OBJECTIVE:To explore the clinical efficacy and safety of Leukotriene receptor antagonist combined with Gluco-corticoid nasal spray(called“intranasal steroid”for short)in the treatment of different degree of adenoidal hypertrophy(AH)com-plicated with allergic rhinitis (AR). METHODS:240 AR children with AH were randomly divided into control group,intranasal steroid group and drug combination group,with 80 cases in each group. Control group was given physiological seawater,3 presses each nostrile,in the morning and evening. The intranasal steroid group received Momestasone furoate nasal spray,one press each nostrile,qd. Drug combination group was additionally given leukotriene receptor antagonist Montelukast sodium chewable tablet,4 mg for under 5 year-old and 5 mg for 5-year-old or above,qd,at bedtime. Treatment course of 3 groups lasted for 12 weeks. The change of clinical symptoms and signs(such as nasal obstruction,snore,mouth breathing,etc)and adenoid/pharyngeal ratio(A/N ratio)were compared among 3 groups after treatment as well as the occurrence of ADR. Each group was divided into two sub-groups (medium and severe) according to the severity of AH so as to evaluate therapeutic efficacy. RESULTS:21 children withdrew from the study,including 11 cases in control group,6 in intranasal steroid group and 4 in drug combination group. After treatment,clinical symptom score and A/N in subgroups of drug combination group and intranasal steroid group were all lower than those of control group,with statistical significance(P<0.05). There was no statistical significance in clinical symptom score and A/N between drug combination group and AR complicated with medium AH subgroup from intranasal steroid group(P>0.05). Clini-cal symptom score and A/N of AR complicated with severe AH subgroup from drug combination group were lower than intranasal steroid group,with statistical significance (P<0.05). No obvious ADR occurred in 3 groups. CONCLUSIONS:Intranasal steroid alone and intranasal steroid combined with leukotriene receptor antagonist can improve clinical symptom of AR patients with AH, and reduce adenoid volume. It is suggested to use intranasal steroid firstly for medium AH complicated with AR,and additionally use Leukotriene receptor antagonist for severe AH complicated with AR.

[Objective] To review the treatment of metabolic syndrome from phlegm and stasis, so as to provide effective ideas for the treatment of metabol-ic syndrome.[Method] Through searching for literatures related to Chinese medicine treatment of metabolic syndrome in the last decade, we can summarize the role of phlegm and blood stasis in the metabolic syndrome and its relationship with various components of metabolic syndrome. We can also research the application of the resolving the phlegm and removing blood stasis in the metabolic syndrome. [Results] Phlegm, blood stasis consistently run through the metabolic syndrome, and have a close relationship with each component of metabolic syndrome. The prescription of resolving the phlegm and remov-ing blood stasis can not only improve the clinical symptoms, but also can improve obesity-related indicators, reduce blood glucose, increase insulin sensitiv-ity, improve endothelial function and so on. [Conclusion] Treating metabolic syndrome from phlegm and stasis is safe and effective, which can reverse dia-betes, insulin resistance and prevent cardiovascular events through multi-channel, multi-level, multi-target. It has a broad application prospect and is worth further in-depth study.

[Objective] To assess the curative effect of acupuncture therapy to chronic mesenteric lymphadenitis. [Methods] Al 120 children patients are ran-domly divided into two groups, 60 cases each. Control group is treated with cefuroxime sodium for infections, and treatment group with acupuncture at Sifeng(EX-UE 10), Neiguan (PC06), Zhongwan(RN 12),Zusanli(ST 36) and etc. [Results] Markedly effective rate of treatment group was 91.7%,and total effective rate was 98.3%; markedly effective rate of control group was 86.7%, and total effective rate was 95%, which showed significant difference in curative effects.The two groups symptoms were decreased compared with before treatment, the difference was significant( P<0.01);after treatment, symptom scores were lower than the control group, with significant difference. The recurrence rate of treatment group after three months was 3.6%. The recurrence rate of treatment group after six months was 1.9%, evidently lower than control group ’s 57.7%,54% respectively. [Conclusion] Acupuncture therapy to chronic mesenteric lymphadenitis has unequivocal short-term effect, a stable long-term effect, and low recurrence rate,deservers clinical applications.

Objective To observe the effect of simvastatin on intimal proliferation in abdominal aorta of rabbits after stenting.Methods Thirty male New Zealand white rabbits were allocated into two groups including the control group(n=15)and the treatment group(n=15).All the rabbits were fed on 1.5% high cholesterol diet and underwent ballon injury of abdominal aorta from femoral approach and stents were implanted in the segments with stenosis rate greater than 50%.Rabbits in the treatment group were given simvastatin 5 mg/d after stenting.Neointima proliferation of the stented segments was examined on the 30th day after stenting by histological staining and the expression of P27kip1 and PCNA in each group was also analyzed.Results Histological staining showed that on the 30th day after stenting,the thickness of vessel wall(0.107?0.072 mm vs 0.133?0.047 mm,P=0.006)and the area of neointima(0.975?0.084 mm2 vs 1.350?0.043 mm2,P=0.001)were less in the simvastatin treatment group compared with the control and the rate of lumen loss was less than that of the control(20.460%?2.325% vs 31.020%?1.904%,P=0.002).The expression of P27kip1 in the neointima VSMC cell nuclear was higher(7.149?0.305 vs 2.997?0.310,t=9.551,P

Objective To evaluate the role of combination of three-vessel views in ultrasound diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.Methods The data of 66 cases of fetal aortic arch and pulmonary arterial branch anomalies were retrospectively analysed,including echocardiographic data,autopsy and operation records and postnatal follow-up results.Echocardiogaphic features and display frequencies on three vessels and trachea view(3VT),three vessels view(3VV)and three vessels and pulmonary arterial branches view(3VP)were summarized.Results There were 52 cases of aortic arch abnormalities,including 32 cases of right aortic arch with left ductus arteriosus,4 cases of double aortic arch,7 cases of aberrant right subclavian artery,6 cases of coarctation of aorta and 3 cases of interruption of aortic arch.Fourteen cases were diagnosed pulmonary aterial branch abnormalities,including 1 0 cases of crossed pulmonary arteries,2 cases of anomalous origin of left pulmonary artery from aortic arch and 2 cases of pulmonary artery sling.The display frequencies of fetal aortic arch and pulmonary arterial branch anomalies on 3VT,3VV and 3VP were 80.3%,19.7% and 39.4%.Conclusions The combination of three-vessel views is of great value in prenatal diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.

Objective To prepare the HPV genotyping control materials. Methods Three hundred cervical smears with different HPV genotypes were collected and detected by surface plasmon resonance and sequencing. The primers for specific genotype were designed according to GenBank. The recombinant plasmid was constructed through PCR amplification, ligation and transformation. Thirty recombinant plasmids were identified through PCR amplification, sequencing, and the sequences were compared using BLAST. Results The collected HPV infectious samples contained 30 different genotypes including HPV 6,16,18 and so on.The fragment sequences of PCR amplification were concordant with the designed. The fragment sizes of the other types ranged from 1 500 to 2 000 bp except HPV CP8304. And the 30 recombinant plasmids identified by PCR were concordant with the target. The identity of BLAST was 99%. In the fragment of 1500 bp in length, 11 bases were inconsistent with the reference sequence. Conclusions Genotyping control materials were developed successfully. The human papillomavirns genotyping control materials covered all the most common types and included 14 types with high-risk, 3 types with medium-risk and 13 types with low-risk.

Numbness is a common symptom in many diseases.In terms of cognition about numbness in past dynasties,and based on clinic observation and practice,the research of Guizhi Huangqi Wuwu Decoction is necessary.As a classic prescription,it is important for doctors to concern about combination of disease and syndrome,but also attaches importance to correspondence of prescription and syndrome.

Objective To investigate the methods and effects of different flaps for repair of high energy injury-induced soft tissue wound of the heel.Methods From January 2002 to June 2012,the patients including 12 males and 9 females aged 18-57 years (mean,32 years) underwent heel soft tissue defect reconstruction.Causes of injury were traffic injury in 11 case and mechanical injury in 10 cases.Dimension of soft tissue defect ranged from 5 cm × 3 cm to 8 cm × 6 cm.Soft-tissue defect was repaired with sural neurovascular flaps at the posterolateral heel in 9 cases (Group A),with posterior tibial artery flaps at the posterolateral heel in 5 cases (Group B),and with medial plantar flaps at the loading area of heel in 7 cases (Group C).Sensory recovery and two point discrimination motion of the ankle joint were observed and compared among groups 12 month after operation.Heel pain was observed during weight bearing and joint activity was evaluated using the visual analogue scale (VAS).Results All the flaps survived,except for one with epidermal necrosis over the distal part,which healed after partial changing medication.Duration of follow-up was 12-24 months.There were no differences in the appearance,texture and contour between the flaps and recipient sites.Flaps showed no ulcer in the weight-bearing area and recovered their protective sense.Patients could walk normally after surgery.At postoperative 1 year,sensory recovery rate of the flaps in Groups A,B and C was 0,20％ and 100％ respectively (P ＜0.01).Appearance of the heel in all groups recovered to almost normal.Cases that could start nil weight-bearing exercise without pain accounted for 8 (89％) in Group A,4 (80％) in Group B,and 6 (86％) in Group C (P ＞ 0.05).While heel pain existed in weight-bearing exercise.Difference in VAS was significant among the three groups (P ＜ 0.05),but ankle range of motion was not (P ＞0.05).Conclusion Medial plantar flaps are suitable for tissue defect of 5-8 cm in length but sural neurovascular flaps and posterior tibial artery flaps should be considered for over 8 cm defect in order to elevate survival rate of the flaps and reconstruct limb function.

Objective To explore the comparative advantage of Team based learning (TBL) in common diseases teaching among pre-selected trainees for medical non-commissioned officer. Methods 200 trainees were randomly divided into two groups of equal size (each having 100 trainees), one TBL group and another lecture based learning (LBL) group as the control group. The teaching content was both Chapters of High Altitude Illness and Hypertension. In the LBL control group, the traditional lec-ture based teaching and learning manner was followed. In contrast, the trainees in the TBL group were assigned pre-lecture self-learning outline and questions to discuss in advance, team-based group dis-cussion was conducted, and scene simulation with typical disease case analysis were adopted in class. In both groups, the teaching effectiveness were evaluated by both exam test and questionnaire manner. Results It turned out the team based learning model resulted in significantly improved overall trainee assessment scores (88.90 ± 5.28 vs. 76.10 ± 5.12, P<0.05) and higher overall teacher satisfaction scores (8.63 ± 0.85 vs 7.18 ± 0.72, P<0.05), compared to the LBL group. Conclusion TBL model is more effective in improving trainees' capabilities of cultivating team work spirit, self-confidence, learn-ing enthusiasm, problem analysis and knowledge application. TBL model significantly brings more advantage in teaching pre-selected trainees for medical non-commissioned officer.

Objective To preliminarily study the effect of high concentration prolactin (PRL) on the immune system in schizo-phrenic patients by analyzing the changes of lymphocyte subsets and immunoglobulins (IgG ,IgM ,IgA) levels .Methods The flow cytometry was used to detect the T lymphocytes CD3+ ,CD4+ and CD8+ subsets ,NK cell percentages and CD4+ /CD8+ ratio re-spectively .The three humoral immune indicators(IgG ,IgM ,IgA) in peripheral blood were detected by using the immunoturbidimet-ric turbidimetric method .The data were analyzed by adopting the analysis of variance .Results Compared with the healthy control group and schizophrenia normal PRL group ,T lymphocytes CD4+ subsets percentages and CD4+ /CD8+ ratio as well as IgG were increased in the schizophrenia PRL increase group(P<0 .05) ,while the percentage of NK cells was decreased(P<0 .05) .Conclu-sion High concentration PRL may have a certain effect on the immune system by influencing the balance among lymphocyte sub-sets and the production of immunoglobulins .