A simulated practicing physician test for trainees of clinical speciality could be important for increasing the rate of passing the real examination.In the past three years,we had investigated the rates of passing practicing physician examination from the several top first-class hospitals,and summarized the experience about the practicing physician examination of ours.Then,we had took an initial practice in simulated practicing physician examination for five-year-program and seven-year-program medical students,and got some achievements.

Objective To explore the atopic condition of children with stable asthma and their parents by detecting total IgE concentration in serum and collecting history. Methods Fifteen children with asthma in remission stage and 24 parents and 40 normal children were involved in this study. The concentrations of serum total IgE were measured with UniCAP Pharmacia system. The history including eczema and allergic rhinitis and asthma of children and parents were collected. Skin test with 10 kinds of inhalant allergens were taken in children with asthma. Results Of 15 children with asthma, 13 cases (86.7%)had eczema in infant stage and allergic rhinitis, 13 parents(86.7%)had allergic rhinitis or asthma. There was significant difference in the stable asthmatic children compared with parents and normal control group increased amounts of serum total lg IgE(F=68.42 P=0). There was significant difference in serum total lg IgE in patients group(2.43?0.73)kU/L compared with that in normal control group(0.72?0.54)kU/L (q=14.176 P0.05). Twelve children were positive in skin test, which were mainly dermatophagoides pteronyssinus and dermatophagoides farinae.Conclusions There is obvious congregate phenomena of atopy in the family of asthmatic children. The continuous high IgE concentration was associated with immune pathological mechanisms of atopic diseases.

Objective To investigate the effect of leukotriene receptor antagonist montelukast on inflammatory factors in children with asthma.Methods Eighty children with moderate asthma who aged 6-14 years old were randomly assigned to 3 treatment groups:5 mg once daily montelukast,or inhaled 100 ?g twice daily budesonide and 5 mg montelukast with inhaled budesonide 100 ?g per day.Each dose group received medicine for 12 weeks.Before starting therapy and 12 months later,clinical effects were observed,and pulmonary function was measured in patients simultaneously;concentrations of serum and sputum eosinophil cationic protein(ECP), IL-5 and TNF-? were measured respectively;also the peripheral blood eosinophil (Eos)was counted.Results Following treatment,clinical evaluation was improved and there were significant increases in pulmonary function in asthmatic children.Compared with control group,the levels of serum ECP,IL-5,TNF-? and blood Eos counting increased significantly in asthmatic children.The blood Eos counting was significantly correlated with ECP concentration in serum of children with asthma(P

OBJECTIVETo observe improved effects of Jingjin acupuncture on fine activity of hemiplegic hand in recovery period of stroke.

METHODSFifty cases were randomly divided into an observation group and a control group, 25 cases in each one. Regular western medicine treatment, rehabilitation training and regular acupuncture (in which Shuigou (GV 26), Baihui (GV 20), Neiguan (PC 6), etc. were selected) were applied in both groups. Additionally, muscles in palm side of affected hand, dorsal metacarpophalangeal joints and proximal interphalangeal joints were treated with acupuncture in the observation group, once every other day and electroacupuncture was applied when arrival of qi was acquired. Baxie (EX-UE 9) in the affected hand were needled in the control group, and electroacupuncture was added when arrival of qi was acquired. Ten days of treatment was considered a treatment course, and after two courses Lindmark score, Brunnstrom movement function grade, joint range of hand and Barthel index (BI) were observed in two groups.

RESULTSCompared before the treatment, the Lindmark score in two groups were both improved after the treatment (both P < 0.01). Compared with the control group, the motor coordination ability, sensory function and total score of Lindmark in observation group were obviously improved (differences before and after treatment: 8.24 +/- 3.07 vs 6.84 +/- 2.43, 3.52 +/- 2.33 vs 2.16 +/- 2.12, 11.76 +/- 3.55 vs 9.00 +/- 3.62, all P < 0.05). The Brunnstrom movement function grade was significantly improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group (P < 0.05). The joint range of hemiplegic hand was improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group [differences before and after treatment: (25.35 +/- 10.91) degrees vs (18.65 +/- 7.86) degrees, p < 0.05]. The score of BI was also significantly improved after treatment in two groups (both P < 0.01).

CONCLUSIONThe Jingjin acupuncture could effectively improve fine activity of hemiplegic hand in recovery period of stroke prove daily life ability.

Acupuncture Therapy ; Aged ; Female ; Hand ; physiopathology ; Hemiplegia ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Movement ; Recovery of Function ; Stroke ; complications ; physiopathology

Objective To observe the influence of long-term treatment with inhaled corticosteroid on biochemical bone indexes and bone mineral density (BMD) in children with asthma. Methods The design was a randomized, paralleled group study with 3 low dose regiments of 100, 200,300 micrograms of budesonide per day in 45 children with asthma aged 5-8 years old for 12 months. Before inhaled corticosteroid therapy and 6th,12th month,clinical effects were observed and lung function(FEV1) was measured; concentration of serum osteocalcin(OST),insulin-like growth factor-1(IGF-1),bony alkaline phosphatase (BALP) and urinary deoxypyridinolin: creatinine (DPD/Cr) were measured; BMD was examined by dual energy X-ray absorptiometry. Results Clinical evaluation was improved and there was significant increase in FEV1 of asthmatic children. The amount of serum OST was slightly higher,yet no significant compared with that of normal control group. There was significant increase of serum BALP in asthmatic children after treatment; there was significant increase in serum IGF-1 of patients group after treatment compared with in normal children at the same age group; there was significant decrease in urinary DPD/Cr after treatment.There was no significant decrease in BMD before and after treatment at the hip (neck of femur , trochanter of femur ,Ward′s triangle),the lumber area of the spine (L2-4) and forearm (ultradis, distal). Conclusion Long-term treatment with low does corticosteroid dose not restrictedly affect bone metabolism and BMD in children with asthma.

Objective To explore the characteristic of the genetic frequency distribution of human leukocyte antigen(HLA)-DR alleles in children with bronchial asthma in Guangxi area.Methods Eighty-four unrelated asthmatic individuals and 168 healthy people without asthma and atopy living in Nanning region of Guangxi as control group were involved in the study.All asthmatics had their serum total IgE levels measured with Pharmacia UniCAP system,and skin-prick test with 10 kinds of inhalant allergens were taken,and pulmonary function were measured among the asthmatic.HLA oligonucleotide array was used to 21 gene frequencies of HLA-DR.Results The frequencies of HLA-DR B1*070X allele and HLA-DR B1*11XX allele among the asthmatic(2.98% and 13.69%)were significantly higher than those in control group(0.3% and 5.95%)(?2 =6.915,9.478 P

OBJECTIVE To explore the protective effects and mechanisms of Ginsenoside Rg1 (Rg1) on H2O2-induced hippocampal neurons aging in vitro. METHODS The primary culture hippo-campal neurons(7 d)were randomly placed into six groups:normal control group,H2O2(200 μM)treat-ment group,and H2O2+Rg1(1,5 and 10μM)groups.The neurons were with Rg1(1,5 and 10 μmol·L-1) for 6h. H2O2(200 μmol·L-1) was added to the medium and incubate for 18 h. The Dihydroethidium (DHE) staining was performed for ROS production assessment. The LDH release and Hoechst 33258 were performed to examine the neuronal damage and apoptosis. The immunoblot was used to deter-mine the expression of β-Gal,NOX2,p22phox,p47phox,NLRP-1,ASC and Caspase-1 in hippocampal neurons.The ELISA was performed to detect the levels of IL-1β and IL-18 released in the supernatant in hippocampal neurons.RESULTS Rg1(5 and 10 μmol·L-1)significantly reduced the ROS production, attenuated H2O2-induced neuronal damage and apoptosis (P<0.05, P<0.01). The immunoblot results showed that Rg1(5 and 10 μmol·L-1)treatment significantly decreased the expression of β-Gal,NOX2, p22phox,p47phox,NLRP-1,ASC and Caspase-1 in hippocampal neurons(P<0.05,P<0.01).Additionally, Rg1(5 and 10 μmol·L-1)treatment significantly decreased IL-1β and IL-18 release in the supernatant. CONCLUSION The protective effect of Rg1 in H2O2-induced hippocampal neurons aging may be due to inhibit NOX2-NLRP1 activation.

OBJECTIVETo investigate the mechanism of tazarotene against active psoriasis vulgaris.

METHODSA randomized, controlled trial was conducted in 43 patients with active psoriasis vulgaris, who were divided into tazarotene and control groups. Promyelocytic leukemia (PML) mRNA in active psoriatic lesions before and 14 days after tazarotene treatment was detected by in situ hybridization.

RESULTSPML mRNA expression was detected not only in the basal layer (86.96%), but also in the suprabasal layers of the epidermis in the manner of focal expression (78.26%). After tazarotene treatment, virtually no PML mRNA expression could be detected in the psoriatic lesions (8.69% in the basal layer and 4.35% in the suprabasal layers). PML mRNA expression in the control group underwent no obvious changes during the observation.

CONCLUSIONSTazarotene may inhibit abnormal proliferation of keratinocytes through down-regulating PML gene expression in active psoriatic epidermis.

Adolescent ; Adult ; Double-Blind Method ; Down-Regulation ; drug effects ; genetics ; Epidermis ; drug effects ; metabolism ; pathology ; Female ; Gene Expression ; drug effects ; Humans ; In Situ Hybridization ; Keratolytic Agents ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Neoplasm Proteins ; genetics ; Nicotinic Acids ; administration & dosage ; therapeutic use ; Nuclear Proteins ; genetics ; Promyelocytic Leukemia Protein ; Psoriasis ; drug therapy ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Transcription Factors ; genetics ; Tumor Suppressor Proteins ; genetics

Objecctive To explore the construction and effect of the Doctor-nurse integrative medical care mode for domestic analgesia in middle and late stage cancer patients.Me thods From september 2016 to February 2017, 120 Cancer patients in The People's hospitalof Du Jiang Yan were included, and randomly divided into experimental group (n=60) and observation group (n=60). The observation group received routine outpatient follow-up after discharge.The experimental group was treated with the Doctor-nurse integrative medical care mode.The analgesic modes included psychological support, immediate morphine and morphine sustained release tablets for personalized home titration. The Net bottom-hospitals were responsible for the follow-up and intervention, the training and guidance were bore by Hub hospitals. The patients were followed up at the first and twelfth weeks, followed by telephone follow-up at fourth and eighthweek, after discharge. The quality of life, the degree of depression and the degree of anxiety of caregiver were compared between the two groups at the beginning of the study and the twelfth weeks after discharge. Re s ults In experimental group, the scores of in the life quality of patints before and after intervention were (62.43±12.83) and (50.33 ±9.04), respectively, the scores of depression before and after intervention were (50.33± 6.59) and (47.37±4.97), respectively, the scores of anxiety before and after intervention were (55.05 ±8.82) and (52.22 ±5.37). There was statistically significant difference between the two groups (P＜0.05). Conclus ions Doctor-nurse integrative medical care mode can improve the quality of life of patients with advanced cancer, reduce the degree of depression, and reduce the degree of anxiety of patients.

Objective To determine the incidence of non-fatal injuries and related influencing factors among children under 5 years old in China. Methods Data involving 10 819 children under 5 years old was from the Fourth National Health Service Survey of China. Injury-related indicators include: history of ever having had an injury, its frequency, cause, location and severity of the injury.A two-level Poissun regression was used to examine the significance of related socio-economic variables. Results The overall incidence rate of nonfatal injuries among children under 5 years old was 16.0 per 1000 population in the prior 12 months. The first three leading causes of non-fatal injuries were falls,animal bite, fire/bum among children under 1 year old,with the rates as 3.9, 1.8 and 1.8 per 1000 population, respectively. For children aged I to 4 years old, the first three leading causes were animal bite, fall, fire/burn with rates as 6.5,6.0 and 2.9 per 1000 population, respectively. 83.0% and 69.0% of last injuries occurred at home for the above said two age groups. No disability was found among children younger than 1 year old who suffered from a nonfatal injury while for the 1-4 age group, the disability accounted for 1.0% of injury-induced outcomes. After adjusting other variables,boys had 1.57 times the risk of injury compared with girls in the 1-4 age group (P＜0.05). The differences on the effects regarding ethmicity,per capita household income, and place were insignificant (P＞0.05). None of the socio-economic variables was found that significantly related to the non-fatal injury risk among children under 1 year old (P＞0.05). Conclusion The incidence of nonfatal injuries among children under 5 years old was 16.0 per 1000 population in the prior 12 months. The three leading causes of injuries were animal bite, falls, fire/bum respectively. Home was the most common place that non-fatal injuries occurred. Boys had a higher risk of injury compared with girls among children aged 1 to 4 years old and the difference was significant.