Free radicals are highly reactive molecules generated predominantly during cellular respiration and normal metabolism. Imbalance between cellular production of free radicals and the ability of cells to defend against them is referred to oxidative stress (OS). OS has been implicated as a potential contributor to the pathogenesis of ischemic cerebrovascular diseases. After brain injury by ischemia, the production of reactive oxygen species (ROS) may increase, leading to tissues damage via several different cellular molecular pathways. Radicals can cause damage to cardinal cellular components such as lipids, proteins, and neucleic acids, leading to subsequent cell death by modes of necrosis or apoptosis. Treatment with antioxidants may prevent propagation of tissues damage and improve both the survival and neurological outcome. The present paper reviews the antioxidants therapy in ischemic cerebrovascular disease, discusses probable reasons of inconsistency between animal experiments and clinical trials on antioxidants, and puts forward strategies against oxidative stress in the treatment of ischemic cerebrovascular diseases.

OBJECTIVE:To explore consumers’perceptions for pharmaceutical care by community pharmacist when purchas-ing OTC drugs. METHODS:Semi-structured interview was conducted for 100 consumers who were recruited in Xingqing District, Jinfeng District and Xixia District of Yinchuan,Ningxia Hui Autonomous Region,their expection for pharmaceutical care by com-munity pharmacists was summarized. RESULTS:Totally 100 residents were interriewed,and 97 completed a full interview with ef-fective interview rate of 97%. Consumers still did not clearly on distinguishing the OTC drugs. The majority of consumers chosen OTC drugs were based on experience and brand,a handful of consumers were under the guidance of community pharmacists. Con-sumers were most concerned about the efficacy,adverse reactions and drug quality in using OTC drugs. Most consumers were not satisfied with the pharmaceutical care in purchasing OTC drugs. Nevertheless,due to a lack of medicine knowledge,consumer had a great demand for pharmaceutical care and willingness to accept it. Low professional level of community pharmacist and staff in current community pharmacy and lack of effective communication between pharmacist and consumer were the obstacles of develop-ing pharmaceutical care. CONCLUSIONS:Because of their distrust on competence of community pharmacist,consumers seek less pharmaceutical care of OTC drugs at community pharmacy though they had expectations on pharmaceutical care of OTC drugs by community pharmacist. Consumers’rely on self-choice of drugs make them exposed to more drug risks.

Objective To investigate the effect of different doses of dexmedetomidine on myocardial injury (in perioperative peri‐od) on cardiopulmonary bypass (CPB) in patients with rheumatic heart valve replacement surgery .Methods Patients undertook rheumatic heart valve replacement surgery with mitral stenosis were divided into three groups (n=20) in randomized and double‐blind method :control group (group C) ,dexmedetomidine 0 .3 μg/kg group (DEX1 group) ,dexmedetomidine 0 .6 μg/kg group (DEX2 group) .Central venous blood was drawn respectively before anesthesia induction (T0 ) ,2h after CPB (T1 ) ,24 h after CPB (T2 ) ,48 h after CPB (T3 ) ,72 h after CPB (T4 ) .Plasma muscle calcium protein I (cTnI) and creatine kinase (CreatineKinase MB , CK‐MB) were measured and mean arterial pressure and heart rate were recorded at each time point .Furthermore ,extubation time , ICU stay ,postoperative inotropic score 24 h after operation ,drainage 24 h after operation ,cardio auto‐resuscitation rates and ad‐verse cardiovascular events were recorded .Results Compared with T0 ,HR was significantly lower in the T1 time point in DEX2 group .Compared with group C ,HR ,plasma CK‐MB ,inotropic score 24 h after operation and cardiovascular adverse events was sig‐nificantly reduced in the T1 time points in DEX1 group (P<0 .05) ,but the heart auto‐resuscitation rate did not significantly im‐proved .HR at T1 ,plasma CK‐MB values at T1 and T2 ,and plasma cTnI values at T2 -T4 were significantly reduced ;the heart re‐suscitation significantly increased ,myocardial contraction power ratings 24 h after operation and the incidence of cardiovascular e‐vents was significantly lower in DEX2 group (P<0 .05) .The extubation time ,ICU stay time and drainage 24 h after operation did not change significantly in both groups .Conclusion Dexmedetomidine has a protective effect on perioperative myocardial injury in patients with rheumatic heart valve replacement surgery ,and the effect would be better when the dexmedetomidine was infused at 0 .6 μg · kg -1 · h-1 after a loading dose of 0 .6 μg/Kg continuously .

Objective: To observe whether transforming growth factor-beta 1 (TGF-β1) can improve the mechanical properties of tissue engineered heart valve (TEHV) prepared by TGF-β1 and myofibroblasts. Methods: Myofibroblasts were isolated, cultured, identified, and seeded onto the decellularized aortic valve leaflet. In the experimental group, TEHV were cultured with DMEM containing 10 ng/ml TGF-β1 for 14 days. In the control group, TEHV were cultured with DMEM only for 14 days. The contents of lysyl oxidase (LOX) and hydroxyproline, the expression of LOX and COLL-1 mRNA, and the mechanical properties of the TEHVs were analyzed in each group. Results: The contents of LOX and hydroxyproline, expression of LOX and COLL-1 mRNA, Max-load, and Max-stress were significantly higher in the experimental group than those in the control group (all P<0.05). However, the experimental and control group showed comparable values of Max-strain and elastic modulus. Conclusion: TGF-β1 can increase expression of LOX and COLL-1 mRNA in the seeded cells during TEHV construction, increasing the production and cross-linking of collagen, and improve the mechanical properties of the TEHV.

Background It is very important for us to understand retinal function change in the patient with diabetic mellitus in clinic. At present,the study about diabetic mellitus associated with macular edema includes fundus fluorescense angiography ( FFA) and multifocal electroretinogram ( mfERG) etc.. However, seldom research is performed in the mfERG findings for different types of diabetic macular edema. Objective This study aimed to investigate the mfERG change in different types of diabetic macular edema compared with normal population. Methods Fifty-seven eyes with diabetic macular edema from 40 patients and 35 eyes from age-and gender-matched normal subjects were enrolled in this study. The eyes with diabetic macular edema were assigned to local macular edema group (n=16) ,diffuse macular edema group (n = 22) and cystoid macular edema ( n = 17 ) based on the manifestation of FFA. MfERG was recorded in all the individuals. The informed consent was obtained from each subject prior to any the medical examination. Results In focal diabetic macular edema group,the response density of P1 wave was significantly attenuated in ring 1 , showing a statistical difference in comparison with controls (t =2. 170,P = 0.038) ,and the latencies of P1 and N1 waves showed obvious prolong in ring 4 and 5 (t = 2.519,P = 0. 017 ;t = 2. 451 ,P = 0. 020). In diffuse diabetic macular edema group,the response densities of P1 and N1 waves were declined in ring 1,3,5 and ring 1,3,4,5 respectively,and the latencies of P, in ring 3,4 were significantly delayed respectively in comparison with controls (all P < 0. 05 ). In cystoid diabetic macular edema group, the response densities of P1 and N1 waves were lowed from ring 1 through 5 respectively, and the latencies of P1 and N1 waves were significantly longer from ring 3 through 5 and ring 4 respectively with the statistically significant difference from controls (all P<0. 05). The visual function of fovea was badly damaged. Conclusion These studies indicate that the most serious damage of visual function is in foveal area in cystoid diabetic macular edema group, and is then parafoveal area of diffuse diabetic macular edema group and perifoveal area in focal diabetic macular edema group. The outcome of mfERG presents a good consistency with FFA findings in the patients with diabetic macular edema.

Objective To summarize the outcomes and clinical experience of orthotopic heart transplantations in Shanghai Zhongshan Hospital.Methods From May 2000 through October 2005,141 patients,101 males and 40 females,diagnosed as having dilated cardiomyopathy in 118,hypertrophic cardiomyopathy in 2,restrictive cardiomyopathy in 2,end-stage ischemic heart disease in 9, primary malignant cardiac tumor in 4,valvular heart disease in 3 and others in 3,underwent orthotopic heart(transplantations) at our center.The operative procedures included 120 bicaval anastomotic cardiac transplantations,19 conventional Stanford orthotopic cardiac transplantations and 2 total heart transplantations.The immunosuppressive therapy strategies included Cyclosporine A or tacrolimus,corticosteroids and mycophenolate mofetil.For the latest 28 patients,induction therapy with Daclizumab was applied.Results There were 3 operative deaths with an operative survival of 97.9 %.During the follow-up from 1 month to 65 months,the actuarial survival rate was 90.8 % after 1 year,84.6 % after 3 year and 81.4 % after 5 year.Acute rejection,infections,graft failure and metastasis of primary cardiac tumor were the main causes of death in the 1st postoperative year,while acute rejection and graft coronary vasculopathy were the leading causes of death thereafter.Postoperative complications included acute rejection,infections,renal dysfunction and graft failure.Conclusions Orthotopic heart transplantation was proved to be a reliable choice for endstage heart disease with excellent outcomes.More attention should be paid to surveillance and management of acute rejection, infections and graft coronary vasculopathy in the long-term follow-up.

Objective To explore the relationship between the expression of nestin protein and the expression of vascular endothelia growth factor(VEGF)in hypoxia-ischemia brain damage(HIBD)of neonatal SD rats.Methods Fifty-six 7-day postnatal SD rats were randomly divided into 2 groups,sham operation(n=28)and hypoxic ischemic(HI)group(n=28).Animals were killed in 0,3,12,24 h,3,7,14 d after HIBD rat models established.The brain tissue was obtained to make paraffin section.Expressions of nestin and VEGF protein were examined with immunohistochemical staining and image quantitative analysis.Results The number of VEGF positive cell in the hippocampus and cortex increased reactively after HI and reached peak at the 12th hour and persistent to the 24th hour,which returned the normal level on d3,however,the number of nestin positive cell reached peak on d7 and returned the normal level on d14 after HI.Conclusions VEGF and nestin may contribute to neurolproctetive effects against HIBD.Studying the way to facilitate the coexpression of the nestin and VEGF may have important rolls to enhance the repairment and regeneration.

Neurofibromatosis type 1 is a term of Von Recklinghausenan.It is an autosomal dominant inherited disease which derived by neural crest cell.Prevalence of this disease is 1/3000 1/3500 and is a disease with the highest mutation rate.The pathogenesis of neurofibromatosis type 1 is associated with the deficiency of NF1 gene.Recently,the genetics and genomics research of neurofibromatosis make a great progress.With the development of gene linkage and position cloning technology,the gene sequence of neurofibromatosis type 1 has been found.Recent research of genetics and genomics of NF1 and the structure and function,abnormal expression,the relation of genotype and phenotype,the mutation sensitivity domain of NF1 gene were reviewed.

Objective:To study the long-term stability of 6MV photon beam on TrueBeam, which is a new linear accelerator introduced by Varian Medical System. Methods:QA BeamChecker Plus (QABC+, Standard Imaging Inc., Middleton, USA) was used to measure 6MV X-ray on TrueBeam linac as daily quality assurance (Daily QA). Dosimetric parameter, including output Constancy, flatness and symmetry, were employed to evaluate the dose delivery stability of TrueBeam linac. Results: Daily QA results of 18 months showed the dose output delta was (0.0%±0.7%), only once out of tolerance of 2%. The constancy of Flatness was excellent with the delta of (0.1%±0.1%). The symmetric of axial and transverse varied within 1%. Conclusion:The output constancy of TrueBeam with 6MV is very stable, as well as flatness and symmetry. It’s stable and reliable to implement Truebeam linear accelerator in clinical.

9β,11β-Epoxypregn-4-ene-17α,21-diol-3,20-dione 21-acetate (Ⅰ) is a substrate for the production of 9β,11β-Epoxypregn-1,4-diene-17α,21-diol-3,20-dione (Ⅳ),which is a key precursor for the production of many 9-fluoro-substituted corticosteroid hormones.By comparing whole cells catalysis and cellular lysates conversion,it was found that whole cells of Mycobacterium sp.MS136 could only convert Ⅰ to 9β,11β-Epoxypregn-4-ene-17α,21-diol-3,20-dione (Ⅱ),and Ⅰ can be effectively converted toⅣ by cellular lysates.The reaction order is that Ⅰ is spontaneously hydrolyzed to Ⅱ and Ⅱ undergoes C1,2-dehydrogenation reaction to Ⅳ.In order to improve the productivity of Ⅳ,the key genes kstD,kstD3 and kstDM encoding C1,2-dehydrogenase (KSTD) were overexpressed in Mycobacterium sp.MS136 to enhance the C1,2-dehydrogenation reaction rate,and the results showed that 1 g/L substrate Ⅰ can be converted by recombinant strain MS136-kstDM cellular lysates at pH 7.0,the productivity of Ⅳ reached 78.4％ after 45 h,which is 38.9％ higher than original strain.The reaction rate is enhanced by optimizing the pH,and the results showed that 1 g/L substrate (Ⅰ) can be converted by recombinant strain MS136-kstDM cellular lysates at pH 7.5,the productivity of Ⅳreached 92.8％ after 45 h,which was 63.4％ higher than original strain.