Thrombolysis is still an important treatment modality in patients with ST-segment elevation myocardial infarction (STEMI) in a hospital without percutaneous coronary intervention (PCI) facility. However, the optimal treatment after thrombolysis is still unclear. Conservative treatment after thrombolysis was recommended in the past. "Guidelines for percutaneous coronary intervention (2009)" also suggested that the condition of STEMI patients should be evaluated to determine whether the patient should be transferred to a hospital with PCI facility. But this suggestion lacksed evidence-based support. In recent years, several clinical trials suggested that immediate transfer to the nearest interventional centre for PCI was plausible regardless of success or failure in thrombolysis in local hospital, and this might reduce the incidence of cardiovascular events in patients with STEMI.

Objective:To systematically evaluate the clinical efficacy and adverse reactions of tegafur combined with apatinib mesylate in treatment of advanced gastric cancer.Methods:The databases such as PubMed, Cochrane Library, CNKI and WanFang data were searched by computer, and the relevant randomized controlled trials were searched. The retrieval time was from the establishment of the database to May 2018. After literatures were selected according to the inclusion and exclusion criteria, the data were extracted and the quality of the included studies were evaluated, meta analysis was conducted by using RevMan 5.3 software.Results:There were 7 studies included in total. Tegafur combined with apatinib mesylate could achieve higher complete remission rate ( RR = 2.00, 95% CI 1.04-3.86, P = 0.04), partial remission rate ( RR = 1.43, 95% CI 1.01-2.03, P = 0.04), and lower inefficiencies rate ( RR = 1.28, 95% CI 1.07-1.53, P = 0.008), but the incidence of adverse reactions such as hypertension was also increased. Conclusion:Tegafur combined with apatinib mesylate in treatment of advanced gastric cancer can achieve better clinical efficacy, but at the same time it can increase the incidence of adverse reactions.

Objective To establish the qualitative and quantitative detective methods of Fuyang granules.Methods The TLC methods for identification of Fructus kochiae and Herba solani lyrati were established.A simple HPLC was established for the determination of hydroxysafflor A(HYSA).The mobile phase was methanol-acetonitrile-0.7% phosphoric acid(24:6:70).UV detecting wavelength was at 403 nm.Results Fructus kochiae and Herba solani lyrati could be identified by TLC.HYSA showed a linear relationship at the concentration range of 0.128～1.024 ?g,r =0.999 8.The average recovery was 99.52% and RSD= 1.97%(n = 5).Conclusion The method can be used for qualitative identification and quantization determination of Fuyang granules.

Objective To investigate the effect of umbilical cord serum(UCS)during induction of dendritic cells derived from umbilical cord blood. Methods Umbilical cord blood was collected aseptically and interface cells were collected with density gradient centrifugation method,CD34 +cells were purified and collected with Mini-MACS technique. Pro-DC were obtained and were divided into 3 groups:①cultured in RPMI-1640 medium with 10%UCS and cytokine,②cultured in RPMI-1640 medium with 10%FCS and cytokine③cultured in RPMI-1640 medium with 10%FCS .Interleukin-4(IL-4),granulocyte-macrophage colony-stimulating factor(GM-CSF)and tumor necrosis factor(TNF-a)were used in the first 2 groups, but not in control group (group 3). Some cells were collected on the 8th d for phenotypes analysis. Results The expression of CD80 ,CD54 and HLA-DR on the surface of DC cultured in UCS medium had no significant difference compared with that of DC cultured in FCS medium. The expression of surface molecules in UCS-DC group and FCS-DC group were both enhanced compared with the control group. Conclusion Mature DC could be induced from pro-DC derived from umbilical cord blood when cultured with UCS instead of FCS. That provides a new approach for the clinical application of DC.

OBJECTIVE: To investigate the effect of enzymatically modified low density lipoprotein(E-LDL) on differation and maturation of human dendritic cells(DC) in peripheral blood and the effect of diltiazem on it.METHODS: Human monocytes were isolated by using gradient centrifugation method and cultured in DC Cellgro medium containing rhGM-CSF and rhIL-4 for 5 days,then DC was then obtained.DC were treated with E-LDL or E-LDL plus diltiazem for 48 hours,the morphological changes were observed under the microscope,and the FACS was used to investigate the expression of DC(CD1a,CD80,CD86 and HLA-DR).PBS group was set up for comparison.RESULTS: The morphological changes were nor observed.The expressions of CD1a,CD80,CD86 and HLA-DR in each groups were significant different(P

Objective To study the therapeutic effect of ankylosing spondylitis treated with sacroiliac joint injection under C-arm X-ray guidance. Methods Four hundred and eighty-three patients of ankylosing spondylitis were divided randomly into two groups according to the treatment method. Four hundred and twenty-one cases were in group A:sacroiliac joint injection under C-arm X-ray, the injection medicine were diprospan or triamcinolone acetonide and methotrexate, and with oral sulfasalazine (SASP) as well. Sixty-two cases were in group B: oral medicion SASP and meloxicam alone without injection. Self-evaluation, finger-to-floor distance, changes in Schober's sign, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) before and after treatment of 3 d, 1 week,2 weeks, 3 weeks, 4 weeks and 3 months were observed. Results Two indicators including self-evaluation and finger-to-floor distance at initial 3 d were significantly lower than those before treatment in group A: (6.18 ±0.55) scores vs. (8.89 ±0.53) scores, (30.10 ±3.94) cm vs. (50.20 ±3.93) cm, P<0.05. Schober's sign and occiput-to-wall distance at 1 week after treatment were significantly lower than those before treatment in group A:(3.44± 0.32) cm vs.(3.19±0.47) cm, (9.49±0.68) cm vs. (10.72±2.36) cm, P<0.05. Two indicators including self-evaluation and finger-to-floor distance at 1 week after treatment were significantly lower than those before treatment in group B:(7.07 ± 0.72) scores vs. (9.08 ±0.46) scores, (48.14 ±5.62) cm vs. (50.84 ±4.33) cm, P<0.05. Schober's sign at 4 weeks after treatment was significantly lower than that than before treatment in group B:(3.49± 0.56) cm vs. (3.22±0.58) cm, P<0.05. Occiput-to-wall distance at 2 weeks after treatment was significantly lower than that before treatment in group B:(9.08±1.54) cm vs. (10.11±1.58) cm, P<0.05. Conclusion The method of C-arm X-ray guided sacroiliac joint injection for treatment of ankylosing spondylitis is effective and feasible.

Objective To investigate the effect of partial sleep deprivation (PSD) on cardiac electric activity and function of vascular endothelium. Methods Eighteen Sprague-Dawley rats were randomly divided into two groups (9 each):PSD group and control group. PSD lasted 10 days,20 hours each day. Body weight and surface electrocardiogram (S-ECG) were examined and recorded 1d before PSD,and 1d,4d,7d and 10d after PSD. Serum concentrations of glucose,total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),creatin kinase (CK),creatin kinase-MB (CK-MB),high-sensitivity C-reactive protein (hs-CRP),nitric oxide (NO),von Willebrand factor (vWf),endothelin-1 (ET-1) and E-selectin were determined the next day after 10d of PSD. Results Compared to that 1d before PSD,body weight in PSD groups decreased significantly,while increased obviously in control group. Compared to that in control group,the body weight of rats decreased significantly (P

Objective To evaluate the effects of sevoflurane preconditioning on postoperative cognitive dysfunction in aged rats.Methods One hundred and twenty healthy male Sprague-Dawley rats,aged 18 months,weighing 400-450 g,were randomly divided into 3 groups (n =40 each) using a random number table:control group (group C),operation group (group O),and sevoflurane preconditioning group (group Sev).In group C,the rats were only anesthetized with pentobarbital sodium and did not undergo operation.In group O,the rats were anesthetized with pentobarbital sodium and underwent 30 min of exploratory laparotomy.In group Sev,the rats inhaled 2.4％ sevoflurane for 30 min and then inhaled air for 30 min,and the other procedures were similar to those previously described in group O.At 30 min before operation and on 1st,3rd,5th and 7th days after operation,Morris water maze test was performed to record the escape latency,time of staying at the original platform quadrant and frequency of crossing the original platform.At 30 min before operation and on 1st and 7th days after operation,10 rats in each group were sacrificed and hippocampi were isolated to detect the apoptotic rate and intracellular [Ca2 +] i (using flow cytometry) and the ultrastructure of hippocampal neurons was observed with transmission electron microscope.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased,and the apoptotic rate and intracellular [Ca2 +] i were increased after operation in O and Sev groups (P ＜0.05).Compared with group O,the escape latency was significantly shorten,the time of staying at the original platform quadrant was prolonged,the frequency of crossing the original platform was increased,and the apoptotic rate and intracellular [Ca2+]i were decreased after operation in group Sev (P ＜ 0.05).Microscopic examination showed no abnormality in the ultrastructure of hippocampal neurons in group C,and the pathological changes of the ultrastructure of hippocampal neurons were obvious in group O,and were significantly attenuated in group Sev.Conclusion 2.4％ sevoflurane preconditioning can reduce postoperative cognitive dysfunction in aged rats,and regulation of imbalance of calcium homeostasis and reduction of cell apoptosis are involved in the mechanism.

Objective To explore the application effect of interactive health education in insulin injections of aged patients with type 2 diabetes in the incipient stage of diagnosis and treatment. Methods 100 cases of aged patients with type 2 diabetes were hospitalized into endocrinology department from January 2014 to December 2014, the pen insulin injections were conducted for them at the beginning. They were equally divided into experimental group and control group through random number method. And, the general education guidance was conducted in control group. Meanwhile, the diabetes health education team was established in observation group on the basis of control group. Then, it was educated through the interactive lectures, interviews, teaching, repeated teaching, psychological intervention and individual assessment. Before and after education, the KAP survey of standard insulin injections were used for the patients in two groups to evaluate their degree of proficiency in the knowledge and skills about insulin injections, and the incidence of glucose metabolism level and low blood sugar. Results After intervention, the insulin injection skill in observation group was better than that of in the control group, (64.6%,31/48 vs. 24.5%, 12/149,χ2=16.441, P<0.01), while the level of glycosylated hemoglobin was reduced from (7.95±0.65)%to (6.58±0.62)%(t=7.85, P<0.01). Conclusions In the incipient stage of diagnosis and treatment, the ability of aged patients with type 2 diabetes in learning new knowledge and technology was improved through interactive health education mode. Besides, the insulin injections were standardized. Also, the glucose metabolism was improved, and the incidence of hypoglycemia was significantly reduced to ensure the patients′safety when the insulin was injected outside hospital, which was worth being clinically applied and promoted.

Objective To investigate the protective effect of edaravone against ischemiareperfusion injury in small-for-size rat liver grafts and its possible mechanisms. Methods 40 % small-for-size rat liver transplantation model was established by using modified two-cuff technique, adult male SD rats were used as donors and recipients, and 16 recipient rats were randomly divided into two groups (8 cases in each group), saline control group (control group) and edaravone treatment group (ED group). In the ED group, 3 mg/kg edaravone was given intravenously via penile vein 30 min before transplantation in the recipients. The same amount of saline was given in the control group at the same time points. Serum hepatic function (AST and ALT) and histopathological changes were analyzed; the contents of MDA and SOD, and hepatic myeloperoxidase (MPO) activity in liver grafts after 6 h were determined; and TNF-α levels at 6th h after reperfusion were measured by using enzyme-linked immunosorbent assay (ELISA method). Results As compared with control group,serum AST and ALT levels were significantly reduced at the 6th h after reperfusion in ED group (AST: 825. 50 5±72. 87 vs 1188. 03 ± 124. 04; ALT. 687. 40 5±72. 21 vs 988. 66 ± 91.07, P<0. 01 ).The content of MDA was lower and SOD level was higher in ED group significantly than in control group (P<0. 01). As compared with control group, hepatic TNF-α levels and MPO activity at the 6th h after reperfusion were significantly decreased in ED group (P<0. 01 ). Histopathological analysis revealed disruption of lobular architecture, apparent hepatocelluar degeneration accompanied by focal necrosis, significant edema, congestion and inflammatory cell infiltration in periportal area at the 6th h after reperfusion in control group, but minimal liver damage was observed in ED group. Conclusion Edaravone could ameliorate early ischemia-reperfusion injury in small-for-size liver grafts significantly.The protective mechanisms were mediated in part by increasing antioxidant ability, inhibiting lipid peroxidation, and down-regulating inflammatory reaction.