Objective To determine whether an environmental intervention tailored to each patient's allergic sensitization and environmental risk factors could improve asthma-related outcomes. Methods Irritant or allergen sensitivity determined by the patient's exposure history and confirmed with skin test. Patients were asked to record 2-week days without symptoms, days off-work(or school) and ?2-agonist puffs. Pulmonary function was also examined. Ninety-six asthmatics with atopic asthma (aged 16-78 years) were randomly assigned to a control group, an intervention group that received an educational handout monthly for 2 months. Asthmatics of both groups inhalded budesonide at a daily dose 200-800 ?g and ?2-agonist as needed. Environmental intervention lasted six months and included education and remediation for exposure to allergens. The control group had no special recommendations. Results The intervention group had more days without symptoms compared with the control group (13.4 vs.10.1days, P

Objective:To observe the clinical efficacy of warm acupuncture in the treatment of diabetic peripheral neuropathy and its effects on the conduction velocity of the tibial nerve and common fibular nerve.Methods:Fifty.two subjects were evenly randomized into two groups and treated by conventional therapy;in addition,the control group was given mecobalamin injection at 500 μg,once a day for four weeks,and treatment group was given warm acupuncture,6 times a week for 4 weeks.The clinical efficacy and the conduction velocity of the tibial nerve and common fibular nerve were observed and compared between the two groups.Results:After four-week treatments.the total effective rate Was 88.5% in the treatment group and 61.5% in the control group,with a higher rate in the treatment group than in the control group (P＜0.05):the conduction velocity of tibial nerve and common fibular nerve Was higher in both groups(P＜0.05),with higher conduction velocity in the treatment group than in the control group (P＜0.05).Conclusion:Warm acupuncture is quite effective to treat diabetic peripheral neuropathy and to improve nerve velocity.

Objective To investigate the compliance of prevention and cure in the old patients with hypertension and analyse the relationship between it and the characteristic of locus of control in the old patients with hypertension. Methods The compliance of sixty-six old patients with hypertension raking medicine ,and the re-exam in outpatient services ,the way of daily behavior with self-made scale about the knowledge of hypertension were investigated. Multimentional Health Locus of Control Scales ( MHLC ) was used to evaluate the locus of control in the patients with hypertension. Results In many aspects ,the old patient with hypertension had different degrees of non-compliance such as taking medicine , the way of daily life and the internal locus of control (r=0.334,0.260), but there was no correlativity with the chance control (P > 0.05 ). Conclusions The compliance of prevention and cure in the old patients with hypertension is needed to be improved. We should offer characteristic support and direction to different patients.

Objective To evaluate the therapeutic efficacy of neoadjuvant chemotherapy in cervical carcinoma. Methods TAC(DDP, EPI and BLM) was applied in 68 patients with cervical carcinoma. Therapeutic efficacy and side effects were documented. Results After 1～3 cycles of neoadjuvant chemotherapy, clinical symptoms remission rares reached 100% ,response rate were 100% (40/40) in Ⅰ b～Ⅱ a,90.9% (20/22) in Ⅱ b and 50% (2/4)in Ⅲ a, respectively. Radical resection reached 91.2 %, and only 6 patients of advanced disease failed to radical resection and turned to radiotherapy. Conclusion Neoadjuvant chemotherapy is a safe and effective therapeutic option which could alleviate clinical symptoms, decrease tumor size, down-staging and increase the radical resection rate.

Objective To investigate the effect of gravity and lung volume on MR perfusion imaging of human lung using an arterial spin labeling sequence called flow sensitive alternating inversion recovery(FAIR).MethodsMagnetic resonance imaging of lung perfusion was performed in supine position in ten healthy volunteers on a 1.5 T whole body scanner(GE medical system).Five sequentially coronal slices with the gap of 3cm from dorsal to ventral(labeled as P3,P6,P9,P12,P15,respeectivly)were obtained on end respiration and the relative pulmonary blood flow(rPBF)was measured.Another coronal perfusion-weighted image of P3 slice was obtained on end inspiration.Tagging efficiency of pulmonary parenchyma with IR(⊿SI%),the rPBF and area of the P3 slice were analyzed.respectively.Paired Student's t test was used for statistical analysis.Results(1)In the direction of gravity,an increase in rPBF of the gravity-dependent lung was found.rPBF of right lung from dorsal to ventral were 100.57±18.22,79.57±12.36,61.65±11.15,48.92±9.96,41.20±9.88,respectively；and that of left lung were 106.61±26.99,78.89±11.98,64.00±13.64,51.27±8.95,43.04±12.18.No statistical differences between P12 and P15,there were significant statistic differences of any other two coronal planes.But along an isogravitational plane,no statistical difference was observed.Regression coefficients of right and left lung were -4.98 and -5.16,respectively.This means the rPBF of right lung falls by 4.98 for each centimeter above the dorsal and that of left lung falls by 5.16.(2)For(⊿)SI%,rPBF and area,there were significant statistic differences at different respiratory phases(P＜0.05).(⊿)SI%,rPBF,area at expiration phase vs.inspiration phase were 1.12±0.31 vs 0.71±0.18,90.78±17.35 vs 52.85±8.75,(12.59±3.23)×103mm2 vs (17.77±4.24)×103mm2 for right lung;and 1.01±0.24 vs 0.70±0.11,91.08±18.68 vs 54.58±10.70,(12.34±3.08)×103mm2 vs(17.34±4.98)×103mm2 for left lung.Greater (⊿)SI%and increased perfusion were observed on end expiration than on end inspiration.The area was larger on end inspiration than on end expiration.ConclusionsThe FAIR is sensitive to perfusion changes in the gravity-dependent lung.Pulmonary blood flow is less in a state of high lung inflation than in a low state(inspiration vs.expiration).Positioning the patient so that the area of interest is down-gravity and breath-hold on end expiration may improve visibility of perfusion defects.

Objective To explore the effect of experimental design in the experimental teaching of fundamental nursing. Methods 168 and 199 baccalaureate nursing students were in the control and experimental group respectively, the control group received traditional experimental teaching method, and the experimental group must complete the experimental design before entering the lab. The teaching effect between the two groups were compared. Results The mean operation score of the experimental group was significantly higher than the control group, the proportion of those students who reflected their teaching method could enhance creative ability, problem-solving ability and practical ability was higher in the experimental group, 100% teachers reflected experimental design could improve operation level, strengthen theoretical knowledge, animate teaching atmosphere. Conclusions Experimental design could arouse students' enthusiasm and initiative to study, advocate them to think and ask.

OBJECTIVETo compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.

METHODSFrom September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.

RESULTSAll patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P>0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.

CONCLUSIONBoth of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; Fracture Healing ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged

Objective:This study aimed to explore the effects ofnesfatin-1 on gastric distension (GD)-sensitive neurons in the basomedial amygdala (BMA) and the potential mechanism for nesfatin-1 to regulate gastric motility through the arcuate nucleus (Arc).Methods:The projection of nerve fiber and expression of nesfatin-1 were observed by retrograde tracing and fluo-immunohistochemistry staining;The nuclei microinjection and nuclei electrical stimulation,extracellular discharges of single unit neuron were used to observe the effects ofnesfatin-1 on the GD neurons;Gastric motility recording in vivo were used to monitor the effects ofnesfatin-1 on the amplitude of constriction and frequency of gastric motility in conscious rats.Results:NUCB2/Nesfatin-1/fluorogold-double labeled neurons were from ARC to BMA;Nesfatin-1 could excited the firing rate of most of the GD-E neurons (4.25± 1.02 Hz vs.5.32± 1.17 Hz,P＜0.01) and decreased the firing rate of most of the GD-I neurons (3.73± 0.92 Hz vs.2.64± 0.86 Hz,P＜0.01),inhibited the gastric motility,amplitude and frequency,SHU9119 could weaken the responses induced by nesfaton-1;Electrical stimulation of the Arc,the firing rate of nesfatin-1-induced GD-response neurons (GD-E:5.14± 1.32 Hz vs.6.75± 1.84 Hz,P＜0.05;GD-I:2.84± 0.86 Hz vs.4.05± 1.12 Hz,P ＜0.05) and the gastric amplitude and frequency were increase.Conclusion:It was suggested that nesfatin-1 in the BMA plays an important role in decreasing gastric motility and the Arc may be involved in this regulation process.

Objective To explore the prevalence of ETS gene fusion in prostate cancer and its correlation with patient's clinicopathologic index.Methods Ninety-one samples from prostate needle biopsy cases with median age 75 (55-90) years and 18 samples from radical prostatectomy cases with median age 72 (63-81) years were collected from Oct.2010 to Feb.2012.TMPRSS2-ERG,TMPRSS2-ETV1 and TMPRSS2-ETV4 fusions were tested by multi-probe fluorescence in situ hybridization (FISH) assay.Fusion positive and negative cases were compared with age,TNM stage,Gleason score (median Gleason score 7 (6-9)),and PSA value (median PSA 33.4 μg/L,mcan PSA 118.8 μg/L).In needle biopsy cases,there were early stage 32 (34％),locally advanced prostate cancer 36 (40％),metastasis 23 (26％) ; in radical prostatectomy cases,there were 9 cases in T2 stage,8 cases in T3 stage,1 cases in T4a stage,respectively.Results TMPRSS2-ERG fusions were present in 14.3％ (13/91,95％ confidence interval,0.071-0.215)biopsy specimens and in 11.1％ (2/18,95％ confidence interval,0-0.256) radical prostatectomy specimens.No TMPRSS2-ETV1 or TMPRSS2-ETV4 fusions were found in any cases.Altogether,13 (86.7％)cases possessed deletion pattern.And 7 (46.6％) hold insertion pattern.5 cases had both deletion and insertion pattern.38.5％ (5/13) deletion pattern had distant metastasis.Except one metastatic case harbored both deletion and insertion pattern,there was no insertion pattern accompanied with metastasis.There were no differences between fusion positive and negative cases in the distribution of age (P =1.000),PSA (P =1.138),primary Gleason score (P=2.186),Gleason score (P=2.107),TNM stage (P=2.052) and Risk Degree (P=2.597).Conclusions The TMPRSS2-ERG fusion positive cases harbor more deletion pattern than insertion pattern.There are no differences between fusion positive and negative cases in the distribution of age,PSA,Gleason score,TNM stage and Risk Degree.

Objective To evaluate the efficacy of intermittent pneumatic compression or sequential compression device in prevention of deep venous thrombosis in long-term bedridden patients.Methods We searched Pubmed (1996～),The Cochrane Library (1997～),CLNAHL (1980～),CNKI (1994～),EM-BASE,Science Direct,Oxford Journals,Wanfang Data(1998 ～),and randomized controlled trials (RCTs) in which IPC or SCD was used as an intervention to prevent DVT,and all the trials were published in English or Chinese.The methodological quality of the included studies was assessed according to the standard of Cochrane systematic review.RevMan 5.0 software was used for Meta-analysis.Results Seven RCTs were included.The results of Meta-analysis showed that the incidence of DVT in the IPC or SCD group was lower than that in the control group.Conclusions IPC or SCD shows an effective tendency in DVT prevention,but because of the low quality and the small sample of the included studies,this conclusion needs to be verified by protocols of more samples and higher quality.