Kawasaki disease,which is an acute multisystem vasculitis of unknown cause,leads to pathognomonic feature of coronary artery lesion.Recent studies show that genetic polymorphism,neutrophils,monocytes,cytokines and other factors are involved in the development of coronary artery disease.Long-term use of anticoagulant drugs may reduce coronary artery damage.

A systematic review is based on randomized controlled trials (RCTs), and the reliability of its conclusion is closely related to the quality of original literature. The low quality of existing RCTs in China leads to the failure of conclusive findings in systematic reviews when evaluating the effectiveness of interventions. It is almost universal for systematic reviews to draw the conclusion that "further well-designed multicenter and large-scale RCTs are still required to confirm the beneficial effects of interventions". This paper analyzed the current status of RCTs in China, discussed the influence of including trials of low quality in a systematic review and assessed how a systematic review should be carried out under such circumstances. Furthermore, the methods to evaluate the quality of RCTs were introduced and evaluated. Finally, several strategies were proposed to improve the quality of RCTs in China: foster an honest academic and social environment, enhance the training of doctors on clinical research methodology, promote the implementation of clinical registration systems and strengthen the quality control of clinical research and the medical journals regulations on the quality of submitted papers.

Objective To study the efficacy and safety of methylcarboprost suppository in preventing postpartum hemorrhage of cesarean section.Methods Two hundred and nine puerperants with cesarean section were randomly divided into two groups: test group(n=103),1mg methylcarboprost suppository was given sublingually after peritoneotomy,and control group(n=106),20IU oxytocin intravenous drip immediately after neonate delivery. 20IU oxytocin were injected into uterine muscularis in the both groups after neonate delivery.The amount of bleeding in perioperation and 24 hours after delivery were measured.Results The blood loss volumes in perioperation and 24hour after delivery in test group were 191 2ml and 317 2ml respectively, and in control group were 216 6ml and 350 5ml respectively,and there was significant difference in the blood loss volume between the two groups(P

Recurrent miscarriage is a common disease in clinical obstetrics and gynecology. There is no curative treatment for recurrent miscarriage in conventional medicine. Traditional Chinese medicine (TCM) has been widely used in the treatment of recurrent miscarriage in China for thousands of years. However, randomized controlled trials (RCTs) with high quality evaluating the effectiveness and safety of Chinese herbal medicine (CHM) still lack. This study was conducted in order to identify methodological problems in published or unpublished RCTs of CHM in the treatment of recurrent miscarriage, and provide suggestions for TCM researchers to conduct high-quality clinical research.

Chinese herbal medicine (CHM) has been widely used in the treatment of Sjogren's syndrome. However, there remains no systematic review to assess the effectiveness and safety of CHM.

Objective To explore the feasibility of laparoscopy-assisted total mesorectal excision(TME) for anterior resection of rectal cancer.Methods The clinical records of 42 patients with rectal cancer who underwentlaparoscopic TME from April 2006 to July 2008 were analyzed retrospectively.Results All the laparoscopic TME with anal sphincter preservation operations were successful;no case was converted to open procedure.The distal end of rectum was anastomosed by a reusable linear stapler.The average operative time was 195 min(170-230 min) and the operative blood loss 15 mL(10-30 mL).The time for bowel functionrecovery was 32 hours.One patient had postoperative dysuria,and one had intraoperative subcutaneousemphysema.No anastomotic leakage or infection of incisional wound occurred.Conclusions Laparoscopy-assisted anterior resection for rectal cancer is safe and feasible.

Objective: To evaluate the clinical application of total cavopulmonary connection with off-pump technique. Methods: Between May 2000 and December 2002, 9 patients underwent total cavopulmonary connection without cardiopulmonary bypass. The patients were 5 males and 4 females, mean age (10.3?6.4) years, ranged 4～24 years and mean body surface area (0.95?0.35) m 2, range 0.65～1.66 m 2. SpO 2 before operation was (73?6)% (60%～80%). Pulmonary pressure was (12.7?2.4) mmHg (10～16 mmHg) at operation. Results: Patient died after surgery. Chylothorax occurred in 1 patient. 2 patients were reoperated for fenestration between the extracardiac conduit and right atrial during the early postoperative period. All survivors were noncyanotic, the average SpO 2 on breathing air was (94?3)% (89%～97%). On d ischarged. Conclusion: Total cavopulmonary connection with off-pump technique is a useful procedure in management of patients with a functional univentricular heart. It is easy to perform. However, much remains to be studied about this unique physiologic status.

Object To study the effects of different growth regulators and organic additives on rooting of regenerated shoots from Dendrobium huoshanense C Z Tang et S J Cheng protocorm like bodies Methods In order to induce root development, the regenerated shoots were cultured on MS medium containing 3% sucrose and 0 8% agar and supplemented with NAA, IBA, BA, KT, banana mud or amino acids at different concentrations During rooting induction, the development of roots was observed and the frequency of rooted shoots was scored Results The frequency and the process of root initiation were significantly influenced by different growth regulators or organic additives For initiation and development of roots, the suitable concentration of NAA, IBA, BA, KT, banana mud or amino acids was 0 2 , 0 1, 0 8, 0 8 mg/L, 20% and 0 1%, respectively Conclusion In all media tested, NAA, IBA or banana mud display greater effects on rooting of regenerated shoots of D huoshanense than others and KT enables shoots to keep green

Objective To analyze the congenital anomalies of inferior vena cava (IVC) with their color Doppler and clinical features, and to evaluate the value of color Doppler ultrasound in the diagnosis of congenital anomalies of the IVC. Methods Between July 2009 and March 2012, 22 patients who were diagnosed as IVC anomalies by color and spectral Doppler ultrasound were retrospectively analyzed. After careful and comprehensive scanning on multiple planes, the final diagnosis was made based on the findings obtained on B-mode, color Doppler and spectral Doppler ultrasound. All the results obtained by sonography were compared with computerized tomography angiography, digital subtraction angiography, and other clinical examinations. Results There were 22 cases diagnosed as congenital anomalies of IVC, including 5 cases of the left IVC, 3 cases of the double IVC, 3 cases of membranous obstruction of the IVC (MOVC) and 11 cases of the anomalies of the left renal vein. In left IVC, the infrarenal left-sided IVC entered into the left renal vein, then crossed anterior to the aorta to join the right-sided suprarenal IVC. In double IVC, bilateral IVCs could be seen on both sides of the abdominal aorta, and the left IVC joined the right IVC over aorta then entered into the right atrium. Some patients of the left IVC and double IVC had left renal vein hypertension. All the cases of MOVC in our study presented as Budd-Chiari syndrome, in which B-mode ultrasonography showed the existence of the membranous obstruction in inferior vena cava at the level of entrance to the right atrium. On color Doppler lfow image (CDFI), reverse blood lfow into lumbar and ascending lumbar vein was found. Eleven cases of left renal vein malformations were also seen in present study, including 9 cases of retroaortic
left renal vein, 1 case of circumaortic left renal vein and 1 case of the left renal vein into the left common iliac vein. Among them, 9 cases were associated with left renal vein hypertension. Conclusion Color and spectral Doppler ultrasound can clearly identify the congenital anomalies of IVC with the evaluation of their hemodynamic modiifcation, and can be used as an important approach in the diagnosis of the anomalies of the IVC.

Objective To discuss the application about the TPDS educational reform of molecular biology in the medical students. Methods Choose 2009 and 2010 7-year program students (174 person) of clinical medicine as the research object, achieve to TPDS teaching; Control group ( 2010 basic medicine and general medicine students , 2011 basic medicine and pediatric medical students (394 person) carry out general teaching model. Taking the students test scores as the main teaching effect evaluation index, the questionnaire survey as the supplement. Statistical analysis was carried out using t test analysis method. Results Molecular biology of the experimental group students scores (94.39 ±4.34)are significantly higher than that of the control group (85.1 ±8.77), and P<0.05. The questionnaire showed that more than 80%students improved themselves in the areas of self-study ability, information collecting ability, problem-solving ability, and team cooperation abilityafter the course of study. Conclusion TPDS educational reform isoptional for the cultivating applied talents, intend to stimulate students' autonomous learning ability, inspire students to independent analysis and solve problems, improve students' unity cooperation spirit and model the humanistic spirit.