The 472nd case: dyspnea, pulmonary shadows, abnormalities of whole blood cells / 中华内科杂志

A 54-year-old man was admitted to respiratory department with chief complaints of recurrent cough and dyspnea. Chest imaging showed multiple patchy shadows and interstitial changes. Evidence of infectious diseases was not definite, and antibiotic treatments were not effective. In the meantime, myelodysplasia syndrome was diagnosed with pancytopenia. The pathologic findings of transbronchoscopic lung biopsyshowed chronic inflammatory interstitial changes, suggesting a clinical diagnosis of organizing pneumonia. After glucocorticoids treatment, his condition aggravated. The second percutaneous lung biopsy showed the infiltration of a large number of neutrophils. Therefore, the final diagnosis of myelodysplasia syndrome with Sweet syndrome was made. Then glucocorticoids and supportive treatment were given This case may improve physicians' understanding of myelodysplasia syndrome complicated with Sweet syndrome.

Interleukin-10 regulates functions of dendritic cell through autophagy inhibition / 中国免疫学杂志

Objective:To study the mechanism of interleukin-10(IL-10)inhibiting the function of dendritic cells(DCs).Meth-ods:Cultured C57BL/6 mouse bone marrow-derived DCs were divided into 5 groups:control group,LPS stimulated group,IL-10 treated group,IL-10+Rapamycin treated group and Rapamycin treated group .The regulatory mechanism of IL-10 on dendritic cells were evalua-ted from DCs function ,Flow cytometry was used to analyse the expression of DCs surface co-stimulator CD80 ,CD40 expression ,the abil-ity of uptaking antigen and stimulating T cell to proliferate;ELISA was used to detect the cytokines IL-6 and TNF-α.Western blot was used to analyse the autophagy related protein LC3.Compared the differences between the groups.Results:(1)Compared to LPS stimu-lated group,IL-10 treated group,DCs surface co-stimulator CD40,CD80 were decreased,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to proliferate were decreased ,the ability to capture OVA antigen was increased .Compared to IL-10 treated group ,the DCs surface co-stimulator CD80 was decreased ( P<0.05 ) ,IL-6 and TNF-αsecretion level and the ability to stimulate T cell to prolifer-ate were increased(P<0.0001)in IL-10+rapamycin treated group.In addition,autophagy related proteins LC3Ⅱ/LC3Ⅰwas decreased in IL-10 treated group.Conclusion:IL-10 may regulate functions of DCs through inhibiting the autophagy of DCs .

Association between Genetic Variants of Transforming Growth Factor-β1 and Susceptibility of Pneumoconiosis: A Meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transforming growth factor-beta 1 (TGF-β1) and gene variants have been extensively studied in various human diseases. For example, TGF-β1 polymorphisms were associated with fibrosis and pneumoconiosis, but the data remained controversial. The aim of this meta-analysis was to assess the association between TGF-β1 -509 C>T [rs1800469], +869 T>C [rs1800470], and +915 G>C [rs1800471] polymorphisms and pneumoconiosis.</p><p><b>METHODS</b>A comprehensive literature search was conducted through searching in PubMed, Embase, the Chinese Biomedical Database, and the Wei Pu (Chinese) Database by the end of April 2016. Eleven publications with 21 studies were included in this meta-analysis, covering a total of 4333 patients with pneumoconiosis and 3478 controls. Study quality was assessed, and heterogeneity and publication bias were measured. All statistical analyses were performed using STATA version 12.0 (StataCorp, College Station, TX, USA) software.</p><p><b>RESULTS</b>The data showed significant associations between TGF-β1 -509 C>T polymorphism and the risk of pneumoconiosis development (T vs. C, odds ratio [OR] = 1.35, 95% confidence interval [CI]: 1.00-1.81, P = 0.046); between TGF-β1 +915 G>C polymorphism and the pneumoconiosis risk (C vs. G, OR = 1.69, 95% CI: 1.19-2.40, P = 0.004; CG vs. GG, OR = 1.79, 95% CI: 1.23-2.60, P = 0.002; CC+CG vs. GG, OR = 1.80, 95% CI: 1.24-2.61, P = 0.002). In addition, the subgroup analysis of ethnicity versus pneumoconiosis types indicated a significant association of silicosis among Asian populations but not that of coal workers' pneumoconiosis in Caucasian populations. In contrast, no significant association was exhibited between TGF-β1 +869 T>C polymorphism and risk of pneumoconiosis.</p><p><b>CONCLUSION</b>The polymorphisms of both TGF-β1 -509 C>T and +915 G>C are associated with increased risk of pneumoconiosis.</p>

Application of clinical pathway in the teaching of respiratory medicine for residency standard training program / 中华医学教育探索杂志

Objective To explore the effect and significance of clinical pathway guided teaching in the residency standard training program of respiratory medicine. Methods Total 47 resident physicians were selected and divided into clinical pathway group and control group from March 2014 to November 2014. The pathway group (n=24) was introduced into the teaching guided by clinical pathway management. The control group (n=23) was taught by traditional teaching method. All physicians were tested for the basic theory and the ability of case analysis after 4 weeks training. The ability of chemotherapy strategy ordered by residents independently and correctly was assessed each week during training. A satisfaction questionnaire survey was conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. GraphPad Prism 5.0 was used and T test was done for comparison of data between groups. Results The medical records about basic theory and case analysis in the pathway group was higher than those in the control group with significant statistical difference (P<0.05). The records of resident physicians who could issue orders for chemotherapy independently and correctly were (70.75±2.79), (81.43±1.91), (85.23±1.3), (90.62±2.34) in the pathway group and (69.65±2.06), (77.11±2.21), (80.3±1.96), (87.78±2.21) in the control group at each week time point. There was statistical increase of the records in the pathway group than in the control group since the second week time point (P<0.05) The overall satisfaction of the pathway group was 95.84%(23/24), and the teaching satisfaction was higher than that of the control group(91.29%, 21/23). Pathway group doctors believe that the relevant teaching effectively improve the level of their knowledge , experience and ability. Conclusions The teaching method guided by clinical pathway is help-ful to standardize the teaching behavior, develop the standardized medical behavior of resident physicians, improve their clinical working ability efficiently, promote the relationship between teaching and studying, which is worth application in the residency standard training program of respiratory medicine.

Research progress of the effect of folic acid in pemetrexed-based chemotherapy / 肿瘤研究与临床

This review analyzed the effect of folic acid on pemetrexed efficacy and toxicity, especially high-does folic acid supplementation. The optimal duration for supplementation prior to the first dose of pemetrexed has not been defined. The review also explored whether total plasma homocysteine levels can be as a marker to predict and avoid toxicity from pemetrexed therapy.

Toll-like receptor polymorphisms and tuberculosis susceptibility: A comprehensive meta-analysis / 华中科技大学学报（医学）（英德文版）

The polymorphisms of toll-like receptor (TLR) have been hypothesized to affect the tuberculosis susceptibility. However, the direct evidence remains controversial. Here we performed a comprehensive meta-analysis to summarize the associations between TLR polymorphisms and tuberculosis susceptibility. We systematically searched the PubMed, Embase, Cochrane library, and Chinese National Knowledge Infrastructure up to April 25, 2014. Case-control studies investigating TLR polymorphisms and tuberculosis susceptibility were included in the meta-analysis. Pooled odds ratios and corresponding 95% confidence intervals were calculated for cases and controls. Stata 11.0 and Review Manager 5.1 were adopted to conduct statistical analysis. We included 29 studies, involving 17 804 individuals. The results revealed an obvious increase of tuberculosis risk in TLR2 2258AA, and decreased risk in TLR6 745TT and TLR8 rs3761624 GA genotypes. Meanwhile, different genetic models were performed. TLR8 rs3764879C, TLR8 rs3761624A and TLR8 rs3764880A alleles were associated with high susceptibility, while TLR6 745T and TLR8 rs3788935C alleles were protective. Other polymorphisms, including TLR9 1486C/T, did not show significant associations with tuberculosis infection. Finally, subgroup analysis in TLR8 rs3764880 according to gender found a slight elevated effect of A allele in males. The meta-analysis suggests significant associations between several TLR polymorphisms and tuberculosis, including TLR2 2258G/A, TLR6 745C/T, TLR8 rs3761624, TLR8 rs3764879, TLR8 rs3761624 and TLR8 rs3764880. This study serves as the framework for additional studies to determine further the role of TLRs in tuberculosis infection.

The whole-process management of advanced non-small cell lung cancer according to the EGFR gene mutation state / 中国癌症杂志

Along with prolongation of overall survival and increasing of therapeutic methods in advanced non-small cell lung cancer, whole-process management has become more and more important. We reviewed the whole-process management strategy according to difference of mutation state of epidermal growth factor receptor (EGFR) gene.

Toll-like receptor polymorphisms and tuberculosis susceptibility: A comprehensive meta-analysis / 华中科技大学学报（医学）（英德文版）

The polymorphisms of toll-like receptor (TLR) have been hypothesized to affect the tuberculosis susceptibility. However, the direct evidence remains controversial. Here we performed a comprehensive meta-analysis to summarize the associations between TLR polymorphisms and tuberculosis susceptibility. We systematically searched the PubMed, Embase, Cochrane library, and Chinese National Knowledge Infrastructure up to April 25, 2014. Case-control studies investigating TLR polymorphisms and tuberculosis susceptibility were included in the meta-analysis. Pooled odds ratios and corresponding 95% confidence intervals were calculated for cases and controls. Stata 11.0 and Review Manager 5.1 were adopted to conduct statistical analysis. We included 29 studies, involving 17 804 individuals. The results revealed an obvious increase of tuberculosis risk in TLR2 2258AA, and decreased risk in TLR6 745TT and TLR8 rs3761624 GA genotypes. Meanwhile, different genetic models were performed. TLR8 rs3764879C, TLR8 rs3761624A and TLR8 rs3764880A alleles were associated with high susceptibility, while TLR6 745T and TLR8 rs3788935C alleles were protective. Other polymorphisms, including TLR9 1486C/T, did not show significant associations with tuberculosis infection. Finally, subgroup analysis in TLR8 rs3764880 according to gender found a slight elevated effect of A allele in males. The meta-analysis suggests significant associations between several TLR polymorphisms and tuberculosis, including TLR2 2258G/A, TLR6 745C/T, TLR8 rs3761624, TLR8 rs3764879, TLR8 rs3761624 and TLR8 rs3764880. This study serves as the framework for additional studies to determine further the role of TLRs in tuberculosis infection.

The Current Status of Enteral Feeding Management in General Surgical Ward

PURPOSE: Development of a standardized guideline and assessment tool is necessary. Therefore, the aim is to investigate the current state of enteral feeding management and to develop a basis for a standardized guideline. METHODS: From July 1, 2010 through June 30, 2011, this study was conducted retrospectively for 100 patients who had enteral feeding more than once only in the Intensive Care Unit, after General Surgery at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. The analysis was based on the following factors; age, diagnosis, name of the operation, period of start and the end of enteral feeding, method of injection, flushing method, residual volumes of the stomach, location and the size of the tube, medication through tubing, and complications related to enteral feeding. RESULTS: The mean age of the patients was 60.5, 65 men and 35 women. There were 30 malignant tumors of the hepatobiliary system and pancreas, 8 gastric and duodenal cancer, 4 colon and rectal cancer, 11 peritonitis, hemoperitoneum, and bowel obstruction, and 47 others. The average period of performing enteral feeding was 11.7 days and the locations of enteral feeding tube were stomach 56%, jejunum 39%, duodenum 3%, and undescribed 2%. The methods of enteral feeding were as follows; continuous feeding 19%, cyclic feeding 75%, intermittent and bolus feeding 3%, respectively. Only 1% of patients were on flushing and 16% on stomach residual. The most common complication of enteral feeding was clogging of the tube (5%). CONCLUSION: Due to the lack of detailed charting related to enteral feeding, we were unable to analyze the statistics on the relevance of complication which was the primary endpoint. As a result, development of a standardized protocol on charting enteral feeding is suggested for optimal enteral nutritional support.

In vitro study of safety and co-efficiency of the transbronchial coagulation techniques / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The usual transbronchial coagulation techniques include microwave, argon plasma coagulation (APC), electrocautery and cryotherapy. However, there are serious clinical problems in the safety of each. By analyzing the experimental data and clinical observations, we observed the variable effects of different coagulation techniques via bronchofibroscopy, to look for an optimal interventional management of luminal bronchus diseases, and evaluate the safety and the equivalent point.</p><p><b>METHODS</b>Four kinds of coagulation techniques under bronchoscopy were performed on the fresh bronchus of healthy sheep, and the pathologic changes in all groups were observed under the microscope. The different treatment parameters were as follows: microwave 60 W×1 second, 3 seconds, 5 seconds and 40 W×1 second, 3 seconds, 5 seconds; APC 40 W×1 second, 3 seconds, 5 seconds; electrocautery 40 W×1 second, 3 seconds, 5 seconds; cryotherapy 100 Ω×60 seconds, 120 seconds.</p><p><b>RESULTS</b>After treatment, ovine bronchial mucosa in all groups showed pathologic changes such as local necrosis and amotio of the mucosa lining epithelium, local submucosa coagulative necrosis or tissue defects, while inflammation in the surrounding tissue was not obvious. Under the same output power and action time, different methods had different outcomes. The damage by APC was the most superficial, microwave was the second, and electrocautery caused the worst damage. The study also found that effects of electrocautery at 40 W×3 seconds, microwave at 40 W×5 seconds or 60 W×3 seconds, APC at 40 W×5 seconds and cryotherapy at 100 Ω×120 seconds were the equivalent point conditions. The appearance included mucosa absence, partial submucosa absence, and collagen fiber coagulation in treatment areas.</p><p><b>CONCLUSIONS</b>Each coagulation technique has its own characteristic. It is very important to choose the appropriate power and action time of the suitable method according to the therapy requirement.</p>

Bronchoscopy in some tertiary grade A hospitals in China: two years' development / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although bronchoscopy has been widely performed in China, little has been known about its current state and development. In order to investigate the clinical application of bronchoscopy and make instructions for future education and development, the Chinese Society of Respiratory Diseases conducted postal surveys in both 2008 and 2010 in China.</p><p><b>METHOD</b>Questionnaires were sent to 40 tertiary grade A hospitals in 2008 and 58 tertiary grade A hospitals in 2010 to investigate bronchoscopies performed in 2007 and 2009 respectively.</p><p><b>RESULTS</b>Thirty (75%) hospitals returned the completed questionnaires in 2008 and forty-one (71%) hospitals in 2010. All the respondents possessed flexible bronchoscopes. Fifty percent of the respondents had less than five in 2007, while more than 50% of the respondents had 5-9 bronchoscopes in 2009. All the respondents performed a radiograph or CT scan before bronchoscopy. Percentage of general anesthesia and no pre-medication before bronchoscopy increased, while atropine usage decreased in 2009 compared to 2007. During bronchoscopy, pulse oximetry was the most widely used monitoring method. Most respondents used the nasal route to perform routine bronchoscopy. After the procedure, they used sinks to wash and glutaraldehyde to disinfect the bronchoscopes. The total number of flexible bronchoscopies performed during 2007 was 37 874 and the average was 1262. Whereas in 2009, the total number was 60 178 and the average was 1468. Diagnostic bronchoscopy was more widely used than therapeutic bronchoscopy. The mortality rate was 0.076‰ in 2007 and 0.032‰ in 2009.</p><p><b>CONCLUSIONS</b>The two surveys, to some extent, reflected the current status and development of bronchoscopy in China. The results are worthy of future education and developing of new guidelines. Regular surveys and monitoring of bronchoscopies across China are needed.</p>

Pseudomembranous necrotizing tracheobronchial aspergillosis: an analysis of 16 cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In our clinical practice we have been attracted by a group of patients with airway aspergillosis who have airway obstruction; we termed the condition as pseudomembranous necrotizing tracheobronchial aspergillosis (PNTA). In this study we analyzed the clinical data from patients with PNTA, so as to guide the diagnosis and treatment of the disease.</p><p><b>METHODS</b>A total of 16 PNTA patients were treated in Changhai Hospital from January 2000 to January 2009. Their clinical data, including the demographic information, clinical symptoms, imaging findings, bronchoscopy findings, treatment strategies and efficacy, and prognosis, were retrospectively analyzed.</p><p><b>RESULTS</b>All 16 patients were found to have primary systemic immunodeficiency diseases and/or damage of the focal airways. Nine patients (9/16, 56.3%) had pulmonary and tracheobronchial tumors, 5/16 (31.3%) had tracheobronchial involvement secondary to non-pulmonary tumors, and 2/16 (12.5%) had lung transplantation. The most common causes of PNTA included local radiotherapy (10/16, 62.5%), repeated chemotherapy (7/16, 43.8%) and recurrent intervention therapy by bronchoscope (4/16, 25.0%). Aspergillus fumigatus was the most frequent pathogen (62.5%, 10/16). The main clinical manifestations included progressive dyspnea (14/16, 87.5%) and irritable cough (12/16, 75.0%). The trachea was involved in 9/16 patients (56.3%), right main bronchus in 10/16 (62.5%). All 16 patients were treated with systemic anti-aspergillosis agents, local anti-aspergillosis agents with amphotericin B inhalation and direct perfusion of amphotericin B by bronchoscope, and interventional treatment by bronchoscope to ensure an unobstructed airway. The total efficiency was 31.3%.</p><p><b>CONCLUSIONS</b>PNTA is an infectious disease caused by aspergillus and it mainly involves the trachea, primary bronchus and segmental bronchus. A. fumigatus is the most common pathogen. PNTA can pose a severe clinical threat and often occurs after systemic immunodeficiency and/or local airway damage, with the main symptoms including dyspnea and irritable cough. Bronchoscopic findings supply the main evidence for diagnosis of PNTA. Treatment of PNTA is difficult and requires a long course. Systemic and local anti-aspergillosis agents plus bronchoscopy debridement can improve the prognosis of the disease.</p>

Dexamethasone protects airway epithelial cell line NCI-H292 against lipopolysaccharide induced endoplasmic reticulum stress and apoptosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Endoplasmic reticulum (ER) stress and ER stress-mediated apoptosis were reported to be involved in the pathogenesis of several diseases. In a recent study, it was reported that the ER stress pathway was activated in the lungs of lipopolysaccharide (LPS)-treated mice. It was also found that the C/EBP homologous protein (CHOP), an apoptosis-related molecule, played a key role in LPS-induced lung damage. The aim of this study was to verify whether LPS could activate the ER stress response in airway epithelial cells and which molecule was involved in the pathway. This study was also aimed at finding new reagents to protect the airway epithelial cells during LPS injury.</p><p><b>METHODS</b>ER stress markers were observed in LPS-incubated NCI-H292 cells. SiRNA-MUC5AC was transfected into NCI-H292 cells. The effects of dexamethasone and erythromycin were observed in LPS-induced NCI-H292 cells.</p><p><b>RESULTS</b>LPS incubation increased the expression of ER stress markers at the protein and mRNA levels. The knockout of MUC5AC in cells attenuated the increase in ER stress markers after incubation with LPS. Dexamethasone and erythromycin decreased caspase-3 activity in LPS-induced NCI-H292 cells.</p><p><b>CONCLUSIONS</b>LPS may activate ER stress through the overexpression of MUC5AC. Dexamethasone may protect human airway epithelial cells against ER stress-related apoptosis by attenuating the overload of MUC5AC.</p>

Microwave induces apoptosis in A549 human lung carcinoma cell line / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Microwaves have other biological effects on cancer as well besides killing tumor cells by coagulation. Some studies showed that microwaves may induce apoptosis in some tumor cells. The apoptotic effect of microwaves may help in clinic to remove residual malignant cells nearby the primary lesion and avoid relapse subsequently. However, there is little evidence on this subject from lung cancer. We studied the effect of microwaves on inducing apoptosis in the human lung carcinoma cell line A549 cells, aiming to identify its effect on apoptosis.</p><p><b>METHODS</b>A549 cells were radiated by various intensities and durations of microwaves. Apoptosis induction in A549 cells was analyzed by morphological observations, tetrazolium blue color method (MTT) assays, flow cytometry, immunohistochemistry, and image analyses.</p><p><b>RESULTS</b>Morphological changes in A549 cells, including cell shrinking and nuclear pyknosis, were observed after microwave radiation. Microwaves significantly inhibited metabolic activities and induced apoptosis in A549 cells. The results of the MTT assay showed a significant decrease of cell activities in all the radiation groups compared with the normal control (P < 0.01). The low point of cell activities often appeared at 6 - 12 hours after radiation. Apoptosis was also confirmed by flow cytometry. The early stage apoptotic rate reached 6.10% - 17.98% and the advanced stage apoptotic rate + necrosis rate reached 8.04% - 44.06% at 6 hours after microwave irradiation, in contrast to 2.32% and 4.10% in the respective control groups. Down-regulation of Bcl-2 expression and up-regulation of p53 expression were observed by immunohistochemistry after radiation. In most treated groups, the down-regulation of Bcl-2 expression reached its lowest level at 3 - 6 hours after radiation (integrated optical density (IOD)-6 hours: 2.13 ± 0.08 - 5.14 ± 0.13 vs. control: 5.79 ± 0.10, P < 0.01) and the up-regulation of P53 expression peaked at about 3 hours (IOD-3 hours: 2.61 ± 0.13 - 8.07 ± 0.11 vs. control: 1.29 ± 0.07, P < 0.01). Cell damage, apoptosis, and protein expression levels in the samples differed depending on the radiation intensity and duration.</p><p><b>CONCLUSIONS</b>Microwaves can promote apoptosis in A549 cells. The effect depends on the duration and dosage of microwave radiation. Bcl-2 and p53 proteins may be involved in the apoptotic process of A549 cells induced by microwaves.</p>

The exploration of the standard training program for bronchosocpists / 中华医学教育探索杂志

This article describes the progress of developing the training base and training methods for bronchoscopists at Changhai hospital in recent years,and then discusses the potential issues and solutions that might occure in the course of training,and finally explores the model and methodology to optimize the training program for Chinese bronchosocpists.

Dynamic study on the anti-HBs level of immunized children born to HBsAg-positive and HBsAg-negative mothers in hyperendemic area of hepatitis B / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the dynamic changes of the anti-HBs level among immunized newborn infants born to HBsAg-positive and HBsAg-negative mothers in hyper-endemic area of Hepatitis B.</p><p><b>METHODS</b>Infants who were regularly vaccinated with Hepatitis B vaccine and tested to be anti-HBs positive were divided into two groups according to HBsAg-positive or negative mothers in Long-an, Guangxi. Each subject was followed up 3 times during age 5 to 8. SPRIA was used to test HBsAg, anti-HBs and anti-HBc. Results During the follow-up period, positive rates of anti-HBs in children born to HBsAg-positive mothers ranged between 52.00% and 78.00%, and those with HBsAg-negative mothers was between 43.84% and 54.74%. GMT in two groups was between 55.36 mIU/ml and 95.66 mIU/ml as well as between 39.90 mIU/ml and 65.47 mIU/ml, respectively. There was no statistical significance in both positive rates and GMT between age groups. The anti-HBs level in the follow-up period of children born to HBsAg-positive mothers was higher than that of those born to HBsAg-negative mothers in the same age group. In the age group of 6-8 years with HBsAg-negative mothers, the positive rates in the follow-up period of children with high anti-HBs titers in the primary vaccination were 2.29-2.84 times of those with low titers. The anti-HBs titer of children in a follow-up period was lower than that in the primary vaccination, no matter whether they were born to HBsAg-positive mothers. However, the decline rate of children born to HBsAg-negative mothers was significantly higher than those born to HBsAg-positive mothers (84.91% vs. 61.54%; chi2 = 28.7982, P = 0.000). The incidence rate (25.64%) of a 4-fold increase in antibody titers of children born to HBsAg-positive mothers was significantly higher than that of children born to HBsAg-negative mothers (7.37%) from the primary vaccination to the follow-up period (chi2 = 6.7661, P = 0.009) with was 3.5 times of the latter. Subjects with HBsAg seroconvertion were those with low anti-HBs titers in primary vaccination.</p><p><b>CONCLUSION</b>The anti-HBs level decreased slowly in successfully immunized children from age 5 to 8. The chance of natural booster yielded by natural infection increased in immunized children born to HBsAg-positive mothers. The anti-HBs level in the primary vaccination played an important role in prevention of seroconversion of HBsAg.</p>

Relationship between Tumor Necrosis Factor-alpha and Smoking-related Chronic Obstructive Pulmonary Disease / 中国康复理论与实践

@#Objective To investigate the relationship between tumor necrosis factor-alpha (TNF-α) and development of chronic obstructive pulmonary disease (COPD).Methods COPD patients and controls were divided into three groups: COPD group (n=66), smoker control group (n=42) and health control group (n=23). COPD group was further divided into the serious group (n=23) and non-serious group (n=43). The concentration of TNF-α of all cases was detected by human Th1/Th2 cytokine kit.Results The concentration of TNF-α in the COPD group was significantly higher than that of the smoker and healthy groups ( P<0.01). Furthermore, compared to non-serious COPD group, the concentration of TNF-α was higher in the serious COPD group ( P<0.05).Conclusion The concentration of TNF-α might be related with the pathogenesis and development of COPD.

Efficacy of hepatitis B vaccination on hepatitis B prevention and on hepatocellular carcinoma / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of hepatitis B vaccination on hepatitis B prevention and on hepatocellular carcinoma.</p><p><b>METHODS</b>Birth cohort study, cross-sectional seroepidemiological survey, and surveillance of hepatitis B (HBV) and hepatocellular carcinoma were used to evaluate the efficacy of hepatitis B vaccination.</p><p><b>RESULTS</b>During the 14 years after hepatitis B vaccination, the HBsAg positive rates were found to be 0.7% - 2.9%, with an average of 1.5%, and the protective rates were 83.5% - 96.6%. Hepatitis B virus infection rates of children immunized with hepatitis B vaccine were 1.1% - 5.1%, with an average of 2.2% and the protective rates of 93.5% - 98.4%. 15 years after hepatitis B vaccination, the incidence of hepatitis B dropped from 3.27/10 000 to 0.17/10 000, a 94.8% decrease, in the group of 0 - 19 year-olds.</p><p><b>CONCLUSION</b>The universal infant hepatitis B vaccination has proved to be effective in reducing the incidence rate of acute hepatitis B as well as the mortality of hepatocellular carcinoma.</p>

Experimental study of tissue-specific suicide gene therapy for lung adenocarcinoma / 中国肺癌杂志

<p><b>BACKGROUND</b>To study the effect and safety of tissue specific gene therapy of suicide gene for lung adenocarcinoma.</p><p><b>METHODS</b>Retroviral vector of G1CEACDNa contained a carcinoembryonic antigen (CEA) promoter regulated cytosine deaminase expression cassete (CEA/CD). By means of infection of virus, tissue specific expressing vectors and non-specific expressing vectors were transfected into A549 cell, which was CEA-producing lung adenocarcinoma cell line and then xenografted in nude mice, and the anti-tumor effect was evaluated. Then the retrovirus was injected directly into the tumor mass on nude mice, and the sensitivity of the xenograft to G1CEACDNa/5-fluorocytosine (5-FC) and the side effects were observed.</p><p><b>RESULTS</b>(1) After transfected and untransfected A549 cells were implanted into nude mice, there was no difference in tumor formation among all the groups. (2) After 5-FC administration, the tumor transfected with tissue-specific gene displayed a higher sensitivity to the drug than those treated with non-specific in vitro gene-therapy. (3) The tumor-bearing nude mice were randomized in a blind manner based on comparable size to receive the supernatant of recombinant retrovirus G1CEACDNa followed by 5-FC, and significant growth suppression could be observed. (4) Comparing to the group with injection of 5-fluorouracil (5-FU) alone, tissue-specific suicide gene therapy showed lower suppression to bone marrow.</p><p><b>CONCLUSIONS</b>The results suggest that tissue-specific suicide gene therapy may play an important role in individual treatment of lung cancer.</p>

The study on the 0, 12 month vaccination schedule' of Healive inactivated hepatitis A vaccine in children / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the safety, immunogenicity and fit dosage of Healive inactivated hepatitis A vaccine (HAV) in children.</p><p><b>METHODS</b>A total of 85 susceptible aged 4 - 10 years with HAV seronegative children, had been enrolled from two adjacent villages in a county. The volunteers were randomized allocated into two groups and to receive a priming dose of 250 U/0.5 ml/dose or 500 U/1.0 ml/dose of Healive vaccine, produced by Sinovac Biotech Co, Ltd. A booster of the same dose was given at 12th month. Local and systemic side effects were examined and seroconversion rate as well as geometric mean titers of anti-HAV antibody were tested at 3-week, 12-month after the primary dose and at 1 month after the booster dose.</p><p><b>RESULTS</b>The vaccine was well tolerated in both groups. At 21 days after the primary dose, the seroconversion rates were 94.4%, 100.0% and geometric mean titers (GMT) were 195 mIU/ml and 370 mIU/ml in 250 U and 500 U groups respectively. At 12 months after the primary dose, the seroconversion rate of anti-HAV was 100.0%, and GMT raised to 361 mIU/ml, 456 mIU/ml (P > 0.05) respectively. One month after the booster dose, GMT raised to 14 893 mIU/ml, 21 696 mIU/ml.</p><p><b>CONCLUSION</b>GMT of the 0, 12 month schedule was higher than other schedule after the booster vaccination. The Healive inactivated vaccine can be used for emergency vaccination. The Healive inactivated vaccine produced by Sinovac Company Ltd was safe and highly immunogenic. Two hundred and fifty U/dose was considered appropriate for children.</p>