Recurrent miscarriage is a common disease in clinical obstetrics and gynecology. There is no curative treatment for recurrent miscarriage in conventional medicine. Traditional Chinese medicine (TCM) has been widely used in the treatment of recurrent miscarriage in China for thousands of years. However, randomized controlled trials (RCTs) with high quality evaluating the effectiveness and safety of Chinese herbal medicine (CHM) still lack. This study was conducted in order to identify methodological problems in published or unpublished RCTs of CHM in the treatment of recurrent miscarriage, and provide suggestions for TCM researchers to conduct high-quality clinical research.

Objective To evaluate lactulose breath hydrogen test in diagnosis of small intestinal bacterial overgrowth in children.Me-thods Thirty-five children,aged 3 to 13 years old with mean (7.72?3.06) years old presented with chronic diarrhea,abdominal pain and flatulence.Among them,18 cases were male and 17 cases were female.Breath hydrogen test was carried out after the administration of a 0.5 g?kg-1 or 10 g lactulose,which was 100 g?L-1 solution.After the ingestion of lactulose,the breath hydrogen was collected in every 20 minutes and up to 3 hours.Small intestinal bacterial overgrowth was diagnosed as positive when the hydrogen concentration increased more than 20 mg?m-3 in a sample.Results Eighteen cases in 35 (51.43%) children were positive and 17 cases were negative.Among these positive cases,8 cases in 18 (22.86%) patients were typically double peaks in breath hydrogen concentrations.Among the causes of small intestinal bacterial overgrowth in children,4 cases with chronic superficial gastritis,4 cases with chronic bacterial enteritis,2 cases with malnutrition and anorexia,1 case with volvulus of stomach,1 case with massive resection of small intestine,1 case with steatorrhea and 5 cases with unknown causes.Four cases of chronic bacterial enteritis were gained remission by antimicrobial agents.The other cases were treated by lac-to-and bifidbacteria probiotics.Seven patients of the clinical systems were controlled,3 cases were improved remarkably and 4 cases were failed.Conclusions The lactulose breath hydrogen test is validated as screening test in the diagnosis of small intestinal bacterial overgrowth in children.Antimicrobial agents and bifidbacteria probiotics is effective in treatment of small intestinal bacterial overgrowth.

Objective To compare the clinical outcomes of different drains in total knee arthroplasty.Methods Fifty-five patients,who had accepted primary unilateral total knee arthroplasty from October 2010 to November 2012,were included in the comparative study.Based on different drainage ways,25 patients were arranged into autotransfusion drain group,18 into routine drain group,and 12 into delayed drain group.Same operative procedure and postoperative care were provided to all patients.The total amount of postoperative drainage (including intraoperative blood loss),information of allogenic blood transfusion,body temperatures of patients on postoperative 1st,3rd,7th day,pre-and post-operative hemoglobin level,and postoperative swelling,wound healing quality and range of motion were recorded and compared.Results The amount of drainage was significantly more in autotransfusion drain group (799.2±196.7ml)than those in other two groups (381.7±129.2 ml in delayed drain group and 666.1±155.0ml in routine drain group).The postoperative hemoglobin level in delayed drain group (91.50±7.92 g/L)was similar to that in autotransfusion group (91.96±9.57 g/L),while significantly higher than that in routine drain group (81.33±9.86 g/L).The highest body temperature of patients in autotransfusion drain group was higher than those in other two groups.Allogenic blood transfusion was performed in 8 patients (44.4％) in routine drain group,4 patients (16.0％) in autotransfusion drain group and 2 patients (16.7％) in delayed drain group.There were no differences between groups in swelling,wound healing quality,and range of motion.Conclusion Delayed release of drain in total knee arthroplasty could reduce blood loss,chances of allogenic blood transfusion and postoperative fever,and extra cost,which can bring more benefits to patients.

The rodipicolinate synthase gene was cloned from Nicotiana tabacum L.cv,which encodes the key enzyme in the synthesis of lysine,and then a vitro molecular reform reliefing feedback suppression was made. Some resistant seedlings were acquired using the mutated gene as selectable marker and analog of lysine as selectable reagent,and the detection results were positive by means of PCR and Real-Time PCR,however the phenotype is somewhat abnormal.

Objective To propose new policies and strategies that will optimize the transformation of medical research achievements at hospital level.Methods In this paper,we systematically analyzed the characteristics and influencing factors of the transformation of medical research achievements based on the status quo in our hospital.Results In our hospital as an example,major problems in the transformation of medical research achievements identified as low investment,low conversion rate,complex procedures,multi-links existed and more multi disciplinary cooperation needed.Conclusions The hospital can take some measurements to optimize the transformation of medical research achievements,such as more stream lined management of scientific research project,establishing and improve the platform for scientific research transfer,increasing the funding,strengthening cooperation among different disciplinaries,building a professional team to promote the transfer and so on.

Objective To determine whether the cross-sectional area (CSA)of the calf measured with MRI could stage lower ex-tremity lymphedema (LEL)secondary to gynecological cancer treatments.Methods 148 patients were enrolled in this research.116 females with unilateral LEL and 32 without LEL after gynecological cancer treatments underwent calf MRI and water displacement. Total soft tissue CSA (T),muscle CSA (M)and subcutaneous tissue CSA (S)of affected calf,and difference of T (DT),M (DM) and S (DS)between calves were obtained on MRI at mid-calf level.Volume of affected calf and difference of volume (DV)between calves were obtained by water displacement.Statistical analysis was performed to determine feasibility of MRI measurements for ac-cessing LEL.Results There were close correlations between volume and T or S of affected calf,and between DV and DT or DS of calves.The correlations of stages of LEL with T and S of affected calf as well as DT and DS were stronger than the volume of affect-ed calf and DV (P< 0.01).Multivariate analysis showed more significant differences in T and S than in volume of affected calf,and in DS than in DV between LEL stages (P< 0.05).No difference was found in volume of affected calf and in DV between stage 0 andⅠ. For staging LEL,DS showed the most profound discrimination ability among all measurable parameters.Conclusion DS of calves could be the most reliable parameter recommended for staging and early diagnosis of LEL.

Adolescent ; Adult ; Anemia, Hemolytic, Autoimmune ; drug therapy ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Middle Aged ; Sirolimus ; therapeutic use ; Treatment Outcome ; Young Adult

Objective To compare diagnostic performance of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum.Methods Totally 46 children suspected with Meckel's diverticulum were enrolled.Ultrasound,radionuclide imaging data were analyzed and compared with pathology.Results In 46 children suspected with Meckel's diverticulum,38 cases were confirmed by operation.Thirty-three cases of 38 were diagnosed Meckel's diverticulum by ultrasound,5 cases of 38 were false negative,there was no false positive case.Radionuclide imaging was positive in 24 cases of 46,false positive in 4 eases and false negative in 18 cases.The ultrasound diagnostic accuracy rate was 89.13％ (41/46),sensitivity was 86.84％ (33/38),specificity was 100％ (8/8).Diagnostic accuracy rate of radionuclide imaging was 52.17％ (24/46),sensitivity was 52.63 ％ (20/38) and specificity was 50.00 ％ (4/8).The sensitivity of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum had significant difference (P＜0.01).Conclusion Ultrasound in diagnosis of Meckel's diverticulum has advantages of non-invasive,no radiation,acceptable price and high sensitivity.

Objective To investigate the relationship between diastolic function of the left ventricle and common carotid artery (CCA) elasticity in patients with hypertension. Methods Forty-one primary hypertension patients and 31 healthy volunteers underwent echocardiography to obtain the indices of LV diastolic function and also echo tracking techniqne (ET) to obtain the CCA elasticity indices. The LV diastolic function indices included Ve (early diastolic peak velocity), Va (late diastolic peak velocity ), Ve/Va, Em (early diastolic mitral annular motive velicity), Am (late diastolic mitral annular motive velicity) and Em/Am. The indices of CCA elasticity included Ep (pressure-strain elasticity modulus), β(stiffness parameter), AC (arterial compliance), AI (augmentation index) and PWVβ (pulse wave velocity). Results Va was higher and Em, Ve/Va and Em/Am were lower in patients than that in the healthy , P＜0.05. Ep and PWVβ were higher in patients,P＜0.05. Am and Va were correlated positively with PWV β and Ep , respectively in patients, P＜0.05. Ve/Va was correlated positively with AC, and negatively with PWV β, P＜0.05 in patients. Em/Am was correlated negatively with β and PWV β in patients. Conclusions The LV diastolic function and common carotid artery elasticity were decreased in patients with hypertension. The decreased common carotid artery elasticity was along with the LV diastolic function decreased.

AIM: To research the correlation factor of the anterior segment values of eyes with different axial lengths.METHODS: In this study, 697 cases 697 eyes were included.According to axial length we divided all the cases into short axial length group, normal axial length group, mild long axial length group, moderate long axial length group and severe long axial length group.The relevant indicators of the anterior segment values of patients in the five groups was comparatively analyzed.RESULTS: In the short axial length group, the anterior chamber volume (ACV) showed a significantly negative correlation with age;anterior chamber depth (ACD) showed a significantly negative correlation with age.In the normal axial length group, the ACV showed a significantly negative correlation with age and a significantly positive correlation with axial length(AXL);the anterior chamber angle (ACA) showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly positive correlation with corneal curvature;the ACD showed a significantly negative correlation with age and a significantly positive correlation with AXL.In the mild long axial length group, the ACV showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly negative correlation with corneal curvature;the ACA showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly positive correlation with corneal curvature;the ACD showed a significantly negative correlation with age and a significantly positive correlation with AXL.In the moderate long axial length group, the ACV showed a significantly negative correlation with age;the ACA showed a significantly positive correlation with AXL;the ACD showed a significantly positive correlation with AXL.In the severe long axial length group, the ACV showed a significantly negative correlation with age.There were no significant differences on ACV, ACA and ACD among mild long axial length group, moderate long axial length group and severe long axial length group (P>0.05), while the difference between other groups was significant (P<0.05).CONCLUSION: There has a correlation between the anterior chamber values (ACV, ACA, ACD) age and AXL for eyes which AXL were 22-27mm, while the correlation would disappear as the AXL became shorter or longer.There was a significant growth trend of anterior chamber values for eyes with AXL <27mm.