Objective: To analyze the published domestic documents of the clinical trial for treatment of anal fissure in past 10 years, to evaluate the quality of literatures about anal fissure randomized controlled clinical trials, and to provide references of clinical studies for the treatments of anal fissure in Traditional Chinese Medicine (TCM). Methods: In term of principles of evidence-based medicine, we evaluate the published domestic literatures of the randomized controlled clinical trial for treatments of anal f issure in past 10 years. Results: We analyze 52 literatures which are in the method of randomized controlled clinical studies. 28 literatures (accounting for 53.85%) record diagnostic criteria, 38 literatures (accounting for 73.08%) make sure standards of evaluating the effect and 18 literatures (accounting for 34.62%) mention comparability between groups without describing the baseline statistics. Only 5 are marked as a funded research projects. Conclusion: in current published literatures of randomized controlled study for treatments of anal fi ssure, the problems are focused on: ① Experimental idea is unclear and design is unreasonable, ② The description of implemented process in randomized control is unspecif ic, ③ Signifi cant parameters in statistical data are missed and with less credibility, ④ Criteria of diagnosis and effi cacy are different, ⑤ Evaluation indicators are fuzzy. All above clue to the quality of clinical research needs to be improved rapidly, and standardized evaluation of eff icacy also needs to be created urgently.

The sub-health status is closely related to the functions and activities of heart in traditional Chinese medicine (TCM). The sub-health is commonly presented with a series of heart system symptoms such as palpitation, chest distress, shortness of breath, fatigue, fidgets and insomnia. It may also be accompanied with arrhythmia or blood pressure value between normal and high level. This heart system sub-health status can be transformed into re-lated heart system diseases with high possibility. This article made a review from aspects of theoretical literature, an-imal experiment, curative effect observation and clinical evaluation on the research progress of heart system sub-health status.

Neuropsychiatric systemic lupus erythematosus (NP-SLE) is more common in young woman but not yet in people over 75 years old.We report a case of NP-SLE in an old woman,who complained of tremor,hypermyotonia and gatism.The lab examinations showed strong positive (1∶3200) ANA,decreased levels of CH50,C3,C4,WBC,RBC,PLT,anti-ds-DNA(+),anti-Sm(+),SSA(+),PO(+),RO-52(+),urine blood (+) and protein (+).The proteins,MBPand IgGin CSF were increased.Head MRI scan showed many demyelination in bilateral intra ventricular and multiple patchy irregular long T1 and T2 signal under right parietal subcortical.The patient was immediately given methylprednisolone hormone therapy,combined with gamma globulin and hydroxychloroquine.After 4 days of treatment,most symptoms such as tremor and hypermyotonia disappeared.Laboratory tests showed that all immune markers changed better in three weeks.The patient was discharged in 4 weeks.it must be identified with cerebrovascular disease,Parkinson's disease and other common diseases in elderly people.It can be improved if the diagnosis and treatment of NP-SLE is immediately and the illness is well controlled.

In this paper, the Fourier transform based minimum mean square error (FT-based MMSE) method is used to calculate the regional cerebral blood volume (rCBV) in magnetic resonance (MR) perfusion imaging, and the method is improved to handle the existing noise in the imaging process. In the experiments with signal-to-noise ratio (SNR) of 50 dB, the rCBV values were compared with the results using MMSE method. The effects of different SNRs on the estimation of rCBV were analyzed. The experimental results showed that MMSE was a simple way to filter the measurement noise, and could calculate rCBV accurately. Compared with other existing methods, the present method is not sensitive to environment, and furthermore, it is suitable to deal with the perfusion images acquired from the environment with larger SNR.
Blood Volume ; Brain ; blood supply ; Fourier Analysis ; Humans ; Magnetic Resonance Angiography

] Objective To explore the role and mechanisms of FGF2 in chemo?resistance in breast cancer. Methods The inhibitors for different signal pathway were used to treat two drug?resistant breast cancer cell lines MCF?7/5?Fu and T47D/5?Fu established in our lab. MTS assay was used to determine chemo?sensitivity and Hoechst stain was used to measure apoptosis. Protein activation and FGF2 protein level in cell culture medium were detected by western blot and ELISA respectively. Results Akt inhibitor MK?2206 (20 nM) and mTOR inhibitor AZD8055 (2 nM) significantly reversed the chemo?resistance of MCF?7/5?Fu and T47D/5?Fu cell lines to 5?Fu and paclitaxel, but ERK1/2 inhibitor SCH772984 showed no significant effect. Compared to parent cell lines MCF?7 and T47D, p?Akt and p?S6K (represented as mTORactivity) levels were obviously up?regulated in MCF?7/5?Fu and T47D/5?Fu cell lines, and so do the FGF2 mRNA level and FGF2 protein level from culture medium. Moreover, FGFR inhibitor AZD4547 (4 nM) markedly reversed the chemo?resistance of MCF?7/5?Fu and T47D/5?Fu cell lines to 5?Fu and paclitaxel and down?regulated activation of FGFR?Akt?mTOR signal pathway. In agreement, FGF2 protein (10ng/ml) enhanced the chemo?resistance of MCF?7 and T47D cell lines to 5?Fu and paclitaxel and up?regulated activation of FGFR?Akt?mTOR signal pathway. Conclusion Activation of FGF2?FGFR?Akt?mTOR signal pathway promoted chemo?resistance of breast cancer cells.

Objective To investigate the incidence of subclinical hypothyroidism (SCH) during the third trimester of pregnancy and its effects on pregnancy outcomes and neonatal hypothyroidism.Methods A total of 10 695 women in the third trimester of pregnancy (28-42 weeks of gestation) who labored from January 1,to December 31,2012 in Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University were enrolled.The levels of thyroid stimulating hormone (TSH),free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb) of the mothers were quantified by electrochemical immunoassay.The time-resolved fluorescence immunoassay was used to detect neonatal thyroid hormone levels.Using t test or x2test,the incidence of adverse pregnancy outcomes was compared between SCH group and euthyroid group and between SCH women with positive (n=40) or negative TPOAb (n=176).Results The incidence of SCH was 2.02％ (216/10 695) and the positive rate of TPOAb in SCH women was 18.5％ (40/216).No neonatal thyroid dysfunction was found.According to the age matched,222 cases were randomly selected as controls from 7 757 euthyroid women.Compared with the controls,SCH women had a higher incidence of premature rupture of membranes [28.7％ (62/216) vs 14.9％ (33/222),x2=12.34],anemia [11.6％ (25/216) vs 4.1％ (9/222),x2=8.65],pregnancy-induced hypertension [9.7％ (21/216) vs 4.5％ (10/222),x2=4.53],premature labor [8.8％ (19/216) vs 3.6％ (8/222),x2=5.10] and intrahepatic cholestasis of pregnancy [8.3％(18/216) vs 2.3％ (5/222),x2=8.14] (all P＜0.05).The overall incidence of adverse pregnancy outcomes was also higher in SCH group than in the controls [69.4％ (150/216) vs 49.5％ (110/222),x2=17.96,P＜0.01].The incidence of fetal growth restriction and still birth in SCH mothers with positive TPOAb was higher than in those with negative TPOAb [7.5％ (3/40) vs 0.0％ (0/176),x2=13.32,P＜0.01; 2.5％ (1/40) vs 0.0％ (0/176),x2=4.40,P＜0.05],but there was no significant difference in the overall incidence of adverse pregnancy outcomes compared with TPOAb-negative mothers [65.0％ (26/40) vs 70.5％ (124/176),x2=0.46,P=0.50].Conclusions SCH diagnosed in the third trimester may lead to adverse pregnancy outcomes.Early screening for thyroid dysfunction is necessary.

Objective To observe the value of virtual tough tissue imaging quantification (VTIQ) in differential diagnosis of thyroid imaging reporting and data system(TI-RADS) 4 thyroid nodules.Methods A total of 185 patients with 192 TI-RADS 4 nodules were included in this study.The nodules were divided into three groups according to the maximum size as follows:Group Ⅰ,the maximum size≤0.6 cm;Group Ⅱ,0.6 cm＜ the maximum size≤ 1.0 cm;Group Ⅲ,the maximum size ＞ 1.0 cm.Shear wave velocities (SWV) of nodules were measured by means of VTIQ technique.With pathological diagnosis as the gold standard,SWV value of benign and malignant nodules were analyzed and ROC curve was drawn to assess the diagnostic efficiency.Results By the ROC curve test,at SWV cut-off values of 2.44 m/s for group Ⅰ and group Ⅱ,2.49 m/s for group Ⅲ,the sensitivity were 79.0 ％,76.0 ％,88.6％,specificity were 88.6％,89.5 ％,93.7 ％,accuracy were 83.5 ％,81.8 ％,90.1％,Youden index were 0.68,0.66,0.82,respectively.Conclusions VTIQ can reflect the hardness of TI-RADS 4 nodules,the value of the differential diagnosis of such nodules is high,convenient,noninvasive and not limited by the size of nodules.

Objective To assess the relationship between auditory evoked potential (AAI) index and plasma concentration of propofol administered by target-controlled infusion (TCI) in Chinese.Methods Ten ASA Ⅰ～Ⅱ tumor patients (5 males,5 females) scheduled for elective abdominal surgery under general anesthesia was enrolled in this study.Age ranged from 34 to 61 years,body weight from 52 to 79 kg and height from 155 to 178 cm.Radial artery was cannulated for blood sampling.The patients were premeditated with intravenous injection Midazolam 0.06 mg/L.Anesthesia was induced by fentanyl 2μg/kg,vecuronium 0.1 mg/kg and TCI of propofol which the target plasm concentration was set at 3 mg/L.After intubation,the target plasma concentration of propofol was adjusted at 1.7～2.5 mg/L.Vecuronium was continuous infusions at 2～3mg/h.Anesthesia was maintained with fentanyl-TCI of propofol-vecuronium and inhalation of 0.5 MAC isoflurane.The TCI system was composed of Base Primea company orchestra infusion pump using,the schnider pharmacokinetics model.ECG,Bp,HR,PETCO2,SpO2 and TETISO were monitored during anesthesia.Danmeter company A-line depth of anesthesia monitor recorded AAI index.Blood samples were taken at induction of anesthesia (To baseline),1,3,5,10,15,30,60 min (T1-7) and after cessation of infusion 10 and 20 min (T9-10).Plasma propofol concentration were determinated by fluorescence photometry.Results Compared with target concentrations,the measured concentrations of propofol were significantly lower during TCI(P＜0.05).There was negative correlation between AAI and plasma propofol concentrations(r=-0.818,P＜0.01).Conclusion On base of the Schnider pharmacokinetics model,the target propofol concentrations are not paralleled to plasma propofol concentrations which is descending with time prolongation.From negative correlation between AAI index and plasma propofol concentrations,AAI index will reflect indirectly plasma propofol concentrations.

Objective To explore the nursing effects of self-care body posture in patients after modified radical mastectomy. Methods The clinical data of 102 patients with modified radical mastectomy were randomly divided into the study group and the control group, all patients met the following standard:clear consciousness, effective communication, no paralysis of limbs, no fracture. In the study group, according to Orem"self-care theory" concept, patients carried out self-care body posture with mainly focus on self-emancipated and the body center of gravity position, in the control group patients were given traditional posture care with mainly emancipated assistance. The first time getting out-of-bed, the occurrence of various complications, the comfort level of emancipation and posture, as well as nursing satisfaction on the first day after surgery were observed and compared between the two groups. Results The two groups showed significant difference in the first time out-of-bed, anxiety, the comfort level of emancipation and posture, as well as nursing satisfaction. There was no significant difference between the two groups in dizziness, limb swelling, flap effusion, flap necrosis. No pressure ulcer occurred. Conclusions Making use of self-care body posture in patients after modified radical mastectomy can improve the satisfaction and comfort of the patients, and improve the patients' recovery, without increasing the complication, which is worth promoting.

Objective To study and evaluate the clinical effect of laparoscopic therapy in endometriosis com-plicated with polycystic ovary. Methods To retrospectively analyze 33 cases of endometriosis complicated with poly-cystic ovary and observe the results of symptomatic relief rate and pregnancy rate after laparoscopic therapy. Results The postoperative eumenorrhca rate, dysmenorrhea relief rate, auto-ovulation rate and pregnancy rate were 90.9%, 100% ,87.9% and 60.6% respectively. Conclusions The clinical symptoms of endometriosis complicated with polyeystic ovary are not predominance. This study confirms the laparoscopic therapy in endometriosis complicated with polycystic ovary is an effective approach to increase the symptomatic relief rate and pregnancy rate.