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Objective: To analyse the microsatellite instability (MI) and loss of heterozygosity (LOH) in non-small cell lung cancer (NSCLC). Methods: MI and LOH at chromosome 17 were checked in 35 cases of NSCLC tumor-normal paired tissues using four microsatellite markers TP53 (17pl3.1), THRA1 (17qll.2–12), D17S579 (17ql2–21) and D17S855 (17q21) by PCR based analysis. Mutations of P53 exons 5–8 were also tested using PCR-single strand conformation polymorphism (PCR-SSCP) and PCR-denaturing gradient gel electrophoresis (PCR-DGGE) analysis. Results: 22 of 35 tumors (62.8%) displayed MI or LOH. 14 tumors (40.0%) exhibited MI, 11 tumors (31.4%) exhibited LOH, while 3 tumors (8.6%) exhibited MI and LOH concurrently. 23 tumors (65.7%) exhibited P53 gene mutations. The frequency of MI or LOH was obviously higher in the early-stage (stages I and II, 78.9%) than in the advanced-stage (stage III, 43.8%). However, the frequency of MI or LOH had no difference either between high-grade (75.0%) and low-grade (52.6%) differentiated NSCLC or between the tumors with P53 mutations (59.1%) and those without P53 mutations (69.2%). No relationship was observed between the presence of MI or LOH and the histologic subtype of NSCLC. Conclusion: The results suggest that MI and LOH at chromosome 17 may play a significant role in the development of NSCLC. The high frequency of MI or LOH in the early-stage tumors indicates that these genetic alterations could occur early during NSCLC development. Our data also show that the genetic alterations of microsatellite at chromosome 17 was not associated with P53 gene mutations.

Appropriate antimicrobial therapy of community-acquired pneumonia (CAP) is mainly based on the distribution of etiology and antimicrobial resistance of major pathogens. We performed a prospective observational study of adult with CAP in 36 hospitals in China.Etiological pathogens were isolated in each of the centers, and all of the isolated pathogens were sent to Zhongshan Hospital for antimicrobial susceptibility tests using agar dilution.A total of 593 patients were enrolled in this study, and 242 strains of bacteria were isolated from 225 patients. Streptococcus pneumoniae (79/242, 32.6%) was the most frequently isolated pathogen, followed by Haemophilus influenzae (55/242, 22.7%) and Klebsiella pneumoniae (25/242, 10.3%). Totally 527 patients underwent serological tests for atypical pathogens; Mycoplasma pneumoniae and Chlamydia pneumoniae infections were identified in 205 (38.9%) and 60 (11.4%) patients respectively. Legionella pneumophila infections were identified in 4.0% (13/324) of patients. The non-susceptibility rate of isolated Streptococcus pneumoniae to erythromycin and penicillin was 63.2% and 19.1% respectively. Six patients died from the disease, the 30-day mortality rate was 1.1% (6/533).The top three bacteria responsible for CAP in Chinese adults were Streptococcus pneumonia, Haemophilus influenza and Klebsiella pneumonia. There was also a high prevalence of atypical pathogens and mixed pathogens. The resistance rates of the major isolated pathogens were relatively low except for the high prevalence of macrolide resistance in Streptococcus pneumoniae.

Background Smoking is the major cause of airway inflammation in chronic obstructive pulmonary disease(COPD), and smoking cessation is regarded as one of the important strategies for prevention and treatment of the inflammation. The inflammation of the chronic airway may be present and deteriorated even if the COPD patients stop smoking. Whether and how early smoking cessation affects the progress of inflammation is still obscure.This study was conducted to find the appropriate time for smoking cessation to terminate the airway inflammation in rats with smoke-induced chronic bronchitis. Methods A rat model of COPD was established by passively inhaling smoke mixture.Fifty-four young male Sprague-Dawley rats were randomly divided into 9 groups with different periods of smoke exposure and different time points of cessation.The inflammation markers to be detected included inflammatory cells in the bronchoalveolar lavage fluid(BALF),the myeloperoxidose(MPO)activity,the morphologic changes and the expression of ICAM-1 on the airway epithelium. Results When smoking was terminated at early stage,the inflammatory markers and related indexes were different from those of the typical chronic bronchitis group(group M7)(P0.01).The pathologic score of group SC7(2 weeks of smoking cessation after occurrence of typical chronic bronchitis)was not different from that of group MT,and the level of ICAM-1 was still up-regulated(compared to group M7,P0.05).Meanwhile,most of inflammatory cells in BALF were neutrophils compared to other groups(P0.01).When smoking was terminated,the MPO activity was significantly lower than that of group M7(P0.01). Conclusions Smoking cessation at early stage can effectively inhibit the inflammatory reaction of COPD.Once chronic bronchitis occurs,little could be improved by smoking cessation. Chin Med J 2007;120(17):1511-1516

To evaluate the efficacy and safety of oseltamivir in the treatment of suspected influenza patients.A randomized, open, control and multiple center trial was conducted among 1176 individuals with suspected influenza. They were randomized either to oseltamivir group (oseltamivir 75 mg, twice daily for 5 days) or control group who were given symptom relief medicine.No difference was found between two groups in influenza symptoms of the patients (P0.05) before the treatment. (1) Oseltamivir treatment significantly reduced the duration of fever about 25 hours post treatment. (2) The AUC score of other symptoms was decreased by 160.21 (about 30.21%), and the duration was shorten by 20 hours. (3) The ratio and duration of antibiotic use in oseltamivir group were less than that of control group (P0.0001 and P0.05). (4) The incident rate of second generation influenza in oseltamivir group was also less than that of control group (P0.0001). (5) Secondary complications such as bronchitis, sinusitis and pneumonia occurred 3.23% in Oseltamivir group and 4.16% in the control group (chi(2) = 1.209, P = 0.272). (6) Digestive symptom such as light nausea were occur in patients who took oseltamivir, there was no difference of side effects rate between two groups (5.18% and 4.16%, chi(2) = 0.680, P = 0.410). (7) 75.68% (28) were confirmed with positive result of virus test in 37 suspected influenza patients.Our data suggests that Oseltamivir is effective and well tolerated in suspected influenza patients. It can reduces the duration and severity of influenza symptom and fever, decrease the incidence of suspected influenza in the contacted population, antibiotic using, and with light side-effect.

There are many candidate genes for chronic obstructive pulmonary disease (COPD). Matrix metalloproteinase-9 (MMP-9) plays an essential role in tissue remodeling and repair associated with development of COPD. In this study we investigated the correlation between MMP-9 gene polymorphism and COPD susceptibility in the Han population of South China.We examined the frequency of polymorphic genotypes of the MMP-9 promoter (-1562C/T) in 100 COPD patients and 98 healthy smokers by restriction fragment length polymorphism.The frequencies of polymorphic genotypes in promoters of MMP-9 were C/C 86%, C/T 14% in COPD group; and C/C 98%, C/T 2% in the control group. There were significant differences between the two groups (P0.01). The allele frequencies were also significantly different between the COPD group and the control group (C allele frequency: 93% vs 99%, T allele frequency: 7% vs 1%, P0.05 respectively).The genetic polymorphism in promoters of MMP-9 gene is associated with the susceptibility to COPD in the Han population of South China.