Objective Valsartan, the angiotensin Ⅱ type 1 receptor blocker, is recently proved to reduce urinary albumin at the microalbuminuria stage in human diabetic nephropathy without altering glucose metabolism. But the pathway is still uncertain. In present study, we examined the changes of adrenomedullin receptor (ADMR) mRNA and protein expressions in the renal cortex of diabetic rats to investigate the protective effects of valsartan on an experimental model of diabetic renal injury. Method The SD rats were randomly divided into following groups: normal rats, STZ-induced diabetic rats, and diabetic rats treated with valsartan. STZ-induced diabetic rats were treated with valsartan (10mg/kg body weight) or vehicle for 8 weeks. The expressions of ADMR mRNA in renal cortex were analyzed by RT-PCR, as well as ADMR protein expressions were detected through western blot. Results We found (1) Valsartan treatments reduced urinary albumin excretion in 24h, compared with the untreated. But no notable difference was seen in HbA1c and blood sugar of diabetic rats between the two groups. (2) Valsartan treatments increased the expressions of ADMR mRNA and protein in diabetic rats renal cortex. Conclusion These results indicate that valsartan treatment can upgrade the expressions of ADMR in the renal cortex of diabetic rats. It may be one of renal protective pathways of Ang Ⅱ type 1 receptor blocker.

Adolescent ; Child ; Child, Preschool ; Female ; Heart Rate ; Humans ; Male ; Sleep Apnea Syndromes ; diagnosis ; physiopathology ; Sleep Arousal Disorders ; diagnosis ; physiopathology

Objective To create the effective community-based day-care model of mental disability with multiple approaches. Methods 30 subjects with schizophrenia in Taoranting community in Beijing were selected in control group (n=15) and intervention group (n=15). A day-care multiple rehabilitation model had been implemented in the intervention group. They were evaluated with Positive and Negative Syndrome Scale (PANSS) and WHO Disability Assessment Schedule 2.0 (WHO-DAS 2.0). Results The scores of PANSS negative symp-tom, general psychopathological symptom and WHO-DAS 2.0 significantly reduced continually in the intervention group 8 and 12 weeks af-ter intervention (P<0.01). Conclusion Community-based day-care model can improve the rehabilitation of mental disabled people and inte-grate the community resources for the schizophrenics.

liver cells.Repair test showed that liver cells had the strongest repair ability,spleen cells were the second and kidney cells had no repair ability nearly within 2 h incubation. Conclusion The tissue cells had a big difference to oxidative damage and repair ability and comet assay could be used as detection of DNA oxidative damage and repair ability in exo_chemicals.

Objective To analyze the appropriate time selection of pregnancy and delivery in women with systemic lupus erythematosus (SLE ). Methods Twenty-nine pregnancies in women with SLE in our hospital from 1998 to 2003 were retrospectively analyzed regarding the selection of appropriate time of pregnancy and delivery. Results All patients did not take any cytotoxic medicine for at least 6 months before pregnancy. Twenty-three conceptions occurred when SLE was inactive for at least 1 year. Two conceptions occurred when SLE was active without doctors' agreement SLE was diagnosed during pregnancy in the remaining 4 cases. The condition of all patients fluctuated and the gestational time at delivery ranged from 30 to 38 weeks after we modified the doses of glucocorticoid (prednisone). Among totally 29 living neonates, eight were premature neonates, three were FGR and one had serious congenital heart disease. Two neonates died of complications in early stage of neonatal period. None of the 29 neonates from all patients had neonatal lupus. Conclusion Pregnancy safety will be improved obviously if the condition of SLE is controlled and the patients are given reasonable doses of glucocorticoid and intensive monitoring. If pharmacotherapy does not work well and the condition threatens the safety of mother and fetus, or the fetus has matured, termination of pregnancy should be done on time, which reduces maternal complications and improves the perinatal mortality rate. The gestational time should be 34 to 38 weeks.

No abstract available.
Asphyxia* ; Phenobarbital* ; Seizures*

Objective To evaluate the preventive effects of dezocine on postoperative hyperalgesia in patients after remifentanil-based anesthesia.Methods One hundred ASA Ⅰ or Ⅱ patients,aged 20-64,weighing 45-65 kg,undergoing laparoscopic cholecystectomy,were randomly divided into 4 groups ( n =25 each): fentanyl group (group F),low-dose dezocine group (group D1 ),medium-dose dezocine group (group D2 ) and high-dose dezocine group (group D3 ).Anesthesia was induced with midazolam,propofol,remifentanil and cisatracurium.The patients were mechanically ventilated after tracheal intubation.Anesthesia was maintained with target-controlled infusion of remifentanil (target effect-site concentration 4 μg/L), intravenous infusion of propofol 4-6mg· kg-1· h-1 and intermittent intravenous injection of cisatracurium 0.03 mg/kg.Groups D1,D2 and D3 received intramuscular injection of dezocine 0.1,0.2,0.3 mg/kg at 30 min before the end of surgery respectively and group F received intravenous injection of fentanyl 1 μg/kg at 15 min before the end of surgery.The emergence time and extubation time were recorded.Visual analog scale(VAS),Bruggrmann comfort scale(BCS) and sedation and agitation scale (SAS) at immediately,1 h,2 h after emergence from anesthesia (T0,1,2),and the incidence of respiratory depression,nausea and vomiting and urinary retention after extubation were recorded.Results Compared with group F,the emergence time and extubation time were shortened,the incidence of respiratory depression and nausea and vomiting was decreased in groups D1,D2 and D3,VAS score was increased and BCS score was decreased at T0-2 in group D1,VAS score at T0 was increased,while VAS score at T1,2 and SAS score at T0-2 was decreased in groups D2 and D3 ( P ＜ 0.05).Compared with group D2,SAS score was decreased at T0-2,while the incidence of respiratory depression was increased in group D3 ( P ＜ 0.05 ).No patient showed urinary retention in the four groups.Conclusion Intramuscular injection of dezocine 0.2 mg/kg at 30 min before the end of surgery can reduce postoperative hyperalgesia with little side effects in patients after remifentanil-based anesthesia.

Objective To investigate the interventional effect of multidimensional strategy to reduce the incidence of neonatal ventilator-associated pneumonia.Methods The patients who were admitted to the NICU department and received mechanical ventilation (MV) for more than 48 hours from October 2012 to September 2014 were recruited. The control group received the experienced interventions from October 2012 to September 2013, neonates from October 2013 to September 2014 were recruited as the intervention group receiving multidimensional controlling strategy, including bundle care, education, pro-cess and outcome surveillance and feedback on the practices. The compliance of before-after implementation of interventions were quantitatively evaluated,and the rate of VAP was compared between the two groups.Results The compliance rate of hand hygiene and the qualiifed rate of sputum suction, oral care, drain condensation from ventilator circuit, semi-recumbent posi-tion, and preventing of stress-ulcers were increased 17.0%, 11.4%, 14.7%, 18.2%, 37.5% and 56.3% respectively after implemen-tation of multidimensional strategy, and had statistical difference (χ2=36.47-294.36,P<0.01). But the qualiifed rate of antibiotic use only was 66.1% in the post-VAP bundle phases, and showed no statistical difference before and after(P>0.05). The VAP rate was 41.7 cases per 1000 MV-days during control group and 19.7 cases per 1000 MV-days during intervention group, had statis-tical signiifcance (P<0.05). But the rate of ventilator application showed no statistical difference between two group (P>0.05). ConclusionThe multidimensional strategy can effectively prevent the incidence of VAP.

BACKGROUND:Because the geographical environment and diet cause obesity and osteoarthritis in Xinjiang Uygur local patients, the number of patients became more. At present, more and more patients received artificial knee replacement. How to master and further apply the technology of soft tissue balance during artificial knee replacement in patients of different physical fitness and nations becomes the focus of many scholars. OBJECTIVE:To analyze the clinical efficacy of soft tissue balance in Xinjiang Uygur patients with knee valgus in total knee replacement. METHODS:A total of 60 cases (72 knees) with severe knee osteoarthritis with a certain degree of knee valgus were subjected to total knee replacement through anterior lateral approach and individualized soft tissue balance from February 2009 to December 2010. Folow-up mode was the clinic visit. X-ray was used to measure tibiofemoral angle (i.e., the supplementary angle of the included angle between anatomic axis of femur and tibia). Clinical score and functional score of American knee society knee score were applied to assess knee joint function. RESULTS AND CONCLUSION:A total of 57 patients were folowed up for 6-35 months. The tibiofemoral angle decreased from 27.9° preoperatively to 5.6° postoperatively. Clinical score of American knee society knee score elevated from 16.7 points preoperatively to 87.5 postoperatively. Functional score of American knee society knee score elevated from 7.9 points preoperatively to 85.2 postoperatively. Significant differences in preoperative and final folow-up scores were detected (P < 0.01). Valgus deformity was corrected and joint stability was good in 57 patients after replacement. These findings indicate that in patients with severe knee osteoarthritis and valgus deformity, to select individualized treatment of soft tissue balance can effectively correct soft tissue imbalance and get more satisfactory clinical results.

Objective To optimize the synthesis process of iloperidone 1 for industrial production.Methods Piperi-dine-4-carboxylic acid, acetic acid and acetic anhydride were used as starting materials to generate 2 via amidation, Friedel-Crafts acylation, hydration, oximation, intramolecular cyclization and salification.Compound 2 was treated with 4-(3-chloropropoxy)-3-methoxyphenylethanone through condensation to afford iloperidone.The target compound 1 was prepared with an overall yield of 34.9%.Results and Conclusion Such factors as the ratio of the raw materials, the catalyst, reactive time were investigated and optimized to make the reaction conditions mild and easy to control with less side effects.The structure has been confirmed by IR, 1 H-NMR and MS.