Objective To explore the change of the total level of lgE and specific allergen for acute exacerbation of bronchial asthma and to offer evidence for the prevention and cure of acute exacerbation of bronchial asthma.Methods The usual inhalant and ingested antigens were chosen in asthma patients,and the allergens were detected by ELISA in sera of acute exacerbation of bronchial asthma patients.Results Total positive rate of lgE was 92％ (48/52),dust mites 61.2％ (25/52),house dust 17％ (9/52),shrimp and crab 15％ (8/52),mould 9％ (5/52).Conclusion The main allergen of acute asthma exacerbation is dust mites.House dust,shrimp and crab,and mould folloo.The rats of pollen or weed are very low.

Objective To explore the clinical characteristics of Chronic obstructive pulmonary diseases(COPD)(≥65 years old,acute episode)with active pulmonary tuberculosis.Methods62 of COPD(≥65 years old,acute episode)with active pulmonary tuberculosis from 2002 to 2007 in hospital were reviewed and analyzed.ResultsThe attack rate of active pulmonary tuberculosis is 7.3% in COPD(≥65 years old,acute episode).By Clinical analysis showed clinical manifestation and chest X-ray or CT were not typical,but positive morbility of acid-fast bacilli sputum smear and bronchoalveolar lavage fluid was higher.ConclusionThe result suggests that COPD(≥65 years old,acute episode)patients are high-risk group of active pulmonary tuberculosis and need to be diagnosed early as soon as possible.

A variety of opportunistic infections can occur in the late-stage of HIV-1 infection,Mycobacterium avium complex (MAC) infection is a common cause of disseminated bacterial infection. Since the advent of highly active antiretroviral therapy (HAART),the rate of MAC infection has declined substantially,but there is risk in individuals with low CD4 cell counts. This article describes the epidemiological,clinical,therapeutic and preventive aspects of MAC infection in HIV-sero-positive individuals.

OBJECTIVE:To develop a method for concentration determination of voriconazole in human plasma and apply it in the clinic. METHODS:UPLC-MS/MS method was adopted. Using ketoconazole as internal standard,the determination was per-formed on Shim-pack VP-ODS column with mobile phase consisted of water(containing 1‰ formic acid and 2 mmol/L ammonium acetate)-acetonitrile(gradient elution)at flow rate of 0.3 ml/min and column temperature of 40℃.The electrospray ion source,pos-itive ionizing pattern and multiple reaction monitoring were used;the mass transition ion-pairs of voriconazole and internal standard were m/z 351.2→282.2 and m/z 532.1→490.2. RESULTS:The linear range of voriconazole were 1-10 000 ng/ml (r=0.999 5,n=5),and the limit of quantitation was 1 ng/ml;RSDs of inter-day and intra-day were all lower than 10%;method recovery was higher than 90%(RSD<8%),and extraction recovery was higher than 70%(RSD<8%). The plasma concentrations of voriconazole in 10 patients with invasive fungal infection determined by this method were 507.33-7 011.24 ng/ml,and those of 3 patients were outside the recommended treatment concentration range. CONCLUSIONS:The established method is fast,accurate and sensitive,and can be applied for the therapeutic drug monitoring of voriconazole.

Transforming growth factor-β(TGF-β), a member of the TGF-β superfamily, plays a role in multiple biological processes, including cell proliferation, differentiation, migration and tissue fibrosis, etc. Normally, TGF-βs widely express in normal tissues and most cell lines, such as macrophages and dendritic cells, But in pathological conditions, Cancer cells and cancer-associated fibroblasts also produce and secrete TGF-β. Scirrhous gastric cancer (SGC) is a special subtype of gastric cancer with rapid development, frequent peritoneal implantation, and accompanied by significant interstitial fibrosis deposition. these biological behavior characteristics all suggest that its occurrence and development are closely related to TGF-β expression, and TGF-β is considered to be associated with poor prognosis of the SGC. The use of antibodies and inhibitors of TGF-β and its signaling pathways can reduce the invasiveness of cancer cells and improve the prognosis of SGC patients. This paper reviews the expression and significance of TGF-β in SGC.

Objective To evaluation the diagnostic value of echocardiography in mechanical prosthesis valve dysfunction(MPVD).Methods Fifty-two patients who underwent reoperation due to MPVD were included,and the preoperative,introperative and postoperative results of echocardiography was compared with the results of surgery or pathologic diagnosis.Results The etiology of MPVD based on cardiac surgery was thrombus in 12,fibrous tissue hyperplasia in 23,thrombus and fibrous tissue hyperplasia in 16,lost of mechanical disc in 1.The types of MPVD diagnosed by echocardiography were stenosis in 29,regurgitation in 2,stenosis and regrigitation in 12,intermittent obstruction in 8,and total obstruction in 1.Successful assessment of prosthetic disc by transthoracic echocardiography was 78.4％ and can be improved to 96.1 ％ when combined with transesophageal echocardiography.Complementary message by transesophageal echocardiography were provided in 10 patients and corrective message in 1 patient.No recurrent MPVD was find during the follow-up.Conclusions Echocardiography can be used as the frist choice for the evaluation of the MPVD and can make precise assessment of the abnormal hemodynamic change and state of motion of the valve.

The build-in low-pressure monolithic column combined with hydride generation atomic fluorescence spectrometry ( HG-AFS ) was employed for speciation analysis of fish meat. The sample pretreatment and separation approach could be accomplished within 30 min. The proper amount of fish sample was weighed and smashed into puree. The extraction solution composed of 10% HCl, 1% thiourea, and 0. 15% KCl was added before loaded into the automatic temperature controlled vertex system with 2000 r/min. The sample solution was separated through Merck monolithic column, with 3% ( V/V) acetonitrile, 30 mmol/L amonium acetate and 0. 03%(V/V) 2-mercaptoethanol (2-ME) as the eluent. The after-column eluent was digested by novel UV digestion device with pipeline sintered into the lamp, and then detected by hydrid-generation AFS. The rapid LC separation enabled fast mercury speciation of fish sample within 10 min. The different UV lamp digestion effects, eluent components, carrier gas, shield gas, lamp current, as well as PMT working power was optimized. Under the optimal conditions, the robust system achieved detection limits (DL) of 0. 15 μg/L and 0. 14 μg/L for methylmercury and HgⅡ, respectively. The RSD (n=7) was less than 5%, the linear correlation coefficient was 0 . 999 , and the matrix spiked recovery was in the range of 85%-110% for Hg speciation. This method was used for the determination of Hg speciation in fish and soil samples, and was proofed to be a reliable, easy approach for daily inspection.

Objective To apply short message service (SMS) for pulmonary rehabilitation in residence. Methods A total of 102 old pa-tients with chronic obstructive pulmonary disease (COPD) in stable situation were equally divided into three groups randomly. They all ac-cepted a two-week lesson of exercise project, and then took in the project for 22 weeks. Meanwhile, group A phoned to their experts once a week, group B was phoned by their experts once a week, and group C accepted SMS once a day and sent back to the experts. They were in-vestigated with Exercise Self Regulatory Efficacy Scale (Ex-SERS), modified British Medical Research Council Scale (mMRC) and COPD Assessment Test (CAT) before and after intervention. Results The score of Ex-SERS was the most in group C (F=179.53, P<0.001), with the interaction of time (F=387.09, P<0.001). While the scores of mMRC (F=8.754, P<0.001) and CAT (F=11.32, P<0.001) were the least in group C. Conclusion Application of SMS in the integrated management for pulmonary rehabilitation in residence may improve the self regu-latory efficacy of exercise, release the dyspnea and the influence on living in patients with COPD.

Objective To explore the effect of self efficacy combined with mobile health information service applied in pulmonary rehabilitation in residence in elderly patients with chronic obstructive pulmonary disease. Methods Sixty-eight elderly patients in stable situation were divided into the control group and the intervention group with 34 cases in each group accoridng to the random digit table. In the control group, the nursing intervention included health education and telephone follow-up. The intervention group adopted self efficacy theory combined with mobile health information service. The items such as persistence in pulmonary rehabilitation, Exercise Self-Regulatory Efficacy Scale (Ex-SRES) and health condition were assessed. Results After intervention for 12 weeks, the scores of persistence in pulmonary rehabilitation in residence in the intervention group scored 5.35 ±1.42, which was higher than that in the control group (2.03±1.40), the difference was significant (t=160.43, P<0.01). Ex-SRES of the intervention group scored 62.06±13.10,91.21±11.12, which were higher than those of the control group, 50.38±18.03,42.56±18.23, the difference was significant (t=9.32,176.88, P<0.01) . The interaction between treatment effects and time effect was significant in COPD Assessment of Tool (CAT) and Ex-SRES respectively(F=489.95,P=0.00;F=134.80, P=0.00). Comparing value of CAT in baseline (24.97±4.74,24.62±5.39) and at the end of the twelfth week(24.94±4.74,24.65±5.35), the difference was not significant in two groups respectively(P>0.05). The improvement of CAT was significant at the end of the twenty-forth week (21.90±4.67) in the intervention group (t=-12.09, P<0.01). Conclusions Self efficacy theory and the application of mobile health information services can help patients persist in long-term rehabilitation exercise training.

Objective To investigate the clinical significance of silent mating-type information regulation 2 homologue 1 (SIRT1) in hepatocellular carcinoma (HCC).Method We analyzed p53 mutation by gene sequencing and activation of SIRT1 and AMP-actived protein kinase (AMPK) using western-blot in 252 patients with hepatitis B virus-positive HCC.Results A higher proportion of tissues with mutant p53 were demonstrated to harbor activated SIRT1 (64.8％ vs 31.8％ ; P ＜ 0.01).Activated SIRT1 predicted a longer relapse-free survival.On multivariate analysis,activated SIRT1 remained significant (OR:0.339,CI:0.160-0.720,P =0.005).Analysis of 252 paired specimens revealed a significant correlation between activated SIRT1 and activated AMPK in HCC tissues harboring mutant p53 (P =0.007).Conclusion SIRT1 exerted anti-carcinogenic effects through the AMPK pathway in HCC in the context of mutant p53.