Before irreversible neuronal damage occurs, quickly and securely recanalize vessels and restore blood flow to save the ischemic penumbra tissue are the main therapeutic target for acute ischemic stroke (AIS). Currently, the method for recanalization in early AIS is intravenous thrombolysis, how ever, the effect of intravenous thrombolysis is often not satisfactory because of the reasons, such as its short treatment time w indow , low vascular recanalization rate, and high incidence of bleeding complications. In recent years, w ith the research and development of mechanical thrombectomy device and the development of interventional technology, the therapeutic time w indow of AIS has been significantly prolonged, the vascular recanalization rate has increased significantly, the clinical outcome has improved significantly, and the treatment of mechanical thrombectomy has show n good application prospects.

Recently a number of acupuncture clinical trial projects mainly conducted by conventional scientists have generated many negative results. A large meta-analysis of patient-level acupuncture data for the treatment of chronic pain conditions have demonstrated that the effects of verum acupuncture on pain improvement have statistically significant, but small, differences compared with sham-acupuncture procedures and no difference between acupuncture points and non-points. These conclusions have puzzled the acupuncture community and made confusion for acupuncture research and practices. The purpose of this paper was to compare differences between acupuncture clinical practices and the trial studies, which include "acupuncture technical principles", "acupuncture clinical trial design", and "acupuncture practice based on the theory of traditional Chinese medicine". These factors contribute to the puzzle between the acupuncture community/practice and acupuncture clinical trials, which can be improved in future studies.
Acupuncture Points ; Acupuncture Therapy ; Chronic Disease ; Clinical Trials as Topic ; Humans ; Meta-Analysis as Topic ; Pain Management ; methods ; Research Design

Some phytoestrogen-containing Chinese herbs have both estrogenic and antiestrogenic activity. With the development of phgtoestrogen study and the application of herbs in breast cancer, phytoestrogen-containing herbs become the hot researches, but consensus is hampered by conflicting data from various in vitro and in vivo experiments. This article will address the effects of some kinds of herbs on breast cancer cell proliferation, the mechanism and their biological activity. The review will focus on 3 popular botanical herb: Angelica sinensis (dong quai) , Salvia miltiorrhiza (dan-shen root) and ginseng.

Objective To investigate the effects of RNA interference (RNAi) targeting angiotensinconverting enzyme (ACE) on blood glucose,insulin resistance,as well as oxidative stress in type 2 diabetic rats.Methods Type 2 diabetic rats were divided into diabetes control group (caudal intravenation with control adenovirus named Ad5),gene treatment group (caudal intravenation with recombinant adenoviral vectors named Ad5-ACE-shRNA,expressing ACE gene-specific shRNA),and enalapril group (intragastric administration with enalapril every day).At the same time,the normal blood glucose control group was set up.All rats were injected two times during the experiment period.Blood glucose was measured before and after the intervention.At the third day of the experiment,expressions of ACE mRNA and protein in pancreas were evaluated by RT-PCR and Western blot,and serum concentrations of ACE and Ang Ⅱ were measured by ELISA.By the end of the experiment,insulin sensitivity index was calculated and expressions of glucose transporter 4 (GLUT4) protein of epididymal adipose tissue and NAD (P) H (p22phox) protein of pancreas were measured.Results Blood glucose levels in the gene treatment group [(17.8 ±1.1) mmol/L] and the enalapril group [(17.9 ± 1.2) mmol/L] were lower than that in the diabetes control group [(24.9 ± 1.3) mmol/L] when the experiment was finished.ACE mRNA and protein expressions in pancreas of the gene treatment group were significantly decreased compared with the diabetes control group (P ＜ 0.05).Serum concentrations of ACE and Ang Ⅱ in the gene treatment group were (16.37 ± 3.01) ng/ml and (18.24 ± 3.69)pg/ml,significantly lower than those of the diabetes control group [(46.67 ± 3.92) ng/ml and (44.93 ± 4.12) pg/ml respectively,both P＜0.05].Insulin sensitivity indexes of the gene treatment group and the enalapril group were (-5.14 ± 0.41) and (-5.17 ± 0.38),being all significantly higher than that of the diabetes control group (-6.18 ±0.46,both P＜0.05).Expressions of GLUT4 protein in epididymal adipose tissue were higher and expressions of p22phox protein in pancreas were lower in the gene treatment group and the enalapril group than those of the diabetes control group (both P＜0.05).Conclusions RNAi targeting ACE gene may delay the progress of hyperglycaemia and improve the situation of insulin resistance and oxidative stress.The RNAi technology may be used as a new strategy of gene therapy for diabetes mellitus.

Objective To analyze the epidemiologic characteristics and tendency of hemorrhagic fever with renal syndrome (HFRS) in Xi'an from 2005 to 2014,and to grasp the epidemic regularity and predict the trend of HFRS for establishing effective prevention and control measures.Methods The descriptive epidemiological method was used to analyze the epidemic situation of HFRS in Xi'an from 2005 to 2014.The autoregressive integrated moving average (ARIMA) model was applied to analyze,fit and predict the epidemic data of 2015.Results There were 8 500 HFRS patients in Xi'an from 2005 to 2014,the incidence rate was 10.60/100 000.The morbidity increased at first and then decreased from 2005 to 2014;the incidence rate was 9.06/100 000 in 2005 and up to 19.46/100 000 in 2010,then down to 3.43/100 000 in 2014.More cases were reported in spring (15.85％,1 347/8 500) and autumn-winter seasons (72.91％,6 197/8 500).The high-risk age group of HFRS was between 15 to 59 years,accounting for 77.71％ (6 605/8 500) of the overall incidence rate;there were no significant differences in ＜ 15 years,15 to 59 years and ＞ 59 years groups (x2 =15.63,P ＞ 0.05).The male to female ratio was 3.01 ∶ 1.00,male incidence was 15.57/100 000 and female incidence rate was 5.41/100 000,and the difference was statistically significant between gender (x2 =1 948.84,P ＜ 0.05).The main occupation was farmers,accounting for 66.04％ (5 613/8 500) of the overall incidence rate.The top 4 districts were Chang'an,Zhouzhi,Huxian and Lintong;the incidence rate was 31.07/100 000,22.74/100 000,21.09/100 000 and 11.06/100 000,respectively,and the 10 years cumulative incidence rate was higher than the total incidence.The monthly incidence was predicted with ARIMA (1,1,0) × (0,1,1)12 models in Xi'an from 2005 to 2014,and the predicted number of cases was 235 in 2015 (lower than 2014).Conclusions The overall trend of the epidemic has continued to fall but slowly.Positive and effective comprehensive measures should be taken to maintain the incidence of hemorrhagic fever at a lower level.

Objective To explore the predicative value of transvaginal ultrasonography and 48 hours blood HCG ratio for ectopic pregnancy(EP).Methods A total of 90 patients in our hospital from June 2014 to May 2016 were selected as the object according to the pregnancy result and postoperative pathology (40 cases in EP group and 50 cases in control group).The endometrial thickness was measured through transvaginal ultrasonography while blood HCG was detected by chemiluminescence technique and 48 hours blood HCG ratio was calculated.To evaluate the individual and combined predicative value of endometrial thickness and 48 hours blood HCG ratio for EP,receiver operating characteristic curves(ROC) were generated and logistic regression analysis was conducted.Results The endometriam thickness and 48 h blood HCG ratio of EP group were (11.75 ± 3.42) mm and (1.06 ± 0.38) ％,respectively,which were lower than (15.52 ± 3.98) mm and (1.46 ± 0.20)％ of control group,the differences were statistically significant (P =0.000).The AUCs and their corresponding 95％ confidential intervals(CI) were 0.77[95％ CI(0.67,0.87)] and 0.82[95％ CI(0.73,0.91)],respectively.Combined ROC analysis based on the 2 indexes revealed an elevated AUC of 0.89 [95％ CI(0.83,0.95)],the differences were statistically significant(P =0.04).Conclusion The endometrial thickness and 48 hours blood HCG ratio can be acted as useful predicative biomarkers for detection of EP.A combination of the two indexes could be a useful predicative biomarker for future clinical trials with EP and may act as a suitable add-on biomarker to the panel of methods already existing for EP.

Objective To investigate the value of high frequency ultrasound and CT in the diagnosis of laryngeal carcinoma. Methods Sixty-nine cases of laryngeal carcinoma were typed and staged by high frequency ultrasound and CT, and compared with the results of laryngoscopy and postsurgical pathology. Results The typing accuracy was ~94.2 % for ultrasonography and ~91.3 % for CT, higher than that of laryngoscopy(~73.9 %).T staging accuracy of ultrasonography was T_1 ~85.9 %,T_2 ~88.5 %,T_3 ~94.1 % and T_4 ~88.9 %, higher than that of CT (~68.8 %) and laryngoscopy (~75.0 %) in T_3 stage and superior to laryngoscopy (~66.7 %) in T_4 stage. Lymph node metastases were found in 37 cases (~53.6 %) by ultrasonography, higher than those by CT scanning (~27.5 %). Color Doppler blood flow laryngeal carcinoma was shown in 65 cases(~94.2 %),most were low resistance spectrum pattern. Conclusions High frequency ultrasonography is superior to CT and laryngoscopy in the staging of laryngeal carcinoma and is of great value in choosing the therapeutical protocol.

Objective To explore the value of dual-source CT monoenergetic-plus imaging in the diagnosis of early gastric cancer. Methods Imaging data of 2 6 cases with pathologically proven early gastric cancer who underwent dual-energy scanning were analyzed retrospectively.Monoenergetic-plus images with energy levels at 40 keV,50 keV,60 keV and 70 keV were reconstructed by using an advanced monoenergetic software (syngo.via.VA30A,Dual energy Mono+).Contrast-to-noise ratio (CNR)of the lesion,image noise,overall image quality score and lesion conspicuity score were com pared between different monoenergetic-plus images and conventional polychromatic images at 1 2 0 kVp.Results The CNRs (3 .2 4 ± 0 .7 6 ,2 .9 4 ± 0 .9 2 ,2 .4 7 ± 0 .7 9 ,2 .3 7 ± 0.98 and 1.22±0.40 respectively)and image noises [(32.7±1.82)HU,(25.6±2.61)HU,(20.30±2.1 7)HU,(1 7.03±2.1 5)HU and (18.15±2.12)HU respectively]among 40 keV,50 keV,60 keV,70 keV and 120 kVp groups all had statistical differences (F =24.654 and 227.05,P <0.01).The CNR in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups,but similar to that in 40 keV group (P >0.05).The SD value in 50 keV group was lower than that in 40 keV group,but higher than that in other three groups (P <0.05).The overall image quality score (3.08±0.27,3.65±0.49,3.31±0.47,3.23±0.43 and 3.1 5±0.37,respectively) and lesion conspicuity score (4.15±0.67,3.92±0.48,3.27 ±0.45,3.08±0.27 and 3.04±0.20)among the five groups all had statistical differences (Z =25.343 and 70.426,P <0.05).The overall image quality score of 50 keV group was higher than that of the other four groups (P <0.05).Lesion conspicuity score in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups and similar to that in 40 keV group (P =0.1 52).Conclusion The 50 keV monoenergetic-plus images can increase the CNR value of early gastric cancer while maintaining the overall image quality.

ObjectiveTo investigate the relationship between liver stiffness and hepatocellular carcinoma (HCC) risk in chronic heptatitis B patients with negative α-fetoprotein (AFP) tests. MethodsFrom September 2012 to August 2014, this study enrolled a total of 82 HBV-relative native HCC patients as the case group. During the same period, a total of 253 chronic hepatitis B patients were also include in this study as the control group. These 253 patients were followed up for six months. All of the two groups were AFP-negative. Liver stiffness was measured in all patients by transient elastography device Fibroscan?. Logistic regression was applied to assess the risk of HCC incidence, and stratum-specific likelihood ratios (SSLR) was calculated.ResultsThe age, liver stiffness measurements and plasma albumin of patients in case group were 53 years old (44-61), 12.00 kPa (7.50-20.75), 43.14 g/L (39.50-46.75) respectively. The age, liver stiffness measurements and plasma albumin of patients in control group were 45 years old (38-56), 8.40 kPa (5.40-13.50), 46.40 g/L (43.75-48.50) respectively. The variables were compared between two groups with unpaired studentt test, and the results were statistically significant (t=4.33, 3.56,
-4.48,P=0.00, 0.00, 0.00). The patients in case group were older, and had higher liver stiffness measurements and lower plasma albumin than that of the patients in control group. Logistic regression analysis showed that HCC incidence was associated with age,male-gender and liver stiffness, and the odds ratios (OR) was 1.053, 2.432, 6.803 respectively. When liver stiffness was<10 kPa, 10.1-15 kPa, 15.1-25 kPa,>25 kPa, SSLR for HCC presence was 0.67, 1.02,1.44, 3.98 respectively.ConclusionsLiver stiffness measured by transient elastography is useful in predicting the risk of HCC incidence in AFP-negative chronic heptatitis B patients. Clinicians needed to carry out close follow-up and appropriate intervention for these patients.

Objective To observe the preventive effect of different doses of diacerein on acute gout model rats and to explore its possible mechanism.Methods A total of 30 Wistar rats and were randomly assigned to the normal control group, the negative control (normal saline control group, and positive (colchicine) control group, diacerein low dose group, medium iddle dose group and high dose group.Except the normal control group that were given normal saline, other groups received colchicine (0.3 mg·kg-1 ·d-1), diacerein (10 mg·kg-1·d-1, 50 mg·kg-1·d-1 and 100 mg·kg-1·d-1) for 8 days respectively, and prepared acute gouty arthritis model on the 6th day, then observed rats joint swelling and gait at 2 h, 6 h, 8 h, 24 h and 48 h after the acute gouty arthritis model were established.After 48 h, the rats were killed, the serum and joint leachate of the rats were collected to test interleukin (IL)-1β and tumor necrosis factor (TNF)-α.One-way analysis of variance (ANOVA), LSD t test and Kruskal-Wallis rank sum test were used for statistical analysis.Results Compared with the normal group, joint swelling of the rats in the negative control group became significantly swollen at 2 h after the model was established,at and it reached the peak at 8 h reached the peak, then decreased gradually and remitted obviously at 48 h obviously remission.Joint swelling of the ccolchicine group and diacerein high dose group joint swelling [(0.106±0.081) cm, (0.112±0.030) cm] and ankle joint inflammation index score [(2.8±1.7), (3.16±0.75)] were significantly decreased compared with the negative control group [(0.208±0.078) cm, (4.7±1.6);P＜0.05].In addition, compared with the negative control group, the gait of diacerein high dose group was significantly improved (F=7.552, F=1.859, P＜0.05), colchieine group and diacerein high dose group, the serum and joint leaching liquid TNF-α and IL-1 levels also decreased significantly (P＜0.05).Conclusion Diacerein in any In each dosage group of has a certain preventive and therapeutic effect on rats gouty arthritis rats, especially in high dose group, the anti-inflammatory mechanism may be down-regulating the expression of proinflammatory mediators such as IL-1 beta and TNF-α.