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.

This article reviewed the internationalization history of the Traditional Korean Medicine (TKM).It expounded the current situation of TKM's international standard application for WHO and International Standard Organization (international organization for standardization,ISO),and the competition between Traditional Chinese Medicine (TCM) and Traditional Korean Medicine.The authors presumed the essence content of TCM should be included in multiple international standards as early as possible to promote the intemationalization of TCM.

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.

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 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.

〔Abstract〕 The paper introduces the definition of mobile health care app , sorts out the research status of mobile health care App from aspects such as classification , contents and quality , supervision , standards and requirements and problems such as low quality , lack of supervision, unsafe data and indefinite definitions , and proposes suggestions from the angle of developers , users, markets, etc.

As a newly identified T helper cell subset, Th9 plays an important role in anti-tumor immunity. Th9 can be differentiated from CD4+T cells that have been induced by TGF-beta and IL-4. In addition, other CD4+T helper cell subsets can be developed to Th9 cell in particular situations, thereby showing its plasticity. Results of animal experiments have indicated that Th9 inhibits tumor growth and plays a significant role in anti-tumor immunity by secreting related cytokines such as IL-9. A few cytokines and molecules can regu-late the differentiation and development of Th9 cells in different signaling pathways. This review will focus on the production, anti-tu-mor immunity, related mechanism, and signaling pathways of Th9 cells, thereby providing a new field of vision and idea for anti-tumor therapy in the future.

Objective To investigate the expression of ACTH in normal and hyperplastic adrenal cortical tissue, and to explore the relationship between plasma ACTH concentration and expression level of ACTH in adrenal cortical tissue of patients with adrenal cortical hyperplasia. Methods The expression of ACTH in adrenal cortical tissue was examined by immunohistochemical technique, and the result was analyzed by computer-assisted image analyzing system. Besides, plasma ACTH concentration was measured by RIA. The correlation between plasma ACTH concentration and expression level of ACTH in adrenal cortical tissue of patients with adrenal cortical hyperplasia was studied. Results The expression of ACTH was significantly higher in adrenal cortical tissue of patients with ACTH-independent adrenal cortical hyperplasia than those with ACTH-dependent adrenal cortical hyperplasia and normal adrenocortical tissue (both P0.05). Conclusion ACTH expression exists in normal adrenal cortical tissue. Local ACTH overproduction appears to participate in the pathogenesis of ACTH-independent adrenal cortical hyperplasia.The raised concentration of plasma ACTH influences the expression of ACTH in cortical tissue of patients with ACTH-dependent adrenal hyperplasia.

Aim To observe the effect of DL-buthionine s ulfoximine(DL-BSO) on the radiosensitivity of rat C 6 glioma cells under the a erobic and the hypoxic condition. Methods The source of radiati on was 60Co ?-rays. The rats C 6 glioma cells were treated by radia tion alone or DL-BSO+radiation under the aerobic and the hypoxic condition. Col ony forming assay was used to measure effects of DL-BSO on the radiosensitivity . Results Radiosensitive effect of DL-BSO was time-depedent u nder the aerobic condition. After treatment with 0.1 mmol?L -1 DL-BSO fo r 2, 6, 12 hours, the radiosensitive effect was not observed, whereas an enhance ment of radiosensitivity was seen at 24 and 48 hours. An enhancement of radiosen sitivity was seen at 2～48 hours after treatment with 0.1 mmol?L -1 DL-B SO under the hypoxic condition. The radiosensitive effects related to DL-BSO co ncentration under the aerobic and the hypoxic condition. Conclusion Both under the aerobic and the hypoxic conditions DL-BSO can increase the radio sensitivity of rat C 6 glioma cells. DL-BSO increased the rat C 6 gliom a cells radiosensitivity especially under the hypoxic condition, and radiosensit ive effect of DL-BSO is time and concentration-dependent.