Diffuse panbronchiolitis complicated with thymoma: a report of 2 cases with literature review / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>Diffuse panbronchiolitis, a distinct clinical entity of unknown etiology, has been reported originally and primarily in Japanese and rarely in non-Japanese populations. Macrolide therapy is effective for this once dismal disease. Diffuse panbronchiolitis complicated with thymoma is uncommon; only 2 cases have been reported to date. The aims of this study were to describe the clinical profiles, assess the response to macrolide therapy, and to discuss the possible pathogenesis of diffuse panbronchiolitis in this setting.</p><p><b>METHODS</b>The clinical profiles, macrolide therapy response of diffuse panbronchiolitis complicated with encapsulated thymoma in 2 histologically confirmed cases were described and discussed with the 2 cases reported in the literature: one complicated with encapsulated thymoma, another with invasive thymoma.</p><p><b>RESULTS</b>Of the 2 cases, both had negative PPD skin testing and abnormal serum levels of various immunoglobulins, 1 had positive anti-nuclear antibody, but none had elevated cold hemagglutinin titers, and both had an excellent response to macrolide therapy. Of the 2 cases reported in the literature, both had negative PPD or tuberculin skin testing, 1 had severe hypogammaglobulinemia, 1 had elevated IgA, 1 had positive anti-DNA, 1 had elevated cold hemagglutinin titers, but both died of respiratory failure in spite of macrolide therapy in 1 case.</p><p><b>CONCLUSIONS</b>Prognosis for diffuse panbronchiolitis complicated with thymoma may depend on the nature of the thymoma and on the disease course. Macrolide therapy is also effective if administered early in the disease course and if the thymoma is cured. Immunological factors may play an important role in the pathogenesis of diffuse panbronchiolitis in this setting.</p>

A double-blind, randomized, placebo-controlled multicenter study of oseltamivir phosphate for treatment of influenza infection in China / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of oseltamivir phosphate as treatment for naturally acquired influenza infection.</p><p><b>METHODS</b>This study was conducted as a double-blind, randomized, placebo-controlled, multicenter trial during the influenza epidemic season from January to April 2001 at 7 centers in China. A total of 478 adults without other medical history, aged 18 to 65 years, were enrolled into the study. All subjects demonstrated febrile respiratory illness of no more than 36 hours' duration with a temperature of 37.8 degrees C or more plus at least two of the following symptoms: coryza/nasal congestion, sore throat, cough, myalgia/muscles aches and pain, fatigue, headache or chills/sweats. Individuals were randomized into either the oseltamivir phosphate or placebo group with identical-looking capsules. Either oral oseltamivir phosphate, 75 mg twice daily, or placebo was administered to the subjects for 5 days.</p><p><b>RESULTS</b>A total of 451 individuals were analyzed for efficacy as the intent-to-treat population (ITT) (216 oseltamivir and 235 placebo) and 273 individuals were identified as influenza-infected through laboratory test, who were then defined as the intent-to-treat infected population (ITTI) (134 oseltamivir and 139 placebo). Four hundred and fifty nine individuals were included in the safety analysis. In the ITTI population, the cumulative alleviation proportion of oseltamivir group was significantly higher than that of the placebo group (P = 0.0466)). The median duration of illness was 91.6 h [95% confidence interval (CI) = 80.2 - 101.3 h] in the oseltamivir group and 95 h (95% CI = 84.5 - 105.3 h) in the placebo group. The median area under the curve of decreased total score was significantly higher in the oseltamivir group than in the placebo group, 1382.9 and 1236.7 score-hours, respectively (P = 0.0196). For the ITT population, similar results were observed. Adverse events (AE) were similarly reported in both the oseltamivir group and the placebo group. The main adverse events following test drug were gastrointestinal symptoms, neurological symptoms and rashes.</p><p><b>CONCLUSION</b>Oseltamivir was effective and well tolerated as treatment of early naturally acquired influenza.</p>

Role of endothelin and nitric oxide in the pathogenesis of asthma / 中国病理生理杂志

AIM:To explore whether the balance between endothelin(ET) and nitric oxide(NO) plays an important role in airway hyperresponsiveness of asthmatic rats. METHODS:The tension of isolated perfused rat tracheal rings was measured after ET-1 stimulation and incubation of JKC 302 and L-NAME. RESULTS:ET-1 constricted isolated rat tracheal ring, produced slowly developing and long-lasting contraction. The ET-1-induced contraction response of asthmatic rat tracheal ring was higher than that of normal control group (P＜0.01). JKC 302, a selective ETA receptor antagonist, partly blocked ET-1-induced contraction in asthmatic rat trachea ring. L-NAME significantly augmented the constriction caused by ET-1. CONCLUSION:The effects of ET on bronchomotor tone may be modified by NO as this is a bronchomotor, and the imbalance between ET and NO may play an important role in asthma pathogenesis.

Comparison between idiopathic pulmonary fibrosis and interstitial lung disease with connective tissue disorder (CTD) in the elderly / 中华老年医学杂志

Objective To study the difference of clinical manifestations,treatment and prognosis between idiopathic pulmonary fibrosis (IPF) and interstitial lung disease associated with connective tissue disorder, secondary pulmonary fibrosis(SPF). Methods The elderly patients≥ 60 yrs old, diagnosed as IPF or SPF in PUMC Hospital between 1990 and 2002 were reviewed and analyzed. Results Cough and dyspnea appeared to be the most common complaints in both groups. The most common signs were Velcro rales and clubbing fingers. The symptoms and signs were more common in IPF group. The mean course was shorter in SPF group (8.5 months vs 24.0 months). Mortality rate was high in both groups (26.3% and 30.0%) and showed no significant difference. The common causes of SPF were Sjogren syndrome, polymyositis, rheumatoid arthritis and progressive systemic sclerosis (9/40, 8/40, 7/40, 7/40, respectively). The most common radiograghic findings were bibasilar reticular patterns and showed more severe in IPF than in SPE〔41(71.9%) vs 14(35.0%)〕,P