In order to improve the Interns’ synthetic medical quality of respiratory medicine, based on the teaching practice of respiratory medicine in our hospital, the analysis of admission introduction and requests for high quality medical ability are reviewed in the present article.

Objective To evaluate the clinical value of radionuclide pulmonary perfusion imaging in diagnosing acute pulmonary embolism.Methods Radioactive pulmonary perfusion imaging was performed in 25 patients clinically suspected for acute pulmonary embolism,meanwhile,imaging of deep veins of lower limb was taken.Results Multiple segments of abnormal blood perfusion were found in 23 of 25 patients,among them,radioactivity defects were found in 41 segments,radioactivity rarefied areas were found in 84 segments.Deep venous thrombosis was detected in 6 patients.Conclusion Radionuclide pulmonary perfusion imaging is a non-invasive and effective method in diagnosing acute pulmonary embolism.

Objective To evaluate the therapeutic effect and safety of the rituximab in the treatment of severe rheumatoid arthritis (RA). Methods A total 22 severe RA patients with DAS28＞5.1 were treated with rituximab 500～1000 mg/24week, or placebo/24 week, along with methotrexate (MTX) 10～25 mg/week.Chi-square test was adapted for statistical analysis if the results met the data criteria for the analysis. Rank conversion analysis was used to test the results if the data did not satisfy the Chi-square test. Results Twenty-two patients (93% were females with the median age of 50 yd and the average MTX dosage was 17.6 mg/week ) completed the treatment. The proportion of ACR 20 responders at 72 week was 80%, 60%,57% respectively. Other secondary efficacy endpoints showed that rituximab could provide substantial benefits to patients with RA by reducing clinical signs and disease activity score. The most frequently occurred adverse event was upper respiratory tract infection. Tne second most frequent adverse events were reduction of lymphocytes and elevation of liver enzymes. Most treatment-related adverse events were mild to moderate in severity. Conclusion Rituximab has demonstrated to be effective and is well tolerated by patients in the treatment of active RA.

BACKGROUND: At present, the researches on murine model of acute radiation encephalopathy are still in investigation, and mature model making method is not clear.OBJECTIVE: To establish a murine model of acute radiation encephalopathy in order to provide a good foundation for further researches of radiation encephalopathy(REP) mechanism and therapy.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Animal laboratory in a university hospital. The Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: The experiment was completed in the Laboratory of the Second Affiliated Hospital of Sun Yat-sen University from June 2001 to August 2002. Totally 30 female and 30 male SD rats, weighted(300 ± 30) g, were selected from the Animal Experiment Center of Sun Yat-sen University, and randomly divided into blank control group with 20 rats and experimental group with 40 rats.METHODS: Fourty rats' brain received 60Co γ-ray irradiation with the dosage of 7 Gy/time per day for 6 consecutive days with the total dosage of 42 Gy. The amount of ingestion and drinking, general activities, central nervous system(CNS) symptoms and signs were recorded every day. The hairs and skin of irradiated field and weight were checked and recorded weekly. On the 3rd, 7th, 14th, 30th days after radiation, the brain tissue was collected and the histopathologic changes were examined.Histopathologic changes after radiation.RESULTS: Since the third day, the ingestion and drinking amount of irradiated rats were decreased. The general activities were increased for the first two days, but decreased without abnormal nervous signs on the 3rd day. The rats in experimental group had a slower weight gain than those of control group, and the difference between them was of no statistical significance. All rats had slight alopecia and neuronal necrosis 2 weeks after irradiation.CONCLUSION: The irradiation method is reliable, practical and good for modeling REP process, which can be used in preventing or reducing the harm effect of radiation therapy on brain tissue.

Objective:To evaluate the accuracy of Cerec Bluecam and Cerec Omnicam with 3D printed resin models.Methods:A metal master model including 4 cylindrical metal preparations on the model base,respectively simulating the maxillary canine and the first molar preparations,was prepared.The right canine and the right first molar were respectively marked as A and B,and the left as C and D.The master model was scanned respectively by Cerec Bluecam and Cerec Omnicam for 10 times,10 digital models were genera-ted in Bluecam group and Omnnicam group respectively.Resin models were obtained by a 3D printer based on the digital models,the distance of AB,AC,BD and the diameter(d)of A were respectively measured.Statistical analysis was conducted by SPSS 13.0 soft-ware.Results:The distance of AB,AC,BD of master model and Bluecam group showed significant difference(P <0.05),but d did not(P >0.05);the distance of AC,BD of master model and Omnicam group showed significant difference(P <0.05),but d did not (P >0.05).All the distances of the Bluecam group and Omnicam group showed significant difference(P <0.05).Conclusion:The scanning accuracy of Cerec Bluecam is higher than that of Cerec Omnicam in a single preparation scanning.When the scanning area ex-tending,the scanning accuracy of Cerec Omnicam is higher than that of Cerec Bluecam.

[Summary] The effects of lipid components on insulin secretion in patients with type 2 diabetes(T2DM) and control subjects were explored. The results demonstrated that in control group, disposal index( DI)0 was positively correlated with high density cholesterol(HDL-C), while DI30 was negatively correlated with total cholesterol(TC), triglycerides( TG) and low density cholesterol ( LDL-C), and DI120 was also negatively correlated with TC and LDL-C. In T2DM group, DI0 was negatively correlated with TC and LDL-C, DI30 was negatively correlated with TC, TG, LDL-C and TG/ HDL-C, DI120 was negatively correlated with TC, TG, LDL-C and TG/ HDL-C.

Objective To assess the effect of the Asthma Healthy Breathing Center on healthy behaviour of asthma patients . Methods Asthma Healthy Breathing Center management mode including asthma specialist out-patient ,asthma health mission cen-ter and asthma patients club .Doctors ,nurses and patients participated jointly in standard treatment ,systematic education manage-ment on asthma patients .the change of treating patients and self management present situation ,the symptoms and lung ventilation function of 144 asthma patients from January 2010 to January 2011 before and after the management were studied .Results After standardization management treatment ,accept and use of inhaled steroid ,correct use of inhaled drugs method ,insisting on drug treatment ,abuse of antibiotics and composition of unknown traditional Chinese medicine(TCM)of 144 patients have been improved significantly from 41 .67% ,20 .14% ,26 .39% ,68 .75% to 93 .06% ,95 .14% ,94 .44% ,6 .25 respectively (P<0 .05) .Knowledge of asthma self-management ,adhere to the peak current meter monitoring used ,records of asthma diary ,health education activities have been improved significantly from 12 .50% ,5 .56% ,5 .56% ,13 .89% to 75 .00% ,88 .89% ,88 .89% ,95 .83% (P<0 .05) .ACT as-sessment ,FEV1 predicated value ,PEF predicated value have been improved from 15 .00 ± 3 .34 ,60 .2 ± 13 .50 ,63 .65 ± 11 .23 to 23 . 00 ± 2 .23 ,77 .6 ± 8 .30 ,80 .00 ± 6 .50(P<0 .05) .Conclusion Establishing Asthma Healthy Breathing Center can significantly im-prove the patient′s health behavior ,and it indicated that establish Prompt construction area slow disease control and prevention cen-ter is effective and necessary for the treatment of patients with asthma .

Objective The variation of serum thyroid hormones within the euthyroid range may be associated with insulin sensitivity.The study was to investigate whether the variation of thyroid hormones within the euthyroid range could influence insulin sensitivity in elderly patients with type 2 diabetes mellitus (T2DM). Methods 200 elderly inpatients and outpatients with type 2 diabetes were collected from September 2013 to May 2014 in our hospital for T2DM group.150 normal controls with normal glucose metabolism were taken as the control group.Blood samples were collected after 75g oral glucose tolerance test(OGTT) on all the re-search objects.Questionaire survey, physical examination and related metabolic index test were also done on them .Chemilumines-cence method were applied to detect their insulin, thyroid stimulating hormone(TSH), FT3 and FT4. Results FT3 levels were significantly lower in T2DM group than in control group[(4.05 ±0.27 )pmol/L vs (4.61 ±0.5)pmol/L), P<0.05].TSH levels were significantly higher in T2DM group than in control group[(2.75 ±1.07) IU/mL vs (2.28 ±0.89) IU/mL, P<0.05], while there was no significant difference as to FT4 levels between these two groups.All subjects were divided into three groups according to the tertiles of FT3 level, Matsuda index of high FT3 level group were significantly higher in comparison to middle and low FT3 level groups, while there was no significant difference as to HOMA-IR in the three groups.FT3 levels were negatively correlated with HO-MA-IR and positively correlated with Matsuda index .After stepwise regression analysis, there was significant positive association be-tween FT3 and Matsuda index. Conclusion Thyroid hormone especially FT3 is significantly associated with insulin resistance .FT3 may participate in the development of type 2 diabetes, which pro-vides a new treatment for T2DM.

Objective To investigate the accuracy and applied value of measurement of pulmonary flow velocity with phase-contrast MRI(PC-MRI).Methods ①42 healthy volunteers were divided into 2 groups randomly,one group was examined by PC-MRI,another was examined by doppler ultrasound.The inner diameter,maximum velocity and mean velocity of main pulmonary artery(MPA) were measured;②The flow volume of MPA in a cardiac cycle was calculated with formulation.Results ①The inner diameters of MPA measured with PC-MRI and doppler ultrasound were(24.4?3.41) mm and(21.5?2.55) mm respectively;②The maximum velocity and mean velocity of MPA measured by PC MRI were(79.9?24.0) cm/s and(50.3?7.71) cm/s respectively;③The maximum velocity and mean velocity of MPA gained by doppler ultrasound was(88.8?8.33) cm/s and(53.7? 5.04) cm/s resepectively;④The flow volume of MPA in a cardiac cycle measured by PC MRI and doppler ultrasound was(73.5?6.60) ml and(69.0?10.6) ml respectively.The results were analyzed by group sample t-test,and the level of test was 0.05.Conclusion The blood flow velocity and volume of pulmonary artery can be measured accurately by PC-MRI,it is of certain applied value in assessing the pulmonary blood flow dynamics changes.

Objective To evaluate the efficacy and safety profile of a recombinant human tumor necrosis factor receptor: Fc fusion protein in ankylosing spondylitis (AS). Methods This was a multicenter,randomized, double-blind, placebo-controlled trial in the first 6 weeks and then followed by an open-labeled trial in the next 6 weeks. One hundred and forty-three patients of active AS were randomly assigned to receive 25 mg twice-weekly subcutaneous injections of rhTNFR:Fc or placebo for 6 weeks. The primary endpoint was proportion of ASAS20 responders at week 6. The secondary endpoints were the proportion of subjects achieving a BASDAI 20%, BASDAI 50% and BASDAI 70% improvement at week 6. Other secondary endpoints, related to reducing signs and symptoms of AS and improving range of motion and physical function, were evaluated.Results Treatment with rhTNFR:Fc resulted in significant improvement. At 6 weeks, 68% of the 71 patients in the rhTNFR: Fc group had a treatment response, as compared with 28% of those in the placebo group(P＜0.01). Improvements over base-line values for other measures of disease activity were significantly greater in the rhTNFR:Fc group, rhTNFR:Fc was well tolerated, The most frequently treatment related adverse event was injection site reaction. Conclusion rhTNFR:Fc has demonstrated consistent evidence of efficacy and is well tolerated in the treatment of active AS.