Objective Under the method of a Meta-analysis, evaluate the early and long-term curative effect after coronary artery bypass grafting with the comparison of benefit and safety between dual anti-platelet therapy and aspirin therapy alone.Methods Medline, Embase, ScienceDirect and Cochrane Library were searched to identify randomized controlled trials concerning the comparison of benefit and safety between dual anti-platelet therapy and aspirin therapy alone, with extraction effect sizes including mortality, bleeding events, myocardial ischemia and graft occlusion.Newcastle-Ottawa Scale and Jadal scales were used to evaluate the quality of observational case-control studies and randomized controlled studies.Statistical analysis was performed using Meta R.15.2 software package.Results 15 literatures were enrolled for Meta-analyses, including 8randomized controlled studies, 3 prospective observational studies and 4 retrospective observational studies.Among a total of 31 365patiens, 8 642 patients were received combination therapy of aspirin and clopidogrel after CABG, and 22 723 patients were received combination therapy of aspirin and placebo or aspirin therapy alone.The Meta-analysis results, with comparison of the early postoperative curative effect in 13 literatures, showed that, relative to aspirin therapy alone, dual anti-platelet therapy could reduce the risk of graft occlusion(OR =0.53,95％ CI: 0.37-0.76, P =0.001), reduce the risk of myocardial ischemia (OR =0.84, 95 ％ CI: 0.71-0.99, P =0.038) , reduce the risk of mortality after CABG (OR =0.47,95 ％ CI: 0.36-0.61, P ＜0.001), simultaneously not increase the risk of bleeding events.The Meta-analysis results, with comparison of the long-term postoperative curative effect in 2 literatures, showed that the significant difference could not be found between two method of therapy about affecting the risk of graft occlusion (OR =0.40, 95 ％ CI: 0.02-6.90, P =0.523) , myocardial ischemia(OR =0.49, 95％ CI: 0.04-6.10, P =0.597), and mortality (OR =0.55, 95 ％ CI: 0.13-2.80, P =0.420).Conclusion Relative to aspirin therapy alone, dual anti-platelet therapy has better efficacy and safety in early postoperative term.However better long-term curative effect of dual anti-platelet therapy are not be confirmed, and more long-term follow-up studies are necessary to provide evidence based medicine.

Objective To investigate the ultrastructure changes of pancreatic islets alpha cells in rats with impaired glucose tolerance.Methods 16 Wistar rats were randomly assigned into normal glucose tolerance group(NGT group,n =8)and impaired glucose tolerance group(IGT group,n =8).NGT group were fed with routine diet and IGT-group were fed with high-sugar high-fat diet.At the 12th week,IGT models were considered successful if the level of 2-hour peripheral blood glucose(2 h PG)was between 7.8 and 11.1 mmol/L in oral glucose tolerance test and continued for more than a week.The pancreas tail of animals in the NGT group and IGT group rats was removed for ultrastructure observation.Alpha cells were observed under transmission electron microscope.Results The big-plump secretory granule with aureole appeared in pancreatic islets alpha cells of NGT group,and it contained a round dense core.The nuclear chromatin and contents were evenly distributed.Mitochondria and en-doplasmic reticulum arranged tightly and orderly.Compared with NGT group,the quantities of secretory granule increased significantly in IGT group.The gap between dense core and membrane was narrower.The quantities of mitochondria and rough endoplasmic reticulum increased significantly.There was no significant change for the structure of the other cell organelle.Conclusion The pathogenesis of IGT is associated with ultrastructural changes and dysfunction of pancreas islets alpha cells.

Objective To investigate the effect of glucagon-like peptide-1 agonist (exendin-4) on expression of glucose transporter 4 (GLUT4) in the skeletal muscle of rats with impaired glucose tolerance (IGT).Methodis 54 Wistar rats were randomly assigned into normal glucose tolerance group (NGT group,n =18) and impaired glucose tolerance group(IGT group,n =36).The rats in NGT group were fed with routine diet and the rats in IGT group were fed with high-sugar high-fat diet.At the 12th week,IGT models were tested successful.Then,half of the rats were allocated to intervention group (Ex group) and the rest were set as IGT control group.The rats in Ex group were subject to exendin-4 subcutaneous injection (5 μg/kg,twice daily).Each rat in NGT group and IGT control group was given the same volume of saline as injection.FBG and 2 h BG were measured before intervention and after 4 weeks.The expression of GLUT4 mRNA and GLUT4 in the skeletal muscle were respectively measured by real time quantitative polymerase chain reaction and immunohistochemistry.Inter-group comparison was conducted using analysis of variance (ANOVA) and least square deviation-test (LSD-t).Results Before intervention,compared with NGT-group,the 2 h BG in IGT control group and Ex group were higher,the GLUT4 mRNA of skeletal muscle in IGT control group and Ex group were lower (respectively P ＜ 0.05).The skeletal muscle cells in IGT control group and Ex group were less colored while the skeletal muscle cells in NGT group were colored extensively,and more colored granules.After 4 weeks of exendin-4 intervention,compared with IGT control group and Ex group of non-intervention,the 2 h BG level in Ex group was lower and the expression level of GLUT4 mRNA of skeletal muscle was higher (respectively P ＜ 0.05).After intervened with exendin-4 for 4 weeks,the GLU protein mainly expressed in cytoplasma of skeletal muscle cells.Its expression was higher in Ex group than in IGT group and in Ex group before intervention.Conclusion Exendin-4 may up-regulate the expression of GLUT4,increase glucose intake of the skeletal muscle,and reduce postprandial blood sugar.

Objective To study the injury and protective action of drugs on neurons, the model of glutamate excitotoxicity on primary cultured hippocampual neurons from new born rats were( set up. Methods)By use of trypan blue dye staning and testing the lactate dehydrogenase leakage from cultured neurons, to investigate the neuron survival rate. Results We found the injury of neurons was related with the concentration of glutamate. NMDAR non-competitive antagonist —MK-801 could protect the glutamate excitotoxic damage on neurons. Conclusion The glutamate results in neuron injury through NMDAR; the model of neuron culture was sufficient for glutamate-induced excitotoxicity.

Sixty-fourth patients with vascular dementia were recruited in the study and randomly assigned in rehabilitation (medication plus rehabilitation)and control group (medication alone).The treatment period lasted for 12 weeks,the scorings of mini mental statement examination(MMSE) and activity of daily living scale (ADL) were compared before and 4,8,12 weeks after treatment in both group.The scorings of MMSE and ADL in rehabilitation group and control group were both improved after treatment(P ＜0.05),but the scorings in rehabilitation group were better than those in control group(P＜0.05).

Objective To investigate CT signs of peripheral small cell lung cancer (SCLC).Methods The CT signs of 78 patients with SCLC confirmed by pathology were retrospectively reviewed.According to the presence of mediastinal lymph node metastasis and its size, 78 cases of peripheral SCLC were divided into two types: typeⅠ(isolated lesion) and typeⅡ(lung lesion + lymph nodes).Type Ⅱwere divided into two subtypes:type Ⅱa (short diameter of lymph nodes of pulmonary hilar and mediastinum less than 10 mm) and type Ⅱ b (short diameter of lymph nodes of pulmonary hilar and mediastinum greater than or equal to 10 mm).Results Of the 78 SCLCs, typeⅠwas 7 cases, and typeⅡwas 71 cases,including 8 cases of typeⅡa and 63 cases of typeⅡb.All of the lesions were soild density.The shape were round or oval in 52 cases, vermicular or spindlein 9 cases, and other shapes in 17 cases.Among 71 cases performed CT enhancement, there were 9 cases with homogeneous enhancement, 58 cases with heterogeneous enhancement, 4 cases with non-enhancement large necrosis area.These cases showed the following CT signs: smooth edge in 65 cases, coarse edge in 12 cases, blurred edge in 1 case;air bronchogram in 3 cases, vacuole sign in 4 cases, calcification in 4 cases;lobulation sign in 46 cases, spiculated sign in 5 cases;thickening of the bronchovascular bundle in 41 cases, pleural indentation in 6 cases, marginal ground-glass opacity in 5 cases, vascular convergence sign in 1 case;emphysema in 42 cases;obstructive pneumonia in 4 cases;bronchus abruptly interruption on the edge of the nodules in 18 cases;enlargement of mediastinal lymph nodes in 63 cases, the diameter of mediastinal lymph nodes larger than the primary lesions in 42 cases;and a little pleural effusion in 9 cases.Conclusion Solid density, smooth margin with lobulation,and significantly enlarged mediastinal lymph nodes are common signs in peripheral SCLC.Thickening of the bronchovascular bundle indicates reletively advanced stage.

Objective To explore the expressions of Bcl-2 and Bax proteins in the neurons of spinal cord after tibial nerve and common peroneal nerve injuries in rats.Methods A total of 90 male SD rats were randomly divided into three groups, the group A was as control group, group B as suture of tibial nerve cut group, and group C as suture of the common peroneal nerve cut group.The L4-6 segment spinal cord of the rats were removed for HE staining and immumohistochemical staining on 3, 7, 14, 28 days after the operation.The number of motor neurons in the spinal anterior horn were calculated.The expressions differences of Bcl-2 and Bax proteins were detected by immuno-histochemistry, and values of Bcl-2/Bax were calculated.Results The number of motor neurons in the anterior horn of spinal cord in group B were less than that in group C on 1, 3, 7, 14, 28 days after the operation (P< 0.01).The expression of Bcl-2 protein in group B and group C showed an upward and then declining trend.It decreased to the lowest on the postoperative 3 d in group B and 7 d in group C, respectively.The expressions of Bax protein in group B and C showed an upward and then declining trend, and it increased to the highest on the postoperative 3 d in groups B and C.The values of Bcl-2/Bax in groups B and C were showed an decreased and then increased trend and it was lower in group B than group C on the postoperative 3, 7, 14, 28 d(P< 0.01).Conclusion Injuries of tibial nerve and common peroneal nerve of the rats would lead the apoptosis of motor neurons in the spinal cord, but compared with the injury of common peroneal nerve, tibial nerve injury would lead less apoptosis of motor neurons.

Objective To explore the expressions of Bcl-2 and Bax proteins in the neurons of spinal cord after tibial nerve and common peroneal nerve injuries in rats.Methods A total of 90 male SD rats were randomly divided into three groups, the group A was as control group, group B as suture of tibial nerve cut group, and group C as suture of the common peroneal nerve cut group.The L4-6 segment spinal cord of the rats were removed for HE staining and immumohistochemical staining on 3, 7, 14, 28 days after the operation.The number of motor neurons in the spinal anterior horn were calculated.The expressions differences of Bcl-2 and Bax proteins were detected by immuno-histochemistry, and values of Bcl-2/Bax were calculated.Results The number of motor neurons in the anterior horn of spinal cord in group B were less than that in group C on 1, 3, 7, 14, 28 days after the operation (P< 0.01).The expression of Bcl-2 protein in group B and group C showed an upward and then declining trend.It decreased to the lowest on the postoperative 3 d in group B and 7 d in group C, respectively.The expressions of Bax protein in group B and C showed an upward and then declining trend, and it increased to the highest on the postoperative 3 d in groups B and C.The values of Bcl-2/Bax in groups B and C were showed an decreased and then increased trend and it was lower in group B than group C on the postoperative 3, 7, 14, 28 d(P< 0.01).Conclusion Injuries of tibial nerve and common peroneal nerve of the rats would lead the apoptosis of motor neurons in the spinal cord, but compared with the injury of common peroneal nerve, tibial nerve injury would lead less apoptosis of motor neurons.