Clinically, chronic obstructive pulmonary disease (COPD) and coronary heart disease (CAD) often interact to promote disease progression. This article discussed that zongqi is the heart-lung correlation functional basis and yingwei relevant is heart-lung correlation core. Zongqi deficiency is the incidence basis of COPD and CAD from the pathology. Communication and transformation of nutrient and defensive qi is the core mechanism of COPD combined with CAD. Phlegm and blood stasis are toxic intricate. Further damage to jingqi is the key to combination of COPD and CAD. It lays the foundation for next clinical syndrome differentiation, development of comprehensive treatment programs and clinical research.

Objective To study the correlation with ketamine and its metabolite norketamine concentration in plasma and saliva in acute toxic rabbits.Methods Experimental rabbits were given intragastric(i.g.group,n=6)and intravenous(i.v.group,n=6)administration of ketamine respectively,and control tabbits(n=6)were given a same volume of physiologic saline.The plasma and saliva were collected before and after ketamine administration.Ketamine and norketamine in plasma and saliva were determined using GC/MS and GC.The correlation with ketamine(norketamine)concentration in plasma and saliva were artalyzed by a double variable Pearson correlation analysis.Results The correlation coefficients(r)of ketamine (norketamine)concentrations in plasma and saliva were from 0.80 to 0.95 in ketamine i.g.group and i. v.group.Conclusion There is a good relativity between the concentration of ketamine(norketamine)in plasma and in saliva.The ketamine(norketamine)concentration in saliva can be used to estimate the plasma concentration in the forensic identification of ketamine abuse.

Objective To analyze the relationship between plasma aldosterone level and gestational diabetes melli?tus. Methods All subjects were divided into three groups (n=20 in each group):gestational diabetes mellitus (GDM) group, pregnancy with normal glucose group,non-pregnant healthy women group. Pre-pregnant body mass index (BMI) was calcu?lated, and fasting blood glucose (FBG), blood lipid level, Fins, HOMA-IR index, RASS, PRA, ATIi and ALD were examined besides glucose intolerance test. Results The plasma ALD level was significantly higher in GDM group than that of NGT group and control group(pmol/L:1 130.15±135.45 vs 1 053.98±108.86 vs 544.31±127.97). The plasma ALD level was posi?tively correlated with FBG,1 h PBG ,2 hPBG,Fins , HOMA-IR and blood triglyceride (r=0.657, 0.757, 0.713, 0.429,P<0.05),but negatively correlated with HDL-C(r=-0.267,P=0.039). Stepwise regression analysis revealed that plasma aldo?sterone was the independent risk factor of GDM. Conclusion RASS is excessively activated in pregnancy, which contrib?utes to gestational diabetes mellitus.

Objective To investigate the influence of ethanol on the toxicokinetic profiles of ketamine and its main metabolite norketamine in rabbits.Methods Ketamine hydroehloride Wills administered orally to the rabbits at a dose of 15mg/kg in the ketamine-treated group.Ketamine hydrochloride combined with ethanol at a dose of 15 mg/kg and 3.0g/kg respectively was administered orally to those of the ethanol-coadministration group.The serum and urine samples were collected before administration and at different time points after drug delivery.The concentrations of ketamine and norketamine were determined by GC and GC/MS.Compartment model and toxicokinetics parameters were assessed by WinNorLin program.Results The mean serum concentration-time profile of ketamine after oral administration was fitted to a two-compartment open model with first order kinetics and not affected by ethanol.The K_(10),AUC and β of ketamine in rabbits of ethanol-coadministration group increased as compared with those of ketamine-treated rabbits,while T_(1/2K_(10)),T_(1/2β),A and C_(max)decreased(P＜0.05).Meanwhile,the K01,A,B and C_(max) of norketamine,the metabolite of ketamine increased in ethanol-coadministration group and T_(1/2K01) and Tmax were lowered than those in ketaminetreated group(P＜0.05).Difference of the other toxicokinetics parameters including V/F,K_(10),K_(12),K_(21),AUC,T_(1/2K_(10)),T_(1/2α),T_(1/2β) and β were not statistically significant between two groups(P＞0.05).Conclusion Ethanol may accelerate elimination of ketamine and the metabolism of ketamine to norketamine and has little effect on the absorption of ketamine,suggesting that interaction between ethanol and ketamine should be considered in cases of co-abuse of the two drugs.

Background and purpose:Esophageal cancer(EC) is one of the most common cancers that account for cancer-related deaths and over 400,000 new cases has been diagnosed per year.The morbility of small cell carcinoma of the esophagus(SCEC) is very low.This paper was to study was the clinical characteristics,treatment and prognosis of undifferentiated small cell carcinoma of the esophagus(SCEC).Methods:From 1961 to 2003,743 patients with SCEC were treated in different hospitals.The number of small cell carcinoma of the esophagus seen accounted for 1.38% of esophageal cancer treated in those hospitals in the same period.the average age was 56.8(range,51 to 66).511 of patients were male and 232 female.2 of them had primary tumor in the cervical proportion of the esophagus,68 in the upper thoracic proportion,420 in the mid thoracic proportion,252 in the lower proportion and 1 in the whole esophagus.88 patients were treated by surgery alone,23 by radiotherapy alone,24 patients by chemotherapy alone and all other of patients were treated by combined modality.Results:The median survival was 12.4 months for all patients,with 10.8 months for surgery,6.2 months for radiotherapy,6.6 months for chemotherapy,14.7 months for surgery combined with radiotherapy,16.1 months for surgery combined with chemotherapy,12.3 months for chemoradiotherapy and 16.2 months for surgery combined with chemoradiotherapy,respectively.The survival rates at 1,2,3,4,and 5 years were 56.4%、27%、19.3%、11.1%、(9.7%) for the whole group,respectively.Conclusions:We recommend that combined modality should be used for SCEC.The combination of surgery and multi-drug chemotherapy may improve the treatment outcomes for the patients with early stage SCEC.

Objective To investigate the possible mechanism of mitochondrial in chronic myeloid leukemia cells K562/G01 cells apoptosis induced by triptolide.Methods K562/G01 cells were treated with different concentrations of triptolide.MTT assay was used to assess cytotoxic effect.FCM was used to determine apoptosis rate,mitochondrial membrane potential and the activity of Caspase-9 of each experimental group.Real-time quantitative PCR assay was used to quantify mRNA levels of Caspase-9 and cytochrome C and Western blot assay was used to determine protein levels of cytochrome C.Results Triptolide inhibited the growth and proliferation of K562/G01 cells in a time-and dose-dependent manner (both P ＜ 0.001).Meantime,triptolide could make the mitochondria membrane potential fade away and enhance the activity of Caspase-9 (F =566.431,2 555.485,P ＜ 0.001).In addition,triptolide could dose-dependently up-regulated the transcription of Caspase-9 and cytochrome C (F =61 007.702,452 121.760,P ＜ 0.001),and the protein expression of cytochrome C,whose gray value in each experimental group was 21.54±0.59,39.63±0.58,53.29± 1.47 and 75.68±1.87 (F =5 677.928,P ＜ 0.001) respectively.Conclusion Triptolide could potently inhibit the growth and proliferation of K562/G01 cells,and the mitochondria apoptosis pathway might be one of the important apoptosis mechanisms in chronic myeloid leukemia cells induced by triptolide.

Objective To evaluate the epileptic focus localization value of MSI in patients with refractory epilepsy and encephalomalacia. Method MSI examination was proceeded in 11 patients with refractory epilepsy and encephalomalacia. Five of them were treated with gamma-knife; the others were treated with surgery. Results In the five patients treated with gamma-knife, the result was satisfied in 3 patients, one patient improved significantly, the other one useless. The distance between the encephalomalacia and the epileptic focus was 4cm in one patient; one patient′s encephalomalacia was located in right frontal-parietal lobe but the epileptic focus mainly located in right temporal lobe, only a little located around the encephalomalacia. Overall agreement among VEEG,ECoG and MEG (presence of concordant spikes with the same localization shown by three techniques) was obtained in three patients, the areas localized by ECoG were larger than VEEG and MSI in two patients. The localization was different in VEEG, MSI and ECoG in one patient, then he was given a resection of bilateral occipital epileptic focus. The results of patients treated with surgery were satisfied. Conclusion The MSI localization of epileptic focus in patients with refractory epilepsy and encephalomalacia is precise, and it can direct the advanced clinical treatment.

OBJECTIVETo analyze the status and characteristics of dental manpower in the center for disease controls (CDC) in Sichuan Province and to provide more evidence for strengthening the oral healthcare workforce in the CDC system.

METHODSA mass survey on dental manpower was made in CDCs in Sichuan Province through questionnaire investigation. Data were collected and entered with the Epidemiological Dynamic Data Collection (EDDC) platform and analyzed with SPSS 13.0 software.

RESULTSSichuan Province had 0.15 hospitals providing oral health services and 0.38 dentists on average per 10,000 people. About 65.53% (135/206) of the CDCs had one department responsible for the oral health service. However, oral health care personnel comprised only 2.23% (237/10,624) of the personnel of the whole CDC system. About 64.67% (119/184) of county CDCs and 47.62% (10/21) of city CDCs knew well the dental health status of local residents. Less than 5% of the CDCs used the data and assisted in the policy making of public health administrators.

CONCLUSIONThe dental care personal deficit exists in the CDC system in Sichuan Province. The distribution and composition of dental manpower are not reasonable. The oral health service ability of CDCs in Sichuan Province should be strengthened and improved.

Objective To investigate the status of life quality in the elderly in Shanxi Province Changzhi City, and to analyze its influencing factors. Methods The quality of life, activities of daily living and status of community services were measured simultaneously by 36-Item Short Form Health Survey (SF-36). Activities of Daily Living Scale, Community Healthy Needs Scale and survey results were used and analyzed using t-test, correlation and stepwise regression analysis. Results According to the criterion of life quality in the elderly which were proposed by Zhang Lei, the quality of life in the elderly scored 72. 1-117.0, reached 98.5%. The quality of life in the elderly was impacted by the ability of caring oneself, marital status, degree of culture, economic situation and so on. The demand rate for health guidance and periodic physical examination was higher. Conclusions The quality of life in the elderly is at a medium level. There is a wide gap between the demand of community healthy services and the utilization of community healthy services.

Aim To study the effect of Tongxinluo on the polarization of macrophages to type M2 and M1, and on Notch signaling pathway.Methods THP-1 was respectively induced by PMA and IL-4 or LPS to M2 and M1 type polarized macrophages, and treated by Tongxinluo.The expressions of marker molecules IL-10, TNF-α, IL-6 and protein of Notch signaling pathway were detected.Results The level of IL-10 increased in M2 group and there was no statistical difference on the level of IL-6 and TNF-α;the level of IL-10 decreased and IL-6, TNF-α increased in M1 group;the level of IL-10 increased and IL-6,TNF-α decreased in TXL group.There was no statistical difference in the expression of active Notch-1, DLL4 and Hes-1 between control group and M2 group;the expression of active Notch-1, DLL4 and HES-1 increased significantly in M1 group;the expression of active Notch-1, DLL4 and HES-1 decreased significantly in TXL group;there was no significant difference in the expression of Notch-1 protein in each group.Conclusion The polarization of macrophages to M1 type can be inhibited by Tongxinluo, and its mechanism may be related to the inhibition of activation of Notch-1 signaling pathway.