The serum autoantibodies,urine routine test and peripheral blood cellswere analyzed in 70 patients with primary sjogren syndrome(SS)and 91 pa-tients with secondary SS(30 associated with systemic lupus crythematosisand 61 with rheumatoid arthritis). The significant findings in primary SS were the high positive rate ofanti-SSA(76.9%)and anti-SSB(53.8%)antibodies and also the defect in urineacidification.Therefore about 40% of the primary SS manifestated as clincalor subclinical renal tubular acidosis.Anemia,leukopenla,thrombocytopeniawere found in 20.9%,20.9%,50% respectively,ANA was found in 43.5%in the primary SS but 93.3% in SS associated with SLE. The positivity of anti-DNA antibody in primary SS was much lowerthan that of SS with SLE. The positivity of RF in primary SS(60.7%)was also significantly lowerthan that of SS wtih RA (88.3%).Although proteinuria is a rather com-mon finding in SS with SLE,it is not commonly seen in primary SS or SSwith RA.SS was considered as a heterogenesis group of patients.The dif-ferences shown by the conventional laboratory findings mentioned aboveconfirmed the concept that the primary SS is a distint systemic entitywhile the sicca syndrome in secondary SS is only one of the systemicmanifetsations of the associated rheumatic disease.

OBJECTIVETo explore the molecular biological mechanism of ZHU's Tiaojing Cuyun Recipe (TCR) for treating anovulatory infertility patients with Shen deficiency syndrome (SDS) by observing its clinical efficacy.

METHODSUsing randomized blocking methods, 80 patients were assigned to the treatment group (40 cases) and the control group (40 cases). Patients with regular menstrual cycle started medication from the 5th day of menstruation. Those with irregular menstrual cycle first took progesterone till withdrawal bleeding ,and then started medication from the 5th day of vaginal bleeding. Patients in the treatment group took ZHU's TCR, one dose per day, while those in the control group took Clomifene Citrate (CC), 50 mg per day. Three menstrual cycles consisted of one therapeutic course, a total of 2 courses. Clinical efficacy such as pregnancy rates and abortion rates were observed. Ovulation indices (the maximal diameter of mature follicles, luteinized follicles, ovulational follicles, and the endometrial thickness on the ovulation day), SDS, and integrals of menstrual symptoms were monitored before and after treatment. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) , and estradiol (E2) were determined using chemiluminescent immunoassay before treatment and after on therapeutic course. Serum levels of activin A (ACTA), inhibin B (INHB), and follistatin (FS) were detected using double antibody sandwich ELISA.

RESULTSCompared with the control group, the pregnancy rate was obviously elevated and the abortion rate was obviously lowered in the treatment group (P <0. 05). Ovulation rates of mature follicles and luteinizing follicles decreased more in the treatment group (P < 0.05). Compared with before treatment, integrals for SDS were lower, the maximal diameter of pre-ovulational follicles was increased, and integrals for menstrual symptoms in non-pregnant patients of the two groups were obviously lowered. Meanwhile, the endometrial thickness on the ovulation day was increased in the treatment group after treatment, but reduced in the control group (P < 0.05, P < 0.01). Compared with the control group, integrals for SDS were decreased, and the maximal diameter of pre-ovulational follicles was lowered in the treatment group after treatment (P < 0.05, P < 0.01). Integrals for SDS and the difference in the endometrial thickness on the ovulation day were increased, but the difference in the maximal diameter of pre-ovulational follicles were reduced (P < 0.05, P < 0.01). In the treatment group serum levels of E2 and ACTA increased more after one therapeutic course than before treatment (P < 0.01), but serum levels of INHB and FS decreased more after one therapeutic course than before treatment (P < 0.05). In the control group serum levels of FSH and ACTA increased more, and the serum level of FS decreased more after one therapeutic course than before treatment (P < 0.05, P < 0.01). Compared with the control group, serum levels of FSH and ACTA increased more, and serum levels of INHB decreased more in the treatment group after one therapeutic course than before treatment (P < 0.05, P < 0.01).

CONCLUSIONSZHU'sTCR could improve SDS of anovulatory infertility patients, regulate the follicular development, and elevate the pregnancy rate. Its actions might be associated with regulating their sex hormones, expressions of ovary local factors such as INHB, ACTA, and FS.

Activins ; Clomiphene ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; Female ; Follicle Stimulating Hormone ; Follistatin ; Humans ; Infertility, Female ; complications ; therapy ; Inhibins ; Luteinizing Hormone ; Medicine, Chinese Traditional ; Ovarian Diseases ; Ovarian Follicle ; Ovulation ; Progesterone

Humans ; Standard of Care ; Vestibulocochlear Nerve Diseases ; diagnosis ; therapy

Treatment of macular hole associated retinal detachment in high myopia has progressively evolved over the years,including the scleral buckling,simple intravitreal gas injection,pars plana vitrectomy (PPV),PPV combined with internal limiting membrane (ILM) peeling or transplantation and so on.Simple vitreous gas injection is less traumatic and good for the patients with small holes and localized retinal detachment.PPV combined with ILM peeling can achieve better treatment effects for small holes with wide retinal detachment.But for large holes with wide retinal detachment,PPV combined with ILM transplantation is necessary to improve the macular holes closure rate.If the ILM has been peeled before,the lens capsule could be a nice substitute for ILM.The scleral surgery can solve the problem of posterior scleral staphyloma and effectively control the elongation of the axial length.However,there is still no one surgery could deal with all the problems of high myopia,we should consider all the circumstances like the size of the macular hole and the range of the retinal detachment to choose the best individualized therapy.

With the development of hardware and software in engineering,the medical robotic techniques makes up for the shortage of conventional laparoscopy,and has good prospect in the field of surgery.In this paper,the application of medical robotic techniques in digestive surgery was focused.Extraneous medical robotic system and intrinsic miniature medical robot are 2 main categories.Most digestive operations,such as cholecystectomy,pancreaticoduodenectomy,lobectomy,antireflux surgery could be carried out by the extraneous medical robotic system,and the intrinsic miniature medical robot is still under research.Benefiting from the cooperation of the surgeons and the engineers,it is certain that the medical robotic techniques could play a more important role in digestive surgery.

Objective To investigate to the role of Angelica sinensis polysaccharides (ASP) against hepatic encephalopathy and explore the probable mechanism. Methods Sprague-Dawley rats were established into carbon tetrachloride (CCl4)-induced liver cirrhosis,then treated with distilled water (negative control),lactulose (positive control),ASP solution (10,20 and 40 g/L respectively,intragastrically at dose of 10 ml.kg-1.d-1) for 14 days. On 15th day,all the survival rats were intraperitoneally injected with endotoxin (3 mg/kg) once,then in the following 12 h,the rats that fall into coma were counted and the time period of coma was recorded. The blood plasma concentrations of ammonia,serum glutamate-pyruvate transaminase (GPT) and glutamic oxaloacetic transaminase (GOT) were determined. The apoptotic cerebral cells were dyed in situ by TUNEL. Glial fibrillary acidic protein (GFAP) in astrocytes was determined by immunohistochemical method. Then we counted the apoptotic cerebral cells and GFAP positive cells under light microscope. Results The survival rats in distilled water group were highest in the concentrations of ammonia,GPT and GOT,the amount of apoptotic cerebral cells,and coma rate than the rats in other groups. The rats in 40 g/L ASP group had the higher ammonia level,GOT concentration,coma rate than those in lactulose group. The rats in 3 ASP groups all had less apoptotic cerebral cells than those in lactulose group. As to GFAP,distilled water group had the lowest immunological activity,and the GFAP immunological positive cells of 3 ASP groups were all more than those in lactulose group. Conclusion ASP,even more effective than lactulose,can protect rat brain function and delay the occurrence of hepatic encephalopathy,whose effects may be related to the decrease of blood ammonia,the amelioration of liver function as well as the protection of astrocyte function and neuronic activity.

Objective To explore a new bio-dynamic differential equation to establish gene regulatory network based on the time-space of gene expression.Methods According to bio-dynamic competitive model and differential equation,a new time-space Lotka-Volterra differential equation was established and was applied to time-order expression data.Results The model was applied to set up the regulation network of yeast genes.The regulatory relation was found and compared with the experiment results.Conclusion The results from the new model were almost consistent with the real situation.So this model can remedy the shortage of other models.It's a new valuable differential equation model.

Policy circumstance plays a pivotal role in transformation of barefoot doctor to village doctor.The resources support fromregime and economic organizationmanagement system, the workpoint system for income from collective economy and politics culture of serving people under the policy circumstances of the People′s Com-mune, lay a firm foundation for rise and development of barefoot doctors.However, the village self-governance re-gime began with Household Contract Responsibility System changed all elements above and ultimately prompt trans-formation from barefoot doctor to village doctor.

Objective To review the characteristics,mechanism,the brain structural and functional changes of cognitive impairment induced by sleep-disordered breathing in children.Methods The retrieve time was from 2002 to 2014 and the retrieve databases were the US.national library of medicine and Weipu Chinese journal databases.Search word included sleep disorders breathing, cognitive, sleep apnea syndrome, neurobehavioralmanifestations,image,sleep deprivation.Results 52 English literature and 1 Chinese literature were accepted.Most literatures were clinical trial, comparative study, multicenter study, randomized controlled trial, controlled clinical trial.Conclusion The study in the cognitive impairment and characteristics change of the brain function and structure in children with SDB is not enough.Most cognitive assessments are completed by scale.How to diagnosis early,more objectively assess cognitive, study molecular mechanisms, study function change and positioning of brain function need more research in clinical.

Image segmentation is a key step of image processing,and it is a hard work too. The experts of this field have tried to find a suitable algorithm for image segmentation for a long term,however,there is not a algorithm is generally accepted till now. J. Holland created genetic algorithm(abbreviation :GA) in 1973. This algorithm has been used in many fields successfully ,and has been introduced to image segmentation field by exports. The principles of image segmentation and algorithm are stated in this article. The author mainly expounded the application of GA in medical image segmentation field in recently years.