With artificial intelligence,the authors designed an Expert System for the Differential Diagnosis and Treatment of Lumbago.ESSDTL shows that it not only helps doctors to diagnose the illness of lumbago but also helps young doctors and medical students to gain experience by running practical cases and explaining their procedures for diagnosing and treting the diseases through ESDDTLexplanation facilities.

Proliferative diabetic retinopathy (PDR) is one of the serious ocular complications of patients with diabetes mellitus and also the leading cause of blindness.Pars plana vitrectomy (PPV) is an effective treatment for severe vitreous hemorrhage and PDR.The intraocular concentration of vascular endothelial growth factor (VEGF) of patients with PDR usually increase abnormally,which promote growth of neovessels and make it early to leak and bleed.Numerous neovessels in vitreous cavity and retinal surface can lead to intraoperative bleeding and may affect the definition and precision of operation and prolong surgical time.If we conduct gas/fluid exchange regardless of severe active bleeding,proliferate membrane may reoccur at a high rate postoperatively due to the residual platelet and impair the success rate of surgery seriously.In addition,with the high activity of neovessels,anterior chamber,vitreous and retinal hemorrhage may appear as well as other postoperative complications like postoperative high intraocular pressure caused by inflammation or hemorrhage and traction retinal detachment because of reoccurrence of fibro membrane,which directly affect the postoperative visual function recovery and long-term prognosis.As wide clinical application of anti-VEGF agents in recent years,studies found that preoperative intravitreal injection of anti-VEGF drugs assisted PPV can limit the activity of neovessels and significantly reduce the incidence of intraoperative and postoperative bleeding,facilitate operation,shorten surgical time and improve the success rate of surgery.In this paper,the mechanism,effectiveness,clinical utility and safety of anti-VEGF therapy assisted vitrectomy for the treatment of PDR are reviewed.

Objective To investigate the efficacy of rabeprazole combined with mosapride in the treatment of reflux esophagitis. Methods A total of 92 patients with reflux esophagitis admitted from April 2016 to April 2017 in our hospital were divided into study group and routine group (n = 46). The routine group was treated with omeprazole and Mosapride,the study group was treated with rabeprazole and mosapride. The clinical efficacy and adverse reactions in the two groups were observed and compared. Results The total effective rate was 91.30％ in the study group and 76.09％ in the conventional group, the difference was statistically significant (P<0.05). The total effective rate of reflux symptoms, esophageal irritation and esophageal irritation was significantly higher in the study group than in the conventional group (P<0.05)The adverse reaction rate was 4.35％ in the study group and 6.52％ in the conventional group, the difference was not statistically significant (P<0.05). Conclusion In the course of clinical treatment of reflux esophagitis, attention should be paid to the two aspects of acid suppression and gastric motility. In the inhibition of acid, the effect of Bella is obviously higher than that of omeprazole. In gastric motility, mosapride in clinical effect is better. Reflux esophagitis by rabeprazole combined with mosapride treatment, clinical efficacy is significant, and adverse reaction rate is low, safe and reliable, worthy of clinical application.

The breast cancer stem cells are a subpopulatiom of breast tumor cells that selectively possess tumor initiation and self-renewal capacity. Recent findings suggest that it may correlate with the failure treatment and relapse of breast cancer. The isolation of phenotypically distinct tumorigenic of breast cancers will find a way to elucidation of the pathways that account for their tumorigenic potential to cure the disease.

Objective:To observe the changes of structure and function of pharyngeal muscle in SD rats with altitude hypoxia induced obstructive sleep apnea syndrome(OSAS),in an attempt to investigate the remodeling of pharyngeal space and the possible biomechanical mechanism of OSAS.Methods:Twenty-four SD rats(12 male and 12 female) were randomly assigned to 4 groups with 6 rats in each group.Rats in group A and B were male and those in group C and D were female.Rats in group A and C were placed in altitude chamber and treated with altitude hypoxia 6 h per day for 22 days.The pressure in the chamber was 53.9 kPa with an oxygen concentration of 10.0%-11.2%.Rats in group B and D,serving as controls,received no treatment.All rats were sacrificed on the 23~(rd)day.The open-angle and the inside diameter of rats′ pharyngeal-ring and the pathology of pharyngeal tissues were examined in all rats.Results: The open-angles of rats′ pharyngeal-ring of group A, B,C and D were(55?24)?,(15?8)?,(38?20)?,and(35?15)?,respectively;and the inside diameters of the pharyngeal-ring(cm) were(0.4?0.2,) 0.2?0.1,0.3?0.1,and 0.3?0.1,respectively.The open-angle and the inside diameter of rats′ pharyngeal-ring in group A were significantly higher(P

Acetyltransferases ; genetics ; Breast Neoplasms ; genetics ; Female ; GPI-Linked Proteins ; Gene Expression Regulation, Neoplastic ; genetics ; Humans ; Membrane Glycoproteins ; genetics ; Neoplasm Metastasis ; genetics ; physiopathology ; S100 Proteins ; genetics ; Transcription Factors ; genetics

Radiotherapy is one of the three main therapies for carcinomas. The techniques of three dimensional conformal radiotherapy and intensity modulated radiotherapy signify a new age of precise localization, planning and treatment. The author reviewed the development of three dimensional conformal radiotherapy and its related new techniques nowadays.

The synaptic organization of the sexually dimorphic nucleus of the preopticarea(SDN-POA)of male and female rats were examined with electron micro-scope.The results indicated that the synaptic pattern of SDN-POA showedsignificant sexual dimorphism:1.The numbers of total and shaft synapses whichoccupied the vast majority of total synapse were 2 times greater in male than infemale.2.The number of spine synapse of the female was 4.6 times greater thanthat of the male.3.In female,either the numbers of spine synapse with clear andmixed synaptic vesicles or the numbers of symmetrical and asymmetrical spinesynapses were markedly higher than in male.In contrast,the ratio of Gray Ⅱ toGray Ⅰ was 2.4 times larger in male than in female.4.The number of shaft synapsewith clear vesicle was greater in male than in female.In both sexes,however,thesignificant difference in the number of shaft synapse with mixed vesicle was notfound.5.There was no significant sexual difference in the number of asymmetricalshaft synapse,while the number of symmetrical shaft synapse was 2.7 times greaterin male than in female.

The cytoarchitecture of the sexually dimorphic nucleus of the preoptic area(SDN-POA)of male and female rats was studied with Nissl stain and rapid Golgimethod under light microscope.The results were as follows:1.The volume of theSDN-POA of the male was markedly 3.1 times larger than that of the female.2.In both sexes,the cell density of the SDN-POA significantly increased as comparedwith that of the surrounding,while the sexual difference of the cell density withinthe SDN-POA was not found.3.There was marked male-female difference in theneu(?)onal organization of the nucleus,in which the number of large cells was signi-ficantly greater in males than in females.4.In males,dendritic trees principallyoriented in dorsolateral,ventrolateral and medial directions.In contrast,dendritictrees in females mainly oriented in dorsal and ventromedial directions.5.The meantotal length of the dendritic tree was larger in males than in females and the dis-tribution of the dendritic tree showed sexual difference in the X axis but not in theY axis.6.The number of the dendritic spine was 2.1 times greater in females thanin males.

Objective To investigate the effects of sevoflurane preconditioning on cardiovascular function in patients with coro -nary heart diseases , and explore its mechanism .Methods Eighty patients with coronary heart disease during 2009 January to 2012 December from our hospital patients were selected and randomly divided into the study group ( 41 cases ) and control group ( 39 ca-ses) .Patients in study group were given sevoflurane preconditioning , while the control group were given propofol .A series of parame-ters were recorded, including the patient's heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), stroke volume (SV), cardiac output (CO), systolic time ratio (STR) and serum cardiac troponin T (cTnT) before induction of anesthesia (T0), 30min (T1) during the operation, incision suture (T2), 6h after operation (T3), 12h after operation (T4), and 24 h after op-eration (T5).Results HR, CO, SV, CVP, MAP, STR, and cTnT of the research group were relatively more stable than the control group in the preoperative, intraoperative, postoperative, and recovery.The study group at CO, T1, SV, STR, and cTnT were (3.48 ±0.40)L/min, (6.4 ±1.9)ml/(min· m2), (0.36 ±0.76), (0.227 ±0.112)ng/ml, CO, SV, STR in T2 and cTnT were (3.58 ±0.52)L/min, (6.6 ±2.3)ml/(min· m2), (0.36 ±0.63), (0.241 ±0.115)ng/ml, control group T1 at CO, SV, STR and cTnT were (3.11 ±0.53)L/min, (5.2 ±2.1)ml/(min· m2), (0.46 ±0.81), (0.351 ±0.106)ng/ml, CO, SV, STR in T2 and cTnT were (3.15 ±0.61)L/min, (5.7 ±1.5)ml/(min· m2), (0.44 ±0.90), (0.311 ±0.112) ng/ml.The patients in study group were in T1 CO, SV CO in T1 , SV, T2 times higher than that in control group .STR in T1 , T2 point was lower than that of the control group, cTnT in T1 , T2 point was lower than that of the control group , and the difference between the groups was statistically significant ( P <0.05 ) .Research group of patients with CO , SV higher than that in control group at in T 1 ,T2 , and STR lower than that at T 1 , T2 , cTnT lower than that of the control group at in T 1 , T2 , and the differences were statistically significant ( P <0.05 ) .Conclusions Sevoflurane preconditioning can make the hemodynamics more stable , more suitable for clinical anesthesia , and its mechanism may be related to the changes of cardiac troponin T .