Objective To preliminarily investigate the effect of high mobility group box 1 (HMGB1) in the pathogenesis of chronic obstructive pulmonary disease (COPD) by detecting the HMGB1 level in bronchoalveolar lavage fluid(BALF) of the COPD patients and analyzing the relation between HMGB1 and airway limitation .Methods The research subjects were divided into the COPD group (stable COPD ,20 cases) and control group[20 cases of upper airway cough syndrome(UACS)] .All subjects were performed the bronchoscopic examination as well as bronchoalveolar lavage .The total cell counting and percentage of neutrophilic granulocytes in BLAF were detected and compared between the two groups .The HMGB1 ,IL‐1βand TNF‐αlevels in BLAF were detected by using ELISA and compared between the two groups .The relation between HMGB1 with IL‐1βand TNF‐αand the rela‐tion between HMGB1 with pulmonary function(FEV1% predicted value) in the COPD group was analyzed .Results The total cell counting and percentage of neutrophilic granulocytes of BLAF in the COPD group were higher than those in the control group (P<0 .01) .The levels of HMGB1 ,IL‐1β,TNF‐αof BALF in the COPD group were higher than those in the control group(P<0 .01 , P<0 .05 ,P<0 .01) .In the COPD group ,the HMGB1 level in BALF was positively correlated with the IL‐1βand TNF‐αlevels(r=0 .79 ,P< 0 .01 ;r= 0 .48 ,P< 0 .05) ,while negatively related with the pulmonary function value(FEV1% predicted value ,r=-0 .70 ,P<0 .01) .Conclusion HMGB1 participates in and promotes the occurrence and development of COPD airway inflamma‐tion and the HMGB1 level in BALF is correlated with the severity of COPD .

Objective To study the effect and the possible mechanism of delavirdine on muhidrng resist-ance-aasociated protein 2(MRAP2)-mediated multidrug resistance in LLC/cMOAT cells. Methods MTT assay was used to determine the effects of delavirdine on proliferation of LLC/CMV and LLC/cMOAT cells. The inhibitory effects of vincristine (VCR),cisplatin (DDP),adriamycin (ADM) and etoposide (VP-16) used alone or in combi-nation with delavirdine on the proliferation of LLC/CMV and LLC/cMOAT cells were evaluated by MTT assay. The cell cycle distribution, the apoptosis rate of the cells treated with different concentration of delavirdine and the intra-cellular concentration of ADM were determined by flow cytometry (FCM). Results Delavirdine at the concentration of 4 μmol/L and below showed no significant cytotoxicity to LLC/CMV and LLC/cMOAT cells. The resistance of LLC/cMOAT cells to VCB, VP-16, ADM and DDP were 9.58,1.11,2.98 and 3.96 folds of that of LLC/CMV cells. When 2 μmol/L delavirdine was added, the resistance was 5.21 and 2.55 folds respectively;when 4 μmol/L dela-virdine was edded,the resistance was 7.56 and 3.03 ,while 2,4 μmol/L delavirdine made no significant changes to the chemosensitivity of LLC/CMV cells to VCR and DDP(P>0.05). Cellular cycle analysis demonstrated that 0,6, 12,24 hours after co-cultured with delavirdine the amount of cells at G1 phase increased from(38.92±0.15)% to (56.87±2.23)%,(65.36±2.76)% and (74.77±5.06)%. The cell apoptosis rate increased from 1.77% to 17.45% and 28.52% when treated with delavirdine at 2,4 μmol/L and VCR for 24 h. When treated with 2,4 μmol/L delavirdine, ADM accumulation in LLC/cMOAT cells was enhanced significantly(P<0.05). Conclusion DLV can partially reverse the multidrng resistance of LLC/cMOAT cells, and the reverse effect correlates to the concentration. The possible mechanism may involve the growth arrest at G1, increasing of intracellular drug concen-tration and promoting apoptosis.

Epigenetics consists of DNA methylation,post-translational modification of histon,microRNA and long non-coding RNA,which regulate angiogenesis by acting on different targets.Epigenetics has become potential targets of anti-angiogenesis in tumor.

Objective]Help students to construct the system of TCM clinical thinking and to cultivate the ability of differential diagnosis and prescription. [Methods]In the late clinical teaching, make junior doctor with a high grade of students, graduate students, or some clinical experience as a research object, designing as a medical record has gradually evolved into a number of different medical records dynamic group, let students practice the tentacles medical records. [Results]Gradually,students learned to distinguish the different parties in the different clinical symptoms, and enhance the understanding of drugs and prescriptions. [Conclusion] The tentacles medical records practicing can cultivate the students' ability of dialectical thinking integration.

Objective To evaluate RR,DCR,PFS,OS and toxicities in a population affected by NSCLC using gefitinib as maintenance therapy after the first line chemotherapy.Methods From January,2006 to January,2008,seventy-one patients were enrolled with stable disease or partial response after firstline chemotherapy.They were divided into the observing group and the control group.Gefitinib was administered at the dose of 250 mg in observing group;placebo was also administered everyday in control group.Results Of 71 assessable patients ,overall response rate was 36.1% (13/36) in observing group and 14.3 % (5/35) in control group respectively (x 2 = 4.633,P = 0.036),and one patient (2.8 %) was observed complete response (CR) in observing group.The disease control rate was 83.3 % (30/36) in observing group and 42.9 % (15/35) in control group,respectively,(x2 = 14.782,P ＜ 0.001).The median PFS (progression free survival time) was 13 weeks in observing group and 11 weeks in control group respectively (x2 = 10.401,P =0.001).The median overall survival time (OS) was 13.2 months in observing group and 10.4 months in control group respectively (x2 = 7.696,P= 0.006).The median OS was 18.5 months in women and 11.2 months in men(x2 =22.864,P=0.011) .The median OS was 15.3 months in non-smokers and 10.3 months in smokers (x2 =10.389,P =0.007).The median OS was 16.0 months in adenocarcinoma and alveolar cell carcinoma patients and 10.2 months in squamous cell carcinoma patients (x 2 = 4.638,P = 0.001).The most common toxicity was rash ,diarrhea,fatigue and dry skin itching,and most of them were 1 or 2 grade.Conclusion Maintenance therapy with gefitinib after first-line chemotherapy may improve overall survival time and progression free survival time in patients with NSCLC,and it is effective and safe.

Objective To investigate the value of the combined detection of serum human epididymal secretory protein 4(HE4) and carbohydrate antigen 125(CA125) in diagnosing ovarian and uterine tumor .Methods Serum levels of HE4 and CA125 were detected in 112 cases of ovarian cancer ,92 cases of uterine cancer ,145 cases of ovarian benign diseases ,138 cases of uterine adeno-myoma and 56 cases of healthy controls by ELISA and electrochemiluminescence(ECL) immunoassay respectively .Results Serum levels of HE4 and CA125 were (246 .80 ± 52 .81)pmol/L and (439 .20 ± 305 .80)U/L in the ovarian malignant tumor group , (196 .50 ± 38 .15)pmol/L and (463 .80 ± 127 .60) U/mL in the uterine malignant tumor group and (19 .76 ± 16 .45)pmol/L and (15 .67 ± 11 .19)U/mL in the control group ,the differences had statistical significance (P<0 .05) .Serum levels of HE4 and CA125 before operation and in postoperative 2 weeks in the ovarian cancer group and the uterine cancer group had statistical difference (P<0 .05) .Conclusion The combination detection of serum HE4 and CA125 can improve the accuracy and sensitivity in the diag-nosis of pelvic tumors .

Objective To investigate the effect of inhaled pravastatin on the acute inflammation of lung in smoked rats.Methods 32 male SD rats were randomly divided into four groups(n=8 per group),as the controls,cigarette-smoking exposure group,saline or pravastatin treatment groups.The rats in the control group were treated routinely,the other groups were exposed to cigarette smoking for one week.Rats in saline or pravastatin group were treated with saline or pravastatin inhalation respectively.During smoking exposure period rats were weighted before and after the treatment,executed at day eight,blood,bronchoalveolar lavage fluid(BALF),and lung tissue were collected.The morphological alternations of lung tissue were observed.Total cell numbers in BALF were counted.Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of serum IL-10 and IL-17 content.Results The increase of body weight of smoke-exposed rats were less than that of the controls.In smoking-exposed rats,acute inflammatory changes were remarkable in the lung.The total cell numbers in BALF and levels of IL-10 were increased significantly(P<0.05).These changes were mitigated in pravastatin treated rats and an IL-10/IL-17 rebalance was observed.Conclusion Inhalation of pravastatin sodium has a certain inhibitory effect on cigarette smoke-induced acute lung inflammation in rats.

Objective To investigate the changes of interleukin-17A(IL-17A)and interleukin-22(IL-22)in the lung of cigarette smoke exposed mice and the effect of smoking cessation and N -acetylcysteine (NAC )treatment . Methods BALB /c mice in experimental groups were exposed to cigarette smoke.Then the smoke-exposure was stopped and mice were treated with NAC gavage.The mice were executed 1,2,and 3 months after smoking cessa-tion.Lung tissue sample and bronchoalveolar lavage fluid(BALF)were collected.HE staining was used to observe the pathologic changes of the lung and ELISA was used to measure the level of IL-17A and IL-22.Results Con-siderable emphysematous changes was found in the lung of mice exposed to cigarette smoke.Compared with the controls,the level of IL-17A and IL-22 elevated remarkably in pulmonary tissue and BALF after smoking exposure and declined gradually after smoking cessation.Additional NAC gavage treatment enhanced the decline tendency. Conclusion IL-17A and IL-22 might play a complex role in the chronic inflammatory changes of lung in mice ex-posed to cigarette smoke.

Objective To observe the changes of pulmonary oxidative stress after cigarette smoking exposure,its re-lationship with inflammatory cytokines,and the effects of smoking cessation. Methods Fifty male BALB / c mice were randomly divided into the smoke exposure group,smoke cessation group,and the controls. Mice in smoke cessation group were exposed to cigarette smoking for 16 weeks. On 4,8,and 12 week after smoking cessation mice were executed and the bronchoalveolar lavage fluid(BALF)and lung tissue were collected. The morphologi-cal alternations of lung tissue were observed. Mean length of interval and mean alveolar number were measured. Total cell numbers in BALF were counted. Superoxide dismutase(SOD)activity was measured with hydroxylamine method,malondialdehyde(MDA)level was measured with TBA method. The levels of pulmonary interleukin-8 (IL-8)and tumor necrosis factor-α(TNF-α)in BALF and lung tissue homogenate were measured with ELISA. Re-sults Compared with the mice in the controls,emphysematous changes were remarkable in the lung of cigarette ex-posed mice,the total cell numbers in BALF were increased significantly(P < 0. 05)and reduced gradually after smoking cessation(P < 0. 05). SOD and MDA levels increased remarkably in the cigarette exposure group(P <0. 05),and declined gradually after smoking cessation. The levels of IL-8 and TNF-α in BALF and lung tissue ho-mogenate in the smoke exposure group increased significantly( P < 0. 05),and lowered time-dependently after smoking cessation,but not reached to normal level even 12 weeks after smoking cessation. SOD and MDA levels were positively correlated with the cytokine changes. Conclusion Abnormal oxidative stress in the airways caused by cigarette smoking exposure was merely partially reversed after smoking cessation. And the inflammation remains persistent concomitantly.

OBJECTIVE To investigate the etiology of acute respiratory tract infection(ARI)in Hefei area and risk factors that may influence the distribution of common pathogens.METHODS Direct immunofluorescence assay was applied to detect the respiratory syncytial virus(RSV),adenovirus(ADV),influenza virus A(FluA),influenza virus B(FluB),parainfluenza virus PIV(1,2,3)and real time fluorescent quantitation polymerase chain reaction (FQ-PCR)was applied to measuring Mycoplasma pneumoniae(MP)and Chlamydia pneumoniae(CP)in nasopharyngeal secretions and sputum specimens.RESULTS Among 530 cases included in this study,421 cases (79.43%)showed positive viral etiology.ADV accounted for 73(13.77%),FluA-68(12.83%),FluB-56 (10.56%),RSV-48(9.05%),PIVl-47(8.86%),PIV3-42(7.92%),PIV2-33(6.22%),MP-32(6.03%)and CP-22(4.15%).The detected positive rate of pathogens isolated in winter was the highest(85.07%).CONCLUSIONS Acute upper respiratory tract infection(AURTI)is common and more than 75%pathogens in Hefei area are virus in which the most commonly virus is ADV.Meanwhile atypical pathogens of infection should not be ignored.