Surgical Efficacy among Laparoscopic Ultrasonic Dissectors in Adenomyosis.

OBJECTIVES: The present study aimed to investigate the efficacy of ultrasonic dissectors for adenomyomectomy using the double/multiple-flap method combined with temporary occlusion of the temporary bilateral uterine artery and the utero-ovarian vessels for the treatment of symptomatic adenomyosis. DESIGN: This was a retrospective study. PARTICIPANTS: In total, 162 patients with symptomatic adenomyosis were included, and all of them had originally been scheduled to group A (n = 82) and group B (n = 80) with each group representing a different surgical application. All eligible women were informed of the potential complications, benefits, and alternatives of each approach before they were assigned to one of the two groups, and patients chose group A or group B by themselves. In group A, we performed laparoscopic ultrasonic dissectors in adenomyosis with the double/multiple-flap method combined with temporary occlusion of the bilateral uterine artery and utero-ovarian vessels, while in group B, we performed adenomyomectomy with scissors. During the period of treatment, we evaluated operative time, intraoperative blood loss, and the degree of fatigue of surgeons' fingers. RESULTS: The estimated blood loss, operative time, and the degree of fatigue of surgeons' fingers in group A were significantly lower than that in group B (p < 0.001). No serious perioperative complications were observed in either group. LIMITATIONS: This was a retrospective study. CONCLUSION: The use of ultrasonic dissectors in laparoscopic adenomyomectomy with temporary occlusion of the bilateral uterine artery and the utero-ovarian vessels leads to improvements and releases the fatigue of surgeons' fingers in laparoscopic adenomyomectomy.

Atypical asthma in children who present with isolated chest tightness: risk factors and clinical features.

ObjectiveAsthmatic children presenting with chest tightness as the only symptom have not been widely recognized. This study attempted to find risk factors, summarize clinical features and offer some suggestions for the diagnosis of this atypical asthma.Methods: We studied 94 children, aged 6 to 14 years, who complained only of chest tightness. Data from clinical manifestations and laboratory tests were analyzed. The atypical asthma group (n = 58) showed positive bronchial challenge tests, and symptoms either improved or resolved in response to the bronchodilator. The control group (n = 36) had negative results on the bronchial challenge, diurnal PEF, and BDR tests, and no response to asthma treatment with bronchodilator.Results: Pollution, weather, recent house renovation, and air-conditioning use may be risk factors for children with atypical asthma. These children had more accompanying symptoms of rhinitis and rhinitis family history (P < 0.05), and a higher positive detection rate of inhaled allergens and multiple sensitizations. Parameters of the pulmonary function test were lower in the atypical asthma group than in the control group, and they also had higher FeNO values. If a cutoff value of improvement in FEV1 of BDR were set at 8.9%, sensitivity would be 48.2%, which is higher than a 12% cutoff.Conclusions: Environmental factors appeared to cause development of the isolated chest tightness symptom. Clinical history and laboratory tests could provide partial values for this diagnosis. In the absence of a bronchial challenge test, a margin of improvement in FEV1 of BDR set at 8.9% may be helpful.

Early life exposure to particulate matter and childhood asthma in Beijing, China: a case-control study.

A case-control study was conducted to examine the association of particulate matter exposure during the pre-natal (the first, second, and third trimesters. and the whole pregnancy) and post-natal periods (the first year after birth) with childhood asthma in Beijing, China. Multivariable logistic regressions showed that childhood asthma was significantly associated with exposures to PM2.5 and PM10 during the entire pregnancy, with ORs of 1.28(95%CI:1.06-1.56) and 1.21(95%CI:1.02-1.42), respectively. The highest association with a 10 µg/m3 increase in PM2.5 and PM10 were both seen for the second trimester, with ORs of 1.17(95% CI: 1.05-1.30) and 1.14(95% CI: 1.04-1.24). Subgroup analyses suggested that significant and positive effects were subject to be observed in children with a family history of atopy. This study added evidence that exposures to PM2.5 and PM10 during pregnancy might increase the risk of childhood asthma in seriously polluted area, highlighting stronger associations in the second trimester.

A cross-sectional study of the prevalence of food allergies among children younger than ages 14 years in a Beijing urban region.

Background: The prevalence of food allergies has increased over the past several decades, but little is known about this issue in Beijing. Objective: The objectives of this study were to assess the prevalence of food allergies in the Beijing urban area and to summarize the clinical features and common food allergens in children <14 years of age. Methods: We conducted a cross-sectional study of children ages 0-14 years who were recruited from 10 kindergartens and 20 primary and middle schools in two communities in the central region (Xicheng district). After the administration of a screening questionnaire, those who reported symptoms of food allergies were interviewed for further diagnoses. All data were analyzed by using χ² tests. Results: Of the 13,073 enrolled children, 423 children (3.2%) were deemed by physicians to probably have food allergies. The boys exhibited a significantly higher prevalence than did the girls (3.6 versus 2.9%, respectively, p < 0.05). Among the children with probable food allergies, 58.9% reported skin symptoms, which were the most frequently occurring symptom type. Preschool age was the most common onset age for food allergies, with a rate (41.8%) that was higher than those for infants (27.1%) and school-age children (31.1%) (p < 0.01). Fruit was the most commonly reported food allergen (46.8%). Food allergies due to milk and eggs mainly occurred during infancy, and fruit allergies occurred in preschool- and school-age children. The seafood allergy prevalences were nearly the same across the three age groups. Conclusion: The total prevalence of probable food allergies in children <14 years of age in the Beijing urban area was 3.2%, and the prevalences were different between genders and among ages and foods. Skin symptoms were the most common manifestation. Fruit and seafood were the most common allergens.

Laparoscopic Myomectomy with Temporary Bilateral Uterine Artery and Utero-Ovarian Vessels Occlusion Compared with Traditional Surgery for Uterine Fibroids: Blood Loss and Recurrence.

AIM: To determine the optimal hemostatic technique for laparoscopic myomectomy (LM) by comparing temporary uterine artery blockage alone or combined with blockage of the utero-ovarian vessels. PATIENTS: Women with symptomatic uterine myoma attending the Department of Obstetrics and Gynecology in Jinhua Municipal Central Hospital. METHOD: A total of 200 patients with symptomatic uterine fibroids were randomly divided into Group A (n = 65), Group B (n = 67) and Group C (n = 68). At the beginning of the procedure, 6 U of vasopressin was injected into the myometrium of all women. LM was performed in Group A; temporary bilateral uterine artery occlusion and myomectomy were performed in Group B and temporary bilateral uterine artery and utero-ovarian vessel occlusion was performed in Group C. We then evaluated operative time, perioperative bleeding, follow-up relief of menorrhagia, and the recurrence of fibroids. RESULTS: General characteristics of the patients were similar across all 3 groups. All patients underwent successful laparoscopic operation and none of the cases needed to be converted to laparotomy; there were no intraoperative complications. There was no significant difference in the operative time between groups (p = 0.332 and p = 0.346 for single-myoma and multiple-myoma respectively), and for both single and multiple-myoma groups, the blood loss was significantly lower in Group C than Groups A and B (p < 0.001). There were no differences in the recurrence rate and menorrhagia symptom relief outcomes when -compared across the 3 groups at the 30-month follow-up (p = 0.953 and p = 0.841, respectively). At final follow-up, the pregnancy rate of the sexually active patients without contraception was not statistically significant (p = 0.958). The fertility index of anti-Mullerian hormone showed no statistical difference between groups preoperatively or at 2 days, 3 months, 6 months, and 1 year postoperatively (p = 0.998, p = 0.965, p = 0.999, p = 0.994 and p = 0.993, respectively). CONCLUSION: LM with temporary bilateral uterine artery and utero-ovarian vessels occlusion has the advantages of less intraoperative bleeding compared with LM and laparoscopic transient uterine artery ligation and does not increase the mean operative time.

Changes in the Level of Immunoglobulins and CD4/CD8 Ratio in Young and Aged Mice with Estradiol Deficiency.

Studies demonstrated that deficiency in 17ß-estradiol (E2) in postmenopausal women influences their immune system. However, few studies have reported alterations in immunologic presentation during nonnatural menopause in young females. Here we compared the differences in immune response between young C57BL/6N mice with surgical or medical variectomy and aged C57BL/6N mice with the common feature of E2 deficiency following Con A stimulation. We observed inverted CD4/CD8 ratios in the aged group and apparent reduced production of serum immunoglobin (Ig)G, IgA, and IgM in the surgical group, whereas changes in immune parameters in the medical group were moderate. These data suggested that the immunological response to Con A stimulus differed among the three groups and that E2 deficiency was only partially responsible for the development of immune deficiency in aged mice.

AMH trend after laparoscopic cystectomy and ovarian suturing in patients with endometriomas.

PURPOSE: To evaluate the ovarian reserve after laparoscopic cystectomy with suturing in patients with endometriomas. METHODS: A total of 80 women with unilateral or bilateral endometriomas underwent laparoscopic cystectomy using sutures for hemostasis after the excision of ovarian cysts. Serum levels of antimullerian hormone (AMH) and FSH were measured at the day 3 of menstrual cycles preoperatively, 6 and 12 months postoperatively. RESULTS: In the bilateral endometrioma group, serum AMH level decreased significantly from the baseline (4.68 ± 2.87 ng/ml) to 6 months (3.05 ± 1.99 ng/ml) and 12 months (2.26 ± 1.88 ng/ml) postoperatively, whereas the FSH level increased significantly from baseline to 12 months postoperatively (P < 0.05). Those patients with unilateral endometriomas also had lower levels of AMH in 6 and 12 months after operation. When compared between unilateral and bilateral endometrioma group, the rate of AMH decline 6 and 12 months and the rate of FSH increase 12 months postoperatively reached statistical significance (P < 0.05). CONCLUSIONS: The changes of the AMH and FSH values suggest that the ovarian reserve is obviously reduced in spite of suturing technology used as a method of hemostasis after stripping ovarian endometriomas, especially in those with bilateral cysts. The protective effect of the ovarian suturing for ovarian reserve may be marginal.

[The prevalence of asthma in children: a comparison between the year of 2010 and 2000 in urban China].

OBJECTIVE: To compare the prevalence of asthma in children aged 0-14 years by the epidemiological survey for children in urban China between the year of 2000 and 2010. METHODS: Cities participated in the national survey of asthma prevalence in urban children aged 0-14 years at 2000 and 2010 were selected. The surveyed sample sizes met the study requirements. Stratified multistage random cluster sampling and unified questionnaire screening were adopted in both surveys of 2000 and 2010. For screening-positive children, asthma was diagnosed by physicians through on-site visits, physical examination, medical records review and auxiliary examination results. Double entry and validation was adopted for all data using Epi-Info software, and analysis was carried out by SPSS V19.0. RESULTS: Thirty-three cities were selected for this study. The prevalence of asthma was 1.59% in 2000 and 2.11% in 2010, respectively. The highest prevalence of asthma was seen in Hefei and Shanghai respectively in the two surveys, while the lowest prevalence was seen in Xining and Lhasa. The prevalence rate increased in most of the cities, especially in Wenzhou, Shanghai and Xining. The prevalence of asthma in boys was significantly higher than that in girls in the two surveys, with a ratio of 1.67:1 and 1.58:1, respectively. Preschool age (aged 3-6) had the highest prevalence in both surveys, and nearly 80% of the onset was observed before age 6. Regarding the age of disease onset in the 2000 and 2010 surveys, 54.92% and 43.30% were found in infants, 45.08% and 56.70% in preschool and school-age, respectively. CONCLUSIONS: In the recent 10 years, childhood asthma prevalence rate increased significantly in urban China and the prevalence increased 32.70% in children younger than 14 years in 2010 than before. Most cities had a higher prevalence rate than before, but mainly in first-tier cities, provincial capitals and eastern coastal cities. Preschool children showed the highest prevalence of asthma. The age of asthma onset was increasing, with a higher prevalence in preschool and school-age children as compared to 10 years ago.

Temporary bilateral uterine artery occlusion combined with vasopressin in control of hemorrhage during laparoscopic management of cesarean scar pregnancies.

STUDY OBJECTIVE: To describe temporary bilateral uterine artery occlusion with titanium clips in combination with vasopressin as an effective surgical intervention to control hemorrhage during laparoscopic management of cesarean scar pregnancies (CSPs). DESIGN: Retrospective study (Canadian Task Force classification III). SETTING: University hospital in an obstetrics and gynecology department. INTERVENTIONS: Five patients with CSPs underwent removal of gestational ectopic masses via laparoscopy. At the beginning of the procedure, all 5 women had temporary bilateral uterine artery occlusion with titanium clips, and vasopressin 6 U was injected into the myometrium. MEASUREMENTS AND MAIN RESULTS: Clinical data, serum ß-human chorionic gonadotropin levels, operative times, and operative blood loss levels were recorded. The mean gestational age at the time of CSP diagnosis was 9.2 ± 1.9 weeks. The mean serum ß-hCG level on the day of surgery was 14262 ± 12870 IU/L. The mean operative time was 86 ± 21.6 minutes, the mean uterine artery occlusion time was 58 ± 13.8 minutes, and the mean blood loss was 144 ± 79.6 mL. No cases were converted to laparotomy, no blood transfusions were required, and there were no complications. CONCLUSIONS: Laparoscopy combined with titanium clip occlusion of the uterine arteries bilaterally with vasopressin injection is an effective, minimally invasive procedure to preserve the uterus in patients with a CSP.

Management of caesarean scar pregnancies using an intrauterine or abdominal approach based on the myometrial thickness between the gestational mass and the bladder wall.

AIM: To describe our experience with various interventions for caesarean scar pregnancies (CSPs) based on the myometrial thickness between the gestational mass and the bladder. METHODS: All patients were initially administered methotrexate. Then, the appropriate therapies hysteroscopy alone or combined with uterine artery embolization (group A) and direct laparoscopy alone or combined with laparoscopic uterine artery occlusion (group B) was selected based on the myometrial thickness between the gestational mass and the bladder. RESULTS: The uteri of all 53 patients with CSPs were conserved; no conversion to laparotomy or blood transfusion was required. Uterine rupture occurred in one case during surgery in group A. The operative time in group B was longer than group A (42 ± 18 vs. 80 ± 33 min; p = 0.022). The two groups were also similar with respect to other characteristics (p > 0.05). CONCLUSION: Myometrial thickness should be considered during the management of CSPs. Surgical approaches in the treatment of CSPs using 2-mm boundaries may yield an optimal clinical outcome.

[Epidemiological survey of children asthma prevalence in Beijing urban area].

OBJECTIVE: To explore the prevalence, diagnosis and management of childhood asthma in Beijing urban area. METHODS: Multi-stage, stratified and random cluster sampling was used to recruit children born during November 1, 1995 to October 31, 2010 from Beijing or other provinces but residing in Beijing for over half a year. The same screening questionnaires for the third national epidemiological survey of children's asthma were distributed to parents of children at schools, kindergartens and communities during October 2010 to March 2011. Asthmatic children were picked among the screening-positive children based on on-the-spot inquiries, physical examinations, medical records and supporting test results. Further survey of asthmatics was carried out to investigate the diagnosis and treatment status of childhood asthma and other associated allergic diseases. All data required double entry by Epi-Info 3.5.3 software and were processed by SPSS 19.0. RESULTS: Among a total of 14 085 questionnaires, 13 513 were completed with a response rate of 95.94%. And 497 (3.68%) children were diagnosed with typical (n = 451, 3.34%) and cough variant (n = 46, 0.34%) asthma. Among them, 40.64% (202/497) were newly diagnosed and 59.36% (295/497) had been previously diagnosed with asthma. The prevalence of asthma was higher in boys than in girls (4.80% (345/1790) vs 2.40% (152/6323), χ(2) = 54.446, P < 0.01). The asthma prevalence of preschoolers (3 - < 7 years old) was the highest (5.05% (180/3563)). In the past two years, the symptoms of 69.42% (345/497) children persisted and the current two-year prevalence of asthma was 2.55% (345/13513). Among the 295 children with previous asthma, only 46.44% (137/295) received inhaled corticosteroids according to the Global Initiative for Asthma (GINA) and 82.37% (243/295) of them used antibiotics. CONCLUSIONS: The prevalence of asthma is 3.68% in children under 14 years old in Beijing urban area and it varies in children with different genders and ages. A considerable number of children are not diagnosed or treated properly. And the management of asthma requires further improvement.

Effect of coexisting adenomyosis on tumour characteristics and prognosis of endometrial cancer: A systematic review and meta-analysis.

To compare clinicopathological features and survival outcomes in patients with endometrial cancer, with and without associated adenomyosis. PubMed, Embase and Scopus databases were systematically searched for relevant observational studies. The pooled effect sizes were reported as either hazards ratio (HR) for survival-related outcomes or as odds ratio (OR) for other categorical outcomes. Weighted mean difference (WMD) was reported for continuous outcomes. All the analyses used the random effects model. A total of 21 studies (N = 46,420) were included. Compared to endometrial cancer patients without adenomyosis, patients with associated adenomyosis had improved overall 5-year survival (OS) (HR 0.62, 95% CI: 0.50, 0.79) and disease-free survival (DFS) (HR 0.60, 95% CI: 0.44, 0.82). Disease-specific survival was statistically similar in patients with and without adenomyosis (HR 0.60, 95% CI: 0.35, 1.05). Among patients with adenomyosis, the risk of having an advanced tumour grade (Grade 2 or 3) was lower (OR 0.51, 95% CI: 0.42, 0.62) and a risk of having International Federation of Gynaecology and Obstetrics (FIGO) stage I or II was higher (OR 2.23, 95% CI: 1.65, 3.01). Patients with adenomyosis had lower risk of tumour invasion of adnexa, cervical stromal invasion, deep myometrial involvement (DMI), lympho-vascular space invasion (LVSI) and peritoneal invasion. Presence of adenomyosis in patients with endometrial cancer is associated with favourable tumour characteristics and may improve the survival.

The management of caesarian scar pregnancy with or without a combination of methods prior to hysteroscopy: Ovarian reserve trends and patient outcomes.

STUDY OBJECTIVE: This study compared the efficacy and safety of a combination of uterine artery embolization or methotrexate before hysteroscopy in the treatment of cesarean scar pregnancy. METHODS: We divided 276 cesarean scar pregnancy patients into three groups. Group A underwent direct hysteroscopy; Group B received uterine artery embolization plus hysteroscopy; Group C received the systemic administration of methotrexate prior to hysteroscopy. RESULTS: The patients in Group A lost significantly more blood than those in Groups B (P < 0.05). There were no significant differences between the three groups with regards to massive hemorrhage and transfusion (P > 0.05). None of the patients required hysterectomy. Group A was also associated with a significantly shorter period of hospitalization, reduced medical costs, and fewer adverse events than either Group B or C (P < 0.05). Moreover, among women of advanced age (≥35y), the levels of serum anti-Mullerian hormone in Group B were significantly lower than those of the baseline group (P<0.05), which were significantly lower than those in Group A after surgery (4.22 ± 2.35 vs 2.78± 1.89 ng/ml, P < 0.05). CONCLUSION: Direct hysteroscopy is a reliable treatment option for most early type I cesarean scar pregnancy patients with a gestational sac. A combination of methotrexate and uterine artery embolization before hysteroscopy in these patients has limited remedial effects. uterine artery embolization may reduce ovarian reserve in patients aged ≥35y.

Laparoscopically assisted Adenomyomectomy Using the Double/Multiple-Flap Method with Temporary Occlusion of the Bilateral Uterine Artery and Utero-Ovarian Vessels in Comparison with the Double/Multiple-Flap Only Method.

Introduction Adenomyomectomy is the most conservative surgical treatment for adenomyosis. However, the surgical efficacy of this treatment and the best approach to use are still debated. We aimed to evaluate the efficacy of laparoscopic adenomyomectomy using the double/multiple-flap method combined with temporary occlusion of the bilateral uterine artery and the utero-ovarian vessels to treat symptomatic adenomyosis. Patients We recruited 155 patients with symptomatic adenomyosis and divided them into group A (n = 76) and group B (n = 79), with each group treated using a different surgical approach. All eligible women were informed of the potential complications, benefits, and alternatives of each approach before they were assigned into one of the two groups. In group A, we performed laparoscopic adenomyomectomy with the double/multiple-flap method while in group B, we performed a double/multiple-flap adenomyomectomy combined with temporary occlusion of the bilateral uterine artery and utero-ovarian vessels. Over a 24-month follow-up period, we evaluated operating time, intraoperative blood loss, visual analog scale (VAS) scores, anti-Mullerian hormone levels, uterine volume, and relief of menorrhagia. Results There were no significant differences between groups A and B with respect to VAS scores, relief of menorrhagia and uterine volume at 3 months, 6 months, 12 months and 24 months after surgery (p > 0.05). Both groups showed significant improvement of these parameters after surgery compared with preoperative values (p < 0.05). Blood loss in group B was significantly lower than in group A (p < 0.001) while there was no significant difference in operating times (p > 0.05). Levels of AMH did not differ significantly between the groups throughout the follow-up period (p > 0.05). Conclusion Laparoscopic adenomyomectomy with temporary occlusion of the bilateral uterine artery and the utero-ovarian vessels offers a feasible surgical option to treat symptomatic adenomyoma.

A modified technique to perform para-aortic lymphadenectomy up to the renal vein.

OBJECTIVE: To investigate the safety and feasibility of our modified technique to perform lymph node excision up to the renal vein in cases of gynecological cancer. MATERIALS AND METHODS: 87 patients with endometrial or ovarian neoplasms underwent laparoscopic para-aortic lymphadenectomy (LPAL) up to the left renal vein were enrolled prospectively. During surgery, the surgeon was positioned to the right side of the patient and an additional trocar was introduced into the upper right abdomen. The laparoscopic video screen was placed to the side of the patient's head. Three-fan retractor forceps were used to hold up the duodenum and small bowel. The rest of the procedure was the same as conventional LPAL. RESULTS: The median operating time for LPAL was 72 min (range: 40-115 min) and the median estimated blood loss was 45 ml (range: 15-1000 mL). There were two cases of intra-operative vascular injury. The median number of retrieved para-aortic lymph nodes (PALNs) was 18 (range: 10-37). Of the 87 patients, 11 patients had positive PALNs. None of the cases required laparotomy. CONCLUSION: Our findings demonstrate that our modified LPAL technique is feasible, reproducible, can achieve good exposure and reduces surgical difficulty.

[Ten years comparison of diagnosis and treatment of asthma in urban children in China].

OBJECTIVE: To compare the changes of diagnosis, treatment and control of 0-14 years old urban asthma children during 10 years. METHOD: The questionnaires were given to diagnosed asthmatic children during the national epidemiological survey of asthma in children in 2000 and 2010 to understand the diagnosis and treatment of asthma and the status of the disease control. Children with asthma of a total of 36 cities were involved in this study, and the diagnosed asthma children in recent 2 years were 6,128 and 8 174, separately. Data were stored using epi-info software by double entry, V19.0 of SPSS was used to do the statistical analysis , χ(2) test was used. RESULT: The proportion of correct diagnosis of asthma before investigation in 2010 was 64.6%, while it was 70.7% in 2010, which showed a significant increase (χ(2) = 59.3, P < 0.01). Diagnosis rate of asthma onset within 1 year was separately 50.8% and 78.6% in 2000 and 2010. The early diagnostic rate was significantly higher in 2010 than that in 2000 (χ(2) = 817.7, P < 0.01). In 2000 and 2010 children with asthma medication in the use of inhaled corticosteroids was 36.3% and 61.7%, it increased by 0.7 times in 2010 (χ(2) = 907.5, P < 0.01). Systemic corticosteroids utilization rate was separately 74.2% and 39.1% (χ(2) = 1 730.6, P < 0.01). Beta 2 agonists utilization rate was separately 71.8% and 73.4%, showing a slight rise (χ(2) = 4.3, P < 0.05). Antibiotics usage was separately 97.4% and 76.0%, compared to a decrease of 21.4% (χ(2) = 1 274.2, P < 0.01). In the survey of 2000 and 2010, children with acute asthma attacks within recent 1 year were separately 86.3% and 77.0% (χ(2) = 194.0, P<0.01), hospitalizations for asthma attack were separately 54.0% and 47.3% (χ(2) = 61.7, P < 0.01), rate of absence from school due to asthma less than 10 days was separately 47.5% and 71.4% (χ(2) = 682.6, P < 0.01). CONCLUSION: The rates of correct diagnosis and early diagnosis of asthma in urban Chinese children within 1 year had a significant increase compared with a decade ago. Inhaled corticosteroids therapy had increased by 0.7 times than before while systemic corticosteroids utilization rate significantly decreased. Antibiotics usage had a decrease of 22.0% but they were still overused. Asthma control was significantly improved, but acute exacerbations and hospitalizations of asthma children still accounts for a large proportion although they both had a great improvement.

Prevalence and Treatment of Children's Asthma in Rural Areas Compared with Urban Areas in Beijing.

BACKGROUND: The prevalence of childhood asthma has been increasing in China. This study aimed to compare the prevalence, diagnosis, and treatment of asthmatic children from urban and rural areas in Beijing, China. METHODS: Schools, communities, and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing. Parents were surveyed by the same screening questionnaires. On-the-spot inquiries, physical examinations, medical records, and previous test results were used to diagnose asthmatic children. Information on previous diagnoses, treatments, and control of symptoms was obtained. RESULTS: From 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires, 587 children were diagnosed as asthma. The prevalence of asthma in rural areas was lower than in urban areas (1.25% vs. 3.68%, χ2 = 100.80, P < 0.001). The diagnosis of asthma in rural areas was lower than in urban areas (48.9% vs. 73.9%, χ2 = 34.6, P < 0.001). Compared with urban asthmatic children (56.5%), only 35.6% of rural asthmatic children received inhaled corticosteroids (P < 0.05). The use of bronchodilators was also lower in rural areas than in urban areas (56.5% vs. 66.4%, χ2 = 14.2, P < 0.01). CONCLUSION: The prevalence of asthma in children was lower in rural areas compared with children in the urban area of Beijing. A considerable number of children were not diagnosed and inadequately treated in rural areas.