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.

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.

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.

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.

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.

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 investigate the outcomes of patients with rheumatoid arthritis (RA) treated by different combination of synthetic disease modifying antirheumatic drugs (DMARDs) under the guidance of treat-to-target strategy.Methods Forty-two RA patients with high disease activity were enrolled into this randomized,open-label and prospective study.It was comprised of a maximal 36-week induction phase and then followed by a maintenance phase up to 84 weeks.Combination of synthetic DMARDs was initiated in the induction phase,with or without low dose glucocorticoids (GCs) during the first 12 weeks.Patients who achieved low disease activity (LDA) were randomized into two maintenance groups.An increase of DAS28 by 0.6 was defined as relapse.The patients achieved LDA in the induction phase,relapsed during maintenance phase and possible relevant risk factors were analyzed.Results Twenty-seven (64％) patients achieved LDA during the induction phase.More non-smoking patients achieved LDA than those smoked [85％ (11/13) vs 55％(16/29),P＜0.05].During the maintenance phase,14 (61％) out of 27 patients relapsed.Patients taking GCs during the first 12 weeks had a significantly higher relapse rate compared to those without GC (83％ vs 36％,P=0.021).Patients who entered maintenance phase at week 12 had a significantly higher tendency to relapse compared to those who entered the maintenance phase at week 24 [75％(9/12) vs 33％(3/9),P=0.026].Conclusion Smoking seems to be a risk factor for RA patients who fail to reach LDA.Low dose GCs as a bridge therapy may require a longer duration.High relapse rates in both the maintenance groups indicat that a longer tight induction phase may be appropriate before downstairs therapy.

Inflammation and infection play an important role in the pathogenesis of many cancers. Toll-like receptors (TLRs) are a class of pattern recognition receptors that recognize conserved components of microbes and trigger the immune response against invading microorganisms. Toll-like receptor 9 (TLR9) recognizes non-methylated cytosine-phosphateguanosine (CpG) DNA sequences which are the surrogate for viral DNA. TLR9 may react to tumor development and progression during chronic inflammation that involves the tumor microenvironment. In order to study the role of TLR9 in cervical cancer, we analyzed the TLR9 expression in different types of HPV infection cervical cancer cells. Then we detected if CpG sequences influenced the TLR9 expression and the sensitivity to cisplatin (DDP) of these cervical cancer cells in vitro. The expression of TLR9 mRNA and protein in SiHa, Hela and C33A cells was detected by RT-PCR and Western blotting. Real-time PCR was used to examine the TLR9 expression changes induced by CpG. Chemosensitivity of the cervical cancer cells to cisplatin (DDP) was measured by MTT. It was observed that the expression of TLR9 mRNA and protein was increased gradually in SiHa (HPV16+), Hela (HPV18+) and C33A (HPV-) cells. Low doses of CpG increased the TLR9 expression only in C33A (HPV-) cells, but not in SiHa (HPV16+) and Hela (HPV18+) cells. Furthermore, low dose of CpG significantly increased the sensitivity of C33A (HPV-) cells, but not that of SiHa (HPV16+) and Hela (HPV18+) cells. These results indicated that TLR9 may serve as a protective agent in HPV negative cervical cancer cells. It was concluded that TLR9 could improve the sensitivity to DDP in HPV negative cervical cancer cells and might represent a potential therapeutic option in clinical practice.