Atypical hemolytic uremic syndrome(aHUS) has recently been shown to be a rare disease of genetic predisposition, including genes of complement factor H(CFH), membrane cofactor protein(MCP, CD46)and complement factor Ⅰ(CFI), which are complement regulatory genes. Genes mutation is about 50%,involving the three genes mutation, including nonsense mutation, missen mutation, silent mutation, splice mutation and insertion mutation. Autosomal dominant inheritance and autosomal recessive inheritance have been reported, however, for autosomal dominant inheritance, the three genes mutations are incomplete penetrance.

Objective To study and observe the intervention effects of Acupuncture on spinal cord injury rats by using factorial design. The best combination rules of the best time course and electrical stimulation site were explored.Methods 96 experimental spinal cord injury rats were randomly divided into four groups: acupuncture on head intervention group (group A), acupuncture on body intervention group (group B), complex intervention group (group A+B) and nonintervention group (group D) . There were 24 rats in each group. The rats received electrical stimulation according experimental design. The motor function of the rats' hind limbs were detected at different time sites(1 w, 2 w, 4 w, 8 w and 12 w).Results The Results among different Methods of electrical stimulation are significantly different. The levels of the rat's BBB scale, and evoked potential(MEP) in the group A+B were the best among four groups (P＜0.05). The BBB scale and evoked potential(MEP)of the rats in each group are significantly different at different time sites (P＜0.05). It means that each kind of electrical stimulation plays a positive role in promoting restoration of motor function. The correct analysis for factorial design data is helpful to the fully application of information.Conclusion Factorial design can be used in research projects of Acupuncture, especially the design for multiple factors and multiple levels.

Neurogenic overactivity bladder is a type of overactive bladder with high incidence. This paper reviewed the research progress of neurogenic overactivity bladder in etiology, pathophysiology and treatment.

Thyroid diseases are often accompanied with dyslipidemia.In me past,low level of myroid hormone(TH) was considered a main factor in causing elevated level of blood cholesterol in hypothyroid patients.However,some clinical features can not be explained by this traditional theory. For example,in subclinical hypothyroid cases,both levels of thyroid-stimulating hormone (TSH) and serum total cholesterol (TC) increase,while TH level remains normal.From this phenomenon,we speculate that in case with hypothyroidism,not only there is a relationship between serum TC and TH levels,but also serum TC level change is related to TSH in some way,which has not been noticed.The purpose of this paper is to review the new and most advanced progress in the research of TSH and cholesterol.

Objective To explore the applicability and feasibility of the hierarchical linear model in dealing with the repeated measurement data by applying it into multi-center clinical trials’ evaluation of new Chinese medicine. Methods The theoretical research described the basic concepts and principles of hierarchical linear model and compared the applying conditions of traditional statistical methods with hierarchical linear model. In the empirical study, the hierarchical linear model was used into a real multicenter clinical trial research of traditional Chinese medicine, with the TCM syndrome score as the analysis indicator. Results The hierarchical linear model added time, group and time×group as random variables into the model to get the final result. All of the three variables were significant in the result. The interaction (time×group) statistical result was t=2.65, P=0.008 1. During the whole treatment, the TCM syndrome mean score of trial group reduced 8.5 and the control group reduced 7.47. At the end of treatment, the TCM syndrome mean score of trial group was 2.46, and the control group was 3.31, which was higher than trail group. For this result, combining with the TCM syndrome score’s developing trend, we can see that the efficacy of trial group is not worse than the control group. Conclusion By comparing the data requirements, applying conditions and analysis results, the hierarchical linear model could be an effective method which can be used in multi-center trial to evaluate traditional Chinese drug.

Traditional Chinese medicine (TCM) emphasizes treatment based on syndrome differentiation, which em-bodies the concept of individualized diagnosis and dynamic treatment on a holistic view. RCT was frequently used in TCM clinical study. However, it cannot reflect the concept of treatment based on syndrome differentiation. The use of adaptive treatment strategies (ATS) in clinical research can adjust therapy in patients according to the change of disease, so it can reflect personalized medicine and dynamic treatment. From this perspective, the process of treat-ment based on syndrome differentiation was a process of adaptive treatment decision. So the method for developing ATS can effectively evaluate the efficacy of different treatment strategies in TCM clinical study. ATS had been used in some clinical studies from published literatures abroad. However, the use of ATS in domestic clinical research was seldom been reported. This paper gave an outline of the concept of ATS. In addition, this paper focused on three methods which can take the delayed effects of current treatment action into consideration and can compare the over-all effect of different ATS. It was hoped to lay foundation for future scientific research of TCM in the implementation of SMART and provide a new idea.

Traditional Chinese medicine (TCM) emphasizes treatment based on syndrome differentiation, which is the core technology that can embody the characteristics and advantages of TCM diagnosis and treatment. This is based on holistic view to illustrate individual diagnosis and treatment and dynamic treatment. However, RCT, which is frequently used in TCM clinical studies, can not reflect the concept of treatment based on syndrome differentiation. The use of adaptive treatment strategies in clinical researches can adjust therapy in patients according to the changes of diseases, so it can reflect individual diagnosis and treatment and dynamic treatment. From this perspective, the process of treatment based on syndrome differentiation is a process of decision-making of adaptive treatment. So the method for developing adaptive treatment strategies can effectively evaluate the efficacy of different treatment strategies in TCM clinical studies. Adaptive treatment strategies have been used in some clinical studies from some published foreign literatures. However, the use of adaptive treatment strategies in domestic clinical researches is seldom reported. This article discussed the concept of adaptive treatment strategies and their important components in detail. In addition, it presented three methods which can take the delayed effects of the current treatment action into consideration and can compare the overall effect of different adaptive treatment strategies, with a purpose to lay some foundation for future TCM researches in the development of optimal clinical pathway and provide new ideas and methods for researches.

Objective To compare the value of clinical application of the ratio of urine albumin to creatinine (ACR) in the community-dwelled middle-aged and elderly at high-risk for diabetes in screening for albuminuria with casual and morning urine specimens. Methods Totally, 443 middle-aged and elderly people (234 men and 209 women) at high-risk for diabetes, with an average age of (59±8) years, were recruited from Changfeng Community of Shanghai in screening for albuminuria with casual and morning urine specimens collected on the same day, as well as another two morning urine specimens collected at an interval of two weeks, for determination of urine ACR. Albuminuria was defined as ACR equal to or more than 30 mg (albumin)/g (creatinnine) in two or more of the three urine specimens collected. Results Overall prevalence of albuminuria was 6. 3% ( 28/443 ) in the middle-aged and elderly according to diagnostic standard mentioned above, significantly higher in casual urine specimens than in morning urine specimens (14. 9% vs. 5.9%, P <0. 05). Urine ACR of casual urine specimens was significantly higher than that of morning urine (7. 1 mg/g vs. 3. 2 mg/g, P<0. 001 ). There was no significant difference in sensitivity and positive predictive value (PPV) between casual and morning urine specimens in screening for albuminuria (96. 4% vs. 92. 9%, and 99.7% vs. 99. 5%, respectively, P >0. 05). Specificity and negative predictive value (NPV) of casual urine specimens was significantly lower than those of morning urine specimens (90.6% vs. 100.0%, and 40.9% vs. 100.0%, respectively, P<0.05). The optimal cut-off value of ACR by casual urine specimens was 40. 0 mg/g in screening for albuminuria, based on receiver operating characteristic (ROC) curve, with sensitivity of 96. 4%, specificity 95.2%, PPV 57.5% and NPV 99. 8%. The middle-aged and elderly with negative albuminuria in morning urine but positive in casual urine had more risk factors for cardiovascular and chronic kidney diseases than those with negative albuminuria in both morning and casual urine specimens. Conclusions Morning urine specimen is better than casual urine for albuminuria screening in the middle-aged and elderly people with risk factors for diabetes in urban community, but casual urine used in screening for albuminuria is very convenient for collection. It is suggested that urine ACR of 40. 0 mg/g be used as an optimal cut-off value for casual urine in albuminuria screening among them.

Objective To explore an optimal cut-off value of waist circumference(WC)for identifying metabolic syndrome(MS)in middle-aged and elder residents in an urban community.Methods Database of 1558 residents aged 40-79 years at high-risk in screening for diabetes from Changfeng community,Putuo District,Shanghai during 2005 to 2007 was used to analyze sensitivity and specificity of varied cut-off values of WC for identifying two or more components of MS in men and women,respectively.Receiver operating characteristics(ROC)curve was used to explore the optimal value.Results Optimal cut-off value of WC was 85.0 cm for men and 80.0 cm for women,respectively,for identifying two or more components of MS bv ROC curve,with sensitivity of 72.3%and 74.9%,and specificity of 50.2%and 62.2%,respectively.Based on that optimal cut-off value of WC and definition of International Diabetes Federation(IOF),prevalence of MS was 38.8%in this population,40.7%in men and 37.8%in women,respectively.Conclusion The optimal cut-off value of WC was 85.0 cm in men and 80.0 cm in women,respectively,for identifying MS in the middle-aged and eldedy in an urban community of Shanghai.

Objective To elucidates the effects of HPV18 E6 siRNA targeting at human papillomavirus(HPV)18 E6 gene on the proliferative activity of HeLa cells and chemotherapy sensitivity.Methods HPV18 E6 expression of HeLa cells was inhibited by siRNA interference,the change of P53 and P21 proteins expression level was measured by Western blot.MTT assay was used to detected proliferative activity and sensitivity to paclitaxel liposome of HeLa cells.Results After inhibition of E6 expression,P53 and P21 proteins increased and the growth of HeLa cells was decreased(P ＜0.01).The inhibition rate of HeLa was markedly increased after transfection of HPV18 E6 siRNA and paclitaxel liposome.Conclusion HPV18 E6 siRNA can effectively silence gene expression of E6 and inhibit proliferation of HeLa cells.HeLa cells are more sensitive to combine HPV18 E6 siRNA with paclitaxel liposome than that of control groups.