Objective To investigate the change in the expression of excitatory amino acid transporter 3 (EAAT3) in the spinal cord neurons in a rat model of chronic morphine tolerance. Methods Forty-five male SD rats were randomly divided into 5 groups ( n = 9 each) : group I sham operation (group S); group II normal saline (group NS); group Ⅰ morphine (group M); group Ⅳ ketamine (group K) and groupV M + K. In group II - V a catheter was placed in the subarachnoid space at L_(3-5) interspace. The animals were observed for 3 days. The animals with motor or sensory paralysis of the hindlimbs were excluded. NS 40 μl,morphine 20 μg, ketamine 30μg,morphine 20μg + ketamine 30μg were injected via intrathecal catheter twice a day for 7 consecutive days. 50% paw withdrawal threshold and latency (PWT, PWL) of the hindpaw to radiant heat were measured before (T_0, baseline) , on day 1, 3, 5, 7 of (T_(1-4)) and 1 day after (T_5 ) IT drug administration. The rats were sacrificed after last pain threshold measurement. The expression of EAAT3 protein in the spinal cord was determined by Western blotting and immuno-histochemistry. Results The sensitivity of the hindpaw to noxious heat stimulation was significantly decreased during (T_(1,2)) and increased after IT administration (T_(4,5)) in group M and was significantly decreased during and after FT administration (T_(1-5)) in group M + K as compared with the baseline values at T_0 and group S and was significant lower in group M + K than in group M. The expression of EAAT3 protein in the spinal cord was significantly decreased in group M and M + K as compared with group S and was significantly lower in group M than in group M + K. Conclusion The down-regulation of the expression of EAAT3 in the spinal dorsal horn neurons is involved in the development of chronic morphine tolerance and the expression of EAAT3 is down-regulated by morphine partly through the activation of NMDA receptor.

OBJECTIVE: To provide reference for the rapid enhancement of clinical pharmacists's level in medication.METHODS: An "eight-part essay"style analysis was conducted with the medication orders of typical cases as example to analyze the several important items including patients' condition,drugs,and adverse drug reactions etc.RESULTS: The "eight-part essay"style case analysis sped up pharmacists' acquisition on medication analysis and help them find the start point for clinical medication.CONCLUSION: Medication analysis is very helpful in facilitating pharmacists' work and improving medical corps' drug treatment level.

OBJECTIVE:To provide reference for playing pharmaceutical support role of clinical pharmacist to offer medical assistance in the emergence such as earthquake.METHODS:Basing on the experience in Wenchuan Earthquake,the character and forms of earthquake medical assistance were introduced,then the role of clinical pharmacist in earthquake medical assistance were analyzed.RESULTS:Clinical pharmacists distributed effectively to the drug supply so as to save medical resources and ensure rational administration during the medical rescue in earthquake.CONCLUSIONS:For achieving better function of the treatment team,national medical rescue team should involve clinical pharmacist.

Objective To discuss the significance of the diagnosis of hypothyroidism or subclinical hypothyroidism and evaluate the correlation of adverse pregnancy outcomes and the intervention effects of levothyroxine in early pregnancy .Methods 500 pregnant women who from April 2015 to April 2016 came to our hospital obstetrics do prenatal outpatient service were served as the objects in our study, at the same time, all the pregnant women received the five items of thyroid function screening.The statistically analyzed the results and followed up the pregnant women who with hypothyroidism and subclinical hypothyroidism to learn the treatment and adverse pregnancy outcomes, so as to evaluate the correlation and the intervention effects. Results In 500 cases of pregnant women,there were 6 cases of hyperthyroidism (1.2%),55 cases of hypothyroidism or subclinical hypothyroidism (11%),includeing four cases of hypothyroidism and 51 cases of subclinical hypothyroidism.The values of TSH,T3, T4,FT3 and FT4 in the group of hypothyroidism pregnant women were significant different to the normal control group (P<0.05), the values of TSH, T3, T4 and FT4 in the group of subclinical hypothyroidism pregnant women were significant different to the normal control group (P<0.05).Then the 25 cases of pregnant women with hypothyroidism or subclinical hypothyroidism received the treatment with levothyroxine, and the incidence rate of adverse pregnancy outcomes in treatment group was significantly lower than the untreated group ( P<0.05 ) .Conclusion The diagnosis of hypothyroidism or subclinical in early pregnancy and then treated with levothyroxine has important significant in decreasing the adverse pregnancy outcomes .

Objective To investigate the clinical forensic assessment on cases of suspected medical malpractice and the other related aspects concerning the assessment in clinical forensic expertise. Methods Clinical data from 25 cases expertized for suspicion of medical malpractice were retrospectively analyzed. Results 16 cases were due to the medical muff (10 cases of 16 medical muff had a bad consequence and happened in the department of operation, 6 cases had not ones); 9 cases were non-medical muff. Conclusion Though the medical muff recognized is basic, but the relationship between the medical muff and the following bad results of medical muff is the best key for the forensic expertise. Otherwise, the scientific and practical value must be considered in the forensic expertise.

Objective To explore the effect of Dingchuantang on the expression of NGF in the lung and thymus of asthmatic rats. Methods Thirty two Wistar rats were randomly divided into control group, asthmatic group, Dingchuantang group and Beclomethasone group, 8 rats for each group. Asthmatic model was made except the control group. The change of NGF expression in the lung and thymus were observed by means of immunohistochemistry. Results The expression of NGF in the lung and thymus of asthmatic group was much higher than that of control group and that of Dingchuantang group was much lower than that of asthmatic group. Conclusion Over-expression of NGF might be involved in the pathogenesis of bronchial asthma, and inhibition of NGF expression by Dingchuantang may be one of the mechanisms in the treatment of asthma.

BACKGROUND:Breviscapine has been shown to impact the reproductive capacity in rats with type 2 diabetes mel itus, but few reports concerned its mechanism of action.
OBJECTIVE:To study the effects of breviscapine on proliferating cel nuclear antigen and proto-oncogene c-fos expression in testis of type 2 diabetes mel itus rats.
METHODS:Total y 36 healthy male rats were randomly divided into control group, model group and breviscapine group with 12 rats in each group. In the model group and breviscapine group, rat models of type 2 diabetes mel itus were established by continuous intraperitoneal injection of streptozotocin. Blood glucose reaching 16.7 mmol/L in rats was considered as the standard of model induction. In the control group, rats were given an equal volume of citrate buffer solution by single intraperitoneal injection. In the breviscapine group, rats were administered breviscapine 10 mg/(kg?d) for 4 consecutive weeks by intraperitoneal injection. Rats in the other two groups were injected with an equal volume of physiological saline at the same time point.
RESULTS AND CONCLUSION:After 4 weeks of intervention, serum testosterone testing, immunohistochemistry and PCR results showed that serum testosterone levels, proliferating cel nuclear antigen, c-Fos protein and mRNA expression:control group>breviscapine group>model group (P<0.05);blood glucose concentration:the control group

[objective] To investigate the effects of curcumin on the behavior of chronic constrictive injury(CCI)rats and the c-fos expression in spinal cord dorsal horn.[Methods]108 male SD rats were randomly divided into 4 groups:Control group(treated with CCI);Sham operation group;Solvent contrast group;Curcumin treated group.Thermal withdrawal latency(TWL)and mechanical withdrawal threshold(MWT)of rats were determined by Hargreave's thermal radiation apparatus and von Frey's method of microfilament,respectively.The time course of expression of c-fos were assessed by immunohistochemical analysis.[Results]Curcumin could significantly attenuate the activation of c-fos induced by CCI and simultaneously ameliorate thermal and mechanical hyperalgesia induced by CCI.[Conclusion]This study shows that curcumin could attenuate the activation of c-fos to ameliorate the CCI-induced neuropathic pain.

Objective:To construct the rehabilitation strategy of anterior cruciate ligament reconstruction based on the evidenced method and evaluate the effectiveness in clinic.Methods:The rehabilitation strategy was firstly built based on evidenced method. And then 80 patients from Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing University Medical School Affiliated Drum Tower Hospital from January to August, 2019 were randomly and equably sent to experiment group and control group. Patients in experiment group or control group were accepted the evidenced method or regular method as treatment strategy, respectively. The visual analogue scale (VAS), thigh circumference, motion range of knee joint and Lysholm score were recorded before and after surgery.Results:Six papers met the inclusion criterion and were been screen out from 1 535 papers, and then the evidenced rehabilitation strategy of anterior cruciate ligament reconstruction was made. The VAS scores in 12 and 24 h were 1(0-2), 1(1-3) in experiment group and 2(1-3), 3(1-3)in control group, the differences were significant between two groups( Z values were 4.955, 6.489, P<0.001). The motion ranges of knee joint in 2, 4, 6, 12 weeks after operation were (61.6±5.1)°, (85.3±6.6)°, (114.6±5.2)°, (127.6±3.4)° in experiment group and(54.9±4.6)°, (71.0±8.8)°, (105.1±5.9)°, (115.8±4.0) °in control group, the differences were significant between two groups( t values were 6.209-14.138, P<0.001). The Lysholm scores at 6,8,12 weeks after operation were 58.8±3.7, 71.1±3.1, 84.3±3.7 in experiment group and 56.0±3.4, 65.4±4.3, 75.6±3.0 in control group, the differences were significant between two groups( t values were 3.511, 6.867, 11.439, P<0.001). Conclusions:This evidenced rehabilitation strategy of anterior cruciate ligament reconstruction in this study was helpful to alleviating the pain, improving motion range of knee joint after anterior cruciate ligament reconstruction.

OBJECTIVE:To analyze the non-irrational prescriptions in pharmacy intravenous admixture services to ensure patient's medication safety.METHODS:We examined the prescriptions in pharmacy intravenous admixture services from Sep.2006 to Feb.2007 and analyzed the non-irrational ones regarding incompatibility,improper choice of infusion carriers,improper medication frequency,and the incompatibility of Chinese medicines etc.RESULTS:The non-irrational prescriptions totaled 126 cases,of which,46 associated with incompatibility,38 with improper choice of infusion carriers,25 with improper medication frequency and 17 with incompatibility of Chinese medicines.Most of the irrational drug use behaviors were corrected by informing the clinic these medication errors.CONCLUSION:Examining prescriptions in pharmacy intravenous admixture services can improve the safety and effectiveness of patient's use of intravenous drugs.