Objective To study the correlation of three different indexes of arterial elastic function(PWV, C_ 1 and C_ 2 , AI). Methods 1306 out-patients with hypertension were recruited. Two or three arterial elastic function were measured at the same time. Large and small arterial elastic indexes(C_ 1 and C_ 2 );pulse wave velocity(PWV)and augmentation index (AI) in 428 cases , C_ 1 , C_ 2 and PWV(n=208), C_ 1 , C_ 2 , PWV and AI(n=60). Results C_ 1 was negatively related to PWV and positively related with C_ 2 . No correlation between AI and PWV, AI and C_ 1 and C_ 2 was found. Conclusion PWV, C_ 1 and C_ 2 are consistent for the arterial elastic function measurement. However, little relevance between AI and PWV, AI and C_ 1 and C_ 2 was shown.

Three dimensional contrast enhanced magnetic resonance antiography(3D CEMRA) is an imaging method with the signal produced by shortening the blood relaxation time with gadolinium contrast medium but not with natural blood flow;it is a convenient and practical method with no trauma or radiation.Imaging quality was satisfactory,in which the normal anatomy,lesion site and stenosis of arteries were showed clearly.High quality images of 3D CEMRA mainly depended on the optimal acquisition delay time,proper injection rate,volume of contrast material,reasonable sequence and parameters and operators' skills.3D CEMRA has the similar effect with digital subtraction angiography;it is an effective,fast,comprehensive and reliable technique and is an ideal measurement for diagnosing vascular diseases of extremities.

Objective To investigate the diagnostic value of T-SPOT.TB in patients with fever.Methods T-SPOT.TB was carried out in 456 febrile patients who had no determined reason for fever or who could not be excluded from infection with Mycobacterium tuberculosis.These patients were followed up for their final clinical diagnosis and the diagnostic value of T-SPOT.TB was evaluated using the receiver operating characteristic (ROC) curve.Results In the present study,85 patients were clinically diagnosed with tuberculosis (TB) (including 34 cases of pulmonary TB,24 cases of TB infection defined as T-SPOT.TB positive without TB lesion,but effective with anti-TB treatment,10 cases of tuberculous pleurisy and 17 cases of other extrapulmonary TB) and 371 patients had no definite evidence of Mycobacterium tuberculosis infection (including 42 cases of suspected TB and 329 cases of other diseases).T-SPOT.TB had a high sensitivity of 84.3％ in TB patients and a high negative predictive value of 94.2 ％,but the specificity was 68.1％ and the positive predictive value was 41.4 ％.The Kappa value was 0.380 and the area under ROC curve was 0.762 (95％CI:0.707-0.817).T-SPOT.TB had a higher sensitivity in extrapulmonary TB than in pulmonary TB (88.2 ％ vs 78.1 ％),with the negative predictive values of 95.3 ％ and 92.6 ％,Kappa values of 0.438 and 0.299,and the areas under ROC of 0.791 (95 ％ CI:0.724-0.857) and 0.719 (95％CI:0.623-0.815),respectively.Ninety-nine cases were T-SPOT.TB positive out of 329 patients diagnosed with other diseases.Conclusions T-SPOT.TB test can be used as a method for TB diagnosis in patients without obvious TB lesions.Due to its relatively high negative predictive value,T-SPOT.TB can be used to rule out infection with Mycobacterium tuberculosis.

Objective To evaluate systematically the clinical efficacy of surgery combined with anti-TNFalpha in treatment of Crohn's disease (CD) with perianal fistula.Method Database including China Biology Medicine disc,Wan Fang Database,PubMed,Cochrane Library and EMBASE were searched withCrohn's disease,anal fistula,fistula,perianal fistula,surgical procedure,surgery,surgical,anti-tumor necrosis factoralpha,anti-TNF-alpha,TNF-alpha,克罗恩病,Crohn's病,肛瘘,手术治疗,外科手术,抗肿瘤坏死因子α制剂,肿瘤坏死因子,肿瘤坏死因子配体超家族员2”between the database establishment and June 2016.Literatures of retrospective case-control studies about surgery combined with anti-TNF-alpha therapy and single surgery in treatment of CD with perianal fistula were retrieved.Data were extracted and evaluated by 2 independent researchers.Patients who underwent surgery combined with anti-TNF-alpha therapy were allocated into the combined therapy group and patients who underwent single surgical treatment were allocated into the surgery group.The complete healing rate,partial healing rate and recurrence rate after therapy were compared between the 2 groups.Count data were represented as the odds ratio (OR) and 95％ confidence interval (CI).The heterogeneity was analyzed by theI2 test.Result Six retrospective case-control studies were retrieved and total sample size was 598 patients,including 256 in the combined therapy group and 342 in the surgery group.The result of Meta analysis showed that there was no significant difference in postoperative complete healing rate and partial healing rate between the 2 groups (OR =1.36,1.47,95 ％ CI:0.94-1.97,0.56-3.88,P ＞ 0.05),and recurrence rate after therapy in the combined therapy group was significantly lower than that in the surgery group (OR =0.26,95％ CI:0.16-0.44,P ＜ 0.05).Conclusion The complete healing rate and partial healing rate of patients with CD with perianal fistula undergoing surgery combined with anti-TNF-alpha therapy are not superior to that undergoing single surgical treatment,however,recurrence rate after therapy is lower for patients undergoing surgery combined with anti-TNF-alpha therapy.

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Objective To investigate the method and efficiency of supracondylar dome osteotomy of femur combined with arthroscopy for the treatment of the adult valgus deformity of knees. Methods From September 2008 to May 2012, 32 patients (35 knees) with valgus deformity of knees were treated with supracondylar dome osteotomy of femur combined with arthroscopy. The study group included 7 male and 25 female (average age: 43 years). The pre-operative HSS knee score was an average of 60.46. The weight-bearing knee joint AP & LAT and the full-length AP view of the lower extremity were examined before and after operation. At the same time , the femoral angle and femoral-tibial angle were measured and evaluated. The internal fixation was taken out in an average in 12 months. All the patients were followed-up and the change of the correction angles , the function of the knee and the condition of bone healing was recorded. Result The follow-up time was an average of 24 months. All the patients got a satisfied correction of the deformity, good bone union and obvious improvement of joint function. The postoperative HSS knee score was an average of 85.40. Conclusion The supracondylar dome osteotomy of femur combined with arthroscopy is a safe, reliable and effective strategy for the treatment of the adult valgus deformity of knees.

Objective To carry out a meta-analysis on the published data to evaluate therapeutic effects of intact canal wall mastoidectomy and open mastoidectomy for cholesteatoma otitis media .Methods A comprehensive search was performed in VIP (1989-2015) ,WANFANG (1999-2015) ,CNKI (1994-2015) and CAJD databases to collect the randomized controlled trials (RCTs) on the intact canal wall mastoidectomy and open mastoidectomy treat cholesteatoma otitis media ,and to analyze the RCTs in meta -analysis method .Results 1 069 patients were analyzed in the 18 RCTs which met the inclusion criteria .Patients were followed up from 3 months to 7 years .The meta-analysis results suggested that ,compared with the open mastoidectomy group ,the patients had less operative time (test for overall effect :Z=15 .54 ,MD= -18 .36 ,95% CI(-24 .54 ,-12 .18) , P<0 .000 01) ,less dry ear time (test for overall effect :Z=8 .64 ,MD= -13 .90 ,95% CI(-17 .05 ,-10 .75) , P<0 .000 01) ,less complica‐tions (test for overall effect :Z=7 .63 ,OR=0 .19 ,95% CI(0 .12 ,0 .29) , P<0 .000 01) ,and more patients with decreased pure tone air conduction thresholds >10 dB (test for overall effect:Z=2 .83 ,OR=2 .47 ,95% CI(1 .32 , 4 .61) ,P=0 .005) ,more patients with air-bone gaps <20 dB(Z=3 .05 ,OR=1 .60 ,95% CI(1 .18 ,2 .17) ,P=0 .002) ,but the recurrent rate is not different significantly (test for overall effect :Z= 1 .92 ,OR =1 .87 ,95% CI (0 .99 ,3 .53) ,P=0 .05) .Conclusion The illness is suitable to be treated by using the two surgical ways while the intact canal wall mastoidectomy treatment takes less operative time ,dry ear time and complications ,and improve hearing more significantly than the open mastoidectomy ,but the recurrent rate is not different significantly for trea‐ting cholesteatoma otitis media .

Circular RNAs are a group of novel non-coding RNA molecules, which form covalently closed continuous loop structures, lacking the terminal 5′ and 3′ ends. They are abundant in eukaryotes and have recently become an increasing area of research in the field of RNA. Circular RNAs have many functions, such as abundant expression, cell- or tissue-specific expression, and high resistance to RNase-induced degradation. They are closely related to tissue development and the occurrence and development of diseases, play an important role in the pathogenesis and development of a variety of diseases, and can be used as a novel molecular marker of some diseases. Therefore, this review summarizes the latest research progress of circular RNAs in the regulation of endocrine diseases to better understand the biological mechanisms underlying endocrine diseases.

OBJECTIVE:To study the protective effects of Li medicine Chushi qufeng decoction on arthritis model rats. METH-ODS:60 rats were randomly divided into normal group,model group,positive group and Chushi qufeng decoction high-dose,me-dium-dose and low-dose groups [45.9,22.95,11.48 g(crude drug)/kg]. Except for normal group,those groups were given chicken type Ⅱ collagen to induce arthritis model. After modeling,normal group and model group were given normal saline intragastrical-ly,once a day,for consecutive 12 d;Chushi qufeng decoction groups were given relevant medicine intragastrically;positive group was given leflunomide 4.5 mg/kg on 1st-3rd day and 1.8 mg/kg on 4th-12th day. The degree of joint lesion in rats were scored. The degree of joint swelling was determined as well as the serum levels of TNF-α,IL-1β and type Ⅱ collagen antibody. RESULTS:Compared with normal group,arthritis index,degree of joint swelling,the serum levels of TNF-α,IL-1βand typeⅡcollagen anti-body increased significantly in model group (P<0.01). Compared with model group,pathological score of positive group and Chushi qufeng decoction high-dose group decreased significantly,and serum levels of TNF-α,IL-1β and type Ⅱ collagen antibody decreased significantly in treatment groups(P<0.05 or P<0.01). CONCLUSIONS:Li medicine Chushi qufeng decoction has cer-tain protective effect on arthritis model rats induced by chicken typeⅡcollagen.

Painful diabetic peripheral neuropathy(PDPN)is a chronic complication of diabetes mellitus.The proportion of patients with PDPN is relatively high in China.At present,the latest guidelines recommend a batch of first-line analgesic drugs for PDPN treatment.Many large-scale randomized trials have confirmed the effectiveness of combination therapy.However,the pathological and physiological mechanisms of PDPN are not fully understood.The clinical treatment effect is still not ideal.This article reviews the research progress on the mechanism of PDPN occurrence.