Objective To study the clinical characteristics of acute asthma during pregnancy,focusing on management of pregnant women presenting with an acute exacerbation.Methods A prospective observational study was conducted in 30 cases of acute exacerbations during pregnancy.Results The prognosis of 25 patients with mild or moderate asthma was good for both mother and fetus;none had severe complications.Among 5 women who had severe exacerbations,there were 4 pulmonary co-infections,1 with respiratory acidosis,1 with respiratory acidosis plus metabolic allkalosis,and 4 with fetal growth-restriction.Conclusions,This study highlights that pregnancy can worsen asthma control in some women.Effective management and prevention of asthma exacerbations during pregnancy is key to ensuring the safety of the mother and the fetus.

This experiment was carried out in 65 New Zealand rabbits. The resultsrevealed that the febrile response and increaed PGE_2 level in cerebrospipel fluid (CSF) were significantly reduced when the calcium-channel-blocking agent (verapamil) wasintravenously injected prior to ET. But, verapamil had no marked effect on the increasedcAMP level in csf during ET-induced fever. It was suggested that most likely this anti-pyretic action was due to the effect on biosynthesis of PGE in hypothalamus, while,cAMP might not be involved in the mechanism of this antipyretic action.

Objective To investigate prognostic factors for gastric cancer patients with liver cirrhosis.Methods The clinicopathological data of 52 gastric caner patients with liver cirrhosis operated on between March 1994 and March 2006 were analyzed retrospectively and the prognostic factors were evaluated.Significant factors were then entered into a Cox regression analysis.Results The postoperative 1-3- and 5- year survival rates for these 52 patients followed up were 78％,44％ and 33％.Univariate analysis revealed that age,Borrmann type,histology timue typing,tumor size,pTNM stage,Child-pugh grade,postoperative complications,ascites,and albumin level were statistical significance for survival rate (P ＜ 0.05 ).Multivariate analysis demonstrated that pTNM stage,Child-pugh grade,ascites were independent prognostic factors affecting prognosis( P ＜ 0.05 ).The risk of Child-pugh grade is 3.005,the risk of pTNM is 1.594.Conclusions Compared with pathological disease stage of the gastric cancer,liver function affects more on the prognosis of cirrhotic gastric cancer patients undergoing gastrectomy.In Child-pugh grade B or C cases,postoperative liver dysfunction was the main concern.While those of Child-pugh grade A should undergo standard D2 gastrectomy.

Objective To explore the characteristics and drug resistance of pulmonary tuberculosis combined with Stenotrophomonas maltophilia infection.Methods The clinical data of 65 patients with Stenotrophomonas maltophilia infection were analyzed retrospectively.Results It showed that 65 strains of Stenotrophomonas maltophilia mainly came from sputum sample [75.4％(49/65)] and were highly resistant to many kinds of antimicrobial agents,of which the resistance rate to carbapenems,β-lactames was above 60％ and the sensitive rate to moxifloxacin,ethoprin-sulfamethoxazole and ticarcillin/clavulanic was above 70％.Conclusion Clinical practices should pay more attention to the high resistance of Stenotrophomonas maltophilia infection,which might result in pulmonary tuberculosis,and prescribe antibiotics rationally according to the drug sensitive test.

Objective To study the aplication effect of fiber bronchoscope examination in the treatment of respiratory internal medicine emergency and its effect on the quality of life of patients.Methods 156 patients with emergency were randomly divided into the observation group and control group,each group in 78 cases.The control group was given routine treatment plan according to the primary disease type which was the respiratory treatment of the corresponding diseases,the observation group in the control group was added fiberoptic bronchoscopy based on the treatment.Compared blood clinical curative effect,heart rate and quality of life score changes of the two groups of patients after treatment.Results The total effective rate of the observation group was 94.87%,which was significantly higher than 81.01% of the control group(χ2 =6.28,P <0.05).The pH,PaO2 and SaO2 in the observation group after treatment were(7.35 ±0.04),(73.23 ±9.11)mmHg and(92.33 ±4.32)%,which were significantly higher than the corresponding index in the control group(t =3.97,6.08,4.96,all P <0.05);while PaCO2 and HR were (51.53 ±9.24)mmHg,(91.69 ±12.42)times/min,which were significantly lower than the corresponding index in the control group(t =6.73,5.13,all P <0.05);The quality of life score in the observation group was(54.04 ± 10.94)points,which was significantly lower than(77.23 ±12.32)points of the control group(t =5.86,P <0.05). Conclusion Fiberoptic bronchoscopy for respiratory internal medicine emergency treatment can significantly improve the clinical curative effect of treating disease and patient quality of life.

This article analyses and describes the influencing mechanism of hospital alliance on quality of care from six aspects:product and technology,organizational structure,psychosocial climate, management,organizational culture,and competition in medical service market.In order to ensure and improve the medical quality,this study discusses that hospital alliance can not only ally in the form but also optimize the internal structure,strengthen the integration of organizational culture of the institutions, gradually form a social psychological climate of“Quality First”.In addition,the government′s regulation on the medical service market is also indispensable.

According to clinical epidemiological researches, the usage of antibiotics in infant increases the risk of childhood asthma morbidity. The mechanism of this link is not entirely clariifed, and it is assumed of being related to side effects of antibiotics, which changes the colonization of normal intestinal lfora and reduces the diversity. It is clear that normal intestinal lfora of infant help to construct innate immune system and adaptive immune system, and forge immune tolerance. Therefore, normal intestinal lfora might be helpful in reducing allergies. The usage of antibiotics in early life changes the quantity and the composition of intestinal lfora, and breaks the balance of immune homeostasis, which might increase the risk of asthma morbidity. The abuse of antibiotics in children is a general phenomenon in China which needs attention from pediatricians.

Objective: To compare utility values measured by different instruments. Methods: Different instruments were used to measure utility values in 350 patients who were diagnosed as age-related macular degeneration at the same time. The median of utility values measured by different instruments was regarded as relative standard utility value to process comparison, analysis of variance, correlation analysis and curve estimation. Results: Most differences and correlations among utility values measured by different instruments were significant, as well as equations estimated from relative standard utility value and utility values measured by different instruments, but the degree of fitting was not high. Conclusion: The utility values of the same subject measured by different instruments are quite different. The results of the study could provide correction reference to the utility value measured by single instrument in the absence of absolute standard.

MiRNA is a small non-coding single stranded RNA(ssRNA)which is made up by 21~23 nucleotide.This ssRNA has a double effect as tumor suppressor genes and oncogenes , and plays an important role in cell proliferation , differentiation and apop-tosis.Pancreatic carcinoma is a highly malignant tumor with poor prognosis and high mortality rate , and the early diagnosis is difficult . In the last decades , growing studies highlighted the interactions between miRNAs and pancreatic carcinoma .This review provides a re-search overview between miRNAs and pancreatic carcinoma .Meanwhile , the significance of Expression Profile in pancreatic carcinoma′s diagnosis ,treatment and prognosis is also discussed .

Objective The incidence of acute pulmonary injury occurred after cardiopulmonary bypass for fallot tetrad has been high. The severity of pulmonary ischemia-reperfusion has been found to be reduced with ulinastatin (UTI) in the animal models and clinical practice. We evaluated the effect of pulmonary artery perfusion with a hypothermic protective solution containing ulinastatin on the inflammatory response in the lung during cardiopulmonary bypass. Methods 30 children with tetralogy of Fallot (TOF) were randomly assigned into control group and protective group, 15 cases in each group. Patients would be excluded if they had signs of infections, such as the white blood cell count was over 12000 per microliter, the temperature was above 38 centi-degree and the c-reaction protein was more than 8 mg/L. Operation with routine approaches was performed in the control group and the pulmonary artery was infused with 4℃ protective solution in the protective group while the heart stoped beating. Plasma tumor necrosis factor α (TNF-α) 、CD11b and Myeloperoxidase (MPO) were measured intraoperatively and postoperatively. Blood gas、pulmonary function and clinic index of the patients were also monitored. Results The level of TNF-α was lower in the protective group as compared with that in the control group immediately and 3 hours after closing the sternum [(11.15±2.47) pg/ml vs. (14.21 ±5.55) pg/ml, P<0.05; (12.01 ±2.69) pg/ml vs. (15.94 ±4.86)pg/ml,P <0.01]. The MFI of CD11b was lower in the protective group as compared with that in the control group at 3 and 6 hoursafter closing the sternum (126.23±36.05 vs. 156.98±48.34, P<0.05; 137.27±38.85 vs. 173.27±67.43, P<0.05). The level of MPO was lower in protective group as compared with that in the control group at 3 hours, 6 hours and 24hours after closing the sternum [(156.52±17.57)U/L vs.(178.45±35.68)U/L, P<0.05; (178.28±23.63) U/L vs.(224.66±49.66)U/L, P<0.01;(130.52±57.50)U/L vs. (96.50±14.49)U/L, P<0.05]. The duration of mechanical ventilation was significantly shorter in the protective group than that in the control group (17.60±6.39 vs. 23.70±8.51,P<0.05). Alveolar-arterial oxygen pressure difference (A-aDO2, calculated as [FiO2×713-5/4×PaCO2]-PaO2) in the protective group was less than that in the control group at 3 and 6 hours after closing the sternum [(120.92±33.08)mm Hg vs. (145.52±39.38)mmHg, P<0.05;(74.76±40.16)mm Hg vs. (112.50±44.16)mmHg, P<0.01]. Dynamic compliance (Cdyn) in protective group was lower than that in control group at 3 and 6 hours after closing the sternum [(0.59±0.11)ml·cmH2O-1·kg-1 vs. (0.46±0.17)ml·cmH2O-1·kg-1, P<0.05;(0.67±0.09)ml·cmH2O-1·kg-1vs. (0.53±0.18)ml·cmH2O-1·kg-1,P<0.05). Conclusion Perfusion with hypothermic protective solution containing UTI to the pulmonary artery during cardiopulmonary bypass may reduce the inflammatory responses substantially in the lung after bypass and had a role in the lung protection.