Tic disorders are common diseases in children,and may negatively impact the quality of life of those ones affected.There is no cure therapy for tics;treatment aims to diminish tic severity and frequency.Behavioral treatment is recommended as first line offer to patients in most cases.It is recognized that behavioral techniques,especially habit reversal training(HRT),can offer an effective alternative or complement to pharmacotherapy in this setting.HRT is the best-studied and most widely-used technique and there is sufficient experimental evidence to suggest that it can significantly reduce tic severity in both adults and children with Tourette syndrome and other tics.It consists of three primary components:awareness training,competing response training and social support.

Objective: To explore the characteristics of control response and sustained attention in children with chronic tic disorders (CTD). Methods: 38 children fulfilled DSM-Ⅳ diagnosis of CTD and 38 normal children are involved in the study. All participants were assessed with the integrated visual and auditory continuous performance test (IVA-CPT). The differences of sustained attention and control response were compared. Results: Most of the values of IVA-CPT were lower in children with CTD compared with normal children. There was no significant difference between the visual and auditory sustained attention and control response in children with CTD. Conclusion: The present study suggests that control response and sustained attention are both impaired in children with CTD.

Objective To analyze the radiological images of osteonecrosis in rare positions in recovered SARS patients, and to study the correlation with the hormone application.Methods The extremities of 41 SARS patients in the recovery stage from June to August in 2003 were examined by using X-ray and 0.5T MR scanner, then the correlation of MR examination results and the application of hormone was analyzed.The mean time interval between the imaging examination and initial hormone application was 88.2 days (66～106 days), the mean maximum hormone (metastab) dose was 392 mg (320-480 mg), and the average medication time was 47.2 days (30-70 days).Results The osteonecrosis of rare positions was revealed in 5 cases involving 11 positions, including bilateral heads of humerus (3), right scaphoid bone (1), right talus (1), bilateral calcaneus (1), and right ischium (1).The main MR manifestation was irregular abnormal signal.Osteonecrosis of right ischium was demonstrated on plain film in only one case.Conclusion MR examination, especially the multi-location scan is necessary in finding the osteonecrosis in SARS patients in the earlier phase.The hormone dose, the medication duration, the sensitivity to hormone, and the difference of individuals are important causes of osteonecrosis.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ ) and angiotensin Ⅱ type 1 receptor antagonist (AT1RA) on the transforming growth factor-β1 (TGF-β1) synthesis and tissue inhibitor of metalloproteinase-1 (TIMP-1) mRNA expression of in vitro cultured hepatic stellate cells (HSCs). Methods HSC-T6 rat hepatic stellate cell line was selected as the study model of the activated hepatic stellate cells. Cultured HSCs were randomized into control group, Ang Ⅱ group, AT1RA group and Ang Ⅱ AT1RA group. Cell culture medium was used to detect the TGF-β1 level by ELISA method. HSCs were harvested to measure the TIMP-1 mRNA expression by RT-PCR. Results TGF-β1 level of control group, Ang Ⅱ group and AngⅡ AT1RA group in cell culture medium was (7.531 ±0. 654) pg/mL, (9. 855± 1. 485)pg/mL and (7.719 ± 0.329) pg/mL respectively, Ang Ⅱ group higher than control group (P ＜ 0.05 ), Ang Ⅱ AT1RA group lower than Ang Ⅱ group (P ＜ 0. 05 ). TIMP-1 mRNA expression level of control group, Ang Ⅱ group and Ang Ⅱ AT1RA group in HSCs was 3. 387 ± 0. 042, 4.870 ± 0.061 and 3. 837 ± 0. 042 respectively, Ang Ⅱ group higher than control group ( P ＜ 0. 05 ), Ang Ⅱ AT1RA group lower than Ang Ⅱ group (P ＜ 0. 05). Conclusion AngiotensinⅡ can increase the TGF-β1 synthesis and TIMP-1 mRNA expression of hepatic stellate cells, while all these effects are inhibited by angiotensinⅡ type 1 receptor antagonist.

Objective To study and analyze the effect of psychological intervention combined with glucocorticoid on the treatment of nephrotic syndrome and the quality of life in patients with nephrotic syndrome. Methods 100 patients with nephrotic syndrome treated in he affiliated hospital of Hangzhou normal university from February 2015 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. Patients in the control group received basic treatment, including trial and treatment, and diuretics, and were treated with corticosteroids on this basis. Patients in the experimental group on the basis of the control group, psychological intervention combined with glucocorticoid treatment, pay attention to the psychological status of patients and patients, strengthen communication and exchanges, increase confidence in the treatment and the treatment compliance of patients. The quality of life and treatment effect of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the daily score of the patients in the experimental group was (15.19±3.19) points, and the daily life score of the control group was (22.21±5.19) points (QOL). The QOL score of the experimental group was significantly lower than that of the control group, and the quality of life was significantly higher than that of the control group, with statistical difference (P<0.05). The effective rate of the experimental group (90.0％) was significantly higher than that of the control group (66.0％), with statistical difference (P<0.05). Conclusion Psychological intervention combined with glucocorticoid on the treatment of nephrotic syndrome, the clinical effect is better, which can greatly improve the quality of life, and is worthy of promotion.

Objective: To evaluate the polysomnology results along with mandibular titrated advancement using oral appliance to treat obstructive sleep apnea and hyponea syndrome(OSAHS).Methods: Several electronic databases (PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang) were systematically searched up to September 2015.There was no restriction of language or source of information.All randomized clinical trials (RCT) and before-after trials (BAT) comparing at least two different mandibular advancements were included.Two independent reviewers selected the studies, extracted data and evaluated risk of bias by quality assessment.Data were pooled using a fixed-effects model, and the summary effect measure was calculated by risk ratio (RR) and 95%CI.Meta-analysis was performed using RevMan 5.3 software.Results: Two RCTs and five BATs were included in the review.Among the five BATs, two of them were randomized, while the other three were not.Outcomes including apnea hypopnea index (AHI), oxygen desaturation index (ODI), success rate (reduction of AHI or ODI >50%), normalization rate (AHI or ODI<10/h) were assessed in this review.Based on the trial design and quality assessment, four studies were included for meta-analysis.No significant difference in the success rate was found between the group with 50% of the maximal mandibular advancement (MMA) and the group with 75% of MMA [I2=0%, RR=0.93, with 95%CI (0.80, 1.09)].No significant dif-ference in the normalization rate was found between the 50% of MMA and 75% of MMA groups [I2=45%, RR=0.85, with 95%CI (0.68, 1.06)].Subgroup analysis displayed that the severity of OSAHS before treatment was a potential factor affecting the normalization rate.Conclusion: Based on current available evidence, the success rate and normalization rate for treating OSAHS in the patients with 75% MMA were not found to be significantly higher than those with 50% MMA.Due to small simple size in this meta-analysis, the results of the present study should be interpreted with caution.Further prospective studies are needed to strengthen the evidence.

Objective To examine the correlation between urotensin Ⅱ (UⅡ) concentration and the severity of liver fibrosis. Methods Liver fibrosis model was induced in rats by intraperitoneal administration of CCl4. At 4,6,8 weeks, the rats were sacrificed, and the hepatic tissue hydroxyproline (HYP) content was measured. Hepatic tissue specimens were histopathologically evaluated according to a fibrosis scoring system. Plasma UⅡ levels were measured by ELISA method. Results Plasma UⅡ gradually increased with the increase of duration of CCL4, UⅡ concentration correlated to liver fibrosis ( R2 = 0.875, P ＜ 0.05) and hepatic HYP( R2 = 0.65, P ＜0.05). Conclusion UⅡ was involved in the pathogenesis of liver fibrosis.

The purpose of this study was to observe whether HBV can infect HSC in vitro. LX-2 cells, the human activated HSC cell line, were incubated with human serum containing HBVDNA at final concen-trations from 0.01 to 10 copies/cell and harvested after 24,48 and 72 hours. Hepatitis B surface antigen (HBsAg) and hepatitis B core antigen(HBcAg) were detected by lmmunohistochemistry dyed by DAB. By Immunohistochemistry, no positive particles in LX-2 cells, a few of dark brown particles (HBsAg and HB-cAg) were found in cytoplasm and nucleoli of HepG2.2. 15 cells,a lot of clark brown particles were found in liver biopsies of patients with chronic hepatitis B. In vitro, there was no evidence that HBV can infect and express antigens in LX-2 cells.

Objective: To analyse the behavioral problems of children with attention deficit hyperactivity disorder.Methods: 70 boys fulfilled ADHD criteria of DSM-IV were further divided into 3 subtypes: predominantly inattentive(PI,44 cases),predominantly hyperactive-impulsive(HI,6 cases) and combined type(CT,20 cases).Compare the behavioral problems of subtypes of ADHD and 63 normal children.Results: The incidence of behavioral problems in boys with ADHD(48.57%) was significantly higher than that in control group(12.70%),and significant differences in incidence of behavioral problems were found among the three subtypes of ADHD.ADHD CT subtype had the highest rate of behavioral problems.PI subtype had more fissility than HI;CT and HI subtypes had more aggressive behaviors,and HI had more delinquence than PI and CT.Conclusion: Boys with ADHD had more behavioral problems than normal ones.CT subtype had the highest rate.The characteristics of behaviors were different among three subtypes.

Objective To explore the role of platelet activating factor(PAF) and its receptor in portal hypertension in liver cirrhosis. Methods A model of hepatic cirrhosis was replicated in rat by intraperitoneal injection of CCL 4 for 8 weeks. The blood and hepatic PAF and PAF receptors contents were assayed with ELISA, RT-PCR and saturation binding technique. Results Compared with control rats, cirrhotic rats had higher hepatic PAF levels, hepatic PAF output, and plasma PAF levels, which were increased by 44%, 87.7% and 54.5%(P