Objective To observe the influence of clopidogrel combined with proton pump inhibitor(PPI) on the incidence rate of in-stent restenosis (ISR) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention(PCI).Methods The clinical data of 132 ACS patients who were taking clopidogrel antiplatelet therapy were retrospectively analyzed.The control group (single clopidogrel) and observation group (clopidogrel +PPI) had 66 cases in each group.The incidence rate of ISR was compared between the two groups.Results The factor of gender,age,history of smoking,high blood pressure,heart function insufficiency,diabetes,peripheral vascular disease,oral medications,and the number of implanted stents in the two groups of patients with ACS may affect ISR factors constitute had no statistical significance (all P ＞ 0.05) ; ISR incidence rate of the observation group and the control group was 19.7％ and 9.1％,the difference was statistically significant (x2 =4.880,P ＜ 0.05).Conclusion PPI combined with clopidogrel could significantly increase ISR incidence rate of patients after PCI during follow up period of (12.0 ± 4.2)months,which should be carefully used in patients after PCI.

Objective To study the relationship between the six-minute walking test (6-MWT) and pulmonary function in the diagnosis course of chronic bronchitis converting into chronic obstructive pulmonary disease (COPD). Methods Pulmonary function was detected in 360 patients with chronic bronchitis.Based on the results and diagnosis standard of COPD by Chinese Medical Association in 2002, the patients were divided into COPD group and pulmonary function normal group.Tbe walking distance in 6-MWT (6-MWD) was measured, and the mean value of twice tests was calculated to study the correlation between 6-MWT and pulmonary function, and 50 healthy volunteers were selected as control group. Results Most 6-MWD in COPD group were less than 420 meters(95.95%, 142/148 ), but those in pulmonary function normal group were more than or equalled to 420 meters mostly (97.17%, 206/212 ). However in patients with the 6-MWD more than or equalled to 420 meters , pulmonary function indexes such as the ratio of forced expiratory volume in one second and forced vital capacity( FVC ), FEV_1%, maximal ventilatory volume(MVV)were all significantly greater than those in patients with 6-MWD less than 420 meters, and there were significant differences (P<0.05). Compared with chronic bronchitis, the results of 6-MWD in control group was more than or equalled to 420 meters, but there was no significant difference (P>0.05 ). Conclusions 6-MWT is simple and feasible. However, it is a better indicator of the patients pulmonary function. The test would be an effective selecting examination for chronic bronchitis patients who are not willing to do puhnonary function test.

0.01). The new caries did not occur in the test group. DMF index was higher in the controls than that in the tested subjects(P

Objective To explore the changing regularity of humeral distal epiphysial anteverted angulation with ultrasonic measurement. Methods Using an ultrasonic diagnostic apparatus with a high frequency bougie to detect the dextral elbow joint of 203 normal individuals whose age range is from 5 d to 23 years old. The subjects were divided into 5 groups by age (5 d-4 years old, 5-8 years old, 9-12 years old, 13-16 years old, ≥17 years old),and by sex into two large parts.Anteverted angulation of capitellum and lateral semitrochlear ossification center were measured with statistic analysis and correlation calculation.Results Anteverted angulation of capitellum was 48.89?? 8.96?, lateral semitrochlea 33.70?? 7.18?. Anteverted angulation of capitellum enlarges with age growth, and it reaches the climax ( 55.00?? 5.88?) at the age 13-16 years old. There was a significant difference among groups. After 17 years old, anteverted angulation slightly reduces to 52.38?? 8.27?, compared with the climax ( 55.00?? 5.88?), there was no statistical difference. Changing regularity of anteverted angulation was similar to that of capitellum. Just between the 5 d-4 years old group and 5-8 years old group, the difference was significant in angulation enlargement. There was no statistical difference among the groups above the 5-8 years old group, and no significant difference between male and female in humeral distal epiphysial anteverted angulation. Conclusions Ultrasonic examination can clearly display the images of humeral distal epiphysis. Observation and measurement is available for the epiphysial anteverted angulation by acoustic images, and the changing regularity of anteverted angulation can be illustrated.

Objective To investigate the scintigraphic features of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) and to explore the clinical significance of 99Tcm-EHIDA hepatobiliary scintigraphy.Methods Hepatobiliary scintigraphy with 99Tcm-EHIDA was performed in 28 genetic confirmed NICCD cases (16 males,12 females,1-8 months).Normal dynamics (i.e.,time-activity curve) of the tracer in heart,liver and kidneys was defined as normal hepatic uptake function.Decreased liver uptake of the tracer and/or prolonged heart and kidneys radioactivity retention was defined as impaired hepatic uptake function.Normal or delayed biliary excretion was defined as radioactivity appearing in the bowel within 60 min or after 60 min.Occluded biliary excretion was defined as absent bowel radioactivity within 24 h.The characteristics of hepatobiliary scintigraphy and their relationship with levels of serum total bilirubin (TB),direct bilirubin(DB),ALT,total bile acid (TBA) were retrospectively analyzed.Statistical analysis was performed using Kruskal-Wallis rank sum test.Results Of 28 NICCD patients,20 showed normal uptake while 8 had impaired hepatic uptake.Ten of twenty patients with normal uptake function showed normal biliary excretion and the others showed delayed biliary excretion.Four of eight cases who presented impaired hepatic uptake function were with delayed biliary and the rest displayed biliary excretion occlusion.Compared with the patients with normal hepatic uptake function,patients with impaired hepatic uptake had significantly higher levels of TB and DB (TB:183.6(128.7-280.9) mmol/L vs 105.5(80.0-141.7) mmol/L,Z=-2.25;DB:135.6 (95.7-212.6) mmol/L vs 73.1(53.9-97.9) mmol/L,Z=-2.73; both P＜0.05).Compared with the cases with normal biliary excretion function,patients with delayed biliary excretion had significantly higher levels of TB,DB and TBA (TB:137.5 (122.0-170.9) mmol/L vs 81.7(65.7-93.5) mmol/L,Z=-3.92;DB:96.5 (81.1-108.0) mrrol/L vs 54.1(45.3-72.6) mmol/L,Z=-3.74; TBA:245.6(183.9-299.2) mmol/L vs 136.0(73.5-163.2) mmol/L,Z=-2.57; all P＜0.05).The levels of TB (262.0(152.1-542.8) mmol/L) and DB (192.7(118.1-407.2) mmol/L; both Z=-2.82; both P＜0.05) were the highest in patients with occluded biliary excretion.Compared with the patients with delayed excretion,the occluded excretion subgroup had significantly higher levels of ALT (71.5 (48.5-144.8) U/L vs 20.0(16.5-27.7) U/L,Z=-2.66,P＜0.05).Conclusion 99Tcm-EHIDA hepatobiliary scintigraphy may evaluate hepatic uptake and excretion function of the NICCD infants.When the hepatic uptake is remarkably decreased,the occluded biliary excretion can be shown.

Objective To evaluate the impact of subclinical hypothyroidism (SCH) on the outcome of pregnancy and the therapeutic effect of L-T4.Methods A total of 1 786 pregnant women during the first, second, and third trimesters were enrolled for thyroid screening by determining serum free thyroxine (FT4), total thyroxine (TT4), thyrotropin (TSH), and thyroid peroxidase antibody;123 pregnant women with SCH were successfully divided into treated group (n =42) and untreated group (n =81).The treated group was treated by L-T4 based on American Thyroid Association (ATA) 2011 guideline.Collected items include obstetric outcomes and complications.Results (1) Compared to control group, the rate of spontaneous abortion in pregnant women during first trimesters was increased in SCH group (20.99％ vs 8.45％, x2 =12.96, P =0.00), with higher incidence of diabetes during second trimester (24.69％ vs 10.45％, x2 =14.11, P =0.00).The incidences of hypertension during pregnancy, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight showed no difference between two groups (all P ＞ 0.05).(2) Compared with the untreated group, the incidences of spontaneous abortion and diabetes were decreased in the treated group (7.14％ vs 20.99％, x2 =3.89, P =0.05;9.52％ vs 24.69％, x2 =4.05, P =0.04), while the incidences of hypertension, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight infant accident rate were not different between two groups (all P ＞ 0.05).Conclusions SCH during the frist trimester is a risk factor of spontaneous abortion;SCH during the middle stage of pregnancy is a risk factor of gestational diabetes mellitus.Treatment of SCH with L-T4 may be beneficial.

Several studies have demonstrated that heparin can significantly inhibit the P-selectin-mediated interaction of platelets and tumor cells during metastasis as a P-selectin ligand. However, little information is available about the specific oligosaccharide structures of heparin in recognition by P-selectin. Two chemically modified heparins, CR-heparin and SCR-heparin were prepared, to explore if such heparin derivatives can reduce the P-selectin-mediated A375 tumor cell adhesion. The results indicated that CR-heparin with low anticoagulant activity could significantly inhibit the P-selectin-mediated A375 tumor cell adhesion, demonstrating that 6-carboxyl group of the glucuronic acid in heparin may not be crucial for recognizing by P-selectin. In contrast, SCR-heparin reduced the inhibiting activity dramatically, suggesting that the recognition of P-selectin to heparin depend on not only densities of negative charge. These results provide valuable experimental evidence for clarifying the molecular mechanism of P-selectin-mediated tumor cell adhesion.

Objective To evaluate the effects of connective tissue growth factor (CTGF) on corneal neovascularization.Methods Twenty-five Wistar rats were divided into control and experimental groups.Corneal neovascularization (CNV) was induced by alkaline burn of the cornea with 1 mmol/L NaOH.On the 1st,4th,7th,and 14th day,CNV was observed,and the expression of CTGF was investigated with immunohistochemical method in rat cornea at the different time point.Results On the 4th day,7th day and 14th day after alkaline burn,the areas of CNV were (12.740 ±2.536) mm2,(26.068 ± 10.028) mm2,and (37.588 ± 8.066) mm2,respectively.CTGF was rarely expressed in the cornea of normal rats,and then CTFG expression was quickly increased after alkaline burn,reached the highest level on the 4th day (1.714 ± 0.185),and then declined remarkably on the 7th day (1.334 ± 0.198).Conclusions CTGF might be involved in the formation process of corneal neovascularization after corneal alkali burn.

Helicobacter pylori (Hp) has been confirmed to be associated with a variety of gastrointestinal tract and extra-gastrointestinal diseases. The eradication rate of classic triple therapy regimen was reduced gradually in recent years, and it was shown that antibiotic resistance and irregular treatment were the main causes of the failure of eradication. The choice of treatment should be based on the local antibiotic resistance situation, if necessary, individual sensitivity tests should be considered. At the same time, the in-depth study on mechanisms of drug resistance is helpful to decrease the eradication failure and reduce the drug resistance. This article reviewed the advances in study on antibiotic resistance of Hp.

A 44-year-old male presented with a neoplasm on the buccal side of the right nasolabial fold for more than two months.Dermatological examination showed a hemispherical bulge sized 1.5 cm × 1.5 cm with central crater-like ulceration on the buccal side of the right nasolabial fold,as well as a crescent-shaped elevation measuring 1.5 cm × 2.5 cm above the hemispherical lesion.Histopathology of the hemispherical lesion revealed irregularly downward proliferation of epidermis,crater-like holes filled with eosinophilic keratinous plug in the center which were surrounded by collar-shaped epithelial cell projections.Small neutrophil abscesses were found in the clumps of epithelial cells,and massive lymphocyte infiltration with a clear bottom boundary was observed around the proliferating epithelial cells.Histopathologic examination of the crescent lesion showed multiple irregularly-shaped lobular-like structures of various sizes with sebaceous glands at different degrees of maturity in the mid dermis,which were surrounded by proliferating connective tissue.Immunohistochemical studies showed that the squamous cells stained positive for cytokeratin (CK),CK5,CK14,CK17,carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) in the keratoacanthoma,and the sebaceous cells for CK,CK5,CK14 and EMA in the sebaceous adenoma.The pathological diagnosis was keratoacanthoma and sebaceous adenoma.The patient was diagnosed with moderately and poorly differentiated rectal adenocarcinoma in 2008.A diagnosis of Muir-Torre syndrome presenting as keratoacanthoma and sebaceous adenoma was finally made.