Celiac disease (CD) is a chronic autoimmune gastrointestinal disorder induced by ingestion of gluten-containing foods.In the past CD was thought prevalent only in Western countries,whereas it has been found common throughout the world and increasing numbers of Chinese patients has been reported recently.However,there are still many deficiencies in management of patients with CD in China and either the diagnosis or the treatment of CD is lacking evidence-based clinical pathway.We report a case of a young woman with CD presenting with chronic diarrhea,abdominal distention,and weight loss,whose outcome was improved by following evidence-based guidelines of medical nutrition therapy.Diagnosis and treatment of the patient was analyzed with review of foreign and domestic literature to provide readers reference of the standardized nutritional intervention of CD.

Objective To explore whether living in rural areas may reduce the risk of atopic sensitization. Methods The standardized questionnaires were answered by the parents of 2 986 school children during 2004 to 2005. Radioallergosorbent technique-fluorescence enzyme immunoassay (RAST-FEIA) was used to determine the level of specific IgE in the serum of the children. The risk factors were analyzed by Logistic regression. Results Compared with the subjects living in the towns from birth, the risk of atopic sensitization was lowest in the subjects living in the villages from birth (OR=0.32, 95%CI: 0.11-0.62) and it was moderate in the subjects who had relocated from village to town (OR=0.51, 95%CI: 0.28-0.92), there was a significant trend among them (P for trend

Adult ; Ear Canal ; Foreign Bodies ; Humans ; Male ; Mandibular Condyle

Bronchogenic Cyst ; Humans ; Laryngeal Diseases ; Male ; Middle Aged

Objective:To assesss the effectiveness of dapoxetine in the treatment of premature ejaculation.Methods:Both English and Chinese studies involving men with prematrue ejaculation who were treated with dapoxetine from the Cochrane Library,MEDLINE,EMBASE and CNKI,CBM,VIP between 1979 and 2009.were included in the randomized controlled trials(RCTs) and the data processed by RevMan.Results:Five RCTs involving 4433 patients were included in the Meta analysis,of which 3 were of grade A and 2 were of grade B according to the quality evaluation of methodology.Intravaginal ejaculatory latency time(IELT),patient-reported global impression of change(PGI),satisfaction with sexual intercourse(SWSI),perceived control over ejaculation(PCOE),personal distress related to ejaculation(PDRE) were used for assessment.Meta analysis based on included studies of patients having been treated with dapoxetine for 9-24 weeks showed that:(1) the difference of the patients' IELT between treatment group and control group was statistically significan [P

SUN Shu-chun,the chief researcher,is one of the famous expert of osteo-traumatology of TCM.He makes systematic sort and study on chirismus on basis of succeeding experience predecessors and his own years of clinic experience.He is good at treating cervical syndrome with TCM chirismus,especially combine it with drugs.In osteo-traumatology academic circles,he is called "the best doctor at home".Professor SUN advocates that the rule of applying various therapies according to different conditions,combination of rigid-flexible,light,skill,gentle,harmony should be obey when we use chirismus.His diagnostic and therapeutic methods and thoughts are original and ingenious.In this article,the author analyzes the academic experience of tendon trauma of professor SUN.

Objective To observe the effect of intra-articular injection of dehydroepiandrosterone (DHEA)on the experimental osteoarthritis in rabbits and study the mechanism.Methods Forty rabbits un derwent unilateral anterior cruciate ligament transection(ACLT)and then divided into two groups randomly. 100?mol/L DHEA resolved in the dimethylsulphoxide were injected into the knees of experimental rabbits 4 weeks after transection,once a week for five weeks.Rabbits in the control group were treated under the same schedule using dimethylsulphoxide.All rabbits were killed 9 weeks after ACLT and the knee joints were evalu- ated by gross morphology and histology.The mRNA expression of metalloproteinases-3(MMP-3),tissue in- hibitor of metalloproteinases-1(TIMP-1)and interleukin-lbeta(IL-1?)in the cartilage and synovium was analyzed using reverse transcription polymerase chain reaction(RT-PCR).Results Gross morphologic in- spection and histological evaluation showed that the extent and grade of cartilage and synovium damage in the experimental group were less severe than the control group.The mRNA expression of MMP-3 in cartilage and synovium decreased significantly in the experimental group(both P＜0.05).The mRNA expression of TIMP-1 in cartilage and synovium increased significantly in the experimental group compared with that in the control group(both P＜0.05).No significant difference of IL-1?mRNA expression in cartilage was found between the experimental and the control groups(P＞0.05).The mRNA expression of IL-1?in the synovium was signifi- cantly suppressed in the experimental group compared with that in the control group(P＜0.01).Conclusion DHEA protects against cartilage degradation,alleviates synovium inflammation and inhibits the progression of osteoarthritis in the experimental model.Down-regulation of MMP-3 and up-regulation of TIMP-1 in cartilage and synovium and IL-1?in the synovium may be the mechanism of the protective effect of DHEA on os- teoarthritis.

ObjectiveTo understand the status and requirement of the clinical researchers in Guang’anmen Hospital of China Academy of Chinese Medical Sciences (hereinafter referred to as Guang’anmen Hospital).MethodsSelf-filling questionnaire was used. All medical care personnel in the clinical specialty with the GCP qualification were set as respondents. The three aspects of recognition degree of clinical trials quality, initiative of participation and knowledge demand for GCP were investigated. Data were analyzed through SPSS11.5.Results 95.6% of clinical researchers considered that the course of clinical trial was legal;89.9% of clinical researchers believed that the quality of clinical trial was good. Most clinical researchers participated in the clinical trials actively (86.9%) and they considered that the trials were helpful for them to enhance research ability and to issue paper.Conclusion Clinical researchers are familiar with GCP knowledge and can participate in the clinical trials actively. They still expect to learn more.

ObjectiveTo investigate the treatment effects of comprehensive nursing intervention on patients with chronic obstructive pulmonary disease(COPD) treated by non-invasive mechanical ventilation with BiPAP mode.Methods96 patients with diagnosed COPD and using non-invasive mechanical ven- tilation with BiPAP mode were randomly divided into the control group(46 cases) which was treated with routine measures and the comprehensive nursing intervention group (50 cases) which adopted comprehen- sive nursing intervention according to experimental design. The frightening degree, incidence rate of com- plications and clinical treatment effect by ventilator were compared between the two groups.ResultsPa- tients compliance with treatment and clinical treatment effect by ventilator in the comprehensive nursing in- tervention group was better than that of the control group. The frightening degree and incidence rate ofcomplications were lower than those of the control group (P < 0.01 ).ConclusionsComprehensive nurs-ing intervention with non-invasive mechanical ventilation with BiPAP mode can improve the treatmentcompliance of COPD patients,reduce complications followed by non-invasive mechanical ventilation andreach the prospective treatment effect.