This study aims to explore the differences of event-related potential (ERP) between attention deficit hyperactivity disorder (ADHD) and normal children, so that these differences provide scientific basis for the diagnosis of ADHD. Eight children were identified to be ADHD group by the diagnostic criteria of DSM-IV (diagnostic and statistical manual of mental disorders-IV), and the control group also consisted of 8 normal children. Modified visual-continuous performance test (CPT) was used as the experiment paradigm. The experiment included two major conditions, i. e. Go and NoGo. All the 16 subjects participated in the study. A high density EEG acquisition instrument was used to record the EEG signal and processed these EEG data by means of ERP and spectrum analysis. P2-N2 peak-peak value and spectral peak around 11 Hz were analyzed between ADHD subjects and those in the control group, and then statistical tests were applied to these two groups. Results showed that: (1) Under the condition of Go, ADHD group had a significant lower P2-N2 peak-peak value than the values in the control group (P < 0.05); but under the condition of NoGo there was no significant difference in between. (2) Compared with the control group, the ADHD group had significant lower spectral amplitude around 11 Hz under the condition of NoGo (P < 0.05). However, under the condition of Go the difference was insignificant. In conclusion, there is certain cognitive dysfunction in ADHD children. P2-N2 peak-peak value and spectral peak around 11 Hz could be considered as clinical evaluation indexes of ADHD children's cognitive function. These two objective indexes provide an early diagnosis and effective treatment of ADHD.
Attention Deficit Disorder with Hyperactivity ; diagnosis ; physiopathology ; Brain ; physiopathology ; Case-Control Studies ; Child ; Cognition Disorders ; diagnosis ; physiopathology ; Electroencephalography ; Evoked Potentials ; Humans

The paper reviewed the project management model and its evolution in the national schistosomiasis control in China at different stages.The key factors impacting the progress of the control activities were analyzed by introducing the concept of project management,and the principles,i.e.objective management,temporal management,cost-effectiveness management,and quality management,that would have to be complied with in the future control activities were put forward,so as to accelerate the elimination of schistosomiasis in China.

Objective To explore the relationship between the risk of amyotrophic lateral sclerosis (ALS) and exposure to rural environments and pesticide.Methods Studies relevant to rural residence,farmer occupation,pesticide exposure and ALS were identified from the databases including Embase,Ovid Medline,Pubmed,Cochrane Library,Wanfang data,Chinese BioMedical Literature Database,Chinese National Knowledge Infrastructure,China Science and Technology Journal Database up to March 2015.Quality of studies was assessed according to the Newcastle-Ottawa Scale (NOS).Analysis of data and publication bias was performed with software Revman 5.3.Results A total of 24 case-control studies and 3 cohort studies were included into the analysis.The NOS scores of all studies were ≥6.The risk of ALS was associated with pesticide exposure (OR =1.41,95％ CI 1.28-1.56) and farmer occupation (OR =1.42,95％ CI 1.29-1.57),but not associated with rural residence (OR =1.21,95％ CI 0.97-1.51).Subgroup analysis of pesticide exposure and ALS revealed that males (OR =1.75,95％ CI 1.39-2.21) had a higher risk than females (OR =1.53,95％ CI 1.13-2.08),and the risk estimate was higher in studies using E1 Escorial standard (OR =1.68,95％ CI 1.45-1.95) than studies not (OR =1.23,95％ CI 1.08-1.40).The meta analysis had a slight publication bias.Conclusions Our findings support pesticide exposure might increase the risk of ALS.Given that farmers always have high levels of pesticide exposure in their work,they should decrease their exposure level or take proper precautions to lower the risk of ALS.

Objective To investigate the diagnostic value of the split-hand sign in amyotrophic lateral sclerosis ( ALS).Methods Ninety ALS patients, 41 patients with other neuromuscular disorders and 71 normal controls were recruited for conventional nerve conduction study.Compound muscle action potential ( CMAP) amplitude recorded from abductor pollicis brevis ( APB) , abductor digiti minimi ( ADM) and first dorsal interosseous (FDI), CMAP amplitude ratios, CMAP amplitude differences and split-hand index ( SI) were analyzed.Results The APB/ADM CMAP amplitude ratio was significantly lower in the ALS patients (0.44(0.44)) than that in the patients with other neuromuscular disorders (1.31(0.87);z=6.967, P<0.01) and the normal controls (0.99(0.42);z=7.687, P<0.01).The FDI/ADM CMAP amplitude ratio was significantly decreased in the ALS patients ( 0.79 ( 0.46 ) ) compared with that in the normal controls ( 1.23 ( 0.39 ); z =5.899, P <0.01 ).The FDI/ADM CMAP amplitude ratio was comparable between the ALS patients and the patients with other neuromuscular disorders ( 0.93 ( 0.62 );z=1.737,P=0.081).SI was significantly lower in the ALS patients (2.42 (3.14)) than that in the patients with other neuromuscular disorders (10.10(6.54);q=7.947, P<0.05) and the normal controls (17.93(8.32);q=10.827, P<0.05).SI <5.2 can help differentiate ALS from mimic disorders, with a sensitivity of 83.33% and specificity of 96.43%.Conclusions The split-hand sign appears to be a specific feature of ALS.SI robustly differentiates ALS from mimic disorders and potentially facilitates an earlier diagnosis of ALS.

Objective:The aim of this study was to investigate the mechanism underlying transforming growth factor-β1 ( TGF-β1 ) induced differentiation of bone marrow-derived mesenchymal stem cells (BMSCs)into myofibroblasts.Methods:Primary mouse BMSCs were isolated from bone marrow by flushing the tibias and femurs of mice , and passage 3 to passage 5 of BMSCs were used in the experiments . BMSCs differentiation into myofibroblast was induced by different doses of TGF-β1.In addition, reactive oxygen species (ROS) inhibitor (N-acetylcysteine, NAC) was added to test its effect on the action of TGF-β1.Expressions of BMSCs differentiation parameters , α-smooth muscle actin (α-SMA), collagenα1(Ⅰ) [Col α1(Ⅰ)] and collagen α1(Ⅲ) [Col α1(Ⅲ)] were measured by real-time quantitative PCR (RT-qPCR) and Western blot analysis.BMSCs were preloaded for 15 min with 2’, 7’-dichlorohydro-fluorescein diacetate ( DCFH-DA) , then stimulated with TGF-β1 for different times , and fluorescence of ROS was measured using high content analysis .Results:TGF-β1 stimulated differentiation of BMSCs into myofibroblasts and up-regulated expression of α-SMA, Col α1(Ⅰ) and Col α1(Ⅲ) in a dose-dependent manner , which blocked by ROS inhibitor NAC .In addition , TGF-β1 could induce a significant rapid and transient increase in ROS production in BMSCs , and the effect of TGF-β1 on ROS production was peaked at 30 min.Conclusion:TGF-β1 induced differentiation of BMSCs into myofibroblasts via production of ROS.

Outpatient care services are usually the patient's first contact between the patients and the most bas-ic health care. The provision of outpatient care contributes to immediate and large gains in health status. The pay-ment method is one of the most common incentive methods applied by purchasers to guide the performance of outpa-tient care providers. This systematic review applied cochrane review method, and searched, screened, assessed and synthesized the relevant original studies. 19 studies were finally included. It was found that existing payment methods combined with P4 P interventions could probably slightly improved the health professionals' use of some tests and treat-ments ( adjusted RR median = 1 . 095 , range 1 . 01 to 1 . 17 ) , but may have led to little or no difference in patients' utilisation of health services ( adjusted RR median = 1 . 01 , range 0 . 96 to 1 . 15 ) and may have led to little or no difference in the control of blood pressure or cholesterol ( adjusted RR = 1 . 01 , range 0 . 98 to 1 . 04 ) . Pay for per-formance involves a complex design, each detail design may contain different incentive effect, therefore policy makers intend to apply pay-for-performance to guide the behavior of health providers, the design on each components of pay for performance should be analyzed in order to find more potential intervention points.

Objective To examine the recurrent ischemic stroke(RIS)in hospitalized patients predicted by Essen Stroke Risk Score(ESRS)and investigate the effect of intensive antiplatelet therapy in patients with high risk of RIS. Methods Retrospective analysis of patients with acute noncardioembolic ischemic stroke consecutively admitted to Peking Union Medical College Hospital(PUMCH)during 2001-2008. All 1008 patients were included in this study, 377 hospitalized in 2001-2002, 315 in 2005 and 316 in 2008. High risk of RIS was defined as ESRS ≥3. The average ESRS score in three groups and percentage of patients with high risk of RIS in each group were calculated. Risk of RIS was evaluated by comparing the average ESRS score in these three groups. Patients with high risk and taking clopidogrel treatment were also evaluated. Results Average ESRS score was 2. 67 ± 1.47,3.55 ± 1.40 and 3.93 ± 1.48(F= 150. 85,P=0.000)in groups of patients hospitalized in 2001-2002, 2005 and 2008 respectively. A significant difference was shown in percentage of high risk patients with ESRS ≥3 in three groups: as 51.64% in 2001-2002,77. 19% in 2005 and 85. 45% in 2008(X2=98.30,P=0. 000),showing a trend of increasing risk of RIS. Except for patients age, rates of having the risk factors in patients increased significantly, including hypertension, diabetes, myocardial infarction, myocardial diseases, smoking,vascular disease and stroke history. Clopidogrel usage has been increasing to 25.63% in 2008, but was far behind high ratio of high risk RIS patients(85.45%). Conclusions This retrospective study showd an increasing trend in RIS risk during 2001-2008. Identifying high risk patients and applying intensified antiplatelet therapy might play an important role in reducing the risk of RIS.

The present residents training for ultrasound departments depends mostly on poorlyscheduled rotation and clinical clerkship,with repeated and obsolete subjects in their training.The authors identified these setbacks and such characteristics as complication of ultrasound medicine,complex and variable ultrasonic scan technique,and the high threshold for beginners.In view of this,the authors adopted the tutorial system training mode for cultivating the residents in their medical care,teaching,research and foreign language competencies.A questionnaire survey of 44 residents so trained evaluated outcomes of the mode,with constructive suggestions raised on expansion of the training base,improvement of teachers’competency and reduction of trainees' workload.

Objective To investigate the clinical features,treatment and the causes of death in severe infectious disease complicated with capillary leak syndrome(CLS)in neonates.Methods The clinical data,laboratory finding,treatmand clinical outcome of 11 neonates who had severe infectious disease complicated with CLS in our NICU from Jan 2009 to Jul 2010 were collected and analysed retrospectively.Results Among the 11neonates,five had pneumonia and the other six had sepsis.All the 11 cases appeared progressive edema on skin and mucosa,dyspnoea,infective shock,oliguria and hypoalbuminemia(10～20 g/L).We treated the 11cases with hydroxyethyl starch(10～15 ml/kg,every 8 to 12 h)at early stage on the basis of infection control,anti-shock treatment,mechanical ventilation,symptomatic treatment and a stable internal environment.At last,6 cases were rescued,in whom 4 cases were well-developed,had normal intelligence and athletic ability,the other two cases had hydrocephalus or muscle tone high of both lower extremities.Five cases died.Conelusion CLS is a severe complication of neonatal severe infection,and had high mortality.Treating with hydroxvethvl starch at an early stage can increase the survival rate.

Objective To establish homogeneous immunoassay for detecting serum cardiac troponin I (cTnI) by using light induced chemiluminescent immunoassay (LiCA). Methods Polyclonal antibodies of cTnI were coated on the receptor particles, monoclonal antibodies of cTnI were biotinylated, and the donor particles were coated with streptavidin, all of which were composed of LiCA reagents. The optimal test conditions and analytical performance of the detection method were studied. Results The method was rapid, sensitive, and detection time was 17.5 min.The analytical sensitivity was 0.045 ng/mL and the functional sensitivity was 0.053 ng/mL.The recovery rate was 104.96%-108.21%;The within-run and the between-run coefficients of variation were 3.88%-5.53%and 7.60%-8.75%, respectively. The interference rates for the endogenous substances were less than 10%. The reference value of cTnI was less than 1.05 ng/mL;Results of cTnI LiCA correlated well with direct chemiluminescence detection (r2 =0.979). Conclusions This approach can be used for the quantitative detection of serum cTnI, and it is homogeneous and is free of clean separation. It provides a convenient, highly sensitive detection platform for clinical practice.