The blood-brain barrier (BBB) exerts its central nervous system (CNS) protective function as it hinders the delivery of diagnostic and therapeutic agents to the brain. With the development of nanotechnology during the last thirty years, the nanocarriers for delivering drugs make it possible to transport drugs across the BBB. The brain-targeted drug delivery system usually consists of two parts: nanocarriers and brain-targeted strategies. In this review, several kinds of nanocarriers are introduced for brain-targeted drug delivery. We focus on several possible strategies for brain-targeting and comment on their advantages and disadvantages in application.

ObjectiveTo analyze the systolic function of subendocardial myocardium of the left ventricle in patients with diabetes mellitus (DM) and DM associated hypertension by speckle tracking imaging (STI).Methods The left ventricular ejection fraction(LVEF) and left ventricular mass index (LVMI) of all subjects including 30 patients with diabetes mellitus(DM group),25 patients with DM associated hypertension (DH group) and 30 healthy volunteers (control group) were normal and near.The common parameters of echocardiogram were measured and the peak systolic longitudinal strain of subendocardial myocardium were analyzed from the long-axis view at the levels of mitral annulus,papillary muscle and apex by STI.All above parameters were compared among three groups.ResultsNo significant difference in all parameters was found between the control group and two patient groups,but the ratio of E/A was significantly lower in the two patient groups than that of control group ( P ＜0.01).The peak systolic longitudinal strain of some segments were significantly lower in the two patient groups than that of control group ( P ＜0.01).The peak systolic longitudinal strain of the subendocardial myocardium of all segments in the two patient groups were different decrease compared with the control group( P ＜0.01 or P ＜ 0.001).The peak systolic longitudinal strain of the subendocardial myocardium of the DH group except some segments were decrease compared with the DM group ( P ＜0.01).ConclusionsSTI may be early used to identify the left ventricular systolic function in patients with diabetes mellitus.

Objective To investigate the induction of specific anti-tumor immune response by transfected dendritic cells (DCs) with survivin mRNA of human pancreatic cancer, and to provide the experimental evidences for the treatment of human pancreatic cancer with DCs vaccine. Methods DCs were isolated and cultured from peripheral blood mononuclear cells (PBMCs). After being transcripted and amplified, survivin mRNA was transfected into DCs by electroporation. The expression of survivin in DCs at different time points was detected by quantitative real-time PCR. The survival rate of DCs before and after transfection was determined by MTT method. The induction of specific cytotoxic T lymphocyte (CTL) response by survivin mRNA transfected DCs was measured by 51Cr standard cytotoxicity test. The induction of specific CTL activation by survivin mRNA transfected DCs was evaluated through testing released IFN-γ by ELISA method. Results After survivin mRNA transfection for 48h, the expression of survivin mRNA in DCs reached the highest point (46.09±6.57). After transfection, the survival rate of DCs was stabilized around 80%. The DCs transfected with survivin mRNA could effectively induce HLA-A2+ / survivin+ specific CTL immune responses. Stimulated with pancreatic cancer cell line Capan-2 cells or SCL-1 cells as control group, the IFN-γ released in 24 hours by survivin specific CTL were (28.79±5.70) U/ml and (25.12±2.13) U/ml respectively, there was no significant difference (P=0.761). Conclusion The induction of CTLs by DCs transfected with human pancreatic cancer survivin mRNA could produce specific anti-tumor immunity.

A method was developed for the determination of 39 polybrominated diphenyl ethers(PBDEs) from mono- to hepta-brominated in coastal sediment by gas chromatography/mass spectrometry. The sample was extracted with a solution of dichloromethane: n-hexane( 1:1,V/V) ,followed by ultrasonic extraction for 60 min at 25℃. The clean-up step was optimized using silica gel and alumina. The detection limit of the method was in the range of 0.003 - 0.10μg/kg. The results indicate that the average recovery of the internal standard was from 66.2% to 118. 6%. The relative standard deviation RSD( % ) was from 0. 8 % to 18. 2%. The method for the detection of 39 PBDE congeners in coastal sediment was sensitive,high reproducible with satisfactory recoveries.

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.

With the wide application of clinical guidelines and standardization of Chinese medicine (CM), guidelines of CM and/or integrative medicine (IM) were also emerging. By the guideline evaluation instruments such as the Appraisal of Guidelines Research and Evaluation (AGREE) Instrument and Conference on Guideline Standardization (COGS), a preliminary assessment of 11 clinical guidelines for CM and/or IM published before October 2008 was performed. Methodological description of evidence collection or synthesization was absent in most clinical guidelines, and evidence-grading criteria were listed in only one of the eleven guidelines. Inadequate standardization of guideline development, single professional background of guideline developers, and lack of high-grade evidence were the current problems. It was suggested that guideline development group should include individuals from multiple relevant professional fields. Stress should be laid on evidence collection and recommendation grading. Guideline developers should follow the rigorous development methodology of evidence-based guidelines, and the methods for evaluating evidence and grading recommendations should be set up according to the characteristics of medical literature of CM. In addition, more attention should be paid to appraise the quality of clinical practice guidelines of CM and IM.

Objective To study the diagnosis and treatment of iatrogenic bile duct injury(IBDI).Methods The clinical data of 92 patients with IBDI who had been admitted to our hospital from January 1994 to December 2007 were retrospectively analyzed.Results The diagnosis of IBDI was based on the clinical findings,diagnostic abdominocentesis and imaging examination.Sixteen patients gave up treatment because of economic reasons,and 2 patients who were complicated with sepsis and multiple organ dysfunction syndrome died shortly after being transferred to our hospital.Forty-eight patients were treated by Roux-en-Y choledochojejunostomy,14 by endoscopic treatment.2 by bile duet repair+T tube drainage,3 by percutaneous catheter drainage,1 by choledochoduodenostomy,4 by percutaneous transhepatic cholangiodrainage,and 2 by ultrasound guided percutaneous puncture drainage.Sixty-two patients were followed up for 4 month to 10 years(mean,3.6 years),and satisfactory results were obtained.Conclusions Detection of IBDI during operation and prompt repair yield favorable outcome.Roux-en-Y choledochojejunostomy is the best choice for bile duct injury complicated with biliary stricture.Endoscopic and interventional treatments are important auxiliary measures in the treatment of bile duct injury.

Objective To evaluate the short-term effect of elemene combined with transcatheter hepatic arterial chemoembolization (TACE) interventional therapy for the treatment of moderate and advanced liver cancer.Methods A total of 63 patients with moderate and advanced liver cancer were randomized into test group(31 cases) and control group(32 cases). Both groups were given TACE, and additionally, the test group was given intra-arterial infusion of Elemene Emulsion(400-600 mg/m2)together with MAO(Mitomycin C 4-6 mg/m2 , adriamycin 20-40 mg/m2, Oxaliplatin 50-85 mg /m2), and the control group was given intra-arterial infusion of MAO. Short-term effect was evaluated by the clinical outcomes of tumor size, progression-free survival(PFS), total survival rate and adverse reactio n. Results(1)The overall response rate(ORR) in the test group was superior to that in the control group, and the difference was statistically significant(P<0.05) .(2)PFS in the test group covered 125 days, and that in the control group covered 118 days, the difference being significant (P<0.05); the median survival time(MST) in the test group was 257 days, and that in the control group was 214 days,the difference being insignificant(P>0.05).(3) No severe toxic or side effect was found in t he twogroups, the difference being not significant(P>0.05). The test group tended to have milder adverse reaction. Conclusion Intra-arterial infusion Elemene Emulsion combined with TACE interventional therapy is effective in increasing ORR, prolonging PFS, promoting adverse reaction endure and relieving symptoms of weakness, abdominal distension and pain.

Objective To investigate the effect of electroacupuncture plus early rehabilitation training on the function recovery after surgery for cervical spinal cord injury. Methods Sixty patients with cervical spinal cord injury undergone anterior cervical decompression and internal fixation were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by electroacupuncture plus rehabilitation training, while the control group was by rehabilitation training alone. The Frankel’s grading (FG), Barthel Index (BI), and Functional Independence Measure (FIM) were adopted for evaluation before and after intervention. Results The FG was not significantly changed after intervention in both groups (P>0.05). After intervention, there was no significant difference in comparing FG between the two groups (P>0.05). The BI and FIM scores were significantly changed after intervention in both groups (P＜0.01). There were significant differences in comparing BI and FIM scores between the two groups (P＜0.05). Conclusion Electroacupuncture plus early rehabilitation training can promote the function recovery after surgery for cervical spinal cord injury, and improve the quality of life.