Table of Content

Volume 18 Issue 10
26 October 2013

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Association analysis of polymorphisms in intron 2 of μ opioid receptor gene and effective dose in methadone maintenance treatment of heroin addiction

XIE Xiao-hu, LIU Hui-fen, Zhang Ya-hai, CHEN Wei-sheng, ZHUANG Ding-ding, ZHANG Jian-bing, ZHOU Wen-hua

2013, 18(10):  1081-1085. 

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AIM: To explore the association between the single nucleotide polymorphisms (SNP) in intron 2 of the μ opioid receptor gene (OPRM1) and the effective dose in methadone maintenance treatment of heroin addiction.METHODS: The genotypes of the two SNPs (rs9479757, rs2075572) in 68 heroin dependent patients in methadone maintenance treatment were detected by TaqMan SNP genotyping technique, and the association between methadone dose and the two SNPs was analyzed.RESULTS: The frequencies of genotype and allele at rs9479757, rs2075572 were not significantly different between the high and low methadone dose groups (P>0.05). The average methadone daily dosages of various genotypes at the two SNPs were not significantly different (P>0.05).CONCLUSION: The polymorphisms (rs9479757, rs2075572) in intron 2 of the μ opioid receptor gene (OPRM1) may not play the major role in the effective dose in methadone maintenance treatment of heroin addiction.

Mechanism underlying the antidepressant effect of Fructus Aurantii

XU Ying, FENG Jie, GUO Jian-you

2013, 18(10):  1086-1092. 

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AIM: To explore the mechanism underlying antidepressant effect of Fructus Aurantii on chronic unpredictable mild stress (CUMS) model of depression in rats.METHODS: The depression animal model was induced by chronic unpredictable mild stress. Sucrose preference test and forced swimming test were measured to assess the depressive behaviors. Moreover, stomach emptying rate and intestines push movement were measured to test the gastric motility. In addition, the serum cortisol was measured by ELISA, mRNA expressions of glucocorticoid receptors (GR), alocorticoid receptors (MR) and brain derived neurotrophic factor (BDNF) in rat brain were tested by RT-PCR.RESULTS: Fructus Aurantii, at dosage of 10, 20 g/kg body weight, significantly increased sucrose preference, prolonged immobility time in forced swimming test, and improved gastric motility. In addition, Fructus Aurantii also increased the expression of GR mRNA expression in hippocampus, and BDNF mRNA expression in hippocampus and cortex of CUMS rats.CONCLUSION: Fructus Aurantii exhibits antidepressant effect via improving gastrointestinal function in rats, attenuating the stimulated function of hypothalamus-pituitary-adrenal axis and activating brain-derived neurotrophic factor in CUMS rat model of depression.

Study on analgesic effect of active component from crude cobra venom in Wannan Area

WANG Hai-hua, ZHANG Gen-bao, MIN Zhi-xue, HUANG Lu, CUI Feng-juan

2013, 18(10):  1093-1099. 

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AIM: To study on analgesic effect of active component from crude cobra venom in Wannan Area(CVAF) and investigate its possible mechanism of analgesic effect.METHODS: Inflammatory pain model of rat (CFA group) was established using CFA (150 μL, s.c.). 40 male SD rats were randomly divided into 4 groups (n=10): NC, CFA, CFA+CVAF and CFA+Morphine groups. Then another 36 male SD rats were randomly divided into 6 groups (n=6): NC, CFA, CFA+CVAF, CFA+Atr+CVAF, CFA+Nal+CVAF and CFA+L-NAME+CVAF groups, the changes of thermal withdrawal latency (TWL) and mechanical withdrawal threshold (MWT), induced by CVAF, were determined by Spurs pain and mechanical pressure methods, respectively. The levels of interleukin (IL)-1 and tumor necrosis factor (TNF)-α in spinal cord were detected by enzyme-linked immunosorbent assay (ELISA). Analgesic activity of CVAF was also evaluated in the CFA group after administrating with atropine, naloxone or L-NAME.RESULTS: Compared with NC group, TWL and MWT were decreased from 1st day to 14th day in CFA group; the levels of IL-1 and TNF-α from spinal cord in CFA group were significantly increased (P<0.01). Compared with the CFA group,the TWL and MWT were increased after injecting CVAF,thermal hyperalgesia and mechanical allodynia were also improved simultaneously,the levels of IL-1 and TNF-α were decreased (P<0.01), the result showed CVAF played a role in analgesic activity via inhibition of inflammatory factor.Compared with CFA+CVAF group, atropine or naloxone could return the increased TWL and MWT by CVAF (P<0.01). The results indicated that both opioid peptide receptor system and cholinergic receptor system could be related to analgesic effect of CVAF for inflammatory pain.CONCLUSION: CVAF plays a role in analgesic effect with inflammatory pain through inhibition of inflammatory factor. Both opioid peptide receptor system and cholinergic receptor system are partially involved in the analgesic effect of CVAF for inflammatory pain.

Expression of somatostatin receptor type 2 in colorectal cancer

CHENG Yuan-guang, WU Pei

2013, 18(10):  1100-1104. 

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AIM: To investigate the expression and role of somatostatin receptor subtype2 (SSR2) in the pathogenesis and progression of human colorectal cancer (CRC).METHODS: 37 cases of CRC in inpatients were identified and all tissue specimens of the cases after surgical resection immediately were selected.The tissue specimens including remote mucosa of tumors (10 cm beyond the tumor),adjacent mucosa of tumors(within 2 cm of the tumor),tumors.The expression of SSR2 mRNA in the specimens were detected by reverse transcription polymerase chain reaction(RT-PCR) and the positive rate and the expression in the specimens were analyzed.RESULTS: The SSR2 mRNA expression rate of the samples shows remote mucosa of tumor 100%(37/37),adjacent mucosa of tumor 91.9%(34/37) and tumor 83.8% (31/37). Compared with the nomal colorectal mucosae,the expression rate and expression intensity of tumor were decreased significantly (P=0.038, P=0.021). The significant correlation of SSR2 mRNA expression rate and intensity in tumor differentiation (P=0.021,P=0.013) and tumor stage (P=0.005,P=0.019) were found,while there was no significant correlation in the expression of SSR2 mRNA and other clinic pathological parameters such as age,sex,tumor size,site and the level of CEA in serum.CONCLUSION: The expression of SSR2 mRNA in tumor is decreased significantly. SSR2 mRNA expression rate and expression intensity of tumor are correlated with the tumor differentiation and stage,and SSR2 may play an important role in the pathogenesis and progression of CRC.

Effects of salviae miltiorrhizae on mice resident cardiac stem cell

YU Hong-song, LING Lin, JIANG Hong, SHI Guang-fei

2013, 18(10):  1105-1109. 

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AIM: To investigate the effect of Salviae miltiorrhizae on the number and paracrine effect of resident cardiac stem cell.METHODS: Mice were divided into three groups and received intragastric administration of high dose Salviae miltiorrhizae (5 g·kg^-1·d^-1), low dose Salviae miltiorrhizae (0.5 g·kg^-1·d^-1) or saline for one week. Blood was collected for analysis of blood routin test, liver and renal function. The number of resident Sca-1⁺ cardiac stem cells was detected by immunofluorescent staining and the expressions of VEGF, IL-6 and BAD in heart tissue were determined with Real-Time PCR .RESULTS: The number of white blood cell, red blood cell, platelet, liver and renal function showed no difference among the three groups (P>0.05),by intragastric administration for 1 week.Compared with the high dose Salviae miltiorrhizae group,the number of resident Sca-1⁺ cardiac stem cells and the expression of VEGF, IL-6 were decreased in low dose Salviae miltiorrhizae group and control group,there was statistically significant difference (P<0.05). Meanwhile, compared the other two groups ,the expression of BAD was decreased in the high dose Salviae miltiorrhizae group,there was statistically significant difference (P<0.05).CONCLUSION: Salviae miltiorrhizae treatment can increase resident Sca-1⁺ cardiac stem cells number and improve paracrine function.

Hepatoprotective effect of Panax notoginseng saponins in hepatic fibrosis rats

JIANG Hui, GAO Jia-rong, CHEN Jin-feng, LIU Yong

2013, 18(10):  1116-1120. 

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AIM: To observe the effect of Panax notoginseng saponins (PNS) on hepatic fibrosis in rats.METHODS: The rats were randomly divided into six groups, including normal group, liver fibrosis model group, PNS (50, 100, 200 mg/kg) treated groups and Col (0.1 mg/kg) group. Rat liver fibrosis was induced by subcutaneous injection 50% carbon tetrachloride (CCl₄) twice a week for 18 weeks. PNS were used daily via lavage at 9th week for subsequent 10 weeks. The superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione peroxidase (GSH) were determinate by chromatometry. Moreover, liver samples were taken to examine the degree of liver fibrosis by HE staining and to stain by immunochemistry of Collagen I. Collagen I mRNA expression was detected by RT-PCR.RESULTS: As compared with the fibrotic model group, PNS (100, 200 mg/kg) significantly reduced histopathological change, degraded MDA contents, raised the levels of SOD and GSH. Meanwhile, PNS could effectively decrease the expression of Collagen I in liver fibrosis rats.CONCLUSION: PNS has protective effect on hepatic fibrosis in rats.

Effects of liver cirrhosis on the expression of myosin heavy chain in rat myocardium

ZHANG Wei-ping, GAO Qin, LI Zheng-hong, SU Ai-rong, WU Ji-feng

2013, 18(10):  1121-1125. 

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AIM: To study the effects of liver cirrhosis on the expressions of myosin heavy chain (MHC) isoforms in rat myocardium. METHODS: Thirty male Sprague-Dawley rats were randomly divided into control group and liver cirrhosis group. The heart weight to body weight ratio (H/B) were recorded. The ventricular hemodynamical parameters in vitro were determined. α-MHC mRNA and β-MHC mRNA expression of myocardium was evaluated by RT-PCR.RESULTS: In contrast to normal rat,H/B were increased , left ventricular systolic pressure LVSP, maximal rise/fall rate of left ventricular pressure ±dp/dt_max were decreased in model rat. The expression of α-MHC mRNA was decreased,and the expression of β-MHC mRNA was in the opposite.CONCLUSION: Liver cirrhosis affects the function of myocardial and stimulates the expressional change of myosin heavy chain gene in rat myocardium, which is related with the occurrence and development of cirrhotic cardiomyopathy.

Situation and suggestion on the pharmacotherapy before and after the percutaneous coronary intervention in Beijing hospital

GAO Ru-ya ZHANG Ya-tong, CAO Guo-ying

2013, 18(10):  1110-1115. 

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AIM: To evaluate the status quo and rationality of medicinal application for patients undergoing percutaneous coronary intervention (PCI) through therapeutic guide of 2009 and 2012.METHODS: Patients who underwent coronary heart disease (CHD) from the department of cardiology of Beijing hospital were included. The medicinal use before and after PCI were analyzed.RESULTS: All the enrolled 73 CHD patients had indications, with 44 patients for coronary angiography and 29 patients for PCI. The percentage of antiplatelet therapy was 100%. 27% patients were using anticoagulant drugs. 74% patients were taking β-blocker and 73% for ACEI or ARB, 96% for plasma lipids regulators.CONCLUSION: There are a gap between evidence and practice. It remains a major challenge for doctors, pharmacists, healthcare professionals and policy makers to resolve this problem rapidly.

A concentration-response observation of butorphanol combined with ropivacaine in labor epidural analgesia

CHEN Lan-feng, JIN Hao-jie, GAO Bao-bin, LU Yuan-yuan, LI Jun

2013, 18(10):  1126-1131. 

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AIM: To investigate the ED₅₀ of butorphanol combined with 0.15% ropivacaine and the most effective concentration of ropivacaine combined with butorphanol in labor epidural analgesia.METHODS: 121 nulliparous women undergoing labor selected for delivery with epidural analgesia. The first of the top 31 woman received 0.15% ropivacaine plus 20 μg/mL butorphanol 10 mL, the next woman's dose of the butorphanol was determined by a modification of sequential method. The other 90 women received 0.08% ropivacaine and butorphanol 16 μg/mL (Group B1), 0.10% ropivacaine and butorphanol 16 μg/mL (group B2), 0.12% ropivacaine and butorphanol 16 μg/mL(group B3) respectively.In the course of labor, block levels of epidural analgesia, the Bromage scores, Ramsay scores, fetal heart rate-uterine contraction were monitored. In addition, onset time of anesthesia, labor time, the cases of oxytocin using, Apgar scores of neonates and side-effect were recorded.RESULTS: There were no significant differences in age, height, weight and gestational weeks in every woman.The ED₅₀ of butorphanol was 14.79 μg/mL (95%CI 13.91～15.61 μg/mL). The ED₉₅ of butorphanol was 16.84 μg/mL (95%CI 15.86～20.97 μg/mL). The onset of anesthesia in group B1 was significantly longer than other two groups (P<0.05). The VAS scores at 30 min, 60 min, 90 min after injection in group B1 was significantly higher than those in other two groups(P<0.05), and the VAS scores when drug withdraw in group B1 was significantly higher than those in group B3(P<0.05). Group B3 showed higher motor block than other two groups (P<0.05).CONCLUSION: 0.10% ropivacaine combined with butorphanol 16 μg/mL is the most effective for epidural analgesia in labor. It is worth clinical application for its kind analgesic effect, slight motor block and high safety.

Topical accumulation of aminolevulinic acid in moderate to severe acne patients

XIE Dong, HE Li-hua, CHENG Ze-neng, WU Wei, GUO Xin, LIU Zhi

2013, 18(10):  1132-1137. 

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AIM: To study topical accumulation of aminolevulinic acid in affected parts of moderate to severe acne patients and to determine the optimal liniment concentration,optimal time of beginning lighting and duration time of protecting from light.METHODS: The study was divided into two parts.24 moderate to severe acne patients were divided into three groups in the first part.High,middle and low concentration liniment was given to three groups respectively.Optimal liniment concentration and optimal time of beginning lighting were determined by collecting the facial fluorescence images.8 moderate to severe acne patients were enrolled in the second part. Optimal liniment concentration and optimal initial light time were applied in this part.Plasma and urine samples were also collected to detect concentration of ALA and protoporphyrin Ⅸ.Duration time of protecting from light was determined by collecting the facial fluorescence images.RESULTS: Aminolevulinic acid was absorbed and aggregated in affected parts.Fluorescence intensity reached to approximate maximum during 4-8 h for three groups. Fluorescence intensity of the 10% group is larger than other groups during 4-8 h in the first part.ALA and protoporphyrin Ⅸ were not detected in plasma and urine.Fluorescence intensity in 24 h after clearing the drug approximate 43% comparing with 0 h. Duration time of protecting from light was more than 24 h after clearing the drug.CONCLUSION: Optimal liniment concentration of aminolevulinic acid was 10%.Optimal time of beginning lighting was during 48 h. The optimal time of beginning lighting is 4 h.Duration time of protecting from light was 48 h after clearing the drug.

Clinical trial in the relief of cancer pain in a combined therapy by Duloxetine plus Morphine sulfate

DAI Zhi-yuan, ZHENG Fang, LI De-qiang

2013, 18(10):  1138-1143. 

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AIM: In order to provide a good reference for clinical treatment, the efficacy and tolerability of Duloxetine plus Morphine sulfate with a single morphine treatment in cancer pain management were compared.METHODS: One hundred and eighty patients with moderate to severe cancer-related pain were enrolled in this randomized, open-label, 12-week clinical study. Subjects were assigned to either a single therapy group (Morphine sulfate sustained release tablet, 100-200 mg/day) or a combined therapy group (same dose of Morphine sulfate sustained release tablet plus Duloxetine 30 mg/day for the first 2 weeks and 60 mg/day thereafter). The follow-up was performed at the baseline and the end of the 4th- , the 8th- and the twelfth-week respectively. Short-Form McGill Pain Questionnaire (SF-MPQ) and the 10-point visual analog scale (VAS) were used to assess the severity of pain. Depressive and anxiety symptoms were assessed using the Hamilton rating scale for depression and Hamilton rating scale for anxiety. The treatment emergent symptom scale and dropout rate were recorded to evaluate the tolerability.RESULTS: A similar dropout rates were noted in the single treatment arms compared to combined treatment arms (8.9% at 4 weeks, 15.6% at 8 weeks and 23.3% at 12 weeks vs 10.0% at 4 weeks, 17.8% at 8 weeks and 25.6% at 12 weeks, all P>0.05). Adverse events such as constipation, sudation and palpitation were higher in the combined treatment group than the single treatment group,but no significant group difference was found. A group difference markedly appeared between combined therapy group and single treatment group in the total score decreases in VAS in week 4 and week 12 [(3.3±0.9) vs (2.1±0.6);(6.4±0.8) vs (4.5±0.5), P<0.01, respectively]. Although no statistical difference appeared in SF-MPQ total score change, higher score-decrease values were found in respect to the painful emotion dimension in combined treatment group as compared to the single treatment group in week 8 and week 12 [(4.2±1.3) vs (2.3±1.0);(6.8±2.9) vs (4.6±1.7), P<0.01, respectively].CONCLUSION: Duloxetine plus Morphine sulfate sustained release tablet is superior to single Morphine sulfate sustained release tablet in the treatment of cancer-related pain in efficacy and has a good tolerability.

Effects of dexmedetomidine to intracranial aneurysms with stress response and awakening quality on tracheal extubation

ZHANG Ling-bin, FAN Li-hua, LU Xiang-hong, HE Ren-hong, CHEN Qin, YOU Min-ji, XU Qiao-min, DING You-fa

2013, 18(10):  1144-1147. 

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AIM: To observe the effect of dexmedetomidine on intracranial aneurysms with stress response and awakening quality on tracheal extubation.METHODS: Select Hunt / Hess grading as I-II-class implementation of intracranial aneurysm surgery patients 50 cases, and randomly divided into dexmedetomidine group (group A) and normal saline group (group B), 25 patients in each. Group A were given dexmedetomidine with 0.5 μg/kg continuous infusion for 10 min before anesthesia, intraoperative 0.4 μg·kg^-1·h^-1 continuous infusion. Group B were given the same dose of 0.9% sodium chloride injection. Both groups were treated with combined intravenous-inhalation anesthesia. We recorded the changes of blood pressure (BP) and heart rate (HR) at into the operating room (T₁),extubation (T₂), extubation after 5 min (T₃), 10 min (T₄),measured the concentration of cortisol (COR), blood glucose (GLU), blood lactate (LAC), and recorded anesthesia recovery time,restlessness rating,visual analogue pain scores (VAS) and Ramsay sedation scores after extubation 30 min.RESULTS: The MBP, HR, COR, GLU, LAC of Group B increased more significantly (P<0.01 or P<0.05) than group A. Group B restlessness score and at VAS score 30 minutes after extubation were higher than those of group A, but Ramsay sedation scores were lower in group A (P<0.05).CONCLUSION: Dexmedetomidine can effectively inhibit the stress response to tracheal extubation period, can improve the quality of recovery from anesthesia, do not delay recovery.

Comparative study on nerve sparing radical hysterectomy with radical hysterectomy

TANG Xiu-wu, SUN Yun, NI Guan-tai

2013, 18(10):  1148-1154. 

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AIM: To compare the life quality of patients after nerve sparing radical hysterectomy or traditional radical hysterectomy and evaluate the safety of two operations.METHODS: Fifty patients with cervical cancer ofⅠB-ⅡA(FIGO) were selected under the guideline of ethic committee.Thirty of them received traditional radical hysterectomy(RH)as control group and twenty received nerve sparing radical hysterectomy (NSRH)as experimental group.The excision extent, operation time, blood loss, urethral catheter remaining days, residual urine volume, the first exhaust time, defecation time and sexual function recovery were followed up for half a year and these data were compared between the two groups.RESULTS: On the tenth day after operation, the residual urine volume of control group and experimental group were (201.83±83.00) mL and (139.75±69.01)mL; the urethral catheter remaining days of control group was (15.20±2.43) d and the experimental group was (11.85±2.08) d; the first exhaust time was (72.97±16.31) h and(59.60±13.37)h;the first defecation time was (121.17±23.07) h and (91.05±11.66) h,there were statistically difference in two groups(P<0.05). The sexual dysfunction in control group and experimental group control group were 86.7%and 45%,respectively. For six months after operation there were statistically difference between two groups(P<0.05). 77.8% of patients who didn't resume intercourse were afraid of relapse and 55.6% of them were afraid of pain.The median operation time of the two groups were 250 (180-330) min and 205 (150-270) min,and there was no statistically difference between two groups in operation time, blood loss and excision extent.CONCLUSION: NSRH for the patients with cervical cancer is feasible and safe and it can improve the recovery of bladder and rectum functions, and eventually make contribution to quality life of patients.

Changes of bone mineral density and bone metabolism and the risk factors in asthmatic patients on inhaled corticosteroids

ZHANG Wen-e, CHEN Li-qiu, WANG Qiang

2013, 18(10):  1155-1159. 

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AIM: To explore the prevence of osteopenia and osteoporosis and to determine the risk factors in ashmatic patients receiving inhaled corticosteroids (ICS)for more than one year.METHODS: The study was conducted from August 2007 to July 2011. Asthmatic patients who had been on ICS for at least one year (test group) and a control group of subjects not on ICS were included and all the included patients were more than 18 years. BMD was measured using DEXA (dual energy X-ray absorptiometry) scan. Osteopenia and osteoporosis was evaluated by the WHO classification of T-score. The levels of serum bone ga protein(BGP)and alkaline phosphatase (AKP) were detected by radio immunoassay.RESULTS: All the subjects were 149 patients. Test group who had been on ICS were 69 subjects and control group were 74 subjects.The levels of BGP in test group and control were (3.8±2.4), (2.7±1.4) μg/L, respectively,and there was no significant difference between two groups. The levels of AKP were (126±68),(119±66) U/L in test group and control, respectively and they also had not significant difference. T-score of the spine, femur, and hip of the asthmatics vs the control subjects were mean, -0.72 vs -0.57 (P=0.98); mean, -0.60 vs -0.80 (P=0.474); and mean, 0.19 vs 0.06 (P=0.275); respectively. T-scores of the spine, femur, and hip showed significantly negative correlation with age and significantly positive correlation with body mass index (BMI).CONCLUSION: The risk factors of osteopenia and osteoporosis are older age and lower body mass index (BMI),not the cumulatively inhaled corticosteroids in asthmatic patients.There are not other risk factors of osteopenia and osteoporosis inpatients inhaled corticosteroids when compared with control.

Clinical effects of levosimendan in patients with left ventricular systolic dysfunction under off-pump coronary artery bypass grafting

NIU Zhao-zhuo, SUN Li-xin, LIN Ming-shan, SUN Long, SHENG Wei, HOU Wen-ming, CHI Yi-fan

2013, 18(10):  1160-1163. 

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AIM: To investigate the clinical effect of levosimendan in patients with lower left ventricular eject fraction(LVEF) under off-pump coronary artery bypass grafting(CABG).METHODS: From May 2010 to November 2012, 40 cases with lower LVEF below 45% undergoing elective CABG were randomly devided into treatment group (20 cases) and control group (20 cases). All the cases received dopamine treatment perioperatively, and levosimendan were additionally used in the treatment group. The ICU time, the incidence of atrial fibrillation(AF),the duration of dopamine use, the mortality in the first 30 days were recorded. The level of LVEF in the first 3 days and the cTnI at 0,6,24,48 h after the operation were examined. RESULTS: No case died in both groups. Comparing with control group, treatment group had lower incidence of AF (P<0.05), and shorter time of dopamine use (P<0.05). Treatment group had a higher LVEF in the first two days than those in control group(P<0.05). Treatment group had lower cTnI at the 6h and 24h time point after the operation than those in control group(P<0.05). There was no remarkable difference between two groups in other aspects .CONCLUSION: Levosimendan has cardiac protection effect on patients under CABG with lower LVEF.

Effects of dexmedetomidine or midazolam given in patient-controlled intravenous analgesic fentanyl solution in gynecological laparoscopic surgery

WANG Peng-yu, LI Bao-chuan, HUANG Hua-jun, CAI Jian-min

2013, 18(10):  1164-1168. 

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AIM: To compare the clinical effects of dexmedetomidine or midazolam given in patient-controlled intravenous analgesic fentanyl solution in gynecological laparoscopic surgery.METHODS: 150 patients undergoing gynecological laparoscopic surgery, received propofol-fentanyl-rocuronium anesthesia induction and conventional sevoflurane for maintain anesthesia, were randomly assigned into five groups with 30 cases each. A dose of 16 mg ondansetron was added to PCA in group O, 5 mg midazolam was added to PCA in group M, 16 mg ondansetron and 5 mg midazolam were added to PCA in group OM, 200 μg dexmedetomidine was added to PCA in group D, while 16 mg ondansetron and 200 μg dexmedetomidine was added to PCA in group OD. PCA using 20 μg/mL of fentanyl was started in all groups postoperatively. Total volume of PCA was 60 mL, and was programmed to deliver 1 mL/h of continuous doses and a 0.5 mL bolus on demand, with a 15 minutes lockout interval. The incidence of postoperative nausea and vomiting (PONV), sedation score, visual analog scale (VAS) for pain, cumulative fentanyl dose, PCA effective pressing times and rescue drug dose for PONV or pain were investigated at the postanesthesia care unit (PACU), 6 h and 24 h after operation.RESULTS: The incidence of PONV was significantly higher in group O at three time periods than those in other four groups(P<0.05), but the sedation score was significantly lower at 6 h and 24 h postoperation than in other four groups(P<0.05). The incidence of PONV was significantly lower in group D and OD at three time periods than in group M(P<0.05). 24 cases (80%) used antiemetics in group O and was significantly more than other four groups(P<0.05). The frequency of used antiemetic in group D and OD were significantly less than other three groups(P<0.05). There were no significant difference of VAS scale at three time periods in five groups, cumulative fentanyl dose and PCA effective pressing times were significantly less in group D and OD than other three groups(P<0.05).CONCLUSION: Dexmedetomidine or midazolam given in PCA fentanyl solution proved more effective than ondansetron in preventing PONV but with some sedation. Dexmedetomidine given auxiliary analgesic and antiemetic effects was better.

Function of pregnane X receptor in drug mechanism and research progress

ZHANG Yi-wen, BAO Mei-hua, ZHOU Li-hua, ZHOU Hong-hao

2013, 18(10):  1169-1174. 

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Pregnane X receptor (PXR) is a member of the nuclear receptor superfamily NR1I subfamily, which is widely expressed in the liver and the intestine. The receptor as a key regulator of drug metabolism are widely involved in drug absorption, distribution, metabolism and excretion process.This review will introduce Ⅰ, Ⅱ phase metabolizing enzymes and transporters in the regulation of PXR. It will provide part of the basis for clinical drug interaction and drug research and development for PXR as a target.

Strategy of fixed-dose combination innovative development

YUAN Bing-xiang, CHEN Li-na, WANG Bing

2013, 18(10):  1175-1181. 

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Development of fixed-dose combination finished pharmaceutical products (FDC-FPPs, FDCs) is an innovative process and has become one of the breakthrough strategies for removing the bottlenecks in drug discovery. Formulating prescription of FDCs is based on drug interactions theory. The principle of formulating prescription is taking full advantage of the drugs' effects with a same remedy goal, then proceeding a demonstration of the prescription and multi-factor and multi-level analyses, verifying of clinical combinations, confirming of the goal prescription, finally accessing the normalize research and trials of new drug development. The whole process of FDCs research and development (pharmacy, pharmacodynamics, pharmacokinetics, toxicology and clinical trials) is as strict as such of the complete innovative drug, and need to optimize the formula and the ratio of prescription. This review summarizes the principles of formulating prescription, development strategy, and technical requirements specification of FDCs.

Research progress on pharmacogenomics of daunorubicin individual differences

HE Hui, ZHOU Hong-hao, LIU Zhao-qian

2013, 18(10):  1182-1185. 

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Daunorubicin is a clinical anti-leukemia drug.The effect is significant but there are significant individual differences. How to learn more about the factors that may cause daunorubicin resistant,thereby improving the efficacy of daunomycin, reducing resistance, and reducing the side effects of the drug, is a concern of clinical worker. This article reviews the genetic factors that affect daunorubicin pharmacokinetics and pharmacodynamics and provides some reference for daunorubicin individualized clinical administration .

Research progress of susceptibility genes in rheumatic heart disease

ZHANG Tao, WEN Chun-jie, SHEN Dong-ya, ZHOU Hong-hao

2013, 18(10):  1186-1191. 

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Rheumatic heart disease (RHD) is an autoimmune disease that results from valvular autoimmune response to group A streptococcal infection leading to severe valvular damage. About 30% to 45% of the rhemutic fever (RF) patients develop into RHD,suggestincg that genetic susceptibility playes important roles in the RHD development.An understanding of the mechanisms underlying host susceptibility can provide important insights into pathogenesis that in turn can inform new treatments.The development of the human genome provides conditions for the studies of RHD genetic susceptibility. There are some susceptibility genes have been found to be related to RHD, including human leukocyte antigen (HLA) and tumor necrosis factor (TNF),many of these genes are associated with the immune response and inflammatory process. This review summarizes the recent study of these related gene polymorphisms.

The progress of maintenance therapy in advanced non-small cell lung cancer

YE Chong-yang, XIE Jia-zheng

2013, 18(10):  1192-1195. 

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The morbidity and mortality of lung cancer showed a trend of increased year by year, the vast majority of lung cancer is non-small cell lung cancer (NSCLC),and more than half diagnosed patients are stage ⅢB or Ⅳ, chemotherapy is the main treatment approaches for patients with this kind of, but 5 years of survival rate is only 5% to 11%.Maintennance treatment is one of the hot research topic in the field how to improve time recurrence and survival time in recent years.This paper reviewed recent advances in the maintenance treatment for NSCLC.

Mouse models of type 2 diabetes mellitus

LIU Qian, LI Xia-hui, ZHANG Xue-mei

2013, 18(10):  1196-1200. 

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Type 2 diabetes was a disease influenced by genetic factors and environmental factors. Animal models of diatetes were essential tools for the understand of the pathogenesis、prevention and treatment of diabetes and its complications. Diabetes mouse models were normally classified into three classes which were spontaneously induced diabetes mouse, experimentally induced diabetes mouse and transgenic diabetes mouse. Each diabetes mouse only imitated clinical diabetes in some aspects and he characteristics of each model about mechanisms and physiology were described in this article. Researchers should choose the suitable diabetes mouse according to their research purpose.