Obgective To analyze the relevant risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life.Methods Wheezing,respiratory sounds,risk factor were used as key words to retrieve papers in Chinese literature databases including Sinomed,Wanfang and Weipu databases.The same strategy was used to retrieve English papers in English literature databases including PubMed,Cochrane library and Embase.Time range was from 31th May 2004 to 1 rd June 2014.The execution of quality evaluation of the included documents was in compliance with Newcastle-Ottawa Scale and cross-sectional study standard recommended by Agency for Healthcare Research and Quality.The evidence quality evaluation was conducted with GRADEpro and followed by the Meta analysis with RevMan 5.2.R~ults A total of 13 studies were included in this Meta-analysis.Several factors were related to recurrent wheezing episodes,including risk factors such as maternal smoking during pregnancy (OR =1.47,95％ CI:1.30-1.66),asthma in parents (OR =1.94,95 ％ CI:1.72-2.19),family history of atopy (OR =1.94,95％ CI:1.72-2.19),male (OR =1.42,95 ％ CI:1.19-1.69),history of eczema (OR =2.36,95 ％ CI:1.69-3.30),colds (＞ 6 times) (OR =2.02,95 ％ CI:1.54-2.64),history of bronchopneumonia (OR =1.85,95 ％ CI:1.46-2.34),exposure to cigarette smoking(OR =2.30,95％ CI:1.68-3.14),daycare attendance(OR =2.27,95％ CI:1.97-2.60);Education received by the mother ＞ 12 years (OR =0.80,95％ CI:0.70-0.92) was the protective factor.Conclusions The risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life are maternal smoking during pregnancy,asthma in parents,family history of atopy,male,history of eczema,colds (＞ 6 times),history of bronchopneumonia,exposure to cigarette smoking and daycare attendance.The protective factor is education received by the mother ≥ 12 years.The prerequisite in precaution of infants recurrent wheezing is to ensure the utmost avoidance of hazardous factors and reinforcement of protective factors.

Objective To analyze the relevant risk factors of recurrent wheezing(≥3 attacks) in the first 3 years of life in Shanghai Pujiang.Methods A case-control study was conducted.Two hundred and sixty-two research children were chosen for clinical visits (＜ 3 years old) with wheezing at the Pediatric Department of Shanghai Renji Hospital (South Campus),School of Medicine,Shanghai Jiaotong University,from January to December 2014.According to the frequency of wheezing,the subjects were divided into 75 cases of recurrent wheezing group (≥ 3 attacks),110 cases of occasional wheezing group(1-2 attacks) and 77 cases of no wheezing group.Probable risk factors were inquired by using face-to-face questionnaire.The passive agglutination method was used to detect the Mycoplasma pneumoniae antibody immunoglobulin M (IgM).The indirect immunofluorescence was used to detect the respiratory pathogens.The Western blot was used to detect 20 items of serum allergen.Chi-square test was firstly used for univariate analysis,and then the multivariate stepwise Logistic regression was used to analyze the independent risk factors associated with infant recurrent wheezing.Results A total of 20 factors were found relevant to infant recurrent wheezing by univariate analysis,which included boys (OR =4.030,95％ CI:1.937-8.388),personal atopy (OR =13.125,95％ CI:5.951-28.946),allergic dermatitis (OR =9.833,95％ CI:4.663-20.737),allergic rhinitis (OR =40.327,95％ CI:5.300-306.842),like rubbing eyes or nose(OR =6.487,95％ CI:3.190-13.191),food allergy (OR =6.689,95 ％ CI:1.860-24.051),premature birth (OR =3.795,95 ％ CI:1.001-14.385),low birth weight (OR =9.075,95％ CI:1.106-74.450),parental atopy (OR =10.667,95％ CI:4.824-23.587),parental allergic dermatitis (OR =8.072,95 ％ CI:2.634-24.734),parental allergic rhinitis (OR =6.524,95 ％ CI:2.920-14.577),parental allergic conjunctivitis (OR =1.087,95％ CI:1.017-1.162),parental asthma history (OR =1.119,95％ CI:1.035-1.210),colds ＞ 6 times (OR =9.111,95％ CI:3.970-20.909),history of bronchopneumonia(OR =7.554,95％ CI:3.588-15.903),age at first time use of antibiotics less than 6 months (OR =2.388,95％ CI:1.129-5.052),exposure to cigarette smoking (OR =1.922,95 ％ CI:1.004-3.681),maternal passive smoking during pregnancy (OR =2.508,95 ％ CI:1.298-4.848),living close to wood stove (OR =3.342,95 ％ CI:1.427-7.827) and positive results of inhaled allergens (OR =1.821,95 ％ CI:1.420-2.336).Keeping cats was the protective factor(OR =0.922,95％ CI:0.864-0.984).The forward Logistic regression analysis showed that personal atopy (OR =10.278,95 ％ CI:2.503-42.202),like rubbing eyes or nose (OR =1 0.316,95 ％ CI:2.722-39.101),food allergy (OR =10.370,95％ CI:1.248-86.145),parental atopy (OR =5.402,95％ CI:1.340-21.778),colds ＞ 6 times (OR =7.048,95 ％ CI:1.688-29.423),history of bronchopneumonia (OR =7.876,95 ％ CI:2.040-30.407) and maternaal passive smoking (OR =3.696,95 ％ CI:1.013-13.494) during pregnancy were the independent risk factors of infants recurrent wheezing.Conclusion Personal atopy,like rubbing eyes or nose,food allergy,parental atopy,colds ＞ 6 times,history of bronchopneumonia,maternal passive smoking are the independent risk factors of recurrent wheezing in infants less than 3 years old.

Objectives To explore the changes of T helper (Th) lymphocyte and its related factors in children with syste-mic-onset juvenile idiopathic arthritis (SoJIA). Methods A total of 36 SoJIA inpatients, hospitalized from January 2012 to June 2013, were divided into active phase group and remission group. In addition, 20 healthy children were selected as normal con-trols. Th1, Th2 and Th17 cell ratios in peripheral blood mononuclear cells were detected and compared between each group by flow cytometry. Serum interferon-γ(INF-γ), interleukin-4 (IL-4), interleukin-17 (IL-17) levels were measured by enzyme-linked immunosorbent assay. Results The proportions of Th17 cells over CD3+CD8-cell were (3.30±2.15)%, (1.78±1.14)%and (1.22± 1.14)%in active phase group, remission group and control group. The difference among three groups was significant (H=14.437, P=0.001), and the active phase group had higher proportion of Th17 than the other two groups (P<0.05). The ratio of Th1 and Th2 over CD3+CD8-cell between each group was not significantly different (P>0.05). The serum IL-17 levels were (125.82 ± 45.87) pg/ml, (57.79±25.84)pg/ml and(50.02±18.37)pg/ml in active phase group, remission group and control group with signifi-cant difference among three groups (F=31.82, P=0.000), and the active phase group had higher level of IL-17 than the other two groups (P<0.05). But serum INF-γ and IL-4 were not significantly different between each group (P>0.05). Conclusions Acquired cellular immunity is involved in pathogenesis of SoJIA, the increased proportion of Th1 and Th17 cell and the changes of related cytokines seem to correlate with active phage of SoJIA.

Objective To investigate the clinical features of polymyositis/dermatomyositis (PM/DM) with anti-nuclear matrix protein (anti-2NXP2) antibodies in Han-Chinese.Methods ImmunoprecipitationWestern Blotting (IP-WB) method was used for screening anti-NXP2 antibodies in 141 adult Han-Chinese patients with PM/DM.The clinical and laboratory data were collected,analyzed and compared with the antiNXP2-positive patients reported in the literature.Statistical analyses were performed using chi-square test and Fisher's exact test.Results Seven (5％) patients,including 6 with DM and 1 with PM,were identified as anti-NXP2 positive.Consistent with the 114 anti-NXP2-positive patients reported in the literature,Han patients with anti-NXP2 had higher frequencies of weakness,heliotrope rash and Gottron's sign.Compared with anti-NXP2-negative patients,anti-NXP2-positive patients presented significantly higher frequencies of dysphagia [43％(3/7) vs 9％(12/134),x2=8.04,P=0.027] and edema [43％(3/7) vs 2％(3/134),x2=26.94,P=0.001 4],while an absence of PM/DM related cancer was observed in Han patients with anti-NXP2.Conclusion Adult Han-Chinese patients with anti-NXP2 are DM predominant,and are characterized by a high frequencies of edema and dysphagia.

Objective To develop a real-time QRS complex detection algorithm of dynamic ECG signals for the GPRS mobile telemonitoring system. Methods Before the first and second derivatives of ambulatory ECG signals were processed by moving average method, the signals sampled from CM5 monitoring lead were filtered with the average of continuous four ECG sample signal points. The R waves could be detected precisely by local minima of second derivatives and Q & S waves were located correctly by cross-zero points of first derivatives of ambulatory ECG signals in a short-time searching windows. The QRS recognition thresholds, which could revise themselves according to the detected values and vary with the analyzing signals, were designed in this paper. Results With a polynomial computation complexity, the novel algorithm insensitive to baseline draft and noise caused by mobile communication filtered power-line interference and most of muscle noise and reduced the search time below 0.02 s during detecting each Q wave, R wave and S wave. For the normal and clinical patients, this algorithm correctly detected up to 99.8% of the QRS complex of ambulatory ECG signals. Conclusion The algorithm can meet the need of real-time QRS complex detection and analysis for the GRRS mobile ECG telemonitoring system.

Objective To compare the significance of two blood glucose monitoring methods of eight-point and five-point after liver transplantation. Methods 160 patients after liver transplantation selected eight-point or five-point blood glucose monitoring methods randomly,each method had 80 patients.Blood glucose value one month after operation,incidence of hypoglycemia,hospitalization time,daily use of insulin,time needed to reach standard level,incidence of infection were compared. Results Eight-point and five-point blood glucose monitoring methods showed no difference in incidence of hypoglycemia,hospitalization time,daily use of insulin,time needed to reach standard level,incidence of infection.Rate of blood glucose to reach standard level 4 days,1,2,3,4 weeks after operation also showed no difference. Conclusions Comparison of eight-point and five-point blood glucose monitoring methods supply the information needed in clinic,reduce the burden of patients,strengthen the compliance of patients,it has important practical significance for clinical work.

Modern medicine generates a great deal of information stored in the medical database. Extracting useful knowledge and providing scientific decision-making for the diagnosis and treatment of disease from the database increasingly becomes necessary. Data mining in medicine can deal with this problem. It can also improve the management level of hospital information and promote the development of telemedicine and community medicine. Because the medical information is characteristic of redundancy, multi-attribution, incompletion and closely related with time, medical data mining differs from other one. In this paper we have discussed the key techniques of medical data mining involving pretreatment of medical data, fusion of different pattern and resource, fast and robust mining algorithms and reliability of mining results. The methods and applications of medical data mining based on computation intelligence such as artificial neural network, fuzzy system, evolutionary algorithms, rough set, and support vector machine have been introduced. The features and problems in data mining are summarized in the last section.
Algorithms ; Automatic Data Processing ; Databases, Factual ; Decision Making, Computer-Assisted ; Decision Trees ; Fuzzy Logic ; Information Storage and Retrieval ; methods ; Neural Networks (Computer)

Objective To explore a unified calculation method of clinical nursing workload in a general hospital,so as to compare objectively nursing workload among different departments.Methods As an attempt to figure out the nursing workload,direct nursing time of venous transfusion was used as the statistical basis and direct nursing time of nursing service items in different departments were standardized.Results Conversion coefficient among different nursing service items was determined,with the result of realization of reasonable calculation of nursing workload and objective comparison of nursing workload among different departments. Conclusions The unified calculation of clinical nursing workload,using direct nursing time of venous transfusion as the statistical basis,is easy in operation and reliable in results,which makes it operable and feasible in comprehensive performance evaluation system and bonus distribution with serving quality and nursing workload as main index.

TCM proposes that the core pathological mechanism of depression is"deficient qi with stagnation and heat",with the following pathogenic characteristics and evolution patterns:"deficient qi"as the nature,and deficiency in nature is in spleen,and deficiency in superficiality is in brain;"stagnation"is the superficiality,and qi stagnation,phlegm stagnation,and blood stagnation are in the brain collaterals;"heat"fires the brain collaterals,depression raised the heat,and excessive heat accumulated to stagnation.Based on the understanding of the pathogenesis of depression caused by stress sensitization in modern medicine,this article explored the potential association between this mechanism and the core pathogenesis of"deficient qi with stagnation and heat".It proposed that tonifying deficiency,promoting circulation,and clearing heat are the basic treatment principles for depression.By inhibiting inflammatory reactions and improving the stress sensitization state of neurons and glial cells,TCM compound formulas can exert multi-target and multi-dimensional therapeutic characteristics.

Objective:To observe the effects of moxibustion on the levels of glucose-6-phosphate dehydrogenase(G6PD)and reduced nicotinamide adenine dinucleotide phosphate(NADPH)in the plasma and spleen and the CD4+T-cell number in the spleen of rats with adjuvant arthritis,thus to explore the mechanism in rheumatoid arthritis(RA)treatment with moxibustion by regulating the CD4+T-cell proliferation through G6PD-mediated pentose phosphate pathway. Methods:Twenty-seven male Sprague-Dawley rats were randomly divided into a blank group,a model group,and a moxibustion group,with 9 rats in each group.Incomplete Freund's adjuvant was used to induce inflammation in the model group and the moxibustion group.The blank group and the model group were not intervened.In the moxibustion group,suspended moxibustion was performed at bilateral Zusanli(ST36),Guanyuan(CV4),and Ashi points for 30 min,once a day for 24 times in total.Hematoxylin-eosin staining was used to evaluate the histopathological changes of rat synovial tissue;the swelling degree of the rat toes was observed by measuring the toe volume;G6PD and NADPH in the spleen and plasma were detected by Western blotting and enzyme-linked immunosorbent assay.Flow cytometry was used to detect the CD4+T-cell number in the spleen. Results:Compared with the blank group,the levels of G6PD and NADPH in the plasma and spleen and the CD4+T-cell number in the spleen were significantly increased in the model group(P<0.01 or P<0.05).Compared with the model group,the NADPH level in the spleen and plasma and the CD4+T-cell number in the spleen in the moxibustion group decreased significantly(P<0.05 or P<0.01),and the G6PD level in the plasma decreased significantly(P<0.05),but there was no significant difference in the G6PD level in the spleen(P>0.05). Conclusion:Moxibustion can regulate immunity and improve joint synovial inflammation in RA.The mechanism may be that the G6PD-mediated pentose phosphate pathway reduces the production of metabolite NAPDH in CD4+T cells,thereby inhibiting the proliferation of naive CD4+T cells.