The incidence and its growth rate of hypertension are both very high. Its pathology and pathogenesis are complex and unclear,and it does serious harm to human health. Hypertension remains incurable. Chemical medicine has good effect on hypertension,but life-long application and multi-drug combination are required,with significant adverse reactions. Also,complications can′t be effectively alleviated. Traditional Chinese medicine (TCM)guided by traditional theories,can lower blood pressure,improve metabolic abnormalities and reduce complications. Its advantages or potentials have not been fully exploited and clinical application is inadequate. Metabolic hypertension has become the main form of hypertension,and its formation mechanism is mainly related to metabolic abnormalities and insulin resistance,metabolic inflammation and other pathology and pathogenesis. A better understanding of the current status of antihypertensive pharmacology of TCM,especially devel?opment and application of metabolic hypertension models is of great significance for TCM treatment of hypertension,and for exploration of new approaches to hypertension.

Diabetic nephropathy is one of the microvascular complications of type 2 diabetes mellitus. Recently, the modern medical researches and treatments of diabetic nephropathy have some progress, but the treatment delaying the progress of renal function is still unknown. Many clinical practices showed that the traditional Chinese medicine on this disease was effective. Thus, this paper was to summarize the traditional Chinese medicine view of etiology and pathogenesis, clinical researches, experimental researches in order provide reference for clinical treatment.

Objective To explore the clinical significance of human papillomavirus L1 capsid protein detection in cervical exfoliated cells in high-risk HPV positive women. Methods From November 2012 to June 2013,386 high-risk HPV positive (detected by hybrid capture Ⅱ) cases were enrolled as eligible women from Huzhou Maternity&Child Care Hospital and Women′s Hospital,School of Medicine, Zhejiang University. All eligible women underwent liquid-based cytology (ThinPrep) followed by colposcopy. Biopsies were taken if indicated. Cervical exfoliated cells were collected for HPV L1 capsid protein detection by immunocytochemistry. Expression of HPV L1 capsid protein in groups with different histological diagnosis were compared, and the role of HPV L1 capsid protein detection in cervical exfoliated cells in cervical lesions screening was accessed. Results Total 386 enrolled eligible women were finally diagnosed histologically as follwed:162 normal cervix, 94 low-grade squamous intraepithelial lesion (LSIL), 128 high-grade squamous intraepithelial lesion (HSIL) and 2 squamous cervical cancer (SCC). The positive expression rate of HPV L1 in HSIL+(HSIL or worse) group was significantly lower than that in LSIL-(LSIL or better) group (19.2% vs 66.4%,P=0.000). While identifying HSIL+ in HPV positive cases and compared with cytology, HPV L1 detection resulted in significant higher sensitivity (80.77%vs 50.77%,P=0.000) and negative predictive value (NPV;87.18% vs 76.47%,P=0.004), significant lower specificity (66.41% vs 81.25%,P=0.000),and comparable positive predictive value (PPV;54.97% vs 57.89%, P=0.619). To identify HSIL+in HPV-positive/cytology-negative women, the sensitivity, specificity, PPV, and NPV of HPV L1 detection were 87.50%, 61.54%, 41.18%, and 94.12%respectively, while 80.00%, 86.36%, 80.00%and 86.36%respectively in HPV-positive/atypical squamous cell of undetermined significance(ASCUS)women. Conclusions HPV L1 capsid detection in cervical exfoliated cells have a role in cervical lesions screening in high-risk HPV positive women, and may be a promising triage for high-risk HPV-positive/cytology-negative or ASCUS women.

Kawasaki disease is generally diagnosed base on its clinical features. Sometimes unusual or atypical presentations make the diagnosis of Kawasaki disease difficult. We experienced an unusual case of Kawasaki disease presented with unilateral parotitis in a 23-month old girl. Despite of intravenous antibiotics treatment, fever and unilateral parotid swelling persisted. Skin rashes, conjunctival injections, and coronary abnormalities showed up on the 8th day of fever. After the intravenous immunoglobulin and salicylates treatment, all symptoms disappeared. Although unilateral parotitis is very unusual presentation of Kawasaki disease, in case of no response to antibiotics, Kawasaki disease should be included in the differential diagnosis.
Anti-Bacterial Agents ; Child* ; Diagnosis ; Diagnosis, Differential ; Exanthema ; Female ; Fever ; Humans ; Immunoglobulins ; Mucocutaneous Lymph Node Syndrome* ; Parotitis* ; Salicylates

Objective To analyze the double contrast-enhanced ultrasonography (DCUS) features of periamupullary carcinoma for enhancing the ultrasound diagnostic value of the disease.Methods The DCUS and clinical data of 40 patients with periampullary carcinoma confirmed by histopathology were reviewed.Results (1) The displaying rate of the lesions and the judgment of lesion location was statistically higher on DCUS than that of ordinary ultrasound (P ＜ 0.05).(2) DCUS features of periampullary carcinoma:the size of most lesions was less than 30 mm except for 1 case in which no lesion was found; In 100％ (39/39) of the lesions,the morphology did not change with duodenum movement ; In 64.1％ (25/39) of lesions hyperenhancement or isoenhancement was displayed in the arterial phase,with low enhancement in the venous phase; In 87.2％ (34/39) of lesions homogeneous enhancement was displayed; In 95％ (38/40) the bile ducts were moderately or severely dilated.The lesion locations and whether the lesions projected into the duodenal cavity or not were statistically different between the three different types of periampullary carcinoma (P ＜ 0.05).The lesions projected into the duodenal cavity of duodenum were more commonly seen in papillary carcinoma and ampullary carcinoma than distal common bile duct carcinoma.The lesion size,whether the lesion morphology changed or not with duodenum movement,enhancement level,enhancement homogeneity,the degree of bile duct dilatation,whether there was pancreatic duct dilatation or not were not statistically different between the three different types of periampullay carcinoma (P ＞ 0.05).Conclusions DCUS is an effective way to show periampullay carcinoma,and is helpful to diagnose periampullary carcinoma and distinguish the three different types of periampullary carcinoma.

Objective To measure the sternal angle corresponded to thoracic plane by three-dimensional reconstruction of spiral CT , and to explore the accurate positioning methods and the preoperative assessment of cervicothoracic junction lesions .Methods Selected 42 cases of normal bone mass , 48 cases with bone loss , and 60 cases of osteoporosis who were diagnosed by dual-energy X-ray absorptiometry , and measured the location of thoracic sternal angle corresponded to the thoracic spine and thoracic kyphosis angle through the volume recon -struction data of the 16-slice spiral CT chest examinations .Results The range of sternal angle corresponded to thoracic plane was measure-ment units ⅢtoⅥ.The measure unit Ⅳwas the most, accounting for about 55%.There was no statistical significance between the position of sternal angle corresponded to thoracic plane and the relationship of bone mass , which required further study .The position of sternal angle corresponded to thoracic plane was associated with the thoracic kyphosis angle .The larger the thoracic kyphosis angle , the lower the corre-sponding position was .Conclusion The thoracic segment corresponded to the sternal angle is not a constant or accurate plane , which is not properly concerned as an accurate positioning mark to the thoracic segment .The measurement of the thoracic sternal angle was corresponded to the thoracic spine location , and its co-relationship evaluation between the thoracic kyphosis angle was vital for the accurately positioning of cervico-thoracic junction area lesions , the pre-assessment methods of surgical treatment , approach selection , and different methods for ster-num and other such contents .This research was of important clinical significance .

Objective To assess the effect of neutrophil?to?lymphocyte ratio ( NLR) on the recurrence rate of patients with alpha?fetoprotein (AFP) ?negative hepatocellular carcinoma (HCC) and the value of NLR in predicting prognosis. Methods The clinical data of seventy?seven patients diagnosed with AFP?negative HCC and treated with hepatocellular carcinoma surgery in the First Hospital in Weinan from June 2015 to March 2017 were analyzed. According to the recurrence at the end of the follow?up, the patients were divided into the recurrence group and the non?recurrence group. Cox single factor analysis was used to analyze the relationship between the clinicopathological features and postoperative recurrence, and the clinical risk factors with statistically significance in the univariate analysis were placed in the Cox multivariate regression analysis to determine whether it is independent risk factor. Results The differences between the two groups in the number of tumors (31/15,28/3),tumor size (>5 cm) (5. 53±1. 83,4. 65±1. 73),portal vein tumor thrombus (18/28,2/29),microvascular invasion (14/32,2/29) were all statistically significant (P<0. 05). Cox univariate analysis showed that preoperative NLR levels ( RR=1. 125, 95%CI 1. 052-1. 203, P=0. 029 ) , tumor number ( RR=0. 943,95%CI 1. 007-1. 330, P=0. 019 ) , tumor size (>5 cm ) ( RR=0. 550, 95%CI 0. 316-0. 956, P=0. 038),portal vein tumor thrombus (RR=1. 294,95%CI 1. 208-1. 386,P=0. 022),microvascular invasion (RR=1. 575,95%CI1. 209-2. 052,P=0. 028) were the risk factors of postoperative recurrence. Cox regression model showed that tumor number (RR=1. 830,95%CI 1. 184-2. 828,P=0. 026),portal vein tumor thrombus ( RR=2. 860,95%CI 2. 062-3. 968,P=0. 001) ,microvascular invasion ( RR=1. 760,95%CI 1. 019-3. 041,P=0. 037) and preoperative NLR level ( RR=1. 890,95%CI 1. 056-3. 383,P=0. 028) were independent risk factors of the recurrence in AFP negative HCC patients after surgery. Among the 77 patients,46 cases were in the recurrent group, the average value of NLR was 3. 49 ± 0. 30, and the average preoperative NLR of the non?recurrence group ( 31 patients ) were 3. 01 ± 0. 30, the difference between the two groups in NLR value was statistically significant (t=-6. 885,P=0. 000). According to the ROC curve,the NLR=3. 17 corresponded to the maximum Youden index,the sensitivity of NLR was 82. 6%,the specificity was 67. 7%. Conclusion The preoperative NLR level is inversely proportional to the recurrence?free survival time of patients with AFP?negative HCC,which is one of the independent risk factors for recurrence. The optimal critical value of NLR is 3. 17.

Recently, traditional Chinese medicine (TCM) researches on diabetic peripheral neuropathy made great progress. It is found that theetiology and pathogenesis was the deficiency in origin and the ecessive in superficialty. The deficiencyincluded Yin deficiency, Qi deficiency, blood deficiency, deficiency of both Qi and Yin, Yang deficiency, while the ecessive in superficialty included blood stasis, stasis of phlegm and blood. Thus, the principles of treatment were supplementing Qi and nourishing Yin, warming Yang, promoting blood and removing blood stasis, and smooth Luo, all of which showed the characteristics of TCM treatment were combination of inside and outside, and multi-target effects. This paper reviewed the progress of clinical and experimental studies on the TCM for diabetic peripheral neuropathy.

Objective To compare the diagnostic value of 3.0T and 1.5T magnetic resonance diffusion weighted imaging (DWI) in lymph node metastasis of gastric cancer. Methods Preoperative magnetic resonance examination was performed on 50 patients with gastric cancer by using Siemens 1.5T and 3.0T superconducting magnetic resonance imaging system, and the outcomes were compared with postoperative pathological results. The sensitivity, specificity and accuracy of the diagnosis in lymph node metastasis of gastric cancer were analyzed statistically. The apparent diffusion coefficient (ADC) values of lymph nodes were also evaluated for 1.5T and 3.0T magnetic resonance DWI. Results The sensitivity, specificity and accuracy of the diagnosis on lymph node metastasis of gastric cancer by 1.5T magnetic resonance DWI were 79.4 %, 81.4%and 80.0%, respectively, and the corresponding percentages of 3.0T magnetic resonance DWI were 84.6%, 79.7%and 83.1%. The accuracy rate of 3.0T magnetic resonance DWI was slightly higher than that of 1.5T in the diagnosis of lymph node metastasis of gastric cancer (χ2=5.451, P=0.020), but there were no significant differences in the sensitivity and specificity between the two groups (both P> 0.05). The accuracy rate of 1.5T magnetic resonance DWI in the diagnosis of lymph node metastasis of gastric cancer was less effective than that of the pathological diagnosis (χ2=7.410, P=0.007), but there was no significant difference between 3.0T magnetic resonance DWI and pathological diagnosis (χ2=2.450, P=0.120). The mean ADC values of metastatic and non-metastatic lymph nodes detected by 1.5T magnetic resonance DWI were (1.036 ±0.203) × 10-3 mm2/s and (1.476 ± 0.215) × 10-3 mm2/s (t= 6.813, P< 0.001), meanwhile, the corresponding values detected by 3.0T magnetic resonance DWI were (1.154 ± 0.183) × 10-3 mm2/s and (1.502 ± 0.264) × 10-3 mm2/s (t= 5.991, P< 0.001). The coincidence of the two methods for ADC value was favorable. Conclusions The diagnostic effect of 3.0T magnetic resonance DWI on lymph node metastasis of gastric cancer is better than that of 1.5T. ADC value provides a reliable imaging quantitative indicator for the determination of metastatic lymph nodes in gastric cancer, which plays a significant role in the clinical treatment options and prognosis of patients.

Objective To explore the effect of Xinkang Tablets on myocardial apoptosis index,collagen volume fraction and sarcoplasmic reticulum Ca2+-ATPase activity of rats with adriamycin-induced heart failure.Methods The chronic heart failure (CHF) SD rat model was established by intraperitoneal injection of doxorubicin.After successful modeling,the rats with CHF were randomly divided into 5 groups,namely model group,western medicine group,and low-,middle-and high-dose of Chinese medicine groups,10 rats in each group.The rats in the above groups were given intragastric administration of distilled water,22.5 μg/kg of Digoxin mixed suspension,9,18,36 g/kg of XinkangTablets,respectively,in the volume of 10 mL/kg of distilled water dilution,once a day,for 5 continuous weeks.Another the same batch of 10 SD rats were randomly allocated to the sham operation group,and were treated with intragastric administration of the same volume of distilled water.And then the apoptotic rate of myocardial cells was measured by TUNEL method,the collagen volume fraction (CVF) was measured after Masson staining,and the sarcoplasmic reticulum Ca2+-ATPase activity was determined by inorganic phosphate assay.Results Compared with the sham operation group,the apoptotic rate of myocardial cells and CVF in the model group were increased(P ＜ 0.01),indicating that the myocardial remodeling occurred in rats with CHF.Compared with the model Group,the apoptotic rate of western medicine group and three Chinese medicine groups was significantly decreased(P ＜ 0.01),suggesting that Digoxin and Xinkang Tablets can relieve apoptosis to certain extent.The CVF in Digoxin group and middle-and high-dose of Chinese medicine groups were lower than those in the model Group (P＜ 0.05 or P＜ 0.01),indicating that Digoxin and Xinkang Tablets can delay the myocardial fibrosis.Last but not least,the SERCA2a activities in the middle-and high-dose of Chinese medicine groups were higher than those in the model group (P ＜ 0.05 or P ＜ 0.01),suggesting that Xinkang Tablets may relieve myocardial remodeling and improve cardiac function through the regulation of SERCA2a activity.Conclusion Xinkang Tablets decrease the apoptotic rate and myocardial cell volume fraction probably through the regulation of SERCA2a activity,which may play a role in counteracting apoptosis and myocardial fibrosis,and ultimately delay the remodeling of the myocardium.