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.

Objective To investigate the effect of tunor necrosis factor alpha (TNF-α) antagonist treatment and traditional disease-modifying antirheumatic drugs treatment on the quality of life of male patients with ankylosing spondylitis (AS).Methods In 42 patients with AS open-label study,patients were grouped after consent,and divided into the TNF-α antagonist treatment group and the non-TNF-α antagonist treatment group.All patients were treated for 4 months.The clinical and laboratory indexes and quality of life changes were analyzed before and after the treatment.T test,Pearson's correlation analysis were used for statistical analysis with software version 13.0.Results There were no significant differences in age,disease course,disease activity and the quality of life between the two groups before treatment.Disease activity and the quality of life of the two groups after treatment were improved compared with that of before treatment.After treatment,the Bath ankylosing spondylitis disease activity index (BASDAI) score [(1.9±1.6) scores,(3.0±1.3) scores,t=-2.429,P=0.020],erythrocyte sedimentation rate (ESR) [(9±6) mm/1 h,(18±17) mm/1 h,t=-2.286,P=0.031] and C reactive protein(CRP) levels [(18±21) mg/L,(62±85) mg/L,t=-2.258,P=0.035] of the TNF-α antagonists treatment group decreased significantly than those non-TNF-α antagonist treatment group,while the hemoglobin (Hb) levels [(143±15) g/L,(138±18) g/L,t=2.545,P=0.015] were significantly increased in TNF-α antagonist treatment group.The improvement extent of quality of life was more evident in TNF-α antagonists treatment group,such as,the average score [(72± 15) scores,(55±19) scores,t =3.254,P=0.002].The average degree of improvement in quality of life and BASDAI score,Bath ankylosing spondylitis functional index (BASFI) score were negatively related to the improvement in the TNF-α treatment group (r=-0.497,P=0.018; r=-0.558,P=0.007).Conclusion TNF-α antagonist treatment can not only improve the AS disease activity,but can also improve the quality of sexual life of male patients,which may direct affect on male reproductive system.

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.

China ; Hearing Loss, Sensorineural ; prevention & control ; Humans

OBJECTIVETo compare the efficacy among acupuncture based on "jin" theory, regular acupuncture and western medication.

METHODSA total of 95 cases, by using incomplete randomization method, were divided into a "jin" theory acupuncture group (32 cases), a regular acupuncture group (31 cases) and a medication group (32 cases). Patients in the "jin" theory acupuncture group were treated with acupuncture based on "jin" theory which included the "gather" and "knot" points on the affected side: positive reacted points, Fengchi (GB 20), Tianrong (SI 17), Tianyou (TE16) and Yiming (EX-HN14) as the main acupoints, while the Ermen (TE 21), Tinggong (SI 19) and Tinghui (GB 2) and zhigou (TE 6) as the auxiliary acpoints; the treatment was given once a day. Patients in the regular acupuncture group were treated with regular acupuncture at Tinggong (SI 19), Tin- ghui (GB 2) and Ermen (TE 21) and other matched acupoints based on syndrome differentiation, once a day. Pa- tients in the medication group were treated with oral administration of betahistine mesylate, three times a day. Ten days of treatment were taken as one session in three groups, and totally 2 sessions were given. Visual analogue scale (VAS), tinnitus handicap inventory (THD), and tinnitus severity assessment scale (TSIS) were evaluated before and after treatment; also the clinical efficacy was compared among three groups.

RESULTSThere are 5 drop-out cases du- ring the study. After the treatment, the VAS, THI and TSIS were improved in three groups (all P < 0.05); the VAS, THI and TSIS in the "jin" theory acupuncture group were lower than those in the regular acupuncture group and medication group (P < 0.05, P < 0.01). The total effective rate was 90.0% (27/30), 80.0% (24/30) and 63.3% (19/30), which was higher in the "jin" theory acupuncture group (P < 0.05, P < 0.01).

CONCLUSIONThe acupuncture based on "jin" theory is superior to regular acupuncture and western medication for cervical tinnitus.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Neck Pain ; complications ; Tinnitus ; etiology ; therapy ; Treatment Outcome

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.

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.

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

Hearing Loss, Sensorineural ; diagnosis ; prevention & control ; Humans