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 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

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 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.

The present study visualized the knowledge map of research hotspots and changes of keywords by importing literatures from The American Journal of Clinical Nutrition (2000 ～ 2011) into CiteSpace.Analysis of the research hotspots (keywords),evolution of clinical nutrition,and front-line research based on tf-idf algorithm was then performed.

This study is to explore the amelioration of piperine on chronic acute combining stress rat with depression-like behavior, visceral sensitivity, and its effect on the expression of serotonin (5-HT) and synaptophysin. Forty two SD rats were divided into seven groups: blank group, model group, piperine (12.5, 25, 50 and 100 mgkg-1, ig) and imipramine (10 mgkg-1, ip) groups. The rat model of irritable bowel syndrome was established by chronic acute combining stress, and then to evaluate depression-like behavior and visceral sensitivity. The expressions of 5-HT and synaptophysin in the hippocampus and colon were determined by high performance liquid chromatography (HPLC) and Western blotting, respectively. The duration of immobility of IBS rat in the forced swimming test had been significantly increased, the sucrose consumption of IBS rat had been reduced and visceral sensitivity was obviously elevated in the IBS model group as compared with those in the normal control group (P<0.05, P<0.01). As compared with those in the normal control group, the expression of 5-HT significantly decreased, 5-HIAA/5-HT ratio significantly increased in the hippocampus of IBS model group (P<0.05), but opposite presentations were noted in the colon (P<0.05). As compared with that in the normal control group, the synaptophysin expression in the hippocampus decreased significantly but obviously increased in the colon (P<0.05). Piperine improved the behavior of IBS rats, and reversed the levels of 5-HT and 5-HIAA, and 5-HIAA/5-HT proportion in the hippocampus and colon (P<0.05); besides, they significantly reverse the synaptophysin level in the hippocampus and colon (P<0.05). The presence of depression and visceral sensitivity had been changed in IBS rats, with abnormal expression of 5-HT and synaptophysin in the brain-gut system. Piperine can ameliorate the changes of the behavior and regulation of serotonin and synaptophysin expression in IBS rat model.

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

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 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.