Objective To know the current status and problems of Traditional Chinese Medicine Clinic and to provide countermeasures.Methods Using literature research and statistical analysis.Results From 2008 to 2014,the number of institutions,health personnel and services of Traditional Chinese Medicine Clinic rose year by year.The Traditional Chinese Medicine Clinic was ahead of TCM-WM Clinic and Minority Clinic.The increase number and increase rate of the number of Traditional Chinese Medicine institutions,health personnel and services are more than TCM-WM Clinic and Minority Clinic.The age constitute is unbalance and the quality of personnel is different in Traditional Chinese Medicine Clinic.Conclusion The government should conduct multi-site practice.Traditional Chinese medicine clinics and other private medical institutions should have the equitable health care treatment.The development in preventive treatment of disease by TCM should be focused on.

BACKGROUND:microRNA-17 is confirmed to play an important role in the development of pulmonary hypertension. Some research has shown that hypoxia-induced proliferation in human pulmonary artery smooth muscle celldepends on the induction of arginase II. There is no report about whether there is some interaction between microRNA-17 and arginase II in human pulmonary artery smooth muscle cells.
OBJECTIVE:To investigate the possible interactions between microRNA-17 and arginase II in hypoxic human pulmonary artery smooth muscle cells.
METHODS:Passage 4 human pulmonary artery smooth muscle cells were cultured in 21%O 2 and 5%CO 2 (normoxia) or 1%O 2 and 5%CO 2 (hypoxia), and then transfected with mimic or inhibitor of microRNA-17 or arginase II-smal interfering RNA. RNA, microRNA and protein were isolated separately. Expression of microRNA-17 and arginase II was detected with real-time quantitative PCR and western blot assay. RESULTS AND CONCLUSION:The level of microRNA-17 was significantly increased in cultured human pulmonary artery smooth muscle cells exposed to 1%O 2 hypoxia, as was arginase II mRNA and protein expression. Furthermore, inhibition of microRNA-17 expression decreased the mRNA and protein levels of arginase II in the human pulmonary artery smooth muscle cells under hypoxia. Conversely, over-expression of microRNA-17 increased the mRNA and protein levels of arginase II in the human pulmonary artery smooth muscle cells under normoxia and hypoxia. Knockdown of arginase II by siRNA abolished the hypoxia-induced up-regulation of microRNA-17 expression. These findings indicate that arginase II is a target gene of microRNA-17 and can regulate the expression of microRNA-17 in human pulmonary artery smooth muscle cells.

Objective To study the effect of various treatments for the Budd-Chiari syndrome (BCS). Methods The clinical data of different treatments in 260 BCS patients were analysed retrospectively. Results Of the 260 patients,273times of BCS underwent interventional treatment?operative treatment or the combination of operation and interventional therapy, including percutaneous transluminal angioplasty(PTA) or/and stenting of the inferior vena cava(IVC)in 149 cases (160 times), percutaneous transhepatic angioplasty or/and stenting of the hepatic venous in 15 cases (17 times ),the combination of the two methods in 10 cases,radical resection in room temperature in 8 cases, mesocaval shunt in 16 cases,mesojugular shunt in 5 cases,mesoatriumr shunt in 8 cases,IVC-atrium shunt in 6 cases,splenopneumoexy in 18 cases, mesocaval shunt combined with PTA and stenting of the IVC in 17 cases, and transcardic membranotomy combined with PTA and stenting of the IVC in 8 cases . Two patients died in the operation:One died of cardiac tamponade,and the another died of operrative hemorrhagic shock.During the follow-up period of 3 months～6 years,20 patients recurred,of whom 7 died of hepatic failure,the other patients recovered satisfacorily. Conclusions The interventional treatment is the first choice for BCS.For patients unable to get interventional treatments or failure for interventional treatments, operation or operation combined with interventional therapy should be considered.

Objective:To explain the mechanism of benefiting qi and activating blood formula on chronic heart failure (CHF)by observing the signal transduction through the medium of AngⅡ,PKC in rat myocardium.Methods:Healthy male SD rats were selected and CHF model were made by ligation of coronary artery combined with starvation and exhausted swimming. Successful model rats were randomly divided into 4 groups:model group,Chinese medicine high dose group,Chinese medicine middle dose group,west medicine control group,each group with 8 rats.In addition,normal control group was set.After 8 weeks, the content of AngII,PKC in myocardial tissue was tested by ABC immunohistochemical method,and the ultrastructural changes of myocardial cell were observed with transmission electronic microscopy.Results:Compared with normal control group,heart function decreased obviously(P

Objective To investigate whether the accelerator image beam line (IBL) full scan and extend field of view(EFOV) scan mode megavoltage cone beam CT(MV CBCT) images can be used for dose calculation in adaptive radiotherapy.Methods The large aperture CT and MV CBCT were used to scan the CIRS 062M electron density modules,the CT value was established to electron density curves in the Pinnacle treatment planning system.Also,CT and MV CBCT were used to scan the head and neck,chest,abdomen and pelvis phantom.The intensity modulated radiotherapy(IMRT) plans were made with CT images and transplanted to MV CBCT images.The dose of targets and organs with their electron density curves was calculated,and two type IMRT plans with different CT images were compared.Results The dose distribution of head and neck phantom was acceptable,compared with the reference plan,the difference was within 3 ％.The dose distribution of chest and.pelvis was significantly reduced from reference plans,and the difference was 5％ and 10％ separately.This difference was beyond the scope of clinical acceptance.Conclusions MV CBCT images of accelerator IBL full scan mode in patients with head and neck site scan could be used for dose calculation in adaptive radiotherapy,chest and pelvic sites in EFOV mode scanning MV CBCT images could only be used for image guidance.

Objective To determine the peripheral dose ( PD) of a Trilogy accelerator under different conditions and the feasibility of PD measurement using the semiconductor diode ionization chamber. Methods In a solid water phantom, a CC13 air?filled ionization chamber and a semiconductor diode ionization chamber were used for PD measurements with different distances (13 measurement locations within 1?31 cm) , depth ( 3, 5, 15 cm) , field sizes ( 10, 20, 30 cm) , wedge ( W15, W45, VW15, VW45) , and beam energy (6, 18 MV). The relationship of PD with PDleakage and PDscat er was determined by removing the scatter phantom. Simulating the patients with cervical cancer undergoing radiotherapy, a CIRS phantom received volumetric modulated arc therapy ( VMAT) , step?shoot intensity?modulated radiotherapy ( IMRT) , and sliding?window IMRT to measure PDs of the breast, thyroid, and lens. All the data were normalized to the isocenter. Results PD was gradually reduced with the increase in distance ( 13?41% at 1 cm from the edge to 0?25% at 31 cm from the edge) . With a fixed distance from the edge of the radiation field, there was no significant difference in PD between different depths. A radiation field with a size of 30 cm had a PD about two?fold higher than that with a size of 10 cm. PD increased with the increase in the physical wedge angle and increased by 1% compared with the open field;PD decreased with the increase in the virtual wedge angle and decreased by 2?3% compared with the open field. PD decayed from 13?35% at 1 cm to 0?23% at 31 cm under 6 MV X?ray and from 11?06% at 1 cm to 0?20% at 31 cm under 18 MV X?ray. Dscat er was dominant in the regions close to the edge of radiation field and decreased from 62?45% at 1 cm to 5?71% at 25 cm. In all measurements under 6 MV X?ray, the maximum proportion difference between CC13 ionization chamber and diode ionization chamber was less than 1%. PDs of the breast, thyroid, and lens were 6?72, 2?90, and 2?37 mGy in VMAT mode, 7?39, 4?05, and 2?48 mGy in step?shoot IMRT mode, and 9?17, 4?61, and 3?21 mGy in sliding?window IMRT mode, respectively. Conclusions For the measurement of PDs, the CC13 air?filled ionization chamber and semiconductor diode ionization chamber have good consistency and feasibility under 6 MV X?ray. In clinical practice, the understanding of the relationship of PD with different radiation conditions helps to reduce the doses to organs at risk. Shielding and protective techniques can further reduce dose deposition.

Objective:To explore the relationship between somatic symptoms of major depressive disorder(MDD)and cortisol(COR) rhythm, C-reactive protein(CRP) and other immune-metabolism-related indicators, and understand its mechanism from the perspective of endocrine and immune regulation.Methods:A case-control study was conducted in hospitalized patients with MDD who met DSM-5 diagnostic criteria.According to the Patient Health Questionnaire (PHQ-15), PHQ-15 ≥10 were classified as the somatic major depressive disorder group(S-MDD group) and 73 patients were enrolled.PHQ-15 <5 was classified as the non-somatic depressive disorder group (NS-MDD group) and 70 patients were enrolled.Plasma cortisol (COR8, COR16 and COR24) levels were measured at 8∶00, 16∶00 and 24∶00 on the same day, plasma CRP and interleukin-6 (IL-6) level, serum uric acid (UA), blood glucose (GLU), blood lipid (TC, TG, HDL, LDL) level were detected at 8∶00.Independent sample t test, non-parametric test, chi-square test, repeated ANOVA, covariance analysis, and multivariate Logistic regression were used for statistical analysis. Results:①Time effect, grouping effect and the interaction effect of the time and grouping in the level of COR were statistically significant ( P<0.05). Covariance analysis excluded age as an influential factor, COR16, AUC(total cortisol output/area under the curve, AUC) and COR8-16 in S-MDD group ((90.50±40.57)μg/L, (1 425.12±564.78), (-6.43±5.76))were higher than those in NS-MDD group((68.74±31.51)μg/L, (1 251.57±456.61), (-8.77±5.48)), and the difference was statistically significant ( F=8.971, 4.320, 8.731, P<0.05). ②CRP in S-MDD group ((1.41±1.06)mg/L) were higher than that in NS-MDD group((0.61±0.53)mg/L), and the difference was statistically significant ( F=25.436, P<0.05). The proportion of patients with higher CRP level(CRP≥1 mg/L) in S-MDD group(58%) was higher than that in NS-MDD group(23%), and the difference was statistically significant(χ 2=17.824, P<0.01). ③Multivariate logistic regression analysis found that CRP ( OR=4.953, 95% CI: 2.407-10.193), COR8-16 ( OR=3.451, 95% CI: 1.380-8.633) were main risk factors of somatic symptoms of MDD ( P<0.05). Conclusion:Cortisol rhythm disturbance and high CRP level may be the biological basis of somatic symptoms in patients with MDD.

Objective To compare the relative dose of small fields measured by clinically common detectors and those obtained from Monte Carlo simulation in order to obtain the accurate measurement method, and to modify the inappropriate detectors.Methods The percentage depth-dose distribution curve and profile (flatness and symmetry) curves were collected at 2 cm×2 cm, 3 cm×3 cm, and 4 cm×4 cm under 6-MV X-ray of Trilogy linear accelerator by CC13, PFD, SFD, and blue phantom.The results were compared with the stimulation results from Monte Carlo method (the current gold standard).The correction factors for the detectors with large error were calculated to provide reference data for clinical practice.Results The results measured by SFD detector were most close to the results from Monte Carlo simulation.The measurement errors of CC13 and PFD detectors were large.The correction factor in the penumbra for CC13 and PFD detector was 0.664-1.499.Conclusions SFD detector is better than CC13 and PFD detector in the measurement of small fields, but CC13 and PFD detector can provide reference data for clinical practice after the corresponding correction.

Objective:To review the patients with supramitral ring (SMR) and summary echocardiographic features and operative prognosis in these patients.Methods:Clinical and echocardiographic data of 53 patients with SMR treated in Fuwai Hospital from Jan 2016 to Jan 2020 were reviewed. Patients were divided into simple group( n=28) and complex group( n=25) based on mitral apparatus normal or not. The echocardiographic characteristics, morphology of the rings, procedure′s results and follow-up data were recorded and assessed. Results:There was no significant difference in age, peak and mean mitral value(MV) gradient before surgery between the two groups (all P>0.05). Patients with mitral regurgitation and left outflow tract obstruction in complex group were more than in simple group (all P<0.05). All patients underwent cardiac operation. The average follow-up were(14.69±11.14)months. The overall missed diagnosis was 13%. The missed diagnosis rate in complex group was higher(20% vs 7%). The peak and mean MV gradient in all patients after surgery were reduced (all P<0.05), but the gradients in complex group were higher than simple group(all P<0.05). Restensis occurred in 3 patients in each group after surgery, in which 3 patients in complex group accepted reoperation. Conclusions:Echocardiography can diagnose different types of SMR and associated malformations, evaluate surgical outcomes, and follow up for recurrence of SMR. Patients with simple SMR have better surgical results, but there is still a certain recurrence rate of stenosis.

Objective:To investigate the association of body mass index (BMI), blood lipid, serum leptin, adiponectin with papillary thyroid carcinoma.Methods:A total of 120 patients including 40 cases of papillary thyroid carcinoma (papillary thyroid carcinoma group), 40 cases of nodular goiter (nodular goiter group) and 40 cases diagnosed without thyroid diseases or other metabolic diseases during the corresponding period (the control group) in Inner Mongolia People's Hospital from April 2015 to January 2016 were enrolled. The BMI of all subjects was calculated. The levels of blood lipid, serum leptin and adiponectin were detected.Results:The number of females was more than that of males in nodular goiter group and papillary thyroid carcinoma group, and the difference in gender distribution of three groups was statistically significant (χ 2 = 19.024, P < 0.01). The level of BMI, leptin, triglyceride and total cholesterol of papillary thyroid carcinoma group was higher than that of the control group [(24.86±3.26) kg/m 2 vs. (20.79±2.15) kg/m 2, (0.68±0.07) ng/ml vs. (0.61±0.39) ng/ml, (1.42±0.53) mmol/L vs. (1.05±0.36) mmol/L, (4.76±0.57) mmol/L vs.(4.28±0.46) mmol/L], and the differences were statistically significant ( t values were 4.302, 3.296, 1.993 and 2.177, respectively, all P < 0.05). The level of total cholesterol and low-density lipoprotein [(4.97±0.55) mmol/L, (2.72±0.58) mmol/L] in the nodular goiter group was higher than that in the control group [(4.28±0.46) mmol/L, (2.18±0.69) mmol/L], and the differences were statistically significant ( t values were 2.954 and 2.148, respectively; all P < 0.05). The level of adiponectin [(4.21±0.34) ng/ml, (4.30±0.27) ng/ml] in papillary thyroid carcinoma and nodular goiter group was lower than that in the control group [(4.87±0.27) ng/ml], and the differences were statistically significant ( t values were 7.631 and 7.416, respectively; all P < 0.05). Conclusion:The increase of BMI, triglyceride, total cholesterol, serum leptin and the decrease of serum adiponectin may be related to the occurrence of papillary thyroid carcinoma.