Objective: To investigate the impact of clopidogrel or aspirin resistance on major adverse cardiovascular events (MACE) in elderly patients with acute coronary syndrome (ACS) and to explore the application value of thromboelastogram (TEG) in antiplatelet therapy. Methods: A total of 177 ACS patients admitted in our hospital from 2012-09 to 2014-12 were enrolled. The patients were at the mean age of (70.4±10.7) years, all of them received TEG and coagulation function test. Based on the reaction of antiplatelet therapy, they were divided into 2 groups: Non-resistance group,n=98 and Resistance group,n=70, which was further divided into 2 subgroups as Maintenance dose subgroup,n=39 and Increased dose subgroup,n=40. The patients were followed-up for 3 months to observe MACE occurrence including cardiovascular death, angina recurrence, ischemic stroke, myocardial infarction, acute thrombosis and hemorrhage. Results: In Resistance group, there were 50/79 (63.3%) patients with aspirin resistance and 29 (36.7%) with clopidogrel resistance. Compared with Non-resistance group, Resistance group showed decreased coagulation time, clot formation time, TEG reducing rate after 30 minutes maximum amplitude (LY30), activated partial thrombin time (APTT), thrombin time (TT) and international normalized ratio (INR), allP<0.05; while increased levels angle, maximum amplitude of TEG, coagulationindex, ifbrinogen and D-dimer, allP<0.05. Compared with Non-resistance group, Resistance group had the higher MACE rate 21.5% vs 7.1%,P<0.05; in addition, Increased dose subgroup had the lower MACE rate than Maintenance dose subgroup 17.5 vs 25.6%,P<0.05. Conclusion: Clopidogrel or aspirin resistance had the higher incidence of MACE in elder ACS patients; TEG was helpful for guiding antiplatelet therapy and reducing MACE incidence.

OBJECTIVE:To establish HPLC fingerprint sectrum of Rhaponticum uniflorum. METHODS:HPLC was performed on the column of Hypersil-ODS with mobile phase of 0.3% phosphoric acid-acetonitrile(gradient elution) at flow rate of 1.0 ml/min,detection wavelength was 220 nm,column temperature was 30 ℃ and volume injection was 10 μl. The luteolin was refer-ence,17 batches of R. uniflorum from different production places was analyzed and similarity evaluation system for chromatograph-ic fingerprint of TCM (2004 A edition)was adopted for the similarity analysis. RESULTS:There were totally 11 common peaks with similarity degree≥0.900 of 17 batches. According to the verification,the fingerprint spectrum and reference fingerprint spec-trum of R. uniflorum had good consistency. CONCLUSIONS:The established method is specific and stable,and can provide refer-ence for the identification and quality control of R. uniflorum.

OBJECTIVE:To establish a method for simultaneous determination of luteolin and apigenin in Mongolian medicine Scabiosa atropurea. METHODS:HPLC was performed on the column of Diamond C18 with mobile phase of acetonitrile-0.4%phos-phoric acid(34∶66,V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 350 nm,column temperature was 30 ℃,and the injection volume was 10 μl. RESULTS:The linear range was 66-396 ng for luteolin(r=0.999 8)and 93-558 ng for apigenin (r=0.999 6);RSDs of precision,stability and reproducibility tests were lower than 2%;recoveries were 98.15%-101.79%(RSD=1.42%,n=6) and 98.66%-104.05%(RSD=1.81%,n=6),respectively. CONCLUSIONS:The method is simple with good precise,stability and reproducibility,and can be used for the simultaneous determination of luteolin and apigenin in Mongo-lian medicine S. atropurea.

Objective To examine the role of SPHK-1/S1P and NFκB p65 signal pathway in non-small cell lung cancer (NSCLC)drug-resistant cells.Methods The drug-resistant cell line of lung cancer H460/DDP was constructed and its biological characteristics were identified successfully.The expression of SPHK-l was tested by RT-PCR and Western blot methods.S1 P and some proteins related to NFκB pathway were studied by Western blot. Results The drug-resistant lung cancer cell line H460/DDP was constructed and its drug-resistant ability was evaluated (IC50H460/DDP = 50.62μg/mL, RIH460/DDP = 2.95 ). Cisplatin at a concentration of 10 - 80 μg/mL significantly decreased cell death of drug-resistant cell line (P<0 .01 ).Western blot assay analysis showed that overexpressions of SPHK-l,S1 P and NFκB p65 were significantly higher in drug-resistant cell line than in their parent cell line H460 (P=0.0415,P=0.0465,P=0.0218).RT-PCR method revealed that SPHK-1 mRNA was overexpressed in drug-resistant cell line compared with that in their parent cell line H460 (P<0.05).More NFκB p65 protein in cell nucleus was expressed in drug-resistant cells than in parent cells.Conclusion SPHK-1/S1P and NFκB p65 signal pathway may play an improtant role in the drug-resistant H460 cell line in non-small cell lung cancer.

OBJECTIVE:To establish the quality standard for Mongolian medicine Yishen powder. METHODS:TLC was used for the qualitative identification of Rheum palmatum and Terminalia chebula in the preparation;HPLC was used for the contents de-termination of aloe emodin,rhein,emodin,chrysophanol and physcion:the column was Inertsil C18 with mobile phase of metha-nol-0.1% phosphoric acid(gradient elution)at a flow rate of 1.0 mL/min,detection wavelength was 254 nm,column temperature was 35 ℃ and the injection volume was 10 μL. RESULTS:The TLC pots of R. palmatum and T. chebula were clear and well-sepa-rated,negative control without interference. The linear range was 23.55-117.75 ng for aloe emodin(r=0.9999),44.72-223.62 ng for rhein(r=0.9998),43.18-215.90 ng for emodin(r=0.9997),77.41-387.12 ng for chrysophanol(r=0.9999)and 46.02-230.10 ng for physcion (r=0.9997);RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 95.80%-99.66%(RSD=1.21%,n=6),95.01%-98.07%(RSD=0.92%,n=6),95.06%-97.84%(RSD=0.5%,n=6),95.19%-97.66%(RSD=1.07%,n=6)and 95.07%-98.20%(RSD=0.95%,n=6). CONCLUSIONS:The established standard can be used for the quality control of Mongolian medicine Yishen powder.

Objective To evaluate the prophylactic effect of abdominal breathing exercises on radiation pneumonitis in patients with chest malignant tumors.Methods 100 patients with chest malignant tumors were given radiotherapy and divided with random digit table into the exercise group and the control group with 50 patients in each group.The incidence rate of radiation pneumonitis in both groups was compared.The prophylactic effect of abdominal breathing exercises on radiation pneumonitis was evaluated.Results The incidence of radiation pneumonitis in abdominal breathing exercise group was significantly reduced [34％ (17/50) vs.56％ (28/50),Z=2.397,P＜0.05],the incidences of grade Ⅰ [22％ (11/50) vs.30％ (15/50)] and grade Ⅱ [12％ (6/50) vs.18％ (9/50)] radiation pneumonitis decreased,and no grade Ⅲ and Ⅳ radiation pneumonitis occurred.Conclusions The incidence of radiation pneumonitis in patients with chest malignant tumors treated with radiation therapy may be decreased by abdominal breathing exercises,which may be widely applied in patients treated with radiation therapy.

Objective:To investigate the influence of different salt concentration on the renal fibrosis and macrophages infiltration in salt sensitive hypertension.Methods:Dahl salt sensitive rats were randomly divided into the normal salt (0.3 ％ nacl) group,4 ％ high salt,8 ％ high salt groups at six weeks continuously feeding for 8 weeks,each group contained 15 rats.Tail-cuffmethod was used to value rat blood pressure at 8 weeks,Masson trichromatic method was used to detect renal fibrosis of the three groups at 8 week.Immunohistochemistry and Western blot method were used to depict the renal macrophage infiltration at 8 week.Results:1) The blood pressure of 4 ％ salt and 8％ high salt group rats were significantly higher than those of the normal salt group at 8week,meanwhile the blood pressure of 8 ％ high salt was further increased than that of 4 ％ high salt group at 8 week.2) The relative kidney weight and renal fibrosis of 4 ％ salt and 8 ％ high salt group rats were obviously higher than that of normal salt group at 8week,meanwhile the relative kidney weight and renal fibrosis of 8 ％ high salt were further increased than those of 4 ％ high salt group at 8 week.3) The macrophage infiltration of 4 ％ salt and 8％ high salt group rats were higher than that of the normal salt group at 8week,meanwhile the macrophage infiltration of 8 ％ high salt was further increased than that of 4 ％ high salt group at 8 week.Conclusion:Different high salt concentrations had different effect on the renal fibrosis and macrophage infiltration in the salt sensitive hypertension,high salt concentration could exacerbate the renal fibrosis and macrophage infiltration.

Objective:To analyze and investigate the clinical efficacy on repairing soft tissue defects of the thumb distal with dorsal neurocutaneous vascular flap.Methods:Select 100 cases of patients with soft tissue defects of the thumb distal from January 2014 to December 2016,who were randomly divided into two groups,the control group and observation group.Take the abdominal skin flap to repair soft tissue defects of the thumb distal in the control group,with the thumb distal with dorsal neurocutaneous vascular flap in the observation group.The survival condition,the indicators of feelings,the appearance of skin flap,as well as the DASH score of the hand fimction have been recorded and analyzed through follow-up patients,to observe the effects on repairing soft tissue defects in the two groups.Results:All transplanted tisssues were all survived in the observation group and control group.Compared with control group,the sense of touch,temperature sense,monofilament,two-point discrimination,scar contracture of the observation group were better(P＜0.05),the incidence of bloat was lower (P＜0.05).The DASH scores were 29.56± 2.14,38.13± 3.12 in the observation group and control group,which was significantly lower in the observation group than that of the control group(P＜0.05).Conclusion:The clinical efficacy of the dorsal neurocutaneous vascular flap is better than that of abdominal skin flap on repairing soft tissue defects of the thumb distal.For no injury for major vascular nerves,little influence on donor area,being simple to operate,being better feelings of the finger pulp,appearance,dorsal neurocutaneous vascular flap on repairing soft tissue defects of the thumb distal is an ideal choice.

Objective To investigate the clinical effect of the treatment for hand trauma with free flap of radial artery superficial palmar branch.Methods Selected 100 cases of patients with hand trauma who were treated in our hospital from January 2013 to December 2015.All the patients were treated with free flap of radial artery superficial palmar branch.The postoperative necrosis rate,survival rate,and infection rate of flap of all the patients were observed.All the patients were followed up for 6 months,and the healing of fracture were evaluated by X-ray examination so as to evaluate the hand function recovery.Results After the treatment,there were 9 cases of flap local necrosis and 10 cases of local infection,and the necrosis rate and infection rate were 9% and 10% respectively.The infection was controlled effectively after the symptomatic treatment and the flaps all survived.The swelling degree of skin flap was slight and the appearance was good.After 6 months of follow-up, the 100 cases all get epithelization completely.The X-ray examination showed that the fracture healing is good,with 7 cases of hook nail deformity and 5 cases of slow nail regeneration.The hand function recovery was excellent in 73 cases (73%),good in 16 cases (16%),and medium in 10 cases (10%).Conclusion It is an effective treatment for hand trauma with free flap of radial artery superficial palmar branch,as it can receive high flap survival rate and good recovery of hand function.

ObjectiveTo summarize the experience on laparoscopic common bile duct exploration(LCDE). MethodsFrom Mar. 1992 to Mar. 2003, there were 693 cases undergoing LCDE. ResultsThe procedure was successful in 373 out of 391 cases with primary closure of duct incision and 272 out of 302 cases of T tube placement. Membrane stenosis dilation was successful in 68 out of 74 cases. Eleven out of 15 cases of malignant stenosis was successfully treated by biliary endoprosthesis and stent without bile leakage. Seven cases were shifted to open CBD exploration. Bile leakage was cured conservatively in 24 cases. Endoscopy failed to totally remove residual stones in 11 cases. Four cases died postoperatively. Conclusion LCDE was safe and effective in the hands of skilled endoscopists.