Objective To explore the correlation between heart rate variability ( HRV ) and multiple system atrophy( MSA) .Methods HRV was performed in 34 MSA patients and 32 healthy controls.The parameters of HRV study was compared, parameters studied included time domain and frequency domain.Single factor analysis andreceiver operating characteristic ( ROC ) curves were used to analyze the detection of parameters of HRV. ResultsThe HRV of MSA showed significant decreased from the health controls: root mean square successive difference of intervals (rMSSD) [(51.6 ±29.4)ms vs (70.1 ±34.1)ms,P=0.023],percentage of interval differences of successive N-N intervals greater than 50 ms(pNN50%) [ 4.2% (1.8%,9.5%) vs 9.6%(5.1%, 16.2%),P=0.005], coefficient of variation(CV) [(0.06 ±0.01) vs(0.08 ±0.02),P=0.005],very low frequency(VLF) [1003.4(586.5,1702.9)ms2vs1825.5(1407.2,2670.1)ms2,P=0.000],lowfrequency(LF) [162.9(90.6,337.4) ms2 vs 375.5(210.4,559.5) ms2,P=0.001], high frequency(HF) [164.9(77.5,470.7) ms2 vs 349.1(209.7,738.5)ms2,P=0.005].The areas under ROC in patients with MSA for VLF was 0.703(S=0.053), while the areas for CV, LF, HF and pNN50%were 0.667(S=0.054), 0.660 (S=0.055), 0.650( S=0.055) and 0.640( S=0.055) ,the results all have statistical significance(all P<0.05).The cutoff value of VLF for diagnosing MSA in the early stage was 1240.85, the sensitivity and specificity were 86.7 and 55.4(95%CI:0.599-0.807,P=0.002) .Conclusion MSA has sympathetic and vagus nerve involvement at the early stage disease, resulting dysfunction of cardiovascular autonomic system,VLF may have high drgree of assessing accuracy of its dysfunction.

Objective To assess dermatoscopic characteristics of lichen sclerosus(LS). Methods Dermatoscopy was performed to observe 27 genital or extragenital porcelain-white skin lesions in 15 outpatients with confirmed LS. Results As dermatoscopy showed, of the 27 skin lesions, 24 showed white-yellowish structureless areas, 25 linear vessels, 27 white patches, 17 keratotic plugs. Characteristic cloverleaf-like structure was observed in 7 skin lesions in 4 patients, which was consistent with LS. Conclusion Patients with LS show atypical clinical manifestations, but specific dermatoscopic patterns.

Objective To evaluate the effectiveness of yoga practice guided by Ziwuliuzhu (midnight-noon ebb-flow) theory on improving the symptoms of kidney deficiency. Methods A single-blind controlled clinical trial was carried out in 21 kidney deficiency patients. The patients were divided into two groups, 10 cases in the treatment group and 11 in the control group. During the experiment, one case of the control group dropped out. The patients in the treatment group took yogo practice ( including yin yogo and flow yogo) at Beijing time 18∶25-19∶25, a period of Youshi for kidney meridian in Guangzhou area, and the patients in the control group took the same yogo practice at Beijing time 10∶00-11∶00. The practice lasted one month. Results ( 1) The total effective rate of treatment group was 80.0% and that of control group was 60.0%, the difference being insignificant between the two trail groups ( P>0.05). ( 2) After practice, kidney-yin deficiency symptoms of aching and weakness of waist and knees, feverish sensation over five centers, and kidney-yang deficiency symptoms of aching and weakness of waist and knees, and short breath were much relieved in the treatment group ( P<0.05). In the control group, only frequent nocturia was much relieved ( P<0.05). The differences of kidney deficiency symptom relief were insignificant between the two groups ( P>0.05). ( 3) No obvious adverse reaction was found in the two groups during practice. Conclusion Compared with other period, yogo practice ( practice position for stimulating kidney meridian) at Youshi period shows better effectiveness on kidney deficiency symptoms, but there are insignificant differences of the effectiveness of yoga practice guided by Ziwuliuzhu theory on improving the symptoms of kidney deficiency.

Objective To analyze the Ag NORs in T cells of different patients to find clues for the diagnosis and monitoring of cancer.Methods A KL 2 imaging system was used to analyze the areas of Ag NORs in T cells. T cells from peripheral blood were cultivated and stimulated, and silver staining was performed. The areas of Ag NORs were analyzed.Results A total of 1 046 nomal adults, 393 patients with non malignant diseases and 706 patients with malignant diseases were analyzed. Their average IS% values were (7.81?0.69)%, (7.85?0 72)% and 5.17?0.87 respectively. The IS% values above 6% were 99.8%, 94.7% and 10% to 35% respectively. No differences were observed in different kinds of cancers except breast cancer and rectum cancer whose IS% were (5.61?0.86)% and (6.10?0.92)% respectively, 75% and 26% of their IS% were less than 6% respectively. 83% to 90% of the IS% in the patients with other cancers were below 6%. In comparison with serum CEA, AFP and the like, Ag NORs in T cells were more powerful in diagnosis and monitoring of cancers.Conclusion The value of Ag NORs of T cells was significantly lower in patients with cancers and was statistically different from that in nomal adults and patients without malignant diseases. The results demonstrated that the analysis of Ag NORs might play an important role in the diagnosis, differenciation and monitoring of cancer.

The P2Y12 receptor antagonist is used widely in prevention and treatment of cardiovascular and cerebrovascular disease. Monitoring changes of platelet function after treatment can improve the prognosis of patients. The platelet function test is the important way to evaluate high residual platelet reactivity after antiplatelet treatment, including light transmission aggregometry (LTA), whole blood impedance aggregometry assay (WBIA), vasodilator- stimulated phosphoprotein (VASP), thrombelastogram (TEG), platelet function analyzer- 100 (PFA-100) and VerifyNow system (VerifyNow). It is very different for the reflecting ability with residual reactivity of platelets among these tests after anti-platelet therapy, and also significant difference for assessment effect. Among them, LTA is a classic method for the curative effect evaluation of anti-platelet agents, which is convenient and cheap, but it is susceptible to the operating and environment interference. The clinical application of WBIA is less, and which lacks threshold value for assessment. VASP is sensitive for the changes of platelet function, but the test is complex and expensive. TEG can monitor the inhibition ratio of drugs on anti-platelets, but it needs to verify the safety of treatment. It is not clear for sensitivity and specificity with monitoring anti-platelet agent by PFA-100. VerifyNow is effective and reliable, but the cost is high. The evidence of clinical study shows that LTA, VASP and VerifyNow can reflect the effect of platelet inhibition of P2Y12 receptor antagonists sensitively, and is associated with the risk of major adverse cardiac events (MACE) in patients with cadiovascular diseases.

Objective To explore the clinical efficacy of anti-helicobacter pylori (HP) treatment on patients with type 2 diabetes mellitus and HP infection.Methods A total of 112 type 2 Diabetes patients were diagnosed with HP infection in Combine Traditional Chinese and Western Medicine Hospital of Taizhou from April 2012 to June 2016.These patients were divided into control and treatment group based on the preprandial blood glucose averages from lower to higher hierarchy.Thus,there were 56 patients in each of the two groups.The control group was given Motilium and Talcid for gastric symptoms in addition to anti-diabetes treatment,while the treatment was administered the same treatments as well as the quadruple anti-HP therapy (omeprazole,amoxicillin,clarithromycin and colloidal-bismuth-subcitrate,with Talcid stopped while colloidal-bismuth-subcitrate was administered).The anti-HP lasted for 14 days.The two groups were compared the gastric symptoms,the blood glucose levels,and the HbA1c one month after treatment.Half a year and one year post treatment,the two groups were compared the gastric mucus signs under gastroscopy.Results The improvement rates after treatment with the treatment group in abdominal pain,bloating,regurgitation,belching and diarrhea/constipation were 88.5％ (23/26),83.3％ (25/30),74.1％ (20/27),83.9％ (26/31),82.6％ (19/23),respectively,and with the control group being 29.2％(7/24),32.1％(9/28),28％(7/25),30.3％(10/33),18.2％ (4/22),respectively.The differences between the two groups were significant (x2=8.06,6.62,3.92,7.65,6.66,P＜0.05 or P＜0.01).The control group did not show significant changes in preprandial glucose levels,the glucose levels two hours post meals and the HbA1c(P＞0.05) while the treatment group showed statistically significant changes(P＜0.05 or P＜0.01).The differences in the three indicators after treatment between the two groups were significant (t =4.07,7.85,4.16,P＜ 0.05).The Gastric mucus signs under gastroscopy showed improvements in both groups after treatment.The improvement rates with the treatment group were 86.2％(25/29),86.7％ (13/15),77.8％ (14/18),72.7％ (8/11) respectively,with the control group being 36％ (9/16),27.3％ (3/11),13.3％ (2/15),14.3％ (1/7),respectively.The differences between the two groups were significant (x2 =6.71,4.12,4.38,3.85,P ＜ 0.05 or P＜ 0.01).The effectiveness rate,which was based on combined improvements in gastric symptoms,glucose levels and gastric mucus signs,was 76.8％ with the treatment group and 32.1％ with the control group.The difference was statistically significant (x2 =6.78,P＜0.01).Conclusion Anti-HP treatment can relieve the gastric symptoms,stabilize the glucose levels,and help to reverse the changed gastric mucus.All these can reduce the complications of the diabetes and improve the prognosis of the patients.

Objective To investigate the interference effects of orexin A on cell proliferation of the insulin?secreting beta?cell line(INS?1 cells) through the orexin receptor 1(OX1R)and the AKT/PKB signaling pathway. Methods INS?1 cells were exposed to different concentrations of orexin A in vitro,and treated with OX1R antagonist(SB334867),PI3K antagonist(wortmannin),or AKT antagonist(PF?04691502). The INS?1 cell proliferation and apoptosis,insulin secretion,OX1R protein activity and AKT phosphorylation level were determined. Results Orexin A(10-10 to 10-6 mol/L)stimulated the proliferation and activation of INS?1 cells,prevented apoptpsis,and increased insulin secretion. Additionally,AKT phosphorylation was stimulated by orexin A(10-10 to 10-6 mol/L). The OX1R antagonist SB334867(10-6 mol/L),the PI3K antagonist wortmannin (10-8 mol/L)and the AKT antagonist PF?04691502(10-6 mol/L)weakened the effects of orexin A. Conclusion Orexin A activated the AKT sig?naling pathway through the mediation of orexin A?OX1R,and promoted cell proliferation in INS?1 cells.

Objective:To introduce a modified method for umbilical reconstruction after single-incision laparoscopic surgery.Methods:Between June 2012 and June 2015,173 patients underwent single-incision laparoscopic cholecystectomy at our institution.All the patients adopted our modified method for umbilical reconstruction.Results:All the surgeries were successful.The umbilical incision healed well with good cosmetic result.Conclusion:The modified method for umbilical reconstruction can improve cosmesis and decrease the possibility of incision hernia after single-incision laparoscopic surgery.More studies are needed to evaluate definitive clinical advantages of this technique.

Objective To investigate the effects of salvianolic Acid A and B(Sal A,Sal B)on acute myocardial ischemia of rats.Method The rat model with acute myocardial ischemia was established by coronary ligation and intravenous injection of posterior pituitary.The effect of Sal A 10,5,2.5 mg/kg and Sal B 10 mg/kg on the electrocardiogram of different time points,serum creatine kinase(CK),lactate dehydrogenase(LDH)and myocardial infarction area were observed.Results To the rat model was established by coronary ligation,Sal A 10,5,2.5 mg/kg and Sal B 10 mg/kg could lower the ST-segment elevation,reduce infarct size and serum CPK,LDH.The effect of Sal A 10,5 mg/kg was significantly higher than that of Sal B.The role of Sal A 2.5 mg/kg was equivalent to Sal B 10 mg/kg.To the rat model was established by intravenous injection of posterior pituitary,Sal A 10,5,2.5 mg/kg and Sal B 10 mg/kg could lower the ST-segment elevation.The effect of Sal A 10,5 mg/kg was significantly higher than that of Sal B.The role of Sal A 2.5 mg/kg and sal B 10 mg/kg had no significant difference.Conclusion Treatment with Sal A 10,5 mg/kg was more effective in the rat models with acute myocardial ischemia than Sal B 10 mg/kg.Sal A 2.5 mg/kg improved acute myocardial ischemia in rats was equivalent to Sal B 10 mg/kg.

Objective To analyze the clinical features and treatment and prognosis of Paget's diseases.Method 7 cases of Paget's disease of the extramammary have been encountered. Results 3 patients with groin matastases were died within 5 years, the patients without groin matastases were all surrived.Conclusions Surgery is the treatment of first choice for Paget's disease. Prognosis of patient with groin matastases is very poor.