OBJECTIVE: To discuss the protective effect of captopril on the nicotine-induced impairment of endothelium-dependent relaxation(EDR) in rat mesenteric arteries and explore the possible mechanisms underlying the observed protective effects of captopril.METHODS: A total of 30 rats were randomly divided into 3 groups: normal control group,nicotine group(2 mg?kg-1),captopril group(nicotine 2 mg?kg-1+captopril 3 mg?kg-1).After treatment for 4 weeks,vasodilatation rate of mesenteric arteries,the content of NO and NOS,and the SOD activities in serum were measured.RESULTS: Nicotine significantly decreased the vasodilatation rate of mesenteric arteries and decreased the content of NO and NOS,SOD activities in serum(P

Objective To observe the efficacy of proparacaine hydrochloride in preoperative venipuncture. Methods Two hundred and furty patients hospitalized for preoperative venipuncture, between June 2015 to December 2015 in Jiangmen Central Hospital, were equally randomized into the intervention group and control group: the former was treated with proparacaine hydrochloride and the control group used traditional method. Visual analogue scale (VAS) was adopted to assess the effects of the anesthesia effect. At the same time the one-time success rate of puncturing and the adverse reactions were observed and compared between the two groups. Results Patients of the intervention group felt significantly less painful than that the control one (P<0.05). The successful rate of the intervention group was significantly higher than that of the control group (P<0.05). Conclusion Proparacaine hydrochloride is safe and effective for preoperative which reduces pain.

Objective To explore whether the Chinese medicine Guben Yiliu III can improve the effect of gemcit -abine on human pancreatic cancer xenograft in nude mice . Methods Nude mice with transplanted human pancreatic cancer were divided randomly into 4 groups: control group, gemcitabine treatment group , combined ( Guben Yiliu III +gemcitabine) group, and Guben Yiliu III group, 10 mice in each group.The gemcitabine group and combined group were treated with gemcitabine from the 8th day after transplantation in a dose of 100 mg/kg by i.p.injection, twice a week. Guben Yiliu III and combined groups were given the aqueous solution of Guben Yiliu III granules p .o.since the 8th day af-ter transplantation .Result The inhibition rate of transplanted tumor in the three treatment groups were 48.9% in the gemcitabine group , 68.9%in the combined group , and 28.0%in the Guben Yiliu III group .The combined group showed a significantly higher inhibition rate than the gemcitabine group (P<0.05).The gemcitabine group, combined group and Guben Yiliu III group showed a significantly slower growth rate than the control group .However, the combined treatment group showed a pronounced side effect and body weight loss than the other 3 groups .Conclusions The Chinese medicine Guben Yiliu III can improve the inhibitory effect of gemcitabine on nude mice with human pancreatic cancer xenograft in the auxilla of nude mice .

The United Kingdom is highly experienced in the career development and deployment of health care assistants ( HCA) to cope with shortage of nurses. This paper introduced the HCA entry requirements and career development in UK. The entry requirements include quality requirements, basic training and education requirements, practice certificate training and effect evaluation. Career development includes job promotion and transfer to clinical nurses. In view of the current situation of nursing assistant position in China, this paper made valuable recommendations.

Objective To investigate the levels of serum N-acetyl-β-D-glucosidase (NAG),neutrophil gelatin-related lipid transporter protein (NGAL) and urinary kidney injury molecule-1 (KIM-1)in children with sepsis and their correlation with the condition.Methods Fifty-eight children with sepsis were selected as the observation group from January 2018 to May 2019 in Guangzhou Red Cross HoSpital,and sequential organ failure assessment (SOFA) score was conducted.According to the score results,all the patients were divided into three groups:mild,moderate and severe group.Meanwhile,58 healthy children were selected as the control group,and the serum NAG,NGAL levels and urinary KIM-1 level in the two groups were detected respectively,and the differences in various indicators among the mild,moderate and severe groups were compared.Pearson correlation analysis was used to explore the correlation between serum NAG,NGAL levels and urinary KIM-1 level and SOFA scores respectively.Results The levels of serum NAG,NGAL and urinary KIM-1 in the observation group were all significantly higher than the control group:(30.53 ± 7.18) U/L vs.(12.36 ± 3.46) U/L,(78.72 ± 12.97)μg/L vs.(30.62 ± 3.24) μg/L,(60.59 ± 10.73) ng/L vs.(22.54 ± 4.25) ng/L,and there were statistical differences (P＜0.05).Serum NAG,NGAL levels and urinary KIM-1 level in the moderate group and the severe group were all higher than the mild group:(31.81 ± 1.41) and (34.24 ± 1.70) U/L vs.(28.11 ± 2.36)U/L,(85.94 ± 5.45) and (94.17 ± 3.91) μg/L vs.(67.45 ± 7.58) μg/L,(67.03 ± 4.63) and (72.17 ± 3.98) ng/Lvs.(51.49 ± 7.08) ng/L,while the levels of serum NAG,NGAL and urinary KIM-1 in the severe group were all higher than those in the moderate group (P＜0.05).Pearson correlation analysis showed that the levels of serum NAG,NGAL and urinary KIM-1 levels in sepsis children were positively correlated with SOFA score (r =0.836,0.935,0.892;P＜0.01).Conclusions The levels of serum NAG,NGAL and urinary KIM-1 in children with sepsis increased significantly,and were related to the severity of the disease,which provides some reference value for the judgment of the sepsis condition.

OBJECTIVE:To evaluate the effectiveness and safety of rolapitant combined with 5-HT3 receptor antagonist and dexamethasone for the prevention of chemotherapy-induced nausea and vomiting systematically,and to provide evidence-based reference in clinic.METHODS:Retrieved from CJFD,VIP,Wanfang Database,PubMed,EMBase and Cochrane Library,randomized controlled trials (RCTs) about rolapitant+5-HT3 receptor antagonist+ dexamethasone (trial group) vs.placebo combined with 5-HT3 receptor antagonist+dexamethasone (control group) for the prevention of chemotherapy-induced nausea and vomiting.Meta-analysis was performed by using Rev Man 5.3 statistical software after data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0.RESULTS:A total of 3 literatures were included,involving 4 RCTs and 2 583 patients.The results of Meta-analysis were as follows:complete remission rate [acute stage:RR=1.10,95％ CI (1.02,1.19),P=0.01;delay stage:RR=1.18,95％ CI (1.11,1.25),P＜0.001;overall stage:RR=1.19,95 ％ CI (1.12,1.26),P＜0.001] and the proportion of patients with ftmctional indexes of vomiting living ＞ 108 [RR =1.10,95 ％ CI (1.04,1.16),P ＜ 0.001] in trial group were significantly higher than control group,with statistical significance.There was no statistical significance in the incidence of ADR between 2 groups[RR=1.10,95 ％ CI (0.82,1.47),P=0.52].CONCLUSIONS:Rolapitant combined with 5-HT3 receptor antagonist and dexamethasone can effectively prevent and relieve chemotherapy-induced nausea and vomiting,and improve the quality of life with good safety.

OBJECTIVE:To provide reference for rational use of TCM injection. METHODS:Each 660 medical records were selected from 9 hospitals of Luzhou city before(Jan.-Mar. in 2015)and after(Jan.-Mar. in 2017)administrative intervention and pharmaceutical intervention(called"intervention"for short)according to random number tablet. The consumption sum,DDDs and B/A,utilization,per capita,cost of drug and TCM injection,rational and irrational use were compared before and after intervention. RESULTS:After intervention,total consumption sum and DDDs of 10 TCM injections were decreased in 7 hospitals compared to before intervention,but those of 2 hospitals were increased slightly. Before and after intervention,consumption sum of Xueshuangtong for injection took up the first place among 10 kinds of TCM injection. Top 5 injections in the list of DDDs were the same generally,i.e. Xuesaitong for injection,Xueshuangtong for injection,Shenmai injection,Salviae miltiorrhizae and ligustrazine hydrochloride injection and Safflower yellow for injection.10 kinds of TCM injections with B/A>1 included Xuesaitong for injection, Salviae miltiorrhizae and ligustrazine hydrochloride injection,Safflower yellow for injection and Gastrodin injection. After intervention,utilization rate of 10 TCM injections(24.70%)was significantly lower than before intervention(32.42%),rational rate of TCM injection(61.35%)was significantly higher than before intervention(41.59%),with statistical significance(P<0.01). After intervention,the per capita cost of TCM injection,the incidence of function inconsistency,excessive dose,irrational solvent selection,insufficient solvent amount and non-individual injection were significantly lower than before intervention,with statistical significance(P<0.05). There was no statistical significance in per capita cost of drug,the irrational utilization rate of repeated medication or excessive long treatment course before and after intervention(P>0.05). CONCLUSIONS:The administrative intervention combined with pharmaceutical intervention promote more safe,rational and economical use of TCM injection.

Objective To investigate antimicrobial resistance among Streptococcus pneumoniae clinically isolated from 14 teaching hospitals located at different areas in China in 2005-2008 and to give logical guidance for clinical empirical therapy.Methods A total of 1 317 non-repetitive S.pneumoniae isolates in 14 teaching hospitals from 2005-2008 were collected and sent to the central lab for reidentification and susceptibility testing, including 271 isolates collected in 2005, 391 isolates collected in 2006, 363 isolates collected in 2007 and 292 isolates collected in 2008. Most of the isolates were from community-acquired respiratory tract infections, which were isolated from outpatient or emergency department patients with respiratory tract infections or those patients with respiratory tract infections within ≤48 hours hospitalization.The districts where the organisms were isolated include North China, Northeast China, South China, Central and Northwest China and East China.The patients included adults, teenagers and children.The minimum inhibitory concentrations (MICs) or inhibitory zone diameter of 17 antimicrobial agents were determined by Etest method, agar dilution method or disk diffusion method.WHONET5.5 software was used to analyze susceptibility rate, intermediate rate, resistance rate, MIC50 and MIC90.Results Linezolid (100%) and fluoroquinolones (95.2%-99.7%) showed excellent activities against S.pneumoniae.Among β-lactams, amoxicillin-clavulanic acid remained high activities (73.8%-92.1%),followed by penicillin, ceftriaxone and cefepime with year-over-year decrease in activities.The activities of three second-generation cephalosporins were low (36.3%-38.4% in 2008).The activities of erythromycin, azithromycin, clindamycin, trimethoprim/sulfamethoxazole and tetracycline against S.pneumoniae were poor and decreased year over year.The incidence of penicillin non-susceptible S.pneumoniae (PNSP) was increasing especially for PISP (from 4.4% in 2005 to 20.2% in 2008).The incidence of PNSP in North China was low (6.0%), while this value were high in central China and East China (30.1% and 38.7%, separately).The incidence of PNSP in adults (15.7%) was obviously lower than that in children(≤5 years:33.0%) and teenagers (6-17 years:38.2%).Conclusions linezolid and fluoroquinolones showed excellent in vitro activity against S.pneumoniae, followed by penicillin and cephalosporins with year-over-year decrease of activity. Clinicians should pay more attention when using those antimicrobial agents with poor activity against S.pneumoniae, which include macrolides, clindamycin, trimethoprim/sulfamethoxazole and tetracycline.

Objective To predict and verify the upstream regulatory microRNA (miRNA)of protein kinase D1 (PKD1),and to investigate its role in cerulein induced acute pancreatitis (AP)in rats. Methods Potential up-stream regulatory miRNA of PKD1 was predicted by using bioinformatics software. Dual luciferase reporter gene system and Western blot were applied to verify the regulation of PKD1 by the selected miRNA. Experimental AP was induced by 6 intraperitoneal injection of cerulein (20 μg/ kg)at hourly intervals after administration of the CY5 - labeled notar-get control (AP group,n = 20)or selected miRNA (treatment group,n = 20),respectively by intraperitoneal injection into rats. Other rats were divided randomly into a normal control group (n = 10)without any treatment. Besides 10 rats in either AP or treatment group were sacrificed 6 hours after the first injection of cerulein,and the rats were all sacri-ficed 24 hours after the first injection. The blood samples and pancreatic tissues of each rat were collected to test serum amylase and lipase activities,or to make hematoxylin - eosin stain for AP pathological scores as well as PKD1 immuno-histochemical staining,respectively. Results TargetScan 7. 1 software analysis showed that miR - 128 - 3p was the po-tential upstream regulatory miRNA of PKD1,which was verified by dual luciferase reporter gene system and Western blot detection. Compared to the normal control group,serum amylase and lipase activities after 6 h exposure to cerulein increased in both AP group and the treatment group[13313. 00(9424. 00 - 15995. 00)U/ L,13552. 00(10399. 50 -18408. 25)U/ L vs. 1430. 50(1214. 25 - 1543. 25)U/ L;547. 00 (515. 00 - 627. 00)U/ L,857. 50(522. 00 -1222. 25)U/ L vs. 34. 00(32. 50 - 34. 75)U/ L],and the differences were significant(χ2 = 8. 715,P < 0. 05;χ2 =9. 115,P < 0. 05),which indicated that the rat models of AP were successfully established. The immunohistochemical scores of PKD1 after 24 h exposure to cerulein decreased in the treatment group[0. 50(0 - 2. 75)scores],compared with the normal control group [4. 00(4. 00 - 8. 00)scores]and the AP group [4. 00(3. 75 - 8. 00)scores],and difference was significant(χ2 = 18. 302,P < 0. 05). Accordingly,the total pathological scores of HE staining decreased significantly in the treatment group,as compared to the AP group (3. 80 ± 0. 85 vs. 6. 90 ± 1. 15,t = 4. 481,P < 0. 01). The results showed that the inflammatory cell infiltration and tissue necrosis were significantly improved after miR -128 - 3p treatment. Conclusions miR - 128 - 3p is the upstream regulatory microRNA of PKD1 which protects pan-creata from necrotic injury and inflammatory cell infiltration in PKD1 - mediated acute pancreatitis.

Objective:To explore the influencing factors and effectiveness of community follow-up in patients with cardiac implantable electronic device (CIED) implantation.Method:A total of 132 patients who received CIED implantation in the Department of Cardiology of Tongren Hospital, Shanghai Jiao Tong University School of Medicine from February 2021 to February 2022 were enrolled in this prospective cohort study. Among them 33 patients were followed up in community health service centers associated with Tongren Hospital (community follow-up group) and 99 matched patients were followed up in the CIED outpatient clinic of the hospital (outpatient follow-up group) with a ratio of 1∶3. The clinical data of the selected patients were collected through a questionnaire survey; the follow-up data were extracted through the CarelinkExpress electronic follow-up platform and the CIED outpatient information system of Tongren Hospital. Adjustment of the treatment protocol or CIED parameters at follow-up, and the referral from the community health service centers were defined as visit with-an-action (VWA). The endpoint of follow-up was the occurrence of major adverse events. The multivariate logistic regression model was used to analyze the factors influencing patient selection for community follow-up.Results:The univariate analysis showed that the frequency of visits to community health service centers and the service contracting rate in community follow-up group were higher than those of outpatient follow-up group ( P<0.05). The multivariate logistic regression analysis showed that the contracted community physician service was an independent influencing factor of patient choosing community follow-up ( OR=2.143, 95% CI: 1.103-4.166, P=0.025). A total of 469 visits of followed up occurred in 132 patients, including 45 community visits and 424 outpatient visits. VWA accounted for 22.2% (10/45) in the community follow-up group, and 17.2% (73/424) in the outpatient follow-up group ( P>0.05). There was no significant difference in the safety and effectiveness indicators (VWA, major adverse events, and unplanned follow-up) between the two groups ( P>0.05). More patients in the community follow-up group walked to the hospital than the outpatient follow-up group ( P<0.05);and the main transportation for the later was by bus or taxi(42(42.4%)or 41(41.4%)). The average waiting time in the community follow-up group was significantly shorter than that in outpatient follow-up group ( P<0.05). The total time required for a single follow-up in the community follow-up group was 50.0 (45.0, 59.5) minutes, which was significantly shorter than that in the routine outpatient follow-up group (107.0 (90.0, 135.0) minutes, P<0.05). Conclusions:The contracting with community physicians is an independent influencing factor for CIED implanted patients to choose community follow-up. The safety and effectiveness of community follow-up are comparable to routine outpatient follow-up, and community follow-up is more convenient.