Objective To observe the clinical curative effect of sijunzi decoction composite with shenqi pills in the treatment of spleen and kidney yang deficiency syndrome in patients with primary hypothyroidism(hypothyroid-ism).Methods 62 spleen kidney yang deficiency patients with hypothyroidism were randomly divided into 30 cases in the control group and 32 cases in the treatment group.Patients in the control group were given L-thyroxine tablets orally,once a day;patients in the treatment group were given sijunzi decoction combined with shenqi pills for decoc-tion,daily 1 agent,3 times a day orally,on the basis of the control treatment group.Two groups treatment cycle were 4 months,and the clinical efficacy of the two groups were observed.Results The treatment group total effective rate was 96.9%,which was higher than that in the control group 80.0%(χ2 =4.402,P<0.05);before and after treat-ment,TCMsyndrome scores were significantly decreased in the two groups (t=21.40,25.40,all P<0.01)and treatment group decreased more significantly(t=4.30,P<0.01 ).Before and after treatment,TSH,FT3,FT4 in the two groups were significantly improved (control group:t=5.31,1.14,4.13,treatment group:t=6.27,1.85,6.08,all P<0.01),and the degree of improvement in treatment group was more obvious compared with the control group (t=1.33,0.67,278,all P<0.05).Conclusion Sijunzi decoction and shenqi pills can significantly improve the clinical symptoms of primary hypothyroidism of spleen-kidney yang deficiency type in addition to thyroid function and blood lipid,indicating that this method is capable of achieving satisfactory clinical effects in treating primary hypothyroidism of spleen-kidney yang deficiency type.

Objective To assess the early response and acute side effects of late course stereotactic radiosurgery (LCSR) for stage Ⅲ b lung squamous cell carcinoma. Methods From June 1997 to July 1999, 136 patients with stage Ⅲ b squamous cell carcinoma of lung were treated with the conventional radiotherapy of 40 Gy followed by LCSR to the residual lesion. Stereotactic radiosurgery was given in the 5～6th weeks, 5～8 Gy per fraction with the total doses ranging from 24 to 38 Gy. Results Five patients were excluded from this study due to distant metastases and acute complications. The remaining 131 patients were analyzed to evaluate the early responses and acute complications. Acute radiation induced esophagitis occurred in 41.2% of patients (Grades Ⅰ Ⅱ (RTOG), 4.4% Grade Ⅲ). Acute radiation induced pneumonitis was observed in 16.9 % of patients ( Grades Ⅰ Ⅱ (RTOG),5.2% Grade Ⅲ). The overall response rate (CR+PR) was 86.3% for the primary tumor, and 92.4% for metastatic mediastinal lymph nodes. Conclusions LCSR is well tolerated in most patients with stage Ⅲ b squamous cell carcinoma of lung. The early responses of LCSR in the of tumor are better than the conventional radiotherapy.Remote results await further follow up.

Objective To evaluate the changes in esophageal pressure and 24h pH on the pathogenesis of esophagitis by means of a multivariate logistic regression analysis of obtained values. Methods Monovariate comparison of parameters from 24h ambulatory esophageal pH measurements and esophageal manometry between two groups of gastro-esophageal reflux disease (GERD) patients, including 45 with esophagitis, 40 without esophagitis, and 42 healthy controls. Multivariate logistic regression analysis of parameters obtained was carried out. Results All parameters of DeMeester-Johson score were significantly higher in esophagitis than those of without esophagitis. The composite scores were 113.29?26.73 and 42.66?11.25, respectively (P

ObjectiveTo study the effect of transcatheter hepatic arterial infusion (TAI) and stereotaxic radiotherapy (SR) for unresectable liver cancer. MethodsFrom June 1997 to July 1999, TAI and SR were used to treat 36 patients with unresectable liver cancer. The first step was interventional chemotherapy(TAI) which consisted of CF 300?mg,5-FU 1?000～1?500?mg, CDDP 60～80?mg, and ADM 60～80?mg (or MMC 10～20?mg). Stereotaxic radiotherapy was given after two sessions or between the two sessions of TAI. The planned target volume was encompassed by more than 70%～90% isodose line, tumor dose from 5?Gy to 8?Gy per fraction, total number was 5～8 fractions. ResultsThe total effective rate were 94% and 97% judged by CT at 3 and 6 months respectively. The 1-,2-year survival rates were 85% and 68%,respecctively. ConclusionCompared with radiotherapy alone and interventional chemotherapy alone, the combined therapy results in higher therapeutic effect and longer remission time in patients with unresectable liver cancer.

BACKGROUND:Exploration on nonlinear acoustic response of the contrast agent microbubble contained in microvessel under ultrasound excitation is of great significance to maximizing ultrasonic energy deposition, promoting the development of quantitative imaging algorithm, revealing the damage mechanism or evaluating the targeted therapy, and overcoming the limitations of the traditional methods that are mainly used in large-size vessels, and measuring microvessel elasticity.
OBJECTIVE:To build a microvessel containing an ultrasound microbubble, revealing the internal mechanism among ultrasound, microbubble, blood flow and microvessel.
METHODS:Based on the finite element analysis and the lumped parameter model, three-dimensional microvessel containing microbubble model was built and simulated on Comsol Multiphysics 4.4 platform.
RESULTS AND CONCLUSION:Microbubble exhibited slower radial motion compared with axial motion due to vascular wal limitation, but maximum displacement and stress were found near the microbubble center because of the oscil ation coupling of the microbubble with the vascular wal . Under the same ultrasound pressure, the excitation frequency increased, accompanied by decreased and stabilized microvessl constriction and dilation;under the same frequency, with the enhancement of ultrasound pressure, the local microbubble oscil ation lasted longer. With the increase of Young’s modulus of the microvessel wal , the frequency of microbubble oscil ation was reduced, while the amplitude increased. Al these findings indicate that the frequency of microbubble oscil ation increased with the reduction of microvessel size, while its amplitude decreased. The frequency of microbubble oscil ation increased with the enhancement of ultrasound excitation, while the amplitude decreased. On the contrary, ultrasound pressure affected the dynamic characteristics of microbubble and microvessel. In particular, it was the first to demonstrate that the elasticity of microvessel has approximate linear positive correlation with the amplitude of microbubble oscil ation, which reveals the relationship between microvessel elasticity and microbubble response so as to provide theoretical basis for indirect measurement of microvessel elasticity.

Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).

Objective To compare the expression changes of neuropeptide Y (NPY) receptor Y1 in different stages of osteoblast differentiation of rat bone marrow mesenchymal stem cells (BMSCs).Methods The rBMSCs were isolated in vitro from Sprague-Dawley (SD) rats using whole bone marrow adherence method and cultured. Then, the rBMSCs were divided into osteoblast-induced group and noninduced group. In different periods of culture at 1, 2 and 3 weeks, identification of the osteoblasts was performed by using immunocytochemistry and Western blot. Expressions of mRNA and protein of Y1 receptor were detected by real time reserve transcriptase-polymerase chain reaction (RT-PCR) and Western blot. Results RT-PCR demonstrated that osteoblast-induced group had a lower expression of Y1 receptor than non-induced group at the same time point and the expression of Y1 receptor was increased in a time-dependent manner in both groups. Western blot demonstrated higher expression of Y1 receptor in osteoblast-induced group compared with non-induced group at the same time point and a decreased expression of Y1 receptor in a time-dependent manner in both groups. Conclusions During the process of osteoblastic differentiation of rat BMSCs, the expressions of mRNA and protein of NPY Y1 receptor show different trends, when NPY may mediate the inhibition of osteoblastic differentiation of BMSCs through Y1 receptor pathway.

Objective To explore the risk factors of lower limb deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT. Methods A total of 1 068 patients with traumatic fractures were involved in the study to analyze the incidence of DVT under 43 risk factors including general state, injury type, fracture condition and operation and screen significant factors for multiple factor analysis. Results The total incidence rate of DVT in 1 068 patients was 12.0%. The univariate analysis showed that male patients at age ＞60 years, with BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension, coronary artery disease and cerebrovascular disease had higher incidence rate of DVT. In different injury types, the fall injury caused the highest incidence rate of DVT (45.6%). There were different DVT rates for different fracture position,with the highest incidence rate of DVT for femur shaft fracture (20.5%). The incidence rate of DVT was 51.7% for fractures of more than three parts, 14.2% for fractures of two parts and only 3.7% for sole part. The incidence rate of DVT for comminuted fractures was higher than the overall rate. The operation duration, massive transfusion during operation and epidural anesthesia were related with the increase of incidence of DVT. Multivariate analysis found nine independent risk factors and showed that the more risk factors were, the higher incidence of DVT was. Conclusions The risk factors of DVT for traumatic fractures include age ＞60 years, BMI≥25 kg/m2, history of smoking, fall injury, more than three parts of fractures, comminuted fractures, operation duration ＞ 2 hours, massive transfusion during operation and epidural anesthesia.

Objective To investigate the effects and mechanism of calcitonin gene-related peptide (CGRP) and substance P (SP) on proliferation of rat bone marrow mesenchymal stem cells. Methods The rBMSCs were isolated using whole bone marrow adherence method. In the different periods of culturing (1, 2,and 3 weeks), expressions of the neuropeptide receptors were detected by Western Blot and reserve transcriptase-polymerase chain reaction (RT-PCR). The BMSCs were treated with CGRP and SP at concentration 10-8 mol/L at different time (1,3,5,7,9 days), cell proliferation was detected with MTT assay, the protein expressions of cyclin D1 ,cyclin E and p53 were examined using Western Blot. Results The CGRP receptor and SP receptor were expressed in BMSCs. The expression of CGRP receptor was statistically higher than that of SP receptorat the same time point. The growth curves of BMSCs cultured by both neuropeptides had similar appearance. CGRP and SP stimulated the proliferation of BMSCs significantly at 9 days and 7 and 9 days. In this process, the expressions of cyclinDl and cyclinE were up-regulated by CGRP, SP only enhanced the expression of cyclinE; these effects all reached a peak at 5 days. The expression of p53 was down-regulated by both neuropeptides. Conclusion CGRP and SP had direct effects on the proliferation of BMSCs, the regulation of cell cycle proteins is one of the mechanisms.

Objective To establish a new method for measuring the 3-D kinematics of hindfoot joints in vivo by using reverse engineering software together with the theory of rigid body kinematics.Methods CT images were gathered from 9 feet of 5 healthy volunteers in both the initial position (neutral position) and the terminal position (extremely inversion-adduction-dorsiflexion position).The 3-D digital modules of hindfoot joints in the initial position and terminal position were established with MIMICS 10.01 software.The data of reconstructed digital modules was inputted into the GEOMAGIC 10.0 software in STL format for twice registration,and then their relatively displacement and changes of angle in 3-D space between the two positions were calculated Results The rotation range of the tibiotalar joint was 3.89° ±2.77° in eversion,5.29°±4.47° in abduction,10.77°+5.70° in dorsiflexion,and the relative displacement was 0.78±0.59 mm towards lateral ankle,0.18±0.75 mm towards the hindfoot,(0.65±0.71) mm towards the proximal limbs;the range of subtalar joint was 16.46°±2.94° in inversion,12.77°±1.81° in adduction,6.33°±4.32° in plantarflexion,and the relative displacement was 5.50±1.45 mm towards medial ankle,1.96±1.77 mm towards forefoot,0.43±1.18 mm towards distal limbs; the range of talonavicular joint was 38.82°±5.98° in inversion,19.71°±6.33° in adduction,5.09°±6.89° in plantarflexion,and the relative displacement was (9.77±1.73) mm towards medial ankle,3.13±1.29 mm towards hindfoot,4.64±1.42 mm towards proximal limbs.Conclusion This method measuring 3-D kinematics of hindfoot joints in vivo is non-invasive and easy to operate.