Objective To compare the efficacy of domestic low-dose versus conventional-dose clopidogrel for patients with unstable angina pectoris (UAP). Methods A total of 206 UAP patients were randomly assigned to low-dose clopidogrel (50 mg/day) as treatment group and conventional-dose clopidogrel (75 mg/day) as control group. Treatment continued for 12 months to observe the extent of alleviating angina and major adverse cardiac events (MACE). Results The numbers of markedly effective, effective, ineffective and worse patients were 56(52.8%), 22 (20.8%), 11(10.4%) and 17(16.0%) in treatment group, and those were 52(51.0%), 20 (19.6%), 12(11.8%) and 18(17.7%) in control group (all P>0. 05). There was death in 3 cases, non-fatal myocardial infarction in 2 cases in treatment group, and death in 4 cases, non-fatal myocardial infarction in 2 cases in control group (χ~2 =0. 620, P>0. 05). Low-dose group had a lower incidence of adverse reactions. Conclusions The efficacy of low-dose clopidogrel for patients with UAP is not inferior to conventional-dose, and the safety is well.

AIM: To investigate the effect of soybean isoflavones (SI) on ventricular remodeling induced by myocardial infarction (MI). METHODS: MI was induced by permanent ligation of the left anterior descending coronary artery (LAD) in male Sprague-Dawley (SD)rats. Rats were randomly divided into six groups: shamThree hours after the operation, the drugs or solvent were administrated ig qd for 35 d. Twenty-four hours after the last administration, heart rate (HR), left ventricular end-diastolic pressure (LVEDP), peak systolic left ventricular pressure (Peak), maximal rate of left ventricular pressure rising (+dp/dtmax), maximal rate of left ventricular pressure declining (-dp/dtmax) and myocardial maximal shortening velocity (Vmax) were measured. After above hemodynamic parameters were measured, hearts were extracted. The ratio of total ventricle weight to body weight(TVW/BW) was calculated. Myocardial collagen was shown with the collagen-specific picrosirius red stain,myocardial interstitial collagen volume fraction(ICVF), perivascular collagen volume fraction(PCVF), infarct size,septal thickness (ST) and left ventricular diameter (LVD) were measured by image analysis system. RESULTS:(31 ± 5) %, respectively, all of which were significantly smaller than that in MI group (( 38.9 ± 2.9) %, P ＜ 0.01 ).In MI group, TVW/BW, LVD, ICVF and PCVF were remarkably increased compared with those in sham group (P ＜ 0.01 ). The increased TVW/BW, LVD, ICVF and PCVF were significantly reduced by treatment with eaprats in MI group was significantly decreased than that in sham group (P ＜ 0.01 ). The reduced ST could be in-dp/dtmax and Vmax were decreased (P ＜ 0.01 ), while LVEDP was increased (P ＜ 0.01 ), significantly. The reSION: SI can improve cardiac function and ventricular remodeling induced by myocardial infarction in the rat.

BACKGROUND: Numerous experiments and clinical practice show that human hair keratin artificial tendon induces the organism to form autogenous tendon. The process of autogenous tendon formation mainly involves the synthesis, secretion and package of collagen subtype I.OBJECTIVE: To explore the role of collagen subtype I mRNA expression in autologous tendon formation after human hair keratin artificial tendon implantation.DESIGN: A completely randomized controlled experiment based on the experimental animals.SETTING: Department of Histology and Embryology and Department of Biochemistry and Molecular Biology of Southern Medical University.MATERIALS: The experiment was conducted in the Experimental Animal Center of the First Military Medical University of Chinese PLA from May 2003 to September 2004. Totally 33 New Zealand rabbits of either gender,weighing 2.0 to 2. 5 kg, were provided by the center. The animals were randomly divided into experiment 3, 6, 9, 12, 16 and 20 weeks groups, negative control 9 and 20 weeks groups and normal control group. Among them,experiment 3 and 6 weeks group and normal control group had 3 rabbits in each and the other groups had 4 rabbits. Human hair keratin artificial tendons were normal human hair treated by a series of biochemical methods and were supplied by the Department of Biochemistry & Molecular Biology of the university. The human hair keratin artificial tendons were divided into three groups with different degradation rates, namely, fast(F), medium(B) and slow(Z). The tendons were made up of the fast, medium and slow degradation groups mixed at the ratio of 4: 3: 3.off by 1.0- 2.0 cm, human hair keratin artificial tendon was grafted by end-to-end anastomosis with both ends of the broken tendon before sewing control group, no artificial tendon was implanted although the animals ungroup was normal rabbits' tendon. Sampling was carried out at 3, 6, 9, 12, 16and 20 weeks after human hair keratin artificial tendon implantation in experiment groups, and at 9 and 20 weeks after operation in negative control group, respectively. The expression of collagen subtype I mRNA was detected at weeks 3, 6, 9, 12, 16 and 20 after grafting using reverse transcription polymerase chain reaction technique.MAIN OUTCOME MEASURES: The ratio of collagen subtype I mRNA to Glyceraldehyde-3-phosphate dehydrogenase(GADPH) mRNA in normal tendon and autogenous tendon induced by human hair keratin artificial tendon at all time points was calculated, and significance test between all these paired groups were performed.collagen subtype I mRNA/GADPH mRNA expression was 0.96 ±0.02 in expression of collagen subtype I mRNA/GADPH mRNA in autogenous tendon induced by human hair keratin artificial tendon in experiment group appeared at week 3, increased rapidly at week 3 to 6, peaked at week 6, and remained stable at week 9 to 20. The expression at week 6 was significantly higher in experiment group than in normal control group( F = 6. 254, P ＜ 0.05); the expression at other weeks was also significantly higher in experiment group than in normal control group( F= 1. 258 - 1. 987, P ＞ 0.05).CONCLUSION: The activation, proliferation and secretion of collagen protein as well as the synthesis of collagen subtype I by tenocytes may be responsible for autologous tendon formation after human hair keratin artificial tendon implantation.

Objective To compare the clinical efficacy of double-lumen tube intubation between McGrath-5 video-laryngoscope and McCoy laryngoscope in patients with difficult airway. Methods Sixty patients who were predicted as difficult double-lumen tube intubation were divided into two groups using random number table method:McGrath-5 video-laryngoscope group (group A, n = 30) and McCoy laryngoscope group (group B, n = 30). All patients were intubated by two laryngoscopes correspondingly after conventional induction. The success rate of the first intubation, intubation time, the ratio of right positioning, the number of SpO2 < 90% within intubation time, the number of pressing the cricoid, the incidence of intubation complications and hemodynamic parameters [The changes in systolic pressure and heart rate and BIS were recorded before induction (T0), glottic exposure upon laryngoscope insertion (T1), immediately after intubation (T2), 3 min (T3) after intubation]. Results The number of pressing the cricoid was smaller in group A than in group B (P < 0.05), whereas the intubation time in group A was significantly higher than that in group B (P < 0.05). The systolic pressure and heart rate at T3 were dramatically reduced compared with those measured at T0 in both groups (P < 0.05). The systolic pressure and heart rate at T1 and T2 in group A were considerably lower in group A than those in group B (P < 0.05). Conclusions Compared with the McCoy laryngoscope, double-lumen tube intubation by McGrath-5 video-laryngoscope can less impact on hemodynamics, less intubation complications, intubation time although prolonged but not for influence the patient's oxygen supply, for difficult airway double-lumen tube intubation provides a good choice.

Objective To evaluate the effect of percutaneous coronary intervention (PCI) or thrombolysis,in patients with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA),in the presence of ST-elevation myocardial infarction (STEMI).We demonstrated the benefits of the two therapies on ROSC patients in hospital discharge and neurological recovery,and clarified the importance of ROSC,so as to guide the treatments for OHCA in the presence of STEMI.Methods It was performed a meta-analysis of clinical studies located in PUBMED and MEDLINE databases from January 1995 to October 2011.OHCA patients with ROSC were as our study objects,the hospital discharge and neurological recovery rates,of patients with and without PCI or thrombolysis,were assessed in patients with ROSC after OHCA in the presence of STEMI.In the same Cohort Study,between received and rejected PCI,or between received and rejected thrombolysis in OHCA patients with ROSC as treated group and control group,using Review Manager 5.1 software to analyze,respectively.Furthermore,we also compared the differences in hospital discharge and neurological recovery rates between patient groups who received PCI or thrombolysis by Pearson x2 analysis.Results The meta-analysis showed that the rate of hospital discharge improved with both PCI (odds ratio [OR],1.65 ; 95％ confidence interval [CI],1.05-2.59,P ＜ 0.01)and thrombolysis (OR,2.03 ; 95％ CI,1.24-3.34,P ＜ 0.01) in patients with ROSC after OHCA,in the presence of STEMI.We also found that there were not significant differences between with PCI and with thrombolysis in the rate of hospital discharge (63.00％ vs.65.19％,P =0.548) and neurological recovery (88.62％ vs.91.25％,P =0.351) for the patients with ROSC after OHCA (P ＞0.05).Conclusions In patients with ROSC after OHCA in the presence of STEMI,both PCI and thrombolysis improved hospital discharge rates.Furthermore,there were similar efficacy in hospital discharge and neurological recovery rates between with PCI and with thrombolysis.

Objective To explore whether the peritoneal cooling was better than other cooling methods on protection neuron damage of the hippocampus CA1 after cardiopulmonary resuscitation (CPR) in New Zealand rabbits.Methods Forty eight adult New Zealand rabbits were induced ventricular fibrillation by AC current and were resuscitated after cardiac arrest for 5 minutes.The rabbits were randomly divided into four groups according to the way of cooling methods,nomothermia group ( NT),peritoneal cooling group (PC),surface cooling group (SC) and local cooling group (LC).The changes of tympanic membrane temperature were recorded in each animal and blood plasma concentrations of electrolyte were tested in each group at different time points after restore of spontaneous circulation (ROSC).Brain tissue were removed,the numbers of vigorous and apoptotic neurons in the hippocampus CA1 area were counted after ROSC at 72h.One-way ANOVA or Mann-Whitney rank was used to determine the statistical significance between two groups.LSD-t test for multiple comparisons,R × C test for ROSC comparisons,a two-tailed value of P ＜0.05 was considered statistically significant. Results Hypothermia was rapidly induced in PC after ROSC,and the time of arriving at target temperature was (26 ±7) min in PC,(60 ±9) min in SC,(69 ± 12) min in LC respectively; in the maintain hypothermia period,the tympanic membrane temperature was maintained at 33～ 35 ℃ in each group exception nomothermia group (NT).There were no differences with main electrolyte,acid-abase liquid balance and renal function between each group at each time point after ROSC.The numbers of vigorous neurons in hippocampus CA1 area were ( 37.07 ± 6.43 ) /40 × in NT group,(35.13 ± 6.97) /40 × in LC group,(55.76 ± 10.13 ) /40 × in PC group,and (50.70 ± 7.38 ) /40 × in SC group (PC:NT,P＜0.01,SC:NT,P＜0.01,PC:SC,P=0.043,PC:LC,P＜0.01,LC:NT,P=0.52).The numbers of apoptotic neurons were (44.07 ±6.09) /40 × in NT group,(29.88 ±4.81 ) /40× in PC group,( 33.55 ± 5.67 ) /40 × in SC group and ( 42.27 ± 5.20 ) /40 × in LC group respectively (PC:NT,P ＜0.01,SC:NT,P ＜0.01,PC:LC,P ＜0.01,SC:LC,P ＜0.01,PC:SC,P=0.026,LC:NT,P =0.364 ).Conclusions The new peritoneal cooling method could rapidly induce and maintain hypothermia,and it had better protections on neurons in hippocampus CA1 than surface cooling and local cooling method after ROSC in New Zealand rabbits.

For medical student, diagnostic practice is the first step of clinical study. To penetrate the humanities education in diagnostic teaching,the combination with practice from the following steps as physical examination, laboratory examination and interrogation, would cultivate medical students' humane quality imperceptibly and play an important role in creating noble medical ethics of them.

AIM: To analyse quantitatively the interactions among ethanol, chloral hydrate and naloxone with isobologram, Q-test and multiple logistic regression methods. METHODS: The hypnotic effects of the three drugs on Kunming mice were observed. In two drugs interaction study, chloral hydrate and ethanol were given at different ratios (25∶75, 50∶50, 78∶22 and 80∶20). In three drugs interactions study, 15 min after treatment of naloxone at fixed dose (0.5 mg*kg-1 and 0.2 mg*kg-1) the mixture of chloral hydrate and ethanol (at 1∶1 and 1∶3 ratio) was given to induce sleep. The ED50 for hypnotic action (righting reflex loss) of chloral hydrate, ethanol, naloxone and their mixtures were calculated by use of isobologram, interaction Q-index test and multivariate logistic regression analysis. RESULTS: The mixtures of ethanol and chloral hydrate in all ratios revealed partial but significant synergism. But in addition with naloxone the three agents showed different natures of interactions according to different naloxone levels. CONCLUSION: There are synergistic interactions in hypnotic ED50s between ethanol and chloral hydrate at different ratios and antagonistic interaction in adding a fixed dose of naloxone. The results coincide with the pharmacologistic mechanism discussed in this paper.

Objective To investigate the therapeutic effects of enhanced external counterpulsation (EECP) on cerebral edema and cerebral blood flow perfusion with MRI following cardiac arrest (CA) and on successful return of spontaneous circulation (ROSC) by cardiopulmonary resuscitation (CPR) in dogs.Methods Sixteen beagle dogs were induced CA with alternating current on epicardium,then were randomly (random number) divided into the EECP and control group after successful ROSC.MR scanning brain of all animals was carried out by diffusion-weighted imaging (DWI) and perfusion weighted imaging (PWI) before CA and on the first,second and third days after ROSC.Blood pressure,right common carotid artery flow,and intracranial microcirculation perfusion were measured.Results There were no significant differences in mean artery pressure at all intervals between two groups (P ＞ 0.05).There was significant increase in right common carotid artery blood flow and intracranial microcirculation of dogs in EECP group compared with the control group (P ＜ 0.05).Apparent diffusion coefficients (ADC) of water molecule on the first and third days after ROSC were significantly higher in the EECP group than those in the control group (P ＜ 0.05).Ratios of post-ROSC relative cerebral blood flow (RCBF) /original cerebral blood flow were higher in the EECP group than those in the control group on the first,second and third days after ROSC (P ＜ 0.05).Conclusions EECP treatment could improve cerebral blood flow perfusion and relieve ischemic cerebral edema,alleviating brain injury in dogs following CA and successful ROSC.

Objective Using twins methods to explore the influence of genetic and environmental factor on Intelligence develop-ment of children and adolescent twins .Methods It was 190 pair of twins aged 6 to 18 who lived in Chongqing were recruited ,DNA were extracted from buccal mucosa and venous blood samples to identify zygosity .The intelligence was investigated by using the Wechsler Intelligence Scale for Children(C-WISC) ,the intrapair correlation coefficients of twins were compared and calculate the genetic degrees .Results The total IQ of children aged 6 to 18 heritability were 0 .63 ,Verbal IQ were 0 .44 ,Performance IQ were 0 .57 .The total IQ heritability of children aged 10 to 14 and 15 to 18 years(0 .78 ,0 .79) were higher than that of those aged from 6 to 9 years(0 .018) .Conclusion This study suggested the intelligence of children aged 6 to 18 affected by genetic and environment , and the older ,the more influence of genetic on intelligence development .