Heart failure is one common critical cardiovascular disease in children.Angiotensin convening enzyme inhibitors plays an important role in the treatment of pediatric heart failure.In this paper,the pharmacological mechanism,pharmacokinetics,clinical studis and application of angiotensin converting enzyme inhibitors in the treatment of pediatric heart failure were concerned.

OBJECTIVE:To investigate the effects of gemcitabine combined with radiotherapy and chemotherapy on angiogen-esis and cell invasion ability of cervical cancer. METHODS:Totally 37 patients undergoing radical operation selected from Chongq-ing Kaizhou District People's Hospital during Jan. 2015-Jun. 2016 were divided into observation group(n=19)and control group (n=18). Control group was given 3-D conformal radiation and chemotherapy which included Cisplatin injection 70 mg/m2,ivgtt+Fluorouracil injection 600 mg/m2,ivgtt on 1st and 21st day after radiotherapy. Observation group was additionally given Gemcitabi-ne hydrochloride for injection 800 mg/m2,ivgtt,1st and 8th day after radiotherapy. A treatment course lasted for 28 d. The radical hysterectomy and pelvic lymphadenectomy were conducted after 2 courses of treatment. Clinical efficacy,microvessel density (MVD) of tumor,vascular endothelial growth factor (VEGF),Wnt1,Wnt3a,Wnt8 and β-catenin level were observed in 2 groups. The relationship of MVD with VEGF was analyzed,and the occurrence of ADR was recorded. RESULTS:The total re-sponse rate of observation group(84.2%)was significantly higher than control group,with statistical significance(P<0.05). The levels of MVD,VEGF,Wnt1,Wnt3a,Wnt8 and β-catenin in 2 groups were significantly higher than healthy tissue;above index-es of focus tissue in observation group were significantly lower than control group,with statistical significance (P<0.05). MVD was positively correlated with VEGF. There was no statistical significance in the incidence of ADR between 2 groups (31.6% vs. 27.8%,P<0.05). CONCLUSIONS:Gemcitabine combined with radiotherapy and chemotherapy can regulate the angiogenesis of cervical cancer cell and the activity of Wnt/β-catenin signal pathway,and reduce the invasion ability of cervical cancer cell,which may be the important mechanism of anti-tumor effect with good safety.

Objective To studythe preventive effects of modified Dihuang decoction on the relapse of urinary calculus after caiculus removed or destroyed.Methods 306 cases were randomly divided into a trealment group (with 149 cases)and a control group(with 157 cases).The trealment group was interfered with modified Dihuang decoction for 6 years,and the control group was not interfered with any medicine.Observe the relapse number in the two groups.Results There were 8 cases relapsed in the treatment group(5.4%)comparing with 46 cases relapsed in the control group(29.3%),showing a significant difference (P＜0.01).Conclusion Medified Dihuang decoction has apparent effects in preventing relapse of urinary calculus.

Chronic renal failure is clinical syndrome manifested as hypoactivity of renal function that can be caused by manifold diseases. CRF is difficult to be treated and has bad prognosis. In recent years, according TCM physiological and pathological mechanism, doctors have achieved good effects in preventing and delaying CRF in its early and middle stage by adopting the therapeutic principle of expelling toxin, strengthening body resistance, and promoting blood circulation to dissipating blood stasis.

Thirty six patients with hypertriglyceridemia and impaired glucose regulation or newly diagnosed type 2 diabetes, whose fasting plasma glucose was ≤8.0 mmol/L, were treated by fenofibrate for 3 months. Lipid profile, insulin during intravenous glucose tolerance test and oral glucose tolerance test ( including glucose) were measured before and after treatment After treatment, lipid profile was significantly improved. Insulinogenic index (△I30/△G30) and acute insulin response were significantly increased (98. 9vs. 129. 2, 3558.9 vs. 4783. 3 pmol · L - 1 · min - 1, respectively, P ＜ 0. 05 ). Fasting insulin and insulin resistant index in homeostasis model assessment ( HOMA IR) decreased ( 128. 6 vs. 84. 8 pmol/L, 4. 8 vs.3.0, respectively, P ＜0. 05 ). The improvement of insulin secretory function was more significant in patients with higher triglyceride (TG ＞ 3. 3 mmol/L). These results indicate that short-term lipid-lowering treatment with fenofibrate can improve β-cell function and insulin resistance. Patients with higher triglyceride are likely to achieve more benefit from lipid-lowering treatment.

[Objective] The study was conducted to investigate the effect of micronized fenofibrate on acute insulin response in the subjects with impaired glucose metabolism and hypertriglyceridemia. [Methods] Fifty-three subjects were randomly (2:1 ratio) allocated to fenofibrate group (n=36, including IFG 3 cases, IGT 19 cases, IFG/IGT 6 cases, T2DM 8 cases) or control group (n = 17, including IFG 1 case, IGT 9 cases, IFG/IGT 4 cases, T2DM 3 cases) without any intervention for 3 months. Fasting blood samples were collected for measuring fasting plasma glucose (FPG), free fatty acids (FFA), and lipid profile. IVGTTs were carried out with measurement of plasma insulin before and after treatment. Acute insulin response (AIR), the maximum insulin concentrations (C_(INS,MAX)) to fasting insulin (FINS) ratio (C_(INS,MAX)/FINS) and values of the maximum insulin concentrations increment (△C_(INS)) during IVGTT were calculated as indexes of first-phase insulin secretion. HOMA insulin resistance index (HOMA IR) was used for assessing insulin resistance. [Results] After 3-month treatment, the lipid profile was evidently improved in fenofibrate group. Levels of trigiyceridemia (TG), low-density lipoprotein cholesterol and FFA were significantly reduced and high-density lipoprotein cholesterol increased significantly. Waist circumference was also significantly declined. No change of above indicators was found in control group. In fenofibrate group, C_(INS,MAX)/FINS and △C_(INS) were significantly increased (median 8.4 pmol/L vs. 5.3 pmol/L, 808±473 pmol/L vs. 660±472 pmol/L, both P<0.0001), along with great improvement of AIR (5 585±3 441 pmol·L~(-1)·min~(-1) vs. 4 444±3 642 pmol·L~(-1)·min~(-1), P<0.0001). The level of FINS and HOMA IR was also markedly reduced (108±65 pmol/L vs. 166±115 pmol/L, P = 0.002; 3.8±2.3 vs. 6.0±4.2, P = 0.001). In contrast, there were modest declining in acute insulin response (AIR: 4 313～1 943 pmol·L~(-1)·min~(-1) vs. 5 362±2 861 pmol·L~(-1).min~(-1); C_(INS,MAX)/FINS: median 4.6 vs. 7.0, P= 0.01; △C_(INS): 641±286 pmol/L, vs. 720±321 pmol/L, P= 0.003 9) and increasing HOMA IR (7.8±4.2 vs. 5.6±3.2, P<0.000 1) in control group after 3-month follow-up. The improvement of AIR was correlated with the decreasing of plasma FFA and TG (r=0.41, 0.36, P = 0.002, 0.014), but no correlation with the changing of FPG and HOMA IR. [Conclusions] These results indicated that sbort-term lipid-lowering treatment with fenofibrate evidently improved acute insulin response and alleviated insulin resistance in subjects with impaired glucose metabolism and hypertriglyceridemia. Moreover, the improvement of insulin secretion capacity may be mainly due to the relieving of iipotoxity resulting from finofibrate.

Objective: To establish a determination method for free salicylic acid in paracetamol, caffeine and aspirin powder by HPLC.Methods: The column was Welch Ultimate(C) C 18 (250 mm× 4.6 mm , 5 μm), the mobile phase was acetonitrile-tetrahydrofuran-glacial acetic acid-water(22∶5∶5∶68), the detection wavelength was 303 nm, and the flow was 1.0 ml·min-1.Results: The linear range of hydrochloride was 1.500-75.000 μg·ml-1 (r=0.999 9), the average recovery was 99.12% with RSD of 0.75% (n =9),and the detection limit was 1.5 ng (S/N =3).Conclusion: The method is simple, the result is accurate with higher sensitivity and the better reproducibility, which can be used for the determination of free salicylic acid in paracetamol, caffeine and aspirin powder.

Objective To compare the efficacy,toxicity and prognosis on treating advanced non-small-cell lung cancer (NSCLC) between using weekly docetaxel (DOC) and using DOC associated with nedaplatin(NDP).Methods 56 cases of NSCLC patients were retrospectively analyzed.Group A included 34 cases who were treated with weekly DOC (35 mg/m2,dl,8).Group B included 22 cases who were treated with DOC associated with NDP (DOC 35 mg/m2,dl,8,NDP 80 mg/m2,d2).One treatment cycle was 21 days.Efficacy,toxicity and prognosis were evaluated after 2 treatment cycles.Results RR of group A was 8.8 ％ (3/34).RR of group B was 27.3 ％ (6/22).DCR of group A was 50.0 ％ (17/34).DCR of group B was 63.6 ％ (14/22).PFS of group A was 2.3 months.PFS of group B was 5.1 months.OS of group A was 8.7 months.OS of group B was 10.5 months.1-year survival rate of group A was 26.5 ％.1-year survival rate of group B was 31.8 ％.The above comparisons were not statistically different (all P ＞ 0.05).In adverse reactions,hematologic toxicity in group B was greater than that in group A (x2 =4.877,P =0.027).Other adverse reactions such as gastrointestinal reactions,fatigue and so on were grade Ⅰ-Ⅱ.Conclusions The treatment of weekly DOC used in advanced NSCLC is safe,effective an low toxicity.There are no significant difference of RR and PFS between single DOC and DOC associated with NDP.

Objective To investigate the role of deferoxamine pretreatment for hepatic ischemia reperfusion injury in liver auto-transplantation in rats. Method Murine liver auto-transplantation model was established. Ninety six male Sprague-Dawley rats were randomly divided into three groups: 32 rats in deferoxamine pretreatment group (D), 32 rats in control group with aqua pro injection pretreatment(C) and 32 rats in sham-operation group (S). The animals were killed at 30 min, 2 h, 6 h, 24 h after operation respectively. ALT and AST level, superoxide dismutase (SOD) and malondialdehyde (MDA), liver histological change(HE), the protein expression of HIF-1α、TNF-α and IL-1 were measured. Results At 30 min, 2 h, 6 h, 24 h after operation, the levels of ALT,AST,MDA and the expression of IL-1 protein and TNF-α protein were higher in group C than group D significantly,while the expression of HIF-1α and SOD were higher in group D [SOD(411±70; 384±53; 379±46)、H1F-1α(0.0413±0.0040; 0.0684± 0.0032; 0.0583±0.0032; 0.0491±0.0026)] than group C significantly (P<0.01) [SOD(341±21; 323±25; 303±25)、HIF-1α (0.0254±0.0024; 0.0312±0.0022; 0.0381±0.0022; 0.0257± 0.0015)] (F>59.881;P<0.01). Conclusion The up-regulated expression of HIF-1α, decreased liver lipid peroxidation injury and TNF-α and IL-1 levels, may be involved in the mechanism hy which deferoxamine pretreatment protects liver from ischemia reperfusion injury in rats' liver auto-transplantation.

Objective To study molecular adsorbent recycling system (MARS) in the treatment of patients with acute liver failure waiting for liver transplantation. Methods The effects of MARS artificial liver treatments in 16 cases were reviewed. Results There was a remarkable improvement in clinical symptoms and physical signs after MARS treatment, including significant decrease in prothrombin time, total bile acid, level of alanine aminotransferase, aspartate aminotransferase, creatinine, and blood ammonia (P＜0.05＝;There was no statistical change in NO,TNF-α and IL-10(P＞0.05).Sequential organ failure assessment(SOFA)score decreased from 9.91±1.09 to 6.64±1.76 and Glascow coma score increased from 7.29±2.06 to 13.26±2.14.Fourteen patients were tided over to liver transplantation among them 13 patients survived and were successfully discharged from the hospital. The survival rate was 89.5%.Conclusion MARS is a safe and effective assistant device in bridging acute liver failure patients to liver transplantation.