ObjectiveTo observe the effects of clopidogrel on inflammatory cytokines in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods68 cases diagnosed of CHD were randomly divided into clopidogrel 1 month group( group A), clopidogrel 6 months (roup B), every group had 34 cases. Before and after treatment adopt fasting blood respectively and in determination of serum interleukin-18 (IL-18)and C-reactive protein(hs-CRP). ResultsIL-18 and CRP were reduced more apparently in group B. Compared with group A,there were significant differences (P ＜ 0.05 ). ConclusionClopidogrel could significandy reduce coronary heart disease patients in which based on conventional treatment postoperative PCI inflammatory reaction, reduce the patients with coronary artery disease postoperative PCI vascular inflammatory reaction.

OBJECTIVE:To observe the influence of capecitabine combined with radiotherapy on postoperative survival rate, relapse rate and survival quality of elderly patients with rectal cancer at Ⅱ-Ⅲ stage. METHODS:110 patients with rectal cancer atⅡ-Ⅲ stage were selected and randomly divided into control group and observation group with 55 cases in each group. Both group received radical resection of rectal carcinoma. Control group was given three dimensional conformal radiation therapy(3DCRT)af-ter operation;observation group was additionally given capecitabine 1 500 mg/m2,d1-14,qd,on the basis of control group. A treatment course lasted for 21 d,and both groups received 2 courses of treatment and followed up for 3 years. The survival rate and metastasis and recurrence rate of 2 groups were compared as well as KPS score before and after treatment. Toxic reaction of 2 groups was also observed. RESULTS:The follow-up total survival rate and disease-free survival rate of observation group were 89.09%and 76.36%,which were significantly higher than 74.55%and 54.55%of control group;the distant metastasis rate and lo-cal recurrence rate were 12.73% and 5.45%,which were significantly lower than 30.91% and 21.82%,with statistical significance (P<0.05). KPS score of 2 groups were increased significantly,between 2 groups before and after treatment ,with statistical signifi-cance(P<0.05);Comparison between groups(P>0.05). There was no statistical significance in the incidence of nausea and vom-iting,diarrhea and urinary tract reaction between 2 groups (P>0.05);but the incidence of bone marrow arrest in observation group was significantly higher than control group(P<0.05). CONCLUSIONS:Capecitabine combined with 3DCRT can effectively improve postoperative distant survival rate of patients with rectal cancer at Ⅱ-Ⅲ stage,and reduce the metastasis and recurrence risk;do not lower life quality and induce serious adverse reactions.

Objective To investigate the myocardial protection effect of dexmedetomidine hydrochloride during off-pump coronary artery bypass graft surgery. Methods Forty patients undergoing off-pump coronary artery bypass grafting were randomly divided into two groups:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine hydrochlo-ride was given at a loading dose of 0. 5 μg?kg-1 to patients in group D, and then infused continuously at a rate of 0.5 μg?kg-1?h-1.The same amount of saline was given to patients in group C. After loading dosing,general anesthesia was per-formed with TCI technique.Trans-esophagus Doppler monitoring was conducted to monitor the blood volume and heart function, and close monitoring of fluid infusion to maintain stable circulation.Invasive blood pressure and heart rate were recorded every 5 min. Blood samples were taken for detection of cTnI,CK-MB,TNF-αand IL-6 contents at the following time points:after induction ( t0 ) ,before operation ( t1 ) ,after operation ( t2 ) ,12 h postoperation ( t3 ) and 24 h postoperation ( t4 ) . Results The blood pressure and heart rate decreased significantly at t0 and t1 in group D compared with group C,and there were no significant differ-ences in the two indexes at other time points between the two groups.Blood CK-MB,cTnI and inflammation factors TNF-α,IL-6 were much higher at t2,t3,t4 than at t0 and t1 in both groups(P<0.05).They were significantly decreased at t2,t3,t4 in group D relative to group C (P<0.05).Vessel active medicines were less given after the operation in group D (P<0.05). Conclusion Dexmedetomidine hydrochloride can mitigate the inflammation responses caused by off-pump coronary artery bypass grafting,re-duce the myocardial injury and improve the cardiac function of the patients.

Objectives To analyse the predisposing cause and clinical manifestasion of diabetic ketoacidosis (DKA) complicated with multiple organic failure (MOF),in order to diagnose early and management timely.Methods 537 diabetic patients admitted in our hospital from 1997 to 2000 were included in this cases retrospective study. 182 cases of them complicated with DKA or DKA complicated with MOF (58) were further analyzed by cause, clinical manifestation, number of organs in MOF and the prognosis. Results Analysis showed that the main cause of MOF in DKA patients was infection (84 5%). The higher incidence of MOF in older DKA patients than those of younger. The possible involved organs in MOF were kidney, heart and brain etc. Involving organs of MOF were much, the mortality was closely correlated with the number of involved organs. Conclusions The possible way to reduce the incidence of MOF in DKA patients is intensive preventing and treating infection. To avoid MOF occurring in DKA patients, complications of kidney, heart and brain should be timely diagnosed and managed.

Objective To investigate the short and long term effect of mifepristone on hysteromyoma.Methods The treatment group ( n=60 ) was given mifepristone and the control group ( n=60 ) vitamin C.The volume of hysteromyoma was measured using B-mode ultrasound prior to and at the end of treatment.L H,FSH,E2 progesterone ( P) ,liver function and blood creatinine were monitored each month.At the second year,3 0 cases from treatmentgroup were given mifepristone again for 3 months in the same way as the first course and with the same indexes monitored. Results Mifepristone had1 0 0 % effective rate with one-course curative rate of6.67% ,the hysteromyoma volume decreased by an average of at least 3 5.1 0 % ,while the volume gradually increased over 6months after discontinuing mifepristone with the recurrence rate of3 0 .0 0 % .At the second course of treatment hysteromyoma was further reduced by50 .2 0 % ,with the scope of reduction larger than thatatthe firstcourse( P

Objective To evaluate the effects of different dosage of aspirin and clopidogrel on the platelet inhibition rate by thromboelastography (TEG)before stent-assisted embolization of aneurysms. Methods The clinical data of 57 patients with unruptured aneurysms treated by stent-assisted coil embolization in General Hospital of Nanjing Military Command were analyzed retrospectively. The patients were divided into a low dose group (aspirin 100 mg + clopidogrel 75 mg,26 cases)and a high dose group (aspirin 300 mg +clopidogrel 75 mg,31 cases). All the patients were treated with aspirin and clopidogrel before surgery. The blood samples were collected on day 3 after oral administration with anti-platelet aggregation drugs. TEG was used to detect the arachidonic acid (AA )-induced inhibition rate of platelet aggregation and adenosine diphosphate (ADP)-induced inhibition rate of platelet aggregation. The platelet inhibition and drug resistance,as well as ischemic complications in the perioperative period between the two groups were compared. Results (1 )The platelet inhibition rates:there was no significant difference in the inhibition rates of platelet aggregation of AA and ADP between low dose group and high dose group at day 3 after oral antiplatelet drugs [AA inhibition rate:(76 ± 21)% vs. (80 ± 21)%;ADP inhibition rate:(72 ± 26)% vs. (73 ± 29 )%;all P >0. 05 ]. (2 )Drug resistance:in the low dose group,the patients of aspirin and clopidogrel resistant were 2 cases(7. 7%)and 1 case(3. 8%),and the patients in high dose group were 3 cases (9. 7%)and 4 cases(12. 9%). No statistical significant difference in the aspirin and clopidogrel resistant was detected in the two groups (all P>0. 05). (3)The ischemic complications in the perioperative period:there was 1 case (3. 8%)with ischemic complications in the low dose group,and 2 cases (6. 5%)in the high dose group. There was no significance difference in the incidence of ischemic complications between the two groups(P >0. 05). Conclusion For patients treated with stent-assisted embolization of aneurysms,no difference could be detected in the inhibitory effect of platelet aggregation between low and high dose groups of aspirin.

OBJECTIVE To estimate the prevalence of nosocomial infections(NI)and the use of antibacterials in pediatric department,find the problems in management of hospital infection and provide the scientific basis for formulating prevention and control measures.METHODS By bed-visiting and patients' medical records checking,we filled out unified case questionnaire.All patients were investigated on August 22,2007.RESULTS Of the 86 patients investigated,the prevalence rate of NI was 4.65%.There were 19 kinds of antibiotics used daily.The daily antibiotics use rate was 95.35%;all of the infection sites were in upper respiratory tract and delivering rate of bacterial culture was only 14.63%.CONCLUSIONS Management and training should be strengthened on antibacterial drug in the pediatric department.The reasonable use of target antibiotics could prevent the abuse ment.

Objective: To screen for proteins which can interact with phosphotyrosine-interacting domain (PID) of differentially expressed gene in human ovarian cancer cell line DOC-2 by yeast-two hybrid technique, so as to provide evidence for the signal pathway of DOC-2. Methods: The cDNA sequence of human DOC-2 gene was amplified and its PID domain (nDOC-2) was subcloned into the bait vector pGBKT7 of yeast two-hybrid system; the product was then used to screen an embryo brain cDNA library and the proteins interacting with nDOC-2 were identified. Quadrople dropout(QDO) medium and X-?-gal were used for selecting the positive clones. PCA was used to analyze the amplified sequence. After elimination of the false positive clones, the positive clones were sequenced and analyzed by bioinformatic methods. Results:Twenty-one candidate positive clones were obtained and 3 of them were plasmids encoding Homo sapiens partial mRNA for betaglycan (TBR III gene), Homo sapiens protocadherin gamma subfamily C 3 (PCDHGC3), and APLP1(amyloid beta precursor-like protein 1).Conclusion: The proteins obtained in this study may play important roles in the signal pathway of DOC-2, which provides a new orientation for DOC-2 gene therapy of ovarian cancers

BACKGROUND: Learning memory disorder is one of the major manifestations of aging. The model of aging induced by D-galactose is a commonly used animal model in recent years, and long-term D-galactose exposure may cause nerve cell morphological changes in animals.OBJETCIVE: To observe spatial learning memory behavior during Dgalactose-induced aging process in order to further explore in vivo evoked long-term potentiation in hippocampus dentate gyrus and synaptic morphological changes in hippocampal CA3 region.DESIGN: Randomized controlled observation.SETTING: Anatomical Teaching and Research Secti , Shanghai Second Medical University; Department of Physiology, Shanghai Traditional Chinese Medicine University.MATERIALS: The experiment was carried out at the Physiological Laboratory of Shanghai Traditional Chinese Medicine University between August 2000 and April 2001. Totally 22 male Wistar rats of 3-month birth age were included and randomized into normal group and D-galactose group with 11 rats in each group. D-galactose was produced by Shanghai No. 2 Chemical Reagent Factory, Morris water maze was home-made by the Institute of Geriatrics, Shanghai Traditional Chinese Medicine university.METHODS: Rats were subjected to hypodermic injection of 1 mL normal saline every day in normal group, or D-galactose of 800 mg/kg daily for 6consecutive weeks in D-galactose group. Rat spatial learning memory behavior was assessed by the latency of Morris water maze; hippocampal dentate gyrus community potentials evoked by monopulse stimulation on perforating fibers were recordedin vivo; meanwhile, the amplitude of monopulse evoked potentials was determined before and after high frequency stimulation, with the amplitude before high frequency stimulation taken as baseline. Transmission electromicroscope was applied in combination with imaging analysis to observe synaptic morphology and structure in rat hippocampal CA3 region. Water labyrinth latency was compared using the variance analysis of repetitive survey design, t-test was used to compare the differences of peak potential latency of community potentials at various time points after long-term potentiation. Moreover, inducing rate of longterm potentiation was compared by χ2-test, XY-540 type biological imaging processing system was used to analyze electromicroscopic pictures, and all available data were analyzed with t-test.MAN OUTCOME MEASURES: [1] Main outcomes: Changes of Morris water maze latency, as well as inducing rate of long-term potentiation and community potentials. [2] Secondary outcomes: Synaptic morphological and structural changes in hippocampal CA3 region.RESULTS: Totally 22 rats were enrolled in this study, with no one lost during water labyrinth test, but one rat in both normal group and D-galactose group died during electrophysiological experiment. Finally 3 rats were randomly selected from each group for electromicroscopic observation. [1]Comparison of the latency for Morris water maze: In contrast with that of normal group, latency for seeking submarine platform was obviously prolonged in D-galactose group [(14.77±10.10), (51.36±12.45) s, P ＜ 0.05].[2] Comparison of evoked potential in hippocampus dentate before high frequency stimulation: The two groups did not obviously differ in community potential amplitude and community potential latency [(1.05±0.47),(0.91±0.41) mV; (5.46±2.09), (5.38±2.26) ms; P ＞ 0.05]. [3] Inducing rate of long-term potentiation in hippocampal dentate gyrus: Compared to that of normal group, inducing rate in D-galactose group obviously reduced after high frequency stimulation (80%, 20%, χ2=7.20, P ＜ 0.01). [4] Comparison of community potential ratio at different time points after high frequency stimulation: Compared to that of normal group, it was notably reduced in D-galactose group at post-stimulation 20, 30, 60 minutes, respectively (1.104±0.196, 0.919±0.162; 1.354±0.212, 0.999±0.219; 1.236±0.174,0.875±0.311; P ＜ 0.05). [5] Comparison of synaptic struc tural parameters in hippocampal CA3 region: Compared to that of normal group, postsynaptic dense bodies became thickened in hippocampal CA3 region of D-galactose group [(40.60±18.26), (26.35±8.15) nm, P ＜ 0.05], the synapse gap increased [(17.69±6.28), (26.95±5.67) nm, P ＜ 0.05] while synaptic active zone was shortened [(265.13±76.50), (229.13±90.68) nm, P ＜ 0.05].CONCLUSION: Hypodermic injection of D-galactose does harm to rat spatial learning memory by reducing the long-term potentiation, inducing rate in rat hippocampal dentate gyrus, attenuating the increase of long-term potentiation-evoked potential amplitude, and even remarkably changing the synaptic ultrastructure in rat hippocampal CA3 region. It suggests that Dgalactose inhibits the long-term potentiation at hippocampal dentate gyrus and affects synaptic structure in hippocampal CA3 region, which is considered as the basis of spatial learning memory behavioral disorder.

Objective To investigate the effects of sensorimotor therapy on patients with knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis were divided into a treatment group and a control group by using random digits table. Both groups received conventional rehabilitation therapy, including knee isometric and isotonic contraction training, ultrashort wave diathermy as well as aerobic exercise. The treatment group was also administered with sensorimotor training, in addition to the conventional training,including the muscle strengthening and control training of quadriceps and hamstring muscle using sling exercise therapy system and on the Thera-band mattress. The visual analogue scale (VAS) for pain, manual muscle testing and knee range of motion as well as the Japanese Orthopedic Association knee function evaluation form were used to evaluate the patients. Results There was no statistic difference between the 2 groups before treatment, with regard to the evaluation parameters used in this study. After 2 months of treatment, both groups improved significantly (P ＜0.05),with the treatment group improved to a significantly greater extent (P ＜0.05). Conclusions Sensorimotor training in addition to the conventional rehabilitation treatment can further relieve the pain of patients with knee osteoarthritis joints arthritis and improve the function of patients with knee osteoarthritis.