Asthma is the most common chronic inflammatory airway disease in childhood. Adhering to a daily anti-inflammatory treatment is the most important cornerstone of bronchial asthma control. However,with the large number of clinical studies conducted in recent years,learning inhaled corticosteroids as an anti-inflam-matory drug of choice,there is a mixed compliance rate of inhaled corticosteroids in children. Standard treatment and control of asthma has yet to be further improved. This review discusses the medication adherence to long-term inhaled corticosteroid as well as the relevant aspects of research progress.

Objective:To evaluate the effect of iliac bone graft and radial forearm flap in the reconstrucion of maxilla.Methods:Maxilla defects were reconstructed using iliac bone graft and radial forearm flap in 4 patients.The effects were evaluated clinicaly.Results:In all the 4 cases,palatal defects resulted from maxillectomy were optimally reconstructed with non-vascularized iliac graft and radial forearm flap.The masticatory function of the upper jaw,intelligible speech,swallow and natural facial appearance were recovered.As a result,quality of life of the patients was improved.Conclusion:Iliac bone graft and radial forearm are feasible in the reconstruction of maxilla defects.

Objective] To explore and summarize clinical experience and academic characteristics of Lei Shaoyi on treating latent-qi leading to diarrhea. [Methods] By analyzing theory of“Impaired by wind in spring, one must get diarrhea containing undigested foods in summer”and related typical clinical cases in treatise on seasonal diseases clinical experience of Lei Shaoyi on treating latent-qi leading to diarrhea has been summarized. [Results] Lei Shaoyi put forward that the pathogenesis of latent-qi leading to diarrhea was wood restrains earth. There were two types of latent-qi leading to diarrhea: lienteric diarrhea and through-flux diarrhea. Due to suffering from disease for a long time, patients with latent-qi leading to diarrhea often were characterized by more asthenia syndrome and less sthenia syndrome, therefore, treatment was given priority to invigoration method.Lei Shaoyi was good at taking advantage of prescriptions and herbs with nature of light, clear and scattering for dispersing to expel inner delitescent pathogenic factors and emphasizing on protecting the spleen and stomach simultaneously. In clinical practice, Lei Shaoyi always adjusted treatments according to different clinical symptoms of diarrhea accompanied with other syndromes, which saved a lot of patients with critical illness.[Conclusions] The treatment methods created by Lei Shaoyi were not only inherited from The Yellow Emperor’s Inner Classic, but also the sublimation of his personal clinical experience, which was well worth learning by physicians of later generations.

Objective To investigate the application of the three-dimensional reconstruction for the random flap.Methods The bones,muscles,fascia,skin and vessels in eleven patents were reconstructed by the MIMICS 10.01 CT angiography (CTA) scanning,and the single artery and its branches were gained by the subdivision of the vessels.3D-images were shown respectively and jointly.Results Arterial reconstruction images were clearly displayed by 3D workstation CTA and if they were combined with the original cross-sectional images and vessel analysis software,they were able to accurately evaluate the location,range,degree of artery,the distal outflow tract.The vessels and soft tissue displayed in the software could show detailed distribution of the vessels in one region and this could provide the accurate anatomical basis for the random flap and the design of the operation.This method could easily meet the preoperative design demands and also had the guiding significance for postoperative evaluation.Conclusions The method of 3D-reconstruction is very good for studying the random flap and the design of the operation.

One hundred and twenty patients with senile primary osteoporosis were enrolled in the study from January 2012 to April 2013,including 41 males and 79 females.Patients were randomly assigned to two groups:60 patients in study group were treated with salmon calcitonin combined with zoledronic acid (salmon calcitonin 50 IU i.m,q.d for 7 d,then 100 IU q.i.d for 7 d,followed by zoledronic acid 5 mg i.v gtt/y);60 cases in control group were treated with alendronate (70 mg p.o/wk).Both groups received the same doses of calcium.Visual analogue scale (VAS) scores were assessed before,and 1,6 and 12 months after treatment,12-Item Short-Form Health Survey (SF-12) and bone mineral density (BMD) were assessed before and 12 months after treatment.There were no significant differences in all baseline parameters between two groups (P ＞ 0.05).After 1 month of treatment,the VAS scores of study group was lower than that of the control group (2.1 ± 3.0 vs.4.2 ± 3.1,P ＜ 0.05),however,both groups had similar improvements in VAS scores in 6 and 12 months after the treatment (P ＞0.05).Compared to those before treatment,physical component summary and mental component summary of SF-12 scores after 1 year of treatment were improved significantly in both groups (P ＜ 0.05).Also,BMD was significantly improved after 1 year of treatment in both groups (P ＜ 0.05).The incidence of side effect in study group was lower than that in control group (16％ vs.20％,P ＜0.05).The results indicate that salmon calcitonin combined with zoledronic acid is an effective,safe,reliable and well tolerated therapy for senile primary osteoporosis.The long-term outcomes remain to be determined.

BACKGROUND:The metastatic potential of hepatocelular carcinoma cels is key factor influencing patient’s prognosis. To observe the effect of human bone marrow mesenchymal stem cels on metastasis of hepatocelular carcinoma is of great significance for improving the lifetime of hepatocelular carcinoma patients. OBJECTIVE:To explore the biological effect of human bone marrow mesenchymal stem cels on hepatocelular carcinoma cels with different metastatic potentials. METHODS:Human bone marrow mesenchymal stem cels and hepatocelular carcinoma cel suspension with high and low metastatic potentials were respectively injected into the Transwel chamber, and after 36 hours of co-culture, ELISA method was used to detect the absorbance value as wel as cel counting method was used to observe the changes in the invasion ability of hepatocelular carcinoma cels. The effects of human bone marrow mesenchymal stem cels on the proliferation of hepatocelular carcinoma cel suspension with high and low metastatic potentials were determined using cel counting kit-8. PCR method was adopted to measure the expression of osteopontin, bone specific sialoproteins, integration (alpha V), transforming growth factor beta 1 and programmed cel death protein 5. RESULTS AND CONCLUSION:(1) The number of migrated hepatocelular carcinoma cels was significantly lower in the co-culture group than the single culture group, and based on the semi-quantitative detection of invasion ability, the absorbance value of the co-culture group was significantly lower than that in the single culture group (P < 0.05). (2) The expression of osteopontin and bone specific sialoproteins was significantly decreased in the co-culture group with high metastatic potential (P < 0.05), but there was no change in the expression of integration (alpha V) (P> 0.05). In the co-culture group with low metastatic potential, the expression of osteopontin, bone specific sialoproteins, and integration (alpha V) were declined remarkably (P < 0.05). (3) Results from the semi-quantitative detection of proliferation ability showed that the absorbance value of the co-culture group was significantly higher than that of the single culture group (P < 0.05). (4) In the co-culture group with high metastatic potential, the expression of transforming growth factor beta 1 was up-regulated significantly (P< 0.05), but the expression of programmed cel death protein 5 showed no changes (P > 0.05). However, in the co-culture group with low metastatic potential, the expression of transforming growth factor beta 1 and programmed cel death protein 5 was both increased dramaticaly (P < 0.05). These findings suggest that the human bone marrow mesenchymal stem cels reduce the invasion ability of hepatocelular carcinoma cels, and enhance their ability of proliferation.

Aim To investigate the effects of harpagide on cerebral ischemia and the mitochondria mediated Caspase dependent apoptotic signaling pathway in mice.Methods The MCAO was employed to establish MCAO model.When the models were established, the mice were given harpagide (4, 8, 12 mg·kg-1) and edaravone (3.2 mg·kg-1) [0.1 ml·(10 g)-1] by tail vein injection after MCAO immediately.And the model and control mice were given equivalent normal saline by the same way.After MCAO for 6 h, the behavior, volume of cerebral ischemia and pathological changes in the brain were observed.Westernblot was employed to determine the contents of Cyt C in mitochondrion and pro-caspase-3 in endochylema.Results Compared with the model group, harpagide (4, 8, 12 mg·kg-1) could significantly decrease the increased nerve functional score, brain index, brain water content and volume of cerebral ischemia induced by cerebral ischemia.Harpagide (4, 8, 12 mg·kg-1) could reduce the contents of Cyt C in mitochondrion and pro-caspase-3 in endochylema.Conclusion Harpagide may have protective effect on the cerebral ischemia injury in mice, which might be related to the inhibition of the cerebral mitochondria mediated Caspase dependent apoptotic signaling pathway.

The professional quality training ofthree orientedpersonnel training mode is one of the three core, which requires medical students to have lifelong learning ability. This study mainly describes the proposed concept of lifelong learning ability, expounds the necessity of lifelong learning ability, and analyzes the connotation, objective and strategies of improving the medical students'!lifelong learning ability under the framework of three oriented medical talents training mode. The training strategy has been discussed mainly from five aspects such as strengthening medical humanistic education, creating a lifelong learning atmosphere in campus, optimizing teaching methods, reform the course of career development and employ-ment guidance, reforming the course of career development and employment guidance, reforming the teaching of medical literature retrieval course and establishing the personal growth archives.

Objective To evaluate the safety and efficacy of ischiospinous ligament fixation in treatment of stage Ⅲ pelvic organ prolapse (POP).Methods Between March 2007 and December 2009,65 patients with stage Ⅲ POP who underwent ischiospinous ligament fixation in Peking Union Medical College Hospital were enrolled in this study.Among 21 cases complicated with stress urinary incontinence (SUI) underwent transobturator tension-free vaginal tape (TVT-O) concomitantly.Clinical parameter associated with perioperation,objective and subjective successful rate and complication were recorded.Results The mean operating time was (71 ±22) min and the mean blood loss was (93 ±40) ml.No intraoperative blood transfusion and viscera injury cases were observed.All patients were able to recover spontaneous micturition.Two cases experienced pelvic hematoma with diameter of 7 cm,after conservative treatment,they all recovered later.The objective success rate was 100％ at 6 weeks follow-up by POP-Q scoring.And 46.2％ (30/65) were followed up at range of 1 -3 years,recurrence rate were 10％ (3/30),and however,no operation were needed.At median of 20 months,all patients were followed up by telephone,the subjective successful rate was 95.4％ (62/65).At 6 weeks after operation,6.2％ (4/65) patients suffered from lower back pain and right thigh pain,visual analogue scale of pain was at range of 3 to 5,which relieved gradually after treatment and disappeared totally within 2 years.The rate of suture exposure was 10％ (3/30),the new urinary incontinence 4.6％ (3/65),and the new dyspareunia 12.5％ (3/24).Conclusions Ischiospinous ligament fixation is a safe and efficacious management.

Objective To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound surgery (MRgFUS) in treatment of symptomatic uterine leiomyoma among Chinese reproductive age women.Methods From April 2010 to April 2012,80 premenopausal women with symptomatic leiomyoma volunteered to participate in this prospective study in Department of Outpatient of Peking Union Medical College Hospital.Among 23 reproductive aged patients with size of uterus less than 16th gestational weeks,2.5 to 10 cm of diameter of myoma,less than 10 myomas and expressing symptoms clearly were treated by MRgFUS.Treatment data,non-perfused volume ratio (NPVR) and adverse events were recorded.After treatment,patients were followed up at 1 week,1,3,6,12 and 24 months,respectively.Patients at initial screening and each time of the follow-up filled out uterine fibroid symptoms quality of life (UFS-QOL),which include symptoms severity score (SSS) and health-related quality of life (HRQL).The volumes of leiomyoma and uterine were evaluated on MRI before and after the treatment (at 6 and 12 months,respectively).Before operation,routine blood test were performed on all patients,anemia patients at 3 months and 1 year after treatment were checked with blood test.Results (1) Treatment data and adverse events:the mean therapeutic temperature was (69 ± 7) ℃,the mean treatment time was (144 ±62) min,the mean NPVR was (62 ±23)％.Adverse events included mild erythema(1/23),abdominal cramp(8/23),vaginal discharge (5/23),and leg numbness (4/23).(2) The rate of secondary surgery:one patient was treated by myoectomy and hysterectomy within one year following up and 4 patients chose surgical treatment during the second-year follow-up.(3) Volume change:the volumes of leiomyoma before the treatment and 6,12 months after the treatment are 75.6 (P25 =43.8,P75 =128.9),52.3 (P25 =23.8,P75 =111.2),45.9 (P25 =26.3,P75 =71.7) cm3,respectively; and the volumes of uterine before the treatment and 6,12 months after the treatment are 270.0 (P25 =208.4,P75 =390.3),216.4 (P25 =151.1,P75 =290.0),200.0 (P25 =149.1,P75 =267.6) cm3,respectively.Both leiomyoma and uterine volumes decreased significantly after treatments (P ＜ 0.01).(4) UFS-QOL change:the symptoms severity score (SSS) before the treatment and 3,12 months after the treatment are (34 13),(22 ± 11),(19 ± 12),which decreased significantly (P ＜ 0.01).The health-related quality of life (HRQL) before the treatment and 3,12 months after the treatment are (74 ± 15),(82 ± 13),(89 ± 10),which increased dramatically (P ＜0.01).(5) Hemoglobin(HGB) change:eleven patients suffered from anemia before treatments,the mean HGB before treatment was (87 ±6) g/L and were (106 ± 14) g/L 3 months after treatment,(112 ± 10) g/L 12 months after treatment.The HGB was increased significantly after treatments (P＜0.01).Conclusions MRgFUS is a safe and effective non-invasive management for symptomatic uterine leiomyoma in short-term follow up.But there is additional treatment ratio after MRgFUS.