The prevalence of bronchial asthma in children is rising year by year,but the control rate is less than one thirds.Case control studies and cohort studies have showed that childhood asthma may persist among teenagers and even the elderly,at the same time,the damage of pulmonary function also starts early in life and continue to exist.Prompt diagnosis and intervention of individualized drug treatment control,specific immunotherapy and follow-up management,regular monitoring of pulmonary function damage and improvement of adverse enviromnental factors,may help to improve the long-term outcome of asthma in children.

Idiopathic hypogonadotropic hypogonadism(IHH) is a complex oligogenic disease.About 60％ of patients are associated with anosmia or hyposmia,also known as Kallmann syndrome. Based on genetic and molecular biological research,about more than ten IHH responsible genes have been discovered.

Severe acute pancreatitis (SAP) is a critical disease which has a high mortality. In order to make the diagnosis and treatment much more promptly, rationally and effectively, this article briefly introduces some methods for assessment of the severity and risk of SAP by clinical manifestation, risk factors,scoring systems, radiology and laboratory examinations.

Objective · To develop a new hybrid tissue-engineered vascular graft (HTEV) with excellent mechanical properties and biological functions. Methods · Decellularized rat aortas (DRAs) were prepared. Then, electrospinning nano poly (1,3-diamino-2-hydroxypropane-co-polyolsebacate) (ES-APS) was used to sheathe DRAs in order to improve the mechanical properties. After that, the intima of HTEV scaffold was modified with heparin coating. HTEVs were implanted in rat models in vivo to evaluate their biological functions. Six weeks later, vascular ultrasound and micro-CT angiography were carried out. Results · The donor aortic vessels were successfully decellularized. The total DNA content of DRA group [(115.4±10.9) ng/mg] significantly decreased compared with natural aorta group [(398.6±14.6) ng/mg] (P=0.000). But collagenous fibers and elastic fibers of decellularized vessels were severely injured. Mechanical tests of scaffolds showed that ES-APS significantly enhanced the mechanical properties. The wall thickness [(187±11) μm], suture retention strength [(0.51±0.06) N] and burst pressure [(2103±232) mmHg] of HTEV group all significantly increased compared with DRA group (P<0.01). Heparin coating modification of HTEV significantly reduced the number of adhesive platelets. Vascular ultrasound and micro-CT angiography showed all grafts were totally patent 6 weeks after implantation in rat models. ES-APS sheath successfully prevented the occurrence of vasodilation and aneurysm formation. Conclusion · DRA sheathed with ES-APS on adventitia and coated with heparin on intima is a new kind of HTEV, which possesses increased tensile strength and improved biocompatibility.

Allergic rhinitis (AR)and bronchial asthma often coexist in the same individual,in which they influence development and severity of each other.Both domestic and foreign research has showed that Syn-ergistic treatment to children with AR and asthma could be achieved by inhaled corticosteroids(ICS),oral leu-kotriene receptor antagonist and subcutaneous /sublingual allergen specific immunotherapy;collaborative manage-ment will be realized by doctors'Comprehensive clinical assessment,children and caregivers'self-assessment and chronic disease management tools.Collaborative treatment and management is significant to children with both allergic rhinitis and asthma.In addition,it has an edge in improving compliance of children and their parents during the treatment,the quality of childrens'life,and reducing burden of the diseases.

OBJECTIVE:To observe the clinical efficacy and safety of nitroprusside combined with dopamine in the treatment of acute heart failure(AHF). METHODS:96 patients with AHF were randomly divided into control group and research group. All patients were given ACEIs,digoxin,diuretics,statins,aspirin and other conventional treatment. On this basis,control group was given nitroprusside 12.5-25.0 mg,adding into 5% Glucose solution 50 ml by micro pump and started at 6.25 μg/min,and then maintained at 12.5-50.0 μg/min based on the blood pressure adjustment;research group was given dopamine 100 mg based on the treatment of control group,adding into 5% Glucose solution 50 ml at rate of 2 μg/(kg·min)by pump,and maintained at 2-10 μg/(kg·min). The course of both was 5-7 d. The clinic data was observed,including clinical efficacy,hemodynamic parameters(cen-tral venous pressure,pulmonary artery systolic pressure,heart rate and cardiac output index)before and 0.5,3,12,24 and 48 h af-ter treatment,renal functions(serum potassium,blood urea nitrogen,serum creatinine and 24 h urine)before and 24,48 and 72 h after treatment,and the incidence of adverse reaction. RESULTS:The total effective rate in research group was significantly higher than control group,with significant difference(P<0.05). The central venous pressure,pulmonary artery systolic pressure,heart rate,serum sodium and potassium in 2 groups at different time points were significantly lower than before;cardiac index,blood uric acid nitrogen,creatinine and 24 h urine were significantly higher than before,with significant difference(P<0.05). However, there were no significant differences on the hemodynamic parameters and renal functions at different time points between 2 groups (P>0.05). There were no significant differences in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Nitroprusside combined with dopamine has more obvious efficacy than only nitroprusside in the treatment of AHF,and can obviously reduce the cardiac stress,increase cardiac output and improve renal function,with similar safety.

Objective:To explore the optimal design for education and teaching mode of general medical students.Methods: 60 general medical students of 2013 grade of ChengduMedical College were divided into experiment group and 60 general medical students of 2013 grade of the Second Affiliated Hospital of Chengdu Medical College were divided into control group. The students of experiment group received the interactive teaching mode of whole teaching process, while students of control group received conventional theory teaching. And then the general medical curriculum assessment, examination results and teaching effects of the two groups were statistically analyzed.Results: The understanding degrees of general medical basic theory, overview of community health services, general medical education of the experimental group were significantly higher than that of control group (P<0.05). The series of indicators, such as health care which was human centered, family as a unit, community as basis and prevention as precursor, and the general medical service of health and fitness in women, children and old people, and physician patient relations and communication in general medicine, and the establishing ability of general medical treatment and health archive of chronic disease, of experiment group were significantly higher than that of control group. After a phase, the examination results of experiment group was significantly higher than that of control group (t=4.303,P<0.05), and the ratios of cultivating vocational interest, stabling vocation belief, establishing occupational planning of experiment group were significantly higher than that of control group (x2=12.83,x2=11.14,x2=9.35,P<0.05).Conclusion: In the teaching for general medical student, the interactive mode of tutor and student in whole teaching process was better than conventional mode of theory teaching.

Objective To investigate the coagulation function,the related factors and prognosis of preterm infants with periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH).Methods Eighty-one preterm infants with PVH-IVH and 81 infants with non-PVH-IVH as a control were enrolled in the study.The changes in activated thromboplastin time(PT),activated partial thromboplastin time (APTT),Fibrinogen and D-dimer were determined by enzyme-linked immunosorbent assay.Clinical factors which were related to PVH-IVH in infants were analyzed with statistical analysis and prognosis was assessed with neonatal behavioral neurological assessment (NBNA).Results The average of gestational age in PVH-IVH group was(30.9 ± 1.79)weeks,in control group were (31.36 ± 1.39)weeks,and there was significant difference between the 2 groups (F =6.52,P =0.012).There were significant differences in APTI,and D-dimer between PVH-IVH and non-PVH-IVH infants(all P ＜ 0.05).Multivariate Logistic regression analysis showed that the related factors included gestational age,neonatal respiratory distress syndrome(NRDS),hyperoxia,and mechanical ventilation(OR =3.98,1.72,2.99,5.65,all P ＜ 0.05).The NBNA scores of the 2 groups were also significantly different(t =9.16,P ＜ 0.05).Conclusions The occurrence of PVH-IVH is very complex resulted from gestational age,NRDS,hyperoxia,mechanical ventilation and other factors.In order to avoid the occurrence of intracranial hemorrhage and improve the life quality of preterm infants,the NRDS was prevented as far as possible,coagulation abnormalities were managed positively and the mechanical ventilation was shortened.

BACKGROUND: Dysfunction of vascular endothelium is the initial event of atherosclerosis. Although there are many approaches to evaluate the function of vascular endothelium, few are widely used in clinic. OBJECTIVE: To evaluate the brachial and superficial femoral endothelium-dependent dilation, i.e. flow-mediated dilation (FMD) and endothelium-independent dilation, i.e. nitroglycerin-mediated dilation (NMD), of elderly patients with peripheral artery disease (PAD), and to investigate the correlation and characteristics between brachial and superficial femoral FMD and NMD.DESIGN, TIME AND SETTING: Non-randomized concurrent control trial was performed at Department of Geriatric Cardiology, Chinese PLA General Hospital from October 2000 to May 2002.PARTICIPANTS: Thirty-three PAD patients were selected as PAD group, including 27 male and 6 female, aged (79±6)years, who had more than one focus of plaque and arterial stenosis more than 50% in artery of lower extremity by Doppler ultrasound. Accorded with the standard for Health of China Academy of Geriatrics in 1995, 40 healthy retired cadres undergoing health examination were selected as control, including 29 male and 11 female. In addition, 30 patients with coronary arteriosclerotic heart disease or cardiovascular risk factors (excluding age and sex) were selected as risk factor group.METHODS: Using non-invasive approach, high resolution color Doppler ultrasound diagnosis system was applied to detect the basic caliber of upper and lower extremtity arteries in all participants, then the blood flow of the tested artery was blocked and the vascular caliber was detected again after the blood flow was restored to evaluate the endothelium-dependent dilation. The tested subjects took 0.6 mg nitroglycerin to induce vasodilatation after detecting the basic caliber of upper and lower extremtity arteries, then the difference between the two detections was regarded as the endothelium-independent dilation.MAIN OUTCOME MEASURES: The endothelium-dependent dilation and endothelium-independent dilation of upper and lower extremtity arteries.RESULTS: Both FMD and NMD of the brachial artery and the superficial femoral artery in 33 PAD patients were significantly lower than those of healthy controls and non-PAD patients with cardiovascular risk factors (t=-11.82-10.91, P <0.05). In old PAD patients, the superficial femoral FMD and NMD were significantly lower than brachial FMD (t=3.535,3.315, P < 0.01); There was close relationship between the brachial and superficial femoral FMD (r=0.931 4, P < 0.01), so was the NMD (r=0.919 1, P < 0.01).CONCLUSION: The superficial femoral FMD and NMD may reflect the vasoreactivity of PAD patients more directly and sensitively than those of brachial artery. There is close relationship between brachial and superficial femoral arteries.