Measurement of the maximum corridor parameters of infra acetabular screw and evaluation of the feasibility of screw insertion by digital analysis / 中国骨伤

OBJECTIVE@#To measure the maximum corridor parameters of the infra acetabular screw and evaluate the feasibility of screw insertion through digital analysis of the acetabular structure.@*METHODS@#The pelvic CT data of 100 patients who received plain pelvic CT scan from April 2013 to June 2015 were retrospectively analyzed. There were 50 males, aged 20 to 84 years, with an average age of (48.42±17.48) years, and 50 females, aged 18 to 87 years, with an average age of (55.02±19.54) years. Patients with acetabular fractures, hip dysplasia, and metal implants in the acetabulum were excluded. Import CT data into Mimics software in DICOM format to generate a three-dimensional model, and find the axialprojection of the infra-acetabular corridor in the middle of the pubis ramus in the inlet view. A virtual screw was placed in the infra-acetabular space and measure the parameters including the diameter and the length of the maximum corridor, the distance from the insertion point to the pubic symphysis, to the anterosuperior iliac spine and to the medial edge of the pelvis. Then import the pelvic model into 3- matic software, establish the pelvic model anterior pelvic plane and median sagittal plane, and measure the angle between the screw axis and the two planes. A minimum corridor diameter of at least 5 mm was defined as a cutoff for placing a 3.5 mm screw, and calculate the screw insertion rate.@*RESULTS@#In 100 cases, 49% of patients had a infra acetabular corridor with a diameter ≥5 mm, and the rate of screw placement in men was significantly higher than that in women. The average diameter of the maximum corridor of infra-acetabular screw was (4.86±1.72) mm, the average length was (94.04±8.29) mm, the average distance from the insertion point to the pubic symphysis was (60.92±4.84) mm, to the anterosuperior iliac spine was (85.15± 6.85) mm, and to the medial edge of the pelvis was (6.12±3.32) mm. The mean angle between the axis of the screw and the median sagittal plane was (-1.38±4.74)°, and the mean angle between the axis of the screw and the anterior pelvic plane was (56.77±7.93)°. There are significant differences between male and female measured parameters, except for the angle between the screw axis and the anterior pelvic plane. There was no statistically significant difference in the maximum corridor parameters of infra-acetabular screw on both sides of the pelvis.@*CONCLUSION@#This study shows that the insertion rate of infra-acetabular screws is low in local patients, and the feasibility of screw insertion should be fully evaluated before surgery.

Investigation and Evaluation of Cultivation Status of Ligusticum chuanxiong in Sichuan / 中国实验方剂学杂志

Objective::To deeply understand important scientific problems and key technical problems in the cultivation of Chuanxiong, the Chuanxiong cultivation situation of 247 households in 23 towns of 5 counties in Sichuan province were investigated, providing basic data for the standardized cultivation of Chuanxiong. Method::On the basis of reported literatures, a questionnaire survey was conducted on the farmers of cultivating Chuanxiong in main producing areas, field measurements were also preformed, and the cultivation status of Chuanxiong was comprehensively analyzed. Result::The proportion of plain-breeding mainly existed in Pengzhou and Shifang, where per farmer had a small scale of planting areas, was 65%, while the proportion of mountain-breeding mainly existed in Meishan, Qionglai and Dujiangyan, where per proprietor had a large scale of planting areas, was 92%. The planting density and yield of Chuanxiong varied greatly among individuals. The growth period of Chuanxiong in Meishan and Qionglai is about 30 days shorter than that in Pengzhou, Shifang and Dujiangyan. About half of farmers applied base fertilizer and top dressing in spring. The proportion of NPK compound fertilizer input was high (>90%). Chuangxiong has a few diseases and insect pests, the incidence of which in new production areas was obviously lower than that in old production areas. The application of herbicide was not standardized. 52% farmers used Chu cao ling No.1 which was made by agricultural material store owners. The labor cost accounted for the highest proportion (37%) in Chuanxiong cultivation. Conclusion::Now in Sichuan clonal propagated patterns of Chuanxiong were both mountain-breeding and plain-breeding. It is suggested to make clear the differences between mountain-breeding nodes and plain-breeding nodes, and breed high qualities of Chuanxiong nodes. The mechanization research and production of Chuanxiong should be promoted, realizing timely planting and harvesting. Farmers should be guided to increase the application of organic fertilizer, and meanwhile standardize the application of agrochemicals.

Analysis of hidden blood loss and its risk factors in the treatment of osteoporotic vertebral compression fractures with PVP / 中国骨伤

OBJECTIVE@#To investigate the influencing factors of hidden blood loss (HBL) during the treatment of percutaneous vertebroplasty (PVP).@*METHODS@#The clinical data of 125 patients with osteoporotic vertebral compression fractures (OVCFs) treated with percutaneous vertebroplasty from March 2016 to December 2017 were retrospectively analyzed. All patients underwent X rays of the AP and lateral lumbar spine, double oblique, and dynamic positions. Lumbar spine CT, MRI, and dual energy X ray bone densitometer (DXA) were used to confirm the diagnosis. There were 55 males and 70 females, 10 cases of thoracic vertebrae, 89 cases of thoracolumbar vertebrae, 26 cases of lumbar vertebrae, 87 cases with single segment, 29 cases with double segment,and 9 cases with 3 segments. The vertebral compression height ratios of 67 patients were less than 1 / 3, and the ratios for 41 patients were from 1 / 3 to 2 / 3,for 17 patients were more than 2 / 3. Blood routine examination were performed before and 3 days after surgery to analyze hidden blood loss and to explore its risk factors.@*RESULTS@#The average hidden blood loss was (317±156) ml in 125 patients. Multiple linear regression analysis revealed a history of diabetes(=0.011),surgical segments(=0.036),number of segments (<0.001),vertebral height loss rate (=0.002),vertebral height recovery rate (<0.001) and bone cement leakage rate (=0.003) were positively correlated with hidden blood loss. Moreover,it was found that the blood loss was higher in those with higher vertebral height loss rate than in those with lower vertebral height loss rate, and the blood loss was higher in those with good vertebral height recovery than those with poor vertebral height recovery. Additionally,the cement leakage was also an important factor in increasing hidden blood loss. However,there was no significant correlation between bone mineral density(=0.814) or history of hypertension(=0.055) and hidden blood loss.@*CONCLUSION@#Patients with OVCFs have a large amount of hidden blood loss after PVP treatment, which needs attention. At the same time, the history of diabetes, surgical segments, number of segments, bone cement leakage rate, vertebral height loss rate and vertebral height recovery rate are the risk factors for hidden blood loss.

Analysis of the clinical effects of different pedicle screw fixation methods for the treatment of thoracolumbar fractures / 中国骨伤

OBJECTIVE@#To discuss the clinical effects of the different pedicle screw fixation methods for the treatment of thoracolumbar fractures.@*METHODS@#The clinical data of 55 patients with single thoracolumbar fractures treated between January 2013 and December 2016 were retrospectively analyzed. There were 32 males and 23 females, aged from 20 to 55 years with an average of 35.6 years old. All the fractures were located on a single segment, 8 cases of T₁₁, 18 cases of T₁₂, 19 cases of L₁, 10 cases of L₂. According to the classification of AO, 10 cases were type A1, 17 cases were type A2, 18 cases were type A3, 7 cases were type B2, 2 cases were type B3, 1 case was type C1. The patients were divided into three groups according to the different fixation methods, among them, 20 cases treated by traditional short-segment 4 pedicle screws fixation were control group, 22 cases treated by intermediate bilateral pedicle screws fixation (6 pedicle screws fixation) were bilateral group, 13 cases treated by intermediate unilateral pedicle screw fixation (5 pedicle screws fixation) were unilateral group. The three groups were compared by operation time, intraoperative blood loss, hospitalization cost, VAS and ODI scores, the correction of the fractured vertebrae height and kyphosis angle postoperatively and the losing rate of the fractured vertebrae height and kyphosis angle at the final follow-up and so on.@*RESULTS@#All the patients were followed up from 12 to 20 months with an average of 15.2 months. No complications such as loosening of internal fixation and breakage were found after operation. There was no significant difference in operation time and intraoperative blood loss among three groups(>0.05). In terms of hospitalization cost, the control group[(20 932.4±298.3)yuan] was significantly lower than the unilateral group[(22 428.2±321.5)yuan] and the bilateral group [(23 630.5±310.5)yuan] (0.05). And there was no significant difference in the correction of the injuried vertebrae height and kyphosis angle immediately after operation among three groups(>0.05). However, for the losing rate of the injuried vertebrae height at the final follow-up, the unilateral group[(6.3±2.1)%] and bilateral group [(5.6±2.8)%] were significantly better than the control group[(9.2±1.8)%] (0.05).@*CONCLUSIONS@#All the three different pedicle screw fixation methods are suitable for the treatment of thoracolumbar fractures and the short-term clinical effects are consistent. Compared with traditional short-segment 4 pedicle screws fixation, intermediate bilateral or unilateral pedicle screw fixation were more effective in maintaining the height of the injuried vertebrae and preventing the occurrence of kyphosis. The intermediate unilateral pedicle screw fixation was comparable to that of bilateral fixation at clinical outcomes, but the unilateral fixed hospitalization cost was lower, which was worthy of clinical promotion.

Construction of nano-silver coating on pure titanium surface and its antibacterial effect on Staphylococcus aureus / 中国组织工程研究

BACKGROUND:Nano-silver is a new antibacterial material developed based on nano-technology. It is characterized as stable physical and chemical properties, and good electrical, optical, and catalytic performance, but its antibacterial response to Staphylococcus aureus is controversial. OBJECTIVE:To explore the preparation methods of nano-silver coating on pure titanium surface and to explore its antibacterial effect on Staphylococcus aureus. METHODS:(1) Preparation of nano-silver coating on the surface of pure titanium: Hydroxyapatite and silver powder as research objects were fully mixed at a ratio of 20:1. The mixture was ball-milled to ensure the formation of nanosized particles. The mixture of hydroxyapatite and silver powder was put into a stirrer for continuous stirring to ensure the uniform distribution. The mixture was then placed in an ethanol solution followed by insertion of a titanium plate (anode) and a stainless steel plate (cathode). The precipitated powder was obtained on the titanium surface at a voltage of 20 V, and the pure titanium surface with nano-silver coating was prepared after heat treatment in a tube resistance furnace. (2) Observation of antibacterial properties: A minimal inhibitory concentration test was used to determine the antibacterial concentration of the nano-silver coating on the pure titanium surface when shaken with Staphylococcus aureus. A scanning electron microscope was used to observe the structure of Staphylococcus aureus on the pure titanium surface with nano-silver coatings of different mass concentrations. RESULTS AND CONCLUSION:Nano-silver/hydroxyapatite composite coating and hydroxyapatite coating were relatively uniform. The nano-silver/hydroxyapatite composite coating was white in color but slightly yellowish. The hydroxyapatite coating was white in color. The coating surface was rough and bonded firmly. No peeling of the coating was observed under gross observation. The antibacterial ability of the nano-silver group at 37℃ static culture and at 37℃ shaking culture was significantly higher than that of the hydroxy-apatite group (P<0.05). The absorbance value of Staphylococcus aureus at 600 nm in the nano-silver group was lower than that of hydroxyapatite group at 7, 10, 30 hours after intervention (P<0.05). The layer cells on the nano-silver coating become lighter in color compared with those on the hydroxyapatite coating and there were cells that ruptured and died. The number of Staphylococcus aureus on the nano-silver coating was reduced, and a large number of vacuoles were found. These findings indicate that the 20:1 mixture of hydroxyapatite and silver at micron level can be used to prepare nano-silver coating through ball milling, water bath, ultrasound and heat treatment. The prepared coating can exert excellent antibacterial effects on Staphylococcus aureus.

Infiltration of tumor associated macrophages in multiple myeloma and its clinical significance / 中华血液学杂志

Objective: To investigate the clinical significance of tumor associated macrophages (TAM) in multiple myeloma (MM) and the relationship with angiogenesis and immunosuppression. Methods: Seventy cases of MM patients diagnosed from August 2015 to June 2017 were enrolled in the study as experimental group, 20 cases of benign hematological diseases (13 with iron deficiency anemia and 7 with megaloblastic anemia) patients as control group. Immunohistochemical method was used to detect the expression of CD163, CD34 and VEGF in bone marrow samples, and flow cytometry was used to detect the proportion of regulatory T cell (Treg cells), ELISA was used to detect the level of IL-10, and the clinical features were analyzed. Results: ①Among the 70 patients, there were 31 males and 39 females with a median age of 65 (50~78) years old. TAM infiltration density, microvascular density (MVD), VEGF expression level, Treg ratio and IL-10 level in bone marrow samples of 70 MM patients were significantly higher than those of benign hematological diseases (P<0.05). ②In the MM group, the above indexes of the patients with disease stabilized (15 cases) were lower than those of the newly diagnosed group (35 cases) and the relapse refractory group (20 cases) (P<0.05), those of relapse refractory group were higher than those of newly diagnosed group (P>0.05). ③Of the 35 newly diagnosed MM patients, 27 completed 4 courses of treatment. In the effective group (15 cases), the TAM infiltration density after treatment was significantly lower than that before treatment, the difference was statistically significant[(20.20±7.66) vs (28.87±11.97), t=2.362, P=0.025]; while in the ineffective group of 12 cases, the difference of the TAM infiltration density before and after treatment was not statistically significant[(42.00±13.76) vs (48.25±13.59), t=1.119, P=0.275]. ④TAM infiltration density in the effective group after bortezomib treatment (21 cases) were lower than those in the non-bortezomib treatment group (18 cases)[(16.52 ±4.26) vs (19.27 ±5.82), t=1.662, P=0.170]. ⑤The TAM infiltration density in MM patients was positively correlated with MVD, VEGF expression level, Treg cell ratio and IL-10 level (P<0.001). Conclusion: The infiltration of TAM in the microenvironment of MM, which may promoting angiogenesis and inhibiting immune response, is related to the occurrence, development, therapeutic effect and drug resistance of MM.

The First Switched Time of PML/RARα Fusion Gene in Patients with Acute Promyelocytic Leukemia and Its Clinical Significance / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the first switched time of PML/RARα fusion gene in patients with acute promyelocytic leukemia (APL) and its clinical significance.</p><p><b>METHODS</b>sixty cases of newly diagnosed APL were enrolled in this study. They received standard remission induction, consolidation and maintenance treatments according to the clinical pathway for APL, and were followed up. During the same time the PML/RARα fusion gene mRNA expression of all cases was detected by multi-nested PCR.</p><p><b>RESULTS</b>except for 3 death cases and 1 case failed to follow-up, the PML/RARα fusion genes in the remaining 56 cases were firstly found to be negative from 24 to 381 days respectively, the mean value of the first switched time was 131 ± 90 days. There was no statistically significant difference in age, sex and risk stratification between different groups. However, the cases with L-type PML/RARα gene had shorter time compared with the patients with S-type PML/RARα gene (P = 0.032); then, for the above-mentimed 56 cases, the follow-up duration ranged from 25-1979 days (median 946 days), long-term molecular remissions had been observed in most cases, but 1 case with the first switched time of 133 days unfortunately recurred to be positive and followed by clinical relapse.</p><p><b>CONCLUSION</b>The PML/RARα fusion gene in newly diagnosed APL patients was first switched to be negative in about 4 months after treatment. The first switched time of PML/RARα fusion gene can objectively reflect the reduction of leukemia cells, and the differences among different subtypes of PML/RARα fusion gene may have some suggestions for the treatment, but without important significance for the evaluation of prognosis and recurrence for APL patients. In addition, minimal residual disease (MRD) can be dynamically monitored by detecting PML/RARα fusion gene, thus having an important clinical significance for analysis of APL recurrence.</p>

Evolution, characteristics and enlightenment of self-innovation of traditional Chinese medicine industry / 中国中药杂志

Traditional Chinese medicine industry is China's strategic emerging industry with great potential for self-innovation. Traditional Chinese medicine industry has successively experienced four stages which are the foundation (laying stage), the core status (establishing stage), the modern system (exploring stage), and the modernization system (constructing stage). Throughout the evolution of the self-innovation in traditional Chinese medicine industry, it presents distinct characteristics which we can explore the beneficial enlightenment.

Value of sonography in diagnosis of thrombophlebitis in superficial dorsal vein of penis / 重庆医学

Objective To summarize ultrasonograph changes and to investigate the diagnositic value of ultrasonography in pa‐tients with thrombophlebitis in superficial dorsal vein of penis .Methods The ultrasonograph finding and clinical data in 19 patients with thrombophlebitis in superficial dorsal veins of penis diagnosed by clinic were retrospective analyed .Results Compared with normal volunteers ,the internal diameter of patients′venae dorsales penis superficiales were significantly widened (P0 .05) .Conclusion Ultrasonograph was a practicable way to examine dorsal veins of penis and an effec‐tive way for the diagnosis of thrombosis ,which could accurately diagnose thrombophlebitis in superficial dorsal veins of penis .

Screening of active compounds with myocardial protective effects from Tongmai Yangxin pill / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>Based on cell model and HPLC-MS technology, to screen myocardial protection active compounds from traditional patent medicine Tongmai Yangxin pill (TMYXP).</p><p><b>METHODS</b>Fractions of TMYXP were prepared by high performance liquid preparation technology. The cardioprotective effects of prepared fractions were tested on H2O2 oxidation-damaged H9c2 myocardiocytes. The active components were analyzed by high performance liquid chromatography (HPLC) coupled with high resolution mass spectrometry. The possible active compounds were putatively identified by comparison of their MS ions and molecular weight with literatures.</p><p><b>RESULTS</b>Ten TMYXP components presented significant myocardial protective activities, 5 of which were investigated and presented good dose-effect relationships. Their median effective concentrations (EC50) were respectively 11.66, 17.44, 13.10, 7.332, 15.15 μg/mL. Totally, 11 potential active compounds were analyzed and identified, including Glycyrrhizic acid, Glycycoumarin, Licoisoflavone, Ophiopogonin D', Licoricon, Gancaonin L, Neoglycyrol, Emodin, Angeloylgomisin H, Angeloylgomisin Q and Glyasperin A.</p><p><b>CONCLUSION</b>The myocardial protection active compounds of TMYXP were screened successfully.</p>

Correlation of the Desialylation of Platelets with Efficacy of the First-line Therapy for ITP / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect desialylation of platelets in primary immune thrombocytopenia(ITP) patients with FITC-labelled ECL and RCA-1, and compare the correlation of the desialylation level and the efficacy of first-line therapy for ITP.</p><p><b>METHODS</b>Before treatment, 48 ITP patients were selected and their levels of ECL and RCA-1 were detected with flow cytometry.</p><p><b>RESULTS</b>The desialylation level in the different efficacy groups by using the first-line therapy of corticosteroids and (or) intravenous immunoglobulin G (IVIG) had a statistically significant difference (P<0.05). The correlation analysis showed negative relation of the therapeutic efficacy with desialylation level, that is to say, the more high of desialylation level, the more poor therapeutic efficacy of the first-line therapy.</p><p><b>CONCLUSION</b>The desialylation level of platelets in ITP patients is related with the first-line therapeutic efficacy, the efficacy for patients with high desialylation level is poor, suggesting that the FcR-independent pathway exists in clearance of platelets in ITP patients. Therefore, the desialylation level of platelets may suggest the first-line therapeutic efficacy for ITP patients to a certain degree, and may be used as a potential target for the treatment of refractory ITP.</p>

Femoral offset and its relationship to femoral neck-shaft angle and torsion angle / Desplazamiento femoral y su relación con el ángulo cuello-diáfisis femoral y el ángulo de torsión

The aims to study the femoral offset and its relationship to femoral neck-shaft angle and torsion angle. One hundred paired (50 males and 50 females) Chinese femurs were used to measure the femoral offset, femoral neck-shaft angle and torsion angle. The data were analyzed by SPSS software. Femoral offsets were male right 44.40±4.56 mm, left 42.70±4.95 mm; female right 39.90±6.00 mm, left 38.90±6.18 mm. Femoral torsion angles were male right 6.02±10.85°, left 7.08±9.30°; female right 10.02±11.69, ° left 6.02±10.85°. Neck-shaft angles were male right 131.80±4.36°, left 134.00±4.78°; female right 132.10±5.94°, left 132.80±4.93°. There were no sexual differences in the two femoral angles (P>0.05) while there was a significant sexual difference in the femoral offset (P<0.01). The differences between left and right femoral offset and neck-shaft angle were significant (P<0.01). Clinically, our results indicate that FO could be obtained using the regression equation when the torsion angle and/or neck-shaft angle is measured.

El objetivo fue estudiar el desplazamiento femoral y su relación con el ángulo cuello-diáfisis femoral y el ángulo de torsión. Se utilizaron 100 pares de fémures (50 hombres y 50 mujeres) y se tomaron las medidas del desplazamiento femoral, ángulo cuello-diáfisis femoral y ángulo de torsión. Los datos fueron analizados con el software SPSS. El desplazamiento femoral en los hombres fue 44,40±4,56 mm en el lado derecho y 42,70±4,95 mm en el lado izquierdo, y en las mujeres, fue de 39,90±6,00 mm y 38,90±6,18 mm para el lado derecho e izquierdo, respectivamente. El ángulo de torsión femoral del lado derecho en los hombres fue 6,02±10,85° y 7,08±9,30° del izquierdo; mientras que en las mujeres, fue de 10,02±11,69° y 6,02±10,85° para el lado derecho e izquierdo, respectivamente. Los ángulos cuello-diáfisis fueron 131,80±4,36° en el lado derecho, y 134,00±4,78° en el izquierdo, para los hombres, mientras que en las mujeres fueron de 132,10±5,94° en el lado derecho y 132,80±4,93° en el izquierdo. No hubo diferencias según sexo en los dos ángulos femorales (P>0,05), mientras que si hubo una diferencia significativa en el desplazamiento femoral (P<0,01). Las diferencias entre el desplazamiento femoral izquierdo y derecho, y el ángulo cuello-diáfisis fueron significativas (P<0,01). Clínicamente, nuestros resultados indican que el desplazamiento femoral podría obtenerse utilizando la ecuación de regresión cuando se mide el ángulo de torsión o el ángulo cuello-diáfisis.

Team-oriented scientific project competition-based teaching of Medical Information Analysis course / 中华医学图书情报杂志

Team-oriented scientific project competition-based ideas and measures in teaching of Medical Information Analysis course were studied by introducing non-medical cases into discussion and analysis , simulating brain storm conference , and supplementing team competition .

Setting up a risk prediction model on metabolic syndrome among 35-74 year-olds based on the Taiwan MJ Health-checkup Database / 中华流行病学杂志

Objective This study aimed to provide an epidemiological modeling method to evaluate the risk of metabolic syndrome (MS) development in the coming 5 years among 35-74 year-olds from Taiwan.Methods A cohort of 13 973 subjects aged 35-74 years who did not have metabolic syndrome but took the initial testing during 1997-2006 was formed to derive a risk score which tended to predict the incidence of MS.Multivariate logistic regression was used to derive the risk functions and using the ‘check-up center' (Taipei training cohort) as the overall cohort.Rules based on these risk functions were evaluated in the remaining three centers (as testing cohort).Risk functions were produced to detect the MS on a training sample using the multivariate logistic regression models.Started with those variables that could predict the MS through univariate models,we then constructed multivariable logistic regression models in a stepwise manner which eventually could include all the variables.The predictability of the model was evaluated by areas under curve (AUC) the receiver-operating characteristic (ROC) followed by the testification of its diagnostic property on the testing sample.Once the final model was defined,the next step was to establish rules to characterize 4 different degrees of risks based on the cut points of these probabilities,after being transformed into normal distribution by log-transformation.Results At baseline,the range of the proportion of MS was 23.9％ and the incidence of MS in 5-years was 11.7％ in the non-MS cohort.The final multivariable logistic regression model would include ten risk factors as:age,history of diabetes,contractive pressure,fasting blood-glucose,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,body mass index and blood uric acid.AUC was 0.827 (95％ CI:0.814-0.839) that could predict the development of MS within the next 5 years.The curve also showed adequate performance in the three tested samples,with the AUC and 95％ CI as 0.813 (0.789-0.837),0.826(0.800-0.852) and 0.794(0.768-0.820),respectively.After labeling the degrees of the four risks,it was showed that over 17.6％ of the incidence probability was in the population under mediate risk while over 59.0％ of them was in the high risk group,respectively.Conclusion Both predictability and reliability of our Metabolic Syndrome Risk Score Model,derived based on Taiwan MJ Longitudinal Health-checkup-based Population Database,were relatively satisfactory in the testing cohort.This model was simple,with practicable predictive variables and feasible form on degrees of risk.This model not only could help individuals to assess the situation of their own risk on MS but could also provide guidance on the group surveillance programs in the community regarding the development of MS.

Estimation on the risk of 5-years obesity development among adults aged 30-59, based on the Taiwan MJ Health-checkup Database / 中华流行病学杂志

Objective This study aimed to provide an epidemiological modeling in evaluating the risk of developing obesity within 5 years in Taiwan population aged 30-59 years.Methods After excluding 918 individuals who were obesitive at baseline,a cohort of 14 167 non-obesity subjects aged 30-59 years in the initial year during 1998-2006,was formed to derive a Risk Score which could predict the incident obesity (IO).Multivariate logistic regression was used to derive the risk functions,using the check-up center (Taipei training cohort,n=8104) of the overall cohort.Rules based on these risk functions were evaluated in the left three centers (testing cohort,n=6063).Risk functions were produced to detect the IO on a training sample using the multivariate logistic regression models.Starting with variables that could predict the IO through univariate models,we constructed multivariable logistic regression models in a stepwise manner which eventually could include all the variables.We evaluated the predictability of the model by the area under the receiver-operating characteristic (ROC) curve (AUC) and to testify its diagnostic property on the testing sample.Once the final model was defined,the next step was to establish rules to characterize 4different degrees of risk based on the cut points of these probabilities after transforming into normal distribution by log-transformation.Results At baseline,the range of the proportion of normal weight,overweight and obesity were 50.00％ 60.00％,26.47％-31.11％ and 5.76％-7.24％ respectively in tour check-up centers of Taiwan.After excluding 918 obesity individuals at baseline,we ascertained 386 (2.73％,386/14 167) cases having IO and 2.66％-2.91％ of them having centered obesity in the four check-up centers respectivcly.Final multivariable logistic regression model would include five risk lactors:sex,age,history of diabetes,weight deduction ≥4 kg within 3 months and waist circumference.The area under the ROC curve (AUC) was 0.898 (95％CI,0.884-0.912) that could predict the development of obesity within 5 years.The curve also had adequate performance in testing the sample [AUC=0.881 (95％CI,0.862 0.900) ].After labeling the four risk degrees,16.0％ and 2.9％ of the total subjects were in the mediate and high risk populations respectively and were 7.8 and 16.6 times higher,when comparing with the population at risk in general.Conclusion The predictability and reliability of our obesity risk score model,derived based on Taiwan MJ Longitudinal Health-checkup-based Population Database,were relatively satisfactory,with its simple and practicable predictive variables and the risk degree form.This model could help individuals to self assess the situation of risk on obesity and could also guide the community caretakers to monitor the trend of obesity development.

The expression and significance of decorin in chronic rejection of liver transplantion / 国际外科学杂志

Objective To investigate expression and significance of decorin(DCN)in liver tissue and serum of liver transplant patients with chronic rejection(CR).Methods Immunohistochemistry(SP method)was used to detect expression of DCN in liver tissue of 16 normal controls, 20 patients with cirrhosis, 46 liver translantion patients without CR and 8 patients with CR.Enzyme-linked immunosorbent assay method(ELISA method)was used to determined the content of DCN in serum of all research subjects.Results The expression of DCN was negative in normal hepatic tissues and with/without CR, cirrhosis tissues showed strong expression of DCN.The positive expression rate and the average optical density value of DCN in liver transplant tissues with CR had significant difference comparing with Cirrhosis tissues(25% vs 55%, 0.1249 ±0.0039 vs 0.2357 ±0.0396, P <0.01,while no statistic siqnificance compared to normal liver tissues and those without CR.The level of DCN in serum was significantly higher in liver transplant patients with CR, with significant difference comparing with normal people, liver cirrhosis and transplant liver patients without CR(54.0833 ± 6.0325)μg/L vs(1.0232 ± 0.9105)μg/L,(12.6202 ± 1.5370)μg/L,(17.7102 ± 2.3562)μg/L, P < 0.01).The concentration of DCN in serum showed a positive correlation with the degree of CR.Conclusions DCN showed negative expression in liver tissue and increased significantly in serum of liver transplantation patients with CR.This suggests that DCN may be involved in occurrence and development of CR.At the same time the determination of DCN in serum maybe become an important indicator of the early diagnosis, development and prognosis of CR for liver transplant patients.

Comparison of two diagnostic criteria for metabolic syndrome applied in health check-up population aged 12-19 years in Taiwan / 中华儿科杂志

<p><b>OBJECTIVE</b>To compare the differences of two recommended diagnostic criteria for metabolic syndrome (MS) in a health check-up population aged 12-19 years in Taiwan province.</p><p><b>METHOD</b>The study data were supplied by the MJ Health Screening Center, which is a private membership chain clinic with 4 health screening centers around the Taiwan Island and provides periodic health examination to its members. The database included a self-administered questionnaire for health history, asking about demographic, socioeconomic, medical, and lifestyle information, and clinical and laboratory measures for every member. A total of 1629 members (873 boys and 756 girls, respectively) received a health check-up first time at MJ centers were recruited from 2005 to 2006. MS detection rate and agreement rate was calculated according to two definitions, respectively. The distributions of MS components and the aggregation of risk factors were further analyzed.</p><p><b>RESULT</b>(1) The range of age-adjusted detection rate of MS for two definitions were 4.05% (5.84% for boys, 1.98% for girls) and 8.35% (10.42% for boys, 5.95% for girls), respectively. It was 0.94% , 14.20% and 36.59% for criterion I among adolescents who were overweight (BMI over 95th percentile), at risk of overweight (BMI between 85th and 95th percentile) and normal weight (BMI below the 85th percentile), respectively; while 3.61%, 25.93% and 53.66% for criterion II. (2) The range of five MS components were 9.09% (low-HDL-C)-16.39% (high blood pressure) for definition I, while 0.98% (high FBG)-27.13% (high WC) for definition II. (3) Of the total subjects, 2.76%, 1.04% and 0.25% were presented with three, four and five MS risk factors for definition I; while 6.69%, 1.60% and 0.34% for definition II, separately. (4) The most common clinical symptom complex of MS was "obesity, hypertension and low-HDL-C" for criterion I, "high TG, obesity and low-HDL-C" for criterion II. (5) The MS diagnostic criterions of I and II were in moderate accordance with agreement rate of 94.35%, Kappa index was 0.518.</p><p><b>CONCLUSION</b>Our findings reveal that there were relatively large differences in detection and aggregation of risk components on MS when using two recommended definitions, the detection rate of MS in adolescents depends strongly on the parameters chosen and their respective cut-off points. In order to avoid possible relevant under- or over-estimation of the prevalence, it seems advisable that the use of unversally specific cut-off values seems to be more appropriate to give more reliable results.</p>

Correlation between major histocompatibility complex class I-related chain A gene alleles and graft rejection in small intestine, liver and kidney transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the correlation between major histocompatibility complex (MHC) class I chain-related gene A (MICA) gene alleles matching rates and graft rejection in small intestine, liver and kidney transplantation.</p><p><b>METHODS</b>Genome DNA were extracted from blood samples or pathological sections collected from donors and recipients of living-related transplantation, included 4 cases of small bowel transplantation, 5 cases of liver transplantation and 6 cases of kidney transplantation. The correlation between MICA alleles matching rates and acute graft rejection was analyzed following 13 MICA alleles determination by polymerase chain reaction based on sequence-specific primers (PCR-SSP).</p><p><b>RESULTS</b>HLA zygosity of all donors and recipients was confirmed to be half-matching. The recipients displaying higher matching rates of MICA alleles with donors showed lighter clinical and pathological rejection and longer survival time. On the contrary, recipients with lower matching rates of MICA alleles with donors showed severer clinical and pathological rejection and shorter survival time relatively.</p><p><b>CONCLUSION</b>Matching rates of MICA alleles has negative relevance to acute rejection, and positive relevance to survival time of recipients in small bowel, liver, and kidney transplantation.</p>

Comparison of five different diagnostic criteria on metabolic syndrome applied during physical check-up programs among population aged 35-74,in Taiwan / 中华流行病学杂志

Objective To compare the differences of five diagnostic criteria used for metabolic syndrome (MS),issued by International Diabetes Federation (IDF),the National Cholesterol Education Program (ATPIII),America-Heart-Associatien (AHA),Chinese Medical Association Diabetes Branch (CDS) and The Taiwan Health Bureau (TAIWAN),during a physical check-up program among population aged 35-74 years,in Taiwan.Methods A total number of 28 408 people who had received physical checkup program first time at the MJ centers,were recruited from 2005 to 2007.The prevalence of MS and the degree of agreement were both calculated according to the five definitions and the results of MS components.Distributions and risk factor aggregation of the results were also analyzed.Results According to the five definitions (1)The range of age-adjusted prevalence of MS appeared to be 10.6%(CDS)23.6%(AHA),and were 13.4%(CDS)-27.6%(AliA)and 8.0%(CDS)-20.5%(IDF) for men and women respectively.(2) The range of five MS components were 22.5%(low-HDL-C)-39.7%(high FPG),with 22.3%of the total subjects presented at least 3 risk factors.In addition,0%(AHA),6.7%(TAIWAN),6.9%(ATP III),8.9%(IDF) and 14.9%(CDS) of the subjects diagnosed as MS-free,by the five criterions,also appeared of having≥3 risk factors.(3) Among all the MS subjects,the proportions of clinical symptom complex,having 5,4 and 3 MS components were 8.0%,29.5%and 62.5%respectively.The most common clinical symptoms complex of MS were obesity,hypertension and high FPG.(4) The MS diagnostic criteria of ATPIII,AHA and TAIWAN were in good accordance with Kappa index,showing 0.81-0.98 for the three criteria.CDS and IDF were in relatively weak agreementwhen comparing with other definitions with Kappa index showed as 0.35 and 0.62.Conclusion Our findings revealed big differences in the prevalence and aggregation of risk components on MS,when using the five definitions.We suggested that prospective cohort studies be planned to investigate the impact on cardiovascular disease morbidity and mortality so as to verify whies criterion might be suitable to the population in Taiwan,considering the possible bias.

Study on the long-term efficacy and safety of medicine named 'Beijing Hypertensive No. 0' in patients with primary hypertension / 中华流行病学杂志

<p><b>OBJECTIVE</b>To assess the antihypertensive effect and safety on medicine named 'Beijing Hypertensive No. 0' in a three-year treatment of primary hypertension.</p><p><b>METHODS</b>A community-based intervention study was conducted. The antihypertensive effects and adverse events were observed.</p><p><b>RESULTS</b>4000 patients with primary hypertension were randomly divided into two groups with 1529 patients treated with 'Beijing Hypertensive No. 0' and 976 patients treated with other antihypertensive drugs, among which 946 and 853 patients in the two groups completed the three-year study. After treatment, the systolic blood pressure decreased 13 mm Hg and 7 mm Hg while diastolic blood pressure decreased 8 mm Hg and 4 mm Hg in the 'No. 0' group and controlled group respectively. After three years of treatment, 90.0% and 79.5% in the 'No.0' group and in the control group had reached the BP 'fulfillment criteria', which were much higher than the baseline data. Side effects occurred in 33/1274 (2.6%) cases during three years' treatment with most commonly seen as dizziness, headache, palpitation and weakness. No serious adverse reactions occurred. There were some positive effects after treated by 'No. 0', including 0.13 mmol/L decrease of TC, 0.70 mmol/L decrease of LDL-C and an average 0.12 mmol/L increase of HDL-C. All of these changes were statistically significant. There were also opposite effects as 0.13 mmol/L increase of TG, 0.24 mmol/L increase of K+, and 0.88 mmol/L increase of Na+ on average, which were also statistically significant.</p><p><b>CONCLUSION</b>Compared with the conventional treatment, this treatment of 'Beijing Hypertensive No.0' was more convenient, safe and effective in treating mild to moderate primary hypertension in the community.</p>