Objective To study the prognosis of patients with unstable angina in PCI adverse events factor analysis,and the function of CYP2C 19 gene mutations.Methods From May 2013 to May 2015,226 cases of PCI postoperative patients,after surgery all took aspirin + clopidogrel maintenance to treat for 1 years,analyzed CYP2C19*1,CYP2C19*2,CYP2C19 *3 genotype with fluorescent polymerase chain reaction (PCR),the patients were followed up for 6 months.According to the result of detection of genotype divided into wild type group (CYP2C19 *1/*1),the mutation of mixed group (CYP2C19 *1/*2 and CYP2C19 *1/*3) group and mutations in pure form group (CYP2C19 *2/*2 and CYP2C19 *3/*3).Observed the occurrence of unstable angina of three groups prognosis.Results The mutation of mixed to form and mutation of pure form had a record of hospital clinical adverse events (61.9％ and 45.3％) was significantly higher risk of wild group (42.4％),with statistical significance (P ＜0.05);Logistic regression analysis of diabetes and CYP2C19 genotype with PCI postoperative patients with unstable angina occurred in hospital records of clinical adverse events had good correlation (R =3.424,P=0.009 and R =5.679,P =0.001).Conclusion The CYP2C19 gene mutations and diabetes patients with unstable angina PCI postoperative prognosis is closely related,the lack of CYP2C19 gene type are more likely to affect the prognosis of unstable angina,provide reliable basis for further research.

Purpose: To observe the long-term and recent clinical effect of needle-warming method plus functional training in the treatment of osteoarthritis of the knee joint. Methods:After 106 cases of the patients were divided into the needle-warming group and comprehensive group by the order of their first visit, the needle-warming group was treated by the needle-wanning method and the comprehensive group was treated by the needle-warming method plus functional training. After ten treatments, the clinical data in the two groups were evaluated upon Lequesne scale before and after the treatments. Three months later, follow-up survey was given to process the statistic management of the reoccurrence rate of the symptoms.Results: In the two groups after the treatment, the symptoms of the knee joint and daily life ability were obviously improved than the respective conditions before the treatment, and the integral decreased (P＜0.05), with no significant difference (P＞0.05) between the two groups. In the follow-up survey, there was a difference (P＜0.05) between the two groups in the positive rate of the recurrent symptoms. Conclusion: Certain therapeutic effect exists in the treatment of osteoarthritis of the knee joint by the needle-warming method. If functional training is combined,the therapeutic effect would be more stable, without easy reoccurrence.

Objective To explore the nursing cooperation in use of lung inflation system for video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax. Method The key nursing points in nursing 42 patients with spontaneous pneumothorax undergoing VATS were analyzed. Results The operations were all successful. One patient contracted lower left atelectasis but it was cured after the tracheal tube was re-adjusted. On day one, there were two cases of gas leakage during thoracic closed drainage:one was of diffuse pulmonary bulla, and the gas leakage stopped on the second day; In the other cases, the gas leakage stopped 2 days after the tube was withdrawn by 3cm probably because the drainage tube was inserted too deep at the beginning. 6-30 months follow-ups showed no recurrence of pneumothorax in the operated site. Conclusions The lung inflation system is safe during VATS for spontaneous pneumothorax. Careful preoperative preparation of the equipment and skillful nursing cooperation at all procedures are critical for the success of VATS.

Stilbene glycoside (TSG) has been shown to have many beneficial properties. It is therefore essential to understand the absorption and metabolism of TSG in detail. We determined the recovery of TSG and its metabolites (TSG sulfate/glucuronides) in rat gastric contents, gastric mucosa, portal vein plasma, celiac arterial plasma, bile, and urine after administration of 15mg of TSG in 0.5mL physiological saline or incubation for 20min in situ in the stomach of rats. Within 20min, (64.0±9.8)% of the administered TSG disappeared from the stomach; later, TSG was recovered in both free and conjugated forms in plasma and bile, but not in urine. On the other hand, only free TSG was detected in the gastric contents and mucosa; it was also detected in the portal vein plasma as (48.1±3.5)% of the total TSG (all forms of TSG). However, the proportion of free TSG in the celiac arterial plasma and bile decreased to 4%-10%. In addition, the proportion of free TSG to total TSG in the liver microsome incubation mixture after TSG was incubated in liver microsome at 37℃ for 30min was very low [(10.6 ± 2.6)%]. These results indicate that TSG could be quickly absorbed from the rat stomach, conjugated in liver and excreted in bile. Such novel information would be helpful for the use of TSG as a beneficial natural product which may improve its proposed efficacy in preventing chronic diseases.

Objective To establish a method for the quality control of Rhizoma Alismatis. Methods The samples of Rhizoma Alismatis were identified with TLC and the content of alisol B-23-acetate in Rhizoma Alismatis was determined by HPLC-ELSD. Results The spots of TLC chromatogram of Rhizoma Alismatis was clear. A good linearity was in the range of 4.4～110.0 ?g/mL of alisol B-23-acetate, r=0.999 2(n=5), and the average recovery rate was 98.98 %(n=9), RSD=1.3 %. Conclusion This method was simple, accurate and with a good reproducibility and can be used for the quality control of Rhizoma Alismatis.

Objective To investigate the effect of albumin on expression of NLRP3 inflammasome and its downstream cytokines IL-1β and IL-18 in tubular epithelial cells.Methods Thirty mesangioproliferative glomerulonephritis (MsPGN) patients with different levels of proteinuria were selected, and their renal biopsy samples were stained by PAS and Masson to observe tubular epithelial cells injury and inflammatory cells infiltration.NLRP3, caspase-1, IL-1β and IL-18, as well as different inflammatory cells, were detected by immunohistostaining.In vitro, Western blotting and real-time PCR were employed to detect NLRP3, caspase-1, IL-1β and IL-18 protein and mRNA in HK-2 cells stimulated by bovine serum albumin (BSA) (20 g/L).Results In MsPGN patients with high levels of proteinuria, there were obvious renal tubular epithelial cell injury and inflammatory cells infiltration (all P ＜ 0.05), and the expressions of NLRP3, caspase-1, IL-1β and IL-18 were up-regulated compared to patients with low levels of proteinuria (all P ＜ 0.05).Furthermore, IL-1β and IL-18expressions were positively correlated with the degree of proteinuria (r=0.836, P ＜ 0.05;r=0.901, P ＜0.05).NLRP3, caspase-1, IL-1β and IL-18 protein and mRNA were significantly increased in HK-2cells stimulated by BSA compared to the control group (all P ＜ 0.05).Conclusions Albumin is able to induce NLRP3 inflammasome activation in tubular epithelial cells, which may be the mechanism of tubulointerstitial injury and inflammation caused by proteinuria.

Nowadays more and more medical study fields need mathematics knowledge.The mathematics abilities of medical students include the ability of basic logic thought,changing medical problems into mathematics ones,understanding and applying mathematics knowledge as well as solving mathematics problems with computers.

In organic chemistry teaching,we discuss with our colleagues some aspects such as how to stimulate students'interest in learning to make them have a sense of innovation,how to create the environment of question to form innovative thinking,how to establish the concept of space and develop their innovative thinking,how to conduct exploring experiment to foster their capacity of innovation.

Objective To summarize the experience of diagnosis and treatment of occult spontaneous pneumothorax in young adults.Methods To review and summarize the imaging data and treatment process of 22 cases of occult spontaneous pneumothorax.Results Surgical treatment was performed in 22 patients.Among them,VATS operation in 18 cases,VATMoperation in 4 cases.Operation difficulty was severe adhesion free existed in the apex of lung and pleural top.22 patients with the successful completion of the operation,no major bleeding during the operation,no open chest surgery.1 -3 years follow -up without recurrence.Conclusion Surgical treatment is the first choice for occult spontaneous pneumothorax in young adults.Often due to severe adhesion of the chest,surgery is difficult,the surgeon should be fully prepared before surgery.Patients with good prognosis,due to the difficulty of early diagnosis,clinicians should pay attention to.

Objective By investigating the effects of AT1 and ERK2 signaling pathway in CHF,to study the effect of Guanxin-Shutong capsule on AT1,ERK2 expression in rats with chronic heart failure (CHF).Methods The CHF rat models were setup by coronary artery ligation,exhausting swimming and reducing feeding.Divided CHF rat methods into a model group,a lisinopril group,Qi-benefiting with Chinese medicine group,blood activating with Chinese medicine group,Qi benefiting and blood activating with Chinese medicine group(QBBA group) and Guanxin-Shutong capsule group.Rats without left coronary artery ligation were set for sham operated group.Real-time quantitative PCR technique and immunohistochemical method were adopted to detect AT1,ERK2 changes of CHF rats.Results AT1,ERK2 expression increased obviously in the model group compared with the sham operated group,and differences were statistically significant (P＜0.01).After treatment,AT1,ERK2 expression reduced significantly in QBBA group and Guanxin-Shutong capsule group than the lisinopril group.(P＞0.05).And therapeutic effect of Guanxin-Shutong capsule group was much better than other Chinese medicine treated group (P＜0.01).Conclusion Guanxin-Shutong capsule would achieve the goal of treating chronic heart failure By inhibiting the expression of AT1 and ERK2 in organizations,and inhibiting or reversing ventricular remodeling process.