There exists different view in the goal of investigative study.Based on the self-fulfilling cycles of self-regulated learning,the author of the article puts forward that developing the ability of self-regulated learning by doing investigative study according to each phase characteristic of self-regulated learning is one of the important goals of investigative study.

Objective Through active intervention of nursing care to improve the cognitive rate of hy-pertension, rate of blood pressure control and treatment compliance for hypertensive patients to reach the aim of alleviation of prognosis and reduction of disability and mortality. Methods Free physical examinations were carried out in population groups of above 30 years old in a certain community in Xinjiang Uygur Autonomous Region and family health files were set up. Totally 108 patients were screened and standardized management was applied in them,besides their conditions before and after the application of the management were investi-gated and analyzed by self-designed "prevention and treatment of hypertension as a chronic disease" and "in-vestigation questionnaire of KAP of patients with hypertension". Results The cognitive rate and rate of con-trol of high blood pressure were more higher after intervention than that before. Conclusions Through a planned health education instruction, popularizing prevention and treatment knowledge of primary hypertension to residents, we can increase the cognitive rate and rate of control of high blood pressure for patients with hyper-tension.

Objective To evaluate the therapeutic response of transcatheter hepatic arterial chemoembolization (TACE) for primary HCC using 18 F-FDG PET/CT.Methods Twenty-four HCC patients (21males,3 females; age range:40 to 75 years,mean age:58.1 years) with high uptake of 18F-FDG on pretreatment PET/CT and with follow-up 18F-FDG PET/CT 1-2 months post TACE were retrospectively analyzed.A lesion was regarded as positive for HCC if it had higher FDG uptake than the surrounding liver parenchyma.All patients were followed for 3 months by clinical symptoms,AFP and 18F-FDG PET/CT.x2 test was used to analyze the difference between the diagnostic value of 18F-FDG PET/CT and AFP.Results On follow-up 18F-FDG PET/CT,9 patients had lower 18F-FDG uptake than the surrounding liver parenchyma,indicating no residual tumor; while 11 patients with residual tumor showed higher uptake of FDG than the liver background though the uptake was lower than that of baseline PET/CT.Two patients with isometabolic FDG uptake were confirmed of having residual tumor during follow-up.One case showed increased 18F-FDG uptake more than that of baseline,indicating disease progression.One case was false positive for residual tumor due to over attenuation correction in the presence of lipiodol.The sensitivity and accuracy for the detection of residual tumor by 18F-FDG PET/CT and AFP were 100％ (14/14) vs 71.4％ (10/14),and 95.8％(23/24) vs 70.8％(17/24) (x2 =6.56 and 4.18,both P＜0.05),respectively.Conclusion 18F-FDG PET/CT is useful to evaluate the efficacy of TACE for 18F-FDG-avid HCC and it may provide important information for further treatment planning.

Objective To evaluate the value and characteristics of 18F-FDG PET/CT and contrastenhanced CT in pulmonary sclerosing hemangioma (PSH).Methods A retrospective study involving 5 patients confirmed as PSH by pathology from June 2007 to June 2011 was performed.The cases consisted of four women and one man with age ranged from 39 to 66 (mean 51.6) years.All patients received dualphase 18 F-FDG PET/CT,high resolution (HR) CT and multi-phase contrast-enhanced CT (Siemens Biograph 16 PET/CT).Lesion SUVmaon early and delayed PET/CT images,retention index,increased HU value,washout time from peak on contrast-enhanced CT and peritumor vessel sign were studied.Results PSH lesions showed patchy increased 18F-FDG uptake with mean SUVmax on early and delayed PET/CT of 3.3 ± 1.1 and 3.4 ± 1.4,respectively.The mean retention index was (2.1 ± 20.8) ％.The morphological features of PSH on HRCT included findings such as a round/oval nodule or mass with well-defined margins and air meniscus sign.On muhi-phase contrast-enhanced CT,PSH showed moderate to high enhancement (the increased value:35 to 59 HU) with washout times from peak of 140 to 260 s,and 1 to 4 peritumor vessel signs.Conclusions A patchy pattern of high 18F-FDG uptake on PET/CT is suggestive of benign entity.Contrast-enhanced CT findings are very useful to increase the confidence for the diagnosis of PSH.

P53 gene (exon7～8) mutatins and p53 proteins and HPV 6，11，16，18-DNA were examined in 49 cervical carcinoma by immunohistochemistry, polymerase chain reaction (PCR) and single strand conformation polymorphism (SSCP) in order to investigate their role and mutual relation and clinical significance in the onco genesis of cervical carcinoma. The results showed that first, p53 proteins posit ive rate was 48.98％, and not outstandingly related to the differentiation and the invasive degree of cervical carcinoma(P＞0.05); the defects of P53 gene (exon7～8) were not found but P53 (exon7～8) mutations were detected in 7 of 49(14.29％) cervical carcinoma; then, HPV16-DNA positive rate was much higher than HPV6,11,18-DNA positive rate respectively(P＜0.001),and the different HPV-DNA was simultaneously tested in one cerv ical carcinoma; last, not all cases of P53 mutations had p53 proteins posi tive, but the cases of P53 mutations and p53 proteins negative certainly had HPV infections, and HPV positive cases were much more than its negative one in the cases of p53 proteins positive(P＜0.001). These results proved that the oncogenesis of cervical carcinoma is mainly associated with HPV16 infections, and second related to P53 (exon7～8) mutations. p53 proteins positive results from P53 mutations or/and HPV infections in cervical carc inoma.

Objective:To explore the genetic polymorphism of cytochrome P450 enzyme 17(CYP17) and its relationship with the pathogenesis ofpolycystic ovary syndrome(PCOS).Methods:A total of 260 patients with PCOS of uyhan and han nationality in Xinjiang,who were admitted to Chinese Medicine Research Institute of Xinjiang Uygur Autonomous Region from January 2015 to February 2017,were chosen as PCOS group;the other 237 healthy fertile women,who were examined in the outpatient department during the same period,were chosen as control group.The CYP17 gene polymorphism in the two groups of subjects was detected by the restriction fragment length polymorphism polymerase chain reaction (PCR-RFLP) technique;the distribution of alleles and gene frequencies was compared between the two groups;combining with its clinical data,the relationship between CYP17 gene polymorphism and the pathogenesis of PCOS was analyzed.Results:Body Mass Index(BMI) and Follicle-stimulating hormone(FSH) levels in the PCOS group were lower than those in the control group;Luteotropic hormone(LH),Testosterone(TES) and LH/FSH levels in the PCOS group were higher than those in the control group,and the differences were statistically significant (P＜0.05).The frequencies of A1A1,A1A2,and A2A2 of CYP17 gene in the PCOS group were 34.62％,41.92％,23.46％,respectively,compared with 34.18％,43.88％,21.94％ in the control group,the difference was not statistically significant (P＞0.05).The allele frequency of A1 and A2 in the PCOS group were 55.58％,and 44.42％ respectively,compared with 56.12％ and 43.88％ in the control grouP,the difference was not statistically significant (P＞0.05).There was not statistical significance in FSH,LH and LH/FSH levels of different CYP17 genotypes in the PCOS group (P＞0.05).There was statistical significance in BMI level A2A2＞A1A2＞A1A1 and TES level A2A2＜A1A1＜A1A2 in the PCOS group (all P＜0.05).The BMI,FSH,LH,TES and LH/FSH levels of different CYP17 genotypes in the control group were not statistically significant (P＞0.05).Conclusion:CYP17 gene-34bp T/C nucleotide polymorphisms is a common base replacement in the population,which is not significantly related to the pathogenesis of PCOS.

Objective To evaluate the value of increased threshold of SUVmax and delayed imaging on diluted and filled bladder for improving the detection of bladder cancer with 18F-FDG PET/CT.Methods From July 2007 to October 2012,18 F-FDG PET/CT was performed on 63 suspected or treated (with bladder preserved) bladder cancer patients (55 males,8 females,average age 69.1 years).After routine imaging,all patients were given 1 500-2 000 ml of water orally three times and voided three times.Then they underwent delayed pelvic imaging at a full bladder status.The routine images were reanalyzed with increased SUVmax threshold (from 6-8 to 8-20).The final diagnosis was confirmed by pathology or follow-up (＞6 months).The differences of SUVmax in urine,18 F-FDG metabolism in lesions between routine and delayed imaging were compared.Paired t test was used to compare their differences.Results The SUVmax of urine on routine and delayed imaging was 15.11±11.11 and 4.73±2.00 respectively (t=4.15,P＜0.01).Among the 63 patients,there were 15 malignant and 3 benign cases confirmed by pathology,and 45 patients without obvious abnormality during follow-up.All 18 cases were detected by 18F-FDG PET/CT including the 3 benign false positive cases (2 were positive by CT though negative by PET,and 1 FDG-avid cystitis).All 15 true positive cases were confirmed as primary or recurrent bladder carcinoma and 1 false positive case as inflammation.The detection rates of early imaging with routine and increased display threshold of SUVmax were 18.8％(3/16) and 43.8％(7/16),respectively.Conclusion Increased SUVmax threshold for display and delayed imaging with diluted urine under full bladder status could effectively improve the detection rate of primary or recurrent bladder cancer with 18F-FDG PET/CT.

Objective To investigate the effective indicators for the prognosis assessment in pa?tients with multiple myeloma (MM) by 18F?FDG PET/CT imaging. Methods A total of 36 patients(22 males, 14 females;median age 63.5 years) with MM confirmed by clinical or pathology from July 2007 to November 2014 were retrospectively reviewed. The number of lesions detected by PET/CT, the number of lesions with SUVmax>2.5, the SUVmax and MTV of each lesion were calculated. The correlation analysis was performed between the number of lesions detected by PET or CT,the number of lesions with SUVmax>2.5, the SUVmax , MTV and serumβ2?microglobulin (β2?M) , respectively. The patients were divided into differ?ent groups according to the development of lesions and the survival situation during the follow?up ( 4-92 months) . Kaplan?Meier analysis and multivariate Cox model were used to analyze the prognostic significance of the number of lesions detected by PET or CT and the number of lesions with SUVmax>2.5, the SUVmax and MTV. Results Both the number of lesions with SUVmax>2. 5 and MTV showed positive correlations with blood β2?M (r=0.776, 0.954, both P<0.001), while the number of lesions detected by PET/CT and SUVmax were not correlated with β2?M ( r=0.053, 0.063, 0.398, all P>0.05) . The number of lesions with SUVmax>2.5 and MTV in the progressive group( n=14) were significantly higher than those in the regressive group(n=22):66.57±4.59 vs 31.95±4.75, t=4.95, P<0.001;(287.54±31.94) cm3 vs (72.17±14.35) cm3, t=6.93, P<0.001. The number of lesions with SUVmax>2.5 and MTV were significantly higher in the dead group(n=15) than those in the survival group(n=21):65.73±4.32 vs 30.90±4.87, t=5.10, P<0?001;(267.28±34.89) cm3 vs (76.39±15.67) cm3, t=5.49, P<0.001. The best cutoff values for predicting pro?gression?free survival and overall survival were both 42 for the number of lesions with SUVmax>2. 5, and those were 114.74 and 105.48 cm3 for MTV, respectively. The progression?free survival rate was worse in the patients with higher index than those with lower value (χ2=18.20, 29.74, both P<0.001) , and the same re?sult was also seen for the overall survival rate (χ2=19.07, 25.34, both P<0.001) . Conclusion The number of lesions with SUVmax>2.5 and MTV on 18 F?FDG PET/CT images could predict the progression?free survival and overall survival rates of patients with MM, which may provide accurate prognosis information.

ObjectiveTo evaluate the clinical curative effect and security by performing the clinical study ofYinggencao formula in treatment of psoriasis vulgaris with blood-heat TCM syndrome.MethodsA total of 75 patients, diagnosed with Psoriasis Vulgaris Blood-heat RCM syndrome, were randomizedly divided into the treatmeat group with 39 patients and the control group with 36. The treatment group tookYinggencao formula twice daily, while the control group tookQingdai capsules three times daily. All the patients were treated 12 weeks. PASI scores were used as the main outcome and to estimate the curative effect rates.ResultsThe PASI scores of patients in the treatment group (6.97 ± 2.02vs. 16.88 ± 2.91;t=14.380,P=0.009) and the control group (13.14 ± 3.18vs. 17.49 ± 2.32;t=7.780,P=0.013) after treatment showed significantly lower than the scores before. The PASI scores showed significant difference between the two groups after the treatment (P=0.027). The total effective rate of treatment group was significantly higher than the control group (76.9%vs. 61.1%;χ2=5.120, P<0.05).Conclusions TheYinggencao formula therapy showed better effect thanQingdai capsules therapy in treatment of psoriasis vulgaris with blood-heat TCM syndrome.

Objective To discuss the clinical characteristics and prognosis of 15 children with hand foot and mouth disease (HFMD) and acute flaccid paralysis (AFP) who were admitted to Beijing Ditan Hospital during the outbreak of HFMD in 2008. Method The epidemiology, clinical manifestations, cerebrospinal fluid (CSF),magnetic resonance imaging and prognosis of 15 children with HFMD and AFP were retrospectively reviewed. The recovery of the patients' affected extremities were monitored for 4 weeks. Results The mean age of these patients was (22.47 ± 20.68) months (range: 5～72 months). Acute paralysis developed (3.47 ± 1.68) days after the onset of fever and progressed to maximum severity within (1～2) days. Poliomyelitis-like syndrome was observed in all cases. Of the 15 cases, 10 had monoplegia of lower limbs, two had paraplegia, one had monoplegia of upper limbs and two had quadriplegia. In these cases, the muscle power varied from level 0 to level 4, and six even showed no muscle power in their affected extremities. Thirteen cases developed neurologic complications (encephalitis, meningitis or ataxia) and three had transient urinary retention. Cerebrospinal MRI examination in eight cases showed hyperintense lesions on T2-weighted images, predominantly in the impaired anterior horn regions of the spinal cord (C2～C7 for cases with upper extremity impairments and T12～L1 for cases with lower extremity impairments), and displayed long T1 signals and long T2 signals. In addition, the midbrain, brain-stem or medulla was also involved in four cases who also contracted encephalitis or meningitis. The muscle strength in 11 patients with single lower extremity impairment showed improvements in the distal limb muscles within 4～8 days, and the other cases showed recovery 2～3 weeks later. Conclusions HFMD in combination with AFP most commonly occurs in children aged less than 2 years old. Acute paralysis develops during the early stage of infection and progresses to a maximum severity within 2 days. In most cases described here, paralysis occurred in a single lower extremity and recovered more rapidly than those with all four limbs affected or with single upper extremity impairment . MRI examination is particularly valuable for the diagnosis and prognosis of AFP because of its high sensitivity and accuracy.