OBJECTIVE:To compare the difference of the information about smoking affecting pharmacodynamics and pharma-cokinetics in prescription drug instructions between US and China. METHODS:The US and Chinese guidance for drug R&D and drug instructions editing,prescription drug instructions were collected;the information about smoking affecting pharmacodynamics and pharmacokinetics were retrieved from FDA drug instruction official website DailyMed and Yaozhi Network in China up to Jun. 19th,2014. The difference in related regulations and drug instruction were compared between US and China. RESULTS & CON-CLUSIONS:The guidance issued by US and China require that great importance should be attached to the effects of smoking on pharmacodynamics and pharmacokinetics,and it must be noted in drug instructions. Of 62 857 drugs recorded,smoking affected pharmacodynamics and pharmcokinetics of 34 drugs in US drug instructions,among which 9 drugs needed dose modifications;for above drugs,Chinese drug instructions pointed out great importance should be attached to the effect of smoking on pharmacodynam-ics and pharmacokinetics of 6 drugs,and only one drug(erlotinid hydrochloride)needed to be modified. The label rate of smoking affecting pharmacodynamics and pharmacokinetics was relatively low in Chinese drug instructions compared to US. It is suggested that the regulatory agent should standardize and improve related description in drug instruction,correct unsuitable content,revise the items which may result in severe consequence,and set up official website which can provide all drug instructions as soon as possible. Drug manufacturers should standardize clinical study of drugs before marketing,focus on the scientificity,completeness and normalization of drug instructions.

Objective To investigate the effect of fluvastatin sodium on the risk factors of atherosclerosis in patients with previous coronary heart disease.Methods 58 cases meeting the inclusion criteria and diagnosed coronary heart disease history of chlamydial infection were selected and randomly divided into study group and control group, 29 cases in each group, the control group were given routine treatment, study group on the basis of conventional treatment of fluvastatin sodium(20 mg pertime, once daily) treatment.A total of 4 weeks treatment for a course, the blood lipid and vascular endothelial function, matrix metalloproteinases and inflammatory factor levels were determined before and after treatment, and adverse reactions were recorded between the two groups.Results Compared with the control group, the total cholesterol ( TC ) , triglyceride ( TG ) , low density lipoprotein cholesterol(LDL-C) and lipid comprehensive index(LCI) in study group after treatment were lower, the high density lipid-cholesterol(HDL-C) was higher, the soluble intercellular adhesion molecule-1(sI-CAM-1) and endothelin-1(ET-1) were lower, the NO was higher, matrix metalloproteinase-1 (MMP-1), MMP-9 and tissue inhibitor of metalloproteinase-1(TIMP-1) were lower, and tumor necrosis factor-α(TNF-α), interleukin 1 beta(IL-1β), high-sensitivity c-reactive protein( Hs-CRP ) and IL-6 were lower ( all P <0.05 ).All patients were followed up, only slight gastrointestinal adverse reaction, there was no significant difference in adverse reactions between the two groups.Conclusion The fluvastatin sodium can reduce the blood lipid, the level of matrix metalloproteinases, improve vascular endothelial function and inflammatory state, with high safety.

Objective To evaluate the effect of reference mAs on radiation dose and image quality characteristics of chest CT scanned with CARE kV technique compared with CARE Dose4D.Methods According to the date of examination,158 consecutive patients were selected in our department and randomly divided into 5 groups:CARE Dose4D group (30 cases,group 1); using CARE kV technology,reference mAs were 110 (32 cases),90 (31 cases),70 (33 cases),50 (32 cases),which were recorded asthe group from 2 to 5,respectively.Volume CT dose index (CTDIvol),dose length product (DLP) and the effective dose (ED) were analyzed.CT value and objective image noise were measured in the lungparenchyma and descending aorta.Two radiologists assessed the images for subjective noise,artefacts and diagnostic acceptability.The radiation dose,CT value and objective noise were compared with the analysis of variance,and the difference between two groups was compared with SNK test; the rank sum tests (Kruskal-Wallis) were used in subjective image quality score,and difference between two groups was compared with K-W test.Results The CTDIvol,DLP,ED values in five groups were (7.7±1.7),(7.7±2.0),(5.5±1.4),(4.2±1.5),(2.8±1.2)mGy,(290.7±67.4),(290.1±85.2),(194.2±52.1),(150.7±63.8),(96.5±38.9) mGy· cm,(4.1±0.9),(4.1±1.2),(2.7±0.7),(2.1 ± 0.9),(1.3±0.5) mSv,respectively.There were significant difference among the 5 groups(F=59.305,57.76,57.76,P＜0.01).With the decrease of the reference mAs,the radiation dose decreased significantly.There were no significant difference among the 5 groups on the average CT values of lung parenchyma and descending aorta(F=0.353,0.102,P＞0.05).The objective noise of 5 groups in pulmonary parenchyma and the descending aorta were (48.7 ± 9.1),(49.2 ± 10.0),(55.5± 11.2),(56.5± 8.3),(63.7 ± 13.2) HU; (9.2± 1.6),(9.5 ± 2.1),(10.7 ± 2.6),(11.6 ± 2.7),(13.6 ± 2.6) HU respectively,and the difference was significant(F=10.774,17.157,P＜0.01).Level assessment onsubjective noise of five groups by radiological expertsalso showed the significant difference (U=33.967,P＜0.01),butthe evaluation on motion,streak,blotchy pixellatedartefacts and diagnostic acceptability had no statistical difference (U=8.847,2.054,6.186,5.296,P＞0.05).Conclusion Comparedwith CARE Dose4D,the use of CARE kV technique of suitable reference mAs for unenhanced chest CT can reduce radiation dose significantly with diagnostically acceptable image quality.

Objective To explore the role of Kupffer cell-expressed Fas ligand(FasL) on acute pancreatitis(AP),and the protective effect of gadolinium chloride(GdCl3),a Kupffer cell inhibitor,on liver injury during AP.Methods Fifty-four ICR mice were randomly assigned into three groups: healthy control group(n=6);AP group(four time points for observation,6 mice each);Gd+AP group(GdCl3 pretreatment group,four time points for observation,6 mice each).AP was induced in mice using cerulein.Liver parenchymal enzymes(AST,ALT and LDH) and amylase(AMY) were assayed using an automatic analyzer.Serum FasL was assayed with ELISA and FasL protein expression in liver was assayed by Western blotting.Results After induction of AP in mice,the serum levels of AST,ALT,LDH,AMY and liver FasL expression were significantly elevated.Serum FasL levels at 4,8,16 and 24h after AP induction were 505.94?36.21,496.60?33.65,476.64?22.66 and 450.75?38.21,respectively,which were significantly higher than those in healthy control group(83.60?7.75,P

Objective To study the expression of bivalent DNA vaccine against Schistosoma japonicum in vitro/vivo and lasting time in vivo. Methods The bivalent DNA pVIVO2-SjFABP/Sj23 was transfected transiently into the human embryonic kidney cells of the line 293. RT-PCR was used to detect the expressions of SjFABP and Sj23 mRNA in the 293 cells. Indirect immunofluorescence antibody test(IFAT) was used to detect the expressions of SjFABP and Sj23 proteins. Twelve BALB/c mice were inoculated with pVIVO2-SjFABP/Sj23 via intramuscular injection. Two blood samples were collected from eye sockets and two mice were vivi-perfused each month. This work lasted for 6 months. IFAT was used to detect the expression of proteins in skeletal muscle. Western-blot was used to detect the serum IgG level. Results RT-PCR and IFAT showed the expressions of SjFABP and Sj23 in the HEK-293 cells. IFAT showed SjFABP/ Sj23 was present in vivo at least for 6 months. Special IgG was not detected by Western blot. Conclusions pVIVO2-SjFABP/Sj23, bivalent DNA vaccine, could express correctly in vitro/vivo, and lasts for 6 months at least in vivo.

ObjectiveTo investigate the effects of type-A behavior pattern on intervention of benasepril in patients with essential hypertension.MethodsAccording to the type-A behavior score patients with essential hypertension were divided into two groups:type-A group(n=80)and non-type-A group(n=80).Benazepfil was given to all patients for 3 months with gradual increase of dosage till the blood pressure (Bp)was controlled under 140/90 nlln Hg(1 mm Hg=0.133 kPa).The plasma levels of angiotensin II (Ang Ⅱ)was measured by radioimmunoassay and left yentrieular mass index(LVMI)was examined by ultrasonic echoeardiography(UCG)before and after treatmenL ResultsBefore benazepril treatment.plasma AngⅡ levels and LVMI in type-A group were higher than those in non-type-A group(P＜0.05),but there was no difference in Bp between two groups.Type-A behavior value were positively correlated with Ang Ⅱ and LVMI in two groups,but only Ang Ⅱ level was independent risk factor.Ang II levels were positively correlated with LVMI in two groups and that was more significantly in type-A group(P＜0.05-0.01).After treatment,Bp,plasma Ang Ⅱ and LVMI were all decreased significantly in two groups(P＜0.05-0.01)and Ang Ⅱ and LVMI were decreased more markedly in type-A group(P＜0.05).The variations of Ang Ⅱ and LVMI before and after treatment were positively correlated in two groups.but more markedly in type.A group (P＜0.05-0.01).CondusionCharacters may affect left ventricular hypertrophy in patients with essential hypertension through some stress factors and benazepril has better intervening effect on it.

Clinical practice, the necessary way which must be passed by medical students, is a key period of medical education and a vital part to realize the goal of higher medical education. Our hospital has taken a series of effective measures to strengthen clinical practice teaching for many years, and we are ex-ploring the concentrated training model to medical students all the time. Every year before clinical practice, the Inspection Section develops theoretical and basic clinical skills training courses, selects experienced teachers to teach, check and evaluate the training result according to students' performance in medical and teaching activities in the ward, the clinical practice syllabus and Medical Qualification Examination aims to improve medical students' theoretical knowledge, skills, medical ethics, humanity, and clinical thinking, etc. Effect evaluation shows that our training model has played a positive role in improving overall qualities of medical students and got good feedback from them.

Objective:To evaluate the correlation of orbital computed tomography and incretion in patients with thyroid associated ophthalmopathy- Ⅰ. Methods : Seventy-six orbits of 38 patients with thyroid associated ophthalmopathy were evaluated by CT in respect to the density and the size of extraocular muscles, and 100 normal orbits of 50 healthy person were evaluated with the same indices for comparison. Results:There was significant difference in the density and the size of extraocular muscles between the patients and the healthy adults. The maximal size of extraocular muscles were positive correlation with T3,T4in TAO-Ⅰ, and negative correlation with TSH. Conclusion:The manifestation of orbital CT may be a good index in the following survey of thyroid associated ophthalmopathy-Ⅰ.

Objective To explore the influence of type A character on early renal impairment in elderly patients with essential hypertension and the protective effect of benazepril. Methods According to the type A behavior measuring scale, 80 cases with type A character and 80 cases without type A character were screened out from the elderly patients with essential hypertension. The patients received benazepril intervention with incipient dose of 10 mg daily, which increased gradually to the largest does of 20 mg daily within 1 month, The treatment lasted 6 months in order to make the patients achieve the normal blood pressure (BP). The general data, plasma angiotensin Ⅱ (AngⅡ )> urinary albumin excretion rate (UAER) and urinary β2-microglobulin (β2-MG) were measured at pretherapy and post-treatment respectively. Results There were no statistically significant differences at pretherapy between the two groups in age, gender, body mass index (BMI), blood urea nitrogen (BUN), creatinine (Cr), systolic pressure and diastolic pressure (all P>0.05). Ang Ⅱ [(60.3±11.6)mg/Lvs (55.8±10.2)mg/L], UAER[(83.3±23.3)μg/min vs. (75.7±16.3)μg/min] and β2-MG [(75.6±24.5)mmol/L vs. (66.0±19.4)mmol/L] were significantly higher in type A character group than in non-type A character group (t=2.598, 2.603, 2.742; P= 0.016,0.012, 0.008). TypeA character value of the two groups showed a positive correlation with Ang Ⅱ (r= 0.361, P=0.002), UAER (r=0.198, P=0.015) and β2-MG (r=0.202, P = 0.021). Only Ang Ⅱ (β=0.291, t=2.793, P= 0.008) was correlated to type A character value independently by multiple stepwise regression analysis. Before treatment in both of the type A character group and the non-type-A character group, there was a positive correlation between Ang II and UAER, (β2-MG, and obvious correlation in type-A character group. The systolic pressure, diastolic pressure, Ang Ⅱ , UREA and β2-MG were all decreased obviously in two groups post treatment. And the variable value of AngⅡ was also positively correlated with UAER (r=0.373, P=0.005; r=0.282, P=0.032), fr-MG (r= 0.385, P=0.003; r= 0.279, P=0.039) before and after treatment. Conclusions Type A character can aggravate injury of early renal function by certain stress systems in the elderly patients with essential hypertension and benazepril has better protective effect for it.

Background and purpose:Breast cancer is one of the most common carcinoma among female patients with high mortalities. Drug-resistance is the major reason that leads to chemotherapy failure in clinical practice. MCF-7/ADR is a multi-drug resistant cell line that was established on the basis of breast cancer cell line MCF-7. This research aimed to investigate the anti-apoptotic effect of c-fos in resistant breast cancer cell MCF-7/ADR, and to compare with its sensitive counterpart MCF-7.Methods:Doxorubicin with various concentrations was used to treat MCF-7 as well as its MDR- counterpart MCF-7/ADR. The growth inhibitory rate of MCF-7 and MCF-7/ADR wasdetermined by MTT assay. Additionally, RT-PCR was used to test the expression of P-gp and c-fos mRNA in MCF-7 and MCF-7/ADR; The expression of c-fos mRNA was detected by RT-PCR after 3 μmol doxorubicin treatment;We further established cell lines that stably interfered with c-fos, named MCF-7/ADR/si-fos-8B, MCF-7/ADR/si-fos-3D. Flow cytometry and MTT assay were used to investigate the apoptosis rate and inhibitory rate in these above cells under the treatment of 5-FU, CDDP or γ-radiation. At last, RT-PCR and Western blot analysis were used to detect the expression of bax, bcl-2, puma, p53.Results:The expression of c-fos and P-gp (MDR-1) was up-regulated in MCF-7/ADR, compared with its sensitive counterpart MCF-7. Additionally, the resistant fold of MCF-7/ADR to doxorubicin was nearly 40; The expression of c-fos was gradually up-regulated after 3 μmol doxorubicin treatment; The sensitivity to drugs (5-FU and CDDP) was increased after c-fos interference while the apoptosis rate was also increased after 5-FU, CDDP and γ-radiation treatment. RT-PCR and Western blot analysis indicated that up-regulation ofbax,puma,p53 after c-fos interference while the expression of bcl-2 was down-regulated.Conclusion:c-fos may act as an anti-apoptotic protein in resistant breast cancer cell line MCF-7/ADR by regulating the expression of apoptosis related proteins, and may play a vital role in the formation of multi-drug resistance phenotype.