Application evaluation of cardiopulmonary exercise test to guide comprehensive pulmonary rehabilitation in patients with pneumoconiosis / 环境与职业医学

Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO2/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO2), maximum metabolic equivalent (METs), and maximum work (Wmax). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO2/kg, AT, EqCO2, METs, or Wmax between the two groups (P>0.05). At the end of the trail, the indicators like pVO2/kg [(19.81±2.38) mL·(min·kg)−1], AT [(14.48±2.33) mL·(min·kg)−1], METs (5.64±0.69), and Wmax [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)−1, (11.70±1.94) mL·(min kg)−1, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO2 between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.

Influencing factors for dynamic changes in the severity of fatty liver in patients with acute pancreatitis and fatty liver / 临床肝胆病杂志

Objective To investigate the dynamic change of fatty liver (FL) in patients with fatty liver-related acute pancreatitis (FLAP) and related influencing factors. Methods A total of 136 FLAP patients who were admitted to The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, from December 2017 to December 2021 were enrolled as subjects. With the first CT examination after admission as the starting point and the last CT examination before discharge as the ending point, the subjects were divided into FL aggravation group (FLAG group), FL mild mitigation group (FLMMG group), and FL significant mitigation group (FLSMG group) according to the degree of change in FL. General information and clinical data were compared between groups. General information included age, sex, length of hospital stay, etiology of acute pancreatitis (AP), and changes in body weight and temperature, and clinical data included treatment modality and the changes in laboratory markers and AP severity. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test with Bonferroni correction was used for further comparison between two groups. Dynamic changes of data were expressed as the difference from the starting point to the ending point, and a covariance analysis was used for comparison of data with dynamic changes. The Spearman correlation analysis was used to investigate the correlation of indices with significant changes with the degree of change in FL. Results Among the 136 FLAP patients, 61 achieved mild mitigation of FL, 59 achieved significant mitigation of FL, and 16 experienced aggravation of FL at the ending point of the study. There were significant differences between the three groups in the length of hospital stay ( χ 2 =16.215, P < 0.001) and the change in body weight ( F =3.908, P < 0.05), and the FLSMG group had a greater reduction in body weight and a longer length of hospital stay. There were also significant differences between the three groups in the number of fasting days ( χ 2 =11.020, P =0.004) and the degree of changes in C-reactive protein (CRP) ( F =8.589, P < 0.001), white blood cell count (WBC) ( F =5.448, P =0.005), and CT severity index (CTSI) ( F =7.544, P =0.001), and the FLSMG group had greater reductions in CRP, WBC, and CTSI and a longer duration of fasting. Length of hospital stay, number of fasting days, and changes in CRP and CTSI were significantly correlated with the change in FL ( r =0.352, 0.372, -0.365, and -0.350, all P < 0.001). Conclusion Most FLAP patients tend to have mitigation of FL, and its dynamic changes are closely associated with the changes in CRP and CTSI.

Role of LIF/LIFR/STAT3 pathway in endometrial receptivity in rats with polycystic ovary syndrome / 西安交通大学学报(医学版)

【Objective】 To investigate the role of LIF/LIFR/STAT3 pathway in endometrial receptivity in rats with polycystic ovary syndrome (PCOS). 【Methods】 Forty 21-day-old SD female rats were divided into normal (control) group, model group, sham-operation group, and LIF group with 10 rats in each. The rat model of PCOS was constructed by subcutaneous injection of prasterone sodium sulfate at the back of the neck. The serum levels of testosterone (T), glucose and insulin in each group were detected. The morphological changes of the uterus in each group were observed by HE staining, and the morphological changes of endometrium were measured. Immunohistochemistry, Western blotting, and Real-time fluorescence quantitative PCR(qRT-PCR) were used to determine the protein expression and mRNA expression of LIF and STAT3 in rat endometrium. 【Results】 Compared with control group, the levels of integrin avb3, serum T, insulin and glucose in PCOS rats were significantly increased (P=0.000, P=0.000, P=0.001). Supplementation of exogenous LIF could significantly reduce the levels of integrin avb3, serum T, glucose and insulin in PCOS rats (P=0.000, P=0.002, P=0.003, P=0.007). HE results showed that exogenous LIF could reduce uterine cavity and glandular morphology in PCOS rats and increase the equivalent diameter (P=0.000, P=0.000) and area (P=0.000, P=0.000) of uterine glands and glandular cavity, the ratio of glandular interstitial area (P=0.000), and the average endometrial thickness (P=0.006), with statistically significant differences. Immunohistochemistry, Western blotting, and qRT-PCR results showed that the expression levels of LIF and p-STAT3 protein and mRNA in model group were significantly decreased compared with control group. Compared with model group, the protein and mRNA expressions of LIF and p-STAT3 in LIF group were significantly increased (P<0.05). 【Conclusion】 Exogenous LIF supplementation can improve endometrial receptivity in PCOS rats, and its mechanism is related to the LIF/LIFR/STAT3 pathway.

Impact of obese levels on the hepatic expression of nuclear receptors and drug-metabolizing enzymes in adult and offspring mice

The prevalence of obesity-associated conditions raises new challenges in clinical medication. Although altered expression of drug-metabolizing enzymes (DMEs) has been shown in obesity, the impacts of obese levels (overweight, obesity, and severe obesity) on the expression of DMEs have not been elucidated. Especially, limited information is available on whether parental obese levels affect ontogenic expression of DMEs in children. Here, a high-fat diet (HFD) and three feeding durations were used to mimic different obese levels in C57BL/6 mice. The hepatic expression of five nuclear receptors (NRs) and nine DMEs was examined. In general, a trend of induced expression of NRs and DMEs (except for and ) was observed in HFD groups compared to low-fat diet (LFD) groups. Differential effects of HFD on the hepatic expression of DMEs were found in adult mice at different obese levels. Family-based dietary style of an HFD altered the ontogenic expression of DMEs in the offspring older than 15 days. Furthermore, obese levels of parental mice affected the hepatic expression of DMEs in offspring. Overall, the results indicate that obese levels affected expression of the DMEs in adult individuals and that of their children. Drug dosage might need to be optimized based on the obese levels.

Study on the relationship between wholeGorgan MRI score (WORMS)and pain in patients with knee osteoarthritis / 实用放射学杂志

Objective To investigate the correlation between wholeGorgan MRI score (WORMS)and pain in patients with knee osteoarthritis (OA).Methods 1 1 9 patients with knee OA were enrolled,and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)was used to estimate the pain.Knees of all the subj ects underwent scanning with sagittal,coronal,transverse TSEG T2 WIGFS and sagittal 3DGFLASHGWE sequences at 3.0T MR.The pathological changes of knee cartilage lesions,subarticular bone marrow edema (BME),bone cysts,bone attrition,osteophytes,meniscal inj ury,ligament inj ury,synovial thickening and joint effusion were evaluated according to the WORMS.The correlations between the above pathological changes and the pain were analyzed.Results There were significant and positive correlations between articular cartilage lesions and osteophytes,articular cartilage lesions and BME,BME and cyst,bone attrition and osteophytes,and BME and osteophytes,with the correlation coefficients of 0.6 70,0.5 9 8,0.5 1 8,0.5 1 4 and 0.505 ,respectively (P＜0.05 ).Multiple regression analysis showed that BME,bone attrition,synovial thickening and joint effusion were the main factors affecting the severity of pain after adj usted for age and BMI (P＜0.05).Conclusion The source of OA pain is multifactorial.The severity of BME,bone attrition,synovial thickening and joint effusion are the main factors associated with joint pain.As a nonGinvasive examination method,MR can make a comprehensive evaluation of the pathological changes of knee OA.

Molecular epidemiologic study on norovirus gastroenteritis outbreaks in Zhuhai from 2011 to 2016 / 中华实验和临床病毒学杂志

Objective@#To describe the molecular epidemiological characteristics of norovirus gastroenteritis outbreaks in Zhuhai from 2011 to 2016.@*Methods@#Anal swab specimens were collected from 576 cases with 56 outbreaks of acute norovirus gastroenteritis from 2011 to 2016. Specimens were tested by real-time RT-PCR. Three to four of norovirus positive specimens were selected from every outbreak to amplify the VP1 gene by RT-PCR and one strain was chosen randomly from every outbreaks to determine the genotype by phylogenetic tree analysis.@*Results@#Eight genotypes were identified from 56 outbreaks and all of them belonged to GⅡ genogroup. The genotype of norovirus strain changed with prevalence time. The GⅡ.4/2006b was dominant from 2011 to 2012, and replaced by GⅡ.4/Sydney _2012 during the 2012—2013 norovirus season, and both of them never appeared after Feb. 2013. GⅡ.17 was the only genotype during the 2014—2015 norovirus season. All the 7 outbreaks occurred from 2015 to 2016 were caused by GⅡ.3 norovirus. The GⅡ.17and GⅡ.3 were identified from Apr. to Sep. 2016; GⅡ.p16-GⅡ.2 were the only genotype in 12 outbreaks from Nov. to Dec. 2016. The GⅠ genogrope was never identified from 2011 to 2016 in Zhuhai.@*Conclusions@#The Norovirus GⅡ was the only pathogeny which caused the outbreaks of norovirus gastroenteritis. The recombinant norovirus strain GⅡ.p16-GⅡ.2 emerged and caused large outbreaks in the last two months of 2016 in Zhuhai; several recombinant strains of the GⅡ.p16 RdRp gene were found now, which suggests that attention should be focused on the prevalence and evolution of the recombinant norovirus.

Effect of different pharmaceutical care on medication compliance of elderly patients under the mode of medical care / 中国基层医药

Objective To analyze the effect of different pharmaceutical care on medication compliance of elderly patients under the mode of medical care .Methods 640 elderly patients in the nursing center for self -care were selected as the research subjects .The elderly patients were divided into study group and control group according to the pharmaceutical care model,320 cases in each group.The control group was given traditional pharmaceutical service mode,the study group was given comprehensive drug counseling ,medication guidance and drug related phar-macy services .The medication compliance and satisfaction of the two groups were observed .Results The compliance rate and total compliance rate of the study group were 96.25％,99.37％,respectively,which were significantly higher than 81.87％,94.37％of the control group (χ2 =33.94,13.21,all P<0.05).The satisfaction of the study group was significantly higher than that of the control group (χ2 =8.23,P<0.05).In the two groups,there were no statisti-cally significant differences between medication compliance and record of formal schooling ,age(χ2 =1.16,0.77,all P>0.05).Conclusion Under the mode of medical care ,high quality pharmaceutical care can effectively improve the medication compliance of elderly patients .

Intervention effect of remifentanil regulated human umbilical vein endothelial cell oxidative stress injury induced by hydrogen peroxide / 临床麻醉学杂志

Objective To establish oxidative stress model of hydrogen peroxide treatment by using human umbilical vein endothelial cells (ECS) as cell model to study the protective mechanism of anti oxidative stress and determine the signal transduction pathway of remifentanil.Methods Primary cultured human umbilical vein endothelial cells which were incubated with 0.1 M hydrogen peroxide to establish injury model to study remifentanil protection and related pathways.The experiment was divided into nine groups: control group (group C), Hydrogen peroxide group (group H1), Hydrogen peroxide+SP600125 group (group H2), Hydrogen peroxide+SB203580 group (group H3), Hydrogen peroxide+PD98059 group (group H4), hydrogen peroxide+remifentanil group (group HR1), hydrogen peroxide+remifentanil+SP600125 group (group HR2), hydrogen peroxide+remifentanil+SB203580 group (group HR3), hydrogen peroxide+remifentanil+PD98059 group (group HR4).Groups H1, H2, H3 and H4 only performed MAPK pathway blockade experiments.Groups HR1, HR2, HR3 and HR4 individually added remifentanil 10 ng/ml to protect 1 h.SOD activity, MDA level, Caspase-3 activity were detected and anti oxidative stress of remifentanil observed to confirm preliminary transduction pathway;Using RT-PCR expression levels of c-Jun before was observed before and after treated with remifentail 10 ng/ml.The aim was to determine the transduction pathway of the signaling molecules.Results Compared with group C, SOD activity were decreased significantly, MDA performance level were increased significantly in groups H1, H2, H3 and H4 (P<0.05).Compared with group H1, SOD activity was increased significantly, MDA performance level was decreased significantly in group HR1 (P<0.05).SOD activity difference and MDA performance level of groups HR2 and H2 had no statistical significance.Compared with group H3, SOD activity was increased significantly, MDA performance level was decreased siginificantly in group HR3 (P<0.05).Compared with group H4, SOD activity was increased significantly, MDA performance level was decreased significantly in group HR4 (P<0.05).Caspase-3 activity of groups H1, H2, H3 and H4 were higher significantly than that of group C (P<0.05).The level of C-Jun mRNA in group H1 was significantly higher than that of group C;But it was higher in group HR1 than that of group C, it was significantly lower than that of group H1 (P<0.05).Conclusion By activating the JNK pathway and its downstream signaling molecule c-Jun, remifentanil 10 ng/ml has the effect of increasing SOD activity, reducing the level of MDA expression and playing a role in anti oxidative stress.

Ontogeny of drug metabolism enzymes and epigentic regulation / 中国药理学通报

Great changes in drug metabolizing enzyme (DME) expression occur in the fetus and child during development. Individual hepatic DME ontogeny can be categorized into one of three groups based on developmental trajectories.Some enzymes such as CYP3A7,are expressed at highest level in the fetus dur-ing the first trimester and either remain elevated or slightly de-crease during gestation,but are silenced or reduced to relatively low levels within one to two years after birth.SULT1 A1 is an ex-ample of the second group of DME.These enzymes are ex-pressed at relatively constant levels throughout gestation and into adulthood.CYP3A4 belongs to the third DME group .These en-zymes are expressed at negligible or low levels in the fetus.Sig-nificant increases in enzyme levels are exhibited within the first one to two years after birth.The epigenetic regulation refers to genomic modifications that do not involve changes in DNA se-quence and include DNA methylation,histone modifications, and non-coding RNAs.The epigenetic regulation mechanisms are responsible for the developmental expression of DME genes dur-ing liver maturation.This review will provide a summary of DME developmental expression profiles and reveal epigenetic mecha-nisms underlying variable drug metabolism and drug response. Thus,knowledge regarding DME ontogeny has permitted im-proved capability to predict drug disposition in pediatric pa-tients,which is crucial for improving drug dosing leading to opti-mal safety and efficacy in children.

Analysis of 1 817 cases of papilloma virus infection in women / 国际检验医学杂志

Objective To investigate the infection status and genotype distribution of human papillomavirus (HPV) infection in Changzhou district ,and to provide a theoretical basis for the prevention ,development and clinical diagnosis and treatment of HPV . Methods From October 2015 to July 2016 ,1 718 cases of female cervical epithelial cells were collected ,and 28 kinds of gene typing were detected by PCR‐reverse dot blot hybridization .Results The infection rate:1 718 cases of women were collected ,the positive HPV infections were 34 .23% .The infection types :single infection rate was 23 .57% (405/1 718) .The high‐risk HPV subtype in‐fections accounted for 17 .17% (295/1 718) and the low‐risk HPV subtype infections accounted for 5 .18% (89/1 718) ,suspected high‐risk infection was 1 .22% (21/1 718) .Multiple infection rate was 10 .94% (188/1 718) .HPV52 was the most common infec‐tion among high‐risk HPV infection ,the positive rate was 16 .16% (95/588) .HPV61 was the most common infection among low‐risk HPV infection ,the positive rate was 4 .08% (24/588) .There was no significant difference between age and HPV positive rate . The 61-70 age group had the highest HPV multiple infection rate in all age groups .Conclusion The high HPV infection is ob‐served in Changzhou district ,among which single HPV52 infection and the high‐risk HPV infection are the most common infec‐tions .There is difference in HPV infection among different age groups .

Drug-induced liver injury:metabolic and genetic basis / 中国药理学通报

Drug-induced liver injury ( DILI) is a significant rea-son of acute liver failure and is the main cause of therapeutic drugs withdrawal from the market .Multiple mechanisms can cul-minate in DILI , but metabolism and genetics play distinct roles in this process .This review will cover papers we consider have addressed these mechanisms of DILI in commonly used medica-tions for adults , and discuss the hot issues .The aim is to gener-ate discussion about the potential clinical significance among these researchs and point out the key areas for further study of DILI.

Analysis of allergens characteristic in 1172 patients with allergic rhinitis in Changzhou area / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To determine the distribution of allergens in patients with allergic rhinitis during from 2008 to 2015 in Changzhou area.@*METHOD@#Allergy Screen method was used to detect the specifical-allergen IgE levels of 1172 patients with allergic rhinitis. Among the patients, the distribution of all allergens was analyzed. The positive rate was compared with age, gender, season and so on.@*RESULT@#The most common allergens in allergic rhinitis patients in Changzhou were dust mite, fungus, house dust, milk, dander of dog, weed mixture, farina and dander of cat. The more higher positive rates of dust mite, fungus, house dust, milk, dander of dog, dander of cat, eggs were found in teenager group than adult group (P < 0.05). There were more higer positive rates of weed mixture, farina, cashew, cockroaches and crab in teenager group than adult group (P < 0.05). There was no significant difference of positive rate between female group and male group. There was significant difference of variation with seasons.@*CONCLUSION@#Dust mite, fungus and house dust were the most common allergens among patiens with allergic rhinitis in Changzhou area. The positive rates of allergens varied with ages and seasons.

Post-transcription regulation of drug metabolic enzymes by miRNAs / 中国药理学通报

microRNAs ( miRNAs) are a family of short non-cod-ing RNAs that regulate the expression of target genes by binding to complementary regions. The miRNAs expression is readily al-tered by drugs, carcinogens, hormones, stress or diseases, and that might lead to changes in the drug metabolism, pharmacoki-netics or potency. Moreover, the evaluation of drug metabolic enzyme-related miRNAs would provide useful information for per-sonalized medicine. This review describes the current knowledge on the post-transcription regulation of drug metabolic enzymes by miRNAs.

Predictive effects of learning burnout on positive and negative mental health in college students / 中国心理卫生杂志

Objective:To explore the predictive role of learning burnout on positive and negative mental in college students.Methods:By convenience sampling method,786 college students were selected.They were as-sessed with the Learning Burnout Scale of Undergraduates (LBUS;including three factors:dejection,improper be-havior and reduced personal accomplishment)to investigate the learning burnout,the Mental Health Continuum Short Form (adult version)(MHC-SF;reflecting positive mental health states:languishing,moderately mentally healthy and flourishing)to investigate positive mental health,and the General Health Questionnaire-28 (GHQ-28;dividing negative mental health levels:pathological one or not)to investigate negative mental health.Results:The total scores and three factors scores of LBUS were negatively correlated with MHC-SF scores (r = -0.48 --0.14,Ps <0.01).The total scores and sub-scores of dejection and improper behavior were positively correlated with GHQ-28 scores (r =0.14 -0.41,Ps <0.01 ).The results of discriminate analysis showed that the learning burnout could predict the positive mental health,the correct prediction rates of three mental health symptoms,lan- guishing,moderately mentally healthy and flourishing were 63.2%,51.2%,and 64.1%,respectively.The total forecast was at a rate of 56.4%,and three factors of learning burnout had the contribution to predict positive psy-chological health.Logistic regression analysis showed that learning burnout of undergraduates could positively pre-dict negative psychological health,the pathological and non-pathological rate of correct prediction were 67.5% and 55.9%,and the total correct prediction rate was 62.0%.Depression could positively predict negative mental health (OR =1.11).Conclusion:Learning burnout could effectively predict both positive and negative mental health in college students.

Establishment of in vitro metabolism of fentanyl by human liver microsomes in Chinese population / 中华麻醉学杂志

Objective To establish in vitro metabolism of fentanyl by human liver microsomes in Chinese population.Methods Thirty patients undergoing elective operation on liver were enrolled in the study.Normal liver specimens were obtained during removal of liver and gall for preparation of liver microsomes (by calcium precipitation) which were used for establishment of the liver microsomal incubation system for fentanyl.Fentanyl served as the metabolic substrate in the incubation reaction.The concentration of fentanyl in the incubation medium was detected at 0,5,10,15,20 and 30 min of incubation using HPLC-UV.Sufentanil served as the interior label element.The n-hexane-ethanol absolute was used to extract the sample.The chromatographic column used in this method was Grace C18 (4.6 mm × 250.0 mm,5 μm).The mobile phase was methyl cyanide-KH2PO4 buffer solution with the flow rate of 1.0 ml/min,detection wavelength of 205 nm and sample size of 20 μl.Linear regression analysis was performed by using the least-squares method.The specimens of the blank incubation system with the final concentration of fentanyl 0.6,2.4 and 10.0 μg/ml were obtained to determine the recovery,precision and stability.The metabolic rate of fentanyl in human hepatic microsomes was calculated.Results Fentanyl and the interior label element sufentanil were separated completely,and the retention time were 5.730 and 9.336 min,respectively.Endogenous matrix of microsomes did not interfere with the analysis.Regression equation was C =0.945 8A-0.140 4,R2 =0.999 2.C was the concentration of fentanyl,and A was the peak area ratio of fentanyl versus sufentanil.The recovery of incubation system with low,medium and high concentrations of fentanyl was 85％-115％,and relative standard deviation (RSD) was less than 10％.The RSD of intra-and inter-day precision and stability was less than 10％.The method was proved to meet the requirements of biological sample analysis.The metabolic rate of fentanyl was (1.6 + 0.8) nmol/min per milligram protein in human hepatic microsomes of 30 cases.Conclusion The in vitro metabolism of fentanyl by human liver microsomes is convenient,and the detectability is high,so it can be used for the research on the in vitro metabolism of fentanyl in Chinese population.

Effect of high-fat meal and ABCB1 C3435 T polymorphism on pharmacokinetics of nifedipine in healthy Chinese subjects / 中国药理学通报

Aim To determine the effects of high-fat meal and ABCB1 C3435 T polymorphism on the phar-macokinetics of nifedipine in the healthy Chinese sub-jects. Methods A total of 90 unrelated healthy Han subjects were divided into two groups:fasting group ( n=45 ) and high-fat meal group ( n=45 ) and then they received a single oral dose of 90 mg extended release tablet. Multiple blood samples were collected after 48 h, and the plasma concentrations of nifedipine were determined by high performance liquid chromatogra-phy- mass spectrometry ( LC-MS ) . PCR-restriction fragment length polymorphism ( RFLP ) analysis was performed to detect the C3435 T polymorphism in AB-CB1 gene. Results The numbers of individuals carry-ing C/C, C/T and T/T genotypes in fasting group were 13, 24 and 8, respectively. The mean area under the curve ( AUC0-∞) in subjects carrying T/T genotype distinctly increased by 46. 34% compared with subjects with C/C genotype, but there was no statistically sig-nificant difference (P=0. 066). In addition, pharma-cokinetic parameters including Tpeak, Cmax and AUC0-48 had statistically significant differences between fasting group and high-fat meal group ( all P<0. 05 ) . Con-clution High-fat meal can speed the absorption and increase the extent of nifedipine absorption; ABCB1 C3435 T polymorphism almost does not affect the phar-macokinetics of nifedipine.

Effects of UDP glucuronosyltransferase 1A9 I399 C ＞ T single nucleotide polymorphism on postoperative analgesia with propofol in patients undergoing breast surgery / 中华麻醉学杂志

Objective To investigate the effects of UDP glucuronosyltransferase (UGT) 1A9 I399 C ＞ T single nucleotide polymorphism on postoperative sedation with propofol in patients undergoing breast surgery.Methods One hundred and fifty-two ASA Ⅰ or Ⅱ female patients,aged 20-50 yr,weighing 50-70 kg,scheduled for elective benign breast tumor excision under general anesthesia,were enrolled in this study.The polymorphic sites of the UGT1A9 I399 C ＞ T allele were analyzed by polymerase chain reaction-restriction fragment length polymorphism.The patients were assigned to one of 3 groups according to their genotypes:wild homozygote (C/C) group,mutation heterozygote (C/T) group and mutation homozygote (T/T) group.During induction and maintenance of anesthesia,propofol was given by target-controlled infusion with the plasma concentration (Cp) of 3μg/ml.Blood samples were taken at 60 min after target-controlled infusion of propofol was started for determination of the Cp of propofol using high-performance liquid chromatography.The time when OAAS was 4 after stopping the infusion of propofol was recorded and the BIS value and effect-site concentration of propofol were also recorded at this time.The time when BIS value was 80 was recorded and the effect-site concentration of propofol was also recorded at this time.Results Genotyping analysis revealed that genotype distribution of UGT1A9 I399 C ＞ T polymorphism was C/C 24 cases,C/T 96 cases and T/T 32 cases.The T allele frequency was 53％.The C allele frequency was 47.4％.There was no significant difference in the Cp of propofol,time when OAAS was 4,BIS value and effectsite concentration of propofol when OAAS was 4,time when BIS value was 80 and effect-site concentration of propofol when BIS value was 80 among the three groups (P ＞ 0.05).Conclusion UGT1 A9 I399C ＞ T single nucleotide polymorphism is not the genetic factor contributing to the individual variation in the patient' s response to postoperative analgesia with propofol in patients undergoing breast surgery.

Evaluation of trigeminal neurovascular compression in patients with trigeminal neuralgia with 3.0 T MRI / 中华放射学杂志

Objective To identify anatomical characteristics of neurovascular compression associated with trigeminal newralgia(TN).Methods Fifty patients with TN (23 of 50 patients underwent microvascular decompression) and 50 patients without facial pain underwent 3.0 T MRI scanning for analysis of 50 trigeminal nerves ipsilaterai to TN symptoms,50 contralateral to TN symptoms,and 100 in asymptomatic patients.MRI sequences included balanced fast-field echo and 3D MR angiography.Images were fused and reconstructed into virtual cisternoscopy images to determine the degree (severity of compression was defined as follows:1=no compression; 2 =compressed by a vein; 3 =contacted by an artery; 4 =indented by an artery; and 5 =nerve displaced or distorted by an artery) and site of neurovascular compression ( the point of each offending vascular structure:proximal was defined as located in 1/3 length of the cisternal segment of the trigeminal nerve near root entry zone; the place of superior was defined as above the cisternal segment of the trigeminal nerve).Reconstructed MPR images were used to measure nerve length and cross sectional area.The chi-square test was used for all 2 × 2 contingency tables.The t-test was used for dependent samples.The Logistic regression was used for prediction of occurrence of the event of TN.Results Twenty-three of 50 patients with TN underwent microvascular decompression,which confirmed predicted neurovascular relationships in all cases,and 21of 23 patients were pain free after the operation.The incidence of neurovascular compression on asymptomatic nerves ( no.of level 1=79,level 2 =5,level 3 =8,level 4 =8),on nerves contralateral to TN symptoms( no.of level 1=27,level 2 =6,level 3 =9,level 4 =8),and on nerves ipsilateral to TN symptoms(no.of level 1=4,level 2 =12,level 3 =12,level 4 =7,level 5 =15) was 21.0％ (21/100),46.0％ (23/50),and 92.0％ (46/50),respectively.The difference between symptomatic and asymptomatic nerves was significant regarding nerve distortion ( level 4 and 5,x2 =27.0,P ＜ 0.01),the point of compression ( no.of proximal of symptomatic nerves =32,not proximal of symptomatic nerves =14,proximal of asymptomatic nerves =4,not proximal of asymptomatic nerves =17,x2 =14.8,P ＜ 0.01),the place of vascular compression ( no.of superior of symptomatic nerves =36,not superior of symptomatic nerves =10,superior of asymptomatic nerves =5,not superior of asymptomatic nerves =16,x2 =18.0,P ＜0.01) and the mean cross-sectional area of the CPA cistern [ ipsilateral:( 183.9 + 52.5 ) mm2,contralateral:( 217.8 + 58.8 )mm2,t =- 3.04,P ＜ 0.01].Decreased nerve size was observed in patients with TN [ the section area of ipsilateral nerve ( 6.3 ±1.3) mm2,contralateral (7.7+1.6) mm2,t =-4.80,P ＜0.01; length of ipsilateral nerve:(8.0 ±1.9) mm,contralateral:(9.0 + 2.0) mm,t =- 2.64,P ＜ 0.05 ].Conclusions Trigeminal neurovascular compression can occur in asymptomatic patients,but is more severe,more proximal,more superior and with smaller size of cross-sectional area of the CPA cistern in patients with TN.This information may help identify patients who are likely to benefit from microvascular decompression.

Potential value of event-related potentials and electroencephalogram in the early diagnosis of dementia / 中国综合临床

Objective To identify the potential value of event-related potentials ( ERPs ) and electroencephalogram(EEG) in early diagnosis of dementia.Methods From June 2008 to July 2011,113 patients with dementia were recruited fom First Affiliated Hospital of Anhui College of Traditional Chinese Medicine.Meanwhile,100 healthy individuals conducting physical examination at this hospital were collected as the control group.P300 and EEG were measured in patients and healthy controls.Results ( 1 ) Compared with healthy controls,patients with early diagnosis of dementia had significantly longer latency(402.5 ± 37.4)ms vs.( 320.4 ± 23.5 ) ms ;t =19.40 ; P =0.02 ) and lower amplitude of P300 ( 3.76 ± 1.76 ) μV vs.( 5.32 ± 1.38 )μV;t=7.24;P=0.01 ).(2)Significant higher proportionof abnormal EEG cases was found in individuals with dementia (68/113,60.2％ ) than that of participants in the healthy control group(34/100,34.0％ ) ( x2 =13.54,P ＜0.01 ).Specifically,patients with early diagnosis of dementia had significantly higher prevalence of moderate (26.5 ％ [ 18/68 ] vs.5.9 ％ [ 2/34 ] ; x2 =4.85,P =0.02 ) and severe ( 8.8 ％ [ 6/68 ] vs.2.9 ％ [ 1/34 ] ; x2 =1.22,P =0.02 ) abnormal EEG than healthy controls,while there were no significant difference of the proportions of mild or borderline abnormal EEG between the two groups ( P ＞ 0.05 ).Conclusion P300 is an extraordinary objective indicator for early diagnosis of dementia.EEG can provide evidence of impaired brain function for individuals with dementia.

Effect of CYP3A4* 1G genetic polymorphism on fentanyl pharmacodynamies in healthy female volunteers / 中华麻醉学杂志

Objective To investigate the effects of CYP3A4* 1G genetic polymorphism on fentanyl pharmadynamics after intravenous injection in healthy female velunteers,Methods Twenty-eight healthy female volunteers aged 18-25 yr weighing 45-70 kg were enrolled in this study.The CYP3A4 * 1G genetic polymorphic sites were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The volunteers were assigned into 3 groups according to their genotypes:group Ⅰ wild homozygote ; group Ⅱ mutation heterozygote and group Ⅲ mutation homozygote.Fentanyl 5 μg/kg was injected iv over 1 min.Pain threshold was measured using electrical stimulation before and at 45,150 and 240 min after fentanyl injection.Results Pain threshold was significantly higher at 45 and 150 min after iv fentanyl injection in mutation homozygote group than in mutation heterozygote group and wild homozygote group.There was no significant difference in pain threshold between mutation heterozygote group and wild homozygote group.Conclusion CYP3A4* 1G genetic mutation can enhance the analgesic efficacy of fentanyl after intravenous injection in healthy female volunteers.