Wiry pulse is one of the common pulse tracings, which was recorded firstly in Inner Canon of Huangdi. Most of the modern textbooks of diagnostics of TCM consider that it relates with liver-gallbladder diseases, ache and phlegm-fluid retention,etc. However, there was not record of stringy pulse relating with liver-gallbladder diseases in Treatise on Cold Pathogenic Diseases. From the original of ZHANG Zhong-jing, this article researched the author’s object of discussing stringy pulse, which can be induced as three aspects: diagnosing diseases, analysing pathogenesis and deducing prognosis. The anticle maybe benefi ted to clinical work of TCM.

Large amounts of calcium are transferred from mother to fetus to meet the fetus's demand for calcium during its bone development.Pregnant women should increase the intake of calcium and vitamin D.However,the exact maternal vitamin D requirements and supplementation remain controversial.This article reviews the recent updates in this field with an attempt to provide evidences for nutritional decision-making.

Objective To evaluate the correlation between pathological findings and clinical characteristics of patients with Sj(o)gren's syndrome (SS). Methods Eighty-four patients diagnosed with SS from 119 suspected ones at Peking University First Hospital were recruited. According to the pathological changes of lip biopsy, 64 patients were focus score (FS)( + ) and 20 patients were FS (-). In the FS( + ) group, 20 patients had germinal center (GC)( + ) and 44 patients had no GC. x2 test and t test were used for statistical analysis. Results The duration of symptoms of dry eyes or dry mouth in the FS (+) group was longer than that in the FS (-) group (P＜0.05). In the FS ( + ) patients, those with GC (+) had significantly longer duration of xerothalmia or xerostomia, higher serum IgG levels, greater FS score, and higher incidence of system involvement than those without GC patients (P＜0.05). In the FS (-) group, lip biopsies showed degenerative changes in 6 (30%) patients. Those with degenerative changes had longer duration of dry eyes and dry mouth and higher incidence of system involvement. Conclusion GC (+) in FS (+) patients and degenerative changes in FS (-) patients from lip biopsy are associated with severer clinical manifestations in patients with SS, suggesting that more clinical attention should be paid to this subgroup of patients.

AIM To elucidate the possible antiarrhythmic mechanism of matrine. METHODS Whole-cell patch-clamp technique was used to record ionic currents in ventricular myocytes. RESULTS In guinea pig ventricular myocytes, matrine 100 μmol·L-1 prolonged 90% action potential duration (APD90) by 40% at a stimulation of 0.1 Hz in a frequency-independent manner, inhibited IK1 by 47% at the test potential of -120 mV, reduced IKr,tail by 50% and had no effect on IKs,tail. CONCLUSION Matrine prolonged APD through blockade of multiple potassium currents, which may relate to its antiarrhythmic efficacy.

Islet transplantation is an effective method for diabetic therapy. This article reviews the recent achievments in the study of induction differentiation of embryonic and adult stem cells into pancreatic islets, and expects that the breakthrough in this field would provide a new method for diabetic therapy.

ObjectiveTo investigate the neural mechanism of processing the salient target during the visual search task with spatiotemporal patterns of event-related potential(ERP).MethodsSixteen subjects were asked to judge the existence of a low or high salient target from 4 items,in which one distractor might be also salient or not.A two-way repeated-measure ANOVA was carried out for behavioral performance and ERP data( distractor saliency:YES,NO)*( target:none,low salient,high salient).ResultsSignificant interaction was found between target and distractor for the reaction time (F( 1.99,29.79) =21.56,P=0.00).For the low salient target,significant difference of reaction time was found between the YES (552.57 ± 82.32 ms) and NO (540.47 ± 75.68 ms)of distractor saliency( t (15) =- 2.489,P =0.025 ).However,such difference of reaction time was not significant for the high salient target.The statistical parametric mapping of F-value of ERP suggested the effect of the distractor saliency revealed in the right fronto-parietal-temporal areas related to stimulus novelty and the effect of the target saliency appeared in the parietal-occipital regions related to visual processing during the same stage ( 350 ～ 450ms ).The significant interaction occurred in the left temporal regions (450 ～ 600 ms ) related to stimulus familiarity and its classification.ConclusionDue to both mechanisms of the parallel processing for the target and the distractor during the perceptual stage and the effective classification of the familiar network within left hemisphere during the stage of pattern classification,the salient target can be processed quickly in spite of the interference from the salient distractor.

Objective To assess the clinical features and risk factors of coronary heart disease(CHD)in patients with systemic lupus erythematosus (SLE).Methods The clinical data of 32 lupus patients with CHD and 64 age and sex-matched lupus patients without CHD from a total of 1792 in-patients with lupus from January 1994 to December 2008 were collected and retrospectively analyzed.The traditional risk factors of atherosclemsis as well as their association with the characteristics of lupus were evaluated and compared between the two group of patients.Results The average age of CHD group was(51±12)years with an average disease duration of((8±6) years、.The most common coronary events were acute myocardial infaretio(53%)and non-stable,angina[34%).Among the 12 patients who accepted coronary angiography or computed tomography scan of coronary artery,11 patients had significant atheroselerosis lesions and 1 had thrombosis in coronary arteries.Their atheroselerosis lesions were severe,which manifested as diffuse stenosis and severe calcification.Compared to the control group,the CHD group patients had more traditional risk factors[(3.9±1.8)vs(2.0±1.6),P<0.01 j as well as higher prevalence of hypertension,hyperlipidemia,postmenopausal and smoking(P<0.05).Meanwhile,the CHD group patients had longer SLE duration[12.0(6.3~19.8)vs 2.0[O.8～9.0)years,P<0.01)J,higher C3 level[(750±364)vs(598±267)mg/L,P<0.05]and higher totalprednisone dose[28.8(0~49.8)vs 24.0(0~24.6)g,P<0.05]compared to patients without CHD.No significant differences were found in auto-antibodies,SLE disease activity,organ damage,average Drednisone dose and cyclophosI,hamide usage between the two groups of patients.Multi-variate analysls showed more traditional risk factors(OR:1.62)and longer SLE duration(OR=1.09)Were independent predictors of CHD.Condusion Atherosclerosis is a common pathological change of coronary in lupus patients with CHD.Traditional risk flactors of atherosclerosis and lupus duration are identified to be the independent risk factors of CHD in SLE patients.Early interventions for traditional risk factors and appropriate control of lupus arerecommended.

Objective To assess the sleep quality of postoperative patients with breast cancer,and find out influencing factors.Methods The measurement was to adopt Athens Insomnia Scale,Hamilton Depression Scale and Big Five Personality Scale to do questionnaire for 60 breast cancer postoperative patients and 60 healthy subjects.Results 88.34％ patients had sleep difficulty after operation.The score of sleep quality of patients (12.60 ± 4.65) were higher than that in control group (3.70 ± 3.77,P ＜ 0.05).Similarly,according to the stepwise multiple regressions,the score of sleep quality of patients were positively associated with anxiety,adaptability of personality and negatively associated with openness of personality.Conclusion Sleep problems of breast cancer postoperative patients are quite severe.The influencing factors of sleep quality of patients are anxiety,openness and adaptability of personality.

Objective:To verify the fracture risk assessment tool ( FRAX) to estimate the probability of osteoporotic fracture in patients with rheumatoid arthritis ( RA ) with or without bone mineral density (BMD), and identify associated risk factors of osteoporosis .Methods: In the study, 200 patients with rheumatoid arthritis aged more than 40 years in Peking University First Hospital from Dec .2009 to Dec. 2012 were recruited.Clinical information was obtained from a questionnaire of their case history and medical records.FRAX tool was administered.Their lumber spine and left femoral BMD were determined by dual energy X ray absorptiometry.The gender, age, disease duration, menopause status, body mass index ( BMI) and accumulative dose of glucocorticoid were obtained in retrospect .Correlation analysis was conducted between the BMD and clinical information .Results:The study population ( female, 77.5%) had a mean age of 59.4 years, in which 10 (13%) patients showed a normal BMD, 67 (87%) were osteopenia or osteoporosis , while 32 patients (16%) had fragile fracture.Compared with the patients with normal BMD, the subjects with low BMD had significantly older age , longer period for corticoids usage , higher day dose and accumulated dose of corticoids .The 10-year fracture risk of sustai-ning major osteoporotic fractures and hip fracture was higher .No significant difference was observed be-tween the 10-year fracture risks calculated with BMD and without BMD .The values of the different area under the receiver operating characteristic ( ROC) curve ( AUC) for major and hip fractures calculated in three ways:without BMD, with the femoral neck BMD, and with T-score.The best result was for FRAX tool for hip fracture with the T-score ( AUC 0 .899 ) .A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinical factors studied and a low BMD . Three statistically significant variables for lumber BMD were pain on visual assessment scale ( VAS ) (P=0.02), fracture history (P=0.003) and a higher steroid accumulated dose (P=0.008).Three statistically significant variables for left hip BMD were age (P<0.001), fracture history (P=0.05) and lower BMI ( P=0.03) .Conclusion:Low BMD is a common complication in RA patients .Risk factors for major fracture and hip fracture are increased .There is a positive correlation between FRAX calculated with and without BMD or T score .FRAX with the femoral neck T score or BMD presents a discriminatory capacity better than FRAX without BMD , according to the AUC ROC .

Objective To evaluate the effect of dexmedetomidine on autophagy in the hippocampal neurons of rats with traumatic brain injury (TBI).Methods Adult male Sprague-Dawley rats,aged 12-16 weeks,weighing 340-370 g,were randomly divided into 3 groups (n=80 each) using a random number table:sham operation group (group S),traumatic brain injury group (group TBI) and dexmedetomidine group (group Dex).The rats were subjected to a diffuse cortical impact injury caused by a modified weight-drop device to induce TBI.Dexmedetomidine 15 μg/kg was injected intravenously immediately after TBI in Dex group.At 24 and 48 h after TBI,neurological deficit score (NDS) was assessed,Morris water maze test was performed,and brains were removed for detection of brain water content in the brain tissue.At 6,12,24 and 48 h after TBI,the expression of hippocampal LC3]Ⅱ was determined using Western blot analysis.Results Compared with group S,brain water content and NDS were significantly increased at 24 and 48 h after TBI,the escape latency was prolonged,and the expression of hippocampal LC3 Ⅱ was upregulated at 6,12,24 and 48 h after TBI in TBI group.Compared with TBI group,brain water content and NDS were significantly decreased at 24 and 48 h after TBI,the escape latency was shortened,and the expression of hippocampal LC3 Ⅱ was down-regulated at 6,12,24 and 48 h after TBI in Dex group.Conclusion The mechanism by which dexmedetomidine reduces TBI is related to inhibition of autophagy in the hippocampal neurons of rats.