Objective To conduct a Meta analysis based evaluation of dual-source computed tomography (DSCT) in the diagnosis of coronary artery disease (CAD). Methods Literatures publicated from January 2006 to July 2009, including in English or Chinese languages, were searched in Medline,China National Knowledge Infrastructure (CNKI), and Chinese Medical Assosiation Digital Periodicals (CMADP). A study was enrolled if it: ( 1 ) used DSCT angiography as the diagnostic test for the detection of significant coronary stenosis ( ≥50% diameter stenosis) in patients with suspected CAD; (2) used coronary angiography as the reference standard. The pooled sensitivity and specificity of the 95% confidence interval (95% CI) were acquired based on the bivariate random-effects modol. Hierarchical weighted symmetric summary receiver-operating curve (HSROC) was also estimated. The pooled likelihood ratios were calculated based on the pooled sensitivity and specificity. Combined with the pooled likelihood ratios, the clinical utility of the results was estimated according to Bayes'theory. Results Total of ten articles enrolled in this study, included 1271 patients. The mean rate of nonevaluable patients and segments were 5.6% (33/590) and 2. 3% (271/11 745 ), respectively. The pooled statistical results were as follows: the sensitivity and specificity were 99% (97%-99% ) and 86% (79%-90% ), respectively; the positive and negative likelihood ratio were 6. 84 and 0. 01, respectively. If a pre-test probability was below 84%, the likelihood of disease was less than 5% on a negative diagnosis of DSCT. If a pre-test probability was above 13%, the likelihood of disease was more than 50% on a positive diagnosis of DSCT. Conclusions DSCT angiography presents good diagnostic performance in the detection of CAD; however, it could not completely replace conventional coronary angiography.

Objective This study discusses the effect of integrating method in the international students' basic chemistry class of medical colleges.Methods The integrating method was composed of the new teaching methods,such as PBL and micro-learning resources,and traditional method.The experimental group was composed of 76 students from the Class 1 of international students of Grade 2015 in clinical medicine of China Medical University,where integrating method was used,namely the teaching methods and means of problem based learning and micro class were integrated into the experimental courses,while the control group was composed of 80 students in Class 2 from the same major and grade,which was using the traditional method of teaching and practicing.A unified examination was applied to evaluate the teaching efficiency in both two groups and the teaching effect of the experimental group was investigated by questionnaire.The data was entered into SPSS 13.0 for two independent samples t-test.Results In the exams the students in the test group got higher scores than that in the control group.The average scores were (17.6 ± 4.5) and (16.0 ± 4.8) respectively (t=4.42,P=0.00),the differences were statistically significant.The effective recovery rate of the experimental group was 100％,and among them,97.4％ (74) of the students thought that they should continue to use the integrating teaching.Conclusion The application of integrating teaching in the course of basic chemistry experiment can improve students' comprehensive ability,and the effect is better than the traditional teaching.

Objective To observe the early clinical efficacy of PFC fixed platform and RP rotating platform prosthesis two kinds of artificial knee replacement system for the treatment of knee osteoarthritis.Methods 39 cases (39 knees)with knee osteoarthritis were treated with total knee arthroplasty(TKA).According to intraoperative use of different types of prosthesis,the cases were divided into two groups:fixed platforms group 16 cases and rotating platform group 23 cases.The wound healing,patients with gait and knee activity after operation were observed.Results Three cases took place postoperative deep vein thrombosis,after conservative treatment,the symptoms improved and discharged,two cases of postoperative wound fat liquefaction,by dressing wound healing,time stitches discharged.3 to 12 months follow-up visit(average 10 months),all patients could walk uptight without noticeable limp.Last follow-up group,fixed platforms,rotating platform group Knee Score (HSS) and knee activity (ROM) were (83.17 ± 7.12),(81.32 ± 5.39) points and (109.73 ± 6.35) °,(103.12 ± 4.28) °,compared with the preoperative differencewasstatisticallysignificant (AgroupHSS:t =22.10,ROM:t =9.21 ; BgroupHSS:t =30.69,ROM:t =9.54,all P ＜ 0.01),but the difference between groups was not statistically significant(HSS:t =0.88,ROM:t =3.63,all P ＞ 0.05).Conclusion Using PFC and RP prosthesis after total knee replacement system in early has a good effect,both of which improve joint function early with no significant difference,but long-term effects need further observation.

0.05). Conclusion: RVPI and RSVPI of can be used as a measure to assess VPF and speech articulation of CP patients after operation.

Background Benign lymphoepithelial lesion of lacrimal gland is not a common orbital disease in clinic,which mainly presented as symmetrical and painless enlargement of bilateral lacrimal glands.However,the etiology and pathogenesis of this disease is still unclear now.Objective This study was to screen the differentially expressed genes between benign lymphoid epithelial lesion of lacrimal gland and orbital cavernous hemangioma and explore the pathogenesis of benign lymphoepithelial lesion of lacrimal gland at the molecular level.Methods Nine patients diagnosed as benign lymphoepithelial lesion of lacrimal gland in Beijing Tongren Hospital,Capital Medical University were enrolled from September 2010 to April 2013,and nine patients with orbital cavernous hemangioma served as control group.The intraorbital tissue was collected during surgery.Whole-genome gene expression microarray was used to detect the expressed genes,and limma algorithm was used to analyze the differentially expressed genes between the benign lymphoepithelial lesion of lacrimal gland and the orbital cavernous hemangioma.Real-time PCR was used to verify differentially expressed genes,Fisher method and gene ontology (GO) functional analysis were performed to realize function and signaling pathways analysis.This study complied with Helsinki Declaration and the protocol was aproved by Institutional Review Board of Beijing Tongren Hospital,and informed consent was obtained.Results Total 5 260 differentially expressed genes were screened between benign lymphoepithelial lesion of lacrimal gland and orbital cavernous hemangioma.The Fisher function and signaling pathways analysis showed that 109 GO terms were significantly upregulated and 101 GO terms were significantly downregulated,and 32 relevant signaling pathways were significantly upregulated and 25 signaling pathways were significantly downregulated in the benign lymphoepithelial lesion of lacrimal gland.GO analysis showed that the expression enrichment of complement receptormediated signaling pathway was high,then following the upregulation of T cell and B cell signaling pathways and downregulation of mitogen-activated protein kinase (MAPK) and transforming growth factor-β (TGF-β) signaling pathways.Real-time PCR results showed that the expressions of TIPRL,TLR7 and TLR10 genes were significantly higher in the benign lymphoepithelial lesion of lacrimal gland than that in the orbital cavernous hemangioma,with significant differences between the two diseases (Z =-2.03,-2.32,-2.32;all at P＜0.05),which was consistent with the microarray data.Conclusions Gene expression profiles are significantly different between benign lymphoepithelial lesion of lacrimal gland and orbital cavernous hemangioma.Those differentially expressed genes play roles in the upregulation of T cell and B cell signaling pathways,downregulation of MAPK and TGF-β signaling pathways and the change of complement system.It is implied that a comprehensive effect of various genes and pathways participates in the pathogenesis of benign lymphoepithelial lesion of lacrimal gland.

Objective To explore the image quality of 3.0 T Magnetic Resonance foot and ankle array coil on Achilles tendon ab-normalities for the clinical application.Methods 26 patients (with Achilles tendon symptoms)and 5 volunteers underwent MR exam-ination.The scanning sequences were used:T1 WI、PDWI、T2 WI-FS and STIR.Image diagnoses and clinical data of all patients were obtained and analyzed.Subjective scores on image quality were used.Degrees of comfort in coil were evaluated.Results 10 patients had Achilles tendon inj ury,6 patients with Achilles tendonitis,3 patients with part Achilles tendon rupture,1 patient with tendon xanthoma,and 6 patients were normal.Image scores in patients with T1 WI、PDWI and T2 WI-FS sequences were higher,the anatom-ic structures,lesions of whole Achilles tendon were clear.On the contrary,the lower scores were in STIR sequences.In the heel, images were distorted,the level of organization was disappeared and signal intensity was increased.The volunteers felt a slight dis-comfort at the coil entrance and support point of the heel.Conclusion Patients using 3.0T foot and ankle array coil for the Achilles tendon scanning could get high image quality and degrees of comfort.

Objective:To construct suitable vectors for the secretory expression of hirudin in Pichia pastoris.Methods:The α-facor-hirudin gene was amplified from pPIC9-hirudin by PCR and sub-cloned into PA0815.The multi-copy recombinant plasmid pA0815-(α-Hirudin)n was constructed.The recombinant was transformed into P.pastoris strain GS115 for induction expression and then the activity of secreted products was identified.Results:A new multi-copy vector pA0815-(αHirudin)n was successfully constructed and was capable of secreting recombinant hirudin efficiently,which was confirmed respectively by PCR and SDS-PAGE.The products possessed the activity of thrombin inhibitor.Conclusion:This result offers efficient P.pastoris stains for mass production of biological active hirudin.

Objective To explore the relationship between serum uric acid and fasting blood glucose ( FBG) in newly-diagnosed type 2 diabetes in regard to different genders. Methods In 282 patients of newly diagnosed type 2 diabetes(208 males and 74 females), detection of serum FBG, uric acid, creatinine, transaminases, blood lipids, etc were determined. FBG<7. 0 mmol/L was found in 118 cases (89 males and 29 females);7. 0 mmol/L≤FBG≤9. 0 mmol/L in 114 cases ( 88 males and 26 females ); FBG>9. 0 mmol/L in 50 cases ( 31 males and 19 females). Results (1)Serum uric acid showed statistically significant difference in regard to sex[Male:(325. 82±92. 26)μmol/L, Female:(292. 26±76. 19)μmol/L, P<0. 01]. (2) FBG and serum uric acid were negatively related(r=-0. 316, P<0. 01). (3) FBG and serum uric acid were negatively related both in male(r=-0. 320, P<0.01)andinfemale(r=-0.291,P<0.05). (4)Multiplestepwiseregressionanalysisshowedthatthethreegroups of FBG and serum uric acid showed regression relationship in male and female patients(P<0. 01). Conclusion With the increased FBG, serum uric acid was decreased in both males and females. Therefore, serum uric acid might serve as a potential biomarker of glucose metabolism.

Objective To investigate the role of renin angiotensin system (RAS) in pathogenesis of nonalcoholic fatty liver disease (NAFLD).Methods Twenty-four Wistar rats were evenly divided into control group and model group.The rats of control group were fed with normal diet,and model group were with high-fat diet.Rats were killed at the eighth week and serum liver function,blood lipid,glucose and insulin were tested.The liver tissues were stained with HE and Picro acid-Sirius red for pathological observation.The liver tissue concentration of angiotensin Ⅱ was determined by ELISA method and the expression of TGF-β1 in liver tissue was examined by immunohistochemistry.Results After eight weeks high fat feeding,weight,liver index,liver function,blood lipids and serum insulin of model group were significantly higher than those of control group (weight:(463.50±22.72) g vs.(404.29±10.32) g; liver index:(3.75±0.21) g vs.(2.66±0.15) g; ALT:(79.8±8.6) U/L vs.(58.8±11.6) U/L; AST:(200.01±51.72) U/L vs.(150.30±37.27) U/L; total cholesterol:(3.67±0.48) mmol/L vs.(1.50±0.23) mmol/L; triglycerides:(2.06±0.40) mmol/L vs.(0.71±0.34) mmol/L; insulin:(17.37±2.89) pmol/L vs.(11.08±2.12) pmol/L),and all the differences were statistically significant (P＜0.01).The histopathological results of model group indicated liver steatosis,inflammatory reaction in part of lobule and portal area and significant fibrosis in part of liver tissue.The liver tissue angiotonin Ⅱ concentration of model group [(32.80 ± 2.81)pg/ml] was higher than that of control group [(22.83 ± 1.75) pg/ml,t =9.559,P＜0.01].The immunohistochemistry results showed that the expression of TGF-β1 of model group was obviously higher than that of control group (Z=-2.540,P =0.011 ).Spearman correlation analysis revealed that the increasing degree of angiotensin Ⅱ concentration was positively correlated with liver steatosis scores (r=0.644,P=0.002) and the expression of TGF-β1 (r=0.470,P=0.037).Conclusion The concentration of angiotensin Ⅱ and TGF-β1 increased in the livers of model rats,which indicated that RAS may participate in the pathogenesis and progress of NAFLD.

Objective To explore the effects of empowerment education model on glycemic control and self-management behavior of community patients with diabetes. Method A total of 120 diabetics from 2 different communities were set as the observation group and control group. The control group was treated by routine medications and health education and the observation group was intervened with empowerment education model. After intervention for 6 months, the patients′blood glucose index and the diabetes self-management behavior were assessed and compared by scale of the diabetes self-care activities (SDSCA) between the two groups. Result By the end of the study, the glycemic index and SDSCA score in the former group were both significantly decreased than those in the control group (P<0.05), indicating the patients in the experiment group had better glycemic control and self-management behaviors compared with those in the control group. Conclusions Empowerment education model can arouse the internal motivation of patients to change their behaviors from passive to active acceptance in the health education. Empowerment education model can enhance diabetes patients′self-management conduct and the glycemic level.