Passive smoking causes significant adverse effects on the origins and progress of childhood asthma. Passive smoking may lead to an increased risk for the development of new cases of asthma in child. For the children who have already established asthma, passive smoking has great impact on asthma control, including increasing asthma symptoms, inducing exacerbations, decreasing quality of life and responsiveness to therapy drugs. The related mechanisms by which passive smoking makes induction of asthma and worsening of established asthma are still in exploration. The presented mechanisms have been postulated are impaired immune responses,impaired lung development, bronchial hyperreactivity, and genetic predisposition.

Flavonoids are polyphenolic plant secondary metabolites, which ubiquitously present in our daily diet.Flavonoids have been found to have several biological effects, that is, antioxidant, anti-inflammatory,anti-allergic and immune-modulating properties.Because of the safety and strong biological effects of flavonoids,it has been widely concemed about the prevention and treatment of asthma.This review focuses on the effects and mechanism of flavonoids in the prevention and treatment of asthma.

BACKGROUND: The main pathological change of intervertebral disc herniation is that nucleus pulposus protrudes from ruptured annulus fibrosus, thus we can hypothesize that it is possible to prevent disc herniation prior to its protrusion by coagulating it as a whole.OBJECTIVE: To observe the coagulation effects of intervertebral disc nucleus pulposus by alum solution.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed between September 2002 and April 2003 at Department of Animal Experiment, Peking University First Hospital, Beijing China.MATERIALS: Twenty-six healthy adult hybrid dogs, 9 for in vitro experiment and 17 for in vivo experiment, weighing 16-21kg, with no restrictions on male and female, were obtained from Department of Animal Experiment, Peking University First Hospital, Beijing, China.METHODS: Twenty canine in vitro intervertebral discs obtained from 5 dogs were randomly divided into 4 groups, with 5 discs in each group, and were put into 2.5%, 5%, 10% alum solutions and 0.9% physiological saline, respectively. Effects of disc coagulation were observed after immersing for 1 day and 10 days, respectively. Another 16 in vitro intervertebral discs obtained from 4 dogs, composed of L2/3, L3/4, L4/5, L5/6, were also injected with the above 4 experimental solutions, 0.15ml, respectively. Sixty-eight in vivo intervertebral discs were obtained from 17 dogs and divided into 4 groups: blank control group, physiological saline group, 10% alum solution+one puncture point group, and 10% alum solution+two puncture points group, 17 discs in each group. Harvesting time: 3 days, 2 weeks, 1 month and 3 months postoperation.MAIN OUTCOME MEASURES: Effects of alum solutions on the coagulation of the intervertebral discs and related histological changes were observed and an alum solution of suitable concentration was preliminarily selected. General observation, light microscopic observation and scanning electron microscopic observation were made of the nucleus pulposuses.RESULTS: In the in vitro and in vivo experiments, it was found that physiological saline did not produce the effect of coagulation on the nucleus pulposus, while immersion in the alum solution induced nucleus pulposus coagulation in the in vitro intervertebral discs. Also, as the concentration of the alum solution increased, the volume of the coagulated nucleus pulposus gradually decreased. After alum solution was injected into the in vitro intervertebral discs, no nucleus pulposus coagulation appeared. When the 10% alum solution was injected into the in vivo intervertebral discs, nucleus pulposus coagulation occurred, with the strongest coagulation effect reached at 1 month postoperation. This was manifested in the agglutination reaction centered around the puncture point. When there were 2 puncture points, 2 coagulated lumps might appear. There was an increase in the mesenchymal component of the coagulated nucleus pulposus. Histochemical and scanning electron microscopic examinations confirmed the proliferation of large numbers of collagen fibers in the mesenchyme.CONCLUSION: Alum can promote nucleus pulposus to coagulate around the injection point. This may be related to the increase of collagens and the fibrosis resulting from stimulation of the nucleus pulposus by alum solution.

[Objective]To investigate the effect of coagulation of intervertebral disc nucleus pulposus(IDNP) by alum.[Method]In vitro,20 canine intervertebral discs(I D) were divided into 4 groups,and immersed into 2.5%,5%,10% alum solution and normal saline respectively.Another 16 I D also randomized into 4 groups and were injected into I D with corresponding solution.In vivo,6 canine ID were grouped into 4:A.blank control;B.one injection of alum;C.two points injection of alum;D.injection of N.S.Experimental dogs were sacrificed and disc samples were taken at 3 days,2 wks,and 1 month post-injection.Gross observation,histological exam by microscopy and scan electron microscopy(SEM) and histochemical test were performed.[Result]NS did not coagulate the IDNP in vivo and in vitro,while in vivo,coagulation was seen around the injection points,two points with two coagulation blocks,and grew with time culminating on one month after injection,but there was no coagulation appeared after alum injection.In vitro,histological study showed aboundant collagenous fibers gathered in coagulation lock representing manifold function of mesenchyme.[Conclusion]The alum can make the IDNP to be coagulated in vivo,the mechanism of coagulation is the collagenous fiber proliferation and fibrosis due to manifold function of mesenchyme.

Objective To study the causes and symptoms about locking knee of unclear causes and analyze the thrapeutic effects of arthroscopy. Methods Arthroscopy was performed for 47 cases who suffered from locking knee of unclear causes.The main focuses observed were synovial shelf(16 cases),synovial hyperplasia(15 cases),synovial cyst(3 cases),Hoffa disease(4 cases)and patellofemoral malalignment(9 cases).These synovial focuses were resected by arthroscopic shaving.For Hoffa disease,arthroscopic partial resection of the infrapatellar fat pad was done.For patellofemoral malalignment,the procedures consisted of a standard lateral retinacular release and distal realignment of the patella. Results All patients were followed up for 2 months to 3 years on (an average of 1 year).The locking of knee disappeared for all cases and painless of knee for 46 cases.The functional recoveries of Knee joint were mostly excellent. Conclusions The main causes consisted of synovial shelf?hyperplasia?cyst,Hoffa disease and patellofemoral malalignment for locking knee of unclear causes.Arthroscopy is not only an important diagnostic method,but also a significant procedure of treatment and the therapeutic effects are satisfactory.

[Objective]To refine operative indications of rotating hinge prostheses and report the medium term results of these implants,and to analyze the reasons for postoperative complications.[Method]From 1999 to 2007,42 Endo-Model(Link) rotating hinge prostheses were used in 34 patients.The cases were all gonarthrosis with severe genu varus,genu valgus or flexion contracture.Bone defect or instability was found in these cases before operation.The mean follow-up was 6.4 years(2.3-10.4 years).[Result]One case of deep infection,and one periprosthetic fracture were noted.And 3 cases of patella subluxation or tilt were detected by postoperative X-ray.All patients had excellent pain relief and restoration of walking capability.The average HSS score improved from 40.5 points to 89 points after surgery.[Conclusion]Besides being used in revision surgery,rotating hinge prostheses are indicated in primary arthroplasties for patients with severe ligament laxity,substantial deformity or bone losses.With appropriate indication selection and accurate operative skill,satisfactory medium term result can be obtained.

Objective Allergic asthma is a chronic inflammatory disease of the airways.T lymphocytes play important roles in the pathogenesis of asthma.The voltage-gated Kvl.3 potassium channel may be a key factor in the activation of T lymphocytes.This research aims to detect the function of Kvl.3 channel in the neutrophlial asthma(NA) model and eosinophilic asthma(EA) model.Methods A total of 24 mice were randomly assigned into three groups:control,neutrophilic asthma model and eosinophilic asthma group.Neutrophilic asthma model was established with ovalbumin (OVA)and lipopolysaccharide(LPS);eosinophilic asthma was established with OVA and Al(OH)3;airway responsiveness of mice in each group was measured with a noninvasive pulmonary function instrument;lung inflammation changes were observed by pathological HE staining;IL-17A and IL-4 cytokines levels in bronchoalveolar lavage fluid were evaluated by ELISA;Kvl.3 channel protein level in lung was evaluated by western blot;the change of current density in CD4 +.T lymphocytes were tested by whole-cell patch clamp technique.Results Levels of IL-17A and IL-4 in bronchoalveolar lavage fluid increased in both NA and EA model (P ＜ 0.05).Compare with EA model,the IL-17A level was significantly higer in NA model,while the IL-4 level was significantly lower.In NA and EA model,kv1.3 protein expression in lung tissue was significantly higher than that in the control group(P ＜ 0.05),and kv1.3 protein expression in NA model was significantly higer than that in the EA model (P ＜ 0.05).Current intensity and current density of kv1.3 channel increased in both NA and EA model.While the current intensity and current density of kv1.3 channel were significantly higher in NA model than that in EA model.Conclusion Kv1.3 protein level,Kv1.3 channel current intensity and kv1.3 channel current density increased in both NA and EA model,especially in NA group,providing a new way for treatment of bronchial asthma.

Objective To elucidate the characteristics and treatment options of the primary joint arthroplasty in patients who had a previous history of the joint infection. Methods Eight total joint arthro-plasties in patients who had previous infection of the joint, were analyzed retrospectively from 1992 to 2001. The diagnosis of joint infection was pyogenic infection in six cases, and tuberculous infection in two cases. Total hip arthroplasty was performed in six cases, the average age of which was 38.1 years (24 to 51 years), and the average quiescent period of infection was 22 years ranging from 6 to 30 years. In these six cases, the average age of infection was 16 years (6 to 31 years); the quiescent period of all five pyogenic infections was more than 20 years, and the quiescent period of other one with tuberculous infection was six years. Total knee arthroplasty was performed in two cases. Results The count of WBC, ESR and CRP were examined routinely with normal values before surgery. While, there were no evidences of infection through intraopertive exploration, and bacterial culture of joint fluids and synovial tissue. The duration of follow-up was 2 to 11 years. The affected limbs had significant shortened deformity of 2 to 6 cm before surgery in hip infections. The hip joints had mal-development and flexion-contracture deformity. All of the patients had no active in-fection before arthroplasty. 5 patients with a quiescent period of pyogenic infection of more than 20 years had no recurrence of infection after total hip arthroplasty. One patient with a quiescent period of 6 months had recurrence of the infection after total knee arthroplasty. There were no recurrence of infection in 2 pa-tients who had tuberculous infection. The results were good except aseptic loosening in one total hip arthro-plasty. Conclusion The total joint replacement for patients with previous joint infection is more difficult in performing in one-stage and on younger patients. The good results can be achieved only on condition that the active infection healed completely, and the patients must keep a definite long period of quiescent time after infection.

Objective To investigate the methods of diagnosis and treatment for delayed infection after hip arthroplasty. Methods From March 1998 to April 2004, 11 patients with delayed infection after hip arthroplasty were analyzed retrospectively. There were 4 males and 7 females with average of 66 years, ranging from 49 to 81 years. The interval between infection and primary hip arthroplasty varied from 9 to 96 months(mean 25.5 months). Pain is the most common symptom in all patients with an infected hip arthroplasty. Abnormal ESR was observed in 9 cases. The increase of CRP was found in 8 patients, and fistula occurred in 5 patients. Radiography findings, such as loosening, osteolysis, and endosteal scalloping, are present on 10 patients. One-stage exchange arthroplasty was performed in 8 patients, among whom 7 prostheses with antibiotic-impregnated cement and one with plain cement for fixation were chosen. Two-stage exchange arthroplasty was performed in 3 patients. After thorough irrigation and debridement of the infected joint and the removal of the femoral and acetabular components, a temporary spacer with irrigation device and antibiotic-loaded beads or a bulb were inserted between the first and second stage. The interval was a minimum of 4 weeks. During the delayed reconstruction, the final prostheses were fixed with antibiotic-loaded cement after the infection was eliminated. Results All 11 patients were followed up for a period of 8 to 72 months. Fracture of femoral shaft happened during the debridement in one patient. None of recurrent infection was found during the average 29.3 months follow-up. Conclusion No test is 100 percent specific; therefore, the diagnosis of infection relies on the patients' history, and the physical examination findings, and the lab test combined with results of imaging study, etiology as well as pathology. The key to success is that the treatment must be tailored to the patients' status.

Objective To investigate the immunologic reactions around prosthesis and the relationship between immunologic reactions and aseptic loosening. Methods Nine specimens of bone- implant interface membranes obtained during revision of loosened total joint replacements were examined in order to investigate the evidence of hypersensitivity. T lymphocytes and it's subgroup (CD 3, CD 4, CD 8),macrophages (CD 68),IL－ 2 receptor (CD 25) and HLA－ DR antigens were demonstrated by immunohistochemistry on tissue sections. The relationship between the changes of T lymphocytes and inflammatory reactions was also evaluated. Results Histological examinations showed granuloma with a plenty of macrophages and foreign body giant cells in all sections of interface membranes. The number of T lymphocytes increased in five of nine cases, and three of them expressed IL－ 2 receptor. The distribution of T lymphocytes and subpopulations was similar in all cases. The increase of T lymphocytes and IL－ 2 receptor expression showed positive correlation with an increase of macrophages and inflammation reactions. Conclusion Hypersensitivity to the prosthetic materials can exist after total joint replacement. Hypersensitivity may be one of the reasons of prosthetic aseptic loosening.