Endometrial blood flow is directly related to endometrial receptivity thereby affecting in vitro fertilization and embryo transfer (IVF-ET) outcomes. In recent years a growing number of studies have shown that traditional Chinese medicine (TCM) can play a role to improve endometrial blood flow and embryo transfer. Studies have confirmed that formulas based on reinforcing kidney and activating blood can promote the formation of uterine endometrial blood vessels by adjusting expressions of a variety of vessel growth factors, and regulating nitric oxide level for inhibition of vascular smooth muscle contraction of the uterus. Treatments based on differentiation of syndromes are key to the theory of TCM. Differentiation of syndromes should be combined with biomedical disease diagnosis. It is also necessary to further clarify other endometrial blood flow disorders using TCM diagnostic methods. In these cases, drugs for reinforcing kidney and activating blood are relevant, but other medicines for smoothing liver qi and nourishing blood, as well as tonifying the spleen and generating blood may also be effective. Future clinical studies should focus on the observation of different types of TCM syndromes and the research on compatibility ratio and dose-dependent relationship of Chinese medicines. Acupuncture has been used during IVF-ET for more than 10 years. Electro-acupuncture can control the expansion of the uterine arteries by inhibiting the sympathetic nerves. However, acupuncture has not been proved to regulate endometrial arteries. To sum up, TCM can be applied to improve endometrial blood flow so as to increase birth rates in IVF-ET. The combination of Chinese and Western medicines and acupuncture application will increase their combined effect, thereby obtaining greater clinical benefits.

Recently the combination of acupuncture with assisted reproductive technology (ART) to increase the outcomes of ART is being widely studied. In this article, the literatures concerning random controlled clinical trials since 2002 are reviewed and the designs of the trials, especially the timing of acupuncture, are evaluated. Over the past 5 years, the related clinical trials have primarily showed that acupuncture done immediately before and after embryo transfer might increase the assisted reproduction rates, but still requiring further high quality trials with large samples; in addition, different stimulation modes could produce different result, and so far there has not been a consensus as to the optimal time-point for the acupuncture intervention during the in vitro fertilization-embryo transfer (IVF-ET) course. Since the effects of acupuncture change with women's endocrine cycles, it is important and possible to make a breakthrough in ART outcomes if acupuncture is performed at a suitable time point during the cycle of IVF/ET combined with ART.

Objective · To explore the effects of brisk walking on blood pressure, body mass index (BMI), and autonomic nerve activity of male elderly with hypertension in community-based health centers in Shanghai. Methods · A total of 630 elderly men received brisk walking treatment (>10000 steps/d) voluntarily, who were selected from six community-based health centers in Pudong New Area of Shanghai. Among them, 210 people stick to training for 12 weeks. According to whether suffering from hypertension, the people were assigned to hypertension intervened group (intervention group, n=110) and normal intervened group (control group 1, n=100). Blood pressure, BMI, heart rate and autonomic nerve activity before and after the training were compared. Results · After 12 weeks of training, systolic blood pressure (SBP), diastolic blood pressure (DBP) and sympathetic nerve activity of intervention group were significantly lower than those before the training (P<0.05). SBP was also significantly lower than control group 2 (P<0.05). However, heart rate, BMI, parasympathetic nerve activity and baroreceptor reflex sensitivity did not change significantly after the training (P>0.05). Conclusion · Brisk walking treatment lasting for 12 weeks can decrease blood pressure and sympathetic nerve activity in elderly men with hypertension. It is worthy to be popularized in the community.

Objective To study the changes of iodine source and the nutritional status of iodine after termination of iodized salt supply in the areas with different water iodine concentrations in Shanxi province,in order to provide scientific bases for developing strategies on control and prevention of iodine deficiency disorders,and to study the cut-off value of water iodine level where iodized salt supply should be stopped.Methods In 2010 in Shanxi province,6 villages with 100％ of non-iodized salt consumption rate were selected as the survey spots based on the iodine concentration in drinking water of 0-,50-,100-,150-,300-,≥500 μg/L.Villages'iodized salt supply was terminated thoroughly.In each village,20 children aged 8 to 10 were selected.At the same time,women of childbearing age 18 to 50 years old and adult men aged 18 to 60 were selected from the same families as the children.Diet surveys were conducted by the method of 3 days recall on all subjects.Drinking water samples,staple foods,supplementary foods and urinary samples of all subjects were collected and the iodine concentration was determined by arsenic-cerium catalytic spectrophotometry.Results ①In the villages of water iodine 25.9,70.6 μg/L,the medians urinary iodine of children,women and men were all ranged from 100 to 199 μg/L,which meant their iodine nutrition levels were appropriate.In the village of water iodine 109.0 μg/L,the medians urinary iodine of children,women and men were all ranged from 200 to 299 μg/L,which meant their iodine nutrition levels were more than appropriate.In the villages of water iodine 225.8,430.0,581.2 μg/L,the medians urinary iodine of children,women and men were all ≥ 300 μg/L,which meant their iodine nutrition levels were too high.②)In all the 6 villages,the intaking amount of iodine met and exceeded the standard recommended intake of dietary iodine by ICCIDD/UNICEF/WHO (8 to 10-year-old children ≥ 120 μg/d,women of childbearing age and adult men ≥ 150 μg/d).But in the village of water iodine 581.2 μg/L,the iodine intake was exceeded the daily maximum safe intake (children aged 8 to 10 ≤800 μg/d,women of childbearing age and adult man ≤ 1000 μg/d).③The amount of iodine ingestion from drinking water was increased with the water content of iodine.When water iodine exceeded 100 μg/L,the amount of iodine ingestion from drinking water was higher than from food intaking,and became a main resource of iodine in the human body.Conclusions In the counties of iodine concentration in drinking water above 100 μg/L in high iodine areas of Shanxi province,the water iodine becomes the most important source of iodine,and iodine nutritional level is more than appropriate or possible excess.It is recommended that in areas of high water iodine of Shanxi province,the standard cut-point of water iodine value is set to 100 μg/L.

Objective To investigate the efficacy of prophylactic pancreatic stent placement and nonsteroidal antiinflammatory drugs( NSAIDs) for the prevention of post?endoscopic retrograde cholangiopan?creatography(ERCP) pancreatitis(PEP). Methods A total of 623 patients with high risk factors for PEP were treated with prophylactic pancreatic stent placement ( 145 patients, group A) or rectal NSAIDs( 478 pa?tients, group B) for PEP prevention by using the propensity score matching( PSM) analysis. Incidence of PEP, moderate and severe PEP were investigated. According to risk factors of PEP, indications of prophy?lactic pancreatic stent placement were analysed. Results Of 623 patients with high risk factors, 145 pairs were generated after PSM.Pancreatitis occurred in 32 patients,10 (6?9%) in group A and 22 (15?2%) in group B( P<0?05 ) . Moderate?to?severe pancreatitis developed in 5 ( 3?4%) patients in group A and 14 (9?7%) patients in group B(P<0?05).Risk factors of post?ERCP PEP were cannulation attempts duration longer than 10 minutes, precut sphincterotomy, more than one pancreatic guidewire passages and history of ampullectomy. Conclusion Although the NSAIDs represent an easy, inexpensive treatment, prophylactic pancreatic stent placement is still a better prevention strategy for PEP.Prophylactic pancreatic stents should be recommended to those with risk factors including cannulation attempts duration longer than 10 minutes, precut sphincterotomy, more than one pancreatic guidewire passages and ampullectomy.

OBJECTIVETo evaluate the preliminary curative effect of interspinous injections for the diagnosis and treatment of back pain caused by lumbar kissing spine (Baastrup's disease) under fluoroscopically guiding.

METHODSFrom November 2011 to March 2013,17 patients with back pain caused by Baastrup's disease were treated with fluoroscopically-guided interspinous injections, including 7 males and 10 females with an average age of 49.6 years old ranging from 40 to 71 years old; the duration of the disease ranged from 2 to 5 years with a mean of 3.7 years. The visual analogue scale (VAS) and the lumbar segments range of motion (ROM) was analyzed at pre-operation, 2 days, 3 months and final followed-up after operation, the effects were evaluated with modified Macnab standard.

RESULTSAll patients were follow-up from 6 to 10 months with an average of 7.6 months. The pre-operative VAS was 6.41 +/- 0.94, the postoperative VAS at different time points improved significantly comparing with pre-operation,and the differences were statistically significant (P < 0.01). There was no significant difference in VAS at different time points after operation (P > 0.05). The ROM of operated segment and adjacent segment was (4.88 +/- 0.86) degrees and (6.82 +/- 0.73) degrees respectively at pre-operation. The postoperative operated segment ROM at different time points improved significantly comparing with pre-operation, and the differences were statistically significant (P < 0.05). Compared with pre-operation, there was no significant difference in adjacent segment ROM at different time points after operation (P > 0.05). According to modified Macnab, the result was excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 1 case.

CONCLUSIONFluoroscopically-guided interspinous injections is an effective method for the diagnosis and treatment of Baastrup's disease. The method has advantages of simple operation, minimal invasion and safety, satisfactory short-term and medium-term therapeutic effect; it can also effectively lessen the pain of lumbar and back.

Adult ; Aged ; Anesthetics, Local ; administration & dosage ; Female ; Humans ; Low Back Pain ; diagnosis ; diagnostic imaging ; drug therapy ; Lumbar Vertebrae ; diagnostic imaging ; drug effects ; Male ; Middle Aged ; Nerve Block ; Spinal Diseases ; diagnosis ; diagnostic imaging ; drug therapy ; Tomography, X-Ray Computed

Purpose To explore the correlation between normal pancreas and abdominal aorta in the peak enhancement (PE) and the shift time at the peak by applying the multislices spiral CT perfusion imaging.Materials and Methods Prospectively analyzed 62 patients who received enhancement CT examination for the superior or the middle abdomen,underwent optimum level CT perfusion imaging after plain scanning.These data were processed on a Vitreal 2.0 worker-station by using Toshiba body software package.The time-density curves (TDC) of the normal pancreas and the abdominal aorta were drawn,the PE and the shift time of PE were recorded and their correlation was analyzed.Results Compared with abdominal aorta,the mean value of PE of the normal pancreas was lower,and the difference was statistically significant [(111.94± 14.42)HU vs (351.83 ± 74.93)HU,P＜0.05],the mean difference was (246.10± 65.86)HU.Compared with abdominal aorta,the mean shift times of PE of the normal pancreas was latter,and the difference was statistically significant [(37.56±6.90) s vs (30.82±6.73) s,P＜0.05],the mean difference was (6.54±2.97)s.The PE and shift time of PE of the normal pancreas were positively and linearly correlated with that of abdominal aorta (r=0.438,r=0.379).Conclusion The PE of the normal pancreas is not synchronous with that of the abdominal aorta.The shift time of the former is usually 6～8 seconds slower than that of the latter.This provides a basis to find the PE of the normal pancreas in enhanced scan.

OBJECTIVE:To promote the healthy development of TCM decoction piece. METHODS:Based on analyzing the literature,national policy and data,the advantages and urgent problems of bringing TCM decoction piece into the National Essen-tial Medicine List were summarized,and the suggestions for its health development were provided. RESULTS:Bringing TCM de-coction piece into the National Essential Medicine List relieved the economic burden of patients and provided opportunity for the de-velopment of TCM decoction piece industry. However,it existed problems,such as production,circulation,storage and monitor-ing;mutual conflict in the relevant supporting policies;inconsistent medicare reimbursement;and urgent improvement of quality standard. CONCLUSIONS:The relevant departments should establish and improve the quality standard system of TCM decoction piece,and clear the varieties of TCM decoction piece in the National Essential Medicine List,perfecting supporting policies such as medicare reimbursement and attaching importance to the training of professional talents can ensure scientific and rational services for the public health.

The traditional Chinese medicine (Tripterygium wilfordiiHook.f.,TWH) has been clinically used to treat primary and secondary renal diseases and proteinuria for nearly 40 years.However,there is a rare literature about the effect of triptolide (the main active ingredient of TWH) on the expression of oxidative carbonyl protein (OCP) in diabetic nephropathy (DN).This study aimed to provide experimental evidence for triptolide treatment on DN through its effect on the expression of OCP,in order to investigate the effects of triptolide on the expression of OCP in rats with DN.Sixty SD rats were randomly divided into five groups:control group,high-dose triptolide (Th) group,low-dose triptolide (T1) group,DN model group,and positive control (benazepril) group.The DN model was established using streptozotocin.Urinary protein excretion,fasting blood glucose (FBG),superoxide dismutase (SOD) in renal homogenate,malondialdehyde (MDA) in renal homogenate and renal nitrotyrosine by immunohistochemistry,and the expression of OCP by oxyblotimmune blotting were detected.In the DN model group,rat urinary protein excretion and renal MDA were significantly increased,while renal SOD significantly decreased and nitrotyrosine expression was obviously upregulated in the kidney.After triptolide treatment,24-h urinary protein excretion (61.96±19.00 vs.18.32±4.78 mg/day,P＜0.001),renal MDA (8.09±0.79 vs.5.45±0.68 nmol/L,P＜0.001),and nitrotyrosine expression were decreased.Furthermore,renal OCP significantly decreased,while renal SOD (82.50±19.10 vs.124.00±20.52 U/L,P＜0.001) was elevated.This study revealed that triptolide can down-regulate the expression of OCP in the renal cortex of DN rats.

Objective To evaluate whether small endoscopic sphincterotomy (EST) plus balloon dilation (EPBD) can replace endoscopic sphincterotomy (EST) alone for patients with common bile duct (CBD) stones.Methods From May 2008 to April 2011,462 patients with CBD stones were randomly divided into two groups.The success rate of complete stone removal after the first session,the rate of using mechanical lithotripsy (ML),the short-term complications,the procedure time and fluo roscopy time were compared between the two groups.Results Overall ductal clearance did not differ between the two groups (96.5％ vs 93.5％,P＞0.05).The complication rates at 24 hours were 6.9％ for the small EST plus EPBD group and 11.7％ for the EST group (P＞0.05).However,the rate of complete stone removal after the first session using small EST plus EPBD was significantly higher than EST alone (86.2％ vs 70.4％,P＜0.05).ML was required significantly more often in the EST group when compared with the small EST plus EPBD group (34.8％ vs 12.1％,P＜0.05).The total procedure time and total fluoroscopy time in the small EST plus EPBD group were significantly shorter than the EST group [(38.6±15.5) min vs (47.1±20.2) min,P＜0.05 and (17.3± 7.0) min vs (26.5±10.8) min,P＜0.05].Conclusions Compared with EST,small EST plus EPBD was safe and more efficacious for bile duct stones.In the future,small EST plus EPBD probably can replace EST to be the first treatment of choice for bile duct stones.