Objective To acknowledge the present status of clinical use of nonsteroidal antiinflammatory drugs(NSAIDs) in China. Methods Five hundred and seventy-five valid questionnaires were collected from 50 hospitals in different areas of China including Shanghai, Beijing, Tianjin, Shenyang and Guangzhou. Results 54.7% of doctors used cyclooxygenase-2 (COX-2) selective inhibitors. The ratio of the doctors prescribing loxoprofen, diclofenac, meloxicam were 22.6%, 23.3%, 14.60%, respectively. The ratio of the doctors who prescribe uncoated routine-dose aspirin, uncoated low-dose aspirin, enteric-coated routine-dose aspirin, enteric-coated low-dose aspirin and others were 17.0%, 14.7%, 36.8%, 28.5% and 3.0%, respectively. The ratio of doctors who only "some-times" prescribed co-medicine to prevent gastrointestinal damages when they prescribed aspirin, conventional NSAID and COX-2 selective inhibitors were 41.10%, 40.70% and 45.1%, respectively, while the most commomly used co-medicine were H2 receptor antagonist (H2 RA) and proton pump inhibitor respectively. 37.1% of doctors examined H. pylori infection status, and 76.3% of doctors would eradicate H. pylori if positive. Conclusions The most commonly used conventional NSAID is diclofe-nac. The most commonly used formulation of aspirin is enteric-coated aspirin. Most doctors only "sometimes" prescribe co-medicine together with aspirin, conventional NSAID and COX-2 selective inhibitors to prevent gastrointestinal damages, and the most commonly used co-medicine is acid inhibitor. Only a few doctors examine H. pylori infection prior to the administration of NSAID.

Cardiovascular diseases (CVDs) are a major cause of morbidity and mortality in the world. So far, there has been substantial progress toward understanding the pathophysiology and treatment of CVDs. There are multiple cell signaling cascades, some of which are beneficial or compensatory and others deleterious. The balance between these pathways determines the outcome as a diseased or non-diseased state. Protein phosphorylation, which is mediated by enzymes, called protein kinases, is a major mechanism for transducing external stimuli into intracellular signals. Electively targeting of signaling pathways using protein kinase inhibitors would have a potential advantage over receptor blockers. By now, there are types of protein kinase inhibitiors available for treating several diseases. The success of kinase inhibitors in cancer treatment has strongly supported application in the treatment of CVDs. Here, we will review several kinds of protein kinases as potential targets for CVDs and some difficulty in identifying a protein kinase as a putative therapeutic target for CVDs.

Objective To evaluate immediate breast reconstruction with extended latissimus dorsi flap after mastectomy for patients of breast cancer. Methods One hundred and sixty-two women with breast cancer underwent surgery from Jan, 2000 to Dec, 2007. Masteetomy was carried out including traditional modified mastectomy in 32 cases, skin sparing mastectomy in 51 cases and nipple-areolar sparing mastectomy in 79 cases. Immediate breast reconstruction was performed with latissimus dorsi flap and surrounding fat tissue. Results Operation was successful in 161 cases. The morphology of reconstructed breasts was excellent in 91.93% cases as evaluated by patients themselves. After operation 6 cases had partial nipple necrosis, 5 cases had rhacoma of the chest, but cured conservatively. Eleven cases had seroma on the back, among them 8 cases cured by puncture and drainage. Two cases cured by erasion of the pseudomembrane and 1 case cured by exairesis of the fibrous capsule. Three cases had limited skin necrosis around the incision. One case had necrosis on part of the donor side, cured by reoperation. One case had implant necrosis necessitating removal of the implant. The patients were followed up for 7～90 months, and the 23 cases were free of tumor recurrence before they lost to follow-up. Among those followed-up cases there were bone metastasis in 2 cases, lung metastasis in 1 case and supra clavicular lymph node metastasis in one. No local recurrence was found. Conclusions Immediate breast reconstruction with extended latissimus dorsi flap after masteetomy is safe and effective, especially suitable for small and medium size breasts.

Serum triglyceride ( TG ) , total cholesterol ( TC ) , low density lipoprotein cholesterol ( LDL-C) , high density lipoprotein cholesterol ( HDL-C) , uric acid ( UA) levels and fasting blood glucose ( FBG) were measured in 67 patients with chronic spontaneous urticaria ( CSU ) and 66 healthy subjects ( controls).Results showed that the rates of increased serum TG and FBG levels in CSU patients were higher than those in controls ( 19% vs.6%,χ2 =5.309, P <0.05; 12% vs.1%,χ2 =4.194, P <0.05, respectively);however, there were no significant differences in abnormal rate of TC(7%vs.3%) , LDL-C (4%vs.1%), HDL-C(6%vs.3%)and UA(6%vs.1%) between CSU patients and healthy controls(all P>0.05).The rate of rising FBG in CSU patients accompanied by angioedema(4/9)was higher than that in CSU patients without angioedema(7%,χ2 =7.181,P<0.05).

Objective To study the expression of Toll-like receptor 4(TLR4) in peripheral blood mononuclear cell (PBMCs) and serum interleukin-6(IL-6) in wheezing children under 5 years of age.Methods A total of 224 wheezing children under 5 years of age were divided into API(asthma predictive index)-positive (n=116) and API-negative groups (n=108).Serum level of IL-6 and TLR4 expression on CD14+ monocytes were measured after wheezing was stable for one month.TLR4 expression on CD14+ monoeytes was quantified via flow-cytometry.Serum level of IL-6 was detected by ELISA.Results Serum level of IL-6 and TLR4 expression on CD14+ monocytes of API-positive group were higher than API-negative group [LR4(％):34.9±10.0 vs.30.2± 8.8;IL-6(ng/L):46.4±15.1 vs.40.5±13.6].There was a significant positive correlation between the expression of TLR4 and the content of serum IL-6 in two groups of wheezing children(P＜0.05).Conclusion TLR4 may play a role in the pathogenesis of asthma through promoting the expression of IL-6.TLR4 may be a index to predicting asthma in wheezing children.

AIM: To determine the relationship between antigen-induced airway inflammation characterized by pulmonary eosinophilia and bronchial hyperreactivity in rats, and to evaluate the effect of theophylline at different doses. METHODS: In ovalbumin (OA)-sensitized rats, bronchiole wall area, eosinophils around bronchi, and the responses to methacholine (MCh) aerosol were measured after 1% OA aerosol challenge with computer-assisted techniques. RESULTS: OA challenge caused both inflammation and airway hyperreactivity, and there was a significantly positive correlation between them. Oral theophylline (1-12.5 mg/kg, bid for 7 days) attenuated antigen-induced inflammation (swelling of bronchiole walls and pulmonary eosinophilia) and bronchial hyperreactivity. CONCLUSION: These findings confirm that bronchial hyperreactivity positively correlates to airway inflammation in the rat, and suggest that theophylline at relatively lower doses has anti-inflammatory effect in airway allergic reaction.

Objective To investigate the clinical characteristics of hypertrophic cardiomyopathy (HCM) in the elderly. Methods The clinical characters of HCM in 70 elderly patients were retrospectively analysed. Results Among the 196 identified HCM patients, 70 were elders. Out of them, 7 patients(10.0%) were suspected as HCM according to the clinical symptoms, 29 patients (41.4%)were suspected as other cardiac diseases, 34 (48.3%) were diagnosed HCM due to other reasons. Among the 70 patients, 12 patients(17.1%) had history of cerebrovascular diseases, 54 (77.1%) manifested symptoms after 45 years of age and 4 (5.7%) showed no obvious symptoms. Among them, 18 patients were examined by UCG for two times and HCM was diagnosed at the second time. Conclusions HCM in the elderly is not an uncommon disease. The onset of cardiac symptoms is relatively late in the elderly HCM and frequently misdiagnosed; cerebrovascular diseases are commonly seen in elderly HCM patients.

Cardiovascular diseases(CVDs) are a major cause of morbidity and mortality in the world.So far,there has been substantial progress toward understanding the pathophysiology and treatment of CVDs.There are multiple cell signaling cascades,some of which are beneficial or compensatory and others deleterious.The balance between these pathways determines the outcome as a diseased or non-diseased state.Protein phosphorylation,which is mediated by enzymes,called protein kinases,is a major mechanism for transducing external stimuli into intracellular signals.Electively targeting of signaling pathways using protein kinase inhibitors would have a potential advantage over receptor blockers.By now,there are types of protein kinase inhibitiors available for treating several diseases.The success of kinase inhibitors in cancer treatment has strongly supported application in the treatment of CVDs.Here,we will review several kinds of protein kinases as potential targets for CVDs and some difficulty in identifying a protein kinase as a putative therapeutic target for CVDs.

BACKGROUND:Insulin-like growth factor 1 is the key factor during cartilage development, which is involved in the growth and reconstruction of condylar cartilage.
OBJECTIVE:To study the effect of insulin-like growth factor 1 on cel apoptosis and the apopotosis-associated factors of Bcl-2, Bax mRNA and protein expressions of rat condylar chondrocytes.
METHODS:The 1-day-old and 28-day-old rat condylar chondrocytes were cultured and identified in vitro. The condylar chondrocytes with different ages were divided into experimental group and control group. After being starved for 24 hours, chondrocytes in the experimental group were incubated with 100μg/L recombined rat insulin-like growth factor 1 for 48 hours, while the chondrocytes in the control group were incubated normal y. RESULTS AND CONCLUSION:Compared with the control group, after being incubated with recombined
insulin-like growth factor 1, the number of condylar chondrocytes was increased with high speed proliferation (P<0.05). Real-time RCR and western blot analysis revealed that the expression levels of Bcl-2 mRNA and protein were increased after added with recombined rat insulin-like growth factor 1, while the expression levels of Bax and protein were decreased (P<0.05). The results indicate that insulin-like growth factor 1 can promote the
proliferation and reduce cel apoptosis of newborn and adolescent rat condylar chondrocytes, which may be mediated by Bcl-2 and Bax.

Objective To investigate the changes of electrolyte metabolism in patients undergoing moderate elective abdominal operation,and explore its relationship with postoperative complications.Methods The clinical data of 1117 inpatients (age ≥ 18 years) who had undergone moderate elective abdominal operation in the Department of General Surgery of Beijing Hospital from January 1,2011 to December 31,2011 were retrospectively analyzed.They received postoperative fasting for ≥ 3 days,and the preoperative liver function and renal function were normal.The perioperative electrolyte changes and clinical outcomes were recorded.For patients with normal preoperative electrolytes but abnormal postoperative electrolytes,its potential correlations with the postoperative infections and total complications were analyzed.Results The rates of abnormal postoperative electrolytes were as follows:potassium,24.1％ ; sodium,6.4％ ; chloride,27.6％ ; calcium,61.7％ ; magnesium,16.3％ ; and phosphorus,71％.The vast majority of ion levels were below the normal levels.The total complication rate was 19.7％ and the postoperative infection rate was 17.19％.Univariate logistic regression analysis showed that the postoperative total and infective complications were significantly associated with the increased (P =0.007) or decreased (P =0.007) serum potassium,the decreased serum sodium (P =0.016),the decreased serum phosphorus (P =0.004),and the decreased magnesium (P =0.049).Conclusions Electrolyte decrease is common after moderate elective abdominal operations.There is a certain correlation between postoperative electrolyte decrease and postoperative complications.Therefore,attention should be paid to maintain electrolyte balance during the perioperative period.