OBJECTIVE:To compare the effects of omeprazole and esomeprazole,two kinds of proton pump inhibitors,on clopidogrel platelet inhibition following cardiac stents implantation.METHODS:Totally 180 patients with coronary artery disease underwent percutaneous coronary intervention (PCI) at the Zhujiang Hospital of Southern Medical University from June 2008 to May 2009 were selected,including 83 males and 97 females.All patients were randomly divided into 3 groups,omeprazole + clopidogrel + aspirin group (OCA group,receiving omerprazole 20 mg/d),esomeprazole+clopidogrel+aspirin group (ECA group,receiving esomeprazole 10 mg/d),and control group (No proton pump inhibitor),with 60 patients in each group.In addition,all patients received a 300 mg clopidogrel and 0.1 g aspirin prior to PCI,and received 75 mg/d clopidogrel and 100 mg/d aspirin treatment for 1 week after PCI.Blood samples from patients were obtained from cubital vein before and at 1 week after adminstration,respectively.The vasodilator stimulated phosphoprotein phosphorylation state and platelet reactivity index (PRI) were calculated by flow cytometric assay.RESULTS:The PRI had no significant difference before administration (P>0.05),which was obviously decreased at 1 week after administration (P<0.05),especially lowest in the control and ECA groups (P<0.05).However,the PRI differences between the control and the ECA group had no significant (P>0.05).CONCLUSION:The administration of omeprazole rather than esomeprazole is associated with impaired clopidogrel platelet inhibition.Esomeprazole can be used as one of the preferred proton pump inhibitor in curing gastrointestinal bleeding caused by anti-platelet therapy following cardiac stents implantation.

Objective To compare the value of CEA、CA19-9、CA12-5、CA72-4、CA50 in serum in the diagnosis and therapevtic response of the gastric carcinoma.Methods The 30 gastric carcinoma’s CEA 、CA19-9、CA12-5、CA72-4 、CA50 were detected with electrochemiluminescence immunoassay and radioimmunoassay(15 is the sufferer of transfer of lymph node,15 is not transfer),at the same time choose 30 health person’s serum as comparison. Results The levels of CEA 、CA19-9、CA12-5、CA72-4 increased notably(P

The effect of bee pollen of Brassica campestris L. and its alcohol extract on lipid peroxidation was observed in vivo and in vitro.The results showed that the production of lipid peroxides in normal liver hotnogenate of mice and elevation of production of lipid peroxides induced by cysteine and FeSO4 in homogenate were found to be inhibited significantly by in vitro addition of alcohol extract of bee pollen.The elevation of lipid peroxides in serum and liver in adult mice induced by alloxan 75 mg/kg(iv)or by administration of peroxidized corn oil 0.2 ml/mouse was markedly inhibited by oral administration of bee pollen (10 g? kg-1?d-1)for 20 days as compared with respective control groups.The level of lipid peroxide in geriatric mice was also markedly lowered by oral administration of bee pollen (10 g?kg-1?d-1)for 3 months as compared to non-treated geriatric mice.Based on the above in vitro and in vivo experimental results, it may be suggested that bee pollen and its alcohol extract protect tissues against destruction by lipid peroxides.

Objective To establish the CT criteria of quantitative diagnosis for liver steatosis by means of studying the CT features of fatty liver cases proven histologically. Methods Twenty-eight cases of fatty liver were underwent non-enhanced CT scan, and the attenuation of liver parenchyma was measured. To differentiate the degree of fatty liver, the mean CT value and the relative density of hepatic vessels were observed. The quantitative diagnosis was made according to the CT number threshold and the criteria of relative density of hepatic vessels, respectively. Results Among the 28 cases, there were 17 cases of mild steatosis with mean CT number of 46 HU (32-65 HU), 7 cases of middle degree fatty liver with mean CT number of 28 HU (15-38 HU), and 4 cases of sever fatty liver with mean CT number of 0.2 HU (-7-11 HU). For the relative density of hepatic vessels, 16 of the 17 cases of mild fatty liver had a appearance of hepatic vessels immersion and 1 mild case had reverse hepatic vessels display, 6 of 7 middle degree cases had reverse hepatic vessels display with 1 case having the appearance of hepatic vessels immersion, and all the 4 case of sever steatosis had the appearance of reverse hepatic vessels display with sharp contrast between vessels and the liver parenchyma. The accuracy of quantitative diagnosis was 65.9% and 93.1% by means of criteria of CT number threshold and relative density of hepatic vessels, respectively (? 2=7.153,P

Objective To investigate CT and MRI manifestations of uveal melanoma as well as their diagnostic value.Methods 33 cases of uveal melanoma proved by operation and pathology were studied retrospectively.CT and MRI scanning were performed in 15 and 18 patients respectively.Results The round occupying lesions within eyeball were the characteristic imaging finding of uveal melanomas, most of them were found in the location of choroid membrane. These lesions appeared as homogenous density on CT and short T 1 and short T 2 intensity on MRI. MRI was superior to CT because it could provide more accurate information such as location, shape,extension,and differentiation of the complication (retina detachment) from lesion itself. The preoperation diagnostic accuracy of CT was 53% compared with that of 88% of MRI. Conclusion MRI is the optimal examination method in confirming suspected uveal melanoma.

Objective: To investigate the chemical constituents from whole herbs of Azolla imbricata. Methods: The chemical constituents were separated and purified by various chromatographic techniques of silica gel, ODS, Sephadex LH-20 gel, and semi-preparative HPLC. Their structures were identified by NMR and MS spectroscopic methods. Results: Twenty compounds were isolated from A. imbricata and identified as chlorogenic acid methyl ester (1), 4-O-caffeoylquinic acid (2), 3,4-O-dicaffeoylquinic acid methyl ester (3), 3,4,5-O-tricaffeoylquinic acid methyl ester (4), (-)-N-[3',4'-dihydroxy-(E)-cinnamoyl]-3-hydroxy-L-tyrosine (5), (-)-N-[3',4'-dihydroxy-(E)-cinnamoyl]-L-tyrosine (6), (-)-N-[3',4'-dihydroxy-(E)-cinnamoyl]-L-tyrosine methyl ester (7), (-)-N- [4'-hydroxy-(E)-cinnamoyl)]-L-tyrosine (8), brainicin (9), quercetin-3-O-β-D-glucoside (10), naringenin-7-O-β-D-glucoside (11), kaempferol-3-O-(6″-O-caffeoyl)-β-D-glucoside (12), caffeic acid (13), epirhododendrin (14), myzodendrone (15), trans-ferulic acid-β-D-glucoside (16), 5,7-dihydroxychromone-2-carboxylic acid (17), pinoresinol-4-O-β-D-glucoside (18), phytol (19) and trans-12-oxo-(10Z,15Z)-phytodienoic acid (20). Conclusion: Compounds 1-12, 14-18, and 20 are isolated from the genus Azolla for the first time and compound 19 is isolated from A. imbricata for the first time. Compounds 1-7, 10, 12, and 13 exhibit good antioxidant activity.

Objective To investigate the utilization of liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for liver function evaluation.Methods Fifty-five patients who received enhanced MRI with Gd-EOB-DTPA were retrospectively analyzed.Images were obtained before injection and in hepatobiliary phase (5,10,and 20 minutes after Gd-EOB-DTPA injection).The patients were assigned into two subgroups according to individual liver function (n =35 in Group 1:normal liver and Child-Pugh class A; n =20 in Group 2:Child-Pugh class B and C).The relative liver enhancement (RE) was calculated at different time point.The general data (age,sex) and relevant laboratory results were recorded.Independent sample t-test was conducted to compare the RE between two groups at different time point.ROC curve was used to determine the best time point and RE threshold that can reflect the differences between two groups.Univariate analyses was performed to analyze the relationship between RE at the best time point and laboratory results.Multivariate analyses was performed to screen the independent influencing factor for RE at the best time point.Results The differences of RE between two groups were statistically significant at all time points (P ＜ 0.0001).10 minutes was the best time point for detecting the differences of liver function between two groups.When an RE cutoff value (＞ 1.52) was applied,normal or Child-Pugh class A could be predicted with sensitivity of 74.3％ and specificity of 90％.RE at the best time point was significantly related with total serum bilirubin level (TBil),serum albumin level (Alb) and prothrombin time (PT).And TBil was an independent influencing factor.Conclusion RE can be used to evaluate the liver function,and 10 minutes is the best time point that can be used to differentiate patients with normal or mild liver damage from those with moderate or severe liver damage.

Objective To evaluate the diagnostic value of proton magnetic resonance spectroscopy (1H MRS) in multiple sclerosis (MS).Methods MRI and 1H MRS were carried out in 29 patients with MS (MS group) and 26 matched normal control subjects(NC group). By calculating the area below peak, the N-acetylasparatate(NAA), creatine (Cr), choline (Cho) in brain were quantified. The NAA/Cr and Cho/Cr ratios were compared between the two groups. Every patient was measured by EDSS. The correlation analysis was done between NAA/Cr, Cho/Cr ratios and EDSS scores.Results The ratios of NAA/Cr, Cho/Cr were 1.38?0.43, 1.99?0.84 in MS group, 1.89?0.49, 1.48?0.36 in NC group. NAA/Cr decreased in MS group. The difference between two groups was statistically significant ( P0.05). Conclusions The metabolic ratios measured by 1H MRS in MS patients are changed significantly. The ratio of NAA/Cr can reflect the severity of the clinic neurological disability in MS patients.

Objective To explore the selection and clinical effects of internal or external drainage for upper urinary tract obstruction complicated with acute renal failure.Methods A total of 25 cases of upper urinary tract obstruction complicated with acute renal failure were treated with double J(DJ) tube internal drainage(12 cases,15 times) or percutaneous nephrectomy(PCN) external drainage(19 cases,23 times).15 cases of obstruction were induced by tumor and 10 cases of obstruction induced by benign disease.Results The drainage treatments were performed successfully in 23 cases,with the success rate of PCN and DJ drainage being 86.9%(20/23) and 60.0%(9/15),respectively.Postoperative bleeding occurred in 1 patient with PCN.Conclusions PCN is superior to DJ in the treatment of malignant obstruction,but DJ internal drainage may be the first choice for non-malignant obstruction.

Objective To find a safe and effective management for upper ureteral calculi after failure of extracorporeal shock wave lithotripsy(ESWL).Methods Under a F20.8 endoscope(EMS Ⅲ,Switzerland),percutaneous nephrolithotripsy was performed with pneumatic and ultrasonic power on 43 patients with upper ureteral calculi after having been treated by ESWL for 1 or 2 times.Results The procedure was completed in 42 of the patients with a mean operation time of 60 min(35 to 75 min),mean time for calculi removal of 12 min(5 to 20 min),and mean blood loss of 50 ml(20 to 150 ml).One patient was converted to open surgery because of failure of percutaneous renal puncture.One patient developed haematoma after the procedure and then was cured by conservative therapy without receiving blood transfusion.One patient had fever due to infection and was cured after antibiotic therapy.42 patients were followed up for 2 to 18 months(mean,6.4 months);none of them had massive hemorrhage,infection,hydronephrosis,or recurrence of the calculi during the period.Conclusions Percutaneous nephrolithotripsy with pneumatic and ultrasonic power is safe,minimally invasive,and effective for upper ureteral calculi after failure of ESWL.