Objective To study warfarin and aspirin for ischemic stroke prevention in elderly patients with atrial fibrillation.Methods Fifty-three elderly patients with atrial fibrillation from January 2007 to December 2009 were enrolled in this study.All patients were divided into two groups by random digits table method:warfarin group treated with warfarin and aspirin group treated with aspirin.Incidence rate of ischemic stroke,side effect and cost-effectiveness were compared between two groups.Results Forty-nine patients were followed up,the dropout rate was 7.5％(4/53),28 patients in warfarin group,21 patients in aspirin group.Incidence rate of ischemic stroke in warfarin and aspirin group was 3.6％(1/28) and 28.6％(6/21),and there was significant difference (x2 =4.28,P ＜0.05).No significant difference was observed for side effect between two groups (x2 =0.07,P ＞ 0.05).For cost-effectiveness analysis,the ratio of cost-effectiveness was 16.3 yuan and 10.4 yuan in warfarin and aspirin group respectively,and there was significant difference (P ＜ 0.05).Conclusion Warfarin is more effective for ischemic stroke prevention in elderly patients with atrial fibrillation,but costs more than aspirin.

BACKGROUND:Laryngeal cartilage defect has a higher incidence, mainly presenting with pain, sweling, and dysfunction after onset. Currently, surgical treatment is the most used in clinical treatment of laryngeal cartilage defect. Although conventional materials can effectively improve symptoms, there is a poor long-term efficacy. In recent years, there are many clinical studies on cartilage tissue engineering, but less about the actual use in the otorhinolaryngology department.
OBJECTIVE:To investigate the effect of polyhydroxyalkanoate polymer carrying chondrocytes on the repair of alogeneic laryngeal cartilage defects.
METHODS:Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHH) served as the extracelular matrix. Tissue engineering technology was used to prepare cel-material composite. Primary tissue-engineered cartilage tissue was transplanted directly into rabbit thyroid cartilage defect (experimental group A), or implanted into a more mature tissue-engineered cartilage for the repair of thyroid cartilage defect (experimental group B). In the experiment, PHBHH group and simple chondrocyte group were set as controls. Repairing effects on thyroid cartilage defect were evaluated through gross and histological observation.
RESULTS AND CONCLUSION:Chondrocytes in the primary tissue-engineered cartilage tissues were beaded under scanning electron microscope, and after 4 weeks of culture, a large amount of jely-shaped substrates were visible. Findings from electron microscope observation showed that the cels were distributed on the surface of composite material and cavernous voids, displaying a plurality of smal round projections. Surgical treatment was successful in al the rabbits, and there was no dyspnea and eating difficulties after surgery. One rabbit appeared to have brief wheezing in the experimental group A, two rabbits died of diarrhea in the experimental B group at 2 weeks after surgery. PHBHH composite carrying chondrocytes had certain hardness. At 4 weeks after subcutaneous implantation, mature cels were shaped as white sheets, and the material had elasticity. After 4 and 8 weeks, the space between repair zone and original cartilage tissue was smooth and plain, but the repair zone was colored yelow. In the simple PHBHH and chondrocyte groups, the repair zones were both depressed, only the connective tissues could be seen. Rabbits in the two experimental groups showed less adverse reactions compared with the two control groups (P < 0.05). These findings indicate that PHBHH composite carrying chondrocytes has better effects to repair alogeneic laryngeal cartilage defects.

Objective To analyze results of blood test for first‐time blood donation volunteers and mutual‐aid blood donors in Anyang area ,in order to improve cognition of characteristics of different blood donors and safety of blood transfusion .Methods A total of 31 363 cases of first‐time blood donation volunteers(first‐time blood donation group) and 1 046 cases of mutual‐aid blood donors(control group) from January to December 2013 in Anyang area were collected .The results of blood tests were compared and related factors affected qualities of blood were analysed .Results A total of 1 160 cases of donors in the first‐time blood donation group were failed to pass the blood test and the unqualified rate was 3 .70% ,in the control group 17 cases of donors failed to pass the blood test and the unqualified rate was 1 .62% ;the difference was statistically significant (P<0 .05) .The test results of unqual‐ified blood samples shown that in the first‐time blood donation group the constituent ratios of alanine aminotransferase(ALT) ,anti‐body to hepatitis C virus(anti‐HCV) ,antibody to human immunodeficiency virus(anti‐HIV) ,hepatitis B surface antigen(HBsAg) and syphilis positive blood donors were 37 .67% ,12 .59% ,8 .79% ,31 .38% and 9 .57% respectively ,and those in the control group were 29 .41% ,17 .65% ,5 .88% ,35 .30% and 11 .76% respectively .The constituent ratio of ALT positive blood donors between the two groups had statistically significant difference(P<0 .05) .There were statistically significant differences in gender ,age and occu‐pations between unqualified blood donors in the two groups(P<0 .05) .Conclusion The first‐time blood donation volunteers might have relatively higher unqualified rate in blood test ,it is necessary to enhance blood screening and management before transfusion , in order to ensure safety of blood transfusion .

AIM: To establish the method of determining five anthraquinone components in Shaotangshang Gel(Rhizoma Coptidis,Cortex Phellodendri Chinensis,Radix et Rhizoma Rhei,etc.). METHODS:HPLC was used to determine emodin,chrysophanol,rhein,physcion,alone-emodin in Shaotangshang Gel.The separation was performed on Yilited-C_(18) Column with MeOH-phosphate acid(0.1%)(80∶20) as the modile phase,the flow rate was 1.0 mL/min and detection wavelength was set at 430 nm. RESULTS: The resolution and the linearity of the method were good with the average recoveries and RSD values of emoldin,chrysophanol,rhein,physcion,aloe-(emodin) of(98.0%),1.3%;97.1%,1.8%;97.8%,1.5%;97.4%,1.7%;96.7%,1.2% respectively.CONCLUSION: This method is sensitive,accurate and can be used for the quality control of Shaotangshang Gel.

OBJECTIVE: To evaluate the curative efficacy of recombinate erythropoietin(r-HuEPO) administered through different route for patients receiving hemodialysis.METHODS: 40 patients undergoing maintenance hemodialysis(MHD) were randomized into subcutaneous injection group and intravenous injection group.The hemoglobin(Hb),hematokrit(Hct) and the adverse effect within 12 weeks were observed.RESULTS: The Hb/Hct level of the two groups increased with the prolonging of treatment,which increased significantly at 8 weeks and 12 weeks as compared with before treatment(P

Epidemiologic studies suggest that intake of excess all-trans-retinoic acid (RA) during embryogenesis induces various developmental defects and the central nervous system (CNS) represents a major site of the teratogenic action of RA. It is therefore important to understand which parameters are affected early by excessive RA in order to devise and improve protective nutritional strategies. The modulations of beta-catenin and caspase-3 levels were investigated in the KM mouse embryo following maternal treatment with a single oral dose of 30mg/kg body weight of RA during the neurula period. In addition, retinoic receptors (RARs) are key transcription factors regulating gene expression in response to RA-activated signals. So the experiment was designed to evaluate whether the alterations in protein expression of RAR alpha and beta during the time of neural tube closure were induced by excessive RA. Maternal intake of excess RA induced early downregulation of RAR alpha and beta, beta-catenin and caspase-3 expression, which was followed by an increase in their expressive levels in the neural tube tissue of mouse embryos. This finding suggests that the alterations in the expression profile of RAR alpha and beta, beta-catenin and caspase-3 may be implicated in the teratogenesis induced by excess RA in KM mouse embryo.

Objective To explore the effect of relaxation training with listening to music on negative emotions of hemodialysis patients.Methods 70 hemodialysis patients were divided into the intervention group and the control group by random number table,and each group had 35 cases.The control group was given routine care,health education and routine discharge guidance during dialysis by the responsible nurses.The intervention group had relaxation training with listening to music on the basis of routine care.Before the intervention and three months after the intervention the Hamilton Rating Scale for Depression was used as an assessment tool to evaluate negative emotion of patients.Results Before intervention,the HAMD scores of the two groups showed no significant differences.3 months after intervention,HAMD scores had significant difference between two groups.Conclusions Relaxation training with listening to music can significantly improve patients' negative emotions,and is worthy of clinical application.

In 2012, the contracted service with the general practitioners ( rural doctors) was implemented in Zhejiang Province. This paper conducted an analysis on the existing problems in the contracted service from three as-pects of policy background, policy objective, main measures and the following suggestions have been put forward:Strengthening the whole family team of doctors and information construction, and improving the multi sectoral coopera-tion mechanism in order to establish the classified diagnosis and treatment system as targeted to lay a good foundation.

Objective To analysis the levels of serum homocysteine (Hcy)and erythropoietin (EPO)levels in patients with ischemic stroke and their relationship with carotid atherosclerosis.Methods The patients with ischemic stroke admitted be-tween January 1,2013 and July 31,2016 were selected as the subjects.Sera test of Hcy,EPO level,and then through the Doppler probe carotid artery method to check the degree of carotid atherosclerosis in all patients,and the use of quantitative records,according to set diagnostic criteria for classification,the use of grading results with the same type of Hcy,EPO lev-els of data analysis to determine the relationship between the two.Results Doppler exploration in 142 patients showed nor-mal carotid intima-media thickness in 34 patients,carotid intima-media thickening in 56 patients,and carotid plaques in 52 pa-tients.After analysis of variance (F=59.64,78.29,P<0.05),and the difference between the two groups was statistically significant (P<0.05),and the difference between the two groups was statistically significant.The data between any two groups were also statistically significant differences.108 patients with different levels of carotid atherosclerosis were graded into 47 of grade 1,34 of grade 2,and 27 of grade 3,with the same type in the plasma of different grades (F=78.39,48.61, P<0.05).After the qtest,there were no significant differences in the levels of Hcy and EPO.Data were also statistically dif-ferent between groups.Conclusion Serum homocysteine (Hcy)and erythropoietin (EPO)were associated with ischemic stroke and were associated with carotid atherosclerosis.

Objective: To investigate the function of healthy education in early enteral nutrition after operation.Methods: 72 patients of upper digestive tract operation were divided into test group(n=36)and control group(n=36).The education about enteral nutrition knowledge was intensified in test group. Results: The degree of grasping enteral nutrition knowledge and the time of receiving enteral nutrition were increased in test group.The complications of EN were decreased in test group.Conclusion: It is helpful to intensify the healthy education in early enteral nutrition after operation.