Objective To explore the influence of self-management education on the quality of life of parents of asthma children. Methods Forty-eight parents of children with asthma underwent one-year intervention of self-management.The results were assessed on the basis of two kinds of questionnaires,the Generic Quality of Life Inventory-74(GQOLI-74)and a self-designed psychological pressure questionnaire.Results After intervention,the scores of person and family,economic burden,lifelong care,lack of sense of accomplishment and overprotection were diminished,compared to those before intervention(P<0.05).There were also significant differences between pre-and post-intervention in the four dimensions with 20 factors(P<0.05 or P<0.01).Conclusion The self-management education can ease parents' psychological pressure and increase their quality of life.

Objective To prove into the effect of parental involvement in nursing to discharged children with metabolic syndrome.Methods Forty-six children with metabolic syndrome were equally divided into the observation group and the control group according to the order of admittance.Both groups accepted health education,guide to lifestyle and so on.After leaving hospital,the observation group accepted parental involvement in nursing,while the control group accepted physical examination regularly.Then the lifestyles,physical indicators,blood pressure and biochemical indicators of both groups were compared.Results The lifestyle of the observation group was significantly greater than that of the control group(All P<0.01).The observation group had greater declines in waist,blood pressure,TC,TG and LDL-C and a greater increase in HDL-C than those of the control group.Conclusions Parental involvement in nursing can improve the lifestyle of children patients,which is good for the declines of their weigh and blood lipid.This treatment can achieve the goal of control and treatment of children metabolic syndrome.

BACKGROUND: It is reported that there is special physiological effect of Neiguan (Luo-connecting point, P6) acupuncture on the cardiovascular system. Instead of acupuncture, irradiation of the Neiguan point with He-Ne laser can improve the cardiac function of senile patients with coronary heart disease (CHD).OBJECTIVE: To study the effect of irradiation of Neiguan acupoint with He-Ne laser on the circulatory system of senile patients with coronary heart disease.DESIGN: Auto-control study.SETTING: Henan Provincial General Hospital of the Chinese People's Armed Police Force.PARTICIPANTS: Forty senile patients with coronary heart disease hospitalized in the General Hospital of Henan People's Armed Police Force for rehabilitation from 2000 to 2001 were selected. There were 28 males and 12 females, aged from 66 to 85 with the average age of 70. The course of their disease was from 2 years to 20 years. Among the patients, 15 were complicated with essential hypertension and 7 were with hyperlipemia.METHODS: He-Ne laser, with wavelength of 632.8 nm and power of 5 mw, was used to irradiate directly the Neiguan acupoint once a day, 15 minutes in each time and 20 times as a whole course. Indexes of hemodynamics were detected before the treatment, just after the first treatment and after the first course of treatment.MAIN OUTCOME MEASURES: ① Cardiac work total (CWT), left heart work effective (LWE) and left cardiac index (LCI); ② Left heart total pumping force (LTPF), left heart jetting pressure (JP), left heart effective pumping force (LEPF) and pressure of efflux (EPE); ③ Consumption myocardium oxygen (CMO) and coronary compliance (CMR); ④ Modulus of elasticity of the cardiac muscle (VE).RESULTS: All 40 senile patients with coronary heart disease entered the final analysis without any loss. ① Comparison between the first time of post-treatment and the pre-treatment: The data of CWT, LCI, and LWE were decreased [(534.086 ±90.923), (616.587 ±137.426) J/minute;(4.821±0.622), (5.469±1.144) L/minute.m2; (116.528±22.476), (136.603 ±30.796) J/minute, P ＜ 0.05 or P ＜ 0.01]. Parameter of CMO was decreased but parameter of CMR was increased [(22.783±4.174), (25.255±6.125) mL/minute,(180.108±31.210), (157.031±35.056) g/cm4s2, P ＜ 0.01]. ② Comparison between post-first course and pretreatment: Parameters of CWT were decreased [(489.291±118.434), (616.587±137.426) J/minute, P ＜ 0.05],those of CMO were also decreased but th ose of CMR were increased [(22.472±6.011), (25.255±6.125) mL/minute, (193.757±51.704),(157.031±35.056) g/cm4s2, P ＜ 0.01].CONCLUSION: The treatment of coronary heart disease with He-Ne laser beam instead of needling may induce heating effect, biological effect and electromagnetic field, which can excitated the physiological function of meridian in order to improve cardiac load and myocardial oxygen consumption, to increase the oxygen supply and the utilization rate of tissue, improve relaxation-contraction function of coronary artery and promote the blood supply and circulation of coronary artery.

Objective To evaluate 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama.Methods The 3D CT features on MIP,VR images were analyzed retrospectively in 589 pediatric cases.The normal anatomy,anatomic variations and fractures of occipital squama were observed respectively,and the differential diagnostic features including the individual location,appearance and extension were analyzed.Results Four hundred and thirty-three patients (75.2％) showed normal anatomy,including 154 patients with adult occipital anatomical features,279 patients with posterior intraoccipital synchondrosis,and 37 patients with Kerckring-supraoccipital synchondrosis.When cases with recent trauma history were excluded,113 patients (19.1％) showed anatomic variants,including unpenetrating sutures and penetrating sutures.The former could be subdivided to Mendosal sutures in 23 cases,superior median fissures in 19 cases,and midline supraoccipital fissures in 4 cases,while the latter could be subdivided to the interparietal bone variations in 54 cases,wormian bones in 23 cases,and accessory bones in 7 cases.Two or more variations coexisted in 33 cases.The occipital squama fractures were shown in 34 cases (5.6％),including linear fractures in 27 cases,comminuted fractures in 3 cases,with depression fracture in one case,separation of cranial sutures in 3 cases,and other fractures associated with variants in 3 cases.The fractures were sharp,or jagged,without limitation of the occification.Conclusion There are different 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama in children,which are important for making the accurate diagnosis.

Objective To conduct comparative study of vertebral artery blood flow of arteriosclerosis patients and healthy people using color Doppler ultrasound (CDUS),and to discuss the effect of arteriosclerosis on vertebral arterial blood flow.Methods Two hundred and eighty-five cases of vertebral artery test were collected and divided in to normal group of one hundred and thirty-five cases and vertebral artery sclerosis group of one hundred and fifty cases according to the presence of vertebral artery sclerosis.Time averaged maximum velocity (TAMV) and vertebral artery diameter(D) of vertebral artery were measured using CDUS technique.Unilateral vertebral artery blood flow and total blood flow were calculated.Results The vertebral artery TAMV and total blood flow of arteriosclerosis group was both lower than that of normal group (P＜0.05).Left side vertebral artery diameters of the two groups were higher than that of the right side.Conclusions Arteriosclerosis can reduce vertebral artery TAMV and blood flow.The inner diameter of the left side vertebral artery dominates the artery blood flow.

Objective To analyze and evaluate the image quality and the impact factors of CT virtual endoscopy (CTVE) in the application of various body parts. Methods CTVE images from 143 patients were classified into 2 types according to the chosen threshold: low attenuation lumen (including natural air filled and artificially air filled lumina) and high attenuation lumen. A 4 point scale was used to evaluate the differences of diagnostic confidence, artifacts, and overall image quality rating between both kinds of lumina. Results There was no statistically significant differences in diagnostic confidence of CTVE images among 3 kinds of lumina, but the image quality of CTVE of natural air filled lumen was better than that of artificially air filled lumen ( P 0.05). There was a significant difference in artifact rating of CTVE images among three kinds of lumina with the most artifacts seen on images of high attenuation lumen. Common artifacts observed on the CTVE images were attributed to patient motion artifacts such as respiration, inappropriate choice of spiral CT scanning parameters, and improper modification of thresholds. Conclusion The threshold setting was one of the most important factors impacting the image quality of CTVE images, and most artifacts seen on the CTVE images were easily recognized on the basis of their characteristic appearance, and did not influence the diagnostic information heavily.

Objective To investigate whether correlation exists between quantitative perfusion parameters obtained from dynamic contrast?enhanced magnetic resonance imaging (DCE?MRI) and different prognostic factors or immunohistochemical subtypes of breast cancers. Methods A retrospective analysis of DCE?MRI was performed in 87 breast cancer patients with 91 pathology confirmed breast lesions. All the patients underwent the immunohistochemistry after the operation, 80 breast cancer patients with 84 breast lesions were divided into different subtypes based on the immunohistochemical profiles. All the patients underwent plain MRI and DCE?MRI. The volume transfer constant (Ktrans), rate constant (kep) and volume of EES per unit volume of tissue (Ve) value were calculated. Results of the immunohistochemistry and observation results of the the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor?2 (HER?2) were recorded. Subtypes were also categorized. The degree of the expression of Ki?67 was observed simultaneously. Among the 87 breast cancer patients (with 91 breast lesions), 68 were ER?positive,18 were ER?negative, 60 were PR?positive, 26 were PR?negative;30 were HER?2 positive and 58 were HER?2 negative. Eighty breast cancer patients (with 84 breast lesions) were divided into different subtypes:19 were Luminal A, 49 were Luminal B, 7 were HER?2 positive subtype and 9 were triple negative breast cancer (TNBC). The quantitative perfusion parameters with diffierent expression of the receptors were analyzed through Mann?Whitney U test, the correlation between the degree of the expression of Ki?67 and quantitative perfusion parameters was obtained with Spearman test. Furthermore, the distributions of the perfusion parameters between groups according to immunohistochemical subtype were compared using the Kruskal?Wallis test. Results Ktrans and kep value were higher in tumors with ER?negative and PR?negative than with ER?positive and PR?positive and difference was statistically different ( P<0.05). There was no statistically significance in the quantitative perfusion parameters between HER?2 positive and HER?2 negative (P>0.05). The degree of the expression of Ki?67 was 5%to 90%the mean value was 33%, the median and interquartile range of Ktrans, kep and Ve value was 1.33/min (0.88/min), 2.63/min (2.34/min) and 0.51 (0.22) respectively. There was no significant correlations between the degree of the expression of Ki?67 and Ktrans and kep value (r value was 0.24 and 0.22 respectively, P value was 0.03 and 0.04 respectively), and the degree of the expression of Ki?67 was not associated with Ve (r=0.00, P=0.97). Ktrans value was lower in Luminal A and Luminal B than that in HER?2 positive subtype and TNBC, kep value was lower in Luminal A and Luminal B than that in TNBC, and Ve value in Luminal A, Luminal B and HER?2 positive subtype were higher than that in TNBC, kep value was lower in Luminal B than that in HER?2 positive subtype, statistically significance was seen among them (P<0.05).Triple?negative breast cancer showed the highest kep value (3.99/min) and the lowest Ve value (0.41) than the other subtypes. Conclusion The different subtypes of breast cancer may be predicted to some extent with quantitative perfusion parameters, and there is no correlation between quantitative perfusion parameters and the prognostic factors.

Objective To investigate the signal intensity ratio and signal-to-noise ratio of breast lesions in 3.0 T MR diffusion weighted imaging with different b values.Methods Ninety seven patients with 106 solid breast lesions (44 malignant,62 benign) confirmed by pathology were retrospectively analyzed.The patients were examined by 3.0 T MR DWI with different b values (b =0,400,800,1 000 s/mm2) before surgery.The signal-to-noise ratio (SNR) and signal intensity ratio (SIR) of benign and malignant lesions were observed and measured under different b values.One-way ANOVA and t test were used to analyze quantitative data.ROC curve was used to analyze the diagnostic efficiency of SIR under different b values.Results Under different b values,class A image was found in 92 cases,class B images was found in 5 cases.While b value were 0,400,800,1 000 s/mm2,SIR of benign lesions were 2.33 ± 1.36,2.25 ± 1.13,2.06 ± 0.84,2.02 ± 0.79 respectively,SIR of malignant lesions were 2.02 ± 0.79,2.27 ± 0.85,2.61±0.78,2.82 ± 1.01 respectively.While b value was 0 or 400 s/mm2,there was no significant differences for SIR between benign and malignant lesions (t value were 1.58,1.26 respectively; P value were 0.12,0.90 respectively),but there were statistically significances between benign and malignant lesions under b value 800 s/mm2 or 1 000 s/mm2 (t value were 3.41,4.29 respectively ;P ＜0.01).There was no differences in SIR for benign and malignant lesions under different b values respectively (F value is 1.21,2.22 respectively; P ＞0.05).While b value were 0,400,800,1 000 s/mm2,the diagnostic sensitivity and specificity of SIR for breast benign and malignant lesions were 56.8％ (25/44),56.8％ (25/44),75.0％ (33/44),77.3％ (34/44) and 51.6％ (32/62),54.8％ (34/62),66.1％ (41/62),66.1％ (41/62) respectively.While b value were 0,400,800,1 000 s/mm2,SNR were 170 ±93,145 ±72,84 ±41,70 ± 39 respectively.Different b values,there was statistically significant difference between groups (F =55.89,P ＜ 0.01) ; and there were significant differences between every two b values (P ＜ 0.05).Conclusion The higher b values (800 s/mm2 and 1 000 s/mm2) are superior to lower b values in the differential diagnosis of benign and malignant breast lesions using 3.0 T MR scanner.

Objective To investigate the morphologic change and phosphatidylserine (PS) exposure of erythrocytes in sepsis patients.Methods 30 healthy volunteers (control group)and 30 sepsis patients were enrolled in this study and were collected venous sampling.Monitoring included Wright's staining blood smear test,erythrocyte aggregation index and the ratio of PS exposure of erythrocytes.A flow-cytometric assay based on FITC-Annexin V was used to measure the PS exposure of erythrocytes.Results The morphological changes of red blood cells included acanthocyte,lachrymiform,rouleaux,spherocyte in sepsis patients,and the peripheral blood erythrocyte aggregation and aggregation index were significantly higher than that of the healthy control group (P＜0.05).The percentage of PS exposure of erythrocytes in sepsis patients were significantly higher than that of healthy volunteers (P＜0.001).Conclusion The PS exposure of erythrocytes were significantly higher in sepsis patients,and the morphology of red blood cells is obvious abnormal.

Objective To investigate risk factors and prognosis of hemorrhagic transformation(HT)in acute cerebral infarction patients treated by intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA).Methods All 128 patients with acute cerebral infarction were treated with intravenous rtPA within 6 hours from stroke onset.The clinic records and laboratory datas of pre-and post-treatment were statistically analyzed between HT group and non-HT group to find potential risk factors to HT and contributors of prognosis.Results HT occurred in 29 patients(22.66％),including 16 patients with symptomatic ICH(12.50％)and 2 patients died(6.90％ of HT).Logistic regression analysis showed that history of atrial fibrillation(OR =1.293,95％ CI 1.224-1.589,P =0.001),CT density changes with mass effect or edema(OR =2.452,95％ CI 1.132-3.309,P =0.034),diastolic blood pressure ≥ 100 mm Hg before thrombolytic therapy(1 mm Hg =0.133 kPa,OR =9.265,95％ CI 1.435-59.836,P =0.019),blood glucose ≥ 11.1 mmol/L(OR =3.037,95％ CI 0.252-57.593,P =0.047),NIHSS score ＞ 15 points (OR =8.752,95％ CI 1.035-30.285,P =0.023)and thrombolysis time ＞ 3 h(OR =98.74,95％ CI 5.067-186.120,P =0.002)are independent risk factors for HT; among these factors,baseline blood glucose(OR =3.265,95 ％ CI 0.435-59.863,P =0.045),NIHSS score(OR =10.453,95 ％ CI 5.647-38.185,P =0.003)and thrombolysis time(OR =2.541,95％ CI 1.098-51.086,P =0.017)also are prediction factors of the prognosis of HT.Conclusion Risk factors associated with HT are diastolic blood pressure before thrombolysis,glucose level,degree of neurological deficits,CT early changes,atrial fibrillation and thrombolytic time.Glucose level,neurological deficits and thrombolysis time affects the prognosis of patients.