Aspirin is a primary and secondary preventive medication for ischemic cerebrovascular diseases .Artery thrombotic events are still possible to occur after taking aspirin for a long time,and this indicates aspirin resistance(AR).At present, there is still lack of gold standard for the diagnosis of AR. It is usually interpreted as the loss of the biological effect of aspirin's antiplatelet aggregation and the role of preventing cerebral thrombosis events. Once AR occurs, other safe and effective altematives to antiplatelet agents should he used timely. This article reviews the concept, epidemiology, mechanisms, laboratory methods for detection and clinical intervention of AR.

Objective To observe the ultrastructural changes in the midgut epithelium of Ixodes sinensis after infesting rabbits immunized with {Mr 105 000} purified tick antigen. MethodsNew Zealand rabbits were inoculated with {Mr 105 000} purified antigen by means of mutiple intradermal injection in foot pad, groin and back. Each immunized rabbit was infested by 30 female Ixodes sinensis. At 24 hours, 48 hours, 72 hours, 5 days and 8 days after infestation, three Ixodes sinensis in each group were observed for ultrastructural changes in the epithelium of their midgut. Results Histological examinations showed that with the time going, digestive cells of the ticks after infesting hosts became more and larger with dense and regularly arranged microvilli, enriched organella, distinct unit_membrane structure, and the appearance of tubli, small vacuole, numerous lipid droplets and hematin granules. These cells also developed a highly infolded basal lamina, forming a labyrinth system. The digestive cells of immunized group were however greatly damaged, whose number and volume were significantly different from control groups. From 24 to 48 hours after infestation, the midgut epithelium of Ixodes sinensis showed pathological changes with the basal lamina becoming thinner, looser and broken; digestive cells damaged and vacuolated; microvilli decreased, shortened and irregularly arranged; the mitochondria swollen and its crests reduced, shortened and even with myeloid changes; the rough endoplasmic reticulum dilated; lipid droplets and hematin granules decreased; phagocytic and pinocytic activity weakened; and basal labyrinth system vacuolated. From 72 hours to 8 days after infestation, cells were severely damaged, organella were denatured and necrotic, nuclei showed pyknosis and cells lysed. Conclusion The rabbits immunized with {Mr 105 000} purified ixodic protein have acquired the adoptive immunity against Ixodes sinensis; in the anti_tick immunity described above, the midgut of Ixodes sinensis is the major affected site.

Objective To investigate the awareness rate of health knowledge,health behavior formation rate and psychological state before and after retirement intervention,analyse comprehensive psychological intervention and general psychological intervention to health behavior formation and improve the negative emotion in retired population.Methods By using cohort study method,206 retired people were randomly divided into comprehensive psychological intervention group (experimental group) and only given general psychological intervention group (control group),and each group included 103 cases.Comprehensive psychological intervention group were given health behavior and cognitive intervention,psychological intervention,psychological intervention in general family and social family care intervention,and the control group was given healthy behavior and cognitive intervention,psychological intervention.The staff were treated within 1 weeks of first assessment,2 weeks after the second assessment,4 weeks after the final.Health behavior was surveyed by Ministry of finance,the Ministry of health on public health subsidies special funds notice in city community health education pilot project in the questionnaire.Health status and quality of life were assessed with the family APGAR index (APGAR).Mental state evaluation and assessment of the treatment effect by using Hamilton Depression Scale (HAMD),MBI index method was assessed with activities of daily living.The effect of the two groups were compared before and after the intervention of health knowledge rate and formation rate of different intervention methods and psychological state of health behavior.Results The results showed that there were no significant differences between experimental group and control group in age,sex,level of education and other social,and there was no significant difference in HAMD,MBI and APGAR scores at baseline.Through the implementation of the comprehensive of psychological intervention,subjects have varying degrees of improving the awareness rate of health knowledge,and the intervention group was significantly higher than the control group (P ＜ 0.05).The two group of healthy behavior of subjects in the chopping board monitoring,physical fitness,blood pressure to separate raw and cooked on such projects had different degrees of improvement,at the same time,although no intervention,in the monitoring of blood pressure.The control group increased compared with the baseline significantly (P＜ 0.05).Intervention group had significant difference in APGAR score increased (P＜ 0.05).HAMD score and MBI score decreased and the differences were statistically significant (P＜ 0.01),while the control group had no significant difference before and after intervention.Conclusion Comprehensive psychological intervention can significantly improve the rate of formation from the awareness rate of health knowledge and health behavior of retirees,and improve the state of negative emotions from retiree.

Objective　To study the preventive effect of hepatic metastasis from colorectal cancer and the immune function influence on postoperative patients with colorectal cancer treated by TIL, rIL-2 and cyclophosphamide by portal vein infusion. Methods　One hundred and twenty-four patients with advanced colorectal cancer (Dukes B and Dukes C stage) were randomly divided into immunotherapy group and control group. The control group were treated with 5-Fu and MMC by intravenous injection after resection of colorectal cancer. The immunotherapy group were treated with TIL, rIL-2 and cyclophosphamide by portal vein infusion after resection of the tumor, then with chemotherapy as the control group. All cases were followed-up for 3 years. Results　Eight cases (12.3%) had hepatic metastases from colorectal cancer in the immunotherapy group, but nineteen cases (33.2%) in the control group. There was significant difference between the two groups (P>0.05). The NK, IL-2 activity and CD3, CD4, CD4/CD8 levels in peripheral blood of the immunotherapy group increased significantly after treatment (P<0.05). Conclusions　The TIL, rIL-2 and cyclophosphamide treatment after resection of colorectal cancer is effective in improving antitumorgenic immune function, and preventing hepatic metastases.

Objective To study the therapeutic effect on murine allergic asthma with recombinant Bla g 2(rBla g 2) allergen and its possible mechanism.Methods Eighteen BALB/C mice were randomly divided into three groups:normal control group(group A) , asthma model group(group B) , and recombinant protein rBlag2 treatment group(group C).Mice in groups B and C were subcutaneously immunized weekly with rBla g 2(50 mg) formulated in Al(OH)3 adjuvant for three weeks.Group A received only adjuvant emulsified with normal saline.Two weeks after the last inoculation, mice in group C were administered each with rBla g 2(100 mg) /dose, and groups A and B were given PBS.All the mice received eight doses at 2-day intervals.One week after the last immunotherapy, mice in groups B and C were intranasally challenged with 50 mg rBla g 2 daily for seven days, while mice in group A received PBS.Twenty-four hours after the challenge, the following items were examined:airway hyperresponsiveness of mice, total cellular score and cell classification in bronchoalveolar lavage fluid(BALF) , level of rBla g 2-specific IgE and IgG2a in serum, lung inflammation by HE stain, and Bcl-2 expression of eosinophils of lung by immunohistochemistry.Results Compared with group B, group C showed a decreased Penh value of airway hyperresponsiveness(P

Objective To investigate the effect of arsenic trioxide(As2O3) on the biology characteristics of multiple myeloma RPMI8226 cells in vitro and the molecular mechanism.Methods Multiple myeloma RPMI8226 cells were used for experiments target,cell cycle,apoptotic peak,and adhesion molecular VLA4(CD49d) were determinded by flow cytometry.Expression of CXCR4gene was examined by RT-PCR.Expression of death receptor DR4 and DR5 were measured by immunofluorescence microscopy and flow cytometry.Results Five ?mol/L As2O3 upregulated DR4 and DR5 expression on RPMI8226 cells markedly(P

Objective To investigate the effect of multidisciplinary physician/nurse collaboration care mode in diagnosis and treatment of elderly patients with intertrochanteric fracture.Methods Clinical data of 433 elderly patients with intertrochanteric fracture treated from August 2011 to September 2013 were studied retrospectively.Among them,136 were diagnosed and treated using conventional methods (control group) and 297 using the multidisciplinary physician/nurse collaboration approach (collaboration group).Hospital stay,surgery rate,time from hospitalization and operation,and complications were compared between the two groups.Results Length of hospital stay [(14.8 ± 5.9) d] in collaboration group was not statistically different from that in control group [(16.0 ± 4.7) d,t =0.433,P ＞ 0.05],but surgery rate was improved (72.8％ vs 83.9％,x2 =7.212,P ＜ 0.05),time from hospitalization and operation shortened [(5.6 ± 2.9) d vs (6.9 ± 3.4) d,t =3.096,P ＜ 0.05],and perioperative complication rate reduced in collaboration group compared to control group (all P ＜ 0.05).Conclusion Multidisciplinary physician/nurse collaboration mode is a novel method for diagnosis and treatment of intertrochanteric fracture in the elderly and is associated with improved surgery rate,reduced perioperative complications and early functional recovery.

Objective To evaluate the clinical effectiveness of double balloon dilation in percutaneous kyphonplasty on curing vertebral?compression fractures. Methods From January 2009 to September 2013, 84 patients (94 vertebral bodies) with vertebral compression were treated by percutaneous kyphonplasty. All were fresh fractures and were injured or obvious low back pain 1 month, accompanied by local tenderness, kowtow attack painful, lumbar mobility, but no lower extremity injury numbness, activities and defecation disorders. After randomization, the double balloon dilation in percutaneous kyphonplasty method was used to treat 44 patients (49 vertebrae). In the process of performing percutaneous unilateral pedicle puncture and balloon dilata?tion of the vertebral body, the balloon has been moved some distance in the vertebral body. Then completed the perfusion of bone cement, vertebral body forming. 40 cases (45 vertebrae) were used conventional unilateral percutaneous kyphonplasty to vertebtal compression fractures. Recorded the operation time, amount of bleeding, bone?cement injection volume. Used visual analogue scale (VAS), the height of the vertebral body and Cobb angle to evaluated the curative effect. Results All 84 patients completed the operation, follow?up time was 22 months (18-24 months). In two mobile open expansion group, the operation time was about 48 min. The amount of bleeding was 8-15 ml. The average bone?cement injection volume was 5.1 ml. No patients quit the study and no bone cement?leakage cases or other side effects were observed , and no clinical accidents occurred. In a single stretching group, 40 cases (45 vertebrae) completed conventional vertebroplasty, the time of 44 min, bone cement average injection rate 3.2 ml, bleeding 10-15 ml. In two mobile open expansion group, the VAS score was 8.5 points, the height of the vertebral body height was 2.1cm, and the Cobb angle was 34°. After operation, the VAS score 2.9 points, the height of the vertebral body 2.8 cm, and Cobb 20° . In the other group, the pain was significantly relieved and the relief was satisfactor after operation.Vertebral height of 2 cm turned to the last follow?up of 2.4 cm. The Cobb angle was 32°, and the last follow?up was 27°. The VAS score, operation time and bleeding volume of the two groups were not statistically significant, and a statistically significant difference of the average bone ce?ment injection volume, postoperative vertebral height and cobb angle improved with statistical significance. A single open group were 2 cases of bone cement leakage and leakage, 1 cases of bone cement tail, the complication rate was 5.6%. Conclusion The application of double balloon dilation in percutaneous kyphonplasty to vertebral?compression fractures improve relocation of verte?bral compression fractures, increase recovery of vertebral height, and more effectively strengthen and stiffen pathological vertebral bodies, while improving kyphosis. Moreover, it can reduce pressure during bone?cement injections, minimizing the chance of over?flow and leakage, as well as the related side effects, but it will also result in an increase of bone cement?injection volume.

Objective To explore the clinical efficacy and indications of kyphoplasty with movement and secondary en?largement of balloon for the compression fracture of vertebral body with ruptured posterior wall. Methods A retrospective analy?sis was carried out on the data of 29 patients (10 males, 19 females;age range:55-86 years old;mean age:71 years old;29 verte?bral bodies in total) who suffered from compression fracture of the thoracolumbar spine and below, and underwent kyphoplasty through the movement and secondary enlargement of balloon within the vertebral body and were followed up from January 2011 to November 2014. These patients had backache, accompanied by lowered support, limitation of movement, no symptom of nervous lesion on both lower extremities and no past history of balloon kyphoplasty. All fractured vertebral bodies were at T 11 or below, in?cluding 1 case at T11, 4 cases T12, 11 cases L1, 9 cases L2 and 4 cases L3. The causes of injury included fall (19 cases), car accident (8 cases) and unknown reasons (2 cases). All patients underwent kyphoplasty with the movement and secondary enlargement of bal?loon within the vertebral body. Photos were taken immediately after the surgery, at 1 month, 3 months, 6 months and 12 months, and these patients were assessed and analyzed in terms of vertebral height, Cobb angle, visual analogue score (VAS) and Oswestry disability index (ODI). Results The operation time (including the formation and solidification of bone cement) of 29 patients was 40 to 65 min and the mean time was 55 ± 7 min;the blood loss during operation was 2 to 15 ml and the mean blood loss was 5 ± 2 ml;the injected volume of bone cement was 2.5-7.5 ml and the mean volume was 5.5±0.5 ml. Post?operative pain was relieved and ambulation was performed under the protection of lumbar orthosis brace. Statstical analysis was conducted on VAS, ODI, vertebral height and Cobb angle before operation and at 1 month, 3 months, 6 months and 12 months after operation, showing statistically significant differences. X ray examination found that there was no alternation or displacement of bone cement location, and no change in vertebral morphology, the vertebral height and cobb angle remained the post?operative status, and posterior wall rupture of the vertebral body was recovered well. CT revealed that the morphology of bone cement was irregular and closely integrated with bone substance, and no cavity or fissure was seen. Conclusion Kyphoplasty with movement and secondary enlargement of bal?loon within the vertebral body has a good, definite clinical efficacy in treating compression vertebral fracture with incomplete pos?terior wall of the vertebral body without obvious displacement of fractured bone and symptom of nervous lesion on both lower ex?tremities. This surgery is easy to operate, and has an immediate analgesic effect, which could recover vertebral height as well as re?duce kyphosis deformity and improve patient’s prognosis.

OBJECTIVETo determine the prevalence of mutations in the non-structural protein 5B (NS5B) of the hepatitis C virus (HCV),which are associated with natural resistance to non-nucleoside and nucleoside polymerase inhibitors (PIs),in treatment-naive hepatitis C patients in south China.

METHODSA nested PCR protocol that amplified three different regions of NS5B was used to detect the naturally occurring drag-resistant substitutions.Direct PCR sequencing was performed to analyze the sequences.

RESULTSNS5B mutations known to confer resistance to nucleoside PIs,such as A15G,S96T and S282T,were mainly detected in HCV genotype 6a (20/88,22.73%).Of the NS5B mutations known to confer resistance to non-nucleoside PIs,C316N and S365A were detected in HCV genotype lb (60/60,100% and 2/60,3.33%, respectively) and I482L and V499A were mainly detected in HCV genotype 2a (9/9,100% and 4/4,100%, respectively) and HCV genotype 6a (9/9,100% and 4/4,100%, respectively).Other NS5B mutations found in the study population included A1 5S,S365F,S365P,S368A and S368L;although none of these has been previously shown to confer resistance to PIs.

CONCLUSIONNaturally occurring dominant PI resistance mutations in NS5B exist in treatment-na(i)ve hepatitis C patients in south China and may be related to the virus genotype.

Antiviral Agents ; pharmacology ; China ; Drug Resistance, Viral ; Genotype ; Hepacivirus ; drug effects ; genetics ; Hepatitis C ; drug therapy ; virology ; Humans ; Mutation ; Viral Nonstructural Proteins ; genetics