Table of Content

Volume 13 Issue 6
26 June 2008

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Advances in study of CYP2C9 gene polymorphisms and its functional significances

LI Zhi, WANG Guo, ZHOU Hong-hao

2008, 13(6):  601-609. 

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Cytochrome P-450 2C9(CYP2C9) is a major drug-metabolizing enzyme in human liver and contributes to metabolism of about 10% of therapeutically usual drugs, including one with narrow therapeutic index.The human CYP2C9 gene is highly polymorphic, having many single nucleotide polymorphisms in promoters and coding regions.To date, at least 30 non-synonymous CYP2C9 alleles have been identified. This review summarizes recent advances in the study of CYP2C9 about the structure-function relationship, the functional significance of various CYP2C9 alleles in vitro and in vivo, and the frequency of CYP2C9 alleles among different populations.

Nordosin enhanced inhibition of FK506 on the secretion of IL-2 by lymphocyte derived from spleen of mice in vitro

DU Jun-ming, WU Ping, SUN Li-juan, LIU Jian-wen, LI Ji-yu, QUAN Zhi-wei

2008, 13(6):  610-613. 

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AIM: To investigate the effect of Nordosin in inhibiting proinflammatory cytokine with FK506 in vitro and potential applied value in the transplantation immunity.METHODS: ConA-stimulated T-cell proliferation model was made.Then, the expression of IL-2 both in protein and mRNA lever were investigated by ELISA and RT-PCR.Furthermore, the expression of IL-2 receptor, CD₂₅⁺ on surface of T lymphocyte was also measured by FCM.RESULTS: Compare with those by FK506 use along, Nordosin enhanced the inhibition of FK506 on the expression of IL-2 significantly (P<0.01).The expression of IL-2 mRNA and its receptor CD₂₅⁺ were also inhibited by their combining medication (P<0.01).CONCLUSION: Nordosin could enhance the inhibition of FK506 on IL-2 secretion significantly, Nordosin maybe become an immunodepression assistant medication to enlarge the pharmacological effect of FK506.

Effects of propofol on TTX-sensitive voltage-gated sodium channels in rat acutely dissociated spinal dorsal horn neurons

LIU Hong-liang, GUO Wei-tao, ZENG Yin-ming, YAO Shang-long

2008, 13(6):  614-619. 

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AIM: To investigate the effects of propofol on TTX-sensitive voltage-gated sodium currents and its mechanism in acutely dissociated rat spinal dorsal horn neurons.METHODS: Seven-day-old male SD rats were decapitated, a segment of lumbar enlargement of the spinal cord was dissected out, then the dorsal horn neurons were dissociated, and the wholecell patch clamp recording were performed.Propofol of 0.3-30 μmol/L was applied 100 μm apart from the cells.The currents were activated by a 30ms-pulse of-10 mV from holding petential(-80 mV).The inhibitory concentration in 50% of the sodium current amplitude (IC₅₀) value of propofol was estimated.For investigation of sodium channels inactivation, propofol of IC₅₀level was applied, sodium currents were activated by a 30 ms-pulse of 0 mV after a 30 ms-prepulse from-80 mV to-20 mV with a voltage step of 10 mV. For investigation of sodium channels deinactivation, sodium currents were activated by a 30 ms-pulse to-10 mV after a 30 ms-prepulse to-10 mV from holding pontential (-80 mV) under propofol of IC₅₀level, the intervals between the two pulses were from 2 ms to 24 ms.RESULTS: Propofol could inhibit tetrodotoxinsensitive sodium currents in a concentration-dependent manner, the IC₅₀value of propofol was (5.35±0.25) μmol/L.In inactivating sodium channels test, from-60 mV to-40 mV of the prepulse, propofol of IC₅₀level could suppress sodium currents activated by the test pulse significantly (P<0.05);in deinactivating sodium channels test, the currents activated by the test pulse with the intervals from 2ms to 6 ms were significantly suppressed by propofol with IC₅₀ level (P<0.01, P<0.05).CONCLUSION: Propofol inhibited TTX-sensitive voltage-gated sodium currents in rat dorsal horn neurons, which was mediated by facilitating sodium channels inactivating and inhibiting sodium channels from its deinactivation.

Chemical hypoxia induced [Ca²⁺]_i and NGB alteration and aspirin intervention

CHENG Ju, XIE Kun, HOU Min, BAI De-cheng

2008, 13(6):  620-626. 

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AIM: To observe changes of intracellular free calcium levels ([Ca²⁺]_i) and neuroglobin (NGB) expression when rats′brain cells were exposed to chemical hypoxia, and the influence of aspirin (ASA) on changes as well as to study its mechanism primarily.METHODS: Sodium dihionite was used to deprive the oxygen in culture medium, and confocal laser scanning microscope with double fluorescence labeling methods were used to measure the changes of [Ca²⁺]_i and NGB expression in rats′brain cells.Flou-3/AM and Cy-3 were used to indicate calcium concentration and NGB expression respectively.RESULTS: [Ca²⁺]_i and NGB expression are related to the time of hypoxia.Compared with the normal control group, average fluorescent intensity of [Ca²⁺]_i and NGB expression in the simple hypoxia group increased gradually with the time of the exposure in hypoxia.Moreover, there is the positive correlation between [Ca²⁺]_i and NGB expression.[Ca²⁺]_i and NGB expression in the ASA pretreated group increased slowly, the increase degree is significantly lower than that in the simple hypoxia group.[Ca²⁺]_i and NGB expression in the ASA treated group were increased significantly in early stage, the increase degree is not significant diffexence from the simple hypoxia group.At 120 min, [Ca²⁺]_i and NGB expression in the ASA treated group increased slowly, the increase degree is significantly lower than that in the simple hypoxia group.CONCLUSION: ASA has a protective effect on hypoxic injury of rats′ brain cells, which may be attribute to its inhibiting calcium overload, and NGB expression is regulated by Ca²⁺-CaM complex.In addition, the neuroprotective effects of ASA pretreated group were better than ASA treated group in early stage.

Effect of nuclear factor-κB on proliferation of vascular smooth muscle cells promoted by thrombin in spontaneously hypertensive rats

HU Rong,HONG Hua-shan, XU Chang-sheng, WU Ke-gui

2008, 13(6):  627-633. 

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AIM: To study the dose-effect and time-effect on proliferation of vascular smooth muscle cells (VSMCs) in spontaneously hypertensive rats (SHR) promoted by hrombin and to explore the relationship between VSMCs proliferation and NF-κB path as well as their possible mechanism.METHODS: VSMCs were incubated with thrombin at the following concentrations of 0.01, 0.1, 0.2, 0.5, 1.0, 2.0 U/mL for 24 h and with 0.5 U/mL thrombin for 1, 2, 6, 12, 24, 48 h respectively;The proliferation rate of VSMCs was determined with both WST-1 metabolic activity and ³H-TdR incorporation efficiency;The expression of NF-κB in VSMCs was tested with both immumofluorescence and western blot in basic condition and with 0.5 U/mL thrombin intervention.Ang Ⅱ and PDGF on proliferation of VSMCs were used as positive control group.In order to research the relationship of NF-κB path and VSMCs proliferation induced by thrombin, after pretreatment with 100 μmol/L PDTC (NF-κB special inhibitor), VSMCs proliferation induced by thrombin was also investigated.RESULTS: Thrombin concentrations of 0.2-2.0 U/mL significantly promoted VSMCs proliferation respectively(P<0.05 or P<0.01).But VSMCs proliferation was not different in the thrombin at the concentrations of 0.5-2.0 U/mL at 24 h (P>0.05).VSMCs proliferation with 0.5 U/mL thrombin exhibited double hump when compared with the Control Group.The peak values at 1 h and 24 h showed that thrombin promotion VSMCs proliferation was not only rapid and brief but also delayed and retarded.The expression of NF-κB of VSMCs in basic condition was mainly distributed in cytoplasmwhile that of VSMCs interfered by thrombin was in nucleus.The PDTC pre-treatment could obviously inhibit VSMCs proliferation induced by thrombin (P<0.01).CONCLUSION: Thrombin promotes VSMCs proliferation in the manner of dose dependent at the concentrations of 0.2-0.5 U/mL.The proliferation curve induced by thrombin exhibits double hump which suggests that thrombin promotion VSMCs proliferation is delayed. Thrombin may activate NF-κB of VSMCs and make it transfer from cytoplasm to nucleus.VSMCs proliferation induced by thrombin is connected with NF-κB path.NF-κB may be the common path for the signal conduction inside the VSMCs proliferation.

Changes of nNOS mRNA in rabbit brain under different anesthetic depths:using target-controlled infusion of propofol

CHEN Jian-yan, YAO Shang-long, ZHAO Da-zhong, LU Jian-fang

2008, 13(6):  634-638. 

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AIM: To investigate alterations of nNOS mRNA in discrete brain regions of rabbits under propofol anesthesia.METHODS: Thirty rabbits were randomly allocated to three groups with ten each: control group, light anesthetic group, deep anesthetic group. Experimentation groups achieved needing drugged state by using target-controlled infusion of propofol, after one hour the rabbits were executed. Control group ear intravenous injection air caused aeroembolism death.Three groups rabbits were isolated to obtain brains under 0-4 ℃, the levels of nNOS mRNA in cerebellar cortex, parietal cortex were observed under different anesthetic depths.RESULTS: Comparing with control group, the levels of nNOS mRNA both in light anesthetic group and in deep anesthetic group decreased significantly in cerebellar cortex and parietal cortex (P<0.05) of rabbit brain.With the increasing of anesthetic depth, significant decreases in nNOS mRNA levels were observed in cerebellar cortex (P<0.05), but no significant difference was found in parietal cortex(P>0.05).CONCLUSION: Propofol probably exerts its anesthetic action through depressing the activity of nNOS, decreasing the levels of NO and cGMP.The depression differs in different brain regions.

Valsartan decrease expression of endothelin-1 in myocardium of rats with chronic renal failure

XU Hai-hong, YANG Li-cai, YANG Yan-lang, ZHANG Dao-you

2008, 13(6):  639-643. 

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AIM: To observe the therapeutic effect of valsartan on cardiac hypertrophy and expression of endothelin-1(ET-1) in myocardium of rats with chronic renal failure and explore the mechanism.METHODS: 24 Sprague Dawley male rats were selected, and performed five-sixths nephrectomy to produce chronic renal failure model.Two weeks after the surgery, the rats were randomly divided into model group, valsartan group, and a sham group was established serving as control group.Systolic blood pressure, BUN and serum creatinine were measured at ten weeks after operation, then the rats were sacrificed to take the hearts for pathological histological examination.Hybridization in situ was used to examine the transcription of ET-1 mRNA in myocardium.RESULTS: Systolic pressure, heart weight, heart weight index, left ventricular weight mass(LVM) and left ventricular weight mass index (LVMI) in model group increased significantly tenth week after operation.Systolic pressure, heart weight, heart weight index, LVM and LVMI were decreased markedly in rats with five-sixths nephrectomy by valsartan(P<0.01);Hybridization in situ indicated that there was a decreasing expression of ET-1 mRNA in myocardium in valsartan group as compared with model group.CONCLUSION: Valsartan could prevent left ventricular hypertrophy in chronic experiment renal failure rats.The improvement of cardiomyopathy may be through the mechanism of downregulating transcription of ET-1 mRNA in myocardium.

Inhibitory effect of rapamycin on stromal cell-derived factor-1 expression in intimal hyperplasia

LEI Jian-jun, XIA Yi-ping, HU Yan, WANG Zuo, LONG Guang, WEI Dang-heng

2008, 13(6):  644-647. 

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AIM: To investigate the anti-restenosis molecular mechanism of rapamycin.METHODS: The animal models of rat carotid artery intimal hyperplasia was established with Balloon injury.Rats were randomized divided into two groups: baseline group (n=10) and treatment group (n=10 rapamycin, 25 mg/kg). HE staining was used to observe vascular lesions.Immunochistochemistry staining was used to detect the expression of SDF-1 in lesions.The migration of smooth muscle cells induced by stromal cell-derived factor 1 (SDF-1) was observed with transwell.RESULTS: Intimal hyperplasia was obviously induced by balloon injury.SDF-1 highly expressed in lesions and rapamycin significantly reduced the expression of SDF-1 in intimal hyperplasia.SDF-1 induced the migration of smooth muscle cells with concentration-dependent manner.CONCLUSION: Rapamycin may inhibit vascular restenosis by inhibiting the migration of smooth muscle cells induced by SDF-1.

Experimental study on therapeutic effects of quercetin on abacterial prostatitis

CHENG Li-yan, ZHENG Xiao-liang, SHI Hong

2008, 13(6):  648-653. 

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AIM: To study the anti-inflammatory effects of quercetin on the experimental animal models of abacterial prostatitis.METHODS: Five types of experimental animal inflammatory models in vivo were applied to investigate the anti-inflammatory and analgesic effects of quercetin, including xiaozhiling-induced chronic prostatitis, carrageenan-induced acute prostatitis, croton oil-induced auricle swelling, photothermal stimulation-induced pain, cotton ball granuloma test of mice, and the rabbit urethral smooth muscle tensile test in vitro to examine the catabatic effects on dysuria.RESULTS: Quercetin displayed good anti-inflammatory effects on acute and chronic abacterial prostatitis. Quercetin also had good inhibitory effects on croton oilinduced auricle swelling, photothermal stimulation-induced pain and cotton ball granuloma test of mice and had definite relaxing effects on rabbit urethral smooth muscle.CONCLUSION: It indicates that quercetin has good therapeutic effects on abacterial prostatitis and could alleviate dysuria.

Clinical analysis of sentinel lymph node biopsy in 80 breast cancer cases

CHEN Xian-jun, WANG Ya-bing, HONG Shu-jian, WU Jian, XU Guo-qiang, ZHANG Fan

2008, 13(6):  654-656. 

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AIM: To investigate the application and clinical efficiency of sentinel lymph node biopsy (SLNB) in breast cancer.METHODS: The sentinel lymph nodes (SLNs) of 80 patients with breast cancer were detected by SLNB with intraoperative frozen section and methylene blue staining.The results were compared with serial section and immunohistochemical staining of SLN after operation.RESULTS: 69 of 80 patients were successfully detected by SLNB, with achievement ratio of 86.3%.24 patients were found positive of carcinomatous metastasis by intraoperative frozen section and methylene blue staining, while 45 negative patients were examined by serial section and immunohistochemical staining after operation and found 5 cases with micrometastasis.CONCLUSION: SLNB with methylene blue staining was safe, cheap and had high achievement ratio.The status of SLNs had important prefigurative value about axillary lymph nodes in breast cancer.The application of serial section associated with immunohistochemical staining of SLN could increase the detective rate of metastasis, and reduce the false negative rate.

Role of Rho-kinase signal pathway on myocardium hypertrophy of 2K1C renal hypertension rats and effects of Fasudil

WANG Xiang-hai, WU Wei, YANG Yu-wen, XIA Chao-hong

2008, 13(6):  657-662. 

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AIM: To investigate the role of Rhokinase mediated signal pathway on myocardium hypertrophy of two-kidneys-one-clip (2K1C) renal hypertension rats and effects of fasudil.METHODS: 2K1C renal hypertensive model was established in Sprague-Dawley rats by chronic partial occlusion of left renal artery.The rats were randomly divided into 3 groups: Sham Group, Model Group, Experimental Group(Fasudil 10mg·kg^-1·d^-1, intraperitoneal injection).Left ventricular mass and left ventricular mass to body mass ratio were measured with electronic balance.Myocardial histomorphology was observed by light microscope. The extent of phosphorylation of myosin-binding submet (MBS-P) of myosin phosphatase was quantified by western blotting analysis, and it was used to evaluate the activity of Rho-kinase.The expression of Rho-kinase mRNA was examined by RT-PCR analysis.RESULTS: At 12th week after renovascular constriction, there was noticeable myocardial hypertrophy in Model Group(P<0.01).The Rho-kinase activity and Rho-kinase mRNA expression were significantly increased in Model Group(P<0.01).There was a positive correlation between Rho-kinase activity and myocardial hypertrophy (P<0.05), and there was a positive correlation between Rho-kinase mRNA expression and myocardial hypertrophy in Model Group(P<0.05).Fasudil-a Rho-kinase specific inhibitor, effectively inhibited myocardial hypertrophy and prevented changes of Rho-kinase activity and mRNA expression in renal hypertension rats (P<0.01).CONCLUSION: The Rho-kinase mediated signal pathway may play an important role in the development of myocardial hypertrophy in 2K1C renal hypertension rats.

Crocetin reduces expression of receptor for advanced glycation end products (RAGE) on endothelial cells induced by AGE

XIANG Min, QIAN Zhi-yu, ZHOU Cheng-hua

2008, 13(6):  663-670. 

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AIM: To investigate the effects of crocetin on receptor for advanced glycation end products (RAGE) mRNA expression in bovine endothelial cells (BEC) induced by advanced glycation end products (AGE) and the possible mechanisms involved.METHODS: The BEC were preincubated with crocetin(1, 0.1 and 0.01 μmol/L) for 12 h, then exposed to AGE (100 mg/L).The RAGE mRNA expression was detected by RT-PCR analysis, the intercellular adhesion molecule-1 (ICAM-1) was measured by ELISA. The extracellular superoxide ion and thiobarbituric acid reactive substances (TBARS) were assessed with superoxide ion kit and colorimetric assay, respectively. The intracellular H₂O₂ was also detected using the probe 2, 7-dichlorofluorescein (DCFH).The mitochondrial membrane potential(MMP) and mitochodrial Succinate dehydrogenase(MSDH) were analyzed by the retention of rhodamine123 (Rh123) and MTT.RESULTS: Compared with AGE Group, crocetin was able to significantly reduce RAGE mRNA expression (P<0.05), decrease the content of super anion and TBARS in supernatant media (P<0.01 or P<0.05) and H₂O₂ in cells (P<0.05).Spontaneously, the MMP and the activity of MSDH were improved.Furthermore, the expression of ICAM-1 protein was suppressed by crocetin in a time-and dose-dependant manner.CONCLUSION: These results demonstrated that crocetin could inhibit RAGE over-expression in AGEexposed BEC by suppressing the generation of reactive oxygen species active oxygen(ROS).This study suggested that crocetin might have beneficial effects in the treatment of diabetic vascular complications.

Application of dose-effect relationship in pharmacoeconomics

ZOU Ya-min, YUAN Bing-xiang, DONG Ya-lin

2008, 13(6):  671-674. 

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AIM: To search new method and idea in pharmacoeconomics and economic regularity in pharmacotherapeutics, and offer theoretical support to rational consumption of drug products.METHODS: The study methods on quantitative pharmacology and pharmacoeconomics were combined together, the dose-effect relationship between the cost and effectiveness was deduced, and the cost-effectiveness curve, cost-toxicity curve and cost-utility curve were drawn.The consumption range on social medication was defined into 5 sections: Ineffective Medication, Ad-utility Medication, Effective Medication, De-utility Medication and Adverse medication.RESULTS: Along with the increasing of drug cost, the effective power was maximized gradually and then was no longer changed, the incidence rate of adverse effect increased by degrees, so the utility value ascended and descended according to the change of purchased drug cost.CONCLUSION: There is quantitative relationship between the drug efficacy and the treatment cost.In order to spare the medical treatment cost and promote the rational administration, Ad-utility Medication and Effective Medication should be advocated;The high-performance drug species with major cost-effectiveness ratio should be chosen;the utilization of essential drugs should be strengthened.

Group-biased proof study-logistic regression analysis on Meta analytic data of amlodipine

ZHANG Dai-rong, HUA Lin, FU Ying

2008, 13(6):  675-678. 

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AIM: To investigate the influence of dosage, therapeutic course, case, group (trial group and contrast group) and publication year on the effectiveness of randomized contrast trials.METHODS: Meta analysis literatures were retrieved from the fulltest data base of CNKI journals in the “Digital Library of Chinese Hospital”.Multiple elements analysis were carried out by binomial logistic regression.RESULTS: One standard-matched literature was got, including 26 clinical contrast trials for the treatment of hypertension by amlodipine, in which 23 cases were randomly divided and 9 cases were treated with amlodipine as the contrast.The course of treatment and groups were both factors for the effectiveness;The therapeutic advantage of trial groups was 2.445-3.690 times as that of contrast.CONCLUSION: In the random contrast test, the tested groups were possibly exaggerated, while the contrast groups depreciated.In the study on Meta analysis and evidence-based medicine, the attention should be paid for the group-bias influence.

Pharmacokinetics profile of famciclovir sustained release capsules in healthy volunteers

HU Hai-tang, TAN Zhi-guang, WANG Xiao-dan, ZHENG Jia-run, XU Lan-fang, CHUI Pangen, CHEN Zhen-qing, CHEN Yun

2008, 13(6):  679-683. 

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AIM: To investigate the pharmacokinetic profile and relative bioavailability of Famciclovir sustained release capsules in healthy volunteers.METHODS: 12 healthy volunteers were divided into four group with single oral dose test famciclovir sustained release capsules(250, 375, 750mg) and conventional Facmciclovir tablets (750 mg) according to an open randomized four way crossover design.A multidose test were given to 10 healthy volunteers according to an open randomized two way crossover design.The concentration of penciclovir in plasma after administration were determinded by HPLC.Pharmacokinetic parameters were calculated with 3P97 program.RESULTS: Concentration-time curves of penciclovir fitted to one-compartment mode, C_max were (0.31±0.06), (0.51±0.09), (1.0±0.16) μg/mL, t_max (4.4± 1.8), (4.0±1.4), (4.3±1.8) h, MRT (6.9± 1.3), (7.3±1.0), (7.6±0.7) h, AUC_0-24 (3.3± 0.8), (5.2±1.1), (11.3±1.4) μg·mL^-1·h respectively for famciclovir sustained release capsules;C_max were (3.81±0.38) μg/mL, t_max (1.2±0.6) h, MRT (3.3±0.4) h, AUC_0-24 (13.7±1.5) μg·mL^-1·h for conventional tablet.The relative bioavailability was 81.96%±2.54%.The parameters after multi-doses of the sustain released capsules and conventional tablets were as follows: C_min (0.32±0.13) and (0.16± 0.04) μg/mL, C_max (0.71±0.14) and 1.67±0.44 μg/mL, C_av (0.44± 0.09) and (0.56± 0.13) μg/mL, DF 90%±26% and 270%±59%, respectively.CONCLUSION: The sustain released capsules have the obvious sustained release characteristic.The two formulation of Famciclovir are of bioequivalence.

Response-adaptive randomization in clinical trials

LIU Xiao-yan, CHEN Feng, WEI Yong-yue, BAI Jian-ling, YU Hao

2008, 13(6):  684-689. 

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AIM: To introduce the response-adaptive randomization, which is one of the randomization strategies in clinical trials.METHODS: The ideas and theories of the play-the-winner rule and randomized-play-the-winner rule, which are two procedures of response-adaptive randomization, are introduced.A simulation study is employed to compare response-adaptive randomization with traditional equal-probability allocation.The advantages and disadvantages of the randomization rules and the issues concerned in implementation of response-adaptive randomization are discussed.RESULTS: The results show that the response-adaptive randomization reduce the number of failures with little decrease in test power than in the case of traditional equal-probability allocation.CONCLUSION: The play-the-winner rule and randomizedplay-the-winner rule deserve the attention of clinicians and statisticians and are suggested in clinical trials after a certain degree of improvement since it is better balanced of the issues between ethics and statistics.

Retrospective analysis of the 258 adxerse drug reaction cases in our hospital

ZHOU She-dian, LIANG Ping, ZHOU Gan-ping, CHEN Yu-qiang, LI Song

2008, 13(6):  690-693. 

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AIM: To strengthen the monitoring of adverse drug reaction (ADR), and promote rational drug use and decrease the incidence rate of ADR.METHODS: 258 ADR case reports were collected and analyzed in our hospital in recent 5 years.RESULTS: The number of the reports about ADR was less, especially the number of ADR reported by nursing staff, which only accounting for 8.92% among total cases. In 258 cases of ADR reports, the higher incidence rate of ADR occured in the age of 21 to 80, which accounting for 8.98%-22.09%.In the different routes of administration, intravenous drip had the highest incidence rate, which was about 67.05%.Skin and accessory organs diseases were involved in ADR, and the incidence rate of ADR was highest, accounting for 41.08%.In various kinds of drugs in ADR, the antibacterials raising the incidence rate of ADR was highest, accounting for 42.64%.CONCLUSION: Unreasonable drug application will increase ADR incidence.

Sevoflurane-nitrous oxide-sufentanil anesthesia for thyroid surgery

LUAN Xiu-shu, TANG Pei, HUANG Yu-guang, LUO Ai-lun

2008, 13(6):  694-698. 

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AIM: To evaluate the effects of continuous infusion sufentanil during a nitrous oxide-sevoflurane balanced anesthesia in patients undergoing thyroid surgery, and to seek a suitable way to ensure hemodynamic stability and fast recovery for a moderately painful operation.METHODS: 45 patients, ASA physical status I or II with age ranging from 18 to 60 years, scheduled for thyroid surgery with general anesthesia were divided into three groups randomly.Patients were induced with a loading dose of sufentanil 0.15, 0.30, and 0.45 μg/kg, respectively, and continuously infused with sufentanil (0.15, 0.30, 0.45 μg·kg^-1·h^-1) throughout surgery.The sevoflurane concentration was adjusted according to conventional clinical variables, and to keep MAC 1.0-1.3.The sevoflurane vaporizer was weighed before and after anesthesia, and consumption was calculated.MAP and heart rate were recorded at different times (before and after intubation, any intervention, and the time of recovery).Recovery time, postoperative analgesia by VAS, and intraopereative awareness were evaluated.RESULTS: Adequate anesthesia was obtained in all groups.Hypertension was more frequent with the small dose sufentanil, and hypotension requiring treatment was more frequent with the large dose sufentanil. Sevoflurane concentration during surgery decreased significantly with increasing sufentanil as well as the sevoflurane consumption.The 0.45 μg·kg^-1 ·h^-1 sufentanil significantly delayed the return of spontaneous breathing.CONCLUSION: Continuous infusing sufentanil 0.30 μg·kg^-1·h^-1 is optimal to ensure hemodynamic stability, and fast recovery, combined with sevoflurane is suitable for thyroid surgery.

Clinical randomized controlled trial on torasemide injection in treating patients with congestive heart failure and edema

ZHENG Wen-yan, CAO Yu-ping

2008, 13(6):  699-703. 

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AIM: To evaluate the efficacy and safety of torasemide injection in the treatment of congestive heart failure with edema.METHODS: A total of 208 patients were enrolled in this clinical randomized controlled trial, but 7 cases were not included in the statistics.Patients in Trial Group were treated with torasemide injection, those in Control Group were treated with furosemide injection.RESULTS: The effective rates of torasemide injection and furosemide injection were 99.0% and 96.1% respectively.There were no significant diference (P>0.05) between the two groups.The 24 h volume of urine was significantly increased in both groups.The incidence rates of adverse drug reactions(ADR)of torasemide injection and furosemide injection were 3.88% and 2.88% respectively.CONCLUSION: Torasemide injection is an effective and safe drug for the treatment of congestive heart failure with edema.

Clinical observation of children bronchiolitis therapy with combination of interferon and pulmicort respules

HU Qun-sheng

2008, 13(6):  704-706. 

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AIM: To investigate the clinical effects of combination with pulmicort respules(budsonide nebulising suspension) and interferon on children with bronchiolitis.METHODS: 48 children with bronchiolitis were divided into two groups randomly: control group(B) were treated with synthetic therapy and group A assist-treated with pulmicort respules inhalation and interferon based on the same synthetic therapy.RESULTS: The clinical effect and pulmonary function were evaluated, and group A gained advantages in all indexes including anhelation relieving, rales extinction time, hospital day, and total effective rates, and those were statistical difference.CONCLUSION: Combination with pulmicort respules(budsonide nebulising suspension) and interferon have better therapeutic effect on children with bronchiolitis than classic synthetic therapy.

Efficacy of propranolol combined with omeprazole in prevention of the patients with rebleeding caused by rupture of esophageal and gastric varices

LAI Ren-xu, GUO Hu-xue, MAI Lei

2008, 13(6):  707-710. 

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AIM: To study the efficacy of propranolol combined with omeprazole with maintenance therapy in prevention of the patients with rebleeding caused by rupture of esophageal and gastric varices.METHODS: 85 cases patients with hepatocirrhosis portal hypertension were divided into two groups randomly: group Ⅰ (propranolol, n=42) and group Ⅱ (propranolol plus omeprazole, n=43).The duration of maintenance therapy was six months, and followed up one year.The aggravation of esophageal and gastric varices, recurrence rates of hemorrhage and the lesions of gastric mucosa were examined and evaluated by gastroendoscopy before and after the period of treatment.RESULTS: After one year's observation, the aggravation of esophageal and gastric varices among two groups had not significant difference (P>0.05);the annual recurrence rates of hemorrhage of group Ⅰ and group Ⅱ were 35.0% and 15.0% respectively, the recurrence rates of hemorrhage in group Ⅱ was significantly lower than that of group Ⅰ (P<0.05), The total effective rates in improving gastric mucosa was 92.5% in group Ⅱ, while 60.0% in group Ⅰ,which was significantly lower than that of group Ⅱ(P<0.01).CONCLUSION: The effect of propranolol plus omeprazole in prevention of the patients with rebleeding caused by rupture of esophageal and gastric varices is effective.

Phosphodiesterase 3: new targets for drug development

YE Yi-lu, ZHANG Qi, YU Yue-ping

2008, 13(6):  711-715. 

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Phosphodiesterase (PDE) is hydrolase of 3', 5'-cyclic adenosine monophosphate (cAMP) and 3', 5'-cyclic guanosine monophosphate (cGMP). PDE3 are composed of two genes and distributed widely in vivo.Its inhibitors have been applied in antiplatelet aggregation and vasodilation.It has been reported that PDE3 inhibitors have neuroprotective effects on cerebral ischemia, which may provide new methods to prevention and therapy of cerebral ischemia.

Keap1-Nrf2-ARE signaling pathway in the chemoprevention of cancer

LIU Xiao-ping

2008, 13(6):  716-720. 

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Chemoprevention of cancers is still very important since we have not got effective treatments for them.Many natural products (e.g.extracts from plants) or chemical synthetic substances (e.g.additives in foods) were used as chemoprevention regents.Some of them fight the carcinogens or other toxins through induction of the phase 2 antioxidant enzymes.Recently, it is wildly believed that the mechanism of this induction is the activation of Keap1-Nrf2-ARE signaling pathway.Thus understanding of this signaling pathway will widen the field of the cancer research and chemoprevention.