Objective To investigate the effect of fluvastatin on ventricular remodeling and serum tumor necrosis factor alpha(TNF-α)level in elderly patients with acute myocardial infarction.Methods 87 elderly patients with acute myocardial infarction were chosen in Jiande Hospital of Integrated Traditional Chinese and Western Medicine from October 2014 to October 2016,were randomly divided into control group(42 cases)and observation group(45 cases),the control group received aspirin,PI Gray chlorine and other conventional treatment,the observation group were given fluvastatinon the basis of the control group treatment.The changes of cardiac function and serum inflammatory factor TNF-α levels were observed before and after treatment.Results After the treatment,left ventricular weight index such asleft ventricular systolic volume index,left ventricular diastolic membrane membrane volume index,left ventricular ejection fraction in the two groups were improved in different degree,but the observation group improved significantly(P<0.05).In the control group,there was no significant improvement; and after treatment,the indexes of the observation group were significantly better than those of the control group(P<0.05).The effective rate in the observation groupwas 93.33％,was significantly higher than the control group(P<0.05).After treatment,the levels of serum TNF-α were significantly improved in the observation group,and the level of serum was significantly decreased compared with before treatment(P<0.05),and the observation group after the treatment was obviously lower than the control group(P<0.05).Conclusion For elderly patients with acute myocardial infarction with fluvastatin can better improve the patient's heart function,improve the body's inflammatory level,effectively improve the treatment effect,inhibit ventricular remodeling.

Objective To investigate the prevention and management strategies of in-hospital complications in the hip replacement in elderly patients(≥80 years old) Methods The data of 42elderly patients with hip replacement between Oct.2004 and Dec.2006 were collected and analyzed.Their age ranged from 80 to 96 years with an average of 84.6 years.Twenty-four cases were associated with severe osteoporosis(Dorr Ⅲ),13 with coronary heard disease,10 with arrhythmia,7with diabetes,5 with cerebral paralysis.Twenty five cases had a cemented stem bipolar femoral head replacement,2 had uncemented stem bipolar femoral head replacement,7 had cemented total hip replacement,3 had revision of total hip replacement. Results No death occurred during operations,1 died postoperatively due to dislocation at the 5th day postoperation.One case had coma for 1 week after general anaesthesia.5 had temporary cognitive handicap,38(90.5%)were able to walk at the aid of walker with easement of pain before discharging. Conclusions To gain good results in elderly patients with hip arthroplasty,less invasive and quick anaesthetic technique and operative procedures are encouraged.Meticulous preoperative preparation.active preventing and treating the intraoperative and postoperative complications should be emphasized.

OBJECTIVETo explore the synergistic antidepressant effect of quercetin and hyperforin (HF, extracted from Hypericum perforatum).

METHODSMale ICR mice were divided into nine groups:blank control, positive control (Paroxetine, 10 mg/kg), quercetin groups (A: 5 mg/kg, B: 10 mg/kg, C: 20 mg/kg), Hypericum perforatum extract (HF 10 mg/kg),combination groups (A: quercetin 2.5 mg/kg + HF 5 mg/kg,B:quercetin 5 mg/kg + HF 5 mg/kg,C: quercetin 10 mg/kg + HF 5 mg/kg). All drugs were administered intragastrically. Reserpine reversal tests were used to compare the reversal effects of drugs on body temperature decline, eyelid ptosis and akinesia. Tail suspension test was used to compare immobility time in each group.

RESULTSCombination group B showed no significant difference (P>0.05) compared with combination group C in reserpine reversal tests and tail suspension test. However, its body temperature reversal effect was significantly higher (P<0.01) than that of quercetin group B, and its effect in shortening immobility time was stronger than that of HF 10 mg/kg group (P<0.05) and quercetin group B (P<0.01).

CONCLUSIONThe combination of quercetin and Hypericum perforatum extract in certain ratio has significant synergistic antidepressant effect in ICR mice.

Animals ; Antidepressive Agents ; pharmacology ; Depression ; drug therapy ; Disease Models, Animal ; Hypericum ; chemistry ; Male ; Mice ; Mice, Inbred ICR ; Plant Extracts ; pharmacology ; Quercetin ; pharmacology

Objective To summarize the characteristics of medical service patterns at Grenada station of Mission Harmony-2015 so as to provide reference for future overseas services in similar island countries .Methods After detailed analysis of actual conditions of the countries visited and efficient communication with host country health organizations , we made an appropriate adjustment of the medical service pattern , which involved multi-site screening of general patients , followed by intensive checkups and treatment aboard the hospital ship .Results The procedure of diagnosis and treatment was streamlined and the efficacy of medical services was significantly enhanced to meet the maximum medical demand of local residents.Grenada became a station with the largest number of patients who received top-quality fee-free healthcare during Mission Harmony-2015 .Conclusion Adjustment of medical service patterns according to the actual conditions could deliver a desired effect during overseas missions .

Tuberous sclerosis complex (TSC) is a hereditary and multisystemic disease, caused by mutations in the TSC1 or TSC2 gene, with an incidence of about 1/14 000 to 1/6 000.The neurological manifestations of TSC often include epilepsy, developmental delay, mental disorders and loss of neurological function.Among them, epilepsy is the most common manifestation, with an incidence of 80%-90%, 55%-62% of which is drug-resistant epilepsy.Epilepsy in TSC severely affects the clinical prognosis and life quality of patients.At present, epilepsy in TSC can be treated with the inhibitors of mammalian target of rapamycin(mTOR), antiepileptic drugs, ketogenic diet(KD), neuromodulation, palliative or resection operation.Although the exact mechanism of KD in the treatment of epilepsy in TSC is not clearly elucidated yet, it has been demonstrated in some studies that it is related to the inhibition of mTOR signaling pathway and other multiple mechanisms.Meanwhile, the safety and efficacy of KD therapy have been proven in many clinical studies.Therefore, KD is recommended for the treatment of epilepsy in TSC, especially when epilepsy is resis-tant to antiepileptic drugs, is not indicated for surgery or the surgery is ineffective.The research progress of the mechanism and clinical efficacy of KD therapy for epilepsy in TSC would be reviewed in this paper.

Genetic factors are important causes of drug-resistant epilepsy.In most cases, epilepsy caused by gene mutation cannot be controlled by existing antiepileptic drugs.Ketogenic diet controls seizures through multi-target mechanism, which is widely used in the treatment of drug-resistant epilepsy caused by gene mutation.In this paper, the advance in application and efficacy of ketogenic diet therapy in 23 kinds of gene mutation related drug-resistant epilepsy is reviewed, which involves energy metabolism, ion channel, mTOR signaling pathway and some other rare diseases.

Objective: To investigate the feasibility of multiplex real-time RT-PCR with fluorescent probes in early screening of Ph-like acute lymphoblastic leukemia (ALL) and analyze the clinical feature and prognos. Method: A total of 118 adult B-ALL patients diagnosed between October 2010 and March 2016 were enrolled in this study. Multiplex RT-PCR was used to detect the Ph-like ALL related fusion gene and CRLF2 expression in 58 BCR-ABL and MLL rearrangement negative patients. The clinical features, treatment response and prognosis were analyzed in Ph-like fusion gene positive and/or CRLF2 over-expression patients. Result: Among 58 patients, 9 patients (9/58, 15.5%) showed Ph-like ALL related fusion genes positive and 10 patients (10/58, 17.2%) showed CRLF2 over-expression. There were statistical differences in age, WBC count, immunophenotypes, cytogenetics and risk stratification among Ph-like fusion gene positive or CRLF2 over-expression patients, Ph⁺ patients, MLL⁺ patients and B-other patients. The 2-year overall survival rates were 65%, 47%, 64% and 74% respectively among these four groups (P=0.043) . The 2-year relapse free survival rates were 51%, 39%, 62% and 70% respectively among these four groups (P=0.010) . Conclusion Routine screening of Ph-like ALL by multiplex RTPCR is feasible.

Objective: To investigate the spectrum of gene mutations in adult patients with B-acute lymphoblastic leukemia (B-ALL), and to analyze the influences of different gene mutations on prognosis. Methods: DNA samples from 113 adult B-ALL patients who administered from June 2009 to September 2015 were collected. Target-specific next generation sequencing (NGS) approach was used to analyze the mutations of 112 genes (focused on the specific mutational hotspots) and all putative mutations were compared against multiple databases to calculate the frequency spectrum. The impact of gene mutation on the patients’ overall survival (OS) and recurrence free survival (RFS) was analyzed by the putative mutations through Kaplan-Meier, and Cox regression methods. Results: Of the 113 patients, 103 (92.0%) harbored at least one mutation and 29 (25.6%) harbored more than 3 genes mutation. The five most frequently mutated genes in B-ALL are SF1, FAT1, MPL, PTPN11 and NRAS. Gene mutations are different between Ph⁺ B-ALL and Ph^- B-ALL patients. Ph^- B-ALL patients with JAK-STAT signal pathway related gene mutation, such as JAK1/JAK2 mutation showed a poor prognosis compared to the patients without mutation (OS: P=0.011, 0.001; RFS: P=0.014,<0.001). Patients with PTPN11 mutation showed better survival than those without mutation, but the difference was not statistically significant (P value > 0.05). Besides, in Ph⁺ B-ALL patients whose epigenetic modifications related signaling pathway genes were affected, they had a worse prognosis (OS: P=0.038; RFS: P=0.047). Conclusion Gene mutations are common in adult ALL patients, a variety of signaling pathways are involved. The frequency and spectrum are varied in different types of B-ALL. JAK family gene mutation usually indicates poor prognosis. The co-occurrence of somatic mutations in adult B-ALL patients indicate the genetic complex and instability of adult B-ALL patients.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.