Objective To evaluate the impact of the asthma education and management model developed by Peking University People's Hospital on the level of asthma control. Methods Trained respiratory physicians from 6 large teaching hospitals in the urban districts of Beijing conducted a successive questionnaire survey in the form of face-to-face interviews with adult asthma patients attending their respective clinics. The results were used to compare the levels of asthma control between patients who were administered "three-in-one" asthma education and management (education group) and those who were not(control group). Results Among the 100 patients in the education group, 85% showed asthma control test(ACT) values ≥20 points. This was significantly higher than that in the 427 control group patients (37%,χ2 =74.345 ,P <0.01 ). During the past 1 year, the rate of hospitalization due to exacerbation of asthma,number of emergency treatments, and missed working days were significantly lower in the education group than in the control group ( 4%, 18%, 20% vs 23%, 32%, 55%, respectively; χ2 = 19.431,7.515 and 17.853 respectively; and P < 0.01 for all). Conclusion The " three-in-one" asthma education and management model can significantly improve asthma control.

Objective To evaluate the therapeutic efficacy of atomoxetine hydrochloride for attention deficit hyperactivity disorder (ADHID) combined with Tourette syndrome (TS).Methods Twenty-six cases of children with ADHD combined with TS were firstly diagnosed American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-Ⅳ) of ADHD and TS were treated with atomoxetine.The symptoms were improved and conditions were assessed based on the fourth version of ADHD parent rating scale and the severity of Yale comprehensive pumping quantity during pre-treatment,the 2nd,4th,6th and the 8 week of therapeutic courses,respectively.The adverse reaction was observed.Results 1.Compared with pre-treatment,attention deficit scores after treatment were statistically different (t =8.41,9.97,all P ＜ 0.05) in the 6th,8th week of therapeutic courses;hyperactivity /imnpulsivity scores were statistically different (Z =-4.39,-4.47,-4.46,all P ＜0.05) in the 4th,6th,8th week; Motor tics scores were statistically different (t =18.30,18.67,20.32,all P ＜ 0.05) in the 4th,6th,8th week; The vocal tic score:the second weeks already had statistically different(t =5.45,P ＜ 0.05); And the impaired function score were statistical significance (Z =-3.95,-3.94,all P ＜ 0.05) at the 6th and 8th week.2.The effective rate of ADHD and TS was 7.69％ and 15.38％,respectively in the 2td week.The curative effect had no statistical significance (x2 =0.188,P ＞0.05).But at the tourth week of assessment,and the rates of curative effect were respectively 19.23％ and 46.15 ％.It had statistical significance (x2 =3.923,P ＜ 0.05).In the 6th,8th weeks,there was no significant difference between the 2 efficiency (x2 =0.083,0.103,all P ＞0.05).3.During the treatment,no severe adverse reaction had appeared.Conclusions Atomoxetine in ADHD comorbid TS had exact curative effect and no obvious adverse reactions.In the treatment of ADHD,hyperactivity / impulsivity effect is better than the attention deficit.In the treatment of TS,vocal tics onset is better than the motor tics.In comparison of ADHD with TS,TS symptoms improve faster than ADHD in the onset,but the final effect is quite.

Objective To examine the role of synthetic cyclic citrullinated peptide (CCP) in T cell autoreactivity in rheumatoid arthritis (RA) by detecting T cell proliferation. Methods Twenty-nine RA, 8 primary Sjo gren syndrome (pSS) and 16 osteoarthritis (OA) patients were included in this study. Proliferation of T cells was measured by methyltetiazolium incorporation following incubation with CCP. Results T cell response to CCP was more common in RA patients than in controls. The response rate to CCP was higher in late RA than in early RA. However, the response wasn′t associated with disease activity. A strong association between T cell proliferation and RF, anti-CCP antibody was observed. Conclusions T cell proliferation in response to CCP was found in the majority of RA patients, even in early RA, suggesting that the citrullinated peptide play an important role in the pathogenesis of RA.

BACKGROUND:Large bone defect caused by various reasons has been a difficult problem in clinical practice. To establish a standard experimental animal model of critical bone defects has vital significance for evaluating the efficacy of bone osteogenesis using various materials and techniques.
OBJECTIVE:To establish the rabbit model of parietal critical bone defects and to determine the diameter of the critical defects of parietal bone in limited time.
METHODS:10 New Zealand white rabbits were selected. The skul seam was treated as the boundary. Four ful-thickness round defects of bone in the parietal bone were made, with diameters of 4, 5, 6 and 7 mm, so as to establish rabbit models of parietal critical bone defects. Gross anatomical observation, X-ray and cone beam CT were used to determine the bone density in the new bone defect area. The healing of bone defects was evaluated by histological examination.
RESULTS AND CONCLUSION:After 12 weeks, the 4 mm group showed high bone healing capacity significantly, and part of the bone bridge had been connected completely. Quantitative analysis of bone mineral density revealed that gray value at defect site and trabecular bone area at the same magnification and the same vision in the 4 mm group were significantly higher than the other three groups (P<0.001). Only a smal amount of new bone in the periphery of bone defects appeared in the 5, 6 and 7 mm groups. The center of defect site was mainly fil ed by fibrous connective tissue. The results confirmed that this study successful y established rabbit models of parietal critical bone defects. During the 12 weeks of observation, bone defects with a diameter of ≥ 5 mm could not be self-healed, which was conformed to the criteria of critical defects of bone, and could be used as a reference value for critical parietal bone defects of a rabbit.

Objective To evaluate the effect of tacalcitol on the proliferation,adhesion,migration and c-kit mRNA expression of cultured human epidermal melanocytes.Methods Cultured epidermal melanocytes from the prepuce of adolescent males were treated with various concentrations of tacalcitol.Then,cell proliferation was evaluated by tetrazolium salt (XTT) assay after 24,48 and 72 hours of treatment,adhesive activity by using fibronectin-coated culture plates after 72 hours,migratory activity by Transwell assay using a microporous membrane after 24 hours,and the c-kit mRNA expression was semiquantitatively analyzed by reverse transcription PCR after 72 hours of treatment.Statistical analysis was done by repeated-measure analysis of variance and completely random design analysis of variance.Results As repeated-measure analysis of variance showed,tacalcitol of 10-10,10-9,10-8,10-7 and 10-6 mol/L significantly promoted the proliferation of melanocytes (F =9.47,P ＜ 0.01),with significant differences in the promoting effect among various durations of treatment with different concentrations of tacalcitol (F =14.44,P ＜ 0.01),and with significant interaction effect between drug concentration and treatment duration (F =2.47,P ＜ 0.01).The highest proliferation level was observed in melanocytes treated with tacalcitol of 10-s mol/Lfor 72 hours.There was a significant increase in the adhesion rate of human epidermal melanocytes to fibronectin after treatment with tacalcitol of 10-8-10-7 mol/L for 72 hours (both P ＜ 0.01),number of melanocytes migrating through micropore membranes per high-power field (× 200) after treatment with tacalcitol of 10-9-10-8 mol/L for 24 hours (both P ＜ 0.01),and in the c-kit mRNA expression in melanocytes treated with tacalcitol of 10-9-10-7mol/L for 72 hours (all P ＜ 0.01).Conclusion Tacalcitol can promote melanocytes to proliferate,migrate,express c-kit mRNA,and adhere to fibronectin.

Objective To study the regulatory effect of ethanol extract of glossy privet fruit and its monomer tyrosol on the adhesion and migration of human epidermal melanocytes.Methods Epidermal melanocytes were isolated from human foreskin,and subjected to a primary culture.Mter 3-5 passages,the melanocytes were treated with various concentrations of ethanol extract of glossy privet fruit (0.0375-0.6 mg/ml)and tyrosol (0.125-2 mmol/L) for 24-72 hours.The XTT colorimetric assay was carried out to evaluate the proliferation of melanocytes,fibronectin (FN)-coated culture plates were used to evaluate the adhesion activity of melanocytes,and Transwell assay was conducted to assess the migration activity of melanocytes.Confocal laser microscopy was utilized to observe the structure and distribution of actin cytoskeleton in melanocytes,and cellular fluorescence intensity was determined by a semi-quantitative analysis.Statistical analysis was carried out by using unpaired t test.Results The adhesion activity of melanocytes to FN was significantly enhanced by the ethanol extract of 0.0375-0.6 mg/ml from glossy privet fruit (P ＜ 0.05 or 0.01),and by tyrosol of 0.5-2 mmol/L (P ＜ 0.05 or 0.01).As XTT assay showed,neither the ethanol extract of 0.15 mg/ml nor tyrosol of 2 mmol/L had cytotoxicity or promotive effect on cell proliferation.Hence,0.15 mg/ml and 2 mmol/L were determined as the working concentrations of ethanol extract and tyrosol respectively.The number of cells migrating through micropore membranes per high-power field (× 200) was 43.7 and 51.0 in melanocytes treated with the ethanol extract of 0.15 mg/ml and tyrosol of 2 mmol/L,respectively,significantly higher than that in untreated melanocytes (20.3,both P ＜ 0.01).Compared with untreated melanocytes,those treated with the ethanol extract of 0.15 mg/ml and those with tyrosol of 2 mmol/L showed higher intracellular fluorescence intensity (P ＜ 0.01) and more stress fiber bundles which congregated inside the cell membrane and around the nuclei.Conclusions The ethanol extract of glossy privet fruit and its monomer tyrosol can promote the adhesion and migration of human melanocytes in vitro,likely by promoting the congregation of actin cytoskeleton in melanocytes.

Objective To investigate the efficacy and safety of full?thickness peroral endoscopic my?otomy( POEM) for achalasia in a follow?up period of 1 year. Methods Data of 28 patients who underwent full?thickness POEM in our hospital from July 2013 to June 2014 were retrospectively studied. Procedure completion and complications were assessed at the end of follow?up of 12 months. Results All patients were treated successfully by full?thickness POEM with the mean operation time of (61?7±15?6) minutes. Intraop?erative mucosal perforation occurred in 2( 7?1%) patients. Symptoms were relieved in 28 patients, but ster?num pain occurred in 6(21?4%) patients. POEM failed in one case in the first 3 months, and was successful in 27 other cases.treatment success rate (Eckardt≤3) was 89?3%(25/28). The incidences of postoperative reflux and esophagitis were 25?9%( 7/27 ) and 22?2%( 6/27 ) , respectively. Conclusion The full?thickness POEM is safe and effective with less complications, but further study is needed to evaluate long?term efficacy and complications.

Objective To discuss the method, safety and selection of instrument in bone biopsy under digital radiography-guided. Methods Bone biopsy in 41 patients with bone lesion were performed under digital radiography-guided. Using the MDTECH super-core Ⅱ biopsy instrument, the MDTECH biopsy needle and osseous drill.Results The successful rate was 100% and the posilive rate was90.3%. None of them had severe complications. Conclusion Bone biopsy is a safe , accurate and effective method under digital radiography-guided.

Adult ; Aged ; Altitude ; Echocardiography, Stress ; Female ; Heart Failure ; diagnostic imaging ; physiopathology ; Humans ; Male ; Middle Aged ; Young Adult

ObjectiveTo investigate the diagnostic value of interferon gamma release assays (IGRAs) in children with tuberculous meningitis.MethodsThe prospective case-control study was applied. From January 2012 to March 2013, 32 children diagnosed with tuberculous meningitis (TBM group) and 30 children diagnosed with non-tuberculous meningitis (non-TBM group) were recruited. The positive rates of the interferon gamma release assays (IGRAs), tuberculin skin test (TST), mycobacterium tuberculosis antibody test (TB-IgG), cerebrospinal lfuid of mycobacterium tuberculosis DNA test (TB-DNA), and the sensitivity, speciifcity, negative and positive predictive value of all these tests were compared between TBM group and non-TBM group.Results The positive rate of IGRAs, TST, TB-IgG, and TB-DNA was 87.50%, 56.25%, 46.88% and 34.38%respectively in TBM group, and 6.67%, 23.33%, 20% and 0% respectively in non-TBM group. The differences were statistically signiifcant (P<0.05). The sensitivity of IGRAs, TST, TB-IgG, and TB-DNA was 87.5%, 56.25%, 6.88% and 34.38% respectively. The speciifcity of IGRAs, TST, TB-IgG, and TB-DNA was 93.33%, 76.67%, 80.00% and 100% respectively. The differences of sensitivity and speciifcity were statistically signiifcant (P<0.05). The sensitivity of IGRAs was higher than that of other tests (P<0.017). The positive predictive value of IGRAs, TST, TB-IgG, and TB-DNA was 93.33%, 72%, 71.43% and 100% respec-tively. The negative predictive value was 87.50%, 62.16%, 58.54% and 58.82% respectively.Conclusions IGRAs, TST, TB-IgG, and TB-DNA are valuable in the diagnosis of tuberculous meningitis. IGRAs has a relatively higher sensitivity and speciifcity.