Objective To explore the clinical values of holter among different types of pacemaker postoperations .Methods Selected 120 patients undergoing pacemaker implantation from November 2013 to October 2014 ,who also received holter examina-tion after operation .The sensing and pacing dysfunction and pacemaker associated arrhythmia were analyzed according to their hol-ter results .Results In the DDD group ,the detection rate of the ventricular premature contraction ,the atrial premature contraction , the paroxysmal atrial tachycardia ,the paroxysmal atrial fibrillation and the paroxysmal supraventricular tachycardia were 38 .9% , 44 .4% ,8 .3% ,2 .8% and 2 .8% ,respectively .In the DDD group ,the detection rate of the sensing and pacing dysfunction and pace-maker associated arrhythmia was 69 .4% ,which was significantly higher ( P < 0 .05) than that in the VVI group (42 .5% ) ,the VVIR group(30 .0% ) ,the DDDR group(31 .3% ) and the AAI group(25 .0% ) ,respectively .In the VVI group ,the positive rate of the ventricular premature contraction ,the atrial premature contraction ,the paroxysmal atrial tachycardia ,the paroxysmal atrial fi-brillation and the paroxysmal supraventricular tachycardia were 37 .5% ,42 .5% ,10 .0% ,17 .5% and 2 .5% ,respectively .In the VVIR group ,the appearance rate of the ventricular premature contraction ,the atrial premature contraction and the paroxysmal atrial tachycardia were 25 .0% ,25 .0% and 5 .0% ,respectively .In the DDDR group ,the detectable rate of the ventricular premature con-traction ,the atrial premature contraction ,the paroxysmal atrial tachycardia and the paroxysmal atrial fibrillation were 31 .3% , 25 .0% ,12 .5% and 12 .5% ,respectively .Finally ,in the AAI group ,the detection rate of the ventricular premature contraction and the atrial premature contraction were 25 .0% each .Conclusion The clinical application of holter can evaluate the working states of different types of pacemakers ,and can monitor the sensing ,the pacing dysfunction and the pacemaker associated arrhythmia .

Objective To offer a theory that supports the individualized tacrolimus dosage regimen by retrospectively investigating the influences of gene polymorphism and other clinical factors on tacrolimus concentration in renal transplant recipients. Methods A total of 280 renal transplant recipients were genotyped for CYP3A4?5, CYP3A4?6, CYP3A4?18B, CYP3A5?3, MDR1 1236C>T, MDR1 2677G>T/A, MDR1 3435C>T polymorphisms by PCR followed by restriction fragment length polymorphism (RFLP) analysis.PXR 6bp deletions (rs3842689) genotypes were determined by Allelic Special-Touch down PCR.Correlation between gene polymorphisms and tacrolimus concentrations was analyzed. Results The mutation frequency of CYP3A4?18B, CYP3A5?3, MDR1 1236C>T, 2677G>T/A, 3435C>T and PXR rs3842689 in the renal transplant recipients was 29.11%, 69.29%, 43.57%, 49.64%, 36.43% and 26.07%, respectively.Multiple regression analysis showed that, CYP3A5?3 and red blood cell count were associated with the value of C0/D of FK506, the best regression model was:D=C0/(-60.445 +95.777×CYP3A5 +34.938×RBC), and the equation could explain 38.8% of tacrolimus individual differences. Conclusion Gene polymorphism of CYP3A5?3 and red blood cell count may be responsible, in part, for the large interindividual variability of FK506 dose and concentration.

Objective:To study the characteristics of the adverse reactions caused by tacrolimus and analyze the risk factors. Methods:Totally 280 cases of renal transplant recipients received standard treatment options were selected from 1997 to 2013 in Wuhan general hospital of Guangzhou military command. The tacrolimus-related adverse reactions and their risk factors were analyzed statistically. Results:Totally 39. 65% of the patients had the tacrolimus-related adverse reactions. The main adverse reactions were hematotoxicity,diabetes mellitus and hyperlipidemia. The univariate analysis showed that age,weight,BMI and treatment course were the suspected risk factors. The multivariate analysis results showed that age,BMI and treatment course were the risk factors of tacrolimus-related adverse reactions. Conclusion:The incidence of tacrolimus-related adverse reactions is relatively high,and if the patient is in advanced age,with poor nutritional status or long-term medication,the probability of adverse reactions will be increased.

OBJECTIVE:To probe into the tendency and influencing factors of the drug expenses of the inpatients in our hospital.METHODS:The total drug expense,the antibiotic expense and its proportion in the total of the inpatients in our hospital were analyzed statistically in this retrospective study.RESULTS:During 2003～2007,the average daily total drug expense per inpatient was 371.77 yuan with average annual growth rate of 11.94%;the average daily antibiotics cost per inpatient was 110.35 yuan with average annual growth rate of 11.92%.Both the drug expense and antibiotic expense were correlated positively with the consumer price index (CPI).And the proportion of antibiotic expense in the total drug cost remained stable at about 29.68%.CONCLUSION:The average daily drug cost and antibiotic expenses per inpatient between 2003 and 2007 fluctuated yet with upward trend on the whole,and the proportion of antibiotic expense in the total drug cost remained stable.

Objective To establish a method for simultaneous determination of icariin and naringin content in bushen huayu extract by HPLC. Methods Reverse-phase high performance liquid chromatography ( RP-HPLC ) separation was performed one C18 column (4.6 mmí250 mm,5 μm).The mobile phase was acetonitrile containing 0.2%H4PO3(pH=2.9). Gradient elution with a flow rate of 0. 8 mL·min-1 was applied to achieve the separation. The detection wavelength was set at 269 nm,and the column temperature was 30℃. Results Icariin had a good linear range from 0. 3-3. 0μg (r=0. 999 9),the recovery rate was 105. 6%,and RSD was 0. 95%. Naringin was linear within the range of 0. 12-1. 20 μg (r=0. 999 9). The recovery rate was 94. 0%and RSD was 0. 52%. Conclusion The method is simple,stable,accurate,and reproducible,which can be used as the quality control standard for bushen huayue extract.

Objective To investigate the delayed alteration of hippocampus proteome after an-esthesia with isoflurane in aduh and aged rats. Methods Ten 8-month-old SD rats were randomly divided into group Caduh and group Iadult (5 in each group) , and another ten 22-month-old SD rats were randomly divided into group Caged and group Iaged (5 in each group). The rats in group Iadult and group Iaged received 2 h anesthesia with 1.2 % isoflurane. The rats in group Cadult and group Caged inhaled 40% oxygen for contrast. The hippocampal proteome of each rat was measured by 2-dimensional gel electrophoresis and mass spectrometry. Results The vital signs of the rats in group Iadult and group Iaged were stable. There were 878±34 protein spots in group Cadult, 864±49 protein spots in group Iadult, 834±47 in group Caged, and 819±24 in group Iaged. There were 12 (4/8)different protein spots between group Iadult and group Cadult. There were 11 (3/8) different protein spots between group Iaged and group Caged. All of the protein spots were identified by MALDI-TOF-MS. Most of the different proteins were related to metabolism, anti-oxidation, and signal conditioning of synapse. Conclusion Isoflurane may cause the alteration of hippocampal pro-teome in rats, which is age-related.

Objective To establish a sensitive method for the determination of rhodamine 123 (Rh123) in rat plasma by high performance liquid chromatography (HPLC).Methods The plasma samples were extracted by acetonitrile,and then separated on a Hypersil BDS C18 colunm (4.6 mm×100 mm,5 μm) equipped with a guard column kept at 25 ℃.The mobile phase consisted of acetonitrile and phosphate buffer (0.02 mol·L-1,pH4.0) (60:40) and was pumped at a constant rate of 1.0 mL·min-1.The peak was detected using a fluorescence detector set at FLD1A:Ex=485 nm,Em=546 nm.Results In this study,the method was validated for the Rh123 range of 0.1 to 32.0 μg·L-1,and the lower limit of quantitation (LLO Q) was 0.1 μg·L-1.The intra-and inter-day precisions for Rh123 were less than 7%,and the mean recoveries of Rh123 were 87.93%,89.03%,86.11% at low,mid,and high concentrations,respectively.Conclusion A simple,rapid and reproducible HPLC method was developed for the determination of Rh123 in rat plasma,which was an applicable method in modeling and description of the possible pharmacological interactions between the medicines and P-glycolprotein transporter.

Objective To examine the effect of berberine hydrochloride ( BER ) on the pharmacokinetic profiles of midazolam,a substrate of CYP3A,in rats. Methods The rats were intragastrically given different doses of BER (50,100, 200 mg?kg-1) or ketoconazole (75 mg?kg-1) for 10 days.Single-pass duodenum perfusion of 20 mg?kg-1 MDZ was performed and the inguinal artery was cannulated for blood sampling.Plasma concentrations of MDZ and 1'-OH-MDZ were analyzed by high performance liquid chromatography ( HPLC) with the CYP3A inhibitor ketoconazole serving as positive control. Results BER (50,100,200 mg?kg-1) and ketoconazole (75 mg?kg-1) could significantly increase the AUC(0-t),AUMC(0-t)and Cmax of MDZ in a dose-dependent manner ( P<0.05) ,and reduce the clearance rate ( CLz ) of MDA and its apparent volume of distribution in the body ( Vz ) ( P<0. 05). But they failed to dramatically affect the half-life ( t1/2z ) and the peak time ( tmax ) of MDZ. Additionally,BER ( 100,200 mg?kg-1 ) and ketoconazole ( 75 mg?kg-1 ) could significantly dose-dependently decrease the AUC(0-t),AUMC(0-t)and Cmaxof 1'-OH-MDZ,and profoundly increase the CLz,tmax and Vz of 1'-OH-MDZ (P<0.05),but they had no remarkable influences on the t1/2z.The ratio of AUC(1'-OH-MDZ)/AUC(MDZ) was decreased with the increase of BER concentration. Conclusion BER can inhibit the in vivo metabolism of MDZ in a dose-dependant manner, which is associated with the suppression of the activity of CYP3A.

Objective To explore the correlation of empowerment with illness perception among inpatients with type 2 diabetes mellitus. Method The convenience sampling method was used to investigate the status of empowerment and illness perception among 102 patients with type 2 diabetes mellitus from October 2014 to July 2015, followed by analyzing the association between the two variables. Results The total score of empowerment was (4.00 ± 0.65), and the total score of illness perception was (38.00 ± 2 . 33 ) . The empowerment was positively correlated with illness perception ( P < 0 . 001 ) . The empowerment was positively correlated with the timeline, personal control, treatment control, illness concern and illness comprehensibility, respectively (all P<0.001). Conclusions The empowerment of patients with type 2 diabetes mellitus is at a high level, and positively correlated with illness perception, more pronounced chronic nature, the better personal control and treatment control, a higher degree of concern about the disease and better personal understanding of the illness contributed to a higher degree of empowerment. Medical staff should evaluate the illness perception of the patients with type 2 diabetes mellitus regularly in the daily work so as to improve the illness perception , improve their empowerment and promote the patients′quality of life eventually.

BACKGROUND:The incidence of patel ar complications is decreasing, however, the necessity of patel ar replacement remains unclear. OBJECTIVE:To investigate the incidence rate of anterior knee pain and postoperative pain score in total knee arthroplasty without the patel ar replacement and to provide a reference for the formulation of clinical operation scheme. METHODS:151 patients with 193 knees receiving total knee arthroplasty were involved in this study. Al the patients were treated with patel ar forming but not resurfacing of the patel a. The Western Ontario and McMaster University (WOMAC) Osteoarthritis Index and America Hospital for Special Surgery (HSS) score were used to evaluate patients before surgery and at 6 and 12 months after surgery. The function of knee joint, the incidence rate of anterior knee pain and visual analogous scale score before and after operation were compared. RESULTS AND CONCLUSION:After 6 and 12 months of total knee arthroplasty, WOMAC osteoarthritis index was significantly lower and HSS score was significantly higher than those before surgery (P<0.05). At 12 months post-operation, the incidence rate of anterior knee pain was 11.3%, which was significantly lower than the preoperative rate (94.5%) (P<0.05). At 12 months post-surgery, visual analogous scale scores were also significantly lower than the preoperative score (P<0.05). Total knee replacement without resurfacing of the patel a can effectively improve knee joint function in knee osteoarthritis or rheumatoid arthritis patients, ameliorate the symptoms of anterior knee pain, has a good clinical effect within short term post-operation. The middle-and long-term effects need further exploration.