A large number of studies have confirmed that antiplatelet agents reduce the relative risk of stroke,myocardial infarction,or death by an average of 22％.However,many patients still have thrombotic events during the period of taking anti-platelet agents,and this is called anti-platelet agent resistance.Its incidences reported are very different.The incidence of aspirin is 3％ to 85％,and that of clopidogrel is 28％ to 44％.The exact cause of antiplatelet agent resistance remains unclear.It may be associated with several factors,including decreased drug bioavailability,genetic polymorphisms,activation of other platelet activation pathways,and increased circulating platelets.Currently,a variety of laboratory methods have been used to detect antiplatelet agent resistance,its criteria are different.In addition,the response measures of antiplatelet agent resistance also have no conclusion,and this has brought greater difficulties for the prevention and treatment of stroke.

Functional near-infrared spectroscopy is a non-invasive optical brain function detection technology,which can do multi-point measurement of changes on cerebral cortical area corresponding to the oxygenation of the blood hemoglobin and deoxygenated hemoglobin concentration,and then reflect the state of brain cortex function.Its greatest advantage is to allow the subjects head moving in a certain range,especially suitable for children.At present this technology could be applied to clinical pediatric,such as epilepsy,autism,attention deficit/hyperactivity disorder,neonatal disease,neurosurgery and cardiovascular surgery,etc.Functional near-infrared spectroscopy technology will have more applications in the field of research on brain function.

Background phacoemulsification combined with limbal relaxing incision (LRI) is reported to be effective for the management of coexisting cataract astigmatism,but the influence of after phacoemulsification with LRI on corneal high-order aberration is still rarely reported.Objective This study was to evaluate the effect of cataract surgery with LRI for preoperative astigmatism or on corneal high-order aberration.Methods A selfcontrolled serial cases observational study was designed.A total of 35 cataractous eyes of 35 patients with astigmatism ≥ 1.0 D before cataract surgery were enrolled in Tianjin Medical University Eye Hospital from August 2014 to April 2015 under the informed consent of patients.LRIs were performed on the eyes during the phacoemulsification and IOL implantation.The uncorrected visual acuity (UCVA),BCVA and optometry were recorded before operation and 1 day,1 week,1 month,3 months after operation.Pentacam was employed to measure the maximal and minimal diopters,astigmatism and high-order aberrations within 3 mm of the anterior corneal surface at above-mentioned time points.All the results were compared among different time points.The optometry outcomes and the anterior corneal surface astigmatism change were analyzed using vector analysis method.Results The UCVA was 0.34 ±0.22,0.38 ± 0.25,0.43±0.27,0.42±0.28 in 1 day,1 week,1 month and 3 months after operation,which was significantly higher than 0.08 ±0.09 before operation;and the BCVA was 0.54 ± 0.27,0.64 ± 0.29,0.67 ± 0.29,0.71 ± 0.32 in 1 day,1 week,1 month and 3 months after operation,showing a significant increase in comparison with 0.22±0.51 before operation(F=54.457,P=0.000;F =62.653,P =0.000).The refractive cylindrical error and corneal astigmatism were significantly decreased after operation in comparison with before operation (F =31.061,P =0.000;F =113.043,P=0.000).High order aberrations (HOA) at postoperative 1 day,1 week,1 month,3 months were all higher than those in preoperation (F =11.189,P =0.000) under the 4 mm pupil diameter.Compared with preoperation,the vertical coma,secondary vertical coma and three leaf clover were significantly increased(all at P＜0.05),but the horizontal coma and primary spherical aberration were not significantly changed (all at P＞0.05) under the 6 mm pupil diameter.Conclusions Phacoemulsification combined with LRI can reduce the corneal astigmatism effectively and steadily,and the increase of corneal aberrations does not affect visual acuity.

BACKGROUND:Breviscapine treatment of cerebral infarction has curative effects, few side effects, stable long-term efficacy and few side effects, which can improve the micro-environment of damaged central nervous system after cerebral infarction.
OBJECTIVE:To investigate the effects of breviscapine injection combined with bone marrow mesenchymal stem cel transplantation on neurological recovery and growth-associated protein 43 expression in rats after cerebral infarction.
METHODS:Sixty Sprague-Dawley rats undergoing middle cerebral artery occlusion were randomized into cerebral infarction group, cel transplantation group and combined group. At 6 hours after modeling, 1 mL PBS, 1 mL bone marrow mesenchymal stem cel suspension (2.5×106), and 1 mL bone marrow mesenchymal stem cel suspension (2.5×106)+75 mg/kg breviscapine injection were respectively injected via the tail vein in the three groups, once a day, continuously for 5 days.
RESULTS AND CONCLUSION:At 2 weeks after transplantation, BrdU-positive bone marrow mesenchymal stem cels were mainly gathered in the peri-infarction region, and the number of positive cels was higher in the combined group than the other two groups (P < 0.01). At 1, 2, 3 weeks after transplantation, the neurological deficit scores were significantly lower in the combined group than the other two groups (P < 0.05). At 2 weeks after transplantation, the combined group had smaler infarct size, milder edema, and higher expression of growth-associated protein 43 as compared with the other two groups (P < 0.05). Under light microscope, glial cels proliferated dramaticaly and brain edema significantly reduced in the combined group. These findings indicate that breviscapine injection combined with bone marrow mesenchymal stem cel transplantation can significantly reduce infarct size and brain edema, promote neurological recovery and increase the expression of growth-associated protein 43 in rats with cerebral infarction.

Objective To evaluate the diagnosis and efficiency of nasal endoscopic surgery treatment for rhinogenous optic function damage (ROFD).Methods The clinical data of 36 patients (36eyes) with ROFD were retrospectively reviewed.All patients were operated on nasal sinus probing and open sinus surgery through transnasal endoscopic approach,and 10 patients underwent endoscopic optic nerve decompression.Results Seven patients had bilateral pansinusitis,9 patients had unilateral posterior ethmoidal sinusitis and sphenoiditis,8 patients had isolated sphenoiditis,8 patients had fungal sinusitis occured in the sphenoid sinus and unilateral posterior ethmoid sinus,3 patients had unilateral pyocyst and cyst of the sphenoid and ethmoid sinus,1 patient had frontal and ethmoidal sinusitis.All patients were confiemed by pathology after surgery.The visual acuity preoperative were as follows:3 eyes no light perception,10 eyes hand movement,11 eyes fingers counting less than 20 cm and 12 eyes were vision impaired in different degree.The visual acuity postoperative were as follows:3 eyes failed,13 eyes cured,20eyes improved from hand movement or fingers counting to fingers counting (30-60 cm).The efficiency rate was 91.7％(33/36).The other eye symptom was disappeared.Sinus epithelization was happened after surgery in all patients.Conclusions If the medicine expectant treatment is invalid,nasal sinus probing and open sinus surgery through transnasal endoscopic approach should be performed early in treatment of ROFD.Patients who suffered frnm severe visual damage and either unresponsive or intolerant to medical treatment should be administrated endoscopic sinus surgery including endoscopic optic nerve decompression.

Objective To investigate the effect of sodium demethylcantharidate injection on adherence,invasion and metastasis and to investigate the related mechanism in human hepatocarcinoma cell line HepG2.Methods Adherence ability,migration and invasion of HepG2 cells inhibited by sodium demethylcantharidate injection were assessed by MTT and Transwell techniques.Expression levels of MMP-9 protein in HepG2 cells were determined by immunohistochemistry.Results The number of adhesion,migration and invasion of HepG2 cells were significantly lower in sodium demethylcantharidate injection group than those in the control group (P ＜ 0.05).HepG2 cells co-incubated with sodium demethylcantharidate injection in the concentration of 0.25 μg/ml for 30,60,90 and 120 min showed higher cell adhesion than the control group.The adhesion inhibition ratios were 48.11％,33.81％,28.97 ％ and 16.83 ％,respectively.The migration and invasion inhibition rates were 64.19 ％ and 58.19 ％.With concentration of sodium demethylcantharidate injection to increasing,expression levels of MMP-9 protein in HepG2 cells more and more lower than control group.Conclusion The adherence,migration and invasion abilities of HepG2 cells are markedly inhibited by sodium demethylcantharidate injection,the mechanisms is possible related to the expression levels of MMP-9 protein.

OBJECTIVE:To provide reference for the development of clinical pharmacists’career and the establishment of le-gal system in China. METHODS:The background,progress and situation of applying for“pharmacists’health care provider sta-tus”in the United States were introduced. The reasons for achieving provider status in California,Washington,and Oregon were summed up in aspects of politics,economics and education. The chance and challenge for achieving provider status at federal level were also discussed. Based on the development of clinical pharmacists in China,the suggestions were put forward for the improve-ment of legal system of clinical pharmacists in China. RESULTS & CONCLUSIONS:“Health care provider status”in the United Stated were recognised by 3 states with local developed economics,high-level education,and collective efforts of pharmacy organi-zations. Multiple national pharmacy organizations as American Pharmacists Association,American Society of Health-System Phar-macists and American Pharmacy College Society are working together toward provider status at the federal level. Our country should pay attention to related legal system construction,establish perfect and definite clinical pharmacists legal system as soon as possible to provide legal guarantee for career development of clinical pharmacists in China.

Objective To study the influences of dichloromethane extraction from crude and processed Cornus Officinalis on bone marrow cells of aging mice induced by D-galactose. Methods DNA damage of bone marrow cells of aging mice induced by D-galactose was detected by the comet assay, the expression of p53 mRNA was detected by RT-PCR. Results The tail formation rate of model group was significantly higher than the rate of control group (P

Objective To build high availability cluster using VMware to improve availability of hospital information system.Methods Virtual machines were installed in VMware server to act as backup servers.High availability software continuously detected status of physical servers using heartbeat signals.Results When physical servers failed,high availability cluster switched services automatically.The business switched to virtual machine quickly and smoothly.Conclusion High availability cluster based on VMware can improve HIS availability and lower implementation costs effectively.

Objective To investigate the causes of high rate of false positives in the detection of syphilis in elderly patients.Methods We used RPR,TP -ELISA and TPPA to detect the antibody of syphilis in 1 200 patients, and the samples were divided into the elderly group (60 or higher)and the control group (<60 years old),confirmed by TPPA,then counted the positive rate and false positive rate,and the results were analyzed.Results The positive rate (8.00%)and false positive rate (4.50%)of the elderly group were significantly higher than the control group (3.83%,1.87%,χ2 =9.36,9.47,all P <0.05).The false positive rate significantly rised with the increase of age of the elderly group.Conclusion The reason of false positive may be associated with the physical condition of the patients,and we should consider it with the clinical manifestations when diagnosed.