OBJECTIVE: To evaluate the current situation and the trend of cardiovascular drugs used in 6 cities in the Yangtze river valley between 2002 and 2004.METHODS:Consumption of cardiovascular drugs used in 157 hospitals of 6 cities in the Yangtze river valley were analyzed by the way of sum and DDDs ranking. RESULTS:The total annual cost of the cardiovascular drugs used in 6 cities was 13.6 billion yuan in 2004, increasing by 58.8%, as compared with that in 2002.The total average consumption of anti-anginal and vasodilating agents, antithrombotic agents and antihypertensives accounted for 84.1% of the total cost in 3 years.CCB, ACEI, Nitrate esters,?-blockers and Chinese medicines dominated in the ranking of sum and DDDs.CONCLUSION: Right medicines with higher patient compliance rates, lower ADR occurrence, more certain therapeutic effect and economical daily cost have become the preferable choices for clinical physicians.

Objective To observe the changes of four quantitative indexes of diabetic macular edema by using optical coherence tomography.Methods Eighty-nine patients (155 eyes) with diabetic retinopathy were included in this project and were divided into two groups according to the present of diabetic macular edema:Negative group (56 cases,100 eyes) and positive group(33 cases,55 eyes).In addition,23 cases (42 eyes) of normal volunteers constituted the normal control group.All the objects accepted an optical coherence tomography examination and the indexes including central retinal thickness (CRT),subfoveal choroidal thickness (SFCT) and integrity of external limiting membrane(ELM) as well as inner/outer segment (IS/OS) were measured and analyzed.Results The average CRT of positive group (219.048 ± 16.798) μm was significantly thicker than that of control group(217.775 ± 26.866) μm and negative group (280.418 ±74.187) μm (P ＜0.001).Mean SFCT among control group (312.893 ±140.559) μm,negative group (302.080 ± 125.287) μm and positive group (293.745 ±140.517) μm had no statistical significance (P =0.781).There were 3 eyes with disrupted ELM layer in the negative group and 8 eyes in the positive group.Difference between them was proved to be significant (P =0.019).Similarly,the integrity of IS/OS layer had significant difference between negative group (5 eyes disrupted) and positive group (19 eyes disrupted) (P ＜ 0.001).Conelusion CRT of patients with diabetic macular edema is always increased and the integrity of ELM or (and) IS/OS can be disrupted in many cases.Indexes including CRT and the integrity of ELM or (and) IS/OS can be used to evaluate the severity of diabetic macular edema quantificationally.

OBJECTIVE:To analyse the current situation and developing trend of consumption of cardiovascular drugs in Nanjing district,so as to provide information for the research,production,sale and application of these drugs METHODS:According to the order of sum of money,the purchasing information of the drugs used for cardiovascular diseases in 19 hospitals in Nanjing district between 1997～2001 were analysed RESULTS:The sum of money of the drugs used for cardiovascular diseases in 19 hopsitals in Nanjing district was increased more than twice in 5 years,and the consumption of anti-anginal and vasodilating agents,antithrombotic agents and antihypertensives occupied first three places in the category all the time In recent three years,calcium antagonists have occupied the front three places in the category CONCLUSION:With the increase of old age people's proportion in our country,the market requirement is enormous and the prospects for exploitation are capacious for the drugs used for cardiovascular diseases

Objective To explore effect of different withdrawal time of dexmedetomidine (DEX) on the quality of general anesthesia recovery.Methods Eighty patients of ASA Ⅰ or Ⅱ undergoing lymph surgery were randomly assigned to four groups (n =20).Groups D1,D2 and D3 received DEX 0.5 μg/kg as bolus before induction,continued with 0.5 μg/(kg · h) by infusion until one hour,30 min before the end of operation and the end of operation,respectively.Group C received equal volume of normal saline.Mean artery pressure (MAP),heart rate (HR) and pulse oxygen saturation (SpO2) were observed during and after operation.Spontaneous respiration recovery time,eyes open time,extubation time,orientation recovery time,observer's assessment of alertness/sedation score (OAA/S),restlessness score (RS),and visual analogue scales (VAS) were observed after operation.Results For MAP and HR in Groups D2 and D3,there were no statistically significant difference during extubation compared to those at preoperation,but at the same time point,they were lower than those in group C (P ＜ 0.05).For groups C and D1,MAP and HR at extubation and 5 min after extubation were higher than those at preoperation (P ＜0.05).Spontaneous respiration recovery time,eyes open time,extubation time,orientation recovery time in group D3 were significantly longer than those in Group C (P ＜ 0.05),while there were no statistically significantly difference between groups D1,D2,and group C.OAA/S in group D3 was significantly lower than that in group C (P ＜ 0.05) at extubation.Incidence of restlessness,VAS,and cases given analgesic 2 hours after operation in groups D2 and D3 were significantly lower than those in groups C and D1.Compared to those in group C,dosages of propofol and remifentanil in groups D2 and D3 were significantly lower.Conclusions Dexmedetomidine administered of 0.5 μg/kg before induction,continued with infusion of 0.5 μg/(kg · h) until 30 min before the end of operation,may improve emergence,without influencing the awakening time of patients,and prolong the duration time of analgesia which comfort the patients.

Objective To explore the relations between physiological retrogressive auricular fibrillation and organical pathological auricular fibrillation in elderly patients.Methods 36 cases paroxysmal auricular fibrillation in elderly patients without organical pathogeny were monitored for 24 hours using dynamic electrocardiogram.The attack time and frequency of paroxysmal auricular fibrillation,the change of heart rate,and other type arrhythmia complexing were analyzed.Results Most cases of paroxysmal auricular fibrillation in elderly patients were companied with arrhythmia,supraventricular arrhythmia occupy in the first place especially.The ventricle rate was slow in most cases.The attack had different rhythm in day and night,there were two flows and one edd in one day.Conclusion The elderly auricular fibrillation is associated with the physiological anaplasia of auricular muscle and artro-ventricular junction area directly.It also relates to the heighten excitability of pneumogastric nerve and secretive conduction.

AIM:To investigate the mechanism of Maxing Shigan Decoction(Herba ephedrae,Semen armeniacae amarum,Radix er Rhizoma glycyrrhizae,Gypsum fibrosum) against type Ⅰ hypersenstivity reaction. METHODS: The experiment of passive cutaneous anaphylaxis(PCA) was used to determine the effect of Maxing Shigan Decoction on degranulation of mast cells in vivo.For in vitro study,the drug serum of Maxing Shigan Decoction was added to the culture medium of sensitized RBL-2H3 cells.The antigen-induced release of degranulation was measured by enzymatic assay,histamine by enzyme immunoassay(EIA) and cytokines by enzyme-linked immunosorbent assay(ELISA). RESULTS: The results showed that treatment with drug serum of Maxing Shigan Decoction was followed by a decrease in PCA of rats and in degranulation,histamine,TNF-? and IL-4 from RBL-2H3 cells induced by antigen. CONCLUSION: Maxing Shigan Decoction may suppress the type Ⅰ hypersensitivity reaction by inhibiting the action of mast cells.

Objective:To study the effect of HLA-Gon proliferation in peripheral blood lymphocytes of childbearing age women and Treg cell subsets,and investigate the mechanisms of immune tolerance in pregnancy.Methods:The high expression of HLA-G cho-riocarcinoma cell lines JEG-3 cells with peripheral blood lymphocytes( PBLC) of healthy childbearing age women co-culture,using the HLA-G neutralizing antibodies(87G)and recombinant human tumor necrosis factor receptor typeⅡ-antibody fusion protein(rhTNFR:Fc)to intervene.Experiments were divided into seven groups:①JEG-3+PBLC culture group;②JEG-3+PBLC+87G culture group;③JEG-3+PBLC non-contact culture group;④JEG-3+PBLC+87G non-contact culture group;⑤The control group(PBLC group);⑥JEG-3+PBLC+rhTNFR:Fc culture group;⑦JEG-3+PBLC+87G+rhTNFR:Fc culture group.Detected the PBLC proliferation inhibition by CCK-8 method and the expression of TNF-αmRNA by RT-PCR in①-⑤groups.The proportion of Treg cells were detected by flow cytometry in①-⑦groups.Results:The assay of CCK-8 showed that the PBLC proliferation inhibition rate of JEG-3+PBLC culture group,JEG-3 +PBLC+87G culture group,JEG-3+PBLC non-contact culture group,and JEG-3+PBLC+87G non-contact culture group were(48.00±5.56)%,(14.67±4.04)%,(37.67±2.31)% and(8.33±3.21)%,there was a statistically significant difference on each group ( P<0.05 ).The result of RT-PCR showed that the expression of TNF-αmRNA in JEG-3+PBLC culture group and JEG-3+PBLC non-contact culture group were significantly lower than the control group.Compared with the corresponding non-87G group,the expression of TNF-αmRNA increased significantly after the intervention of 87G,P<0.05.Compared with the control group, the proportion of Treg cells of JEG-3+PBLC culture group detected by flow cytometry was significantly increased(P<0.05).There was no significant difference between JEG-3+PBLC non-contact culture group and control group ( P>0.05 ).Compared with the JEG-3+PBLC culture group,the proportion of Treg cells of JEG-3+PBLC+87G culture group was significantly decreased(P<0.05).Compared with JEG-3+PBLC culture group,the proportion of Treg cells of JEG-3+PBLC+rhTNFR:Fc culture group was significantly increased( P<0.05).Set JEG-3+PBLC+rhTNFR:Fc culture group as control,the proportion of Treg cells of JEG-3+PBLC+rh TNF:FC+87G culture was significantly decreased,but obviously higher than JEG-3+PBLC+87G culture group,there was a statistically significant difference on each group(P<0.05).Conclusion:HLA-G can inhibit peripheral blood lymphocyte proliferation of childbearing age women and inhibit the expression of TNF-α,and up-regulate the proportion of Treg cells.

Aim To investigate the mechanism of achyranthes bidentata polysaccharides on degranulation of mast cells. Methods The experiment of passive cutaneous anaphylaxis was used to determine the effect of achyranthes bidentata polysaccharides on degranulation of mast cells in vivo. For in vitro study, various doses of achyranthes bidentata polysaccharides were added to the culture medium of sensitized RBL-2H3 cells. The antigen-induced release of degranulation was measured by enzymatic assay, histamine by EIA and cytokines by ELISA. In addition, the activation of Akt and p38 were measured by Western blot. Results Treatment with achyranthes bidentata polysaccharides was followed by a decrease in PCA of rats and ?-hexosaminidase, histamine, TNF-?,IL-4,Akt and p38 of RBL-2H3 cells induced by antigen. Conclusions Achyranthes bidentata polysaccharides might suppress the anaphylactic reaction through inhibition of action of mast cells. Akt and p38 contributed at least in part to this event.

Objective To observe the changes of the depressive behavior and amygdaloid nucleus nerve growth factor(NGF)expression in estro?gen?deprived female rats and explore the possible mechanism and targets of estradiol in depression treatment. Methods A total of 30 adult SD fe?male rats were randomly assigned to 3 groups:sham operation group(SHAM,n=10);ovariectomized group(OVX,n=10)and ovariectomized rats treated with estradiol group(OVX+E,n=10). The behavior changes were observed by tail suspension test(TST)and sucrose preference test (SPT) after 8?week estradiol treatment. Subsequently ,immunohistochemical staining detect NGF expression in amygdaloid nucleus. Results Compared with the SHAM group rats,sucrose preference ratio significantly decreased in SPT(P<0.01),immobile time prolonged in TST(P<0.01),serum estradiol level and amygdaloid NGF expression significantly decreased(all P<0.01). 8?week estradiol treatment ameliorated depres?sion?like behavior and increased serum E2 level and NGF expression in amygdaloid nucleus in OVX+E group rats when compared with the OVX group(all P<0.01). Conclusion Estradiol treatment can improve the depressive behavior of ovariectomized rats ,which may be related to the in?crease of serum estradiol level and the expression of NGF in amygdaloid nucleus.

Objective To investigate the utility of bedside electromyography (EMG) in diagnosis and management of critical illness patients with suspected neuromuscular diseases.Methods Bedside EMG was performed in 34 critical illness patients with weakness and respiratory involvement,including segmental motor nerve conduction studies,sensory nerve conduction studies,F waves,concentric needle EMG and repetitive nerve stimulation.The clinical manifestations and clinical utility of bedside EMG in critical illness patients with suspected neuromuscular diseases were analyzed. Results EMG was normal in 5 patients.Low-frequency repetitive nerve stimulation showed decrement response of compound muscle action potential (CMAP) in 4 of 8 patients.Motor nerve conduction studies showed CMAP amplitude decreased in 73.3％(22/30) patients,and demyelinating changes was detected in 20.0％ (6/30)patients.F-wave persistence was 0 in 55.0％ (11/20) patients.Amplitude of sensory nerve action potential decreased in 28.6％ (6/21)patients.Bedside EMG could help to confirm or exclude diagnoses and guide the management in 82.4％(28/34) patients,confirm the diagnoses of peripheral neuropathy but have no effect on management in 11.8％ (4/34) patients,and bedside EMG was inconclusive in 2 patients.Conclusions Bedside EMG is useful for the diagnosis and management of critical ill with suspected neuromuscular diseases,while motor nerve conduction studies and repetitive nerve stimulation are more valuable.Individualized protocol for EMG studies should be made on the basis of clinical problem.