Anticoagulation is one of the important approaches in the prophylaxis and treatment of iSCheroic stroke.However.it may increase the risk of bleeding events in reducing the risk of recurrent stroke at the same time.This article reviews the status of anticoagulants in the prophylaxis and treatment of ischemic stroke by retrospecting their application in the prevention and treatment of ischemic stroke and the study of new anticoagulants.

Objective To investigate the clinical pathological factors related to recurrence and metastasis of colorectal cancer patients treated with resection ,expect to improve the treatment effects .Methods The clinicopathologic and follow-up data of 212 patients with stage Ⅰ - Ⅲ colorectal cancer patients treated with resection from January 2009 to December 2013 were retrospec-tively analyzed by univariate and multivariate Logistic regression methods .Results Univariate analysis showed that T staging sys-tems ,gross type ,intestinal obstruction or perforation ,lymphatic and vascular invasion were correlated to recurrence of colorectal cancer after operation(P< 0 .05) ;age ,tumor size ,lymph node involvement ,T staging systems ,histological differentiation ,intestinal obstruction or perforation ,lymphatic and vascular invasion were correlated to metastasis of colorectal cancer after operation(P <0 .05) .Multivariate Logistic regression analysis showed that age ,tumor size and histological differentiation were independent factors for metastasis rate of colorectal cancer after operation(P< 0 .05) .There were no significant differences in Logistic regression analy-sis for recurrence(P> 0 .05) .Conclusion Age ,tumor size and histological differentiation are independent factors for metastasis rate of colorectal cancer after operation .

Objective To investigate the effect of the application of tranexamic acid in unilateral total knee arthroplasty (TKA)with different methods .Methods Totally 120 cases of primary unilateral TKA patients admitted from June 2013 to May 2012 were studied ,including 33 males and 97 females ,with the average age of (65 ± 9) years (31 to 81 years) .Patients were divided into intravenous tranexamic acid group (group V ) ,topical tranexamic acid group (group T ) and irrigation using tranexamic acid group (group I) ,and control group (group C) .There were 30 cases in each group .Four groups of patients had no differences in age ,gender ,body mass index and disease diagnosis ,operative time ,preoperative hemoglobin ,preoperative hematocrit differences sta‐tistically(P>0 .05) .Postoperative blood loss and blood transfusion were observed .Groups were compared using one‐way ANOVA analysis .Results The total blood loss of group V was (368 ± 95)mL ,total blood loss of group T was (407 ± 118)mL ,both were less than the control group (509 ± 96)mL ,the difference was statistically significant (P<0 .05) .The differences between the blood loss of group I (491 ± 122) mL and the control group was not statistically significant (P=0 .924) .Group V showed the least a‐mount of hidden blood loss .Group T showed the least amount of visible blood loss .There were not deep vein thrombosis ,infections and other complications in any groups .Conclusion Intravenous and topical application of tranexamic acid can significantly reduce postoperative blood loss in TKA .Irrigation with tranexamic acid can not reduce the blood loss effectively .

Objective To evaluate the safety and effectiveness of Stoppa approach combined with iliac incision in periacetabular osteotomy for treatment of hip dysplasia.Methods From September 2011 to July 2012,18 patients (20 hips) with hip dysplasia were performed periacetabular osteotomy through Stoppa approach combined with iliac incision.There were 15 female patients with 17 hips and 3 male patients with 3 hips.The average age was 29 years old (range 19 to 35).The surgical incision included two parts with the abdominal transverse incision (Stoppa approach) and the iliac incision (the lateral window of ilioinguinal approach).The duration of surgery,length of incision,intraoperative blood loss,and amount of allogeneic blood transfusion were measured.The clinical function,radiographic parameters,and operative complications were analyzed at 12 months follow-up.Results The mean operation time was 145 min (range,125-180 min).The mean incision length of Stoppa approach was 7 cm (range,5-10 erm) for the abdominal part and 6 cm (range,4-8 cm) for the iliac part,and the average of total incision length was 13 cm (range,12-16 cm).The mean blood loss during operation was 800ml (range,500-1 600 ml).The mean amount of allogeneic blood transfusion was 1 161 ml (range,400-2 400 ml).The mean duration of follow-up was 19.6 months (range,14-22 months).Compared to the preoperative data,both postoperative Harris hip score and center-edge angle improved significantly,with a mean increase of 13.2±6.0 and 22.5°±4.5° respectively.The mean Harris hip score improved form 80.3±8.5 preoperatively to 93.5±5.2 postoperatively at the time of 12 months follow-up.The average center-edge angle improved from 7.5°±5.4° preoperatively to 30.0°±4.6° postoperatively.All of the osteotomies except two pubic osteotomies healed at the time of three months follow-up.The two pubic osteotomies were treated with protected weight bearing and had a delayed union until the six months follow-up.The mean time of osteotomies union was 3.3 months.Complications included three transient]ateral femoral cutaneous nerve palsies which completely resolved within three months after oral medicine therapy.There were no major neurovascular complications,no infection,no incision hernia or any other surgical complications.Conclusion Stoppa approach combined with iliac incision is a safe and effective approach for periacetabular osteotomy.It is an alternative to conventional ilioinguinal approach for treatment of mild hip dysplasia.

Objective To conduct the comparative comprehensive evaluation on the actual healthy effects and safety of two kinds of healthy foods capsule A and B made of Chinese medicinal herbs on sale through the low-nutritional sub-health mice model com-bined with the benefit-damage index-general score(BDI-GS) approach ,and to perform the discussion on the relevant problems a-round healthy foods .Methods The experimental healthy ICR male mice during growth period were fed with maize low-nutritional feed and the mixed feed with 3 doses of 0 .25% ,0 .5% ,0 .75% healthy foods for 12 d and the mice body masses were recorded .Af-ter dissection ,9 items of the organ index and their BDI ,GS and serum biochemical indicators were performed the statistics .Results In the capsule A ,the medium and high dose groups manifested certain health-promoting effect ,while the slight negative effect exis-ted in the low dose group ,which was expressed in the GS values ;but in the capsule B ,3 doses all caused the damage to main internal organs in different degrees ,which was expressed in BDI<1 .0 and GS<9 .0 .Conclusion At present ,despite of possessing similar ingredients ,Chinese medicinal healthy foods in market are of greater differences in intrinsic qualities ,and even partial products have some adverse effect ,the healthy functions and safety are not enough to be fully ensured .Through the systematic evaluation of the BDI-GS system ,the criteria of marketing threshold for healthy foods will be increased so as to enhance their effects and safety level .

Objective To study the maintenance of BJ-6B accelerator. Methods Analyzed retrospectively the maintenance record of BJ-6B accelerator, including phenomena, causes and handle from 2002 to 2009. Results In 231 records, there were motion-controlling 64, hand-controlling-pendant 20.modulator 41, anti-peak overload 36, charging overload 5. Flatness 7, mechanical 21, digital-display 20,others lie in magnetron power, water-cooling system, light-indicator system, dose-monitor system and wedge system. Motion-controlling system is the highest among those, followed by high-voltage modulator and mechanical system. Conclusions The down time for BJ-6B accelerator is low because of its perfect technology. To keep its stability in clinic, the hospital authorities should emphasize training of engineer for improving their maintenance ability. The engineer must be familiar with the circuit diagram, check the electric wire and machine unit on time and prepare unit for maintenance. The temperature and humidity in machine house must be controlled on demand. The engineer must pay attention to machine parameters when beam is on for avoiding the spark's damage to magnetron and accelerating-tube

Exosomes are produced by multivesicular bodies,they are extracellular lipid nano-vesicles carrying a variety off bioactive substances,containing lipids,RNA,DNA and proteins.Exosomes produced by tumor cells carry important information about tumor cells.Exosomes produced by hepatocellular carcinoma can participate in the formation of a microenvironment suitable for the proliferation,growth,invasion,metastasis and drug resistance of tumor cells.Meanwhile,circulating exosomes can be used as non-invasive biomarkers for early diagnosis of tumors and as drug delivery vectors for treatment.This review summarizes the characteristics of exosomes in the growth,invasion and metastasis,immune escape,and drug resistance biology of hepatocellular carcinoma,as well as the potential clinical application of early detection and treatment.

The effects of fish oil rich in eicosapentaenoic acid (C20:5?-3; EPA) and docosahexaenoic acid (C22:6?-3; DHA) on serum total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) levels were investigated in experimental hypercholesterolemic rats. The fish oil contained about 15% EPA and 43% DHA. Each animal was given 1ml fish oil/day by intragastric feeding for 30 days. The results in twice experiments showed that TC concentration in the serum of rats fed fish oil was markedly decreased as compared to rats fed olive oil, but serum HDL-C elevated. Furthermore, the ratio of HDL-C to TC in the serum was also significantly elevated in rats fed fish oil.

Objective To investigate the expression and genetic alterations of KLF6 in hepatocellular carcinoma (HCC) and explore their functional mechanisms in the oncogenesis and development of HCC. Methods Real-time quantitative-PCR, direct sequencing and LOH approaches were used to detect KLF6 genetic abnormalities in HCC. The experiment had 2 groups, an experimental group and a control group. In the experimental group, the transfected plasmid pcDNA3.0 was recombined with KLF6 and tranfected into HCC HepG2 cells. MTT, flow cytometry and Western blotting were used to observe the effect of anti-oncogene wild type KLF6 on HepG2 cells by transgenic method for 48 h.Results Expression levels of KLF6 were significantly downregulated in HCCs(P＜0. 01), as detected by qRT-PCR. LOH occurred in 11 (52%) of the 21 tumors, and all the samples with LOH showed KLF6 down-regulation. The mutational frequency was 29%, and sequence changes located in activation domain of KLF6. Meanwhile, MTT assay showed a significant antiproliferative effect of the transfected wtKLF6 on HepG2 cells(42.7%, P＜0.05). Fluorescence-activated cell sorting analysis revealed that KLF6 induced apoptosis. Conclusion The deregulation of KLF6 together with genetic abnormalities of allelic imbalance and mutations may play an important role in HCC pathogenesis.

Objective To investigate the clinical features,treatment and the causes of death in severe infectious disease complicated with capillary leak syndrome(CLS)in neonates.Methods The clinical data,laboratory finding,treatmand clinical outcome of 11 neonates who had severe infectious disease complicated with CLS in our NICU from Jan 2009 to Jul 2010 were collected and analysed retrospectively.Results Among the 11neonates,five had pneumonia and the other six had sepsis.All the 11 cases appeared progressive edema on skin and mucosa,dyspnoea,infective shock,oliguria and hypoalbuminemia(10～20 g/L).We treated the 11cases with hydroxyethyl starch(10～15 ml/kg,every 8 to 12 h)at early stage on the basis of infection control,anti-shock treatment,mechanical ventilation,symptomatic treatment and a stable internal environment.At last,6 cases were rescued,in whom 4 cases were well-developed,had normal intelligence and athletic ability,the other two cases had hydrocephalus or muscle tone high of both lower extremities.Five cases died.Conelusion CLS is a severe complication of neonatal severe infection,and had high mortality.Treating with hydroxvethvl starch at an early stage can increase the survival rate.