Bronchial asthma (also called asthma) is the most common chronic respiratory inflammatory disease in childhood.With the increased incidence of asthma in recent years,the guidelines for diagnosis and treatment of asthma have been also updated quickly at both domestic and overseas.Acute exacerbations of asthma will result in unscheduled medical attendances in emergency department or hospitalizations,and the severe one may be life-threatening,which brings a heavy burden to the families and society.Several guidelines,Meta analysis,and studies in treatment of childhood asthma exacerbations are reviewed in this article,so as to provide recommendations in the treatment of childhood asthma exacerbations for physicians.

Based on 418 cases of patients with advanced lung cancer early assessment , actively deal with ac-companying symptoms , respect patients psychological needs and families , to provide personalized palliative care , proper view of death education , give family psychological comfort and care .8 patients with in-hospital deaths had not been in the last issue to rescue , family good acceptance .For patients with advanced lung cancer patients under-going palliative nursing care can reduce the pain of dying period and the fear of death , to improve patients′families to treatment satisfaction .

To explore the relation between the gene polymorphism of type 2 diabetes patients and their response to sulphonylurea(SU) and accomplish the personal therapy,the range of the SU pharmacogenomics should includes genes involved in the process of SU metabolism and acting,other pathological or physiological process of type 2diabetes also should be investigated,the genes recoding sulphonylurea receptor 1(SUR1),inwardly rectifying K+ channels 6.2(Kir6.2),CYP2C9 and insulin receptor substrate 1(IRS1) are the most important.

Berberine is an alkaloid initially isolated from some Chinese medicinal herbs,such as Rhizoma coptidis(Huanglian),preferable for its inexpensiveness and low adverse effects as a broad-spectrum antibiotic in the treatment of various infectious diseases.More and more investigations have shown that berberine has a great potential for the treatment of digestive tract diseases.This paper updates the recent discoveries in the clinical and basic studies of berberine for the treatment of digestive tract diseases.

This article reveals the present state of teaching staff in teaching hospitals and difficulties and obstacles the hospitals confront when conducting the clinical courses through the investigation and analysis of 6 teaching hospitals.It provides a very useful reference for teaching hospitals in term of expanding their teaching resources and carrying out staff training.

Objective To construct a novel recombinant human IFN-ε,and to analyze its physi-cal,chemical properties and biological characteristics.Methods Human genomic DNA was used as the template to synthesize IFN-ε gene by PCR.The sequence was cloned into plasmid vector pET-32a(+),and the recombinant plasmid pET-32a(+)/IFN-ε was transformed into E.coli BL2l(DE3).The form of ex-pression product was inclusion bodies.After purification and renaturation.high purity active protein IFN-εwas achieved.The final product was tested for its physical.chemical properties and biological characteristics including anti-viral and anti-proliferative acfivities.Results IFN-ε was expressed in inclusion body in E.coli.After the protein renaturation and purification,the purity was more than 95%.The rhIFN-ε protein had a specific anti-viral activity of about 1.2×103 IU/mg.Its anti-poliferative activity is obvious and can in-duce cells to produce anti-viral protein MxA.Conclusion Human IFN-ε protein was expressed successful-ly.and this protein has anti-virus and anti-prolireration activity.

Objective To investigate the etiology and the efficacy of endoscopic management of acute recurrent pancreatitis. Methods Patients with acute pancreatitis (AP) who were admitted in Changhai Hospital from January 2002 to December 2008 were included in the study population. The medical records were reviewed; the ERCP procedures and other treatment options and complications were documented. After the follow-up the patients were divided into two groups: single attack group (SAG) and recurrent attack group (RAG). The etiology and the efficacy of endoscopic management were analyzed. Results 804 patients were included, 512 patients(63.68%) had AP attacked once, 292(36.32%) had AP recurrent attack . The SAG had a mean age of 52 years old; the RAG had a mean age of 44 years old, the age difference between the two groups had statistical significance (P<0.01). In 201 patients with severe AP, 104(20.31%) patients had AP attacked once, 97 (33.22%) had AP recurrently attacked , the difference between the two groups was statistically significant (P < 0.01). There were 46 cases in SAG complicated with pancreatic pseudocysts, and 44 cases in RAG complicated with pancreatic pseudocysts, the incidence between the two groups was statistically significant (P < 0.05). Biliary origin, hypertriglyceridemia were risk factors for recurrent AP. 139 patients with recurrent AP underwent ERCP, and 15 patients developed post-ERCP pancreatitis, 1 patient developed post-endoscopic sphincterotormy bleeding. Follow-up of 118 recurrent AP patients showed the overall remission rate of endoscopic treatment was 78.8%. Conclusions The patients in RAG were younger than those in SAG. The incidence of severe AP and pancreatic pseudocyst was higher in RAG. Cholelithiasis and hypertriglyceridemia were high risk factors of recurrent AP. Endoscopic management was an effective treatment for recurrent AP.

Objective To increase the appreciation of manifestations in autoimmune pancreatitis (AIP) and to decrease misdiagnosis rate by investigating the clinical characteristics of AIP. Methods Clinical data were collected and laboratory ,imaging and histopathology were analyzed from the Chinese PLA General Hospital from 1995 to 2009. Patients with AIP were included in the study. Results Eight patients (male 6, female 2) aged 35-69 (52.4 ±9.4) years were diagnosed as AIP from 2006 to 2009. The main clinical manifestations include intermittent jaundice in 6 cases (6/8), abdominal pain in 5 cases (5/8),weight loss in 4 cases (4/8), and accompanied with other diseases of immune system in 4 cases (4/8).The imaging showed head of pancreas enlargement in 3 cases (3/8) and whole pancreas enlargement in 5 cases (5/8). There is a "banana-peel like" ring around the pancreas and irregular stenosis of pancreatic duct. Massive lymphocytes and plasma cells infiltration and parenchymal fibrosis were shown in pancreatic tissues, bile duct,salivary gland and liver in pathology. Clinical manifestations, laboratory examinations and images in 7 cases (7/8) were improved after treatment with prednisone. Twenty-two of them were misdiagnosed as pancreatic or biliary carcinoma and 21 were performed laparotomy in the period of 1995-2005 ( 23 cases). After 2006, however, the misdiagnosis rate significantly decreased from 95.7% ( 22/23 ) to 0. Conclusions AIP seems to be a systemic autoimmune disease rather than an isolated disorder,markedly overlapping with other autoimmune diseases. Definitive diagnosis can be improved by the detection of immune parameters and pathological examination.

Objective To explore the therapeutic effect of loop electrosurgical excision procedure (LEEP)in the treatment of patients with cervical intraepithelial neoplasia (CIN) and its influence on pregnancy outcome.Methods 62 women with CIN who underwent LEEP were selected as treatment group,and 63 women with CIN who did not undergo LEEP in the same period were selected as control group.Then the curative effect and the pregnancy outcome were observed.Results The total effective rate was 93.65％ in the treatment group and 76.19％ in the control group,the difference was significant (x2 =7.034,P ＜ 0.01).The operation blood loss,operation time and the day of colporrhagia after operation in the treatment group were less than those in the control group(all P ＜ 0.05).There were no significant differences in the gestational age,incidence rates of abortion and cesarean section between the two groups (all P ＞ 0.05),while there were significant difference in the incidences of preterm delivery,premature rupture of membrane and low birth weight infant (all P ＜ 0.05).Conclusion LEEP is an effective treatment for patients with CIN,which can increase the incidence rates of preterm delivery,premature rupture of membrane and low birth weight infant,but not increase the gestational age,incidence rates of abortion and cesarean section.

ER, PR, HER-2 are signiifcant biological markers in guiding the choice of treatment and evaluating clinical prognosis. As the progression of tumor cells, the expressions of these receptors in recurrent tumors may be different from primary tumors. Nowadays clinicians have realized the necessity of receptor detection in the metastatic lesions. This article summarized the current research status on the above issues.