Objective:To explore effectiveness of Russell Barkley's parent training in children with comorbid attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD),and to evaluate its applicability in mainland China.Methods:Parents of 30 DSM-Ⅳ ADHD+ODD children were given 10 weekly trainings.Results:Total numbers of symptoms,symptoms of ADHD,symptoms of inattention,hyperactivity/impulsivity and ODD declined significantly(P

Objective:To explore risk factors of attention deficit hyperactivity disorder(ADHD) comorbid with oppositional defiant disorder(ODD) in children.Methods:Parents of 43 pure ADHD+ODD children,and 43 pure ADHD children(criteria of DSM-Ⅳ;group matched by sex,age and ADHD subtypes) were asked to complete a set of investigation questionnaires including child and family information;family history;pregnancy,delivery and infancy complications;physical development and temperament;and predisposing factors and parents' or teachers' responses toward children's misbehaviors.Results:Probabilities of psychosis or schizophrenia of family members,long-term conflict between parents and parents' constant/stringent criticism to children in ADHD+ODD group were significantly higher than those in ADHD group(psychosis or schizophrenia of family members(16% vs 2%,P=0.058,OR=8.167);long-term conflict between parents(23% vs 7%,P=0.035,OR=4.040);parents' constant/stringent criticism to children(51% vs 28%,P=0.027,OR=2.706);probability of having anoxia at birth in ADHD group was significantly higher than that in ADHD+ODD group(12% vs 0,P=0.055,OR=0.469).Setting diagnosis of ADHD+ODD as dependent variable,and factors with significant difference between the two groups as independent variables,after 2 steps of regression analyses,one factor,i.e.parents' constant/stringent criticism to children was left in the model(P=0.054,OR=2.879).The regression formula had a sensitivity of 53.5%,a specificity of 83.7%,and total correction rate of 68.6%.Conclusion:Inappropriate parenting is a risk factor of ADHD comorbid with ODD,and long-term conflict between parents and positive family history of psychoses might have influence on ADHD comorbid with ODD.

Accessory pathway-induced dilated cardiomyopathy is a new diagnosis proposed recently.Pre-excitation of part of the myocardium may mediate electrical and mechanical dyssynchrony,which will result in decreased left ventricular systolic function and increased diameter of left ventricle in patients with right-sided overt accessory pathways (type B ventricular preexcitation).Its features are listed as follows:(1) Incessant and prolonged tachyarrhythmia never happened.Tachycardiomyopathy and other causes of dilated cardiomyopathy are excluded.(2) Right-sided overt accessory pathways are shown by electrocardiogram.(3)Echocardiography indicates dyssynchronous left ventricle contraction,decreased left ventricular systolic function and increased diameter of left ventricle.Normal interventricular septal motion,recovered left ventricular and reversed left ventricular remodeling can be realized by radiofrequency ablation with a good prognosis.To infant patients,taking anti arrhythmia drugs to inhibit the conduction of the accessory pathway was recommended.

Objective To observe the change of glucocxnticoid(GC) and the messenger RNA expression of its receptor(GRmRNA) in MRL/lpr mice with the intervention of nourishing yin and clearing heat decoction.Methods Forty MRL/lpr mice were randomly divided into four groups:model control group,TCM group,west medicine group,combined treatment of traditional chinese medicine and west medicine group,10 mice in each group.The group was intragastrically administrated normal sodium,nourishing yin and clearing heat decoction,prednisone suspension,nourishing yin and clearing heat decoction plus prednisone suspension,0.5 mL every time,once daily for 10 weeks respectively.Meanwhile,10 Kungming mice were selected as normal group,administrated normal sodium,like the model group.The expression of glucocxnticoid receptor-alpha and beta(GR?mRNA,GR?mRNA) were detected by reverse transcription polymerase chain reaction(RT-PCR).Results Compared with normal,the expression of GRmRNA was increased in model groups,but the level of GC was not different.Compared with model group,GR?mRNA and GR?mRNA of MRL/lpr mice were improved in all treatment groups,especially in combined treatment of traditional Chinese medicine and western medicine group.Conclusion Nourishing yin and clearing heat decoction has effect of upregulating the expression of GRmRNA in MRL/lpr mice,so as to enhance the effect of glucocorticoid and reduce its side effects.

Objective To study the clinical effect of the treatment of patients with bronchial dilation in the treatment of patients with the combination.MethodsWenzhou Hospital of integrated traditional Chinese and Western Medicine in March 2013~July 2015 diagnosed and treated with bronchial dilation and infection of 72 cases of elderly patients, according to the random number table method is divided into the study group and the control group, each group of 36 people.Two groups were given conventional intervention of bronchial dilation.The control group in the conventional intervention based on the given first cell risperidone sulbactam sodium and ambroxol intravenous injection treatment.The study group in the control group on the basis of the implementation of the whole treatment plan based on bronchial alveolar lavage and local administration of rice.Compared with the two groups, the main symptoms and signs of the total improvement time, blood gas indicators before and after treatment.ResultsThe study group cough sputum, fever and chest X-ray shadow the significant remission time were significantly faster than that of the control group (P<0.05).After treatment, two groups above the index of blood gas analysis were group than before treatment significantly improved (P<0.05) study group on each index improved significantly better than the control group (P<0.05).ConclusionAged bronchiectasis infection patients given according to for etimicin plus bronchoalveolar lavage can be more significant to promote the improvement of patients with respiratory symptoms and signs, curb inflammation.At the same time, the index of blood gas and respiratory function in patients with more significant.

Objective To master the status of"Knowledge Attitude Practice"(KAP)methodology used in China by philological research.Methods Choosing the appropriate key words to retrieve the literatures based on CNKI total library,removing the false one by intensive reading,and analyzing the valid literatures in different ways based on which subject.Results①The amount of related literatures rising steadily from the middle of 1990's and remarkably since 2000.②The over 2000 valid literatures were mostly distributed in the healthcare field,and the most common subjects related in which were disease control,nourishment,smoking control,sex,conception control,drug abuse etc.③Not all of the research reported in the literatures performed the 3 core elements of KAP, and most of the literatures did not mention about the special interference on the targets,let alone the result analysis of the interference.④There were few literature whose main topic is KAP methodology.⑤The terms used for representing the KAP concept are not standardized.Conclusion ①The KAP methodology had been introduced into China and had been widely used in many fields.but the Chinese concept and terms of which should be more standardized,and the usage of which in some special application should be more advanced.②The KAP methodology Can be used and should be useful in TCM healthcare monitoring.

OBJECTIVE:To provide reference for clinical rational use and purchase of TCM decoction pieces for rheumatism. METHODS:Using Excel software,the application of TCM decoction pieces for rheumatism in our hospital during 2010-2014 was analyzed statistically in respects of drug type,consumption quantity and consumption sum,etc. RESULTS:The consumption quan-tity of TCM decoction pieces for rheumatism increased from 46 026 kg to 79 139 kg in our hospital during 2010-2014,and annual growth rate was 14.68%;consumption sum increased from 3 851 300 yuan to 6 403 800 yuan,with annual growth rate was 15.46%;consumption quantity ratio was 2.48%-2.85%. Among antirheumatic drug subtype,the quantity of drugs for antirheumatic and dissipating cold was the largest (accounting for 51.43%-58.42%),followed by drugs for antirheumatic and strengthening the bones and muscles(accounting for 23.05%-28.42%)and drugs for antirheumatic and clearing heat(accounting for 18.53%-21.08%). Top 3 TCM decoction pieces for rheumatism in the list of annual quantity were Viscum coloratum,Cynanchum paniculatum and Clematis chinensis/Chaenomeles sinensis during 2011-2014. Top 3 TCM decoction pieces for rheumatism in the list of consumption sum were Zoacys dhumnades,C. paniculatum and V. coloratum during 2011-2014. CONCLUSIONS:Both consumption quantity and consumption sum of TCM decoction pieces for rheumatism have increased year by year in our hospital,but the ratio of total quantity to total amount and medication structure keep stable,and TCM for expelling wind-damp and dispelling cold is the greatest in consumption quantity which is in line with clinical drug use characteristics. Purchasing staff can purchase drugs predictably ac-cording to the results.

Objective To investigate the visual spatial attention of occipital stroke patients with hemianopia during the acute phase.Methods Eight occipital stroke patients with homonymous hemianopia of left side in the acute stage and 10 age-matched healthy controls were recruited to examine the capability of visual spatial attention.The cue-target paradigms were applied in this behavioral research.Results In the repeated measures analysis of variance,the difference of group and cue range had distinct main effect in reaction time and accuracy rate,while the difference of target location only had main effect in reaction time.Compared with the control group,the patients exhibited longer reaction time ((1 628.26 ± 183.97) ms vs (839.79±61.29) ms,F(1,16) =163.706,P＜0.05) and lower accuracy rate (73.40％ ±3.12％ vs 92.99％ ±0.76％,F(1,16) =371.850,P ＜ 0.05).The patients displayed lower accuracy rate under large cue than small cue (71.38％ ±3.35％ vs 75.42％ ±4.23％,F(1,7) =6.706,P ＜0.05),while that of healthy controls did not vary under different cue range(93.01％ ± 0.50％ vs 92.96％ ± 1.42％,F(1,9) =0.010,P ＞ 0.05).The patients showed longer reaction time in blind-side target than healthy-side target ((1 664.17±196.57) msvs (1 594.35±174.45) ms,F(1,7) =14.157,P＜0.05),while that of control group in two target location had no statistically significant difference ((839.67 ± 60.41) ms vs (839.91 ±73.54) ms,F(1,9) =0.000,P ＞0.05).Furthermore,the mean reaction time of stroke patients had a negative correlation with the binocular vision field index (r =-0.824,P ＜ 0.05).Conclusions The extent of vision field loss in occipital stroke patients with hemianopia can reflect impairment of visual spatial attention during the acute phase.The rehabilitation training should emphasize promoting recovery of visual spatial attention in the blind side under large cue.

Objective To explore the surgical methods in the treatment of carotid aneurysms. Methods A retros-pective analysis was made on the operations and results in 21 cases with 24 carotid aneurysms. Of the 24 carotid aneurysms, 18 were true and 6 false aneurysms. Nineteen cases underwent various operations including emergency operation in 3 cases. Carotid shunting device was used in 3 cases during operation. Results 2 cases were re-operated because of the recurrence of aneurysm,and 17 cases had satisfactory outcome without complications.None died in this series in perioperative period. Conclusions For carotid aneurysms,the first choice of treatment is syrgery.Surgical treatment is relatively safe and effective.

Objective:To investigate methylphenidate response to different subtypes of attention deficit hyperactivity disorder(ADHD) boys by measuring the changes of the alpha competitive structure after administration of single dose of methylphenidate,explore the neuropathological mechanism and search for the sensitive index to predict methylphenidate response in this disorder.Methods:The study involved 88 ADHD boys(40 ADHD-C boys,48 ADHD-I boys) who met the DSM-Ⅳ diagnostic criteria of ADHD,and their continuous Electroencephalogram(EEG) data collected before and 2 hours after taking methylphenidate(10 mg) were analyzed with EEG-encephaloflutuographic technology(EEG-ET).Results:After taking methylphenidate,(1) The main frequency of alpha band obviously increased in ADHD-C boys and ADHD-I boys(from 9.05?0.96 Hz up to 9.72?0.99 Hz,P=0.000;from 8.90?0.93 Hz up to 9.25?0.86 Hz,P=0.002;separately),especially in ADHD-C boy group(Z=-2.111,P=0.035).(2) The dominant probability of 8 Hz was significantly decreased in ADHD-C boys and ADHD-I boys(from 24.34%?12.70% down to 20.74%?12.46%,P=0.002;from 28.82%?12.51% down to 25.64%?12.176%,P=0.003;separately).There was no significant difference in the changes of the dominant probability of 8 Hz between the two ADHD groups(Z=-0.494,P= 0.621).(3)The entropy value was significantly decreased in ADHD-I boys group(from 0.74?0.10 down to 0.70?0.13,t =3.579,P=0.001).There was no significant difference in the changes of the entropy value between the two ADHD groups(Z=-1.131 P= 0.258).Conclusion:After administra-tion of single dose of methylphenidate,slow ? wave decreased in ADHD boys,especially in ADHD-Cboy group;Single dose of methylphenidate can ameliorate the brain self-organization of ADHD-I boys.These findings suggest that the main frequency of alpha band may be the sensitive index to predict methylphenidate response in ADHD.