Objective To investigated the distribution of intraluminal thrombus (ILT) in abdominal aortic aneurysms (AAAs), and to examine the influence of age, gender and aneurysm diameters on the ILT formation. Methods Morphological analysis of ILT in AAA of 103 consecutive patients was undertaken with helical CT angiography. ILT shape, distribution and thickness of ILT were recorded and analyzed in correlation with age, gender and aneurysm diameters. Results ILT were found in 66.9% of all the patients. ILT was always situated in the area away from the main axis of AAA. The incidence of ILT in female group (n=13) was much lower than that in male group (n=90) (15.5% vs 77.4%, P

Objective To evaluate the efficacy of total glucosides of paeony(TGP) in the treatment of undifferentiated spondyloarthropathies(uSpA) and investigate its mechanism.Methods One hundred and sixteen cases of uSpA were randomly assigned to 2 groups,one group was treated with TGP and diclofenac sodium,the other group with SASP and diclofenac sodium.The efficacy and side effects of the two groups were compared after 12 weeks treatment.The level of IL-6,IL-10 and TNF-? was determined at the same time.Result After 12 weeks treatment,the major clinical manifest and the indexes of disease activity were no difference of statistical significance in the two groups.The incidence of parenterally side effects was 8.6% in TGP group,and 25.9% in SASP group.There was difference at statistical significance between the two groups(? 2 =6.042,P=0.014).Before treatment,the level of IL-6,IL-10 and TNF-? in the serum of two groups were no statistical difference,while there was obviously difference after 12 weeks treatment(t= 2.672,2.483 and 2.088,P=0.009,0.014 and 0.039).Conclusion The efficacy of TGP and SASP has no significant difference in the treatment of uSpA.But the incidence of parenterally side effects in the TGP group was less than SASP group.The mechanism of efficacy of TGP may be related to inhibiting the production of IL-6,IL-10 and TNF-?.

Objective To investigate the intra-aneurysmal pressure curve in the presence of endoleak after endovascular exclusion (EVE) for abdominal aortic aneurysm(AAA). Methods Infrarenal aortic aneurysms were created with bovine jugular vein segements or patches. Then they were underwent incomplete endovascular exclusion of the aneurysm and formation of endoleaks. The pressures of blood flow outside the graft into the sac were measured. Results The intrasac pressure was higher than systemic pressure in the presence of endoleak. After sealing the endoleak, pressure decreased siginificantly, and the pressure curve showed approximately linear. Conclusion The change of intra-aneurysmal pressure curve reflected the load on aneurysmal wall after EVE, and can also help to determine the endoleak existance.

The authors adopted acupuncture plus auricular electro-acupuncture to treat 38 cases of dysmenorrhea belonging to qi stagnation and blood stasis pattern, the better therapeutic effect was achieved, with the effective rate of 97.4%.

Objective To investigate the surgery opportunity choice of congenital esotropia.Methods A retrospective research was taken using the clinical data and the results of the treatment of 146 inpatients with congenital esotropia in our department from Mar 2012 to Mar 2015.The correction rate,lackingcorrection rate,and over-correction rate were compared between early surgery group and late surgery group on time of 1 week after surgery and 6 months after surgery,respectively.Results In all the 146 patients,88 (60.3％) had an esotropia deviation greater than or equal to 40 pupil distance (PD),38 (26.0％) combined with amblyopia,12 (8.2％) combined with nystagmus,30 (20.5％) combined with inferior oblique muscle overaction,6 (4.1％) combined with dissociated vertical divergence (DVD).There was no significant difference between early surgery group and late surgery group on correction rate,lacking-correction rate,and over-correction rate on the time of 1 week after surgery and 6 months after surgery,respectively.Conclusions Congenital strabismus should take surgery at the early-stage,especially for those have large angles.It is better to be operated before 2-year old for a better formation and recovery of binocular visual function.

Objectives To assess the efficacy and safety of Xiaoyao Powder (Carefree Powder) in the treatment of depression using the method of systematic review of evidence-based medicine.Method Data published before December 2009 were searched from MEDLINE,Cochrane library,CNKI,VIP,CBM.We included randomize-controlled trials (RCT) testing Xiaoyao Powder against placebo or antidepressants,and Xiaoyao Powder combined with antidepressants against antidepressants alone.Two researchers collected data independently.The assessment of methodological quality was based on Cochrane handbook and the materials were analyzed with software RevMan 5.017.The outcome measure index was relative risk or difference of mean value (95% confidence interval).Results Thirty-two RCTs involving 2 253 patients were included.Involved trials published in Chinese were of low quality.In the trials of comparison between Xiaoyao Powder and placebo,only decrease of self-rating depression scale (SDS) score was not significantly different.For general clinical improvement and decrease of Hamilton rating scale for depression (HAMD) and SDS scores,Xiaoyao Powder combined with antidepressants was more effective than antidepressants alone,but the effect of Xiaoyao Powder was equal to antidepressants.No adverse effect was reported in the trials regarding Xiaoyao Powder.Conclusions Xiaoyao Powder appears to be effective for depression.However,the exact effect needs to be confirmed in well-designed large-sampled clinical trials.

Objective To investigate the effect of total glucosides of paeony(TGP) on hepatic dysfunction caused by Methotrexate (MTX) and Leflunomide (LEF) in patients with moderate or severe rheumatoid arthritis (RA).Methods From July 2010 to February 2011,204 cases with definite-diagnosed rheumatoid arthritis were included in three hospitals in Anhui province.All these patients suffered from moderate or severe rheumatoid arthritis and they were divided randomly into two groups,the therapeutic groups were treated with TGP combined with MTX and LEF and the control group were treated without TGP.The incidence of hepatic dysfunction was observed.Statistical anylysis was carried out by using t test and x2 test.Results One hundred and ninty-four patients had completed observation for at least 12 weeks.In the therapeutic group,only 10 of 105 patients had hepatic dysfunction compared to 31 of 89 patients in the control group.The incidence of hepatic dysfunction of the therapeutic group was significantly lower than the control group.After 12 weeks treatment with TGP,the effective respohse rates of the therapeutic group was 81.9％,which was higher than 74.6％ in the control group.The good response rate in the therapeutic group was 21.6％,which was better than 11.7％ in the control group.Although the difference between the two groups was not statistically significant,we could observed the tendency of increasing in effectiveness and the good response rate in the therapeutic group when compared with the control group.Conclusion TGP can decrease the incidence of hepatic dysfunction during the treatment with MTX and LEF,and it may improve the therapeutic effecacy of patients with RA.

Objective To evaluate changes of regional cerebral metabolism by proton MR spectroscopy (~1H-MRS) in patients with minimal hepatic encephalopathy (MHE) and to correlate these changes with the neuropsychological test. Methods Fifty-four patients with cirrhosis including nine patients with hepatic encephalopathy (HE),23 patients with MHE,22 patients without HE and 13 controls underwent neuropsychological tests and ~1H-MRS scanning. The volumes of interest included occipital gray matter and left parietal white matter regions. Ratio of spectral peak areas of N-acetylaspartate (NAA),choline (Cho),myo-inositol (mI),and glutamine/glutamate (Glx) relative to creatine (Cr) were acquired. Statistical analysis was conducted using independent t test and one-way analysis of variance. The results of different groups were compared by using the nonparametric Mann-Whitney U test with Bonferroni correction. Correlations among the ~1H-MRS ratios, the grade of HE, neuropsychological test and ammonia data were calculated with Spearman correlation test. Results The ratios of NAA/Cr,Cho/Cr,mI/Cr,Glx/Cr of the occipital gray matter and left parietal white matter regions in patients with cirrhosis are 1.55±0.12,0.48±0.10,0.42±0.14,2.52±0.48 and 1.73±0.17,0.75±0.16,0.42±0.16,2.75±0.59respectively,and they are 1.53±0.10,0.48±0.09,0.51±0.11,2.20±0.39 and 1.69±0.15,0.82±0.14,0.53±0.12,2.40±0.40 in patients without HE,1.58±0.13,0.48±0.08,0.38±0.13,2.62±0.39 and 1.78±0.18,0.74±0.14,0.38±0.15,2.84±0.58 in patients with MHE,1.54±0.12,0.50±0.13,0.29±0.07,3.04±0.31 and 1.70±0.19,0.62±0.16,0.29±0.07,3.37±0.38 inpatients with HE.Compared with controls, decreased mI/Cr and Cho/Cr ratios and elevated Glx/Cr ratios were found in patients with cirrhosis (t=3.196,9.394,-6.527,P＜0.01,occipital gray matter. t=5.592,9.717,-6.681,P＜0.01,left parietal white matter＝ and in subgroup of patients without HE, with MHE and HE (F=5.097,25.896,20.204,P＜0.01,occipital gray matter.F=16.435,28.660,21.283,P＜0.01,left parietal white matter).Significant difference in these metabolic alterations was also found among the different groups of cirrhosis especially the ratios of Glx/Cr in occipital gray matter and left parietal white matter (P＜0.0084).The ratios of mI/Cr also significantly altered between patients without HE and with MHE (P＜0.0084).There was a significant negative correlation between the ratios of Cho/Cr,mI/Cr and the grade of HE (P＜0.01＝ and a significant positive correlation between the ratios of Glx/Cr and the grade of HE (r=0.709,P＜0.01,occipital gray matter; r=0.720,P＜0.01,left parietal white matter＝.NCT-A and DST of controls is (49±8) s and 39±6.They are (134±37),(83±26),(64±22) second and 15±2,25±9,35±8 in patients with HE,MHE and without HE respectively.The metabolic alterations of Cho/Cr,mI/Cr,Glx/Cr correlated significantly with neurepsychological tests in all subjects (P＜0.01＝.There was a significant positive and a negative correlation between the ratios of Glx/Cr and the data of NCT-A and DST respectively (r=0.570,-0.642,occipital gray matter; r=0.541,-0.632,left parietal white matter).The metabolic alterations of Glx/Cr had no correlation with ammonia data as well as other metabolic alterations.Conclusions ~1H-MRS study shows cerebral metabolic alterations of gray and white matter in patients with cirrhosis,especially the reduction in mI/Cr ratio and increase in Glx/Cr ratio. These changes correlate well with the neuropsychological tests and may be useful in predicting the presence of MHE.

Objective The aim of this study is to examine the expressions of Toll like receptor (TLR) 7 and TLR9 in the peripheral blood B lymphocytes of SLE patients and to analyze the correlation between TLR7/9 and clinical parameters. Methods lntracellular expression of TLR7/9 in the peripheral blood CD19+Blymphocytes was analyzed in 50 SLE patients and 30 healthy controls by flow cytometry. The difference of intracellular TLR7/9 expression levels in two groups was compared. Furthermore,the correlation between TLR7/9 expression and clinical parameters such as ESR, CRP, complement 3 (C3), complement 4 (CA), the level of serum IgG, anti-double stranded DNA antibody, anti-nuclear antibodies, SLEDAI score and urine protein excretion level, were analyzed. Results Compared with healthy subjects, the proportion of B cells expressing TLR7 and TLR9 was higher among SLE patients. Positive correlation was observed between TLR7 expression levels and clinical measurement of the SLEDAI and ESR. Negative correlation was observed between TLR7 expression levels and serum C3 levels. Positive correlation was observed between TLR9 expression levels and SLEDAI scores. Negative correlation was observed between TLR9 expression levels and serum C3 levels. Conclusion TLR7 and TLR9 expression is increased in the peripheral blood B cells of SLE patients, and correlates well with clinical parameters.

Objective To investigate the value of ultrasound integrated backscatter (IBS) in quantitative analysis of in-traluminal thrombus in abdominal aortic aneurysm (AAA).Methods IBS of intraluminal thrombus in 29 patients were measured,including All (average image intensity) and SDI (standard deviation of image intensity).Meanwhile,different echoes and characteristics of IBS in thrombus were compared and pathologic analysis was performed.Results ①Individual All value of homogenous thrombus differed remarkably,SDI value was low.There was no significant difference about All in homogeneous group and adjacent cavity group (P>0.05).All and SDI value in adjacent wall group were higher than those in other groups (P<0.01).②According to pathologic analysis,cellulose contents were abundant in adjacent wall group,but fewer in adjacent cavity group and homogeneous group.Conclusion IBS might be regarded as a sensitive and specific method and a quantitative basis for estimating and predicting the rupture risk of AAA.