HBeAg阴性的慢性HBV感染者HBV DNA与肝组织病理的关系

目的分析HBeAg阴性、ALT正常的HBV感染者HBV DNA水平与肝组织病理的关系。方法 89例HBeAg阴性慢性HBV感染者均接受肝组织穿刺病理学检查,并行肝炎病毒标志物、血清HBV标志物和HBV DNA检测,分析其HBV DNA水平与肝组织病理的关系。组间比较采用单因素方差分析,相关性分析采用Spearman等级相关。结果 89例患者的肝组织病理结果大部分异常,其中肝组织炎症分级≥G2者70例,占78.6%;纤维化分期≥S2者66例,占74.2%。不同肝组织炎症活动度分级患者之间的HBV DNA定量有明显的差别（F=2.678,P〈0.05）,而且二者呈正相关（rs=0.327,P〈0.01）;不同肝纤维化分期患者之间的HBV DNA定量也有明显的差别（F=2.625,P〈0.05）,而且二者呈正相关（rs=0.314,P〈0.01）。结论 HBeAg阴性的慢性HBV感染者血清HBV DNA定量与肝组织病理损伤程度具有良好的一致性,如HBeAg阴性慢性HBV感染者HBV DNA滴度明显升高,应及早进行肝脏穿刺病理检查,以明确诊断并指导抗病毒治疗。     

171例慢性乙型肝炎病毒感染者临床与肝组织病理分析

目的:观察171例HBV DNA阳性的慢性乙型肝炎病毒(HBV)感染者临床检测指标与肝脏组织病理的关系.方法:将171例患者分为4组,A组丙氨酸氨基转移酶(ALT)≤0.5 ×ULN(正常值上限),B组0.5 ×ULN＜ALT≤1×ULN,C组1×ULN＜ ALT≤2×ULN,D组2×ULN＜ ALT≤5 × ULN,观察各组患者肝脏炎症分级(G)和纤维化分期(S)的差异,进一步分析各组炎症分级和纤维化分期与其他肝脏生化学指标如天门冬氨酸氨基转移酶(AST)、血小板(PLT).及肝纤维化模型(APRI,以AST/PLT比值的统计量作为数字化模型)的关系.结果:A组25％患者肝组织炎症为G2,B组和C组分别有16.4％、49.2％患者肝组织炎症分级为G2～G3,不同ALT组间肝组织炎症分级的差异有显著性意义(P＜0.05),随着ALT水平升高,肝组织G2～G3检出比例增加;171例患者不同肝组织炎症分级组,球蛋白(Glo)、AST、γ-谷氨酰转肽酶(GGT)、PLT、APRI的差异均有显著性意义(P＜0.05);不同肝组织纤维化分期组,年龄、HBeAg状态、白蛋白(Alb)、AST、GGT、PLT、HBV DNA、APRI的差异均有显著性意义(P＜0.05),其中随着纤维化程度进展,AST、APRI值逐渐升高,Alb、PLT逐渐下降.结论:HBV DNA阳性的慢性HBV感染者,即使ALT正常,仍有不同程度的肝组织炎症和纤维化改变,需综合观察年龄、AST、GGT、APRI、HBeAg状态和HBV DNA水平,必要时建议患者行肝脏穿刺病理检查,以准确了解肝脏疾病进展.     

LT正常和轻度升高慢性HBV感染者的年龄与肝组织病理及HBV DNA定量的相关分析

目的：探讨不同年龄的ALT正常和轻度升高慢性HBV感染者的肝组织病理及HBV DNA定量的特点。方法对2005年1月至2013年12月石家庄市第五医院收治的1123例ALT正常和轻度升高且行肝穿刺活组织检查的慢性HBV感染者进行回顾性分析,依据年龄分为＜40岁和≥40岁两组,分析两组中HBeAg阳性与阴性及ALT正常与轻度升高患者的肝组织病理炎症分级（G）和纤维化分期（S）分布特点,并进行年龄与炎症分级、纤维化分期、HBV DNA定量的相关性分析。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,采用Spearman进行等级相关分析。结果与＜40岁组相比,≥40岁组患者肝组织炎症分级≥G2的比例明显增高,差异均有统计学意义（P值均＜0．001）;无论是HBeAg阳性还是HBeAg阴性,ALT水平正常或轻度升高的患者均随着年龄增大其肝纤维化分期在≥S2所占比例明显增多,差异均有统计学意义（P值均＜0．001）;年龄与炎性分级、纤维化分期均呈正相关（r值分别0．219、0．293,P值均＜0．001）;≥40岁组中HBeAg阴性、ALT轻度升高的患者其HBV DNA定量与＜40岁组患者相比,差异具有统计学意义（P＜0．05）。结论 ALT正常和轻度升高慢性HBV感染者肝组织炎症分级、纤维化分期均随年龄的增加有所增加,可考虑将年龄作为病情进展的因素之一。     

ALT＜2ULN慢性HBV感染者HBVDNA水平与肝脏病理特征的关系

目的探讨ALT＜2 ULN慢性 HBV感染者 HBV DNA水平与肝组织病理特征的关系。方法将在延安大学附属医院收集的120例ALT＜2 ULN慢性 HBV感染者按血清 HBV DNA水平分为3组,A组：HBV DNA＜105 IU/mL ;B组：105 IU/mL≤HBV DNA＜107 IU/mL ;C组：HBV DNA≥107 IU/mL。对不同HBV DNA水平的患者肝组织炎症程度及纤维化分期进行对比。结果三组患者的肝脏炎症活动度、纤维化程度差异均具有统计学意义（χ2＝16．208、χ2＝12．132,P均＜0．05）。A组患者的肝脏炎症程度重于B组和C组,C组患者的肝脏纤维化程度重于B组和A组。结论对于ALT＜2 ULN的慢性HBV感染者,HBV DNA水平不能独立地用来评价患者的肝脏病变程度,还应结合年龄、HBeAg状态等对其进行全面的评价。     

ALT轻度升高的HBeAg阳性和阴性慢性乙型肝炎患者肝组织病理学特点

目的 分析ALT轻度升高(1～2倍正常值上限)的HBeAg阳性和阴性慢性乙型肝炎患者肝组织病理学特点,并探讨年龄及HBV DNA水平对其的影响.方法 收集2009年10月至2011年3月,“十一五”国家科技重大专项——慢性乙型肝炎中西医结合治疗方案入组病例中符合条件者,行B超引导下肝穿刺活组织检查,并检测HBsAg、HBeAg滴度及HBV DNA水平.比较HBeAg阳性和阴性患者炎症分级和纤维化分期情况及年龄(≥40岁和＜40岁)、HBVDNA水平(≥105拷贝/ml和＜105拷贝/ml)对其的影响.两样本构成比的比较用x2检验,相关性分析用多因素logistic回归分析.结果 389例HBeAg阳性与126例HBeAg阴性患者的肝组织炎症分级与纤维化分期分布差异均无统计学意义(x2值分别为4.326和3.464,P值均＞0.05).＜40岁组中,HBeAg阳性与阴性患者的炎症分级及纤维化分期分布差异无统计学意义(x2值分别2.543和5.024,P值均＞0.05).≥40岁组中,HBeAg阳性患者中、重度炎症(G3、G4)所占百分比(32.9％)明显高于HBeAg阴性者(16.4％),x2=8.777,P＜0.05;纤维化分期分布差异无统计学意义(x2=0.977,P＞0.05).HBV DNA≥105拷贝/ml患者中,HBeAg阳性患者轻度炎症(Gl)所占百分比(17.5％)明显高于HBeAg阴性患者(7.3％),x2=8.851,P＜0.05;HBeAg阳性和阴性患者肝组织纤维化分期分布差异无统计学意义(x2=8.227,P＞0.05).HBVDNA＜105拷贝/ml的患者中,HBeAg阴性患者轻度炎症(Gl)所占百分比(29.6％)明显高于HBeAg阳性患者(6.9％),x2=6.357,P＜0.05;HBeAg阳性和阴性患者肝组织纤维化分期分布差异无统计学意义(x2=4.061,P＞0.05).多因素Logistic回归分析结果显示,年龄是肝脏病理炎症和纤维化轻重程度的独立危险因素(OR值分别为1.92和2.11,P值均＜0.05).结论 ALT轻度升高慢性乙型肝炎患者中,HBeAg状态与肝脏病理炎症及纤维化程度无关.年龄≥40岁的HBeAg阳性患者中、重度炎症比例明显升高;不同HBV DNA水平的HBeAg阳性与阴性患者肝脏炎症分级也有差异.     

"免疫耐受期"慢性乙型肝炎病毒感染者临床与肝脏病理学特点

目的 了解免疫耐受期慢性HBV感染者临床及肝脏病理学特征.方法 分析98例"免疫耐受期"慢性HBV患者年龄、性别、血清HBV DAN水平、肝脏炎症活动度及纤维化程度、肝脏HBsAg和HBcAg表达情况.并对不同血清ALT水平的肝脏炎症活动度及纤维化程度进行比较.采用X2检验.结果 98例患者中,＜30岁者83例,占84.7%,≥30岁者15例,占15.3%.有48.0%感染者的母亲HBsAg阳性.所有感染者血清HBVDNA为高水平复制,＞1×107拷贝/mL者占78.5%.仅5例感染者肝脏炎症活动度为Go,占5.1%;其中G1 64例,占65.3%;G2 29例,占29.6%.56例肝脏无明显纤维化(SO),占57.1%;S1 23例,占23.5%;S2 14例,占14.3%;S3 5例,占5.1%;未发现肝硬化.肝组织HBsAg阳性79例,占80.6%;HBeAg阳性80例,占81.6%.血清ALT在正常范围高水平的感染者肝脏纤维化程度明显高于ALT低水平者(X2=8.112 3,P=0.043 7).结论绝大部分"免疫耐受期"慢性HBV感染者肝脏存在轻度炎性反应,部分已出现纤维化;对"免疫耐受期"HBV感染者进行肝脏病理学检查,有利于正确判断病情和确定治疗方案.     

71例血清ALT正常的慢性HBV感染者临床与肝脏病理特征

目的 了解血清ALT正常的慢性HBV感染者的临床及肝脏病理特征.方法 分析71例血清ALT正常,且HBeAg阳性的慢性HBV感染者的年龄、性别、血清HBV DNA水平、肝脏病理改变等.结果 本组病例中＜30岁者61例(85.92%),≥30岁者10例(14.08%).45.07%感染者母亲HBsAg阳性,所有感染者血清HBVDNA为高水平复制,＞107copies/ml者占78.87%.95.77%感染者肝脏有轻度炎症反应,43.66%有不同程度的纤维化,未发现肝硬化.结论 血清ALT正常、HBeAg阳性的慢性HBV感染者多处于免疫耐受期,肝组织病理损害轻微,但部分患者肝脏有一定程度纤维化,显示ALT虽然正常,肝损伤可能在隐匿中进展.因此,对ALT正常的HBV感染者及早进行肝脏病理检查,有利于判断病情和确定治疗方案.     

ALT轻度升高的慢性HBV感染者临床特征与病理学的关系

目的探讨ALT在1~2倍正常值上限的慢性HBV感染者肝组织病理学改变和临床特征之间的关系。方法收集2015年7月-2016年12月于蚌埠医学院第一附属医院住院的80例ALT水平在1~2正常值上限的慢性HBV感染者,所有患者行肝穿刺活组织检查,根据HBeAg阳性(n=42)或阴性(n=38)分为2组,并分析其肝组织病理学改变与患者年龄、性别、HBV DNA载量等的关系。计量资料组间比较采用t检验,计数资料组间比较采用χ~2检验。结果 HBeAg阴性患者的年龄、血清ALT水平明显高于HBeAg阳性患者,差异均有统计学意义(t值分别为12.35、7.18,P值均0.01)。HBeAg阴性组中炎症程度≥G2患者的比例、纤维化程度≥S2患者的比例均高于HBeAg阳性组,差异有统计学意义(54.8%vs 76.3%,χ~2=53.68,P0.01;57.1%vs 73.7%,χ~2=46.67,P0.01)。共有35例患者予免疫组化染色法显示肝组织内HBsAg和HBcAg的表达,2组患者肝组织内HBsAg和HBcAg的免疫染色评分差异均无统计学意义(P值均0.05)。结论对于ALT轻度升高的慢性HBV感染者,HBeAg阴性患者的肝脏病变明显重于HBeAg阳性患者,对年龄较大、病程较长的患者,均建议行肝穿刺活组织检查,对指导抗病毒治疗具有积极意义。     

丙氨酸转氨酶正常的慢性乙型肝炎病毒感染者的肝脏病理学分析

目的 了解ALT正常的慢性HBV感染者的肝脏病理学改变及其影响因素.方法 观察632例ALT正常的慢性HBV感染者,采用超声定位穿刺取肝组织,行HE染色、纤维Masson染色,HBsAg和HBcAg免疫组织化学染色,观察Knodell坏死炎症评分和Ishak纤维化评分,并分析它们与年龄、ALT水平、血清HBV DNA载量、HBsAg和HBcAg肝组织表达的关系.两均数比较采用t检验,多均数比较采用单因素方差分析及q检验,计数资料采用x2检验.结果 632例ALT正常的HBV感染者中,中度炎症坏死167例,占26.4%,重度炎症坏死26例,占4.1%,中度纤维化217例,占34.3%,重度纤维化(肝硬化)52例,占8.2%.Knodell坏死炎症评分和Ishak纤维化评分在高ALT层次组比低ALT层次组高,在女性高ALT层次组比男性高ALT层次组高,在年龄＞40岁组比年龄≤20岁组高(q=19.63,P＜0.05).肝组织损伤程度在HBV DNA载量≤5×105拷贝/L组明显轻于HBV DNA 5×105～1×107拷贝/L、1×107～1×109拷贝/L和＞1×109拷贝/L组(Knodell评分,q=3.87、2.87、6.34;Ishak评分,q=2.64、2.64、5.54;均P＜0.05),在不同HBV DNA载量复制组之间差异无统计学意义(F=1.35,P＞0.05).HBsAg(F=1.65、0.73,均P＞0.05)和HBcAg(F=0.17、1.29,均P＞0.05)肝组织表达与Knodell坏死炎症评分和Ishak纤维化评分差异均无统计学意义.结论 可检测到HBV DNA的ALT持续正常的慢性HBV感染患者应考虑进行肝组织活检,特别是年龄＞40岁且ALT在(0.75～1.00)×正常值上限者.     

慢性乙型肝炎患者H BV DNA水平与肝脏病理相关性及影响因素

目的：本研究以血清 e 抗原状况和患者年龄分组对 ALT＜2×ULN 的乙型肝炎（CHB）患者血清 HBV DNA水平与肝脏炎症和纤维化严重程度的相关性进行探讨。方法对253例ALT＜2×ULN 的CHB患者进行肝组织病理学检查,并检测肝功能、HBV DNA定量和 HBV血清标志物,分别按肝脏病理分级、e-抗原状态和 HBV DNA载量分组,比较各组肝脏炎症及纤维化程度。结果重度肝脏炎症、纤维化组中 HBeAg 阴性比例均较轻度组高（P＝0．043,P＝0．033）;重度肝脏炎症、纤维化组患者年龄均较轻度组大（P＝0．004,P＝0．000）。HBeAg阴性患者中高病毒载量组中肝脏炎症、纤维化患者比例较高（P＝0．001,P＝0．007）。≥38岁的 HBeAg 阴性CHB患者中,高病毒载量组较低病毒载量的患者重度肝脏炎症及纤维化比例高（P＝0．000,P＝0．041）,HBeAg 阳性 CHB 患者中,低病毒载量CHB患者比高病毒载量的患者重度肝脏炎症及纤维化比例高（P＝0．042,P＝0．042）,年龄＜38岁的CHB患者无论是HBeAg阳性和阴性CHB患者肝脏炎症及纤维化严重程度与血清HBV DNA水平间均无相关。结论年龄是预测不同HBV DNA水平下CHB患者结局的关键因素。对于ALT＜2×ULN的CHB患者,均应积极建议患者进行肝脏穿刺活组织检查,而对于≥38岁 HBeAg阳性低病毒载量的CHB患者更应给予高度重视。     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.     

The Technology Transfer from Europe to China in the 17th–18th Centuries: Non-Invasive On-Site XRF and Raman Analyses of Chinese Qing Dynasty Enameled Masterpieces Made Using European Ingredients/Recipes

Two masterpieces of the Qing Dynasty (1644–1912 CE), one in gilded brass (incense burner) decorated with cloisonné enamels stylistically attributed to the end of the Kangxi Emperor’s reign, the other in gold (ewer offered by Napoleon III to the Empress as a birthday present), decorated with both cloisonné and painted enamels bearing the mark of the Qianlong Emperor, were non-invasively studied by optical microscopy, Raman microspectroscopy and X-ray microfluorescence spectroscopy (point measurements and mapping) implemented on-site with mobile instruments. The elemental compositions of the metal substrates and enamels are compared. XRF point measurements and mappings support the identification of the coloring phases and elements obtained by Raman microspectroscopy. Attention was paid to the white (opacifier), blue, yellow, green, and red areas. The demonstration of arsenic-based phases (e.g., lead arsenate apatite) in the blue areas of the ewer, free of manganese, proves the use of cobalt imported from Europe. The high level of potassium confirms the use of smalt as the cobalt source. On the other hand, the significant manganese level indicates the use of Asian cobalt ores for the enamels of the incense burner. The very limited use of the lead pyrochlore pigment (European Naples yellow recipes) in the yellow and soft green cloisonné enamels of the Kangxi incense burner, as well as the use of traditional Chinese recipes for other colors (white, turquoise, dark green, red), reinforces the pioneering character of this object in technical terms at the 17th–18th century turn. The low level of lead in the cloisonné enamels of the incense burner may also be related to the use of European recipes. On the contrary, the Qianlong ewer displays all the enameling techniques imported from Europe to obtain a painted decoration of exceptional quality with the use of complex lead pyrochlore pigments, with or without addition of zinc, as well as cassiterite opacifier.     

Formoterol Delivered via the Dry Powder Aerolizer® Inhaler Versus Albuterol MDI and Placebo in Mild-to-Moderate Asthma: A Randomized, Double-Blind, Double-Dummy Trial

The objectives of this study were to compare the efficacy and tolerability of twice-daily formoterol dry powder 12 µg and 24 µg (Foradil) delivered via Aerolizer inhaler with four times daily albuterol (salbutamol) 180 µg delivered via metered dose inhaler (MDI) and placebo. A total of 554 adolescents and adults (ages 12-75 years) with mild-to-moderate asthma were randomized to this 12-week, multicenter, double-blind, double-dummy, placebo-controlled, parallel-group study. Twelve-hour spirometry measurements were taken at weeks 0, 4, 8, and 12. A total of 484 patients completed the study (122, 116, 127, and 119 given formoterol 12 µg, formoterol 24 µg, albuterol, and placebo, respectively). For the primary efficacy variable, the forced expiratory volume in 1 second (FEV₁), both formoterol 12 µg and 24 µg were statistically superior to placebo at all time points on all test days (p ≤ 0.017) and to albuterol at most time points on all test days (p ≤ 0.001). The onset of improvement in FEV₁ was rapid, with 15% increase within 5 min in 57%, 71%, and 65% of formoterol 12 µg, formoterol 24 µg, and albuterol patients, respectively. Formoterol was also superior to placebo and albuterol in terms of secondary efficacy variables: FEV₁ area under the curve, percentage of predicted FEV₁, forced vital capacity and forced expiratory flow, asthma symptom scores, and peak expiratory flows. In conclusion, both formoterol doses were superior to placebo in all lung function measurements. Overall, compared with albuterol, both formoterol doses produced superior bronchodilation. Formoterol and albuterol were safe and well-tolerated.