BACKGROUND: Ischemic preconditioning (IPC) can effectively improve the ischemic resistance of skeletal muscle and reduce the necrotic areas during ischemia-reperfusion; However, the impacts of IPC on contractile function of skeletal muscle during ischemia-reperfusion is unclear.OBJECTIVE: To investigate the effect of IPC on contractile function of skeletal muscle during ischemia-reperfusion.DESIGN: A randomized controlled study by employing experimental animals as subjects.SETTING: Tongji Medical College, Huazhong University of Science and Technology and the 252 Hospital of Chinese PLA.MATERIALS: The experiment was completed in the 252 hospital of Chinese PLA. Totally 14 healthy SD rats were involved.METHODS: A rat right hindlimb ischemic model was utilized, 14 SD rats were randomly divided into control group and experimental group. Control group: sustained ischemia for 4 hours and reperfusion of 1 hour. Experimental group: ischemia for 5 minutes and reperfusion for 5 minutes, after 3 cycles, ischemia for 4 hours and reperfusion for 1 hour continuously of IPC.The isometric twitch contractile force of the right gastrocnemius muscle was measured as a parameter indicating the muscle functional status during is chemia reperfusion. The changes of creatine kinase (CK), malondialdehyde (MDA) in blood sample and the uptake of 99Tcm-methylene diphosphonate (99TcmMDP) in skeletal muscle were measured after 1 hour of reperfusion.MAIN OUTCOME MEASURES: The impacts of IPC on contractile force of gastroenemius and serous CK, MDA and the uptake of 99TcmMDP.RESULTS: The muscle contractile force in the experimental group after four hours of ischemia was (14.32 ± 5.05) g or (25.71 ± 7.58) g after one-hour reperfusion, which was significantly higher than 0 g or (4. 73 ± 2.05) g of control group(P ＜0. 05). The serous levelsofCK [(104.85 ±9. 84) nkat/L], MDA [ (3 988.60 ± 455.92) nmol/L] and the uptake of 99TcmMDP [ (56.0± 8.1 ) mBq/g per minute] were significantly lower in the experimental group than control group [CK(136.36 ± 14.50) nkat/L, MDA (6 542.90±536.72)nmol/L, and 99TcmMDP (97.3 ±5.8) mBq/g per minute, P＜0.05, P ＜0.01].CONCLUSION: IPC can effectively ameliorate the contractile force of skeletal muscle and reduce the necrotic degree of skeletal muscle. Therefore, IPC has a protective effect on the contractile force of ischemic skeletal muscle.

Objective To evaluate the lethal effect of adenovirus-mediated Ad-hTERTp-HSV-TK/GCV suicide gene system in combination with oxaliplatin (L-OHP) on human hepato carcinoma cell line HepG2 in vitro.Methods It was used that the replication-defective adenovirus carring the HSV-TK gene under control of the hTERT promoter to transfer the HepG2 cells in vitro. Human hepato carcinoma cell line HepG2 was transfected with MOI=100. It was studied that the grow inhibitory effct with Ad-hTERTp-HSV-TK/GCV therapy, oxaliplatin, Ad-hTERTp-HSV-TK/GCV therapy in combination with oxaliplatin through different drug concentration on human hepato carcinoma cell line HepG2. The growth inhibition rate of HepG2 cells was determined by trypan blue exclusion assay and MTT.Results The growth of HepG2 cells Ad-hTERTp-HSV-TK/GCV, oxaliplatin, and combination of Ad-hTERTp-HSV-TK/GCV and oxaliplatin was significantly slower.The more concentration the greater inhibition of cell growth. The growth inhibition rate of combined Ad-hTERTp-HSV-TK/GCV with oxaliplatin was 86.63 %.The growth inhibition rate of Ad-hTERTp-HSV-TK/GCV was 72.12 % compared to the combined therapy (P =0.023). The growth inhibition rate of oxaliplatin was 59.41% compared to the combined therapy (P =0.019). Combination of Ad-hTERTp-HSV-TK/GCV and oxaliplatin resulted in greater inhibition of cell growth compared with TK gene and L-OHP (P ＜0.05).Conclusion HSV-TK/GCV in combination with L-OHP can enhance thelethal effect of suicide gene therapy against HepG2 cells.It is more targetable than the function of single drug therapy.Also, it could reduce drug level and plays an important role on the future's clinical medication.

Objective To investigate the clinical efficacy of transthoracic echocardiography (TTE) in catheter interventional treatment of congenital heart disease. Methods 57 patients with congenital heart disease were selected by preoperative TTE screening and then received Amplatzer occluder interventional treatment under X-ray monitoring. 23 of them were atrial septal defect (ASD), 29 were ventricular septal defect (VSD), 4 were patent ductus arteriosus (PDA), and one was VSD complicated with ASD. Results All the patients were treated successfully. The occlusion effect was observed by follow-up immediately after the procedure, and one week, one month, three months, six months, and one year after the procedure. The position of the occluder did not change, the surrounding of the occluder has no residual shunt. 3 cases of ASD and 2 of VSD were failed to plugged. Conclusions TTE has important clinical values in selection of the patients with indication , intraoperative detection of the release of Amplatzer, and postoperatve assessment of the efficacy.

Objective To observe the effect of Ad-bTERTp-HSV-TK/GCV system on malignant ascites of mice and probe into its mechanism of action.Methods The SX1 inbred strain mice were injected with H22 cell line of liver cancer and were divided into 4 groups at random.The mice in each group were given corresponding treatment after 48 hours.The production of ascites and survival period were evaluated. The apoptosis rates of tumor cells were detected by FCM.Morphological changes of tumor cells were studied by electromicroscope.Results Compared with other groups.Ad-hTERTp-HSV-TK/GCV Can obviously inhibit the production of ascites(P<0.01),prolong the survival period (P<0.01),and apoptosis rate in this group (27.12±2.12)% was significantly higher than that in other groups.No obvious side effect Was found during the treatment.Conclusion Ad-hTERTp-HSV-TK/GCV system Can inhibit production of ascites and prolong the survical period of mice by inducing apoptosis of hepatoma cells,which is a safe and feasible treatment for hepatoma therapy.

The training of clinical pharmacists in pain specialists often focuses on the education of professional knowledge,while neglecting the important role of ethics in the teaching process.Ethical elements such as the patient's right to informed consent,privacy,health,autonomy have not received sufficient attention in the teaching process.This training model poses a potential threat to patients'rights and interests and may bring ethical risks to pharmacists.To improve teaching quality and avoid risks,lecturers and trainees should deeply understand and respect the various rights of patients,safeguard their right to health from infringement,and ensure that privacy is fully protected.In addition,the patient's right to informed consent should be implemented to allow them to make autonomous choices based on a full understanding of the treatment plan,and humanistic care should be strengthened so that patients can feel the warmth and care from the pharmacists.Through the implementation of ethical measures,the paper aims to provide useful inspirations and references for the teaching work of clinical pharmacists in pain specialists,thereby promoting clinical pharmacists to achieve comprehensive improvement in professional skills and ethical literacy,and better serving the majority of pain patients.