Volume 88  ·   Issue 24  ·  2008

hematopoietic stem cell transplantation (HSCT) has gradually developed into a complete therapeutic system from a rescue measure for end-stage patients, as well as the emergence of new immunosuppressants and anti-infective drugs.

Male reproductive health refers to the healthy state of male reproductive system development and its functional state in physiological, psychological and social aspects. This is an idea that the international community has paid increasing attention to and advocated in recent years, and all this depends on the development of male reproductive medicine, especially the progress of basic research field. Basic research of reproductive medicine is the premise and guarantee of reasonable treatment of male diseases.

Objective To study the protective effects of inhibition of tissue nitric oxide in the initial stage against the tardive injury of eontralateral testicular spermatogenic function after unilateral testicular torsion.Methods 56 prepubertal Sprague-Dawley rats were randomly divided into 4 equal groups:placebo group undergoing rotation of left testis 720°clockwise for 4 h.Fixing thereof to the scrotum,and then intravenous injection of normal saline;cyclosporine group,undergoing intraperitoneal injection of cyclosporine once daily for 1 month after the testicular rotation and fixation;NG-methyl L-arginine(L-NMMA)group,undergoing intravenous injection of L-NMMA 30 ms/kg 30 rain before the testicular rotation;and sham-operation group,undergoing isolation and suture of testis only.The right(untwisted)testes were removed from 7 rats from each group 1 week and 2 months after surgery.The malondialdehyde (MDA)level and nitrous oxide(NO)/nitrogen oxide synthase(NOS)content were evaluated.Histological examination was conducted.The mean seminiferous tubule diameter(MSTD)was assessed.The level of MHC peptide-tetramer complex Was determined by flow cytometry.Results The levels of MDA,NO,NOS,and MHC peptide-tetramer complex of the L-NMMA,placebo,and eyclosporine groups one week after surgery were all significantly hisher than those of the sham operation group(all P<0.05).The levels of MDA,NO,NOS,and MHC peptide-tetramer complex of the L-NMMA group were all significantly lower then those of the placebo group(all P<0.05).The pathological damage of the contrallateral testis in early and late stages in the L-NMMA group Was lighter than in the placebo group.Conclusion By inhibiting tissue NO production in focal organizations during the early period,L-NMMA reduces the damages in the testis eontralateral to the testis undergoing unilateral torsion.

Objective To stuay the effects of murine cytomegalovirus(MCMV)infection on mature sperm apoptosis in mice,and to explore the mechanism of MCMV-induced apoptosis regulated by mitochondria.Methods MCMV was inoculated into the testes of 15 BALB/c mice to establish acute MCMV infection models and 15 mice were used as controls.1,2,4,6,and 9 days after the infection 3 mice from each group were killed.Flow cytometry was used to observe the apoptosis of sperms.Laser scanning confocal microscopy was performed to examine the mitochondrial membrane potential(△ψm)of sperm.The mitochondria ultrastructure of sperm was observed under electron microscope.Reslllts The sperm apoptotic rate began to increase from day 2 after inoculation(D2 PI),peaked to the level of(39.3±1.0)％ compared withthat of the control group on D4 PI,andthenfell.Off(F=362.822,P<0.05).The △ψm of sperm began to increase on D1 PI at the level of(74.0±1.4),began to decrease on D2 PI [(63.0±2.2)],dropped to the minimum on I)4 PI[(40.2±2.3)],then ascended slowly again(F=32.257,P<0.05).The mitochondria uhrastructure of sperm showed damage after MCMV infection that Was especially severe from D2 PI to D6 PI.Conclusion MCMV acute infection in reproductive organ induces apoptosis of mature sperm in the cauda epididymidis. Sperm mitochondria participate in and regulate initiatively the apoptosis of sperm.

Objective To investigate the expression of hypoxia induced factor-1α(HIF-1α)and the content of sialic acid and carnitine in the epididymis in varicocele(VC)and to investigate the mechanism of induction of epididymis dysfunction by VC.Methotis Forty-five Wister rats were randomly divided into 3 equal groups:experimental group undergoing decreasing of the diameter of the left renal vein so as to cause VC,control group,and sham operation group.49 days after the operation the left epididymis samples were collected.Western blotting and immunohistochemistry were used to detect the HIF-1α expression.The contents of sialic acid and carnitine were detected.Results The HIF-1α expression level detected by Western blotting of the experimental group was 0.96±0.65.Significantly higher than those of the control group(0.11±0.08)and sham operation group(0.07±0.05)(both P<0.05);and the positive rate of HIF-1α detected with immunohistochemistry of the experimental group was 91.67％.Significantly higher than those of the control group(16.67％)and sham operatio group(21.43％)(both P<0.01).The contents of sialic acid and camitine in the epididymis of the experimental group were 6.3±2.3 and 1.1±0.3 respectively.Both significantly lower t11an those of the control group(24.7±4.4 and 2.8±0.6)and sham operation group(26.1±4.4 and 3．2±0.6)(all P<0.05).The contents of sialic acid and carnitine in the epididymis were significantly negatively correlated with the HIF-1α expression(r=-0.649,P=0.017;r=-0.666,P=0.013).Conclusion VC causes epididymal hypoxia and epididymal dysfunction,and hypoxia plays an important role in VC induced epididymal dysfunction.

Objective To investigate the expression characteristics of neuronal nitric oxide synthase (Nnos)in the corpus cavernosum of diabetic erectile dysfunction(ED).Methods Fifty rabbits underwent single intravenous injection of alloxan(100 mg/kg).Blood glucose,system arterial pressure(SAP),and intracavemosal pressure(ICP)were measured 15,30,and 45 days later.The rabbits with the blood glucose>10 mmol/L were used as diabetic models and those with the ICP lower than the normal control group by more than 25％were used as diabetic ED models.RT-PCR.Immunohistochemistry.And Western-blotting were used to detect the expression of Nnos in the corpus cavernosum.Resuits Seven days after the alloxan injection the blood glucose levels of 35 rabbits(70％)were>10 mmol/L.40％rabbits(14/35)were were used as diabetic ED models.Compared with control group.The ICP 15,30,and 45 days after alloxan injection were considerately decreased in diabetic ED rabbits(Au P<0.01),and there was no significant diffefence in SAP between the two groups(all P>0.05).The relative values of Nnos Mrna expression 15,30,and 45 days after alloxan iniection of diabetic ED rabbits were 0.670±0.030,0.451±0.012,and 0．206±0.023 respectively.All significantly lower than those of the control group(0.817±0.010,0.814±0.020.And 0.802±0.007 respectively.All P<0.05).Western blotting showed that the relative values of Nnos 15.30,and 45 days after ailoxan injection of the ED rabbits were 0.713 4±0.014,0.424±0.007.and 0.337±0.009 respectively,all significantly lower than those of the control group(0.797±0.015,0.706±0.020,and 0.750±0.022 respectively,all P<0.05).Conclusion Decreased expression of Nnos in corpus cavernosum is one of possible pathway of diabetic ED.

Objective To set up a simple and reliable method to screen Y chromosome microdeletions in semen of azoospermic patients.And to explore the incidence and loci of Y chromosome microdeletions in Chinese azoospermia.Methods Two hundred and forty-one semen samples.51 containing blood.Were collected from 241 Chinese azoospermic patients.45 normal semen samples and 1 anticoagulated blood sample from female were used as controls.DNA was quickly abstracted by incubating the cells with a lysis buffer containing polymerase chain reaction(PCR)buffer and protease K,and was used to detect the deletion of 15 kinds of sequence tagged site(STs)distributed in AZFa,AZFb,and AZFc by 4 sets of multiplex PCR.Agarose electrophoresis was used to observe and compare the PCR products from the semen samples and their corresponding blood samples.And the PCR products from l semen sampie were confirmed by sequencing.Results All muhiplex PCR reactions were amplified successfullv.The sequencing of the PCR products from the semen samples confirmed the PCR reactions.No microdeletion was detected in the 45 normal semen samples.Microdeletion was found in 26 out of the 241 semen samples of azoospermic patients(10.8％):2 patients(7.7％)had the deletions located in AZFa,2 patients(7.7％)in AzFb,3 patients (11.5％)in both AZFb+AZFc,and other 19 patients(73.1％)in AZFc.The detection results of the blood samples were completely consistent with those of the semen samples.The STS deletion recommended by European Academy of Andrology(EAA)and European Molecular Genetics Quality Network(EMQN)were all found in these 26 cases.Conclusions The semen samples of azoospermie patients present a convenient,reliable,and noninvasive substitute for blood in screening of Y chromosome microdeletions.And can be employed in study and clinical examination.The EAA/EMQN recommendations Mlow the detection of complete AZF deletions in Chinese azoospermia.

Objective To research the structure of the unique gene UL148 of the human cytomegalovirus(HCMV)clinical strain in Guangzhou,analyze the relation between its structure polymorphism and HCMV congenital infection,investigate the function of its expression products,and try to reveal the pathogenic mechanism of the gene in HCMV infection in newborns.Methods Urine samples were collected from 10 newborns with HCMV infection and inoculated on human fetal lung cells.The viral DNA was isolated,and UL148 gene fragment was amplified and identified．After TA clone and gene sequencing,total RNA of virus was extracted and the mRNA expression of UL148 gene was identified by using RT-PCR.Results The UL148 gene complete sequence Was determined.A specific 582 bp length DNA fragment Was amplified by RT-PCR.which confirmed the expression of UL148 gene.Conclusions UL148 gene exists in the low-passage clinical HCMV isolate from Guangzhou.It is confirmed that open reading frame of UL148 has genetic structure with mRNA expression.

Objective To observe different objective observation parameters of the benign prostatic hyperplasia(BPH)patients accepting different treatment strategies,and to further analyze the relationship of these factors with the treatment option．Methods Three hundred and twenty-nine BPH patients,aged 50-80,were assigned into 3 groups jointly decided by the physicians and patients based on the individual conditions and the patients'willingness:watchful waiting group(n=61),aged(63±8),drug treatment group(n=179),aged(68±7),and operation group(n=89),aged(71±6).The data of prostate volume,prostate specific antigen(PSA),maximum flow rate(Qmax),average flow rate,urinating volume,and residual urine volume before treatment were recorded.Results The prostate volume of the watchful waiting group was 33.0 ml,significantly smaller then those of the drug treatment and operation groups(40.1 and 65.5 ml respectively,both P<0.01);the Qmax of the watchful waiting group was 17.1 ml/s,significantly higher than those of the drug treatment and operation groups(12.4 and 9.1 ml/s respectively,both P<0.01).and the urinating volume of the watchful waiting group was 332 ml,significantly more than those of the drug treatment and operation groups(247 and 188 ml respectively,both P<0.01).The serum PSA of the operation group Was 5.44 ng/ml,significantly higher than those of the watchful waiting and drug treatment groups(1.53 and 1.99 ng/ml respectively,both P<0.01):and the residual urine volume of the operation group was 208 ml,significantly higher than those of the watchful waiting and drug treatment groups(21 and 45 ml respectively,both P<0.01).There were no significant differences in the serum PSA and residual urine volume between the drug treatment and watchful waiting groups.Conclusions Prostate volume,PSA,Qmax,average flow rate,urinating volume,and residual urine volume are important influential factors influencing the treatment option of BPH．Data analysis of the objective observation parameters will be helpful in clinical decision making.

Objective To introduce a method of retrograde ureterie catheter placement via flexible eystoscope,and to evaluate the feasibility and safety of this method．Methods 112 patients,62 males and 50 females undergoing retrograde ureteropyelography by 2 same physicians in cooperation were randomly divided into two equal groups with 31 males and 25 females each:one group via flexible cystoscope and the other group via rigid cystoscope.The catheterizing time,visual analogue scale(VAS)pain score,gross hematuria rate,and fever rate were compared between these 2 groups.Results Fifty-five patients underwent ureteric catheter placement successfully via flexible cystoscope(98％,55/56),while 53 cases were technically successful by rigid cystoscope(95％,53/56).The inserting time in women patients of the flexible cystoscopy group was(7.6±1.8)min,significantly shorter than that of the men[(8.0±1.8)min,P<0.05].The inserting time in women patients of the rigid eystoscopy group was(7.4±1.5)min,significantly shorter than that of the men[(8.2±1.2)min,P<0.05].However,there were not significant differences in the inserting times in both men and women between these 2 groups(both P>0.05).The VAS pain scores in men and women of the flexible eystoscope group were 3.5 and 2.3 respectively,both significantly lower than those of the rigid cystoscopy group(7.2 and 3.3 respectively,both P<0.05).The gross hematuria rate of the flexible cystoscope group was 8.9％(5/56),significantly lower than that of the rigid cystoscopy group(25.0％,14/56,P<0.05).Four patients had a fever after flexible eystoscopy while 6 cases did after rigid cystoscopy,however,without significant difference between these 2 groups(P>0.05).Conclusions Retrograde placement of ureteric catheter via flexible cystoscope is safe and reliable as rigid cystoscopy.Meanwhile,inserting ureteric catheter via flexible cystoscope causes the patients less pain and less chance of hematuria.

Objective To investigate the features of expression of miRNAs in colon cancer and corresponding normal tissues and the significance thereof in the diagnosis of colon cancer.Methods Fifteen pair samples of colon cancer and matched adjacent normal tissue were collected during operation.A highthroughput real-time quantitative RT-PCR method designed to detect mature miRNA sequences was adapted to screen miRNA expression patterns in 6 palrs of matched colon cancer and normal adjacent tissue samples.Northern blotting Was conducted to verify the accuracy of the real-time qRT.PCR assay.Moreover,a thermostable reverse transcriptase based real-time qRT-PCR assay designed to quantify the miRNA precursors Wag performed.Problem analysis methad WaS used to quantitatively determine the characteristics(cancer or non-cancer)of the other 9 pair samples.Results Among the more than 200 miRNAs exam.Ined.132 were found to be expressed in both the colon cancer and normal adjacent tissue samples.Compared with normal tissue,47 kinds of miRNA in cancer were down．Regulated(less than 0.55).The resuhs of qualitative determination on the 9 samples of cancer tissue/normal tissue were con-sistent with the results of pathological examination.Conclusion Closely linked with the pathogenesis and development of colon cancer.miRNA may be a promising diagnostic biomarker in diagnosis of colon cancer.

Objective To use continuous glucose monitoring system(CGMS)to investigate the features of hypoglycemia in control of hyperglycemia in T2DM patients by continuous subcutaneous insulin infusion(CSⅡ)and to study the influencing factors of hypoglycemia.Methods Sixty-one T2DM patients,35 males and 26 females,age 23-88,with the disease duration of 0.5-12 years,HbA1c level of(11.1±1.6)％,and glycosylated serum prorein of(32±6)％.Underwent.CSⅡ and finger blood sugar test.On the second day CGMS was used for 72 hours.Logistic regression WaS used to analyze the correlation among different factors.Results CGMS discovered 31 hypoglycemia events in 18 patients in tlle early stage of CSⅡ treatment.20 events occurring at night.A number significantly higher than that by self-monitoring of blood sugar.The C-peptide and mean blood glucose(BMG)of the patients with hypoglycemia were significantly lower than those of the patients without hypoglycemia.And the total cholesterol,standard deflation of blood glucose(SDBG),and insulin pump basal rate of the patients with hypoglycemia were significantly higher than those of the patients witllout hypoglycemia(all P<0.05).Multiple regression indicated that MBG was negatively correlated with hypoglycemia but SDBG and basal rate wore positively correlated with hypoglycemia.Conclusion①Hypoglycemia detected by CGMS occurs in about 1/3 of the type 2 diabetes patients at the early stage of CSⅡ therapy.②In addition of MBG and insulin pump basal rate,glycemic excursion is related closely to hypoglycemia.

Objective To assess and compare the prevalence of age-related cataract(ARC)among adults aged 50 years or older in Western China.Methotis Questionnaire survey and ophthalmologic examination were conducted among 5562 permanent rural residents aged 50 years and above in Ping'an County,Qinghai Province,Chuxiong City,Yunnan Province,Liupanshui City,Guizhou Province,and Chongzuo City,Guangxi Zhuang Autonomous region,selected by cluster sampling.All lenses were graded and classified for lens opacities by slit lamp,using the Lens Opacification Classification System(LOCS)Ⅱ and standard photographs.Definite ARC Waft,defined as either LOCS Ⅱ nuclear opalescence of grade 1.0 or more and/or cortical cataract of grade 1.0 or more and/or posterior subcapsular cataract of grade 1.0 or more in persons with the visual acuity worse than 10/16.Resuits The overall response rate was 88.4％.The prevalence rates of ARC in one or both eyes Was 41.8％in Qinghai,48.2％in Yunnan,18.8％in Guizhou and 39.4％in Guangxi.After age correction under the data of China Census 2000.The age-adjusted prevalence of ARC correspondingly changed to 44.1％ in Qinghai,45.9％in Yunnan,18.8％in Guizhou,and 32.8％in Guangxi.The prevalence of ARC increased significantly with increasing age.In those eyes with ARC.eortical cataract Was more common in Qinghai and Guizhou,while nuclear cataract Was more comlnon in Yunnan and Guangxi.The proportion of grades 4 lens opacities in Qinghai Was 17.49％,higher than those in Yunnan。Guizhou,and Guangxi(15.58％,11.03％,and 10.00％respectively).Conclusions Generally the ARC prevalence among the permanent rural residents aged 50 and above in Western China is higher than that in Eastern China.And there iS difference in the prevalence rate among different areas.Special attention should be paid toward this situation.

Objective To investigate the effects of estrogen-deficiency upon the expression of osteoprotegerin(OPG)in alveolar bone so as to clarify the role of estrogen in alveolaf bone metabolism．Methods Fifty-three SD rats were randomly divided into 3 groups:OVX group(n=18)undergoing bilateral ovariectomy,OVX+E2 group(n=18),undergoing bilateral ovariectomy and subcutaneous injection of estradiol once 3 days since day 2 after the operation,and sham operation group(n=17)undergoing sham operation.Four weeks after the operation periodontal ligature was conducted and hish-sugar diet was fed to establish periodontitis models.Four weeks later the rats were killed.The morphological changes and expression of OPG in alveolar bone were observed by light microscopy and immunohistochemistry.Results All the rats showed sparseness of bone trabeculae in alveolar bone and osteoclasts and lacuna at the surface of alveolar bone.Especially the rats of the group OVX.The A values(absorption of the OPG expression)in the alveolar bone of the OVX groups was 27 854±5246,significantly lower than those of the sham operation group and OVX+E,group(38 799±6228 and 37 146±6394 respectively,both P<0.05)without significant difference between the sham operation group and OVX+E2 group(P>0.05).Conclusion Estrogen deficiency decreases the expression of OPG in alveolar bone,and enhances the absorption of alveolar bone.

Objective To investigate the neumprotective effect of epigalloeatechin gallate(EGCG),the main extract from green tea．On the oxidative-stress-injured retinal ganglion cells.Methods Rat retinal ganglion cells(RGC-5)were cultured into 3 groups(normal control;H202;H202+EGCG or Trolox or NU1025).In-situ TUNEL was used to detect the apoptosis of the RGC-5 cells.Dihydroethidlum(DHE)assay was used to observe the intracellular ROS generation.The activation of nuclear enzyme.PARP-1 Was quantitatively detected by Western blot and the cell viability Was measured by MTT method.Results Hydrogen peroxide reduced RGC-5 cell viability in a time-concentration-dependent manner.The treatment of 500 μmol/L H2O2for 24 hours reduced RGC-5 cell viability by about 50％of contr01．Hydrogen peroxide caused apoptosis of the RGC-5 cell.Obviously increased intracellular ROS generation and up-regulated the PARP-1 expression．The pretreatment with EGCG Was able to markedly reduce the number of apoptotic cells.attenuate intracellular ROS generation.Furthermore,MTT assay showed that the pretreatment with EGCG(50 μmol/L)increased the most cell viability to 87％ of control,but pretreatment with Trolox(100μmol/L)and NU1025(100μmol/L,a PARP-1 inhibitor)recovered the most cell viability to 62％and 71％ of control respectively.Conclusion EGCG is able to effectively protect retinal ganglionn cell against oxidative-stressed injury and can be used as a very potential neuroprotective drug.

Objective To investigate the effects of sympathetic nerve stimulation(SNS)on eonnexin43(Cx43)and ventricular arrhythmias during acute myocardial ischemia(MI).Methods Ninety five Wistar rats were randomly divided into four groups:MI group(n=25),undergoing:ligation of the anterior descending coronary;MII-SNS group(n=25);undergoing electric stimulation of sympathetic nerve since the beginning of ligation of the anterior descending coronary and lasting till 30 min after the ligation.sympathetic nerve stimulation preconditioning+myocardial isehemia(pSNS-MI) group(n=25),undergoing electric stimulation of sympathetic nerve since the beginning of ligation of the anterior descending coronary that ended just after the ligation;and sham operation(SO)group(n=20),without coronary ligation.Ventricular arrhythmias were monitored by electrocardiography.Westem blotting and RT-PCR were used to detect the protein and mRNA expression of Cx43 respectively.Immunofluorescence analysis Was used to observe the changes of Cx43 protein distribution.Results One and 3 rats died due to ventricular fibrillation in the MI group and MI-SS group respectively.The incidence of ventfieular tachycardia(VT)/VF within 30-minute after ligation in the MI-SNS group Was 80.0％,significant higher than that of the MI group(52.O％,P<0.05).The incidence of Vr/VF within 30-minute after ligafion of the pSNS.MI group was 20.0％,significantly lower than that of the MI-SNS group(P<0.05).30 minutes after the ligation,the percentage of phosphorylated Cx43 of the pSNS.MI and MI.SNS groups were 71.2％±7.0％and 73.4％±6.7％respectively,both significantly higherthanthat of the MI group(46.7％±6.3％)(bothP<0.05).The total contents of Cx43 of the MI and pSNS-MI groups were 1.29±0.14 and 1.25±0.13 respectively.Both similar to that of the SO group [(1.30±0.10),both P>0.05],while the total Cx43 content of the MI-SNS group Was 0.73±0.12,significantly lower than that of the SO group[(1.30±0.10),P<0.05].The Cx43 mRNA levels of the 3 experimental groups were all significantly lower than that of the SO group(all P<0.05).Immunofluoreseence analysis confirmed tllat ischemia and sympathetic nerve stimulation induced the changes of eonnexin43 distribution and sympathetic nerve stimulation preconditioning inhibited the changes of connexin43 distribution induced by isehemia.Conclusion SNS promotes ventficular arrhythmias by promoting Cx43 degradation,and sympathetic nerve stimulation preconditioning inhibits ventrieular arrhythmias by preventing Cx43 dephosphorylation.

Objective To observe the effects of silencing of livin gene expression combined with anthracycline chemotherapy on the apoptosis of human breast cancer cells．Methods Double stranded RNA (dsRNA)targeting the 1ivin gene was chemically synthesized in vitro and transfected into human breast cancer cells of the line ZR-75-30 mediated by lipofectamneTM 2000.The transfection efficiency Was observed by fluorescence confocal microscopy.Reverse transcription.Polymerase chain reaction(RT-PCR)and Western blotting were used to detect the expression of livin at mRNA and protein levels.ZR-75-30 cells transfected with dsRNA targeting livin for 24 h were treated with 50 μg/Ⅱd epirubicin for 12 h flow cytometry Was used to detect the apoptosis rate of the cells.Results The livin mRNA expression rates of the livin-siRNA transfected group Was(29.68±2.7)％.With an inhibitory rate of 53.66％,significanfly lower than those of the negative control and blank control groups[(52.01±2.9)％and(51.95±3.1)％respectively.both P<0.01].The livin protein expression rate of the livin.siRNA group Was(27.80±2.1)％,significantly lower than those of the negative control siRNA group and blank control group [(53.80±3.0)％and(55.12±2.8)％respectively,both P<0.01].36 h after the treatment of siRNA asainst livin combined with epimbicin the apoptosis rate was(15.18±0.05)％,significantly higher than those of the negative control group and blank control group[(2.78±0.08)％and(2.65±0.12)％ respectively,both P<0.01].Conclusions Sequence specific siRNA targeting livin synergistic with epimbicin iS capable of enhancing the apoptosis rate of human breast cancer ceils.Silencing of livin gene expression with siRNA combined with anthracycline chemotherapy may hold great promise as a novel therapy for livin expressing breast cancer.

A 66-year-old female was admitted to the hospital on August 18, 2007. The patient had a history of hepatitis B for more than 10 years; One year ago, due to yellowing of the skin and sclera with fatigue and mild edema of the lower limbs, liver function and B-ultrasound showed cirrhotic changes, and the diagnosis of "cirrhosis" was made. The symptoms improved after liver protection support and symptomatic treatment. Abdominal distension and edema of both lower limbs appeared 1 week ago, and gradually worsened. There were no symptoms such as fever, hematemesis, melena and emaciation.

Noise pollution has become one of the public hazards that cannot be ignored in today's society, among which hearing damage is the most serious, mainly including temporary threshold shift (TTS) and permanent threshold shift (PTS).

A 72-year-old male was admitted to the hospital on March 25, 2008 due to chest tightness and asthma for 2 months. In the past 2 months, the patient felt chest tightness without obvious trigger, asthma after activity, cough, sputum, hemoptysis and chest pain, fever and night sweats, and nocturnal paroxysmal dyspnea.

A 76-year-old male was admitted to the hospital on June 22, 2007 due to cough and sputum for more than 2 months. In April of the same year, the patient developed cough without obvious trigger, with a small amount of white sputum and occasionally bloodshot sputum. Physical examination was performed in an external hospital in May. Chest CT showed diffuse nodular shadows in both lungs, with uniform size, mainly in both upper lungs, and old tuberculosis in the right upper lung; Erythrocyte sedimentation rate (ESR) 87 mm/1 h; Tuberculin pure protein derivative (PPD) test hard nodule diameter 1.5 cm ×1.2 cm, suspected small blister; No obvious abnormalities were found in lung cancer screening.

A 26-year-old male was admitted to the hospital on October 11, 2006 due to fever and shortness of breath for about 20 days after surgical resection. The patient began to develop cough and night sweats in February, 2004, and was diagnosed as left pulmonary tuberculosis in another hospital. He had been treated with anti-tuberculosis for 1 year.