The application framework of big data technology during the COVID-19 pandemic in China

Big data has been reported widely to facilitate epidemic prevention and control in health care during the coronavirus disease 2019 (COVID-19) pandemic. However, there is still a lack of practical experience in applying it to hospital prevention and control. This study is devoted to the practical experience of design and implementation as well as the preliminary results of an innovative big data-driven COVID-19 risk personnel screening management system in a hospital. Our screening system integrates data sources in four dimensions, which includes Health Quick Response (QR) code, abroad travelling history, transportation close contact personnel and key surveillance personnel. Its screening targets cover all patients, care partner and staff who come to the hospital. As of November 2021, nearly 690 000 people and 5.79 million person-time had used automated COVID-19 risk screening and monitoring. A total of 10 376 person-time (0.18%) with abnormal QR code were identified, 242 person-time with abroad travelling history were identified, 925 person-time were marked based on the data of key surveillance personnel, no transportation history personnel been reported and no COVID-19 nosocomial infection occurred in the hospital. Through the application of this system, the hospital's expenditure on manpower and material resources for epidemic prevention and control has also been significantly reduced. Collectively, this study has proved to be an effective and efficient model for the use of digital health technology in response to the COVID-19 pandemic. Based on the data from multiple sources, this system has an irreplaceable role in identifying close contacts or suspicious person, and can significantly reduce the social burden caused by COVID-19, especially the human resources and economic costs of hospital prevention and control. It may provide guidance for clinical epidemic prevention and control in hospitals, as well as for future public health emergencies.

Circulating exosomal long non-coding RNA H19 as a potential novel diagnostic and prognostic biomarker for gastric cancer

Objective

Long non-coding RNAs (lncRNAs) are involved in carcinogenesis and could be used as diagnostic biomarkers. Our study aimed to elucidate the clinical role of serum exosomal lncRNA H19 in gastric cancer (GC).

Methods

In this prospective clinical study, we determined serum exosomal lncRNA H19 levels in 81 patients with GC and analysed the correlations between serum lncRNA H19 levels and clinical characteristics. Receiver operating characteristics (ROC) curves were constructed to determine the diagnostic performance of exosomal lncRNA H19 in GC.

Results

Serum exosomal lncRNA H19 levels were significantly upregulated in patients with GC both before and after surgery compared with healthy controls. Furthermore, serum exosomal lncRNA H19 levels were significantly decreased after compared with before surgery in patients with GC. Preoperative lncRNA H19 levels were significantly correlated with TNM stage. The area under the ROC curve (AUC) value for exosomal lncRNA H19 was 0.849, which was significantly higher than the AUC values for cancer antigens 19-9 and 72-4 and carcinoembryonic antigen, either alone or combined.

Conclusions

These results suggest that circulating exosomal lncRNA H19 may be a potential biomarker with diagnostic and prognostic value in GC.

Genomic scan revealed KIT gene underlying white/gray plumage color in Chinese domestic geese

Goose is an important type of domesticated poultry. The wild geese that are regarded as the ancestors of modern domestic geese present gray plumage. Domesticated, geese have both white and gray feathers. To elucidate the genetic mechanisms underlying the formation of white and gray plumage in geese, we resequenced the whole genome of 18 geese from six populations including white and gray goose breeds. The average sequencing depth per individual was 9.81× and the average genome coverage was 96.8%. A total of 346 genes were detected in the top 1% of F_ST scores of gray- and white-feathered geese, and a significant F_ST site was located in the intron region within the KIT gene, the 18 bp deletion in KIT having the strongest potential association with white feathers. It has been reported that a number of genes are associated with plumage colors in birds. However, no studies have identified the relationship between KIT and plumage color in birds at present, although the white coat can be attributed to mutations in KIT in some mammals. Our study showed that that KIT is a plausible candidate gene for white/gray plumage color in Chinese domestic geese.

Knockdown of circ_0060745 alleviates acute myocardial infarction by suppressing NF-κB activation

It has been shown that circRNAs are involved in the development of heart diseases. However, few studies explored the role of circRNAs in acute myocardial infarction (AMI). The present study aims to investigate the role of circ_0060745 in the pathogenesis of AMI. We found that the expression of circ_0060745 was significantly increased in the myocardium of AMI mice and was mainly expressed in myocardial fibroblasts. The knockdown of circ_0060745 decreased myocardial infarct size and improved systolic cardiac functions after AMI. The knockdown of circ_0060745 in cardiac fibroblasts inhibited the migration of peritoneal macrophage, the apoptosis of cardiomyocytes and the expressions of IL‐6, IL‐12, IL‐1β, TNF‐α and NF‐κB under hypoxia. Overexpression of circ_0060745 caused an increase in infarct size and worsened cardiac functions after AMI. In summary, our findings showed that knockdown of circ_0060745 mitigates AMI by suppressing cardiomyocyte apoptosis and inflammation. These protective effects could be attributed to inhibition of NF‐κB activation.

Higher thyroid-stimulating hormone levels in the first trimester are associated with gestational diabetes in a Chinese population

AIM

To evaluate the relationship between maternal thyroid-stimulating hormone levels during the first trimester and gestational diabetes risk.

METHODS

In Tianjin, China, 7258 women underwent a thyroid-stimulating hormone screening test within 12 gestational weeks and then had a glucose challenge test at 24-28 weeks of gestational age. The women with a glucose challenge test ≥7.8 mmol/l underwent a 75 g oral glucose tolerance test. Gestational diabetes was diagnosed following International Association of Diabetes and Pregnancy Study Group criteria. Restricted cubic spline analysis was performed to explore full-range risk associations of thyroid-stimulating hormone levels with gestational diabetes. Logistic regression was performed to obtain odds ratios and 95% confidence intervals.

RESULTS

In all, 594 women (8.2%) had gestational diabetes. Among women with thyroid-stimulating hormone ≤3.2 mIU/l, a positive association between thyroid-stimulating hormone levels and gestational diabetes risk was found (adjusted OR: 1.13, 95% CI: 1.00-1.27). There was no relationship between thyroid-stimulating hormone levels and gestational diabetes risk in univariable and multivariable analyses among women with thyroid-stimulating hormone >3.2 mIU/l. In subgroup analyses, among women with thyroid-stimulating hormone ≤3.2 mIU/l and BMI ≥25 kg/m² , the adjusted odds ratio for thyroid-stimulating hormone levels with gestational diabetes was enhanced to 1.25 (95% CI: 1.02-1.53).

CONCLUSIONS

In pregnant Chinese women, thyroid-stimulating hormone levels even within normal range in the first trimester were positively related to gestational diabetes risk, especially for pre-pregnancy overweight/obese women.

Insulin resistance in Alzheimer's disease (AD) mouse intestinal macrophages is mediated by activation of JNK

OBJECTIVE

Alzheimer's disease (AD) has been considered as a metabolic disorder disease, which closely related to insulin signaling impairment. Therefore, identifying the potential mechanism of insulin resistance is important for AD treatment.

MATERIALS AND METHODS

An APP/PS1 double transgenic AD mouse model was introduced to study insulin resistance in gut. The expressions of AD markers and key elements of insulin signaling were detected in ileum and intestinal macrophages of AD mice by immunohistochemistry. Furthermore, mouse intestinal macrophage cell line RAW264.7 was treated by Aβ25-35 or Aβ25-35 + insulin to explore the mechanism of insulin resistance in vitro. The expression of IR-β and the activation of cell signaling related proteins (Insulin receptor substrate 1 (IRS1), protein kinase B (AKT) and c-Jun N-terminal kinase (JNK)) in Aβ25-35-stimulated macrophages were performed via Western blotting.

RESULTS

The expressions of IRS1, Aβ and Tuj in AD mice ileum were significantly different from WT mice (p<0.05). Also, there were significant discrepancies in the expressions of β2AR and eNOS in intestinal macrophages of two groups (p<0.05). After exposure to Aβ25-35, cell proliferation rate (p<0.01) of macrophage and the levels of TNF-α (p<0.01) and Il-6 (p<0.01) was significant elevated and treatment with insulin could reverse these changes (p<0.05). The amount of IR-β and the p-AKT/AKT ratio significantly decreased in Aβ25-35-treated macrophages (p<0.01), while the ratios of p-IRS1/IRS1 and p-JNK/JNK significantly enlarged (p<0.01). Furthermore, all the changes caused by Aβ25-35 treatment were attenuated by insulin addition.

CONCLUSIONS

Activation of JNK pathway played an important role in insulin resistance of AD mice, suggesting that inhibition of JNK pathway might be a new strategy toward resolving insulin resistance related diseases, such as AD.

[Effect of inserted angle on the stability of loaded microscrews]

Objective: To evaluate the effect of different insertion angles on the osseointegration of loaded microscrews in beagle jaws. Methods: Forty-eight microscrews were inserted at four different angles (30°, 50°, 70° and 90°) into the interradicular zones between the mandibular first molar and third premolar in twelve beagles and the microscrews had been loaded with a force of 2 N immediately for 8 weeks. After microscrew-bone specimens fixed, the maximum output value (F_max) of pull-out test was recorded and the histomorphological changes of hard tissue were observed. The bone-implant contact (BIC%) was quantitatively analyzed and the osseointegration of microscrew-bone interface was comprehensively evaluated. Results: Both F_max and BIC% values of microscrews were influenced by the insertion angles. The maximum value of F_max was (385±23) N in the group with 50° angle, and the minimum value was (198±16) N in the group with 30° angle(P <0.05). The maximum value of BIC% was (59.1±6.0)% in the group with 70° angle, and the minimum value was (30.2±3.2)% in the group with 30° angle (P <0.05). Histomorphology observation revealed that in peri-screws region, the various degree of bone remodeling was found in different angle samples. Conclusions: The insertion angles (50°and 70°) were favorable to the stability of the microscrew.

Metformin treatment of antipsychotic-induced dyslipidemia: an analysis of two randomized, placebo-controlled trials

Dyslipidemia is one of the most common adverse effects in schizophrenia patients treated with antipsychotics. However, there are no established effective treatments. In this study, data were pooled from two randomized, placebo-controlled trials, which were originally designed to examine the efficacy of metformin in treating antipsychotic-induced weight gain and other metabolic abnormalities. In total, 201 schizophrenia patients with dyslipidemia after being treated with an antipsychotic were assigned to take 1000 mg day^-1 metformin (n=103) or placebo (n=98) for 24 weeks, with evaluation at baseline, week 12 and week 24. The primary outcome was the low-density lipoprotein cholesterol (LDL-C) levels. After metformin treatment, the mean difference in the LDL-C value between metformin treatment and placebo was from 0.16 mmol l^-1 at baseline to -0.86 mmol l^-1 at the end of week 24, decreased by 1.02 mmol l^-1 (P<0.0001); and 25.3% of patients in the metformin group had LDL-C ≥3.37 mmol l^-1, which is significantly <64.8% in the placebo group (P<0.001) at week 24. Compared with the placebo, metformin treatment also have a significant effect on reducing weight, body mass index, insulin, insulin resistance index, total cholesterol and triglyceride, and increasing high-density lipoprotein cholesterol. The treatment effects on weight and insulin resistance appeared at week 12 and further improved at week 24, but the effects on improving dyslipidemia only significantly occurred at the end of week 24. We found that metformin treatment was effective in improving antipsychotic-induced dyslipidemia and insulin resistance, and the effects improving antipsychotic-induced insulin resistance appeared earlier than the reducing dyslipidemia.

Microwave-assisted extraction and purification of chlorogenic acid from by-products of Eucommia Ulmoides Oliver and its potential anti-tumor activity

An efficient method for the rapid extraction, separation and purification of chlorogenic acid (CGA) from by-products of Eucommia Ulmoides Oliver (E. ulmoides) by microwave-assisted extraction (MAE) coupled with high-speed counter-current chromatography (HSCCC) was developed. The optimal MAE parameters were evaluated by response surface methodology (RSM), and they were extraction time of 12 min, microwave power of 420 W, ethanol concentration of 75 %, solvent/sample ratio of 30:1 (mL/g), yield of CGA reached 3.59 %. The crude extract was separated and purified directly by HSCCC using ethyl acetate-butyl alcohol-water (3:1:4, v/v) as the two-phase solvent system. The 14.5 mg of CGA with the purity of 98.7 % was obtained in one-step separation from 400 mg of crude extract. The chemical structure of CGA was verified with IR, ESI-MS analysis. Meanwhile, the purified CGA extract was evaluated by MTT assay and results indicate that CGA extract exhibited potential anti-tumor activity for AGS gastric cancer cell.

Serotonin regulates osteoblast proliferation and function in vitro

The monoamine serotonin (5-hydroxytryptamine, 5-HT), a well-known neurotransmitter, also has important functions outside the central nervous system. The objective of this study was to investigate the role of 5-HT in the proliferation, differentiation, and function of osteoblasts in vitro. We treated rat primary calvarial osteoblasts with various concentrations of 5-HT (1 nM to 10 µM) and assessed the rate of osteoblast proliferation, expression levels of osteoblast-specific proteins and genes, and the ability to form mineralized nodules. Next, we detected which 5-HT receptor subtypes were expressed in rat osteoblasts at different stages of osteoblast differentiation. We found that 5-HT could inhibit osteoblast proliferation, differentiation, and mineralization at low concentrations, but this inhibitory effect was mitigated at relatively high concentrations. Six of the 5-HT receptor subtypes (5-HT_1A, 5-HT_1B, 5-HT_1D, 5-HT_2A, 5-HT_2B, and 5-HT_2C) were found to exist in rat osteoblasts. Of these, 5-HT_2A and 5-HT_1B receptors had the highest expression levels, at both early and late stages of differentiation. Our results indicated that 5-HT can regulate osteoblast proliferation and function in vitro.

A functional polymorphism in the CYR61 (IGFBP10) gene is associated with prostate cancer risk

BACKGROUND

CYR61 (cysteine-rich protein 61, also named IGFBP10) is a secreted signaling molecule that promotes angiogenesis and tumor growth. The goal of this study is to determine whether a functional polymorphism in the promoter region of the CYR61 gene (rs3753793) is associated with prostate cancer (PCa) risk and gene expression in Chinese patients.

METHODS

A total of 665 patients diagnosed with PCa and 703 cancer-free controls were genotyped in this hospital-based case-control study, and 26 PCa tissue samples were evaluated for mRNA expression of CYR61 by real-time quantitative reverse-transcription PCR.

RESULTS

Men carrying the G allele of rs3753793 (TG+GG) had significantly lower risk of PCa when compared with the TT genotype (odds ratio (OR) = 0.76, 95% confidence interval (CI) = 0.61-0.95). The association was generally more pronounced among subgroups of PCa patients with advanced stage (OR = 0.70, 95% CI = 0.53-0.94), Gleason score >7 (OR = 0.63, 95% CI = 0.46-0.86) and PSA>20 ng ml(-1) (OR = 0.68, 95% CI = 0.53-0.88). Prostate tumors derived from cases with the GT/GG genotypes had significantly lower levels of CYR61 mRNA when compared with cases with the TT genotypes (P = 0.02).

CONCLUSIONS

Our results indicate that the genetic variation of rs3753793 in the CYR61 promoter may contribute to genetic predisposition to PCa and intra-tumor expression gene expression.

Circadian rhythms in serum bone markers and their relation to the effect of etidronate in rats

Circadian rhythmicity is an essential feature of bone metabolism. The present study was undertaken to (Aoshima et al., 1998) determine the changes in bone resorption and formation in rats over 24h, (Black et al., 1999) evaluate the effect of the consecutive administration of etidronate on circadian rhythms of serum bone markers, and (Blumsohn et al., 1994) determine whether the effect of etidronate on bone metabolism is circadian time-dependent. One hundred twenty male Wistar rats, which had been adapted to a 12/12h light/dark cycle, were injected subcutaneously once daily with either 0.5 mgP/kg etidronate or 0.9% NaCl (control group) at 0090, 1300, 1700, 2100, 0100, or 0500h for 10d. Serum was collected and tibiae were dissected 24h after the last injection. Serum pyridinoline (Pyd), tartrate-resistant acid phosphatase (TRAP), osteocalcin (OC), alkaline phosphatase (ALP), calcium (Ca), phosphorus (Pi), calcitonin (CT), and parathyroid hormone (PTH) were determined. Bone mineral density (BMD) in the proximal tibia, and the rate of formation of longitudinal trabecular bone over the past 48h were also determined using a chronological labeling method with NTA-Pb. The results showed characteristic circadian rhythms in serum bone markers in rats, with peaks in both bone resorption and bone formation during the animals' rest span. The administration of etidronate at the different times of the day decreased the level of bone-resorption markers (Pyd and TRAP) without affecting the circadian patterns of markers of bone formation (OC and ALP). However, the magnitude of the decrease due to etidronate was not uniform throughout the day, and was greatest during the daytime. Etidronate increased the BMD in the tibial metaphysis in all of the time-treatment groups, but the magnitude of the increase did not vary with the time of etidronate administration. The present data provide a physiological basis for future studies on bone metabolism and may be important in the design of future experiments and in the interpretation of experimental data.

Chronic toxicity of rare-earth elements on human beings: implications of blood biochemical indices in REE-high regions, South Jiangxi

Blood analyses for rare-earth element (REE)-high background regions in South Jiangxi show that the population averages of many of the biochemical indices deviate markedly from normal values in the normal region. These deviations are thought to be caused by prolonged intake of REE through food chains in view of that the toxicity of other harmful metals such as Pb and Cd can be neglected because of their insignificant amounts in the environment. In comparison with the normal region, blood biochemical indices abnormal in the REE-high regions are manifested as low total serum protein (TSP), albumin, beta-globulin, glutamic pyruvic transitanase, serium triglycerides, and immunoglobulin, but high cholesterol. These deviations may be related to the REE concentration and composition of food chains, and are sex dependent. Certain blood indices (such as TSP) of different age groups in the LREE-high region indicate that the influence of REE on males is a one-way irreversible process, whereas females show a strong ability of restoration.

Bioelectrical activity of the central nervous system among populations in a rare earth element area

Auditory brainstem electric response (ABR) and somatosensory evoked potential (SEP) of 21 subjects (41 ears) among villagers in a rare earth element (REE) area in Gan County, Jiangxi, China, were studied. No difference in ABR between the subjects from the REE area and the control group was noted. However, the conduction detected by SEP from the median nerve to the thalamus (P15) was shortened (P < 0.05), especially to the first-grade primary somatosensory responsive region (S1) (P < 0.01) and the amplitude of S1 decreased (P < 0.05), indicating that REE was difficult to accumulate in the brainstem, but it was susceptible to cerebral cortex, thus causing sub-clinical damage. This condition was confirmed in the animal experiment. It was suggested that the toxicity through long-term intake of small doses of REE might not be negligible, and the hazard of REE environments should be investigated.

Investigation on arteriosclerosis among population in a rare earth area in south China

An ophthalmofunduscope was used to investigate arteriosclerosis among villagers aged 20-40 yr old in two rare earth areas in Ganzhou, Jiangxi Province. It was noted that the occurrence of arteriosclerosis of the fundus aculi was significantly high (P < 0.05-0.01), the detection of serum cholesterol (CHO) was remarkably increased (P < 0.01), and the level of IgM was also elevated. However, high-density lipoprotein (HDL) remained at a low level. The effect of taking rare earth elements (REE) could be direct or indirect, thus causing an increase in cholesterol and interfering with the synthesis of high-density lipoprotein. Furthermore, rare earth could also cause immunogenic damage to the vascular wall. All of these could facilitate the formation of arteriosclerosis.

[Study of skeletal and occlusal pattern]

The aims of this study were to analyze the characteristics of craniofacial structure in normal occlusion and to assess the relationship between the skeletal and occlusal pattern. Fifty-seven subjects with normal occlusion were divided into three skeletal groups according to Hauston measurement. One hundred and sixty-six subjects with Angle's malocclusion were also classified according to ANB values. The result showed that there were significant differences in the values of NA-APg, AB-NPg, SNA, SNB, U1-NA, L1-NB among the three groups. These data indicate that skeletal pattern does not coincide with occlusion. Different skeletal pattern exists even in normal occlusion. In diagnosis and treatment planning, the data of skeletal pattern should be referred.

Changes in p53 and cyclin D1 protein levels and cell proliferation in different stages of human esophageal and gastric-cardia carcinogenesis

The objective of this study was to quantify the changes in p53 and cyclin D1 protein levels in different stages of human esophageal and gastric cardia carcinogenesis in a high-risk population in Henan, China. Immunoreactivity of p53, cyclin D1 and proliferating-cell nuclear antigen (PCNA) was observed in the cell nuclei of esophageal and gastric cardia biopsies. The number of p53-immunostaining-positive cells was low in normal epithelia, slightly increased in basal-cell hyperplasia (BCH), markedly increased in dysplasia (DYS) (10-fold), and further increased in squamous-cell carcinoma (SCC) (40-fold). This pattern of change was similar to that of cell proliferation as indicated by PCNA immunostaining. On the other hand, the number of cyclin D1-immunostaining-positive cells did not increase from BCH to DYS, although a slight increase from DYS to SCC was noted. In the gastric cardia, again, the pattern of change of p53-positive cells in different stages of lesions paralleled the pattern of cell proliferation. The number of p53-positive cells was very low, much lower than that of PCNA-positive cells, in normal, chronic superficial gastritis (CSG) and chronic atrophic gastritis (CAG); therefore, the increase of p53-positive cells from CAG to DYS was more dramatic (100-fold). From DYS to adenocarcinoma (AC), the p53-positive and the PCNA-positive cells increased 4-fold. On the other hand, the number of cyclin D1-positive cells did not increase in pre-cancerous lesions, but increased slightly in AC. This study demonstrates that p53 protein accumulation increased with the progression of pre-cancerous lesions, especially in the genesis of dysplasia, both in the esophagus and in the gastric cardia. Our approach of quantitative immunohistochemistry sheds light on the mechanisms of genesis of esophageal and gastric-cardia cancers, which frequently occur together in many high-incidence areas.

The effect of calcium supplementation on the circadian rhythm of bone resorption

Bone resorption shows a circadian rhythm in human subjects, but the physiological mechanisms underlying this rhythm are unknown. We compared the circadian rhythm of bone collagen degradation in 18 premenopausal women before and after oral calcium supplementation (1000 mg calcium for 14 days). Subjects were randomized to receive calcium at either 0800 h or 2300 h. Continuous 48-h urine collections and 1 day of 4-h urine collections were obtained before and after the 14-day supplementation period. We measured urinary deoxypyridinoline (Dpd) and the cross-linked N-telopeptide of type I collagen (NTx) as biochemical markers of bone resorption. There was a significant effect of time of day on excretion of Dpd and NTx (analysis of variance, P < 0.001) with peak excretion between 0300-0700 h and a nadir between 1500-1900 h. The mean amplitude (peak to trough) was similar for Dpd and NTx (70.3% and 63.3%, respectively). Evening calcium supplementation resulted in marked suppression of the nocturnal increase in Dpd and NTx and reversed the usual nocturnal increase in the level of parathyroid hormone. In contrast, morning calcium supplementation had no significant effect on the circadian rhythm of Dpd or NTx. Evening calcium supplementation suppressed overall daily excretion of Dpd by 20.1% (P = 0.03) and NTx by 18.1% (P = 0.03). Morning calcium supplementation had no significant effect on overall daily excretion of either Dpd or NTx. We conclude that evening calcium supplementation suppresses the circadian rhythm of bone resorption. The daily rhythm of PTH secretion or calcium intake is likely to be an important determinant of this rhythm. Experimental protocols designed to investigate the effect of calcium supplementation on bone mineral density should take the timing of supplementation into account.

Monitoring bone resorption in early postmenopausal women by an immunoassay for cross-linked collagen peptides in urine

A new immunoassay using an ELISA approach for measuring urinary excretion of cross-linked N-telopeptides of type 1 collagen was evaluated as a specific measure of bone resorption. The assay was applied to 65 early postmenopausal women who participated in a placebo-controlled trial of the aminobisphosphonate, alendronate sodium. Eight blood and urine samples were collected over a 9 month interval. Baseline cross-linked peptide excretion varied from 26 to 216 pmol BCE (bone collagen/mumol Cr. Within-subject variability (CV) for cross-linked peptide excretion was 20.2% over the 9 months in placebo-treated subjects, substantially less than that observed for other biochemical markers of bone resorption: 45, 53, and 63% for fasting urinary calcium and hydroxyproline and 24 h urinary lysylpyridinoline (HPLC assay), respectively. Baseline cross-linked peptide excretion correlated significantly (p < 0.001) with baseline total urine lysylpyridinoline and serum osteocalcin, but not with the other biochemical markers. Initial peptide excretion also correlated inversely with lumbar spine bone mineral density at entry (r = -0.26, p < 0.05). Treatment for 6 weeks with alendronate produced a dose-dependent suppression of cross-linked peptide excretion (0 +/- 8, 29 +/- 6, 56 +/- 5, and 64 +/- 3% for 0, 5, 20, and 40 mg, respectively, p < 0.01 versus placebo for treatment effect), with a return toward pretreatment values during follow-up. Measurement of the urinary cross-linked N-telopeptides of type I collagen by this new ELISA approach appears promising as a simple and reliable method to assess overall bone resorption.(ABSTRACT TRUNCATED AT 250 WORDS)