Objective To investigate the effect of postconditioning with propofol and ischemia on the hepatic ischemia-reperfusion (I/R) injury in rats. Methods Thirty male SD rats weighing 200-250 g were randomly divided into 5 groups of 6 animals each: group I sham operation (group S); groupⅡ I/R; group Ⅲ ischemic postconditioning (group IPC); group Ⅳ propofol postconditioning (group PPC) and group V IPC + PPC. In group Ⅱ-Ⅳ the hepatic arteries and veins of middle and left lobes were occluded for 1 h followed by 4 h reperfusion. Ischemia of the liver was confirmed by the color of the liver turning from red to gray. In group Ⅲ and Ⅴ the livers were subjected to six episodes of 10 s ischemia at 10 s intervals at the end of 1 h ischemia before 4 h reperfusion. In group Ⅳ and V 0.5 % propofol 10 mg/kg was given iv at the end of ischemia followed by propofol infusion at 40 mg·g~(-1) ·h~(-1). Blood samples were taken at the end of 4 h reperfusion for determination of serum ALT activity. Mean-while liver specimens were taken for electron microscopic examination and determination of MDA content and SOD activity. Results I/R significantly increased serum ALT activity and MDA content in the liver and decreased liver SOD activity in group Ⅱ . The I/R-induced changes were significantly attenuated by propofol and/or ischemic postconditioning in group Ⅲ ,Ⅱ and Ⅴ . I/R significantly increased Bel-2 and Bax protein expression in the liver cells. Propofol and/or ischemic postconditioning increased Bel-2 protein expression further but decreased Bax protein expression in group Ⅲ , Ⅳ and Ⅴ as compared with group Ⅱ (group I/R).Electron microscopic examination showed that the pathologic changes induced by I/R were less severe in group Ⅲ, Ⅳ and Ⅴ than in group I/R. Conclusion Postconditioning with propofol and ischemia can reduce the hepatic I/R injury and the mechanism may be related to inhibition of lipid peroxidation and apoptosis, but the efficacy is the same as that of propofol postconditioning alone.

Objective To explore the differential diagnosis of hydrops fetalis and the rare presentations of neonatal congenital hypothyroidism. Methods The data of one congenital hypothyroidism diagnosed neonate with hydrops fetalis leading to birth asphyxia and respiratory failure were retrospectively analyzed. The relevant literatures were reviewed. Results A Uyghur female infant by cesarean delivery at gestational age of 38+5 week for intrauterine distress, presented general edema with cyanosis and dyspnea after birth. Trachea cannula was used to assist ventilation. At one-day old, the thyroid function examination showed that the serum thyroid stimulating hormone was>100 mU/L and the free thyroid was 6 . 56 pmol/L. Moreover, ultrasonographic examination indicated the thyroid aplasia. The clinical symptoms were improved after the treatment with the levothyroxine tablets replacement, and breathing machine was removed at 8-day old. The dosage of drug was adjusted by clinical manifestation and laboratory monitoring. The patient was discharged at 18-day old with the medicine and was followed-up. Conclusions Congenital hypothyroidism can be the pathogenesis of hydrops fetalis and its differential diagnosis should be paid attention.

Objective To study the determining method of trace amounts of Pb?Cd in nature water body. Methods Pb, Cd in nature water body were concentrated by on-line chelate resin, and concentration was determined by concentration-AAS. Results The Pb and Cd detection limit of the present method were 0.500,0.02 ?g/L respectively, RSD were 2.3%,1.7% respectively and the rates of recovery were 94%-104.4%. Conclusion Using on-line chelate resin concentration technic and atom absorption,the sensitivity will increase two order of magnitudes compared to concentration FAAS,the precision will be better than that of GAAS. The present method can be used for quick determination of trace Pb?Cd in nature water body.

Objective To evaluate the effect of dexmedetomidine and small dose of ketamine on the expression of P2X4 receptor (P2X4 R) mRNA and P2X7 receptor (P2X7R) mRNA in the dorsal root ganglion of rats with neuropathic pain.Methods Ninety male Sprague-Dawley rats,aged 6-9 weeks,weighing 180-220 g,were randomly divided into 5 groups (n =18 each):sham group (group S),chronic constrictive injury group (group CCI),dexmedetomidine group (group D),ketamine group (group K) and dexmedetomidine + ketamine group (group DK).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 400 mg/kg.Neuropathic pain was induced by CCI in CCI,D,K and DK groups.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1mmintervals with 4-0 silk thread.In group S,the sciatic nerves were only exposed but not ligated.In D,K and DK groups,dexmedetomidine 50μg/kg,ketamine 10 mg/kg and dexmedetomidine 25μg/kg + ketamine 5 mg/kg were injected intraperitoneally,respectively,while the equal volume of normal saline was injected in S and CCI groups,once a day for 14 consecutive days after CCI.Mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before CCI,and 3,7 and 14 days after CCI.Six animals were sacrificed after measurement of pain threshold at 3,7 and 14 days after CCI and the lumbar segments (L4-6) of the dorsal root ganglion were removed for determination of P2X4 R mRNA and P2X7 R mRNA expression by RT-PCR.Results Compared with group S,MWT and TWL were significantly decreased at 3,7 and 14 days after CCI in groups CCI,D,K and DK,the expression of P2X4R mRNA and P2X7R mRNA was up-regulated at 3,7 and 14 days after CCI in groups CCI,D and K,and the expression of P2X4 R mRNA and P2X7 R mRNA was up-regulated at 3 and 7 days after CCI in group DK (P ＜ 0.05).Compared with group CCI,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in groups D,K and DK (P ＜ 0.05).Compared with D and K groups,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in group DK (P ＜ 0.05).Conclusion The mechanism by which the combination of dexmedetomidine and small dose of ketamine produces a synergistic antinociception in rats with neuropathic pain may be related to down-regulation of the expression of P2X4 R mRNA and P2X7 R mRNA.

Objective To evaluate the effects of dexmedetomidine on the activity of cAMP response element binding protein (CREB) and c-fos in the spinal dorsal horn in a rat model of neuropathic pain.Methods Fifty-four adult male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =18 each):sham operation group (group S),chronic neuropathic pain group (group C) and dexmedetomidine group (group D).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The sciatic nerve was exposed and 4 ligatures were placed on the right sciatic nerve at 1 mm intervals with 4-0 silk thread in C and D groups.In group D,dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until 1 day before the animals were sacrificed,while the equal volme of normal saline was injected instead of dexmedetomidine in S and C groups.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured on 1 day before operation and 3,7 and 14 days after operation.The animals were sacrificed after measurement of MWT and TWL.Their lumbar segments (L4-6) of the spinal cord were removed for measurement of the expression of phosphorylated CREB (pCREB) and c-fos by immunohistochemistry.Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of pCREB and c-fos was up-regulated on 3,7 and 14 days after operation in C and D groups (P ＜ 0.05).Compared with group C,MWT was significantly increased,TWL was prolonged,and the expression of pCREB and c-fos was down-regulated on 3,7 and 14 days after operation in group D (P ＜ 0.05).MWT was significantly lower,and TWL was shorter on 3,7 and 14 days after operation than on 1 day before operation in C and D groups (P ＜ 0.05).MWT was significantly lower,TWL was shorter,and the expression of pCREB and c-fos was higher on 7 and 14 days after operation than on 3 days after operation in C and D groups (P ＜ 0.05).MWT was significantly higher,TWL was longer,and the expression of pCREB and c-fos was lower on 14 days after operation than on 7 days after operation in C and D groups (P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine reduces neuropathic pain is related to inhibition of the activity of CREB and c-fos in the spinal dorsal horn of rats.

Objective To investigate the risks and benefits of interventions promoting placental transfusion (PT) at delivery [delayed cord clamping (DCC) or umbilical cord milking (UCM)] compared with early cord clamping (ECC) on outcomes among very low birth weight infants (VLBWI).Methods A systematic search was conducted of PubMed, EMBASE, ClinicalTrials.gov, China Academic Journal Network Publishing Database and Wanfang Medical Databases (January 1965 to July 2014) for randomized controlled trial (RCT) articles relating to PT strategies (DCC and UCM) in VLBWI.The Cochrane Handbook 5.1.0 was used to evaluate the methodological quality and RevMan 5.3 software from Cochrane Collaboration was used for metaanalysis.The fixed effect or random effect model was adopted according to the result of heterogeneity, Results We identified 14 eligible studies describing a total of 659 neonates with an average birth weight ＜ 1 500 g.There were eight studies for DCC and six studies for UCM.Compared with the control, benefits of greater PT decreased any grade intraventricular hemorrhage (IVH) (nine studies, OR=0.49, 95％CI: 0.32-0.77, P ＜ 0.01), increased the blood pressure at four hours of life (eight studies, MD=4.42, 95％CI: 3.85-4.98, P ＜ 0.01), and also showed higher initial hemoglobin (Hb) level (six studies, MD=3.52, 95％CI: 1.67-5.37, P ＜ 0.01) and lower incidence of sepsis during the hospital stay (five studies, OR=0.46, 95％CI: 0.26-0.83, P=0.01).No differences were observed between the groups about the fllowing indicators (all P ＞ 0.05): 5-minute Apgar scores (MD=0.01,95％CI:-0.21-0.22), admission temperature (MD=0.13, 95％CI:-0.15 to 0.41), peak serum bilirubin levels (MD=0.59, 95％CI:-0.13 to 1.31), initial reported hematocrit (MD=3.48, 95％CI:-0.46 to 7.43), mortality before discharge (OR=0.63, 95％CI:0.31-1.25), Bell's stage 2 or greater necrotizing enterocolitis (OR=0.62 ,95％CI: 0.29-1.33), rates of transfusion due to anemia (OR=0.63, 95％CI: 0.35-1.15) and oxygen therapy at 36 weeks of corrected age (OR=0.79, 95％CI: 0.46-1.34).Conclusions It is suggested that enhanced PT (both DCC and UCM) at birth is safe and provide better neonatal outcomes than ECC for those VLBWI, most notably reduces the overall IVH occurrence and lower the incidence of sepsis.The optimal umbilical cord clamping practice and UCM among VLBWI infants remains uncertain and long-term neurodevelopmental outcomes are warranted.

Objective To study the effect of internal fixation of fibula on treatment of tibia and fibula unstable fractures. Methods 50 cases with middle and lower 1/3 fractures of tibia and fibula were treated with internal fixation of fibula and close reduction and external stabilization of tibia. Fibula was stabilized with plate and screw or intramedullary nail. Results All the 50 cases of the fracture achieved clinic union, reduction was satisfactory, and the average time of clinical union was 5 months. The functions of the joint were normal. No skin necrosis or infection occurred. Conclusion Fixation of fibula is suitable for treatment of close fracture combined with local skin injury or open fractures of tibia and fibula and lower 1/3 comminuted fracture of tibia combined with fibula fracture.

Objective To improve the understanding of drug-induced lupus (DIL) and the differences from systemic lupus erythematosus (SLE).Methods Clinical manifestation and treatment of patients with definite DIL were retrospectively analyzed.Results Six patients with DIL were enrolled in this study,including 4 females and 2 males.Two patients were diagnosed after receiving interferon,one after soluble tumor necrosis factor receptor fusion protein,one after propylthiouracil,one after penicillamine,and one after levofloxacin.High titer of antinuclear antibody was identified in all six patients,including 3 with positive anti-dsDNA antibody.One patient had positive anti-Sm antibody.One patient had positive anti-RNP antibody.One patient had anti-nucleosome antibody.One patient had anti-histone antibody.One patient had antimitochondrial antibodies-M2,and one patient had anticardiolipin antibodies.Conclusion Patients with DIL are not as severe as those with SLE.After cessation of suspected drugs and administration of standard treatment,the clinical outcome of DIL is satisfying.

OBJECTIVE:To investigate new thought and method for improving the practice teaching effect of pharmacy under-graduates under the collaboration of medicine and education. METHODS:The training objectives of pharmacist team,the current sit-uations and problems of teaching that existing in the institute of pharmacy and the requirement of talents in the work were summa-rized and investigated,and then reform targets and measures were put forward. RESULTS:Training for pharmacists tream gradual-ly movedcloser to clinical pharmacists in China.The teaching work in the pharmacy department of our hospital was relatively com-plete,including relevant teaching system,practice systems and processes,training program for clinical pharmacists and develop-ment of workflow;however,there still remained some problems,including lacking of professional quality training,suitable cours-es,effective interactive medical and education scientific assessment mode and no attention for the training of clinical thinking and school-university research thinking. The above-mentioned problems needed to be solved by reforming internship tutorial system and improving the contents,establishing the school-hospital united system,emphasizing the connection between schools and teaching bases,establishing integrated teaching evaluation system and assessment criteria,strengthening clinical experience and training for clinical thinking by the teaching mode of physicians and pharmacists. CONCLUSIONS:Strengthening the collaboration of medicine and education and improving the training standards and evaluation system are helpful for improving the practice teaching quality of pharmacy undergraduates.

OBJECTIVE To observe the preventive effect of and to study the immunomechanism of Fangan 1 prescription (traditional Chinese medicine prescription) on repetitive upper respiratory infection in aged people. METHODS Sixty five old patients with repetitive upper respiratory infection as study objects were divided randomly into treatment group and control group and their T lymphocyte subset was detected. RESULTS CD3 and CD4 were decreased in different degree among them, the difference was significant in comparison with the healthy aged (P