

OBJECTIVE@#To analyze the spatial-temporal distribution characteristics of Oncomelania hupensis snails in Anhui Province from 2011 to 2020, to provide insights into precision control of O. hupensis snails in Anhui Province.@*METHODS@#O. hupensis snail distribution data were collected in Anhui Province from 2011 to 2020 and descriptively analyzed, including actual area of snail habitats, area of emerging snail habitats and area of Schistosoma japonicum-infected snails. The actual area of snail habitats and area of emerging snail habitats were subjected to spatial autocorrelation analysis, hotspot analysis, standard deviation ellipse analysis and space-time scanning analysis, and the clusters of snail distribution and settings at high risk of snail spread were identified in Anhui Province from 2011 to 2020.@*RESULTS@#The actual area of snail habitats gradually decreased in Anhui Province from 2011 to 2020. The actual area of snail habitats were 26 238.85 hm2 in Anhui Province in 2020, which were mainly distributed in marshland and lake regions. There was a large fluctuation in the area of emerging snail habitats in Anhui Province during the period from 2011 to 2020, with the largest area seen in 2016 (1 287.65 hm2), and 1.96 hm2 emerging infected snail habitats were detected in Guichi District, Chizhou City in 2020. Spatial autocorrelation and hotspot analyses showed spatial clusters in the distribution of actual areas of snail habitats in Anhui Province from 2011 to 2020 (Z = 3.00 to 3.43, all P values < 0.01), and the hotspots were mainly concentrated in the marshland and lake regions and distributed along the south side of the Yangtze River, while the cold spots were mainly concentrated in the mountainous regions of southern Anhui Province. There were no overall spatial clusters in the distribution of areas of emerging snail habitats (Z = -2.20 to 1.71, all P values > 0.05), and a scattered distribution was found in local regions. Standard deviation ellipse analysis showed relatively stable distributions of the actual areas of snail habitats in Anhui Province from 2011 to 2020, which was consistent with the flow direction of the Yangtze River, and the focus of the distribution of areas of emerging snail habitats shifted from the lower reaches to upper reaches of Anhui section of the Yangtze River. Space-time scanning analysis identified two high-value clusters in the distribution of actual areas of snail habitats in lower and middle reaches of Anhui section of the Yangtze River from 2011 to 2020, and two high-value clusters in the distribution of areas of emerging snail habitats were identified in mountainous and hilly regions.@*CONCLUSIONS@#There were spatial clusters in the distribution of O. hupensis snails in Anhui Province from 2011 to 2020, which appeared a tendency of aggregation towards the south side and upper reaches of the Yangtze River; however, the spread of O. hupensis snails could not be neglected in mountainous and hilly regions. Monitoring of emerging snail habitats should be reinforced in mountainous and hilly regions and along the Yangtze River basin.

Investigation on prevalence of Schistosoma japonicum infections in wild mice in Shitai County, Anhui Province, 2018 / 中国血吸虫病防治杂志

Objective To investigate the prevalence of Schistosoma japonicum infection in wild mice in Shitai County, Anhui Province, so as to provide insights into precise control of the source of S. japonicum infections. Methods Wild mice were captured using the trapping method for three successive nights at snail-infested settings from Jitan Village of Jitan Township, and Shiquan Village and Xibai Village of Dingxiang Township, Shitai County, Anhui Province in June and October, 2018. All trapped wild mice were sacrificed and liver and mesenteric vein specimens were collected for detection of S. japonicum eggs using microscopy, while the fecal samples in mouse intestines were collected for identification of S. japonicum infections using Kato-Katz technique. In addition, the population density of trapped wild mice was estimated and the prevalence of S. japonicum infection was calculated in trapped wild mice. Results A total of 376 wild mice were trapped from three villages in Shitai County. The population density of trapped wild mice was 9.1% (376/4 124), and the prevalence of S. japonicum infection was 24.2% (91/376) in trapped wild mice. The highest prevalence of S. japonicum infection was detected in Shiquan Village of Dingxiang Township (30.1%), and the lowest prevalence was seen in Xibai Village of Dingxiang Township; however, there was no significant difference in the prevalence of S. japonicum infection in trapped wild mice among three villages (χ2= 4.111, P > 0.05). In addition, there was no significant difference in the prevalence of S. japonicum infection in wild mice captured between on June (26.8%, 34/127) and October (22.9%, 57/249) (χ2 = 0.690, P = 0.406). The trapped wild mice included 6 species, including Rattus norvegicus, Niviventer niviventer, R. losea, Apodemus agrarius, Mus musculus and N. coning, and the two highest prevalence of S. japonicum infection was detected in R. losea (34.9%, 22/63) and R. norvegicus (31.2%, 44/141). Conclusions The prevalence of S. japonicum infections is high in wild mice in Shitai County, and there is a natural focus of schistosomiasis transmission in Shitai County.

New oligomeric neolignans from the leaves of Magnolia officinalis var. biloba / 中国天然药物

Six new oligomeric neolignans including two trimeric neolignans (1 and 2) and four dimeric neolignans (3-6) were isolated from the leaves of Magnolia officinalis var. biloba. Their structures were determined based on HR-ESIMS and NMR data, as well as electronic circular dichroism (ECD) calculations. Compound 1 is formed from two obovatol moieties directly linked to an aromatic ring of the remaining obovatol moiety, which is an unprecedented type of linkage between monomers. All isolates were assessed for their inhibitory effects on NO production in LPS-stimulated RAW 264.7 macrophage cells. Compounds 1 and 3 showed significantly inhibitory activities with IC

Spatiotemporal distribution of Oncomelania hupensis snail habitats in Anhui Province / 中国血吸虫病防治杂志

Objective To investigate the spatiotemporal distribution of Oncomelania hupensis snails and infected snails in the endemic areas of schistosomiasis in Anhui Province. Methods Based on the snail survey data in Anhui Province in 2016, the distribution of snails and infected snails were analyzed, and the spatial distribution of snails and spatial cluster patterns of infected snails were investigated in snail habitats in Anhui Province from 1950 to 2016. Results A total of 22 757 snail habitats and 5 004 infected snail habitats were identified in Anhui Province from 1950 to 2016, which appeared single-peak and double-peak patterns, with an inflection point seen in 1970. There were 141 000 hm2 historically accumulative snail habitats, 88.08% of which were firstly identified from 1950 to 1979, and totally 114 500 hm2 snail habitats were eradicated, 77.17% of which were eradicated from 1970 to 1999. There were 4 830 snail habitats identified until 2016, in which 1 051 were once detected with infected snails. In addition, 78.12% of current snail habitats had been present for over 40 years, and infected snails had been eliminated in 65.75% of the infected snail habitats within 10 years. There was a spatial autocorrelation of the living snail density in current snail habitats in Anhui Province (Moran’s I = 0.196, Z = 139.63, P < 0.001), and local hotspot analysis showed spatial clusters of living snails density in snail habitats, with high-value clusters in south of the Yangtze River and low-value clusters in north of the Yangtze River. The 21 high-value clusters of living snail density with statistical significance were distributed along the Yangtze River basin and its branches. Spatiotemporal scan analysis revealed spatiotemporal clusters of infected snails in 4 current snail habitats. Conclusions The current snail habitats have been present for a long period of time, and snails are difficult to be eliminated by chemical treatment alone, which requires the combination of environment improvements. There are spatial clusters of living snail density in current snail habitats in Anhui Province. The epidemic factors and risk of human and animal infections still remain in some clusters of historical infected snail habitats revealed by spatiotemporal scan analysis, which should be consid- ered as the key target areas for snail control in Anhui Province.

Positive Effects of Qing'e Pill () on Trabecular Microarchitecture and its Mechanical Properties in Osteopenic Ovariectomised Mice / 中国结合医学杂志

OBJECTIVE@#To investigate the impact of Qing'e Pill (, QEP) on the cancellous bone microstructure and its effect on the level of β-catenin in a mouse model of postmenopausal osteoporosis.@*METHODS@#Ninety-six 8-week-old specific pathogen free C57BL/6 mice were randomly divided into 4 groups (24/group): sham, ovariectomised osteoporosis model, oestradiol-treated, and QEP-treated groups. Three months after surgery, the third lumbar vertebra and left femur of the animals were dissected and scanned using micro-computed tomography (micro-CT) to acquire three-dimensional (3D) parameters of their cancellous bone microstructure. The impact of ovariectomy, the effect of oestradiol and QEP intervention on cancellous bone microstructure, and the expression of β-catenin were evaluated.@*RESULTS@#The oestradioland the QEP-treated groups exhibited a significant increase in the bone volume fraction, trabecular number, trabecular thickneßs, bone surface to bone volume ratio (BS/BV), and β-catenin expression compared with those of the model group (P <0.05). In contrast, the structure model index, trabecular separation, and BS/BV were significantly decreased compared with those of the ovariectomised osteoporosis model group (P <0.05). No differences were observed in the above parameters between animals of the QEP- and oestradiol-treated groups.@*CONCLUSIONS@#The increased β-catenin expression may be the mechanism underlying QEP's improvement of the cancellous bone microstructure in ovariectomised mice. Our findings provide a scientific rationale for using QEP as a dietary supplement to prevent bone loss in postmenopausal women.

Influence of different interventional opportunity on advanced aged patients with acute coronary syn‐drome non‐ST elevation type／ / 心血管康复医学杂志

To study influence of different interventional opportunity on advanced aged patients with acute coronary syndrome non‐ST elevation type (ACS‐NSTE).Methods : The180 advanced aged ACS‐NSTE patients from our hospital , were randomly and equally divided into group A , B and C , and they received interventional surgery within 1d ,2～3d and 3d later after hospitalization respectively .Serum levels of cystatin C (CysC ) , lipoprotein a [Lp (a)] , ApoA , hsCRP and vascular endothelial function indexes before and 7d after intervention , cardiac func‐tion indexes before and two months after intervention , and incidence of major adverse cardiovascular events (MACE) within two years after intervention were observed and compared among three groups .Results : Compared with group A and C on 7d after intervention , there were significant reductions in levels of CysC [ (0. 97 ± 0.13) mg／L vs .(1.08 ± 0.15) mg／L vs.(0.90 ± 0.11) mg／L] , Lp (a) [ (175.74 ± 18.18) mg／L vs.(197.89 ± 20. 15) mg／L vs .(163. 98 ± 16.54) mg／L] , hsCRP [ (1. 44 ± 0.20) mg／L vs.(2.34 ± 0.25) mg／L vs.(0.79 ± 0.09) mg／L] , plasma von Willebrand factor [vWF , (158. 79 ± 16.28)% vs.(174.68 ± 18. 28)% vs .(142.87 ± 14. 31)%] and endothelin‐1 [ET‐1 , (93. 28 ± 9.34) ng／L vs.(99.10 ± 9.94) ng／L vs .(86.43 ± 8.71) ng／L] , and significant rise in levels of ApoA [ (0.91 ± 0. 16) mg／L vs.(0. 82 ± 0.14) mg／L vs.(1.03 ± 0.17) mg／L] and NO [ (59. 92 ± 5. 93) mol／L vs.(55. 33 ± 5.48) mol／L vs.(64. 29 ± 6. 42) mol／L] in group B , P＜0. 01 all.After two months , com‐pared with group A and C , there were significant reductions in LVEDd [ (47.87 ± 4.72) mm vs.(50.58 ± 5.11) mm vs.(44. 68 ± 4. 50) mm] and LVESd [ (37.87 ± 3.82) mm vs .(40.57 ± 4. 19) mm vs.(34.98 ± 3. 52) mm] , and significant rise in LVEF [ (52. 87 ± 5.38)% vs.(49.04 ± 5. 02)% vs.(55. 89 ± 5.62)%] in group B , P＜0. 01 all.On two years after intervention , incidence rate of MACE in group B was significantly lower than those of group A and C (3.33% vs.15. 00% vs .31.67%, P＜0.05 or ＜0.01).Conclusion : Interventional therapy on 2～3d after hospitalization can significantly reduce inflammatory factor level , improve vascular endothelial function and cardiac function , and reduce incidence rate of MACE in ACS‐NSTE patients .

Application of infrared camera technique in investigation of wild animals as infectious source of schistosomiasis / 中国血吸虫病防治杂志

Objective To investigate the species and activities of wild animals infected with schistosome in hilly and mountain areas by using an infrared camera technique, so as to provide the evidence for the surveillance of schistosomiasis in these areas. Methods Six infrared cameras were selected and placed in 6 environments of the risk monitoring points of schistosomiasis in Shitai County in Anhui Province. The species and activities of the wild animals in the 6 environments were observed through the photographs and videos taken by the cameras. Results Through 5 day’s monitoring, 3 wild mammals, such as voles, hares and wild boars, were found in 4 monitoring environments, of which voles were found at 2 environments with snails, and hares, wild boars and voles were found in 2 environments adjacent to environments with snails respectively. The monitoring showed that the vole activity was most frequent in the monitored environment. Conclusion The use of infrared camera technique has a good effect in the investigation of wild animal infectious source of schistosomiasis, and it is also suitable for the monitoring work in other types of environments.

Investigation of Oncomelania hupensis snails in Anhui Province in 2016 / 中国血吸虫病防治杂志

Objective To investigate the status of Oncomelania hupensis snails in Anhui Province in 2016, so as to provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control. Methods In 2016, a snail survey was conducted in Anhui Province according to the National Programme of the Oncomelania Snail Survey, covering all snail habitats or historical snail habitats and suspected environments of snail breeding, and the results of the survey were analyzed. Results In 2016, 22 848 environments were surveyed, and no schistosome-infected snails were found. There were 17 927 historical snail habitats in whole province, among which, the environments without changes, changed partly and changed completely accounted for 71.2%, 19.3% and 9.5%, respectively. The area of historical snail habitats was 1.410 billion m2. There were 4 830 environments with snail habitats covering an area of 0.265 billion m2 in 38 counties of 7 cities, including newly emerging area of 1 287.65 hm2 and reemerging area of 1 375.32 hm2. The density of living snails was 0.392 0 snails/0.1 m2, and the rate of frame with living snails was 12.93%. The type of marshland and lake regions, and the type of hilly and mountainous regions accounted for 22.4% and 77.6% of number of snail habitats, and accounted for 86.7% and 13.3% of areas of snail habitats, respectively. Among the different types of vegetation in snail habitats, grass was superior owe to accounting for 82.2% of the number of snail habitats, 57.3% of the area with snail habitats, and the highest density of living snails (0.413 9 snails/0.1 m2). Among the different types of environments in snail habitats, the ditch was superior owe to accounting for 56.8% of the number of snail habitats, the highest density of living snails (0.570 3 snails/0.1m2) and the highest rate of frame with living snails (18.57%), and the beach was superior owe to accounting for 87.8% of the area with snail habitats. In Anhui Province, the first year of snails and schistosome-infected snails being found was 1950 and 1952, respectively, and the latest year of schistosome-infected snails being found was 2012. The map showed that the most environments with snail habitats were distributed along the Yangtze River in Anhui Province. Conclusion For the first time, the investigation has built the database and map of snail spatial distribution, which truly reflect the historic and current status of snail distribution in Anhui Province and can provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control and improving the schistosomiasis prevention and control work in the future.

Investigation of Oncomelania hupensis snails in Anhui Province in 2016 / 中国血吸虫病防治杂志

Objective To investigate the status of Oncomelania hupensis snails in Anhui Province in 2016, so as to provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control. Methods In 2016, a snail survey was conducted in Anhui Province according to the National Programme of the Oncomelania Snail Survey, covering all snail habitats or historical snail habitats and suspected environments of snail breeding, and the results of the survey were analyzed. Results In 2016, 22 848 environments were surveyed, and no schistosome-infected snails were found. There were 17 927 historical snail habitats in whole province, among which, the environments without changes, changed partly and changed completely accounted for 71.2%, 19.3% and 9.5%, respectively. The area of historical snail habitats was 1.410 billion m2. There were 4 830 environments with snail habitats covering an area of 0.265 billion m2 in 38 counties of 7 cities, including newly emerging area of 1 287.65 hm2 and reemerging area of 1 375.32 hm2. The density of living snails was 0.392 0 snails/0.1 m2, and the rate of frame with living snails was 12.93%. The type of marshland and lake regions, and the type of hilly and mountainous regions accounted for 22.4% and 77.6% of number of snail habitats, and accounted for 86.7% and 13.3% of areas of snail habitats, respectively. Among the different types of vegetation in snail habitats, grass was superior owe to accounting for 82.2% of the number of snail habitats, 57.3% of the area with snail habitats, and the highest density of living snails (0.413 9 snails/0.1 m2). Among the different types of environments in snail habitats, the ditch was superior owe to accounting for 56.8% of the number of snail habitats, the highest density of living snails (0.570 3 snails/0.1m2) and the highest rate of frame with living snails (18.57%), and the beach was superior owe to accounting for 87.8% of the area with snail habitats. In Anhui Province, the first year of snails and schistosome-infected snails being found was 1950 and 1952, respectively, and the latest year of schistosome-infected snails being found was 2012. The map showed that the most environments with snail habitats were distributed along the Yangtze River in Anhui Province. Conclusion For the first time, the investigation has built the database and map of snail spatial distribution, which truly reflect the historic and current status of snail distribution in Anhui Province and can provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control and improving the schistosomiasis prevention and control work in the future.

Effects of Modified Qing'e Pill () on expression of adiponectin, bone morphogenetic protein 2 and coagulation-related factors in patients with nontraumatic osteonecrosis of femoral head / 中国结合医学杂志

<p><b>OBJECTIVES</b>To observe the regulation of Chinese herbal medicine, Modifified Qing'e Pill (, MQEP), on the expression of adiponectin, bone morphogenetic protein 2 (BMP2), osteoprotegerin (OPG) and other potentially relevant risk factors in patients with nontraumatic osteonecrosis of the femoral head (ONFH).</p><p><b>METHODS</b>A total of 96 patients with nontraumatic ONFH were unequal randomly divided into treatment group (60 cases) and control group (36 cases). The treatment group were treated with MQEP while the control group were treated with simulated pills. Both groups were given caltrate D. Six months were taken as a treatment course. Patients were followed up every 2 months. The levels of plasma adiponectin, BMP2, OPG, von Willebrand factor (vWF), von Willebrand factor cleaving protease (vWF-cp), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (tPA), C-reactive protein (CRP), blood rheology, bone mineral density (BMD) of the femoral head and Harris Hip Score were measured before and after treatment.</p><p><b>RESULTS</b>After 6 months of treatment, compared with the control group, patients in the treatment group had signifificantly higher adiponectin and BMP2 levels (P<0.01 and P=0.013, respectively), lower vWF, PAI-1 and CRP levels (P=0.019, P<0.01 and P<0.01, respectively), and lower blood rheology parameters. BMD of the femoral neck, triangle area and Harris Hip Score in the treatment group were signifificantly higher than those in the control group. Moreover, plasma adiponectin showed a positive association with BMP2 (r=0.231, P=0.003) and a negative association with PAI-1 (r=-0.159, P<0.05).</p><p><b>CONCLUSION</b>MQEP may play a protective role against nontraumatic ONFH by increasing the expression of adiponectin, regulating bone metabolism and improving the hypercoagulation state, which may provide an experimental base for its clinical effects.</p>

Association of serum Dkk-1 levels with β-catenin in patients with postmenopausal osteoporosis / 华中科技大学学报（医学）（英德文版）

Wnt signaling plays an important role in the bone development and remodeling. The Wnt antagonist Dkk-1 is a potent inhibitor of bone formation. The aims of this study were firstly to compare the serum Dkk-1 levels in postmenopausal osteoporosis patients with age-matched healthy controls, and secondly, to assess the possible relationship between Dkk-1 and β-catenin, sclerostin, or bone turnover markers [CTX, PINP, N-MID-OT and 25(OH)D] in the setting of postmenopausal osteoporosis. A total of 350 patients with postmenopausal osteoporosis and 150 age-matched healthy controls were enrolled, and the serum levels of Dkk-1, β-catenin, sclerostin, OPG, and RANKL were detected by ELISA, and bone turnover markers [CTX, PINP, N-MID-OT and 25(OH)D] were measured by Roche electrochemiluminescence system in two groups. Serum Dkk-1 levels were significantly higher in postmenopausal osteoporosis group than in control group (P<0.001). Univariate analyses revealed that serum Dkk-1 levels were weakly negatively correlated to β-catenin (r=-0.161, P=0.003) and OPG (r=-0.106, P=0.047), while multiple regression analysis showed a negative correlation between serum Dkk-1 levels with β-catenin (β=-0.165, P=0.009) and BMD (β=-0.139, P=0.027), and a positive correlation between serum Dkk-1 levels and CTX (β=0.122, P=0.040) in postmenopausal osteoporosis group. No similar correlations ware observed in control group. The results provided evidence for the role of Dkk-1 in bone metabolism and demonstrated the link of Dkk-1 and Wnt/β-catenin in some ways.

Association of serum Dkk-1 levels with β-catenin in patients with postmenopausal osteoporosis / 华中科技大学学报（医学）（英德文版）

Wnt signaling plays an important role in the bone development and remodeling. The Wnt antagonist Dkk-1 is a potent inhibitor of bone formation. The aims of this study were firstly to compare the serum Dkk-1 levels in postmenopausal osteoporosis patients with age-matched healthy controls, and secondly, to assess the possible relationship between Dkk-1 and β-catenin, sclerostin, or bone turnover markers [CTX, PINP, N-MID-OT and 25(OH)D] in the setting of postmenopausal osteoporosis. A total of 350 patients with postmenopausal osteoporosis and 150 age-matched healthy controls were enrolled, and the serum levels of Dkk-1, β-catenin, sclerostin, OPG, and RANKL were detected by ELISA, and bone turnover markers [CTX, PINP, N-MID-OT and 25(OH)D] were measured by Roche electrochemiluminescence system in two groups. Serum Dkk-1 levels were significantly higher in postmenopausal osteoporosis group than in control group (P<0.001). Univariate analyses revealed that serum Dkk-1 levels were weakly negatively correlated to β-catenin (r=-0.161, P=0.003) and OPG (r=-0.106, P=0.047), while multiple regression analysis showed a negative correlation between serum Dkk-1 levels with β-catenin (β=-0.165, P=0.009) and BMD (β=-0.139, P=0.027), and a positive correlation between serum Dkk-1 levels and CTX (β=0.122, P=0.040) in postmenopausal osteoporosis group. No similar correlations ware observed in control group. The results provided evidence for the role of Dkk-1 in bone metabolism and demonstrated the link of Dkk-1 and Wnt/β-catenin in some ways.

Effect of Qing'e formula on circulating sclerostin levels in patients with postmenopausal osteoporosis / 华中科技大学学报（医学）（英德文版）

Serum sclerostin is positively associated with serum 25 hydroxyvitamin D concentration. Our preliminary studies confirmed that Qing'e formula (QEF) could effectively increase serum 25 hydroxyvitamin D concentration in patients with postmenopausal osteoporosis (PMOP), but the effect of supplementation with QEF on serum sclerostin is unknown. This study investigated the effects of supplementation of QEF on serum sclerostin levels in patients with PMOP. Totally 120 outpatients and inpatients with PMOP treated in our hospital between January and October 2012 were randomly divided into QEF+calcium group, alfacalcidol+calcium group, and placebo+calcium group (n=40 each), with a follow-up period of 2 years. The serum levels of sclerostin, 25 hydroxyvitamin D, and bone turnover markers (β-CTX, N-MID and T-PINP) at baseline and at the 6th month, 1st year, 1.5th year, and 2nd year after treatment were measured. The results showed that the levels of circulating sclerostin were increased significantly at the 6th month after treatment in QEF+calcium group and alfacalcidol+calcium group as compared with placebo+calcium group (P<0.05), but there was no significant difference between the former two groups (P>0.05). The levels of β-CTX, N-MID and T-PINP in serum were decreased in both QEF+calcium group and alfacalcidol+calcium group at the 6th month after treatment, without significant difference between the two groups (P>0.05). But the levels were significantly lower than that in placebo+calcium group (P<0.05). These results suggest that the mechanism by which QEF modulates bone metabolism in patients with PMOP might be related with the effect of QEF in increasing sclerostin expression. Our findings provide a scientific rationale for using QEF as an effective drug to prevent bone loss in PMOP.

Clinical research on warm acupuncture therapy for pain in postmenopausal osteoporosis / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy on pain in postmenopausal osteoporosis treated with the warm acupuncture therapy and discuss its effect mechanism.</p><p><b>METHODS</b>Ninety cases of postmenopausal osteoporosis were randomized into a warm acupuncture group, an electroacupuncture group and a medication group, 30 cases in each group. In the warm acupuncture group and the electroacupuncture group, Dazhu (BL 11), Shenshu (BL 23) and Xuanzhong (GB 39) were selected bilaterally and stimulated with the warm acupuncture and electroacupuncture therapies respectively, once a day for 30 days totally. In the medication group, caltrate-D tablets were prescribed, 600 mg, once a day for 30 days totally. The changes in the bone density T value, visual analogue scale (VAS) score, serum insulin like growth factor 1 (IGF-1), interleukin 6 (IL-6) and tumor necrosis factor (TNF-alpha) were observed before and after treatment in the three groups.</p><p><b>RESULTS</b>(1) The bone density T value in the patients of postmenopausal osteoporosis did not change obviously after 30 days treatment with the three therapies; (2) VAS score was all reduced after treatment, in which, the result in the warm acupuncture group was the most obvious (6.73 +/- 0.24 before treatment vs 4.43 +/- 0.26 after treatment). The value after treatment in the warm acupuncture group was different significantly as compared with the electroacupuncture group (5.13 +/- 0.31) and the medication group (5.17 +/- 0.33, both P < 0.05). (3) The level of serum IGF-1 was improved after treatment in the warm acupuncture therapy [(119.5 +/- 20.1) ng/mL before treatment vs (156.5 +/- 23.9) ng/mL after treatment], which was more apparent as compared with the electroacupuncture group [(136.3 +/- 24.5) ng/mL] and the medication group [(127.7 +/- 22.1) ng/mL, all P < 0.05]. Concerning to reducing the levels of IL-6 and TNF-alpha in serum, the results in the warm acupuncture group were superior to the other two groups (all P < 0.05).</p><p><b>CONCLUSION</b>The warm acupuncture therapy achieves the significant efficacy on pain in postmenopausal osteoporosis, which could be related to increasing the level of IGF-1, decreasing the levels of IL-6 and TNF-alpha, promoting bone formation and inhibting bone absorption.</p>

Serum sclerostin levels associated with lumbar spine bone mineral density and bone turnover markers in patients with postmenopausal osteoporosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sclerostin, expressed exclusively by osteocytes, is a negative regulator of bone formation. To gain insights into the action of sclerostin in postmenopausal osteoporosis, we evaluated serum sclerostin levels in postmenopausal women and investigated its possible associations with bone turnover markers in patients with postmenopausal osteoporosis.</p><p><b>METHODS</b>We detected serum sclerostin, and measured lumbar spine bone mineral density in 650 Chinese postmenopausal women. We also assessed serum levels of β-isomerized C-terminal crosslinking of type I collagen, intact N-terminal propeptide of type I collagen, N-mid fragment of osteocalcin, 25-hydroxyvitamin D, and estradiol.</p><p><b>RESULTS</b>Serum sclerostin levels were lower in postmenopausal osteoporotic women compared with non-osteoporotic postmenopausal women ((38.79 ± 7.43) vs. (52.86 ± 6.69) pmol/L, P < 0.001). Serum sclerostin was positively correlated with lumbar spine bone mineral density (r = 0.391, P < 0.001) and weakly negatively correlated with β-isomerized C-terminal crosslinking of type I collagen, intact N-terminal propeptide of type I collagen, N-mid fragment of osteocalcin (r = -0.225, P < 0.001; r = -0.091, P = 0.046; r = -0.108, P = 0.018; respectively) in postmenopausal osteoporosis. There was no significant association of serum sclerostin with age, body mass index, 25-hydroxyvitamin D, and estradiol (r = -0.004, P = 0.926; r = 0.067, P = 0.143; r = 0.063, P = 0.165; r = -0.045, P = 0.324; respectively).</p><p><b>CONCLUSION</b>Sclerostin may be involved in the pathogenesis of postmenopausal osteoporosis and may play a role in bone turnover.</p>

Cloning and expression of the Apx IVA gene of Actionbacillus pleuroneumoniae and development of an indirect ApxIVA-ELISA / 生物工程学报

Apx IV, a forth RTX toxin indentified in Actionbacillus pleuropneumoniae recently, is expressed by all A. pleuropneumoniae regardless the serotypes and inducible only in vivo toxin, so it is the optimal to develop species-specific and differentiated diagnostic assay. Here the 2445bp DNA fragment of apxIVA gene of A. pleuroneumoniae was amplified and fused in-frame to the downstream of the T7 promoter and 6 His Tag of the prokaryotic expression vector pET-28b. The construct was transformed into E. coli BL21(DE3). After induction by 1.0 mol/L IPTG, a recombinant protein about 90 kD in size, designed as ApxIVAN, was detected, which was present as inclusion bodies and reacted specifically with swine antisera to the APP-serotype-1 by dot-blot. An indirect ELISA (ApxIVA-ELISA) was developed using purified recombinant ApxIVAN from the inclusion bodies as described previously, which had excellent specificity to A. pleuroneunoniae. Using the ApxIVA-ELISA, the ApxIV antibodies were not detected in the inactivated APP bacterins vaccinated pigs, but were detected in A. pleuropneumoniae serotype 1, 2 and 7 infected pigs and mice. These results suggested that ApxIVA-ELISA can be used not only to detect all serotypes of APP, but also to differentiate the naturally infected and inactivated vaccine immunized pigs.

Construction and characterization of a pseudorabies virus TK-/gG- mutant / 生物工程学报

To construct a TK-/gG- mutant of pseudorabies virus, the gG-detected transfer vector pUSKKBB and genomic DNA of pseudorabies virus TK-/gG-/LacZ+ were co-transfected into IBRS-2 cells. Transfection progeny were plated onto PK-15 cells and incubated for 2 days under methylcellulose. Then the overlay was removed and replaced by 1% low melting point agarose in DMEM supplemented with 150 microg/mL X-gal. After 2 days, white plaques were screened for and purified 4 times. By PCR amplification of gG-deleted gene and LacZ gene, a recombinant virus with TK-/gG- phenotype was confirmed. Sequence of the PCR product revealed that there were 1,176 bp detection in gG gene of the PRV TK-/gG- mutant. Amplifying the gG-deleted gene of different generations of the TK-/gG- mutant showed that the mutant was stable within PK-15 cells. TCID50 assay indicated that the recombinant virus grows well on PK-15 cells. The mice immunized with the TK-/gG- virus showed no sign of abnormality. As a control, all mice inoculated with PRV strain died from the infection. All mice that received TK-/gG- survived after a lethal PRV challenge. However none of the mice injected with phosphate-buffer saline (PBS) survived from the challenge. The above results demonstrated that the recombinant virus could be a candidate marker vaccine strain for eradicating pseudorabies in pig herds.