Objective To explore the delayed protection of ischemic preconditioning against myocardial ischemia-reperfusion injury in rabbits. Methods Twenty four healthy rabbits were randomly into sham, ischemia-reperfusion(I/R) and ischemic preconditioning(IP) groups, each group containing 8 rabbits. After 24h IP, rabbits in IP group received 60 min coronary artery occlusion followed by 120 min reperfusion. Myocardial morphological changes were observed by optics microscope and electron microscope, infarction size and the area at risk were determined by triphenyltetrazolium chloride(TTC) and Evan's blue dye, and concentrations of adenosine and calcitonin gene-related peptide(CGRP) in serum were assayed. Results There were a few of cardial fibers ruptured, focus hemorrhage and a mass of inflammatory cell infiltration, and the concentrations of adenosine and CGRP in serum also decreased in rabbits of I/R group. Above changes were improved in rabbits of IP group, and infarction size and the area at risk markedly reduced compared with sham group and I/R group(P

Objective To investigate the clinical effects and significance of different-dose atorvastatin on soluble CD105(sCD105),high sensitive-C reactive protein(hs-CRP)and the parameters of heart rate turbulence in patients with acute coronary syndrome(ACS). Methods One hundred and six ACS patients were divided into three groups by random digits table: control group(30 patients, routine treatment),treatment group Ⅰ(38 patients, routine treatment + atorvastatin 20 mg), and treatment group Ⅱ(38patients, routine treatment + atorvastatin 40 mg). All patients were treated for 4 weeks. The levels of serum sCD105,hs-CRP,and the parameters of heart rate turbulence before and after treatment. Results Before treatment, the levels of turbulence onset(TO), turbulence slope(TS),sCD105 and hs-CRP in three groups had no significant difference(P ＞ 0.05). After treatment, TO,sCD105 and hs-CRP decreased significantly,and TS increased significantly(P＜ 0.05 or ＜ 0.01). The change amplitude of treatment group Ⅱ was the most obvious, and the levels of above mentioned index showed significantly difference compared with that of treatment group Ⅰ[TO:(0.22 ±0.18)% vs.(0.66 ± 0.23)%;TS:(6.22 ±0.83)ms/RR interval(RRI)vs.(3.90 ±0.73)ms/RRI;sCD105:(1.65 ±0.43)mg/L vs.(2.92 ±0.50)mg/L;hs-CRP:(1.68 ±0.55)mg/L vs.(2.08±0.61)mg/L](P ＜0.01). Correlation analysis showed the levels of sCD105 and hs-CRP had significantly positive correlation with TO(P ＜ 0.01)and had negative correlation with TS(P ＜ 0.01).Conclusions The atorvastatin treatment in patients with ACS may stabilize coronary vascular endothelial cells and atherosclerotic plaque, and improve autonomic nerve function. Larger doses of atorvastatin may get more benefit.

Objective:To systematically evaluate the influence of the implementation of essential drug policy ( EDP) on prescrip-tion use rate of antibiotics in primary hospitals. Methods:Based on CNKI, Wanfang and VIP of China journal databases, all litera-tures were adopted including the data of the prescription use rate of antibiotics in primary hospitals. RevMan5. 3 and Stata 12. 0 soft-ware were used to conduct the Meta analysis. Results:Totally 43 literatures were included in the study according to the evaluation se-lection criteria. After the implementation of EDP, the prescription use rate of antibiotics in primary hospitals was decreased, and com-pared with that before the implementation of EDP, the risk difference value was significant [RD= -0. 03,95%CI( -0. 04,-0. 03), P<0. 000 01], while the use rate was still high (46. 16%). The result of Egger’s test indicated the publication bias of the 43 litera-tures was not significant (P=0. 571). However, there was high heterogeneity(I2 =94%,P<0. 000 01)among the different studies. Based on the classification of hospital type and different areas, the results of sub-group analysis showed the differences of study methods in the literatures and regional implementation measures of EDP contributed to the high heterogeneity among the different studies. Con-clusion:In order to reduce the heterogeneity of studies, a unified evaluation criteria for the research quality of the cross-section survey should be established. And special policies related to EDP should be taken to effectively decrease the use rate of antibiotics in primary hospitals.

Objective To discuss the surgical effect of adult lipomatous tethered cord syndrome (TCS). Methods The clinical data of 29 patients with adult lipomatous TCS were systematically analyzed. Eleven of male and 18 of female,who ranged from 20 to 59 years. All patients were performed filum terminale release and lipoma excision, the clinical outcome after operation was analyzed according to Hoffman grading criteria and visual analog scale (VAS). Results According to Hoffman grading criteria, 9 cases were obviously improved in leg muscle weakness, including 1 case with urination disturbance improved significantly. Also the lower back pain of patients were improved obviously: (2.63 ± 1.30) scores vs. (8.67±0.30) scores, there was significant difference (P<0.05). Conclusions Filum terminale release and lipoma excision can effectively improve the symptom of lower back pain of adult lipomatous TCS patients, meanwhile the symptom of paraparesis can improve appropriate postoperatively. But urinary deficits do not show a significant change.

Objective To determine the relation between the graduation and type of Modic change and low back pain. Methods Ninety-seven patients with low back pain associated with Modic change were enrolled, and the data of clinical were analyzed. The degree of back pain was evaluated by visual analog score (VAS) and Oswestry disability index (ODI). The relation between Modic change and the degree of low back pain was evaluated. Results In 97 patients, the type of Modic change:28 cases (28.9%) were type Ⅰ, 37 cases (38.1%) were type Ⅱ, 11 cases (11.3%) were Ⅱ/Ⅲ, and 21 cases (21.6%) were type Ⅲ. The graduation of Modic change:39 cases (40.2%) were minimal, 34 cases (35.1%) were moderate, and 24 cases (24.7%) were severe. The VAS of type Ⅰ, type Ⅱ, typeⅡ/Ⅲand typeⅢin patients with Modic change were (3.8 ± 0.4), (2.6 ± 0.2), (1.7 ± 0.5) and (1.0 ± 0.6) scores, and there were statistical differences (P<0.05). The ODI scores of type Ⅰ, type Ⅱ, type Ⅱ/Ⅲ and type Ⅲ in patients with Modic change were (11.8 ± 0.7), (8.4 ± 1.1), (5.7 ± 1.3) and (2.0 ± 1.0) scores, and there were statistical differences (P<0.05). Spearman correlation analysis result showed that the type of Modic change was negatively correlated with the intensity of low back pain (r=-0.342, P<0.01). There were no statistical difference in VAS and ODI score among the patients with minimal, moderate and severe of Modic change (P>0.05). Spearman correlation analysis result showed that the graduation of Modic change had no correlation with the intensity of low back pain (r = 0.351, P>0.05). Conclusions The graduation of Modic change does not directly correlate with the low back pain, but the type of Modic lesion is more important.

Objective To investigate the effect and mechanism of combined therapy using anti-CTLA-4 antibody and doxoru-bicin on mice bearing breast cancer.Methods Balb/c mice inoculated with 4T-1 mouse breast cancer cell were used as tumor mod-els,which were randomly divided into blank group,solvent control group,anti-CTLA-4 antibody only group,doxorubicin only group and combined therapy group.Tumor growth of mice was observed.The ratio of spleen and bone marrow cell subgroup were evaluated.Tumor microenvironment apoptosis and microvessel density (MVD)were evaluated.Results The tumor volume of an-ti-CTLA-4 antibody only group,doxorubicin only group and combined therapy group were lower than those in the rest groups(P <0.05).The tumor volume and mass of combined therapy group was significantly higher than those of anti-CTLA-4 antibody only group,doxorubicin only group (P <0.05).Compared with blank group,solvent control group,CD8 + Tand CD4 + T ratio in anti-CTLA-4 antibody only group,doxorubicin only group,combined therapy group increased with significant difference (P <0.05). The positive cell apoptosis rate of combined therapy group was significantly higher than those of other groups(P < 0.05 ).The MVD of combined therapy group was significantly lower than those of other groups(P <0.05).The positive cell apoptosis rate and MVD of anti-CTLA-4 antibody only group,doxorubicin only group were better than those of blank group,solvent control group. Conclusion Combined therapy using anti-CTLA-4 antibody and doxorubicin could improve the immune,significantly inhibit the growth of tumor,promote cancer cell apoptosis and decrease MVD.

Objective To observe the regularities of distribution of TCM syndrome types and correlation between TCM syndrome types and cardiovascular prognosis risk factors of elderly hypertensive patients in three different urban and rural communities.Methods Totally 299 elderly hypertensive patients who conformed to the hypertensive diagnostic criteria from 896 respondents which participated in the health monitoring questionnaire drafted by health management team of China Academy of Chinese Medical Sciences were screened. The syndrome types were differentiated according to Guiding Principle of Clinical Research on New Drugs of Traditional Chinese Medicine (for Trial Implementation). The levels of some risk indicators, such as blood glucose, blood lipid, CREA, ET, Hcy and mALB were measured by radioimmunoassay, enzymatic cycling assay and other methods. Age, gender, BMI and pulse pressure were recorded.Results The TCM syndrome types of 299 elderly hypertensive patients were deficiency of yin and yang type (74 cases), hyperactivity of yang due to yin deficiency type (65 cases), blood stasis syndrome type (62 cases), stagnation of phlegm-dampness type (61 cases), hyperactivity of liver-fire type (37 cases). Single factor analysis showed that there existed statistical significance among BMI, FBG, GHbA1c, CREA, TC, LDL-C, ET, Hcy and mALB in the 5 TCM syndromes (P<0.05,P<0.01), and the statistical significance was more apparent in the stagnation of phlegm-dampness type, blood stasis syndrome type and hyperactivity of yang due to yin deficiency type. Discriminant analysis showed BMI and Hcy have certain reference value for the diagnosis of TCM syndrome types in elderly hypertensive patients. Binary-Logistic regression analysis showed that the course of disease had a positive correlation with syndrome of deficiency of yin and yang.Conclusion Compared with other types of elderly hepertensive patients, stagnation of phlegm-dampness type and blood stasis syndrome type are more closely related to hypertension cardiovascular prognosis risk factors.

Objective To study the sugical treatment of elderly patients with acute intestinal ob-struction caused by colorectal cancer. Methods The clinical data of 56 elderly patients of acute colonic ob-struction caused by colorectal cancer from Janury 2002 to Janury 2007 were analyzed retrospectively. There were 20 cases with right side coloniclesion,32 cases with left side coloniclesion and 4 cases with rectal lesion. All patients received emergency operation. One stage tumor resection and anastomosis was performed in 20 cases with right side coloniclesion and in 25 cases with left side coloniclesion,Hartmann operation in 4 cases,proximal colostomy in 3 cases were performed with left side coloniclesion. Dixon operation in 2 cases and proximal colostomy in 3 cases were performed with rectum cancer. Results Postoperative complications occurred in 18 cases,including wound infection,intraperitoneal sepsis and intestinal fistula. Fifty-five cases recovered,there was one perioperative death. Conclusions Positive operation should be taken when the diagnosis of acute obstructing colorectal cancer the elderly is made. The operative methods depended on the patient'conditions. The perioperative managment should be emphasized and selection of rational operation procedure is important for decreasing mortality and complications of acute obstructing colorectal cancer in the elderly.

Dioscin is the main ingredient of Dioscorea,a tradi-tional medical herb.Traditional theory of Chinese medicine be-lieves that Dioscorea has effects of clearing lung,digesting food, diuresis, improving blood circulation, relaxing muscles and stopping attack of malaria.Pharmacological studies have shown that dioscin has many pharmacological effects,particularly the anti-tumor effect.Many studies have also shown dioscin im-proves symptoms of atherosclerosis and protects blood vessel en-dothelium,reduces ischemia-reperfusion injury of heart,brain and kidney,lowers blood sugar,inhibits hepatic fibrosis,im-proves menopausal osteoporosis,relieves rheumatoid arthritis, ulcerative colitis and other inflammatory disorders,and posses-ses anti-bacterial and anti-viral activity.This article focuses on the progress of the modern pharmacological study of dioscin,and reports its advances in recent years.

Objective To find out fluorine content in drinking water in Yi County,and to provide ascientific basis for prevention of endemic fluorosis and children's dental caries.Methods According to FluorideDistribution Survey Program in Drinking Water of Hebei Province,an administrative village was taken as a unit,one drinking water sample was randomly collected from every village with centralized water supply.For villages withdecentralized water supply,five drinking water samples were randomly collected according to directions (east,west,south,north and centre) if there were more than five water sources in the village;samples from all the water sourceswere collected if there were less than five.Fluorine content was determined with drinking water standard testmethods (GB/T 5750.2-2006).Analysis and comparison of fluoride content in drinking water of different landscapes,water types and different well depth were carried out.Results The range of water fluoride content was 0.00-18.39 mg/L,and water fluorine median was 0.24 mg/L in 1 024 water samples in 27 towns in the county.Watersamples of 490,505 and 29 copies were collected in the hills,plains and mountains,and water fluorine medianwas 0.26,0.22 and 0.21 mg/L,respectively.Concerning water fluorine content in drinking water,mountains werehigher than hills and plains (x2 =71.71,17.74,all P ＜ 0.01).There was no significant difference between waterfluoride content in hills and plains (x2 =2.48,P ＞ 0.05).Water samples of 742,228 and 54 copies were collected,respectively,in household well water,tap water and mountain spring water,and water fluoride median was 0.22,0.24 and 0.33 mg/L,respectively.Concerning water fluoridation content in drinking water,spring water were higherthan tap water and household well water (x2 =53.16,50.85,all P ＜ 0.01).There was no significant differencebetween water fluoridation content in tap water and household well water (x2 =2.97,P ＞ 0.05).Water samples of583 and 441 copies were collected,respectively,in well depth ＜ 40 m and well depth ≥40 m,and water fluoride median was 0.24 and 0.23 mg/L,respectively,and there was no significant difference between water fluoridation content in the well depth ＜ 40 m and the well depth ≥40 m (Hc =0.17,P ＞ 0.05).Conclusions Fluoride content of drinking water in Yi County is not high,endemic fluorosis disease does not occur.