The serum autoantibodies,urine routine test and peripheral blood cellswere analyzed in 70 patients with primary sjogren syndrome(SS)and 91 pa-tients with secondary SS(30 associated with systemic lupus crythematosisand 61 with rheumatoid arthritis). The significant findings in primary SS were the high positive rate ofanti-SSA(76.9%)and anti-SSB(53.8%)antibodies and also the defect in urineacidification.Therefore about 40% of the primary SS manifestated as clincalor subclinical renal tubular acidosis.Anemia,leukopenla,thrombocytopeniawere found in 20.9%,20.9%,50% respectively,ANA was found in 43.5%in the primary SS but 93.3% in SS associated with SLE. The positivity of anti-DNA antibody in primary SS was much lowerthan that of SS with SLE. The positivity of RF in primary SS(60.7%)was also significantly lowerthan that of SS wtih RA (88.3%).Although proteinuria is a rather com-mon finding in SS with SLE,it is not commonly seen in primary SS or SSwith RA.SS was considered as a heterogenesis group of patients.The dif-ferences shown by the conventional laboratory findings mentioned aboveconfirmed the concept that the primary SS is a distint systemic entitywhile the sicca syndrome in secondary SS is only one of the systemicmanifetsations of the associated rheumatic disease.

Children with hepatitis C virus RNA positive were considered to start antiviral treatment.Alpha interferon or pegylated interferon plus ribavirin in children achieved satisfactory sustain virology response.Although there were many adverse events,some can be relieved by communicating with the guardian,bringing care to the patient and giving treatment.Clinical trials in children with hepatitis C by the direct-acting antiviral agents were in progress,safety and efficacy have no differences with the adult.There were still lots of work to do in view of the particularity of children.

Hearing Loss, Sensorineural ; diagnosis ; prevention & control ; Humans

Image segmentation is a key step of image processing,and it is a hard work too. The experts of this field have tried to find a suitable algorithm for image segmentation for a long term,however,there is not a algorithm is generally accepted till now. J. Holland created genetic algorithm(abbreviation :GA) in 1973. This algorithm has been used in many fields successfully ,and has been introduced to image segmentation field by exports. The principles of image segmentation and algorithm are stated in this article. The author mainly expounded the application of GA in medical image segmentation field in recently years.

Objective To investigate the effect of tunor necrosis factor alpha (TNF-α) antagonist treatment and traditional disease-modifying antirheumatic drugs treatment on the quality of life of male patients with ankylosing spondylitis (AS).Methods In 42 patients with AS open-label study,patients were grouped after consent,and divided into the TNF-α antagonist treatment group and the non-TNF-α antagonist treatment group.All patients were treated for 4 months.The clinical and laboratory indexes and quality of life changes were analyzed before and after the treatment.T test,Pearson's correlation analysis were used for statistical analysis with software version 13.0.Results There were no significant differences in age,disease course,disease activity and the quality of life between the two groups before treatment.Disease activity and the quality of life of the two groups after treatment were improved compared with that of before treatment.After treatment,the Bath ankylosing spondylitis disease activity index (BASDAI) score [(1.9±1.6) scores,(3.0±1.3) scores,t=-2.429,P=0.020],erythrocyte sedimentation rate (ESR) [(9±6) mm/1 h,(18±17) mm/1 h,t=-2.286,P=0.031] and C reactive protein(CRP) levels [(18±21) mg/L,(62±85) mg/L,t=-2.258,P=0.035] of the TNF-α antagonists treatment group decreased significantly than those non-TNF-α antagonist treatment group,while the hemoglobin (Hb) levels [(143±15) g/L,(138±18) g/L,t=2.545,P=0.015] were significantly increased in TNF-α antagonist treatment group.The improvement extent of quality of life was more evident in TNF-α antagonists treatment group,such as,the average score [(72± 15) scores,(55±19) scores,t =3.254,P=0.002].The average degree of improvement in quality of life and BASDAI score,Bath ankylosing spondylitis functional index (BASFI) score were negatively related to the improvement in the TNF-α treatment group (r=-0.497,P=0.018; r=-0.558,P=0.007).Conclusion TNF-α antagonist treatment can not only improve the AS disease activity,but can also improve the quality of sexual life of male patients,which may direct affect on male reproductive system.

Policy circumstance plays a pivotal role in transformation of barefoot doctor to village doctor.The resources support fromregime and economic organizationmanagement system, the workpoint system for income from collective economy and politics culture of serving people under the policy circumstances of the People′s Com-mune, lay a firm foundation for rise and development of barefoot doctors.However, the village self-governance re-gime began with Household Contract Responsibility System changed all elements above and ultimately prompt trans-formation from barefoot doctor to village doctor.

Objective To review the characteristics,mechanism,the brain structural and functional changes of cognitive impairment induced by sleep-disordered breathing in children.Methods The retrieve time was from 2002 to 2014 and the retrieve databases were the US.national library of medicine and Weipu Chinese journal databases.Search word included sleep disorders breathing, cognitive, sleep apnea syndrome, neurobehavioralmanifestations,image,sleep deprivation.Results 52 English literature and 1 Chinese literature were accepted.Most literatures were clinical trial, comparative study, multicenter study, randomized controlled trial, controlled clinical trial.Conclusion The study in the cognitive impairment and characteristics change of the brain function and structure in children with SDB is not enough.Most cognitive assessments are completed by scale.How to diagnosis early,more objectively assess cognitive, study molecular mechanisms, study function change and positioning of brain function need more research in clinical.

Humans ; Standard of Care ; Vestibulocochlear Nerve Diseases ; diagnosis ; therapy

OBJECTIVE:To provide reference for small interfering ribonucleic acid (SiRNA) R&D and registration in China. METHODS:The situation of SiRNA R&D at home and abroad were introduced,and problems encountered in the evaluation and approval process were summed up to put forward suggestions. RESULTS & CONCLUSIONS:SiRNA has developed slowly in Chi-na,with a gap of 5-10 years at least compared with foreign developed countries. The registration category of SiRNA is not clear;applicants lack of guidance documents;production workshop which meet requirement is in shortage;the efficiency of drug registra-tion allows of no optimism. It is recommended that pharmaceutical registration departments carry out the pilot reform for SiRNA registration,publish SiRNA registration guide,relax regulations for IND gradually,encourage applicants to participate in the inter-national multicenter clinical trials in order to improve the efficiency of SiRNA evaluation and approval efficiency.

Treatment of macular hole associated retinal detachment in high myopia has progressively evolved over the years,including the scleral buckling,simple intravitreal gas injection,pars plana vitrectomy (PPV),PPV combined with internal limiting membrane (ILM) peeling or transplantation and so on.Simple vitreous gas injection is less traumatic and good for the patients with small holes and localized retinal detachment.PPV combined with ILM peeling can achieve better treatment effects for small holes with wide retinal detachment.But for large holes with wide retinal detachment,PPV combined with ILM transplantation is necessary to improve the macular holes closure rate.If the ILM has been peeled before,the lens capsule could be a nice substitute for ILM.The scleral surgery can solve the problem of posterior scleral staphyloma and effectively control the elongation of the axial length.However,there is still no one surgery could deal with all the problems of high myopia,we should consider all the circumstances like the size of the macular hole and the range of the retinal detachment to choose the best individualized therapy.