Objective To establish a rapid culture method for monitoring of influenza circulation and laboratory diagnosis of individual patients with influenza. Methods Nasal aspirate specimens were spun onto 24-well plate containing confluent monolayers of Madin-Darby Canine Kidney (MDCK) cells. Fluorescein labeled monoclonal antibodies to influenza A and B viruses were used to stain and type the isolates. Results A total of 713 nasal aspirates specimens from patients experiencing influenza-like symptoms was collected in Beijing between December of 2000 and March of 2001, 187(26 2%) specimens were found with influenza A virus and 109(15 3%) with influenza B virus. 2 2% with influenza A and 11 2% with influenza B virus were detected in 89 nasal aspirates specimens between Jan-Apr 2002. Conclusion Prevalence of influenza was low during 2000～2002 year non-epidemic period in Beijing. The combination of shell viral assay and direct immunofluorescent staining can provide a rapid laboratory diagnosis of influenza, which makes possible for the patients to receive treatment of anti-influenza virus drugs.

Objective To report the outcome of gefitinib for Chinese patients with advanced nonsmall cell lung cancer(NSCLC) at Peking Union Medical College Hospital. Methods From Oct. 2002 to Apr. 2006,204 patients with advanced NSCLC received oral ZD1839(250 mg/d)treatment. The were 110(59.9%)men and 94(40.1%)women aged between 25 and 85 years. Thirty-two patients had squamous cell carcinoma, 125 adenocarcinoma, 30 bronchoalveolar carcinoma or adenocarcinoma with partial bronchoalveolar carcinoma, 6 adenosquamous carcinoma. and 11 unspecified. Twenty-six patients had no history of chemotherapy, 62 had no disease progression after chemotherapy, and 111 failed to prior one or more regimens. Median survival was calculated using the Kaplan-Meier method and a Cox regression analysis was used to detect differences in median survival between strata. Results The median survival of all patients and of patients failed to prior chemotherapy were 16.3 months(95% confidential interval CI, 14.5-18.2)and 12.5 months(95% CI 9.3-15.7). The rate of 1-year survival was 57%. The obiective tumor response rate and stable disease rate were 31.4% and 41.7% respectively.The median survival were significantly related with ECOG scores,pathology types,disease progression after chemotherapy,objective efficacy of gefitinib and changes of short-breathing. Among 26 patients with no prior chemotherapy,the median survival was not statistically significant compared with that of other patients. Among the enrolled patients,111 had disease progression and 62 had stable disease after prior chemotherapy, and their median survivals was statistically different. At the time of this analysis. 142 patients had disease progression,58 of whom withdrew from taking gefitinib,and 84 continued gefitinib therapy until death. The median survivals for these subgroups were not significantly different. Among 142 patients with disease progression, 40 received other systemic treatment, the median survival was statistically significant compared with that of other patients. Objective response was significantly related with age,smoking status,pathological type,change of short-breathing and rashes induced by gefitinib. Adverse events were generally mild(grade 1 and 2)and reversible. The most frequent adverse events were rash 72.6%(138/190)and diarrhea 33.7%(64/190).Conclusion Our studv suggests that treatment with gefitinib may be well tolerate and beneficial for some Chinese patients after failure of prior chemotherapy.

Objective To assess the outcome of pemetrexed as monotherapy for Chinese patients with advanced non-small cell lung cancer ( NSCLC) at the Peking Union Medical College Hospital.Methods From February 2006 to August 2009, 69 patients with advanced NSCLC, including 36 (52.2% ) men and 33 (47.8%) women, received pemetrexed monotherapy.Six patients had squamous cell carcinoma, 57 adenocarcinoma, 6 unspecified.Median survival (MS) and progress-free survival (PFS) were calculated using the Kaplan-Meier method.Results Adverse events (AEs) were generally mild (grade 1 and 2) and reversible. The most frequent AEs were gastrointestinal adverse events, skin rash, fever and fatigue. Total 5 cases with 3/4 grade AEs were reported, including fever, fatigue, rash, decreased platelets and elevated ALT/AST. The objective tumour response rate and stable disease rate were 10.1% (7/69) and 47.8% (33/69) respectively. Median PFS of all patients was 4.7 months (95% CI 3.0 -6.4) and mean overall survival was 14.7 months (95% CI 11.5 - 17.9).Conclusions Our study suggests that treatment with pemetrexed may be well-tolerated and beneficial for some Chinese patients after failure of prior chemotherapy. The rate of disease control is high and the frequency of 3/4 grade AEs is very low.

Choledochoscopic minimally invasive gallbladder-preserving cholecystolithotomy is a surgical method for preserving the gallbladder in the treatment of gallstones, and recurrence of gallstones is a hot topic for gallbladder-preserving cholecystolithotomy. The postoperative recurrence rate of gallstones can be reduced by selecting appropriate surgical indications and adopting effective preventive measures after surgery. This article reviews the indications for minimally invasive gallbladder-preserving cholecystolithotomy and postoperative preventive measures for the recurrence of gallstones, in order to better understand the influencing factors for recurrence and provide guidance for the treatment of gallstones by minimally invasive gallbladder-preserving cholecystolithotomy.

Bronchopulmonary dysplasia(BPD)is a severe complication in premature infants, and the pathogenesis remains complex, potentially involving pulmonary inflammatory injury and faulty reparative response.T-cell immaturity in preterm neonates and the upregulation of related harmful regulatory genes, as well as the imbalance of T-cell homeostasis, have been reported to contribute significantly to the development of inflammatory diseases.Growing evidence suggests that alterations in the levels and functions of T cell subsets may participate in the development of BPD, serving as a new avenue for BPD prevention and treatment.Herein, we summarize recent advancements in understanding the role of T lymphocytes in the pathogenesis of BPD.

OBJECTIVETo arrive at correct diagnosis of pulmonary solitary nodule by clinical manifestation and chest CT scan.

METHODSNinety-eight patients with pulmonary solitary nodule were treated from 1990 to 2000. Their CT findings with clinical manifestations were correlated with the pathology results.

RESULTSOf 98 patients, there were 46 (46.9%) lung cancers, 14 (14.3%) benign tumors, 38 (38.8%) tuberculosis. Fifty-six (57.1%) patients had been asymptomatic or only associated with cough and sputum. 50% of these patients had stage I lung cancer. Tuberculosis was diagnosed more frequently in young patients with protracted feverishness, night sweats, chest and back pain, whereas lung cancer was more common in older patients who were asymptomatic or associated only with cough, sputum and hemoptysis. Lesions with well-defined margin, smooth and in the middle lobe by chest CT was suggestive of benign tumor, while those with irregular margin, un-even density, spiculated margin, lobulated contour and pleural shrinkage were more commonly associated with lung cancer. Those with calcification and in the lower lobe implied tuberculosis.

CONCLUSIONScreening of high risk population is useful in finding early lung cancer. Pulmonary solitary nodule can be correctly diagnosed chiefly by referring to the clinical manifestations and characteristics of chest CT scans. Nodules less than 1cm across are difficult to diagnose and, therefore, exploration is indicated.

Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; Male ; Middle Aged ; Radiography, Thoracic ; Solitary Pulmonary Nodule ; diagnosis ; diagnostic imaging ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; diagnostic imaging ; etiology

Objective To evaluate four detectors for the off-axis ratio profile measurements of a CyberKnife system, and provide reference and suggestions for selecting and using the correct detectors. Methods Profiles were acquired by using four detectors, PTW-60017, PTW-60018, PTW-60019 and IBA-SFD, at different depths for different collimator sizes, with the detector stem being oriented both perpendicular and parallel to the central beam axis. The differences of profiles and the influence of detector orientation on measurement result were analyzed. Results All full width at half maximum ( FWHM) of field measured by four detectors in parallel orientation was larger than that in actual field size. The deviation was increased with the size of collimator and measurement depth, with the maximum deviation of 1. 9 mm. The maximum deviation of FWHM among four detectors was 0. 2 mm. The penumbra was the smallest for IBA-SFD, and the largest for PTW-60019. The maximum deviation of penumbra was 0. 3 mm. The IBA-SFD tended to over-respond in the out-of-field region when the collimator size was larger than 30 mm. Both FWHM and penumbra in perpendicular orientation were smaller than those in parallel orientation for PTW-60017, PTW-60018 and PTW-60019, especially at 5 mm collimator. However, the trend was opposite for IBA-SFD. With the increase of collimator aperture, the difference between the right and left penumbra acquired by four detectors was increased, with more obvious stem effects. Conclusions Similar profiles were acquired by four detectors, but the detector characteristics and effects of detector orientations should be considered.

Objective To evaluate the role of transbrochial needle aspiration (TBNA) in the diagnosis of patients with enlarged mediastinal and/or hilar lymph node. Methods Patients with mediastinal and/or hilar lymphoadenopathy proven by CT scan were eligible for TBNA as reported. All specimens were directly and instantly smeared for pathological examination. Results From June 1 2004 to December 31 2007, 164 patients were examined: including 80 lung cancers, 69 lung bengin diseases, 2 other malignancy tumor, and 13 without definite diagnosis. Total 260 lymph nodes were punctured. TBNA procedures were successfully carried out in 445/463(96.1%). Sensitivity of TBNA was 82. 5 % (66/80) in patients who had been proven to suffer from bronchogenic carcinoma. There were 25 patients that diagnosis of lung cancer was pathologically determined by TBNA only. A total of 122 lymph nodes in the 80 lung cancer patients were aspirated by TBNA with a positive rate of 65. 6% (80/122). Severe complications were rare except small amount of bleeding at the TBNA site (100/164, 61.0%). From June 1 2006 to December 31 2007, lymph node tissues able to make histology diagnosis were yield in 73.5% (64/87) patients. Through histology pathology, the sensitivities of TBNA were 53. 3% (8/15) for sarcoidosis and 78.6% (33/42) for lung cancer. Conclusion TBNA is quite safe and helpful in diagnosis and staging of bronchogenic carcinoma, and in diagnosis of benign lung diseases.

Through serial problem-oriented teaching method(S-PBL),problem based learning-case-based-case based learn-ing(PBL-CBL)comprehensive teaching method,industry-university-research case integration teaching,cutting-edge literature review and other teaching methods,students'attention to learning immunology knowledge is grasped and students'learning efficiency is im-proved;combined with immunology experiment,enhance students'understanding of classroom teaching content;through professional practice,strengthen students'understanding of the development process,production process and market demand of immune products,and enhance students'interest and initiative in learning and consolidating immunology knowledge;through the introduction of major research achievements such as the Nobel Prize in immunology,students'interest and motivation in exploring innovative content in the field of immunology research will be cultivated.Through the above teaching reform,we will cultivate a new generation of biological people who have a solid knowledge of immunology,have the potential to develop immune products,have the sense of innovation and entrepreneurship,and have responsibility and responsibility.

OBJECTIVETo evaluate the efficacy and safety of oseltamivir phosphate as treatment for naturally acquired influenza infection.

METHODSThis study was conducted as a double-blind, randomized, placebo-controlled, multicenter trial during the influenza epidemic season from January to April 2001 at 7 centers in China. A total of 478 adults without other medical history, aged 18 to 65 years, were enrolled into the study. All subjects demonstrated febrile respiratory illness of no more than 36 hours' duration with a temperature of 37.8 degrees C or more plus at least two of the following symptoms: coryza/nasal congestion, sore throat, cough, myalgia/muscles aches and pain, fatigue, headache or chills/sweats. Individuals were randomized into either the oseltamivir phosphate or placebo group with identical-looking capsules. Either oral oseltamivir phosphate, 75 mg twice daily, or placebo was administered to the subjects for 5 days.

RESULTSA total of 451 individuals were analyzed for efficacy as the intent-to-treat population (ITT) (216 oseltamivir and 235 placebo) and 273 individuals were identified as influenza-infected through laboratory test, who were then defined as the intent-to-treat infected population (ITTI) (134 oseltamivir and 139 placebo). Four hundred and fifty nine individuals were included in the safety analysis. In the ITTI population, the cumulative alleviation proportion of oseltamivir group was significantly higher than that of the placebo group (P = 0.0466)). The median duration of illness was 91.6 h [95% confidence interval (CI) = 80.2 - 101.3 h] in the oseltamivir group and 95 h (95% CI = 84.5 - 105.3 h) in the placebo group. The median area under the curve of decreased total score was significantly higher in the oseltamivir group than in the placebo group, 1382.9 and 1236.7 score-hours, respectively (P = 0.0196). For the ITT population, similar results were observed. Adverse events (AE) were similarly reported in both the oseltamivir group and the placebo group. The main adverse events following test drug were gastrointestinal symptoms, neurological symptoms and rashes.

CONCLUSIONOseltamivir was effective and well tolerated as treatment of early naturally acquired influenza.

Acetamides ; adverse effects ; therapeutic use ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; Double-Blind Method ; Enzyme Inhibitors ; therapeutic use ; Female ; Humans ; Influenza, Human ; drug therapy ; Male ; Middle Aged ; Neuraminidase ; antagonists & inhibitors ; Oseltamivir