Objective To compare the clinical effect of montelukast sodium and ketotifen in the treatment of children with cough variant asthma,thus to provide theoretical basis for clinical treatment.Methods 61 children with cough variant asthma were randomly divided into control group and observation group according to the digital table method,31 cases in each group.Patients of two groups were all given antispasmodic and antitussive.The control group was given ketotifen tablets drug therapy,1mg/time,2 times/d,and the observation group was treated with montelukast chewable tablets,5mg/time,1 time /d.After 8 weeks of treatment,the clinical effects were compared between the two groups.Results The total effective rate of the observation group (96.77%)was higher than that of the control group (77.42%),and the difference was statistically significant (χ2 =16.65,P <0.05).The clinical symptoms improved time of the observation group was (5.78 ±1.36)d,which was shorter than (8.45 ±2.24)d of the control group,the difference was statistically significant (t =2.71,P <0.05).The recurrence rate of the observation group (6.45%) was lower than the control group (16.13%),the difference was statistically significant (χ2 =4.67,P <0.05 ). Recurrence time of the observation group was better than that of the control group,the difference was statistically significant (t =7.98,P <0.05 ).Conclusion The curative effect of montelukast special chewing tablets in the treatment of children with bronchial asthma is obviously superior to ketotifen,has less adverse reactions.It was worthy of clinical application.

To explore the effect of high glucose on the NF-κB/IκB signal pathway in cultured rat glomerular mesangial cells. The results showed that high glucose increased the degradation of IκB-α and the translocation to nucleus of NF-κB. These changes could be reverted mostly by MG132, a proteasome inhibitor. It suggests that the activation of the NF-κB signal pathway by high glucose concentration may probably be via the ubiquitin-proteasome pathway.

One hundred and fifty eight post-stroke patients in the recovering period were divided into intervention group (78 cases) and control group (80 cases).Patients in intervention group received home rehabilitation service provided by general practitioners (GP) for 6 months,while patients in control group received routine rehabilitation.After 6-months,the scores of self-rated health measurement scale (SRHMS) in intervention group were significantly higher than those of control group (P ＜0.01);the visiting time and frequency,medical costs and time of caregiving were decreased (P ＜ 0.01);and the satisfaction score of the patients in intervention group was 97％.The results show that home rehabilitation service can improve effectiveness of rehabilitation for post-stroke patient in recovering period.

Objective To investigate the molecular regulatory mechanism of glucagon like peptide 1 (GLP-1) on proliferation, differentiation and apoptosis of human umbilical cord blood endothelial progenitor cells (EPCs). Methods EPCs were isolated from the umbilical cord blood of healthy pregnant women and cultured in 6-hole cell plate at 2×105 density in vitro, transfected with empty vector plasmid (control group), pcDNA3-GLP-1 plasmid (GLP-1 group), pcDNA3-GLP-1plasmid+AMD3100 (GLP-1+AMD3100 group) and simple AMD3100 (AMD3100 group). The pcDNA3-GLP-1 was transfected into EPCs. The 25μmol/L AMD3100 was used to block the SDF-1/CXCR4 signal pathway of EPCs for 1 h. The cell proliferation was determined by MTT method. The mRNA expressions of differentiation and apoptosis related genes PPARγ, C/EBPα and Caspase-3 were investigated by RT-PCR, and Caspase-3 activity was determined by Caspase-3 activity assay kit. Results Compared to control group, AMD3100 inhibitor showed no effects on cell proliferation, differentiation and apoptosis, while over-expression of GLP-1 in EPCs obviously promoted cell proliferation, and differentiation related genes PPARγand C/EBPαmRNA expression, but down-regulated mRNA expression and the activity of Caspase-3 significantly (P＜0.05), indicating that GLP-1 increased proliferation and differentiation of EPCs while decreased cell apoptosis. When the SDF-1/CXCR4 signaling pathway was blocked by AMD3100, over-expression of GLP-1 induced promotion of cell proliferation, and the differentiation was decreased significantly and the apoptosis was significantly increased (P＜0.05). Conclusion These data confirm that GLP-1 might promote EPCs proliferation and differentiation, and inhibit cell apoptosis through the regulation of the SDF-1/CXCR4 signaling pathway.

Objective To compare sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation (SEM-rTMS) with routine repetitive transcranial magnetic stimulation (R-rTMS) in the treatment of primary insomnia. Methods One hundred and twenty six patients with insomnia were divided randomly into a SEM-rTMS group (44 cases) , a R-rTMS group (42 cases) and a sham rTMS group (40 cases). Each case was treated with rTMS for 30 min once a day for 10 d under double blinding of the patient and therapist. The clinical effect was observed along with Krakow sleep scores, electroencephalograms and blood pressure before and after a 10-day course of therapy and 30 days later. Results During rTMS treatment, some patients reported feeling sleepy, and this was confirmed by their EEGs at the time. After the entire course of therapy, 80% of the SEM-rTMS group and 45% of the R-rTMS group showed improvements, a significant difference. At the 30th day after therapy, the effect in the SEM-rTMS group was still significantly better than in the R-rTMS group. There were no obvious side effects in any group throughout the whole observation period. Conclusions SEM-rTMS is more effective and more reliable than R-rTMS. SEM-rTMS is safe to use with primary insomnia patients.

Objective To explore and build a real, objective, comprehensive clinical nursing individual performance indicators architecture model,and check the rationality and validity for prize distribution by clinical application. Methods The methods included that discuss new ideas of nursing performance management by multi- disciplinary experts,developed clinical personal nursing staff performance evaluation program,worded out indicators and methods for the clinical assessment of individual nurses and nurse managers respectively,then applied research in the pilot departments and hospital step by step. Results A personal performance evaluation framework model was constructed, which include clinical nurses and nursing managers. Experimental results show that the nursing staff in this regard performance program have a high degree of recognition, 98.82% (1 741/1 762) nursing staff understanding of the purpose and significance, 97.15%(1 712/1 762) nurses think the performance model structure is reasonable. After the implementation of the performance program, the outstanding rate of personal performance appraisal of nurses was 93% (1 639/1 762). Conclusions The application of scientific performance appraisal programs can play a positive role in helping improve the quality of clinical care, and promote the stable development of the care team.

Objective To characterize the expressions of androgen receptor (AR) and estrogen receptor (ER) in penis skin of patients with congenital hypospadias. Methods Dorsal prepuce, ventral prepuce, and urethral plate were harvested from 30 patients with congenital hypospadias. The expressions of AR and ER in epidermal cells and dermal fibroblasts were assessed respectively by automated immunohistochemistry. Image Pro plus 6.0 was used to analyze the optical density (OD) value of AR and ER in different parts of epidermal cells and dermal fibroblasts. Results AR and ER were located mainly in nucleis of the squamous basal cells and prickle cells, and were also found in nucleis of subcutaneous fibroblast cells. The expression of AR was lower in epidermis of urethral plate than that of dorsal prepuce and ventral prepuce (P<0.05), but no significant difference was detected in dermal fibroblasts. The expression of ER was higher in epidermis of dorsal prepuce than that of urethral plate and ventral prepuce (P<0.05). The dermal expression of ER in fibroblast cells was increased successively in dorsal prepuce, ventral prepuce and urethral plate (P<0.05). Conclusion Lower expression of AR in urethral plate may contribute the development of hypospadias. Disorder of ER in dermal fibroblast cells of prepuce may play an important role in hypospadias.

AIM:To investigate the effect of growth differentiation factor 11 ( GDF11 ) on the expansion of CD8 +memory stem T cells ( Tscm) and to further improve the effect of adoptive immunotherapy.METHODS:Healthy human peripheral blood mononuclear cells ( PBMCs) were isolated by density gradient centrifugation at first.Among the i-solated PBMCs, CD8 +T cells were further purified with MACS microbeads.The CD8 +T cells were then randomly divided into experimental groups and control group.The same volume of different concentrations of GDF11 were added into the ex-perimental groups, and the same volume of PBS solution was added into the control group.Finally, the expansion of Tscm in experimental groups and control group was measured by flow cytometry at several time points.RESULTS:GDF11 sig-nificantly increased the number of Tscm in CD8 +T cells in vitro expansion and also dramatically increased the ratio of Tscm in CD8 +T cells.Furthermore, 400 μg/L GDF11 treatment for 3 weeks was the optimal condition to induce CD8 +Tscm. CONCLUSION:GDF11 effectively increases the number and ratio of Tscm in the CD8 +T cells in cell culture growth, thereby creating a new strategy to further improve the efficiency of adoptive immunotherapy.

Objective To report the clinical features and inwardly rectifying potassium channel 18 (KCNJ18) gene mutation in a group of patients with thyrotoxic periodic paralysis (TTP).Methods Fiftyseven TTP cases (55 male and 2 female) were collected in our clinic from July 2002 to October 2011.The KCNJ18 gene was directly sequenced in 57 TTP patients and 50 health Chinese controls through the nested PCR.According to the results of gene screening,the clinical features of KCNJ18 patients and non-KCNJ18 patients were retrospectively summarized and analyzed.Results In 4 male patients with TPP,we found 3 novel heterogeneous mutations (p.Q126X,p.K360T,p.E388K) and 1 reported mutation (p.A200P) in the KCNJ18 gene.The age of onset was 19-25 years old,and the duration ranged from 2 to 8 hours.The 4 patients all presented severe muscle weakness.The attacks of muscle weakness preceded overt symptoms of hyperthyroidism in the 4 patients. Three patients showed recurrent weakness during the 13-28 months follow-up,while the episodic weakness never appeared when patients got euthyroid. Conclusions The mutations in the KCNJ18 gene are responsible for a part of Chinese patients with TPP.The patients with KCNJ18 mutations have a shorter disease course,severer manifestation,and higher prevalence of recurrence as compared with those TPP patients without KCNJ18 mutations.

Objective To develop a method of loop-mediated isothermal amplification(LAMP) to Staphyloccocus aureus rapidly, specifically, sensitively and simply suited for the primary health agency. Methods According to conserved nucleotide of Staphyloccocus aureus and principle of LAMP, we designed a set of LAMP primers and set up an LAMP reaction system. We evaluated the specificity, sensitivity and re-peatability of the method. In addition,we evaluated the linearity between initial template copies 1g value and reaction time (the time when the fluorescent value is 1×10~4). Results The optimal assay showed that it was no cross-reaction with other closely related members of pathogens, and was 10 times more sensitive than PCR. The coefficient of variance between tests was less than 5% ,and the kinetics curves showed a good line-arity between initial template copies lg value and reaction time(r~2=0. 9501). The detection activity could be finished within 1 h with the sensitivity of LAMP was 100% and the specificity was 94.4%, and the accuracy was 96.6%. Conclusion These findings demonstrated that the LAMP had the potential clinical application for detection and differentiation of Staphyloccocus aureus in the public health agency for its sensitive, specific and simple feature.