Objective To investigate the effect of seretide plus montelukast on clinical symptoms、pulmonary functions and the serum IL-6 and TNF-α of patients with asthma.Methods 73 cases patients with asthma were randomly divided into seretide group and seretide plus montelukast group and were treated respectively for two weeks.The clinical symptoms,lung functions and serum IL-6,TNF-α contents of patients were measured respectively before treatment and after two weeks treatment.Results After two weeks treatment,the clinical symptom scores、FEV1.0、FVC and PEFR of two groups had significantly changed than that before treatment(P<0.05);Each index was further compared after treatment,and it was found that two groups had significant differernces statistically (P<0.05),these showed that combination of seretide and montelukast could significantly enhance the therapeutic effect.After treatment,the TNF-α and IL-6 contents in the peripheral blood of seretide group and seretide plus montelukast group had both significantly reducted (P<0.05 or P<0.01);The TNF-α and IL-6 contents of seretide plus montelukast group had reduced more significantly than that of the seretide group(P<0.05).Conclusion The seretide plus montelukast group could improve the clinical symptoms and pulmonary function of patients with asthma,and the action mechanism might be related to lower the serum IL-6 and TNF-α contents.

Clinics are a main institutional form for doctors to open personal business in China .The develop-ment process of clinic reflects the situation of medical staff free practice .This study summarized the supervision poli-cies on clinic in China since the founding of China and got three conclusions .The first one was the attitude of the practice of the clinic has changed significantly .The change include four stages which were authorization ( 1949—1957 ) , limitations ( 1958—1977 ) , re-authorization ( 1978—1996 ) , promotion and encourage ( 1997—) along with macroeconomic system reform and the changes of government's governance ideas on health sector .The second conclu-sion was that the government gradually raised awareness of the status and role of the clinic institutions in the health system over the past several decades .The third conclusion was the supervision policies became more meticulous .In the future , clinical institutions can be a useful supplement to public medical institutions in China for its development process and characteristics .

This study was aimed to evaluate clinic effect of the layers adjusting external application therapy on knee osteoarthritis (OA). A total of 240 knee OA cases were randomly divided into the treatment group and the control group, with 120 cases in each group. The layers adjusting external application therapy was used in the treatment group. And analgesic plaster of compound of rhizoma arisaematis was used in the control group. The treatment was continued for 21 days. Then, 14-day follow-up was given after the treatment course. There were a total of 35 days. Observations were made on indexes of pain, swelling and joint dysfunction with quantitative scoring. The results showed that the total effective rate was 98.2%in the treatment group, and 83.9%in the control group. The indexes of pain, swelling and joint dysfunction were markedly improved in the treatment group as compared with the control group (P<0.01). It was concluded that the layers adjusting external application therapy was effective on the treat-ment of knee OA.

OBJECTIVE To investigate the genetic causes of deaf patients in a special educational school of Chifeng city, Inner Mongolia by SLC26A4 whole gene sequencing. This study focused on analyzing mutations of coding sequence of SLC26A4 gene and their relevant phenotype. METHODS DNA were extracted from peripheral blood of 134 deaf patients of Chifeng special educational school and 100 normal hearing controls in Northern China. SLC26A4 gene mutation was analyzed by direct sequencing for its 20 coding exons. All individuals found with SLC26A4 mutation were given temporal bone CT scan, and those with confirmed enlarged vestibular aqueduct and/or other malformation of inner ear were then given further ultrasound scan of thyroid and thyroid hormone assays. RESULTS The sequencing results revealed 32 cases carried SLC26A4 mutation. Twenty-nine cases underwent temporal bone CT scan. Twentycases were confirmed to have malformation of inner ear by CT scan (eighteen were EVA, one was EVA and other inner ear malformation and one was Mondini Syndrome). The shape and function of thyroid were confirmed to be normal by ultrasound scan of thyroid and thyroid hormone assays in nineteen of these 20 patients except one who had cystoid change in the right side of thyroid. Twelve types of novel variants of SLC26A4 gene were found. CONCLUSION Byscreening SLC26A4 gene coupled with temporal bone CT scan ,we could determine genetic cause related to this gene up to 14.93 % of deaf patients in special educational school of Chifeng city. SLC26A4 is another common gene besides GJB2 that cause deafness in this area. The discovery of novel variants of SLC26A4 gene makes the mutational and polymorphic spectrum more plentiful in Chinese population.

Objective To compare X-ray,CT,and MRI in detection of abnormal sacroiliac joint changes in patients with early stage of ankylosing spondylitis (AS).Methods Fifty-three patients with clinical suspected early stage of AS underwent X-ray and MRI scan.MR scan sequences for the sacroiliac joints consisted of T1-weighted,T2-weighted,short time inversion recovery (STIR) and three dimensional balance turbo field echo with water selective excitation (3D-BTFE-WATS) in all patients.In 24 of the patients,fat-saturated contrast-enhanced T1-weighted was used.Twenty-five of 53 patients underwent CT scan.The Chi-square test was used to analyse the uniformity of bone erosions detected by X-ray,CT,and MRI.Results Of the 106 sacroiliac joints in 53 patients,16 sacroiliac joints with bone erosions were detected by X-ray and 63 sacroiliac joints by MRI.Of the 50 sacroiliac joints in 25 patients,26 sacroiliac joints with bone erosions were found by CT.With regard to the detection of bone erosions,there was no difference between CT and MRI (x2 =0.16,P ＞0.05 ) and there was significant difference between CT and X-ray or MRI and X-ray ( x2 =14.44 and 17.36,P ＜ 0.05 ).3D-BTFE-WATS was better than other sequences in detection of bone erosions.Acute inflammatory changes were determined by MRI,which included subchondral bone marrow edema in 32 patients,synovitis in 35 patients,fat depositions in 16 patients,enthesitis in 15 patients,capsulitis in 9 patients,and cartilaginous disruption in 31 patients.Conclusions MRI can detect acute inflammatory changes that can not display by X-ray and CT.Compared with radiography and CT,MRI is more useful in detection of abnormal sacroiliac joint changes in patients with early stage of AS.

Objective To study the imaging findings of hip involvement and to compare the sensitivity of radiography,CT,and MRI in the identification of hip involvement in patients with ankylosing spondylitis(AS).MethodsAnteroposterior radiography of the pelvis and MRI of hip were performed in 55 patients with AS.CT scan of hip was performed in 29 of 55 patients.T1-weighted,T2-weighted,short tau inversion recovery (STIR) and three dimensional balanced turbo field echo with water selective excitation (3D-BTFE-WATS) coronal sequences of hips were obtained in all patients,of which fat-saturated contrastenhanced T1-weighted sequence was performed in 24 patients.The imaging data of 55 patients were analyzed.The chi-square test was used to analyze the sensitivity in the identification of hip involvement among radiography,CT,and MRI.ResultsAmong 110 hips in all 55 patients,abnormal changes were detected in 13 hips by radiography,85 hips by MRI.The findings of radiography included bone erosions in 13 hips,joint space narrowing in 4 hips,syndesmophytes in 5 hips.MRI revealed bone erosive destruction in 31 hips,joint space narrowing in 4 hips,joint effusion in 80 hips,subchondral bone marrow edema in 32 hips,fat accumulation of bone marrow in 28 hips,enthesitis in 21 hips.Bilateral synovial enhancement was showed in 19 of 24 patients who underwent fat-saturated contrast-enhanced T1-weighted sequence.Of the 58 hip joints in 29 patients who underwent CT examination,not only did CT show all bone erosions detected by radiography and MRI,but CT revealed bone erosive destruction that were not identified by radiography in 10 hips and by MRI in 1 hip as well.Abnormal changes were detected in 10.3％ (6/58)by radiography,27.6％ (16/58) by CT,and 77.6％ (45/58) by MRI.The sensitivity of MRI in the identification of hip involvement is higher than that of radiography and CT ( x2 =53.22 and 29.08,P ＜ 0.05 ).In addition to chronic bone structural changes,MRI depicted acute inflammatory changes which could not be detected by radiography and CT.ConclusionsMRI can detect early acute inflammatory changes of hip joint that can not be showed by radiography and CT.Effusion of joint and synovial enhancement caused by synovitis are the most common MRI findings of the hip in patients with AS.

Objective To investigate the value of MR DWI in the detection of early acute sacroiliitis in patients with spondyloarthritis(SpA).Methods The data of sacroiliac joint MRI were retrospectively analyzed in fifty-nine patients with inflammatory low back pain and negative plain radiographs and/or CT.T1WI,T2WI,short tau inversion recovery (STIR) and DWI images were obtained in all cases.Contrast-enhanced T1WI with fat suppression (FST1WI) images were obtained in 28 patients and follow-up MRI examinations were performed during treatment in 7 cases.Acute inflammatory lesion was defined as hyperintense signal located in subchondral or periarticular regions on STIR images and or on enhanced FST1WI.Cases were divided into acute inflammation group and non-inflammation group.Comparison was performed among STIR,enhanced FST1WI and DWI in the detection of acute inflammation by using Chi-square test.Mean ADC value was obtained from normal and inflammatory areas in acute inflammation group and from subchondral bone marrow in non-inflammation group,and t test was used for comparison of ADC values.Results Acute inflammation existed in 38 cases (72 sacroiliac joints) and acute inflammatory lesions displayed as high signal on DWI in 35 cases (67 sacroiliac joints).STIR,enhanced FST1WI and DWI showed no significant difference in the detection of acute sacroilliitis (37/38,38/38,36/38,respectively;x2=0.16,P=0.923).ADC values measured from acute inflammatory areas were significantly higher than values measured from normal area in acute inflammation group [(1.087± 0.207)× 10-3 and (0.537±0.091) × 10-3mm2/s],and values measured from subchondral bone marrow in non-inflammation group [(0.487±0.112) × 10-3mm2/s],there were significant difference (t values were 14.971 and 12.289,P＜0.01).ADC values were similar between normal area in acute inflammation group and subchondral bone marrow in non inflammation group (t=1.874,P=0.066).ADC values were (1.018±0.266) × 10-3 and (0.706±0.164) ×10-3mm2/s before and after the treatment (t=5.312,P＜0.01).Conclusions DWI is a sensitive method to display acute inflammatory lesions in sacroiliac joints.ADC values can be effectively used to quantify inflammatory lesions in acute sacroilliitis as well as in the evaluation of efficacy of treatment.

In order to clarify material basis of effective parts of liangxue tongyu prescription, blood-heat and blood-stasis rat model induced by dry yeast was established. The changes of rectal temperature, blood viscosity and plasma viscosity were used to evaluate the cooling-blood and activating-blood effects of liangxue tongyu prescription and its parts. Compared with the model group, the extract from liangxue tongyu prescription, its volatile oil and n-butanol part could significantly reduce rectal temperature (P<0.01), and also reduce blood viscosity and plasma viscosity to various degrees (P<0.01 or P<0.05). So volatile oil and n-butanol part were primarily identified as effective parts of liangxue tongyu prescription. By using GC-MS with normalization method of area to analyze volatile oil of liangxue tongyu prescription, 70 compounds were identified, accounting for about 92.54%, mainly as β-asarone, paeonol, α-asarone and shyobunone. 42 compounds such as peony glycosides, tannins, and iridoid glycosides were identified by HPLC-MS techniques and standard comparison. The study determined the effective parts of liangxue tongyu prescription and clarified the chemical composition providing the foundation for further studies on material basis of liangxue tongyu prescription.

Objective To explore an effective method for enhancing basic clinical skill of students.Methods Selective course of basic clinical skill was launched for the fourth grade clinical medicine students by using simulation-based medical education (SBME).Elective courses have 21 class hours,involving 15 items of basic clinical skills in internal medicine,surgery and nursing.Training methods include preparation,explanation,demonstration,operation,group competition,examination and questionnaire.Selective course examination includes class activation and final examination,accounting for 20％ and 80％ of the final scores,respectively.Scores were classified into A (excellent),B (good) and C (moderate) levels.Scores and questionnaire data were processed by Microsoft Office Excel 2007 software and percentages of score and questionnaire feedback were calculated.Results Results suggested that the scores of 70％ students were more than 90.Results of questionnaire indicated that the basic clinical skills of 76.6％ of the students were improved a lot.79.2％ considered that it was useful for their clinical practices.Conclusion Clinical-skill course based on SBME is conducive to enhancing basic clinical skills of students.

Objective To select omeprazole content changes smaller with dispensing method and to seek for rationality of off-label uses.Methods To measure content change of omeprazole sodium for injection mixed by different subscriptions at different time through HPLC, and compared effect of different dispensing methods on content of omeprazole sodium for injection.Results 10 mL 0.9%sodium chloride injection was chosed as dissolvent,the change of omeprazole sodium for injection content would be minor, and stability of drug solution was superior.Conclusion Dispensing methods of drug impact on its'security and validity, which is part of discuss category about medicine rational use as well.Off-label uses could not vest in unreasonable use, which should contingent on specific document,data and actual environment of medical treatment.