This study was set up to observe the changes in stress and immune functions in upper abdominal surgery after general anesthesia.In thirty elective upper abdominal operation patients,general anesthesia was induced with propofol,fentanyl,scoline and maintained with isoflane and atrumium. Catecholamines(CA),cortisol,interleukin-2(IL-2) and soluble interleukin-2 receptor(sIL-2R) were measured before anesthesia,after induction of anesthesia,at the end of operation,and on the first and third postoperative days.The results showed that epinephrine(E),norepinephrine(NE) concentration increased at the end of operation and on the first postoperative day(P<0.01)，Cortisol concentration decreased after anesthesia induction(P<0.05)，IL-2 concentration decreased at the end of operation(P<0.05)，and sIL-2R lever did not change.The investigation suggested that general anesthesia with propofol,fentanyl and isoflane can suppress CA and cortisol increase resulting from induction of anesthesia. There was no change in IL-2 level.However it can not suppress the increase of stress hormones and decrease of IL-2 due to operation.The stress response correlate with immune functions.

AIM：To introduce evidence-based pharmacy in respect to the definition,contents and principle in applying to decisions of clinical pharmacotherapy.METHODS：We focused the discussion on a brief summary of different study designs,factors affecting the strength of scientific evidence,and interpretation of the data.RESULTS：These application principles are helpful to guide clinical pharmacists solving clinical problems.CONCLUSION：Clinical pharmacist should use concepts in the evidence-based practice when making pharmacotherapeutic decisions in the future.

Objective To assess the pulmonary function before liver transplantation in patients with end-stage liver disease. Methods One hundred and fifty-four patients with end-stage liver disease, who were waiting for liver transplantation in our hospital, were enrolled into the study. The pulmonary ventilation function,small airway function and diffusion capacity were measured and analyzed respectively. Results Among 154 subjects,140 (90. 9%, 140/154) patients had abnormal pulmonary function, shown as pulmonary diffusing capacity reduction;followed by restrictive ventilatory function reduction (42. 8% ,66/154) and small airway function reduction (37. 7%, 58/154 ), the least common manifestation was obstructive ventilatory function reduction (28.6 % ,44/154 ). Conclusion Abnormal pulmonary function in patients with end-stage liver disease is common, and the pulmonary function tests before liver transplantation has certain referential value for pulmonary function damage evaluation and postoperatively respiratory tract management.

Brain natriuretic peptide(BNP) emerges as another cardiac hormone after atrial natriuretic peptide (ANP). It plays a prominent role in natriuresis, diuresis, vasorelaxation and decreasing blood pressure. The plasma levels of BNP are closely related to the left ventricular function. In this review, the author highlights the latest progress of BNP in the diagnosis, risk stratification, prognosis and therapeutic monitoring of patients with congestive heart failure and other cardiac dysfunction.

Diabetic cardiomyopathy is a type of specific cardiomyopathy which be relevant to metabolic derangement of diabetes mellitus. The exact mechanism is still questionable and has been the focus of much interest and debate in the cardiovascular domain . In this review, we aim to summarize the update advances of its pathogeneses and physiopathologic mechanisms at the histological, molecular and cytologic levels.

Objective To observe and compare the clinical effect of treating benign primary blepharospasm(BPB)with acupuncture and injection of type A botulinum toxin. Methods Between January 2012 to July 2013, 80 cases of BPB patients in ophthalmology of Tongren hospital were randomly recruited into a acupuncture group and a control group, with 40 cases in either group. The acupuncture group was treated with acupuncture on points of strengthening spleen and distributing liver and the control group was treated by type A botulinum toxin injection around effected eyes. Then effective rate, visual impairment of quality of life scale and self-rating depressive scale were tested after the treatments. Results The total effective rate of acupuncture was 95%, which was better than injection with type A botulinum toxin, with statistical difference(P<0.01). There was no statistical difference in visual impairment of quality of life scale in both groups after the treatment compared with before treatment(P>0.05). Visual impairment score was (121.88±30.16) and (121.00±28.72) in the acupuncture group and control group respectively before the treatment, However, acupuncture group(70.00±22.88)reduced less than control group(95.25±28.39)after the treatment, and there was statistical difference(P<0.01). There was no statistical difference in self-rating depressive scale in groups before treatments(P>0.05), (acupuncture group was(15.90±7.99) and control group was(15.75±6.26). However, acupuncture group(10.40±4.95)reduced less than control group(13.38±6.32)after the treatment, and there was statistical difference(P<0.01). Conclusion It proved that the therapy of acupuncture with strengthening spleen and distributing liver method for benign primary blepharospasm has a better result than injection with type A Botulinum toxin. Moreover, acupuncture can promote optical function and prevent depression for BPB patients.

Diabetic retinopathy (DR) is a common ocular complication in patients with diabetes, and diabetic macular edema (DME) is the main cause of vision loss in patients with DR, so the early diagnosis and treatment of DME is of an important clinical significance.Optical coherence tomography (OCT) can provide high-quality imaging of retina and choroid.It has been widely used in clinical practice and can be used for long-term follow-up of the diagnosis and treatment of DME.Recent studies have found various characteristic changes in retina and choroidal layer of DME on OCT, including vitreomacular interface abnormalities, disorganization of retinal inner layers, inner segment-outer segment (IS-OS) continuity destruction, external limiting membrane continuity destruction, outer retinal tubulations, hyperreflective foci, intraretinal cystic fluid, subfoveal neuroretinal detachment, low optical reflectivity, subfoveal choroidal thickness change, and choroidal vascularity index change, etc.These changes are related to the prognosis of DME, so they can be used as biomarkers of DME.This paper reviews the research progress in this field.

AIM: To discuss the complications and prevention of phacoemulification in primary angle-closure glaucoma after trabeculectomy.
METHODS:Retrospective analysis of 33 cases (37 eyes) phacoemulification in primary angle-closure glaucoma after trabeculectomy in our hospital between January 2008 and June 2012, followed up 12-33mo, intraoperative and postoperative complications were observed.
RESULTS: Compared with pre-operation, intraocular pressure hadn't increased in follow-up 6mo. Iris was injured in 5 eyes, corneal edema was in 14 eyes, anterior chamber inflammation was in 16 eyes, all symptoms were improved in 3-7d. And no case with posterior capsule rupture or vitreous loss.
CONCLUSION: Phacoemulification is an effective way for the treatment of cataract after angle-closure glaucoma trabeculectomy, careful preoperative examination, intraoperative prevention can reduce or avoid the occurrence of surgical complications.

Psychological disorder has a high morbidity rate among patients with cardiovascular disease. Patients with cardiovascular disease associated with depression, especially post myocardial infarction and acute coronary syndromes associated with psychological disorder, have not only a poor prognosis, but also a high mortality . Therefore, comprehensive and perfect intervention is extremely important for patients with cardiovascular disease associated with psychological disorder. The intervention for such kind patients needs an integrated disease management. It needs to consolidate the treatment of body's disease to strengthen second-level prevention of heart disease, and pay attention to the intervention for psychological disorder as well.This paper aims to provide reference for reducing the negative effects of psychological illness in patients with cardiovascular disease during clinical treatment process, and make prospects about the significance of double heart medical model, through summarizing the interaction effects of psychological factors on patients with coronary heart disease, the significance ofdouble heartnursing mode and the specific nursing measures.

Objective To study the effects of ligustrazine(LTZ) on the preeclampyic umbilical serum induced-expression of precollagen I,III in cultured human umbilical artery smooth muscle cell(HUSMC). Methods The cultured HUSMC was treated with LTZ for 30 min, and then incubated with medium containing 20% serum either from women with preeclampsia or normal pregnant women for 48h. The cell activity was determined by MTT, the cell cycle was analyzed by flow cytomerty, and RT-PCR analysis was used to dectect the expression of precollagen I,III. Results The cell proliferation, percentage of S and G2/M phases, and expression of precollagen I obviously increased in HUSMC incubated with preeclampsia umbilical serum compared with normal pregnant women one(P