Objective:To evaluate the management effect of clinical pharmacist on antibiotics use during perioperative period of great saphenous varicose veins surgery. Methods:The medical records of all the patients undergoing simple great saphenous vein strip-ping, great saphenous vein high ligation plus simple stripping and saphenous vein ligation plus endovenous laser treatment between June and September in 2010 ( before the intervention) , 2011 ( after the intervention) and 2014 ( consolidation period) were selected, and the rationality of prophylactic use of antibiotics during perioperative period was evaluated. Results: After the management of clinical pharmacists, the preventive application of antibiotics during perioperative period was markedly improved in the indication, medicine va-riety choice,application and dosage, administration route, solvent and solvent dose, administration time, course of treatment and drug combination when compared with that before the intervention. Antibiotics use ratio, average hospitalization days, antibiotics ratio, drug ratio and infusion ratio were reduced obviously, which could be consolidated. Conclusion: The intervention of clinical pharmacists in antibiotics use during perioperative period of great saphenous varicose veins surgery improves the reasonable use ratio of antibiotics, and makes certain significance in the cost reduction for patients and the specification for hospital management.

ObjectiveTo investigate the difference of blood pressure variability among patients with lacunar infarction,nonlacunar infarction and normotension.MethodsBlood pressure was measured serially at 1-hour intervals during the first 24 hours after infarction with ambulatory blood pressure monitoring in 31 patients(17 cases with nonlacunar infarction and 14 cases with lacunar infarction).The blood pressure variability index were compared.ResultsBoth 24 h and day systolic blood pressure variability were significantly higher in lacunar infarction patients compared with nonlacunar infarction ones.ConclusionFluctuation of systolic blood pressure may disturb small arteries rather than large or middle arteries.

Objective To compare the effect of continuous positive airway pressure (CPAP)and bilevel positive airway pressure(BiPAP)on the cardiac structure and function of patients with obstructive sleep apnea and hypopnea syndrome(OSAHS).Methods 100 patients with OSAHS were selected as the research subjects.The patients were randomly divided into two groups by digital table method,CPAP group had 50 cases,adopted the CPAP ventilation mode,BiPAP group had 50 cases,adopted the BiPAP ventilation mode.The heart rate,blood pressure, blood brain natriuretic peptide(BNP),nitric oxide(NO),endothelin -1 protease,matrix metalloprotein 9(MMP -9), C -reactive protein (CRP) and polysomnography (PSG) related indicators,cardiac structure and function and endothelial function changes before and after treatment were observed in the two groups,compared the clinical effect of the two modes.Results Before treatment,in both groups,there were no statistical differences in blood pressure,heart rate,BNP,NO,endothelin -1,MMP -9,CRP,PSG related indicators,cardiac structure and function,endothelial function.After six months of noninvasive ventilator treatment,results of the heart rate,systolic pressure,diastolic blood pressure,blood oxygen saturation,oxygen partial pressure,the BNP,endothelin -1,NO,MMP -9,CRP,body mass index,the Epworth sleepiness scale(ESS),Apnea hypoventilation index(AHI),oxygen and lowest at night,aortic di-ameter(AO),left ventricular inner diameter (LA),right ventricular(RV)inside diameter,left ventricular ejection fraction(LVEF),pulmonary artery systolic pressure(PASP)of the CPAP group were (79.83 ±11.47)times/min, (114.06 ±11.45)mmHg,(72.44 ±7.38)mmHg,(97.6 ±1.45)%,(93.17 ±1.86)mmHg,(110.78 ±38.32)ng/L, (17.58 ±2.07)ng/L,(8.55 ±0.55)μmol/L,(372.73 ±189.00)μg/L,(3.34 ±2.29)mg/L,(23.87 ±1.59), (0.98 ±0.70),(0.65 ±0.30),(94.04 ±1.62)%,(31.52 ±2.17 )mm,(31.19 ±1.09 )mm,(20.86 ± 1.69)mm,(61.13 ±5.02)%,(20.74 ±5.49)mmHg.which of the BiPAP group were (80.96 ±8.56)times/min, (114.58 ±9.34)mmHg,(71.67 ±8.57)mmHg,(96.96 ±1.43)%,(94.52 ±1.66)mmHg,(87.63 ±28.33)ng/L, (17.76 ±2.20)ng/L,(8.54 ±0.52)μmol/L,(359.63 ±268.95)μg/L,(4.96 ±2.00)mg/L,(24.15 ±1.65), (0.85 ±0.75 ),(0.58 ±0.19 ),(94.50 ±1.18)%,(31.73 ±1.57 )mm,(31.97 ±1.12)mm,(21.58 ± 2.43)mm,(62.24 ±5.79)%,(21.45 ±3.76)mmHg.In the oxygen partial pressure,the BNP,MMP -9,CRP,ESS score,AHI,LA,LVEF and other indicators,BiPAP mode were better than CPAP mode(t =2.13,4.32,2.13,4.32, 1.39,4.93,2.58,4.36,all P <0.05 ).Conclusion BiPAP mode and CPAP mode can improve cardiovascular function in patients with OSAHS,improve the symptoms of low ventilation,reduce obesity,but in terms of reducing cardiac load,improve blood vessel function,BiPAP mode is better than CPAP.

Objective To explore the effect of topical application of sodium hyaluronate on preventing perivascular adhesion of the vein grafts in rabbits. Methods Thirty-six male New Zealand white rabbits, aged 5 months, were randomly and equally divided into 2 groups: groups A and B. Arterial defect model was established by cutting about 1cm artery from the middle part of the dissected left common carotid artery. A section about 3cm was cut from the right external jugular vein, and the harvested vein was inverted and anastomosed end-to-end to the artery defect. After the anastomosis, the adventitia and two anastomoses of the grafted veins in group A were coated locally with 0.2ml sodium hyaluronate. The grafted veins were obtained 1, 2 and 4 weeks after the operation, with the perivascular adhesion of the vein grafts being examined macroscopically before the resection. HE staining and Masson staining were preformed for histological changes of grafted vein wall and the perivascular adhesion of the vein grafts. At 2, 4 weeks postoperation, the perivascular adhesions of the vein grafts were graded by the grading criteria of adhesion in macroscopic evaluation and histological evaluation. Result At 1, 2 and 4 weeks postoperatively, the macroscopic and histological observation found that the perivascular adhesions in group A were looser than those in group B. The macroscopic grade and histological grade were lower in group A than in group B, there was a significant difference between the two groups at 2 and 4 weeks postoperation (P<0.05). Conclusion Topical application of sodium hyaluronate can reduce the perivascular adhesion and is an ideal treatment strategy for preventing perivascular adhesion of vein grafts.

Purpose: Cerebral ischemia is related to insufficient blood supply and is characterized by abnormal reactive oxygen species (ROS) production and cell apoptosis. Previous studies have revealed a key role for basic helix-loop-helix family member e40 (Bhlhe40) in oxidative stress and cell apoptosis. This study aimed to investigate the roles of miR-494-3p in cerebral ischemia/reperfusion (I/R) injury. Materials and Methods: A mouse middle cerebral artery occlusion (MCAO/R) model was established to mimic cerebral ischemia in vivo. Brain infarct area was assessed using triphenyl tetrazolium chloride staining. Oxygen-glucose deprivation/reoxygenation (OGD/R) operation was adopted to mimic neuronal injury in vitro. Cell apoptosis was analyzed by flow cytometry. The relationship between miR-494-3p and Bhlhe40 was validated by luciferase reporter and RNA immunoprecipitation assays. Results: Bhlhe40 expression was downregulated both in MCAO/R animal models and OGD/R-induced SH-SY5Y cells. Bhlhe40 overexpression inhibited cell apoptosis and reduced ROS production in SH-SY5Y cells after OGD/R treatment. MiR-494-3p was verified to bind to Bhlhe40 and negatively regulate Bhlhe40 expression. Additionally, cell apoptosis and ROS production in OGD/ R-treated SH-SY5Y cells were accelerated by miR-494-3p overexpression. Rescue experiments suggested that Bhlhe40 could reverse the effects of miR-494-3p overexpression on ROS production and cell apoptosis. Conclusion MiR-494-3p exacerbates brain injury and neuronal injury by regulating Bhlhe40 after I/R.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate electrocardiographic (ECG) and angiographic characteristics of patients with acute solitary posterior myocardial infarction. Patients complicated by inferior wall or right ventricular infarction were excluded.

METHODECG and angiographic changes in 11 patients with acute solitary posterior myocardial infarction admitted to our emergency room from 2001 to 2006 were analyzed.

RESULTSBesides typical ST segment elevation in V(7)-V(9) leads, other ECG manifestations in these patients included V(1)-V(2) R/S > or = 1 (9/11, 81.8%), 1 - 2 mm ST depression in V(1)-V(4) (5/11, 45.5%), 0.5 - 1.5 mm ST elevation in I, aVL leads (4/11, 36.4%) and 0.5 - 1.5 mm ST elevation in V(5)-V(6) leads (5/11, 45.5%). Coronary angiography showed that left circumflex artery (LCX) was the infarction related artery in all cases. The infarction area located before OM1 origination in 1 patient with a 95% pipe-like stenosis (1/11), after OM1 origination in 6 patients (6/11, 4 with total occlusion, 1 with sub-total occlusion and 1 with 90% long length stenosis), in OM1 in 4 patients (4/11, 2 with total occlusion, 1 with sub-total occlusion and 1 with 95% local stenosis). There were 3 patients (27.3%) with single vessel lesion, 4 patients (36.4%) combined with left anterior descending artery (LAD) lesion, 2 patients (18.2%) combined with right coronary artery (RCA) lesion and 2 patients (18.2%) combined with LAD and RCA lesions.

CONCLUSIONSAcute posterior myocardial infarction should be suspected with V(1)-V(2) R/S > or = 1 and V(1)-V(4) ST depression in standard 12 leads ECG. Besides symptoms and cardiac enzyme measurements, recording posterior leads electrocardiogram and performing coronary angiography will help to make the correct diagnosis.

Aged ; Coronary Angiography ; Coronary Vessels ; physiopathology ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; physiopathology ; Myocardium ; enzymology

OBJECTIVETo analyze and optimize the gene rearrangement primers of different frame regions (FR) of immunoglobulin heavy chain (IgH) genes by bioinformatic methods and explore the application of these primers in the detection of paraffin-embedded lymphoma tissues.

METHODSThree pairs of primers from IgH FR1, FR2 and FR3 regions (P1c, P2A and P31, respectively) were selected as the B cell gene rearrangement primers after comparison of the gene fragments in 44 IgH variable and 6 joining regions. Using one pair of T cell receptor (TCR) gamma primer as the T cell gene rearrangement primer, 101 histopathologically confirmed lymphoproliferative samples including 80 B cell lymphomas, 14 T cell lymphomas, and 7 reactive proliferative lymph nodes were examined by PCR for gene arrangement. The DNAs from DG75 and Jurkat cell lines were used as the positive controls for B and T cell lymphoma, respectively, with those from reactive proliferative lymph nodes as the negative control.

RESULTSThe positivity rates of IgH primers (P1c, P2A and P31) in the 80 B cell lymphomas were 37.5% (30/80), 52.5% (42/80) and 70.0% (56/80), respectively, and only one of the 14 T cell lymphoma cases was positive for the primers, suggesting significant differences in the detection rates of B cell lymphomas by the 3 primers. The detection rate was increased to 83.9% by combining the results by P31 and P2A primers. No positivity was found in the proliferative reaction tissues.

CONCLUSIONPrimers from IgH FR3 region genes are more sensitive than that from the FR1 and FR2 regions in the detection of gene rearrangement in paraffin-embedded lymphoma tissues. The detection rates can be increased by combining the results with the primers for IgH FR3 with that of FR2.

DNA Primers ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; genetics ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Lymphoma, B-Cell ; diagnosis ; genetics ; pathology ; Lymphoma, Non-Hodgkin ; diagnosis ; genetics ; pathology ; Lymphoma, T-Cell ; diagnosis ; genetics ; pathology ; Male ; Paraffin Embedding

OBJECTIVETo identify the genetic variants of angiotensin II type 1 receptor (AT1) gene in a population of Han ethnicity in east China and to determine whether the AT1 gene polymorphisms are associated with essential hypertension (EH) and coronary heart disease (CHD).

METHODSThe detection of single nucleotide polymorphisms (SNPs) was performed in 20 subjects by a direct DNA sequencing. All 213 EH patients, 171 patients of EH with CHD and 200 controls were genotyped by three detected SNPs.

RESULTSEight positive SNPs were detected in the promoter, exon and 3' untranslated region (3'UTR) of AT1 gene. A case-control study by using a frequent SNP (A-153G) in the promoter region, showed a significant increase in allele frequency of G-153 in the subjects of EH complicated with CHD (17.8% vs 11.5% for normal controls, P < 0.05). The SNP A1166C, which has been widely studied, manifested no difference in the three groups.

CONCLUSIONA polymorphism in the promoter region (A-153G) of AT1 gene might be involved in the development of EH and CHD in Han ethnicity population in east China.

Aged ; Alleles ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; China ; Coronary Disease ; complications ; genetics ; DNA Primers ; Female ; Humans ; Hypertension ; complications ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Receptor, Angiotensin, Type 1 ; genetics

OBJECTIVETo study the chemical constituents of the root of Paeonia sinjiangensis.

METHODThe constituents were isolated by silica column chromatography, and their structures were identified on the basis of spectral analysis and their physical-chemical constants.

RESULTFive compounds, paeoniflorin( I ), albiflorin (II), lactiflorin(III), daucosterol(IV), sucrose (V), were obtained.

CONCLUSIONAll of the compounds were obtained from this plant for the first time.

Benzoates ; chemistry ; isolation & purification ; Bridged-Ring Compounds ; chemistry ; isolation & purification ; Glucosides ; chemistry ; isolation & purification ; Glycosides ; chemistry ; isolation & purification ; Molecular Conformation ; Molecular Structure ; Monoterpenes ; chemistry ; isolation & purification ; Paeonia ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry