In order to improve rational useage of inerferon in clinic,this article elaborate the background of this Specialists consensus on pediatric clinical application of recombinant human interferon-α1 b,the differences of various subtypes of interferon,the envidence and method of interferon-α1b clinical application,the satety and the adverse reaction monitoring issues in this article.

Objective To investigate the value of pulmonary function tests in the diagnosis and treatment of children with refractory mycoplasmapneumoniae pneumonia.Methods The clinical data of 58 children with refractory mycoplasmapneumoniae pneumonia (RMPP) from May 2015 to February 2016 were retrospectively analyzed in the Department of Paediawics, Shengjing Hospital of China Medical University.They have done bronchoscopy and interventional therapy in the acute phase.Pulmonary function test was performed 24 hours before bronchoscope examinations.The endoscopic manifestation and pulmonary function data were analysed in the study.According to whether the mucosa of endoscopic manifestation is complete, fifty-eight cases were divided into mild group and severe group, record the pulmonary function indexes of each of the children.Results Severe group decreased than mild group, both of large airway pulmonary function in children with acute severe MPP (FVC, FEV1, PEF) and small airway index (FEF25, FEF50, FEF75, FEF25-75％), and the difference was significant(P ＜ 0.05).Conclusion In the acute phase, there may be different pulmonary function,such as, expressed as a normal, performance of the restrictive or obstructive ventilation dysfunction, performance ofrnixed ventilatory dysfunction, The most common one is the change of small airway function.The more severe of the endoscopic manifestation in RMPP acute phase, the more severe the same period of pulmonary function index decreased degree.The severity of RMPP in children can be predicted by the classification and severity of pulmonary function,it can be used as an important basis for the early identification of severe MPP.Pulmonary function indicators may further guide the need for bronchoscopy intervention treatment and to evaluate the curative effect.

Objective To study the expression of estrogen receptor beta in the lung tissue of mice treaded with B[a]p alone or combined with estrogen (17 ?-estradiol, E2) in female Kunming strain mice and to explore the effect of estrogen in the lung cancer of mice induced by benzo[a]pyrene (B[a]P). Methods One hundred and twenty-five female Kunming mice were randomly divided into 5 groups: normal control group was group 1 ;group 2 was treated with subcutaneous injection of estrogen ( 900 ?g/kg); group 3 was given B[a]P(75 ?mol/kg) by gavage;the last two groups were given the same dosage of B[a]P (75 ?mol/kg)plus two different dosage of estrogen: 900 ?g/kg and 300 ?g/kg. After 8 weeks,there was a recovery period of 8 weeks. Then, the lung tissue was obtained by surgical resection. The expression of estrogen receptor-? gene and estrogen receptor-? protein of the lung tissue was detected by real-time PCR and Western blotting technology respectively. Results The expression of estrogen receptor-? protein and estrogen receptor-? gene in the B[a]P group and the B[a]P plus low dosage estrogen group was significantly higher than the normal group (P

Objective To investigate the influence of Mycoplasma pneumonia (MP) on the levels of interferon (IFN)-γ,interleukin (IL)-4 and IL-5 in bronchoalveolar lavage fluid (BALF) of BALB/c mice infected by MP,and to study whether MP infection may be involved in the pathogenesis of asthma through the pathway of influencing T helper type 1 (Th1)/T helper type 2 (Th2) immune response.Methods Forty BALB/c mice were randomly divided into two groups,control group and MP infected group,each group 20 mice.The BALF of MP infected group was respectively collected after MP infection at 3,7,14,21 days,each time 5 mice.The levels of IFN-γ,IL-4 and IL-5 were detected by enzyme linked immunosorbent assay.Results The levels of IFN-γ,IL-4 and IL-5 increased in MP infected group compared with control group,the differences were significant respectively (P ＜ 0.05).The levels of IFN-γ,IL-4 and IL-5 reached the peak at 7 d after MP infection.The IFN-γ/IL-4 ratio was significantly lower in MP infected group than control group,and achieved the trough at 7 d,the difference was significant (P ＜ 0.05).Conclusion MP infection can lead to the increased level of IFN-γ,IL-4 and IL-5 in BALF of BALB/c mice,peaked at 7 d.MP infection can increase the discharging of Th1 cytokines and Th2 cytokines,induce Th1/Th2 immune response disequilibrium,and it may be involved in the pathogenesis of asthmatic airway inflamation through the pathway.

Objective To explore effect of grape seed proanthocyanidin extract (GSPE)on airway inflammation and hyperresponsiveness of ovalbumin-induced murine asthma model and the associated regulatory effect on Treg/Th17 imbalance.Methods A total of 40 mice were randomly assigned to four experimental groups:control,asthma model,low dose GSPE (40 mg/kg),and high dose GSPE (80 mg/kg).Acute asthma model was established with OVA;airway responsiveness of mice in each group was measured with a noninvasive pulmonary function instrument;lung inflammation changes were observed by pathological HE staining;Treg/Th17 cytokines levels in bronchoalveolar lavage fluid were evaluated by ELISA;the expressions of forkhead/winged helix transcription factor(Foxp3) mRNA and retinoid-related orphan receptor gammat (RORγt) mRNA in lung tissue of each group were gained by Real-time PCR method.Results GSPE inhibited ovalbumin-induced increases in airway responsiveness(P ＜ 0.05).Histological studies demonstrated that GSPE substantially inhibited OVA-induced airway inflammation in lung tissue.GSPE decreased IL-17A levels and increased IL-10 levels in bronchoalveolar lavage fluid (P ＜ 0.05).In the asthma model group,RORγt mRNA expression in lung tissue was significantly higher than that in the control group(P ＜ 0.05)and Foxp3 mRNA expression was significantly lower than that in the control group (P ＜ 0.05).In the GSPE group,RORγt mRNA expression was lower than that in asthma model group (P ＜ 0.05),however the Foxp3 mRNA expression was higher than that in asthma model group(P ＜ 0.05).Conclusion GSPE could alleviate airway hyperresponsiveness and airway inflammation of in asthmatic mice.It can modify the asthmatic mice Treg/Th17 imbalance by decreasing IL-17A and increasing IL-10 concentration at the level of cytokines;and also by increasing Foxp3 mRNA expression and inhibiting the expression of RORγt mRNA at the transcriptional level,which provide a new way for treatment of bronchial asthma.

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 investigate the alteration of the cytoskeleton of airway smooth muscle cells in young asthmatic rats with airway remodeling and the effect of RhoA/ROCK signal pathway.Methods Airway smooth muscle cells (ASMCs) were primary cultured and purified from Sprague-Dawley(SD) rats that were induced by ovalbumin (OVA) inhalation for 8w,then incubated by Pho kinase inhibitor Y27632.Real time quantitative polymerase chain reaction (RT-PCR),Western blot,and immunohistochemistry were used to measure the alteration of F-actin,and α-tubulin in the cytoskeleton of airway smooth muscle.Results (1) The asthma group showed a high average gray value of F-actin in ASMC than control groups,especially 8 weeks;and were significantly down in the group after adding Y27632(P ＜0.01).(2) The intension and intensity of fluorescence signal of α-tubulin in asthma groups in 8 weeks were higher than control greup(P ＜0.01),and were significantly decreased in Y27632 group.(3) A higher expression of α-tubulin protein was shown in the asthma group in 8 weeks relative to control group(P ＜0.01),and was significantly down-regulated in Y27632 group(P ＜0.05).Conclusions Alteration of the cytoskeleton of airway smooth muscle exists in young asthmatic rats and the RhoA/ROCK signal pathway possibly plays a significant role.

Objective To compare the risk of tumor invasion and metastasis under paravertebral block (PVB) combined with general anesthesia versus general anesthesia in the patients undergoing radical resection for lung cancer performed via video-assisted thoracoscope in terms of plasma concentrations of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9).Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 30-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective radical resection for lung cancer performed via video-assisted thoracoscope,were randomly divided into 2 groups (n =20 each) using a random number table:general anesthesia group (group G) and PVB combined with general anesthesia (group PG).PVB of T4-7 was performed successfully with local injection of 0.375％ ropivacaine 5 ml before induction of anesthesia.Double-lumen endotracheal tube was placed after induction of anesthesia,and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of sevoflurane (end-tidal concentration 1％-2％),and intravenous infusion of remifentanil 0.2-0.3 μg · kg-1 · min-1,and intermittent intravenous boluses of atracurium.Before anesthesia and at 24 h after surgery,the venous blood samples were collected for measurement of plasma concentrations of VEGF and MMP-9.Results The plasma VEGF and MMP-9 concentrations were significantly lower after surgery in group PG than in group G.Conclusion PVB combined with general anesthesia significantly decreases the risk of tumor invasion and metastasis in the patients undergoing radical lung cancer resection performed via video-assisted thoracoscope in comparison to general anesthesia.

Objective To investigate the effect of transcutaneous electric acupoint stimulation (TEAS)of Hegu-Neiguan-Houxi-Zhigou for preventing postoperative nausea and vomiting (PONV) in patients undergoing thoracoscopic lobectomy.Methods Sixty-four ASA physical status Ⅰ-Ⅲ pa-tients,aged 18-75 years,scheduled for elective thoracoscopic lobectomy were enrolled.Patients were randomly allocated into two groups (n =32):TEAS group (group E)and sham TEAS group (group C).TEAS at Hegu,Neiguan,Houxi and Zhigou was applied to patients before,during and after sur-gery in group E.The frequency was 2/100 Hz and the intensity was 2 times the threshold of sensation before and after surgery,and 30 mA during surgery.While sham TEAS with the intensity of sensory threshold was given to patients before and after surgery in group C.Patients in both groups received sufentanil,propofol and rocuronium for induction of anesthesia.Target controlled infusion of propofol and remifentanil was administered for maintenance of anesthesia.Patient-controlled intravenous anal-gesia (PCIA)was applied in both groups.No antiemetic was given to patients before and during sur-gery.Frequency of nausea or vomiting and any use of antiemetic for remediation were recorded after surgery.The postoperative Visual Analogue Scale (VAS)score and analgesic dosage were also docu-mented.Results Compared to group C,the incidence of nausea immediately after surgery,6 h after surgery,24 h after surgery and 48 h after surgery were significantly lower in group E.The incidence of vomiting 24 h after surgery was significantly lower in group E.The VAS score 6h and 24 h after surgery were significantly lower in group E.The analgesic dosage 48 h after surgery were reduced in group E.There were no significant differences regarding the use of antiemetic for remediation between the two groups.Conclusion TEAS at Hegu-Neiguan-Houxi-Zhigou is effective for preventing PONV in patients undergoing thoracoscopic lobectomy.

Objective To investigate the changes of the levels of interleukin(IL)-17 in bronchoalveolar lavage fluid (BALF) of BALB/c mice infected by mycoplasma pneumonia (MP).Methods Sixtyfour BALB/c mice were randomly divided into two groups,normal group (n =32) and MP infected group (n =32).The BALF and lung tissue of two groups were collected after MP infection on day 3,7,14,21,each time 8.HE staining was used to observe the pathological changes of the lung tissue.IL-17 content in BALF was detected by ELISA.Results The inflammatory changes of the lung tissue was the most obvious at 7 day,and had begun to subside at 14 day,disappeared at 21 day after MP infection.IL-17 levels in BALF were (53.783 ±2.218) pg/ml(3 day),(65.913 ± 10.693) pg/ml(7 day),(59.915 ± 8.085) pg/ml(14 day),(57.043 ± 11.997) pg/ml(21 day) in MP infection group,and (46.220 ± 3.260) pg/ml in normal group.BALF IL-17 content increased significantly in MP infection group compared with normal group(P ＜ 0.05).IL-17 content reached its peak on day 7 after MP infection (P ＜ 0.05).Conclusion MP infection increased the level of IL-17 in the mice of BALF,reaching the peak on day 7.MP infection may be involved in airway inflammation in asthma through the IL-17 pathway.