Drug metabolism will change significantly during inflammation, including the reduction of expression and activity of many drug metabolizing enzymes and transporters. Body would release a series of inflammatory cytokines which can regulate drug metabolizing enzymes. Recent studies have revealed that drug transporters are also regulated by the cytokines with obvious species difference. Mechanism studies show that several transcription factors play important roles during the signal pathways of regulation. This review focuses on the progress in the regulation of drug transporters during inflammation.

Objective To compare the cerebral blood flow (CBF) and intracranial pressure (ICP) during laparoscopic gynecologic surgery performed under propofol and sevoflurane combined anesthesia.Methods Forty ASAⅠ orⅡ patients aged 20-59 yr weighing 44-69 kg were randomly divided into 2 groups(n=20 each):propofol group (group P) and sevoflurane group (group S).Anesthesia was induced with TCI of propofol (Ce 4μg/ml) in group P or 8% sevoflurane in group S combined with TCI of remifentanil (Ce 6 ng/ml).Tracheal intubation was facilitated with cis-atracurium 0.15 mg/kg.The patients were mechanically ventilated.PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with TCI of propofol or sevoflurane.inhalation combined with TCI of remifentanil.BIS value was maintained at 45-50 by adjusting Ce of propofol or concentration of sevoflurane.Intraabdominal pressure (IAP) was maintained at 12-14 mm Hg.Transcranial Doppler monitoring wag used.Cerebral blood flow velocity (CBFV) and pulsatility index (PI) were recorded at 5 min after supine position(T1)and 5 min after supine lithotomy position before induction(T2),while tracheal tube was being inserted(T3),5 min after tracheal intubation(T4),immediately and 15 min after abdominal CO2 iusnfflation in trendelenburglithotomy position (T5,T6) and at 10 min after deflation of abdomen(T7).Results CBFV was significandy decreased at T3,T4 and T7 in group P and at T4 and T7 in group S as compared with the baseline at T1.CBFV at T3 was significantly lower in group P than in group S.PI at T3,T4 was significantly decreased in group P as compared with the baseline at T1 and was significantly lower than in group S.PI at T5,6 was significantly increased as compared with the baseline in both groups but was not significantly different between the 2 groups.Conclusion When combined with remifentanil.propofol could decrease CBF and ICP while sevoflurane has no significant effect on CBF and ICP after induction.CBF and ICP are significantly increased in both groups after abdominal CO2 insufflation.

Objective To investigate the effect of different treatment on ST-elevation myocardial infarction (STEMI) by evaluating the changes of myocardial collagen metabolism. Methods Forty-one patients with STEMI were divided into drug treatment group (22 cases) and selective percutaneous coronary intervention (PCI) group (19 cases). Meanwhile,47 healthy controls were included in control group. The levels of serum carboxy terminal propeptide of type Ⅰ procollagen (PⅠCP), precollagen Ⅲ ( PC Ⅲ ), matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were measured by enzyme-linked immunosorbent assay at the 3rd ,6th, 12th, 18th month after STEMI,and compared with those in control group. Results The level of P Ⅰ CP in selective PCI group was significantly lower than that in drug treatment group at the 3rd, 6th month [( 15.08 ± 3.37 ) μ g/L vs. ( 19.78 ± 2.22 ) μ g/L, (23.88 ± 3.33 ) μg/Lvs. ( 30.00 ± 3.14) μ g/L, P ＜ 0.05], but there was no significant difference at the 12th and 18th month (P ＞0.05 ). The level of serum PC Ⅲ in selective PCI group was significantly lower than that in drug treatment group at the 3rd month [(50.70 ±4.83) ng/L vs. (59.91 ±4.64) ng/L,P ＜0.05],and there was no significant difference at others times between drug treatment group and selective PCI group. There was no significant difference in P Ⅰ CP/PC Ⅲ between drug treatment group and selective PCI group in all times(P ＞0.05). Compared with those in control group,the levels of serum MMP-1 in all times were significantly decreased in drug treatment group and selective PCI group(P ＜ 0.05 ), but there was no significant difference between drug treatment group and selective PCI group at same times (P ＞ 0.05). The level of serum TIMP-1was significantly higher in selective PCI group than that in drug treatment group at the 3rd and 6th month [(61.89 ± 11.44) μg/L vs. (52.23 ±4.97)μg/L, (62.85 ±6.31) μg/L vs. (52.97 ±6.43)μg/L,P＜0.05] ,and there was no significant difference in TIMP-1 between drug treatment group and selective PCI group in other times (P＞ 0.05). MMP-1/TIMP-1 in selective PCI group was significantly lower than that in drug treatment group at the 6th month [( 1.53 ± 0.25 )% vs. ( 1.95 ± 0.04)% ,P ＜ 0.05] ,and there was no significant difference in MMP-1/TIMP-1 between drug treatment group and selective PCI group in other times (P ＞0.05). Conclusions Selective PCI can improve myocardial collagen metabolism in patients with STEMI in short term ( ＜ 6 months), but it doesn't appear to be superior to drug treatment in long term (6 - 18 months). Patients with STEMI should enforce drug treatment if they have not been treated with PCI.

Objective To investigate the relationship between air pollution and respiratory diseases in Nanning. Methods To analyze the prominent pollutants in the last 12 years: total suspensible particulate (TSP), drop dust, sulphur dioxide (SO2) and nitrogen oxide (NOx) by using Shanghai Air Quality Index, and study the correlation between the above data and the constituent ratio of chronic odstructive lung disease(COPD) inpatients of Guanxi Zhuangzu Autonomous Region People's Hospital as well as the mortality of respiratory diseases in Nanning in the same period. Results The air pollution in Nanning was classified into coal pollution. The dominating pollutants were TSP, drop dust, SO2 and NOx. The epidemiology research showed that the mortality of respiratory diseases in industrial zone were 1.4-2.4 times of that in the city zoon, the city zone was less higher than suburb. During the most severe air pollution period in 1991-1995, the mortality of respiratory diseases was highest, and the inpatients of COPD in the hospital was relevant higher. Conclusion Air pollution is the primary environmental pathogeny and fatal factor for respiratory diseases.

0.05).CONCLUSION:Mecobalamin and buflomedil hydrochloride are more economic than alprostadil,while mecobalamin more economic than bu?flomedil hydrochloride.

Objective To assess the effects of gelatine and 6% hydroxyethyl starch 200/0.5 (HES 200 / 0.5) on phagocytic activity of human neutrophils and monocytes using flow cytometry.Methods Thirty-three ASA Ⅰ - Ⅱ patients aged 18-70 years scheduled for urological minor surgery were randomly divided into three equal groups of eleven patients :group I gelatine;group II HES 200 / 0.5 and group Ⅲ lactated Ringer's solution (LR) . 10 ml?kg-1 of gelatine, HES or LR was infused over 60 min and venous blood samples were taken before infusion and 1 h after the start of infusion for determination of phagocytes with ingested FITC-labeled E coli by flow cytometry. Results In gelatine group the percentage of neutrophils and monocytes with phagocytic activity decreased significantly after infusion ( P

Objective To study the etiology and relative factors of dilated cardiomyopathy (DCM). Methods A total of 233 DCM patients were enrolled and conducted epidemiological survey. Stable angina patients in the same region were collected as control group. The epidemiological investigation included: life styles and history of diseases; blood pressure, electrocardiogram and echocardiography; serum lipids, glucose, hs-CRP, cTNI and NT-proBNP. Results The prevalence rate of DCM was 29.1 per 100 000 population, the male being almost 2-fold more involved than female, and farmers accounted for 77.7%. Familial clustering was not obvious. There were low level of history of hypertension (12.4%), ischemic heart disease (2.1%), myocarditis (5.2%) and diabetes (3.4%). Compared with control group, DCM patients had higher proportion of farmer (60.0% vs 77.7%, P

Objective To evaluate the long-term efficacy of modified loop choledochojejunostomy (MLC). Methods The clinical data of 259 patients who had underwent choledochojejunostomy in First Affiliated Hospital of Sun Yat-Sen University from January 2000 to December 2006 were retrospectively analyzed. Of all the patients, 130 underwent MLC (MLC group) and 129 underwent Roux-en-Y choledochojejunostemy (RYC, RYC group). The changes in incidence of cholangitis and liver function between the 2 groups were compared. All the data were analyzed by t test, chi-square test or Fisher exact probability. Results The levels of alaninetransa-minase and alkaline phosphomonoesterase were (63±42) U/L and (147±147) U/L in MLC group, and (84±52)U/L and (256±201)U/L in RYC group, with statistical difference between the 2 groups (t=1.634, 1.655, P>0.05). The level of gamma-glutamyl transferase in MLC group was (116±91)U/L, which was signifieandy lower than (169±96)U/L in RYC group (t=2.461, P<0.05). Three patients (2.3%) in MLC group and 9 (7.0%) in RYC group suffered from acute cholangitis after operation, with no statistical difference in the incidence between the 2 groups (P>0.05). Of the 12 patients with acute cholangids, 1 in MLC group and 7 in RYC group were hospitalized, with statistical difference between the 2 groups (P<0.05). Conclusions The incidence of acute cholangitis in patients who underwent MLC is comparable to that of RYC. However, the procedure of MLC is simpler than RYC, and patients have milder symptom and lesser frequency of reflux cholangitis onset after MLC.

Objective To analyze the factors influencing the prognosis of patients with pancreatic cancer.Methods The clinical data of 276 patients with pancreatic cancer who had been admitted to our department from September 1995 to August 2005 were retrospectively analyzed.Cox regression analysis was used to screen out independent risk factors influencing the prognosis of patients with pancreatic head cancer or pancreatic body and tail cancer,and Kaplan-Meier method to calculate the median survival time.The effects of tumor location on the prognosis were examined by Log-rank and Breslow test.Results Cox regression analysis showed that the diameter of tumor,invasion of the superior mesenteric vessel and treatment method were the independent risk factors influencing the prognosis of patients with pancreatic head cancer;while age,lymphadenectasis and treatment method were the independent risk factors influencing the prognosis of patients with pancreatic body and tail cancer.The median survival time of patients with pancreatic head cancer and pancreatic body and tail cancer after radical resection were 460 days and 480 days,which were significantly longer than 240 days and 200 days of patients who received palliative treatment or gave up treatment.The median survival time of patients with whole pancreatic cancer was 117 days,which was significantly shorter than 330 days of patients with pancreatic head cancer and 300 days of pancreatic body and tail cancer.Conclusions Radieal resection is currently the best choice for pancreatic cancer.The prognosis is poor for patients with pancreatic head cancer(diameter≥4 cm)and invasion of the superior mesenteric vessel.Patients with age≤60 and lymphadenectasis are the factors resulting in poor prognosis of pancreatic body and tail cancer.The prognosis of patients with pancreatic head cancer and pancreatic body and tail cancer are close.Patients with whole pancreatic cancer is in the terminal stage with the worst prognosis.

Objective：To study the mental health status of heroin addicts and their need for psychotherapy after detoxification. Methods：The mental health of 83 heroin addicts and 70 normal subjects were assessed by SCL-90, Social Support Rating Scale , EPQ, SAS and SDS. Results：As compared to normal controls, heroin additions were found to score higher on various mental health measures, including SCL-90 total and factor scores, the N score of EPQ, as well as total scores on SAS and SDS. The social support in heroin addicts scored lower than normal subjects. Conclusion：Heroin addicts have severe psychological problems, which warrant long-term psychological rehabilitation after detoxification.