FGF23 Is Endogenously Phosphorylated in Bone Cells

Levels of serum phosphate are controlled by the peptide hormone FGF23, secreted from bone osteocytes. Elevated levels of circulating FGF23 are a key factor in several hypophosphatemic disorders and play a role in chronic kidney disease. Posttranslational processing of FGF23 includes multi‐site O‐glycosylation, which reduces intracellular cleavage by proprotein convertases. The FGF23 protein also contains four serine phosphorylation consensus sequences (S‐X‐D/E); in this work, we asked whether FGF23 is a substrate for secretory phosphorylation. Both HEK cells as well as IDG‐SW3 cells, an osteocyte model, incorporated radiolabeled orthophosphate into intact FGF23, as well as into the 14‐kDa carboxy‐terminal—but not the 17‐kDa N‐terminal—fragment. Sequential serine‐to‐alanine site‐directed mutagenesis of four kinase consensus sites showed that labeling occurred on three serines within the carboxy‐terminal fragment, Ser180 (adjacent to the cleavage site), Ser207, and Ser212. Liquid chromatography‐coupled mass spectroscopy indicated the presence of phosphate at Ser212 in recombinant R&D mouse FGF23^R179Q, confirming labeling results. A phosphopeptide‐specific antibody was raised against phospho‐Ser212 and exhibited immunoreactivity in osteocytes present in mouse long bone, providing further evidence that FGF23 is naturally phosphorylated in bone. Bone SIBLING proteins are serine‐phosphorylated by the ubiquitous Golgi secretory kinase FAM20C. Cotransfection of HEK and MC3T3 cells with FGF23 and active, but not inactive, FAM20C kinase increased the storage and release of FGF23 in radiolabeling experiments, indicating potential effects of phosphorylation on FGF23 stability. Collectively, these data point to an important role for phosphorylation of FGF23 in bone. © 2014 American Society for Bone and Mineral Research.     

坦度螺酮治疗2型糖尿病伴发焦虑抑郁情绪患者疗效及对血糖的影响

目的：探讨坦度螺酮治疗2型糖尿病伴发焦虑抑郁情绪患者的疗效和安全性以及对血糖的影响。方法将80例2型糖尿病伴焦虑抑郁患者随机分为两组,均予以糖尿病常规治疗,实验组联合坦度螺酮治疗,观察6周。治疗前后采用汉密顿焦虑量表及汉密顿抑郁量表评定焦虑抑郁状况,副反应量表评定不良反应;检测空腹血糖、餐后2h血糖、糖化血红蛋白、三酰甘油水平的变化。结果治疗第2周末起两组汉密顿焦虑量表及汉密顿抑郁量表评分均较治疗前显著下降（P＜0．01）,治疗各时点实验组评分较对照组下降更显著（P＜0．01）。治疗6周末两组空腹血糖、餐后2 h血糖、糖化血红蛋白、三酰甘油水平均较治疗前显著下降（P＜0．01）,实验组空腹血糖、餐后2 h血糖、三酰甘油水平较对照组下降更显著（P＜0．01）。两组不良反应较轻微,治疗各时点两组副反应量表评分比较无显著性差异（P＞0．05）。结论坦度螺酮能显著改善2型糖尿病患者伴发的焦虑抑郁情绪,安全性高,有利于控制血糖水平。     

两种不同有创动脉血压监测护理方法应用于儿童的效果比较

[目的]比较两种不同有创动脉血压监测的护理方法应用于儿童的临床效果。[方法]对使用有创动脉血压监测的58例患儿采用随机方法分为生理盐水组(30例)和肝素盐水组(28例),予以持续冲洗管路,比较两种不同冲洗方法在48h内的临床效果。[结果]生理盐水组和肝素盐水组在24h内均未发生管路堵塞,在36h内分别堵塞2例(6.6%)和1例(3.6%),在48h内分别累计堵塞3例(9.9%)和2例(7.1%)。两种护理方法在血栓形成和患儿使用前后凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)变化方面差异无统计学意义(P0.05)。[结论]使用生理盐水和肝素盐水冲洗管路对有创动脉血压监测管路在血栓形成和患儿凝血功能方面差异不明显,对于儿童特别是低体重患儿建议使用生理盐水1mL/h冲洗。     

Anatomy,Definition, and Treatment of the “Terrible Triad of the Elbow” and Contemplation of the Rationality of this Designation

In the realm of orthopaedics, the terrible triad of the elbow is infamous, not simply because the prognosis is poor for most patients, but also, maybe to a greater extent, because the unique name of this malady attracts considerable attention and interest in both doctors and patients. The adjective terrible is bestowed on an elbow triad that comprises three coexisting complicated traumas; namely, radial head and ulnar coronoid process fractures and posterior dislocation of the elbow joint. In this review, the classification, treatment principles and prognosis for different forms of management of the radial head and ulnar coronoid process fractures and the ligaments lesions are introduced sequentially and various surgical procedures and their efficacy are discussed. This triad has long given orthopedic surgeons headaches. Nonetheless, in recent years a series of anatomical mechanical studies on the elbow joint have been published and there have been several breakthroughs in surgical techniques for managing this elbow triad. This review examines some memorable millstones and unveils trends in the current clinical norm for this triad. The accomplishments achieved recently have reportedly resulted in enhanced prognoses in the last two or three years compared with previous years. It is therefore high time to revise our thoughts about the justice and accuracy of defining this triad of the elbow as terrible. Lastly, we may safely conclude that the terrible triad of the elbow is much less terrible than previously, provided the commonly approved clinical approaches are undertaken.     

The Number of Positive Pelvic Lymph Nodes and Multiple Groups of Pelvic Lymph Node Metastasis Influence Prognosis in Stage ⅠA-ⅡB Cervical Squamous Cell Carcinoma

Background:Pelvic lymph node metastasis (LNM) is an important prognostic factor in cervical cancer.Cervical squamous cell carcinoma accounts for approximately 75-80％ of all cervical cancers.Analyses of...     

外直肌超常量后徙固定在知觉性外斜视手术中的应用

目的 观察外直肌超常量后徙固定在知觉性外斜视手术中的远期疗效,分析其应用价值.方法 回顾性分析我科2012年5月至2013年9月行外直肌超常量后徙固定的知觉性外斜视病例12例.外斜视度数均＞50△,患眼固视功能差.在斜视眼行外直肌超常量后徙固定(缝合于原肌止点后12.0 mm)联合内直肌缩短术(4.0～7.0 mm),观察术后眼位、眼球运动、眼面外观及视功能远期疗效.结果 随访13 ～ 27个月后,12例患者术后眼位正位,眼球外转稍有受限;眼面外观良好;均获得较稳定的患眼固视能力,但未建立明确的双眼视功能.结论 外直肌超常量后徙固定稳定了后徙外直肌的位置,减少了手术肌肉条数,具有安全可行、远期疗效稳定等优点.     

The investigation of glucose metabolism and insulin secretion in subjects of chronic hepatitis B with cirrhosis

Aims: To investigate the situations of abnormal glucose metabolism and dysfunction of pancreatic islet beta cells in subjects of chronic hepatitis B (CHB) with cirrhosis. Methods: 106 hepatitis B virus (HBV) positive subjects with liver cirrhosis as well as with different grade of Child-Pugh and 37 healthy subjects were included in this study. The oral glucose tolerance test (OGTT), C-peptide and insulin release test were detected. Plasma glucose and insulin levels were analyzed periodically for 2 h after oral glucose loading. Results: There was no significant difference in the level of fasting plasma glucose and C-peptide between cirrhosis group and control group (P>0.05). The levels of OGTT 2 h glucose, insulin and C peptide were significantly higher in cirrhosis group than control group (P<0.01). Peak plasma glucose levels were obtained at 60 min in normal group and cirrhosis group. The peak insulin and C-peptide response occurred at 60 min in normal group, whereas it was delayed to 120 min in cirrhosis group. There was a significant difference between two groups in the pattern of plasma glucose levels at corresponding time points (P<0.05). The OGTT 2 h glucose and insulin levels were positively correlated with Child-Pugh Score (r1 = 0.389, r2 = 0.508, P<0.01). Conclusion: These findings implied that there was a certain degree of insulin resistance and abnormal glucose metabolism in the patients with liver cirrhosis.