BACKGROUND: It is generally thought that the pathogenesis of the chronic blocking pulmonary disease (COPD) is characteristics in chronic inflammations of air passage, lung essence and the lung blood vessels. As the classic Chinese medicine, Maxing Shigan decoction has the pharmaco logical effects on fever alleviation, anti-inflammation, anti-virus, cough relieving and phlegm resolving, which is suitable for the treatment of phlegm heat cumber lung COPD, and is remarkable in the curative effect.OBJECTIVE: To probe into the mechanism of Maxing Shigan decoction ini the treatment of COPD by studying the changes in interleukin-8 (IL-8),tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-4 (IL-4)and the ratio between IFN-γ and IL-4 in rats with COPD.DESIGN: Randomized control animal experiment.SETTING: Affiliated Hospital of Shandong University of Traditional Chinese Medicine.MATERIALS: Seventy-two healthy male Wistar rats of SPF level with the body mass of (200±20) g were selected. Maxing Shigan decoction, composed of 5 g of ephedra, 9 g of almond, 6 g of liquorices, 18 g of gypsum.The water-decocted enrichment was 0.475 g/mL, and the medical herb pieces were supplied by the TCM Dispensary of Affiliated Hospital of Shandong Medical University of Traditional Chinese Medicine.METHODS: The experiment was conducted in the Central Laboratory,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from April to October 2005. ① 72 healthy male Wistar rats were randomly divided into 3 groups: blank control group (n=24), retention of phlegm-heat modeling group (modeling group, n=24) and retention of phlegm-heat treatment group (treatment group, n=24). Improved smoking and trachea dropping lipopolysaccharide was adopted to copy COPD model, and model of phlegm heat cumber lung was remodeled for copy.② Rats in the treatment group were lavaged with 2 mL of Maxing Shigan decoction per day (the medicine composition: Chinese ephedra 5 g, almond 9 g, licorice 6 g, gypsum 18 g, the water fries the concentration for the density 475 g/L concentrated solution) from the 30th day, while rats in the modeling group were lavaged with 2 mL of normal saline each day.Rats in the blank control group received no interventions, which ate and drank freely under the same environment. ③ The contents of IL-8, IL-4 and TNF-α in the homogenate of lung tissues were tested by radio-immune method. ④ The content of IFN-γ in the homogenate of lung tissues was detected by the enzyme immunoassay method. ⑤ The ratio of IFN-γ and IL-4 was calculated. MAIN OUTCOME MEASURES: The contents of IL-8, TNF-α, IFN-γ,IL-4 as well as the ratio between IFN-γ and IL-4 in the homogenate of lung tissues in rats of each group.RESULTS: ① The level of IL-8 in the modeling group was markedly higher than that in the blank control group [(581.41±74.72), (318.63±40.01 ) ng/L,P ＜ 0.01], which was significantly decreased after the treatment [(533.95±68.67) ng/L,P ＜ 0.01], while there was difference in comparison with the blank control group (P ＜ 0.05). ② The level of TNF-α in the modeling group was significantly higher than that in the blank control group [(160.78±20.90), (100.29±24.2) ng/L, P ＜ 0.01], which was remarkably decreased after the treatment [(147.08±19.43) ng/L,P ＜ 0.05],whereas it was different in comparison with that in the blank control group(P ＜ 0.01). ③ Compared with the blank control group, the level of IFN-γ in the modeling group was markedly decreased [(230.32±72.33), (328.08±50.57) ng/L ,P＜ 0.01], which was obviously increased after the treatment [(267.24±55.14) ng/L ,P ＜ 0.05], and there were differences between the two groups (P ＜ 0.01). ④ The level of IL-4 was significantly increased in the modeling group than that in the blank control group[(135.08±29.17), (82.41±14.66) ng/L,P ＜ 0.01], which was significantly decreased after the treatment [(107.99±23.76) ng/L,P ＜ 0.01], and there was difference between the two groups (P ＜ 0.01 ). ⑤ The ratio between IFN-γ and IL-4 declined markedly in the modeling group than that in the blank control group (1.77±0.73,4.09±0.91 ,P ＜ 0.01), and the ratio increased markedly after the treatment(2.59±0.79, P ＜ 0.01 ). There was difference between the two groups(P ＜ 0.01 ).CONCLUSION: Maxing Shigan decoction can regulate the changes in level of multiple cytokines in rats with COPD, which has the effects of anti-inflammation and enhancing the immunity of organism immunization with clear curative effect on COPD (syndrome of retention of phlegmheat).

BACKGROUND: Many diseases accompany with changes of gene expression which can provide a valuable clue for pathogenesis and therapy of cognitive diseases.OBJECTIVE: To screen expression of different genes in lung tissue of model rats with chronic obstructive pulmonary disease (COPD) by gene expression profiling technique. DESIGN: Open study. SETTING: Affiliated Hospital of Shandong University of Traditional Chinese Medicine; Radiation Medical Institute of Academy of Military Medical Sciences of Chinese PLA; Shangdong University of Traditional Chinese Medicine.MATERIALS: The experiment was carried out in the Central Laboratory of Affiliated Hospital, Shandong University of Traditional Chinese Medicine from April to October 2005. ① Fifteen healthy male Wistar rats of SPF grade and aged 50 days were randomly divided into normal group, model control group and Chinese herb group with 5 in each group. ② Type of gene chip was BiostarR-40S and provided by Shanghai Boxing Gene Chip Company Limited (batch number: G050510010052).METHODS: ① COPD models in model control group and Chinese herb group were established with modified smoking-fumigated method plus adding lipopolysaccharide in windpipe. Pathological changes of airway were observed under optic microscope. Models were established successfully based on the following phenomenon: hyperemia and edema in mucous membrane of airway; degeneration and necrosis of epithelial cells; infiltration of bronchial cavity in lung tissue and surrounding chronic inflammatory cells; proliferation of smooth muscle and fibrocyte surrounding dissepiment; thin and broken interval; amplifying confluence of pulmonary alveolus; thickness of vascular wall of arteriole; decrease of vaso-cavity; infiltration of surrounding inflammatory cells. ② At 30 days after modeling,0.65 g/mL self-made Chinese herb (mahuang, xingren, huangqi, etc.) wasperfused into rats in Chinese herb group with 2 mL each time, once a day,for successive 14 days. Rats in model control group were perfused with 2 mLsaline; however, rats in normal group were untouched. All rats drank freely under the same internal environment. ③ After administration, rats in each group were sacrificed to extract total RNA, label and hybridizated with probe, wash pieces, analyze gray value of clip with clip imaging software,obtain original signal of each gene point (signal values of foreground and background) and determine differently expressed genes. If size of test was more than 2.0, genes were regarded as up-regulation genes; otherwise, if ratio was less than 0.5, they were regarded as down-regulation genes. In this study, based on reliability, if size of test was more than 2.5, they were regarded as up-relation genes; however, if ratio was less than 0.375, they were regarded as down-regulation genes.MAIN OUTCOME MEASURES: ① Comparisons of differently expressed genes in normal and model control groups; ② Comparisons of differently expressed genes in normal and Chinese herb groups; ③Comparisons of differently expressed genes in model control and Chinese herb groups.RESULTS: Fifteen rats were all involved in the final analysis. ① As compared with those in normal group, there were 57 differently expressed genes in model control group, involving in immunity, metabolism, signal transduction, adjusting of gene expression, cell cycle, cell transport, cell migration, fibrosis, etc. ② Gene expression in Chinese herb group reached normal level and there were 11 differently expressed genes as compared with those in normal group, involving in stress, signal transduction, cytoskeleton, etc. ③ As compared with those in model control group, there were 7 differently expressed genes in Chinese herb group, involving in immunity and excretion of neurotransmitter.CONCLUSION: Changes of gene expression may be one of reasons of COPD pathogeneses; moreover, most differently expressed genes can recover the normal level after drug therapy which is beneficial to correct pathological changes of COPD.

Objective To explore the application of the automatic bone age assessment of BoneXpert software in Children and adolescent of China (Shanghai).Methods Left hand and wrist radiographs of 434 cases of children from trauma (264 boys and 170 girls) were obtained from Jan.2010 to Dec.2013.Bone age was assessed by BoneXpert software and 40 radiographs were randomly chosen and re-evaluated after a week.Results Seven images were rejected by BoneXpert,so the efficiency of the software was 98.4％ and it takes only 14.5 s for every image.Sample assessments by two times are exactly the same.As to BoneXpert software,there were statistical differences between bone age and chronological age in 8 groups:7,8,9,11 years old boys and 2,3,9,11 years old girls(P ＜ 0.05) out of 26 groups,and the average difference was about 1 s.The following modifications suggested that 0.57,0.79,0.93,-0.38 and-0.22,0.30,0.37,0.59 years could be added respectively for the groups of boys aged 7,8,9,11 and girls aged 2,3,9,11 years old according to their average differences between the bone age and the chronological age.Conclusions The BoneXpert method for automated determination of skeletal maturity which evaluates bone age objectively and quickly can be applied clinically after slight adjustment in some age groups.BoneXpert software is 100 percent automatic and could eliminate the subjective evaluation inaccuracy.

It is imperative to apply information technology in the area of management of clinical research so as to ensure the quality of clinical trials and to improve management efficiency.In this study,the based analysis method was the quality function deployment (QFD).This methodology is used to analysis the clinical trials management information system on a hospital directly under the Ministry of Health.It ensured user participation,lay a solid foundation for software engineers on system design.

Objective:To analyze the influential factors of medical staff's cognition on medical ethics review in Wuhan municipal medical institutions,and thus to provide suggestions for strengthening the ethical construction.Methods:Aquestionnaire survey was conducted among medical staff.Chi-square test and Logistic regression method were performed to analyze the influential factors of medical staff's cognition on medical ethics review.Results:The results showed that medical staff's cognition on medical ethics review was affected by the technical tide,education background,whether had received ethical education,the cognition on ethics committees and whether the medical institution had established ethics committee.With higher technical titles,they thought more necessity to establish ethics committees and conduct ethical review of the clinical applications of new technology and new business.Those with higher technical titles and had read the ethical propaganda materials thought it more necessary to conduct ethical review of the clinical application of new technology and new business and the ethical review of biomedical research involved human beings.Conclusions:The medical institution should embody the establishment and standardization of ethical committees into the hospital assessment management system,as a necessary condition for the application of research projects and achievement awards.Also,it should conduct medical ethics training for all medical staff.Only those passed the examination can enter into the research and clinical operation with certificates,which can protect the medical ethics education into practice.It should strengthen the medical staff's cognition on ethical review,constantly innovate the operation rules and management system based on following the basic ethical review principles,and constantly improve the medical ethical review mechanism.

OBJECTIVE:To systematically review the effect of organic cation transporter 2 [(OCT2)808G>T] gene polymor-phism on the metformin hydrochloride pharmacokinetics in vivo,and to provide evidence-based reference for clinical medication. METHODS:Retrieved from PubMed,EMBase,Foreign Medical Journey Service,CJFD,VIP database and Wanfang database,re-lated studies about the effect of (OCT2)808G>T gene polymorphism on the metformin hydrochloride pharmacokinetics in vivo were collected,and Meta-analysis was performed by using Rev Man 5.1 statistics software. RESULTS:A total of 5 retrospective studies were included,involving 172 patients. The result of gene type was type GT,type TT and type GG. Results of Meta-analysis showed,compared with type GT volunteers,type TT could prolong the half-time period of metformin hydrochloride;compared with type TT,type GG could increase the peak concentration. However,(OCT2)808G>T gene polymorphism had no effects on the renal clearance rate,creatinine clearance rate and area under the drug-time curve. CONCLUSIONS:(OCT2)808G>T gene poly-morphism has certain effect on the half-time period and peak concentration of metformin hydrochloride in vivo of health volunteer, and has no effect on the renal clearance rate,creatinine clearance rate and area under the drug-time curve. Due to the limit of re-search methodological quality,large-scale and high quality studies are required for further validation of the conclusions.

Human health is closely related to the intestinal flora. The intestinal flora regulates the body's immune function by promoting the development of the immune system of the intestine, inducing differ-entiation of T cells, and other ways, so that it is in equilibrium, thereby avoiding or reducing the occurrence of immune-related diseases. Allergic diseases are related to incomplete development of the autoimmune system and imperfect immune control mechanisms. Moreover, the distribution and diversity of bacterial flora in chil-dren with allergies are significantly different from those in healthy children. Therefore, allergic diseases are closely related to the functional status of the intestinal flora. This review summarizes the associations and mech-anisms of common childhood allergic diseases, such as food allergies, eczema, asthma, and anaphylactoid purpura with intestinal flora.

This study aimed to investigate the presence of human papillomavirus and Epstein-Barr virus in male lichen sclerosus patients. We extracted DNA from formalin-fixed paraffin-embedded foreskin tissue blocks of 47 male LS patients and 30 healthy men and performed real-time PCR test to detect HPV and EBV. None of the 47 LS patients and 30 healthy men had detectable HPV infection. EBV was detected in 18 LS patients (38.3%) and four healthy men (13.3%), the difference is significant (P < 0.05). Tissue blocks with significant inflammatory reaction tend to have higher EBV load. HPV has no significant relationship with LS. Male LS patients have higher EBV infection rate, but the role of EBV in the pathogenesis of LS needs further investigate.

Objective:To evaluate the reliability of several formulae for estimating the quantity of glucose absorption of peritoneal dialysate (GA).Methods:Forty-four patients receiving continuous ambulatory peritoneal dialysis (CAPD) were enrolled in this study. The quantities of GA obtained from actual measurement and estimation were compared to judge whether there was statistical difference between them.Results:The GA quantities estimated by Grodstein formula, Bodnar formula, K/DOQI formula, empirical method A (based on 60% absorption rate) and empirical method B (based on 50% absorption rate in daytime and 80% absorption rate in night) were as follows: 81.3 (64.2, 118.0) g, (97.8±19.7) g, (94.1±25.8) g, 87.1 (76.2, 109.0) g and (89.5±16.0) g, respectively; the actually measured GA quantity was [94.2 (77.5, 111.6)] g. Wilcoxon signed rank test of paired samples showed that only the results of Bodnar formula and K/DOQI formula did not present statistical differences from actually measured result.Conclusion:It can be considered to use Bodnar formula and K/DOQI formula to roughly estimate the GA quantity of CAPD patients, but to accurately understand the individual GA value, actual measurement is still required.

Objective:To explore if there is premature senescence of chondrocytes in patients with Kashin-Beck disease (KBD) and osteoarthritis.Methods:Five knee cartilage samples of KBD, osteoarthritis and control groups were collected, respectively, from the Second Affiliated Hospital of Xi'an Jiaotong University. DNA was then extracted from cartilage samples and DNA methylation was analyzed by Illumina Infinium HumanMethylation450 BeadChip. At the same time, based on genome-wide methylation data, the online DNA methylation aging clock calculator (https://dnamage.genetics.ucla.edu/home) was used to calculate the DNA methylation age (DNAm age) of samples, and the results were compared with their actual ages.Results:In the comparison between KBD group and control group, 1 212 differentially methylated CpG sites were found, including 497 hypermethylated CpG sites and 715 hypomethylated CpG sites, corresponding to 264 hypermethylated genes and 368 hypomethylated genes, respectively. In the comparison between osteoarthritis group and control group, 656 differentially methylated CpG sites were found, including 343 hypermethylated CpG sites and 313 hypomethylated CpG sites, corresponding to 177 hypermethylated genes and 174 hypomethylated genes, respectively. In the above comparison, 367 overlapped CpG sites (corresponding to 182 genes) were found, which were differentially methylated in both KBD and control groups and osteoarthritis and control groups. The results of DNA methylation aging clock showed that the average age acceleration differences between DNAm age and actual age of KBD, osteoarthritis and control groups were 2.549, 0.017, and - 5.364 years, respectively, the DNAm ages of KBD and osteoarthritis groups were greater than the actual ages.Conclusion:The chondrocytes show premature senescence in both KBD and osteoarthritis.