Respiratory infections have an important relationship to asthma as they provoke wheezing and increase symptoms in many patients.Respiratory syncytial virus and rhinoviruses are the principal triggers to wheezing and worsening of asthma.It has been disccused that the mechanisms,clinical picture,and treatment of asthmatics with respiratory infections.

Special considerations are required in managing asthma in relation to pregnancy,surgery,rhinitis,sinusitis and nasal polyps,occupational asthma,respiratory infections,gastroesophageal reflux,aspirin-induced asthma and anaphylaxis.

OBJECTIVE:Inhaled glucocorticoids(GC) are the first-line medicine for bronchial asthma during relieve phase, thereby this study was designed to explore if patient tends to suffer osteoporosis due to long term inhalation of glucocorticoids. DATA SOURCES:Literatures about GC and osteoporosis were computer-searched in Medline and Embase from January 1980 to December 2003, with the key word of " asthma, bone density, bone metabolism and inhaled glucocorticoids" and language limited to English.Meanwhile it was also computer-searched in CBM, CBM disc and manually searched in Chinese Journal of Clinical Rehabilitation between January 1990 and April 2004 with language limited to Chinese. DATA SELECTION: Literatures about the comparison of bone density and bone metabolic change between inhaled GC group and control group were consorted deleting randomized controlled trial(RCT) so as to look up the whole content of healthy controls;While patients in the treatment group received GC inhalation.Exclusive standards:obvious non-RCT. Quality assessment is mainly focused on the reality of data,the strictness of design and implementation,and the rationality of statistical management. DATA EXTRACTION:Totally 30 randomized and nonrandomized studies about the influence of inhaled GC on the bone density and bone metabolism of patients with asthma were referred to amongst which 18 studies were admitted with the other 12 excluded for similarity in content in 8 and Meta-analysis in 4. DATA SYNTHESIS:A total of 1 153 asthmatic patients in 18 studies were divided into GC inhalation group and non-inhalation control group for comparing the difference of bone density and/or bone metabolism between them. CONCLUSION:Although the results of studies on the influence of long-term inhaled GC on bone quantity were different, but there was still not enough evidence to demonstrate that osteoporosis was due to long-term GC inhalation.

Objective To investigate the effect of 15-deoxyspurgualin (DSG) on graft coronary arteriosclerosis (GCA) and the platelet-derived growth factor-A (PGDF-A) mRNA expression of graft myocardium after heterotopic heart transplantation and the possible mechanism. Methods The rat heterotopic heart transplantation model was developed. Two groups of Lewis rats ( n =7 in each group) underwent heterotopic heart transplantationin from Wistar-King donors and were treated with either DSG (5 mg/kg daily, DSG group) or cyclosporine A (10 mg/kg daily, control group). Histological examinations of rejection and coronary arteriosclerosis, as well as Northern blot analysis of graft PDGF-A mRNA expression were made 60 days after transplantation. Results No significant difference in the degree of rejection was found between the two groups. However, the degree of coronary arterial intimal thickening in the DSG group was significantly less than that in the control group ( P

Objective To observe the effect and mechanism of imiquimod on T helper (Th) cell subsets in the Parabronchial lymph node (PBLN) cell cultures from ovalbumin (OVA)-sensitized rats.Methods PBLN were isolated and cultured. PBLN cells were divided into A~F, according to different concentrations of intervention. Cultured for 0, 3, 6, 12, 24, 48 hours, the expressions of IL-4 and IFN-? in supernatants were determined by ELISA. The mRNA expressions of the cytokines in cells were detected by RT-PCR.Results In the group A, only low concentrations of IFN-? were detected. Based on the cultured time, the concentrations of IFN-? were increased significantly if imiquimod concentration was between 1 and 10 ?g/ml. Levels of IL-4 were increased slowly compared with those in the group B (P0.05).Conclusion Imiquimod show the best effect on antigen-specific Th cell subsets when cultured for 12h. The results suggest that imiquimod have benefit in atopic diseases such as the late inflammation reaction of asthma.

The effect of tranilast on the down- regulation of beta- adrenoceptor agonist was investigated. Male guinea pigs were divided into 3 groups, one group is control. Others were received injection of terbutaline or terbutaline plus tranilast for successive 5 days. The radioli-gand binding assays for beta-adrenoceptors in the lung membranes of the guinea pigs were per-formed. The results showed the numbers of maximal binding sites (Bmax) of beta-adrenoceptors in terbutaline group was significantly less than that in control group ( P 0. 05).The affinity ( Kd) of beta-adrenoceptors both in terbutaline group and in terbutaline plus tranilast group was higher than that in control (P

Objective To study the diagnostic value of fractional exhaled nitric oxide(FeNO)in non-typical bronchial asthma.Methods Ninety-five patients with unknown-cause respiratory symptoms including wheezing,cough and breathlessness were enrolled.FeNO was measured by nitric oxide analyzer.The clinical symptoms and bronchial bronchodilator test were defined as golden standard for asthma diagnosis.The diagnostic value of FeNO was assessed and the optimal operating point of FeNO test was determined by means of the receiver operating characteristic(ROC)curve.Results Among 95 patients,44 cases were diagnosed as asthma,51 cases were diagnosed as non-asthma.The level of FeNO of asthma patients were higher than that of non-asthma patients[(55.2±14.0)nmol/L vs.(18.9±5.2)nmol/L,P＜0.01].A non-linear correlation of FeNO with FEV1％ was revealed in the cases with asthma(r=-0.162,P＞0.05).Area under ROC curve was 0.858.The optimal diagnostic cut off point was 36 nmol/L which was capable of differentiating asthma and non-asthma with sensitivity of 80.2％,specificity of 79.5％,positive predictive value of 85.4％,negative predictive value of 83.3％ and accuracy of 85.9％.Conclusions FeNO test may be helpful in the diagnosis of non-typical asthma with high sensitivity and specificity,which can also improve the diagnostic effectiveness and avoid misdiagnosis,missed diagnosis when combined with lung function test.

BACKGROUND: Inhaled glucocorticoids(IGC) are powerful anti_inflammatory agents used in the treatment of asthma. But it is still uncertain whether long-term use of the IGC affects bone metabolism in asthmatic patients, especially women.OBJECTIVE: To investigate if the prolonged treatment with IGC to Chinese asthmatic woman has a detrimental effect on bone mass and metabolism.DESIGN: A matched controlled study based on the patients SETTING:Clinical Laboratory and the Department of Respiratory Medicine, First Affiliated Hospital, Nanjing Medical University.PARTICIPANTS: From February 1998 to February 2002, forty female Chinese patients with bronchial asthma, regularly followed up at our outpatient clinic, all in the Nanjing area, none of them having a history of chronic systemic GC use, agreed to take part in the study, were selected and divided into two groups: therapeutic group (IGC group): 20 asthmatic women, aged 18-63 years, 5 menopausals, received IGC therapy regularly for at least 5 months; Control group: 20 asthmatic women, aged 18-60 years, 5 menopausals, never received IGC received conventional bronchodilators . They were matched individually for sex, age and menopausal status.METHODS: Bone mineral density (BMD) at the lumbar spine (2-4),femoral neck, trochanter, ward's triangle and total body of femur were measured by dual energy X-ray absorptiometry, BMD were expressed as a absolute value and a T score considered as a SD from peak bone mass respectively. Meanwhile, BMD was also expressed as a percentage (%), which was defined by comparing the BMD absolute value of subjects and BMD normal value of isosexual age cohorts. Osteocalcin and some other markers of bone metabolism were measured by radio immunoassay in two groups.daily dose and accumulative total dose of IGC and BMD in the IGC group.RESULTS: There were no significant difference between two groups in BMD and T score (including the lumbar spine (2-4), femoral neck,trochanter, ward' s triangle and total body of femur) (P ＞ 0.05). There were also no significant correlation between daily dose of IGC and BMD of above 5 parts in the IGC group (r=-0.325 to -0.1102, P ＞ 0.05). But,there were significantly negative correlation between the accumulative total dose of IGC and BMD at lumbar spine2-4,femoral neck and ward's triangle(r=-0.495 ,-0.517,-0.531 ,P ＜ 0.05).There were no significant correlation between the accumulative total dose of IGC and T score of above 5 parts in the IGC group (r=0.443to 0.295 ,P ＞ 0.05). There was negative correlation between the age and the BMD at ward's triangle in the IGC group(r=-0.506,P ＜ 0.05). However ,BMD at 5 locus were not correlated with the age in control group (r=-0.079 to 0.326, P ＞ 0.05).Osteocalcin and some other markers of bone metabolism were no significant difference between two groups (P ＞ 0.05).CONCLUSION: The data suggests that there is no significant influence of IGC on bone mineral density and bone metabolism in asthmatic women,but if continuing exposures to high doses over many years,there may be a detrimental effect on bone mass and metabolism in women, especially elder or postmenopausal asthmatic women treated with IGC who may be more susceptible to any bone mineral loss caused by IGC.

To evaluate the efficacy and safety of Azithromycin in the treatment of the bacterial infections. Method s: 94 patients with lower respiratory tract infection were randomly d ivided into 2 groups(47 for each gruop). The treated group were given Azithrom ycin 500mg in 5% glucose injection 500mL, iv drip, bid, for 5-7 days. Another 12 patients (including 4 patients with pelvic inflammatory disease and 8 patients with lower respiratory tract infection) were treated with Azithromycin as the op en group. Results: The treated group yielded a recovery ra te 61.7%, aeffective rate 91.5% and abacterial clearance rate 95.8%, which wer e higher than the controlled group [31.9%, 70.2%, and 76.6% (P＜0.01)]0,res pectively. The total response rate and the cure rate in 59 patients treated with Azithromycin were 93.2% and 62.7%, respectively. The incidence of clinical adve rse drug reactions in the treated group was 12.8%, being lower than 34.0% in the controlled group (P＜0.05). Conclusion: Azithromycin is an effective agent in the treatment of the acquired lower respiratory tract infection, urogenital and urogenital tract infection with slight adverse reaction .

Objective:To investigate the effects of interferon-? on bleomycin-induced pulmonary fibrosis in rats and to study the mechanism of its effects.Methods:60 SD rats were randomly divided into 3 groups of 20:normal control group(Group N), model control group(Group M) and interferon-?(IFN-?)treated group(Group R). The pulmonary fibrosis model was established by a single intratracheal injection of 5 mg/kg of bleomycin. The rats were sacrificed at days 3,7,14,28 after modeling in batch. Lung tissues were restored to analyze the pathological changes, the content of hydroxyproline,mRNA expression of IFN-? and transforming growth factor-?(TGF-?).Results:The scores of alveolitis in Group M and R were higher than that in Group N at each poin-in-time after modeling.The scores of alveolitis in Group R were higher than that in Group M. The scores of pulmonary fibrosis and the content of hydroxyproline in lung tissues in Group M and R were higher than that in Group N at day 14 and 28. The expression of IFN-? mRNA in lung tissues at day 3,7,14,28 and TGF-? mRNA at day 3 in Group R were higher than that in Group M(P