Objective To observe the effect of Compound Fuling Gancao Decoction(CFGD) on transforming growth factor ?1(TGF-?1) in pulmonary artery of rats with pulmonary hypertension(PH),and to explore its therapeutic mechanism for PH and pulmonary vascular remodeling.Methods Thirty SD male rats were randomized into the normal control group,model group,and CFGD(5.46g?kg-1?d-1) group.PH rats models were induced by intraperitoneal injection of monocrotaline(50mg/kg).The mean pulmonary artery pressure(MPAP) in rats was detected with the method of right cardiac catheterization,right ventricular hypertrophy index was calculated,histological changes of lung small artery were analyzed with pathological image analysis,and TGF-?1 expression in pulmonary artery was detected by immunohistochemical method.Results MPAP and right ventricular hypertrophy index were enhanced obviously,the number of muscular arteries and partially-muscular arteries was increased,ratio of media area and luminal thickness in the muscular arteries became bigger,and TGF-?1 expression in pulmonary artery of the model group was increased.The above indexes were improved in CFGD group.Conclusion CFGD is effective on decreasing pulmonary pressure and improving pulmonary vascular remodeling,and its mechanism is probably related with the inhibition of TGF-?1 expression in pulmonary artery.

OBJECTIVETo analyze diagnostic approach to severe acute respiratory syndrome (SARS) according to the diagnostic criteria issued by the Ministry of Health of China (MHC).

METHODSThe clinical data and the diagnostic results of 108 cases of SARS were retrospectively reviewed according to the MHC criteria.

RESULTSThere were 55 men and 53 women, with a median age of 34.5 years (range, 12 - 78 years). The interval between their first visit and clinical diagnosis was 3 days (range, 0 - 14 days). The diagnosis was made at the first visit in 7 (6.5%, 7/108) cases with a history of exposure to SARS patients and infiltrates on chest radiograph. Eighty-nine (82.4%) and 12 (11.1%) patients were categorized as probable cases and suspected cases respectively at their first visit and a clinical diagnosis of SARS was made subsequently. The interval between first visit and reaching the final diagnosis was 1 - 3 days in 72 (66.7%) cases and 4 days in 29 (26.9%) cases. The final diagnosis was made in 0 - 14 days (median, 2 days) for those (n = 59, 54.6%) with a history of close contact with SARS patients and 2 - 8 days (median, 3 days) for those (n = 49, 45.4%) living in Beijing but without such a history (P = 0.03). The chest radiograph was interpreted as unremarkable in 26 (24.1%) cases at their first visit, and the diagnosis was made in 4 days (range 2 - 8 days), which was significantly longer compared with other cases (P < 0.001). In patients without a history of close contact with SARS patients, all the five criteria were met after combination antibiotic therapy had failed.

CONCLUSIONSA chest radiograph without infiltrates at the early stage of SARS is an important factor responsible for delayed diagnosis. In patients without a history of close contact with SARS cases, antibiotic effect was a major factor influencing doctors' diagnosis.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Retrospective Studies ; Severe Acute Respiratory Syndrome ; diagnosis