OBJECTIVE:To investigate the effects of atorvastatin with different doses on related indicators and major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI). METHODS:120 patients with AMI after PCI were randomly divided into conventional dose group(60 cases)and high dose group (60 cases). All patients were immediately given low molecular weight heparin,Aspirin enteric-coated tablet,Clopidogrel bisulfate tablet,Angiotensin-converting enzyme inhibitor,β-blockers,nitrates and other conventional treatment;based on it,conventional dose group was given 20 mg Atorvastatin calcium tablet,once every day before bedtime;high dose group was given 40 mg Atorv-astatin calcium tablet,once every day before bedtime. The treatment course for both groups was 1 month. Total cholesterol(TC), triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),C-reactive protein (CRP),OX40L,interleukin (IL)-6 levels in 2 groups before and after treatment were observed,the correlation among OX40L with CRP and IL-6 were analyzed,and the incidence of MACE in 2 groups was recorded after 1 month follow-up. RESULTS:Be-fore treatment,there were no significant differences in the TG,TC,LDL-C,HDL-C,OX40L,CRP and IL-6 between 2 groups (P>0.05). After treatment, TG, TC, LDL-C, OX40L, CRP and IL-6 were aignificantly lower than before, TC, LDL-C, OX40L,CRP and IL-6 in high dose group were lower than conventional dose group,HDL-C was significantly higher than before, the differences were statistically significant(P<0.01 or P<0.05);but there was no significant difference in the HDL-C between 2 groups(P>0.05). Before treatment,OX40L showed positive correlation with CRP(r=0.746,P<0.01)and IL-6(r=0.763,P<0.01);after treatment,OX40L also showed positive correlation with CRP (r=0.755,P<0.01) and IL-6 (r=0.760,P<0.01). The incidence of MACE in high dose group were significantly lower than conventional dose group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on the conventional treatment,atorvastatin can significantly reduce lipid,inflamma-tion levels and incidence of MACE,but the effect is more significant in high dose.

Objective To investigate the problems existing in hospital transfusion records,analyze unreasonable factors,and improve the quality of blood transfusion.Methods Investigation of our hospital from January 2016 to January 2017 with blood transfusion medical records,according to hospitalization number,900 cases were selected,using random number table.Investigating blood transfusion records on each record integrity,according toGuidelines for Surgical and Traumatic Blood Transfusion and Internal medicine transfusion guide in clinical blood transfusion technical specifications.The common blood components such as red blood cells,plasma and cryoprecipitate infusion and rationality evaluation.Results There were 583 surgical departments and 557 non-surgical departments.There was a significant difference between the surgical department and the non-surgical department.The reasonable rate of non-operation department was higher than that of the operation department (x2 =7.723,P=0.021).The rational rate of the department was 93.8％,while the operation department was only 88.0％;900 blood transfusion records of four kinds of blood components of the rationality of the difference was statistically significant (x2=214.767,P＜0.001).Non-surgical department of erythrocyte,plasma,cold precipitate reasonable rate than the surgical department;900 medical records in 55 records failed,mainly after the assessment of incomplete blood transfusion,no recorded blood transfusion reaction.There were significant differences in the failure rate between the surgical department and the non-surgical department (x2 =4.613,P=0.032).Conclusion Some physicians transfusion indications,for evaluation before and after blood transfusion blood insufficient attention to curative effect evaluation,blood transfusion is not reasonable,and in the operation department,do not take the blood transfusion medical record writing,hospitals should strengthen the blood transfusion blood transfusion continuously improve the scientific and normative management.

We studied the effect of photodynamic therapy with phycobiliproteins on human liver cancer cells in vitro. With 3-(4, 5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay (MTT assay), we used two phycobiliproteins, R-phycoerythrin (R-PE) and C-phycocyanin (C-PC) prepared from Porphyra yezoensis, to determine the killing rates and apoptosis rates of human liver cancer cells (SMMC-7721) mediated by laser. When the concentration of R-PE was 120 mg/L, the survival rate of human liver cancer cells was 27% after treated by Argon laser with 100 J/cm2 doses, while the survival rate in the control group (without adding R-PE) was 65%. When the C-PC concentration was 120 mg/L, the survival cell rate was 47% after treated by He-Ne laser with 35 J/cm2 dose, while the survival rate in the control group (without adding C-PC) was 70%. After handled only with these two kinds of phycobiliproteins for 72 h, the growth of cancer cells presented significant inhibition. The maximal inhibition rates reached up to 31% with R-PE (120 mg/L concentration) and 27% with C-PC (250 mg/L concentration) respectively. After irradiated by laser for 8 h, the maximal cell apoptosis rates were 31.54% with R-PE and 32.54% with C-PC, respectively. It indicated that R-PE and C-PC extracted from Porphyra yezoensis could develop to new photosensitizers for cancer photodynamic therapy.
Apoptosis ; drug effects ; radiation effects ; Cell Line, Tumor ; Humans ; Lasers ; Liver Neoplasms ; pathology ; Photochemical Processes ; Photochemotherapy ; methods ; Phycobiliproteins ; isolation & purification ; pharmacology ; Phycoerythrin ; isolation & purification ; pharmacology ; Porphyra ; chemistry

Objective:To compare the efficacy of individualized PEEP determined by lung electrical impedance tomography (EIT) and dynamic lung compliance (Cdyn) during lung-protective ventilation strategies in the patients undergoing general anesthesia.Methods:Sixty patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, with body mass index of 18.5-28.0 kg/m 2, undergoing elective surgery with general anesthesia and endotracheal intubation in the Second Affiliated Hospital of Soochow University, were selected.Lung-protective ventilation strategy was applied in supine position after general anesthesia.The peak value of PEEP did not exceed 10 cmH 2O, with an increment/decrement of 2 cmH 2O for titration.The corresponding Cdyn value and lung EIT data were collected during titration.The patients were divided into 2 groups ( n=30 each) using a random number table method: titration first increased and then decreased group (group A) and titration first decreased and then increased group (group B). The determination method of individualized PEEP: Cdyn method was the PEEP corresponding to the maximum Cdyn value; EIT method was obtained through PV500 PC software analysis.The level and success rate of individualized PEEP determined by the Cdyn and EIT methods were compared, and the ICC consistency analysis of the determined individualized PEEP was performed. Results:Compared with the Cdyn method, the success rate of individualized PEEP determined by EIT method was significantly increased, and the level of individualized PEEP was decreased in the two group ( P<0.05). In group A, the individualized PEEP titrated by the EIT and Cdyn methods showed good agreement (the ICC value of the increment-Cdyn and increment-EIT methods was 0.761, P<0.05; the ICC value of the decrement-Cdyn and decrement-EIT methods was 0.763, P<0.05). In group B, the individualized PEEP titrated by the EIT and Cdyn methods showed good agreement (the ICC value of the increment-Cdyn and increment-EIT methods was 0.809, P<0.05; the ICC value of the decrement-Cdyn and decrement-EIT methods was 0.797, P<0.05). Conclusion:The agreement between the individualized PEEP determined by lung EIT method and Cdyn method during lung-protective ventilation is good in the patients undergoing general anesthesia, and the success rate of EIT method is higher, and the level of individualized PEEP is lower.

Objective To explore the relations between pulse pressure and LDL-C for elderly patients with hyperten-sion. Methods A total of 451 elderly patients with hypertension were selected and divided into four groups. Group A was 65 to 69 years of age, group B was 70 to74 years of age, group C was 75 to 79 years of age, and group D was ≥80 years of age. They were also divided into four groups according to PP levels: PP1 group ≤40 mm Hg, PP2 group 41 to 60 mm Hg, PP3 group 61 to 80 mm Hg, and PP4 group>80 mm Hg. They were divided into LDL-C group 1 (≥2.6 mmol/L) and LDL-C group 2 (<2.6 mmol/L) according to their LDL-C levels. Distribution of different age groups in four PP groups and the effects of different levels of LDL-C on pulse pressure were analyzed. Results (1) The propor-tions of PP2 group among the four age groups were 59.41%, 48.84%, 55.45% and 51.67%. The proportions of PP4 a-mong the four age groups were 4.95%, 3.88%, 3.96% and 7.50%. (2) Compared with PP1 group, the proportion of LDL-C ≥2.6 mmol/L in PP2 group, PP3 group and PP4 group was significantly increased. Conclusion (1) PP levels in different ages groups are concentrated on 41-60 mmHg. Among elderly patients with hypertension>80 mmHg, the pro-portion of patients with advanced age (≥years of age) is relatively higher. (2) LDL-C is the risk factor of increased pulse pressure for elderly patients with hypertension.

Objective To evaluate the role of the mitochondrial ATP-sensitive potassium (mito-KATP)channel in sevoflurane preconditioning-induced delayed cardioprotection against ischemia-reperfusion (I/R) injury in isolated rat hearts.Methods Seventy-two adult male Sprague-Dawley rats were randomly divided into 6 groups (n =12 each):control group (group CON),I/R group,sevoflurane control group (group SEVO),sevoflurane preconditioning group (group SWO P),5-hydroxydeconoate (5-HD) + sevoflurane preconditioning group (group 5-HD+ SWOP) and 5-HD control group (group 5-HD).The rats were exposed to 33％ pure oxygen for 1 h in groups CON and I/R.The rats were exposed to 2.5％ sevoflurane for 1 h in groups SEVO and SWOP.5-HD (a mito-KATP channel inhibitor) 10 mg/kg was injected intraperitoneally 30 min before sevoflurane preconditioning in group 5-HD + SWOP.5-HD 10 mg/kg was injected intraperitoneally in group 5-HD.The hearts were immediately removed and perfused in a Langendorff apparatus.The hearts were made globally ischemic for 30 min followed by 120 min reperfusion in groups I/R,SWOP,5-HD + SWOP and 5-HD.The expression of phosphorylated protein kinase C-epsilon (p-PKC-ε) and caspase-8 was measured by Western blot immediately before ischemia (T0) and at 120 min of reperfusion (T1).The myocardial infarct volume was measured by TTC staining.Results Compared with group CON,the myocardial infarct volume was significantly increased at T1 in groups I/R,SWOP,5-HD +SWOP and 5-HD,p-PKC-ε expression was up-regulated at T0 in groups SEVO and SWOP and at T1 in groups I/R,SWOP,5-HD + SWOP and 5-HD,and caspase-8 expression was down-regulated at T1 in group SEVO (P ＜0.05).Compared with group I/R,the myocardial infarct volume was significantly decreased at T1 in groups SWOP and 5-HD + SWOP,p-PKC-ε expression was up-regulated at T0 in groups SEVO and SWOP,and caspase-8 expression was down-regulated at T1 in group SWOP (P ＜ 0.05).Compared with group SWOP,the myocardial infarct volume was significantly increased,p-PKC-ε expression was down-regulated at T0,and caspase-8 expression was up-regulated at T1 in group 5-HD + SWOP (P ＜ 0.05).Conclusion The mito-KATP channel is involved in sevoflurane preconditioning-induced delayed cardioprotection against I/R injury in isolated rat hearts through upregulation of p-PKC-ε expression before ischemia and inhibition of cell apoptosis during reperfusion.

Objective:To bring to doctors' attention to the first time attack of epilepsy in the patients with Parkinson' s disease, enhance the rational drug use and reduce the occurrence of adverse reactions in clinics. Methods: A Parkinson patient with the first time attack of epilepsy was synthetically analyzed on the mechanism of disease, therapy regimen and pharmaceutical care. Results:It was difficult to distinguish the symptom of epilepsy during the treatment of Parkinson' s disease from that of L-dopa induced dyskinesia, therefore, the suitable treatment was difficult to perform. Moreover, antiepileptic drug valproic acid could aggravate Parkinson syn-drome imperceptibly, which was easy to be ignored in clinics. Conclusion:L-dopa induced dyskinesia should try to avoid during the treatment of Parkinson, and should distinguish from the first time attack of epilepsy in order to choose proper antiepileptic drugs.

Objective To determine the optimal positive end-expiratory pressure (PEEP) for volume-controlled ventilation using pulmonary electrical impedance tomography in the patients undergoing surgery with general anesthesia.Methods Fifty patients of both sexes,aged 18-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18.5-28.0 kg/m2,scheduled for surgery for ureteral calculi under general anesthesia,were enrolled in this study.The patients were tracheally intubated after anesthesia induction and mechanically ventilated in volume-controlled mode,with tidal volume 6 ml/kg,mean arterial pressure was recorded at 3 min of ventilation and served as the baseline value,and then PEEP was increased with an increment of 3 cmH2O every 3 min until PEEP reached 15 cmH2 O.The percentage of dorsal pulmonary ventilation and peak airway pressure were recorded at 3 min of ventilation with different PEEPs.When the decrease in mean arterial pressure was more than 20％ of the baseline value during ventilation,deoxyepinephrine 0.1 mg was injected intravenously,and the consumption of deoxyepinephrine was recorded within 3 min of ventilation with different PEEPs.Results Peak airway pressure was gradually increased with the increase of PEEP (P＜0.05),the percentage of dorsal pulmonary ventilation was gradually increased when PEEP was 6 cmH2O (P＜ 0.05),and the consumption of deoxyepinephrine was gradually increased when PEEP was 15 cmH2O (P＜0.05).Conclusion The optimal PEEP is 12 cmH2O during volume-controlled ventilation with tidal volume of 6 ml/kg in the patients undergoing surgery with general anesthesia.

Pyroptosis,as the main mechanism of host defense,is the key link between innate immunity and adaptive immunity.Pyroptosis is accompanied by membrane rupture,and the cells release a large number of inflammatory mediators,which recruit inflam-matory cells and activate the inflammatory response.Tumor immunotherapy utilizes the natural defense mechanism of the host to ad-minister certain immunomodulators,antibodies or stimulation-adjusted immune cells to obtain stronger anti-tumor effects.Recent stud-ies have shown that pyroptosis has a positive regulatory effect on tumor immunotherapy,including immune checkpoint inhibitors and chimeric antigen receptor T-cell immunotherapy,etc.In this paper,based on the published experimental studies,the mechanism of pyroptosis and its correlation with tumor immunotherapy.In this paper,based on the published experimental studies,the mechanism of cellular apoptosis in tumor immunity is elucidated on the basis of the mechanism of apoptosis and the correlation between tumor im-munotherapy,in order to provide new ideas for the basic and clinical research of malignant tumors.

Tumor-associated macrophages （TAMs）， as the main immune cells in the human body， are key factors in maintaining the homeostasis of the tumor microenvironment. With high plasticity， they can polarize into the classically activated （M1） macrophages or alternatively activated （M2） macrophages under different conditions. M1 macrophages can inhibit tumor growth by phagocytosis， and M2 can inhibit the immune microenvironment to promote tumorigenesis and immune escape. Small molecules of traditional Chinese medicine have been widely studied in gastrointestinal tumors. These small molecules exert anti-tumor activity by enhancing TAM activity and promoting the polarization of macrophages. Targeted intervention in TAMs with these molecules has the potential to inhibit the development of gastrointestinal tumors. This article summarizes the research status and significance of small molecules of traditional Chinese medicine targeting TAMs against gastrointestinal tumors， aiming to provide reference for the future studies in this field.