Objective:To identify the contributions of allergen to Th1 and Th2 by determined the levels of IFN-?,IL-4 and the transcription factors T-bet and GATA-3 in peripheral blood mononuclear cells(PBMC)of allergic asthmatics.Methods:①Plasma IFN-? and IL-4 were measured in 35 asthmatics and 32 healthy by ELISA,as well as the production of IFN-? and IL-4 by Dermatophagoides farinae(Df)-activated PBMC in asthmatics and 15 healthy controls.②Twenty-five asthmatics and 15 healthy persons were enrolled.The T-bet mRNA and GATA-3 mRNA expressing levels in PBMC were assayed by one step reverse transcription polymerase chain reaction(RT-PCR).Results:①The plasma IL-4 in the patients was significantly higher than that in healthy(t=3.265 9,P=0.001 7).The plasma IFN-? levels in asthmatics were no significantly different from that of the healthy(t=0.306 8,P=0.760 0).② In the condition of PBMCs activated by Df,the IL-4 and IFN-? levels in asthmatics were increased compared with healthy(t=3.564 4,P=0.001 0;t=3.350 0,P=0.002 0).③ There were some expression of the transcription factors T-bet and GATA-3 of PBMC in asthmatics and healthy.The expression of GATA-3 in the patients was significantly higher than that in healthy(t=2.274 3,P=0.028 0).The expression of T-bet and the ratio of T-bet/GATA-3 in the patients was no significant difference with the healthy(t=0.222 0,P=0.825 8;t=1.115 2,P=0.283 4).④ In the Df-activated PBMC,the expression of T-bet and GATA-3 in asthmatics were significantly higher than that of healthy(t=2.298 2,P=0.027 6;t=3.788 7,P=0.000 6),but the ratio of T-bet/GATA-3 was no significant difference with healthy(t=1.195 9,P=0.249 1).Conclusion:The production of Th2,Th1 cytokines and the expression of GATA-3 and T-bet in allergic asthmatics are both increased.It is suggested that the imbanlance of Th1/Th2 unsatisfactorily explain the pathogenesis of allergic asthma.

Objective To compare the clinical effectiveness of whole blood derived platelets and apheresis platelets in children with hematological diseases.Methods Children were divided into two groups: apheresis platelet group(463 children) and whole-blood-derived platelet group(155 children).The platelet corrected count increment(CCI),percentage platelet recovery(PPR),the incidence rate of post-transfusion refractoriness to platelets(PTR) and adverse reaction were observed and assayed at 24,48 and 72hours after transfusion.Results In the apheresis platelet group,CCI and PPR at 24,48,and 72 hours after transfusion were significantly higher(P

The soybean high branched-chain amino acid mixture was composed of soybean protein hydrolyzed by special method with a few types additional amino acids in small amount. The mixture contained 68.9% of essential ami-no acids and 42.9% of branched-chain amino acids.The animal experiment showed that the mixture could promote the growth of young rats and maintain the normal levels of Hb, serum total protein and albumin. Its protein efficiency ratio (PER), true protein digestibility (TD), biological value (BV) and net protein utilization (NPU) were 2.78, 94.0%, 85.0 and 80.0% respectively. These values were significantly higher than that of casein. The results indicated that the soybean high branched-chain amio acid mixture did not produce amino acid antagonism caused by the high amount of branched-chain amino acids and had higher nutritional quality.

Objective To evaluate the effect of the expression of P-glycoprotein (P-gp) in tumor tissue on analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain. Methods One hundred and fifty advanced cancer patients with pain aged 51-64 yr weighing 54-65 kg were included in this study. The expression of P-gp was negative in the tumor tissue in 50 patients (group M1 and B1, n = 25 each) and positive in 100 patients (group M2 ,M3 ,and B2 ,B3, n =25 each). The PCA regimen for the 6 groups were listed in the table .Pain was assessed with VAS scores (0 = no pain, 10 = worst pain) and venous blood samples were taken for determination of blood morphine/buprenorphine concentrations at 4, 12, 24 and 48 h of PCIA. Results The six groups were comparable with respect to age, body weight, M/F sex ratio, types of cancer, baseline pain level and education. The analgesic efficacy of morphine and buprenorphine was better ( VAS scores were significantly lower)in P-gp expression negative patients (group M1 and B1 ) than in P-gp expression positive patients (group M2 and B2 ). Higher doses of morphine and buprenorphine provided better analgesic efficacy in P-gp expression positive patients in group M3 and B3 than in group M2 and B2. Plasma morphine and buprenorphine concentrations were comparable between group M1 , B1 and M2, B2 and were significantly higher in group M3 and B3 at each time point. Conclusion Positive P-gp expression in the tumor tissue can decrease the analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain.

Purpose:To investigate the value of susceptibility-weighted imaging(SWI)in evaluating the histopathologic grade of cerebral astrocytomas.Materials and Methods: 18 patients with histologically proven cerebral astrocytomas,including 7 diffuse astrocytomas,3 ana-plastic astrocytomas and 8 glioblastomas before treatment were involved in this study.The features on SWI were analyzed in 18 cerebral astrocytomas.Results: The veins in the tumors were not detected in 7 diffuse astrocytomas.Slight edema round tumors appeared in all the diffuse astrocytomas.Plenty veins in the tumors and severe edema round the tumors appeared in 3 anaplastic astrocytomas and 8 glioblastomas.The hemorrhagic foci were detected in 1 anaplastic astrocytomas and 6 glioblastomas.The edema round the tumors were moderate or severe in all the anaplastic astrocytomas or glioblastomas.Conclusions: Susceptibility-weighted imaging can provide the informations about blood supply,hemorrhagic focus and edema round the tumors.SWI is very useful for preoperative evaluation of the histopathologic grade of cerebral astrocytomas,especially for evaluation of high or low grade astrocytomas.

OBJECTIVE To discuss the liable episodes of the urinary tract infection with relation of catheter and propose the prevention measures.METHODS We radomly selected 536 patients with catheter.The urinary tract infection,as well as related factors were observed in patients with indwelling catheter.RESULTS The catheter replacement time interval as well as indwelling time were the risk factors,when the indwelling catheter time was 1-3 days,the CAUTI rate was 10.3%,if the time was ≥10 day,the CAUTI rate was 97.6%.Additionally the antibiotic use would cause dysbacteriosis which also easily caused the urinary tract road infection.CONCLUSIONS When taking care of the patients who had catheter,we should grasp the indications of catheterization,reduce the indwelling time,apply the effective nursing measures and correct choice of antibiotics,that can evidently control the infection.

OBJECTIVE To explore the reason and the nursing measure of the ventilator-associated pneumonia(VAP).METHODS Fifty five patients with VAP after mechanical ventilation were statistically analyzed and the pathogens were detected,at the same time to carry out comprehensive nursing measure.RESULTS After effective nursing measuring the motality due to VAP was decreased and the successful rescue rate was increased.CONCLUSIONS The VAP associates with various risk factors,but it can be prevented and controalled via overall reasonable and effective nursing measure.

Objective To study the constituents in Melastoma dodecandrum.Methods The constituents were isolated by chromatographic methods,and their structures were elucidated by spectroscopic evidences.Results Five compounds were purified and their structures were identified as: daucosterol(Ⅰ),oleanolic acid(Ⅱ),avicularin(Ⅲ),3,7,4′-trimethoxyquercetin(Ⅳ),and atractylenolidone(Ⅴ).Conclusion Compound Ⅴ is a new chemical constituent named atractylenolidone.Compound Ⅳ is isolated from M.dodecandrum for the first time.

BACKGROUND: Morphine is the first choice for the pain of medium and advanced degrees due to cancer. This is advocated in the Pain Relieving Guide of the WHO. Controlled-release morphine sulfate tablets(CRM) and sustained-release morphine sulfate tablets (SRM) all belong to oral long-acting morphine. It plays an important role in relieving cancer pain effectively and improving their quality of life(QOL).OBJECTIVE: To observe the analgesic effect of CRM and SRM and to observe how they improve the QOL of the cancer patients with severe cancer pain.SETTING: Department of oncology, department of surgery, department of internal medicine and department of traditional chinese medicine in the first affiliated hospital of a university.PARTICIPANTS: During October 1995 to June 1998, all inpatients that were pathologically proved to suffer from malignant tumor with severe pain were recruited into our study.METHODS: There were 182 patients with severe pain due to advanced cancers pathologically proven. They all met the entry criterion of the study. Totally 95 patients were treated with CRM, of which 12 cases were lost in follow-up due to side effects, death, or discharge from the hospital, and the rest 83 cases entered the stage of clinical trial. Eighty-seven patients were treated with SRM. Of them 25 cases were lost in follow-up due to side effects, death, or discharge from the hospital, and the rest 62 cases entered the stage of clinical trial. The recommended initial dosage of CRM or SRM was 30 mg every 12 hours for all patients, and then the dosage was regulated according to the effects until the ideal anesthesia was achieved.MAIN OUTCOME MEASURES: Assessments included pain severity, the effective rate, complete remission rate, remission time, adverse reactions, and the QOL before and after the treatment.RESULTS: The effective rates of CRM and SRM were 95% and 94%respectively. The complete remission rates were 82% and 80% respectively, and the remission time was(9.1 ±4.1) hours and (8.7±4.4)hours respectively. Statistically, there was no significant difference in analgesic effect and remission time between CRM and SRM. QOL was elevated for a higher degree in 62(75% ) and 47(76% ) patients after the treatment. QOL scores of CRM were (34.6 ± 11.5 ) points before treatment and (52.6 ± 13.0) points after the treatment( P = 0. 000), while QOL scores of SRM were(37.7 ± 9.7) points before the treatment and points (49.8 ± 12.9) points after the treatment (P = 0. 000). There was significant difference in QOL after the treatment. They could relicve osteocope,visceral pain, soft tissue infiltrative pain more effectively than they do about neurological pain.CONCLUSION: Oral treatment with CRM and SRM for the patients with server cancer pain shows a similar analgesic effect. They are effective, safe,and convenient, and can improve the QOL.

Taking Suxi Healthcare Center in Yiwu City, Zhejiang province as an example, the paper analyzed the present mission and organizational characteristics of township healthcare centers in China, especially their dual functionality of community public health and primary medicare. Based on such analysis, it designed a matrix-based model for organizational structure and job performance management for such heslthcare centers. The features are as follows. 1) The two dimensions of the matrix structure refer to the departments for medical treatment and the multi-village doctors team in the community, respectively and jointly offering primary medicare and public health services; 2) Jobs are designed based on the organizational structure and functionality. Every job carries out dual Junctions as described and managed by the job description and target responsibility certificate; 3) The job responsibility certificate is a breakdown of the balanced scorecard of the healthcare center, as divided between the departments for medical treatment and the multi-village doctors team; 4) The balanced scorecard of the township healthcare center is designed based on its strategic mission and developing plan. The entire organizational design and management of the center are built on the strategic orientation and logical programmed research.