Objective To examine the consistency between asthma children's self-assessment health-related quality of life and their proxies' assessment, to give theoretic basis of clinical treatment for asthma children. Methods Parents and asthma children completed the PedsQLTM 4.0 Generic Core Scales and PedsQLTM 3.0 Asthma Module during an outpatient visit or in the hospital. Wilcoxon signed rank test and ICC were used to compare the difference between asthma children's self-report and their proxies' report. Results The findings indicated that neither the total scores nor domain scores (except physiological domain) between asthma children's self-reports and proxies' reports (parents most of all)showed inconsistency. The value of ICC was not less than 0.7 except physiological dimension and showed consistency. Some different information in several domains was founded by the scores after layered by age. Conclusions There are consistency between children's self assessment of health-related quality of life and their proxies' assessment based upon results of PedsQLTM scale.

OBJECTIVE:To study the effect of paroxetine combined with low dose of olanzapine on sleep process and architec-ture of depression patients with insomnia. METHODS:84 depression patients with insomnia were randomly divided into control group and observation group. Control group was given 20 mg Paroxetine tablet,once every morning;observation group was addi-tionally given 2.5 mg Olanzapine tablet,once before going to bed. Sleep quality [Pittsburgh Sleep Quality Index(PSQI)],depres-sion scores [Hamilton Depression Scale (HAMD)],sleep process [sleep latency (SL),awakening times (AT),the actual total sleep time (TST),sleep efficiency (SE),rapid eye movement (REM) sleep latency (RL)] and sleep architecture [sleep stage 1 (S1),2(S2),3(S3)and the proportion of REM to sleep] in 2 groups before and 3,6 months after treatment and the incidence of adverse reactions(ADR)were observed. RESULTS:After treatment,PSQI and HAMD scores in 2 groups were significantly lower than before,and gradually decreased by time,and observation group was lower than control group;TST in observation group was significantly higher than before and control group,S1 in observation group was significantly lower than before,SE,S3 and REM in 2 groups were significantly higher than before,and observation group was higher than control group,SL,AT,RL and S2 were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). There were no obvious ADR in 2 groups. CONCLUSIONS:Paroxetine combined with low dose of olanzapine can sig-nificantly relieve depression,optimize sleep process and sleep architecture,then impove sleep quality.

Objective To detect the expression of Survivin and hypoxia inducible factor-1α (HIF-1α) in prostatic hyperplasia and prostatic carcinoma,and investigate their roles and mutual correlations in pathogenesis and progression of prostatic carcinoma.Methods The expression of Survivin and HIF-1α in proliferative lesions of prostate (15 cases) and prostatic carcinoma (62 cases) were detected by immunohistochemistry method.The relationship between the expressions of Survivin and HIF-1α was analyzed,as well as their correlations with clinicopathological features.Results The positive expression of Survivin and HIF-1α were significantly higher in the prostatic carcinoma [71.0 ％ (44/62) and 69.4 ％ (43/62),respectively] compared with those of the prostatic proliferation [6.7 ％ (1/15) and 0] (x2 =20.56,P 0.001; x2 =23.56,P =0.001,respectively).The expression of Survivin and HIF-1α in prostate carcinoma was significantly related with the histological grading,clinical staging (x2 =10.64,5.39,7.62,6.43,all P ＜ 0.05).And there was positively correlated between Survivin and HIF-lα (rs =0.350,P =0.006).Conclusion Survivin and HIF-1α synergistically play important roles in pathogenesis and progression of prostatic carcinoma.

ObjectiveTo evaluate the reliahility and validity of the chronic HBV-infections related stigma scale.MethodsThe initial items and construct of the scale were developed according to theoretical analysis and interviews of experts and patients.A total of 151 patients with chronic HBV-infection were administered by convenient sampling method in this pilot study. The reliability and the validity of the scale were then evaluated.ResultsThe response rate of the scale was 94.5％.The Cronbach α coefficients of all dimeusions ranged from 0.75-0.87.The results of correlation analysis showed that there were higher correlation coefficients ( r ranged from 0.62-0.86) between items and their hypothesized subscales than those with other subscales ( r ranged from 0.14-0.55).The scale distinguished between patients with low subscale scores ( the subscale scores were ( 1.89 ±0.30 ),( 1.86 ± 0.29 ),( 1.96 ± 0.23 ),( 2.29 ± 0.45 ),( 1.59 ± 0.42 ) independently) and those with high subscale scores(the subscalc scores were (3.62 ±0.44),(3.99 ±0.41 ),(3.79 ±0.37),(4.13 ±0.34),(3.10 ±0.53 ) independently) (P ＜ 0.01 ).Confirmatory factor analysis showed that the main indices of goodness of fit CFI was 0.94,NNFI 0.92,RMSEA 0.087.ConclusionThe chronic HBV-infections related stigma has good psychometric properties regarding to reliability and validity.

Objective To investigate the clinical features and survival status of mucosal melanoma of the nasal cavity and paranasal sinuses and to analyze the prognostic factors.Methods A retrospective analysis was performed on the clinical data of 94 patients with mucosal melanoma of the nasal cavity and paranasal sinuses treated from January 2000 to December 2012.Of the 94 patients,50 were male,and 44 were female.The median age of onset was 60 years (range,26-85 years).The primary sites were nasal cavity (86 patients),maxillary sinus (7 patients),and nasopharynx (1 patient).Cervical lymph node metastasis was observed in 10 patients (7 patients before treatment,2 patients during treatment,and 1 patient after treatment).No patient had distant metastasis.Patients were treated with surgery ± radiotherapy.The Kaplan-Meier method was used to calculate survival rates,and the logrank test was used for univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis.Results The 1-,3-,and 5-year sample sizes were 80,54,and 50,respectively.The 1-,3-,and 5-year disease-related survival rates were 71％,33％,and 22％,respectively.Univariate analysis showed that the prognostic factors were age over 55 years (P =0.034),involvement of the posterior naris (P =0.011),involvement of the maxillary sinus (P =0.009),involvement of the hard palate (P =0.003),cervical lymph node metastasis (P =0.001),and therapeutic method (P =0.038).Multivariate analysis showed that the prognostic factors were involvement of the posterior naris (P =0.027),involvement of the orbit (P =0.005),and involvement of the hard palate (P =0.003).Conclusions The distant metastasis and local recurrence rates are high among patients with mucosal melanoma of the nasal cavity and paranasal sinuses,so combination therapy is imperative.Cervical lymph node metastasis rate is low.Rational clinical staging needs to be further explored.

ObjectiveTo evaluate the clinical and radiographic efficacy and safety of the combination of recombinant human tumor necrosis factor-αt receptor Ⅱ IgG Fc fusion protein (rhTNFR:Fc) and methotrexate (MTX) in patients with rheumatoid arthritis (RA). MethodsThirty patients with highly active RA were treated with rhTNFR:Fc (25 mg subcutaneously twice weekly) and oral MTX (up to 15 mg weekly). Clinical efficacy was assessed using ACR response criteria and the disease activity score in 28 joints (DAS28).Radiographs of the hands and wrists were assessed with the modified Sharp score. Chi-square test, Fisher is exact test and paired t-test were performed. ResultsAt week 52, ACR20, ACR50 and ACR70 responses were achieved by 90％, 87％ and 67％ respectively. At week 52, mean DAS28 was 3.4±1.1 compared to 6.4±0.6 at base-line(P＜0.01), with 23％ patients achieving clinical remission and 17％ patients in low disease activity. Similarly, the HAQ was improved significantly, declining from 1.18±0.56 at base-line to 0.25t±0.34 at week 52 (P＜0.01). No radiographic progression was found in 22 cases. Adverse events were mild in general.ConclusionTreatment with rhTNFR:Fc plus MTX has shown good efficacy throughout 52 study period in reducing disease activity, improving function, and retarding radiographic progression. Combination therapy for 52 weeks can achieve disease remission and no radiographic progression, which are the two goals of therapy for RA.

From September 2020 to August 2021, 34 general practice trainees in Xuanwu Hospital, Capital Medical University were were randomly divided into the control group and trial group with 17 in each group. The control group adopted the traditional clerkship method for outpatient clinical teaching; the trial group independently received patients with the supervision of clinical instructors, and the Leicester assessment package (LAP) was used for evaluation and training. The performance of two groups were assessed using the Beijing General Practitioner's Graduation Assessment and Admissions Patient Score Sheet. The LAP training was also given to control group at the late stage of the study, and the application of LAP was assessed with a questionnaire survey in two groups of trainees. The results showed that the performance of trial group was better than that of control group in terms of medical history collection [(23.12±1.05) vs. (21.18±0.88), t=-5.82, P<0.01 ], physical examination [(24.88±1.62) vs. (23.12±1.58), t=-3.22, P< 0.01 ], case analysis [(22.94±0.90) vs. (20.82±0.73), t=-7.55, P<0.01 ] and total score [(86.59±2.65) vs. (80.12±2.45) t=-7.40, P<0.01]. For assessment of LAP, all 34 trainees gave 5 points in items of improving patient care, knowledge and skills, communication skills, professional quality, reception skills, clinical thinking, clinical judgment, decision-making skills, and learning interest with the application of LAP in outpatient clinical teaching; the satisfaction of the trainees on the pertinence, teaching effect and LAP training method of the instructing physicians was 100% (34/34). It is suggested that the application of LAP for evaluation and implementation in general practice outpatient teaching will help to improve the teaching quality and the patient receiving ability of general practitioners.

Objective: To study the expression and distribution of filaggrin (FLG) in oral submucous fibrosis (OSF) and to explore the significance of FLG in the occurrence and development of OSF. Methods : Ten cases with a normal oral mucosa (normal buccal mucosa group) and 30 cases of tissues with OSF lesions, including 10 cases each in the early (early OSF group), moderate (middle OSF group) and advanced stages (late OSF group), were selected. FLG was analyzed by immunohistochemistry. The FLG-positive cells were counted to calculate the percentages of cells with FLG-positive expression in each group. Results: FLG expression was negative in most of the normal buccal mucosa group specimens and was positive in the OSF buccal mucosal epithelial specimens. With aggravation of the OSF lesion, the number of FLG-positive cells increased. In the early OSF group, FLG-positive expression was mainly concentrated in the granular and keratinized epithelial layers. In the middle OSF group, the number of FLG-positive epithelial cells increased gradually. In the late OSF group, almost all epithelial cells were FLG-positive in the cytoplasmic nucleus. The percentages of FLG-positive cells in the early, middle and late OSF groups were (24.63 ± 9.06)%, (54.23 ± 10.63)% and (83.97 ± 8.72)%, respectively. The percentage of FLG-positive cells was significantly higher in the OSF group than in the normal mucosa group (P < 0.05). Conclusion FLG was expressed at a higher level in the OSF epithelium than in the normal oral mucosal epithelium and was upregulated in the OSF epithelium with aggravation of the OSF lesions. Abnormal FLG expression may be related to the terminal differentiation disorder of OSF epithelial keratinocytes.