Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; drug therapy ; prevention & control

Technological innovation paves a way for constant advances of medical sciences.Presently great emphasis has been put on creative clinical researches globally.More and more clinical studies by Chinese authors have been published in internationally reputed journals,and they have drawn wide attention.Compare with experimental research,clinical research may yield huge social and/or economic benefits,and may help to solve clinical problems over a relatively short period of time.In a populous country like China,large cohort of patients may mean a conceivable advantage for clinical research,which is of paramount significance in promotion of medical sciences and in improving the health status of the Chinese people.Clinical researchers should therefore be actively involved in this clinical research.Understandably,solutions are urgently needed for some obstacles,such as the low financial input from government and the incompetence in selecting research subjects and in designing study by clinicians.Nevertheless,we believe that,with the substantial support from our government,Chinese clinical research will surely have a bright future.

Following the one in the last,Five spirits should be advocated in scientific research,Prof Zhong's paper in this issue goes further with 5 expectations he has for the young generation of Chinese clinical scientists.The expectations highlight the need for willingness-to-do,ability-to-do,skill-to-do,perseverance-to-do and immunity against frustration for young scientists in clinical research.Among these,the willingness-to-do seems to be the primary motion,ability-to-do,skill-to-do and immunity against frustration are considered crucial aspects,and perseverance-to-do is the basis.His passionate intention was directed to education of readers in review of his strenuous efforts and valuable experiences during decades of scientific research.Hopefully,meeting with Prof Zhong in this journal would bring about implications and enlightenments for your work in clinical science.

Academician Zhong Nanshan advocates to broad scientific and technical workers nationwide five spirits which should be upheld in scientific research:first,scientific and technical workers should love their homeland;second,they should respect and promote science;third,they should advocate innovation;fourth,they should respect and stick to honesty;and fifth,they should advocate the spirit of cooperation.

The new revision of 《Guideline on Diagnosis and Management of Cough(2009)》 is published in China in 2009 following the first revision of 《Guideline on Diagnosis and Management of Cough (draft)》in 2005.The new revision hold prvious stucture basically,more focuses on diagnosis and management of chronic ough,adds new sections including subacute cough,empiric treatment,phlegm-removing drugs,and assessement of cough severity as an appendix.A few news terms have been intrduced to replace older terms,such as upper airway cough syndrome for post nasal drip symdrome,and postinfection cough for cough post influenza.

AIM: To study the expression of matrix metalloproteinase-9 (MMP-9) in human bronchial epithelial cell treated with TNF-?, ConA and mechanical injury. METHODS: RT-PCR and gelatin zymography were performed to observe the dynamic expression of matrix metalloproteinase-9(MMP-9) in human bronchial epithelial cell line H292 at different timepoint(2 h, 6 h,12 h, 24 h) after stimulation with TNF-?, ConA and mechanical injury. RESULTS: Human bronchial epithelial cell H292 expressed and secreted matrix metalloproteinase-9 in the presence of TNF-?, ConA and mechanical injury. On stimulation with mechanical injury alone, MMP-9 was initially expressed at 2 h, peaked at 12 h, and decreased at 24 h. Furthermore, on stimulation with combination of ConA and mechanical injury, the MMP-9 mRNA expression was the highest among in all the groups. Zymography show that the MMP-9 activity appeared just at 24 h timepoint, and was highest at the group of combination of ConA and mechanical injury. CONCLUTION: Human bronchial epithelial cell expressed and secreted MMP-9 when treated with TNF-?, ConA and mechanical injury.

Objective To investigate antimicrobial resistance of clinical isolates from 15 hospitals submitted to Guangzhou Surveillance of Antimicrobial Resistance (GSAR) in 2007,and to learn the feature of bacterial resistance in Guangzhou.Methods Disc diffusion test (K-B methods) was employed to study the antimicrobial resistance.Results Of 18 500 clinical isolates,Gram negative bacilli and Gram positive cocci accounted for 68.4% and 31.6%,respectively,and 45.7% isolates in Gram negative bacilli belonged to non-fermentative bacilli.The detection rotes of methiciHin-resistant strains was 55.9% in Staphylococcus aureus and 75.9% in coagulase negative Staphylococcus.All of the Staphylococcus pneumoniae isolates were penicillin-susceptible (PSSP) according to 2008 CLSI criterion.One strains of Enterobacter faecium were identified as vancomycin-resistance (VRE).The resistant rates of Enterobacter to imipenem and merpenem were the lowest.The prevalence of ESBLs-producing strains in Enterobacter coli and Klebsiella spp.isolates was 43.8% and 39.8%,respectively.Against all the ESBLs strains in Enterobacter coli and Klebsiella spp,meropenem,imipenem,cefoperazone/sulbactam,and piperacillin/tazobactam showed the lowest resistant rates,ranging from 0 to 14.1%,20.4%,24.4% and 25.4% isolates of Pseudomonas aernginosa were resistant to efoperazone/sulbactam,piperacillin/tazobactam and meropenem,while 75.6%,72.4% and 63.2% isolates of Pseudomonas aeruginosa were susceptible to piperacillin/tazobactam,meropenem and cefoperazone/sulbactam,respectively.The resistance rates of Acinetobacter spp.to cefoperazone/sulbactam and meropenem were 2.6% and 5.1%,respectively.Some panresistant isolates of Pseudomonas aeruginosa (5.5%) and Ac/naobacter baumannii (1.5%) emerged.The resistance of Pseudomonas aeruginosa and Aeinetobacter baumannii isolated from sputum sample was higher than those from blood sample.Conclusions The increase of isolated rates of non-fermentative Gram-negative bacilli and the emerging bacterial resistance and oandrug resistance in Pseudomonas aeruginosa and Acinetobacter baumannii warrants further enbancing the local surveillance of bacterial resistance and characterization of panresistance mechanism to inform the rational use of anfimicrobial agents and containment of bacterial resistance.

Objective To study the effects of N-acetylcysteine (NAC) on the proliferation, apoptosis and collagen synthesis of human lung fibroblast (HLF). Methods HLF was primarily cultured in complete medium of DMEM/F12. Different concentrations of NAC (5,10,20,40mmol/L) were administrated. Cell proliferations were tested by methylthiazolyltetrazolium (MTT) ,apoptosis and cell cycle were detected with Flow cytometer and mRNA and 40 mmoi/L )after 24 hours,the apoptosis rates were (34.38±5.80)%, (37.72±3.10)%, (44.05± 4.52) % and (59.18±5.24) % ) respectively, significantly higher than that of the controls (3.92±1.24) % pression of type Ⅰ procollagen in HLF was decreased significantly after administration of NAC at 5, 10,20, 40 mmol/L respectively (P < 0.01 ). Conclusion Administration of NAC induces apoptosis and directly inhibites the proliferation and the collagen synthesis of HLF.

Objective:To construct and evaluate a Salmeterol lungs-specific liposomal delivery system.Methods:①Liposome were prepared by the reverse-phase evaporation method and instilled into the tracheas of SD strain rats.The influence of Salmeterol on the uptakes of liposome was evaluated.②pEGFPC1(25 ?g/rodent) encapsulated in lungs-specific liposome were administered intravenously into Guinea pigs,GFP expression were observed by means of fluorescent microscopy 24h and 48h after administration.Results:①2,4,8,12,16 hours after instillation,lungs-specific liposome uptake were significantly higher than nonspecific liposome uptake(P