To management of syncope in children and adolescents,the primary objectives are etiological diag-nosis and risk stratification.The possible causes for syncope ranging from relatively benign conditions to potentially life -threatening events.The efficient methods of diagnosis and risk stratification are vital important to identify those syncope patients who are at short -term or long -term risk of life -threatening events,avoiding unnecessary hospitali-zation of low -risk patients.In recent years,there came up with a multitude of quantitative methods in diagnosis and risk stratification,according to clinical history and physical exam and 1 2 -lead electrocardiograph.These methods can assit front -line physicians do an optimal decision -making,especially providing valuable guidance to make a well -in-formed choice between hospitalization and outpatient referral.Nevertheless,these existing methods can not replace criti-cal assessment by an experienced physician.

To evaluate the mechanism,treatment and prescription acupoint of acupuncture when it was used for osteoporosis.The observation index,effect and outcomes were studied objectively.The characteristics and associated problems of acupuncture were discussed.

?AlM: To evaluate the expressions and significances of endoplasmic reticulum stress related protein ( BlP ) , hypoxia-inducible factor-1α ( HlF-1α) and vascular endothelial growth factor ( VEGF) in the retina of diabetic rats.
?METHODS:Seventy-two male Sprague-Dawley ( SD) rats were chosen and divided randomly into 6 groups:normal control 2mo (C2m, n = 12), diabetes mellitus 2mo (D2m, n=12), normal control 4mo (C4m, n=12), diabetes mellitus 4mo (D4m, n = 12), normal control 6mo (C6m, n=12) and diabetes mellitus 6mo (D6m, n=12 ) . The diabetes mellitus mouse were induced by intraperitoneal injection of 0. 1mol/L streptozotocin (STZ, 65mg/kg). The expression of BlP, HlF-1α and VEGF in the retina were detected by enzyme- linked immuno sorbent assay. The location of BlP, HlF-1α and VEGF in epiretinal membranes were investigated by immunohistochemistry staining.
?RESULTS: BlP were significantly increase than control groups in all DM groups with the course of diabetes ( P<0. 01). HlF-1α were detected higher than control groups in all DM groups (P< 0. 05), but there was no statistical significance among treatment groups. VEGF in D4m and D6m groups were higher than control groups (P<0. 05), and there was statistical significance between D4m and D6m groups. BlP can be detected in control groups a little, mainly in the inner limiting membrane and ganglion cell layers. HlF - 1α cannot be detected in control groups, meanwhile it can be detected in all layers in DM. VEGF can be detected in control groups a little, it mainly be detected in inner nuclear layer, outer nuclear layer, around retinal vessel and ganglion cell layers in DM groups.
?CONCLUSlON:The expressions of BlP, HlF-1α and VEGF increase in the retina of diabetic rats than control groups with progressive of diabetes mellitus, both endoplasmic reticulum stress and HlF-1α signal path play important role in the progress of diabetic retinopathy.

ObjectiveTo observe the effect of long-term fluoride excess on rat thyroid morphology,thyroid peroxidase(TPO) activity and the expression of TPO protein,and to explore its possible mechanism of action.MethodsForty male SD rats were randomly divided into four groups by weight:control group,low-fluoride group,moderate-fluoride group and high-fluoride group(n =10),and they were fed with ordinary tap water containing fluorine 0.40,15.00,30.00,60.00 mg/L,respectively,and ate ordinary food prepared feed.After fed for 180 days,rats were anesthetized,and thyroid was taken.The morphology of thyroid was observed under light microscope.TPO activity was measured with improved guaiacol method.The expression of TPO protein was evaluated by Western blotting.ResultsThe thyroid histopathology results show:in control group,the thyroid follicular epithelial cells were columnar or cuboidal,with the follicular cavity filled with pink gum; in low-fluoride group,the thyroid follicular epithelial cell presented active hyperplasia; in moderate-fluoride group,the size of follicular increased,and follicular cavity was filled with dark,sticky colloid follicular; follicular increases,follicular cavity filled with dark,sticky colloid follicular; in high-fluoride group,the follicular epithelial cells showed apparent flat shape and excessive concentration of follicular colloid,a small amount of follicular lumen even showed the phenomenon of fusion,forming a giant follicular or cystic cavity.Among the four groups of control group,low-fluoride group,moderate-fluoride group and high-fluoride group,with increased fluoride,TPO activity [ ( 1.572 ± 0.046), ( 1.414 ± 0.086), (1.322 ± 0.049), (0.960 ± 0.083)U/L] decreased,and the differences were statistically significant between the two groups(all P ＜ 0.05).With increased fluoride,the expression of TPO protein (0.335 ± 0.011,0.156 ± 0.027,0.084 ± 0.020,0.045 ± 0.002) decreased,and the differences were statistically significant between the two groups(all P ＜ 0.05).Conclusioons Long-term intake of excessive fluoride can inhibit the thyroid TPO activity and the expressions of TPO as well as thyroid hormone synthesis,and leads to histological changes in rat thyroid.

Objective To study the effect of long-term fluoride excess on the activity of thyroid peroxidase (TPO) and the expression of TPO mRNA in rat thyroid,and explore the underlying mechanism.Methods Forty male SD rats were randomly divided into four groups based on their body mass(n =10 in each group):control group,low-fluoride group,moderate-fluoride group and high-fluoride group,and rats were fed on water containing 0.40(tap water),15.00,30.00 and 60.00 mg/L NaF,respectively,eating ordinary food formulated feed.All rats were sacrificed 180 days afterwards.Serum FT3 and FT4,TPO activity and mRNA expression level were determined by radio-immunoassay,modificd guaiacol method and semi-quantitative RT-PCR,respectively.Results Although serum FT3 levels in low-fluoride [(3.62 ± 0.47)pmol/L],moderate-fluoride [(3.57 ± 0.55)pmoi/L]and high-fluoride [(3.30 ± 0.68)pmol/L]treated groups were decreased compared with the control[(3.64 ± 0.45)pmol/L],the difference was not statistically significant (P ＞ 0.05).Serum T4 levels of the high-fluoride group [(8.64 ± 1.72)pmol/L]were significantly lower compared with other groups[(13.08 ± 1.69),(12.68 ± 1.32),(12.05 ± 1.43)pmol/L,all P ＜ 0.05].TPO activity in control,low-fluoride,moderate-fluoride and high-fluoride-treated groups[(1.572 ± 0.064),(1.414 ± 0.086),(1.322 ± 0.049),(0.960 ± 0.083)U/L]was decreased with the dose of fluoride increasing,the difference was statistically significant between any two groups(all P ＜ 0.05).The TPO activity was negatively correlated with the dose of fluoride(r =-0.955,P ＜ 0.05).With increased fluoride,the expression of TPO mRNA (0.936 ± 0.160,0.368 ± 0.095,0.115 ± 0.018,0.016 ± 0.008) decreased,the difference was statistically significant between any two groups (all P ＜ 0.05).Conclusion Chronic fluoride excess inhibits the activity and the expression of TPO as well as thyroid hormone synthesis.

Objective To investigate the maternal nutritional status and its influences on pregnancy outcomes in order to provide evidence for possible prenatal interventions.Methods A survey was conducted in 800 pregnant women,who presented at Xiamen Maternal and Child Healthcare Hospital between January 2006 to April 2008.The information of knowledge,attitude and behavior towards maternal nutrition were collected in 734 women and 571 women were followed up before 20 weeks of gestation,at 26-27 weeks,and 35-36 weeks to analyze the relationship between different nutrients and the pregnant outcomes.Results The questionnaire survey showed that women who had received higher education presented with better knowledge,attitude and behavior on maternal nutrition (P<0.05).Among the 734 women,39.2%(288) had poor knowledge,44.5%(326) were lack of knowledge,and 44.8%(358) with poor behavior.Prenatal diet analysis found that the percentage of these women with milk,fish and beans intake daily was 52.2%,34.3%,and 29.5%,respectively.Before 20 weeks of gestation,significant difference was identified only in the level of triglyceride among different BMI groups,and the higher the BMI,the higher the level of triglyeeride (P<0.01).With the progress of pregnancy,the level of serum ferritin and folic acid was decreasing (P<0.05),while the level of triglyceride and cholesterol was increasing (P<0.01).The newborn's birth weight was positively correlated to maternal BMI before 20 weeks (r=0.23,P<0.05),and higher BMI was a risk factor for abnormal birth weight (OR=4.051,95%CI:1.085～15.117,P<0.05) and also complicated with higher cesarean section rate than those women with lower or normal BMI (60.3%vs 29.4%and 34.7%,P<0.05).The rate of postpartum hemorrhage was increased with the reduced ferritin level (P<0.05).Conclusions The pregnancy outcomes can be improved through the following measures:appropriate control of the maternal weight before and during the pregnancy,increased intake of milk,fish,beans and so on,reduced intake of food containing abundant fat and sugar,more intake of red animal foodstuff,supplementation of folie acid,iron and calcium throughout the pregnancy,and prevention against high level of triglyceride and cholesterol.

Objective To evaluate the differentiation and diagnosis of benign renal tumors and tumor-like lesions. Methods The data of 49 cases of benign renal tumors and tumor-like lesions were retrospectively analyzed.All the 49 cases underwent B-ultrasonography and CT;14 cases underwent MRI.The clinical manifestation,imaging features and the pathological results were evaluated.21 cases of benign renal tumors and tumor-like lesions were misdiagnosed as renal carcinoma and underwent nephrectomy.28 cases underwent nephron-sparing tumor excision. Results There was no specificity of the clinical presentation in all the cases.CT and MRI showed that angiomyolipoma had imaging features of intra-tumoral fat.Color Doppler ultrasonography showed the specific features of renal arterio-venous fistula and renal artery aneurysms.The other imaging features of benign renal tumors and tumor-like lesions had no specificity.28 cases who underwent nephron-sparing surgery were followed up for 1 to 9 years and had no relapse.Their renal functions were normal. Conclusions Bulltrosonography,CT and MRI are contributive to the diagnosis and treatment of benign renal tumors and tumor-like lesions.Using nephron-sparing surgery for indeterminate renal masses may reduce misdiagnosis and unnecessary nephrectomy.

WANG Ji's opinion on moxibustion therapy in Questions and answers of acupuncture and moxibustion (Zhenjiu Wendui) was explored and analyzed. With his two contraindications of moxibustion as breakthrough points, the arrangement and discussion was performed. The results showed that based on summary of moxibustion treatment theory before Ming dynasty, WANG Ji could provide characteristic idea, which is of great reference value and guide significance to the inheritance and development of moxibustion.
China ; History, 15th Century ; History, 16th Century ; Humans ; Moxibustion ; history

With deep acupuncture at Baliao points (eight sacral foramina) as the core, Professor WANG Ling-ling has treated diseases of urinary, digestive and reproductive systems with superior therapeutic effect. The key for efficacy of Baliao points is deep acupuncture. Only deeply insert into acupoints with long needles and directly stimulate at sacral nerves, could Baliao points play a superior role in treatment effect. Searching acupoints is the basis of deep acupuncture, and superficial anatomy should be combined to summarize the methods of searching Baliao points. The premise of deep acupuncture is needling manipulation. The angles of needles must be adjusted according to morphological features of posterior sacral foramina, or it is hard to practice deep acupuncture into Baliao points. The description of location and manipulation on Baliao points in ancient and modern literature was vague, which restricts clinical application of Baliao points. A lot of research on location, manipulation and clinical application of Baliao points has performed by Professor WANG Ling-ling, and its manipulation and clinical cases are introduced to make a positive effect on its application and popularization.
Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Female ; Humans ; Male ; Middle Aged ; Pelvic Floor Disorders ; therapy ; Postoperative Complications ; therapy ; Urination Disorders ; therapy

With the increasing incidence and prevalence of male sexual dysfunction, andrologists are more and more in need of accurate and efficient tools to assess therapeutic efficacy and patients' satisfaction and to help patients achieve satisfactory treatment results. This article summarizes some of the most commonly used questionnaires for the diagnosis and assessment of the treatment of male sexual dysfunction, including International Index of Erectile Function (IIEF), Erection Hardness Score (EHS), Quality of Erection Questionnaire (QEQ), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Treatment Satisfaction Scale (TSS), Self-Esteem and Relationship (SEAR), Premature Ejaculation Profile (PEP), Premature Ejaculation Diagnostic Tool (PEDT), Index of Premature Ejaculation (IPE), Arabic Index of Premature Ejaculation (AIPE), Aging Male Symptoms Scale (AMS), Androgen Deficiency in the Aging Male (ADAM), and Symptomatic Inventory for Screening Late-Onset Hypogonadism in Males (SILOH), and presents an overview on their clinical application.
Erectile Dysfunction ; Humans ; Male ; Surveys and Questionnaires