Objective To study the method based on gradient vector flow (GVF) and particle swarm optimization (PSO) for realizing multimodal medical image registration and improving its accuracy. Methods In view of three major components of image registration, i.e. the feature space, the similarity metric and the search strategy, a novel method was proposed with three improvements. Firstly, the GVF field was employed as the feature space. Then three similarity metrics were proposed based on GVF field. Finally, an improved PSO combined with crossover mechanism of genetic algorithm was utilized to search for the optimal transformation of two images. Results With 54 times of experiments on both simulated and real medical images, it was demonstrated that this method accurately registered the multimodal medical images to be superior to the method based on PSO of pixels, and the Walsh transform method. Conclusion The method based on GVF and PSO is effective for multimodal medical image registration.

Difficult-to-treat asthma is a complex disease with poor response to high-dose inhaled corticosteroids plus a second controller or need high levels of treatment to maintain control.Difficult-to-treat asthma represents a significant clinical challenge and a heavy medical burden due to its heterogeneity.Identification of the phenotypes and endotypes in difficult-to-treat asthma is very helpful for individualized therapy.This review summarizes the latest studies on the classification of difficult-to-treat asthma in order to provide evidence for the diagnosis and treatment of difficult-to-treat asthma in children.

Objective To evaluate the diagnostic value of DCE-MRI and breast MR reporting and data system(BI-RADS-MR)in differentiation of breast lesions. Methods Seventy-five patients with 75 pathological-confirmed breast lesions underwent DCE-MRI before treatment and DCE-MRI quantitative analysis. Two senior doc-tors assessed the imaging features blindly by BI-RADS-MR. The pathology results were set as a gold standard. The receiver operating characteristic curve(ROC)interpretation of two physician′s curve analysis was used to evaluate the sensitivity,specificity of BI-RADS classification. Results According to the BI-RADS MR score,38 breast cancer patients were rated as 1 case in grade Ⅰ,0 case in grade Ⅱ,4 cases in gradeⅢ,13 cases in gradeⅣ,20 cases in grade V;37 breast benign tumors were rated as 17 cases in grade Ⅰ,5 cases in grade Ⅱ,12 cases in gradeⅢ,3 cases in gradeⅣandⅤ0 cases. The statistical difference of Tpeak,S max,K1 between benign and malig-nant breast tumors were significant(P<0.05). On ROC,the area under the curve was 0.940,95%confidence in-terval was from 0.887 to 0.994. The sensitivity of BI-RADS in the diagnosis of breast cancer was 94.59%and speci-ficity was 92.11%. Conclusion DCE-MRI combined with BI-RADS-MR classification in diagnosis of benign and malignant breast tumors has an important value and can improve diagnosis and differential diagnosis level.

Objective To optimize the extraction process for the effective fraction of Bushen Yizhi ( BSYZ) formula. Methods Yield of the effective fraction and contents of two marker compounds 2,3,5,4 -tetrahydroxystilbene-2-O-β-D-glucoside and osthole assayed by high performance liquid chromatography (HPLC) were used as the optimizing indexes, and weighted coefficient of the indexes was analyzed by analytic hierarchy process ( AHP). Ratio of liquid-to-solid, extraction time, and extraction times were used to screen the optimal conditions by orthogonal test. Results The optimized extraction process of the effective fraction of BSYZ formula was as follows: extracting with 8-fold water for three times, and boiling for 1.5 hours each time. The verification test showed that the comprehensive scores of the optimized extractive process were higher than those obtained in the orthogonal test. Conclusion The optimized extraction process and conditions are practical in the manufacture of the effective fraction of BSYZ formula.

Objective To assess the suppression effect on WWOX gene in SKOV3/SB cell line by small interference RNA (siRNA). Methods Transfection of siRNA using lipofeetamine 2000 was conducted to silence WWOX gene expression, the expression levels of WWOX mRNA and protein were evaluated,and the effects on the cell cycles at 48 hours of transfection were assessed by RT-PCR, western blot and flow eytometry (FCM) respectively. The cisplatin resistance index was assayed after transfection of SKOV3/SB with siRNA by methyl thiazolyl tetrazolium(MTT) and the cisplatin concentration of SKOV3/SB cells transfected with siRNA of WWOX was measured by high performance liquid chromatography. Results(1) In SKOV3/SB cells transfected with WWOX interference fragment, whether at the mRNA or protein level, the expression of both of WWOX decreased. There was a significant difference (P<0.05) compared with SKOV3 cells and non-transfected cells. (2) After transfecfion of the WWOX interference fragment, the index of platinum resistance of SKOV3/SB decreased from 5.04 to 3.89. (3) The number of cell transfected with the WWOX interference fragment in G1 phase was increased, while that in S-phase was decreased. (4) The cisplatin concenla'ation of SKOV3/SB cells transfected with the WWOX interference fragment was increased from 9.43 ng/L to 23.45 ng/L compared with SKOV3/SB cells non-transfected with a significant difference (P<0.05). Conclusion WWOX gene may be involved in cisplatin resistance phenomenon in epithelial ovarian cancer.

Objective To research clinical significance of electrocardiogram(ECG) measuring in diagnosis of hyperkalemia. Methods ECG changes and serum potassium concentration from 72 cases have been analyzed and contrasted. Results Forty-one cases with hyperkalemia are detected by ECG changes. Coincidence rate is up to 56.9% with serum potassium test. When the serum potassium concentration exceeds 5.5mmol/L, the accuracy of ECG in diagnosis of hyperkalemia was 22.2%. The main features arc peaked T wave with tabernacle shape ;when the serum potassium concentration exceeds 6.7mmol/L, the accuracy of ECG in diagnosis of hyperkalemia was 74.3%. The main features are ST debased,P wave with low amplitude and time limit increased. Some patients appeared sinus node-ventride conduction. One or two appeared malignant ventricular arrbythmia; when the serum potassium concentration exceeds 10.0mmol/L,the accuracy of ECG was 100% ,most patients appeared malignant ventricular. Conclusion The electrocardiogram measurement has the better consistency with serum potassium test, and abnormal electrocardio-gram will be eccurred,when mixed other electrolyte unbalance. Pseudo-hyperkalemia can be distinguished accurately and conveniently by using this method.

Objective To observe the relationship between liver steatosis in rats with long-term high-caloric and high-fat diet and the expression of angiotensinogen(AGT)、uncoupling protein 2(UCP-2)and transforming growth factorβ1(TGFβ1).Then angiotensin-converting enzyme inhibitor(ACEI)and angiotensin Ⅱ receptor blocker(ARB)drugs were given to investigate whether rennin-angiotensin system (RAS)blockade can mitigate the liver steatosis and to probe its mechanisms.Methotis Forty male Wistar rats were divided into normal control group(NC group,n=10),high-calorie and high-fat fed group(HF group,n=10),ARB treated group(AR group,n=10)and ACEI treated group(AE group,n=10).Rats were fed with high-calorie and high-fat diet and given RAS inhibitor drugs(valsartan 40mg/kg to the AR group and perindopril 4 mg/kg to the AE group)for eight weeks.Serum TG,free fatty acids(FFAs) lever and the fat content in liver were then measured with biochemical tests;insulin resistance was evaluated with euglycemic hyperinsulinemia clamp technique,the expression of UCP-2 and TGFβI in liver tissue were examind with immunohistochemical staining and AGT mRNA,UCP-2 mRNA and TGFβ1 mRNA were tested with RT-PCR.Results With the administration of RAS inhibitor drugs,following changes were observed.The levels of TG and FFAs and the fat content in liver decreased(P＜0.01 or P＜0.05),insulin resistance in high-fat fed rats was improved(P＜0.05),liver steatosis,inflammation and fibrosis were mitigated.The levels of UCP-2 decreased by 36.5%(P＜0.05)in AE group and 42.5%(P＜0.05)in AR group and TGFβ1 decreased by 37%(P＜0.05)in AE group and 41.6%(P＜0.05)in AR group as compared with the HF group with immunohistochemical staining.The expression of AGTmRNA decreased by 14.9%(P＜0.05)in AE group and 21%(P＜0.05)in AR group,UCP-2 mRNA decreased by 9%(P＜0.05)in AE group and 11%(P＜0.05)in AR group and TGFβ1 mRNA decreased by 17%(P＜0.05)in AE group and 19%(P＜0.05)in AR group as compared with the HF group with RT-PCR.Conclusions RAS blockade could improve insulin resistance,mitigate the liver injury of long term high-fat fed rats and have a protective effect on liver.The mechanism may be associated with the effects of improved insulin resistance,the interaction within RAS and the down-regulation of UCP-2 and TGFβ1 in liver tissue.

Objective To compare the clinical effects of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of intertrochanteric fractures in elderly patients.And provide a reasonable basis for clinical treatment of elderly patients with intertrochanteric fractures.Methods The clinical and follow-up records of 58 elderly patients with intertrochanteric fractures treated by PFNA and DHS were retrospectively reviewed.For times of operation,blood loss in operation,length of incision,incidents of complication and Harris's hip functional standard score were compared and analyzed.Results PFNA group operation time[(59.61 ± 8.27)min],amount of bleeding[(234.51 ± 38.80)ml] were both better than the DHS group of[(83.54 ± 11.12)min and (446.57 ±54.01) ml] respectively.There were significant differences (t =9.80,18.10,all P ＜ 0.05).The satisfactory rate was 92.8％ in PFNA group,higher than the DHS group's 83.3 ％ (x2 =6.18,P ＜ 0.05).There was significant difference between two groups in the incident of complication,DHS group was higher.Conclusion PFNA internal fixation with a minimally invasive,fixed solid and recovery fast,is the better internal fixation in the treatment of elderly intertrochanteric fracture patients.

Objective To study the chemical constituents of Bombycis Feculae. Methods Chemical constituents were isolated BPLC-ELSD. The structures of the isolated compounds were determined by spectral means. Results Two compounds were isolated and identified as 1-deoxynojirimycin (1) and (2R,3R,5R)-2-(hydroxymethyl)piperidine-3,5-diol, named as 1,3-dideoxygalatonojirimycin (2). Conclusion Compound 2 is a new alkaloid. The extract of Bombycis Feculae, compound 1 and compound 2 show inhibitory activities against a-glucosidase.

Background The incidence of dry eye is growing.However,the early diagnosis of dry eye is still difficult up to now.Keratograph 5M analyzer,a novel noninvasive ocular surface analyzer for dry eye may offer important parameters.Objective This study was to evaluate the clinical value of Keratograph 5M analyzer for clinical diagnosis of dry eye.Methods An observational study was proceeded with 88 cases who accepted myopia diagnosis in Tianjin Medical University Eye Hospital from October to December 2013.A series of conventional dry eye-related examinations were performed on the patients,including tear film break-up time (TBUT),corneal fluorescein staining scoring,Schirmer Ⅰ test (S Ⅰ t),and then Keratograph 5M analyzer-related examinations were subsequently carried out,including noninvasive tear film break-up time (NITBUT) and conjunctival hyperemia scoring.The correlations between conventional dry eye-related examinations and Keratograph 5M analyzer-related examinations were assessed by using Spearman rank correlation analysis.Results A total of 88 patients were recruited with male 32 and female 56.No significant difference in age was found between different genders (P =O.34).In 88 patients,Keratograph 5M analyzer showed the non-dry eyes in 15 patients,suspicious 44 patients (50.0％) and dry eyes in 29 patients (33.0％).However,the non-dry eyes were checked out in 39 patients and dry eyes were in 49 (55.7％) based on China Dry Eye Clinical Diagnosis and Treatment Consensus.The first NITBUT (NITBUTf) was less than the average NITBUT (NITBUTav) (P =0.00),and a positive correlation was seen between them (rs =0.62,P =0.00).Dry eye grade was significantly correlated with NITBUTf or NITBUTav or conjunctival hyperemia scoring (rs =-0.60,P =0.00 ; r,=-0.89,P =0.00 ; rs =0.24,P =0.02).A negative correlation was found between the conjunctival hyperemia scoring and NITBUTav (rs =-0.24,P =0.02).However,no significant correlation was seen between conjunctival hyperemia scoring and NITBUTf,TBUT,S Ⅰ t or corneal fluorescein staining scoring (rs=-0.13,P=0.22;rs=0.16,P=0.14;rs =-0.16,P=0.13;rs=-0.08,P=0.44).No significant difference was found between TBUT and NITBUTf (P =0.71).And TBUT was correlated with NITBUTf (rs =0.23,P =0.03),but not NITBUTav (rs =0.18,P =0.09).In addition,no significant correlations were seen between S Ⅰ t and NITBUTf or NITBUTav (rs=0.20,P=0.07;rs=0.05,P=0.66).Conclusions NITBUTav has an important significance in assessing overall ocular surface conditions.The conjunctival hyperemia score is one of refrent indicators to judge ocular surface status.