In the last few years,the morbidity of pulmonary fungal infection is keeping increasing.However,misdiagnosis is very common in clinical practice since it has no specific clinical characteristics.Subsequently,delayed treatment happened.Laboratory test is the key method to diagnose pulmonary fungal infection.In fact,only pathology and positive cultural results obtained from germfree specimens could make the final diagnosis.Recently,some new methods put into effect such as G-test and GM-test.These methods greatly improve the early diagnosis of invasive fungal infection.Among them,PCR is a very prospective way.Nevertheless,the most basic and common used way is to detect and analysis sputum,blood and the specimen obtained through bronchoscopy.The specimen collecting process need to be standardized and the results need to be evaluated along with the clinical data. Abstract:Summ ary: In the last few years,the morb id ity of pu lmo-nary fungal infection is keep ing increasing.However,m isd iag-nosis is very common in c lin ical practice since it has no spec if-ic c lin ical characteristics.Subsequently,delayed treatm ent hap-pened.Laboratory test is the key m ethod to d iagnose pu lmonary fungal infection.In fact,on ly pathology and positive cu ltural re-su lts obtained from germ free spec im ens cou ld m ake the final d i-agnosis.Recently,som e new m ethods put into effect such as G-test and GM-test.These m ethods greatly improve the early d iag-nosis of invasive fungal infection.Among them,PCR is a very prospective way.Nevertheless,the most basic and common used way is to detect and analysis sputum,b lood and the spec im en obtained through bronchoscopy.The spec im en collecting process need to be standard ized and the resu lts need to be eval-uated along w ith the c lin ical data.

Atypical pathogens are very common in community-acquired pneumonia(CAP) with the morbidity of about 22%(20%～28%).Therefore,CAP guidelines around the world usually emphasize the importance of atypical pathogens.The diagnosis tests are also listed in the guidelines,but only applied among inpatients.Japanese Respiratory Society recommended the diagnosis criteria of atypical pneumonia based on the clinical characteristics for the first time in the world.All guidelines recommended that empirical antibiotic therapy should cover those atypical pathogens when Mycoplasma pneumoniae,Chlamydia pneumonia or legionella pneumophilia infection are possibly exist.Antibiotic therapy against Mycoplasma pneumoniaen and Chlamydia pneumonia should be considered among outpatients and inpatients as well as anti-legionella pneumophilia therapy in severe patients in ICU.The recommended regimen is beta-lactam antibiotics combined with macrolides or fluoroquinolones alone.

The incidence of gram-positive coccus infection was keeping rising in recent years,with increase in hospital-and community-acquired pneumonia,as well as the incidence of infection caused by drug-resistant bacteria.Staphylococcus sp.,Streptococcus sp.and Enterococcus sp.were the most common pathogens inducing infection of the respiratory system,among which Streptococcus ranked the first.Streptococcus pneumoniae is still the most common pathogen causing respiratory infection.Recently,infection produced by penicillin-resistant strains of Streptococcus pneumoniae became more and more prevalent,leading to frequent failure in treatment.Regarding to Staphylococcus aureus,the methicillin-resistant strains (MRSA) account for approximately 60% of the pathogens inducing hospital-acquired infections,and what is worse,such a tendency is spreading to community,while the features of community-acquired MRSA infections (CA-MRSA) are very different from that of hospital-acquired MRSA infections (HA-MRSA).The purpose of present article is mainly to summarize the advances in diagnosis and treatment of pneumonia caused by Streptococcus pneumoniae and Staphylococcus aureus.

Objective To reveal the literature resources in traditional Chinese medicine from the end of the Qing Dynasty to 1949 .Methods The papers published in journals of traditional Chinese medicine from the end of the Qing Dynasty to 1949 were statistically analyzed .Results The largest number of journals was published in Shang-hai, the largest number of papers was published in Guanghua Medical Journal, 95%of the papers were published by a single author, the contents were focused on classical prescriptions and proved recipes, food therapy, disease treatment, baby care knowledge, and the most commonly studied were infectious diseases, such as exogenous febrile disease, cholera, and malaria.Conclusion The papers published in journals of traditional Chinese medicine from the end of the Qing Dynasty to 1949 are focused much more on the application of the knowledge about traditional Chinese medicine , but less on the theories of traditional Chinese medicine .

Objective To investigate the effect of mycophenolic acid (MPA) on the endotheline-1 (ET-1) induced proliferation, contraction and migration of pulmonary arterial smooth muscle cells (PASMCs)and to explore the mechanism of MPA on pulmonary arterial hypertension (PAH), and the effect of exogenous guanosine nucleotide reversing anti-proliferative effect of MPA. Paired-samples t-test was used for statistical analysis. Methods MTT test, scarification test, Millicell cell culture insertion and the length of PASMCs mcasured under microscope were used. Results The A values of group ET-1 + low concentration MPA decreased when compared with group ET-1 (0.348±0.036 vs 0.447±0.013, t=6.357, P=0.000) and the A values of group ET-1 + high concentration MPA was further decreased. The A values of group ET-1 + low concentration MPA + guanosine was higher than that of group ET-1 + low concentration MPA (0.390±0.018 vs 0.348 ±0.036, t=2.573, P=0.028). The average migration distance and the average migration numbers of PASMCs of groups MPA was decreased than that of group ET-1. The average cell length of PASMCs of groups MPA was increas ed than that of group ET-1. Conclusion MPA can effectively inhibit the proliferation,contraction and migration of PASMCs by ET-1 induction. The IMPDH may play a role in anti-proliferative effect of MPA on PASMCs, but is unnecessary to be the sole mechanism. These findings has provide new insight into the mechanisms of mycophenolate mofetil in the treatment of PAH.

With the development of minimally invasive surgery,great developments have been made in laparoscopie techniques and digestive endoscopy.However,laparoscopy may cause injury by abdominal puncture,and digestive endoscopy is a painful examination for patients and is difficult to localize the tumor.Magnetic anchor makes use of magnetic attraction in positioning,and it improves laparoscopy and endoscopy by external magnetic field or magnetic handle.Nowadays,combined application of magnetic anchor and laparoscope and endoscope in the treatment of digestive diseases has been accepted by many medical centers,and further researches need to be carried out to realize the aim(small trauma,little pain and quick recovery)of minimally invasive surgery.

As a species of acute respiratory tract pathogen in mankind, Chlamydia pneumoniae can cause upper respiratory tract infection, pneumonia, it may also play an important role in bronchial asthma, chronic obstructive pulmonary diseases, sarcoid, lung cancer.

Objective To investigate the characteristics of mesenteric vascular thrombosis (MVT) in patients with antiphospholipid antibody syndrome (APS).Methods The cases reports about MVT in patients with APS were searched in Pubmed and Chinese biomedical database (1983.1-2007.7) and then were analyzed.Results There were 13 males and 8 females in 21 patients.The average age was (37±17) years (5months～69 years).Three cases (14%) had a history of deep venous thrombosis and 4 (19%) had spontaneous abortions.The course of disease was 4 hours to 4 months.The clinical manifestations included abdominal pain 18 (86%),hemafecia or melaena 4 (19%),vomiting 3 (14%),diarrhea 2 (10%),hematemesis 2(10%).Physical signs included abdominal tenderness in 10(48%),peritoneal irritation signs in 5 (24%),shifting dullness in 3 (14%) anddecreased bowel sounds in 3 (14%).Mesenteric vascular thrombosis were detected through B uhrasonography (3/10,33%),abdominal CT (9/13,69%),MRI (4/4,100%),Doppler ultrasound (4/4,100%),angiography (6/6,100%).Eighteen cases (86%) had positive anti-cardiophospholipin antibody and 14 (67%) were IgG-subtype.Lupus anticoagulants were detected in 4 (19%).Sixteen cases reee-ived exploratory laparotomy,lsehemia or necrosis of intestine were found in 9(56%).In 21 cases,superior mesenteric vein thrombosis,suprior mesenteric artery thrombosis,inferior mesenteric vein thrombosis,inferior mesenteric artery thrombosis were discovered in 17 (81%),4 (19%),0 (0%),1 (5%)patients respectively.Portal vein was also involved in 7 (33%) cases who had superior mesenteric vein thrombosis.Conclusion Superior mesenteric vein is usually involved in patients with APS who have MVT.MVTs are always occurr in middle-age male patients.Some patients have deep vein thrombosis or spontaneous abortion before MVT.The disease may be fulminant or had is insidious in onset.Abdominal pain and intestinal obstruction are the most common manifestations.IgG-subtype anticardiophospholipin antibodiesare the common antibodies discovered in these patients.Combined more than one image methods can detect the thrombi effectively.Anticoagulation and essential exploratory laparotomy are effective interventions in most cases.

With the methods of light microscopic histochemistry and electron-microscopic cytochemistry, we studied the changes of lactate dehydrogenase (LDH) and succinic dehydrogenase (SDH) in the anoxic myocardium of the mice; to which normal saline (INSAM group) or 10％ aqueous extract of Ginsengradix rubra (IGRAM group) was injected before the anoxic experiment. The results were as follows:Ⅰ. The Light Microscopic Study:1. In the myocardial sections of the INSAM group, the reaction of SDH of myofibrillae are variegated and the fibrillae vary in thickness. Granular mitochondria are clearly stained and arranged in alignment in the intermyofibrillar spaces. The intercalated discs fail to be stained and their spaces widen. In the IGRAM group, the reactions of SDH are similar to that of the normal control. The enzyme reaction product in the myofibrillae appear as homogeneous diffuse blue precipitate of formazan, the cross striations of myofibrillae are clear and strings of mitochondria are visible.2. The reactions of LDH in the INSAM group reveals that myofibrillar staining is also lost in a length of myofibrilla, strings of mitochondria are clearly stained. The reaction in the IGRAM group is similar to that of the normal control. In the myofibrillae there is a homogenous continuous violet precipitate of formazan.Ⅱ. The Electron-Microscopic Study:1. The reaction of SDH in the INSAM group shows that the enzyme activity in the mitochondrial inner membrane and the cristae is stronger than that of the normal control. The increased activity is represented by the increase of electronic density or darkening and thickening of the membranes. However, the activity in the IGRAM group is simillar to that of the normal control but weaker in reaction.2. The reaction of LDH in the INSAM group reveals that the enzyme activity exhibited by membrane darkening is obviously stronger than that of the normal control but in the IGRAM group it shows clearly a weaker reaction.The results mentioned above suggest that Ginsengradix rubra might alleviate the metabolic disturbance caused by myocardial anoxia.