Objective To study the curative efficacy of different doses of atorvastatin combined with fenofibrate in treatment of mixed type hyperlipidemia and its effects on blood lipid and prognosis.Methods 120 patients of mixed type hyperlipidemia who received therapy were selected as research subjects.According to random number table,the patients were divided into A group (n=60) and B group (n=60).The two groups were treated with atorvastatin and fenofibrate,the dose of atorvastatin in A group was 10mg,which in B group was 20mg,fenofibrate dose was 200mg.After 4 weeks of treatment,the therapeutic effect was compared.Results After treatment,the blood lipids of the two groups were improved(P<0.05),but total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) in A group were better than those in B group[(5.20±0.31)mmol/L vs.(5.87±0.46)mmol/L,(2.61±0.29)mmol/L vs.(3.85±0.34)mmol/L,(1.12±0.17)mmol/L vs.(0.93±0.13)mmol/L,(3.03±0.32)mmol/L vs.(3.48±0.41)mmol/L](t=9.355,21.493,6.877,6.702,all P<0.05).There was no significant difference in the total effective rate between the two groups[96.67%(58/60) vs.91.67%(55/60)](x2=1.365,P>0.05).The incidence rate of adverse reactions in A group was lower than that in B group[96.67%(58/60) vs.76.67%(46/60)](x2=6.171,P<0.05).Conclusion Low dose (10 mg) of atorvastatin combined with fenofibrate for mixed type hyperlipidemia has good lipid regulating effect,and adverse reaction is low,has little effect on the liver function of patients,which can effectively improve the prognosis,it is worthy of application and promotion.

Background Diabetic retinopathy (DR) is one of the most important microvascular complications of diabetes,which has become one of the leading causes of blindness.Neovascularization is the main pathological manifestations of DR,but its mechanism is unknown.There is a clear need to investigate its pathogenesis which can offer potential therapeutic targets.Objective The aim of this study was to investigate the expression and distribution of visfatin and vascular endothelial growth factor (VEGF) in diabetic model rats.Methods This study was approved by Animal Ethic Committee of Inner Mongolia Medical University.Sixty SPF 8-week-old male SpragueDawley rats were randomized into the diabetic group and control group.The rats were housed under a condition that alternated between 12 hours of light and darkness,with free access to rat food and water.Diabetes was induced by intraperitoneal injection of 60 mg/kg (0.60 ml/100 g) of streptozotocin (STZ) and control rats received equivalent volume of buffer.The models were regarded as successful when blood glucose was ≥ 16.7 mmol/L.Rats were sacrificed 12 weeks after the injection of STZ and retinal specimens were prepared to detect the expression of visfatin and VEGF.Total retinal protein was isolated from the retinas of experimental and control eyes,and the expression of visfatin and VEGF was assessed by Western blot.Frozen cross sections of retinas of 5 μm thickness were used to perform double immunofluorescence staining with anti-visfatin and anti-VEGF antibodies.Results Mean body weight of the diabetic rats was (189.02±11.34) g and that of the control rats was (489.57 ± 14.48) g at 12 weeks post-injection,showing a significant difference between them (t =5.236,P =0.003).Mean blood glucose level was (29.25±3.86) mmol/L in the diabetic group and (5.32±1.01) mmol/L in the control group,demonstrating a significant difference (t =11.778,P =0.000).Double immunofluorescence staining showed reduced expression of visfatin and VEGF in the retinal nerve fibrous layer and glial cells in the control rats.A stronger staining for visfatin and VEGF was found in the various layers of the retina in the diabetic rats,with an expression level of visfatin (A value) of 346.26±41.23,which was considerably higher than that of the control group (102.07±65.01) (t =8.291,P =0.000) in 12 weeks after injection.Furthermore,the expression of VEGF in the retina was elevated in the diabetic group compared with the control group (A value) (415.88±92.15 vs.113.06±32.06) (t=10.067,P=0.000).Conclusions Visfatin might contribute to the pathologic progression of diabetic retinal,neovascularization and it might play a synergistic role with VEGF in the pathophysiology of DR.

Background and purpose:Drug-resistance is the main obstacle in terms of efficacy of chemotherapy for leukemia, RNA interference(RNAi) strategy possesses the characteristics of specilization, high-efficiency and low-toxicity, and can effectively and specifically inhibit the overexpression of given gene. This study was designed to investigate the effect of small interfering RNA (siRNA) on expression of mdr1 gene and drug-resistance in multidrug-resistant human leukemia K562/ADM cell.Methods:Human multidrug-resistant leukemia cell line K562/ADM over-expressing mdr1 gene was used as the target cells, Two siRNAs (si-mdr1-1 and si-mdr1-2) targeted mdr1 gene were chemically synthesized and transfected into K562/ADM cells. Expression of mdr1 mRNA was determined by RT-PCR, P-glycoprotein (P-gp) expression was measured using flow cytometry (FCM), and the sensitivity of K562/ADM cells to adriamycin was assessed with a MTT colorimetric assay.Results:Two siRNAs (si-mdr1-1 and si-mdr1-2) specially designed in this study could markedly down-regulate the expression of mdr1 mRNA and its product P-gp in K562/ADM cells. After cells transfected with si-mdr1-1 or si-mdr1-2 for 24h and 48h, the inhibition of mdr1 mRNA expression in the cells for si-mdr1-1 was 55.5% and 22.5%; and for si-mdr1-2, 16.0% and 57.6%, respectively. Treated with siRNA for 72h, the expression intensity of P-gp in the two transfected cell lines decreased 74% and 85%, respectively. Both si-mdr1-1 and si-mdr1-2 significantly enhanced the sensitivity of K562/ADM cells to adriamycin and reversed their drug-resistance, the reversal efficiency was 2.52-folds and 1.96-folds, respectively.Conclusions:The siRNA could effectively and specifically silence the expression of mdr1 gene and overcome the drug-resistance mediated by P-gp in K562/ADM cells.

Xanthone and its derivatives occupy a large part of the family of natural polyphenolic compounds with various biological and pharmacological activities.In recent years (from 2006 to 2011),it was reported that 127 xanthones were discovered from plants and fungi using various modem separation methods including silica gel/polyamide column chromatography,HPLC,high-speed counter-current chromatography,high-performance centrifugal partition chromatography,etc.Since total synthesis and structure modification for xanthone and its derivatives have been given attention worldwide,we introduced the synthetic methods of xanthone skeletons as well.Unfortunately,to date,there are still weaknesses in current methods of separation and synthesis,which need to be improved.This review,to a certain extent,provides necessary foundation for the further research and development of medicines containing xanthone and its derivatives.

Holistic education is an important philosophy of medical education.Medical graduate students can show their skills of medical specialties,improve their abilities of communication and cooperation,and promote their sense of social responsibility through social practice.Through conducting questionnaire among medical graduate students of Peking University Third Hospital who major in internal medicine,we have got to know the effect of social practice on holistic education philosophy.Meanwhile,social practice is a crucial approach to implementing holistic education.

ObjectiveThe present study was designed evaluate the aspirin effectiveness in the inhibition of platelet aggregation in patients after OPCAB.Methods290 patients were recruited.145 patients underwent first time OPCAB (surgery group).Arachidonic acid induced platelet aggregation and urine 11-dehydro thromboxane B2 (11-dehydroTxB2) were measured before operation and on aspirin re-administered days 1,4, 10, and 6 months after surgery.The same tests were also detected in 145 patients from the cardiology department (non-surgery group) received medicine therapy as controls.Results Ninety-nine patients were defined as aspirin sensitive after OPCAB (AS Group).Postoperative aspirin resistance was identified in 46 (32％) patients at the first day after aspirin treatment started (AR Group).19 (13％) and 5 (3％) patients remained as AR at day 4 and 10 after aspirin re-administration, respectively.Patients in the AR group had higher 11-dehydroTxB2 levels than those in the AS group (P = 0.049).Six months follow-up showed ARA-induced platelet aggregation was (11.5 ± 3.4) ％.Urine level of 11-dehydroTxB2 was (50.3 ± 15.4) ng/L.No resistance was found.All cardiologic patients were identified as aspirin sensitive, the change of platelet aggregation and 11-dehydroTxB2 were similar as those in the AS group.Weight ＞75 kg and postoperative drainage ＞500 ml were risk factors of aspirin resistance after OPCAB.ConclusionAnti-platelet effect of aspirin was reduced during the early postoperative period in certain patients undergoing OPCAB.In case of resistance,antiplatelet treatment strategy should be intensified or modified.

Objective To investigate the protective effects of midazolam on noise-induced hearing loss in guinea pigs by testing reactive oxygen species (ROS) level in the cochlea and plasma SOD and MDA. Methods Totally forty male pigmented guinea pigs were randomly divided into four groups: control (C) , midazolam (M), normal saline (S) and noise-induced deafened (D) groups, with ten guinea pigs in each. Groups M, S and D were exposed to a continuous noise (4kHz , octave band, 100dB SPL) 3h every day for 3 consecutive days. Group M was treated with midazolam, which was administered intramuscularly (0.1mg/kg) 24h before noise exposure, and immediately upon and during noise exposure. Group S was exposed to noise and treated with the same volume of normal saline intramuscularly, the time of injection was the same as that of Group M. Group C was not exposed to noise, but was treated with midazolam intramuscularly, the time of injection and the dosage were the same as those of Group M. Group S was exposed to noise and treated with normal saline intramuscularly ,the time of injection was same with that of Group M.Group D was exposed to noise only. All animals received auditory brainstem response (ABR) threshold recording before and immediately after noise exposure. Blood was collected when the guinea pigs were killed after the last ABR threshold recording, and serum SOD activity and MDA content were detected. Both the cochleae were removed and prepared for ROS assay. Results After noise exposure, ABR threshold shift (1.6±1.5) and ROS content [(291.10±2.30)u/mL] in Group M were significantly lower than those in Groups S and D [41.7±3.3, 44.3±3.9; (348.52±3.60)u/mL, (315.56±6.70)u/mL, P<0.05]. Serum SOD activity and MDA content were significantly increased in Group M, but the amplitude was less than that in Groups S and D.Conclusion Midazolam can prevent noise-induced hearing loss by reducing the increased ROS level in the cochlea after noise exposure.

Objective To investigate the effect of sodium citrate on the efficacy of oral midazolam premedication in children with congenital heart disease. Methods Forty ASA Ⅱ or Ⅲ children, aged 2-6 yr, weighing 12-20 kg, undergoing cardiac surgery, were randomly divided into 2 groups (n = 20 each): control group (gronp C) and sodium citrate group (group S). Group S received oral mixture of midazolam 0.12 ml/kg (0.6 my/kg), ketamine 0.12 ml/kg (6 my/kg), glucose 0.12 ml/kg (60 mg/kg) and sodium citrate 0.12 ml/kg (3 mg/kg), total volume 0.48 ml/kg. Group C received oral mixture of midazolam 0.12 ml/kg, ketamine 0.12 ml/kg and glucose 0.24 ml/kg, total volume 0.48 ml/kg. Hydrochloric acid (pH value 1.75) was mixed with the mixtures in the two groups and pH values were measured. Preoperative anxiety scale and the onset time,sedation score and parental separation score after receiving oral drugs were recorded in preparation room for anesthesia. After entering the operating room, HR, MAP and SpO2 were monitored, and the response to venepuncture in children and the adverse effects associated with oral drugs were also observed and recorded. Results The pH value was 1.97 in group C and 4.52 in group S. The parental separation score, sedation score and response score were significantly lower and the onset time was significantly shorter in group S than in group C. HR, MAP and SpO2 were in the normal range after entering the operating room. There was no obvious adverse effect after administration of oral drugs in the two groups. Conclusion Application of sodium citrate in the oral premedication in children with congenital heart disease can raise the pH value, shorten the onset time of midazolam, and enhance the sedative efficacy.

AIM To evaluate the anti-angiogenesis action of Bevacizumab on corneal neovascularization(CNV) in rats induced by alkali burns.·METHODS: 20 Health Wistar rats, aging from 6 to 8 weeks and weighting from 170g to 190g from 170g to 190g were prepared for CNV animal models. Both corneas of each animal in experimental were cauterized with alkali, then all rats were randomly divided into four groups (each group have 5 rats and 10 corneas), the both corneas of each rats were received subconjunctival Bevacizumab in different dosage (group 2, 0.5rag; group 3, 1.0mg; group 4, 2.0mg)and the group 1 received carrier solution. The occurrence and development ofCNVwereobservedbyslit-lamp microscope, and length and area of CNV were calculated. All rats were followeded up 16 days after alkali burns. The 40 corneas were taken for histopathological examination. Vascular endothelial growth factor (VEGF) were detected in all rat corneas by immunohistochemistry method. ·RESULTS: In the bevacizumabotreated eyes, the vascular area was lower than in the control eyes. The treated group was statistical differences compared with the control group; when vascular area were compared between the treated groups, no statistical differences were observed. The histopathological findings showed that the inflammation cells and the neovascularity in each treated group were significantly fewer than that in the control group. The expression of VEGF markedly increased in CNV control group compared with bevacizumab-injected group. ·CONCLUSION: Subconjunctival application of a certain concentrations Bevacizumab could inhibit angiogenesis in rats corneas induced by alkali burns.