AIM Action of adenosine triphosphate(ATP)on longitudinal muscle strips of the rat distal colon has been reported, however, that of the rat proximal colon remains to be clarified. In this study we investigated the effects of ATP on longitudinal muscle strips isolated from the rat proximal colon and the receptors involved in the effects. METHODSIsometric relaxant and contractile responses to ATP (0.1 μmol · L- 1 - 1 mmol· L- 1 ) and adenosine (1 - 100 μmol· L-1) in longitudinal muscle strips of the rat proximal colon were observed. RESULTS ATP (0.1 μmol· L- 1 - 1 mmol· L- 1 ) produced a complicated response including an inhibition of rhythmic contraction and a weakly transient decrease in basic tone (0.05-0.08 g) followed by a concentration-dependent contraction (0.04- 0.44 g) in longitudinal muscle strips of the rat proximal colon at resting tension. Tetrodotoxin (0.1 μmol·L-1) did not influence the responses to ATP.Adenosine (1 - 100 μmol· L-1) did not produce an obvious contractile response in the preparation at resting tension. Concentration-dependent relaxant responses to ATP ( 1 μmol· L- 1 - 1 mmol· L- 1 ) in the preparation precon tracted with 5-hydroxytryptamine or with acetylcholine were 23.2％ - 94.6％ or 24.8 ％ - 92.4％, however the relaxant responses to adenosine were much weaker than those to ATP. CONCLUSION ATP produces contractileresponsesmainly via purine and pyrimidine (P) 2receptors and relaxant responses partially via P1 receptors in longitudinal muscle strips of the rat proximal colon.

Purines and pyrimidines have widespread and specific action in many tissues of both invertebrates and vertebrates. These compounds have powerful physiological roles in both short-term actions of neurotransmission, exocrine and endocrine secretion, and regulation of immune cell function,and long-term actions of cell growth, cell differentiation and proliferation in the development and regeneration.

Objective To evaluate the clinical efficacy and safety of high-dose Ambroxol in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Retrieved from PubMed, EMbase, Cochrane Library, CNKI, VIP and WanFang databases by computer, randomized controlled trials (RCTs) about high-dose of Ambroxol in treatment of AECOPD were included. According to the inclusive and exclusive criteria, literatures and data were independently screened and extracted by two researchers, and the quality of the studies were assessed, Meta-analysis was conducted by RevMan 5.2 software. Results A total of 7 RCTs were included, involving 534 patients. Meta-analysis showed that experiment group can obviously improve the overall effective rate [OR = 4.11, 95%CI (2.31, 2.31), P < 0.000 01), shorten hospital stays(OR = 3.60, 95% CI (4.66, 2.55), P < 0.00001), compared with the control group was statistically difference, and no obvious adverse reactions. Conclusion High-dose of Ambroxol could improve AECOPD overall effective rate, shorten hospital stays, improve pulmonary function and blood gas analysis, and no serious adverse reactions, be worth clinical promote using.

Objective To explore the best mass ratio of calcium phosphate cement (CPC) / cisplatin complex filling and to repair bone defect caused by tumor resection. Methods Mixed-molding method was used to obtain cisplatin/calcium phosphate cement complex at 0, 0.1%, 0.2%, and 0.4% mass ratio. Drug concentration was determined by atomic absorption spectrophotometry. Bone defect of rabbits and osteosarcoma of rats were prepared. We implanted CPC and CPC/cisplatin complex to observe the repair of bone defect and the inhibition of tumor in vivo. Results CPC containing 0.1% ～ 0. 2 % cisplatin not only repaired the bone defect in rabbits but also eliminated osteosarcoma in rats. Conclusion CPC containing 0.1% ～ 0. 2 % cisplatin can repair bone defect and eliminate tumor without influencing the prosthetic precess.

Objective To investigate the clinical effect of prenatal B ultrasound in the diagnosis of fetal hydronephrosis.Methods 105 pregnant women with advanced hydronephrosis in the Department of Ultrasound of our hospital were selected as the research subjects from November 2013 to September 2015.Grignon classification was performed according to the first B ultrasound results,including 2 cases of level Ⅴ,3 cases of level Ⅳ,6 cases of level Ⅲ,30 cases of level Ⅱ and 64 cases of level Ⅰ.The hydronephrosis was reexamined by ultrasonography within the postnatal 24h.Meanwhile,the B ultrasound reexamination was performed in the postnatal 1,3,6 and 12 months.The change of hydronephrosis was observed.Results Among 105 cases of fetal hydronephrosis,64 cases of kidneys at level Ⅰ were improved in the postnatal 6 months,including 46 cases during 1 month and 16 cases during 3 months;30 cases of kidneys at level Ⅱ were improved during 6 months,including 24 cases during 3 months;6 cases of kidneys at level Ⅲ were progressing;Among 3 cases,2 cases of hydronephrosis at level Ⅳ underwent the surgery and 1 case was progressing;2 cases of hydronephrosis at level Ⅴ underwent the surgery.98 cases of hydronephrosis were physiological (93.33％).2 cases of hydronephrosis progression at level Ⅲ required to follow up.MRU examination suggested no surgical indication at present;1 case belonged to the hydronephrosis progression at level Ⅳ.The family members asked to be reviewed.Conclusion The fetal hydronephrosis can be classified accurately through the prenatal B ultrasound examination.The prenatal B ultrasound examination is the best method for the diagnosis and prognosis of fetal hydronephrosis.

OBJECTIVE:To systematically evaluate the efficacy and safety of cetuximab in the adjuvant chemotherapy treat-ment of advanced non-small cell lung cancer(NSCLC),and to provide evidence-based reference for clinical treatment. METH-ODS:Retrieved from Cochrane Library,PubMed,CJFD and Wanfang database,randomized controlled trials (RCT) about cetux-imab adjuvant chemotherapy (test group) versus single chemotherapy (control group) in the treatment of advanced NSCLC were collected,and Meta-analysis was performed by using Rev Man 5.2 statistical software after extracting data and evaluating quality. RESULTS:A total of 8 RCT were included,involving 2 367 patients. Results of Meta-analysis showed survival rate in 1 year [OR=1.33,95%CI(1.08,1.64),P=0.006],partial remission rate [OR=1.48,95%CI(1.23,1.78),P<0.001],total effective rate [OR=1.34,95%CI(1.19,1.51),P<0.001],incidence of leucopenia [OR=1.50,95%CI(1.23,1.83),P<0.001],incidence of rash [OR=53.26,95%CI(13.09,216.65),P<0.001] and incidence of infusion reactions [OR=3.72,95%CI(1.86,7.42),P<0.001] in test group were significantly higher than those of control group,there were significant differences in 2 groups. However,there were no significant differences in the complete remission rate [OR=1.57,95%CI(0.91,2.70),P=0.11] and incidences of other ADR(P>0.05). CONCLUSIONS:Cetuximab has good efficacy in the adjuvant chemotherapy treatment of advanced NSCLC,however,the incidence of ADR should be prevented in clinic. Duo to the methodology limit of included studies,large-scale and high quality RCT are required for further validation of the conclusions.

Objective To explore job satisfaction degrees and the influencing factors among community nurses. Method General information questionnaire and the revised job satisfaction questionnaire were adopted in the investigation among 124 nurses from 28 community health service centers in Nanchong City between February to October 2016. Results The total score was (119.62 ± 15.37), at the moderate to high level. Of the eight dimensions, relationship with colleagues was scored the highest, and personal growth was the lowest. The influencing factors of the nurse's job satisfaction were found to be employment type, work positions, service duration in the community and whether they have been trained on community nursing position (all P<0.05). Conclusions The job satisfaction degree of community nurses is generally at middle level. Therefore, measures should be taken to improve the job satisfaction for the development of community nursing services.

Objective To investigate the protective effect of pitavastatin on the patients with earlystage diabetic nephropathy and its mechanism.Methods Seventy cases of early-stage type 2 diabetic nephropathy were divided into pitavastatin group and regular treatment group by random digits table method with 35 cases each.Meanwhile,35 healthy adults with physical examination were recruited as control group.Before and after treatment in pitavastatin group and regular treatment group and on the day of physical examination in control group,the blood glucose,blood lipid,renal function,urinary albumin excretion rate (UAER),high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor (TNF)-α,interleukin (IL)-18 were determined and compared.Results Before treatment,the levels of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglycerides (TG),fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,UAER,hs-CRP,TNF-α,IL-18,HDL-C were (5.74 ± 1.35) mmol/L,(3.73 ± 0.75) mmol/L,(3.46 ± 1.87) mmol/L,(10.25 ± 2.36) mmol/L,(15.59 ± 3.64) mmol/L,(8.67 ± 2.28)％,(124.2 ± 52.5) μg/min,(3.64 ± 1.48) mg/L,(43.74 ± 8.35) μ g/L,(113.43 ± 32.75) ng/L,(1.15 ± 0.36) mmol/L in regular treatment group and (5.93 ± 1.41) mmol/L,(3.68 ± 0.71) mmol/L,(3.29 ± 1.92) mmol/L,(10.48 ± 2.69) mmol/L,(16.04 ± 3.16) mmol/L,(9.48 ± 2.46)％,(116.2 ± 50.4) μ g/min,(3.48 ± 1.46) mg/L,(45.93 ± 9.41) μg/L,(120.68 ±35.20) ng/L,(1.18 ±0.35) mmol/L in pitavastatin group,and (4.57 ±0.83) mmol/L,(2.87 ± 0.64) mmol/L,(1.37 ± 0.58) mmol/L,(4.57 ± 1.37) mmol/L,(7.38 ± 1.30) mmol/L,(5.84 ± 1.57)％,(14.8 ± 9.4) μ g/min,(0.84 ± 0.52) mg/L,(10.42 ± 2.83) μ g/L,(20.84 ± 8.56) ng/L,(1.54 ± 0.39) mmol/L in control group.Before treatment,the levels of TC,LDL-C,TG,fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,UAER,hs-CRP,TNF-α,IL-18 in regular treatment group and pitavastatin group were higher than those in control group,HDL-C was lower than that in control group,and there were significant differences(P ＜ 0.01).The levels of TC,LDL-C,TG were (4.42 ± 1.28),(3.20 ± 0.57),(2.02 ± 0.87) mmol/L after treatment in pitavastatin group,which were lower than those before treatment,and there were significant differences (P ＜ 0.01).The levels of UAER,hs-CRP,TNF-α,IL-18 were (88.3 ± 36.7) μ g/min,(2.54 ± 0.76) mg/L,(35.62 ± 5.28) μg/L,(83.23 ± 21.57) ng/L in regular treatment group and (64.8 ± 34.6)μ g/min,(2.19 ± 0.65) mg/L,(27.70 ± 7.58) μ g/L,(63.20 ± 18.67) ng/L in pitavastatin group after treatment,which were lower than those before treatment,but the decreased degree was obvious in pitavastatin group.Conclusions Pitavastatin can significantly reduce not only UAER,but also the levels of hs-CRP,TNF-α,IL-18,while effectively lower the blood lipid,in early diabetic nephropathy,which indicates that pitavastatin can reduce urine protein and protect renal function by inhibiting the inflammatory process.

Objective To discuss the effect of two different warming methods on the circulation of free flaps during operation and seek for an optimal warming method which is benificial for the circulation of free flaps, and thus provide clinical evidences for intraoperative care. Methods A total of 96 patients undergoing free flap transplantation were divided into routine warming group and diversification warming group randomly (n=48 each). In routine warming group, temperature in the operating room was set at routine temperature and flaps were douched by routine heated saline. In diversification warming group, the temperature in the operation room, fluids used for washing wounds and flaps were warmed, fluids for intravenous application were pre-warmed by a fluid warmer, in addition, the operation table where patients were lying on was covered with warmer blanket. The influence of two different warming methods on the circulation of free flaps was observed. Results The scores of flap elasticity and capillary refill time in routine warming group were 2.02 ± 0.79 and 2.04 ± 0.81, respectively, vs. 2.50 ± 0.61 and 2.48 ± 0.6 in diversification warming group, showing diversification warming group was statistically better than routine warming group (Z=1.949, 3.872, P<0.05). In addition, the flap survival rate in routine warming group was 81.2%(39/48) vs. 95.8%(46/48) in diversification warming group, showing significantly better results in diversification warming group (χ2=4.02, P < 0.05). Conclusions The diversification warm keeping method can effectively promote the circulation and survival of flaps, improve clinical prognosis, accelerate postoperative rehabilitation, therefore is worthy of being recommanded its clinical application.

Group A β-hemolytic streptococcus (GAS),namely Streptococcus pyogenes,is one of the most im-portant human pathogen.GAS can cause skin and mucous membrane superficial infectious diseases,life -threatening invasive disease,toxin -mediated diseases and immune -related diseases.Antibiotic is an effective mean to control GAS infection.The β-lactam antibiotics remain the first -choice treatment for GAS infection and the macrolides are often recommended as a replacement therapy for β-lactam antibiotics allergic patients or a means to blocking GAS exotoxin product.But with the widespread use of macrolides autibiotics,macrolide -resistant GAS spread in the world. This paper will elaborate the situation of macrolide -resistant clones.