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 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.

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 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.

Adolescent ; Adult ; Female ; Heart Rate ; physiology ; Humans ; Locomotion ; Male ; Military Personnel ; Multivariate Analysis ; Regression Analysis ; Weight-Bearing

Objective To investigate the clinical features,diagnosis,treatment and prognosis of gastric neuroendocrine carcinoma (G-NEC).Methods Clinical data of 52 G-NEC cases were analyzed.Follow-up was conducted by telephone.The survival curves were drawn using Kaplan-Meier method.Univariate analysis was performed by the Log-rank test and multivariate analysis was performed by COX proportional hazards model.Results The median overall survival rate was 19 months (range 6 to61 months),and the overall 1,3,5-year survival rates were 74％,16％ and 5％ respectively.Tumor stage surgery,vascular nerve involvement and Ⅲ and Ⅳ phase chemotherapy were related to prognosis (x2 =24.254,10.005,7.261,8.790,all P ＜ 0.05).Multivariate analysis showed tumor stage and vascular nerve involvement were independent prognostic factors (x2 =17.170,5.810,all P ＜ 0.05).Conclusion G-NEC is a highly malignant tumor with poor prognosis.Preoperative diagnosis rate is low.Surgery is the treatment of first choice.Definite diagnosis depends on postoperative pathology and immunohistochemical examination.

OBJECTIVE To investigate the effect of pranlukast(Pran) on learning and memory impairment and neuroinflammatory and apoptotic response in streptozocin(STZ)-induced type 1 diabetic mice. METHODS Male ICR mice were injected through the tail vein with STZ(150 mg·kg-1)to induce the type 1 diabetes model. Diabetic mice were administered orally with Pran. After 4 consecutive weeks of administration,the escape latency in hidden platform trials,number of platform crossings and time spent in the target quadrant of mice were assessed by the Morris water maze(MWM)test. Western blot was used to detect the proteins of cysteinyl-leukotrienes receptor-1(CysLT1R)and pro-inflammatory factors,nuclear factor-κB p65 subunit(NF-κB p65),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),and cleaved caspase 3,Bax and Bcl-2 in the hippocampus and prefrontal cortex of diabetic mice. We also determined fasting blood glucose,serum insulin and lipids such as triglyceride,total cholesterol,high density lipoprotein cholesterol,and low density lipoprotein cholesterol. RESULTS The data of the MWM test showed that untreated diabetic mice displayed a higher escape latency in hidden platform trials(P<0.05),and a smaller number of platform crossings(P<0.05)as well as shorter per?centage of time spent in the target quadrant(P<0.05). The data of Western blotting showed that treat?ment with Pran 0.6 and 1.2 mg·kg-1 significantly reduced the levels of CysLT1R,nuclear NF-κB p65, IL-1βand TNF-α,cleaved caspase 3,and the ratio of Bax and Bcl-2 in the hippocampus and prefrontal cortex of diabetic mice(P<0.05). However,Pran did not improve the fasting blood glucose,serum insulin or lipid metabolism disorder in diabetic mice. CONCLUSION Pran improves memory impairment and nerve injury in STZ-induced type 1 diabetic mice.

Objective To determine whether focal adhesion kinase (FAK) signal pathway was involved in migration of hepatocarcinoma cells by inhibiting focal adhesion kinase (FAK) phosphorylation in HepG2 cells with focal adhesion related nonkinase (FRNK). Methods The recombinant of FRNK and pEGFP-C2, an endogenous inhibitor of FAK activation,was transfected into HepG2 cells. HepG2 migration was examined by transmembrane assay. FAK and phosphatinositol 3-kinase (PI3-K) phosphorylation were detected by immunoprecipitation method. Confocal scanning microscopy was used to verify nuclear translocation of nuclear factor-kappa B (NF-?B). Results The transfection of FRNK recombinant plasmid could inhibit HepG2 migration, FAK and PI3-K phosphorylation decreased by 50.2 percent and 39.5 percent respectively. Furthermore, NF-?B translocation was down-regulated from 3.495?0.227 to 1.182?0.106. Conclusion These results suggested FAK was a main signal pathway in mediating HepG2 migration. Over expression of FRNK might inhibit signal transduction of FAK via depression of the phosphorylation of PI3-K and NF-?b activation, resulting in the decrease in migration of hepatocarcinoma cell.

Objective To investigate the relationship between PSMA expression and histologic grading of prostatic carcinoma. Methods Different prostatic tissues and non-prostatic tumors (PCa 70,prostate intraepithelial tumor 21,BPH 20,nonprostatic malignancies 30) were analysed for the expression of PSMA by using PSMA mono-clonal antibody and ABC immunohistochemical staining. Results All prostatic tissues but 2 cases of prostatic carcinoma and 4 cases of benign prostate hyperplasia were stained positively,while all of the non-prostatic tumors were stained negatively.There was a negative correlation between PSMA expression and histologic grading of prostatic adenocarcinoma. Conclusions PSMA was prostatic organic specific and could be a prognostic marker of prostate adenocarcinoma.

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.