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Objective The present study aimed to establish a bone mineral density (BMD) reference database in China and to investigate the prevalence of osteoporosis in Chinese adults aged 50 years and older using dual energy X-ray absorptiometry (DXA). Method A total of 75321 examineers over 25 years old who underwent health checkups in 7 health check centers between 2008 and 2018 were included. All centers used a GE Lunar-DXA system to measure BMD of the lumbar spine (L1-L4), femoral neck, and total femur. The same European Spine Phantom (ESP) was used for scanning 10 times at every center, a regression equation was generated, and BMD data were cross-calibrated in each center. Peak BMD and standard deviation (SD) were identified according to 5-year age groups, and T scores were calculated based on the peak BMD and SD. Osteoporosis was defined according to the World Health Organization criteria. The prevalence of osteoporosis was standardized based on 2010 national census data for the Chinese population. Result The mean BMD values decreased with age, were highest in North China, followed by Northeast China, East China, and Southwest China, respectively, and increased with body mass index. Males aged 20-30 years and females aged 35-40 years had peak BMD values. Peak BMD values of the lumbar spine, femoral neck, and total femur were 1.09 g/cm2, 0.97 g/cm2, and 0.97 g/cm2 in males, and 1.11 g/cm2, 0.84 g/cm2, and 0.88 g/cm2 in females, respectively. Among all scanned sites, the prevalence of osteoporosis was highest in the femoral neck in males (4.58％) and in the lumbar spine in females (23.38％). The age-standardized prevalence of osteoporosis at any site was 6.46％ in males and 29.13％ in females aged 50 years and older. Based on the 2010 national census data, 10879115 males and 49286542 females currently have osteoporosis. Conclusion Mean BMD values varied according to geographic region, body mass index, age group, and sex in Chinese adults. The age-standardized prevalence of osteoporosis was 6.46％ in males and 29.13％ in females aged 50 years and older.
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Objective To study the clinical efficacy and safety of microwave ablation (MWA) in the treatment of autonomous functional thyroid nodules(AFTN) . Methods Sixty-seven nodules of 53 AFTN patients who refused or were not suitable for surgical resection and 131I therapy were enrolled in the study . All the nodules were evaluated by ultrasound ,color Doppler flow imaging ( CDFI) and contrast enhanced ultrasound(CEUS) ,and all of them were benign and confirmed by pathology . And then ,percutaneous MWA was performed . Fluid isolation and mobile ablation were used to completely inactivate the nodules ,and CEUS was used to evaluate the efficacy of the treatment . The following items included thyroid hormone level ,nodule volume ,nodular blood supply ,thyroid radionuclide imaging ,conscious symptom ,beauty score and complication . Finally ,the factors influencing the curative effect were analyzed . Results The follow-up period was at least 12 months . Compared with before treatment ,the differences of thyroid hormone level , the volume of nodules ,the nodule blood supply were statistically significant ( P ＜ 0 .01) . The 61 hot nodules" changed to cold or warm nodules" . The differences between the improvement ratio of conscious symptoms and beauty scores were statistically significant( P ＜ 0 .05) . The cure ratio in this study was 81 .13% ,and the incidence of complications was 11 .32% ,and the recurrence ratio was 4 .48% . The nodule volume≥14 .04 ml or in a dangerous position were the main factors affecting the curative effect . Conclusions MWA can inactivate the AFTN in situ ,make it lose the secretory function and reduce the volume of nodules . Therefore ,percutaneous MWA guided by ultrasound and CEUS treatment of AFTN can be regarded as another safe and effective treatment besides surgical resection or 131I therapy .
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Objective To evaluate the effect of 131 iodine(131I) therapy in medium and large goiter with hyperthyroidism in order to investigate the influence of pretreatment with antithyroid drugs (ATD) methimazole(MMI) and propylthiouracide (PTU) on 131I therapy.Methods A total of 338 hyperthyroidism patients (136 cases for male,202 cases for female) with thyroid mass greater than 40 grams were treated with 131I in the People's Hospital of Sichuan Province.Thyroid function,thyroid 131I uptake ratio and thyroid imaging were measured before treatment were measured 1-3 months later after administration of 131I,and they were followed up for 6 months to 4 years.Results There were statistical difference between pretreatment and 3 months later of 131I therapy in terms of free triiodothyronine (FT3),(Free thyroxine) FT4.The level of FT3 decreased from (31.9 ± 16.2) pmol/L to (7.8 ±8.5) pmol/L(t =23.9,P =0.000) and level of FT4 decreased from (58.8 ± 22.2) pmol/L to (19.4 ± 16.9) pmol/L(t =25.4,P =0.000).Among 338 patients,109 patients (32.2％) were developed hypothyroidism,and 91 patients (26.9％) were cured,91patients (26.9％) with improved state,20 patients(5.9％) with ineffective and 27 patients(8.0％) with relapse after administration of 131I.The total effective rate was 94.1％ (318/338).Thyroid weight,levels of FT3,FT4,thyroglobulin antibody(TGA),thyroid microsomal antibody(MCA) in effective group were (49.8 ± 9.97) g,(32.5 ± 16.3) pmol/L,(59.5 ± 22.2) pmol/L,(43.6 ± 35.3) ％,(30.1 ± 22.6) ％ respectively,and were (56.9±15.7) g,(22.8 ± 12.8) pmol/L,(47.9 ±20.3) pmol/L,(22.8±30.0)％,(15.3 ±20.5)％ respectively in ineffective group.There were statistically significant differences between the ineffective group and effective group (t =2.932,2.602,2.287,2.501,2.766 ; P =0.000,0.010,0.023,0.013,0.006).Logistic regression analysis was showed that weight of thyroid and serum FT3 were the most important factors in affecting 1131 therapy.Conclusion 131 I therapy for medium and large-sized goiter with hyperthyroidism is safe and effective.ATD may not reduce the effectiveness of subsequent 131I of hyperthyroidism.Thyroid weight and FT3 are the key influential factors in affecting 131I.
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Objective To evaluate the screening effect of osteoporosis self-assessment tool for Asians (OSTA) in middle aged and elderly healthy men in Chengdu.Methods A total of 4042 healthy men aged 40 to 106 years received dual energy X-ray absorptiometry (DXA) assay,and OSTA index evaluation.Measurement sites included lumbar spine (L1-4),left femoral neck,trochanter,Ward's area,total hip and femoral shaft.All persons were classified into highosteoporosis-group (OSTA≤-4),mediumosteoporosis-group (-4 ＜ OSTA≤≤-1),low osteoporosis-group (OSTA＞-1),or the low risk-group (OSTA＞-1) and high risk-group (OSTA≤-1) by OSTA scores.T-scores were compared between different measurement sites detected by DXA.The sensitivity,specificity,Kappa value and the area under receiver operating characteristic (ROC) curve (AUC) of OSTA in screening osteoporosis were evaluated.Results The prevalence of osteopenia and osteoporosis in lumbar spine,proximal femur were gradually increased along with aging.The detection rate of osteoporosis in lumbar spine and proximal femur were 16.2％ and 24.0％ respectively in subjects aged over 80 years.OSTA index in low-risk,medium-risk group,high-risk group were 85.0％,11.0％,4.0％ respectively.The detection rate of osteoporosis in lumbar spine and proximal femur were 2.6％ and 1.6％ in low-risk group,10.4％ and 10.4％ in medium-risk group,and 29.3％ and 30.5％ in high-risk group,respectively.Taking OSTA ≤-1 as the cut-off value,the sensitivity and specificity of OSTA in screening osteoporosis in lumbar spine and femur by T-score＜-1 were 28.1％,28.7 ％,89.0％ and 92.4％ respectively,and by T-score≤-2.5 were 51.6％,63.2％,86.7％ and 86.8％ respectively.The consistency of diagnosis result between T-score and OSTA index according to the three versus two risk levels was 0.153 and 0.197 versus 0.195 and 0.243 Kappa value,respectively.The AUC of OSTA index for lumbar spine and femur by T-score＜-1 and T-score≤-2.5 were 0.689 and 0.823,and for different age groups and different measurement sites were 0.639 and 0.899 (all P＜0.001).Conclusions OSTA index has a certain ability in screening osteoporosis in men aged over 50 years.There are different screening results on osteoporosis among the different age groups.
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Objective To explore the mechanism of arginine vasopressin(AVP) in the onset of febrile convulsion.Methods Radioimmunoassay(RIA) was used to determine plasma AVP levels in 24 children with complicated febrile convulsion,32 children with simple febrile convulsion,20 children with upper respiratory infection,and 18 normal children.Their plasma sodium ion and plasma osmotic pressure were measured at the same time.Results AVP level in complicated febrile convulsion group and simple febrile convulsion group was significantly higher than upper respiratory infection group and control group(P