New oral anticoagulants,including direct thrombin inhibitors and factor Xa inhibitors.They have overcome several shortcomings of warfarin.The efficacy of preventing stroke and systemic embolism is superior to or not inferior to warfarin in patients with non-valvular atrial fibrilhtion,and they can decrease the risk of bleeding (especially intracranial hemorrhage).However,no agent can efficiently reverse its anticoagulant effect now.This article reviews the pharmacological characteristics,clinical efficacy,complications,and its management of the commonly used new oral anticoagulants at present.

Objective To evaluate the effects of volume resuscitation with different fluids on expression of aquaporin 1 (AQP-1) in pulmonary capillary endothelial cells of endotoxemic rats.Methods Fifty pathogen-free male Sprague-Dawley,rats,weighing 250-300 g,aged 6-8 weeks,were randomly divided into 4 groups (n =10 each):control group (group C),lipopolysaccharide group (group LPS),NaCl group (group NS),6％ hydroxyethyl starch 130/0.4 group (group HES) and hypertonic hydroxyethyl starch 40 group (group HSH).Sepsis was induced with LPS 5 mg/kg injected via the femoral vein.At l0 min after the model was successfully established,the corresponding fluids were infused into the femoral vein at a constant speed (15 ml/kg over 6 h) via a pump.At 0,3 and 6 h after LPS administration,blood samples were collected from the femoral artery for measurement of serum tumor necrosis factor-α (TNF-α) concentrations and for blood gas analysis.PaO2 and lactate (Lac) concentrations were recorded and oxygenation index (PaO2/FiO2) was calculated.The rats were sacrificed at 6 h after LPS administration,and lungs were removed for determination of AQP-1 expression in pulmonary capillary endothelial cells and wet-to-dry lung weight ratio (W/D ratio),and for microscopic examination of the pathological changes which were scored.Results Compared with group C,W/D ratio,serum TNF-α and Lac concentrations,and pathological scores were significantly increased,AQP-1 expression was down-regulated,and PaO2 and oxygenation index were decreased in LPS,NS,HES and HSH groups.Compared with group LPS,W/D ratio,serum TNF-a and Lac concentrations,and pathological scores were significantly decreased,AQP-1 expression was up-regulated,and PaO2 and oxygenation index were increased in NS,HES and HSH groups.Compared with group NS,W/D ratio,serum TNF-α and Lac concentrations,and pathological scores were significantly decreased,AQP-1 expression was up-regulated,and PaO2 and oxygenation index were increased in HES and HSH groups.Compared with group HES,the blood Lac concentrations were significantly decreased,and no significant changes were found in the other parameters in group HSH.Conclusion Volume resuscitation with NaC1,hydroxyethyl starch 130/0.4 and hypertonic hydroxyethyl starch 40 can reduce the lung injury effectively in endotoxemic rats,and hypertonic hydroxyethyl starch 40 provides more significant efficacy,and up-regulated AQP-1 expression in pulmonary capillary endothelial cells is involved in the mechanism.

Objective To investigate the feasibility of laparoscopic splenectomy(LS).Methods Laparoscopic splenectomy was performed in 32 cases from June 1999 to December 2005 in this hospital.The splenic ligaments were disconnected using a harmonic scalpel and the pedicle of spleen was cut using the Endo-GIA system.After the spleen was mobilized,it was placed into an extraction bag,broken into small pieces,and removed from the extraction incision.Results The operation was successfully completed in 29 cases.The operation time was 60~270 min(mean,100 min),the amount of intraoperative blood loss was 30~1 000 ml(mean,230 ml),and the length of postoperative hospital stay,3~7 d(mean,5 d).No postoperative complications occurred.Conversions to open surgery were needed in 3 cases because of hemorrhage of the splenic pedicle,hemorrhage of the short gastric vessels,and extensive adhesion,respectively.Of the 22 cases of idiopathic thrombocytopenic purpura(ITP),the platelet count recovered to normal levels in 18 cases and kept unchanged in 4 cases.Of the 2 cases of hemolytic anemia,the hemoglobin levels were elevated after operation.Of the 4 cases of hypersplenism accompanying posthepatitic cirrhosis,the platelet count recovered to normal levels.Conclusions Laparoscopic splenectomy is a safe and feasible,especially for patients with hematologic diseases.

Objective To investigate the effect of miR-141 up-regulation through miR-141 mimic transfection on proliferation,apoptosis and cell cycle of hepatocellular carcinoma (HCC) cells.Methods Real-time polymerase chain reaction (qPCR) was employed to detect differential expression of miR-141 in normal hepatic epithelial cells (L02) and hepatocellular carcinoma cells (HepG2).Furthermore,miR-141 mimics were used to transfect into HepG2 to up-regulate the expression of niR-141 (experimental group).Blank group (CON) and negative control group (miR-NC) were used as control group.qPCR was used to detect expression of miR-141.CCK8 assay was used to detect the proliferation of HepG2 cells.Flow cytometry was used to detect the apoptosis and cell cycle of HepG2 cells.Results The results of qPCR showed that miR-141 was significantly down-regulated in HepG2 cells (0.64 ± 0.13) compared to L02 cells (1.00 ± 0.18),and the difference was significant (P ＜ 0.05).Relative expression of miR-141 was significantly increased after transfection (3.33 ± 0.66),compared to CON group (1.00 ± 0.17,P ＜ 0.05) and miR-NC group (1.08 ±0.14,P ＜0.05).CCK8 assay showed that the absorbance values of HepG2 of miR141 group at 48,72,96 h (0.67 ± 0.07,1.17 ± 0.05,1.36 ± 0.03) were all decreased significantly compared with those in CON group (0.81 ±0.02;1.42±0.03;1.73 ±0.05,all P＜0.05) and miR-NC group (0.78 ±0.01;1.38 ±0.02;1.69 ±0.01,all P ＜0.05).The results showed that miR-141 group [(11.81 ± 0.23)％] had significantly increased apoptosis rate compared to CON group [(4.18 ± 0.18) ％] and miR-NC group [(4.04 ± 0.08) ％],and the difference was statistically significant (P ＜ 0.05).miR-141 group had decreased percentage of S phase cells [(19.89 ± 2.78) ％] compared to CON group [(31.87 ± 1.00) ％,P ＜ 0.05] and miR-NC group [(30.49 ± 1.73) ％,P ＜ 0.05],while miR-141 group had significantly increased percentage of G1 phase cells [(74.74 ±2.03)％] compared to CON group (60.85 ± 1.69) ％ and miR-NC group (60.93 ± 1.95) ％,and the differences were all statistically significant (all P ＜ 0.05).Conclusions miR-141 was in low expression in HepG2 cells.Upregulation of miR-141 could specifically inhibit proliferation and promote apoptosis of HepG2 and change the distribution of cell cycle.

Objective To observe the inhibition effect of recombinant human monocyte chemoattractant protein－ 1(MCP－ 1) on implantation and growth of human osteosarcoma cells. Methods The method of protein fusion was used for the expression of MCP－ 1 in b.coli and then the MCP－ 1 was extracted and purified. Fifty nude mice were divided into 10 groups. For A1－ 4 groups, the 5 mice in each group were locally injected with doses of 1? g, 10? g, 100? g, 1 mg of MCP－ 1 at the same time when 4.4? 106 osteosarcoma cells were implanted in vivo. For B0－ 4 groups, 5 mice in each group, the injection were given 2 weeks later when there was the formation of the tumor mass at doses of 0? g(0.2 ml normal saline), 1? g, 10? g, 100? g, 1 mg of MCP－ 1 every other day. Five mice in group C were injected with dose of 0.2 ml NS as control. Results Implantation of osteosarcoma cells were completely prevented among mice of group A2－ 4, tumor inhibiting effect even in group A1 and the rate of tumor inhibition was 69.69％ . AKP values in mice of group A1－ 4 were much lower than those of group B0(P

ObjectiveTo compare the results of Verme ul en calculation and the enzyme immunoassay in the determination of serum free tes tosterone (FT)concentration in aging males.Methods129 healthy males over 45 years of age who have no disease or medicine that can infl uence the secretion of hormone were enrolled in the study. They were divided int o 4 age groups. The serum specimens were prepared and kept under -40 ℃ until as saying. All the samples were divided into two parts, one measured by enzyme immu noassay and the other calculated with the Vermeulen formula after determining th e total testosterone(T)and sex-hormone-binding globulin(SHBG):FT=T- 23.43FTSHBG-(T-23.43FT)?10 -9 mol/L.The data were analyzed by S PSS.ResultsThe results of FT in the 129 males were (46 .69?21.79)pmol/L by enzyme immunoassay and (396.30?317.04)pmol/L by calculatio n.Pairing test suggested that " t " was 13.01 and the difference of FT w as remarkably significant ( P

IHC-65 was found to be a potent inhibitor of platelet function . It inhibited platelet aggregation induced by threshold concentration of ADP, arachidonic acid and collagen with dose-dependent manner in vitro, and at 96?mol/L, AIR ( aggregation inhibition rate,) were 71.56, 66.93 and 68.47% respectively. IHC-65 inhibited platelet serotonin release induced by collagen,and at 96 ?mol/L, release inhibition rate was 82.97%. IHC-65 did not influence cAMP level in platelet significantly. It is concluded that IHC-65 inhibited platelet aggregation and its action mechanism may be related to inhibition of serotonin release and to antagonizing Ca ++ .

0.05).In the ineffective group,CCI was 32.2%,in which positive LCT was 57.9%.In the effective group,CCI was 67.8%,in which positive LCT was 12.5%,and there was significant difference in LCT positive rate between the ineffective and effective groups (? 2=13.43,P

0.05).Expression of Stat3 mRNA in human gastric cancer was significantly higher than that in their adjacent noncancerous tissues(P

Objective Boy sexual development is affected not only by age, but also by environment factors .The present study was to survey and evaluate the status of sexual development in boys from Zhengzhou area and to explore their influencing factors. Methods The height, weight, waist circumference, hip circumference, penis and testicles in 3779 boys aged from 6 to 13 years old in Zhengzhou were measured .The penis length and testicular volume of different ages and their influencing factors were compared, and the beginning age and sexual development characteristics were explored .The development of genitalia and pubes were evaluated by Tanner staging criteria and standards, which were divided into five stages. Results There were 3779 boys, including 395 overweight cases (10.45%) and 208 obesity cases (5.50%).The testicular volume and penis length increased by age, which increased slowly at the age of 6 to 11, followed by a rapid increase after the age of 11 year old.Testicular volume increased more rapidly than that of penis length. The medians quartile of testicular volume in overweight group ,obese group and normal group were 2.50 mL, 2.50 mL, 2.00 mL, 2.00 mL,2.00 mL,1.00 mL respectively .The testicular volume in overweight group and obese group were significantly greater than that in nor -mal group (P<0.01) and there were no difference between overweight group and obese group .The penis length in overweight group and obese group were significantly less than that in normal group (P<0.01), and there was no difference between overweight group and obese group.Testicular volume and penis length were positively correlated with age, height, weight, body mass index, waist circumference and hip circumference; the correlation between testicular volume and height, penis length and age were the strongest. The age of development of testicle (average 12.02 years) in urban area was later by 2.73 years than that in the rural area (average 9.9 years), the difference was statistically significant (P<0.001).The age of pubic development (P2) and maturity (P5) was (12.34 ±0.83) years and (12.39 ±1.24 ) years.The incidence of precocity in boys was 0.40%. Conclusion The sexual development of boys from Zheng-zhou area is similar to the results of large scale survey from China .Attention should be paid to the effect of obesity on sexual develop-ment, and early intervention should be given, the occurrence of adverse events of sexual development can be avoided .