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.

Mitochondria are involved not only in energy metabolism but also in free radical metabolism. Superoxide anion can be generated through a way of electron leak of respiratory chain and the reactive oxygen species (ROS ) can be formed in the further reactions of O2* in mitochondria. The role of mitochondria in anti-oxidant functions and cell apoptosis is discu ssed in terms of electron leak of respiratory chain, uncoupling of oxidative pho sphorelation, mitochondrial pore, Box- or/and PTP-mediated release of cytochro me c from mitochondria and so on. The signaling act of ROS is emphasized in the regulation of cell apoptosis.

Objective To explore the postoperative nursing experience of respiratory tract in patients with heart disease and pulmonary hypertension.Method Thirty-two patients with adult heart disease combined with pulmonary hypertension were managed with perioperative pertinent care as well as postoperative rational use of ventilator and effective supply of oxygen,strengthened monitoring of pulmonary hypertension and respiratory care.Result The postoperative putrnonary infection pulmonary artery pressure were well controlled in all the patients even though two of them died of pulmonary hypertension crisis and pulmonary infection.Conclusion For patients with adult heart disease combined with pulmonary hypertension,nursing measures including strengthened care to the respiratory tract to ensure the effective supply of oxygen can reduce postoperative mortality and the incidence of complications.

Objective To analyze the distribution features of injury regions and severty of patients with traumatic brain injury ( TBI ) associated with muhiple injuries and discuss the influence of different injury regions and severity on their outcome.Methods Retrospective analysis was performed for clinical data of 1026 patients treated from August,2007 to August,2010. Results The majority of TBI patients associated with multiple injuries were young people( accounting for 78.07％ of the total injuries),among whom the males outnumbered females in proportion of 3.62:1,and the multiple injuries were mainly characterized by chest injuries (accounting for 46.69％ of multiple injuries).Spearman analysis indicated that Glasgow Outcome Scale (GOS) was correlated with Glasgow Coma Scale (GCS)score,age,maxillofacial region injuries,chest and abdomen injuries (P ＜ 0.05 ).Logistic regression analysis manifested that age,GCS score,and lung injury were the independent risk factors of high mortality in TBI patients associated with multiple injuries. Conclusion Low GCS scores,old age and severe lung injuries indicate a high mortality and morbidity,while injuries in extremities and pelvis have no significant influence on the outcome.

ObjectiveTo improve imaging teaching of the central nervous system ( CNS ) by applying picture archiving and communication system ( PACS ).MethodsFifty medical imaging undergraduate students were arranged to study the content of CNS by introduction training about PACS,postprocess viewing cerebral stenosis and aneurysm by practicing,studying by searching the disease and browsing teaching picture archiving.ResultsStudents could master the content efficiently and enhance their initiative and creativity.ConclusionPACS has an important value in the imaging teaching of CNS.

High myopia is frequently associated with retinal degenerative changes (such as myopic foveoschisis, macular hole and its related retinal detachment, and choroidal neovascularization) which are the major causes of visual loss in high myopic eyes. Optical coherence tomography may help us to understand the macular lesions in high myopia. Peeling of internal limiting membrane and removal of posterior vitreous cortex at an appropriate time, are believed to facilitate restoring the retinal flexibility and resolution of myopic foveoschisis, and promote the macular hole closure and retinal reattachment. Anti-angiogenesis treatment combined with photodynamic therapy and (or) corticosteroid therapy are the future options to treat myopic choroidal neovascularization. Correctly understanding and mastering the methods and timing of diagnosis and treatment of high myopia-related macular degeneration, and taking targeted interventions to enable patients to be rational and effective treated, are the keys to further reduce the damage of visual function in patients with high myopia.

Objective To investigate the present situation of use of the antipsychotic in schizophrenic inpatients,To find out factors of using the antipsychotic.Methods The prescriptions of schizophrenic inpatients was investigated in cross-sectional survey.Results The 47 remedy in 465 schizophrenic inpatients were investigated.The remedy of use of single antipsychotic had 175 patients(37.6%),the remedy of use of combined 2 kinds of antipsychotic had 262 patients(56.3%),the remedy of use of combination 3 kinds of drugs had 28 patients(6.0%),combined more than two drugs therapy was very common;Using rate and constituting rate of clozapine in prescription were No.1,non-classical antipsychotics was playing a leading role in the antipsychotic;Inpatients with public health services used non-classical antipsychotics more than inpatients of non-public health services.Conclusion Non-classical antipsychotics is replacing classical antipsychotics in curing schizophrenic.Paying way of patient influences the antipsychotic choice.

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.

Although single thermotherapy has certain curative effect for cancer treatment,it normally leads to the recurrence of tumor in clinical application.Multi-thermotherapy could be an effective approach to solve the problem.Multi-thermotherapy not only kills the tumor cells by heating cells above the physiological temperature,but also induces the anti-tumor immunity of the body to further kill the tumor cells.In order to obrain optimal treatment effect,the time interval of thermotherapy is often set once or twice a week for the consideration of thermotolerance.

BACKGROUND: As a new-type and effective restoration means of dentition defect and edentulous,implant denture is a restoration method most closely related to natural teeth,and is accepted by more and more patients.OBJECTIVE: To investigate the clinical effects of non-submerged dental implants with sandblasted and acid-etched surface preparation(Straumann implants system).METHODS: Patients who visited Oral Implantology Center of the Affiliated Hospital of Qingdao University Medical College from June 2007 to June 2009 were selected as study subjects.Systemic and local contraindications were excluded.A total of 124patients who had 218 Straumann implants implanted were followed up for 3 to 24 months.According to various patients' conditions,conventional approach,immediately implanted,GBR technique and flapless operation were adopted respectively.Clinical effects were evaluated with the Albrektsson's criteria.RESULTS AND CONCLUSION: There was no implant loosen,shedding or X-ray transmission in 218 implants.Both the survival rate and successful rate of implants were 100%.High degree of satisfaction from patients was achieved.Straumann implants system could be considered as a manageable and satisfactory non-submerged implant system.