Objective: To explore the feasible methods for item selection of TCM syndrome scale.Methods:Elderly hypertension with syndrome of kidney qi deficiency was selected as example.The symptoms and signs of elderly hypertension patients were statistically analyzed with clinical epidemiological investigation on the basis of discussion among focus group and expert consultation.Six selection methods were used,such as correlation coefficient method,dispersion tendency method,factor analysis method,etc.Results:18 Items were selected in the end and constituted the preliminary scale of kidney qi deficiency of elderly hypertension.Conclusion:Only if combine subjective and objective selection methods,use kinds of proper statistical methods and master the scale of preserving items,can we acquire good reliability and validity of scale.

AIM To evaluate the value of arsenic trioxide (ATO) in the treatment of systemic lupus erythematosus and to investigate its mechanism. METHODS① Thirty four BXSB lupus mice were averagely and randomly divided into ATO treated group and control group. The mice of ATO treated group were given (ip) ATO 0.4 mg·kg-1 every other day until d 105 and the observation was ended on d 210. The survival rate of mice was recorded, and the levels of serum IgG and anti-dsDNA antibody were measured with enzyme-linked immunosorbent assay. ② Other 20 BXSB lupus mice were also divided into 2 groups and treated as above and sacrificed on d 90. The spleen and kidneys of each mouse were removed and total RNA was extracted. The levels of interferon-γ (IFN-γ) mRNA in renal and spleen tissues were measured by using reverse transcription polymerase chain reaction. RESULTSUp to d 210, 8 mice died in ATO treated group and 13 died in control group. On d 90 and d 105, the average levels of serum anti-dsDNA antibody (A450 nm) were (0.335±0.011) and (0.223±0.017) in ATO treated group, and (0.688±0.016) and (0.683 ±0.014) in control group. On d 90, the expressions of IFN-γ mRNA in spleen and renal tissues of ATO treated group were significantly lower than that of control group. On d 105, the serum level of IgG was much lower in ATO treated group than that in control group, which were (4.9±1.3) and (6.9±1.0)g·L-1, respectively. CONCLUSION ATO elevates the survival rate, lowers the serum levels of IgG and anti-dsDNA antibody, and depresses the expression of IFN-γ mRNA in spleen and kidney tissues of BXSB mice.

Objective To study the Val247Leu and Trp316Ser polymorphisms of β2-glycoprotein Ⅰ(β2GPⅠ) in systemic lupus erythematosus (SLE) patients and their associations with antiphospholipid antibodies and thrombotic complications.Methods We used DNA sequencing to detect the polymorphisms of Val247Leu and Trp316Ser in 378 SLE patients and 240 normal controls.Anti-β2GP Ⅰ antibodies and anticardiolipin (ACA) were tested by enzyme linked immunosorbent assay (ELISA).Lupus-type anticoagulants(LAC) was performed by diluted Russell's Viper Venom Test.Then the patient group was further analyzed according to APLs (Anti-β2GP Ⅰ antibody,LAC and ACA),thrombosis and obstetrical complications using Logistic regression analysis to confirm whether there are associations between β2GPⅠpolymorphism and those factors.Results For Va1247Leu,the predominant genotype was LL in healthy controls which accounted for 57.08％,while it was VL in SLE patients which accounted for 59.5％ (x2=45.01,P=0.000).Frequency of VV genotype was significantly higher in patients with thrombosis,anti-β2GP Ⅰ,ACA and obstetrical complications (OR=6.79,3.75,2.12 and 3.85,respectively;P=0.000,0.001,0.044 and 0.017,respectively).Those patients with VL genotype tended to have positive anti-β2GPI,LAC,ACA,thrombosis and also obstetrical complications (OR=2.95,1.88,2.47,2.97 and 2.74,respectively;P=0.000,0.007,0.000,0.001 and 0.016,respectively) than those negative ones.The predominant genotype of Trp316Ser was TT,then TS.No correlations could be found between Trp316Ser polymorphism and APLs,neither relation to thrombosis complications.Conclusion The polymorphism of Val247Leu is significantly associated with the presence of APLs,thrombosis and obstetrical complications.Both VV and VL genotype are risk factors for the generation of APLs,occurrence of thrombosis and obstetrical complications.The VV genotype is a high risk factor for thrombosis.Trp316Ser polymorphism does not contribute to the APLs production and also have no correlations with thrombotic complication.

Objective To explore the correlation between B lymphocyte activation and CD154 expression and lupus anticoagulants (LAC) in patients with systemic lupus erythematosus (SLE). Methods Sixty newly diagnosed SLE patients (SLE group) and 32 healthy controls (control group) were involved. The expressions of CD27 and CD154 in peripheral blood were determined by flow cytometry, and the positive expression rates were computed. The LAC was determined by activated partial thromboplastin time, and the LAC ratio > 1.20 was positive. Results The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE group were significantly higher than those in control group: 0.047 ± 0.021 vs. 0.035 ± 0.014, 0.387 ± 0.185 vs. 0.214 ± 0.091, 0.191 ± 0.108 vs. 0.101 ± 0.081 and 0.049 ± 0.018 vs. 0.022 ± 0.012, and there were statistical difference (P<0.05 or <0.01). Among patients with SLE, the LAC positive was in 28 cases, and the LAC negative was in 32 cases. The positive rate of CD27, expression intensity of CD27, positive rate of CD154 and expression intensity of CD154 in SLE patients with LAC positive were significantly higher than those in SLE patients with LAC negative: 0.055 ± 0.023 vs. 0.037 ± 0.014, 0.444 ± 0.179 vs. 0.329 ± 0.123, 0.218 ± 0.101 vs. 0.158 ± 0.044 and 0.058 ± 0.035 vs. 0.020 ± 0.009, and there were statistical differences (P<0.05). Conclusions The B lymphocyte activation and CD154 abnormal expression correlates with generation of LAC in patients with SLE. It provides a basis for the further study on intervening the generation of LAC and reducing the risk of thromboembolism.

Objective To compare the dosimetric results of postoperative intensity modulated radiation therapy (IMRT) using single-energy or mixed-energy photons in invasive thymoma patients.Methods Simulation CT images were acquired and clinical target volume (CTV),planning target volume (PTV) and organs at risk (OARs) were defined.Three sets of fixed-field IMRT planning were generated using 6 MV,10 MV and mixed 6/10 MV photons for each case.Monitor Units (MUs) for each plan were recorded after optimization,and parameters of PTV such as conformity index (CI),homogeneity index (HI) and dose to OARs were evaluated on dose-volume histograms.Results Near-Maximal dose (D2％) received by PTV was better in mixed-energy IMRT as compared with 6 MV(t =3.107,P ＜0.05).HI was better in mixed-energy than in 6 MV(t =2.924,P ＜0.05).There were statistically significant differences in CI among three IMRT plans.MU was higher in 6 MV than in both 10 MV and mixed-energy IMRT.The percentages of lung volumes receiving 5 Gy (V5),10 Gy(V10),20 Gy (V20),30 Gy (V30) and the mean lung dose (D) were also significantly different in most plans.V30 and V40 of the heart were comparable between 6 MV and mixed energy plans but better than in 10 MV plan.Conclusions If the reasonable choice of beam angles and number,and capability of energy selection according to beam directions,with combined advantages of low and high energy photons,mixed IMRT plans can improve the quality of IMRT plans in general and has clinical potential for postoperative radiotherapy of invasive thymomas.

Objective To explore the radiosensitivity of berberine on esophageal cancer cells under hypoxia condition.Methods MTT assay and clonogenic survival assay were used to evaluate the effect of berberine on proliferation inhibition and radiosensitivity of esophageal cancer cells,respectively.Immunofluorescence was employed to examine the expression of HIF-1.The change of cell cycle distribution and cell apoptosis was assayed by flow cytometry.The expression of HIF-1 was measured by Western blot.DNA damage was detected by γ-H2AX Foci counting.Results With a clear dose and time effect,berberine inhibited cell proliferation and enhanced cell radiosensitivity(t =3.69,P＜0.05)with a sensitizing enhancement ratio(SER)of 1.42.Berberine caused a dose-dependent decrease in HIF-1 protein expression and also significantly increased the cell apoptosis in ECA-109 population(t=4.74,P＜0.05).Compared with the radiation alone group,berberine enhanced X-ray induced DNA double chain breaks(DSB).Conclusions Berberine can increase the radiosensitivity of esophageal cell line ECA-109,which may be associated with decrease of HIF-1 expression and induction of apoptosis in ECA-109 cells.

This study was aimed to choose the best fixing method of electrocardiogram (ECG) measurement in mice by comparison of ECG index in three different fixing ways. Changes of ST amplitude and heart rate in ECG were measured in the self-made mouse sets, tape bundling or breathing anesthesia state. The amplitudes of the ST seg-ment in C57BL6 mice and β1/β2-AR double knockout mice were elevated in tape bundling or breathing anesthesia state in comparison with that in the self-made mouse sets (all P < 0.01). The heart rate under the tape bundling state in C57BL6 mice was significantly faster than that in the self-made mouse sets (P< 0.05 or P< 0.01). And the heart rate under anesthesia in β1/β2-AR double knockout mice was significantly slower than that in tape bundling state or the self-made mouse sets (both P < 0.01). It was concluded that relative to the binding and anesthesia method, fixing mouse in the self-made mouse sets, which can more truly reflect the physiological or pathological states, is a relatively good fixing method of ECG measurement in experimental study.

Studies have found that depression is closely related to the hyperactivity of the hypothalamo–pituitary–adrenal (HPA) axis, which is manifested in increases in HPA axis-related hormones CRH, ACTH and CORT contents. Traditional Chinese medical acupuncture can down-regulate HPA axis levels to produce a marked antidepressant effect. However, at present there is no HPA axis mechanism analysis of the antidepressant effect of acupuncture. From two aspects: the relationship between depression and HPA axis, and clinical and animal mechanism studies of the antidepressant effect of acupuncture by regulating the HPA axis, an analysis has been made to provide a more powerful scientific basis and the idea of further in-depth study for clinical acupuncture treatment of depression.

Objective To investigate the clinical characteristics of tuberculosis (TB) first presenting as fever of unknown origin (FUO). Methods The clinical data of 100 cases of FUO, diagnosed as TB finally, among in-patients in Peking Union Medical College Hospital were analyzed retrospectively.Results ( 1 ) Sites of TB: there were 39 patients with merely pulmonary TB, 28 patients with merely extrapulmonary TB, and 33 patients with both pulmonary and extrapulmonary TB. (2) Clinical manifestations: depending on the different sites of tuberculous lesion, the clinical symptoms varied accordingly. The common laboratory findings included anemia, hypoalbuminemia, elevation of the level of ESR and C-reactive protein (CRP). (3) Methods for diagnosis: 34 cases were diagnosed by sputum smearor cultivation-positive for acid-fast bacilli; 8 cases by histopathology; 49 cases by clinical diagnosis of TB with an effective anti-TB therapy; and 9 cases by effective diagnostic anti-TB therapy. (4) Responses to treatment: among 73 cases with complete follow-up data, only 2 cases (2. 7% ) died and the other cases were cured or alleviated. Fifty-five cases (77.5%) showed marked efficacy after less than 4 weeks of regular anti-TB therapy, 37 cases ( 52. 1% ) suffered adverse effects of anti-TB agents, and all of them had improved after modifying anti-TB therapy and supporting treatment. Conclusions The diagnosis of TB that presents as FUO is quite difficult, and the median interval time for making diagnosis is 14 weeks (3-77weeks). Investigating clinical manifestations comprehensively, reviewing radiology data carefully, and eliciting microbiological and pathologic evidence of TB, are extremely important for making the correct diagnosis. In some cases, a therapeatic trial of anti-TB therapy is necessary.

Objective To compare the dose distribution and setup error of angled breast board position ( ABB) with plain breast board position ( PBB) in breast cancer radiotherapy. Methods Twenty consecutive postoperative left breast cancer patients in the First Affiliated Hospital, Zhejiang University were enrolled from March 2017 to January 2018. All cases were assigned into the ABB and PBB groups according to positions and there were 10 cases in each groups respectively. The target volume, heart and lung structures were defined on the CT images of the localized scan. The plan was designed using the field in field ( FIF) technique to compare the dosimetric parameters of the PTV, lung, and heart treatments, and the setup errors for the two different positions. Results The ipsilateral lung V20[ABB:(11.2 ±3.2)％, PBB:(15.9 ±5.3)％, t= -2.47,P< 0.05], and V30[ABB:(9.8 ±1.5)％, PBB:(12.9 ±2.2)％, t= -4.46,P<0.05] were both statistically significant for the two different position and immobilization. Heart dose V25[ABB: (1.9 ± 0.2)％, PBB: (2.8 ± 0.4)％, t = -8.28, P <0.05], V30 [ABB:(1.8 ±0.1)％, PBB: (2.7 ± 0.3)％, t = -8.34,P < 0.05], and Dmean of heart [ABB: (3.0 ±0.5)Gy, PBB:(5.3 ± 1.2)Gy, t=5.58,P<0.05] were all statistically significant for the two different positions. The translational errors of ABB and PBB on LR, SI, and AP were ( 3.23 ± 2.63 ) , ( 5.42 ± 3.22), (4.58 ± 2.30) mm, and (2.35 ± 1.22), (2.17 ± 1.29), (2.27 ± 1.58) mm, respectively. The rotation errors of pitch(θ), yaw(Φ) and roll(ψ) for ABB and PBB were (1.60 ± 0.56)°, (3.40 ± 1.65)°, (2.50 ± 1.72)°, and (1.37 ± 0.43)°, (1.79 ± 0.71)°, (2.06 ± 0.63)°, respectively. Meanwhile, the in-and out-SI, anterior and posterior AP, yaw rotation error (Φ) were also statistically significant(t=3.06, 2.80, 3.33,P<0.05). Conclusions There is no statistically significant difference in the tumor target between the two position and immobilization techniques. However, the ABB is better than the PBB in normal tissue sparing while the setup accuracy of PBB is better than the ABB.