Objective To observe the influence of clopidogrel combined with proton pump inhibitor (PPI) on the postoperative complication of percutaneous coronary intervention.Methods The clinical data of 600 patients who were taking clopidogrel antiplatelet therapy were retrospectively analyzed.All patients were divided into observation group (with PPI,n =300) and control group (without PPI,n=300).In-stent restenosis (ISR) and the adverse event rates were compared between the two groups during the period of follow up.Results The incidence of gastrointestinal bleeding was less in observation group than in control group (6.7％ vs.13.7％,x2 =8.048,P＜0.01),but the incidences of ISR,target vessel revascularization (TVR) and non-fatal myocardial infarction were higher in observation group than in control group(x2 =6.426、5.511、4.718,all P＜0.05).Conclusions Clopidogrel combined with PPI treatment can significantly reduce the risk of gastrointestinal bleeding,but increase the incidences of major adverse cardiovascular events.We suggest that PPI should be used with caution for the patients who need longer-term PPI use.

BACKGROUND:The regional gene therapy of bone defect is to transfer genes capable of accelerating bone healing into target cells, which will transcript the genes into mRNA and translate them into proteins, then the target cells will be stimulated to differentiate under the role of protein, and finally reach the purpose of accelerating bone healing by means of autocrine or paracrine. With the development of cell recombination technique, more and more genes of growth factors involved in the bone repairing have been successfully cloned, which make it possible to treat bone defect with gene therapy. The present status for the regional gene therapy of bone defect is summarized.DATA SOURCES: An online search in Pubmed database was undertaken to identify articles about the regional gene therapy of bone defect published in English from January 1965 to January 2006 by using keywords of "gene therapy,bone defect". Meanwhile, Chinese relevant articles published from January 2000 to January 2006 were searched in Wanfang database by using the same keywords in Chinese.STUDY SELECTION: The data were primarily checked, and the references of each article were looked up. Inclusive criteria: related to the regional gene therapy of bone defect. Exclusive criteria: repetitive study or Meta analysis.DATA EXTRACTrON: Totally 237 articles were collected, 32 of them were in accordance with the inclusive criteria, and the other 205 were old or repetitive ones. Of the 32 articles, 4 were about the selection of destination genes, 3 about the selection of target cells, 7 about the selection of gene expression vector, 3 about the methods of gene transfer, 4 about gene therapy combined with tissue engineering in treating bone defect, 5 about polygenes in treating bone defects, and 2 about the problems and prospects in the gene therapy of bone defect.DATA SYNTHESIS: The regional gene therapy of bone defect is a new technique developed base on the basic theoretical cognition of bone regeneration and gene recombination technique, and provides ideal solving program for the treatment of bone defect caused by various reasons. The basic problems mainly include the selection of destination genes, selection of target cells, selection of gene expression vectors and the selection of the methods of gene transfer.The studies about the selection of target cells and methods of gene transfer become mature day by day, bone marrow stromal cells have become the target cells should be selected firstly, and it has been generally acknowledged that ex vivo gene transfer has more obvious advantages than in vivo one. The key problem at present is how to further explain the natural process of the repair of bone defect, and select the most effective component from the signal molecules involved in the process to apply in the gene therapy of bone defect, and further improve the gene expression vector, so as to ensure the safety of gene therapy. It is believed that with the continuously deepened theoretical cognition of bone regeneration and the continuous perfection of gene recombinant technique, the gene therapy of bone defect will finally go out of laboratory, and really serve the patients with bone defect.CONCLUSION: The regional gene therapy of bone defect can effectively activate the activity of bone regeneration at the site of bone defect, also can avoid the problems of immunologic rejection and systematic toxicity caused by the direct application of cytokines, and has good prospects of clinical application. At present, this technique is not completely perfect, and there are many problems to be deeply investigated in destination genes, gene vectors and transfection technique, etc.

The technology of bone tissue engineering has got rid from autologous bone implant and allograft bone. With the development in recent 20 years,the basic pattern of tissue engineered bone has already been constructed,consisting of related molecules to bone regeneration,active cells for osteogenesis and scaffold materials. The related molecule to bone regeneration is the dominant factor to determine the bio-activity of tissue engineered bone,and also is the key researches in the field of bone tissue engineering. As the molecule bio-mechanism of bone regeneration has been elucidated and molecule bio-techniques have been combined with bone tissue engineering,many achievements regarding the related molecules to bone regeneration are observed in bone induction mechanism,vector,gene therapy technology and the combined use,which all improve the effect of tissue engineered bone on repairing the bone defects.

Recently,increasing evidence suggests that gingivitis and periodontitis may be one of the etiological factors for some adverse pregnancy outcomes such as preterm birth,preeclampsia,fetal growth restriction and lateral miscarriage.Although there are some conflicting findings and potential problems regarding uncontrolled underlying risk factors,most of the clinical studies indicate a positive correlation of gingivitis and periodontitis with those complications.This review discusses the relationship and its possible pathological mechanism in order to better prevent the development of adverse pregnancy outcomes.

Objective:To investigate the effects of the treatment of early cracked teeth with vital pulp preservation.Methods:63 early cracked teeth with vital pulp in 56 patients were treated by light cured composite resin filling with or without MTA rebasing,and restored by precious metal crown.The patients were followed up for 2 years.Results:After 2 years follow-up,57 teeth were successfully treated and failure was found in 6 teeth,the effective rate was 90.4％.Conclusion:Light cured resin filling directly or with MTA rebasing for early cracked teeth with vital pulp,and restoration by precious metal crown are effective in the treatment of early cracked teeth with vital pulp.

Objective To explore the psychological intervention effect of ulinastatin combined with Xuebijing in the treatment of severe sepsis. Methods 76 patients with severe sepsis in our hospital from January 2016 to March 2017 were selected,and according to the different nursing intervention divided into observation group and control group,38 cases in each groups. control group with Ulinastatin and Xuebijing treatment, observation group with Ulinastatin and Xuebijing plus psychological intervention; before and after treatment in two groups of patients with clinical symptoms, psychological status (SAS and SDS score) to improve the situation, and the related data for comparative analysis. Results Ulinastatin and Xuebijing+psychological intervention (observation group) the clinical effect of treatment of severe sepsis patients than Ulinastatin and Xuebijing (control group) the clinical treatment effect of inflammatory factors in patients with improvement than the control group, SAS and SDS was better than that of control group, the difference was statistically significant (P<0.05). Conclusion severe sepsis patients choose the Ulinastatin+Xuebijing+psychological intervention of ulinastatin Xuebijing significantly, can effectively reduce the level of inflammatory factors in the patients, and fully improve the psychological status of patients, is worthy of clinical application.

Objective To investigate the therapeutic effect and analgesic mechanism of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fracture.Methods80 cases of patients with painful osteoporotic thoracolumbar vertebral compression fracture in Shaoxing second hospital from May 2014 to May 2016 were selected, they were randomly divided into percutaneous vertebroplasty group (40 cases) and conservative treatment group (40 cases) two groups, the clinical efficacy, VAS scores and ODI scores of the two groups were statistically analyzed.ResultsThe total treatment effective rate of the percutaneous vertebroplasty group 95% (38/40) was significantly higher than the conservative treatment group (30/40) (P<0.05);The VAS scores and ODI scores of the two groups after treatment were significantly lower than before treatment (P<0.05);The differences of VAS scores and ODI scores before treatment between the two groups were not significant.The VAS score and ODI score after treatment of the percutaneous vertebroplasty group were significantly lower than the conservative treatment group (P<0.05).ConclusionThe therapeutic effect of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fractures is more significant than conservative treatment, it has better analgesic effect, so is worthy of promotion in the clinical.

BACKGROUND:Vascular endothelial injury usually appears following atherosclerosis, hypertension, diabetes mellitus and other diseases, which can be repaired by endothelial progenitor cells (EPCs) in the systemic circulation. OBJECTIVE:To study the effect of salveanolic acid B on the mobilization and adhesion of EPCs in mice. METHODS:Thirty C57BL/6 mice were selected and randomly divided into surgical and non-surgical groups, (n=15 per group). Common carotid arteries of mice in the surgical group were injured by iron wire, then were subdivided into three groups (n=5 per group), and were given the injection of 5% of glucose (control group), 100 g/L salveanolic acid B and 10 μmol/L vascular endothelial growth factor, respectively. Meanwhile, the mice in the non-surgical group received the same assignment and treatment, but the common carotid arteries were not injured. After consecutive 7-day administration, the EPCs in the peripheral blood of the mice were isolated, and the EPCs adhesion was tested by flow chamber experiment. The serum levels of stromal cell-derived factor-1 and interleukin-8 were detected by ELISA kits. RESULTS AND CONCLUSION:The proportion of EPCs in the surgical group was significantly increased compared with the non-surgical group (P < 0.05). After 7-day administration, the proportion of EPCs in the salveanolic acid B and vascular endothelial growth factor subgroups of the surgical group was significantly higher than that in the control subgroup (P < 0.05); the proportion of EPCs in the vascular endothelial growth factor subgroup of the non-surgical group was significantly higher than that in the control and salveanolic acid B subgroups (P < 0.05). Flow chamber experiment revealed that the number of EPCs in the salveanolic acid B subgroup was significantly more than that in the control subgroup (P < 0.05). In the surgical group, the serum levels of stromal cell-derived factor-1 and interleukin-8 in the in the salveanolic acid B and vascular endothelial growth factor subgroups were significantly higher than those in the control subgroup (P < 0.05); in the non-surgical group, the serum levels of stromal cell-derived factor-1 and interleukin-8 in the in the vascular endothelial growth factor subgroup were significantly higher than those in the control subgroup (P < 0.05). To conclude, salveanolic acid B can increase the efficiency of the EPCs mobilization in bone marrowin vivo, help the EPCs adhere to the collagen surface, and upregulate the serum levels of stromal cell-derived factor-1 and interleukin-8.

Objective To study the reverse roles of reverse effect of tetramethylpyrazine on the resistance to adriamycin in human ovarian carcinoma cell line A2780/ADM.Methods The drug sensitivity of A2780/ADM cells was measured by MTT assay.The intracellular concentration of ADM was determined by fluorescent spectrophotometry.The changes of cell apoptosis percentage of A2780/ADM was demonstrated by flow cytometry.Results The IC50 value of TMP in A2780/ADM cell line was significantly decreased by the non-cytotoxic dose or low-cytotoxic dose of TMP.The resistance reversing effect comparing with the IC50 value of ADM cells was respectively 2.07 folds.The intracellular ADM concentration in A2780/ADM cells was significantly elevated by TMP at the same dose and the cell apoptosis percentage was significantly increased by TMP.The expression of P-gp was reduced significantly by TMP.Conclusion TMP could reverse the resistance of human ovarian carcinoma of A2780/ADM cell line to ADM,which may be related to the increased intracellular.

Objectives:To investigate the effects of nutritional support by the way of peripheral vein(PV) in the patients of severe acute pancreatitis(SAP). Methods:The treatment results of nutritional support by the way of PV was observed retrospectively within the latest eight years in the patients of SAP. Results:31 cases were cared,and no complications relating to the use of PV in TPN happened. Conclusions:Nutritional support is an important and effective treatment in SAP patients,and the use of PV is an effective and safety route.