Infertility can be resulted from ovulation barrier, fallopian tube obstruction, endometriosis and abnormal immune functions. From "kidney dominating reproduction" angle, a lot of document materials on the treatment of infertility with Chinese medicine are summarized. The treatment of Chinese medicine on infertility have positiv eclinical effects and outstanding advantages.

Objective To compare the clinical features and treatment between elderly onset rheumatoid arthritis(EORA)and young onset rheumatoid arthritis(YORA).Methods The EORA patients (n=60)and the YORA patients (n =90)were compared regarding sex ratio,activity of pathogenetic condition,disease severity,extra-articular manifestations,complications,laboratory indexes,and therapeutic schedules.Results The female/male ratio was 36/24(1.50 ∶ 1.0)in group EORA,and 69/21(3.3 ∶ 1.0)in group YORA,with higher female/male ratio in in group YORA.The frequency of morning stiffness,proximal interphalangeal joint involvement and metacarpophalangeal joint involvement were lower in group EORA(53.3 ％,46.676％ and 61.67 ％) than in group YORA (72.2 ％,77.8 ％,81.11％) (x2 =5.521,15.385,6.960,P =0.018,0.000,0.008 respectively).Large joints involvement at onset of rheumatoid arthritis was higher in group EORA(38.33 ％)than in group YORA(18.89 ％)(x2=6.960,P=0.008).The joint swollen and tender counts were comparatively less (16.51 ± 7.34) and (15.92 ± 8.44) in group EORA than in group YORA(22.46 ± 7.58) and (23.8 ± 8.93) (t =5.080、5.740,all P =0.000) respectively.The accumulated disease activity score(DAS28)was higher in group EORA(5.86± 1.57)than in YORA(4.92± 1.64) (t=3.360,P =0.001).HAQ score was lower in group EORA(0.83 ± 0.85)than in group YORA (1.16±0.91) (t=2.43,P =0.02).Comorbid conditions such as osteoarthritis,osteoporosis,cardiovascular disease and chronic renal insufficiency were more frequent in group EORA (51.7 ％,31.7 ％,18.3 ％ and 15.00％)than in group YORA(27.8％,15.6％,5.6％ and 4.4％)(x2 =11.722,5.445,6.168,5.067,P=0.001,0.020,0.013,0.024).The positive rate of RF were more higher in YORA(70.00％)than in group EORA (48.33％)(x2 =7.126 P=0.008).The synthetic or biologic traditional DMARDs (disease modifying antirheumatic drugs)were widely used in group YORA(78.9％ and 31.1％)than in group EORA(40.0％ and 10.0％)(x2 =14.940,9.153,P =0.000,0.002).The more frequently used program with glucocorticoids hormonal therapy was received in group EORA(38.3 ％)than in group YORA(20.00 ％)(x2 =6.092 P=0.014) Conclusions EORA patients differs from YORA patients in many of ways,including a more balanced gender distribution,atypical presentation at onset of disease,more frequent involvement of large joints,seronegativity in a higher percentage,and less frequent positivity of anti CCP-antibody,which makes diagnosis more difficult in the earlier period.Therapy of EORA with DMARDs should be instituted based on disease activity,if there is no contraindication.

Objective:To investigate the gross motor function, manual ability and language communication of children with cerebral palsy (CP) and their correlation.Methods:A total of 318 children with CP (132 with spastic diplegia, 27 with spastic quadriplegia, 32 with spastic hemiplegia, 54 with dyskinesia, 41 with ataxia and 32 children with multiple difficulties) aged 4 to 12 years were classified according to the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). Spearman correlation coefficients were used to analyze the correlation among the three ratings.Results:Only 125 of the 318 children (39%) had the same classification level according to all three scales, showing moderate correlation and different levels for patients with different types of disability. The GMFCS and MACS levels of the subjects with spastic quadriplegia and those with dyskinesia were highly correlated. The GMFCS and CFCS levels of the hemiplegic children and those with spastic quadriplegia were also highly correlated. The MACS and CFCS levels were strongly correlated for children with spastic quadriplegia and multiple disabilities.Conclusions:The functioning of children with CP differs with their CP subtype. Correlations among the three functional assessments also differ for children with different subtypes. Combining the three classification systems provides a more comprehensive picture of the children′s ability to function in daily life.

By feeding rats with high-fat diet insulin resistant models were induced.Some of the models were treated with intragastric administration of curcumin,then the effects were evaluated by hyperinsulinaemic-euglycaemic clamp technique.Curcumin reduced the level of serum resistin and the expression of resistin mRNA in adipose tissue,and thus ameliorated insulin resistance in rats.

Objective : To assess the health risks of polycyclic aromatic hydrocarbons（PAHs）exposed through cereal,fried and grilled foods in Hangzhou. Methods : A cross-sectional study was conducted to collect food consumption data of three inconsecutive days among 1 769 subjects selected by probability proportional to size sampling method from two districts in Hangzhou.Fifty samples of fried and grilled food and twenty samples of cereal were collected from five districts in Hangzhou. They were tested for B（a）P,PAH2,PAH4 and PAH8 by high performance liquid chromatography coupled with triple quadrupole gas chromatography-tandem mass spectrometry. The probabilistic models were established for the evaluation of PAHs exposure by @risk software and then margin of exposure（MOE）was calculated. Results : The contents of B（a）P in one sample of fried and grilled food exceeded the limit. The median contents of PAHs ranged from 0.20 to 3.64 μg/kg. The median exposures of B（a）P,PAH2 and PAH4 from both two kinds of foods were 1.54,3.54 and 8.13 ng/（kgbw·d）in the mixed model,1.61,3.76 and 8.09 ng/（kgbw·d）in the non-parameter model. The MOEs of≤95% PAHs exposure level in one kind of food or ≤90% PAHs exposure level in both kinds of foods were more than 10 000. The MOEs of ≥97.5% exposure level of B（a）P,≥95% exposure levels of PAH2 and PAH4 in both kinds of foods in the mixed model,and ≥95% exposure levels of B（a）P,PAH2,PAH4 in both kinds of foods in the non-parameter model were less than 10 000. Conclusion The health risk of PAHs exposure was very low in more than 90% of the population in Hangzhou. However,for high-end consumers,97.5% or 99% exposure level in one kind of food and 95% exposure level in both kinds of foods had a potential health risk.

Setting up the innovative and entrepreneurship education and teaching system is the important content of the current university education reform. Through the idea of leading innovation with entrepreneurial practice, we have implemented a series of education reforms in the students of medical laboratory technology, reformed the teaching methods and content, set up the tutors for undergraduates and improved the scientific research ability of students. The results show that the education reforms have enhanced the ability and sense of innovation, providing a good reference for the reform of innovation and entrepreneurship education in medical laboratory technology.

ObjectiveTo explore the value of Tth-single strand binding protein (SSB) used as an additive to improve the polymerase chain reaction (PCR) specificity for single nucleotide polymorphisms(SNP) alleles genotyping.MethodsTth-SSB plasmid was constructed and the protein was expressed,then the expressed Tth-SSB was added into PCR system detecting cytochrome P450 Protein ( CYP2C19 * 3,636G＞A)genotype to determine the optimal usage and condition.Then,the genotypes of 30 cerebral ischemia patients were tested with established methods and compared with direct sequencing to verify the accuracy of Tth-SSB as an additive into PCR for SNP genotyping.ResultsThe purity of Tth-SSB was 85％ and optimal dosage was 1 μg.The protein could improve the specificity and reduce the dimer when Tth-SSB was added into the PCR system.Thirty patients genotyping results as follow:26 patients belong to G/G homozygote,4 patients belong to G/A heterozygote,no body belong to A/A homozygote.The coincidence acquire 100％ with parallel sequencing.ConclusionAs an additive,Tth-SSB could significantly improve the accuracy of genotyping by eliminating non-specific bands.

Objective To compare theγpassing rate between measurements at actual degree gantry angle and zero degree gantry angle for dose verification of intensity?modulated radiotherapy ( IMRT) in the treatment of nasopharyngeal carcinoma ( NPC) and cervical carcinoma. Methods Thirty patients with NPC and thirty patients with cervical carcinoma were randomly chosen from 87 patients with NPC and 54 patients with cervical carcinoma, respectively. Using a gamma criterion of 3 mm/3%, the γ passing rates at actual gantry angle and zero degree gantry angle were measured using ArcCHECK and compared by paired t test. Results The γ passing rate was significantly lower at actual gantry angle than at zero degree gantry angle in patients with NPC or cervical carcinoma ((93.8±3. 6)% vs. (97.8±1. 1)%, P=0. 00;(96.3±2. 1)% vs. (98.2±1. 0)%, P=0. 00). Moreover, the variation range of the γ passing rate at actual gantry angle was larger than that at zero degree gantry angle. Bothγpassing rates at actual gantry angle and zero degree gantry angle were lower in the patients with NPC than in the patients with cervical carcinoma . Conclusions Compared with that at zero degree gantry angle, theγpassing rate at actual gantry angle is closer to reality. Therefore, the actual gantry angle is recommended for dose verification. In order to meet the clinical requirement, a higher standard of γ passing rate should be proposed when zero degree gantry angle is used for dose verification.

Objective To observe the visual acuity change in patients with different patterns of optical coherence tomography (OCT) of diabetic macular edema (DME) after intravitreal ranibizumab injection and/or laser photocoagulation.Methods A retrospective observational case series.Seventy patients (99 eyes) with DME were enrolled.Best-corrected visual acuity (BCVA) was evaluated using the international vision test chart,and then convert the result to the logarithm of the minimum angle of resolution (logMAR).According to the morphological characteristics of OCT,the DME was divided into 3 patterns,including diffuse macular edema (DRT),cystoid macular edema (CME) and serous neuroepithelial layer detachment.The average follow-up was (80.43 ± 74.89) days.The patients were divided into 3 groups according to the different treatments,including intravitreal ranibizumab injection group (group A,21 patients,25 eyes),intravitreal ranibizumab injection and laser photocoagulation group (group B,23 patients,26 eyes),laser photocoagulation group (group C,26 patients,48 eyes).The changes of absolute BCVA (ABCVA) and improved visual acuity were compared between different treatment groups and different OCT patterns.ABCVA =logMAR BCVA before treatment-logMAR BCVA after treatment.Improvement more than 0.3 of logMAR value was considered as improved visual acuity.Results There was no significant difference in ABCVA between different treatment groups (F=0.050,P＞0.05).The improved visual acuity in group A and B were great than group C (x2=5.645,6.301;P＜0.05).In group A,B and C,there was no significant difference in ABCVA and improved visual acuity between different OCT patterns (P＞0.05).Improved visual acuity of DRT and CME eyes were higher in group A&B (70.59％ and 50.00％) than in group C (26.47％ and 14.29％),the difference was statistically significant (x2=5.075,4.453;P＜0.05).Conclusions There is no obvious change of visual acuity in patients with different OCT patterns of DME after the same treatment by intravitreal ranibizumab injection and/or laser photocoagulation.The improved visual acuity is not consistent in same OCT patterns after different treatment.

To investigate the assessed value of serum lactate dehydrogenase (LDH) and vascular endothelial growth factor (VEGF) for short-term efficacy of transcatheter arterial chemoembolization (TACE). Methods: Serum concentrations of LDH and VEGF from 70 patients with primary liver cancer on the 1st day before therapy and the 3rd, 7th, 14th, and 21st day after TACE ther-apy was determined. The benefit group includes complete remission, partial remission, and stable disease, while the invalid group in-cludes only disease progression. Results:The serum levels of LDH and VEGF in the invalid group were significantly higher than those in the benefit group on the 14th and 21st days after TACE (P<0.05). The percentage changes of the serum concentrations of LDH and VEGF in the invalid group were higher than those in the benefit group on the 21st day after TACE. Percentage changes on the 21st day after TACE were drawn into the ROC curve;the areas under the curve were 65.9%and 85.5%. The optimal cutoff points of LDH and VEGF, which correspond to the Youden index, were 0.272 and 0.745, respectively. Conclusion:The expression levels of VEGF and LDH can be used to assess the short-term efficacy of TACE. A lower expression level corresponds to short-term efficacy.