Objective To evaluate the clinical efficacy, impacts on lung function and cytokines, and safety of azithromycin on the treatment for asthma. Methods Forty patients with asthma were randomized equally to receive azithromycin combined with inhaled cortisteroid (ICS) plus long-acting β_2-agonists (LABA), or only ICS plus LABA for 12 weeks. We evaluated the clinical efficacy including asthma control test scores and lung function, cytokines in induced-sputum including interleukin-4, interleukin-5 and interferon-γ, and the safety of azithromycin. Results After 12 weeks, asthma control test (ACT) scores and lung function were improved obviously, and concentrations of IL-4, IL-5 and IFN-γ in induced-sputum were reduced significantly in both groups. Comparing with the control group, the decline of cytokines in induced-sputum was much more significant in patients treated with azithromycin. No severe adverse events were found in both groups. Conclusions Azithromycin combined with ICS plus LABA is an effective and safe treatment for asthma, which could significantly reduce the level of cytokines elaborated from Th2-type cells in the airways.

AIM: To probe into the influence of liver functions in traditional Chinese medicine on physiology and pathology of heart so as to provide theoretic guides for treatment of coronary heart disease by focusing on liver functiosn. METHODS: Several liver functions are considered, such as to maintain the normal circulation of qi and blood, regulate emotional factors and promote digestion and absorption, to probe into the regulation of liver in the heart and pathological mechanism of liver in failure to maintain free flow of qi on occurrence of coronary heart disease. RESULTS: Liver is the important factor to regulate cardiac function. Failure of liver to maintain free flow of qi is the startup prerequisite of coronary heart disease. CONCLUSION: The research on mechanism of coronary heart disease in Chinese medicine should emphasize on liver functions. To focus on liver theory is the essential approach in treatment of coronary heart disease in Chinese medicine.

Objective To inquire into the diagnosis and management of renal angiomyolipoma.Methods The 22 cases of RAML were studied restrospectively.Results The diagnosis accuracy was 54.5% for B ultrasound and 81.8% for CT,18 were diagnosed as RAML and 4 were misdiagnosed as renal cell carcinoma preoperatively,of which 3 were diagnosed as RAML based on intraoperative frozen section study.11 had been performed enuoleation,7 partial nephrectomy,3 nephrectomy and 1 radical nephrectomy. Conclusions CT is the first line imaging method for RAML.the cow fatty component,intratumor hemorrhage and small tumor are the main canse of misdiagnosis in RAML.careful analysis to clinical feature and imaging data,intraoperative frozen sect,ion study can avoid misdiagnosis.nephron sparing surgery is the best operative management.

Objective To study the effect of simultaneously combined liver and kidney transplantation (SLKT) on end-stage liver and kidney diseases. Methods Thirteen cases subject to SLKT from 1996 to 2004 were reviewed in The First Affiliated Hospital of Sun Yat-sen University. Among them, there were 4 cases of polycystic liver and kidney, 4 cases of hepatic cirrhosis and renal failure, and 5 cases of fulminant heptic failure and hepatorenal syndrome. Ten were males and 3 females with an average age of 45.5 years old.Results Four cases of polycystic liver and kidney have all survived for more than one year after SLKT, and one of them has survived for 4 years. The 3 of 4 patients with hepatic cirrhosis and renal failure have survived more than one year, and one of them died perioperatively. The 2 of 5 patients with fulminant hepatic failure and hepatorenal syndrome have survived for one year, and 3 of them died perioperatively.Conclusion SLKT has been the effective therapy for end-stage liver and kindney diseases; The indications of SLKT for hepato-renal syndrome were discussed. SLKT may immunologically protect the renal graft.

Objective To assess the immune tolerance of allogeneic T cells induced by dendritic cells genetically engineered to express I?B? mutant. Methods DCs were prepared from WF rat bone marrow cells and modified by I?B?M gene wit h adenovirus vector, and then the expression of I?B? and I?B?M was detected by Western-blot. The cell-surface expression of costimulatory molecules (CD80, CD86 and CD40) was detected by flow cytometry, and the production of IL-12 in DCs culture supermatant was determined by ELISA. The ability to stimulate the pr oliferation of Lewis rat T cells was analyzed by mixed leukocyte reactions (MLR) . The antigen-specific T cell hyporesponsiveness was tested by secondary MLR. Results I?B?M suppressed the cell-surface expression of costimulatory molecules and i nhibited the production of IL-12. I?B?M-DC showed reduced ability to stimula te T cells proliferation, and potential to induce antigen-specific T cell hypo responsiveness. Conclusion Immune tolerance of T cells can be induced by dendritic cells genetically engine ered to express I?B? mutant.

BACKGROUND: Serum uric acid level is associated with some chronic diseases and prognosis of severe infection. This study aimed to investigate the relationship between serum uric acid (SUA) and prognosis of infection in critically ill patients. METHODS: The data from 471 patients with infection admitted from January 2003 to April 2010 were analyzed retrospectively at Huashan Hospital Affiliated to Fudan University, Shanghai, China. The data of SUA, serum creatinine, blood urea nitrogen (BUN) and other relevant examinations within 24 hours after admission were recorded and the levels of SUA in those patients were described, then Student's t test was used to evaluate the relationship between SUA and pre-existing disorders. Different levels of SUA were graded for further analysis. The Chi-square test was used to examine the difference in the prognosis of infection. RESULTS: The mean initial level of SUA within 24 hours after admission was 0.232±0.131 mmol/L and the median was 0.199 mmol/L. Remarkable variations in the initial levels of SUA were observed in patients with pre-existing hypertension (t=–3.084,P=0.002), diabetes mellitus (t=–2.487, P=0.013), cerebral infarction (t=–3.061,P=0.002), renal insufficiency (t=–4.547,P<0.001), central nervous system infection (t=5.096,P<0.001) and trauma (t=2.875,P=0.004). SUA was linearly correlated with serum creatinine and BUN (F=159.470 and 165.059, respectively,P<0.001). No statistical correlation was found between the initial levels of SUA and prognosis of infection (χ2=60.892,P=0.100). CONCLUSION: The current study found no direct correlation between the initial levels of SUA after admission and prognosis of infection in critically ill patients.

Objective To evaluate the clinical application value of a new type of Bard Max-Core coaxial biopsy system and com-pare the effectiveness and safety of different diameter biopsy guns.Methods This retrospective study included 286 patients who re-ceived CT-guided percutaneous lung biopsy using Bard MC disposable biopsy system.We divided patients into three groups:1 6G, 18G,and 20G group.Then,we evaluated the biopsy effectiveness,histological diagnosis rate and complication incidence of this new type of Bard Max-Core coaxial biopsy system.Results All lung biopsy specimens were successfully obtained.The total histological diagnosis rate was 80.8%.Patients with malignant lesions had higher histological diagnosis rate than patients with benign lesions. The histological diagnosis rate in 1 6G group was the highest among three groups.There was no significant difference among three groups regarding to the rate of diagnosis of malignant lesions.Group with 1 6G had the highest histological diagnosis rate among three groups in diagnosing begin lesions.The incidences of pneumothorax in three groups had no significant difference.The incidence of bleeding in 1 6G group was the highest among three groups.Conclusion The new Bard MC disposable coaxial biopsy system is a safe and effective instrument for lung biopsy.We should select the biopsy needles with appropriate diameter according to the fully as-sessment of patients'preoperative conditions.

0. 05) . The sensitivity and specificity of NMP-,2 in diagnosing transitional cell carcinoma of bladder were 85. 7% and 60% when the cut-off was set 10 u/ml, In contrast, the sensitivity and specificity of urinec cytology were 32. 1% and 100%. Conclusions: Urinary NMP22 can be used to screen and follow up transitional cell carcinomas of bladder with high sensitivity and high specificity.

0.05). Serum glutamate pyruvate transaminase activity significantly decreased in the injured liver BMSCs group (P

BACKGROUND:Transplantation of exogenous stem cells for functional cardiac celldeath or apoptosis easily induced complications after transplantation. Therefore, cardiac progenitor cells of heart itself have been ideal seed cells. OBJECTIVE:To establish stable celllines of cardiac progenitor cells from mouse heart, and to provide ideal cellmodels for studying proliferation and differentiation factors affecting cardiac progenitor cells during adult myocardial cells were damaged. METHODS:(1) Myocardiocytes were isolated from embryonic 15.5 days mice. (2) The cultured myocardiocytes were immortalized using retrovirus SSR69. Immortalized monoclonal myocardial cells were obtained using antibiotic selection and infinite dilution. (3) Monoclonal cellline with the property of cardiac progenitor cells was screened out. RESULTS AND CONCLUSION:(1) Myocardiocytes were successful y isolated and cultured. Partial cells showed obvious beating. (2) Myocardiocytes infected with retrovirus SSR69 were cloned and got 76 clones, then were named as CP15-#, (3) Screening the first 20 clones, the reasonable clones with the characteristics of cardiac progenitor cells were obtained according to myocardial cellmarker genes. The results suggested that immortalized cardiac progenitor cells were established mediated by reversible SV40 T antigen.