Objective To evaluate the clinical value of fractional exhaled nitric oxide (FeNO) level in asthmatic children to predict bronchial hyperresponsiveness by analyzing the correlation between fraction of exhaled nitric oxide and bronchial provocation test.Methods One hundred and fourteen asthma outpatients of Shengjing Hospital were enrolled, FeNO levels, spirometry and bronchial provocation test were measured.Results In the bronchial provocation test,there were 33 positive and 81 negative cases.The positive group had a significantly higher FeNO levels than the negative ones(19.0 × 10-9 vs.16.0 × 10-9 ,p =0.000).By the ROC curve, the best FeNO cut-off value to predict bronchial hyperresponsiveness was 38.5 × 10-9 with high specificity (92.6％) but relatively low sensitivity (36.4％).There was no relationship between methacholine provocative dose causing a 20％ fall in FEV1 (PD20-FEV1) and the level of FeNO.Conclusion FeNO level has important predicting value for bronchial hyperreactivity in children with asthma.The level of FeNO ＞ 38.5 × 10-9 has high predictive value in asthmatic children with bronchial hyperreactivity.

Objective To investigate the role of hypoxia inducible factor(HIF)-prolyl hydroxylase 1 (HPHl)and factor inhibiting HIF-1(FIH-1)in placentas in the pathogenesis and development of severe pre-eclampsia.Methods RT-PCR and western blot analyses were used to detect the HPH1 and FIH-1expression levels in placentas of 34 patients with severe pre-eclampsia and 24 cases of term pregnancy (normal pregnancy group)and their correlations with symptoms were analyzed.Results (1)The HPHI mRNA and protein expression levels in placentas of severe pre-eclampsia group were 0.40±0.04 and 59.5±3.4 separately,significantly lower than those of normal pregnancy group,0.84±0.12 and 71.6±1.7(P<0.01).The FIH-1 mRNA and protein expression levels in placentas of severe pre-eclampsia group wereQ 31 ±0.05 and 45.6±2.4 separately,significantly lower than those of normal pregnancy group,0.43±0.04 and 54.9±2.1(P<0.01).(2)The mRNA and protein expression levels of HPH1 and FIH-1 in severe pre-eclampsia group were all negatively correlated with mean arterial pressure(MAP)[the Spearman correlation coefficient was-0.854(P<0.01)],urinary protein per 24 hours[the Spearman correlation coefficient was-0.936(P<0.01)1 and the occurrence of fundus oculi artery spasm[the Spearman correlation coefficient was-0.854(P<0.01)].(3)rrhe expression of HPHl mRNA in placentas of all the 58 cases WBB 0.58±0.27.higher than the expression of FIH-1 mRNA,which was 0.39±0.10.There was a positive correlation between them.The pearson correlation coefficient was 0.686(P<0.01).The expression of HPH1 protein in placentas of all the 58 cases was 64.5±6.7,higher than the expression of FIH-1,which was 49.4±5.2.There was a positive correlation between them.The Pearson correlation coefficient was 0.947(P<0.01).Conclusion The expression imbalance of HPH1 and FIH-1in palcenta may play an important role in the pathogenesis and development of severe pre-eclampsia through inhibiting HIF-1a.

Objective To study the characteristics of pulmonary function in atypical asthmatic children with chest tightness or sighing breath as the sole presenting manifestation,and explore the diagnostic values of fractional exhaled nitric oxide (FeNO) for the atypical asthma.Methods Seventy-nine atypical asthmatic children with chest tightness as the sole presenting manifestation during January 2012 to June 2015 were selected as subjects.All of the subjects performed spirometry,FeNO measurement,total serum IgE and specific IgE determination on their first visit,and with either positive bronchial provocation test or positive bronchial dilation test.As well as 100 healthy children who perfomred FeNO measurement were selected as control group during the same period.The pulmonary function data and FeNO values were analyzed in children who were finally confirmed as atypical asthma.Results In atypical asthma children,the abnormal rate of forced expiratory flow 50％,75％ (FEF50,FEF75) and maximum mid-expiratory flow (MMEF) were 27％,43％ and 33％.Methacholine provocation dose causing a 20％ fall in FEV1 (PD20-FEV1) were 0.41 (0.19 ～0.67)mg and were positively related with MMEF(r =0.301,P =0.007).FeNO concentration in atypical asthma patients were 13.0 × 10-9 (7.0 ×10-9 ～24.0 × 10-9),higher than that in control group(P ＜0.05).Significant correlations were found between FeNO and total serum IgE (r =0.672,P =0.001).No correlations were found between FeNO and FEV1 (P ＞0.05),between FeNO and FEV1/FVC％ (P ＞0.05) or between FeNO and PD20-FEV1 (P ＞0.05).The diagnostic values of FeNO for the atypical asthma were analyzed using the receiver operating characteristic curve,the area under the curve was 0.600.Conclusion The characteristics of pulmonary function in atypical asthma are hypofunction mainly in small airway and patients with lower MMEF had higher airway hyperresponsiveness.The diagnostic values of FeNO in atypical asthma are limited.

Objective To analysis the long-term retention rate of Levetiraceram (LEV) monotherapy or combination therapy of infant epilepsy. Methods The clinical data of patients with infant epilepsy treated by LEV had been retrospectively analyzed from July 2006 to June 2007. Results Sixty patients with infant epilepsy treated by LEV had been recruited, 20 cases with partial seizures, 19 cases with generalized seizures, 21 cases with epilepsy syndrome. Among them 21 cases was intractable epilepsy. The retention rates of LEV in 6-month, 1-year, 2-year, 3-year and 4-year were 95.5%, 75.0%, 60.0%, 51.7%, and 38.3%. The most common reason for withdrawal was lack of effect (43.2%). COX regression model suggested that duration>1 month (RR=2.91, 95%CI:1.16~7.30) and refractory epilepsy (RR=2.30, 95%CI:1.22~4.32) were risk factors of withdrawal (all P<0.05). After treatment, the seizure frequency signiifcantly reduced compared with baseline (P<0.01). To the end of the follow-up, the efifciency was 100%and the complete remission rate was 69.57%in 23 cases continued treatment. The main side effect were fatigue (56.0%), and sleep increased, irritability, and so on. Conclusions LEV monotherapy or combination therapy has well long-term retention rate, maintains well efifcacy and tolerability in infant epilepsy.

Traditional Chinese medicine (TCM) has its own system of diagnosis and treatment theory, and its methods for evaluating clinical efficacy are different from those of Western medicine. Applying evaluation techniques and methods that are used in Western medicine mechanically to TCM will not work. So building evaluation techniques, which adhere to regulations and characteristics of TCM, is necessary and imperative. As the quality of life and patient-reported outcome instruments were brought into practice and developed, clinical evaluation ideas and methods for TCM are provided with an opportunity for development. This article puts forward the concept of subjective complex outcomes (SCOs), which constitutes subjective feelings gained from the patient, doctor and caregiver, different from laboratory parameters. SCOs provide a multidimensional and complex health-related quality of life (HRQL) assessment and focus on the source of assessment information of diseases. This article also introduces a case study building SCO methods of TCM treatment for chronic obstructive pulmonary diseases, in order to promote discussion and provide a platform for future research.

Objective To evaluate different expressions of high mobility group box 1(HMGB1)and receptor for advanced glycation end products(RAGE)in placentas and their relationship with preeclampsia.Methods Fifteen early-onset pre-eclaraptic women(early-onset pre-eclampsia group),22 late-onset pre-eclamptic women(late-onset pre-eclampsia group)and 12 normotensive women(control group)in the third trimester were recruited at the Shengjing Hospital of China Medical University from March 2006 to March 2007.The localization and levels of HMGB1 and RAGE in placentas of the three groups were detected by the strept avidin biotin-peroxidose method.Results (1)Immunoreactivities to HMGB1:positive immnnostaining for HMGB1 was observed in trophoblast,macrophages,decidual cells,vascular muscle cells,endothelial cells and placental mesenchymal cells in the placentas from the pre-eclamptic women,while a low level of immunoreactivities was observed in the placentas from healthy pregnancies;the staining was observed within both the nuclei and the cytoplasm,mainly in the cytoplasm.The cytotrophoblast,especially the nuclei was extensively positive for HMGB1 in early-onset pre-eclampsia. (2)Immunoreactivities to RAGE:positive immunostaining for HMGB1 was observed in syncytiotrophoblast,macrophages and endothelial cells in the placentas from the preeclamptic women,while a low level of immunoreactivities was observed in the placentas from healthy pregnancies:the staining was in the cytoplasm and(or)cell membrane.The trophoblast was extensively positive for RAGE in early-onset pre-eclampsia.(3)Positive rate of HMGB1 expression:the expression of HMGB1 in early-onset group(73%,11/15)and late-onset group(64%,14/22)was significantly higher than that in normal group(17%,2/12;P<0.05),but no significant difference was found in early-onset group and late-onset group(P>0.05).(4)Positive rate of RAGE expression:the expression of RAGE in early-onset group(80%,12/15)and late-onset group (82%,18/22)was significantly higher than that in normal group(25%,3/12;P<0.05),but no significant difference was found in early-onset group and late-onset group(P>0.05).Conclusions The increased expression of HMGB1 and RACE in the placenta may play an important role in the pathogenesis of pre-eclampsis.The different locations may be associated with the occurrence of different onset types of pre-eclampsia.

Objective To establish the analytical method for fingerprint of Aristolochia manshuriensis by HPLC-DAD-ESI/MS,which can be used as the basis for quality control of the drug and for the further studies on kidney toxicity metabolite.Methods Samples A.manshuriensis from different habitats were extracted by 75% methanol and analyzed by HPLC-DAD-ESI/MS,whose chromatographic fingerprints were established.Two ways to calculate the similarity were selected to compare the results by determining the common peaks.Results There were 30 main characteristic components in A.manshuriensis.The HPLC-DAD-ESI/MS fingerprint of the 30 common peaks was established preliminarily.The samples of A.manshuriensis from different habitats was found having a good similarity,and the range of similarities for 24 balches of A.manshuriensis were 0.871—0.998.Conclusion The method is reliable,accurate,and of good stability,and can be used for the quality control and variety identification of A.manshuriensis.

objective To study the TCR gene mutation in peripheral blood lymphocytes induced by X-ray exposure using cultured lymphocytes cloning method.Methods Freshly isolated peripheral lymphocytes from healthy aduh donors were irradiated with X-ray in doses ranging from 0 to 8 Gy and cultured with interleukin2 and phytohemagglutinin for 7 days.The mutant frequencies of TCR gene(TCR MF)were detected by flow cytonletry and the dose response curves were fitted.Results TCR MF increased with the dose going up.An aquadratic polynomial dose response model was fitted.Conclusions TCR gene mutation could which serve as a potential biological dosimeter.It might be applied for the estimation of biological dose in emergency exposure.

OBJECTIVE:To establish a method of simultaneous determination of inulicin and deacetylinulicin in Inulae Flos. METHODS:HPLC was performed on the column of Zorbax SB-C18 with mobile phase of acetonitrile-water(gradient elution)at a flow rate of 1.0 ml/min,the column temperature was 25 ℃,the detection wavelength was 210 nm,and the injection volume was 10 μl. RESULTS:The linear range was 0.000 2-0.005 μg/ml(r=0.999 8)for inulicin and 0.000 1-0.001 7 μg/ml(r=0.999 4)for deacetylinulicin;RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 99.63%-103.56%(RSD=1.26%,n=9)and 95.98%-101.21%(RSD=1.84%,n=9),respectively. CONCLUSIONS:The method is simple,accurate and reliable,and can be used for the quality evaluation of Inulae Flos.

OBJECTIVE:To study the metabolites,distribution,metabolic type and the possible activity of harpagide which is the active component from Scrophularia ningpoensis in rats in vivo. METHODS:4 SD rats were divided into blank group (ul-tra-pure water) and administration group (harpagide reference solution),2 in each group,ig,160 mg/kg,twice a day,for 3 d. Urine and feces were collected every 12 h before administration and the first administration;sample blood 8 mL was taken after 0.5,1 h of last administration;heart,liver,spleen,lung,kidney,stomach and small intestine were taken. The blood,urine,fe-ces and other tissue solutions were prepared,HPLC-MS was conducted to detect and identify the harpagide metabolites in rats in vi-vo and presume metabolic pathways,and PharmMapper software was used to predict metabolites activity. RESULTS:12 harpagide metabolites were identified in rats in vivo,the form of prototypes and metabolites were distributed in heart,liver,spleen,lung, kidney,stomach and small intestine. The metabolic type mainly included hydrolysis,dehydration,reduction,methylation,sul-fation,glucuronic acid binding,grade A coumaric acid binding,etc. The 12 compounds may have activities in the treatment of epi-lepsy,amyotrophic lateral sclerosis,diabetes,stroke,etc. CONCLUSIONS:Harpagide may be effective in the form of prototypes and metabolites. The study has provided basis for attributing the origins of metabolite,studying the effective form of S. ningpoensis clarifying its pharmacological mechanism and processing mechanism.