Objective To observe sputum cytology counts, the levels of nerve growth factor (NGF) and IL-4 in cough variant asthma (CVA) patients and the change of their levels after using glucocorticoids combined with β2-adrenergic agonists one month, and to investigate CVA's characteristics of airway inflammation. Methods Totally 36 patients with untreated CVA were selected, as well as 23 healthy controls. Coughed up sputum cells were obtained and HE strained for differential cell counting in each enrolled patient. In induced sputum's supernatant, the levels of NGF and IL-4 were determined by ELISA.Results Before treatment, CVA patients had a median eosinophils (EOS) percentage of 8%, which was significantly higher than that after treatment (2%, P＜0.05) and in healthy control group (1%, P＜0. 001). The levels of NGF and IL-4 in induced sputum of CVA group were (9. 50 ± 1.69) ng/L and (257.37 ± 53.57) ng/L. After treatment, they were (8.78±1.02) ng/L and (228.60 ±52.93)ng/L in CVA group, (6.98±0.69) ng/L and (166.44±24.75) ng/L in healthy control group. The levels of NGF and IL-4 before and after treatment in the CVA group , as compared with the healthy control group, had statistically significant differences (all P＜0.001). In CVA group before and after treatment, the level of NGF and IL-4 paired difference was significant (P＜0.001). The percentage of induced sputum EOS correlated with sputum supernatant concentrations of NGF and IL-4 (P ＜ 0.01). In induced sputum supernatant, the concentrations of NGF and IL-4 were significant correlated (P＜0.01). Conclusions Glucocorticoid joint long-term β2 agonist inhaled treatment significantly reduced NGF, IL-4 and EOS levels and reduced eosinophilic inflammation, which are closely related with the nerve-immune mechanism, NGF as well as IL-4 participated the inflammation. Induced sputum examination is non-invasive, economical,simple, easily accepted by patients, and repeatable, widely used in clinical.

Objective Analysis the treatment and management of thirty-six out-patients of asthma,in order to share the new experience in the implementation of the strategy.Methods Janaury 2007 36 newly diagnosed or diagnosed bronchial asthma patients in Department of Respiratory Medicine,the first affiliated hospital of China Medical University inhaled budesonide/formoterol dry powder inhalation treatment.Clinical symptoms,rescue medication,lung function and assessment questionnaire score of Asthma Control Test(ACT),Asthma Control Questionnaire(ACQ)were investigated during six months.Results After 6 months' thearopy,the majority of patients showed significant improvement.symptoms and signs got Marked improvement,indicators related to lung function increased in different degrees than before,ACQ score showed a downward trend,with the ease and alleviate symptoms of drug use reduction agreement,ACT score and an upward trend that the condition persistly revived.Conclusion When doctors institut eindividual treatment programme to patients with asthma,they should help patients learn to self-management,so as to make for the condition continued revived and long-term controlled.

Bronchial asthma is defined as a chronic inflammatory airway disease in response to a wide variety of provoking stimuli.Over 200 million people in the world are affected with asthma.Because the incidence of asthma appears to be increasing,the importance of proper perioperative management of persons with asthma will also continue to increase.Patients with asthma are thought to be at high risk for pulmonary complications to develop during the perioperative period,and these complications may lead to serious morbidity.So it is very important to control asthma,to prevent and treat pulmonary complications for increasing operational success rate.

Objective To constitute a correlation with the subjective indicators by investigation of the causes and clinical features in patients with chronic cough.Methods Totally 100 patients with chronic cough were recruited followed a diagnostic program.Airway responsiveness[by methacholine challenge test (MCT)],Leicester cough questionnaire(LCQ),visual analogue scale(VAS),cough score,age,gender and disease duration were all recorded for analysis.Results The top five causes of chronic cough in these patients were variant asthma,post infectious cough,atopic cough,eosinophilic bronchitis and upper airway cough syndrome.LCQ total score was negatively correlated with age and the VAS score(r=-0.239 and -0.470 respectively,all P<0.05),while no difference was found among patients with different causes of disease or gender(F=1.233,t=1.918,all P>0.05)and no correlation was found with BMI(r=-0.029,P>0.05).The physiological and psychological field score in female patients significantly reduced(t=2.174,1.990,P<0.05),and LCQ total score of MCT positive patients obviously reduced than negative ones(t=-2.22,P<0.05).After the treatment of two weeks,LCQ three component field and total score could be improved significantly(all P<0.01).Conclusion Gender and age may have some impact on the quality of life in patients with chronic cough.LCQ,VAS and cough score should be used to assess cough severity and evaluate therapeutic effect in patients with chronic cough.

Objective To investigate the prevalence of occupational asthma,airway inflammation and analyze the risk factors for workers exposed to isocyanates.Methods A cross-sectional study was applied.Totally 429 isocyanates exposed workers were surveyed and the prevalence of occupational asthma and airway inflammation situation were examined by questionnaire,physical examination and laboratory tests.Multivariate logistic regression was applied to analyze the possible risk factors of isocyanate-induced occupational asthma.Results (1) A total of 366 patients with complete data were included in the study,and finally 11 cases were diagnosed as isocyanate-induced occupational asthma with a prevalence of 3.0％.(2) Neutrophil percentage in the induced sputum of occupational asthma increased significantly [42.00％ (34.00％-55.00％) before work and 59.00％ (51.00％-70.00％) after work (Z =-2.940.P ＜ 0.05)].(3) Length of service (OR =3.096,P =0.025) and rhinitis (OR =1.901,P =0.008) were independent dangerous factors,and protective measures (OR =0.074,P =0.015) was protective factors to isocyanateinduced occupational asthma.Conclusions Neutrophilic inflammation can be triggered by isocyanate exposure.Regular health examinations,effective protective measures can reduce the prevalence of isocyanateinduced occupational asthma.

AIM: To investigate relationship between activity of matrix metalloproteinases - 2 ( MMP - 2, 72 kD) and invasion, metastasis of breast cancer. METHODS: Useing zymography and computer software assisted analysis, the activitive levels of MMP- 2 (72 kD) in tissues from breast cancer were measeured. RESULTS: Mean activitive levels of MMP- 272 kD (13.93 + 3.60) in breast cancer were lower than those in benign disease (21.43 + 8.31), P < 0.05. There was no difference (P > 0.05) in MMP - 2 62 kD + 72 kD of benign and malignant dis ease, but MMP - 262 kD ( 13.83 + 4.53) and MMP - 262 kD/62 kD + 72 kD (0.48) respectively were significantly higher in malignant disease (P < 0.01). It was also found that MMP- 262 kD/62 kD + 72 kD were apparently higher in invasive carcinomas (0.48) and lymph node metastases (0.61), P < 0.01, respectively. CONCLUSION: These results demonstrated that a clear relationship between MMP - 2 activity and the invasion and metastasis of breast carcinoma.

Objective To study MRI differential diagnosis of peripheral hemangioma and vascular malformations.Methods MRIfindings of peripheral hemangiomas and vascular malformations proved by operation in 61 cases were retrospectively analyzed in comparison with pathological results.Results In 29 cases of peripheral hemangiomas,20 cases showed equal signal intensity (equal to muscle) and 9 cases showed heterogeneous signal intensity on T1-weighted images; 24 cases showed increased signal intensity (approach fat signal) and 5 cases showed markedly increased signal intensity (increase fat signal) on T2-weighted images,25 cases had septa as low signal network on T2-weighted images,4 cases showed enhancement separated mass enhancement after intravenous contrast injection.In 32 cases peripheral vascular malformations,16 cases showed equal signal intensity and 16 cases showed heterogeneous signal intensity on T1-weighted images.3 cases showed high signal intensity and 29 cases showed markedly increased signal intensity on T2-weighted images,15 cases showed inhomogeneous enhancement after intravenous contrast injection.Conclusion MRI plays an important role in differential diagnosis of peripheral hemangiomas and vascular malformations.

Objective To investigate the therapeutic effects of givinostat , a histone deacetylase inhibitor (HDACI), on the development of chronic asthma with airway inflammation , airway remodeling and airway hyperresponsiveness ( AHR) .Methods BALB/C mice were randomly divided into control group , asthma group, dexamethasone group and givinostat group (n=12 per group).AHR was assessed.Total cell numbers and differential counts , interleukin-4 ( IL-4 ) , interleukin-5 ( IL-5 ) and interferon-γ( IFNγ) levels in the bronchoalveolar lavage fluid ( BALF) were measured in the above 4 groups.The pathology of lung tissue was evaluated .Immunohistochemical ( IHC) staining and Western blot were used to detect αsmooth muscle actin(α-SMA) and transforming growth factor-β1(TGFβ1).Results Compared with the asthma only group, givinostat treatment relieved airway resistance (2.96 ±1.01 vs 6.50 ±0.79,P<0.05).Total inflammatory cells [(33.04 ±5.62) ×104/ml vs (98.04 ±9.27) ×104/ml,P<0.01], eosinophil cells [(9.17 ±2.33) ×104/ml vs(37.64 ±6.98) ×104/ml, P <0.01], IL-4 [(10.12 ±2.98)ng/ml vs (16.88 ±2.78)ng/ml,P<0.05] and IL-5 [(27.09 ±3.62)ng/ml vs (37.86 ±7.34)ng/ml, P<0.05] levels were all reduced in givinostat group , while IFNγ[ ( 91.86 ±23.73 ) pg/ml vs ( 60.49 ±11.88 ) pg/ml, P>0.05] was enhanced in BALF.Inflammatory cell infiltration around the airway was reduced , with decreased inflammatory cell score [(1.60 ±0.69) points vs (3.40 ±0.68) points, P <0.01] and inflammatory cell number (111.65 ±31.41 vs 601.25 ±186.85, P<0.01).The goblet cell metaplasia [(26.36 ±2.33)%vs (57.21 ±11.56)%] and collagen deposition area [(52.77 ±7.58)μm2/μm vs (111.81 ±12.40)μm2/μm] were obviously reduced (P<0.01).The expressions of α-SMA and TGFβ1 in the lung tissue were both significantly decreased ( P<0.01 ) .Conclusion Givinostat treatment can reduce airway inflammation , airway remodeling and airway hyperresponsiveness in chronic asthma .Its effect is comparable to that of glucocorticoid hormone treatment .

Objective To evaluate the role of magnetic resonance angiography ( MRA ) in diagnosing peripheral hemangioma andvascular malformation . Methods 61 cases of hemangioma and vascular malformations in peripheral soft tissue were undergone MRAexamination.Results Of 13 patients with hemangioma,the arteries within hemangioma were increased and gradually fine from proximal to distal in 7 cases and in company with arteriovenous fistulae in 2 cases,there were no arteries within hemangioma in 6 cases.Vascular malformations were found in 48 patients,arteries and veins of vascular malformation were showed in 35 cases,but arteries of vascular malformations were only showed in one case.Arteries of vascular malformation were showed in 5 cases and the arteries were pressed on arterial angioyraphy in 23 cases.On MR venography(MRV),the shallow malformed veina were showed in 25 cases and in company with deep malformed veina in 13 cases,only the shallow and deep veina increased and thickness be showed in 2 cases.Arterioveinous fistulae could be seen in 8 cases on MR aterio-venography.There were no vessel be showed in 12 cases within the losions.Conclusion MRA is of significant value in diagnosis and differential diagnosis of peripheral hemangioma and vascular malformations.