Objective To explore the effect of fluticasone propionate nasal spray(Fu Shu-liang) in improving children's symptoms of allergic rhinitis and recurrent asthma.Methods 100 children with allergic rhinitis and asthma syndrome were randomly divided into control group and experimental group.The control group was treated with loratadine.The experimental group was treated with water-soluble auxiliary Fu Shu-liang nasal spay on the basis of the control group.The treatment effects were observed.Results The total effective rate of the observation group was 94％,which was significantly higher than 76％ of the control group (x2 =6.35,P ＜ 0.05).After 10-12 weeks,the rhinitis symptom score and asthma symptom score between the two groups had statistically significant differences (t =2.47,2.64,3.41 ; 2.30,3.17,2.47,all P ＜ 0.05).The incidence rate of adverse reactions such as nasal dryness,epistaxis between the two groups had statistically significant differences (x2 =7.11,7.53,all P ＜ 0.05).Conclusion Fu Shu-liang(Eph propionate and fluticasone propionate nasal spray) has good effect in improving symptoms of children with allergic rhinitis and asthma,it is worthy of clinical vigorously promoted.

Objective To explore the difference of serum and pleural effusion CEA ,CA125 and CA199 levels in benign and ma‐lignant pleural effusions to accumulate the practical experience for clinical diagnosis .Methods 125 patients with pleural effusion in this hospital from February 2010 to March 2014 were performed the retrospective analysis and divided into the benign group(49 ca‐ses) and malignant group(76 cases) according to the nature of the fluids .The etiology composition ,pleural effusion and serum tumor markers levels were recorded in the two groups and at the same time the diagnosis efficiency of the tumor markers in pleural effusion was calculated .Results The specificity of the combined detection of CEA ,CA125 and CA199 for diagnosing benign and malignant pleural effusion was 90 .6% ,the sensitivity was 95 .1% ,the positive predictive value was 90 .2% ,negative predictive val‐ue was 95 .3% and accuracy was 92 .7% ,which were higher than those of the single index detection and any 2‐marker combined de‐tection .Conclusion The combined diagnosis of CEA ,CA125 and CA199 in pleural effusion conduces to the assisted diagnosis of be‐nign and malignant pleural effusion .

Objective: To observe the effects of ginsenoside Rg_(1) , chitosan and TGF-?_(1) on the proliferation and differentiation of human periodontal ligament cells( PDLC). Methods:Human periodontal ligament cells were isolated and cultured. The effects of ginsenoside Rg_(1)(0.01 ?mol/L), chitosan((0.05 g/L,)0.1 g/L, 0.2 g/L) and TGF-?_(1)(0.5 ?g/L, 1 ?g/L, 2 ?g/L) on the proliferative ability of human PDLCs were evaluated with MTT method. The alkaline phosphatase activities of human PDLCs were measured with spectrophotometric assay. The secretion of osteocalcin of human PDLCs were measured with radioimmunological method and the apotosis rates of human PDLCs were assayed with flow cytometry with PI staining method. Results: ①Comparing with the control group, the proliferative ability of human PDLCs in ginsenoside Rg_(1)(0.01 ?mol/L)group ,Chi(0.05 g/L, 0.1 g/L, 0.2 g/L) groups and TGF-?_(1 )((0.5 ?g/L), 1 ?g/L, 2 ?g/L) groups on day 3,5,7 were considerably increased (P

Objective To analyze the pathophysiological variation in patients with penetrating cardiac trauma (PCT) and discuss the classified treatment strategies.Methods A retrospective analysis was conducted on pathogenetic condition,medical interventions and other clinical information of 133 PCT patients.The patients were divided into four groups in accordance with their symptom classification on arrival at emergency department,including sub-clinic type,cardiac tamponade type,hemorrhagic shock type and agonal type.Meanwhile,the patients were classified into three groups according to their pathogenesis phase,including sub-clinical phase,clinical phase and agonal phase.Development characteristic of patients' condition in each group was investigated in each time point by survival analysis.Impacts of medical interventions on prognosis of those patients were analyzed,such as pericardial space exploration,emergency room thoracotomy (ERT),operating room thoracotomy (ORT).Results Some patients at sub-clinical phase were aggravated into clinical phase or agonal phase,as well as some patients at clinical phase were aggravated into agonal phase during in-hospital treatment.There were significance differences of posttraumatic suvival course among the four groups,namely sub-clinical type,cardiac tamponade type,hemorrhagic shock type and agonal type (P ＜ 0.01).The differences of posttraumatic survival course were also significant among the three groups,namely sub-clinical phase,clinical phase and agonal phase (P ＜ 0.01).Conclusion Clinical symptom classification (or pathogenesis phase) of PCT may not be always unchangeable,thus it is recommended that PCT patients should be treated based on their clinical symptom classification or patbogenesis phase at consultation.

Tourette syndrome is a neuropsychiatric disorder characterized by the presence of both multiple motor and vocal tics. The pathogenesis is obscure . Infection and the immunologic abnormality after infection may be associated with this disease.The major study is about streptococcal infection. Interleukin may play an important role. Morever, some studies indicate that Mycoplasma pneumoniae infection is related to the Tourette syndrome.

Objective To investigate the moderator of children' s perceptions quality of parental involvement on parenting style and children' s sport expectancy-value beliefs.Methods 595 students of grade 2 to 6 from five elementary schools were chosen and analyzed.Data were analyzed by SPSS16.0 software packet using independent sample t test,One-Way ANOVA,correlation analysis and hierarchical regression statistical analysis of regulation.Results Children' s expectancy beliefs was predicted by authoritarian and behavior encouragement(β=0.076,t =2.35,P=0.019 ;β =0.111,t =3.748,P =0.000).Children' s value beliefs was predicted by affect -warmed and behavior encouragement (β =0.070,t =2.883,P =0.004 ;β =0.070,t =2.745,P =0.006).Children' s sport behavior was predicted by trust-encouragement(β=0.294,t=3.193,P=0.001).The prediction of expectancy beliefs was significant positive by the interaction between indulgence and time involvement (β=0.078,t =2.065,P =0.039).The prediction of expectancy beliefs was significant negative by the interaction between authoritarian and time involvement(β=-0.084,t =-2.454,P=0.014).The prediction of expectancy beliefs was borderline significant positive by the interaction between neglecting and equipment provision(β=0.073,t =1.94,P =0.053).Conclusion Different parenting styles are significant predicators of children sport involvement.Children' s perceptions quality of parental involvement play an important role on parenting style and children' s sport expectancy-value beliefs.

Objective To study the clinical characters of coronary artery triple vessel lesion, and to provide a theoretical basis for the therapy to the disease. Methods The clinical data of 68 cases of coronary artery triple vessel lesion (group A) and 71 cases of coronary artery of single or double vessel lesion (group B) were analyzed retrospectively. Results The related risk factors (hypertension, hyperlipidemia, diabetes and smoking) and the clustering of these factors were not significantly different between the two groups (P>0.05). While the positive rate of the exercise stress test existed remarkable difference between the two groups(P<0.01).The extreme differences between the two groups existed also in the cases of building collateral circulation (P<0.001), and in LVEF and LVEDP (P<0.0001) demonstrated by left ventricular angiography. The majority of the coronary artery lesion in group A was on level Ⅳ, and much more lesions of level Ⅲ and level Ⅳ occurred in group A than in group B. Most patients in group A accepted the coronary intervention, while after operation the angina pectoris emerged in a high rate, then the rebuilding of coronary circulation had to be done. Conclusions The best treatment for the patients with coronary artery triple vessel lesion should be the operation of coronary artery bypass graft (CABG), if it's possible.

Objective: To evaluate the preventive effect of ephedrine on hypotension under spinal anesthesia in patients with different age. Methods: Sixty patients scheduled for spinal anesthesia were randomly allocated to four groups with 15 each. Group Ⅰ and Ⅱ were adult patients aged from 25 to 55 years old and group Ⅲ and Ⅳ were geratic aged patients of 6575 years old. Every patient received a fluid loading of 7ml/kg before spinal anesthesia. The ephedrine was administrated to group Ⅱ and IV patients in a dose of 10mg i v and 30 mg i m and same amount of normal saline was administrated to group Ⅰ and Ⅲ as soon as spinal anesthesia was performed. Results:Thirty patients in the placebo groups developed a maximal decrease in MAP exceeding 20%. Ten of these (2 in group Ⅰ and 8 in group Ⅲ ) developed a decrease in MAP exceeding 35% and required treatment. In aged groups, all patients in group Ⅲ had a decrease in MAP exceeding 20 %, 53 % of whom, the decrease exceeded 35 %. Conclusion:Prophylactic use of ephedrine is effective in the prevention of hypotension during spinal anesthesia, especially in aged patients.

Local resection of duodenal papillary neoplasm has the advantages of small trauma,few complications and retaining the normal function of digestive tract.While this surgical procedure is not widely applied because of high demand of surgical techniques,difficulty in the management of complications and its efficacy still needs the verification of evidence based medicine.From January 2000 to June 2012,4 patients received local resection of duodenal papillary neoplasm at the Renji Hospital of Shanghai Jiaotong University.All patients were confirmed as with duodenal papillary neoplasm by endoscopic retrograde cholangiopancreatography,and the diameters of the tumors were under 1 cm.The results of duodenal papillary biopsy showed that 3 cases were with hyperplasia and 1 case with adenocarcinoma.Lymph node metastasis or distal metastasis was excluded by computed tomography and magnetic resonance imaging preoperatively.The results of postoperative pathological examination confirmed that 1 case of duodenal papillary adenoma and 3 cases of duodenal papillary adenocarcinoma were with negative margin and no metastasis in the hepatoduodenal ligament was detected.There was no complications except 1 case of pancreatic leakage.There was no recurrence during a follow-up period of 3-24 months.Strictly abiding the indications and technical manual of local resection of duodenal papillary neoplasm is a key point to acquire good clinical effect.

Objective To learn the burnout and turnover intention of physicians from township hospitals in Xi County,Henan province,for reference of health administrators and healthcare institution managers.Methods Cluster sampling method and qualitative interviews were used and all physicians from such hospitals were sampled for questionnaire survey in 2014,with 1 70 scales distributed.The questionnaire was the Markov Burnout Inventory generic version revised by Li Chaoping,and turnover intention questionnaire was that revised by Liang Kaiguang.Results 140 physicians from such hospitals were found with zero or low burnout (94.6%);Collaborative care in the county poses great positive effect on promoting professionalism and interpersonal relations, yet has limited positive impact on reducing workload and performance appraisal stress and increasing their income.Conclusion It is imperative to enhance training of managers of such hospitals for them to learn the appraisal method with organizational scale,and build a humanistic concern mechanism for physicians,for purposes of improving the organizational environment and minimize the burnout and turnover intention of the physicians.