Objective To study the clinical application and its impact factors of tidal flow - volume measurement in infants with bronchiolitis and pneumonia. Methods Thirty infants with bronchiolitis and thirty infants with pneumonia were studied. Tidal breathing flow- volume loops were obtained after the patients were sedated. The tidal volume per kilogram(VT/kg) ,the fraction of tidal volume ex-heled at peak tidal expiratory flow (PTEF) to total tidal volume (VPTEF/VE), and the fraction of exhaled time at PTEF to total expirato-ry time (TPTEF/TE) were measured. Results VT/kg was not significant different between the bronehiolitis group and the pneumonia group. VPTEF/VE and TPTEF/TE were lower in the bronehiolitis group than those in the pneumonia group. Conclusion The measure-ment of tidal breathing flow - volume loops is a good technology, which would be helpful to evaluate airway obstruction in wheezing in-fants. The impact factors should be controlled during the measurement. Otherwise, the results would be affected.

Objective To study the effect of inhalation combined salmeterol plus fluticasone propionate in treatment of asthma in children between 4 ～ 5 years old.Methods Seventy-four children (age range,4 ～ 5 years) were enrolled for our study,they were randomly divided into 2 groups (one group inhaled combined salmeterol plus fluticasone,37 children;the other group inhaled fluticasone,37 children).Comparative studies of clinical efficacy,quantified symptom score,and regular follow-up observations were conducted at the interval of one week,one month,three months.Results In the first week and first month during the treatment,there were no difference between salmeterol plus fluticasone group and fluticasone group (P ＞ 0.05).In the third month during the treatment,the daytime ratings(0.16 ± 0.09 vs 0.32 ± 0.11,P ＜ 0.05) and night ratings(0.04 ± 0.01 vs 0.14 ±0.00,P ＜0.05) of salmeterol plus fluticasone group were significantly better than those of fluticasone group.After three months,more children in salmeterol plus fluticasone group were responsive to the decreased dose of the drug than those of fluticasone group (x2 =4.57,P ＜ 0.05).Conclusion In the follow-up of exacerbatious,treatment with combined salmeterol and fluticasone propionate was as efficient as that of fluticasone in alleviating symptoms.During remission of asthma,combined salmeterol and fluticasone propionate was probably better than fluticasone for control of symptoms.

Objective To investigate the safety and effectiveness of endoscopical therapy for small grastric stromal tumor( d<2 cm) . Methods Clinical records of 80 patients dignosed as having small grastric stromal tumor by pathology and immunohistochemistry were retrospectively analyzed. Endoscopic or laparo?scopic or open surgery was performed, so patients were divided into endoscopic treatment group ( n=37) and surgical treatment group ( n=43) accordingly. Perioperative period data, effectiveness and follow?up data were analysed. Results Thirty?five cases( 94?6%) of endoscopic treatment group were successfully treated by endoscopic surgery. Intraoperative perforation occurred in 8 cases, among which 2 cases transferred for conventional operations.Pneumoperitoneum occurred in 2 cases (better after symptomatic treatment), while no serious infection or perioperative death occurred. There were no significant differences in the complete re?section rate[ 91?89% ( 34/37) VS 100?0%( 43/43) , P=0?095) , the incidence of postoperative complica?tions[5?71%(2/35)VS 2?33%(1/43),P=0?855)or the improvement of postoperative symptoms[93?10%( 27/29) VS 85?71% ( 30/35) , P=0?589] ,while statistically significant differences were found in operation time[(37?41±13?45)min VS(84?56±38?37)min, P=0?000], intraoperative blood loss[(5?65±5?88)ml VS(31?48 ±39?57)ml, P=0?000], postoperative feeding time[(2?47±0?61)d VS(3?26 ±1?27)d, P=0?001], postoperative hospital stay[(5?76 ±2?28)d VS(7?64±2?99)d,P=0?022],and medical expenses [(18 554?4±9 736?45)yuan VS(31 138?11±1 206?24)yuan, P=0?000]. Conclusion Endoscopic re?section is safe and effective for small grastric stromal tumor with minimal invasion,simple procedure, faster recovery and less economic burden for the patients.

[Objective] To discuss the efficacy of Telbivudine treating chronic hepatitis B.[Method] Randomly divide 164 cases into treatment group 85 and control one 79,respectively taking Telbivudine and Ramivudine for anti virus for 48 w,then observe their efficacy.[Result] The ALT normalization and HbeAg positive rates were separately 87.50% and 71.15% for both groups; HBV DNA reduction rates and HbeAg postive-5.3 and-4.2log10 copies/ml,negative-6.6 and-5.5 log10 copies/ml;HbeAg negative rates respectively 28.57% and 23.08%;HbeAg serum conversion rates 23.21% and 15.38%;resistance rates of HbeAg positive 3.57% and 11.53%,negative 3.45% and 14.81%;the difference was very obvious(P

The Doha Declaration has entrusted to the members of WHO the right to use the compulsory licensing for drug patents in the face of global public health crises.Although the basic compulsory licensing system for drug patents has been established in China, the efficiency of its implementation is low, the responsibility of its executive departments is unclear, the related rules are not fully understood by pharmaceutical enterprises, it is thus necessary to improve and perfect the relevant legal provisions and systems in order to effectively improve the accessibility of drugs.

ObjectiveTo investigate the lipid metabolism in ketosis-prone type 2 diabetes mellitus (T2DM) patients classified by Aβ classification scheme.Methods Two hundred and seventy-seven ketosis-prone T2DM patients were classified according to the A β classification scheme which was based on the presence or absence of pancreatic islet β-cell autoantibody and fasting C peptide:A-β- group (78 cases ),A+ β -group (41 cases ),A- β + group ( 113 cases ) and A+ β + group (45 cases).The levels of blood lipid were determined and compared in the four groups.ResultsIn A- β -,A+ β -,A- β + and A+ β +groups,the levels of triglyeride (TG) were separately (1.72 ± 1.07),(1.86 ± 1.04),(2.21 ± 1.66) and (2.60 ± 1.87 )mmol/L,the levels of very low density lipoprotein-cholesterol(VLDL-C) were separately (0.57 ±0.45),(0.61 ±0.48),(0.79 ±0.63) and(0.81 ±0.62) mmol/L,and there were significant differences in TG and VLDL-C among the four groups(P =0.004 and 0.010).There were significant differences in TG and VLDL-C between β + group ( 158 cases) and β - group ( 119 cases) [ (2.32 ± 1.72) mmol/L vs.(1.77 ± 1.06)mmol/L,(0.80 ±0.63) mmol/L vs.(0.58 ±0.46) mmol/L,P =0.001 and 0.001 ].Conclusions Ketosis-prone T2DM patients with different situations of pancreatic islet β-cell autoimmunity and function are different in lipid metabolism,so it is very lmportant to evaluate the blood lipid and perform related lipid-lowering therapy in order to reduce the occurrence of diabetic complication.

Objective To study the sensitivity and reliability of rat skin anaphylactoid test method, detect and evaluate the anaphylactoid reaction of traditional Chinese medecine injection. Methods The condition of rat skin anaphylactoid test was optimized by studying the influencing factors of sensitivity and reliability of test with C48/80 as a tool drug, Tween80, endotoxin, China cobra toxin, trichosanthin injection, Tanreqing injection and Xuesaitong injection were investigated. Results The best conditions of rat skin anaphylactoid test was as follows:intrademal inject the drug with insulin syringe, 50-100μL per point, immediately inject 0.5%Evans blue dye 1 mL though caudal vein, 15 min later, kill the rat by carotid artery bleeding, clip dorsal skin to do the test. With this method, Tween80, endotoxin, China cobra toxin and trichosanthin injection all can induce blue stain in rat skin. Tanreqing injection showed no blue stain at the clinical dose. Xuesaitong injection although can induce blue stain in rat skin at the clinical dose, but the results cannot exclude the interference of its pharmacological function. Conclusion The method is simple with short test cycle, less dose of test drug, high detection sensitivity and good reproducibility, but some drug can show false positive result due to its own property.

Objective To analyze CMV DNA stability of 30 EDTA plasma samples in the order of magnitude between 300 and 100 000 copies/mL over a 21 day period. Methods Thirty plasma samples were grouped into three categories according to the CMV DNA loads , including low CMV DNA contents , intermediate CMV DNA loads and high CMV DNA loads. Ten milliliters of whole blood was freshly collected from each patient. Plasma samples without hemolysis were divided into 1-ml aliquots. One aliquot was processed immediately (Day 0) for baseline PCR assays. The remaining aliquots were then processed after one , two, three, seven, 14 or 21 day of storage at 4℃. Results There was no significant difference between the mean of the difference time point in viral loads following storage at 4 ℃ by paired-samples t test, including Day 1 compared to Day 0 (t = 1.654, P =0.109), Day 2 compared to Day 0 (t = 1.487, P = 0.148), Day 3 compared to Day 0 (t = 1.609, P = 0.118), Day 7 compared to Day 0 (t=0.831, P=0.413), Day 14 compared to Day 0 (t=1.721, P=0.096), and Day 21 compared to Day 0 (t=0.244, P=0.810). Conclusion The concentration of CMV DNA in all samples stored at 4 ℃ for 21 days did not differ significantly from the baseline viral load ,and it was not observed the trend in continued degradation in different time point (Day 1, 2, 3, 7 and 14).

Objective To investigate the protective effect of continuous intravenous infusion of Isoproterenol (ISO)on myocardial mitochondria of early septic rats and the corresponding mechanism.Methods Thirty Sprague Dawley (SD)rats were randomly divided into 5 groups (6 cases per group):control group,endotoxin group,ISO small-dose group,ISO medium-dose group and ISO large-dose group.Endotoxin group and ISO intervene group received same management apart from drug intervention:receiving intravenous injection of lipopolysaccharide (LPS)10 mg/kg followed by an continuous intravenous infusion of 9 g/L saline 1 mL/h or ISO 0.06 μg/(kg · min),0.30 μg/(kg · min)and 0.60 μg/(kg · min).Control group received intraperitoneal injection and continuous intravenous infusion with the same amount of 9 g/L saline.The primary endpoint of the study was 24 hours after injection of 9 g/L saline or LPS.Serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB),oxidative and nitrosative stress levels and swelling of isolated heart mitochondrion were detected.The pathological changes of the myocardium and morphologic changes of the heart mitochondria were observed through light microscope and scanning electron microscope,respectively.Results The levels of CK,CK-MB,nitric oxide (NO) content,inducible nitric oxide synthase (iNOS) activity and malondialdehyde (MDA)content in endotoxin group were increased compared with control group (all P ＜ 0.05),while the superoxide dismutase (SOD) activity decreased [(11.543 ± 1.080) U/mg prot vs (9.892 ±0.815) U/mg prot,P ＜0.05].The morphology of the heart mitochondria significantly changed (such as swelling,disordered arrangement,crest fracture,fusion and cavitations,and so on).ISO intervention significantly decreased the levels of CK,CK-MB and mitochondrial swelling (all P ＜ 0.05) and increased the SOD activity (all P ＜ 0.05).The levels of NO content,iNOS activity and MDA content were significantly decreased in small-dose group [(10.823 ± 2.240) μmol/g prot vs (7.917 ± 2.203) μmol/g prot,(0.045 ± 0.008) U/mg prot vs (0.033 ± 0.003) U/mg prot,(1.663 ± 0.618) mmol/mg prot vs (0.768 ± 0.312) mmol/mg prot,all P ＜ 0.05],while the levels of iNOS activity and MDA content were significantly increased in medium-and large-dose group (all P ＜ 0.05) ; compared with medium-dose group,the degree of mitochondrial swelling in large-dose group increased (1.160 ± 0.186 vs 1.393 ± 0.128,P ＜ 0.05).The pathological changes of the myocardium mitochondria significantly improved.Conclusions The myocardium and myocardial mitochondria of early septic rats were damaged,continuous intravenous infusion of low-dose ISO revealed protective effect on these damages,and the corresponding mechanism may relate to the decrease of the oxidative and nitrosative stress.

Objective To study the effects of repeated hypoxic exposures (HEs) on glycolysis, mitochondrial oxi-dative phosphorylation and energy charge in mouse brain. Methods Adult BALB/c mice were repeatedly exposed to hypoxia for 5 times and the standard tolerant time and body temperature were recorded. The activities of PFK, PK and mitochondrial complex Ⅰ in the brain were assayed. Phosphoadenosines and energy charge were measured. Results Repeated HEs prolonged the hypoxic tolerance and reduced the body temperature. The activities of PFK and PK experienced regular changes, with an increase in 1st and 3rd HEs and a decline to control levels in 5th HE. The complex Ⅰ activity continued to decrease during HEs. The energy charge was stable. Conclusion HEs lead to a regular change of glycolysis, a continued inhibition of mitochondrial oxidative phosphorylation, and a main-tained energy charge in the brains of mouse.