Objective To analyze the clinical features of eosinophilic granulomatosis with polyangiitis (EGPA).Methods The clinical characteristics,laboratory test,therapeutic regimen,pathology and imaging diagnosis in 23 cases with EGPA from the First Affiliated Changhai Hospital of Second Military Medical University within June 2007 to January 2013 were retrospectively analyzed.Results There were 14 males and 9 females,with the age ranged from 21 to 68 years.The mean age was (42±9) years.The overall prevalence of asthma was 78％(18/23).The allergic rhinitis accounted for 61％(14/23).The maxillary sinuses were the most frequendy involved,which accounted for 57％(13/23).Skin involvement was 57％(13/23),peripheral neuritis was 70％(16/23).Central nervous system involvement presented cerebrovascular event.Cardiac involvement accounted for 48％(11/23),digestive system involvement accounted for 17％(4/23).The outcome of auxiliary laboratory test revealed that 96％(22/23) patients expressed significantly higher levels of IgE and 70％(16/23) patients carried anti-neutrophil cytoplasmic antibodies (ANCA) which were presented as the perinuclear ANCA (p-ANCA).The patchy infiltrates of lung CT scan accounted for 69％ (11/23).EMG showed mononeuritis multiplex and symmetric sensory motor neuropathy.The abnormal ratios of ECG and Echocardiography were 48％(11/23),79％(11/14) respectively.The pathological manifestations were necrotizing vasculitis,eosinophilic tissue infiltration,and extravascular granulomas.Conclusion Our results confirm the heterogenicity in clinical presentation and lack of specificity.Early diagnosis and treatment will be helpful for good prognosis.

Objective To explore the clinical value of dynamic electrocardiogram ( DCG) in the diagnosis of coronary artery damage (CAD) in children with Kawasaki disease (KD).Methods A total of 125 cases of children with KD admitted to hospital in recent years was analyzed , without CAD as the control group (83cases), and others as the experimental group (42cases).All cases were undertaken DCG and electrocardiogram (ECG).The results of heart rate, heart Rhythm, and voltage changes were compared be-tween two groups .Results The abnormal rate of total ECG and DCG in the control group was significantly lower than the experimental group ( P <0.01 ) , The total ECG and DCG abnormal rate was no difference in control group ( P >0.05 ) , but DCG abnormal rate of experimental group was significantly lower than ECG (χ2 =15.30, P <0.01).The sensitivity, specificity, Youden index, and diag-nostic accuracy of normal ECG , DCG and Joint were 59.5%, 86.7%, 0.463 , and 77.6%;95.2%, 94.0%, 0.892 , and 94.4 %;95.2%, 84.3%, 0.796 , and 88.0%.Common ECG results were lower than DCG and joint ( P <0.05 ) , But DCG results were sim-ilar with the joint ( P >0.05 ) .Conclusions DCG test provides scientific parameter in the diagnosis of CAD in children with KD , and is superior to normal ECG , but the value of Joint is the same .

Objective The aim of this study was to explore the effects of health education intervention on asthma control level for asthma patients through the survey of general demographic information,asthma clinical characteristics of patients with asthma,the Asthma Control Test (ACT),and pulmonary function examination.Methods 126 asthma patients were selected from the clinic and randomly divided into the health education group and the control group.All the patients were followed up for 3 months.In our study,we would scored them in terms of demographic data,clinical features of asthma,asthma cognitive level,medication compliance and Asthma Control Test (ACT) and pulmonary function examination before and after the health education for all patients respectively,and compared the data of the above parameters obtained before and after the intervention and the data from the health education intervention group and the control group.Results In our study,10 cases were lost to follow-up,and 116 cases completed the study at last.There were 68 patients in the health education intervention group and 48 patients in the control group.The results showed that patients with acute attack times,ACT score,pulmonary function indicators and asthma control situations of the health education intervention group after 6 months’ health education,were significantly improved,and the difference was statistically significant.Otherwise,comparison of the contents above of the control group before and after intervention,it was not statistically significant.Meanwhile,com-pared with the control group,the contents above of the health education intervention group were improved with statistically significant differences.Conclusions The standardized health education can improve the quality of life significantly,decrease the asthmatic symptoms,reduce the times of acute onset,which results in maintenance of asthma control,meanwhile the pulmonary function of patients with asthma will improve,so that more patients can live as normal or nearly normal people.

Objective evaluate the role of vagus nerve?muscarinic cholinergic receptor ( M recep?tor) pathway in mitigation of myocardial ischemia?reperfusion (I∕R) injury by intrathecal morphine postcon?ditioning in rats. Methods Seventy adult male Sprague?Dawley rats in which intrathecal catheters were suc?cessfully placed without complications, weighing 250-350 g, were randomly assigned into 7 groups ( n=10 each) using a random number table:sham operation group (Sham group), I∕R group, intrathecal morphine postconditioning group ( MP group) , vagal transection ( VT) group, VT+ intrathecal morphine postcondi?tioning group (VT+MP group), atropine (ATP, M receptor antagonist) + morphine postconditioning group ( ATP+MP group) , and ATP group. Myocardial I∕R was produced by occlusion of the anterior descending branch of left coronary artery for 30 min followed by 2 h of reperfusion. Morphine ( 3μg∕kg, 10μl) was in?trathecally infused over 5 min starting from onset of reperfusion in MP group. Normal saline 10 μl was in?trathecally infused over 5 min starting from onset of reperfusion in NS group. The bilateral vagus nerves were transected at 10 min before reperfusion in VT+MP group. Atropine ( 0?1 mg∕kg, 0?5 ml) was intravenously infused over 5 min starting from 10 min before reperfusion in ATP+MP group. The occurrence of cardiac ar? rhythmia ( premature ventricular contractions ( PVCs) and ventricular tachycardia ( VT)∕ventricular fibrilla?tion ( VF) ) within the first 30 min of reperfusion was recorded. The rats were sacrificed at 120 min of reper?fusion, and myocardial specimens were obtained for determination of myocardial infarct size ( IS) as a per?centage of area at risk (AAR). IS∕AAR ratio was calculated. Results Compared with Sham group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly increased in the other groups. Compared with I∕R group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly decreased in MP group. Compared with MP group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly in?creased in VT+MP and ATP+MP groups. Conclusion Vagus nerve?M receptor pathway is involved in miti?gation of myocardial I∕R injury by intrathecal morphine postconditioning in rats.

Objective To determine the effects of curcumin microemulsion on proliferation and apoptosis of the human leukemia cell line K562 cells.Methods The curcumin microemulsion was prepared with the routine procedure.MTT assay was used to determine cell proliferation in cultured K562 cells,flow cytometry analysis was applied to examine cell apoptosis,and WT1 mRNA was determined with RT-PCR.The results about curcumin microemulsion were compared with these on curcumin.Results The prepared curcumin microemulsion was a stable clear solution with diameter of 10-100 nm.Curcumin microemulsion inhibited K562 cell proliferation by 24％,46％,68％with a 24 h incubation at dose of 2.5 μg/ml,5.0 μg/ml,and 10.0 μg/ml respectively,whereas curcumin reduced the proliferation by 6％,14％,25％at equal concentrations.WT1 mRNA level of curcumin microemulsion group(0.190±0.036)was reduced stronger than that of curcusin group(0.456±0.047).Conclusions Microemulsion is a great carrier for curcumin.Curcumin microemulsion is more effective in inhibiting proliferation,pro-apoptosis,and reducing WT1 gene expression than curcumin.A strong basis of medical value for the use of curcumin microemulsion to treat tumors is provided.

Objective To explore the effect of hospital-community-based collaborative management on elderly out-patients with chronic heart failure (CHF).Methods A total of 228 out-patients with CHF were randomly assigned to the community-based health management group (n =106 ) and the hospitalcommunity-based collaborative health management group (n =122).In community-based health management group,the patients only received community-based health management,while in hospital-community-based collaborative health management group the patients accepted comprehensive health management.One year later,medication compliance,readmission rate,mortality,average length of hospitalization,medical costs and Minnesota living with heart failure questionnaire (LiHFe) were compared between the two groups.Results No statistically significant differences in clinical data were found between the two groups at baseline.After one year,medication compliance was significantly improved in hospital-community-based collaborative health management group when compared to community-based health management group ( x2 =8.97,P ＜ 0.05 ).Readmission rate,averagelengthof hospitalizationandmedicalcostsof hospital-community-based collaborative health management group were lower than community-based health management group (x2 =9.91 ; t =3.78,3.61 ; all P ＜ 0.05 ).One year ago,the items of LiHFe including physical dimension,emotion,symptom and social dimension and total score showed no significant between the two group (t =0.42,0.81,0.66,0.44,0.41 ; all P ＞ 0.05 ).While one year later,all the scores of hospital-communitybased collaborative health management group were significantly declined( t =6.37,11.81,6.16,9.64,9.13;P ＜ 0.05 ).Mortality showed no significant difference between the two groups ( x2 =0.247,P ＞ 0.05 ).Conclusion Hospital-community-based collaborative management for health care may be a practical and valuable strategy for decreasing readmission rate and medical burden and improving quality of life of elderly patients with CHF.

Objective To observe the expression of acid-sensing ion channel la (ASICla) and to investigate the effect of intracellular Ca2 + concentration on focal cerebral ischemia in diabetic rats.Methods 108 male Wistar rats were divided into three groups:group A [rats with middle cerebral artery occlusion (MCAO)],group B [rats with MCAO and diabetes (DM + MCAO)],group C [rats with MCAO and diabetes treated with fasudil intervention (DM+ MCAO+ fasudil)] (n=36 each).Samples were obtained at the time points of 1,3,6 and 24 h after ischemia respectively (n=9).Models of MCAO and DM+MCAO were prepared.Rats in DM+MCAO+Fasudil group were treated with fasudil 1 mg/Kg by caudal vein injection after half an hour when DM+MCAO model successfully prepared.ASICla expressions were detected at different time points of ischemia in the 3 groups respectively.Ca2+ concentration in ischemia cortex cells were determined at different time points of ischemia in group B and C.Results ASICla expressions were gradually increased along with the ischemia time in group A and B (group A:0.71±0.10,0.80±0.11,0.86±0.08,0.93±0.09;groupB:0.86±0.11,1.05±0.51,2.42±0.08,2.78±0.04; all P＜ 0.05),and ASICla expressions at different time points were higher in group B than in group A (all P＜ 0.05).Ca2-concentration were gradually increased along with the ischemia time in group B (106.32± 18.6,137.84±14.32,151.94± 18.38,183.61±7.96,all P＜0.05).Compared with group B,the levels of ASICla expression and calcium current were reduced in group C.Conclusions The activation of ASICla increases calcium ion flow internal pathway leading to intracellular calcium overload,which may be one of the reasons for the aggravation of focal cerebral ischemia in diabetes.

Objective To investigate the application of field work logs in collection of the disaster information in medical rescue of earthquake.Methods The self-designed work logs were made according to the condition of the wounded in the medical rescue of Lushan earthquake.Through the field work logs,we got first hand information which facilitate statistics,inquiry and subsequent follow-up work.Results By using the field work logs,the rescue workers guaranteed the collection of original data timely and accurately,supplied a number of rich and a-list clinical data and also facilitated the masses in disaster areas looking for their relatives.Conclusions The application of field work logs played a pivotal role in medical rescue of Lushan earthquake.It can be widely extended as a general manner in emergency disaster rescue after further perfection.

BACKGROUND:Studies have shown that the finite element method could preferably simulate the biomechanical analysis for the object with complicated structures and irregular shapes. The similarities for the finite element model have great influences on the results of the analysis. However, to construct an ideal model is the most time-consuming and complicated portion for the finite element analysis. OBJECTIVE:To construct a finite element model for the maxilary first molar and the periodontal tissue, and to provide a basis of biomechanical researches of the maxilary first molar. METHODS: A volunteer with complete mandibular dentition and healthy periodontal tissue was selected in this study. Cone-beam CT was scanned. The images were saved as DICOM format. These images were imported to the medical modeling software Mimics. The surface model for the maxilary first molar and the alveolar bone was constructed. The model was then imported to GiD for pre-processing. Thus, the complete three-dimensional finite element model for the maxilary first molar and the periodontal tissue was constructed. RESULTS AND CONCLUSION:A finite element model for bilateral maxilary first molar, periodontal ligament and maxilary alveolar bone was constructed, including 896 035 nodes and 4 881 067 elements. This model has restored the geometric shape and the structure of the research object. This study successfuly constructed finite element models of maxilary first molar and the periodontal tissue, which can be a basis of biomechanical researches for the maxilary first molar and the periodontal tissue under the effect of different clinical orthodontic forces.

Objective To investigate current status of learned resourcefulness in pregnant women,and to identify its influencing factors.Methods With convenient sampling,a self-made General Data Questionnaire and the Chinese version of Self-Control Schedule (C-SCS) was used to survey 360 pregnant women in the antenatal clinic in one three-class hospital in Guangzhou.Results The mean score of learned resourcefulness in pregnant women was (115.00±14.42) and its influencing factors included education degree,gravidity,pregnancy school training and planed pregnancy.Conclusions Learned resourcefulness in pregnant women loads upper level.Medical staff should take targeted interventions to strengthen it and facilitate the mental well-being of pregnant women.