Objective To observe the impacts of Kechuanning on expression of signal transducer and activator of transcription 6 (STAT 6) in CD4+, CD8+T lymphocytes of athma rats induced by virus, and analyze the mechanism of Kechuanning in treating asthma induced by RSV. Methods The PBMC was isolated from the peripheral blood, CD4+T, CD8+T lymphocyte was separated by immunomagnetic beads. The purity and activity of CD4+T and CD8+T lymphocytes were measured by using flow cytometry, trypan-blue dye exclusion test. The protein expression of STAT6 was detected by fluorescence-activated cell sorting. Results The descending progress of the trial were supported by the purity and activity of CD4+T, CD8+T lymphocyte. CD4+T lymphocyte in the asthma model group were increased (P<0.01), however the increase of CD8+T lymphocyte were not significant (P>0.05). The expression of the protein of STAT6 in the treated group with Kechuanning decoction were decreased than that in the model group (P<0.01). Compared with Dexamethasone and Salbutamol group, there were no significant differences (P>0.05). Conclusion Kechuanning decoction could decrease the protein of STAT6 in CD4+, CD8+T lymphocyte, thereby it could regulate the disorder of Th1/Th2, thus prevent and treat the asthmatic attack induced by virus.

OBJECTIVE: To explore the nature of pathology of sluggishness of lung-defensive qi and to offer objective experimental indexes for weifen syndrome (defensive phase syndrome). METHODS: According to the completely random design, the plasma levels of vasoactive intestinal peptide (VIP) and thromboxane B2 (TX2) of 19 patients with weifen syndrome and 13 patients with qifen syndrome (qi phase syndrome) were detected by radioimmunoassay. The plasma levels of VIP and TX2 at different stages of weifen syndrome and qifen syndrome were observed. RESULTS: The plasma levels of VIP in weifen syndrome and in the late stage of weifen syndrome increased greatly at different stages as compared to qifen syndrome and the blank group (P < 0.01), while the plasma level of TX2 of weifen syndrome was higher only at the late stage than the blank group and qifen syndrome (P < 0.01). As for the levels of VIP and TX2 in weifen syndrome with different internal organs infected, there was no significant difference (P > 0.05). CONCLUSION: VIP may be an index reflecting the pathology of weifen syndrome, and it is one of the material foundations of sluggishness of lung-defensive qi, but it has nothing to do with the infected internal organs. The level of TX2 increases only after the fever of patients with weifen syndrome subsided, so it can not be the basis for diagnosis of the early stage of weifen syndrome. It doesn't increase in qifen syndrome either, the mechanism remains to be further studied.

Erchen Decoction is widely used to dampness-phlegm syndrome and it can be flexibly used in clinical application by my supervisor Professor OU Zheng-wu, especially in cough, pneumonia, asthma and influenza, which has obvious efficacy in treatment. This article reviewed five medical cases during the follow-up process with Professor OU in application of Erchen Decoction, with a purpose to share experience of famous doctors and improve TCM diagnosis and treatment level together.

Objective To deeply understand the risk factors of lymphedema for patients with breast cancer after surgery. Methods The phenomenological method was applied in this study. Semi-structured interview was used to collected data from 9 female breast cancer patients with lymphedema after surgery in our hospital from June to September 2016 for generic analysis. Results The risk factors of lymphedema could be categorized into four themes:(1)choice of treatment is the primary cause:axillary lymph node dissection; radiotherapy; chemotherapy; (2)not paying enough attention to lymphedema:lacking the knowledge of lymphedema; imbalance of physical activities for the affected limb; lacking awareness of exercise and protection of the affected limb. Conclusions Axillary lymph node dissection after radical surgery for patients with breast cancer is the primary cause of lymphedema, and paying not enough attention is an important factor, especially lacking the consciousness of prevention, so the nurses should emphasize education about prevention of lymphedema after surgery for patients, to improve the consciousness of them to reduce the occurrence of lymphedema and its influence on their quality of life.

Objective:To report the diagnosis, treatment, and follow-up of a 21-hydroxylase deficiency boy with central precocious puberty caused by complex heterozygous mutation of CYP21A2 gene.Methods:The child was symptomatic of rapid growth and secondary sexual characteristics at the age of 6. The diagnosis of central precocious puberty was confirmed by serum testosterone, gonadotropin levels, and gonadotropin-releasing hormone (GnRH) stimulation test. 21-hydroxylase deficiency was diagnosed clinically based on the serum adrenocorticotropic hormone (ACTH), 17-hydroxyprogesterone levels, and images on the computed comography (CT) of the adrenal glands.Results:The CYP21A2 gene was detected to have a compound heterozygous mutation by Sanger sequencing and multiplex ligation-dependent probe amplification. During the 3 years follow-up, the effects of glucocorticoids, GnRH analogs, and recombinant human growth hormone were regularly monitored and evaluated.Conclusions:Glucocorticoid replacement followed the principle of the lowest effective dose. GnRH analogs showed an effective inhibition of the hypothalamus-pituitary-gonadal axis, while recombinant human growth hormone had no such growth-promoting effect.

Objective:To observe the effect of Kechuanning on Th cytokine expression in pediatric virus-induced asthma.Methods:120 cases of pediatric virus-induced asthma were randomly divided into Kechuanning group(treatment group,n =60,treated with Kechuanning) and Western medicine group(control group,n=60,treated with virazole).The change of Th1 cytokine IL-12 and Th2 cytokine IL-4 in blood serum were detected and analyzed.Results:Kechuanning could increase IL-12 but decrease IL-4 level in the patient's blood,therefore regulate Th cell subset,and the effect was more obvious than in control group.Conclusion:The mechanism of Kechuanning in curing pediatrics asthma induced by virus was related with increasing IL-12 and decreasing IL-4 level.

Objective To observe the effect of Kechuanning Oral liquid on the expression of P13K in CD4+and CD8+T cells of asthma rats induced by respiratory syncytial virus (RSV), and explore its mechanism of preventing and treating asthma induced by virus. Methods SD rats were randomly divided into phosphate-buffered saline (PBS) control group, model group, dexamethasone and salbutamol group (positive drug group), and Kechuanning oral liquid group. Ovalbumin asthma rats model was built and induced by RSV. CD4+and CD8+T cells were separated by magnetic beads method. The expressive level of PI3K-110αin T cells was detected by immumofluorescence method with flow cytometry. Results Compared with PBS control group, positive drug group and Kechuanning oral liquid group, the CD4+and CD8+T cells percentage and the expression level of PI3K-110α in CD4+ and CD8+T cells of model group were significantly higher. The differences were statistically significant (P<0.01). The CD4+and CD8+T cells percentage was not associated with the expression level of PI3K-110α in CD4+ and CD8+T cells of each group by Pearson correlation analysis. Conclusion The CD4+ and CD8+T cells involve in the asthma immunity balanced modulation, and the level of PI3K expressed by CD4+ and CD8+T cells increase distinctly. Kechuanning oral liquid can restrain the expression of PI3K in CD4+ and CD8+T cells, which might be one of the immunologic mechanisms of treating asthma.

BACKGROUNDTo detect the micrometastases status in peripheral blood and regional lymph nodes of lung cancer patients by reverse transcription-polymerase chain reaction (RT-PCR).

METHODSCK19 mRNA expression in peripheral blood and regional lymph nodes was detected in 78 patients with lung cancer, and 30 patients with pulmonary benign lesions and 10 healthy volunteers as controls by RT-PCR. Meanwhile, all lymph nodes were also examined by traditional pathological method.

RESULTSThe positive rate of CK19 mRNA expression was 38.5% in peripheral blood of lung cancer patients, and 6.7% in patients with pulmonary benign lesions (6.7%) (Chi-square=10.505,P=0.001). No positive CK19 mRNA expression was found in peripheral blood of 10 healthy volunteers. The positive rates of CK19 mRNA of lymph nodes were 36.9% and 0 in lung cancer patients and pulmonary benign disease patients respectively (Fisher's exact=0.014). In lung cancer group, the metastatic rate of lymph nodes was 17.9% by traditional pathological examination, which was much lower than that by RT-PCR (Chi-square=7.664, P=0.006).

CONCLUSIONSRT-PCR amplification of CK19 mRNA is an sensitive method to detect early haematogenous and regional lymph nodes dissemination of cancer cells for patients with lung cancer. This method may lead to an earlier diagnosis and treatment of patients with subclinical metastasis in circulation and regional lymph nodes.

BACKGROUNDTo investigate the diagnostic value of chest CT scan combined with telomerase activity and p16 gene methylation from exfoliated cells of sputum in 55 cases of solitary pulmonary nodules (SPN; ≤30 mm)suspected early peripheral lung cancer.

METHODSThe sputum specimens from 34 cases of cancer nodules and 21 cases of benign lesion were detected for telomerase activity by TRAP-PCR-ELISA and p16 gene methylation by PCR-based methylation analysis.

RESULTSThe qualitative diagnostic accuracy of CT scan was 61.8%(34/55) for SPN provided by pathology. Cytology analysis of sputum was positive in 13 cases (38.2%). Telomerase activity was positive in 29 cases: sensitivity was 79.4%, specificity was 90.5%, accuracy was 83.6%; p16 gene methylation was found in 11 cases: sensitivity was 32.4%, specificity was 100.0%, and accuracy was 58.2%. The sensitivity was increased to 86.1% by combination of telomerase activity and p16 gene methylation. Compared with nodules without malignant CT signs, expression of telomerase activity and p16 methylation of SPN with malignant CT signs (lobulation or spiculate protuberance or spicule sign) had a significant difference (P < 0.01).

CONCLUSIONSThe results suggest that chest CT scan combined with telomerase activity and p16 gene methylation detection in sputum for patients with peripheral lung cancer may enhance the diagnostic value of radiology and conventional cytology.

BACKGROUNDTo investigate the methylation and deletion of p16 gene and its diagnostic value in non-small cell lung cancer.

METHODSA total of 50 lung cancer tissues and 54 normal lung tissues were examined for p16 gene methylation in exon 1 and deletion in exon 2 by PCR based methylation analysis and duplex PCR respectively.

RESULTSOut of 50 lung cancer tissues, 16 were positive for the p16 gene exon 1 methylation (32.0%), and 14 for the p16 gene exon 2 deletion (28.0%). However, in 54 cases of normal lung tissues, only 2 showed the p16 gene exon 1 methylation(3.7%), and none showed the p16 gene exon 2 deletion. There were significant differences in methylation rate (Fisher's exact= 0.000 ) and deletion rate (Fisher's exact= 0.000) between the two groups.

CONCLUSIONSThe methylation and deletion may be important mechanisms for p16 gene inactivation in non-small cell lung cancer. The detection of p16 gene status may contribute to the diagnosis of lung cancer.