Objective To discuss the reason of pain on the shoulders and epigastrium after the reprotenal laparoscopic operations. Methods One hundred and eight patients had undergone the laparoscopic adrenalectomy or laparoscopie renal cyst unroofing. They were divided into two groups at random, group A and group B. In group A, discharged CO2 as soon as finished the operation, but did not in group B. At the same period, there were 49 patients who had received retroperitoneal laparoscopic radical nephrectomy, divided into two groups by the CO2-pheunopertomeum time, group C and group D. In the group D, the CO2-pheunopertomeum time was over 90 minutes, and the time was less than 90 minutes in the group C. Evaluated the pain degree through the vision analogue score (VAS) and recorded the pH,PaO2, PaCO2,BE in the arterial blood in group A and B before and after operation. Results The incidence rate of pain postoperation was significantly higher in group B than A (P < 0.05). In group A and group B, there was no difference in PaCO2, PaO2, pH, BE in the arterial blood(P > 0.05 ). The incidence rate of pain and the grade of VSA both were significantly higher in group D than group C (P < 0.05). Conclusions The stimuli of acid materials such as carbonate that derived from postoperative residual CO2 is probably the main cause of the pain on the shoulders and epigastrium after the laparoscopicsurgery.

Objective To compare the efficacy of valsartan,benazepril and felodipine on reversal of left ventricular hypertrophy(LVH)in patients with hypertension and the relevant "aldosterone escape phenomena".Methods One hundred eleven patients with hypertension-related LVH were randomly to receive valsartan(80-160 mg/d,n=36),benazepril(10-20 mg/d,n=39)and felodipine(5 mg/d,n=36).Plasma angiotensin Ⅱ(Ang Ⅱ)and aldosterone(Ald)were determined before and 10-14 weeks 20-26 weeks after treatment.Echocardiographic examinations and blood routine,urine routine,blood glucose,blood lipid,liver function and renal function were conducted in all subjects before and after treatment.Results Blood pressure was significantly decreased in all three groups(P0.05).Valsartan increased plasma Ang Ⅱ at 10-14 weeks and furthermore at 20-26 weeks;benazepril decreased plasma Ang Ⅱ initiatively with trend of rebound at 20-26 weeks;however,plasma Ang Ⅱ was kept constantly in felodipine group.Valsartan decreased Ald and sustained during the all treatment period.On contrary,benazepril initiatively decreased Ald which was rebound to baseline level at 20-26 weeks.No change in Ald by felodipine was found during the treatment.After treatment plasma Ald level was significantly related to the reduction of LVH in both valsartan and benazepril groups.36% patients in benazepril group was found to have "aldosterone escape".Conclusion The antihypertensive effect was similar between valsartan,benazepril and felodipine.Although three medications all reversed LVH,but valsartan,benazepril was more effective than felodipine.There was no evidence of aldosterone escape in the long-term treatment with valsartan.Valsartan might have more advantages in reversal of LVH than benazepril.Felodipine had no effect on the plasma level of aldosterone.

Objective To study the effects of Yunnan BaiYao on the expressions of c-fos and c-jun mRNA in HPDLFs and explore the potential mechanism that Yunnan BaiYao promotes the proliferation and differentiation of HPDLFs.Methods The HPDLFs tissue was obtained from the extracted healthy premolar.The HPDLFs used underwent four to six passages.Cells were divided into untreated group,positive control group and treated group.In treated group,HPDLFs were co-cultured with Yunnan BaiYao solution for 4h with gradient concentration.The expressions of c-fos and c-jun mRNA were determined by RT-PCR.Results The results showed that the expressions of c-fos and c-jun mRNA were up-regulated significantly in treated group compared with control group (P＜0.05) Conclusion Yunnna BaiYao can upregulate the expressions of c-los and C-jun mRNA in HPDLFs.Through upregulating the expressions of c-fos and c-jun mRNA in hPDLs,Yunnan BaiYao can promote proliferation and differentiation of ossification of HPDLFs to induce bone formation.

Aim To investigate the influence of total fl avones of buckwheat flower (TFBF) on the productivity of the non-enzymatic advanced glycation end products (AGEs) in vivoand vitro. Methods TFBF in different dosages (0.1 g?kg -1?d -1,0.2 g?kg -1?d -1,0.4 g?kg -1?d -1) was taken orally by streptozotocin-induced diabetic rats for 12 wk. After the treatment, blood glucose, fructosamine and AGEs in plasma and kidney were measured. Meanwhile, glucose and bovine serum albumin (BSA) were incubated with TFBF at different concentrations (0.01 mg?L -1,0.05 mg?L -1,0.10 mg?L -1) respectively for 4,8,12 wk.The fluorescence intensity of glycated BSA was detected by a spectrophotometer BSA was detected spectrophotometer.Results TFBF significantly lowered the level of blood glucose in diabetic rats (P

ObjectiveTo research the relationship between the plasma levels of myeloperoxidase (MPO) and the onset and progress of acute coronary syndrome (ACS) and the severity of coronary lesions in patients with ACS.MethodsSeventy-eight patients hospitalized with chest pain were enrolled,including 41 patients with ACS (ACS group),17 patients with stable angina pectoris(SAP,SAP group) and 20 patients serving as control (control group).Forty-one patients undergoing coronary angiography were divided into single vessel lesions group (7 patients),double vessel lesions group (7 patients),multiple vessel lesions group ( 12 patients) and no vessel lesions group ( 15 patients) based on the vessel lesions of the left anterior descending,left circumflex artery and right coronary artery.According to the diameter stenosis of major coronary artery,there were 15 patients in no vascular stenosis group,2 patients in mild vascular stenosis group,6 patients in moderate vascular stenosis group and 18 patients in severe vascular stenosis group.The levels of MPO were measured by enzyme-linked immunosorbent assays(ELISA).ResultsThe levels of MPO in ACS group [( 252.10 ± 27.07 ) μ g/L]were higher than those in SAP group[( 185.81 ± 17.85 ) μ g/L]and control group [( 140.42 ± 71.40) μ g/L](P ＜ 0.05 ),the levels of MPO in SAP group were higher than those in control group(P＜ 0.05 ).The levels of MPO in single vessel lesions group and multiple vessel lesions group were higher than those in no vessel lesions group (P ＜ 0.05 ),but there was no significant difference among single vessel lesions group,double vessel lesions group and multiple vessel lesions group (P ＞ 0.05 ).The levels of MPO in mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group were higher than those in no vascular stenosis group (P ＜ 0.05),but there was no significant differenceamong mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group(P ＞ 0.05 ).A positive correlation was observed between the levels of MPO and neutrophils (r =0.288,P=0.018 ),creatine kinase isoenzyme-MB(r =0.469,P=0.043 ),subject groups( r =0.757,P=0.000),vessel lesions (r =0.584,P=0.000) and the degree of vascular stenosis (r =0.491,P=0.001).Conclusion MPO may predict ACS and reflect the severity of coronary lesions in ACS as a novel inflammatory marker.

Chronic heart failure(CHF)is the performance of end-stage cardiovascular disease and the leading cause of death in recent years.With the rapid development of medical care,the mortality rate of heart failure is still high.This is one in the two major challenges in the cardiovascular field in the 21st century.The new drug LCZ696 is a dual inhibitors of angiotensin receptor blockers(ARB)and neprilysin(NEP),which may lead to new hope for patients with heart failure.In order to determine the efficacy and safety of LCZ696 in the treatment of heart failure,foreign countries have carried out some large-scale trials,such as PARAMOUT, PARADIGM,TITRATION and so on.The results of these studies reflected the superiority of LCZ696 compared with enalapril,valsartan and other drugs in the treatment of chronic heart failure.ARB/antiotensin converting enzyme inhibitors(ACEI)targets the angiotensin receptor to dilate blood vessels and inhibits the sympathetic nerve,but their effects on sodium withdrawal and diuresis are weak.The sacubitril in LCZ696 prevents natriuretic peptide from degrading,strengthens the natriuretic diuretic and further expansion of blood vessels.Thereby it improves water and sodium retention and cardiac function.It can play a better synergistic role combined with valsartan.

Heat stroke (HS) is a life-threatening illness characterized by an altered level of consciousness with an elevated core body temperature 40 ℃, which may be further classified as exertional heat stroke (EHS) or classical heat stroke (CHS) according to the etiology of the condition. In recent years, the morbidity of EHS increases year by year. The severity and clinical outcome for an EHS casualty have a strong correlation with the area under the time and temperature curve for heat exposure. The early recognition and rapid cooling body core temperature ≤38.9 ℃ within 30 minutes of EHS results in the best clinical outcome and minimize severe multiple organ dysfunction and death for patients. Cold water immersion (CWI) is considered as an optimum cooling method for the reversal of hyperthermia in EHS. Some alternative modalities have also shown acceptable cooling rate, for example, the subjects immersed in a circulated water bath controlled below 20 ℃, tarp-assisted cooling with oscillation, body cooling unit, undressed, air-conditioned room, the whole body and large vessels placed ice packs, massaging the extremities; cold intravenous saline applied to dehydrated one. It is necessary to monitor body core temperature for hypothermia and/or recurrent hyperthermia, and to provide physical care for shivering, agitation, or concerns with the potential discomfort combativeness that may occur during cooling process. In this paper, pre-hospital recognition, care, monitoring and rapid cooling treatment measures of EHS have been reviewed to provide references for early identification of EHS and scientific, reasonable and effective cooling treatment.

Objective To investigate the correlation between three single nucleotide polymorphisms of ABCG1 gene ( rs4148102,rs225445 and rs183436) and cerebral infarction of Li nationality in Hainan. Methods Totally 236 cases ( case group) of patients with cerebral infarction and 144 healthy controls (control group) of Li nationality who were treated in a hospital in Hainan province from January 2015 to June 2018 were selected. Genomic DNA from peripheral blood of patients in the two groups was extracted and gen-otype analysis was conducted using flight mass spectrometry. Snapstatus analysis software was used to analyze the association between haplotype and cerebral infarction,and Hardy-Weinberg equilibrium verification was performed. SPSS25. 0 was used to analyze the difference in genotype distribution and allele distribution. Re-sults The distribution frequencies of GG, AG, AA genotypes of rs4148102 in the case group ( 62. 7%, 25. 9%,11. 4%) and the control group(521. %,38. 2%,9. 7%) were significantly different (P<0. 05),and the occurrence frequencies of GG in the control group were significantly lower than those in the case group. The occurrence frequencies of TT,CT and CC of rs225445 were also statistically different between the two groups(36. 9%,41. 1%,22. 0% in case group,48. 6%,38. 2%,13. 2% in control group),and the occur-rence frequencies of CC in the control group was significantly lower than that in the case group. There were statistically significant differences in the frequencies of allele T and C of rs225445 and allele C and A of rs183436 between the two groups (P<0. 05). Conclusion Genotype GG of rs4148102 and genotype CC of rs225445 may be the susceptible factors of cerebral infarction in Li nationality in Hainan province.

OBJECTIVETo explore the effect and mechanism of flavones of buckwheat flower and leaf (FBFL) on lowering blood glucose and improving insulin resistance in type 2 diabetic rats.

METHODSeventy healthy male Wistar rats were used in this trial. Ten of them were selected randomly as normal group; the others were given fat milk by intragastric administration daily, from the 14th day on, low dose tetraoxypyrimidine was added by intraperitoneal injection every other day for three times. Rats with fasting (72 hours after the last injection) blood sugar > or = 16.7 mmol x L(-1) and K(IPT) < 60% of normal group were selected as type 2 diabetic model with insulin resistance, which were randomly divided into 5 groups: model group. LGLT group; low, moderate and high dosage FBFL groups (L-FBFL; M-FBFL; H-FBFL). Every rat was treated accordingly for 4 weeks; then FBG, FFA, INS were detected and ISI was calculated to evaluate the degree of insulin resistance. Liver PTP1B expression was determined by immunohistochemistry method. staining were observed by light microscopy.

RESULTFBFL could dose-dependently inhibit the rising of FBG, FFA, INS, improve the state of insulin resistance and reduce the expression level of liver PTP1B.

CONCLUSIONFBFL could effectively improve insulin resistance in type 2 diabetic rats induced by tetraoxypyrimidine and fat milk and showed dose-dependence relationship.

Animals ; Diabetes Mellitus, Type 2 ; drug therapy ; genetics ; metabolism ; Disease Models, Animal ; Fagopyrum ; chemistry ; Flavones ; administration & dosage ; Flowers ; chemistry ; Gene Expression ; drug effects ; Humans ; Insulin Resistance ; Liver ; drug effects ; metabolism ; Male ; Plant Extracts ; administration & dosage ; Plant Leaves ; chemistry ; Protein Tyrosine Phosphatase, Non-Receptor Type 1 ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar

OBJECTIVE:To investigate the role orientation of pharmacists in China,and to provide legislative suggestions for the formulation of pharmacist law in China. METHODS:Through literature study,the career and evolution process of pharmacists at home and abroad were traced. The obstacles of the role change of pharmacists in China were analyzed to put forward the enlight-enment to the legislation of pharmacist law in China. RESULTS & CONCLUSIONS:Pharmacists in the world had generally en-tered the stage of"taking medication safety of patients as the center"pharmaceutical care,but pharmacists in China were still in the transition stage from"taking drugs as the center"traditional pharmacy to"taking safe medication as the center"clinical phar-macy. The role cognition of pharmacists needed to be improved. Pharmaceutical care should be taken as the role orientation,and the scope of pharmacist law adjustment should be defined;the qualification admittance threshold of pharmacists should be im-proved with the goal of pharmaceutical care-oriented talents;Taking pharmaceutical care as the content,the rights and obligations of pharmacists should be defined. The legislation of pharmacists should be conducted in China to speed up the transformation of pharmacist's role into pharmaceutical care.