Objective Cigarette smoking remains highly prevalent in most countries.It can affect drug therapy by both pharmacokinetic and pharmacodynamic mechanisms.Correlation between smoking and drugs has been reviewed, and the future study about situation of smoking and drugs also was reviewed.

Objective To analyze the CT findings of heterotopic pancreas and the correlation with pathologic changes.Methods CT findings in 1 9 patients with heterotopic pancreas proven by surgery were reviewed retrospectively,14 of whom were scanned with enhanced CT.The correlation of CT findings and pathologic results were also analyzed.Results All patients had a single lesion with sized range from 0.8 to 4.7 cm and mean diameter of (2.2±0.6)cm.All lesions with homogeneous density were showed on plain scans including 7 lesions in stomach,8 in duodenum,2 in jejunum,1 in ileum and 1 beside the cardiac lymph nodes.The border of the lesions in 5 was unclear with exudative changes,mimicking acute pancreatitis.A sign of central umbilical concave was found in 2.Pathological results confirmed 14 lesions in submucosa,3 in muscular layer,1 in serosal layer and 1 in abdominal cavity.Hetero-topic pancreas presented early obvious enhancement in 9,mimicking normal pancreas,which was composed chiefly of pancreatic aci-ni.The enhanced degree of 4 lesions was lower than normal pancreas,which were composed of pancreas ductal epithelium and few pancreatic acini.No significantly enhancement was seen in 1,mimicing liomyoma,which was composed chiefly of pancreas ductal epithelium and smooth muscle hyperplasia.Conclusion Heterotopic pancreas in most cases presents characteristic submucosal disea-ses-like pattern,and different enhanced patterns of heterotopic pancreas are related with the pathologic changes.

To study the transport mechanisms of drugs for transplacental treatment of fetal tachyarrhythmia, MDCKII-BCRP and MDCKII cell models was used. MDCKII-BCRP and MDCKII cell monolayer model was used to investigate the bi-direction transport of sotalol, propranolol, propafenone, procainamide and flecainide. Drug concentrations were measured by HPLC-UV or chemiluminescence. The apparent permeability coefficient (P(app)), efflux rate (R(E)) and net efflux rate (R(net)) were calculated. Drugs with R(net) greater than 1.5 were further investigated using cellular accumulation experiments with or without a BCRP inhibitor. The R(net) of sotalol, propranolol, propafenone and procainamide were less than 1.5, while R(net) of flecainide with concentrations of 20 and 5 μmol x L(-1) were 1.6 and 1.9, respectively. The results showed that the transport of flecainide on MDCKII-BCRP cell monolayer could be mediated by BCRP; and the affinity increased when the concentration of flecainide decreased. Cellular accumulation experiments further suggested that accumulation of flecainide in MDCKII-BCRP cells was significantly lower than that in MDCKII cells in a concentration-dependent manner. BCRP inhibitor quercetin (50 μmol x L(-1)) significantly increased the accumulation of flecainide in MDCKII-BCRP cells (P < 0.05). Our preliminary data showed that flecainide but not sotalol, propranolol, propafenone or procainamide can be a substrate of BCRP. Thus the effect of flecainide may be affected by the BCRP in the maternal placental trophoblast membrane layer when treating fetal tachyarrhythmia.

According to the characteristics of pediatric resident training, the situation in clinic practice of medical imageology are analyzed and the major problems are pointed out.This article empha sizes significance of standardized resident training of medical imageology, presents detailed requirement which the residents must meet and aims to improve the training effect by the solutions summarized after years of experience.

Objective To investigate the effects of levocarnitine on pregnancy outcome of the patients with obstructive azoospermia treated with intracytoplasmic sperm injection ( ICSI ) . Methods A total of 74 patients with obstructive azoospermatism treated with ICSI randomly divided into 2 groups:treatment group( n=38) , taking levocarnitine before treatment with ICSI 1 g twice a day for three months;control group( n=36) , taking vitamine E before treatment with ICSI 0.1 g twice a day time for three months.tumor necrosis factor-α(TNF-α), reactive oxygen species(ROS) level, epididymal sperm motility and morphology in epididymal fluid of the two groups were determined before and after treatments. The number of matured oocytes, fertilization, and embryos of adequate quality, the rate of fertilization and embryo of adequate quality, and pregnancy rates after PESA-ICSI were compared between the two groups. Results TNF-α in epididymal fluid before and after the treatment was (5.39±2.28)and(4.05±2.14)ng.mL-1 in the treatment group(P<0.05), and(4.97±2.13)and(4.83±2.35)ng.mL-1 in the control group.ROS in epididymal fluid before and after the treatment was(62.72±8.51),(56.28±8.70)RLU.s-1(P<0.05)in the treatment group( P<0. 05 ) , and ( 62. 61 ± 7. 55 ) and ( 61. 05 ± 6. 77 ) RLU . s-1 in the control group. After treatment with levocarnitine, epididymal sperm motility was significantly increased(P<0.05).There were no significant differences in all the indexes in the control group before and after the treatment(P>0.05).After PESA-ICSI, the number and percentage of high quality embryo in the treatment group were significantly higher than those of the control group(P<0.05). Conclusion Levocarnitine can down-regulate epididymal TNF-α and ROS in patients with obstructive azoospermatism, thereby improve the environment of the epididymis and elevate the quality of sperm and ICSI pregnancy outcome.

Objective To discuss the effects of sevoflurane on perioperative hemodynamics and serum cardiac troponin I(cTnI) in patients undergoing abdominal surgery,and offer the reference for selecting anesthetic in clinic.Methods Forty patients with ASA Ⅱ—Ⅲ,undergoing radical gastrectomy were randomly allocated into sevoflurane group(group S) and propofol group(group P),with each 20 patients.Systemic blood pressure(SBP),diastolic blood pressure(DBP),heart reat(HR) and saturation of oxygen(SPO2) were monitored as routine.The concerntration of cTnI was examined at pre-anesthesia(T1),post-induction(T2),beginning of operation(T3),end of operation(T4),the first day post-operation(T5) and the third day post-operation(T6) with radioimmunoassay.Results SBP,DBP and HR in group P at post-induction were significantly lower than those in group S(P

Objective To find out the cognition understanding of iodine deficiency disorders(IDD) of target population in Xi’an City, and evaluate the effectiveness of a health education project on prevention and control of IDD. Methods By using the random number table, three towns in each project county were selected. Obeying the requirements of the education program for IDD control, the health education activities were implemented during 2007 - 2011. Before and after intervention, questionnaire was used to investigate the intervention effect. The primary school grade 5 students and women of childbearing age were included in the survey of IDD knowledge. Hierarchical random sampling method was used to select pupils and childbearing women. Results After health education, the rate of knowledge on IDD increased from 66.97%(13 321/19 890) to 93.49%(18 610/19 905,χ2 = 4 413.07, P < 0.05) among pupils, and 62.27%(6 193/9 945) to 93.96%(9 361/ 9 963, χ2= 2 924.18, P<0.05) among childbearing women. And the awareness had reached the national standard. But the survey results showed that: the rate of IDD related knowledge in rural areas was lower than that in town areas. The awareness rates of IDD in precaution, main hazards, identification of iodized salt were 46.50%(239/514), 55.25%(284/514) and 50.97%(262/514) among pupils in rural areas and 61.44%(376/612), 65.69%(402/612) and 70.59%(432/612) among pupils in town areas, and the awareness rates of pupils in rural areas were lower than those of pupils in town areas. Thirty-six point ninety-three per cent(226/612) of the pupils in towns and 35.60%(183/514) of the pupils in rural areas told this information to their parents. The awareness rates of IDD in precaution, main hazards, IDD prevention day were 49.25%(197/400), 50.75%(203/400) and 36.50%(146/400) among women in rural areas and 75.44%(298/395), 80.25%(317/395) and 57.97%(229/395) among women in town areas, and the rates of women in rural areas were lower than those of women in town areas. The rate of consciously purchasing of qualified iodized salt was 51.75%(207/400) and the consumption rate of iodized salt was 36.75%(147/400) among women in rural areas, which were 73.42%(290/395) and 43.80%(173/395) among women in town areas, and the rates in rural areas were lower than those in town areas. Conclusions Before health education of IDD, the rate of IDD related knowledge in Xi’an City is poor, rural areas are lower than town areas. Health education project is effective in promoting the understanding and grasp of IDD knowledge.

OBJECTIVE To explore the effect and underlying mechanism of promethazine(PMZ) on proarrhythmia in guinea pigs. METHODS ① InvivoECG recordings were made to analyze effects of jugular intravenous(iv)injection of PMZ on ECG in guinea pigs. PMZ was injected in this order:3.83→7.67→15.33→38.33 mg·kg-1 cumulatively. ② In vitroECG recordings were made to analyze effects of PMZ on ECG in isolated hearts of guinea pigs. PMZ was perfused in such order:0. 1 → 1 → 10 →50 μmol·L-1 . ③ L-type Ca2+ currents from ventricular myocytes in guinea pigs were recorded to investi-gate the PMZ's blocking effect. PMZ was perfused in such order:0.1→1→10→50 μmol·L-1→washout.④ hNav1.5 and hERG currents were recorded to investigate the PMZ's blocking effects. PMZ-perfused in such order:1→3→10→30 μmol·L-1 for hNav1.5 current analysis,and 0.3→1→3→10 μmol·L-1 for hERG current analysis. RESULTS ① PMZ(15.33 mg·kg-1 )significantly prolonged QRS intervals in guinea pigs invivoECG(P﹤0.05). PMZ(38.33 mg·kg-1 )prolonged QRS,QTc,and P-R intervals but reduced the heart rate( P﹤0.05). PMZ(10 μmol·L-1 )reduced the heart rate of isolated guinea pig hearts. PMZ 50 μmol·L-1 prolonged QRS and QTc intervals and further reduced the heart rate(P﹤0.05).③ PMZ inhibited the L-type Ca2+ current from ventricular myocytes in guinea pigs in a concentration-dependent manner with the lC50 of(8.9±1.0)μmol·L-1 . ④ PMZ inhibited the hNav1.5 and hERG currents in a concentration-dependent manner with the lC50 of 6.1±1.5 and(1.6±0.2)μmol·L-1 ,respectively. CONCLUSION PMZ might cause arrhythmia at overdoses and incombination with other drugs which have potential blocking effect on /Na ,Ca2+ and /kr currents. The proarrhythmic effect of PMZ might be mediated by the blocking effect on /Na ,Ca2+ and /kr currents.

OBJECTIVE Toexploretheantagonisticeffectofadrenaline(Adr)onproarrhythmiain-duced by Chinese herbal intravenous injection of Shuanghuanglian Injection (SHL).METHODS ① In vivo ECG recording was made to analyze effects of jugular intravenous (iv)injection of SHL alone and SHL plus adrenaline on ECG in guinea pigs.SHL and/or adrenaline were injected accumulatively in this order:SHL 276 mg·kg -1→2760 mg·kg -1→adrenaline 0.0078 mg·kg -1→adrenaline 0.039 mg·kg -1 .② In vitro ECG recording was made to analyze effects of SHL and SHL plus adrenaline on ECG in isola-ted hearts of guinea pigs.SHL and/or adrenaline were perfused in this order:SHL 0.3 g·L-1→SHL 1 .5 g·L-1→SHL 1 .5 g·L-1 +Adr 0.42 mg·L-1→SHL 1 .5 g·L-1→control perfusion solution.③ Single ventricular myocyte action potential was recorded to analyze the effect of SHL alone and SHL plus adren-aline on the action potential durations at 50% (APD50 )and 90% (APD90 )repolarization levels.SHL alone was perfused in such order:SHL 0.3 g·L-1 →SHL 1 .5 g·L-1 →SHL 3 g·L-1 +adrenaline 0.83 mg·L-1 .RESULTS ①SHL (2760 mg·kg -1 )significantly reduced heart rate and prolonged QRS and QTc intervals in vivo ECG.Adrenaline (0.0078 mg·kg -1 and 0.039 mg·kg -1 )significantly amelio-rated the proarrhyth mia of SHL by shortening QTc,P-R intervals and increasing heart rate.② SHL (1 .5 g·L-1 )remarkably reduced heart rate and prolonged P-R interval in isolated guinea pig hearts in vitro.Adrenaline (0.42 mg·L-1 )significantly increased heart rate and shortened the QTc interval.③ SHL (3 g·L-1 )remarkably prolonged the APD50 and APD90.Adrenaline abolished the prolonged effectofSHLonAPD50APD90.CONCLUSION Adrenalinemightbeclinicallyusedtotreatsevere adverse drug reactions induced by SHL based on its antagonistic effect on arrhythmia.

Objective To investigate the pathogen distribution and drug resistance of gram-negative bacteria causing lower respiratory tract infections in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) .Methods A total of 742 sputum samples were collected from AECOPD patients with lower respiratory tract infections in Taizhou Hospital of Zhejiang Province during January 2013 and December 2014.Vitek 2 Compact system combined with disk diffusion was used for strains identification and drug susceptibility test.Modified Hodge test and ethylenediamine tetraacetic acid (EDTA) synergic test were used to screen carbapenem-resistant strains.Statistical analysis was performed using WHONET 5.6 and SPSS 20.0 software.Results A total of 593 strains of gram-negative bacteria were isolated , in which 367 strains were nonfermentative bacteria (61.89%), 220 strains were enterobacteriaceae (37.10%), and the rest 6 strains ( 1.01%) were other gram-negative bacteria.Acinetobacter baumannii ( 186 strains ), Pseudomonas aeruginosa (99 strains), Stenotrophomonas maltophilia (33 strains) and Burkholderia cepacia (22 strains ) were top 4 nonfermentative bacteria , and they all showed high resistance to ampicillin , ampicillin/sulbactam, cefazolin, ceftriaxone, cefotetan and nitrofurantoin with resistant rates of 67.20%-100.00%. Drug resistance rates to other β-lactams, fluoroquinolones, aminoglycoside, compound sulfamethoxazole and minocycline were significantly higher in carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains than those in non-carbapenem-resistant strains , and the differences were statistically significant (P <0.05 or <0.01).Stenotrophomonas maltophilia and Burkholderia cepacia strains were only sensitive to levofloxacin , compound sulfamethoxazole and minocycline . Klebsiella pneumonia (89 strains), Escherichia coli (80 strains) and Enterobacter cloacae (25 strains) were top 3 enterobacteriaceae , which were almost completely resistant to ampicillin , but were sensitive to piperacillin/tazobactam , cefoperazone/sulbactam , amikacin and carbapenems ( with resistant rates <15%) .More than 50%strains of extended spectrum β-lactamases ( ESBLs )-producing Klebsiella pneumonia and Escherichia coli were moderately or highly resistant to ampicillin/sulbactam , most cephalosporins ( except cefotetan and cefoperazone/sulbactam ), gentamycin, tobramycin, fluoroquinolones, aztreonam, compound sulfamethoxazole and minocycline , and the resistant rates were higher than those in non-ESBLs-producing strains (P <0.05 or <0.01).Conclusions Nonfermentative bacteria and enterobacteriaceae are the most prevalent gram-negative bacterial pathogens in lower respiratory tract infections in patients with AECOPD . Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains, as well as ESBLs-producing Klebsiella pneumonia and Escherichia coli strains are highly resistant to most antibacterial agents .