Objective:To analyze the direct-to-patient( DTP)model in the field of pharmacy retail. Methods:The meaning and features of the model were analyzed,the advantages and challenges of the model were summarized,and some countermeasure sugges-tions for the model application in the pharmacy retail field were provided. Results:The DTP model can promote the development of drug retail enterprises. However,there are still some challenges needing continue exploration in practice. Conclusion:In order to pro-mote the application and development of the DTP model,drug retail enterprises demand the policy adjustment by government,increased investment,enhancement of centralized development and implementation of new business forms.

Objective To investigate the effects of surgical trauma on Toll?like receptor 4 ( TLR4) expression in the hippocampus of aged mice. Methods Ninety male Kunming mice, aged 16-18 months, weighing 30-40 g, were randomly divided into 3 groups ( n=30 each) using a random number table:control group ( group C), anesthesia group ( group A), and partial hepatectomy group ( group PH). Normal saline 0.1 ml∕10 g was injected intraperitoneally in group C. In group A, fentanyl 0.2 mg∕kg and droperidol 5 mg∕kg were injected intraperitoneally. In group PH, fentanyl 0. 2 mg∕kg and droperidol 5 mg∕kg were injected intraperitoneally, and the mice underwent partial hepatectomy. Cognitive function was assessed using Morris water maze test at 1, 3, and 7 days after anesthesia or surgery. After the end of the test, the hippocampus was immediately harvested for determination of the TLR4, tumor necrosis factor?alpha ( TNF?α) and interleukin?1 beta ( IL?1β) protein and mRNA expression by Western blot and real?time reverse transcriptase?polymerase chain reaction, respectively. Results Compared with group C, no significant changes were found in group PH in the escape latency, percentage of swimming distance in the target quadrant, and TLR4, TNF?α and IL?1β protein and mRNA expression at each time point after anesthesia in group A (P>0.05), and the escape latency was significantly prolonged, the percentage of swimming distance in the target quadrant was decreased, and the expression of TLR4, TNF?α and IL?1βprotein and mRNA was up?regulated at 1 and 3 days after surgery in group PH ( P<0. 05 or 0. 01 ) . Compared with group A, the escape latency was significantly prolonged, the percentage of swimming distance in the target quadrant was decreased, and the expression of TLR4, TNF?αand IL?1βprotein and mRNA was up?regulated at 1 and 3 days after surgery in group PH (P<0.05 or 0.01). Conclusion Surgical trauma can up?regulate the expression of TLR4 in the hippocampus of aged mice, which may be involved in the mechanism of surgical trauma?induced postoperative cognitive dysfunction.

AIM: To study the effect of natural killer(NK)-cells on graft-versus-host disease(GVHD), graft rejection, engraftment and reconstituting of hematopoiesis in mouse allogeneic bone marrow transplantation. METHODS: Lethally irradiated BALB/c(H-2 d) mice were transplanted with C57/6j(H-2 b) bone marrow containing donor peripheral T cells and/or NK cells. Recipients CD 34 + cell counts and the expression of H-2K b+ cell were detected by flow cytometry, peripheral white blood cell(WBC) was detected by auto-cytometry, and the recipients survival rates, GVHD, engraftment and hematopoiesis recovery were then observed. RESULTS: In the group of transplanted with NK cells infusion, the incidence of GVHD was evidently lessened, the survival rates, WBC and CD 34 + cell counts and the expression of H-2K b+ cell were significantly high than that without NK cells infusion. CONCLUSION: In mouse allogeneic bone marrow transplantation, alloreactivity NK cells prevent GVHD, reduce graft rejection, and promote engraftment and reconstituting of hematopoiesis. [

Objective To investigate the effect of postoperative analgesia with difference methods on immunity in patients after thoracic tumour surgery. Methods Forty ASA Ⅰ-Ⅱ patients aged 35-65 years old undergoing thoracic tumour surgery were randomized to receive either postoperative patient- controlled intravenous analgesia (PCIA) (group Ⅰ, 20 cases) or patient-controlled epidural analgesia (PCEA) (group E, 20 cases) for 48 h. Medicine compatibility in group Ⅰ: sulfentanyl 1μg/ml, tropisetron 0.05 mg/ml, the PCIA pump was set up to deliver a 5 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h. Epidual catheter was placed at T4-5interspace before induction of anesthesia in group E. The PCEA solution contained 2 mg/ml ropivacaine. The PCEA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h after a loading dose of 0.33% ropivacame 6 ml. The VAS score, Ramsay sedation score and complications were reeorded. Blood samples were taken before induction (baseline) and at 2 h and 1st, 3rd and 7th day after surgery for determination of plasma concentrations of cortisol, interleukin 2 (IL-2) and the level of natural killer (NK) cells and eytokine-induced killer (CIK) cells. Results There was no significant difference in VAS score at 2 h after operation between two groups [(1.8±0.3) scores in group Ⅰ and (1.8±0.5)scores in group E].Ramsay sedation score at Ist, 3rd and 7th day after operation in group E were significantly lower than those in group Ⅰ (P<0.05), The plasma concentration of cortisol at 2 h and Ist, 3rd, 7th day after operation in group Ewere significantly lower than those in group Ⅰ (P<0.05), the levels of IL-2, NK cells and CIK cells in group E were significantly higher than those in group Ⅰ (P<0.05). Conclusions The efficacy of postoperative PCEA in improving immunity after thoracic tumour surgery is better than that of postoperative PCIA.

AIM: To study the effect of genistein on activation and proliferation of T cells,and explore the molecular mechanism of genistein. METHODS: Fluorescence conjugated monoclonal antibodies and flow cytometry were used to detect the express of CD69 and CD25 by activated T cells in vitro in response to Concanavalin (ConA )and Phorbol 12,13-dibutyrate(PDB) or T cell proliferation stained by CFSE in response to PDB / Ionomycin or ConA. RESULTS: Genistein inhibited the expression of CD69 and CD25 in activated T cells in response to Con A in a concentration-dependent manner and in response to PDB in a high concentration. Genistein inhibited proliferation of T cells in both groups in a concentration-dependent manner. CONCLUSION: Genistein inhibited activation and proliferation of T cells in vitro in response to polyclonal stimulus,and it may hold potential as a new immunosuppressant.

Objective To observe and contrast the effects of dexmedetomidine and ketamine on the restlessness and analgesia during recovery period of anesthesia after tonsillectomy in children. Methods Sixty ASA Ⅰ-Ⅱ child patients underwent tonsillectomy and adenoidectomy were randomly divided into three groups, group P (appropriate amount of placebo was given in the operation), group D (dexmedetomidine) and group K (ketamine). Data of mean arterial pressure and heart rate of three groups were documented before anesthesia (T0), during extubation (T1), 5 min (T2), 10 min (T3), 15 min (T4) and 30 min (T5) after extubation were recorded. The analepsia time, adverse reactions, restlessness score and pain score were collected in three groups of patients. Results Compared with group P, values of mean arterial pressure and heart rate were more stable at T1, T2 and T3 in groups D and K (P<0.05). The restlessness score, incidence of restlessness and adverse reactions were lower in groups D and K than those in group P (P<0.05), and which were lower in group D than those of group K (P<0.05). Conclusion Both dexmedetomidine and ketamine can play an analgesic role in recovery period of anesthesia and reduce restlessness, adverse reactions and pain score in child patients. Moreover, dexmedetomidine is more effective on inhibiting restlessness and adverse reactions.

Objective To evaluate the effects of dexmedetomidine on the expression of spinal matrix metalloproteinase-9 (MMP-9) in a rat model of neuropathic pain (NP).Methods Eighty-one adult male SpragueDawley rats,weighing 190-230 g,were randomly divided into 3 groups (n =27 each) using a random number table:sham operation group (group S); group NP; dexmedetomidine group (group Dex).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread in NP and Dex groups.In group Dex,dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.The equal volume of normal saline was given instead of dexmedetomidine in S and NP groups.Paw withdrawal threshold to von Frey filament stimulation (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured at 1 day before operation (To,baseline) and 5,9 and 16 days after operation (T1-3).Nine animals were sacrificed after measurement of pain threshold at T1-3 and their lumbar segments (L4,5) of the spinal cord were removed for detection of MMP-9 expression (by immuno-histochemistry) and tumor necrosis factor-alpha (TNF-α) content (by ELISA).Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the levels of MMP-9 and TNF-α were increased at T1-3 in NP and Dex groups.Compared with NP group,MWT was significantly increased,TWL was prolonged,and the levels of MMP-9 and TNF-α were decreased at T1-3 in Dex group.Conclusion Dexmedetomidine can inhibit up-regulation of MMP-9 expression,and decrease inflammatory responses,thus attenuating NP in rats.

Objective To evaluate the effects of propofol on the expression of hippocampal γ-aminobutyric acid (GABAA) and NMDA receptor in a rat model of inflammatory pain (IP).Methods A total of 32 female Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =8 each):control group (group C),group IP,and different doses of propofol groups (P1,2 groups).IP was induced by injection of formalin.In group C,normal saline and dimethyl sulfoxide (DMSO) 0.1 ml/kg were injected intraperitoneally.In group IP,normal saline and DMSO 0.1 ml/kg were injected intraperitoneally,and 5 min later formalin was injected.In P1,2 groups,propofol 30 and 100 mg/kg were intraperitoneally injected,respectively,and 5 min later formalin was injected.The pain behavior of rats was observed within 1 h after injection of formalin and pain intensity scoring (PIS) value was calculated.The animals were sacrificed at 1 h after injection of formalin and the hippocampi were isolated for determination of GABAA and NMDA receptor expression by immunohistochemisty.Results Compared with group C,PIS value was significantly increased,GABAA and NMDA receptor expression was up-regulated in IP and P1.2 groups.Compared with group IP,PIS value was significantly decreased,GABAA receptor expression was up-regulated,and NMDA receptor expression was down-regulated in P1,2 groups.PIS value was significantly lower,GABAA receptor expression was higher,and NMDA receptor expression was lower in group P2 than in group P1.Conclusion Intraperitoneal propofol can down-regulate NMDA receptor expression in hippocampi of rats with IP,thus inhibiting responses to pain sensitivity; intraperitoneal propofol can up-regulate hippocampal GABAA receptor expression,thus enhancing endogenous mechanism of analgesia.

BACKGROUND:The existed artificial anal sphincter cannot sense whether there are intestinal contents in the bowel and the state of intestinal contents, and the previous studies on the intestinal content signal did not included the different parts of colon and the signals of different intestinal content status.
OBJECTIVE:To compare the differences of ultrasound signals of different intestinal content status in different parts of New Zealand rabbits detected with transmission-type ultrasonic signal detection system.
METHODS:Twenty healthy New Zealand rabbits were used;the rabbits were divided into groups according to distal part of proximal colon, distal colon and distal rectum. Five positions of solid stool particles were selected randomly as the detection point in each group. The voltage signals of stool were measured under solid, fluid, gaseous, and deflation status of the lumen.
RESULTS AND CONCLUSION:In rectum, there were no significant differences in voltage signals between solid and gaseous conditions, while there were significant differences between fluid and deflation conditions (P=0.000). Multiple comparison showed there were significant differences between four conditions in distal part of proximal colon and distal colon (P=0). There were significant differences in voltage singles between rectum, distal colon and proximal colon under solid and fluid conditions (P=0). Multiple comparison showed there were significant differences in any part of large bowel for solid and fluid status (P=0). There were no significant differences in voltage singles between rectum, distal colon and proximal colon under gaseous and deflation conditions. There was interactive effect of intestinal contents between three parts of large bowel under the four conditions (P=0.000). Transmission-type ultrasonic detection system can distinguish artificial intestinal contents sensory nerves of various intestinal contents. And the application of ultrasonic detection system to detect the intestinal contents under different conditions can provide a new effective method for the research on artificial intestinal content sensory nerves.

Objective To determine the median effective concentration (EC50) of amitriptyline for intravenous regional anesthesia (IVRA) in rats.Methods Ninety healthy male SD rata weighing 190-240 g were randomly divided into 3 groups (n=30 each) : amitripryline group,bupivncaine group and lidocaine group.The rat's tail was divided into 3 epual parts: the proximal,middle and distal part.A 24 gauge needle was inserted into vena caudalis in the distal part.Esmarch bandage was applied around the tail from distal to proximal to expel blood from the taft and was removed after a tourniquet was applied between the proximal and middle part of the tail to occlude artery.0.5 ml of amitriptyline,bupivncaine or lidocaine was injected into the taft vein immediately after the application of the tourniquet.Ten minutes after drug administration the tourniquet was released.The ECho was determined by the up-and-down sequence method.The initial concentration of amitriptyline was 0.05%,the consecutive concentration-ratio was 1.4i4; the initial concentration of bupivacaine was 0.03%,the consecutive concoatration-ratio was 1.667 and the initial concentration of lidncaine was 0.08%,the consecutive concentrationratio was 1.250.EC50 and 95% confidence interval were calculated.Tail-flick latency (TFL) was assessed at 1 h before (baseline) and at 3 min and 2 d after drug administration.Central nervous system toxicity (seizure,convulsion,death) and local tissue damage to the tail were also recorded.Results The EC50 for IVRA was 0.111% (95% CI,0.092%-0.133%) in amitripthline group; 0.058% (95% CI,0.048%-0.078%) in bupivacaine group and 0.129% (95% CI,0.103%-0.160%) in lidocaine group respectively.The EC50 was significantly lower in bupivacaine group than in amitriptyline and lidocaine group.There was no significant difference in EC50 between amitriptyline and lidocaine group.The TFL measured at the proximal part of the tail was not significantly different between different time points in each group.The TFL measured at the middle part at 3 rain after drug adminisuation was significantly increased as compared with the baseline in all 3 groups but was not significantly different between the baseline and that measured at 2 d after drug administration.No CNS toxicity and local tissue damage were found during the experiment in all 3 groups.Conclusion Amitriptyline can produce intravenous regional anesthesia.The potency of amitriptyline is significantly lower than that of bupivncaine but is not significantly different from that of lidocaine.