30 and calcification distribution were the most reliable signs for the diagnosis of breast cancer. The shape and size of calcification also were helpful to the differential diagnosis of benign and malignant breast lesions.

Objective To observe the clinical efficacy of acupuncture at the six mind-calming points plus the four gate points in treating migraine.Method Totally 128 eligible migraine patients were randomized into a treatment group and a control group, 64 cases in each group. The treatment group was intervened by acupuncture at the six mind-calming points plus the four gate points, while the control group was by ordinary acupuncture. The Numerical Rating Scale (NRS), headache attack frequency, headache duration, headache intensity, complicated symptoms, Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS) were observed before and after treatment and in the follow-up study.Result The NRS scores and the headache symptoms and functions scores were significantly changed respectively after 2-week and 4-week treatment in both groups (P<0.01,P<0.05). The NRS score, headache duration, and headache intensity in the treatment group were significantly different from that in the control group after 4-week treatment and in the follow-up study (P<0.05,P<0.01). The SDS and SAS scores were significantly changed after 2-week and 4-week treatments as well as in the follow-up study in the treatment group (P<0.01). The SDS and SAS scores were significantly changed after 4-week treatment in the control group (P<0.01). There were significant differences in comparing the SDS and SAS scores between the two groups after 2-week and 4-week treatment as well as in the follow-up study (P<0.05,P<0.01). In the treatment group, the SDS and SAS scores in the follow-up study were significantly different from that after 2-week treatment (P<0.01).Conclusion Acupuncture at the six mind-calming points plus the four gate points is an effective method in treating migraine, and it can reduce headache intensity, and improve the anxiety and depression state.

Objective BOLD-fMRI was used to observe the activated auditory cortex evoked by pure tone stimuli in patients with sensorineural hearing loss and this paper is to discuss the objective measure for patient with sensorineural hearing toss. Methods BOLD-fMRI examinations were taken in 22 patients with unilateral moderate to severe sensorneural hearing loss and 15 control subjects. The volumes and intensities of the two hemispheres of the activated auditory cortex were analyzed quantitatively. Results Significant activation was found in the temporal lobe in control subjects, and significant differences in the volume and intensity were noted between the contralateral and ipsilateral activated auditory cortexes in them (P<0.01), exhibiting clearly eontralateral predominance. When the normal ear of patients with sensorineural hearing loss received signals, there was no significant difference be-tween contralateral and ipsilateral activated auditory cortexes (P>0.05). Conclusion When the normal ear of pa-tients with sensorneural hearing loss was stimulated by pure tone, the contralateral hemisphere predominance disap-peared. This result seems to show the plasticity of auditory cortex of patients with unilateral hearing loss.

Objective To investigate the expression of type Ⅱ and type Ⅲ iodothyronine deiodinases (D2 and D3 ) of human placenta on pregnant women with different thyroid diseases and different autoimmunity.Methods Pregnant women with different thyroid diseases and autoimmunity were selected into the experiment group,and pregnant women who had no individual or family history of thyroid diseases with normal thyroid function and negative thyroid peroxidase antibody (TPOAb) were selected into the control group.Expression level of iodothyronine deiodinase( D2 and D3 )on placenta was measured by RT-PCR.Results D2 and D3 were both expressed on human placenta.D2 showed significantly higher expression level in hypothyroidism uncontrolled group than that in control group ( 0.916 ± 0.035 vs 0.833 ± 0.029,P ＜ 0.05 ),however,D3 showed a lower expression(0.766 ±0.038 vs 0.848 ±0.052),on placenta and the difference was not significant(P ＞ 0.05 ).In those who had history of hyperthyroidism or hypothyroidism but whose thyroid function become normal by effective treatment,D2 and D3 expression exhibited no difference from that of the control(P ＞ 0.05).In those pregnant women with normal thyroid function and TPOAb-positive,D2 and D3 expression was (0.842 ± 0.032 ) and ( 0.837 ± 0.053 ) respectively and there was also no difference from that of the control( P ＞ 0.05 ).Conclusion D2 and D3 were simultaneously expressed on human placenta.In those pregnant women with hypothyroidism,the level of D2 expression is high and the level of D3 expression is low.Those changes might be important and helpful for the stabilization of thyroid hormone transportation between mother and fetus.

Objective To study the brain functional activation under speech stimulation in presbycusis pa‐tients using blood oxygenation level dependent functional magnetic resonance imaging (BOLD - fMRI) .Methods Eighteen normal hearing young volunteers ,10 normal hearing elderly people and 10 presbycusis patients received fM ‐RI under auditory task .Experimental tasks included monosyllabic verbal stimulating at tone of 1 kHz and sound in‐tensity to 90 dB ± 3 dB(after ambient noise detector Smart Sensor AR844 measurement and calibration) randomly transmitted to left and right ear .Following block design ,each stimulus was repeated twice .The lateralization of brain activation analysis observed changes in hemispheric dominance cases (or ear advantage change) .We observed brain activation analysis and changes of hemispheric lateralization advantage (or ear advantages) .SPM5 software was used to deal with the original pictures in the off - line work station to get fictional maps ,volume and intensity of the acti‐vated brain regions of interest ,and calculate the laterality index (LI) .Results To young people ,regardless of left or right ear stimulation ,the contralateral (region of intrest ,ROI) activation volume and intensity significantly increased compared to ipsilateral ,appearing contralateral hemispheric dominance ,and laterality index were - 0 .58 (left ear stimulation) and 0 .37 (right ear stimulation) .Compared to young people ,elderly people with normal hearing and presbycusis contralateral hemisphere conduction advantage was significantly reduced under monaural stimulation ,and the laterality indexes were - 0 .24 ,0 .28 (the aged group) ,- 0 .18 ,0 .25 (presbycusis group) .Young people received the left and the right ear auditory task respectively ,and the ratio of the total volume of bilateral ROI activation was 1 :2 .06 ,appearing to the right ear advantage (left brain dominance) .While the aged and presbycusis group manifes‐ted as right ear advantage decreased (left ear advantage enhanced) ,whose the total volume ratio was 1 :1 .51 for the old normal subjects and 1 :1 .61 for the hearing impaired seniors .Conclusion Auditory verbal tasks activated brain regions in the superior temporal gyrus and middle temporal gyrus were most obvious .Aging may cause these brain regions to be activated weaker ,appearing to the trend of contralateral hemisphere .The aging and deafness lead to the cortical reorganization .This may be one of the reasons for the declined speech recognition .

ObjectiveTo investigate the influence of positive serum thyroid peroxidase antibody (TPOAb) on pregnancy outcomes in biochemically euthyroid women during gestation.MethodsFrom July 2006 to December 2010,in the prenatal care unit all pregnant women,who had no medical and family history of thyroid diseases,underwent thyroid function screening.Serum TPOAb was tested among those pregnant women with euthyroidism.Pregnancy outcomes,including obstetric complications,neonate birth weight,and Apgar score,were compared between 185 TPOAb positive women and 1417 TPOAb negative women.ResultsCompared with TPOAb negative women,it was more frequent for TPOAb positive women to suffer from various obstetric complications.The prevalences of umbilical cord entanglement ( 18.9％ vs 12.9％,RR =1.47,95％ CI 1.06-2.03,P＜0.05 ),threatened premature delivery or abortion (3.8％ vs 1.0％,RR =3.83,95％ CI 1.57-9.37,P＜0.05 ),intrauterine growth retardation (5.4％ vs 0.8％,RR =6.96,95％ CI 3.00-16.17,P＜0.01 ),and neonatal pneumonia ( 4.9％ vs 1.3％,RR =3.83,95％ CI 1.75-8.40,P＜0.01 ) in the group of TPOAb positive women were higher than those in the group of TPOAb negative women.Apgar score of those newborns whose mothers had positive TPOAb was 9.27 ±1.13 at one minute and 9.44 ± 1.09 at five minutes,being lower than that of the TPOAb negative group (9.49 ±0.69 and 9.68 ±0.52,both P＜0.01 ).The rate of newborns with Apgar score at 7 or less by 5 min in group with positive TPOAb was higher than that of group with negative TPOAb ( 1.6％ vs 0.1％,RR =11.49,95 ％ CI 1.93-68.31,P＜ 0.05 ).ConclusionsThese results indicate that pregnant women with normal thyroid function but positive TPOAb may be liable to increase risk of serious pregnancy outcomes,such as threatened premature delivery or abortion,intrauterine growth retardation,and a lower Apgar score in neonatal.

Objective To investigate the prevalence of thyroid disorders and positive thyroid autoantibodies,and evaluate the necessity for universal thyroid screening during the second and third trimesters of pregnancy.Methods The pregnant women during the second and third trimesters who visited Shanghai Jiaotong University Affiliated First People's Hospital between June 2006 and February 2008 were chosen for thyroid screening by determining serum free triiodothyronine,free thyroxine,thyrotropin,thyroid peroxidase antibody (TPOAb),and thyrotropin receptor antibody.A personal and family history of thyroid disease and other autoimmune diseases was investigated by questionnaire.The pregnant women were divided into high risk or low risk groups for thyroid disease based on their personal or family histories.Results A total of 2 101 pregnant women were screened,712 ( 33.89％ ) of them were identified to suffer from thyroid disorders or with positive thyroid autoantibody.The prevalence of thyroid dysfunction was increased in high risk group.While in low risk group( n =1 983 ),the prevalence of clinical hypothyroidism was 2.27％ ( n =45 ),subclinical hypothyroidism 11.60％ ( n =230 ),clinical hyperthyroidism 0.20％ ( n =4 ),subclinical hyperthyroidism 1.06％ ( n =21 ),hypothyroxinemia 6.45％ ( n =128 ),and euthyroid with positive TPOAb 10.74％ ( n =213 ) in our study.Pregnant women with positive TPOAb were susceptible to thyroid dysfunction.It was shown that 79.74％ of pregnant women with thyroid disorders were diagnosed by universal thyroid screening.Conclusions 33.89％ of pregnant women in the second and third trimesters were identified to suffer from thyroid disorders or positive thyroid autoantibody by universal thyroid screening.Increased prevalence of thyroid dysfunction was found in pregnant women with positive TPOAb.79.74％ of pregnant women with thyroid disorders might be missed if screening was made only in the high risk cases.

Objective To analyze the factors affecting the effects of hearing aids in presbycusis patients . Methods One hundred and twenty cases with presbycusis were investigated by using general data and the Satisfac-tion with Amplification in Daily Life questionnaire(SADL) .The individual scores and total scores of all the subjects were collected together with the personal information ,including age ,gender ,degree of education ,pure-tone aver-age ,hearing aid type ,monaural/binaural status ,total hearing aid experience ,daily use time ,the time of perceived hearing difficulty .A single factor analysis and multiple stepwise regression analysis were used to filter out main fac-tors influencing the effect of hearing aids .Results The degree of education ,hearing aid type ,monaural/binaural status ,daily use time ,the time of perceived hearing difficulty were factors influencing the effect of hearing aids . The patients with higher level of education ,the longer daily use ,binaural status obtained more scores than those of the low degree of education ,the shorter daily use ,and monaural status( P< 0 .01) .The older people felt better than the youngers(P<0 .01) .The patients with long -time perceived hearing difficulty got more scores than those with short -time perceived hearing difficulty (P<0 .01) .In general ,the degree of education ,and the daily use time were the main factors influencing the effects of hearing aids .Conclusion There are many factors that influence the effects of hearing aids ,in which the degree of education ,daily use time are the main factors ,and the combination of the two factors obtain the effects of hearing aid maximization ,and the binaural status ,the short time of perceived hearing difficulty and the older obtain better satisfaction .The gender doesn't significantly influence the effects of the hearing aids .

AIM:To explore the ability of different group B streptococci ( GBS) strains on inducing platelet activation.METHODS:Six strains of GBS, separated from the septic patients with thrombocytopenia, were used as the inducers.Light transmission aggregometry was used to measure platelet aggregation.Scanning electron microscopy ( SEM) was performed to investigate the interaction of platelets with bacteria.The expression of platelet CD62P, Toll-like receptor 2 ( TLR2) and TLR4 was determined by flow cytometry and Western blotting.Furthermore, the activity of platelet TLR2 (or TLR4) was blocked by anti-TLR2 (or anti-TLR4) monoclonal antibody, and the platelet aggregation induced by GBS was detected.RESULTS:Only 3 of 6 GBS strains isolated from the septic patients induced platelet aggregation and up-regulated the expression of CD62P and TLR2 in the platelets (P<0.05), but not TLR4.Incubation with anti-TLR2 anti-body, but not anti-TLR4 antibody, significantly blocked platelet aggregation induced by GBS.CONCLUSION:Some GBS strains from the patients are able to trigger platelet activation in vitro, and platelet TLR2 may play an important role in the interaction between GBS and platelets.

This study was aimed to evaluate the feasibility of wind-warm lung-heat disease (non-severe community-acquired pneumonia, CAP) from the clinical curative effect, hospitalization days, medical expenses and other aspects. This study selected 198 wind-warm lung-heat disease (non-severe CAP) inpatients from January, 2012 to December, 2012 with the conventional therapy in the Respiratory Department, Wuhan Integrated Traditional Chinese Medicine (TCM) & Western Medicine Hospital as the control group. And another 179 wind-warm lung-heat disease (non-severe CAP) inpatients were selected from January, 2013 to December, 2013 with the TCM clinical pathway treatment in the Respiratory Department of the same hospital as the treatment group. Retrospective analysis was used to compare the clinical curative effects, hospitalization days, and medical cost differences. The results showed that TCM clinical pathway for wind-warm lung-heat disease (non-severe CAP) can shorten the hospitalization days and reduce patients’ medical costs, and ensure the clinical curative effects. It was concluded that the standardized TCM clinical pathway had positive effect on wind-warm lung-heat disease (non-severe CAP). Therefore, the formulation and implementation of TCM clinical pathway was of great significance in the treatment of wind-warm lung-heat disease (non-severe CAP).