Professor Zhang Yonghong thinks that the deficiency of lung qi always exists in advanced lung cancer cases. Pathogen infection, phlegm and blood stasis are key factors to the occurrence and development of lung cancer. Clinical treatment in advanced lung cancer should emphasize on the benefiting of qi and supplementing the lung as well as reducing phlegm, removing blood stasis and disintoxication. Attention should be paid to both syndrome differentiation and disease differentiation with the combination of strengthening the body resistance and eliminating evil factors according to different stages of lung cancer.

Objective To investigate the differences of background in anxiety neurosis and obsessive－ compulsive disorder,and their suicide rate and comorbidity.Method 68 anxiety neuroses and 62 obsessive－ compulsive disorders were investigated by the selfconstructed scule.Rusult Age of onset,style of onset,marriage and education were significantly differences between anxiety neurosis and obsessive－ compulsive disorder(P< 0.01～ 0.001).The rates of suicide behavior and suicide intent in anxiety neurosis and obsessive－ compulsive disorder were 10.3％ and obsessive－ compulsive disorder with depressive disorders were 70.6％ and 35.5％ respectively.Conclusion Anxiety neurosis and obsessive－ compulsive disorder two different disorders,they had higher suicide rates and comorbidity.

Objective To investigate the mechanism of cross resistant inducibility of ciprofloxacin and imipenem which led to cross resistance in Pseudomonas aeruginosa in vivo. Methods Cross resistant mutant strains were selected and induced with clinical isolates of P.aeruginosa PA5 susceptible to ciprofloxacin and imipenem by experiment of murine peritonitis. Mutation of DNA gyrase gene, drug uptake and membrance proteins of P.aeruginosa PA5 and its mutants resistant to ciprofloxacin and imipenem were examined. Results Both ciprofloxacin and imipenem could induce resistant strain of P.aeruginosa in experimental murine peritonitis, the cross resistance rates after ciprofloxacin and imipenem challenge were 3.8% and 0.98% respectively. The results of PCR SSCP showed that 3 of six cross resistant of P.aeruginosa strains had gyrA gene mutation. Electrophoresis of outer and inner membrane proteins did not exist any difference between cross resistant strains and their parent strain PA5. Fluorometric assay for ciprofloxacin uptake by bacterial cells indicated that the accumulation of ciprofloxacin in all cross resistant variants decreased to 1/2～1/3 compared with that of PA5. After chanllenge with CCCP, the drug uptake in cross resistance mutants increased to the same level as in PA5. Conclusions The results show that cross resistant strains of P. aeruginosa could be selected and induced in vivo. Active drug efflux is the major factor contributing to the cross resistance of P. aeruginosa to both quinolone and imipenem.

Objective To evaluate the payment effect of hospitalization expense under the urban employee basic medical insurance in Guangzhou.Methods Analyze the differences between the expenses paid by medical insurance with actual hospitalization expenses of the 22 settlement units from 1 5 tertiary hospitals,and the expense settlement data of the insured patients,based on the early,the mid-term,and the recent periods since the urban employee basic medical insurance was implemented since 2002.Results The ratio of good payment effect units reduced to 9.09%(the recent)from 42.86%(the earlier).The ratio of poor payment effect units was 42.86% in the early,to mid-term 18.18%,and sharply increased to 77.27%in the near term.The settlement units which exceeded its flat standard accounted for 52%,50%, and 91%respectively(in the early,the mid-term,and the recent).The medical insurance agency and the hospital shared the overrun costs by 52.88%and 47.12%respectively in 201 1.Conclusion The payment effect of the urban employee medical insurance was greatly influenced by the adjustment of medical insurance policy and the payment ability of the pooling fund.It should improve the payment effect of the medical insurance timely,so as to ensure the hospitals’operation normally.The hospitals should take the effective cost management measures so as to deal with the increasing cost control pressure.

Objective To investigate the effect of salbutamol aerosol combined with magnesium sulfate on IL-2, IL-4, IL-5, IFN-γand T lymphocyte subsets in pediatric asthma patients.Methods 38 pediatric asthma patients were selected and randomly divided into control group and experimental group.Control group was treated by clinical routine method.Experimental group was treated by salbutamol aerosol combined with magnesium sulfate.The IL-2, IL-4, IL-5, IFN-γ, T lymphocyte subsets, blood pressure, heart rate, respiratory and clinical effects were observed and compared.ResuIts Compared with control group, the serum levels of IL-2 and IFN-γwere higher(P<0.05).The IL-5, IL-4 level were lower(P<0.05).The CD3 +, CD4 +, CD4 +/CD8 +level were higher(P<0.05).The serum CD8 +were lower(P<0.05).The total efficiency were higher(P<0.05).ConcIusion Salbutamol aerosol combined with magnesium sulfate can effectively regulate T lymphocyte subsets proportion and cytokine levels in asthmatic children, enhance immunity, and improve the clinical symptoms.

Objective To study the relationship between serum hepatitis B virus covalently closed circle DNA (HBV cccDNA) as well as liver function and liver tissue pathological changes in children with chronic hepatitis B.Methods One hundred and twenty-four HBV-DNA positive children with hepatitis B were enrolled.Among 124 patients,65 cases were HBV carriers,59 cases were chronic hepatitis (mild in 31 cases,moderate in 18 cases and severe in 10 cases).HBV cccDNA in serum and liver function were detected,46 of which underwent liver biopsy and liver tissue inflammation and fibrosis grading classification was made.Results In moderate and severe cases,positive rates of serum HBV cccDNA (77.8％,100％) were higher than those of the HBV carriers and mild cases (32.3％,54.8％) (x2 =25.429,P ＜ 0.01),indicating more severe illness in children,detection rate of serum HBV cccDNA was higher.ALT,AST,and TBIL were higher in serum HBV cccDNA positive group than those of negative group[(95.6 ± 18.2) U/L vs (52.5 ± 17.7) U/L,(88.8 ±20.3) U/L vs (48.4 ±21.4) U/L,(68.4 ±24.6) μmol/L vs (28.3 ± 23.9) μmol/L](t =15.572,10.750,17.067,P ＜ 0.01).Serum HBV cccDNA and liver inflammatory activity and fibrosis showed no significant correlationship.Conclusion Serum HBV cccDNA is a sensitive indicator of viral replication,the more severe the disease situation,the peripheral HBV cccDNA detection rate is higher.But it is not entirely consistent with liver inflammation and fibrosis,so it can not completely reflect the degree of liver damage.

Objective To explore the value of tubercular antibody (TBAb) in the diagnosis of tuberculous pericarditis (TBP).Methods The TBAb in 38 patients were determined by colloidal gold (CG) and compared with 64 healthy control. Results The positive ratio in TBP group was significantly higher as compared with control group. The hydropericardium was significantly decreased or disappeared after 6 months of antituberculotic treatment by color Doppler ultrasonography. It seemed that patients were rehabilitated and electrocardiogram (ECG) was normal. Conclusion TBAb is valuable in the diagnosis,differential diagnosis or treatment of TBP.

Objective To evaluate the changes of thyroid function during pregnancy in the second and third trimester in the regions with or without iodine deficiency. Methods The serum TSH, FT 3, FT 4 and TT 4 levels of 90 pregnant women (30 from iodine deficient area as study group, 60 from iodine sufficient area as control group) and 30 non pregnant women were assayed by high sensitive immunoradiometric assay (IRMA) or radioimmunoassay (RIA), and urine iodine level of pregnant women before delivery was also examined. Results (1) The serum TSH level in pregnant women in the second and third trimester was significantly higher than that of non pregnant women. The serum free thyroid hormone levels of pregnant women were significantly lower than that of non pregnant women, especially in the third trimester. (2) The serum TSH level of pregnant women from iodine deficient area in the second trimester and before delivery was significantly higher than that of pregnant women from iodine sufficient area (P

Objective To evaluate the relationship between airway obstruction and peripheral arterial stiffness in elderly patients with chronic obstructive pulmonary disease (COPD).Methods Ninetyeight elderly patients with COPD were enrolled.The patients were divided into two groups according to forced expired volume in 1 second (FEV1) percentage of predicted (FEV1 ％):mild-moderate group (FEV1 ％ ≥ 50％,62 cases) and severe group (FEV1％ ＜ 50％,36 cases).The brachium-ankle pulse wave velocity (baPWV),body mass index (BMI),24 h average heart rate,blood level of lipid,fasting blood glucose,arterial partial pressure of oxygen (PaO2) and high sensitivity C reactive protein (hs-CRP) level were compared between two groups.Results Compared with mild-moderate group,the BMI in sever group was lower:(22.9 ± 4.3) kg/m2 vs.(25.4 ± 3.3) kg/m2,24 h average heart rate was higher:(77.5 ± 12.8) times/rmin vs.(70.7 ± 9.5) times/min,PaO2 was lower:(71.7 ± 13.1) mmHg (1 mmHg =0.133 kPa) vs.(84.5 ± 13.2) mmHg,and there were statistical differences (P ＜ 0.05).The baPWV in mild-moderate group was (18.9 ± 4.2) m/s,and in sever group was (21.8 ± 3.6) m/s,and there was statistical difference (P ＜ 0.05).The hs-CRP in miid-moderate group was (6.62 ± 4.57) mg/L,and in sever group was (3.38 ± 2.13) mg/L,and there was statistical difference (P＜ 0.05).Conclusions The morbidity of peripheral arterial stiffness is increased in elderly patients with COPD.Progression of peripheral arterial stiffness is related to the severity of airway obstruction.

Objective To distinguish BRO ?-lactamase by use of restriction endonuclease analysis and investigate antibacterial agents resistance of Moraxella catarrhalis(M. Catarrhalis) with different BRO ?-lactamases .Methods Nasopharyngeal swabs of children with respiratory tract infections from the outpatient department of Beijing Children's Hospital were cultured for isolating M.Catarrhalis. BSAC(british society for antimicrobial chemotherapy) agar diffusion test was used to determine antibacterial agents resistance of M.Catarrhalis.Nitrocefin disk was used to detect ?-lactamase. Restriction endonuclease analysis was used to distinguish BRO ?-lactamases . Antibacterial agents resistance of M. Catarrhalis with different bro genes was compared.Results (1)95.0% of the 80 strains were beta-lactamase positive. MIC 90 of ampicillin was 32 ?g/ml and MIC 90 of cefuroxime,cefaclor and cefotaxime were 4 ?g/ml,8?g/ml and 1?g/ml respectively,MIC 90 of tetracycline was 16?g/ml. Among the antibacterial agents,ciprofloxacin was the most sensintive agent.(2)Among 80 strains,6(7.5%) Strains were bro negative,55(68.8%) were bro-1 positive,19(23.8%)were bro-2 positive。Except 2 strains,the results of ?-lactamases were same as the results of nitrocefin disk and restriction endonuclease analysis.(3)Compared with bro-2 positive strains,the MIC value of ampicillin and cefaclor for bro-1 positive strains were higher.Conclusions Antibacterial agents resistance of M. Catarrhalis to ampicillin was sierous in China. It should be strengthened to monitor antibacterial agents resistance of M.Catarrhalis. Restriction endonuclease analysis can play an important role on characterizing bro genes,evaluating antibacterial agents resistance of Moraxella Catarrhalis to ?-lactam and investigating molecular epideminology