BACKGROUND: It is proved that nerve regeneration induced by terminolateral neurorrhaphy(TLN) is not as active as that induced by end-to-end suture. Exogenous epidermal growth factor(EGF) increases the opportunity of neuron survival in vitro and promotes nerve regeneration. Whether it can increase nerve regeneration after terminolateral neurorrhaphy deserves further study.OBJECTIVE: To evaluate the effect of exogenous EGF in promoting nerve regeneration after terminolateral neurorrhaphy.DESIGN: A randomized controlled trial.SETTING: Orthopedic Institute of Chinese PLA General Hospital.PARTICIPANTS: The trial was conducted in the Orthopedic Institute of Chinese PLA General Hospital from September 2001 to February 2002. A total of 32 male Wistar rats, weighting 200- 250 g, were randomized to control group and EGF group with 16 rats in each group.METHODS: The right peroneal nerve was transected and an epineural window of 1 mm was created on the neighboring tibial nerve. The distal end of the transected peroneal nerve was sutured to the windowed tibial nerve by means of end-to-side attachment. Each rat in EGF group received injection of 0. 1 mL/d EGF diluted with normal saline at 2 g/L for two weeks while each in control group received injection of normal saline (0. 1 mL/d) at the distal site of the transected peroneal nerve for two weeks. Histological, morphological and electrophysiological examinations were performed 4 and 8 weeks after operation.MAIN OUTCOME MEASURES: The regeneration rate of myelinated nerve, motor nerve conduction velocity and ultrastructural changes of the two groups.rate of myelinated nerve fibers: 4 and 8 weeks after operation, it was better in EGF group[ (52.42 ± 1.45)% and(61.41 ± 1.54)% ] than that in control nerve conduction velocity: 4 and 8 weeks after operation it was obviously greater in EGF group[ (30. 33 ±0. 88)m/s and(34. 36 ± 1.09)m/s] than that in conObservation of ultrastructure: The number of myelinated nerve fibers, and the thickness and maturation degree of myelin sheath were significantly better than those in control group.CONCLUSION: Exogenous EGF can promote nerve regeneration, increase nerve conduction velocity after terminolateral neurorrhaphy.

Objective To investigate the manifestations of esophageal motility disorders and evaluate the association between them and dysphagia, laboratory tests and other accessory examinations in patients with Sj(o)gren's syndrome (SS). Methods Esophageal manometry was performed in 31 patients with SS and 18 healthy volunteers by the step pull-through method. Results Decreased upper esophageal sphincter pressure was detected in 19 of the 31 patients (61%) with SS, while 4 of 18 (22%) in controls. The frequency was significantly higher in patients than in healthy controls (P=0.008). Fifteen of 31 patients (48%) showed various patterns of esophageal dysfunction including ineffective esophageal motility in 6 patients, nutcracker esophagus in 3 patients and nonspecific dysmotility in 6 patients. No major differences were found in esophageal parameters (peak amplitude, wave duration and velocity) when comparing primary SS with secondary SS. These esophageal abnormalities were not correlated with clinical manifestations, laboratory examinations and other auxiliary examinations. Conclusion Patients with SS may have esophageal motility disorders, which can presents with different patterns.

Pharmacometrics,developed from the conventional pharmacokinetics,is the science of applying mathe-matical and statistical methods to characterize,understand,and predict a drug's pharmacokinetic,phannacodyna-mic,and biomarker-outcome behaviors.Pharmacometrics has been widely valued for its utility of modeling and simulation in drug research and development,therapeutic drug monitoring and individualized therapy.This paper reviewed the advances of pharmacometrics employed in new drug research and development and therapeutic drug monitoring both at home and abroad.

Objective To observe the changes of the cells of human hepatocellular carcinoma (HepG2)using RNA for silencing the expression of COMMD7 gene,and investigate related mechanism of COMMD7 gene promoting HepG2 proliferation.Methods COMMD7 gene shRNA was designed and constructed into COMMD7-shRNA plasmid.HepG2 cells were divided into the HepG2 group,control-shRNA group (empty vectors were infected) and COMMD7-shRNA group (positive vectors were infected).Cells shapes were observed by fluorescence microscope after infecting.The expression of COMMD7 and expression and phosphosylation of extracellular regulated protein kinase1/2 (ERK1/2) and MEK1/2 protein were measured by Western blot.The cell vitality was measured by cholecystokinin octapeptide (CCK-8),and the apoptosis of cell was detected by flow cytometry.The measurement data with normal distribution were presented as (x) ± s.The comparisons among groups were evaluated with the one-way ANOVA,and pairwise comparison was analyzed by the LSD-t test.Results The cells were oval or spindle shapes and displayed green fluorescent after infected successfully.The results of Western blot showed that the relative quantitative expression of COMMD7 protein in the HepG2 group,control-shRNA group and COMMD7-shRNA group were 0.90 ±0.18,1.03 ±0.05 and 0.23 ±0.03,respectively,with a significant difference among the 3 groups (F =152.08,P ＜ 0.05),and the expression of COMMD7 protein in the COMMD7-shRNA group was significantly lower than those in the other 2 groups (t =20.74,21.16,P ＜ 0.05).The results of CCK-8 showed that the scores of the HepG2 vitality in the HepG2 group,control-shRNA group and COMMD7-shRNA group were 1.193 ±0.024,1.225 ±0.034 and 1.147 ±0.021,respectively,with a significant difference among the 3 groups (F =6.90,P ＜ 0.05),and the HepG2 vitality in the COMMD7-shRNA group was significantly lower than those in the other 2 groups (t =3.53,3.69,P ＜ 0.05).The results of flow cytometry showed that the apoptosis rate of HepG2 in the HepG2 group,control-shRNA group and COMMD7-shRNA group were 6.1％ ± 0.3％,7.8％ ± 0.5％ and 20.9％ ± 1.4％,showing a significant difference among the 3 groups (F =270.80,P ＜0.05),and the apoptosis rate of HepG2 in the COMMD7-shRNA group was significant higher than those in the other 2 groups (t =21.77,19.36,P ＜0.05).The results of Western blot showed that the relative quantitative expression of phosphorylation (p)-ERK1/2 and p-MEK1/2 in the HepG2 group,control-shRNA group and COMMD7-shRNA group were 0.932 ±0.046,0.945 ±0.017,0.553 ±0.052 and 0.452 ±0.031,0.468±0.027,0.263 ± 0.022,respectively,showing significant differences among the 3 groups (F =93.61,49.16,P ＜ 0.05),and the relative quantitative expression of p-ERK1/2 and p-MEK1/2 in the COMMD7-shRNA group were significantly lower than those in the other 2 groups (t =11.94,12.17,9.33,8.65,P ＜ 0.05).Conclusions COMMD7 gene can promote HepG2 proliferation via activating ERK/mitogen-activated protein kinase (MAPK) signaling pathway,and its mechanism may be promoting the phosphorylation of expression of ERK1/2 and MEK1/2.

OBJECTIVE To compare three surgical hand preparations for their effects on hand skin conditions.METHODS Three surgical hand antisepsis methods were selected to compare their immediate antimicrobial(efficacies) and effect on skin conditions,including 1% chlorhexidine gluconate(CHG)and 61% ethanol(pre-surgical) waterless,scrubless hand preparation,iodophor surgical scrub with sponge,and iodophor surgical scrub with brush.RESULTS All of the three methods could achieve satisfying immediate reduction in the normal(bacterial)(flora) of the hands.The alcohol-based surgical hand rub method was gentler to skin than the other two.(CONCLUSIONS) The alcohol-based surgical hand rub is recommended for surgical hand antisepsis.

OBJECTIVETo investigate the effect of Compound Qingqin Liquid (CQL) on the expression level of angiotensin II (Ang II) and COX-2 mRNA transcription and protein expression in the renal tissue of rats with uric acid nephropathy.

METHODSSD rats were randomly divided into the blank control group, the model group, the positive drug group, the high, moderate, and low dose CQL group according to number randomization principle. The model was established by gastrogavage of adenine, accompanied with yeast feeding. Distilled water was given by gastrogavage to rats in the blank control group and the model group. Allopurinol at the daily dose of 9.33 mg/kg was given by gastrogavage to rats of the positive control group. CQL at the daily dose of 3.77 g/kg, 1.89 g/kg, and 0.09 g/kg was respectively given by gastrogavage to rats in the high, moderate, and low dose CQL groups. All treatment lasted for 6 weeks. Rats were randomly divided at week 4 (3 in the blank control group, and 6 in the rest groups), and the rest rats were killed at week 6. The renal tissue was extracted. The expression level of Ang II and COX-2 mRNA transcription were detected by RT-PCR. The expression level of Ang II was detected by ELISA. The expression level of COX-2 protein was detected by Western blot and immunohistochemical assay.

RESULTSCompared with the blank control group, except the mRNA expression of Ang II at week 4, the mRNA and protein expression of Ang II and COX-2 obviously increased at week 4 and 6 in the model group (P < 0.01, P < 0.05). The COX-2 protein expression at week 4 was obviously lower in the high and moderate dose CQL groups than in the model group and the low dose CQL group (P < 0.05); the average integral of optical density value was obviously lower in the positive control group than in the model group. Except the mRNA expression of Ang II in the high dose CQL group at week 6, the mRNA and protein expression of Ang II obviously decreased in the positive control group and each dose CQL group (P < 0.01, P < 0.05). Of them, the effects were better in the high and moderate dose CQL groups than in the positive control group and the low dose CQL group (P < 0.05, P < 0.01). Besides, the mRNA expression of COX-2, the average integral of optical density value were obviously lower in the positive control group and each dose CQL group than in the model group (P < 0.05). The protein expression of COX-2 was obviously lower in the high and moderate dose CQL groups than in the model group (P < 0.05). Of them, the mRNA expression of COX-2 was better in the moderate dose CQL group than in the positive control group (P < 0.05); the protein expression of COX-2 was better in the high dose CQL group than in the low dose CQL group (P < 0.05).

CONCLUSIONCQL was capable of lowering the expression level of Ang II, COX-2 mRNA transcription and protein expression, thus suppressing the inflammatory pathological injury of the renal tissue.

Angiotensin II ; metabolism ; Animals ; Cyclooxygenase 2 ; genetics ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Kidney ; metabolism ; Kidney Diseases ; drug therapy ; metabolism ; Male ; RNA, Messenger ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Uric Acid

OBJECTIVETo identify the electrophysiological properties of long-QT syndrome (LQTS) associated missense mutations in the outer mouth of the HERG potassium channel in vitro.

METHODSMutations V630A and N633S were constructed by Megaprimer PCR method and cRNA were produced by T7 RNA polymerase. The electrophysiological properties of the mutation were investigated in the Xenopus oocyte heterologous expression system.

RESULTSCoexpression of mutant and wild-type HERG subunits caused a dominant-negative effect, and the currents were significantly decreased. Compared with wild-type HERG channels, V630A and N633S mutations were related to decreased time constants for inactivation for V630A/WT and N633S/WT at all potentials, reduced slope conductance and the voltage dependence of steady-state inactivation was shifted to negative potentials for V630A/WT and N633S/WT.

CONCLUSIONPresent study shows that LQTS associated missense mutations located in the outer mouth of HERG cause a dominant-negative effect and alterations in steady-state voltage dependence of channel gating of heteromultimeric channels suggesting a reduction in expressional current might be one of the pathophysiologic mechanisms of LQTS.

Animals ; DNA Mutational Analysis ; ERG1 Potassium Channel ; Electrocardiography ; Ether-A-Go-Go Potassium Channels ; genetics ; Humans ; Long QT Syndrome ; genetics ; Mutation, Missense ; Oocytes ; Patch-Clamp Techniques ; RNA, Complementary ; Xenopus

OBJECTIVETo identify the causes of respiratory complications following liver transplantation (LT) and to discuss the management of these complications.

METHODSOne hundred and twenty four cases with pulmonary complications in the first two weeks after LT were identified among 163 patients admitted to the First Affiliated Hospital, College of Medicine, Zhejiang University from February, 1999 to March, 2003.

RESULTSThe incidence rate of complications was 76%(124/163) with the total cure rate of 92%(114/124). The cure rates of the various complications were as follows: pleural effusion 100%(113/113), pneumonia 92%(76/83), respiratory insufficiency 91%(59/65), pulmonary hypertension 98%(101/103), pulmonary edema 98(58/59), atelectasis 100%(4/4) and pneumothorax 100%(2/2).

CONCLUSIONTo drainage the pleural effusion with an unicameral venous catheter is safety and effective. To cure or prevent pneumonia and atelectasis, aseptic manipulating, aspiration of sputum and keeping respiratory channel open were the key measurements of treatment. Restrictive ventilatory functional disturbance (RVFD) and dysfunction of ventilation are two major types of respiratory insufficiency in early stage of post-transplantation. The causes of pulmonary hypertension and edema are associated with pulmonary angiotasis and blood flow volume, and the vasodilator and diuretic often introduced in the therapy.

Female ; Humans ; Hypertension, Pulmonary ; etiology ; therapy ; Liver Transplantation ; adverse effects ; Male ; Pleural Effusion ; etiology ; therapy ; Pneumonia ; etiology ; therapy ; Postoperative Complications ; etiology ; therapy ; Pulmonary Atelectasis ; etiology ; therapy ; Pulmonary Edema ; etiology ; therapy ; Respiratory Insufficiency ; etiology ; therapy ; Respiratory Tract Diseases ; etiology ; therapy

Antibiotic-associated diarrhea(AAD) is a frequent adverse effect of antibiotic in children.AAD is associated with longer hospitalization, higher healthcare cost and even lead to death.Pediatricians usually do not pay enough attention to AAD.Domestic experts from pulmonary medicine, infection and gastroenterology are organized to develop the consensus, to improve the diagnosis, treatment and prevention of AAD, and contribute the children health in future.

Objective :To analyze therapeutic effect of different dose of simvastatin on hypertension complicated hy‐perlipidemia and its safety .Methods :A total of 90 patients with hypertension complicated hyperlipidemia treated in our hospital were randomly and equally divided into simvastatin routine dose group (20mg／d simvastatin) and high dose group (40mg／d simvastatin) ,both groups were treated for six months .Therapeutic effect ,levels of blood pressure (BP) and blood lipids before and after treatment ,and incidence of adverse reactions were compared between two groups .Results :Compared with routine dose group after treatment , there were significant rise in total effective rates of hypertension (75.56% vs.93.33%) and hyperlipidemia (71.11% vs.95.56%) in high dose group ,P＝0.020 ,0.002 ;Compared with routine dose group after treatment ,there were significant reductions in levels of serum TC [ (5.68 ± 0.68) mmol／L vs. (4.07 ± 0.62) mmol／L] ,TG [(1.89 ± 0.37) mmol／L vs.(1.03 ± 0.31) mmol／L] ,LDL‐C [ (3.59 ± 0.74) mmol／L vs. (2.12 ± 0.69) mmol／L] and blood pressure [ (134.84 ± 11.92)／(90.96 ± 8.79) mmHg vs.(120.09 ± 11.43)／(81.78 ± 8.57) mmHg] ,and significant rise in serum HDL‐C level [ (1.28 ± 0.41) mmol／L vs.(1.48 ± 0.46) mmol／L] in high dose group , P＜0.05 or ＜0.01. There was no significant difference in incidence rate of adverse reactions between two groups (P＝0.535).Conclusion :High dose simvastatin possesses more significant therapeutic effect on hypertension compli‐cated hyperlipidemia .It can significantly reduce BP and blood lipids with good safety .