Objective To study the correlation between the occurrence of encephaledema and the target dose-volume after the low dose stereotactic radiosurgery of epilepsy.Methods Totally 136 epilepsy patients treated by low dose stereotactic radiosurgery with Novalis System were analysed retrospectively.The target doses and volumes of the patients were analysed by drawing out the scatterplot and conducting the binary Logistic regression to all of the data.An equation was obtained to predict the occurrence of radiation induced encephaledema in certain range of target volume and dose.Results Among all of 136 patients,different degree of local encephaledema occurred in 19 cases after the radiosurgery.Higher occurrence of radiation induced encephaledema was observed when the target central dose (i.e.90％ isodose circling the target)was more than 18 Gy or the target volume more than 30 cm3.Moreover,in patients with multitargets the doses of different targets devoted to each other,which could lead to the occurrence of local encephaledema.The equation to predict the occurrence probability was obtained by regression analysis.By testing this equation in all of 136 patients the coincidence percentage was 94.7％.Conclusions The target dose and volume could be effective parameters in certain range to predict the occurrence probability of radiation induced encephaledema.This equation would help to establish and optimize the therapeutic planning system.So it could finally reduce the side-effect of low dose stereotactic radiosurgey in epilepsy patients.The equation has some clinical value.

OBJECTIVE:To put forward some suggestions for the development of e-commerce in China's pharmaceutical retail chains.METHODS:To drawn on experiences from the western developed countries in developing B to C pharmaceutical e-commerce and analyzed the problems existing in China's pharmaceutical industry.RESULTS & CONCLUSIONS:To develop e-commerce in China's pharmaceutical retail chains,the cooperated supervision of the concerned governmental departments is indispensable,in addition,the level of informatization should be improved step by step and the network of retail chain should be relied on to offer customer-centered services.

OBJECTIVE: To propose some suggestions towards the operation and development of online pharmacies in China.METHODS: From the following three aspects: website design,information provision,and customer service,the paper introduced and compared the websites of three approved online pharmacies,which include Jingwei Pharmacy,Shanghai Pharmacy and Jinxiang Pharmacy.RESULTS & CONCLUSIONS: To develop online pharmacies,the information display should be customer-centered,new marketing plans based on the characteristics of the internet should be developed;meanwhile,the operators of online pharmacies should help consumers developing an awareness of drug safety and offer them corresponding services.

Objective To evaluate the clinical significance of serum thyroglobulin autoantibody(TGAb) in thyroglobulin(TG)-negative and TGAb-positive patients with differentiated thyroid carcinoma(DTC)after thyroid ablation and ascertain the optimal operating point(OOP)of TGAb.Methods A total of 169 patients with histologically confirmed DTC and thyroid remnant ablation showed TG-negative and TGAb-positive results which were assessed by electrochemiluminescence immunoassay(ECLIA).The cases were divided into group A(59 cases)and group B(110 cases)with or without evidence of recurrence or metastasis,respectively.The receiver operating characteristic(ROC)curve and positive likelihood ratio of different threshold values were analysed according to their serum TGAb level.Results Serum TGAb level(1368?1343)IU/ml in group A was significantly higher than that(154?539)IU/ml in group B(P1000 IU/ml was 1.12 times that of 204 IU/ml≤TGAb≤1000 IU/ml,4.03 times that of 100 IU/ml≤TGAb

Objective The aim of this study was to evaluate the diagnostic value of thyroglobulin(Tg)mRNA in peripheral blood samples of patients with differentiated thyroid carcinoma(DTC)after remnant ablation.Methods Tg mRNA Was detected by reverse transcription-polymerase chain reaction(RT-PCR)in peripheral blood of 162 patients.SPSS 13.0 was used for date analysis.Results The Tg mRNA assay had higher sensitivity than the conventional serum Tg measurement[86.61%(97/112)vs 53.57%(60/112),X2=29.153,P＜0.001]which Was the"gold standard"for the identification of recurrence or metastases.In the anti-Tg antibodies(TgAb)positive DTC patients,the sensitivity of Tg mRNA was higher than that of serum Tg[86.54%(45/52)vs 0]in identifying recurrent or metastatic thyroid disease(X2=79.322,P＜0.001).There was a significantly positive correlation between Tg mRNA expression and the clinical stages(Kendall correlation coefficient=0.515,P＜0.001).There was no difference of Tg mRNA expression in peripheral blood among ages,sex,pathological types and location of metastases,respectively(Kendall correlation coefficient=0.020,0.069,0.050 and 0.028;all P＞0.05).Conclusions Circulating Tg mRNA is a more sensitive marker than serum Tg in identifying recurrent or metastatic DTC,particulady in patients during levo-thyroxine(l-T4)therapy and with TgAb-positive.The DTC patients who have positive expression of Tg mRNA indicates poor prognosis.

We find that there is a correlation among thesize of ventricular septal defect (VSD) (X_2), PaO_2(X_3), V. /V. (X_7) and pulmonary systolic pressure(Y_1), diastolic pressure (Y_2), mean pressure (Y_3)by multivariate stepwise regression analysis, andso there are their parameters in the regression e-quations. The regression equations are Y_1 = 13. 24+ 0. 22X_2 - 0. 09X_3 + 0. 14X_7; Y_2 = 0. 65 + 0. 24X_2+ 0. 12X_7; Y_3 = 3. 54+ 0. 17X_2 + 0. 16X_7. But thecourse of the disease, ∑9 leads QRS dimension,R. /R., L. /L. are non-dominant factors, and sothere are not their parameters in the regression e-quation. The above-mentioned equations mayavoid the patients. with mild, moderate pulmonaryhypertension to have invasive examination, and re-duce its complications.

Objective To evaluate the effect of alginate polysaccharide JM on rats impaired by brain ischemia,and to elucidate its mechanisms.Methods By using the middle cerebral artery occlusion(MCAO) induced by nylon surgical thread inserted through the internal carotid artery into the anterior cerebral artery in rats,the effects of JM on neurological dysfunction and infarct volumn in rats brain were investigated.Neuroblastoma SH-SY5Y cells were employed to study the inhibitory effects of JM on cytotoxicity induced by hypoxia-hypoglycemia.Results JM at the doses of 12.5 and 25 mg?kg-1,iv,30 min before ischemia impressed neurological dysfunction,characterized by the decreased behavioral obstacle scores of MCAO rats.The infarct volumn declined 24h after ischemia as well.Further investigation by flow cytometry revealed that JM significantly reduces the overloading of intracellular free calcium on and suppresses apoptosis induced by hypoxia-hypoglycemia in human neuroblastoma SH-SY5Y cells.Conclusion JM showed protective effects on brain ischemia,probably related to its inhibitory effect on the overloading of intracellular free calcium ion(\i) and cell apoptosis.

Objective: To examine whether the progression of early diabetic renal disease with normotension can be slowed by ACE inhibitors(ACEI). Methods: MEDLINE and Chinese Biological Medicine Disk were searched for randomized controlled trials about the effect of ACE inhibitors on patients with normotensive early diabetic renal disease from January, 1990 to April, 1999. According to included criteria, 10 studies were chosen at last.Data were combined by RevMan 3.1 software. Results: The pooled effect sizes of urinary microalbuminuria excretion rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were -77.502 mg/24 h[-100.748,-54.256], -5.002 mmHg [-9.630, -0.685 ], -2.949 mmHg[-4.005, -1.892], -4.284 mmHg[-5.444, -3.123] respectively. Regarded progression to clinical albuminuria as end point,the pooled OR(odds ratio) was 0.27[0.18,0.40]. The sub category analysis showed no differences between type 1 and type 2 diabetes.There were no significant correlations between the pooled effect of urinary microalbuminuria excretion rate and systolic blood pressure, diastolic blood pressure or mean arterial blood pressure. Conclusion: ACE inhibitors can decline urinary microalbuminuria excretion rate in patients with normotensive early diabetic renal disease and delay the progression of early diabetic renal disease to clinical albuminuria, and the effects may not depend on its blood pressure reduction effect. [

Objective We sought to evaluate the effect of structured health education on quality of life and the end point of patients with coronary disease with evidence-based method.Methods The Cochrane Library,Cochrane Database of Systematic Reviews (CDSR),Medline (OVID),Pubmed and Web of Science were searched to collect the randomized controlled trials (RCT) which mentioned the structured health education to CHD patients,the quality of the RCTs was evaluated by Jadad Score,then effective data were extracted and analyzed by Meta-analysis with RevMan 5.2 software.Results A total of 12 eligible studies of RCT were included in the study with Jadad Score evaluations at B level or above.There were 20 476 cases in the intervention group,14 522 cases in the control group.Meta-analysis showed that the quality of life scores of the intervention group were significantly higher than those of the control group,weighted mean difference was 3.29,95％ CI (0.49-6.09).No significant difference was found in cardiac morbidity outcomes,re-hospitalization and the mortality rate,relative risk,95％ confidence interval were respectively 0.72(0.50-1.04),0.98(0.86-1.11),0.77(0.58-1.03).Conclusions The structured health education can improve the quality of life of patients with coronary disease,but has no obvious effect on the cardiac morbidity outcomes,re-hospitalization and mortality rate.We suggest transitional care to be carried out in future research to decrease the incidence rates of them.

Because of breaking through time and space limitations of classroom teaching,micro class has become a better choice for students' autonomous learning and lifelong learning.Complete system of micro class can maximize learning efficiency,and among the system,the content and presentation form are the key to attract the learners,and perfect evaluation system is an important guarantee for effective learning by using micro courses.Pathological micro curriculum should highlight the characteristics of the course,and the task of pathology is to introduce the students to clinical medicine based on correlative basic science.We should adopt the dapper micro video aggregation type to interpret the teaching key points and difficulties,and with the help of network teaching platform or micro platform,give the full play to the advantages of micro course.Whether in the traditional teaching,or in the curriculum integration,the reasonably designed micro curriculum will improve the teaching quality by collaborating with classroom teaching.