Objective To evaluate the role of contrast enhanced ultrasound in treatment of ultrasound guided high intensity fo‐cused ultrasound ablation for uterine fibroids .Methods Forty eight women with uterine fibroids were allocated into contrast en‐hanced group(25cases ,42fibroids) and non contrast enhanced group(23 cases ,35 fibroids) .The average volume of fibroids and the non perfused volume and the fractional ablation and adverse effects between the tow groups were compared .Results Non perfused volume was observed in all fibroids of the two groups after high intensity focused ultrasound ablation through sulphur hexafluoride micro bubbles .The average non perfused volume was 19 .5(18 .2)cm3 and 22 .5(14 .5)cm3 ,fractional ablation was (78 ± 18)% and (87 ± 13)% of the uterus immediately after HIFU respectively .The average non perfused volume was 18 .6(18 .2)cm3 and 19 .5 (18 .7)cm3 ,fractional ablation was (85 .7 ± 15 .2)% and (87 .6 ± 8 .0)% of the uterus two days after HIFU .There was no signifi‐cant difference was observed in average non perfused volume and the fractional ablation between the two groups(P>0 .05) .During HIFU procedure ,more patients in non contrast enhanced group complained sacral pain than those in contrast enhanced group(P<0 .05) .Conclusion Contrast enhanced ultrasound is an accurate method in assessing the treatment effect of HIFU and could be safely used during HIFU treatment for uterine fibroids ,shorten therapy time ,and decrease side reaction .

Objective To investigate the diagnostic value of CT virtual endoscopy on the small intestine (CTVE)technology for intestinal diseases. Methods Forty-nine cases with suspected small bowel disease were tested by CTVE from December 2010 to February 2014. They also were performed. Results Of 49 patients, operation or electronic endoscopy showed that 9 cases were benign tumors,29 cases with malignant tumors,3 cases with intestinal polyps,4 cases with intestinal inflammation,2 cases with bowel dysfunction and 2 cases with normal intestinal. CTVE test showed that 11 cases were with benign tumors,29 cases with malignant tumors,2 cases with intestinal inflammation,1 case with intestinal polyps,4 cases with intestinal dysfunction and 2 cases with normal small intestine. Better consistency between the two diagnosis was seen(Kappa = 0. 70). The accurate rate of diagnosis was 85. 71%(42 / 49). The correct rate of CTVE diagnosis of space occupying lesions was 90. 24%(37 / 41). The correct rate of non occupied lesions was 50. 00%(3 / 6). Conclusion CTVE technology has the advantages of simple operation,safe,painless,and clinical diagnosis of small bowel disease rate is higher especially for small bowel accounted disease. It is worthy of clinical application.

Objective To investigate the safety and effectiveness of high intensity focused ultrasound (HIFU ) in the treat‐ment of uterine fibroid (<4 cm) .Methods Retrospectively studied 79 single fibroid (<4 cm) patients that treated with HIFU in our hospital from January 2011 to February 2013 .Evaluated the improvement of post‐treatment ,shrinkage of fibroid volume and HIFU‐related adverse reaction .Results All the 79 patients were successfully cured by HIFU treatment .The shrinkage rate of fi‐broid was 79 .0% (four point spacing 57 .9% ,92 .1% ) after 2‐year treatment ;Symptom severity score (SSS) and uterine fibroid symptom and quality of life score (UFS‐QOL) were significantly improved ;and there was no adverse reaction .Conclusion HIFU can be safely used in the treatment of small uterine fibroids (diameter<4 cm ) .

Applying combined PBL and traditional teaching method to medical chemistry experimental teaching.Questionnaire and course examination were used to evaluate teaching ef-fect.The conclusion was that PBL teaching method was more helpful and effective than that of single traditional teaching method.

Objective To investigate and analyze the behavior and therapeutic status of rheumatoid arthritis (RA) patients. Methods Out patients diagnosed with rheumatoid arthritis in our hospital from May to August 2007 were enrolled. The data including sex, age of onset, site of first hospitalization and medication status were collected and analyzed. Results In this 181 RA patients, the mean age of onset was (53±11) year-old, mean history duration was (10±8) years, the ratio of male to female was 1:4.2. The orthopedics department was the most common site of first hospital visit (32.0%, 58/181) and rheumatology department was the most common site to clarify the diagnosis (62.4% ,113/181). The diagnosis delay caused by patients themselves was (5.9±17.2) months and the delay caused by doctors was (9.0±22.0) months. More than half of the patients were not treated appropriately before they came to our hospital. Methotrexate was the most commonly used DMARDs (67.3%), followed by leflunomide (46.4%), sulfasalazine (37.5%) and hydroxyehloroquine (19.6%). Conclusion In this cohort, the proportion of patients who come to rheumatology department immediately after disease onset is low. There is delay between symptoms and final diagnosis. More than half of the patients are not treated appropriately.

OBJECTIVETo compare the efficacy difference in treatment of myofasical pain syndrome between sparrow-pecking moxibustion and acupuncture at trigger points so as to provide the reference of the effective therapeutic method for myofascial pain syndrome.

METHODSNinety patients were randomized into a sparrow-pecking moxibustion group and an acupuncture group, 45 cases in each one. The trigger points were selected in pain areas in the two groups. In the sparrow-pecking moxibustion group, the sparrow-pecking moxibustion was applied, 30 min in each time. In the acupuncture group, the filiform needles were inserted obliquely at 45 degrees and retained for 40 min in each treatment. The treatment was given once a day and 10 treatments made one session in the two groups. The short-form McGill pain questionnaire was used as the observation index, and the changes in pain rating index (PRI), present pain intensity (PPI) and visual analogue scale (VAS) before and after treatment were used for efficacy assessment.

RESULTSThe results of PRI, PPI and VAS after treatment were reduced apparently as compared with those before treatment in the sparrow-pecking moxibustion group and the acupuncture group (all P<0.001). The differences in PRI, PPI and VAS after treatment were not significant in comparison of the two groups (both P>0.05). The curative and remarkably effective rate was 80.0% (36/45) in the sparrow-pecking moxibustion group, which was better than 40.0% (18/45, P<0.001) in the acupuncture group.

CONCLUSIONSparrow-pecking moxibustion at trigger points achieves the superior efficacy on myofascial pain syndrome as compared with acupuncture at trigger points. This therapy is simpler in operation additionally.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Myofascial Pain Syndromes ; physiopathology ; therapy ; Treatment Outcome ; Trigger Points ; physiopathology ; Young Adult

Multilevel models are applicable to both the quantitative data and categorical variables. We used the methods, including the multilevel models, analysis of covariance and CMH chi-square test, to analyse different types of data, to explore the application of multilevel models in the analysis of the multicenter clinical trial center effect. The results showed that the analysis of covariance is more sensitive to find the center effect for quantitative data, while multilevel models are more sensitive to categorical variables. It can be seen that results with different analytical methods for center effect are not the same, and the most appropriate method should be selected in accordance with the characteristics of data, the objective of research, and the applicable conditions of the various methods in practical use.
Clinical Trials as Topic ; Humans ; Models, Theoretical ; Research Design

Objective To explore the value of 3‐dimensional volumetric diagnosis system in quantitative measurement of pulmona‐ry lobar volumetry using a 64 row MDCT .Methods Seventy‐seven adult volunteers were scanned twice on a 64 row MDCT at the end of the maximum inspiratory and maximum expiratory end respectively .On a volumetric computer‐aided diagnosis system ,the en‐tire lung was semiautomatically separated into 5 anatomy lobes including the right upper lobe ,right middle lobe ,right lower lobe ,left upper lobe ,and left lower lobe .Each lobar volume was measured .Results The lung volume of left upper lobe ,right lower lobe ,left lower lobe ,right upper lobe ,right middle lobe in male volunteers were 1 303 .90 mL and 938 .31 mL ,1 276 .90 mL and 737 .69 mL , 1 204 .47 mL and 678 .67 mL ,1 048 .49 mL and 754 .83 mL ,519 .53 mL and 407 .86 mL at the end of the inspiratory and expiratory respectively .The lung volume of left upper lobe ,right lower lobe ,left lower lobe ,right upper lobe ,right middle lobe in female volun‐teers were 915 .78 mL and 666 .23 mL ,913 .87 mL and 576 .62 mL ,822 .17 mL and 509 .30 mL ,734 .20 mL and 530 .23 mL ,389 .13 mL and 316 .70 mL at the end of the inspiratory and expiratory respectively .The values of each lobe volume between the full inspiration phase and expiration phase group showed significant difference the same sex group (P<0 .05) .The values of each lobe volume in the man group were significantly larger than those of female group in both respiratory phase (P<0 .05) .Of the D‐value in the each lobe volume in 5 anatomy lobe at full inspiration phase and expiration phase in both sex group ,both of the lower lobes were the largest , followed by the left upper lobe ,right upper lobe and right middle lobe .The D‐value in the each lobe volume at full inspiration phase and expiration phase in the man group were significantly larger than those of female group .Conclusion Three‐dimensional volumet‐ric diagnosis system and 64 row MDCT images can be used to assess the volume of each lung lobe .

AIM: To investigate the effect of PMA(phorbol 12-myristate 13-acetate) on the expression of CD18 and the mechanism. METHODS: The technique of quantitative RT-PCR analysis was used to measure the expression of CD18 mRNA in U937 cells treated by PMA. RESULTS: PMA could significantly induce CD18 mRNA expression in a dose and time-dependent manner. The induction effects of PMA on CD18 mRNA could be inhibited obviously by Myr (2 ?mol/L), a specific inhibitor of PKC, and APDC, an inhibitor of NF-?B, but not be inhibited by curcumin, a inhibitor of transcriptional factor AP-1. CONCLUSION: PMA enhanced the expression of CD18 via the pathway of PKC. Transcriptional factor NF-?B, but not AP-1, was essential for the gene transcription of CD18 in U937 cells treated by PMA.

Objective To investigate the relationship between interleukin 1β( IL?1β) , interleukin?33 ( IL?33) , neutrophil?to?lymphocyte ratio ( NLR ) and atrial fibrillation. Methods Eighty?two patients with nonvalvular atrial fibrillation treated in the department of cardiology in the Fourth People′s Hospital of Jinan from October 2015 to October 2016 were enrolled in the study,including 43 patients with persistent atrial fibrillation and 39 patients with paroxysmal atrial fibrillation. 50 healthy subjects were selected as the control group. Enzyme linked immunosorbent assay (ELISA) was used to determine the concentration of IL?1βand IL?33,and the left atrial diameter ( LAD) was measured by echocardiography. Results ( 1) The concentrations of IL?1β,NLR and LAD in the paroxysmal atrial fibrillation group were (24. 44±4. 89) ng/L,(2. 51±1. 22) %,(36. 16± 6. 12) mm,the concentrations of IL?1β,NLR and LAD in the persistent atrial fibrillation group were (26. 95±5. 86) ng/L,(5. 7±1. 8) %,(39. 36±4. 78) mm and the values in the control group were (19. 53±4. 51) ng/L,(1. 82 ± 0. 41 ) %, ( 33. 31 ± 2. 89 ) mm, respectively. The differences among the three groups were statistically significant ( F=16. 74,11. 82,14. 85,P<0. 01) . The indexes of paroxysmal atrial fibrillation group and persistent atrial fibrillation group were higher than those of the control group ( P<0. 01 ) . ( 2 ) In the persistent atrial fibrillation group, NLR and LAD were ( 5. 7 ± 1. 8 )% , and ( 39. 36 ± 4. 78 ) mm, higher than those of the paroxysmal atrial fibrillation group ( (2. 51±1. 22)%,(36. 16±6. 12) mm),the differences were statistically significant ( P<0. 01) . However,the level of IL?1βin the persistent atrial fibrillation group was not significantly different from that in the paroxysmal atrial fibrillation group ( (26. 95±5. 86) ng/L vs. (24. 44±4. 89) ng/L,P>0. 05). (3) The concentrations of IL?33 in the paroxysmal atrial fibrillation group,atrial fibrillation group, control group were ( 48. 31 ± 4. 72 ) ng/L, ( 50. 03 ± 2. 18 ) ng/L, ( 56. 87 ± 5. 12 ) ng/L, respectively. The difference among the three groups has no statistical significance ( F=2. 52, P>0. 05 ) . ( 4 ) NLR level was positively correlated with LAD ( r=0. 32,P=0. 002) . There was no significant correlation among IL?1β,IL?33 and LAD ( r=0. 16, P=0. 11, r=0. 02, P=0. 37 ) . Conclusion The levels of IL?1β, NLR and LAD in peripheral blood of patients with atrial fibrillation were significantly higher than those in patients with sinus rhythm,and there was a positive correlation between NLR and LAD.